Test Bank for Abnormal Psychology 9th Edition Oltmanns All Chapters 1 - 18

Abnormal Psychology 9th Edition Oltmanns Test Bank Chapter 1 Examples and Definitions of Abnormal Behavior Total Assessment Guide (T.A.G.) Topic

Overview

Question Type Multiple Choice True/False

Understand the Concepts 1,2,3,4,5

Apply What You Know

Analyze It

51

Essay Recognizing the Presence of a Disorder

Defining Abnormal Behavior

Multiple Choice True/False

10,11,12

81,82 15,16,21 54,55,56,57, 58,59

Essay Who Experiences Abnormal Behavior?

The Mental Health Professions

Multiple Choice True/False

Essay Multiple Psychopathology Choice In Historical True/False Context Essay Methods for the Scientific Study

Multiple Choice True/False

14,17,18,20, 22,24 60

19,23

83,84 27,28,29,30, 32,34,35 61,62,63,64, 65,67,69

Essay Multiple Choice True/False

7

52,53

Essay Multiple Choice True/False

6,8,9,13

25,26,31

33

66,68 85,86

36,38

37,39

40

41,42,43

87 44

45

75,76

77

89,90

88

46,48,49,50

47

78,79

80

70,71,72,73, 74

Evaluate It

of Mental Disorders

Essay

91

93

92

Chapter 1: Examples and Definitions of Abnormal Behavior Multiple Choice 1.1.1. In the United States and other developed countries, mental disorders are the disease-related disability and mortality. a. b. c. d.

leading cause of

2nd 5th 10th 30th Answer: a.

Difficulty: Easy Question ID: 1.1.1 Topic: Overview Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder

1.1.2.

The symptoms and signs of mental illness are known as

a. b. c. d.

the analysis of the mind. the treatment of mental disorders. psychopathology. the ancient philosophy of the interaction of mind and body.

Answer: c.

Difficulty: Easy Question ID: 1.1.2 Topic: Overview Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder

1.1.3.

The point of view of this textbook is that

a.

very few people will ever come into contact with the problems that are associated with mental illness. isolation between people with mental illness and people without mental illness benefits both groups. it is likely that everyone will be touched by the problems associated with mental illness at some point in their life. mental illness is almost a thing of the past due to modern treatments.

b. c. d.

Answer: c.

Difficulty: Easy Question ID: 1.1.3 Topic: Overview

1.1.4.

Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder Which is the best description of abnormal psychology?

a. b. c. d.

a deviant personality trait analysis of the childhood roots of pathology study of unconscious influences on mental disorders application of psychological science to the study of mental disorders Answer: d.

Difficulty: Easy Question ID: 1.1.4 Topic: Overview Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder

1.1.5.

What is the literal meaning of the word “psychopathology”?

a. b. c. d.

demons within deviant behavior brain dysfunction pathology of the mind Answer: d.

Difficulty: Easy Question ID: 1.1.5 Topic: Overview Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder

1.1.6. The case of Kevin Warner was presented in the text as an example of the diagnosis of schizophrenia. Which of Kevin’s symptoms strongly suggested that he had lost touch with reality, which is the defining feature of schizophrenia? a. b. c. d.

social withdrawal difficulty in communicating inability to succeed at work belief that people were poisoning him Answer: d.

Difficulty: Moderate Question ID: 1.1.6 Topic: Recognizing the Presence of a Disorder Skill: Apply What You Know LO 1.1: Explain the process of identifying a mental disorder

1.1.7. Why did the staff at the psychiatric hospital give Kevin Warner injections of antipsychotic medication? a. b. c. d.

People with Kevin’s blood type do not respond to medication in pill form.

A high level of gastric juices in his digestive system destroyed the medication.

He only pretended to take the pills because he believed people were trying to poison him.

Antipsychotic drugs given by injection do not have the same serious side effects as those in pill form.

Answer: c.

Difficulty: Difficult Question ID: 1.1.7 Topic: Recognizing the Presence of a Disorder Skill: Analyze It LO 1.1: Explain the process of identifying a mental disorder

1.1.8.

Determining the presence of disorder is based on several criteria, including

a. b. c. d.

the duration of a person’s symptoms. the presence of a specific symptom in isolation. the outcome of laboratory tests. a person’s culture.

Answer: a.

Difficulty: Moderate Question ID: 1.1.8 Topic: Recognizing the Presence of a Disorder Skill: Apply What You Know LO 1.1: Explain the process of identifying a mental disorder

1.1.9. Sam displays symptoms of paranoid schizophrenia; she feels ill after eating her lunch two days in a row. One of her symptoms is a paranoid belief that her coworkers are poisoning her. This type of belief is associated with a. b. c. d.

conflicts with society. a nervous breakdown. a psychosis. adaptive behavior.

Answer: c.

Difficulty: Moderate Question ID: 1.1.9 Topic: Recognizing the Presence of a Disorder Skill: Apply What You Know LO 1.1: Explain the process of identifying a mental disorder

1.1.10. In what terms are mental disorders defined? a. b. c. d.

when a person is out of contact with reality persistent maladaptive behaviors inconsistent, socially unacceptable behaviors unrealistic beliefs Answer: b.

Difficulty: Easy Question ID: 1.1.10 Topic: Recognizing the Presence of a Disorder Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder

1.1.11. A group of symptoms that appear together and are assumed to represent a specific type of disorder is referred to as a a. b. c. d.

syndrome. sign. psychosis. disease.

Answer: a.

Difficulty: Easy Question ID: 1.1.11 Topic: Recognizing the Presence of a Disorder Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder

1.1.12. Specific laboratory tests to confirm the presence of psychopathology a. b. c. d.

do not at present exist. are used by psychologists but not by psychiatrists. are used by psychiatrists but not by psychologists. are used to test for the presence of some viral infection or brain lesion to confirm a diagnosis.

Answer: a.

Difficulty: Easy Question ID: 1.1.12 Topic: Recognizing the Presence of a Disorder Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder

1.1.13. Nate is a clinical psychologist and is trying to determine if Jennifer has schizophrenia. In what way will he make this determination? a. b. c. d.

blood tests studying the concentration of schizophrenia in Jennifer’s geographic area heredity making observations of Jennifer’s behavior and her descriptions of personal experience Answer: d.

Difficulty: Moderate Question ID: 1.1.13 Topic: Recognizing the Presence of a Disorder Skill: Apply What You Know LO 1.1: Explain the process of identifying a mental disorder

1.1.14. A problem with defining abnormal behavior in terms of deviation from statistical norms is that this definition a. b. c. d.

focuses only on very rare conditions. focuses only on conditions that are actually relatively common. does not specify how unusual the behavior must be to be considered abnormal. only considers deviations that are harmful.

Answer: c.

Difficulty: Moderate Question ID: 1.1.14 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health

1.1.15. If a person with an abnormal behavior is unable to or unwilling to appreciate the extent of their problem or the impact it had on other people, what would psychologists say that person lacked? a. b. c. d.

ignorance insight logic common sense Answer: b.

Difficulty: Easy Question ID: 1.1.15 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health

1.1.16. In the term “harmful dysfunction,” the word “dysfunction” refers to a. b. c. d.

a mental disorder. a set of distinguishing symptoms. a disruption of thought, feeling, or perception. the inability of the person to function at work or school.

Answer: c.

Difficulty: Easy Question ID: 1.1.16 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health

1.1.17. Applying the concept of harmful dysfunction to the case of Kevin Warner, we can emphasize Kevin’s failures of several mental mechanisms, including a. b. c. d.

perception. motivation. learning. feeling.

Answer: a.

Difficulty: Moderate Question ID: 1.1.17 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health

1.1.18. What dysfunctions are considered to be disorders? a. b. c. d.

those resulting in significant harm to the person those differing in any way from the ordinary function of a biological process those eliciting abnormal behavior characteristics those leading to the inability to occasionally misconstrue reality Answer: a.

Difficulty: Easy Question ID: 1.1.18 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health

1.1.19. What is one of the advantages of Jerome Wakefield’s harmful dysfunction approach to defining mental disorders? a. b. c. d.

Cultural factors do not affect the definition.

The definition is based on established humanistic criteria.

The meaning of harmful is limited to life-threatening conditions.

As much as possible objective evaluation is used to define the dysfunction.

Answer: d.

Difficulty: Difficult Question ID: 1.1.19 Topic: Defining Abnormal Behavior Skill: Analyze It LO 1.2: Analyze the evolving definitions of mental health

1.1.20. Beliefs and actions that are shared by religious, political, or sexual minority groups are not considered evidence of a mental disorder because such behaviors a. b. c. d.

are voluntary. are rare and unusual. can cause harm. deviate from society’s standards of proper behavior.

Answer: a.

Difficulty: Moderate Question ID: 1.1.20 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health

1.1.21. Which organization publishes the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)? a. b. c. d.

World Health Organization American Psychiatric Association American Psychological Association National Institute of Mental Health Answer: b.

Difficulty: Easy Question ID: 1.1.21 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health

1.1.22. What is the emphasis of the definition of abnormal behavior in the DSM-5? a. b. c. d.

statistical rarity biological etiology biological disadvantage in terms of reproduction personal distress or impairment in social functioning Answer: d.

Difficulty: Moderate Question ID: 1.1.22 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health

1.1.23. A woman who is unable to achieve orgasm and who lives in a society that discourages female sexuality would probably not be given the DSM diagnosis of female orgasmic disorder because she a. b. c. d.

probably would not experience any distress or impairment. would be distressed but not impaired. would be impaired but not distressed. would probably be both distressed and impaired.

Answer: a.

Difficulty: Difficult Question ID: 1.1.23 Topic: Defining Abnormal Behavior Skill: Analyze It LO 1.2: Analyze the evolving definitions of mental health

1.1.24. What is the history of the “diagnosis” homosexuality in the DSM? a. b. c. d.

Homosexuality was never a diagnosis in the DSM. Homosexuality was, and is, a possible diagnosis in the DSM. Homosexuality was a diagnosis in the first two editions of the DSM, taken out for the third edition, and then reintroduced in the 4th.

Homosexuality was a diagnosis in the first two editions of the DSM, taken out for the third edition, and has never been reintroduced.

Answer: d.

Difficulty: Moderate Question ID: 1.1.24 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health

1.1.25. What was one of the factors that seems to have played a role in Mary’s development of an eating disorder? (This is from one of the case studies.) a. b. c. d.

sexual abuse throughout childhood being prone to sleepwalking episodes a genetic predisposition to high levels of anxiety being determined that she would never gain as much weight as her mother had Answer: d.

Difficulty: Moderate Question ID: 1.1.25 Topic: Who Experiences Abnormal Behavior?

Skill: Apply What You Know LO 1.3: Assess the demographics of mental illness

1.1.26. Why are Mary Childress and Kevin Warner’s behaviors considered abnormal? a. b. c. d.

because they found it impossible to see reality because they were both acutely aware of their disorders because their disorders affected their physical health because both of their behaviors fits the criteria for one of the DSM-5 categories and they each suffered from a dysfunction Answer: d.

Difficulty: Moderate Question ID: 1.1.26 Topic: Who Experiences Abnormal Behavior?

Skill: Apply What You Know LO 1.3: Assess the demographics of mental illness

1.1.27. In addition to incidence, what other term is particularly important in epidemiological research? a. b. c. d.

statistical validity correlation prevalence N Answer: c.

Difficulty: Easy Question ID: 1.1.27 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness

1.1.28. Epidemiology is the scientific study of the a. b. c. d.

effects of diets. biological treatment of diseases. frequency and distribution of disorders. classification systems for mental disorders.

Answer: c.

Difficulty: Easy Question ID: 1.1.28 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness

1.1.29. Which is the most accurate statement about the lifetime prevalence rates for bipolar disorder in the United States? a. b. c. d.

More men than women will be diagnosed with bipolar disorder.

More women than men will be diagnosed with bipolar disorder.

Almost twice as many women will receive this diagnosis.

The rates for this disorder are the same for men and women.

Answer: d.

Difficulty: Easy Question ID: 1.1.29 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness

1.1.30. Which of the following disorders is more common in women than men? a. b. c. d.

schizophrenia anxiety disorders bipolar disorder alcoholism Answer: b.

Difficulty: Easy Question ID: 1.1.30 Topic: Who Experiences Abnormal Behavior?

Skill: Understanding the Concepts LO 1.3: Assess the demographics of mental illness

1.1.31. Based on the results of the National Comorbidity Survey Replication (NCS-R) Study, which disorder has the highest lifetime prevalence in the United States? a. b. c. d.

schizophrenia major depression bipolar mood disorder obsessive-compulsive disorder Answer: b.

Difficulty: Moderate Question ID: 1.1.31 Topic: Who Experiences Abnormal Behavior?

Skill: Apply What You Know LO 1.3: Assess the demographics of mental illness

1.1.32. The presence of more than one condition within the same time period is known as a. b. c. d.

twin diagnosis. double diagnosis. comorbidity. confounded morbidity.

Answer: c.

Difficulty: Easy Question ID: 1.1.32 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness

1.1.33. How has research on comorbidity changed the focus of epidemiological research? a. b. c. d.

shifted the focus from the psychotic disorders to milder disorders that affect more people higher than expected prevalence of mental retardation led to more emphasis on intellectual ability shifted the focus from counting the number of people with a disorder to measuring the functional impairment associated with the problems evidence for the biological etiology of more mental disorders has switched the focus to identifying the genes responsible for particular disorders Answer: c.

Difficulty: Difficult Question ID: 1.1.33 Topic: Who Experiences Abnormal Behavior?

Skill: Analyze It LO 1.3: Assess the demographics of mental illness

1.1.34. What two factors are combined to measure disease burden? a. b. c. d.

mortality and disability infection rates and poverty levels physician visits and pollution levels daily caloric intake and hospitalization rates Answer: a.

Difficulty: Easy Question ID: 1.1.34 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness

1.1.35. The World Health Organization estimates that all mental disorders combined account for percent of all disability worldwide. a. b. c. d.

less than 1 11 28 52 Answer: c.

Difficulty: Easy Question ID: 1.1.35 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness

1.1.36. Which of the following statements most accurately describes the specialized training needed to prepare people to provide professional assistance to those who suffer from mental disorders? a. b. c. d.

It is necessary to pursue a degree in medicine.

It is desirable to pursue a degree in medicine.

It is necessary to pursue an advanced degree in psychology.

There are many forms of appropriate specialized training available.

Answer: d.

Difficulty: Easy Question ID: 1.1.36 Topic: The Mental Health Professions Skill: Understand the Concepts LO 1.4: Describe the functions of mental health professions

1.1.37. One specific difference between psychiatrists and psychologists is that psychiatrists a. b. c. d.

are able to provide psychotherapy. can prescribe medication. use the DSM to diagnose mental disorders. have had supervised clinical experience.

Answer: b.

Difficulty: Moderate Question ID: 1.1.37 Topic: The Mental Health Professions Skill: Apply What You Know LO 1.4: Describe the functions of mental health professions

1.1.38. What is the best description of clinical psychology? a. b. c. d.

a branch of medicine concerned with the treatment of mental disorders a legal term used to identify practitioners who use various forms of psychotherapy the application of psychological science to the assessment and treatment of mental disorders a newly established branch of medicine that has connections to both psychiatry and psychology Answer: c.

Difficulty: Easy Question ID: 1.1.38 Topic: The Mental Health Professions Skill: Understand the Concepts LO 1.4: Describe the functions of mental health professions

1.1.39. George completed five years of graduate school that led to a Psy.D. degree. He is now completing a one-year internship at a mental health clinic. What type of mental health professional is George? a. b. c. d.

psychiatrist social worker medical therapist clinical psychologist Answer: d.

Difficulty: Moderate Question ID: 1.1.39 Topic: The Mental Health Professions Skill: Apply What You Know LO 1.4: Describe the functions of mental health professions

1.1.40. The textbook suggests that one likely change in the future in the mental health professions is a. b. c. d.

boundaries between professions will become less rigid. boundaries between professions will become more rigid. restricting the rights of non-psychologists to administer tests will increase. legislation restricting the use of psychological terminology to licensed personnel will be adopted.

Answer: a.

Difficulty: Moderate Question ID: 1.1.40 Topic: The Mental Health Professions Skill: Analyze It LO 1.4: Describe the functions of mental health professions

1.1.41. When we adopt an historical perspective to study how other societies have viewed the problems that we consider to be mental disorders, we find that they have a. b. c. d.

held quite different views. held very similar views. almost always emphasized natural explanations. almost always emphasized supernatural explanations.

Answer: a.

Difficulty: Easy Question ID: 1.1.41 Topic: Psychopathology in Historical Context Skill: Understand the Concepts LO 1.5: Summarize the history of mental illness treatments

1.1.42. Hippocrates is viewed as one of the first figures in history to emphasize that psychopathology can be attributed to a. b. c. d.

supernatural causes. the influence of culture. natural causes. unconscious mental processes.

Answer: c.

Difficulty: Easy Question ID: 1.1.42 Topic: Psychopathology in Historical Context Skill: Understand the Concept LO 1.5: Summarize the history of mental illness treatments

1.1.43. The improvement in conditions of mental hospitals in the 1800s was based in part on the belief that a. b. c. d.

humanistic care would help to relieve mental illness. patients, though incurable, deserved compassionate care. patients with mental disorders were not really dangerous. patients had the right to sue to gain better treatment.

Answer: a.

Difficulty: Easy Question ID: 1.1.43 Topic: Psychopathology in Historical Context Skill: Understand the Concepts LO 1.5: Summarize the history of mental illness treatments

1.1.44. The large patient populations placed in mental hospitals in the 1800s are important in the history of abnormal psychology because they a. b. c. d.

provided physicians with an opportunity to observe and treat various types of psychopathology. created growing awareness of the need for psychological rather than medical interventions. gave public officials a new way to deal with dangerous criminals. led to a steady reduction in the number of people with mental illness.

Answer: a.

Difficulty: Moderate Question ID: 1.1.44 Topic: Psychopathology in Historical Context Skill: Apply What You Know LO 1.5: Summarize the history of mental illness treatments

1.1.45. Samuel Woodward’s claim of a 90 percent success rate in treating the seriously disturbed patients at Worcester Lunatic Hospital a. b. c. d.

was backed by rigorous scientific evidence. reflects his lack of training in scientific research. was a tactic he used to increase state funding for his hospital. was based on the value of such treatments as bleeding and purging.

Answer: b.

Difficulty: Moderate Question ID: 1.1.45 Topic: Psychopathology in Historical Context Skill: Analyze It LO 1.5: Summarize the history of mental illness treatments

1.1.46. What type of hypothesis is a new prediction called? a. b. c. d.

a null hypothesis an experimental hypothesis an alternative hypothesis a scientific hypothesis Answer: b.

Difficulty: Easy Question ID: 1.1.46 Topic: Methods for the Scientific Study of Mental Disorders Skill: Understand the Concepts LO 1.6: Compare methods for studying mental disorders

1.1.47. You are a member of a research team that is about to begin research on the effectiveness of a drug called Relax on the symptoms of anxiety. One of the researchers asks you to describe the null hypothesis for this study. What will you say? a. b. c. d.

The null hypothesis states that the drug’s effect will not differ from any treatment.

The null hypothesis states that the dependent variable in this experiment must be objectively measured.

The null hypothesis means the researchers must be blind to the identity of the individuals who are receiving the drug.

The null hypothesis means there are no differences in demographic characteristics between the control and the experimental groups.

Answer: a.

Difficulty: Moderate Question ID: 1.1.47 Topic: Methods for the Scientific Study of Mental Disorders Skill: Apply What You Know LO 1.6: Compare methods for studying mental disorders

1.1.48. What is the best definition of a case study? a. b. c. d.

a detailed description of one person a psychological evaluation for legal purposes an analysis of the daydreams of college students a large-scale study of the rates of a disorder Answer: a.

Difficulty: Easy Question ID: 1.1.48 Topic: Methods for the Scientific Study of Mental Disorders Skill: Understand the Concepts LO 1.6: Compare methods for studying mental disorders

1.1.49. What is one of the major uses of case studies? a. b. c. d.

studying unusual conditions verifying the effectiveness of therapies validating correlations established in the laboratory establishing the borderline between normal and abnormal behaviors Answer: a.

Difficulty: Easy Question ID: 1.1.49 Topic: Methods for the Scientific Study of Mental Disorders Skill: Understand the Concepts LO 1.6: Compare methods for studying mental disorders

1.1.50. Abraham Lincoln suffered through periods of profound depression throughout his life. What do some historians believe his mood disorder can be traced to? a. b. c. d.

his poverty-stricken upbringing on the Western frontier his father losing his property due to faulty property titles the death of his mother when he was nine years old insomnia Answer: c.

Difficulty: Easy Question ID: 1.1.50 Topic: Methods for the Scientific Study of Mental Disorders Skill: Understanding the Concepts LO 1.6: Compare methods for studying mental disorders

True/False 1.2.51. The term “psychopathology” describes the symptoms and signs of mental disorders, including phenomena as depressed mood, panic attacks, and bizarre beliefs.

Answer: True Difficulty: Easy Question ID: 1.2.51 Topic: Overview Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder 1.2.52. A general term that refers to several types of severe mental disorders in which the person is considered to be out of contact with reality is psychosis.

Answer: True Difficulty: Easy Question ID: 1.2.52 Topic: Recognizing the Presence of a Disorder Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder

1.2.53. A group of symptoms that appear together and are assumed to represent a specific type of disorder is referred to as a constellation.

Answer: False Difficulty: Easy Question ID: 1.2.53 Topic: Recognizing the Presence of a Disorder Skill: Understand the Concepts LO 1.1: Explain the process of identifying a mental disorder 1.2.54. In the United States the definition of abnormal behavior is presented in the official Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychological Association.

Answer: False Difficulty: Easy Question ID: 1.2.54 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health 1.2.55. In the realm of psychological functioning, people who function at the highest levels can be described as successful.

Answer: False Difficulty: Easy Question ID: 1.2.55 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health 1.2.56. Culture is defined in terms of the values, beliefs, and practices that are shared by a specific community or group of people.

Answer: True Difficulty: Easy Question ID: 1.2.56 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health 1.2.57. The American Psychiatric Association launched the original version of the DSM in 1960.

Answer: False Difficulty: Easy Question ID: 1.2.57 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health

1.2.58. According to Jerome Wakefield, one essential component of the definition of a mental disorder is an individual’s subjective distress.

Answer: True Difficulty: Moderate Question ID: 1.2.58 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health 1.2.59. A guiding principle for the developers of the DSM-5 as they wrote definitions of mental disorder was that abnormal behaviors should have a biological basis to be considered mental disorders.

Answer: False Difficulty: Moderate Question ID: 1.2.59 Topic: Defining Abnormal Behavior Skill: Understand the Concepts LO 1.2: Analyze the evolving definitions of mental health 1.2.60. The DSM definition of mental disorder excludes impairment in social functioning.

Answer: False Difficulty: Moderate Question ID: 1.2.60 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health 1.2.61. Epidemiology is the scientific study of the frequency and distribution of disorders within a population.

Answer: True Difficulty: Easy Question ID: 1.2.61 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness 1.2.62. Prevalence refers to the number of new cases of a disorder that appear in the population during a specific period of time.

Answer: False Difficulty: Easy Question ID: 1.2.62 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness

1.2.63. Incidence refers to the total number of active cases, both old and new, of a disorder that are present in a population during a specific period of time.

Answer: False Difficulty: Easy Question ID: 1.2.63 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness 1.2.64. The overall incidence of a disorder is the total proportion of people in a given population who have been affected by the disorder at some point during their lives.

Answer: False Difficulty: Easy Question ID: 1.2.64 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness 1.2.65. The presence of more than one condition within the same period of time in an individual is known as comorbidity.

Answer: True Difficulty: Easy Question ID: 1.2.65 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness 1.2.66. One of the signs of the possible presence of bingeing and purging that was noticed in the case of Mary was teeth and gum problems.

Answer: True Difficulty: Easy Question ID: 1.2.66 Topic: Who Experiences Abnormal Behavior?

Skill: Apply What You Know LO 1.3: Assess the demographics of mental illness 1.2.67. Studying chromosomes to find abnormal genes associated with various diseases is something an epidemiologist might do.

Answer: False Difficulty: Moderate Question ID: 1.2.67 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness

1.2.68. If a disorder is short-term and typically has a high rate of recovery, then lifetime prevalence rates for that disorder will be much higher than one-year prevalence rates.

Answer: True Difficulty: Moderate Question ID: 1.2.68 Topic: Who Experiences Abnormal Behavior?

Skill: Apply What You Know LO 1.3: Assess the demographics of mental illness 1.2.69. Depression is about equally common in men and women in the United States.

Answer: False Difficulty: Moderate Question ID: 1.2.69 Topic: Who Experiences Abnormal Behavior?

Skill: Understand the Concepts LO 1.3: Assess the demographics of mental illness 1.2.70. Psychiatry is the branch of medicine that is concerned with the study and treatment of mental disorders.

Answer: True Difficulty: Easy Question ID: 1.2.70 Topic: The Mental Health Professions Skill: Understand the Concepts LO 1.4: Describe the functions of mental health professions 1.2.71. Clinical psychology is concerned with the application of psychological science to the assessment and treatment of mental disorders.

Answer: True Difficulty: Easy Question ID: 1.2.71 Topic: The Mental Health Professions Skill: Understand the Concepts LO 1.4: Describe the functions of mental health professions 1.2.72. People who seek help for mental health disorders are most likely to receive help from psychiatrists.

Answer: False Difficulty: Easy Question ID: 1.2.72 Topic: The Mental Health Professions Skill: Understand the Concepts LO 1.4: Describe the functions of mental health professions

1.2.73. The largest group of clinically trained professionals providing mental health services in the United States are social workers.

Answer: True Difficulty: Easy Question ID: 1.2.73 Topic: The Mental Health Professions Skill: Understand the Concepts LO 1.4: Describe the functions of mental health professions 1.2.74. Some professionals work in crisis, residential, and case management programs for people with severe forms of disorder, such as schizophrenia. They teach people practical, day-to-day skills that are necessary for living in the community. This field is known as psychosocial rehabilitation.

Answer: True Difficulty: Moderate Question ID: 1.2.74 Topic: The Mental Health Professions Skill: Understand the Concepts LO 1.4: Describe the functions of mental health professions 1.2.75. One of the bodily fluids that Hippocrates included in his explanation of abnormal behavior is plasma.

Answer: False Difficulty: Easy Question ID: 1.2.75 Topic: Psychopathology in Historical Context Skill: Understand the Concepts LO 1.5: Summarize the history of mental illness treatments 1.2.76. People trained in the Hippocratic tradition viewed disease as an invasion of the body by evil spirits.

Answer: False Difficulty: Easy Question ID: 1.2.76 Topic: Psychopathology in Historical Context Skill: Understand the Concepts LO 1.5: Summarize the history of mental illness treatments 1.2.77. The large patient populations placed in mental hospitals in the 1800s are important in the history of abnormal psychology because they provided physicians with an opportunity to observe and treat various types of psychopathology.

Answer: True Difficulty: Moderate Question ID: 1.2.77 Topic: Psychopathology in Historical Context Skill: Apply What You Know LO 1.5: Summarize the history of mental illness treatments

1.2.78. A case study is an in-depth look at the symptoms and circumstances surrounding one person’s mental disturbance.

Answer: True Difficulty: Easy Question ID: 1.2.78 Topic: Methods for the Scientific Study of Mental Disorders Skill: Understand the Concepts LO 1.6: Compare methods for studying mental disorders 1.2.79. In scientific research the alternative to the experimental hypothesis is known as the null hypothesis.

Answer: True Difficulty: Easy Question ID: 1.2.79 Topic: Methods for the Scientific Study of Mental Disorders Skill: Understand the Concepts LO 1.6: Compare methods for studying mental disorders 1.2.80. A good analogy for the null hypothesis would be the assumption of innocence in the legal system.

Answer: True Difficulty: Moderate Question ID: 1.2.80 Topic: Methods for the Scientific Study of Mental Disorders Skill: Apply What You Know LO 1.6: Compare methods for studying mental disorders

Essay 1.3.81. Describe the problems that are associated with attempts to define abnormal behavior in terms of (a) personal distress and (b) statistical rarity.

Answer: (a) The individual may not demonstrate insight into the condition, and the behaviors may bother others but not the individual. (b) The cutoff for statistical rarity might be arbitrary and would be different for different disorders. Statistical rarity doesn’t address the issue of whether the behavior is harmful or not harmful. Moreover, some mental disorders are actually quite common.

Difficulty: Moderate Question ID: 1.3.81 Topic: Recognizing the Presence of a Disorder Skill: Apply What You Know LO 1.1: Explain the process of identifying a mental disorder

1.3.82. Explain why the duration of a person’s symptoms is important.

Answer: The duration of a person’s symptoms is important because mental disorders are defined in terms of persistent maladaptive behaviors. Many unusual behaviors and inexplicable experiences are short lived; if we ignore them, they go away. Some forms of problematic behavior are not transient, and they eventually interfere with the person’s social and occupational functioning.

Difficulty: Moderate Question ID: 1.3.82 Topic: Recognizing the Presence of a Disorder Skill: Apply What You Know LO 1.1: Explain the process of identifying a mental disorder 1.3.83. Explain how abnormal behavior can be defined in terms of statistical norms.

Answer: Statistical norms define abnormal behavior in terms of how common or rare it is in the general population. By this definition, people with unusually high levels of anxiety or depression would be considered abnormal because their experience deviates from the expected norm.

Difficulty: Moderate Question ID: 1.3.83 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health 1.3.84. Describe the categories of behavior that are excluded from categorization as mental illness in the DSM-5, and give an example of each.

Answer: (1) expected or culturally sanctioned responses to a particular event (such as the death of a loved one); (2) behaviors expressing shared beliefs (such as the actions of political, religious, or sexual minorities); (3) conflicts that are between the individual and society (voluntary efforts to express individuality such as political protest or controversial art work) Difficulty: Moderate Question ID: 1.3.84 Topic: Defining Abnormal Behavior Skill: Apply What You Know LO 1.2: Analyze the evolving definitions of mental health 1.3.85. How do epidemiologists measure disease burden and what have their results revealed?

Answer: Disease burden is a combination of measures of mortality and disability. By equating certain medical diseases and injuries with specific mental disorders, epidemiologists estimate the disease burden due to various conditions. Their results indicate that the top three conditions in terms of disease burden are all cardiovascular conditions; all mental disorders, including suicide; and all malignant disease (cancer). The specific mental disorder that accounts for the greatest disease burden is unipolar major depression.

Difficulty: Moderate Question ID: 1.3.85 Topic: Who Experiences Abnormal Behavior?

Skill: Apply What You Know LO 1.3. Assess the demographics of mental illness

1.3.86. Describe the results of the Global Burden of Disease Study sponsored by the World Health Organization and predictions of mental disorders in the future.

Answer: The Global Burden of Disease Study evaluated and compared the impact of more than 100 forms of disease and injury throughout the world. The study revealed that mental disorders are responsible for only 1 percent of all deaths, and produce 47 percent of all disability in economically developed countries, such as the United States, and 28 percent of all disabilities worldwide. The combined index reveals that, as a combined category, mental disorders are the second leading source of disease burden in developed countries. Investigators in the WHO study predict that, relative to other types of health problems, the burden of mental disorders will increase dramatically in coming years. These results indicate that mental disorders are one of the world’s greatest health challenges.

Difficulty: Moderate Question ID: 1.3.86 Topic: Who Experiences Abnormal Behavior?

Skill: Apply What You Know LO 1.3: Assess the demographics of mental illness 1.3.87. Discuss the different types of specialized mental health professionals, their role in the treatment of people with mental disorders, and how people are most likely to receive mental health care.

Answer: There are three general sources of mental health care. Fewer than half of those who seek help for mental disorders receive help from specialized mental health professionals. Roughly onethird are treated by primary care physicians and roughly one-quarter receive help from social agencies and self-help groups. Among the specialized providers, there are various kinds.

Psychiatrists are specialists in medicine and can prescribe medications. Clinical psychologists typically have completed five years of graduate study to earn a Ph.D. or Psy.D., and are trained in the use of psychological assessment and in the use of psychotherapy. Social workers usually have a master’s degree in social work, which emphasizes social and cultural factors. Psychiatric social workers receive specialized training in the treatment of mental health problems. There are also other types of specialized providers, including professional counselors, marriage and family therapists, and psychosocial rehabilitation professionals, most of whom are also trained at the master’s level.

Difficulty: Moderate Question ID: 1.3.87 Topic: The Mental Health Professions Skill: Apply What You Know LO 1.4: Describe the functions of mental health professionals

1.3.88. Trace the development of the Greek tradition in medicine on the causes and treatments of mental disorders. Trace the development of asylums from the Middle Ages to the 1800s in the United States.

Answer: In contrast to earlier times, the Greek philosopher Hippocrates proposed natural explanations for mental disorders. He suggested that a balance among four humors was necessary for health. An excess or deficiency in one of the humors could result in a disorder. His attempts to uncover natural, biological explanations dominated medical thought in Western countries until the middle of the nineteenth century. During the Middle Ages, “lunatics” or “idiots” (terms used for the mentally ill and mentally retarded) aroused little interest. Their disturbed behavior was considered to be the responsibility of the family rather than the community or the state. In the 1600s and 1700s “insane asylums” were established to house the mentally disturbed. However, changes in economic, demographic, and social conditions brought a different perspective to the care of the mentally ill. For example, there was rapid population growth and the rise of large cities between 1790 and 1850 in the United States. This increased urbanization led to a shift from an agricultural to an industrial economy. Lunatic asylums were created to serve the needs of heavily populated cities and to assume responsibilities that had been performed by families.

Although the early asylums were little more than warehouses, the moral treatment movement led to improved conditions in some of these hospitals. This approach offered support, care, and some degree of freedom rather than just confinement. This treatment approach coupled with Dorothea Dix’s advocacy led to expansion of the number of mental institutions in the United States.

Difficulty: Moderate Question ID: 1.3.88 Topic: Psychopathology in Historical Context Skill: Apply What You Know LO 1.5: Summarize the history of mental illness treatments 1.3.89. Explain how the American Psychiatric Association came into being.

Answer: By the middle of the 1800s, superintendents of asylums for the insane were practically all physicians who had experience in the care of people with severe mental disorders. The Association of Medical Superintendents of American Institutions for the Insane later became the American Psychiatric Association in 1844.

Difficulty: Easy Question ID: 1.3.89 Topic: Psychopathology in Historical Context Skill: Understand the Concepts LO 1.5: Summarize the history of mental illness treatments

1.3.90. During the 1920s and 1930s several somatic treatments were widely used to treat mental disorders. Give a brief description of the procedure and the rationale for the following: fever therapy, insulin coma therapy, and lobotomy.

Answer: (1) Fever therapy involved taking blood from people with malaria and injecting it into people with psychiatric disorders so they would develop a fever. This method was used because the symptoms of some people with mental disorders had disappeared after they became ill with typhoid fever. (2) Insulin coma therapy involved injecting insulin into psychiatric patients. These injections lower the sugar content of the blood and induce a hypoglycemic state and a deep coma.

The method was used because mental changes had been noted in some diabetic drug addicts who were treated with insulin. (3) A lobotomy involves inserting a sharp knife through a hole bored in a patient’s skull. Nerve fibers between the frontal lobes and the rest of the brain were cut. This surgical procedure had led to a reduction of negative emotions in chimpanzees.

Difficulty: Easy Question ID: 1.3.90 Topic: Psychopathology in Historical Context Skill: Understand the Concepts LO 1.5: Summarize the history of mental illness treatments 1.3.91. Describe the benefits and drawbacks of the use of case studies in research on psychopathology.

Answer: (1) Benefits: rich clinical descriptions (symptoms displayed, manner in which symptoms emerged, developmental and family history, response to any treatment efforts), especially important if the disorder is rare (e.g., dissociative identity disorder and gender dysphoria); can be used to generate hypotheses; associated details can give clues about the nature of mental illness.

(2) Drawbacks: can be viewed from many different perspectives and competing explanations may be equally plausible; risky to draw general conclusions from a single case.

Difficulty: Easy Question ID: 1.3.91 Topic: Methods for the Scientific Study of Mental Disorders Skill: Understanding the Concepts LO 1.6: Compare methods for studying mental disorders

1.3.92. A pharmaceutical company has asked you to design a study to evaluate the effectiveness of a new drug for treating bulimia. They have asked you specifically to do case studies. You are writing a memo in reply to this request in which you explain what case studies can do for the project, but also what they cannot do. Include a brief description of the components you would add to the study to make it more useful in testing a theory.

Answer: (1) Case studies can suggest a research direction and give hints about theory, but they can’t actually tell much about cause and effect. A hypothesis can be derived from a case study and a few case studies can suggest that a more experimental project would be worthwhile. It would be valuable to follow several cases to see if the new drug does in fact reduce their symptoms. (2) In order to actually know something about cause and effect, however, it is necessary to conduct a controlled experiment. For this you would need a larger group of subjects, one-third of whom were given the drug, one-third of whom were given a placebo, and one-third of whom were provided with the current standard treatment. This study would have to follow the rules of science. From this study you could tell something about which condition is more effective in treating this disorder.

Difficulty: Difficult Question ID: 1.3.92 Topic: Methods for the Scientific Study of Mental Disorders Skill: Evaluate It LO 1.6: Compare methods for studying mental disorders 1.3.93. Explain the two risks associated with studying abnormal psychology.

Answer: The first risk associated with studying abnormal psychology is the medical student’s syndrome. Similar to how medical students learn about new illnesses—they often develop the symptoms of each successive disease they study—the same is true for a student of abnormal psychology. Second, if you are genuinely concerned about your own problems or those of a loved one, you likely have or will consult various self-help resources. Don’t accept uncritically the treatment programs they may suggest. You probably know that not everything you hear or read is true, and psychological advice is no exception.

Difficulty: Moderate Question ID: 1.3.93 Topic: Methods for the Scientific Study of Mental Disorders Skill: Apply What You Know LO 1.6: Compare methods for studying mental disorders

Chapter 2 Causes of Abnormal Behavior Total Assessment Guide (T.A.G.) Topic

Overview

Brief Historical Perspective Systems Theory

Question Type Multiple Choice True/False Essay Multiple Choice True/False

Understand the Concepts 1,2

Essay Multiple Choice True/False Multiple Choice True/False

Essay Multiple Psychological Choice Factors True/False

Social Factors

Analyze It

51,52 82 81 4,5,6,7,8,10,11, 9,12,13 14,15 53,54,55 17,18,19,20,21, 16 22 56,57,58,59,60 83

Essay Biological Factors

Apply What You Know 3

23,24,25,26,27, 28,29,30,34 31,32,33,35,36 61,62,63,64,65, 70 66,67,68,69,71, 72,73 87,88 86,89

84,*85

*85

37,38,40,41,43, 39,42 44,45,46 74,75,76,77,78

Essay Multiple Choice True/False

90,91 48,49

Essay

94

47,50

79,80

* This question covers two topics.

95

93

Evaluate It

Chapter 2: Causes of Abnormal Behavior Multiple Choice 2.1.1. The etiology of a problem behavior is its a. b. c. d.

cause. paradigm. treatment. classification.

Answer: a.

Difficulty: Easy Question ID: 2.1.1 Topic: Overview Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.2. Most forms of abnormal behavior are thought to be caused by a. b. c. d.

genetics. learning. a single cause. multiple factors.

Answer: d.

Difficulty: Easy Question ID: 2.1.2 Topic: Overview Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.3. A researcher described her approach to understanding mental disorders as biopsychosocial. When you ask her to explain what she means, what is she likely to say? a. b. c. d.

Biological abnormalities give rise to psychological disturbances that have social consequences.

Biological, psychological, and social factors are just as likely to be the cause of these disorders.

The integration of biological, psychological, and social factors provides the most fruitful avenue for discovering the cause of most mental disorders.

The search for etiologies is best accomplished by viewing the evidence through the lens provided by one of the major paradigms.

Answer: c.

Difficulty: Easy Question ID: 2.1.3 Topic: Overview Skill: Apply What You Know LO 2.1: Outline the historical origins of psychology paradigms

2.1.4. The search for explanations of the etiology of abnormal behavior dates to ancient times. It was not until the nineteenth and twentieth centuries that three major advances occurred: the work of Sigmund Freud, the discovery of general paresis, and the a. b. c. d.

blank slate theory. stationary universe model. development of the germ theory. development of academic psychology.

Answer: d.

Difficulty: Easy Question ID: 2.1.4 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.5. What is the assertion of the psychodynamic paradigm? a. b. c. d.

Feelings, thoughts, and behaviors are shaped by the unconscious.

Behavior is a function of environment.

Behavior is a function of biology.

Abnormal behavior is caused by unconscious mental conflicts that have roots in early childhood experience.

Answer: d.

Difficulty: Easy Question ID: 2.1.5 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.6. DSM-5 uses the descriptive approach to classify abnormal behavior because experts do not know what causes mental disorders and because it a. b. c. d.

helps diagnose the underlying cause of a mental disorder. is easier to understand. helps professionals to agree about the presence or absence of an emotional problem. categorizes behavior with a known mental disorder.

Answer: c.

Difficulty: Easy Question ID: 2.1.6 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.7. According to Sigmund Freud, what are the three parts of the mind? a. b. c. d.

id, ego, superego oral, anal, phallic reality, pleasure, spiritual conscious, preconscious, unconscious Answer: a.

Difficulty: Easy Question ID: 2.1.7 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.8. According to Freudian theory, what part of the mind is roughly equivalent to the conscience? a. b. c. d.

id ego libido superego Answer: d.

Difficulty: Easy Question ID: 2.1.8 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.9. When we are around someone we dislike intensely we often “bend over backward” to be nice to this individual. Which defense mechanism is illustrated here? a. b. c. d.

denial projection sublimation reaction formation Answer: d.

Difficulty: Moderate Question ID: 2.1.9 Topic: Brief Historical Perspective Skill: Apply What You Know LO 2.1: Outline the historical origins of psychology paradigms

2.1.10. Ivan Pavlov rang a bell every time he fed meat powder to dogs. After repeated trials, the dogs began to salivate when they heard the bell, even if there was no food in sight. According to Pavlov, the dogs’ salivation in the absence of food, following the ringing of the bell, is called the a. b. c. d.

conditioned stimulus. conditioned response. unconditioned stimulus. unconditioned response.

Answer: b.

Difficulty: Moderate Question ID: 2.1.10 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.11. What is the primary concept in operant conditioning? a. b. c. d.

a conditioned stimulus is neutral conditioned response leads to extinction behavior is determined by its consequences negative reinforcement is the same as punishment Answer: c.

Difficulty: Easy Question ID: 2.1.11 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.12. Your neighbors are playing loud music late at night and it annoys you. You ask them to turn down the music and they do. The next time they play loud music, you call them even sooner. B. F. Skinner would say this happens because a. b. c. d.

your assertiveness is like a punishment. the noise was an unconditioned stimulus. the decreased noise negatively reinforced your assertiveness. the decreased noise positively reinforced your assertiveness.

Answer: c.

Difficulty: Moderate Question ID: 2.1.12 Topic: Brief Historical Perspective Skill: Apply What You Know LO 2.1: Outline the historical origins of psychology paradigms

2.1.13. Though easily confused, negative reinforcement and punishment are quite different. With negative reinforcement, behavior when the aversive stimulus is , and with punishment, behavior when the aversive stimulus is . a. b. c. d.

increases; removed; increases; introduced increases; removed; decreases; introduced decreases; removed; increases; introduced decreases; introduced; increases; removed Answer: b.

Difficulty: Moderate Question ID: 2.1.13 Topic: Brief Historical Perspective Skill: Apply What You Know LO 2.1: Outline the historical origins of psychology paradigms

2.1.14. Watson made the very important assumption that all behavior is a. b. c. d.

under the control of free will. inborn rather than learned. the result of hidden desires and unconscious conflicts. a result of learning.

Answer: d.

Difficulty: Easy Question ID: 2.1.14 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.15. Which paradigm views human nature as basically good, attributes abnormal behavior to frustrations of society, and uses non-directive therapy to treat abnormal behavior? a. b. c. d.

biomedical humanistic psychoanalytic cognitive behavioral Answer: b.

Difficulty: Easy Question ID: 2.1.15 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms

2.1.16. A newspaper headline heralds a finding that an excess of a particular brain chemical is the cause of a certain mental disorder. The article is not convincing to you. What potential flaw do you note in the report? a. b. c. d.

The chemical change could be due to other variables.

Chemical changes cannot bring about changes in behavior.

The genetic code associated with the chemical has not been identified.

Such findings are very difficult to generalize to the entire population.

Answer: a.

Difficulty: Moderate Question ID: 2.1.16 Topic: Systems Theory Skill: Apply What You Know LO 2.2: Relate systems theory to psychopathology

2.1.17. Assume that variables X and Y are significantly correlated; the third variable problem means that a. b. c. d.

the correlation could be explained by their joint relation with some other factor. another variable must correlate with X but not Y. another variable must correlate with Y but not X. X causes Y and Y causes X. Answer: a.

Difficulty: Moderate Question ID: 2.1.17 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology

2.1.18. The principle of equifinality, or the concept of multiple pathways, means that a. b. c. d.

many risk factors might be involved in a disorder’s etiology. disorders must always be explained in terms of many different risk factors. a diathesis must always be combined with some form of stress. the same risk factors can produce many different disorders.

Answer: a.

Difficulty: Moderate Question ID: 2.1.18 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology

2.1.19. Which of the following best illustrates reciprocal causality? a. b. c. d.

Parents influence their children and are also influenced by their own parents.

Parents influence their children both through heredity and through socialization.

Parents influence their children and children influence their parents.

Children are influenced both by their parents and by their peers.

Answer: c.

Difficulty: Moderate Question ID: 2.1.19 Topic: Systems Theory Skill: Understand the Concepts LO 2.2 Relate systems theory to psychopathology

2.1.20. Some researchers view alcoholism as the result of having a genetic predisposition to alcohol addiction while also having to cope with difficult life circumstances. This type of analysis is an example of a. b. c. d.

circular thinking. biological etiology. the diathesis-stress model. the nature-nurture controversy.

Answer: c.

Difficulty: Moderate Question ID: 2.1.20 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology

2.1.21. Developmental psychopathology is a new approach to abnormal psychology that emphasizes the importance of analyzing behavior in terms of a. b. c. d.

cybernetics. early childhood trauma. learned patterns that are ingrained over time. comparisons of individual behavior to age-based norms.

Answer: d.

Difficulty: Easy Question ID: 2.1.21 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology

2.1.22. What term is used to describe the pattern of behavior that is apparent before a disorder develops? a. b. c. d.

premorbid history prognosis homeostasis developmental history Answer: a.

Difficulty: Easy Question ID: 2.1.22 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology

2.1.23. What has been suggested as a way that neurotransmitters could play a role in abnormal behavior? a. b. c. d.

an oversupply of a certain neurotransmitter an absence of neuromodulators faulty genes that misfold the proteins that make up a given neurotransmitter there is no relationship Answer: a.

Difficulty: Easy Question ID: 2.1.23 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.1.24. Which of the following neurotransmitters was first implicated in the development of schizophrenia? a. b. c. d.

GABA dopamine serotonin norepinephrine Answer: b.

Difficulty: Easy Question ID: 2.1.24 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.1.25. Evidence that effective treatments for depression inhibit the reuptake of a neurotransmitter links a depletion of that neurotransmitter to mood disorders. That neurotransmitter is a. b. c. d.

dopamine.

GABA. serotonin.

Prozac.

Answer: c.

Difficulty: Easy Question ID: 2.1.25 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.1.26. In patients with schizophrenia, what two parts of the brain are larger than normal? a. b. c. d.

Frontal lobe and parietal lobe Medulla and corpus callosum Ventricles and planum temporale Planum temporale and amygdala Answer: c.

Difficulty: Moderate Question ID: 2.1.26 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.1.27. Which region of the brain plays a key role in regulating emotion? a. b. c. d.

cerebellum limbic system corpus callosum reticular activating system Answer: b.

Difficulty: Easy Question ID: 2.1.27 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.1.28. Which of the following is most likely to be affected by a tumor on the hypothalamus? a. b. c. d.

creativity long-term memory motor coordination basic biological urges Answer: d.

Difficulty: Moderate Question ID: 2.1.28 Topic: Biological Factors Skill: Apply What You Know LO 2.3: Identify biological factors that impact mental health

2.1.29. Your patient shows signs of restlessness, agitation, and anxiety. One of the first disorders to test for would be Graves’ disease, so you order tests of a. b. c. d.

dopamine levels. blood sugar levels. thyroid function. cerebral blood flow.

Answer: c.

Difficulty: Moderate Question ID: 2.1.29 Topic: Biological Factors Skill: Apply What You Know LO 2.3: Identify biological factors that impact mental health

2.1.30. A patient has just undergone a complete examination of the brain using the most sophisticated imaging tools available. The neurosurgeon found a tumor in the frontal lobe. Which of the following is most likely to be affected by this tumor? a. b. c. d.

sleep biological urges reasoning and planning hearing and vision Answer: c.

Difficulty: Moderate Question ID: 2.1.30 Topic: Biological Factors Skill: Apply What You Know LO 2.3: Identify biological factors that impact mental health

2.1.31. Theories that attempt to link psychophysiology to the etiology of psychopathology have implicated a. b. c. d.

both overarousal and underarousal. only overarousal. both overmodulation and undermodulation. only overmodulation.

Answer: a.

Difficulty: Moderate Question ID: 2.1.31 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.1.32. What is a phenotype? a. b. c. d.

a genetic structure a set of observable traits a pattern of dominant and recessive genes a description of a chromosomal abnormality Answer: b.

Difficulty: Easy Question ID: 2.1.32 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Are Identify biological factors that impact mental health

2.1.33. Most theories developed by behavior geneticists to pin down genetic explanations for abnormal behavior assume that mental disorders are most likely a. b. c. d.

polygenic; that is, caused by a single gene. polygenic; that is, caused by multiple genes. autosomal; that is, caused by a single gene. autosomal; that is, caused by multiple genes.

Answer: b.

Difficulty: Easy Question ID: 2.1.33 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Are Identify biological factors that impact mental health

2.1.34. In a study of twins, a researcher finds that 40 percent of dizygotic (DZ) twins and 40 percent of monozygotic (MZ) twins share a trait. What is the researcher most likely to conclude about the trait? a. b. c. d.

It is 40 percent concordant.

It is 60 percent concordant.

It is genetically determined.

It is not genetically determined.

Answer: d.

Difficulty: Moderate Question ID: 2.1.34 Topic: Biological Factors Skill: Apply What You Know LO 2.3: Identify biological factors that impact mental health

2.1.35. Adoption studies are important in behavior genetics because they help to a. b. c. d.

investigate the effects of adoption. provide evidence on genetic versus environmental contributions. separate the MZ twins from the DZ twins. determine whether adoption can influence genetic makeup.

Answer: b.

Difficulty: Moderate Question ID: 2.1.35 Topic: Biological Factors Skill: Understand the Concepts LO 23: Identify biological factors that impact mental health

2.1. 36. Dr. Andrew Wakefield has speculated that the measles/mumps/rubella vaccination may be responsible for 12 cases of autism. A Danish study of half a million children found a. b. c. d.

weak evidence to support this theory. strong evidence to support this theory. no evidence to support this theory. evidence that rubella itself is part of the cause of autism.

Answer: c.

Difficulty: Easy Question ID: 2.1.36 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.1.37. In evolutionary psychology, which of the following would be a good description of natural selection? a. b. c. d.

Successful genetically determined adaptations become more common over successive generations.

Successful genetically determined adaptations become less common over successive generations.

Unsuccessful genetically determined adaptations become more common over successive generations.

Successful genetically determined adaptations become more common in many other species.

Answer: a.

Difficulty: Moderate Question ID: 2.1.37 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.38. According to attachment theorists, why do anxious attachments develop during the first year of life? a. b. c. d.

modeling low self-actualization inconsistent and unresponsive parenting temperament differences Answer: c.

Difficulty: Moderate Question ID: 2.1.38 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.39. While visiting your niece in the hospital, you see several other very young children. You observe one young child who is placid and smiles often, whereas another child seems to be very active and fussy.

Such differences in style are often described as reflections of a. b. c. d.

imprinting. motivation. affiliation. temperament.

Answer: d.

Difficulty: Moderate Question ID: 2.1. 39 Topic: Psychological Factors Skill: Apply What You Know LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.40. In addition to conscientiousness and extraversion, what is one of the “big five” dimensions of temperament? a. b. c. d.

aggressiveness mood distractability neuroticism Answer: d.

Difficulty: Moderate Question ID: 2.1.40 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.41. In addition to love, joy, surprise, anger, and fear, what other basic emotion has been identified by researchers? a. b. c. d.

hesitant melancholy sadness conscientiousness Answer: c.

Difficulty: Moderate Question ID: 2.1.41 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.42. What conclusion follows from the finding that emotions are controlled primarily by subcortical brain structures? a. b. c. d.

Emotional response may be more basic than cognition.

In terms of evolution, emotions are a rather new development.

Emotional response requires the input of the cerebral cortex.

Reduced memory capacity has led to expression of a limited number of emotions.

Answer: a.

Difficulty: Moderate Question ID: 2.1.42 Topic: Psychological Factors Skill: Apply What You Know LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.43. Erikson’s concept of continuity. a. b. c. d.

is an integrated sense of individuality, wholeness, and

ego self identity schema Answer: c.

Difficulty: Easy Question ID: 2.1.43 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.44. Socialization is a process that leads a child to develop a. b. c. d.

identity. self-schema. self-concept. self-control.

Answer: d.

Difficulty: Moderate Question ID: 2.1.44 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.45. In their stage theories, Sigmund Freud focused on on stages. a. b. c. d.

stages while Erik Erikson focused

psychological; biological unlearned; learned conscious; unconscious psychosexual; psychosocial Answer: d.

Difficulty: Moderate Question ID: 2.1.45 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.46. What is an important characteristic of Erik Erikson’s theory of psychosocial development? a. b. c. d.

There are no stages in development.

Development does not end in adolescence.

Children ages 5–12 are in a period of latency.

Developmental changes are quantitative, not qualitative.

Answer: b.

Difficulty: Moderate Question ID: 2.1.46 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.1.47. A child overhears her teacher call her a “troublemaker.” This label may play a key role in the child’s development of a. b. c. d.

ADHD. ADD. psychotic tendencies. antisocial behavior.

Answer: d.

Difficulty: Moderate Question ID: 2.1.47 Topic: Social Factors Skill: Apply What You Know LO 2.5: Analyze the relationship between society and mental health

2.1.48. What two relationship problems have researchers found that are associated with various mental disorders? a. b. c. d.

lying and cheating conflict and anger insecurity and lack of self-confidence jealousy and anger Answer: b.

Difficulty: Moderate Question ID: 2.1.48 Topic: Social Factors Skill: Understand the Concepts LO 2.5: Analyze the relationship between society and mental health

2.1.49. Research suggests that one reason why many children facing troubled family circumstances are protected against the development of psychopathology is a. b. c. d.

social support from adults outside the family. that their parents still love them. their ability to learn to repress negative feelings. their agreeable temperament.

Answer: a.

Difficulty: Easy Question ID: 2.1.49 Topic: Social Factors Skill: Understand the Concepts LO 2.5: Analyze the relationship between society and mental health

2.1.50. Which of the following is an example of how gender roles may influence psychopathology? a. b. c. d.

Mike cannot remember any of the details of an accident that killed two of his friends.

Alice has developed a form of schizophrenia involving delusions related to television shows.

Carol has been dependent on others for most of her life and has recently developed depression.

Andy fears water as an adult after falling into a pool at the age of 4.

Answer: c.

Difficulty: Moderate Question ID: 2.1.50 Topic: Social Factors Skill: Apply What You Know LO 2.5: Analyze the relationship between society and mental health

True/False 2.2.51. A paradigm is a set of shared assumptions that includes both the substance of a theory and beliefs about how scientists should collect data and test hypotheses.

Answer: True Difficulty: Moderate Question ID: 2.2.51 Topic: Overview Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms 2.2.52. Many contemporary psychological scientists are guided by the sociocultural model, an effort to integrate research on various contributions to the causes of mental disorders.

Answer: False Difficulty: Moderate Question ID: 2.2.52 Topic: Overview Skill: Understand the Concepts

LO 2.1: Outline the historical origins of psychology paradigms 2.2.53. According to Freud the ego protects itself from anxiety by utilizing various defense mechanisms that he saw as unconscious self-deceptions.

Answer: True Difficulty: Easy Question ID: 2.2.53 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms 2.2.54. In Freudian theory the part of the psyche that is present at birth and houses biological drives, such as hunger, as well as two key psychological drives, sex and aggression, is known as the ego.

Answer: False Difficulty: Easy Question ID: 2.2.54 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms 2.2.55. Negative reinforcement is when the cessation of a stimulus increases the frequency of a behavior.

Answer: True Difficulty: Moderate Question ID: 2.2.55 Topic: Brief Historical Perspective Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms 2.1.56. Reductionism attempts to understand problems by focusing on smaller and smaller units, suggesting the smallest account is the true case.

Answer: True Difficulty: Moderate Question ID: 2.2.56 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology 2.2.57. Equifinality has a mirror concept, the principle of multifinality, which says that the same event can lead to different outcomes.

Answer: True Difficulty: Moderate Question ID: 2.2.57 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology

2.2.58. A risk factor is a predisposition toward developing a disorder, for example, an inherited tendency toward alcoholism.

Answer: False Difficulty: Moderate Question ID: 2.2.58 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology 2.2.59. The diathesis-stress model suggests that mental disorders develop only when a stress is added on top of a predisposition.

Answer: True Difficulty: Easy Question ID: 2.2.59 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology 2.2.60. Multiple stressors or risk factors may contribute to mental disorders.

Answer: True Difficulty: Easy Question ID: 2.2.60 Topic: Systems Theory Skill: Understand the Concepts LO 2.2: Relate systems theory to psychopathology 2.2.61. The basic building blocks of the brain, the cells that are most active, are known as neurons.

Answer: True Difficulty: Easy Question ID: 2.2.61 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.2.62. Neurotransmitters are released into the synaptic gap and eventually come into contact with sites called axon terminals at the surface of the receiving neuron.

Answer: False Difficulty: Easy Question ID: 2.2.62 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.2.63. The pituitary gland controls basic biological urges, such as eating, drinking, and sexual activity.

Answer: False Difficulty: Moderate Question ID: 2.2.63 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.2.64. The brain is said to be dualistic, since often one hemisphere of the brain serves a specialized role as the site of specific cognitive and emotional activities.

Answer: False Difficulty: Moderate Question ID: 2.2.64 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.2.65. Endocrine glands produce psychophysiological responses by releasing hormones into the bloodstream.

Answer: True Difficulty: Moderate Question ID: 2.2.65 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.2.66. An individual’s actual genetic makeup is known as her/his phenotype.

Answer: False Difficulty: Moderate Question ID: 2.2.66 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.2.67. Chromosomes have alternative forms known as alleles.

Answer: False Difficulty: Moderate Question ID: 2.2.67 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.2.68. If a mental disorder has a genetic component at its root, a single gene is rarely the cause. Instead, the disorder is said to be multigenetic.

Answer: False Difficulty: Moderate Question ID: 2.2.68 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.2.69. Genes are located on chainlike structures known as chromosomes, which are found in the nucleus of cells.

Answer: True Difficulty: Easy Question ID: 2.2.69 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.2.70. Family incidence studies ask whether diseases “run in families.” Investigators identify normal and ill probands, and tabulate the frequency with which other members of their families suffer from the same disorder.

Answer: True Difficulty: Moderate Question ID: 2.2.70 Topic: Biological Factors Skill: Apply What You Know LO 2.3: Identify biological factors that impact mental health 2.2.71. Dizygotic twins start when one sperm fertilizes one egg. They start off being genetically identical, having identical genotypes.

Answer: False Difficulty: Easy Question ID: 2.2.71 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.2.72. Genetic influences on abnormal behavior are predispositions (i.e., increased risks), not predestinations or inevitabilities.

Answer: True Difficulty: Easy Question ID: 2.2.72 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.2.73. The widely accepted idea that a combination of a genetic risk and an environmental stress causes emotional disorders is known as gene-environment interaction.

Answer: True Difficulty: Moderate Question ID: 2.2.73 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.2.74. Attachment theory is known mainly through the writing of John Bowlby.

Answer: True Difficulty: Easy Question ID: 2.2.74 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health 2.2.75. From the perspective of evolutionary psychology, sexual selection improves inclusive fitness through increased access to mates and mating.

Answer: True Difficulty: Moderate Question ID: 2.2.75 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health 2.2.76. John Bowlby based his approach known as attachment theory on anthropology, the study of animals in their natural habitat.

Answer: False Difficulty: Moderate Question ID: 2.2.76 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.2.77. One of the most important areas of study of individual differences is categorizing personality traits or characteristic styles of relating to the world.

Answer: False Difficulty: Moderate Question ID: 2.2.77 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health 2.2.78. Having internal rules for guiding appropriate behavior is an important concept in research on abnormal behavior and is known as self-control.

Answer: True Difficulty: Moderate Question ID: 2.2.78 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.2.79. Social support is the emotional and practical assistance received from others.

Answer: True Difficulty: Easy Question ID: 2.2.79 Topic: Social Factors Skill: Understand the Concepts LO 2.5: Analyze the relationship between society and mental health 2.2.80. Poverty affects a disproportionate number of people of all minority races.

Answer: False Difficulty: Moderate Question ID: 2.2.80 Topic: Psychological Factors Skill: Understand the Concepts LO 2.5: Analyze the relationship between society and mental health

Essay 2.3.81. Describe how a paradigm can both direct and misdirect scientists.

Answer: A paradigm can suggest ways to look for answers to questions and the methodology to test ideas. On the other hand, a paradigm works under assumptions that may be appropriate for one theory, but may hinder the discovery of solutions to other problems because of a limiting mindset.

Difficulty: Moderate Question ID: 2.3.81 Topic: Overview Skill: Apply What You Know

LO 2.1: Outline the historical origins of psychology paradigms 2.3.82. Explain how scientists suspect abnormal behavior is caused by a combination of biological, psychological, and social factors.

Answer: Biological contributions range from brain chemistry to genetic predispositions.

Psychological contributions range from troubled emotions to distorted thinking. Social and cultural contributions range from conflict in family relationships to sexual and racial bias.

Difficulty: Moderate Question ID: 2.3.82 Topic: Overview Skill: Understand the Concepts LO 2.1: Outline the historical origins of psychology paradigms 2.3.83. Define systems theory and explain how it has influenced many sciences.

Answer: Systems theory is an integrative approach to science, one that embraces not only the importance of multiple contributions to causality but also their interdependence. Systems theory has influenced many sciences; for example, it is basic to ecology, the study of the interdependence of living organisms in the natural world.

Difficulty: Moderate Question ID: 2.3.83 Topic: Systems Theory Skill: Apply What You Know LO 2.2: Relate systems theory to psychopathology 2.3.84. Define reductionism. Discuss the limitations of the reductionistic idea that if a depletion of certain chemicals in the brain accompanies depression, then the depletion must be the cause of the depression.

Answer: Reductionism is the belief that ultimate causes rest in the smallest unit of analysis.

However, in the case of depression, just because chemicals are a small unit of analysis does not mean that they are a more likely causal element. Broader elements such as behavior, relationships, and negative cognitions associated with depression could also cause chemical changes in the brain.

Difficulty: Moderate Question ID: 2.3.84 Topic: Systems Theory Skill: Analyze It LO 2.2: Relate systems theory to psychopathology

2.3.85. Explain why it is not possible to assume that a correlation must indicate causation. Relate this to the correlation of depression with the depletion of neurotransmitters.

Answer: In interpreting any correlation, there are always two alternative explanations. Reverse causality means that if X and Y are correlated, X could cause Y but Y might also cause X. The third variable problem means that the correlation between X and Y could be explained by their joint relation with some unmeasured factor. Thus, even if there is a correlation between depression and the depletion of neurotransmitters, it is possible that the depletion causes the depression, but it is also possible that the depression causes the depletion. Moreover, both the depression and the depletion could come about as the result of stress.

Difficulty: Moderate Question ID: 2.3.85 Topic: Systems Theory & Biological Factors Skill: Apply What You Know LO 2.3: Identify biological factors that impact mental health 2.3.86. Discuss the implications of the idea that most forms of psychopathology are polygenic.

Answer: Phenotypes produced by a single gene produce characteristics that are categorically different. Polygenic traits (caused by more than one gene) are continuously distributed, and thus polygenic abnormal traits are on a continuum with normal traits. This point may make it difficult to determine the threshold of abnormality, which may be a question of degree rather than qualitative differences. What’s more, when behavior geneticists find that a given mental disorder is “genetic,” our interpretation must be cautious. This finding does not mean the disorder is caused by the presence or absence of one or two genes, nor does it confirm that the abnormal behavior is in a different category from normal behavior.

Difficulty: Moderate Question ID: 2.3.86 Topic: Biological Factors Skill: Apply What You Know LO 2.3: Identify biological factors that impact mental health 2.3.87. The assumption that the environment affects dizygotic (DZ) twins in the same way it influences monozygotic (MZ) twins has been criticized. Describe this criticism and the research methodology used to address it.

Answer: The criticism is that there may be greater concordance among MZ twins in part because they are treated more similarly than the DZ twins are treated. To address this concern, adoption studies have been conducted. If the concordance rate is higher for biological relatives than for adoptive relatives, this finding will point to genetic involvement in the trait.

Difficulty:Easy Question ID: 2.3.87 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health

2.3.88. When discussing biological functions, it is important to note the distinction between the study of biological structures and biological functions. Explain these distinctions.

Answer: The field of anatomy is concerned with the study of biological structures; the field of physiology investigates biological functions. Neuroanatomy and neurophysiology are subspecialties within these broader fields that focus on brain structure and brain functions. The study of neuroanatomy and neurophysiology is the domain of an exciting, multidisciplinary field of research called neuroscience.

Difficulty: Easy Question ID: 2.3.88 Topic: Biological Factors Skill: Understand the Concepts LO 2.3: Identify biological factors that impact mental health 2.3.89. Summarize the evidence in the matter of the hypothesis that vaccinations contribute to the cause of autism.

Answer: In 1998, Andrew Wakefield and several other authors speculated that it was likely that MMR vaccinations were responsible for 12 cases of autism. They did not however base this speculation on any empirical evidence. Since then several very large, empirical studies have looked for epidemiological evidence of a link between vaccinations and the rate of autism. For example a Danish study of 1.5 million children found no statistical difference in the rate of autism between children who had received the suspect vaccination and children who hadn’t. The same conclusion was published by studies in the United Kingdom and Japan, which also found no evidence of a link between vaccinations and autism.

Difficulty: Moderate Question ID: 2.3.89 Topic: Biological Factors Skill: Apply What You Know LO 2.3: Identify biological factors that impact mental health 2.3.90. Researchers have identified the five basic dimensions of personality (temperament). List them.

Answer: (1) extraversion (active and talkative vs. passive and reserved); (2) agreeableness (trusting and kind vs. hostile and selfish); (3) conscientiousness (organized and reliable vs. careless and negligent); (4) neuroticism (nervous and moody vs. calm and pleasant); (5) openness to experience (imaginative and curious vs. shallow and imperceptive).

Difficulty: Easy Question ID: 2.3.90 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4: Evaluate the impact of psychological factors on mental health

2.3.91. Describe emotions and list the six basic emotions researchers have isolated to reduce our lexicon of feelings.

Answer: Emotions, internal feeling states, are essential to human experience and to our understanding of mental disorders. The six basic emotions are love, joy, surprise, anger, sadness, and fear.

Difficulty: Easy Question ID: 2.3.91 Topic: Psychological Factors Skill: Understand the Concepts LO 2.4 Evaluate the impact of psychological factors on mental health

2.3.92. What are attributions? Why are psychologists interested in them? Describe, with a specific example, how attributions can be used to explain depression.

Answer: Attributions involve how people perceive causes, their beliefs about cause-effect relations. Attribution errors can play a prominent role in the development of psychopathology.

For example, a person who attributes a bad event to internal, stable, and global causes is more at risk for depression. So a student getting a bad grade who says “I'm stupid” will feel more helpless and ultimately more depressed.

Difficulty: Moderate Question ID: 2.3.92 Topic: Psychological Factors Skill: Apply What You Know LO 2.4: Evaluate the impact of psychological factors on mental health 2.3.93. What has research revealed concerning the relationship between marital status and mental health?

What particular problems of interpretation occur when trying to reach valid conclusions on this relationship?

Answer: Data from the Epidemiological Catchment Area study provided valuable data in assessing the relationship between marriage and mental health. Researchers found consistent relationships between marital status and mental health. For example, depression occurred in 1.5 percent of people still in their first marriage. The rate for those who were never married (one-year prevalence) was 2.4 percent. Among those who had been divorced, the rate was 4.1 in the past year. Finally, 5.8 percent of people who had been divorced more than once had experienced depression in the previous 12 months. Similar findings were found for alcoholism and schizophrenia as well as virtually every disorder diagnosed in the study. How do we interpret these results? The usual interpretation is that not being married causes emotional problems. The absence of a supportive mate makes one more susceptible to psychological problems. However, reverse causality needs to be considered as an alternative explanation. Specifically, emotional problems may be the cause of marital status. Psychologically disturbed people may have more trouble dating and forming permanent relationships. If they get married, their emotional struggles may make them or their spouses unhappy in their marriages and prone to divorce. What’s more, third variable interpretations could create spurious relationships, and poverty has been suggested as one possible third variable. Researches have concluded that although the relationship between marriage and mental health may be partly explained by third variables, the correlation is still found when the effects of poverty are excluded. For severe psychological disorders like schizophrenia, it seems clear that being single or getting divorced is a reaction to, not a cause of, the emotional problems.

Difficulty: Moderate Question ID: 2.3.93 Topic: Social Factors Skill: Analyze It LO 2.5: Analyze the relationship between society and mental health 2.1.94. Explain why MZ twins who divorce have more psychological problems than their married cotwins is not due to the difference in genes nor childrearing experiences that the twins share.

Answer: Identical twins have identical genes and grow up in the same families. Any difference between them is caused by the non-shared environment, or their unique experiences, one of which is divorce. Twin research suggests that divorce causes some psychological problems in both children and adults.

Difficulty: Easy Question ID: 2.3.94 Topic: Social Factors Skill: Understand the Concepts LO 2.5: Analyze the relationship between society and mental health 2.3.95. Discuss how gender roles affect the development, expression, and consequences of psychopathology.

Answer: Gender roles may cause problems (e.g., women are raised to show dependency and helplessness, which may cause depression). Gender roles may affect the expression of problems (e.g., it is socially acceptable for women to show depression, and for men to show physical illness). Gender roles can affect the consequences of problems (e.g., once a phobia develops, it is socially acceptable for women, but not men, to continue to avoid the feared object, and this avoidance may exacerbate the problem for women).

Difficulty: Moderate Question ID: 2.3.95 Topic: Social Factors Skill: Apply What You Know LO 2.5: Analyze the relationship between society and mental health

Chapter 3 Treatment of Psychological Disorders Total Assessment Guide (T.A.G.) Topic

Overview

Biological Treatments

Question Type Multiple Choice True/False

Understand the Concepts 1,2,5,6,8

Essay

81

Multiple Choice True/False

9,10,11,13,15, 16 53,54,56

12,14 55 82

17,18,19,20

21,22,23

57,58,59,61

60 83,*85

Essay CognitiveBehavior Therapy

Multiple Choice True/False Essay

Humanistic Therapies

Research on Psychotherapy

Couple, Family, And Group Therapy

Multiple Choice True/False Essay Multiple Choice True/False Essay Multiple Choice True/False Essay

* This question covers three topics.

Analyze It

51,52

Essay Multiple Psychodynamic Choice Psychotherapies True/False

Apply What You Know 3,4,7

24,25,26,29,31, 27,28,30,33 32,34,35 62,63,64,65,67 66 68,69 84

*85

36,37,38 70,71,72,73 *85 39,40,42,44,45

41,43

74,76

75 86,87,88

47,48,49

46,50

77,78,80

79 90

89

Evaluate It

Chapter 3: Treatment of Psychological Disorders Multiple Choice 3.1.1.

A clinician who uses research to select the most effective form of treatment is practicing psychotherapy.

a. b. c. d.

eclectic outcome based evidence-based epidemiological Answer: c.

Difficulty: Easy Question ID: 3.1.1 Topic: Overview Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.1.2. Which of the following best describes the evidence for how many people receive psychological help out of all those who need it? a. b. c. d.

Most people will receive help.

Only people with severe disturbances will receive help.

Most people will not receive help.

Only people with the most common disturbances will receive help.

Answer: c.

Difficulty: Easy Question ID: 3.1.2 Topic: Overview Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.1.3. Therapists representing the biological, psychodynamic, behavioral, and humanistic orientations are discussing the case of Frances from the text. What common feature will these therapists see in this case of depression? a. b. c. d.

All focus on her use of defense mechanisms.

All note her tendency to blame herself for troubles in her relationships.

All see how the basic cause of the depression can be traced to early childhood experiences.

All focus on the influence of her family as a causative agent in the development of her depression.

Answer: b.

Difficulty: Easy Question ID: 3.1.3 Topic: Overview Skill: Appy What You Know LO 3.2: Compare historical approaches to psychotherapy

3.1.4. In viewing the case of Frances presented in your text, a biologically oriented therapist would view her interpersonal problems as a. the cause of her depression. b. the result of her depression. c. irrelevant to her condition. d. a separate problem requiring another diagnosis.

Answer: b.

Difficulty: Moderate Question ID: 3.1.4 Topic: Overview Skill: Apply What You Know LO 3.1: Analyze the history of biological treatments for mental illness 3.1.5. What is the primary goal of psychodynamic therapy as presented in the case of Frances in the textbook? a. b. c. d.

gaining insight into unconscious motivations encouraging acceptance of individual responsibility changing psychological experience with the use of medication applying psychological research to foster learning of new behaviors Answer: a.

Difficulty: Easy Question ID: 3.1.5 Topic: Overview Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.1.6. What is a cognitive-behavioral therapist likely to do in treating Frances, whose battle with depression was described in the text? a. b. c. d.

be very directive in getting her to look at her distorted thinking reward her each time she gets through the day without feeling depressed teach her a relaxation technique and slow breathing to help her deal with stress use role-playing to demonstrate healthy and unhealthy interactions Answer: a.

Difficulty: Easy Question ID: 3.1.6 Topic: Overview Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.7. These are the notes of a therapist who is treating Frances, whose case of depression was described in the text: “Client assigned homework to monitor conflict with family and to try out new ways of relating to them.” The orientation of this therapist is probably a. b. c. d.

humanistic. cognitive-behavioral. biological. psychodynamic.

Answer: b.

Difficulty: Moderate Question ID: 3.1.7 Topic: Overview Skill: Apply What You Know LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.8. A straightforward example of an eclectic approach to the case Frances presented in your text would be to a. b. c. d.

combine psychotherapy with medication. conduct outcome research. conduct process research. follow one specific paradigm of treatment.

Answer: a.

Difficulty: Moderate Question ID: 3.1.8 Topic: Overview Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.1.9. medication is used to treat many psychological conditions. It is generally effective, but it is not a “cure” for any disorder. a. b. c. d.

Psychostimulant Analgesic Psychotropic Antimanic Answer: c.

Difficulty: Easy Question ID: 3.1.9 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness

3.1.10. When biological treatments are used for various mental disorders without knowing the specific cause of the problem, such treatments focus on a. b. c. d.

prevention. discovering the cause. establishing the correct diagnosis. symptom alleviation.

Answer: d.

Difficulty: Easy Question ID: 3.1.10 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness

3.1.11. Which form of treatment for certain mental disorders produces retrograde amnesia? a. b. c. d.

free association systematic desensitization electroconvulsive therapy forced cold baths Answer: c.

Difficulty: Moderate Question ID: 3.1.11 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness

3.1.12. Agnes has been recently diagnosed as suffering a particularly severe form of depression. She was admitted to the hospital and given the typical recommended electroconvulsive therapy (ECT) treatment.

What will her medical chart reveal about her treatment? a. b. c. d.

She was given one major unilateral treatment.

She was given mild shocks throughout two days of treatment.

A series of 6 to 12 ECT sessions was given over a few weeks.

A series of 15 to 25 sessions was given in a week followed by psychosurgery.

Answer: c.

Difficulty: Moderate Question ID: 3.1.12 Topic: Biological Treatments Skill: Apply What You Know LO 3.1: Analyze the history of biological treatments for mental illness

3.1.13. What was one of the severe side effects of prefrontal lobotomies? a. b. c. d.

epilepsy manic behavior increased anxiety absence of emotional responsiveness Answer: d.

Difficulty: Easy Question ID: 3.1.13 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness

3.1.14. You are reading a case study of a patient who has been prescribed the following: Haldol, Clozaril, and Thorazine. You recognize these drugs as belonging to the category called a. b. c. d.

antimanic. antianxiety. antipsychotic. antidepressant.

Answer: c.

Difficulty: Moderate Question ID: 3.1.14 Topic: Biological Treatments Skill: Apply What You Know LO 3.1: Analyze the history of biological treatments for mental illness

3.1.15. Ted wants to learn about the effects of the drug Prozac. Under what category of medications would he find the drug listed? a. b. c. d.

antimanic antianxiety antipsychotic antidepressant Answer: d.

Difficulty: Easy Question ID: 3.1.15 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness

3.1.16. Current evidence on the effects of psychotropic medications indicate that they a. b. c. d.

are effective cures for many disorders. are effective cures only for mild disorders. offer symptom relief but not a cure. are not very effective and usually cause serious side effects.

Answer: c.

Difficulty: Easy Question ID: 3.1.16 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness

3.1.17. Joseph Breuer’s method of catharsis provided relief for psychological symptoms by helping patients to a. b. c. d.

release previously unexpressed feelings. overcome their anxiety through using systematic desensitization. open up under the influence of “truth serum.” assess the irrational basis of their beliefs.

Answer: a.

Difficulty: Easy Question ID: 3.1.17 Topic: Psychodynamic Psychotherapies Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.1.18. What did Sigmund Freud believe was the “true benefit” of free association? a. b. c. d.

induces hypnosis increases drive levels reveals aspects of the unconscious mind encourages conversations concerning taboo topics Answer: c.

Difficulty: Moderate Question ID: 3.1.18 Topic: Psychodynamic Psychotherapies Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.1.19. What is the meaning of the term “interpretation” from psychoanalysis? a. b. c. d.

a method used to induce catharsis in difficult cases a general guideline for the therapist that is not shared with the patient material the therapist shares with patients to help them understand their own behavior statements the patient shares with the therapist that explain the troubling behavior Answer: c.

Difficulty: Moderate Question ID: 3.1.19 Topic: Psychodynamic Psychotherapies Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.1.20. Therapeutic neutrality is viewed as a key component of a. b. c. d.

psychoanalysis. client-centered therapy. in vivo desensitization. rational-emotive therapy.

Answer: a.

Difficulty: Easy Question ID: 3.1.20 Topic: Psychodynamic Psychotherapies Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.1.21. In psychoanalytic therapy, what is supposed to happen to a patient’s defenses? a. b. c. d.

They should be eliminated.

They should be left alone.

The healthier ones should be strengthened.

They should be replaced with resistance.

Answer: c.

Difficulty: Moderate Question ID: 3.1.21 Topic: Psychodynamic Psychotherapies Skill: Apply What You Know LO 3.2: Compare historical approaches to psychotherapy

3.1.22. For an assignment you are asked to create a poster that shows the similarities and differences between psychoanalysis and psychodynamic therapy. When you are finished, your poster shows that psychodynamic therapy is a. b. c. d.

more directive. more focused on the id. likely to take longer to complete treatment. likely to focus on original Freudian theory.

Answer: a.

Difficulty: Moderate Question ID: 3.1.22 Topic: Psychodynamic Psychotherapies Skill: Apply What You Know LO 3.2: Compare historical approaches to psychotherapy

3.1.23. If Harry Stack Sullivan could comment on the case of Frances presented in your text, he would probably focus on a. b. c. d.

both her relationship with her mother and her feelings about her mother. her relationship with her mother, but not her feelings about her mother. her feelings about her mother, but not her relationship with her mother. her sexual feelings for her father.

Answer: a.

Difficulty: Moderate Question ID: 3.1.23 Topic: Psychodynamic Psychotherapies Skill: Apply What You Know LO 3.2: Compare historical approaches to psychotherapy

3.1.24. John B. Watson’s behaviorism can be seen as the forerunner of modern a. b. c. d.

classical conditioning therapy. cognitive-behavioral therapy. new psycodynamic therapy. attachment therapy.

Answer: b.

Difficulty: Easy Question ID: 3.1.24 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.25. What is a major difference between a psychoanalytic approach and a cognitive-behavioral approach to therapy? a. b. c. d.

Psychoanalytic approaches have been better researched.

Psychoanalytic therapy focuses on direct education of the patient.

Cognitive-behavioral therapy focuses on change without offering a theory of human personality.

The course of cognitive-behavioral therapy depends on theoretical assumptions about the nature of the pathology.

Answer: c.

Difficulty: Moderate Question ID: 3.1.25 Page Reference: 61 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.26. Which therapy emphasizes empirical evaluation and the application of psychological science to treating clinical problems? a. b. c. d.

ego analysis cognitive-behavioral therapy humanistic therapy psychoanalytic therapy Answer: b.

Difficulty: Easy Question ID: 3.1.26 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.27. In an experiment, a researcher gives some patients psychotherapy, gives others medication, and puts others on a waiting list. The researcher then measures how depressed the patients are feeling after six months. What is the independent variable in this experiment? a. b. c. d.

number of patients time span of six months improvement in depression kind of treatment received Answer: d.

Difficulty: Moderate Question ID: 3.1.27 Topic: Cognitive-Behavioral Therapy Skill: Apply What You Know LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.28. Under which of the following circumstances would a study of the effectiveness of different forms of psychotherapy have high internal validity? a. b. c. d.

The results are statistically significant.

The independent variable is confounded with other factors.

The findings can be generalized to other types of patients.

Patient improvement can be attributed to the psychotherapy and not to other factors.

Answer: d.

Difficulty: Difficult Question ID: 3.1.28 Topic: Cognitive-Behavioral Therapy Skill: Apply What You Know LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.29. Which of the following is one of the three key elements of systematic desensitization? a. b. c. d.

progressive muscle relaxation constructing a hierarchy of needs operant conditioning in the presence of the object of fear learning to relax while forgetting about the feared stimulus Answer: a.

Difficulty: Easy Question ID: 3.1.29 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.30. Sid wants to end his habit of smoking three packs of cigarettes a day; Ted wants to stop his serious drinking problem. Which treatment might be used for both individuals? a. b. c. d.

aversion therapy flooding in vivo desensitization systematic desensitization Answer: a.

Difficulty: Moderate Question ID: 3.1.30 Topic: Cognitive-Behavioral Therapy Skill: Apply What You Know LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.31. Contingency management involves changing the relationship between a. b. c. d.

one behavior and another. a behavior and the stimulus that triggers it. a behavior and its consequences. what one thinks and how one acts.

Answer: c.

Difficulty: Easy Question ID: 3.1.31 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.32. Assertiveness training and social problem solving are examples of a. b. c. d.

teaching clients new ways of behaving that are likely to be rewarded. teaching clients new ways of thinking that are likely to be more rational. short-term psychodynamic psychotherapy. in vivo desensitization.

Answer: a.

Difficulty: Moderate Question ID: 3.1.32 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.33. If a cognitive therapist trained by Beck were treating Frances, whose depression was presented in your text, the therapist would probably a. b. c. d.

use role playing to help her acquire some new behaviors. challenge her tendency to blame herself. teach her deep breathing and how to relax. try to uncover her hidden motivations.

Answer: b.

Difficulty: Moderate Question ID: 3.1.33 Topic: Cognitive-Behavioral Therapy Skill: Apply What You Know LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.34. You are asked to compare Ellis’s rational-emotive therapy (RET) and Aaron Beck’s cognitive therapy. After comparing the two you note that one difference is that the therapist in RET is likely to a. b. c. d.

use operant conditioning techniques. require the client to keep a dream log. directly challenge the rationality of the client’s beliefs. accept the client’s irrationality.

Answer: c.

Difficulty: Easy Question ID: 3.1.34 Topic: Cognitive-Behavioral Therapy Skill: Apply What You Know LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy?

3.1.35. Which is a treatment for borderline personality disorder that includes an emphasis on “mindfulness,” an increased awareness of your feelings, thoughts, and motivations? a. b. c. d.

dialectical behavior therapy cognitive-behavioral therapy neo-psychodynamic therapy focused humanistic therapy Answer: a.

Difficulty: Easy Question ID: 3.1.35 Page Referen35ce: 64 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.1.36. Rogers viewed three qualities as essential in a therapist. Which of the following is one of those qualities? a. b. c. d.

knowledge about different therapies empathy intelligence sympathy Answer: b.

Difficulty: Easy Question ID: 3.1.36 Topic: Humanistic Therapies Skill: Understand the Concepts LO 3.4: Characterize humanistic therapies

3.1.37. A unique technique that Carl Rogers suggested for humanistic psychotherapists was a. b. c. d.

therapist self-disclosure. client self-disclosure. the use of positive reinforcement. the use of thought analysis.

Answer: a.

Difficulty: Moderate Question ID: 3.1.37 Topic: Humanistic Therapies Skill: Understand the Concepts LO 3.4: Characterize humanistic therapies

3.1.38. In client-centered therapy the bond between therapist and client that is seen as central to the process of therapy is known as the a. b. c. d.

therapy relationship. transference relationship. therapeutic bond. therapeutic alliance.

Answer: d.

Difficulty: Moderate Question ID: 3.1.38 Topic: Humanistic Therapies Skill: Understand the Concepts LO 3.4: Characterize humanistic therapies

3.1.39. Which of the following most accurately summarizes the results of outcome research on different forms of psychotherapy? a. b. c. d.

Despite decades of research there is little evidence that psychotherapy is effective.

Psychotherapy is effective, and many types of psychotherapy share key “active ingredients.”

Psychoanalytic treatment tends to be superior to other treatments because it is the only one that seeks to uncover underlying causes of disorders.

Various forms of psychotherapy are so radically different that it is not possible to offer definitive conclusions concerning their effectiveness.

Answer: b.

Difficulty: Moderate Question ID: 3.1.39 Topic: Research on Psychotherapy Skill: Understand the Concepts LO 3.5: Evaluate the impact of psychotherapy treatments

3.1.40. Spontaneous remission refers to a patient getting a. b. c. d.

worse with therapy. better with therapy. worse without therapy. better without therapy.

Answer: d.

Difficulty: Easy Question ID: 3.1.40 Topic: Research on Psychotherapy Skill: Understand the Concepts LO 3.5: Evaluate the impact of psychotherapy treatments

3.1. 41. Therapy outcome studies typically have a no-treatment control group, but results from such studies can be difficult to interpret because a. b. c. d.

people waiting for therapy often seek counseling and advice from others. it is not possible to randomly assign people to that group. the control group patients usually improve more than the treated patients. nobody wants to wait for therapy.

Answer: a.

Difficulty: Moderate Question ID: 3.1.41 Topic: Research on Psychotherapy Skill: Apply What You Know LO 3.5: Evaluate the impact of psychotherapy treatments

3.1.42. Which best summarizes the views of the authors of the text about the placebo effect? a. b. c. d.

The placebo effect is itself a treatment—one that heals psychologically.

Using the placebo effect in psychotherapy would be considered unethical.

The placebo effect is benign, but never effective.

The placebo effect is a dangerous interference with the process of psychotherapy.

Answer: a.

Difficulty: Easy Question ID: 3.1.42 Topic: Research on Psychotherapy Skill: Understand the Conceptsl LO 3.5: Evaluate the impact of psychotherapy treatments

3.1.43. Which of the following describes allegiance effects in psychotherapy? a. b. c. d.

Psychotherapists tend to use the form of therapy they encountered first in training.

Psychotherapists tend to use the form of therapy for which they are reimbursed by insurance companies.

Patients tend to seek out those therapists who will give them “a break” when they bill for their time.

Psychotherapy researchers tend to find evidence that their preferred form of therapy is more effective than other forms.

Answer: d.

Difficulty: Easy Question ID: 3.1.43 Topic: Research on Psychotherapy Skill: Understand the Concepts LO 3.5: Evaluate the impact of psychotherapy treatments

3.1.44. What were the findings of the Consumers Reports survey of psychotherapy effectiveness concerning medications in treatment? a. b. c. d.

Medication adds little to psychotherapy.

Medication was superior to psychotherapy in treating clients.

Medication added significantly to the effectiveness of psychotherapy.

The use of medication detracted from the overall effectiveness of the psychotherapy.

Answer: a Difficulty: Moderate Question ID: 3.1.44 Topic: Research on Psychotherapy Skill: Applied LO 3.5: Evaluate the impact of psychotherapy treatments

3.1.45. Research comparing behavioral and psychoanalytic therapies has found that a. b. c. d.

behavior therapists offer fewer interpretations. therapists’ empathy only matters in psychoanalytic therapy. psychodynamic therapy is more effective with severe cases. clients see the therapist-client relationship as most important to outcome in both types of therapy.

Answer: d.

Difficulty: Moderate Question ID: 3.1.45 Topic: Research on Psychotherapy Skill: Understand the Concepts LO 3.5: Evaluate the impact of psychotherapy treatments

3.1.46. The fact that researchers have found that clients tend to adopt beliefs similar to those of their therapists is evidence that psychotherapy is a form of a. b. c. d.

social influence. brain-washing. faith healing. collaborative enterprise.

Answer: a.

Difficulty: Easy Question ID: 3.1.46 Topic: Research on Psychotherapy Skill: Understand the Concepts LO 3.5: Evaluate the impact of psychotherapy treatments

3.1.47. During a couple’s therapy session with Frances and her husband, the therapist suggests that she has been using “mind reading” again and that it is not helping her in improving communication. Which of the following is an example of what the therapist thinks needs work? a. b. c. d.

She has a tendency to put words in the mouths of others.

She fails to tell her husband of her wants in the hope that he will just know.

She uses too many non-verbal gestures when she speaks, which is distracting to listeners.

She often offers interpretations of her own behavior before the therapist has a chance to speak.

Answer: b.

Difficulty: Moderate Question ID: 3.1.47 Topic: Couple, Family, and Group Therapy Skill: Apply What You Know LO 3.6: Describe psychotherapy in group settings

3.1.48. Parent management training is designed to a. b. c. d.

provide support for teen mothers. provide child care for mentally ill parents. teach parents new skills for rearing troubled children. educate professionals about the demands of parenting.

Answer: c.

Difficulty: Easy Question ID: 3.1. 48 Topic: Couple, Family, and Group Therapy Skill: Understand the Concepts LO 3.6: Describe psychotherapy in group settings

3.1.49. What is a common goal in systems approaches to family therapy? a. b. c. d.

to train parents in behavior management to strengthen the alliance between parents to encourage family members to express emotion to point out how family behavior can cause psychopathology Answer: b.

Difficulty: Easy Question ID: 3.1.49 Topic: Couple, Family, and Group Therapy Skill: Understand the Concepts LO 3.6: Describe psychotherapy in group settings

3.1.50. Which term describes efforts to improve the environment in order to prevent new cases of mental illness from developing? a. b. c. d.

social ecology primary prevention tertiary prevention secondary prevention Answer: b.

Difficulty: Easy Question ID: 3.1.50 Topic: Couple, Family, and Group Therapy Skill: Understand the Concepts LO 3.6: Describe psychotherapy in group settings

3.1.51. As a community psychologist you have been hired to design a violence prevention program for a local school district. Your target population includes teenagers who have been convicted of violent crimes. Therefore your program will, by necessity, involve a. b. c. d.

primary prevention. secondary prevention. tertiary prevention. forensic prevention.

Answer: c.

Difficulty: Moderate Question ID: 3.1.51 Topic: Couple, Family, and Group Therapy Skill: Apply What You Know LO 3.6: Describe psychotherapy in group settings

True/False 3.2.52. Most mental health professionals today identify themselves as eclectic, meaning they use different treatments for different disorders.

Answer: True Difficulty: Easy Question ID: 3.2.52 Topic: Overview Skill: Understand the Concepts LO 3.5: Evaluate the impact of psychotherapy treatments 3.2.53. Humanistic therapy aims to gain insight into defenses and unconscious motivations and relies on the interpretation of defenses.

Answer: False Difficulty: Easy Question ID: 3.2.53 Topic: Overview Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy 3.2.54. The erroneous assumption that epileptic seizures prevented schizophrenia led to the development of electroconvulsive therapy (ECT).

Answer: True Difficulty: Moderate Question ID: 3.2.54 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness 3.2.55. The most promising form of biological treatment in use today is psychopharmacology, the use of medications to treat mental disorders.

Answer: True Difficulty: Moderate Question ID: 3.2.55 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness

3.2.56. While reading a medical article, you come across the category of minor tranquilizers. The writer then gives the term “benzodiazepine” as an example of the chemical group of drugs. This category of medication would commonly be used to alleviate symptoms of depression.

Answer: False Difficulty: Moderate Question ID: 3.2.56 Topic: Biological Treatments Skill: Apply What You Know LO 3.1: Analyze the history of biological treatments for mental illness 3.2.57. For an assignment you are asked to look up a group of drugs known as major tranquilizers.

You consult a drug handbook and find that another term for these drugs is antipsychotic.

Answer: True Difficulty: Easy Question ID: 3.2.57 Topic: Biological Treatments Skill: Understand the Concepts LO 3.1: Analyze the history of biological treatments for mental illness 3.2.58. The form of psychotherapy used by Sigmund Freud himself was called psychoanalysis.

Answer: True Difficulty: Easy Question ID: 3.2.58 Topic: Psychodynamic Psychotherapies Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy 3.2.59. Free association refers to a defense mechanism seen in personality disorders.

Answer: False Difficulty: Easy Question ID: 3.2.59 Topic: Psychodynamic Psychotherapies Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy 3.2.60. According to Freudian psychoanalysis it is sufficient to cure mental illness if the therapist were to break down a person’s defenses.

Answer: False Difficulty: Moderate Question ID: 3.2.60 Topic: Psychodynamic Psychotherapies Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy

3.2.61. A psychoanalyst might suggest that Frances, whose case was presented in the text, is demonstrating transference if she begins to treat the analyst in ways that suggest she feels about him the way she felt about her father.

Answer: True Difficulty: Moderate Question ID: 3.2.61 Topic: Psychodynamic Psychotherapies Skill: Apply What You Know LO 3.2: Compare historical approaches to psychotherapy 3.2.62. The innovation in Freudian theory that emphasizes the person’s way of dealing with reality is known as ego analysis.

Answer: True Difficulty: Easy Question ID: 3.2.62 Topic: Psychodynamic Psychotherapies Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy 3.2.63. The experimenter’s prediction about the outcome of a given experiment is known as the thesis.

Answer: False Difficulty: Easy Question ID: 3.2.63 Topic: Cognitive Behavior Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy 3.2.64. In an experiment to compare the effects of a treatment to no treatment, the group receiving the treatment is known as the experimental group.

Answer: True Difficulty: Easy Question ID: 3.2.64 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

3.2.65. In most psychology experiments a research finding is considered to be statistically significant if the result would occur no more than 10 percent of the time by chance.

Answer: False Difficulty: Easy Question ID: 3.2.65 Topic: Cognitive-Behavioral Therapy: Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

79 Copyright © 2019, 2015, 2012 Pearson Education, Inc. All rights reserved.

3.2.66. Joseph Wolpe developed an effective form of treatment for phobias designed to break the link between the object of fear and the experience of fear. His therapy is known as systematic desensitization.

Answer:True Difficulty: Easy Question ID: 3.2.66 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy 3.2.67. Rewarding a patient when he/she performs desired behaviors and withholding rewards when he/she performs undesired behaviors in a psychiatric hospital is an example of contingency management.

Answer: True Difficulty: Easy Question ID: 3.2.67 Topic: Cognitive-Behavioral Therapy: Skill: Apply What You Know LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy 3.2.68. The main goal of behavioral management training is to teach clients new ways of behaving that are both desirable and likely to be rewarded in everyday life.

Answer: False Difficulty: Moderate Question ID: 3.2.68 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy 3.2. 69. According to Albert Ellis emotional disorders are caused by erratic beliefs.

Answer: False Difficulty: Easy Question ID: 3.2.69 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy 3.2.70. According to the text recent years have witnessed the development of a third wave of CBT based on broad principles such as acceptance and mindfulness.

Answer: True Difficulty: Easy Question ID: 3.2.70 Topic: Cognitive-Behavioral Therapy Skill: Understand the Concepts LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy

80 Copyright © 2019, 2015, 2012 Pearson Education, Inc. All rights reserved.

3.2.71. Humanistic psychotherapy was conceived of as a third force to counteract flaws in psychodynamic and cognitive-behavioral therapies.

Answer: True Difficulty: Easy Question ID: 3.2.71 Topic: Humanistic Therapies Skill: Understand the Concepts LO 3.4: Characterize humanistic therapies 3.2.72. An argument that humanists have against psychodynamic, cognitive-behavioral, and biological therapists is that these other therapists place too much emphasis on free will.

Answer: False Difficulty: Moderate Question ID: 3.2.72 Topic: Humanistic Therapies Skill: Understand the Concepts LO 3.4: Characterize humanistic therapies

3.2.73. Carl Rogers suggested that three qualities made for a good therapist: warmth, genuineness, and particularly willingness to be directive in their approach.

Answer: .False Difficulty: Easy Question ID: 3.2.73 Topic: Humanistic Therapies Skill: Understand the Concepts LO 3.4: Characterize humanistic therapies 3.2.74. Client-centered therapists demonstrate unconditional positive regard, valuing their clients for who they are and not judging them.

Answer: True Difficulty: Easy Question ID: 3.2.74 Topic: Humanistic Therapies Skill: Understand the Concepts LO 3.4: Characterize humanistic therapies 3.2.75. A statistical procedure that allows researchers to combine the results from several studies on a similar topic in a standardized way is known as meta-analysis.

Answer: True Difficulty: Easy Question ID: 3.2.75 Topic: Research on Psychotherapy Skill: Understand the Concepts LO 3.5: Evaluate the impact of psychotherapy treatments

3.2.76. In a double-blind study of medication, the patient does not know if he/she is taking a placebo, but the doctor does.

Answer: False Difficulty: Easy Question ID: 3.2.76 Topic: Research on Psychotherapy Skill: Apply What You Know LO 3.5: Evaluate the impact of psychotherapy treatments 3.2.77. From analyzing the tapes of therapy sessions conducted by Carl Rogers, it was found that his advocacy of a directive therapeutic approach was subtly evident in the way he emphasized some client statements but not others.

Answer: False Difficulty: Moderate Question ID: 3.2.77 Topic: Research on Psychotherapy Skill: Understand the Concepts LO 3.5: Evaluate the impact of psychotherapy treatments 3.2.78. Prevention efforts that aim to improve the overall environment in order to reduce the incidence of new cases of mental disorders in called primary prevention?

Answer: True Difficulty: Easy Question ID: 3.2.78 Topic: Couple, Family, and Group Therapy Skill: Understand the Concepts LO 3.6: Describe psychotherapy in group settings 3.2.79. A widely held view among current therapists is that family therapy should not be used in conjunction with individual therapy.

Answer: False Difficulty: Moderate Question ID: 3.2.79 Topic: Couple, Family, and Group Therapy Skill: Understand the Concepts LO 3.6: Describe psychotherapy in group settings 3.2.80. Jason is attending a group in which he is learning specific information and skills that are designed to improve his psychological well-being. Jason is probably attending a(n) encounter group.

Answer: False Difficulty: Moderate Question ID: 3.2.80 Topic: Couple, Family, and Group Therapy Skill: Apply What You Know LO 3.6: Describe psychotherapy in group settings

3.2.81. Programs designed to focus on the early detection of emotional problems in order to keep them from becoming more serious are forms of secondary prevention.

Answer: True Difficulty: Moderate Question ID: 3.2.81 Topic: Couple, Family, and Group Therapy Skill: Understand the Concepts LO 3.6: Describe psychotherapy in group settings

Essay 3.3.82. What is the DSM-5 and why is it important?

Answer: The DSM-5 is the Diagnostic and Statistical Manual, 5th edition. It is the official list of mental disorders and provides the criteria for the assessment and diagnosis of these disorders. This establishes a standardized system of diagnosing utilized by all mental health professionals regardless of their role or therapeutic orientation.

Difficulty: Moderate Question ID: 3.3.82 Topic: Overview Skill: Understand the Concepts LO 3.2: Compare historical approaches to psychotherapy 3.3.83. Discuss some of the major issues in the use of psychotropic drugs to treat mental disorders.

Answer: (1) There is considerable evidence that indicates that various drugs are safe and effective treatments for particular mental disorders. (2) These drugs offer symptom relief, but they do not offer a cure for the underlying pathology. (3) All drugs have side effects, which is one of the major reasons that many patients do not take their medications. (4) Many drugs must be taken for long periods of time. It may be necessary to take the drugs for months, years, or sometimes for a lifetime.

Difficulty: Moderate Question ID: 3.3.83 Topic: Biological Treatments Skill: Apply What You Know LO 3.1: Analyze the history of biological treatments for mental illness

3.3.84. Describe some of the key elements of psychodynamic therapy. In what ways is it similar to psychoanalysis and in what ways is it different?

Answer: Psychodynamic therapy emphasizes the importance of the patient developing insight and seeks to help the patient uncover hidden motivations for their behavior. Similar to psychoanalysis, it examines the influence of the patient’s past experiences on their current functioning. Therapists maintain neutrality, pay attention to transference, and utilize interpretation of the patient’s defenses. In contrast to psychoanalysis, therapists are more active, “human,” and more directive. Therapy may be relatively short-term compared to psychoanalysis, which is typically very long-term with multiple sessions per week.

Difficulty: Moderate Question ID: 3.3.84 Topic: Psychodynamic Therapies Skill: Analyze It LO 3.2: Compare historical approaches to psychotherapy 3.3.85. Describe the technique of systematic desensitization.

Answer: Systematic desensitization, developed by Joseph Wolpe, has three key elements. The first is relaxation training (usually progressive muscle relaxation) and is used to induce a calm state through the contraction and relaxation of all of the major muscle groups. The second component is the construction of a hierarchy of fears ranging from very mild to very frightening stimuli. The third part is the learning process, namely, the pairing of the feared stimulus with the relaxation response. Wolpe had his clients carry out the pairing in their imagination. Evidence supports the effectiveness of this treatment for fears and phobias, although the specific mechanism that leads to the fear reduction is not clear.

Difficulty: Moderate Question ID: 3.3.85 Topic: Cognitive-Behavioral Therapy Skill: Apply What You Know LO 3.3: Differentiate therapies associated with the three waves of cognitive-behavioral therapy 3.3.86. In what ways is humanistic therapy different from psychodynamic and behavioral therapies? In what ways is humanistic therapy similar to psychodynamic and behavioral therapies?

Answer: Humanistic therapy was promoted originally to counteract what were seen as overly mechanistic and deterministic views of psychodynamic and behavioral approaches. Different: humanistic therapy focuses on a genuine, reciprocal relationship as the treatment, not as the means for delivering therapy. Similar to psychoanalytic: focus on uncovering hidden emotions.

Similar to behavioral: focus on the present.

Difficulty: Difficult Question ID: 3.3.86 Topic: Humanistic Therapies, Psychodynamic Therapies, Cognitive-Behavioral Therapy Skill: Analyze It LO 3.2: Compare historical approaches to psychotherapy 3.3.87. Discuss the problems associated with using no-treatment control groups in experimental research on treatment effectiveness.

Answer: In experimental research on psychotherapy, some clients are assigned to a no-treatment control group. These people are part of a waiting list, so they will receive psychotherapy at some

future time. While waiting for therapy, people in no-treatment control groups often seek counseling and advice from family members, friends, or religious leaders. Thus, any improvement in their condition may not be due to spontaneous remission, but may be due to receiving informal psychological help.

Difficulty: Moderate Question ID: 3.3.87 Topic: Research on Psychotherapy Skill: Apply What You Know LO 3.5: Evaluate the impact of psychotherapy treatments 3.3.88. What is the placebo effect, why is it important, and how do researchers deal with it in outcome research?

Answer: The placebo effect refers to the powerful healing that can be produced by apparently inert treatment. It is important because it has been repeatedly shown to be a factor that can produce many of the benefits associated with physical and psychological treatments, thus making it difficult to determine if an active ingredient in the treatments was effective. Researchers have to isolate these active ingredients to determine whether they have effects beyond what the placebo effect alone could account for. Researchers do this by including a placebo control group in their outcome studies, and then they use double-blind procedures so that neither the patient nor the person treating the patient knows whether the patient received the active ingredient or the placebo.

Difficulty: Moderate Question ID: 3.3.88 Topic: Research on Psychotherapy Skill: Apply What You Know LO 3.5: Evaluate the impact of psychotherapy treatments 3.3.89. Describe the procedures used in the Consumer Reports study of psychotherapy. What are some of the major findings of this study?

Answer: Consumer Reports surveyed nearly 3,000 respondents who had seen a mental health professional in the past three years. These respondents were generally satisfied with the treatment. For example, of those who were feeling “very poorly” at the beginning of treatment, 87 percent were feeling “very good,” “good,” or at least “so-so” when they were surveyed. The survey found that psychologists, psychiatrists, and social workers were essentially equal in treatment effectiveness. People who had received psychotherapy alone reported similar outcomes as those who had received psychotherapy plus medication.

Difficulty: Moderate Question ID: 3.3.89 Topic: Research on Psychotherapy Skill: Apply What You Know LO 3.5: Evaluate the impact of psychotherapy treatments

3.3.90. What are possible common factors in psychotherapy that might account for its effectiveness, and why is it important to know about them?

Answer: Studies indicate that clients’ ratings of therapist warmth, empathy, and supportiveness predicted successful outcomes. Several studies have found that the actual therapeutic procedures differ during therapy, but the outcomes do not. One possible explanation for this is that while it may appear that psychotherapies are different, the most significant therapeutic factors may be the same. Clients rate their personal relationship with their therapists as the single most important aspect of both behavior therapy and psychodynamic psychotherapy. A therapist’s supportiveness is related to positive outcomes across various approaches to treatment. It could be that no matter what the actual therapeutic procedures, the heart of the therapeutic endeavor is the relationship between client and therapist. Another possible common factor is that therapies all involve an element of social persuasion. No matter what the procedures, it is implied, by the therapist, that the client should behave and feel differently. Frank has defined psychotherapy as involving (1) a trained, socially sanctioned healer, whose healing powers are accepted by the sufferer and by his social group or an important segment of it, (2) a sufferer who seeks relief from the healer, (3) a circumscribed, more-or-less structured series of contacts between the healer and the sufferer, through which the healer, often with the aid of a group, tries to produce certain changes in the sufferer’s emotional state, attitudes, and behavior. There is research evidence that the attitudes and beliefs of the client do begin to match those of the therapist as the therapy progresses.

Knowing about common factors is important to help us to understand why many studies, like the Consumer Reports study, often do not show much difference in effectiveness among various treatment approaches. These common factors can also help us to understand why psychotherapy usually works.

Difficulty: Difficult Question ID: 3.3.90 Topic: Research on Psychotherapy Skill: Analyze It LO 3.5 Evaluate the impact of psychotherapy treatments 3.3.91. Discuss the overall aims and strategies of community psychology.

Answer: Community psychology is a branch of psychology that aims to reduce the incidence and severity of mental health problems by improving social conditions. This field believes that many social factors play a role in the cause of mental illness. Examples include poverty; the stress of prejudice, both racial and sexual; and social stress. Primary prevention programs, such a Head Start, aim at a wide social group before any problems are specifically identified. Secondary programs aim at target groups in which emerging social problems have been identified. Tertiary programs identify individuals who have already developed problems, but attempt to provide supports and social improvements that will likely reduce repeat problems.

Difficulty: Difficult Question ID: 3.3.91 Topic: Couple, Family, and Group Therapy Skill: Apply What You Know LO 3.6: Describe psychotherapy in group settings

Chapter 4 Classification and Assessment of Abnormal Behavior Total Assessment Guide (T.A.G.) Topic

Overview

Question Type Multiple Choice True/False

Understand the Concepts 1,2

Multiple Choice True/False

81 5,6,7

4

53,54,55 82

Essay Classifying Abnormal Behavior

Multiple Choice True/False Essay

Evaluating Classification Systems

Multiple Choice True/False

8,9,11,12,14,17 10,13,15,16, 18,19 56,57,58,59,60, 61 62,63 84 83 20,21,22,26

23,24,25,27

64,65,69

66,67,68 86,90

Essay Basic Issues in Assessment

Psychological Assessment Procedures

Biological Assessment Procedures

Multiple Choice True/False

28,31

Essay Multiple Choice True/False Essay

87 30,32,33,37, 34,35,36,39 38,40,41,42,43 72,73,75,76,77, 74 78 88

Multiple Choice True/False

44,45,46,47,48, 50 49 79,80

Essay

Analyze It

51,52

Essay Basic Issues in Classification

Apply What You Know 3

29

70,71

89

85

Evaluate It

Chapter 4: Classification and Assessment of Abnormal Behavior Multiple Choice 4.1.1. In the field of mental health, a clinician’s decision to assign a diagnosis when a person’s behavior meets the specific criteria for a particular type of disorder is important because it tells the clinician a. b. c. d.

that the person’s problems are similar to those experienced by others. what caused the person’s problems. exactly how the problems can best be treated. that the person’s problems are unique.

Answer: a.

Difficulty: Easy Question ID: 4.1.1 Topic: Overview Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification

4.1.2.

What is a diagnosis?

a. b. c. d.

an explanation of the etiology of a problem an estimate of the chances of a full recovery a description of behavior as fitting the criteria for a particular type of disorder a mental health professional's estimate of the impact of family conflict on a disorder Answer: c.

Difficulty: Easy Question ID: 4.1.2 Topic: Overview Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification

4.1.3. In the case of Michael presented in your text, which of these is one of the keys that should lead a mental health professional to suspect that Michael suffers from obsessive-compulsive disorder? a. b. c. d.

Michael’s symptoms fall into a recognized pattern.

There is a significant family history of conflict.

Michael expresses a need to be alone.

Michael has trouble communicating his thoughts.

Answer: a.

Difficulty: Moderate Question ID: 4.1.3 Topic: Overview Skill: Apply What You Know LO 4.1: Describe the theoretical processes of classification

4.1.4.

One advantage of a dimensional system of classification is that it allows scientists to

a. b. c. d.

make all-or-none decisions. arrive at a specific diagnosis. record subtle distinctions. go beyond what people say.

Answer: c.

Difficulty: Moderate Question ID: 4.1.4 Topic: Basic Issues in Classification Skill: Apply What You Know LO 4.1: Describe the theoretical processes of classification

4.1.5. In the classification of intellectual ability, psychologists determine how much intelligence a person has on a particular set of tasks; such a classification system is known as a. b. c. d.

archetypal. dimensional. categorical. diagnostic.

Answer: b.

Difficulty: Moderate Question ID: 4.1.5 Topic: Basic Issues in Classification Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification

4.1.6.

The most likely theories for the cause of mental disorders involve

a. b. c. d.

biological systems only. psychological systems only. social systems only. interactions involving biological, psychological, and social systems.

Answer: d.

Difficulty: Easy Question ID: 4.1.6 Topic: Basic Issues in Classification Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification

4.1.7.

Mental disorders are currently classified on the basis of

a. b. c. d.

causal mechanisms. biological features. descriptive features. theoretical relatedness.

Answer: c.

Difficulty: Easy Question ID: 4.1.7 Topic: Basic Issues in Classification Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification

4.1.8. Currently there are two classification systems for mental disorders used in the world; the DSM, used mostly in North America, and the , used in most other parts of the world. a. b. c. d.

WHO ICD DSM-TR PCL Answer: b.

Difficulty: Easy Question ID: 4.1.8 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.9.

Labeling theory is a perspective on mental disorders that focuses on

a. b. c. d.

interrater reliability in diagnosis. identification of biological causes of mental disorders. social factors that influence the assignment of a diagnosis. validity of including certain symptoms in criteria for diagnosis.

Answer: c.

Difficulty: Easy Question ID: 4.1.9 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.10. According to labeling theory, a psychiatric diagnosis serves to a. b. c. d.

identify etiological factors. eliminate bias due to social factors. clarify the nature of a psychiatric disorder. create a social role that perpetuates abnormal behavior.

Answer: d.

Difficulty: Moderate Question ID: 4.1.10 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.11. A patient was just released from a psychiatric hospital where he has spent the last five years. A social worker spends some time trying to help him prepare for what she calls stigma. What was the focus of these sessions? a. b. c. d.

negative attitudes that result in various forms of discrimination the tendency for most mental patients to cease taking their medications the tendency for the public to provide too much assistance to former mental patients a government effort to assist former mental patients by providing group living arrangements Answer: a.

Difficulty: Easy Question ID: 4.1.11 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.1: Why do we need a system to classify abnormal behavior?

4.1.12. Modern classification systems in psychiatry were introduced a. b. c. d.

by biologists and then adapted by psychiatrists. by clinical psychologists working for the World Health Organization.

by Freud before WWII. shortly after WWII. Answer: d.

Difficulty: Easy Question ID: 4.1.12 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.13. A clinician is using DSM-5 to arrive at a diagnosis for Michael, whose case is presented in your text; to justify a diagnosis of obsessive-compulsive disorder, the clinician will have to a. b. c. d.

conduct extensive psychological tests. refer Michael to a physician. compare Michael symptoms to a specific set of criteria. arrange for Michael to undergo a brain scan.

Answer: c.

Difficulty: Moderate Question ID: 4.1.13 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.14. In order to meet the criteria for obsessive-compulsive disorder, a person’s compulsive rituals must take more than one hour each day. Moreover, the symptoms cannot be due to drug use or the presence of other disorders. What aspects of the DSM system are illustrated by these diagnostic criteria? a. b. c. d.

reliable and valid criteria primary and secondary criteria inclusion and exclusion criteria etiological diagnosis and assessment Answer: c.

Difficulty: Moderate Question ID: 4.1.14 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.15. DSM-5 encourages clinicians to consider the influence of cultural factors in both the expression and recognition of symptoms of mental disorders. This is especially challenging when a. the clinician and the person with the problem do not share the same cultural background. b. the clinician and the person with the problem share the same cultural background. c. cultural background does not factor into the diagnostic equation. d. the clinician and the person with the problem share the same faith.

Answer: a.

Difficulty: Moderate Question ID: 4.1.15 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.16. Michael, whose case serves as an example in your textbook, was diagnosed with obsessivecompulsive disorder (OCD). Which of the following pointed toward that diagnosis? a. b. c. d.

He performed repetitive counting rituals in response to obsessive thoughts.

He considered his obsessive concerns to be logical.

His relationships with his friends were unlimited and satisfying.

His rituals interfered with his family’s routine.

Answer: d.

Difficulty: Easy Question ID: 4.1.16 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.17. In the DSM, the behavior referred to as ataques de nervios is viewed as an example of a. b. c. d.

paranoid schizophrenia. panic disorder. a culture-free syndrome. a culture-bound syndrome.

Answer: d.

Difficulty: Easy Question ID: 4.1.17 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.18. One theory to explain ataques de nervios is that it may be a culturally sanctioned way of expressing a. b. c. d.

fear of darkness. disagreement with the cultural group. distress in response to a threat to the family. fear of death.

Answer: c.

Difficulty: Moderate Question ID: 4.1.18 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.19. Your text suggests the possibility that the eating disorder known as bulimia could be listed as a culture-bound syndrome; what fact best supports this view? a. b. c. d.

Eating rituals vary between cultures.

Bulimia is found primarily in developed Western cultures.

Bulimia is a rare condition.

The prevalence of eating disorders does not vary between countries.

Answer: b.

Difficulty: Moderate Question ID: 4.1.19 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.1.20 Two clinical psychologists each interview and diagnose a group of patients. The extent to which they agree on the diagnosis of each patient is called a. b. c. d.

utility. validity. coverage. reliability.

Answer: d.

Difficulty: Easy Question ID: 4.1.20 Topic: Evaluating Classification Systems Skill: Understand the Concepts LO 4.3: Evaluate mental disorder classification systems

4.1.21. When we ask whether a category or diagnosis is useful, we are asking about its a. b. c. d.

kappa. coverage. validity. reliability.

Answer: c.

Difficulty: Easy Question ID: 4.1.21 Topic: Evaluating Classification Systems Skill: Understand the Concepts LO 4.3: Evaluate mental disorder classification systems

4.1.22. “Kappa” is a measure of interrater reliability that describes a. b. c. d.

the proportion of time raters agree exactly. the proportion of agreement beyond chance agreement. whether certain diagnoses are used disproportionately. whether a clinician is equally accurate with all diagnoses.

Answer: b.

Difficulty: Easy Question ID: 4.1.22 Topic: Evaluating Classification Systems Skill: Understand the Concepts LO 4.3: Evaluate mental disorder classification systems

4.1.23. A team of researchers has developed a structured interview to diagnose a new type of personality disorder. A series of trials to check the reliability of the structured interview yields a kappa of .75. How should the researchers view this result? a. b. c. d.

The kappa is so low they decide to abandon the project.

The kappa is not at an acceptable level but encouraging for a new instrument that can be improved.

Kappa is not the appropriate measure to be used when evaluating the reliability of a new diagnostic category.

The kappa is at an acceptable level for well-established diagnostic instruments, so the interview is ready to be used in clinical settings.

Answer: d.

Difficulty: Moderate Question ID: 4.1.23 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems

4.1.24. If you had to briefly summarize the results of research on diagnostic reliability of mental disorders, which of the following sentences would do the job? a. b. c. d.

“The reliability has increased with few exceptions.”

“We should not accept the assumption that the diagnostic categories in DSM-5 are used reliably.”

“The highest reliability is found for the specific examples of each of the major categories.”

“There is good reliability for personality disorders but lower reliability for other disorders.”

Answer: b.

Difficulty: Moderate Question ID: 4.1.24 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems

4.1.25. You are part of a team designing a study to see if a given DSM category tends to run in families.

Concerned with contributing factors to the onset of a disorder, your team is looking for evidence of validity. a. b. c. d.

genetic test-retest reliable etiological Answer: d.

Difficulty: Easy Question ID: 4.1.25 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems

4.1.26. The case of Michael presented in your text illustrates comorbidity because a. b. c. d.

Michael suffers from more than one disorder.

Michael suffers from a life-threatening disorder.

Michael’s disorder resulted from family conflict.

Michael shares the disorder with other members of his family.

Answer: a.

Difficulty: Easy Question ID: 4.1.26 Topic: Evaluating Classification Systems Skill: Understand the Concepts LO 4.3: Evaluate mental disorder classification systems

4.1.27. A clinician has met with a client who presents symptoms that would meet the criteria for several disorders; according to DSM, the clinician would a. b. c. d.

pick the most severe disorder to diagnose. pick the disorder that appeared first to diagnose. diagnose each disorder that fits the client’s symptoms. have to decide which disorder was the most treatable.

Answer: c.

Difficulty: Easy Question ID: 4.1.27 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems

4.1.28. The three primary goals that guide most assessment procedures are a. b. c. d.

making predictions, planning treatments, and evaluating treatments. pinpointing etiology, testing etiology, and planning treatments pinpointing etiology, evaluating etiology, and making predictions. deciding on a diagnosis, testing the diagnosis, and pinpointing etiology.

Answer: a.

Difficulty: Moderate Question ID: 4.1.28 Topic: Basic Issues in Assessment Skill: Understand the Concepts LO 4.4: Analyze the processes involved in psychological assessment

4.1.29. A psychologist wants to obtain a measure of children’s attention spans under quiet conditions.

She arranges for a group of children to meet individually with a research assistant who reads each child a list of numbers and then asks the child to repeat the numbers in reverse order. A week later the children repeat this task. The psychologist finds that the scores that each child received at week one and at week two tend to be very similar. She concludes that this test has high a. b. c. d.

validity. split-half reliability. interrater reliability. test-retest reliability.

Answer: d.

Difficulty: Moderate Question ID: 4.1.29 Topic: Basic Issues in Assessment Skill: Apply What You Know LO 4.4: Analyze the processes involved in psychological assessment

4.1.30. What are the most commonly used psychological assessment procedures? a. b. c. d.

IQ tests interviews rating scales personality tests Answer: b.

Difficulty: Easy Question ID: 4.1.30 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.5: Compare psychological assessment procedures

4.1.31. Paul Meehl has suggested that when clinicians mistakenly pay attention to vague, superficial, or stereotyped statements by clients, and fail to pay to attention to subtler but more important evidence, they are victims of the cognitive error he has labeled the a. b. c. d.

cognitive dissonance effect. unreliability bias.

Barnum effect. diagnostic fallibility crisis.

Answer: c.

Difficulty: Easy Question ID: 4.1.31 Topic: Basic Issues in Assessment Skill: Understand the Concepts LO 4.4: Analyze the processes involved in psychological assessment

4.1.32. A clinical psychologist is interviewing a client and asks a series of questions. Later the same psychologist interviews another client and asks the same series of questions in the same order. What type of interview is the psychologist using? a. b. c. d.

primary objective projective structured Answer: d.

Difficulty: Easy Question ID: 4.1.32 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.5: Compare psychological assessment procedures

4.1.33. What is one of the advantages of structured interviews in assessing clients? a. b. c. d.

Scoring is based on empirical research.

Structured interviews do not require training.

The interviewer can probe further when necessary.

The structured interview has a strict time limit that provides more time for other diagnostic tests.

Answer: c.

Difficulty: Easy Question ID: 4.1.33 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.5: Compare psychological assessment procedures

4.1.34. Using observation as part of a clinical interview can help the interviewer to a. b. c. d.

clearly understand issues that are hidden in the client’s unconscious.. understand the client’s hidden behaviors not performed in front of the interviewer . both confirm and question the client’s self-report. help the client change her self-report.

Answer: c.

Difficulty: Moderate Question ID: 4.1.34 Topic: Psychological Assessment Procedures Skill: Apply What You Know LO 4.5: Compare psychological assessment procedures

4.1.35. A researcher wants to compare the use of rating scales to behavioral coding systems. After making the comparison, he concludes that behavioral coding systems tend to a. b. c. d.

be less reliable. be more qualitative. require more subjective judgment. require less inference by the observer.

Answer: d.

Difficulty: Moderate Question ID: 4.1.35 Topic: Psychological Assessment Procedures Skill: Apply What You Know LO 4.5: Compare psychological assessment procedures

4.1.36. Alice has been experiencing a number of symptoms of anxiety for several months. A psychologist decides to assess her symptoms by using a behavioral coding system. What is Alice likely to be asked to do? a. b. c. d.

evaluate the symbolism of each of her symptoms record the presence of specific symptoms during 30-minute segments throughout the day rate the level of anxiety she feels on a scale ranging from very anxious to not anxious discuss her symptoms while a psychologist checks instruments designed to measure her pulse and breathing Answer: b.

Difficulty: Moderate Question ID: 4.1.36 Topic: Psychological Assessment Procedures Skill: Apply What You Know LO 4.5: Compare psychological assessment procedures

4.1.37. What is the benefit of personality tests in psychological assessment? a. b. c. d.

The same stimuli are used every time the test is given.

It is more useful to assess personality than specific behaviors.

People are generally unable to describe their own personalities.

They do not have to be administered and interpreted by trained clinicians.

Answer: a.

Difficulty: Easy Question ID: 4.1.37 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment

4.1.38. Carol is asked to complete a questionnaire made up of more than 500 true-false items. What test is she taking? a. b. c. d.

Visual Analogue Test Thematic Apperception Test Wechsler Adult Intelligence Test Minnesota Multiphasic Personality Inventory Answer: d.

Difficulty: Easy Question ID: 4.1.38 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment

4.1.39. A psychologist is reviewing results of the MMPI-2 test administered to a client who was mandated by a judge to seek therapy. The psychologist is concerned that the client may not have answered the questions consistently and honestly. Which part of the MMPI-2 will be of special interest to this psychologist? a. b. c. d.

validity scales actuarial scales projective scales reliability scales Answer: a.

Difficulty: Easy Question ID: 4.1.39 Topic: Psychological Assessment Procedures Skill: Apply What You Know LO 4.6: Evaluate the use of personality tests in psychological assessment

4.1.40. Several questions on the MMPI-2 contain questions that almost everyone is likely to answer in the same way; these questions are included to catch unsophisticated attempts to avoid answering honestly and are scored on the a. b. c. d.

D or Deception Scale.

L or Lie Scale.

T or Truth Scale.

O or Obfuscation Scale.

Answer: b.

Difficulty: Easy Question ID: 4.1.40 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment

4.1.41. A psychologist administers a series of projective tests to a client. Which major theoretical orientation is most consistent with this psychologist’s preference in assessment methods? a. b. c. d.

behavioral biological humanistic psychodynamic Answer: d.

Difficulty: Easy Question ID: 4.1.41 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment

4.1.42. The textbook suggests that which of the following is a potential advantage of a projective test? a. b. c. d.

Some people feel less comfortable talking with someone than they do completing a lengthy questionnaire such as the MMPI. The results of projective tests are subject to interpretation and bias.

While there are problems with both the reliability and validity of projective tests, they are still slightly better on both of these measures than tests such as the MMPI. If a person’s relationships with others have some unconscious cognitive or emotional component, this information may be obtained in a way that is not possible through direct interviewing methods or observational studies.

Answer: d.

Difficulty: Moderate Question ID: 4.1.42 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment

4.1.43. What is the main advantage of projective personality tests over other forms of personality tests? a. b. c. d.

objective scoring based on extensive research efficient self-administration can provide details about a patient’s unique view of the world Answer: d.

Difficulty: Easy Question ID: 4.1.43 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment

4.1.44. fMRI is a new and exciting method of imaging brains that is based on the physiological observation that a. b. c. d.

the magnetic properties of neurons change as they release neurotransmitters. the magnetic properties of blood changes as a function of the level of oxygen it is carrying. the magnetic resonance of brain regions changes with age and experience. blood flow can be measured directly by the magnetic properties of the vessels containing the blood.

Answer: b.

Difficulty: Moderate Question ID: 4.1.44 Topic: Biological Assessment Procedures Skill: Understand the Concepts LO 4.7: Differentiate biological assessment procedures

4.1.45. PET and fMRI scans have found valuable information about the biological components of OCD including over-activity in a. b. c. d.

occipital lobe. caudate and the orbital prefrontal cortex. cerebellum.

Broca’s area.

Answer: b.

Difficulty: Difficult Question ID: 4.1.45 Topic: Biological Assessment Procedures Skill: Understand the Concepts LO 4.7: Differentiate biological assessment procedures

4.1.46. One of the main advantages of modern brain imaging techniques is that they may a. b. c. d.

illuminate the relationship between brain activity and mental problems. reduce the cost of clinical assessments. be used to validate the diagnostic information derived from projective techniques. eliminate the need for costly interview techniques in the diagnostic process.

Answer: a.

Difficulty: Moderate Question ID: 4.1.46 Topic: Biological Assessment Procedures Skill: Understand the Concepts LO 4.7: Differentiate biological assessment procedures

4.1.47. One of the main limitations of modern brain imaging techniques in the field of abnormal psychology is that a. b. c. d.

very few hospitals in the United States have access to these tools. they are quite unreliable in their measures. the images are not of sufficient quality to allow for diagnostic use. they lack the normative information that would allow them to be used for diagnosis.

Answer: d.

Difficulty: Moderate Question ID: 4.1.47 Topic: Biological Assessment Procedures Skill: Understand the Concepts LO 4.7: Differentiate biological assessment procedures

4.1.48. Currently, brain imaging techniques are used mostly for research, but are being used in the assessment and treatment of a. b. c. d.

dissociative identity disorder. bulimia. depression.

Alzheimer’s disease.

Answer: d.

Difficulty: Easy Question ID: 4.1.48 Topic: Biological Assessment Procedures Skill: Understand the Concepts LO 4.7: Differentiate biological assessment procedures

4.1.49. The newest and most exciting method of imaging brain functions involves a. b. c. d.

MRI fMRI TPD PET Answer: b.

Difficulty: Easy Question ID: 4.1.49 Topic: Biological Assessment Procedures Skill: Understand the Concepts LO 4.7: Differentiate biological assessment procedures

4.1.50. In clinical practice, brain imaging techniques can be used to rule out various neurological

conditions that might explain behavioral or cognitive deficits. These conditions include a. b. c. d.

high blood pressure and low T counts. bulimia and anorexia. brain tumors and vascular disease. malingering and somatoform disorders.

Answer: c.

Difficulty: Easy Question ID: 4.1.50 Topic: Biological Assessment Procedures Skill: Apply What You Know LO 4.7: Differentiate biological assessment procedures

True/False 4.2.51. A psychologist conducts an interview and administers several psychological tests in order to evaluate the nature of a person’s problem and to formulate a treatment plan. This process is called an assessment.

Answer: True Difficulty: Easy Question ID: 4.2.51 Topic: Overview Skill: Understand the Concepts LO 4.1. Describe the theoretical processes of classification 4.2.52. A diagnosis is in effect a causal analysis, as it explains the etiology of the problem.

Answer: False Difficulty: Moderate Question ID: 4.2.52 Topic: Overview Skill: Understand the Concepts LO 4.1. Describe the theoretical processes of classification

4.2.53. A categorical approach to classification assumes that distinctions among members of different categories are qualitative.

Answer: True Difficulty: Easy Question ID: 4.2.53 Topic: Basic Issues in Classification Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification 4.2.54. A measurement-based approach focuses on how much of a diagnostic characteristic an individual exhibits.

Answer: False Difficulty: Easy Question ID: 4.2.54 Topic: Basic Issues in Classification Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification 4.2.55. A categorical approach assumes that all distinctions among members of different categories are qualitative.

Answer: True Difficulty: Moderate Question ID: 4.2.55 Topic: Basic Issues in Classification Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification 4.2.56. The current Diagnostic and Statistical Manual of the American Psychiatric Association is also called the DSM-5.

Answer: True Difficulty: Easy Question ID: 4.2.56 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification 4.2.57. In the 1950s and 1960s, mental health clinicians using early editions of the DSM who independently evaluated the same client relied heaving on psychological tests.

Answer: False Difficulty: Moderate Question ID: 4.2.57 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification

4.2.58. DSM-5 diagnoses are grouped under 22 primary headings based on theoretical assumptions.

Answer: False Difficulty: Moderate Question ID: 4.2.58 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification 4.2.59. Stigma refers to rejection or isolation of an individual resulting from a stamp or label.

Answer: True Difficulty: Easy Question ID: 4.2.59 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification 4.2.60. Recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress are called compulsions.

Answer: False Difficulty: Easy Question ID: 4.2.60 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.1: Describe the theoretical processes of classification 4.2.61. Oscar has recently lost a loved one. A mental health professional who is trying to be sensitive to the cultural context of Oscar’s problem will want to know what Oscar has learned about how grief should be displayed.

Answer: True Difficulty: Moderate Question ID: 4.2.61 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.2: Relate DSM-5 classification to cultural concepts of distress 4.2.62. Culture-bound syndromes in DSM are also known as idioms of distress because they represent non-existent or imagined forms of pathology.

Answer: False Difficulty: Moderate Question ID: 4.2.62 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.2.63. A key feature of ataques de nervios seems to be loss of control.

Answer: True Difficulty: Easy Question ID: 4.2.63 Topic: Classifying Abnormal Behavior Skill: Understand the Concepts LO 4.2: Relate DSM-5 classification to cultural concepts of distress 4.2.64. The two principal criteria used to evaluate a classification system like DSM-5 are reliability and validity.

Answer: True Difficulty: Easy Question ID: 4.2.64 Topic: Evaluating Classification Systems Skill: Understand the Concepts LO 4.3: Evaluate mental disorder classification systems 4.2.65. In reliability research, the statistic that is used to measure agreement between clinicians is known as correlation.

Answer: False Difficulty: Moderate Question ID: 4.2.65 Topic: Evaluating Classification Systems Skill: Understand the Concepts LO 4.3: Evaluate mental disorder classification systems 4.2.66. Your text describes a study of reliability of diagnoses for several types of mental disorders which concludes that the diagnostic categories of the DSM are not always reliably used by clinicians.

Answer: True Difficulty: Moderate Question ID: 4.2.66 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems 4.2.67. Generalized anxiety disorder has especially high diagnostic reliability.

Answer: False Difficulty: Moderate Question ID: 4.2.67 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems

4.2.68. Videotapes of 20-year-old children are being used to determine if their social interactions are related to the development of schizophrenia in adulthood. The focus of interest in this study is predictive validity.

Answer: True Difficulty: Moderate Question ID: 4.2.68 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems 4.2.69. According to the National Comorbidity Survey, almost 100 percent of people who qualify for a diagnosis of one mental disorder in their lifetime are likely to meet the criteria for two or more disorders.

Answer: False Difficulty: Moderate Question ID: 4.2.69 Topic: Evaluating Classification Systems Skill: Understand the Concepts LO 4.3: Evaluate mental disorder classification systems 4.2.70. Based on their assessment, clinicians want to generalize, or draw inferences about the person’s behavior in the natural environment, however, clinicians must rely on specific samples of a person’s behavior.

Answer: True Difficulty: Easy Question ID: 4.2.70 Topic: Basic Issues in Assessment Skill: Understand the Concepts LO 4.4: Analyze the processes involved in psychological assessment 4.2.71. Split-half reliability is a measure of a test’s interrater consistency.

Answer: False Difficulty: Moderate Question ID: 4.2.71 Topic: Basic Issues in Assessment Skill: Understand the Concepts LO 4.4: Analyze the processes involved in psychological assessment 4.2.72. In a client’s intake interview, the clinician reads him a set specific questions about his symptoms in a particular order. He is being given a structured interview.

Answer: True Difficulty: Easy Question ID: 4.2.72 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.5: Compare psychological assessment procedures

4.2.73. One goal of nondirective interviews is to help people clarify their subjective feelings.

Answer: True Difficulty: Easy Question ID: 4.2.73 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.5: Compare psychological assessment procedures 4.2.74. One of the limitations of structured interviews is that there is no room for clinical judgment.

Answer: False Difficulty: Moderate Question ID: 4.2.74 Topic: Psychological Assessment Procedures Skill: Apply What You Know LO 4.5: Compare psychological assessment procedures 4.2.75. Behavioral coding systems focus on the frequency of specific behavioral events during assessment.

Answer: True Difficulty: Easy Question ID: 4.2.75 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.5: Compare psychological assessment procedures 4.2.76. The scale on the MMPI-2 that measures physical symptoms that cannot be traced to a medical illness is called the hypochondriasis scale.

Answer: False Difficulty: Moderate Question ID: 4.2.76 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment 4.2.77. The primary assumption of projective personality tests is that individuals would project unconscious feelings onto ambiguous stimuli.

Answer: True Difficulty: Easy Question ID: 4.2.77 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment

4.2.78. Recent advances in scoring of projective tests focus on the content of the client’s answers rather than the form.

Answer: False Difficulty: Moderate Question ID: 4.2.78 Topic: Psychological Assessment Procedures Skill: Understand the Concepts LO 4.6: Evaluate the use of personality tests in psychological assessment 4.2.79. A recent advance in brain imaging is CT scans, which allow details of both the structure and function of the brain to be seen.

Answer: False Difficulty: Moderate Question ID: 4.2.79 Topic: Biological Assessment Procedures Skill: Understand the Concepts LO 4.7: Differentiate biological assessment procedures 4.2.80. Recent advances in brain imaging have allowed clinicians to make scientifically useful comparisons in the relative size of the chambers in the brain that are filled with cerebrospinal fluid.

These chambers are called cerebrospinal spaces.

Answer: False Difficulty: Moderate Question ID: 4.2.80 Topic: Biological Assessment Procedures Skill: Understand the Concepts LO 4.7: Differentiate biological assessment procedures

Essay 4.3.81. Explain how the term “diagnosis” in psychopathology does not have the same meaning that it has in other fields, and explain the significance of this difference.

Answer: In many fields, diagnosis refers to causal analysis. It means that one can look underneath to pinpoint the origins of the problem. In this way, the diagnosis leads directly to the problem’s solution. In the field of psychopathology, assigning a diagnosis does not mean that we understand the etiology of the person’s problem. Assigning a diagnosis of a mental disorder simply identifies the nature of the problem without implying exactly how the problem came into existence. A diagnostic label does not provide an explanation, and thus does not lead directly to a specific solution.

Difficulty: Moderate Question ID: 4.3.81 Topic: Overview Skill: Apply What You Know LO 4.1: Describe the theoretical processes of classification

4.3.82. Compare and contrast a dimensional classification system with a categorical classification system, such as the current DSM-5.

Answer: The current DSM-5 is based on a categorical system. It attempts to treat mental disorders as physical disorders. It assumes that there are disease entities, such as schizophrenia, unipolar depression, OCD, etc., that are discrete, that are caused by a specific etiological process, and that are qualitatively different from each other. The DSM lays out the behaviors and signs to look for and then spells out when to assign an individual to a discrete category. If the DSM were a dimensional system, such as “intelligence,” it would assume that an individual was possessed of various properties and assign each individual an estimate of how much of a given property they demonstrate. An individual may demonstrate a significant level of delusional thinking, somewhat less intellectual impairment, varying degrees of unhappiness, etc. This system may or may not result in a definitive or categorical diagnosis.

Difficulty: Moderate Question ID: 4.3.82 Topic: Basic Issues in Classification Skill: Analyze It LO 4.1: Describe the theoretical processes of classification 4.3.83. During the 1950s and 1960s, psychiatric classification systems were widely criticized. Discuss some of the reasons for this criticism.

Answer: (1) low reliability and interrater consistency; (2) the ideas that people who are diagnosed as mentally ill actually are having “problems in living” and are not “sick”; (3) the problems of self-fulfilling prophecies: those who are diagnosed live up to the expectations of the “sick” role.

Patients may be stigmatized by being labeled.

Difficulty: Easy Question ID: 4.3.83 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.1: Describe the theoretical processes of classification 4.3.84. What are two major uses of a classification system for abnormal behavior?

Answer: (1) matching clients’ problems with the most effective treatment; (2) searching for knowledge, and the possibility of identifying unique disorders and their causes so that treatments can later be developed.

Difficulty: Easy Question ID: 4.3.84 Topic: Classifying Abnormal Behavior Skill: Apply What You Know LO 4.2: Relate DSM-5 classification to cultural concepts of distress

4.3.85. Explain why it is important for clinicians to consider the influence of cultural factors when diagnosing mental disorders. What challenges does this pose?

Answer: The DSM-5 encourages clinicians to consider the influence of cultural factors in both the expression and recognition of symptoms of mental disorders. People express extreme emotions in ways that are shaped by the traditions of their families and other social groups to which they belong. Interpretations of emotional distress and other symptoms are influenced by the explanations that a person’s culture assigns to such experiences. The accuracy and utility of a clinical diagnosis depends not only on a count of the symptoms that appear to be present, but also on the clinician’s ability to consider the cultural context in which the problem appeared. This can be especially challenging when the clinician and the patient do not share the same cultural background. There are patterns of thinking and behavior that may be unique to particular societies, but do not conform to typical patterns of mental disorders in the United States or Europe. If the clinician is not sensitive to this possibility, they may view a symptom as pathological, whereas it is actually normative in a given culture.

Difficulty: Moderate Question ID: 4.3.85 Topic: Classifying Abnormal Behavior Skill: Analyze It LO 4.2: Relate DSM-5 classification to cultural concepts of distress 4.3.86. Describe the different ways in which diagnosis can be useful (valid). Mention two types of validity.

Answer: (1) meaningful or important: provides information and communication value; can provide evidence that leads to a theory of the cause of a disorder; (2) etiological validity: provides information on cause; (3) concurrent validity: agrees with information about behavior in other situations and from other sources; (4) predictive: provides information about the predictable course of the disorder, and later status and behavior.

Difficulty: Moderate Question ID: 4.3.86 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems 4.3.87. Describe the three primary goals of clinical assessment procedures, and give an example of each.

Answer: (1) making predictions: will this person engage in violence if he/she is released from jail? (2) plan interventions: does this person have the intelligence level necessary to benefit from insight-oriented therapy? (3) evaluate treatment effectiveness: has this person’s depression decreased over the course of therapy?

Difficulty: Moderate Question ID: 4.3.87 Topic: Basic Issues in Assessment Skill: Understand the Concepts LO 4.4: Analyze the processes involved in psychological assessment

4.3.88. Describe the advantages and limitations of using a clinical interview to assess a patient’s psychopathology.

Answer: A clinical interview allows the clinician the opportunity to ask the patient for their own description of their problems, as well as to observe important features of the person’s appearance and non-verbal behavior. Specific questions can be asked to assist the clinician in making diagnostic decisions. The interview can cover past events, gather information about the patient’s relationships, and provide a lot of information in a short period of time. The interview also allows the clinician to be aware of and sensitive to the influence of cultural factors. Limitations of using a clinical interview include the fact that the information provided is the patient’s subjective account and may be influenced errors in memory, their reluctance to admit to experiences they view as embarrassing or frightening, or by their inability to provide a rational account of their problems. In addition, there is the possibility that the patient’s account may be influenced by the way in which the clinician phrases their questions or responds to the patient’s responses.

Difficulty: Moderate Question ID: 4.3.88 Topic: Psychological Assessment Procedures Skill: Apply What You Know LO 4.5: Compare psychological assessment procedures 4.3.89. A psychologist is diagnosing a patient and wants to measure the patient’s prefrontal brain metabolism levels while the patient is told to concentrate on her obsessions. The psychologist uses fMRI to measure prefrontal brain metabolism levels before, during, and after her patient concentrates on obsessions. She finds that her patient’s concentration on obsessions is correlated with increases in prefrontal brain metabolism levels, and she concludes that her patient has obsessive-compulsive disorder.

Discuss the grounds on which such a conclusion would be criticized, and describe what else the psychologist might do to diagnose her patient.

Answer: Physiological assessment is not sufficient because (1) any individual autonomic response has a low correlation with other autonomic responses; (2) individuals vary in their reactivity, and for some, thinking about obsessions may be associated with great increases in prefrontal brain activity while for others, there may be no increase; and (3) some people with OCD do not exhibit increased metabolism rates in the prefrontal cortex, while others without OCD do exhibit increased metabolism in this brain region. The psychologist’s assessment of her patient’s condition could include (1) other physiological measures; (2) the psychologist’s observations of her patient; (3) measures from some form of rating scale or self-report inventory.

Difficulty: Moderate Question ID: 4.3.89 Topic: Biological Assessment Procedures Skill: Apply What You Know LO 4.7: Differentiate biological assessment procedures

4.3.90. Describe some disadvantages of the current DSM-5 classification system.

Answer: The current DSM is widely used and recognized, but that very acceptance may mean that new ways of looking at and conceptualizing mental illness may be overlooked. Most patients don’t fit neatly into one category; they exhibit a variety of symptoms that vary over time and with changing circumstances. If we categorize them, are we overlooking other, possibly more important aspects of their problem? The problem of comorbidity is identified by many clinicians and researchers. The National Comorbidity Study suggests that a small subgroup of individuals exhibit three or more diagnoses and that this group accounts for a significant percentage of serious diagnoses. In addition, the DSM has difficulty handling change over time. There is a tendency to label individuals, while periodic changes to the nature of disorders go unnoticed. It is not unusual for an individual to be mainly anxious one day and mainly unhappy a few days later.

Difficulty: Moderate Question ID: 4.3.90 Topic: Evaluating Classification Systems Skill: Apply What You Know LO 4.3: Evaluate mental disorder classification systems

Chapter 5 Mood Disorders and Suicide Total Assessment Guide (T.A.G.) Topic

Overview

Symptoms

Diagnosis

Course, Outcome, and Frequency Causes: Social & Psychological Factors

Question Type Multiple Choice True/False

Understand The Concepts 1,2,3,4,7,8 51,52,53

Apply What You Know 5,6,9 57

Essay Multiple Choice

10,12,13

11,14

True/False

54,55,56

58

Essay

81

Multiple Choice

19

15,16,17,18

True/False

59,60,61,63,64

62

Essay Multiple Choice

21

20,22

True/False

65,66,67

Essay

82

Multiple Choice

23,25,26

24,27

True/False

68,69

70,71

Essay

85

84 28,31,34

Multiple Choice

29,30,33

Causes: Biological Factors

True/False

72,73,74

Treatment for Depressive Disorders

Multiple Choice

35,36,37

True/False

75,76

Treatment for Bipolar and Mood Disorders

Multiple Choice

39

40,41

True/False

77

78

42,43,44,45,46, 47,48 79,80 89

49,50

Essay

86,87,91

Essay

38 88

Essay Multiple Choice

Suicide True/False Essay

90

Analyze It

83

Evaluate It

Chapter 5: Mood Disorders and Suicide Multiple Choice 5.1.1. You were asked to give a talk to illustrate the problems caused by depression for youth as compared to their parents’ generation. Which of the following could be an accurate way to start your talk? a. b. c. d.

The younger generation is experiencing rates of depression higher than previous generations.

The younger generation is experiencing rates of depression lower than previous generations.

The younger generation is experiencing depression at a later age than previous generations.

The younger generation is experiencing rates of depression at the same rate as previous generations.

Answer: a.

Difficulty: Easy Question ID: 5.1.1 Topic: Overview Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression

5.1.2.

Which of the following describes the term affect?

a. b. c. d.

a state of arousal subjective feelings observable behaviors associated with subjective feelings physiological changes associated with subjective feelings Answer: c.

Difficulty: Easy Question ID: 5.1.2 Topic: Overview Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression

5.1.3. Which of the following is the term that psychologists use for a pervasive and sustained emotional response that can color the person’s perception of the world? a. b. c. d.

affect mania depression mood Answer: d.

Difficulty: Easy Question ID: 5.1.3 Topic: Overview Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression

5.1.4.

Which of the following is a clinical feature of mania?

a. b. c. d.

elated mood criminality dissociation blunted affect Answer: a.

Difficulty: Easy Question ID: 5.1.4 Topic: Overview Skill: Understand the Concepts LO 5.2: Differentiate diagnoses for depressive and bipolar disorders

5.1.5. Mary has had two episodes of major depression with no other periods of psychological disturbance. What is the appropriate description of her symptoms? a. b. c. d.

dysthymia double depression bipolar mood disorder depressive disorder Answer: d.

Difficulty: Moderate Question ID: 5.1.5 Topic: Overview Skill: Apply What You Know LO 5.1: Identify symptoms associated with depression

5.1.6. Robert has just experienced an episode of mania. Which diagnostic label best describes his condition? a. b. c. d.

dysthymia bipolar mood disorder depressive disorder dysphoric mood disorder Answer: b.

Difficulty: Moderate Question ID: 5.1.6 Topic: Overview Skill: Apply What You Know LO 5. 2: Differentiate diagnoses for depressive and bipolar disorders

5.1.7.

Euphoria is characterized by

a. b. c. d.

elated mood. labile affect. depressed mood. inappropriate affect.

Answer: a.

Difficulty: Easy Question ID: 5.1.7 Topic: Overview Skill: Understand the Concepts LO 5.2: Differentiate diagnoses for depressive and bipolar disorders

5.1.8. Which one of these characteristics of clinical depression helps to distinguish it from normal sadness? a. b. c. d.

altered brain chemistry caused by an identifiable precipitant occurs only in people who suffered early losses accompanied by a cluster of signs and symptoms, including cognitive features Answer: d.

Difficulty: Moderate Question ID: 5.1.8 Topic: Overview Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression

5.1.9. The case of Cathy presented in your text is an example of major depressive disorder. One of the aspects of her case that clearly tells us her mood was more than just normal sadness is that Cathy a. b. c. d.

had become impaired in her ability to work. did not have any manic or hypomanic symptoms. had been separated from her husband for five years. felt unworthy of her latest promotion at work.

Answer: a.

Difficulty: Moderate Question ID: 5.1.9 Topic: Overview Skill: Apply What You Know LO 5.1: Identify symptoms associated with depression

5.1.10. Which of the following is an important consideration in distinguishing clinical depression from normal sadness? a. b. c. d.

In clinical depression the mood change always occurs in the absence of any precipitating event.

A clinically depressed mood is often accompanied by an enhanced ability to function in usual social situations.

Engaging in pleasant activities may temporarily lift a clinically depressed mood.

A clinical mood change is usually accompanied by a cluster of additional signs and symptoms.

Answer: d.

Difficulty: Easy Question ID: 5.1.10 Topic: Symptoms Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression

5.1.11. Betty believes she is less capable than her coworkers, even though she has won many awards for her performance. She often feels lonely and believes no one wants to be her friend. Her future seems empty and meaningless. These traits characterize a. b. c. d.

cyclothymia. psychotic depression. the “depressive triad.” somatic deficits in depression.

Answer: c.

Difficulty: Moderate Question ID: 5.1.11 Topic: Symptoms Skill: Apply What You Know LO 5.1: Identify symptoms associated with depression

5.1.12. People who are clinically depressed frequently note that their thinking is slowed down, while manic patients commonly report that their thoughts are . a. b. c. d.

unrealistic very focused speeded up focused on the future Answer: c.

Difficulty: Easy Question ID: 5.1.12 Topic: Symptoms Skill: Understand the Concepts LO 5.2: Differentiate diagnoses for depressive and bipolar disorders

5.1.13. Which of the following is an example of a somatic symptom of depression? a. suicidal thoughts b. sleeping problems c. feelings of low self-worth d. pessimistic thoughts about the future Answer: b.

Difficulty: Easy Question ID: 5.1.13 Topic: Symptoms Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression 5.1.14. Harold has just been diagnosed as suffering from major depressive disorder. In planning his treatment, the mental health professionals will discover that he has a comorbid condition. Which of the following is the most likely comorbid condition? a. b. c. d.

alcoholism hypochondriasis paranoid schizophrenia histrionic personality disorder Answer: a.

Difficulty: Moderate Question ID: 5.1.14 Topic: Symptoms Skill: Apply What You Know LO 5.1: Identify symptoms associated with depression

5.1.15. For the past two years, Nick has experienced poor appetite, insomnia, fatigue, and several other symptoms. These symptoms have kept him from feeling happy, and yet they do not indicate a major depressive episode. When assessing Nick, what disorder is the psychologist most likely to consider? a. b. c. d.

bipolar I disorder persistent depressive disorder cyclothymia seasonal affective disorder Answer: b.

Difficulty: Moderate Question ID: 5.1.15 Topic: Diagnosis Skill: Apply What You Know LO 5.2: Differentiate diagnoses for depressive and bipolar disorders

5.1.16. Henry has a serious episode of depression that is diagnosed as major depressive disorder. A year later he experiences an episode of mania. What is his diagnosis after this event? a. b. c. d.

cyclothymia bipolar I disorder dysthymic disorder cyclical major depressive disorder Answer: b.

Difficulty: Moderate Question ID: 5.1.16 Topic: Diagnosis Skill: Apply What You Know LO 5.2: Differentiate diagnoses for depressive and bipolar disorders

5.1.17. For several years, Greg has experienced alternating episodes of very severe depression and episodes of hypomania. What is the most appropriate DSM diagnosis? a. b. c. d.

bipolar I disorder without psychotic features bipolar II disorder cyclothymic disorder mixed bipolar disorder Answer: b.

Difficulty: Moderate Question ID: 5.1.17 Topic: Diagnosis Skill: Apply What You Know LO 5.2: Differentiate diagnoses for depressive and bipolar disorders

5.1.18. For the past two weeks Barbara has experienced serious symptoms including weight loss, feelings of worthlessness, insomnia, and difficultly in concentrating. She is also experiencing depressed mood and loss of interest in doing much of anything. What is the DSM-5 term for what Barbara is experiencing? a. b. c. d.

dysthymic disorder bipolar I disorder, mixed episode cyclothymic disorder major depressive episode Answer: d.

Difficulty: Moderate Question ID: 5.1.18 Topic: Diagnosis Skill: Apply What You Know LO 5.2: Differentiate diagnoses for depressive and bipolar disorders

5.1.19. Which of the following sets of symptoms suggests the presence of melancholia? a. b. c. d.

weight gain, dysphoria, and hallucinations anxiety, excessive guilt, and depression worse in the evening difficulty getting to sleep, psychomotor agitation, and significant weight gain absence of any feelings of pleasure, early morning awakening, and marked psychomotor retardation Answer: d.

Difficulty: Moderate Question ID: 5.1.19 Topic: Diagnosis Skill: Understand the Concepts LO 5.2: Differentiate diagnoses for depressive and bipolar disorders

5.1.20. According to the National Comorbidity Survey Replication, the approximate percentage of individuals diagnosed with a major mood disorder in the past 12 months who received adequate treatment for that disorder was a. b. c. d.

10 percent.

20 percent.

40 percent.

60 percent.

Answer: b.

Difficulty: Moderate Question ID: 5.1.20 Topic: Course, Outcome, and Frequency Skill: Apply What You Know LO 5.3: Compare factors influencing depressive and bipolar disorders

5.1.21. What do cross‑ cultural studies of psychopathology suggest concerning depression? a. b. c. d.

DSM categories are culture-free.

Chinese psychiatrists often mistake depression for a form of schizophrenia.

There are very different rates of mood disorder in Western and non-Western countries.

Depression is a universal phenomenon that may be expressed differently depending on cultural factors.

Answer: d.

Difficulty: Easy Question ID: 5.1.21 Topic: Course, Outcome, and Frequency Skill: Understand the Concepts LO 5.3: Compare factors influencing depressive and bipolar disorders

5.1.22. You are given the topic of age and mood disorders for a term paper in abnormal psychology and instructed to write the paper in the format of a newspaper report for the general public. Which of the following titles would be the best choice? a. b. c. d.

“Mania Runs Wild in Older Generations” “Age and Mood Disorders: A Positive Correlation” “High Rates of Depression in the Elderly: Correcting a Myth” “Age Trends in Prevalence of Mood Disorders Obscured by Gender Effects” Answer: c.

Difficulty: Moderate Question ID: 5.1.22 Topic: Course, Outcome, and Frequency Skill: Apply What You Know LO 5.3: Compare factors influencing depressive and bipolar disorders

5.1.23. A strong correlation exists between stressful life events and the onset of depression, but it is difficult to interpret this relationship because a. b. c. d.

there haven’t been enough studies. stress can cause depression, but depression can cause stress. depression is a very subjective state and thus very difficult to measure. people are usually aware of any connection between their depression and stress in their lives.

Answer: b.

Difficulty: Moderate Question ID: 5.1.23 Topic: Causes: Social and Psychological Factors Skill: Understand the Concepts LO 5.4: Analyze the socio-psychological causes of mood disorders

5.1.24. A researcher investigating the link between stressful life events and depression has decided to use a prospective research design. This means that the researcher will have to a. b. c. d.

select subjects with the prospect of becoming depressed. select subjects with the prospect of experiencing stress. follow subjects over time to see if stress predicts the onset of depression. question subjects carefully to see if their depression has always followed some identifiable stress.

Answer: c.

Difficulty: Moderate Question ID: 5.1.24 Topic: Causes: Social and Psychological Factors Skill: Apply What You Know LO 5.4: Analyze the socio-psychological causes of mood disorders

5.1.25. Severe events are clearly related to the onset of depression, but they do not provide a complete account of who will become depressed. Studies that examine factors that might explain which people are most likely to become depressed are seeking evidence for what psychologists call a. b. c. d.

fragmentation. vulnerability. retrospective exposure. prospective exposure.

Answer: b.

Difficulty: Moderate Question ID: 5.1.25 Topic: Causes: Social and Psychological Factors Skill: Understand the Concepts LO 5.4: Analyze the socio-psychological causes of mood disorders

5.1.26. According to cognitive theories of depression, various types of cognitive errors, or distortions in thinking, are partly responsible for the disorder. Which of the following is one of the cognitive distortions mentioned in your textbook? a. b. c. d.

assigning specific, impersonal meaning to an experience of failure a tendency to overgeneralize conclusions about the self based on positive experiences a tendency to turn suspicion toward others toward the self a tendency to recall selectively events with negative consequences Answer: d.

Difficulty: Easy Question ID: 5.1.26 Topic: Causes: Social and Psychological Factors Skill: Understand the Concepts LO 5.4: Analyze the socio-psychological causes of mood disorders

5.1.27. Robert strikes out during a softball game, causing his team to lose the game. He begins to brood about his failure, and concludes that not only is he a failure in sports, but in all areas of his life. How might we describe Robert’s attribution style? a. b. c. d.

stable global external magnified Answer: b.

Difficulty: Moderate Question ID: 5.1.27 Topic: Causes: Social and Psychological Factors Skill: Apply What You Know LO 5.4: Analyze the socio-psychological causes of mood disorders

5.1.28. A report in a research journal describes the symptoms of a mental disorder along with information on its etiology, including a heritability of 50 percent. How should this finding be interpreted? a. b. c. d.

Genetic factors and the environment contribute about equally to this disorder.

Half of the people who suffer from the disorder have a genetically caused disorder.

Half of the children of carriers of this disorder will actually develop the disorder.

Geneticists have identified half of the genes thought to be responsible for this disorder.

Answer: a.

Difficulty: Difficult Question ID: 5.1.28 Topic: Causes: Biological Factors Skill: Apply What You Know LO 5.5: Evaluate the biological impact on mood disorders

5.1.29. What is the estimated heritability for depressive disorder? a. b. c. d.

5 percent 25 percent 50 percent 75 percent Answer: c.

Difficulty: Moderate Question ID: 5.1.29 Topic: Causes: Biological Factors Skill: Understand the Concepts LO 5.5: Evaluate the biological impact on mood disorders

5.1.30. Failure to suppress production of the hormone cortisol in response to the dexamethasone suppression test has implicated a dysfunction of which system in the etiology of depression? a. b. c. d.

genetics MAO inhibition neurotransmitter system hypothalamus—pituitary—adrenal axis Answer: d.

Difficulty: Moderate Question ID: 5.1.30 Topic: Causes: Biological Factors Skill: Understand the Concepts LO 5.5: Evaluate the biological impact on mood disorders

5.1.31. You are running a clinical trial on a method of stimulating regions of the brain in order to relieve symptoms of depression. Given the evidence that underacting in this region is associated with depression, you decide to start clinical trials in the a. b. c. d.

reticular activating system. dorsolateral prefrontal cortex. posterior occipital cortex. amygdala.

Answer: b.

Difficulty: Difficult Question ID: 5.1.31 Topic: Causes: Biological Factors Skill: Apply What You Know LO 5.5: Evaluate the biological impact on mood disorders

5.1.32. Using brain imaging techniques to examine activity of the prefrontal cortex (PFC) in depressed patients, researchers have reported finding a. b. c. d.

decreased activity. increased activity. decreased activity in some PFC regions and increased activity in others. decreased activity in patients with depressive disorder and increased activity in patients with bipolar depression.

Answer: c.

Difficulty: Easy Question ID: 5.1.32 Topic: Causes: Biological Factors Skill: Understand the Concepts LO 5.5: Evaluate the biological impact on mood disorders

5.1.33. The activity at the synapse of which of the following is most especially enhanced by medications like Prozac? a. b. c. d.

serotonin dopamine activity of the amygdala activity of the cingulate gyrus Answer: a.

Difficulty: Moderate Question ID: 5.1.33 Topic: Causes: Biological Factors Skill: Understand the Concepts LO 5.5: Evaluate the biological impact on mood disorders

5.1.34. Some clinicians have argued that mental disorders cannot be studied using laboratory animals as subjects, because a. b. c. d.

studies of depression should only be done in natural settings, and very few of those exist. cognitive symptoms cannot be measured in animals. animals do not express emotions similar to depression. the brains of animals are too different from Homo sapiens.

Answer: b.

Difficulty: Moderate Question ID: 5.1.34 Topic: Causes: Biological Factors Skill: Apply What You Know LO 5.5: Evaluate the biological impact on mood disorders

5.1.35. Which of the following characterizes a cognitive therapy approach to the treatment of depression? a. b. c. d.

probing for unconscious roots of anger focusing on early childhood experiences increasing internal causal attributions reducing patients’ self-defeating thoughts Answer: d.

Difficulty: Easy Question ID: 5.1.35 Topic: Treatment for Depressive Disorders Skill: Understand the Concepts LO 5.6: Describe treatments for depressive disorders

5.1.36. Among patients who respond positively to antidepressant medication, a. b. c. d.

improvement usually occurs within four to six weeks. side effects usually force them to terminate early. improvement usually occurs almost immediately. side effects are almost never a problem.

Answer: a.

Difficulty: Easy Question ID: 5.1.36 Topic: Treatment for Depressive Disorders Skill: Understand the Concepts LO 5.6: Describe treatments for depressive disorders

5.1.37. Compared to tricyclics and MAO inhibitors, what is a major reason for the popularity of newer antidepressant drugs such as Prozac? a. b. c. d.

lower cost fewer side effects available over-the-counter more effective Answer: b.

Difficulty: Easy Question ID: 5.1.37 Topic: Treatment for Depressive Disorders Skill: Understand the Concepts LO 5.6: Describe treatments for depressive disorders

5.1.38. The U.S. Food and Drug Administration has ruled that care should be taken when prescribing some SSRIs to children because of the possible side effects of a. b. c. d.

catatonic, lethargic behavior. sever sleep disturbance. extreme weight loss. violent or suicidal thoughts or behavior.

Answer: d.

Difficulty: Moderate Question ID: 5.1.38 Topic: Treatment for Depressive Disorders Skill: Apply What You Know LO 5.6: Describe treatments for depressive disorders

5.1.39. The first choice for treating bipolar disorders is a. b. c. d.

an SSRI like Prozac. electroconvulsive therapy. lithium. cognitive therapy plus a self-help group.

Answer: c.

Difficulty: Easy Question ID: 5.1.39 Topic: Treatment for Bipolar and Mood Disorders Skill: Understand the Concepts LO 5.7: Differentiate treatments for bipolar and other mood disorders

5.1.40 A bipolar patient in therapy is learning to lead a more orderly life and to resolve interpersonal problems more effectively. With this type of therapy, mood stabilizing medication will a. b. c. d.

still be very important. no longer be needed. only confuse the patient. be less likely to cause side-effects.

Answer: a.

Difficulty: Moderate Question ID: 5.1.40 Topic: Treatment for Bipolar and Mood Disorders Skill: Apply What You Know LO 5.7: Differentiate treatments for bipolar and other mood disorders

5.1.41. The family of a patient about to undergo electroconvulsive therapy (ECT) is concerned about how the treatment will affect their loved one’s memory. They meet with the psychiatrist and ask questions.

What is the psychiatrist likely to tell them? a. b. c. d.

“Memory problems are typically of short duration.”

“Although there will be some loss of memory, the patients rarely complain.”

“Although there are serious memory losses, the benefits of treatment outweigh these losses.”

“The memory problems are actually a benefit because they keep negative memories out of consciousness.”

Answer: a.

Difficulty: Moderate Question ID: 5.1.41 Topic: Treatment for Bipolar and Mood Disorders Skill: Apply What You Know LO 5.7: Differentiate treatments for bipolar and other mood disorders

5.1.42. Durkheim’s classification of suicides focused on a person’s social circumstances in terms of high and low levels of social a. b. c. d.

apathy and altruism. egotism and fatalism. integration and regulation. anomie and bonhomie.

Answer: c.

Difficulty: Moderate Question ID: 5.1.42 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

5.1.43. What percentage of patients with mood disorders will eventually kill themselves? a. b. c. d.

5–10 percent 15–20 percent 40–45 percent more than 50 percent Answer: b.

Difficulty: Easy Question ID: 5.1.43 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

5.1.44. Deliberate self harm is listed in DSM-5 as one of the symptoms of a. b. c. d.

schizophrenia. borderline personality disorder. psychopathy. self-injurious neuroses.

Answer: b.

Difficulty: Easy Question ID: 5.1.44 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

5.1.45. From rates of attempted and successful suicides, we can conclude that females more often attempt suicide and males more often . a. b. c. d.

succeed give away prized possessions leave notes use poisons Answer: a.

Difficulty: Easy Question ID: 5.1.45 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

5.1.46. According to Schneidman, the most common stressor in suicide is a. b. c. d.

hostility. anger. frustration of psychological needs. the desire to make others suffer.

Answer: c.

Difficulty: Moderate Question ID: 5.1.46 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

5.1. 47. Studies of the role of genetic factors in suicide indicate that a. b. c. d.

there is a genetic factor independent of the risk for depression. the only genetic factor is the genetic risk for depression. genetic factors do not play a role in suicide. genetic factors play a role in suicides by males but not in suicides by females.

Answer: a.

Difficulty: Easy Question ID: 5.1.47 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

5.1.48. According to Schneidman, the most common emotion in suicide is a. b. c. d.

fear. anger. hopelessness. depression.

Answer: c.

Difficulty: Easy Question ID: 5.1.48 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

5.1.49. The state legislature is considering enacting measures that will have an impact in reducing suicide rates. Which of the following individuals who are testifying before a legislative committee will be able to provide the most empirical support for his/her suggestion? a. b. c. d.

Al, who wants to reduce access to guns Jim, who wants to make suicide a criminal offense Stacey, who wants public service announcements focused on famous suicides Randy, who wants to establish crisis lines to handle calls from individuals contemplating suicide Answer: a.

Difficulty: Moderate Question ID: 5.1.49 Topic: Suicide Skill: Apply What You Know LO 5.8: Characterize the relationship between suicide and mental health

5.1.50 The city council is considering funding a suicide hotline, and they ask you to review the literature on the topic. What will your report tell the council? a. b. c. d.

Special training for police officers is a better way to spend the money.

A hot line phone service is the most economical way to reduce the rate of suicide.

Suicide rates do not differ between communities with and without suicide prevention programs.

Crisis hot lines must be connected with hospital emergency rooms in order to be effective.

Answer: c.

Difficulty: Moderate Question ID: 5.1.50 Topic: Suicide Skill: Apply What You Know LO 5. 8: Characterize the relationship between suicide and mental health

True/False 5.2.51. Dysphoric mood is the most common and obvious symptom of depression.

Answer: True Difficulty: Easy Question ID: 5.2.51 Topic: Overview Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression 5.2.52. The syndrome of depression is also called clinical depression.

Answer: True Difficulty: Easy Question ID: 5.2.52 Topic: Overview Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression

5.2.53. Labile mood is the opposite emotional state from depressed mood.

Answer: False Difficulty: Moderate Question ID: 5.2.53 Topic: Overview Skill: Understand the Concepts LO 5.2: Differentiate diagnosis or depressive and bipolar disorders 5.2.54. As was the case of Debbie in the textbook, it is often the case that symptoms of mania are initially triggered by some specific life stress.

Answer: False Difficulty: Moderate Question ID: 5.2.54 Topic: Symptoms Skill: Understand the Concepts LO 5.2: Differentiate diagnosis or depressive and bipolar disorders 5.2.55. Depressed patients often walk and talk as though they are in slow motion; this quality is described by the term psychomotor retardation.

Answer: True Difficulty: Easy Question ID: 5.2.55 Topic: Symptoms Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression 5.2.56. Mood disorder symptoms that are related to basic bodily functions are known as psychomotor symptoms.

Answer: False Difficulty: Moderate Question ID: 5.2.56 Topic: Symptoms Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression 5.2.57. If, during a period of mood disturbance, your patient experiences inflated self-esteem or grandiosity, you likely will diagnosis this as a(n) manic episode.

Answer: True Difficulty: Moderate Question ID: 5.2.57 Topic: Overview Skill: Apply What You Know LO 5.2: Differentiate diagnosis or depressive and bipolar disorders

5.2.58. One of your patients has been diagnosed with depressive disorder and alcohol addiction. As a clinician, you know that depression always comes first, then alcoholism develops as the person attempts to cope with their depression.

Answer: False Difficulty: Difficult Question ID: 5.2.58 Topic: Symptoms Skill: Apply What You Know LO 5.1: Identify symptoms associated with depression 5.2.59. In the DSM-5 classification of mood disorders, an emphasis is placed on the distinction between depressive and bipolar disorders.

Answer: True Difficulty: Easy Question ID: 5.2.59 Topic: Diagnosis Skill: Understand the Concepts LO 5.2: Differentiate diagnosis or depressive and bipolar disorders

5.2.60. A mood disorder that is regularly associated with changes in the seasons is called cyclothymic disorder.

Answer: False Difficulty: Moderate Question ID: 5.2.60 Topic: Diagnosis Skill: Understand the Concepts LO 5.2: Differentiate diagnosis or depressive and bipolar disorders 5.2.61. The most typical course of depressive disorder is a single episode of major depression.

Answer: False Difficulty: Moderate Question ID: 5.2.61 Topic: Diagnosis Skill: Understand the Concepts LO 5.2: Differentiate diagnosis or depressive and bipolar disorders 5.2.62. Generally your patient of the past two years has exhibited depression. She did, however, have one quite dramatic symptom that rules out a diagnosis of both major depressive disorder and persistent depressive disorder. This symptom is mania.

Answer: True Difficulty: Difficult Question ID: 5.2.62 Topic: Diagnosis Skill: Apply What You Know LO 5.2: Differentiate diagnosis or depressive and bipolar disorders

5.2.63. Hypomania is an episode involving high energy, but more severe than mania.

Answer: False Difficulty: Easy Question ID: 5.2.63 Topic: Diagnosis Skill: Understand the Concepts LO 5.2: Differentiate diagnosis or depressive and bipolar disorders 5.2.64. The most typical seasonal pattern in mood disorders is depression in winter, recovery in spring.

Answer: True Difficulty: Easy Question ID: 5.2.64 Topic: Diagnosis Skill: Understand the Concepts LO 5.2: Differentiate diagnosis or depressive and bipolar disorders 5.2.65. Sid, who is 21 years old, is at the average age for the onset of depressive disorder.

Answer: False Difficulty: Easy Question ID: 5.2.65 Topic: Course, Outcome, and Frequency Skill: Understand the Concepts LO 5.3: Compare factors influencing depressive and bipolar outcomes 5.2.66. When an individual’s symptoms are improved for a period of time, this improvement is referred to as remission.

Answer: True Difficulty: Easy Question ID: 5.2.66 Topic: Course, Outcome, and Frequency Skill: Understand the Concepts LO 5.3: Compare factors influencing depressive and bipolar outcomes 5.2.67. Gender differences are typically not observed in prevalence of depression.

Answer: False Difficulty: Moderate Question ID: 5.2.67 Topic: Course, Outcome, and Frequency Skill: Understand the Concepts LO 5.3: Compare factors influencing depressive and bipolar outcomes

5.2.68. A good example of the type of cognitive distortions that lead to depression, according to the textbook, would include overgeneralized conclusions about one’s self based on negative experiences.

Answer: True Difficulty: Moderate Question ID: 5.2.68 Topic: Causes: Social and Psychological Factors Skill: Understand the Concepts LO 5.4: Analyze the socio-psychological causes of mood disorders 5.2.69. A schema is an example of a cognitive distortion.

Answer: False Difficulty: Easy Question ID: 5.2.69 Topic: Causes: Social and Psychological Factors Skill: Understand the Concepts LO 5.4: Analyze the socio-psychological causes of mood disorders 5.2.70. Meredith is depressed. According to the concept of depressogenic attributional style, a likely description of Meredith is that she makes internal, stable, and global causal attributions.

Answer: True Difficulty: Moderate Question ID: 5.2.70 Topic: Causes: Social and Psychological Factors Skill: Apply What You Know LO 5.4: Analyze the socio-psychological causes of mood disorders 5.2.71. Some research evidence suggests that persons who show a ruminative style by writing in a diary or talking extensively with friends about their depressed moods show shorter and less severe depressed moods because these activities are cathartic.

Answer: False Difficulty: Moderate Question ID: 5.2.71 Topic: Causes: Social and Psychological Factors Skill: Apply What You Know LO 5.4: Analyze the socio-psychological causes of mood disorders 5.2.72. Genetic factors seem to play a stronger role in depressive than bipolar mood disorders.

Answer: False Difficulty: Easy Question ID: 5.2.72 Topic: Causes: Biological Factors Skill: Understand the Concepts LO 5.5: Evaluate the biological impact on mood disorders

5.2.73. The system in the body responsible for regulating a person’s response to stress is known as the endocrine system.

Answer: True Difficulty: Easy Question ID: 5.2.73 Topic: Causes: Biological Factors Skill: Understand the Concepts LO 5.5: Evaluate the biological impact on mood disorders 5.2.74. When rats are exposed to stress in the lab, they exhibit signs of depression and evidence that the concentration of chemicals in their brains have been changed. These chemicals are known collectively as neurotransmitters.

Answer: True Difficulty: Moderate Question ID: 5.2.74 Topic: Causes Biological Factors Skill: Understand the Concepts LO 5.5: Evaluate the biological impact on mood disorders 5.2.75. The focus of interpersonal therapy is primarily on unconscious feelings for the attachment figure.

Answer: False Difficulty: Moderate Question ID: 5.2.75 Topic: Treatment for Depressive Disorders Skill: Understand the Concepts LO 5.6: Describe treatments for depressive disorders 5.2.76. SSRI drugs produce their antidepressant effect by increasing production of serotonin.

Answer: False Difficulty: Moderate Question ID: 5.2.76 Topic: Treatment for Depressive Disorders Skill: Understand the Concepts LO 5.6: Describe treatments for depressive disorders 5.2.77. Based on outcome studies that have evaluated the effectiveness of light therapy for seasonal depressions, it appears that light therapy is an expensive but useless gimmick.

Answer: False Difficulty: Easy Question ID: 5.2.77 Topic: Treatment for Bipolar and Mood Disorders Skill: Understand the Concepts LO 5.7: Differentiate treatments for bipolar and other mood disorders

5.2.78. In a case conference about a procedure you are about to perform on your depressed patient, the main topic is the amount of amnesia or memory loss they will experience as a result of the therapy. The treatment you are likely considering is ECT. Answer: True Difficulty: Moderate Question ID: 5.2.78 Topic: Treatment for Bipolar and Mood Disorders Skill: Apply What You Know LO 5.7: Differentiate treatments for bipolar and other mood disorders 5.2.79. The highest suicide rate in the United States is among white males under 40 years old.

Answer: False Difficulty: Easy Question ID: 5.2.79 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health 5.2.80. Altruistic suicide occurs when the rules of a society or social group dictate that an individual must sacrifice his life for the good of the group.

Answer: True Difficulty: Moderate Question ID: 5.2.80 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

Essay 5.3.81. What are the two primary issues central to the debate regarding definitions of mood disorders?

What are the five major considerations we can use in distinguishing clinical depression from normal sadness?

Answer: (1) should these disorders be defined in a broad or narrow fashion? (2) the issue of heterogeneity. All depressed persons do not have the same set of symptoms, same pattern of onset, or the same course over time. Some patients have manic episodes, whereas others experience only depression. Some exhibit psychotic symptoms, such as delusions and hallucinations. The important considerations in distinguishing clinical depression from normal sadness are: (1) Intensity: The mood change pervades all aspects of the person and impairs social and occupational functions. (2) Absence of precipitants: The mood may arise in the absence of any discernible precipitant or may be grossly out of proportion to those precipitants. (3) Quality: The mood change is different from that experienced in normal sadness. (4) Associated features: The change in mood is accompanied by a cluster of signs and symptoms, including cognitive and somatic features. (5) History: The mood change may be preceded by a history of past episodes of elation and hyperactivity.

Difficulty: Moderate Question ID: 5.3.81 Topic: Symptoms Skill: Understand the Concepts LO 5.1: Identify symptoms associated with depression 5.3.82. What has research revealed concerning the rate of depression among the elderly?

Answer: Although people mistakenly identify depression with the elderly, data from the NCS-R suggest that mood disorders actually are more frequent among young and middle-aged adults.

The rates of both major depression and bipolar mood disorder are lowest among people over age 60. Several explanations have been offered for this pattern. It is possible that this finding is due to how the research was conducted, not actual differences in the rate of depression across age groups. One interpretation is that the elderly have greater difficulty remembering episodes of depression. In addition, mood disorders are associated with increased mortality; thus, some severely depressed people might not have survived into old age. However, the pattern observed in the NCS-R has been observed in several studies, and most investigators believe the effect (lower rates of depression among the elderly) is genuine.

Difficulty: Moderate Question ID: 5.3.82 Topic: Course, Outcome, and Frequency Skill: Understand the Concepts LO 5.3: Compare factors influencing depressive and bipolar disorder outcomes

5.3.83. Summarize the findings of research investigating the relationship between stressful life events and depression, and then explain why it is difficult to interpret what the relationship means.

Answer: People who become clinically depressed experience an increased number of stressful life events. Comparisons among different populations show that communities with the highest rates of severe events produced the highest prevalence of major depression. One troublesome problem involves the direction of the relationship. If depressed people experience more stressful events, what is the direction of effect? Does failure lead to depression, or does depression lead to failure?

Another problem is that many people who experience stressful life events do not become depressed, and we don’t always know who will become depressed. The research of Brown, Harris, and others points to “severe” events, ones that are particularly threatening, as factors in the cause of depression, especially in women. Events that lead to humiliation, entrapment or defeat seem to be particularly related to depression.

Difficulty: Difficult Question ID: 5.3.83 Topic: Causes: Social and Psychological Factors Skill: Analyze It LO 5.4: Analyze the socio-psychological causes of mood disorders 5.3.84. Discuss the concept of cognitive vulnerability as a model of the cause of depression.

Answer: There are several cognitive models of the etiology of depression. One model is based on the work of Aaron Beck who suggests that people develop, through the course of their lives, habitual ways of looking at the world and themselves. These cognitive patterns determine how they interpret and react to life events. Some patterns, or habitual ways of thinking and perceiving, make an individual more vulnerable to depression. From this perspective, persistent negative or pessimistic thoughts would be such a vulnerability. Various types of distortions, errors or biases in thinking or perceiving, such as a tendency to assign a global, personal meaning to negative experiences, would be conducive to depression. There are several cognitive distortions that could be mentioned here including a tendency to overgeneralize negative conclusions from one negative experience, a tendency to draw arbitrary inferences about one’s self without evidence, and a tendency to exaggerate any negative experience. Mention should be made of Beck’s concept of schema, which is a cognitive term for the collection of assumptions, attributions, and ways of perceiving that guide ones cognitive habits or tendencies.

Difficulty: Moderate Question ID: 5.3.84 Topic: Causes: Social and Psychological Factors Skill: Apply What You Know LO 5.4: Analyze the socio-psychological causes of mood disorders

5.3.85. What are the two response styles described by Nolen-Hoeksema? How are these response styles related to depression?

Answer: Nolen-Hoeksema has proposed that the manner in which a person responds to the onset of a depressed mood influences its duration and severity. Ruminative styles involve responding to feelings of depression by turning attention inward, contemplating causes and implications of sadness. Distracting style involves diverting oneself from unpleasant mood by working on hobbies, playing sports, etc. People with ruminative style experience longer and more severe episodes of depression than do people with distracting style. Women tend to use the ruminative style.

Difficulty: Moderate Question ID: 5.3.85 Topic: Causes: Social and Psychological Factors Skill: Understand the Concepts LO 5.4: Analyze the socio-psychological causes of mood disorders 5.3.86. Describe the research results suggesting that there is a greater genetic influence on bipolar disorder than on depressive disorder.

Answer: (1) There is a greater difference in the concordance rates for MZ and DZ twins in the case of bipolar disorder than in the case of depressive disorder. (2) The rate of bipolar disorder in family members of depressive patients is similar to the rate in the general population, but the rate of depressive disorder in family members of bipolar patients is higher than the rate in the general population.

Difficulty: Moderate Question ID: 5.3.86 Topic: Causes: Biological Factors Skill: Apply What You Know LO 5.5: Evaluate the biological impact on mood disorders 5.3.87. Briefly describe the brain regions that have been associated with a biological model of the cause of depression.

Answer: There are several brain regions currently associated with models of the cause of depression. Likely they interact in some complicated fashion, but we are still in the process of sorting out their individual contributions. Mention could be made of the following.

Hypothalamic–pituitary–adrenal (HPA) axis: When the CNS perceives a threat, it signals the hypothalamus, which in turn signals the pituitary gland to secrete the hormone ACTH. The ACTH modulates the secretion of, for example, cortisol from the adrenal cortex ,which helps the individual prepare for fight or flight in a number of ways. Depressed patients show a failure of suppression of the HPA axis after being given DST, which suggests that they have, during depression, a hyperactive HPA axis. Stress causes the release of adrenal steroids, such as cortisol, which has been shown to cause structural and functional changes in the brain, including alterations in gene expression that are associated with depression. Functional imaging of the brain suggests abnormal activation in several regions of the brain, including decreased activity in the regions of the prefrontal cortex (PFC) responsible for planning and the anticipation of emotion; increased activity in the region of the PFC responsible for the experience of reward and punishment; the anterior cingulate cortex (ACC), which is activated when a person’s goals are frustrated; increased activity in the amygdale, which is the part of the limbic system responsible for emotional experiences. Individuals who respond well to any form of therapy show reduced activity in the amygdala.

Difficulty: Difficult Question ID: 5.3.87 Topic: Causes: Biological Factors Skill: Apply What You Know LO 5.5: Evaluate the biological impact on mood disorders 5.3.88. Summarize what is currently known about the effectiveness of psychotherapy and medication in the treatment of depression, and cite some of the research evidence.

Answer: There are several different kinds of antidepressant medications, but they are generally equal in terms of effectiveness, with positive responses being shown by 50 to 60 percent of depressed patients. Cognitive therapy and antidepressant medication appear to be equally effective for people who suffer from depressive disorder, including major depressive disorder and dysthymia. Medication and psychotherapy also appeared equally effective in randomized trials conducted in primary care settings, with 64 percent of patients recovering from an episode of depression after 11 weeks of treatment with either an SSRI or problem-solving therapy.

Difficulty: Moderate Question ID: 5.3.88 Topic: Treatment for Depressive Disorders Skill: Apply What You Know LO 5.6: Describe treatments for depressive disorders 5.3.89. Discuss Joiner’s (closely related to Schneidman’s) model of the psychological factors that are involved in the cause of suicide. Mention the common elements of suicide.

Answer: For Joiner, social factors can set the stage for thoughts or motivations of suicide, but psychological events lie at the core of suicidal behavior. Emotional stress and hopelessness are central features of many individuals who actually attempt suicide. Joiner, and others, consider the common elements of suicidal psychology to focus on an attempt to escape from unbearable psychological pain, often the pain associated with prolonged frustration of basic psychological needs. Most important are the needs for affiliation and competence. People who view themselves as having failed in these domains—those who are low in belongingness or high in burdensomeness—will experience intense negative emotional states, such as shame, guilt, anger, and grief. Suicide then becomes a somewhat logical route to escape this ongoing pain caused by these psychological states. Of particular association with the act of suicide are the belief and experience of being socially isolated and being a burden to others.

Difficulty: Moderate Question ID: 5.3.89 Topic: Suicide Skill: Understand the Concepts LO 5.8: Characterize the relationship between suicide and mental health

5.3.90. What are some of the recommendations for dealing with individuals who have expressed a serious intent to harm themselves?

Answer: (1) reduce the lethality: reduce psychological pain and reduce access to means of committing suicide; (2) negotiate agreements: ask the client to sign a contract agreeing to postpone self-destructive behavior for at least a short period of time, include an agreement that the client will contact the therapist directly before engaging in any lethal actions; (3) provide support: make concrete arrangements for social support, alert friends and family members to be available; (4) replace tunnel vision with a broader perspective: suicidal individuals are often unable to consider alternative solutions for their problems; help clients to use a more flexible and adaptive pattern of problem solving to replace death as the only solution.

Difficulty: Moderate Question ID: 5.3.90 Topic: Suicide Skill: Apply What You Know LO 5. 8: Characterize the relationship between suicide and mental health 5.3.91. Discuss the concept of genetic risk interacting with stress as demonstrated in the work of Caspi on the 5-HTT gene.

Answer: Caspi’s work focused on the 5-HTT transporter gene, which has been studied because several drugs that are used to treat depression have a direct impact on this particular neurotransmitter. There are two alleles or different versions of this gene, one of which is shorter and is associated with reduced efficiency of neural transmission in serotonin pathways.

Individuals who inherit this short allele or version of the gene are at particularly high risk for becoming clinically depressed if they experience stressful life events. In the absence of increased stress, the presence of this gene does not increase the person’s risk for depression. Both factors seem to be necessary.

Difficulty: Difficult Question ID: 5.3.91 Topic: Causes: Biological Factors Skill: Apply What You Know LO 5.5: Evaluate the biological impact on mood disorders

Chapter 6 Anxiety Disorders and Obsessive-Compulsive Disorder Total Assessment Guide (T.A.G.) Topic

Introduction

Question Type

Understand the Concepts Multiple Choice 1,3 51,55 True/False

Apply What You Know 2

88 Essay Multiple Choice 4,5,6,7,8,10,12 9,11 Symptoms of Anxiety Disorders Diagnosis of Anxiety Disorders

True/False

52,53,57

81 Essay Multiple Choice 13,14 True/False

54,56,59

Essay Multiple Choice 17,18,19,20 Frequency of Anxiety True/False 60,61,62 Disorders Essay Multiple Choice 21,22,31,32 Causes of Anxiety Disorders: Social and True/False 63,67,70,71 Biological Factors Essay Multiple Choice 24,25,29,30 Causes of Anxiety True/False 64,65,66,69 Disorders: Psychological Essay Factors Multiple Choice 33,37,38,39 Treatment of Anxiety True/False 72,73,75 Disorders Essay Obsessive-Comp. and Related Disorders: Symptoms & Diagnosis Obsessive-Comp. and Related Disorders: Frequency & Treatment

15,16 58 89

84 23 86 26,27,28 90 34,35,36,40 74 87

Multiple Choice 41,42,44 True/False 76,77,78 82 Essay

43,45

Multiple Choice 46,49,50 79,80 True/False 85 Essay

47,48

83

Analyze It

Evaluate It

Chapter 6: Anxiety Disorders and Obsessive-Compulsive Disorder Multiple Choice 6.1.1. that

The close relationship between symptoms of anxiety and the symptoms for depression suggests

a. b. c. d.

anxiety and depression are really the same emotion. these disorders may share common etiological features. psychological testing is needed to tell them apart. anxiety and depression are not true mental disorders.

Answer: b.

Difficulty: Easy Question ID: 6.1.1 Topic: Introduction Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.1.2.

In which of these situations would an agoraphobic be most likely to exhibit avoidance or fear?

a. b. c. d.

touching an insect swimming in a backyard pool being at the top of a tall building sitting in the middle of a row in a crowded theater Answer: d.

Difficulty: Moderate Question ID: 6.1.2 Topic: Introduction Skill: Apply What You Know LO 6.2: Classify anxiety disorders according to their symptoms

6.1.3. According to the case study of the writer presented in your textbook, why would individuals with agoraphobia feel terrified of crowds? a. b. c. d.

They fear people.

They are paranoid.

They have low self-esteem.

They fear not being able to escape.

Answer: d.

Difficulty: Easy Question ID: 6.1.3 Topic: Introduction Skill: Understand the Concepts LO 6.2: Classify anxiety disorders according to their symptoms

6.1.4.

Anxiety is a reaction to

a. b. c. d.

avoidance. impaired insight. anticipated future problems. an immediate threat from the environment.

Answer: c.

Difficulty: Easy Question ID: 6.1.4 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.1.5.

In what way is fear different from anxiety?

a. b. c. d.

Fear is more general.

Fear occurs appropriately in the face of real danger.

Fear is associated with anticipation of future problems.

Fear is out of proportion to threats from the environment.

Answer: b.

Difficulty: Easy Question ID: 6.1.5 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.1.6.

Which of the following is typically associated with an anxious mood?

a. b. c. d.

fainting and cramps preoccupation with other people pessimistic thoughts and feelings organization and rehearsal of adaptive responses Answer: c.

Difficulty: Easy Question ID: 6.1.6 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.1.7. Worry is a relatively uncontrollable sequence of negative emotional thoughts and images concerned with a. b. c. d.

immediate danger. physiological hypoarousal. absence of positive affect. possible future threats or dangers.

Answer: d.

Difficulty: Easy Question ID: 6.1.7 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.1.8.

Worriers are preoccupied with

a. b. c. d.

fears fantasies affects “self-talk”

rather than unpleasant visual images.

Answer: d.

Difficulty: Easy Question ID: 6.1.8 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders 6.1.9. According to the DSM, which of the following questions would be most useful in distinguishing a panic attack from anxiety? a. b. c. d.

Do you experience a lot of nightmares?

Would you describe your symptoms as distressing?

Do your symptoms reach peak intensity within 10 minutes?

Are your symptoms difficult for you to control?

Answer: c.

Difficulty: Moderate Question ID: 6.1.9 Topic: Symptoms of Anxiety Disorders Skill: Apply What You Know LO 6.1: Identify symptoms associated with anxiety disorders

6.1.10. Under what circumstances is a panic attack said to be cued? a. b. c. d.

when it occurs only in predictable situations when it occurs without warning or “out of the blue” when it is triggered by real, not imagined, dangers when it is triggered by imagined, not real, dangers Answer: a.

Difficulty: Easy Question ID: 6.1.10 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.1.11. Which of the following situations is most likely to be associated with the development of a panic attack? a. b. c. d.

Al was out walking his dog when another dog barked loudly.

When Al was four years old, he almost drowned at the beach.

Al misinterpreted a sudden increase in his heart rate as evidence of a heart attack.

Al feels constantly on edge as a result of a long list of worries at work and at home.

Answer: c.

Difficulty: Moderate Question ID: 6.1.11 Topic: Symptoms of Anxiety Disorders Skill: Apply What You Know LO 6.1: Identify symptoms associated with anxiety disorders

6.1.12. Fear is not considered phobic unless a. b. c. d.

the person avoids contact with the source of the fear or experiences intense anxiety in the presence of the feared stimulus. the fear is generalized to more than one stimulus. the person has a failed attempt to repress the fear. the person experiences a parasympathetic storm.

Answer: a.

Difficulty: Easy Question ID: 6.1.12 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.1.13. DSM-5 approach to classifying anxiety disorders is based primarily on a. b. c. d.

a psychodynamic model of the cause of each disorder. descriptive features of each disorder. specific scores on tests of anxiety. a dimensional approach.

Answer: b.

Difficulty: Easy Question ID: 6.1.13 Topic: Diagnosis of Anxiety Disorders Skill: Understand the Concepts LO 6.2: Classify anxiety disorders according to their symptoms

6.1.14. Which of the following are contained in the current DSM categories of phobias? a. b. c. d.

linguistic, natural, and symbolic neurotic, physical, and psychotic agoraphobia, social, and specific generalized, antisocial, and non-specific Answer: c.

Difficulty: Easy Question ID: 6.1.14 Topic: Diagnosis of Anxiety Disorders Skill: Understand the Concepts LO 6.2: Classify anxiety disorders according to their symptoms

6.1.15. Bill worries about a long list of concerns. He finds himself constantly thinking about these topics at work, when he exercises, and as he tries to sleep. He is easily fatigued, can’t concentrate, and is often restless. He has been worrying like this for the past year. Bill seems to meet the criteria for the diagnosis of a. b. c. d.

agoraphobia. social phobia. generalized anxiety disorder. obsessive-compulsive disorder.

Answer: c.

Difficulty: Moderate Question ID: 6.1.15 Topic: Diagnosis of Anxiety Disorders Skill: Apply What You Know LO 6.2: Classify anxiety disorders according to their symptoms

6.1.16. Tim has been worried about his grades for more than three months. After hearing about the diagnosis of generalized anxiety disorder, he becomes convinced that he has the disorder himself. After seeing a mental health professional, what is he told? a. b. c. d.

He is actually suffering from the early stages of panic disorder.

His concern over grades is more indicative of obsessive-compulsive disorder.

He does not meet the criteria for generalized anxiety disorder in terms of length of time and number of worries.

The focus of his worry suggests that he is suffering from a phobic reaction rather than a generalized anxiety disorder.

Answer: c.

Difficulty: Difficult Question ID: 6.1.16 Topic: Diagnosis of Anxiety Disorders Skill: Apply What You Know LO 6.2: Classify anxiety disorders according to their symptoms

6.1.17. According to the National Comorbidity Survey Replication (NCS-R), which type of anxiety disorder is the most common? a. b. c. d.

specific phobias generalized anxiety disorder obsessive-compulsive disorder agoraphobia with panic attacks Answer: a.

Difficulty: Easy Question ID: 6.1.17 Topic: Frequency of Anxiety Disorders Skill: Understand the Concepts LO 6.3: Characterize the frequency of anxiety disorders

6.1.18. Prospective studies of the relationship between drinking problems and anxiety disorders suggest that a. b. c. d.

anxiety disorders lead to heavy drinking. heavy drinking increases the probability that an anxiety disorder will later develop. anxiety disorders can lead to heavy drinking, and heavy drinking can lead to anxiety disorders. the relationship exists for patterns of alcohol abuse but not for alcohol dependence.

Answer: c.

Difficulty: Moderate Question ID: 6.1.18 Topic: Frequency of Anxiety Disorders Skill: Understand the Concepts LO 6.3: Characterize the frequency of anxiety disorders

6.1.19. One study found that percent of people who met the criteria for one anxiety disorder also met the criteria for at least one other form of anxiety disorder or mood disorder. a. b. c. d.

10 25 50 75 Answer: c.

Difficulty: Moderate Question ID: 6.1.19 Topic: Frequency of Anxiety Disorders Skill: Understand the Concepts LO 6.3: Characterize the frequency of anxiety disorders

6.1.20. In Western societies anxiety is most frequently associated with work performance, whereas in non-Western societies, anxiety is most frequently associated with a. b. c. d.

family or religious concerns. personal appearance. intimate relationships. educational achievement.

Answer: a.

Difficulty: Moderate Question ID: 6.1.20 Topic: Frequency of Anxiety Disorders Skill: Understand the Concepts LO 6.3: Characterize the frequency of anxiety disorders

6.1.21. Current theories regarding the evolutionary significance of anxiety and fear suggest that a. b. c. d.

anxiety is viewed as often adaptive, but fear is not. fear is viewed as often adaptive, but anxiety is not. both emotional responses are adaptive in some circumstances. neither emotional response is considered to be adaptive under any circumstances.

Answer: c.

Difficulty: Moderate Question ID: 6.1.21 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Understand the Concepts LO 6.4: Explain how sociobiological factors affect the development of anxiety disorders

6.1.22. What conclusion was reached by researchers studying the relationship between stressful life events and anxiety/depressive disorders? a. b. c. d.

Stressful life events are much more common precursors of depression.

Stressful life events are much more common precursors of anxiety disorders.

Stressful events frequently precede the development of both anxiety and depressive disorders.

The reported association between life events and these disorders is the result of the tendency to expect such a relationship rather than a true association.

Answer: c.

Difficulty: Moderate Question ID: 6.1.22 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Understand the Concepts LO 6.4: Explain how sociobiological factors affect the development of anxiety disorders

6.1.23. According to John Bowlby’s research on agoraphobia in 1973 and in 1980, which of the following individuals would be at greatest risk for the onset of this disorder? a. b. c. d.

Alice, who has just changed her college major Teresa, who is having difficulty finding a job Sara, who has just moved away from home for her first year in college Christine, who has had an increase in the number of serious arguments with her parents Answer: d.

Difficulty: Difficult Question ID: 6.1.23 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Apply What You Know LO 6.4: Explain how sociobiological factors affect the development of anxiety disorders

6.1.24. After Harriet was in a bicycle accident, she became fearful of riding bicycles. Which theory of the development of phobias would explain this fear? a. b. c. d.

preparedness psychoanalytic operant conditioning classical conditioning Answer: d.

Difficulty: Easy Question ID: 6.1.24 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Understand the Concepts LO 6.5: Describe the impact of psychological factors on developing anxiety disorders

6.1.25. The preparedness model of phobic acquisition holds that phobias develop in response to a. b. c. d.

stimuli to which the person has had little exposure. objects with symbolic associations to sex and aggression. any neutral stimulus paired with an unconditioned stimulus. objects and situations that are fear-relevant.

Answer: d.

Difficulty: Moderate Question ID: 6.1.25 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Understand the Concepts LO 6.5: Describe the impact of psychological factors on developing anxiety disorders

6.1.26. One important element in the development of social phobias may be a biologically based preparedness to fear a. b. c. d.

large crowds. faces that appear angry or rejecting toward us. the body posture of people who are seen as important. unrelated persons more than biologically related persons.

Answer: b.

Difficulty: Moderate Question ID: 6.1.26 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Apply What You Know LO 6.5: Describe the impact of psychological factors on developing anxiety disorders

6.1.27. As a cognitive psychologist, you hypothesis that many factors can contribute to the cause of an anxiety disorder, but the following are especially important: a. b. c. d.

conditioned stimuli and responses. perceptions, memories, and attention. negative reinforcement. neurotransmitter levels.

Answer: b.

Difficulty: Moderate Question ID: 6.1.27 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Apply What You Know LO 6.5: Describe the impact of psychological factors on developing anxiety disorders

6.1.28. A patient with panic disorder tends to interpret the rapid beating of his heart as a heart attack; a cognitive psychologist would call this a. b. c. d.

automatic thinking. catastrophic misinterpretation. illusion of predictability. “what-if” thinking.

Answer: b.

Difficulty: Moderate Question ID: 6.1.28 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Apply What You Know LO 6.5: Describe the impact of psychological factors on developing anxiety disorders

6.1.29. Cognitive psychologists believe that people whose threat schemas contain a high proportion of “what-if” questions a. b. c. d.

are more likely to suffer from a conviction that they will fail. usually experience depression along with anxiety. experience a dramatic increase in negative affect. are able to avoid the experience of anxiety by suppressing their anxious thoughts.

Answer: c.

Difficulty: Moderate Question ID: 6.1.29 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Understand the Concepts LO 6.5: Describe the impact of psychological factors on developing anxiety disorders

6.1.30. According to cognitive models of anxiety, such as Borkovec, Alcaine, and Behar’s model, why do people continue to worry despite the fact that it is unproductive? a. b. c. d.

They have a superstition that worry will lead to symptom reduction.

Classical conditioning has led to an association between worry and cognitive stability.

The worry is reinforced by a temporary reduction in uncomfortable physiological sensations.

The worry results from activation of the superego in order to punish oneself for past misdeeds.

Answer: c.

Difficulty: Moderate Question ID: 6.1.30 Topic: Causes of Anxiety Disorders Skill: Understand the Concepts LO 6.5: Describe the impact of psychological factors on developing anxiety disorders

6.1.31. What have studies of the genetics of panic disorder and generalized anxiety disorder found concerning the genetic component in a model of the cause of these disorders? a. b. c. d.

both appear to be either modestly or moderately heritable neither appears to have a significant heritable component both have a very high heritable component generalized anxiety disorder has a high heritable component, but panic disorders appear to be very low Answer: a.

Difficulty: Easy Question ID: 6.1.31 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Understand the Concepts LO 6.4: Explain how sociobiological factors affect the development of anxiety disorders

6.1.32. The two different pathways in the brain involved in the detection of danger differ from one another with respect to a. b. c. d.

their roles in panic disorder versus specific phobia. the amount of conscious thinking and reasoning. the detection of reality-based versus unrealistic threats. their presence in humans versus lower animals.

Answer: b.

Difficulty: Moderate Question ID: 6.1.32 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Understand the Concepts LO 6.4: Explain how socio-biological factors affect the development of anxiety disorders

6.1.33. Systematic desensitization involves a. b. c. d.

suppression of phobic thoughts. insight into unconscious motivations. exposure to the feared item while maintaining relaxation. dampening of physiological reactions with medication.

Answer: c.

Difficulty: Easy Question ID: 6.1.33 Topic: Treatment of Anxiety Disorders Skill: Understand the Concepts LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.1.34. Alex suffers from agoraphobia, and while in treatment he is asked to repeatedly confront places like crowded shopping malls and theaters that he has been avoiding. The treatment he is receiving is a. b. c. d.

stimulus generalization. stimulus discrimination. situational exposure. avoidance reconditioning.

Answer: c.

Difficulty: Moderate Question ID: 6.1.34 Topic: Treatment of Anxiety Disorders Skill: Apply What You Know LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.1.35. Pamela experiences frequent unexpected panic attacks. A treatment that could help her to reduce her fear of bodily sensations that seem to trigger her panic attacks would be a. b. c. d.

situational exposure. interoceptive exposure. flooding. deep breathing.

Answer: b.

Difficulty: Moderate Question ID: 6.1.35 Topic: Treatment of Anxiety Disorders Skill: Apply What You Know LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.1.36. A therapist asks a patient to describe what he believes would happen if his worst-case scenario became reality. The patient says, “If I fail this test, I'll never get into graduate school.” What cognitive aspect is the therapist working with? a. b. c. d.

self-fulfilling prophecy automatic thinking decatastrophizing all-or-nothing thinking Answer: c.

Difficulty: Moderate Question ID: 6.1.36 Topic: Treatment of Anxiety Disorders Skill: Apply What You Know LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.1.37. A psychiatrist prescribes a benzodiazepine for a patient suffering from an anxiety disorder. Which of the following symptoms are most likely to respond to this treatment? a. b. c. d.

worry and rumination palpitations and rumination rumination and muscle tension muscle tension and palpitations Answer: d.

Difficulty: Easy Question ID: 6.1.37 Topic: Treatment of Anxiety Disorders Skill: Understand the Concepts LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.1.38. Which neurotransmitter is affected by benzodiazepine drugs? a. b. c. d.

GABA dopamine acetylcholine norepinephrine Answer: a.

Difficulty: Moderate Question ID: 6.1.38 Topic: Treatment of Anxiety Disorders Skill: Understand the Concepts LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.1.39. Another class of antianxiety medication is known azapirones. Rather than working on GABA neurons, this antianxiety medication works on transmission. a. b. c. d.

dopamine serotonin amygdala sympathetic Answer: b.

Difficulty: Moderate Question ID: 6.1.39 Topic: Treatment of Anxiety Disorders Skill: Understand the Concepts LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.1.40. At a meeting of psychiatrists, you see a sign for a session titled “Antidepressant drugs: Not just for depression.” A summary of the session indicates that the speaker will outline how selective serotonin reuptake inhibitors can be used in treating anxiety disorders. What are some reasons for using these drugs instead of antianxiety drugs? a. b. c. d.

They are cheaper and act faster.

They act naturally and do not affect appetite.

They have fewer side effects and are safer to use.

They are much more powerful and can be used in smaller doses.

Answer: c.

Difficulty: Moderate Question ID: 6.1.40 Topic: Treatment of Anxiety Disorders Skill: Apply What You Know LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.1.41. Repetitive, unwanted, intrusive cognitive events in the form of thoughts, images, or impulses that intrude suddenly into consciousness are called a. b. c. d.

phobias. disorders. obsessions. compulsions.

Answer: c.

Difficulty: Easy Question ID: 6.1.41 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Understand the Concepts LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders

6.1.42. What are compulsions? a. b. c. d.

a type of obsession normal feelings of drive intrusive, unwanted thoughts irrational, repetitive behaviors or mental acts Answer: d.

Difficulty: Easy Question ID: 6.1.42 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Understand the Concepts LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders

6.1.43. What motivated Ed, in the case presented in your text, to rush to the mailbox and tear open an envelope containing a form that he had just completed? a. b. c. d.

He feared he would let down his company if his work was not perfect.

He was afraid that his writing contained symbolic representations of hidden sexual desires.

He thought his writing of a particular letter would be associated with the strangulation of his wife.

He thought the evil voices he heard would punish him for his failure to follow their plan as they had instructed.

Answer: c.

Difficulty: Moderate Question ID: 6.1.43 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Apply What You Know LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders

6.1.44. Compulsives can sometimes resist their compulsions, but they usually return to their compulsive behavior because they a. b. c. d.

will become more distressed if they do not engage in the compulsive behavior. miss the pleasure produced by their compulsions. do not view their compulsions as a problem. need the attention that their compulsive behaviors attracts.

Answer: a.

Difficulty: Moderate Question ID: 6.1.44 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Understand the Concepts LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders

6.1.45. You are starting a research project in which you wish to compare the everyday compulsive behavior of individuals not diagnosed with a mental disorder with the most common forms of compulsive behavior found in those diagnosed with OCD. What are the two most common forms of compulsion found in those so diagnosed? a. b. c. d.

eating and dressing escape and avoidance checking and cleaning counting and collecting Answer: c.

Difficulty: Moderate Question ID: 6.1.45 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Apply What You Know LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders

6.1.46. Studies of the long-term course of obsessive-compulsive disorder indicate that which of the following is true? a. b. c. d.

60 percent of patients demonstrate recovery after one year.

At a 40-year follow-up, approximately 30 percent show improvement.

Approximately 50 percent of patients still show symptoms after 30 years.

A higher percentage of females than males had not relapsed after 30 years.

Answer: c.

Difficulty: Moderate Question ID: 6.1.46 Topic: Obsessive-Compulsive and Related Disorders: Frequency and Treatment Skill: Understand the Concepts LO 6.8: Outline the experience of obsessive-compulsive disorder from causes to outcomes

6.1.47. According to Wegner, what typically happens when people prone to anxiety disorders try to rid their mind of distressing or unwanted thoughts? a. b. c. d.

The thoughts actually become more associated with emotions.

They relax because physiological cues are decreased.

Physiological changes in the brain attempt to repress the unwanted thoughts.

The thoughts are replaced with scenes related to images from previous dreams.

Answer: a.

Difficulty: Moderate Question ID: 6.1.47 Topic: Obsessive-Compulsive and Related Disorders: Frequency and Treatment Skill: Apply What You Know LO 6.8: Outline the experience of obsessive-compulsive disorder from causes to outcomes

6.1.48. Your textbook presents the case study of Ed, a 38-year-old lawyer diagnosed with OCD. What was the first form of treatment Ed received for this disorder? a. b. c. d.

sugar (placebo) an anticonvulsant antidepressant medication an antianxiety drug Answer: c.

Difficulty: Moderate Question ID: 6.1.48 Topic: Obsessive-Compulsive and Related Disorders: Frequency and Treatment Skill: Apply What You Know LO 6.8: Outline the experience of obsessive-compulsive disorder from causes to outcomes

6.1.49. Exposure and response prevention is most effective in the treatment of a. b. c. d.

panic attacks. social phobias. generalized anxiety disorder. obsessive-compulsive disorder.

Answer: d.

Difficulty: Easy Question ID: 6.1.49 Topic: Obsessive-Compulsive and Related Disorders: Frequency and Treatment Skill: Understand the Concepts LO 6.8: Outline the experience of obsessive-compulsive disorder from causes to outcomes

6.1.50. Brain imaging studies of patients with obsessive-compulsive disorder (OCD) show that OCD a. b. c. d.

has neurological foundations similar to other anxiety disorders. has neurological foundations different from other anxiety disorders. has no neurological foundation. can be related to danger-detection pathways.

Answer: b.

Difficulty: Moderate Question ID: 6.1.50 Topic: Causes of Anxiety Disorders Skill: Understand the Concepts LO 6. 8: Outline the experience of obsessive-compulsive disorder from causes to outcomes

True/False 6.2.51. According to the National Comorbidity Survey Replication (NCS-R), in any given year, approximately 10 percent of adults suffer from at least one type of anxiety disorder.

Answer: False Difficulty: Easy Question ID: 6.2.51 Topic: Introduction Skill: Understand the Concepts LO 6.3: Characterize the frequency of anxiety disorders 6.2.52. Anxiety can be adaptive at low levels.

Answer: True Difficulty: Easy Question ID: 6.2.52 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.2.53. Panic attacks that are cued are less severe than unexpected panic attacks.

Answer: False Difficulty: Moderate Question ID: 6.2.53 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders 6.2.54. Altaphobia is the term for a fear of flying.

Answer: False Difficulty: Moderate Question ID: 6.2.54 Topic: Diagnosis of Anxiety Disorders Skill: Understand the Concepts LO 6.2: Classify anxiety disorders according to their symptoms

6.2.55. Agoraphobia refers to an exaggerated fear of being in situations from which escape might be difficult, such as being caught in a traffic jam, on a bridge, or in a tunnel.

Answer: True Difficulty: Easy Question ID: 6.2.55 Topic: Introduction Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders 6.2.56. Phobias are persistent, irrational, narrowly defined fears that are associated with specific objects or situations.

Answer: True Difficulty: Easy Question ID: 6.2.56 Topic: Diagnosis of Anxiety Disorders Skill: Understand the Concepts LO 6.2: Classify anxiety disorders according to their symptoms 6.2.57. Laboratory research indicates that feelings of lack of control contribute to the onset of panic attacks among patients with panic disorder.

Answer: True Difficulty: Easy Question ID: 6.2.57 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders

6.2.58. A differential diagnosis between social and specific phobia is a bit tricky. You need to look for the most important difference between social phobia and specific phobia, which is that social phobia involves both the element of performance and interpersonal interactions.

Answer: True Difficulty: Moderate Question ID: 6.2.58 Topic: Diagnosis of Anxiety Disorders Skill: Apply What You Know LO 6.2: Classify anxiety disorders according to their symptoms 6.2.59. Research on the long-term outcomes for people experiencing anxiety disorders indicates that even with therapy, long-term outcomes are generally poor.

Answer: False Difficulty: Moderate Question ID: 6.2.59 Topic: Diagnosis of Anxiety Disorders Skill: Understand the Concepts LO 6.2: Classify anxiety disorders according to their symptoms 6.2.60. Among those diagnosed with an anxiety disorder the relapse rates are higher for men than for women.

Answer: False Difficulty: Moderate Question ID: 6.2.60 Topic: Frequency of Anxiety Disorders Skill: Understand the Concepts LO 6.3: Characterize the frequency of anxiety disorders 6.2.61. Compared to the prevalence rates among other age groups, the prevalence of anxiety is lower among the elderly.

Answer: True Difficulty: Moderate Question ID: 6.2.61 Topic: Frequency of Anxiety Disorders Skill: Understand the Concepts LO 6.3: Characterize the frequency of anxiety disorders 6.2.62. The symptoms of various anxiety disorders overlap considerably. When a person meets the diagnostic criteria for more than one disorder, this is known as comorbidity.

Answer: True Difficulty: Easy Question ID: 6.2.62 Topic: Frequency of Anxiety Disorders Skill: Understand the Concepts LO 6.3: Characterize the frequency of anxiety disorders

6.2.63. Ambivalent attachment has been reported to be associated with the development of agoraphobia.

Answer: False Difficulty: Moderate Question ID: 6.2.63 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Understand the Concepts LO 6.4: Explain how sociobiological factors affect the development of anxiety disorders 6.2.64. Research has consistently found evidence that problems with anxiety show up at high rates in people who believe that they are not in control of events.

Answer: True Difficulty: Moderate Question ID: 6.2.64 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Understand the Concepts LO 6.5: Describe the impact of psychological factors on developing anxiety disorders 6.2.65. The observation that conditioned responses to fear-relevant stimuli, such as spiders and snakes, are more resistant to extinction than are those responses to fear-irrelevant stimuli, such as flowers, supports the preparedness model.

Answer: True Difficulty: Moderate Question ID: 6.2.65 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Understand the Concepts LO 6.5: Describe the impact of psychological factors on developing anxiety disorders 6.2.66. D.M. Clark, a psychologist, suggests that panic disorder may be caused by the catastrophic misinterpretations of bodily sensations or perceived threat.

Answer: True Difficulty: Easy Question ID: 6.2.66 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Understand the Concepts LO 6.5: Describe the impact of psychological factors on developing anxiety disorders 6.2.67. Work by LeDoux and others suggests that the hippocampus plays a central role in circuits in the brain designed to detect danger and organize a response to it.

Answer: False Difficulty: Easy Question ID: 6.2.67 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Understand the Concepts LO 6.4: Explain how sociobiological factors affect the development of anxiety disorders

6.2.68. While walking along the road, a car drives by and honks right next to you. The car hits your leg, and you are slightly injured. A few weeks later, you hear a car horn and become very nervous. In this scenario, the horn honking is a conditioned stimulus.

Answer: True Difficulty: Moderate Question ID: 6.2.68 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Apply What You Know LO 6.5: Describe the impact of psychological factors on developing anxiety disorders 6.2.69. A person with social phobia can perform a particular task when alone but not in front of an audience; according to Barlow’s model of anxious apprehension, this is due to misinterpreting the audience as hostile.

Answer: False Difficulty: Moderate Question ID: 6.2.69 Topic: Causes of Anxiety Disorders: Psychological Skill: Understand the Concepts LO 6.5: Describe the impact of psychological factors on developing anxiety disorders 6.2.70. Twin studies of anxiety disorders indicate that generalized anxiety disorder has a heritability of over 50 percent.

Answer: False Difficulty: Moderate Question ID: 6.2.70 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Understand the Concepts LO 6.4: Explain how sociobiological factors affect the development of anxiety disorders 6.2.71. The brain pathway that operates as a “short cut” in the detection of danger allows some threats to be responded to very quickly.

Answer: True Difficulty: Moderate Question ID: 6.2.71 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Understand the Concepts LO 6.4: Explain how sociobiological factors affect the development of anxiety disorders

6.2.72. In the years since systematic desensitization was originally proposed, many different variations on this procedure have been employed. The crucial feature of the treatment involves using medication to reduce the physiological responses.

Answer: False Difficulty: Moderate Question ID: 6.2.72 Topic: Treatment of Anxiety Disorders Skill: Understand the Concepts LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders 6.2.73. Flooding refers to the recovery of repressed memories.

Answer: False Difficulty: Easy Question ID: 6.2.73 Topic: Treatment of Anxiety Disorders Skill: Understand the Concepts LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders 6.2.74. Current evidence suggests that patients who receive both medication and psychotherapy may do better in the short run, but patients who receive only cognitive- behavioral therapy may do better in the long run because of difficulties that can be encountered when medication is discontinued.

Answer: True Difficulty: Moderate Question ID: 6.2.74 Topic: Treatment of Anxiety Disorders Skill: Apply What You Know LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders 6.2.75. Approximately 40 percentage of patients who have used a benzodiazepine for more than six months will experience withdrawal effects if they discontinue use of the drug.

Answer: True Difficulty: Moderate Question ID: 6.2.75 Topic: Treatment of Anxiety Disorders Skill: Understand the Concepts LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders 6.2.76. In the case of an anxiety disorder, behavior that represents an attempt to ensure the person’s safety or the safety and health of a friend or family member is known as compulsive monitoring.

Answer: False Difficulty: Easy Question ID: 6.2.76 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Understand the Concepts LO 6.7: Match symptoms to the diagnosis for obsessive-compulsive disorder and related disorders

6.2.77. Experts who classify mental disorders can be described informally as belonging to one of two groups. Those who argue that anxiety is a generalized condition or set of symptoms without any special subdivisions are referred to as lumpers.

Answer: True Difficulty: Easy Question ID: 6.2.77 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Understand the Concepts LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders 6.2.78. Patients diagnosed with obsessive-compulsive disorder typically view their compulsions as making sense.

Answer: False Difficulty: Moderate Question ID: 6.2.78 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Understand the Concepts LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders 6.2.79. Hoarding disorder is much less common than obsessive-compulsive disorder.

Answer: False Difficulty: Moderate Question ID: 6.2.79 Topic: Obsessive-Compulsive and Related Disorders: Frequency and Treatment Skill: Understand the Concepts LO 6.8: Outline the experience of obsessive-compulsive disorder from causes to outcomes 6.2.80. The episodic nature of obsessive-compulsive disorder symptoms is thought to be related to a rebound from attempts to suppress strong emotion.

Answer: True Difficulty: Moderate Question ID: 6.2.80 Topic: Obsessive-Compulsive and Related Disorders: Frequency and Treatment Skill: Understand the Concepts LO 6.8: Outline the experience of obsessive-compulsive disorder from causes to outcomes

Essay 6.3.81. Define phobia. Describe the difference between a phobia and a normal fear. Give an example of the difference between a phobia and a normal fear.

Answer: (1) A phobia is a persistent, irrational narrowly defined fear that is associated with a specific object or situation. (2) In contrast to a normal fear, phobia involves attempts to avoid an object that others do not find dangerous. (3) A person who fears cats may prefer not to be around them, and may show physiological arousal when close to a cat; a person who is phobic of cats would have an immediate fear reaction upon seeing a cat, and the person’s attempts to avoid getting closer to the cat might interfere with whatever the person was doing at the time.

Difficulty: Moderate Question ID: 6.3.81 Topic: Symptoms of Anxiety Disorders Skill: Understand the Concepts LO 6.1: Identify symptoms associated with anxiety disorders 6.3.82. Describe the nature of obsessions and compulsions in obsessive-compulsive disorder, and explain how they differ from “normal” obsessions and compulsions. Do both have to be present for the diagnosis of OCD to be made? Which typically comes first? What is their functional relationship?

Answer: Obsessions are repetitive, unwanted, intrusive thoughts or images or impulses that may seem silly or crazy, are anxiety-provoking, and are resisted strongly but unsuccessfully.

Compulsions are repetitive behaviors or mental acts that are used to reduce anxiety, especially the anxiety associated with the obsessions, and that do not produce any pleasure. Most patients with OCD show both obsessions and compulsions, but this is not necessary for the diagnosis. The person must recognize that the obsessions or compulsions are excessive or unreasonable. What’s more, the thoughts must not be simply excessive worries about real problems. Most normal people (80–90%) experience obsessive thoughts at times. Research suggests that the difference between normal obsessions and clinical obsessions is a matter of degree. In most cases, it would appear that the obsessive thoughts come first and that the compulsive behaviors are often an attempt to cope with the anxiety provoked by the obsessive thoughts.

Difficulty: Moderate Question ID: 6.3.82 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Understand the Concepts LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders

6.3.83. Compare and contrast the theoretical position of “lumpers” with that of “splitters” with regard to anxiety disorders.

Answer: Lumpers are theorists who suggest that there should be no subdivisions of anxiety disorders. For them, anxiety is anxiety and the particular manner in which it manifests is not particularly relevant. These theorists believe it is quite likely there is one etiological model that can account for all forms of anxiety disorders, and variations are only a matter of individual differences and life experiences. Splitters, on the other hand, suggest that we need different diagnostic categories for several variations of anxiety disorders. For them, the differences seen in anxiety disorder are due to different etiologies and, likely, different treatments. Splitters believe diagnostic distinctions will guide the research and treatment of what, for them, are different diseases. DSM-5 has taken splitting to a new level, as OCD and PTSD have now been removed from the group of anxiety disorders and are listed under separate headings. This has increased diagnostic precision for these disorders. However, the differing opinions of lumpers and splitters continues to be a point of controversy.

Difficulty: Difficult Question ID: 6.3.83 Topic: Obsessive-Compulsive and Related Disorders: Symptoms and Diagnosis Skill: Analyze It LO 6.7: Match symptoms to diagnosis for obsessive-compulsive disorder and related disorders 6.3.84. Discuss the prevalence rates of anxiety disorder across life spans, comparing adults with the elderly.

Answer: Prevalence rates for anxiety disorders are lower for individuals over 60 than those who are under 60, although there is some evidence that this rate may increase as individuals reach ages of 70 or 80 and encounter the inevitable fears of old age, disease and death. In addition it is relatively uncommon for an individual to develop an anxiety disorder later in life. Older adults diagnosed with anxiety disorder most likely developed the condition at an earlier age. The diagnostic process is also complicated by age. Some physical disorders associated with age, such as cardiovascular problems, have symptoms similar to some anxiety disorders. For example, hearing loss can lead one to behave in a way that looks like social avoidance. Now, if an elderly person has a physical trauma, such as a fall or a car accident, that leads her to go out less, should this be seen as a symptom of agoraphobia or a sensible precaution due to failing abilities?

Difficulty: Moderate Question ID: 6.3.84 Topic: Frequency of Anxiety Disorders Skill: Apply What You Know LO 6.3: Characterize the frequency of anxiety disorders

6.3.85. Describe the hypothesized role of thought suppression in the etiology of obsessive-compulsive disorder.

Answer: Attempts to disregard or forget a troubling thought may actually make the thought more intrusive, as the troubling thought becomes associated with the other thoughts meant to replace it.

The troubling thought also becomes associated with negative feelings, so that afterward the negative feelings can trigger the unwanted thought, and the unwanted thought can trigger negative feelings. As a result of the individual’s attempt to suppress strong emotions, a rebound effect may occur, culminating in a vicious cycle, which may help to explain the episodic nature of obsessive-compulsive symptoms.

Difficulty: Moderate Question ID: 6.3.85 Topic: Obsessive-Compulsive and Related Disorders: Frequency and Treatment Skill: Understand the Concepts LO 6.8: Outline the experience of obsessive-compulsive disorder from causes to outcomes 6.3.86. Discuss what is known about the role of genetics in anxiety disorders and whether evidence points toward specific genetic risks for specific disorders.

Answer: Genetic factors seem to be involved to a modest extent in all the anxiety disorders, with evidence for separate risks for panic disorder versus generalized anxiety disorder. However, although there is also a genetic risk for obsessive-compulsive disorder, it appears to be part of a more generalized increased risk for several types of anxiety disorder. The overall degree of heritability for anxiety disorders appears to be in the range of 20 to 30 percent.

Difficulty: Difficult Question ID: 6.3.86 Topic: Causes of Anxiety Disorders: Social and Biological Factors Skill: Apply What You Know LO 6.4: Explain how socio-biological factors affect the development of anxiety disorders 6.3.87. Which anxiety disorders respond to treatment with antianxiety medications? What are the major drugs used and what are their side effects?

Answer: In the past, the major class of drugs used to treat anxiety disorders was the benzodiazepine class. Examples of these drugs are diazepam (Valium) and alprazolam (Xanax).

These drugs tend to reduce symptoms of anxiety, especially vigilance and subjective somatic sensations. They reduce muscle tension, palpitations, perspiration, and gastrointestinal distress.

They have been used to treat generalized anxiety disorder and social phobias. The side effects include sedation and cognitive impairments; the most serious adverse effect is the potential for addiction. More recently, the selective serotonin reuptake inhibitors (e.g., Luvox, Prozac, Paxil) have become the preferred drugs for treating almost all forms of anxiety disorders. These drugs have fewer unpleasant side effects and are safer to use.

Difficulty: Moderate Question ID: 6.3.87 Topic: Treatment of Anxiety Disorders Skill: Apply What You Know LO 6.6: Evaluate the effectiveness of current treatments for anxiety disorders

6.3.88. Discuss the relationship between anxiety disorders and mood disorders. What do they have in common and what do these commonalities suggest?

Answer: From a descriptive point of view, both anxiety disorders and mood disorders are defined in terms of negative emotional responses. Both disorders frequently are accompanied by worry, guilt, and anger. Many patients who are anxious are also depressed, and many patients who are depressed are also anxious. The order in which these problems emerge can vary, but usually anxiety precedes the onset of depression. The similarities between symptoms of these two disorders suggests that they may share causal features. Stressful live events seem to play a role in the onset of both disorders, although the nature of the event seems to be a factor in determining the type of disorder that develops. Events involving danger, insecurity, or family discord are likely to result in the development of an anxiety disorder, whereas events involving a severe loss are likely to result in depression. From a biological perspective, certain brain regions and a number of neurotransmitters are involved in the etiology of both anxiety disorders and mood disorders.

Difficulty: Moderate Question ID: 6.3.88 Topic: Introduction Skill: Apply What You Know LO 6.1: Identify symptoms associated with anxiety disorders 6.3.89. Describe social anxiety disorder and the type of situations which are likely to be difficult for a person with this disorder.

Answer: Social anxiety disorder is characterized by a marked sense of fear or anxiety regarding social situations in which there is a possibility that the person may be closely observed or evaluated by others. People with this disorder are afraid of (and avoid) social situations which fall into two broad headings: doing something in front of unfamiliar people (performance anxiety) and interpersonal interactions (such as dating and social events). Fear of being humiliated or embarrassed is a key concern for them, and they may be characterized by others as being extremely shy.

Difficulty: Easy Question ID: 6.3.89 Topic: Diagnosis of Anxiety Disorders Skill: Apply What You Know LO 6.2: Classify anxiety disorders according to their symptoms

6.3.90. Discuss the theory that panic disorder may be caused by catastrophic misinterpretation of bodily sensations or perceived threat.

Answer: Although panic attacks can be precipitated by external stimuli, they are usually triggered by internal stimuli such as bodily sensations, thoughts, or images. On the basis of past experiences, these stimuli initiate an anxious mood, which leads to a variety of physiological sensations that accompany negative emotional reactions. Anxious mood is accompanied by a narrowing of the person’s attentional focus and an increased awareness of their bodily sensations.

The person then may misinterpret these physical sensations as a catastrophic event. An example would be a person who misinterprets an acceleration in his heartrate as meaning that he is about to have a heart attack. This reaction sets in motion the continuation of a feedback loop, with the misinterpretation enhancing the person’s sense of threat, and so on, until the process spirals out of control. Thus, both cognitive misinterpretation and biological reactions associated with the perception of threat are necessary for a panic attack to occur.

Difficulty: Moderate Question ID: 6.3.90 Topic: Causes of Anxiety Disorders: Psychological Factors Skill: Apply What You Know LO 6.5: Describe the impact of psychological factors on developing anxiety disorders

Chapter 7 Acute and Posttraumatic Stress Disorders, Dissociative Disorders, and Somatic Symptom Disorders Total Assessment Guide (T.A.G.) Topic

Introduction

Question Type Multiple Choice True/False

Understand the Concepts 1

Apply What You Know

51

Essay Acute and Posttraumatic Stress Disorders Frequency, Causes, and Treatment of PTSD and ASD

Dissociative Disorders

Multiple Choice True/False Essay Multiple Choice True/False

Multiple Choice True/False

Multiple Choice True/False

82 20,21,23,26,27 22,24,25,28 29 62,63,64,65,66, 67,68 84 30,33,35,36

Multiple Choice True/False Essay

Frequency, Causes, and Treatment of Somatic Symptom Disorders

31,32,34

69,70,71,72 85,89,90

Essay Somatic Symptom Disorders

3,4,5,7,8,9

52,53,54,55,56 81 11,12,13,14,15, 10,16,8,19 17 57,58,59,60,61

Essay

Essay Diagnosis, Causes, and Treatment of Dissociative Disorders

2,6

37,43

38,39,40,41, 42,44,45

73,74,75,76,77, 78,79 88

Multiple Choice True/False

46,47,48,49

Essay

86,87

80

50

Analyze It

Evaluate It

Chapter 7: Acute and Posttraumatic Stress Disorders, Dissociative Disorders, and Somatic Symptom Disorders Multiple Choice 7.1.1.

Which of the following is a good definition of dissociation?

a. b. c. d.

separation from loved ones withdrawal from intimate relationships and social isolation disruption of the mental processes of memory, consciousness, identity, and perception the disengagement of physiological from psychological processes Answer: c.

Difficulty: Easy Question ID: 7.1.1 Topic: Introduction Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders

7.1.2. An event that involves actual or threatened death, or serious injury to self or others, and creates intense feelings of fear, helplessness, or horror is defined by DSM-5 as involving a. b. c. d.

feelings of numbness. stress. traumatic stress. eustress.

Answer: c.

Difficulty: Easy Question ID: 7.1.2 Topic: Acute and Posttraumatic Stress Disorders Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders

7.1.3. Which of the following events would fit the DSM description of situations that could lead to posttraumatic stress disorder? a. b. c. d.

The car Ted was driving spun out of control and almost fell off a bridge; in the car, Ted waited helplessly to be rescued.

While driving on the interstate, Kevin passes the site of a serious bus accident that is commemorated by a stone monument.

The roller coaster ride was faster and had more turns than Alice had been told before she agreed to go on the ride with her friends.

The newspaper account of a bank robbery and the resulting gun fight between the robbers and police contained more vivid details than Frank expected.

Answer: a.

Difficulty: Easy Question ID: 7.1.3 Topic: Acute and Posttraumatic Stress Disorders

Skill: Apply What You Know LO 7.1: Compare acute and posttraumatic stress disorders 7.1.4. Ray has the diagnosis of acute stress disorder; Bob has been diagnosed as suffering from posttraumatic stress disorder. What is a major difference in their conditions? a. b. c. d.

Bob has had symptoms for longer than Ray has had symptoms.

Ray’s symptoms are the result of a social stressor, not a natural stressor.

Bob’s symptoms involve a greater level of autonomic nervous system activation.

Ray is likely to have more trouble sleeping than Bob, who is more likely to have appetite difficulties.

Answer: a.

Difficulty: Easy Question ID: 7.1.4 Topic: Acute and Posttraumatic Stress Disorders Skill: Apply What You Know LO 7.1: Compare acute and posttraumatic stress disorders

7.1.5. Your textbook discusses the case of Stephanie, who is a victim of rape. For months after her assault, Stephanie was constantly on the lookout for new threats. This condition is called a. b. c. d.

hypersensitivity. hypovigilance. hypervigilance.

Korsokoff’s syndrome.

Answer: c.

Difficulty: Moderate Question ID: 7.1.5 Topic: Acute and Posttraumatic Stress Disorders Skill: Apply What You Know LO 7.1: Compare acute and posttraumatic stress disorders

7.1.6. Which of the following is a common characteristic of acute stress disorder and posttraumatic stress disorder? a. b. c. d.

flashbacks sleepwalking multiple personalities increased parasympathetic nervous system arousal Answer: a.

Difficulty: Easy Question ID: 7.1.6 Topic: Acute and Posttraumatic Stress Disorder Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders

7.1.7. A psychologist wants to collect some information from individuals who have been diagnosed as suffering either acute stress disorder or posttraumatic stress disorder. Which of the following could provide the best indication of the presence of certain symptoms in these individuals? a. b. c. d.

They are asked to keep track of their calorie intake for a period of two months.

They are asked to fill out a questionnaire asking for basic demographic information.

They are videotaped as they wait to be interviewed and react to an unexpected loud noise.

They are asked to proceed to another building on campus and their speed of walking is measured.

Answer: c.

Difficulty: Moderate Question ID: 7.1.7 Topic: Acute and Posttraumatic Stress Disorder Skill: Apply What You Know LO 7.1: Compare acute and posttraumatic stress disorders

7.1.8. Marjorie has just experienced a traumatic event; she is feeling cut off from herself and her environment and reports feeling like a robot. A mental health professional would say that Marjorie is experiencing a. b. c. d.

derealization. depersonalization. amnesia. flashbacks.

Answer: b.

Difficulty: Easy Question ID: 7.1.8 Topic: Acute and Posttraumatic Stress Disorder Skill: Apply What You Know LO 7.1: Compare acute and posttraumatic stress disorders

7.1.9. A psychologist is interviewing a client who reports having experienced a severe trauma; before making a diagnosis of posttraumatic stress disorder, the psychologist would want to find evidence that the client is experiencing a. b. c. d.

dissociative symptoms. persistent symptoms of increased arousal. depression. physical symptoms, such as headaches or stomach distress.

Answer: b.

Difficulty: Moderate Question ID: 7.1.9 Topic: Acute and Posttraumatic Stress Disorder Skill: Apply What You Know LO 7.1: Compare acute and posttraumatic stress disorders

7.1.10. As a clinician, you would be most concerned about the probability of posttraumatic stress disorder in a victim of which of the following? a. b. c. d.

rape natural disaster minor car crash expected death of a loved one Answer: a.

Difficulty: Moderate Question ID: 7.1.10 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Apply What You Know LO 7.2: Relate the causes of stress disorders to their treatments

7.1.11. A psychologist is talking about the self-blame that occurs in cases of rape. What factors tend to influence such reactions to rape? a. b. c. d.

cultural myths that suggest women provoke rape deep-seated tendencies to punish oneself for past deeds a natural physiological reaction to restore a sense of justice pre-existing disorders such as obsessive-compulsive disorder Answer: a.

Difficulty: Moderate Question ID: 7.1.11 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments

7.1.12. A national study found that approximately from PTSD at some point.

percent of the people in the United States suffered

a. 2 b. 7

c. d.

12 15 Answer: b.

Difficulty: Moderate Question ID: 7.1.12 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments

7.1.13. Which of the following is the best description of the development of posttraumatic stress disorder (PTSD)? a. b. c. d.

Some individuals are predisposed to develop PTSD, and there is nothing they can do to stop its emergence.

The severity of the traumatic event is the most important factor in the development of PTSD. PTSD develops in individuals who have inherited certain physiological patterns, regardless of their level of exposure to trauma.

PTSD results from the interaction of a traumatic event occurring to individuals with certain risk factors such as a history of mental disorder or a susceptibility to PTSD. Answer: d.

Difficulty: Moderate Question ID: 7.1.13 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments

7.1.14. The National Comorbidity Study found that the course of posttraumatic stress disorder is best described as follows: a. b. c. d.

The person fully recovers.

Symptoms tend to diminish gradually.

Most people with PTSD report symptoms of the disorder 10 years later.

PTSD usually leads to severe alcohol and drug problems.

Answer: b.

Difficulty: Moderate Question ID: 7.1.14 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments

7.1.15. Research on social factors and the risk of posttraumatic stress disorder suggests a role of social support in the etiology of posttraumatic stress disorder (PTSD). It was found that veterans a. b. c. d.

who didn’t face the embarrassment of being treated as heroes had lower rates of PTSD. from units that encouraged independence had lower rates of PTSD. who did not receive social support on their return had high rates of PTSD. who had high social support through the Veterans Administration still had high rates of PTSD. Answer: c.

Difficulty: Easy Question ID: 7.1.15 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments

7.1.16. Following September 11, New York City college students had lower rates of PTSD if they were better at enhancing and suppressing emotional expression. This is an example of what psychologist Edna Foa calls emotional processing, which involves three key stages. Which of the following is one of her stages? a. b. c. d.

Victims need to engage in specialized counseling as soon as possible after the event.

Victims must engage emotionally with their traumatic memories.

Victims need to find a way to forget about their chaotic experience.

Victims must come to believe that the world is a terrible place.

Answer: b.

Difficulty: Moderate Question ID: 7.1.16 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Apply What You Know LO 7.2: Relate the causes of stress disorders to their treatments

7.1.17. Which of the following types of medication is most often prescribed for PTSD? a. b. c. d.

antianxiety medications antihypertensive medications antidepressant medications stimulant medications Answer: c.

Difficulty: Easy Question ID: 7.1.17 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments

7.1.18. Jane has been diagnosed with PTSD and has begun seeing a psychotherapist. Which of the following will be the most important strategy for her therapist to employ to achieve long-term benefit? a. b. c. d.

reexposure to the traumatic event stress-inoculation training emotional distancing reactivation of defense mechanisms Answer: a.

Difficulty: Moderate Question ID: 7.1.18 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Apply What You Know LO 7.2: Relate the causes of stress disorders to their treatments

7.1.19. Your friend has just come from a therapist who has recommended eye movement desensitization and reprocessing for posttraumatic stress disorder. Because you are taking a course in abnormal psychology, your friend asks what you think. Based on the literature, what would you say? a. b. c. d.

This technique is based on operant conditioning principles and seems quite effective.

This technique does not seem to have a theoretical basis, and the limited effectiveness it does show may be due to the fact that it involves exposure.

Classical conditioning provides the theoretical rationale for this technique that has had mixed results.

Because the eyes are the “window on the mind,” this technique explores hidden meanings related to traumatic events and has been extremely successful.

Answer: b.

Difficulty: Difficult Question ID: 7.1.19 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Apply What You Know LO 7.2: Relate the causes of stress disorders to their treatments

7.1.20. Which symptom of dissociative fugue can be used to distinguish fugue from the other dissociative disorders? a. b. c. d.

malingering identity confusion purposeful, unplanned travel inability to remember details of the past Answer: c.

Difficulty: Moderate Question ID: 7.1.20 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders

7.1.21. Jean Charcot influenced the thinking of Sigmund Freud and Pierre Janet. Specifically, Freud and Janet were influenced by Charcot’s a. b. c. d.

views on gynecology. integration of multiple personalities. use of hypnosis to treat and induce hysteria. discovery of biological causes of somatic symptom disorders.

Answer: c.

Difficulty: Easy Question ID: 7.1.21 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders

7.1.22. Why are studies that seem to demonstrate the phenomenon of implicit memory important? a. b. c. d.

They indicate that memory can only affect behavior when there is conscious remembering.

They show that unconscious mental processes really do not exist.

They represent a research technique that enables scientists to study unconscious processes.

They provide objective evidence for the existence of a dissociative disorder.

Answer: c.

Difficulty: Moderate Question ID: 7.1.22 Topic: Dissociative Disorders Skill: Apply What You Know LO 7.3: Describe symptoms associated with dissociative disorders

7.1.23. Some psychologists do not see hypnosis as an altered state of consciousness. How are they likely to view being hypnotized? a. b. c. d.

a form of depersonalization a form of dissociative amnesia a sign of predisposition to dissociation a response to suggestion and expectations Answer: d.

Difficulty: Moderate Question ID: 7.1.23 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders

7.1.24. After Linda witnessed a violent crime, she could not recall anything that happened before the trauma. Linda’s experience is an example of a. b. c. d.

fugue. dementia. regressive amnesia. dissociative amnesia.

Answer: d.

Difficulty: Moderate Question ID: 7.1.24 Topic: Dissociative Disorders Skill: Apply What You Know LO 7.3: Describe symptoms associated with dissociative disorders

7.1.25. While in his bedroom, Zack suddenly feels as if he is in a strange and unfamiliar place. Later, he experiences the feeling that his body does not belong to him. What is Zack experiencing? a. b. c. d.

fugue deja vu depersonalization identity disorder Answer: c.

Difficulty: Moderate Question ID: 7.1.25 Topic: Dissociative Disorders Skill: Apply What You Know LO 7.3: Describe symptoms associated with dissociative disorders

7.1.26. While, in DSM-5, fugue and dissociative amnesia are in the category of dissociative disorders, and ASD and PTSD are classified as trauma- and stressor-related disorders, many psychologists believe there is an important link between these separately categorized disorders. Which of the following provides evidence of such a link? a. b. c. d.

They are all closely tied to the phenomenon of recovered memories.

They all usually involve a clear and sudden trauma that, for most people, would be followed by a rapid return to normal psychological functioning.

They all involve some significant distortions of reality.

They are all chronic disorders from which a return to normal psychological functioning is very unlikely.

Answer: b.

Difficulty: Moderate Question ID: 7.1.26 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders

7.1.27. One of the greatest controversies in psychology today is the issue of recovered memories. Some individuals argue that such memories reveal past sexual abuse; others disagree. What is one of the concerns for those who raise questions about recovered memories? a. b. c. d.

Therapists may be suggesting the existence of such memories to their clients.

Many people cannot tell the difference between reality and what they may have dreamed.

Some psychotic individuals are reporting their delusions as examples of claimed sexual abuse.

Some clients are deliberately creating memories of sexual abuse in order to sue individuals against whom they have held grudges.

Answer: a.

Difficulty: Moderate Question ID: 7.1.27 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders

7.1.28. George Franklin was convicted of the murder of an 8-year-old that occurred over 20 years earlier.

What aspect of this case is of interest to psychologists? a. b. c. d.

Franklin claimed he committed the murder while in a dissociative state.

His daughter’s recovered memories were the basis for Franklin’s conviction.

A polygraph was used to identify those who were telling the truth about the murder.

Franklin was covering up for a crime committed by his daughter who developed dissociative fugue.

Answer: b.

Difficulty: Moderate Question ID: 7.1.28 Topic: Dissociative Disorders Skill: Apply What You Know LO 7.3: Describe symptoms associated with dissociative disorders

7.1.29. Neisser and Harsch interviewed people about how they learned about the explosion of the space shuttle Challenger, and what they were doing at the time. They interviewed people at the time of the explosion, and then three years later. What did they find at the three-year follow-up? a. b. c. d.

leading questions led to false memories hardly anyone remembered what they were doing about one-third had vivid but inaccurate memories nearly everyone showed accurate memories of where they were Answer: c.

Difficulty: Easy Question ID: 7.1.29 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders

7.1.30. What is the most common form of dissociative amnesia? a. b. c. d.

selective regressive continuous generalized Answer: a.

Difficulty: Easy Question ID: 7.1.30 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Understand the Concepts LO 7.4: Analyze the history of diagnosing dissociative disorders

7.1.31. Which of the following individuals is going through a depersonalization experience? a. b. c. d.

Peter who believes the world is out to get him Abigail who has amnesia for her name and identity Ronald who believes he has more than one personality Terry who has the sensation of floating above her body Answer: d.

Difficulty: Moderate Question ID: 7.1.31 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Apply What You Know LO 7.4: Analyze the history of diagnosing dissociative disorders

7.1.32. Research suggests many reasons to disbelieve the claims that dissociative disorders are prevalent but overlooked. Which of the following reasons presented in your textbook supports disbelieving these claims? a. b. c. d.

Most cases of DID are diagnosed by a large group of advocates from varied mental health backgrounds.

The increase in the frequency of the diagnosis correlated with the release of a popular book and movie.

DID is frequently diagnosed outside of Canada and the United States.

The diagnosis of DID has been associated with specific religious groups.

Answer: b.

Difficulty: Difficult Question ID: 7.1.32 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Apply What You Know LO 7.4: Analyze the history of diagnosing dissociative disorders

7.1.33. Some epidemiological studies, using instruments like the Dissociative Experiences Questionnaire (DEQ), have reported high rates of dissociative symptoms, but these studies are viewed skeptically because a. b. c. d.

dissociative symptoms cannot be measured based on self-reports. the symptoms measured by the DEQ are far less dramatic than those found in dissociative disorders. there is no agreement as to what dissociative symptoms should be measured. people with real dissociative disorders are not able to complete the DEQ. Answer: b.

Difficulty: Easy Question ID: 7.1.33 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Understand the Concepts LO 7.4: Analyze the history of diagnosing dissociative disorders

7.1.34. To test the role-playing hypothesis of dissociative identity disorder (DID), Nicholas Spanos and colleagues conducted analogue experiments in which they asked college students to play the role of an accused murderer. What have these studies shown? a. b. c. d.

Role playing causes dissociative identity disorder The symptoms of DID can be induced through hypnosis The ease of role-taking correlates with risk for DID Most individuals deny having a “hidden part,” even under hypnosis Answer: b.

Difficulty: Moderate Question ID: 7.1.34 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Apply What You Know LO 7.4: Analyze the history of diagnosing dissociative disorders

7.1.35. What is the basis for the controversy about the role of trauma in the etiology of dissociative identity disorder? a. b. c. d.

patients’ reluctance to disclose trauma poor reliability of the definition of trauma concern about the validity of retrospective reports case histories that show few cases associated with trauma Answer: c.

Difficulty: Moderate Question ID: 7.1.35 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Understand the Concepts LO 7.4: Analyze the history of diagnosing dissociative disorders

7.1.36. What is the main objective in treating patients with dissociative identity disorder? a. b. c. d.

stop abreaction reduce depersonalization induce amnesia for all but one personality reintegrate the different personalities into a whole Answer: d.

Difficulty: Easy Question ID: 7.1.36 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Understand the Concepts LO 7.4: Analyze the history of diagnosing dissociative disorders

7.1.37. Which of the following is characteristic of somatic symptom disorders? a. b. c. d.

They are the result of malingering.

They have no clear biological cause.

The symptoms are hypnotically induced.

The disorders consist of the presentation of impossible symptoms.

Answer: b.

Difficulty: Easy Question ID: 7.1.37 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7.5: Characterize somatic symptom disorders

7.1.38. Terry is unable to see, even though a medical examination reveals no physical problems with her eyes or brain. What is the most likely diagnosis? a. b. c. d.

illness anxiety disorder dissociative fugue conversion disorder psychosomatic disorder Answer: c.

Difficulty: Moderate Question ID: 7.1.38 Topic: Somatic Symptom Disorders Skill: Apply What You Know LO 7.5: Characterize somatic symptom disorders

7.1.39. Alice has lost sensitivity to pain only on the left side of her face. Why is it reasonable to suspect that Alice suffers from conversion disorder? a. b. c. d.

Conversion disorder often involves loss of sensitivity to pain.

Conversion disorder does not usually involve bilateral symptoms.

There is no possible organic explanation for why someone would lose pain sensation in the face.

The nerves involved in pain sensation do not divide the face neatly in half.

Answer: d.

Difficulty: Moderate Question ID: 7.1.39 Topic: Somatic Symptom Disorders Skill: Apply What You Know LO 7.5: Characterize somatic symptom disorders

7.1.40. If a patient with somatic symptom disorder is described as presenting symptoms in a histrionic manner what has the clinician concluded? a. b. c. d.

The physical symptoms do not make anatomical sense.

The patient’s report is filled with suspicious gaps of memory.

The patient’s symptoms are consistent with “la belle indifference.”

The symptoms were presented in a vague but seductive and dramatic manner.

Answer: d.

Difficulty: Moderate Question ID: 7.1.40 Topic: Somatic Symptom Disorders Skill: Apply What You Know LO 7.5: Characterize somatic symptom disorders

7.1.41. When Bob noticed a pain in his thigh, he was convinced it was the first sign of bone cancer.

Although X-rays revealed no sign of cancer, Bob sought the opinions of several other physicians who agreed with the original opinion. What mental disorder might Bob’s behavior indicate? a. b. c. d.

a mood disorder illness anxiety disorder conversion disorder catatonic schizophrenia Answer: b.

Difficulty: Moderate Question ID: 7.1.41 Topic: Somatic Symptom Disorders Skill: Apply What You Know LO 7.5: Characterize somatic symptom disorders

7.1.42. Frank is experiencing a lot of pain. His condition would be classified as a somatic symptom disorder in DSM-5 if a. b. c. d.

Frank’s pain is the expected result of a medical condition. the pain is chronic.

Frank is faking or intentionally producing the pain. psychological factors are judged to be significant.

Answer: d.

Difficulty: Moderate Question ID: 7.1.42 Topic: Somatic Symptom Disorders Skill: Apply What You Know LO 7.5: Characterize somatic symptom disorders

7.1.43. What part of the body is the most frequent preoccupation of individuals with body dysmorphic disorder? a. b. c. d.

brain sense organs facial features internal organs Answer: c.

Difficulty: Easy Question ID: 7.1.43 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7.5: Characterize somatic symptom disorders

7.1.44. Rick walks into the emergency room and asks to see a doctor. He explains that he has a fever, but he does not report that he gave himself an injection of dirty water that is probably responsible for his fever. Without this information, the medical staff cannot determine the cause of Rick’s fever, so they admit him for observation. Rick is delighted because he enjoys the “sick role.” After numerous tests are run, the staff is still puzzled, so they call for a psychiatric consult. The psychiatrist should consider the diagnosis of disorder. a. b. c. d.

factitious somatic symptom bipolar mood psychosomatic Answer: a.

Difficulty: Moderate Question ID: 7.1.44 Topic: Somatic Symptom Disorders Skill: Apply What You Know LO 7.5: Characterize somatic symptom disorders

7.1.45. Hannah’s doctors are convinced that her physical symptoms are not real, but they cannot decide whether this is an instance of malingering or factitious disorder. What factor will best help them to choose between these two possibilities? a. b. c. d.

the severity of her symptoms how long her symptoms have been affecting her whether she is achieving some specific external gain whether she seeks or refuses medical treatment Answer: c.

Difficulty: Moderate Question ID: 7.1.45 Topic: Somatic Symptom Disorders Skill: Apply What You Know LO 7.5: Characterize somatic symptom disorders

7.1.46. Which of these individuals is most likely to suffer from somatic symptom disorder? a. b. c. d.

Eight-year-old Alice who is from an upper socioeconomic background and is in grade-school at this time Sixty-five-year-old Harry who is from a lower socioeconomic background and has two college degrees Fifty-year-old John who is from an upper socioeconomic background and has a doctoral degree in education Twenty-two-year-old Mary who is from a lower socioeconomic background and has eight years of education Answer: d.

Difficulty: Moderate Question ID: 7.1.46 Topic: Frequency, Causes, and Treatment of Somatic Symptom Disorders Skill: Understand the Concepts LO 7.6: Outline the experience of somatic symptom disorders from cause to outcomes

7.1.47. People who suffer from somatic symptom disorder also commonly suffer from a. b. c. d.

delusions. nightmares. depression. factitious disorder.

Answer: c.

Difficulty: Easy Question ID: 7.1.47 Topic: Frequency, Causes, and Treatment of Somatic Symptom Disorders Skill: Understand the Concepts LO 7.6: Outline the experience of somatic symptom disorders from cause to outcomes

7.1.48. Which of the following is a significant problem in confirming a diagnosis of somatic symptom disorder? a. b. c. d.

Patients don’t always tell the truth about symptoms.

A true somatic illness will often be detected only later, after medical treatment has been exhausted.

There is no objective measure of a person’s pain.

Somatic symptom disorders overlap substantially with mood disorders.

Answer: b.

Difficulty: Moderate Question ID: 7.1.48 Topic: Frequency, Causes, and Treatment of Somatic Symptom Disorders Skill: Understand the Concepts LO 7.6: Outline the experience of somatic symptom disorders from cause to outcomes

7.1.49. According to the social view of the etiology of somatic symptom disorders, these disorders are more common in non-industrial societies and among the poorly educated in the United States. Why do people in these communities tend to develop these disorders? a. b. c. d.

They view therapists with great suspicion.

They typically live in very crowded conditions.

They learn to express emotions as physical symptoms.

They are subjected to more pollution and discrimination.

Answer: c.

Difficulty: Moderate Question ID: 7.1.49 Topic: Frequency, Causes, and Treatment of Somatic Symptom Disorders Skill: Understand the Concepts LO 7.6: Outline the experience of somatic symptom disorders from cause to outcomes

7.1.50. How would a therapist use cognitive-behavioral approaches to treat chronic pain? a. b. c. d.

use pain as a punisher reward successful coping and life adaptation reduce reinforcement for the sick role induce relaxation by using biofeedback Answer: b.

Difficulty: Moderate Question ID: 7.1.50 Topic: Frequency, Causes, and Treatment of Somatic Symptom Disorders Skill: Apply What You Know LO 7.6: Outline the experience of somatic symptom disorders from cause to outcomes

True/False 7.2.51. Trauma is defined in DSM-5 as an event that involves actual or threatened death, or serious injury to self or others, and creates intense feelings of fear, helplessness, or horror.

Answer: True Difficulty: Easy Question ID: 7.2.51 Topic: Introduction Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders

7.2.52. You are asked to review the DSM diagnostic criteria for traumatic stress disorders. The category under which category will you find these disorders is anxiety disorders.

Answer: False Difficulty: Easy Question ID: 7.2.52 Topic: Acute and Posttraumatic Stress Disorders Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders 7.2.53. To meet the DSM-5 criteria for PTSD, an individual must not only experience a traumatic event, but he must also exhibit the presence of one (or more) intrusion symptoms associated with that traumatic event.

Answer: True Difficulty: Easy Question ID: 7.2.53 Topic: Acute and Posttraumatic Stress Disorder Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders 7.2.54. Sudden memories during which a trauma is replayed in images or thoughts—often at full emotional intensity—are known as flashbacks.

Answer: True Difficulty: Easy Question ID: 7.2.54 Topic: Acute and Posttraumatic Stress Disorder Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders 7.2.55. Considered a dissociative symptom, derealization is a marked sense of unreality about yourself and the world around you.

Answer: True Difficulty: Moderate Question ID: 7.2.55 Topic: Acute and Posttraumatic Stress Disorder Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders 7.2.56. Many people with PTSD also suffer from other mental disorders, such as depression, anxiety, and/or drug abuse. This is known as concurrent conditions.

Answer: False Difficulty: Moderate Question ID: 7.2.56 Topic: Acute and Posttraumatic Stress Disorder Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders

7.2.57. Women are most likely to develop PTSD as a result of rape. For men, the leading cause is a result of auto accidents.

Answer: False Difficulty: Easy Question ID: 7.2.57 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments 7.2.58. A recent study found that 33 percent of rape survivors had thoughts of suicide?

Answer: True Difficulty: Moderate Question ID: 7.2.58 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments 7.2.59. Some individuals experience positive changes as a result of living through a traumatic event.

Psychologists label this rebound growth.

Answer: False Difficulty: Moderate Question ID: 7.2.59 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments 7.2.60. When people with PTSD are able to integrate the experience of trauma and find some broader reason or higher value for enduring it, they are engaging in the task of intellectualizing.

Answer: False Difficulty: Moderate Question ID: 7.2.60 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments 7.2.61. With respect to the value of critical incident stress debriefing (CISD), there is no evidence that CISD prevents PTSD. Answer: True Difficulty: Moderate Question ID: 7.2.61 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Understand the Concepts LO 7.2: Relate the causes of stress disorders to their treatments

7.2.62. Dissociative disorders are characterized by persistent, maladaptive disruptions in the integration of memory, consciousness, or identity.

Answer: True Difficulty: Easy Question ID: 7.2.62 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders 7.2.63. Summarized in your textbook, the case study called “Dallae’s Journey” involves a dissociative identity disorder.

Answer: False Difficulty: Easy Question ID: 7.2.63 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders 7.2.64. The view of contemporary psychology regarding unconscious processes is that they only play a role in abnormal emotion and cognition.

Answer: False Difficulty: Easy Question ID: 7.2.64 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders 7.2.65. Epstein has suggested that we have two systems of information processing: a rational system that uses abstract, logical knowledge and a(n) unconscious system that uses intuitive knowledge to respond more quickly.

Answer: False Difficulty: Difficult Question ID: 7.2.65 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders 7.2.66. Psychologists disagree as to the nature of hypnosis. Some see it as an altered state of consciousness, while others see it as merely an example of a social role.

Answer: True Difficulty: Moderate Question ID: 7.2.66 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders

7.2.67. Exceeding normal forgetfulness autobiographical amnesia involves a sudden inability to recall extensive and important personal information.

Answer: False Difficulty: Easy Question ID: 7.2.67 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders 7.2.68. Malingering is a cause of dissociative amnesia.

Answer: False Difficulty: Easy Question ID: 7.2.68 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms associated with dissociative disorders 7.2.69. Multiple personality disorder is now known as dissociative identity disorder.

Answer: True Difficulty: Easy Question ID: 7.2.69 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Understand the Concepts LO 7.4: Analyze the history of diagnosing dissociative disorders 7.2.70. Iatrogenic disorders involve the creation of a disorder by its treatment.

Answer: True Difficulty: Moderate Question ID: 7.2.70 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Understand the Concepts LO 7. 4: Analyze the history of diagnosing dissociative disorders 7.2.71. Not all psychologists agree that dissociative identity disorder is a psychological disorder. The most commonly asserted alternative hypothesis used to explain behavior described as “dissociative identity disorder” is that the patient has an affective disorder.

Answer: False Difficulty: Moderate Question ID: 7.2.71 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Understand the Concepts LO 7.4: Analyze the history of diagnosing dissociative disorders

7.2.72. Catharsis is the term is used to describe the emotional reliving of past traumatic experiences?

Answer: False Difficulty: Moderate Question ID: 7.2.72 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Understand the Concepts LO 7. 4: Analyze the history of diagnosing dissociative disorders 7.2.73. Somatic symptom disorders are characterized by unusual physical symptoms that occur in the absence of a known physical illness.

Answer: True Difficulty: Easy Question ID: 7.2.73 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7.5: Characterize somatic symptom disorders 7.2.74. A flippant lack of concern about symptoms, called “la belle indifference,” is sometimes observed in patients with psychosomatic illness.

Answer: False Difficulty: Easy Question ID: 7.2.74 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7. 5: Characterize somatic symptom disorders 7.2.75. Today, a somatic symptom disorder that is much more common than the type seen by Freud or Charcot is illness anxiety disorder, characterized by a history of multiple somatic complaints in the absence of organic impairments.

Answer: False Difficulty: Moderate Question ID: 7.2.75 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7. 5: Characterize somatic symptom disorders 7.2.76. The aspect of somatic symptom disorders that makes them different from medical disorders is that they cannot be explained by a known organic cause.

Answer: True Difficulty: Easy Question ID: 7.2.76 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7. 5: Characterize somatic symptom disorders

7.2.77. The symptoms of conversion disorder often resemble neurological diseases.

Answer: True Difficulty: Easy Question ID: 7.2.77 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7.5: Characterize somatic symptom disorders 7.2.78. Body dysmorphic disorder is a different type of somatic symptom disorder in which the patient is preoccupied with some imagined defect in appearance.

Answer: True Difficulty: Easy Question ID: 7.2.78 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7.5: Characterize somatic symptom disorders 7.2.79. In the DSM-5, body dysmorphic disorder is considered an obsessive-compulsive disorder.

Answer: True Difficulty: Moderate Question ID: 7.2.79 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7.5: Characterize somatic symptom disorders 7.2.80. Freud recognized that individuals who exhibited various psychological symptoms could gain certain advantages such as sympathy or an excuse to avoid work. He labeled this “secondary gain.”

Cognitive-behavioral psychologists would call this process positive reinforcement.

Answer: True Difficulty: Moderate Question ID: 7.2.80 Topic: Frequency, Causes, and Treatment of Somatic Symptom Disorders Skill: Understand the Concepts LO 7.6: Outline the experience of somatic symptom disorders from cause to outcomes

Essay 7.3.81. Identify the major clusters of symptoms used in diagnosing acute stress disorder and posttraumatic stress disorder. Give an example of each.

Answer: (1) Re-experiencing: visualizing the trauma over and over or in dreams or in flashbacks (sudden, repeated, intrusive memories during which the memory is replayed in thoughts or images); (2) avoidance: avoidance of stimuli associated with the trauma (including thoughts or feelings); (3) arousal or anxiety: increased arousal and anxiety evident in trouble falling or staying asleep or difficulty maintaining concentration; (4) dissociative symptoms (likely to occur in acute stress disorder): becoming less aware of surroundings following a traumatic event or depersonalization (feeling cut off from oneself) or derealization (a marked sense of unreality about oneself).

Difficulty: Moderate Question ID: 7.3.81 Topic: Acute and Posttraumatic Stress Disorders Skill: Understand the Concepts LO 7.1: Compare acute and posttraumatic stress disorders 7.3.82. How and why has the definition of traumatic events changed from earlier versions of DSM to the current DSM? What have surveys revealed about traumatic events?

Answer: Earlier versions of DSM defined trauma as an event “outside the range of usual human experience.” Recent research has revealed that many traumatic events are common in the United States. Now, DSM defines traumatic events as (1) the experience of an event involving actual or threatened death or injury to self or others, and (2) a response of intense fear, helplessness, or horror in reaction to the event. A study of a random sample of over 2,000 adults living in the Detroit area found that almost 90 percent of the participants reported having experienced at least one traumatic stressor in their lives. About 9 percent of the participants developed PTSD following the trauma.

Difficulty: Moderate Question ID: 7.3.82 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Apply What You Know LO 7.2: Relate the causes of stress disorders to their treatments 7.3.83. Discuss cognitive-behavioral therapy methods used to treat posttraumatic stress disorder (PTSD).

Answer: The most effective types of treatments for PTSD involve a re-exposure to the events or stimuli that caused the trauma in the first place. A study of prolonged exposure to traumatic stimuli found it to be more effective in relieving symptoms than relaxation and supportive counseling. Similarly, a method that involves imagining nightmares while awake, called imagery rehearsal therapy, was also found to relieve symptoms. Other cognitive techniques are also employed, such as challenging faulty assumptions like “no one cares,” but it is the exposure to the events that seem to have the most consistent therapeutic effect.

Difficulty: Moderate Question ID: 7.3.83 Topic: Frequency, Causes, and Treatment of PTSD and ASD Skill: Apply What You Know LO 7.2: Relate the causes of stress disorders to their treatments

7.3.84. Recovered memories from early childhood have become an important and controversial issue.

Discuss the reasons for this controversy and the research evidence that casts doubt on some reports of “recovered memories.”

Answer: (1) Memory research indicates that most memories from preschool are forgotten. (2) Therapists rarely doubt their patients’ memories and may ask leading questions or set up expectations that induce false memories. (3) Research indicates high rates of erroneous memories for important events, such as where people were on the day the space shuttle Challenger blew up Difficulty: Moderate Question ID: 7.3.84 Topic: Dissociative Disorders Skill: Understand the Concepts LO 7.3: Describe symptoms of dissociative disorders .

7.3.85. Explain why dissociative identity disorder is such a controversial diagnosis.

Answer: Dissociative identity disorder (DID) is being diagnosed with much greater frequency in recent years, with some studies suggesting unbelievably high prevalence rates. Most cases of DID are diagnosed by only a handful of clinicians, and the number of personalities claimed to exist has grown rapidly. Dissociative disorders are rarely diagnosed outside of the United States and Canada. It is even possible that the disorder does not exist, that it is only created by the power of suggestion, or that it represents a form of role enactment.

Difficulty: Moderate Question ID: 7.3.85 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Apply What You Know LO 7.4: Analyze the history of diagnosing dissociative disorders 7.3.86. Describe the association between antisocial personality disorder and somatic symptom disorder.

Answer: The two disorders do not typically occur in the same individual, but they often are found in different members of the same family. Since antisocial personality is far more common among men, while somatic symptom disorders have the opposite pattern, some have speculated that the two problems are flip sides of the same coin. Antisocial personality disorder may be the male expression of high negative emotion and the absence of inhibition, whereas somatic symptom disorder is the female expression of the same characteristics.

Difficulty: Moderate Question ID: 7.3.86 Topic: Frequency, Causes, and Treatment of Somatic Symptom Disorders Skill: Understand the Concepts LO 7.6: Outline the experience of somatic symptom disorders from causes to outcomes

7.3.87. Explain the effect of social factors on the role of learning in the etiology of somatic symptom disorders.

Answer: The social learning perspective would suggest that somatic symptom disorders are caused by learning. There is a concept called “learning the sick role” in which behaving as if sick is acquired through observation of others, some of whom are actually ill. Once the patient is in a sick role, operant conditioning may take over. People take care of you, do things for you and reduce demands made of you, all of which can act as either positive or negative reinforcement and increase the behavior in question. Getting attention acts generally as positive reinforcement, while receiving reduced demands acts generally as negative reinforcement.

Difficulty: Moderate Question ID: 7.3.87 Topic: Frequency, Causes, and Treatment of Somatic Symptom Disorders Skill: Understand the Concepts LO 7.6: Outline the experience of somatic symptom disorders from causes to outcomes 7.3.88. Describe the characteristic symptoms of illness anxiety disorder.

Answer: Illness anxiety disorder is characterized by a preoccupation with having or acquiring a serious illness, even though actual physical symptoms are either absent or minor. Even if a thorough medical evaluation is negative, the person persistently worries that the tests were wrong or that something was overlooked. The level of anxiety is clearly excessive or disproportionate, and the individual performs excessive health-related behaviors or exhibits maladaptive avoidance.

The disorder was formerly known as hypochondriasis, but the term was changed in DSM-5. The disorder is enduring (the preoccupation must be present for at least six months to meet diagnostic criteria), and often leads to substantial impairment in life functioning.

Difficulty: Moderate Question ID: 7.3.88 Topic: Somatic Symptom Disorders Skill: Understand the Concepts LO 7.5: Characterize somatic symptom disorders 7.3.89. Hypnosis is used by some clinicians as a component of treatment for dissociative disorders.

Discuss the controversy surrounding this practice.

Answer: Most treatments of dissociative disorders have focused on uncovering and recounting traumatic memories due to the belief that the need for dissociation disappears if the trauma can be expressed and accepted. Many clinicians use hypnosis to help patients explore and relive traumatic events. However, no research supports the effectiveness of either abreaction or hypnosis as an effective treatment for dissociative disorders. On the contrary, there has been concern that a therapist could actually “plant” traumatic memories by suggestions that are made during a hypnosis session. Hypnosis itself is a controversial topic. Some experts assert that hypnosis is a dissociative experience, while others maintain that hypnosis is merely a social role— with the subject voluntarily complying with the suggestions made to them due to social expectations.

Difficulty: Moderate Question ID: 7.3.89 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Apply What You Know LO 7.4: Analyze the history of diagnosing dissociative disorders

7.3.90. Discuss a “state dependent learning” model as a possible cause of a dissociative disorder.

Answer: State dependent learning is a process where learning that takes place in one state of affect or consciousness is best recalled in the same state of affect or consciousness. Research has shown that if a memory is acquired in a state of fear, then in the future, it sometimes serves as a trigger for those memories that have become associated with that particular emotion. A person who behaves in a certain way, under certain conditions, but then later forgets the events, may have formed an autonomous cluster of memories associated with a particular state or emotional set. If this is the case, then the person has developed independent personalities that are themselves state dependent.

Difficulty: Moderate Question ID: 7.3.90 Topic: Diagnosis, Causes, and Treatment of Dissociative Disorders Skill: Apply What You Know LO 7.4: Analyze the history of diagnosing dissociative disorders

Chapter 8 Stress and Physical Health Total Assessment Guide (T.A.G.)

Topic

Introduction

Question Type Multiple Choice True/False

Understand the Concepts 1,2,3,5,6

Apply What You Know 7,8

Analyze It

10,11,12,19,

20

Essay

9,13,14,15,16, 17,18 52,53,54,55, 56,57,58,59 81

Multiple Choice True/False

21,23,25,26, 27 60,61,62

22,24

Essay

83

84,85

Multiple Choice True/False

28,30,32,33,34

29,31,35,36, 37 68

51

Essay

Defining Stress

Coping and Resilience

Diagnosis of Stress and Physical Illness

Multiple Choice True/False

Essay Cardiovascular Disease and Stress

Multiple Choice True/False Essay

63,64,65,66, 67,69,70

82

86,87 38,39,40,45,46, 41,42,43,44, 47,49,50 48 71,72,73,74,75, 78 76,77,79,80 88,89,90

Evaluate It

Chapter 8: Stress and Physical Health Multiple Choice 8.1.1. What broad definition of stress has been offered by scientists? a. b. c. d.

a subtype of mental disorder that emphasizes physiological symptoms a challenging event that requires behavioral, cognitive, and physiological adaptation a set of specific symptoms that are associated with increased risk for mental disorders an evolutionary development that has enabled humans to adapt to rapid technological changes Answer: b.

Difficulty: Easy Question ID: 8.1.1 Topic: Introduction Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.1.2.

Stress is caused by

a. b. c. d.

confused thought processes. other people. both minor hassles and major events. severe traumas.

Answer: c.

Difficulty: Easy Question ID: 8.1.2 Topic: Introduction Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.1.3. Which of the following is an accurate description of the relationship between stress and illness, according to DSM-5? a. b. c. d.

Stress only contributes to a few physical diseases, such as ulcers.

Psychosomatic disorders are caused by stress alone.

Stress has no effect on physical illness but a great effect on psychological ones.

Stress plays a role in the onset or exacerbation of all physical illnesses, from a cold to AIDS. Answer: d.

Difficulty: Moderate Question ID: 8.1.3 Topic: Introduction Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.1.4. At work, some coworkers are discussing psychosomatic disorders. Which one of them has the best understanding of the term? a. b. c. d.

Hank, who says, “These disorders are not as bad as real physical illnesses.”

Anna, who says, “The concept of psychosomatic disorders is outdated. The mind and body both affect physical illness.”

Sal, who says, “I don't know why anyone would want to consciously create the symptoms of a disease.”

Ted, who says, “If you have one of these disorders you have nothing to worry about, because it’s just all in your head.”

Answer: b.

Difficulty: Moderate Question ID: 8.1.4 Topic: Introduction Skill: Apply What You Know LO 8.3: Relate stress to physical illness

8.1.5.

Evidence indicates that learning more adaptive ways of coping can

a. b. c. d.

change the amount of stress we face. prevent most physical and all psychological disorders. limit the recurrence or improve the course of many physical illnesses. make it more likely that illnesses will be correctly diagnosed.

Answer: c.

Difficulty: Easy Question ID: 8.1.5 Topic: Introduction Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.1.6. What multidisciplinary field includes both medical and mental health professionals who investigate psychological factors in the symptoms, etiology, and treatment of physical illness and chronic disease? a. b. c. d.

holistic wellness psychophysiology behavioral medicine psychosomatic medicine Answer: c.

Difficulty: Easy Question ID: 8.1.6 Topic: Introduction Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.1.7.

Which of the following is LEAST likely to take place in a behavioral medicine clinic?

a. b. c. d.

support groups for people with terminal cancer dialysis for patients with renal failure classes that introduce coping strategies to patients with chronic pain interventions to educate parents of chronically ill children Answer: b.

Difficulty: Easy Question ID: 8.1.7 Topic: Introduction Skill: Apply What You Know LO 8.3: Relate stress to physical illness

8.1.8.

The case of Bob Carter, as presented in your textbook, is important because it shows

a. b.

that Bob is destined for another heart attack since he declined counseling. that stress and lifestyle are more important factors in heart attacks than genetic or physiological factors. that complex interactions between behavioral choices and outside stressors impact a person’s health. that Bob’s combination of genetic, behavioral, and personality factors made his heart attack inevitable.

c. d.

Answer: c.

Difficulty: Moderate Question ID: 8.1.8 Topic: Introduction Skill: Apply What You Know LO 8.3: Relate stress to physical illness 8.1.9. How did the developers of the Social Readjustment Rating Scale measure the amount of stress caused by each of the items on the scale? a. b. c. d.

Each item was evaluated by a group of experts on stress and behavioral medicine.

They assigned the items life change units based on the judgments of a large group of normal adults.

Scores were given to each item based on how much family members thought each event contributed to the death of a loved one.

The items were weighted according to estimates from epidemiological research on how much each contributes to mortality.

Answer: b.

Difficulty: Moderate Question ID: 8.1.9 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.1.10. Which of the following is an example of why some researchers object to instruments such as the Social Readjustment Rating Scale? a. b. c. d.

Stressors rarely have physiological effects.

Stressors can be positive or negative.

Life changes caused by stress are always immediate.

Stressors don’t necessarily affect social relationships.

Answer: b.

Difficulty: Moderate Question ID: 8.1.10 Topic: Defining Stress Skill: Apply What You Know LO 8.1: Characterize the experience of stress

8.1.11. Your teacher describes the following incident to the class: His teenage daughter called home and tearfully described getting a speeding ticket on her way to an amusement park. Her father tells her not to worry, that it was not a big deal. What is he suggesting that she do? a. b. c. d.

change her primary appraisal of the event change her secondary appraisal of the event grow up and accept responsibility for what she has done recognize that her id has gotten the better of her at the moment Answer: a.

Difficulty: Moderate Question ID: 8.1.11 Topic: Defining Stress Skill: Apply What You Know LO 8.1: Characterize the experience of stress

8.1.12. Imagine you have failed a class. You have evaluated this situation and decided that failing the class is stressful and important enough to make you upset. You also realize, however, that you have the option to repeat the class in summer school. This realization is an example of a. b. c. d.

primary appraisal. primary prevention. secondary appraisal. secondary prevention.

Answer: c.

Difficulty: Moderate Question ID: 8.1.12 Topic: Defining Stress Skill: Apply What You Know LO 8.1: Characterize the experience of stress

8.1.13. Recognizing the adaptive, evolutionary aspects of stress, Walter Cannon viewed stress as the activation of the a. b. c. d.

caretaking response. activation or inhibition response. fight-or-flight response. autonomic nervous system.

Answer: c.

Difficulty: Easy Question ID: 8.1.13 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.1.14. An expert on human physiology and stress responses is giving a public lecture on the history of the fight-or-flight response and its effectiveness in ancient and modern times. What is a good title for this presentation? a. b. c. d.

“When an Adaptive Response Becomes Maladaptive” “Fight or Flight: Major Physiological Changes Over Time” “Slowly Eroding: Elements of the Stress Response Lost to Evolution Over Time” “How Speed, Toxins, and Pollution are Destroying the Fight-or-Flight Response” Answer: a.

Difficulty: Moderate Question ID: 8.1.14 Topic: Defining Stress Skill: Apply What You Know LO 8.1: Characterize the experience of stress

8.1.15. Which of the following are likely to occur during the fight-or-flight response? a. b. c. d.

respiration increases, blood pressure rises, pupils dilate pupils constrict, blood pressure increases, heart rate increases blood sugar levels decrease, blood pressure rises, pupils dilate blood flow redirects for muscular activity, respiration increases, blood pressure decreases Answer: a.

Difficulty: Moderate Question ID: 8.1.15 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.1.16. Which of the following is known as the “stress hormone”? a. b. c. d.

adrenalin epinephrine cortisol norepinephrine Answer: c.

Difficulty: Moderate Question ID: 8.1.16 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.1.17. Stress affects a. b. c. d.

, which fight off antigens like bacteria or viruses.

T-cells cortisol CRF platelets Answer: a.

Difficulty: Moderate Question ID: 8.1.17 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.1.18. Which best describes the current thinking about stress response and the immune system? a. b. c. d.

Short-term stressors enhance immune responses that are quick, while chronic stressors create immunosuppression.

Chronic stressors enhance long-term immune responses, but short-term stressors create immunosuppression.

Neither chronic nor short-term stressors impair the immune system.

Both chronic and short-term stressors impair the immune system.

Answer: a.

Difficulty: Difficult Question ID: 8.1.18 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.1.19. Marcus is explaining Hans Selye’s concept of stress to the class. He correctly states that the first stage of Selye’s general adaptation syndrome is a. b. c. d.

resistance: a period of time when the body is physiologically activated and prepared to respond to the threat. alarm: the mobilization of the body in reaction to threat. exhaustion: the body’s resources are depleted by chronic stress. homeostasis: the body’s tendency to return to a steady state of normal functioning.

Answer: b.

Difficulty: Moderate Question ID: 8.1.19 Topic: Defining Stress Skill: Apply What You Know LO 8.1: Characterize the experience of stress

8.1.20. Which of the following is the best automotive analogy for Walter Cannon’s theory of chronic stress? a. b. c. d.

a car that has run out of gas and is damaged because stress keeps turning the key a car in which the engine continues to race instead of idling down after running fast a car that has enough gas but has a clogged fuel line; no fuel can reach its engine a car that can not start because it has an electrical short in its ignition system Answer: b.

Difficulty: Difficult Question ID: 8.1.20 Topic: Defining Stress Skill: Analyze It LO 8.1: Characterize the experience of stress

8.1.21. What are the two basic types of coping that were identified by Lazarus and Folkman? a. b. c. d.

nonspecific and specific emergency and chronic adaptive and maladaptive problem-focused and emotion-focused Answer: d.

Difficulty: Easy Question ID: 8.1.21 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.1.22. Lucas is feeling increasingly stressed because a coworker has been belittling his contributions and spreading gossip behind his back ever since he declined her offer to go out for drinks after work. Which of the following behaviors is an example of Lucas’s problem-focused coping? a. b. c. d.

He makes an appointment with the Human Resources office to file a harassment complaint.

He tries to see his office mate’s point of view.

He repeats Reinhold Niebuhr’s “Serenity Prayer” until he calms down.

He thinks about the problem so much that it interferes with his work.

Answer: a Difficulty: Moderate Question ID: 8.1.22 Topic: Coping and Resilience Skill: Apply What You Know LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.1.23. Which of the following correctly describes emotion-focused coping? a. b. c. d.

an attempt to cause others to change their emotional responses an attempt to change physiological responses directly in order to alter emotions indirectly an attempt to change a stressor an attempt to alter internal distress Answer: d.

Difficulty: Easy Question ID: 8.1.23 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.1.24. Shana is under a lot of stress, but she is not acknowledging any anxiety and seems to be repressing unpleasant emotions. Evidence suggests that, as a result, Shana will probably a. b. c. d.

develop a dissociative disorder. develop an anxiety disorder. experience heightened psychophysiological reactions to stress. strengthen her positive outlook and maintain good health.

Answer: c.

Difficulty: Moderate Question ID: 8.1.24 Topic: Coping and Resilience Skill: Apply What You Know LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.1.25. What are two critical components that allow humans to better cope with stressful events? a. b. c. d.

alarm and exhaustion control and predictability disclosure and anticipation specificity and non-specificity Answer: b.

Difficulty: Easy Question ID: 8.1.25 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.1.26. Positive psychologists define the ability to cope well with life’s challenges, even stressful ones, as a. b. c. d.

immunosupport. resilience. self-actualization. very rare.

Answer: b.

Difficulty: Easy Question ID: 8.1.26 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.1.27. Stress can indirectly affect our health and contribute to illness by leading people to a. b. c. d.

engage in more unhealthy activities. exercise in excessive and risky ways. seek out unnecessary medical treatment. engage in more primitive fight-or-flight responses.

Answer: a.

Difficulty: Easy Question ID: 8.1.27 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.1.28. To understand the relationship between stress and health, it is important to realize that a. b. c. d.

only certain types of stress can affect health. only chronic stress can affect health. stress can affect health, and health problems can create stress.

DSM-5 does not include any health-related factors in its classification system.

Answer: c.

Difficulty: Easy Question ID: 8.1.28 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.1.29. In the past year, Alice’s mother and two friends died. Because she has been laid off several times, Alice has moved and currently lives in an unsafe neighborhood. Alice reports that she has a lot of pain, but the physician is unable to find a specific cause. Following the criteria in DSM-5, the physician diagnoses her with a. b. c. d.

Munchhausen by proxy. borderline personality disorder. a somatic symptom disorder. psychosomatic illness.

Answer: c.

Difficulty: Moderate Question ID: 8.1.29 Topic: Diagnosis of Stress and Physical Illness Skill: Apply What You Know LO 8.3: Relate stress to physical illness

8.1.30. To a health psychologist, what interesting observation can be made when comparing the top 10 causes of death in the United States in 1900 to the top 10 causes of death in the United States in 2000? a. b. c. d.

The leading causes of death today are lifestyle diseases.

Infectious diseases continue to be the major causes.

There has been little change over almost 100 years.

Homicide and suicide cause almost as many deaths as cancer.

Answer: a Difficulty: Moderate Question ID: 8.1.30 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.1.31. Jane has been diagnosed with cancer; her prognosis is not good and she needs to decide about her treatment. She is considering joining a support group. What does the evidence suggest about this option? a. b. c. d.

Patients in support groups live longer than those who are not.

Participating in support groups can increase quality of life but not longevity.

Such self-help groups have developed in order to prepare people to die with greater dignity.

Time spent engaging in non-medical activities, such as support groups, takes time away from medical treatment.

Answer: b.

Difficulty: Moderate Question ID: 8.1.31 Topic: Diagnosis of Stress and Physical Illness Skill: Apply What You Know LO 8.3: Relate stress to physical illness

8.1.32. According to the Centers for Disease Control and Prevention, which group has the highest rate of new cases of HIV infection in the United States? a. b. c. d.

individuals who participate in high-risk heterosexual sexual intercourse homosexual women who engage in high-risk homosexual intercourse heterosexual males in general intravenous drug users Answer: a.

Difficulty: Moderate Question ID: 8.1.32 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.1.33. For those infected with HIV, a. b. c. d.

is associated with a more gradual onset of symptoms.

use of condoms social support being female access to prevention programs Answer: b.

Difficulty: Moderate Question ID: 8.1.33 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.1.34. Researchers have discovered an association between depression, anxiety, and pain. How do they explain this association? a. b. c. d.

People who are prone to anxiety and depression have lower levels of endogenous opioids.

Anxious and depressed people are more sensitive to pain and less able to cope with it.

Anxious and depressed people are more likely to become involved in accidents as a result of high levels of distractibility.

People who are anxious and/or depressed have learned that reporting pain symptoms is a prime means of gaining attention from friends and relatives.

Answer: b.

Difficulty: Easy Question ID: 8.1.34 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.1.35. Rebecca is suffering from recurrent chronic pain; she is referred to a psychologist who talks in terms of pain management. What can Rebecca expect when the psychologist begins treatment? a. b. c. d.

Hypnosis will be used to help her forget about the pain.

Efforts will be made to help her cope in ways that minimize the pain’s impact on her life.

A psychoanalytic approach will delve into the unconscious roots of the pain.

A variety of drugs will be mixed to reduce the pain to the lowest level possible, without causing severe side effects.

Answer: b.

Difficulty: Moderate Question ID: 8.1.35 Topic: Diagnosis of Stress and Physical Illness Skill: Apply What You Know LO 8.3: Relate stress to physical illness

8.1.36. Your uncle returns home after visiting a sleep clinic. He says the sleep specialists diagnosed him as suffering from narcolepsy. Which of the following sets of symptoms probably led to his decision to seek an evaluation at the sleep clinic? a. b. c. d.

loud snoring and violent leg movements during sleep early morning waking and an inability to get back to sleep irresistible sleep attacks and sudden loss of muscle tone for brief periods of time inability to breathe and sleep at the same time and difficulty getting to sleep Answer: c.

Difficulty: Moderate Question ID: 8.1.36 Topic: Diagnosis of Stress and Physical Illness Skill: Apply What You Know LO 8.3: Relate stress to physical illness

8.1.37. Four-year-old Mary’s parents rush into her bedroom when they hear her screaming in the night, but she appears to be sleeping normally when they get there. In the morning, they ask her if she had a bad dream, but she says she didn’t. Mary is experiencing a. b. c. d.

sleep terrors. nightmares.

REM sleep behavior disorder. hypersomnia.

Answer: a.

Difficulty: Moderate Question ID: 8.1.37 Topic: Diagnosis of Stress and Physical Illness Skill: Apply What You Know LO 8.3: Relate stress to physical illness

8.1.38. Determining that someone suffers from hypertension depends on which of the following two measures? a. b. c. d.

systolic and diastolic blood pressure sympathetic and parasympathetic blood pressure self-reports of tension and psychophysiological measures of heart rate self-reports of tension and objective behavior ratings by skilled observers Answer: a.

Difficulty: Easy Question ID: 8.1.38 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.1.39. There is no single, identifiable cause for hypertension, which accounts for approximately 85 percent of all cases of high blood pressure. a. b. c. d.

systolic secondary essential diastolic

Answer: c.

Difficulty: Moderate Question ID: 8.1.39 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.1.40. Which of the following illustrates the relationship between stress and cardiovascular disease? a. b. c. d.

Stress is associated with thinned artery walls.

Over the long run, stress can damage the heart.

Type B personality is associated with higher blood pressure.

Stress causes people to focus on the warning signs of heart attack.

Answer: b.

Difficulty: Easy Question ID: 8.1.40 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.1.41. Ann is studying the different ways in which people respond physically to stress. While increased blood pressure and heart rate are normal reactions, researchers have long observed that some people exhibit different to stress, for better or worse. a. b. c. d.

attitudes cardiac resilience types of CHD due cardiovascular reactivity Answer: d.

Difficulty: Moderate Question ID: 8.1.41 Topic: Cardiovascular Disease Skill: Apply What You Know LO 8.4: Relate the causes of CVD to its treatments

8.1.42. In developing prevention programs with the goal of reducing heart disease in women, the health department should especially target which of the following groups? a. b. c. d.

employed women homemakers employed women with children homemakers with children Answer: c.

Difficulty: Moderate Question ID: 8.1.42 Topic: Cardiovascular Disease Skill: Apply What You Know LO 8.4: Relate the causes of CVD to its treatments

8.1.43. In assessing your patients for risk of heart disease, you would be most concerned about discovering which of these Type A behavior characteristics? a. b. c. d.

anxiety hostility impatience achievement orientation Answer: b.

Difficulty: Moderate Question ID: 8.1.43 Topic: Cardiovascular Disease Skill: Apply What You Know LO 8.4: Relate the causes of CVD to its treatments

8.1.44. Marvin has answered “Yes” to the following question: “Have you felt so sad, discouraged, hopeless, or had so many problems that you wondered if anything is worthwhile?” What can we say about Marvin’s risk for coronary heart disease (CHD) compared to the general population? a. b. c. d.

He is depressed but not more likely to suffer CHD. He is twice as likely to suffer CHD. He is no more likely to suffer CHD but more likely to die from it.

He is five times more likely to suffer CHD. Answer: b.

Difficulty: Difficult Question ID: 8.1.44 Topic: Cardiovascular Disease Skill: Apply What You Know LO 8.4: Relate the causes of CVD to its treatments

8.1.45. Which of the following is a benefit of longitudinal research? a. b. c. d.

provides systematic control of stress costs less than cross-sectional research allows one to rule out reverse causality easier to conduct than cross-sectional research Answer: c.

Difficulty: Moderate Question ID: 8.1.45 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.1.46. In longitudinal studies, prospective designs are preferred to retrospective designs because a. b. c. d.

it is easier to follow subjects forward in time than to follow them backward in time. retrospective studies are limited by distorted memories. only prospective designs can rule out reverse causality. prospective designs can be conducted more quickly.

Answer: b.

Difficulty: Moderate Question ID: 8.1.46 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.1.47. Relaxation training for patients with high blood pressure is an example of a. b. c. d.

treatment of coronary heart disease. primary prevention of coronary heart disease. tertiary prevention of coronary heart disease. secondary prevention of coronary heart disease.

Answer: d.

Difficulty: Moderate Question ID: 8.1.47 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.1.48. Carol suffers from coronary heart disease and is trying to decide between stress management and antihypertensive medication. Based on current research findings, how would you advise her? a. b. c. d.

Stress management will provide her with greater benefit.

Stress management might be a useful adjunct to medication.

There is no evidence that stress management lowers blood pressure.

Stress management is better because it has fewer side effects.

Answer: b.

Difficulty: Moderate Question ID: 8.1.48 Topic: Cardiovascular Disease Skill: Apply What You Know LO 8.4: Relate the causes of CVD to its treatments

8.1.49. In designing a public health prevention program, you plan to target a group that has already experienced the problem you aim to prevent. Your program is called what type of prevention program? a. b. c. d.

primary secondary tertiary sirius Answer: c.

Difficulty: Moderate Question ID: 8.1.49 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.1.50. Successful intervention to teach Type A patients how to respond to stressful interactions with less hostility often uses , so the patient can try out new, less hostile ways of responding. a. b. c. d.

acting out group therapy acting intervention role playing Answer: d.

Difficulty: Easy Question ID: 8.1.50 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

True/False 8.2.51. One reason that a list of psychosomatic illnesses was not included in DSM-5 is because psychosomatic illnesses are only imaginary and no threat to a person’s health.

Answer: False Difficulty: Moderate Question ID: 8.2.51 Topic: Introduction Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.2.52. According to the conceptualization of stress used in the Social Readjustment Rating Scale, an outstanding personal achievement would be viewed as stressful if it were unexpected, but not stressful if it were expected.

Answer: False Difficulty: Moderate Question ID: 8.2.52 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress 8.2.53. Richard Lazarus defined stress as the individual’s appraisal of a challenging life event.

Answer: True Difficulty: Easy Question ID: 8.2.53 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress 8.2.54. Lazarus defines our assessment of our abilities and resources for coping with a challenging life event as secondary appraisal.

Answer: True Difficulty: Easy Question ID: 8.2.54 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress 8.2.55. The parasympathetic nervous system is activated during the fight-or-flight response.

Answer: False Difficulty: Easy Question ID: 8.2.55 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress 8.2.56. The amygdala is the region of the brain that is considered to be the principal mediator of the stress response.

Answer: True Difficulty: Moderate Question ID: 8.2.56 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress

8.2.57. Taylor has suggested that the fight-or-flight response may be a predominantly male response to stressful stimuli; she suggests that females may be more likely to tend and befriend.

Answer: True Difficulty: Easy Question ID: 8.2.57 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress 8.2.58. Canon proposed that the body has a natural tendency to return to a steady state of normal functioning that he termed homeostasis.

Answer: True Difficulty: Moderate Question ID: 8.2.58 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress 8.2.59. Chronic stressors and losses create immunosuppression.

Answer: True Difficulty: Moderate Question ID: 8.2.59 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress 8.2.60. The National Research Council reported in 2013 that life expectancy in the United States lags behind other high-income countries for four reasons. One of those reasons is the number of people who engage in poor health behavior like excessive smoking, drinking, and eating.

Answer: True Difficulty: Easy Question ID: 8.2.60 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress 8.2.61. Fifty to sixty percent of patients fail to fully adhere to medical advice.

Answer: False Difficulty: Moderate Question ID: 8.2.61 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.2.62. Social support affects health because it can encourage positive health behavior and create more adaptive immune system functioning.

Answer: True Difficulty: Easy Question ID: 8.2.62 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress 8.2.63. DSM-5 classifies stress related to physical illness as Conditions Resulting from Physical and Mental Factors.

Answer: False Difficulty: Moderate Question ID: 8.2.63 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness 8.2.64. In the early twentieth century, the most common forms of disease in the United States were infectious diseases, but today, the most common forms are cancers.

Answer: False Difficulty: Moderate Question ID: 8.2.64 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness 8.2.65. Stress is linked with risky behaviors associated with HIV. Answer: False Difficulty: Moderate Question ID: 8.2.65 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness 8.2.66. The goal of pain management programs is to use a balance of relaxation techniques and medication to eliminate pain.

Answer: False Difficulty: Moderate Question ID: 8.2.66 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness

8.2.67. Circadian rhythm sleep disorder is characterized by problems with sleep quantity or quality and may include problems in initiating or maintaining sleep.

Answer: False Difficulty: Easy Question ID: 8.2.67 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness 8.2.68. A patient being prepared to sleep in the sleep laboratory is believed to suffer from sleep apnea.

You have been given permission to observe this evening. You expect to observe loud snoring or pauses in breathing.

Answer: True Difficulty: Easy Question ID: 8.2.68 Topic: Diagnosis of Stress and Physical Illness Skill: Apply What You Know LO 8.3: Relate stress to physical illness 8.2.69. Excessive sleepiness accompanied by prolonged daytime sleep is diagnosed as primary hypersomnolence disorder.

Answer: True Difficulty: Easy Question ID: 8.2.69 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness 8.2.70. Restless legs syndrome is considered a type of parasomnia.

Answer: True Difficulty: Moderate Question ID: 8.2.70 Topic: Diagnosis of Stress and Physical Illness Skill: Understand the Concepts LO 8.3: Relate stress to physical illness 8.2.71. Cardiovascular disease is a group of disorders affecting the peripheral nervous system.

Answer: False Difficulty: Easy Question ID: 8.2.71 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.2.72. Hypertension is often called the “silent killer” because it has a strong genetic link.

Answer: False Difficulty: Easy Question ID: 8.2.72 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments 8.2.73. The immediate cause of coronary heart disease (CHD) is uncontrolled blood pressure.

Answer: False Difficulty: Moderate Question ID: 8.2.73 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments 8.2.74. The technical term for a heart attack is myocardial infarction.

Answer: True Difficulty: Difficult Question ID: 8.2.74 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.2.75. When high blood pressure is the principal or only disorder, the diagnosis is principal hypertension.

Answer: False Difficulty: Moderate Question ID: 8.2.75 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments 8.2.76. A study that looks at a group of people periodically over a period of time is known as a longitudinal study.

Answer: True Difficulty: Easy Question ID: 8.2.76 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.2.77. A study that looks at a group of people at one point in time is known as a horizontal study.

Answer: False Difficulty: Easy Question ID: 8.2.77 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments 8.2.78. The new boss is supposed to be on the job today. The word is that he is “a real Type A.” Because you are not sure what this means, you ask a fellow worker. She tells you to expect the new boss to be humorless and unassertive.

Answer: False Difficulty: Moderate Question ID: 8.2.78 Topic: Cardiovascular Disease Skill: Apply What You Know LO 8.4: Relate the causes of CVD to its treatments 8.2.79. Social ecology refers to maintaining a group of close friends for social support.

Answer: False Difficulty: Easy Question ID: 8.2.79 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments 8.2.80. Findings from the Trials of Hypertension Prevention (TOHP) suggest that the most important factor in lowering high blood pressure is stress management.

Answer: False Difficulty: Moderate Question ID: 8.2.80 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

Essay 8.3.81. Describe the difference between primary appraisal and secondary appraisal of stress.

Answer: According to Richard Lazarus, any given life event can be a stressor if it is considered stressful by the individual. Primary appraisal is the evaluation of the challenge, threat, or harm posed by an event. Secondary appraisal is the assessment of one’s ability and resources for coping with a difficult event.

Difficulty: Easy Question ID: 8.3.81 Topic: Defining Stress Skill: Understand the Concepts LO 8.1: Characterize the experience of stress 8.3.82. Both Walter Cannon and Hans Selye theorized about a link between stress and physical disease.

Describe the primary differences in their theories.

Answer: Selye saw exhaustion as the key to the link: after prolonged stress, the body can no longer respond appropriately and is subsequently damaged. Cannon saw chronic arousal as most important to the link: experiencing fight-or-flight arousal, without being able to fight or flee, causes prolonged arousal of the sympathetic nervous system, which in turn causes physical damage to the body.

Difficulty: Moderate Question ID: 8.3.82 Topic: Defining Stress Skill: Analyze It LO 8.1: Characterize the experience of stress 8.3.83. Describe the difference between emotion-focused coping and problem-focused coping.

Answer: Lazarus and Folkman suggested two general methods or strategies for coping with stress. Problem-focused coping involves attempts to change a stressor. While problem-focused methods involve trying to find ways to alter your external circumstances, emotion-focused coping involves attempts to alter your own internal distress. Emotion-focused methods help you alter your own internal responses to stressors.

Difficulty: Easy Question ID: 8.3.83 Topic: Coping and Resilience Skill: Understand the Concepts LO 8.2: Differentiate beneficial and harmful adaptations to stress

8.3.84. Define health behavior and explain how such behaviors are related to illness.

Answer: Health behavior involves activities that promote good health, and it includes both positive actions like eating, sleeping, and exercising adequately and the avoidance of unhealthy activities, such as cigarette smoking, excessive alcohol consumption, and drug use. Stress can lead people to engage in less positive and more negative health behavior, and these poor health habits, and not stress, per se, may be responsible for much of the relationship between stress and illness.

Difficulty: Moderate Question ID: 8.3.84 Topic: Coping and Resilience Skill: Apply What You Know LO 8.2: Differentiate beneficial and harmful adaptations to stress 8.3.85. Discuss what research has found regarding the benefits of religious coping.

Answer: Research has revealed evidence that among those who attend church services the mortality risk is lower, likely as a result of improved health behavior. Specific factors that appear to be involved are forgiveness and finding meaning in life. There is also evidence that religion encourages active coping strategies, leading to less pain, less depression, and improved psychological well-being.

Difficulty: Moderate Question ID: 8.3.85 Topic: Coping and Resilience Skill: Apply What You Know LO 8.2: Differentiate beneficial and harmful adaptations to stress 8.3.86. Discuss the relationship between stress, health behavior, and cancer.

Answer: While cancer is a biological disorder with genetic and physiological causes, there are still links between this disease and behavior and stress. The major preventable cause of cancer in the United States is a voluntary behavior, smoking. For those with cancer, there is the danger of anxiety and depression, both of which can lead to behavior that is unhealthy, such as drinking alcohol or failing to maintain a healthy diet and exercise regime. Social support can contribute to healthy behavior, medication and treatment compliance, and reduced stress.

Difficulty: Moderate Question ID: 8.3.86 Topic: Diagnosis of Stress and Physical Illness Skill: Apply What You Know LO 8.3: Relate stress to physical illness

8.3.87. Describe the typical components and the goals of pain management programs.

Answer: Pain management programs typically include education about pain; pain control methods, such as relaxation and exercise; attempts to change maladaptive expectations about pain; and interventions with families or support groups. The goal of pain management is to help people cope with pain in a way that minimizes its impact on their lives, even if the pain cannot be eliminated or controlled entirely. Following treatment, patients typically report greater satisfaction with their lives and relationships, improved employment status, and less reliance on medication.

Difficulty: Moderate Question ID: 8.3.87 Topic: Diagnosis of Stress and Physical Illness Skill: Apply What You Know LO 8.3: Relate stress to physical illness 8.3. 88. Discuss the psychological factors affecting cardiovascular disease (CVD).

Answer: In addition to biological and possibly genetic causes, CVD is affected by certain psychological factors. These include health behavior, such as smoking, lack of exercise, and unhealthy diet; immediate and chronic stress, which can damage the heart; personality, with an emphasis on Type A behavior, especially hostility; and the presence of depression and anxiety, since depression is three times more common among CHD patients than the general population.

While it remains unknown whether depression acts as a symptom or a cause of CHD, it is certain that anxiety is a critical aspect of sudden cardiac death.

Difficulty: Moderate Question ID: 8.3.88 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments 8.3.89. Describe the concept of Type A behavior and how it is measured. What does research show concerning the relationship between Type A and cardiovascular disease?

Answer: Type A behavior is characterized as a time-urgent, hostile, competitive, impatient, and achievement-oriented style of responding to challenges. The classification of Type A behavior has predicted CHD in several prospective studies; however, other studies have failed to support these findings. Researchers now suggest that only one element of Type A behavior increases risk for CHD, and that element is hostility. One study found that three items reliably predicted death among men who had a history of CHD or hypertension: ease with which anger was aroused, argumentativeness, and irritability.

Difficulty: Moderate Question ID: 8.3.89 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

8.3.90. Give examples of the primary, secondary, and tertiary prevention of cardiovascular disease.

Answer: Primary prevention focuses on encouraging people to develop positive health behaviors that will help keep them from developing CVD. For instance, public service programs that encourage people to quit smoking, eat well, exercise, monitor their blood pressure, and otherwise improve their health can all be considered primary prevention. Secondary prevention involves treating essential hypertension so that it does not develop into CHD. These attempts fall into two categories: improving health behavior and stress management programs. Tertiary prevention focuses on patients who have already had a cardiac event, such as a myocardial infarction. The goal of tertiary prevention is to prevent or reduce the incidence of recurrence. Examples of tertiary prevention include exercise programs and interventions that teach patients how to respond to stressful interactions with reduced hostility.

Difficulty: Moderate Question ID: 8.3.90 Topic: Cardiovascular Disease Skill: Understand the Concepts LO 8.4: Relate the causes of CVD to its treatments

Chapter 9 Personality Disorders Total Assessment Guide (T.A.G.) Topic

Multiple Choice

Understand the Concepts 1,2,3,4,5

True/False

52,53,54

Essay

82

Multiple Choice

10,12

True/False

55,56,57,58

Essay

83

Multiple Choice

13,14,17,20,22 15,18,19,21

True/False

59,60,61,62,63 64

Essay

84

Multiple Choice

23,24,25

True/False

65

Essay

85

Multiple Choice

27,28,30

Frequency

True/False

66,67,68,69 87 32,33

Schizotypal Personality Disorder

Essay Multiple Choice True/False Essay Multiple Choice True/False

35,36,39,40, 41,42 73,74,75,76

Essay

89

Multiple Choice

44,47,48,49,50 45,46,51

True/False

77,78,79,81

80

Essay

90

91

Introduction

Question Type

Apply What You Know 6,7,8,9

Analyze It

11

Symptoms

Diagnosis

A Dimensional Perspective on Personality Disorders

Borderline Personality Disorder

Antisocial Personality Disorder

26,29,31 86 34

70,71,72 88 37,38,43

16

Evaluate It

Chapter 9: Personality Disorders Multiple Choice 9.1.1.

To meet the definition of a personality disorder in DSM-5, one must meet the criteria of

a. b. c. d.

personality traits never seen in normal people. an enduring pattern of behavior that differs considerably from one’s culture. the presence of emotional symptoms that make one aggressive. the presence of psychotic symptoms.

Answer: b.

Difficulty: Easy Question ID: 9.1.1 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.2. The pattern associated with a personality disorder must be evident in two or more specific domains that include a. b. c. d.

motor skills. emotional responses. intelligence. culture.

Answer: b.

Difficulty: Easy Question ID: 9.1.2 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.3.

People diagnosed with a personality disorder exhibit behavior that is described as

a. b. c. d.

clustered and psychotic. inflexible and pervasive. acutely, not chronically problematic. more impaired than that associated with most other mental disorders.

Answer: b.

Difficulty: Easy Question ID: 9.1.3 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.4.

What is one of the reasons that the category of personality disorders is controversial?

a. b. c. d.

These disorders are difficult to identify reliably.

These disorders were conceptualized for insurance purposes.

These disorders are not associated with social or occupational impairment.

These disorders are easily learned and unlearned, so they don’t require therapy.

Answer: a.

Difficulty: Moderate Question ID: 9.1.4 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.5. Mental health professionals who are actively involved in treating people with mental disorders view personality disorders as important because personality disorders a. b. c. d.

are the most common mental disorders that they treat. make it easier to treat people with other mental disorders. can interfere with the treatment of disorders such as depression. are more easily defined and easier to diagnose.

Answer: c.

Difficulty: Moderate Question ID: 9.1.5 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.6. In the case of Tom, which is described in your textbook, what were some of the early indications that he would one day grow up to exhibit behaviors that meet the criteria for antisocial personality disorder? a. b. c. d.

Tom was often truant from school, stole items, and lied.

Tom reported that he heard voices directing him to engage in actions that would cause trouble.

Tom’s eating, sleeping, and motor behaviors were all sources of difficulty that required medical intervention.

In order to prove that he was tough, Tom would deliberately engage in actions that would lead to serious physical punishment.

Answer: a.

Difficulty: Easy Question ID: 9.1.6 Topic: Introduction Skill: Apply What You Know LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.7. Tom’s case, as described in your textbook, illustrates which of the following characteristics of personality disorders that would allow a clinician to differentiate his disorder from other disorders that are more episodic in nature? a. b. c. d.

Tom’s problems were intense but very brief.

Tom understood the nature for his problems and felt bad about them.

Tom’s problems began early and were exhibited consistently over an extended period of time.

Tom was able to recognize his need for help and participate actively in treatment.

Answer: c.

Difficulty: Moderate Question ID: 9.1.7 Topic: Introduction Skill: Apply What You Know LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.8. During a case conference, one of the staff describes a patient as experiencing an “ego-dystonic” disorder. What is the most likely description of this patient? a. b. c. d.

He is distressed by his symptoms.

He views his symptoms as a moral failure.

He does not view his disorder as a problem.

He believes he can solve his own problems without a therapist’s help.

Answer: a.

Difficulty: Easy Question ID: 9.1.8 Topic: Introduction Skill: Apply What You Know LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.9. At a conference, a researcher reports prevalence rates for personality disorders. Several audience members conclude that these figures are lower than those reported in the literature. During a questionand-answer period, which of the following is likely to be viewed as a reason for this discrepancy? a. b. c. d.

The researcher relied on a psychodynamic model of the etiology of personality disorders.

The researcher failed to consider the impact of mental retardation on the prevalence of these disorders.

The researcher failed to obtain records of physiological functions that can often reveal otherwise hidden pathology.

The researcher used self-report instruments to estimate the prevalence of disorders seen in people with little awareness of their behavior.

Answer: d.

Difficulty: Moderate Question ID: 9.1.9 Topic: Introduction Skill: Apply What You Know LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.10. Which of the following is part of the definition of a person’s temperament? a. b. c. d.

emotional reactivity guilt feelings ego development personality development Answer: a.

Difficulty: Easy Question ID: 9.1.10 Topic: Symptoms Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.11. The plant manager needs to fill a newly created position. He tells the Director of Human Resources that he wants someone who is well organized, reliable, dependable, and punctual. The director intends to screen applicants using scores on the five-factor model of personality. High scores on which factor should mark applicants as having the desired characteristics? a. b. c. d.

openness neuroticism extraversion conscientiousness Answer: d.

Difficulty: Moderate Question ID: 9.1.11 Topic: Symptoms Skill: Apply What You Know LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.12. In personality theory, neuroticism refers to a. b. c. d.

conscientiousness. bizarre and unusual thinking. the expression of anxiety and depression. a low interest in interacting with other people.

Answer: c Difficulty: Moderate Question ID: 9.1.12 Topic: Symptoms Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.1.13. Based on the clusters of personality disorders listed in DSM-5, which of the following sets of characteristics is associated with paranoid personality disorder? a. b. c. d.

anxious or fearful odd or eccentric out of contact with reality and delusional dramatic, emotional, or erratic Answer: b.

Difficulty: Easy Question ID: 9.1.13 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster

9.1.14. What common thread runs through paranoid, schizoid, and schizotypal personality disorders? a. b. c. d.

They are commonly mistaken for schizophrenia.

They typically follow schizophrenic episodes.

They sometimes precede the onset of full-blown schizophrenia.

They are inherited disorders that often lead to dementia.

Answer: c.

Difficulty: Moderate Question ID: 9.1.14 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster

9.1.15. A patient at the mental health center talks in a vague and disjointed manner. His behavior, perceptions, and dress are considered odd. However, he does not report any delusions or hallucinations.

Which of the following is the most likely diagnosis? a. b. c. d.

schizoid personality disorder avoidant personality disorder borderline personality disorder schizotypal personality disorder Answer: d.

Difficulty: Moderate Question ID: 9.1.15 Topic: Diagnosis Skill: Apply What You Know LO 9.2: Compare personality disorders by cluster

9.1.16. A novelist wants to write a book centered on a character described as suspicious and on guard all of the time. The character has difficult relationships with friends and relatives as a result of a distrustful nature, he overreacts to minor events that may lead to aggression, and he is delusional. What advice would you give to the novelist? a. b. c. d.

The symptoms that you describe are rarely seen in adults in this country.

You have accurately described paranoid personality disorder, except that the disorder does not involve delusions.

Your description does not seem to meet the criteria of any of the disorders found in DSM. You have captured the essence of a series of disorders that tend to be comorbid and untreatable.

Answer: b.

Difficulty: Moderate Question ID: 9.1.16 Topic: Diagnosis Skill: Apply What You Know LO 9.2: Compare personality disorders by cluster

9.1.17. Which personality disorder is characterized by excessive emotionality, attention-seeking behavior, and inappropriate seductiveness? a. b. c. d.

dependent histrionic schizotypal obsessive-compulsive Answer: b.

Difficulty: Easy Question ID: 9.1.17 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster

9.1.18. At the drop of a hat, Pete will tell you, in as many ways as one can imagine, that he is the most talented salesperson in the company. He often boasts about his ability to “size up” customers and to close deals. He says he has not been promoted to manager because his work is not really appreciated. He resents those who have been promoted and views them as self-promoters. He expects others to meet his wishes, but he is insensitive to their needs. Pete’s behavior represents personality disorder. a. b. c. d.

schizoid paranoid borderline narcissistic Answer: d.

Difficulty: Moderate Question ID: 9.1.18 Topic: Diagnosis Skill: Apply What You Know LO 9.2: Compare personality disorders by cluster

9.1.19. A psychologist is describing the different personality disorders. When she comes to avoidant and schizoid personality disorders, the students look puzzled. How will she distinguish these two personality disorders? a. b. c. d.

Avoidant personality disorder has closer etiological ties to mood disorders than schizoid personality disorder has.

Those with schizoid personality disorder tend to become extremely dependent on others, while those with avoidant personality disorder manage to maintain their independence.

Those with schizoid personality disorder prefer to be alone; those with avoidant personality disorder want to be liked by others but are afraid of even minimal signs of disapproval.

Those with avoidant personality disorder are not distressed by their self-induced social isolation, while those with schizoid personality disorder are distressed by their lack of social skills.

Answer: c.

Difficulty: Moderate Question ID: 9.1.19 Topic: Diagnosis Skill: Apply What You Know LO 9.2: Compare personality disorders by cluster

9.1.20. Which personality disorder is characterized by a fear of separation from others who are looked to for advice and reassurance? a. b. c. d.

paranoid dependent borderline schizotypal Answer: b.

Difficulty: Easy Question ID: 9.1.20 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster

9.1.21. A psychologist has developed a series of personality inventories and wants to determine if they are valid. One of the scales measures perfectionism, so he asks a colleague for advice on how to establish the validity of this scale. The colleague tells him that if he were to find a sample of people with personality disorder, these people would obtain high scores on a scale that measures perfectionism. a. b. c. d.

avoidant histrionic antisocial obsessive-compulsive Answer: d.

Difficulty: Moderate Question ID: 9.1.21 Topic: Diagnosis Skill: Apply What You Know LO 9.2: Compare personality disorders by cluster

9.1.22. Unlike obsessive-compulsive personality disorder (OCPD), obsessive-compulsive disorder (OCD) involves a. b. c. d.

lack of guilt. excessive emotionality. dependency and advice‑ seeking. intrusive thoughts and ritualistic behavior.

Answer: d.

Difficulty: Moderate Question ID: 9.1.22 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster

9.1.23. What is one criticism of the DSM classification of personality disorders as discrete categories rather than dimensional traits? a. b. c. d.

Category names are arbitrary.

A categorical approach does not explain etiology.

The labels have created more problems than they solved.

There are a lot of people with serious personality problems who do not fit the official DSM-5 subtypes.

Answer: d.

Difficulty: Easy Question ID: 9.1.23 Topic: A Dimensional Perspective on Personality Disorders Skill: Understand the Concepts LO 9.3: Evaluate the dimensional personality disorder model

9.1.24. The proposed dimensional model places primary emphasis on a. b. c. d.

reducing stigma associated with a personality disorder diagnosis. explaining the etiology of personality disorders. reducing the number of personality disorder diagnoses. ratings of maladaptive traits.

Answer: d.

Difficulty: Easy Question ID: 9.1.24 Topic: A Dimensional Perspective on Personality Disorders Skill: Understand the Concepts LO 9.3: Evaluate the dimensional personality disorder model

9.1.25. Comparing borderline and antisocial personality disorders using the dimensional approach shows the two disorders are distinguished by the fact that a diagnosis of borderline personality disorder would also include a. b. c. d.

high levels of traits involving negative affectivity. high levels of traits involving psychoticism. high levels of traits involving detachment. high levels of traits involving antagonism.

Answer: a.

Difficulty: Moderate Question ID: 9.1.25 Topic: A Dimensional Perspective on Personality Disorders Skill: Understand the Concepts LO 9.3: Evaluate the dimensional personality disorder model

9.1.26. Dr. Patel has just determined that his new client meets the criteria for a personality disorder. What would you tell Dr. Jones about the possibility that there could be a comorbid diagnosis involving some other kind of mental disorder? a. b. c. d.

Comorbid mood, anxiety, and substance use disorders are very common.

He is only likely to find evidence of a mood disorder.

It is unlikely that there will be a comorbid diagnosis.

There might well be a comorbid diagnosis, but it would not have any connection to the personality disorder.

Answer: a.

Difficulty: Moderate Question ID: 9.1.26 Topic: Frequency Skill: Apply What You Know LO 9.4: Contextualize personality disorders within a population

9.1.27. There is some evidence to support the idea that prevalent in women than in men. a. b. c. d.

personality disorder is more

schizotypal borderline antisocial psychopathic Answer: b.

Difficulty: Moderate Question ID: 9.1.27 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population

9.1.28. What is the most common personality disorder found among persons in inpatient and outpatient treatment settings? a. b. c. d.

dependent personality disorder antisocial personality disorder borderline personality disorder schizotypal personality disorder Answer: c.

Difficulty: Moderate Question ID: 9.1.28 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population

9.1.29. The class is reading a case history of an individual whose reaction to the death of a loved one is described. The individual writes that he hears the voice of a dead relative. The class is asked for a diagnosis, and everyone agrees this is an example of dysfunctional behavior. However, when the instructor disagrees, everyone is puzzled. What aspect of this case history could have led the instructor to his opinion? a. b. c. d.

Hearing the voices of a dead relative is a metaphor for the bereavement process.

The experience was probably drug induced and thus would not meet the criteria for a mental disorder.

The individual is a Native American, and in their culture, they expect to hear from the spirits of dead relatives.

The individual in question does not recognize that the symptoms are actually dysfunctional and thus would not seek therapy.

Answer: c.

Difficulty: Moderate Question ID: 9.1.29 Topic: Frequency Skill: Apply What You Know LO 9.4: Contextualize personality disorders within a population

9.1.30. Based on a longitudinal study conducted by Robins, what was one factor that predicted which boys would receive a diagnosis of antisocial personality disorder in adulthood? a. b. c. d.

history of child abuse a sibling with a criminal record extremely harsh punishment from parents history of theft or aggressive behavior Answer: d.

Difficulty: Moderate Question ID: 9.1.30 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population

9.1.31. A newspaper reporter is given the job of reporting on the survey of adolescents designed to determine the prevalence and stability of personality disorders. Which of the following would be the best headline for the reporter’s story? a. b. c. d.

“Adolescents’ Personality Disorders: Rare and Not Stable” “Adolescents’ Personality Disorders: Not Rare and Not So Stable” “Do All Adolescents Meet the Criteria for Personality Disorders?”

“Adolescence: A Period of Stress Causes A High Rate of Personality Disorders” Answer: b.

Difficulty: Moderate Question ID: 9.1.31 Topic: Frequency Skill: Apply What You Know LO 9.4: Contextualize personality disorders within a population

9.1.32. What is DSM’s position regarding the role of culture in the diagnosis of personality disorders? a. b. c. d.

Cultural standards for appropriate behavior are not taken into account.

Cultural standards for appropriate behavior must be taken into account.

The criteria for personality disorders are culturally universal.

Cultural standards are only taken into account for Cluster C disorders.

Answer: b.

Difficulty: Easy Question ID: 9.1.32 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population

9.1.33. What have family studies of the first-degree relatives of schizophrenic patients revealed about these individuals? a. b. c. d.

They rarely show schizotypal personality disorder.

They almost always show schizotypal personality disorder.

They have higher than average rates of schizotypal personality disorder.

They have lower than average rates of schizotypal personality disorder.

Answer: c.

Difficulty: Easy Question ID: 9.1.33 Topic: Schizotypal Personality Disorder (SPD) Skill: Understand the Concepts LO 9.5: Describe the psychological outlook of patients with schizotypal personality disorder

9.1.34. At a treatment planning conference, a psychologist is describing a new client who has been diagnosed with a personality disorder. The psychologist is emphasizing the ego-syntonic nature of the client’s problems because a. b. c. d.

treatment will have to focus on the client’s weak ego. the client might not be motivated for treatment. the client is an excellent candidate for treatment. the problems are psychotic in nature.

Answer: b.

Difficulty: Moderate Question ID: 9.1.34 Topic: Schizotypal Personality Disorder (SPD) Skill: Apply What You Know LO 9.5: Describe the psychological outlook of patients with schizotypal personality disorder

9.1.35. What impulse control disorder is defined by aggressive behaviors resulting in serious assaultive acts or destruction of property? a. b. c. d.

pyromania kleptomania intermittent explosive disorder borderline personality disorder Answer: c.

Difficulty: Easy Question ID: 9.1.35 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.36. The definition of personality disorder was heavily influenced by psychodynamic views about the origins of personality traits. a. b. c. d.

borderline antisocial schizotypal obsessive-compulsive Answer: a.

Difficulty: Easy Question ID: 9.1.36 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.37. Miguel feels pleasure and relief after deliberately setting a fire. Why would Miguel’s behavior be considered impulsive, rather than compulsive? a. b. c. d.

The goal of impulsive behavior is to experience pleasure.

The goal of impulsive behavior is to reduce anxiety.

The goal of impulsive behavior is motivated by anger and vengeance.

The goal of impulsive behavior is to satisfy delusional beliefs.

Answer: a.

Difficulty: Moderate Question ID: 9.1.37 Topic: Borderline Personality Disorder (BPD) Skill: Apply What You Know LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.38. You are reading for a part in a play. The description of the part describes the character as exhibiting a pervasive pattern of intense and unstable interpersonal relationships, an unstable self-image, and repeated suicidal gestures. You conclude that this character would meet the criteria for personality disorder. a. b. c. d.

schizoid dependent borderline antisocial Answer: c.

Difficulty: Moderate Question ID: 9.1.38 Topic: Borderline Personality Disorder Skill: Apply What You Know LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.39. Which disorder commonly occurs with borderline personality disorder? a. b. c. d.

phobia depression schizophrenia generalized anxiety disorder Answer: b.

Difficulty: Easy Question ID: 9.1.39 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.40. Various forms of abuse and frequent witnessing of domestic violence have been reported by adolescent girls diagnosed with a. b. c. d.

schizophrenia. hypochondria. borderline personality disorder. obsessive-compulsive personality disorder.

Answer: c.

Difficulty: Moderate Question ID: 9.1.40 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.41. What characteristics of patients with borderline personality disorder make it especially difficult to treat them with psychotherapy? a. b. c. d.

They are indifferent to others.

They are psychotic and need medication.

They are generally of very low intelligence.

They don’t easily form relationships with their therapists.

Answer: d.

Difficulty: Moderate Question ID: 9.1.41 Topic: Borderline Personality Disorder (BPD) Skill: Apply What You Know LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.42. To treat borderline personality disorder patients, dialectical behavior therapy helps patients to a. b. c. d.

makes use of philosophical arguments. seek a balance between the client’s contradictory needs. use confrontation as its major technique. remember to take their medication.

Answer: b.

Difficulty: Moderate Question ID: 9.1.42 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.43. At a conference on the treatment of borderline personality disorder, a group of psychiatrists is discussing the available drug treatment options. What is the consensus on drug treatment of this disorder? a. b. c. d.

The entire spectrum of psychoactive medications has been used, but no substantial evidence marks any one of them as effective to holistically treat the disorder.

Antidepressants seem to be the preferred choice.

Since there are many symptoms involved in this disorder, powerful antipsychotics seem to be the wisest treatment choice.

These patients are not likely to agree to take any medications that could alter their behavior.

Answer: a.

Difficulty: Moderate Question ID: 9.1.43 Topic: Borderline Personality Disorder (BPD) Skill: Apply What You Know LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.1.44. Which of the following is part of Cleckley’s description of the psychopath? a. b. c. d.

dependent, anxious, unstable psychotic, delusional, schizoid deceitful, intelligent, unreliable confused sexual identity, guilt-ridden, impotent Answer: c.

Difficulty: Easy Question ID: 9.1.44 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder

9.1.45. You are reading the records of Paul, a 28-year-old who has been diagnosed as exhibiting ASPD. The records describe his background, history, and treatments since age 8. According to the research of Lee Robins and her follow-up research, which of the following disorders is most likely to be among those given to him at some time in his 28 years? a. b. c. d.

conduct disorder mental retardation schizoid personality disorder schizotypal personality disorder Answer: a.

Difficulty: Moderate Question ID: 9.1.45 Topic: Antisocial Personality Disorder (ASPD) Skill: Apply What You Know LO 9.7: Analyze antisocial personality disorder

9.1.46. Mark has a longstanding pattern of deceitful and manipulative behaviors. He has an arrest record that traces back to his high school days. He has been arrested for driving while intoxicated, for using cocaine, and for petty larceny. Each time he has been arrested, he has been able to explain his behavior in such a way that he has been put on probation. However, those who know him well are certain that he has no real remorse for his actions. If Mark received a diagnosis, which of the following is most likely? a. b. c. d.

schizoid personality disorder antisocial personality disorder borderline personality disorder narcissistic personality disorder Answer: b.

Difficulty: Moderate Question ID: 9.1.46 Topic: Antisocial Personality Disorder (ASPD) Skill: Apply What You Know LO 9.7: Analyze antisocial personality disorder

9.1.47. Which of the following is typical of Terrie Moffitt’s category of life-course-persistent antisocial behavior? a. b. c. d.

Equal numbers of women and men are included in this category.

This category of behavior is rarely associated with antisocial personality disorder.

People whose behavior fits this category express their antisocial personality through different problem behaviors at different ages.

This type of behavior is much more common than adolescence-limited antisocial behavior.

Answer: c.

Difficulty: Moderate Question ID: 9.1.47 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder

9.1.48. Studies of antisocial personality disorder in biological and adoptive families have found that the highest rates of antisocial personality disorder (ASPD) are found in children a. b. c. d.

who are raised in adverse environments. whose adoptive parent had ASPD. whose biological parent had ASPD. who are raised in adverse environments and whose biological parents had ASPD. Answer: d.

Difficulty: Moderate Question ID: 9.1.48 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder

9.1.49. In laboratory studies, individuals are asked to learn a sequence of responses in order to receive a reward or punishment. How do the responses of psychopaths compare to the responses of normal control groups? a. b. c. d.

Psychopaths have a much more difficult time learning.

Psychopaths show high aversion to anticipated punishment.

Psychopaths show high intelligence and better overall performance.

Psychopaths do not seem to be affected by the anticipated punishment.

Answer: d.

Difficulty: Moderate Question ID: 9.1.49 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder

9.1.50. Which hypothesis offers an explanation for why psychopaths often do not respond normally to punishment? a. b. c. d.

They are preoccupied with the potential for a successful outcome.

They have never been punished.

They have been punished too often.

They lack the necessary cognitive skills to understand punishment.

Answer: a.

Difficulty: Moderate Question ID: 9.1.50 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder

9.1.51. As a forensic psychologist working for a federal prison system, you have been asked to design a treatment for antisocial personality disorder. You are aware that most programs have limited success atbest, but you also know that there are some positive findings with regard to a. b. c. d.

psychoanalytic programs that would require an inmate to see a psychiatrist five times a week. behavioral programs originally designed for the treatment of deviant sexual crimes. humanistic programs that focus on learning empathy skills. programs that stress the importance of taking all of their prescribed medicine.

Answer: b.

Difficulty: Moderate Question ID: 9.1.51 Topic: Antisocial Personality Disorder (ASPD) Skill: Apply What You Know LO 9.7: Analyze antisocial personality disorder

True/False 9.2.52. A large part of the justification for defining personality disorders as mental disorders is that they involve social dysfunction.

Answer: True Difficulty: Moderate Question ID: 9.2.52 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders 9.2.53. Generally, personality disorders tend to be ego-syntonic in nature, which means that people with personality disorders have tremendous insight into their problems.

Answer: False Difficulty: Moderate Question ID: 9.2.53 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders 9.2.54. In DSM-5, there are 10 personality disorder subtypes.

Answer: True Difficulty: Moderate Question ID: 9.2.54 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.2.55. Two of the most important motives in understanding human personality and personality disorders are affiliation and power.

Answer: True Difficulty: Moderate Question ID: 9.2.55 Topic: Symptoms Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders 9.2.56. In his perception of himself and others, Andy displays what a psychologist describes as paranoid beliefs. We can assume that Andy believes that others are trying to exploit or harm him.

Answer: True Difficulty: Moderate Question ID: 9.2.56 Topic: Symptoms Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders 9.2.57. Personality refers to a person’s most basic, characteristic styles of relating to the world, especially those styles that are evident during the first year of life.

Answer: False Difficulty: Difficult Question ID: 9.2.57 Topic: Symptoms Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders 9.2.58. With regard to the number of basic dimensions of temperament and personality, experts agree that there are at least 10.

Answer: False Difficulty: Moderate Question ID: 9.2.58 Topic: Symptoms Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders 9.2.59. Antisocial personality disorder is defined in terms of a pervasive pattern of indifference to other people, coupled with a diminished range of emotional experience and expression.

Answer: False Difficulty: Easy Question ID: 9.2.59 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster

9.2.60. Schizotypal personality disorder is defined in terms of a persistent pattern of irresponsible and remorseless behavior that begins during childhood or adolescence and continues into the adult years.

Answer: False Difficulty: Easy Question ID: 9.2.60 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster 9.2.61. Instability in mood, instability within relationships, and difficulty being alone are all characteristics of borderline personality disorder.

Answer: True Difficulty: Easy Question ID: 9.2.61 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster 9.2.62. The personality disorder in which individuals are fearful of any involvement with other people and are afraid of being publicly embarrassed is referred to as paranoid personality disorder.

Answer: False Difficulty: Easy Question ID: 9.2.62 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster 9.2.63. Avoidant personality disorder overlaps most closely with social anxiety disorder.

Answer: True Difficulty: Easy Question ID: 9.2.63 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster 9.2.64. You have a client who is diagnosed with obsessive-compulsive personality disorder. As a result, you are concerned because she is also at risk of developing schizophrenia.

Answer: False Difficulty: Moderate Question ID: 9.2.64 Topic: Diagnosis Skill: Apply What You Know LO 9.2: Compare personality disorders by cluster

9.2.65. The fact that many patients meet the criteria for more than one diagnosis is a frequent complaint about the categorical approach to diagnosis in DSM-5 that could be addressed by a dimensional approach.

Answer: True Difficulty: Easy Question ID: 9.2.65 Topic: A Dimensional Perspective on Personality Disorders Skill: Understand the Concepts LO 9.3: Evaluate the dimensional personality disorder model 9.2.66. In studies of community-based samples of adults, the overall lifetime prevalence rate for at least one personality disorder of any type is approximately 10 percent.

Answer: True Difficulty: Moderate Question ID: 9.2.66 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population 9.2.67. The personality disorder with the lowest prevalence rate is antisocial.

Answer: False Difficulty: Moderate Question ID: 9.2.67 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population 9.2.68. According to your textbook, the personality disorders may be more related to cultural expectations than any other kind of mental disorder.

Answer: True Difficulty: Easy Question ID: 9.2.68 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population 9.2.69. Cross-cultural psychology is the scientific study of ways that human behavior and mental processes are influenced by social and cultural factors.

Answer: True Difficulty: Easy Question ID: 9.2.69 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population

9.2.70. The term schizotypal originally meant an abbreviation for schizophrenic phenotype.

Answer: True Difficulty: Easy Question ID: 9.2.70 Topic: Schizotypal Personality Disorder (SPD) Skill: Understand the Concepts LO 9.5: Describe the psychological outlook of patients with schizotypal personality disorder 9.2.71. The DSM definition of schizoid personality disorder is a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships, as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts.

Answer: False Difficulty: Moderate Question ID: 9.2.71 Topic: Schizotypal Personality Disorder (SPD) Skill: Understand the Concepts LO 9.5: Describe the psychological outlook of patients with schizotypal personality disorder 9.2.72. One of the problems in treating patients with personality disorders is their high level of distress about their problems.

Answer: False Difficulty: Easy Question ID: 9.2.72 Topic: Schizotypal Personality Disorder (SPD) Skill: Understand the Concepts LO 9.5: Describe the psychological outlook of patients with schizotypal personality disorder 9.2.73. In reference to borderline personality disorder, a common feature is splitting, which is the tendency to see people as all good or all bad.

Answer: True Difficulty: Easy Question ID: 9.2.73 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder 9.2.74. Repetitive behaviors can be described as either compulsive or impulsive, depending on whether the original goal was to express anger or anxiety.

Answer: False Difficulty: Moderate Question ID: 9.2.74 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder

9.2.75. Kleptomania is defined as stealing objects that are not needed for personal use or for their financial value, and theft is not motivated by anger or vengeance.

Answer: True Difficulty: Easy Question ID: 9.2.75 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder 9.2.76. In psychodynamic therapy, the transference relationship is defined as the way in which the patient behaves toward the therapist that reflects early primary relationships. In this type of therapy, this relationship is interpreted in order to improve the patients’ ability to experience themselves and other people in a more realistic and integrated way.

Answer: True Difficulty: Moderate Question ID: 9.2.76 Topic: Borderline Personality Disorder (BPD) Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder 9.2.77. Out of all personality disorders, paranoid personality disorder has been studied the most thoroughly and for the longest period of time.

Answer: False Difficulty: Easy Question ID: 9.2.77 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder 9.2.78. Long-term studies of antisocial behavior in psychopaths suggest that these behaviors tend to remain constant throughout adulthood.

Answer: False Difficulty: Easy Question ID: 9.2.78 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder

9.2.79. It is thought that one reason children with a difficult temperament are more likely to end up showing life-course-persistent antisocial behavior is because they evoke maladaptive reactions from their parents.

Answer: True Difficulty: Moderate Question ID: 9.2.79 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder 9.2.80. A psychologist is studying individuals who have been diagnosed with antisocial personality disorder. The research involves hooking up physiological devices near the eye. This researcher is investigating shiftiness of the eyes as an indication of deception.

Answer: False Difficulty: Moderate Question ID: 9.2.80 Topic: Antisocial Personality Disorder (ASPD) Skill: Apply What You Know LO 9.7: Analyze antisocial personality disorder

9.2.81. One of the factors that complicates treatment of antisocial personality disorder is high rates of comorbid alcoholism and other substance dependence.

Answer: True Difficulty: Easy Question ID: 9.2.81 Topic: Antisocial Personality Disorder (ASPD) Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorder

Essay 9.3.82. What do we mean when we say a disorder is ego-syntonic?

Answer: Personality disorders are usually described as ego-syntonic, which means the ideas or impulses with which they are associated are acceptable to the person. These people do not see themselves as disturbed and do not have insight into their problems. Most other forms of mental disorder are ego-dystonic, which means the people that experience these disorders are distressed by their symptoms.

Difficulty: Easy Question ID: 9.3.82 Topic: Introduction Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders

9.3.83. Describe the maladaptive traits someone scoring high or low on the neuroticism factor might experience.

Answer: High scorers on the neuroticism scale may be extremely nervous, hypersensitive, easily angered, depressed, easily embarrassed, impulsive, or easily overwhelmed by stress. Low scorers on the neuroticism scale may lack appropriate anxiety, have an inability to express anger or appreciate losses, be indifferent to opinions of others, be restrained or restricted, or be oblivious to danger.

Difficulty: Easy Question ID: 9.3.83 Topic: Symptoms Skill: Understand the Concepts LO 9.1: Explain the major factors involved in the symptomology of personality disorders 9.3.84. DSM-5 uses a categorical system for personality disorders, in which 10 types are organized into 3 clusters on the basis of broadly defined characteristics. What are these clusters and what are the organizing characteristics of each?

Answer: The 3 clusters are labeled Clusters A, B, and C. Cluster A describes people who often appear odd or eccentric. This cluster includes paranoid, schizoid, and schizotypal personality disorders. Cluster B includes antisocial, borderline, histrionic, and narcissistic personality disorder. Patients with these disorders often appear dramatic, emotional, or erratic in their behavior. All are associated with marked difficulty in sustaining interpersonal relationships.

Cluster C describes people who often appear anxious or fearful. This cluster includes avoidant, dependent, and obsessive-compulsive personality disorders.

Difficulty: Easy Question ID: 9.3.84 Topic: Diagnosis Skill: Understand the Concepts LO 9.2: Compare personality disorders by cluster 9.3. 84. DSM-5 describes personality disorders in terms of discrete categories. Discuss the limitations of this approach.

Answer: Use of discrete categories leaves no way of describing people with traits who don’t meet the criteria for a disorder. Because of common overlap in personality disorders, the final diagnosis (either using one diagnosis or two) doesn’t provide an accurate description of individual traits. The dimensional approach is more complete, especially for individuals on the boundary of two disorders. The dimensional approach retains six of the 10 specific types of PD from the categorical system, which retains some continuity with the categorical system while allowing ratings of traits to replace the currently used diagnostic criteria.

Difficulty: Moderate Question ID: 9.3.85 Topic: A Dimensional Perspective on Personality Disorders Skill: Understand the Concepts LO 9.3: Evaluate the dimensional personality disorder model

9.3.86. Discuss the importance of understanding a patient’s culture when making a diagnostic decision.

Answer: The personality disorders may be more closely tied to cultural expectations than any other kind of mental disorder. In DSM-5, personality disorders are defined in terms of behavior that “deviates markedly from the expectations of the individual’s culture.” In setting this guideline, the authors of DSM-5 recognized that judgments regarding appropriate behavior vary considerably from one society to the next. Some cultures encourage restrained or subtle displays of emotion, whereas others promote visible, public displays of anger, grief, and other emotional responses. Behavior that seems highly dramatic or extraverted in the former cultures might create a very different impression in the latter cultures. Cultures also differ in the extent to which they value individualism as opposed to collectivism. Someone who seems exceedingly self-centered and egotistical in a collectivist society, such as Japan, might appear to be normal in an individualistic society like the United States.

Difficulty: Moderate Question ID: 9.3.86 Topic: Frequency Skill: Apply What You Know LO 9.4: Contextualize personality disorders within a population 9.3.87. Discuss the results of studies of the prevalence of personality disorders based on community and clinical samples.

Answer: Community-based samples of adults have yielded lifetime prevalence rates of having at least one personality disorder at about 10 percent. The highest prevalence rates are for antisocial, obsessive-compulsive, and avoidant personality disorders. Narcissistic personality disorder seems to be the least common. Borderline personality disorder seems to be the most common in both inpatient and outpatient settings.

Difficulty: Moderate Question ID: 9.3.87 Topic: Frequency Skill: Understand the Concepts LO 9.4: Contextualize personality disorders within a population 9.3.88. Discuss the relationship between schizotypal personality disorder and schizophrenia.

Answer: The term “schizotypal” was originally coined as an abbreviation for schizophrenic phenotype. The maladaptive personality traits of this diagnosis are presumably seen among people who possess a genotype that makes them vulnerable to developing schizophrenia. It has been recognized for many years that a fairly large proportion of the family members of schizophrenic patients exhibit strange or unusual behaviors that are similar to, but milder than, the disturbance shown by the patient. Evidence from twin studies also points to a significant genetic contribution to schizotypal personality disorder, and there is an increased prevalence of schizotypal personality disorder among the parents and siblings of schizophrenic patients.

Difficulty: Moderate Question ID: 9.3.88 Topic: Schizotypal Personality Disorder Skill: Understand the Concepts LO 9.5: Describe the psychological outlook of patients with schizotypal personality disorder

9.3.89. Discuss the etiology of borderline personality disorder.

Answer: Genetic factors are clearly involved in the etiology of borderline personality disorder when it is viewed in terms of the syndrome that is defined in DSM-5. Furthermore, the fundamental personality traits that serve to define the disorder, such as neuroticism and impulsivity, are also influenced by genetic factors. Some investigators have argued that borderline patients suffer from the negative consequences of parental loss, neglect, and mistreatment during childhood. Adolescent girls with borderline personality disorder report a pervasive lack of supervision, frequent witnessing of domestic violence, and being subject to inappropriate behavior by parents and other adults, including verbal, physical, and sexual abuse.

Difficulty: Moderate Question ID: 9.3.89 Topic: Borderline Personality Disorder Skill: Understand the Concepts LO 9.6: Outline treatment challenges for patients with borderline personality disorder 9.3.90. Describe some of the key characteristics of Hervey Cleckley’s description of psychopathy? What are the key characteristics of the DSM definition of antisocial personality disorder?

Answer: In his book, The Mask of Sanity, Hervey Cleckley described psychopaths as impulsive, self-centered, pleasure-seeking individuals who seemed to lack emotions such as anxiety, shame, and guilt. These individuals were also seen as intelligent and superficially charming, but also chronically deceitful, unreliable, and incapable of learning from experience. Psychopathy, as a diagnostic approach, places primary emphasis on emotional deficits and personality traits. The characteristics in Cleckley’s definition were difficult to diagnose reliably. Consequently, DSM-III placed special emphasis on observable behaviors and repeated conflicts with authorities, including a failure to conform to social norms. Psychopathy and antisocial personality disorder are two different attempts to define the same disorder. However, they are sufficiently different in that they do not identify the same people. According to critics, DSM-III blurred the distinction between antisocial personality and criminality. However, Cleckley was clear on this point: all criminals are not psychopaths, and all psychopaths are not convicted criminals. DSM-5 criteria require the presence of the symptoms of conduct disorder prior to age 15. In addition, the individual must exhibit at least three of seven signs of irresponsible and antisocial behavior after age 15.

Difficulty: Moderate Question ID: 9.3.90 Topic: Antisocial Personality Disorder Skill: Understand the Concepts LO 9.7: Analyze antisocial personality disorders

9.3.91. Explain how genetic factors, family processes, and the social environment interact in the etiology of antisocial behavior.

Answer: Children with a difficult temperament may be especially irritating to their parents. Their resistance to disciplinary efforts may discourage parents from maintaining persistent discipline, and this type of child might be most likely to evoke maladaptive reactions from parents who are poorly equipped to deal with this kind of behavior. As a result, parents might be driven either to use unusually harsh punishments or to abandon any attempt at discipline. This interaction fosters the development of poorly controlled behavior, which is then perpetuated when the person selects friends who share similar antisocial interests and problems.

Difficulty: Moderate Question ID: 9.3.91 Topic: Antisocial Personality Disorder Skill: Apply What You Know LO 9.7: Analyze antisocial personality disorders

Chapter 10 Feeding and Eating Disorders Total Assessment Guide (T.A.G.) Topic

Overview

Question Type Multiple Choice

Understand the Concepts 1,3,4,5,6

True/False

51,52,53,67

Apply What You Know 2

Essay

Symptoms of Anorexia

Symptoms of Bulimia

Diagnosis of Feeding and Eating Disorders Frequency of Anorexia and Bulimia

Multiple Choice

7,8,9,13,14*

10,11,12

True/False

54,55,56

57

Essay

81,82*

Multiple Choice

14*,15,17

True/False

58,59,60,61

Essay

82*,89

Multiple Choice

20,21,22

True/False

62,63

Essay

83,90

Multiple Choice

24

True/False

64,65,66,67,68, 69,70 84

Essay Multiple Choice

Causes of Anorexia and Bulimia

True/False

27,29,30,31,32, 34,36,39,40 71,72,73,74,75,76

Essay

85,86

Multiple Choice Treatments for Anorexia and True/False Bulimia Essay

*This question covers two topics

16,18

19

23,25,26

28,33,35,37,38

42,43,44,47,48, 49,50 77,78,79,80

41,45,46

88

87

Analyze It

Evaluate It

Chapter 10: Feeding and Eating Disorders Multiple Choice 10.1.1. What is the primary characteristic of anorexia nervosa? a. b. c. d.

self-induced vomiting eating non-nutrient substances repeated episodes of binge eating starving oneself Answer: d.

Difficulty: Easy Question ID: 10.1.1 Topic: Overview Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia

10.1.2. During a lecture on eating disorders, the lecturer tells the audience, “Let's be candid, anorexia is a misnomer.” Most of the people around you are puzzled until the expert explains. What does she say? a. b. c. d.

“Anorexia nervosa is much less prevalent than is generally believed.”

“Anorexia is actually a form of suicide among clinically depressed adolescents.”

“The emphasis should be on the nervosa because this is a neurological disorder.”

“The term anorexia means 'loss of appetite,' but people with this disorder are actually hungry.”

Answer: d.

Difficulty: Moderate Question ID: 10.1.2 Topic: Overview Skill: Apply What You Know LO 10.1 Outline the symptoms of anorexia

10.1.3. The chief characteristic of bulimia nervosa is a. b. c. d.

self-induced vomiting. binge eating. self-starvation. a preoccupation with food.

Answer: b.

Difficulty: Easy Question ID: 10.1.3 Topic: Overview Skill: Understand the Concepts LO 10.2. Summarize the symptoms of bulimia

10.1.4. According to the National Centers for Disease Control and Prevention, at any point in time percent of high school females are attempting to lose weight, as compared with percent of males. a. b. c. d.

60/30 15 / 44 10 / 2 2 / 10 Answer: a.

Difficulty: Moderate Question ID: 10.1.4 Topic: Overview Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia

10.1.5. A national survey found that almost percent of American women have a negative body image, particularly concerning their waists, hips, and/or thighs. a. b. c. d.

1 25 50 75 Answer: c.

Difficulty: Moderate Question ID: 10.1.5 Topic: Overview Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia

10.1.6. In the case of Serrita, whose struggle with anorexia is described in your textbook, what was her attitude about her condition that is common to many diagnosed with anorexia? a. b. c. d.

She admitted to being too thin and acknowledged her need to gain weight.

She admitted to being too thin but denied that she needed to gain weight.

She denied that she was too thin.

She admitted to being too thin but blamed it on a biochemical deficiency.

Answer: c.

Difficulty: Easy Question ID: 10.1.6 Topic: OverviewSkill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia

10.1.7. The average victim of anorexia nervosa is a. b. c. d.

percent below normal body weight.

10 15 25 35 Answer: c.

Difficulty: Moderate Question ID: 10.1.7 Topic: Symptoms of Anorexia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia

10.1.8. Which of the following is a defining symptom of anorexia nervosa? a. b. c. d.

amenorrhea fear of gaining weight binge eating depression Answer: b.

Difficulty: Easy Question ID: 10.1.8 Topic: Symptoms of Anorexia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia

10.1.9. One reason why individuals with anorexia steadfastly deny problems with their weight seems to be because they a. b. c. d.

don’t trust others enough to admit the truth. have a distorted body image and do not perceive their appearances accurately. never feel hungry. are often at or near normal weight.

Answer: b.

Difficulty: Easy Question ID: 10.1.9 Topic: Symptoms of Anorexia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia

10.1.10. Agnes, who suffers from anorexia, is dangerously thin but has been steadfastly refusing to eat enough to gain weight. If Agnes could honestly explain to you why she doesn’t eat, what would she probably say? a. b. c. d.

“I'm not hungry.”

“I don't enjoy the taste of food and it makes me sick.”

“I am intensely afraid of becoming fat.”

“I want to die.”

Answer: c.

Difficulty: Moderate Question ID: 10.1.10 Topic: Symptoms of Anorexia Skill: Apply What You Know LO 10.1 Outline the symptoms of anorexia

10.1.11. A patient’s medical chart includes the word lanugo. You can tell from the chart that the patient has anorexia nervosa. What will you expect to observe when the patient is examined? a. b. c. d.

brittle bones a wide eyed stare irregular heart beat fine, downy hair on her face and trunk Answer: d.

Difficulty: Moderate Question ID: 10.1.11 Topic: Symptoms of Anorexia Skill: Apply What You Know LO 10.1 Outline the symptoms of anorexia

10.1. 12. A film producer wants to make a movie describing several cases of young women who have been diagnosed as suffering from anorexia nervosa. He is especially interested in exploring some of the psychological dynamics related to the disorder. Which of the following titles might be the best choice for the film? a. b. c. d.

A Struggle for Control: Anorexia Nervosa Anorexia Nervosa: I Don't Want to Grow Up How Depression Masquerades as Eating Disorders Sexual Disorders and Anorexia Nervosa: A Two-Way Street Answer: a.

Difficulty: Moderate Question ID: 10.1. 12 Topic: Symptoms of Anorexia Skill: Apply What You Know LO 10.1 Outline the symptoms of anorexia

10.1.13. Which of these are likely to be comorbid with anorexia nervosa? a. b. c. d.

bipolar disorder and somatization disorder depression and obsessive-compulsive disorder agoraphobia and borderline personality disorder hypochondriasis and dependent personality disorder Answer: b.

Difficulty: Moderate Question ID: 10.1.13 Topic: Symptoms of Anorexia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia

10.1.14. In the two cases of eating disorders presented in your textbook—Serrita with anorexia and Michelle with bulimia—there was a very clear difference in their emotional reactions to their behavior.

Serrita felt while Michelle felt . a. b. c. d.

shame / pride pride / shame out of control / in control depressed / euphoric Answer: b.

Difficulty: Moderate Question ID: 10.1.14 Topic: Symptoms of Anorexia and Symptoms of Bulimia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia and LO 10.2 Summarize the symptoms of bulimia

10.1.15. What types of food are individuals with bulimia nervosa most likely to consume during an episode of binge eating? a. b. c. d.

high protein foods foods they do not ordinarily eat foods that are high in cholesterol non-nutritive, high bulk substances Answer b.

Difficulty: Easy Question ID: 10.1.15 Topic: Symptoms of Bulimia Skill: Understand the Concepts LO 10.2 Summarize the symptoms of bulimia

10.1.16. Assume that each of the following individuals has a diagnosis of bulimia nervosa. Which one of them is most likely to engage in an episode of binge eating at this point? a. b. c. d.

Penelope, who is upset over failing two exams and just had an argument with her parents Farrah, who is wondering what will happen to her town now that a major employer has cut back on jobs Diane, who is watching television and feels sleepy as she listens to the reports of political polls Suchira, who just won a scholarship to the college she wanted to attend and is going out to celebrate Answer: a.

Difficulty: Difficult Question ID: 10.1.16 Topic: Symptoms of Bulimia Skill: Apply What You Know LO 10.2 Summarize the symptoms of bulimia

10.1.17. The DSM-5 criteria for bulimia nervosa refer to compensatory behavior. Which of the following represents this type of behavior? a. b. c. d.

going to the gym to watch others exercise use of laxatives after an episode of bingeing feeling out of control during an episode of bingeing fantasizing about food rather than giving in to the temptation to eat Answer: b.

Difficulty: Easy Question ID: 10.1.17 Topic: Symptoms of Bulimia Skill: Understand the Concepts LO 10.2 Summarize the symptoms of bulimia

10.1.18. Janet is making her annual visit to the dentist. As he is examining her mouth, she senses some concern. She asks if he has found cavities, and he says no. He finally comes right out and asks if she has bulimia. What clue suggested this possible diagnosis? a. b. c. d.

eroded dental enamel large gaps between teeth teeth that are growing in crooked open sores at the base of the teeth Answer: a.

Difficulty: Moderate Question ID: 10.1.18 Topic: Symptoms of Bulimia Skill: Apply What You Know LO 10.2 Summarize the symptoms of bulimia

10.1.19. Ann has the diagnosis of anorexia nervosa, the restricting type. What does this diagnosis mean to the team of professionals that is going to treat her? a. b. c. d.

She rarely engages in bingeing or purging.

Her personality characteristics have made it difficult to determine if she has a problem at all.

She has a rare form of anorexia nervosa in which she is able to maintain her weight within five pounds of her expected weight.

The treatments that can be used are limited to those that can address the underlying biological malfunctions responsible for the disorder.

Answer: a.

Difficulty: Moderate Question ID: 10.1.19 Topic: Diagnosis of Feeding and Eating Disorders Skill: Apply What You Know LO 10.3 Analyze how to recognize eating disorders

10.1.20. The validity of the distinction between the restricting type and the binge eating/purging type of anorexia nervosa is questioned mainly because a. b. c. d.

they both express a gender bias. they do not differ in terms of comorbidity, recovery, relapse, or mortality. individuals diagnosed with either subtype describe themselves in similar terms. these subtypes are clearly distinct and never appear with any overlapping.

Answer: b.

Difficulty: Moderate Question ID: 10.1.20 Topic: Diagnosis of Feeding and Eating Disorders Skill: Understand the Concepts LO 10.3 Analyze how to recognize eating disorders

10.1.21. Which of the following diagnoses is new to the DSM-5? a. b. c. d.

binge-eating disorder pica rumination disorder bulimia nervosa Answer: a.

Difficulty: Easy Question ID: 10.1.21 Topic: Diagnosis of Feeding and Eating Disorders Skill: Understand the Concepts LO 10.3 Analyze how to recognize eating disorders

10.1.22. Which is most accurate with regard to why the purging and nonpurging subtypes of bulimia nervosa were removed from DSM-5? a. b. c. d.

They were not supported by the research.

The subtypes were separated into distinct diagnoses.

This distinction was only useful when deciding on treatment strategies.

The distinction was confusing to clinicians.

Answer: a.

Difficulty: Easy Question ID: 10.1.22 Topic: Diagnosis of Feeding and Eating Disorders Skill: Understand the Concepts LO 10.3 Analyze how to recognize eating disorders

10.1.23. A researcher discussing the prevalence of eating disorders makes reference to what she says is a cohort effect for these disorders. What does this mean? a. b. c. d.

Eating disorders tend to run in close-knit families.

Women born after 1960 have a higher rate of bulimia nervosa than women born prior to 1960.

Families that place a special emphasis on eating meals together have high rates of eating disorders.

The frequency of eating disorders is strongly related to the rate among friends, especially in high school.

Answer: b.

Difficulty: Moderate Question ID: 10.1.23 Topic: Frequency of Anorexia and Bulimia Skill: Apply What You Know LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia

10.1.24. Which of the following is a reason frequently given by scientists to explain the much higher rate of eating disorders among females? a. b. c. d.

Women are much more likely than men to base self-image on body image.

Men are not concerned about appearance.

Men do not have to be concerned about the cultural image of good looks.

Women do not tend to judge men based on appearance.

Answer: a.

Difficulty: Moderate Question ID: 10.1.24 Topic: Frequency of Anorexia and Bulimia Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia

10.1.25. Although it is certainly an unusual source of data for researchers, some have looked at Playboy centerfolds and Miss America Beauty pageant contestants. How is this research relevant to eating disorders? a. b. c. d.

The emphasis on thinness is a relatively recent phenomenon in the last 20 years.

These women’s facial features indicated they had dieted beyond the point of medical safety.

Between 1959 and 1988, their ratio of weight to height for these groups declined dramatically.

In their interviews, almost all of these women gave subtle clues suggesting they were in deep conflict concerning weight control.

Answer: c.

Difficulty: Moderate Question ID: 10.1.25 Topic: Frequency of Anorexia and Bulimia Skill: Apply What You Know LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia

10.1.26. Your friend is a whiz when it comes to maps. He decides to create a computerized map showing the countries where eating disorders are likely to occur. He asks you for assistance in creating this visual image. What will you tell him? a. b. c. d.

These disorders occur in nearly all societies.

These disorders occur only in the United States and Canada.

These disorders occur in cultures with small population growth.

These disorders occur almost exclusively in North America, Europe, and industrialized Asian countries.

Answer: d.

Difficulty: Moderate Question ID: 10.1.26 Topic: Frequency of Anorexia and Bulimia Skill: Apply What You Know LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia

10.1.27. Which of the following occupations is associated with an elevated risk for developing eating disorders? a. b. c. d.

nurse singer secretary gymnast Answer: d.

Difficulty: Easy Question ID: 10.1.27 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.28. You have been asked to design a targeted prevention program of eating disorders. Which group would receive the most focus in your program design? a. b. c. d.

lower-class 20- to 24-year-old black females upper-class 16- to 20- year-old black females lower-class 24- to 30- year-old white females upper-class 16- to 20-year-old white females Answer: d.

Difficulty: Difficult Question ID: 10.1.28 Topic: Causes of Anorexia and Bulimia Skill: Apply What You Know LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.29. The tendency to develop eating disorders seems related to which of the following variables? a. b. c. d.

high school grades degree of extraversion exposure to popular media ratio of female to male friends Answer: c.

Difficulty: Easy Question ID: 10.1.29 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.30. Which of the following characterizes the concept proposed by Minuchin of the enmeshed family? a. b. c. d.

mood disorders run in the family family members are overly involved in one another’s lives the children in the family were born within short periods of time family members have overlapping responsibilities within the home Answer: b.

Difficulty: Moderate Question ID: 10.1.30 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.31. What have researchers found concerning the relationship between eating disorders and an individual's report of sexual abuse? a. b. c. d.

Sexual abuse is reported much more frequently by those with eating disorders than other pathologies.

The rate of reports of sexual abuse among those with eating disorders is lower than in the general population.

Sexual abuse is reported by those with anorexia at higher rates than those with other pathologies, but not those with bulimia.

The rate of reports of sexual abuse among those with eating disorders is similar to that found in other pathologies.

Answer: d.

Difficulty: Moderate Question ID: 10.1.31 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.32. An expert on eating disorders describes those with such disorders as “lacking interoceptive awareness.” Which of the following characterizes this lack? a. b. c. d.

People with eating disorders do not recognize internal cues, including emotional states and hunger.

Those with eating disorders do not understand how other people are trying to influence their behavior in subtle ways.

People with eating disorders do not pay attention to the nonverbal behavior of individuals during conversations.

Those with eating disorders often confuse hunger pangs with signs of deeper psychological significance.

Answer: a.

Difficulty: Moderate Question ID: 10.1.32 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.33. An expert on eating disorders is giving a talk about the relationship between eating disorders and depression. Which of the following would be an appropriate title for this talk? a. b. c. d.

“Depression: The Primary Cause of Eating Disorders” “Depression: Both Cause and Effect” “Successful Treatment of Eating Disorders Has No Effect on Depression” “Eating Disorders Are Symptoms of Depression” Answer: b.

Difficulty: Moderate Question ID: 10.1.33 Topic: Causes of Anorexia and Bulimia Skill: Apply What You Know LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.34. Efforts to understand the relationship between depression and eating disorders have focused on which of the following depressive symptoms? a. b. c. d.

psychomotor retardation sleep disturbances low self-esteem generalized anxiety Answer: c.

Difficulty: Easy Question ID: 10.1.34 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.35. Research participants have been asked to identify with a figure within a series of schematic figures of women ranging from very thin to very obese. What is the subject of this research? a. b. c. d.

body-size delusional systems deficits in sensory perception dissatisfaction with body image the effects of punishment on eating behavior Answer: c.

Difficulty: Moderate Question ID: 10.1.35 Topic: Causes of Anorexia and Bulimia Skill: Apply What You Know LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.36.

Vogele and Gibson. a. b. c. d.

,or a negative mood state, commonly triggers episodes of binge eating according to

Anaphylaxis Hysteria Anhedonia Dysphoria Answer: d.

Difficulty: Moderate Question ID: 10.1.36 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.37. Ann suffers from bulimia and has been gaining weight. Her parents are concerned and have been encouraging her to go on a diet. What would you tell her and her parents? a. b. c. d.

“She lacks the will power to diet successfully.”

“She has an unconscious reason to maintain weight.”

“An inherited endocrine dysfunction is most likely responsible for the difficulty she has losing weight.”

“Dieting is likely to contribute directly to subsequent binge eating.”

Answer: d.

Difficulty: Difficult Question ID: 10.1.37 Topic: Causes of Anorexia and Bulimia Skill: Apply What You Know LO 10.5 Evaluate the causes of anorexia and bulimia?

10.1.38.A medical technician looks up from the microscope and says to his supervisor, “I think we have a case of hyperlipogenesis here.” What would this information tell the physician about the patient whose tests the technician just analyzed? a. b. c. d.

The patient suffered cardiac arrest secondary to an eating disorder.

The patient’s body is storing an abnormally large amount of fat in fat cells.

The patient’s endocrine system is working at a high rate that will soon lead to exhaustion.

The patient’s heart rate has increased as a result of having to push more blood through clogged arteries.

Answer: b.

Difficulty: Moderate Question ID: 10.1.38 Topic: Causes of Anorexia and Bulimia Skill: Apply What You Know LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.39. With respect to the role of genetics in eating disorders, it is most likely that a. b. c. d.

anorexia is inherited, but not bulimia. bulimia is inherited, but not anorexia. genetics might influence some personality characteristics that increase the risk for eating disorders. eating disorders are responses to cultural pressures and are totally unrelated to genetics.

Answer: c.

Difficulty: Moderate Question ID: 10.1.39 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.40. Although extremely rare, eating disorders have been linked to lesions in the a. b. c. d.

striatum. cerebellum. hippocampus. hypothalamus.

Answer: d.

Difficulty: Easy Question ID: 10.1.40 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.1.41. In establishing an eating disorder clinic, your group of professionals is keen to include all of the therapies that are currently being used to treat these disorders. You will likely include several different therapies, including a. b. c. d.

token economies. the Maudsley method. hypnosis. role playing.

Answer: b.

Difficulty: Moderate Question ID: 10.1.41 Topic: Treatments for Anorexia and Bulimia Skill: Apply What You Know LO 10.6 Contrast treatments for anorexia and bulimia

10.1.42. The most widely studied form of family therapy for eating disorders involves parents initially taking complete control over the child’s eating. Age-appropriate autonomy is returned to the child as eating improves. This system is called the a. b. c. d.

parental control method. pyschodynamic method.

Montreux method.

Maudsley method.

Answer: d.

Difficulty: Moderate Question ID: 10.1.42 Topic: Treatmentss for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia

10.1.43. In one study, a. b. c. d.

lead to a 70 to 80 percent reduction in binge eating and purging.

psychodynamic therapy aversive conditioning client-centered therapy cognitive-behavioral therapy Answer: d.

Difficulty: Moderate Question ID: 10.1.43 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia

10.1.44. Frances suffers from bulimia nervosa and is seeing a therapist who is focusing on normalizing her eating patterns and addressing her dysfunctional attitudes. Which form of therapy is her therapist providing? a. b. c. d.

psychodynamic therapy aversive conditioning interpersonal therapy cognitive-behavioral therapy Answer: d.

Difficulty: Easy Question ID: 10.1.44 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia

10.1.45. Paula suffers from bulimia nervosa and is considering treatment with an antidepressant medication. Knowing that you have been studying this issue, she asks your opinion. What should you tell her? a. b. c. d.

“Antidepressants have been shown to be very effective.”

“Antidepressants will help you with your purging but not with your bingeing.”

“Relapse is common when medication is stopped.”

“Because antidepressants make you feel better, you will be less motivated to deal with your eating disorder.”

Answer: c.

Difficulty: Moderate Question ID: 10.1.45 Topic: Treatments for Anorexia and BulimiaSkill: Apply What You Know LO 10.6 Contrast treatments for anorexia and bulimia

10.1.46. A cognitive psychologist is proposing a study of the effectiveness of several forms of therapy for treating anorexia nervosa. She sends her proposal to the ethics committee for review. Although the committee approves the proposal from an ethics standpoint, one of the committee members writes her a note saying, “Be aware of the allegiance effect.” What will this note mean to the psychologist in regard to her proposal? a. b. c. d.

Clients will show greater recovery when they are treated by the same therapists across time.

Clients will work hard to recover to demonstrate that their choice of therapist is indeed the best.

Because she is a cognitive therapist she is more likely to find that form of therapy to be the most successful.

Funding agencies will be more likely to give grants to researchers who are responsive to the needs of the granting agency.

Answer: c.

Difficulty: Difficult Question ID: 10.1.46 Topic: Treatments for Anorexia and BulimiaSkill: Apply What You Know LO 10.6 Contrast treatments for anorexia and bulimia

10.1.47. is a form of treatment that does not address eating disorders directly and was actually used as the placebo treatment in several early studies. Still, this form of treatment has been found to be more effective after 12 months than therapies that are directed at eating disorders. a. b. c. d.

Interpersonal therapy Antianxiety medications Antidepressant medications Education about nutrition and health Answer: a.

Difficulty: Moderate Question ID: 10.1.47 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia

10.1.48. How do long-term outcomes for the treatment of anorexia nervosa compare to long-term outcomes for the treatment of bulimia nervosa? a. b. c. d.

The long-term success is greater for bulimia nervosa.

The long-term success is greater for anorexia nervosa.

There is no difference in long-term outcomes for treating these disorders.

Although there is a higher mortality rate for anorexia, the success of treatment is otherwise better for anorexia.

Answer: a.

Difficulty: Moderate Question ID: 10.1.48 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia

10.1.49. A third generation of more successful prevention efforts for eating disorders does not directly focus on body image or disordered eating. These efforts attack the thinness ideal indirectly, or focus on a. b. c. d.

eliminating unhealthy eating habits rather than promoting healthy habits. promoting healthy eating rather than eliminating unhealthy habits. encouraging healthy communications styles in families. eliminating unhealthy communication styles in families.

Answer: b.

Difficulty: Moderate Question ID: 8.1.49 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia

10.1.50. A study is a research study in which neither the patient nor the therapist knows if the patient is receiving the treatment in question or the placebo. a. b. c. d.

double blind double control dependent control post hoc Answer: a.

Difficulty: Easy Question ID: 10.1.50 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia

True/False 10.2.51. An eating disorder is a severe disturbance in eating behavior that results from an obsessive fear of gaining weight. Some experts have suggested that dieting disorder would be a more accurate term to describe this disturbance.

Answer: True Difficulty: 2 Question ID: 10.2.51 Topic: Overview Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia 10.2.52. For both anorexia and bulimia, the rate of occurrence in females compared to in males is about 2 to 1.

Answer: False Difficulty: 1 Question ID: 10.2.52 Topic: Overview Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia 10.2.53. According to the textbook, European American and Latina women report higher rates of body dissatisfaction than African American women.

Answer: True Difficulty: Moderate Question ID: 10.2.53 Topic: Overview Skill: Understand the Concepts LO 10. 4 Explain the factors contributing to the frequency of anorexia and bulimia 10.2.54. An inaccurate perception of body size and shape is known as distorted body image.

Answer: True Difficulty: Easy Question ID: 10.2.54 Topic: Symptoms of Anorexia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia 10.2.55. About 10 percent of people with anorexia nervosa are estimated to die of starvation, suicide, or medical complications stemming from their extreme weight loss.

Answer: False Difficulty: Moderate Question ID: 10.2.55 Topic: Symptoms of Anorexia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia

10.2.56. Amenorrhea is an undue influence of body shape on self-evaluation.

Answer: False Difficulty: Easy Question ID: 10.2.56 Topic: Symptoms of Anorexia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia 10.2.57. Priya’s physician is distressed by her anorexia nervosa. Her weight loss is bad enough, but her medical tests show clear signs of an electrolyte imbalance. The physician’s major concern is that she could possibly develop cardiac or kidney problems.

Answer: True Difficulty: Moderate Question ID: 10.2.57 Topic: Symptoms of Anorexia Skill: Apply What You Know LO 10.1 Outline the symptoms of anorexia 10.2.58. Binge eating is defined as eating an amount of food that is clearly larger than most people would eat under similar circumstances in a fixed period of time, for example, less than 2 hours.

Answer: True Difficulty: Easy Question ID: 10.2.58 Topic: Symptoms of Bulimia Skill: Understand the Concepts LO 10.2 Summarize the symptoms of bulimia 10.2.59. Purging involves behaviors designed to eliminate consumed food from the body.

Answer: True Difficulty: Easy Question ID: 10.2.59 Topic: Symptoms of Bulimia Skill: Understand the Concepts LO 10.2 Summarize the symptoms of bulimia 10.2.60. Anxiety disorders are often comorbid with bulimia, especially in bulimic patients who self induce vomiting.

Answer: False Difficulty: Moderate Question ID: 10.2.60 Topic: Symptoms of Bulimia Skill: Understand the Concepts LO 10.2 Summarize the symptoms of bulimia

10.2.61. In the middle of an episode of binge eating, a woman is likely to describe feeling like she is in a hypnotic trance.

Answer: False Difficulty: Moderate Question ID: 10.2.61 Topic: Symptoms of Bulimia Skill: Understand the Concepts LO 10.2 Summarize the symptoms of bulimia 10.2.62. Anorexia nervosa includes two subtypes; the restricting type and the binge eating/purging type.

Answer: True Difficulty: Moderate Question ID: 10.2.62 Topic: Diagnosis of Feeding and Eating Disorders Skill: Understand the Concepts LO 10.3 Analyze how to recognize eating disorders 10.2.63. A diagnostic criterion for binge-eating disorder is that the person feels embarrassed while eating.

Answer: True Difficulty: Easy Question ID: 10.2.63 Topic: Diagnosis of Feeding and Eating Disorders Skill: Understand the Concepts LO 10.3 Analyze how to recognize eating disorders 10.2.64. The prevalence of bulimia is declining, while the prevalence of anorexia is increasing.

Answer: False Difficulty: Easy Question ID: 10.2.64 Topic: Frequency of Anorexia and Bulimia Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia 10.2.65. A cohort is a group that shares some feature in common, for example, year of birth.

Answer: True Difficulty: Easy Question ID: 10.2.65 Topic: Frequency of Anorexia and Bulimia Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia

10.2.66. Psychological studies repeatedly show that exposure to images of super-thin women increases body image distortion among girls and young women.

Answer: False Difficulty: Moderate Question ID: 10.2.66 Topic: Frequency of Anorexia and Bulimia Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia 10.2.67. Some experts argue that pressures to be strong and muscular have created a new eating disorder among males sometimes called “reverse anorexia,” which is characterized by excessive emphasis on extreme muscularity and often accompanied by the abuse of anabolic steroids. This disorder is referred to by some as the superhero complex.

Answer: False Difficulty: Moderate Question ID: 10.2.67 Topic: Overview Skill: Understand the Concepts LO 10.3 Analyze how to recognize eating disorders 10.2.68. Epidemiologists have found that bulimia nervosa and anorexia nervosa occur at the same rates.

Answer: False Difficulty: Easy Question ID: 10.2.68 Topic: Frequency of Anorexia and Bulimia Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia 10.2.69. A cross-cultural researcher is investigating the relationship between body weight and wealth in Third World countries. He is most likely to have found that there is a strong positive relationship between body weight and wealth.

Answer: True Difficulty: Moderate Question ID: 10.2.69 Topic: Frequency of Anorexia and Bulimia Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia 10.2.70. Anorexia and bulimia typically begin in early childhood.

Answer: False Difficulty: Easy Question ID: 10.2.70 Topic: Frequency of Anorexia and Bulimia Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia

10.2.71. Compared to families of individuals with anorexia nervosa, in families of individuals with bulimia nervosa you more likely to find cohesion and the absence of conflict.

Answer: False Difficulty: Moderate Question ID: 10.2.71 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia 10.2.72. Recognition of internal cues, including hunger and various emotional states, is called interoceptive awareness.

Answer: True Difficulty: Moderate Question ID: 10.2.72 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia 10.2.73. Researchers are finding an increased rate of schizotypal personality disorder in both victims of eating disorders and their family members.

Answer: False Difficulty: Moderate Question ID: 10.2.73 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia 10.2.74. A dysphoric body image is a highly critical evaluation of one’s weight and shape that is thought, by clinicians, to contribute to the development of eating disorders.

Answer: False Difficulty: Easy Question ID: 10.2.74 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia 10.2.75. A weight level the body seems to defend by adjusting its rate of energy use is called the metabolic weight.

Answer: False Difficulty: Easy Question ID: 10.2.75 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.2.76. The etiology of eating disorders underscores the importance of equifinality, which is the idea that all eating disorders develop in the same way.

Answer: False Difficulty: Moderate Question ID: 10.2.76 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia 10.2.77. The first goal of the treatment of anorexia nervosa is gaining at least a minimal amount of weight.

Answer: True Difficulty: Easy Question ID: 10.2.77 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia 10.2.78. Predictors of a better prognosis for eating disorders include an early age of onset, conflict-free parent–child relationships, early treatment, less weight loss, and the absence of binge eating and purging.

Answer: True Difficulty: Easy Question ID: 10.2.78 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia 10.2.79. In the long run, viewed in a timeframe longer than 12 months, the most effective form of psychotherapy for the treatment of bulimia nervosa seems to beinterpersonal.

Answer: True Difficulty: Moderate Question ID: 10.2.79 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia 10.2.80. Third-generation eating disorder prevention programs that have had the most success in reducing binge eating are ones that focus on eliminating unhealthy eating habits.

Answer: False Difficulty: Moderate Question ID: 10.2.80 Topic: Treatments for Anorexia and Bulimia Skill: Understand the Concepts LO 10.6 Contrast treatments for anorexia and bulimia

Essay 10.3.81. Discuss the defining characteristics of anorexia.

Answer: The most obvious and most dangerous symptom is significantly low weight. While DSM-5 has no formal cutoff, the average victim is 25 to 30 percent below normal body weight.

The second defining characteristic is an intense fear of gaining weight. This fear is not assuaged by weight loss. In fact, the fear may grow more intense as the individual loses more weight. The final defining symptom is a disturbance in how weight or shape is experienced. Many individuals with eating disorders tend to deny that they have any problem at all with weight. Other symptoms, including amenorrhea, medical complications, and comorbid psychological disorders may be present in an individual suffering from anorexia as well.

Difficulty: Moderate Question ID: 10.3.81 Topic: Symptoms of Anorexia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia 10.3.82. Explain why bulimia nervosa and anorexia nervosa are both considered to be characterized by a struggle for control.

Answer: People with bulimia feel out of control and ashamed of their lack of control, and their disorder is an attempt to regain a sense of control. People with anorexia pride themselves in selfcontrol, and their disorder is typified by excessive self-control.

Difficulty: Moderate Question ID: 10.3.82 Topic: Symptoms of Anorexia and Symptoms of Bulimia Skill: Understand the Concepts LO 10.1 Outline the symptoms of anorexia and LO 10.2 Summarize the symptoms of bulimia 10.3.83. How does DSM-5 handle obesity and binge-eating disorder?

Answer: Binge-eating disorder, a new diagnosis that has been added to DSM-5, is defined by episodes of binge eating without compensatory behavior. Binge eating is associated with a number of psychological and physical difficulties, including obesity. Obesity, which is typically defined as having a BMI greater than 30, was also considered for inclusion into DSM-5.

Ultimately, obesity was not included. Calling obesity a “mental disorder” is controversial, especially given the high prevalence of overweight individuals in the United States.

Difficulty: Moderate Question ID: 10.3.83 Topic: Diagnosis of Feeding and Eating Disorders Skill: Understand the Concepts LO 10.3 Analyze how to recognize eating disorders

10.3.84. What patterns in the epidemiology of eating disorders suggest sociocultural influences on their development?

Answer: The prevalence of eating disorders is higher in industrialized societies such as North America, Europe, and industrialized Asian countries. In the United States, the prevalence is higher in whites than blacks, those in higher socioeconomic groups, and women in jobs where slimness is valued. Eating disorders are also more frequent among groups who move into new areas where eating disorders exist, such as among Arabs and Asians who move to Western countries. Finally, in the United States, there are an increasing number of eating disorder cases among well-to-do African Americans.

Difficulty: Moderate Question ID: 10.3.84 Topic: Frequency of Anorexia and Bulimia Skill: Understand the Concepts LO 10.4 Explain the factors contributing to the frequency of anorexia and bulimia 10.3.85. Summarize the research on the biological factors involved in eating and weight regulation.

Answer: Physiologically, weight is maintained around weight set points, which are fixed or small ranges in weight. Weight regulation around set points results from the interplay between behavior, peripheral physiological activity, and central physiological activity. The process works like a thermostat to regulate the heating and cooling of air temperature near a given setting. If weight declines, hunger increases and food consumption goes up. There is a slowing of the metabolic rate and movement toward hyperlipogenesis. These reactions have obvious survival value and are likely products of evolution. The body does not distinguish between intentional attempts to lose weight and potential starvation.

Difficulty: Moderate Question ID: 10.3.85 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia 10.3.86. Summarize what is currently known about the role of genetics and neurophysiology in eating disorders.

Answer: Concordance rates for bulimia are higher for monozygotic twins than for dizygotic twins. However, the difference can be explained by several different heritable mechanisms.

Eating disorders are unlikely to be directly inherited. Genetics may influence personality characteristic that lead to bulimia, or a certain body type or weight set point may be inherited.

Genes clearly affect weight and body type, but we cannot mindlessly conclude that eating disorders are genetic without carefully considering genetic mechanisms and gene-environment interactions. In rare instances, a hormonal disturbance or a lesion in the hypothalamus has been linked to eating disorders.

Difficulty: Moderate Question ID: 10.3.86 Topic: Causes of Anorexia and Bulimia Skill: Understand the Concepts LO 10.5 Evaluate the causes of anorexia and bulimia

10.3.87. As a clinical psychologist who specializes in the treatment of bulimia nervosa, you have been asked to design a program based on the successful work of Fairburn, who utilized a variety of cognitivebehavioral techniques. Discuss the program you will design.

Answer: Fairburn conceptualizes the cause of Bulimia nervosa as a combination of maladaptive tendencies, including an excessive emphasis on weight and shape, perfectionism, and dichotomous “black or white” thinking. His program, that we will replicate, involves three stages.

The first stage involves education and behavioral strategies to normalize eating patterns and end the cycle of eating restraint followed by binging and purging. Second, we will introduce traditional cognitive therapy methods that aim to convince the client of her cognitive errors, such as illogical and dysfunctional beliefs about the importance of weight and its connection to the self-image. This stage will draw heavily on the methods introduced by Beck. Third, as clients develop more logical and reasonable cognitions and beliefs, we will attempt to consolidate these into day to day realistic expectations about weight, diet, and strategies for relapse prevention.

Difficulty: Moderate Question ID: 10.3.87 Topic: Treatments of Anorexia and Bulimia Skill: Apply What You Know LO 10.6 Contrast treatments for anorexia and bulimia 10.3.88. Describe the research on the effectiveness of different forms of therapy for treating bulimia nervosa.

Answer: Although interpersonal therapy does not directly address eating disorders, it has emerged as a very successful form of treatment. This therapy focuses on difficulties in close relationships.

Interpersonal therapy was studied in an investigation of the effectiveness of cognitive-behavioral therapy. The researchers used interpersonal therapy as a placebo control group in their study.

They were interested in studying the effectiveness of cognitive-behavioral therapy and needed a credible placebo. At the end of the study, cognitive therapy was more effective than interpersonal therapy. However, at the 12-month follow-up, the interpersonal therapy group continued to improve. They equaled those of the cognitive-behavioral therapy group and outdistanced those in the behavior therapy alone group.

Difficulty: Moderate Question ID: 10.3.88 Topic: Treatments of Anorexia and Bulimia Skill: Conceptual LO 10.6 Contrast treatments for anorexia and bulimia 10.3.89. Discuss the defining characteristics of bulimia nervosa.

Answer: The three essential characteristics of bulimia are recurrent episodes of binge eating, recurrent inappropriate compensatory behaviors to prevent weight gain, and a self-evaluation that is unduly influenced by body shape and weight. Binge eating is defined as consuming an amount of food that is clearly larger than most people would eat under similar circumstances in a fixed period of time. Whether planned in advance or beginning spontaneously, binges are typically characterized by a lack of control and secretiveness. Most people with bulimia are ashamed of their behavior and go to elaborate efforts to conceal their binge eating. A binging episode is commonly triggered by emotional distress, and the binge eating may temporarily alleviate the unhappy feelings. However, physical discomfort, shame, and fear of gaining weight quickly return. Most people with bulimia then engage in some form of purging designed to eliminate the consumed food from their body. While the most common form of purging is vomiting, other

forms of compensatory behavior include the misuse of laxative, diuretics, or enemas, or extreme exercising or rigid fasting. The self-esteem and daily routines of a person with bulimia are often focused on their weight and diet. Their sense of self is closely linked to their appearance, making them highly sensitive to the compliments or criticisms from others. Depression is a common comorbid condition, as are anxiety disorders, personality disorders, and substance use.

Difficulty: Moderate Question ID: 10.3.89 Topic: Symptoms of Bulimia Skill: Understand the Concepts LO 10.2 Summarize the symptoms of bulimia 10.3.90. In addition to anorexia, bulimia nervosa, and binge eating disorder, DSM-5 includes three other relatively rare feeding and eating disorders. What are these and what are their key characteristics?

Answer: The other feeding and eating disorders included in DSM-5 are pica, rumination disorder, and avoidant/restrictive food intake disorder. Pica is the eating of non-nutritive, nonfood substances, such as paper, soap, cloth, or dirt. Although the onset of pica can occur at any age, it is most common that it begins in childhood and is most likely in the context of intellectual disability or other mental disorders. Rumination disorder involves repeated regurgitation of food, which may then be re-chewed and either re-swallowed or spit out of the mouth. The onset of this disorder most commonly occurs in infancy, but may begin at any age, and is most common in individuals with intellectual disability. Avoidant/restrictive food intake disorder is characterized by an apparent lack of interest in food, an avoidance of food based on the sensory characteristics of food, or a concern about aversive consequences of eating. This disorder most commonly develops in childhood, but can arise at any age. There is no evidence of a disturbance in how someone with this disorder perceives their weight or body shape.

Difficulty: Moderate Question ID: 10.3.90 Topic: Diagnosis of Feeding and Eating Disorders Skill: Understand the Concepts LO 10.3 Analyze how to recognize eating disorders

Chapter 11 Substance-Related and Addictive Disorders Total Assessment Guide (T.A.G.)

Topic

Introduction

Symptoms of Addiction Alcohol, Tobacco, & Psychomotor Stimulants Impact of Other Drugs on Human Physiology & Behavior Diagnosis of Substance Use Disorders Frequency of Substance Use Disorders Causes of Substance Addiction Treatment for Substance Use Disorders Gambling Disorder

Question Type

Understand The Concepts

Apply What You Know

Multiple Choice True/False Essay Multiple Choice True/False Essay Multiple Choice True/False Essay Multiple Choice

2,3,4,5,6 51,52,53

1,7

8,9,12,13,15

10,11,14

True/False

63,64,65,66

Essay Multiple Choice True/False Essay Multiple Choice True/False Essay Multiple Choice True/False Essay Multiple Choice True/False Essay Multiple Choice True/False Essay

54,55,56,57 81,82 17,18 58,59,60,61,62

16,19

83 20,21,22,23,24,26 25

27,28,30 67,68 84 33,34 69,70

29

35,36,37,39 71,72,73,74,75 85,86,87,88 43,44,48 76,77 89 50

38,40,41,42

78,79,80 90

31,32

45,46,47,49

Analyze It

Evaluate It

Chapter 11: Substance-Related and Addictive Disorders Multiple Choice 11.1.1. Your friend misses work and has serious family difficulties because he uses drugs. However, he is not addicted to drugs. What DSM-5 diagnosis should be made in this case? a. b. c. d.

substance use disorder substance abuse substance dependence substance ingestion habit Answer: a.

Difficulty: Moderate Question ID: 11.1.1 Topic: Introduction Skill: Apply What You Know LO 11.1: Describe psychological features common to addictive disorders

11.1.2. DSM-5 defines substance use disorders in terms of a. b. c. d.

addiction. tolerance and withdrawal. craving and lack of control. a maladaptive pattern of behaviors.

Answer: d.

Difficulty: Easy Question ID: 11.1.2 Topic: Introduction Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.1.3. Previous versions of the diagnostic manual used the term substance use disorders that were at least moderate in severity. a. b. c. d.

substance abuse anhedonia substance dependence self-destructive tendencies Answer: c.

Difficulty: Easy Question ID: 11.1.3 Topic: Introduction Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

to describe

11.1.4. While watching a television show, you hear one of the characters, a physician, talking about narcotic analgesics. What is another name for these drugs? a. b. c. d.

opiates hypnotics cannabinoids benzodiazepines Answer: a.

Difficulty: Moderate Question ID: 11.1.4 Topic: Introduction Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.1.5. What type of drug is alcohol? a. b. c. d.

opiate analgesic central nervous system stimulant central nervous system depressant Answer: d.

Difficulty: Easy Question ID: 11.1.5 Topic: Introduction Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.1.6. Which term describes central nervous system depressants that are used to relieve anxiety? a. b. c. d.

opiates hypnotics analgesics anxiolytics Answer: d.

Difficulty: Easy Question ID: 11.1.6 Topic: Introduction Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.1.7. For a class assignment, you are asked to find information on cocaine. A reference book on drugs lists them by major category. Under which category will you find cocaine? a. b. c. d.

opiates stimulants depressants hallucinogens Answer: b.

Difficulty: Moderate Question ID: 11.1.7 Topic: Introduction Skill: Apply What You Know LO 11.1: Describe psychological features common to addictive disorders

11.1.8. Which of the following offers a useful basis for distinguishing between people who are dependent on alcohol and those who are not? a. b. c. d.

legal involvement due to drinking the amount of money spent on alcohol the number of problems due to drinking the amount of alcohol consumed each week Answer: c.

Difficulty: Moderate Question ID: 11.1.8 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.1.9. Which of the following is an example of psychological dependence on alcohol? a. b. c. d.

not wanting to drink alone drinking to relieve negative moods the ability to drink more and more over time cognitive impairments due to alcohol abuse Answer: b.

Difficulty: Moderate Question ID: 11.1.9 Topic: Symptoms Skill: Apply What You Know LO 11.1: Describe psychological features common to addictive disorders

11.1.10. You are designing a research study to test the effectiveness of a new type of treatment program for alcohol use disorder, and you want to be able to assess changes in your subjects’ craving for alcohol.

Which of the following would be a good index of their craving? a. b. c. d.

the amount of alcohol they drink the discomfort they experience when they don’t drink their need to increase the amount that they drink the amount of time they spend planning to drink Answer: d.

Difficulty: Moderate Question ID: 11.1.10 Topic: Symptoms Skill: Apply What You Know LO 11.1: Describe psychological features common to addictive disorders

11.1.11. Metabolic tolerance involves changes in involves changes in . a. b. c. d.

while pharmacodynamic tolerance

neurons / enzymes enzymes / neurons brain / neuron neuron / brain Answer: b.

Difficulty: Difficult Question ID: 11.1.11 Topic: Symptoms Skill: Apply What You Know LO 11.1: Describe psychological features common to addictive disorders

11.1.12. In one type of tolerance, cues that are regularly associated with the administration of a drug begin to function as conditioned stimuli and elicit a conditioned response that is opposite in direction to the natural effect of the drug in the process of conditioning. a. b. c. d.

tolerance drug metabolic behavioral Answer: d.

Difficulty: Moderate Question ID: 11.1.12 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.1.13. When a heavy drinker stops drinking alcohol, what happens to his biological system that causes withdrawal symptoms? a. b. c. d.

It is deprived of essential vitamins.

It has become psychologically dependent.

It rebounds after functioning in a chronically depressed state.

It rebounds after functioning in a chronically stimulated state.

Answer: c.

Difficulty: Moderate Question ID: 11.1.13 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.1.14. The police find a man in a seedy part of town; he looks in “bad shape,” so they call for an ambulance. On the way to the hospital, the paramedic calls the hospital base with the following description: approximately 50-year-old white male, heavy sweating, hand tremors, seems delirious, and appears to be experiencing hallucinations. When the patient arrives at the hospital, the emergency room physician suspects that the patient is experiencing a. b. c. d.

cocaine withdrawal. barbiturate overdose. a schizophrenic episode. alcohol withdrawal delirium.

Answer: d.

Difficulty: Moderate Question ID: 11.1.14 Topic: Symptoms Skill: Apply What You Know LO 11.1: Describe psychological features common to addictive disorders

11.1.15. Based on reports from people who use drugs, which psychoactive substance is least associated with tolerance and withdrawal effects? a. b. c. d.

opiates sedatives and hypnotics hallucinogens cocaine Answer: c.

Difficulty: Moderate Question ID: 11.1.15 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.1.16. Charles is administered a blood alcohol level test, and the results show 400 mg percent. Which of the following characterizes his state? a. b. c. d.

slightly intoxicated very intoxicated, at risk of slipping into coma unaffected by the small amount he drank earlier his driving is impaired, but he could walk home Answer: b.

Difficulty: Difficult Question ID: 1.1.16 Topic: Symptoms Skill: Apply What You Know LO 11.2: Summarize the effects of different drugs on substance abusers

11.1.17. What is the physiological basis of the short-term effects of nicotine? a. b. c. d.

blocks the release of GABA and acetylcholine increases the release of GABA and acetylcholine blocks the release of norepinephrine and dopamine increases the release of norepinephrine and dopamine Answer: d.

Difficulty: Moderate Question ID: 11.1.17 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Understand the Concepts LO 11.2: Summarize the effects of different drugs on substance abusers

11.1.18. Why are cocaine and amphetamines called stimulant drugs? a. b. c. d.

They activate the sympathetic nervous system.

They activate the parasympathetic nervous system.

They reduce the level of GABA available in the brain.

They increase the level of GABA available in the brain.

Answer: a.

Difficulty: Easy Question ID: 11.1.18 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Understand the Concepts LO 11.2: Summarize the effects of different drugs on substance abusers

11.1.19. In your role as a police officer, you sometimes come across individuals who seem to be hallucinating and have delusions of persecution. In addition to the possibility that these individuals may have a mental disorder or be under the influence of various hallucinogenic drugs, you must also consider the possibility of a. b. c. d.

marijuana withdrawal. amphetamine use. acute depression. nicotine withdrawal.

Answer: b.

Difficulty: Difficult Question ID: 11.1.19 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Apply What You Know LO 11.2: Summarize the effects of different drugs on substance abusers

11.1.20. Alex is listening to a lecture on the history of opiate drugs, and he learns something that he finds very surprising. What has he heard the lecturer say? a. b. c. d.

“Heroin is a synthetic opiate made from morphine.”

“Heroin has actually been legally available by prescription in the U.S. for years.”

“Heroin is a synthetic drug that was originally developed as an antidepressant.”

“Heroin is not really an opiate because it is synthetic and does not actually come from poppies.”

Answer: a.

Difficulty: Moderate Question ID: 11.1.20 Topic: Impact Skill: Understand the Concepts LO 11.3: Differentiate the effects of controlled substances by drug class

11.1.21. Which category of drugs is made up of those used to treat anxiety disorders and sleeping problems? a. b. c. d.

opiates stimulants benzodiazepines selective serotonin reuptake blockers Answer: c.

Difficulty: Moderate Question ID: 11.1.21 Topic: Impact Skill: Understand the Concepts LO 11.3: Differentiate the effects of controlled substances by drug class

11.1.22. People who stop taking relatively high doses of benzodiazepines can experience an abrupt return of the original anxiety they were using the drugs to suppress. This is called a. b. c. d.

a return of the repressed. high anxiety. the rebound anxiety syndrome. a discontinuance syndrome.

Answer: d.

Difficulty: Moderate Question ID: 11.1.22 Topic: Impact Skill: Understand the Concepts LO 11.3: Differentiate the effects of controlled substances by drug class

11.1.23. What is the most common active ingredient in marijuana? a. b. c. d.

LSD PCP THC LOB Answer: c.

Difficulty: Easy Question ID: 11.1.23 Topic: Impact Skill: Understand the Concepts LO 11.3: Differentiate the effects of controlled substances by drug class

11.1.24. Cannabis intoxication is often accompanied by temporal disintegration. This means that a. b. c. d.

the drug breaks down quickly in the body. people have trouble retaining and organizing information. intoxication can quickly lead to a nervous breakdown. intoxication leads to social withdrawal and isolation.

Answer: b.

Difficulty: Easy Question ID: 11.1.24 Topic: Impact Skill: Understand the Concepts LO 11.3: Differentiate the effects of controlled substances by drug class

11.1.25. While out in the wild, a group of vacationers pick some mushrooms. Later in the day, they use them in cooking the evening meal. Several members of the group begin to experience strange sensations and even hallucinations. The drug in the mushrooms was most likely a. b. c. d.

PCP. marijuana. psilocybin. exogenous opiates.

Answer: c.

Difficulty: Moderate Question ID: 11.1.25 Topic: Impact Skill: Apply What You Know LO 11.3: Differentiate the effects of controlled substances by drug class

11.1.26. What hallucinogen, at high doses, can induce psychotic behavior, including delusional thinking, catatonic behavior, manic excitement, and sudden mood changes? a. b. c. d.

LSD PCP cocaine alcohol Answer: b.

Difficulty: Moderate Question ID: 11.1.26 Topic: Impact Skill: Understand the Concepts LO 11.1: 3: Differentiate the effects of controlled substances by drug class

11.1.27. What evidence led developers of DSM-5 to remove the distinction between substance abuse and substance dependence? a. b. c. d.

Substance abuse was moved to the impulse control disorders section.

Substance abuse was removed because abusers do not suffer serious impairment.

People who abuse substances are always dependent on substances.

Evidence suggests dependence and abuse are not clearly distinct forms of disorder.

Answer: d.

Difficulty: Moderate Question ID: 11.1.27 Topic: Diagnosis Skill: Understand the Concepts LO 11.4: Analyze substance abuse within a sociocultural context

11.1.28. Tolerance and withdrawal are considered the alcohol use disorder. a. b. c. d.

criteria included in the definition of

impaired control social impairment pharmacological risky use Answer: c.

Difficulty: Moderate Question ID: 11.1.28 Topic: Diagnosis Skill: Understand the Concepts LO 11.4: Analyze substance abuse within a sociocultural context

11.1.29. Mindy was just arrested for driving while intoxicated (DWI). Why would we not necessarily diagnose Mindy with an alcohol use disorder? a. b. c. d.

She is female, and alcohol use disorder is only seen in males.

DSM excludes DWI as a criterion for alcohol use disorder.

DSM requires a recurrent pattern of problematic use.

Intoxication is not pathological.

Answer: c.

Difficulty: Moderate Question ID: 11.1.29 Topic: Diagnosis Skill: Apply What You Know LO 11.4: Analyze substance abuse within a sociocultural context

11.1.30. What pattern of drinking-related behavior was reported by Vaillant in his longitudinal study of males? a. b. c. d.

Most of the men stopped drinking prior to age 30.

Those who remained abstinent for six years were unlikely to relapse.

The majority of the men drank so heavily, they were dead before the age of 40.

The rate of abstinence was low and changed little over the course of the follow-up.

Answer: b.

Difficulty: Moderate Question ID: 11.1.30 Topic: Diagnosis Skill: Understand the Concepts LO 11.4: Analyze substance abuse within a sociocultural context

11.1.31. As a behavioral advisor to the World Health Organization, you are required to assess drug use and abuse in indigenous populations. You have been assigned to study the South American natives’ use of coca leaves, which are part of the plant from which cocaine is derived. In reading about past findings, you discover that these native groups a. b. c. d.

have very few drug use problems. have very serious drug use problems. are so hostile to the World Health Organization that no studies have been done. have almost been wiped out due to local drug wars.

Answer: a.

Difficulty: Moderate Question ID: 11.1.31 Topic: Frequency Skill: Apply What You Know LO 11.5: Apply demographic data to substance use disorders

11.1.32. You have been asked to design a targeted drug prevention program. Your task is to decide on which sex, if any, should receive more attention. You decide that it depends on which drug or drugs are under consideration and that a. b. c. d.

for alcohol abuse only, the focus should be on women, who have a higher rate of alcohol abuse. for drug abuse, in general, the focus should be on women, who have a higher rate than men. for drug abuse, in general, the focus should be on men, who have the highest rate. for drug abuse, in general, the rates are equal, so each sex will have to be targeted.

Answer: c.

Difficulty: Moderate Question ID: 11.1.32 Topic: Frequency Skill: Apply What You Know LO 11.5: Apply demographic data to substance use disorders

11.1.33. According the National Comorbidity Study, the lifetime prevalence of nicotine dependence is approximately percent. a. b. c. d.

2 12 24 40 Answer: c.

Difficulty: Moderate Question ID: 11.1.33 Topic: Frequency Skill: Understand the Concepts LO 11.5: Apply demographic data to substance use disorders

11.1.34. Which of the following are you most likely to find among the elderly in the United States? a. b. c. d.

higher rates of alcohol abuse than among younger people higher rates of drug abuse than among younger people prescription drug abuse and dependence illegal drug abuse and dependence Answer: c.

Difficulty: Easy Question ID: 11.1.

Topic: Frequency Skill: Understand the Concepts LO 11.5: Apply demographic data to substance use disorders

11.1.35. Which of the following characteristics are strong predictors of adolescents’ initial experimentation with drugs? a. b. c. d.

extroversion and agreeableness introversion and impulsiveness rebelliousness and extroversion introversion and conscientiousness Answer: c.

Difficulty: Easy Question ID: 11.1.35 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.1.36. Why are investigators interested in the fast flush phenomenon? a. b. c. d.

It is often seen in people of Asian ancestry and might explain why they drink less.

It is often seen in people of Asian ancestry and might explain why they drink more.

It is often seen in young people and might explain why they drink more.

It is often seen in females and might explain why they drink less.

Answer: a.

Difficulty: Moderate Question ID: 11.1.36 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.1.37. What have researchers concluded from research on the concordance rates of monozygotic (MZ) and dizygotic (DZ) twins? a. b. c. d.

The role for genetics is much larger for males than it is for females.

Genetic factors play a small role in etiology of alcoholism among women.

Similar concordance rates for MZ and DZ twins suggest no significant role for genetics.

Concordance rates suggest a role for genetics, and higher concordance rates among males reflect the higher prevalence of alcoholism among males.

Answer: d.

Difficulty: Moderate Question ID: 11.1.37 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.1.38. Genetic factors in the cause of alcohol abuse could be somewhat indirect. It has been suggested, for example, that genes that influence may cause a person to be more likely to risk alcohol dependence. a. b. c. d.

intelligence depression ADHD sensation seeking Answer: d.

Difficulty: 3 Question ID: 11.1.38 Topic: Causes Skill: Apply What You Know LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.1.39. Scientists who study the biological basis of addiction have devoted considerable attention to understanding the rewarding properties of drugs. Much of this attention has focused on a. b. c. d.

serotonin. dopamine. norepinephrine.

GABA. Answer: b.

Difficulty: Easy Question ID: 11.1.39 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.1.40. You have access to an fMRI facility and plan to study brain regions associated with drug addiction. You advise your team that it would be wise to focus on the a. b. c. d.

reward pathways of the brain. hippocampus. cerebellum. substantia nigra.

Answer: a.

Difficulty: Moderate Question ID: 11.1.40 Topic: Causes Skill: Apply What You Know LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.1.41. What evidence has been cited by scientists who propose that alcoholism is related to endogenous opioid production? a. b. c. d.

Alcohol is an opioid derivative.

Rats given morphine refuse alcohol.

The symptoms of withdrawal from alcohol and heroin are similar.

Opioid-antagonists can reduce the subjective “high” of drinking.

Answer: d.

Difficulty: Difficult Question ID: 11.1.41 Topic: Causes Skill: Apply What You Know LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.1.42. A researcher is using the balanced placebo design to investigate the effects of alcohol on aggression. What has this research added to our knowledge of alcohol? a. b. c. d.

Given a choice, most participants prefer tonic to alcohol.

Expectations play an important role in the effects attributed to alcohol.

Alcohol has powerful placebo effects in the treatment of many medical conditions.

The effects of alcohol are the result of an inherited failure to metabolize the drug.

Answer: b.

Difficulty: Moderate Question ID: 11.1.42 Topic: Causes Skill: Apply What You Know LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.1.43. The treatment of alcoholism and other types of substance use disorders is an especially difficult task because a. b. c. d.

no effective treatment techniques have been developed. it is unethical to use drugs in the treatment of substance use disorders. many people with substance use disorders do not acknowledge their difficulties. very few professionals have any expertise in the treatment of substance use disorders.

Answer: c.

Difficulty: Easy Question ID: 11.1.43 Topic: Treatment Skill: Understand the Concepts LO 11.7: Evaluate treatments for substance use disorders

11.1.44. One of the controversies involving the treatment of substance use disorders is whether a. b. c. d.

total abstinence from drinking or drug use is the only acceptable goal. people recovering from substance use disorders should be allowed to treat others. treatment should begin before the person has stopped drinking or drug use. it is appropriate to encourage people to seek help when they are not ready to admit to a problem.

Answer: a.

Difficulty: Moderate Question ID: 11.1.44 Topic: Treatment Skill: Understand the Concepts LO 11.7: Evaluate treatments for substance use disorders

11.1.45. What is likely to occur if Javier takes Antabuse and then has a shot of whiskey? a. b. c. d.

He will become aggressive.

He will become violently ill.

He will become intoxicated more quickly.

He will not feel the effects of the alcohol.

Answer: b.

Difficulty: Moderate Question ID: 11.1.45 Topic: Treatment Skill: Apply What You Know LO 11.7: Evaluate treatments for substance use disorders

11.1.46. A relative was admitted to the hospital and given doses of naltrexone for problems related to alcohol. How will this drug affect the man? a. b. c. d.

It will block the action of GABA. It will block the action of norepinephrine.

It will increase levels of dopamine in the brain.

It will decrease the level of endogenous opioids.

Answer: d.

Difficulty: Moderate Question ID: 11.1.46 Topic: Treatment Skill: Apply What You Know LO 11.7: Evaluate treatments for substance use disorders

11.1.47. Barbara is seeing a therapist to help her with her drinking problem, and her therapist is trying to improve Barbara’s social skills and ability to solve problems. This therapist is probably a a. b. c. d.

psychiatrist. recovering alcoholic. cognitive-behavioral therapist. motivational counselor.

Answer: c.

Difficulty: Moderate Question ID: 11.1.47 Topic: Treatment Skill: Apply What You Know LO 11.7: Evaluate treatments for substance use disorders

11.1.48. The cognitive behavioral model of relapse prevention is concerned with the abstinence violation effect. What is the abstinence violation effect? a. b. c. d.

a patient’s tendency to lie about concealed drinking the fact that drinking in public is illegal in some states a patient's feeling that he or she is being controlled by the therapist the pattern of going back to chronic drinking if one slips up even a little Answer: d.

Difficulty: Moderate Question ID: 11.1.48 Topic: Treatment Skill: Understand the Concepts LO 11.7: Evaluate treatments for substance use disorders

11.1.49. At the mental health center, a young man will begin what is called motivational interviewing.

What can this man expect during the session that will follow? a. b. c. d.

Several members of law enforcement organizations will “lay it out” for this client: either he “shapes up or he will go to jail.”

A physician will try to ascertain the reasons behind this man’s failure to comply with instructions to take Antabuse on a daily basis.

Using a nonconfrontational approach, an interviewer will help him to resolve his ambivalence about using drugs and to make a definite commitment to change.

A number of recovered drug addicts will confront him with what awaits if he does not change his ways.

Answer: c.

Difficulty: Moderate Question ID: 11.1.49 Topic: Treatment Skill: Apply What You Know LO 11.7: Evaluate treatments for substance use disorders

11.1.50. Gambling disorder was moved to the chapter on substance-related and addictive disorders because a. b. c. d.

all gambling is seen as a mental disorder. people with serious gambling problems often suffer from substance use disorders. behavioral addictions involve the same exposure of toxic chemicals on the brain. all of the impulse control disorders were moved along with gambling disorder.

Answer: b.

Difficulty: Easy Question ID: 11.1.50 Topic: Gambling Disorder Skill: Understand the Concepts LO 11.8: Compare gambling disorder to substance use disorders

True/False 11.2.51. Addiction and dependence are older terms that are often used to describe problems such as alcoholism. These terms have been replaced in official terminology by the term substance use disorder.

Answer: True Difficulty: Easy Question ID: 11.2.51 Topic: Introduction Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.2.52. The term psychoactive substances is used to describe chemicals that can alter a person’s mood, perception, or brain functioning?

Answer: True Difficulty: Easy Question ID: 11.2.52 Topic: Introduction Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders 11.2.53. Polysubstance abuse refers to abuse of synthetic drugs.

Answer: False Difficulty: Easy Question ID: 11.2.53 Topic: Introduction Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.2.54.A term that is frequently used to describe a forceful urge to use drugs is a Craving.

Answer: True Difficulty: Easy Question ID: 11.2.54 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders 11.2.55. Tolerance for a psychoactive substance refers to the ability to consume several drugs at the same time with limited adverse effects.

Answer: False Difficulty: Moderate Question ID: 11.2.55 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders 11.2.56. The symptoms that can be thought of as the “flip side” of tolerance symptoms are known as dependency symptoms.

Answer: False Difficulty: Moderate Question ID: 11.2.56 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders

11.2.57.The process in which neurons adapt to psychoactive drug use by reducing the number of receptors or by reducing their sensitivity to the drug is known as metabolic regulation.

Answer: False Difficulty: Moderate Question ID: 11.2.57 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders 11.2.58. The legal limit of alcohol concentration for driving in most states, as measured in the number of milligrams (mg) of alcohol per 100 milliliters of blood (percent) is 10 mg percent.

Answer: False Difficulty: Moderate Question ID: 11.2.58 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Understand the Concepts LO 11.2: Summarize the effects of different drugs on substance abusers 11.2.59. Many people who abuse alcohol experience blackouts. A blackout is losing consciousness and passing out.

Answer: False Difficulty: Easy Question ID: 11.2.59 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Understand the Concepts LO 11.2: Summarize the effects of different drugs on substance abusers 11.2.60. Some theorists have suggested that nicotine mimics the effects of antianxiety medications.

Answer: False Difficulty: Moderate Question ID: 11.2.60 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Understand the Concepts LO 11.2: Summarize the effects of different drugs on substance abusers 11.2.61. Your textbook suggests that withdrawal from nicotine is on a par with withdrawal from heroin.

Answer: True Difficulty: Easy Question ID: 11.2.61 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Understand the Concepts LO 11.2: Summarize the effects of different drugs on substance abusers

11.2.62. Cocaine is a member of a group of drugs known as psychomotor stimulants.

Answer: True Difficulty: Easy Question ID: 11.2.62 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Understand the Concepts LO 11.2: Summarize the effects of different drugs on substance abusers 11.2.63. The active substances in opium are codeine and morphine.

Answer: True Difficulty: Moderate Question ID: 11.2.63 Topic: Impact Skill: Understand the Concepts LO 11.3: Differentiate the effects of controlled substances by drug class 11.2.64. The families of drugs that include barbiturates and benzodiazepines are also known informally as narcotics.

Answer: False Difficulty: Moderate Question ID: 11.2.64 Topic: Impact Skill: Understand the Concepts LO 11.3: Differentiate the effects of controlled substances by drug class 11.2.65.The dried leaves and/or flowers of a cannabis plant are known as marijuana.

Answer: True Difficulty: Easy Question ID: 11.2.65 Topic: Impact Skill: Understand the Concepts LO 11. \3: Differentiate the effects of controlled substances by drug class 11.2.66. Hashish refers to the dried resin from the center of the opium poppy.

Answer: False Difficulty: Easy Question ID: 11.2.66 Topic: Impact Skill: Understand the Concepts LO 11.3: Differentiate the effects of controlled substances by drug class

11.2.67. Although the course of alcoholism is different in every individual, nearly all cases of alcoholism involve alternating periods of heavy use and abstinence.

Answer: True Difficulty: Easy Question ID: 11.2.67 Topic: Diagnosis Skill: Understand the Concepts LO 11.4: Analyze substance abuse within a sociocultural context 11.2.68. Conduct disorder (the childhood manifestation of ASPD) is strongly related to the subsequent development of alcohol dependence.

Answer: True Difficulty: Moderate Question ID: 11.2.68 Topic: Diagnosis Skill: Understand the Concepts LO 11.4: Analyze substance abuse within a sociocultural context 11.2.69. Out of all men and women who have ever used alcohol, approximately 10 percent will develop serious alcohol related problems.

Answer: False Difficulty: Easy Question ID: 11.2.69 Topic: Frequency Skill: Understand the Concepts LO 11.5: Apply demographic data to substance use disorders 11.2.70. Considering differences among age group, middle-aged adults have the highest prevalence rates for alcohol dependence.

Answer: False Difficulty: Easy Question ID: 11.2.70 Topic: Frequency Skill: Understand the Concepts LO 11.5: Apply demographic data to substance use disorders 11.2.71. The lifetime prevalence of alcoholism among families of alcoholics is higher than in the general population, by a factor of about 3 to 5.

Answer: True Difficulty: Moderate Question ID: 11.2.71 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.2.72. Natural rewards, such as food and sex, as well as many drugs of abuse increase endorphin levels in brain reward pathways.

Answer: False Difficulty: Moderate Question ID: 11.2.72 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction 11.2.73. Several genes that affect the reception of GABA have been seen to correlate with the risk of alcohol dependence.

Answer: True Difficulty: Moderate Question ID: 11.2.73 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction 11.2.74. One of the most interesting and important advances in neuroscience research was the discovery of the endogenous opioids known as endorphins and enkephalins.

Answer: True Difficulty: Moderate Question ID: 11.2.74 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction 11.2.75. Traditional learning theory has held that people drink because parents model drinking behavior.

Answer: False Difficulty: Moderate Question ID: 11.2.75 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction 11.2.76. Detoxification refers to symptoms of withdrawal from drug dependence.

Answer: False Difficulty: Easy Question ID: 11.2.76 Topic: Treatment Skill: Understand the Concepts LO 11.7: Evaluate treatments for substance use disorders

11.2.77. Antabuse is a drug that blocks the breakdown of alcohol.

Answer: True Difficulty: Easy Question ID: 11.2.77 Topic: Treatment Skill: Understand the Concepts LO 11.7: Evaluate treatments for substance use disorders 11.2.78. DSM-5 describes pathological gambling as a behavioral addiction.

Answer: True Difficulty: Easy Question ID: 11.2.78 Topic: Gambling Disorder Skill: Understand the Concepts LO 11.8: Compare gambling disorder to substance use disorders 11.2.79. Unlike people with substance use disorders, people with gambling disorder do not experience withdrawal-like symptoms when they try to stop or cut back on their gambling.

Answer: False Difficulty: Moderate Question ID: 11.2.79 Topic: Gambling Disorder Skill: Understand the Concepts LO 11.8: Compare gambling disorder to substance use disorders 11.2.80. A feature unique to gambling disorder is chasing losses, which refers to the process of trying to win back money that has already been lost.

Answer: True Difficulty: Easy Question ID: 11.2.80 Topic: Gambling Disorder Skill: Understand the Concepts LO 11.8: Compare gambling disorder to substance use disorders

Essay 11.3.81. Describe the three mechanisms associated with the development of drug tolerance.

Answer: There are two pharmacological mechanisms involved in the development of drug tolerance, metabolic tolerance and pharmacodynamic tolerance, and one behavioral mechanism.

Metabolic tolerance develops when repeated exposure to a drug causes the person’s liver to produce more enzymes that are used to metabolize the drug. Therefore, the drug is metabolized more quickly, and the person has to take increasingly larger doses in order to maintain the same level in his or her body. Pharmacodynamic tolerance occurs when receptors in the brain adapt to the continued presence of the drug. The neuron may adapt by reducing the number of receptors or by reducing their sensitivity to the drug through a process called down regulation. The third

process involved in the development of drug tolerance involves behavioral conditioning mechanisms. This occurs when cues that are regularly associated with the administration of a drug begin to function as conditioned stimuli and elicit a conditioned response that is opposite in direction to the natural effect of the drug. As this compensatory response increases in strength, it competes with the drug response so that larger amounts of the drug must be taken to achieve the same effect.

Difficulty: Moderate Question ID: 11.3.81 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe the psychological features common to addictive disorders 11.3.82. What are the symptoms and causes of withdrawal? Which drugs cause serious signs of withdrawal?

Answer: The symptoms occur when a person stops taking a drug, and they can persist for days. If a heavy drinker stops drinking alcohol, he may experience hand tremors, sweating, nausea, anxiety, and insomnia. The especially serious symptoms include convulsions and hallucinations.

In some cases, delirium may develop. The symptoms of withdrawal related to other drugs vary.

Withdrawal symptoms are most obvious for alcohol, opioids, and sedatives, hypnotics, and anxiolytics. Withdrawal signs are not often seen after repeated use of cannabis or hallucinogens and can be relatively light for cocaine. When an individual uses a psychoactive drug, the body, especially the brain, reacts against it. This process, known as tolerance, has the effect of reducing the impact of the drug. When this person stops taking the drug, the processes that caused his tolerance are still in place until his body has a chance to undo them. During this period of time, the individual will experience symptoms that are essentially the opposite of taking the drug, which are called withdrawal symptoms.

Difficulty: Moderate Question ID: 11.3.82 Topic: Symptoms Skill: Understand the Concepts LO 11.1: Describe psychological features common to addictive disorders 11.3.83. Nicotine is classified as a stimulant, yet many people say they smoke to feel more relaxed.

Explain the biological mechanisms that account for this apparent inconsistency.

Answer: Nicotine is classified as a stimulant because it produces CNS arousal through stimulating the release of norepinephrine from several sites. It also effects the peripheral nervous system, increasing heart rate and blood pressure. However, nicotine also causes the release of dopamine and norepinephrine in the mesolimbic dopamine pathway, or reward system in the brain, as well as influencing the serotonin system. In this way, it appears to mimic the effects of antidepressant medications. Thus, nicotine has a complex influence on subjective mood states and some people believe that it helps reduce their subjective response to stress. One explanation for this involves differences in dosage levels. Low doses of nicotine may lead to increased arousal, while higher dosages lead to relaxation. Another explanation is that regular smokers may feel relaxed when they smoke a cigarette because it relieves the unpleasant symptoms of withdrawal.

Difficulty: Moderate Question ID: 11.3.83 Topic: Alcohol, Tobacco, & Psychomotor Stimulants Skill: Apply What You Know

LO 11.2: Summarize the effects of different drugs on substance abusers 11.3.84. Discuss the other disorders commonly associated with substance use disorders.

Answer: People with substance use disorders often exhibit other forms of mental disorder as well.

Most prominent among these are antisocial personality disorder (ASPD), mood disorders, and anxiety disorders. Conduct disorder is strongly related to concurrent alcohol use in adolescence and the subsequent development of alcohol dependence. ASPD and alcohol/drug dependence frequently co-occur, and there is evidence to suggest that they represent alternative manifestations of a general predisposition toward behavioral disinhibition.

Difficulty: Moderate Question ID: 11.3.84 Topic: Diagnosis Skill: Understand the Concepts LO 11.4: Analyze substance abuse within a sociocultural context 11.3.85. Discuss cultural differences in alcohol-related problems.

Answer: People who don’t drink obviously won’t develop alcoholism, and culture can influence that decision. Some cultures prohibit or actively discourage alcohol consumption. Many Muslims, for example, believe that drinking alcohol is sinful. Other religions encourage the use of small amounts of alcohol in religious ceremonies—such as Jewish people drinking wine at Passover Seders—while also showing disdain for those who drink to the point of intoxication. This type of cultural constraint can decrease rates of alcohol use disorder. In one large epidemiological study, for example, Jews had significantly lower rates of alcoholism than Catholics and Protestants.

Difficulty: Moderate Question ID: 11.3.85 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction 11.3.86. Discuss the ways that parent behaviors influence the likelihood that an adolescent will abuse substances.

Answer: Parents can influence their children’s drinking behaviors in many ways. They can serve as models for using drugs to cope with stressful circumstances. They may also help promote attitudes and expectations regarding the benefits of drug consumption, or they may simply provide access to licit or illicit drugs. Adolescents with alcoholic parents are more likely to drink alcohol than those whose parents do not abuse alcohol. This increased risk seems to be due to several factors, including the fact that alcoholic parents monitor their children’s behavior less closely, thereby providing more opportunities for illicit drinking. Parental monitoring and discipline have an important impact on adolescent substance use; higher parental monitoring is associated with reduced risk of tobacco and alcohol use.

Difficulty: Moderate Question ID: 11.3.86 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.3.87. Review the evidence for the role of the brain’s reward systems in a model of the cause of drug addiction in general.

Answer: A good deal of research into the etiology of drug abuse and addiction focuses on the brain’s reward systems. Older models of drug addiction looked at the effects of tolerance and withdrawal, but more recent research suggests that drugs that have the potential to contribute to addiction all share the property of directly or indirectly facilitating the firing of the brain’s reward centers. One primary circuit in this pathway is the medial forebrain bundle, which connects the ventral tegmental area to the nucleus accumbens. Connections from these structures to the frontal and prefrontal cortex as well as areas of the limbic system, such as the amygdala, also moderate the influence of reward. For many years, scientists have known electrical stimulation of the medial forebrain bundle can serve as a powerful source of positive reinforcement for animals.

Now they know that addictive drugs injected into the mesolimbic dopamine pathway also act as powerful positive reinforcers. Different drugs produce these rewarding effects in different ways.

Amphetamines, for example, block the reuptake of dopamine in the reward circuits which causes an increase in the firing of reward messages. Measures of brain concentrations of dopamine increase in the medial prefrontal cortex and the limbic system after ingesting cocaine. Alcohol, on the other hand, does fire these same reward systems, but much more indirectly. Its main effect is on the neurotransmitter GABA. Alcohol seems to eventually reduce the activity of GABA, which would normally inhibit the firing of pleasure systems. Some theorists associate alcoholism with exaggerated activation of the endogenous opioid system in response to alcohol consumption.

Studies have suggested that blocking opioid receptors reduces an animal’s interest in alcohol.

Overall there is considerable empirical and clinical evidence that points to a central role of the brain’s pleasure circuits in the creation of the craving that is the hallmark of current models of drug addiction.

Difficulty: Moderate Question ID: 11.3.87 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction 11.3.88. Discuss what balanced placebo and longitudinal designs can tell us about the possible role of expectations as factors in both alcohol and drug effects and in the onset of alcohol and drug problems.

Answer: Using the balanced placebo design, researchers have shown that subjects’ expectations about how a drug will affect their behavior can account for many of the effects that are usually attributed to the drug itself. For example, subjects who believed they had ingested alcohol but who had actually consumed only tonic water displayed exaggerated aggression and reported enhanced feelings of sexual arousal. Expectations may constitute one of the primary reasons for continued and increasingly heavy consumption of alcoholic beverages. Longitudinal studies have found that adolescents who initially have the most positive expectations about the effects of alcohol go on to consume greater amounts of alcoholic beverages.

Difficulty: Difficult Question ID: 11.3.88 Topic: Causes Skill: Understand the Concepts LO 11.6: Explain how systemic factors can interact to cause substance addiction

11.3.89. Describe the uses of short-term motivational therapy in the treatment of substance use disorders.

Answer: Many people with substance use disorders do not seek or take full advantage of treatment opportunities because they fail to recognize the severity of their problems. Motivational interviewing is a nonconfrontational procedure that can be used to help people resolve their ambivalence about using drugs and make a definite commitment to change their behavior. The procedure is based on the notion that in order to make a meaningful change, people must begin by recognizing the inconsistency between their current behavior and their long-term goals. For example, chronic heavy drinking is not compatible with academic or occupational success.

Motivational interviewing begins with a discussion of problems—issues reported by the patient as well as concerns that have been expressed by others, such as friends and family members. The person is asked to reflect on feedback that is provided in a non-threatening way. The therapist does not confront the person, argue about the reasons for drinking, or demand action. Instead, the therapist responds empathically in an effort to avoid or minimize defensive reactions that will interfere with attempts to change.

Difficulty: Moderate Question ID: 11.3.89 Topic: Treatment Skill: Understand the Concepts LO 11.7: Evaluate treatments for substance use disorders 11.3.90. Describe the differences between the DSM-IV and DSM-5 definitions of gambling disorder.

Answer: There are two noteworthy differences between the definitions of gambling disorder that appeared in the previous version of the manual (DSM-IV) and the current manual. First, one diagnostic criterion—illegal acts—was dropped from the previous list. That feature stipulated that the person “has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling.” Research studies demonstrated that the illegal acts criterion was rarely endorsed, was only associated with the most severe cases, and was not useful in distinguishing between people who do and who do not seek treatment for gambling. Second, the threshold for a diagnosis was dropped from five features to four. Empirical data support the validity of this change.

Difficulty: Moderate Question ID: 11.3.90 Topic: Gambling Disorder Skill: Understand the Concepts LO 11.8: Compare gambling disorder to substance use disorders

Chapter 12 Sexual Dysfunctions, Paraphilic Disorders and Gender Dysphoria Topic

Normal and Abnormal

Total Assessment Guide (T.A.G.) Question Type Understand Apply What the Concepts You Know 5,7,8 Multiple Choice 1,2,3,4,6,9,10 True/False

51,52,53

Essay

81,82

Multiple Choice 13,14,15,16 Sexual Dysfunctions

True/False Essay

54,55,56,57, 58,59 83

Multiple Choice 18,19,20,21,23 Origins of Sexual Dysfunction

True/False

11,12,17

22

60,61

Essay Multiple Choice 24

25,26

Treating Sexual Dysfunction

True/False

Paraphilic Disorders

84 Essay 30,31,32,33, Multiple Choice 27,28,29,31, 35,36,37,38 34 65,66,67,68,69, True/False 70,71,72,73,74 85,86 Essay

62,63

64

Multiple Choice 39,40,41 Origins of Paraphilia

True/False

75,76

Essay

87,88

Multiple Choice 42,45,46,47 Treating Paraphilia

True/False

77,78

Essay

90

Multiple Choice 49,50 Gender Dysphoria

True/False Essay

79,80

43,44

89 48

Analyze It

Evaluate It

Chapter 12: Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria Multiple Choice 12.1.1. What was the major contribution made by William Masters and Virginia Johnson? a. b. c. d.

classifying sexual perversions describing the human sexual response cycle outlining the effects of childhood sexual abuse documenting the diversity of normal sexual behavior Answer: b.

Difficulty: Easy Question ID: 12.1.1 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual naormativity

12.1.2. What was the basis of the descriptions of the human sexual response cycle offered by William Masters and Virginia Johnson? a. b. c. d.

detailed interviews with thousands of adults observations of people engaging in sexual activities cross-cultural analysis of texts on human sexuality analogue studies of the sexual behavior of primates Answer: b.

Difficulty: Easy Question ID: 12.1.2 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual naormativity

12.1.3. What are the phases of the human sexual response cycle described by Masters and Johnson? a. b. c. d.

id, ego, and superego pre-erotic, erotic, and post-erotic physiological, emotional, and eros excitement, orgasm, and resolution Answer: d.

Difficulty: Moderate Question ID: 12.1.3 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual naormativity

12.1.4. Some of the most dramatic physiological changes during sexual excitement are due to vasocongestion, which refers to a. b. c. d.

increased muscular tension. elevated respiration rates. engorgement of blood vessels. decreased neurotransmitter activity.

Answer: c.

Difficulty: Easy Question ID: 12.1.4 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual naormativity

12.1.5. Kevin has just reached orgasm and finds that he is unable to get an erection again. Although this concerns him greatly, it is actually a normal phenomenon called a. b. c. d.

a plateau. dyspareunia. vasocongestion. the refractory period.

Answer: d.

Difficulty: Moderate Question ID: 12.1.5 Topic: Normal and Abnormal Skill: Apply What You Know LO 12.1: Analyze the concept of sexual naormativity

12.1.6. What is the major difference between men and women in the sexual response cycle? a. b. c. d.

Men do not have an excitement phase.

Women do not have an excitement phase.

Women may be able to respond to stimulation during the resolution phase.

Men typically are able to respond to stimulation during the resolution phase.

Answer: c.

Difficulty: Moderate Question ID: 12.1.6 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual naormativity

12.1.7. What point concerning sexual problems was highlighted by the case of Bill and Margaret described in your textbook? a. b. c. d.

Couples who are not truly in love have high rates of sexual dysfunction.

Clinicians have tended to neglect the biological factors involved in human sexual behavior.

The thoughts people have about the meaning of sexual behavior are extremely important.

Usually one person is responsible for the disorder.

Answer: c.

Difficulty: Moderate Question ID: 12.1.7 Topic: Normal and Abnormal Skill: Apply What You Know LO 12.1: Analyze the concept of sexual normativity

12.1.8. Which of the following was characteristic of the interviews Alfred Kinsey conducted between 1938 and 1956 about sexual behavior? a. b. c. d.

They focused on subjective distress.

They focused on experiences that resulted in orgasm.

They were structured to make psychiatric diagnosis possible.

They classified perversions as sadism, masochism, and fetishism.

Answer: b.

Difficulty: Moderate Question ID: 12.1.8 Topic: Normal and Abnormal Skill: Apply What You Know LO 12.1: Analyze the concept of sexual naormativity

12.1.9. Based on the results of the National Health and Social Life Survey, which of the following is accurate? a. b. c. d.

A low percentage of men had experienced oral sexual activities.

Masturbation was very common in women.

Less than 10 percent of women had ever engaged in oral intercourse.

Most sexual activity occurred outside monogamous relationships.

Answer: b.

Difficulty: Moderate Question ID: 12.1.9 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual naormativity

12.1. 10. According to DSM-5, it is possible for a person to be uninterested in sex or to have difficulty engaging in sexual relations and yet not be diagnosed with any sexual dysfunction because a. b. c. d.

sexual dysfunctions require deviant sexual behavior. the person might not experience any distress or interpersonal difficulty. the person would probably pretend to be interested and to deny any difficulty. sexual dysfunctions are only diagnosed when a major personality disorder is also present.

Answer: b.

Difficulty: Moderate Question ID: 12.1.10 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual naormativity

12.1.11. After gathering data on the typical individuals who seek treatment for hypoactive sexual desire, how will researchers describe these individuals? a. b. c. d.

They are confused about sexual identity.

They are likely to have been abused as children.

They are likely to have other mental and medical disorders.

They are overwhelmed with guilt and anxiety concerning sexual activity.

Answer: c.

Difficulty: Moderate Question ID: 12.1.11 Topic: Sexual Dysfunctions Skill: Apply What You Know LO 12.2: Diagnose sexual dysfunctions by their symptoms

12.1.12. Mary has been experiencing pain during intercourse. Mary’s psychologist is likely to refer to that persistent genital pain as a. b. c. d.

dyspareunia. hypoactive sexual desire. inhibited sexual arousal. orgasmic disorder.

Answer: a.

Difficulty: Moderate Question ID: 12.1.12 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms

12.1.13. A client was recently diagnosed as having erectile dysfunction. What would you conclude about this man? a. b. c. d.

He is by definition experiencing dyspareunia.

He cannot obtain an erection because he is not subjectively aroused.

He ejaculates immediately upon insertion during intercourse.

He may be subjectively aroused, but blood does not flow to his penis.

Answer: d.

Difficulty: Moderate Question ID: 12.1.13 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms

12.1.14. Why do psychologists consider sexual arousal to be a hypothetical construct? a. b. c. d.

It cannot be measured directly.

Its definition differs across cultures.

It has such diverse expression across individuals.

It can be objectively measured for research purposes.

Answer: a.

Difficulty: Moderate Question ID: 12.1.14 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms

12.1.15. A vaginal photometer and a penile plethysmograph can be used as measures of a. b. c. d.

orgasm. sexual arousal. sexual satisfaction. blood flow to the vagina or penis.

Answer: b.

Difficulty: Moderate Question ID: 12.1.15 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms

12.1.16. Traditional definitions of dyspareunia and vaginismus focus exclusively on problems that occur during intercourse, but some experts suggest a. b. c. d.

these disorders do not exist. other mental disorders are the cause. these disorders should be viewed as genital pain disorders rather than forms of sexual dysfunction. these disorders should be defined as always resulting from abuse.

Answer: c.

Difficulty: Moderate Question ID: 12.1.16 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms

12.1.17. Martha has been diagnosed as having vaginismus. Besides intercourse, in what other scenario would Martha experience the difficulty associated with this condition? a. b. c. d.

urination masturbation to orgasm a vaginal examination sexual arousal by men Answer: c.

Difficulty: Moderate Question ID: 12.1.17 Topic: Sexual Dysfunctions Skill: Apply What You Know LO 12.2: Diagnose sexual dysfunctions by their symptoms

12.1.18. Which of the following describes the sexual performance of men between the ages of 70 and 74? a. b. c. d.

Very few men this age obtain an erection.

Over 60 percent of these men are sexually active.

Less than 50 percent of these men are sexually active.

Erection is rarely a problem, but premature ejaculation usually is a problem.

Answer: b.

Difficulty: Easy Question ID: 12.1.18 Topic: Origins of Sexual Dysfunctions Skill: Understand the Concepts LO 12.3: Contextualize the development of sexual dysfunctions

12.1.19. As a woman gets older, how does her physiological response to sexual stimulation change? a. b. c. d.

slower rate of lubrication increased risk of vaginismus less responsiveness in the clitoris increased blood flow to the vaginal walls Answer: a.

Difficulty: Easy Question ID: 12.1.19 Topic: Origins of Sexual Dysfunctions Skill: Understand the Concepts LO 12.3: Contextualize the development of sexual dysfunctions

12.1.20. Which of the following characterizes the association between testosterone levels and men’s levels of sexual appetite? a. b. c. d.

There is no association.

Very low levels of testosterone predict inhibited desire.

Very high levels of testosterone predict excessive interest.

There is a nearly one-to-one ratio between testosterone levels and sexual desire.

Answer: b.

Difficulty: Moderate Question ID: 12.1.20 Topic: Origins of Sexual Dysfunctions Skill: Understand the Concepts LO 12.3: Contextualize the development of sexual dysfunctions

12.1.21. Which of these behaviors has a tendency to increase risk for erectile dysfunction? a. b. c. d.

taking aspirin smoking cigarettes eating a high fat diet sleeping more than eight hours a night Answer: b.

Difficulty: Easy Question ID: 12.1.21 Topic: Origins of Sexual Dysfunctions Skill: Understand the Concepts LO 12.3: Contextualize the development of sexual dysfunctions

12.1.22. In sharing her history, your client makes several remarks that indicate that her parents had quite negative attitudes regarding sexual behavior. As you continue to explore issues of sex with this client, you will be on the look out for indications of a. b. c. d.

drug-induced sexual dysfunctions. nystagmus. hyperactive sexual desire. hypoactive sexual desire.

Answer: d.

Difficulty: Difficult Question ID: 12.1.22 Topic: Origins of Sexual Dysfunctions Skill: Apply What You Know LO 12.3: Contextualize the development of sexual dysfunctions

12.1.23. What is one of the most important psychological factors that can contribute to impaired sexual arousal? a. b. c. d.

the need for control depression performance anxiety guilt Answer: c.

Difficulty: Moderate Question ID: 12.1.23 Topic: Origins of Sexual Dysfunctions Skill: Understand the Concepts LO 12.3: Contextualize the development of sexual dysfunctions

12.1.24. What is the rationale for sensate focus in sex therapy? a. b. c. d.

Couples need to focus on erotic sensations rather than performance demands.

Couples need to understand their intrapsychic conflicts.

Receiving support from other couples with similar problems is a key to successful treatment.

Successful treatment requires ruling out other possible medical or physical causes of sexual dysfunction.

Answer: a.

Difficulty: Moderate Question ID: 12.1.24 Topic: Treating Sexual Dysfunctions Skill: Understand the Concepts LO 12.4: Describe current treatments for sexual dysfunctions

12.1.25. Maria and Juan go to a therapist because they consistently have difficulty accomplishing intercourse. The therapist recommends a procedure called sensate focus, which means that Maria and Juan will be asked to a. b. c. d.

explore their painful emotions in therapy. spend time together relaxing and holding hands. go to a physician, to rule out medical problems. attempt to have intercourse every night for a week.

Answer: b.

Difficulty: Moderate Question ID: 12.1.25 Topic: Treating Sexual Dysfunctions Skill: Understand the Concepts LO 12.4: Describe current treatments for sexual dysfunctions

12.1.26. A physician prescribes Viagra to treat a patient’s erectile dysfunction and advises him to be aware of possible side effects such as a. b. c. d.

insomnia and muscular pain. headaches and altered vision. hallucinations and body rashes. constipation and rapid heartbeat.

Answer: b.

Difficulty: Moderate Question ID: 12.1.26 Topic: Treating Sexual Dysfunctions Skill: Apply What You Know LO 12.4: Describe current treatments for sexual dysfunctions

12.1.27. Which of the following is characteristic of a man with a paraphilia? a. b. c. d.

inhibited sex drive aversion to his own sexuality physically incapable of having an erection sexual interest other than sexual interest in genital stimulation Answer: d.

Difficulty: Easy Question ID: 12.1.27 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.28. The compulsive and inflexible features of paraphilias make them similar to a. b. c. d.

mood disorders. addictions. sexual dysfunctions. antisocial personality disorder.

Answer: b.

Difficulty: Easy Question ID: 12.1.28 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.29. What is the central problem in paraphilias? a. b. c. d.

inhibited sexual desire physiological problems prevent arousal the individual feels guilt about the behavior sexual arousal is detached from a reciprocal, loving adult relationship Answer: d.

Difficulty: Moderate Question ID: 12.1.29 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.30. Sam is looking for a job to earn money and put him near the stimuli he uses to achieve sexual excitement. He is offered what he views as the “ideal job” at a shoe store; but he is fired when his interactions with customers provide evidence that he has a paraphilia known as a. b. c. d.

voyeurism. fetishism. klismaphilia. exhibitionism.

Answer: b.

Difficulty: Moderate Question ID: 12.1.30 Topic: Paraphilic Disorders Skill: Apply What You Know LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.31. Which of these individuals would most clearly fit the DSM diagnostic criteria for transvestic disorder? a. b. c. d.

Carl, who collects women’s boots and shoes and masturbates while holding these objects Danny, a gay man, who is known among members of the gay community as a drag queen Dennis, who dresses in women’s clothing as part of his job in a Las Vegas nightclub act Barry, a heterosexual, who dresses in women’s clothing for the purpose of sexual arousal Answer: d.

Difficulty: Difficult Question ID: 12.1.31 Topic: Paraphilic Disorders Skill: Apply What You Know LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.32. Ted dreams and daydreams about being humiliated during sexual encounters. He finds the fantasies to be quite arousing. If Ted experiences subjective distress or interpersonal difficulty as a result of these daydreams, what diagnosis would be made in his case? a. b. c. d.

Ted would qualify for the diagnosis of fetishism.

Ted would not meet the criteria of masochism because he enjoys the fantasies.

Ted would not meet the criteria of masochism because he does not act on his fantasies.

Ted would qualify for the diagnosis of sexual masochism.

Answer: d.

Difficulty: Moderate Question ID: 12.1.32 Topic: Paraphilic Disorders Skill: Apply What You Know LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.33. Your textbook describes the masochistic behaviors of Daphne Merkin, but then the authors remark that Daphne might not necessarily qualify for a diagnosis of sexual masochism because a. b. c. d.

she acknowledged her interests in masochistic sex. she married the people involved in her masochistic fantasies. it is not clear that she experienced subjective distress or social impairment. she never allowed herself to be seriously hurt.

Answer: c.

Difficulty: Moderate Question ID: 12.1.33 Topic: Paraphilic Disorders Skill: Apply What You Know LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.34. A female friend of yours is expressing great concern about the possibility that she might one day encounter an exhibitionist. To help her deal with her fears, you tell her that exhibitionists a. b. c. d.

rarely touch or otherwise molest their victims. are only dangerous to people they know. are only dangerous to women who are in the company of young children. will always run away whenever their intended victim screams for help.

Answer: a.

Difficulty: Moderate Question ID: 12.1.34 Topic: Paraphilic Disorders Skill: Apply What You Know LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.35. Which of the following represents a case of voyeurism? a. b. c. d.

A man fondles a black boot while he masturbates.

A man exposes his genitals to people in the subway.

A man uses binoculars to watch his neighbors undress.

A man rubs up against an unsuspecting young woman in a crowded department store.

Answer: c.

Difficulty: Easy Question ID: 12.1.35 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.36. A person with a paraphilia that entails recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a young child is suffering from a. b. c. d.

rapism. pedophilia. necrophilia. voyeurism.

Answer: b.

Difficulty: Easy Question ID: 12.1.36 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.37. Many incest perpetrators would not be considered pedophiles because a. b. c. d.

they have no sexually arousing fantasies. their victims are often postpubescent adolescents. they employ force, and they humiliate their victims. incest is a crime, not a mental disorder.

Answer: b.

Difficulty: Difficult Question ID: 12.1.37 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.38. According to the results of a study on coercive sex, conducted by Edward Laumann and his colleagues, it was estimated that percent of women had been forced to participate in a sexual act against their will. a. b. c. d.

1 10 20 45 Answer: c.

Difficulty: Easy Question ID: 12.1.38 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.1.39. Which part of the brain has been implicated in some paraphilias? a. b. c. d.

thalamus cerebellum temporal lobes parietal lobes Answer: c.

Difficulty: Moderate Question ID: 112.1.39 Topic: Origins of Paraphilia Skill: Understand the Concepts LO 12.6: Evaluate theories on the origin of paraphilias

12.1.40. According to Marshall and Seidman, the core feature of unusual sexual behavior is not deviant sexual arousal but a. b. c. d.

a failure to achieve intimacy in adult relationships. deficient sexual arousal. aggression. the absence of career achievement.

Answer: a.

Difficulty: Moderate Question ID: 12.1.40 Topic: Origins of Paraphilia Skill: Understand the Concepts LO 12.6: Evaluate theories on the origin of paraphilias

12.1.41. Several background factors have been observed repeatedly among people who engage in atypical sexual behaviors, including a. b. c. d.

lack of early church- or school-based sex education. early failures at intimate relationships. lack of a consistent parenting environment. high self-esteem.

Answer: c.

Difficulty: Difficult Question ID: 12.1.41 Topic: Origins of Paraphilia Skill: Understand the Concepts LO 12.6: Evaluate theories on the origin of paraphilias

12.1.42. Under what set of circumstances do men with paraphilias usually enter treatment? a. b. c. d.

voluntarily at the request of a loved one in order to receive a reduced sentence for a crime referral from marital therapists Answer: c.

Difficulty: Moderate Question ID: 12.1.42 Topic: Treating Paraphilia Skill: Understand the Concepts LO 12.7: Summarize treatment options for paraphilia

12.1.43. Michael is ordered to undergo aversion therapy for pedophilia. What will this treatment entail? a. b. c. d.

education about sexual norms confrontation by other men with similar problems therapy to increase insight to the consequences of pedophilia receiving electrical shock when sexually aroused by pictures of children Answer: d.

Difficulty: Moderate Question ID: 12.1.43 Topic: Treating Paraphilia Skill: Apply What You Know LO 12.7: Summarize treatment options for paraphilia

12.1.44. You are a cognitive-behavioral therapist who has started to see a client suffering from a paraphilia. What are you likely to try to do with this client? a. b. c. d.

investigate deep-seated conflicts about his sexuality provide training to help him overcome cognitive and social deficits help him to understand that his behavior is illegal and might lead to imprisonment refer him to a self-help group that will help him with his addiction Answer: b.

Difficulty: Moderate Question ID: 12.1.44 Topic: Treating Paraphilia Skill: Apply What You Know LO 12.7: Summarize treatment options for paraphilia

12.1.45. The California Sex Offender Treatment and Evaluation Project (SOTEP) was designed for men convicted of either rape or child molestation. The treatment was comprehensive using cognitivebehavioral therapy and several other interventions. In a carefully controlled study, the SOTEP results a. b. c. d.

found no difference in subsequent sexual crimes between the treatment and the control group. suggest a 13 percent reduction in subsequent recidivism between the therapy group and the control group. found an actual increase in recidivism in the therapy group. found a significant increase in violent crime in both groups.

Answer: a.

Difficulty: Moderate Question ID: 12.1.45 Topic: Treating Paraphilia Skill: Understand the Concepts LO 12.7: Summarize treatment options for paraphilia

12.1.46. The U.S. Congress and all 50 states have passed laws that are intended to protect society from people who have been convicted of violent or repeated sexual offenses. One set of laws, sometimes called Megan’s laws, are actually called a. b. c. d.

community protection laws. child protection laws. community notification laws.

Amber Alerts.

Answer: c.

Difficulty: Moderate Question ID: 12.1.46 Topic: Treating Paraphilia Skill: Understand the Concepts LO 12.7: Summarize treatment optons for paraphilia

12.1.47. Sexual predator laws allow states to a. b. c. d.

force a sexual predator to undergo a state-prescribed therapy. force a sexual predator to live in a specified location. force a sexual predator to wear a GPS tracking devise at all times. keep a sexual predator in either a prison or mental hospital for life.

Answer: d.

Difficulty: Moderate Question ID: 12.1.47 Topic: Treating Paraphilia Skill: Understand the Concepts LO 12.7: Summarize treatment optons for paraphilia

12.1.48. Which of the following individuals is most likely to be diagnosed with gender identity disorder? a. b. c. d.

Harry, who is sexually attracted to boys Mary, who looks like a female, but feels herself to be more like a male Marko, who likes to dress in women’s clothes as he makes love to his wife Vivek, who identifies himself as gay Answer: b.

Difficulty: Moderate Question ID: 12.1.48 Topic: Gender Dysphoria Skill: Apply What You Know LO 12.8: Analyze the experiences of gender dysphoria

12.1.49. Which of the following is another name for gender identity dysphoria in adults? a. b. c. d.

homosexuality transsexualism transvestic fetishism pseudohermaphroditism Answer: b.

Difficulty: Easy Question ID: 12.1.49 Topic: Gender Dysphoria Skill: Understand the Concepts LO 12.8: Analyze the experiences of gender dysphoria

12.1.50. People suffering from gender dysphoria are likely to dress up in the clothing of the opposite sex because a. b. c. d.

the clothing represents a fetish. the clothing is sexually arousing. it helps them to adopt the role of the gender with which they identify. they want to make themselves more attractive to members of their own sex.

Answer: c.

Difficulty: Moderate Question ID: 12.1.50 Topic: Gender Dysphoria Skill: Understand the Concepts LO 12.8: Analyze the experiences of gender dysphoria

True/False 12.2.51. The resolution phase of the sexual response cycle typically lasts no more than 15 minutes.

Answer: False Difficulty: Moderate Question ID: 12.2.51 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual normativity 12.2.52. One of Alfred Kinsey’s conclusions based on interviews with 18,000 men and women between 1938 and 1956 was that distinctions among sexual orientations were essentially meaningless.

Answer: True Difficulty: Easy Question ID: 12.2.52 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual normativity

12.2.53. From the extensive information it collected concerning patterns of sexual activity, the National Health and Social Life Survey revealed that men and women did not differ significantly in either the frequency or the satisfaction related to orgasms.

Answer: False Difficulty: Easy Question ID: 12.2.53 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual normativity

12.2.54. Hypoactive sexual desire is defined in terms of lack of sexual fantasies and lack of interest in sexual experiences.

Answer: True Difficulty: Easy Question ID: 12.1.54 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms 12.2.55. Inhibited sexual arousal in a woman means she can neither achieve nor maintain genital responses, such as lubrication and swelling, that are necessary to complete sexual intercourse comfortably.

Answer: True Difficulty: Moderate Question ID: 12.2.55 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms 12.2.56. Construct validity is the extent to which specific measures produce results that are consistent with the theoretical idea of interest.

Answer: True Difficulty: Difficult Question ID: 12.2.56 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms 12.2.57. An operational definition is based on conventional ideas, not scientific measurement.

Answer: False Difficulty: Easy Question ID: 12.2.57 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms

12.2.58. Generalized orgasmic difficulties occur when a woman is able to reach orgasm in some situations but not in others.

Answer: False Difficulty: Moderate Question ID: 12.2.

Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2 Diagnose sexual dysfunctions by their symptoms 12.2.59. Vaginismus is involuntary muscle spasms that prevent intercourse.

Answer: True Difficulty: Easy Question ID: 12.2.59 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms 12.2.60. The most frequent form of male sexual dysfunction is erectile disorder.

Answer: False Difficulty: 1 Question ID: 12.2.60 Topic: Origins of Sexual Dysfunctions Skill: Understand the Concepts LO 12.3: Contextualize the development of sexual dysfunctions 12.2.61. The influence of male sex hormones on sexual behavior is thought to be on sexual appetite rather than on sexual performance.

Answer: True Difficulty: Moderate Question ID: 12.2.61 Topic: Origins of Sexual Dysfunctions Skill: Understand the Concepts LO 12.3 Contextualize the development of sexual dysfunctions 12.2.62. In their therapy for sexual dysfunctions, Masters and Johnson thought that, in addition to sensate focus, it was also important to include communication training.

Answer: True Difficulty: Easy Question ID: 12.2.62 Topic: Treating Sexual Dysfunctions Skill: Understand the Concepts LO 12.4: Describe current treatments for sexual dysfunctions

12.2.63. Changing the way in which people think about sex is called thought restructuring.

Answer: False Difficulty: Moderate Question ID: 12.2.63 Topic: Treating Sexual Dysfunctions Skill: Understand the Concepts LO 12.4: Describe current treatments for sexual dysfunctions 12.2.64. Your female client has had her ovaries removed and, as a result, is feeling less interested in sex.

You are likely to prescribe estrogen for her.

Answer: False Difficulty: Difficult Question ID: 12.2.64 Topic: Treating Sexual Dysfunctions Skill: Apply What You Know LO 12.4: Describe current treatments for sexual dysfunctions 12.2.65. For some people, sexual arousal is strongly associated with unusual things and situations, such as inanimate objects, sexual contact with children, exhibiting their genitals to strangers, or inflicting pain on another person. When a person is preoccupied with or consumed by these interests, we say they are suffering from a paraphilia.

Answer: True Difficulty: Moderate Question ID: 12.2.65 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.2.66. The association of sexual arousal with nonliving objects is called fetishism.

Answer: True Difficulty: Easy Question ID: 12.2.66 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.2.67. A man having sexual contact with a corpse is an example of necrophilia.

Answer: True Difficulty: Easy Question ID: 12.2.67 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.2.68. Transsexualism is characterized by sexual arousal when dressing in clothing of the opposite gender.

Answer: False Difficulty: Moderate Question ID: 12.2.68 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.2.69. The sexual interest of a person diagnosed with partialism would focus on one specific article of clothing.

Answer: False Difficulty: Difficult Question ID: 12.2.69 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.2.70. Sexual sadism involves sexual arousal associated with feeling pain and humiliation.

Answer: False Difficulty: Easy Question ID: 12.2.70 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.2.71. Another common term for exhibitionism is indecent exposure.

Answer: True Difficulty: Easy Question ID: 12.2.71 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.2.72. A person with a paraphilia known as frotteurism is likely to rub up against someone in a crowded department store.

Answer: True Difficulty: 2 Question ID: 12.2.72 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.2.73. “Acts involving nonconsensual sexual penetration obtained by physical force, by threat of bodily harm, or when the victim is incapable of giving consent by virtue of mental illness, mental retardation, or intoxication” is the legal definition ofrape.

Answer: True Difficulty: Easy Question ID: 12.2.73 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.2.74. According to Knight and Guay’s categorical system of rape motivations, an individual who appears to be intent on directing violence exclusively toward women would be classified as a vindictive rapist?

Answer: True Difficulty: Moderate Question ID: 12.2.74 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.2.75. “Crossing” of paraphilic behaviors refers to the fact that these behaviors are against cultural norms.

Answer: False Difficulty: Moderate Question ID: 12.2.75 Topic: Origins of Paraphilia Skill: Understand the Concepts LO 12.6: Evaluate theories on the origin of paraphilias 12.2.76. Most paraphilias are exhibited by men, with the exception of exhibitionism.

Answer: False Difficulty: Moderate Question ID: 12.2.76 Topic: Origins of Paraphilia Skill: Understand the Concepts LO 12.6: Evaluate theories on the origin of paraphilias 12.2.77. Research results about the effectiveness of psychological treatments for sexual offenders indicate that most offenders can be helped.

Answer: False Difficulty: Easy Question ID: 12.2.77 Topic: Treating Paraphilias Skill: Understand the Concepts LO 12.7: Summarize treatment options for paraphilia

12.2.78. One approach to the treatment of paraphilias involves drugs that reduce the levels of testosterone.

Answer: True Difficulty: Easy Question ID: 12.2.78 Topic: Treating Paraphilias Skill: Understand the Concepts LO 12.7: Summarize treatment options for paraphilia 12.2.79. Our sense of ourselves as being either male or female is known as our sexual identity.

Answer: False Difficulty: Easy Question ID: 12.2. 79 Topic: Gender Dysphoria Skill: Understand the Concepts LO 12.8: Analyze the experiences of gender dysphoria 12.2.80. One of the documented benefits of gender affirming surgery is reduced anxiety and depression.

Answer: True Difficulty: Easy Question ID: 12.2.80 Topic: Gender Dysphoria Skill: Understand the Concepts LO 12.8: Analyze the experiences of gender dysphoria

Essay 12.3.81. Name and describe the phases of the sexual response cycle described by Masters and Johnson.

Answer: (1) The excitement phase: increases continuously from initial stimulation to orgasm; may last from a few minutes to several hours. One of the most dramatic physiological changes during the phase is vasocongestion—the engorgement of blood vessels in various organs, especially the genitals. Sexual excitement also increases muscular tension, heart rate, and respiration rate. These physiological responses are accompanied by subjective feelings of arousal.

(2) The orgasm phase: distinct from the gradual buildup of sexual excitement. This sudden release of tension is almost always experienced as intensely pleasurable. (3) The resolution phase: may last 30 minutes or longer; the person’s body returns to its resting state.

Difficulty: Moderate Question ID: 12.3.81 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual nomativity

12.3.82. What is the National Health and Social Life Survey (NHSLS)? What are some of its key findings?

Answer: The NHSLS surveyed 3,500 men and women between the ages of 18 and 59 throughout the United States. Some key findings from the study are that masturbation is relatively common in men and women, that virtually all men and women experienced vaginal intercourse at some point in their lives, that most men and women had engaged in oral sex, and that most sexual activity occurs in the context of monogamous relationships. Also of note, there is a very large difference between men and women with regard to the experience of orgasm, with more men than women reporting they always have an orgasm. Men are also more likely to report their partners also always had orgasms.

Difficulty: Moderate Question ID: 12.3.82 Topic: Normal and Abnormal Skill: Understand the Concepts LO 12.1: Analyze the concept of sexual nomativity 12.3.83. The penile plethysmograph and the vaginal photometer measure physiological events directly related to sexual arousal, but they do not measure sexual arousal itself. Instead, these tools are said to offer reflections of a hypothetical construct called “sexual arousal.” Using this example, explain the following terms: hypothetical construct, construct validity, and operational definition.

Answer: A hypothetical construct is a theoretical idea that refers to something that can’t be observed directly. For example, arousal involves a subjective feeling of being aroused, which cannot be directly observed. In order to use such an idea scientifically, it must be defined in terms of observable indicators, even if these indicators do not define the idea completely. These observable indicators are the operational definition. In the case of arousal, observable factors such as penile circumference and vaginal engorgement are used as indicators of arousal. If these indicators turn out to be related to other indicators of arousal, such as the person’s subjective report, then the indicators are said to have construct validity. This means that they are thought to be valid, if incomplete, indicators of the hypothetical construct.

Difficulty: Moderate Question ID: 12.3.83 Topic: Sexual Dysfunctions Skill: Understand the Concepts LO 12.2: Diagnose sexual dysfunctions by their symptoms 12.3.84. Discuss the psychological treatments for sexual dysfunction and the limitations to this treatment approach.

Answer: Psychological treatments for sexual dysfunction address negative attitudes toward sexuality, failure to engage in effective sexual behaviors, and deficits in communication skills.

Sex therapy cnters on three primary types of activities: sensate focus and scheduling, education and cognitive restructuring, and communication training. Sensate focus involves a series of simple exercises in which the couple spends time together in a quiet, relaxed setting, learning to touch each other. The goal is to help them become more comfortable with this kind of physical sharing and intimacy, to learn to relax and enjoy it, and to talk to each other about what feels good and what does not. Couples are encouraged to schedule time for sex, purposefully arranging for a quiet, relaxed, and private environment in order to engage in pleasurable and satisfying sexual behavior. Cognitive restructuring is designed to change the way people think about sex, correcting their mistaken beliefs and attitudes about sexual behavior. This often

alleviates guilt and anxiety about sexual experiences as sexual behaviors are normalized. The final element of psychological treatment for sexual dysfunction is communication training, aimed at helping a couple talk to one another about their sexual desires and what they find sexually arousing and what turns them off. Research regarding efficacy of psychological treatments has been mixed. Important questions have been raised about the usefulness of these procedures for clients in other cultures, as culture dictates the ways in which sexual issues may be discussed, as well as defining acceptable sexual behaviors. Therefore, mental health professionals must give careful consideration to their clients’ cultural background when conducting an assessment and designing a treatment program.

Difficulty: Moderate Question ID: 12.3.84 Topic: Treating Sexual Dysfunction Skill: Understand the Concepts LO 12.4: Describe current treatments for sexual dysfunctions 12.3.85. Discuss the approach to viewing the problem of uncontrolled sexual behavior as a form of addiction.

Answer: Although DSM-5 includes unusually low sexual desire as a sexual dysfunction, it does not mention unusually high sexual desire. A proposal was submitted, and ultimately rejected, to include hypersexual disorder. Symptoms associated with this disorder would include seeking new sexual encounters out of boredom with old ones, frequent use of pornography, and legal problems resulting from sexual behaviors. Additional features include obsessive thoughts about sexual encounters, guilt resulting from problematic sexual behavior, and rationalization for continued reckless sexual behavior. There are several good reasons to be skeptical of this concept. Perhaps most important is the heterogeneous nature of excessive or uncontrolled sexual behavior. Failure to control sexual impulses can be associated with several other disorders, including paraphilic disorders, impulse control disorders, and bipolar disorder. Many people who admit to compulsive sexual behavior also suffer from major depression, anxiety disorders, and substance use disorders.

The concept obviously includes a diverse set of behavioral problems. It also suffers from conceptual problems that have been raised with regard to impulse control disorders and behavioral addictions. For all of these reasons, the proposal for recognizing hypersexual disorder as a new diagnosis in DSM-5 was rejected.

Difficulty: Moderate Question ID: 12.3.85 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships

12.3.86. Explain how paraphilias are usually viewed in terms of more than just deviant sexual behavior.

Answer: DSM-5 requires that the erotic preoccupation must have lasted at least six months before the person would meet diagnostic criteria for a paraphilic disorder. Furthermore, the diagnosis of paraphilic disorder is made only if the person’s paraphilic urges lead to clinically significant distress or impairment. The person would be considered to be impaired if the urges have become compulsory, if they produce sexual dysfunction, if they require the participation of nonconsenting persons, if they lead to legal problems, or if they interfere with social relationships.

Difficulty: Moderate Question ID: 12.3.86 Topic: Paraphilic Disorders Skill: Understand the Concepts LO 12.5: Differentiate paraphilias from normative sexual relationships 12.3.87. Explain why some paraphilias are considered by evolutionary psychologists to be “courtship disorders.”

Answer: For male primates, sexual behavior involves a sequence of three steps: location and appraisal of potential partners; exchange of signals of mutual interest; and tactile interactions that set the stage for sexual intercourse. Voyeurism, exhibitionism, and frotteurism in humans may represent aberrant versions of these basic processes in which something has apparently disrupted the mechanisms that facilitate the identification of a sexual partner and govern behavior used to attract a partner.

Difficulty: Moderate Question ID: 12.3.87 Topic: Origins of Paraphilia Skill: Understand the Concepts LO 12.6: Evaluate theories on the origin of paraphilias 12.3.88. Describe the proposed explanation for the development of paraphilic disorders which attributes this to neurological abnormalities.

Answer: It is believed that structures located in the temporal lobes of the brain, especially the amygdala and the hippocampus, play an important role in the control of both aggression and sexual behavior. These limbic structures, in conjunction with the hypothalamus, form a circuit that regulates biologically significant behaviors that are sometimes called the four Fs—feeding, fighting, fleeing, and fornication. Research with rhesus monkeys has shown that damage to this temporal lobe area caused a dramatic increase in sexual activity, as well as unusual patterns in sexual behavior. Subsequent research has studied neurological and neuropsychological factors in convicted sex offenders. There is some indication that men with pedophilic disorder and exhibitionistic disorder show subtle signs of left temporal lobe dysfunction, as evidenced by abnormal patterns of electrophysiological response and impaired performance on neuropsychological tests.

Difficulty: Moderate Question ID: 12.3.88 Topic: Origins of Paraphilia Skill: Understand the Concepts LO 12.6: Evaluate theories on the origin of paraphilias

12.3.89. Summarize the psychological treatments used to treat paraphilias and their efficacy.

Answer: The treatments that are used for paraphilias have unique problems and limited success.

Perhaps at the heart of the problem is that most individuals labeled as paraphilias do not feel that they are in need of therapy. They are being asked to undergo some very unpleasant procedures in order to forgo pleasurable behaviors. Often they are in therapy via court order. Several procedures known as aversion therapy illustrate this problem. Aversion therapies live up to their name. They are an attempt to pair unpleasant sensations, like nausea, with the stimuli that the client finds inappropriately attractive and sexually arousing, such a children. It is hoped that in future the stimuli, that is, the children, will elicit the unpleasant sensation, like nausea, rather than sexual arousal. This goal is somewhat questionable ethically. Cognitive-behavioral strategies have also been used as treatment for paraphilias. These procedures attempt to change both the clients’ attitudes and beliefs through logic and debate and to teach them social and interpersonal skills that they may be lacking through a straightforward process of education and practice.

Unfortunately all procedures lack empirical evidence of efficacy. One large evaluation project, California’s SOTEP, is mentioned in the textbook; this was a controlled study that compared a comprehensive treatment program that included cognitive therapy, skills training, relaxation, relapse prevention, etc., with a control group. The results indicated no significant difference between the therapy group and the control group.

Difficulty: Moderate Question ID: 12.3.89 Topic: Treating Paraphilia Skill: Apply What You Know LO 12.7: Summarize treatment options for paraphilia 12.3.90. Discuss the two types of laws that have been passed to protect society from people who have been convicted of violent or repeated sexual offenses.

Answer: The U.S. Congress and all 50 states have passed two categories of laws that are intended to protect society from people who have been convicted of violent or repeated sexual offenses. The first type is community notification laws, which require the distribution of information to the public regarding the presence of child molesters and sexually violent offenders when they are released from prison or placed on parole. These laws are based on two assumptions: (1) notification will reduce the offender’s opportunities to commit further crimes, and (2) citizens are better able to protect themselves and their children if they know that a dangerous person lives in their neighborhood. This type of law has been criticized as being a violation of the former offender’s constitutional rights by imposing an additional, unfair penalty after his sentence has been served. Although these laws are popular, their benefit has not been evaluated. The second category is the sexual predator laws, which are designed to keep some criminals in custody indefinitely. Under these laws, authorities can commit certain sex offenders to a mental hospital after their prison sentence has been completed. Each case is evaluated in a series of steps that end with a civil trial. The person can be hospitalized involuntarily for an indefinite period of time if the jury decides the person has a “mental abnormality” that will lead him to commit further sexual offenses. Again, critics question the need to balance public safety aganst the protection of the offender’s constitutional rights.

Difficulty: Moderate Question ID: 12.3.90 Topic: Treating Paraphilia Skill: Understand the Concepts LO 12.7: Summarize treatment options for paraphilia

Chapter 13 Schizophrenia Spectrum and Other Psychotic Disorders Topic

Introduction

Total Assessment Guide (T.A.G.) Question Type Understand Apply What the Concepts You Know Multiple Choice 1,2 True/False Essay Multiple Choice

Symptoms True/False Essay

Essay

18,19,20,22, 24,25 61,62,63,64, 65,66 82

Multiple Choice

27,28

True/False

67,68

Multiple Choice Diagnosis True/False

Frequency

Essay Multiple Choice Biological Causes

3,4,5,7,9,10, 6,8,11,15,17 12,13,14,16 51,52,53,54, 58 55,56,57,59,60 81

True/False

29,30,32,33, 34,36 69,70,71

Search for Markers of Vulnerability

Multiple Choice

37,38,39

True/False

72,73,74

Essay

85,86

Multiple Choice

40,41,42,43,44

True/False

75

Essay

87

Multiple Choice True/False

45,56,47,48, 49,50 76,77,78,79,80

Essay

88,89

Treatment

83 31,35

84

Essay Social and Psychological Causes

21,23,26

90

Analyze It

Evaluate It

Chapter 13: Schizophrenia Spectrum and Other Psychotic Disorders Multiple Choice 13.1.1. Ted is taking notes in an abnormal psychology course; the topic today is the diagnosis of schizophrenia. When Ted reviews the material next week, how might he summarize the material on the symptoms used to identify schizophrenia? a. b. c. d.

No single symptom is indicative of schizophrenia.

Delusions and hallucinations define the disorder.

Psychosis is not found in any condition other than schizophrenia.

The negative symptoms indicate the absence of schizophrenia.

Answer: a.

Difficulty: Easy Question ID: 13.1.1 Topic: Introduction Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.2. What is the long-term outcome for people with schizophrenia? a. b. c. d.

Most people recover.

Most people do not recover completely.

Males have a higher recovery rate than females.

Those who develop the disorder while young rarely recover completely.

Answer: b.

Difficulty: Easy Question ID: 13.1.2 Topic: Introduction Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.3. The most common age when symptoms of schizophrenia may initially appear is a. b. c. d.

before age 3. between 6 and 10 years old. in adolescence and early adulthood. after age 40.

Answer: c.

Difficulty: Moderate Question ID: 13.1.3 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.4. The experience of most schizophrenics may be seen as falling into three phases: prodromal, active, and a. b. c. d.

terminal. residual. acute. chronic.

Answer: b.

Difficulty: Easy Question ID: 13.1.4 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.5. When does the prodromal phase of schizophrenia occur? a. b. c. d.

after the active phase at the point of greatest disturbance before active psychotic symptoms are present when the patient is treated with neuroleptic medications Answer: c.

Difficulty: Easy Question ID: 13.1.5 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.6. In January, Rita was beginning to perform poorly at work; she was neglecting her appearance, becoming withdrawn, and exhibiting odd behaviors. In June, Rita showed the full‑ blown symptoms of schizophrenia. Her behavior in January can be considered part of which phase of the disorder? a. b. c. d.

active residual prodromal undifferentiated Answer: c.

Difficulty: Moderate Question ID: 13.1.6 Topic: Symptoms Skill: Apply What You Know LO 13.1: Identify symptoms associated with schizophrenia

13.1.7. The phase of schizophrenia in which the most dramatic symptoms of psychosis have improved, but in which the person continues to be impaired in various ways, is labeled a. b. c. d.

prodromal. active. residual. acute.

Answer: c.

Difficulty: Easy Question ID: 13.1.7 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.8. Marvin has a long history of schizophrenia. His doctors say that he is currently in the residual phase; from this we can conclude that he a. b. c. d.

has recovered. has recently suffered an acute relapse. continues to be impaired in various ways. is experiencing hallucinations but not delusions.

Answer: c.

Difficulty: Moderate Question ID: 13.1.8 Topic: Symptoms Skill: Apply What You Know LO 13.1: Identify symptoms associated with schizophrenia

13.1.9. Schizophrenic symptoms, sometimes called psychotic symptoms, that include hallucinations and delusions are known as a. b. c. d.

positive symptoms. negative symptoms. aberrant symptoms. hallucinatory symptoms.

Answer: a.

Difficulty: Easy Question ID: 13.1.9 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.10. Which of the following is an example of a positive symptom of schizophrenia? a. b. c. d.

flat affect hallucinations social withdrawal lack of initiative Answer: b.

Difficulty: Easy Question ID: 13.1.10 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.11. During an interview, a patient says he frequently hears the voice of his sister coming from his image in the bathroom mirror. The psychologist who is conducting the interview most likely writes that the patient presents evidence of a. b. c. d.

delusions. hallucinations. negative symptoms. loose associations.

Answer: b.

Difficulty: Moderate Question ID: 13.1.11 Topic: Symptoms Skill: Apply What You Know LO 13.1: Identify symptoms associated with schizophrenia

13.1.12. The feature that hallucinations in schizophrenia share in common is a. b. c. d.

visual experience. auditory experience. the voice of God. sensory experience.

Answer: d.

Difficulty: Moderate Question ID: 13.1.12 Topic: Symptoms Skill: Apply What You Know LO 13.1: Identify symptoms associated with schizophrenia

13.1.13. What term is used to describe patients who feel no joy or excitement, even while doing things they formerly enjoyed? a. b. c. d.

anhedonia blunted affect affective disorder inappropriate affect Answer: a.

Difficulty: Easy Question ID: 13.1.13 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.14. Avolition refers to a. b. c. d.

indecisiveness and a lack of willpower. lack of speech. loose associations. inappropriate affect.

Answer: a.

Difficulty: Easy Question ID: 13.1.14 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.15. During an interview, a patient suffering from schizophrenia gives answers that seem to be responses to the questions but are entangled in irrelevant details. What term is used to describe this phenomenon? a. b. c. d.

alogia hallucination perseveration tangentiality Answer: d.

Difficulty: Moderate Question ID: 13.1.15 Topic: Symptoms Skill: Apply What You Know LO 13.1: Identify symptoms associated with schizophrenia

13.1.16. What aspect of the symptoms of schizophrenia is described by the term “loose associations”? a. b. c. d.

social withdrawal shifting topics too abruptly disruptions in neurotransmitter functioning lack of relation between cognitive and emotional symptoms Answer: b.

Difficulty: Easy Question ID: 13.1.16 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.1.17. Tania suffers from schizophrenia, and hospital staff have observed that she has been purposelessly pacing back and forth and rubbing her hands together in a special pattern for several hours.

Tania is exhibiting a. b. c. d.

paranoia. catatonic behavior. motor fluidity. dementia.

Answer: b.

Difficulty: Moderate Question ID: 13.1.17 Topic: Symptoms Skill: Apply What You Know LO 13.1: Identify symptoms associated with schizophrenia

13.1.18. “Schizophrenia” refers to the splitting of mental associations. As an unfortunate result of this choice of terms, laypeople often think “schizophrenia” refers to a. b. c. d.

major depression. memory loss. anorexia nervosa. dissociative identity disorder.

Answer: d.

Difficulty: Moderate Question ID: 13.1.18 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.1.19. In order to diagnose schizophrenia, DSM-5 requires that active-phase symptoms be present for a significant portion of time during a period of a. b. c. d.

one week. one month. three months. one year.

Answer: b.

Difficulty: Moderate Question ID: 13.1.19 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.1.20. If a person displays psychotic symptoms for at least one month but less than six months, the DSM-5 diagnosis would be a. b. c. d.

schizophrenia. grossly disorganized disorder. autism spectrum disorder. schizophreniform disorder.

Answer: d.

Difficulty: Moderate Question ID: 13.1.20 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.1.21. Adrian, a graduate student, is learning to use DSM-5 and is surprised to find that there are no official subtypes of schizophrenia given, even though he remembers seeing them in previous DSM versions. Which of the following statements is true regarding this discrepancy? a. b. c. d.

The previous subtypes were strong predictors of the course of the disorder.

Recent genetic evidence showed that the subtypes were etiologically distinct syndromes.

Evidence has shown that the previous subtypes were not qualitatively different disorders.

The subtypes were valid.

Answer: c.

Difficulty: Difficult Question ID: 13.1.21 Topic: Diagnosis Skill: Apply What You Know LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.1.22. To diagnose an illness as schizophrenia, DSM-5 requires that a. b. c. d.

be ruled out.

hallucinations silly, child-like behaviors negative symptoms other medical conditions that could cause the disturbance Answer: d.

Difficulty: Moderate Question ID: 13.1.22 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.1.23. Which of these individuals is most likely to receive the diagnosis of delusional disorder? a. b. c. d.

Beverly, whose behavior is normal apart from the fact that she believes the pope is trying to poison her food Carol, who meets the full symptomatic criteria for schizophrenia David, who displays disorganized speech Eileen, who displays catatonic and negative symptoms of schizophrenia Answer: a.

Difficulty: Difficult Question ID: 13.1.23 Page Reference: 357 Topic: Diagnosis Skill: Apply What You Know LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.1.24. In terms of duration, schizophreniform disorder falls between a. b. c. d.

autism spectrum disorder the residual phase of schizophrenia brief psychotic disorder major depression Answer: c.

Difficulty: Moderate Question ID: 13.1.24 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders

and schizophrenia.

13.1.25. Schizoaffective disorder involves a. b. c. d.

split personality. emotionally based delusions. “cut off” emotions and lack of expressiveness. the overlapping of symptoms of schizophrenia with those of mood disorder with psychotic features.

Answer: d.

Difficulty: Moderate Question ID: 13.1.25 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.1.26. Two patients are in the local mental hospital: one is diagnosed with delusional disorder and the other with schizophrenia. What is the major difference between these two patients? a. b. c. d.

The patient with delusional disorder shows evidence of a mood disorder.

The patient with schizophrenia has negative, but not positive symptoms.

The patient with schizophrenia has no history of schizophrenia in the family.

The behavior of the patient with delusional disorder is not bizarre, and other than in areas related to his delusions, he experiences no social or occupational impairment.

Answer: d.

Difficulty: Moderate Question ID: 13.1.26 Topic: Diagnosis Skill: Apply What You Know LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.1.27. Rich always heard that there are no gender differences in the rate of schizophrenia; however, he has just been told that closer inspection yields certain differences of interest. Which of the following describes some of those differences? a. b. c. d.

Men have more positive symptoms and a more chronic course.

Men develop the disorder earlier and have a more chronic course.

Women develop the disorder later and have a more chronic course.

Women have more negative symptoms and a less chronic course.

Answer: b.

Difficulty: Moderate Question ID: 13.1.27 Topic: Frequency Skill: Understand the Concepts LO 13.3: Contextualize schizophrenia within a population

13.1.28. Cross-cultural studies of the rate of schizophrenia in various types of communities found that clinical outcomes were significantly better in developing countries such as Nigeria and India. What aspect of life in these cultures has been hypothesized to account for these outcomes? a. b. c. d.

less stressful lifestyles milder forms of schizophrenia greater tolerance and acceptance of people with schizophrenia racial differences in response to medication and dietary factors Answer: c.

Difficulty: Moderate Question ID: 13.1.28 Topic: Frequency Skill: Understand the Concepts LO 13.3: Contextualize schizophrenia within a population

13.1.29. What do studies of concordance rates for schizophrenia in monozygotic (MZ) and dizygotic (DZ) twins show? a. b. c. d.

almost 100 percent concordance in MZ twins, 0 percent in DZ very low rates of concordance in either type of twin consistent evidence of higher concordance in DZ than MZ consistent evidence of higher concordance in MZ than DZ Answer: d.

Difficulty: Difficult Question ID: 13.1.29 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia

13.1.30. Leonard Heston conducted an adoption study of the possible causes of schizophrenia. What was the major finding in his study? a. b. c. d.

There was no evidence of a genetic influence on schizophrenia.

Adopted individuals had higher rates of schizophrenia regardless of the mental health status of their parents.

An individual’s childhood environment has a much greater impact on the incidence of schizophrenia than do genetic factors.

Adopted children whose birth mothers were schizophrenic developed schizophrenia at a higher rate than did children born to normal mothers.

Answer: d.

Difficulty: Moderate Question ID: 13.1.30 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia

13.1.31. In the search for genetic contributions to schizophrenic disorders, attention is being paid to a form of the COMT gene (called the Val allele), which seems to a. b. c. d.

decrease the rate of apoptosis. alter the functioning of the amygdala. affect the transmission of dopamine in the prefrontal cortex. alter GABA activity.

Answer: c.

Difficulty: Difficult Question ID: 13.1.31 Topic: Biological Causes Skill: Apply What You Know LO 13.4: Relate biological factors to the development of schizophrenia

13.1.32. What have researchers discovered from their examinations of the pregnancy and birth records of people who later develop schizophrenia? a. b. c. d.

Their mothers experienced more complications at the time of labor and delivery.

Their mothers experienced fewer complications at the time of labor and delivery.

Their mothers experienced more complications during pregnancy but not at the time of labor and delivery.

Their mothers experienced fewer complications during pregnancy.

Answer: a.

Difficulty: Easy Question ID: 13.1.32 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia

13.1.33. Studies using magnetic resonance imaging (MRI) have found diminished size of structures in the limbic systems of schizophrenics’ brains. Why is this finding potentially important? a. b. c. d.

The limbic system integrates cognition and emotion.

The limbic system coordinates eye tracking and visual perception.

The limbic system is the seat of consciousness and sense of identity.

Abstract reasoning and problem solving are organized in the limbic system.

Answer: a.

Difficulty: Difficult Question ID: 13.1.33 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia

13.1.34. Measures of blood flow in various areas of the cerebral cortex show that while working on various tasks, schizophrenic patients do not show expected increases in blood flow to the a. b. c. d.

cerebellum and corpus callosum. occipital lobes and parietal lobes. prefrontal cortex and temporal lobes. lateral ventricles and corpus callosum.

Answer: c.

Difficulty: Moderate Question ID: 13.1.34 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia

13.1.35. The newspaper contains a report of a research team in Europe that has found a brain area in a group of schizophrenic patients that is smaller than the same area in normal individuals. The article was written by a well-known science writer who has a keen understanding of schizophrenia. What is he likely to conclude? a. b. c. d.

Dietary factors account for most differences in brain size.

A complex disorder such as schizophrenia is not likely to be traced to a single brain site.

The differences are probably the result of differences in the size of the individuals that made up the respective groups.

Most such differences have been found to be the result of drug treatments for the disorder and not reflections of some underlying cause.

Answer: b.

Difficulty: Moderate Question ID: 13.1.35 Topic: Biological Causes Skill: Apply What You Know LO 13.4: Relate biological factors to the development of schizophrenia

13.1.36. One of the first neurochemical theories of schizophrenia focused on altered activity of which of the following systems? a. b. c. d.

serotonin dopamine norepinephrine estrogen Answer: b.

Difficulty: Easy Question ID: 13.1.36 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia

13.1.37. What does the social causation hypothesis propose as the cause of the high rate of schizophrenia in the lower classes in the United States? a. b. c. d.

inappropriate mothering labeling and rejection by society stressful events and poor health care high negative emotions in lower class families Answer: c.

Difficulty: Moderate Question ID: 13.1.37 Topic: Social and Psychological Causes Skill: Understand the Concepts LO 13.5: Analyze the relationship between environment and schizophrenia

13.1.38. According to the social selection hypothesis, the rate of schizophrenia is higher in the lower classes in the United States because a. b. c. d.

the stresses of living in poverty trigger schizophrenic symptoms. poor health care and nutrition trigger schizophrenic symptoms. schizophrenics are less able to find or hold good jobs. only poor schizophrenics are labeled as mentally ill.

Answer: c.

Difficulty: Moderate Question ID: 13.1.38 Topic: Social and Psychological Causes Skill: Understand the Concepts LO 13.5: Analyze the relationship between environment and schizophrenia

13.1.39. Expressed emotion refers to a. b. c. d.

family members being negative and intrusive. family members showing acceptance and caring. the appropriateness of a schizophrenic person’s affect. the schizophrenic person’s stated desire to engage in social relations.

Answer: a.

Difficulty: Easy Question ID: 13.1.39 Topic: Social and Psychological Causes Skill: Understand the Concepts LO 13.5: Analyze the relationship between environment and schizophrenia

13.1.40. A component or trait that lies somewhere on the pathway between the genotype which lays the foundation for the disorder and full-blown symptoms of the disorder is known as a. b. c. d.

anhedonia. a phenotype. a schizotype. an endophenotype.

Answer: d.

Difficulty: Moderate Question ID: 13.1.40 Topic: Search for Markers of Vulnerability Skill: Understand the Concepts LO 13.6: Describe current measures for markers of vulnerability

13.1.41. Researchers are focusing on the discovery of a specific measure, such as a biochemical assay or a psychological test, and they are interested in knowing whether it might be useful in identifying people who are predisposed to schizophrenia. These researchers are looking for what type of marker? a. b. c. d.

vulnerability schizotypic phenotypic genotypic Answer: a.

Difficulty: Moderate Question ID: 13.1.41 Topic: Search for Markers of Vulnerability Skill: Understand the Concepts LO 13. 6: Describe current measures for markers of vulnerability

13.1.42. The identification of deficits in working memory is particularly interesting with regard to schizophrenia because it links to other evidence regarding brain functions and this disorder. Processes that are associated with central executive processing are associated with brain activity located in the area of the prefrontal cortex that seems to be dysfunctional in schizophrenia. a. b. c. d.

preoptic dorsolateral verbal posterior Answer: b.

Difficulty: Difficult Question ID: 13.1.42 Topic: Search for Markers of Vulnerability Skill: Understand the Concepts LO 13.6: Describe current measures for markers of vulnerability

13.1.43. Research on the relationship between dysfunctional smooth-pursuit eye movement and schizophrenia has suggested that this dysfunction may be a. b. c. d.

absent in other mental disorders. induced by an environmental toxin. present in all forms of schizophrenia. associated with a predisposition to schizophrenia.

Answer: d.

Difficulty: Difficult Question ID: 13.1.43 Topic: Search for Markers of Vulnerability Skill: Understand the Concepts LO 13.6: Describe current measures for markers of vulnerability

13.1.44. The real test of any potential vulnerability marker for schizophrenia will be its ability to a. b. c. d.

identify the neuropathology involved in schizophrenia. show that people with a family history of schizophrenia are at greater risk for the illness. predict the later appearance of schizophrenia. identify the right medications to be used to treat the illness.

Answer: c.

Difficulty: Easy Question ID: 13.1.

Topic: Search for Markers of Vulnerability Skill: Understand the Concepts LO 13.6: Describe current measures for markers of vulnerability

13.1.45. After patients recover from acute psychotic episodes and are receiving antipsychotic medications, there is a high probability that they will have another episode if they discontinue their medication. According to your textbook, percent of patients have a relapse in the first year after hospital discharge. a. b. c. d.

10–15 25–30 45–50 65–70 Answer: d.

Difficulty: Moderate Question ID: 13.1.45 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

13.1.46. Which of the following symptoms is likely to show the most improvement with the use of antipsychotic medication? a. b. c. d.

alogia avolition diminished emotional expression hallucinations Answer: d.

Difficulty: Moderate Question ID: 13.1.46 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

13.1.47. Most studies find that about half of the patients who receive antipsychotic medication are rated as being much improved after what length of time? a. b. c. d.

twenty-four hours forty-eight hours four to six weeks two to four months Answer: c.

Difficulty: Moderate Question ID: 13.1.47 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

13.1.48. For patients with schizophrenia being treated with antipsychotic drugs, the real-world rates of relapse are significantly higher than best-case rates because a. b. c. d.

the best-case rates are based on inaccurate assumptions about neurochemistry. many patients stop taking their medication to avoid unpleasant side effects. best-case rates are promoted by pharmaceutical companies trying to market their drugs. antipsychotic drugs only work for short periods of time.

Answer: b.

Difficulty: Moderate Question ID: 13.1.48 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

13.1.49. The major goal of most family treatment programs is to a. b. c. d.

help family members improve their coping skills. instruct family members in the methods of administering drug treatments. encourage family members to keep the patient as calm and sedate as possible. provide family members that the same forms of therapy as the patient receives.

Answer: a.

Difficulty: Easy Question ID: 13.1.49 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

13.1.50. A comprehensive, integrated program aimed at the improvement of the cognitive abilities of schizophrenic patients, including those that are concerned with social cognition and performance on laboratory tasks, such as attention, working memory, and problem solving, is known as a. b. c. d.

cognitive schizophrenic therapy. cognitive enhancement therapy. cognitive-behavioral therapy. social skills training.

Answer: b.

Difficulty: Moderate Question ID: 13.1.50 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

True/False 13.2.51. The phase of schizophrenia that precedes the active phase, but is characterized by deteriorating functioning, is known as the precursor phase.

Answer: False Difficulty: Moderate Question ID: 13.2.51 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia 13.2.52. The residual phase follows the active phase of schizophrenia.

Answer: True Difficulty: Easy Question ID: 13.2.52 Topic: Symptoms Skill: Understand the Concepts

LO 13.1: Identify symptoms associated with schizophrenia 13.2.53. A schizophrenic client who is exhibiting lack of initiative, social withdrawal, and anhedonia would be showing negative symptoms.

Answer: True Difficulty: Moderate Question ID: 13.2.53 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia 13.2.54. When patients who are suffering delusions are confronted with contradictory evidence, they defend their beliefs with conviction.

Answer: True Difficulty: Moderate Question ID: 13.2.54 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia 13.2.55. When seen in a schizophrenic client, a rigidly held, idiosyncratic belief or preposterous idea is known as disorganized thinking Answer: False Difficulty: Moderate Question ID: 13.2.55 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia 13.2.56. When a schizophrenic demonstrates flattened emotions or restricted expression of verbal or nonverbal emotions, it is known as avolition.

Answer: False Difficulty: Moderate Question ID: 13.2.56 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia 13.2.57.Impoverished thinking in a schizophrenic client is known as alogia.

Answer: True Difficulty: Moderate Question ID: 13.2.57 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia

13.2.58. Monty, who has been diagnosed as suffering from schizophrenia, shows only the slightest smile when happy or the slightest frown when upset. His limited emotional expressiveness is called anhedonia.

Answer: False Difficulty: Moderate Question ID: 13.2.58 Topic: Symptoms Skill: Apply What You Know LO 13.1: Identify symptoms associated with schizophrenia 13.2.59. In a schizophrenic client, obviously incongruent and inconsistent emotional responses to situations are called perseveration.

Answer: FalseDifficulty: Moderate Question ID: 13.2. 59 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia 13.2.60. Catatonic behavior is characterized by motor immobility or purposeless movement.

Answer: True Difficulty: Moderate Question ID: 13.2.60 Topic: Symptoms Skill: Understand the Concepts LO 13.1: Identify symptoms associated with schizophrenia 13.2.61. The term “schizophrenia” was coined by Sigmund Freud.

Answer: False Difficulty: Easy Question ID: 13.2.61 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders 13.2.62. DSM-5 requires a minimum of three symptom(s) in order to diagnose schizophrenia.

Answer: False Difficulty: Moderate Question ID: 13.2.62 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders

13.2.63. Subtypes of schizophrenia are absent from DSM-5.

Answer: True Difficulty: Moderate Question ID: 13.2.63 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders 13.2.64. DSM-5 states that continuous signs of the disturbance, which can include prodromal or residual symptoms as well as active-phase symptoms, must persist for at least six month(s) in order to diagnose schizophrenia.

Answer: True Difficulty: Moderate Question ID: 13.2.64 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders 13.2.65. The long-term prognosis for patients who experience brief psychotic disorder is guarded.

Answer: False Difficulty: Moderate Question ID: 13.2.65 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders 13.2.66. According to DSM-5, brief psychotic disorder refers to psychotic symptoms lasting one day to one month.

Answer: True Difficulty: Easy Question ID: 13.2.66 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders 13.2.67. Worldwide, five people out of every 100 will experience or display symptoms of schizophrenia at some time during their lives.

Answer: False Difficulty: Easy Question ID: 13.2.67 Topic: Frequency Skill: Understand the Concepts LO 13.3: Contextualize schizophrenia within a population

13.2.68. Current literature suggests that men are 30 to 40 percent more likely to develop schizophrenia than women.

Answer: True Difficulty: Easy Question ID: 13.2.68 Topic: Frequency Skill: Understand the Concepts LO 13.3: Contextualize schizophrenia within a population 13.2.69. The fact none of the twin studies of schizophrenia have found a concordance rate that even approaches 100 percent suggests that the development of schizophrenic disorders is not entirely explained by genetics.

Answer: True Difficulty: Moderate Question ID: 13.2.69 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia 13.2.70. In support of the theory that viral infection may play a role in the etiology of schizophrenia is the observation that children born during the fall season are more likely to develop the disorder.

Answer: False Difficulty: Moderate Question ID: 13.2.70 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia 13.2.71. Current neurochemical hypotheses regarding schizophrenia focus on excessive levels of dopamine.

Answer: False Difficulty: Moderate Question ID: 13.2.71 Topic: Biological Causes Skill: Understand the Concepts LO 13.4: Relate biological factors to the development of schizophrenia 13.2.72. Studies done in Chicago over 70 years ago evaluating the relationship between the rate of schizophrenia and social class found the highest rates in the lower classes.

Answer: True Difficulty: Moderate Question ID: 13.2.72 Topic: Social and Psychological Causes Skill: Understand the Concepts LO 13.5: Analyze the relationship between environment and schizophrenia

13.2.73. Expressed emotion in families is thought to influence the development of schizophrenia.

Answer: False Difficulty: Moderate Question ID: 13.2.73 Topic: Social and Psychological Causes Skill: Understand the Concepts LO 13.5: Analyze the relationship between environment and schizophrenia 13.2.74. Disorganized speech is the symptom of schizophrenia which is most difficult for family members to accept and tolerate.

Answer: False Difficulty: Moderate Question ID: 13.2.74 Topic: Social and Psychological Causes Skill: Understand the Concepts LO 13.5: Analyze the relationship between environment and schizophrenia 13.2.75. Neural circuits in the dorsolateral prefrontal cortex may function improperly in schizophrenia.

Answer: True Difficulty: Difficult Question ID: 13.2.75 Topic: Search for Markers of Vulnerability Skill: Understand the Concepts LO 13. 6: Describe current measures for markers of vulnerability 13.2.76. The textbook refers to drugs that are used to treat schizophrenia as antipsychotic medications.

Answer: True Difficulty: Moderate Question ID: 13.2.76 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia 13.2.77. While antipsychotic medication does relieve the symptoms of schizophrenia in many cases, approximately 10 percent of schizophrenic patients do not improve with the use of classical antipsychotic drugs.

Answer: False Difficulty: Moderate Question ID: 13.2.77 Topic: Treatments Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

13.2.78. Extrapyramidal symptoms, common side effects of traditional medications used to treat schizophrenia, are disturbances in affect regulation.

Answer: False Difficulty: Moderate Question ID: 13.2.78 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia 13.2.79. Prolonged treatment with traditional antipsychotic drugs can lead to the development oftardive dyskinesia, a syndrome that consists of abnormal involuntary movements of the mouth and face, such as tongue protrusion, chewing, and lip puckering.

Answer: True Difficulty: Moderate Question ID: 13.2.79 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia 13.2.80. Institutionalized schizophrenics are sometimes helped with the use of token economies. The basis of these programs is that the patients receive rewards for appropriate behavior.

Answer: True Difficulty: Easy Question ID: 13.2.80 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

Essay 13.3.81. Describe the three phases of schizophrenia, including the prominent characteristics of each.

Answer: Schizophrenia typically can be divided into three phases of variable and unpredictable duration. The prodromal phases precedes the active phase and is marked by an obvious deterioration in role functioning. Friends and family often view the beginning of this phase as a change in the patient’s personality. Signs and symptoms include peculiar behaviors, unusual perceptual experiences, outbursts of anger, increased tension, and restlessness. Social withdrawal, indecisiveness, and lack of willpower are also often seen in this phase. The next phase is termed the active phase, when symptoms such as hallucinations, delusions, and disorganized speech are evident. The active phase is followed by the residual phase, which is defined by signs and symptoms that are similar in many respects to the prodromal phase.

Although the most dramatic symptoms of psychosis have improved, the patient continues to be impaired in various ways. Negative symptoms such as impoverished expression of emotion, may remain pronounced during the residual phase.

Difficulty: Moderate Question ID: 13.3.81 Topic: Symptoms Skill: Understand the Concepts

LO 13.1: Identify symptoms associated with schizophrenia 13.3.82. In addition to the duration of the disorder, what does the DSM-5 definition of schizophrenia take into account?

Answer: In addition to the duration of the disorder, the DSM-5 definition of schizophrenia takes into account the person’s level of functioning and the exclusion of related conditions, particularly mood disorders. For the level of functioning, evidence is required of a person’s decline in social or occupational functioning in order to diagnose schizophrenia. If symptoms of mania or depression are present, they must be of brief duration relative to the active and residual symptoms of schizophrenia.

Difficulty: Moderate Question ID: 13.3.82 Topic: Diagnosis Skill: Understand the Concepts LO 13.2: Differentiate forms of schizophrenic psychotic disorders 13.3.83. Are gender differences found in schizophrenia? Generally, what are the two hypotheses about gender differences in schizophrenia?

Answer: Men are about 30 to 40 percent more likely to develop schizophrenia according to recent studies. Moreover, men show an earlier onset by about four or five years. The premorbid functioning of men tends to be poor and is marked by more schizotypal traits. In contrast, the premorbid functioning of women is good and is marked by fewer schizotypal traits. Men tend to exhibit more negative symptoms; women tend to have more hallucinations and paranoia. In men, the course of the disorder tends to be chronic, and men show a poorer response to treatment. The course of schizophrenia in women is less likely to be chronic, and women show a better response to treatment. Gender differences in the age of onset and symptomatic expression of schizophrenia can be interpreted in several ways. One approach assumes that schizophrenia is a single disorder and that its expression varies in men and women. A common, genetically determined vulnerability to schizophrenia might be expressed differently in men and women. Mediating factors that might account for this difference could be biological differences between men and women (e.g., hormones) or different environmental demands, such as timing and the form of stress associated with typical male and female sex roles. An alternative approach suggests that there are two qualitatively distinct subtypes of schizophrenia: one that is characterized by an early onset affects men more often than women, while the other, with a later onset, affects women more often than men.

Difficulty: Moderate Question ID: 13.3.83 Topic: Frequency Skill: Apply What You Know LO 13.3: Contextualize schizophrenia within a population

13.3.84. Discuss the evidence that suggests the dopamine hypothesis as a factor in the cause of schizophrenia.

Answer: The dopamine hypothesis derives from the discovery that all of the first generation of antipsychotic drugs reduced the activity of the neurotransmitter dopamine. It was then hypothesized that too much dopamine or too much dopamine activity was a causal factor in the etiology of this disorder. After the therapeutic effects were observed, studies showed that most antipsychotic drugs block or prevent dopamine from interacting with dopamine receptors.

Eventually it was observed that a drug’s therapeutic effects were directly and strongly correlated with its ability to block dopamine reception. Imaging studies of schizophrenic patients’ brains have found that some patients have elevated levels of dopamine functioning in the striatum.

Recent attention is focused on multiple neurotransmitters and receptors.

Difficulty: Moderate Question ID: 13.3.84 Topic: Biological Causes Skill: Apply What You Know LO 13.4: Relate biological factors to the development of schizophrenia 13.3.85. Explain the difference between the social causation hypothesis and the social selection hypothesis in the explanation of higher rates of schizophrenia among the lower classes in the United States.

Answer: The social causation hypothesis holds that members of the lower classes experience more stressors; these experiences can trigger the manifestation of schizophrenia. The social selection hypothesis holds that schizophrenic individuals are less able to complete education and keep a good job, and so their status drifts down to the lower class.

Difficulty: Moderate Question ID: 13.3.85 Topic: Social and Psychological Causes Skill: Understand the Concepts LO 13.5: Analyze the relationship between environment and schizophrenia 13.3.86. Explain what is meant by expressed emotion (EE) and why researchers have been so interested in it. Discuss its relevance to our understanding of schizophrenia and other disorders.

Answer: EE is an aspect of disturbed communication within families where one member suffers from schizophrenia. It is associated with family members who make statements that reflect negative or intrusive attitudes toward the patient. Family members may express hostility toward the patient or be repeatedly critical. Other family members appear to be overprotective or too closely identified with the patient. Patients who live in a family high in EE were more likely to relapse than patients from low EE families. Average relapse rates are 52 percent for patients in high EE families and 22 percent for patients in low EE families. However, the influence of EE is not unique to schizophrenia. Patients with mood disorders, eating disorders, panic disorder with agoraphobia, and obsessive-compulsive disorder are also more likely to relapse following discharge from a hospital if they are living with a high EE relative.

Difficulty: Moderate Question ID: 13.3.86 Topic: Social and Psychological Causes Skill: Understand the Concepts LO 13.5: Analyze the relationship between environment and schizophrenia

13.3.87. What criteria should be met by a potential marker for vulnerability to schizophrenia?

Answer: A potential marker for vulnerability to schizophrenia should distinguish between persons who have schizophrenia and those who do not. The marker should be a stable characteristic over time. The proposed measure of vulnerability should identify more people among the biological relatives of schizophrenic patients than among people in the general population. The proposed measure of vulnerability should be able to predict the future development of schizophrenia among those who have not yet experienced psychotic episodes.

Difficulty: Moderate Question ID: 13.3.87 Topic: Search for Markers of Vulnerability Skill: Apply What You Know LO 13.6: Describe current measures for markers of vulnerability 13.3.88. Describe the benefits and side effects of first-generation antipsychotic medications.

Answer: The first generation of antipsychotic drugs were discovered in the 1950s. They have a relatively specific beneficial effect in reducing the severity of psychotic symptoms. Reduction in agitation and hostility may be noticed within a week of the patient beginning to take these drugs, but it usually takes two or three weeks for other positive symptoms such as hallucinations to improve. Positive symptoms respond better to these drugs than negative symptoms, such as alogia and diminished emotional expression. Most studies have found that about half of the patients are much improved after four to six weeks of receiving the medication. Unfortunately, about 25 percent of patients do not improve, and another 30 to 40 percent improve but do not show full remission of symptoms. Antipsychotic medications produce several unpleasant side effects. The most obvious and troublesome are extrapyramidal symptoms, which include an assortment of neurological disturbances such as motor rigidity, tremors, restless agitation, peculiar involuntary postures, and motor interia. Prolonged treatment with these medications can lead to the development of tardive dyskinesia, a syndrome consisting of involuntary movements of the mouth and face as well as spasmodic movements of the limbs and trunk of the body.

Difficulty: Moderate Question ID: 13.3.88 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia 13.3.89. What are the atypical antipsychotic drugs and why are they used?

Answer: The term “atypical” is used because these drugs do not produce extrapyramidal symptoms and are less likely to produce tardive dyskinesia. These drugs include Clozapine (Clozaril), risperidone (Risperdal), and olanzapine (Zyprexa). All of these drugs block serotonin receptors, in addition to other neurochemical actions.

Difficulty: Moderate Question ID: 13.3.89 Topic: Treatment Skill: Understand the Concepts LO 13.7: Compare current treatments for schizophrenia

13.3.90. Describe the various forms of psychological treatments available for schizophrenic patients.

Answer: In addition to medication, several forms of psychological treatments have been developed that have proved to be effective for schizophrenic patients. Family treatment programs attempt to improve the coping skills of family members, recognizing the burdens that people experience while caring for a family member with a chronic mental illness. Most of these interventions include an educational component to help the family members understand and accept the nature of the disorder, and to eliminate unrealistic expectations for the patient.

Considerable emphasis I placed on the improvement of communication and problem-solving skills, which may facilitate cooperation among family members and minimize conflict. Patients who remain impaired by residual symptoms often experience problems in social and occupational functioning. Social skills training, a structured educational approach to teaching basic social skills, can often help these patients. Cognitive therapy has also proven to be beneficial in helping patients evaluate, test, and correct distorted ways of thinking about themselves and their social environments. Cognitive enhancement therapy for schizophrenia has been shown to help patients with tasks involving attention, working memory, and problem solving, as well as social cognition.

Assertive community treatment is a psychosocial intervention that is delivered to the patient by an interdisciplinary team of clinicians who go to the patient throughout the week. Obviously, this is an expensive program that requires an extensive network of professionals, but it is believed that the costs will be offset by reduction in costs of inpatient care through relapse prevention.

Difficulty: Moderate Question ID: 13.3.90 Topic: Treatment Skill: Apply What You Know LO 13.7: Compare current treatments for schizophrenia

Chapter 14 Neurocognitive Disorders Total Assessment Guide (T.A.G.) Topic

Introduction

Question Type Multiple Choice True/False

Understand the Concepts 3,4,5

Apply What You Know 1,2,6,7,8

51,52,53

Essay

Symptoms

Diagnosis

Multiple Choice True/False

9,10,12,14,15, 19 55,56,57,60

11,13,16,17,18

Essay

81,82,83,84

Multiple Choice True/False

20,22,23,24,25, 21,28,30,33 26,27,29,31,32 61,62,63,64,65, 66,67,68,69,70

58,59

Essay Frequency of Delirium and Major Neurocognitive Disorders

Causes

Treatment and Management

Multiple Choice True/False

34,35

Essay

85,86

Multiple Choice True/False

36,37,38,39,40, 45 41,42,43,44, 73,74,75,76 77

Essay

87,88,89

Multiple Choice True/False

46,47,48,50

4

79,80

78

Essay

90

71,72

Analyze It

Evaluate It

Chapter 14: Neurocognitive Disorders Multiple Choice 14.1.1. Stanley is 65, and for the past couple of years he has been suffering from a gradual worsening of his memory, as well as experiencing some language difficulties and problems with his reasoning and decision making. What is the most likely diagnosis? a. b. c. d.

delirium organic psychosis dementia schizophrenia Answer: c.

Difficulty: Moderate Question ID: 14.1.1 Topic: Introduction Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.2. A 68-year-old man is brought to the emergency room by his family. Family members tell the physician that their relative has been confused, agitated, and exhibiting memory impairments. These symptoms developed in the last few days; he has no prior history of memory problems. Based on the family's information, the physician suspects the man is experiencing delirium. Which of the following questions would provide information that could confirm this diagnosis? a. b. c. d.

“Does schizophrenia run in your family?”

“Is he taking any medications at this time?”

“Does he experience any difficulties with motor movements?”

“Do any members of the family suffer from Huntington's disease?”

Answer: b.

Difficulty: Moderate Question ID: 14.1.2 Topic: Introduction Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.3. Among elderly psychiatric patients, neurocognitive disorders are the a. b. c. d.

most frequent second-most frequent fifth-most frequent rarest Answer: a.

Difficulty: Easy Question ID: 14.1.3 Topic: Introduction Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.4. Forgetting to make a phone call or to pick up something from the store are a. b. c. d.

signs of delirium. symptoms that suggest that Alzheimer’s disease is reaching an advanced stage. part of normal experience. probably diagnostic of dementia.

Answer: c.

Difficulty: Easy Question ID: 14.1.4 Topic: Introduction Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.5. The cognitive symptoms seen in dementia and delirium a. b. c. d.

are not seen in any other disorders. are seen in other disorders as well but are not defining features. are seen in other disorders but are not as severe. are only seen in schizophrenia and other psychotic disorders.

Answer: b.

Difficulty: Moderate Question ID: 14.1.5 Topic: Introduction Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

disorders.

14.1.6. At the insistence of family members, you take your elderly grandfather to a general practice physician, who refers him to a neurologist. When you ask for a description of neurologists, the general practitioner tells you they are a. b. c. d.

psychologists specializing in neuroses. psychiatrists specializing in nervous disorders. psychologists specializing in neuropsychological testing. physicians specializing in diseases of the brain and nervous system.

Answer: d.

Difficulty: Easy Question ID: 14.1.6 Topic: Introduction Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.7. You are head of an assessment team that needs some testing to determine the level and type of cognitive impairment being experienced by your client. You call on the services of which type of team member for this assessment? a. b. c. d.

psychiatric social worker neuropsychiatrist neuropsychologist psychiatric nurse Answer: c.

Difficulty: Moderate Question ID: 14.1.7 Topic: Introduction Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.8. Your textbook presents the case of 84-year-old Mary. What was one of the first indications that Mary was suffering from dementia? a. b. c. d.

She could not remember her age.

She reported hearing voices calling her.

Some of her animals were found dead because she forgot to feed them.

After being admitted to a nursing home, she became agitated and belligerent.

Answer: c.

Difficulty: Easy Question ID: 14.1.8 Topic: Introduction Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.9. Which of the following is characteristic of delirium? a. b. c. d.

agnosia delusions identity confusion clouded consciousness Answer: d.

Difficulty: Easy Question ID: 14.1.9 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.10. Typically the symptoms of delirium a. b. c. d.

develop rapidly and then remain at a steady level as they further develop. develop slowly and fluctuate throughout the day. occur rapidly and then fluctuate throughout the day. occur slowly and then remain at a steady level as they further develop.

Answer: c.

Difficulty: Moderate Question ID: 14.1.10 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.11. While hospitalized, Jack begins to show signs of delirium. Which of the following is a possible clue that leads his physician to suspect that Jack is experiencing delirium? a. b. c. d.

Jack reports paranoid delusions.

Jack experiences fleeting perceptual disturbances.

Motor functions on Jack’s right side have slowed.

Jack appears sedated and doesn’t show much emotion.

Answer: b.

Difficulty: Moderate Question ID: 14.1.11 Topic: Symptoms Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.12. In trying to make a differential diagnosis between delirium and dementia, which of the following would be accurate? a. b. c. d.

Delirium has a stable, rather than fluctuating, course.

Delirium often involves hallucinations, but dementia rarely does.

With delirium, one has consistently poor insight, but with dementia, there are often insightful periods.

Sleep is more disturbed with dementia than it is with delirium.

Answer: b.

Difficulty: Moderate Question ID: 14.1.12 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.13. Last year, Bob was admitted and released from the hospital within two days. The diagnosis was a neurocognitive disorder. Since that time, he has held down a job as a carpenter. Which of the following disorders is most likely to have caused Bob’s hospitalization? a. b. c. d.

delirium dementia Parkinson’s disease Huntington’s disease Answer: a.

Difficulty: Moderate Question ID: 14.1.13 Topic: Symptoms Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.14. Your textbook states that the hallmark of dementia is a. b. c. d.

aphasia. hallucinations. delirium. memory loss.

Answer: d.

Difficulty: Easy Question ID: 14.1.14 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.15. What is the most obvious problem during the beginning stages of dementia? a. b. c. d.

chorea delirium retrograde amnesia anterograde amnesia Answer: d.

Difficulty: Moderate Question ID: 14.1.15 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.16. After suffering a head injury in a car accident, Molly cannot remember anything that happened before the accident. What term will her physician use to describe her condition? a. b. c. d.

agnosia apraxia retrograde amnesia dissociative amnesia Answer: c.

Difficulty: Moderate Question ID: 14.1.16 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.17. A neuropsychologist is describing several patients at a case conference. He says John does not know the names of common objects, such as shoes, shirts, and screwdrivers. Jill does not know how to use such objects. What terms will he use to describe John and Jill’s difficulties? a. b. c. d.

John exhibits apraxia; Jill exhibits aphasia.

John exhibits aphasia; Jill exhibits apraxia.

John exhibits retrograde amnesia; Jill exhibits anterograde amnesia.

John exhibits anterograde amnesia; Jill exhibits retrograde amnesia.

Answer: b.

Difficulty: Moderate Question ID: 14.1.17 Topic: Symptoms Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.18. People with dementia often show difficulty with abstract thinking. Which of the following questions to a person with dementia would help to demonstrate this difficulty? a. b. c. d.

“What time is it?”

“What was the name of your first grade teacher?”

“Why are a baseball bat and a hockey stick alike?”

“What would you like to have for supper tonight?”

Answer: c.

Difficulty: Moderate Question ID: 14.1.18 Topic: Symptoms Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.19. The Mini-Mental State Examination is used to assess a. b. c. d.

cognitive impairment. microscopic brain lesions. a patient’s level of depression. clinicians’ qualifications as neurologists.

Answer: a.

Difficulty: Easy Question ID: 14.1.19 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.1.20. In DSM-5, the distinction between major neurocognitive disorder and mild neurocognitive disorder is a. b. c. d.

the evidence of significant cognitive decline, which is characteristic of major NCD. a recessive gene. the evidence of significant cognitive decline, which is characteristic of mild NCD. an interference with a person’s capacity for independence, which is characteristic of mild NCD. Answer: a.

Difficulty: Moderate Question ID: 14.1.20 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1.21. A doctor has just finished her examination of an 82-year-old patient who has recently been showing significant and worsening memory loss and other forms of cognitive impairment, and the doctor says, “This woman is definitely suffering from Alzheimer's disease.” Why should you be skeptical about this diagnosis? a. b. c. d.

Alzheimer’s disease only affects younger people.

Alzheimer’s disease does not typically involve memory problems.

A definite diagnosis of Alzheimer’s can only be determined by an autopsy.

The patient’s condition is worsening, but Alzheimer’s disease involves very stable symptoms.

Answer: c.

Difficulty: Moderate Question ID: 14.1.21 Topic: Diagnosis Skill: Apply What You Know LO 14.2: Describe diagnosis methodologies for NCDs

14.1.22. What are the two specific types of brain lesions found in Alzheimer’s disease? a. b. c. d.

microtubules and dopamine deposits neurofibrillary tangles and amyloid plaques ballooning nerve cells and absent myelin sheaths clogged train arteries and enlarged microtubules Answer: b.

Difficulty: Easy Question ID: 14.1.22 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1.23. Which of the following describes the amyloid plaques found in Alzheimer's disease? a. b. c. d.

asymmetrical neurofibrils ballooning of nerve cells clogged arteries in the frontal lobes a central core of protein material surrounded by clumps of debris from destroyed neurons Answer: d.

Difficulty: Moderate Question ID: 14.1.23 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1.24. Frontotemporal neurocognitive disorder is a rare form of dementia associated with atrophy of the frontal and temporal lobes of the brain. In this disorder, generally precede(s) the onset of cognitive impairment. a. b. c. d.

extreme anxiety personality changes lose of long-term memory hallucinations Answer: b.

Difficulty: Moderate Question ID: 14.1.24 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1.25. Many conditions other than those that attack the brain tissue directly can also produce symptoms of neurocognitive disorder. These can be either medical conditions or other types of mental disorders.

One cause of neurocognitive disorder is the severe interruption of blood flow to the brain known as a a. b. c. d.

stroke. myocardial infection. vascular occlusion. vasodementia.

Answer: a.

Difficulty: Moderate Question ID: 14.1.25 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1.26. In comparison to patients with Alzheimer’s disease, patients with frontotemporal neurocognitive disorder are a. b. c. d.

more likely to engage in impulsive sexual actions, roaming, and aimless exploration. less likely to engage in impulsive sexual actions, roaming, and aimless exploration. likely to engage in impulsive sexual actions, roaming, and aimless exploration at about the same rate. more likely to develop impaired perception.

Answer: a.

Difficulty: Difficult Question ID: 14.1.26 Topic: Diagnosis Skill: Apply What You Know LO 14.2: Describe diagnosis methodologies for NCDs

14.1.27. Chorea is a symptom of a. b. c. d.

vascular neurocognitive disease.

Alzheimer’s disease.

Parkinson’s disease.

Huntington’s disease.

Answer: d.

Difficulty: Moderate Question ID: 14.1.27 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1.28. You are reading a medical chart in which a patient is referred to as displaying chorea. If you met this patient, you might expect a lot of a. b. c. d.

restless and fidgety movements. incoherent speech. obscene language. listlessness and psychomotor retardation.

Answer: a.

Difficulty: Moderate Question ID: 14.1.28 Topic: Diagnosis Skill: Apply What You Know LO 14.2: Describe diagnosis methodologies for NCDs

14.1.29. The cognitive and motor deficits associated with Huntington’s disease are due to neuronal degeneration in the a. b. c. d.

hippocampus. frontal lobe. basal ganglia. medial thalamus.

Answer: c.

Difficulty: Moderate Question ID: 14.1.29 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1.30. Franklin has Huntington’s disease, and on that basis, we can be virtually certain that a. b. c. d.

Franklin is at least 73 years old.

Franklin has a history of excessive alcohol consumption.

Franklin’s family has a history of this disease.

Franklin can be effectively treated with drugs used to treat Parkinson’s disease.

Answer: c.

Difficulty: Moderate Question ID: 14.1.30 Topic: Diagnosis Skill: Apply What You Know LO 14.2: Describe diagnosis methodologies for NCDs

14.1.31. What are the typical symptoms that mark a diagnosis of Parkinson’s disease? a. b. c. d.

chorea, tremors, and retardation tremors, dementia, and postural abnormalities writhing, aimless exploration, and depression tremors, reduction in voluntary movements, and rigidity Answer: d.

Difficulty: Moderate Question ID: 14.1.31 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1.32. What is one way that Huntington’s disease and Parkinson’s disease can usually be distinguished? a. b. c. d.

Only Parkinson’s disease involves motor symptoms.

Huntington’s disease usually leads to neurocognitive disorder, while Parkinson’s does not.

It is possible to recover from Huntington’s disease but not Parkinson’s.

Only Huntington’s disease carries a risk for depression.

Answer: b.

Difficulty: Moderate Question ID: 14.1.32 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.1. 33. A pathologist has just finished an autopsy and includes in her report a reference to “Lewy bodies.” This means that in her autopsy, she has discovered a. b. c. d.

senile plaques filled with protein. ballooning of nerve cells and enlarged areas between adjacent neurons. rounded clumps of protein surrounded by masses of destroyed neural tissue. rounded deposits in nerve cells often found in the brains of patients with Parkinson’s disease.

Answer: d.

Difficulty: Difficult Question ID: 14.1.33 Topic: Diagnosis Skill: Apply What You Know LO 14.2: Describe diagnosis methodologies for NCDs

14.1.34. The average time between the diagnosed onset of Alzheimer’s disease and death is a. b. c. d.

six months. one year. six years. twelve years.

Answer: c.

Difficulty: Moderate Question ID: 14.1.34 Topic: Frequency of Delirium and Major Neurocognitive Disorders Skill: Understand the Concepts LO 14.3: Identify factors associated with increased risk of NCDs

14.1.35. Which of the following statements is true with regard to the incidence of Alzheimer’s disease (AD)? a. b. c. d.

The incidence of AD is greater for women at all ages.

The incidence of AD is greater for men at all ages.

After age 90, the incidence of AD apparently decreases for men.

After age 100, the incidence of AD apparently decreases for women.

Answer: c.

Difficulty: Moderate Question ID: 14.1.35 Topic: Frequency of Delirium and Major Neurocognitive Disorders Skill: Understand the Concepts LO 14.3: Identify factors associated with increased risk of NCDs

14.1.36. One Swedish study of genetic factors in the cause of dementia found that the concordance rate for monozygotic twins was percent. a. b. c. d.

1 20 40 over 50 Answer: d.

Difficulty: Moderate Question ID: 14.1.36 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that led to neurocognitive disorders

14.1.37. A result of recent gene identification efforts is the a. b. c. d.

firm rejection of gene–environment interaction. diminishment of our understanding of the etiology of disorders. discovery that a single gene is responsible for most disorders. incorporation of gene–environment interaction.

Answer: d.

Difficulty: Moderate Question ID: 14.1.37 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that led to neurocognitive disorders

14.1.38. If the World Health Organization assembled the most respected researchers on the genetics of Alzheimer’s disease and asked them to review the research, which of the following would be the most appropriate title for that report? a. b. c. d.

“A Single Disease, a Single Gene” “How Toxins Affect Genetic Vulnerability” “Link Identified: Distractibility as the Key” “Alzheimer’s Disease: No Single Genetic Path” Answer: d.

Difficulty: Moderate Question ID: 14.1.38 Topic: Causes Skill: Apply What You Know LO 14.4: Summarize factors that led to neurocognitive disorders

14.1.39. The amyloid plaques and neurofibrillary tangles that are typical in Alzheimer’s disease are also found in people with a. b. c. d.

schizophrenia.

Down syndrome.

Parkinson’s disease.

Korsakoff’ syndrome.

Answer: b.

Difficulty: Moderate Question ID: 14.1.39 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that led to neurocognitive disorders

14.1.40. From the evidence so far, it seems that Alzheimer’s disease. a. b. c. d.

is/are responsible for early-onset and late-onset

Pick’s bodies no genes different genes the same gene Answer: c.

Difficulty: Moderate Question ID: 14.1.40 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that led to neurocognitive disorders

14.1. 41. Which neurotransmitter is implicated in the development of Parkinson’s disease? a. b. c. d.

GABA dopamine serotonin norepinephrine Answer: b.

Difficulty: Moderate Question ID: 14.1.41 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that led to neurocognitive disorders

14.1. 42. Which of the following is a correct pairing of a disorder with the neurotransmitter thought to play a significant role in its etiology? a. b. c. d.

Pick’s disease and dopamine Alzheimer’s disease and ACh Parkinson’s disease and GABA Huntington’s disease and serotonin Answer: b.

Difficulty: Moderate Question ID: 14.1.42 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that led to neurocognitive disorders

14.1.43. What etiology for Alzheimer’s disease is suggested by the presence of beta-amyloid at the core of amyloid plaques? a. b. c. d.

dopamine deficiency radiation overdose immune system dysfunction circulatory system dysfunction Answer: c.

Difficulty: Difficult Question ID: 14.1.43 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that led to neurocognitive disorders

14.1.44. Exposure to what type of trauma as an adult puts an individual at greater risk of developing Alzheimer’s disease? a. b. c. d.

exposure to lead being knocked unconscious exposure to radioactivity losing consciousness due to carbon monoxide Answer: b.

Difficulty: Moderate Question ID: 14.1.44 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that led to neurocognitive disorders

14.1.45. One possible theoretical explanation for the negative correlation between education and the rate of Alzheimer’s disease in nuns is that a. b. c. d.

education increases “brain work,” which in turn increases the density of synaptic connections in the cortex. going to college is also correlated with a family’s social economic status, which may be the real cause. nuns who are educated rise in the church hierarchy, and therefore, lead less stressful lives. the nuns are aware of how the brain functions.

Answer: a.

Difficulty: Moderate Question ID: 14.1.45 Topic: Causes Skill: Apply What You Know LO 14.4: Summarize factors that led to neurocognitive disorders

14.1.46. Which of the following disorders has the best chance for successful treatment and recovery? a. b. c. d.

delirium Down syndrome primary dementia secondary dementia Answer: a.

Difficulty: Moderate Question ID: 14.1.46 Topic: Treatment and Management Skill: Understand the Concepts LO 14.5: Determine NCD management based on diagnosis

14.1.47. It is generally believed that accurate diagnosis is especially important in dealing with cognitive disorders because a. b. c. d.

insurance companies only pay benefits when an organic basis has been confirmed. the diagnosis can identify specific medical conditions that can then sometimes be successfully treated. cognitive disorders are too easily confused with schizophrenia and other psychotic disorders. once diagnosed, most cognitive disorders can be successfully treated.

Answer: b.

Difficulty: Easy Question ID: 14.1.47 Topic: Treatment and Management Skill: Understand the Concepts LO 14.5: Determine NCD management based on diagnosis

14.1.48. A group of experimental drugs focuses on blocking the construction of neurofibrillary tangles by keeping tau protein anchored to microtubules as a possible treatment for a. b. c. d.

Kraepelin’s disease.

Huntington’s disease.

Alzheimer’s disease.

All of the above are correct.

Answer: c.

Difficulty: Moderate Question ID: 14.1.48 Topic: Treatment and Management Skill: Understand the Concepts LO 14.5: Determine NCD management based on diagnosis

14.1.49. You are asked to assist in the design of a living environment that would be most beneficial for patients with dementia. Which of the following would be particularly helpful? a. b. c. d.

alternate routes to the dining room to allow patients choices clearly visible common areas that can be seen from the patients’ rooms open access to the setting so that patients can feel free to come and go as they want confining patients to their rooms as much as possible Answer: b.

Difficulty: Moderate Question ID: 14.1.49 Topic: Treatment and Management Skill: Apply What You Know LO 14.5: Determine NCD management based on diagnosis

14.1.50. In the United States, percent of the primary care for people with dementia and Alzheimer’s disease is provided by family members. a. b. c d.

10 20 60 80 Answer: d.

Difficulty: Easy Question ID: 14.1.50 Topic: Treatment and Management Skill: Understand the Concepts LO 14.5: Determine NCD management based on diagnosis

True/False 14.2.51. A gradual worsening loss of memory and related cognitive functions, including the use of language, as well as reasoning and decision making is known as dementia.

Answer: True Difficulty: Easy Question ID: 14.2.51 Topic: Introduction Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.52. Delirium is a confusional state that develops over a short period of time and is often associated with agitation and hyperactivity.

Answer: True Difficulty: Easy Question ID: 14.2.52 Topic: Introduction Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.53. A physician who deals primarily with diseases of the brain and the nervous system is known as a neuropsychologist.

Answer: False Difficulty: Easy Question ID: 14.2.53 Topic: Introduction Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.54. A professional that has particular expertise in the assessment of specific types of cognitive impairment is known as a neurologist.

Answer: False Difficulty: Easy Question ID: 14.2.54 Topic: Introduction Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.55. Retrograde amnesia refers to the loss of memory for events prior to the onset of an illness or the experience of a traumatic event.

Answer: True Difficulty: Moderate Question ID: 14.2.55 Topic: Symptoms Skill: Understand the Concepts

LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.56. Apraxia is a term that describes various types of loss or impairment in language that are caused by brain damage.

Answer: False Difficulty: Moderate Question ID: 14.2.56 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.57. A term that means “perception without meaning” is agnosia.

Answer: True Difficulty: Easy Question ID: 14.2.57 Topic: Symptoms Skill: Understand the Concepts LO 14. Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.58. A psychologist holds out a comb and asks Mr. Bonte if he knows what it is called. Mr. Bonte replies, “I have no idea what that's called.” The psychologist then asks Mr. Bonte to show what he would do with the object. Mr. Bonte says, “How should I know? I don't know what it is!” Mr. Bonte's response led the psychologist to describe his condition as apraxia.

Answer: False Difficulty: Moderate Question ID: 14.2.58 Topic: Symptoms Skill: Apply What You Know LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.59. Your aunt, who is in her 80s, has been referred to a professional. Your aunt is given a series of tests that assess cognitive, sensorimotor, perceptual, and speech function. It is most likely that your aunt is seeing a psychiatrist.

Answer: False Difficulty: Easy Question ID: 14.2.59 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.60. Dyskinesia is a term that describes involuntary movements that also involve tics, tremors, and jerky movements of the face and limbs.

Answer: True Difficulty: Easy Question ID: 14.2.60 Topic: Symptoms Skill: Understand the Concepts

LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.2.61. Alois Alzheimer first discovered the disease named after him through a microscopic postmortem examination of his patient’s brain.

Answer: True Difficulty: Moderate Question ID: 14.2.61 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs 14.2.62. In DSM-5, the disorders that were formerly referred to as “amnestic disorders” are now included under the classification of amnestic spectrum disorders.

Answer: False Difficulty: Moderate Question ID: 14.2.62 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs 14.2.63. Many specific conditions are associated with neurocognitive disorder. These are distinguished primarily on the basis of the specific types of chromosomal abnormalities.

Answer: False Difficulty: Moderate Question ID: 14.2.63 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs 14.2.64. Alzheimer’s disease is distinguished from other types of dementia in DSM-5 based on the gradual speed of onset.

Answer: True Difficulty: Easy Question ID: 14.2.64 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs 14.2.65. Neurofibrillary tangles, which are typically found in patients with Alzheimer’s disease, are unique to that disease and allow for definite diagnosis.

Answer: False Difficulty: Moderate Question ID: 14.2.65 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.2.66. In Alzheimer’s disease, the microtubules of neurons disintegrate in the absence of tau proteins, and the whole neuron shrivels and dies. The disorganized tangles of tau that are left at the end of this process are known as neurofibrillary tangles.

Answer: True Difficulty: Easy Question ID: 14.2.66 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs 14.2.67. Patients with frontotemporal neurocognitive disorder display symptoms similar to Alzheimer’s disease, but early personality changes before cognitive impairment are more frequent.

Answer: True Difficulty: Easy Question ID: 14.2.67 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs 14.2.68. Unusual involuntary muscle movements known as chorea (from the Greek word meaning “dance”) represent the most distinctive feature of Parkinson’s Disease.

Answer: False Difficulty: Easy Question ID: 14.2.68 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs 14.2.69. In Huntington’s disease, an area of the brain implicated is the substantia nigra.

Answer: False Difficulty: Moderate Question ID: 14.2.69 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs 14.2.70. An infarct is a clogged artery in the brain.

Answer: False Difficulty: Easy Question ID: 14.2.70 Topic: Diagnosis Skill: Understand the Concepts LO 14.2: Describe diagnosis methodologies for NCDs

14.2.71. Approximately 40 percent of individuals over the age of 90 will exhibit symptoms of moderate to severe dementia.

Answer: True Difficulty: Moderate Question ID: 14.2.71 Topic: Frequency of Delirium and Major Neurocognitive Disorders Skill: Understand the Concepts LO 14.3: Identify factors associated with increased risk of NCDs 14.2.72. Studies suggest that Alzheimer’s disease is more common in developing countries, than it is in other places.

Answer: False Difficulty: Moderate Question ID: 14.2.72 Topic: Frequency of Delirium and Major Neurocognitive Disorders Skill: Understand the Concepts LO 14.3: Identify factors associated with increased risk of NCDs 14.2.73. A common cause of delirium among the elderly is urinary tract infection.

Answer: True Difficulty: Moderate Question ID: 14.2.73 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that lead to neurocognitive disorders 14.2.74. Researchers who study Alzheimer’s disease also very interested in Down syndrome because both have been linked to dopamine and serotonin deficiencies.

Answer: False Difficulty: Moderate Question ID: 14.2.74 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that lead to neurocognitive disorders 14.2.75. Huntington's disease has been associated with deficiencies in which the neurotransmitter GABA. Answer: True Difficulty: Moderate Question ID: 14.2.75 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that lead to neurocognitive disorders

14.2.76. The suspected cause of Creutzfeldt-Jakob disease is a slow-acting virus.

Answer: True Difficulty: Moderate Question ID: 14.2.76 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that lead to neurocognitive disorders 14.2.77. According to research on Catholic nuns, spirituality reduces the incidence of Alzheimer’s disease?

Answer: False Difficulty: Easy Question ID: 14.2.77 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that lead to neurocognitive disorders 14.2.78. A patient’s medical chart indicates that her physician recommended a trial of donepezil (Aricept). Her likely diagnosis is Alzheimer’s disease.

Answer: True Difficulty: Moderate Question ID: 14.2.78 Topic: Treatment and Management Skill: Apply What You Know LO 14.5: Determine NCD management based on diagnosis 14.2.79. Effective management of patients with dementia can be improved by helping them to follow structured and predictable daily schedules.

Answer: True Difficulty: Easy Question ID: 14.2.79 Topic: Treatment and Management Skill: Understand the Concepts LO 14.5: Determine NCD management based on diagnosis 14.2.80. Some drugs are designed to relieve cognitive symptoms of dementia by boosting the action of acetylcholine (ACh), a neurotransmitter that is involved in memory and whose level is reduced in patients with Alzheimer’s disease.

Answer: True Difficulty: Moderate Question ID: 14.2.80 Topic: Treatment and Management Skill: Understand the Concepts LO 14.5: Determine NCD management based on diagnosis

Essay 14.3.81. What are some of the features that distinguish delirium from dementia?

Answer: (1) Onset: sudden in delirium, slow in dementia; (2) duration: brief in delirium, extended in dementia; (3) course: fluctuating in delirium, stable in dementia; (4) hallucinations: visual/tactile/vivid in delirium, rare in dementia; (5) insight: lucid intervals in delirium, consistently poor in dementia; and (6) sleep: disturbed in delirium, less disturbed in dementia Difficulty: Moderate Question ID: 14.3.81 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.3.82. Describe the emotional changes that may accompany dementia.

Answer: Patients with dementia may appear to be apathetic, or emotionally flat. On the other hand, sometimes patients with dementia may have unpredictable and exaggerated emotional expressions. Nevertheless, depression often accompanies dementia.

Difficulty: Moderate Question ID: 14.3.82 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.3.83. How do retrograde and anterograde amnesia differ?

Answer: Retrograde amnesia is the loss of memory for events before the start of an illness or the experience of a traumatic event. Anterograde amnesia is the inability to learn or remember new things after a particular point in time.

Difficulty: Moderate Question ID: 14.3.83 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms 14.3. 84. What signs and symptoms can be used to distinguish depression from dementia?

Answer: Depression: uneven progression over weeks, the person complains of memory loss, the symptoms are often worse in the morning and better as the day goes on, the person is aware of and may exaggerate the disability, and the person may abuse alcohol or other drugs. Dementia: there is an even progression over months or years there are attempts to hide the memory loss, the symptoms are worse later in the day or when fatigued, the person is unaware of the symptoms or minimizes the disability, and drug abuse is rare.

Difficulty: Moderate Question ID: 14.3.84 Topic: Symptoms Skill: Understand the Concepts LO 14.1: Differentiate neurocognitive disorders (NCDs) by their symptoms

14.3.85. Explain why it is difficult for epidemiologists to get an accurate picture of the number of cases of dementia, and the types of dementia, in the U.S. population.

Answer: Generally the epidemiologists’ problem is one of diagnosis. Mild symptoms of dementia are difficult to distinguish from problems associated with normal aging. Mild symptoms are hard to detect reliably. In order to diagnose dementia, multiple assessments are required over time, whereas epidemiological assessments are usually made at one point in time. Finally, the undifferentiated dementias require post mortem analysis of brain tissue to make an accurate diagnosis of a specific type of dementia.

Difficulty: Moderate Question ID: 14.3.85 Topic: Frequency of Delirium and Dementia Skill: Understand the Concepts LO 14.3: Identify factors associated with increased risk of NCDs 14.3.86. Explain why it is difficult to collect cross-cultural data regarding the prevalence of dementia.

Answer: Several issues make it difficult to collect cross-cultural data. Test that are used to measure cognitive impairment must be developed carefully to be sure that they are not culturally or racially biased. Elderly people in developing countries who have little formal education pose a special challenge, since most cognitive tasks have been developed for use with a different population. Those who follow more traditional ways of life may have very different views of old age and its problems. Prevalence rates for dementia seem to be relatively consistent across various regions of the world, but it is less clear whether there are regional variations with regard to the prevalence of specific types of neurocognitive disorders.

Difficulty: Moderate Question ID: 14.3.86 Topic: Frequency of Delirium and Dementia Skill: Understand the Concepts LO 14.3: Identify factors associated with increased risk of NCDs 14.3.87. Researchers have concluded that Alzheimer’s disease is genetically heterogeneous. What does this mean?

Answer: That Alzheimer’s disease is genetically heterogeneous means that there are several different forms of Alzheimer’s disease, each of them probably associated with a different gene or combination of genes.

Difficulty: Moderate Question ID: 14.3.87 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that lead to neurocognitive disorders

14.3.88. Which chromosomes contain genes that, when mutated, cause early-onset forms of Alzheimer’s disease?

Answer: Chromosomes 1, 14, and 21 contain genes that, when mutated, cause early-onset forms of Alzheimer’s disease.

Difficulty: Difficult Question ID: 14.3.88 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that lead to neurocognitive disorders 14.3.89. Discuss the role of the immune system as it is related to the development of dementia.

Answer: Some forms of primary dementia are known to be the products of “slow” viruses— infections that develop over a much more extended period of time than do most viral infections.

Creutzfeldt-Jakob disease is one example. The immune system is the body’s first line of defense against infection, using antibodies to break down foreign materials, such as bacteria and viruses that enter the body. The production of these antibodies may be dysfunctional in some forms of dementia, such as Alzheimer’s disease. In other words, the destruction of brain tissue may be caused by a breakdown in the system that regulates the immune system.

Difficulty: Moderate Question ID: 14.3.89 Topic: Causes Skill: Understand the Concepts LO 14.4: Summarize factors that lead to neurocognitive disorders 14.3.90. Summarize the medications that are currently available for use to relieve the cognitive symptoms of dementia.

Answer: Some drugs are designed to relieve cognitive symptoms of dementia by boosting the action of acetylcholine (Ach), a neurotransmitter that is involved in memory and whose level is reduced in patients with Alzheimer’s disease. Donepezil (Aricept) increases Ach activity by inhibiting acetylcholinesterase, an enzyme that breaks down Ach in the synapse. It cannot reverse the progression of the disease, and usually works for only six to nine months. New drug treatments are being pursued that are aimed more directly at the processes by which neurons are destroyed. One possibility involves the use of synthetic peptides and natural proteins that inhibit the formation of amyloid plaques. Others focus on blocking the construction of neurofibrillary tangles by keeping tau protein anchored to microtubules. Neuroleptic medication can also be used to treat some patients who develop psychotic symptoms, but dosages are typically kept low and caution must be taken using these medications with patients suffering from dementia with Lewy bodies.

Difficulty: Moderate Question ID: 14.3.90 Topic: Treatment and Management Skill: Understand the Concepts LO 14.5: Determine NCD management based on diagnosis

Chapter 15 Intellectual Disabilities and Autism Spectrum Disorders Topic

Introduction

Total Assessment Guide (T.A.G.) Question Type Understand Apply What the Concepts You Know Multiple Choice 1,2

Analyze It

True/False Essay

Symptoms of Intellectual Disabilities

Diagnosis of Intellectual Disabilities

Causes of Intellectual Disabilities Prevention and Normalization of Intellectual Disabilities

Multiple Choice 3,4,7,8,9,12, 13,14 51,52,53,54, True/False 55,56 81,82 Essay

5,10,11

Multiple Choice 16

15,17

True/False

58

Essay

83

18,22,29,30 Multiple Choice 19,20,21,23, 24,25,26,31,32 59,60,61,62,63, True/False 64,65,66,67,68 84,85 Essay Multiple Choice 33,34,35 True/False

69,70,71

Essay

86

Multiple Choice 36,38,39,41,43 Autism Spectrum Disorder

57

True/False Essay

37,40,42,44

72,73,74,75,76, 77 87,88

Multiple Choice 45,46 Causes of ASD

True/False

78

Essay

89

Multiple Choice 49 Treatment of ASD

True/False

79,80

Essay

90

47,48,50

6

Evaluate It

Chapter 15: Intellectual Disabilities and Autism Spectrum Disorders Multiple Choice 15.1.1. You are watching the film Rain Man and, based on your course work in abnormal psychology, you recognize that an appropriate diagnostic category for the character Raymond, portrayed by Dustin Hoffman, is a. b. c. d.

Rett disorder. fetal alcohol syndrome. neurosis. autism spectrum disorders.

Answer: d.

Difficulty: Easy Question ID: 15.1.1 Topic: Introduction Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder

15.1.2. Which of the following is a similarity between intellectual disabilities and autism spectrum disorders? a. b. c. d.

Both begin late in life.

Each leads to difficulties within a narrow range of life functioning.

Academic aptitude is impaired with both.

Both are initially a shock to parents.

Answer: d.

Difficulty: Moderate Question ID: 15.1.2 Topic: Introduction Skill: Understand the Concepts LO 15.2: Contextualize the concept of intellectual disability

15.1.3. The American Association on Intellectual and Developmental Disabilities (AAIDD), as well as DSM-5, use the term for what was previously called “mental retardation.” a. b. c. d.

intellectually challenged savantism intellectual disability learning disability Answer: c.

Difficulty: Moderate Question ID: 15.1.3 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.1.4. Which of the following is a DSM-5 criterion for intellectual disability? a. b. c. d.

unconfirmed (based on clinical judgment) limitation in intellectual functioning significant limitation in adaptive functioning significant perceptual impairment onset after age 21 Answer: b.

Difficulty: Moderate Question ID: 15.1.4 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.1.5. 29-year-old Brenda has an IQ of 67, yet she finished fourth grade. She lives with her boyfriend, pays her bills with money she earns as a factory worker, and is able to live without supervision. What is Brenda's most likely diagnosis in terms of the DSM-5 classification of intellectual disability? a. b. c. d.

intellectual disability, because of low IQ not intellectual disability, because she is over 18 intellectual disability, because of low educational status not intellectual disability, because she is functioning adaptively Answer: d.

Difficulty: Difficult Question ID: 15.1.5 Topic: Symptoms of Intellectual Disabilities Skill: Apply What You Know LO 15.1: Evaluate theories of intellect measurement

15.1.6. Al is 64 years old; he is currently a patient at a local hospital where a psychological battery revealed that he has subaverage intelligence and related deficits. Physicians and psychologists believe that his condition is the result of a degenerative brain disease. What is Al’s most likely diagnosis? a. b. c. d.

dementia delirium emotional trauma Asperger disorder Answer: a.

Difficulty: Difficult Question ID: 15.1.6 Topic: Symptoms of Intellectual Disabilities Skill: Analyze It LO 15.1: Evaluate theories of intellect measurement

15.1.7. Both the American Association on Intellectual and Developmental Disabilities and DSM-5 recognize that a. b. c. d.

IQ scores define intelligence. intelligence is more than an IQ score. conceptual skills are part of IQ scores.

IQ measures social intelligence.

Answer: b.

Difficulty: Moderate Question ID: 15.1.7 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.1.8. What system was used in early intelligence tests to compute an IQ? a. b. c. d.

comparing a score to group norms dividing chronological age by mental age dividing mental age by chronological age translating a score into standard deviations Answer: c.

Difficulty: Moderate Question ID: 15.1.8 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.1.9. What is the mean and standard deviation of most intelligence tests? a. b. c. d.

mean of 85, standard deviation of 15 mean of 100, standard deviation of 30 mean of 100, standard deviation of 15 mean of 115, standard deviation of 30 Answer: c.

Difficulty: Moderate Question ID: 15.1.9 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.1.10. The cutoff score for intellectual disability is approximately two standard deviations below the mean. If IQ scores were normally distributed, this would mean that approximately percent of the population would fall below this cutoff? a. b. c. d.

0.5 2 9 15 Answer: b.

Difficulty: Moderate Question ID: 15.1.10 Topic: Symptoms of Intellectual Disabilities Skill: Apply What You Know LO 15.1: Evaluate theories of intellect measurement

15.1.11. Which child is most likely to show a significant change in IQ score if retested five years later? a. b. c. d.

Anne, who is 3 years old Bob, who is 10 years old Cara, who is 13 years old Darla, who is 17 years old Answer: a.

Difficulty: Moderate Question ID: 15.1.11 Topic: Symptoms of Intellectual Disabilities Skill: Apply What You Know LO 15.1: Evaluate theories of intellect measurement

15.1.12. IQ scores are derived from standard scores, and to calculate a standard score, you need to know a. b. c. d.

the mode. the normal distribution. the mean and standard deviation. the mode and the median.

Answer: c.

Difficulty: Moderate Question ID: 15.1.12 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.1.13. A culture-fair IQ test a. b. c. d.

is designed to be used with one particular culture. contains material equally familiar to people from diverse backgrounds. recognizes cultural differences in the definition of intelligence. is impossible to construct, which is why IQ testing is invalid.

Answer: b.

Difficulty: Easy Question ID: 15.1.13 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.1.14. IQ tests were originally designed to a. b. c. d.

detect the extraordinarily gifted. assess level of adaptive functioning. rank people according to intelligence. measure the potential for school achievement.

Answer: d.

Difficulty: Easy Question ID: 15.1.14 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.1.15. Due to a U.S. Supreme Court ruling that death constitutes “cruel and unusual punishment” for people with intellectual disabilities, an IQ score of 70 rather than 69 can mean a. b. c. d.

death. retrial. treatment. exoneration.

Answer: a.

Difficulty: Moderate Question ID: 15.1.15 Topic: Diagnosis of Intellectual Disabilities Skill: Understand the Concepts LO 15.2: Contextualize the concept of intellectual disability

15.1.16. Alfred Binet and Theophile Simon developed the first intelligence test in 1905 in response to a request by the French government to identify a. b. c. d.

men fit for the military. extraordinarily gifted individuals. civil service personnel needing further training. children in need of special educational services.

Answer: d.

Difficulty: Moderate Question ID: 15.1.16 Topic: Diagnosis of Intellectual Disabilities Skill: Understand the Cocepts LO 15.2: Contextualize the concept of intellectual disability

15.1.17. Jim has been diagnosed with intellectual disability. In her report, a social worker notes that Jim is likely to need close supervision for community living over a long period. What term has traditionally been used to describe the type of intellectual disability that would require this level of support? a. b. c. d.

mild moderate severe profound Answer: c.

Difficulty: Moderate Question ID: 15.1.17 Topic: Diagnosis of Intellectual Disabilities Skill: Apply What You Know LO 15.2: Contextualize the concept of intellectual disability

15.1.18. Which of the following individuals with intellectual disability is most likely to be diagnosed with a form that is due to a known biological origin? a. b. c. d.

Beverly, who has physical handicaps Edward whose family lives in a poor neighborhood Sara, whose intellectual disability is in the mild range Robert, who was 6 years old when his intellectual disability was diagnosed Answer: a.

Difficulty: Moderate Question ID: 15.1.18 Topic: Causes of Intellectual Disabilities Skill: Apply What You Know LO 15.3: Outline causes of intellectual disability

15.1.19. Trisomy 21 is another name for a. b. c. d.

Down syndrome.

Turner syndrome.

Kanner syndrome. fragile X syndrome.

Answer: a.

Difficulty: Easy Question ID: 15.1.19 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.20. A researcher has collected nationwide data for the age of mothers at the time they give birth and the incidence of Down syndrome. What relationship between maternal age and Down syndrome is this researcher likely to find? a. b. c. d.

a very weak relationship incidence of Down syndrome increases among those born to mothers who are older incidence of Down syndrome decreases among those born to mothers who are older incidence of Down syndrome increases among mothers under the age 35 Answer: b.

Difficulty: Moderate Question ID: 15.1.20 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.21. By their 30s, individuals with Down syndrome develop brain pathology that is similar to that found in a. b. c. d.

Alzheimer’s disease.

Parkinson’s disease.

Huntington’s disease.

Korsakoff syndrome.

Answer: a.

Difficulty: Moderate Question ID: 15.1.21 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.22. A researcher is investigating the biological and psychological characteristics of a sample of individuals with XYY syndrome. Which of the following is he likely to find? a. b. c. d.

They have criminal records.

They experience delusions and hallucinations.

Their mean IQ is about 10 points lower than average.

Their behavior is likely to meet the criteria for pervasive developmental disorder.

Answer: c.

Difficulty: Moderate Question ID: 15.1.22 Topic: Causes of Intellectual Disabilities Skill: Apply What You Know LO 15.3: Outline causes of intellectual disability

15.1.23. Which of the following occurs only in females? a. b. c. d.

XYY syndrome Turner syndrome fragile X syndrome Klinefelter syndrome Answer: b.

Difficulty: Moderate Question ID: 15.1.23 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.24. What can a caretaker do to diminish the intellectual disability associated with PKU? a. b. c. d.

use long‑ term behavior modification schedule monthly blood transfusions serve foods that are low in phenylalanine teach the child to communicate via sign language Answer: c.

Difficulty: Moderate Question ID: 15.1.24 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.25. Phenylketonuria, Tay-Sachs disease, Hurler syndrome, and Lesch-Nyhan syndrome are all included in the same section of your textbook because they are all a. b. c. d.

mild forms of intellectual disability. prevalent only in boys. caused by recessive gene pairings. linked to chromosome 21.

Answer: c.

Difficulty: Moderate Question ID: 15.1.25 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.26. Rubella, human immunodeficiency virus, syphilis, and encephalitis are all included in the same section of your textbook because they are all a. b. c. d.

caused by recessive gene pairings. infectious diseases that can cause intellectual disability. the most common forms of death for people with severe and profound intellectual disability. the result of per-natal and perinatal complications.

Answer: b.

Difficulty: Moderate Question ID: 15.1.26 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.27. Which of the following symptoms are associated with fetal alcohol syndrome? a. b. c. d.

severe intellectual disability and gaze aversion profound intellectual disability and sensory deficits mild intellectual disability and learning disabilities moderate intellectual disability and motor dysfunctions Answer: c.

Difficulty: Moderate Question ID: 15.1.27 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.28. What is the problem in Rh incompatibility during pregnancy? a. b. c. d.

Chromosomal abnormalities cause intellectual disability.

Unmetabolized amino acids cause brain damage.

Brain infection causes damaging cranial pressure.

The mother’s antibodies attack the blood cells of the fetus.

Answer: d.

Difficulty: Moderate Question ID: 15.1.28 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.29. A nurse in a pediatrician's office is instructing the new assistant. Together, they review files in order to help the assistant become familiar with the job and the terminology. When they review one file, they see the word “anoxia.” What can they conclude about the child based on the inclusion of this term in his file? a. b. c. d.

The baby suffered oxygen deprivation and may have intellectual disabilities.

The child prefers to play by himself rather than in social groups.

The child has not developed language at the same rate as other children of his age.

The baby has a rare genetic disorder that predisposes him to develop behavioral difficulties.

Answer: a.

Difficulty: Moderate Question ID: 15.1.29 Topic: Causes of Intellectual Disabilities Skill: Apply What You Know LO 15.3: Outline causes of intellectual disability

15.1.30. A researcher is describing a theory of the interaction of genes and the environment on intelligence and uses the term “reaction range.” Which of the following is an example of this concept? a. b. c. d.

The effects of environment occur only at the lower ends of the distribution of intelligence scores.

An individual who may have genes for lower IQ can reach a higher level of intelligence in an enriched environment.

Psychologists are developing new tests of intellectual functioning that are thought to be more culture-free than previous tests.

There is a very specific level of intelligence that can be affected by genetic factors; the rest is the result of the environment.

Answer: b.

Difficulty: Moderate Question ID: 15.1.30 Topic: Causes of Intellectual Disabilities Skill: Apply What You Know LO 15.3: Outline causes of intellectual disability

15.1.31. Why does cultural-familial mental disability occur more frequently among the poor? a. b. c. d.

Poor nutrition causes PKU. Impoverished environments can be less intellectually stimulating.

Chromosomal abnormalities are more common in the lower classes.

Sexually transmitted diseases are more common in the lower classes.

Answer: b.

Difficulty: Moderate Question ID: 15.1.31 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.32. Which of the following is an example of the eugenics movement in the United States? a. b. c. d.

the selective breeding of people with high IQs the investigation of the human genome the forced sterilization of people with intellectual disabilities the establishment of Head Start programs Answer: c.

Difficulty: Moderate Question ID: 15.1.32 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.1.33. Which of the following is an example of the primary prevention of a biological cause of intellectual disability? a. b. c. d.

vaccinations for rubella medical screening for PKU programs such as Sesame Street enrollment of toddlers in Head Start programs Answer: a.

Difficulty: Moderate Question ID: 15.1.33 Topic: Prevention and Normalization of Intellectual Disabilities Skill: Understand the Concepts LO 15.4: Analyze treatments for intellectual disabilities

15.1.34. What has research on the effectiveness of Head Start revealed? a. b. c. d.

long-term increases in IQ levels no reduction in cultural-familial intellectual disability short-term increases in IQ and academic achievement improved health but no differences in academic performance Answer: c.

Difficulty: Moderate Question ID: 15.1.34 Topic: Prevention and Normalization of Intellectual Disabilities Skill: Understand the Concepts LO 15.4: Analyze treatments for intellectual disabilities

15.1.35. What would be the goal of a tertiary prevention program for people with intellectual disability? a. b. c. d.

to prevent pregnant women from abusing alcohol to deal with the various social and emotional difficulties faced by people with intellectual disability to encourage the use of amniocentesis to reduce the incidence of infectious diseases that can cause intellectual disability Answer: b.

Difficulty: Moderate Question ID: 15.1.35 Topic: Prevention and Normalization of Intellectual Disabilities Skill: Understand the Concepts LO 15.4:Analyze treatments for intellectual disabilities

15.1.36. Which of the following characterizes the physical appearance of children with ASD? a. b. c. d.

uncoordinated movements small head circumference normal physical appearance “mongoloid” facial features Answer: c.

Difficulty: Easy Question ID: 15.1.36 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder

15.1.37. You are attempting to design ways of observing young children that predict an increased risk for autism. Based on recent NIMH research, you would look for a. b. c. d.

exceptional artistic ability. infants who orient to their names less than do others. infants who use more gestures than other children use. exceptional mathematical ability.

Answer: b Difficulty: Moderate Question ID: 15.1.37 Topic: Autism Spectrum Disorder Skill: Apply What You Know LO 15.5: Describe autism spectrum disorder

15.1.38. A common problem with ASD is where the subtleties of speech production are unusual: speech is disturbed in rate, rhythm, and intonation. The child or adult with ASD sounds unusual to the normal listener, even when the speech content is normal. These disruptions are referred to as a. b. c. d.

aphonia. dysprosody.

dysrhythmia. anhedonia.

Answer: b.

Difficulty: Moderate Question ID: 15.1.38 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder

15.1.39. What do psychologists mean when they say that an autistic individual lacks a theory of mind? a. b. c. d.

The individual’s brain is so damaged there is no mind there.

These individuals fail to appreciate that other people have a point of reference that differs from their own.

The disorder is so devastating that there is no chance of recovery, and it affects the mental health of other family members.

The inability to bond to caretakers has left these individuals in an existential vacuum, without a way of explaining the complexity that surrounds them.

Answer: b.

Difficulty: Moderate Question ID: 15.1.39 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder

15.1.40. Temple Grandin was diagnosed as autistic when she was young. What aspect of her life has been of special interest to psychologists? a. b. c. d.

She has given birth to children who show no signs of autism.

She has managed to live longer than most individuals with autism.

She earned a Ph.D. in animal science and has developed widely used techniques for animal management.

Her experience with autism has allowed her to become a clinician who has expertise in treating autistic children.

Answer: c.

Difficulty: Moderate Question ID: 15.1.40 Topic: Autism Spectrum Disorder Skill: Apply What You Know LO 15.5: Describe autism spectrum disorder

15.1.41. What basic problem is reflected in the communication difficulties and impaired social relationships of ASD children? a. b. c. d.

motor impairments perceptual impairment depression and sleeplessness lack of social imitation and reciprocity Answer: d.

Difficulty: Moderate Question ID: 15.1.41 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder

15.1.42. How would a psychologist describe the behavior of children with ASD? a. b. c. d.

psychotic restrictive and repetitive manipulative and antisocial dependent and emotionally needy Answer: b.

Difficulty: Moderate Question ID: 15.1.42 Topic: Autism Spectrum Disorder Skill: Apply What You Know LO 15.5: Describe autism spectrum disorder

15.1.43. Four times as many boys as girls have ASD, which suggests a. b. c. d.

causes.

gender-linked genetic poor parenting-related vaccination-related Answer: b.

Difficulty: Moderate Question ID: 15.1.43 Topic: Autism Spectrum Disorder Skill: Apply What You Know LO 15.5: Describe autism spectrum disorder

15.1.44. Your family is discussing autism because a neighbor was recently diagnosed as suffering from ASD. Most of the members of the family say they are not surprised, because autism occurs in bettereducated families. You recognize that this is not true, so you tell your family that their false correlation is a result of a referral bias. They look at you with puzzlement and ask you to explain. What do you say? a. b. c. d.

Better educated families with autistic children tend to demand more of therapists.

Better educated families are more likely to seek diagnosis and treatment for their children at specialty clinics.

These families tend to blame themselves for their child’s autism and often are the source of media reports on autism.

These families tend to be sought out by researchers seeking individuals to study in research on autism.

Answer: b.

Difficulty: Moderate Question ID: 15.1.44 Topic: Autism Spectrum Disorder Skill: Apply What You Know LO 15.5: Describe autism spectrum disorder

15.1.45. What has research on twins revealed concerning a possible genetic etiology for autistic disorder? a. b. c. d.

High MZ concordance rates suggest a strong role for genetic factors.

Similar concordance rates for MZ and DZ twins point to the significant role of the environment.

Concordance rates have been low and inconsistent, suggesting little, if any, role for genetic factors.

Analysis of the concordance rates suggests that a predisposition to dementia is the primary etiological factor.

Answer: a.

Difficulty: Moderate Question ID: 15.1.45 Topic: Causes of ASD Skill: Understand the Concepts LO 15.6: Summarize the history of ASD causation theories

15.1.46. Some theorists propose that autism is related to elevated levels of a. b. c. d.

education. praise. endorphins. serotonin Answer: c.

Difficulty: Moderate Question ID: 15.1.46 Topic: Causes of ASD Skill: Understand the Concepts LO 15.6: Summarize the history of ASD causation theories

15.1.47. Which of the following 6-year-old children with autism has the best prognosis? a. b. c. d.

Sally, who has unusual mathematic abilities Tommy, who has unusual musical abilities Andy, who has developed some language skills Tammy, who does not engage in any self-injuring behavior Answer: c.

Difficulty: Moderate Question ID: 15.1.47 Topic: Treatment of ASD Skill: Apply What You Know LO 15.7: Explain how treatments for autism spectrum disorder work

15.1.48. You are advising a school about the adoption of programs for their ASD students. Several treatment options are presented, but one caught your attention. It is a program that is still used despite clear evidence from the APA that it is ineffective. You will advise against the use of a. b. c. d.

facilitated communication. risperidone. applied behavior analysis. any therapy.

Answer: a.

Difficulty: Moderate Question ID: 15.1.48 Topic: Treatment of ASD Skill: Apply What You Know LO 15.7: Explain how treatments for autism spectrum disorder work

15.1. 49. The most promising approach in the treatment of autism involves a. b. c. d.

secretin. facilitated communication. applied behavior analysis. psychodynamic psychotherapy.

Answer: c.

Difficulty: Moderate Question ID: 15.1.49 Topic: Treatment of ASD Skill: Understand the Concepts LO 15.7: Explain how treatments for autism spectrum disorder work

15.1.50. Research indicates that the highly structured intensive behavior therapy techniques developed by Ivar Lovaas and his colleagues a. b. c. d.

can be very effective within very short periods of time. only work when combined with antipsychotic medications. lead only to temporary improvements. can be effective but only when they are provided many hours a week and for many years.

Answer: d.

Difficulty: Moderate Question ID: 15.1.50 Topic: Treatment of ASD Skill: Apply What You Know LO 15.7: Explain how treatments for autism spectrum disorder work

True/False 15.2.51. According to DSM-5 criteria, a person can only be diagnosed as having intellectual disability if he or she has an IQ that is below approximately 50.

Answer: False Difficulty: Easy Question ID: 15.2.51 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement 15.2.52. In the United States, the term “mental retardation” has been replaced by the term “intellectual disability” by law.

Answer: True Difficulty: Moderate Question ID: 15.2.52 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.2.53. Modern intelligence tests yield a score that is indicative of intelligence known as an intelligence quotient.

Answer: True Difficulty: Easy Question ID: 15.2.53 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement 15.2.54. In calculating a deviation IQ, it is assumed that intelligence follows a normal (or bell-shaped) distribution.

Answer: True Difficulty: Moderate Question ID: 15.2.54 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement 15.2.55.IQ scores are designed so that they have a standard deviation of 15 and a mean (average) of 50.

Answer: False Difficulty: Easy Question ID: 15.2.55 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement 15.2.56. One potential problem with deviation IQ scores is that research suggests that IQ scores are rising with each successive generation. This is called the Flynn effect.

Answer: True Difficulty: Moderate Question ID: 15.2.56 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement 15.2.57. If your client has an IQ score between 20 and 40, he or she is likely to be described as suffering from moderate intellectual disability.

Answer: False Difficulty: Moderate Question ID: 15.2.57 Topic: Diagnosis of Intellectual Disabilities Skill: Understand the Concepts LO 15. 2: Contextualize the concept of intellectual disability

15.2.58. Even though more than 2.3 percent of people have IQs below the 70 cutoff, only about 1 percent of the population has an intellectual disability. The prevalence of intellectual disability is lower than the prevalence of low IQs because many adults with low IQs have adequate adaptive skills.

Answer: True Difficulty: Moderate Question ID: 15.2.58 Topic: Diagnosis of Intellectual Disabilities Skill: Understand the Concepts LO 15.2: Contextualize the concept of intellectual disability 15.2.59. Approximately 20 percent of intellectual disability cases can be attributed to known biological abnormalities.

Answer: False Difficulty: Moderate Question ID: 15.2.59 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.2. 60. The most common form of intellectual disability with a known biological cause is the chromosomal disorder known as Down syndrome.

Answer: True Difficulty: Easy Question ID: 15.2.60 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.2. 61. The genetic disorder in which a female is missing one X chromosome (an XO individual) is known as Klinefelter syndrome.

Answer: False Difficulty: Moderate Question ID: 15.2.61 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.2.62. Intellectual disability has been associated with several recessive gene pairings. One causes an absence of or an extreme deficiency in phenylalanine hydroxylase, an enzyme that metabolizes phenylalanine. The acronym (initials) for this disorder is PKU. Answer: True Difficulty: Moderate Question ID: 15.2.62 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts

LO 15.3: Outline causes of intellectual disability 15.2.63. A mother’s infection rubella (German measles) can cause her child to be born with severe intellectual disability, especially if the mother contracts the infection in the last three months of pregnancy.

Answer: False Difficulty: Moderate Question ID: 15.2.63 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.2.64. Genital herpes can cause intellectual disability in children when it is transmitted from the mother to the child during delivery.

Answer: True Difficulty: Moderate Question ID: 15.2.64 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.2.65. According to the recommendation of the Surgeon General of the United States, the level of alcohol consumption which is safe for pregnant women is 1 ounce per day.

Answer: False Difficulty: Easy Question ID: 15.2.65 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.2.66. One common cause of lead exposure in children is chipping lead-based paint.

Answer: True Difficulty: Moderate Question ID: 15.2.66 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.2.67.Up to 50 percent of the normal range of intelligence can be attributed to a genetic factor.

Answer: False Difficulty: Moderate Question ID: 15.2.67 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.2.68. Eugenics is the name of a movement designed to genetically “improve” the human race through legislated breeding rules.

Answer: True Difficulty: Moderate Question ID: 15.2.68 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.2.69. Drawing amniotic fluid and testing the fetal DNA for possible genetic abnormalities is a procedure called amniocentesis.

Answer: True Difficulty: Easy Question ID: 15.2.69 Topic: Prevention and Normalization of Intellectual Disabilities Skill: Understand the Concepts LO 15.4: Analyze treatments for intellectual disabilities 15.2.70. The process of devising ways to accommodate people with intellectual disability so that their lives are as much as possible like other members of society is called mainstreaming.

Answer: False Difficulty: Easy Question ID: 15.2.70 Topic: Prevention and Normalization of Intellectual Disabilities Skill: Understand the Concepts LO 15.4: Analyze treatments for intellectual disabilities 15.2.71. The Education for All Handicapped Children Act affirmed that all children have a right to a free and appropriate education in the “least restrictive environment.”

Answer: True Difficulty: Easy Question ID: 15.2.71 Topic: Prevention and Normalization of Intellectual Disabilities Skill: Understand the Concepts LO 15.4: Analyze treatments for intellectual disabilities 15.2.72. Autism spectrum disorder begins early in life and involves severe impairments in relationships, communication, and behaviors.

Answer: True Difficulty: Easy Question ID: 15.2.72 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder

15.2.73. One of the classic symptoms of ASD is impaired communication ability.

Answer: True Difficulty: Easy Question ID: 15.2.73 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder 15.2.74. Uttering phrases back is known as echolalia.

Answer: True Difficulty: Moderate Question ID: 15.2.74 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder 15.2.75. Approximately 25 percent of children with classic autism remain mute.

Answer: False Difficulty: Moderate Question ID: 15.2.75 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder 15.2.76. People with autism are said to lack a theory of mind, in that they fail to appreciate that other people have a point of reference that differs from their own.

Answer: True Difficulty: Moderate Question ID: 15.2.76 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder 15.2.77. Historically, the diagnosis of ASD exploded after the introduction of Asperger’s disorder.

Answer: True Difficulty: Moderate Question ID: 15.2.77 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder

15.2.78. Recent theorizing as to the cause of ASD has looked at the functioning of mirror neurons that fire both when an individual performs an action and when the individual observes another performing the same action.

Answer: True Difficulty: Easy Question ID: 15.2.78 Topic: Causes of ASD Skill: Understand the Concepts LO 15.6: Summarize the history of SD causation theories 15.2.79. A likely effective reinforcer for changing specific behaviors associated with autism would be a pat on the head.

Answer: False Difficulty: Moderate Question ID: 15.2.79 Topic: Treatment of ASD Skill: Understand the Concepts LO 15.7: Explain how treatments for autism spectrum disorder work 15.2.80. Behavior modification to reduce self-injurious behaviors has been most successful in programs that rely on the use of punishment.

Answer: True Difficulty: Moderate Question ID: 15.2.80 Topic: Treatment of ASD Skill: Understand the Concepts LO 15.7: Explain how treatments for autism spectrum disorder work

Essay 15.3.81. What are the requirements for making the diagnosis of intellectual disability?

Answer: The requirements for making the diagnosis of intellectual disability are (1) deficits in intellectual functions, (2) deficits in adaptive functioning, and (3) onset before age 18.

Difficulty: Moderate Question ID: 15.3.81 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement

15.3.82. Describe the controversy around the issue of whether IQ tests are culture-fair.

Answer: On average, the IQ scores of African Americans and Latino Americans are lower than those of Caucasians and Asian Americans, and the rates of intellectual disability are also higher in these former groups. Some of these differences have been attributed to bias in the composition of intelligence tests, which may be geared toward the language and experience of majority groups.

In addition, lower IQ is also associated with poverty, and a disproportionate number of blacks and Latinos in the U.S. are poor.

Difficulty: Moderate Question ID: 15.3.82 Topic: Symptoms of Intellectual Disabilities Skill: Understand the Concepts LO 15.1: Evaluate theories of intellect measurement 15.3.83. Even though more than 2.3 percent of the population has IQs below 70, only about 1 percent of people are diagnosed as having intellectual disability at any one point in time. Explain this discrepancy.

Answer: Many young children with intellectual disability are not identified as such because it is difficult to obtain a reliable IQ score from people this age. Also, many adults who have IQs under 70 function adaptively, and therefore, they are not considered as having an intellectual disability.

Difficulty: Moderate Question ID: 15.3.83 Topic: Diagnosis of Intellectual Disabilities Skill: Understand the Concepts LO 15.2: Contextualize the concept of intellectual disability 15.3.84. Describe the concern that alcohol consumption during pregnancy can cause intellectual disabilities.

Answer: Exposure to toxic chemicals during pregnancy can produce intellectual disabilities.

Because of its frequent use, alcohol presents the greatest threat of this type. Fetal alcohol syndrome occurs in about 1 to 2 of every 1,000 births. This disorder is characterized by retarded physical development, a small head, narrow eyes, cardiac defects, and cognitive impairment.

Intellectual functioning ranges from mild intellectual disability to normal intelligence accompanied by learning disabilities, particularly difficulties in mathematics. Women who drink heavily during pregnancy (an average of 5 ounces of alcohol per day) are twice as likely to have a child with the syndrome as women who average 1 ounce of alcohol per day or less. Although controversy continues about the risk of drinking in the intermediate range, the U.S. Surgeon General recommends that pregnant women abstain from alcohol altogether.

Difficulty: Moderate Question ID: 15.3.84 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability

15.3.85. Describe the concept of a reaction range and how it relates to intelligence level.

Answer: Genes and environment interact to determine intelligence. The concept of a reaction range holds that heredity establishes the upper and lower limits of possible IQ, but environmental factors determine the extent to which people fulfill their genetic potential.

Difficulty: Moderate Question ID: 15.3.85 Topic: Causes of Intellectual Disabilities Skill: Understand the Concepts LO 15.3: Outline causes of intellectual disability 15.3.86. Discuss the role of Head Start as a secondary prevention method aimed at reducing intellectual disability.

Answer: Head Start provides preschool children living in poverty with early educational experience, nutrition, and health care monitoring. Head Start produces short-term increases in IQ (5 to 10 points) and achievement. The academic advantages diminish or disappear within few years after intervention ends, but data indicate that children who participate in Head Start are less likely to repeat a grade or to be placed in special education classes. They are also more likely to graduate from high school. Head Start undoubtedly reduces the prevalence of cultural-familial intellectual disability through its influence on adaptive behavior if not on IQ itself.

Difficulty: Moderate Question ID: 15.3.86 Topic: Prevention and Normalization of Intellectual Disabilities Skill: Understand the Concepts LO 15.4: Analyze treatments for intellectual disabilities 15.3.87. What are the typical symptoms seen in ASD? Answer: The three defining symptoms of ASD are impaired social interaction, impaired communication, and restricted, repetitive behaviors. Also sometimes seen are apparent sensory deficits, self-injurious behavior, and savant performance.

Difficulty: Moderate Question ID: 15.3.87 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder

15.3.88. What is meant by a “theory of mind” as it applies to autism, and how can it be illustrated?

Answer: The theory is that people with autism fail to appreciate that other people have a point of reference that differs from their own. In the “Sally-Ann task,” the child is shown two dolls, Sally who has a basket, and Ann who has a box. While Sally is gone, Ann takes a marble out of Sally's basket and puts it in her box. The child is then asked where will Sally look for the marble when she returns. Sally, of course, should look for the marble in her basket, because that is where it was when she left, and she did not see Ann hide it in the box. However, children with autism, lacking a theory of mind, fail to appreciate Sally’s perspective and say Sally would look in the box because that is where they saw Ann put it.

Difficulty: Moderate Question ID: 15.3.88 Topic: Autism Spectrum Disorder Skill: Understand the Concepts LO 15.5: Describe autism spectrum disorder 15.3.89. What evidence suggests that there is a genetic component to the etiology of ASD? Answer: The prevalence of ASD is much greater among siblings of a child with ASD. Researchers have also found higher concordance rates among MZ than among DZ twins. In the largest twin study to date, concordance rates were 60 percent for MZ twins and 0 percent for DZ twins. For a broader spectrum of disturbances, concordance rates were 92 percent for MZ pairs and 10 percent for DZ pairs. Other research has suggested that a combination of different genes, or even spontaneous genetic mutations, may be involved.

Difficulty: Moderate Question ID: 15.3.89 Topic: Causes of ASD Skill: Understand the Concepts LO 15.6: Summarize the history of ASD causation theories 15.3.90. Describe the applied behavior analysis (ABA) approach to treating classic autism.

Answer: Applied behavior analysis (ABA) is an intensive behavior modification procedure using operant conditioning techniques. It is the most promising, evidence-based approach to treating classic autism. ABA therapists focus on treating specific symptoms, including communication deficits, lack of self-care skills, and self-stimulatory or self-destructive behavior. Behavior modification emphasizes very specific and small goals. In attempting to teach language, for example, the therapist might spend hours, days, or weeks teaching the pronunciation of a specific syllable. Unlike normal children, who are reinforced by social interest and approval, children with classic autism often do not respond to ordinary praise, or they may find all social interaction unpleasant. For these reasons, the child’s successful efforts must be rewarded repeatedly with primary reinforcers, such as a favorite food, at least in the beginning phases of treatment.

Difficulty: Moderate Question ID: 15.3.90 Topic: Treatment of ASD Skill: Understand the Concepts LO 15.7: Explain how treatments for autism spectrum disorders work

Chapter 16 Psychological Disorders of Childhood Total Assessment Guide (T.A.G.) Topic

Introduction

Externalizing Disorders

Question Type Multiple Choice True/False

Internalizing and Other Disorders

Causes and Treatment of Internalizing Disorders

51,52,53 81

Multiple Choice True/False

5,6,8,11,13,14, 7,9,10,12,19,20 15,16,17,18 54,55,56,57,58, 60 59 82

Multiple Choice True/False Essay

Treatment of Externalizing Disorders

Apply What You Know

Essay

Essay Causes of Externalizing Disorders

Understand the Concepts 1,2,3,4

21,22,24,26,27, 23,25,28,30,31 29 61,62,63,64,65, 69,70 66,67,68 83,84,85

Multiple Choice True/False

34,35,36,37

32,33

71,72,73

74

Essay

86,87

Multiple Choice True/False

38,39,41,42,43, 40 44,45 75,76,77

Essay

88

Multiple Choice True/False

46,47,48,49,50

Essay

89

78,79,80 90

Analyze It

Evaluate It

Chapter 16: Psychological Disorders of Childhood Multiple Choice 16.1.1. What is the major contribution of a developmental psychopathology perspective on children’s problems? a. b. c. d.

Developmental psychopathology offers greater focus on genetic factors.

Developmental psychopathology suggests ways that biological processes account for these types of problems.

Developmental psychopathology provides norms across the lifespan that can be used to determine whether a behavior is abnormal.

Developmental psychopathology highlights the importance of environmental differences across different socioeconomic groups.

Answer: c.

Difficulty: Easy Question ID: 16.1.1 Topic: Introduction Skill: Understand the Concepts LO 16.1: Diagnose externalizing behaviors by their symptoms

16.1.2. DSM-5 reorganized its classification of psychological problems usually diagnosed first among children in an effort to a. b. c. d.

make a clear distinction between childhood disorders and adult disorders. make developmental considerations a part of all disorders. provide a consistent means of diagnosis for the best health insurance coverage. replicate the system used in earlier editions of the DSM. Answer: b.

Difficulty: Easy Question ID: 16.1.2 Topic: Introduction Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.3. A child with which of the following would likely be diagnosed as having an externalizing disorder? a. b. c. d.

excessive anxiety depressed mood somatic complaints serious misconduct Answer: d.

Difficulty: Easy Question ID: 16.1.3 Topic: Introduction Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.4. A child with which of the following would likely be diagnosed as having an internalizing disorder? a. b. c. d.

excessive anxiety depressed mood somatic complaints serious misconduct Answer: a.

Difficulty: Easy Question ID: 16.1.4 Topic: Introduction Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.5. Externalizing behavior is more problematic when it is part of a than when it occurs in isolation. a. b. c. d.

system symptom syndrome synod Answer: c.

Difficulty: Easy Question ID: 16.1.5 Topic: Eternalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

, or cluster of problems,

16.1.6. Externalizing problems that begin a. b. c. d.

are more likely to persist into adult life.

during adolescence in the late 20s and early 30s before adolescence in early adulthood Answer: c.

Difficulty: Easy Question ID: 16.1.6 Topic: Eternalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.7. Jeremy is an 8-year-old boy whose case is described in your textbook. Based on a recommendation from his teacher, he was evaluated by a psychologist. Which of the following findings would be significant in planning a treatment program for Jeremy? a. b. c. d.

Jeremy has a sibling who was mentally retarded and autistic.

He had an older sister who expressed herself better verbally than did Jeremy.

Although Jeremy had an IQ of 108, his achievement test scores were a grade behind his current grade.

Jeremy’s mother took him to the psychologist only reluctantly because she did not believe he had a problem.

Answer: c.

Difficulty: Moderate Question ID: 16.1.7 Topic: Eternalizing Disorders Skill: Apply What You Know LO 16.1: Diagnose externalizing disorders by their symptons

16.1.8. Many externalizing disorders are characterized by a. b. c. d.

overcontrolled behavior. symptoms of sadness and anxiety. violations of age-appropriate social rules. expression of worry through physical symptoms.

Answer: c.

Difficulty: Easy Question ID: 16.1.8 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.9. The PTA invited a speaker to address the topic of crime among adolescents. What information might the speaker cite in this talk to parents of young people? a. b. c. d.

The rate of crime committed by young people is increasing in spite of intervention efforts.

The worst 5 percent of juvenile offenders account for about half of all juvenile arrests.

Most of the crimes committed by young people are committed against schools and are generally taken as signs of rebellion.

Young people under the age of 18 frequently engage in serious, violent crimes.

Answer: b.

Difficulty: Moderate Question ID: 16.1.9 Topic: Externalizing Disorders Skill: Apply What You Know LO 16.1: Diagnose externalizing disorders by their symptons

16.1.10. Six-year-old Nick’s parents have been called to school repeatedly during the past two years for a variety of problems ranging from disobeying teachers to bullying classmates. Their position is that, like any other boy his age, Nick is testing the limits. Which of the following correlates to how school officials should respond if they take a developmental psychopathology perspective? a. b. c. d.

All children test the limits, but the only way they become adults is to stop that testing.

Although it is normal for children to test the limits, your son’s limit testing is not appropriate for his age.

We just want to make you aware of your son’s behavior; we do expect that he will outgrow this stage soon.

Testing the limits is a sign of a deeply rooted psychological disturbance that needs to be treated.

Answer: b.

Difficulty: Difficult Question ID: 16.1.10 Topic: Externalizing Disorders Skill: Apply What You Know LO 16.1: Diagnose externalizing disorders by their symptons

16.1.11. Adolescents often engage in rule violations, so it is essential to distinguish between and antisocial behavior. a. b. c. d.

externalized / internalized biologically-based / psychologically based adolescent-limited / life-course-persistent intentional / unintentional Answer: c.

Difficulty: Moderate Question ID: 16.1.11 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.12. Chris begins to show externalizing and antisocial behaviors at age 6. Doug begins to show these behaviors at age 16. What would a clinical psychologist conclude concerning the differences in the problems these two individuals present? a. b. c. d.

Chris’s problems are less disruptive to other people.

Chris’s problems are likely to persist throughout life.

Chris’s problems will probably have a shorter duration.

Chris’s problems will be more related to physical health issues.

Answer: b.

Difficulty: Moderate Question ID: 16.1.12 Topic: Externalizing Disorders Skill: Apply What You Know LO 16.1: Diagnose externalizing disorders by their symptons

16.1.13. Compared to boys, girls are more likely to engage in in subtle ways, such as put downs, gossip, and social exclusion. a. b. c. d.

relational aggression passive aggression intentional hostility caring hostility Answer: a.

Difficulty: Moderate Question ID: 16.1.13 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.14. Hyperactivity is most notable in a. b. c. d.

unfamiliar places. a physician’s office. structured settings, such as classrooms. unstructured situations, such as on playgrounds.

Answer: c.

Difficulty: Easy Question ID: 16.1.14 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

, actions designed to hurt others

16.1.15. DSM-5 classifies attention-deficit/hyperactivity disorder as disorder, a diagnostic grouping that includes intellectual disability, autism spectrum disorder, and specific learning disorder. a. b. c. d.

neurological intellectual deficit neurodevelopmental behavioral Answer: c.

Difficulty: Moderate Question ID: 16.1.15 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.16. Which of the following is one of DSM-5’s criteria for hyperactivity and impulsivity in a child with ADHD? a. b. c. d.

often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities often runs about or climbs in situations where it is inappropriate often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace often loses things necessary for tasks or activities Answer: b.

Difficulty: Moderate Question ID: 16.1.16 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.17. What is the key difference between ADHD and ODD? a. b. c. d.

ADHD is a psychological problem, while ODD is biological.

ADHD is a biological problem, while ODD is psychological.

ADHD is an internalized problem, while ODD is externalized.

ADHD behavior is unintentional, while ODD behavior is intentional.

Answer: d.

Difficulty: Moderate Question ID: 16.1.17 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.18. The symptoms of property. a. b. c. d.

are frequently index offenses, which are crimes against people or

oppositional defiant disorder conduct disorder relational aggression adult-onset ADHD Answer: b.

Difficulty: Moderate Question ID: 16.1.18 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.1.19. A psychologist is evaluating a child by first trying to determine if the child loses his temper, if he argues with adults, and if he is often spiteful and vindictive. To which disorder does the focus of the psychologist’s evaluations lead? a. b. c. d.

conduct disorder Tourette syndrome oppositional defiant disorder attention-deficit/hyperactivity disorder Answer: c.

Difficulty: Moderate Question ID: 16.1.19 Topic: Externalizing Disorders Skill: Apply What You Know LO 16.1: Diagnose externalizing disorders by their symptons

16.1.20. Tim has been diagnosed as having oppositional defiant disorder; Vince has been diagnosed as having conduct disorder. What is the major difference between these two boys? a. b. c. d.

Tim is older than Vince.

Compared to Tim, Vince has a much better prognosis.

Vince has engaged in more serious forms of rule violations than has Tim. They demonstrate the same symptoms, but Tim is more likely to be mentally retarded.

Answer: c.

Difficulty: Moderate Question ID: 16.1.20 Topic: Externalizing Disorders Skill: Apply What You Know LO 16.1: Diagnose externalizing disoders by their symptoms

16.1.21. What is the purpose of Michael Rutter’s Family Adversity Index? a. b. c. d.

identifies six family predictors of behavior problems among children counts the number of arguments within a family during a specified period of time records the number of family members who have ever experienced any mental disorder in the past indicates the likelihood that family members are genetically predisposed to develop mental disorders Answer: a.

Difficulty: Easy Question ID: 16.1.21 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.22. A researcher who wanted to determine the effects of a particular treatment on children with ADHD could use which kind of research tool? a. b. c. d.

a small convenience sample a large representative sample data on the whole population of interest information from interviews and other global measures Answer: a.

Difficulty: Moderate Question ID: 16.1.22 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.23. Jack lives in a small apartment with his mother, father, and four brothers and sister. The family struggles to pay the rent and put food on the table. His mother has been quite depressed. Which of the following speaks to Jack’s future? a. b. c. d.

Jack is at high risk for developing Down syndrome.

Jack is at high risk for an externalizing problem.

Jack is at high risk for an internalizing problem.

Jack is at high risk for developing an eating disorder.

Answer: b.

Difficulty: Moderate Question ID: 16.1.23 Topic: Causes of Externalizing Disorders Skill: Apply What You Know LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.24. What is the general conclusion of researchers who have investigated the influence of genetic factors on attention-deficit/hyperactivity disorder? a. b. c. d.

Genetic factors strongly contribute to this disorder.

The concordance rate for MZ twins is high, but symptoms appear to be reactions to other mental disorders.

Genetic factors seem to play no role in the development of this disorder.

The concordance rate among dizygotic twins is higher than it is for monozygotic twins.

Answer: a.

Difficulty: Moderate Question ID: 16.1.24 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.25. In a hospital corridor, you overhear physicians discussing a patient’s soft signs. You ask your own physician what they meant and find that they were referring to a. b. c. d.

neurological symptoms, such as delays in fine motor coordination. symptoms that only appear in evidence from low-tech types of testing equipment. indications that suggest a low level of a certain neurotransmitter is present. an area of the brain that experienced a direct blow that causes seizure-like symptoms.

Answer: a.

Difficulty: Moderate Question ID: 16.1.25 Topic: Causes of Externalizing Disorders Skill: Apply What You Know LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.26. In a large sample of males followed from birth into adulthood, child maltreatment predicted significantly more adolescent conduct problems if the boys were genetically predisposed to activity. a. b. c. d.

high MAOA low MAOA low dopamine high dopamine Answer: b.

Difficulty: Difficult Question ID: 16.1.26 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.27. Developmental psychologists classify parenting into four styles based on warmth and discipline.

Which is most likely to produce well-adjusted children? a. b. c. d.

neglectful indulgent authoritarian authoritative Answer: d.

Difficulty: Moderate Question ID: 16.1.27 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.28. The people next door emphasize obedience through the enforcement of their guidelines and the use of punishment. For example, when their 14-year-old was five minutes late returning from a basketball game last weekend, they immediately grounded the youngster for two weeks. What style of parenting has been described? a. b. c. d.

indulgent neglectful authoritarian authoritative Answer: d.

Difficulty: Moderate Question ID: 16.1.28 Topic: Causes of Externalizing Disorders Skill: Apply What You Know LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.29. Which of the following most clearly captures how Gerald Patterson uses the term coercion? a. b. c. d.

An interaction in which parents negatively reinforce a child’s misbehavior by ignoring it.

An interaction in which parents negatively reinforce a child’s misbehavior by overreacting to it.

An interaction in which parents negatively reinforce a child’s misbehavior, and the child responds by positively reinforcing the parent’s neglect.

An interaction in which parents and children reciprocally reinforce child misbehavior and parent capitulation.

Answer: d Difficulty: Difficult Question ID: 16.1.29 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.30. Which of the following situations illustrates the concept of negative attention and its potential consequences? a. b. c.

d.

When a child misbehaves, he is sent out of the class for a specified period of time known as a time-out.

The parents of a 2-year-old pay no attention to the child until she is quiet for least two minutes.

The second-grade teacher says the entire class must be quiet before the students can leave for recess. Any sounds from the class delay or reduce recess time, so the class remains quiet on cue from the teacher.

The parents of an 8-year-old boy tend to punish his misbehaviors in front of his siblings, who find his antics during the punishment hilarious.

Answer: d.

Difficulty: Difficult Question ID: 16.1.30 Topic: Causes of Externalizing Disorders Skill: Apply What You Know LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.31. A family with a young son decides to move from a poor, inner-city neighborhood to a small town because their first-grade son is wanting to dress like the “gangstas” he sees on his street and at school. Is this an effective strategy? a. b. c. d.

No, because moving creates instability, which leads to a greater risk of externalizing problems.

No, because a tendency to externalizing problems is completely genetic.

Yes, because kids in these kinds of neighborhoods are at greater risk of developing externalizing problems.

Yes, because kids in these kinds of neighborhoods are at greater risk of developing internalizing problems.

Answer: c.

Difficulty: Moderate Question ID: 16.1.31 Topic: Causes of Externalizing Disorders Skill: Apply What You Know LO 16.2: Compare the role of factors that cause externalizing disorders

16.1.32. Eight-year-old Julio attends an elementary school where a lot of children are taking Ritalin. After his teacher suggested that his parents take him to a pediatrician for an evaluation, Julio was put on Ritalin.

If Julio has a typical response to the drug, what is likely to happen? a. b. c. d.

Julio has a minor improvement in his hyperactivity.

Julio responds positively to the medication, and his hyperactivity decreases.

Julio has strong side effects and must be taken off the drug immediately.

Julio experiences the paradoxical effect, and his behavior actually gets worse.

Answer: b.

Difficulty: Moderate Question ID: 16.1.32 Topic: Treatment of Externalizing Disorders Skill: Apply What You Know LO 16.3: Evaluate treatments for externalizing disorders

16.1.33. The parents of a child who has just been put on Ritalin are given a pamphlet describing some of the benefits and side effects of the drug. What types of side effects might the parents expect to see? a. b. c. d.

itching and rashes nausea and vomiting depression and anxiety decreased appetite and sleeping difficulties Answer: d.

Difficulty: Moderate Question ID: 16.1.33 Topic: Treatment of Externalizing Disorders Skill: Apply What You Know LO 16.3: Evaluate treatments for externalizing disorders

16.1.34. Behavioral family therapy seems to be promising as a treatment for a. b. c. d.

conduct disorder. oppositional defiant disorder. antisocial personality disorder. attention-deficit/hyperactivity disorder.

Answer: b.

Difficulty: Moderate Question ID: 16.1.34 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders

16.1.35. Which of the following is a key element of behavioral family therapy? a. b. c. d.

teaching parents to systematically reward positive behavior and ignore or mildly punish misbehavior teaching both parents and their children to use the techniques of progressive relaxation training contacting a negotiator immediately when there is any hint that a serious situation is about to erupt encouraging both parents and their children to go to “neutral corners” for at least 30 minutes following any confrontation Answer: a.

Difficulty: Moderate Question ID: 16.1.35 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders

16.1.36. What has research shown concerning residential programs, such as Achievement Place? a. b. c. d.

long-term reductions in aggression few results while teens are still in the group home lower rates of recidivism once teens leave the program effective results only while teens are living in the group home Answer: d.

Difficulty: Moderate Question ID: 16.1.36 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders

16.1.37. What is the long-term prognosis for children who have oppositional defiant disorder or conduct disorder into adulthood? a. b. c. d.

About half will have problems with antisocial behavior in adulthood.

There is a high probability of full recovery of normal functioning in the majority of cases.

Some of their symptoms will decrease unless they also have ADHD. There is a high rate of development of a wide range of pathologies from anxiety disorders to psychotic disorders.

Answer: a.

Difficulty: Easy Question ID: 16.1.37 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders

16.1.38. Which of the following is an example of an internalizing symptom? a. b. c. d.

sadness fighting talking back hyperactivity Answer: a.

Difficulty: Moderate Question ID: 16.1.38 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Contextualize the development of internalizing disorders

16.1.39. Which of the following is true of the way that DSM-5 identifies internalizing disorders in children? a. b. c. d.

DSM-5 includes the separate category of internalizing disorders of childhood because depressive and anxiety disorders in children are significantly different than in adults.

DSM-5 includes no separate category of internalizing disorders of childhood, but it indicates that children may qualify for “adult” diagnoses of depressive and anxiety disorders.

DSM-5 includes separate categories for children with depression but not with anxiety disorders.

DSM-5 includes separate categories for children with anxiety disorders, but children with depression are included as a subsection of the adult depression diagnostic criteria.

Answer: b.

Difficulty: Moderate Question ID: 16.1.39 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Contextualize the development of internalizing disorders

16.1.40. A psychologist is reluctant to use parents’ observations of their children in determining levels of their children’s depression. However, parents often insist on being consulted. What is the psychologist likely to find when parents are asked to evaluate their children’s levels of depression? a. b. c. d.

Parents tend to underestimate the extent of depression reported by their children.

Parents frequently mistake the symptoms of depression as signs of a developing psychotic process.

Parents tend to overreact to minor symptoms and overestimate the severity of the depression.

Whenever parents are involved in such data collection, they immediately put themselves in the role of the therapist and begin treatment, often with disastrous results.

Answer: a.

Difficulty: Difficult Question ID: 16.1.40 Topic: Internalizing and Other Disorders Skill: Apply What You Know LO 16.4: Contextualize the development of internalizing disorders

16.1.41. Which fear is prevalent between ages 5 to 8? a. b. c. d.

darkness school-related fears separation from parents enclosed spaces Answer: b.

Difficulty: Easy Question ID: 16.1.41 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Contextualize the development of internalizing disorders

16.1.42. The main difference between children’s fears and anxiety is that a. b. c. d.

fear is a reaction to a real and immediate danger. anxiety is a reaction to a real and immediate danger. fear involves the brain’s limbic system. anxiety involves the brain’s limbic system.

Answer: a.

Difficulty: Moderate Question ID: 16.1.42 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Contextualize the development of internalizing disorders

16.1.43. What is a problematic consequence of separation anxiety disorder? a. b. c. d.

delinquency hyperactivity school refusal fighting with peers Answer: c.

Difficulty: Easy Question ID: 16.1.43 Topic: Internalizing and Other Disorders Skill:Understand the Concepts LO 16.4: Contextualize the development of internalizing disorders

16.1.44. Which of the types of children identified in peer sociometric studies is most likely to develop an externalizing disorder? a. b. c. d.

average rejected neglected controversial Answer: b.

Difficulty: Moderate Question ID: 16.1.44 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Contextualize the development of internalizing disorders

16.1.45. According to peer sociometric methods, which of the following groups of children has the highest rate of internalizing symptoms? a. b. c. d.

average rejected neglected controversial Answer: c.

Difficulty: Moderate Question ID: 16.1.45 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Contextualize the development of internalizing disorders

16.1.46. How do the changes with age of the prevalence rates for externalizing and internalizing disorders compare? a. b. c. d.

Externalizing disorders increase with age, while internalizing disorders decrease.

Externalizing disorders decrease with age, while internalizing disorders increase.

Both increase with age.

Both decrease with age.

Answer: b.

Difficulty: Moderate Question ID: 16.1.46 Topic: Causes and Treatment of Internalizing Disorders Skill: Understand the Concepts LO 16.5: Relate internalizing disorder causes to their treatments

16.1.47. Which of the following correctly describes the condition known as anaclitic depression? a. b. c. d.

a form of depression that is related to weather a form of biologically induced depression that can be seen in young children the lack of social responsiveness that can occur when an infant does not have a consistent attachment figure what happens when young children model the behavior of their parents who have a history of depression Answer: c.

Difficulty: Moderate Question ID: 16.1.47 Topic: Causes and Treatment of Internalizing Disorders Skill: Understand the Concepts LO 16.5: Relate internalizing disorder causes to their treatments

16.1.48. Infants who are wary of exploration, not easily soothed by the attachment figure, and angry or ambivalent about contact are displaying attachment. a. b. c. d.

anxious avoidant anxious resistant disorganized secure Answer: b.

Difficulty: Moderate Question ID: 16.1.48 Topic: Caluses and Treatments of Internalizing Disorders Skill: Understand the Concepts LO 16.5: Relate internalizing disorder causes to their treatments

16.1.49. What is predicted by insecure attachment in infancy? a. b. c. d.

Anxious attachments are the primary risk factor for eating disorders.

Anxious attachments are not as great a risk factor as was believed in the past.

Such attachments are a general risk factor for a number of internalizing problems.

Such attachments are a major risk factor for medical conditions due to poor child care.

Answer: c.

Difficulty: Moderate Question ID: 16.1.49 Topic: Causes and Treatment of Internalizing Disorders Skill: Apply What You Know LO 16.5: Relate internalizing disorder causes to their treatments

16.1.50. What have researchers determined concerning the treatment of anxiety disorders in children? a. b. c. d.

Psychodynamic therapy seems to be the most effective treatment.

Drug treatments have been shown to be unhelpful in treating these problems.

Cognitive behavior therapy and family therapy both have been successful.

Family therapy seems to be the most effective long-term treatment because these are really family caused disorders.

Answer: c.

Difficulty: Moderate Question ID: 16.1.50 Topic: Causes and Treatment of Internalizing Disorders Skill: Understand the Concepts LO 16.5: Relate internalizing disorder causes to their treatments

True/False 16.2.51. Psychologists become concerned only when a child deviates substantially from developmental norms.

Answer: True Difficulty: Easy Question ID: 16.2.51 Topic: Introduction Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptoms 16.2.52. Externalizing disorders are characterized by children’s failure to control their behavior according to the expectations of parents, peers, teachers, and/or legal authorities.

Answer: True Difficulty: Easy Question ID: 16.2.52 Topic: Introduction Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons 16.2.53. Externalizing disorders are characterized by a child’s feelings of anxiety, fear or prolonged sadness.

Answer: False Difficulty: Easy Question ID: 16.2.53 Topic: Introduction Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.2.54. “Adolescent limited” problems tend to go away as the child develops. Other problems are more serious and long lasting and are labeled “life-course prevelant.”

Answer: False Difficulty: Easy Question ID: 16.2.54 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons 16.2.55. The diagnosis of attention-deficit/hyperactivity disorder (ADHD) is characterized by hyperactivity, attention deficit, andimpulsivity.

Answer: True Difficulty: Easy Question ID: 16.2.55 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons 16.2.56. A child who exhibits behaviors that could be characterized as negative, hostile, and defiant may get diagnosed with oppositional defiant disorder.

Answer: True Difficulty: Moderate Question ID: 16.2.56 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons 16.2.57. A disorder that is more serious than ODD and is marked by serious rule violations and often by illegal behavior is called juvenile antisocial disorder.

Answer: False Difficulty: Easy Question ID: 16.2.57 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons 16.2.58. Based on recent research, to predict antisocial personality disorder, you would focus on the variable of callousness in the child.

Answer: True Difficulty: Moderate Question ID: 16.2.58 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disorders by their symptons

16.2.59. The current consensus regarding the relationship between attention-deficit/hyperactivity disorder (ADHD) and oppositional-defiant disorder (ODD) is that the two are separate but frequently comorbid.

Answer: True Difficulty: Moderate Question ID: 16.2.59 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1: Diagnose externalizing disoders by their symptoms 16.2.60. Everyone in the sixth grade and throughout the entire school knows Carl is a bully. He likes his reputation and calls himself “the enforcer.” He gets a kick out of being cruel to small animals and has used a baseball bat as a weapon. He was referred to the mental health center for an evaluation. When the report is returned to the school, it is likely that Carl has been diagnosed with oppositional-defiant disorder.

Answer: False Difficulty: Moderate Question ID: 16.2.60 Topic: Externalizing Disorders Skill: Apply What You Know LO 16.1: Diagnose externalizing disoders by their symptoms 16.2.61. The Centers for Disease Control and Prevention found that almost 10 percent of children in the United States had a lifetime diagnosis of ADHD. Answer: True Difficulty: Easy Question ID: 16.2.61 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders 16.2.62. Inborn behavioral characteristics, including activity level, emotionality, and sociability, are said

by Thomas, Chess, and others to form a child’s personality .

Answer: False Difficulty: Moderate Question ID: 16.2.62 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.2.63. Genetic factors explain 90 percent of the variance in ADHD symptoms, a much higher proportion than for most behavior disorders.

Answer: True Difficulty: Moderate Question ID: 16.2.63 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders 16.2.64. The process of shaping children’s behavior and attitudes to conform to the expectations of parents, teachers, and society as a whole is known as behavior modification.

Answer: False Difficulty: Moderate Question ID: 16.2.64 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders 16.2.65. Parenting that is both loving and firm is labeled authoritative.

Answer: True Difficulty: Easy Question ID: 16.2.65 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders 16.2.66. Children with serious conduct problems often have parents who are authoritarian.

Answer: False Difficulty: Moderate Question ID: 16.2.66 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders 16.2.67. Gerald Patterson defines coercion as the process that happens when a parent positively reinforces a child’s misbehavior by giving into the child’s demands, and the child reinforces the parent’s poor decision by ceasing the misbehavior.

Answer: True Difficulty: Moderate Question ID: 16.2.67 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.2.68. Isolating a child briefly following misbehavior is the disciplinary technique known as time-out.

Answer: True Difficulty: Easy Question ID: 16.2.68 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders 16.2.69. Ricky’s mother tends to scold him when he fights with other children, while Ricky’s father encourages him to fight. This type of inconsistent discipline has been linked to internalizing disorders.

Answer: False Difficulty: Moderate Question ID: 16.2.69 Topic: Causes of Externalizing Disorders Skill: Apply What You Know LO 16.2: Compare the role of factors that cause externalizing disorders 16.2.70. A group of children previously identified as aggressive were put in a social situation and observed. Based on Dodge’s research, observers are likely to see these children overinterpret the aggressive intentions of their peers.

Answer: True Difficulty: Moderate Question ID: 16.2.70 Topic: Causes of Externalizing Disorders Skill: Apply What You Know LO 16.2: Compare the role of factors that cause externalizing disorders 16.2.71. Psychostimulant medication shows improvement in behavior for about 90 percent of children treated for ADHD. Answer: False Difficulty: Moderate Question ID: 16.2.71 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders 16.2.72. In normal children, psychostimulant drugs increase energy but decrease alertness.

Answer: False Difficulty: Moderate Question ID: 16.2.72 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders

16.2.73. Studies of the long-term benefits of psychostimulant medication for attentiondeficit/hyperactivity disorder show no significant improvement in learning or behavior.

Answer: True Difficulty: Moderate Question ID: 16.2.73 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders 16.2.74. The parents of an 8-year-old boy are talking to the pediatrician who has just prescribed Ritalin for their son. The pediatrician wants to make sure that the parents are aware of the possible side effects and will report them if and when they occur. They are cautioned to watch for suicidal thoughts and agitation.

Answer: False Difficulty: Moderate Question ID: 16.2.74 Topic: Treatment of Externalizing Disorders Skill: Apply What You Know LO 16.3: Evaluate treatments for externalizing disorders 16.2.75. Separation anxiety disorder is defined by symptoms, such as persistent and excessive worry for the safety of an attachment figure, fears of getting lost or being kidnapped, and refusal to be alone.

Answer: True Difficulty: Easy Question ID: 16.2.75 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Conceptualize the development of internalizing disorders 16.2.76. School refusal, also known as school phobia, is characterized by an extreme reluctance to go to school and is accompanied by various symptoms of anxiety, such as stomach aches and headaches.

Answer: True Difficulty: Easy Question ID: 16.2.76 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Conceptualize the development of internalizing disorders

16.2.77. Disruptive mood dysregulation disorder is a controversial new diagnosis in DSM-5 that is applied to severe, recurrent temper outbursts that are way out of proportion to the situation that provokes them and that begin before age 10.

Answer: True Difficulty: Moderate Question ID: 16.2.77 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Conceptualize the development of internalizing disorders 16.2.78. Research by Lewinsohn, Rohde, and Seeley indicate that 25 percent of young women experience at least one major depressive episode by the age of 19.

Answer: False Difficulty: Moderate Question ID: 16.2.78 Topic: Causes and Treatment of Internalizing Disorders Skill: Understand the Concepts LO 16.5: Relate internalizing disorder causes to their treatments 16.2.79. Suicide is the third leading cause of death among teenagers.

Answer: True Difficulty: Moderate Question ID: 16.2.79 Topic: Causes and Treatment of Internalizing Disorders Skill: Understand the Concepts LO 16.5: Relate internalizing disorder causes to their treatments 16.2.80. Emotion regulation is the process by which children learn to identify, evaluate, and control their feelings.

Answer: True Difficulty: Moderate Question ID: 16.2.80 Topic: Causes and Treatments of Internalizing Disorders Skill: Understand the Concepts LO 16.5: Relate internalizing disorder causes to their treatments

Essay 16.3.81. Describe any special problems associated with the assessment and diagnosis of children’s psychological problems.

Answer: Few children or adolescents identify themselves as having an emotional or behavioral problem. Instead, some adult, often a parent or teacher, decides that the child has a problem.

Sometimes, a child is unable to recognize or admit to his or her difficulties. Other times, however, the problem is as much the adult’s as the child’s. For example, a stressed parent may have trouble coping with normal misbehavior. This can make it challenging to figure out where the problem lies.

Difficulty: Easy Question ID: 16.3.81 Topic: Introduction Skill: Understand the Concepts LO 16.1:Diagnose externalizing disorders by their symptoms 16.3.82.Describe the difference between an index offense and a status offense, and their relationship to conduct disorder.

Answer: Most of the symptoms of conduct disorder involve index offenses—crimes against people or property that are illegal at any age. But conduct disorder is not identical to the concept of juvenile delinquency. A few symptoms are comparable to status offenses—acts that are illegal only because of the youth’s status as a minor, such as truancy from school. Adolescents who repeatedly break the law have conduct disorders whether or not they are arrested and convicted.

Furthermore, one could be diagnosed with conduct disorder having never committed a crime.

Difficulty: Moderate Question ID: 16.3.82 Topic: Externalizing Disorders Skill: Understand the Concepts LO 16.1:Diagnose externalizing disorders by their symptoms 16.3.83. Mental health professionals sometimes use convenience samples of patients who have presented for treatment. Give an example of when this would not be a methodological problem and when it would be a methodological problem.

Answer: The use of convenience samples is not a problem in studies where the convenience sample is the same as the population of interest, such as studies of the effectiveness of medication or therapy techniques for people in therapy. Such samples are problematic, however, when conclusions about causality are drawn and generalizations are made to larger populations.

Difficulty: Moderate Question ID: 16.3.83 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders

16.3.84. Discuss if there is evidence to support the notion that genetic factors play a role in ADHD. Answer: A recent study of 4,000 Australian twins has provided evidence that strongly supports the view that genetic factors contribute to ADHD. The concordance rate for MZ twins was 80 percent; whereas the rate for DZ was 40 percent. These concordance rates are close to what one would expect for a purely genetic disorder. Genetic factors explain 90 percent of the variance of ADHD symptoms. At this point, however, a specific gene (or genes) responsible has not been isolated.

Difficulty: Moderate Question ID: 16.3.84 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders 16.3.85.Describe Gerald Patterson’s concept of coercion and how it contributes to children’s externalizing.

Answer: According to Patterson, coercion occurs when parents positively reinforce a child’s misbehavior by giving in to the child’s demands. The child, in turn, negatively reinforces the parents’ response by ending his or her obnoxious behavior as soon as the parents capitulate.

Thus, coercion describes an interaction in which parents and children reciprocally reinforce child misbehavior and parent capitulation. To break this pattern, parents need to change their response to the child’s misbehavior by ignoring it, punishing it, or rewarding more positive actions.

Difficulty: Moderate Question ID: 16.3.85 Topic: Causes of Externalizing Disorders Skill: Understand the Concepts LO 16.2: Compare the role of factors that cause externalizing disorders 16.3.86. Discuss the current thinking regarding the “paradoxical effect” of psychostimulant medication on children with ADHD. Answer: For many years, researchers believed that psychostimulant drugs had a paradoxical effect of slowing down overactive children. Researchers at NMIH found that the psychostimulants affected normal children in the same way as ADHD children. The medication improved attention and decreased motor activity in both children and adults. There is no paradoxical effect of psychostimulants on children with ADHD. Difficulty: Moderate Question ID: 16.3.86 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders

16.3.87. Describe some of the side effects of psychostimulant medication.

Answer: Some side effects are relatively minor, such as decreased appetite, increased heartbeat, and sleeping difficulties. Others are more serious, such as an increase in motor tics in a small percentage of cases. Some delays in growth have been noted but rebound after medication is discontinued.

Difficulty: Moderate Question ID: 16.3.87 Topic: Treatment of Externalizing Disorders Skill: Understand the Concepts LO 16.3: Evaluate treatments for externalizing disorders 16.3.88. Since children are not as able as adults to describe symptoms of depression, discuss signs child clinical psychologists look for to determine if children of different ages are depressed.

Answer: When assessing children directly, child clinical psychologists are sensitive to different signs that may indicate depression at different ages: unresponsiveness to caregivers in infancy; sad expressions and social withdrawal in preschoolers; somatic complaints in young school-aged children; more direct admission of sad feelings or marked irritability in older school-aged children or early adolescents; and full-blown depression, including suicide risk, among adolescents. Depression in children also differs from depression in adolescents in its lower prevalence, equal frequency among boys and girls, stronger relation with family dysfunction, and less persistent course.

Difficulty: Moderate Question ID: 16.3.88 Topic: Internalizing and Other Disorders Skill: Understand the Concepts LO 16.4: Contextualize the development of internalizing disorders 16.3.89. What are some of the reasons that more boys are treated for psychological problems than are girls, but more women are treated in therapy than are men?

Answer: Externalizing problems are more common in boys, and for boys, these behaviors are more noticeable as a problem. The prevalence of externalizing behaviors decreases with age, whereas the prevalence of internalizing disorders increases with age. By adulthood, internalizing disorders (typically in women) are more common.

Difficulty: Moderate Question ID: 16.3.89 Topic: Causes and Treatment of Internalizing Disorders Skill: Understand the Concepts LO 16.5: Relate internalizing disorder causes to their treatments

16.3.90. Describe the relationship between the quality of attachments in infancy and the likelihood that child will develop an internalizing disorder.

Answer: Based on the work of John Bowlby and Mary Ainsworth, attachment theory proposes that adverse consequences may develop as a result of troubled attachment relationships in infancy. These troubled attachments may include the failure to develop a selective attachment, the development of an insecure attachment, or multiple, prolonged separations from (or permanent loss of) an attachment figure. Extreme parental neglect deprives infants of the opportunity to form a selective attachment. This can cause reactive attachment disorder, characterized by a lack of social responsiveness in the child. In contrast to infants who form secure attachments in infancy, those who form anxious attachments are fearful of exploration and are not easily comforted by their attachment figures, who typically respond inadequately or inconsistently to the child’s needs. A number of longitudinal studies have demonstrated that anxious attachments during infancy foreshadow difficulties in children’s social and emotional adjustment throughout childhood. Insecure attachments predict a number of internalizing and social difficulties, including lower self-esteem, less competence in peer interaction, and increased dependency on others.

Difficulty: Moderate Question ID: 16.3.90 Topic: Causes and Treatment of Internalizing Disorders Skill: Apply What You Know LO 16.5: Relate internalizing disorder causes to their treatments

Chapter 17 Adjustment Disorders and Life-Cycle Transitions Total Assessment Guide (T.A.G.) Topic

Introduction

Adjustment Disorders

Question Type Multiple Choice True/False

Understand the Concepts 2,3

Apply What You Know 1

51

Essay

81

Multiple Choice True/False

4,5,6,7,8,9,10, 11,12 52,53,54

13

Multiple Choice True/False

14,15,16,17,20

18,19

Essay

82,83

Multiple Choice True/False

21,22,25,27,28, 23,24,26,33 29,30,31,32 60,62,64,65,66, 61,63 67,68,69 84,85,86,87

Essay Transition to Adulthood

Family Transitions

Essay Transition to Later Life

Multiple Choice True/False Essay

55,56,57,58,59

34,35,36,37,40, 38,39,41,43 42,44,45,46,47, 48,49,50 70,71,72,73,74, 76 75,77,78,79,80 88,89,90

Analyze It

Evaluate It

Chapter 17: Adjustment Disorders and Life-Cycle Transitions Multiple Choice 17.1.1. Donna has experienced what her therapist calls clinically significant symptoms of stress.

However, they are not severe enough to warrant classification as one of the mental disorders associated with traumatic stressors. In order for her insurance carrier to pay for her therapy, the therapist must provide a diagnosis. What diagnosis will the therapist report? a. b. c. d.

adjustment disorder acute stress disorder life-cycle transition posttraumatic stress disorder Answer: a.

Difficulty: Easy Question ID: 17.1.1 Topic: Introduction Skill: Apply What You Know LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.2. Adult development is characterized by a. b. c. d.

little change or growth. a sequence of time‑ limited stages. coping with fairly predictable challenges. a series of qualitatively different stages.

Answer: c.

Difficulty: Easy Question ID: 17.1.2 Topic: Introduction Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.3. Which of the following is characteristic of life-cycle transitions? a. b. c. d.

They are the times when people move smoothly from one stage of life to another.

They mark the acceptance of death that comes at the end of a long life.

DSM-5 places them in the category of mental disorders.

They are times when people often struggle as they move from one life stage to the next.

Answer: d.

Difficulty: Easy Question ID: 17.1.3 Topic: Introduction Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.4. In order to meet the DSM-5 definition of an adjustment disorder, two conditions must be met: (1) clinically significant symptoms occur in response to stress, and (2) a. b. c. d.

these symptoms are not severe enough to be labeled a mental disorder. these symptoms are severe enough to be labeled a mental disorder. depression and/or anxiety must be present. symptoms of identity or role confusion must co-occur.

Answer: a.

Difficulty: Moderate Question ID: 17.1.4 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.5. Which of the following characterizes Erik Erikson’s conceptualization of human development? a. b. c. d.

Role confusion and identity are resolved by age 5.

Each stage involves a crisis of the healthy personality.

Psychosocial development is finished by young adulthood.

Healthy people experience little conflict during adult development.

Answer: b.

Difficulty: Easy Question ID: 17.1.5 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.6. In what section would you find housing and economic problems listed in DSM-5? a. b. c. d.

causes of depression financial problems mental disorders other conditions that may be a focus of clinical attention Answer: d.

Difficulty: Moderate Question ID: 17.1.6 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.7. DSM-5 groups adjustment disorders, acute stress disorders, and posttraumatic stress disorder together because all are caused by stress. What makes adjustment disorder different from the other two? a. b. c. d.

Adjustment disorder is a reaction to a very high degree of stressor that is not life-threatening.

Adjustment disorder can be a reaction to a stressor of any severity.

Adjustment disorder is much less severe and will always get better on its own.

Adjustment disorder is much more severe and requires medical interventions.

Answer: b.

Difficulty: Moderate Question ID: 17.1.7 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.8. Erik Erikson’s major contribution to a model of psychosocial development was a. b. c. d.

identifying the developmental stages that occur in every human from birth to age 18. ordering developmental stages in infants and toddlers. recognizing that human development continues into adulthood. identifying adjustment disorders as a clinically significant mental disorder.

Answer: c.

Difficulty: Moderate Question ID: 17.1.8 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.9. What struggle did Erik Erikson view as the major challenge of adolescence? a. b. c. d.

integrity versus despair identity versus role confusion generativity versus stagnation intimacy versus self-absorption Answer: b.

Difficulty: Easy Question ID: 17.1.9 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.10. Erik Erikson viewed the primary life task of young adulthood to be a struggle between a. b. c. d.

integrity and despair. role confusion and identity. generativity and stagnation. intimacy and self-absorption.

Answer: d.

Difficulty: Moderate Question ID: 17.1.10 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.11. According to Erik Erikson, when does the struggle of generativity versus stagnation occur? a. b. c. d.

adolescence young adulthood middle age old age Answer: c.

Difficulty: Easy Question ID: 17.1.11 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.12. According to Erik Erikson, the last stage of psychosocial development involves the conflict between a. b. c. d.

identity and role confusion. generativity and stagnation. intimacy and self-absorption. integrity and despair.

Answer: d.

Difficulty: Moderate Question ID: 17.1.12 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.13. Your professor is telling the class that people need to develop social clocks. Thinking this is an odd phrase, you look it up in your textbook and discover that it refers to a. b. c. d.

how people keep track of their social appointments. the idea that time is a social phenomenon. how people evaluate whether they are on time for age-related goals. the influence that others have on peoples’ ability to achieve their goals in a timely manner.

Answer: c.

Difficulty: Moderate Question ID: 17.1.13 Topic: Adjustment Disorders Skill: Apply What You Know LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.1.14. How would Erik Erikson describe the period of moratorium? a. b. c. d.

intimacy with a sexual partner hard work and financial independence uncertainty and experimentation with different roles balance between independence and closeness with parents Answer: c.

Difficulty: Easy Question ID: 17.1.14 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition

17.1.15. According to Erik Erikson, why do teens need to experiment with different roles? a. b. c. d.

to avoid moratorium to find a unique niche in society to ease their separation from their parents to distract parents from their own conflicts Answer: b.

Difficulty: Moderate Question ID: 17.1.15 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition

17.1.16. According to ego psychologist Karen Horney, why do adolescents experience conflict with their parents? a. b. c. d.

They are in a developmental stage of despair.

They have not yet achieved a stable identity.

They are insecurely attached to their parents.

They experience competing needs with respect to their parents.

Answer: d.

Difficulty: Moderate Question ID: 17.1.16 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition

17.1.17. How would we describe a teen with identity diffusion? a. b. c. d.

In the middle of a profound identity crisis Not actively seeking new adult roles Actively searching for new adult roles Never questioned his childhood identity Answer: b.

Difficulty: Easy Question ID: 17.1.17 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition

17.1.18. At age 10, Joseph decided to become a priest. By age 20, he had the same goal, never having considered any other options and never having questioned his earlier decision. Which of the following terms describes Joseph’s identity category? a. b. c. d.

identity diffusion identity moratorium identity achievement identity foreclosure Answer: d.

Difficulty: Moderate Question ID: 17.1.18 Topic: The Transition to Adulthood Skill: Apply What You Know LO 17.2: Explain how the concept of identity affects adulthood transition

17.1.19. Rebecca is a college graduate who has made decisions about her long-term goals, although her goals are quite different from her parents’ expectations for her. What does research tell us about where she may be in terms of Erikson’s view of development? a. b. c. d.

Rebecca probably is an identity achiever who is confident in social interactions.

Rebecca is probably in an identity moratorium and will therefore remain there until she finds a job.

Rebecca has probably reached a level of identity characterized by a high degree of generativity.

Like most college students, Rebecca has delayed the establishment of an identity, and it shows in her impulsive behavior.

Answer: a.

Difficulty: Moderate Question ID: 17.1.19 Topic: The Transition to Adulthood Skill: Apply What You Know LO 17.2: Explain how the concept of identity affects adulthood transition

17.1.20. What treatment approach do many clinicians suggest for those experiencing distress associated with transitions to adult life? a. b. c. d.

psychoanalytic behavioral supportive and non-directive challenging and confrontational Answer: c.

Difficulty: Moderate Question ID: 17.1.20 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition

17.1.21. What did research by Gorchaff, John, and Helson reveal about the relationship between having children and marital satisfaction? a. b. c. d.

Marital satisfaction increases with each additional child born.

Marital satisfaction increases with the birth of children and decreases when the children leave home.

Marital satisfaction declines with the birth of children and rises when the children leave home.

The joy of having children overrides any affect on marital satisfaction.

Answer: c.

Difficulty: Moderate Question ID: 17.1.21 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.22. Psychologists are not so much interested in the content of family struggles as the process. One of the most consistent findings concerns , or social exchange of cooperation and conflict. a. b. c. d.

mutuality remuneration intimacy reciprocity Answer: d.

Difficulty: Moderate Question ID: 17.1.22 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.23. As a couples therapist, you know that dissatisfaction. a. b. c. d.

interactions predict future marital

intimacy struggle demand and withdrawal familial withdrawal unbalanced parent–child Answer: b.

Difficulty: Moderate Question ID: 17.1.23 Topic: Family Transitions Skill: Apply What You Know LO 17.3: Analyze impacts on family wellness

17.1.24. You are a family therapist in a first interview with a couple. You note a style of communication that has been seen in couples who are basically unhappily married. This indicator is their a. b. c. d.

expression of anger to each other. tendency to blame their conflict on each other’s personality. tendency to blame their conflict on circumstances. desire to resolve conflicts in their own favor.

Answer: b.

Difficulty: Moderate Question ID: 17.1.24 Topic: Family Transitions Skill: Apply What You Know LO 17.3: Analyze impacts on family wellness

17.1.25. Which of the following is an example of a scapegoating pattern of family relationships? a. b. c. d.

One family member is blamed for all the family problems.

One family member bullies another family member out of jealousy.

One family member complains of problems that are denied by other family members.

One family member takes on all the responsibility for solving the family’s problems.

Answer: a.

Difficulty: Easy Question ID: 17.1.25 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.26. A researcher wants to discover whether a particular behavior is caused by genetic background or by environmental factors. This can be complicated by the , the fact that environmental experience is itself affected by genetic background. a. b. c. d.

gene-environment correlation nature-nurture concordance evolutionary adaptation genetic behavioral concordance Answer: a.

Difficulty: Moderate Question ID: 17.1.26 Topic: Family Transitions Skill: Apply What You Know LO 17.3: Analyze impacts on family wellness

17.1.27. What is one of the limitations in the use of a heritability ratio? a. b. c. d.

It cannot be generalized to the whole population.

It reflects only theoretically diverse environments.

Its calculation ignores environmental variance in a sample.

It can only be used to describe biological characteristics.

Answer: a.

Difficulty: Moderate Question ID: 17.1.27 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.28. Based on observations of marital interactions, John Gottman classified four problematic communication styles. How would he describe the problem labeled as contempt? a. b. c. d.

A spouse shows disinterest in the marriage.

A spouse is consistently isolated and withdrawn.

A spouse hurls angry insults at the other spouse.

A spouse denies responsibility for the marital problem.

Answer: c.

Difficulty: Easy Question ID: 17.1.28 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.29. Which of the following statements supports genetic influences on divorce? a. b. c. d.

Twins rarely divorce.

Divorced couples produce fewer offspring.

Genes influence personality traits associated with divorce.

Unmarried couples reproduce at lower rates than married couples.

Answer: c.

Difficulty: Moderate Question ID: 17.1.29 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.30. McGue and Lykken found that, for divorce, the concordance rates were a. b. c. d.

higher for DZ twins than MZ twins. higher for MZ twins than for DZ twins. very similar for DZ and MZ twins. impossible to calculate with any accuracy for twins.

Answer: b.

Difficulty: Moderate Question ID: 17.1.30 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.31. The Premarital Relationship Enhancement Program (PREP) involves couples meeting in small groups to discuss marital relations and to learn communication skills. What has research revealed concerning the effectiveness of this program? a. b. c. d.

Couples that go through this program report higher marital satisfaction after three years than do couples in the control group.

Couples that go through this program report less marital satisfaction three years later than do couples in the control group.

Couples that go through this program report more satisfaction, but they also report more conflict than do the couples in the control group.

Couples that were randomly assigned to this program reported less marital satisfaction after three years than did couples who made the decision on their own to participate.

Answer: a.

Difficulty: Moderate Question ID: 17.1.31 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.32. What is the focus of cognitive-behavioral couple therapy? a. b. c. d.

changing one partner’s psychopathology improving the couple's moment-to-moment interactions talking about the marriage in individual therapy changing how parents act toward their troubled child Answer: b.

Difficulty: Moderate Question ID: 17.1.32 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.1.33. Your friend has been having some psychological problems, and he tells you that he and his wife are seeing a couple therapist. You are surprised that he is receiving couple therapy, since he is the one with problems. When you ask your psychology professor about this, she explains that a. b. c. d.

the therapist gets paid twice as much for couple therapy. research suggests that an improved relationship helps in alleviating individual disorders. couple therapy is less threatening than individual therapy for reluctant patients. your friend's problems must actually be marital problems, not his individual problems.

Answer: b.

Difficulty: Moderate Question ID: 17.1.33 Topic: Family Transitions Skill: Apply What You Know LO 17.3: Analyze impacts on family wellness

17.1.34. The term “ageism” refers to a. b. c. d.

changes as one grows older. prejudice against the elderly. the study of aging and the elderly. the incorporation of age norms in research.

Answer: b.

Difficulty: Easy Question ID: 17.1.34 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.35. How is personality affected by aging? a. b. c. d.

Older adults tend to be less inwardly focused than when they were younger.

Older adults are more stubborn, bossy, and irritable than when they were younger.

Older adults are greatly affected by depression and anxiety.

Older adults have personalities that are consistent with earlier stages of their adulthood.

Answer: d.

Difficulty: Moderate Question ID: 17.1.35 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.36. Hormone (estrogen) replacement therapy during menopause is effective for reducing a. b. c. d.

depression. infertility. the risk for cancer. physical symptoms.

Answer: d.

Difficulty: Moderate Question ID: 17.1.36 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.37. Which of the following individuals is most likely to suffer from osteoporosis? a. b. c. d.

Jill, who is 24 years old Jack, who is 56 years old Betty, who is 71 years old Diane, who is 18 years old Answer: c.

Difficulty: Easy Question ID: 17.1.37 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.38. You are a psychologist assigned to assess older individuals in a community centre. Informed by research, you will be looking for predictors of psychological well-being, such as a. b. c. d.

signs of Erikson’s concept of integrity. positive relationships. comfort with living alone. apprehension about retirement.

Answer: b.

Difficulty: Moderate Question ID: 17.1.38 Topic: The Transition to Later Life Skill: Apply What You Know LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.39. Your textbook presents the case of Mrs. J, who had great difficulty accepting the loss of her husband. Mrs. J believed her husband died due to the inadequacy of his care in a nursing home. She was experiencing great anger over this and thought about it frequently. Which of the following best describes her condition? a. b. c. d.

Mrs. J. was experiencing pathological depression.

Mrs. J’s reaction was seen as normal grieving.

Mrs. J was diagnosed as clinically grieving.

Mrs. J was diagnosed with grief compounded by OCD. Answer: b.

Difficulty: Moderate Question ID: 17.1.39 Topic: The Transition to Later Life Skill: Apply What You Know LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.40. Which is one of the reasons that older people have fewer friendships? a. b. c. d.

They become more irritable and demanding.

They have lost most of the people they once cared about.

They become more selective in their companions.

They spend more time with their families.

Answer: c.

Difficulty: Moderate Question ID: 17.1.40 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.41. Mrs. Pallagio’s husband died at age 70. For the next year, she finds herself thinking about him constantly. Every night she talks out loud to his photo. How would a clinical psychologist describe these behaviors? a. b. c. d.

normal grieving delusional thinking abnormal obsession normal obsession Answer: a.

Difficulty: Moderate Question ID: 17.1.41 Topic: The Transition to Later Life Skill: Apply What You Know LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.42. What element is important in both the Bowlby and Kübler-Ross models of bereavement? a. b. c. d.

anger bargaining moratorium identity crisis Answer: a.

Difficulty: Easy Question ID: 17.1.42 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.43. Which of the following indicates that the model of bereavement proposed by Kübler-Ross does not tell the whole story regarding how people grieve? a. b. c. d.

There are actually more stages than proposed by Kübler-Ross.

Many people do not go through the stages in the sequence proposed, and some show no signs of any of the stages.

Men, but not women, seem to proceed through the stages in different orders and at different speeds.

The bargaining stage does not occur very often because most people realize the futility of such a response.

Answer: b.

Difficulty: Moderate Question ID: 17.1.43 Topic: The Transition to Later Life Skill: Apply What You Know LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.44. Which of the following is most accurate in regard to the rate of affective disorders in younger and in older Americans? a. b. c. d.

Affective disorders are more common in older adults than they are in younger adults.

Affective disorders are more common in younger adults than they are in older adults.

Younger adults and older adults experience affective disorders at about the same rate.

The rates are about the same for the two age groups except for older males, who have a very high rate of affective disorders.

Answer: b.

Difficulty: Moderate Question ID: 17.1.44 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.45. An epidemiologist has received a grant to study rates of suicide in the overall population. Which group will she find has the highest rate of completed suicides? a. b. c. d.

adolescents young adults age 20–29 adults over age 30 adults over age 65 Answer: d.

Difficulty: Moderate Question ID: 17.1.45 Topic: The Transition to Later Life Skill: Apply What You Know LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.46. Many experts view the increase in suicide among older adults as not only a consequence of emotional problems, but also as a result of a. b. c. d.

loneliness after the loss of a spouse. chronic pain, disease, or long-term illness. anger caused by ageism. depression and anxiety.

Answer: b.

Difficulty: Easy Question ID: 17.1.46 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.47. Based on age and health status, most elderly people fall into which category? a. b. c. d.

young-old middle-old old-old oldest-old Answer: a.

Difficulty: Moderate Question ID: 17.1.47 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.48. The “silver tsunami” expected into the middle of the twenty-first century is primarily due to a. b. c. d.

the aging of the “baby boom” generation. medical advances increasing the number of older and frail adults. immigration of young families resulting in a younger population. divorce and remarriage resulting in more children and a younger population.

Answer: a.

Difficulty: Moderate Question ID: 17.1.48 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.49. Census statistics show that 72 percent of older men live with a spouse, while only 42 percent of older women remain living with their spouses. What is one consequence of this gender difference? a. b. c. d.

Poverty rates decline for older Americans in part because both spouses contribute to retirement income through Social Security and pension plans.

Poverty rates are higher for older Americans in part because of the lower economic status of widowed women.

Older men live longer if there is a wife in the home to take care of them.

Older men are 30 percent more likely to remarry after the loss of a spouse.

Answer: b.

Difficulty: Moderate Question ID: 17.1.49 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

17.1.50. Which social factor is thought to moderate the ill effects of bereavement, particularly for men? a. b. c. d.

remarriage within two years of a spouse’s death moving into a new home religious affiliation and involvement family members encouraging self-sufficiency Answer: c.

Difficulty: Easy Question ID: 17.1.50 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

True/False 17.2.51. If you are experiencing significant psychological symptoms in response to stress, but those symptoms aren’t severe enough to warrant a diagnosis as a mental disorder, DSM-5 has a classification for you under adjustment disorders.

Answer: True Difficulty: Easy Question ID: 17.2.51 Topic: Introduction Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions

17.2.52. Erik Erikson suggested that diverse life-cycle transitions have conflict as a common theme.

Answer: True Difficulty: Moderate Question ID: 17.2.52 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions 17.2.53. According to Erikson’s view of adult development, despair comes from self-absorption.

Answer: False Difficulty: Moderate Question ID: 17.2.53 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions 17.2.54.According to Daniel Levinson’s social model of adult development, the “midlife crisis” involves becoming less driven and more compassionate.

Answer: True Difficulty: Moderate Question ID: 17.2.54 Topic: Adjustment Disorders Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions 17.2.55. For Erik Erikson, getting some sense of who you are brings resolution to a role confusion crisis?

Answer: False Difficulty: Easy Question ID: 17.2.55 Topic: Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition 17.2.56. Erik Erikson suggested that young people need a period of time that involves uncertainty about themselves and their futures, which he labeled a moratorium.

Answer: True Difficulty: Easy Question ID: 17.2.56 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition

17.2.57. Researchers used beepers to signal adolescents and adults at various times to assess their emotional states. They found that, compared to adults, young people between the ages of 13 and 18 tend to experience more intense moods than adults.

Answer: True Difficulty: Easy Question ID: 17.2.57 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition 17.2.58. One of Marcia’s proposed categories of identity conflicts is described as “young adults who never questioned themselves or their goals but instead proceed along the predetermined course of their childhood commitments.” This describes identity diffusion.

Answer: False Difficulty: Moderate Question ID: 17.2.58 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition 17.2.59. Critics of Erik Erikson’s views on adult psychosocial development believed that men form identities based on work and that women form identities based on relationships. In recent years, however, gender roles are changing for both sexes.

Answer: True Difficulty: Easy Question ID: 17.2.59 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition 17.2.60. Social scientists often see family change in terms of the family stages, or the developmental course of family relationships.

Answer: False Difficulty: Moderate Question ID: 17.2.60 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.2.61. A psychologist is trying to understand the level of cooperation and conflict evident in the social exchanges of a family. This psychologist is focusing on roles.

Answer: False Difficulty: Moderate Question ID: 17.2.61 Topic: Family Transitions Skill: Apply What You Know LO 17.3: Analyze impacts on family wellness 17.2.62. Marital conflict and distress tend to be associated with an increased risk for depression, especially among women.

Answer: True Difficulty: Easy Question ID: 17.2.62 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness 17.2.63. Frank and Consuela are happily married, while Tyrone and Amanda are unhappily married. Both couples have been having some disputes lately. Frank and Consuela are likely to blame their disputes on temporary circumstances, while Tyrone and Amanda blame their disputes on the other’s personality.

Answer: True Difficulty: Moderate Question ID: 17.2.63 Topic: Family Transitions Skill: Apply What You Know LO 17.3: Analyze impacts on family wellness 17.2.64. Some psychologists question the basic assumption made by DSM-5 that diagnoses disorders rather than individuals.

Answer: False Difficulty: Moderate Question ID: 17.2.64 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness 17.2.65. In genetic studies, the formula variance due to genetic factors/total variance is called the heritability ratio.

Answer: True Difficulty: Moderate Question ID: 17.2.65 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness

17.2.66. A nonrandom association between inborn propensities and environmental experience is referred to as the gene-environment correlation.

Answer: True Difficulty: Moderate Question ID: 17.2.66 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness 17.2.67. John Gottman, a researcher on marital interaction, has described one pattern of problematic communication called stonewalling. He would describe this pattern as one spouse consistently denying responsibility for marital difficulties.

Answer: False Difficulty: Moderate Question ID: 17.2.67 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness 17.2.68. Research has shown that, compared to more traditional unions, marriages in which both spouses are androgynous are happier and less distressed.

Answer: True Difficulty: Moderate Question ID: 17.2.68 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness 17.2.69.Systematic research on the effectiveness of cognitive behavioral couple therapy (CBCT) indicates that it produces very significant short- and long-term improvement for 70 percent of participating couples.

Answer: False Difficulty: Moderate Question ID: 17.2.69 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyze impacts on family wellness 17.2.70. Social misunderstanding and prejudice against older individuals is labeled ageism.

Answer: True Difficulty: Easy Question ID: 17.2.70 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

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17.2.71. Menarche is the cessation of menstruation in women.

Answer: False Difficulty: Easy Question ID: 17.2.71 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.2.72. Hormone replacement therapy in women generally involves replacing depleted supplies of estrogen.

Answer: True Difficulty: Easy Question ID: 17.2.72 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.2.73. Bereavement is a specific form of grieving in response to the death of a loved one.

Answer: True Difficulty: Easy Question ID: 17.2.73 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.2.74. Researchers have just begun to study the phenomenon of reminiscence, or remembering and recounting experiences from the distant past, which is common among the elderly.

Answer: True Difficulty: Moderate Question ID: 17.2.74 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.2.75. The emotional and social process of coping with a separation or a loss is called grief.

Answer: True Difficulty: Easy Question ID: 17.2.75 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

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17.2.76. The concept of off time loss suggests that if you had a patient who just lost a loved one, you would be most concerned about an adverse reaction if that patient had lost a spouse.

Answer: False Difficulty: Moderate Question ID: 17.2.76 Topic: The Transition to Later Life Skill: Apply What You Know LO 17.4: Evaluate the role of health behavior in later life transitions 17.2.77. Ageism is the multidisciplinary study of aging.

Answer: False Difficulty: Easy Question ID: 17.2.77 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.2.78. The most important biological contribution to psychological well-being in later life is good physical health.

Answer: True Difficulty: Easy Question ID: 17.2.78 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.2.79. Among men over 70, the most frequently listed factor for making a positive contribution to their quality of lives is relationships with family and friends.

Answer: True Difficulty: Easy Question ID: 17.2.79 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.2.80. The legal documents that direct health care professionals to refrain from performing certain procedures that would keep a terminally ill or severely disabled patient alive are called living wills.

Answer: True Difficulty: Easy Question ID: 17.2.80 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

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Essay 17.3.81. Discuss the primary stages of adult development and the major life-cycle transitions associated with moving from one stage to another.

Answer: There are fairly predictable challenges that occur during adult life in relationships, work, life goals, and personal identity. Several theorists divide adult development into three periods: early, middle, and later life. Consistent with this division, we highlight three major life-cycle transitions struggles in moving from one stage of adult development to the next. The transition to adult life is a time for grappling with the major issues related to identity, career, and relationships.

Family transitions in the middle adult years may include very happy events like the birth of the first child, or very unhappy ones, like a difficult divorce. The transition to later life may involve major changes in life roles such as retirement, grief over the loss of loved ones, and inner conflicts about aging, mortality, and the life one has lived.

Difficulty: Moderate Question ID: 17.3.81 Topic: Introduction Skill: Understand the Concepts LO 17.1: Summarize the theoretical framework describing human responses to difficult transitions 17.3.82. As young people transition to adulthood, they must negotiate new boundaries with their parents, a process that often involves some challenges and even conflict. Describe how Karen Horney’s theories explain this transitional challenge.

Answer: As young adults and their parents negotiate new boundaries for their relationsip, finding the right balance between autonomy and relatedness is a challenge. Conflicts typically increase, as young people interpret parental control as an infringement on their independence. Ego psychologist Karen Horney theorized that people have competing needs to move forward, to move away from, and to move against others. Moving toward others fulfills needs for love and acceptance. Moving away from others is a way of establishing independence and efficacy.

Moving against others meets the individual’s need for power and dominance. Horney saw relationship difficulties as stemming from conflicts among these three basic needs. Young adults want their parents’ support, they also want their own independence, and at the same time, they may also want to outdo their parents.

Difficulty: Moderate Question ID: 17.3.82 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition

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17.3.83. Explain how cross-cultural considerations affect the idea of adolescent identity crisis.

Answer: Cross-cultural considerations suggest that the “storm and stress” of the transition to adult life is a consequence of the affluence, education, and independence of young people in Western, industrialized societies. In other cultures, an individual’s life course may be determined by parental authority or economic necessity, neither of which allows for an identity crisis. In the nottoo-distant past, people also assumed adult roles at much younger ages in the United States. In some families and socioeconomic groups, they still do.

Difficulty: Moderate Question ID: 17.3.83 Topic: The Transition to Adulthood Skill: Understand the Concepts LO 17.2: Explain how the concept of identity affects adulthood transition 17.3.84. Describe the type of emotional reciprocity found in families with happy relationships compared to the type found in families with troubled relationships.

Answer: Happy families reciprocate each other’s positive actions and overlook one another’s negative behavior. Families with troubled relationships get caught in negative cycles of interaction. They ignore positive actions but reciprocate negative ones. A particular problem in intimate relationships is the demand and withdrawal pattern, where one partner becomes increasingly demanding and the other withdraws further and further. Other evidence shows that conflicts in troubled families are more likely to continue over time and spill over into other family relationships.

Difficulty: Moderate Question ID: 17.3.84 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyse impacts on family wellness 17.3.85. Discuss the argument put forward by some theorists for classifying troubled relationships instead of just classifying troubled individuals, as is the case with DSM’s current classification.

Answer: DSM-5 bases its diagnostic categories on the assumption that psychological problems reside within individuals. However, some psychologists question this assumption. They view human beings as relational beings and see human problems as existing in relation to something or someone else. Various individuals and groups have proposed systems for making relational or interpersonal diagnoses. Some relational classifications focus on categories, like “partner relational problem.” Other classifications are more theoretical. Psychologist Timothy Leary proposed the still influential “interpersonal circumplex,” which grouped personality types around the two dimensions of power and love. Still other systems are based on interaction patterns, on patterns like demand–withdraw, or patterns of blaming a family scapegoat. These are patterns that unite dysfunctional family members together. Unfortunately, the appeal of any current system for classifying troubled relationships is pretty much limited to intuition. No system for classifying relationships is well-supported empirically, and the more interesting systems require us to somehow discern causality in relationships.

Difficulty: Moderate Question ID: 17.3.85 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyse impacts on family wellness

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17.3.86. Describe the four basic communication problems John Gottman found in his research on marital communication.

Answer: Gottman’s four basic communication problems are criticism, contempt, defensiveness, and stonewalling. Criticism involves attacking someone’s personality rather than his or her actions: for example, “You’re boring!” instead of “Can we do something different?” Contempt is an insult that may be motivated by anger and is intended to hurt the other person: for example, “I never loved you!” Defensiveness is a form of self-justification: for example, “I was only trying to help, but I guess my feelings don’t matter!” Stonewalling is a pattern of isolation and withdrawal: for example, verbally or nonverbally saying, “I don’t want to talk about this anymore!”

Difficulty: Moderate Question ID: 17.3.86 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyse impacts on family wellness 17.3.87. Explain how heritability might play a role in divorce, and give an example.

Answer: Twin studies show that the concordance rates for divorce are higher for MZ twins than for DZ twins, indicating that divorce may be partly explained by genetic factors. Even though divorce is commonly assumed to be determined purely by psychological and social factors, family events such as divorce do not occur at random. The gene-environment correlation means that environmental experience is itself correlated with genetic background. To the extent that background, personality, or physical characteristics are influenced by genes, the family experience is also correlated with those genes. For example, a divorce may be partly determined by impulsivity, which, in turn, is influenced by genes. McGue and Lykken speculated that divorce may be a consequence of personality factors that are partially shaped by genetics: for example, a tendency toward thrill-seeking, relative insensitivity to social sanctions, or early puberty that could lead to attention for traits unrelated to character and attract less committed mates. So, while any individual divorce cannot be directly attributed to a “divorce gene,” genetic heritage affects the environment in ways that can affect the stability of an individual marriage.

Difficulty: Moderate Question ID: 17.3.87 Topic: Family Transitions Skill: Understand the Concepts LO 17.3: Analyse impacts on family wellness

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17.3.88. Discuss the research findings on the issue of reminiscence in older adults.

Answer: Reminiscence, sometimes called life review or nostalgia, is a common phenomenon among older adults. Researchers Wong and Watt outlined six categories of reminiscences.

Integrative reminiscence is an attempt to achieve a sense of self-worth, coherence, and reconciliation with the past through discussion and acceptance of past conflicts and losses.

Instrumental reminiscence reviews goal-directed activities and attainments, reflecting a sense of control and success in overcoming life’s obstacles. Transitive reminiscence passes on cultural heritage and personal legacy, including direct moral instruction and stories with clear moral implications. Escapist reminiscence glorifies the past and deprecates the present, yearning for the “good old days.” Obsessive reminiscence is preoccupied with failure, guilt, bitterness, and despair. Narrative reminiscence is descriptive rather than interpretive. It does not serve clear intrapsychic or interpersonal functions. Integrative and instrumental reminiscence are related to successful aging. Obsessive reminiscence is associated with less successful adjustment in later life. Reminiscence can be positively or negatively related to better mental health. It remains to be seen if reminiscence can be structured or guided in such a way that it helps older adults review and come to terms with their lives Difficulty: Moderate Question ID: 17.3.88 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.3.89. Describe the five stages of bereavement outlined by Elizabeth Kübler-Ross and discuss one of the criticisms of this approach.

Answer: Elisabeth Kübler-Ross developed a popular model of bereavement, based on her work with the terminally ill, that describes grief as occurring in five stages: denial, anger, bargaining, depression, and acceptance. Researchers have questioned whether bereavement follows any clearcut series of stages. Few people seem to experience grief in a fixed sequence of stages; many individuals experience some of the stages but not all and in different orders, and some individuals experience none of the stages as outlined by Kübler-Ross.

Difficulty: Moderate Question ID: 17.3.89 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions 17.3.90. Define a living will and discuss its purpose in relation to older adults.

Answer: A living will is a legal document allowed in some states that instructs health care professionals not to carry out certain life-saving procedures on terminally ill or severely disabled individuals. The purpose of a living will is to help the older adult maintain integrity in both life and death. Older adults often are much better at accepting death than are younger people, and living wills and other efforts to humanize dying allow dignity to be maintained through the end of life.

Difficulty: Moderate Question ID: 17.3.90 Topic: The Transition to Later Life Skill: Understand the Concepts LO 17.4: Evaluate the role of health behavior in later life transitions

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Chapter 18 Mental Health and the Law Total Assessment Guide (T.A.G.) Topic

Introduction

Question Type Multiple Choice True/False

Understand the Concepts 1

Apply What You Know

Analyze It

Essay

Conflicts

Mental Illness and Criminal Responsibility

Multiple Choice True/False

2,3,4,5,6

Essay

81

Multiple Choice True/False

7,9,12,14,15, 8,10,11,13 16 54,55,56,57, 58,59,60,61,62 83,84

Essay

51,52,53 82

True/False

17,18,19,20, 25,26 21,22,23,24, 27,28 63,64,65,66,67

Essay

85

Committed Patients’ Rights

Multiple Choice True/False

Mental Health and Family Law

Essay Multiple Choice True/False Essay

29,30,31,32, 33,34 68,69,70,71, 72,73,74 87 35,36,37,38, 39,41,42,43 75,76,77,78 88,89

Multiple Choice Civil Commitment

Professional Responsibilities and the Law

Multiple Choice True/False

86

44,45,49,50

40

46,47,48

79,80 90

Essay 481

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Evaluate It

Chapter 18: Mental Health and the Law Multiple Choice 18.1.1. Your textbook presents the case of John Hinckley, who, in 1981, tried to kill Ronald Reagan, the president of the United States. Hinckley had a history of odd behavior and was subsequently found not guilty by reason of insanity. As a result, a. b. c. d.

Hinckley was released. federal laws regarding the burden of proof and the definition of insanity were changed.

Hinckley was released but required to have a secret service agent with him at all times.

Hinckley was confined to a mental hospital with no chance of release.

Answer: b.

Difficulty: Easy Question ID: 18.1.1 Topic: Introduction Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law

18.1.2. The legal definition of insanity is a. b. c. d.

not the same as the psychological definition of mental illness. essentially the same as the psychological definition of mental illness. a requirement that must be met prior to voluntary commitment. that a person who is insane is legally responsible for his or her actions.

Answer: a.

Difficulty: Easy Question ID: 18.1.2 Topic: Conflicts Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law

18.1.3. The legal concept of reflects the idea that people act out of free will and are accountable for their actions when they violate the law. a. b. c. d.

mens rea innocent until proven guilty criminal responsibility individual responsibility Answer: c.

Difficulty: Moderate Question ID: 18.1.3 Topic: Conflicts Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law

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18.1.4. One limitation placed on expert witnesses is that a. b. c. d.

testimony can only be given by psychiatrists or medical doctors. only neutral witnesses can be used, and they must be appointed by the judge in a trial. expert testimony is limited to opinion based on established science. expert witnesses must not be paid.

Answer: c.

Difficulty: Moderate Question ID: 18.1.4 Topic: Conflicts Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law

18.1.5. In U.S. law, a. b. c. d.

is an exception to the concept of criminal responsibility.

insanity mental illness determinism free will Answer: a.

Difficulty: Moderate Question ID: 18.1.5 Topic: Conflicts Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law

18.1.6. American psychiatrist Thomas Szasz has taken the somewhat radical position that a. b. c. d.

even people who commit serious crimes should not be imprisoned if they are suffering from a mental disorder. that everyone who commits a crime is mentally ill to some degree. even people who are seriously mentally ill should still be held responsible for their behavior. that all criminals should be allowed access to psychiatric treatment.

Answer: c.

Difficulty: Moderate Question ID: 18.1.6 Topic: Conflicts Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law

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18.1.7. The mental disorder defense was codified in 1843, after of insanity. a. b. c. d.

was found not guilty by reason

Freud Hinckley M’Naghten Conan-Doyle Answer: c.

Difficulty: Easy Question ID: 18.1.7 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

18.1.8. Harry Jenkins has pled “not guilty by reason of insanity.” The state where Harry is being tried uses the M’Naghten test of insanity. What question will the judge use when instructing the jury on the basis of their decision in this case? a. b. c. d.

Did the defendant know right from wrong?

Did the defendant experience an irresistible impulse?

Does the defendant have the burden of proving insanity?

Did the defendant show behavior that was the product of mental illness?

Answer: a.

Difficulty: Moderate Question ID: 18.1.8 Topic: Mental Illness and Criminal Responsibility Skill: Apply What You Know LO 18.2: Explain how mental disorders impact legal responsibilities

18.1.9. What was the basis for the irresistible impulse test first used in the late nineteenth century? a. b. c. d.

the legal assumption that everyone knows right from wrong the finding that the M'Naghten test was too broad the finding that even though some people intellectually know that their behavior is illegal, they still can’t control their behavior the observation that some diagnoses are based on evidence of criminal behavior Answer: c.

Difficulty: Moderate Question ID: 18.1.9 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

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18.1.10. A defense attorney making use of the conditions of the American Law Institute model legislation on the insanity defense would have to provide evidence that her client a. b. c. d.

was mentally ill at the time of his offense. lacked substantial capacity to appreciate the criminality (wrongfulness) of his offense. lacked a knowledge of the law that he is accused of due to his mental illness. demonstrated substantial capacity to control his actions.

Answer: b.

Difficulty: Moderate Question ID: 18.1.10 Topic: Mental Illness and Criminal Responsibility Skill: Apply What You Know LO 18.2: Explain how mental disorders impact legal responsibilities

18.1.11. A psychologist is hired by the defense in a case involving the issue of not guilty by reason of insanity. Based on changes resulting from the Hinckley case and the Insanity Defense Reform Act of 1984, it is likely that the thrust of the psychologist’s testimony would be in support of the defendant’s a. b. c. d.

inability to stand trial due to her mental illness. inability to appreciate the nature and quality or wrongfulness of her behavior due to her mental illness. right to treatment versus imprisonment due to her mental illness. inability to discuss the nature of her offense with her attorney due to her mental illness.

Answer: b.

Difficulty: Moderate Question ID: 18.1.11 Topic: Mental Illness and Criminal Responsibility Skill: Apply What You Know LO 18.2: Explain how mental disorders impact legal responsibilities

18.1.12. is defined this way: “The test must be whether he [the defendant] has sufficient present ability to consult with his attorney with a reasonable degree of rational understanding and a rational as well as factual understanding of proceedings against him.” a. b. c. d.

Sanity Rationality Competence Innocence Answer: c.

Difficulty: Moderate Question ID: 18.1.12 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

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18.1.13. Which of the following is most likely to result in an individual being ruled incompetent to stand trial? a. b. c. d.

The accused is diagnosed with a psychotic disorder.

The crime was so abhorrent that a trial is not necessary.

The accused does not have enough money for a lawyer.

The accused is unable to communicate with counsel because of brain damage.

Answer: d.

Difficulty: Moderate Question ID: 18.1.13 Topic: Mental Illness and Criminal Responsibility Skill: Apply What You Know LO 18.2: Explain how mental disorders impact legal responsibilities

18.1.14. At what stage of criminal proceedings may the issue of competence be raised? a. b. c. d.

while the defendant is being read her/his Miranda Rights prior to the preliminary hearing prior to the sentencing phase of a trial at many stages in the legal process Answer: d.

Difficulty: Moderate Question ID: 18.1.14 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

18.1.15. In the landmark case of Atkins v. Virginia (2002), the U.S. Supreme Court ruled—consistent with laws already in effect in many states—that a. b. c. d.

schizophrenia is a mitigating factor that makes the death penalty unconstitutional. schizophrenia is not a mitigating factor that makes the death penalty unconstitutional. intellectual disability is a mitigating factor that makes the death penalty unconstitutional. intellectual disability is not a mitigating factor that makes the death penalty unconstitutional.

Answer: c.

Difficulty: Moderate Question ID: 18.1.15 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

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18.1.16. In Kansas v. Hendricks, the Supreme Court ruled the Kansas sexual predator law to be a. b. c. d.

unconstitutional because the continued confinement constituted “double jeopardy.” constitutional because the confinement did not constitute punishment. unconstitutional because the confinement was “cruel and unusual.” constitutional because the law punishes sexual predators.

Answer: b.

Difficulty: Moderate Question ID: 18.1.16 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

18.1.17. The discovery of antipsychotic drugs in the 1950s paired with the patients being released from care. a. b. c. d.

lead to mental

drop in the crime rate across the United States increase in the populations of mental health institutions increase in the number of mental patients now eligible for the death penalty the deinstitutionalization movement Answer: d.

Difficulty: Easy Question ID: 18.1.17 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the process of civil commitment

18.1.18. The U.S. law prohibits confining people for crimes they might commit in the future except in the case of a. b. c. d.

civil commitment. mental health commitment. mental retardation. psychopaths.

Answer: a.

Difficulty: Moderate Question ID: 18.1.18 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the process of civil commitment

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18.1.19. The philosophy of parens patriae holds that the government has a humanitarian responsibility to a. b. c. d.

care for society’s weaker members. keep the mentally ill from having children. reimburse family members who care for the mentally ill. protect society at large from the mentally ill.

Answer: a.

Difficulty: Moderate Question ID: 18.1.19 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the process of civil commitment

18.1.20. The civil commitment of people who are dangerous to others is justified by a. b. c. d.

the state’s authority to supervise minors and physically incapacitated adults. the state’s duty to protect public safety, health, and welfare. police powers belonging to the people. the need to care for mentally disordered people.

Answer: b.

Difficulty: Easy Question ID: 18.1.20 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the process of civil commitment

18.1.21. Today, the emergency commitment procedures in most states allow an acutely disturbed individual to be confined to a. b. c. d.

jail for a few days. a mental hospital for a few days. jail until the person agrees to be treated. a mental hospital until treatment is finished.

Answer: b.

Difficulty: Easy Question ID: 18.1.21 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the process of civil commitment

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18.1.22. While the grounds for civil commitment vary from state to state, there is some commonality.

Which of the following is one of the generally accepted grounds for involuntary hospitalization? a. b. c. d.

ability to care for oneself having no friends or family dangerousness to others hearing voices Answer: c.

Difficulty: Moderate Question ID: 18.1.22 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the process of civil commitment

18.1.23. Which of the following individuals is more likely to commit acts of violence than the others? a. b. c. d.

a man with schizophrenia a woman with major depression a man or woman with bipolar disorder a man or woman who abuses drugs and alcohol Answer: d.

Difficulty: Moderate Question ID: 18.1.23 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment

18.1.24. Professional, clinical predictions that an individual patient will behave violently are correct approximately percent of the time. a. b. c. d.

10 25 33 50 Answer: c.

Difficulty: Moderate Question ID: 18.1.24 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitmen

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18.1.25. Dr. Davis has incorrectly hospitalized someone who is not dangerous. Dr. Eliot has incorrectly released someone from the hospital who is, in fact, still dangerous. Dr. Davis has made a error, while Dr. Eliot has made a error. a. b. c. d.

justifiable / unjustifiable unjustifiable / justifiable false positive / false negative false negative / false positive Answer: c.

Difficulty: Moderate Question ID: 18.1.25 Topic: Civil Commitment Skill: Apply What You Know LO 18.3: Evaluate the practice of civil commitment

18.1.26. When Supreme Court Justice Blackmun heard that the prediction of violence is wrong two out of three times, he concluded that predicting violence using a coin flip would be more accurate. Why was he wrong? a. b. c. d.

The specificity of a coin flip is above 50 percent.

The sensitivity of a coin flip is above 50 percent.

The base rate of violence is much lower than 50 percent.

The coin flip is random, not based on clinical judgment.

Answer: c.

Difficulty: Difficult Question ID: 18.1.26 Topic: Civil Commitment Skill: Apply What You Know LO 18.3: Evaluate the practice of civil commitment

18.1.27. The base rate of the actual occurrence of serious violence is

percent.

a. 1 b. 3 c. 9

d.

27 Answer: b.

Difficulty: Difficult Question ID: 18.1.27 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment

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18.1.28. The accuracy of predictions of violence is better when the focus is on a. b. c. d.

violence against others. violence against oneself. imminent violence. violence that may occur over the long term.

Answer: c.

Difficulty: Moderate Question ID: 18.1.28 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment

18.1.29. Which of the following rights for mental patients was established by the Wyatt v. Stickney decision? a. b. c. d.

standardized treatment plans adequate medication humane conditions treatment by medical doctors only Answer: c.

Difficulty: Moderate Question ID: 18.1.29 Topic: Committed Patients’ Rights Skill: Apply What You Know LO 18.4: Outline the history of patient rights regarding mental illness

18.1.30. What is the most important issue about the patient’s right to be treated in the least restrictive environment alternative? a. b. c. d.

Less restrictive environments are often not available.

Treatment in these settings is usually prohibitively expensive.

Insurance companies will not pay the expenses for alternative treatments.

Treatment in a less restrictive environment is usually less effective.

Answer: a.

Difficulty: Moderate Question ID: 18.1.30 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness

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18.1.31. A mental patient involuntarily admitted to a mental hospital may refuse treatment if he or she a. b. c. d.

can provide a good reason. is willing to post a bond. doesn’t agree that he or she is mentally ill is competent to give informed consent.

Answer: d.

Difficulty: Moderate Question ID: 18.1.31 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness

18.1.32. A newer, more assertive approach to treating patients who lack insight is court–ordered mandatory treatment in the community rather than in the hospital. This is known as a. b. c. d.

deinstitutionalized commitment. outpatient treatment. community commitment. outpatient commitment.

Answer: d.

Difficulty: Moderate Question ID: 18.1.32 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness

18.1.33. While there may have been some benefits to the deinstitutionalization of mental patients, one serious problem that has resulted is reflected in the report of a 1986 study that found percent of homeless individuals were in need of mental health services. a. b. c. d.

13 31 57 90 Answer: b.

Difficulty: Moderate Question ID: 18.1.33 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness

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18.1.34. Individuals can use a legal procedure called should they be found mentally ill in the future. a. b. c. d.

to list their preferences for treatment

sanity wills advance psychiatric directives treatment contracts community mental health directives Answer: b.

Difficulty: Moderate Question ID: 18.1.34 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness

18.1.35. Legal custody refers to a. b. c. d.

where the child lives at which time. foster care placement of abused children. convincing a judge that one is a fit parent. how the parents will make decisions about their child’s life.

Answer: d.

Difficulty: Moderate Question ID: 18.1.35 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

18.1.36. About family. a. b. c. d.

percent of children in the United States today will experience a divorce in their

10 20 40 60 Answer: c.

Difficulty: Easy Question ID: 18.1.36 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

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18.1.37. A neutral third party who helps partners in divorce decisions is a(n) a. b. c. d.

mediator. unbiased lawyer. facilitator. family counselor.

Answer: a.

Difficulty: Easy Question ID: 18.1.37 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

18.1.38. In 1962, Henry Kempe focused public attention on a family problem that had not previously received much attention. Kempe called the problem a. b. c. d.

mentally disordered families. post traumatic stress disorder. the “refrigerator mother syndrome” the “battered child syndrome.”

Answer: d.

Difficulty: Moderate Question ID: 18.1.38 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

18.1.39. The most commonly reported form of child abuse is , which places children at risk for physical or psychological harm by failing to provide basic and expected care. a. b. c. d.

physical child abuse child neglect emotional abuse harm by omission Answer: b.

Difficulty: Moderate Question ID: 18.1.39 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

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18.1.40. In reviewing hospital security tapes, several parents are observed trying to do physical harm to their children. These parents may be diagnosed with , a rare mental disorder in which parents fabricate or induce illness or injury in their children. a. b. c. d.

child abuse syndrome schizophrenia psychopathy Munchausen-by-proxy syndrome Answer: d.

Difficulty: Moderate Question ID: 18.1.40 Topic: Mental Health and Family Law Skill: Apply What You Know LO 18.5: Relate mental health to the practice of family law

18.1.41. While the number of reports of child abuse have increased from around 669,000 in 1976 to well over 3 million in 2009, how many reports of abuse are found to be unsubstantiated? a. b. c. d.

almost one half up to 25 percent practically none more than two-thirds Answer: d.

Difficulty: Moderate Question ID: 18.1.41 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

18.1.42. Each year, more than 100,000 children are placed in another family. a. b. c. d.

, where they live temporarily with

group homes short-term adoptions foster care protective custody Answer: c.

Difficulty: Moderate Question ID: 18.1.42 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

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18.1.43. Children taken from their family homes can be adopted only if a. b. c. d.

both parents are deceased. the parents are divorced. the child has been abused. parental rights have been terminated.

Answer: d.

Difficulty: Moderate Question ID: 18.1.43 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

18.1.44. Two of the most common reasons for malpractice claims against mental health professionals are a. b. c. d.

inappropriate use of medication and sexual harassment. inappropriate use of medication and negligent treatment. negligent treatment and involuntary hypnosis. sexual relations between therapist and client and financial fraud.

Answer: b.

Difficulty: Moderate Question ID: 18.1.44 Topic: Professional Responsibilities and the Law Skill: Understand the Concepts LO 18.6: Summarize the legal responsibilities of psychology professionals

18.1.45. In Osheroff vs. Chestnut Lodge, Dr. Osheroff successfully sued Chestnut Lodge for a variety of reasons, including: a. b. c. d.

failure to offer him informed consent about treatment alternatives. the refusal to allow him to prescribe off-label medications to his patients. that the hospital’s provided treatment was not consistent with the type of theoretical orientation it advertised. that he was subjected to electroshock therapy without his consent.

Answer: a.

Difficulty: Moderate Question ID: 18.1.45 Topic: Professional Responsibilities and the Law Skill: Understand the Concepts LO 18.6: Summarize the legal responsibilities of psychology professionals

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18.1.46. As a therapist, you are obliged to maintain confidentiality because you have an ethical obligation not to reveal a patient’s private communication during therapy. What is an exception to this rule? a. b. c. d.

hiding assets during a divorce anger toward others suspected illegal activity suspected cases of child abuse Answer: d.

Difficulty: Moderate Question ID: 18.1.46 Topic: Professional Responsibilities and the Law Skill: Apply What You Know LO 18.6: Summarize the legal responsibilities of psychology professionals

18.1.47. Your client has just admitted to you that she intends to run her car into her ex-husband’s house, hopefully as he answers the door. As a result of which court decision are you now required to warn him of her intent? a. b. c. d.

Megan California Tarasoff Mendonza Answer: c.

Difficulty: Moderate Question ID: 18.1.47 Topic: Professional Responsibilities and the Law Skill: Apply What You Know LO 18.6: Summarize the legal responsibilities of psychology professionals

18.1.48. You are a psychotherapist practicing in San Francisco. You are concerned because a patient has just expressed a fairly detailed plan to kidnap, mutilate, and kill a coworker. Under California law, you have a duty to the potential victim, which may include actions like hospitalizing the potentially dangerous patient. a. b. c. d.

warn protect notify inform Answer: b.

Difficulty: Moderate Question ID: 18.1.48 Topic: Professional Responsibilities and the Law Skill: Apply What You Know LO 18.6: Summarize the legal responsibilities of psychology professionals

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18.1.49. A dilemma for mental health professionals involves whether they should tell their clients that they must break confidentiality in cases of a. b. c. d.

child abuse. plans for divorce. repressed memories. tax evasion.

Answer: a.

Difficulty: Easy Question ID: 18.1.49 Topic: Professional Responsibilities and the Law Skill: Understand the Concepts LO 18.6: Summarize the legal responsibilities of psychology professionals

18.1.50. The legal case of Tarasoff v. Regents of the University of California (1976) established that therapists must a. b. c. d.

refrain from having sex with their clients. report suspected cases of child abuse. notify police of a patient’s imminent suicide attempt. warn potential victims of a patient’s intent to harm them.

Answer: d.

Difficulty: Easy Question ID: 18.1.50 Topic: Professional Responsibilities and the Law Skill: Understand the Concepts LO 18.6: Summarize the legal responsibilities of psychology professionals

True/False 18.2.51. The legal definition of insanity is not the same as the scientific definition of mental illness.

Answer: True Difficulty: Easy Question ID: 18.2.51 Topic: Conflicts Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law 18.2.52. Criminal law assumes that human behavior is the product of personal responsibility.

Answer: False Difficulty: Moderate Question ID: 18.2.52 Topic: Conflicts Skill: Understand the Concepts

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LO 18.1: Analyze theoretical conflicts between psychology and law 18.2.53. Mental health professionals operate under an assumption of determinism, the perspective that human behavior is determined by biological, psychological, and social forces.

Answer: True Difficulty: Moderate Question ID: 18.2.53 Topic: Conflicts Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law 18.2.54. The 1843 M’Naghten decision was the beginning of the insanity defense in Western law.

Answer: True Difficulty: Moderate Question ID: 18.2.54 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.1: Is “insanity” the same thing as “mental illness”?

18.2.55. A 1954 ruling by a Washington D.C. federal court in Durham v. United States broadened the insanity defense to say that an accused is not criminally responsible if his or her unlawful act was the product of mental disease or defect. This came to be known as the Durham test.

Answer: False Difficulty: Moderate Question ID: 18.2.55 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities 18.2.56. The major change contained in the Insanity Defense Reform Act was that the prosecution is now required to prove the defendant was not insane.

Answer: False Difficulty: Moderate Question ID: 18.2.56 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities 18.2.57. In the United States, only about 1 percent of those charged with a crime attempt a defense of not guilty by reason of insanity (NGRI). Of those, approximately 25 percent are successful.

Answer: True Difficulty: Moderate Question ID: 18.2.57 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

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18.2.58. In most cases of a successful defense based on not guilty by reason of insanity, the defendant spends some time in a mental health facility after the verdict. The time spent in a mental health facility is generally shorter than a prison sentence would have been.

Answer: False Difficulty: Moderate Question ID: 18.2.58 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities 18.2.59. Another attempt to reform the insanity defense is known as guilty but mentally ill.

Answer: True Difficulty: Moderate Question ID: 18.2.59 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities 18.2.60. If a defendant is determined to be incompetent, legal proceedings are suspended until they can be understood by the defendant.

Answer: True Difficulty: Moderate Question ID: 18.2.60 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities 18.2.61. In all death penalty cases, mitigation evaluations must be conducted, which include an assessment for mental disorders.

Answer: True Difficulty: Moderate Question ID: 18.2.61 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities 18.2.62. A defendant’s ability to understand the legal proceedings that are taking place against him and to participate in his own defense defines the concept of competence.

Answer: True Difficulty: Easy Question ID: 18.2.62 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

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18.2.63. Using legal proceedings to confine an individual to a mental health facility against his will is known as civil commitment.

Answer: True Difficulty: Easy Question ID: 18.2.63 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment 18.2.64. Most states provide for two types of civil commitment procedures: emergency and psychological.

Answer: False Difficulty: Easy Question ID: 18.2.64 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment 18.2.65. Approximately 90 percent of the mentally disturbed have no history of violence.

Answer: True Difficulty: Moderate Question ID: 18.2.65 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment 18.2.66. A base rate is the accuracy of predictions about the event in the past.

Answer: False Difficulty: Moderate Question ID: 18.2.66 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment 18.2.67. The general conclusion concerning making predictions of future violence is that clinical judgment is better than chance.

Answer: True Difficulty: Moderate Question ID: 18.2.67 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment

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18.2.68. The case of Lake v. Cameron established a patient’s right to treatment in the least restrictive environment.

Answer: True Difficulty: Moderate Question ID: 18.2.68 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness 18.2.69. The question of a patient’s right and ability to refuse treatment often turns on the issue of informed consent.

Answer: True Difficulty: Moderate Question ID: 18.2.69 Topic: Commited Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness 18.2.70. A new legal device that addresses the issue of treatment for patients who lack insight yet who are eligible for release into the community issupervised release.

Answer: False Difficulty: Moderate Question ID: 18.2.70 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness 18.2.71. The problematic process that removed mental patients from hospitals and placed them in the community was known as deinstitutionalization.

Answer: True Difficulty: Moderate Question ID: 18.2.71 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness 18.2.72. The deinstitutionalization movement was based on the philosophy that the mentally ill need to be hospitalized under more humane conditions.

Answer: False Difficulty: Easy Question ID: 18.2.72 Topic: Committed Patiens’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness

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18.2.73. One of the reasons that deinstitutionalization has not worked as well as its proponents had hoped is that the needed numbers of Community Mental Health Centers were never built.

Answer: True Difficulty: Easy Question ID: 18.2.73 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness 18.2.74. As a result of the decline in public hospitalization of mental patients, more people with mental illness are living in nursing homes or are being confined in jail.

Answer: True Difficulty: Easy Question ID: 18.2.74 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness 18.2.75. In contrast to mental health law, virtually all of family law is based on the principal of protecting the community.

Answer: False Difficulty: Easy Question ID: 18.2.75 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law 18.2.76. The guiding principle in custody and abuse cases is that judges must make decisions according to the “child’s best interest.” Fortunately, the law makes it clear what constitutes the concept of “best interest.”

Answer: False Difficulty: Easy Question ID: 18.2.75 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law 18.2.77. Child abuse involves the accidental or intentional infliction of harm to a child due to acts or omissions on the part of an adult responsible for the child’s care.

Answer: True Difficulty: Easy Question ID: 18.2.77 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

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18.2.78. The definition os physical child abuse is complicated by the fact that corporal punishments, such as spankings, are widely accepted disciplinary practices.

Answer: True Difficulty: Easy Question ID: 18.2.78 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law 18.2.79. Malpractice is when a professional fails to perform in a manner consistent with the level of skill exercised by other professionals in the field.

Answer: False Difficulty: Easy Question ID: 18.2.79 Topic: Professional Responsibilities and the Law Skill: Understand the Concepts LO 18.6: Summarize the legal responsibilities of psychology professionals 18.2.80. Confidentiality is the ethical obligation not to reveal private communications that is basic to psychotherapy.

Answer: True Difficulty: Easy Question ID: 18.2.80 Topic: Professional Responsibilities and the Law Skill: Understand the Concepts LO 18.6: Summarize the legal responsibilities of psychology professionals

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Essay 18.3.81. Discuss the role of expert witnesses and the limitations placed on them by court rulings.

Answer: There are three ways in which the law assumes that mental disorders may affect an individual’s ability to exercise his or her rights and responsibilities: (1) Defendants who are not guilty by reason of insanity are not criminally responsible for their actions; (2) Defendants who are incompetent to stand trial are unable to exercise their right to participate in their own defense; and (3) mental illness may be a mitigating factor that can lead to a less harsh sentence, or a harsher one. Since neither judges nor juries have expert psychological knowledge that allows them to make these decisions, mental health experts testify about these matters. One conflict between mental health and the law concerns the role of expert witnesses, specialists allowed to testify about matters of opinion (not just fact) that lie within their area of expertise. In Daubert v.Merrell Dow Pharmaceuticals (1993), the U.S. Supreme Court ruled that expert opinion must be based on an “... inference or assertion . . . derived by the scientific method,” and courts must determine “whether the reasoning or methodology underlying the testimony is scientifically valid and ... whether that reasoning or methodology can be applied to the facts in issue.” Since experts can and do interpret the same information in different ways, and lawyers “shop” for friendly experts who have a history of interpreting evidence in a way that will help their case. Lawyers expect challenges to their expert witnesses’ testimony, and they anticipate that experts for the opposing side will present conflicting testimony. One way to limit conflict, and hopefully improve expert testimony, is for courts to appoint neutral experts rather than having each side employ its own “hired gun.”

Difficulty: Moderate Question ID: 18.3.81 Topic: Conflicts Skill: Understand the Concepts LO 18.1: Analyze theoretical conflicts between psychology and law 18.3.82. Compare and contrast the assumptions held by the legal system and those held by mental health professionals concerning the nature of the cause of human behavior.

Answer: The legal system starts with the assumption that individuals are in possession of “free will,” that they have control over their behavior, and that they make choices and freely act on them. Thus, the law can hold people accountable for their actions. Mental health professionals tend to start from the assumption of “determinism,” that is, all human behavior is the result of complex interactions between genetics, biological factors, past experience, local conditions, social pressures, etc., and they recognize that sometimes, as the result of factors, such as brain tumors or social coercion, individuals actually can be made to behave against their will. The law does make one exception with regard to the assumption of free will in the “insanity” defense that recognizes that an individual can be suffering from a mental disorder that clouds his reason, perception, or judgment so much that it no longer makes any logical or legal sense to hold him fully responsible for his actions. At this point, the two definitions overlap, and a judge and/or jury needs to sort out the issue of responsibility.

Difficulty: Moderate Question ID: 18.3.82 Topic: Conflicts Skill: Analyze It LO 18.1: Analyze theoretical conflicts between psychology and law

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18.3.83. Briefly outline the conditions inherent in the M’Naghten ruling for finding a defendant not guilty by reason of insanity, and then discuss the changes that have occurred in U.S. law that have modified the conditions for its successful application.

Answer: The basic condition laid down in the M’Naghten ruling was that a defendant could be found not guilty by reason of insanity (NGRI) if suffering a “defect of reason” (mental disorder) that made it impossible for him to understand right from wrong. Subsequent developments first broadened and later narrowed the grounds for determining insanity. Parsons expanded it to include conditions in which the person might intellectually know that what he did was wrong, but he was overcome by an “irresistible impulse.” Durham introduced the product test, which suggested that if someone’s behavior was the product of a mental disorder or mental disease, they could be found NGRI. This ruling made no attempt to define either product or mental disease, and it led to circular reasoning: for instance, antisocial personality disorder is defined by criminal behavior, yet the same criminal behavior proved the perpetrator was insane. Durham was overruled in 1972 and replaced by the Insanity Defense Reform Act of 1984 in which an individual can be found NGRI if he suffers from a mental disorder and, as a result of that disorder, can’t comprehend the nature and quality of his actions. This combines concepts from the M’Naghten case with the idea of irresistible impulses, stating: A person is not responsible for criminal conduct if, at the time of such conduct and as a result of mental disease or defect, he lacks substantial capacity either to appreciate the criminality (wrongfulness) of his conduct or to conform his conduct to the requirements of the law.

Difficulty: Moderate Question ID: 28.3.83 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities 18.3.84. Discuss the conditions that need to be met in order for an individual to be found “competent to stand trial.”

Answer: Many more people are institutionalized because of findings of incompetence than because of insanity rulings. Competence is a defendant’s ability to understand the legal proceedings that are taking place against him and to participate in his own defense. The U.S. Supreme Court defined competence this way: “The test must be whether he [the defendant] has sufficient present ability to consult with his attorney with a reasonable degree of rational understanding and a rational as well as factual understanding of proceedings against him.” Competence refers to the defendant’s current mental state and the defendant's ability to understand criminal proceedings.

The defendant must show legal understanding, legal reasoning, and legal appreciation.

Difficulty: Moderate Question ID: 18.3.84 Topic: Mental Illness and Criminal Responsibility Skill: Understand the Concepts LO 18.2: Explain how mental disorders impact legal responsibilities

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18.3.85. What are the two broad rationales for the government’s power to put people into psychiatric hospitals against their will, through civil commitment procedures?

Answer: The U.S. law has two broad rationales for involuntary hospitalization, which hinge on the government’s responsibility to protect those who cannot protect themselves, as well as to protect the public at large. The concept of parens patriae (“state as parent”) refers to the government’s humanitarian responsibility to care for its weaker members. Under parens patriae authority, civil commitment may be justified when the mentally disturbed are either dangerous to themselves or unable to care for themselves. Police power refers to the government’s responsibility to protect the public safety, health, and welfare. This concept means that civil commitment is used to confine those who present a danger to others.

Difficulty: Moderate Question ID: 18.3.85 Topic: Civil Commitment Skill: Understand the Concepts LO 18.3: Evaluate the practice of civil commitment 18.3.86. A public policy official reads that the rates of violence are five times higher among people with serious mental illness than they are among the general population. Based on this evidence, the public policy official recommends legislation that would allow those with serious mental illness to be detained preventatively to keep them from committing violent offences. What is the scientific evidence that suggests that such a policy is not justified?

Answer: The actual risk of violence is much lower than publicly perceived. Ninety percent of mentally ill people have no history of violence. Furthermore, while current psychotic symptoms predict violence, past psychotic episodes do not predict future violence. While the percentage of violent behavior among those with mental illness is higher than it is among the general population, those statistics include those who abuse alcohol or drugs. Substance abuse increases the likelihood of violence for both the mentally ill and the general population. Finally, other factors, such as poverty, also increase the risk for violence, and our society would consider it a violation of civil liberties to detain someone simply for being poor. Except in certain extreme cases, this policy would not be justified.

Difficulty: Moderate Question ID: 18.3.86 Topic: Civil Commitment Skill: Apply What You Know LO 18.3: Evaluate the practice of civil commitment

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18.3.87. Discuss three rights mental patients have in the United States with regard to treatment and how they are sometimes contradictory.

Answer: Mentally ill patients in the United States are considered to have three important rights: the right to treatment, the right to treatment in the least restrictive alternative environment, and the right to refuse treatment. The right to treatment was codified in the Wyatt decision, which expanded the individual’s right to treatment by trained staff, under humane conditions, with individualized treatment plans. Mentally ill patients cannot simply be warehoused; they must receive treatment. The right to treatment in the least restrictive alternative environment is an attempt to balance paternalistic and libertarian concerns. The state provides mandatory care, but restricts individual liberties as little as possible. Unfortunately, community care centers that are less restrictive than hospitals are not always available. The most recent right is the right to refuse treatment. Several courts and state legislatures have concluded that mental health patients have the right to refuse treatment under certain conditions, although this right is on increasingly shaky ground. If a patient is competent to give informed consent, treatment can be refused. If the patient is incompetent, an independent guardian offers a substituted judgment based on what the patient would choose if he or she was competent (but this is not necessarily what is in the patient’s best interest). Courts have ruled that a patient can be medicated involuntarily to reduce dangerous behavior, so the third right is limited in these cases.

Difficulty: Moderate Question ID: 18.3.87 Topic: Committed Patients’ Rights Skill: Understand the Concepts LO 18.4: Outline the history of patient rights regarding mental illness 18.3.88. Discuss the value of divorce mediation in child custody disputes.

Answer: Leaving the decision of child custody in a divorce settlement to the judge is problematic because what is in the child’s best interest is only vaguely defined in the law. Many mental health and legal experts believe they serve children and the legal system better if they help settle custody disputes outside of court. In divorce mediation, parents meet with a neutral third party, who may be a mental health or legal professional, who helps them to identify, negotiate, and ultimately resolve their disputes. Mediators adopt a cooperative approach to dispute resolution, treating separated parents as parents rather than as legal adversaries. Mediation reduces custody hearings, helps parents reach decisions more quickly, and is viewed more favorable than litigation by parents. One randomized trial found that five to six hours of mediation causes nonresidential parents to remain far more involved in their children’s lives and work together better 12 years later. Many states now require mediation as a more “family friendly” forum for dispute resolution.

Difficulty: Moderate Question ID: 18.3.88 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law

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18.3.89. Describe the disorder of Munchausen-by-proxy.

Answer: Munchausen-by-proxy is a rare but potentially very harmful, even deadly, form of child abuse. In this syndrome, a parent feigns, exaggerates, or induces an illness in a child. This can range from fabrication of symptoms to causing severe harm, such as illness or injury. Video recordings have captured parents attempting suffocation, trying to break a child’s arm, and attempting to poison a child with disinfectant. Even more alarming is the fact that many of these children had siblings who had died suddenly and unexpectedly.

Difficulty: Moderate Question ID: 18.3.89 Topic: Mental Health and Family Law Skill: Understand the Concepts LO 18.5: Relate mental health to the practice of family law 18.3.90. Discuss the circumstances in which you, as a therapist would be obliged to break confidentiality regarding a patient.

Answer: Confidentiality is an ethical obligation that is basic to psychotherapy in order to establish and maintain trust with patients. However, there are cases when confidentiality must be broken.

Confidentiality must be broken when a patient is dangerous to himself or to others; a therapist has the duty to warn or protect potential victims. In particular, cases of suspected child abuse or when the patient has threatened to harm someone override confidentiality. The Tarasoff case established the duty to warn in California; subsequent cases expanded this to the duty to protect, which can involve protective actions like hospitalizing the potentially dangerous patient.

Difficulty: Moderate Question ID: 18.3.90 Topic: Professional Responsibilities and the Law Skill: Apply What You Know LO 18.6: Summarize the legal responsibilities of psychology professionals

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