Abnormal Child Psychology 7th Edition Test Bank

Abnormal Child Psychology 7th Edition Test Bank

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Chapter 01 Multiple Choice 1. A child typically enters the mental health system ____. a. by asking for a referral from a pediatrician b. through the criminal justice system c. by the actions, positive or negative, of peers d. through teachers, counselors, or parents ANSWER: d 2. Many child and adolescent problems can be best described as the ____. a. failure to demonstrate expected developmental progress b. absence of the key survival skills needed to thrive c. result of excessive expectations by parents d. stresses associated with educational demands ANSWER: a 3. Patterns of behavioral, cognitive, emotional, or physical symptoms shown by an individual are defined as ____. a. psychological disorders b. defiance of norms c. disobedience d. distress ANSWER: a 4. Interventions for children and adolescents are often intended to ____. a. restore previous levels of functioning b. serve as a warning for negative behavior c. reform behavior to conform to norms d. eliminate distress and promote further development ANSWER: d 5. In the seventeenth and eighteenth centuries, children’s mental health problems were attributed to ____. a. possession by the devil or other evil forces b. poor parenting practices c. chemical imbalances d. low self-esteem ANSWER: a 6. In the seventeenth and eighteenth centuries, acts of child maltreatment were ____. a. illegal and punishable by severe fines b. very uncommon but largely overlooked Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 c. practiced primarily among lower socioeconomic classes d. considered to be a parent’s right for educating or disciplining a child ANSWER: d 7. John Locke (1632–1704) advanced the belief that children were ____. a. possessed by the devil b. uncivilized c. emotionally sensitive beings d. young adults ANSWER: c 8. The work of Jean-Marc Gaspard Itard (1775–1838) is notable in that ____. a. his orientation toward children was one of care and helping, in contrast to the times b. he was the first documented individual to use behavioral techniques with children c. he was a strong advocate for sending disturbed children to asylums d. he initiated the Massachusetts’ Stubborn Child Act ANSWER: a 9. How did Jean-Marc Gaspard Itard believe he could tame the “wild boy of Aveyron”? a. Exorcism b. Environmental stimulation c. Allow him to behave as he did in the wild d. Peer modeling ANSWER: b 10. Which method did Jean-Marc Gaspard Itard use to tame the “wild boy of Aveyron”? a. Cold showers b. Tranquilizers c. Timeouts d. Massages ANSWER: d 11. At the end of the nineteenth century, children with intellectual disabilities were regarded as ____. a. suffering from “moral insanity” b. imbeciles c. lunatics d. possessed by the devil ANSWER: b 12. At the end of the nineteenth century, children with normal cognitive abilities but disturbing behavior were thought to be ____.

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Chapter 01 a. suffering from “moral insanity” b. imbeciles c. diseased d. possessed by the devil ANSWER: a 13. The first disorder unique to children and adolescents was ____. a. masturbatory insanity b. schizoid disorder c. moral insanity d. manic depression ANSWER: a 14. During the early part of the twentieth century, the biological disease model of mental problems led to ____. a. the belief that mental illness had no physical basis b. improved treatments c. more controlled research methods d. eugenics and segregation ANSWER: d 15. Freud was the first to link mental disorders to ____. a. neurotransmitter imbalances b. early childhood experiences c. possession by evil spirits d. classical conditioning ANSWER: b 16. Freud’s theory focused on ____. a. single causes of behavior b. multiple causes of behavior c. diseases of the mind d. neurological causes of behavior ANSWER: b 17. Efforts to classify psychiatric disorders into descriptive categories are called ____. a. etiologies b. differentials c. nosologies d. prescriptives ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 18. Who is referred to as the “Father of Behaviorism”? a. Freud b. Albert c. Watson d. Rayner ANSWER: c 19. The development of ____ treatment can be traced back to the rise of behaviorism in the early 1900s. a. psychodynamic b. evidence-based c. group-based d. humanist ANSWER: b 20. In the first half of the twentieth century, most children with mental disorders were ____. a. institutionalized b. treated with behavior therapy c. treated with psychoanalysis d. overlooked ANSWER: a 21. The work of Rene Spitz ____. a. led to the development of an organic model of mental illness b. is the first documented attempt to help a special needs child c. led to some of the first empirically supported behavioral techniques for eliminating children’s fears d. raised serious questions about the harmful impact of institutionalization on children’s development ANSWER: d 22. During the 1950s and 1960s, ____ emerged as a systematic approach to the treatment of childhood disorders. a. psychoanalysis b. family therapy c. behavior therapy d. institutionalization ANSWER: c 23. The Individuals with Disabilities Education Act (IDEA; Public Law 104-446) mandates ____. a. segregated education for children with special needs b. the use of IQ tests for assessing children c. standardized programs for children identified as special needs d. education in the least restrictive environment possible Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 ANSWER: d 24. What is the purpose of an Individualized Educational Plan (IEP)? a. To test the child using standardized tests b. To accurately diagnose each child’s illness against a model c. To tailor the child’s school program to his or her needs d. To understand the role of family history in mental health ANSWER: c 25. The 2007 United Nations Treaty adopted a new convention to ____. a. provide free and appropriate education to children with special needs b. improve disability rights and abolish discrimination c. provide psychotherapy services to children with special needs d. improve test measures to diagnose children with special needs ANSWER: b 26. Psychological disorders are defined as patterns of behavioral, cognitive, emotional, or physical symptoms that are associated with ____. a. deviance b. defiance of norms c. disobedience d. distress ANSWER: d 27. In contrast to adults, abnormality in children is often defined in terms of ____. a. stage of development b. everyday stress c. disability d. addiction ANSWER: a 28. Which description of a child would be considered labeling a child rather than describing her behavior? a. Ashley is a child with mental retardation. b. Karlee is an anxious child. c. Amber is a child with autism. d. Robyn is a child who is small.

ANSWER: b 29. Boundaries between abnormal versus normal functioning are ____. a. scientifically defined b. relatively arbitrary Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 c. well-established d. determined by each family ANSWER: b 30. What concept states that various outcomes may stem from similar beginnings such as child maltreatment? a. Trifinality b. Ethnic finality c. Equifinality d. Multifinality ANSWER: d 31. Successful adaptation to the environment varies across ____. a. psychological theories b. developmental stages c. region of the country d. culture and ethnicity ANSWER: d 32. The ability to successfully adapt in the environment is referred to as ____. a. intelligence b. adjustment c. resilience d. coping ANSWER: c 33. To determine a child’s competencies, it is useful to have some knowledge of ____. a. institutional norms b. animal behavior c. adult dysfunctions d. developmental tasks ANSWER: d 34. Which of the following is not a developmental task of middle childhood? a. Academic achievement b. Getting along with peers c. Differentiating self from environment d. Rule-governed conduct ANSWER: c 35. Which of the following is not a developmental task of adolescence? a. Academic achievement Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 b. Self-control and compliance c. Forming a cohesive sense of self-identity d. Involvement in extracurricular activities ANSWER: b 36. Which of the following is not a developmental task of infancy? a. Attachment to caregiver b. Language c. Differentiation of self from environment d. Forming close friendships within and across gender ANSWER: d 37. Which of the following is not an affect that occurs because of stigma? a. Fear b. Rejection c. Avoidance d. Motivation ANSWER: d 38. Multifinality refers to the observation that ____. a. different disorders may stem from similar causes b. various outcomes may stem from similar beginnings c. the same disorder may have different causes d. developmental pathways may converge at the end ANSWER: b 39. Conduct disorder may arise from different developmental pathways, a concept known as ____. a. equifinality b. multifinality c. developmental diversity d. disordered beginnings ANSWER: a 40. Which is an example of resiliency? a. Submissiveness b. Coping skills c. Networking skills d. Physical aptitude ANSWER: b 41. A risk factor is a variable that ____.

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Chapter 01 a. follows a negative outcome b. increases the likelihood that a negative outcome will occur c. indicates positive outcomes d. decreases the likelihood that negative outcome will occur ANSWER: b 42. Which of the following is true with respect to resilience? a. Resilience is relevant to a few, traumatic life events. b. Resilience cannot be learned or taught. c. Resilience remains consistent over time. d. Resilience may vary over time and across situations.

ANSWER: d 43. By the year 2020, global child and adolescent mental health issues, in terms of disability, will ____. a. decrease by 50% b. remain the same as the present day c. slightly increase d. surpass physical health issues ANSWER: d 44. Which risk factor is most likely to increase a child’s vulnerability to psychopathology? a. Chronic poverty b. Impulsivity c. Two-career families d. Lack of siblings ANSWER: a 45. “Forming a cohesive sense of self-identity” is a task done by children in which age group? a. Infancy to preschool b. Middle childhood c. Adolescence d. None of these are correct ANSWER: c 46. Girls have higher rates of ____ than boys. a. illiteracy b. autism c. depression d. ADHD ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 47. Childhood poverty is a daily reality for about one in ____ children in the United States. a. four b. five c. seven d. eight ANSWER: b 48. Which statement about children’s mental health is false? a. About 1 in 15 children has a mental health problem that impairs their functioning. b. Approximately 75% of children with mental health problems receive proper services. c. Race plays more of a role than socioeconomic status (SES) in disorder rates among children. d. About 1 in 10 children meets the criteria for a specific psychological disorder.

ANSWER: b 49. A significant number of children today ____. a. will have the same development trajectory to adulthood b. do not grow out of their childhood difficulties by adulthood c. face greater stressors at earlier ages than children of the past d. have the same types of problems as children of the past ANSWER: b 50. Which children are disproportionately afflicted with mental health problems? a. Those who are recent immigrants b. Those who are only children c. Those with more than two siblings d. Those born to parents with mental health issues ANSWER: d 51. The significant difficulties that children in chronic poverty experience may be due to ____. a. damage to the cerebellum b. an underactive amygdala c. certain genetic markers d. impaired prefrontal cortex development ANSWER: d 52. Which statement is true regarding LGBT youth? a. They are more likely to seek help from adults. b. They often experience verbal and physical abuse. c. They have fewer academic problems. d. They are more likely to be bullies.

ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 53. Which statement reflects the differences in mental health problems between boys and girls? a. Anxiety disorders are more common in boys than girls. b. Sex differences in problem behaviors exhibit by early infancy. c. Boys demonstrate more difficulties than girls starting in early adolescence. d. Boys’ externalizing problems are more prevalent than girls’ in the preschool years.

ANSWER: d 54. Which statement is true about children with mental health problems from ethnic and racial minority groups? a. Minority children in the United States are overrepresented in rates of some disorders. b. No differences emerge in relation to race and mental health even when controlling for other factors. c. Minority children and youth do not face any more disadvantages in life than other children. d. Ethnic representation in research studies has received a great deal of attention in studies of child psychopathology.

ANSWER: a 55. Each year nearly ___________verified reports of child abuse and neglect are reported in the United States. a. 100,000 b. 200,000 c. 500,000 d. 1,000,000 ANSWER: d 56. U.S. phone surveys suggest that about ____ of 10- to 16-year-olds experience physical and/or sexual abuse. a. one-tenth b. one-fourth c. one-third d. one-half ANSWER: c 57. Phone surveys suggest that about ____ of 12- to 17-year-olds met criteria for either post-traumatic stress disorder, major depressive episode, or substance abuse/dependence. a. 1% to 5% b. 5% to 9% c. 16% to 19% d. 20% to 35% ANSWER: c 58. Which of the following issues make adolescence a particularly vulnerable period? a. Risky sexual behavior b. Sporting teams Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 c. Chores at home d. Technology use ANSWER: a 59. Children with the most chronic and serious disorders ____. a. are more likely to receive help, and therefore, to succeed in school b. face sizable difficulties throughout their lives c. are less likely to have social problems in online venues d. do not tend to carry a psychiatric disorder into adulthood ANSWER: b 60. What might be one consequence associated with child psychopathology? a. Increased demands on community resources, such as health systems b. Less funding for educational institutions c. Less interest in interventions d. Increased funding for criminal justice systems ANSWER: a 61. The most dangerous place for a child to try to grow up in America is at the intersection of __________. a. race and poverty b. race and ethnicity c. child maltreatment and nonaccidental trauma d. poverty and ethnicity ANSWER: a 62. Which of the following disadvantages can impair a child’s developmental progress significantly? a. Less education b. Limited resources c. Greater exposure to violence d. All of these are correct ANSWER: d 63. __________ % of homeless families in the United States are headed by women. a. 100 b. 40 c. 88 d. 90 ANSWER: d 64. Until the mid-twentieth century, which mental condition was believed to be caused by inadequate, uncaring parents?

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Chapter 01 a. Bipolar disorder b. Autism c. Depression d. Obsessive compulsive disorder (OCD) ANSWER: b 65. According to surveys conducted in North America, one in eight children has a mental health problem that ___________. a. impairs functioning b. results in poor development c. results in malnutrition d. All of these are correct ANSWER: b 66. Mental health and substance abuse social workers are projected to have the largest shortage of more than __________ counselors nationwide in 2025. a. 50,000 b. 2,000 c. 30,000 d. 10,000 ANSWER: d Subjective Short Answer 67. How has the societal view of children changed throughout history and who were some of the major historical figures responsible for these changes?

ANSWER: Early writings suggest that children were considered servants of the state in the city-states of early Greece.

Ancient Greek and Roman societies believed that any person—young or old—with a physical or mental handicap, disability, or deformity was an economic burden and a social embarrassment, and thus was to be scorned, abandoned, or put to death. Today we recognize children as valuable, independent of any other purpose, to help them develop normal lives and competencies. Some of the major influences were Freud, Watson, and Locke.

68. Compare and contrast various childhood risk factors that increase a child’s vulnerability for developing a psychological disorder.

ANSWER: Children who face many known risk factors, such as community violence and parental divorce, are vulnerable to abnormal development. Acute, stressful situations as well as chronic adversity put children’s successful development at risk. Chronic poverty, serious care-giving deficits, parental mental illness, divorce, homelessness, and racial prejudice are known risk factors that increase children’s vulnerability to psychopathology—especially in the absence of compensatory strengths and resources.

69. In regard to legislation pertaining to children with special needs and education, what is IDEA and what does it mandate?

ANSWER: In the United States, the Individuals with Disabilities Education Act (IDEA; Public Law 104-446) mandates free and appropriate public education for any child with special needs in the least restrictive environment for Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 that child; each child with special needs, regardless of age, must be assessed with culturally appropriate tests; each of these children must have an individualized education program (IEP) tailored to his or her needs, and must be reassessed.

70. What is an IEP and what is its purpose?

ANSWER: An IEP is an individualized education program tailored to his or her needs and must be reassessed.

71. What is the goal of the Treaty that the United Nations General Assembly adopted in 2007 regarding persons with disabilities?

ANSWER: In 2007, the United Nations General Assembly adopted a new convention to protect the rights of persons with disabilities around the world. This convention represents an important shift from addressing the “special needs” of children to realizing their rights and removing the physical, linguistic, social, and cultural barriers that remain. Countries that ratify the convention agree to enact laws and other measures to improve disability rights, and also to abolish legislation, customs, and practices that discriminate against persons with disabilities.

72. What should be considered when diagnosing most child and adolescent psychological disorders?

ANSWER: To judge what is abnormal, we need to be sensitive to each child’s stage of development and consider each child’s unique methods of coping and way of compensating for difficulties.

73. In what ways can low income and/or poverty affect children’s development?

ANSWER: Poverty has a significant, yet indirect, effect on children’s adjustment, most likely because of its association with negative influences—particularly harsh, inconsistent parenting and elevated exposure to acute and chronic stressors—that define the day-to-day experiences of children in poverty.

74. Define the concept of competence. How may competence be assessed?

ANSWER: Definitions of abnormal child behavior must consider the child’s competence—that is, the ability to successfully adapt in the environment. Developmental tasks, which include broad domains of competence such as conduct and academic achievement, tell how children typically progress within each domain as they grow. Knowledge of the developmental tasks provides an important backdrop for considering a child or adolescent’s developmental progress and impairments.

75. Distinguish between the concepts of multifinality and equifinality. Provide an example of each concept.

ANSWER: Multifinality is a concept that proposes that various outcomes may stem from similar beginnings (in this case, child maltreatment). Equifinality is a concept that proposes that similar outcomes stem from different early experiences and developmental pathways.

76. Distinguish between risk and resilience.

ANSWER: A risk factor is a variable that precedes a negative outcome of interest and increases the chances that the outcome will occur. Children who survive risky environments by using their strong self-confidence, coping skills, and abilities to avoid risk situations may be considered resilient—they seem able to fight off or recover from their misfortune.

77. What are some of the key factors affecting rates and expression of mental disorders?

ANSWER: New pressures and social changes may place children at increasing risk for the development of disorders at younger ages (Obradovic et al., 2010). Many stressors today are quite different from those faced by our parents and grandparents. Some have been around for generations: chronic poverty, inequality, family breakup, single parenting, and so on. Others are more recent or are now more visible: homelessness, Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 adjustment problems of children in immigrant families, inadequate child care available to working parents, and conditions associated with the impact of prematurity, parental HIV, and cocaine or alcohol abuse on children’s growth and development.

78. What are some of the findings regarding sex differences in children’s mental health problems?

ANSWER: Hyperactivity, autism, childhood disruptive behavior disorders, and learning and communication disorders are more common in boys than in girls; the opposite is true for most anxiety disorders, adolescent depression, and eating disorders.

79. What child-rearing environment predicts the best resiliency for boys, and which predicts the best for girls?

ANSWER: Resilience in boys is associated with households in which there is a male role model (such as a father, grandfather, or older brother); structure; rules; and some encouragement of emotional expressiveness. In contrast, girls who display resilience come from households that combine risk taking and independence with support from a female caregiver.

80. Discuss the influence of race and ethnicity in the development of psychological disorders.

ANSWER: Children from certain ethnic and racial groups in the United States are overrepresented in rates of some disorders, such as substance abuse, delinquency, and teen suicide (Nguyen et al., 2007). However, once the effects of socioeconomic status (SES), sex, age, and referral status are controlled for (i.e., the unique contributions of these factors are removed or accounted for), few differences in the rate of children’s psychological disorders emerge in relation to race or ethnicity.

81. Discuss the difficulties sexual minority youth experience in society and which mental health disorders they are most at risk for developing.

ANSWER: According to several large surveys of LGBT youths in middle and high schools, they are more likely to be victimized by their peers as well as by family members, and they report more bullying, teasing, harassment, and physical assault than other students. Given the stigma and prejudice that exist in many parts of society, it is not surprising that young people who are LGBT have higher rates of mental health problems, including depression and suicidal behavior, substance abuse, and risky sexual behavior, as compared with their heterosexual counterparts.

82. Compare and contrast the factors that are most associated with the standard of “normal” behavior between adults and children. How are the standards of “normal” differently assessed for children as compared to adults and what are some potential problems with a system that involves an arbitrary standard for determining who is normal versus abnormal?

ANSWER: The current system involves an arbitrary line that determines normal versus abnormal behavior that can lead to problems with labels, stigma, incorrect diagnosis, and ineffective treatments. Adult patterns of abnormal behavior include personal distress, impairment of daily function, and increased risk of harm to self or others.

Childhood abnormal behavior is assessed in terms of developmental pathways, which include reviewing various domains of competency, resiliency, and risk factors that may increase vulnerability. The process for both children and adults involves agreement about particular patterns of behavior, emotional and physical symptoms show by the individual.

83. Do the majority of children with psychological disorders have access to appropriate mental health services? Support your answer with evidence and discuss the long-term implications for this current mental health system.

ANSWER: No, fewer than 10% of children with mental health problems receive appropriate services at the appropriate time. Limited access to appropriate services increases long-term vulnerability and dysfunction.

84. Compare and contrast the psychoanalytic perspective with behaviorism. Discuss the key figures associated with each area of psychology and major theories. Identify the perspective that has contributed the most to current treatments for Copyright Cengage Learning. Powered by Cognero.

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Chapter 01 childhood psychological disorders.

ANSWER: Freud is most associated with psychoanalytic theory, which asserted that behaviors are the result of unresolved, unconscious conflicts. Freud is the first to associate childhood experiences with mental disorders.

Behaviorism includes theories that highlight the influence of the environment on behavior and include classical conditioning. Pavlov, Watson, and Skinner are most associated with this perspective. The development of evidence-based treatments are most associated with behaviorism.

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Chapter 02 Multiple Choice 1. Children’s problems must be considered in the context of their ____. a. individual nature b. family dynamics c. community/culture d. all of these ANSWER: d 2. Victor is fearful of approaching new situations and often appears inhibited. Victor’s mother reports that she struggles with similar difficulties and he may have inherited it from her. This is an example of ____. a. emotional influences b. biological influences c. cognitive influences d. behavioral influences ANSWER: b 3. Etiology refers to the ____ of childhood disorders. a. possible root causes b. possible treatments c. various correlations d. various preventions ANSWER: a 4. What is an underlying assumption with regard to abnormal child behavior? a. Abnormal development is solely determined by the child’s genetic makeup. b. Abnormal development is solely determined by the child’s environment. c. Abnormal development involves continuities and discontinuities. d. Abnormal development focuses on extreme or bizarre behavior.

ANSWER: c 5. Isabella is 3 years old, and frequently demands attention, overreacts, and refuses to go to bed. These behaviors are considered ____. a. typical because of her age b. diagnosable as a clinical disorder c. signs of an overly sensitive child d. early warning signs of future difficulties ANSWER: a 6. Brett is an aggressive preschooler, who often bites other children and throws toys at his teacher. When Brett finished 3rd grade, he was asked to find another school to attend since he had repeatedly hit his classmates and kicked the principal. Brett’s behavioral patterns are an example of Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 a. abnormal behavior that follows a discontinuities pattern. b. abnormal behavior that follows a continuity pattern. c. normal age appropriate development. d. sociopathic behavior that is rare in young children.

ANSWER: b 7. When developmental psychopathologists view adaptive and maladaptive behaviors as the result of previous interactions and experiences spread over several years, they refer to the process as a. typical development. b. environmental determinants. c. developmental cascades. d. developmental theoretics.

ANSWER: c 8. An integrative approach to the psychopathology of a child means that a. maladaptive behaviors are acceptable. b. all development takes place on a continuum. c. more than one therapist has to see the child. d. many theories and concepts can be used to explain behavior.

ANSWER: d 9. Most often, adaptational failure is due to a(n) ____. a. single, definable cause b. longstanding biological maladaptation c. ongoing interaction between the individual and environment d. sudden onset of an environmental challenge ANSWER: c 10. A toddler learning to make sounds such as “mememe” and “bagabaga” before learning how to use intelligible language indicates a structure and process to development, otherwise known as the a. organization of development. b. hierarchy of development. c. biological perspective. d. integrative perspective.

ANSWER: c 11. The windows of time during which environmental influences on development are enhanced are called ____. a. sensitive periods b. critical periods c. crucial periods d. necessary periods Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 ANSWER: a 12. ____, The brain develops and grows over a lifetime, but from birth to 11 years, the most dramatic changes occur. Problems or disruptions that occur when a child is young can lead to a. disorganized development. b. organic disorders. c. hierarchical development. d. broken synapses.

ANSWER: b 13. Children’s development occurs in a(n) ____ manner. a. mostly random b. strictly organized c. strictly hierarchical d. organized and hierarchical ANSWER: d 14. The developmental psychopathology approach to studying childhood disorders emphasizes the importance of developmental____. a. disruptions b. processes and tasks c. regressions d. obstacles ANSWER: b 15. The two terms that are used to explain how a child’s interaction with his/her environment can lead to the development of maladaptive behaviors are a. organized and interactive b. interactive and proactive c. transaction and interdependent d. transaction and transition ANSWER: d 16. The role that a child’s primary caretaker has in terms of that child’s brain development is crucial, since those early experiences form the part of the brain that is responsible for their__. a. planning and complex processes b. Problem-solving skills c. emotion, personality, and behavior d. Fine and gross motor skills ANSWER: c 17. Brain maturity occurs in a(n) ____ fashion.

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Chapter 02 a. mostly random b. strictly organized c. strictly hierarchical d. organized and hierarchical ANSWER: d 18. Which statement about neural development is false? a. Most developing axons reach their destination even before a baby is born. b. Synapses both proliferate and disappear in early childhood. c. Brain connections are relatively predetermined and cannot be changed by the environment. d. Primitive areas of the brain develop first.

ANSWER: c 19. Which statement about neural development is true? a. Major restructuring of the brain in relation to puberty occurs between 6 and 9 years of age. b. The brain stops developing after 3 years of age. c. Primitive areas of the brain mature last. d. The prefrontal cortex and the cerebellum are not wired until a person is 5 to 7 years old.

ANSWER: d 20. Which statement about our genetic makeup is false? a. Genes determine behavior. b. Genes are composed of DNA. c. Genes produce proteins. d. The expression of genes is influenced by the environment.

ANSWER: a 21. The problem with family aggregation studies is that they ____. a. are difficult to carry out b. do not control for environmental variables c. only tell us about the influence of the environment d. only tell us about chromosomal abnormalities ANSWER: b 22. Molecular geneticists focus on finding a specific gene for childhood disorder, while behavioral geneticists ____. a. study the possible connection between genetic predisposition and behavior b. study the possible connection between genes and education c. focus on brain development between 3 and 5 years d. focus on neural synapsis developing until age 11 ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 23. Which part of the brain is most responsible for regulating our emotional experiences, expressions, and impulses? a. Hypothalamus b. Hindbrain c. Basal ganglia d. Limbic system ANSWER: d 24. Epinephrine is also known as ____. a. dopamine b. serotonin c. cortisol d. adrenaline ANSWER: d 25. Which part of the brain is implicated in disorders affecting motor behavior? a. Hypothalamus b. Hindbrain c. Basal ganglia d. Limbic system ANSWER: c 26. The ____ gives us the distinct qualities that make us human and allows us to think about the future, to be playful, and to be creative. a. cerebral cortex b. limbic system c. brainstem d. hippocampus ANSWER: a 27. The _________ lobes contain the functions underlying much of our thinking and reasoning abilities. a. temporal b. frontal c. parietal d. occipital ANSWER: b 28. The ____ gland produces epinephrine in response to stress. a. hypothalamus b. thyroid Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 c. adrenal d. pituitary ANSWER: c 29. Mike is having a very difficult time in school. Which gland would produce epinephrine in response to the stress he is experiencing? a. Hypothalamus b. Cortisol c. Adrenal d. Tegmentum ANSWER: b 30. Cindy has recently been diagnosed with anorexia. From a biological perspective, which neurotransmitter plays a role in eating disorders? a. GABA b. Serotonin c. Dopamine d. Pituitary ANSWER: b 31. The ____ gland oversees the body’s regulatory functions by producing several hormones, including estrogen and testosterone. a. pineal b. pituitary c. thyroid d. adrenal ANSWER: b 32. ____ has been implicated in several psychological disorders, especially those connected to a person’s response to stress and ability to regulate emotions. a. The HPA axis b. BZ-GABA c. Norepinephrine d. Dopamine ANSWER: a 33. What is an inhibitory neurotransmitter that reduces overall arousal and levels of anger, hostility, and aggression? a. Serotonin b. Benzodiazepine-GABA c. Norepinephrine Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 d. Dopamine ANSWER: b 34. ____ acts like a “switch” in the brain, turning on various circuits associated with certain types of behavior. a. Serotonin b. Benzodiazepine-GABA c. Norepinephrine d. Dopamine ANSWER: d 35. The neurotransmitter implicated in regulatory problems, such as eating and sleep disorders, is ____. a. norepinephrine b. serotonin c. benzodiazepine-GABA d. dopamine ANSWER: b 36. The child-caregiver role helps children explore their own emotions. Which style of parenting allows for the healthiest development of the child? a. Restrictive b. Demanding c. Emotional d. Authoritative ANSWER: d 37. ACTH causes the adrenal glands to release ____. a. benzodiazepine-GABA b. cortisol c. serotonin d. dopamine ANSWER: b 38. James often appears to be in a bad mood and he is easily frustrated when given challenging tasks. His temperament would be described as ____. a. angry and intense b. negative affect or irritability c. fearful or inhibited d. positive affect and approach ANSWER: b 39. Kim had been physically abused when she was 5, and is now a 10-year-old showing signs of “numbing,” Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 which is an emotional dysregulation. In Kim’s situation, is her behavior a. completely maladaptive and in need of change? b. adaptive and protective? c. maladaptive and will lead to a personality disorder? d. adaptive and should not be changed?

ANSWER: b 40. A child who cannot control his temper has problems in emotion ____. a. sensitivity b. reactivity c. regulation d. deregulation ANSWER: c 41. _______ relates to how children think about themselves and others, resulting in mental representations of themselves, relationships, and their social world. a. Social cognition b. Observational learning c. Cognitive mediation d. Cognitive development ANSWER: a 42. Individual differences in emotion ____ account for differing responses to a stressful environment. a. affectivity b. sensitivity c. reactivity d. regulation ANSWER: c 43. ____ problems refer to weak or absent control structures, whereas ____ problems indicate that existing control structures operative in a maladaptive way. a. Regulation; dysregulation b. Dysregulation; regulation c. Reactivity; regulation d. Regulation; reactivity ANSWER: a 44. Temperament ____. a. refers to a child’s unpredictable behavior b. shapes a child’s approach to the environment and vice versa c. is not related to personality Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 d. forms very late in development ANSWER: b 45. Brendan is considered by his caregivers as a “slow-to-warm-up child,” who is cautious in approaching novel or challenging situations. Which of the following would describe Brendan’s temperament? a. Positive affect and approach b. Fearful or inhibited c. Negative affect or irritability d. Adaptive with negative mood ANSWER: b 46. Sharon is a psychologist who is using the ABA method with her client Katie, a difficult 6-year-old. As an ABA therapist, Sharon would focus on a. behavior only. b. antecedents and consequences only. c. behavior and consequences only. d. behavior, antecedents, and consequences.

ANSWER: d 47. ____ explain the acquisition of problem behavior on the basis of paired associations between previously neutral stimuli (e.g., homework), and unconditioned stimuli (e.g., parental anger). a. Operant models b. Classical conditioning models c. Social learning models d. Social cognition models ANSWER: b 48. ____ theorists emphasize attributional biases, modeling, and cognitions in their explanation of abnormal behavior. a. Behavior b. Psychodynamic c. Social learning d. Biological ANSWER: c 49. ____ models portray the child’s environment as a series of nested and interconnected structures. a. Environmental b. Ecological c. Societal d. Macroparadigm ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 50. John Bowlby’s research on attachment showed that a child who has a secure attachment with a caregiver generally leads to a. atypical development. b. extra neurotransmitters being released. c. the development of a child’s positive internal working model. d. an unknown outcome, since that attachment is broken after 12 months of age.

ANSWER: c 51. Attachment theory considers crying (in an infant) to be a behavior that ____. a. serves to keep predators away b. stimulates the immune system c. irritates others d. enhances relationships with the caregiver ANSWER: d 52. According to Bronfenberger’s ecological model of environmental influences, which influence plays a role in the child’s life? a. Church or synagogue b. Neighborhood play areas c. Mass media d. All of the above ANSWER: d 53. The process of attachment typically begins between ____ of age. a. 0 to 2 months b. 6 to 12 months c. 12 to 18 months d. 18 to 24 months ANSWER: b 54. Infants that explore the environment with little affective interaction with the caregiver are likely to have a(n) ____ attachment pattern. a. secure b. anxious-avoidant c. anxious-resistant d. disorganized ANSWER: b 55. Jace is a baby that often seems nervous in new situations and around new people and is not easily comforted by his mother in these situations. Jace most likely has which attachment pattern? a. Secure Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 b. Anxious-avoidant c. Anxious-resistant d. Disorganized ANSWER: c 56. Luca has been showing aggressive behavior with his peers and has difficulty conducting himself in a normal fashion, and is constantly getting in trouble at school. According to attachment theories, which type of attachment pattern did Luca most likely exhibit as a child? a. Secure b. Anxious-avoidant c. Anxious-resistant d. Disorganized ANSWER: b 57. Which attachment pattern has been linked to phobias and anxiety problems? a. Secure b. Anxious-avoidant c. Anxious-resistant d. Disorganized ANSWER: c 58. Which term describes a child’s model of relationships in terms of what the child expects from others and how the child relates to others? a. Internal working model b. External working model c. Internal attachment model d. External attachment model ANSWER: a 59. _____ theorists argue that a child’s behavior can only be understood in terms of relationships with others. a. Cognitive b. Behavioral c. Family systems d. Genetic ANSWER: c 60. The _____ view of child development recognizes the importance of balancing the abilities of individuals with the challenges and risks of their environments. a. health promotion b. family systems c. attachment Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 d. psychopathological ANSWER: a Subjective Short Answer 61. Discuss the three major underlying assumptions regarding abnormal child behavior.

ANSWER: The first underlying assumption is that abnormal child behavior is multiply determined. Thus, we have to

look beyond the child’s current symptoms and consider developmental pathways and interacting events that, over time, contribute to the expression of a particular disorder. The second assumption extends the influence of multiple causes by stressing how the child and environment are interdependent—how they influence each other. This concept departs from the tradition of viewing the environment as acting on the child to cause changes in development, and instead argues that children also influence their own environment. In simple terms, the concept of interdependence appreciates how nature and nurture work together and are, in fact, interconnected. Few psychological disorders or impairments suddenly emerge without at least some warning signs or connections to earlier developmental issues. This connection is apparent, for example, in early-onset and persistent conduct disorders, with which parents and other adults often see troublesome behaviors at a young age that continue in some form into adolescence and adulthood.

62. Distinguish between continuous and discontinuous patterns of behavior development. Which category would an eating disorder fall? Which category would persistent conduct disorders fall?

ANSWER: Continuity implies that developmental changes are gradual and quantitative (i.e., expressed as amounts that can be measured numerically, such as weight and height changes) and that future behavior patterns can be predicted from earlier patterns. Discontinuity, in contrast, implies that developmental changes are abrupt and qualitative (i.e., expressed as qualities that cannot be measured numerically, such as changes in mood or expression) and that future behavior is poorly predicted by earlier patterns.An eating disorder is discontinuous. Persistent conduct disorder is continuous

63. What is meant by using an integrative approach to understanding factors that influence a child’s behavior?

ANSWER: Because no single theoretical orientation can explain various behaviors or disorders, we must be familiar with many theories and conceptual models—each contributes important insights into normal and abnormal development.

64. Most children follow a predictable pattern of development in terms of walking, talking, learning, and so on.

Additionally most clinical disorders commonly appear at predictable points in development. For the following ages, list two common clinical disorders: 0–2, 2–5, and 6–11.

ANSWER: 0–2: mental retardation and autism; 2–5: speech and language disorders, anxiety, and problems stemming from child abuse and neglect; 6–11: ADHD and learning disorders.

65. How can a baby with a difficult temperament influence and be influenced by the environment?

ANSWER: This dimension describes the “difficult child,” who is predominantly negative or intense in mood, not very adaptable, and arrhythmic. Some children with this temperament show distress when faced with novel or challenging situations, and others are prone to general distress or irritability, including when limitations are placed on them.

66. Discuss how children learn from their emotions and the emotional expression of others.

ANSWER: Children have a natural tendency to attend to emotional cues from others, which helps them learn to interpret and regulate their own emotions. They learn, from a very young age, through the emotional expressions of others.

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Chapter 02 67. How permanent are early neuronal connections?

ANSWER: This question has provoked different theories and agonized many parents who are concerned about their

children’s early development. For instance, if early brain functions are unlikely to change, this implies that early experiences set the course for lifetime development. Freud’s similar contention implied that an individual’s core personality is formed from an early age, which sets the pace and boundaries for further personality formation.

68. Discuss the major functions of four major neurotransmitters in the brain and their implicated role in psychopathology.

ANSWER: Benzodiazepine-GABA reduces arousal and moderates emotional responses, such as anger and hostility; it is implicated in anxiety disorder. Dopamine may act as a switch that turns on various brain circuits, allowing other neurotransmitters to inhibit or facilitate emotions or behavior and is implicated in schizophrenia, mood disorders, and attention-deficit/hyperactivity disorder. Norepinephrine facilitates or controls emergency reactions and alarm responses; it plays a role in emotional and behavioral regulation, but is not directly implicated with any specific disorder. Serotonin plays a role in information and motor coordination, and is implicated in regulatory problems, obsessive-compulsive disorder, schizophrenia, and mood disorders.

69. Caspi (2003) conducted a study that connected early temperament style in children, and their personality traits as adults. Is this study practically helpful in terms of what we can do, if anything, to prevent a difficult child with self-control issues from being a difficult adult with self-control issues?

ANSWER: Yes.

70. Distinguish between emotion reactivity and emotion regulation.

ANSWER: Emotion reactivity refers to individual differences in the threshold and intensity of emotional experience, which provide clues to an individual’s level of distress and sensitivity to the environment. Emotion regulation, on the other hand, involves enhancing, maintaining, or inhibiting emotional arousal, which is usually done for a specific purpose or goal.

71. Briefly describe the three primary dimensions of temperament.

ANSWER: Positive affect and approach. This dimension describes the “easy child,” who is generally approachable and adaptive to his or her environment and possesses the ability to regulate basic functions of eating, sleeping, and elimination relatively smoothly.

Fearful or inhibited. This dimension describes the “slow-to-warm-up child,” who is cautious in his or her approach to novel or challenging situations. Such children are more variable in self-regulation and adaptability and may show distress or negativity toward some situations. Negative affect or irritability. This dimension describes the “difficult child,” who is predominantly negative or intense in mood, not very adaptable, and arrhythmic. Some children with this temperament show distress when faced with novel or challenging situations, and others are prone to general distress or irritability, including when limitations are placed on them.

72. Provide everyday examples of positive and negative reinforcement, extinction, and punishment.

ANSWER: An example of positive reinforcement would be a mother giving a child a special treat if the child behaved in the store. Negative reinforcement would occur when you get in your car and buckle your seatbelt in order to stop the beeping noise. If I got sick on a certain food and was then conditioned to avoid it because it caused nausea, extinction would occur when I no longer pair the sickness with the food and can eat it again. Positive punishment is an active process—doing something to someone like assigning extra chores.

73. Explain why an integrative approach is important in abnormal psychology.

ANSWER: Each model is restricted in its ability to explain abnormal behavior to the extent that it fails to incorporate important components of other models. Fortunately, such disciplinary boundaries are gradually diminishing Copyright Cengage Learning. Powered by Cognero.

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Chapter 02 as different perspectives take into account important variables derived from other models. Over time, major theories of abnormal child psychology have become compatible with one another. Rather than offering contradictory views, each theory contributes one or more pieces of the puzzle of atypical development. As all the available pieces are assembled, the picture of a particular child or adolescent disorder becomes more and more distinct.

74. Discuss the main principles of a developmental psychopathology perspective.

ANSWER: Developmental psychopathology is an approach to describing and studying disorders of childhood, adolescence, and beyond in a manner that emphasizes the importance of developmental processes and tasks.

This approach provides a useful framework for organizing the study of abnormal child psychology around milestones and sequences in physical, cognitive, social–emotional, and educational development. It also uses abnormal development to inform normal development, and vice versa (Cicchetti, 2006; Hinshaw, 2013).

Simply stated, developmental psychopathology emphasizes the role of developmental processes, the importance of context, and the influence of multiple and interacting events in shaping adaptive and maladaptive development. We adopt this perspective as an organizing framework to describe the dynamic, multidimensional process leading to normal or abnormal outcomes in development.

75. Why do family systems theorists stress the importance of looking at the whole family as opposed to one individual’s difficulties?

ANSWER: This view is in line with our earlier discussion of underlying assumptions about children’s abnormal development—relationships, not individual children or teens, are often the crucial focus.

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Chapter 03 Multiple Choice 1. Skepticism exists regarding research in abnormal child psychology because _____. a. experts on childhood disorders frequently disagree b. research findings in abnormal child psychology have no clear results c. many conclusions from research with children produce the same findings d. research findings are primarily extrapolated from adult studies ANSWER: a 2. The ______ of research findings is what advances the field of psychology. a. reliability b. standardization c. accumulation d. validity ANSWER: c 3. When evaluating whether claims are scientifically believable, each of the following is a difference between science and pseudoscience EXCEPT a. the quality of evidence. b. how evidence is organized. c. how evidence is obtained. d. how evidence is presented.

ANSWER: b 4. In research terms, research questions about behavior that follow from a theory are called ____. a. speculations b. hypotheses c. assumptions d. proposals ANSWER: b 5. Because there is no one correct approach to research, most problems in abnormal child psychology are best studied by ____. a. utilizing rigorous experiments b. using case studies c. using only one strategy d. using multiple methods and strategies ANSWER: d 6. Evaluating the mental health of children can be particularly difficult due to the ____. a. cultural variations of what constitutes abnormal behavior Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 b. difference in psychological theories c. limited amount of assessment tools available for children d. vague information often given by children ANSWER: a 7. Factors such as SES, child’s age, and cultural background affect the _____ of symptoms and disorders. a. rate and expression b. pervasiveness c. outcome d. termination ANSWER: a 8. Questions about the nature and distribution of childhood disorders are frequently addressed through ____. a. epidemiological research b. regression analysis c. correlation studies d. efficacy studies ANSWER: a 9. The fact that effects of parental conflict and divorce may not surface immediately but rather years later is an example of ____. a. mediating variable b. sleeper effect c. correlate d. risk factor ANSWER: b 10. ______ rates refer to the extent to which new cases of a disorder appear over a specified time period. a. Comorbidity b. Comortality c. Incidence d. Prevalence ANSWER: c 11. _____ rates refer to all cases of a disorder, whether new or previously existing, that are observed during a specified time period. a. Comorbidity b. Comortality c. Incidence d. Prevalence ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 12. Variables that are associated at a particular point in time with no clear proof that one precedes the other are said to be ____. a. predictive b. moderating c. correlated d. comorbid ANSWER: c 13. A variable that precedes an outcome of interest and increases the chances that the negative outcome will occur is a(n) ____. a. risk factor b. protective factor c. predictive factor d. epidemiological factor ANSWER: a 14. Mediator variables are those that ____. a. predict the relationship among variables b. have an independent effect on the existing relationship among variables c. influence the direction or strength of the relationship between variables d. refer to the process through which a variable produces an outcome ANSWER: d 15. Research into risk and protective factors requires that large samples of children be studied and multiple areas of functioning be assessed over long periods of time because ____. a. the areas of child functioning that will be affected are known in advance b. a high percentage of children who are at risk will develop the disorder c. the ages at which a disorder may occur or reoccur is not known in advance d. the risk and protective factor processes take years to develop ANSWER: d 16. ____ evaluate treatment outcomes for children who are unsystematically assigned to treatment and control conditions. a. Efficacy studies b. Case studies c. Randomized controlled trials d. Correlational studies ANSWER: c 17. Factors that influence the direction or strength of a relationship of variables of interest are called ____. a. correlated variables Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 b. mediator variables c. risk variables d. moderator variables ANSWER: d 18. If a study of the effect of divorce found a more negative impact for girls than for boys, sex will be a ____. a. protective factor b. risk factor c. mediating variable d. moderating variable ANSWER: d 19. The process, mechanism, or means through which a variable produces a particular outcome is known as a(n) ____ variable. a. comorbid b. correlated c. mediating d. moderating ANSWER: c 20. Questions about ________ are complicated because what qualifies varies according to the variables of interest as well as the causal chain. a. effects b. correlates c. risks d. causes ANSWER: d 21. A researcher investigating the relationship between maternal distress and child conduct problems found that maternal distress was related to disciplinary strategies toward the child, which in turn were related to child conduct problems. In this study, disciplinary strategies are a ____. a. comorbid variable b. correlated variable c. mediator variable d. moderator variable ANSWER: c 22. Treatment ____ refers to whether or not a treatment can produce changes under well-controlled conditions. a. efficacy b. effectiveness c. reliability Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 d. validity ANSWER: a 23. To know if a treatment would truly be useful in community settings, researchers should focus on treatment ____. a. efficacy b. effectiveness c. reliability d. validity ANSWER: b 24. Taking a child to see three different psychologists and receiving three different diagnoses would be an example of a lack of ____. a. convergent validity b. discriminant validity c. internal consistency d. interrater reliability ANSWER: d 25. A ____ assessment measure allows for the scores of one child to be compared to the scores of other similar children. a. reliable b. valid c. standardized d. distributed ANSWER: c 26. Emily’s mother was asked to complete a behavior checklist on two separate occasions several weeks apart.

The results yielded from both occasions were very similar. The behavior checklist can be said to be a. reliable. b. valid. c. standardized. d. effective.

ANSWER: a 27. An assessment tool that actually measures the construct it is intended to measure can be considered ____. a. reliable b. valid c. standardized d. effective ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 28. ____ validity refers to whether scores on a measure behave as predicted by theory or past research. a. Face b. Convergent c. Construct d. Discriminant ANSWER: c 29. ____ validity refers to the degree of correlation between measures that are expected to be related to one another. a. Convergent b. Construct c. Criterion d. Discriminant ANSWER: a 30. A measurement method that is highly structured with no opportunity for probes or clarification would be which of the following? a. Clinical observation b. Interview c. Questionnaire d. Observation ANSWER: c 31. ____ validity refers to the degree of correlation between measures that are not expected to be related to one another. a. Convergent b. Construct c. Criterion d. Discriminant ANSWER: d 32. A limitation of psychophysiological measures is ____. a. deception by the child b. poor interrater reliability c. high level of inference for interpretation d. inappropriateness with young children ANSWER: c 33. To record electrical activity of the brain, one would want to use a(n) ____. a. EEG b. PET scan Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 c. CT scan d. MRI ANSWER: a 34. ____ use radio signals generated in a strong magnetic field. a. EEGs b. PET scans c. CT scans d. MRIs ANSWER: d 35. ____ are used to study cerebral glucose metabolism. a. PET scans b. EEGs c. CT scans d. MRIs ANSWER: a 36. Which of the following is a magnetic imaging method that produces images showing connections between brain regions? a. Positron-Emission Tomography (PET) b. Functional connectivity MRI c. Functional MRI d. Diffusion MRI ANSWER: d 37. One of the major limitations of observational research methods is that ____. a. they are not cost effective b. behavior may be altered as a function of participants’ awareness of being observed c. results tend to be invalid d. observation cannot be conducted in a structured way ANSWER: b 38. Maturation is a threat to ____. a. external validity b. internal validity c. convergent validity d. interrater reliability ANSWER: b 39. The degree to which findings can be generalized to children, settings, times, measures, and characteristics Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 other than the one in a particular study is referred to as ____. a. external validity b. internal validity c. face validity d. generalized validity ANSWER: a 40. The overlapping or co-occurrence of disorders is called ____. a. multifinality b. comortality c. multidiagnosis d. comorbidity ANSWER: d 41. The use of ____ is rare in studies of child psychopathology. a. randomly selected samples b. samples of convenience c. reliable measures d. valid measures ANSWER: a 42. The greater the degree of control that a researcher has over the ____, the more a study approximates a true experiment. a. subjects in the sample b. moderator variables c. independent variable d. dependent variable ANSWER: c 43. A correlation score of +0.75 between two variables such as symptoms of anxiety and symptoms of depression indicates what kind of relationship between these variables? a. A weak, negative association between them b. A weak, positive association between them c. A strong, positive association between them d. A strong, negative relationship between them ANSWER: c 44. ____ increases the chance that characteristics other than the independent variable will be equally distributed across treatment groups. a. Manual distribution b. Predetermined distribution Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 c. Natural assignment d. Random assignment ANSWER: d 45. Asking college students to describe their childhood relationships with peers is an example of a ____ design. a. longitudinal b. cohort c. prospective d. retrospective ANSWER: d 46. Recall bias and distortion are potential limitations of ____ studies. a. analogue b. case c. retrospective d. cohort ANSWER: c 47. ____ research focuses on a specific research question under conditions that only resemble or approximate the situation to which the researcher wishes to generalize. a. Cohort b. Retrospective c. Circumscribed d. Analogue ANSWER: d 48. In ___________________, comparisons are made between conditions or treatments that already exist. a. natural experiments b. correlational studies c. retrospective design d. real-time prospective designs ANSWER: a 49. Which statement about case studies is false? a. They involve intensive observation and analysis of an individual child. b. They use controlled methods without biases. c. They are rich in detail and provide valuable insights. d. They usually study rare childhood disorders.

ANSWER: b 50. Qualitative research ____.

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Chapter 03 a. provides a numerical approach to understanding research b. provides an intensive and intimate understanding of a situation c. uses normed assessment tools d. uses statistical analysis ANSWER: b 51. In an A-B-A-B design, the “B” stands for ____. a. intervention b. baseline c. behavior d. observation ANSWER: a 52. In ____ research, the same individuals are studied at different ages/stages of development. a. cross-sectional b. longitudinal c. between groups d. cohort ANSWER: b 53. In ____ research, different individuals at different ages or stages of development are studied at the same point in time. a. analogue b. within group c. cross-sectional d. between group ANSWER: c 54. Aging effects and cohort effects are some of the potential disadvantages of ____ research designs. a. longitudinal b. cross-sectional c. experimental d. between group ANSWER: a 55. Qualitative research is characterized by ____. a. operational definitions b. isolation of variables of interest c. careful control of subject matter d. in-depth narratives and observations ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 56. Qualitative data are typically collected by ____. a. open-ended interviewing and observations b. already developed observational and assessment tools c. controlled and structured interviewing d. forced choice survey questions ANSWER: a 57. _____ means that the child shows some form of agreement to participate in research without necessarily understanding the full significance of the research. a. Uninformed consent b. Partial consent c. Assent d. Voluntary participation ANSWER: c 58. The fact that vulnerable populations often feel pressure to participate in research studies is a factor relating to which ethical concern? a. Informed consent and assent b. Nonharmful procedures c. Confidentiality and anonymity d. Voluntary participation ANSWER: d 59. Research procedures that may harm a child physically or psychologically should ____. a. only be used when necessary b. only be used when a parent gives consent c. never be used d. only be used when the researcher is very careful ANSWER: c 60. Participation in research is done through direct informed consent except when the participants are ____. a. children b. adult women c. war veterans d. college students ANSWER: a Subjective Short Answer 61. Explain the importance of using scientific research methods and strategies in abnormal child psychology.

ANSWER: Relationships between variables may not be as straightforward as they seem. Complex interactions and Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 combinations of variables can significantly influence what seems to be a simple cause-and-effect relationship.

Parents and professionals may interpret and relate information according to their own beliefs, biases, and preconceived notions, which may influence their interpretations of facts.

62. When would qualitative research be preferred over quantitative research?

ANSWER: Proponents of qualitative research believe that it provides an intensive and intimate understanding of a situation that is rarely achieved in quantitative research (Denzin & Lincoln, 2011). Qualitative methods, such as the use of examples or stories, may be particularly engaging to children and enable the discussion of sensitive topics, while allowing the children a sense of control over the research situation.

63. Why is it difficult to use true experimentation to study child psychopathology?

ANSWER: Most variables of interest in child psychopathology cannot be manipulated directly, including the nature or

severity of the child’s disorder, parenting practices, or genetic influences. As a result, much of the research conducted on children with problems and their families relies on nonexperimental, correlational approaches.

64. Distinguish between interviews, questionnaires, and observations as measurement methods.

ANSWER: Questionnaires are highly structured, whereas interviews and observations can vary from structured to more loosely structured situations and responses. However, questionnaires require significantly less time and other resources for administration compared to observations and interviews. Sources of bias with interviews and questionnaires rests with participants, but with researchers almost exclusively in observational studies.

Finally, data reduction methods require significant and complex systems of analysis for both interviews and observations, but can be more standardized for questionnaires.

65. Why is it important for research to be both reliable and valid?

ANSWER: Results need to be consistent in order to determine that they are genuine from one trial to the next, and valid to ensure that they are measuring what they are supposed to be measuring.

66. Distinguish between prospective and retrospective research.

ANSWER: In a retrospective design, individuals who have shown a particular outcome of interest are identified.

Assessments focus on characteristics in the past. While data are immediately available, these data are highly susceptible to bias and distortion in recall. In real-time prospective designs, the research sample is identified and then followed over time, with data collection occurring at specific intervals. The benefit of prospective designs is that problems relating to bias and distortion are minimized as data are collected in real time and are not subject to the recall biases of observers. The disadvantage of prospective designs include the loss of participants over time due to maturation and other considerations, as well as the lengthy time required to collect data.

67. Describe a study in which you would use a qualitative approach. Be sure to indicate why it would be beneficial to use a qualitative approach in your study.

ANSWER: A study that looked at victims of child sexual abuse would benefit from qualitative study. Qualitative methods, such as the use of examples or stories, may be particularly engaging to children and enable the discussion of sensitive topics, while allowing the children a sense of control over the research situation.

68. What ethical and pragmatic issues must be considered when conducting research with children?

ANSWER: Although researchers are obligated to use nonharmful procedures, exposing the child to mildly stressful conditions such as a brief separation from their parent or exposure to an anxiety-producing stimulus may be necessary in some instances if benefits associated with the research are to be realized. Children are more vulnerable than adults to physical and psychological harm, and their immaturity may make it difficult or impossible for them to evaluate exactly what research participation means. In view of these realities, Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 precautions must be taken to protect children’s rights during the course of a study.

69. Describe two neuroimaging techniques used to examine the brain.

ANSWER: Two types of functional imaging procedures are functional magnetic resonance imaging (fMRI) and positronemission tomography (PET). fMRI is a form of MRI that registers neural activity in functioning areas of the brain. By doing so, it can show which brain areas are active during particular mental operations, such as solving a specific type of problem or reacting to a fear-inducing stimulus.

70. Explain the benefits and limitations of the case study. Why is the case study important in abnormal child psychology?

ANSWER: Case studies yield narratives that are rich in detail and provide valuable insights into factors associated with a

child’s disorder. Nevertheless, they also have drawbacks. They are typically viewed as unscientific and flawed because they are characterized by uncontrolled methods and selective biases, by inherent difficulties associated with integrating diverse observations and drawing valid inferences among the variables of interest, and by generalizations from the particular child of interest to other children. Hence, case studies have been viewed primarily as rich sources of descriptive information that provide a basis for subsequent testing of hypotheses in research using larger samples and more controlled methods. They may also provide a source for developing and trying out new treatment methods. Despite their unscientific nature, there are compelling reasons why systematically conducted case studies are likely to continue to play a useful role in research on childhood disorders. First, some childhood disorders, such as childhood-onset schizophrenia, are rare, making it difficult to generate large samples of children for research. Second, the analyses of individual cases may contribute to the understanding of many striking symptoms of childhood disorders that either occur infrequently or are hidden and therefore difficult to observe directly. Third, significant childhood disturbances such as post-traumatic stress disorder (see Chapter 12) often develop as the result of a natural disaster, severe trauma, or abuse. These extreme events and circumstances are not easily studied using controlled methods.

71. Describe the limitations of longitudinal studies.

ANSWER: Practical concerns include obtaining and maintaining research funding and resources over many years and the long wait for meaningful data. Design difficulties relate to aging effects and cohort effects. Aging effects are general changes that occur because as participants age there are increases in physical prowess, impulse control, or social opportunity. Cohort effects are influences related to being a member of a specific cohort—a group of individuals who are followed during the same time and experience the same cultural or historical events.

72. How can qualitative and quantitative research methods be used in complementary ways?

ANSWER: Qualitative methods can be used to identify important dimensions and theories that can then be tested quantitatively. Alternatively, qualitative case studies may be used to illuminate the meaning of quantitatively derived findings (Guerra et al., 2011). In addition, if qualitative data have been reduced to numbers through word counts or frequency counts of themes, the data can be analyzed using quantitative methods.

73. What are the primary differences between pseudoscience and science?

ANSWER: The differences between scientific and pseudoscientific claims are not simply whether or not they are based on evidence (Finn, Bothe, & Bramlett, 2005). As we discuss later in this chapter, it is the quality of the evidence, how it was obtained, and how it is presented that are crucial in evaluating whether claims are scientifically believable. Scientists are certainly capable of making incorrect claims. What distinguishes them from pseudoscientists is that they play by the rules of science, are prepared to admit when they are wrong, and are open to change based on new evidence.

74. Discuss how cultural differences can impact data collection and research outcomes for childhood disorders.

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Chapter 03 ANSWER: The rate and expression of childhood symptoms and disorders often vary in relation to demographic and situational factors, such as socioeconomic status (SES) (e.g., the social, economic, and physical environment in which the child lives as reflected in measures such as family income, education, or occupation); parents’ marital status; and the child’s age, gender, and cultural background, to name but a few. Consequently, these variables must be assessed and controlled in most studies.

75. Why is it important to use randomized controlled trials in research?

ANSWER: By assigning participants to groups on the basis of the flip of a coin, numbers drawn from a hat, or a table of random numbers, the chance is increased that characteristics other than the independent variable will be equally distributed across treatment groups.

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Chapter 04 Multiple Choice 1. The relationship between assessment and intervention is best viewed as ____. a. separate and unrelated b. related and ongoing c. related but separate d. related but time-limited ANSWER: b 2. All of these are examples of parent- and teacher-rated problems that best discriminate between referred and nonreferred children EXCEPT: . a. unhappy, sad, or depressed b. withdrawn c. impulsive d. stubborn ANSWER: b 3. This describes a process of gathering information that is used to understand the nature of an individual’s problem, its possible causes, treatment options, and outcomes. a. Problem-solving analysis b. Clinical description c. Taxonomic diagnosis d. Prognostic diagnosis ANSWER: a 4. Which factor has the least bearing on a clinician’s approach to assessment, diagnosis, and treatment? a. Age b. Gender c. Culture d. Popularity ANSWER: d 5. A child’s ____ has the most implications for judgments about deviancy and for selecting appropriate assessment and treatment methods. a. peer group b. family history c. age d. academic achievement ANSWER: c 6. Analyzing information and drawing conclusions about the nature or cause of a problem refers to ____. a. a clinical description Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 b. diagnosis c. prognosis d. treatment planning, and evaluation ANSWER: b 7. Which psychological condition is more common among females than males? a. Intellectual disability b. Autistic disorder c. Conduct disorder d. Adolescent depression ANSWER: d 8. Which condition is equally common among males and females? a. Childhood depression b. Eating disorders c. Enuresis d. Attention deficit hyperactivity disorder ANSWER: a 9. The over-representation of boys with psychological disorders likely reflects ____. a. functional deficits in the male brain b. media influence c. referral biases d. different socialization practices for males and females ANSWER: c 10. When working with children and families, cultural information is most needed to ____. a. establish a relationship with the child and family b. keep traditional practice in place c. report statistics for census d. determine whether or not to use medication ANSWER: a 11. What variables can impact scores on measures of psychopathology? a. SES and acculturation b. Educational level c. Previous attendance in therapy d. Ability to remain focused ANSWER: a 12. Culturally competent mental health services include ____.

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Chapter 04 a. matching families with clinicians who have a master’s degree b. customizing treatment to the family’s values and customs c. relying on knowledge gained through personal experience with that particular culture d. basing treatment on what has been reported about a particular culture ANSWER: d 13. What does it mean if a test is normed on a group that is representative of the population? a. The majority culture was taken into consideration. b. The test is as free from cultural bias as possible. c. Age and ethnicity were considered but not biological sex. d. The test yields higher rates of psychopathology for minorities.

ANSWER: b 14. Research demonstrates that, with respect to aggression, girls ____. a. tend not to engage in aggressive acts b. are more distressed by aggressive acts c. engage in more relational forms of aggression d. are more aggressive than boys ANSWER: c 15. Generalizations regarding cultural practices frequently fail to capture ____ differences that exist within and across ethnic groups. a. universal b. biological c. personality d. SES ANSWER: d 16. Mal de ojo is an example of ____. a. a culturally based diagnosis b. a cultural syndrome c. a culturally based treatment technique d. a cultural formulation ANSWER: b 17. A ____ summarizes the child’s unique behaviors, thoughts, and feelings that together make up the features of a given psychological disorder. a. nomothetic description b. symptomatic description c. diagnostic description d. clinical description Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 ANSWER: d 18. Which element(s) are typically included in a clinical description? a. Taxonomic diagnosis b. Assessment of prior history c. Treatment and referral plan d. Intensity, frequency, and severity of the problem ANSWER: d 19. The formal assignment of a clinical case to a DSM-5 classification category is referred to as a(n) ____. a. empirical diagnosis b. taxonomic diagnosis c. proper diagnosis d. psychological diagnosis ANSWER: b 20. Which pairing is least common to comorbid disorders? a. Enuresis and schizophrenia b. Conduct disorder and ADHD c. ASD and intellectual disability d. Depression and anxiety ANSWER: a 21. ____ means generating predictions concerning future behavior under specified conditions. a. Assessment b. Diagnosis c. Outcome generation d. Prognosis ANSWER: d 22. The primary purpose of assessment is to ____. a. find correlating causes for the problem b. plan and evaluate treatment c. determine who is responsible for the problem d. treat individual symptoms ANSWER: b 23. The assessment of childhood problems typically makes use of a(n) ____ approach. a. multimethod b. idiographic c. divergent Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 d. single theoretical ANSWER: a 24. The most universally used assessment procedure with parents and children is ____. a. personality testing b. behavioral observation c. the clinical interview d. intelligence testing ANSWER: c 25. Which factor would typically be addressed in the developmental/family history component of the initial interview? a. Child’s birth weight b. Age at which the child began eating solid foods c. Mental history of parents and siblings d. Parent responsibilities at problem onset ANSWER: d 26. Unstructured interviews tend to be ____ than semistructured interviews. a. more consistent b. less reliable and more flexible c. more reliable and less flexible d. less biased ANSWER: b 27. Interview questions focused on somatic symptoms for an older child or adolescent with depression could include which of the following? a. Do you get muscle pains and aches? b. Do you get moody? c. Do you have trouble concentrating in school? d. Do you often feel tired?

ANSWER: a 28. Semistructured interviews tend to be ____ than unstructured interviews. a. less consistent b. more spontaneous c. less reliable d. more consistent and less spontaneous ANSWER: d 29. Which aspect would generally be assessed by behavioral assessment methods?

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Chapter 04 a. Descriptions of the problem b. Anger in school c. Meaning of pictures drawn by child d. Inkblot interpretations ANSWER: b 30. The “C” in the “ABCs of behavioral assessment” stands for ____. a. consequences b. causes c. child d. correction ANSWER: a 31. Gathering information about a child’s behavior for analysis involves ____. a. making inferences about the child’s behavior b. observing the child in real-life settings c. assessing personality d. having the child write a story ANSWER: b 32. An advantage of behavior checklists over interviews is that checklists allow a clinician to ____ while interviews typically do not. a. establish rapport b. assess mental status c. compare results to a reference sample d. obtain a measure of mood ANSWER: c 33. A leading checklist for assessing behavioral problems in children and adolescents is the ____. a. Wechsler Intelligence Scale for Children b. Kaufman Assessment Battery for Children c. Child Behavior Checklist d. Rorschach inkblot test ANSWER: c 34. A clearly defined group used to compare an individual child’s test score against is called a a. reference group. b. comparative group. c. standard group. d. norm group.

ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 35. The most commonly used intelligence scale today is the ____. a. Stanford–Binet 5 (SB5) b. Wechsler Intelligence Scale for Children (WISC-IV) c. Kaufman Assessment Battery for Children (K-ABC-II) d. Rorschach inkblot test ANSWER: b 36. The Wechsler Intelligence Scale for Children (WISC-IV) provides a measure of: a. verbal comprehension and working memory. b. personality profile. c. psychological abnormality. d. emotional stability.

ANSWER: a 37. The Rorschach test is an example of a(n) ____ test. a. intelligence b. achievement c. projective d. objective ANSWER: c 38. Projective tests ____ with children. a. should not be used b. are one of the most commonly used assessment methods c. are one of the least commonly used assessment methods d. have not been designed specifically for use ANSWER: b 39. Neuropsychological assessments are primarily used to ____. a. identify underlying brain lesions b. identify genetic abnormalities c. make inferences about central nervous system dysfunction d. diagnose mental deficits ANSWER: c 40. Functions assessed in neuropsychological tests are most likely to include ____. a. social b. perceptual c. physical d. personality Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 ANSWER: b 41. Categorical classification systems are based primarily on ____. a. underlying etiologic bases of the disorders classified b. normative data c. informed clinical consensus d. multivariate statistical methods ANSWER: c 42. The ____ classification approach assumes that all children possess the same traits to varying degrees. a. trait b. categorical c. feature d. dimensional ANSWER: d 43. Which symptom would be characteristic of the anxious/depressed dimension of child psychopathology? a. Feels worthless b. Refuses to talk c. Gets teased d. Strange ideas ANSWER: a 44. Which behavior would be characteristic of someone with issues on the internalizing behavior dimension? a. Hitting another child in anger b. Refusing to sit in a seat at school c. Feeling sad all of the time d. Intentionally hurting another child’s feelings ANSWER: c 45. The hypothesis behind ________________ is that the child will reveal unconscious fears, needs, and inner conflicts onto ambiguous stimuli of other people and things. a. behavioral observation and recording b. developmental testing c. personality testing d. projective testing ANSWER: d 46. Which activity is particularly compatible with the dimensional approach? a. Communicating with other clinicians b. Researching the degree of association between two variables Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 c. Creating a treatment plan based on all of the child behaviors d. Taking the entire package of child behaviors into account when diagnosing ANSWER: b 47. Interventions are ____. a. unique to the field of psychology b. designed to maintain the status quo c. problem-solving strategies d. typically rejected by children and families ANSWER: c 48. Which of the following is a criticism of the DSM-5? a. It fails to capture the simplicity of influences on child psychopathology. b. It gives relatively more attention to disorders of infancy and childhood than to those of adulthood. c. It lacks sufficient emphasis on situational and contextual factors. d. It emphasizes underlying causes rather than symptoms.

ANSWER: c 49. An example of a neurodevelopmental disorder would be ____. a. Oppositional Defiant Disorder b. ADHD c. Anxiety Disorders such as Separation Anxiety Disorder d. Feeding and Eating Disorders such as Pica ANSWER: b 50. Intervention focuses on ____. a. noncompliance b. assimilation c. motivation d. treatment ANSWER: d 51. ____ refers to efforts to increase adherence with treatment over time to prevent reoccurrence. a. Maintenance b. Prevention c. Treatment d. Intervention ANSWER: a 52. What is a common goal of treatment? a. Improved outcomes in intelligence Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 b. Measurable outcomes in family functioning c. Reduced impact of prior undesirable outcomes d. Increased adherence to treatment over time ANSWER: c 53. Minimum ethical standards for practice include: a. selecting procedures that are in the best interest of the parent. b. making sure involuntary client participation occurs. c. protecting the confidentiality of the therapeutic relationship. d. ensuring parent participation.

ANSWER: c 54. More than 70% of practicing clinicians identify their therapeutic approach as ____. a. behavioral b. cognitive c. humanistic d. eclectic ANSWER: d 55. ____ approaches to treatment view child psychopathology as the result of faulty thought patterns and faulty learning and environmental experiences. a. Behavioral b. Cognitive c. Cognitive-behavioral d. Client-centered ANSWER: c 56. ____ approaches to treatment view child psychopathology as the result of social or environmental circumstances that are imposed on the child and interfere with his or her capacity for personal growth and adaptive functioning. a. Psychodynamic b. Client-centered c. Cognitive-behavioral d. Family ANSWER: b 57. Which of the following is NOT one of the core principles of therapeutic change identified by Weisz, Bearman et al. 2017)? a. Increasing motivation b. Repairing thoughts c. Solving problems Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 d. Restoring feelings ANSWER: d 58. Which medication would best be used for a child suffering from a severe anxiety disorder? a. Concerta b. Elavil c. Xanax d. Zyprexa ANSWER: c 59. Which medication would best be used for a child diagnosed with bipolar disorder? a. Depakote b. Elavil c. Ritalin d. Zyprexa ANSWER: a 60. Which medication would best be used for a child suffering from ADHD? a. Concerta b. Elavil c. Xanax d. Zyprexa ANSWER: a Subjective Short Answer 61. Distinguish between idiographic and nomothetic case formulations, and indicate when each of these formulations is useful.

ANSWER: The focus of clinical assessment is to obtain a detailed understanding of the individual child or family as a

unique entity (e.g., Felicia and her family), referred to as “idiographic case formulation.” This is in contrast to a nomothetic formulation, which emphasizes broad general inferences that apply to large groups of individuals (e.g., children with a depressive disorder).

62. What is relational aggression? Are males or females more likely to exhibit this behavior? Provide two examples of relational aggression.

ANSWER: Studies into social aggression in girls have found that when angry, girls show aggression indirectly through verbal insults, gossip, ostracism, getting even, or third-party retaliation—referred to as “relational aggression.”

63. What are cultural syndromes? Why are they important for clinicians to be aware of in relation to understanding symptoms in children? Provide one example of a cultural syndrome and the symptoms that the clinician may see exhibited by the child.

ANSWER: Cultural syndromes refer to a pattern of co-occurring, relatively invariant symptoms associated with a particular cultural group, community, or context (APA, 2013). For example, mal de ojo or the “evil eye” is a Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 concept that is widespread throughout Mediterranean cultures and Latino communities throughout the world.

It is a malady to which children are especially vulnerable and believed to be caused by a hateful look or glance from a malicious person; the evil eye can cause fitful sleep, crying without apparent cause, diarrhea, vomiting, and fever in children. Cultural syndromes rarely fit neatly into one Western diagnostic category (Alarcón, 2009). In addition, although the cross-cultural validity of Western diagnostic criteria varies widely depending on the disorder, data regarding their validity across cultures for many childhood disorders are lacking (Canino & Alegria, 2008). Therefore, it is important that clinicians assess the extent to which a child’s cultural background and context affect the expression of both individual symptoms and clinical disorders.

64. Describe three ways that a therapist can strive to provide culturally competent mental health services.

ANSWER: Culturally competent children’s mental health services may be provided in a number of ways. For example, in therapy for Hispanic children and adolescents, cultural competence may be achieved by matching children and families with clinicians of the same ethnicity; by customizing the treatment to Hispanic cultural values, beliefs, and customs (e.g., familism, spiritualism, and respeto); or by incorporating ethnic and cultural narratives and role-play into therapy.

65. What considerations must be taken into account when making judgments about abnormality?

ANSWER: Usually, the age inappropriateness, severity, and pattern of symptoms, rather than individual symptoms, define childhood disorders. Also, the extent to which symptoms result in impairment in the child’s functioning is a key consideration.

66. Under what circumstances would a clinician choose to administer a semistructured versus an unstructured interview?

What are the benefits and/or drawbacks of each?

ANSWER: Most interviews with children and parents are unstructured. Clinicians use their preferred interview style and format, as well as their knowledge of the disorder, to pursue various questions in an informal and flexible manner. Unstructured clinical interviews provide a rich source of clinical hypotheses. However, their lack of standardization may result in low reliability and selective or biased gathering of information. To address this problem, clinicians sometimes use semistructured interviews that include specific questions designed to elicit information in a relatively consistent manner regardless of who is conducting the interview. The format of the interview usually ensures that the most important aspects of a particular disorder are covered. An appealing feature of semistructured interviews, especially for older children and youths, is that they can be administered by computer, something many children find entertaining and often less threatening at first than a face-to-face interview. The semistructured format also permits the clinician to follow up on issues of importance that may emerge during the interview. For younger children, a semistructured interactive interview using hand puppets may provide useful information about the child’s emotional, behavioral, and peer problems (Ringoot et al., 2013). The consistency and coverage of semistructured interviews may be offset by a loss of spontaneity between the child and the clinician, especially if the interview is conducted too rigidly.

67. What are some of the areas that are typically covered by developmental and family history questionnaire/interview?

ANSWER: The child’s birth and related events, such as pregnancy and birth complications or the mother’s use of drugs,

alcohol, or cigarettes during pregnancy. The child’s developmental milestones, such as age at which walking, use of language, bladder and bowel control, and self-help skills started. The child’s medical history, including injuries, accidents, operations, illnesses, and prescribed medications. Family characteristics and family history, including the age, occupation, cultural background, and marital status of family members and the medical, educational, and mental health history of parents and siblings. The child’s interpersonal skills, including relations with adults and other children, and play and social activities. The child’s educational history, including schools attended, academic performance, attitudes toward school, relations with teachers and peers, and special services. The adolescent’s work history and relationships, including relationships with others of the same sex and the opposite sex. A description of the presenting problem, including a detailed

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Chapter 04 description of the problem and surrounding events, and how parents have attempted to deal with the problem in the past. The parents’ expectations for assessment and treatment of their child and themselves

68. Explain the “ABCs of assessment” and give examples of each.

ANSWER: Examples will vary.

A: Antecedents, or the events that immediately precede a behavior B: Behavior(s) of interest C: Consequences, or the events that follow a behavior

69. What steps have researchers taken to ensure that psychological tests are free from bias?

ANSWER: For example, test developers now select normative groups that are representative of the population, and test items that are as free of cultural bias as possible. In addition, several professional organizations have joined together to develop a Code of Fair Testing Practices.

70. Identify and provide examples of neurodevelopmental disorders.

ANSWER: Neurodevelopmental disorders include intellectual disabilities (examples are intellectual development disorder and global developmental delay); Autism Spectrum Disorder; Communication Disorders (language disorder, speech sound disorder, childhood-onset fluency disorder, social communication disorder); Specific Learning Disorder (with impairment in reading, written expression, or math); ADHD (predominantly hyperactive/impulsive, predominantly inattentive, or predominantly combined); and Motor Disorders (Developmental Coordination Disorder, Stereotypic Movement Disorder, Tourette’s Disorder, Persistent Motor, or Vocal Tic Disorder).

71. Name and describe four psychological tests commonly used when assessing children.

ANSWER: Developmental tests are used to assess infants and young children, and are generally carried out for the

purposes of screening, diagnosis, and evaluation of early development. Evaluating a child’s intellectual and educational functioning is a key ingredient in clinical assessments for a wide range of childhood disorders.

Projective tests present the child with ambiguous stimuli such as inkblots or pictures of people, and the child is asked to describe what she or he sees. Personality is usually considered an enduring trait or pattern of traits that characterize the individual and determine how he or she interacts with the environment (Roberts & DelVecchio, 2000). In the clinical context, neuropsychological assessment attempts to link brain functioning with objective measures of behavior known to depend on an intact central nervous system.

72. Distinguish between categorical and dimensional classification approaches.

ANSWER: Categorical classification systems such as DSM-5 are based primarily on informed professional consensus, an approach that has dominated and continues to dominate the field of child (and adult) psychopathology.

Dimensional classification approaches assume that many independent dimensions or traits of behavior exist and that all children possess them to varying degrees.

73. What conclusions have been made regarding the effectiveness of treatments with children?

ANSWER: First, although research generally shows that most treatments are effective in reducing symptoms such as anxiety, depression, and oppositional behavior, fewer than 20% of treatments demonstrate evidence that they reduce impairment in life functioning.

74. What are some criticisms of the DSM-5?

ANSWER: The DSM-5 has been criticized for failing to capture the complexity of child psychopathology, for giving less attention to disorders of infancy and childhood than to those of adulthood, for its relative lack of emphasis on situational and contextual factors, and for its emphasis on symptoms rather than on underlying etiology.

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Chapter 04 75. Compare and contrast the cultural values, parenting practices, and beliefs among African Americans, Latino Americans, Asian Americans, Native Americans, and European Americans.

ANSWER: African American families value independence, individualism, kinship relations, unity, creativity, cooperation, authenticity, and racial identity. Latino American families value family loyalty, interpersonal connectedness, mutual respect, and self-respect. Asian American families value self-control, social courtesy, emotional maturity, and respect for elders. Native American families value the centrality of family, sharing, harmony, and humility. European American families value autonomy, individualism, initiative, acquisition of skills, self-development, and standing up for one’s own rights. Regarding parenting practices and beliefs, African Americans value authoritarian parenting, obedience, unilateral parental decision making, an egalitarian family structure, strict discipline, and communal parenting. Latino Americans value permissive parenting, a patriarchal family structure, high expression of parental warmth, communal parenting, and freedom. Asian Americans value authoritarian parenting, structural and managerial parental involvement, a patriarchal family structure, strict discipline, parental control, negotiation of conflict, and the parent as teacher. Native Americans value permissive, lax parenting, shame as discipline, both patriarchal and matriarchal family structures, and communal parenting. European Americans value authoritative parenting, egalitarian family structures, and parent as manager, and can be demanding.

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Chapter 05 Multiple Choice 1. Evolutionary degeneracy theory attributed the intellectual and social problems of children with intellectual disability to ____. a. cold parenting b. regression to an earlier period in the development of humankind c. degeneration of societal values d. genetic abnormalities ANSWER: b 2. During the eugenics movement, persons with intellectual disability were considered ____. a. relatively harmless b. a threat to society c. the missing evolutionary link d. amusing individuals ANSWER: b 3. Subaverage intellectual functioning is defined as an IQ approximately ____. a. one standard deviation below the mean b. two standard deviations below the mean c. a mental age of less than 10 years d. a mental age of less than 15 years ANSWER: b 4. To be diagnosed with intellectual disability, a person must exhibit ____. a. subaverage intellectual functioning b. genetic anomalies c. deficits in adaptive functioning d. subaverage intellectual functioning and deficits in adaptive functioning ANSWER: d 5. IQ scores among individuals without intellectual disability are ____. a. stable throughout the life span b. stable only after age 12 c. relatively stable with the exception of infancy d. not at all stable ANSWER: c 6. In comparison to the IQ scores of normally developing children, those of infants and children with developmental delays or intellectual disability are ____. a. more stable Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 b. less stable c. equally stable d. unmeasurable ANSWER: a 7. The ____ refers to the phenomenon that IQ scores have risen sharply since the beginning of IQ testing. a. Flynn effect b. Foster effect c. IQ effect d. scoring effect ANSWER: a 8. The rising of IQ scores is due to ____. a. more testing b. rising cost of living c. medical advances d. decreased need for manual labor ANSWER: c 9. The most likely explanation for the discrepancy in IQ scores between blacks and whites in North America is ____. a. genetic dissimilarities b. test bias c. economic and social inequalities d. poor attitude ANSWER: c 10. To be labeled with intellectual disability, below average intellectual and adaptive abilities must be ____. a. due to chromosomal abnormalities b. due to genetic anomalies c. present before age 12 d. present before age 18 ANSWER: d 11. Examples of conceptual adaptive behavior skills are: a. money concepts. b. responsibility. c. obeying laws. d. eating, dressing, mobility, and toileting.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 12. In the DSM-5, the level of disability, reflecting a child’s degree of difficulty, is based upon the ____. a. number of deficits in adaptive functioning b. extent of cognitive impairment c. extent of support needed d. number of social deficits ANSWER: b 13. The majority of individuals with intellectual disabilities have ____ impairment. a. mild b. moderate c. severe d. profound ANSWER: a 14. The ____ category of intellectual disability is overrepresented in minority groups. a. mild b. moderate c. severe d. profound ANSWER: a 15. Individuals with mild intellectual disability can usually acquire academic skills up to approximately the _______ grade level. a. second b. sixth c. tenth d. twelfth ANSWER: b 16. Many persons with Down syndrome function at the ____ level of disability. a. mild b. moderate c. severe d. profound ANSWER: b 17. The more severe forms of intellectual disability are more likely due to ____ causes than is mild intellectual disability. a. cultural b. familial c. idiopathic Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 d. organic ANSWER: d 18. Adults with mild intellectual development disorder need support with all of the following EXCEPT: a. shopping and transportation. b. cooking and money management. c. considerable support needed from co-workers/supervisors in employment. d. health care and legal decisions ANSWER: c 19. The American Association on Intellectual and Developmental Disabilities (AAIDD) categorizes persons with intellectual disability according to the ____. a. number of deficits in adaptive functioning b. extent of cognitive impairment c. extent of support needed d. number of social deficits ANSWER: c 20. The prevalence estimate for intellectual disability in children and adults is about ____ of the entire population. a. 0.4% b. 1% c. 4% d. 5% ANSWER: b 21. If a true male excess of intellectual disability exists, and the higher prevalence rate is not due to identification and referral patterns, it is likely due to ____. a. testosterone b. fetal alcohol syndrome c. fragile-X syndrome d. Klinefelter’s syndrome ANSWER: c 22. Intellectual disability is more prevalent among ____. a. lower SES b. rural families c. higher SES d. middle children ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 23. The suggestion that children with intellectual disability demonstrate the same behaviors and underlying processes as typically developing children who are at the same level of cognitive functioning is referred to as the ____. a. difference hypothesis b. developmental hypothesis c. similar sequence hypothesis d. similar structure hypothesis ANSWER: d 24. The ____ argues that cognitive development of children with intellectual disability differs from that of children without intellectual disability in more ways than merely differences in developmental rate and upper limit. a. developmental difference b. developmental viewpoint c. disparity hypothesis d. difference viewpoint ANSWER: d 25. In general, children with Down syndrome display ____. a. progressive loss of adaptive functioning skills from birth on b. declining IQ but increasing social skills c. significant gains in adaptive behaviors up to age 6, followed by a leveling off or decline d. a surge in abilities from ages 10 to 15 ANSWER: c 26. The observation that children with Down syndrome may alternate between periods of gain and functioning and periods of little or no advance is the ____. a. functioning difference hypothesis b. variance hypothesis c. variance observation d. slowing and stability hypothesis ANSWER: d 27. Children with Down syndrome display considerable delay in ____. a. expressive language development b. receptive language development c. expressive and receptive language development d. neither expressive nor receptive language development ANSWER: a 28. ____ is critical to regulating social interaction and providing a foundation for early self/other understanding. a. Expressive language Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 b. Receptive language c. Internal state language d. Secure attachment ANSWER: c 29. In the “strange situation” attachment assessment technique, children with Down syndrome ____. a. display significant distress upon separation b. readily reach for strangers for comfort c. show few distress signals despite an apparent need for contact with their caregivers d. angrily turn away from their caregivers upon reunion ANSWER: c 30. When toddlers with Down syndrome begin to recognize themselves in a mirror, they often ____. a. cry b. smile and laugh c. strike out d. appear confused ANSWER: b 31. Children with mild to moderate intellectual disability learn symbolic play ____. a. in much the same manner as other children b. in a different manner than other children c. only to a very small degree d. in a different manner than other children and only to a very small degree ANSWER: a 32. When mainstreamed into a regular classroom, children with intellectual disability ____. a. are accepted readily by other children b. are targeted and abused by other children c. are often aggressive toward other children d. end up being socially isolated because other children do not play with them ANSWER: d 33. Which chronic health condition is most common among children with intellectual disability? a. Epilepsy b. Oppositional deviant disorder c. Anxiety disorders d. Autistic disorder ANSWER: a 34. Generally, the emotional and behavioral problems of children with intellectual disability ____.

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Chapter 05 a. constitute major psychiatric disorders b. are considered part of the spectrum of problems coexisting with intellectual disability c. often are not severe enough to require intervention d. have prevalence rates comparable to those of the general population ANSWER: b 35. Children with intellectual disability and ADHD, when placed on stimulant medication, typically: a. show slight but limited gains on cognitive tasks. b. are overstimulated. c. are able to remain on task for longer periods. d. show no increased functioning as a result of medication.

ANSWER: c 36. Which statement regarding the causes of intellectual disability is false? a. The causes of mild intellectual disability are better understood than the causes of moderate to severe intellectual disability. b. There are over 1,000 different known organic causes of intellectual disability. c. Scientists cannot account for the cause of intellectual disability in the majority of cases. d. A genetic cause is known for almost three-quarters of individuals with moderate intellectual disability.

ANSWER: a 37. As a social risk factor for intellectual disability, this stands as both a prenatal and a postnatal condition.. a. Lack of access to prenatal care b. Domestic violence c. Malnutrition d. Poverty ANSWER: d 38. ______ factors are implicated in mild forms of intellectual disability. a. Genetic b. Environmental c. Genetic and environmental d. Situational ANSWER: c 39. The proportion of variance in a trait attributable to genetic influences is called ____. a. genotype b. phenotype c. heritability d. attribution Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 ANSWER: c 40. The gene-environment interaction is referred to as ____. a. genotype b. phenotype c. heritability d. attribution ANSWER: b 41. The evidence points to a heritability of intelligence of approximately ____. a. 0% b. 10% c. 50% d. 75% ANSWER: c 42. Postnatal risk factors for intellectual disability include a. parental immaturity. b. traumatic brain injury. c. lack of preparation for parenthood. d. parental abandonment of child.

ANSWER: b 43. ____ is the most common form of intellectual disability resulting from chromosomal abnormalities. a. Klinefelter’s syndrome b. Fragile-X syndrome c. Down syndrome d. Prader-Willi syndrome ANSWER: c 44. ____ is associated with intellectual disability and is a disorder in which males have an extra X chromosome. a. Klinefelter’s syndrome b. Turner’s syndrome c. Fragile-X syndrome d. Prader-Willi syndrome ANSWER: a 45. Down syndrome occurs more often with older mothers than younger mothers because_______. a. chromosomal nondisjunction increases with maternal age b. women’s ova become generally less healthy with age c. older women are generally less healthy than younger women Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 d. younger mothers do not carry genes containing chromosome issues ANSWER: a 46. ____ is the most common cause of inherited intellectual disability. a. Down syndrome b. Fragile-X syndrome c. Prader-Willi syndrome d. Phenylketonuria ANSWER: b 47. Lindsay and her sister were born into a socially disadvantaged family. Lindsay was adopted into a more privileged home. Lindsay’s IQ score is likely to be: a. higher then her sister’s score b. the same as her sister’s score c. lower then her sister’s score d. one standard deviation lower than her sister’s score ANSWER: a 48. Which cause of intellectual disability is associated with an involuntary urge to eat? a. Down syndrome b. Fragile-X syndrome c. Prader-Willi syndrome d. Angelman syndrome ANSWER: c 49. Both Prader-Willi and Angelman syndromes are ____. a. inherited conditions b. associated with an involuntary urge to eat c. believed to be spontaneous genetic birth defects that occur around the time of conception d. none of these ANSWER: c 50. Phenylketonuria is a(n) ____ that can cause intellectual disability if untreated. a. chromosomal abnormality b. environmental toxin c. inborn error of metabolism d. infection ANSWER: c 51. Which of the following is not associated with fetal alcohol syndrome? a. Central nervous system dysfunction Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 b. Abnormalities in facial features c. Growth retardation below the tenth percentile d. Non-teratogenic cause ANSWER: d 52. Behavioral risk factors that contribute to intellectual disability include all of the following EXCEPT: a. parental smoking and drug and alcohol use. b. lack of adequate stimulation. c. parental immaturity and rejection of caretaking. d. child abuse, neglect, and domestic violence.

ANSWER: b 53. On average, the IQ of children with fetal alcohol syndrome is in the ____ range of intellectual disability. a. mild b. moderate c. severe d. profound ANSWER: a 54. What is most likely to be of concern to the father of a child with intellectual disability? a. How to raise the child properly b. What effect the child will have on his personal relationship with his wife c. What restrictions the child will place on his role in the family d. How to feel close to the child ANSWER: d 55. _______ teaches children to use verbal cues to process information, to keep themselves on task, and to remind themselves how to approach a new task. a. Strategic training b. Self-instructional training c. Metacognitive training d. Social skill training ANSWER: b 56. Self-instructional training programs are most beneficial for ____. a. children with severe intellectual disability b. children whose parents are also mentally retarded c. children with no language skills d. children with some language proficiency, but who have trouble understanding and following directions ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 57. Which of the following is NOT a recommendation for enhancing children’s lives through early intervention? a. Encouragement of exploration b. Emphasis on developing rote knowledge and skills through repeated drills c. Mentoring in basic skills d. A rich and responsive language environment ANSWER: b 58. Which statement regarding the adjustment of families of children with intellectual disability is false? a. Most parents of children with intellectual disability come to see their child as a positive contributor to their family and quality of life. b. Families of children with intellectual disability experience higher-than-average levels of stress. c. Parents of children with intellectual disability experience higher-than-average depressive symptoms. d. Family involvement has not been shown to be as beneficial as residential care.

ANSWER: d 59. Research investigating the effectiveness of residential care for children with intellectual disability indicates that ____. a. residential care is not an effective treatment option b. family involvement is crucial to children’s adaptation to and benefit from residential care c. contact with family serves to confuse the child and disrupts the child’s progress d. residential care is the most effective treatment option ANSWER: b 60. The inclusion movement, along with this law, give children with disabilities the option of being educated in regular education settings. . a. No Child Left Behind Act b. Individuals with Disabilities Education Improvement Act c. Every Student Succeeds Act d. Disabled Student Success Act ANSWER: b Subjective Short Answer 61. Provide examples of adaptive behaviors as outlined in the text.

ANSWER: Personal activities of daily living such as eating, dressing, mobility, and toileting. Instrumental activities of daily living such as preparing meals, taking medication, using the telephone, managing money, using transportation, and doing housekeeping activities.

62. Discuss three reasons why IQ scores have been rising.

ANSWER: In attempting to explain the Flynn effect, scientists have considered the rising standards of living, better schooling, better nutrition, medical advances, more stimulating environments, and even the influence of Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 computer games and complex toys. Additionally, relatively permissive and child-focused parenting style has emerged during recent decades, which may have given children greater facility with language and stronger overall cognitive capacity. Moreover, there are unprecedented cultural differences between successive generations—daily life and occupational experiences are far more complex today than in the past.

63. Trace the origins and development of the Eugenics movement in the nineteenth century, including causes of popularity of the movement as well as emphasis on labels such as “imbecile” and “moron.”

ANSWER: Evolutionary degeneracy theory attributed the intellectual and social problems of children with intellectual disability to regression to an earlier period in human evolution. Researchers such as Down believed that persons with intellectual disability were an evolutionary throwback to the Mongol race, and that such individuals represented a “retrogression” to another group. Evolutionary degeneracy theory served as an explanation for insanity, mental deficiency, and social deviance in the late nineteenth century. By 1910, eugenics gained popularity as the needs of individuals with intellectual disabilities became less important than the perceived needs of society; that is, to protect others from the harm done by such individuals. Thus, people with intellectual disabilities were blamed for the social ills of their time and given such labels as moral imbecile or moron to describe and explain these differences. Morons were considered a threat to society because they could easily pass for “normal,” unlike others deemed to be insane.

64. Discuss the different reasons why more males than females are diagnosed with intellectual disability.

ANSWER: Similar to racial differences in the diagnosis of intellectual disability, gender differences in ID may be an artifact of identification and referral patterns rather than true differences in prevalence (Einfeld et al., 2010).

If a true male excess of intellectual disability does exist, researchers suspect this may be due to the occurrence of X-linked genetic disorders such as fragile-X syndrome, which affect males more often than females (Handen, 2007).

65. Discuss the connection between SES and intellectual disability.

ANSWER: This link is found primarily among children in the mild intellectual disability range; children with more severe levels are identified almost equally in different racial and economic groups. Whether or not signs of organic etiology are present, diagnoses of mild intellectual disability increase sharply from near zero among children from higher SES categories to about 2.5% in the lowest SES category (APA, 2000). These figures indicate that SES factors play a suspected role both in the cause of intellectual disability and in the identification and labeling of persons with intellectual disability.

66. Discuss the developmental-versus-difference controversy regarding the development of children with intellectual disability.

ANSWER: Simply stated, the developmental-versus-difference controversy is this: Do all children—regardless of intellectual impairments—progress through the same developmental milestones in a similar sequence, but at different rates? Or do children with intellectual disability develop in a different, less sequential, and less organized fashion?

67. Explain how learned helplessness may arise in a child with intellectual disability.

ANSWER: This learned helplessness may be unwittingly condoned by adults. When they are told a child is “retarded,” adults are less likely to urge that child to persist after failure than they are to urge a normal child at the same level of cognitive development.

68. Discuss why some children with Down syndrome have problems developing secure attachments.

ANSWER: A significant number of these children may have problems in developing a secure attachment because they express less emotion than other children.

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Chapter 05 69. What considerations would you have to take into account when diagnosing ADHD in a child with intellectual disability?

ANSWER: The diagnosis of attention-deficit/hyperactivity disorder (ADHD) requires the presence of behavioral

disturbance that is inappropriate for an individual’s developmental level. Attention spans, distractibility, and on-task behaviors vary considerably among individuals with profound intellectual disability. An individual with profound intellectual disability must be compared with other children with profound intellectual disability for the purpose of diagnosing any other psychiatric disturbance.

70. Describe common emotional and behavioral problems for individuals with intellectual disabilities ANSWER: Typical problems experienced include internalizing problems such as a decline in sociability, increased depression, and social withdrawal. Additionally, ADHD-related symptoms are common, as well as Pica and other self-injurious behaviors.

71. Discuss two conditions that can arise from chromosomal abnormalities.

ANSWER: The most common disorder that results from a chromosome abnormality is Down syndrome. These abnormalities also can occur in the number of sex chromosomes, resulting in intellectual disability syndromes such as Klinefelter’s (XXY, a disorder in which males have an extra X chromosome) and Turner’s (XO, a disorder in which women are missing a second X chromosome).

72. Explain how intellectual disability may result from PKU. ANSWER: One of the best understood examples of a single gene condition is phenylketonuria (PKU), a rare disorder occurring in approximately 1 in 15,000 individuals (Waisbren, 2011). Unlike chromosomal abnormalities that cause Down syndrome, the cause of PKU is a recessive gene transmitted by typical Mendelian mechanisms.

73. Describe how you would use shaping to teach a nonverbal child to say “hungry.”

ANSWER: Shaping is a procedure that begins by forming a list of responses (such as “he,” “ha,” “hu”) that were progressively more similar to the target response (in this case, the word hungry). After an individual mastered the first sound, she would be reinforced only for attempts at the next sound on the list, and so on, until the desired sound or word was gradually shaped.

74. What are practical recommendations for enhancing children’s lives through early intervention, according to Ramsey and Ramsey (1992)?

ANSWER: Recommendations include: encouragement of exploration; mentoring in basic skills; celebration of developmental advances; guided rehearsal and extension of new skills; protection from harmful displays of disapproval, teasing, or punishment; and a rich and responsive language environment.

75. Describe self-instructional training used with children with intellectual disability.

ANSWER: Self-instructional training is most beneficial for children who have developed some language proficiency but still have difficulty understanding and following directions. Self-instructional training teaches children to use verbal cues, initially taught by the therapist or teacher, to process information, to keep themselves on task.

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Chapter 06 Multiple Choice 1. Leo Kanner used the term early infantile autism, which literally means ____. a. absence of language b. need of sameness c. outside of oneself d. within oneself ANSWER: d 2. Early theories about autism attributed the autistic child’s behaviors to ____. a. biological abnormalities of the brain b. the inability to integrate senses c. the parent’s wish that the child should not exist d. lack of stimulating environments ANSWER: c 3. A DSM-5 diagnosis of ASD will be based on ____. a. five different subtypes b. one overarching category c. dimensional symptoms d. easily separated symptoms ANSWER: b 4. Which statement about ASD is true? a. ASD is a subtype of Asperger’s disorder. b. ASD is a single domain disorder. c. ASD is a disorder children outgrow. d. ASD is a neurodevelopmental disorder.

ANSWER: d 5. Which statement about the social skills of children with ASD is true? a. Children with ASD experience profound difficulties relating to others, even when they have average or aboveaverage intelligence. b. Children with ASD experience profound difficulties relating to others, but only when they have below-average intelligence. c. Children with ASD experience profound difficulties relating to others, but only when they have co-occurring ID. d. Children with ASD experience profound difficulties relating to others, but only when they have below-average intelligence and no useful language.

ANSWER: a 6. Children who have been diagnosed with ____ have deficits in recognizing facial expressions.

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Chapter 06 a. depression b. ASD c. ADHD d. anxiety ANSWER: b 7. Joint attention refers to the ability to ____. a. communicate with two people at the same time b. coordinate one’s focus of attention on another person and an object of mutual interest c. hold a conversation on two different topics d. pay attention to the conversation that two other people are having ANSWER: b 8. With respect to attachment, most children with ASD ____. a. do not form meaningful social attachments to their parents b. form indiscriminate attachments with any adult c. do not form attachments with any individual except their parents d. prefer their caregivers over unfamiliar adults ANSWER: d 9. Children with ASD ____. a. have reduced sharing of emotions b. initiate most social interactions c. tend to listen to the speaker d. make exaggerated facial expressions ANSWER: a 10. The use of protodeclarative gestures requires ____. a. verbal ability and shared social attention b. theory of mind and verbal ability c. implicit understanding and shared social attention d. intelligence and shared social attention ANSWER: c 11. Critical factors contributing to the differences in how the symptoms of ASD are manifested in children include all of the following EXCEPT a. the level of intellectual ability.

b. the severity of their language problems. c. the age at diagnosis and corresponding treatments. d. the behavioral change with age.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 12. Children with ASD are most likely to use ____. a. instrumental gestures b. expressive gestures c. protodeclarative gestures d. joint social behaviors ANSWER: a 13. Echolalia in children with ASD is believed to be a(n) ____. a. sign of pathology b. sign of co-occurring obsessive–compulsive disorder c. important step in their language acquisition d. uncontrollable habit ANSWER: c 14. The primary language deficit of children with ASD (who develop language) is ____. a. grammatical usage b. semantics c. morphological usage d. pragmatics ANSWER: d 15. Examples of social communication or social interaction deficits indicative of ASD include which of the following? a. Deficits in social-emotional reciprocity b. Insistence on sameness c. Stereotyped motor movements d. Highly restricted, fixated interests ANSWER: a 16. Examples of restricted, repetitive patterns of behavior indicative of ASD include which of the following? a. Reduced sharing of interests or emotions b. Unusual interest in sensory aspects of environment c. A total lack of facial expressions d. Absence of interest in peers ANSWER: b 17. Special cognitive skills that are above average for the general population and well above the autistic child’s own general level of intellect are referred to as ____. a. savant skills

b. splinter skills c. macro skills Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 d. supernatural skills ANSWER: b 18. The tendency to focus on one feature of an object in the environment while ignoring other equally important features is called stimulus ____. a. dominance

b. specialization c. screening d. overselectivity ANSWER: d 19. The tendency to focus on certain types of sensory input over others is called sensory ____. a. dominance b. specialization c. screening d. overselectivity ANSWER: a 20. The theory of mind hypothesis of ASD suggests that children with ASD ____. a. focus on one feature of an object in an environment while ignoring other equally important features b. do not understand others’ mental states c. cannot take in the larger picture because of a tendency to focus on details d. are unable to split their social attention in social situations ANSWER: b 21. A person lacking central coherence ____. a. processes information in bits and pieces but fails to see the big picture b. does not understand others’ mental states c. cannot coordinate left and right body movements d. fails to understand social hierarchies ANSWER: a 22. If you were to administer the WISC to a child with ASD, which subscale would likely cause the child the most difficulty? a. Nonverbal subtests involving short-term memory

b. Image memory tasks c. Repetitive design tasks d. Verbal comprehension subtests ANSWER: d 23. Children with ASD are likely to experience problems with ____.

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Chapter 06 a. repetition b. gastrointestinal problems c. overeating d. nonverbal play ANSWER: d 24. The cognitive deficit most specific to children with ASD is ____. a. weak central coherence b. deficits in executive functions c. deficient theory of mind d. sensory overselectivity ANSWER: c 25. Many children with ASD also have ____. a. intellectual disability and epilepsy b. superior intelligence c. schizophrenia d. intellectual disability and schizophrenia ANSWER: a 26. As many as _____% of individuals with ASD have a head size that is above average. a. 80 b. 85 c. 90 d. 95 ANSWER: c 27. ____ in some children with ASD distinguishes them from those with intellectual disability or language disorders. a. Low-set ears b. Abnormally large head circumference c. Flattened bridge of the nose d. Wide-spaced eyes ANSWER: b 28. A test in which children with ASD perform relatively well due to the nature of focusing on details of a figure rather than the overall pattern would be the: a. WISC-IV

b. embedded figures test c. test for central coherence d. executive function test.

ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 29. Children with ASD and language development are most likely to show deficits in ____. a. language acquisition b. length of utterances c. spontaneous social conversation d. grammatical complexity ANSWER: c 30. Recent findings estimate the prevalence of ASD worldwide to be ____. a. 1 per 124 b. 1 per 500 c. 1 per 257 d. 1 per 68 ANSWER: d 31. The rise in prevalence of ASD is most likely due to ____. a. increase in mercury in the diet b. greater recognition of milder forms of ASD c. more harmful vaccines administered d. stricter guidelines for diagnosis ANSWER: d 32. Which statement about gender differences in ASD is true? a. ASD is equally common in boys and girls. b. ASD is more common in boys. c. ASD is more common in boys, except among those with profound ID, where the numbers of boys and girls are similar. d. ASD is more common in boys, except among those with average or above-average IQ, where the numbers of boys and girls are similar.

ANSWER: c 33. Which racial/ethnic group has the highest prevalence of ASD? a. African American b. Non-Hispanic white c. Asian d. Native American ANSWER: b 34. The extreme male brain theory of ASD suggests that ____. a. autistic brains are more “systemizing” b. autistic brains are less “systemizing” c. females are more “systemizing” Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 d. males are more “empathizing” ANSWER: a 35. The deficits of ASD become increasingly noticeable ____. a. from birth b. around 6 months of age c. around 2 years of age d. when the child enters school ANSWER: c 36. The two strongest predictors of adult outcomes in children with ASD are ____. a. absence of stereotyped behavior and theory of mind b. intellectual ability and language development c. parental responsiveness and early intervention d. intact motor skills and sensory specialization ANSWER: b 37. The American Academy of Pediatrics (AAP) recommends that children be screened for ASD at _______. a. 12 months b. 15 months c. 12 months and 24 months d. 18 months and 24 months ANSWER: d 38. ____ has been associated with ASD more than any other genetically based condition. a. Tuberous sclerosis b. Down syndrome c. PKU d. Fragile X ANSWER: a 39. Family members of children with ASD display higher than normal rates of ____. a. echolalia b. intellectual disability c. language deficits d. social communication ANSWER: c 40. Many parents who have a child with ASD feel that the ____ in vaccines increased number of incidences of ASD. a. niacin b. copper Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 c. mercury d. lead ANSWER: c 41. Studies of brain metabolism in individuals with ASD suggest decreased blood flow in these two lobes. a. Frontal and temporal b. Frontal and parietal c. Temporal and parietal d. Occipital and temporal ANSWER: a 42. A step-by-step approach that first increases the child’s vocalizations and then teaches imitation of sounds and words, the meanings of words, labeling objects, making verbal requests, and expressing desires is better known as: a. TEACCH

b. discrete trial training c. operant speech training d. Pivotal Response Training ANSWER: c 43. A step-by-step approach to presenting a stimulus and requiring a specific response that is used in the treatment of ASD is called ____. a. subtle trial training

b. response training c. trial-response approach d. discrete trial training ANSWER: d 44. ____ strengthens behaviors by capitalizing on naturally occurring opportunities. a. Naturalistic training b. Discrete trial training c. Incidental training d. Pivotal response training ANSWER: c 45. The promise of early intervention with ASD derives primarily from ____. a. the likelihood that parents have not yet become discouraged b. the likelihood that intrusive and disruptive behaviors will not yet have been developed c. the willingness of young children to please adults d. the plasticity of neural systems early in development ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 46. Which of the following is NOT considered by consensus to be an effective intervention for children with ASD? a. Initiating intensive engagement, at least 25 hours a week b. Beginning intervention as soon as an ASD diagnosis is seriously considered c. Removing children from their homes and placing them in more structured settings d. Monitoring the child’s progress and making adjustments in treatment as needed ANSWER: c 47. A drawback of psychotropic medications for children with ASD is that a. studies have not shown that medications help alleviate specific behavioral symptoms. b. side effects tend to magnify other symptoms of ASD. c. the benefits vary from child to child. d. children with ASD are likely to overuse these drugs.

ANSWER: c 48. What is it called when an individual with ASD is unable to play with a toy while listening to a social partner? a. Echolalia b. Theory of mind c. Protoimperative d. Joint attention ANSWER: d 49. An example of a highly structured intervention would be one that a. actively engages the child for at least 25 hours a week, year-round. b. allows sufficient one-on-one time c. uses predictable routines, visual activity schedules, and clear physical boundaries d. emphasizes ongoing assessment.

ANSWER: c 50. A child is close to school age and needs to learn to sit in a chair. Which would be a step-by-step approach using a stimulus that requires a specific response? a. Skills training

b. TEACCH c. Discrete trial training d. ABA ANSWER: c 51. In comparison to children with ASD, children with childhood-onset schizophrenia ____. a. tend to be younger at diagnosis b. show a more chronic and declining course c. show similar social and language deficits d. show less intellectual impairment Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 ANSWER: d 52. Which statement about childhood-onset schizophrenia is false? a. Childhood-onset schizophrenia appears to be a more severe form of adult-onset schizophrenia. b. The criteria used to diagnose schizophrenia in adults can reliably be used to diagnose schizophrenia in children. c. Childhood-onset schizophrenia typically has a sudden onset.

d. Childhood-onset schizophrenia is likely to persist into adolescence and adulthood.

ANSWER: c 53. The most common presenting symptom for children with childhood-onset schizophrenia is ____. a. auditory hallucinations b. visual hallucinations c. paranoid delusions d. flat affect ANSWER: a 54. The most common co-morbid disorders in children with schizophrenia are ____. a. ASD and other PDDs b. anxiety disorders c. conduct disorder and depression d. pica and mental retardation ANSWER: c 55. Schizophrenia is extremely rare prior to ____. a. the preschool years b. the early school years c. adolescence d. early to mid-adulthood ANSWER: c 56. Current views regarding the causes of schizophrenia emphasize ____. a. biological factors b. family environment factors c. disruptions to prenatal development d. genetic vulnerability and early neurodevelopmental insults ANSWER: d 57. Which characteristic is least prevalent in the families of children with schizophrenia? a. Communication deviance b. Use of harsh criticism toward the children Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 c. Economic hardship d. Supportive bonds ANSWER: d 58. Children with schizophrenia may be treated with ____ to diminish psychotic symptoms. a. behavior modification b. individual therapy c. medications d. family treatment ANSWER: c 59. Current treatments for child-onset schizophrenia emphasize medications in combination with ____. a. critical feedback b. intellectual skills training c. an educational support program d. behavior analysis ANSWER: d 60. Medications help control psychotic symptoms in children with schizophrenia by blocking ____ transmission at the ____ receptor. a. dopamine, G2 GABA

b. dopamine, 5HT2 serotonin c. serotonin, D2 dopamine d. dopamine, D2 dopamine ANSWER: d Subjective Short Answer 61. What does it mean to say that ASD is a “spectrum” disorder?

ANSWER: ASD is defined as a spectrum disorder because its symptoms, abilities, and characteristics are expressed in many different combinations and in any degree of severity (Lai et al., 2013a). Thus, ASD is not an “all or nothing” phenomenon.

62. What are the core features of ASD? ANSWER: The core features of ASD are represented by two symptom domains: (1) social communication and social interaction and (2) restricted, repetitive patterns of behavior, interests, or activities.

63. Describe the features that commonly characterize the speech of children with ASD who have developed some useful language.

ANSWER: Although almost all children with ASD show delays in their language development, it is their lack of spontaneity and their use of qualitatively unusual forms of communication that is most striking (Chiang & Carter, 2008). The rhythm and intonation of their speech is often unusual (Peppe et al., 2007), but most noticeable is their lack of social chatter—their failure to use language for social communication.

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Chapter 06 64. Discuss the theory of mind hypothesis of ASD. What findings provide support for this hypothesis?

ANSWER: By age 4, most children can comprehend what others might know, think, and believe; this is something that even older individuals with ASD have great difficulty doing. The theory of mind (ToM) hypothesis of ASD begins with the premise that the ability to read the intentions, beliefs, feelings, and desires of others from their external behavior has adaptive significance in human evolution. ToM proposes that all humans are, by nature, mind readers.

65. In what ways are children with intellectual disability distinguishable from children with intellectual disability in addition to ASD? ANSWER: Most children with intellectual disability (ID) without ASD show a general delay across all areas of intellectual functioning on the WISC test. In contrast, the performance of children with ASD tends to be uneven across different WISC subtests.

66. In what ways are children with ASD distinguishable from children with language delays?

ANSWER: Features of atypical development, that are very similar to those found in ASD but are less severe, have

recently been detected in infant siblings of children with ASD by the infants’ first birthday (Ozonoff et al., 2014). Possible early indicators of ASD may include: “uses few gestures to express social interest,” “doesn’t respond when name is called,” “rarely makes eye contact when interacting,” “limited babbling, particularly in a social context,” and “displays odd or repetitive ways of moving hands and/or fingers” (Zwaigenbaum et al., 2009). Children with ASD have been found to differ from typically developing children on most of these indicators between the ages of 12 and 24 months. However, in one study, only early communicative gestures were found to distinguish children with ASD from those with developmental delay or language impairment.

67. Explain the controversial extreme male brain theory of ASD. ANSWER: Those with ASD are presumed to fall at the extreme high end of a continuum of cognitive abilities associated with systemizing (understanding the inanimate world) and at the extreme low end of abilities associated with empathizing (understanding our social world). Both abilities are present in all males and females, but males are presumed to show more systemizing and females more empathizing.

68. Discuss the evidence for genetic factors in the etiology of ASD. ANSWER: The discovery of the fragile-X anomaly (see Chapter 5) in about 2% to 3% of children with ASD led to increased attention to this and other chromosomal defects that might be related to ASD. Some studies have found that as many as 15% to 20% of siblings of individuals with ASD also have the disorder, a number nearly twice that seen in earlier reports. New research using molecular genetics has pointed to particular areas on many different chromosomes as possible locations for susceptibility genes for ASD (Klinger et al., 2014).

Susceptibility genes are causally implicated in the susceptibility to ASD but do not cause it directly on their own.

69. Describe and identify the most common disorders and symptoms present in individuals with ASD. ANSWER: The disorders most commonly associated with ASD are ID and epilepsy, anxiety disorders, ADHD, learning disabilities, oppositional and conduct problems, and mood disturbances. Some children with ASD also engage in self-injurious behavior, including head banging, hand or arm biting, and excessive scratching and rubbing.

70. What are the goals of treatment for children with ASD? ANSWER: The goals for most treatments are to minimize the core problems of ASD, maximize the child’s independence and quality of life, and help the child and family cope more effectively with the disorder.

71. How are disruptive behaviors in early treatment of children with ASD addressed?

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Chapter 06 ANSWER: Many procedures are effective in eliminating disruptive behavior, including rewarding competing behaviors, ignoring the behavior, and mild forms of punishment.

72. What are some symptoms of initial stages of childhood-onset schizophrenia (COS)?

ANSWER: In the initial stages of COS, the afflicted youngster may have difficulty concentrating, sleeping, or doing schoolwork, and may start to avoid friends. As the illness progresses, she or he may begin to speak incoherently and see or hear things that no one else does. Periods of improvement may be followed by terrifying relapses that are characterized by disordered thinking in which the youngster leaps illogically from one idea to another. The youngster may experience hallucinations, paranoia, and delusions. During their psychotic phases, youngsters with schizophrenia may be convinced that they have godlike powers or that people are spying on them. When in the grip of a psychosis, they may behave unpredictably and may become violent and suicidal.

73. Why might it be difficult to identify schizophrenia in young children?

ANSWER: Schizophrenia may be expressed differently at different ages. For example, hallucinations, delusions, and formal thought disturbances are extremely rare and difficult to diagnose before the age of 7; when they do occur, they may be less complex and reflect childhood themes (Caplan, 1994). A failure to adjust diagnostic criteria for developmental changes, such as social withdrawal or peer problems, may overlook children who show early signs of schizophrenia but may not develop the full-blown adult type until a later age.

74. Identify and describe initial symptoms that youngsters with COS may experience.

ANSWER: In the initial stages of COS, afflicted youth may have difficulty concentrating, sleeping, or doing schoolwork, and may start to avoid friends. As the illness progresses, the child may begin to speak incoherently as well as beginning to see or hear things that no one else can see or hear. Periods of improvement can occur simultaneously with relapses characterized by disordered thinking, hallucinations, paranoia, and delusions.

75. Discuss the connection between vulnerability and stress in the cause of COS. ANSWER: Current views regarding the causes of COS are based on a neurodevelopmental model in which a genetic vulnerability and early neurodevelopmental insults result in impaired connections between many brain regions. This impaired neural circuitry may increase the child’s vulnerability to stress.

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Chapter 07 Multiple Choice 1. Learning disabilities differ from physical disabilities in childhood in that they are ____. a. more pronounced b. not as easy to detect c. not diagnosed by professionals d. fairly rare ANSWER: b 2. ____ is/are connected to the later onset of learning disorders. a. Parental age b. Communication disorders c. Head injuries d. Developmental delay ANSWER: b 3. Which statement regarding the general intellect of children with learning disabilities is true? a. Children with learning disabilities usually have mild intellectual disability. b. Children with learning disabilities usually have below-average intelligence. c. Children with learning disabilities usually have average intelligence. d. Children with learning disabilities usually have average or above-average intelligence.

ANSWER: d 4. Which statement about learning disabilities is true? a. Learning problems occurring as a result of intellectual disability may qualify as “learning disabilities.” b. Learning problems occurring as a result of brain injury may qualify as “learning disabilities.” c. Learning problems occurring as a result of either intellectual disability or brain injury may qualify as “learning disabilities.” d. Learning disabilities can affect daily routines, work, and family life.

ANSWER: d 5. Which disorder is determined by achievement test results that are substantially below what is expected for the child’s age, schooling, and intellectual ability? a. Communication disorder

b. Phonological awareness c. Specific learning disorder d. Fluency disorder ANSWER: c 6. Dyslexia refers to ____. a. problems with fine motor control b. problems decoding and recognizing simple words Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 c. a specific kind of reading problem in which the child reverses letters d. problems in writing ANSWER: b 7. A child diagnosed with a learning disorder would typically score ____. a. better on IQ tests than on tests of academic achievement b. lower on IQ tests than on tests of academic achievement c. comparably high on both IQ tests and tests of academic achievement d. comparably low on both IQ tests and tests of academic achievement ANSWER: a 8. By the age of ____, a child’s auditory map for phonetic discrimination is complete. a. 1 month b. 6 months c. 1 year d. 5 years ANSWER: c 9. The basic sounds that make up a language are called ________. a. phonology b. phonemes c. phonetics d. phonics ANSWER: b 10. ____ is one of the best predictors of school performance and overall intelligence. a. Well-developed fine motor skill b. Early infant stimulation c. Early attainment of developmental milestones d. The development of language ANSWER: d 11. Deficits in ____ are a chief reason that most children with communication and learning disorders have problems in learning to read and spell. a. phonology

b. comprehension c. attention d. adaptation ANSWER: a 12. Phonological awareness is a broad construct that includes ____.

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Chapter 07 a. recognition of the independence of sounds and letters b. awareness that sounds cannot be manipulated within syllables in words c. detection of rhyme and alliteration d. reciting the alphabet ANSWER: d 13. ____ is highly related to expressive language development. a. Semantic ability b. Pragmatic awareness c. Phonological awareness d. Morphological ability ANSWER: c 14. To see if a child has phonological awareness, a teacher might ____. a. ask the child to rhyme words b. have the child try to complete a page of math problems c. have the child sing out loud d. ask the child to recite the alphabet ANSWER: a 15. Julia’s father asked her to go to her bedroom to select a book that they could read together. Julia went upstairs to her bedroom and chose her favorite book from her bookshelf. On her way back downstairs, Julia’s mother asked her what she was doing. Julia’s response was “Book read.” Based on this description, Julia may meet the criteria for ____. a. phonological disorder

b. expressive language disorder c. speech sound disorder d. stuttering ANSWER: b 16. Deficits in phonological awareness are diagnosed when a child ____. a. cannot express his or her thoughts b. cannot understand others c. stutters d. has trouble manipulating sounds ANSWER: d 17. When a developmental language problem involves articulation or sound production rather than word knowledge, it is typically known as a __________________ disorder. a. pragmatic communication

b. childhood-onset c. speech sound Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 d. language ANSWER: c 18. By the early school-age years, which communication disorder is most prevalent? a. Language disorder b. Speech sound disorder c. Childhood-onset fluency disorder d. Pragmatic communication disorder ANSWER: a 19. By mid-to-late adolescence, most children with communication disorders ____. a. stop speaking b. have acquired normal language c. show decline in the quality of speech d. drop out of school ANSWER: b 20. Which statement regarding gender differences in rates of communication disorders is true? a. Girls are more likely to be diagnosed with communication disorders due to biological differences. b. Girls are more likely to be diagnosed with communication disorders due to referral bias. c. Boys are more likely to be diagnosed with communication disorders due to biological differences. d. Boys are more likely to be diagnosed with communication disorders due to acting out.

ANSWER: d 21. ____ education strategies are based on the premise that children with special needs will benefit from associating with normally developing peers. a. Segregation

b. Inclusion c. Incorporation d. Cooperation ANSWER: b 22. Studies comparing language-impaired children with and without a positive family history for a language-based learning disability suggest that children with a positive family history may inherit ____. a. co-morbid behavior problems

b. temporal processing deficits c. structural abnormalities in the temporal lobe d. brain lesions in a pinpointed region ANSWER: b 23. Language functions are housed primarily in the ____.

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Chapter 07 a. left temporal lobe b. right temporal lobe c. frontal lobe d. occipital lobe ANSWER: a 24. Language functions are housed primarily in which lobe of the brain? a. The frontal lobe b. The occipital lobe c. The left temporal lobe d. The parietal lobe ANSWER: c 25. Studies investigating the causes of communication disorders suggest that ____. a. there is no genetic basis for language problems b. left-handed people are more likely to develop language impairments c. communication problems are often tied to poor parental efforts to stimulate language development d. there is an interaction of genetic influences, slowness of brain maturation, and possible minor brain lesions ANSWER: d 26. The age at which stuttering tends to recede is around ____. a. 2 years b. 5 years c. 9 years d. 10 years ANSWER: b 27. Which statement about gender differences in rates of stuttering is true? a. Boys and girls are equally affected by stuttering. b. Girls are more likely to stutter than boys. c. Boys are more likely to stutter than girls. d. Boys are more likely to stutter than girls, except among children of low socioeconomic status.

ANSWER: c 28. Which is an appropriate treatment for children who stutter? a. Teach parents how to discipline their children. b. Aggressively encourage proper speech. c. Use contingency management procedures. d. Make the child accountable for progress.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 29. Almost ________ of children who stutter before the age of 5 will no longer stutter once they have been in school for about a year. a. 10%

b. 50% c. 80% d. 100% ANSWER: c 30. Which statement about the causes of stuttering is true? a. Empirical studies have shown stuttering to be due to unresolved emotional problems or anxiety. b. The communicative behavior of mothers significantly contributes to the development of stuttering. c. Stuttering is probably related to abnormal development of the right hemisphere of the brain. d. A combination of genetic and environmental factors seem to cause the abnormal development.

ANSWER: d 31. Which of the following is a category of learning disorders? a. Social b. Mathematics c. Phonological d. Fluency ANSWER: b 32. The most common underlying feature associated with reading disorders is ____. a. associating new words with those in memory b. visually processing the shapes of letters c. interpreting the meaning of words d. distinguishing or separating sounds in spoken words ANSWER: d 33. Mary is reading out loud to her class. She reads “from,” when in fact the word is “form.” Mary has made a(n) ____ error.

a. omission b. reversal c. transposition d. sight ANSWER: c 34. Decoding can be described as ____. a. interpreting the hidden meaning of words b. recognizing concepts in sentences c. breaking a word into parts rapidly enough to read the whole word Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 d. recognizing errors in sequence of words and spelling ANSWER: c 35. Evidence of mathematics disorder typically emerges ____. a. well before entry into school b. upon entry into school c. several years after beginning school d. in early adolescence ANSWER: a 36. A child with a mathematics disorder would most likely have difficulty with ____. a. reading b. visual–spatial ability c. coordination d. memory ANSWER: b 37. A child with a writing disorder has the most difficulty with ____. a. spelling accuracy b. visual–spatial ability c. gross motor skills d. memory ANSWER: c 38. Diagnostic criteria for specific learning disorder include all of the following EXCEPT ____. a. difficulty memorizing basic facts and procedures b. inaccurate or slow and effortful word reading c. difficulty understanding the meaning of what is read d. difficulties mastering number sense, number facts, or calculation ANSWER: a 39. Boys are more likely to be diagnosed with learning disorders because ____. a. their parents are more likely to seek help b. they are more likely to also have behavior problems c. their problems are more severe d. they actually outnumber girls in epidemiological studies ANSWER: b 40. The course of SLD is associated with ____. a. improvement in high school b. better reading comprehension in adulthood Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 c. reduction in reading deficits, but not in mathematics d. dropping out of school ANSWER: d 41. Mild specific learning disorders include which of the following? a. Difficulties learning skills in multiple academic domains, but the individual is able to compensate without any accommodations or interventions. b. Difficulties learning skills, affecting several academic domains, so that the individual is unlikely to learn skills without ongoing individualized and specialized teaching. c. Difficulties learning skills in one or more academic domains, so that the individual is unlikely to become proficient without some intervals of specialized teaching during the school years. d. Difficulties learning skills in one or two academic domains, but the individual may be able to compensate well when provided with appropriate accommodations.

ANSWER: d 42. Children with learning disorders are likely to also have ____. a. low sports self-concept b. difficulty with appearance self-concept c. poor academic self-concept d. trouble balancing an overactive social life with school ANSWER: d 43. Typical errors students with SLD with impairment in reading make include all of the following EXCEPT ____. a. reversals of letters b. transposition of letters c. omission of letters d. patterned replacement of letters ANSWER: d 44. A term sometimes used to describe a pattern of reading difficulties would be ___________. a. inversion b. transposition c. decoding d. dyslexia ANSWER: d 45. Which factor is least likely to lead to increased resiliency and adaptation in children with learning disorders? a. Easy or positive temperament b. Positive sense of efficacy and self-esteem c. Competent and supportive caregivers d. Clear consequences for when mistakes are made ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 46. The cause of most learning disorders is ____. a. limited exposure to reading material in the home b. genetically based neurological problems c. perinatal injury and/or anoxia d. poor instructional methods ANSWER: b 47. Children with impairment in written expression often have problems with tasks that require ____________. a. good handwriting b. proper spelling c. hand–eye coordination d. sitting and reasoning ANSWER: c 48. The planum temporale in individuals with reading disorders is ____. a. larger on the right side of the brain b. larger on the left side of the brain c. of equal size on both sides of the brain d. scarred and malfunctioning ANSWER: c 49. Shaywitz and Shaywitz (2002) found that the brains of dyslexic children compared to nonimpaired children had ____. a. higher activation primarily in the right hemisphere b. lower activation primarily in the right hemisphere c. higher activation primarily in the left hemisphere d. lower activation primarily in the left hemisphere ANSWER: d 50. Eden et al. (1996) found that the brains of adults with reading disorders show no activation in an area that detects ____.

a. pressure b. auditory stimuli c. vestibular changes d. visual motion ANSWER: d 51. Factors that increase resilience and adaptation among children with learning disorders in their transition to adulthood include all of the following EXCEPT a. a commitment to getting things done correctly the first time

b. a basic temperament that elicits positive responses from others Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 c. a well-developed sense of efficacy, preparedness, and self-esteem d. competent caregivers and supportive adults ANSWER: a 52. Nonverbal learning disabilities are deficits related to ____. a. cellular abnormalities in the left hemisphere b. functional abnormalities in the right hemisphere c. abnormalities of the planum temporale d. excesses of dopamine neurotransmitters ANSWER: b 53. Nonverbal learning disabilities are characteristic of children who perform worse at ____ than reading. a. sports b. singing c. math d. spelling ANSWER: c 54. This part of the brain, which is the first part of the brain to process speech, receives electrical signals from receptors in the ears and transforms them into sound sensations. a. The temporal lobe

b. The auditory association area c. The primary auditory cortex d. The parietal lobe ANSWER: c 55. ____ is based on the premise that the ability to decode and recognize words accurately and rapidly must be acquired before reading comprehension can occur. a. Recognition learning

b. Direct learning c. Direct instruction d. Recognition instruction ANSWER: c 56. Which intervention would be least likely to be used with a child with a learning disorder? a. Implementation of behavioral reinforcement b. Prescribing medications that help learning c. Teaching the child to monitor his or her own thought processes d. Individual counseling to help the child to develop more positive feelings about his or her abilities ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 57. Intervention methods and treatments for SLD rely primarily on _________. a. psychosocial methods b. surgical treatments c. prescription medications d. a combination of biological and educational treatments ANSWER: a 58. The FIRST step in direct behavioral instruction is to ___________. a. review the child’s existing disabilities b. develop a short statement of goals at the beginning of a lesson c. provide clear and detailed instructions and explanations d. provide explicit guidance for each student during initial practice ANSWER: a 59. This law, originally passed in 1975 and renamed in 2004, mandates that children with special needs must be afforded access to all educational services, regardless of their handicaps. The Act, signed into U.S. law in 2002, allowed for more intensified efforts by each state to improve the academic achievement of public school students considered at risk for school failure. a. Individuals with Disabilities Education Act

b. No Child Left Behind Act c. Every Student Succeeds Act d. Old Deluder Satan Act ANSWER: a 60. Which of the following is NOT a critical element for a successful beginning reading program? a. Providing direct instruction in language analysis b. Providing direct teaching of the alphabetic code c. Teaching reading and spelling in coordination d. Teaching reading and writing in coordination ANSWER: d Subjective Short Answer 61. Differentiate between the terms learning disabilities, communication disorders, and specific learning disorder.

ANSWER: Learning disability is a lay term (not a diagnostic term) that refers to significant problems in mastering one or more of the following skills: listening, speaking, reading, writing, reasoning, and mathematics.

Communication disorder is a diagnostic term that refers to deficits in language, speech, and communication.

Specific learning disorder is a diagnostic term that refers to specific problems in learning and using academic skills. The DSM-5 integrates the frequently co-occurring problems in reading, mathematics, and written expression into this one category, and uses specifiers to designate impairments in one or more of these areas.

62. Strauss and Werner (1943) pointed out that children learn in their own individual ways. List the three important concepts developed from their idea that continues to influence the field to this day.

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Chapter 07 ANSWER: (1) Children approach learning in different ways, so each child’s individual learning style and uniqueness should be recognized and used to full advantage. (2) Educational methods should be tailored to an individual child’s pattern of strengths and weaknesses; one method should not be imposed on everyone. (3) Children with learning problems might be helped by teaching methods that strengthen existing abilities rather than emphasize weak areas.

63. What is meant by a “perceptual map” for language and how does it develop?

ANSWER: A perceptual map forms that represents similarities among sounds and helps the infant learn to discriminate among different phonemes. These maps form quickly; 6-month-old children of English-speaking parents already have auditory maps different from infants in non-English-speaking homes, as measured by neuron activity in response to different sounds (Kuhl et al., 2006). By their first birthday, the maps are complete, and infants are less able to discriminate sounds that are not important in their own language.

64. Outline and describe the diagnostic criteria for a language disorder.

ANSWER: Criteria include: (1) persistent difficulties in the acquisition and use of language across modalities due to deficits in comprehension or production that include reduced vocabulary knowledge and use, limited sentence structure, and impairments in discourse; (2) language abilities that are substantially and quantifiably below those expected for age, resulting in functional limitations in effective communication, social participation, academic achievement, or occupational performance; (3) onset of symptoms occurring in the early developmental period; and (4) difficulties that are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition or better explained by an intellectual disability.

65. What particular difficulties and errors might suggest that a child has a reading disorder?

ANSWER: A child with an SLD with impairment in reading lacks the critical language skills required for basic reading: word reading accuracy, reading comprehension, and reading rate or fluency. Dyslexia is an alternative term sometimes used to describe this pattern of reading difficulties. These core deficits stem from problems in decoding—breaking a word into parts rapidly enough to read the whole word—coupled with difficulty reading single small words (Cho et al., 2017). When a child cannot detect the phonological structure of language and automatically recognize simple words, reading development will very likely be impaired (Peterson & Pennington, 2010). The slow and labored decoding of single words requires substantial effort and detracts from the child’s ability to retain the meaning of a sentence, much less a paragraph or page.

66. What kind of deficits might a parent or teacher notice in a child who has a writing disorder?

ANSWER: Children with impairment in written expression often have problems with tasks that require eye–hand coordination, despite their normal gross motor development. Teachers notice that, as compared with children who have normal writing skills, children with impairments in writing produce shorter, less interesting, and poorly organized essays and are less likely to review spelling, punctuation, and grammar to increase clarity (Hooper et al., 2011, 2013). However, spelling errors or poor handwriting that do not significantly interfere with daily activities or academic pursuits do not qualify a child for this diagnosis. In addition, problems in written expression signal the possibility of other learning problems because of shared metacognitive processes: planning, self-monitoring, self-evaluation, and self-modification (Lewandowski & Lovett, 2014).

67. What particular difficulties, errors, and/or deficits suggest a child has an impairment in mathematics?

ANSWER: For some children, impairment in mathematics is displayed by an inability to grasp the abstract concepts inherent in many forms of numerical and cognitive problem solving. Criteria for SLD with impairment in mathematics include difficulties in number sense, memorization of arithmetic facts, accurate or fluent calculation, and/or accurate math reasoning. Other manifestations include recognizing numbers and symbols, aligning numbers, and understanding concepts such as place value and fractions.

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Chapter 07 68. It has been suggested that language-based learning disorders are related to neurological deficits in sensitivity. What is the nature of this argument?

ANSWER: A specific defect in the perception of visual motion may interfere with many different brain functions, and it has been noted among children with autism as well as those with learning disorders (Benassi et al., 2010; Skottun, 2015). To detect differences between consonant sounds—such as b and t—we must be able to distinguish between very rapid changes in sound frequency. A subtle neurological deficit in sensitivity could prohibit this distinction, which would then show up clinically as problems in reading and phonological processing (Raschle et al., 2011).

69. How do the biological causes of language-based learning disabilities and nonverbal learning disabilities differ?

ANSWER: SLD with impairment in mathematics, and perhaps SLD with impairment in written expression as well, are associated with brain deficits that differ from those described for language-based learning disorders. These deficits are largely found in areas not related to verbal ability, which has led to the term nonverbal learning disability. Nonverbal learning disability (NLD) is associated with deficits related to right-hemisphere brain functioning, which are characteristic of children who perform considerably worse at math than reading. These deficits involve social/emotional skills, spatial orientation, problem solving, and the recognition of nonverbal cues such as body language. In addition to math deficiencies, NLD may be accompanied by neuropsychological problems such as poor coordination, poor judgment, and difficulties adapting to novel and complex situations.

70. Discuss the two major findings that implicate specific biological underpinnings of reading disorders.

ANSWER: (1) Language difficulties for people with reading disorders are specifically associated with the neurological processing of phonology and storage of such information into memory; and (2) behavioral and physiological abnormalities are found in the processing of visual information. It is not surprising, therefore, that phonological and visual processing problems often coexist among people with reading disorders (Skottun, 2015).

71. Summarize the use of computer-assisted learning for specific learning disorders.

ANSWER: Computers have been used as simple instructional tools to deliver questions and answers since the 1970s.

Since discovering phonological awareness and timing problems in the brain, researchers are now testing whether computers can remedy some basic auditory problems. Some children with communication and learning disorders are unable to process information that flashes by too quickly, such as the consonant sounds ba and da, and this deficit interferes with vital speech processes. Computer programs are able to slow down these grammatical sounds, allowing young children to process them more slowly and carefully.

72. Eight-year-old Jessica has a mathematics disorder. You have been asked to make recommendations to Jessica’s parents and teacher as to how they might help Jessica. From a behavioral and cognitive–behavioral standpoint, what specific recommendations would you make?

ANSWER: Behavioral methods often are used in conjunction with a complete program of direct instruction, which typically proceeds in a cumulative, highly structured manner (Wright & Jacobs, 2003), as shown in A Closer Look 7.2. Because this method places a strong emphasis on the behavior of the teacher in terms of explicit correction, reinforcement, and practice opportunities, it is sometimes referred to as “faultless instruction”: Each concept should be so clearly presented that only one interpretation is possible. Each lesson is structured according to field-tested scripts. Teachers work with one small group of students at a time, and shoot questions at them at a rate as high as 10 to 12 per minute. This highly structured, repetitive method is clearly effective. Like behavioral methods, these procedures actively involve students in learning, particularly in monitoring their own thought processes. Considerable emphasis is placed on self-control by using strategies such as self-monitoring, self-assessment, self-recording, self-management of reinforcement, and so on (Cuillo et al., 2016; Cobb et al., 2009). Essentially, children are taught to ask themselves several questions as they progress, to make themselves more aware of the material.

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Chapter 07 73. List the steps involved in direct behavioral instruction.

ANSWER: 1. Review the child’s existing abilities.

2. Develop a short statement of goals at the beginning of each lesson.

3. Present new concepts and material in small steps, each followed by student practice.

4. Provide clear and detailed instructions and explanations.

5. Provide considerable practice for all students.

6. Check student understanding of concepts continually, in response to teacher questions.

7. Provide explicit guidance for each student during initial practice.

8. Provide systematic feedback and corrections.

9. Provide explicit instruction and practice for exercises completed by students at their desks.

74. Compare and contrast behavioral strategies for addressing SLD with cognitive–behavioral interventions.

ANSWER: Behavioral strategies include providing children with a set of verbal rules that can be written out and reapplied. In addition to academic concepts, some of the associated problems with peers can be addressed in this same way. Behavioral methods often are used in conjunction with a program of direct instruction, and should be highly structured and repetitive. Cognitive–behavioral interventions also actively involve students in learning and monitoring their own thought processes. Emphasis is placed on self-control by using strategies such as self-monitoring, self-assessment, self-recording, and self-management.

75. Discuss why children with learning disorders might display more acting out behaviors at school and the behavioral strategies used.

ANSWER: Many problems that children with communication and learning disorders have stem from the fact that the material is simply presented too fast for them (Tallal & Benasich, 2002). Thus, a strategy to provide children with a set of verbal rules that can be written out and reapplied may be more beneficial than one that relies on memory or on grasping the concept all at once. Tried-and-true behavioral principles of learning are well suited to this task of teaching systematically. Behavioral methods often are used in conjunction with a complete program of direct instruction, which typically proceeds in a cumulative, highly structured manner (Wright & Jacobs, 2003), as shown in A Closer Look 7.2. Because this method places a strong emphasis on the behavior of the teacher in terms of explicit correction, reinforcement, and practice opportunities, it is sometimes referred to as “faultless instruction”: Each concept should be so clearly presented that only one interpretation is possible. Each lesson is structured according to field-tested scripts. Teachers work with one small group of students at a time, and shoot questions at them at a rate as high as 10 to 12 per minute.

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Chapter 08 Multiple Choice 1. One of the first known published accounts of hyperactivity in children, published in 1845, referred to a. a child named “Fidgety Phil.” b. a boy from Chicago named Dusty. c. a child who was often the symptom of ridicule at school. d. a boy who was ostracized and had no friends ANSWER: a 2. In an early study, Sir Alexander Crichton described a syndrome that included early onset, restlessness, inattention, and poor school performance. Such individuals were described as having _______________. a. attention deficit disorder (ADD)

b. the fidgets c. ADHD d. brain-injured child syndrome ANSWER: b 3. The brain damage theory of ADHD, which arose in the 1940s and 1950s, was discarded because ____. a. no evidence of brain damage could be found using x-ray b. the psychological cause of ADHD was “found” in 1958 c. it could explain only a very small number of cases of ADHD d. brain damage was thought to cause mental retardation, not ADHD ANSWER: c 4. Which of the following statements about ADHD is false? a. No single cause for the behavior patterns of children with ADHD has been identified. b. ADHD is an umbrella term used to describe several different patterns of behavior that differ slightly. c. Hyperactivity and inattention together are essential features of ADHD. d. There are no distinct signs of ADHD that can be seen with an x-ray or a lab test.

ANSWER: c 5. Virginia Douglas (1972) made the argument that ____. a. hyperactivity is the primary component of ADHD b. in addition to hyperactivity, inattention and deficits in impulse control are the primary symptoms c. ADHD is due to minimal brain damage d. ADHD is psychological rather than biological in origin ANSWER: b 6. Recently, the symptoms that have been emphasized as the central impairments of ADHD are ____. a. inattention and difficulty regulating motor behavior b. difficulty inhibiting behavior and poor self-regulation Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 c. inattention and poor moral control d. hyperactivity and cognitive problems ANSWER: b 7. Jeremy cannot remember a phone number without jotting it down. He demonstrates a deficit in ____. a. impulsivity b. sustained attention c. selective attention d. attentional capacity ANSWER: d 8. When Jessica sits down to do her homework and study, she is easily distracted by the television in another room.

Jessica demonstrates a deficit in ____. a. attentional control

b. sustained attention c. selective attention d. attentional capacity ANSWER: c 9. Bradley has particular difficulty paying attention when he is tired or uninterested in the task at hand. Bradley demonstrates a deficit in ____. a. sustained attention

b. distractibility c. selective attention d. attentional capacity ANSWER: a 10. Which of the following is another term for a deficit in selective attention? a. Distractibility b. Impulsivity c. Dual attention d. Disorganization ANSWER: a 11. The core attentional deficit in ADHD is believed by many to be ____. a. selective attention b. attentional capacity c. sustained attention/vigilance d. distractibility ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 12. What might be the most difficult task for a child with ADHD? a. Learning a new video game b. Paying attention to the teacher when someone else in the class is talking c. Remembering a friend’s phone number d. Working for 45 minutes on a sheet of simple math problems ANSWER: d 13. When is a child with ADHD likely to display more motor activity than other children? a. When asked to sit still at his desk b. In his sleep c. While playing on the playground d. All of these ANSWER: a 14. What is an example of cognitive impulsivity? a. Blurting out an answer in class b. Touching a hot stove c. Rushed thinking d. Interrupting a parent on the telephone ANSWER: c 15. Children with ADHD who are at increased risk for conduct or oppositional problems are those who exhibit ____. a. behavioral impulsivity b. cognitive impulsivity c. selective inattention d. diminished attentional capacity ANSWER: a 16. Children who are at increased risk for problems in academic achievement are those who exhibit ____. a. behavioral impulsivity b. cognitive impulsivity c. selective inattention d. behavioral impulsivity and cognitive impulsivity ANSWER: d 17. Which of the following is an additional criterion for a diagnosis of ADHD? a. Symptoms must appear prior to age 12. b. Symptoms must be present for at least one year. c. Symptoms must occur in at least one setting. d. Symptoms must produce significant impairments in the child’s social or academic performance.

ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 18. Which of the following is not an additional criterion for a diagnosis of ADHD? a. Symptoms must appear prior to age 12. b. Symptoms must be present for at least 6 months. c. Symptoms must occur in more than one setting. d. Symptoms must produce significant impairments in the child’s social or academic performance.

ANSWER: a 19. In comparison to children with ADHD-HI, children with the subtype ADHD-PI are at greater risk of ____. a. antisocial behavior b. rejection by peers c. anxiety/mood disorders d. placement in a special education class ANSWER: c 20. Which of the following is not true about ADHD-HI? a. Children with ADHD-HI are often older than those with ADHD-C. b. The ADHD-HI subtype is the rarest subtype of ADHD. c. Children with ADHD-HI are more likely to display behavioral problems than those with ADHD-PI. d. Children with ADHD-HI are more likely to be suspended from school than those with ADHD-PI. ANSWER: a 21. Which of the following is not true about ADHD-PI? a. Children with ADHD-PI are often described as daydreamy and drowsy. b. Children with ADHD-PI have difficulties with speed of information processing. c. Children with ADHD-PI are often described as aggressive and rude. d. Research evidence suggests that children diagnosed with ADHD-PI may actually have a completely different disorder than children with ADHD-HI and ADHD-C.

ANSWER: c 22. Diagnostic criteria for ADHD includes which symptom of inattention? a. Often fidgets with or taps hands or feet or squirms in seat b. Often has difficulty organizing tasks and activities c. Often talks excessively d. Often has difficulty waiting his/her turn ANSWER: b 23. The mental processes underlying children’s capacity for self-regulation are called ____. a. executive functions b. metacognition c. self-perceptions Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 d. thought tracking ANSWER: a 24. Which statement best describes the intelligence of a child with ADHD? a. Over 50% of children with ADHD are below average in intelligence. b. Over 50% of children with ADHD are above average in intelligence. c. Brighter children tend to show more symptoms of impulsivity and hyperactivity. d. Most children with ADHD are of average intelligence.

ANSWER: d 25. Which child would be more likely to display a positive illusory bias? a. A child with ADHD-HI and conduct problems b. A child with ADHD-HI and depression c. A child with ADHD-PI and anxiety d. A child with ADHD-PI and conduct problems ANSWER: a 26. Which is a characteristic of the speech/language of a child with ADHD? a. Mumbling that is difficult to distinguish b. Consistent topic discussion c. Quiet speech that is difficult to hear d. Unclear links in conversation ANSWER: d 27. Which of the following is NOT an area in which symptoms of accident-proneness and risk taking that are common in individuals with ADHD are manifested? a. Driving behaviors

b. Anxiety disorders c. Incidence of STDs d. Substance abuse ANSWER: b 28. Mothers of children with ADHD are also more likely to have ____. a. substance abuse problems b. schizophrenia c. depression d. antisocial personality disorder ANSWER: c 29. Which of the following is TRUE of children with ADHD? a. They are deficient in social reasoning.

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Chapter 08 b. They have the same social agenda as their peers. c. They report receiving high social support from peers. d. They are consistently rejected by peers ANSWER: d 30. Children with ADHD display ____. a. a decreased desire for peer relationships b. a poor understanding of social reasoning c. a strong ability to correctly recognize emotions in others d. little give-and-take in relationships with peers ANSWER: d 31. The most common comorbid psychological disorder(s) in children with ADHD is/are ____. a. anxiety and depression b. oppositional defiant disorder and depression c. tic disorder d. conduct disorder and oppositional defiant disorder ANSWER: d 32. A common condition among children with ADHD, a ______________ is characterized by marked motor incoordination and delays in achieving motor milestones. a. mood dysregulation disorder

b. tic disorder c. developmental coordination disorder (DCD) d. developmental learning disorder (DLD) ANSWER: c 33. The relationship between ADHD and depression appears to be a function of ____. a. the bullying and isolation that a child experiences b. family risk for one disorder increasing the risk for the other c. general family stress d. the parallel impact of school achievement ANSWER: b 34. The best prevalence estimate for ADHD in school-age children in North America is ____. a. 1% to 2% b. 5% to 9% c. 12% to 14% d. 15% to 20% ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 35. The higher incidence of ADHD in boys versus girls is most likely due to ____. a. girls age out of ADHD in childhood b. societal expectations and acceptance c. more aggression in girls d. greater attention span in females ANSWER: b 36. In comparison to boys, girls with ADHD are more likely to display ____. a. higher levels of hyperactivity b. greater impairment in executive functions c. higher levels of aggression d. inattentive/disorganized symptoms ANSWER: d 37. Girls with ADHD are more likely than girls without ADHD to have ____. a. conduct, mood, and anxiety disorders b. lower rates of verbal aggression c. higher IQ and school achievement scores d. a large social network ANSWER: a 38. The higher rates of ADHD in lower SES groups are best accounted for by ____. a. the presence of co-occurring depression b. the presence of co-occurring parental psychopathology c. the presence of co-occurring conduct problems d. the presence of co-occurring learning problems ANSWER: c 39. Which is true regarding ADHD and culture? a. ADHD has been found to occur more in higher SES groups than lower ones. b. ADHD has been identified in only one or two countries around the world in which it has been studied. c. Differences in the prevalence of ADHD across cultures may reflect cultural norms. d. ADHD presents the same in each country.

ANSWER: c 40. Children from which racial/ethnic group are teachers most likely to rate as ADHD? a. Caucasian b. African American c. Asian d. Hispanic ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 41. Mothers of children with ADHD often describe their children as being ____ as infants. a. difficult b. easy c. indistinguishable from their siblings d. overly anxious and depressed ANSWER: a 42. With regard to the onset of symptoms of ADHD, ____. a. symptoms of hyperactivity–impulsivity and inattention tend to emerge at about the same time, usually in the preschool years b. symptoms of hyperactivity–impulsivity and inattention tend to emerge at about the same time, usually in the early primary school years c. symptoms of inattention usually emerge before symptoms of hyperactivity–impulsivity

d. symptoms of hyperactivity–impulsivity usually decline by adolescence ANSWER: d 43. Which is true of the course of ADHD? a. ADHD does not develop until school age. b. The majority of children with ADHD outgrow their problems before adolescence. c. Many adults have ADHD but were never been diagnosed in childhood. d. Signs of ADHD are unlikely to be present before the age of two.

ANSWER: c 44. Individuals with ADHD are typically identified as ADHD and referred for special assistance during the __________. a. preschool b. elementary school c. adolescence d. adulthood ANSWER: b 45. Which of the following is most likely to cause ADHD? a. Too much sugar b. Fluorescent lighting c. Poor school environment d. No single theory has been able to identify a cause ANSWER: d 46. Children with ADHD display deficits in ____. a. intelligence b. motor activity c. self-regulation Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 d. arousal ANSWER: d 47. Research into causal factors provides strong evidence for ADHD as a disorder with ____ determinants. a. biological b. neurobiological c. socioenvironmental d. familial ANSWER: b 48. Twin studies suggest that ____ factors play the largest role in accounting for ADHD. a. shared environmental b. nonshared environmental c. heritable d. cultural ANSWER: c 49. DRD4, the dopamine receptor gene, has been linked to ____. a. inhibition b. attention c. impulsivity d. cognition ANSWER: c 50. Minor physical anomalies and other risk factors before, during, and after birth are specific risk factors for ____. a. ADHD, but not other forms of psychopathology b. many forms of psychopathology c. ADHD and conduct disorder alone d. anxiety and depression alone ANSWER: b 51. Neurobiological research on the causes of ADHD has shown consistent support for the implication of the a. limbic system. b. hippocampus. c. reticular activating system. d. frontostriatal circuitry.

ANSWER: d 52. In Hoover and Milich’s study (1994), mothers who (erroneously) believed that their children had ingested sugar ____. a. described them as “sweeter” than did mothers of children in the control condition b. rated them as happier and calmer than did mothers of children in the control condition Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 c. were more critical of their children and rated them as more hyperactive than did mothers of children in the control condition d. did not notice any change in their children’s behavior

ANSWER: c 53. What does research into the negative influence of family on ADHD symptomatology indicate? a. Familial factors account for a significant degree of variance in ADHD symptoms. b. Familial factors account for only a small degree of variance in ADHD symptoms. c. Familial factors may increase the severity of certain ADHD symptoms. d. Familial factors account for only a small degree of variance in ADHD symptoms, although they may increase the severity of certain symptoms.

ANSWER: d 54. One focus of educational intervention treatments is to a. provide a supportive relationship in which the youth can discuss personal concerns and feelings. b. combine other treatments in an intensive treatment program. c. reduce conflicts at home. d. teach prosocial and self-regulating behaviors.

ANSWER: d 55. Stimulant medications work by ____. a. paradoxically slowing kids down b. altering neurotransmitter activity in the frontostriatal region of the brain (stimulating areas that are underaroused) c. enhancing mood, which in turn enhances self-esteem and behavioral control

d. “convincing” parents and teachers that the medications are working, even when they’re not (placebo effect) ANSWER: b 56. An educational intervention for ADHD may include ____. a. positive punishment procedures in the classroom b. use of workbooks in the classroom c. giving written and oral instructions in the classroom d. residential care ANSWER: c 57. What were the results of the Multimodal Treatment Study of Children with ADHD (MTA Study)? a. In general, behavioral treatment was superior to medication management. b. Adding behavioral treatments to medication resulted in benefits over and above medications in terms of alleviating core symptoms. c. Three years after the conclusion of the treatment, only the medication management group continued to benefit from treatment. d. There were no variations in the amount of change between groups.

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Chapter 08 ANSWER: c 58. When utilizing educational interventions, disruptive or off-task classroom behaviors may be punished with ____ that involve the loss of privileges, activities, points, or tokens following inappropriate behavior. a. partial-response procedures

b. all-or-nothing procedures c. response-cost procedures d. delayed-cost procedures ANSWER: c 59. Causes for the controversy over Ritalin and other stimulants include all of the following EXCEPT a. questions about whether parents are being coerced into administering stimulants so that their children can attend school. b. a large and growing number of children and adolescents in the US are taking stimulants for ADHD.

c. research on the benefits of stimulants is contradictory; some studies suggest substantial benefits while others suggest that their usage is harmful. d. wide varieties in diagnostic practices, treatment decisions, and rates of use contribute to inconsistent practices and conclusions about results.

ANSWER: c 60. One exemplary intensive intervention for ADHD, developed by Dr. William Pelham, is known as the a. parent management training (PMT). b. school-based intervention program. c. summer treatment program. d. stimulant medications intensive treatment program.

ANSWER: c Subjective Short Answer 61. Describe three types of attention deficits seen in children with ADHD, and provide an example of each.

ANSWER: Inattention refers to an inability to sustain attention or stick to tasks or play activities, to and follow through on instructions or rules, and to resist distractions. It also involves difficulties in planning and organization and in timeliness and problems in staying alert. With hyperactivity, recordings of body movements indicate that even when they sleep, children with ADHD display more motor activity than other children (Teicher et al., 1996). However, the largest differences are found in situations requiring the child to inhibit motor activity— to slow down or sit still in response to the structured task demands of the classroom. Children who are impulsive seem unable to bridle their immediate reactions or think before they act. They may take apart an expensive clock with little thought about how to put it back together. It’s very hard for them to stop an ongoing behavior or to regulate their behavior in accordance with the demands of the situation or the wishes of others.

62. What are some of the limitations of the DSM-5 as a means of diagnosing ADHD? What changes have been suggested to address these limitations?

ANSWER: Although DSM states that clinical judgment may be used to assess whether symptoms are “inconsistent with developmental level,” it applies the same symptoms to individuals of all ages, even though some symptoms, Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 particularly for hyperactive–impulsive behaviors (running and climbing), apply more to young children.

According to DSM, ADHD is a disorder that a child either has or doesn’t have. However, because the number and severity of symptoms are also calculated on a scale, children who fall just below the cutoff for ADHD are not necessarily different from children just above the cutoff. These limitations highlight the fact that DSM criteria are designed to classify and diagnose. They help shape our understanding of ADHD but are also shaped by—and in some instances lag behind—new research findings.

63. Executive functions include cognitive, language, motor, and emotional processes. Give an example of each, and explain how executive functions relate to ADHD. ANSWER: Executive functions (EFs) are cognitive processes in the brain that activate, integrate, and manage other brain functions. Cognitive processes, such as working memory (holding facts in mind while manipulating information), mental computation, planning and anticipation, flexibility of thinking, and the use of organizational strategies. Language processes, such as verbal fluency and the use of self-directed speech.

Motor processes, such as allocation of effort, following prohibitive instructions, response inhibition, and motor coordination and sequencing. Emotional processes, such as self-regulation of arousal level and tolerating frustration.

64. Identify and describe symptoms of ADHD related to accident-proneness and risk taking.

ANSWER: Children with ADHD are significantly more likely to experience serious accidental injuries. They are at higher risk for traffic accidents and deviant peer associations that could also encourage risky behaviors, especially among adolescents. One study of boys with ADHD found that they had more risky driving behaviors, STDs, head injuries, and ER admissions, compared to a control group. A Danish study found that ADHD associated with excess mortality, notably driven by deaths from unnatural causes. Finally, ADHD prevalence is negatively associated with health-promoting behaviors, such as exercise, proper diet, safe sex, and avoidance of tobacco, alcohol, and caffeine use.

65. The co-occurrence of ADHD and conduct disorder has led some researchers to suggest a subgroup of children with ADHD at increased risk for conduct problems. What support is there for such a subtype?

ANSWER: Longitudinal studies have found that ADHD leads to ODD and CD rather than vice versa (Thapar et al., 2006). Interestingly, persistent and severe ODD and CD outcomes among children with ADHD are related to variations in a specific gene (COMT) known to be associated with the regulation of neurotransmitters in the areas of the brain implicated in ADHD. These findings suggest the existence of a subgroup of children with ADHD who are at biological risk for later developing conduct problems (Caspi et al., 2008). Finally, ADHD is also a risk factor for the later development of antisocial personality disorder (APD) (Storebø & Simonsen, 2013), a pervasive pattern of disregard for, and violation of, the rights of others, as well as involvement in multiple illegal behaviors.

66. How do the symptoms of inattention and hyperactivity–impulsivity change over the lifespan?

ANSWER: Symptoms of inattention become especially evident when the child starts school. Classroom demands for sustained attention and goal-directed persistence are formidable challenges for these children (Kofler, Rapport, & Alderson, 2008). Not surprisingly, this is when children are usually identified as having ADHD and referred for special assistance. Symptoms of inattention continue through grade school, resulting in low academic productivity, distractibility, poor organization, trouble meeting deadlines, and an inability to follow through on social promises or commitments to peers. The hyperactive–impulsive behaviors that were present in preschool continue, with some decline, from 6 to 12 years of age (Barkley, 2006a). Although hyperactive– impulsive behaviors decline significantly by adolescence, they still occur at a higher level than in 95% of same-age peers who do not have ADHD. The disorder continues into adolescence for at least 50% or more of clinic-referred elementary school children. Childhood symptoms of hyperactivity–impulsivity (more so than symptoms of inattention) are generally related to poor adolescent outcomes (Barkley, 2006b). Unfortunately, most children with ADHD will continue to experience problems, leading to a lifelong pattern of suffering and Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 disappointment (Barkley, 2014a, b). Once thought of primarily as a disorder of childhood, ADHD is now well established as an adult disorder. Adults with ADHD are restless, easily bored, and constantly seeking novelty and excitement; they may experience work difficulties, impaired social relations, and suffer from depression, low self-concept, substance abuse, and personality disorder

67. Distinguish between the different subtypes of ADHD. ANSWER: Predominantly inattentive presentation (ADHD-PI) describes children who meet symptom criteria for inattention but not hyperactivity–impulsivity. Predominantly hyperactive–impulsive presentation (ADHD-HI) describes children who meet symptom criteria for hyperactivity-impulsivity but not inattention. Combined presentation (ADHD-C) describes children who meet symptom criteria for both inattention and hyperactivity–impulsivity.

68. List and describe impaired executive functions in ADHD as well as resulting impairments.

ANSWER: Six impaired executive functions in individuals with ADHD have been identified. Along with their resulting impairments, they are as follows: (1) Organize, prioritize, and activate: trouble getting started; difficulty organizing work; misunderstanding directions; (2) Focus, shift, and sustain attention: lose focus when trying to listen; forget what has been read and need to reread; easily distracted; (3) Regulate alertness, effort, and processing speed: excessive daytime drowsiness; difficulty completing a task on time; slow processing speed; (4) Manage frustration and modulate emotion: very easily irritated; feelings hurt easily; overly sensitive to criticism; (5) Working memory and accessing recall: forget to do a planned task; difficulty following sequential directions; quickly lose thoughts that were put on hold; (6) Monitor and regulate action: find it hard to sit still or be quiet; rush things or slapdash; often interrupt, blurt things out.

69. Describe the difficulties children experience that have co-occurring ADHD and anxiety.

ANSWER: These children worry about being separated from their parents, trying something new, taking tests, making social contacts, or visiting the doctor. They may feel tense or uneasy and constantly seek reassurance that they are safe and protected. Because these anxieties are unrealistic, more frequent, and more intense than normal, they have a negative impact on the child’s thinking and behavior.

70. Describe the influence that dietary factors, notably sugar consumption, contribute to hyperactivity.

ANSWER: Despite popular perception, multiple studies have conclusively shown that sugar is not a cause of hyperactivity. Popular perception, contrary to these findings, are long-standing and have been scientifically verified as related to the power of suggestion in studies showing parents’ reactions and behavior with regard to perceived sugar consumption. This relates to ADHD because what parents believe about the causes of their children’s ADHD can affect their views of their children, how they treat them, as well as treatment options pursued.

71. Discuss the behavioral differences in boys and girls with ADHD that have been found in clinical samples.

ANSWER: In the past, girls with ADHD were a highly understudied group (Hinshaw & Blachman, 2005). Although girls with ADHD tend to display inattentive/ disorganized symptoms, some research shows more similarity between girls and boys with ADHD than was previously thought to exist. Some studies have found that among clinic-referred school-age children with ADHD, boys and girls are quite similar with respect to their expression and severity of symptoms, brain abnormalities, deficits in response inhibition and executive functions, level of impairment, family correlates, response to and young adulthood, including anxiety; depression; romantic relationship difficulties; conflict with mothers; significant peer rejection and conduct problems; large deficits in academic achievement; continuing deficits in attention, executive functions, and language; impaired decision making; and high rates of service utilization (Babinski et al., 2010; Biederman et al., 2010; Mick et al., 2011; Miller et al., 2013; Owens et al., 2014).

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Chapter 08 72. Discuss the nature of relationships in adolescence.

ANSWER: Despite their many social problems with peers, some adolescents with ADHD may meet their social needs by maintaining one or two positive close friendships (Glass, Flory, & Hankin, 2012). The social premise for such relationships may differ from those of other teens, possibly with a mutual focus on “having fun” rather than on seeking emotional support. Positive friendships may buffer the negative outcomes of peer rejection commonly seen in children with ADHD.

73. What is the role of the family in etiology and development of ADHD symptoms?

ANSWER: Family influences may lead to ADHD symptoms or to a greater severity of symptoms. In some cases, ADHD symptoms may be the result of interfering and insensitive early caregiving practices (Carlson, Jacobvitz, & Sroufe, 1995), especially in children with a specific genetic risk for ADHD (Martel et al., 2011). Thus, parenting practices may interact with the child’s genetic makeup to moderate risk for ADHD. In addition, for children at risk for ADHD, family conflict may raise the severity of their hyperactive–impulsive symptoms to a clinical level. Family problems may result from interacting with a child who is impulsive and difficult to manage (Mash & Johnston, 1990). The clearest support for this child-to-parent direction of effect comes from double-blind placebo-controlled drug studies in which children with ADHD who received stimulant medications showed a decrease in their symptoms. Family conflict is likely related to the presence, persistence, or later emergence of associated oppositional and conduct disorder symptoms. In children with an inherited biological risk for ADHD, family conflict may heighten the emergence of early ODD and later comorbid ADHD and CD (Beauchaine et al., 2010). For example, children with ADHD report observing more interparental conflict than do children without ADHD, which may worsen ADHD and related ODD and CD symptoms in those who have a genotype that makes them particularly vulnerable to the effects of the emotional stress and self-blame associated with interparental conflict.

74. Discuss the relationship between ADHD and race and ethnicity. What racial/ethnic groups are teachers most and least likely to rate as ADHD. ANSWER: Research on the relationships among ADHD, race, and ethnicity has been inconsistent, and it remains unclear whether current tools for assessing ADHD adequately capture the expression of ADHD in minority groups.

By kindergarten entry, children in the United States who are black are 70% less likely to be diagnosed with ADHD than otherwise similar white children—even though they are equally likely to display ADHD-related behaviors in the classroom (Morgan et al., 2014). However, for older children, teacher-rated ADHD and observed rates of ADHD behavior are higher for black than for white children, which are not explained by rater bias or SES (Miller, Nigg, & Miller, 2009). Slightly lower rates of ADHD have been reported for Hispanic, Asian, American Indian, and Pacific Islander children (Cuffe, Moore, & McKeown, 2005).

Knowledge about ADHD and access to treatment seem to be greater among Caucasian, non-Hispanic, and more highly educated families (McLeod et al., 2007; Miller et al., 2009).However, some research suggests that when families from different ethnic groups do receive treatment, they do not differ in the benefits derived (Jones et al., 2010).

75. Discuss the factors that can influence more positive outcomes for children with ADHD. ANSWER: Some children with ADHD either outgrow their disorder or learn to cope with it, particularly those with mild ADHD and without conduct or oppositional problems. Better outcomes are more likely for children whose symptoms are less severe and who receive good care, supervision, and support from their parents and teachers and who have access to economic and community resources, including educational, health, and mental health services (Kessler et al., 2005).

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Chapter 09 Multiple Choice 1. Which of the following is true regarding antisocial behavior in adolescents? a. Very few adolescents completely refrain from antisocial behavior, and they tend not to be well adjusted. b. Antisocial behavior in adolescence is generally not common and is typically associated with poor adjustment. c. Antisocial behavior tends to increase in adolescence. d. Antisocial behavior is as common in adolescence as it is in childhood.

ANSWER: a 2. Which of the following is true regarding gender differences in antisocial behavior? a. Boys and girls do not differ in rates of antisocial behavior in childhood. b. Throughout the lifespan, males display more antisocial behavior than females. c. Boys are more aggressive than girls in childhood, but this difference decreases or disappears by adolescence. d. Boys are more aggressive in childhood, but girls are more aggressive in adolescence ANSWER: c 3. Which statement about the stability of antisocial behavior is true? a. Aggressive behavior is relatively unstable over the course of the lifespan. b. Aggressive behavior is highly stable for brief periods of the lifespan. c. Aggressive behavior is not as stable as IQ scores. d. Aggressive behavior is highly stable over the course of the lifespan, about as stable as IQ scores.

ANSWER: d 4. Delinquency, in the legal sense, may result from ____, whereas a mental disorder requires ____. a. one or two isolated acts, several isolated acts b. a persistent pattern of antisocial behaviors, one or two isolated acts c. one or two isolated acts, a persistent pattern of antisocial behaviors d. related acts, unrelated acts ANSWER: c 5. Violations such as running away, setting fires, skipping school, and using drugs and alcohol are referred to as ____. a. aggressive behaviors b. delinquent behaviors c. internalizing behaviors d. rule-breaking behaviors ANSWER: d 6. Behaviors such as fighting, destructiveness, and threatening others are referred to as ____. a. aggressive behaviors b. delinquent behaviors c. rule-breaking behaviors Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 d. internalizing behaviors ANSWER: a 7. Children who engage in covert behaviors only are typically ____. a. aggressive as well b. negative, irritable, and resentful in their reactions to stressful situations c. from families that experience significant conflict d. less social, more anxious, and more suspicious of others ANSWER: d 8. Children who engage in primarily overt behaviors are typically a. from families that provide little family support. b. less social, more anxious, and more suspicious of others. c. negative, irritable, and resentful in their reactions to hostile situations. d. sneaky with others.

ANSWER: c 9. Which of the following is NOT a diagnostic criterion for CD that is related to aggression to people and animals? a. Bullying b. Shoplifting c. Physical cruelty d. Use of a weapon ANSWER: b 10. In the DSM-5, oppositional defiant disorder and conduct disorders fall under the larger category of ____. a. disruptive, impulse-control, and conduct disorders b. destructive behavior disorders c. conduct problems d. aggressive behavior disorders ANSWER: a 11. The public health perspective of conduct problems attempts to reduce ____ associated with youth violence. a. injuries and deaths b. negative media c. school failure d. public policy mistakes ANSWER: d 12. ____ describes children who display an age-inappropriate recurrent pattern of stubborn, hostile, and defiant behaviors. a. Oppositional defiant disorder b. Conduct disorder Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 c. Early-onset psychopathy d. Callous behavior disorder ANSWER: a 13. Diagnostic criteria for ODD in the DSM-5 related to anger include which of the following? a. Arguing with authority figures b. Being touchy or easily annoyed c. Deliberately annoying others d. Spiteful or vindictive behavior ANSWER: b 14. ____ describes children who display severe aggressive and antisocial acts involving inflicting pain on others or interfering with others’ rights a. Oppositional defiant disorder

b. Conduct disorder c. Early-onset psychopathy d. Callous behavior disorder ANSWER: b 15. Children with adolescent-onset CD are ____ than those with childhood-onset CD. a. more likely to be girls b. more likely to display psychopathology c. more likely to be aggressive d. less likely to persist in their antisocial behavior as they get older ANSWER: d 16. Which of the following is true regarding the relationship between ODD and CD? a. Most children who display ODD go on to develop CD later. b. There is no relationship between ODD and CD. c. CD is almost always preceded by ODD. d. ODD is almost always preceded by CD. ANSWER: c 17. The lifetime prevalence rates for ODD and CD are about ____. a. 12% and 8%, respectively b. 20% and 15%, respectively c. 5% and 10%, respectively d. 9% and 7%, respectively ANSWER: a 18. At which stage would poor peer relationships be a common symptom of disruptive and antisocial behavior?

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Chapter 09 a. Adulthood b. Adolescence c. Elementary school d. Preschool ANSWER: c 19. Psychopathic features are marked by ____. a. a pattern of deceitful, callous, manipulative, and remorseless behavior b. repeated criminal acts c. diminished intelligence and inability to distinguish right from wrong d. excessive anxiety ANSWER: a 20. On tests of cognitive ability, children with conduct disorder typically ____. a. score in the below average to borderline range b. display lower performance (nonverbal) scores than verbal scores c. show no unique patterns of deficits d. show impairments despite normal intelligence ANSWER: d 21. Deficits in executive functions in children with conduct problems are likely due to ____. a. poor parenting practices b. comorbid borderline cognitive abilities c. the presence of ADHD d. comorbid learning disorders ANSWER: c 22. Underachievement in language and reading among children with conduct problems is most likely mediated by ____. a. truancy b. poor parenting practices c. the presence of ADHD d. comorbid borderline cognitive abilities ANSWER: c 23. Which statement is true regarding the relationship between conduct problems and self-esteem? a. Low self-esteem is a primary cause of antisocial behavior. b. There is no relationship between conduct problems and self-esteem. c. Conduct problems are related to an inflated, unstable, or tentative self-esteem. d. The relationship between conduct problems and self-esteem only applies to children with callous and unemotional traits.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 24. Hostile attribution bias is more likely to be displayed in ____________________ children. a. proactive–aggressive b. reactive–aggressive c. dominant–aggressive d. deviant–aggressive ANSWER: b 25. The tendency to attribute negative intent to others, especially when the actual intentions of the other child are unclear, is referred to as ____. a. trait confluence

b. hostile attribution bias c. reactive aggression d. social cognitive deficit ANSWER: b 26. General family disturbances include ____. a. marital discord and family instability b. excessive use of harsh discipline c. lack of supervision d. oversupervision ANSWER: a 27. The siblings of children referred for conduct problems usually ____. a. display as much negative behavior as their referred sibling(s) b. display normative rates of negative behavior c. display less negative behavior than their referred siblings d. only engage in negative behavior when the referred sibling is present ANSWER: a 28. Children with comorbid ____ usually escalate to more severe forms of conduct disorder. a. depression b. ADHD c. anxiety d. mental retardation ANSWER: b 29. Children with conduct problems generally show ____ anxiety than those without conduct problems, and children with a callous–unemotional interpersonal style show ____ anxiety. a. more; less

b. less; more Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 c. less; less d. more; more ANSWER: a 30. The lifetime prevalence rate for CD is about ____. a. 6% b. 8% c. 10% d. 15% ANSWER: b 31. The lifetime prevalence rate for ODD is about ____. a. 2% b. 6% c. 12% d. 18% ANSWER: c 32. The prevalence of ODD is ____ the prevalence of CD. a. less than b. equal to c. more than d. less stable from decade to decade than ANSWER: c 33. An early symptom of CD in girls is often ____. a. aggression b. lying c. theft d. sexual misbehaviors ANSWER: d 34. Compared to boys’ aggression, girls’ aggression tends to involve more ____. a. confrontation b. overtly aggressive acts c. relationally aggressive acts d. externalizing behaviors ANSWER: c 35. A factor that predicts increased delinquency among girls who attend mixed-gender schools is ____. a. early onset of menarche Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 b. aggressive behavior c. anxiety d. depression ANSWER: a 36. The earliest signs of antisocial behavior may be ____. a. parental overactivity b. difficult temperament as an infant c. ODD in toddlerhood d. rejection by peers in elementary school ANSWER: b 37. In comparison to children on the adolescent-limited path to antisocial behavior, those on the life-course-persistent path ____. a. display less consistency in their behavior across situations

b. are more relationally aggressive c. are more likely to drop out of school d. are less likely to use drugs ANSWER: d 38. In comparison to youth on the life-course-persistent path, those on the adolescent-limited path ____. a. display more extreme antisocial activity b. are more likely to drop out of school c. are often being influenced by situational factors, such as their peers d. have weaker family ties ANSWER: c 39. By their late twenties, ____ former delinquents have desisted from offending. a. very few b. about a quarter of c. about half of d. most ANSWER: d 40. The general relationship between childhood conduct problems and adult outcomes depends in part on ____. a. gender b. type and severity of conduct problems c. cultural background d. education level ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 41. Which of the following is a consistent finding for the genetic contribution to antisocial behavior? a. Genetic contributions to covert behaviors are stronger than those for overt behaviors. b. Heritability accounts for less than 10% of the variance in antisocial behavior. c. Genetics is more strongly implicated for the life-course-persistent pattern than for the adolescent-limited pattern of antisocial behavior. d. Genetic evidence indicates a complete genetic contribution to antisocial behavior.

ANSWER: b 42. Joshua is considered to have a low-active MAOA genotype. He is likely to ____. a. have difficulty concentrating b. act more aggressively c. be more sexually active d. lie frequently ANSWER: b 43. A child with antisocial behavior has an ____. a. overactive BAS and an overactive BIS b. underactive BAS and an underactive BIS c. underactive BAS and an overactive BIS d. overactive BAS and an underactive BIS ANSWER: d 44. Neurobiological factors (e.g., low arousal and autonomic reactivity) play a more central role for ____. a. late onset CD b. early onset CD c. adult criminality d. CD accompanied by anxiety ANSWER: b 45. What neurobiological factor has been linked to conduct problems? a. Paternal smoking b. Gastrointestinal deficits c. Exposure to lead d. Domestic violence ANSWER: d 46. ____ refers to the concept that the child’s behavior is both influenced by and influences the behavior of others. a. Coercion b. Attachment c. Reciprocal influence d. Influential factor Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 ANSWER: c 47. Ineffective parenting has been found to be related to conduct problems in ____. a. all children b. all children with conduct disorder c. children with conduct disorder who also display significant callous–emotional traits d. children with conduct disorder who also display high anxiety ANSWER: c 48. Unemployment, low SES, and multiple family transitions are related specifically to ____. a. early-onset CD b. late-onset CD c. criminality d. ODD ANSWER: a 49. Fathers of children with conduct disorder often display ____. a. histrionic personality and depression b. antisocial personality disorder and substance abuse c. antisocial personality disorder d. antisocial personality disorder, substance abuse, and criminality ANSWER: d 50. Mothers of children with conduct disorder often display ____. a. histrionic personality and depression b. antisocial personality and depression c. substance abuse and depression d. schizophrenia and substance abuse ANSWER: a 51. According to the social-selection hypothesis, ____. a. people change or adapt to the environment in which they live b. children with conduct disorder choose to be friends with other children with conduct problems c. people who move into different neighborhoods differ before they arrive, and those who remain differ from those who leave d. neighborhoods “embrace” those who are similar to the majority of the individuals already living in the neighborhood and actively reject those who are not

ANSWER: c 52. In high-risk neighborhoods, ____ can protect against the development of antisocial behavior. a. increased police surveillance b. removing children and placing them in foster homes in low-risk neighborhoods Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 c. a positive school experience d. imposing curfews ANSWER: c 53. Risk factors for antisocial behaviors that are associated the most with ineffective parenting include which of the following? a. Exposure to lead and other toxins

b. Parental antisocial or criminal behavior c. Poor supervision and monitoring d. Chaotic household ANSWER: c 54. Which of the following is a characteristic of parent management training for conduct problems? a. Intensive and direct intervention of the therapist with the child b. Teaching contingency management techniques c. Legal services d. Substance abuse treatment ANSWER: b 55. Which of the following is a characteristic of cognitive problem-solving skills training (PSST) for conduct problems? a. Teaching parents contingency management techniques b. Substance abuse treatment c. Alteration of the child’s attributions regarding other children’s motivations d. Special education classes ANSWER: c 56. Elizabeth’s parents, teachers, and probation officer met to discuss treatment strategies for Elizabeth’s aggressive and criminal behavior. What treatment modality is this? a. Family therapy

b. Community intervention c. Social skills training d. Multisystemic treatment ANSWER: d 57. This treatment emphasizes changing children’s behavior in the home and in other settings using contingency management techniques. a. Family therapy

b. Multisystemic therapy (MST) c. Problem-solving skills training (PSST) d. Parent management training (PMT) ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 58. This treatment is an intensive approach that draws on other techniques as well as specialized interventions and referral to substance abuse treatment programs or legal services. a. Family therapy

b. Multisystemic therapy (MST) c. Problem-solving skills training (PSST) d. Parent management training (PMT) ANSWER: b 59. This treatment identifies the child’s cognitive deficiencies and distortions in social situations and provides instruction, practice, and feedback to teach new ways of handling social situations. a. Family therapy

b. Multisystemic therapy (MST) c. Problem-solving skills training (PSST) d. Parent management training (PMT) ANSWER: c 60. MST has been found to reduce long-term rates of criminal behavior for periods as long as ___ years. a. 2 b. 3 c. 4 d. 5 ANSWER: d Subjective Short Answer 61. Define conduct problems from the legal, psychological, psychiatric, and public health perspectives.

ANSWER: Legally, conduct problems are defined as delinquent or criminal acts. The broad term juvenile delinquency describes children who have broken a law, ranging from sneaking into a movie without paying to homicide.

Delinquent acts include property crimes (e.g., vandalism, theft, and breaking and entering) and violent crimes (e.g., robbery, aggravated assault, homicide). From a psychological perspective, conduct problems fall along a continuous dimension of externalizing behavior (Burns et al., 1997). Children at the upper extreme of this dimension, usually one or more standard deviations above the mean, are considered to have conduct problems. From a psychiatric perspective, conduct problems are defined as distinct mental disorders based on DSM-5 symptoms (APA, 2013). DSM-5 contains the general category of disruptive, impulse-control, and conduct disorders. All disorders in this category involve problems in the self-control of emotions and behaviors, including two that refer to persistent patterns of antisocial behavior in youth—oppositional defiant disorder (ODD) and conduct disorder (CD). This perspective blends the legal, psychological, and psychiatric perspectives with public health concepts of prevention and intervention (U.S. Department of Health and Human Services, 2001). The goal is to reduce the number of injuries and deaths, personal suffering, and economic costs associated with youth violence, in the same way that other health concerns such as automobile accidents or tobacco use are addressed. The public health approach cuts across disciplines and brings together policy makers, scientists, professionals, communities, families, and individuals to understand conduct problems in youths and determine how they can be treated and prevented (Dodge, 2011).

62. Crossing the covert–overt and destructive–nondestructive dimensions of conduct problems yields four quadrants of Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 antisocial behavior. Describe behaviors in each of these quadrants.

ANSWER: The overt–covert dimension ranges from overt visible acts such as fighting to covert hidden acts such as lying or stealing. Children who display overt antisocial behavior tend to be negative, irritable, and resentful in their reactions to hostile situations and to experience higher levels of family conflict (Kazdin, 1992). In contrast, those displaying covert antisocial behavior are less social, more anxious, and more suspicious of others and come from homes that provide little family support. The destructive–nondestructive dimension ranges from acts such as cruelty to animals or physical assault to nondestructive behaviors such as arguing or irritability.

63. Distinguish between childhood-onset versus adolescent-onset conduct disorder.

ANSWER: Those with childhood-onset conduct disorder display at least one symptom of the disorder before age 10, whereas those with adolescent-onset conduct disorder do not. Increasing evidence points to the importance of age at onset in diagnosing and treating children with CD (Odgers et al., 2008). Children diagnosed with childhood-onset CD are more likely to be boys, show more aggressive symptoms, account for a disproportionate amount of illegal activity, and persist in their antisocial behavior over time (Lahey, Goodman, et al., 1999). In contrast, youths diagnosed with adolescent-onset CD are as likely to be girls as boys and do not display the severity or psychopathology that characterizes the childhood onset group. They are also less likely to commit violent offenses or to persist in their antisocial behavior as they get older.

64. What role do cognitive deficits and/or distortions play in conduct problems?

ANSWER: Children with conduct problems rarely consider the future consequences of their behavior or its impact on others. They fail to inhibit their impulsive behavior, keep social values or future rewards in mind, or adapt their actions to changing circumstances. This pattern suggests deficits in executive functions similar to those of children with ADHD (Raine et al., 2005). Because ODD/CD and ADHD frequently co-occur, the observed deficits in executive functions in these children could be due to the presence of co-occurring ADHD (Pennington & Ozonoff, 1996).

65. What lines of reasoning suggest that ADHD and CD are separate disorders?

ANSWER: It is also possible that the types of executive functioning deficits experienced by children with ODD and CD may differ from those experienced by children with ADHD (Nigg et al., 2006). For example, Rubia (2010) has made the distinction between cool (as in temperature, not as in Lady Gaga) cognitive executive functions, such as attention, working memory, planning, and inhibition, and hot executive functions that involve incentives and motivation. Both cool and hot executive functions are associated with distinct but interconnected brain networks. Cool executive function deficits are thought to be more characteristic of children with ADHD, whereas hot executive function deficits are more characteristic of children with conduct problems. Children with both ADHD and conduct problems, which is common, likely display a combination of the two types of executive function deficits.

66. Compare and contrast the life-course-persistent (LCP) path with the adolescent-limited (AL) path, emphasizing causes, behaviors, and severity.

ANSWER: The LCP path describes children who engage in aggression and antisocial behavior at an early age and continue to do so into adulthood. Their behaviors can vary and change over time. Their underlying disposition remains, but the way it is expressed changes with new opportunities at different points in development. Antisocial behavior begins early. In contrast, the AL path describes youths whose antisocial behavior begins around puberty and continues into adolescence, only to cease these behaviors in adulthood.

Antisocial behavior in these children is limited primarily to their teen years. Their antisocial behavior is less extreme than LCP children, and their delinquency is more likely to be related to temporary situational factors, especially the influence of their peers.

67. Explain the general progression of CD. Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 ANSWER: The earliest indications of conduct problems may be a difficult temperament in the first few years of life, expressed as fussiness, irritability, irregular sleeping and eating patterns, or fearfulness in response to novel events. During the preschool and early school years, a child with a difficult temperament displays an increase in hyperactivity and impulsivity with growing mobility, weak emotion-regulation skills, and a heightened risk for simple forms of oppositional and aggressive behaviors that peak during the preschool years (Tremblay, 2000). Most children with conduct problems show diversification—they add new forms of antisocial behavior over time rather than simply replacing old behaviors. Poor social skills and social–cognitive deficits often accompany early oppositional and aggressive behaviors, predisposing the child to poor peer relationships, rejection by peers, and social isolation and withdrawal. In this progression, we see a snowballing negative cycle over time, where one deficit or problem behavior produces direct and indirect changes in others. For example, peer rejection leads to social–cognitive deficits and aggression; social– cognitive deficits lead to peer rejection and aggression; aggression leads to peer rejection (Lansford et al., 2010). Conversely, better social–cognitive skills may increase peer acceptance and lower aggressiveness.

These cascading effects highlight the importance of looking at the progression of antisocial behavior over time as a dynamic developmental process involving relationships among neurobiological dispositions, social environments, cognitions, and behavior (Lansford et al., 2010).

68. Distinguish between life-course-persistent and adolescent-limited pathways to antisocial behavior.

ANSWER: The life-course-persistent (LCP) path describes children who engage in aggression and antisocial behavior at

an early age and continue to do so into adulthood (Moffitt et al., 1996). They may display “biting and hitting at age 4, shoplifting and truancy at age 10, selling drugs and stealing cars at age 16, robbery and rape at age 22, and fraud and child abuse at age 30” (Moffitt, 1993, p. 679). Their underlying disposition remains, but the way it is expressed changes with new “opportunities” at different points in development. For these children, antisocial behavior begins early because of subtle neuropsychological deficits that may interfere with their development of language, memory, and self-control, resulting in cognitive deficits and a difficult temperament by age 3 or younger. The adolescent-limited (AL) path describes youths whose antisocial behavior begins around puberty and continues into adolescence, but who later cease these behaviors during young adulthood. This path includes most juvenile offenders whose antisocial behavior is limited primarily to their teen years (Hamalainen & Pulkkinen, 1996). Teens on the AL path display less extreme antisocial behavior than those on the LCP path, are less likely to drop out of school, and have stronger family ties. Their delinquent activity is often related to temporary situational factors, especially peer influences. The behavior of AL youths is not consistent across situations; they may use drugs or shoplift with their friends while continuing to follow rules and to do well in school. Although these children do not display antisocial behavior in childhood, they do experience, like youngsters on the LCP path, greater social adversity and personal risk during childhood relative to other youths, suggesting that the AL pathway is not simply part of normal adolescent development (Roisman et al., 2010).

69. What are some of the findings regarding genetic influences on the development of antisocial behavior?

ANSWER: Adoption and twin studies indicate that 50% or more of the variance in antisocial behavior is attributable to heredity for both males and females. This influence is somewhat higher for aggressive versus nonaggressive conduct problems and in childhood versus adolescence. Research indicates that parents pass on a general liability for externalizing disorders to their children that may be expressed in different ways, including oppositional and conduct problems, inattention, and hyperactivity– impulsivity (Bornovalova et al., 2010).

The heritability of conduct problems also varies by age at onset and other factors (Burt & Neiderhiser, 2009).

For example, the strength of the genetic contribution is higher for children who display the LCP versus the AL pattern and for those with callous–unemotional traits (Viding et al., 2008). However, all externalizing disorders appear to share substantial genetic influences, suggesting at least some common causal factors among them (Lahey et al., 2011). Overall, adoption and twin studies suggest that both genetic and environmental factors contribute to antisocial behavior across development.

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Chapter 09 70. Explain what the behavioral activation and behavioral inhibition systems are, and describe the role they play in conduct problems.

ANSWER: The behavioral activation system (BAS) stimulates behavior in response to signals of reward or nonpunishment. In contrast, the behavioral inhibition system (BIS) produces anxiety and inhibits ongoing behavior in the presence of novel events, innate fear stimuli, and signals of nonreward or punishment. Other behavioral patterns may result from the relative balance or imbalance of activity in these two neural systems.

71. Crick and Dodge (1994) and Dodge and Pettit (2003) have presented a social–cognitive model to account for the behavior of socially aggressive boys. As outlined by their model, discuss the steps in the thinking and behavior of aggressive children in social situations.

ANSWER: Step 1: Encoding. Socially aggressive children use fewer cues before making a decision. When defining and resolving an interpersonal situation, they seek less information about the event before acting.

Step 2: Interpretation. Socially aggressive children attribute hostile intentions to ambiguous events.Step 3: Response Search. Socially aggressive children generate fewer and more aggressive responses and have less knowledge about social problem solving.Step 4: Response Decision. Socially aggressive children are more likely to choose aggressive solutions.Step 5: Enactment. Socially aggressive children use poor verbal communication and strike out physically.

72. Create a scenario between a mother and child that illustrates Patterson’s coercion theory.

ANSWER: Gerald Patterson’s coercion theory contends that parent–child interactions provide a training ground for the development of antisocial behavior (Patterson, Reid, & Dishion, 1992). This occurs through a four-step, escape-conditioning sequence in which the child learns to use increasingly intense forms of noxious behavior to escape and avoid unwanted parental demands. The coercive parent–child interaction begins when a mother finds her son, Paul, who is failing in school, watching TV rather than doing his homework. Coercive parent–child interactions are made up of well-practiced actions and reactions, which may occur with little awareness. This process is called a “reinforcement trap” because, over time, all family members become trapped by the consequences of their own behaviors. For example, mothers of antisocial children are eight times less likely to enforce demands than are mothers of nonproblem children (Patterson et al., 1992).

73. What role do neighborhoods and schools play in antisocial behavior?

ANSWER: The social selection hypothesis states that people who move into different neighborhoods differ from one another before they arrive, and those who remain differ from those who leave. For individuals with antisocial traits, this creates a community organization that minimizes productive social relations and effective social norms, leading to the antisocial behavior becoming the rule (Sampson, Raudenbush, & Earls, 1997). The effects of community characteristics on crime and delinquency are likely to be reinforced by neighborhood social disorganization characterized by few local friendship and acquaintance networks, low participation in local community organizations, and an inability to supervise and control teenage peer groups (Sampson & Groves, 1989). In high-risk neighborhoods, enrollment in a poor-quality school is associated with antisocial and delinquent behavior, whereas a positive school experience can be a protective factor for the development of these behaviors (Rutter, 1989). A good school environment characterized by clear requirements for homework completion, high academic expectations, clear and consistent discipline policies, and incentives for appropriate school behavior and achievement may partially compensate for poor family circumstances.

Systematic interventions to promote these school characteristics have resulted in schoolwide reductions in children’s conduct problems (Gottfredson, Gottfredson, & Hybel, 1993).

74. How does the media influence aggression in children?

ANSWER: Exposure to media violence can be both: (1) a short-term precipitating factor for aggressive and violent behavior that results from priming, excitation, or imitation of specific behaviors and (2) a long-term predisposing factor for aggressive behavior acquired via desensitization to violence and observational learning of an aggression-supporting belief system (i.e., “the world is a hostile place,” “aggression is Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 acceptable,” “aggression can be used to solve social problems”) (Huesmann et al., 2003). Exposure to media violence may reinforce preexisting antisocial tendencies in some children. For example, in a series of studies spanning more than a decade, children with conduct problems were found to view relatively large amounts of violent material, prefer aggressive characters, and believe fictional content to be true (Gadow & Sprafkin, 1993).

75. Compare and contrast the focus of treatment methods for parent management training (PMT), problem-solving skills training (PSST), multisystemic therapy (MST), and preventive interventions. Discuss some of the limitations of PMT programs in treating conduct problems.

ANSWER: PMT emphasizes changing children’s behaviors at home and other settings through active parent involvement. It assumes that poor parent–child interactions are at least partially responsible for a child’s antisocial behavior. The focus is on improving parent–child communication, monitoring, and supervision.

PSST focuses on cognitive deficiencies displayed by children with interpersonal conduct problems. PSST can be used alone in with PMT. PSST assumes that the child’s perceptions and appraisals of environmental events will trigger antisocial responses, and that correcting family thinking will improve behavior.

Instruction, practice, and feedback are used to help the child discover different ways to handle social situations. MST is a treatment for adolescents with severe conduct problems that threaten out-of-home placement by their nature and severity. The emphasis in MST is on viewing the adolescent as functioning within a web of social systems, not just the family setting, and that antisocial behavior results from influences within any of these systems. Treatment is not limited to the adolescent but can include anyone in the child’s life. Preventive interventions assume that conduct problems can be treated with younger (as opposed to older) children, and that limiting or preventing the escalation of antisocial behaviors is possible through early treatment efforts.

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Chapter 10 Multiple Choice 1. A state of prolonged bouts of sadness is called ____. a. dysphoria b. dysthymia c. anhedonia d. depression ANSWER: a 2. ____ is one of the most common symptoms of depression in children, occurring in about 80% of clinic-referred youngsters with depression. a. Irritability

b. Anger c. Grandiosity d. Inattention ANSWER: a 3. The earlier and mistaken belief that children could not suffer from depression was rooted in ____. a. biological findings b. psychoanalytic theory c. behavioral theory d. cognitive theory ANSWER: b 4. The earlier concept of “masked” depression was that ____. a. children wear a characteristic “mask” of depression, including downcast eyes and downturned mouth b. depression is difficult to diagnose in children because they “mask” their feelings with a happy face c. children purposely conceal or “mask” their depression so as to avoid treatment d. depression could be “masked” or concealed by a variety of other behaviors, and thus, any clinical symptom could be evidence of underlying depression

ANSWER: d 5. Children who experience depression ____. a. rarely attempt suicide b. rarely relapse c. typically make a full recovery on their own d. are at risk for future depressive episodes ANSWER: d 6. The increase in depression in young people has been attributed, at least in part, to a. poorer childhood nutrition leading to disrupted neurological development. b. media influences leading children to feel hopeless about the future.

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Chapter 10 c. rapid social change leading to increased stress levels for young people. d. increased awareness of symptoms of depression in youth leading to an increase in the number of children seen in clinics for diagnoses.

ANSWER: c 7. Anaclitic depression was the term used by Renee Spitz in the 1940s to describe the pattern of behavior he saw in ____. a. emotionally deprived infants b. abused toddlers c. pregnant adolescents d. bereaved children ANSWER: a 8. Young people suffering from severe depression often exhibit symptoms on a spectrum that include ____ in levels of severity. a. comorbid behavior problems

b. sleep difficulties c. poor eating habits d. suicidal ideation ANSWER: d 9. Which of the following is NOT a type of disorder associated with depression? a. Major depressive disorder (MDD) b. Persistent depressive disorder (P-DD) c. Chronic depressive symptoms disorder (CDSD) d. Disruptive mood dysregulation disorder (DMDD) ANSWER: c 10. The lifetime prevalence rate of depression in adolescents is as high as ____. a. 5% b. 7% c. 20% d. 40% ANSWER: c 11. Which of the following occurs more frequently in younger than older individuals? a. Depressed appearance b. Irritability c. Somatic complaints d. Phobias ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 12. Children with major depressive disorder are at greater risk than adults for developing ____. a. bipolar disorder b. somatoform disorder c. schizophrenia d. panic disorder ANSWER: a 13. Prevalence estimates for major depressive disorder in all children ages 4 to 18 range from ____. a. 0.3% to 1% b. 2% to 8% c. 10% to 15% d. 20% to 25% ANSWER: b 14. The increase in depression from preschool to elementary school is not likely to be a reflection of ____. a. biological maturation b. growing self-awareness c. growing cognitive capacity d. increased performance and social pressures ANSWER: a 15. The increase in depression from childhood to adolescence appears to be largely a result of ____. a. biological maturation b. increased cognitive capacity c. growing self-awareness d. substance use ANSWER: a 16. The most frequent co-occurring disorder(s) in clinic-referred youngsters with major depressive disorder is/are ____. a. conduct disorders b. ADHD c. anxiety disorders d. somatoform disorders ANSWER: c 17. Which of the following is least likely to be a symptom of MDD? a. Significant weight loss or gain b. Insomnia c. Hyperactivity d. Diminished ability to think or concentrate ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 18. Major depressive disorder in children is more likely to occur after the onset of all other psychiatric disorders, except for ____. a. bipolar disorder

b. separation anxiety disorder c. ADHD d. substance abuse ANSWER: d 19. Prospective studies of children and adolescents have found that the age of onset for the first depressive episode is usually ____ years. a. 7 to 10

b. 10 to 12 c. 13 to 15 d. 16 to 18 ANSWER: c 20. When symptoms of depressed mood occur for most of the day, on most days, and persist for at least one year, that is known as ____. a. major depressive disorder (MDD)

b. persistent depressive disorder (P-DD) c. chronic depressive symptoms disorder (CDSD) d. disruptive mood dysregulation disorder (DMDD) ANSWER: b 21. A history of depression during the school years increases the risk for later ____. a. resilience b. suicidal behavior c. underemployment d. aggressive behavior ANSWER: b 22. Youngsters who have an onset of depression prior to age 15 and a recurrent episode prior to age 20 are likely to ____. a. have mild depression as a younger teen b. recover from their depressive episode faster in adulthood c. have mild depression as a teen, but chronic depression as an adult d. have severe depression as a teen and poor psychosocial outcomes as a young adult ANSWER: d 23. Which of the following is true regarding gender differences in the prevalence of depression among males and females? a. Throughout the lifespan, females are more likely to suffer from depression than males.

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Chapter 10 b. Depression is equally common among preadolescent boys and girls, but after about age 13, the rate is higher for females. c. Depression is equally common among boys and girls in childhood and adolescence, but after about age 18, the rate is higher for females. d. Females are more likely to suffer from depression at all ages, but only when there is a comorbid anxiety disorder.

ANSWER: b 24. The increased risk for depression among adolescent girls compared to boys has been attributed to ____. a. changes in brain structure b. gender identity issues c. their tendency to use ruminative coping styles to deal with stress d. less willingness to cooperate ANSWER: c 25. Adolescent girls may be at higher risk for depression if they have a history of ____. a. interpersonal stress and lack of social support b. under average height c. lower levels of testosterone and estrogen at puberty d. longer friendships with others who are depressed ANSWER: d 26. A recent study found that in transition from adolescence to young adulthood, depressive symptoms were highest for which ethnic/racial groups? a. Hispanic and Asian

b. Caucasian and African American c. Hispanic and African American d. Caucasian and Asian ANSWER: a 27. Double depression occurs when ____. a. MDD is superimposed on P-DD b. the symptoms of P-DD last at least two years or longer c. children experience twice the normal symptoms of P-DD d. the symptoms of DMDD occur simultaneously with those of P-DD ANSWER: a 28. The most prevalent co-occurring disorder/s with dysthymic disorder is/are ____. a. anxiety disorders b. ADHD c. conduct disorders d. major depressive disorder Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 ANSWER: d 29. The central feature of _______ is chronic, severe persistent irritability. a. major depressive disorder (MDD) b. persistent depressive disorder (P-DD) c. chronic depressive symptoms disorder (CDSD) d. disruptive mood dysregulation disorder (DMDD) ANSWER: d 30. Which of these diagnostic statements about DMDD is false? a. It cannot coexist with a diagnosis of MDD. b. Associated moods must have an onset prior to age 10. c. It cannot coexist with a diagnosis of ODD. d. It cannot coexist with a diagnosis of BP. ANSWER: a 31. Which symptom interferes with normal youth development of interpersonal relationships? a. Sleeplessness b. Agitation c. Social withdrawal d. Somatic complaints ANSWER: c 32. Which of the following statements about suicide is true? a. Suicidal attempts are only specific to depression. b. Drug overdose and wrist cutting are the most common means for adolescents who successfully complete suicide. c. Most youngsters with depression report suicidal thinking.

d. Suicide attempts of youngsters with depression almost never occur during times when they are symptom-free.

ANSWER: b 33. Which of the following statements about DMDD is true? a. It occurs fairly evenly between males and females. b. Effective courses of treatment for DMDD are unknown. c. It has high comorbidity with BP. d. It does not have a significant effect on peer relationships.

ANSWER: b 34. The fact that depression occurs in many youngsters who do not experience loss or rejection, and does not occur in many children who do, is support against which theory of depression? a. Psychodynamic Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 b. Cognitive c. Behavioral d. Attachment ANSWER: a 35. The ____ theory of depression focuses on parental separation and disruption of a bond as predisposing factors for depression. a. psychodynamic

b. behavioral c. cognitive d. attachment ANSWER: d 36. Which theory of depression claims that depression is related to a lack of response-contingent positive reinforcement? a. Psychodynamic b. Behavioral c. Cognitive d. Attachment ANSWER: b 37. Depression-prone individuals tend to make ______ attributions for the causes of negative events. a. external, unstable, and global b. external, stable, and specific c. internal, stable, and global d. internal, unstable, and specific ANSWER: c 38. ____ are the negative perceptual and attributional styles and beliefs associated with depressive symptoms. a. Depressed thoughts b. Cognitive delusions c. Depressogenic cognitions d. Destructive cognitions ANSWER: c 39. Information-processing biases displayed by depressed individuals ____. a. are errors in thinking in specific situations b. are negative effortful thoughts c. often include thoughts of past accomplishments d. are based on poor faulty memory systems ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 40. The “cognitive triad” refers to ____. a. the three parts of the brain that process information b. attending to, processing, and interpreting information c. the three cognitive theorists who have advanced our understanding of depression d. a depressed individual’s negative outlook about one’s self, the world, and the future ANSWER: d 41. ____ view youngsters with depression as having difficulty organizing their behavior in relation to long-term goals. a. Interpersonal models b. Self-control theories c. Socioenvironmental models d. Neurobiological models ANSWER: b 42. The single best predictor of a child’s risk for major depressive disorder is ____. a. drug use b. family history of depression c. psychosocial problems d. academic problems ANSWER: b 43. Children of depressed parents have a higher rate of ____. a. conflict with siblings b. eating disorders c. physical injuries d. sexual abuse ANSWER: c 44. In general, brain activity in youths with depression is LESS active than normal in regions of the brain associated with which of the following? a. Recognizing and regulating emotions

b. Sensory processes c. Mediating stress responses d. Learning and recalling emotion-arousing memories ANSWER: b 45. What is not a typical characteristic of families of children with depression? a. Less warmth b. Less support c. Poor communication d. Underinvolvement Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 ANSWER: d 46. In comparison to nondepressed children, those with depression experience ____ in the year preceding their depression. a. fewer friendship changes

b. fewer daily hassles c. more severe stressful events and more daily hassles d. more resilience ANSWER: c 47. The most successful treatment/s for major depressive disorder is/are ____. a. nondirective supportive therapy b. family therapy c. psychoanalytic therapy d. CBT and IPT-A ANSWER: d 48. A therapy for young people that focuses on helping the youth become more aware of pessimistic and negative thoughts, as well as causal attributions of self-blame for failure, is known as ____. a. CBT

b. behavior therapy c. cognitive therapy d. ITP-A ANSWER: c 49. The only SSRI that is currently FDA approved for the treatment of depression in children is ____. a. paroxetine (Paxil) b. fluoxetine (Prozac) c. sertraline (Zoloft) d. none are approved ANSWER: b 50. Due to recent findings of possible increased risk of suicide and self-harm of young people using SSRIs to treat depression, the FDA has mandated ____. a. parents be well-informed and monitor their children closely

b. warning labels on medication and patient education guides c. that children and adolescents should not be prescribed SSRIs d. that SSRIs be prescribed in combination with psychotherapy ANSWER: b 51. Which of the following regarding bipolar disorder in young people is false? a. Manic episodes in their fully developed state are clearly different usual behavior.

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Chapter 10 b. Girls are more commonly diagnosed with bipolar disorder than boys. c. Bipolar disorder is extremely rare in young children. d. Rates of bipolar disorder are higher in clinical samples.

ANSWER: b 52. Regarding bipolar disorder, boys display ____. a. more depressed mood than girls b. later onset than girls c. more severity than girls d. more manic behaviors than girls ANSWER: d 53. Children or adolescents who display numerous and persistent hypomanic and depressive symptoms can be classified as having ____. a. bipolar I disorder

b. bipolar II disorder c. double depression d. cyclothymic disorder ANSWER: d 54. Which diagnosis is a child least likely to receive? a. Major depressive disorder b. Bipolar I disorder c. Bipolar II disorder d. Cyclothymic disorder ANSWER: b 55. Common symptoms of BP that are present in years preceding an initial manic episode include all of the following EXCEPT ___________. a. insomnia

b. indecisiveness c. diminished ability to think d. lethargy or lack of energy ANSWER: d 56. Which disorder is least likely to co-occur with bipolar disorder in young people? a. Mental retardation b. ADHD c. Anxiety disorders d. Substance abuse ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 57. Bipolar disorder appears to be the result of ____. a. genetic vulnerability b. environmental factors c. genetic vulnerability in combination with environmental factors d. untreated major depressive disorder ANSWER: c 58. Brain imaging studies in adolescents with bipolar disorder point to abnormalities in parts of the brain that ____. a. regulate emotion b. plan executive functions c. control memory d. regulate sleep patterns ANSWER: a 59. In general, ____ is the first choice in the treatment of bipolar disorder. a. cognitive–behavioral therapy b. interpersonal therapy c. lithium d. family therapy ANSWER: c 60. Dr. Smith prescribes Sally a certain medication for the treatment of bipolar disorder; it causes weight gain. Which treatment is Sally taking? a. Risperidone

b. Alprazolam c. Valproate d. Fluoxetine ANSWER: c Subjective Short Answer 61. Why do mood disorders in children frequently go undetected?

ANSWER: Many young people with depression express these combined feelings of sadness and loss of interest or pleasure. However, some may never report feeling sad. Rather, they express their depression through their irritable mood. This is not something people would normally associate with depression.

62. How do the symptomatic presentations of depression in preschoolers, school-aged children, preteens, and teens differ?

How are they the same?

ANSWER: Children express and experience depression differently at different ages (Weiss & Garber, 2003). An infant may show sadness by being passive and unresponsive; a preschooler may appear withdrawn and inhibited; a school-age child may be argumentative and combative or complain of feeling sick; and a teenager may express feelings of guilt and hopelessness, sulk, or feel misunderstood. These examples are not various types Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 of depressions but likely represent different stages in the developmental course of the same process.

63. Distinguish between depression as a symptom, syndrome, and disorder.

ANSWER: As a symptom, depression refers to feeling sad or miserable. Depressive symptoms often occur without the existence of a serious problem, and they are relatively common at all ages. As a syndrome, depression is more than a sad mood. A syndrome refers to a group of symptoms that occur together more often than by chance. Along with sadness, the child may display a reduced interest or pleasure in activities, cognitive and motivational changes, and somatic and psychomotor changes. As a syndrome, depression represents an extreme on a dimension reflecting the number or severity of co-occurring symptoms that the child displays.

As a disorder, depression comes in several forms. We will consider three types. The first, major depressive disorder (MDD), has a minimum duration of two weeks and includes low mood, loss of interest or pleasure, other symptoms (e.g., sleep disturbances, difficulty concentrating, feelings of worthlessness), and significant distress or impairment in functioning. The second, persistent depressive disorder (P-DD), or dysthymia, is associated with depressed or irritable mood, generally fewer, less severe, but longer-lasting symptoms (a year or more in children) than MDD, and significant impairment in functioning. The third, disruptive mood dysregulation disorder (DMDD), is a recently introduced depressive disorder characterized by (1) frequent and severe temper outbursts that are extreme overreactions to the situation or provocation and (2) chronic, persistently irritable or angry mood that is present between the severe temper outbursts.

64. What reasons have been put forth for the increase in depression from the preschool to elementary school years and from childhood to adolescence?

ANSWER: The modest increase in depression from preschool to elementary school is likely not biologically based but rather is a reflection of the school-age child’s growing self-awareness and cognitive capacity, verbal ability to report symptoms, and increased performance and social pressures. In contrast, the sharp increase in depression in adolescence appears to be the result of biological maturation at puberty interacting with important developmental changes that occur during this tumultuous period. This hypothesis is supported by the emergence of large sex differences in depression after puberty, the emergence of bipolar disorder, and the relative stability in rates of depression through adolescence (Birmaher et al., 1996).

65. Distinguish between major depressive disorder and dysthymic disorder.

ANSWER: Young people who suffer from persistent depressive disorder (P-DD) experience symptoms of depressed mood that occur for most of the day, on most days, and persist for at least one year. They are unhappy or irritable most of the time. (The sad and gloomy life of Eeyore the donkey in the 100 Acre Wood likely qualifies for a diagnosis of P-DD.) Combined with their chronic depressed (or irritable) mood, these children also display at least two somatic (e.g., eating problems, sleep disturbances, low energy) or cognitive symptoms (e.g., lack of concentration, low self-esteem, feelings of hopelessness) that are present while they are depressed. Although the symptoms of P-DD are chronic, they are less severe than those for children with MDD. P-DD is a “new” category in DSM-5; it combines the previous DSM-IV categories of Dysthymic Disorder and MDD—Chronic. This was done because of the lack of differences between youths with a dysthymic disorder and those with a chronic type of major depression. In comparison to nonchronic MDD, chronic forms of depression, whether referred to as dysthymic disorder, chronic major depression, or P-DD are associated with a poorer response to treatment, greater long-term morbidity at follow-up, and greater familial loading for affective disorders (McCullough et al., 2003).

66. What role do cognitive deficits and cognitive distortions play in depression?

ANSWER: Many children with depression experience biases, deficits, and distortions in their thinking (Lakdawalla, Hankin, & Mermelstein, 2007). These children commonly notice depression-relevant cues such as sad facial expressions more often than positive cues such as happy facial expressions (Ehrmantrout et al., 2011; Hankin et al., 2010). Given the importance of accurately reading emotional cues for successful social relationships, these selective attentional biases can contribute to adverse relationships with family members and peers.

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Chapter 10 67. How is self-esteem related to depression in children?

ANSWER: Almost all young people with depression experience negative self-esteem. In fact, low self-esteem is the symptom that seems most specifically related to depression in adolescents (Lewinsohn et al., 1997). Selfesteem in children with depression is also highly reactive to daily life events, and such daily fluctuations in self-esteem appear to be related to depression following exposure to major life stresses (Roberts & Gotlib, 1997). Thus, both low self-esteem and unstable self-esteem seem to play an important role in depression.

68. What is the role of the family in the development and maintenance of depression in young people?

ANSWER: Youngsters with depression experience less supportive and more conflictual relationships with their mothers, fathers, and siblings than do children who do not have depression. They report feeling socially isolated from their families and prefer to be alone rather than with them. In family situations, the child’s social isolation may not be a social skill deficit, but rather a reflection of the child’s desire to avoid conflict. Family relationship difficulties have been found to persist even when children are no longer clinically depressed (Sheeber et al., 2007).

69. Explain some of the concerns of treating young people with depression with medications.

ANSWER: The main concerns are possible serious side effects such as suicidal thoughts and self-harm and a lack of information about the long-term effects of these medications on the developing brain. Related to these concerns and warnings by the FDA, the use of SSRIs with young people has decreased by about 20% in more recent years (Gibbons et al., 2007; Libby et al., 2007). In 2004, the FDA asked all manufacturers of antidepressant medications to include in their labeling a boxed warning (black box) and Patient Education Guide to alert consumers about the increased risk of suicidal thinking and behavior in youngsters treated with these medications.

70. Compare and contrast behavior therapy, cognitive therapy, CBT, ITP-A, and medication as treatments for young people with depression.

ANSWER: Behavior therapy aims to increase behaviors that elicit positive reinforcement and to reduce punishment from the environment. It may involve teaching social and other coping skills and emphasizing anxiety management and relaxation training. Cognitive therapy focuses on helping the youth become more aware of pessimistic and negative thoughts, beliefs and biases, and self-blame. CBT combines elements of behavioral and cognitive therapies in an integrated approach. Attribution retraining may also be used. Interpersonal Psychotherapy for Adolescent Depression (ITP-A) explores family and interpersonal interactions that maintain depression. Family and individual counseling sessions occur in which youths are encouraged to understand their own negative cognitive style and the effects of their depression on others. Medication, in contrast, treats mood disturbances and other symptoms using antidepressants.

71. What are some of the characteristics of a family with a depressed child? Of a family with a depressed parent?

ANSWER: Families of children with depression display more critical and punitive behavior toward their depressed child than toward other children in the family. As compared with families of youngsters without depression, these families display more anger and conflict, greater use of control, poorer communication, more overinvolvement, and less warmth and support (Sheeber et al., 2007; Stein et al., 2000). They often experience high levels of stress, disorganization, marital discord, and a lack of social support (Messer & Gross, 1995; Slavin & Rainer, 1990). Depression interferes with a parent’s ability to meet the basic physical and emotional needs of a child, including feeding, bedtime routines, medical care, and safety practices.

Mothers who suffer from depression also create a child-rearing environment teeming with negative mood, irritability, helplessness, less emotional flexibility, and unpredictable displays of affection. When their children display negative emotions and distress, mothers with a history of depression are less likely to respond supportively with comfort, empathy, or assistance and are more likely to disapprove, dismiss, punish, or ignore their child’s negative emotions (Silk et al., 2011). Depressed mothers also display less energy in Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 stimulating play, less consistent discipline, less involvement, poor communication, lack of affection, and more criticism and resentment of their children than mothers without depression (Goodman, 2007).

72. What approach is used in “The ACTION” for treating children with depression and their families? Describe “The ACTION” program.

ANSWER: The ACTION acronym is used to nourish the idea that youngsters can have an impact on their moods, and it is presented to them as follows (Stark & Kendall, 1996, p. 14): A = Always find something to do to feel better; C = Catch the positive; T = Think about it as a problem to be solved; I = Inspect the situation; O = Open yourself to the positive; N = Never get stuck in the negative muck. Multiple treatment procedures are used to reduce the child’s mood disturbances, behavioral deficits, and cognitive symptoms: Dysphoria, anger, anhedonia, and excessive anxiety are treated by educating the child about the relation between mood, thinking, and behavior, and by using anger management procedures, scheduling pleasant activities, and relaxation training. Interpersonal deficits are treated using social skills training. Cognitive distortions and negative and self-critical thinking are addressed by using cognitive restructuring procedures and training in effective problem-solving and self-control procedures.

73. Distinguish between manic, mixed, and hypomanic episodes.

ANSWER: A manic episode, which is the hallmark feature of BP, involves a discrete period of a week or more during which the youngster displays an ongoing, pervasive, and unusually elevated or irritable mood and persistently increased goal-directed activity or energy. This episode is accompanied by the types of symptoms we have been describing such as an exaggerated self-esteem, a reduced need for sleep, racing thoughts, rapid and frenzied speech, attention to irrelevant details, increased activity, or overinvolvement in pleasurable but often reckless and risky behaviors. A hypomanic episode has features that resemble a manic episode in quality but are less intense—the mood disturbance and increased activity or energy are less severe, of shorter duration, and produce less impairment in functioning than a manic episode. DSM-5 also includes a specifier of “with mixed features,” which can be used when a current manic or hypomanic episode includes subthreshold symptoms of depression or dysthymia or when an episode of MDD includes subthreshold symptoms of mania or hypomania.

74. Identify and describe common co-occurring disorders for youths with bipolar disorder.

ANSWER: Common co-occurring disorders for youths with BP include anxiety disorders, ADHD, ODD, CD, substanceuse problems, and suicidal ideations and attempts. Additionally, sleep disturbances, disrupted relationships, risk-taking behaviors, and medical problems such as obesity, cardiovascular and metabolic disorders, epilepsy, and migraines are common for youths with BP.

75. What are some of the concerns with medications such as lithium in treating a child who has been diagnosed with bipolar disorder?

ANSWER: Lithium is a common salt that is widely present in the natural environment—for example, in drinking water—usually in amounts too small to have any effects. However, the side effects of therapeutic doses of lithium can be serious, especially when used in combination with other medications; side effects may include toxicity (poisoning), renal and thyroid problems, and substantial weight gain (Gracious et al., 2004). It can be given to young people when used with the same safety precautions and similar careful monitoring used for adults. However, lithium cannot be given to children in chaotic families or to children who are unable to keep the multiple appointments needed for monitoring potentially dangerous side effects (Carlson, 1994; Geller & Luby, 1997).

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Chapter 11 Multiple Choice 1. Which of the following is NOT true of anxiety disorders? a. While prevalent in adults, they are relatively rare in children. b. There are several different types of anxiety disorders. c. Anxiety disorders can be persistent across the lifespan. d. Anxiety disorders often occur with other disorders.

ANSWER: a 2. The ____ mobilizes the body for action in a fight/flight situation. a. central nervous system b. peripheral nervous system c. sympathetic nervous system d. parasympathetic nervous system ANSWER: c 3. When activated, the sympathetic nervous system causes the release of ____ from glands on the kidney. a. insulin b. adrenaline c. growth hormone d. testosterone ANSWER: b 4. ____ is an immediate alarm reaction to current danger or life-threatening emergencies. a. Anxiety b. Panic c. Fear d. Worry ANSWER: c 5. ____ is characterized by feelings of apprehension and lack of control over upcoming events that might be threatening. a. Anxiety b. Panic c. Fear d. Worry ANSWER: a 6. ____ is a group of physical symptoms of the fight/flight response that unexpectedly occur in the absence of any obvious threat or danger. a. Anxiety

b. Panic Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 c. Fear d. Worry ANSWER: b 7. ____ fears increase with age. a. Social b. School-related c. Nighttime d. Parental separation ANSWER: a 8. The fear of death is common among children aged ____. a. 1 to 2 b. 4 to 5 c. 6 to 8 d. 8 to 11 ANSWER: b 9. The fear of separation from parent(s) is common among children aged ____. a. 1 to 5 b. 3 to 6 c. 6 to 9 d. 8 to 11 ANSWER: a 10. Behavioral symptoms of anxiety include ____. a. fatigue b. blurred vision c. thoughts of inadequacy d. fidgeting ANSWER: d 11. Ritualistic behavior is ____ in young children. a. nonexistent b. uncommon c. common d. difficult to observe ANSWER: c 12. Anxiety disorders in the DSM-5 are divided into categories that reflect ____. a. primary dimensions of anxiety (biological/cognitive/behavioral) Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 b. varieties of reaction and avoidance c. the response to treatment (good/poor) d. typical age of onset ANSWER: b 13. When would an absence of separation anxiety suggest an insecure attachment? a. at 2 months of age b. at 7 months of age c. at 10 years of age d. never ANSWER: b 14. One of the most common anxiety disorders of childhood is ____. a. obsessive–compulsive disorder (OCD) b. panic disorder c. generalized anxiety disorder d. separation anxiety disorder (SAD) ANSWER: d 15. The anxiety disorder with the earliest age of onset is ____. a. obsessive–compulsive disorder b. panic disorder c. generalized anxiety disorder d. separation anxiety disorder ANSWER: d 16. The average age of onset for separation anxiety disorder is ____. a. 2 to 3 years of age b. 4 to 6 years of age c. 7 to 8 years of age d. 9 to 10 years of age ANSWER: c 17. Excessive and unreasonable fears usually peak around _____________. a. pre-K b. kindergarten c. second grade d. fourth grade ANSWER: c 18. Which of the following is LEAST likely to lead to school refusal?

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Chapter 11 a. Difficulty with academics b. Separation anxiety disorder c. Fear of being teased or bullied d. Fear of being socially evaluated ANSWER: a 19. Which of the following is NOT a DSM diagnosis? a. Separation anxiety disorder b. Obsessive–compulsive disorder c. Panic disorder d. Test anxiety disorder ANSWER: d 20. For many children, fear of school is really a fear of what? a. Having a difficult time socializing b. Being afraid of the teacher c. Worrying about test taking d. Leaving your parents ANSWER: d 21. School refusal is equally common in boys and girls, and it occurs most often between the ages of ____. a. 3 and 10 b. 5 and 11 c. 7 and 11 d. 8 and 12 ANSWER: b 22. Which of the following distinguishes children with generalized anxiety disorder from those with other anxiety disorders? a. Their worries are age-inappropriate.

b. They experience somatic symptoms. c. They worry about minor events. d. They worry about minor events and experience somatic symptoms.

ANSWER: c 23. To be diagnosed with generalized anxiety disorder, a child must exhibit ____. a. separation anxiety disorder b. worry about academic performance c. an inability to control worry d. perfectionism and self-critical behavior ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 24. The lifetime prevalence of generalized anxiety disorder is ____. a. 1.2% b. 2.2% c. 3.6% d. 6.8% ANSWER: b 25. Unlike adults, children with specific phobias ____. a. avoid the feared stimuli b. do not recognize that their fears are extreme and unreasonable c. experience physiological arousal when presented with the feared stimuli d. are more easily treated ANSWER: b 26. The fact that the most common specific phobia in children is a fear of animals is believed to be due to ____. a. the high rates of exposure to animals in young childhood b. evolutionary processes c. parental overprotection when young children encounter animals d. the large size of the animals ANSWER: b 27. A situational specific phobia would most likely involve a fear of ____. a. heights b. elevators c. illnesses d. injections ANSWER: b 28. ____ is the most common secondary diagnosis for children with another anxiety disorder. a. Specific phobia b. Social anxiety disorder c. Obsessive–compulsive disorder d. General anxiety disorder ANSWER: b 29. Most social anxiety disorders first occur in ____. a. the preschool years b. the primary school years c. late childhood d. adolescence Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 ANSWER: d 30. Selective mutism is believed to be a type of ____. a. specific phobia b. generalized anxiety disorder c. obsessive–compulsive disorder d. social phobia ANSWER: d 31. Children who exhibit selective mutism may also ____. a. be developmentally delayed b. have higher than average intelligence c. have strong social skills d. an absence of anxiety ANSWER: d 32. Which of the following is NOT an OCD-related disorder? a. Germ avoidance disorder b. Body dysmorphic disorder c. Hoarding disorder d. Excoriation ANSWER: a 33. Compulsions and obsessions experienced by children typically last ____. a. between 30 and 60 minutes a day b. more than an hour a day c. two to three hours daily d. over three hours daily ANSWER: b 34. The most common compulsions include____________. a. touching and counting b. checking and repeating c. excessive washing and bathing d. ordering and arranging ANSWER: c 35. The rate of obsessive–compulsive disorder in children is ____ the rate of obsessive–compulsive disorder in adults. a. less than b. more than c. equal to Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 d. more variable ANSWER: c 36. ____ influences have a greater role in early onset cases of obsessive–compulsive disorder than late onset cases of obsessive–compulsive disorder. a. Parenting

b. Learning c. Neurobiological d. Genetic ANSWER: d 37. Which of the following is NOT a characteristic of a panic attack? a. Intense fear or discomfort b. Can last for a few days c. Sense of imminent danger d. Occur several times a week or month ANSWER: b 38. The onset of first panic attack is often related to ____. a. adult stressors b. pubertal stage c. cognitive developmental stage d. the development of internalized speech ANSWER: b 39. Agoraphobia can be best described as the fear of ____. a. leaving home and not being able to get back in the house b. being separated from one’s parents c. having a panic attack in situations in which escape would be difficult or help unavailable d. spiders ANSWER: c 40. Panic attacks occur in about ____ of adolescents. a. 3 % to 4% b. 8% to 10% c. 15% to 20% d. 25% to 30% ANSWER: c 41. A marked fear or avoidance of certain situations in which the individual thinks that escape may be difficult if he or she were to experience panic-like symptoms refers to ________________. .

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Chapter 11 a. ophidiophobia b. acrophobia c. arachnophobia d. agoraphobia ANSWER: d 42. What is one of the main features separating early onset OCD and later onset? a. Individuals in early onset are more likely to be females. b. Individuals in early onset are more likely to be males. c. Individuals in early onset are more likely to have learning disorders. d. Individuals with early onset are more likely to be from wealthy families.

ANSWER: b 43. Increased functional impairment and poorer OCD outcomes are more likely when _____________. a. parents practice accommodation b. parents confront the OCD behaviors of their children head on c. children also experience trichotillomania d. children are not diagnosed with OCD until they are older ANSWER: a 44. The most common physical symptoms of anxiety disorders include a. stomachaches and nausea. b. sleep-related problems. c. headaches. d. joint pain.

ANSWER: b 45. In most cases, ____. a. anxiety precedes depression b. depression precedes anxiety c. depression and anxiety occur simultaneously d. there is not a clear relationship between anxiety and depression ANSWER: a 46. In comparison to children who are anxious, children who are depressed display ____. a. more negative affectivity b. less negative affectivity c. more positive affectivity d. less positive affectivity ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 47. Females are ____ than males to experience anxiety symptoms. a. twice as likely b. less likely c. slightly more likely d. equally likely ANSWER: a 48. Child psychopathology reflects a mix of actual child ____ and the ____ through which others view it in a child’s culture. a. symptoms; structure

b. disorders; focus c. behavior; perspective d. behavior; lens ANSWER: d 49. The two-factor theory explains anxiety disorders as arising and persisting through a combination of ____. a. attachment and social learning b. temperament and exposure c. classical and operant conditioning d. modeling and reinforcement ANSWER: c 50. Children with a behavioral inhibition temperament may be less likely to develop a later anxiety disorder if ____. a. their parents protect them from stressful events b. their parents set firm limits that teach them how to cope with stress c. they have older siblings d. their parents ignore their bids for comfort and protection ANSWER: b 51. Findings from twin and adoption studies of anxiety in children and adolescents suggest that the genetic contribution for anxiety ____. a. decreases with age and environmental influence increases

b. decreases with age, along with environmental influence c. increases with age and environmental influence decreases d. increases with age, along with environmental influence ANSWER: a 52. The brain system associated with anxiety is called ____. a. behavioral activation system b. behavioral inhibition system c. behavioral formation system Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 d. hypothalamic system ANSWER: b 53. The neurotransmitter system most often implicated in anxiety disorders is the ____ system. a. dopaminergic b. nondopaminergic c. GABA-ergic d. prominergic ANSWER: c 54. Prolonged exposure to ______ as a result of early stress or trauma may have neurotoxic effects on the developing brain.

a. cortisol b. serotonin c. GABA d. norepinephrine ANSWER: a 55. According to __________________, fearfulness in children is biologically rooted in the need for survival. . a. the two-factor theory b. survival conditioning theory c. behavioral and learning theories d. attachment theory ANSWER: d 56. The parenting style most often associated with anxiety disorders in children is one in which parents are overly ____. a. supportive b. controlling c. permissive d. positive ANSWER: b 57. Twin studies suggest that about ______________ of the variance in childhood anxiety symptoms is accounted for by genetic influences. a. 5%

b. 10% to 20% c. 20% to 30% d. 30% to 40% ANSWER: d 58. The most effective treatment of a child’s phobia of riding in a car would involve which final step?

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Chapter 11 a. Playing with toy cars b. Watching tapes of other children riding in cars c. Imagining riding in a car d. Actually riding in a car ANSWER: d 59. The most effective procedure for treating most anxiety disorders is ____. a. behavioral therapy b. cognitive–behavioral therapy (CBT) c. family therapy d. use of medications ANSWER: b 60. To date, the strongest evidence for the effectiveness of medication to treat anxiety disorders in children and adolescents is for ____. a. generalized anxiety disorder

b. panic disorder c. obsessive–compulsive disorder d. social phobia ANSWER: c Subjective Short Answer 61. Discuss in detail what happens when the physical response system is activated in the face of perceived danger.

ANSWER: Chemical effects. Adrenaline and nonadrenaline are released from the adrenal glands. Cardiovascular effects.

Heart rate and strength of the heart beat increase, readying the body for action by speeding up blood flow and improving delivery of oxygen to the tissues. Respiratory effects. Speed and depth of breathing increase, which brings oxygen to the tissues and removes waste. This may produce feelings of breathlessness, choking or smothering, or chest pains. Sweat gland effects. Sweating increases, which cools the body and makes the skin slippery. Other physical effects. The pupils widen to let in more light, which may lead to blurred vision or spots in front of the eyes. Salivation decreases, resulting in a dry mouth. Decreased activity in the digestive system may lead to nausea and a heavy feeling in the stomach. Muscles tense in readiness for fight or flight, leading to subjective feelings of tension, aches and pains, and trembling.

62. Review the three anxiety response systems and give examples from each.

ANSWER: Physical System. When a person perceives or anticipates danger, the brain sends messages to the sympathetic nervous system, which produces the fight/flight response. The activation of this system produces many important chemical and physical effects that mobilize the body for action. Cognitive System. Since the main purpose of the fight/flight system is to signal possible danger, its activation produces an immediate search for a potential threat. For children with anxiety disorders, it is difficult to focus on everyday tasks because their attention is consumed by a constant search for threat or danger. When these children can’t find proof of danger, they may turn their search inward: “If nothing is out there to make me feel anxious, then something must be wrong with me.” Behavioral System. The overwhelming urges that accompany the fight/flight response are aggression and a desire to escape the threatening situation, but social constraints may prevent fulfilling either impulse. For example, just before a final exam, you may feel like attacking your professor or Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 not showing up at all, but fortunately, for your professor and your need to pass the course, you are likely to inhibit these urges! However, they may show up as foot tapping, fidgeting, or irritability (consider the number of teeth marks in pencils) or as escape or avoidance by getting a doctor’s note, requesting a deferral, or even faking illness.

63. Distinguish between worry, anxiety, and panic.

ANSWER: Worry, which is characterized as thinking about all possible negative outcomes, serves an extremely useful function in normal development. In moderate doses, worry can help children prepare for the future—for example, by checking their homework before they hand it in or by rehearsing for an upcoming class play.

Anxiety is a mood state characterized by strong negative emotion and bodily symptoms of tension in which the child apprehensively anticipates future danger or misfortune (Barlow, 2002). Panic is a group of physical symptoms of the fight/flight response that unexpectedly occur in the absence of any obvious threat or danger.

64. What are some of the normal worries, anxieties, and rituals/routines of children?

ANSWER: The most frequent symptoms in samples of children with normal anxieties are separation anxiety, test anxiety, overconcern about competence, excessive need for reassurance, and anxiety about harm to a parent (Barrios & Hartmann, 1997). In moderate doses, worry can help children prepare for the future—for example, by checking their homework before they hand it in or by rehearsing for an upcoming class play.

Ritualistic, repetitive activity is extremely common in young children (Peleg-Popko & Dar, 2003). A familiar example is the bedtime ritual of saying good night—addressing people in a certain order or giving a certain number of hugs and kisses. Normal ritualistic behaviors in young children include preferences for sameness in the environment (e.g., watching the same DVD over and over again), rigid likes and dislikes, preferences for symmetry (e.g., carrying a toy in each hand), awareness of minute details or imperfections in toys or clothes (e.g., being bothered by a minuscule thread on a jacket sleeve), and arranging things so they are “just right” (e.g., insisting that different foods not touch each other on the plate).

65. Give some examples of behavior of a child with separation anxiety disorder (SAD).

ANSWER: Young children with SAD may have vague feelings of anxiety or repeated nightmares about being kidnapped or killed or about the death of a parent. They frequently display excessive demands for parental attention by clinging to their parents and shadowing their every move. Often, they are reluctant to sleep separated from their parents, and they try to climb into their parents’ bed at night or sleep on the floor just outside their parents’ bedroom door (Allen et al., 2010). Older children with SAD may have difficulty being alone in a room during the day, sleeping alone even at home, running errands, going to school, or going to camp. They may also have specific fantasies of illness, accidents, kidnapping, or physical harm.

66. What are some symptoms of generalized anxiety disorder (GAD), and which symptom distinguishes GAD from other anxiety disorders?

ANSWER: For children with GAD, worrying can be episodic or almost continuous. The worrier is unable to relax and may experience physical symptoms such as muscle tension, headaches, or nausea. Common symptoms of GAD include irritability, difficulty concentrating, and a lack of energy, difficulty falling asleep, and restless sleep (Comer et al., 2012; Layne et al., 2009). In other anxiety disorders, anxiety converges on specific situations or objects, such as separation, social performance, animals or insects, or bodily sensations. In contrast, the anxiety experienced by individuals with GAD is widespread and focuses on a variety of everyday life events (Andrews et al., 2010).

67. List the five subtypes of specific phobias, and give an example of the focus of fear for each one.

ANSWER: As specified in DSM-5, common types of specific phobias in young people include fears of animals or insects (e.g., dogs or spiders); fears of natural events (e.g., heights or thunderstorms); fears of blood, injuries, or medical procedures (e.g., seeing blood or receiving an injection); and fears of specific situations (e.g., flying Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 in airplanes, riding on a bus). Both similarities (e.g., age at onset, gender, treatment response) and differences (e.g., focus of fear, physiological reaction, neural response patterns, impairment, comorbidity) have been found across these types, with natural environment and animal phobias having the most in common with other types, and blood, injury, and injection phobias the least (LeBeau et al., 2010; Lueken et al., 2011).

68. Distinguish between obsessions and compulsions, and discuss the relationship between them.

ANSWER: Obsessions are persistent and intrusive thoughts, urges, or images that are experienced as intrusive and unwanted and generally cause significant anxiety or distress. Compulsions are repetitive, purposeful, and intentional behaviors (e.g., hand washing) or mental acts (e.g., repeating words silently) that are performed in response to obsessions in an attempt to suppress or neutralize them. Most children with OCD have multiple obsessions and compulsions, and certain compulsions are commonly associated with specific obsessions. For example, washing and cleaning rituals are likely to be associated with contamination obsessions, such as a concern with dirt or germs, a concern or disgust with body wastes or secretions (e.g., urine, feces, saliva), or an excessive concern about chemical or environmental contamination.

69. Why are panic attacks rare in young children?

ANSWER: One explanation is that young children lack the cognitive ability to make the catastrophic misinterpretations (e.g., “my heart is beating rapidly and I’m sitting here watching TV like I always do—I must be going crazy”) that usually accompany panic attacks (Nelles & Barlow,1988).

70. What are the different symptoms for a diagnostic criteria of panic disorder?

ANSWER: One common element is that an abrupt surge can occur from a calm state or from an anxious state. Symptoms include palpitations; pounding heart; accelerated heart rate; sweating; trembling or shaking; sensations or shortness of breath or smothering; feelings of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, light-headed, or faint; chills or heat sensations; paresthesias; derealization or depersonalization; fear of losing control or going crazy; and fear of dying.

71. Identify the diagnostic criteria needed for a diagnosis of OCD. ANSWER: First, a child must present obsessions, compulsions, or both. Next, the obsessions or compulsions are timeconsuming (at least an hour a day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning; the symptoms are not attributable to the physiological effects of a substance abuse or use, or another medical condition; and the disturbance is not better explained by the symptoms of another mental disorder.

72. Compare and contrast positive and negative affectivity and the role of these concepts in understanding the link between anxiety and depression.

ANSWER: Positive affectivity refers to a persistent positive mood that includes states such as joy, enthusiasm, and energy. Negative affectivity, in contrast, is a persistent negative mood, as reflected in nervousness, sadness, anger, and guilt. Negative affectivity is related to both anxiety and depression, whereas positive affectivity is negatively correlated with depression and is independent of anxiety symptoms and diagnoses. Children with anxiety generally do not differ from children with depression in their negative affect, suggesting that a general underlying dimension of negative affectivity is common between anxiety and depression.

73. What is the behavior lens principle?

ANSWER: Perhaps the most accurate way to analyze cultural differences in anxiety is using Weisz and colleagues’ (2003, p. 384) behavior lens principle, which states that child psychopathology reflects a mix of actual child behavior and the lens through which it is viewed by others in a child’s culture.

74. What role does temperament play in the development of anxiety disorders?

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Chapter 11 ANSWER: Children with a high threshold for novelty are presumed to be at low risk for developing anxiety disorders.

Other children (about 15% to 20%) are born with a low threshold for becoming overexcited and to withdrawing in response to novel stimulation as infants, a tendency to be fearful and anxious as toddlers, and a tendency to be unusually shy or withdrawn in novel or unfamiliar situations as young children. This type of temperament is called behavioral inhibition (BI), an enduring trait for some and a predisposing factor for the development of later anxiety disorders, particularly SOC (Chronis-Tuscano et al., 2009; Kagan, 2017).

75. Discuss Kendall’s CBT treatment program Coping Cat, for treating social phobia, generalized anxiety disorder, and separation anxiety disorder.

ANSWER: The CBT treatment program Coping Cat, developed by Philip Kendall and his colleagues, is one of the most carefully evaluated treatments for youngsters 7 to 13 years old who have GAD, SAD, and SOC (Kendall, Furr, & Podell, 2010). A teen version is available, as is an Australian adaptation (Coping Koala). This approach emphasizes learning processes and the influence of contingencies and models, as well as the pivotal role of information processing. Treatment is directed at decreasing negative thinking, increasing active problem solving, and providing the child with a functional coping outlook. The intervention creates behavioral experiences with emotional involvement while simultaneously addressing thought processes (Kendall et al., 2010).

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Chapter 12 Multiple Choice 1. Which statement best describes the occurrence of maltreatment? a. Children want to get away from the family of violence. b. Children in violent households only know violence. c. The intensity of the violence always increases with time. d. There is a great deal of loyalty to the offenders.

ANSWER: d 2. An event would be considered traumatic if it ____. a. is based on stress before a big test b. involves any type of stress c. is based on an uncommon or extreme stressor d. is stress related directly to an incident of physical harm only ANSWER: c 3. For healthy development, children need a caregiving environment that balances their need for ____ with their need for ____.

a. control; responsiveness b. ego-mastery; discipline c. ego-mastery; responsiveness d. control; discipline ANSWER: c 4. For teens, which feeling or action is least likely to occur as a result of stress? a. Feeling overwhelmed b. Feeling depressed or sad c. Feeling tired d. Skipping a meal ANSWER: d 5. A babysitter who notices bruises on a child who subsequently tells the sitter that her mother hits her is obligated (by law) to ____. a. do nothing

b. remove the child from the home c. confront the parent d. alert the police or child welfare agency ANSWER: d 6. If a child with a diagnosed psychological disorder (e.g., depression) was also being abused, the maltreatment would be noted in the ____ based on the DSM-5. a. Axis I category Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 b. extra comments section of the assessment c. progress notes but not the diagnosis d. other conditions that may be a focus of clinical attention category ANSWER: d 7. Which of the following would qualify as physical neglect? a. Supervision from the next room b. Refusing to allow an adolescent to see friends c. Delay in seeking health care d. Letting a teenager come home from school alone ANSWER: c 8. Many of the acute symptoms of sexual abuse resemble children’s common reactions to ____. a. fatigue b. stress c. illness d. loss of a parent ANSWER: b 9. Allostatic load refers to ____________. a. a measure of how much stress teens can safely handle b. the biological response of a stressful event on a child c. the progressive wear and tear on biological systems due to the effects of chronic stress d. an indicator of the effects of child maltreatment on a child’s outlook ANSWER: c 10. ____ exists to some degree in all forms of maltreatment, making it difficult to define the consequences. a. Emotional abuse b. Physical abuse c. Emotional neglect d. Physical neglect ANSWER: a 11. Exploitation takes many forms but is most likely to include ____. a. child labor b. child discipline c. child photography d. child poverty ANSWER: a 12. By far, the most common form of maltreatment of children is ____________.

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Chapter 12 a. neglect b. physical abuse c. sexual abuse d. psychological maltreatment ANSWER: a 13. Which of the following is NOT among the worst and most intrusive forms of childhood stress and trauma? a. Child maltreatment b. Stressful incidents, such as terrorist attacks or hurricanes c. Exposure to domestic violence d. Chronic childhood poverty ANSWER: b 14. The highest incidence of maltreatment in the United States is due to ____ cases. a. sexual abuse b. physical abuse c. neglect d. emotional abuse ANSWER: c 15. An example of physical child neglect would be ____________. a. a middle schooler who is permitted to drink and use drugs b. siblings who were subjected to repeated incidents of family violence between their parents c. a teenager who is permitted to decide for himself whether to go to school and how long to stay each day d. children living in a home contaminated with animal feces and rotting food ANSWER: d 16. A history of sexual abuse is reported more often by ____. a. young males b. young females c. adolescent females d. adolescent males ANSWER: c 17. An example of emotional child neglect would be ____________. a. an infant who had to be hospitalized for near drowning after being left alone in a bathtub b. a 2-year-old found wandering in the street late at night, naked and alone c. an 11-year-old who is chronically truant d. a child whose mother helped him shoot out the windows of a neighbor’s house ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 18. How do cultural norms influence the prevalence of sexual abuse? a. Children are portrayed erotically. b. Children observe sex play. c. Children are not valued by parents. d. Children with anxiety are more likely to be abused.

ANSWER: a 19. Younger children are the most common victims of ____. a. physical abuse b. emotional abuse c. sexual abuse d. neglect ANSWER: d 20. Child maltreatment affects boys and girls almost equally except for sexual abuse, where girls account for ____ of the reported victims. a. 65%

b. 75% c. 80% d. 90% ANSWER: c 21. Boys are more likely to be sexually abused by ____. a. their mothers b. their fathers c. siblings d. male nonfamily members ANSWER: d 22. Girls are more likely to be sexually abused by ____. a. female family members b. female nonfamily members c. male family members d. male nonfamily members ANSWER: c 23. Maltreatment is more common among ____. a. the poor and disadvantaged b. minority religious groups c. minority ethnic groups d. parents with average intelligence Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 ANSWER: a 24. The one form of child maltreatment that boys and girls do not experience equally is _______________. a. emotional abuse b. physical abuse c. psychological abuse d. sexual abuse ANSWER: d 25. Children living with __________________ are at significantly greater risk of all types of maltreatment. a. both parents b. a single parent with a live-in partner c. a single parent d. nonparental guardians ANSWER: b 26. Children may be protected in part from the effects of maltreatment if they ____. a. are immediately removed from the home b. can prosecute the offending parent c. are abused by only their father and not by their mother d. have a positive relationship with at least one important and consistent person ANSWER: d 27. Maltreated children may experience fewer negative outcomes if they ____. a. are immediately removed from the home b. can prosecute the offending parent c. have an external locus of control d. have a positive self-esteem and sense of self ANSWER: d 28. ________________ is characterized by a pattern of disturbed and developmentally inappropriate attachment behaviors. a. Disinhibited social engagement disorder

b. Post-traumatic stress disorder c. Reactive attachment disorder d. Chronic fatigue syndrome ANSWER: c 29. Maltreated children have a greater tendency to ____ than nonmaltreated children. a. have a disinhibition of emotional expressions b. exaggerate emotional expressions Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 c. have difficulty understanding the emotional states of others d. inhibit emotional expressions and modulating their emotional states ANSWER: d 30. After prolonged and unpredictable stressful events, cortisol levels ____ and the feedback systems that control hormone levels in the brain may become ____. a. increase; dysfunctional

b. decrease; more functional c. increase; more functional d. decrease; dysfunctional ANSWER: d 31. ____ is characterized by a child showing a pattern of overly familiar and culturally inappropriate behavior with relative strangers. a. Disinhibited social engagement disorder

b. Post-traumatic stress disorder c. Reactive attachment disorder d. Chronic fatigue syndrome ANSWER: a 32. In comparison to boys, girls who express symptoms of PTSD tend to show more: a. shame and self-blame. b. anger. c. physical aggression. d. verbal aggression.

ANSWER: a 33. A maltreated child who has been chronically aroused for a long period of time becomes ____ to stress. a. immune b. unresponsive c. addicted d. hyperresponsive ANSWER: d 34. Physically abused children tend to have peer relationships marked by ____. a. withdrawal and aggression b. avoidance and withdrawal c. dependency and clinginess d. friendliness and interest ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 35. Children who experience chronic stress tend to develop ____, a progressive wear and tear on biological systems. a. oppositional defiance b. allostatic load c. obsessive–compulsive disorder d. regulatory disinhibition ANSWER: b 36. Children with histories of __________ have the most severe and wide-ranging problems in school and interpersonal adjustment. a. learning disabilities

b. mental illness c. physical disabilities d. abuse and neglect ANSWER: d 37. Reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) are diagnoses that apply only to children ages __________________. a. birth to 3 years old

b. 9 months to 5 years old c. 1 year to 7 years old d. 3 years to 9 years old ANSWER: b 38. How many children and adolescents with histories of maltreatment involving sexual abuse or combined sexual and physical abuse meet criteria for post-traumatic stress disorder (PTSD)? a. 20%

b. 30% c. 50% d. 60% ANSWER: c 39. Children who have been abused are more likely to develop PTSD symptoms if ____. a. the perpetrator was their mother b. they were infants at the time of the abuse c. they were adolescents at the time of the abuse d. the abuse was chronic and coercive ANSWER: d 40. ____ is an altered state of consciousness, in which the individual feels detached from the body or self, as if what is happening (e.g., a traumatic/abusive experience) is not happening to him or her. a. Self-splitting

b. Dissociation Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 c. Projection d. Mental fragmentation ANSWER: b 41. While adaptive in abusive and inescapable situations, dissociation may lead to ____. a. borderline personality disorder b. schizophrenia c. bipolar disorder d. split psychotic disorder ANSWER: a 42. Traumatic sexualization occurs when ____. a. the child is unaware of sexual practices b. the emotional abuse is chronic c. a child’s sexual knowledge occurs inappropriately d. the child is forced to abuse others ANSWER: c 43. A history of ____ among males is a significant risk factor for inappropriate sexual behaviors, alienation, and social incompetence in adolescence. a. physical abuse

b. sexual abuse c. neglect d. any form of maltreatment ANSWER: d 44. Which of the following statements regarding the relationship between childhood maltreatment and later violent delinquent behavior is true? a. All children who experience physical abuse in childhood later go on to engage in violent delinquent behavior.

b. Very few children who experience physical abuse in childhood later go on to engage in violent delinquent behavior. c. Children who experience routine violence in childhood are significantly more likely to engage in violent delinquent behavior later on. d. The experience of physical abuse is significantly associated with violent delinquent behavior later on, except for children who only experience abuse prior to adolescence.

ANSWER: c 45. Maltreatment is least likely to be associated with ____. a. family stress b. reduced financial status c. parental resilience d. marital conflict Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 ANSWER: c 46. Which of the following is not characteristic of parents who maltreat their children? a. Information-processing disturbances b. Unfamiliarity of developmentally appropriate expectations for children c. Unfamiliarity of the parenting role d. Self-discipline and patience ANSWER: d 47. Compared to abusive parents, neglectful parents ____. a. have less striking personality disorders b. have better knowledge of children’s needs c. have more chronic patterns of social isolation d. become more emotionally and behaviorally reactive under stress ANSWER: c 48. Which destabilizing factor is most closely associated with the third and final stage of an integrated model of child abuse?

a. A low sense of control and predictability is evident. b. Multiple sources of anger and aggression exist. c. The parent believes that the child’s behavior is threatening or harmful. d. The child increases problem behavior.

ANSWER: d 49. Once environmental and adult factors are controlled, the only child characteristic that has been associated with the risk of sexual abuse is ____. a. age

b. gender c. temperament d. conduct problems ANSWER: b 50. Pedophiles ____. a. sexually abuse only their children b. sexually abuse only children unknown to them c. sexually abuse or fantasize about minor children d. are sexually aroused by female children only ANSWER: c 51. Which statement about sexual abuse offenders is true? a. Sexual abuse offenders only target female children.

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Chapter 12 b. Sexual abuse offenders often have good social skills. c. Sexual abuse offenders often gradually indoctrinate children into sexual activity. d. Sexual abuse offenders have close trusting family relationships.

ANSWER: b 52. The major sociocultural factor contributing to abuse and neglect of children is ____. a. inequality b. poverty c. media violence d. social violence ANSWER: a 53. ____ involves a combination of exposure therapy and skill building to allow the individual to practice more effective ways of coping with intrusive memories and emotions. a. Psychological first aid

b. Trauma-focused cognitive–behavioral therapy c. Grief and trauma intervention for children d. Brief counseling ANSWER: b 54. ____ is related to sexually abused children’s level of distress as well as their recovery from the trauma. a. Gender b. Maternal support c. Relation to the perpetrator d. Paternal support ANSWER: b 55. Which treatment is LEAST likely to be given to a child who has been sexually abused? a. Education and support b. Controlled-exposure techniques c. Cognitive–behavioral methods d. Escapism ANSWER: d 56. Successful treatment of children who have experienced sexual abuse results in children ____. a. regaining their normal rate of development b. confronting the abuser c. no longer needing to attend therapy d. returning to school and peer-related activities ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 57. Treatment of physical abuse involves training parents in ____. a. positive child-rearing skills b. stronger discipline c. adopting distorted beliefs d. avoiding interaction ANSWER: d 58. Treatment for child neglect focuses on ____. a. parents modeling skills for children b. social dominance c. household management d. giving children more chores ANSWER: d 59. Treatment services for families that have maltreated a child have been limited due to ____. a. lack of available services b. difficulty of parents admitting culpability c. children not wanting to attend therapy d. families being financially unable to retain services ANSWER: b 60. Which form of treatment focuses on children who have learned of harm to others? a. Psychoeducation b. Psychological first aid c. Psychodynamic storytelling d. Resilient friend treatment ANSWER: b Subjective Short Answer 61. What are some of the paradoxical dilemmas commonly faced by maltreated children?

ANSWER: The victim not only wants to stop the violence but also longs to belong to a family. Loyalty and strong

emotional ties to the abuser are powerful opponents to the victim’s desire to be safe and protected. Affection and attention may coexist with violence and abuse. A recurring cycle may begin, whereby mounting tension, characterized by fear and anticipation, ultimately gives way to more abusive behavior. A period of reconciliation may follow, with increased affection and attention. Children are always hopeful that the abuse will not recur. The intensity of the violence tends to increase over time, although in some cases physical violence may decrease or even stop altogether. Abusive behavior may vary throughout the relationship, taking verbal, sexual, emotional, or physical forms, but the adult’s abuse of power and control remains the central issue.

62. What are some of the determinants of healthy parent–child relationships and family roles?

ANSWER: Adequate knowledge of child development and expectations, including knowledge of children’s normal Copyright Cengage Learning. Powered by Cognero.

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Chapter 12 adequate skill in coping with the stress related to caring for small children, and knowledge of ways to enhance child development through proper stimulation and attention; opportunities to develop normal parent– child attachment and early patterns of communication; adequate parental knowledge of home management, including basic financial planning, proper shelter, and meal planning; opportunities and willingness to share the duties of child care between two parents, when applicable; and provision of necessary social and health services.

63. Compare and contrast elements of a positive parenting style with elements of a negative parenting style.

ANSWER: A positive parenting style provides a variety of sensory stimulation and positive emotional expressions,

expresses joy at a child’s efforts and accomplishments, engages in competent, child-centered interactions to encourage development, as well as friendly, positive interactions that encourage independent exploration. A positive style also demonstrates consistency and predictability to promote the parent–child relationship, makes rules for safety and health, and employs appropriate safeguards based on the child’s age. These parents occasionally scold, criticize, and interrupt child activity, and they teach the child through behavioral rather than psychological control methods, using emotional delivery and tone that are firm but not frightening. In contrast, negative parenting styles express conditional love and ambivalent feelings toward the child, showing little sensitivity to the child’s needs. Negative parenting rejects the child’s attention and takes advantage of the child’s dependency status through coercion, threats, or bribes, as well as responding unpredictably, typically accompanied by emotional discharge. Rules and limits are sporadic and capricious, and they tend to be exploited for the parent’s benefit. Disciplinary practices include cruel and harsh control methods with emphasis on frightening, threatening, denigrating, and insulting the child.

64. Describe the continuum of child care.

ANSWER: At the positive end of this continuum, we see appropriate and healthy forms of child-rearing actions that

promote child development. Competent parents encourage their child’s development in a variety of ways and match their demands and expectations to the child’s needs and abilities. Of course, parents are human, and many on occasion will scold, criticize, or even show insensitivity to the child’s state of need; in fact, discipline often requires such firm control, with accompanying verbal statements and affect.

Poor/dysfunctional actions, shown in the middle of the diagram, represent greater degrees of irresponsible and harmful child care. Parents who show any discernible degree of these actions toward their child often need instruction and assistance in effective child-care methods. Finally, the far right of the diagram depicts parents who violate their child’s basic needs and dependency status in a physically, sexually, or emotionally intrusive or abusive manner. Similarly, their failure to respond to a child’s needs is the cornerstone of neglect.

65. Identify the determinants of “demandingness” and “responsiveness” that are required for children to adequately meet their developmental needs.

ANSWER: These include adequate knowledge of child development and expectations, including knowledge of children’s normal sexual development and experimentation; adequate skill in coping with the stress related to caring for small children, and knowledge of ways to enhance child development through proper stimulation and attention; opportunities to develop normal parent–child attachment and early patterns of communication; adequate parental knowledge of home management, including basic financial planning, proper shelter, and meal planning; opportunities and willingness to share the duties of child care between two parents, when applicable; and provisions of necessary social and health services.

66. What is the nature of maltreated children’s representational models of themselves and others?

ANSWER: Maltreated children often lack these core positive beliefs about themselves and their world. Instead, they may develop negative representational models of themselves and others based on a sense of inner “badness,” selfblame, shame, or rage, all of which further impair their ability to regulate their affective responses (Simon, Feiring, & McElroy, 2010; Valentino et al., 2008).

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Chapter 12 67. What is the cycle-of-violence hypothesis? Does the literature support or refute this hypothesis? (Be sure to support your answer.)

ANSWER: This relationship between being abused as a child and becoming abusive toward others as an adult is known as the “cycle-of-violence hypothesis.” Although victims of violence have a greater chance of becoming perpetrators of violence, this relationship is not inevitable and it can be attenuated through early intervention (Berlin et al., 2011).

68. What are traumatic events and what do they include?

ANSWER: Traumatic events are defined as exposure to actual or threatened harm or fear of death or injury and are considered uncommon or extreme stressors. Such terrifying or life-threatening events are wide-ranging. They include careless or intentional acts such as physical and sexual abuse, neglect, and exposure to domestic and community violence, as well as unintended medical traumas, accidents, natural disasters, war, terrorism, refugee trauma, and traumatic loss (Gerson & Rappaport, 2013).

69. Describe the dynamic process of child abuse.

ANSWER: In a dynamic process, parental and situational factors interact over time to either increase or decrease the risk of physical abuse or neglect (MacKenzie, Kotch, & Lee, 2011). Figure 12.3 depicts this dynamic process in relation to three hypothetical transitional stages. These stages suggest that maladaptive interaction patterns, like adaptive ones, do not develop simply because of the predilections of the parent or child. On the contrary, these patterns are the result of complex interactions between child characteristics, parental personality and style, the history of the parent–child relationship, and the supportive or nonsupportive nature of the broader social context within which the family is embedded (Wolfe, 1999). This process, moreover, includes both destabilizing and compensatory factors that can influence the likelihood of abuse or neglect in a negative or positive fashion, respectively.

70. What are some of the media and entertainment industry’s influences on child maltreatment?

ANSWER: Consider how the entertainment industry, including many aspects of the media and professional sports, earns billions of dollars in profits from exploiting our interests in violence in all of its forms. Equally disturbing is the portrayal of sex roles by society’s envoys in the media and the entertainment industry: Females are stereotypically presented as relatively powerless and passive and men as vested with power; women are encouraged to defer to the benevolence of powerful men, and men are encouraged to challenge the autonomy of powerful and assertive women (Hedley, 2002). These cultural phenomena are ingrained through years of repeated imagery, and they are presumed to be the basis for the motivation of some men to maintain control and power in a relationship (Williams, 2003).

71. Describe acute stress disorder and distinguish from PTSD. ANSWER: Acute stress disorder is characterized by the development during or within 1 month after exposure to an extreme traumatic stressor of at least nine symptoms associated with intrusion, negative mood, dissociation, avoidance, and arousal (these are largely the same symptoms as PTSD, described below, but last for 1 month or less). Similar to PTSD, the traumatic event is relived over and over, leading to attempts to avoid any reminders that arouse memories of it. Acute stress disorder emphasizes the more immediate, but short-term, dissociative reactions to trauma, whereas PTSD reflects the longer-lasting, ongoing pattern.

72. What would be considered manageable stress for children?

ANSWER: All children must cope with various degrees of stress, and these experiences can be strengthening if they do not exceed the child’s coping ability—that is, the nature and amount of stress is manageable (Masten & Wright, 2010). Stressful experiences that are mild, predictable, and brief are usually manageable and can actually enhance a child’s biological and psychological competence (Thompson, 2014).

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Chapter 12 73. What is the nature of the relationship between poverty and child sexual abuse?

ANSWER: Poverty is the greatest factor in the child prostitution explosion, as migration of families from rural areas into cities creates unemployment, the breakdown of family structures, homelessness, and inevitably, an increase in child prostitution.

74. What are some of the obstacles to intervention and prevention services for maltreating families?

ANSWER: (1) Those most in need are least likely to seek help on their own; (2) these children are brought to the

attention of professionals as a result of someone else’s concern, usually after they have violated expected norms or laws; and (3) parents do not want to admit to problems because they fear losing their children or being charged with a crime (fears that are, of course, realistic).

75. Describe treatments used for physically abused or neglected children.

ANSWER: Interventions for physical abuse usually involve ways to change how parents teach, discipline, and attend to their children, most often by training parents in basic child-rearing skills, accompanied by cognitive– behavioral methods that target specific anger patterns or distorted beliefs. Treatment for child neglect also focuses on parenting skills and expectations, coupled with teaching parents how to improve their skills in organizing important family needs—such as home safety, finances, and medical needs, among others—as well as drug and alcohol counseling (Azar & Wolfe, 2006). Similarly, children who have witnessed violence in the home benefit from interventions that address their needs in the context of their family circumstances.

For example, their nonoffending mothers may attend treatment with them, so that mothers learn ways to deal with problematic child behavior while also providing appropriate maternal support (Graham-Bermann et al., 2007; Jaffe et al., 2011).

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Chapter 13 Multiple Choice 1. In the early 1900s, children with enuresis were considered ____. a. evil b. medically compromised c. behaviorally disturbed d. willful and defiant ANSWER: c 2. ____ is the primary activity of the brain during the early years. a. Growth b. Learning c. Sleep d. Development of language ANSWER: c 3. By the age of ____, the brain has reached 90% of its adult size. a. 6 months b. 1 year c. 2 years d. 5 years ANSWER: c 4. Up until the age of ____, children spend more time asleep than in waking activities. a. 6 months b. 1 year c. 2 years d. 5 years ANSWER: d 5. Which statement best describes the relationship between sleep problems and psychological adjustment? a. Sleep problems may cause emotional and behavioral problems among children and adolescents. b. Psychological problems are unrelated to sleep problems. c. Sleep problems may arise from some underlying factor that is specific to biological causes. d. Psychological problems are not worsened by sleep problems.

ANSWER: a 6. Excessive sleepiness that is displayed as either prolonged sleep episodes or daytime sleep episodes is known as ____. a. insomnia b. narcolepsy c. hypersomnolence disorder Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 d. circadian rhythm sleep disorder ANSWER: c 7. Sleep deprivation impairs functioning of the ____. a. endocrine system b. prefrontal cortex c. occipital lobe d. left temporal lobe ANSWER: b 8. Sleep produces an “uncoupling” of neurobehavioral systems, providing the ____ with a break. a. central nervous system b. sympathetic nervous system c. peripheral nervous system d. parasympathetic nervous system ANSWER: a 9. Which of the following statements about sleep problems is NOT true? a. Infants and toddlers have less night-waking problems. b. Preschoolers have more falling-asleep problems. c. Younger school-age children have more going-to-bed problems. d. Adults have trouble finding enough time to sleep.

ANSWER: a 10. Insomnia is most common among ____. a. toddlers b. preschoolers c. younger school-aged children d. adolescents and adults ANSWER: d 11. Night-waking problems are most common among ____. a. infants and toddlers b. preschoolers c. younger school-aged children d. adolescents and adults ANSWER: a 12. ____ occurs during early to mid-childhood and includes nightmares, sleep terrors, and sleepwalking. a. Parasomnia b. Narcolepsy Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 c. Dyssomnia d. Hypersomnia ANSWER: a 13. A dyssomnia in childhood that is either uncommon or underdiagnosed is ____. a. protodyssomnia b. hypersomnia c. breathing-related sleep disorder d. narcolepsy ANSWER: d 14. A child with insomnia disorder has ____. a. difficulty falling asleep and maintaining sleep b. recurrent nightmares c. excessive sleepiness d. sleep-related breathing problems ANSWER: a 15. Nightmares usually occur ____. a. during the first half of the sleep cycle b. during the second half of the sleep cycle c. at the very beginning and the very end of the sleep cycle d. at variable times throughout the sleep cycle ANSWER: b 16. NREM sleep disorders are characterized by ____. a. easily and constantly aroused from sleep b. vivid memories of episodes c. disorientation and difficulty with arousal d. continuous insomnia ANSWER: c 17. Which dyssomnia is least common in children? a. Protodyssomnia b. Hypersomnia c. Breathing-related sleep disorder d. Narcolepsy ANSWER: d 18. Chronotherapy is a treatment for ____. a. circadian rhythm sleep disorder Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 b. hypersomnia c. narcolepsy d. protodyssomnia ANSWER: a 19. Behavioral intervention for sleeping problems involves ____. a. sleep medicine b. exercise c. positive reinforcement d. removal of adenoids ANSWER: d 20. Which statement about enuresis is true? a. A child must be 3 years of age (or developmental equivalent) to receive the diagnosis. b. Secondary enuresis is more common than secondary enuresis. c. Nocturnal enuresis cannot exist in combination with diurnal enuresis. d. More girls than boys are diagnosed with diurnal enuresis.

ANSWER: c 21. To keep individuals from urinating at night, antidiuretic hormone (ADH) serves to ____. a. concentrate the urine during sleep hours b. signal the reticular activating system to wake them up when they need to urinate c. loosen the bladder walls so that they may hold more urine d. strengthen the bladder sphincter ANSWER: a 22. Full-spectrum home training for enuresis is a combination of ____. a. punishment and positive reinforcement b. medication and positive reinforcement c. dry bed training and a urine alarm d. a urine alarm and medication ANSWER: c 23. The most effective and long-lasting treatment for enuresis is ____. a. desmopressin b. imipramine c. dry bed training d. the urine alarm ANSWER: d 24. Which statement about encopresis is true?

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Chapter 13 a. Encopresis is more common in girls than boys. b. Up to 3% of 5-year-old children are estimated to have encopresis. c. Encopresis usually results from defiance. d. Encopresis may be associated with abnormal defecation dynamics.

ANSWER: d 25. Optimal treatment for encopresis involves ____. a. medical interventions and therapy to address underlying psychological disturbances b. behavioral and medical interventions c. therapy to address underlying psychological disturbances and behavioral interventions d. behavioral interventions alone ANSWER: b 26. To be diagnosed with a chronic illness, a child must have the illness for ____. a. at least 1 month b. at least 3 months c. at least 6 months d. at least a year ANSWER: b 27. Somatic symptom and related disorders are best described as ____. a. medical conditions that are exacerbated by stress b. physical symptoms of a medical condition without organic evidence c. the conscious feigning of an illness for attention or secondary gain d. disorders of elimination (enuresis and encopresis) ANSWER: b 28. A child with diabetes who is subsequently depressed would be best diagnosed with ____. a. a somatoform disorder b. dysthymia c. an adjustment disorder d. psychological factors affecting physical condition ANSWER: c 29. ____ refers to the various forms of physical and functional consequences and limitations resulting from an illness. a. Mortality b. Morbidity c. Somatization d. Adaptation ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 30. Which statement best describes children’s experience and expression of pain? a. Because their nervous systems are incomplete, infants do not fully experience pain. b. Girls have a lower pain threshold than boys. c. Children have a higher pain threshold than adults. d. Children and adults experience pain similarly.

ANSWER: d 31. Which of the following is NOT true regarding differences between boys and girls with chronic illnesses? a. Girls show more symptoms of pain and anxiety than boys do. b. Girls are more likely to cling, cry, and seek emotional support. c. Excessive somatic complaints are associated with emotional disorders in boys. d. Boys show more symptoms of sensitivity to pain.

ANSWER: c 32. Children with forms of recurrent unexplained pain are more likely to ____ than children whose pain is due to organic causes.

a. be younger and female b. have lower intellectual abilities c. identify someone in their family who often expresses pain d. have family members with organic issues ANSWER: c 33. By far, the most common of these chronic illnesses in U.S. children is ____________. a. asthma b. cancers and tumors c. diabetes mellitus d. sickle-cell anemia ANSWER: a 34. The most common chronic illness in childhood is ____. a. asthma b. diabetes mellitus c. cystic fibrosis d. leukemia ANSWER: a 35. Children and adolescents with insulin-dependent diabetes mellitus must monitor their insulin levels carefully because too little insulin can result in ____, and too much insulin can result in ____. a. hypoglycemia; diabetic coma

b. blindness; diabetic coma c. diabetic coma; hypoglycemia Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 d. hypoglycemia; blindness ANSWER: c 36. Which of the following is NOT a factor affecting good regimen adherence in children with diabetes? a. Correct knowledge of diabetes and its treatment b. Family intelligence c. The belief that adherence is important d. Adequate problem-solving skills ANSWER: b 37. Behavioral intervention can help children with diabetes and their families by ____. a. inhibiting physical symptoms b. promoting parent accountability c. teaching self-control and monitoring methods d. providing distractions ANSWER: c 38. Which statement about childhood cancer is true? a. The onset of cancer in children is slower than in adults. b. Children are often at a more advanced stage of cancer when they are first diagnosed than are adults. c. The rarest form of childhood cancer is acute lymphoblastic leukemia. d. Childhood cancer remains almost 100% fatal.

ANSWER: b 39. The most common form of childhood cancer is ____. a. chronic lymphoblastic leukemia b. acute lymphoblastic leukemia c. acute lymphoblastic melanoma d. nonlymphoblastic leukemia ANSWER: b 40. Adjustment of children with chronic illness is typically ____ than that of other children referred to mental health clinics for nonhealth-related problems. a. worse

b. better c. no worse or better d. slightly worse ANSWER: b 41. In general, what can we conclude about the adjustment of children with chronic illnesses? a. Most can be diagnosed with a major depressive disorder.

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Chapter 13 b. Most can be diagnosed with a major anxiety disorder. c. Their illnesses are in part caused by psychological problems. d. By and large, most adapt successfully and the incidence of DSM-5 diagnoses is quite low.

ANSWER: d 42. Which of the following is NOT a common dimension that varies among the different parameters of chronic illnesses? a. It has a stable or improving prognosis. b. It involves a physical deformity. c. It is severe and life threatening. d. It requires intrusive or painful procedures.

ANSWER: a 43. About 10% of mothers and fathers suffer severe symptoms of ____ after their child is diagnosed with a chronic illness.

a. major depressive disorder b. post-traumatic stress disorder c. delusional disorder d. panic disorder ANSWER: b 44. One of the most important correlates of adjustment of children with chronic illness is ____. a. parental adjustment b. the type of illness c. healthy peer relationships d. premorbid adjustment ANSWER: a 45. In a longitudinal study of children with cancer, adolescents were perceived by their teachers as more ____. a. sociable b. likely to be leaders c. socially isolated d. chronically depressed ANSWER: c 46. For children with chronic illnesses, the illness parameters that play the most significant role in adjustment include all of the following EXCEPT ____. a. severity of the illness

b. their verbal and nonverbal abilities c. their prognosis d. their functional status ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 47. Across all medical conditions, the illness parameters that play the most significant role in children’s adjustment are ____.

a. visibility to others, presence of physical deformity, and severity b. intrusiveness and painfulness of treatments, visibility to others, and prognosis c. presence of physical deformity, severity, and functional status d. severity of illness and functional impairment ANSWER: d 48. Which of the following has not been linked to parental adaptation in families where a child suffers from a chronic illness? a. A sense of self-efficacy

b. Cohesive family relationships c. Effective use of denial as a coping strategy d. Perceived social support ANSWER: c 49. Research suggests that children cope best with painful medical procedures when ____. a. they are given an anesthetic b. the procedure is explained first c. they are given little information about the procedure beforehand d. their mothers are not in the room when the procedure is being conducted ANSWER: b 50. Which parental behavior would help a child cope most effectively with a painful medical procedure? a. Crying b. Reassuring c. Criticizing d. Distracting ANSWER: d 51. For how long would an adolescent have to show a maladaptive pattern of substance use to be diagnosed with substance dependence? a. 1 month

b. 3 months c. 6 months d. 12 months ANSWER: d 52. Which statement regarding substance use/abuse differences between adolescents and adults is true? a. Adolescents drink more often and in larger amounts. b. Adolescents are more likely to show cognitive and affective features associated with substance use and/or Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 withdrawal. c. Adolescents’ physiological dependence is less common than those among adults.

d. Adolescents do not experience withdrawal.

ANSWER: b 53. The most commonly used drug in the United States is ___________. a. marijuana b. alcohol c. cocaine d. heroin ANSWER: b 54. Which statement regarding the course of adolescent SUDs is true? a. Rates of substance abuse do not peak until after adulthood. b. Substance abuse is not harmful in adolescence unless it continues in adulthood. c. Experimentation with substances is common among teenagers. d. Age of first use is not considered a risk factor.

ANSWER: c 55. Based on ethnicity, ____ students have the highest rate of illicit drug use. a. American Indian/Alaska Native b. African American c. Hispanic d. Asian ANSWER: a 56. Which of the following personality characteristics has the clearest link to adolescent substance use? a. Hyperactive b. Defiance c. Distrust d. Sensation seeking ANSWER: d 57. Which of the following poses the greatest health hazard to most people in the United States? a. Heroin b. Codeine c. Caffeine d. Cigarettes ANSWER: d 58. Which of the following is likely to increase the risk of substance abuse?

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Chapter 13 a. Parental expectations for abstaining from alcohol b. Parental overinvolvement c. Inconsistent parenting and poor monitoring d. Knowledge about the risks of substance abuse ANSWER: c 59. Which of the following would most likely be used as treatment for an adolescent diagnosed with an SUD? a. Cognitive therapy b. Multisystemic therapy c. Peer therapy d. Psychoanalytic therapy ANSWER: b 60. According to 2016 data, about what percentage of eighth graders report that they have used alcohol over the past year?

a. Under 10% b. 10% to 15% c. 15% to 20% d. Over 20% ANSWER: c Subjective Short Answer 61. What is the nature of the relationship between sleep problems and psychological adjustment?

ANSWER: Sleep problems may cause emotional and behavioral problems among children and adolescents, and they may be caused by a psychological disorder. An underlying factor common to both sleep problems and other disorders may cause sleep issues in some cases.

Problems in the brain’s arousal and regulatory systems can cause increased anxiety and can affect sleep (see Chapter 11). Stress-related events, especially those that affect the child’s safety—such as war, disaster, and family conflict—both increase arousal and interfere with normal sleep patterns (El-Sheikh, Bub, et al., 2013; Kelly & El-Sheikh, 2013). Simply stated, sleep–wake disorders can cause other psychological problems, or they can result from other disorders or conditions. Sleep–wake disorders have considerable importance to abnormal child psychology because they mimic or worsen many of the symptoms of major disorders.

62. Why do children spend much of their early developmental years asleep?

ANSWER: Arguably, sleep is the primary activity of the brain during the early years of development. Consider this: By 2 years of age, the average child has spent almost 10,000 hours (nearly 14 months) asleep, and approximately 7,500 hours (about 10 months) in waking activities (Anders, Goodlin-Jones, & Sadeh, 2000). During those two years, the brain has reached 90% of its adult size and the child has attained remarkable complexity in cognitive skills, language, concept of self, socioemotional development, and physical skills (Dahl, 2007; Dahl & El-Sheikh, 2007). And most of these maturational advances occurred while the child was asleep.

63. Distinguish between dyssomnias and parasomnias.

ANSWER: Dyssomnias are disorders of initiating or maintaining sleep, characterized by difficulty getting enough sleep, not sleeping when you want to, not feeling refreshed after sleeping, and so forth. Parasomnias, in contrast, are Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 sleep disorders in which behavioral or physiological events intrude on ongoing sleep. Whereas dyssomnias involve disruptions in the sleep process, parasomnias involve physiological or cognitive arousal at inappropriate times during the sleep–wake cycle, which can result in sleepwalking or in nightmares that jolt someone from sleep. Persons suffering from parasomnia sleep disorders often report unusual behaviors while asleep, rather than sleepiness or insomnia.

64. Distinguish between nightmares and sleep terrors.

ANSWER: They include nightmares (repeated awakenings, with frightening dreams that you usually remember), sleep terrors (abrupt awakening, accompanied by autonomic arousal but no recall), and sleepwalking (getting out of bed and walking around, but with no recall the next day). Nightmares occur during rapid-eye-movement (REM) (dream) sleep, usually during the second half of the sleep period, whereas sleep terrors and sleepwalking occur during non-REM (NREM) sleep (for this reason, DSM-5 combines sleep terrors and sleepwalking into one category: NREM sleep arousal disorders). Sleep terrors and sleepwalking occur during deep sleep in the first third of the sleep cycle, when the person is so soundly asleep that he or she is difficult to arouse and has no recall of the episode the next morning (Reid et al., 2009).

65. Discuss how symptoms of sleep disturbances can appear similar to diagnosable disorders, such as ADHD. ANSWER: Perhaps you have noticed how sleep problems co-occur with many different disorders, including attentiondeficit/hyperactivity disorder (ADHD), depression, anxiety, conduct problems, and developmental disorders (Chorney et al., 2008; Kelly & El-Sheikh, 2013). This connection raises an important consideration: Do sleep problems cause other disorders, or do they result from them? The answer to this question requires an understanding of how sleep problems interact with a person’s psychological well-being. Since sleep problems commonly arise from particular stressors—an upcoming exam or a relationship problem—we tend to think that sleep difficulties are secondary symptoms of a more primary problem. However, the relationship between sleep problems and psychological adjustment is bidirectional.

66. Explain how behavioral conditioning methods can be used to treat enuresis.

ANSWER: The standard behavioral intervention, based on classical conditioning principles, is using an alarm that sounds at the first detection of urine. Bed-wetting alarms have been around since Mowrer and Mowrer (1938) first invented the “bell and pad” (a battery-operated device that produced a loud sound as soon as a drop of urine closed the electrical circuit), and they are among the safest and most effective treatments. Modern alarms have a simple moisture sensor that snaps into a child’s pajamas, with a small speaker attached to the shoulder to awaken the child. A single drop of urine completes the electronic circuit, setting off a piercing alarm that causes the child to tense and reflexively stop urinating.

67. What are some of the most important correlates of adjustment of children to chronic illness?

ANSWER: When maternal abilities remain intact, child and family functioning is less impaired. This illustrates the

reciprocal relationship between children’s adjustment and parental stress and distress—healthy parental adjustment is related to healthy child adjustment, and vice versa. (Most research has considered only the role of mothers on child adjustment, but the specific influence of fathers on children’s coping and adaptation to chronic illness is being recognized [Ware & Raval, 2007].) Thus, parental adjustment is one of the important correlates of children’s adjustment to chronic illness.

68. Discuss the transactional stress and coping model (for chronic childhood illness) as proposed by Thompson and colleagues.

ANSWER: The transactional stress and coping model explains how children’s adaptation to chronic illness is influenced not only by the nature of the illness itself but also by personal and family resources (Gustafson et al., 2006; Thompson et al., 1994). This model helps make sense of the complicated processes that shape children’s outcomes. The transactional stress and coping model emphasizes the stressful nature of chronic illness, which Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 compels the child and family members to adapt. How they accomplish the adaptation is a key factor in children’s outcomes.

69. Michelle has recently been diagnosed with childhood cancer. Understandably, her parents are concerned about her well-being and want to know how they can best help Michelle to cope with the painful procedures she will have to endure.

What advice and suggestions would you make to Michelle’s parents?

ANSWER: In general, there are two main psychological approaches to helping children cope with stressful medical procedures and chronic and recurrent pain: providing information and training them in coping skills (Thompson & Gustafson, 1996). Information strategies offer verbal explanations and demonstrations as well as modeling the procedure, which reduce distress because this makes the medical procedure more predictable (Jaaniste, Hayes, & von Baeyer, 2007).

Coping strategies involve teaching the various coping skills of deep breathing, attention distraction muscle relaxation, relaxing imagery, emotive imagery, and behavioral rehearsal (e.g., children may be asked to imagine themselves as superheroes undergoing a test of their powers) (Dahlquist, 1999). Children are encouraged to identify specific stressors associated with their illness (e.g., giving themselves an injection) and to learn ways to handle those stressors and prevent distress or failure.

70. Explain how diabetes impacts children, especially adolescents.

ANSWER: Children and teens must carefully follow the instructions given to them by their physicians and practice careful regimen adherence. This requires children to have correct knowledge about their disease and its treatment, recognizing the need to adhere to treatment needs, and adequate problem-solving skills.

Adolescence is a particularly difficult period for diabetics because of the impact that the illness can have on self-esteem and social and educational experiences.

71. Explain how a diagnosis of cancer can affect a child.

ANSWER: Children with cancer undergo complicated medical treatment regimens, especially in the years immediately following diagnosis. They face school absences, significant treatment side effects, and an uncertain prognosis. Chemotherapy and radiation therapy can cause hair loss and weight changes, as well as nausea, vomiting, increased fatique, endocrine and growth retardation, and a depressed immune system. Treatment requires children to be away from friends and some family members, hindering their psychosocial development.

72. Define and give an example of psychological dependence and physical dependence.

ANSWER: Psychological dependence refers to the subjective feeling of needing the substance to adequately function.

Physical dependence occurs when the body adapts to the substance’s constant presence, and tolerance refers to requiring more of the substance to experience an effect once obtained at a lower dose. Another aspect of physical dependence is the experience of withdrawal, an adverse physiological symptom that occurs when consumption of an abused substance is ended abruptly and is thus removed from the body.

73. Identify and describe the leading causes of adolescent substance use.

ANSWER: Several pathways and various risk factors have been associated with substance abuse in adolescents, including personality associated with substance use; perceiving oneself to be physically older than same-age peers and striving or adult social roles are risky attitudes held by some teens. Feelings about school—in particular how connected they feel to their school community—are associated with a lower risk for use of substances. Adolescents with a positive family history for alcoholism may inherit certain brain structures and functional abilities from parents. Additionally, low parental monitoring is a predictor of adolescent substance abuse. Finally, the importance of peers and peer culture plays a large role in determining the extent to which teens use and abuse substances.

74. What kind of a treatment program would you suggest for an adolescent diagnosed with a SUD? Copyright Cengage Learning. Powered by Cognero.

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Chapter 13 ANSWER: Derived from interventions for conduct disorders, family-based approaches seek to modify negative interactions between family members, improve communication between members, and develop effective problem-solving skills to address areas of conflict (Anderson et al., 2007; Spoth et al., 2012). Multisystemic therapy (MST), for example, involves intensive intervention that targets family, peer, school, and community systems; it has been especially effective in the treatment of SUDs among delinquent adolescents (Henggeler et al., 2008).

75. Give an example of a substance abuse prevention program and explain its goals.

ANSWER: Life skills training, a detailed and well-evaluated program, emphasizes building drug resistance skills, personal and social competence, and altering cognitive expectancies around substance use (Griffin & Botvin, 2010). Because adolescents must receive consistent messages and reinforcement regarding pressures to use alcohol and drugs, as well as develop effective refusal skills, societal messages about responsible use are emphasized to influence students’ behavior.

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Chapter 14 Multiple Choice 1. Though similar in their concerns about eating and gaining weight, individuals with bulimia differ from individuals with anorexia in that they _____, while those with anorexia do/are not. a. do not eat

b. are within 10% of their normal weight c. are driven to thinness d. are secretive about their disorder ANSWER: b 2. Eating disorders are the ____ most common illness in adolescent females. a. second b. third c. fifth d. tenth ANSWER: b 3. Unlike most of the disorders of childhood and adolescence, the causes of eating disorders are disproportionately related to ____ influences. a. sociocultural

b. biological c. familial d. psychological ANSWER: a 4. Which statement about picky eating in young childhood is true? a. Over a third of young children are described as picky eaters. b. Picky eating is more common among boys than girls. c. Picky eating in young childhood is clearly connected to the later emergence of eating disorders. d. Picky eating always leads to eating disorders.

ANSWER: c 5. Which factor is LEAST characteristic of teens who develop eating problems (Graber et al., 1994)? a. Higher percentage of body fat b. Early pubertal maturation c. Poor academic achievement d. Concurrent psychological problems ANSWER: c 6. Which of the following is NOT necessarily a part of the binge-purge cycle? a. Tension and cravings b. Shame and disgust Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 c. Strict monitoring of body weight d. Strict dieting ANSWER: c 7. Which of the following effects is LEAST likely to occur when an individual is malnourished? a. A loss of circadian rhythm b. A decrease in the release of growth hormone c. Dermatological changes d. Lethargy, apathy, and depression ANSWER: b 8. An individual’s balance of energy expenditure is referred to as their ____. a. set point b. metabolic rate c. circadian rhythm d. net caloric intake ANSWER: b 9. If fat levels decrease below our body’s normal range, the hypothalamus ____. a. produces less insulin b. triggers the proliferation of fat cells c. slows metabolism d. releases growth hormone ANSWER: c 10. Approximately 50% to 75% of growth hormone production occurs ____. a. prenatally b. after the onset of deep sleep c. during adolescence d. when eating ANSWER: b 11. Avoidant/restrictive food intake disorders in childhood are most characterized by ____. a. the eating of nonnutritive substances b. bingeing and purging to lose weight c. significant weight loss d. purposeful regurgitation of food ANSWER: c 12. Failure to thrive is more common among ____. a. girls Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 b. children from disadvantaged environments c. adolescents d. individuals with mental retardation ANSWER: b 13. Early onset of feeding disorder is often associated with ____. a. intellectual disability b. parental overemphasis on food c. inadequate care giving d. poor metabolic control ANSWER: c 14. ____ has/have been identified as a specific risk factor for an infant’s eating or feeding disorder. a. Difficult temperament b. Poor metabolic control c. Parental psychopathology d. Maternal eating disorders ANSWER: d 15. A child who eats insects and wood chips is likely to be diagnosed with ____. a. feeding disorder of childhood b. rumination disorder c. failure to thrive d. pica ANSWER: d 16. Pica is often seen in individuals with ____. a. intellectual disability b. ADHD c. depression d. bulimia ANSWER: a 17. Pica among young children (without intellectual disability) often remits ____. a. when the child starts teething b. after the child experiences a bout of sickness due to eating something inedible c. when the child experiences increased stimulation d. once the child has the cognitive capacity to understand that certain substances are not edible ANSWER: c 18. Pica in the first and second years of life among otherwise normally developing infants and toddlers is likely due to Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 ____.

a. undiagnosed learning disorders b. hunger c. exploration d. underlying depression ANSWER: c 19. Failure to thrive is characterized by ____. a. serious digestion problems b. growth and eating problems c. overeating problems d. fear of getting fat ANSWER: b 20. Mothers of infants with failure to thrive have been found to be ____ than mothers of infants without failure to thrive. a. more insecurely attached b. lower in self-esteem c. older d. less intelligent ANSWER: a 21. Studies have found that failure to thrive may affect physical growth in childhood but does not affect future ____. a. psychological health b. physical growth c. eating patterns d. cognitive functioning ANSWER: d 22. Obesity is a ____. a. chronic medical condition b. disorder of weight regulation c. failure of willpower d. childhood-onset mental disorder ANSWER: a 23. Obesity is usually defined in terms of a body mass index above the _____ percentile. a. 60th b. 70th c. 80th d. 95th ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 24. Approximately ____ of American children are obese. a. 1 in 4 b. 1 in 5 c. 1 in 6 d. 1 in 7 ANSWER: c 25. Obesity ____ is strongly related to obesity in ____. a. in infancy; later childhood b. in infancy; adolescence c. in childhood; adulthood d. at any time during the course of development; adulthood ANSWER: c 26. Obese children are a risk factor for later ____ disorders. a. mood b. anxiety c. eating d. substance ANSWER: c 27. The relationship between preadolescent obesity and the later emergence of eating disorders is likely due to ____. a. biological abnormalities that underlie both conditions b. the teasing that obese children experience from their peers c. an underlying psychiatric condition d. an urge to stop eating ANSWER: b 28. A protein that plays a major role in some genetic cases of obesity is called ____. a. lutein b. peptin c. leptin d. tyrosine ANSWER: c 29. Treatment methods to help children who are obese to lose weight should emphasize ____. a. demanding exercise regimens b. strict caloric reduction/restriction c. avoidance of food cues d. active, less sedentary routines Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 ANSWER: d 30. For some teens, particularly girls, excessive efforts to control eating may be a misguided effort to ____. a. punish parents b. manage the stress and physical changes c. punish themselves d. regress back to the oral stage of development ANSWER: b 31. In the early 1900s, the treatment for anorexia was ____. a. psychodynamic psychotherapy b. hypnotherapy c. removal from home and forced feeding d. family therapy ANSWER: c 32. Which of the following is NOT a characteristic of anorexia? a. Loss of appetite b. Fear of gaining weight c. Denial of being too thin d. Refusal to maintain minimal normal body weight ANSWER: a 33. The DSM-5 specifies two subtypes of anorexia based on ____. a. percentage of weight loss b. methods used to limit caloric intake c. presence or absence of comorbid depression d. family dynamics ANSWER: b 34. In comparison to persons with bulimia, those with binge eating/purging type of anorexia ____. a. eat the same amount of food but purge more thoroughly b. eat relatively small amounts of food and purge more consistently c. binge only on healthy foods d. purge more inconsistently ANSWER: b 35. In comparison to the binge eating/purging type, individuals with restricting anorexia tend to ____. a. be more impulsive b. have stronger family histories of obesity c. have more labile moods Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 d. lose weight through diet ANSWER: d 36. In comparison to the restricting type, individuals with the binge eating/purging type of anorexia tend to ____. a. be more controlled and rigid b. be more obsessive c. have less mood problems d. eliminate the food quicker ANSWER: d 37. Which of the following statements relating to bulimia is true? a. Anorexia is more common than bulimia. b. The DSM-5 subdivides bulimia into two types: purging type and restrictive type. c. Approximately, one-third of individuals with bulimia engage in purging. d. No specific quantity of food constitutes a binge.

ANSWER: d 38. Binge eating typically follows changes in _______. a. school routines b. weight gain c. interpersonal stress d. family eating patterns ANSWER: c 39. The most common compensatory technique after an episode of binge eating among clinical samples is ____. a. fasting b. vomiting c. exercise d. laxatives ANSWER: b 40. Vomiting is used by people with bulimia to ____. a. prevent weight gain b. avoid bacteria c. gain attention d. act independently ANSWER: a 41. Young women who have dietary-depressive pattern of bulimia differ from women with only the dietary pattern, as those with the dietary-depressive subtype display ____. a. less eating pathology Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 b. more social impairment c. less psychiatric comorbidity d. more anorexic symptoms ANSWER: b 42. Mild binge eating is characterized by how many episodes of binge eating? a. At least one a day b. Four to seven episodes per week c. At least one episode per month d. One to three episodes weekly ANSWER: d 43. Which disorder has become increasingly widespread during this age of abundant fast food and obesity? a. Reduced eating disorder b. Bulimia c. Anorexia d. Binge eating disorder ANSWER: d 44. Binge eating disorder (BED) differs from bulimia in that individuals with BED ____. a. do not feel a loss of control while binge eating b. eat over 1,000 calories in one sitting c. do not have compensatory behaviors d. have lower self-esteem ANSWER: c 45. Studies have estimated the prevalence of anorexia among adolescents at ____. a. 0.2% b. 0.3% c. 7% d. 14% ANSWER: b 46. Which statement about gender differences in relation to eating disorders is true? a. Young men with eating disorders generally have different clinical features than young women. b. Men show more of a drive for thinness than women. c. Men show less of a preoccupation with food than women. d. Men place more emphasis on personal attractiveness than women.

ANSWER: c 47. Most commonly, individuals with anorexia ____.

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Chapter 14 a. die from starvation b. overcome their disorder completely c. become overweight in their late twenties d. restore to a normal weight but then relapse ANSWER: d 48. The onset of bulimia ____. a. typically occurs in late adolescence b. typically occurs in mid-adolescence to late adolescence c. typically occurs in adulthood d. may occur at any time after the onset of puberty (no particular time is more likely than others) ANSWER: b 49. Follow-up studies of patients with bulimia indicate that between ____ of patients show full recovery over several years.

a. 10% and 15% b. 20% and 25% c. 30% and 45% d. 50% and 75% ANSWER: d 50. Which of the following is a predictor of full recovery for individuals with bulimia? a. Higher social class b. Older age at onset c. Family history of alcohol abuse d. Less weight gain ANSWER: a 51. The neurotransmitter that has been most focused on as a possible cause of eating disorders is ____. a. dopamine b. GABA c. serotonin d. norepinephrine ANSWER: c 52. Scientists have found biochemical similarities between people with eating disorders and those with ____. a. ADHD b. social phobia c. schizophrenia d. obsessive–compulsive disorder ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 53. Which factor has been linked to the development of eating disorders? a. Parental supervision b. Sexual abuse c. Single-parent family d. Low socioeconomic status ANSWER: d 54. According to research, __________ appear to be at greater risk for behavioral symptoms of eating disorders. a. homosexual men b. homosexual women c. heterosexual men d. bisexual individuals ANSWER: a 55. Cross-cultural evidence for eating disorders suggests that _________________. a. bulimia, and not anorexia, is mainly a Western phenomenon b. anorexia, and not bulimia, is mainly a Western phenomenon c. both bulimia and anorexia appear mostly in Western countries d. both bulimia and anorexia occur commonly worldwide ANSWER: a 56. Which of the following is considered a perpetuating factor of eating disorders? ? a. Obsession with food b. Starvation symptoms and reaction from others c. Dieting to increase feelings of self-worth and self-control d. Dissatisfaction with body weight and body shape ANSWER: b 57. Which of the following disorders is LEAST likely to co-occur with eating disorders? a. Depression b. Anxiety c. Obsessive–compulsive disorder d. ADHD ANSWER: d 58. A common link between depression and eating disorders may be ____. a. high impulsivity b. poor emotion regulation c. excessive anger d. inability to focus Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 ANSWER: b 59. ____ is the initial treatment of choice for children and adolescents with anorexia who are living at home. a. Temporary removal from the home b. Family-based therapy c. Psychopharmacology d. Individual psychotherapy ANSWER: b 60. The most effective current treatment for bulimia is ____. a. insight-oriented psychotherapy b. family therapy c. psychopharmacology d. cognitive–behavior therapy ANSWER: d Subjective Short Answer 61. How may present-day societal messages regarding females’ roles contribute to the development of eating disorders?

ANSWER: Societal norms and media’s focus on thinness and attractiveness are partly to blame for weight consciousness among pre-teen girls (Bell & Dittmar, 2011; Nouri, Hill, & Orrell-Valente, 2011). In addition, normal concerns about weight and appearance can either be reduced or increased by the comments of parents, friends, and romantic partners. The effects of the early parent–child relationship on fundamental biological processes such as eating and growth patterns are of paramount importance (Corning et al., 2010).

62. Why does dieting sometimes lead to overeating?

ANSWER: Decreasing caloric intake reduces a person’s metabolic rate, which allows fat to remain in the cells so that weight loss is, in fact, impeded. This failure to lose weight sets the stage for a vicious cycle of increased commitment to dieting and vulnerability to binge eating.

Psychological consequences also contribute to this cycle by creating what some researchers call the “false hope syndrome”—an initial commitment to change one’s appearance leads to short-term improvements in mood and self-image, but this hope declines as feelings of failure and loss of control increase (Polivy & Herman, 2005). Loss of control may lead to binge eating, and purging is seen as a way to counteract the perceived effects of binge eating on weight gain.

63. Why is it often difficult to lose weight?

ANSWER: In effect, people who gain or lose weight will experience metabolic changes that strive to bring the body back to its natural weight. If fat levels decrease below our body’s normal range, the brain (specifically, the hypothalamus) compensates by slowing metabolism. We begin to feel lethargic, we increase our sleep, and our body temperature decreases slightly to conserve energy (which is why many persons with anorexia complain of being cold). In this state of relative deprivation, uncontrollable urges to binge are common because our bodies are telling us that they need more food than they are getting to function properly.

Similarly, the body fights against weight gain by increasing metabolism and raising body temperature in an effort to burn off extra calories. (Admittedly, this valiant effort is seldom enough to conquer the force of holidays and other feasts.) Because of its responsivity to change, researchers often compare the body’s set point to the setting on a thermostat that regulates room temperature. When room temperature falls below a certain range, the thermostat automatically sends a signal to the heating system to increase the heat level until

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Chapter 14 it again reaches the established temperature setting. Human bodies respond similarly to deviations in body weight by turning their metabolic “furnace” up or down (Wilkin, 2010).

64. Twelve-month old Dean has been diagnosed with failure to thrive. You have been asked to formulate a general treatment plan. What might you include in your treatment plan and why?

ANSWER: Because the mother–child relationship during the early stages of attachment is critical, eating disorders shown by infants and young children may be symptomatic of a fundamental problem in this relationship (Lyons-Ruth et al., 2014). Thus, treatment regimens involve a detailed assessment of feeding behavior and parent–child interactions, such as smiling, talking, and soothing, while allowing the parents to play a role in the infant’s recovery (Atalay & McCord, 2011; Linscheid, 2006).

65. What are some of the danger signals that an individual may have anorexia?

ANSWER: The refusal to maintain a minimally normal body weight, an intense fear of gaining weight, a significant disturbance in the individual’s perception, and experiences of his or her own size.

66. Discuss three risks that are associated with infant and early childhood feeding disorders.

ANSWER: Drive for thinness is a key motivational variable that underlies dieting and body image, among young females in particular, whereby the individual believes that losing more weight is the answer to overcoming her troubles and to achieving success (Philipsen & Brooks-Gunn, 2008). However, such behavior creates the negative side effects of weight preoccupation, concern with appearance, and restrained eating, which increase the risk of an eating disorder (Touyz, Polivy, & Hay, 2008). Disturbed eating attitudes describe a person’s belief that cultural standards for attractiveness, body image, and social acceptance are closely tied to one’s ability to control diet and weight gain.

67. Why are eating disorders in infants and young children often considered symptomatic of a problem in the mother– child relationship?

ANSWER: A prominent controversy concerns the significance of emotional deprivation (lack of love) and malnutrition (lack of food), especially for failure to thrive. Investigators have argued that the infant with FTT, for example, has been deprived of maternal stimulation and love, which results in emotional misery, developmental delays, and eventually, physiological changes. In one study, mothers of infants diagnosed with FTT were found to be more insecurely attached than mothers of normal infants. These mothers also were more passive and confused and either became intensely angry when discussing past and current attachment relationships or dismissed the attachments as unimportant and noninfluential (Benoit, Zeanah, & Barton, 1989). Children who have suffered from FTT as a result of early abuse exhibit poorer outcomes 20 years later than children whose failure to thrive resulted from neglect, lack of parenting, or feeding difficulties (Iwaniec, Sheddon, & Allen, 2003).

68. Outline and describe the dangers of obesity in children and adolescents.

ANSWER: Obesity can affect a child’s psychological and physical development significantly. Obese children and adolescents are five times more likely than healthy children to experience an impaired quality of life, similar to children with cancer. Individuals with obesity risk many health concerns, including cardiovascular problems, diabetes, and elevated cholesterol and triglycerides. Obesity in children is a risk factor in the later emergence of eating disorders, and it is strongly correlated with teasing by peers, which leads to dissatisfaction with appearance and body image. Finally, obesity is a major factor in reducing life expectancy in Western society.

69. Distinguish between anorexia and bulimia, both in terms of their major features as well as their associated characteristics. In what ways are these two eating disorders similar?

ANSWER: Although the word anorexia literally means “loss of appetite,” that definition is misleading because the Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 person with this disorder rarely suffers appetite loss. Weight loss is accomplished deliberately through a very restricted diet, purging, and/or exercise. Although many persons occasionally use these methods to lose weight, the individual with anorexia intensely fears obesity and pursues thinness relentlessly. The DSM-5 specifies two subtypes of anorexia based on the methods used to limit caloric intake. In the restricting type, individuals seek to lose weight primarily through diet, fasting, or excessive exercise; in the binge eating/purging type, the individual regularly engages in episodes of binge eating or purging, or both.

Compared with persons with bulimia, those with the binge eating/purging type of anorexia eat relatively small amounts of food and commonly purge more consistently and thoroughly. Of the two major forms of eating disorders afflicting adolescents and young adults, bulimia nervosa is far more common than anorexia.

The DSM-5 diagnostic criteria listed in Table 14.2 note that the primary hallmark of bulimia is binge eating.

Because most of us overeat certain foods at certain times, you may ask, “What exactly is a binge?” As noted in the criteria, a binge is an episode of overeating that must involve (1) an objectively large amount of food (more than most people would eat under the circumstances) and (2) lack of control over what or how much food is eaten. No specific quantity of food constitutes a binge—the context of the behavior that must also be considered. The second important part of the diagnostic criteria involves the individual’s attempts to compensate somehow for a binge. Compensatory behaviors are intended to prevent weight gain following a binge episode and include self-induced vomiting, fasting, exercising, and the misuse of diuretics, laxatives, enemas, or diet pills.

70. What are the commonalities among males and females who have eating disorders as well as the differences each have regarding body ideals?

ANSWER: There is increased recognition that eating disorders are more common among young men than was originally believed. Males also are subjected to powerful media images although perhaps not to the same extent as females. The increasingly muscular male body ideal may be contributing to body dissatisfaction, disordered eating, and harmful weight-control or body-building behaviors (Smolak & Stein, 2010). Young men with eating disorders show some of the same clinical features as young women with eating disorders. However, young men show less of a preoccupation with food or a drive for thinness; rather, they want to be more muscular than they actually are and more muscular than the average male body (Olivardia et al., 2004). In addition, young men and boys are more likely to engage in excessive exercising and overeating, whereas young women and girls are more likely to engage in purging behaviors, to report loss of control while eating, and to try to reduce their caloric intake (von Ranson & Wallace, 2014).

71. Discuss what is meant in the recent research that indicated that anorexia may not be a culture-bound syndrome and that bulimia may be considered a culture-bound syndrome.

ANSWER: Anorexia has been observed in Western countries as well as every non-Western region of the world, suggesting that anorexia may not be a “culture-bound” syndrome as once believed (Sohl, Touyzl, & Surgenor, 2006). It is becoming increasingly clear that eating disorders do not always manifest the same way in different cultures. In Hong Kong, for example, studies suggest that anorexia may be divided into fatphobic and non-fat-phobic subtypes and that questionnaires used in Western countries to assess eating disorders may not be sufficiently sensitive to detect the Chinese non-fat-phobic subtype (Lee, Lee, & Leung, 1998). However, the cross-cultural evidence for bulimia and BED outside of a Western context tells a different story. Keel and Klump’s (2003) review of culture and eating disorders found no studies reporting the presence of bulimia in individuals who have not been exposed to Western ideals. Epidemiological data for bulimia in non-Western nations suggest that bulimia has a lower prevalence than anorexia in these countries, and even when it is found in non-Western nations, it is not found in the absence of Western influence. A meta-analysis examining the role of ethnicity and culture in the development of eating disturbances found few differences across ethnic groups for bulimia (Wildes & Emery, 2001). These findings seem to suggest that bulimia is a culture-bound syndrome, arising predominantly in Western regions of the world or in places where individuals probably or definitely have been exposed to Western ideals and culture (Anderson-Fye, 2009).

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Chapter 14 72. Discuss predominant treatments for obesity in children.

ANSWER: Childhood obesity prevention and intervention efforts focus on the child’s health as well as the family’s resources. Proper nutrition, not necessarily dieting, is recommended by pediatricians. Emphasis on family functioning is critical, as this relates to eating patterns and choices. Efforts to curb childhood obesity often focus on addressing parents’ knowledge of nutrition and increasing children’s physical activity levels.

73. In what ways may family members contribute to the development of an eating disorder?

ANSWER: From the very start, researchers and clinicians have placed considerable importance on the role of the family, and parental psychopathology in particular, in considering causes of eating disorders. They have argued that alliances, conflicts, or interactional patterns within a family may play a causal role in the development of eating disorders among some individuals (Minuchin, Rosman, & Baker, 1978). Accordingly, a teen’s eating disorder may be functional in that it directs attention away from basic conflicts in the family to the teen’s more obvious (symptomatic) problem. Evidence has confirmed that families with members who have eating disorders report worse family functioning than control families, although a typical pattern of family dysfunction is not evident (Holtom-Viesel & Allan, 2014).

74. Describe how cognitive–behavioral therapy might be used to treat an individual with an eating disorder.

ANSWER: The goals of CBT are to modify abnormal cognitions on the importance of body shape and weight and to replace efforts at dietary restraint and purging with more normal eating and activity patterns (Poulsen et al., 2014; Touyz et al., 2008). CBT for the treatment of bulimia includes several components. Patients are first taught to self-monitor their food intake and bingeing and purging episodes, as well as any thoughts and feelings that trigger these episodes. This is combined with regular weighing; specific recommendations on how to achieve desired goals, such as the introduction of avoided foods and meal planning, designed to normalize eating behavior and curb restrictive dieting; cognitive restructuring aimed at habitual reasoning errors and underlying assumptions relevant to the development and maintenance of the eating disorder; and regular review and revision of these procedures to prevent relapse.

75. What interventions are used for bulimia, and are they successful?

ANSWER: As noted, the most effective current therapies for bulimia involve CBT delivered individually or by involving the family unit (Rutherford & Couturier, 2007; Wilson et al., 2007). Cognitive–behavioral therapists change eating behaviors by rewarding or modeling appropriate behaviors, and by helping patients change distorted or rigid thinking patterns that may contribute to their obsession. CBT has become the standard treatment for bulimia, and it forms the theoretical base for much of the treatment for anorexia (Chavez & Insel, 2007). This evidence-based treatment is appropriate for patients whose age does not mandate family therapy and whose symptoms are moderate to severe.

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