Test Bank for Abnormal Psychology-An Integrative Approach 6E by Barlow,Durand,Hofmann & Lalumière -

TEST BANK

TEST BANK

W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

Indicate the answer choice that best completes the statement or answers the question.

1. Why was electroconvulsive therapy originally used as a therapy for schizophrenia? a. It was (mistakenly) observed that schizophrenia was rarely found in people with epilepsy. b. It was (mistakenly) observed that it could reduce brain seizures, providing a cure. c. It was (mistakenly) observed to induce convulsions and stimulated appetite in psychotic patients. d. It was (mistakenly) observed to alleviate the depression that often accompanies schizophrenia.

2. According to Abraham Maslow’s hierarchy of needs, individuals will be unable to achieve high levels of selfactualization and self-esteem unless which of the following has taken place? a. unless they have been raised with unconditional positive regard from primary caregivers b. unless they have first met more basic human requirements such as food, sex, and friendship c. unless they have developed sufficient ego strength d. unless they have gratified their basic needs and satisfied their drive for physical pleasure through the five psychosexual stages of development 3. How do most mental health professionals view psychoanalysis as a treatment technique? a. It has been proven effective. b. It has been subject to careful measurement criteria. c. It is basically unscientific. d. It is noted for consistency in analytic interpretation.

4. After receiving the results of four different sets of tests, Mary’s doctor tells her that she has cancer. Mary states, “This can’t be true; I’m going to get a second opinion.” Which defence mechanism does this example illustrate? a. displacement b. denial c. projection d. repression 5. What is the name for learning in which a neutral stimulus is paired with a response until it elicits that response? a. operant conditioning b. classical conditioning c. systematic desensitization d. extinction 6. Statistical data are relevant to researchers. For example, one major epidemiological study found that about 7.8 percent of people in North America have had a mood disorder at some point in their lives and 3.7 percent have experienced a mood disorder over the past year. What do the 7.8 percent and 3.7 percent statistics refer to, respectively? a. incidence; prevalence b. incidence; recurrence c. proportion; prevalence d. prevalence; incidence 7. When 20-year-old Larry was first identified as suffering from schizophrenia, his family wanted to know how the disorder would progress and how it would affect him in the future. In medical terms, what did the family want to know? a. Larry’s psychosocial profile b. Larry’s pathology c. Larry’s diagnosis d. Larry’s prognosis 8. Ron has just been diagnosed with schizophrenia and hospitalized. What would Thomas Szasz most likely argue? a. Ron should not be hospitalized because doing so will only make his symptoms worse. b. Ron’s behaviour does not represent an illness like diabetes, and “schizophrenia” is merely a label applied on the basis of highly subjective judgments. c. Ron’s schizophrenia is a serious illness that is best treated with a combination of drugs and family therapy. d. Ron should be assessed further because mistakes in diagnosis are made frequently.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

9. According to psychoanalytic theory, what function does a person develop early in life to ensure that they can adapt to the demands of the real world while still finding ways of meeting their basic needs? a. id b. conscience c. superego d. ego 10. A four-year-old girl sucks her thumb, a teenager binges on food, and an adult woman bites her fingernails. According to the Freudian theory of psychosexual development, what underlies all these behaviours? a. repression of aggressive impulses b. a fixation at the oral stage of psychosexual development c. a trauma during the toilet-training phase d. denial of unacceptable feelings, thoughts, or wishes 11. In the Middle Ages, one of the chief advisers to France’s King Charles V, Nicholas Oresme, suggested that which of the following was responsible for bizarre behaviour? a. the moon b. religion c. melancholy d. greed 12. Bloodletting, often through the use of leeches, was a treatment devised centuries ago. What was this treatment used for? a. to reduce excessive blood in the brain b. to correct a chemical imbalance in the brain c. to reduce the negative effects of stress d. to restore the balance of humors 13. Who is the concept of a “hierarchy of needs” most strongly associated with? a. Carl Rogers b. Anna Freud c. Abraham Maslow d. Carl Jung 14. You are listening to old musical tunes, including “Melancholy Baby.” Your friends are impressed when you tell them that “melancholic,” referring to a depressive personality, derives from the Greek term melancholer. What does this term mean? a. yellow bile b. phlegm c. blood d. black bile 15. In most Western societies, what happens when a person enters a trance state and believes he or she is possessed? a. The person is believed to be suffering from a psychotic disorder. b. The person is diagnosed with a dissociative disorder. c. The person may be viewed as having a psychological disorder. d. The person can be cured with antipsychotic medication.

16. Which Greek philosopher suggested that maladaptive behaviour was rooted in social and cultural factors? a. Galen b. Hippocrates c. Plato d. Aristotle 17. Which of the following is a characteristic of how defence mechanisms affect coping styles? a. They are dependent upon the age of the person and how they are used. b. They can be either adaptive or maladaptive.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

c. They are self-defeating. d. They are adaptive.

18. Who was the first theorist to argue that genetics were related to abnormal functioning? a. Hippocrates b. Galen c. Freud d. Grey 19. What is the relationship between a presenting problem and a clinical description? a. Obtaining the patient’s clinical description is the first step in determining what the patient’s presenting problem is. b. Describing the patient’s presenting problem is the first step in determining the patient’s clinical description. c. The presenting problem refers to the current status of a distressed individual; the clinical description refers to the treatment plan. d. The presenting problem refers to symptoms that last only a short time, whereas the clinical description refers to symptoms that are chronic.

20. Why are operant conditioning techniques being applied in Canadian hospital settings? a. to increase patients’ insight into their fears and wishes b. to reduce psychiatric patients’ undesirable behaviour and increase their desirable behaviour c. to reduce patients’ fear of surgery d. to increase nursing staff’s empathy 21. Realizing patients are often unaware of material previously recalled under hypnosis, Breuer and Freud hypothesized the existence of a concept considered one of the most important developments in the history of psychopathology. What was that concept? a. psychosis b. the unconscious mind c. catharsis d. repression 22. According to psychoanalytic theory, what do the conflicts between the id and the superego often lead to? a. anxiety b. anger c. violent behaviour d. depression 23. During more superstitious times, which of the following was thought to be the cause of abnormal behaviour? a. a demonic possession b. black bile c. homosexuality d. punishment of the illiterate 24. The ego operates according to one principle, and the id operates according to another principle. What are they, respectively? a. reality; pleasure b. conscious; unconscious c. pleasure; aggression d. reality; aggression 25. What is the formal definition of psychopathology? a. the medications used to treat some psychological disorders b. the criteria used to define psychological disorders c. the psychological therapies used to treat psychological disorders d. the scientific study of psychological disorders

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

26. Jack and Kelly have been dating for six months. Kelly is not interested in continuing their relationship. She calls Jack and informs him that although she cares about him, she must end their relationship. Jack laughs and says, “Funny joke.”

Kelly states, “This is not a joke; I am serious.” Jack then says, “I’ll pick you up in an hour for dinner.” Which defence mechanism does this example illustrate? a. displacement b. projection c. denial d. repression 27. Jason has been having a lot of difficulty because of his irrational fears. His doctor advises Jason to participate in an anxiety-reduction procedure based on the work of Joseph Wolpe. What is this procedure? a. aversive conditioning b. person-centred therapy c. systematic desensitization d. mesmerism 28. Which term refers to the study of the origins of a disorder? a. prognosis b. etiology c. symptomology d. prevalence 29. Frank drinks three bottles of wine each day and believes he would be fine if people would just “mind their own business.” Which criterion for abnormality is absent from this scenario? a. objective harm to others b. personal distress c. maladaptiveness d. qualitative uniqueness 30. According to psychoanalytic theory, the id operates according to the pleasure principle. What does that mean? a. It uses secondary-process thinking. b. It thinks in an unemotional, logical, and rational manner. c. It is sexual, aggressive, selfish, and envious. d. It adheres to social rules and regulations.

31. According to Freudian theory, anxiety is a signal for the ego to marshal its mechanisms of defence. This is a function of which of the following? a. reality-based actions b. conscious efforts to maintain control c. unconscious protective processes d. primitive emotional responses 32. What do humanistic therapists regard as the most positive influence in facilitating human growth? a. therapist interpretations of the patient’s verbalizations b. self-esteem c. ego development d. relationships (including the therapeutic relationship) 33. You are in a mall when a young child begins to scream and shout because his parents will not buy him the latest toy.

What would B.F. Skinner most likely say about the child’s behaviour? a. It is an expression of repressed Oedipal anger toward his father and it will diminish naturally as he gets older. b. It is a classically conditioned response to being in the mall. c. It would be most effectively altered over the long term by simply ignoring it. d. It would be most effectively altered over the long term by scolding him and positively reinforcing more appropriate behaviour.

34. Which of the following is associated with the humanistic theories of Carl Rogers? a. hierarchy of needs b. dream analysis Copyright Cengage Learning. Powered by Cognero.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

c. moral hygiene

d. person-centred therapy

35. Anton Mesmer, an early 18th-century physician, purported to cure patients by unblocking the flow of a bodily fluid he called “animal magnetism.” Benjamin Franklin’s double-blind experiment indicated that any effectiveness of Mesmer’s methods was actually because of which of the following? a. undetectable magnetic fields b. chemically induced humoral balance c. the power of suggestion d. mental telepathy 36. The Oedipus complex is the psychosexual conflict occurring during the phallic stage of development in boys. How is this complex characterized? a. by love for the mother and feelings of anger and envy toward the father b. by a repressed need for oral gratification c. by a love for the father and feelings of repulsion toward the mother d. by a repressed need for genital self-stimulation 37. When using the psychological disorder criteria, when would an individual be assessed as having psychological dysfunction? a. when his or her thought processes are totally out of touch with reality b. when he or she is extremely distressed c. when his or her behaviour violates social norms d. when he or she avoids interactions with other people 38. In classical psychoanalysis, why is the process whereby the therapist interprets a patient’s dreams often difficult? a. because the patient may resist uncovering repressed material and deny the interpretation b. because patients often forget their dreams c. because the patient may relate to the therapist much as he or she did toward a parent figure d. because the therapist may wish not to upset the patient with a negative interpretation 39. Psychological disorders can be described as following a typical course or individual pattern. Disorders that tend to last a long time follow one type of course, whereas disorders that show a discontinuous, recurrent pattern follow another type of course. What are these courses, respectively? a. chronic; episodic b. chronic; time-limited c. pervasive; time-limited d. insidious; recurrent 40. Based on Hippocrates’ humoral theory, what type of person does the term “sanguine” describe? a. humorous b. pessimistic c. pale d. cheerful 41. Which of the following terms for mental illness is related to movements of the moon and stars? a. lunatic b. mental defective c. maniac d. idiot 42. Louie was barking like a dog and walking on his hands and knees. A professional thought the cause of Louie’s problem was an excess of a specific neurotransmitter and prescribed a drug to treat him. What kind of professional was this most likely to be? a. a clinical psychologist b. a social worker c. a psychiatric social worker d. a psychiatrist Copyright Cengage Learning. Powered by Cognero.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

43. Whose work lead to a decline in moral therapy? a. John Grey b. Dorothea Dix c. Aristotle d. Sigmund Freud 44. In the middle of the 20th century, what were some of the first effective drugs for psychological disorders? a. benzodiazepines to treat depression b. bromides and opium for sedation c. insulin and neuroleptics for sedation d. neuroleptics for psychotic symptoms 45. In 14th- and 15th-century Europe, to what was inexplicable behaviour attributed? a. evil b. stupidity c. humors d. astrology 46. In 1895, how did neurologist Josef Breuer treat Anna O.’s hysterical symptoms? a. using mesmerism b. using hydrotherapy c. using the placebo effect d. using hypnosis 47. When did moral therapy work best? a. when it was used with groups of patients, rather than through individual attention to patients b. when the number of patients in an institution was 200 or fewer c. when it was used in populations of immigrants and the poor d. when it was supplemented by the use of restraint and seclusion 48. Popular musician Lady Gaga has performed with blood spurting out of her clothes. Why might having blood spurt from her clothes be considered abnormal? a. because her behaviour demonstrates a sense of subjective discomfort b. because she has an inability to distinguish right from wrong c. because it is a deviation from what is typical in her society d. because she shows an inability to function effectively 49. What does Wolpe’s technique of systematic desensitization involve? a. reinforcing successive approximations to a final behaviour or set of behaviours b. gradually introducing the feared objects or situations so that fear can be extinguished c. gradually reinforcing fearless behaviour and punishing fear responses d. reinforcing an incompatible response to a feared situation 50. As a result of moral therapy, what was eliminated in asylums in the mid-18th century? a. physical restraints and seclusion b. individual attention from the hospital staff c. lectures on interesting subjects for hospitalized patients d. opportunities for normal social interaction 51. After graduation, two of your friends express an interest in psychology careers. Carl wants to work with relatively healthy individuals who are experiencing adjustment or vocational difficulties. Anna wishes to focus on the more severe psychological disorders and conduct research into their causes. Because you are studying abnormal psychology, they ask you for career advice. What do you tell them? a. Carl should study psychology at the graduate level, and Anna should apply to medical school. b. Carl should study clinical psychology at the graduate level, and Anna should study counselling psychology at the graduate level.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

c. Both of them should apply to medical school. d. Anna should study clinical psychology at the graduate level, and Carl should study counselling psychology at the graduate level.

52. Why is a patient’s age important information in the clinical description? a. Young children do not experience true psychological disorders. b. Older adults are reluctant to report psychological symptoms. c. Children are not reliable sources of information about symptoms. d. Disorders occurring in childhood may present differently at older ages.

53. What is one of the three ways a mental health practitioner can function as a scientist-practitioner? a. by writing textbooks b. by evaluating clinical practice c. by prescribing medications d. by teaching students 54. In psychoanalytic psychotherapy, which of the following is most important for patients? a. to strive to reach their full potential b. to remain emotionally detached from the analyst c. to find an effective medication d. to describe the content of their dreams to the analyst 55. In Freudian theory, the terms “libido” and “thanatos” represent two basic but opposing drives. What are they? a. life and death b. pleasure and pain c. sex and celibacy d. good and evil 56. What was Erikson’s greatest contribution to psychoanalytical theorizing? a. his idea that development occurs across the life span b. his idea that sexual arousal and interest occur during the latency stage c. his idea that societal factors influence our behaviour d. his idea that intrapsychic conflicts are resolved in early childhood 57. In many parts of the world during the 1970s, what would an individual suffering from an anxiety disorder most likely have been prescribed? a. bromides b. neuroleptics c. benzodiazepines d. electroconvulsive therapy 58. In ancient Greece, a woman suffering from hysteria might be told that her condition could be cured by which of the following? a. induced seizures b. bloodletting c. marriage d. rest and relaxation 59. As compared to her father, Sigmund Freud, Anna Freud (1895–1982) focused her work on the way our behaviour is influenced. Which of the following did she write? a. Id and the Mechanisms of Defense b. Our Neurosis and the Mechanisms of Defense c. Our Self-actualization and the Mechanisms of Defense d. Ego and the Mechanisms of Defense

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

60. Sarah underwent chemotherapy treatment for cancer. She now reports experiencing mild nausea when she drives by the hospital and severe nausea when she enters the hospital where her chemotherapy was administered. What phenomenon best explains these reactions to stimuli she associates with her chemotherapy? a. reconditioning b. introspection c. operant conditioning d. stimulus generalization 61. A dog had been conditioned to salivate to the sound of a bell because of its association with the presentation of food.

Later, when exposed to the bell without food for a long period, the dog eventually stopped salivating to the sound of the bell. What is this phenomenon known as? a. extinction b. response fading c. conditioned forgetting d. stimulus fading 62. In the 14th century, what did the physician who first treated France’s King Charles VI suggest as a cure? a. reducing his responsibilities b. bloodletting c. exorcism d. sexual abstinence 63. In the psychosocial approach called “moral therapy,” what does the term “moral” mean? a. emotional b. ethical c. religious d. story 64. Why was Emil Kraeplin’s lasting contribution to modern psychiatry in the area of diagnosis and classification of psychological disorders, rather than that of treatment? a. because of his discomfort with actually working with patients b. because of his conviction that better diagnosis was necessary for more effective treatment c. because of his belief that these disorders were due to brain pathology d. because of his belief in the influence of the social environment in mental illness 65. A classmate in your psychology course is worried about the selfish and sometimes dangerous drives of the id. What should you say to your classmate to address this fear? a. Because id impulses are usually part of conscious awareness, we can learn to control them. b. Id fantasies never become part of conscious awareness, so we never act on them. c. Each of us develops an ego to help us behave more realistically. d. The selfish drives of the id are transformed to positive emotional expressions.

66. Which of the following is NOT included as part of Freud’s structure of the mind? a. psyche b. superego c. ego d. id 67. According to Freud, what are all nonpsychotic psychological disorders called? a. anxiety b. neuroses c. thanatos d. intrapsychic conflict 68. According to psychoanalytic theory, what is the role of the ego? a. to counteract the aggressive and sexual drives of the id b. to maximize pleasure and reduce tension c. to mediate conflict between the id and the superego d. to increase self-esteem and a strong sense of identity Copyright Cengage Learning. Powered by Cognero.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

69. If a psychological disorder is said to have an acute onset, how did the symptoms develop? a. atypically b. suddenly c. gradually d. sporadically 70. The Electra complex is the psychosexual conflict that occurs at the phallic stage of development in girls. How is this complex characterized? a. by latency lust b. by feelings of anger and envy toward the mother c. by castration anxiety d. by a desire to replace the mother and possess the father 71. Induced vomiting was a 17th-century treatment for depression. As described in Anatomy of Melancholy (1621), this could be accomplished by eating what? a. tobacco b. ice c. raw meat d. onions 72. William lived in the 19th century and had the cognitive disorder known as “general paresis.”Based on this information, what other disease do you know William suffered from? a. epilepsy b. hysteria c. malaria d. syphilis 73. Which of the following is an example of a healthy defence mechanism? a. sublimation b. projection c. denial d. repression 74. In contrast to Freud, how did Jung and Adler view human nature? a. They believed that cognitive and personality factors shape human potential. b. They believed that humans are born with a strong drive toward self-actualization. c. They believed that the ego is much stronger than Freud postulated. d. They believed that humans are shaped through learning from their environment.

75. In classical psychoanalysis, what does the concept of “transference” refer to? a. the process whereby the patient falsely attributes his or her own unacceptable feelings or thoughts to the therapist b. the process whereby the therapist projects some of his or her own personal feelings onto the patient c. the process whereby the patient relates to the therapist as he or she would toward a parent figure d. the process whereby the patient directs potentially maladaptive impulses to socially acceptable behaviour 76. According to the ancient Greek physician Hippocrates, which factor could negatively influence psychological functioning? a. bodily fluids b. birth order c. believing in astrology d. supernatural forces 77. Alonso believes that Hedwig’s behaviour disturbance is due to an excess of black bile. Whose ideas about psychiatry does Alonso’s belief best align with? a. Blueler b. Aristotle c. Newton d. Hippocrates Copyright Cengage Learning. Powered by Cognero.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

78. Why are hysterical disorders no longer considered to be caused by a “wandering” uterus? a. because men also suffer from hysterical disorders b. because of greater knowledge of physiology c. because the theory is considered insulting to women d. because when the uterus is removed, symptoms tend to remain 79. What did Jean Charcot find when he used a variation of Mesmer’s techniques? a. These methods were effective in treating a number of psychological disorders. b. These methods were no more effective than previous methods he had used. c. Patients were better able to understand the link between their emotional problems and their psychological disorder. d. The symptoms of some patients actually worsened.

80. In Freud’s structure of the mind, which two elements are almost entirely unconscious? a. the ego and the id b. the id and the superego c. the conscience and the ego d. the superego and the ego 81. The concept of hysteria traditionally meant physical symptoms for which no organic pathology could be found. Which term is now used to refer to this concept? a. neurosis b. anxiety disorders c. delusions d. somatic symptom disorders 82. Trent is in psychoanalysis and states to his therapist that he thinks that his wife is considering having an affair with her co-worker. Later in the session, Trent admits that he is tempted to start an affair with his own co-worker. What defence mechanism was Trent displaying when he accused his wife of thinking about being unfaithful? a. sublimation b. projection c. displacement d. denial 83. John Grey was an important figure in 19th-century psychiatry in the United States. What did he believe was always the cause of mental illness? a. physical causes b. social/environmental influences c. psychological factors d. unknown influences 84. Mrs. Babcock received a very poor rating from her supervisor, who had been constantly criticizing her in front of her co-workers. When she got home, her children ran up to greet her, all talking at once. She responded by yelling, “Leave me alone! Can’t you see I’m tired?” According to psychoanalytic theory, which defence mechanism does this situation illustrate? a. projection b. displacement c. repression d. rationalization 85. What does the term psychotherapist describe? a. clinical psychologists and psychiatrists only b. people who provide therapy but who do not hold medical degrees c. people who followed in the traditions of Sigmund Freud d. anyone who can provide therapy to members of the public

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

86. George, a male college student, began feeling sad and lonely. Although he is still able to go to classes and work at his job, George finds himself feeling down much of the time and he worries about what is happening to him. Which part of the definition of abnormality applies to his situation? a. personal distress b. lack of social support c. impaired functioning d. violation of societal norms 87. Which approach brought the systematic development of a more scientific approach to psychological aspects of psychopathology? a. behavioural b. psychoanalytic c. humanistic d. Gestalt 88. How does Gestalt therapy differ from psychoanalytic therapy? a. In Gestalt therapy, there is no delving into past experiences. b. In Gestalt therapy, the critical element is the therapist’s unconditional positive regard for the patient. c. In Gestalt therapy, there is little emphasis on the here and now. d. In Gestalt therapy, there is little or no training required for therapists.

89. The discovery of certain tranquilizers made it possible to control psychotic symptoms, including hallucinations and delusions. What kind of drugs were these tranquilizers? a. neuroleptics b. bromides c. benzodiazepines d. opiates 90. According to Hippocrates’ humoral theory, which term best characterizes the choleric personality? a. hot tempered b. kind c. lacking affect d. easygoing 91. John is showing complete and almost unqualified acceptance of most of his client’s feelings and actions. What is John demonstrating? a. therapeutic alliance b. unconditional positive regard c. empathy d. conditional positive regard 92. In the late 1800s, there was an emphasis on biological causes of mental disorders, which ironically reduced interest in treatments for mental patients. Why did this happen? a. It was thought that hospital staff were not adequately trained to administer new treatments. b. It was thought that patients would improve more rapidly if they were not hospitalized. c. It was thought that mental illness due to brain pathology was incurable. d. It was thought that physicians should devote more time to the physically ill.

93. You are a psychiatrist in the 1930s who has decided to begin treating your patients diagnosed with schizophrenia with a new treatment known as “electroconvulsive therapy” instead of the traditional “insulin shock therapy.” What is the most likely reason for this decision? a. You believe that insulin therapy is too expensive. b. You believe that insulin therapy is too dangerous. c. You believe that insulin therapy is not effective. d. You believe that insulin therapy is unethical.

94. What movement did Dorothea Dix start? a. the mental hygiene movement b. the moral movement Copyright Cengage Learning. Powered by Cognero.

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c. the humane therapy movement

d. the deinstitutionalization movement

95. How does psychodynamic psychotherapy differ from classical (Freudian) psychoanalysis? a. It emphasizes the goal of personality reconstruction. b. It focuses more on social and interpersonal issues. c. It considers past experiences important. d. It requires a long-term commitment on the part of the person being analyzed.

96. What did Freud and Breuer discover about the process known as “catharsis”? a. They discovered that it reduces psychotic symptoms such as hallucinations and delusions. b. They discovered that it occurs beyond the conscious awareness of the patient. c. They discovered that it leads to insight. d. They discovered that the power of suggestion subconsciously changed behaviour.

97. According to Anna Freud’s ego psychology, when does abnormal behaviour develop? a. when the ego does not develop normally due to psychosexual conflicts at the oral stage of development b. when the ego is deficient in regulating such functions as delaying and controlling impulses c. when there are social and psychological barriers to achieving self-actualization d. when maladaptive defense mechanisms are not overridden by adaptive defense mechanisms 98. You have just read a newspaper article about a savage rape and murder. You wonder how anyone could commit such a horrible crime. Then you recall from your study of Freudian theory that anyone could be a killer or rapist if certain impulses are not well controlled. Which term best describes these impulses? a. intrapsychic forces b. a libidinous desire c. the drive of the id d. primitive forces 99. In the 14th and 15th centuries, in addition to attributing mental illness to the supernatural, some people suggested that mental illness was caused by what other factor? a. an unhealthy lifestyle b. head injuries c. stress d. genes 100. In which defence mechanism does an individual substitute behaviour, thoughts, or feelings that are the direct opposite of unacceptable ones? a. displacement b. repression c. rationalization d. reaction formation 101. What are two recent developments that have contributed to a multidimensional, integrative approach to psychopathology? a. the introduction of highly specialized drugs and more sophisticated training for mental health workers b. increasingly sophisticated medical technology and the realization that no one influence on behaviour ever occurs in isolation c. deinstitutionalization and the growth of humanistic therapies d. an increase in public mental health education and less reliance on drugs to control abnormal behaviour 102. What is the most notable contribution of Clarence Hincks? a. He argued that mental illness is treatable with a combination of drugs and individualized attention. b. He argued that mental illness was incurable but more humane institutions were needed to care for the mentally ill.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

c. He argued that mental illness was caused by brain pathology and, therefore, was incurable and that therapy should consist of learning to cope with symptoms. d. He argued that mental illness was treatable, which was contrary to the prevailing view at the time.

103. Why is Watson and Rayner’s experiment in which they induced a fear of white, furry objects in Little Albert famous? a. It was the first real-life demonstration of operant conditioning. b. It was the first recorded lawsuit made against the psychology profession for unethical behaviour. c. It was the first recorded example of inducing fear of an object in a laboratory setting. d. It proved the law of effect.

104. Compare the basic assumptions and techniques of behaviour therapy versus humanistic therapy. Mention significant figures who contributed to each approach and the key concepts associated with those individuals.

105. Discuss the criteria for abnormality and the meanings of psychological dysfunction, personal distress, and atypical or not culturally expected behaviour.

106. Discuss the evolution of biological treatments for psychological disorders across the 20th century. Explain the development and use of insulin shock therapy and electroconvulsive therapy in the first part of the century and describe the major drug therapies developed in the latter half.

107. Compare and contrast classical psychoanalysis and psychodynamic psychotherapy. Note the criticisms of classical psychoanalysis and explain why it is more of historical than of current interest.

108. Describe the educational and professional differences between psychologists and psychiatrists. In Canada, who is permitted to hold him- or herself out to the public as a “psychologist” (e.g., in advertising)?

109. Explain the basic assumptions of psychoanalytic theory. Refer to concepts such as anxiety, defence mechanisms, and psychosexual development. Use specific examples to illustrate these concepts.

110. Describe the psychosocial approach to mental disorders called moral therapy. Mention key figures who contributed to or promoted this approach. Discuss whether this approach was effective in improving conditions for the mentally ill.

Explain the reasons for the decline of moral therapy.

111. Discuss the controversy surrounding the use of medical diagnoses in the case of psychological disorders. Explain the position taken by Thomas Szasz.

112. Compare and contrast the three traditional models of abnormal behaviour: supernatural, psychological, and biological. Mention key aspects of the explanations of abnormal behaviour and treatments of the mentally ill associated with each model.

113. Identify and explain the developments in the 1990s that contributed to a multidimensional, integrative approach to psychopathology. Describe the contributions that cognitive science and neuroscience have made to our expanding knowledge about psychopathology.

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Answer Key 1. a 2. b 3. c 4. b 5. b 6. d 7. d 8. b 9. d 10. b 11. c 12. d 13. c 14. d 15. c 16. c 17. b 18. a 19. b 20. b 21. b 22. a 23. a 24. a 25. d 26. c Copyright Cengage Learning. Powered by Cognero.

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W.Docs TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière] Chapter 1 Abnormal Behaviour in Historical Context

27. c 28. b 29. b 30. c 31. c 32. d 33. d 34. d 35. c 36. a 37. a 38. a 39. a 40. d 41. a 42. d 43. b 44. d 45. a 46. d 47. b 48. c 49. b 50. a 51. d 52. d 53. b Copyright Cengage Learning. Powered by Cognero.

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54. d 55. a 56. a 57. c 58. c 59. d 60. d 61. a 62. a 63. a 64. c 65. c 66. a 67. b 68. c 69. b 70. d 71. a 72. d 73. a 74. b 75. c 76. a 77. d 78. b 79. a 80. b Copyright Cengage Learning. Powered by Cognero.

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81. d 82. b 83. a 84. b 85. d 86. a 87. a 88. a 89. a 90. a 91. b 92. c 93. b 94. a 95. b 96. c 97. b 98. c 99. c 100. d 101. b 102. d 103. c 104. Student responses will vary.

105. Student responses will vary.

106. Student responses will vary.

107. Student responses will vary.

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108. Student responses will vary.

109. Student responses will vary.

110. Student responses will vary.

111. Student responses will vary.

112. Student responses will vary.

113. Student responses will vary.

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Chapter 02 An Integrative Approach to Psychopathology Multiple Choice 1. The best description of the multidimensional integrative approach to understanding psychopathology is that it is based on a. biological dimensions. b. biological and psychological dimensions. c. biological and psychological dimensions, as well as emotional influences. d. biological and psychological dimensions, as well as emotional and developmental influences.

ANSWER: d 2. Within the multidimensional integrative approach to understanding psychopathology, learned helplessness is considered a(n) dimension. a. biological b. psychological c. emotional d. physiological ANSWER: b 3. The basis of the multidimensional integrative approach to understanding psychopathology is that each dimension (psychological, biological, emotional, etc.) a. operates independently. b. is sufficient to cause pathology. c. builds on the dimension that precedes it. d. is influenced by the other dimensions.

ANSWER: d 4. Your uncle spent most of his teen years in a hospital undergoing treatment for a severe physical illness. As an adult, he is rather shy and withdrawn, particularly around women. He has been diagnosed with social phobia, which you believe is entirely due to lack of socialization during his teen years. Your theory or model of what caused his phobia is ________. a. multidimensional b. integrative c. one-dimensional d. biological ANSWER: c 5. According to the multidimensional integrative approach to psychopathology, the following statement is true for most psychological disorders: a. If one monozygotic twin has a particular disorder, the other twin will definitely have the disorder as well. b. Monozygotic twins are no more likely to share psychological disorders than any other siblings. c. Monozygotic twins are no more likely to share disorders than any other two people selected at random from the population. d. If one monozygotic twin has a particular psychological disorder, the other twin is more likely to have the disorder than the rest of the population.

ANSWER: d

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Chapter 02 An Integrative Approach to Psychopathology 6. Amanda is 12 years old, and her sister Samantha is 5 years old. While riding in a car with their parents, the girls witness a major automobile accident where a number of people are injured. The girls react very differently to the accident. This is probably due to a. biological differences. b. developmental differences. c. psychological differences d. sociocultural differences ANSWER: b 7. The multidimensional integrative approach to pathology includes causal factors from which fields? a. Neuroscience b. Genetics c. Psychology d. All of the above are correct ANSWER: d 8. Behavioral influences in the multidimensional model include a. conditioned Responses. b. cultural Factors. c. genetics. d. violation of Social Norms.

ANSWER: a 9. Social influences in the multidimensional model include a. the fact that illness usually gets attention. b. heart rate. c. genetics. d. conditioned responses.

ANSWER: a 10. The most accurate way to think of genes is that they a. set boundaries for our development. b. determine both our physical and psychological characteristics. c. determine physical but not psychological characteristics. d. actually have very little to do with any of the characteristics that we display.

ANSWER: a 11. Referring to behavior and personality as polygenic means that both are a. influenced by only a few genes, but each has a large effect. b. influenced by many genes, with each individual gene contributing a relatively small effect. c. influenced by individual genes only rarely. d. a result of our genetic structure only.

ANSWER: b 12. The procedures referred to as quantitative genetics are used to 2020

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Chapter 02 An Integrative Approach to Psychopathology a. determine the effects of multiple genes. b. provide genetic counseling. c. correct genetic abnormalities. d. test the multidimensional integrative model.

ANSWER: a 13. Most psychological disorders appear to be influenced by many individual genes rather than caused by one single gene, a process referred to as influence. a. multigenic b. polygenic c. unigenic d. morphogenic ANSWER: b 14. Inga is a charming and intelligent young lady who is well-liked by family and friends. Approximately ______ of Inga’s enduring personality traits and cognitive abilities can be attributed to genetic influence. a. 25% b. 50% c. 75% d. 100% ANSWER: b 15. The most recent estimates are that genetics contribute approximately ________ to the development of personality characteristics such as shyness or activity level. a. 10-20% b. 30-50% c. 75-85% d. nothing ANSWER: b 16. According to recent estimates, genetic contributions to the development of most psychological disorders are __________________. a. below 50% b. above 50% c. different for each disorder (estimates range from 0 to 100%) d. nonexistent ANSWER: a 17. Recent evidence regarding the genetic influence on most psychological disorders has shown that a. single genes are usually responsible for psychological disorders. b. genes that influence psychopathology are usually recessive. c. there is no evidence that genes influence psychopathology. d. multiple genes interact, with each gene contributing a small effect.

ANSWER: d

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Chapter 02 An Integrative Approach to Psychopathology 18. In the diathesis-stress model, "diathesis" refers to a. an inherited disorder. b. conditions in the environment that can trigger a disorder depending upon how severe the stressors are. c. an inherited tendency or condition that makes a person susceptible to developing a disorder. d. the inheritance of multiple disorders.

ANSWER: c 19. In the diathesis-stress model, "stress" refers to a. life events, in combination with an inherited tendency, that trigger a disorder. b. inherited tendencies, in combination with life events, that trigger a disorder. c. defective genes. d. exposure to very unusual and extreme environmental conditions.

ANSWER: a 20. According to the diathesis-stress model, psychopathology is the result of the a. interaction between normal and defective or damaged genes. b. stress level of an individual and how stress is managed in a person's life. c. family history of an individual. d. interaction of an inherited tendency and events in a person's life.

ANSWER: d 21. According to the diathesis-stress model, monozygotic twins raised in the same household will a. not necessarily have the same disorders because of potential differences in their diathesis. b. have the same disorders because their diathesis and stress are exactly the same. c. not necessarily have the same disorders because of potential differences in their stress. d. have no more likelihood of sharing a disorder than any other two randomly selected individuals from the population.

ANSWER: c 22. According to the diathesis-stress model, a. mental disorders will always develop given a certain level of stress. b. once a diathesis for a particular disorder is inherited, the disorder will eventually develop. c. an individual's inherited tendencies are not affected by stressful life events he or she encounters. d. it is possible to inherit a diathesis and never develop a disorder.

ANSWER: d 23. The model that describes the development of psychopathology as a combination of an inherited predisposition and the events that have occurred in the individual's life is called . a. diathesis-stress b. genetic c. bio-behavioral d. psychoanalytic ANSWER: a

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Chapter 02 An Integrative Approach to Psychopathology 24. In a landmark study by Caspi et. al. (2003), researchers studied the stressful life events and genetics of 847 individuals. For individuals who had at least four stressful life events, the risk of major depression a. remained unchanged regardless of genetic makeup. b. doubled if they possessed two short alleles of the gene being studied. c. was reduced by half if they possessed two short alleles of the gene being studied. d. was entirely related to the genetic makeup and not the number of life stressors.

ANSWER: b 25. The idea that our inherited tendencies influence the probability that we will encounter stressful life events is a characteristic of the _________________. a. diathesis-stress model b. reciprocal gene-environment model c. genetic model d. psycho-social model ANSWER: b 26. John has inherited a personality trait that makes him more likely to keep to himself than to socialize. As a result, he does not have many friends and spends a lot of time alone. If John were to develop depression, the model that would probably best explain this situation and the cause of his depression is . a. diathesis-stress b. biological c. reciprocal gene-environment d. interpersonal ANSWER: c 27. Some people may be genetically predisposed to seek out difficult relationships. These difficult relationships may contribute to their experience of depression. This is an example of the . a. diathesis-stress model b. reciprocal gene-environment model c. genetic model d. quantitative genetics model ANSWER: b 28. Research studies using the procedure called "cross fostering" have shown that genetically emotional and reactive young animals raised by calm mothers tended to be a. calm. b. emotional and reactive. c. calm but emotional and reactive when raising their own young. d. emotional and reactive but calm when raising their own young.

ANSWER: a 29. Cross-fostering studies indicate that the environmental effects of early parenting a. had no effect on any genetic contribution to be reactive to stress. b. seem to override any genetic contribution to be reactive to stress. c. had no effect on future generations in the expression of personality traits or temperament. d. had random effects on any genetic contribution to be reactive to stress.

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Chapter 02 An Integrative Approach to Psychopathology ANSWER: b 30. Looking at the findings of many cross-fostering studies (Francis et al., 1999, Suomi, 1999, Tienari et al., 1994) it appears that positive interventions such as good parenting in early life may a. have little effect in terms of preventing psychopathology in those genetically predisposed to such conditions. b. dramatically change the genetics of individuals genetically predisposed to psychopathology. c. have a greater effect on future generations than on the individual exposed to the "good parenting." d. override the genetically influenced tendency to develop psychopathology in later life.

ANSWER: d 31. Some of the most recent research studies regarding genetic vs. environmental causes of disorders in animals and humans have suggested a. genetic influences are greater than originally observed because positive environmental conditions do not prevent disorders. b. genetics and the environment share equal roles in the development of all psychological disorders. c. the relative contributions of genetics and the environment in the development of psychological disorders are different for lower animals than for humans. d. genetic influences may have been oversimplified by previous studies (i.e., without sufficient environmental stress, the genetic predisposition may never be activated.)

ANSWER: d 32. Recent research suggests that a. environmental manipulations early in life may do much to override the genetically induced tendency to develop undesirable behavioral activities. b. environmental manipulations early in life may do much to override the genetically induced tendency to develop undesirable emotional activities. c. an interaction between genes and environment plays an important role in every psychological disorder. d. all of these.

ANSWER: d 33. According to the Diathesis-Stress Model: a. Alcoholism is inherited. If you inherit the gene, it is only a matter of time before you become an alcoholic. b. Alcoholism is not inherited at all; no one makes you drink against your will. c. Genetic vulnerability lowers the threshold for stress to create alcoholism. d. Everyone has the same likelihood of becoming an alcoholic.

ANSWER: c 34. The central nervous system is made up of the a. brain and spinal cord b. brain only c. spinal cord only d. nerves leading to and from the brain ANSWER: a

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35. The brain and the spinal cord comprise the a. peripheral nervous system.

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Chapter 02 An Integrative Approach to Psychopathology b. somatic nervous system. c. parasympathetic nervous system. d. central nervous system.

ANSWER: d 36. The area between the axon of one neuron and the dendrite of another neuron is the a. axon terminal b. soma c. synaptic cleft d. transmission cleft ANSWER: c

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37. Which of the following statements is TRUE? a. Glial cells are passive cells that serve to connect and insulate neurons. b. There are fewer glial cells than there are neurons. c. There are different types of glial cells with several specific functions. d. Glial cells slow down the process of neural communication.

ANSWER: c 38. The synaptic cleft is the area between the a. soma of one neuron and the dendrite of another neuron. b. axon of one neuron and the dendrite of another neuron. c. axon of one neuron and the soma of another neuron. d. somas of two neurons.

ANSWER: b 39. Neurotransmitters are important because they a. allow neurons to send signals to other neurons. b. maintain the oxygenation of the brain. c. prevent the development of psychopathology. d. allow the brain to maintain its structural integrity.

ANSWER: a 40. The chemicals that allow transmission of signals between neurons are called a. re-uptake inhibitors b. hormones c. neurotransmitters d. genes ANSWER: c 41. GABA, dopamine, and norepinephrine are all examples of a. electrical brain waves b. neurons c. neurotransmitters d. areas of the brain 2020

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Chapter 02 An Integrative Approach to Psychopathology ANSWER: c 42. Most automatic functions (e.g., breathing, sleeping, and motor coordination) are controlled by the part of the brain called the _________. a. brain stem b. forebrain c. cortex d. frontal lobes ANSWER: a 43. Recent research has associated the ______ with autism. This is also the part of the brain that controls motor coordination. a. reticular activating system (RAS) b. medulla c. pons d. cerebellum ANSWER: d 44. The part of the brain stem that regulates vital activities such as heartbeat, breathing, and digestion is the . a. cerebellum b. reticular activating system (RAS) c. hindbrain d. thalamus ANSWER: c 45. The ______ coordinates movement with sensory input and contains parts of the reticular activating system. a. hindbrain b. midbrain c. cerebral cortex d. forebrain ANSWER: b 46. Functions of the limbic system include control or regulation of a. basic body functions such as breathing. b. sleep cycles. c. emotional experiences, expressions, impulse control, and basic drives such as aggression, sex, hunger, and thirst. d. body posture, coordinated movement, and involuntary responses such as reflexes and other automatic processes.

ANSWER: c 47. About 80% of the neurons contained in the central nervous system are located in the a. cerebral cortex b. brain stem c. midbrain 2020

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Chapter 02 An Integrative Approach to Psychopathology d. basal ganglia ANSWER: a 48. The ability to plan, think, reason, and create is located in the part of the brain called the a. thalamus b. midbrain c. cerebral cortex d. brain stem ANSWER: c

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49. Although the two halves of the cortex look alike structurally, the left hemisphere seems to be chiefly responsible for a. motor coordination. b. perceiving the world around us. c. creating images. d. verbal and other cognitive processes.

ANSWER: d 50. For most people, verbal and cognitive processes are usually controlled by the a. left hemisphere of the cortex b. right hemisphere of the cortex c. entire cortex d. midbrain ANSWER: a

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51. For most people, perception and the creation of images are usually handled by the a. left hemisphere of the cortex b. entire cortex c. midbrain d. right hemisphere of the cortex ANSWER: d 52. The part(s) of the brain most associated with memory, thought, and reasoning is(are) the a. occipital lobes b. brain stem c. left parietal lobe d. frontal lobes ANSWER: d 53. The peripheral nervous system is made up of the a. endocrine system b. brain stem and cortex c. somatic and autonomic nervous system d. brain and spinal cord ANSWER: c 2020

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Chapter 02 An Integrative Approach to Psychopathology 54. The major function of the peripheral nervous system is to a. carry messages to and from the central nervous system. b. process information received from the central nervous system. c. regulate arousal. d. control hormonal activity.

ANSWER: a 55. The network of glands that releases chemical messengers directly into the bloodstream is called the a. autonomic nervous system. b. somatic nervous system. c. limbic system. d. endocrine system.

ANSWER: d 56. According to your text's discussion of how neurotransmitters such as serotonin work, the term "biochemical imbalance" for the cause of disorders such as depression is probably . a. an oversimplification b. about accurate c. completely incorrect d. a perfect description ANSWER: a 57. Drugs that increase the activity of a neurotransmitter are called a. agonists b. antagonists c. enhancers d. psychotropics ANSWER: a

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58. Drugs that decrease the activity of a neurotransmitter are called a. agonists b. blockers c. reuptake inhibitors d. antagonists ANSWER: d

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59. The neurotransmitter associated with regulation of mood, behavior, and thought processes is a. GABA b. norepinephrine c. serotonin d. dopamine ANSWER: c 60. Extremely low levels of GABA are associated with a. decreased anxiety 2020

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Chapter 02 An Integrative Approach to Psychopathology b. increased depression c. increased anxiety d. decreased depression ANSWER: c 61. Recent research and increased understanding about the role of neurotransmitters in psychopathology point out that a. each psychological disorder is caused by a deficit in a specific neurotransmitter. b. chemical imbalances of the brain are the cause of psychopathology. c. simple cause/effect conclusions stating that an individual neurotransmitter abnormality causes a disorder are incomplete. d. neurotransmitters have very little to do with psychopathology for most individuals but may be the single cause of disorders for others.

ANSWER: c 62. Extremely low activity levels of serotonin are associated with a. aggression, suicide, and impulsive behavior b. schizophrenia c. anxiety disorders and general feelings of nervousness d. mania ANSWER: a

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63. The neurotransmitter thought to regulate or moderate certain behavioral tendencies rather than directly influence specific patterns of behavior or psychological disorders is . a. norepinephrine b. GABA c. dopamine d. serotonin ANSWER: a 64. The neurotransmitter associated with both schizophrenia and Parkinson's disease is a. GABA b. norepinephrine c. dopamine d. serotonin ANSWER: c 65. Extremely low levels of dopamine activity are associated with a. muscle rigidity, tremors, and impaired judgment b. schizophrenia c. pleasure seeking d. exploratory behaviors ANSWER: a

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66. In the 1992 studies conducted by Baxter et al., OCD patients were provided with cognitive-behavioral therapy (exposure and response prevention) but no drugs. This study is important because brain imaging showed that 2020

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Chapter 02 An Integrative Approach to Psychopathology a. the neurotransmitter circuits of the brain had been normalized. b. the patients' OCD symptoms improved without changes in neurotransmitter function. c. neither OCD symptoms nor neurotransmitter function had improved. d. neurotransmitter circuits are the direct and only cause of OCD. ANSWER: a 67. What is one of the conclusions generally drawn from the 1990s studies of OCD, brain imaging, and cognitivebehavioral therapy by Baxter et al., and the follow up studies by Schwartz et al.? a. Neurotransmitters affect how people feel and act. b. Drugs are the only way to impact faulty neurotransmitter circuits. c. Neurotransmitters are a result of how people feel and act, not a cause. d. Psychosocial factors such as therapy affect neurotransmitters.

ANSWER: d 68. In a recent study (Petrovic, Kalso, Peterson & Ingvar, 2002), subjects were exposed to a painful stimulus (heat to the hand) under three conditions: opiate medication, placebo (sugar pill) medication, and no medication. Brain scans indicated that a subject's experience of reduced pain with the placebo is due to a. activation of brain regions identical to those activated by opiate medication. b. activation of brain regions that are overlapping, but not identical, to those activated by opiate medication. c. psychological expectation since a placebo does not activate brain regions associated with pain control. d. similarities in activated brain regions during the "no medication" condition.

ANSWER: b 69. Cognitive-behavior therapy facilitates changes in thinking patterns in the cortex, which in turn affects the emotional brain. This is called . a. confabulation b. consolidation c. a top-down change d. a bottom-up change ANSWER: c 70. Drugs often seem to work in a manner by reaching higher areas of the cortex where thinking occurs last. This is called _____________. a. consolidation b. confabulation c. top-down processing d. bottom-up processing ANSWER: d 71. Insel, Scanlan, Champoux, and Soumi (1988) raised one group of rhesus monkeys with the ability to control things in their environment and another group of monkeys who had no control of their environment (e.g., when they would receive treats and toys). When injected with a drug that produces a feeling of severe anxiety, the monkeys a. raised with a sense of control appeared angry and aggressive while the monkeys raised without a sense of control appeared very anxious. b. raised with a sense of control appeared anxious while the monkeys raised without a sense of control appeared angry and aggressive.

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Chapter 02 An Integrative Approach to Psychopathology c. in both groups appeared anxious. d. in both groups appeared angry and aggressive.

ANSWER: a 72. The significance of the study conducted by Insel, Scanlan, Champoux, and Soumi (1988) in which rhesus monkeys were raised either with a sense of control or without one and later exposed to an anxiety-inducing drug is that chemicals such as neurotransmitters a. have very direct effects on behavior. b. influence behavior in different ways depending upon the psychological history of the individual. c. influence individuals in fairly direct and consistent ways regardless of the psychological history of the individual. d. have few reliable and consistent effects on observed behavior.

ANSWER: b 73. The most recent research evidence suggests that the relationship between the brain (structure, function, neurotransmitters) and psychosocial factors (socialization, rearing, life events) is best described as a. a system where our brains directly influence our behavior and psychosocial factors but not the other way around. b. an interaction where the brain affects our psychosocial factors and psychosocial factors impact our brain. c. a system where our behavior and psychosocial factors impact our brain but not the other way around. d. far too complex to ever understand whether one system influences the other.

ANSWER: b 74. When comparing the brains of rats raised in a rich environment requiring lots of learning and motor behavior with the brains of rats raised as "couch potatoes" (Greenough, et al., 1990), the cerebellums of the more active rats a. contained more neuronal connections and dendrites. b. contained fewer neuronal connections but more axons and dendrites. c. were less likely to possess pathological neurotransmitter circuits. d. were exactly the same as the inactive rats.

ANSWER: a 75. Studies regarding rat learning and brain structure by Greenough, et al. (1990) and Wallace, et al. (1992) suggest that a. early experiences such as learning cause physical changes in the brain. b. psychopathology is the result of early learning experiences. c. while psychopathology is often a result of early life experiences, it is generally due to the physical changes in the brain that such experiences cause. d. genetically caused brain structure problems can be corrected by positive life experiences.

ANSWER: a 76. One conclusion that can be drawn from the studies regarding rat learning and brain structure (Greenough, et al., 1990; Wallace, et al., 1992) is that a. early psychological experience affects the development of the nervous system and will absolutely determine whether or not the individual will develop a psychological disorder later in life. b. early psychological experience does not result in physical changes to the nervous system but can still influence whether or not one develops a psychological disorder.

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Chapter 02 An Integrative Approach to Psychopathology c. early psychological experience affects the development of the nervous system and influences vulnerability to psychological disorders later in life. d. early psychological experience has little to do with brain structure or later development of psychopathology.

ANSWER: c 77. Regarding biological influences on the development of psychopathology, the most accurate statement is a. both genetics and life events play a part in the development of brain structure and function that can affect vulnerability to psychopathology. b. life events can only cause changes in brain structure or function for those with genetic defects. c. early life events play a much greater role in the development of brain structure or function than genetics. d. vulnerability to psychopathology has little to do with the brain changes associated with genetics or early life events.

ANSWER: a 78. When one examines the current state of knowledge regarding genetics and life experience effects on brain structure and function, the best overall conclusion is that most psychological disorders are a. the result of a complex interaction of genetics and faulty neurotransmitter circuits. b. the result of stressful early life experiences and the negative effects such experiences have on brain structure or function. c. the result of both biological and psychosocial factors. d. beyond our current ability to understand in any meaningful way.

ANSWER: c 79. Recent research suggests that learning and experience a. only change the brain before birth. b. change the brain through childhood. c. change the brain through young adulthood. d. change the brain at any age.

ANSWER: d 80. Bullying studies in mice suggest that the functions of the mesolimbic system a. can be switched from avoidance to reinforcement. b. can be switched from reinforcement to avoidance. c. cannot be changed by experience. d. can only be changed with drugs.

ANSWER: b 81. Marta is right-handed. She falls and hurts the left side of her head and impacts brain function. Which is most likely to happen? a. Marta may likely be more clumsy. b. Marta may have some difficulty with language and cognitive processing. c. Marta will have difficulty in math. d. All of the above are correct.

ANSWER: b 82. Endocrine glands located in your head include: 2020

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Chapter 02 An Integrative Approach to Psychopathology a. Thyroid gland. b. Pituitary Gland. c. Hypothalamus. d. B and C are correct.

ANSWER: d 83. Rescorla (1988) demonstrated that simply pairing two events closely in time a. demonstrates the simplicity of classical conditioning. b. does not allow us to make predictions. c. becomes more meaningful as the pairings continue. d. is not what’s important in this type of learning.

ANSWER: d 84. Learned helplessness is demonstrated in laboratory animals by a. creating aversive stimuli (such as electrical shocks to the foot) that the animal can control. b. creating aversive stimuli (such as electrical shocks to the foot) that the animal cannot control. c. creating pleasant stimuli (such as a food pellet) that the animal cannot control. d. creating pleasant stimuli (such as a food pellet) that the animal can control.

ANSWER: b 85. Placing a rat in a cage where electrical shocks over which the rat has no control are occasionally administered through the floor is a way to create . a. social learning b. learned helplessness c. unconscious learning d. negative neurotransmitter pathways ANSWER: b 86. It is important to understand the process of how learned helplessness is created in laboratory animals because learned helplessness in animals resembles the human disorder of . a. panic disorder b. depression c. mania d. schizophrenia ANSWER: b 87. Candace believes that no matter how hard she studies, she will never succeed in college. This behavior can best be explained by _______________. a. personality disorder b. faulty neurotransmitter circuits c. learned helplessness d. internal conflicts ANSWER: c

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Chapter 02 An Integrative Approach to Psychopathology 88. Meno is 64 years old. Although continuously faced with considerable stress and difficulty in his life, he always displays an optimistic, upbeat attitude. According to research, Meno should a. probably live longer than those without such positive attitudes. b. live about the same length of time as those without such positive attitudes. c. be less likely to have heart disease than those without such positive attitudes. d. be more likely to be involved with positive community activities than those without such positive attitudes.

ANSWER: a 89. According to Seligman, if a person who is faced with considerable stress and difficulty in his/her life displays an optimistic, upbeat attitude, he/she is likely to function better psychologically and physically. He called this ______________. a. learned optimism b. learned helplessness c. learned awareness d. learned predictability ANSWER: a 90. One important contribution of the work of Albert Bandura regarding modeling or observational learning is that a. much of our learned behavior depends upon our interactions with those around us. b. our learned behavior has much more to do with the types of consequences (reinforcements and punishments) of our actions than our interactions with those around us. c. it is impossible to learn behavioral patterns without observing those around us. d. learning acquired through observation is much more resistant to extinction than behavior acquired through classical or operant conditioning.

ANSWER: a 91. Amanda learned to fear snakes after seeing one for the first time at the zoo. However, it took many exposures to the sound of tapping dancing shoes before she learned to fear that sound. The concept that would explain the fact that we learn to fear some objects more easily than others is a. prepared learning. b. learned helplessness. c. observational learning. d. reciprocal determinism.

ANSWER: a 92. The major difference between the modern cognitive science idea of the unconscious and Freud's view of the unconscious is that Freud saw the unconscious as______ , whereas modern cognitive science views it as __________________. a. the function of the id; the result of multiple neuronal pathways interacting with the stimuli presented to the individual b. a seething caldron of emotional conflicts; neuronal pathways interacting with the stimuli presented to the individual c. the function of the superego; the ability to process, store, and act upon information without awareness d. a seething caldron of emotional conflicts; the ability to process, store, and act upon information without awareness ANSWER: d 2020

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Chapter 02 An Integrative Approach to Psychopathology 93. According to modern cognitive science, the unconscious a. clearly exists in much the same way that Freud imagined. b. may or may not exist, as it is impossible to study material that we are not aware of. c. clearly does not exist. d. clearly exists but in a very different way than Freud imagined.

ANSWER: d 94. In the Stroop color naming paradigm, a patient with a blood phobia would be expected to name the color of the printed word "wound" a. more quickly than a neutral word. b. in about the same time it takes to name the color of a neutral word. c. more slowly than a neutral word. d. with a great deal of difficulty or not at all.

ANSWER: c 95. Ben just got robbed. He tells his friends “wouldn’t you know it, bad things ALWAYS happen to me.” Ben’s friends often tease him that he is a pessimist. Ben a. has a negative attitude and will likely outlive his more positive friends. b. has a negative attitude and will likely suffer from poorer health and not live as long as his more positive friends. c. will have difficulty concentrating. d. will not be able to make more friends.

ANSWER: b 96. Learned helplessness: a. is genetic. b. occurs when an animal encounters (usually negative) conditions over which the animal has no control. c. occurs only when animals receive an electric shock. d. all of the above are correct.

ANSWER: b 97. Anna is embarrassed when her mom sings in the car in front of her friends. When her mother’s favorite song comes on the radio, Anna sinks into her seat with embarrassment. In this scenario, the _______ is the neutral stimulus, and the ______ is the unconditioned stimulus. a. embarrassment, Anna’s friends b. Anna’s friends, embarrassment c. embarrassment, music d. music, embarrassment ANSWER: d 98. You feed your dog every time you come home from school at night. One day your afternoon classes are cancelled and you come home early. Your dog barks for food, even though it is not her dinnertime yet. In this scenario, the _______ is the neutral stimulus, and the ______ is the unconditioned stimulus. a. arrival home, food b. food, arrival home c. dog, food 2020

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Chapter 02 An Integrative Approach to Psychopathology d. food, dog ANSWER: a 99. Emotion is generally thought to be a(n) elicited by a(n) a. cognition; behavior b. action tendency; threat c. affect; cognition d. physiological response; affective occurrence ANSWER: b

.

100. You and a friend are lost while walking on a street in a foreign city. A stranger approaches, and you are concerned that the stranger may try to mug you. Your friend assumes that the stranger is approaching to give you directions. As the stranger approaches, you experience fear, but your friend experiences relief. Your different emotional reactions can be explained by the______ theory of emotion. a. physiological b. neurological c. affective d. cognitive ANSWER: d 101. The relationship between emotion and health is demonstrated by the fact that a. panic is related to poor concentration. b. people with chronic diseases are often angry about their care. c. those in poor physical health almost always develop psychological disorders. d. hostility and anger increase one's risk of heart disease.

ANSWER: d 102. Studies examining the effects of anger and hostility on the cardiovascular system have demonstrated that anger results in a. decreased pumping efficiency of the heart. b. increased pumping efficiency of the heart. c. heart changes similar to those found when exercising. d. few if any measurable changes in the heart.

ANSWER: a 103. The "evil eye," Latin American susto, and the Haitian phenomenon of voodoo death are currently viewed as examples of the a. unsubstantiated myths that people can become ill without physical cause. b. power of the social environment on our physical and psychological health. c. power of the supernatural model of psychopathology. d. isolated cultural phenomena with little practical significance.

ANSWER: b 104. The fact that women are more likely to suffer from insect phobias than men is most likely due to a. biological differences. b. differences in neurochemical pathways.

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Chapter 02 An Integrative Approach to Psychopathology c. cultural expectations. d. genetic influences.

ANSWER: c 105. Anxious males tend to have a higher rate of alcoholism than females. One likely explanation for this difference is that men are a. more likely to use alcohol to deal with anxiety than to admit they are afraid. b. less likely to be fearful of becoming alcoholic. c. exposed to alcohol more often than women are. d. more likely to see alcohol as a good long-term solution to problems such as anxiety.

ANSWER: a 106. The influences of culture and gender on psychopathology are most clearly evident in the disorder of a. bulimia nervosa b. panic disorder c. bipolar disorder d. depression ANSWER: a

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107. People who have many social contacts and live their lives continually interacting with others a. develop more infections and have poorer overall health. b. have not been found to differ on any health outcome. c. often suffer from psychological disorders such as dependency. d. live longer and healthier lives.

ANSWER: d 108. Research exposing subjects to the virus that causes the common cold (Cohen et al., 1997) demonstrated that a. the lower the individual's socialization, the lower the chances of contracting a cold. b. the greater the individual's socialization, the lower the chances of contracting a cold. c. extent of socialization and chances of contracting a cold were unrelated. d. the quality of social contact predicted whether the individual would contract a cold, but the frequency of social contact did not.

ANSWER: b 109. Regarding the research on socialization and health, the safest conclusion is that a. social support is important but mostly for those individuals who are at high risk for various physical or psychological disorders. b. having a supportive group of people around us is important to our physical health but not our psychological well-being. c. having a supportive group of people around us is important to our psychological well-being but not our physical health. d. having a supportive group of people around us is one of the most important parts of maintaining our physical and mental health.

ANSWER: d

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Chapter 02 An Integrative Approach to Psychopathology 110. In a study conducted by Haber and Barchas (1983), monkeys were injected with amphetamine, a central nervous system stimulant. Comparison of the drug's effects on the dominant versus submissive monkeys demonstrated that the effects of brain chemicals such as drugs are a. different for individual animals depending upon their place in the social hierarchy. b. the same for all animals regardless of their place in the social hierarchy. c. the same for all animals except for those with a biological predisposition for aggression. d. different for individual animals but the differences appear to be random.

ANSWER: a 111. Research with the elderly has found that depression is more likely in those individuals who a. have frequent social contacts. b. live in group settings. c. have fewer social contacts. d. receive increased attention from their families when they are sick.

ANSWER: c 112. Depression and schizophrenia seem to appear in all cultures but tend to be characterized by different symptoms within individual cultures. For example, depression in Western culture is generally characterized by feelings of guilt and inadequacy, whereas in developing countries it is characterized by physical distress such as fatigue or illness. This is most likely due to a. genetic differences between individuals living in different cultures. b. differences in treatment provided in different cultures. c. reasons that our current methods of study are incapable of understanding. d. the fact that social and cultural factors influence psychopathology.

ANSWER: d 113. Given the role of social factors in psychological disorders and the fact that psychological disorders are still associated with social stigma (people tend to think that the disorder is something to be ashamed of), there is a much greater chance that people with psychological disorders will a. be far more easily treated than those with physical disorders. b. seek help for their disorders but be more likely to receive insufficient treatment than those with physical illness. c. be ignored by mental health professionals when they seek help. d. not seek and receive the treatment and support of others that are most needed for recovery.

ANSWER: d 114. When we compare the incidence of psychological disorders across countries and cultures, we find that a. there is remarkable similarity in the rates of various disorders in different countries and cultures. b. all Western countries have a similar rate of common disorders, but this is not true for developing countries. c. developing countries have a much higher rate of psychological disorder than Western countries. d. there are enormous differences in the rates of various disorders in different countries and cultures.

ANSWER: d 115. Political strife, war, and suffering in a country tend to ______ the rate of psychological disorders in the country. a. decrease b. have little effect on 2020

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Chapter 02 An Integrative Approach to Psychopathology c. have unpredictable effects on d. increase ANSWER: d 116. A lifespan psychologist would point out that the only way to understand a patient's disorder is to understand how the individual a. developed from childhood to adulthood. b. developed during the psychosexual stages. c. resolved conflicts in early life. d. sees himself/herself as part of a family, a community, and a culture.

ANSWER: a 117. According to Eric Erikson, people a. only experience major change in adulthood. b. are fully developed by age 50. c. experience eight typical developmental crises across time. d. experience no developmental changes after adolescence.

ANSWER: c 118. When therapists ask patients how they are feeling and how they are experiencing their disorder today, it is essentially taking "snapshots" of their lives at the moment. This approach to understanding psychopathology is criticized as incomplete by . a. lifespan psychologists b. cognitive-behaviorists c. humanists d. all mental health workers ANSWER: a 119. In an experiment by Kolb, Gibb, and Gorny (2003), animals of varying ages were placed in complex environments.

Their findings suggest that a. the impact of the environment on the brain is different at varying stages of life. b. the impact of the environment on the brain is significant but uniform throughout the lifespan. c. environments that are beneficial to the aged may be harmful to the young. d. the environment has little effect on the brain throughout the lifespan.

ANSWER: a 120. The fact that some behaviors can be symptoms of many different disorders (e.g., delusions can be a result of amphetamine abuse or of schizophrenia) is an example of . a. equifinality b. psychopathology c. pathogenesis d. orthogonal causation ANSWER: a 121. Children who are resistant to stress are considered to be a. resilient 2020

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Chapter 02 An Integrative Approach to Psychopathology b. reliant c. resistant d. reactive ANSWER: a 122. The term equifinality refers to the fact that a. once a process has begun, it will always lead to a final outcome. b. many causes of psychopathology are equal in influence. c. a number of paths can lead to the same outcome. d. all forms of psychopathology have similar causes.

ANSWER: c 123. The fact that depression can be caused by mental illness or drug use is an example of how a. once a process has begun, it will always lead to a final outcome. b. many causes of psychopathology are equal in influence. c. a number of paths can lead to the same outcome. d. all forms of psychopathology have similar causes.

ANSWER: c 124. The fact that a disorder can be caused by a variety of factors illustrates the principle of a. equifinality b. isolation c. equilibration d. isolation ANSWER: a

.

125. Which of the following is true about biological sex and depression? a. Boys and girls have equal rates of depression until puberty; after which depression becomes more common in girls. b. Boys and girls have equal rates of depression until puberty; after which depression becomes more common in boys. c. Boys and girls have equal rates of depression through the lifespan. d. Depression almost never occurs in children under the age of 18.

ANSWER: a 126. According to the abnormal psychology video clip, psychopathology is due to a. psychological processes b. biological processes c. both biological and psychological processes d. neither biological or psychological processes ANSWER: c 127. Our understanding of psychology as an integrated process is in part a function of a. better measurement tools b. greater biological knowledge 2020

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Chapter 02 An Integrative Approach to Psychopathology c. application of scientific study to psychological processes d. all of the above ANSWER: d 128. Children who are resistant to stress are considered to be a. resilient b. reliant c. resistant d. reactive ANSWER: a

.

Subjective Short Answer 129. Describe the diathesis-stress model. Use it to explain how one identical twin suffers from clinical depression while the other does not.

ANSWER: This model argues that a diathesis is a vulnerability and a stress is an unpleasant experience, which together can cause behavioral and emotional disorders. Identical twins typically share the same genetic vulnerability but may not have the same life experiences.

130. Psychoactive medications (drugs that impact our thoughts, emotions, and behavior) usually alter neurotransmitters in the brain. Explain how both an agonist and an antagonist operate on a neurotransmitter. Explain the process of blocking reuptake and the effect it has on a neurotransmitter.

ANSWER: Agonists increase the effects of a transmitter, while antagontists decrease their effects. Reuptake involves the process of neurons reabsorbing their own transmitters from the synapse. When reuptake is blocked, the neurotransmitter stays in the synapse longer, which tends to prolong its effects in an agonistic way.

131. What are the basic components of the multidimensional integrative model, and what does the term integrative mean in this model?

ANSWER: -Behavioral -Biological -Social -Emotional -Developmental This use of the term “integrative” refers to the model’s premise that many factors interact to cause any given disorder.

132. Name three important neurotransmitters and describe what impact each one is thought to have on human experience.

ANSWER: GABA - inhibitory neurotransmitter Glutamate-excitatory transmitter Serotonin- neurotransmitter that regulates behavior, moods, and thought processes Norepinephrine-neurotransmitter involved in endocrine regulation Dopamine-neurotransmitter implicated in psychological disorders and the control of movement 133. Explain the principle of equifinality and its use in developmental psychopathology.

ANSWER: Equifinality indicates that a number of paths to a given outcome must be considered, for example, a hallucinatory syndrome may be the result of schizophrenia or the result of taking LSD. The different paths 2020

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Chapter 02 An Integrative Approach to Psychopathology can also be the result of the interaction of psychological and biological factors during various stages of development.

134. Briefly explain the differences between the one-dimensional versus the multidimensional models of psychopathology.

ANSWER: Sample Answer: The one-dimensional model, also called the linear model, traces the origins of behavior to a single cause. This single cause can be biological (such as a genetic abnormality) or social (such as a recent divorce). In contrast, the multidimensional model posits that independent risk factors, such as a genetic vulnerability or a stressful life event, influence the context of psychopathology. Specifically, biology and behavior work in an interrelated way with cognitive, emotional, social, and cultural environments to influence the outcomes. In this way, the multidimensional model of psychopathology is systemic.

135. From memory, draw and label the brain with at least five areas. Label the function of each identified area.

ANSWER: Sample Answer: Any of the diagrams shown in Figures 2.7 and 2.8 (pages 45-47 in the text) are appropriate.

When grading, emphasize the labelling and general location of the various functions over the accuracy of the brain drawing itself.

136. What scientific evidence supports the idea that biology, environment, and development work together to impact vulnerability to psychological disorders later in life?

ANSWER: Sample Answer: Many scientific studies show the importance of a multidimensional approach to psychopathology. Even biological studies, which once relied on understandings of disease as stemming from problems in a certain area of the brain, now recognize the importance of environmental and developmental impacts on the mental health of an individual. William Greenough (page 58 of text) raised rats in stimulusrich environments and compared them with stimulus-poor environments. The rats raised in more complex learning environments had more developed brains and were better able to quickly learn new tasks than those that were not. The impacts of traumatic brain injuries are mediated by the age and experiences of those individuals. In sum, those that are the most vulnerable to psychopathology are people who have genetic vulnerabilities, poor social environments, and are at crucial developmental periods in their lives (such as adolescence).

Essay 137. Describe the diathesis-stress model. Use it to explain how one identical twin suffers from clinical depression while the other does not.

ANSWER: This model argues that a diathesis is a vulnerability and a stress is an unpleasant experience, which together can cause behavioral and emotional disorders. Identical twins typically share the same genetic vulnerability but may not have the same life experiences.

138. Psychoactive medications (drugs that impact our thoughts, emotions, and behavior) usually alter neurotransmitters in the brain. Explain how both an agonist and an antagonist operate on a neurotransmitter. Explain the process of blocking reuptake and the effect it has on a neurotransmitter.

ANSWER: Agonists increase the effects of a transmitter, while antagontists decrease their effects. Reuptake involves the process of neurons reabsorbing their own transmitters from the synapse. When reuptake is blocked, the neurotransmitter stays in the synapse longer, which tends to prolong its effects in an agonistic way.

139. What are the basic components of the multidimensional integrative model, and what does the term integrative mean in this model?

ANSWER: -Behavioral -Biological -Social -Emotional 2020

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Chapter 02 An Integrative Approach to Psychopathology -Developmental This use of the term “integrative” refers to the model’s premise that many factors interact to cause any given disorder.

140. Name three important neurotransmitters and describe what impact each one is thought to have on human experience.

ANSWER: GABA - inhibitory neurotransmitter Glutamate-excitatory transmitter Serotonin- neurotransmitter that regulates behavior, moods, and thought processes Norepinephrine-neurotransmitter involved in endocrine regulation Dopamine-neurotransmitter implicated in psychological disorders and the control of movement 141. Explain the principle of equifinality and its use in developmental psychopathology.

ANSWER: Equifinality indicates that a number of paths to a given outcome must be considered, for example, a hallucinatory syndrome may be the result of schizophrenia or the result of taking LSD. The different paths can also be the result of the interaction of psychological and biological factors during various stages of development.

142. Briefly explain the differences between the one-dimensional versus the multidimensional models of psychopathology.

ANSWER: Sample Answer: The one-dimensional model, also called the linear model, traces the origins of behavior to a single cause. This single cause can be biological (such as a genetic abnormality) or social (such as a recent divorce). In contrast, the multidimensional model posits that independent risk factors, such as a genetic vulnerability or a stressful life event, influence the context of psychopathology. Specifically, biology and behavior work in an interrelated way with cognitive, emotional, social, and cultural environments to influence the outcomes. In this way, the multidimensional model of psychopathology is systemic.

143. From memory, draw and label the brain with at least five areas. Label the function of each identified area.

ANSWER: Sample Answer: Any of the diagrams shown in Figures 2.7 and 2.8 (pages 45-47 in the text) are appropriate.

When grading, emphasize the labelling and general location of the various functions over the accuracy of the brain drawing itself.

144. What scientific evidence supports the idea that biology, environment, and development work together to impact vulnerability to psychological disorders later in life?

ANSWER: Sample Answer: Many scientific studies show the importance of a multidimensional approach to psychopathology. Even biological studies, which once relied on understandings of disease as stemming from problems in a certain area of the brain, now recognize the importance of environmental and developmental impacts on the mental health of an individual. William Greenough (page 58 of text) raised rats in stimulusrich environments and compared them with stimulus-poor environments. The rats raised in more complex learning environments had more developed brains and were better able to quickly learn new tasks than those that were not. The impacts of traumatic brain injuries are mediated by the age and experiences of those individuals. In sum, those that are the most vulnerable to psychopathology are people who have genetic vulnerabilities, poor social environments, and are at crucial developmental periods in their lives (such as adolescence).

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Chapter 03 Clinical Assessment and Diagnosis Multiple Choice 1. The systematic evaluation and measurement of psychological, biological, and social factors in a person with a possible mental disorder is known as clinical . a. assessment b. interpretation c. validation d. standardization ANSWER: a 2. The process of determining whether an individual's symptoms meet the criteria for a specific psychological disorder is called _____________. a. prognosis b. diagnosis c. classification d. analysis ANSWER: b 3. The process of clinical assessment in psychopathology has been equated to using a ______ to determine the source of the problem. a. funnel b. hose c. bucket d. plow ANSWER: a 4. In order to be useful, assessment techniques should be based on a. beliefs b. attitudes c. evidence d. assumptions ANSWER: c

.

5. In the first interview with Frank, a patient described in the textbook, he stated that he had been having intrusive thoughts that he tried to prevent by performing certain movements. Based on this information, you might predict that Frank would be diagnosed with . a. major depressive disorder b. obsessive-compulsive disorder c. a personality disorder d. schizophrenia ANSWER: b 6. A measurement which is consistent is considered to be a. valid b. reliable c. standardized Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis d. accurate ANSWER: b 7. If the short version of a test yields the same results as a longer version, then you could conclude that the brief version had validity. a. concurrent b. divergent c. predictive d. excessive ANSWER: a 8. Clifton had been experiencing a number of psychological issues, so he decided to go to a psychiatrist to see what was wrong. Dr. A told him he had major depressive disorder. He decided to seek a second opinion. Dr. B diagnosed him with generalized anxiety disorder. Wanting yet another opinion, he went to Dr. C who told him he was obsessive-compulsive.

This demonstrates poor . a. test-retest reliability b. concurrent validity c. descriptive validity d. inter-rater reliability ANSWER: d 9. The process of clinical assessment results in narrowing the focus to a. concentrate on problem areas that seem most relevant. b. consider a broad range of problems. c. cover all possible problems. d. concentrate on all problem areas equally.

ANSWER: a 10. In order to develop useful standards for a test, it is important to use a normative group that consists of a a. small group of people who are very similar to each other. b. large group of people who all share a key characteristic. c. large group of very diverse people. d. small group that differs from the population at large.

ANSWER: c 11. Which of the following is NOT one of the three basic concepts that help determine the value of a psychological assessment procedure? a. Reliability b. Subjectivity c. Validity d. Standardization ANSWER: b 12. Treminitia, who had recurrent headaches, fatigue, and loss of appetite, received different diagnoses from several psychologists. In terms of assessment, this indicates a problem with . a. reliability Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis b. subjectivity c. validity d. standardization ANSWER: a 13. Anna sees a doctor for persistent nausea. Her primary care physician tells her that she is probably dehydrated and suggests drinking more water. Her neurologist tells her that there could be swelling in her brain and that she should get a CAT scan. Anna’s allergist suggests that her sinus infection is to blame. Anna is anxious and confused as to the cause of her headaches. This is due to what aspect of her doctors’ diagnoses? a. Reliability b. Validity c. Standardization d. Inaccuracy ANSWER: a 14. In terms of psychological assessment, which of the following describes the concept of validity? a. Two or more "raters" get the same answers. b. An assessment technique is consistent across different measures. c. Scores are used as a norm for comparison purposes. d. An assessment technique measures what it is designed to measure.

ANSWER: d 15. Comparing assessment scores to those of individuals who are demographically similar to you reflects what concept of clinical assessments? a. Reliability b. Validity c. Standardization d. All of the above are correct ANSWER: c 16. Mr. J., a 40-year-old recent immigrant to the United States, comes from a working-class background and is just learning to speak English. He applies for a job and is given a test. His score is compared to others who have taken the test, mostly young college graduates whose native language is English. Mr. J. thinks this is unfair. In fact, this is an issue of __________. a. reliability b. classification c. validity d. standardization ANSWER: d 17. A clinical interview should be based on information from the client’s a. past behaviors, attitudes, and emotions b. interpersonal and social history c. present behaviors, attitudes, and emotions d. all of the above ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis 18. In trying to understand and help an individual with a psychological problem, the psychologist will obtain detailed information about the person's life as part of a . a. physical exam b. clinical interview c. mental status exam d. brain scan ANSWER: b 19. As part of a psychological assessment, a mental status exam is used to find out how a person thinks, feels, and behaves; its primary purpose, however, is to determine a. if a psychological disorder might be present. b. what type of treatment should be used. c. which medication would be most effective. d. whether the individual also has a medical condition.

ANSWER: a 20. Observing appearance and behavior during a mental status exam a. is simply done to give the appearance that the clinician is paying attention. b. rarely yields useful information. c. can yield clues regarding the presence of certain disorders. d. may just confuse the diagnostic process.

ANSWER: c 21. In a mental status exam,a psychologist evaluates an individual's thought processes by a. asking the person to read aloud. b. listening to what the person says. c. reading what the person has written. d. evaluating the person's dreams.

ANSWER: b 22. When Abernathy went to a psychologist for the first time, the clinician asked him what the date was, what time it was, what year was it, and where they were. Which category of a mental status exam do these questions cover? a. Thought processes b. Appearance and behavior c. Sensorium d. Intellectual functioning ANSWER: c 23. Determining mood and affect is an important part of the mental status exam. Although both of these terms refer to feeling states of the individual, it would be correct to say that affect is more than mood. a. immediate b. severe c. problematic d. stable Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis ANSWER: a 24. A mental status exam covers all of the following categories EXCEPT a. intellectual functioning b. appearance c. behavior d. physical symptoms ANSWER: d

.

25. In regard to a mental status exam, which of the following questions is NOT related to the concept of sensorium? a. What is today's date? b. Where are you? c. Who are you? d. How old are you?

ANSWER: d 26. In a mental status exam, it is important to determine if the individual's sensorium is clear and if he/she is "oriented times three." This refers to a. person, place, and time. b. day, month, and year of birth. c. ability to follow directions. d. spatial orientation.

ANSWER: a 27. The initial assessment of the patient in your textbook named Frank, who was anxious about his job and his marriage, revealed that he a. had intrusive thoughts. b. was disoriented. c. showed inappropriate affect. d. had a low intelligence level.

ANSWER: a 28. All of the following describe how a psychologist conducts a clinical interview EXCEPT a. attempts to facilitate communication. b. uses non-threatening ways of seeking information. c. keeps patient information confidential in all circumstances. d. applies appropriate listening skills.

ANSWER: c 29. Even though there is no evidence that this is true, Roger thinks that someone is following him. Roger is experiencing: a. delusions of persecution. b. derailment. c. psychomotor retardation. d. delusions of grandeur.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis 30. Javon, who is normally energetic and lively, is walking and talking slowly. The therapist thinks that Javon may be depressed because ______can indicate severe depression. a. psychomotor retardation b. derailment c. delusions of persecution d. delusions of grandeur ANSWER: a 31. Maria-Christina tells stories which are disconnected with each other and with reality. A disorganized speech pattern is referred to as: a. psychomotor retardation. b. derailment. c. delusions of persecution. d. delusions of grandeur.

ANSWER: b 32. In a clinical interview, the law regarding "privileged communication" does NOT apply if the patient a. threatens self-harm or harm to another person. b. relates a history of sexual abuse. c. has been mentally ill for more than five years. d. is hospitalized in a psychiatric facility.

ANSWER: a 33. The Anxiety Disorders Interview Schedule for DSM-5 (ADIS-5) is an example of a a. personality inventory. b. semistructured clinical interview. c. projective test. d. behavioral intervention.

ANSWER: b 34. Behavioral assessments are used to formally assess an individual’s thoughts, feelings, and behavior in ____________. a. general b. context c. the abstract d. theory ANSWER: b 35. Four-year-old Roberto is very aggressive toward his peers, which results in poor peer relationships. A psychologist has been asked to assess Roberto’s aggressiveness and determine if he needs intervention. The psychologist would probably do what type of assessment? a. General b. Projective c. Cognitive d. Behavioral Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis ANSWER: d 36. As part of a behavioral assessment, psychologists sometimes use________________settings when it is not possible to do direct observation in a naturalistic setting. a. imaginary b. empirical c. analogue d. virtual ANSWER: c 37. Which of the following people would make a good candidate for a behavioral assessment? a. A very verbal adult b. A young child c. A person with a cognitive deficit d. Both b and c ANSWER: d 38. The ABCs of observation refer to the a. affect-behavior-cognition b. antecedent-behavior-cognition c. antecedent-behavior-consequence d. affect-behavior-consequence ANSWER: c

sequence.

39. An operational definition refers to identifying behaviors that are: a. abnormal b. harmful c. long-standing d. measurable ANSWER: d 40. An observation that involves identifying specific behaviors that are observable and measurable is called a(n) _______________. a. informal observation b. formal observation c. unstructured observation d. self-observation ANSWER: b 41. A clinician who wished to assess the effects of treatment over a period of time would be most likely to do so by repeatedly administering a(n) . a. neuropsychological test battery b. projective test c. intelligence test d. behavior rating scale Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis ANSWER: d 42. Observing one’s own behavior to find patterns is called: a. antecedent behavior searching. b. behavioral introspection. c. psychoanalysis. d. self-monitoring.

ANSWER: d 43. The reactivity phenomenon of self-monitoring procedures has been shown to a. increase desired behaviors. b. decrease undesired behaviors. c. both increase desired behaviors and decrease undesired behaviors. d. neither increase desired behaviors nor decrease undesired behaviors.

ANSWER: c 44. Which of the following is an example of the reactivity phenomenon? a. A man joins a weight-loss center, but quits after he feels he is not getting the desired results. b. After joining a fitness club, a woman stops exercising in her home and instead walks 2 miles a day by herself. c. A man changes his brand of cigarettes after his father dies of lung cancer. d. On parents' visiting day in a classroom, the children who often misbehave in class are unusually compliant and well-behaved.

ANSWER: d 45. Most of the “psychological tests” in popular magazines are a. reliable b. valid c. for entertainment only d. informative and educational ANSWER: c

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46. Interpreting ambiguous figures on cards is usually associated with which test: . a. MMPI b. MENSA Intelligence test c. Rorschach inkblot test d. Halstead-Reitan Neuropsychological Battery ANSWER: c 47. Hannibal is presented with a series of cards that are blots of ink. He is asked to state what he sees on these cards.

Hannibal is probably taking a(n) a. personality inventory. b. response inventory. c. projective test. d. intelligence test.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis 48. The projective type of psychological test is based on a. behavioral b. cognitive c. humanistic d. psychoanalytic ANSWER: d

theory.

49. When an individual describes what he/she sees in the ambiguous stimuli of the Rorschach test, it is assumed that the person's thoughts are revealed. a. unconscious b. conscious c. preconscious d. subconscious ANSWER: a 50. A psychoanalytic therapist who wants to assess the unconscious thoughts and feelings of a patient would be most likely to use the test. a. MMPI b. Bender Visual-Motor Gestalt Test c. Rorschach inkblot test d. Halstead-Reitan Neuropsychological Battery ANSWER: c 51. The Rorschach test is considered controversial because of all of the following concerns EXCEPT that a. for some time there was no standardized way of administering the test. b. there is little or no data regarding its reliability or validity. c. the inkblots have been changed many times since the test was developed. d. until recently there were no standardized procedures for administering the test.

ANSWER: c 52. Dr. Jiminez is using Exner’s Comprehensive System to administer and score the Rorschach inkblot test. This specifies all of the following EXCEPT a. how the cards with the inkblots should be presented. b. exactly what the psychologist administering the test should say. c. the way in which the test taker's responses should be recorded. d. the amount of time allowed for each inkblot card to be presented.

ANSWER: d 53. The comprehensive system for administering and scoring the Rorschach inkblot test was developed because a. a lack of standardized procedures affects the way the test taker responds to the questions. b. it was discovered that inter-rater reliability had increased significantly. c. Hermann Rorschach was dissatisfied with the way his test was being given. d. the previous scoring system was found to be difficult and time-consuming.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis 54. The Thematic Apperception Test (TAT) differs from the Rorschach inkblot test in that the person taking the TAT is asked to use his or her imagination to a. tell a complete story about a picture. b. draw a picture based on a story that is read aloud by the examiner. c. write down responses after reading a short story. d. tell a story and draw a picture about it.

ANSWER: a 55. In regard to projective tests, research has found that most clinicians a. do not use projective tests. b. have their own ways of administering and scoring the tests. c. use standardized procedures when administering and scoring the tests. d. rely on these tests to diagnose psychopathology.

ANSWER: b 56. Which of the following is an accurate statement about the Thematic Apperception Test (TAT)? a. Most psychologists interpret responses to the TAT cards in the same way. b. High inter-rater reliability exists among those administering the test. c. The TAT is used as a diagnostic test because validity is high. d. Many clinicians use the TAT to encourage people to talk more openly about their lives.

ANSWER: d 57. Which of the following describes a personality inventory? a. Determines the possible contribution of brain damage to the person's condition b. Uses imaging to assess brain structure and/or function c. Involves self-report questionnaires that assess individual traits d. Ascertains the structure and patterns of cognition ANSWER: c 58. "The questions make sense to the person reading them and the wording of the questions seems to fit the type of information desired." In regard to personality inventories, which type of validity is defined by the preceding statement? a. Predictive b. Face c. Construct d. Analytic ANSWER: b 59. All of the following statements are TRUE about the MMPI EXCEPT that a. there is little room for interpretation. b. the test is tedious and time-consuming. c. there is a version for adolescents. d. individual responses are examined to determine a diagnostic pattern.

ANSWER: d 60. As an assessment measure, the MMPI is considered unique because it is Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis a. empirically based. b. theory based. c. based on the biological model. d. based on the humanistic approach.

ANSWER: a 61. If you were asked to compare and contrast the MMPI and the Rorschach inkblot test, you could say correctly that a. responses are interpreted individually in the MMPI. b. the pattern of responses is evaluated in the MMPI. c. the Rorschach test is more tedious and time-consuming for the patient to complete. d. the Rorschach test more accurately predicts psychopathology.

ANSWER: b 62. Since the MMPI is , the assessment concept known as reliability is increased. a. often interpreted by computer b. made up of many scales c. non-sexist d. well-researched ANSWER: a 63. The MMPI-2 differs from earlier versions of the MMPI because it a. is shorter. b. was normed on a much more diverse sample. c. is less reliable. d. is normed on a much more selective sample.

ANSWER: b 64. Heinrich falsifies answers his answers on the MMPI so that he will look good. He will probably have a high score on the __________ scale. a. Cannot Say b. Lie c. Paranoia d. Defensiveness ANSWER: b 65. The MMPI is a notable measurement instrument because it a. has been shown to be valid with a range of psychological problems. b. relies on subjective interpretations of patterns. c. is short and easy to administer. d. is the oldest test measure developed.

ANSWER: a 66. The MMPI-A, a new version of the Minnesota Multiphasic Personality Inventory, has been developed specifically for testing ____________. a. children with ADHD Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis b. children with autism c. adults d. adolescents ANSWER: d 67. The MMPI-2, a more recent version of the personality inventory, has been updated to reflect all of the following EXCEPT _____________. a. cultural diversity b. gender equality c. contemporary issues d. sexual values ANSWER: d 68. Personality tests linked through social media are typically: a. based on scientific evidence b. valid c. reliable d. just for fun ANSWER: d 69. Intelligence Quotients (IQs) were historically measured by: a. assessing a child’s reading. b. observing the child playing with peers. c. dividing the child’s mental age by their chronological age. d. measuring how much the child cried.

ANSWER: c 70. The calculation of an IQ, previously done by using a child's mental age, is now done by using a deviation IQ. This means that the child's score is compared to the scores of others . a. of the same age b. in the same grade c. who took the test at the same time d. with the same level of intelligence ANSWER: a 71. Intelligence tests were originally designed to a. determine a person’s mental status. b. predict academic success. c. identify potential psychopathology. d. indicate the presence of neurological problems.

ANSWER: b 72. IQ tests measure all of the following abilities EXCEPT a. attention. b. memory.

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Chapter 03 Clinical Assessment and Diagnosis c. reasoning. d. adaptability.

ANSWER: d 73. In regard to IQ tests, which of the following statements is FALSE? a. IQ and intelligence are the same thing. b. An IQ test has some validity with respect to predicting academic success. c. IQ tests measure abilities such as attention, memory, reasoning, and perception. d. Psychologists have different theories about which skills and abilities constitute intelligence.

ANSWER: a 74. The performance scales on the WISC-IV (Weschler Intelligence Scale for Children) measure all of the following EXCEPT ____________. a. factual knowledge b. psychomotor abilities c. ability to learn new relationships d. non-verbal reasoning ANSWER: a 75. Which of the following describes a neuropsychological test? a. Determines the possible contribution of brain impairment to the person's condition b. Uses imaging to assess brain structure and/or function c. Assesses long-standing patterns of behavior d. Ascertains the structure and patterns of cognition ANSWER: a 76. A neuropsychological test measures abilities in all but which of the following areas? a. Attention and concentration b. Perceptual abilities c. Learning and abstraction d. Adaptive personality traits ANSWER: d 77. Neuropsychological tests are used to assess whether or not an individual might a. suffer from a dissociative disorder b. have a brain dysfunction c. have had a psychotic episode d. be in a depressed state ANSWER: b

.

78. If it were important to determine the exact location of brain impairment, which of the following tests would most likely be used? a. Bender Visual-Motor Gestalt Test b. Halstead-Reitan Neuropsychological Battery c. Gall Phrenological Brain Scan Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis d. Stanford-Binet Intelligence Scale ANSWER: b 79. Although abnormalities in the structure and functioning of the brain can be detected by neuroimaging techniques, current research is also looking at a. a possible association of these abnormalities with psychological disorders. b. using brain-imaging techniques as a treatment for psychological disorders. c. preventing psychological disorders with neuroimaging techniques. d. changing brain functioning from abnormal to normal.

ANSWER: a 80. When an assessment strategy shows a problem when none exists, it is referred to as a a. false negative b. false positive c. negative outcome d. forecast error ANSWER: b

.

81. The problem with generating a false negative during an assessment strategy is that the patient a. will not receive treatment for an actual disorder. b. will receive treatment for a disorder they don’t have. c. will be tired of being tested. d. will be discredited.

ANSWER: a 82. Recent research involving PET scans has shown that patients with Alzheimer's disease have a. increased dopamine reuptake in the occipital lobes. b. increased serotonin levels in the temporal lobes. c. reduced glucose metabolism in the parietal lobes. d. reduced amino acid production in the frontal lobes.

ANSWER: c 83. A procedure used to assess brain functioning much like a PET scan, but less accurate and using a different tracer substance, is ___________. a. SQUID b. SPECT c. TCM d. JCT ANSWER: b 84. In addition to MRI, PET, and CT, other brain-imaging techniques are currently in use or are now being developed. Which of the following is one of these newer neuroimaging techniques? a. EEG b. TMS c. SPECT Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis d. EMG ANSWER: c 85. Which of the following is a reason why MRIs are used less in diagnosis: a. they are costly. b. they usually require that the participant be closed-in and still for a long period of time. c. both a and b are correct. d. neither a or b are correct.

ANSWER: c 86. A primary diagnostic technique for identifying seizure disorders is the a. EEG b. DOT c. GSR d. ERP ANSWER: a

.

87. When brief periods of EEG patterns are recorded in response to a specific event, the response is called a(n) ____________. a. evoked potential b. alpha wave c. electrodermal response d. artifact ANSWER: a 88. A healthy adult at rest is most likely to show an EEG pattern characterized by a high level of _____________. a. alpha waves b. delta waves c. critical waves d. irregular ANSWER: a 89. Sweat gland activity (electrodermal activity) is measured in order to assess a. stress and emotional arousal b. exhaustion c. brain damage d. sexual dysfunction and disorders ANSWER: a

.

90. According to the textbook, assessment of psychophysiological response to emotional stimuli is important in treating all of the following EXCEPT _____________. a. sexual dysfunctions b. posttraumatic stress disorder c. hypertension d. cancer Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis ANSWER: d 91. The likely future course of a disorder is called its a. prognosis b. diagnosis c. etiology d. inference ANSWER: a

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92. Determining what is unique about an individual’s personality, cultural background, or circumstances can be termed a(n) ________ strategy. a. idiographic b. nomothetic c. classification d. categorical ANSWER: a 93. Identifying which general class of problems to which a presenting problem belongs is known as a(n) ________ strategy. a. idiographic b. nomothetic c. classification d. categorical ANSWER: b 94. The term that describes the names or labels of the disorders is a. taxonomy b. nomenclature c. nosology d. etiology ANSWER: b

.

95. When a taxonomic system is applied to a psychological problem, it becomes a a. diagnosis b. prognosis c. nosology d. nomenclature ANSWER: c

.

96. The terms taxonomy and nosology refer to a. scientific classification. b. the accuracy of a diagnostic system. c. the reliability of a grouping of clinical symptoms. d. theoretical ideas that cannot be tested objectively.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis 97. One important advantage of using a classification and diagnostic system like DSM-5 is that knowing a patient's diagnosis a. helps the therapist to develop a treatment plan and prognosis. b. allows patients to fully participate in their own treatment. c. permits the insurance company to have access to patients' records. d. allows the therapist to see the patient as an individual.

ANSWER: a 98. The dimensional approach to classification of mental disorders differs from the categorical approach because the dimensional system provides a. lists of symptoms that are associated with all of the forms of psychopathology that are currently believed to exist. b. diagnostic labels based on the presence of specific symptoms. c. information that is used to determine the cause and treatment of the disorder. d. scales that indicate the degree to which patients are experiencing various cognitions, moods, and behaviors.

ANSWER: d 99. The classical categorical approach to diagnosis assumes that each person with a particular disorder will a. be helped by recognizing the cause of the disorder. b. experience very few of the same symptoms. c. respond to the same treatments equally. d. experience the same symptoms with little or no variation.

ANSWER: d 100. People who are correctly diagnosed with a DSM-5 disorder like Major Depressive Episode will a. usually have at least some of the same symptoms as others with the disorder. b. always have at least five of the same symptoms as others with the disorder. c. typically have very few of the same symptoms as others with the disorder. d. usually experience all of the same symptoms as others with the disorder.

ANSWER: a 101. Several clinicians interview a patient and use a new diagnostic system to independently provide the same diagnosis.

We can say that it appears the new diagnostic system is . a. reliable b. valid c. both reliable and valid d. neither reliable nor valid ANSWER: a 102. Quantifying a person’s moods, behaviors, and cognitions on a scale constitutes a(n) ______ understanding of psychopathology. a. idiographic b. nomothetic c. dimensional d. prototypical Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis ANSWER: c 103. Identifying certain essential characteristics of an entity while allowing for nonessential variations that don’t change is considered a(n) approach to understanding psychopathology. a. idiographic b. nomothetic c. dimensional d. prototypical ANSWER: d 104. A classical categorical approach to diagnosis is a. more useful in psychology than in medicine. b. more useful in medicine than in psychology. c. not appropriate in either medicine or psychology. d. equally useful in medicine and psychology.

ANSWER: b 105. The dimensional approach to diagnosis is characterized by a. quantification of patients' experiences using scales measuring several areas such as anxiety or depression. b. lists of symptoms that patients must experience for the diagnosis to be assigned. c. essential elements that all patients must report for the diagnosis to be assigned but allowance for specific nonessential variations as well. d. a theoretical explanation for the underlying cause of the disorder that is assumed to be shared by all patients experiencing similar symptoms.

ANSWER: a 106. The crucial test as to whether a diagnostic system has a high degree of validity is that it should result in a. an effective treatment plan. b. all clinicians reaching the same diagnosis for the patient. c. the accurate diagnostic label for the patient. d. the same diagnostic label regardless of when the patient is evaluated.

ANSWER: c 107. When a diagnosis tells the clinician what is likely to happen and possibly predict the course of the disorder and the likely effect of one treatment or another, the diagnosis has a. construct validity. b. predictive validity c. content validity. d. none of the above ANSWER: b 108. The extent to which a disorder would be found among the patient’s relatives is known as a. familial sharing b. familial reliability c. familial validity Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis d. familial aggregation ANSWER: d 109. The Diagnostic and Statistical Manual of Mental Disorders is a publication of the a. American Psychological Association. b. International Association of Psychologists. c. American Psychiatric Association. d. National Institutes of Mental Health.

ANSWER: c 110. An important change in the DSM versions that followed DSM-III was a. the lack of a presumed theoretical cause for each disorder. b. a change from a dimensional to a categorical system. c. greater emphasis on validity and less concern for reliability. d. the inclusion of the humanistic view of pathology.

ANSWER: a 111. One of the important changes from DSM-III-R to DSM-IV reflected our greater understanding of the multiple causes and influences on various mental states and disorders. This change is a. less distinction between organically (physically) caused and psychologically based disorders in DSM-IV. b. more distinction between organically (physically) caused and psychologically based disorders in DSM-IV. c. more distinction between neurosis and psychosis in DSM-IV. d. less emphasis on the types of treatment that might be appropriate for each disorder in DSM-IV. ANSWER: a 112. Which of the following statements best reflects your textbook's overall position on the changes found in DSM-5? a. The general consensus is that DSM-5 is largely unchanged from DSM-IV. b. DSM-5 represents a massive departure from DSM-IV. c. DSM-5 has enhanced the multiaxial diagnostic system, and therefore is better at detecting the difference between different mental disorders. d. DSM-5 has included over 100 new mental disorders, and thus has increased the likelihood of overdiagnosis.

ANSWER: a 113. Perhaps the biggest change that has been seen with the release of DSM-5 is a. the removal of the multiaxial diagnostic system. b. the inclusion of a list of FDA-approved psychotropic medications. c. the addition of treatment recommendations for the most commonly diagnosed illnesses. d. augmentation of the personality disorders category that increases the number of diganoses from 10 to 15.

ANSWER: a 114. The addition of ratings in the DSM-5 did not change the categories of disorders, but rather provides clinicians with additional information for ______ assessment, treatment planning, and treatment monitoring. a. dimensional b. nosological c. prototypical Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis d. idiographic ANSWER: a 115. One of the most unreliable categories in current classification is in the area of a. schizophrenia b. anxiety disorders c. mood disorders d. personality disorders ANSWER: d

.

116. _____ or diagnosis with more than one disorder at a time is particularly problematic in DSM-5. a. schizophrenia b. multiple personality disorder c. comorbidity d. none of the above are correct ANSWER: c 117. Adrianne has suffered from cognitive deficits for her entire life. When she was a child, she was diagnosed as suffering from "mental retardation." If she was now rediagnosed with the DSM-5 and found to have the same symptoms, which label would replace her former diagnosis? a. Intellectual disability b. Learning disorder c. Autism-spectrum disorder d. Functional neurological impariment ANSWER: a 118. Which section of DSM-5 would include disorders that need further study and would potentially be included in future editions of the manual? a. Section 1 b. Section 2 c. Section 3 d. Section 4 ANSWER: c 119. Which of the following conditions that affects women has been included in DSM-5 as a mood disorder, after previously being called "late luteal phase dysphoric disorder?" a. Premenstrual Dysphoric Disorder b. Climacteric Dissatisfaction Disorder c. Genito-Pelvic Penetration/Pain disorder d. Menopause Dyspareunic Disorder ANSWER: a Essay 120. Marisa goes to see a psychologist because she has been having some acute distress and seems overwhelmed.

Describe the process that Marisa’s psychologist will use to reach a diagnosis and develop a treatment plan.

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Chapter 03 Clinical Assessment and Diagnosis ANSWER: Marisa will be asked to describe her problem and any symptoms she is experiencing. She will relate all concerns regarding her behavior and thinking to the clinician, who will assess Marisa’s behavior and communication during the interview. The clinician will form an initial diagnosis and those areas that need to be ruled out. The clinician may do various types of psychological assessment to help determine the diagnosis. Where appropriate, certain neuropsychological testing or neuro imaging may be done, The clinician will evaluate all assessment data and reach a diagnosis that will be presented in a multiaxial format. Based on the diagnosis and possible theoretical orientation of the clinician, a treatment plan will be developed. The clinician will take into account the research data on the effectiveness of certain treatments for certain disorders.

121. What is the difference between validity and reliability? Give an example of each.

ANSWER: Validity is whether an assessment measures what it is designed to measure. Reliability is the degree to which the measurement is accurate. Quizzes found in popular magazines and on social media tend not to be valid or reliable. For example, a quiz on whether you are an optimist or a pessimist could reveal more about the bad day that you are having than your actual outlook on life (validity). You could theoretically take the same quiz on three different days and get three different scores/interpretations (reliability).

122. Discuss the principle of standardization. Why is it important in mental health assessments?

ANSWER: Standardization is important in many mental health assessments because it ensures consistency across different measures. For example, part of the diagnosis of depression is ongoing symptoms. What if Sally was sad for 2 days after her cat died and John was sad for 2 months? Are they both “depressed?” What other symptoms would need to be present for a depression diagnosis? Standardization creates ways in which we can define disorder across people, time periods, geographic areas, and therapists.

123. Describe the major objectives and typical procedures of the mental status exam. Be sure to include the typical activities of the examiner and the intended outcomes of the process.

ANSWER: Mental status exams cover the following five categories: -Appearance and behavior. The clinician records the client’s dress, appearance, and motor actions.

-Thought processes. The clinician listens to the patient talk in order to assess the rate and content of his/her speech.

-Mood and affect. The clinician observes the patient’s emotion, and actions regarding his/her feelings.

-Intellectual functioning. The clinician assesses the client’s vocabulary, memory, and overall intellectual functioning.

-Sensorium. The client’s general awareness of his/her surroundings is assessed.

The mental status exam is done to allow the clinician to make a preliminary determination of the areas of the patient’s behavior and condition that should be assessed further.

124. Projective tests such as the Thematic Apperception Test and the original Rorschach inkblot test are often criticized with regard to their reliability. Explain why the reliability of these tests may not be as good as a personality measure such as the MMPI. ANSWER: Projective tests are based on the use of ambiguous stimuli onto which the client projects his/her own personality and unconscious fears and so reveal unconscious thoughts to the therapist. The TAT, which uses pictures as stimuli, and the Rorschach, which uses inkblots as stimuli, are both subject to variation in their administration and interpretation. Consequently, they are less reliable than more objective assessments such as the MMPI, which consists of multiple-choice questions and has clear norms and guidelines for its interpretation.

125. Why would a doctor order a PET scan? How does a PET scan work?

ANSWER: PET scans are images of brain functioning and are often used when diagnosing brain trauma or early Alzheimer’s. PET scans work when a tracer substance is attached to radioactive isotopes. The substance Copyright Cengage Learning. Powered by Cognero.

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Chapter 03 Clinical Assessment and Diagnosis interacts with blood, oxygen, and glucose rushes to active areas of the brain. The location of the isotopes are then imaged, measured and compared with uninjured brains.

126. Name at least two approaches to classification. Under which does the DSM-5 fall?

ANSWER: Answers may vary but could include: —Classical (or pure) categorical approach-assuming every diagnosis has a clear patho-physiological cause —Dimensional approach-which notes the variety of cognitions, moods, or behaviors and quantifies them on a scale —Protypical approach-identifies essential characteristics of an entity into a category but allows flexibility so that all variations do not necessarily change the classification. The DSM-V falls in this category.

127. The DSM-5 is a very new diagnostic system, and it has brought changes to the diagnosis of mental disorders that have also created criticism. Discuss the major criticisms of DSM-5 that are discussed in your textbook.

ANSWER: While the DSM-5 is more scientifically advanced than it's predecessors, it is necessarily considered a "work in progress." For that reason there are several areas that have been the target of criticism in this edition: —There are still "fuzzy" categories that blur the lines between different disorders, making diagnosis difficult.

—The DSM-5 emphasizes reliability, potentially sacrificing validity.

—Methods of constructing a nosology of mental disorders have a way of perpetuating past diagnostic labels and categories, even if they were fundamentally flawed. Some have argued that instead of revising what already existed that a better approach may be to simply "start again." This resetting of diagnostic categorization did not occur with DSM-5.

128. Labeling a patient with a diagnosis is often referred to as a "double-edged sword" as the diagnostic label can both help and hurt the patient. Explain the advantages and disadvantages (to the patient) of a diagnostic label.

ANSWER: The use of labels in diagnosis allows clinicians to formulate and compare diagnoses and to select treatment approaches. However, many psychological disorders carry with them significant stigma. Therefore, the label may diminish the client’s self-esteem or result in him/her being treated poorly by others. Incorrect labels can also result in ineffective or harmful treatment choices.

129. Discuss why Mixed Anxiety Disorder is not included in the DSM-5.

ANSWER: Mixed Anxiety Disorder is not included in the DSM-5 for several reasons including: —symptoms tend to be mild and not cause major impairment.

—symptoms do not usually last long.

—Mixed Anxiety Disorder is difficult to identify in a reliable way.

—mental health diagnoses have political and legal ramifications such as the potential for an individual to sue the government or require insurance coverage.

—if Mixed Anxiety were to qualify someone for disability payments, this could create chaos within mental health clinics.

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Chapter 04 Research Methods Multiple Choice 1. Internal validity is defined as a. the extent to which the results of a study can be explained by the dependent variable. b. the degree to which the hypothesis is supported by the study. c. the overall quality of the research. d. the extent to which the results in a study can be explained by the independent variable.

ANSWER: d 2. External validity refers to the a. degree that the dependent variable was changed in the study. b. power of the independent variable to cause a change in the dependent variable. c. extent to which findings apply to individuals or situations other than those studied. d. overall quality of the study.

ANSWER: c 3. A researcher studies the impact of stress on college students' exam scores. Whether the results of this study help us to understand the relationship between job performance and stress level of real-life organizational workers is a question of a. internal validity. b. study confounds. c. external validity. d. the original research hypothesis.

ANSWER: c 4. Dr. Smith uses a sample of participants in his memory study. Any conclusions that can be drawn from the results may be applied to the general population if there is a high degree of a. internal reliability. b. external reliability. c. internal validity. d. external validity.

ANSWER: d 5. Your friend has trouble making commitments in relationships. You believe that this is because her parents had a bitter divorce when she was young. Your belief that a child who lives through a bitter parental divorce will have trouble making commitments in relationships as an adult would be considered a(n) . a. hypothesis b. independent variable c. empirical conclusion d. applied theory ANSWER: a 6. A hypothesis is defined as a(n) a. theory b. empirical conclusion c. research study Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods d. educated guess ANSWER: d 7. Of the following, which hypothesis would NOT be appropriate given the concept of testability: a. Behavior is influenced by the rewards that follow the behavior. b. Children who view aggression are more likely to act in an aggressive manner. c. Invisible forces influence our behavior every day. d. Personality traits can be influenced by genetics.

ANSWER: c 8. The dependent variable in a research study is the variable that a. is expected to influence or change the variable being studied. b. is the empirical result of the study. c. is expected to be changed or influenced in the study. d. forms the most important component of the hypothesis.

ANSWER: c 9. The independent variable in a research study is the variable that a. is expected to be changed or influenced in the study. b. is expected to influence or change the dependent variable. c. is the empirical result of the study. d. forms the most important component of the hypothesis.

ANSWER: b 10. The independent variable is the ___________ whereas the dependent variable measures ________________. a. treatment or intervention; impact of the treatment or intervention b. measurement; explanation c. impact of the treatment or intervention; treatment or intervention d. none of the above are correct ANSWER: a 11. Shonda and her company have developed a new drug to treat Parkinson’s Disease. She conducts a randomized control trial. Which is most likely the independent variable? a. Whether or not the drug impacts the symptoms of Parkinson’s disease b. The experimental drug c. The number of patients in the trial d. Whether or not the drug cures Parkinson’s patients ANSWER: b 12. A researcher is testing the effects of sunlight on depression. The dependent variable is independent variable is a. sunlight; depression b. depression; sunlight c. sunlight; mood d. depression; mood Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods ANSWER: b 13. In an experimental study, a. the independent variable is manipulated. b. the dependent variable is manipulated. c. both the independent variable and the dependent variable are manipulated. d. the environment is manipulated.

ANSWER: a 14. With regard to research design, all of the following statements are true EXCEPT that a. independent variables are hypothesized to have an impact on dependent variables. b. independent variables are generally manipulated by the researcher. c. dependent variables are hypothesized to have an impact on independent variables. d. dependent variables are generally measured by the researcher.

ANSWER: c 15. Any factor in a research study that makes the results uninterpretable is called a(n) . a. independent variable b. confound c. dependent variable d. confluence ANSWER: b 16. While studying the impact of nutrition on intelligence, a researcher has one group of rats on a vitamin-rich diet and the other group eating Big Macs. While observing the rats run a complicated maze, the researcher notes that the vitaminenhanced rats' maze is more brightly lit than the Big Mac rats' maze. The difference in lighting in this study is a(n) _________. a. confound b. independent variable c. dependent variable d. hypothesis ANSWER: a 17. Studies that have significant confounds are said to be low in a. external validity b. internal validity c. fidelity d. empirical validity ANSWER: b

.

18. Internal validity is: a. an educated guess or statement to be supported by the data b. the extent to which the results of the study can be generalized or applied outside the immediate study c. the extent to which the results of the study can be attributed to the independent variable d. none of the above are correct Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods ANSWER: c 19. External validity is: a. an educated guess or statement to be supported by the data b. the extent to which the results of the study can be generalized or applied outside the immediate study c. the extent to which the results of the study can be attributed to the independent variable d. none of the above are correct ANSWER: b 20. If a study of a medication is conducted using only 25-year-old white males, the results would be limited in their ______________. a. generalizabiity b. internal validity c. concurrent reliability d. usefulness ANSWER: a 21. A researcher separates participants into two groups. Group A receives an active medication, and Group B receives an empty capsule that looks and feels like the real medication. Group B is the group. a. treatment b. analog c. control d. experimental ANSWER: c 22. In a study to investigate the effects of alcohol on reflexes, some students were given three bottles of beer and some were given three bottles of nonalcoholic beer, and reaction time was measured. The group that received the nonalcoholic beer is the . a. treatment group b. dependent variable c. control group d. confound ANSWER: c 23. The purpose of randomization is to make sure that a. each research participant spends an equal amount of time in the treatment and control groups. b. each research participant has an equal chance of being in the treatment or control group. c. everyone in each group is exactly the same on the independent variable. d. everyone in each group is exactly the same on the dependent variable.

ANSWER: b 24. The reason that researchers cannot allow participants to decide whether to be in the control or treatment group is that this procedure may result in differences between the treatment and control group participants that a. have nothing to do with the independent variable. b. are a direct result of the independent variable.

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Chapter 04 Research Methods c. have nothing to do with the dependent variable. d. are a direct result of the dependent variable.

ANSWER: a 25. Matilda designed a study in which she had a treatment group and a control group. She then took 100 participants and flipped a coin with each one to determine which group they would be in. This assigning of participants is called _____________. a. randomization b. generalization c. experimentation d. uniformity ANSWER: a 26. Randomization is used to assign research participants to groups in order to a. prevent assembling groups that differ in a way that may influence the research outcome. b. make sure that all participants in the study are the same with respect to the dependent variable when the study is concluded. c. make sure that all participants are the same with respect to the independent variable before the study begins. d. prevent any differences in the way the independent variable is manipulated for all research subjects.

ANSWER: a 27. Analog research models a. are conducted outside of the laboratory. b. generally utilize case studies to maximize similarity to the phenomenon under study. c. are correlational. d. create laboratory conditions that are comparable to the phenomenon under study.

ANSWER: d 28. A study that uses the controlled conditions of the lab to replicate the phenomenon under study is called a(n) a. analogue model. b. longitudinal study. c. cross-sectional study. d. retrospective study.

ANSWER: a 29. Analogue models are useful when: a. there are too many potential confounds outside of the laboratory. b. there is a need to tightly control for internal validity. c. it is not reasonable/practical to study the phenomenon outside of the laboratory. d. all of the above are correct.

ANSWER: d 30. Statistical significance determines whether an observed difference between a treatment and control group is likely due to _____________.

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Chapter 04 Research Methods a. random assignment b. external validity c. chance d. confounds ANSWER: c 31. In research, the term “clinical significance” refers to a. whether the effects observed in the study are due to chance. b. the external validity of the study. c. whether the treatment was meaningful for those affected. d. randomization of the sampling procedure.

ANSWER: c 32. A researcher studying the effect of a dietary supplement on sleep finds that research participants who take the supplement sleep an average of 7 hours and 25 minutes per night, while participants who were given a placebo pill with no active ingredients in it sleep for an average of 7 hours and 20 minutes. These findings are clearly a. statistically significant. b. not clinically significant. c. not valid. d. clinically significant.

ANSWER: b 33. In research studies, the term "effect size" refers to a. how much each treated and untreated person in the study changes. b. the power of the statistical tests that are used to detect the impact of the independent variable. c. how many subjects are included in a particular study. d. the degree of external validity that the study has.

ANSWER: a 34. The patient uniformity myth refers to the tendency to a. see all study participants as homogenous. b. see all study participants as heterogenous. c. emphasize patient symptoms and uniformity. d. give all patients the same medications.

ANSWER: a 35. In well-designed research studies, medications that enhance serotonin functioning have been found to help patients recover from episodes of depression. Given the realities of the patient uniformity myth, it would be a mistake to conclude that a. most depressed patients will be helped substantially by these medications. b. all depressed patients will be helped by these medications. c. research can help us determine which treatments should be used for specific disorders. d. medication can be an appropriate treatment for a psychological disorder.

ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods 36. Joe is suffering from a severe anxiety disorder. His psychiatrist prescribes a medication that has been found in many research studies to help reduce anxiety. Joe takes the medication, but his anxiety level does not improve at all. Since the anxiety medication did not work, Joe concludes that his psychiatrist must be wrong and he must be suffering from some other disorder. The problem with Joe's conclusion is that he is failing to consider the a. patient uniformity myth. b. internal validity of the research studies. c. lack of clinical significance of many research findings. d. external validity of the prior research.

ANSWER: a 37. The type of study that generally does not follow the scientific method and typically contains many confounds is the a. case study. b. correlation model. c. true experiment. d. longitudinal study.

ANSWER: a 38. One of the major problems with the case study method is that it is too easy to make false conclusions based on a. statistical significance. b. unreliable measures. c. poorly defined dependent variables. d. coincidence.

ANSWER: d 39. One advantage of the case study method is that it can: a. measure causation. b. study a rare phenomena in-depth. c. none of the above are correct. d. all of the above are correct.

ANSWER: b 40. Which of the following is most likely to be investigated using a case study method: a. the effectiveness of a new anxiety drug on alcoholics. b. whether or not tall people have more friends than short people. c. whether or not the hippocampus is involved in the production of language. d. how a very rare physical disability impacts the mental health of 14-and-a-half year olds living in the American southeast.

ANSWER: d 41. Jessie is the first person to contract a new virus by drinking unsafe water. How are psychologists most likely to study Jessie’s health in the next year? a. Randomized control trial b. Clinical trial c. Correlational study d. Case study Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods ANSWER: d 42. If you observe that umbrellas cause rain since they always occur together, you may be confusing a. correlation with causation. b. confounds with correlations. c. independent variable with dependent variable. d. statistical and clinical effects.

ANSWER: a 43. The most accurate description of the correlational model is a. manipulation of an independent variable to measure the effects on a dependent variable. b. in-depth examination of many variables associated with a small number of individuals. c. statistical examination of the relationships between variables. d. statistical examination of the cause of changes in a dependent variable.

ANSWER: c 44. When studying family functioning, it has been observed that marital discord often increases as child behavior problems increase in the family. Using the correlational model, a. it is possible to determine that marital problems generally cause child behavior problems. b. it is not possible to determine whether marital discord causes child behavior problems, whether child behavior problems cause marital discord, or whether both may be true. c. it is possible to determine whether marital problems cause child behavior problems or whether child behavior problems cause marital problems, but it is not possible to determine whether both may be true. d. it is possible to determine whether any or all observed effects may be causing changes on any of the variables being studied.

ANSWER: b 45. As a child's age increases, so does her height. This is an example of a(n) a. negative b. zero c. causal d. positive ANSWER: d

correlation.

46. The more time one spends exercising, the less one generally weighs. The correlation between time on a treadmill each month and overall body weight would represent a(n) correlation. a. positive b. zero c. negative d. causal ANSWER: c 47. The correlation between the amount of time a college student studies and the student's height in inches is ______. a. positive b. negative Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods c. zero d. causal ANSWER: c 48. Every incremental increase in variable A is associated with an exactly equal increase in variable B. The correlation between these two variables is . a. +1.00 b. -1.00 c. 0 d. causal ANSWER: a 49. When is a correlation negative? a. When an incremental increase in one variable produces an incremental decrease in a second variable b. When the variables are not related c. When an incremental increase in one variable produces an incremental increase in the second variable d. None of the above are correct ANSWER: a 50. The Surgeon General gathered data that demonstrated the more people smoked, the more likely they were to develop lung cancer, heart disease, and other dangerous illnesses. This data demonstrates a. that there is a positive correlation between smoking and serious illnesses like lung cancer. b. that there is a negative correlation between smoking and serious illnesses like lung cancer. c. that smoking causes lung cancer and other serious illnesses. d. there is no relationship between smoking and lung cancer or other serious illnesses.

ANSWER: a 51. It has been demonstrated the amount of time watching violent shows on TV is correlated with aggressiveness in children. However, we cannot say that watching violence on TV causes children to be aggressive because a. we do not know if children watch violent TV shows because they are aggressive. b. we do not know if violent TV shows causes children to act violent. c. both variables may be related to another factor such as violent parents. d. all of the above ANSWER: d 52. Epidemiology is the study of a. the effectiveness of the correlational model in determining cause. b. research methods. c. various forms of therapy. d. incidence, distribution, and consequences of a problem in a population.

ANSWER: d 53. Epidemiologists study a. distribution b. incidence

of a particular problem in one or more populations.

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Chapter 04 Research Methods c. consequences d. all of the above ANSWER: d 54. Epidemological researchers such as DeLisi and colleagues (2003), who assessed men and women in Manhattan following the terrorist attacks of September 11, 2001, generally use the research method called the . a. correlational model b. case study c. experiment d. longitudinal study ANSWER: a 55. The basis of an experiment is a. manipulation of a dependent variable. b. examining the relationship between an independent and a dependent variable. c. manipulation of an independent variable. d. in-depth fact gathering regarding many variables.

ANSWER: c 56. A researcher manipulates an independent variable and observes the effects on a dependent variable in a(n) a. correlational study. b. analog study. c. experiment. d. epidemiological study.

ANSWER: c 57. While trying to discover the nature of the relationship between stress and blood pressure, a researcher asks participants to complete a difficult task. The researcher monitors the participants' blood pressure, while some are exposed to noisy distractions and others stay in a quiet environment. This type of research study is a(n) ______________. a. correlational study b. experiment c. analog study d. placebo control study ANSWER: b 58. When a control group is used in experimental research, the members of the control group will be treated exactly the same as the a. treatment group, except that they will be exposed to the independent variable. b. treatment group in every way. c. control group in any other psychology study. d. treatment group, except that they will not be exposed to the independent variable.

ANSWER: d 59. The purpose of a control group in experimental research is to Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods a. control for the expectation of some research subjects that they will improve just because they are in a research study. b. determine whether a treatment or independent variable actually influenced change in the independent variable. c. determine statistical significance. d. control the dependent variable.

ANSWER: b 60. Placebos are used in experiments to a. control for the variability of individuals who tend to volunteer for research studies. b. control for the expectations of some research participants that they will improve just because they are in a research study. c. help determine whether an independent variable actually causes a statistically significant change in a dependent variable. d. make certain that the treatment and control group are randomly selected.

ANSWER: b 61. In a typical drug study, some research participants are given an active medication and others are given a sugar pill.

The subjects given the sugar pill are in the group. a. placebo control b. treatment c. independent variable d. dependent variable ANSWER: a 62. In a double-blind study, a. participants are not aware of who is in the treatment and control groups, but the researcher providing the treatment does know. b. neither the researcher providing the treatment nor the participants are aware of who is in the treatment and who is in the control group. c. neither the researcher providing the treatment nor the research participants can ever be made aware of the research findings. d. participants are not aware that they are participating in a research study.

ANSWER: b 63. It can be important to use a double-blind procedure in a research study to prevent the a. independent variable from influencing the dependent variable. b. researcher's expectations from biasing the outcome. c. participants' expectations from biasing the expectations of the researcher. d. both b and c.

ANSWER: d 64. Of the following, researchers use _______ to attempt to control for the phenomenon called the "allegiance effect," which occurs when experimenter bias influences research outcomes. a. correlation studies b. double-blind control Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods c. epidemiological studies d. placebo pills ANSWER: b 65. Which of the following is an example of treatment outcome research? a. Examining the changes in serotonin levels from taking Prozac b. Determining whether the active ingredients in a medication actually have any impact on the function of the brain c. Exploring the parts of cognitive-behavioral therapy homework that are most difficult for patients to perform d. Examining the impact of Prozac on depression ANSWER: d 66. Which of the following is an example of treatment process research? a. Examining the impact of Prozac on depression b. Determining how many therapy sessions it takes for most anxiety patients to feel better c. Examining the impact of Prozac on serotonin levels d. Determining which treatment reduces patients' anxiety in the fewest number of sessions ANSWER: c 67. Single-case experimental designs utilize several strategies such as a. repeated measurement b. process measures c. random assignment d. placebo controls ANSWER: a

to improve their internal validity.

68. One important difference between a typical case study and the single-case experiment is that the single-case experiment attempts to a. increase the number of confounding variables. b. improve external validity. c. improve internal validity. d. utilize a single strategy to reduce confounds.

ANSWER: c 69. Single-case experimental designs are sometimes criticized because they tend to a. always involve a single case. b. decrease internal validity. c. have lower external validity. d. have very poor reliability estimates.

ANSWER: c 70. The single-case experimental design a. always uses a single case. b. is not concerned with external validity.

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Chapter 04 Research Methods c. is not concerned with internal validity. d. often incorporates several people at once.

ANSWER: d 71. The advantage of using a withdrawal design as part of a single-case experiment is that the researcher can a. counterbalance the research design with additional measures to improve internal and external validity. b. control for the placebo effect. c. conduct a true double-blind experiment. d. determine whether improvements gained with treatment are lost when the treatment is withheld.

ANSWER: d 72. One of the problems of using a withdrawal design as part of a single-case experiment is the a. difficulty of measuring changes that are associated with removal of a treatment. b. confounding factor of the placebo effect when the treatment is removed. c. ethical issue of removing treatment that appears to be helping the patient. d. impossibility of removing the treatment equally for the treatment and control subjects.

ANSWER: c 73. Which of the following is NOT a component of withdrawal designs? a. Establishing a baseline b. Manipulating the independent variable c. Withdrawing the dependent variable d. Returning to baseline ANSWER: c 74. A child is having temper tantrums at home, at school, and at his grandparents' house. After working with the parents for a while, the therapist believes that the child is being rewarded for his tantrums in each setting because his teacher, parents, and grandparents generally give him what he wants just to make him stop yelling. The therapist devises a plan to stop his tantrums but first implements the plan at home, then the following week at school, and finally at the grandparents' home several weeks later. From a research perspective, this is an example of a. withdrawal method. b. multiple baseline. c. placebo control. d. external validity.

ANSWER: b 75. An advantage of the multiple baseline design in evaluating treatments is that a. it enables a clinician to see predictable and orderly changes related to where and when treatment is used. b. it does not require withdrawal of treatment. c. it resembles the way treatment would naturally be implemented. d. all of the above ANSWER: d 76. An important advantage of the multiple baseline design over the withdrawal design for evaluating treatments is that multiple baseline Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods a. has greater internal validity. b. has greater external validity. c. does not require the removal of a potentially helpful treatment. d. does not require the artificial intervention of the researcher.

ANSWER: c 77. A phenotype is defined as an individual's a. hidden characteristics. b. observable characteristics. c. genetic influences. d. unique genetic makeup.

ANSWER: b 78. A genotype is defined as an individual's a. unique genetic makeup. b. recessive genes. c. hidden characteristics. d. observable features and behavior.

ANSWER: a 79. Mary looks nothing like her mother, but Mary's daughter grows up to look exactly like Mary's mother. In other words, grandmother and granddaughter look alike. The fact that Mary's daughter looks like her (Mary's) mother but she herself doesn't is a good example of the a. difference between genotype and phenotype. b. influence of environment on genes. c. fact that we really have no idea of how genes work. d. diathesis-stress model.

ANSWER: a 80. At this point, we know much more about the _____ of psychological disorders than the _____ of psychological disorders. a. genotype; phenotype b. phenotype; genotype c. behavioral causes; social influences d. social influences; behavioral causes ANSWER: b 81. At this point, the human genome project has been successful in producing a. a complete listing of each human gene and its function. b. little if any success in mapping the structure and location of human genes. c. a rough draft of the mapping of all human genes. d. some success in mapping the structure of human genes, but little success in mapping gene locations.

ANSWER: c 82. Which of the following patterns is typical for a disorder that is influenced by genetics?

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Chapter 04 Research Methods a. Siblings of the person with the disorder are more likely to have the disorder than cousins, and cousins are just as likely to have the disorder as the general public. b. Siblings of the person with the disorder will almost always have the same or similar disorders, and cousins are more likely than the general public to have disorders. c. Siblings of the person with the disorder are more likely than cousins to have the disorder, and cousins are more likely to have the disorder than the general public. d. Siblings will almost always have the same or similar disorders, though cousins may have a similar rate of the disorder as the general public.

ANSWER: c 83. While conducting a family study, a researcher determines that the siblings and parents of the person with a disorder are much more likely than the general public to have the disorder, although cousins, uncles, and grandparents are only moderately more likely to have the disorder than the general public. This is an example of a disorder with a. no genetic component. b. a single gene influence. c. a genetic component. d. strong environmental and very weak genetic components.

ANSWER: c 84. The genetic mechanism that ultimately contributes to the underlying problems causing the symptoms and difficulties experienced by people with psychological disorders is called . a. genotypes b. phenotypes c. endophenotypes d. causal types ANSWER: c 85. The study of what genes do and how they interact with the environment to create the symptoms associated with psychological disorders is called genetics. a. molecular b. behavior c. environmental d. interactive ANSWER: a 86. One of the major problems of using family studies to determine the genetic components of psychological disorders is that family members may have similar disorders due to a. shared genes. b. common diet factors. c. physical similarities. d. the fact that they live together.

ANSWER: d 87. Adoption studies can be used to study the influence of genetic influences on psychopathology a. without the typical confound of common biological parents.

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Chapter 04 Research Methods b. using more sophisticated statistical techniques. c. through direct examination of genetic causes. d. without the typical confound of siblings raised in the same environment.

ANSWER: d 88. Monozygotic twins allow for unique genetic studies because they a. have identical genes. b. always share the same environment. c. share approximately 50% of the same genes. d. are usually raised in similar ways.

ANSWER: a 89. Combining the monozygotic and adoption study methods, researchers often study monozygotic twins raised in different families. Using this method, similarities in behaviors, traits, and psychological disorders between monozygotic twins raised apart helps researchers determine a. the effects of adoption on a child's psychological functioning. b. whether it is detrimental to separate twins at birth. c. whether genes or adoption impact psychopathology. d. the effects of genes.

ANSWER: d 90. Given what we know about the effects of genes and the environment, which of the following pairs of children would be expected to be most similar in terms of overall personality, psychological disorders, and intelligence? a. Monozygotic twins, one raised in a wealthy family living in a modern city and the other raised in poverty in a developing nation b. Adopted children from different biological families raised in the same home c. Biological siblings raised in the same house d. Biological siblings, each adopted immediately after birth, one raised in Chicago and the other raised in New York City ANSWER: c 91. Family, twin, and adoption studies can identify all of the following EXCEPT a. whether a particular form of psychopathology is influenced by genes. b. whether a particular form of psychopathology is influenced by the environment. c. identification and location of a gene associated with psychopathology. d. approximate degree of influence of genetics for a specific psychological disorder.

ANSWER: c 92. In family studies, scientists simply examine a behavioral pattern or emotional trait in the context of the family. The member with the trait singled out for study is called the . a. sibling b. prototype c. genetic marker d. proband ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods 93. If a match is found between the inheritance of a disorder and a genetic marker, the genes for both are probably a. on different chromosomes. b. on different ends of the same chromosome. c c. identical. d. close together on the same chromosome.

ANSWER: d 94. The implication of the fact that genetic linkage studies frequently fail to replicate when subsequent researchers repeat the study in different families is that a. the human genome is not well mapped. b. researchers need to be more careful with their methods. c. the environment is a more powerful influence on most forms of complex psychopathology than genetics. d. it is doubtful that there are single gene causes for complex disorders.

ANSWER: d 95. A researcher studying a family with a history of obsessive-compulsive disorder (OCD) records data for each person in the family with OCD and for those who have been diagnosed with OCD in the past. The researcher is particularly interested in determining if family members who now have OCD or who were previously diagnosed share any other inherited characteristics. The researcher is conducting a(n) . a. association study b. chromosome analysis c. genetic linkage analysis d. family DNA analysis ANSWER: c 96. Genetic linkage analysis has not yet provided the types of answers scientists hope for in terms of understanding the specific genetic causes of psychopathology. The most likely reason that this type of analysis has not been as promising as hoped is that the genetic influences of psychopathology are a. impossible to understand until the entire human genome is sequenced. b. difficult to understand with the limited statistical models available. c. based on more than single gene defects. d. insignificant in comparison to the power of the environment.

ANSWER: c 97. An association study of the genetic influences of psychopathology compares people with and without a specific disorder in terms of a. shared environments. b. inherited characteristics other than the disorder. c. family history. d. inherited tendencies to behave in a specific manner.

ANSWER: b 98. A researcher collects data comparing people with and without a particular disorder. The researcher is particularly interested in inherited tendencies that are not part of the disorder but that occur with much greater frequency in afflicted people. The researcher is conducting a(n) Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods a. genetic linkage analysis. b. association study c. family study. d. DNA analysis.

ANSWER: b 99. As Van Gogh slowly began developing schizophrenia, he painted a series of self-portraits that depicted the progression of the disorder over time. This is a good example of a(n) a. negative development strategy. b. anecdotal study. c. prospective study d. retrospective study.

ANSWER: c 100. Positive development strategies involve efforts to blanket a. an entire family, including all blood relatives to prevent later problems. b. a large group of unrelated participants who are at risk for a disorder to prevent later problems. c. a large group of people to fix existing problems. d. entire populations of people to prevent later problems.

ANSWER: d 101. Longitudinal and/or cross-sectional research is often necessary to determine a. how disorders change and progress over a typical patient's lifetime. b. the genetic causes of a particular disorder. c. the environmental causes of a particular disorder. d. if a particular treatment is appropriate for patients suffering from a specific disorder.

ANSWER: a 102. The two most frequently used methods in prevention research for examining psychopathology across time are a. longitudinal and case study. b. case study and experimental. c. longitudinal and cross-sectional. d. experimental and cross-sectional.

ANSWER: c 103. Brown and Finn (1982) found that attitudes regarding alcohol were somewhat different for 12-year-olds, 15-yearolds, and 17-year-olds. All measures were taken during the same year from children of different ages. This type of research is an example of the research method called . a. longitudinal b. cross-sectional c. experimental d. case-study ANSWER: b

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Chapter 04 Research Methods 104. A researcher is studying how depression tends to be experienced by people of different ages. The researcher interviews depressed adolescents, young adults, individuals in their 30s and 50s, and those over 70 years old. The research design being used is called . a. cross-sectional b. longitudinal c. experimental d. case-study ANSWER: a 105. A researcher is studying how anxiety tends to be experienced by people of different ages. The researcher interviews depressed adolescents, young adults, individuals in their 30s and 50s, and those over 70. The individuals in each age group represent a . a. treatment group b. control group c. longitudinal group d. cohort ANSWER: d 106. The confounding of age and experience is referred to as the a. cohort b. proband c. longitudinal d. participant ANSWER: a 107. In a sequential study and a. cross-sectional; longitudinal b. case study; experimental c. cross cultural; individual d. internal; external ANSWER: a

effect.

designs are combined.

108. One significant limitation of the cross-sectional design is called the "cohort effect." This relates to the fact that a. experience is confounded with participation in the study. b. age is confounded with experience. c. genetics and experience are confounded. d. reliable statistics cannot be computed for cohort groups.

ANSWER: b 109. Age and experience are confounded while using the cross-sectional design. This means that it cannot be determined if a. findings for cohort groups are due to their similar experiences or similar age. b. findings are due to the fact that age and life experience tend to be correlated. c. differences across groups are due to differences in assignment to the treatment conditions. d. differences across groups are due to age, experience, or the experimental manipulation.

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Chapter 04 Research Methods ANSWER: a 110. Use of a cross-sectional design would be appropriate in trying to find an answer to all of the following questions EXCEPT: a. How does panic disorder differ in children and adults? b. Are the cognitive triggers for panic disorder different in children and adults? c. What early behaviors did adult panic disorder patients tend to display when they were young? d. Does exposure therapy tend to be more or less effective when it is used in the treatment of children versus adults?

ANSWER: c 111. The research design most helpful in determining how individuals with particular disorders change over time is the __________. a. longitudinal method b. cross-sectional design c. family study d. association study ANSWER: a 112. One reason that cross-sectional studies are more common than longitudinal studies is the fact that a. cross-sectional studies involve large numbers of subjects. b. longitudinal studies involve very sophisticated statistical procedures. c. cross-sectional studies take many years to complete. d. longitudinal studies take many years to complete.

ANSWER: d 113. Which research method often suffers from losing research participants due to high dropout rates or even death? a. Cross-sectional study b. Longitudinal study c. Family study d. Twin study ANSWER: b 114. In cross-cultural research, the independent or treatment variable is generally the a. culture b. disorder c. method used to treat the disorder d. success of the treatment ANSWER: a

.

115. One of the most important reasons to conduct cross-cultural research in psychopathology is that a. we can gain a better appreciation for the virtues of various cultures by examining how psychopathology is viewed by different cultures. b. the stigma of psychopathology can be removed by understanding that psychopathology exists in all cultures. c. genetic influences of disorders can be best determined through careful comparison of the different Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods environmental stressors found in various cultures. d. we can understand more about psychopathology by understanding how culture impacts the experience of various disorders.

ANSWER: d 116. One of the problems in trying to understand how psychopathology may be "caused" by cultural influences is that similarities in the way individuals of a culture experience psychopathology a. are confounded by the cross-cultural methods used to study psychopathology. b. may be due to the culture or to common genetic factors. c. cannot be understood by those outside of the culture. d. generally do not exist.

ANSWER: b 117. Which of the following are potential problems when conducting cross-cultural research in the area of psychopathology? a. Different cultures may describe or experience similar psychological sensations in very different ways b. The level of "abnormality" that is considered acceptable may differ greatly across cultures c. Treatment models developed in one culture may be unacceptable according to another culture's customs and values d. All of these ANSWER: d 118. The most influential research generally utilizes a. multiple well-controlled, double-blind experiments. b. a combination of well-controlled correlational studies and cross-sectional research. c. a program of multiple research designs over a period of time. d. multiple cross-sectional and longitudinal designs over a period of time.

ANSWER: c 119. A new research study is published and becomes the "hot story" in the news. This story concerns you because the researchers report that they are the first scientists to find a higher incidence of depression in individuals who are taking a particular vitamin—the same vitamin that your physician has had you taking for years. While this may be cause for you to investigate further, you probably shouldn't panic because a. your physician will call you if there is anything to worry about. b. research like this is rarely accurate. c. without replication, the finding could just be due to coincidence. d. unless it was a double-blind experiment, the results are probably in error.

ANSWER: c 120. The function of replication in research is to a. better define independent and dependent variables. b. improve the research design. c. rule out coincidence. d. enhance the external validity of the study.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods 121. The basic components of informed consent are a. competence, volunteerism, full information, and comprehension. b. volunteerism and comprehension. c. competence, volunteerism, comprehension, and knowledge of results. d. anonymity, volunteerism, full information, and comprehension.

ANSWER: a 122. Your psychology professor is conducting research and desperately needs more participants because the existing subjects keep running from the building screaming! She tells the class that everyone must be a subject to get a grade in the class and that there are no exceptions. In terms of ethical treatment of research subjects, her policy would a. violate the informed consent concept of competence. b. be acceptable as long as her procedures were presented to the institutional review board. c. be acceptable if she carefully explained the experiment to each participant and allowed participants to quit if they were uncomfortable during the procedure. d. violate the informed consent concept of volunteerism.

ANSWER: d 123. When conducting research with adults who suffer from schizophrenia, a. informed consent is not necessary. b. informed consent must be given by a mentally competent family member or guardian. c. it is difficult to meet the requirements of informed consent. d. it is necessary to have the research procedures approved by the American Psychological Association.

ANSWER: c 124. Which of the following is NOT part considered part of proper ethical research? a. Conducting research with many participants so that none are identified individually b. Obtaining informed consent c. Not coercing the participant to participate d. Giving the participant full information from which to make a decision to participate in the research ANSWER: a 125. Which of the following is TRUE with regard to deception of research participants? a. It is not allowed under any circumstances. b. The researcher must tell the participants about the deception after the study. c. The researcher must obtain approval of the procedure from a special national review board. d. The researcher need only tell the participants about the deception if not telling them would place the participants in any harm.

ANSWER: b 126. Institutional review boards are typically made up of a. animal rights group members and lawyers. b. research participants and their families. c. faculty and community members. d. administrators and students.

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Chapter 04 Research Methods ANSWER: c 127. According to the APA’s IRB guidelines, participants in experiments must be fully informed a. that they may or may not receive an active treatment. b. that they will not receive active treatment until the research study is over. c. if they are in the placebo group or the treatment group. d. only that they are participants in a research study and that they can quit at any time.

ANSWER: a 128. Experiments designed to test new clinical treatments are called clinical a. trials b. exams c. functions d. expectations ANSWER: a

.

Subjective Short Answer 129. Provide definitions for the terms hypothesis, independent variable, dependent variable, and confound. Discuss how you could use a control group and randomization to ensure that the results of an experiment are accurate.

ANSWER: Hypothesis—a statement summarizing your expected findings Independent variables—the things you manipulate in a study Dependent variables—the things you measure in a study Confound—a factor in a study that renders the results impossible to interpret In order to make sure your study results are accurate, it is a good idea to randomly assign people to the control group and the experimental group so you know there is no systematic bias in the groups that would confound your results.

130. Write a testable and untestable hypothesis. Explain each.

ANSWER: Answers will vary but an example of a testable hypothesis is “People taller than 5 feet and 11 inches have more followers on Twitter than those shorter than 5 feet 11 inches.” It is testable because “tall” and “short: are well defined. In addition, the number of followers on Twitter is something that can be measured.

In contrast, an untestable hypothesis could be “taller people have more friends.” This is not testable as it is because “tall” and “friends” are undefined.

131. Write a hypothesis and identify the independent and dependent variables that could be measured.

ANSWER: Answers will vary. Correct answers will include a testable hypothesis. The independent variable will be the variable manipulated by the researcher. The dependent variable will be the change in outcome. For example: Hypothesis: “Taking a placebo in the morning increases how many times a participant smiles per day” Independent Variable: Placebo Dependent Variable: Smiles per day 132. Explain why you cannot imply a cause and effect relationship from data of a correlational study.

ANSWER: Correlational designs are designed to study the relationships between two variables. When a high correlation exists, one cannot conclude Factor A caused Factor B. One reason is directionality: Did A cause Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods B, or did B cause A? For example, does violence on TV cause children to be aggressive, or because children are aggressive they watch violent TV? A second reason is the third variable. Factors A and B may actually be related to a third variable that is affecting the noted outcome. For example, college students who achieve well in the classroom sit in the front of the room. Students may sit in the front because they are highly motivated and want a seat where they are free from distraction and can see and hear clearly.

133. Explain why it is important to make a distinction between statistical and clinical significance when interpreting research findings.

ANSWER: Statistical significance refers to the statistical or mathematical probability of something occurring, while clinical significance refers to the actual real-world significance of the finding. It is important to make sure that a finding matters in real-life terms.

134. Describe the Patient Uniformity Myth and explain why it is important to recognize in clinical research.

ANSWER: The Patient Uniformity Myth is when researchers mistakenly see all participants as one homogenous group.

It is problematic when it leads researchers to make inaccurate generalizations about disorders and their treatments.

135. Describe the procedures of the cross-sectional and longitudinal research methods. What are the uses and limitations of each of these methods?

ANSWER: In cross-sectional designs, researchers take a cross-section of a population across different age groups and compare them on some characteristics. Longitudinal studies involve following the same group of people over time to assess change on the measures of interest. Longitudinal studies allow researchers to assess individual change without cohort effects, however longitudinal studies take a long time, can require enormous resources (including money), and may suffer from the loss of participants over time.

136. Why is studying behavior across cultures important?

ANSWER: Culture can contextualize what is considered “normal” and “abnormal” in a given setting. For example, nudity is more acceptable in Western Europe than in many parts of the Middle East. Therefore, someone who regularly goes to a nude beach will be interpreted differently given the context. Although the characteristics of different cultures can complicate research designs, it is important to consider the impacts of beliefs, values, and even varying genetic information in your research.

137. Why is replication important in research? Explain and give anexample.

ANSWER: Replication is an immunization against cynicism. Replicating findings is what makes researchers confident that what they are observing is not a coincidence. In short, replication builds confidence in the results of the research study. Imagine if you took a random sample of Americans and asked how much tofu they ate.

Suppose the results yielded a whopping 20 lbs per year! However, you may have over-sampled healthy Americans or Americans in a particular region of the country. Replicating the findings gives more confidence that what you found is true.

138. Describe each of the four components of informed consent for research participants. Explain why it may be

difficult to satisfy informed consent when research participants are mentally retarded adults.

ANSWER:

Competence—the participant is capable of consenting to participate in the research Voluntarism—the person must volunteer, not be coerced, into participating in the study Full information—participant must have all relevant information needed to make decisions about whether or not to participate in the study Comprehension—the participant must understand the study procedures

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Chapter 04 Research Methods It can be difficult to meet these criteria if the individual is unable to fully understand and make a voluntary decision about whether or not to participate.

Essay 139. Provide definitions for the terms hypothesis, independent variable, dependent variable, and confound. Discuss how you could use a control group and randomization to ensure that the results of an experiment are accurate.

ANSWER: Hypothesis—a statement summarizing your expected findings Independent variables—the things you manipulate in a study Dependent variables—the things you measure in a study Confound—a factor in a study that renders the results impossible to interpret In order to make sure your study results are accurate, it is a good idea to randomly assign people to the control group and the experimental group so you know there is no systematic bias in the groups that would confound your results.

140. Write a testable and untestable hypothesis. Explain each.

ANSWER: Answers will vary but an example of a testable hypothesis is “People taller than 5 feet and 11 inches have more followers on Twitter than those shorter than 5 feet 11 inches.” It is testable because “tall” and “short: are well defined. In addition, the number of followers on Twitter is something that can be measured.

In contrast, an untestable hypothesis could be “taller people have more friends.” This is not testable as it is because “tall” and “friends” are undefined.

141. Write a hypothesis and identify the independent and dependent variables that could be measured.

ANSWER: Answers will vary. Correct answers will include a testable hypothesis. The independent variable will be the variable manipulated by the researcher. The dependent variable will be the change in outcome. For example: Hypothesis: “Taking a placebo in the morning increases how many times a participant smiles per day” Independent Variable: Placebo Dependent Variable: Smiles per day

142. Explain why you cannot imply a cause and effect relationship from data of a correlational study.

ANSWER: Correlational designs are designed to study the relationships between two variables. When a high correlation exists, one cannot conclude Factor A caused Factor B. One reason is directionality: Did A cause B, or did B cause A? For example, does violence on TV cause children to be aggressive, or because children are aggressive they watch violent TV? A second reason is the third variable. Factors A and B may actually be related to a third variable that is affecting the noted outcome. For example, college students who achieve well in the classroom sit in the front of the room. Students may sit in the front because they are highly motivated and want a seat where they are free from distraction and can see and hear clearly.

143. Explain why it is important to make a distinction between statistical and clinical significance when interpreting research findings.

ANSWER: Statistical significance refers to the statistical or mathematical probability of something occurring, while clinical significance refers to the actual real-world significance of the finding. It is important to make sure that a finding matters in real-life terms.

144. Describe the Patient Uniformity Myth and explain why it is important to recognize in clinical research.

ANSWER: The Patient Uniformity Myth is when researchers mistakenly see all participants as one homogenous group.

It is problematic when it leads researchers to make inaccurate generalizations about disorders and their treatments.

Copyright Cengage Learning. Powered by Cognero.

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Chapter 04 Research Methods 145. Describe the procedures of the cross-sectional and longitudinal research methods. What are the uses and limitations of each of these methods?

ANSWER: In cross-sectional designs, researchers take a cross-section of a population across different age groups and compare them on some characteristics. Longitudinal studies involve following the same group of people over time to assess change on the measures of interest. Longitudinal studies allow researchers to assess individual change without cohort effects, however longitudinal studies take a long time, can require enormous resources (including money), and may suffer from the loss of participants over time.

146. Why is studying behavior across cultures important?

ANSWER: Culture can contextualize what is considered “normal” and “abnormal” in a given setting. For example, nudity is more acceptable in Western Europe than in many parts of the Middle East. Therefore, someone who regularly goes to a nude beach will be interpreted differently given the context. Although the characteristics of different cultures can complicate research designs, it is important to consider the impacts of beliefs, values, and even varying genetic information in your research.

147. Why is replication important in research? Explain and give anexample.

ANSWER: Replication is an immunization against cynicism. Replicating findings is what makes researchers confident that what they are observing is not a coincidence. In short, replication builds confidence in the results of the research study. Imagine if you took a random sample of Americans and asked how much tofu they ate.

Suppose the results yielded a whopping 20 lbs per year! However, you may have over-sampled healthy Americans or Americans in a particular region of the country. Replicating the findings gives more confidence that what you found is true.

148. Describe each of the four components of informed consent for research participants. Explain why it may be

difficult to satisfy informed consent when research participants are mentally retarded adults.

ANSWER:

Competence—the participant is capable of consenting to participate in the research Voluntarism—the person must volunteer, not be coerced, into participating in the study Full information—participant must have all relevant information needed to make decisions about whether or not to participate in the study Comprehension—the participant must understand the study procedures It can be difficult to meet these criteria if the individual is unable to fully understand and make a voluntary decision about whether or not to participate.

Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety Multiple Choice 1. Which of the following characterizes the mood-state known as anxiety? a. Positive mood state b. Reduced heart rate c. Apprehension about the future d. Muscle relaxation ANSWER: c 2. Which of the following is not a physiological symptom of anxiety? a. Positive mood state b. Physical Tension c. Apprehension about the future d. Elevated Heart Rate ANSWER: a 3. Anxiety is closely related to which of the following psychological disorders? a. Schizophrenia b. Depression c. Dementia d. Psychosis ANSWER: b 4. People tend to have their best performance on tasks when they are a. very anxious b. not anxious at all c. a little anxious d. fearful ANSWER: c

.

5. When people experience severe anxiety, they a. often know it is irrational, but can’t help it. b. usually are able to just "turn off" those feelings. c. often experience a break with reality. d. don't recognize that the feelings are, in fact, anxiety.

ANSWER: a 6. Anxiety is thought to be a a. future-oriented; immediate b. short-term; long-term c. real; irrational d. immediate; future-oriented ANSWER: a

state, while fear is more

.

7. Fear activates a Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety a. surge of energy in the autonomic nervous system so we can flee. b. psychological but not physiological response. c. physiological but not psychological response. d. decrease in inhibitory mechanisms in the somatic nervous system so we can flee.

ANSWER: a 8. Generalized psychological vulnerabilities lead to: a. tendency toward lack of self-confidence. b. low self-esteem. c. inability to cope. d. all of the above.

ANSWER: d 9. Specific psychological vulnerabilities are: a. irritating. b. equivalent to low self-esteem. c. show the inability to cope. d. physical sensations.

ANSWER: d 10. Which of the following is an accurate statement about anxiety? a. An inherited tendency can make us tense or uptight. b. A single gene makes us vulnerable to anxiety. c. Panic disorder does not "run in families." d. Stress is a direct cause of panic disorder.

ANSWER: a 11. According to Jeffrey Gray, a British neuropsychologist, the behavioral inhibition system (BIS) is activated by danger signals , resulting in the experience of anxiety. a. ascending from the brain stem b. descending from the cortex c. arising from the brain stem or descending from the cortex d. within the amygdala only ANSWER: c 12. Members of the Falcons High School senior class will have an increased risk of developing anxiety disorders if they a. smoke marijuana more than once per week. b. smoke 20 or more cigarettes daily. c. drink alcohol every day. d. use anabolic steroids for 6 months or more.

ANSWER: b 13. According to Gray and McNaughton (1996), the fight-or-flight system is partially activated by deficiencies in the neurotransmitter in the brain. a. serotonin Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety b. dopamine c. acetylcholine d. norepinephrine ANSWER: a 14. Research suggests that we inherit a tendency to be tense, which is a. caused by a single gene b. caused by multiple genes c. related to depression d. related to schizophrenia ANSWER: b

.

15. The area of the brain most often associated with anxiety is the a. limbic system b. reticular activating system c. occipital lobe d. corpus callosum ANSWER: a

.

16. "I've got to get out of here right now, or I may not make it!" This statement is most likely to be said by someone experiencing a(n) a. episode of depression. b. future-oriented mood state. c. fear reaction. d. parasympathetic "surge."

ANSWER: c 17. _______ is characterized by apprehension because of future unpredictability, whereas ____________ characterized by strong escapist tendencies. a. Anxiety; fear b. Fear; anxiety c. Psychoses; neuroses d. neuroses; psychoses ANSWER: a

is

18. Which of the following is NOT a basic type of panic attack? a. Expected b. Unexpected c. Cued d. Situation inevitable ANSWER: d 19. Mrs. Pan has an anxiety disorder in which she has occasional panic attacks when shopping at the mall. This type of panic attack is referred to as _______________. a. uncued Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety b. diathesis-originated c. cued d. situationally premeditated ANSWER: c 20. Which type of panic attack is most closely related to phobias? a. Situationally predisposed b. Expected c. Unexpected d. Uncued ANSWER: b 21. Lawanda was walking down the street on a bright sunny day when, all of a sudden, she had an abrupt attack of intense fear that totally surprised her. This is what type of panic attack? a. Situationally predisposed b. Situationally bound c. Cued d. Uncued ANSWER: d 22. Hideki was attending his fifth baseball game at Condor Stadium, where he had previously had a panic attack. He did not know if he would have a panic attack today, but shortly after entering the stadium, he did. This type of panic attack is ____________. a. environmentally predisposed b. situationally bound c. cued d. uncued ANSWER: c 23. According to the DSM-IV-TR criteria, the symptoms of a panic attack develop abruptly and reach a peak within minute(s). a. 1 b. 10 c. 30 d. 60 ANSWER: b 24. Physiological assessments of panic attacks recorded in the laboratory indicate an increase in all of the following EXCEPT ______________. a. heartbeat b. finger temperature c. muscle tension d. stomach contractions ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety 25. The recent research by Johnson et al. (2000) on cigarette smoking by teenagers indicates the possibility that a. brain circuits are permanently "wired." b. neurotransmitter systems operate independently of non-biological influences. c. sensitivity of brain circuits can be effected by environmental factors. d. respiratory disorders cause changes in neurotransmitter systems.

ANSWER: c 26. Which of the following brain areas is NOT closely associated with anxiety? a. Hippocampus b. Amygdala c. Prefrontal cortex d. Hypothalamus ANSWER: d 27. The behavioral inhibition system is activated by signals from the a. brain stem b. hypothalamus c. hippocampus d. cerebellum ANSWER: a

.

28. Research suggests that generalized anxiety disorder is five-times more likely to develop in adults if they a. smoked after age 20. b. never smoked. c. smoked as a teen. d. chewed tobacco as a teen.

ANSWER: c 29. Studies suggest that parents can protect their child from anxiety if they a. never let them experience adversity. b. teach independence by ignoring the child’s needs. c. let children explore the world and deal with the unexpected. d. cope for the child as much as possible.

ANSWER: c 30. Stressful life events—such as marriage, divorce, familial death, or academic pressures—trigger our vulnerabilities to anxiety. These are examples of a contribution. a. psychological b. biological c. social d. cultural ANSWER: c 31. A child who is afraid of dogs because her father was afraid of dogs is said to have a a. specific psychological Copyright Cengage Learning. Powered by Cognero.

vulnerability.

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Chapter 05 Anxiety b. general biological c. general psychological d. specific biological ANSWER: a 32. Research suggests that anxiety and depression frequently a. co-occur. b. are totally separate disorders. c. can occur in the same person, but not at the same time. d. share no vulnerability.

ANSWER: a 33. Recent research by Barlow (2002) and others indicates that vulnerability to anxiety disorders is related to a. one's sense of control over environmental events. b. the number of unexpected occurrences in one's life. c. the number of siblings in one's family. d. genetic or biological factors only.

ANSWER: a 34. At the time of assessment of an anxiety disorder, ______ of patients should have at least one other anxiety or depressive disorder. a. 15% b. 25% c. 55% d. 75% ANSWER: c 35. Having an anxiety disorder increases the risk of a. depression b. migraines c. suicidal ideation d. all of the above ANSWER: d

.

36. Which of the following statements is TRUE about anxiety disorders? a. Major depression occurs in 65% of the cases of people diagnosed with an anxiety disorder. b. Having an anxiety disorder along with depression has no effect on the recovery rate. c. Having an anxiety disorder might contribute to a physical disorder such as arthritis. d. The most common additional diagnosis for all anxiety disorders was alcoholism.

ANSWER: c 37. In what way is worry not useful? a. It helps us plan for the future. b. It makes sure we are prepared for a task. c. It makes us double check that we have thought of everything before leaving on a trip.

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Chapter 05 Anxiety d. It ensures that we respond appropriately to fear-inducing events.

ANSWER: d 38. Which of the following terms is most associated with generalized anxiety disorder (GAD)? a. Fear b. Panic c. Worry d. Emotion ANSWER: c 39. For Generalized Anxiety Disorder (GAD), intense cognitive process is accompanied by: a. Restricted autonomic response b. Inadequate problem solving skills c. Worry d. Emotion ANSWER: b 40. For Generalized Anxiety Disorder (GAD), avoidance of imagery is accompanied by: a. Restricted autonomic response b. Inadequate problem solving skills c. Worry d. Emotion ANSWER: a 41. All of the following are symptoms of generalized anxiety disorder (GAD) EXCEPT a. muscle tension. b. mental agitation. c. worrying about minor daily events. d. hypersomnia.

ANSWER: d 42. Research studies have found that generalized anxiety disorder (GAD) is most common among a. adults in early adulthood b. adolescent girls c. adults over 45 years of age d. adolescent boys ANSWER: c

.

43. People with GAD a. have a median age of onset at 25, based on interviews. b. have episodes that come and go. c. have a 58% chance of recovery after having the disorder for 12 years. d. are three times as likely to develop agoraphobia as those without GAD. ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety 44. People with GAD tend to worry about a. large, extremely stressful events only. b. mostly minor things. c. physical threats only. d. germs and diseases only.

ANSWER: b 45. Which of the following people living in the United States is most likely to develop GAD? a. Monica, a 50-year-old woman b. Billy, an 8-year-old boy c. Sam, a 50-year-old male d. Tanya, a 15-year-old girl ANSWER: a 46. Which physiological measure consistently distinguishes individuals with generalized anxiety disorder (GAD) from non-anxious normal subjects? a. Increased muscle tension b. Increased heart rate c. Decreased EEG beta activity d. Heightened autonomic arousal ANSWER: a 47. For generalized anxiety disorder (GAD), the pharmacological treatment of choice has been the category of drugs known as ___________. a. benzodiazepines b. SSRIs c. tricyclics d. MAO inhibitors ANSWER: a 48. Research suggests that people with GAD worry a. with images but try to avoid the associated negative affect. b. without images but try to avoid the associated negative affect. c. with images to magnify the associated negative affect. d. without images to magnify the associated negative affect.

ANSWER: b 49. Barlow and others (1992) developed a cognitive-behavioral treatment for GAD that helps the patient a. avoid feelings of anxiety as well as the negative images associated with those feelings. b. confront anxiety-provoking thoughts and images. c. adjust medication levels as needed to cope with the anxiety. d. analyze the unconscious sources of the anxiety.

ANSWER: b 50. Evidence now suggests that agoraphobic avoidance behavior is one component of Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety a. exaggerated obsessive-compulsive disorder. b. major phobias. c. severe, unexpected panic attacks. d. mild generalized anxiety disorder.

ANSWER: c 51. Agoraphobic avoidance behavior appears to be determined by a. how recently the last panic attack occurred. b. the extent to which the person expects another panic attack to occur. c. the number of panic attacks the person has had in the past. d. how severe the panic attacks have been.

ANSWER: b 52. Which of the following is an accurate statement about panic disorder? a. An individual who suffers through an agoraphobic situation rather than avoiding it entirely is not considered agoraphobic. b. Most individuals with panic disorder will also avoid internal sensations that produce physiological arousal. c. Approximately 75% of those with agoraphobia are male. d. Women are more likely than men to cope with panic disorder by drinking alcohol.

ANSWER: b 53. Agoraphobia, which has come to mean "fear of going out," derives from the Greek word agora, meaning ____________. a. marketplace b. home c. travel d. safe ANSWER: a 54. A teenage girl had recently been having panic attacks while shopping at the mall. She was sitting in her room feeling very depressed. To cheer her up, a friend suggested that they both go to an exercise class. Shortly after the warm-up started, however, she had another panic attack. What is the best explanation for this occurrence? a. She was angry with the friend for insisting that she go out. b. The medication that had been prescribed for her was only treating the depression, not the anxiety. c. The physical sensations experienced during exercise had become an internal cue for panic to occur. d. The exercise class was an unconditioned stimulus that resulted in a panic attack.

ANSWER: c 55. An individual who suffers from panic disorder might become anxious about climbing stairs, exercising, or being in hot rooms because these activities produce sensations similar to those accompanying a panic attack. In psychological terms, the exercise and hot rooms have become . a. conditioned stimuli b. unconditioned stimuli c. conditioned responses d. unconditioned responses Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety ANSWER: a 56. Panic attack studies suggest that men a. simply endure panic attacks better than women. b. don’t experience panic attacks. c. mask panic attacks with depression. d. consume alcohol to deal with panic attacks.

ANSWER: d 57. Panic attacks tend to occur most often a. at daybreak due to a fear of the new day. b. at sunset after a stressful day. c. during deep sleep between 1:30 and 3:30 a.m. d. in the evening when people start dreaming.

ANSWER: c 58. People with a psychological vulnerability to panic attacks tend to a. catastrophize b. minimize c. fake d. ignore ANSWER: a 59. Nocturnal panic attacks generally occur when an individual is a. in REM sleep b. having a nightmare c. deeply asleep d. dreaming ANSWER: c

normal physical sensations.

.

60. The phenomenon known as "isolated sleep paralysis" is most likely to occur in __________ who suffer from panic disorder. a. Caucasians b. African Americans c. Latinos d. Asians ANSWER: b 61. Panic control treatment a. was developed by the textbook authors. b. concentrates on exposing the patients to the cluster of physical sensations that remind them of their panic attacks. c. involves the therapist to create "mini" attacks in the office. d. all of the above ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety 62. In treating panic disorder, all of the following types of medications are used EXCEPT a. SNRIs b. SSRIs c. opiates d. benzodiazepines ANSWER: c

.

63. The purpose of creating mini panic attacks in panic control treatment therapy is to a. allow the patient to develop alternative attitudes about the feared situation. b. convince the patient that panic attacks are not real. c. force the panic attacks into the unconscious. d. help patients identify what makes them panic.

ANSWER: a 64. What is one factor that distinguishes between traditional exposure-based treatments for panic disorder and the more recent panic control treatment (PCT) developed at one of Barlow's clinics? a. Exposure to the interceptive sensations associated with panic attacks b. Referral to a psychiatrist for medication monitoring c. Traditional exposure-based treatments result in a higher rate of cures d. As part of PCT, the therapist accompanies the patient on "reality testing" activities ANSWER: a 65. Which of the following procedures is NOT part of Barlow's panic control treatment (PCT)? a. Cognitive therapy to modify conscious or unconscious perceptions about the "dangerousness" of feared situations b. Creation of mini panic attacks in the therapist's office c. Exercises to elevate the heart rate or spinning to make the patient dizzy d. Reducing agoraphobic avoidance by exposure to feared situations ANSWER: d 66. Which of the following is NOT a somatic sensation that accompanies Panic Disorder and Agoraphobia? a. Stomach ache b. Heart pounding c. Excessive sweating d. All of the above answers are correct ANSWER: d 67. A friend stated that when she went to a clinic, she had to spend several 30- to 60-second sessions shaking her head from side to side, spinning in a chair, tensing all her muscles, hyperventilating, or breathing through a narrow straw. She is surprised that you correctly guessed that she is receiving treatment for a. specific phobia. b. social phobia. c. panic disorder. d. posttraumatic stress disorder.

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Chapter 05 Anxiety ANSWER: c 68. A major double-blind research study sponsored by the National Institute of Mental Health looked at the separate and combined effects of both psychological and drug treatments for patients suffering from panic disorder. Participants were randomized into five different treatment conditions, including all but which of the following? a. Psychological treatment alone (PCT) b. Combined drug and psychological treatment c. Placebo alone d. Deep brain stimulation and transcranial magnetic stimulation ANSWER: d 69. A relative of yours who suffers from panic disorder asks you what treatment would have the longest-lasting benefits.

Since you have just read about the double-blind NIMH research study evaluating psychological treatments with and without medication, you tell your relative to first try a. the drug imipramine. b. psychological treatment along with medication. c. psychological treatment that includes cognitive-behavioral therapy (CBT). d. any available treatment since patients in all treatment conditions achieved the same long-lasting gains.

ANSWER: c 70. Is agoraphobic behavior always accompanied by panic attacks? a. Yes, panic attacks always precede agoraphobic behavior. b. Yes, but only when the person feels safe. c. Sometimes panic attacks precede agoraphobic behavior. d. Never, panic attacks never precede agoraphobic behavior.

ANSWER: c 71. Your best friend refuses to go out because she is afraid that she will say or do the wrong thing. Social situations make her heart rate accelerate and she tends to avoid shopping malls, public transportation, tunnels, and restaurants.

Your friend may be suffering from: a. migraines b. panic disorder c. OCD d. specific phobia ANSWER: b 72. D-cycloserine is a drug that seems to act to work in the a. amygdala to diminish anxiety. b. hippocampus to reduce the memory of anxiety. c. hypothalamus to produce homeostasis. d. thalamus to decrease sensory signals of anxiety.

ANSWER: a 73. All of the following are characteristics common to specific phobias EXCEPT a. strong and persistent anxiety related to a specific object or situation. b. significant attempts by the anxious individual to avoid the phobic situation.

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Chapter 05 Anxiety c. recognition by the person with the phobia that the anxiety is excessive or unreasonable. d. decreased arousal of the autonomic nervous system.

ANSWER: d 74. In the type of specific phobia called "blood-injury-injection," there is an inherited vasovagal response and a tendency to faint due to a. an increase in blood pressure. b. a decrease in blood pressure. c. an increase in body temperature. d. a decrease in body temperature.

ANSWER: b 75. Manuel had a fear of riding on buses, so his mother had to drive him to school every day. Manuel's phobia is a(n) _________ phobia. a. situational b. natural environment c. blood-injury-injection d. animal ANSWER: a 76. The main difference between situational phobia and panic disorder with agoraphobia (PDA) is a. people with situational phobia never experience panic attacks outside the context of the phobic situation. b. people with situational phobia experience panic attacks when confronted with the phobic situation as well as at other times. c. people with PDA experience panic attacks only in specific situations. d. people with PDA experience panic attacks only at specific times.

ANSWER: a 77. You are told about a child who has shown behavior consistent with "separation anxiety." In order to determine if the child actually has a disorder or whether the behavior is normal, you would first need to know a. the child's age. b. whether the child is a boy or a girl. c. if other family members have anxiety disorders. d. how long the child has shown this behavior.

ANSWER: a 78. The median age of onset for a specific phobia is a. 7 b. 15 c. 25 d. 40 ANSWER: a

.

79. A psychological disorder in children characterized by unrealistic and persistent worry that something will happen to their parents, which may result in refusal to leave home, is called Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety a. globus hystericus. b. school phobia. c. situational phobia. d. separation anxiety disorder.

ANSWER: d 80. When diagnosing separation anxiety disorder in children, clinicians must a. determine whether the anxiety matches that expected for the child’s age. b. differentiate between separation anxiety and social anxiety disorder. c. consider the various types of medication that will be therapeutically effective. d. be wary for the psychotic episodes that often precipitate this condition.

ANSWER: d 81. In the general population, as many as a. 1.7% b. 12.1% c. 31.8% d. 51% ANSWER: b

of people suffer from social anxiety disorder at some point in their lives.

82. According to your textbook, there are at least three ways of developing a phobia. Which is NOT one of these ways? a. Experiencing a panic attack in a specific situation b. Having a nightmare about a feared situation c. Observing someone else experience severe fear d. In certain conditions, being told about danger ANSWER: b 83. According to your textbook, new techniques have made it possible to treat some phobias effectively in one a. day b. week c. month d. year ANSWER: a

.

84. In regard to treatment of specific phobias, which of the following statements is correct? a. Structured exposure-based exercises are no longer considered necessary. b. Individuals with "blood" phobias must learn to relax their muscles to keep their blood pressure high enough to prevent fainting. c. Exposure-based exercises actually change brain functioning. d. Avoiding a phobic situation weakens the phobic response.

ANSWER: c 85. Which of the following would NOT be considered an example of social phobia? a. A student who is reluctant to speak up in a classroom due to fear of embarrassing herself. b. A male who has difficulty urinating in a public restroom when others are present.

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Chapter 05 Anxiety c. A person who can only eat comfortably when he is alone. d. An individual who cannot travel on public transportation without a family member present.

ANSWER: d 86. Which of the following is the most prevalent psychological disorder in the general population? a. Social phobia b. Agoraphobia c. Specific phobia d. Panic disorder ANSWER: c 87. Unlike most of the anxiety disorders in which female sufferers predominate, the sex ratio is almost equal in __________. a. agoraphobia b. specific phobias c. social phobia d. panic disorder ANSWER: c 88. The anxiety disorder called social phobia, involving anxiety about being evaluated or criticized, usually begins during ________. a. childhood b. adolescence c. young adulthood d. middle age ANSWER: b 89. In Japan, the anxiety syndrome termed taijin kyofusho involves a fear of a. performing onstage. b. personally offending others. c. embarrassing oneself. d. speaking to females.

ANSWER: b 90. Research by Lundh and Öst (1996) and Mogg (2004) demonstrated that social phobics presented with pictures of faces were more likely to remember expressions. a. smiling and pleasant b. critical and angry c. sad and tearful d. blank, meaningless ANSWER: b 91. Which of the following drugs received FDA approval in 1999 as a treatment for social phobia?

Whichof the followingdrugs received FDA approval in 1999 as atreatment for social phobia? a. Zoloft Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety b. Paxil c. Prozac d. Phenelzine ANSWER: b 92. Separation Anxiety Disorder is: a. Unrealistic worry that parents will not return b. Realistic appraisal of their parents’ financial situation c. Persistent worry that they will be different than their classmates d. None of the above are true ANSWER: a 93. All young children experience separation anxiety to some extent. About what percentage of children have separation anxiety severe enough to meet the criteria for Separation Anxiety Disorders? a. 1% b. 4% c. 10% d. 25% ANSWER: b 94. The setting for posttraumatic stress disorder to occur follows an experience accompanied by a triad of feelings, including all of the following EXCEPT . a. horror b. paranoia c. helplessness d. fear ANSWER: b 95. Individuals suffering from posttraumatic stress disorder (PTSD) display a characteristic set of symptoms including all of the following EXCEPT a. numbing of emotional responsiveness. b. sudden "flashbacks" in which the traumatic event is relived. c. decreased startle response and chronic under-arousal. d. memories and nightmares of the event.

ANSWER: c 96. Which of the following is an accurate statement about posttraumatic stress disorder (PTSD)? a. Acute stress disorder is diagnosed instead of PTSD if a person's symptoms begin 6 months or more after the traumatic event. b. PTSD occurs in all individuals who experience a traumatic event. c. Most persons diagnosed with acute stress disorder do not eventually develop PTSD. d. Acute stress disorder was included as a DSM-IV diagnosis so early severe reactions to trauma could receive health insurance coverage for immediate treatment.

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Chapter 05 Anxiety 97. Which of the following people is most likely to develop PTSD? a. A child who has social support after surviving a trauma b. A man who is very angry and blaming about a traumatic experience c. A woman who was psychologically prepared for a possible disaster d. An individual who watches extensive television coverage of a crisis ANSWER: b 98. Veterans returning home to the United States after the end of the war in Vietnam experienced a high rate of posttraumatic stress disorder due in part to a. high rates of drug addiction. b. youth and inexperience. c. absence of social support. d. separation from family.

ANSWER: c 99. Although the "alarm reactions" experienced in both PTSD and panic disorder are very similar and result in conditioned responses, in panic disorder the alarm is . a. false b. real c. stronger d. weaker ANSWER: a 100. Physiologically, PTSD appears to be related to damage to a. the hippocampus, which disrupts sleep. b. the amygdala, which disrupts learning and memory. c. the hippocampus, which disrupts learning and memory. d. the amygdala, which disrupts sleep.

ANSWER: c 101. One difference between panic disorders and PTSD is a. in a panic attack, the alarm is false, while in PTSD, the initial alarm is true. b. in panic disorder, the alarm is true, while in PTSD, the alarm is false. c. panic disorder but not PTSD has a biological vulnerability. d. PTSD but not panic disorder has a biological vulnerability.

ANSWER: a 102. Which of the following is an accurate statement about factors affecting treatment for PTSD? a. Psychoanalytic therapists help patients to relive emotional trauma through a process called free association. b. Victims of PTSD often repress the emotional part of their memories of the traumatic event. c. Re-exposure to the trauma should be accomplished quickly to assure the best therapeutic response. d. Medications effective for other anxiety disorders are ineffective with PTSD. ANSWER: b 103. Obsessive-compulsive disorder is often accompanied by all of the following EXCEPT _______.

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Chapter 05 Anxiety a. severe generalized anxiety b. major depression c. visual hallucinations d. panic attacks ANSWER: c 104. Actions, or sometimes thoughts, that an individual with OCD uses to reduce anxiety are called a. operants b. fixations c. habits d. rituals ANSWER: d

.

105. Which type of compulsion has the highest prevalence rate? a. Symmetry b. Cleaning and contamination c. Hoarding d. Forbidden thoughts or actions ANSWER: a 106. In regard to OCD, when the term "magical" is used to refer to compulsive acts, it means a. the person with OCD believes he/she is possessed. b. compulsive behaviors are similar to superstitions. c. the compulsions have no logical relation to the obsessions. d. many magicians have been diagnosed with OCD. ANSWER: c 107. The most common type of obsession is related to a. aggression b. sex c. contamination d. symmetry ANSWER: d

.

108. In regard to the obsessions seen in patients with OCD, the term "need for symmetry" refers to a. doing something a number of different ways. b. keeping things in perfect order. c. putting everything on one's right and nothing on the left. d. accumulation of possessions.

ANSWER: b 109. Richard, whose case is described in the textbook, was obsessed with the idea that if he did not eat in a certain ritualistic way, he would become possessed. This is an aspect of OCD that is termed . a. symmetrical b. magical Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety c. logical d. demonic ANSWER: b 110. Richard, the patient with OCD described in the textbook, was compelled to take very small steps as he walked and to look back repeatedly. As with other types of checking compulsions, Richard was trying to a. restore a sense of safety and control. b. reduce the possibility of contamination. c. ward off an imagined disaster. d. make sure he didn't make a mistake.

ANSWER: c 111. The compulsions that an individual with OCD uses to suppress disastrous consequences or ward off intrusive thoughts can be either a. behavioral or mental. b. positive or negative. c. biological or psychological. d. autonomic or somatic.

ANSWER: a 112. Normal, ordinary people who have occasional intrusive thoughts with bizarre, sexual, or aggressive content would not be considered to have OCD unless they find the thoughts unacceptable or even dangerous and also a. use alcohol or other drugs to reduce anxiety. b. develop insomnia and nightmares as well as dissociation symptoms and, on occasion, psychosis. c. become horrified by such thoughts and consider them signs of some alien, intrusive, evil force. d. suffer from either posttraumatic stress disorder or social phobia.

ANSWER: c 113. In OCD, certain types of obsessions lead to certain types of compulsions. From the following, choose the one that is a correct match between an obsession and its consequent rituals. a. Aggression obsessions: cleaning b. Contamination: ordering c. Sexual obsessions: checking d. Symmetry: hoarding ANSWER: c 114. An observation has been made between children presenting with OCD and tics after a bout of strep throat. The resulting syndrome was called a. Strep Throat Acquired Compulsive Disorder (STACD). b. Streptococcal Caused Obsessive Compulsive Disorder (SCOCD). c. Pediatric Autoimmune Disorder associated with Streptococcal Infection (PANDAS). d. Tic Activated by Strep Throat Exemplar (TASTE).

ANSWER: c 115. According to several cross-cultural research studies reported in the textbook, the prevalence of OCD is Copyright Cengage Learning. Powered by Cognero.

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Chapter 05 Anxiety a. very similar across cultures. b. lower in European countries. c. higher in African nations. d. virtually nonexistent in some cultures.

ANSWER: a 116. In regard to a type of thinking pattern found in some patients with OCD, which of the following would be an example of thought-action fusion? a. Washing one's hands repeatedly to ward off germs b. Taking only very small steps while walking to prevent others from being in danger c. Believing that thinking about an abortion is the moral equivalent of having an abortion d. Saving stacks of old newspapers or magazines because they might be needed some day ANSWER: c 117. A young child has thoughts about hating her younger brother and wishing he would die. She becomes very anxious about these thoughts because she has developed the idea that if anything really happened to him, it would be her fault.

This pattern of thinking is called . a. neutralizing b. thought-action fusion c. thought suppression d. fundamental responsibility ANSWER: b 118. Tony has thoughts about hating his younger brother and wishing he would die. He becomes very anxious about these thoughts because he has developed the idea that if anything really happened to his brother, it would be his fault. For no explainable reason, Tony starts mentally counting by odd numbers each time he walks past his brother's room and discovers that this activity makes him less anxious. Tony's behavior can be described as a. a phobia of going into his brother's room because he is afraid his hatred will actually hurt him. b. a mental compulsion developed to neutralize his bad thoughts. c. an attempt to be better in math than his brother to gain parental acceptance d. a compulsive ritual designed to make him like his brother more.

ANSWER: b 119. What happens when people with OCD attempt to neutralize or suppress disturbing, intrusive thoughts? a. The obsessive thoughts disappear. b. The frequency of the obsessive thoughts increases. c. Other kinds of obsessive thinking start to occur. d. This strategy has no effect on the obsessive thoughts.

ANSWER: b 120. According to research studies reported in the textbook, people with OCD who hold fundamentalist religious beliefs often present a. both checking and hoarding rituals. b. a reduced sense of responsibility for their actions. c. attitudes of inflated responsibility.

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Chapter 05 Anxiety d. non-equivalence of obsessive thoughts and compulsive actions.

ANSWER: c 121. In regard to pharmacological treatments for obsessive-compulsive disorder, the most effective drugs are those that inhibit the reuptake of the neurotransmitter called . a. serotonin b. dopamine c. noradrenaline d. epinephrine ANSWER: a 122. The behavioral process in which OCD patients are not permitted to carry out their compulsions while in the presence of the anxiety-producing stimulus or situation is called a. exposure and ritual prevention. b. thought-stopping technique. c. anxiety reduction therapy. d. behavioral inhibition conditioning.

ANSWER: a 123. Which of the following is an example of the treatment technique for OCD called exposure and ritual prevention (ERP)? a. Carrie has an obsessive fear of contamination that has led to compulsive hand-washing rituals. Her therapist is treating her by making her touch dirty laundry but not allowing her to wash for increasingly longer periods of time afterward. b. Kerry has an obsessive fear of contamination that has led to compulsive hand-washing rituals. Her therapist is treating her by forcing her to wash her hands repeatedly, even when she doesn't feel anxious. c. Kelly has religious obsessions. She feels that if she doesn't read biblical passages every hour of the day, she will do something evil. Her therapist is treating her by having her attend religious services more frequently so that good thoughts will replace the bad ones. d. Callie has a hoarding compulsion. She becomes anxious whenever she has to throw something away; she even keeps stuff that she doesn't need and will never use. Her therapist has arranged for all Callie's junk to be dumped when she is away from home.

ANSWER: a 124. The model of the etiology of obsessive-compulsive disorder suggests that in order for an individual to develop OCD, __________ must be present. a. biological vulnerability b. psychological vulnerability c. both biological and psychological vulnerabilities d. neither biological nor psychological vulnerabilities ANSWER: c 125. Research studies have shown that combining exposure and ritual prevention (ERP) with medication when treating patients with OCD a. is better than drug treatment alone. b. is better than ERP alone.

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Chapter 05 Anxiety c. causes patients to discontinue treatment. d. does not produce any additional therapeutic advantage.

ANSWER: d 126. Overall it can be concluded that the combination of medical and psychological interventions for anxiety work a. only as well as the individual psychological treatments. b. better than the individual treatments alone. c. worse in combination. d. only as well as the individual medical treatments.

ANSWER: a 127. A rather unusual affliction that is marked by an unwarranted preoccupation with some imagined defect in one's physical appearance is called disorder. a. body dysmorphic b. conversion somatoform c. somatization d. aesthetic disregulatory ANSWER: a 128. Because people with body dysmorphic disorder often complain of persistent, intrusive, and horrible thoughts about their appearance, this condition is believed to be closely related to disorder. a. obsessive-compulsive b. social anxiety c. functional neurological symptom d. brief psychotic ANSWER: a 129. Sophia and Layla are laying on the beach one sunny day when they see a woman walk past. They are astounded at the condition of this woman's skin. She is deeply bronzed from years of tanning, and her skin has a wrinkled and leathery look. Sophia says, "I can't believe she thinks that is good for her skin!" Layla, having read your textbook, says, "She may be tanning like that to cover up some flaw that she perceives in her own skin." Layla is clearly implying that this woman suffers from disorder. a. body dysmorphic b. somatic skin-picking c. excoriation d. obsessive-compulsive ANSWER: a 130. The overall prevalence for body dysmorphic disorder in the general population is about a. 2.2% b. 4.7% c. 7.9% d. 10.3% ANSWER: a

.

131.

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Chapter 05 Anxiety Tonia's house is almost unimaginable! She has piles of junk (she calls it "treasures") piled from floor to ceiling in virtually every room. There is a narrow pathway that she can use to walk from room to room. All of her furniture is covered in various items, so she has one small folding chair that she takes with her when she wants to sit down.

Her bed has one small area that is clear enough for her to sleep. There is a foul odor in the house, mold growing under her piles of possessions, and she never has visitors. When Tonia tries to get rid of any possessions, she experiences tremendous anxiety and gives up quickly. Which diagnosis would best suit Tonia? a. Hoarding disorder b. Body dysmorphic disorder c. Obsessive-Compulsive disorder d. Excoriation disorder ANSWER: a 132. A person with which of the following conditions might regularly wear hats, even in situations where it is not appropriate to do so, in order to hide unusual bald spots on their head? a. Trichotillomania b. Excoriation c. Body dysmorphic disorder d. Kleptomania ANSWER: a 133.

Marika regularly shows up at school with bandages on her arm. When her friends ask her why she has a new one, she dodges the question and just says, "Oh I got a small cut." She is regularly seen playing with the bandages, and one day one of her friends was sure she saw Marika actually picking at her own skin in the same area of her arm.

Which problem may Marika be challenged by? a. Excoriation b. Trichotillomania c. Body dysmorphic disorder d. Obsessive-Compulsive disorder ANSWER: a Subjective Short Answer 134. Describe the symptoms, causes, and treatment of panic disorder and the three categories of panic attack.

ANSWER: Panic disorder is characterized by the abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and possibly dizziness.

The three categories of panic attacks: Situationally bound—attack is cued by a particular setting or situation.

Unexpected—no clear cue or trigger for the attack.

Situationally predisposed—cues may, but don’t inevitably, cause an attack.

135. Define generalized anxiety disorder, and discuss how it differs from panic attacks.

ANSWER: GAD is a syndrome that characterizes every anxiety disorder. The criteria specify at least 6 months of excessive anxiety and worry that is ongoing for more days than not and is difficult to forget.

Panic attacks are associated with autonomic arousal, while GAD is characterized by muscle tension and mental agitation, fatigue, irritability, and difficulty sleeping. People with GAD also tend to worry excessively about minor things as well as major events.

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Chapter 05 Anxiety 136. Discuss the different types of specific phobias and how they are acquired.

ANSWER: Blood-injury-injection phobias demonstrate a fear of blood, physical injury, and needles.

Situational phobias address fears of a particular situation such as riding on public transportation.

Natural environmental phobias are fears of natural events such as tornadoes, hurricanes, thunderstorms, etc.

Animal phobias consist of fear of animals.

Other is everything that does not fit into any of the above categories.

Phobias may be acquired in several different ways. One way is through classical conditioning. We may also learn fears vicariously (seeing someone else have a traumatic experience). Sometimes just being warned repeatedly about a potential danger is sufficient to develop a phobia.

Finally, it appears that several things have to take place to develop a phobia. First, some form of traumatic conditioning experience. Second, fear develops more easily if we are prepared to fear, i.e., inherently dangerous situations. Third, one must be susceptible to developing anxiety that the event will happen again.

137. Describe posttraumatic stress disorder and acute stress disorder, and discuss the difference between the two.

ANSWER: Posttraumatic stress disorder is an emotional disorder that follows a trauma in which one feels fear, helplessness, or horror. Victims later experience vivid memories and nightmares, display restriction or numbing of emotional responsiveness, may be unable to remember certain aspects of the event, and may remember the event.

Acute stress disorder is PTSD that occurs within the first month after the trauma. People with this disorder may display severe disassociative symptoms, amnesia for all or part of the trauma, emotional numbing, derealization, and feelings of unreality.

People with acute stress disorder experience very severe early reactions to trauma that did not meet the criteria for PTSD but over time may eventually develop PTSD. 138. Discuss obsessive-compulsive disorder, and explain the concept of thought-action fusion.

ANSWER: Obsessive-compulsive disorder (OCD) is characterized by avoidance of a dangerous thought, image, or impulse. Those thoughts that are intrusive are called obsessions, while compulsions are the thoughts or actions used to suppress the obsession in order to obtain relief; they may become rituals. Clients who equate thoughts with specific actions or activity represented by thoughts exhibit thought-action fusion, which can develop as a result of feelings of excessive responsibility and guilt.

Essay 139. Why do anxiety conditions differ from person to person?

ANSWER: There is much evidence that psychological and physical reactions to fear and anxiety reactions differ person to person. This is illustrated by the DSM-5 diagnostic criteria for panic attack which shows a list of 13 possible symptoms of which you must have 4 or more. Biological vulnerabilities and generalized and specific psychological vulnerabilities (student may describe some in Figure 5.3 on page 132 of the text) lead to a variety of anxiety symptoms in individuals.

140. Starting with the DSV-4, panic disorder and agoraphobia were integrated into one disorder called panic disorder with agoraphobia. Why was this the case?

ANSWER: Many people do experience panic disorder and agoraphobia at the same time and thus the diagnosis was combined. They are related in that the fear of a panic disorder can often lead someone to not want to go out in public and/or stay close to their safety support system. However, agoraphobic behavior can be independent of panic, especially initially as the client may choose other coping mechanisms such as substance use and other avoidant behaviors.

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Chapter 05 Anxiety 141. Many of the DSM-5 criteria specify that the diagnosis must not be “better explained by another disorder.” Why do you think that this is the case?

ANSWER: Answers will vary but correct answers will discuss how anxiety disorders share many symptoms with other psychological disorders. It is important to evaluate each individual case for a proper diagnosis as certain disorders are more responsive to medication and/or therapies than others.

142. What do the integrative models of the various disorders in this chapter tell us?

ANSWER: Answers will vary but should include that the situation does not equal the development of the disorder. Individual biological and psychological differences mediate whether the situation will create a disorder. How the individual processes the event (for example, a traumatic event) and the social support available to the individual often further mediate the conditions under which stress will cause a disorder.

143. Discuss Body Dysmorphic Disorder. How is it diagnosed?

ANSWER: Body Dysmorphic Disorder is an “imagined ugliness” wherein the individual does not see their body in the same ways in which society sees it. It is clinically defined as: —preoccupation with one or more flaws either invisible or barely visible to others.

—repetitive behaviors —a preoccupation with the body that causes clinically significant distress or impairment.

—the preoccupation is not better explained otherwise.

144. Describe the symptoms, causes, and treatment of panic disorder and the three categories of panic attack.

ANSWER: Panic disorder is characterized by the abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and possibly dizziness.

The three categories of panic attacks: Situationally bound—attack is cued by a particular setting or situation.

Unexpected—no clear cue or trigger for the attack.

Situationally predisposed—cues may, but don’t inevitably, cause an attack.

145. Define generalized anxiety disorder, and discuss how it differs from panic attacks.

ANSWER: GAD is a syndrome that characterizes every anxiety disorder. The criteria specify at least 6 months of excessive anxiety and worry that is ongoing for more days than not and is difficult to forget.

Panic attacks are associated with autonomic arousal, while GAD is characterized by muscle tension and mental agitation, fatigue, irritability, and difficulty sleeping. People with GAD also tend to worry excessively about minor things as well as major events.

146. Discuss the different types of specific phobias and how they are acquired.

ANSWER: Blood-injury-injection phobias demonstrate a fear of blood, physical injury, and needles.

Situational phobias address fears of a particular situation such as riding on public transportation.

Natural environmental phobias are fears of natural events such as tornadoes, hurricanes, thunderstorms, etc.

Animal phobias consist of fear of animals.

Other is everything that does not fit into any of the above categories.

Phobias may be acquired in several different ways. One way is through classical conditioning. We may also learn fears vicariously (seeing someone else have a traumatic experience). Sometimes just being warned repeatedly about a potential danger is sufficient to develop a phobia.

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Chapter 05 Anxiety Finally, it appears that several things have to take place to develop a phobia. First, some form of traumatic conditioning experience. Second, fear develops more easily if we are prepared to fear, i.e., inherently dangerous situations. Third, one must be susceptible to developing anxiety that the event will happen again.

147. Describe posttraumatic stress disorder and acute stress disorder, and discuss the difference between the two.

ANSWER: Posttraumatic stress disorder is an emotional disorder that follows a trauma in which one feels fear, helplessness, or horror. Victims later experience vivid memories and nightmares, display restriction or numbing of emotional responsiveness, may be unable to remember certain aspects of the event, and may remember the event.

Acute stress disorder is PTSD that occurs within the first month after the trauma. People with this disorder may display severe disassociative symptoms, amnesia for all or part of the trauma, emotional numbing, derealization, and feelings of unreality.

People with acute stress disorder experience very severe early reactions to trauma that did not meet the criteria for PTSD but over time may eventually develop PTSD. 148. Discuss obsessive-compulsive disorder, and explain the concept of thought-action fusion.

ANSWER: Obsessive-compulsive disorder (OCD) is characterized by avoidance of a dangerous thought, image, or impulse. Those thoughts that are intrusive are called obsessions, while compulsions are the thoughts or actions used to suppress the obsession in order to obtain relief; they may become rituals. Clients who equate thoughts with specific actions or activity represented by thoughts exhibit thought-action fusion, which can develop as a result of feelings of excessive responsibility and guilt.

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Chapter 06 Chapter 6 Preoccupation and Obsession Multiple Choice 1. All of the following are classified as somatic symptom and related disorders EXCEPT a. dissociative identity disorder. b. factitious disorder. c. conversion disorder. d. illness anxiety disorder.

ANSWER: a 2. The common aspect of all somatic symptom disorders is a maladaptive or excessive a. belief that a serious medical condition will cause death. b. belief that one's appearance is ugly. c. response to physical or associated health symptoms. d. concern with the meaning of a physical pain.

ANSWER: c 3. Hippocrates and the Egyptians before him thought that hysterical disorders were the result of a a. dysfunctional ovary b. tense vagina c. wandering uterus d. none of these ANSWER: c

.

4. In 1859, Pierre Briquet described patients who came to see him with a seemingly endless list of complaints for which he could find no basis. This was later called: a. Obsession/compulsion Disorder b. Somatic Symptom Disorder c. Dissociative Identity Disorder d. Depression.

ANSWER: b 5. Your friend Jorge is always complaining that he doesn’t feel well. He thinks his symptoms are serious, has a high-level of anxiety about his symptoms, and often Googles his symptoms. What must be ruled out before Jorge can be diagnosed for Somatic Symptom Disorder: a. medical attention to ensure that he does not have an underlying injury. b. medical attention to ensure that he does not have an underlying illness. c. discussion with his doctor about recent and previous substance abuse. d. all of the above are correct.

ANSWER: d 6. According to psychological theory, neuroses stem from a. underlying unconscious conflicts. b. the clash of conscious and unconscious therapy. c. dream process. d. identity concepts.

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Chapter 06 Chapter 6 Preoccupation and Obsession ANSWER: a 7. Illness anxiety disorder exists when a. a person is excessively concerned about being sick, even when only experiencing minor symptoms. b. real physical illness is exaggerated to the point where the patient can only focus on the pain. c. the patient has an unrealistic fear of contacting germs. d. the patient is truly ill but does not trust the medical establishment enough to seek treatment.

ANSWER: a 8. An essential element of illness anxiety disorder is a. psychosis b. worry c. depression d. dissociation ANSWER: b

.

9. Joe just ate six chili dogs and drank a liter of soda. If Joe suffers from illness anxiety disorder, he would probably interpret any resulting stomach discomfort as a. his own fault for eating so much. b. the result of poor quality food. c. gas pains from overeating. d. a sign that something is seriously wrong with his stomach.

ANSWER: d 10. Panic disorder shares several common characteristics with both somatic symptom disorder and illness anxiety disorder. Which of the following is not one of those shared features? a. Age of onset b. Running in families c. Personality characteristics d. Manner in which anxiety is expressed ANSWER: d 11. Illness anxiety disorder was formerly known as: a. hypochondriasis b. OCD c. schizophrenia d. irreality disorder ANSWER: a 12. Clients with illness anxiety disorder are likely to a. avoid doctors. b. avoid unnecessary medical procedures. c. soon reject assurances that they are healthy. d. ignore the long-term process of illness.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession 13. Since Jane has been diagnosed with illness anxiety disorder, we can expect her to see her physician a. often and feel completely reassured that there is nothing wrong with her health. b. rarely but continue to believe that she is quite ill. c. almost never because she does not trust physicians. d. often but continue to be anxious about her health anyway.

ANSWER: d 14. Although Jill feels fine now and believes that she is healthy, she still worries endlessly about developing a serious illness. Most likely Jill would be diagnosed with a. illness anxiety disorder. b. conversion disorder. c. somatization disorder. d. body dysmorphic disorder.

ANSWER: a 15. Although both panic disorder patients and persons with somatic symptom disorder tend to misinterpret bodily sensations, patients with panic disorder a. are having real physical sensations, while the sensations of those with somatic symptom disorder are "all in their heads." b. tend to fear immediate catastrophe, while those with somatic symptom disorder tend to fear long-term illness. c. are having imagined physical sensations, while those with somatic symptom disorder are experiencing real physical sensations. d. tend to ignore the symptoms of their first attacks, while those with somatic symptom disorder tend to seek immediate medical treatment following the first indication of pain.

ANSWER: b 16. Minor, physical complaints are common among a. young children b. adolescents c. the middle aged d. the elderly ANSWER: a

.

17. With regard to a diagnosis of somatic symptom disorder, women are a. equally likely as men to be diagnosed. b. less likely than men to be diagnosed. c. more likely than men to be diagnosed. d. more likely than men to be diagnosed during middle to late adulthood but no more likely than men to be diagnosed during teen years and early adulthood.

ANSWER: c 18. Disorders such as koro and dhat that are similar to somatic symptom disorders demonstrate the a. influence of culture on psychopathology. b. physical basis of many hypochondriacs' complaints. c. difficulty of accurately diagnosing hypochondriasis.

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Chapter 06 Chapter 6 Preoccupation and Obsession d. influence of genetics on psychopathology.

ANSWER: a 19. Although it's name has changed from DSM-IV to DSM-5, hypochondriasis is essentially an emotional disturbance triggered by a. physical pathology. b. misinterpretation of normal physical sensations. c. social concerns. d. severe or unusual physical sensations.

ANSWER: b 20. Studies suggest that patients with somatic symptom disorder or illness anxiety disorder are characterized by a tendency to a. interpret ambiguous stimuli as threatening. b. minimize physical symptoms. c. have low sensitivity to perceived illness. d. avoid bad news cues.

ANSWER: a 21. Paradoxically, an effective treatment for somatic symptom disorder and illness anxiety disorder involves helping the patient to focus on a. creating their own symptoms. b. ignoring their own symptoms. c. getting reassurance about their symptoms. d. understanding other life stressors.

ANSWER: c 22. With regard to the treatment of illness anxiety disorder and somatic symptom disorder, some research supports the use of __________. a. conditioning b. psychoanalysis c. cognitive-behavioral treatment and stress reduction d. humanistic therapy ANSWER: c 23. With regard to the treatment of somatic symptom disorder and illness anxiety disorder, research exploring the use of reassurance in a process called "explanatory therapy" showed that a. some significant gains were achieved. b. reassurance did not work for hypochondriacs. c. reassurance showed some gains but they lasted less than several days. d. the gains were so significant that participants were essentially "cured."

ANSWER: a 24. The effectiveness of reassurance in treating Illness Anxiety Disorder is a “surprising” because a. the efficacy has never been shown empirically. b. family members begin reassuring the patient and then give up.

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Chapter 06 Chapter 6 Preoccupation and Obsession c. by definition, patients with these disorders are not supposed to respond to reassurance. d. all of the above are true.

ANSWER: c 25. Which of the following is a reason why physicians do not thoroughly explain illness to people with Illness Anxiety Disorder? a. Empirical evidence suggests that it makes no difference b. Lack of time c. Hypochondriasis is no longer recognized in the DSM d. All of the above are true ANSWER: b 26. In terms of antidepressant medication treatments for somatic symptom disorder, the most accurate statement based on the research so far is a. antidepressants are effective but not significantly different from a placebo condition. b. antidepressants are not effective. c. some reports suggest that antidepressants may be effective, but placebo-controlled studies have not been performed. d. placebo-controlled studies have been performed and the results suggest that antidepressants work for some hypochondriacs but not for most.

ANSWER: a 27. Research suggests that somatic symptom disorder often occurs in families with a strong tendency toward__________. a. antisocial personality disorder b. schizophrenia c. depression d. obsessive-compulsive disorder ANSWER: a 28. A possible link between antisocial personality disorder and somatic symptom disorder is a. a lack of impulse control b. lack of aggression c. social isolation d. dependence ANSWER: a

.

29. The hypothesized connections between somatic symptom disorder and antisocial personality disorder are a. poor modeling by parents and other authority figures. b. sibling rivalry and attention deficits. c. pleasure seeking and impulsivity. d. genetic defects and poor nutrition.

ANSWER: c 30. A patient with somatic symptom disorder tends to generate higher healthcare costs than an average patient due to a. an extensive medical and physical workup with every visit to a new physician.

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Chapter 06 Chapter 6 Preoccupation and Obsession b. the person's tendency to visit numerous medical specialists. c. both a and b. d. neither a or b.

ANSWER: c 31. One method that is used to reduce the financial burden associated with somatic symptom disorder is____________. a. psychoanalysis b. encouraging patients to speak to family and friends about their symptoms c. exposure therapy d. assignment of a gatekeeper physician ANSWER: d 32. When clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical condition, we say that this is: a. somatization disorder. b. hypochondriasis. c. conversion disorder. d. dissociative disorder.

ANSWER: c 33. Joe injured his back at work several years ago. Although he was treated and considered healed by his physicians, he still complains of severe and debilitating back pain. Other than some minor scar tissue, his doctors can't find anything that could be causing more than some minor stiffness. It appears that Joe might be diagnosed with_________________. a. conversion disorder b. depersonalization/derealization disorder c. somatic symptom disorder with predominant pain d. illness anxiety disorder ANSWER: c 34. The disorder that involves physical malfunctioning without any physical cause is called a. conversion disorder b. hypochondriasis c. somatization disorder d. body dysmorphic disorder ANSWER: a

.

35. Tom was in a coma after an automobile accident which killed his wife. His physical health improved and there is no medical reason why he should not be able to move his arms and legs. Tom may be suffering from: a. conversion disorder b. hypochondriasis c. obsessive/compulsive disorder d. body dysmorphic disorder ANSWER: a 36. George has completely lost his sight during the past year, but medical experts can find no physical reason for his blindness. This could be an example of .

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Chapter 06 Chapter 6 Preoccupation and Obsession a. somatization disorder b. hypochondriasis c. conversion disorder d. dissociative disorder ANSWER: c 37. Conversion disorder patients were conceptualized by Freud as a. converting unconscious conflicts into physical symptoms. b. converting unconscious conflicts into defense mechanisms. c. experiencing physical symptoms as a result of the superego. d. experiencing internal conflicts as a result of id impulses being suppressed by the superego.

ANSWER: a 38. Conversion disorder symptoms generally appear a. randomly b. following a physical injury to the affected area c. shortly after some marked stress d. in children ANSWER: c

.

39. Which of the following would be typical for a patient suffering from a conversion disorder? a. Feeling a lump in the throat that interferes with swallowing, eating, or talking. b. Ability to see some bright objects when calm but suffering complete loss of sight during a stressful period or emergency. c. Great concern with the loss of function and belief that it is a symptom of a potentially fatal disease. d. Ability to identify everything in the visual field even though the patient reports that she is blind.

ANSWER: a 40. In regard to diagnosing a patient's symptoms as a conversion disorder, it is a. quite apparent when a patient is malingering (faking), but it is difficult to determine whether symptoms are due to real physical disorders or a conversion disorder. b. quite apparent when a symptom is due to a real physical disorder, but it is impossible to determine the difference between a conversion disorder and patient malingering (faking). c. rather easy to determine the difference between symptoms that the patient fakes, those caused by real physical disorder, and symptoms caused by conversion disorder. d. very difficult to determine whether the symptoms are due to malingering (faking), real physical disorders, or conversion disorder.

ANSWER: d 41. Which of the following statements is TRUE about factitious disorders? a. Fortunately, the disorder does not seem to extend to other members of the family. b. The symptoms are under involuntary control. c. There is no obvious reason for voluntarily producing symptoms. d. The symptoms lead to a splintering off of one's identity into several "subpersonalities."

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession 42. Samson knows that he has a cold but goes to the movie theatre anyway. When you confront him about being sick, he replies “misery loves company.” Samson is showing evidence of: a. Factitious disorder b. Somatic Symptom Disorder c. Conversion Disorder d. None of the above ANSWER: d 43. Munchausen Syndrome by Proxy is: a. common, particularly with mothers and newborn babies. b. rare and considered child abuse. c. usually consistent with the symptoms of OCD. d. most likely to co-occur when the perpetrator has Factitious Disorder themselves.

ANSWER: b 44. Factitious disorder imposed on another is often characterized by a. deliberate actions directed toward making a child sick. b. a parent denying that a child has symptoms that have, in fact, been observed. c. a parent developing the same symptoms that their child has. d. convincing a child to lie to a doctor about factitious symptoms.

ANSWER: a 45.

A person who fakes symptoms for a goal is called a___________, while a person who fakes a disease for no clear goal has a____________disorder: a. malingerer; factitious b. conversion disorder patient; malingering c. fictitious disorder patient; conversion d. hypochondriac; factitious ANSWER: a 46. A mother who repeatedly seeks medical treatment for her child’s unusual illness and is overly involved in the child’s treatment might need to be assessed for . a. factitious disorder imposed on another b. malingering c. conversion disorder d. illness phobia ANSWER: a 47. A commonly-seen form of factitious disorder imposed on another is a set of conditions that a. falls somewhere between malingering and conversion disorders. b. falls under voluntary control like malingering. c. is an atypical form of child abuse. d. is a combination of a somatic symptom disorder and a dissociative disorder.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession 48. Catharsis is a. the process of placing a tube into the bladder to release urine. b. a conscious behavioral process. c. a purging of emotionally traumatic events. d. none of these ANSWER: c 49. Which of the following statements is TRUE about conversion disorders? a. The prevalence of conversion disorders is equal in men and women. b. Conversion disorders typically develop in the late 20s or early 30s. c. Conversion disorders are not uncommon in males at times of extreme stress. d. Once conversion disorders disappear, they do not reoccur.

ANSWER: c 50. Freud called the reduction in anxiety by converting unconscious conflicts into physical symptoms a. primary narcissism. b. secondary narcissism. c. primary gain. d. secondary gain.

ANSWER: c 51. The modern view of the causes of conversion disorder is a. completely different from Freud's ideas of the etiology of this disorder. b. somewhat similar to the causes that Freud described for this disorder. c. a combination of genetic predisposition and neurobiological deficits. d. based on social learning theory.

ANSWER: b 52. With regard to Freud's explanation of "la belle indifference" (the observation that conversion disorder patients are not concerned about their symptoms), research conducted by Lader and Sartorius (1968) suggests that a. conversion disorder patients do display "la belle indifference," but Freud's explanation of primary gain is not supported. b. Freud's explanation is essentially correct since there is great variability in the amount of concern that conversion disorder patients display regarding their symptoms. c. conversion disorder patients actually are quite concerned with their symptoms, so Freud's explanation of primary gain is not supported. d. "la belle indifference" is a myth, thus validating Freud's explanation of primary gain.

ANSWER: c 53. Your textbook authors describe a treatment plan for conversion disorder involving a. in-depth exploration of psychological conflicts. b. regression to the early psychosexual stages of development. c. application of a strict behavioral program that includes reinforcement for each display of progress and punishment when necessary. d. reduction of any reinforcing or supportive consequences of the conversion symptoms.

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Chapter 06 Chapter 6 Preoccupation and Obsession ANSWER: d 54. In treating conversion disorder, which of the following statements is true? a. Clients responded well to cognitive-behavioral therapy. b. Clients responded well to hypnosis. c. Clients responded well when hypnosis and cognitive-behavioral therapy were combined. d. Like somatic symptom disorder, clients do not respond well to any treatment.

ANSWER: a 55. The experience of dissociation occurs in a. psychotic disorders only. b. individuals with dissociative disorders only. c. only in those individuals who have experienced great personal trauma. d. certain psychological disorders as well as in non-disordered people at times.

ANSWER: d 56. Depersonalization is defined as a. altered perception including loss of the sense of one's own reality. b. altered perception involving loss of the sense of reality of the external world. c. vivid hallucinations. d. the feeling that one is no longer a person.

ANSWER: a 57. Jason suddenly notices that the world looks weird to him. Some objects look bigger than normal and others look smaller. Cars passing by seem oddly shaped and people appear dead or mechanical. Joe is experiencing________. a. derealization b. depersonalization c. classic early psychosis symptoms d. mania ANSWER: a 58. While driving alone in her car, Sarah suddenly looks around and, for a moment, she can't remember where she is, how she arrived at this point on the road, or even why she is driving her car. Sarah is experiencing_______________. a. derealization b. depersonalization c. the early stages of what will eventually become a severe psychotic disorder d. symptoms of a mood disorder ANSWER: b 59. Individuals with depersonalization show a. decreased emotional responsiveness. b. increased emotional responsiveness. c. erratic emotions. d. insincere emotions.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession 60. Losing your own sense of reality is called a. depersonalization b. a fugue state c. a trance state d. a dissociative disorder ANSWER: a

.

61. The diagnosis of depersonalization-derealization disorder is a. rare and only applied when the experience of depersonalization interferes with normal functioning. b. rare but applied to anyone who experiences depersonalization. c. fairly common since many people experience depersonalization. d. fairly common and applied to anyone who is frightened by an experience of depersonalization.

ANSWER: a 62. In dissociative amnesia, the individual typically has no memory of a. any events. b. events prior to a trauma. c. selective events, particularly those involving trauma. d. events following a trauma, particularly those involving interpersonal issues.

ANSWER: c 63. In dissociative fugue, the term fugue relates to a. confusion b. flight or travel c. loss of consciousness d. hallucination ANSWER: b

.

64. Patients diagnosed with dissociative amnesia with a dissociative fugue a. will travel and typically experience memory loss during their trip. b. will travel but do not experience memory loss. c. typically experience memory loss but do not travel. d. seldom recover any sense of their own identity.

ANSWER: a 65. During a dissociative fugue state, it is not uncommon for individuals to a. commit suicide. b. see the world as a strange and foreign place. c. take on a new identity. d. contact friends and family.

ANSWER: c 66. A man who finds himself living in a small town in Alaska with no recall of how he got there may have___________. a. dissociative amnesia with dissociative fugue Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession b. conversion c. depersonalization-derealization disorder d. dissociative identity disorder ANSWER: a 67. A distinctive dissociative state that is not found in Western cultures is a. amok b. exorcism c. trance d. voodoo ANSWER: a

.

68. Dissociative trance disorder is diagnosed a. only when the trance is unpredictable in terms of when it appears (i.e., individual goes into a trance without prior religious ritual). b. only when the trance is undesirable and considered pathological in the individual's culture. c. only when the trance causes harm to the individual or others. d. whenever an individual repeatedly enters a trance state.

ANSWER: b 69. In non-Western cultures, trance and possession are a. extremely rare. b. never considered a disorder. c. the most common forms of dissociative disorders. d. the rarest forms of dissociative disorders.

ANSWER: c 70. The disorder in which more than one distinct personality exists within one individual was changed from multiple personality disorder to ___________ in the DSM-IV. a. dissociative identity disorder b. dissociative trance disorder c. schizophrenia d. multiple personality disorder ANSWER: a 71. An alter is a. a separate identity experienced by someone with dissociative identity disorder. b. a new identity created by someone with dissociative fugue. c. a new identity created by someone with generalized amnesia. d. a physical symptom with no physical cause experienced by someone with somatic symptom disorder.

ANSWER: a 72. The host identity usually: a. is the original personality. b. is engaged in sexual identity and often sex work.

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Chapter 06 Chapter 6 Preoccupation and Obsession c. the personality that most often seeks psychological treatment. d. none of the above are correct.

ANSWER: c 73. With regard to dissociative identity disorder, the term "alter" refers to a. the "host" personality b. a dangerous personality c. the most recent personality to emerge d. a different personality ANSWER: d

within the individual.

74. A switch a. usually occurs instantaneously. b. is the transition from one personality to another. c. may exhibit physical transformations. d. all of these.

ANSWER: d 75. In dissociative identity disorder, the "host" personality is usually the one that a. is the most aggressive of the personalities. b. asks for treatment and becomes the patient. c. earns income for the individual. d. is sexually provocative.

ANSWER: b 76. In dissociative identity disorder, the "host" personality usually a. is of a gender opposite to that of the individual. b. becomes overwhelmed trying to hold all of the personality fragments together. c. is male. d. is well aware of each personality and everything that happens while each personality is active.

ANSWER: b 77. The existence of a cross-gendered alter in dissociative identity disorder is a. common b. rare c. present in every patient d. almost never seen in this disorder ANSWER: a

.

78. One aspect of the DSM-5 criteria for diagnosis of dissociative identity disorder is a. patient awareness of the distinct personalities b. existence of three or more personality fragments c. amnesia d. history of abuse ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession 79. Vanna, who is 40, apparently believes that she is a 20-year-old woman. Suddenly, she starts to speak and behave very differently, and says she no longer thinks of herself as "Vanna." Instead, she claims to be Elise, a 10-year-old child. It is likely that Vanna has just experienced a . a. switch b. dissociative trance disorder c. conversion reaction d. schizophrenic moment ANSWER: a 80. In dissociative identity disorder, the transition from one personality to another is called a a. transformation b. substitution c. switch d. alteration ANSWER: c

.

81. The process of changing from one personality to another generally occurs ______ in most patients with dissociative identity disorder. a. slowly b. quickly c. rarely d. only after many warning signs that a change is about to occur ANSWER: b 82. With regard to evidence for the scientific validity of dissociative identity disorder (DID), the most accurate statement is a. most DID patients are faking. b. research suggests that faking dissociative experiences is possible. c. it is virtually impossible to fake the types of changes that occur in dissociative identity disorder. d. objective tests can always determine which patients are faking dissociative identity disorder.

ANSWER: b 83. Studies of faking, amnesia, and hypnosis, such as the one conducted by Spanos (1996), suggest that symptoms of dissociative identity disorder a. cannot be developed through therapist suggestion and reinforcement. b. are almost always the result of hypnotically inserted (false) memories. c. can be developed through therapist suggestion and reinforcement. d. are almost never the result of therapist intervention.

ANSWER: c 84. Comparisons of optical functioning in the various personalities of dissociative identity disorder patients show changes that would be a. easy to fake. b. absolutely impossible to fake. c. consistent with an individual who was trying to fake.

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Chapter 06 Chapter 6 Preoccupation and Obsession d. difficult to fake.

ANSWER: d 85. With regard to the studies of DID described in your text regarding faking, amnesia, and hypnosis, as well as the studies regarding the physiological changes that occur in the different personalities, the most accurate statement is a. while DID symptoms can be faked or developed through suggestion, many physiological changes observed in DID patients would be very difficult to fake. b. DID symptoms and the many physiological changes observed in DID patients can be developed through suggestion and are easily faked. c. while physiological changes associated with DID are relatively easy to fake, the symptoms of DID are very difficult to fake or to develop through suggestion. d. almost all cases of DID are probably faked or developed through therapist suggestion.

ANSWER: a 86. Dissociative identity disorder tends to be associated with a. child abuse b. multiple psychological disorders c. dissociation d. all of these ANSWER: a

.

87. Which of the following statements is FALSE about dissociative identity disorder? a. Once established, the disorder lasts a lifetime without treatment. b. For prevalence rates, the ratio of females to males is approximately 9 to 1. c. The frequency of switching increases with age. d. The form that the disorder takes does not differ substantially over the lifespan.

ANSWER: c 88. Individuals with dissociative identity disorder generally a. have only one other distinct personality. b. suffer a loss of their own identity that lasts several years. c. maintain complete awareness of all of their personalities. d. have several distinct personalities.

ANSWER: d 89. One distinction that may help determine those with DID from individuals who are malingering (faking their symptoms) is that malingerers are a. usually eager to demonstrate their symptoms. b. usually hiding the existence of a major life crisis. c. more likely to have many alters. d. less likely to seek treatment.

ANSWER: a 90. The average number of alter personalities observed in individuals with dissociative identity disorder is______________. a. 1 Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession b. 2 c. 15 d. 100 ANSWER: c 91. Dissociative identity disorder is most commonly found in a. females b. males c. children d. the elderly ANSWER: a

.

92. The average length of time between an individual's first symptoms of DID and the identification and diagnosis of the disorder by a professional is ____________. a. one year b. 20 years c. less than a month d. seven years ANSWER: d 93. Without treatment, it is expected that DID will last ___________________. a. 10 years b. a lifetime c. several months d. 20 years ANSWER: b 94. Studies examining the incidence of DID in non-clinical populations (the population at large or a university population) suggest that approximately_____________percent of the general population suffer from DID. a. .001 b. .01 to .05 c. 1.5 d. 5 ANSWER: c 95. Sue has DID. It is extremely likely that she also has a. at least one other psychological disorder. b. a problem with her weight. c. a history of problems with the law. d. no desire to get better.

ANSWER: a 96. One reason that DID can be misdiagnosed as psychosis is that a. auditory hallucinations are common in both disorders. b. both disorders are in the same DSM-IV category.

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Chapter 06 Chapter 6 Preoccupation and Obsession c. mental health professionals generally do not believe that dissociation is possible. d. substance abuse makes it difficult to differentiate these disorders.

ANSWER: a 97. The common feature in almost every case of DID is a. hallucinations and delusions. b. unrelenting substance abuse. c. a history of body dysmorphic disorder. d. a history of severe child abuse.

ANSWER: d 98. The causes of dissociative identity disorder appear to be a. physical abuse b. sexual abuse c. witness to a traumatic event d. all of these ANSWER: d

.

99. A comparison of dissociative reactions in "normals" and in DID patients indicates that the experience of dissociation is _____________in normal versus DID patients. a. very different b. very similar c. identical d. so different as to have no similarities at all ANSWER: a 100. Some theorists suggest that dissociative identity disorder is an extreme subtype of . a. dissociative amnesia b. obsessive-compulsive disorder c. posttraumatic stress disorder d. antisocial personality disorder ANSWER: c 101. According to the autohypnotic model, people who are suggestible may be a. able to create false memories to ease their trauma. b. able to use dissociation as a defense against extreme trauma. c. able to remember the trauma that created the false memories. d. unable to switch at will.

ANSWER: b 102. Which of the following statements is TRUE about DID? a. DID is easy to fake. b. DID is absolutely impossible to fake. c. Dissociative symptoms may be the result of sleep deprivation. d. DID is made up of false memories.

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Chapter 06 Chapter 6 Preoccupation and Obsession ANSWER: c 103. Studies suggest that false memories are a. difficult to create b. easily created in children c. unrelated to suggestions d. very rare ANSWER: b

.

104. There is now incontrovertible evidence that the following statement is TRUEwith respect to the accuracy of recovered memories: a. False memories can be created, and selective dissociative amnesia can occur for early traumatic experiences. b. False memories can be created, but there is no evidence of selective dissociative amnesia for early traumatic experiences. c. False memories cannot be created, and individuals do not develop selective dissociative amnesia for early trauma. d. False memories cannot be created, but there is evidence that individuals do develop selective dissociative amnesia for early trauma ANSWER: a 105. In studies conducted by Elizabeth Loftus and her colleagues (Loftus, 2003; Loftus, Coan, and Pickrell, 1996), individuals were told about false events that had supposedly occurred when they were children. The results of this study indicated that a. people cannot be convinced of events that did not happen. b. people can become quite convinced of events that never happened. c. only individuals with diagnosable disorders can be convinced of events that never happened. d. people can become convinced of events that did not happen only during hypnosis or other dissociative states.

ANSWER: b 106. While interviewing 129 women with documented histories of childhood sexual abuse, Willams (1994) found with extensive questioning that a. every woman remembered minute details of the abuse. b. almost none of the women recalled the abuse. c. 38% of the women did not recall the abuse. d. 75% of the women did not recall the abuse.

ANSWER: c 107. Goodman et al. (2003) interviewed 175 individuals with documented child abuse histories and found that ______ of the subjects remembered and reported the abuse. a. 25% b. 53% c. 81% d. 100% ANSWER: c 108. The part of the treatment plan for DID that is similar to the treatment plan for posttraumatic stress disorder is Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession a. integration of personality fragments. b. use of antipsychotic medications. c. reliving the trauma (catharsis). d. hypnotic regression to early life experiences.

ANSWER: c Subjective Short Answer 109. Describe the factors that contribute to anxiety, focusing on physical sensations and illness in illness anxiety disorder.

ANSWER: Illness anxiety disorder is characterized by severe anxiety about the possibility of having a serious disease, which is not eliminated by medical reassurance that the person is healthy.

Individuals who develop illness anxiety disorder may have learned to focus on their anxiety of specific physical conditions from family members. Also, illness anxiety disorder seems to develop in the context of a stressful event. People who develop illness anxiety disorder tend to have had a disproportionate incidence of disease in their family when they were children.

People who come from families where illness is a major issue seem to learn that an ill person often gets a lot of attention. The benefits of being sick might contribute to development of the disorder.

110. Women are more likely than men to be diagnosed with Somatic Symptom Disorder. Why do you think that this is the case?

ANSWER: Many health messages are targeted directly to women themselves or to women who are the assumed overseers of health for the family. Women may be disproportionally exposed to worrisome health messages.

Women are also more likely to report anxiety, which is central in the development of Somatic Symptom Disorder. Finally, it may be more socially acceptable for women to complain about symptoms of illness and can provide a source of socially appropriate attention for them.

111. Apply the Integrative Model of Causes of Hypochondriasis to partially explain the sharp increase in mammograms in Breast Cancer Awareness Month.

ANSWER: Answers will vary but must include information and/or a figure like that in 6.1. For “triggers,” students may report that women are disproportionally likely to have breast cancer. For example, in the month of October, much media attention will be focused on breast cancer awareness. For some women, this can lead to apprehension and increased focus on the body, etc. Normal variations in breast tissue can sometimes be mistaken for cancerous lumps.

112. How might medical doctors help alleviate dissociative disorders in their patients in their normal course of duty?

ANSWER: The text and several studies (described on page 188) show that doctors can be key allies for patients with Somatic Symptom Disorder. Spending time reassuring patients and providing education for them about normal bodily function is key. Doctors can provide detailed information about any illness that they may have and this could reduce the anxiety surrounding their symptoms. One difficulty with this is that in the age of managed care, doctors may not have the time to provide this extra reassurance with the patient. Open dialogue between the patient and health care provider regarding Somatic Symptom Disorder will increase the possibility of this avenue of treatment.

113. Describe one normal dissociative experience. How would you differentiate this from a Dissociative Disorder?

ANSWER: Some dissociation is normal, particularly when someone is experiencing an impactful physiological situation such as extreme fatigue, hunger, cold, etc. One example is feeling in a “fog” after skipping breakfast and lunch. Dissociative Identity Disorders (DID) are characterized as persistent depersonalization or derealization where reality testing remains intact. DID is also associated with clinically significant distress or impairment that cannot otherwise be explained by the physiological situation or substance use.

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Chapter 06 Chapter 6 Preoccupation and Obsession 114. Describe a common treatment for dissociative disorders which are linked to a traumatic event.

ANSWER: Treatment of dissociative disorders can involve helping the patient build better coping skills before reexperiencing the traumatic event in a controlled matter. Therapy is often long-term and requires great trust between the therapist and patient.

115. Describe how conversion reactions, real physical disorders, and outright malingering can be differentiated.

ANSWER: It turns out that indifference to symptoms is not a reliable distinguishing factor, and it can be difficult to tell these conditions apart. However, conversion symptoms are often precipitated by stress, although the person is not aware of his/her own inabilities. Malingerers may also have clear goals or benefits behind their actions, while physical illness may be a significant stressor to people who are truly ill.

116. Compare and contrast depersonalization-derealization disorder and dissociative amnesia.

ANSWER: Depersonalization-derealization disorder is characterized by severe feelings of unreality.

Individuals with the disorder tend to have deficits in attention, short-term memory, and spatial reasoning.

Dissociative amnesia involves the inability of individuals to remember details from their own life, which can be generalized or localized in relation to a specific, usually traumatic, event. Although both may be triggered by trauma, people with depersonalization are aware of their own personal history and details.

117. Discuss the controversy surrounding false memories.

ANSWER: A controversial issue in abnormal psychology involves the extent to which memories of early trauma, particularly sexual abuse, is really accurate or not. Some argue that these memories are simply the result of strong suggestions by therapists, others believe they reflect memories that were repressed and must be reexperienced to relieve suffering. It turns out memory can be altered through suggestion, therefore the use of recovered memories legally has been especially problematic. Children in particular may be affected by how questions about past events are phrased. Further research is required to resolve these issues.

Essay 118. Describe the factors that contribute to anxiety, focusing on physical sensations and illness in illness anxiety disorder.

ANSWER: Illness anxiety disorder is characterized by severe anxiety about the possibility of having a serious disease, which is not eliminated by medical reassurance that the person is healthy.

Individuals who develop illness anxiety disorder may have learned to focus on their anxiety of specific physical conditions from family members. Also, illness anxiety disorder seems to develop in the context of a stressful event. People who develop illness anxiety disorder tend to have had a disproportionate incidence of disease in their family when they were children.

People who come from families where illness is a major issue seem to learn that an ill person often gets a lot of attention. The benefits of being sick might contribute to development of the disorder.

119. Women are more likely than men to be diagnosed with Somatic Symptom Disorder. Why do you think that this is the case?

ANSWER: Many health messages are targeted directly to women themselves or to women who are the assumed overseers of health for the family. Women may be disproportionally exposed to worrisome health messages.

Women are also more likely to report anxiety, which is central in the development of Somatic Symptom Disorder. Finally, it may be more socially acceptable for women to complain about symptoms of illness and can provide a source of socially appropriate attention for them.

120. Apply the Integrative Model of Causes of Hypochondriasis to partially explain the sharp increase in mammograms in Breast Cancer Awareness Month.

ANSWER: Answers will vary but must include information and/or a figure like that in 6.1. For “triggers,” students may report that women are disproportionally likely to have breast cancer. For example, in the month of October, Copyright Cengage Learning. Powered by Cognero.

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Chapter 06 Chapter 6 Preoccupation and Obsession much media attention will be focused on breast cancer awareness. For some women, this can lead to apprehension and increased focus on the body, etc. Normal variations in breast tissue can sometimes be mistaken for cancerous lumps.

121. How might medical doctors help alleviate dissociative disorders in their patients in their normal course of duty?

ANSWER: The text and several studies (described on page 188) show that doctors can be key allies for patients with Somatic Symptom Disorder. Spending time reassuring patients and providing education for them about normal bodily function is key. Doctors can provide detailed information about any illness that they may have and this could reduce the anxiety surrounding their symptoms. One difficulty with this is that in the age of managed care, doctors may not have the time to provide this extra reassurance with the patient. Open dialogue between the patient and health care provider regarding Somatic Symptom Disorder will increase the possibility of this avenue of treatment.

122. Describe one normal dissociative experience. How would you differentiate this from a Dissociative Disorder?

ANSWER: Some dissociation is normal, particularly when someone is experiencing an impactful physiological situation such as extreme fatigue, hunger, cold, etc. One example is feeling in a “fog” after skipping breakfast and lunch. Dissociative Identity Disorders (DID) are characterized as persistent depersonalization or derealization where reality testing remains intact. DID is also associated with clinically significant distress or impairment that cannot otherwise be explained by the physiological situation or substance use.

123. Describe a common treatment for dissociative disorders which are linked to a traumatic event.

ANSWER: Treatment of dissociative disorders can involve helping the patient build better coping skills before reexperiencing the traumatic event in a controlled matter. Therapy is often long-term and requires great trust between the therapist and patient.

124. Describe how conversion reactions, real physical disorders, and outright malingering can be differentiated.

ANSWER: It turns out that indifference to symptoms is not a reliable distinguishing factor, and it can be difficult to tell these conditions apart. However, conversion symptoms are often precipitated by stress, although the person is not aware of his/her own inabilities. Malingerers may also have clear goals or benefits behind their actions, while physical illness may be a significant stressor to people who are truly ill.

125. Compare and contrast depersonalization-derealization disorder and dissociative amnesia.

ANSWER: Depersonalization-derealization disorder is characterized by severe feelings of unreality.

Individuals with the disorder tend to have deficits in attention, short-term memory, and spatial reasoning.

Dissociative amnesia involves the inability of individuals to remember details from their own life, which can be generalized or localized in relation to a specific, usually traumatic, event. Although both may be triggered by trauma, people with depersonalization are aware of their own personal history and details.

126. Discuss the controversy surrounding false memories.

ANSWER: A controversial issue in abnormal psychology involves the extent to which memories of early trauma, particularly sexual abuse, is really accurate or not. Some argue that these memories are simply the result of strong suggestions by therapists, others believe they reflect memories that were repressed and must be reexperienced to relieve suffering. It turns out memory can be altered through suggestion, therefore the use of recovered memories legally has been especially problematic. Children in particular may be affected by how questions about past events are phrased. Further research is required to resolve these issues.

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Chapter 08 Mood Multiple Choice 1. “Depressive neuroses” were more formalized and named Mood Disorders beginning in the: a. 1890s. b. 1920s. c. 1960s . d. 1980s.

ANSWER: d 2. Prior to the DSM-III, conditions that are currently characterized as mood disorders were referred to by several different names, including all of the following EXCEPT a. depressive disorders. b. affective disorders. c. psychotic episodes. d. depressive neuroses.

ANSWER: c 3. The physical symptoms of a major depressive disorder include a. changes in appetite or weight. b. decreased ability to concentrate. c. increased energy. d. decreased self-esteem ANSWER: a 4. One of the symptoms of a mood disorder is called anhedonia, which means a. a feeling of worthlessness. b. an altered pattern of sleep. c. indecisiveness. d. an inability to engage in pleasurable activities.

ANSWER: d 5. Mood disorders can range from mild to severe; the most severe type of depression is called a. major depressive disorder b. dysthymia. c. cyclothymia. d. profound depression.

ANSWER: a 6. The first episode of major depression is usually time-limited—often lasting up to a. 3 months b. 6 months c. 9 months d. 1 year ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood 7. Which of the following is a symptom of a manic mood state? a. Clear, coherent speech b. Hypoactive behavior c. Fatigue d. Grandiose planning ANSWER: d 8. When used in connection with mood disorders, "flight of ideas" means a. anxiety about airplane travel. b. rapid speech expressing many exciting ideas at once. c. limited imagination reflected in a slow way of speaking. d. repression of all creative ideas.

ANSWER: b 9. In comparing the length of untreated depressive episodes to untreated manic episodes, which of the following is an accurate statement? a. Depressive episodes generally last longer. b. Manic episodes generally last longer. c. Both types of episodes typically last about the same amount of time. d. This comparison cannot be made because depressive episodes are always treated.

ANSWER: a 10. Which of the following are true about hypomanic episodes: a. They are generally less severe than manic episodes. b. They do not cause marked impairment in social functioning. c. They generally last less than a week. d. All of the above are correct.

ANSWER: d 11. Which of the following is NOT TRUE about a hypomanic episode? a. It is not necessarily problematic. b. It does contribute to the definition of several mood disorders. c. It causes marked impairment in social or occupational functioning. d. It need only last 4 days.

ANSWER: c 12. A 35-year-old individual named Manny has recently formulated an elaborate plan to cure AIDS with vitamin therapy.

To provide funding for this cause, he has withdrawn all the money from his bank account and purchased thousands of jars of vitamins and small boxes in which to put them. When he appeared at a hospital emergency room loudly demanding names of patients with AIDS, he himself was hospitalized for psychiatric observation. What is your diagnosis of Manny? a. Major depressive episode b. Hypomanic episode c. Manic episode d. Postpartum psychosis Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood ANSWER: c 13. Unipolar mania a. does not exist. b. is rare. c. is fairly common. d. is a part of bipolar disorder.

ANSWER: b 14. During a dysphoric manic episode, the patient experiences mania and a. schizophrenia b. confusion c. anxiety and depression d. anger ANSWER: c

.

15. Dysphoric mania refers to a type of mood disorder in which manic episodes are a. extremely severe. b. very mild. c. accompanied by depression or anxiety. d. related to a medical condition.

ANSWER: c 16. Most individuals who experience a single episode of major depressive disorder will a. never have another episode. b. most likely have just one more episode. c. probably have several episodes throughout their lives. d. later have a manic episode.

ANSWER: c 17. Debbie has been diagnosed with major depressive disorder, recurrent. She wants to know what to expect in the future regarding her condition. You tell her that according to recent research the median lifetime number of major depressive episodes is . a. 2 to 3 b. 4 to 7 c. 8 to 11 d. 12 to 15 ANSWER: a 18. Persistent depressive disorder (formerly called dysthymia) differs from major depressive disorder because people diagnosed with dysthymia have symptoms of depression that are . a. more severe b. longer-lasting c. episodic Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood d. temporary ANSWER: b 19. Jack has experienced recurrent episodes of major depressive episodes. In the intervals between the episodes, he does not seem to return to "normal." In fact, during those periods, he has been diagnosed as suffering from persistent depressive disorder. Jack's condition is referred to as . a. double depression b. bipolar disorder c. atypical depression d. dysfunctional dysthymia ANSWER: a 20. A person who experiences a persistent depressed mood for at least 2 years but is not experiencing major depression may have a. persistent depressive disorder. b. cyclothymic disorder. c. bipolar disorder. d. double depression.

ANSWER: a 21. After fun weekends with her friends, Anna-Kate feels very down most Mondays. She has trouble focusing on her work. She has recently gained 20 pounds and is often tearful. What DSM-5 criteria does Anna-Kate NOT meet for a depression diagnosis: a. Significant weight gain/loss. b. Diminished ability to concentrate. c. Feeling sad. d. Occurrence most of the day nearly every day.

ANSWER: d 22. Milton has been mildly depressed for many years. Just recently, however, his depression deepened, and he was severely depressed for about three months. His deep depression then lifted and he was once again mildly depressed.

Milton a. will be easier to treat now that the severe depression is resolved. b. will quickly respond to treatment and will recover completely from his depression. c. will require a longer and more intense course of treatment to maintain a normal mood state. d. will require treatment for the rest of his life.

ANSWER: c 23. Katie has been diagnosed with major depressive disorder. Most recently, she has been lying immobile for long periods. If someone moves one of her arms to a different position, it just stays there. Katie has stopped speaking and does not appear to hear what is being said to her. What specifier would you apply to her diagnosis of major depressive disorder? a. Chronic b. With catatonic features c. With atypical presentation Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood d. Melancholic ANSWER: b 24. Which of the following is NOT one of the criteria for a manic episode: a. inflated self-esteem. b. more talkative than usual. c. ideas that seem to be racing. d. ability to concentrate.

ANSWER: d 25. Tamara gave birth to a healthy child 4 days ago. Now she is tearful and having mood swings. Fortunately, these symptoms disappeared relatively quickly. Tamara was probably suffering from . a. major depressive disorder with peripartum onset b. baby blues c. persistent depressive disorder d. major depressive episode with seasonal onset ANSWER: b 26. A person who eats and sleeps too much is experiencing a depressive episode with features. a. atypical b. melancholic c. chronic d. catatonic ANSWER: a 27. The melancholic specifiers for depressive disorders include all of the following EXCEPT a. weight loss. b. loss of libido (sex drive). c. sleeping late and hypersomnia. d. anhedonia.

ANSWER: c 28. Although catatonic symptoms occur in major depressive disorders, they are more frequently associated with ______________. a. phobias b. somatoform disorders c. dissociative identity disorder d. schizophrenia ANSWER: d 29. The peripartum onset specifier is used to characterize a severe manic or depressive episode with psychotic features that occurs in a woman immediately before or after . a. childbirth b. a hysterectomy Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood c. a physical assault d. menopause ANSWER: a 30. In rare tragic cases, a mother suffering from major depression with peripartum onset sometimes a. kills her child. b. commits suicide. c. murders other people's children. d. injures the child's father.

ANSWER: a 31. The most usual pattern of a temporal specifier in major depressive disorder occurs in the late fall and ends with the beginning of spring. This type of depression is known as . a. melancholic b. recurrent c. postpartum d. seasonal affective disorder ANSWER: d 32. Which of the following statements applies to the condition known as seasonal affective disorder (SAD)? a. Women with SAD reported more autonomous negative thoughts throughout the year than women without SAD. b. People with SAD have symptoms of decreased sleep and decreased appetite. c. Depression in vulnerable people might be triggered by decreased production of the hormone called melatonin. d. SAD can be treated with phototherapy, i.e., 2 hours of exposure to bright light just before going to sleep.

ANSWER: a 33. Morning light is thought to help with seasonal affective disorder because it a. produces phase advances of the melatonin rhythm. b. reverses melatonin release. c. increases the amount of melatonin released. d. eliminates melatonin release.

ANSWER: a 34. An effective treatment for SAD is a. exposure to bright light shortly after awakening. b. exposure to bright light in the evening. c. exposure to a negative ion generator shortly after awakening. d. exposure to a negative ion generator in the evening.

ANSWER: a 35. Light Therapy for SAD has been shown to provide relief from depressive symptoms in: a. the first day of exposure. b. the first night of exposure.

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Chapter 08 Mood c. the first week of exposure. d. Never-light therapy has not be found to be effective in providing relief for SAD. ANSWER: c 36. According to recent research (Kessler et al., 2003), the percentage of people aged 18 to 29 that have already experienced major depression is . a. 10% b. 18% c. 25% d. 40% ANSWER: c 37. How many patients with severe cases of depression where the episode lasts 5 years or longer can be expected to recover? a. 4% b. 22% c. 38% d. 56% ANSWER: c 38. The probability that a person will recover from a major depressive episode within 1 year approaches 90% in _________________. a. almost all cases b. mild cases only c. severe cases only d. double depression only ANSWER: a 39. Symptoms of severe depression are generally NOT considered a psychological disorder when they are associated with ________________. a. a grief reaction b. a manic episode c. anxiety d. thoughts of suicide ANSWER: a 40. Children who may have been diagnosed with _____ in the past are now typically diagnosed with ______. a. Bipolar I or II: Disruptive Mood Dysregulation Disorder b. OCD: PTSD c. SAD: Depression d. Anger: SAD ANSWER: a 41. Which of the following is not true of children diagnosed with Disruptive Dysregulation Mood Disorder? a. They have chronic irritability.

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Chapter 08 Mood b. They have temper tantrums often. c. They frequently have manic episodes. d. All of the above answers are true.

ANSWER: c 42. A woman who is extremely depressed a year or so after the loss of her spouse might be diagnosed with ___________. a. normal bereavement b. dysthymia c. major depression d. complicated grief ANSWER: d 43. Although grieving is considered a normal process, it does sometimes become a psychological disorder. Which of the following cases would NOT be diagnosed as a pathological grief reaction? a. Mr. A experienced a death in his family. In addition to symptoms of depression, he has been having auditory hallucinations in which he hears other deceased people talking to him. b. Miss B. has experienced the death of a close friend. She is so depressed that she has no appetite, no energy, and is suicidal. c. Mrs. C's dog recently died. Three weeks later, her friends suggest that she get another dog "to help her get over the loss." Mrs. C. refuses and says she just isn't ready to get another dog and besides, it would be impossible to replace her beloved "Toto." d. Dr. D's wife died a few months ago. Recently, in addition to his depressive symptoms, he has been having paranoid delusions in which he believes that certain unnamed individuals are planning to remove his wife's body from the grave.

ANSWER: c 44. If a friend of yours stops sleeping and suddenly claims that he is going to go to law school and medical school simultaneously so he can change the world, you might suspect he is . a. anxious b. depressed c. manic d. anhedonic ANSWER: c 45. Andy is currently completing a chemical formula that he knows will cure cancer. Shortly before, he had submitted a book to a publisher and was sure that it would become a bestseller. For several weeks prior to this, he was bedridden, morose, had no energy, and lacked any spontaneity. He never left his bed and had to be cared for by his family. Andy's diagnosis is . a. major depressive disorder b. persistent depressive disorder c. bipolar I disorder d. bipolar II disorder ANSWER: d 46. Bipolar II disorder consists of Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood a. depression with hypomanic episodes. b. depression with anxiety. c. depression with mania. d. depression with dysthymia.

ANSWER: a 47. Jane is diagnosed with bipolar II disorder. You can expect that she will experience a. full manic episodes. b. hypomanic episodes. c. both manic and hypomanic episodes. d. neither manic nor hypomanic episodes.

ANSWER: b 48. When manic episodes alternate with depressive episodes, the disorder most correctly diagnosed would be a. bipolar disorder. b. major depressive disorder. c. bipolar II disorder d. cyclothymic disorder ANSWER: a 49. Recent evidence indicates a higher level of ______ in patients with bipolar disorder that was marked by a rapid cycling pattern compared to those with a non-rapid cycling pattern. a. treatment response b. resistance to treatment c. medication side effects d. suicide ANSWER: d 50. Suicide associated with bipolar disorder almost always occurs during a. a manic phase. b. depressive episode. c. a prodromal period. d. a hypomanic phase.

ANSWER: b 51. The rapid-cycling specifier refers to an individual with bipolar disorder who experiences at least _____ manic or depressive episodes in a year. a. 2 b. 4 c. 6 d. 8 ANSWER: b 52. In studies of bipolar patients who experience rapid cycling, it has been found that from 60% to 90% are Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood _________. a. female b. male c. elderly d. adolescents ANSWER: a 53. At various times, Cynthia, a 20-year-old college student, has been considered by her family and/or friends to be moody, high-strung, explosive, or hyperactive. She never fails to take care of her responsibilities, but the fact that she seems to experience mood swings that are outside the norm has been noticed by those around her. Knowing the criteria for mood disorders, you would diagnose Cynthia with . a. major depressive disorder b. panic disorder c. persistent depressive disorder d. cyclothymic disorder ANSWER: d 54. When referring to the mood disorders called cyclothymia and persistent depressive disorder, it would be accurate to say that an individual with cyclothymia probably a. would be considered "moody." b. cannot function normally at all. c. has more depressive episodes. d. has full manic episodes.

ANSWER: a 55. The less severe but more chronic version of bipolar disorder is called a. dysphoric b. seasonal affective c. bipolar III d. cyclothymic ANSWER: d 56. In about a. 25% to 33% b. 33% to 50% c. 50% to 66% d. 10% to 20% ANSWER: b

disorder.

patients, cyclothymic mood swings develop into full-blown bipolar disorder.

57. Approximately ______ experience major depressive disorder over a lifetime and approximately ______ in the last year. a. 11%; 4% b. 16%; 6% c. 21%; 8% d. 25%; 10% Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood ANSWER: b 58. With regard to the prevalence of mood disorders, which of the following has been found consistently? a. Females experience major depressive disorders less frequently than males. b. Men have twice as many mood disorders as women. c. Bipolar disorders occur equally across the sexes. d. Dysthymia occurs equally across the sexes.

ANSWER: c 59. Depression rates in adolescents appear to be a. increasing. b. leveling off. c. about the same as adults. d. decreasing.

ANSWER: c 60. All of the following are accurate statements about the prevalence of mood disorders in children and adolescents EXCEPT: a. Bipolar disorder in children is often misdiagnosed as attention deficit hyperactivity disorder (ADHD). b. Major depressive disorder in adolescents is largely a female disorder. c. Rates of attempted suicide decrease during adolescence. d. Adolescents with bipolar disorder may become aggressive, impulsive, sexually provocative, and accidentprone.

ANSWER: c 61. A child raised by depressed parents is likely to a. struggle with depression as well. b. learn how to avoid depression. c. be inoculated against depression. d. deny stress symptoms.

ANSWER: a 62. A common characteristic of depression in boys is a. aggression b. passiveness c. shyness d. coping behavior ANSWER: a

.

63. Which of the following is TRUE of depression in the elderly? a. Being depressed triples the risk of death in the elderly. b. Suicide rates are the second highest of any age group due to depression. c. The prevalence of depression is almost equal among elderly men and women. d. All of the above Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood ANSWER: c 64. Being depressed a. has no effect b. doubles c. triples d. reduces

the risk of death in elderly patients who have had a stroke or heart attack.

ANSWER: b 65. Cross-cultural research indicates that, due at least in part to appalling social and economic conditions, the prevalence of major depression is extremely high among . a. African Americans b. Hispanic Americans c. Asian Americans d. Native Americans ANSWER: d 66. According to your textbook, researchers have been studying the life histories of American poets to determine if there is a relationship between creativity and . a. anxiety b. bipolar disorder c. dissociation d. schizophrenia ANSWER: b 67. In research looking at the biological causes of mood disorders, studies have shown that if one of a set of twins has a mood disorder, the probability that the other twin will have a mood disorder is . a. 29% b. 42% c. 66% d. 81% ANSWER: c 68. Which of the following statements is TRUE? a. Overwhelming evidence suggests mood disorders are familial and reflect an underlying genetic vulnerability. b. Studies are now beginning to identify a small group of genes that may contribute to genetic vulnerability to some types of depression. c. The genetic contribution to depression falls in the range of approximately 40% for females and 20% for males. d. All of the above ANSWER: d 69. Recent research suggests that a. social and psychological explanations seem to account for factors that contribute to both anxiety and depression.

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Chapter 08 Mood b. for mania, the biological vulnerability may not be specific to that disorder. c. the same genetic factors contribute to both anxiety and depression. d. All of the above ANSWER: c 70. Current research into neurotransmitter systems has produced the "permissive" hypothesis, which states that a. low levels of serotonin are sufficient to explain the etiology of mood disorders. b. the norepinephrine system regulates serotonin levels; if norepinephrine is low, depression will occur. c. when serotonin levels are low, other neurotransmitter systems become dysregulated and contribute to mood irregularities. d. the absolute levels of neurotransmitters are more significant in mood regulation than the overall balance of the various neurotransmitters.

ANSWER: c 71. A friend of yours tells you that he thinks he is mildly depressed, but he's not sure. Knowing that you are studying abnormal psychology, he asks if there is any kind of laboratory test that could determine whether or not someone is depressed. You respond correctly with one of the following statements: a. Currently there is no way of diagnosing depression with a laboratory test. b. The dexamethasone suppression test is a biological test for depression. c. The dexamethasone suppression test can only be used to diagnose severe cases of depression. d. Cortisol levels are decreased in depression; he could have his cortisol levels checked by a blood test.

ANSWER: a 72. In regard to most disorders, serotonin is thought to a. function independently of other neurotransmitters. b. regulate other neurotransmitters, such as norepinephrine and dopamine. c. be unrelated to symptoms. d. none of the above.

ANSWER: b 73. The best conclusion about the dexamethasone suppression test (DST) for the diagnosis of depression is that a. it is accurate. b. it is effective but cannot differentiate bipolar disorder from major depression. c. it promises to be an effective diagnostic tool in the future. d. it is not useful as a diagnostic tool.

ANSWER: d 74. Recent research suggests that a. the suppression of neurogenesis in the hippocampus is due to the connection between high stress hormones and depression. b. low hippocampal volume may precede and contribute to the onset of depression c. electroconvulsive therapy seems to produce neurogenesis in the hippocampus d. all of the above.

ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood 75. One symptom of depression is an increase in sleeping. What other symptoms related to sleep occur in depression? a. A reduction of slow-wave (deep) sleep b. Less intense REM activity c. Stages of deepest sleep occurring earlier in the sleep cycle d. Slower onset of REM sleep ANSWER: a 76. Which of the following is NOT characteristic of the sleep of depressed patients? a. They enter REM sleep quickly. b. They experience intense REM episodes. c. They show delayed slow wave sleep. d. They show advanced slow wave sleep.

ANSWER: d 77. Depressive individuals tend to exhibit a. greater right anterior brain activity. b. greater left anterior brain activity. c. more alpha wave activity. d. less overall brain activity.

ANSWER: a 78. In regard to the relationship between stress and depression, all of the following statements are true EXCEPT a. the context of the life event, as well as its meaning to the individual, is more important than the nature of the event itself. b. an individual's current mood state might distort earlier memories of stressful life events that precipitated the depression. c. stressful life events are strongly related to the onset of mood disorders. d. recurrent episodes of depression, but not initial episodes, are strongly predicted by major life stress.

ANSWER: d 79. When individuals who are biologically vulnerable to depression place themselves in high-risk stressful environments, it is called a. humoral theory. b. the cognitive-behavioral model. c. the gene-environment correlation model. d. a stress-depression linkage effect.

ANSWER: c 80. Stressful events are strongly related to the onset of a. depression b. bipolar disorder c. both d. neither Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood ANSWER: c 81. Martin Seligman's theory that people become anxious and depressed because they believe that they have no control over the stress in their lives is called a. the learned helplessness theory. b. cognitive-behavioral theory. c. humanistic/existential theory. d. the control theory of depression.

ANSWER: a 82. In 1989, Abramson and his colleagues revised Seligman's theory of learned helplessness, changing the focus from specific attributions to as the crucial factor in depression. a. lack of control b. a sense of hopelessness c. repressed anger d. a feeling of failure ANSWER: b 83. A student who has been doing very well in her psychology class receives a minor critical comment on an essay that she wrote as part of an exam. The student thinks, "This is terrible. I'm probably going to fail the course." This type of cognitive error in thinking is called . a. arbitrary inference b. overgeneralization c. splitting d. dissociating ANSWER: b 84. Regarding Beck's views on depression, which of the following definitions of cognitive errors and negative schema is NOT correct? a. In a self-blame schema, depressed individuals feel personally responsible for every bad thing that happens. b. Arbitrary inference means that a depressed individual emphasizes the positive rather than the negative aspects of a situation. c. In a negative self-evaluation schema, depressed individuals believe that they can never do anything correctly. d. Overgeneralization occurs when a small error is magnified to mean something much more significant.

ANSWER: b 85. Negative cognitive styles are associated with a vulnerability to subsequent depression a. in people in general. b. in people who have already been depressed. c. only in people who are currently depressed. d. only in women.

ANSWER: a 86. According to recent research on the development of depression, dysfunctional attitudes (a negative outlook) and hopelessness attributes (explaining things negatively) constitute a vulnerability to depression.

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Chapter 08 Mood a. biological b. cognitive c. behavioral d. sociological ANSWER: b 87. In Aaron Beck's depressive cognitive triad, individuals think negatively about all of the following EXCEPT ________. a. themselves b. their immediate world c. their past d. their future ANSWER: c 88. For individuals who had not been previously depressed, research studies indicate that a marital separation or divorce resulted in a. a higher rate of depression in men. b. a higher rate of depression in women. c. approximately equal rates of depression for males and females. d. no symptoms of depression in either males or females.

ANSWER: a 89. Possible reasons for the higher rates of depression found in women include all of the following EXCEPT a. culturally induced dependence and passivity. b. sense of uncontrollability and helplessness. c. low value placed on intimate relationships. d. self-blame for being depressed.

ANSWER: c 90. Possible reasons for the higher rates of depression found in women relate to the disadvantages experienced by women in the United States such as a. discrimination and poverty. b. abuse and sexual harassment. c. both of these d. none of these ANSWER: c 91. With regard to social support, a. having one close friend did not affect depression rates. b. having social support helped speed recovery from depressive episodes. c. having social support had no effect in China. d. having social support helped speed recovery from manic episodes.

ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood 92. The Integrative Model of Mood Disorders shows that: a. biological and psychological vulnerabilities partially explain disorders. b. that interpersonal problems are irrelevant to mood disorders. c. that social support is irrelevant to mood disorders. d. that being adopted increases your chances of a mood disorder by 25%.

ANSWER: a 93. Which of the following is NOT a symptom of mania in the Integrative Model of Mood Disorders: a. feeling powerful. b. increased risk-taking. c. impulsivity. d. irritability.

ANSWER: d 94. Which of the following factors contribute to the integrative theory of depression? a. Stressful life events b. Stress hormones c. Neurotransmitter systems d. All of these ANSWER: d 95. The following types of medications are all used to treat depression EXCEPT a. SSRIs. b. mixed reuptake inhibitors. c. MAO inhibitors. d. GABA inhibitors.

ANSWER: a 96. Which of the following is perhaps the best-known and widely used SSRI medication? a. Prozac b. Valium c. Hypericum d. Thorazine ANSWER: a 97. The antidepressant medications known as imipramine (Tofranil) and amitriptyline (Elavil) are included in the class of drugs called a. SSRIs. b. tricyclics. c. MAO inhibitors. d. tranquilizers.

ANSWER: b 98. The class of drugs that blocks the enzyme that breaks down norepehinephrine and serotonin is Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood a. SSRIs. b. tricyclics. c. MAO inhibitors. d. tranquilizers.

ANSWER: c 99. Which of the following statements is TRUE about tricyclics? a. Tricyclics work within 24 hours after they are ingested. b. They can be accompanied by very unpleasant side effects. c. Tricyclics block the reuptake of acetylcholine. d. Weight loss is a side effect of taking a tricyclic.

ANSWER: b 100. Side effects of the tricyclic antidepressants include . a. weight loss b. excessive urination c. sexual dysfunction d. diarrhea ANSWER: c 101. Clinical studies have shown that the response rate for patients receiving at least some relief from depressive symptoms is approximately --. a. 25% b. 50% c. 75% d. 100% ANSWER: b 102. Studies have shown that tricyclics have caused a. manic episodes in the elderly. b. severe weight loss in adolescents. c. sudden death in some children under 14 years old. d. all of the above ANSWER: c 103. With regard to treatment of mood disorders, which of the following statements is accurate? a. Patients do not recover from episodes of major depression without treatment. b. Delaying or preventing future episodes of major depression is an important treatment goal. c. After a patient has experienced a major depressive episode and recovered, treatment can be discontinued. d. Close to 100% of patients with major depressive disorder respond to drug treatment.

ANSWER: b 104. A goal of treatment for patients who have experienced major depressive disorders is delaying or preventing the next episode. In which of the following situations would this goal be LEAST important?

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Chapter 08 Mood a. Patients who have recovered from a major depressive episode but still have some residual symptoms b. Patients with a past history of chronic depression (dysthymia) c. Patients with a past history of multiple episodes of major depressive disorder d. Patients who have had a single, brief episode of major depressive disorder and recovered without treatment ANSWER: d 105. All of the following are side effects of lithium therapy EXCEPT a. lowered thyroid functioning b. weight loss c. toxicity d. lack of energy ANSWER: b

.

106. All of the following statements about lithium therapy are true EXCEPT a. lithium can act as an antidepressant. b. lithium can act as a mood stabilizer. c. dosage must be carefully regulated to prevent toxicity. d. the side effects of lithium are less serious than those of other antidepressants.

ANSWER: d 107. A relative of yours has been diagnosed with bipolar disorder. Your family is impressed when you mention that the preferred drug for this condition is . a. Prozac b. St. John's Wort c. an anticonvulsant d. lithium ANSWER: d 108. All of the following statements about lithium therapy are true EXCEPT a. for those patients who respond to lithium, approximately 70% will relapse. b. for anyone with recurrent manic episodes, maintenance on lithium is recommended to prevent relapse. c. once a person is symptom-free for 6 months, he/she may stop taking lithium. d. people stop taking lithium to regain the euphoric feeling that mania produces.

ANSWER: c 109. One of the problems encountered by psychiatrists who prescribe medication for patients with bipolar disorder is that patients often a. stop taking the medication in order to bring on a depressive state. b. stop taking the medication in order to bring on a manic state. c. overdose on the medication during a severe manic state. d. become addicted to the medications during a severe manic state.

ANSWER: b 110. The antidepressant medication lithium is also referred to as a mood stabilizer because it Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood a. increases the availability of both dopamine and norepinephrine in the brain. b. is less toxic than the SSRI medications. c. helps to prevent manic episodes. d. increases thyroid functioning, which results in improved mood stabilization.

ANSWER: c 111. Although electroconvulsive therapy (ECT) has been a controversial issue for decades, it is an effective treatment for depression especially when a. patients cannot afford antidepressant medication. b. patient response to antidepressant medication is poor. c. symptoms of depression are mild. d. a manic-depressive patient is currently experiencing a manic episode.

ANSWER: b 112. All of the following statements are true about ECT EXCEPT a. electric shock is administered directly to the brain for less than a second. b. patient response to antidepressant medication is poor. c. for severely depressed patients with psychotic features, approximately 25% of those not responding to medication will benefit. d. ECT treatments are administered every other day for a total of 6 to 10 treatments.

ANSWER: c 113. All of the following statements are accurate about electroconvulsive therapy (ECT) EXCEPT a. relief of symptoms can occur within a week or two with ECT. b. ECT treatment should be followed up with medication. c. short-term memory loss can be a side effect of treatment with ECT. d. psychotically depressed patients should be treated with ongoing medication, not ECT, even when response to those drugs is poor.

ANSWER: d 114. Recent research suggests that an equally effective alternative to some antidepressant medications that appears to alter electrical activity in the brain may be a. transcranial magnetic stimulation (TMS). b. electrocranial stimulation (ECS). c. magnetic resonance stimulation (MRS). d. positron cranial stimulation (PCS).

ANSWER: a 115. Interpersonal psychotherapy deals with all of the following interpersonal problems EXCEPT a. environmental interactions. b. acquiring new relationships. c. identification and correction of deficits in social skills. d. interpersonal role disputes.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood 116. Prevention of mood disorders in children and adolescents include all of the following EXCEPT a. universal programs. b. selected interventions. c. indicated interventions. d. milieu interventions.

ANSWER: d 117. Which of the following statements about suicide is correct? a. The suicide rate is high among African Americans but low among Native Americans. b. The suicide rate among adolescents in the U.S. is decreasing. c. For teenagers, suicide is the third leading cause of death after auto accidents and homicide. d. Females are more likely than males to die from suicide.

ANSWER: c 118. Research has found that low serotonin levels may be implicated in suicidal behavior because they affect all of the following EXCEPT . a. impulsivity b. instability c. agnosia d. overreactivity ANSWER: c 119. With regard to the relationship between mood disorders and suicide, which of the following statements reflects the current thinking on this issue? a. Suicide is often associated with psychological disorders, especially depression. b. All people who attempt suicide have mood disorders. c. A small percentage of adolescent suicides are an expression of severe depression. d. Suicide is generally a response to some disappointment in people who are otherwise psychologically healthy.

ANSWER: a 120. Statistics on suicide indicate that approximately one-quarter to one-half of all suicides are associated with _____________. a. alcohol use b. guns c. aggression d. work stress ANSWER: a 121. Although glorifying and romanticizing suicide in the media contributes to copycat suicides, it is more likely that the person copying the suicide is a. just doing it for attention. b. vulnerable due to an existing psychological disorder. c. not really serious about the suicide attempt. d. trying to impress others.

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Chapter 08 Mood ANSWER: b 122. Impulsive suicidal behavior is often a symptom of a. schizoid b. borderline c. obsessive-compulsive d. paranoid ANSWER: b

personality disorder.

123. Which of the following statements is accurate regarding the relationship between anxiety and depression? a. Many depressed patients are or have been anxious and many anxious patients are or have been depressed. b. Cognitive content (thinking) is more negative in anxious patients than in those with depression. c. A core symptom of anxiety is the inability to experience pleasure. d. Anxiety is often preceded by an episode of major depression.

ANSWER: a Subjective Short Answer 124. Compare and contrast the symptoms of major depressive episode, a manic episode, persistent depressive disorder, and hypomania.

ANSWER: Major depression is characterized by a depressed mood state that lasts at least 2 weeks and includes cognitive symptoms such as feeling worthless, disturbed physical function such as altered sleep or appetite, and the loss of interest and pleasure in activities and social interactions.

Mania is characterized by exaggerated elation euphoria, little sleep, rapid speech, and grandiose plans.

Persistent depressive disorder shares the symptoms of major depressive disorder, but the symptoms are milder. The condition, however, is more chronic, with symptoms lasting for a minimum of two years.

Hypomania is a less severe version of a manic episode that does not cause marked impairment in social or occupational functioning.

125. Discuss the symptoms, causes and treatments for seasonal affective disorder.

ANSWER: This disorder occurs during winter, in cold environments. People with SAD report excess sleep, increased appetite, and weight gain. It is thought to be related to seasonal changes in light that affect the production of melatonin by the pineal gland. SAD patients may produce too much melatonin, experience disrupted circadian cycles, and reports negative cognitions and a tendency toward rumination. Exposure to light, called phototherapy, is an effective treatment.

126. Discuss the relationship between depression and anxiety.

ANSWER: Research suggests that almost all depressed patients are anxious, but not all anxious patients are depressed. It appears that while anhedonia is key to depression, the key to anxiety is the experience of autonomic activation, which can also occur in depressed people. Research in this area suggests that we may eventually need to rethink our diagnostic criteria to combine anxiety and the mood disorders into one larger category.

127. Discuss the role of neurotransmitters, brain-wave activity, and negative cognitions in the etiology and treatment of depression.

ANSWER: Low levels of depression in relation to norepinephrine and dopamine are thought to be related to the etiology of depression. The permissive hypothesis argues that when serotonin levels are low, other neurotransmitters Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood are permitted to range more widely and so become deregulated. EEG studies suggest that depressed individuals exhibit greater right-side anterior activation in their brains and lower levels of such activity on the left side than non-depressed individuals. Negative thoughts or attributions about themselves, the immediate world, and the future are characteristic of depressed individuals.

Antidepressan t medications can effectively treat depression but may take several weeks to work, and symptoms may reappear when the medication is continued. Cognitive-based treatments take longer to work but can be instrumental in limiting later depression. The combination of both is often the most effective treatment.

128. Identify and explain the risk factors associated with suicide.

ANSWER: Family history: If a family member has committed suicide, there is an increased risk that someone else in the family will also. Research has shown that the offspring of family members who have attempted suicide had six times the risk compared to the offspring of nonattempters. If a sibling was the suicide attempter, this increased the risk even more.

Neurobiology: Research indicates that low levels of serotonin may be associated with suicide and violent suicide attempts. Low levels of serotonin are associated with impulsivity, instability, and a tendency to overreact in situations.

Existing Psychological Disorders: More than 80% of the people that kill themselves have an existing psychological disorder, usually a mood disorder, substance use disorder, or impulse control disorder.

Hopelessness, a specific component of depression, is a strong predictor of suicide. Alcohol use and abuse are associated with 25% to 50% of all suicides and are especially prominent in adolescent suicides Stressful Life Events: The most important risk factor for suicide appears to be a severe, stressful event.

Often a stressful event can put the person over the edge.

129. Recreate the Integrative Model of Mood Disorders. Be sure to label potential causes and protective factors.

ANSWER: Answers will vary but diagram will look similar to Figure 7.7 on page 250. Here, it is less important that the student has memorized every word than it is for them to show that they conceptually understand that biological and psychological vulnerabilities predispose but do not cause Mood Disorders. They should also show that they understand the role of social support (protective factor) and the activation of stress hormones (accelerant), etc.

130. It is likely that you have seen a movie or television show which features Electroconvulsive Therapy (ECT). Describe ways in which the treatment is done today as well as its success rate for providing relief from depression.

ANSWER: There is evidence of abuse of this treatment historically. In current administration, patients are anesthetized to reduce discomfort and given muscle-relaxing drug to prevent bone breaks from convulsions. Electric shock is administered to the brain for less than a second. Treatments are typically administered every other day for a total of 6 to 10 treatments. This treatment is considered a “last resort,” yet it is quite effective with 50% of patients who did not respond to drug therapy.

131. Describe how Cognitive Behavior Therapy works for depression.

ANSWER: In Cognitive Behavior Therapy, clients are taught to examine their thought processes and re-evaluate negative thinking. This can be a difficult process as depressed patients almost always automatically assign negative values to themselves and their own experiences. A client learns to substitute more realistic and positive images in place of the distorted negative ones in their day to day life.

132. How might a therapist use Interpersonal Therapy to help a couple reconcile their marriage?

ANSWER: Interpersonal Therapy focuses on resolving problems in existing relationships and learning to form new, healthy relationships. The therapist works by helping the patient identify the dispute, determine the stage of the dispute (negotiation, impasse, or resolution stage), and outline the dispute for all parties. Since a lack of Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood meaningful interpersonal relationships is a trigger for depression, Interpersonal Therapy can help move the patient to relationship and personal goals.

133. What are the three indices for understanding suicidal behavior and why is it important to know them?

ANSWER: The three indices are: 1. Suicidal ideation (serious thoughts about committing suicide) 2. Suicidal plans (a detailed method for killing oneself), and 3. Suicidal attempts (previous attempts that were not successful Suicidal ideation is always important and needs to be taken seriously. These three criteria provide additional information about the stage to which the individual has considered suicide and likely danger in the nearterm.

Essay 134. Compare and contrast the symptoms of major depressive episode, a manic episode, persistent depressive disorder, and hypomania.

ANSWER: Major depression is characterized by a depressed mood state that lasts at least 2 weeks and includes cognitive symptoms such as feeling worthless, disturbed physical function such as altered sleep or appetite, and the loss of interest and pleasure in activities and social interactions.

Mania is characterized by exaggerated elation euphoria, little sleep, rapid speech, and grandiose plans.

Persistent depressive disorder shares the symptoms of major depressive disorder, but the symptoms are milder. The condition, however, is more chronic, with symptoms lasting for a minimum of two years.

Hypomania is a less severe version of a manic episode that does not cause marked impairment in social or occupational functioning.

135. Discuss the symptoms, causes and treatments for seasonal affective disorder.

ANSWER: This disorder occurs during winter, in cold environments. People with SAD report excess sleep, increased appetite, and weight gain. It is thought to be related to seasonal changes in light that affect the production of melatonin by the pineal gland. SAD patients may produce too much melatonin, experience disrupted circadian cycles, and reports negative cognitions and a tendency toward rumination. Exposure to light, called phototherapy, is an effective treatment.

136. Discuss the relationship between depression and anxiety.

ANSWER: Research suggests that almost all depressed patients are anxious, but not all anxious patients are depressed. It appears that while anhedonia is key to depression, the key to anxiety is the experience of autonomic activation, which can also occur in depressed people. Research in this area suggests that we may eventually need to rethink our diagnostic criteria to combine anxiety and the mood disorders into one larger category.

137. Discuss the role of neurotransmitters, brain-wave activity, and negative cognitions in the etiology and treatment of depression.

ANSWER: Low levels of depression in relation to norepinephrine and dopamine are thought to be related to the etiology of depression. The permissive hypothesis argues that when serotonin levels are low, other neurotransmitters are permitted to range more widely and so become deregulated. EEG studies suggest that depressed individuals exhibit greater right-side anterior activation in their brains and lower levels of such activity on Copyright Cengage Learning. Powered by Cognero.

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Chapter 08 Mood the left side than non-depressed individuals. Negative thoughts or attributions about themselves, the immediate world, and the future are characteristic of depressed individuals.

Antidepressant medications can effectively treat depression but may take several weeks to work, and symptoms may reappear when the medication is continued. Cognitive-based treatments take longer to work but can be instrumental in limiting later depression. The combination of both is often the most effective treatment.

138. Identify and explain the risk factors associated with suicide.

ANSWER: Family history: If a family member has committed suicide, there is an increased risk that someone else in the family will also. Research has shown that the offspring of family members who have attempted suicide had six times the risk compared to the offspring of nonattempters. If a sibling was the suicide attempter, this increased the risk even more.

Neurobiology: Research indicates that low levels of serotonin may be associated with suicide and violent suicide attempts. Low levels of serotonin are associated with impulsivity, instability, and a tendency to overreact in situations.

Existing Psychological Disorders: More than 80% of the people that kill themselves have an existing psychological disorder, usually a mood disorder, substance use disorder, or impulse control disorder.

Hopelessness, a specific component of depression, is a strong predictor of suicide. Alcohol use and abuse are associated with 25% to 50% of all suicides and are especially prominent in adolescent suicides Stressful Life Events: The most important risk factor for suicide appears to be a severe, stressful event.

Often a stressful event can put the person over the edge.

139. Recreate the Integrative Model of Mood Disorders. Be sure to label potential causes and protective factors.

ANSWER: Answers will vary but diagram will look similar to Figure 7.7 on page 250. Here, it is less important that the student has memorized every word than it is for them to show that they conceptually understand that biological and psychological vulnerabilities predispose but do not cause Mood Disorders. They should also show that they understand the role of social support (protective factor) and the activation of stress hormones (accelerant), etc.

140. It is likely that you have seen a movie or television show which features Electroconvulsive Therapy (ECT). Describe ways in which the treatment is done today as well as its success rate for providing relief from depression.

ANSWER: There is evidence of abuse of this treatment historically. In current administration, patients are anesthetized to reduce discomfort and given muscle-relaxing drug to prevent bone breaks from convulsions. Electric shock is administered to the brain for less than a second. Treatments are typically administered every other day for a total of 6 to 10 treatments. This treatment is considered a “last resort,” yet it is quite effective with 50% of patients who did not respond to drug therapy.

141. Describe how Cognitive Behavior Therapy works for depression.

ANSWER: In Cognitive Behavior Therapy, clients are taught to examine their thought processes and re-evaluate negative thinking. This can be a difficult process as depressed patients almost always automatically assign negative values to themselves and their own experiences. A client learns to substitute more realistic and positive images in place of the distorted negative ones in their day to day life.

142. How might a therapist use Interpersonal Therapy to help a couple reconcile their marriage?

ANSWER: Interpersonal Therapy focuses on resolving problems in existing relationships and learning to form new, healthy relationships. The therapist works by helping the patient identify the dispute, determine the stage of the dispute (negotiation, impasse, or resolution stage), and outline the dispute for all parties. Since a lack of meaningful interpersonal relationships is a trigger for depression, Interpersonal Therapy can help move the patient to relationship and personal goals.

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Chapter 08 Mood 143. What are the three indices for understanding suicidal behavior and why is it important to know them?

ANSWER: The three indices are: 1. Suicidal ideation (serious thoughts about committing suicide) 2. Suicidal plans (a detailed method for killing oneself), and 3. Suicidal attempts (previous attempts that were not successful Suicidal ideation is always important and needs to be taken seriously. These three criteria provide additional information about the stage to which the individual has considered suicide and likely danger in the nearterm.

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Chapter 09 Eating Multiple Choice 1. The chief motivating factor in both anorexia nervosa and bulimia nervosa is a. desire to purge. b. an overwhelming drive to eat. c. an overwhelming urge to be thin. d. a desire to starve oneself.

ANSWER: c 2. Eating Disorders are common in: a. Western countries b. Sub-Saharan Africa c. people who have Bipolar Disorder d. Basketball players ANSWER: a 3. When individuals with anorexia nervosa are evaluated over long periods of time, it has been found that the percentage of individuals who die as a result of their disorder is . a. 20% b. 5% c. 2% d. 40% ANSWER: a 4. Approximately a. 5 to 10% b. 10 to 15% c. 20 to 30% d. 40 to 45% ANSWER: c

of anorexia nervosa deaths are due to suicide.

5. The death rate (including suicide) due to anorexia nervosa is a. higher than for any other psychological disorder except depression. b. lower than that of most psychological disorders. c. higher than that any psychological disorder reviewed in your text. d. the highest of all of the psychological disorders.

ANSWER: c 6. Obesity is not classified as a disorder in the DSM-5 because a. very few Americans suffer from it. b. many Americans suffer from it, therefore it is not a “disorder. c. it is related to too many other health concerns. d. none of the answers are correct.

ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 Eating 7. Between 1960 and 1995, most Western countries experienced a dramatic a. decrease in the incidence of anorexia nervosa and bulimia nervosa. b. increase in the incidence of anorexia nervosa and bulimia nervosa. c. increase in the incidence of anorexia nervosa but a decrease in the incidence of bulimia nervosa. d. increase in the incidence of bulimia nervosa and no change in the rate of anorexia nervosa.

ANSWER: b 8. The strongest contributions to etiology of eating disorders seem to be a. genetic b. psychological c. somatogenic d. sociocultural ANSWER: d

.

9. Jody sometimes eats more than just about any other girl that you know. You wonder if her eating sometimes could be considered bingeing. In order to determine this, you would have to know a. the caloric intake of the foods. b. whether she is eating junk foods. c. whether eating gets to be out of her control. d. the situations under which she eats a great deal.

ANSWER: c 10. The most significant feature of bulimia nervosa is . a. purging b. overeating c. overeating followed by an urge to vomit d. binge eating followed by compensatory behavior ANSWER: d 11. Purging techniques are ______ for bulimia nervosa. a. common and necessary for diagnosis b. common but not necessary for diagnosis c. not as common as laxative use d. none of the above are correct ANSWER: b 12. Susan, a woman of relatively normal weight, sometimes eats huge quantities of junk food with no ability to stop herself. She follows this with long periods of complete fasting. Based on this information, Susan a. might be diagnosed with bulimia nervosa. b. should be diagnosed with anorexia nervosa. c. will not be diagnosed with any disorder because she is of normal weight. d. cannot be diagnosed with bulimia nervosa because she is not purging.

ANSWER: a

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Chapter 09 Eating 13. After engaging in an extended session of binge eating, Thomas goes to the bathroom and makes himself vomit. He thinks that he has removed all of the food he consumed from his stomach, but in fact he will only have removed around percent of the calories he consumed. a. one-third b. one-quarter c. one-half d. two-thirds ANSWER: c 14. Amy is a young woman who is very competitive and comes from a high-achieving, wealthy family. She is very social and likes the fact that she is quite popular. She believes that her popularity is dependent on the weight and shape of her body. Amy has a boyfriend but worries that she may care more about their relationship than he does. The feature that puts Amy most at risk for an eating disorder such as bulimia nervosa is her a. belief that her weight and body shape influence her popularity. b. belief that her boyfriend cares less about the relationship than she does. c. successful family. d. competitive nature.

ANSWER: a 15. The most serious medical consequence of bulimia nervosa is potential a. electrolyte imbalance b. salivary gland damage c. starvation d. tooth erosion ANSWER: a

.

16. Individuals with bulimia nervosa are typically a. within 10% of their "normal" weight. b. very overweight. c. very underweight. d. overweight during the development of the disorder but become underweight as the disorder progresses.

ANSWER: a 17. People with bulimia nervosa often present with additional psychological disorders, particularly ________ and _________. a. body dysmorphic disorder; substance disorders b. mood disorders; sexual disorders c. anxiety disorders; mood disorders d. obsessive compulsive disorder; sexual disorders ANSWER: c 18. Which of the following statements is TRUE? a. Eating disorders are a way of expressing depression. b. Eating disorders have a high comorbidity with stress disorders. c. Depression may be a reaction to bulimia nervosa.

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Chapter 09 Eating d. Around 20 to 40% of all people with bulimia nervosa meet the criteria for a mood disorder during the course of their eating disorder.

ANSWER: c 19. Research suggests that the restricting and bingeing/purging subtypes of anorexia nervosa a. are really different disorders. b. have completely different causes. c. show few differences in severity of symptoms. d. are useless distinctions of the same disorder.

ANSWER: c 20. Which of the following diagnoses would require the noticeable loss of weight? a. Anorexia nervosa b. Bulimia nervosa c. Binge-eating disorder d. Body dysmorphic disorder ANSWER: a 21. A common medical complication found in both bulimia nervosa and anorexia nervosa is a. brittle hair b. downy hair on limbs c. electrolyte imbalance d. cessation of menstrual cycle ANSWER: d

.

22. The most common reason that anorexic individuals generally do not seek treatment on their own is that they a. are ashamed of their disorder. b. fear that they will be hospitalized. c. do not truly believe that they are too thin. d. have little desire for food.

ANSWER: c 23. Individuals who experience loss of control of their eating and consume great quantities of food but do not engage in any attempts to compensate for their binge would be diagnosed with a. bulimia nervosa. b. binge-eating disorder. c. obsessive-compulsive disorder. d. anorexia nervosa.

ANSWER: b 24. The best evidence that binge-eating disorder (BED) may not just be a special case of bulimia nervosa is that a. more males than females suffer from BED. b. no genetic component has been identified for BED. c. there is a greater likelihood of remission and a better response to treatment for BED. d. the average age of onset is much younger for BED than it is for bulimia nervosa or anorexia nervosa.

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TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière]

Chapter 09 Eating ANSWER: c 25. Binge-eating disorder is characterized by a. laxative use b. purging c. a lack of compensatory behaviors d. emaciation ANSWER: c

.

26. The males most likely to develop an eating disorder such as bulimia nervosa are those who are a. overweight b. depressed c. homosexual d. only children ANSWER: c

.

27. Which of the following statements is TRUE? a. Anorexia nervosa typically occurs at a much earlier age than bulimia nervosa. b. Once bulimia nervosa develops, it tends to be chronic if untreated. c. Bulimic individuals eventually shift to symptoms of other eating disorders. d. Bulimia nervosa is more resistant to treatment than anorexia nervosa.

ANSWER: b 28. Studies of foreign-born students who are attending Western universities show that a. anorexia nervosa and bulimia nervosa do not occur in students who were raised in countries where these disorders do not exist. b. anorexia nervosa and bulimia nervosa are observed in some students who were raised in countries where these disorders do not exist. c. anorexia nervosa, but not bulimia nervosa, has been observed in some students who were raised in countries where these disorders do not exist. d. bulimia nervosa, but not anorexia nervosa, has been observed in some students who were raised in countries where these disorders do not exist.

ANSWER: b 29. Which of the following is not a symptom of anorexia nervosa? a. Eating minimal amounts of food b. Vigorous exercise to offset food intake c. Eating large quantities of food at one time d. Overwhelming desire to be thin ANSWER: c 30. One American study (Mann, Tomiyama, & Ward, 2015) showed that over ______ people are dieting at any one time. a. 10,000 b. 250,000 c. 1 million Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 Eating d. over 100 million ANSWER: d 31. Which of the following is NOT true about dieting: a. is less problematic than previously thought. b. 55% of girls are dieting at age 12. c. dieting increases between adolescence and young adulthood. d. it can lead to an eating disorder.

ANSWER: a 32. Studies have found that adolescent girls of which race/ethnicity had less body dissatisfaction, fewer weight concerns, and a more positive body image when compared to Caucasian adolescent girls? a. African Americans b. Hispanics c. Native Americans d. Asians ANSWER: a 33. Which of the following might help to explain the vast differences in the incidence of eating disorders among men and women? a. The influence of behavioral genetics b. The fact that boys are encouraged to play sports and girls to be active in social functions c. The fact that puberty brings boys' bodies closer to the societal ideal and girls' bodies further from the societal ideal d. The differences in the way boys and girls tend to gain weight from overeating ANSWER: c 34. The median age of onset for all eating disorders is a. 13 to 19 b. 18 to 21 c. 20 to 26 d. 10 to 14 ANSWER: b

years of age.

35. The overwhelming majority of people with anorexia are ____ of their normal weight. a. 1% b. 5% c. 10% d. 25% ANSWER: c 36. The increase in the incidence of eating disorders such as anorexia nervosa and bulimia nervosa has been referred to as a "collision between our culture and our physiology." The most accurate interpretation of this statement is that a. people have become too dependent on media determinations of beauty. b. media standards of beauty are increasingly unattainable for the average woman.

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Chapter 09 Eating c. dieting has become a fad that has been taken to an extreme. d. society has no business telling us how to define beauty.

ANSWER: b 37. Dana eats a large Sunday meal with her family every week. She generally vomits after. In fact, Dana follows her caloric consumption carefully and makes herself vomit anytime that she eats more than 2000 calories in one meal. Which of the following best explains why Dana vomits: a. Vomiting relieves anxiety about overeating. b. Dana does not “feel” anything and is vomiting to feel more alive. c. Dana is bipolar. d. None of the answers are correct.

ANSWER: a 38. Which of the following is NOT true about the relationships between the media and attitudes about body shape? a. Prime-time situation comedies often feature women dieting or complaining about their weight. b. Most magazine models are thinner than average women. c. Men on TV are more likely to be overweight than women. d. The media has no impact on body image.

ANSWER: d 39. Mothers of girls with anorexia nervosa tend to be a. perfectionistic b. dieting themselves c. less satisfied with their families d. all of the above ANSWER: d

.

40. Studies suggest that young males would often prefer to be a. thinner b. heavier c. taller d. shorter ANSWER: b

than they are.

41. When women are asked to identify the most attractive female body weight, they typically identify a weight that is a. lower than the weight identified by men. b. the same as the weight identified by men. c. higher than the weight identified by men. d. 20% lower than their own body weight.

ANSWER: a 42. When men are asked to identify the ideal male body, they typically select a body weight that is about a. equal to their own. b. 28 pounds more muscular than their own. c. equal to the average male of their age.

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Chapter 09 Eating d. 15 pounds lighter than their own.

ANSWER: b 43. Which of the teenage girls described below is at greatest risk for developing an eating disorder? a. Alice is currently on a diet; her friends also diet aggressively. b. Sue is of average to slightly above average weight but wants to lose a few pounds. c. Megan's friends are concerned about the weight she has lost since she began working out with the swim team. d. Jean has always been fairly thin despite the fact that she eats quite normally.

ANSWER: a 44. Weight reduction efforts by girls tend to result in a. overall weight loss b. overall weight gain c. no change in weight d. stunted growth ANSWER: a

.

45. The families of anorexia nervosa patients are typically characterized by all of the following EXCEPT a. open communication. b. high achievement. c. perfectionism. d. concern with external appearances.

ANSWER: a 46. Of the following, the group in which we would expect to see the highest incidence of anorexia nervosa is a. male homosexuals. b. female body builders. c. ballet dancers. d. female track stars.

ANSWER: c 47. Dietary restraint studies suggest that people who are starved a. stop caring about food. b. may become preoccupied with food and eating. c. lose interest in food over time. d. gradually adjust to starvation diets.

ANSWER: b 48. Which of the following young women appears to be at the highest risk for developing an eating disorder? a. Linda, whose mom and dad recently divorced b. Carla, whose family members always seem to be fighting with each other c. Sandy, whose family emphasizes achievement, support, and communication d. Bonnie, whose family is perfectionistic, successful, and eager to maintain harmony ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 Eating 49. With regard to the biological influences of anorexia nervosa and bulimia nervosa, the most accurate statement is a. anorexia nervosa and bulimia nervosa are culturally determined and not biologically influenced. b. the biological influences of anorexia nervosa and bulimia nervosa have not been studied. c. although the studies are still limited, there appears to be some biological influence in the development of anorexia nervosa and bulimia nervosa. d. although the studies are limited, there does appear to be a large biological influence for anorexia nervosa and a very small biological influence for bulimia nervosa.

ANSWER: c 50. Genetic influences on eating disorders most likely involve a. a specific gene for each actual eating disorder. b. inherited personality traits that may make development of an eating disorder more likely. c. multiple genes interacting in ways not yet determined that directly produce eating disordered behavior. d. recessive genes.

ANSWER: b 51. Which of the following statements is TRUE about individuals with an eating disorder? a. They have a diminished sense of personal control. b. They may manifest as strikingly low self-esteem. c. They display more perfectionistic attitudes. d. All of these statements tend to be accurate.

ANSWER: d 52. With respect to eating disorders, drug treatments a. have not been found to be effective in the treating of anorexia nervosa. b. had no benefit in preventing relapse in patients with anorexia nervosa. c. do not have long-lasting effects on bulimia nervosa. d. all of these.

ANSWER: d 53. According to your textbook, which of the following treatments is considered MOST effective for bulimia in adults: a. IPT b. CBT-E c. Family therapy d. Guided self-help ANSWER: b 54. Which of the following statements is TRUE with regard to drug treatments for patients with anorexia nervosa? a. Medications have not generally been found to be effective for the treatment of anorexia nervosa. b. Antidepressants have some effectiveness in the treatment of anorexia nervosa. c. Anti-anxiety medications have some effectiveness in the treatment of anorexia nervosa. d. Anti-psychotic mediations have been found to be effective for the treatment of anorexia nervosa.

ANSWER: a 55. With regard to drug treatments for bulimia nervosa patients, which of the following statements is TRUE? Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 Eating a. Medications have not been found to be effective for the treatment of bulimia nervosa. b. Antidepressants have some effectiveness in the treatment of bulimia nervosa. c. Benzodiazipine medications have some effectiveness in the treatment of bulimia nervosa. d. Anti-psychotic medications have been found to be effective for the treatment of bulimia nervosa.

ANSWER: b 56. One major problem with the use of medication in the treatment of bulimia nervosa is that a. well-controlled studies have not found medication more effective than a placebo. b. the beneficial effects of the medication may be short-term. c. side effects make most patients discontinue the medication. d. patients refuse to take their medication.

ANSWER: b 57. With regard to treatment for eating disorders, Prozac is considered to be an effective treatment in the long term for a. anorexia nervosa but not bulimia nervosa. b. bulimia nervosa but not anorexia nervosa. c. both anorexia nervosa and bulimia nervosa. d. neither anorexia nervosa or bulimia nervosa.

ANSWER: d 58. An early stage of Phoebe's cognitive-behavioral treatment for bulimia nervosa will likely involve a. antidepressant medication. b. family therapy. c. small, frequent meals. d. in-patient treatment.

ANSWER: c 59. An important aspect of the cognitive-behavioral approach to the treatment of bulimia nervosa involves a. changing patients' dysfunctional thoughts regarding their weight and previous weight control strategies. b. helping the patient's family learn new ways of interacting with each other and with the patient. c. changing the type and frequency of reinforcement associated with being an identified patient. d. making sure that the patient has a lot of quiet time where she can be alone.

ANSWER: a 60. A comparison of cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) for the treatment of bulimia nervosa indicates that one year after treatment, a. CBT was superior to IPT. b. IPT was superior to CBT. c. CBT and IPT had equivalent rates of helping clients improve. d. neither therapy was successful at helping clients improve.

ANSWER: a 61. One intriguing result from the studies comparing cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) for bulimia nervosa is the finding that Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 Eating a. IPT is more effective in the short term but CBT is more effective when we look at how well patients are doing one year following treatment. b. IPT and CBT appear to be indistinguishable in terms of their effectiveness in the short and long term, despite their very different approaches. c. IPT is always more effective than CBT. d. CBT is more effective in the short term, but IPT patients "catch up" and will do as well as CBT patients one year after treatment.

ANSWER: d 62. Research reported in your text conducted by Grilo, Masheb, & Wilson (2006) found that patients with binge-eating disorder who responded rapidly to cognitive-behavioral therapy (by the fourth week) tended to a. have good responses to therapy both in the short long term. b. have good short-term responses but show higher rates of long-term relapse c. have a difficult time in the short-term but show good long-term responses. d. relapse almost immediately after treatment was discontinued.

ANSWER: a 63. Which of the following statements is TRUE with regard to the treatment of binge-eating disorder? a. Cognitive-behavioral therapy and self-help appear to be effective. b. Cognitive-behavioral therapy appears to be effective but self-help does not. c. Neither cognitive-behavioral nor self-help appears to be effective. d. Antidepressant medication is the only proven treatment.

ANSWER: a 64. Studies of the effectiveness of cognitive-behavioral treatment for bulimia nervosa have demonstrated a. significant short-term gains in reduction of purging, but little change in binge-eating behavior. b. significant short-term gains in reduction of binge eating but no long-term gains. c. a few short-term gains in reduction of binge eating and purging but no long-term gains. d. significant short- and long-term gains in reduction of binge eating and purging.

ANSWER: d 65. The most important and immediate goal in the treatment of a patient with anorexia nervosa is ________________. a. family acceptance of the problem b. weight gain c. balanced diet d. resolution of family issues ANSWER: b 66. Jill has been in treatment for anorexia nervosa for the past 2 months. Over this time, she has gained weight to the point where her weight is in the average range for a woman of her height. The fact that she gained weight fairly quickly in treatment means a. her prognosis for a full recovery is very good. b. she is probably in need of little if any more treatment. c. she has completed the most difficult part of her treatment.

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Chapter 09 Eating d. little in terms of how likely she is to be successful in the long term.

ANSWER: d 67. Many clinicians suggest that the most difficult part of treatment for anorexia nervosa, and the part of treatment where many anorexic individuals are not successful, is a. initial weight gain. b. admitting that there is a problem and agreeing to begin treatment. c. changing their attitudes regarding body shape and addressing interpersonal disruptions in their lives. d. when they become bulimic.

ANSWER: c 68. Matilda has had anorexia nervosa for several years. She started losing weight because her family said she needed to lose a few pounds. A crucial part of treatment for Matilda is family therapy that focuses on the issues regarding a. attitudes toward body shape and image distortions. b. negative communications in the family regarding food and eating. c. dysfunctional communication in the family regarding food and eating. d. all of these.

ANSWER: d 69. Outcome research regarding the long-term success of treatment for eating disorders indicates that a. anorexia nervosa patients tend to have a better prognosis than bulimia nervosa patients. b. bulimia nervosa patients tend to have a better prognosis than anorexia nervosa patients. c. both anorexia nervosa and bulimia nervosa patients almost always make a full and long-term recovery after treatment. d. neither anorexia nervosa nor bulimia nervosa patients tend to make long-term recoveries, with most patients going through repeated bouts of these disorders throughout their lives.

ANSWER: b 70. Programs that have the best chance of success for preventing eating disorders a. should be administered to all girls under 15 years of age to prevent the disorder from developing. b. should be administered to girls under 15 years of age who are concerned about being overweight. c. should be administered to all girls 15 years of age or older to prevent the disorder from developing. d. should be administered to girls 15 years of age or older who are concerned about being overweight.

ANSWER: c 71. In studies of Internet-based eating disorder prevention programs (Winzelberg et al., 2000), such as the "student bodies program," a. the participants showed no beneficial effects. b. participants reported improvement in body image and decreased drive for thinness. c. not a single participant has developed symptoms of an eating disorder. d. the drop-out rate has been extremely high.

ANSWER: b 72. As of 2008, the percentage of the adult population of the United States with a body mass index in the obese range was about __________. a. 12% Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 Eating b. 17% c. 26% d. 34% ANSWER: d 73. Obesity is the major factor in a. Type 1 diabetes b. Type 2 diabetes c. anorexia nervosa d. bulimia nervosa ANSWER: b

.

74. Individuals with night eating syndrome a. consume a third of their daily intake after their evening meal. b. binge during the night. c. do not wake up while eating during the night. d. often purge after eating.

ANSWER: a 75. Which of the following genetic factors does NOT contribute to obesity? a. Number of fat cells b. Likelihood of fat storage c. Activity levels d. Fat cell shape ANSWER: d 76. Average weight loss on diet programs such as Atkins and Weight Watchers is a. 4 to 7 pounds b. 10 to 15 pounds c. 20 to 25 pounds d. 30 or more pounds ANSWER: a

.

77. The most successful weight loss programs are a. commercial self-help plans that limit carbohydrates or calories. b. self-directed diet plans based on diet books. c. professionally directed behavior modification programs. d. hypnosis-based plans.

ANSWER: c 78. Bariatric surgery is a. effective at any weight. b. more successful than dieting for the treatment of the very obese. c. less successful than diet for the very obese. d. always successful.

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Chapter 09 Eating ANSWER: b 79. Surgical treatments are likely to be the a. first line of treatment for the very obese. b. last line of treatment for the very obese. c. treatment of choice for anyone who wants to lose weight. d. most rare of weight loss treatments.

ANSWER: b 80. One method of preventing obesity that has been suggested is a. instituting a "Twinkie tax" on all food with a high sugar content. b. reducing the cost of health foods. c. taking soda and junk food vending machines out of schools. d. all of these.

ANSWER: d 81. The proposal that we should discuss taxing high calorie, fat, or sugar foods to control obesity has a. been adopted nationwide. b. been viewed as a means of deterring unhealthy eating and raising money to combat obesity. c. been rejected outright as having no possibility of decreasing obesity. d. thought to benefit the poor more than the well-to-do.

ANSWER: b 82. The intent of taxing the purchase of unhealthy foods would be to a. make unhealthy foods less attractive to consumers. b. punish the poor. c. raise general government revenue. d. increase profits for food manufacturers.

ANSWER: a 83. Seriously obese adolescents are most likely to lose weight with a. the use of medications. b. the use of behavioral treatments. c. the combination of medications and behavioral treatments. d. the use of surgery.

ANSWER: b 84. Sleep studies suggest that around 28% of Americans a. get more than 6 hours of sleep a night. b. report feeling excessively sleepy during the day. c. have insomnia. d. need less than 5 hours of sleep a night.

ANSWER: b 85. Lack of adequate sleep has a negative effect on Copyright Cengage Learning. Powered by Cognero.

.

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Chapter 09 Eating a. health b. productivity c. clarity of thought d. all of these choices ANSWER: d 86. Sleep research suggests that a. REM sleep is related to depression. b. sleep abnormalities follow clinical depression. c. sleep problems don’t predict who is at risk for later mood disorders. d. sleep deprivation has permanent antidepressant effects on some people.

ANSWER: a 87. Individuals who feel tired and cranky all day despite falling asleep at a normal hour and awakening at their usual time are most likely suffering from a(n) . a. parasomnia b. dyssomnia c. type of REM sleep deprivation d. anxiety problem ANSWER: b 88. Of the following, the correct pairing is . a. dyssomnia - sleepwalking b. dyssomnia - inability to fall asleep c. parasomnia - waking up after 3 or 4 hours of sleep and then being unable to fall back to sleep d. parasomnia - lack of REM sleep ANSWER: b 89. The most comprehensive evaluation of sleep is performed by a(n) a. polysomnographic b. actigraphic c. electromyographic d. electroencephalographic ANSWER: a

evaluation.

90. While a patient sleeps, a polysomnographic evaluation collects data on all of the following characteristics EXCEPT _________. a. respiration b. muscle movements c. brain waves d. metabolic rate ANSWER: d 91. Individuals with a sleep efficiency of 90% a. spend more of their "bed time" awake than asleep.

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Chapter 09 Eating b. have a diagnosable sleep disorder. c. need to increase the number of hours in bed. d. spend 10% of their "bed time" awake.

ANSWER: d 92. Individuals suffering from primary insomnia a. do not sleep at all. b. have difficulty initiating or maintaining sleep. c. wake up during their sleep cycle with severe nightmares. d. frequently sleepwalk.

ANSWER: b 93. Sleep disorders are appropriately diagnosed based on the a. quality and quantity of sleep as well as daytime sequelae (how the individual feels when awake). b. quality and quantity of sleep only. c. quantity of sleep plus the amount of sleep time the individual believes is appropriate. d. subjective judgment of the clinician.

ANSWER: a 94. Fred has been having a great deal of trouble initiating and maintaining sleep. He guesses that he is sleeping for an average of about 3 hours each night and complains that he feels terrible during the day. In addition, Fred has always experienced some anxiety but has recently felt a tremendous increase in his overall anxiety level. The existence of both a sleep disorder and anxiety a. makes the diagnosis of primary insomnia incorrect. b. increases our confidence that primary insomnia is the correct diagnosis. c. indicates that the insomnia is a result of the anxiety rather than a cause of the anxiety. d. is extremely common since sleep problems can be both a cause and a result of anxiety.

ANSWER: d 95. The percentage of the general population that reports some symptoms of insomnia during any given year is approximately . a. 10% b. 20% c. 33% d. 50% ANSWER: c 96. As we grow older, it seems that the amount of sleep that we require a. decreases b. increases c. stays the same d. decreases until early adulthood and then begins to increase again ANSWER: a

.

97. Adolescents tend to shift toward a Copyright Cengage Learning. Powered by Cognero.

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Chapter 09 Eating a. biologically determined later sleep schedule. b. culturally determined earlier sleep schedule. c. biologically determined earlier sleep schedule. d. culturally determined later sleep schedule.

ANSWER: a 98. One biological factor that has been related to individuals who experience insomnia is a. genetics b. higher body temperature c. low body weight d. percentage of body fat ANSWER: b

.

99.

Samantha started having difficulty falling asleep during final exam week. Although exams are over, she now starts to worry about sleep right after dinner. Even the sight of her bed makes her very anxious. The fact that Samantha's insomnia continues long after the stress of exams is over points to the role of ________ in the maintenance of sleep disorders. a. biology b. other medical conditions c. learning d. unknown factors ANSWER: c 100. Sam sleeps for 8 or more hours every night but never feels rested. He can't understand why he is always tired despite the fact that he reports no difficulties with the quality or quantity of his sleep. Of the following, Sam's most likely diagnosis is . a. hypersomnolence disorder b. sleep apnea c. narcolepsy d. non-specific parasomnia ANSWER: a 101. Rose sleeps about 8 hours each night. She awakens feeling fine and well rested, but she tends to fall asleep about two or three times during the day. We can conclude that a. Rose should be diagnosed with primary insomnia. b. Rose would be diagnosed with hypersomnolence disorder if her symptoms cause disruptions or distress in her life. c. Rose should be diagnosed with a parasomnia. d. a medical condition is a more appropriate diagnosis than a sleep disorder.

ANSWER: b 102. Of the following, the only symptom that both patients with narcolepsy and patients with hypersomnolence disorder experience is a. falling asleep during normal waking hours. b. sudden loss of muscle tone.

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Chapter 09 Eating c. sleep paralysis. d. hypnagogic hallucinations.

ANSWER: a 103. In which of the following situations is Bill, who has narcolepsy, most likely to experience cataplexy? a. Immediately upon waking up after a long, restful sleep b. At any random moment c. Under hypnosis d. While jumping up and cheering for his favorite team ANSWER: d 104. While suddenly and unexpectedly falling asleep during normal waking hours, Sarah experiences vivid hallucinations of being in a horrible car crash. The experience is so realistic that she actually feels physical sensations as if the hallucination were real. Sarah's most likely diagnosis is . a. sleep apnea b. hypersomnia c. schizophrenia d. narcolepsy ANSWER: d 105. Cataplexy as experienced by patients with narcolepsy can be characterized by a. sudden, minor loss of muscle tone. b. physical collapse. c. slight muscle weakness. d. any of these ANSWER: b 106. An individual who wakes up feeling that there are other people in the room but is unable to move or say anything may be experiencing a. cataplexy associated with sleep apnea. b. hypnagogic hallucinations associated with hypersomnia. c. sleep paralysis and hypnagogic hallucinations associated with narcolepsy. d. sleep paralysis and hypnogogic hallucinations associated with hypersomnia.

ANSWER: c 107. Which of the following conditions is thought to be a potential explanation for UFO experiences? a. Sleep paralysis b. Cataplexy c. Hypnagogic hallucinations d. Sleep apnea ANSWER: c 108. Obstructive sleep apnea is characterized by a. complete cessation of respiratory activity for brief periods. b. interruption of air flow and brief cessation of respiratory activity.

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Chapter 09 Eating c. interruption of air flow without cessation of respiratory activity. d. central nervous system disorders and trauma.

ANSWER: c 109. The different types of sleep apnea are a. obstructive, central, and sleep-related hypoventilation. b. obstructive, chronic, and sleep-related hypoventilation. c. central, chronic, and mixed. d. hypersomnolent, chronic, and parasomnic ANSWER: a 110. A severe difficulty in regulating sleep that is induced by jet lag or by working rotating shifts is an example of ___________. a. circadian rhythm sleep disorder b. sleep apnea c. hypersomnolence disorder d. narcolepsy ANSWER: a 111. Two factors that help regulate our natural sleep/wake cycles are a. melanin and auditory stimulation. b. melatonin and auditory stimulation. c. melatonin and light. d. light and blood sugar levels.

ANSWER: c 112. All of the following are examples of causes of circadian rhythm sleep disorder EXCEPT ____________. a. jet lag b. shift work c. delayed sleep phase d. sleep rebound ANSWER: d 113. Benzodiazepine medication is not recommended as a long-term solution for the treatment of insomnia because of a. the addictive properties of these medications. b. rebound insomnia that occurs after the medication is discontinued. c. excessive sleepiness that may persist during the day. d. all of these.

ANSWER: d 114. The reason that antidepressant medications are sometimes used to treat narcolepsy is that a. narcolepsy is often caused by depression. b. the anti-anxiety properties of these medications reduce narcolepsy. c. these medications suppress REM sleep that can trigger cataplexy. d. antidepressants are found to reduce hypnagogic hallucinations.

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Chapter 09 Eating ANSWER: c 115. Medical treatments for severe sleep apnea include medication, mechanical devices, and a. surgery b. exercise of the neck muscles c. a high protein diet d. changing the patient's sleep schedule ANSWER: a

.

116. When attempting to "reset the biological clock" of an individual with a circadian rhythm sleep disorder, it is generally easier and more effective to a. make the patient's bedtime earlier. b. leave the patient's bedtime alone and change the duration of sleep. c. make the patient's bedtime later. d. keep the person awake for several days in a row.

ANSWER: c 117. Abnormal events such as nightmares, sleep terrors, and sleepwalking that occur during sleep or during the twilight time between sleep and waking are classified as . a. parasomnias b. dyssomnias c. narcolepsy d. REM disorders ANSWER: a 118. Sleepwalking is characterized by all of the following EXCEPT a. acting out a dream. b. occurrence during NREM stages of sleep. c. no memory of the sleepwalking event. d. occurrence primarily in children.

ANSWER: a 119. Sleepwalking is fairly common, and recent research suggests that more than ____ of school-aged children sleepwalk. a. 10% b. 20% c. 30% d. 50% ANSWER: a 120. Martin sits up every night screaming. He does not remember these terrors nor is he easily awakened or comforted. What should Martin's mother do? a. Wake Martin up during the attack. b. Make sure that Martin is very tired before going to bed. c. Use scheduled awakenings to briefly awaken Martin before an attack occurs.

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Chapter 09 Eating d. All of these have been demonstrated to reduce the frequency and duration of sleep terrors ANSWER: c 121. A recent study (Stokes & Preston, 2015), suggests that obesity: a. is less problematic than previously thought. b. is less common than previously thought. c. is more dangerous to other health outcomes than previously thought. d. is related to hormones.

ANSWER: c Subjective Short Answer 122. Eating disorders such as anorexia nervosa and bulimia nervosa are generally "blamed" on culture and society. At the same time, there appears to be a genetic influence. Explain how culture and genetics may interact in the development of anorexia nervosa and bulimia nervosa.

ANSWER: Cultures and societies tend to develop specific ideals regarding body weight and appearance. In the modern world, thinness is seen as highly desirable and is promoted through advertising and entertainment sources.

Because the ideals are unrealistic and unattainable, this experience may be contributing to the high rates of body dissatisfaction seen in the US. Genetic factors can predispose people to eating disorders if they cause the biological disregulation of eating or weight gain, or predispose people to stress, anxiety, and mood disorders thus triggering behaviors such as starving or bingeing.

In combination, cultural pressure to be thin and increasingly unattainable body ideals are thought to be contributing to the increase seen in body dissatisfaction and eating disorders.

123. In what ways do anorexia nervosa and bulimia nervosa patients tend to be similar and in what ways do they differ?

Make certain to include similarities and differences in the symptoms of the disorders as well as the dysfunctional thoughts typically associated with each disorder.

ANSWER: Anorexic individuals voluntarily starve themselves while simultaneously believing that they can never be thin enough. By definition, anorexics are extremely underweight, and so compromise their health. Anorexics may engage in excess exercise or purging behaviors, but don’t necessarily do so. Bulimic individuals tend to binge eat and then purge by throwing up or using laxatives. They may be of any weight, but do experience health problems related to their purging behaviors.

124. Describe the characteristics of binge-eating disorder and differentiate it from bulimia nervosa.

ANSWER: The major characteristic of this disorder, as indicated by its name, is a chronic pattern of binge- eating. What differentiates it from bulimia nervosa is the absence of compensatory behaviors that follow these episodes.

125. Discuss possible reasons for the current obesity epidemic seen in the US and other countries and the relative efficacy of currently available obesity treatment options and preventions.

ANSWER: The causes of obesity in the modern world tend to be related to advances in technology. People are sedentary and prone to eat unhealthy, inexpensive food. It is also possible that genetic factors are interacting with these dietary choices.

Although most overweight individuals start with self-directed weight loss programs or commercial weight loss programs, people tend to lose only 4 to 7 pounds, to have trouble sticking with the diet, and to gain weight back again over time. Professionally directed behavior modification programs have better success rates if people comply, but the results do not appear to be permanent. For the dangerously obese, the combination of diets, behavior modification, and medication can result in minimal weight loss, but surgery may eventually be the best option for this population.

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Chapter 09 Eating A suggestion that has gained nationwide interest is the taxing of unhealthy foods and the price reduction of health foods. There has been a great deal of controversy over the "Twinkie tax." The idea is that like cigarettes, for example, the more they cost, the less likely people are to buy them while healthy foods that are reduced in price become a more health alternative.

126. Discuss possible treatments for eating disorders.

ANSWER: Several psychosocial treatments are effective, including cognitive-behavioral approaches combined

with family therapy and interpersonal psychotherapy. Drug treatments tend to be less effective but there is some promising research with Selective Serotonin Reuptake Inhibitors (SSRIs) and bulimia.

When applied, drug treatments are typically used in conjunction with psychological treatments.

127. What current research supports the relationship between thin images in the media and eating disorders?

ANSWER: Grabe, Ward, and Hyde (2008), reviewing 77 studies, demonstrated a strong relationship between

exposure to media images depicting the thin-ideal body and body image concerns in women. An analysis of prime-time situation comedies revealed that 12% of female characters were dieting and many were making disparaging comments about their body image (Tiggemann, 2002).

128. Discuss the importance of gender and culturally-nuanced treatments for Binge Eating Disorder (BED). Cite an example.

ANSWER: Some racial and ethnic differences are apparent in people with BED seeking treatment (Franko et

al., 2012). African American participants tend to have higher BMI and Hispanic participants have greater concerns with shape and weight than Caucasian participants. Thus, it would seem that tailoring treatment to these ethnic groups would be useful. Also, males may respond somewhat differently than females to treatment since one recent study demonstrated that men with lower shape/weight concerns responded well to brief treatments, whereas females with shape/weight concerns at any level of severity, and men at more severe levels, all required longer treatment (Shingleton, Thompson, Pratt,& Franko, 2015).

129. Describe primary insomnia and contrast it with hypersomnolence disorder and narcolepsy.

ANSWER: Primary insomnia refers to an inability to sleep that is not related to another medical or psychiatric problem.

Such insomnia may be related to problems with the biological clock or temperature control, but can also stem from environmental influences such as changes in light, noise, or temperature. People may also have unrealistic expectations about how much they sleep and may even learn to associate sleep and things like their beds with anxiety and worry about sleep. Poor behaviors such as drug or alcohol use can interfere with sleep.

Hypersomnolence disorder is a problem of sleeping too much or feeling that one is sleeping too much. It seems to be genetically influenced, as Hypersomnolence disorder runs in families, but it also may be related to viral infection exposure.

Narcolepsy is a specific sleep disorder characterized by daytime sleepiness, sudden loss of muscle tone (cataplexy), sleep paralysis, or a brief period after waking when it is hard to move or speak, and hypnagogic hallucinations or vivid scary experiences that begin at the start of sleep.

130. How does light influence hormones that determine your sleep/wake cycle? Draw a diagram.

ANSWER: Light signals from the retina are conveyed by nerve fibers to the superchiasmatic nucleus. This message is then transferred to the hypothalamus containing melatonin receptors. Darkness stimulates melatonin production and this production is suppressed in bright light. For an example of a diagram, see Figure 8.11 on page 312 of the text.

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Chapter 09 Eating 131. What is “sleep hygiene?” Give at least two examples.

ANSWER: Sleep hygiene allows the brain’s normal drive for sleep to take over. Some examples include

keeping to regular sleep and wake times and avoiding use of caffeine and nicotine as described in your text. You may also be familiar with some additional recommendations including avoiding bright lights before bed and turning your cell phone off.

Essay 132. Eating disorders such as anorexia nervosa and bulimia nervosa are generally "blamed" on culture and society. At the same time, there appears to be a genetic influence. Explain how culture and genetics may interact in the development of anorexia nervosa and bulimia nervosa.

ANSWER: Cultures and societies tend to develop specific ideals regarding body weight and appearance. In the modern world, thinness is seen as highly desirable and is promoted through advertising and entertainment sources.

Because the ideals are unrealistic and unattainable, this experience may be contributing to the high rates of body dissatisfaction seen in the US. Genetic factors can predispose people to eating disorders if they cause the biological disregulation of eating or weight gain, or predispose people to stress, anxiety, and mood disorders thus triggering behaviors such as starving or bingeing.

In combination, cultural pressure to be thin and increasingly unattainable body ideals are thought to be contributing to the increase seen in body dissatisfaction and eating disorders.

133. In what ways do anorexia nervosa and bulimia nervosa patients tend to be similar and in what ways do they differ?

Make certain to include similarities and differences in the symptoms of the disorders as well as the dysfunctional thoughts typically associated with each disorder.

ANSWER: Anorexic individuals voluntarily starve themselves while simultaneously believing that they can never be thin enough. By definition, anorexics are extremely underweight, and so compromise their health. Anorexics may engage in excess exercise or purging behaviors, but don’t necessarily do so. Bulimic individuals tend to binge eat and then purge by throwing up or using laxatives. They may be of any weight, but do experience health problems related to their purging behaviors.

134. Describe the characteristics of binge-eating disorder and differentiate it from bulimia nervosa.

ANSWER: The major characteristic of this disorder, as indicated by its name, is a chronic pattern of binge- eating. What differentiates it from bulimia nervosa is the absence of compensatory behaviors that follow these episodes.

135. Discuss possible reasons for the current obesity epidemic seen in the US and other countries and the relative efficacy of currently available obesity treatment options and preventions.

ANSWER: The causes of obesity in the modern world tend to be related to advances in technology. People are sedentary and prone to eat unhealthy, inexpensive food. It is also possible that genetic factors are interacting with these dietary choices.

Although most overweight individuals start with self-directed weight loss programs or commercial weight loss programs, people tend to lose only 4 to 7 pounds, to have trouble sticking with the diet, and to gain weight back again over time. Professionally directed behavior modification programs have better success rates if people comply, but the results do not appear to be permanent. For the dangerously obese, the combination of diets, behavior modification, and medication can result in minimal weight loss, but surgery may eventually be the best option for this population.

A suggestion that has gained nationwide interest is the taxing of unhealthy foods and the price reduction of health foods. There has been a great deal of controversy over the "Twinkie tax." The idea is that like cigarettes, for example, the more they cost, the less likely people are to buy them while healthy foods that are reduced in price become a more health alternative.

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Chapter 09 Eating 136. Discuss possible treatments for eating disorders.

ANSWER: Several psychosocial treatments are effective, including cognitive-behavioral approaches combined

with family therapy and interpersonal psychotherapy. Drug treatments tend to be less effective but there is some promising research with Selective Serotonin Reuptake Inhibitors (SSRIs) and bulimia.

When applied, drug treatments are typically used in conjunction with psychological treatments.

137. What current research supports the relationship between thin images in the media and eating disorders?

ANSWER: Grabe, Ward, and Hyde (2008), reviewing 77 studies, demonstrated a strong relationship between

exposure to media images depicting the thin-ideal body and body image concerns in women. An analysis of prime-time situation comedies revealed that 12% of female characters were dieting and many were making disparaging comments about their body image (Tiggemann, 2002).

138. Discuss the importance of gender and culturally-nuanced treatments for Binge Eating Disorder (BED). Cite an example.

ANSWER: Some racial and ethnic differences are apparent in people with BED seeking treatment (Franko et

al., 2012). African American participants tend to have higher BMI and Hispanic participants have greater concerns with shape and weight than Caucasian participants. Thus, it would seem that tailoring treatment to these ethnic groups would be useful. Also, males may respond somewhat differently than females to treatment since one recent study demonstrated that men with lower shape/weight concerns responded well to brief treatments, whereas females with shape/weight concerns at any level of severity, and men at more severe levels, all required longer treatment (Shingleton, Thompson, Pratt,& Franko, 2015).

139. Describe primary insomnia and contrast it with hypersomnolence disorder and narcolepsy.

ANSWER: Primary insomnia refers to an inability to sleep that is not related to another medical or psychiatric problem.

Such insomnia may be related to problems with the biological clock or temperature control, but can also stem from environmental influences such as changes in light, noise, or temperature. People may also have unrealistic expectations about how much they sleep and may even learn to associate sleep and things like their beds with anxiety and worry about sleep. Poor behaviors such as drug or alcohol use can interfere with sleep.

Hypersomnolence disorder is a problem of sleeping too much or feeling that one is sleeping too much. It seems to be genetically influenced, as Hypersomnolence disorder runs in families, but it also may be related to viral infection exposure.

Narcolepsy is a specific sleep disorder characterized by daytime sleepiness, sudden loss of muscle tone (cataplexy), sleep paralysis, or a brief period after waking when it is hard to move or speak, and hypnagogic hallucinations or vivid scary experiences that begin at the start of sleep.

140. How does light influence hormones that determine your sleep/wake cycle? Draw a diagram.

ANSWER: Light signals from the retina are conveyed by nerve fibers to the superchiasmatic nucleus. This message is then transferred to the hypothalamus containing melatonin receptors. Darkness stimulates melatonin production and this production is suppressed in bright light. For an example of a diagram, see Figure 8.11 on page 312 of the text.

141. What is “sleep hygiene?” Give at least two examples.

ANSWER: Sleep hygiene allows the brain’s normal drive for sleep to take over. Some examples include

keeping to regular sleep and wake times and avoiding use of caffeine and nicotine as described in your text. You may also be familiar with some additional recommendations including avoiding bright lights before bed and turning your cell phone off.

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Chapter 09 Eating

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Chapter 07 Trauma and Dissociation Multiple Choice 1. At the beginning of the 20th century, the leading cause of death in the U.S. was ______________. a. automobile accidents b. infectious diseases c. heart attacks d. suicides ANSWER: b 2. According to the text, some of the major contributing factors to illness and death in the United States are currently a. viral and bacterial. b. behavioral and psychological. c. neurological and endocrinological. d. pharmacological and hormonal.

ANSWER: b 3. Using the word psychosomatic to describe a disorder with an obvious physical component is considered misleading because a. it gives the impression that psychological disorders like anxiety or depression do not have a biological component. b. it assumes that the physical aspects of a disorder are less important than the psychological aspects. c. it emphasizes the psychological symptoms of a disorder instead of the physical symptoms. d. it gives the impression that biological disorders are not influenced by psychological factors.

ANSWER: a 4. Knowledge derived from the behavioral sciences applied to the prevention, diagnosis, and treatment of medical problems is called a. health psychology. b. behavioral medicine. c. psychophysiological disorders. d. psychosomatic medicine.

ANSWER: b 5. What is the name of the new field of study that reflects the shift in focus from infectious disease to psychological/behavioral factors as causes of illness and death? a. Behavioral medicine b. Abnormal psychology c. Medical psychology d. Physical medicine ANSWER: a 6. Health Psychology is: a. subfield of behavioral medicine. b. the study of psychological factors important to the promotion and maintenance of health c. Both of these d. Neither of these Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation ANSWER: c 7. Which of the following is NOT considered an interdisciplinary field: a. Behavioral Medicine b. Behavioral Economics c. Health Psychology d. All of these are interdisciplinary ANSWER: c 8. In which of the following ways do psychological and social factors influence health? a. They can affect basic biological processes resulting in illness and disease. b. Risky behaviors can increase the likelihood of developing physical disorders. c. Both of these d. Neither of these ANSWER: c 9. Health psychology, a subfield of behavioral medicine, focuses on all of the following EXCEPT a. promotion and maintenance of health. b. health policy formation. c. improvements in healthcare systems. d. psychosomatic effects on health.

ANSWER: d 10.

"AIDS, a disease of the immune system, is directly affected by stress. Stress may then promote the deadly progression of the disease." These two statements are an example of ______ factors influencing ______ processes. a. psychological; biological b. biological; psychological c. sociocultural; genetic d. genetic; sociocultural ANSWER: a 11. Which of the following statements is TRUE? a. Around 50% of deaths from the 10 leading causes of death in the United States can be traced to behaviors common to certain lifestyles. b. Smoking is the leading preventable cause of death in the United States. c. Smoking has been estimated to cause 20% of all deaths. d. All of the above ANSWER: d 12. According to the principles of health psychology, which of the following is the best protection against acquiring AIDS? a. Getting an injection of the AIDS vaccine b. Being treated for HIV before it develops into AIDS c. Changing risky behaviors that can lead to disease acquisition Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation d. Deciding to be sexually abstinent after years of being sexually active ANSWER: c 13. The United States Centers for Disease Control estimate that ______ of Americans aged 14 to 49 years old are infected with herpes simplex virus. a. 5.1% b. 15.5% c. 25.7% d. 100% ANSWER: b 14. Lifestyle factors includes things such as: a. Smoking b. Nutrition c. Physical activity d. All of the above are lifestyle factors ANSWER: d 15. In 1936 Canadian researcher Hans Selye discovered that giving injections to laboratory rats caused them to develop ulcers. His finding led to a new area of study called a. stress physiology. b. stress psychology. c. animal psychology. d. psychosomatic pathology.

ANSWER: a 16. In response to sustained stress, the body goes through several stages that together constitute the general adaptation syndrome (GAS), a concept proposed by researcher Hans Selye. The GAS consists of all the following stages EXCEPT _____________. a. alarm b. resistance c. exhaustion d. remediation ANSWER: d 17. The physiological response of an individual to a stressor is called___________. a. adaptation b. fight-or-flight reaction c. stress d. a syndrome ANSWER: c 18. Smoking is the leading preventable cause of death in the Unites States and lowers the overall national life expectancy because of: a. premature death. b. maternal mortality.

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Chapter 07 Trauma and Dissociation c. its link with poor eating habits. d. its link with alcoholic consumption.

ANSWER: a 19. Research has shown that increased levels of cortisol in response to stress may cause damage to parts of the_________________. a. skeletal system b. brain c. lungs d. stomach ANSWER: b 20. Which of the following statements accurately describes a process in the activation of the HPA (hormonal) axis? a. The hippocampus secretes corticotropin releasing factor (CRF). b. CRF stimulates the thyroid gland. c. The hippocampus (via the somatic nervous system) activates the adrenal glands. d. The adrenal glands secrete the stress hormone cortisol.

ANSWER: d 21. Research has shown that excessive secretion of the stress hormone cortisol can result in cell death in the hippocampal region of the brain in cases of . a. substance abuse b. mania c. posttraumatic stress disorder d. AIDS ANSWER: c 22. Continuous secretion of the stress hormone cortisol by the adrenal glands can lead to all of the following EXCEPT a. damage to the hippocampus. b. impaired functioning of the immune system. c. muscle atrophy. d. low blood pressure in the cardiovascular system.

ANSWER: d 23. Which of the following best represents the emotional continuum believed to be related to coping with threat and challenge? a. Anxiety, stress, depression, excitement b. Stress, anxiety, depression, excitement c. Depression, stress, excitement, anxiety d. Excitement, stress, anxiety, depression ANSWER: d 24. Which of the following factors is most closely related to how well you think you can cope with a threat or challenge? a. Control b. Effort Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation c. Cortisol d. Practice ANSWER: a 25. Whether or not stress and/or anxiety develop in a stressful situation appears to be related to one's perceived sense of ________________. a. happiness b. excitement c. control d. acceptance ANSWER: c 26. Based on your knowledge of recent research studies, which of the following people would you predict is LEAST likely to catch a cold following exposure to the virus? a. Karen, a very sociable woman who has many good friends b. Mike, a very intelligent student who understands complex information and concepts c. Judy, a very assertive individual who frequently says exactly what's on her mind d. Marilyn, a very compulsive person who likes to point out other people's mistakes ANSWER: a 27. How does early life stress contribute to cardiovascular disease, type 2 diabetes, and cancer? a. Increases blood sugar levels b. Increases platelets c. Increases inflammation d. Decreases serotonin ANSWER: c 28. Josh goes to the doctor to talk about his risks for heart disease. Based on this chapter, what is his doctor likely to ask? a. Do you have any family history of heart disease? b. Do you smoke? c. Is your diet rich in fruits and vegetables? d. All of the above are correct.

ANSWER: d 29. Which of the following is associated with a stronger immune system? a. Optimism b. Pessimism c. Realism d. Depression ANSWER: a 30. The work of Cohen and his associates suggests that a. intensity of stress one experiences impacts the severity of cold symptoms. b. social support has no effect on cold symptoms. c. exposure to friends increases the chance of illness.

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Chapter 07 Trauma and Dissociation d. cold symptoms are mostly psychological.

ANSWER: a 31. All of the following situations have been associated with lowered immune system functioning EXCEPT a. marital conflict or relationship difficulties. b. job loss. c. death of a loved one. d. pregnancy.

ANSWER: d 32. Research findings have suggested that it might not be the stressful event itself that lowers immune system functioning but rather the accompanying _________________. a. dissociation b. isolation c. depression d. anger ANSWER: c 33. Stress affects immune function a. but only if the stressful event is life-threatening. b. even if the stressful event lasts as little as 2 hours. c. in real life but not in the lab. d. only in the chronically ill.

ANSWER: b 34. The immune system identifies and eliminates foreign materials, which are called _____________. a. antigens b. mitogens c. lymphokines d. antibodies ANSWER: a 35. The cells of the humoral immune system that produce immunoglobulins are called a. B cells b. T cells c. NK cells d. macrophages ANSWER: a

.

36. B cells are associated with _____________ immunity, while T cells are associated with ___________ immunity: a. humoral; memory b. humoral; cellular c. cellular; humoral d. vascular; suppressor ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation 37. Which of the following immune cells enhance immune system responses by signaling B cells to produce antibodies and signaling other T cells to destroy antigens? a. B cells b. Helper T cells c. T suppressor cells d. NK cells ANSWER: b 38. Too many T4 (helper) cells can result in a. an autoimmune disease. b. diminished antibody responses. c. long-term immune activity. d. diminished immune functions.

ANSWER: a 39. The immune system is weakened in AIDS patients because the human immunodeficiency virus directly attacks the lymphocytes called _________. a. killer T cells b. T4 (helper cells) c. suppressor T cells d. B cells ANSWER: b 40. Given the map of prevalence of HIV, where might philanthropists target their money if their goal is to eradicate HIV? a. Central Europe b. Southern Africa. c. The United States d. Latin America ANSWER: b 41. Contrary to the earlier belief that the brain and immune system operate independently of each other, scientists now know that a. the immune system functioning can be suppressed through classical conditioning. b. there are many connections between the nervous system and the immune system. c. there are psychological influences on the neurological responding implicated in our immune response. d. all of the above.

ANSWER: d 42. Psychoneuroimmunology focuses on the study of a. physiology, neurons, and immune function. b. psychology, neurological responses, and immune function. c. psychology, nature, and illness. d. physiological numbers and images.

ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation 43. In 2011, it was estimated that the total number of people afflicted with HIV, the human immunodeficiency virus, was slightly more than million. a. 13 b. 23 c. 34 d. 43 ANSWER: c 44. Estimates regarding the prevalence of AIDS in southern Africa indicate that a. the percent of the adult population that are HIV positive comprises two-thirds of the cases worldwide. b. 10% of the adult population has AIDS. c. 5 million children are orphaned by the disease. d. all of the above.

ANSWER: a 45. Which of the following statements about AIDS is TRUE? a. An infected person immediately develops AIDS-related complex (ARC). b. The median time for the development of full-blown AIDS is around 7 to 10 years. c. The death rate from AIDS increased 80% since 1990. d. The current successful treatment of AIDS is the result of highly active antiviral therapy (HAART), which eliminates the virus.

ANSWER: c 46. AIDS is now treated with new combinations of drugs called "highly active antiretroviral therapy" (HAART), which a. suppress the virus in people who are HIV positive. b. cure AIDS by eliminating the virus from the body. c. reduce herpes virus but not HIV cells. d. are well tolerated and cause minimal side effects.

ANSWER: a 47. LaDanian has recently started losing weight, developed a fever, and experiences night sweats. He may be experiencing ______________. a. HIV b. AIDS c. pneumonia d. AIDS-related complex ANSWER: d 48. Group psychotherapy for cancer patients tends to a. reduce recovery times. b. increase survival times. c. affect mental but not physical health. d. cure cancer.

ANSWER: b

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Chapter 07 Trauma and Dissociation 49. Which of the following is NOT true? a. Group psychotherapy always prolongs life in cancer patients. b. Group psychotherapy seems to decrease depression in cancer patients. c. Group psychotherapy may prolong life in some cancer patients. d. Mothers of children with cancer benefit from therapy.

ANSWER: a 50. Benefit finding refers to a. looking for the positive consequences of getting cancer. b. obtaining adequate healthcare coverage for cancer. c. promoting immune function in response to cancer. d. enhancing medical treatments for cancer.

ANSWER: a 51. Which of the following does NOT describe an effective psychosocial intervention that has been reported in oncology research studies? a. Use of psychological treatments that reduce pain and depression and enhance feelings of well-being b. Use of videotapes and dolls that reduce children's stress and anxiety during medical procedures c. Use of therapy sessions that temporarily prolong life for breast cancer patients both during and after the intervention d. Use of cognitive imaging techniques that temporarily render the AIDS virus inactive for brief periods ANSWER: d 52. Unhealthy and/or risky behaviors that impact directly on the cardiovascular system may contribute to a. strokes and high blood pressure only. b. coronary heart disease only. c. strokes, high blood pressure, and coronary heart disease. d. reduced immunity to autoimmune diseases.

ANSWER: c 53. Essential hypertension refers to a. the need to hold blood pressure levels constant. b. hypertension caused by a disease. c. hypertension caused by pregnancy. d. hypertension with no verifiable physical cause.

ANSWER: d 54. During laboratory stress tests, which of the following individuals has been shown to have greater reactivity in their blood pressure? a. Those with normal blood pressure whose parents had normal blood pressure b. Those with normal blood pressure whose parents had high blood pressure c. Those with very low blood pressure whose parents had low blood pressure d. Those with very low blood pressure whose parents had normal blood pressure ANSWER: b

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Chapter 07 Trauma and Dissociation 55. Since heart disease is the number one cause of death in the United States, it would be very important, in terms of prevention, to determine if a. better medications can be found to treat heart disease b. changes in behavior, lifestyle, and attitude can prevent heart attacks c. psychotherapy can help people adjust to having an artificial heart d. heart transplants can be made available to more patients ANSWER: b 56. Various psychological factors have been used to explain individual variations in blood pressure, including all of the following EXCEPT . a. coping style b. personality c. level of stress d. cognitive skills ANSWER: d 57. Which of the following is a correct match of medical condition and its definition? a. Angina: obstruction caused by build up of plaque in the arteries b. Atherosclerosis: deficiency of blood to a body part caused by narrowing of the arteries c. Mycardial infarction: death of heart tissue due to a completely clogged artery d. Ischemia: chest pain caused by partial obstruction of the arteries ANSWER: c 58. In reference to the clinical research studies focusing on factors that are implicated in heart disease, which of the following is an accurate statement? a. Males who displayed a Type A behavior pattern were less likely to develop coronary heart disease than females in the Type A group. b. Younger males in the Type A group were much less likely to develop coronary heart disease than older males in the Type A group. c. Both men and women with the Type A behavioral pattern were twice as likely to develop coronary heart disease than were non-Type A individuals. d. In comparison to "white collar" workers, men in lower socioeconomic positions were more likely to develop coronary heart disease.

ANSWER: c 59. Gregor has just learned that his spouse of 28 years has died in an automobile accident. Upon hearing the news, Gregor collapsed and was rushed to the hospital in apparent heart failure. Gregor probably suffered a. myocardial infarction. b. tranischemic attack. c. angina pectoris. d. myocardial stunning.

ANSWER: d 60. In comparison to men in the U.S., Japanese men exhibit a. increased Type A behavior and decreased coronary heart disease (CHD). b. decreased Type A behavior and decreased CHD. Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation c. increased Type A behavior and increased CHD. d. decreased Type A behavior and increased CHD. ANSWER: b 61. Mr. Velasquez is participating in a clinical research study that is investigating psychological factors that may influence the development of heart disease. When he is instructed to imagine a situation in which he was very angry, the sensors monitoring his heart reveal that a. his heartbeat has slowed significantly. b. his heart is pumping less efficiently. c. the area around his heart has become swollen and inflamed. d. he is having a "painless" heart attack.

ANSWER: b 62. Cardiac problems have recent been found to be related to _____________. a. anger b. anxiety c. depression d. all of the above ANSWER: d 63. Miss T was slightly injured in an accident but has fully recovered. Although she has been given medical clearance to go back to work and resume her normal activities, she maintains that she is still suffering from pain. You would correctly assess Miss T as someone who probably has a. adequate coping skills. b. strong family and social support. c. no history of anxiety and/or depression. d. a disability claim pending.

ANSWER: d 64. All of the following are examples of "pain behaviors" EXCEPT a. complaining about pain to others. b. grimacing. c. positional changes (while sitting or walking). d. suffering in silence.

ANSWER: d 65. People who experience phantom limb pain a. have lost an arm or a leg. b. can describe in exquisite detail the exact location and type of pain. c. experience changes in the sensory cortex of the brain. d. all of the above.

ANSWER: d 66. Based on findings from clinical research, treatment programs for chronic pain focus primarily on a. surgical procedures.

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Chapter 07 Trauma and Dissociation b. herbal remedies. c. psychological factors. d. experimental procedures for pain relief.

ANSWER: c 67. Researchers who study the clinical experience of pain have determined that pain is a. entirely due to physical causes. b. entirely due to psychological causes. c. neither entirely physical, nor entirely psychological. d. always due to unknown and unpredictable factors.

ANSWER: c 68. Which of the following is NOT an example of the complex interaction of physical and psychological factors in the experience of pain? a. The gate control theory of pain b. Phantom limb pain c. Chronic pain d. Delusional pain ANSWER: d 69. In the phenomenon known as "operant" control of pain, the pain behaviors manifested by an individual are determined by a. the type of injury. b. social consequences. c. the side effects of medications. d. the patient's reaction to treatment.

ANSWER: b 70.

In regard to the gate control theory, the___________are thought to open the gates, allowing pain sensations to be transmitted, while__________are thought to close the gate and block the sensations. a. small fibers; large fibers b. large fibers; small fibers c. small fibers; internal fibers d. psychological factors; physiological fibers ANSWER: a 71. The "natural" opioids called endorphins or enkephalins act like neurotransmitters to a. increase awareness of pain. b. shut down the sensation of pain. c. cause a "natural" addiction. d. relieve the pain caused by a heroin overdose.

ANSWER: b

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Chapter 07 Trauma and Dissociation 72. Endogenous opioids have been implicated in a variety of psychopathological conditions including________________. a. eating disorders b. phobias c. obsessive-compulsive disorder d. personality disorders ANSWER: a 73. Regarding gender differences in the experience of pain, women suffer more frequently than men from all of the following EXCEPT _____________. a. migraine headaches b. arthritis c. carpal tunnel syndrome d. backache ANSWER: d 74. Females may have an "extra" pain-regulating pathway focused on relieving pain associated with the reproductive system. One implication of this biological gender difference is that a. men need more pain relief than women following surgical procedures. b. women do not need pain relief during childbirth. c. males and females may benefit from different kinds of medications and different kinds of pain management. d. the psychological experience of pain is the same for men and women.

ANSWER: c 75. In the mid-19th century, symptoms of fatigue, vague aches and pains, low-grade fever, and lack of energy were attributed to a disorder called . a. neurasthenia b. neurosis c. hysteria d. somatic syndrome ANSWER: a 76. The same symptoms that were diagnosed in the 19th century as a condition called neurasthenia are currently referred to as ________________. a. somatization disorder b. chronic fatigue syndrome c. wasting disease d. psychogenic pain disorder ANSWER: b 77. At various times the symptoms of the disorder known as chronic fatigue syndrome were attributed to all of the following EXCEPT . a. viral infection b. environmental toxins c. clinical depression d. brain atrophy Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation ANSWER: d 78. The development of chronic fatigue syndrome is associated with a. an extremely stressful life event. b. over exercise. c. achievement-oriented lifestyles. d. a tendency to minimize pain.

ANSWER: a 79. A treatment for chronic fatigue syndrome developed by Michael Sharpe includes all of the following EXCEPT____________. a. medication b. increased activity c. regulated rest periods d. breathing exercises ANSWER: a 80. A controlled research study investigating the effects of a cognitive-behavioral treatment for chronic fatigue syndrome resulted in improvement on a. measures of fatigue. b. measures of illness belief. c. both measures of fatigue and measures of illness belief. d. neither measures of fatigue nor measures of illness belief.

ANSWER: c 81. Pain may be associated with ________________________. a. decreased natural killer (NK) cells b. increased natural killer (NK) cells c. increased B cells d. decreased T cells ANSWER: a 82. All of the following are psychosocial treatments that have been developed for physical disorders and pain EXCEPT______________. a. biofeedback b. meditation c. relaxation procedures d. acupuncture ANSWER: d 83. The procedure known as biofeedback involves a process by which a person is first helped to become aware of his/her ________________. a. physiological functions b. psychological state of mind c. negative thoughts Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation d. level of pain ANSWER: a 84. It has been suggested that biofeedback relieves the pain of tension headaches because it "teaches people to relax," but it is more likely that a. the patients whose pain is seemingly relieved by biofeedback are probably also taking aspirin or Tylenol. b. biofeedback training gives patients a sense of control over their headache pain. c. biofeedback has a "numbing effect" because it affects the nerve endings in the somatic nervous system. d. patients experience a placebo effect because the headache pain returns once the biofeedback sessions are completed.

ANSWER: b 85. Which of the following has been shown as the MOST effective to reduce your number of headaches? a. Taking ibuprofen daily b. Avoiding loud noises c. General stress reduction techniques and desensitization to triggers d. All of the above are correct ANSWER: c 86.

In the 1960s, Neal Miller, using with animals, discovered the first experimental evidence that physiological functions were subject to voluntary control. a. classical conditioning b. physical retraining c. operant conditioning d. obedience training ANSWER: c 87. In biofeedback procedures, clinicians use physiological monitoring equipment to make the responses______________ to the patient. a. visible b. audible c. visible and/or audible d. tactile ANSWER: c 88. In the 1970s, Herbert Benson developed a brief relaxation procedure that involved focusing on a . a. word b. photo c. person d. musical note ANSWER: a 89.

Cassandra is sitting cross-legged on her rug with her arms outstretched. She closes her eyes and makes a sound like "ummmm." She continues this procedure. Cassandra is demonstrating______ and the sound is a(n) ________.

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Chapter 07 Trauma and Dissociation a. relaxation response; focus b. meditation; mantra c. biofeedback; focus d. hypnosis; focal point ANSWER: b 90. According to Holroyd et al., (1984) biofeedback may decrease pain because it a. instills a sense of control over the pain. b. decreases tension. c. increases awareness of the body. d. decreases sensitivity to pain.

ANSWER: a 91. Recent clinical studies indicate that it is a good pain relieving strategy to use biofeedback in conjunction with_______________. a. medication b. relaxation procedures c. a placebo d. psychotherapy ANSWER: b 92. Comprehensive pain management programs usually include programs for teaching patients about______________. a. relaxation b. meditation c. both meditation and relaxation d. neither meditation nor relaxation ANSWER: c 93. Although the improvement is only moderate, relaxation techniques have been shown to have a positive effect on_______________. a. headaches b. hypertension (high blood pressure) c. pain d. all of these ANSWER: d 94. In keeping daily records of the stressful events in their lives, patients in pain management programs are taught to be very specific about all of the following EXCEPT a. the actual time of day that they experience stress b. what seems to "trigger the stress." c. how they attempted to control the stress. d. the level of intensity of the stress.

ANSWER: c 95. In a stressful events record, clients in a pain management program are asked to record Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation a. somatic symptoms only. b. thoughts that occur during stress but not somatic symptoms. c. thoughts that occur during stress as well as somatic symptoms. d. intensity of the stress, but not thoughts or somatic symptoms.

ANSWER: c 96. Cognitive therapy is used in stress management programs to help clients learn to do all of the following EXCEPT a. develop more realistic appraisals and attitudes. b. identify unrealistic negative thoughts. c. tell off people they don't like as a way of reducing stress. d. assert themselves in an appropriate way in stressful situations.

ANSWER: c 97. For coping with chronic pain, chronic fatigue syndrome, and hypertension, _________________is considered generally more effective than either ___________ or ______________alone. a. a stress management program; biofeedback; relaxation techniques b. biofeedback; relaxation techniques; a stress management program c. relaxation techniques; biofeedback; a stress management program d. relaxation, biofeedback, and stress management programs are all considered equally effective ANSWER: a 98. Individuals who are high users of pain relieving medications are _______________to benefit from pain management programs than less frequent users. a. more likely b. less likely c. equally likely d. unable ANSWER: b 99. Chronic use of pain medications to treat headaches a. decreases the efficacy of comprehensive programs to treat headaches. b. is associated with decreased pain initially, but is followed by rebound pain. c. decreased pain in the long run. d. is associated with an increase in short- and long-term pain.

ANSWER: b 100. In a comprehensive headache treatment program, people who were low users of analgesic medications achieved at least a reduction in headache severity and frequency. a. 25% b. 50% c. 75% d. 99% ANSWER: b 101. Studies of pain suggest that people who are optimistic Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation a. use denial to cope. b. use wishful thinking to manage. c. deal with pain directly. d. avoid treatment.

ANSWER: c 102. Jon W. has just been diagnosed with cancer. His initial response is to deny the seriousness of his condition. This type of coping mechanism a. will enable him to develop better coping mechanisms later. b. is never psychologically helpful. c. doesn't really help him endure the initial shock any more easily. d. results in higher levels of corticosteroids (stress hormones).

ANSWER: a 103. Which of the following is NOT one of the three most common behaviors that put us at risk for physical disorders? a. Unhealthy eating habits b. Lack of exercise c. Smoking d. Watching too much TV ANSWER: d 104. The leading preventable cause of death is _____________ . a. smoking b. cirrhosis of the lever (from alcoholism) c. poisoning d. accidents ANSWER: a 105. According to the textbook, the leading cause of death for people between the ages of 1 and 45 years is a. cancer b. injury c. infectious disease d. genetic defect ANSWER: a

.

106. Injury prevention programs have proven effective in teaching children about all of the following EXCEPT a. escaping fires. b. crossing streets. c. riding bikes safely. d. properly extinguishing cigarettes.

ANSWER: d 107. Which is an accurate statement regarding injury prevention programs for children? a. Most communities have injury prevention programs.

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Chapter 07 Trauma and Dissociation b. Repeated warnings have been effective in preventing or reducing the number of injuries. c. Children who participated in safety skills programs remembered what they had learned even after the programs were over. d. Injury prevention programs have been ineffective in changing children's behavior.

ANSWER: c 108. The only effective prevention strategy currently available for reducing the spread of AIDS appears to be_______________. a. a vaccine b. medications c. changing high-risk behavior d. educating people about the risk of the disease ANSWER: c 109. With regard to the epidemic of AIDS in Africa, an individual is most likely to become HIV positive following a. heterosexual sex with an infected partner. b. homosexual sex with an infected partner. c. repeated injections with unsterilized needles. d. close non-sexual contact with an infected person.

ANSWER: a 110. Steven and Diane, two young adults who live in different cities and do not know each other, have learned recently that they are HIV positive following sexual intercourse with infected partners. What changes in their behavior are most likely to occur in the future? a. Both Steven and Diane will now abstain from sex completely. b. Steven will abstain from sex, but Diane will continue to have sex. c. Both Steven and Diane will continue to have unprotected sex. d. Both Steven and Diane will be sure to tell future sexual partners that they are HIV positive.

ANSWER: c 111. Carla and Carlos have recently learned that they are HIV positive. According to research studies involving people who are HIV positive, what is most likely to occur? a. Carla will now have sex only if her partner uses a condom. b. Carlos will abstain from sex completely. c. Both Carla and Carlos will stop sharing needles with other drug users. d. Neither Carlos nor Carla is likely to change any of their previous behaviors.

ANSWER: d 112. When high-risk individuals are given educational and informational pamphlets about ways to reduce their chances of becoming HIV positive, they typically a. change their high-risk behaviors. b. do not change their high-risk behaviors. c. abstain from unprotected sex. d. notify previous sex partners of their HIV condition.

ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation 113. Which of the following was NOT one of the procedures or types of information used as part of San Francisco's 1990 community-level program to reduce new cases of HIV infection? a. Personal detailed assessment of HIV risk for each individual b. Instructions on how to clean needles c. Classes and videos to demonstrate safe sex skills d. Discussions of the moral and religious consequences of being HIV positive ANSWER: d 114. Which of the following factors does NOT accurately represent the circumstances regarding women and HIV/AIDS? a. Women frequently do not consider themselves at risk because most media coverage of the AIDS epidemic has focused on gay white males. b. Most research on the spread of AIDS has ignored the disease in women. c. Women accounted for 50% of new AIDS cases in 2003. d. The highest age of risk for women is after age 25.

ANSWER: d 115. Regarding the age ranges for the risk of HIV/AIDS, which of the following statements is accurate? a. For women, the highest risk is between 15 and 25. b. For women, the highest risk is during their late 20s and early 30s. c. The age range for risk is younger for men than for women. d. The age ranges for risk are the same for both males and females.

ANSWER: a 116. In regard to setting up behavioral change programs that address the HIV/AIDS epidemic, which of the following is an accurate statement? a. The same kinds of programs can be set up for both females and males. b. Women and men need different types of programs because their risk factors are different. c. Women are not acquiring HIV/AIDS as fast as men are. d. Media attention and even research has focused on women with AIDS and largely ignored men.

ANSWER: b 117. Which is a type of circumstance in which women put themselves at risk for HIV/AIDS infection differently from men? a. Having unprotected sex with partners whose sexual history is unknown b. Using contaminated needles when injecting illegal drugs c. Becoming prostitutes in response to economic deprivation d. Having sex with multiple partners ANSWER: c 118. Your textbook reports on a behavioral change program to address the high rate of smoking in China. This was an important study for several reasons including the fact that a. the number of people who smoke in China equals the entire population of the United States. b. almost 100% of the women in China smoke. c. males and females in China have equally high rates of smoking. d. the types of cigarettes smoked in China are more potent than in the U.S. Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation ANSWER: a 119. A massive antismoking campaign in China in 1989 involved a. bonuses to employees who quit smoking. b. wives threatening divorce of their husbands didn't stop smoking. c. school children intervening in their fathers' smoking habits. d. married couples' written agreements to stop smoking.

ANSWER: c 120. In 1989, health professionals in China began a massive antismoking effort in several cities that involved children whose fathers smoked. As part of this effort, all of the following are accurate statements EXCEPT a. schoolchildren were given antismoking literature and questionnaires to take home to their fathers. b. children wrote letters to their fathers asking them to quit smoking. c. children submitted monthly reports on their fathers' smoking habits to their schools. d. photos of the fathers who continued smoking were published in the school newspapers.

ANSWER: d 121.

In the massive antismoking campaign in China in 1989, the results indicated that of the 10,000 fathers in the intervention group ______ quit smoking for at least 6 months in comparison to a control group of 10,000 in which only quit smoking. a. 1%; 0.1% b. 12%; 0.2% c. 22%; 2.2% d. 50%; 25% ANSWER: b 122. One of the most successful efforts to reduce risk factors for a medical condition involved three entire communities in California in which residents received different types of interventions or no intervention at all (for the community that served as the control group). The targeted condition in this effort was . a. diabetes b. cancer c. heart disease d. obesity ANSWER: c 123. When pain is induced after people are given a placebo, they feel less pain because a. the endogenous opioid system is activated. b. they simply report less pain. c. they think they feel less pain. d. they pretend to have pain.

ANSWER: a 124. Research on the placebo effect is valuable because it a. shows that it is difficult to easily separate the effects of biochemical and psychological factors on brain function.

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Chapter 07 Trauma and Dissociation b. may make it possible to more efficiently integrate placebo and drug treatments. c. can help us understand the mechanisms by which drugs are effective in pain treatment d. all of these ANSWER: d Subjective Short Answer 125. Define and describe the new fields of behavioral medicine and health psychology.

ANSWER: In the field of behavioral medicine, knowledge derived from behavioral science is applied to the prevention, diagnosis, and treatment of medical problems. This interdisciplinary field involves psychologists, physicians, and other health professionals working together to develop prevention and treatment strategies.

Health psychology is a subfield of behavioral medicine, which is not interdisciplinary. Practitioners in this area study the psychological factors that are important in the promotion and maintenance of health, and study and influence healthcare systems and health policy formation.

Both areas contribute to our understanding of psychological, social, and biological factors that impact health.

126. Discuss some effective and less effective strategies for preventing headaches.

ANSWER: Traditional medical advice for people suffering from headaches are to avoid the triggers leading to

the headache in the first place. However, it is possible that avoiding triggers is not as effective as learning how to cope with the triggers. This includes general stress reduction techniques and “planned exposures” to achieve desensitization and to examine whether an alleged trigger does, in fact, precipitate headaches. Pain medication is an obvious and commonly practiced strategy to avoid pain. Despite its frequent use, it is not overly effective and can lead to overuse and even dependency.

127. Is denial a reasonable response to coping with chronic illness? Why or why not?

ANSWER: Denial is not always unreasonable. Health psychologist Shelley Taylor (2009) points out that most

individuals who are functioning well deny the implications of a potentially serious condition, at least initially. A common reaction is to assume that what they have is not serious or will go away quickly. Most people with serious diseases react this way, including those with cancer and Chronic Heart Disease. Several groups of investigators have found that during an extremely stressful period when a person is first diagnosed, denial may help patients endure the shock more easily. They are then better able to develop coping responses later. The value of denial as a coping mechanism may depend more on timing than on anything else. In the long run, however, all evidence indicates that at some point we must face the situation, process our emotions, and come to terms with what is happening.

128. Discuss the relationship between stress, immune function, and illness.

ANSWER: Stress refers to stimuli that cause stress, often called stressors, and responses to those stimuli.

Physiologically, stress responses mobilize resources to respond to threats. During a stress response, the sympathetic nervous system activates internal organ responses to stress called the fight-or-flight response.

This complex process mobilizes neuropeptides, neuromodulators, and hormones, which carry messages throughout the body, increasing energy, strength, and alertness. This process can be triggered by physical, psychological, and social events. If such responses become chronic, they can strain the body’s response capabilities and suppress immune system functioning. Diminished immune function can create susceptibility to illnesses.

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Chapter 07 Trauma and Dissociation 129. Discuss the evidence that we have supporting Cognitive Behavioral Therapy (CBT) for stress reduction the

progression of Cardio Vascular Disease.

ANSWER: The study by Gulliksson et al., (2011) showed that a CBT program focusing on stress management can prevent recurrent heart problems in patients who experienced their first cardiovascular events.

During the 94 months follow up period, patients who received CBT had a 41% lower rate of fatal or nonfatal recurrence of cardiovascular events (such as a stroke or heart attacks) than those who received only traditional care. Similar results were reported in a Swedish study (Orth-Gomer et al., 2013). Approximately 7 years after randomization, patients in the CBT group were 3 time more likely to survive than people in the usual care group.

130. Discuss why stress is often implicated as a factor in cardiovascular disease and how the Type A behavior pattern relates to this process.

ANSWER: The cardiovascular system includes the heart, blood vessels, and control mechanisms for its regulation.

Cardiovascular disease often occurs because of blockages in blood vessels to the heart, which cause heart attacks, and in blood vessels to the brain, which cause stress. High blood pressure (hypertension) and high cholesterol levels contribute to both of these problems. Hypertension can occur as a result of strong physiological responses to stress, kidney problems, emotional distress, feelings of uncontrollability, and low social support. Type A behavior was originally described as a combination of impatience, energy, time pressure, and competitiveness. Early researchers (Freidman and Rosenman) thought this behavior pattern caused heart disease, although later research suggests that the relationship is complex, with negative emotions such as anger, hostility, anxiety, and depression being stronger predictors of cardiovascular disease than the Type A pattern itself.

131. Discuss chronic fatigue syndrome (CFS) and chronic pain. What psychological factors are thought to maintain chronic pain?

ANSWER: CFS is characterized by fatigue, a lack of energy, aches, pains, and a low-grade fever, in the absence of clear physical pathology. The disease has been attributed to the demands of time and work, although no clear cause has as yet been identified. CFS patients suffer pain for long periods of time and often have to significantly adjust their lives, although the condition is not life threatening. At this time, it is not clear why some people develop this disorder or how best to treat it, although cognitive-behavioral approaches may be helpful. In contrast, chronic pain usually begins with an acute episode or injury, but the pain does not decrease over time, even when the injury has healed or effective treatments have been administered.

Typically, chronic pain occurs in muscles, joints, or tendons, but it can also be related to headaches and degenerative diseases. Chronic pain can affect all aspects of a person’s life, but responses vary as a function of psychological responses. Anxiety and depression exacerbate the affects of chronic pain, while a sense of control and optimism can result in less distress and disability.

132. Describe the use of biofeedback, meditation, and relaxation techniques in the management of stress-related disorders.

How effective are these treatments for stress management and pain relief?

ANSWER: Biofeedback refers to the process of making patients aware of specific physiological functions that they would not ordinarily notice such as heart rate and muscle tension. Using feedback regarding their responses, they are taught to alter or change these responses to promote relaxation. Biofeedback has been shown to be effective at controlling a number of types of pain, including headaches. Relaxation and meditation techniques focus on helping people to focus attention on either a single thought or image, or part of the body, in order to promote the relaxation response. By minimizing distractions, people learn to focus on internal sensations.

This process can promote a sense of calm, control, and mastery, and relax the body. Such techniques have been shown to have positive effects on headaches, hypertension, and some types of acute and chronic pain.

133. Why might it be important to engage sexual partners in HIV prevention?

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Chapter 07 Trauma and Dissociation ANSWER: As people across the gender spectrum can contract HIV, we must focus prevention efforts on all people.

Sexual relations outside of a stable union are the reality for many couples worldwide. Consistent condom use is typically low in these partnerships. Interventions of couples counseling and testing have occurred in

Rwanda, Uganda, and Kenya, and have been shown to be successful in reducing HIV incidence there.

134. What evidence do we have as to the success of large-scale community health interventions?

ANSWER: One of the best-known and most successful efforts to reduce risk factors for disease in the

community is the Stanford Three Community Study. Investigators studied three entire communities in central California that were reasonably alike in size and type of residents between 1972 and 1975. The target was reduction of risk factors for Chronic Heart Disease. The positive behaviors that were introduced focused on smoking, high blood pressure, diet, and weight reduction. Participants in all three communities were surveyed once a year for a 3-year period following the intervention. Results indicate that the interventions were markedly successful at reducing risk factors for CHD in these communities. A similar community-wide study on CHD was conducted in Franklin County in rural Maine over a period of 40 years (1970-2010). Franklin County is a low-income community with fewer than 31,000 inhabitants. Using modest grants and many volunteers, a community-wide program was implemented to reduce hypertension, cholesterol and smoking, and to improve diet and exercise. Compared to other areas of Maine and also compared to the same county 10 years prior to implementing the program, these efforts resulted in fewer hospitalizations and mortality rates over a period of 40 years.

Essay 135. Define and describe the new fields of behavioral medicine and health psychology.

ANSWER: In the field of behavioral medicine, knowledge derived from behavioral science is applied to the prevention, diagnosis, and treatment of medical problems. This interdisciplinary field involves psychologists, physicians, and other health professionals working together to develop prevention and treatment strategies.

Health psychology is a subfield of behavioral medicine, which is not interdisciplinary. Practitioners in this area study the psychological factors that are important in the promotion and maintenance of health, and study and influence healthcare systems and health policy formation.

Both areas contribute to our understanding of psychological, social, and biological factors that impact health.

136. Discuss some effective and less effective strategies for preventing headaches.

ANSWER: Traditional medical advice for people suffering from headaches are to avoid the triggers leading to

the headache in the first place. However, it is possible that avoiding triggers is not as effective as learning how to cope with the triggers. This includes general stress reduction techniques and “planned exposures” to achieve desensitization and to examine whether an alleged trigger does, in fact, precipitate headaches. Pain medication is an obvious and commonly practiced strategy to avoid pain. Despite its frequent use, it is not overly effective and can lead to overuse and even dependency.

137. Is denial a reasonable response to coping with chronic illness? Why or why not?

ANSWER: Denial is not always unreasonable. Health psychologist Shelley Taylor (2009) points out that most

individuals who are functioning well deny the implications of a potentially serious condition, at least initially. A common reaction is to assume that what they have is not serious or will go away quickly. Most people with serious diseases react this way, including those with cancer and Chronic Heart Disease. Several groups of investigators have found that during an extremely stressful period when a person is first diagnosed, denial may help patients endure the shock more easily. They are Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation

then better able to develop coping responses later. The value of denial as a coping mechanism may depend more on timing than on anything else. In the long run, however, all evidence indicates that at some point we must face the situation, process our emotions, and come to terms with what is happening.

138. Discuss the relationship between stress, immune function, and illness.

ANSWER: Stress refers to stimuli that cause stress, often called stressors, and responses to those stimuli.

Physiologically, stress responses mobilize resources to respond to threats. During a stress response, the sympathetic nervous system activates internal organ responses to stress called the fight-or-flight response.

This complex process mobilizes neuropeptides, neuromodulators, and hormones, which carry messages throughout the body, increasing energy, strength, and alertness. This process can be triggered by physical, psychological, and social events. If such responses become chronic, they can strain the body’s response capabilities and suppress immune system functioning. Diminished immune function can create susceptibility to illnesses.

139. Discuss the evidence that we have supporting Cognitive Behavioral Therapy (CBT) for stress reduction the

progression of Cardio Vascular Disease.

ANSWER: The study by Gulliksson et al., (2011) showed that a CBT program focusing on stress management can prevent recurrent heart problems in patients who experienced their first cardiovascular events.

During the 94 months follow up period, patients who received CBT had a 41% lower rate of fatal or nonfatal recurrence of cardiovascular events (such as a stroke or heart attacks) than those who received only traditional care. Similar results were reported in a Swedish study (Orth-Gomer et al., 2013). Approximately 7 years after randomization, patients in the CBT group were 3 time more likely to survive than people in the usual care group.

140. Discuss why stress is often implicated as a factor in cardiovascular disease and how the Type A behavior pattern relates to this process.

ANSWER: The cardiovascular system includes the heart, blood vessels, and control mechanisms for its regulation.

Cardiovascular disease often occurs because of blockages in blood vessels to the heart, which cause heart attacks, and in blood vessels to the brain, which cause stress. High blood pressure (hypertension) and high cholesterol levels contribute to both of these problems. Hypertension can occur as a result of strong physiological responses to stress, kidney problems, emotional distress, feelings of uncontrollability, and low social support. Type A behavior was originally described as a combination of impatience, energy, time pressure, and competitiveness. Early researchers (Freidman and Rosenman) thought this behavior pattern caused heart disease, although later research suggests that the relationship is complex, with negative emotions such as anger, hostility, anxiety, and depression being stronger predictors of cardiovascular disease than the Type A pattern itself.

141. Discuss chronic fatigue syndrome (CFS) and chronic pain. What psychological factors are thought to maintain chronic pain?

ANSWER: CFS is characterized by fatigue, a lack of energy, aches, pains, and a low-grade fever, in the absence of clear physical pathology. The disease has been attributed to the demands of time and work, although no clear cause has as yet been identified. CFS patients suffer pain for long periods of time and often have to significantly adjust their lives, although the condition is not life threatening. At this time, it is not clear why some people develop this disorder or how best to treat it, although cognitive-behavioral approaches may be helpful. In contrast, chronic pain usually begins with an acute episode or injury, but the pain does not decrease over time, even when the injury has healed or effective treatments have been administered.

Typically, chronic pain occurs in muscles, joints, or tendons, but it can also be related to headaches and degenerative diseases. Chronic pain can affect all aspects of a person’s life, but responses vary as a function Copyright Cengage Learning. Powered by Cognero.

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Chapter 07 Trauma and Dissociation of psychological responses. Anxiety and depression exacerbate the affects of chronic pain, while a sense of control and optimism can result in less distress and disability.

142. Describe the use of biofeedback, meditation, and relaxation techniques in the management of stress-related disorders.

How effective are these treatments for stress management and pain relief?

ANSWER: Biofeedback refers to the process of making patients aware of specific physiological functions that they would not ordinarily notice such as heart rate and muscle tension. Using feedback regarding their responses, they are taught to alter or change these responses to promote relaxation. Biofeedback has been shown to be effective at controlling a number of types of pain, including headaches. Relaxation and meditation techniques focus on helping people to focus attention on either a single thought or image, or part of the body, in order to promote the relaxation response. By minimizing distractions, people learn to focus on internal sensations.

This process can promote a sense of calm, control, and mastery, and relax the body. Such techniques have been shown to have positive effects on headaches, hypertension, and some types of acute and chronic pain.

143. Why might it be important to engage sexual partners in HIV prevention?

ANSWER: As people across the gender spectrum can contract HIV, we must focus prevention efforts on all people.

Sexual relations outside of a stable union are the reality for many couples worldwide. Consistent condom use is typically low in these partnerships. Interventions of couples counseling and testing have occurred in

Rwanda, Uganda, and Kenya, and have been shown to be successful in reducing HIV incidence there.

144. What evidence do we have as to the success of large-scale community health interventions?

ANSWER: One of the best-known and most successful efforts to reduce risk factors for disease in the

community is the Stanford Three Community Study. Investigators studied three entire communities in central California that were reasonably alike in size and type of residents between 1972 and 1975. The target was reduction of risk factors for Chronic Heart Disease. The positive behaviors that were introduced focused on smoking, high blood pressure, diet, and weight reduction. Participants in all three communities were surveyed once a year for a 3-year period following the intervention. Results indicate that the interventions were markedly successful at reducing risk factors for CHD in these communities. A similar community-wide study on CHD was conducted in Franklin County in rural Maine over a period of 40 years (1970-2010). Franklin County is a low-income community with fewer than 31,000 inhabitants. Using modest grants and many volunteers, a community-wide program was implemented to reduce hypertension, cholesterol and smoking, and to improve diet and exercise. Compared to other areas of Maine and also compared to the same county 10 years prior to implementing the program, these efforts resulted in fewer hospitalizations and mortality rates over a period of 40 years.

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Chapter 10 Sleeping Multiple Choice 1. Sleep studies suggest that around 28% of Americans a. get more than 6 hours of sleep a night. b. report feeling excessively sleepy during the day. c. have insomnia. d. need less than 5 hours of sleep a night.

ANSWER: b 2. Lack of adequate sleep has a negative effect on a. health b. productivity c. clarity of thought d. all of these choices ANSWER: d

.

3. The chief motivating factor in both anorexia nervosa and bulimia nervosa is a. desire to purge. b. an overwhelming drive to eat. c. an overwhelming urge to be thin. d. a desire to starve oneself.

ANSWER: c 4. Eating Disorders are common in: a. Western countries b. Sub-Saharan Africa c. people who have Bipolar Disorder d. Basketball players ANSWER: a 5 . When individuals with anorexia nervosa are evaluated over long periods of time, it has been found that the percentage of individuals who die as a result of their disorder is . a. 20% b. 5% c. 2% d. 40% ANSWER: a 4. Approximately a. 5 to 10% b. 10 to 15% c. 20 to 30% d. 40 to 45% ANSWER: c

of anorexia nervosa deaths are due to suicide.

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Chapter 10 Sleeping 5. The death rate (including suicide) due to anorexia nervosa is a. higher than for any other psychological disorder except depression. b. lower than that of most psychological disorders. c. higher than that any psychological disorder reviewed in your text. d. the highest of all of the psychological disorders.

ANSWER: c 6. Obesity is not classified as a disorder in the DSM-5 because a. very few Americans suffer from it. b. many Americans suffer from it, therefore it is not a “disorder. c. it is related to too many other health concerns. d. none of the answers are correct.

ANSWER: d 7. Between 1960 and 1995, most Western countries experienced a dramatic a. decrease in the incidence of anorexia nervosa and bulimia nervosa. b. increase in the incidence of anorexia nervosa and bulimia nervosa. c. increase in the incidence of anorexia nervosa but a decrease in the incidence of bulimia nervosa. d. increase in the incidence of bulimia nervosa and no change in the rate of anorexia nervosa.

ANSWER: b 8. The strongest contributions to etiology of eating disorders seem to be a. genetic b. psychological c. somatogenic d. sociocultural ANSWER: d

.

9. Jody sometimes eats more than just about any other girl that you know. You wonder if her eating sometimes could be considered bingeing. In order to determine this, you would have to know a. the caloric intake of the foods. b. whether she is eating junk foods. c. whether eating gets to be out of her control. d. the situations under which she eats a great deal.

ANSWER: c 10. The most significant feature of bulimia nervosa is . a. purging b. overeating c. overeating followed by an urge to vomit d. binge eating followed by compensatory behavior ANSWER: d 11. Purging techniques are ______ for bulimia nervosa. a. common and necessary for diagnosis Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping b. common but not necessary for diagnosis c. not as common as laxative use d. none of the above are correct ANSWER: b 12. Susan, a woman of relatively normal weight, sometimes eats huge quantities of junk food with no ability to stop herself. She follows this with long periods of complete fasting. Based on this information, Susan a. might be diagnosed with bulimia nervosa. b. should be diagnosed with anorexia nervosa. c. will not be diagnosed with any disorder because she is of normal weight. d. cannot be diagnosed with bulimia nervosa because she is not purging.

ANSWER: a 13. After engaging in an extended session of binge eating, Thomas goes to the bathroom and makes himself vomit. He thinks that he has removed all of the food he consumed from his stomach, but in fact he will only have removed around percent of the calories he consumed. a. one-third b. one-quarter c. one-half d. two-thirds ANSWER: c 14. Amy is a young woman who is very competitive and comes from a high-achieving, wealthy family. She is very social and likes the fact that she is quite popular. She believes that her popularity is dependent on the weight and shape of her body. Amy has a boyfriend but worries that she may care more about their relationship than he does. The feature that puts Amy most at risk for an eating disorder such as bulimia nervosa is her a. belief that her weight and body shape influence her popularity. b. belief that her boyfriend cares less about the relationship than she does. c. successful family. d. competitive nature.

ANSWER: a 15. The most serious medical consequence of bulimia nervosa is potential a. electrolyte imbalance b. salivary gland damage c. starvation d. tooth erosion ANSWER: a

.

16. Individuals with bulimia nervosa are typically a. within 10% of their "normal" weight. b. very overweight. c. very underweight. d. overweight during the development of the disorder but become underweight as the disorder progresses.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping 17. People with bulimia nervosa often present with additional psychological disorders, particularly ________ and _________. a. body dysmorphic disorder; substance disorders b. mood disorders; sexual disorders c. anxiety disorders; mood disorders d. obsessive compulsive disorder; sexual disorders ANSWER: c 18. Which of the following statements is TRUE? a. Eating disorders are a way of expressing depression. b. Eating disorders have a high comorbidity with stress disorders. c. Depression may be a reaction to bulimia nervosa. d. Around 20 to 40% of all people with bulimia nervosa meet the criteria for a mood disorder during the course of their eating disorder.

ANSWER: c 19. Research suggests that the restricting and bingeing/purging subtypes of anorexia nervosa a. are really different disorders. b. have completely different causes. c. show few differences in severity of symptoms. d. are useless distinctions of the same disorder.

ANSWER: c 20. Which of the following diagnoses would require the noticeable loss of weight? a. Anorexia nervosa b. Bulimia nervosa c. Binge-eating disorder d. Body dysmorphic disorder ANSWER: a 21. A common medical complication found in both bulimia nervosa and anorexia nervosa is a. brittle hair b. downy hair on limbs c. electrolyte imbalance d. cessation of menstrual cycle ANSWER: d

.

22. The most common reason that anorexic individuals generally do not seek treatment on their own is that they a. are ashamed of their disorder. b. fear that they will be hospitalized. c. do not truly believe that they are too thin. d. have little desire for food.

ANSWER: c

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Chapter 10 Sleeping 23. Individuals who experience loss of control of their eating and consume great quantities of food but do not engage in any attempts to compensate for their binge would be diagnosed with a. bulimia nervosa. b. binge-eating disorder. c. obsessive-compulsive disorder. d. anorexia nervosa.

ANSWER: b 24. The best evidence that binge-eating disorder (BED) may not just be a special case of bulimia nervosa is that a. more males than females suffer from BED. b. no genetic component has been identified for BED. c. there is a greater likelihood of remission and a better response to treatment for BED. d. the average age of onset is much younger for BED than it is for bulimia nervosa or anorexia nervosa.

ANSWER: c 25. Binge-eating disorder is characterized by a. laxative use b. purging c. a lack of compensatory behaviors d. emaciation ANSWER: c

.

26. The males most likely to develop an eating disorder such as bulimia nervosa are those who are a. overweight b. depressed c. homosexual d. only children ANSWER: c

.

27. Which of the following statements is TRUE? a. Anorexia nervosa typically occurs at a much earlier age than bulimia nervosa. b. Once bulimia nervosa develops, it tends to be chronic if untreated. c. Bulimic individuals eventually shift to symptoms of other eating disorders. d. Bulimia nervosa is more resistant to treatment than anorexia nervosa.

ANSWER: b 28. Studies of foreign-born students who are attending Western universities show that a. anorexia nervosa and bulimia nervosa do not occur in students who were raised in countries where these disorders do not exist. b. anorexia nervosa and bulimia nervosa are observed in some students who were raised in countries where these disorders do not exist. c. anorexia nervosa, but not bulimia nervosa, has been observed in some students who were raised in countries where these disorders do not exist. d. bulimia nervosa, but not anorexia nervosa, has been observed in some students who were raised in countries where these disorders do not exist.

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Chapter 10 Sleeping ANSWER: b 29. Which of the following is not a symptom of anorexia nervosa? a. Eating minimal amounts of food b. Vigorous exercise to offset food intake c. Eating large quantities of food at one time d. Overwhelming desire to be thin ANSWER: c 30. One American study (Mann, Tomiyama, & Ward, 2015) showed that over ______ people are dieting at any one time. a. 10,000 b. 250,000 c. 1 million d. over 100 million ANSWER: d 31. Which of the following is NOT true about dieting: a. is less problematic than previously thought. b. 55% of girls are dieting at age 12. c. dieting increases between adolescence and young adulthood. d. it can lead to an eating disorder.

ANSWER: a 32. Studies have found that adolescent girls of which race/ethnicity had less body dissatisfaction, fewer weight concerns, and a more positive body image when compared to Caucasian adolescent girls? a. African Americans b. Hispanics c. Native Americans d. Asians ANSWER: a 33. Which of the following might help to explain the vast differences in the incidence of eating disorders among men and women? a. The influence of behavioral genetics b. The fact that boys are encouraged to play sports and girls to be active in social functions c. The fact that puberty brings boys' bodies closer to the societal ideal and girls' bodies further from the societal ideal d. The differences in the way boys and girls tend to gain weight from overeating ANSWER: c 34. The median age of onset for all eating disorders is a. 13 to 19 b. 18 to 21 c. 20 to 26 d. 10 to 14 Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping ANSWER: b 35. The overwhelming majority of people with anorexia are ____ of their normal weight. a. 1% b. 5% c. 10% d. 25% ANSWER: c 36. The increase in the incidence of eating disorders such as anorexia nervosa and bulimia nervosa has been referred to as a "collision between our culture and our physiology." The most accurate interpretation of this statement is that a. people have become too dependent on media determinations of beauty. b. media standards of beauty are increasingly unattainable for the average woman. c. dieting has become a fad that has been taken to an extreme. d. society has no business telling us how to define beauty.

ANSWER: b 37. Dana eats a large Sunday meal with her family every week. She generally vomits after. In fact, Dana follows her caloric consumption carefully and makes herself vomit anytime that she eats more than 2000 calories in one meal. Which of the following best explains why Dana vomits: a. Vomiting relieves anxiety about overeating. b. Dana does not “feel” anything and is vomiting to feel more alive. c. Dana is bipolar. d. None of the answers are correct.

ANSWER: a 38. Which of the following is NOT true about the relationships between the media and attitudes about body shape? a. Prime-time situation comedies often feature women dieting or complaining about their weight. b. Most magazine models are thinner than average women. c. Men on TV are more likely to be overweight than women. d. The media has no impact on body image.

ANSWER: d 39. Mothers of girls with anorexia nervosa tend to be a. perfectionistic b. dieting themselves c. less satisfied with their families d. all of the above ANSWER: d

.

40. Studies suggest that young males would often prefer to be a. thinner b. heavier c. taller d. shorter Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping ANSWER: b 41. When women are asked to identify the most attractive female body weight, they typically identify a weight that is a. lower than the weight identified by men. b. the same as the weight identified by men. c. higher than the weight identified by men. d. 20% lower than their own body weight.

ANSWER: a 42. When men are asked to identify the ideal male body, they typically select a body weight that is about a. equal to their own. b. 28 pounds more muscular than their own. c. equal to the average male of their age. d. 15 pounds lighter than their own.

ANSWER: b 43. Which of the teenage girls described below is at greatest risk for developing an eating disorder? a. Alice is currently on a diet; her friends also diet aggressively. b. Sue is of average to slightly above average weight but wants to lose a few pounds. c. Megan's friends are concerned about the weight she has lost since she began working out with the swim team. d. Jean has always been fairly thin despite the fact that she eats quite normally.

ANSWER: a 44. Weight reduction efforts by girls tend to result in a. overall weight loss b. overall weight gain c. no change in weight d. stunted growth ANSWER: a

.

45. The families of anorexia nervosa patients are typically characterized by all of the following EXCEPT a. open communication. b. high achievement. c. perfectionism. d. concern with external appearances.

ANSWER: a 46. Of the following, the group in which we would expect to see the highest incidence of anorexia nervosa is a. male homosexuals. b. female body builders. c. ballet dancers. d. female track stars.

ANSWER: c 47. Dietary restraint studies suggest that people who are starved Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping a. stop caring about food. b. may become preoccupied with food and eating. c. lose interest in food over time. d. gradually adjust to starvation diets.

ANSWER: b 48. Which of the following young women appears to be at the highest risk for developing an eating disorder? a. Linda, whose mom and dad recently divorced b. Carla, whose family members always seem to be fighting with each other c. Sandy, whose family emphasizes achievement, support, and communication d. Bonnie, whose family is perfectionistic, successful, and eager to maintain harmony ANSWER: d 49. With regard to the biological influences of anorexia nervosa and bulimia nervosa, the most accurate statement is a. anorexia nervosa and bulimia nervosa are culturally determined and not biologically influenced. b. the biological influences of anorexia nervosa and bulimia nervosa have not been studied. c. although the studies are still limited, there appears to be some biological influence in the development of anorexia nervosa and bulimia nervosa. d. although the studies are limited, there does appear to be a large biological influence for anorexia nervosa and a very small biological influence for bulimia nervosa.

ANSWER: c 50. Genetic influences on eating disorders most likely involve a. a specific gene for each actual eating disorder. b. inherited personality traits that may make development of an eating disorder more likely. c. multiple genes interacting in ways not yet determined that directly produce eating disordered behavior. d. recessive genes.

ANSWER: b 51. Which of the following statements is TRUE about individuals with an eating disorder? a. They have a diminished sense of personal control. b. They may manifest as strikingly low self-esteem. c. They display more perfectionistic attitudes. d. All of these statements tend to be accurate.

ANSWER: d 52. With respect to eating disorders, drug treatments a. have not been found to be effective in the treating of anorexia nervosa. b. had no benefit in preventing relapse in patients with anorexia nervosa. c. do not have long-lasting effects on bulimia nervosa. d. all of these.

ANSWER: d 53. According to your textbook, which of the following treatments is considered MOST effective for bulimia in adults: a. IPT Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping b. CBT-E c. Family therapy d. Guided self-help ANSWER: b 54. Which of the following statements is TRUE with regard to drug treatments for patients with anorexia nervosa? a. Medications have not generally been found to be effective for the treatment of anorexia nervosa. b. Antidepressants have some effectiveness in the treatment of anorexia nervosa. c. Anti-anxiety medications have some effectiveness in the treatment of anorexia nervosa. d. Anti-psychotic mediations have been found to be effective for the treatment of anorexia nervosa.

ANSWER: a 55. With regard to drug treatments for bulimia nervosa patients, which of the following statements is TRUE? a. Medications have not been found to be effective for the treatment of bulimia nervosa. b. Antidepressants have some effectiveness in the treatment of bulimia nervosa. c. Benzodiazipine medications have some effectiveness in the treatment of bulimia nervosa. d. Anti-psychotic medications have been found to be effective for the treatment of bulimia nervosa.

ANSWER: b 56. One major problem with the use of medication in the treatment of bulimia nervosa is that a. well-controlled studies have not found medication more effective than a placebo. b. the beneficial effects of the medication may be short-term. c. side effects make most patients discontinue the medication. d. patients refuse to take their medication.

ANSWER: b 57. With regard to treatment for eating disorders, Prozac is considered to be an effective treatment in the long term for a. anorexia nervosa but not bulimia nervosa. b. bulimia nervosa but not anorexia nervosa. c. both anorexia nervosa and bulimia nervosa. d. neither anorexia nervosa or bulimia nervosa.

ANSWER: d 58. An early stage of Phoebe's cognitive-behavioral treatment for bulimia nervosa will likely involve a. antidepressant medication. b. family therapy. c. small, frequent meals. d. in-patient treatment.

ANSWER: c 59. An important aspect of the cognitive-behavioral approach to the treatment of bulimia nervosa involves a. changing patients' dysfunctional thoughts regarding their weight and previous weight control strategies. b. helping the patient's family learn new ways of interacting with each other and with the patient. c. changing the type and frequency of reinforcement associated with being an identified patient. d. making sure that the patient has a lot of quiet time where she can be alone.

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Chapter 10 Sleeping ANSWER: a 60. A comparison of cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) for the treatment of bulimia nervosa indicates that one year after treatment, a. CBT was superior to IPT. b. IPT was superior to CBT. c. CBT and IPT had equivalent rates of helping clients improve. d. neither therapy was successful at helping clients improve.

ANSWER: a 61. One intriguing result from the studies comparing cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) for bulimia nervosa is the finding that a. IPT is more effective in the short term but CBT is more effective when we look at how well patients are doing one year following treatment. b. IPT and CBT appear to be indistinguishable in terms of their effectiveness in the short and long term, despite their very different approaches. c. IPT is always more effective than CBT. d. CBT is more effective in the short term, but IPT patients "catch up" and will do as well as CBT patients one year after treatment.

ANSWER: d 62. Research reported in your text conducted by Grilo, Masheb, & Wilson (2006) found that patients with binge-eating disorder who responded rapidly to cognitive-behavioral therapy (by the fourth week) tended to a. have good responses to therapy both in the short long term. b. have good short-term responses but show higher rates of long-term relapse c. have a difficult time in the short-term but show good long-term responses. d. relapse almost immediately after treatment was discontinued.

ANSWER: a 63. Which of the following statements is TRUE with regard to the treatment of binge-eating disorder? a. Cognitive-behavioral therapy and self-help appear to be effective. b. Cognitive-behavioral therapy appears to be effective but self-help does not. c. Neither cognitive-behavioral nor self-help appears to be effective. d. Antidepressant medication is the only proven treatment.

ANSWER: a 64. Studies of the effectiveness of cognitive-behavioral treatment for bulimia nervosa have demonstrated a. significant short-term gains in reduction of purging, but little change in binge-eating behavior. b. significant short-term gains in reduction of binge eating but no long-term gains. c. a few short-term gains in reduction of binge eating and purging but no long-term gains. d. significant short- and long-term gains in reduction of binge eating and purging.

ANSWER: d 65. The most important and immediate goal in the treatment of a patient with anorexia nervosa is ________________.

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Chapter 10 Sleeping a. family acceptance of the problem b. weight gain c. balanced diet d. resolution of family issues ANSWER: b 66. Jill has been in treatment for anorexia nervosa for the past 2 months. Over this time, she has gained weight to the point where her weight is in the average range for a woman of her height. The fact that she gained weight fairly quickly in treatment means a. her prognosis for a full recovery is very good. b. she is probably in need of little if any more treatment. c. she has completed the most difficult part of her treatment. d. little in terms of how likely she is to be successful in the long term.

ANSWER: d 67. Many clinicians suggest that the most difficult part of treatment for anorexia nervosa, and the part of treatment where many anorexic individuals are not successful, is a. initial weight gain. b. admitting that there is a problem and agreeing to begin treatment. c. changing their attitudes regarding body shape and addressing interpersonal disruptions in their lives. d. when they become bulimic.

ANSWER: c 68. Matilda has had anorexia nervosa for several years. She started losing weight because her family said she needed to lose a few pounds. A crucial part of treatment for Matilda is family therapy that focuses on the issues regarding a. attitudes toward body shape and image distortions. b. negative communications in the family regarding food and eating. c. dysfunctional communication in the family regarding food and eating. d. all of these.

ANSWER: d 69. Outcome research regarding the long-term success of treatment for eating disorders indicates that a. anorexia nervosa patients tend to have a better prognosis than bulimia nervosa patients. b. bulimia nervosa patients tend to have a better prognosis than anorexia nervosa patients. c. both anorexia nervosa and bulimia nervosa patients almost always make a full and long-term recovery after treatment. d. neither anorexia nervosa nor bulimia nervosa patients tend to make long-term recoveries, with most patients going through repeated bouts of these disorders throughout their lives.

ANSWER: b 70. Programs that have the best chance of success for preventing eating disorders a. should be administered to all girls under 15 years of age to prevent the disorder from developing. b. should be administered to girls under 15 years of age who are concerned about being overweight. c. should be administered to all girls 15 years of age or older to prevent the disorder from developing. d. should be administered to girls 15 years of age or older who are concerned about being overweight.

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Chapter 10 Sleeping ANSWER: c 71. In studies of Internet-based eating disorder prevention programs (Winzelberg et al., 2000), such as the "student bodies program," a. the participants showed no beneficial effects. b. participants reported improvement in body image and decreased drive for thinness. c. not a single participant has developed symptoms of an eating disorder. d. the drop-out rate has been extremely high.

ANSWER: b 72. As of 2008, the percentage of the adult population of the United States with a body mass index in the obese range was about __________. a. 12% b. 17% c. 26% d. 34% ANSWER: d 73. Obesity is the major factor in a. Type 1 diabetes b. Type 2 diabetes c. anorexia nervosa d. bulimia nervosa ANSWER: b

.

74. Individuals with night eating syndrome a. consume a third of their daily intake after their evening meal. b. binge during the night. c. do not wake up while eating during the night. d. often purge after eating.

ANSWER: a 75. Which of the following genetic factors does NOT contribute to obesity? a. Number of fat cells b. Likelihood of fat storage c. Activity levels d. Fat cell shape ANSWER: d 76. Average weight loss on diet programs such as Atkins and Weight Watchers is a. 4 to 7 pounds b. 10 to 15 pounds c. 20 to 25 pounds d. 30 or more pounds ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping 77. The most successful weight loss programs are a. commercial self-help plans that limit carbohydrates or calories. b. self-directed diet plans based on diet books. c. professionally directed behavior modification programs. d. hypnosis-based plans.

ANSWER: c 78. Bariatric surgery is a. effective at any weight. b. more successful than dieting for the treatment of the very obese. c. less successful than diet for the very obese. d. always successful.

ANSWER: b 79. Surgical treatments are likely to be the a. first line of treatment for the very obese. b. last line of treatment for the very obese. c. treatment of choice for anyone who wants to lose weight. d. most rare of weight loss treatments.

ANSWER: b 80. One method of preventing obesity that has been suggested is a. instituting a "Twinkie tax" on all food with a high sugar content. b. reducing the cost of health foods. c. taking soda and junk food vending machines out of schools. d. all of these.

ANSWER: d 81. The proposal that we should discuss taxing high calorie, fat, or sugar foods to control obesity has a. been adopted nationwide. b. been viewed as a means of deterring unhealthy eating and raising money to combat obesity. c. been rejected outright as having no possibility of decreasing obesity. d. thought to benefit the poor more than the well-to-do.

ANSWER: b 82. The intent of taxing the purchase of unhealthy foods would be to a. make unhealthy foods less attractive to consumers. b. punish the poor. c. raise general government revenue. d. increase profits for food manufacturers.

ANSWER: a 83. Seriously obese adolescents are most likely to lose weight with a. the use of medications.

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Chapter 10 Sleeping b. the use of behavioral treatments. c. the combination of medications and behavioral treatments. d. the use of surgery.

ANSWER: b 84. Sleep studies suggest that around 28% of Americans a. get more than 6 hours of sleep a night. b. report feeling excessively sleepy during the day. c. have insomnia. d. need less than 5 hours of sleep a night.

ANSWER: b 85. Lack of adequate sleep has a negative effect on a. health b. productivity c. clarity of thought d. all of these choices ANSWER: d

.

86. Sleep research suggests that a. REM sleep is related to depression. b. sleep abnormalities follow clinical depression. c. sleep problems don’t predict who is at risk for later mood disorders. d. sleep deprivation has permanent antidepressant effects on some people.

ANSWER: a 87. Individuals who feel tired and cranky all day despite falling asleep at a normal hour and awakening at their usual time are most likely suffering from a(n) . a. parasomnia b. dyssomnia c. type of REM sleep deprivation d. anxiety problem ANSWER: b 88. Of the following, the correct pairing is . a. dyssomnia - sleepwalking b. dyssomnia - inability to fall asleep c. parasomnia - waking up after 3 or 4 hours of sleep and then being unable to fall back to sleep d. parasomnia - lack of REM sleep ANSWER: b 89. The most comprehensive evaluation of sleep is performed by a(n) a. polysomnographic b. actigraphic c. electromyographic Copyright Cengage Learning. Powered by Cognero.

evaluation.

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Chapter 10 Sleeping d. electroencephalographic ANSWER: a 90. While a patient sleeps, a polysomnographic evaluation collects data on all of the following characteristics EXCEPT _________. a. respiration b. muscle movements c. brain waves d. metabolic rate ANSWER: d 91. Individuals with a sleep efficiency of 90% a. spend more of their "bed time" awake than asleep. b. have a diagnosable sleep disorder. c. need to increase the number of hours in bed. d. spend 10% of their "bed time" awake.

ANSWER: d 92. Individuals suffering from primary insomnia a. do not sleep at all. b. have difficulty initiating or maintaining sleep. c. wake up during their sleep cycle with severe nightmares. d. frequently sleepwalk.

ANSWER: b 93. Sleep disorders are appropriately diagnosed based on the a. quality and quantity of sleep as well as daytime sequelae (how the individual feels when awake). b. quality and quantity of sleep only. c. quantity of sleep plus the amount of sleep time the individual believes is appropriate. d. subjective judgment of the clinician.

ANSWER: a 94. Fred has been having a great deal of trouble initiating and maintaining sleep. He guesses that he is sleeping for an average of about 3 hours each night and complains that he feels terrible during the day. In addition, Fred has always experienced some anxiety but has recently felt a tremendous increase in his overall anxiety level. The existence of both a sleep disorder and anxiety a. makes the diagnosis of primary insomnia incorrect. b. increases our confidence that primary insomnia is the correct diagnosis. c. indicates that the insomnia is a result of the anxiety rather than a cause of the anxiety. d. is extremely common since sleep problems can be both a cause and a result of anxiety.

ANSWER: d 95. The percentage of the general population that reports some symptoms of insomnia during any given year is approximately . a. 10% b. 20% Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping c. 33% d. 50% ANSWER: c 96. As we grow older, it seems that the amount of sleep that we require a. decreases b. increases c. stays the same d. decreases until early adulthood and then begins to increase again ANSWER: a

.

97. Adolescents tend to shift toward a a. biologically determined later sleep schedule. b. culturally determined earlier sleep schedule. c. biologically determined earlier sleep schedule. d. culturally determined later sleep schedule.

ANSWER: a 98. One biological factor that has been related to individuals who experience insomnia is a. genetics b. higher body temperature c. low body weight d. percentage of body fat ANSWER: b

.

99.

Samantha started having difficulty falling asleep during final exam week. Although exams are over, she now starts to worry about sleep right after dinner. Even the sight of her bed makes her very anxious. The fact that Samantha's insomnia continues long after the stress of exams is over points to the role of ________ in the maintenance of sleep disorders. a. biology b. other medical conditions c. learning d. unknown factors ANSWER: c 100. Sam sleeps for 8 or more hours every night but never feels rested. He can't understand why he is always tired despite the fact that he reports no difficulties with the quality or quantity of his sleep. Of the following, Sam's most likely diagnosis is . a. hypersomnolence disorder b. sleep apnea c. narcolepsy d. non-specific parasomnia ANSWER: a

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Chapter 10 Sleeping 101. Rose sleeps about 8 hours each night. She awakens feeling fine and well rested, but she tends to fall asleep about two or three times during the day. We can conclude that a. Rose should be diagnosed with primary insomnia. b. Rose would be diagnosed with hypersomnolence disorder if her symptoms cause disruptions or distress in her life. c. Rose should be diagnosed with a parasomnia. d. a medical condition is a more appropriate diagnosis than a sleep disorder.

ANSWER: b 102. Of the following, the only symptom that both patients with narcolepsy and patients with hypersomnolence disorder experience is a. falling asleep during normal waking hours. b. sudden loss of muscle tone. c. sleep paralysis. d. hypnagogic hallucinations.

ANSWER: a 103. In which of the following situations is Bill, who has narcolepsy, most likely to experience cataplexy? a. Immediately upon waking up after a long, restful sleep b. At any random moment c. Under hypnosis d. While jumping up and cheering for his favorite team ANSWER: d 104. While suddenly and unexpectedly falling asleep during normal waking hours, Sarah experiences vivid hallucinations of being in a horrible car crash. The experience is so realistic that she actually feels physical sensations as if the hallucination were real. Sarah's most likely diagnosis is . a. sleep apnea b. hypersomnia c. schizophrenia d. narcolepsy ANSWER: d 105. Cataplexy as experienced by patients with narcolepsy can be characterized by a. sudden, minor loss of muscle tone. b. physical collapse. c. slight muscle weakness. d. any of these ANSWER: b 106. An individual who wakes up feeling that there are other people in the room but is unable to move or say anything may be experiencing a. cataplexy associated with sleep apnea. b. hypnagogic hallucinations associated with hypersomnia. c. sleep paralysis and hypnagogic hallucinations associated with narcolepsy. d. sleep paralysis and hypnogogic hallucinations associated with hypersomnia.

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Chapter 10 Sleeping ANSWER: c 107. Which of the following conditions is thought to be a potential explanation for UFO experiences? a. Sleep paralysis b. Cataplexy c. Hypnagogic hallucinations d. Sleep apnea ANSWER: c 108. Obstructive sleep apnea is characterized by a. complete cessation of respiratory activity for brief periods. b. interruption of air flow and brief cessation of respiratory activity. c. interruption of air flow without cessation of respiratory activity. d. central nervous system disorders and trauma.

ANSWER: c 109. The different types of sleep apnea are a. obstructive, central, and sleep-related hypoventilation. b. obstructive, chronic, and sleep-related hypoventilation. c. central, chronic, and mixed. d. hypersomnolent, chronic, and parasomnic ANSWER: a 110. A severe difficulty in regulating sleep that is induced by jet lag or by working rotating shifts is an example of ___________. a. circadian rhythm sleep disorder b. sleep apnea c. hypersomnolence disorder d. narcolepsy ANSWER: a 111. Two factors that help regulate our natural sleep/wake cycles are a. melanin and auditory stimulation. b. melatonin and auditory stimulation. c. melatonin and light. d. light and blood sugar levels.

ANSWER: c 112. All of the following are examples of causes of circadian rhythm sleep disorder EXCEPT ____________. a. jet lag b. shift work c. delayed sleep phase d. sleep rebound ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping 113. Benzodiazepine medication is not recommended as a long-term solution for the treatment of insomnia because of a. the addictive properties of these medications. b. rebound insomnia that occurs after the medication is discontinued. c. excessive sleepiness that may persist during the day. d. all of these.

ANSWER: d 114. The reason that antidepressant medications are sometimes used to treat narcolepsy is that a. narcolepsy is often caused by depression. b. the anti-anxiety properties of these medications reduce narcolepsy. c. these medications suppress REM sleep that can trigger cataplexy. d. antidepressants are found to reduce hypnagogic hallucinations.

ANSWER: c 115. Medical treatments for severe sleep apnea include medication, mechanical devices, and a. surgery b. exercise of the neck muscles c. a high protein diet d. changing the patient's sleep schedule ANSWER: a

.

116. When attempting to "reset the biological clock" of an individual with a circadian rhythm sleep disorder, it is generally easier and more effective to a. make the patient's bedtime earlier. b. leave the patient's bedtime alone and change the duration of sleep. c. make the patient's bedtime later. d. keep the person awake for several days in a row.

ANSWER: c 117. Abnormal events such as nightmares, sleep terrors, and sleepwalking that occur during sleep or during the twilight time between sleep and waking are classified as . a. parasomnias b. dyssomnias c. narcolepsy d. REM disorders ANSWER: a 118. Sleepwalking is characterized by all of the following EXCEPT a. acting out a dream. b. occurrence during NREM stages of sleep. c. no memory of the sleepwalking event. d. occurrence primarily in children.

ANSWER: a

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Chapter 10 Sleeping 119. Sleepwalking is fairly common, and recent research suggests that more than ____ of school-aged children sleepwalk. a. 10% b. 20% c. 30% d. 50% ANSWER: a 120. Martin sits up every night screaming. He does not remember these terrors nor is he easily awakened or comforted. What should Martin's mother do? a. Wake Martin up during the attack. b. Make sure that Martin is very tired before going to bed. c. Use scheduled awakenings to briefly awaken Martin before an attack occurs. d. All of these have been demonstrated to reduce the frequency and duration of sleep terrors ANSWER: c 121. A recent study (Stokes & Preston, 2015), suggests that obesity: a. is less problematic than previously thought. b. is less common than previously thought. c. is more dangerous to other health outcomes than previously thought. d. is related to hormones.

ANSWER: c Subjective Short Answer 122. Eating disorders such as anorexia nervosa and bulimia nervosa are generally "blamed" on culture and society. At the same time, there appears to be a genetic influence. Explain how culture and genetics may interact in the development of anorexia nervosa and bulimia nervosa.

ANSWER: Cultures and societies tend to develop specific ideals regarding body weight and appearance. In the modern world, thinness is seen as highly desirable and is promoted through advertising and entertainment sources.

Because the ideals are unrealistic and unattainable, this experience may be contributing to the high rates of body dissatisfaction seen in the US. Genetic factors can predispose people to eating disorders if they cause the biological disregulation of eating or weight gain, or predispose people to stress, anxiety, and mood disorders thus triggering behaviors such as starving or bingeing.

In combination, cultural pressure to be thin and increasingly unattainable body ideals are thought to be contributing to the increase seen in body dissatisfaction and eating disorders.

123. In what ways do anorexia nervosa and bulimia nervosa patients tend to be similar and in what ways do they differ?

Make certain to include similarities and differences in the symptoms of the disorders as well as the dysfunctional thoughts typically associated with each disorder.

ANSWER: Anorexic individuals voluntarily starve themselves while simultaneously believing that they can never be thin enough. By definition, anorexics are extremely underweight, and so compromise their health. Anorexics may engage in excess exercise or purging behaviors, but don’t necessarily do so. Bulimic individuals tend to binge eat and then purge by throwing up or using laxatives. They may be of any weight, but do experience health problems related to their purging behaviors.

124. Describe the characteristics of binge-eating disorder and differentiate it from bulimia nervosa.

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Chapter 10 Sleeping ANSWER: The major characteristic of this disorder, as indicated by its name, is a chronic pattern of binge- eating. What differentiates it from bulimia nervosa is the absence of compensatory behaviors that follow these episodes.

125. Discuss possible reasons for the current obesity epidemic seen in the US and other countries and the relative efficacy of currently available obesity treatment options and preventions.

ANSWER: The causes of obesity in the modern world tend to be related to advances in technology. People are sedentary and prone to eat unhealthy, inexpensive food. It is also possible that genetic factors are interacting with these dietary choices.

Although most overweight individuals start with self-directed weight loss programs or commercial weight loss programs, people tend to lose only 4 to 7 pounds, to have trouble sticking with the diet, and to gain weight back again over time. Professionally directed behavior modification programs have better success rates if people comply, but the results do not appear to be permanent. For the dangerously obese, the combination of diets, behavior modification, and medication can result in minimal weight loss, but surgery may eventually be the best option for this population.

A suggestion that has gained nationwide interest is the taxing of unhealthy foods and the price reduction of health foods. There has been a great deal of controversy over the "Twinkie tax." The idea is that like cigarettes, for example, the more they cost, the less likely people are to buy them while healthy foods that are reduced in price become a more health alternative.

126. Discuss possible treatments for eating disorders.

ANSWER: Several psychosocial treatments are effective, including cognitive-behavioral approaches combined

with family therapy and interpersonal psychotherapy. Drug treatments tend to be less effective but there is some promising research with Selective Serotonin Reuptake Inhibitors (SSRIs) and bulimia.

When applied, drug treatments are typically used in conjunction with psychological treatments.

127. What current research supports the relationship between thin images in the media and eating disorders?

ANSWER: Grabe, Ward, and Hyde (2008), reviewing 77 studies, demonstrated a strong relationship between

exposure to media images depicting the thin-ideal body and body image concerns in women. An analysis of prime-time situation comedies revealed that 12% of female characters were dieting and many were making disparaging comments about their body image (Tiggemann, 2002).

128. Discuss the importance of gender and culturally-nuanced treatments for Binge Eating Disorder (BED). Cite an example.

ANSWER: Some racial and ethnic differences are apparent in people with BED seeking treatment (Franko et

al., 2012). African American participants tend to have higher BMI and Hispanic participants have greater concerns with shape and weight than Caucasian participants. Thus, it would seem that tailoring treatment to these ethnic groups would be useful. Also, males may respond somewhat differently than females to treatment since one recent study demonstrated that men with lower shape/weight concerns responded well to brief treatments, whereas females with shape/weight concerns at any level of severity, and men at more severe levels, all required longer treatment (Shingleton, Thompson, Pratt,& Franko, 2015).

129. Describe primary insomnia and contrast it with hypersomnolence disorder and narcolepsy.

ANSWER: Primary insomnia refers to an inability to sleep that is not related to another medical or psychiatric problem.

Such insomnia may be related to problems with the biological clock or temperature control, but can also stem from environmental influences such as changes in light, noise, or temperature. People may also have unrealistic expectations about how much they sleep and may even learn to associate sleep and things like their beds with anxiety and worry about sleep. Poor behaviors such as drug or alcohol use can interfere with sleep.

Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping Hypersomnolence disorder is a problem of sleeping too much or feeling that one is sleeping too much. It seems to be genetically influenced, as Hypersomnolence disorder runs in families, but it also may be related to viral infection exposure.

Narcolepsy is a specific sleep disorder characterized by daytime sleepiness, sudden loss of muscle tone (cataplexy), sleep paralysis, or a brief period after waking when it is hard to move or speak, and hypnagogic hallucinations or vivid scary experiences that begin at the start of sleep.

130. How does light influence hormones that determine your sleep/wake cycle? Draw a diagram.

ANSWER: Light signals from the retina are conveyed by nerve fibers to the superchiasmatic nucleus. This message is then transferred to the hypothalamus containing melatonin receptors. Darkness stimulates melatonin production and this production is suppressed in bright light. For an example of a diagram, see Figure 8.11 on page 312 of the text.

131. What is “sleep hygiene?” Give at least two examples.

ANSWER: Sleep hygiene allows the brain’s normal drive for sleep to take over. Some examples include

keeping to regular sleep and wake times and avoiding use of caffeine and nicotine as described in your text. You may also be familiar with some additional recommendations including avoiding bright lights before bed and turning your cell phone off.

Essay 132. Eating disorders such as anorexia nervosa and bulimia nervosa are generally "blamed" on culture and society. At the same time, there appears to be a genetic influence. Explain how culture and genetics may interact in the development of anorexia nervosa and bulimia nervosa.

ANSWER: Cultures and societies tend to develop specific ideals regarding body weight and appearance. In the modern world, thinness is seen as highly desirable and is promoted through advertising and entertainment sources.

Because the ideals are unrealistic and unattainable, this experience may be contributing to the high rates of body dissatisfaction seen in the US. Genetic factors can predispose people to eating disorders if they cause the biological disregulation of eating or weight gain, or predispose people to stress, anxiety, and mood disorders thus triggering behaviors such as starving or bingeing.

In combination, cultural pressure to be thin and increasingly unattainable body ideals are thought to be contributing to the increase seen in body dissatisfaction and eating disorders.

133. In what ways do anorexia nervosa and bulimia nervosa patients tend to be similar and in what ways do they differ?

Make certain to include similarities and differences in the symptoms of the disorders as well as the dysfunctional thoughts typically associated with each disorder.

ANSWER: Anorexic individuals voluntarily starve themselves while simultaneously believing that they can never be thin enough. By definition, anorexics are extremely underweight, and so compromise their health. Anorexics may engage in excess exercise or purging behaviors, but don’t necessarily do so. Bulimic individuals tend to binge eat and then purge by throwing up or using laxatives. They may be of any weight, but do experience health problems related to their purging behaviors.

134. Describe the characteristics of binge-eating disorder and differentiate it from bulimia nervosa.

ANSWER: The major characteristic of this disorder, as indicated by its name, is a chronic pattern of binge- eating. What differentiates it from bulimia nervosa is the absence of compensatory behaviors that follow these episodes.

Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping 135. Discuss possible reasons for the current obesity epidemic seen in the US and other countries and the relative efficacy of currently available obesity treatment options and preventions.

ANSWER: The causes of obesity in the modern world tend to be related to advances in technology. People are sedentary and prone to eat unhealthy, inexpensive food. It is also possible that genetic factors are interacting with these dietary choices.

Although most overweight individuals start with self-directed weight loss programs or commercial weight loss programs, people tend to lose only 4 to 7 pounds, to have trouble sticking with the diet, and to gain weight back again over time. Professionally directed behavior modification programs have better success rates if people comply, but the results do not appear to be permanent. For the dangerously obese, the combination of diets, behavior modification, and medication can result in minimal weight loss, but surgery may eventually be the best option for this population.

A suggestion that has gained nationwide interest is the taxing of unhealthy foods and the price reduction of health foods. There has been a great deal of controversy over the "Twinkie tax." The idea is that like cigarettes, for example, the more they cost, the less likely people are to buy them while healthy foods that are reduced in price become a more health alternative.

136. Discuss possible treatments for eating disorders.

ANSWER: Several psychosocial treatments are effective, including cognitive-behavioral approaches combined

with family therapy and interpersonal psychotherapy. Drug treatments tend to be less effective but there is some promising research with Selective Serotonin Reuptake Inhibitors (SSRIs) and bulimia.

When applied, drug treatments are typically used in conjunction with psychological treatments.

137. What current research supports the relationship between thin images in the media and eating disorders?

ANSWER: Grabe, Ward, and Hyde (2008), reviewing 77 studies, demonstrated a strong relationship between

exposure to media images depicting the thin-ideal body and body image concerns in women. An analysis of prime-time situation comedies revealed that 12% of female characters were dieting and many were making disparaging comments about their body image (Tiggemann, 2002).

138. Discuss the importance of gender and culturally-nuanced treatments for Binge Eating Disorder (BED). Cite an example.

ANSWER: Some racial and ethnic differences are apparent in people with BED seeking treatment (Franko et

al., 2012). African American participants tend to have higher BMI and Hispanic participants have greater concerns with shape and weight than Caucasian participants. Thus, it would seem that tailoring treatment to these ethnic groups would be useful. Also, males may respond somewhat differently than females to treatment since one recent study demonstrated that men with lower shape/weight concerns responded well to brief treatments, whereas females with shape/weight concerns at any level of severity, and men at more severe levels, all required longer treatment (Shingleton, Thompson, Pratt,& Franko, 2015).

139. Describe primary insomnia and contrast it with hypersomnolence disorder and narcolepsy.

ANSWER: Primary insomnia refers to an inability to sleep that is not related to another medical or psychiatric problem.

Such insomnia may be related to problems with the biological clock or temperature control, but can also stem from environmental influences such as changes in light, noise, or temperature. People may also have unrealistic expectations about how much they sleep and may even learn to associate sleep and things like their beds with anxiety and worry about sleep. Poor behaviors such as drug or alcohol use can interfere with sleep.

Hypersomnolence disorder is a problem of sleeping too much or feeling that one is sleeping too much. It seems to be genetically influenced, as Hypersomnolence disorder runs in families, but it also may be related to viral infection exposure.

Copyright Cengage Learning. Powered by Cognero.

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Chapter 10 Sleeping Narcolepsy is a specific sleep disorder characterized by daytime sleepiness, sudden loss of muscle tone (cataplexy), sleep paralysis, or a brief period after waking when it is hard to move or speak, and hypnagogic hallucinations or vivid scary experiences that begin at the start of sleep.

140. How does light influence hormones that determine your sleep/wake cycle? Draw a diagram.

ANSWER: Light signals from the retina are conveyed by nerve fibers to the superchiasmatic nucleus. This message is then transferred to the hypothalamus containing melatonin receptors. Darkness stimulates melatonin production and this production is suppressed in bright light. For an example of a diagram, see Figure 8.11 on page 312 of the text.

141. What is “sleep hygiene?” Give at least two examples.

ANSWER: Sleep hygiene allows the brain’s normal drive for sleep to take over. Some examples include

keeping to regular sleep and wake times and avoiding use of caffeine and nicotine as described in your text. You may also be familiar with some additional recommendations including avoiding bright lights before bed and turning your cell phone off.

Copyright Cengage Learning. Powered by Cognero.

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Chapter 11 Sex and Gender Multiple Choice 1. Gender dysphoria is characterized by dissatisfaction with a. sexual experiences. b. gender role expectations. c. one’s biological sex d. media portrayals of gender ANSWER: c 2. Among men surveyed for a CDC study, a. almost 100% b. just over 40% c. approximately 75% d. about 12% ANSWER: a

were sexually experienced.

3. Sexual behavior surveys suggest that a. almost all men have more than 15 sexual partners. b. most men have had more than 4 partners in the previous year. c. about 21% of men have had more than 15 sexual partners. d. None of the answers are correct.

ANSWER: c 4. In reference to sexuality, which of the following is NOT true: a. most men and women have engaged in vaginal intercourse with someone of the opposite sex. b. most men and women have engaged in oral sex with someone of the opposite sex. c. most men and women have engaged in anal intercourse with someone of the opposite sex. d. few men and women have engaged in some type of intercourse with someone of the same sex.

ANSWER: c 5. Recent studies have shown that: a. men tend to have more partners than women. b. women tend to self-report homosexual attraction or behavior more often than men. c. most men and women are bisexual. d. most people who identify as gay or lesbian live in the United States.

ANSWER: a 6. Recent studies on sexual practice indicate that sexual practices are a. consistent in many different countries. b. very different in Western and Asian countries. c. inconsistent no matter where they are measured. d. culturally diverse.

ANSWER: a 7. According to recent surveys, the following statement is true regarding sexual activity of the elderly: .

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Chapter 11 Sex and Gender a. very few individuals remain sexually active beyond age 70. b. more than half of the individuals over age 70 remain sexually active. c. 80% of males and 50% of women aged 75 to 79 remained sexually active d. 38.5% of males and 16.7% of women aged 75 to 85 remained sexually active.

ANSWER: d 8. Approximately what percentage of males report ever masturbating? a. 23% b. 42% c. 50% d. 72% ANSWER: d 9. Approximately what percentage of females report ever masturbating? a. 23% b. 42% c. 50% d. 72% ANSWER: b 10. The largest difference in sexual behavior for men versus women is that a. men are more likely to engage in premarital sex. b. women are more likely to engage in premarital sex. c. men are more likely to masturbate. d. women are more likely to masturbate.

ANSWER: c 11. Differences in male and female attitudes toward sexuality have generally a. decreased b. increased c. remained the same d. disappeared completely ANSWER: a

over the past 40 years.

12. Data from research studies on gender differences in human sexuality reflect all of the following themes EXCEPT a. men masturbate more than women. b. men are more permissive about casual premarital sex than women. c. men are less accepting about homosexuality than women. d. men and women value sexual satisfaction equally.

ANSWER: c 13. Gender differences in attitudes toward premarital sex have been a. shrinking b. increasing c. fluctuating .

over time.

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Chapter 11 Sex and Gender d. unreliable ANSWER: a 14. Data from research studies on gender differences in human sexuality reflect all of the following themes EXCEPT a. men show more sexual desire and arousal than women. b. men emphasize committed relationships more than women. c. men's self-concept is characterized in part by power, aggression, and independence. d. women's sexual beliefs are more influenced by cultural, social, and situational factors.

ANSWER: b 15. Which of the following is NOT a gender difference in sexual beliefs: a. men show more sexual desire and arousal than women. b. females are more likely to value the experience of passionate and romantic feelings. c. men tend to have more negative core beliefs about sex. d. a minority of women hold embarrassed, conservative, or self-conscious views toward sex.

ANSWER: c 16. In Sweden, where attitudes toward sexuality are somewhat more permissive than they are in the United States, the percentage of Swedish women reporting use of contraception during their first sexual intercourse was a. significantly higher than it was for American women. b. significantly lower than it was for American women. c. approximately the same as it was for American women. d. just about 100%.

ANSWER: a 17. Research regarding sexual orientation suggests that homosexuality is a. purely genetic. b. that sexual orientation has an exclusively biological cause. c. based on learning and choice only. d. influenced by biological/genetic, psychological, and social factors.

ANSWER: d 18. Which of the following is a true cultural difference in the views of sexuality in children: a. West African girls masturbate more frequently than West African boys. b. Munda people in India encourage mutual masturbation among cohabiting children. c. Brazilian boys have more semen than Brazilian men. d. Incest is considered acceptable in Norway.

ANSWER: b 19. Joe is homosexual and has an identical (monozgyotic) twin named Sam. The following statement is TRUE: a. Sam is more likely than the general population to be homosexual. b. Sam is no more likely than the general population to be homosexual. c. Sam is homosexual also. d. Sam is only likely to become homosexual if Joe is a positive role model.

ANSWER: a .

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Chapter 11 Sex and Gender 20. Of those identical (monozygotic) twins where one twin is homosexual, the other twin is also homosexual in 50% of cases. This means a. homosexuality is determined by genetics. b. genes are only one influence for sexual orientation. c. the environment determines sexual orientation. d. genes are not an influence for sexual orientation.

ANSWER: b 21. Which of the following does NOT support the fact that homosexuality is related to differential hormone exposure in utero? a. Homosexual males are more likely to be left handed or mixed handed than right handed. b. Males and masculine lesbians often have a longer fourth ring finger than index finger. c. Homosexual males have smaller feet than heterosexual males. d. Actual structure of the brain might be different in homosexuals than heterosexuals.

ANSWER: c 22. Statistically, homosexual males are more likely to have grown up with a. older brothers. b. older sisters. c. younger brothers. d. younger sisters.

ANSWER: a 23. Sexual dysfunctions are a. more common in heterosexuals than homosexuals. b. more common in homosexuals than heterosexuals. c. equally common in heterosexuals and homosexuals. d. generally not reported, so little is known about their incidence.

ANSWER: c 24. Which of the following is NOTone of the three stages of sexual response? a. Desire b. Arousal c. Orgasm d. Refractory period ANSWER: d 25. Sexual dysfunction can be a(n) a. lifelong b. acquired c. situational d. all of the above ANSWER: d

.

condition.

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Chapter 11 Sex and Gender 26. Sexual problems are difficult to diagnose when a. dysfunction is present and the person is distressed about it. b. dysfunction is present but the person is not distressed about it. c. the couple has been together a long time. d. the couple is sexually inexperienced.

ANSWER: b 27. Happily married couples typically report a. occasional sexual dysfunction that does not result in sexual dissatisfaction. b. occasional sexual dysfunction that is associated with sexual dissatisfaction. c. very little sexual dysfunction. d. sexual dysfunction on the part of women but not men.

ANSWER: a 28. Of the following, the individual most likely to receive an appropriate diagnosis of male hypoactive sexual desire disorder is a. Charles, who fantasizes about sex often, but is so exhausted when he gets home that he only has sex about twice a month. b. John, who thinks about sex, but does not have sexual relations because he thinks it is morally wrong to do so unless the goal is procreation. c. Phil, whose wife wishes he thought about sex more often because he seems satisfied having sex a few times a month. d. Fred, who has sex at least once a week to satisfy his wife, but would prefer to be left alone since he is rarely interested in sex.

ANSWER: d 29. Which of the following statements is TRUE about desires of sexual disorder? a. More than 65% of the problems who come to sexuality clinics for help complain of this disorder. b. It is the most common presenting complaint of both men and women. c. For women, the prevalence of this disorder (female sexual interest/arousal disorder) decreases with age. d. For men, the prevalence of this disorder (male hypoactive sexual desire disorder) decreases with age.

ANSWER: c 30. A person who suffers from a disorder of sexual desire may a. never think about sex. b. never have sex. c. have sex (even frequently), but not because of desire. d. all of the above ANSWER: d 31. The main feature of sexual arousal disorders is a. lack of desire for sex despite normal physical sexual response. b. sexual arousal to inappropriate stimuli. c. the experience of pain during sex. d. lack of physical sexual response despite desire for sex. .

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Chapter 11 Sex and Gender ANSWER: d 32. Sexual arousal disorders are diagnosed when there is an a. inability to achieve or maintain an erection in males and a lack of desire for sex in females. b. inability to achieve or maintain an erection in males and a lack of orgasm in females c. inability to achieve orgasm for either gender despite erection in males and lubrication in females. d. inability to achieve or maintain an erection in males and a lack of lubrication in females.

ANSWER: d 33. Based on stringent criteria, research data indicate that the percentage of men between the ages of 18 and 59 with erectile dysfunction is . a. 1% b. 3% c. 5% d. 10% ANSWER: c 34. What is the percentage of men in their 70s with at least some impairment of erectile function? a. 10% b. 30% c. 50% d. 70% ANSWER: d 35. The prevalence of sexual arousal disorders appears to be a. much higher for men than it is for women. b. much lower for men than it is for women. c. about the same in both sexes. d. slightly lower for men than it is for women.

ANSWER: a 36. Female Orgasmic Disorder is characterized by a. complete inability to reach sexual climax. b. stress, which leads to the disorder. c. relationship problems, which lead to the disorder. d. delay, absence, or decreased intensity in orgasm.

ANSWER: d 37. The percentage of women reporting significant difficulty reaching orgasm is a. 5% b. 10% c. 25% d. 40% ANSWER: c .

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Chapter 11 Sex and Gender 38. One reason that different diagnostic criteria are used for males and females with inhibited orgasm disorder is that a. many men who do not achieve orgasm through intercourse can reach climax through alternate forms of stimulation. b. only about 20% of women regularly experience orgasm from intercourse. c. both a and b are correct. d. neither a nor b is correct.

ANSWER: c 39. Jacob and Liu have been happily married for 10 years. Although fulfilling in other ways, Jacob typically ejaculates within 1 minute of penetration and before Liu is ready. Which of the following is true about premature ejaculation: a. Premature ejaculation is uncommon, impacting only 5% of men. b. Premature ejaculation typically happens in older men. c. Premature ejaculation is most common in younger, less experienced men. d. Premature ejaculation is not serious and does not require a medical examination to rule out physiological causes.

ANSWER: c 40. Sandra and Jim have been happily married for several years. Sandra reports that she reaches orgasm from intercourse only about half of the time and wonders if something is "wrong" with her. Sandra should a. seek treatment for inhibited orgasm disorder. b. realize that her inhibited orgasm problem means that she doesn't really love Jim c. relax and realize that this is not unusual for women d. have a medical exam before assuming that she has a diagnosable psychological disorder.

ANSWER: c 41. Jody and Howard have been happily married for several years. Howard reports that in spite of being sexually aroused and having an erection, he only reaches orgasm from intercourse about half of the time. Howard wonders if something is "wrong" with him. Howard should a. seek treatment for inhibited orgasm disorder. b. realize that this problem means that he does not really love his wife. c. relax and realize that this is normal. d. seek treatment for sexual aversion disorder.

ANSWER: a 42. The following pairing is correct based on the ages most affected by the disorders: a. inexperienced men - premature ejaculation; older men – vaginismus. b. inexperienced men - premature ejaculation; older men - erectile dysfunction. c. inexperienced men - inhibited orgasm; older men - erectile dysfunction. d. inexperienced men - erectile dysfunction; older men – male hypoactive sexual arousal disorder.

ANSWER: b 43. The most common of all the male sexual dysfunctions is a. erectile dysfunction b. inhibited orgasm c. premature ejaculation d. sexual aversion .

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Chapter 11 Sex and Gender ANSWER: c 44. One reason that it is difficult to provide a precise diagnosis of premature ejaculation is that a. the concept of "too soon" is dependent on the individual and the couple. b. most men are too ashamed to admit the problem. c. women generally are reluctant to tell their partners of the problem. d. men are often unaware of what is considered "normal."

ANSWER: a 45. Premature ejaculations are a. clearly defined by the amount of time between penetration and climax. b. generally a result of perception of control rather than actual time. c. always a sign of serious sexual problems. d. more likely in men with a higher level of sexual experience.

ANSWER: b 46. Vaginismus refers to a. painful pelvic spasms during penetration. b. painful cramps during the menstrual cycle. c. strong orgasms. d. a disorder of male sexual responsivity.

ANSWER: a 47. One reason that your text suggests questionnaires be used when assessing sexual behavior is that a. people may provide more sexual information in writing than during an interview. b. written information regarding sexuality has been shown to be more accurate than a verbal report. c. therapists are often uncomfortable asking questions regarding sexual behavior. d. the therapist needs a written record in the patient's own words to demonstrate progress as the patient improves.

ANSWER: a 48. One of the most important skills that therapists must possess when conducting an interview regarding sexual behavior is a. communicating their own sexual values. b. using only the proper clinical terms for sexual behavior. c. demonstrating that they are comfortable talking about sexual issues. d. being able to diagnose medical causes of sexual dysfunction.

ANSWER: c 49. A Sex Therapist is likely to assess multiple dimensions of sexual behavior including: a. sexual attitudes. b. sexual behaviors. c. relationship issues. d. All of the answers are correct.

ANSWER: d .

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Chapter 11 Sex and Gender 50. Psychophysiological assessment of sexual dysfunction is generally conducted by a. using a device that measures physical arousal during exposure to an erotic video or audio tape. b. asking patients to keep a diary of their sexual activities. c. a physician during a medical exam. d. using a device that measures brain waves during exposure to an erotic video or audio tape.

ANSWER: a 51. An instrument that is used to assess physical changes in a woman’s vagina as she experiences sexual arousal and is smaller than a tampon is called a vaginal ______ . a. photoplethysmograph b. strain gauge c. EMG device d. snap gauge ANSWER: a 52. Two very common medical causes of erectile dysfunction are a. asthma and diabetes. b. vascular disease and diabetes. c. vascular disease and asthma. d. arthritis and diabetes.

ANSWER: b 53. Some research suggests that as many as 80% of individuals taking________medication experience some degree of sexual dysfunction, though estimates closer to 50% seem much more reliable. a. SSRI b. beta blocker c. tricyclic antidepressant d. anti-hypertensive ANSWER: a 54. Sherri and Leo have been having some sexual difficulties lately. Both have experienced some symptoms of sexual arousal disorders. They decide to have a few glasses of wine before engaging in sex tonight. Is this a good idea or a bad idea? a. It's a good idea since wine could increase desire. b. It's a good idea since wine could help performance. c. It's a bad idea since wine could further impair arousal. d. It's a bad idea since wine tends to decrease desire.

ANSWER: c 55. The effects of alcohol on sexual behavior were well noted by William Shakespeare and can be summarized as a. alcohol decreases desire and performance. b. alcohol may increase desire but it decreases performance. c. alcohol may increase performance but it decreases desire. d. alcohol may increase desire, but nobody wants to sleep with a drunk!

ANSWER: b .

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Chapter 11 Sex and Gender 56. Who will be most likely to have a sexual dysfunction? a. Santo, a 28-year-old, who sometimes gets overexcited and ejaculates after a couple of minutes. b. Henry, who is 65 and once had a heart attack. c. Imelda, who is 33 and sexually inexperienced. d. Katrina, who is 65 and has sex only once a week.

ANSWER: b 57. Our current understanding of the psychological causes of sexual dysfunction suggests that the primary psychological factor in sexual dysfunction is . a. anxiety b. distraction c. relationship issues d. unreasonable expectations ANSWER: b 58. The original concept of performance anxiety as a cause of sexual dysfunction has been replaced with a more modern view that performance anxiety is comprised of a. distraction, cognition, and depression. b. arousal, anxiety, and distraction. c. cognition, arousal, and distraction. d. arousal, cognitive processes, and negative affect.

ANSWER: d 59. As a typical male with erectile dysfunction, we can expect Bill to show a. decreased arousal during performance demand and an inaccurate sense of how aroused he is. b. decreased arousal during performance demand and an accurate sense of how aroused he is. c. increased arousal during performance demand and an inaccurate sense of how aroused he is. d. increased arousal during performance demand and an accurate sense of how aroused he is.

ANSWER: a 60. Greg often has problems with premature ejaculation. As he becomes more anxious about his problem, the amount of time between initiating intercourse and ejaculation will most likely . a. increase b. decrease c. remain the same d. depend upon what is making him anxious ANSWER: b 61. The most accurate description for the condition called erotophobia is a. negative feelings toward sexuality. b. negative feelings about other people. c. fear of sex. d. fear of being raped ANSWER: a .

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Chapter 11 Sex and Gender 62. Sexual dysfunction is often related to . a. dislike for partner b. perception of self as less attractive than before c. guilt about sex d. all of the above ANSWER: d 63. Children or young adults who experience sexual victimization are a. no more likely to experience sexual dysfunction as adults than anyone else. b. more likely to experience sexual dysfunction as adults if they are females. c. more likely to experience sexual dysfunction as adults if they are males. d. more likely to experience sexual dysfunction as adults.

ANSWER: d 64. An unusually high concern with nocturnal emissions has been reported in____where there is a strong culturally held belief that loss of semen causes depletion of physical and mental energy. a. Ireland b. Indonesia c. India d. Iceland ANSWER: c 65. Belief in common sexual myths such as are more commonly held by men a. who do not have sexual disorders. b. with conservative sexual attitudes. c. who have sexual disorders. d. who are homosexual.

ANSWER: c 66. Development of sexual dysfunction can be viewed as a negative cycle that involves a variety of factors, since the typical case progresses in the following manner: a. Initial dysfunction may be triggered by an event such as substance use; concern about the dysfunction then leads to more dysfunction, and sex itself becomes associated with negative feelings. b. Initial dysfunction may be triggered by an event such as substance use; this causes a strain on the relationship and reduces the intimacy in the relationship, which then leads to anxiety about one's desirability. c. Initial dysfunction occurs through slow and gradual deterioration, possibly due to a medical condition; as the medical condition develops, the individual's concern with failing sexuality increases, resulting in relationship problems. d. A general medical condition triggers the first dysfunction, which is followed by increased anxiety; as the anxiety increases, the sexual dysfunction becomes more severe over time and causes loss of interest in sex.

ANSWER: a 67. The authors of your textbook suggest that one of the most effective treatments for many sexual dysfunctions is a. exploration of the patient's sexual orientation. b. improving the relationship with the patient's partner. c. education regarding normal sexuality. .

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Chapter 11 Sex and Gender d. anti-anxiety medication.

ANSWER: c 68. Maggie and Jim have started sex therapy to deal with Jim's recent erectile dysfunction. The therapist has instructed them to refrain from intercourse or genital touching but to spend the next several days enjoying each other through hugging, kissing, and mutual massage. This is an example of a. phase one of sensate focus treatment. b. phase two of sensate focus treatment. c. a strict behavioral treatment for erectile dysfunction. d. the first step in cognitive therapy for erectile dysfunction.

ANSWER: a 69. Sensate focus and non-demand pleasuring were designed by Masters and Johnson to treat sexual dysfunctions primarily through a. improving a couple's sexual skills. b. identifying medical conditions that contribute to sexual dysfunction. c. involving an objective third party. d. elimination of psychologically-based performance anxiety.

ANSWER: d 70. Phase two of sensate focus involves "genital pleasuring" but prohibits intercourse or orgasm. The main purpose of this stage is to a. allow an individual to communicate his or her desires to the partner. b. change the usual ways that the couple has tried to have sex. c. allow sexual experience without the anxiety of performance. d. provide increased anticipation of intercourse.

ANSWER: c 71. As a couple completes phase two of sensate focus therapy, they are instructed to a. return to full, prior sexual activity. b. slowly begin sexual activity, continuing non-demand pleasuring as they progress. c. take a break from sexual activity for several weeks and then slowly return to normal sexuality. d. begin the "genital pleasuring" stage of the treatment.

ANSWER: b 72. Masters and Johnson reported that the use of sensate focus therapy for the treatment of premature ejaculation was effective in of cases treated. a. 50% b. 65% c. 75% d. almost 100% ANSWER: d 73. Treatment effectiveness studies of Masters and Johnson's sensate focus therapy have indicated that a. certain aspects of the treatment such as two therapists and daily therapy are not necessary. .

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Chapter 11 Sex and Gender b. many therapists using Masters and Johnson's techniques are able to demonstrate even greater treatment effectiveness than Masters and Johnson did. c. daily treatment is a critical component of the method. d. sensate focus is generally only effective when administered by Masters and Johnson.

ANSWER: a 74. Sex therapy for erectile dysfunction has produced a positive treatment outcome in approximately_____ of the cases treated. a. 20 to 30% b. 40 to 50% c. 60 to 70% d. 80 to 90% ANSWER: c 75. The sex therapy technique designed specifically to treat premature ejaculation is a. the squeeze technique b. sensate focus c. non-demand pleasuring d. cognitive restructuring ANSWER: a

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76. The specific treatment found effective in the treatment of female orgasmic disorder is a. anti-anxiety medication b. sensate focus c. explicit training in masturbation procedures d. increased sexual relations ANSWER: c

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77. A woman is sent home from sex therapy with an assignment to purchase a vibrator and practice masturbating. She is likely being treated . a. for vaginismus b. for hypoactive sexual desire disorder c. for female orgasmic disorder d. by a sex therapist with little or no formal training in psychology ANSWER: c 78. Dilators of gradually increasing sizes are used in the treatment of a. female orgasmic disorder b. vaginismus c. hypoactive sexual desire disorder d. all of these ANSWER: b

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79. According to your textbook, what is the percentage of women who successfully overcome vaginismus? a. Less than 30% .

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Chapter 11 Sex and Gender b. 30% to 45% c. 50% to 75% d. 80% to 100% ANSWER: d 80. The percentage of men with erectile dysfunction who take Viagra and are then able to maintain an erection sufficient for intercourse is between . a. 5% and 40% b. 50% and 80% c. 80% and 90% d. 90% and 100% ANSWER: b 81. What significant side effect is experienced by as many as 30% of Viagra users? a. Severe headache b. Addiction c. Groin pain d. Dizziness ANSWER: a 82. Research studies on Viagra users indicate that a. most users are able to engage in intercourse and are very satisfied with the results. b. approximately half of the users are able to engage in intercourse and are highly satisfied with results. c. 61% of men were able to get erections adequate for intercourse, but only 32% rated the results as at least “good.” d. most users were unable to engage in intercourse and were not satisfied with results.

ANSWER: c 83. Papaverine and prostaglandin, vasodilating drugs used in the treatment of erectile dysfunction, are delivered to the patient a. in a capsule taken orally. b. as a dietary supplement. c. by injection directly into the penis. d. by injection into the arm or hip.

ANSWER: c 84. Although vasodilating drugs such as papaverine and prostaglandin are effective in producing an erection for patients with erectile dysfunction, many patients discontinue use of the drugs because of a. the painful nature of the treatment. b. the fact that these drugs eventually cure the disorder. c. the expense of the drug. d. the fact that the effectiveness of the drug decreases with continued use.

ANSWER: a 85. Which of the following treatments is NOT currently used in the treatment of erectile dysfunction? .

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Chapter 11 Sex and Gender a. Vasodilating drugs b. Anti-anxiety medication c. Surgical prosthetic implant d. Vacuum device therapy ANSWER: b 86. One of the reasons that Viagra has become so widely accepted as a treatment for erectile dysfunction is that a. it is more effective than the other available treatments. b. it is less expensive than other medications such as vasodilators. c. people are unaware of the other options. d. an oral medication is less awkward and intrusive than other treatments.

ANSWER: d 87. Therapy for sexual dysfunctions such as disorders of sexual desire can best be described as a. well-studied and widely available. b. well-studied but only available in specialty clinics. c. not well-studied and not available in all locations. d. not well-studied but generally available everywhere.

ANSWER: c 88. A paraphilic disorder is defined as a. a sexual dysfunction. b. an attraction to inappropriate individuals or objects. c. an attraction to machines. d. a desire that dominates the personality.

ANSWER: b 89. The definition of fetishistic disorder is sexual a. dysfunction b. attraction to inappropriate individuals c. attraction to nonliving objects d. desire that dominates the personality ANSWER: c

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90. Charles gets very sexually excited by women's shoes. While he used to fantasize about women wearing particular shoes, he now focuses almost exclusively on the shoes themselves. Charles has a(n) . a. sexual dysfunction b. unusual interest but does not have a diagnosable disorder c. fetishistic disorder d. frotteuristic obsession ANSWER: c 91. Greg and Diana often begin their sexual activity with Greg putting on a striptease show for Diana. They both report great satisfaction and excitement with this activity. In fact, Greg says that he gets aroused by exposing himself, and Diana reports getting aroused when she watches him undress. Which of the following statements is true? .

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Chapter 11 Sex and Gender a. Greg is an exhibitionist, and Diana is a voyeur. b. Greg is a voyeur, and Diana is an exhibitionist. c. Both Diana and Greg have nonspecific fetishes because they admit to getting sexually excited by their atypical behaviors. d. Neither Greg nor Diana should be diagnosed with a fetish because these behaviors involve consenting individuals.

ANSWER: d 92. One psychological aspect of voyeurism and exhibitionism that seems to maintain the disordered behavior is a. some anxiety that increases arousal. b. the fact that these individuals are rarely caught. c. the desire to hurt their victims. d. some sense that their victims really enjoy being subjected to their fetish.

ANSWER: a 93. All of the following are true statements regarding transvestic disorder EXCEPT a. all people with transvestic disorder are either homosexual or transsexual. b. a significant percentage of individuals with this disorder are married or have been married at some time. c. there are cross-dressing clubs and newsletters for individuals with this fetish. d. some transvestic fetishists compensate by joining macho or paramilitary organizations.

ANSWER: a 94.

Individuals with _____are those who receive a sexual thrill from inflicting pain on others, and people with_______are individuals who receive a sexual thrill from receiving physical pain. a. sexual sadism disorder; sexual masochism disorder b. sexual masochism disorder; sexual sadism disorder c. transvestic disorder ; pedophilic disorder d. pedophilic disorder; transvestic disorder ANSWER: a 95. "Opportunistic" rape differs from sadistic rape in that the rape in the latter is committed by an individual a. who meets the criteria for antisocial personality disorder. b. with a particular pattern of sexual arousal. c. who rarely masturbates. d. during an unplanned assault.

ANSWER: b 96. Which of the following is TRUE about most rapists? a. They are sexually aroused only by violence. b. They are aggressive and have little regard for others. c. They are either hyposexual or asexual. d. They are hypersexual and generally obsessed with sex.

ANSWER: b

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Chapter 11 Sex and Gender 97. Victims of incest tend to be___________, and victims of pedophilia (who are not also incest victims) tend to be_________. a. male; female b. young children; girls who are beginning to mature physically c. girls who are beginning to mature physically; young children d. female; male ANSWER: c 98. The typical adult who molests a child a. is violent and aggressive. b. threatens the child physically but is not violent. c. does not use physical force. d. is fully aware of the psychological damage that he is causing the child.

ANSWER: c 99. One model of learning predicts that the following boy might grow up to be a voyeur: a. Tim, whose father is a voyeur. b. Joe, who watches a lot of pornography. c. Sid, who masturbates while peeping at his neighbor. d. Jim, who thinks it's funny to spy on people.

ANSWER: c 100. The procedure that is carried out entirely in the patient's imagination and used to reduce the inappropriate sexual arousal that exists in fetishistic behavior is called . a. classical conditioning b. sexual re-training c. sensate focus d. covert sensitization ANSWER: d 101. The basic concept behind the covert sensitization method of treating unwanted sexual arousal is to a. create empathy for the victim of the behavior. b. replace the immediate reinforcement of the behavior with the unpleasant consequences that ordinarily take longer to be experienced. c. create a physically painful experience to replace the immediate reinforcement that the unwanted behavior has previously produced. d. improve family functioning, social skills, and overall effectiveness of appropriate adult relations.

ANSWER: b 102. Patients undergoing the procedure called orgasmic reconditioning are instructed to a. masturbate to their usual fantasies but to substitute more desirable ones just before ejaculation. b. masturbate to their usual fantasies but substitute images of the consequences associated with their behavior (such as getting caught, hurting someone else, etc.) just before ejaculation. c. substitute images of the consequences associated with their behavior (such as getting caught, hurting someone else, etc.) every time they feel aroused by thoughts of their inappropriate desires. d. watch video tapes of normal adult sexuality repeatedly until such images result in arousal. .

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Chapter 11 Sex and Gender ANSWER: a 103. The procedure called orgasmic reconditioning works according to the principle of . a. punishment of inappropriate patterns of arousal b. extinction of inappropriate patterns of arousal c. reinforcement of appropriate patterns of arousal d. reinforcement of self-control ANSWER: c 104. Research regarding the success of treating paraphilias with procedures such as orgasmic reconditioning and covert sensitization indicates that a. treatment is generally not successful. b. treatment is successful in only the small number of cases where the patient completes all treatment sessions. c. the number of cases in the research studies is too small to make conclusions at this point. d. treatment is generally effective.

ANSWER: d 105. Treatment for paraphilias is considered successful when someone has a. completed all treatment sessions. b. demonstrated no deviant sexual arousal on objective physiological testing. c. had no legal record of any charges of deviant sexual activity. d. all of the above.

ANSWER: d 106. Which of the following is TRUE regarding drugs currently available for the treatment of paraphilias? a. The drugs eliminate sexual desire but are only effective while they are being taken. b. The drugs reduce sex drive and continue to be effective long after the patient stops the medication. c. The drugs dramatically reduce sex drive but have side effects that make them harmful to many patients. d. They produce a "chemical castration" that effectively eliminates all sex drive permanently so that the patient will never desire sex even after discontinuing the medication.

ANSWER: a 107. Gender dysphoria is diagnosed when a. a person's physical sex is inconsistent with the person's gender identity. b. an individual receives sexual pleasure from cross-dressing. c. an individual is born with ambiguous genitalia. d. all of these are correct.

ANSWER: a 108. Which of the following is NOT true about gender nonconformity in children: a. Gender nonconformity is common. b. Gender nonconformity always leads to gender dysphoria. c. Gender nonconformity can lead to negative social adjustment. d. All of the answers are correct.

ANSWER: b .

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Chapter 11 Sex and Gender 109. Why is it important that treatment for gender nonconformity be individualized for each child? a. Each child has different needs. b. Each child is in a different social environment. c. Each child and family varies on the level with which gender nonconformity is problematic. d. All of the answers are correct.

ANSWER: d 110. Inappropriate sexual arousal (e.g., fetishism) appears to be learned through a. exposure to pornography. b. masturbatory fantasies about the object. c. social "scripts" that are transferred from one generation to the next. d. poor social skills.

ANSWER: b 111. Of the following, the individual who should be diagnosed with gender dysphoria is a. Joe, who gets sexually aroused by wearing women's bras. b. Lisa, who is gay and has many traditional masculine traits. c. Mark, who feels like a woman trapped in a man's body. d. Sid, who can only become sexually aroused while dressed like a woman.

ANSWER: c 112. The incidence of gender dysphoria a. is higher than that of transvestic disorder. b. occurs three times more frequently in natal males than natal females. c. is based on studies in Norway, United Sates, and England. d. is moderate, with about 5% or more of the population affected.

ANSWER: b 113. According to research on gender dysphoria, a. genetics contribute around 62% of the vulnerability to experiencing gender dysphoria. b. environment and genetics contribute equally to the cause. c. it cannot be determined, as yet, regarding the extent of the genetic and environmental contributions to the cause. d. none of the above.

ANSWER: a 114. Recent twin studies suggest that the majority of the vulnerability for gender dysphoria comes from a. genetic factors. b. environmental factors. c. medical accidents. d. media exposure.

ANSWER: a

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Chapter 11 Sex and Gender 115. Studies suggest that in comparison to other girls and boys, girls with congenital adrenal hyperplasia are _____________. a. more feminine b. more masculine c. smaller d. smarter ANSWER: b 116. A boy who consistently behaves in feminine ways is exhibiting a. gender non-activation. b. gender experimentation. c. gender crises. d. gender nonconformity.

ANSWER: d 117. All of the following statements are correct about gender nonconformity EXCEPT a. a higher proportion of gender-nonconforming children develop a homosexual orientation as adults. b. gender nonconformity was related to psychological distress for gay men only. c. gender nonconformity was related to psychological distress for lesbians only. d. gender nonconformity was related to psychological distress for gay men and lesbians.

ANSWER: c 118. Research suggests that gender nonconformity typically results in a. gender identity issues b. homosexual preferences c. bisexuality d. none of the above ANSWER: d

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119. All of the following are factors that may play a role in gender nonconformity EXCEPT a. excessive attention on the part of the mother. b. high levels of fetal testosterone. c. lack of male playmates. d. excessive physical contact on the part of the mother.

ANSWER: c 120. All of the following statements about sex reassignment surgery are true EXCEPT a. 2% attempt suicide after surgery. b. 15% later regret surgery. c. transmen generally report better post-surgical adjustment than transwomen. d. all of the above are true.

ANSWER: b 121. Intersexuality refers to people who a. are born with ambiguous genitals. .

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Chapter 11 Sex and Gender b. are sexually attracted to members of both sexes. c. like to dress like the opposite sex. d. are no longer sexually active.

ANSWER: a 122. The new approaches to understanding and treating intersexed individuals that have been proposed recently (FaustoSterling, 2000) are based on the concept of "five sexes," which include all of the following EXCEPT _______________. a. "herms" b. "merms" and "ferms" c. males and females d. "andros" and "estros" ANSWER: d Subjective Short Answer 123. According to your text, what is “normal” sexual behavior?

ANSWER: As shown in the introduction and throughout Chapter 10, what is “normal” is dependent on many factors, including the level of distress it causes an individual, the association with substantial impairment in the future, and/or whether it involves children or non-consenting adults. As your text explains, what is considered an acceptable variety of sexual expressions changes over time. The DSM-5 has separated out categories of sexual dysfunction, paraphilic disorders, and gender dysphoria in an attempt to differentiate the diagnoses and treatment options. However, further disaggregation is expected in future editions of the DSM. 124. What does the research suggest about frequency of sex in older adults?

ANSWER: Contrary to popular opinion, sexual activity does continue after 80 years old. Approximately 39% of men and 17% of women are sexually active from ages 75-85. Most of the decrease in sexual activity is attributed to health changes and not changes related to desire.

125. Describe the impact of culture on the definition of a sexual disorder. What cross-cultural evidence suggests that "normal" sexual behavior is culturally defined?

ANSWER: Cultural influences affect what people are told about sexual behavior, as well as what they experience and observe around them. Variations in the age of sexual intercourse, gender roles, and types of behaviors judged acceptable are all functions of cultural values. For example, researchers know that in Papua New Guinea, young boys engage in homosexual oral sex with teenage boys and avoid masturbation because it is believed that semen is crucial for male development. In Western cultures, attitudes toward premarital sex and use of contraception vary.

126. Are there gender differences in masturbation? If so, what might cause them?

ANSWER: The majority of men (72%) and 42% of women report ever masturbating. Some reasons for this discrepancy may include those that are biological (such as masturbating is easier for men whose genitals lay outside the body), or sociological (such as men are culturally encouraged to seek sexual pleasure more often than women). Despite a difference in frequency of masturbation, there are no differences in the acceptability of masturbation.

127. Describe the evidence for the genetic and/or biological basis for homosexuality as well as the evidence for the environmental influences on sexual preference.

ANSWER: Homosexuality appears to run in families, with concordance rates for homosexuality more common among identical twins than fraternal twins or siblings. Other evidence suggests that homosexuality is associated with .

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Chapter 11 Sex and Gender differential exposure to hormones in utero. Research also suggests that the structure of the brain may differ in homosexuals. However, temperamental factors may also interact with environmental factors to produce sexual orientation. Bem (1996) argues that those things that seem exotic tend to become erotic. In support of environmental influences, even identical twins don’t always have the same sexual orientation, and boys with an increased number of older brothers are more likely to be gay.

128. Explain the features of the treatment options (psychosocial and surgical sex reassignment) for gender identity disorder. Why is it so important for the patient to consider treatment options very carefully?

ANSWER: The treatment for gender identity disorders is controversial and can only been done in specialty clinics.

The most common approach is sex reassignment surgery to change a person’s physical anatomy to match his/her chosen gender identity. In order to undergo this surgery, individuals are typically asked to live in the opposite-sex role for 1 to 2 years and to be psychologically, financially, and socially stable. In some cases, hormones are also used to alter physical characteristics. Careful consideration of this surgery is important because approximately 7% of sex reassignment cases later regret surgery, and 2% may even attempt suicide after surgery.

129. Describe and contrast male erectile disorder and female sexual arousal disorder with inhibited orgasmic disorders.

ANSWER: Males with erectile disorder become aroused and are interested in sexual activity but have trouble achieving or maintaining an erection. Females have trouble achieving or maintaining adequate lubrication. Men tend to more disturbed by arousal issues than women, and the disorder is exacerbated by age and becomes common after age 60.

Disorders of orgasm consist of the inability to have an orgasm despite adequate sexual desire and arousal, and are far more common in women than men. Approximately 20% of all women reliably experience regular orgasms during sexual intercourse, meaning that in order to make the diagnosis, it is important to take into account the couple’s level of distress about the situation. Studies indicate that about 8% of men report delayed or nonexistent orgasms during sexual interactions but are unlikely to seek treatment for this condition.

130. Describe the symptoms of three different forms of paraphilia. What do all paraphilias have in common?

ANSWER: Paraphilias are all characterized by sexual attraction to something or somebody other than another adult, including animals, children, and household objects. Individuals may exhibit more than one paraphilic pattern and often experience mood, anxiety, and substance abuse disorders as well.

Examples: Frotteuristic disorder refers to a male in a crowded place rubbing against someone he doesn’t know until he is stimulated to the point of ejaculation.

A sexual attraction to a nonliving object is referred to as a fetishistic disorder. Women’s undergarments and shoes are typical objects, although individuals may have very specific objects of sexual attraction.

Voyeuristic disorder refers to watching an unsuspecting individual undressing or naked in order to get aroused.

Exhibitionistic disorder involves exposing one’s genitals to unsuspecting strangers for sexual gratification.

Transvestic disorder involves sexual arousal associated with the act of dressing in clothes of the opposite sex.

Sexual sadism and masochism refer to achieving sexual gratification either by inflicting pain or humiliation or suffering pain or humiliation respectively. .

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Chapter 11 Sex and Gender Sadistic rape refers to rapists who are particularly aroused when force and acts of cruelty are involved.

Pedophilic disorder refers to sexual attraction to children or very young adolescents.

Essay 131. According to your text, what is “normal” sexual behavior?

ANSWER: As shown in the introduction and throughout Chapter 10, what is “normal” is dependent on many factors, including the level of distress it causes an individual, the association with substantial impairment in the future, and/or whether it involves children or non-consenting adults. As your text explains, what is considered an acceptable variety of sexual expressions changes over time. The DSM-5 has separated out categories of sexual dysfunction, paraphilic disorders, and gender dysphoria in an attempt to differentiate the diagnoses and treatment options. However, further disaggregation is expected in future editions of the DSM. 132. What does the research suggest about frequency of sex in older adults?

ANSWER: Contrary to popular opinion, sexual activity does continue after 80 years old. Approximately 39% of men and 17% of women are sexually active from ages 75-85. Most of the decrease in sexual activity is attributed to health changes and not changes related to desire.

133. Describe the impact of culture on the definition of a sexual disorder. What cross-cultural evidence suggests that "normal" sexual behavior is culturally defined?

ANSWER: Cultural influences affect what people are told about sexual behavior, as well as what they experience and observe around them. Variations in the age of sexual intercourse, gender roles, and types of behaviors judged acceptable are all functions of cultural values. For example, researchers know that in Papua New Guinea, young boys engage in homosexual oral sex with teenage boys and avoid masturbation because it is believed that semen is crucial for male development. In Western cultures, attitudes toward premarital sex and use of contraception vary.

134. Are there gender differences in masturbation? If so, what might cause them?

ANSWER: The majority of men (72%) and 42% of women report ever masturbating. Some reasons for this discrepancy may include those that are biological (such as masturbating is easier for men whose genitals lay outside the body), or sociological (such as men are culturally encouraged to seek sexual pleasure more often than women). Despite a difference in frequency of masturbation, there are no differences in the acceptability of masturbation.

135. Describe the evidence for the genetic and/or biological basis for homosexuality as well as the evidence for the environmental influences on sexual preference.

ANSWER: Homosexuality appears to run in families, with concordance rates for homosexuality more common among identical twins than fraternal twins or siblings. Other evidence suggests that homosexuality is associated with differential exposure to hormones in utero. Research also suggests that the structure of the brain may differ in homosexuals. However, temperamental factors may also interact with environmental factors to produce sexual orientation. Bem (1996) argues that those things that seem exotic tend to become erotic. In support of environmental influences, even identical twins don’t always have the same sexual orientation, and boys with an increased number of older brothers are more likely to be gay.

136. Explain the features of the treatment options (psychosocial and surgical sex reassignment) for gender identity disorder. Why is it so important for the patient to consider treatment options very carefully?

ANSWER: The treatment for gender identity disorders is controversial and can only been done in specialty clinics.

The most common approach is sex reassignment surgery to change a person’s physical anatomy to match his/her chosen gender identity. In order to undergo this surgery, individuals are typically asked to live in the opposite-sex role for 1 to 2 years and to be psychologically, financially, and socially stable. In some cases, .

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Chapter 11 Sex and Gender hormones are also used to alter physical characteristics. Careful consideration of this surgery is important because approximately 7% of sex reassignment cases later regret surgery, and 2% may even attempt suicide after surgery.

137. Describe and contrast male erectile disorder and female sexual arousal disorder with inhibited orgasmic disorders.

ANSWER: Males with erectile disorder become aroused and are interested in sexual activity but have trouble achieving or maintaining an erection. Females have trouble achieving or maintaining adequate lubrication. Men tend to more disturbed by arousal issues than women, and the disorder is exacerbated by age and becomes common after age 60.

Disorders of orgasm consist of the inability to have an orgasm despite adequate sexual desire and arousal, and are far more common in women than men. Approximately 20% of all women reliably experience regular orgasms during sexual intercourse, meaning that in order to make the diagnosis, it is important to take into account the couple’s level of distress about the situation. Studies indicate that about 8% of men report delayed or nonexistent orgasms during sexual interactions but are unlikely to seek treatment for this condition.

138. Describe the symptoms of three different forms of paraphilia. What do all paraphilias have in common?

ANSWER: Paraphilias are all characterized by sexual attraction to something or somebody other than another adult, including animals, children, and household objects. Individuals may exhibit more than one paraphilic pattern and often experience mood, anxiety, and substance abuse disorders as well.

Examples: Frotteuristic disorder refers to a male in a crowded place rubbing against someone he doesn’t know until he is stimulated to the point of ejaculation.

A sexual attraction to a nonliving object is referred to as a fetishistic disorder. Women’s undergarments and shoes are typical objects, although individuals may have very specific objects of sexual attraction.

Voyeuristic disorder refers to watching an unsuspecting individual undressing or naked in order to get aroused.

Exhibitionistic disorder involves exposing one’s genitals to unsuspecting strangers for sexual gratification.

Transvestic disorder involves sexual arousal associated with the act of dressing in clothes of the opposite sex.

Sexual sadism and masochism refer to achieving sexual gratification either by inflicting pain or humiliation or suffering pain or humiliation respectively.

Sadistic rape refers to rapists who are particularly aroused when force and acts of cruelty are involved.

Pedophilic disorder refers to sexual attraction to children or very young adolescents.

.

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Chapter 12 Substance Use and Impulse Control Multiple Choice 1. Cameron has a cup of coffee every morning, smokes 10 cigarettes a day, and has a beer with dinner. This is an example of a. substance use. b. substance abuse. c. polysubstance abuse. d. substance intoxication.

ANSWER: a 2. Which of the following would NOT be an example of substance use? a. Smoking a cigarette b. Drinking a cup of coffee c. Taking a sleeping pill d. Getting drunk ANSWER: d 3. The American Psychiatric Association defines substance abuse in terms of a. how drunk or intoxicated a person gets after ingesting a psychoactive substance. b. whether or not the substance interferes with the person's life. c. the type and intensity of the substance abuser's biological reaction. d. which drug is used and whether it is legal or illegal.

ANSWER: b 4. Substance intoxication includes all of the following EXCEPT a. the specific drug that is used. b. how much of a drug is used or ingested. c. the drug user's individual biological reaction. d. physiological dependence on the drug.

ANSWER: d 5. In terms of substance-related disorders, the word “addiction” is most closely associated with a. substance use b. intoxication c. drug dependence d. polysubstance abuse ANSWER: c

.

6. How many symptoms must a patient display to meet the DSM-5 diagnosis of a Substance Use Disorder? a. 1 b. 2 c. 4 d. 6 or more ANSWER: b

.

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Chapter 12 Substance Use and Impulse Control 7. How many symptoms must a patient display to meet the DSM-5 diagnosis of a moderate Substance Use Disorder? a. 1 b. 2 c. 4 d. 6 or more ANSWER: c 8. How many symptoms must a patient display to meet the DSM-5 diagnoses of a severe Substance Use Disorder? a. 1 b. 2 c. 4 d. 6 or more ANSWER: a 9. A person who is physiologically dependent on a drug will experience a. tolerance to the effects of the drug. b. withdrawal symptoms if the drug is withdrawn. c. both tolerance and withdrawal. d. neither tolerance nor withdrawal.

ANSWER: c 10. The repeated use of a drug, a desperate need to ingest more of the substance (stealing money to buy drugs, standing outside in the cold to smoke), and the likelihood that use will resume after a period of abstinence are ______ behaviors. a. drug-seeking b. drug-avoidant c. typical d. psychological ANSWER: a 11. Carol has been addicted to narcotics for many years. Recently, she has been trying to quit and has not used any drugs for the last week. We can expect that Carol will be experiencing _________________ . a. fever and chills b. nausea, vomiting, and diarrhea c. aches and pains d. all of these ANSWER: d 12. A perspective of Substance Use Disorder that involves "drug-seeking behaviors" includes all of the following EXCEPT a. repeated use of the drug. b. a desperate need to ingest more of the drug. c. resuming drug use after a period of abstinence. d. physical symptoms when the drug is no longer used.

ANSWER: d .

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Chapter 12 Substance Use and Impulse Control 13. Tirkel steals money from his mother's handbag every time he needs to buy drugs. His Substance Use Disorder is manifested by a. withdrawal symptoms. b. drug-seeking behavior. c. continuing tolerance. d. psychological addiction.

ANSWER: b 14. Angelina has had difficulty falling asleep for some time. She started taking a prescribed sleeping pill every night for her insomnia. Now, she needs the pill to fall asleep. Without it, she will toss and turn all night, getting little sleep.

Angelina is a. dependent and drug abusive. b. dependent and not drug abusive. c. dependent but not physiologically addicted. d. dependent and tolerant.

ANSWER: b 15. Alcoholism and substance abuse, previously considered a _________________, is now conceptualized by many as a disease. a. sociopathic personality disturbance b. schizophrenic-like behavioral pattern c. type of dependent personality disorder d. hysterical conversion syndrome ANSWER: a 16. Alcohol and the drugs Seconal, Halcion, and Valium are all classified as____________________ . a. stimulants b. opiates c. depressants d. narcotics ANSWER: c 17. All of the following analgesic substances are classified as opiates EXCEPT a. cocaine b. codeine c. heroin d. morphine ANSWER: a 18. All of the following are hallucinogens EXCEPT a. cannabis b. codeine c. LSD d. all of the answers are correct ANSWER: b .

.

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Chapter 12 Substance Use and Impulse Control 19. Both morphine and codeine produce analgesia, which means that they a. activate the central nervous system. b. relieve pain and produce euphoria. c. increase alertness. d. cause delusions and dissociative experiences.

ANSWER: b 20. Which of the following is an example of alcohol's effects on brain functioning? a. Faster reaction time b. Improved judgment c. Impaired motor coordination d. Clear speech ANSWER: c 21. Which of the following neurotransmitters affects the emotion of anxiety during alcohol use? a. GABA b. Serotonin c. Glutamate d. Dopamine ANSWER: a 22. Alcohol can initially appear to cause stimulation because it a. makes vision and hearing more acute. b. has an excitatory effect on the brain. c. depresses inhibitory centers in the brain. d. alters motor coordination.

ANSWER: c 23. Although most psychoactive substances interact with specific substances in brain cells, the effects of more complex because several different neurotransmitter systems are affected. a. opiates b. tranquilizers c. alcohol d. marijuana ANSWER: c

are much

24. The condition called delirium tremens, also known as the "DTs," involves hallucinations and body tremors during withdrawal from . a. heroin b. cocaine c. alcohol d. marijuana ANSWER: c 25. Blackouts appear to be related to the interaction of alcohol with the a. glutamate .

system.

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Chapter 12 Substance Use and Impulse Control b. serotonin c. GABA d. dopamine ANSWER: a 26. Because of its impact on GABA receptors, alcohol a. inhibits b. facilitates c. randomizes d. eliminates ANSWER: a

neuronal communication.

27. What explains the apparent stimulation, feeling of well-being, and outgoing behavior that occur as the initial effects of alcohol ingestion? a. Depression of the inhibitory centers in the brain b. Activation of the inhibitory centers in the brain c. Depression of the autonomic nervous system d. Stimulation of the autonomic nervous system ANSWER: a 28. Which of the following does NOT describe the specific effect of alcohol on a particular neurotransmitter system? a. Serotonin - alcoholic cravings b. Glutamate - alcoholic blackouts c. Dopamine - slurred speech d. GABA - anti-anxiety effect ANSWER: c 29. All of the following are symptoms of withdrawal from alcohol EXCEPT____________. a. nausea and/or vomiting b. hypersomnia c. transient hallucinations d. agitation ANSWER: b 30. In some individuals, chronic alcohol use causes physical damage to the body. Whether this occurs depends on all of the following factors EXCEPT a. blood alcohol levels during drinking periods. b. type of alcohol consumed (e.g., beer, wine, liquor). c. genetic vulnerability. d. the frequency of alcohol use.

ANSWER: b 31. Annabelle has been a heavy drinker for years. Her behavior reflects confusion, loss of muscle coordination and unintelligible speech. Such behavior is probably the result of . a. dementia b. substance abuse psychotic disorder .

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Chapter 12 Substance Use and Impulse Control c. fetal alcohol syndrome d. Wernicke-Korsakoff syndrome ANSWER: d 32. The correct pairing of the names, causes, and symptoms of two types of organic brain syndromes that may result from chronic, long-term alcohol abuse are a. dementia - loss of intellectual abilities caused by a deficiency of the vitamin called thiamine. b. Broca’s disease - confusion, loss of muscle coordination, and unintelligible speech caused by a deficiency of the vitamin called thiamine. c. dementia - confusion, loss of muscle coordination, and unintelligible speech caused by the toxic effects of alcohol on the brain. d. Fetal alcohol syndrome - loss of intellectual abilities caused by the toxic effects of alcohol on the adult brain.

ANSWER: b 33. Fetal alcohol syndrome (FAS) is a combination of problems that can occur in a child whose mother drank alcohol while pregnant. Symptoms of FAS include all of the following EXCEPT a. cognitive deficits and behavior problems. b. distorted facial features. c. learning difficulties. d. excessive fetal growth.

ANSWER: d 34. Differences in fetal alcohol syndrome (FAS) rates among women who drink may be due to a. cultural/racial b. cognitive c. metabolic d. emotional ANSWER: a

differences.

35. Research that asks individuals to indicate their frequency of alcohol use found that alcohol use is highest among______________. a. Hispanics b. Asian Americans c. Caucasian Americans d. people with multiracial backgrounds ANSWER: c 36. Peak alcohol use is typical: a. during late teen years b. in graduate school c. during the early 20s d. over the age of 65 ANSWER: a 37. Which of the following is true about alcohol use disorders internationally? a. Highest in Russia and other very cold countries .

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Chapter 12 Substance Use and Impulse Control b. Highest in the Middle East c. Highest in Latin America d. Highest in the United States ANSWER: d 38. Which of the following is an accurate statement about alcohol use? a. Education is negatively correlated with recent alcohol use. b. Half of all Americans over the age of 12 report being current drinkers of alcohol. c. Female college students were more likely than male college students to report several episodes of binge drinking in a two-week period. d. Alcohol use in the elderly population is typically high.

ANSWER: b 39. In a large survey among college-age men and women, it was found that a. about 75% of the respondents had gone on a binge of heavy drinking once in the preceding two weeks. b. there was no relationship between frequency of drinking and grades. c. students with a grade-point average of "A" had no more than one drink per week. d. "D" and "F" students averaged 11 alcoholic drinks per week.

ANSWER: d 40. In 2012, researchers at the Substance Abuse and Mental Health Services Administration estimated that more than Americans are probably dependent on alcohol. a. 5million b. 11 million c. 16 million d. 25 million ANSWER: c 41. A report from the Substance Abuse and Health Services Administration (2012) indicates that just under Americans reported binge drinking in the month preceding the report. a. 2% b. 24% c. 51% d. 65% ANSWER: b

of

42. The prevailing view that alcohol abuse usually follows a predictable downward spiral was based on Jellinek's mid 20th century survey of Alcoholics Anonymous (AA) members that asked them how alcohol had affected them physically and psychologically. Data from this survey are now considered inaccurate because a. respondents faked their answers to the questions on the survey. b. too few AA members answered the survey questions. c. since the survey was only sent to older members of AA, information on the progression of alcohol use was not available. d. Jellinek himself became an alcoholic and never finished the research.

ANSWER: b .

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Chapter 12 Substance Use and Impulse Control 43. According to Jellinek's model (no longer considered accurate but still of scientific interest), an individual with alcoholism progresses through four stages. Which of the following INCORRECTLY describes the characteristic behaviors associated with each of Jellinek's stages? a. Prealcoholic stage - hangovers, DWI or DUI charges, blackouts b. Prodromal stage - drinking heavily but few outward signs of problems c. Chronic stage – primary daily activities involve drinking and getting drunk d. Crucial stage – loss of control with occasional binges ANSWER: a 44. A research study of 6,000 lifetime drinkers (DeWitt et al., 2000) found that drinking at an early age (ages 11 to 14) a. was predictive of later alcohol use disorders. b. had no relationship to alcohol use later in life. c. caused more frequent blackouts than drinking at later ages. d. resulted in more severe withdrawal symptoms than drinking at later ages.

ANSWER: a 45. Which of the following is an accurate statement about alcoholism? a. A progressive pattern leading to alcoholism is inevitable for those who drink alcohol. b. The factors that determine a drinker's susceptibility to alcoholism are not yet fully understood. c. Alcohol use and aggressive behavior are negatively correlated. d. Use of alcohol by preteens and young teenagers does not predict later abuse.

ANSWER: b 46. Although alcohol use and aggression are positively correlated, the factors that actually determine aggressive behavior involve all of the following EXCEPT a. quantity and timing of alcohol consumed. b. the person's previous history of violence. c. the expectations about drinking. d. the person's level of intelligence.

ANSWER: d 47. You have just heard about a situation in which someone who was drunk vandalized a building and assaulted a security guard. From your knowledge of abnormal psychology, you are aware that although alcohol does not cause aggressive behavior, it may a. stimulate the inhibitory center of the brain, causing aggressive behavior. b. activate the aggressive genes in the person's DNA. c. impair the ability to consider the consequences of acting impulsively. d. increase the anxiety associated with being punished for one's actions.

ANSWER: c 48. Alcohol is related to violence because it a. increases impulsivity b. increases rational thinking c. causes aggression d. decreases aggressive behavior ANSWER: a .

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Chapter 12 Substance Use and Impulse Control 49. Which of the following terms is the definition of anxioltytic? a. Sleep-inducing b. Anxiety-reducing c. Anti-seizure d. Anxiety-increasing ANSWER: b 50. Which of the following terms is the definition of sedative? a. Sleep-inducing b. Anxiety-reducing c. Anti-seizure d. Calming ANSWER: d 51. Which of the following terms is the definition of hypnotic? a. Sleep-inducing b. Anxiety-reducing c. Anti-seizure d. Calming ANSWER: a 52. Which of the following terms is the definition of anticonvulsant? a. Sleep-inducing b. Anxiety-reducing c. Anti-seizure d. Calming ANSWER: c 53. Which of the following drugs is NOT classified as a barbiturate? a. Amytal b. Seconal c. Rohypnol d. Nembutal ANSWER: c 54. Which of the following drugs is NOT classified as a benzodiazepine? a. Ativan b. Valium c. Xanax d. Seconal ANSWER: d 55. Minerva was extremely anxious and worried about everything. She thought that something terrible would happen and worried what people thought about her. Her doctor most likely prescribed to help her. a. an opiate .

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Chapter 12 Substance Use and Impulse Control b. an anticonvulsant c. a sedative d. an antidepressant ANSWER: c 56. Misuse of the benzodiazepine _________________has resulted in it being referred to as the "forget-me pill," and it has been used to facilitate date rape. a. Amytal b. Halcion c. Rohypnol d. Ritalin ANSWER: c 57. Which of the following types of drugs typically is used in large amounts to commit suicide? a. Benzodiazepines b. Barbiturates c. Stimulants d. Hallucinogens ANSWER: b 58. The most commonly consumed of all the psychoactive drugs are the stimulants, which include all of the following EXCEPT _____________. a. caffeine b. cocaine c. nicotine d. mescaline ANSWER: d 59. Which of the following is an accurate statement about amphetamines and/or amphetamine use disorders? a. Amphetamines cause a period of depression and fatigue (called "crashing"), which is followed by feelings of elation and euphoria. b. Amphetamines cause an increase in appetite and a decrease in fatigue. c. Amphetamines decrease the availability of dopamine and norepinephrine in the nervous system. d. Amphetamine overdose can cause hallucinations, panic, agitation, and paranoid delusions.

ANSWER: c 60. Until 1903, Coca-Cola contained which of the following? a. Cocaine b. Heroin c. Caffeine d. Chocolate ANSWER: a 61. Ecstasy, or MDMA, a. increases appetite. b. rarely causes Emergency Room visits. .

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Chapter 12 Substance Use and Impulse Control c. is now used more than LSD. d. acts like speed, but has major withdrawal symptoms.

ANSWER: c 62. Which of the following effects is associated with cocaine use? a. Decreased alertness b. Increased appetite c. Decreased pulse and blood pressure d. Rapid and irregular heartbeat ANSWER: d 63. "Crack babies," born to mothers who have used cocaine, often develop problems that are attributed not only to the effects of cocaine but also to a. mother’s use of alcohol. b. mother’s use of nicotine. c. disrupted home environments. d. all of these.

ANSWER: d 64.

Stimulation of the neurons in the "pleasure pathway" (the site in the brain that seems to be involved in the experience of pleasure) probably causes the "high associated with cocaine use. a. dopamine b. serotonin c. adrenaline d. endorphin ANSWER: a 65. Your shy and introverted friend tells you that she has discovered a wonder drug that produces feelings of euphoria and is not addictive. When you realize that she is talking about cocaine, you inform her that a. scientists agree that it is a wonder drug just as she describes. b. in the early 20th century cocaine was an ingredient in Pepsi-Cola. c. cocaine will make her more social and outgoing. d. dependence on cocaine develops slowly over a period of years.

ANSWER: d 66. Nikki has decided to stop smoking (again). She can expect to experience which of the following withdrawal symptoms? a. Elevated mood b. Decreased appetite c. Weight loss d. Irritability ANSWER: d 67. The most common of the psychoactive substances, used by 90% of Americans, is a. nicotine .

.

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Chapter 12 Substance Use and Impulse Control b. caffeine c. marijuana d. opium ANSWER: b 68. Which of the following are examples of opioids? a. Chemicals in the poppy b. Hydrocodone c. Enkephalins d. All of the above ANSWER: d 69. Legally available narcotic medications, including morphine and codeine, are used primarily as a. antagonists b. analgesics c. antibiotics d. antidotes ANSWER: b

.

70. Which of the following is an accurate statement about opiate (narcotic) addiction? a. Discontinuing narcotic use brings on withdrawal symptoms in 1 to 2 hours. b. Since opiates (narcotics) are usually injected, users are at increased risk for HIV and, by extension, AIDS. c. The withdrawal process for narcotic addiction takes about 1 to 3 weeks. d. Most addicts die before the age of 50 from a drug overdose.

ANSWER: b 71. Angus had been "hooked" for a while before he decided to "go clean." Within 6 to 12 hours, he started to experience excessive yawning, nausea and vomiting, chills, muscle aches, diarrhea, and insomnia. His behavior disrupted his work and social relationships. These symptoms persisted for three days. After a week, he felt better. Angus is probably withdrawing from . a. alcohol b. cocaine c. heroin d. LSD ANSWER: c 72. Enkephalins and endorphins are natural opioids found in a. the brain b. the humoral system c. DNA d. poppy seeds ANSWER: a

.

73. Which of the following is an accurate statement concerning marijuana use and abuse? a. Paranoia and hallucinations can occur. b. Tolerance develops rapidly. .

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Chapter 12 Substance Use and Impulse Control c. Substance Use Disorders can occur with even occasional use. d. Marijuana is free of carcinogens.

ANSWER: a 74. Cannabis use often results in a. mood swings b. blunted sensory experience c. an accurate sense of time d. enhanced nausea ANSWER: a

.

75. Health-wise, marijuana a. wards off nausea. b. eases pain associated with multiple sclerosis. c. contains as many carcinogens as tobacco smoke. d. all of these.

ANSWER: d 76. Even after Timon read "Psychedelics for Dummies," he was unable to produce LSD in the lab. He decided he would have to find a hallucinogen naturally. Therefore, he should look for which naturally occurring hallucinogen? a. Psilocybin b. Mescaline c. LSD d. All of these ANSWER: d 77. Which of the following hallucinogenic substances is processed synthetically? a. Marijuana b. LSD c. Psilocybin d. Mescaline ANSWER: b 78. Which of the following statements is false about hallucinogens? a. LSD is chemically similar to serotonin. b. Mescaline is chemically similar to norepinephrine. c. A number of hallucinogens are chemically similar to acetylcholine. d. MDMD is chemically similar to glutamate.

ANSWER: d 79. All of the following are informative and accurate statements about inhalants EXCEPT a. inhalant use is most commonly observed among college students. b. symptoms of inhalant use include slurred speech, dizziness, and euphoria. c. long-term inhalant use can damage bone marrow, the kidneys, the liver, and the brain. d. use of inhalants can cause users to be antisocial and aggressive. .

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Chapter 12 Substance Use and Impulse Control ANSWER: a 80. Use of the testosterone-derived anabolic-androgenic steroids differs from other illicit drug use because a. the "high" produced from steroid use is more intense than that experienced with other drugs. b. steroids are used to increase body mass and enhance performance. c. more females than males use anabolic steroids. d. steroids can be taken orally or by injection.

ANSWER: b 81. Among the so-called recreational or illicit "designer drugs" is a dissociative anesthetic that produces a sense of detachment along with a reduced awareness of pain. It is called . a. Ecstasy (MDMA) b. "K" or "Special K" c. Eve d. Nexus ANSWER: b 82. A recent research study on alcoholism suggests that use of illegal drugs is influenced by environmental factors, but abuse and dependence are more influenced by factors. a. genetic b. psychological c. non-biological d. cultural ANSWER: a 83. The field of research that studies how genes work to affect addiction is called a. behavior genetics b. the genome project c. functional genomics d. genetic cross-transformation ANSWER: c

.

84. The common factor among psychoactive drugs may be a. their ability to activate the "pleasure pathways" of the brain. b. the ease of obtaining them and the relatively inexpensive cost. c. the similar way in which they are metabolized in the body. d. their identical effect on neurotransmitters at the synapse.

ANSWER: a 85. The "pleasure pathways," or internal reward centers, in the human brain are primarily made up of______________. a. dopamine-sensitive neurons b. serotonin-sensitive neurons c. both of these d. neither of these ANSWER: a .

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Chapter 12 Substance Use and Impulse Control 86. The drugs that directly stimulate the internal reward center or pleasure pathways in the brain include a. amphetamines and cocaine b. the opiates c. all of these d. none of these ANSWER: c 87. Yesterday you asked your friend Ray for a couple of aspirin tablets. Ray has been taking a psychology course and informs you that, in behavioral terms, aspirin is a headache begins to gets worse.) a. positive b. negative c. neutral d. variable ANSWER: b 88. In behavioral terms, drugs like aspirin are considered negative reinforcers because they a. quickly make a person feel good. b. stop a person from feeling pain. c. have toxic effects on the nervous system. d. can cause frequent users to become dependent on them.

ANSWER: b 89. Which of the following drugs is known to have an anxiolytic (anxiety-relieving) effect? a. Methamphetamine b. Alcohol c. Caffeine d. LSD ANSWER: b 90. In trying to understand why some people continue to use drugs until they become dependent on them and others are able to stop before this happens, it is important to consider a. how sensitive a person is to both the negative effects of alcohol when it is first ingested and to the negative effects of alcohol after a few hours b. how sensitive a person is to the positive effects of alcohol when it is first ingested and to the negative effects after a few hours. c. how sensitive a person is to the negative effects of alcohol when it is first ingested and to the positive effects a few hours later. d. how sensitive a person is to the positive effects of alcohol when it is first ingested and to the positive effects a few hours later.

ANSWER: d 91. In a study involving the sons of alcoholics who were at high risk themselves for developing alcoholism, it was found that a. they were less sensitive to the positive effects of alcohol when it was first ingested. b. they were more sensitive to the negative effects of alcohol after a few hours. c. both of these. .

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Chapter 12 Substance Use and Impulse Control d. neither of these.

ANSWER: d 92. In a laboratory research study involving "drug addiction" in animals, it was demonstrated that the positive reinforcing effect of drugs was a. biological only. b. tied to social and cultural influences. c. free from social and cultural influences. d. biological, social, and cultural.

ANSWER: c 93. Many individuals use drugs as negative reinforcement to escape from the unpleasantness (pain, stress, anxiety) in their lives. This phenomenon is called all of the following EXCEPT . a. self-medication b. tension reduction c. controlled dosing d. negative affect ANSWER: c 94. The integration of both positive and negative reinforcement in explaining why the "crash" that follows the initial euphoria of drug use is not a deterrent to further drug use is called a. the opponent-process theory. b. amotivational syndrome. c. substance induced myopia. d. an expectancy effect.

ANSWER: a 95. Which of the following is an accurate statement about the opponent-process explanation of drug addiction? a. An increase in positive feelings will be followed by an increase in negative feelings b. An increase in negative feelings will be followed by an increase in positive feelings c. Both of these d. Neither of these ANSWER: c 96. Research examining the expectations that kids in grades 7 through 11 have about drinking alcohol revealed that some of the students begin drinking because they think it will have positive effects on their social behavior and cognitive and motor skills, a phenomenon called a. alcoholic myopia. b. an expectancy effect. c. opponent-process theory. d. regressive alcoholism.

ANSWER: b 97. Expectancies about alcohol use a. start before people even start drinking. b. predict who will later have drinking problems. .

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Chapter 12 Substance Use and Impulse Control c. change over time and alcohol use. d. all of the above ANSWER: d 98. Substance abuse can be seen from either a biological or a psychosocial perspective. For example, the condemnation of drug abuse as an official sin by the Catholic Church is an example of . a. the moral weakness model b. the disease model of dependence c. the AA model of drug dependency d. a 12-step program ANSWER: a 99. Drug-addicted parents may contribute to their child’s drug use by a. failing to monitor the child’s behavior. b. making drugs available to the child. c. creating an environment where peers use drugs. d. all of the above.

ANSWER: a 100. Cravings seem to be exacerbated by a. the availability of drugs. b. specific moods. c. places and objects associated with drug taking. d. all of the above.

ANSWER: d 101. The disease model of dependence a. assumes that dependence is caused by a psychological disorder. b. assumes that dependence is caused by an underlying physiological disorder. c. is a psychosocial perspective. d. assumes that dependence is a failure of self-control.

ANSWER: a 102. Research on changes in Korean drug use patterns suggests that a. cultural norms can override biological factors that inhibit alcohol use. b. cultural norms cannot override biological factors that inhibit alcohol use. c. personality factors contribute to substance use. d. all of these.

ANSWER: a 103. The brain’s tendency to reorganize by forming new neural connections is called a. neuroplasticity b. neuroelasticity c. neuroconsolidation d. neurogenesis .

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Chapter 12 Substance Use and Impulse Control ANSWER: a 104. Which of the following are examples of agonist types of treatment for substance abuse? a. The use of methadone to treat heroin addiction b. A nicotine patch or nicotine gum to treat addiction to cigarette smoking c. Both of these d. Neither of these ANSWER: c 105. The opiate-antagonist naltrexone is a treatment for substance abuse that works by a. substituting a chemically similar drug for the addictive drug. b. both counteracting the effects of opiates and producing withdrawal symptoms. c. producing a cross-tolerance effect in a drug user. d. producing only a temporary euphoric effect if opiates continue to be used.

ANSWER: b 106. The drug called Antabuse helps people abstain from drinking alcohol by a. causing alcoholic drinks to taste bitter. b. disrupting breakdown of a byproduct of alcohol, leading to feelings of illness. c. making people allergic to alcohol. d. reducing the pleasurable feelings that are associated with alcohol.

ANSWER: b 107. An individual with alcoholism who is highly motivated to stop drinking and who understands the possibly severe consequences of treatment may be prescribed the drug called Antabuse. This medication is an example of an_________ treatment for alcoholism. a. agonist (substitution) b. antagonist c. aversive d. 12-step ANSWER: c 108. Which of the following is NOT an accurate statement about Alcoholics Anonymous (AA)? a. AA is clearly an effective treatment for some people with a Substance Use Disorder. b. More than 9% of the adult population of the United States has attended an AA meeting. c. AA advocates controlled drinking in which former alcoholics can become social drinkers. d. It is difficult to conduct accurate research on AA because participation is anonymous.

ANSWER: c 109. For which of the following groups has Alcoholics Anonymous shown to have mixed results? a. Women b. Atheists c. Asian Americans d. Experience for all of these groups has been mixed.

ANSWER: d .

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Chapter 12 Substance Use and Impulse Control 110. A component that seems to be an integral part of substance abuse therapy is a. covert sensitization b. contingency management c. relapse prevention d. pharmacotherapy ANSWER: b

.

111. The community reinforcement approach, a new type of program that has been started to address the problem of substance abuse, includes all of the following components EXCEPT a. a non-substance-abusing relative participates with the alcoholic in relationship improvement sessions. b. encouraging the substance abuser to accept that his or her friends may continue to be users but associating with them is still OK. c. assistance with employment, education, finances, or other social service areas is provided to help reduce stress. d. suggesting options for new recreational activities to replace previous drug-related activities.

ANSWER: b 112. Contingency management involves a. the use of reinforcement for specific behaviors. b. the elimination of abuse cues. c. altering expectations. d. use of medications to create substance aversions.

ANSWER: a 113. According to your book, controlled drinking is believed to be a. a viable alternative to abstinence. b. much more effective than abstinence. c. much less efficient than abstinence. d. helpful for everyone.

ANSWER: a 114. Relapse prevention refers to a treatment mode that views relapse as a. a failure of cognitive and behavioral coping skills. b. a failure of willpower. c. proof that a person will never be able to control his/her drinking. d. an insurmountable obstacle to treatment for substance abuse.

ANSWER: a 115. Which of the following has NOT been shown to be effective in preventing drug use in adolescents? a. Skills training to avoid or resist social pressure b. Education on how the media glorifies drug use c. Community strategies about each person’s role in reducing drug use d. Fear based tactics on the dangers of drug use ANSWER: d 116. Substance abuse prevention efforts in the past have focused on .

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Chapter 12 Substance Use and Impulse Control a. education-based approaches. b. changing laws regarding drug use and possession. c. working with parents to change substance use. d. all of the above ANSWER: a 117. Of the following types of drug prevention strategies, which one has the potential for the most successful outcome (accordin g to the information in your textbook)? a. Education-based programs (e.g., DARE) b. Skills training to resist social, media, and peer pressure to use drugs c. Relapse prevention programs focusing on the learned aspects of dependence, i.e., the failure of cognitive and behavioral coping skills d. Cultural attitude change (e.g., widespread enactment of no-smoking legislation) ANSWER: d 118. Although most impulse control disorders are considered rare, one that affects an increasing number of people is ______________. a. kleptomania b. pyromania c. gambling disorder d. intermittent explosive disorder ANSWER: c 119. Pyromania a. is fairly common among arsonists. b. is a disorder where an individual is preoccupied with setting fires and the associated equipment involved in putting out those fires. c. is fairly common among people who were bedwetters as children. d. is all of these.

ANSWER: b 120. Which of the following statements is TRUE about kleptomania? a. The stolen objects are not needed for personal use or their monetary value. b. The disorder appears to be more common than many disorders. c. The disorder has been fairly well-studied because of the somewhat high prevalence. d. All of these are true.

ANSWER: a 121. Although AA (Alcoholics Anonymous) programs are considered effective, the drop-out rate for GA (Gambler's Anonymous) programs is . a. 10 to 30% b. 30 to 50% c. 50 to 70% .

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Chapter 12 Substance Use and Impulse Control d. 70 to 90% ANSWER: d 122. Nicotine synergism refers to combining nicotine with a. contextual cues b. expectancies c. practice d. experience ANSWER: a

.

123. In the impulse control disorders, the individual feels a. relaxed and calm b. tension and anticipation c. spaced out d. angry and aggressive ANSWER: b

prior to carrying out the act.

Subjective Short Answer 124. Compare and contrast the "levels of involvement" in the following substance-related disorders: use, intoxication, abuse, and dependence. Define the meaning of the word "addiction."

ANSWER: Substance intoxication refers to the physiological reaction to an ingested substance. The degree of intoxication is related to the drug used, how much is ingested, and the person’s individual biological reaction.

Substance abuse according to DSM-IV-TR is defined in terms of how significantly it interferes with the user’s life. If it disrupts your education, job, relationships, health, or well-being, or causes legal problems, it can be judged as abuse. Substance dependence is described as an addiction. It can involve physiological reactions to the chemicals being ingested, and may include tolerance and withdrawal, but does not have to. In general, the term addiction is used to describe people who are under the control of a drug or drugs.

125. According to your text, is it possible to use drugs without becoming addicted to them?

ANSWER: Yes, substance use (ingesting psychoactive substances in moderate amounts) is defined differently than a Substance Use Disorder. Substance Use Disorder is defined in DSM-5 as having at least 2 symptoms in the last year that interfere with your life or bother you a great deal. Many people use drugs casually, such as drinking a cup of coffee in the morning to wake up or having a glass of wine with friends after work to relax.

However, genetics, social circumstances, and the environment can slowly increase use to abuse and abuse to a disorder.

126. Compare and contrast benzodiazepines and the barbiturates. Discuss medical uses for these substances and the potential for abuse and/or addiction.

ANSWER: Benzodiazepines are drugs used to reduce anxiety, including Valium, Xanax, Rohypnol, and Ativan.

These drugs impact the GABA system, and their use can result in tolerance and dependence. In recent years, Rohypnol has become known as the “forget-me drug,” and has been used to assist in date-rape.

Barbiturates include Amytal, Seconal, and Nembutal, and are prescribed to help people sleep. They affect the GABA system and can be addictive. These drugs relax the muscles and produce mild well- being, but can also impact speech, concentration, and walking. Overdoses can result in suffocation.

127. A commonly held-opinion is that alcohol increases social skills because it loosens inhibitions in communication. Describe recent research that supports or negates this opinion. .

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Chapter 12 Substance Use and Impulse Control ANSWER: Although alcohol may seem to make us more sociable, in reality, alcohol makes it more difficult to communicate with other people. The GABA system affects the emotion of anxiety and anti-anxiety properties may result from its interaction with the GABA system. Alcohol reinforces movement of chloride ions and as a result, neurons have difficulty firing. There are individual differences in this though. Genetic research suggests that genes responsible for communication between neurons may also be responsible for individual differences in response to alcohol.

128. Discuss some of the racial differences in binge drinking. What do you think accounts for these differences?

ANSWER: About 63 Million Americans over the age of 18 report binge drinking in the last month. Binge drinking is defined as four or more drinks (women) and five or more drinks (men) over a 2-hour time span. Whites and Hispanic/Latinos report the highest levels of binge drinking while Asian Americans report the lowest levels of binging. Reasons for this disparity are many including individual factors. Genetics, acceptability within communities, and other environmental factors can account for much of the difference between groups.

129. Discuss the effectiveness of prevention education on adolescent drug use.

ANSWER: Adolescents are at high risk for drug addiction due to their higher rates of experimentation with drugs. When done right, education about drugs’ risks can lead to decreases in drugs of abuse (e.g., ecstasy and tobacco).

Many states and school districts have implemented education-based programs in schools to try to deter students from using drugs. The widely used Drug Abuse Resistance Education (DARE) program encourages a “no drug use” message through fear of consequences, rewards for commitments not to use drugs, and strategies for refusing offers of drugs. Unfortunately, several extensive evaluations suggest that this type of program may not have its intended effects (Pentz, 1999). Fortunately, more comprehensive programs that involve skills training to avoid or resist social pressures (such as peers) and environmental pressures (such as media portrayals of drug use) can be effective in preventing drug abuse among some people.

130. Why are gambling problems so difficult to treat? What have researchers found to be effective in treating Gambling Disorder.

ANSWER: Gambling Disorder impacts approximately 1.9% of adult Americans and can be quite devastating in terms of job loss, bankruptcy, arrests, and incarceration. Gambling includes the same patterns of urges that we see in other substance-related disorders and thus DSM-5 groups them together. Those with gambling disorder exhibit a combination of characteristics—including denial of the problem, impulsivity, and continuing optimism (“One big win will cover my losses!”)—that interfere with effective treatment. There is also likely a genetic component to gambling disorders. Cognitive-behavioral interventions can reduce symptoms of Gambling Disorders. However, effectiveness in the population is weakened as impulsivity inherent in Gambling Disorders can lead to treatment dropout.

131. Discuss current research on the genetic/biological, cognitive, social, and cultural factors related to alcoholism.

Whic h factors appear most strongly related to the development and progression of the disorder?

ANSWER: Alcohol is thought to have an anxiolytic effect as a result of its effects on the septal/hippocampal system, which includes a large number of GABA-sensitive neurons. Studies of the sons of alcoholics suggest that there may be a genetic predisposition to being less sensitive to alcohol when it is first ingested and then less sensitive to its effects over time, meaning that the euphoric effects take precedence. Alcoholics and their sons also tend to show altered brain-wave activity, although it is not clear whether this pattern is connected to the reasons people become alcohol dependent or a sign of some other similarity. Alcohol may also enable people to cope with stress or anxiety, and so becomes a negative reinforcer; people who experience stress or abuse are at risk for increased drinking. People’s expectancies about a drug such as alcohol can affect their response to the substance and their tendency to use or abuse the drug. Cultural guidelines influence people’s definitions of what is acceptable regarding substance use, how such use is linked to daily activities and social events, and may affect the social and legal consequences of such drinking. .

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Chapter 12 Substance Use and Impulse Control 132. Discuss the various component treatments for substance abuse.

ANSWER: Often, biological treatments are more successful when combined with psychotherapy. For example, when using aversion therapy, the subject may utilize covert sensitization. The subject associates substance use with something very unpleasant. The goal would be to counteract the positive associations with the substance.

A component that seems a valuable part of therapy is contingency management, where the clinician and client decide on the reinforcers that will reward reaching certain goals.

Another approach is the community reinforcement approach, in which several facets of the drug problem are addressed to help identify and correct a person's behavior that might contribute to abuse. For example, certain relationships are recognized as influencing drug use, so they are to be avoided, etc.

Motivational interviewing suggests that reminding a client about what he or she cherishes most in order to improve the client's belief that any changes made will have positive outcomes.

Cognitive-behavio r therapy addresses multiple aspects of the disorder and the problem of relapse. Relapse prevention treatment models help clients remove ambivalent feelings toward stopping their drug use and confronting the negative consequences of its use.

133. Discuss what is meant by impulse control disorders, and describe why pathological gambling fits into this category of disorders and how it can be treated.

ANSWER: Impulse-control disorders are characterized by the temptation to engage in behaviors that are destructive but irresistible in some way. Usually, the person experiences increased tension leading up to the act or pleasurable anticipation about it. Pathological gambling refers to the need to gamble in spite of its destructive effects on the person’s life. Pathological gamblers show decreased levels of activities in brain regions involved in impulse regulation. It is believed that this pattern may be the result of abnormalities in the dopamine reinforcement system and the serotonin impulse control system. The treatment of gambling is difficult because the person often denies the problem and continues to believe that he/she is just around the corner from a big win. Gamblers Anonymous programs incorporating a 12-step approach have been used, although research suggests that 70 to 90% of people drop out of these programs. Cognitive-behavioral approaches, which involve financial limit setting, alternative activity planning, problem-solving relapse prevention, and imaginable desensitization, may also have some utility.

Essay 134. Compare and contrast the "levels of involvement" in the following substance-related disorders: use, intoxication, abuse, and dependence. Define the meaning of the word "addiction."

ANSWER: Substance intoxication refers to the physiological reaction to an ingested substance. The degree of intoxication is related to the drug used, how much is ingested, and the person’s individual biological reaction.

Substance abuse according to DSM-IV-TR is defined in terms of how significantly it interferes with the user’s life. If it disrupts your education, job, relationships, health, or well-being, or causes legal problems, it can be judged as abuse. Substance dependence is described as an addiction. It can involve physiological reactions to the chemicals being ingested, and may include tolerance and withdrawal, but does not have to. In general, the term addiction is used to describe people who are under the control of a drug or drugs.

135. According to your text, is it possible to use drugs without becoming addicted to them?

ANSWER: Yes, substance use (ingesting psychoactive substances in moderate amounts) is defined differently than a Substance Use Disorder. Substance Use Disorder is defined in DSM-5 as having at least 2 symptoms in the last year that interfere with your life or bother you a great deal. Many people use drugs casually, such as drinking a cup of coffee in the morning to wake up or having a glass of wine with friends after work to relax.

.

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Chapter 12 Substance Use and Impulse Control However, genetics, social circumstances, and the environment can slowly increase use to abuse and abuse to a disorder.

136. Compare and contrast benzodiazepines and the barbiturates. Discuss medical uses for these substances and the potential for abuse and/or addiction.

ANSWER: Benzodiazepines are drugs used to reduce anxiety, including Valium, Xanax, Rohypnol, and Ativan.

These drugs impact the GABA system, and their use can result in tolerance and dependence. In recent years, Rohypnol has become known as the “forget-me drug,” and has been used to assist in date-rape.

Barbiturates include Amytal, Seconal, and Nembutal, and are prescribed to help people sleep. They affect the GABA system and can be addictive. These drugs relax the muscles and produce mild well- being, but can also impact speech, concentration, and walking. Overdoses can result in suffocation.

137. A commonly held-opinion is that alcohol increases social skills because it loosens inhibitions in communication. Describe recent research that supports or negates this opinion.

ANSWER: Although alcohol may seem to make us more sociable, in reality, alcohol makes it more difficult to communicate with other people. The GABA system affects the emotion of anxiety and anti-anxiety properties may result from its interaction with the GABA system. Alcohol reinforces movement of chloride ions and as a result, neurons have difficulty firing. There are individual differences in this though. Genetic research suggests that genes responsible for communication between neurons may also be responsible for individual differences in response to alcohol.

138. Discuss some of the racial differences in binge drinking. What do you think accounts for these differences?

ANSWER: About 63 Million Americans over the age of 18 report binge drinking in the last month. Binge drinking is defined as four or more drinks (women) and five or more drinks (men) over a 2-hour time span. Whites and Hispanic/Latinos report the highest levels of binge drinking while Asian Americans report the lowest levels of binging. Reasons for this disparity are many including individual factors. Genetics, acceptability within communities, and other environmental factors can account for much of the difference between groups.

139. Discuss the effectiveness of prevention education on adolescent drug use.

ANSWER: Adolescents are at high risk for drug addiction due to their higher rates of experimentation with drugs. When done right, education about drugs’ risks can lead to decreases in drugs of abuse (e.g., ecstasy and tobacco).

Many states and school districts have implemented education-based programs in schools to try to deter students from using drugs. The widely used Drug Abuse Resistance Education (DARE) program encourages a “no drug use” message through fear of consequences, rewards for commitments not to use drugs, and strategies for refusing offers of drugs. Unfortunately, several extensive evaluations suggest that this type of program may not have its intended effects (Pentz, 1999). Fortunately, more comprehensive programs that involve skills training to avoid or resist social pressures (such as peers) and environmental pressures (such as media portrayals of drug use) can be effective in preventing drug abuse among some people.

140. Why are gambling problems so difficult to treat? What have researchers found to be effective in treating Gambling Disorder.

ANSWER: Gambling Disorder impacts approximately 1.9% of adult Americans and can be quite devastating in terms of job loss, bankruptcy, arrests, and incarceration. Gambling includes the same patterns of urges that we see in other substance-related disorders and thus DSM-5 groups them together. Those with gambling disorder exhibit a combination of characteristics—including denial of the problem, impulsivity, and continuing optimism (“One big win will cover my losses!”)—that interfere with effective treatment. There is also likely a genetic component to gambling disorders. Cognitive-behavioral interventions can reduce symptoms of Gambling Disorders. However, effectiveness in the population is weakened as impulsivity inherent in Gambling Disorders can lead to treatment dropout.

141. Discuss current research on the genetic/biological, cognitive, social, and cultural factors related to alcoholism. .

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Chapter 12 Substance Use and Impulse Control Which factors appear most strongly related to the development and progression of the disorder?

ANSWER: Alcohol is thought to have an anxiolytic effect as a result of its effects on the septal/hippocampal system, which includes a large number of GABA-sensitive neurons. Studies of the sons of alcoholics suggest that there may be a genetic predisposition to being less sensitive to alcohol when it is first ingested and then less sensitive to its effects over time, meaning that the euphoric effects take precedence. Alcoholics and their sons also tend to show altered brain-wave activity, although it is not clear whether this pattern is connected to the reasons people become alcohol dependent or a sign of some other similarity. Alcohol may also enable people to cope with stress or anxiety, and so becomes a negative reinforcer; people who experience stress or abuse are at risk for increased drinking. People’s expectancies about a drug such as alcohol can affect their response to the substance and their tendency to use or abuse the drug. Cultural guidelines influence people’s definitions of what is acceptable regarding substance use, how such use is linked to daily activities and social events, and may affect the social and legal consequences of such drinking.

142. Discuss the various component treatments for substance abuse.

ANSWER: Often, biological treatments are more successful when combined with psychotherapy. For example, when using aversion therapy, the subject may utilize covert sensitization. The subject associates substance use with something very unpleasant. The goal would be to counteract the positive associations with the substance.

A component that seems a valuable part of therapy is contingency management, where the clinician and client decide on the reinforcers that will reward reaching certain goals.

Another approach is the community reinforcement approach, in which several facets of the drug problem are addressed to help identify and correct a person's behavior that might contribute to abuse. For example, certain relationships are recognized as influencing drug use, so they are to be avoided, etc.

Motivational interviewing suggests that reminding a client about what he or she cherishes most in order to improve the client's belief that any changes made will have positive outcomes.

Cognitive-behavior therapy addresses multiple aspects of the disorder and the problem of relapse. Relapse prevention treatment models help clients remove ambivalent feelings toward stopping their drug use and confronting the negative consequences of its use.

143. Discuss what is meant by impulse control disorders, and describe why pathological gambling fits into this category of disorders and how it can be treated.

ANSWER: Impulse-control disorders are characterized by the temptation to engage in behaviors that are destructive but irresistible in some way. Usually, the person experiences increased tension leading up to the act or pleasurable anticipation about it. Pathological gambling refers to the need to gamble in spite of its destructive effects on the person’s life. Pathological gamblers show decreased levels of activities in brain regions involved in impulse regulation. It is believed that this pattern may be the result of abnormalities in the dopamine reinforcement system and the serotonin impulse control system. The treatment of gambling is difficult because the person often denies the problem and continues to believe that he/she is just around the corner from a big win. Gamblers Anonymous programs incorporating a 12-step approach have been used, although research suggests that 70 to 90% of people drop out of these programs. Cognitive-behavioral approaches, which involve financial limit setting, alternative activity planning, problem-solving relapse prevention, and imaginable desensitization, may also have some utility.

.

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Chapter 14 Psychosis Multiple Choice 1. Which of the following characterize the disorder known as schizophrenia? a. Delusions and hallucinations b. Inappropriate emotions c. Disorganized speech and behavior d. All of these ANSWER: d 2. Which of the following is accurate in regard to the long-term outlook for schizophrenic patients? a. About 50% of people diagnosed with the disorder eventually recover.. b. Recovery is possible only if the person stays on medication. c. Recovery is possible only if the patient receives psychotherapy. d. Complete recovery from schizophrenia is rare.

ANSWER: d 3. According to statistical data, the prevalence of schizophrenia is about a. 01% b. 1% c. 5% d. 10% ANSWER: b

.

4. In the 1850s, a French physician named Benedict Morel used the terms demence (loss of mind) and precoce (early, premature) to describe what we now know as schizophrenia because he observed that the onset of symptoms often occurs a. in the early part of the year. b. during adolescence. c. in the morning. d. prior to symptoms of other mental illnesses.

ANSWER: b 5. Which of the following was the main characteristic of dementia praecox, according to Emil Kraepelin? a. Silly and immature behavior b. Mental weakness c. Alternating immobility and agitated excitement d. Delusions of grandeur or persecution ANSWER: b 6. In Observations on Madness and Melancholy, John Haslam characterized (what is now known as) schizophrenia as: a. dementia praecox. b. hallucinations, delusions, and negativism. c. insanity. d. catatonia.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis 7. In the late 1800s, the German psychiatrist Emil Kraeplin made all of the following contributions to our knowledge of schizophrenia EXCEPT a. distinguishing dementia praecox (schizophrenia) from manic-depressive illness. b. noting that hallucinations, delusions, and negativism were symptoms of dementia praecox (schizophrenia). c. combining several symptoms of insanity (catatonia, paranoia, hebephrenia) that had usually been viewed as reflecting separate and distinct disorders. d. conceptualizing a treatment for schizophrenic patients that is still being used today.

ANSWER: d 8. Which of the following is the definition for hebephrenia? a. Silly and immature behavior b. Early madness c. Alternating immobility and agitated excitement d. Delusions of grandeur or persecution ANSWER: a 9. Toward the end of the 19th century, Emil Kraeplin, studying the disorder we now call schizophrenia, used the term because he observed that the onset of symptoms often occurred before adulthood. a. adolescent insanity b. folie à deux c. catatonia previa d. dementia praecox ANSWER: d 10. The term "schizophrenia" was introduced circa 1908 by a Swiss psychiatrist named a. Emil Kraepelin. b. Sigmund Freud. c. Eugen Bleuler. d. Phillipe Pinel.

ANSWER: c 11. Eugen Bleuler's concept of schizophrenia as an "associative splitting" of the basic functions of personality led to the incorrect use of the term to mean a. a fugue state. b. multiple personality. c. cognitive slippage. d. folie à deux.

ANSWER: b 12. Bleuler described the underlying behaviors of schizophrenia as the destruction of the forces that connect one function to the next. He called this underlying foundation of the disorder a. a fugue state. b. split personality. c. associative splitting. d. folie à deux.

Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis ANSWER: c 13. Which of the following is the best description of schizophrenia? a. Schizophrenia is characterized by symptoms shared by everyone with the diagnosis. b. Schizophrenia is characterized by multiple personalities. c. Schizophrenia is characterized by behavior and symptoms that aren’t necessarily common to everyone with the diagnosis. d. The course of schizophrenia is always predictable.

ANSWER: c 14. In the textbook case of Arthur, he said that he had a "secret plan to save all the starving children in the world."

After Arthur showed other bizarre behavior and also said he was going to climb the fence of a government building, his parents tried to have him admitted to a psychiatric hospital. They were not able to do that because a. he was not considered a danger to himself or others. b. he was given medication instead to calm him down. c. the hospital staff didn't believe his parents. d. his behavior was due to a substance abuse problem.

ANSWER: a 15. According to your text, delusions are defined as: a. irrational beliefs. b. bad dreams. c. feeling invincible. d. sensory experiences that are not real.

ANSWER: a 16. According to your text, hallucinations are defined as: a. irrational beliefs. b. bad dreams. c. feeling invincible. d. sensory experiences that are not real.

ANSWER: d 17. When you interview Dr. Kwame, a psychologist in your local health department, he says that one of his clients fell in love with Jennifer Lopez and created stories about how they would run off to the Caribbean and get married. Dr. Kwame is reflecting which category or view of delusions: a. irrational beliefs. b. motivational. c. deficit. d. cognitive.

ANSWER: b 18. Rashad blames martians for the rainy weather. Rashad’s doctor is exploring what kinds of brain dysfunctions Rashad has through a PET scan study. Rashad’s doctor is using which kind of theory: a. irrational beliefs.

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Chapter 14 Psychosis b. motivational. c. deficit. d. cognitive.

ANSWER: c 19. If an individual is diagnosed as psychotic, it usually means that the person has a. hallucinations b. delusions c. both of these d. neither of these ANSWER: c

.

20.

In working with schizophrenic patients, mental health professionals typically distinguish between ______symptoms (an excess or distortion of normal behavior) and__________symptoms (deficits in normal behavior). a. positive; negative b. negative; positive c. manic; depressive d. dysmorphic; dysfunctional ANSWER: a 21. Which of the following is the persecution type of psychotic delusion? a. A familiar person is actually a double b. One is a famous or important person c. People are out to get you d. A body part has changed in some impossible way ANSWER: c 22. Which of the following describes a delusion of grandeur? a. A familiar person is actually a double b. One is a famous or important person c. People are out to get you d. A body part has changed in some impossible way ANSWER: b 23. A woman diagnosed as schizophrenic announces that she has a plan to end poverty and homelessness in the world and that the Pope has given her secret instructions on how this can be accomplished. Her thinking is indicative of a delusion of . a. persecution b. thought insertion c. grandeur d. reference ANSWER: c 24. Antoinette believes that her brother is not really her brother. He has, in fact, been replaced by a double. This is known as _______________ syndrome.

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Chapter 14 Psychosis a. Capgras b. Cotard's c. Barlow's d. Durand's ANSWER: a 25. Which of the following defines Cotard's syndrome? a. A familiar person is actually a double b. One is a famous or important person c. People are out to get you d. The person believes he is dead ANSWER: d 26. The most common type of hallucination experienced by psychotic individuals is a. visual b. auditory c. tactile d. olfactory ANSWER: b

.

27. Research using brain-imaging techniques has localized auditory hallucinations in the part of the brain called _____________. a. Wernicke's area b. Broca's area c. the occipital lobe d. the limbic system ANSWER: b 28. One explanation for the fact that the parts of the brain usually associated with producingrather than comprehending speech are active when one is experiencing an auditory hallucination is that such individuals are actually a. listening to voices outside themselves. b. listening to their own thoughts. c. misinterpreting voices from the sources such as the radio and television. d. making up the experience.

ANSWER: b 29. Results of research showing that auditory hallucinations are localized in the expressive speech area of the brain suggest that a. these hallucinations are produced by the auditory nerve in the ear as well as the speech area of the brain. b. people who are hallucinating think the voices of other people are actually their own. c. a person who is hallucinating is actually listening to his/her own thoughts. d. these hallucinations are related to the disorganized speech that occurs in schizophrenia.

ANSWER: c 30. The negative schizophrenic symptom called avolition is defined as Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis a. inability to initiate and persist in activities. b. inability to experience pleasure. c. lack of emotional response, blank facial expression. d. lack of speech content and/or slowed speech response.

ANSWER: a 31. Mort has displayed a number of schizophrenic symptoms. An obvious one was his lack of speech content manifested in nonsensical ramblings and slowed speech response. This symptom is called . a. anhedonia b. avolition c. clanging d. alogia ANSWER: d 32. The negative schizophrenic symptom called anhedonia is defined as a. inability to initiate and persist in activities. b. inability to experience pleasure. c. lack of emotional response, blank facial expression. d. lack of speech content and/or slowed speech response.

ANSWER: b 33. Which of the following is the most accurate definition of flat affect? a. An inability to initiate and persist in activities b. The inability to experience pleasure c. A lack of emotional response, blank facial expression d. A lack of speech content and/or slowed speech response ANSWER: c 34. Which of the following is the most accurate definition of alogia? a. An inability to initiate and persist in activities b. The inability to experience pleasure c. A lack of emotional response, blank facial expression d. A lack of speech content and/or slowed speech response ANSWER: d 35. The deficiency in communication called alogia likely reflects a. an inability to initiate and persist in activities. b. lack of communication skills. c. poor language education. d. a negative thought disorder.

ANSWER: d 36. Apathy is to not caring as avolition is to a. an inability to initiate and persist in activities. b. lack of communication skills.

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Chapter 14 Psychosis c. poor language education. d. a negative thought disorder.

ANSWER: d 37. Dr. Smith conducted a research study involving schizophrenic adults in which he looked at their facial expressions in home movies taken when they were children. He was trying to determine if the development of schizophrenia could be predicted by facial expressions showing limited emotional reactions. This research study focused on the negative symptom called . a. alogia b. affective flattening c. associative splitting d. emotional effect syndrome ANSWER: b 38. According to research, an individual with schizophrenia who exhibits flat affect a. is incapable of experiencing emotion. b. can display emotion a certain times. c. is capable of experiencing emotion. d. will display the “wrong” emotion based on an eliciting stimulus.

ANSWER: c 39. Which of the following is the definition of catatonia? a. Silly and immature behavior b. Early madness c. Immobility or agitated excitement d. Delusions of grandeur or persecution ANSWER: c 40. DSM-5 no longer specifies different subtypes of schizophrenia, but in DSM-IV-TR the subtype called paranoid schizophreniawas characterized by a. silly and immature behavior. b. a complete mental breakdown. c. alternating immobility and agitated excitement. d. delusions of grandeur or persecution.

ANSWER: d 41. Mark was diagnosed with schizophrenia many years ago. Most recently, he has been exhibiting some bizarre behaviors. For example, he stands for hours in unusual postures. Mark's motor dysfunction is called __________________. a. cognitive slippage b. inappropriate affect c. catatonic immobility d. hebephrenia ANSWER: c

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Chapter 14 Psychosis 42. Marta, a hospitalized schizophrenic patient, shows an unusual form of catatonia. If someone moves one of her arms or legs into a different position, it just stays that way. Marta's bizarre behavior is called . a. postural dysfunction b. aerobic mobility c. waxy flexibility d. schizophrenic movement disorder ANSWER: c 43. Which of the following is closely associated with catatonia? a. Negative withdrawal b. Repetitive echolalia c. Agitation d. Waxy flexibility ANSWER: d 44. Marshall has suffered from several symptoms that indicate a schizophrenia-related condition, but his symptoms have only been present for 4 months. Which of the following would be the appropriate diagnosis? a. Brief psychotic disorder b. Delusional disorder c. Schizoaffective disorder d. Schizophreniform disorder ANSWER: d 45. Callie has been diagnosed with schizoaffective disorder. This means that in addition to schizophrenic symptoms, she also has symptoms of a. an anxiety disorder. b. a mood disorder. c. a split personality. d. obsessive-compulsive disorder.

ANSWER: b 46. How do the delusions in delusional disorder differ from the delusions in paranoid schizophrenia? a. In delusional disorder, the imagined events could really be happening but there is no evidence that they are happening. b. In paranoid schizophrenia, the imagined events have actually happened or are now happening. c. In delusional disorder, the imagined events are so bizarre that they could never have happened and never will happen. d. There is no difference. Delusions are defined similarly for all conditions.

ANSWER: a 47. At various times, individuals have been arrested for stalking celebrities who they believed were in love with them.

This condition is called a(n) delusion. a. jealous b. erotomanic c. somatic d. persecutory Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis ANSWER: b 48. Which of the following defines the jealous type of delusional disorder? a. Believing that one is loved by an important person or celebrity b. Falsely believing that one's sexual partner is unfaithful c. Believing in one's inflated worth, identity, or special relationship d. Believing one is being malevolently treated in some way ANSWER: b 49. Which of the following defines the erotomanic type of delusional disorder? a. Believing that one is loved by an important person or celebrity b. Falsely believing that one's sexual partner is unfaithful c. Believing in one's inflated worth, identity, or special relationship d. Believing one is being malevolently treated in some way ANSWER: a 50. Which of the following defines the persecutory type of delusional disorder? a. Believing that one is loved by an important person or celebrity b. Falsely believing that one's sexual partner is unfaithful c. Believing in one's inflated worth, identity, or special relationship d. Believing one is being malevolently treated in some way ANSWER: d 51. Which of the following defines the grandiose type of delusional disorder? a. Believing that one is loved by an important person or celebrity b. Falsely believing that one's sexual partner is unfaithful c. Believing in one's inflated worth, identity, or special relationship d. Believing one is being malevolently treated in some way ANSWER: c 52. The case of Arthur (described in your textbook), who suddenly experienced the delusion that he could save all the starving children in the world with a "secret plan," but whose symptoms lasted only a few days, was diagnosed with a. schizotypal personality disorder. b. folie à deux (shared psychotic disorder). c. brief psychotic disorder. d. cocaine abuse.

ANSWER: c 53. In which of the following disorders are hallucinations and delusions NOT part of the symptom pattern? a. Schizotypal personality disorder b. Schizoaffective disorder c. Schizophreniform disorder d. Brief psychotic disorder ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis 54. James is a security guard at the mall who seems lost in his own world. Often, he feels the presence of his dead mother nearby. He knows it is an illusion and that she is not real. Her presence does give him comfort. James probably would be diagnosed with a. schizoaffective disorder. b. schizotypal disorder. c. schizoid disorder. d. brief psychotic disorder.

ANSWER: b 55. Consuela believes that she is the wicked stepmother and her daughter Carmella believes she is Cinderella. If they had been diagnosed using the DSM-IV-TR, the condition would have been called . This diagnosis was removed from DSM-5 and was added as a specifier to delusional disorder. a. schizoaffective disorder. b. shizotypal disorder c. schizophreniform disorder d. folie a deux ANSWER: a 56. Which of the following statistical data are NOT accurate regarding schizophrenia? a. The lifetime prevalence rate is 3%. b. Life expectancy is less than average due to suicides and accidents. c. Men with schizophrenia have a poorer prognosis than women with schizophrenia. d. More women than men develop schizophrenia later in life.

ANSWER: a 57. Making the diagnosis of schizophrenia is controversial because a. the symptoms can vary as a function of culture or race. b. the symptoms are similar across culture and race. c. the symptoms simply reflect biases in the minds of mental health professionals. d. the label is derogatory and has no clinical utility.

ANSWER: a 58. Schizophrenia appears to be more frequently diagnosed in minorities in a number of countries. An explanation for this is that a. people from devalued ethnic minority groups may be victims of bias and stereotyping. b. they may be the result of misdiagnosis. c. the levels of stress associated with stigma and isolation. d. all of the above.

ANSWER: d 59. Research studies on the genetic basis of schizophrenia have focused on high-risk individuals including all of the following EXCEPT a. healthy twins of schizophrenic patients. b. adopted children of schizophrenic parents. c. family members or relatives of schizophrenics. d. children adopted by schizophrenic mothers.

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Chapter 14 Psychosis ANSWER: d 60. Research studies focusing on genetic factors in schizophrenia have found that a. an individual with a schizophrenic identical twin has the highest risk factor (almost 50%) of developing schizophrenia. b. in family studies of schizophrenia, the genetic influence can be separated from the environmental impact. c. if one person in a family has a particular subtype of schizophrenia, e.g., paranoid, the other family members inherit a predisposition for that subtype only. d. the more severe a parent's schizophrenic disorder, the less likely the children were to develop it.

ANSWER: a 61. The famous case of the Genain sisters, identical quadruplets all diagnosed with schizophrenia, points out that siblings raised in the same household may experience their environment very differently, a concept called a(n) a. variable home structure. b. unshared environment. c. environmental phenomenon. d. unique perceptive interpretation.

ANSWER: b 62. In which of the following situations would the risk of developing schizophrenia be the LOWEST for a child? a. A child's schizophrenic parent has a non-schizophrenic identical twin b. A child's non-schizophrenic parent has a schizophrenic identical twin c. A child's schizophrenic parent has a non-schizophrenic fraternal twin d. A child's non-schizophrenic parent has a schizophrenic fraternal twin ANSWER: d 63. With regard to research on schizophrenia involving the offspring of twins, all of the following are accurate statements EXCEPT a. the child of a schizophrenic identical twin has the same risk (17%) of having the disorder as the child of the non-schizophrenic identical twin. b. the child of a non-schizophrenic fraternal twin has about a 2% risk of having the disorder. c. a mentally healthy individual with a schizophrenic parent cannot pass on a genetic predisposition for the disorder to his or her offspring. d. an individual can be free from schizophrenia but still be a "carrier."

ANSWER: c 64. Of the various genetic linkage and association studies, the one that seems to be a possible "marker" for schizophrenia involves . a. eye-tracking b. dopamine sites c. unusual facial features d. blood type ANSWER: a 65. Which of the following is TRUE in regard to the genetic basis of schizophrenia? a. Researchers have discovered the gene responsible for causing schizophrenia.

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Chapter 14 Psychosis b. Genes are responsible for making some individuals vulnerable to schizophrenia. c. Both of these statements are true. d. Neither of these statements is true.

ANSWER: b 66. Endophenotyping refers to looking for a. a gene or genes that cause the symptoms or behaviors of schizophrenia. b. basic processes that contribute to symptoms of the disorder. c. basic processes that contribute to behaviors of schizophrenia. d. all of the above.

ANSWER: d 67. The positive symptoms of schizophrenia are most closely associated with a. serotonin b. dopamine c. norepinephrine d. acetylcholine ANSWER: b

activity.

68. Which of the following statements reflects "circumstantial evidence" for the dopamine theory of schizophrenia? a. Antipsychotic drugs (neuroleptics) act as dopamine agonists, increasing the amount of dopamine in the brain. b. Antipsychotic drugs (neuroleptics) can produce symptoms similar to those of Parkinson's disease (a disorder due to insufficient dopamine). c. The drug L-dopa, a dopamine agonist, is used to treat schizophrenic symptoms in patients with Parkinson's disease. d. Amphetamines, which activate dopamine, can lessen psychotic symptoms in people with schizophrenia.

ANSWER: b 69. Which of the following statements counters the "circumstantial evidence" for the dopamine theory of schizophrenia? a. Antipsychotic drugs (neuroleptics) act as dopamine agonists, increasing the amount of dopamine in the brain. b. A significant number of people with schizophrenia are not helped by dopamine antagonists. c. The drug L-dopa, a dopamine agonist, is used to treat schizophrenic symptoms in patients with Parkinson's disease so it cannot be used for schizophrenia. d. Amphetamines, which activate dopamine, can lessen psychotic symptoms in people with schizophrenia.

ANSWER: b 70. In regard to the ways that drugs affect neurotransmitters, which of the following is TRUE? a. A drug that is an agonist occupies the receptor sites, blocking the neurotransmitter. b. A drug that is an antagonist helps increase the release of the neurotransmitter. c. Both of these are correct. d. Neither of these is correct.

ANSWER: d 71. Which of the following occurs when drugs are administered to schizophrenic patients? a. Drugs that increase dopamine (agonists) cause an increase in schizophrenic behavior.

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Chapter 14 Psychosis b. Drugs that decrease dopamine (antagonists) decrease schizophrenic symptoms. c. Both of these statements are accurate d. Neither of these statements is accurate ANSWER: c 72. Which of the following statements contradicts the dopamine theory of schizophrenia? a. Many people with schizophrenia are not helped by dopamine antagonists. b. Olanzapine, one of the weakest dopamine antagonists, reduces schizophrenic symptoms in those patients who were not helped by stronger dopamine antagonists. c. Both of these statements contradict the dopamine theory of schizophrenia. d. Neither of these statements contradicts the dopamine theory of schizophrenia.

ANSWER: c 73. Which of the following neurotransmitters has recently been linked to schizophrenia? a. Deficiency in the stimulation of prefrontal dopamine D1 receptors b. Excessive stimulation of striatal dopamine D2 receptors c. Alterations in prefrontal activity involving glutamate transmissions d. All of the above ANSWER: d 74. New research on schizophrenia suggests that a. only D2 receptors are involved in schizophrenia. b. D2 receptors may be involved when D1 receptors are less active. c. D2 receptors may be involved when D1 receptors are more active. d. dopamine is not actually involved in schizophrenia.

ANSWER: b 75. Which of the following neurotransmitters has recently been linked to schizophrenia? a. Glutamate b. Glycine c. GABA d. Serotonin ANSWER: a 76. Which of the following drugs can cause psychotic symptoms in those who do not have schizophrenia and can exacerbate such symptoms in those who do? a. Marijuana b. PCP c. Cocaine d. LSD ANSWER: b 77. What is the evidence for structural damage in the brains of schizophrenic patients? a. All schizophrenic patients have smaller ventricles in their brains. b. In some schizophrenic patients, there is an excess amount of "gray matter" in the cerebral cortex.

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Chapter 14 Psychosis c. The majority of schizophrenic patients have enlarged ventricles in their brains. d. Many schizophrenic patients have increased activity in the frontal lobes of the brain.

ANSWER: c 78. Influenza infection during the second trimester of pregnancy has been linked to a. the mother developing schizophrenia. b. the child developing schizophrenia. c. both of the above . d. neither of the above.

ANSWER: b 79. Recent research into the causes of schizophrenia, including studies of schizophrenic patients who had been exposed prenatally to influenza epidemics, suggests that there might be a cause of schizophrenia. a. viral b. bacterial c. parasitic d. metabolic ANSWER: a 80. Manuella would respond coolly when her daughter embraced her, but when the child tried to pull away Manuella would say, "Don't you love me anymore?" This is an example of a. a schizophrenogenic mother. b. double-bind communication. c. expressed emotion. d. none of the above ANSWER: b 81. Which of the following is NOT correlated with schizophrenia? a. Fetal exposure to viral infection b. Pregnancy complications c. Delivery complications d. Viral exposure as a toddler ANSWER: d 82. Current research suggests that a. environmental stress may trigger schizophrenia. b. genes cause schizophrenia. c. genes carried by a fetus may make it vulnerable to schizophrenia. d. all of these are true.

ANSWER: d 83. In regard to the family interactions among schizophrenic patients, the word "schizophrenogenic" (no longer used), was first proposed in the 1940s to describe a. an abusive and alcoholic father whose child became schizophrenic. b. an emotionally distant mother whose child became schizophrenic.

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Chapter 14 Psychosis c. divorced parents who had several psychotic children. d. a family in which relatives on both sides were psychotic.

ANSWER: b 84. Which of the following statements is TRUE? a. A cold, dominant, and rejecting mother causes schizophrenia. b. A communication style that produces conflicting messages cause schizophrenia. c. High expressed emotion in a family is a good predictor of relapse among chronic schizophrenics. d. None of these are true.

ANSWER: c 85. In terms of a particular emotional communication style known as expressed emotion (EE), researchers have shown that schizophrenic patients were more likely to relapse if a. they had long periods of contact with their families. b. they had families who were disapproving and intrusive. c. both of these are correct. d. neither of these is correct.

ANSWER: c 86. In regard to cultural differences in "expressed emotion," which is thought to be positively correlated with schizophrenia, research has found that families have the highest percentage of expressed emotion. a. Indian b. Mexican c. British d. Anglo-American ANSWER: d 87. The familial communication style called expressed emotion (EE), sometimes used to predict relapse rates in schizophrenic patients, includes all of the following EXCEPT . a. emotional over-involvement b. criticism c. emotional distance d. hostility ANSWER: c 88. Families with a high expressed emotion (EE) score view the symptoms of schizophrenia as a. controllable b. uncontrollable c. inevitable d. inconvenient ANSWER: a

.

89. A treatment first used in the 1930s as a treatment for schizophrenia but now used primarily to treat severe depression is _____________. a. electroconvulsive therapy (ECT) Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis b. prefrontal lobotomy c. insulin coma therapy d. psychosurgery ANSWER: a 90. The neuroleptic drugs introduced in the 1950s affect primarily the positive symptoms of schizophrenia, which include all of the following EXCEPT . a. hallucinations b. delusions c. social deficits d. agitation ANSWER: c 91. During the 1990s, a new class of antipsychotic medications became available to treat schizophrenic patients who were not helped by conventional antipsychotic medications or who had developed unpleasant side effects. These new antipsychotic medications include all of the following EXCEPT . a. Thorazine (chlorpromazine) b. Clozaril (clozapine) c. Risperdal (risperidone) d. Zyprexa (olanzapine) ANSWER: a 92. Which of the following is NOT one of the typical minor side effects of antipsychotic medications? a. Grogginess b. Blurred vision c. Headaches d. Dryness of the mouth ANSWER: c 93. Extrapyramidal symptoms, serious side effects of antipsychotic medications that occur in some schizophrenic patients, are similar to the symptoms of . a. Alzheimer's disease b. Parkinson's disease c. multiple sclerosis d. leukemia ANSWER: b 94. Tardive dyskinesia, a severe side effect of antipsychotic medications, includes all of the following involuntary movements EXCEPT ______________. a. involuntary chewing b. puffing of the cheeks c. tongue protrusion d. tooth grinding ANSWER: d 95. Which of the following statements is TRUE? Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis a. Recent research demonstrates that many people are helped by antipsychotic drugs. b. Resent research indicates that many people no longer experience unpleasant side effects. c. Recent research found that second-generation antipsychotic meds were no more effective than the older drugs. d. Recent research found that second-generation antipsychotic meds were better tolerated than the older drugs.

ANSWER: c 96. Tardive dyskinesia, a condition that can occur in patients who take antipsychotic medications, a. can result from short-term use. b. can result from low doses. c. occurs in less than 2% of patients. d. may often be irreversible.

ANSWER: d 97. Which of the following statements is TRUE? a. Some people respond well to the newer antipsychotic drugs. b. The newer antipsychotic drugs show promise for helping patients who were previously unresponsive to medications. c. Recent research found that second-generation antipsychotic meds were no more effective than the older drugs. d. All of these ANSWER: d 98. Patients with schizophrenia who take antipsychotic medications sometimes develop severe side effects such as akinesia, a Parkinsonian-like condition that produces all of the following EXCEPT . a. hand tremors b. expressionless face c. slowed movements d. monotonous speech ANSWER: a 99. Which of the following factors is true in the treatment of schizophrenia? a. Patients often discontinue effective medication. b. The use of neurotransmitters is not effective. c. There are no effective drugs to treat schizophrenia. d. All treatment drugs have severe side effects.

ANSWER: a 100. All of the following factors seem to be related to patients' noncompliance with medication EXCEPT ______________. a. negative patient-doctor relationship b. cost of medication c. comorbidity d. negative side effects ANSWER: c 101. What is the generic name of the antipsychotic medication Risperdal?

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Chapter 14 Psychosis a. Haloperidol b. Chlorpromazine c. Clozapine d. Risperidone ANSWER: d 102. What is the generic name of the antipsychotic medication Haldol? a. Haloperidol b. Chlorpromazine c. Clozapine d. Risperidone ANSWER: a 103. What is the generic name of the antipsychotic medication Clozaril? a. Haloperidol b. Chlorpromazine c. Clozapine d. Risperidone ANSWER: c 104. What is the generic name of the antipsychotic medication Thorazine? a. Haloperidol b. Chlorpromazine c. Clozapine d. Risperidone ANSWER: b 105. Second-generation or atypical antipsychotics may a. help patients who were previously unresponsive. b. have fewer side effects than traditional antipsychotics. c. be less likely to be discontinued by the patient. d. be no longer used to treat schizophrenia.

ANSWER: a 106. One of the attempts at improving patient compliance in regard to taking antipsychotic medication involves the use of ____________. a. injectable medications b. skin patches c. pills d. liquids ANSWER: a 107. Which of the following implements new technology in the treatment of schizophrenia? a. Implementation of a token economy b. Creating a virtual reality task Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis c. Both of these d. Neither of these ANSWER: b 108. Recently, treatment for schizophrenic people has expanded to include self-help and self-advocacy groups. These psychosocial clubs a. provide a person-centered approach. b. focus on getting positive experiences through employment opportunities. c. provide friendship and empowerment. d. all of the above.

ANSWER: d 109. In the 1970s, researchers set up a treatment system called a token economy in a mental health center. This type of "milieu" treatment for schizophrenic patients focused on a. language and speech. b. socialization and self-care skills. c. educational studies. d. spiritual and religious development.

ANSWER: b 110. A token economy is an incentive system in which hospitalized patients with schizophrenia a. earn "tokens" for appropriate behavior. b. lose "tokens" for disruptive behavior. c. both of these . d. neither of these.

ANSWER: c 111. An experimental technique called transcranial magnetic stimulation has been used in some schizophrenic patients to try to a. block auditory hallucinations. b. change delusional content. c. both of these are correct. d. neither of these is correct.

ANSWER: a 112. A technique that uses wire coils to repeatedly generate magnetic fields that pass through the skull to the brain is called: a. magnetic resonance imaging. b. functional magnetic resonance imaging. c. transcranial magnetic stimulation. d. electroconvulsive stimulation.

ANSWER: c 113. The 1970s experiment in which behavioral (or social learning) principles were applied to a traditional inpatient environment in the form of a token economy resulted in a. more patients being able to be discharged.

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Chapter 14 Psychosis b. fewer patients being able to be discharged. c. more patients recovering from schizophrenia. d. fewer patients recovering from schizophrenia.

ANSWER: a 114. In the latter half of the 20th century, the routine institutionalization of schizophrenic patients was significantly reduced because of a. the effectiveness of antipsychotic medications. b. court rulings limiting involuntary hospitalization. c. both of these. d. neither of these.

ANSWER: c 115. Since the latter half of the 20th century, the policy of deinstitutionalization (time-limited hospital stays for psychotic patients) has resulted in a. more patients remaining hospitalized. b. former patients becoming productive members of the community. c. many former patients becoming homeless. d. greater patient compliance regarding medication.

ANSWER: c 116. Some schizophrenic patients function better in the community in independent living skills programs that teach them all of the following EXCEPT a. medication management. b. to identify signs that warn of a relapse. c. to maintain eye contact when interacting with others. d. how to help others who are mentally ill.

ANSWER: d 117. Social skills training programs for schizophrenic patients have been a. very successful. b. not at all successful. c. somewhat successful while the program is in effect. d. only successful when the patient is on medication.

ANSWER: c 118. Assertive community treatment for schizophrenia utilizes a. medication management. b. psychological treatment. c. vocational treatment. d. all of the above ANSWER: d 119. Research suggests that treatments such as individual social skills training and family interventions a. cure schizophrenia.

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Chapter 14 Psychosis b. reduce schizophrenic relapses. c. are ineffective at treating schizophrenia. d. interfere with medication benefits.

ANSWER: b 120. There are cross-cultural differences in the treatment of schizophrenia. For example, a schizophrenic patient in China would probably receive treatments including in addition to antipsychotic medication. a. burning candles b. joss sticks c. both of these are correct d. neither of these are correct ANSWER: c 121. An integrated treatment approach to schizophrenia would include a. collaborative psychopharmacology. b. assertive community treatment. c. family psychoeducation. d. all of the above.

ANSWER: d Subjective Short Answer 122. Describe some of the "positive" and "negative" symptoms of schizophrenia. Explain what is meant by these terms and how they relate to prognosis and outcome.

ANSWER: The positive symptoms of schizophrenia involve the active manifestations of abnormal behavior including delusions and hallucinations, inappropriate affect, and formal thought disorders. Negative symptoms involve deficits in normal behavior in areas such as poverty of speech, lack of motivation, and flat or blunted affect.

123. Discuss some of the causative factors of schizophrenia, including genetic influences, neurotransmitter imbalances, prenatal viral exposure, and psychological stressors.

ANSWER: Evidence from family, twin, and adoption studies suggests that genes may make people vulnerable to schizophrenia, although there does not appear to be a single gene responsible, but rather a combination of multiple genes. Basically, the more genes you share with someone who has the disorder, the higher your risk of developing it.

Neurobiological evidence suggests that dopamine is implicated in schizophrenia because antipsychotic drugs that treat the disease are dopamine antagonists, amphetamines can mimic psychotic symptoms, and antipsychotic drugs can produce motor symptoms similar to Parkinson’s disease. However, the relationship is complicated, and involves both abnormal receptor function and alterations in prefrontal activity involving glutamate transmission.

Fetal exposure to viral infection, pregnancy complications, and delivery complications have all been implicated in the schizophrenia.

Stress has been implicated as trigger for schizophrenia in people who are already vulnerable to the disease.

Chaotic family environments and expressed emotions in which people are very critical of the schizophrenic can exacerbate symptoms.

124. Compare the conventional antipsychotic medications with the newer drugs in terms of their biochemical dynamics, side effects, and treatment effectiveness.

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Chapter 14 Psychosis ANSWER: The conventional antipsychotic medications developed in the 1950s are dopamine antagonists and are effective in about 60% of patients. The second-generation or atypical antipsychotics may help patients who were previously unresponsive to medications and have fewer side effects. Unfortunately, many patients stop using both classes of medication because of their negative side effects.In addition, recent research has cast doubt on the idea that atypical antipsychotics are superior to other sorts of medications in the treatment of schizophrenia symptoms.

125. Describe what the affective flattening symptom of Schizophrenia looks like.

ANSWER: Approximately ¼ of people with schizophrenia exhibit a “flat affect.” The textbook compares interacting with someone with a flat affect to conversing with someone wearing mask. Affective flatting may include things like a lack of facial emotion, lack of variation in verbal tone, vacantly staring, and a person who is seemingly unaffected by things around them.

126. Identify and define the three subtypes of Schizophrenia.

ANSWER: Paranoid-delusions of grandeur or persecution Disorganized-silly and immature emptions Catatonic-alternating between immobility and agitation Psychologists have struggled to identify and categorize differences between manifestations of Schizophrenia. Although many therapists still refer to these three subtypes, the dimensional assessment of severity is increasingly used in diagnosis (see Table 13.3) 127. Identify and describe the stages of schizophrenic development. Be sure to include approximate ages as well as severity in your description.

ANSWER: There are four stages of Schizophrenia that occur over the lifetime. They are: • • • •

Premorbid (approximately birth to age 10). This stage is characterized by mild motor, cognitive, and social impairments.

Prodromal (approximately age 10 to 20). This stage is characterized by unusual psychotic-like behaviors but is not generally severe.

Onset/Deterioration (approximately age 20 to 35). This stage is characterized by positive, negative, cognitive, and mood symptoms. Symptoms fluctuate greatly in severity.

Chronic/Residual (approximately ages 36 and older). This stage is characterized by positive, negative, and cognitive symptoms but is more even and typically less severe than the Onset/Deterioration phase.

128. Discuss the psychotic disorders that can be diagnosed other than schizophrenia.

ANSWER: Some people may experience the symptoms of schizophrenia for a very short duration (less than 1 month).

This is brief psychotic disorder. If the symptoms persist for 1 to 6 months, then it is shizophreniform disorder. People with schizoaffective disorder display the symptoms of both schizophrenia and the mood disorders.

Delusional disorder is a persistent belief that is contrary to reality. It can take several forms. The erotomanic type is the irrational belief that one is loved by another person, usually of higher status or famous. The grandiose type involves believing in one's inflated worth, power, knowledge, identity, or special relationship to a deity or famous person. The persecutory type involves believing oneself is being malevolently treated in some way. And the somatic type involves the person feeling afflicted by a physical defect or general medical condition.

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Chapter 14 Psychosis Shared psychotic disorder is the condition in which an individual develops delusions as the result of a close relationship with a delusional individual. It is no longer included in DSM-5 as a standalone diagnosis, but it is listed as a specifier of delusional disorder.

When a person experiences psychotic symptoms that are sometimes punctuated by extended periods of mood disruption (symptoms that resemble major depression or bipolar disorder) then schizoaffective disorder may be diagnosed.

129. Describe evidence for the heritability of Schizophrenia. Be sure to include at least three examples of familial risks.

ANSWER: Studies have shown that Schizophrenia likely has a strong but not exclusive genetic component. If Schizophrenia was completely heritable, risk would be near 100% in monozygotic twins (who share genes). You do have the greatest chance (about 48%) of developing Schizophrenia if your monozygotic twin has Schizophrenia. Siblings with 1 schizophrenic parent have approximately 17.5% risk of developing Schizophrenia, while risk in first cousins (third degree relation) drops to about 3%. The prevalence of Schizophrenia in the general population is approximately 1%.

130. Diagram some ways in which medication can work to treat Schizophrenia.

ANSWER: Answers will look like Figure 13.6 on textbook page 503.

131. Diagram some ways in which medication can work to treat Schizophrenia.

ANSWER: Answers will look like Figure 13.6 on textbook page 503.

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Chapter 14 Psychosis

Essay 132. Describe some of the "positive" and "negative" symptoms of schizophrenia. Explain what is meant by these terms and how they relate to prognosis and outcome.

ANSWER: The positive symptoms of schizophrenia involve the active manifestations of abnormal behavior including delusions and hallucinations, inappropriate affect, and formal thought disorders. Negative symptoms involve deficits in normal behavior in areas such as poverty of speech, lack of motivation, and flat or blunted affect.

133. Discuss some of the causative factors of schizophrenia, including genetic influences, neurotransmitter imbalances, prenatal viral exposure, and psychological stressors.

ANSWER: Evidence from family, twin, and adoption studies suggests that genes may make people vulnerable to schizophrenia, although there does not appear to be a single gene responsible, but rather a combination of multiple genes. Basically, the more genes you share with someone who has the disorder, the higher your risk of developing it.

Neurobiological evidence suggests that dopamine is implicated in schizophrenia because antipsychotic drugs that treat the disease are dopamine antagonists, amphetamines can mimic psychotic symptoms, and antipsychotic drugs can produce motor symptoms similar to Parkinson’s disease. However, the relationship is complicated, and involves both abnormal receptor function and alterations in prefrontal activity involving glutamate transmission.

Fetal exposure to viral infection, pregnancy complications, and delivery complications have all been implicated in the schizophrenia.

Stress has been implicated as trigger for schizophrenia in people who are already vulnerable to the disease.

Chaotic family environments and expressed emotions in which people are very critical of the schizophrenic can exacerbate symptoms.

134. Compare the conventional antipsychotic medications with the newer drugs in terms of their biochemical dynamics, side effects, and treatment effectiveness.

ANSWER: The conventional antipsychotic medications developed in the 1950s are dopamine antagonists and are effective in about 60% of patients. The second-generation or atypical antipsychotics may help patients who were previously unresponsive to medications and have fewer side effects. Unfortunately, many patients stop using both classes of medication because of their negative side effects.In addition, recent research has cast Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Psychosis doubt on the idea that atypical antipsychotics are superior to other sorts of medications in the treatment of schizophrenia symptoms.

135. Describe what the affective flattening symptom of Schizophrenia looks like.

ANSWER: Approximately ¼ of people with schizophrenia exhibit a “flat affect.” The textbook compares interacting with someone with a flat affect to conversing with someone wearing mask. Affective flatting may include things like a lack of facial emotion, lack of variation in verbal tone, vacantly staring, and a person who is seemingly unaffected by things around them.

136. Identify and define the three subtypes of Schizophrenia.

ANSWER: Paranoid-delusions of grandeur or persecution Disorganized-silly and immature emptions Catatonic-alternating between immobility and agitation

Psychologists have struggled to identify and categorize differences between manifestations of Schizophrenia. Although many therapists still refer to these three subtypes, the dimensional assessment of severity is increasingly used in diagnosis (see Table 13.3) 137. Identify and describe the stages of schizophrenic development. Be sure to include approximate ages as well as severity in your description.

ANSWER: There are four stages of Schizophrenia that occur over the lifetime. They are: • • • •

Premorbid (approximately birth to age 10). This stage is characterized by mild motor, cognitive, and social impairments.

Prodromal (approximately age 10 to 20). This stage is characterized by unusual psychotic-like behaviors but is not generally severe.

Onset/Deterioration (approximately age 20 to 35). This stage is characterized by positive, negative, cognitive, and mood symptoms. Symptoms fluctuate greatly in severity.

Chronic/Residual (approximately ages 36 and older). This stage is characterized by positive, negative, and cognitive symptoms but is more even and typically less severe than the Onset/Deterioration phase.

138. Discuss the psychotic disorders that can be diagnosed other than schizophrenia.

ANSWER: Some people may experience the symptoms of schizophrenia for a very short duration (less than 1 month).

This is brief psychotic disorder. If the symptoms persist for 1 to 6 months, then it is shizophreniform disorder. People with schizoaffective disorder display the symptoms of both schizophrenia and the mood disorders.

Delusional disorder is a persistent belief that is contrary to reality. It can take several forms. The erotomanic type is the irrational belief that one is loved by another person, usually of higher status or famous. The grandiose type involves believing in one's inflated worth, power, knowledge, identity, or special relationship to a deity or famous person. The persecutory type involves believing oneself is being malevolently treated in some way. And the somatic type involves the person feeling afflicted by a physical defect or general medical condition.

Shared psychotic disorder is the condition in which an individual develops delusions as the result of a close relationship with a delusional individual. It is no longer included in DSM-5 as a standalone diagnosis, but it is listed as a specifier of delusional disorder.

When a person experiences psychotic symptoms that are sometimes punctuated by extended periods of mood disruption (symptoms that resemble major depression or bipolar disorder) then schizoaffective disorder may be diagnosed.

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Chapter 14 Psychosis 139. Describe evidence for the heritability of Schizophrenia. Be sure to include at least three examples of familial risks.

ANSWER: Studies have shown that Schizophrenia likely has a strong but not exclusive genetic component. If Schizophrenia was completely heritable, risk would be near 100% in monozygotic twins (who share genes). You do have the greatest chance (about 48%) of developing Schizophrenia if your monozygotic twin has Schizophrenia. Siblings with 1 schizophrenic parent have approximately 17.5% risk of developing Schizophrenia, while risk in first cousins (third degree relation) drops to about 3%. The prevalence of Schizophrenia in the general population is approximately 1%.

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Chapter 14 Neurodevelopment Multiple Choice 1. Psychological disorders are considered developmental disorders when there is a a. change in symptoms over the lifespan. b. genetic component to the disorder. c. neurological basis for the condition. d. general decline in functioning over time.

ANSWER: c 2. Although not classified as “developmental disorders”, most psychological disorders can be considered developmental in nature because they a. appear early in life and change over the lifespan. b. have a genetic component. c. lack biological causes and are influenced by learning. d. are unique to children.

ANSWER: a 3. The major reason that developmental disorders are considered to be so serious in terms of their capacity to disrupt later functioning is a. the fact that medications used in children can have long-term effects. b. the impact that they have on family functioning. c. that the purely biological nature of developmental disorders leads to subsequent developmental failures. d. subsequent skills often build upon one another.

ANSWER: d 4. The main reason that it is so important to identify children with developmental disorders as early as possible is that a. medications are most effective when administered at an early stage of the disorder. b. skill deficits can be identified and addressed before they impact later development. c. family functioning often declines as the developmental disorder progresses. d. children are more receptive to therapy when they are young.

ANSWER: b 5. One of the most common reasons that children are referred for mental health services in the United States is ______________. a. ADHD b. autism c. pervasive developmental disorder d. stuttering ANSWER: a 6. An individual diagnosed with attention deficit/hyperactivity disorder will always present with a. hyperactive behavior that alternates with periods of distraction. b. patterns of inattention or hyperactivity and impulsivity. c. both patterns of inattention and hyperactivity/impulsivity. d. periods of distraction that lead to hyperactive/impulsive behavior.

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Chapter 14 Neurodevelopment ANSWER: b 7. Which of the following is NOT characteristic of ADHD? a. Inattention b. Learning disabilities c. Self-control d. Fidgeting ANSWER: c 8. What are the three types of symptoms for attention deficit/hyperactivity disorder? a. Hyperactivity, impulsivity, inattention b. Inattention, distraction, hyperactivity c. Inattention, impulsivity, distraction d. Hypervigilance, increased startle, and distraction ANSWER: a 9. The inattention category of attention deficit/hyperactivity disorder symptoms is characterized by _______________. a. careless mistakes b. fidgeting c. not waiting one's turn to answer questions d. accelerated motor skills ANSWER: a 10. Because the diagnosis of ADHD is comparable across countries, a. ADHD is considered a normal high activity level of children. b. it is now found to be equally prevalent among boys and girls. c. this suggests that ADHD should not be thought to be the result of intolerant parents. d. this suggests that ADHD has significantly increased and spread worldwide.

ANSWER: c 11. ADHA is found in about a. 1 to 2% b. 3 to 9% c. 8 to 10% d. 10 to 13% ANSWER: b

of the child populations across all regions of the world.

12. Recent research has shown that ADHD a. is considered to be highly influenced by genetics with a relatively small role played by environmental influences. b. is caused by multiple genes. c. appears be related to the neurotransmitter dopamine. d. all of the above.

ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment 13. In order to diagnose an individual with attention deficit/hyperactivity disorder, it is necessary for symptoms to be present in a. both symptom clusters. b. the hyperactivity cluster. c. the area of impulsivity. d. either of the symptom categories.

ANSWER: d 14. Which of the following often overlaps with ADHD? a. Oppositional defiant disorder b. Bipolar disorder c. Conduct disorder d. All of the above ANSWER: d 15. The most accurate statement with regard to the genetic influences of attention deficit/hyperactivity disorder is a. there are no known genetic influences. b. there appears to be a single gene influence. c. there appear to be multiple genetic influences. d. defects on the Y chromosome are the major influence.

ANSWER: c 16. The inattentive subtype of ADHA typically refers to (the): a. absence of hyperactivity. b. multiple acts of impulsivity. c. inaccuracy in diagnosis. d. all of the above.

ANSWER: a 17. People with ADHD that meet the criteria for inattention and hyperactivity/impulsivity are labeled as the _____ subtype. a. mixed b. multiple c. combined d. most severe ANSWER: c 18. The hypothesis that attention deficit/hyperactivity disorder (ADHD) may be influenced by toxins, food additives, or diet a. is based on well-controlled studies. b. is not well understood or studied, but generally effective as a treatment. c. appears true for a small subset of individuals diagnosed with ADHD. d. has little to no scientific evidence.

ANSWER: d

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Chapter 14 Neurodevelopment 19. ADHD tends to occur in families where another family member has ADHD and with increased rates of all but which of the following? a. Conduct disorders b. Mood disorders c. Substance abuse d. Eating disorders ANSWER: d 20. Based on a telephone survey of parents in the United States, researchers found that____ of kids between 4 and 17 years of age were diagnosed with ADHD between 2011 and 2012. a. 2.5 % b. 6% c. 9 % d. 11% ANSWER: c 21. Which of the following environmental influences has been found to contribute to the development of ADHD? a. Exercise while pregnant b. High socio-economic status c. Parental marital instability and discord d. Not eating green vegetables during pregnancy ANSWER: c 22. Recent research has shown that a. ADHD is found equally among boys and girls. b. ADHD is caused by a single gene called DAT 1. c. the brains of children with ADHD are 3% to 4% smaller than children without ADHD. d. the same medications used to treat depressive symptoms are the most effective at reducing symptoms of ADHD. ANSWER: c 23. Recent research has found the following with regard to causes of ADHD: a. Food colors and additives, which for years were thought to cause ADHD, then later refuted, now appear to have a small but measurable impact on increased levels of hyperactivity. b. Pesticides found in foods may be a contributing factor to an increased risk of ADHD. c. Both a and b d. Neither a or b ANSWER: c 24. Recent ADHD research has focused on endophenotypic correlates of a. specific attentional characteristics. b. emotional control. c. extraverted characteristics. d. environmental factors.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment 25. Which best describes the way attention deficit/hyperactivity disorder (ADHD) develops as children grow into adulthood? a. Children tend to outgrow ADHD. b. ADHD tends to evolve into more severe forms of pathology. c. Symptoms remain relatively stable throughout the lifespan for most individuals. d. Manifestations of ADHD tend to change over time but many problems often persist.

ANSWER: d 26. Neurotransmitters implicated in the cause of ADHD include all of the following EXCEPT a. dopamine b. glutamate c. norepinephrine d. GABA ANSWER: b

.

27. Which of the following is not one of the medications that has been found to reduce the core symptoms of hyperactivity and impulsivity, as well as improving concentration, in those with ADHD? a. Ritalin b. Adderall c. Strattera d. Haldol ANSWER: d 28. Ritalin and Adderall, medications generally used to treat attention-deficit/hyperactivity disorder, are classified as ____________. a. minor sedatives b. depressants c. stimulants d. antidepressants ANSWER: c 29. Current estimates (Centers for Disease Control and Prevention, 2013) are that approximately___________children in the United States are being treated with stimulant medications. a. 1 million b. 4 million c. 10 million d. 14.5 million ANSWER: b 30. Seven-year-old Jess has been diagnosed with ADHD. Which of the following is NOT a reason for Jess’s parents to put her on medication? a. Medication can cure ADHD. b. Stimulants help the brain develop in more typical ways. c. Medication manages the symptoms of ADHD and helps children focus while learning. d. ADHD medication is one important aspect of treatment for ASD. Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment ANSWER: a 31. The drug Strattera (atomoxetine) appears effective for some children with ADHD, and according to recent research, does not cause the same as stimulant medication when used in larger doses. a. intolerance b. withdrawal symptoms c. "high" d. academic disturbance ANSWER: c 32. Clorinda is very concerned about giving her son Mario medication to treat his hyperactivity. She read that the use of prescription medications to treat ADHD places children at increased risk for later substance abuse. If she were to treat her son with medication, which would be the best one to give him that would address these concerns? a. Ritalin b. Cylert c. Adderall d. Strattera ANSWER: d 33. Stimulant medications seem to treat ADHD because they a. reinforce the brain’s ability to focus attention. b. decrease emotional response. c. distribute attention. d. increase dream sleep.

ANSWER: a 34. All of the following side effects EXCEPT _________are associated some of the medications that are used to treat attention deficit/hyperactivity disorder. a. insomnia b. drowsiness c. irritability d. weight gain ANSWER: d 35. The study of how your genetic makeup influences your response to certain drugs is called a. behavior genetics b. psychopharmocology c. psychopharmocogenetics d. psychogenetics ANSWER: c

.

36. Non-medication treatments for attention deficit/hyperactivity disorder usually involve a. interpersonal therapy. b. behavioral programs and social skills training. c. brief, inpatient treatment at a specialty hospital.

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Chapter 14 Neurodevelopment d. cognitive behavioral therapy and diet control.

ANSWER: b 37. Ron is a 9-year-old boy recently diagnosed with attention-deficit/hyperactivity disorder. His parents have chosen a combined approach to treatment. If their approach is based on what research suggests is most effective, it will most likely involve a. new experimental medications and behavior therapy. b. no medication but a combination of behavioral therapy and parent training. c. medication such as Ritalin and behavior therapy. d. medication such as Ritalin and psychoanalysis.

ANSWER: c 38. One common misunderstanding about ADHD medication is that: a. they cannot be taken with food. b. they impact a woman’s ability to get pregnant later. c. they are regularly misused to improve focus in people without ADHD. d. all of the answers are correct.

ANSWER: c 39. A specific learning disorder is defined as a. academic performance that is substantially below the level predicted by the individual's age, IQ, and education. b. a complete inability to learn in a given academic subject. c. substandard IQ score in comparison to the individual's family and educational background. d. the existence of a neurological deficit that interferes with the individual's ability to assimilate new information.

ANSWER: a 40. Why would it be incorrect to say that individuals diagnosed with specific learning disorders are not intelligent? a. It would confuse specific learning disorders with giftedness. b. The concept of specific learning disorder has absolutely nothing to do with intelligence. c. Specific learning disorders can be diagnosed in people of any intelligence, since they are partially determined by academic performance that falls substantially below IQ-based expectations. d. Specific learning disorders are only diagnosed in people of high intelligence.

ANSWER: c 41. Which area of learning is affected by a specific learning disorder in approximately 4% to 10% of the population? a. Written expression b. Oral communication c. Mathematics d. Reading ANSWER: d 42. An alternative to using the discrepancy between IQ and achievement in identifying children with specific learning disorders is a. discrepancy prognosis. b. learning intervention strategy.

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Chapter 14 Neurodevelopment c. response to intervention. d. none of the above.

ANSWER: c 43. All of the following are problems observed to result from specific learning disorders EXCEPT a. low employment b. school drop-out c. drug abuse d. suicidal thoughts and attempts ANSWER: c

.

44. Ken is a 12-year-old boy of average intelligence as indicated by his IQ scores. He loves school and works hard on his homework. Ken has earned straight As in every subject except math, where he has been achieving grades in the C range.

Which of the following statements is correct? a. Ken does not appear to have a specific learning disorder because his achievement is consistent with expectations based on his intelligence. b. Ken appears to have a math disorder because his math grade is so far below his other grades. c. Ken appears to have a math disorder because there is a discrepancy between his intelligence and his achievement in many subjects. d. Ken does not appear to have a specific learning disorder because he has shown that he can achieve when he wants to.

ANSWER: a 45. Samantha is a sixth-grade girl who has great difficulty in school. She pays attention and works hard but appears to have trouble remembering facts and concepts that she has read about. Before we can determine whether Samantha has a learning disability, it is most important to know her . a. family history b. social skills c. math skills d. IQ ANSWER: d 46. Studies with identical twins have indicated that reading disorders a. run in families. b. have no genetic component. c. are influenced more by learning than genetics. d. have a smaller genetic component than mathematics disorders.

ANSWER: a 47. The American Psychological Association (2013) estimates that between ______ and _____ percent of youth across ages and cultures have Specific Learning Disorders. a. 1;5 b. 5;15 c. 10;20 d. 40;60 ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment 48. Which of the following is associated with Specific Learning Disorders? a. Dropping out of school b. Unemployment c. Suicidal ideation d. All of the answers are correct ANSWER: d 49. The fact that reading disorders occur most often in English-speaking countries may be due to a. the relative difficulty of English. b. differences in left-brain dominance across cultures. c. differences in right-brain dominance across cultures. d. different educational practices across cultures.

ANSWER: a 50. Raphael’s son has just been diagnosed with a Specific Learning Disorder. What can Raphael to do help and support his son? a. Work to address/adjust cultural expectations when possible b. Visit a specialist to ensure parental interactions and expectations are appropriate c. Cooperate with the school to ensure that his son gets academic support d. All of the answers are correct ANSWER: d 51. One intriguing finding from research involving reading disordered individuals who speak multiple languages is that a. reading disorders are independent of culture/language. b. individuals who speak more than one language rarely have specific learning disorders. c. evidence of the reading disorder may exist for one or two languages, while the individual may be completely free of the disorder in another language. d. the complexity of the English language may contribute to the higher rate of reading disorders in Englishspeaking countries.

ANSWER: d 52. Treatment for specific learning disorders generally involves a. stimulant medication. b. educational intervention and assistance. c. family therapy. d. cognitive-behavioral therapy.

ANSWER: b 53. Alvin is a 10-year-old boy diagnosed with a mathematics disorder. His treatment plan will most likely involve a. teaching him different strategies to improve cognitive skills. b. stimulant medication. c. developing an educational plan that exempts him from mathematics requirements. d. placing him in a school for children with a specific learning disorder.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment 54. Given the available intervention strategies for specific learning disorders, the method that probably has the best chance of overcoming the specific learning disorder is a. development of better study skills. b. efforts to develop compensating cognitive skills. c. systematic instruction and teaching for mastery. d. improving overall intelligence.

ANSWER: c 55. All of the following were previously classified as pervasive developmental disorders EXCEPT a. childhood disintegrative disorder. b. Rett's disorder. c. autistic disorder. d. specific learning disorder.

ANSWER: d 56. One of the most characteristic patterns for children with autistic disorder is that they are generally a. uninterested in people. b. very intelligent. c. extremely talkative. d. hyperactive.

ANSWER: a 57. Robin is a 3-year-old girl who appears uninterested in people. She generally interacts with her mom only when she needs something. In some ways, Robin seems to be interested in her mother only as a tool to help her get what she wants.

Robin would probably be diagnosed with a. autistic disorder. b. childhood disintegrative disorder c. ADHD d. a specific learning disorder.

ANSWER: a 58. The restricted pattern of behavior generally observed in autistic disorder involves a. repetitive movements such as spinning in circles. b. an intense preference for keeping things the same. c. inappropriate communication patterns. d. lack of recognition of significant others.

ANSWER: b 59. Jean is a 14-year-old girl with autistic disorder who seems compelled to run around touching each door every time she comes home. If she is prevented from touching each door, Jean has a tantrum. This is an example of a. restricted behavior pattern. b. social impairment. c. ritualistic behavior. d. maintenance of sameness.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment 60. All of the following are typical behaviors for children with autistic disorder EXCEPT a. spinning a wheel on a toy truck and staring at it for hours. b. throwing a loud tantrum when prevented from carrying out a ritual. c. becoming wildly upset when one toy was removed from the shelf. d. performing complex math calculations that appear well beyond their abilities.

ANSWER: d 61. Most autistic individuals develop symptoms of the disorder a. at birth b. before age one c. before age three d. before teen years ANSWER: c 62. In terms of the level of support that will be necessary for an autistic child, which factor is used as a predictor to determine the prognosis? a. Age of onset b. Severity of initial symptoms c. Rate of symptom progression d. IQ ANSWER: d 63. Monte is a 3-year-old boy recently diagnosed with autistic disorder. He appears completely unresponsive to his parents and shows no indication of any language development. Monte seems uninterested in communication of any kind and has significant rituals such as lining up his toys and realigning them every few minutes. He becomes hysterical if anyone interrupts his ritualistic activity. On an IQ assessment designed for very young children, Monte's score was extremely low. His prognosis is poor primarily because of a. lack of language acquisition and low IQ. b. low IQ and early age of onset. c. early age of onset and lack of language acquisition. d. ritualistic behavior and disinterest in his parents.

ANSWER: a 64. Research regarding the behavior of the parents of autistic children suggests that autistic disorder is a. the result of cold and aloof parenting. b. the result of a complex interaction of genetics and parenting style. c. the result of overindulgent parenting style. d. not the result of parenting behaviors.

ANSWER: d 65. Parents who have a child with autism spectrum disorder have about a chance of having another child with such a disorder. This rate is more than 100 times the risk in the general population, lending weight to the idea that there is a strong genetic component to these conditions. a. 2% b. 8% c. 13% Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment d. 29% ANSWER: d 66. The ability to perform "computer-like" mathematical calculations and other incredible skills that are sometimes associated with autistic individuals (such as the character in the movie Rain Man) are a. not typical of the disorder. b. a defining symptom of the disorder. c. fairly common but not present in every autistic individual. d. a complete myth and not possible for any autistic individual.

ANSWER: a 67. Which of the following is NOT true about the exceptional abilities? a. Exceptional skills are referred to as “savant” skills. b. Exceptional skills are seen even in the most severe forms of ASD. c. Exceptional skills are the result of a superior working memory. d. Exceptional skills are the result of a highly focused attention.

ANSWER: b 68. Which of the following is currently being researched as a possible cause of autistic disorder? a. The neuronal structure of the hippocampus b. The levels of the neuropeptide oxytocin c. The mercury used as a preservative in childhood vaccines d. All of these ANSWER: b 69. Researchers, studying the brain of individuals with autistic disorder, suggest that one area of the brain that may be involved with the disorder is the . a. brain stem b. hypothalamus c. amygdala d. reticular formation ANSWER: c 70. James and Shanita’s have one child diagnosed with ASD. James and Shanita want to have another child. What is the risk that the second child will also have ASD? a. 1 % b. 5% c. 20% d. 50% ANSWER: c 71. Research on the social skills of people with autistic disorder suggests that people with the condition a. are interested in socialization but do not know how to socialize. b. are not interested in socialization. c. enjoy social relationships but cannot express this joy.

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Chapter 14 Neurodevelopment d. are none of these.

ANSWER: b 72. Jim is a teen who has no friends. Although he is quite verbal, he speaks in a strange and formal style of speech. Jim is obsessed with airplanes and behaves in a very strange way. He is very self-focused and does not understand the concept of social reciprocity. The most likely form of autistic spectrum disorder affecting Jim is . a. childhood disintegrative disorder b. Asperger's disorder c. Rett's disorder d. autistic disorder ANSWER: b 73. a. b. c. d.

ANSWER: d 74. An appropriate treatment goal for a child with autistic disorder is a. resolution of all autistic symptoms by age 18. b. immediate cessation of ritualistic behaviors. c. development of normal social skills by age 18. d. reduction in tantrums and enhancement of communication skills.

ANSWER: d 75. Modern treatment programs for autistic disorder generally involves a. pharmacological treatments. b. psychological supports for communication and socialization problems. c. behavioral approaches. d. all of these.

ANSWER: d 76. Which treatment approach has been most clearly documented as benefitting children with autistic disorder by helping to decrease agitation? a. Pharmacological treatment b. Behavioral approaches c. School education d. Parent support ANSWER: a 77. Some success has been noted in the development of communication skills in autistic children through the use of a. modeling appropriate communication. b. behavioral procedures involving shaping and discrimination training. c. intensive therapy where the patient is placed in many social situations.

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Chapter 14 Neurodevelopment d. stimulant medications.

ANSWER: b 78. The results of behavioral treatment targeting the socialization deficits of individuals with autistic disorder have shown a. no improvement. b. that those with autism can improve their socialization skills. c. that those with autism can significantly improve their socialization skills. d. that there is some improvement but it is not permanent.

ANSWER: b 79. Jane is a 14-year-old autistic girl currently participating in a behavioral social skills training program for autistic adolescents. Jane's most likely outcome from this program is a. relatively normal socialization for her age. b. no progress at all. c. improvement in her socialization skills. d. significant improvement in her socialization skills.

ANSWER: c 80. Based on the research of Lovaas (1987), improvements in the intellectual and educational functioning of autistic children have been documented for intervention programs that a. use a group therapy model. b. provide multiple therapists. c. meet for 40 hours or more per week. d. are school based.

ANSWER: c 81. Research by Lovaas (1987) and others suggest that intervention for autism may be most effective when it is provided ______________. a. at as young an age as possible b. during adolescence c. during late childhood/early adolescence d. to adults ANSWER: a 82. Jake is an 8-year old boy with autistic disorder whose parents have just been informed that their son will be provided with whatever special psychological support he needs. Jake's parents should a. insist on a special education classroom since research suggests this is best for autistic children. b. consider changing schools because it is obvious that Jake's school knows nothing about the needs of autistic children. c. be relieved that Jake's autism must be very mild since the school would not place a child with significant autistic deficits in a regular classroom. d. be pleased since research suggests that this approach is best for children with autistic disorder.

ANSWER: d 83. Medication treatment for autistic disorder has been found to be _________ in addressing the core symptoms of the disorder.

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Chapter 14 Neurodevelopment a. mildly effective b. ineffective c. generally effective d. highly effective initially, though the benefits of medication decrease over ANSWER: b 84. Generally speaking, the treatment for a child with autistic disorder should involve a. behavioral therapy, school education, and a focus on developing as much independence as possible. b. behavioral therapy, home schooling, and a focus on developing as much independence as possible. c. cognitive therapy, school education, and a focus on developing as much independence as possible. d. behavioral therapy and a focus on provisions for long-term custodial care.

ANSWER: a 85. The goal of most modern therapy for people with autistic disorder is to a. have the child and family accept the inherent limitations of the disorder. b. provide a separate and secure environment for the individual. c. integrate the autistic child into regular society as much as possible. d. isolate autistic children in intensive therapy for as long as possible before attempting to introduce them into the larger world.

ANSWER: c 86. Intellectual disability is defined as a. below-average intellectual ability. b. below-average intellectual ability and adaptive functioning. c. significant deficits in self-care abilities. d. low IQ score.

ANSWER: b 87. An individual with an IQ score of 60 would be classified with a. mild b. moderate c. severe d. profound ANSWER: a

intellectual disability.

88. An individual with an IQ score of 35 would be classified with a. mild b. moderate c. severe d. profound ANSWER: c

intellectual disability.

89. Individuals with intellectual disability show an extremely a. similar range of abilities and personalities. b. similar range of abilities, although personality varies greatly.

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Chapter 14 Neurodevelopment c. broad range of abilities and personalities. d. varied ranges of abilities, although personality tends to be quite similar.

ANSWER: c 90. The reason that intellectual disability was recorded on the same DSM-IV axis as personality disorders is because a. this axis relates to relatively chronic conditions that are less responsive to treatment. b. intellectual disability and personality disorder generally have similar causes. c. intellectual disability and personality disorder are generally treated using similar methods. d. this axis relates to biologically influenced conditions.

ANSWER: a 91. The DSM-IV criteria for intellectual disability are an IQ that is a. significantly below average and symptom onset prior to age 18. b. significantly below average, deficits in adaptive functioning, and onset prior to age 18. c. significantly below average, deficits in communication, and onset prior to age 18. d. significantly below average and deficits in adaptive functioning.

ANSWER: b 92. Joe is 24 years old, lives in a rural area, and works as a helper/stock boy in a small local store. Joe's IQ was tested when he was in elementary school and again in high school. His IQ score was about 68 and he did not finish high school.

Joe lives in a guesthouse on his parents' farm, and although he does spend lots of time with his family, he takes care of himself. Based on the information provided, Joe should receive a diagnosis of . a. intellectual disability b. borderline intellectual disability c. specific learning disorder d. no diagnosis ANSWER: d 93. The diagnostic criteria for intellectual disability include an assessment of adaptive functioning because an IQ score is a. not a measure of intelligence. b. an insufficient measure of impairment. c. is not adjusted statistically for people of different ages. d. score is always highly inaccurate.

ANSWER: b 94. The reason that "onset prior to age 18" is part of the DSM-5 diagnostic criteria for intellectual disability is that a. the diagnosis indicates that the individual was affected during the developmental period. b. the diagnosis is not intended to include individuals who have suffered any form of brain damage. c. the diagnosis has legal implications for children. d. this diagnosis is reserved for children; other diagnostic terms are applied once the mentally retarded individual reaches the age of 18.

ANSWER: a 95. Fran is a 25-year-old woman who has been having a great deal of difficulty taking care of herself. Her IQ score is 68, though this surprises her parents because they recall that her IQ was tested several times when she was in school and it was always in the 80s. The diagnosis of intellectual disability for Fran is Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment a. appropriate because she meets the criteria for IQ and has difficulty with self-care. b. inappropriate because she does not meet the IQ criterion. c. inappropriate because we do not have sufficient evidence of impairment. d. inappropriate because she did not appear to meet criteria before age 18.

ANSWER: d 96. The age before which symptoms must be evident in order to substantiate a diagnosis of intellectual disability is a. fairly arbitrary. b. based on medical considerations. c. based on the significant differences found in individuals who are either just above or just below the designated age. d. based on studies showing that the designated level separates most individuals with brain deficits from those who do not have such abnormalities.

ANSWER: a 97. Which of the following statements is TRUE regarding an individual who is classified as mildly intellectually disabled? a. She can live independently. b. She requires continual supervision and assistance. c. She is unlikely to ever be able to hold a meaningful job. d. She will not be able to make it past fifth grade in school.

ANSWER: c 98. What is one effective treatment strategy for ID? a. Encouraging people with ID to take classes on test taking strategies b. Skills training for jobs within a community setting c. Memorization skills so that people with ID do not have to read d. All of the answers are correct ANSWER: b 99. The major difference between the DSM-5 system of classification of levels of intellectual disability and the American Association on Intellectual Developmental Disabilities (AAIDD) system is that the AAIDD system is based on ___________. a. abilities b. disabilities c. IQ d. support required ANSWER: d 100. The fact that IQ scores have, on average, risen over the past century is called the a. Cleckley b. Flynn c. Hare d. Graves ANSWER: b

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effect.

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Chapter 14 Neurodevelopment 101. The percentage of people with intellectual disability who are classified as mildly intellectually disabled is approximately . a. 90% b. 70% c. 50% d. 25% ANSWER: a 102. Which is the most accurate statement regarding the causes of intellectual disability? a. It is caused by genetics. b. It has four known causes. c. It is caused by either substances or trauma. d. It is caused by either substances or trauma.

ANSWER: d 103. Lesch-Nyhan syndrome is an example of a a. genetic disorder that causes intellectual disability. b. cluster of symptoms displayed by some intellectually disabled individuals. c. form of cerebral palsy. d. viral infection that causes intellectual disability.

ANSWER: a 104. Down syndrome is caused by a. an extra 21st chromosome. b. a missing 21st chromosome. c. lack of oxygen at birth. d. unknown influences.

ANSWER: a 105. The incidence of a child being born with Down syndrome to a mother at age 35 is 1 in 500 births. The risk at maternal age 45 is 1 in births. a. 250 b. 100 c. 50 d. 18 ANSWER: d 106. Down syndrome can be detected by a. the first trimester of pregnancy. b. only at birth. c. ages 1 to 2. d. adolescence.

ANSWER: a 107. Fragile X syndrome Copyright Cengage Learning. Powered by Cognero.

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Chapter 14 Neurodevelopment a. is caused by too many X chromosomes on a gene. b. is similar to Lesch-Nyhan syndrome. c. primarily affects males. d. results in an inability to metabolize certain amino acids.

ANSWER: c 108. When there are no known genetic or organic influences, the causes of intellectual disability are generally considered to be ______________. a. substances b. cultural-familial c. prenatal d. completely unknown ANSWER: b 109. An appropriate treatment goal for an individual with mild or moderate intellectual disability is a. resolution of symptoms by age 18. b. increase intellectual functioning by 15%. c. improve abilities to care for self. d. select an institution for long-term care.

ANSWER: c 110. ________approaches have been found to be successful for teaching individuals with intellectual disability a variety of basic self-care activities. a. Biological b. Cognitive c. Humanistic d. Behavioral ANSWER: a 111. Breaking a skill down into its component parts for teaching purposes is called task a. analysis b. awareness c. acceptance d. articulation ANSWER: a

.

112. Research regarding early intervention programs such as Head Start indicates that such programs a. are ineffective. b. may help improve the functioning of mentally retarded children. c. may help prevent "at risk" children from developing cultural-familial disability. d. help parents manage the behavior of their mentally retarded children.

ANSWER: c 113. Gene therapy is under development for potential future treatment of those with intellectual disability. If employed, when would this therapy be utilized?

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Chapter 14 Neurodevelopment a. During the prenatal period b. Immediately after birth c. When puberty begins d. In early or middle adulthood ANSWER: a 114. Prenatal gene therapy refers to the future possibility of using genetic techniques to a. detect intellectual disability before birth. b. intervene in brain development prior to birth. c. counsel parents about their risks of having a child with intellectual disability. d. avoid misdiagnosing intellectual disability .

ANSWER: b 115. Research on supported employment indicates that a. the practice can be cost-effective. b. the costs outweigh the benefits. c. the mentally retarded rarely find meaningful jobs. d. mentally retarded individuals cannot be a productive part of society.

ANSWER: a 116. Johnny is a 2-year-old boy who has no motivation to interact with other people. His absence of interest in people may also lead to severe deficits in his ability to . a. amuse himself b. think c. communicate d. walk ANSWER: c 117. Which of the following often overlaps with ADHD? a. Oppositional defiant disorder b. Bipolar disorder c. Conduct disorder d. All of the above ANSWER: a Subjective Short Answer 118. Describe the symptoms of attention deficit/hyperactivity disorder and discuss the controversy surrounding this diagnosis.

ANSWER: ADHD is characterized by a pattern of inattention that can significantly disrupt academic performance and relationships. In addition to inattention, people with ADHD may exhibit hyperactivity and impulsivity. The disorder is more common among boys than girls. Some argue that too many normal children are given the diagnosis in order to compensate for poor academic achievement or unrealistic explanations on the parts of parents and teachers, but recent studies showing that ADHD rates are comparable across cultures seems to indicate that it is indeed a valid disorder.

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Chapter 14 Neurodevelopment 119. Your text discusses the racial differences in the diagnoses of Specific Learning Disorder. Based on what you learned about diagnosis, describe likely causes for these differences: ANSWER: Approximately 1% of white children and 2.6% of black children were receiving services for problems with learning in 2001 (Bradley, Danielson, & Hallahan, 2002). It appears that societal views of disability, racism, and inequitable assessment are among the factors that contribute to disproportionality (Bruce & Venkatesh, 2014). Low expectations (e.g. “soft racism”) and implicit bias may lead to overidentification in some people. For example, an African-American boy’s fidgety behavior and inattentiveness may be more noticable and more likely to be appropriated to him as a person (reflecting a personal attribution) than a white boy’s behavior (where environmental causes may be blamed).

120. Autism Spectrum Disorder was wrongly seen as a result of poor parenting. What harm might this misunderstanding cause?

ANSWER: Mothers and fathers of children with the more severe form of ASD were characterized as perfectionistic, cold, and aloof (Kanner, 1949). Descriptions such as these held parents responsible for their children’s unusual behaviors. These views were devastating to a generation of parents, who felt guilty and responsible for their children’s problems. More sophisticated research using larger samples of children and families suggests that the parents of individuals with autism may not differ substantially from parents of children without disabilities (Bhasin & Schendel, 2007). Yet, the stereotypes persist and many parents do feel guilty about their child’s prognosis. Guilty feelings, though, do not help a child with ASD, and in fact, may rob the parents of much needed emotional resources to advocate for their child.

121. Discuss why portrayals such as Dustin Hoffman’s character in Rain Man are helpful and hurtful in ASD advocacy.

ANSWER: Myths about people with ASD are perpetuated when the idiosyncrasies of the disorder are highlighted.

These perceptions are furthered by portrayals such as Dustin Hoffman’s character in the movie Rain Man. Hoffman could, for instance, instantaneously and accurately count hundreds of toothpicks falling to the floor. It is helpful when Hollywood highlights mental health issues as it brings attention and some level of normalization to mental disorders that are often hidden. It is hurtful when popular media “gets it wrong” by showing these disorders as easily curable. It can also be hurtful when one or a few examples are assumed to represent large numbers of people with very complex and individualized symptoms. For example, exceptional mental ability—referred to as savant skills—as shown in Rain Man do not occur in all individuals with ASD. It is estimated that only one third of individuals with ASD have these unusual skills. It would be careless to assume all individuals with ASD have such skills and wrong to expect “special” abilities from all people with ASD. 122. Explain what is meant by specific learning disorders, and why the effects of a reading disorder might be influenced by the language the person speaks.

ANSWER: Specific learning disorders are characterized by performance in the areas of reading, mathematics, and written expression that are significantly below what would be expected given the person’s age, IQ, and education level. Difficulties with reading are the most common of the specific learning disorders. These conditions do run in families, suggesting a genetic link, but subtle brain damage may also be involved.

Studies suggest that reading disorders cause more disruption among people who speak a relatively complex language such as English than those who speak a simpler language such as Italian, even though measures of brain activity are comparable. Perhaps it is easier for people to compensate when the language is less complex.

123. Discuss the possible causes of autistic disorder.

ANSWER: Historically, autism was seen as the result of failed parenting, although this has not held up. It is now clear that the disorder has a genetic component that involves a number of chromosomes, some of which may be related to the neuropeptide oxytocin. Study of the brains of those with autism suggests that they have fewer

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Chapter 14 Neurodevelopment neurons in the amygdala. Although some have argued that mercury used in vaccines is responsible for increases in autism, research does not support this assumption.

124. Discuss the DSM-5 criteria for intellectual disability and the controversy regarding descriptions of the different levels of this disorder.

ANSWER: There are three criteria for the diagnosis of intellectual disability. The first is significantly sub-average intellectual functioning based on IQ test scores. The second is concurrent deficits or impairments in adaptive functioning, including difficulty in at least two areas such as communication, self-care, home living, social and interpersonal skills, use of community resources, self-direction, academic skills, work, leisure, health, or safety. The third is based on the age of onset, meaning that the disorder must be evident before age 18.

Since the criteria for academic and social function vary based on cultural expectations, intellectual disability, more than other disorders, is defined by the society in which the individual lives. This can make it difficult to label and compare people across cultures, and the classification of intellectual disability is made harder by the fact that people with intellectual disability differ significantly in their degree of disability, even within levels.

Essay 125. Describe the symptoms of attention deficit/hyperactivity disorder and discuss the controversy surrounding this diagnosis.

ANSWER: ADHD is characterized by a pattern of inattention that can significantly disrupt academic performance and relationships. In addition to inattention, people with ADHD may exhibit hyperactivity and impulsivity. The disorder is more common among boys than girls. Some argue that too many normal children are given the diagnosis in order to compensate for poor academic achievement or unrealistic explanations on the parts of parents and teachers, but recent studies showing that ADHD rates are comparable across cultures seems to indicate that it is indeed a valid disorder.

126. Your text discusses the racial differences in the diagnoses of Specific Learning Disorder. Based on what you learned about diagnosis, describe likely causes for these differences: ANSWER: Approximately 1% of white children and 2.6% of black children were receiving services for problems with learning in 2001 (Bradley, Danielson, & Hallahan, 2002). It appears that societal views of disability, racism, and inequitable assessment are among the factors that contribute to disproportionality (Bruce & Venkatesh, 2014). Low expectations (e.g. “soft racism”) and implicit bias may lead to overidentification in some people. For example, an African-American boy’s fidgety behavior and inattentiveness may be more noticable and more likely to be appropriated to him as a person (reflecting a personal attribution) than a white boy’s behavior (where environmental causes may be blamed).

127. Autism Spectrum Disorder was wrongly seen as a result of poor parenting. What harm might this misunderstanding cause?

ANSWER: Mothers and fathers of children with the more severe form of ASD were characterized as perfectionistic, cold, and aloof (Kanner, 1949). Descriptions such as these held parents responsible for their children’s unusual behaviors. These views were devastating to a generation of parents, who felt guilty and responsible for their children’s problems. More sophisticated research using larger samples of children and families suggests that the parents of individuals with autism may not differ substantially from parents of children without disabilities (Bhasin & Schendel, 2007). Yet, the stereotypes persist and many parents do feel guilty about their child’s prognosis. Guilty feelings, though, do not help a child with ASD, and in fact, may rob the parents of much needed emotional resources to advocate for their child.

128. Discuss why portrayals such as Dustin Hoffman’s character in Rain Man are helpful and hurtful in ASD advocacy.

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Chapter 14 Neurodevelopment ANSWER: Myths about people with ASD are perpetuated when the idiosyncrasies of the disorder are highlighted.

These perceptions are furthered by portrayals such as Dustin Hoffman’s character in the movie Rain Man. Hoffman could, for instance, instantaneously and accurately count hundreds of toothpicks falling to the floor. It is helpful when Hollywood highlights mental health issues as it brings attention and some level of normalization to mental disorders that are often hidden. It is hurtful when popular media “gets it wrong” by showing these disorders as easily curable. It can also be hurtful when one or a few examples are assumed to represent large numbers of people with very complex and individualized symptoms. For example, exceptional mental ability—referred to as savant skills—as shown in Rain Man do not occur in all individuals with ASD. It is estimated that only one third of individuals with ASD have these unusual skills. It would be careless to assume all individuals with ASD have such skills and wrong to expect “special” abilities from all people with ASD. 129. Explain what is meant by specific learning disorders, and why the effects of a reading disorder might be influenced by the language the person speaks.

ANSWER: Specific learning disorders are characterized by performance in the areas of reading, mathematics, and written expression that are significantly below what would be expected given the person’s age, IQ, and education level. Difficulties with reading are the most common of the specific learning disorders. These conditions do run in families, suggesting a genetic link, but subtle brain damage may also be involved.

Studies suggest that reading disorders cause more disruption among people who speak a relatively complex language such as English than those who speak a simpler language such as Italian, even though measures of brain activity are comparable. Perhaps it is easier for people to compensate when the language is less complex.

130. Discuss the possible causes of autistic disorder.

ANSWER: Historically, autism was seen as the result of failed parenting, although this has not held up. It is now clear that the disorder has a genetic component that involves a number of chromosomes, some of which may be related to the neuropeptide oxytocin. Study of the brains of those with autism suggests that they have fewer neurons in the amygdala. Although some have argued that mercury used in vaccines is responsible for increases in autism, research does not support this assumption.

131. Discuss the DSM-5 criteria for intellectual disability and the controversy regarding descriptions of the different levels of this disorder.

ANSWER: There are three criteria for the diagnosis of intellectual disability. The first is significantly sub-average intellectual functioning based on IQ test scores. The second is concurrent deficits or impairments in adaptive functioning, including difficulty in at least two areas such as communication, self-care, home living, social and interpersonal skills, use of community resources, self-direction, academic skills, work, leisure, health, or safety. The third is based on the age of onset, meaning that the disorder must be evident before age 18.

Since the criteria for academic and social function vary based on cultural expectations, intellectual disability, more than other disorders, is defined by the society in which the individual lives. This can make it difficult to label and compare people across cultures, and the classification of intellectual disability is made harder by the fact that people with intellectual disability differ significantly in their degree of disability, even within levels.

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Chapter 16 Aging and Neurocognition Multiple Choice 1. Traditionally, delirium, dementia, and amnestic disorders were categorized as a. resulting from complications of birth. b. part of the normal aging process. c. organic and then cognitive disorders. d. as temporary conditions.

ANSWER: c 2. The three categories of neurocognitive disorders are a. delirium, chromosomal disorders, and amnestic disorders. b. delirium, dementia, and Alzheimer's disease. c. Alzheimer's, delirium, and Parkinson’s disease. d. major neurocognitive disorders, mild neurocognitive disorders, and delirium.

ANSWER: a 3. The term "organic mental disorders" is no longer used to describe cognitive disorders because a. there is nothing "organic" about these disorders. b. cognitive disorders are actually thought disorders. c. the term implies that there is no effective treatment. d. most psychological disorders have an "organic" component.

ANSWER: d 4. The cause of most cognitive disorders is a. the normal process of aging b. brain dysfunction c. alcohol/substances d. medication side effects ANSWER: b

.

5. The conditions that are now called neurocognitive disorders typically cause impairment in all of the following primary abilities EXCEPT . a. memory b. perception c. dreaming d. attention ANSWER: c 6. Cognitive disorders are often associated with changes in a. behavior and personality b. anxiety and depression c. levels of paranoia d. all of the above ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition 7. From the following choices, the age group most likely to use prescription medications is a. infants and young children b. children and adolescents c. middle-aged adults d. older adults ANSWER: d

.

8. Which of the following is true of delirium? Delirium: a. impacts approximately 20% of older adults admitted into acute care facilities. b. is associated with confusion and disorientation. c. comes on gradually. d. all of the answers are correct.

ANSWER: d 9. Designer drugs such as Ecstasy, “Molly,” and “bath salts”: a. impact the ability to focus. b. can cause delirium. c. indicate the complex interaction between physical and psychological health. d. all of the answers are correct.

ANSWER: d 10. Developing delirium in the hospital is associated with what further health risk? a. 1.5 times as likely to die that year b. 10 times as likely to die that year c. Heart disease d. Cancer ANSWER: a 11. Grandpa is admitted to critical care during one of his delirium episodes. Approximately what is Grandpa’s increased risk of mortality in the next year? a. Twice the risk b. 2.5 times the risk c. 5% more risk d. 25% more risk ANSWER: b 12. Impaired consciousness and cognition during the course of several hours or days defines a. delirium b. neurocognitive disorder c. Alzheimer's disease d. Pick’s disease ANSWER: a

.

13. Which of the following is NOT a typical cause of delirium? a. Poison Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition b. Drug use c. Infections d. Allergic reactions ANSWER: d 14. Mr. Smith (age 72) is brought to the hospital emergency room. His son explains that his father woke up this morning and was "not himself." Mr. Smith appears confused, agitated, and a bit frightened. He does not know his own name and cannot recognize his son. Mr. Smith's son reports that his father had been completely fine with no symptoms prior to that morning. Mr. Smith appears to be suffering from . a. neurocognitive disorder due to Lewy Body disease b. neurocognitive disorder due to Alzheimer's disease c. delirium d. amnestic disorder ANSWER: c 15. Lauren goes to her usual family doctor after experiencing her first bout with delirium. What questions is the doctor likely to ask: a. Are you or have you currently withdrawn from alcohol use? b. Have you been tested for an infection? c. Have you had an accident or otherwise been in a position to injure your brain? d. All of the answers are correct.

ANSWER: d 16. Which of the following groups is likely to show delirium? a. Older adults b. AIDS patients c. Cancer patients d. All of these ANSWER: d 17. Among the elderly, delirium a. occurs because drugs are eliminated from their system quickly. b. accounts for a significant number of falls that cause hip fractures. c. is rarely caused by improper medication use. d. is easily attributed to a limited number of causes.

ANSWER: b 18. The symptoms of delirium tend to develop a. very slowly, over the course of several years. b. very quickly, over the course of a few hours to a few days. c. moderately slowly, over the course of several months. d. either very quickly or very slowly, depending on the cause.

ANSWER: b 19. The symptoms of delirium tend to subside Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition a. very slowly, over the course of several years. b. relatively quickly. c. moderately slowly, over the course of several months. d. very slowly, if they ever subside at all.

ANSWER: b 20. Substance-induced delirium is a major problem for the elderly because a. they are more likely to take prescription medications than other age groups. b. their bodies are less able to process and eliminate drugs. c. improper use of medication is likely to have serious side effects. d. all of the above.

ANSWER: d 21. Which of the following individuals is MOST likely to develop delirium? a. Joe (age 76) takes multiple medications for various medical conditions. Two new medications have just been prescribed for him, and he has already made a mistake taking the first dose. b. Jean (age 89) is in good physical and mental health. This morning, she has a little bit of a head cold, but has not yet taken any medication for it. c. Mark (age 12) woke up with a low-grade fever from the viral infection that has been going around his class this past week. d. Sarah (age 40) was in a minor car accident but claims to feel fine.

ANSWER: a 22. Delirium is generally treated with . a. antibiotic medication b. benzodiazepine medication c. antidepressant medication d. a treatment based on the specific cause of the delirium ANSWER: d 23. Delirium brought on by withdrawal from alcohol or other drugs is generally treated with a. rest and reassurance. b. antipsychotic medication. c. antidepressant medication. d. restraining the patient until the withdrawal symptoms are over.

ANSWER: b 24. Approximately what percentage of chronic heavy alcohol users show some cognitive impairment? a. 10% to 25% b. 25% to 35% c. 50% to 70% d. almost 100% ANSWER: c

.

25. Typical psychosocial intervention for a patient with delirium includes Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition a. restraining the patient to prevent self-harm. b. placing the person in a new environment. c. reassurance and surrounding with familiar belongings. d. excluding the patient from any medical decision to avoid increased anxiety.

ANSWER: c 26. What is MOST successful in assisting people who are susceptible to delirium? a. Psychosocial approach b. Preventive efforts such as patient counseling c. Antipsychotic medications d. Rest and reassurance ANSWER: b 27. The gradual deterioration of brain functioning that affects judgment, memory, language, and other cognitive processes is called _______________. a. major neurocognitive disorder b. delirium c. amnestic disorder d. mental retardation ANSWER: a 28. One of the major differences between major neurocognitive disorder caused by Alzheimer's disease and major neurocognitive disorder caused by depression is that Alzheimer's type major neurocognitive disorder a. is generally reversible. b. is not reversible. c. involves a slow increase in symptoms. d. leads to a rapid decline in abilities.

ANSWER: b 29. All of the following are possible causes of dementia EXCEPT _______________. a. Alzheimer's disease b. drugs and alcohol c. infection or depression d. food additives and preservatives ANSWER: d 30. The most common cause of major neurocognitive disorder is a. a history of substance abuse b. Alzheimer's disease c. improper use of prescription drugs d. syphilis ANSWER: b

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31. One major difference that is useful in the diagnosis of major neurocognitive disorder or delirium is that a. major neurocognitive disorder symptoms develop slowly over time, and delirium symptoms develop quickly.

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Chapter 16 Aging and Neurocognition b. major neurocognitive disorder symptoms are usually associated with underlying medical conditions, and delirium is usually the result of other factors. c. the initial symptoms of major neurocognitive disorder are generally more severe than the symptoms of delirium. d. the symptoms of major neurocognitive disorder involve memory, but the symptoms of delirium are more likely to involve expressive language.

ANSWER: a 32. At the age of 50, Debra has begun to receive quite a bit of teasing from her family about being "absentminded." The truth is that Debra has been hiding the fact that each week she seems to remember less and less. For the last month, she has been getting lost while driving home from work. Lately, Debra has been relying on a hand-drawn map to get home.

She has started having trouble recognizing the faces of people at work and frequently forgets why she started to do something. Debra appears to be developing . a. delirium b. amnestic disorder c. neurocognitive disorder d. medically induced dementia ANSWER: c 33. People with neurocognitive disorder sometimes suffer from agnosia, which is defined as the inability to _________. a. use language b. understand language c. recognize and name objects d. remember events and places ANSWER: c 34. The inability to recognize objects is called a. agnosia b. alexia c. anhedonia d. apraxia ANSWER: a

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35. Which of the following is TRUE of major neurocognitive disorder? a. The number of new cases per year is decreasing. b. More men than women have major neurocognitive disorder. c. The financial costs of major neurocognitive disorder are decreasing. d. Major neurocognitive disorder rates are increasing as people live longer.

ANSWER: d 36. Which of the following statements about major neurocognitive disorder is FALSE? a. Globally, one new case of major neurocognitive disorder is identified every 30 seconds. b. Worldwide, the cost of major neurocognitive disorder is about $315 billion per year. c. Nearly half of the cases of major neurocognitive disorder are of the Alzheimer's type. d. The rate of new cases doubles with every 5 years of age after age 75.

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Chapter 16 Aging and Neurocognition ANSWER: a 37. When a person has major neurocognitive disorder, he or she may also experience delusions, depression, agitation, aggression, and/or apathy, all of which are due to a. progressive deterioration of brain functioning. b. frustration experienced by these patients as they lose their cognitive abilities. c. neither of these. d. both of these.

ANSWER: d 38. The prevalence of major neurocognitive disorder in adults between the ages of 65 and 74 is a. around .5% b. less than 1% c. hovering at 3% d. a little more than 5% ANSWER: d 39. The prevalence of major neurocognitive disorder in adults over the age of 85 is a. 1% to 5% b. 10% to 15% c. 20% to 40% d. more than 50% ANSWER: c

.

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40. In the United States alone, the cost of caring for patients with Alzheimer's type major neurocognitive disorder is estimated to be about . a. $100 thousand b. $100 million c. $100 billion d. $100 trillion ANSWER: c 41. All of the following are types of neurocognitive disorder EXCEPT a. vascular neurocognitive disorder. b. substance/medication-induced neurocognitive disorder. c. neurocognitive disorder due to mononucleosis. d. neurocognitive disorder due to prion disease.

ANSWER: c 42. The definitive diagnosis of neurocognitive disorder due to Alzheimer’s disease can currently be made based solely on ______________. a. cognitive testing b. brain scans c. autopsy results d. behavioral analysis Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition ANSWER: c 43. How is neurocognitive disorder due to Alzheimer's disease usually diagnosed? a. MRI findings b. Brain biopsy c. Functional brain scan d. Simplified mental status exam ANSWER: d 44. Neurocognitive disorder due to Alzheimer's disease is characterized by a. multiple cognitive deficits that progress over time. b. a few severe cognitive deficits that develop gradually and steadily. c. multiple cognitive deficits that develop quickly. d. a few severe cognitive deficits that develop quickly.

ANSWER: a 45. Which of the following is used for a definitive diagnosis of neurocognitive disorder due to Alzheimer's disease? a. Psychological testing b. A mental status exam c. Reported observations of the patient by family members d. None of the above ANSWER: d 46. In the advanced stages of neurocognitive disorder due to Alzheimer's disease, a phenomenon called "sundowner syndrome" occurs in which cognitive disturbances tend to a. improve as the day goes on. b. become worse toward evening. c. come and go during the course of the day. d. peak around mid-day.

ANSWER: b 47. Although the sample size is small, the results of a study that looked at the writings of a group of Catholic nuns (Snowden et al., 1996), suggest that the development of neurocognitive disorder due to Alzheimer's disease might be predicted in early life by analyzing the present in an individual's writing. a. errors b. word usage c. idea density d. emotional tone ANSWER: c 48. The progress of cognitive deterioration in Alzheimer’s disease is most rapid during the a. early b. middle c. late d. advanced Copyright Cengage Learning. Powered by Cognero.

stages of the disease.

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Chapter 16 Aging and Neurocognition ANSWER: b 49. The progression of cognitive deterioration in neurocognitive disorder due to Alzheimer's disease is a. slow during early stages and late stages, and rapid during middle stages. b. rapid during early and late stages, and slow during middle stages. c. slow and progressive throughout the individual's life. d. slow in the early stages and rapid during late stages.

ANSWER: a 50. Recent research on Alzheimer’s Disease reveals that: a. it is likely to go away on its own. b. some people with Alzheimer’s actually increase their cognitive functioning. c. early diagnosis can potentially impact the development of the disease. d. All of the answers are correct.

ANSWER: c 51. What is the approximate average survival time of a patient diagnosed with neurocognitive disorder due to Alzheimer's disease? a. 4 years b. 8 years c. 15 years d. 20 years ANSWER: b 52. Symptoms of neurocognitive disorder due to Alzheimer's disease typically appear during the a. 40s and 50s b. 50s and 60s c. 60s and 70s d. 70s and 80s ANSWER: c 53. Research suggests that Alzheimer’s disease accounts for about a. 15% b. 25% c. 50% d. 75% ANSWER: c

.

of the cases of neurocognitive disorder.

54. Which of the following individuals has the greatest risk of developing neurocognitive disorder due to Alzheimer's disease? a. Paul, who is wealthy and well educated. b. Rena, who completed college although she has an average IQ. c. Jason, who is extremely bright but never finished college. d. Carrie, who dropped out of school when she was very young.

ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition 55. One hypothesis to explain the observed differences in the rate of neurocognitive disorder due to Alzheimer's disease for individuals of varying educational level is that a. the abilities acquired through formal education create a “mental reserve” that helps offset the symptoms of the illness as they progress. b. the type of mental activity associated with formal education places an additional burden on the brain that makes symptoms worse once a person has the disorder. c. knowledge acquired through formal education helps one avoid exposure to environmental stimuli that might influence the disorder. d. the type of work that most college graduates pursue is less likely to expose the individual to the stressors associated with the disorder.

ANSWER: a 56. In regard to neurocognitive disorder due to Alzheimer's disease, the biological “cognitive reserve” hypothesis suggests that a. skills acquired through formal education can actually enhance the early symptoms of the illness. b. the more synapses one develops throughout life, the more neuronal death required before the person becomes impaired. c. individuals with neurocognitive disorder due to Alzheimer's disease never had reserve neurons. d. neurocognitive disorder due to Alzheimer's disease is caused by a lack of formal education.

ANSWER: b 57. What is the biological version of the theory that states that formal education helps insulate people from the effects of neurocognitive disorder due to Alzheimer's disease? a. Mind-body hypothesis b. Neuronal network theory c. Cognitive reserve hypothesis d. Cortical activity theory ANSWER: c 58. Higher levels of education are associated with a. the prevention of neurocognitive disorder due to Alzheimer's disease. b. a delay in the onset of symptoms of neurocognitive disorder due to Alzheimer's disease. c. a slow course of deterioration after neurocognitive disorder due to Alzheimer's disease first starts. d. the rapid onset of symptoms in neurocognitive disorder due to Alzheimer's disease.

ANSWER: b 59. The theory that the more synapses a person develops, the more neurons must die before the signs of neurocognitive disorder due to Alzheimer's disease are apparent is called the . a. cognitive reserve hypothesis b. synaptic deterioration hypothesis c. oversight theory d. genetic hypothesis ANSWER: a 60. According to the most recent research, which of the following statements is TRUE concerning ethnic background and the development of neurocognitive disorder due to Alzheimer's disease?

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Chapter 16 Aging and Neurocognition a. Japanese, Nigerian, and Amish individuals have lower prevalence of the disorder. b. The illness is found in roughly the same numbers across all ethnic groups. c. Educated European ethnic groups have a lower rate of getting the disease. d. Native Americans have a slightly higher rate of the disorder.

ANSWER: b 61. Which of the following statements is TRUE with regard to the rate of neurocognitive disorder due to Alzheimer's disease for different demographic groups? a. Males and certain racial groups appear to have lower rates of the disorder. b. No differences are found in the rate of neurocognitive disorder due to Alzheimer's disease by gender, but some racial differences have been noted. c. No differences are found in the rate of neurocognitive disorder due to Alzheimer's disease by race, but women appear to have a higher rate of the disorder than men. d. No differences in the rate of the disorder by race or gender have been noted.

ANSWER: c 62. Which of the following statements is TRUE about vascular neurocognitive disorder? a. The prevalence rate is 25% for those over age 80. b. The risk for women is slightly higher than men. c. The outcome is similar to that of neurocognitive disorder due to Alzheimer's disease. d. The onset is about the same as for neurocognitive disorder due to Alzheimer's disease.

ANSWER: c 63. There are fewer studies on vascular neurocognitive disorder because a. it is less serious than neurocognitive disorder due to Alzheimer’s disease. b. of its lower incidence rates as compared to Alzheimer’s disease. c. its cause is clear and not in need of research. d. none of the above ANSWER: b 64. A key difference between vascular neurocognitive disorder and Alzheimer’s disease is/are a. rate of onset b. prevalence c. gender distribution d. all of the above ANSWER: d

.

65. Why are the symptoms of vascular neurocognitive disorder so different in each patient? a. It is not known why patients with vascular neurocognitive disorder have different symptoms. b. The symptoms relate to the area of the brain damaged. c. The symptoms depend upon the person's other medical conditions. d. Patients tend to be elderly and easily confused.

ANSWER: b 66. The risk of developing vascular neurocognitive disorder is Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition a. greater for women than men. b. greater for men than women. c. equal for men and women. d. greater for men in Western cultures, but equal for men and women in other cultures.

ANSWER: b 67. Which of the following statements is TRUE regarding the different types of neurocognitive disorder? a. All forms of neurocognitive disorder have the same onset, symptoms, and course. b. Vascular neurocognitive disorder has a more rapid onset and patients suffer a much more rapid demise than with the other forms of neurocognitive disorder. c. Vascular neurocognitive disorder has a more rapid onset and results in fewer deficits than neurocognitive disorder due to Alzheimer’s disease. d. Vascular neurocognitive disorder has a more rapid onset than neurocognitive disorder due to Alzheimer’s disease, although the course and outcome are similar.

ANSWER: d 68. All of the following are causes of neurocognitive disorder EXCEPT a. HIV b. vitamin B12 deficiency c. pneumonia d. chronic traumatic encephalopathy ANSWER: c 69. Neurocognitive disorder caused by HIV appears to be due to a. the HIV infection itself b. side effects of medications used to treat HIV c. opportunistic infections that occur in HIV patients d. chemical imbalances in the brain ANSWER: a

.

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70. The neurocognitive disorder experienced by HIV patients primarily affects areas of the brain in the a. meninges b. hindbrain c. inner areas of the brain d. brain stem ANSWER: c

.

71. Neurocognitive disorder due to HIV is more likely to cause _________________ than neurocognitive disorder due to Alzheimer’s disease. a. death b. short-term memory loss c. long-term memory loss d. severe depression ANSWER: d

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Chapter 16 Aging and Neurocognition 72. The differing patterns of impairment associated with neurocognitive disorder due to Alzheimer's disease and neurocognitive disorder due to HIV are primarily attributable to a. the different areas of the brain affected. b. the immune response to the virus in HIV patients. c. psychosocial differences in the lives of the typical patients with each disorder. d. unexplained causes.

ANSWER: a 73. Early symptoms of HIV-induced neurocognitive disorder include: a. seizures. b. forgetfulness. c. susceptibility to brain infection. d. all of these answers are correct.

ANSWER: b 74. The introduction of new medications for AIDS (e.g., HAARTs) has ________________ the percentage of patients who develop neurocognitive disorder. a. increased b. decreased c. eliminated d. had no effect on ANSWER: b 75. If Jane's neurocognitive disorder is caused by a process that has damaged her brain's dopamine pathways, it can be assumed that this condition is caused by ____________________________ . a. head trauma b. Parkinson's disease c. Huntington's disease d. neurocognitive disorder due to Alzheimer’s disease ANSWER: b 76. The involuntary limb movements in Huntington’s Disease are known as: _________________________________________________ . a. infarctions b. delirium tremors c. chorea d. chronic tremors ANSWER: c 77. Parkinson’s disease is associated with _____________________ . a. subcortical neurocognitive disorder b. delirium tremens c. delirium d. development of a Trendelenburg gait ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition 78. Parkinson’s disease affects _____________________________ . a. 1% to 3% of people b. 5% of people c. 10% of people over the age of 90 d. It cannot be estimated how many people have Parkinson’s Disease ANSWER: a 79. Only some of the patients diagnosed with ___________________ and ___________________ go on to develop neurocognitive disorder. a. Alzheimer's; Huntington's disease b. Pick's disease; Huntington's disease c. Huntington's disease; Parkinson's disease d. Parkinson's disease; Pick's disease ANSWER: c 80. Compared to most disorders, Huntington's disease is very unusual because it is a. the result of one gene. b. influenced by many genes. c. always a cause of neurocognitive disorder. d. associated with subcortical impairment.

ANSWER: a 81. The disorder that causes a form of neurocognitive disorder called Creutzfeldt-Jakob disease is a variant of a. Huntington's disease. b. Pick's disease. c. neurocognitive disorder due to Alzheimer’s disorder. d. bovine spongiform encephalopathy (”mad cow disease”).

ANSWER: d 82. The symptoms of substance/medication-induced neurocognitive disorder are most similar to the symptoms observed in _______________. a. vascular neurocognitive disorder b. neurocognitive disorder due to Alzheimer’s disease c. Huntington's disease d. HIV-induced neurocognitive disorder ANSWER: b 83. The symptoms of substance/medication-induced neurocognitive disorder are generally associated with a. toxic effects of the substances. b. temporary impairment in brain functioning. c. permanent brain damage. d. poor diet and self-care behaviors.

ANSWER: c

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Chapter 16 Aging and Neurocognition 84. The research finding of a negative correlation between smoking and neurocognitive disorder due to Alzheimer's disease is generally interpreted to mean that a. research findings are sometimes in error. b. nicotine protects against neurocognitive disorder due to Alzheimer’s disease for most people. c. smoking may be helpful in protecting people at high risk for Alzheimer's disease. d. smoking may shorten the lives of smokers so they do not live long enough to develop neurocognitive disorder due to Alzheimer’s disease.

ANSWER: d 85. Genetic research suggests that Alzheimer’s disease is linked to a. Down syndrome through chromosome 21. b. Parkinson’s Disease through a single gene. c. depression through chromosome 12. d. Huntington’s disease due to a genetic mutation.

ANSWER: a 86. Which disorder is associated with the formation of neurofibrillary tangles and amyloid plaques in the brain? a. Huntington's disease b. Pick's disease c. neurocognitive disorder due to Alzheimer's disease d. Creutzfeldt-Jakob disease ANSWER: c 87. The neurofibrillary tangles associated with neurocognitive disorder due to Alzheimer's disease are best described as a. tangled, strand-like filaments in brain cells. b. tangled, strand-like filaments throughout the nervous system. c. gummy protein deposits in the cortex. d. gummy protein deposits throughout the nervous system.

ANSWER: a 88. The amyloid plaques that accumulate in the brain of patients with neurocognitive disorder due to Alzheimer's disease are best described as a. tangled, strand-like filaments. b. gummy protein deposits. c. plaques of dead nerve cells. d. mineral deposits.

ANSWER: b 89. Research into the causes of neurocognitive disorder due to Alzheimer's disease indicates the influence of a. multiple genes. b. a single gene. c. environmental toxins. d. high levels of aluminum.

ANSWER: a

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Chapter 16 Aging and Neurocognition 90. The late onset form of Alzheimer’s disease is related to chromosome ________________ . a. 21 b. 14 c. 19 d. 12 ANSWER: c 91. A gene with a 100% chance of causing Alzheimer disease is identified as __________________ . a. deterministic b. susceptible c. relative d. functional ANSWER: a 92. If the presence of a gene means you have a 100% chance of developing the disease, the gene is considered ________________. a. deterministic b. reductionistic c. susceptible d. absolutist ANSWER: a 93. Some studies suggest that deposits of ___________ cause the cell death associated with Alzheimer’s disease. a. amyloid beta b. fat c. cholesterol d. protein ANSWER: a 94. A possible external cause of neurocognitive disorder involves __________________ . a. repeated head trauma b. constant stress c. sleep deprivation d. smoking ANSWER: a 95. One theory about the development of neurocognitive disorder due to Alzheimer’s disease suggests that the formation of solid waxy proteins in the brain causes the disorder in a process similar to a. cholesterol build-up in blood vessels causing cardiovascular disease. b. vascular spasms causing migraines. c. head trauma causing neuronal death. d. formation of scar tissue following an injury.

ANSWER: a 96. The gene responsible for producing amyloid precursor protein (APP) appears to explain the development of Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition a. neurocognitive disorder due to Alzheimer’s disease in general. b. late onset neurocognitive disorder due to Alzheimer’s disease. c. non-Alzheimer's type of neurocognitive disorder that tends to affect unique populations, such as those with strong family history of the disorder. d. early onset neurocognitive disorder due to Alzheimer’s disease and the higher frequency of the disorder in Down Syndrome patients.

ANSWER: d 97. The greater the number of apolipoprotein (apo E4) genes an individual possesses, the a. more likely the individual is to develop vascular neurocognitive disorder. b. less likely the individual is to develop vascular neurocognitive disorder. c. more likely the individual is to develop neurocognitive disorder due to Alzheimer’s disease. d. less likely the individual is to develop neurocognitive disorder due to Alzheimer’s disease.

ANSWER: c 98. Apolipoprotein (apo E4) is associated with the development of neurocognitive disorder because apo E4 a. helps insulate neurons from various toxins. b. results in neurofibrillary tangles. c. causes aluminum to concentrate in the brain. d. helps transport amyloid protein through the bloodstream.

ANSWER: d 99. In regard to neurocognitive disorder due to Alzheimer’s disease, having two genes for apolipoprotein (apo E4) a. increases the risk of developing neurocognitive disorder due to Alzheimer’s disease, but does not relate to the age of onset. b. decreases the risk of developing neurocognitive disorder due to Alzheimer’s disease and raises the average age of onset. c. decreases the risk of developing neurocognitive disorder due to Alzheimer’s disease but lowers the average age of onset. d. increases the risk of developing neurocognitive disorder due to Alzheimer’s disease and decreases the average age of onset.

ANSWER: d 100. The condition called dementia pugilistica is diagnosed in _______________. a. baseball players b. boxers c. bowlers d. basketball players ANSWER: b 101. Individuals who have the apo E44 gene ______________ of developing Alzheimer's disease. a. are at increased risk b. have nearly a 100% chance c. are not at risk d. may or may not be at risk Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition ANSWER: a 102. All of the following are considered deterministic genes EXCEPT ___________. a. presenilin-1 b. presenilin-2 c. apo E44 d. ß-amyloid precursor ANSWER: c 103. Which of the following environmental stressors appears to be a significant factor in the later development of neurocognitive disorder (including that caused by Alzheimer's disease)? a. Smoking b. Low blood pressure c. Repeated head trauma d. Exposure to high levels of aluminum ANSWER: c 104. Recent research regarding the biological processes and genetic factors associated with neurocognitive disorder due to Alzheimer’s disease is best viewed as a. absolute fact. b. preliminary findings that need to be studied further. c. hypotheses that have yet to be tested. d. interesting theories regarding influences, though of little potential use for finding a way to predict and treat neurocognitive disorder.

ANSWER: b 105. The risk for developing neurocognitive disorder is influenced by all of the following psychological or social factors EXCEPT a. cigarette smoking. b. participation in sports such as boxing. c. personality traits such as extroversion. d. level of formal education.

ANSWER: c 106. Psychological and social influences involved in neurocognitive disorder a. help determine the onset and course. b. are direct causes. c. have no influence. d. have not been studied.

ANSWER: a 107. Treatment for Alzheimer's disease utilizes drugs that prevent the breakdown of acetylcholine including all of the following EXCEPT a. paroxetine (Paxil). b. tacrine hydrochloride (Cognex). c. donepezil (Aricept).

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Chapter 16 Aging and Neurocognition d. galantamine (Reminyl).

ANSWER: a 108. Appropriate treatment goals for a patient recently diagnosed with neurocognitive disorder include all of the following EXCEPT a. reverse the neurological damage already done. b. improve lifestyle to prevent further neurological damage. c. reduce the current rate of decline. d. learn strategies to compensate for existing limitations.

ANSWER: a 109. The primary treatment for neurocognitive disorder due to Alzheimer’s disease is a. antidepressant medication such as SSRIs. b. diet and exercise. c. vitamin B-12 supplements. d. medications such as Cognex or Aricept.

ANSWER: d 110. Patients with neurocognitive disorder due to Alzheimer’s disease benefit from medications that work by a. preventing the breakdown of acetylcholine. b. enhancing the level of dopamine. c. preventing the reuptake of serotonin. d. unknown mechanisms.

ANSWER: a 111. What is the typical response to medication that can be expected for a patient with neurocognitive disorder due to Alzheimer’s disease? a. About one year without symptoms b. Doubling of life expectancy c. Temporary improvement in abilities d. Relief of physical but not cognitive symptoms ANSWER: c 112. John was recently diagnosed with neurocognitive disorder due to Alzheimer’s disease. After researching his treatment options, he decides to try medication and attempt to make the most of his remaining abilities. John plans to stay as physically and mentally active as possible for as long as he can and to use compensation strategies if necessary. His decision a. makes little sense as there are more aggressive biological treatments that are effective. b. seems reasonable given the fact that there are no effective treatments available. c. ignores the additional demands that his decision will ultimately place on his caregivers. d. makes little sense since intensive psychosocial intervention has been shown to be effective.

ANSWER: b 113. Which of the following are problems associated with the medications used to treat neurocognitive disorder due to Alzheimer's disease? a. Abilities only improve to the same point where they were 6 months prior to treatment.

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Chapter 16 Aging and Neurocognition b. Any gains in ability are temporary. c. Many patients discontinue medication because of severe side effects and expense. d. All of these are significant problems with the medications used to treat neurocognitive disorder due to Alzheimer’s disease.

ANSWER: d 114. What is the primary goal of most psychosocial treatments for neurocognitive disorder? a. Relieve depression b. Enhancing the lives of those with the disease, as well as their family members. c. Treat the anxiety associated with knowing that the disorder is progressive d. Enhance family functioning ANSWER: b 115. During the late stages of neurocognitive disorder, the _________________ probably experiences the greatest need for psychosocial treatment. a. caregiver b. patient c. family d. healthcare provider ANSWER: a 116. Recent studies suggest that Ginkgo biloba has _____________ on memory. a. little or no impact b. a mild impact c. a moderate impact d. a major impact ANSWER: a 117. Of the following, which is NOT one of the potential consequences associated with caregiving for patients with neurocognitive disorder? a. Anxiety b. Depression c. Contagion d. Elder abuse ANSWER: c 118. In DSM-IV-TR, the organic mental disorders were relabeled as cognitive disorders because a. almost all disorders involve brain dysfunction. b. delirium and dementia involve cognitive symptoms while the other disorders don’t. c. delirium and dementia occur primarily in the very young. d. both a and b.

ANSWER: d 119. If the findings from the study regarding the writings of a group of Catholic nuns (Snowden et al., 1996) are correct, which of the following individuals is most likely to eventually develop neurocognitive disorder due to Alzheimer's disease?

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Chapter 16 Aging and Neurocognition a. John, whose writing is very descriptive and a bit bizarre. b. Mary, whose writing has many religious themes. c. Maureen, whose writing is mostly about animals. d. Lisa, whose writing describes events in very brief terms.

ANSWER: d 120. Some types of Down Syndrome predispose the individual to developing ________________. a. dementia pugilistica b. Parkinson's disease c. Alzheimer's disease d. vascular neurocognitive disorder ANSWER: c 121. What is the main reason that we do NOT have an effective treatment for neurocognitive disorder due to Alzheimer’s disease? a. The disorder affects the elderly who generally have many other health problems. b. We do not have a way to replace extensive brain damage. c. The amount of treatment research is considerably less for neurocognitive disorder than for other disorders. d. The cause is genetic.

ANSWER: b Subjective Short Answer 122. Describe delirium, its typical causes, and how it is treated.

ANSWER: Delirium is characterized by impaired consciousness and cognition during the course of hours or days.

People with delirium appear confused, disoriented, and out of touch. Their memory, language, and attention are impaired. Delirium increases with age and is often related to medical conditions such as cancer, HIV, drug use, poisons, and head injuries. Antipsychotic drugs can decrease symptoms, and psychosocial interventions can help patients and their families cope with emotional and mental changes caused by the disease.

123. With organic physiological causes, why are neurocognitive disorders often studied by psychologists rather than solely by medical doctors?

ANSWER: The consequences of a neurocognitive disorder often include profound changes in a person’s behavior and personality. Intense anxiety, depression, or both are common, especially among people with major neurocognitive disorder. In addition, paranoia is often reported, as are extreme agitation and aggression.

Families and friends are also profoundly affected by such changes. Imagine your emotional distress as a loved one is transformed into a different person, often one who no longer remembers who you are or your history together. The deterioration of cognitive ability, behavior, and personality and the effects on others are major concerns for mental health professionals.

124. What is the prevalence of Alzheimer’s Disease and why is it difficult to measure?

ANSWER: Globally, it is estimated that one new case of major neurocognitive disorder is identified every 7 seconds.

The methodology for estimating the number of those suffering from major neurocognitive disorder has resulted in sometimes diverging numbers. This is due to several factors. It is nearly impossible to detect Alzheimer’s until the patient is deceased. Memory loss is one symptom of Alzheimer’s that can often be attributed to other factors such as recent surgeries and other health concerns. Finally, in-home and familial care can delay diagnosis.

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Chapter 16 Aging and Neurocognition 125. Discuss cross-cultural differences in the diagnosis of Alzheimer’s Disease.

ANSWER: Early research seemed to suggest that certain populations (such as those with Japanese, Nigerian, certain Native American, and Amish backgrounds) were less likely to be affected. Similarly, prevalence rates of Alzheimer’s disease in low and middle-income countries have also been reportedly lower than higher income countries. More recent work indicates, however, that some of these differences may be due to lower numbers in those who seeks assistance (possibly due to stigma as well high levels of social care from family members), as well as differences in education and how the disorders were measured. For example, individuals in low and middle-income countries did not meet DSM criteria for the disorder. They did not have the social or occupational interference since their families were taking care of them.

126. Describe the differences and similarities between neurocognitive disorder due to Alzheimer’s disease and vascular neurocognitive disorder. Why it is not always possible to determine the actual cause of neurocognitive disorder while the patient is alive?

ANSWER: Neurocognitive disorder is a condition characterized by the gradual deterioration of brain function that affects thought, judgment, memory, and language. Alzheimer’s disease is the most common cause of neurocognitive disorder. People with this disease experience difficulty forming new memories, eventually have trouble remembering older information, and show deficits in orientation, judgment, and language problems as well. Physiologically, the brains of Alzheimer’s patients show plaques and tangles. Vascular neurocognitive disorder refers to memory loss due to stroke, which interrupts the flow of oxygen and nutrients to brain tissue and causes physical damage to neurons. The extent of damage is a function of the amount and location of the damage, which occurs more suddenly than in Alzheimer’s disease but can include disruptions in language, thought, memory, and motor functions. Because the symptoms of these two disorders overlap, autopsies have to be done in order to make a definitive diagnosis.

127. Explain how neurocognitive disorder due to Alzheimer’s disease is usually treated. Include information about medication and psychosocial therapies. How would you characterize the success of the currently available treatment options for neurocognitive disorder due to Alzheimer’s disease?

ANSWER: A number of drugs have been developed to treat Alzheimer’s disease. Most of these medications work by preventing ACH breakdown. These drugs slow the progression of the disease, but are not a cure. Vitamins and herbal remedies have been used with mixed results, and antidepressants and antipsychotics can be used to manage the emotional and cognitive symptoms of the disorder. Psychosocial approaches focus on improving the lives of patients by teaching them memory tricks and promoting cognitive stimulation.

128. How does a holistic psychosocial intervention best serve someone with a cognitive impairment?

ANSWER: The recommended first line of treatment for a person experiencing delirium is psychosocial intervention. The goal of nonmedical treatment is to reassure the individual to help them deal with the agitation, anxiety, and hallucinations of delirium. The inclusion of a family member in the care for patients with delirium, such as overnight stays with the patient, may be a great comfort to the patient. Similarly, familiar personal belongings such as family photographs may also be an easy and comforting intervention. Also, a patient who is included in all treatment decisions retains a sense of control that can aid patients cope with anxiety and agitation due to the delirium Some evidence suggests that this type of support can also delay institutionalization for elderly patients.

129. Explain the relationship that has been observed between formal education and the development of neurocognitive disorder due to Alzheimer’s disease. What theoretical and neurological explanations have been offered for this observation?

ANSWER: People with higher education levels seem to function more effectively than other patients with the same level of brain dysfunction. Theoretically, they have more complex neuronal pathways and so have greater cognitive resources at their disposal. Referred to as the cognitive reserve hypothesis, this model suggests that the more synapses a person develops over the course of their life the more neuronal death must take place Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition before the signs of neurocognitive disorder would be evident. It is theoretically possible, therefore, that more educational achievement will “strengthen” the brain against this illness by creating greater interconnections of neurons. This will delay the onset of symptoms in some cases.

130. Describe recent research on the prevention of neurocognitive disorders. Give an example.

ANSWER: It is very difficult to study prevention efforts for neurocognitive disorders because of the need to follow individuals for long periods to see whether the efforts are effective. One major study conducted in Sweden— where socialized medicine provides complete medical histories of all residents—looked at many risk and protective factors. Risk factors include things that increase the chance of having neurocognitive disorder.

Protective factors include things that decrease the risk. Researchers looked at the medical records of 1810 participants who were older than 75 years and followed them for about 13 years. Through interviews and medical histories, they came to three major conclusions: control your blood pressure, do not smoke, and lead an active physical and social life! You cannot change your genetics, however. Additional prevention research is ongoing, and there may be other potentially fruitful research areas that can lead to successful prevention.

Essay 131. Describe delirium, its typical causes, and how it is treated.

ANSWER: Delirium is characterized by impaired consciousness and cognition during the course of hours or days.

People with delirium appear confused, disoriented, and out of touch. Their memory, language, and attention are impaired. Delirium increases with age and is often related to medical conditions such as cancer, HIV, drug use, poisons, and head injuries. Antipsychotic drugs can decrease symptoms, and psychosocial interventions can help patients and their families cope with emotional and mental changes caused by the disease.

132. With organic physiological causes, why are neurocognitive disorders often studied by psychologists rather than solely by medical doctors?

ANSWER: The consequences of a neurocognitive disorder often include profound changes in a person’s behavior and personality. Intense anxiety, depression, or both are common, especially among people with major neurocognitive disorder. In addition, paranoia is often reported, as are extreme agitation and aggression.

Families and friends are also profoundly affected by such changes. Imagine your emotional distress as a loved one is transformed into a different person, often one who no longer remembers who you are or your history together. The deterioration of cognitive ability, behavior, and personality and the effects on others are major concerns for mental health professionals.

133. What is the prevalence of Alzheimer’s Disease and why is it difficult to measure?

ANSWER: Globally, it is estimated that one new case of major neurocognitive disorder is identified every 7 seconds.

The methodology for estimating the number of those suffering from major neurocognitive disorder has resulted in sometimes diverging numbers. This is due to several factors. It is nearly impossible to detect Alzheimer’s until the patient is deceased. Memory loss is one symptom of Alzheimer’s that can often be attributed to other factors such as recent surgeries and other health concerns. Finally, in-home and familial care can delay diagnosis.

134. Discuss cross-cultural differences in the diagnosis of Alzheimer’s Disease.

ANSWER: Early research seemed to suggest that certain populations (such as those with Japanese, Nigerian, certain Native American, and Amish backgrounds) were less likely to be affected. Similarly, prevalence rates of Alzheimer’s disease in low and middle-income countries have also been reportedly lower than higher income countries. More recent work indicates, however, that some of these differences may be due to lower numbers in those who seeks assistance (possibly due to stigma as well high levels of social care from family members), as well as differences in education and how the disorders were measured. For example, Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition individuals in low and middle-income countries did not meet DSM criteria for the disorder. They did not have the social or occupational interference since their families were taking care of them.

135. Describe the differences and similarities between neurocognitive disorder due to Alzheimer’s disease and vascular neurocognitive disorder. Why it is not always possible to determine the actual cause of neurocognitive disorder while the patient is alive?

ANSWER: Neurocognitive disorder is a condition characterized by the gradual deterioration of brain function that affects thought, judgment, memory, and language. Alzheimer’s disease is the most common cause of neurocognitive disorder. People with this disease experience difficulty forming new memories, eventually have trouble remembering older information, and show deficits in orientation, judgment, and language problems as well. Physiologically, the brains of Alzheimer’s patients show plaques and tangles. Vascular neurocognitive disorder refers to memory loss due to stroke, which interrupts the flow of oxygen and nutrients to brain tissue and causes physical damage to neurons. The extent of damage is a function of the amount and location of the damage, which occurs more suddenly than in Alzheimer’s disease but can include disruptions in language, thought, memory, and motor functions. Because the symptoms of these two disorders overlap, autopsies have to be done in order to make a definitive diagnosis.

136. Explain how neurocognitive disorder due to Alzheimer’s disease is usually treated. Include information about medication and psychosocial therapies. How would you characterize the success of the currently available treatment options for neurocognitive disorder due to Alzheimer’s disease?

ANSWER: A number of drugs have been developed to treat Alzheimer’s disease. Most of these medications work by preventing ACH breakdown. These drugs slow the progression of the disease, but are not a cure. Vitamins and herbal remedies have been used with mixed results, and antidepressants and antipsychotics can be used to manage the emotional and cognitive symptoms of the disorder. Psychosocial approaches focus on improving the lives of patients by teaching them memory tricks and promoting cognitive stimulation.

137. How does a holistic psychosocial intervention best serve someone with a cognitive impairment?

ANSWER: The recommended first line of treatment for a person experiencing delirium is psychosocial intervention. The goal of nonmedical treatment is to reassure the individual to help them deal with the agitation, anxiety, and hallucinations of delirium. The inclusion of a family member in the care for patients with delirium, such as overnight stays with the patient, may be a great comfort to the patient. Similarly, familiar personal belongings such as family photographs may also be an easy and comforting intervention. Also, a patient who is included in all treatment decisions retains a sense of control that can aid patients cope with anxiety and agitation due to the delirium Some evidence suggests that this type of support can also delay institutionalization for elderly patients.

138. Explain the relationship that has been observed between formal education and the development of neurocognitive disorder due to Alzheimer’s disease. What theoretical and neurological explanations have been offered for this observation?

ANSWER: People with higher education levels seem to function more effectively than other patients with the same level of brain dysfunction. Theoretically, they have more complex neuronal pathways and so have greater cognitive resources at their disposal. Referred to as the cognitive reserve hypothesis, this model suggests that the more synapses a person develops over the course of their life the more neuronal death must take place before the signs of neurocognitive disorder would be evident. It is theoretically possible, therefore, that more educational achievement will “strengthen” the brain against this illness by creating greater interconnections of neurons. This will delay the onset of symptoms in some cases.

139. Describe recent research on the prevention of neurocognitive disorders. Give an example.

ANSWER: It is very difficult to study prevention efforts for neurocognitive disorders because of the need to follow individuals for long periods to see whether the efforts are effective. One major study conducted in Sweden— where socialized medicine provides complete medical histories of all residents—looked at many risk and Copyright Cengage Learning. Powered by Cognero.

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Chapter 16 Aging and Neurocognition protective factors. Risk factors include things that increase the chance of having neurocognitive disorder.

Protective factors include things that decrease the risk. Researchers looked at the medical records of 1810 participants who were older than 75 years and followed them for about 13 years. Through interviews and medical histories, they came to three major conclusions: control your blood pressure, do not smoke, and lead an active physical and social life! You cannot change your genetics, however. Additional prevention research is ongoing, and there may be other potentially fruitful research areas that can lead to successful prevention.

Copyright Cengage Learning. Powered by Cognero.

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MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

1) Two treatment elements that are combined in the management of all psychological disorders are: A) the therapeutic relationship and psychological techniques B) medications and psychological techniques C) transference and countertransference D) interpretation and insight Answer: A 2) Two key therapeutic elements in the treatment of behaviour disorders are not only the therapy

techniques but also the A) problem severity C) therapeutic relationship

.

B) client's motivation D) client's openness

Answer: C 3) Though psychological treatments and medications are often thought of as the main curative

elements in psychotherapy, often positive changes are produced as a function of the power of .

A) countertransference B) behaviour modification C) the therapeutic relationship D) insight Answer: C 4) Bob has been feeling rather down and depressed the past few months and is considering talking to

someone about his problems. Which of the following professionals is Bob more likely to consult with first?

A) a family physician B) a psychiatric social worker C) a psychiatrist D) a psychologist Answer: A 5) Which of the following mental-health professionals receives his or her training in medical school?

A) a clinical psychologist

B) a psychiatrist

C) a marriage and family counsellor

D) a psychiatric social worker

Answer: B 6) Which of the following mental-health professionals are medical doctors specializing in

psychotherapy and biomedical treatments?

A) counselling psychologists C) psychiatrists

B) family counsellors D) clinical psychologists

Answer: C 7) Helping people achieve greater insight, which is an awareness of the underlying dynamics of their

problems, is the primary therapeutic goal of A) behaviour modification C) humanistic therapy

.

B) cognitive therapy D) psychoanalysis

Answer: D 1

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8) The goal of psychoanalysis is to: A) help clients achieve insight.

B) change the client's negative transference to positive transference.

C) help clients understand their resistance to the therapeutic process.

D) analyze and resolve the client's transference reactions.

Answer: A 9) Susan has an anxiety disorder and has sought help from a therapist, Dr. Jones. Dr. Jones believes

that Susan's anxiety is related to her unconscious fear of her unmet sexual impulses and that in order for Susan to get over her anxiety problem, she needs to have greater awareness of this unconscious dynamics. Dr. Jones appears to be trying to produce positive changes by fostering more insight and is most likely associated with the approach to therapy.

A) psychoanalytic B) cognitive C) humanistic D) interpersonal Answer: A 10) Kelly's therapist listens to her talk about the problems she is having this school year but continues to

ask about events and emotions Kelly experienced as a child and hasn't thought about in ages. Her therapist believes she will change the unconscious factors that are creating her inability to deal with her current maladaptive behaviours by helping Kelly achieve .

A) self-actualization B) counterconditioning C) insight D) positive transference Answer: C 11) A therapist asks her client to begin sharing the various thoughts and feelings that are currently in her

awareness. This continues for several minutes, with the client commenting on the changing process of what is appearing in her conscious mind. This therapist is using the therapeutic technique known as: A) analyzing the transference.

B) insight.

C) random reporting.

D) free association.

Answer: D 12) The techniques of free association and dream analysis are similar in that both are used to: A) access unconscious material.

B) increase feelings of unconditional positive regard.

C) identify important antecedents and consequences.

D) identify maladaptive thinking.

Answer: A 13) According to psychoanalytic theory, which of the following is "the royal road to the unconscious"?

A) free association

B) dreams

C) transference

Answer: B

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D) fixations

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14) Psychoanalysts study the dreams of their patients because it is assumed that dreams: A) express unconscious wishes and fantasies that are typically repressed during the day.

B) represent the patients' first attempts at resistance in therapy.

C) represent the patients' unconscious attempts to successfully solve their problems.

D) contain the essential elements of the transference.

Answer: A 15) In psychoanalytic theory, it is assumed that while the person may consciously want help, there may

be an unconscious motivation not to change. The defensive patterns that disrupt therapy and function to maintain the present condition are called: A) repression.

B) resistance.

C) transference.

D) insight.

Answer: B 16) John has made little progress during his last few months in therapy, but just last week, his therapist

thought that he was close to gaining some important awareness about his unconscious patterns.

John's therapist is eager for their next session, but when John's appointment time comes, John does not show up and phones later to apologize, saying that he accidentally forgot about it.

Psychoanalytic theorists would most likely interpret John's behaviour as an example of: A) resistance.

B) free association.

C) negative transference.

D) repression.

Answer: A 17) While listening to his client talk about her favourite memories from childhood, Dr. Peabody begins

to notice that whenever his patient's thoughts approach her sister, she quickly changes the topic and talks about something else. When Dr. Peabody begins probing her memories and thoughts about her sister, his client starts missing therapy appointments often cancelling without notice. This defensive manoeuvre is known as .

A) free association B) resistance C) modelling D) transference Answer: B 18) Her stepfather abused Samantha emotionally and physically. Now, as a young adult, she is working

with a therapist to resolve some of her low self-esteem and relationship issues. Over the course of therapy, Samantha begins to feel great anger toward her male therapist, telling him how much she resents his control over her. She almost quits therapy because she begins to feel that he is too controlling and makes her feel so insignificant. Her therapist is able to show Samantha that she is acting irrationally and has experienced a of her feelings to her therapist.

A) positive transference B) free association C) negative transference D) resistance Answer: C 19) When a therapy client responds to his therapist as if the therapist was an important figure from his

past,

is said to occur.

A) resistance B) transference

C) wish fulfillment

Answer: B

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D) insight

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20) During the course of therapy, a client develops strong emotional feelings for his therapist. He thinks

about her often and though he is unwilling to admit it, he has become quite dependent on and attracted to her. Though he is only just becoming aware of this, he has noticed that his therapist in many ways reminds him of his mother. This example best demonstrates the psychoanalytic concept of: A) free association.

B) insight.

C) resistance.

D) transference.

Answer: D 21) In psychoanalytic theory, any statement made by the therapist that is intended to help the client gain

insight into their behaviour or dynamics is called: A) an explication B) a clarification

C) an explanation

D) an interpretation

Answer: D 22) Which of the following is considered to be the primary or chief therapeutic technique used by

psychoanalysts to help clients gain awareness of important material?

A) transference B) interpretation C) dream analysis

D) free association

Answer: B 23) After several months of psychoanalytic therapy, a psychoanalyst makes the comment to his client:

"It seems as if you're responding to me as if I was your father and you believe that you have significantly disappointed me." This statement is best considered as an example of: A) an interpretation.

B) a free association.

C) an explanation.

D) resistance.

Answer: A 24) To increase the insight of their clients, psychoanalysts use the primary therapeutic technique of

.

A) free association

B) transference

C) resistance

D) interpretation

Answer: D 25) Which of the following was mentioned as a difference between traditional and brief psychodynamic

therapy?

A) Brief psychodynamic therapy tends to focus on current life problems while traditional psychoanalysis attempts to rebuild the client's personality.

B) In brief psychodynamic therapy, the therapist is considerably less active than in traditional psychoanalysis.

C) Brief psychodynamic therapy relies more heavily on free association than traditional psychoanalysis does.

D) Brief psychodynamic therapy pays significantly less attention to the importance of insight than traditional psychoanalysis does.

Answer: A

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26) Studies showing that most of the therapeutic improvement of clients occurs by the 10th session of

psychodynamic therapy were presented to make the argument that: A) traditional long-term psychoanalysis yields significantly better patient outcomes than brief psychodynamic therapy does.

B) brief psychodynamic therapy is a viable and effective alternative to traditional psychoanalysis.

C) interpretations do not appear to be necessary for psychodynamic therapy to be effective.

D) there is little empirical evidence supporting the psychodynamic concept of resistance.

Answer: B 27) All of the following are differences between traditional psychoanalysis and brief psychodynamic

therapies except: A) the therapists conducting brief psychodynamic therapies are usually more active.

B) most brief psychodynamic therapies do not make use of insight or interpretation.

C) most brief psychodynamic therapies replace free association with talking.

D) most brief psychodynamic therapies focus on current life problems rather than the reconstruction of personality.

Answer: B 28) Which of the following therapeutic approaches is considered to be a brief therapy based primarily on

the principles of psychoanalysis?

A) rational-emotive therapy C) client-centred therapy

B) cognitive therapy D) interpersonal therapy

Answer: D 29) The assumption that psychological disorders are produced by the blockage of natural tendencies

toward personal growth is most consistent with the: A) behavioural approach.

C) humanistic approach.

B) cognitive approach.

D) psychodynamic approach.

Answer: C 30) According to the humanistic theorist Carl Rogers, the "active ingredient" in therapy is

for

which he identified three important and interrelated therapist attributes.

A) the therapeutic relationship B) the client's personality C) the client's own self-exploration D) the therapist's personality Answer: A 31) A therapist who takes a humanistic approach to psychotherapy would most likely have the goal of

creating a therapeutic environment that: A) discovers unconscious impulses.

C) challenges irrational thoughts.

B) reinforces desired behaviours.

D) allows for self-exploration.

Answer: D

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32) Cathy has been seeing a therapist for a month. The therapy sessions focus on showing Cathy that she

can control her actions and how she should take responsibility for her behaviour. Most likely, her therapist is coming from a perspective.

A) psychodynamic B) trait C) humanistic D) behavioural Answer: C 33) In contrast to a psychoanalytic therapy session, the perspective that focuses on the present and future

instead of the past is the A) humanistic

perspective.

B) behavioural

C) biological

D) trait

Answer: A 34) Though they are usually considered to be quite different, the psychoanalytic and the humanistic

approaches to psychotherapy are similar in that: A) they both have similar conceptualizations of humans and human nature.

B) they both assume that childhood events play an important role in psychological disorders.

C) the humanistic perspective is essentially an extension of basic psychoanalytic principles.

D) they both rely heavily on the use of dreams and interpretations.

Answer: B 35) Mary has been working with a therapist because she has felt very confused and unsure about herself

for the past few years. Mary's therapist tends to be very nondirective and devotes a great deal of the session to allowing Mary to explore her identity, wants, and dreams for the future. The therapist rarely gives direct advice and instead is primarily interested in helping Mary clarify her own ideas and feelings. Mary's therapist is most likely associated with the perspective of psychotherapy.

A) behavioural B) cognitive C) humanistic D) psychoanalytic Answer: C 36) All of the following were mentioned by Carl Rogers as important and essential therapist

characteristics EXCEPT: A) genuineness.

C) unconditional positive regard.

B) empathy.

D) congruence.

Answer: D 37) According to Carl Rogers, the most important curative agent in psychotherapy is: A) the relationship between client and therapist.

B) increased awareness of negative thoughts.

C) self-actualization.

D) the development of insight.

Answer: A

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38) A humanistic therapist's refusal to offer advice or guidance to his or her client is best representative

of the client-centred therapist attribute of: A) unconditional positive regard.

C) resistance.

B) empathy.

D) genuineness.

Answer: A 39) A therapist takes a moment to paraphrase what he has just heard his client say in a way that

accurately captures the feelings the client was experiencing. In client-centred therapy, this would be considered an example of reflecting, and this technique is often used to foster the important therapist characteristic of .

A) unconditional positive regard B) empathy C) interpretation D) genuineness Answer: B 40) A therapist feels frustrated because her client has recently missed three of her last five appointments.

If the therapist were to express these negative feelings to her client, this would best demonstrate Carl Rogers's important therapist characteristic of: A) empathy.

B) sympathy.

C) genuineness.

D) unconditional positive regard.

Answer: C 41) Which of the following therapeutic approaches is considered to be a humanistic approach to

therapy?

A) free association therapy C) Gestalt therapy

B) rational-emotive therapy D) cognitive therapy

Answer: C 42) This therapy is often conducted in a group format, it sometimes incorporates role-playing, and it can

be rather confrontational. This is A) cognitive behavioural C) Gestalt

therapy.

B) psychodynamic D) rational-emotive

Answer: C 43) Carl is involved in a therapy group in which he is frequently asked to role-play various people and

even inanimate objects in order to gain more access to feelings from which he has been cut-off. The therapist facilitating the group is rather imaginative when suggesting activities for the group and has been known to be challenging every now and then. Carl's therapy group is most likely based on the principles of: A) cognitive therapy.

B) person-centered therapy.

C) Gestalt therapy.

D) interpersonal therapy.

Answer: C

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44) The Gestalt therapy approach of Fritz Perls is largely based on: A) perceptual principles that describe how different stimuli are perceived.

B) operant conditioning principles that describe how associations between behaviours and

consequences are learned.

C) classical conditioning principles that describe how associations between stimuli are learned.

D) social learning principles that describe how people can learn from modelling and behavioural

observations.

Answer: A 45) Carl Rogers and Fritz Perls were similar in all of the following ways EXCEPT: A) Their therapies are both considered to be humanistic in nature.

B) They both asserted that self-exploration is important for growth and health.

C) They both assumed the existence of a self-actualizing tendency.

D) They both agreed in the importance of validating their therapies through research.

Answer: D 46) The decrease in popularity of Gestalt therapy may have been due to: A) the strong psychoanalytic influence on his approach to therapy.

B) extensive research that found the techniques of Gestalt therapy are ineffective.

C) the fact that Fritz Perls was not interested in testing his ideas through research.

D) the personal conflict that he had with the more popular Carl Rogers.

Answer: C 47) Josh is visiting a friend when he accidentally breaks a valuable plate. He begins to berate himself for

his clumsiness and stupidity, and almost instantaneously he starts to feel embarrassed and upset.

According to Ellis's ABCD model of emotion, the breaking of the plate would represent the: A) "A" B) "B" C) "C" D) "D" Answer: A 48) Nadine wants to ask Ramon out on a date but is afraid he will say "no." According to Ellis's theory,

Nadine is not really afraid of Ramon saying "no," but rather .

A) she has an irrational belief that she is worthless and will never get a date B) she is reminded of past boys, those that have turned her down C) that she will feel foolish D) she has a fear of going out alone Answer: A 49) When Josh brings home a report card with a failing grade in French, he is very sad. According to

rational-emotive therapy, the failing grade is the A) activating event B) disputing factor Answer: A

8

of the sadness.

C) consequence

D) outcome

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50) In Albert Ellis's ABCD model of emotional disturbance, the "A" stands for the: A) automatic thoughts.

B) antecedent.

C) activating event.

D) aversive situation.

Answer: C 51) The identification and replacement of irrational thoughts and the ABCD model of emotional

disturbance are most closely associated with which of the following people?

A) Carl Rogers B) Aaron Beck C) Albert Ellis

D) Sigmund Freud

Answer: C 52) Jerry is working with a therapist to get over his depression. The therapist points out how most of his

depressive feelings appear to be produced by thoughts such as, "because my boss doesn't like me, I will never get promoted!" The therapist helps Jerry to identify when this previously automatic thought is present and suggests that he come up with some way of challenging this conclusion. Jerry most likely has a therapist who is using: A) interpersonal therapy.

B) client-centred therapy.

C) rational-emotive therapy.

D) cognitive therapy.

Answer: C 53) The rational-emotive therapy is concerned with

.

A) negative feelings

B) negative thoughts

C) irrational thoughts

D) irrational feelings

Answer: C 54) Cognitive therapy is currently considered to be the psychological treatment of choice for which of

the following disorders?

A) schizophrenia C) somatic symptom disorder

B) depression D) generalized anxiety disorder

Answer: B 55) Research has found positive results for cognitive therapy with all of the following disorders

EXCEPT: A) somatoform disorders.

C) anger disorders.

B) depression.

D) anxiety disorders.

Answer: A 56) Which of the following pays the least amount of attention to internal processes, including thoughts,

feelings, or unconscious dynamics?

A) humanistic therapies C) cognitive therapies

B) psychodynamic therapies D) behaviour therapies

Answer: D

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57) The assumptions that psychological disorders are learned in exactly the same ways as normal

behaviours and that they can be treated by applying the basic principles of learning is typical of the approach to therapy.

A) biological B) behavioural C) humanistic D) interpersonal Answer: B 58) Brad's therapist is unconcerned with the reasons why Brad is always late and focused on how to

change Brad's maladaptive behaviour of always being late. It is likely that Brad's therapist engages in which type of therapy?

A) Gestalt therapy B) cognitive therapy C) psychoanalysis D) behaviour therapy Answer: D 59) All of the following were mentioned as examples of therapy procedures derived directly from the

principles of classical conditioning EXCEPT: A) aversion therapy.

C) systematic desensitization.

B) exposure therapies.

D) rational-emotive therapy.

Answer: D 60) Exposure therapies operate on the assumption that the most direct way to reduce or eliminate a

learned anxiety response is A) operant extinction C) positive reinforcement

.

B) classical extinction D) response cost punishment

Answer: B 61) Treating anxiety symptoms by presenting a feared stimulus (such as a dog or heights) and

preventing the target person from avoiding that stimulus is typical of A) exposure B) humanistic C) cognitive

therapies.

D) aversive

Answer: A 62) According to the two-factor learning theory, the most direct way to reduce a phobia is through

exposure to the feared conditioned stimulus (CS) in the absence of the unconditioned stimulus (UCS) while keeping the operant avoidance response from occurring by using .

A) response prevention B) shaping C) behaviour modification D) systematic desensitization Answer: A 63) Exposure therapies have been used effectively to treat agoraphobics by: A) requiring them to confront feared situations.

B) treating them with brief psychodynamic therapy.

C) enabling them to identify and change key automatic thought patterns.

D) training them in systematic desensitization.

Answer: A

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64) The results from a neuroimaging study suggest that the correlation between serotonin levels and

dysfunctional beliefs is a A) positive

correlation.

B) normal

C) negative

D) no

Answer: C 65) Bartock was treated for depression with medication and Shula took Cognitive Behaviour Therapy

(CBT). A PET showed changes in their: A) gray matter.

B) cortex.

C) corpus callosum.

D) white matter.

Answer: B 66) Cognitive Behaviour Therapy (CBT) appears to help individuals who are depressed become: A) less anxious.

B) less emotional.

C) more stimulated.

D) more emotionally responsive.

Answer: B 67) Lennon was diagnosed with depression. Following an fMRI, the doctor suggested that Cognitive

Behaviour Therapy (CBT) would not likely be the best treatment option. It is likely that when Lennon rated words with negative emotional meaning he showed low levels of activity in his: A) frontal cortex B) hippocampus C) cingulate cortex D) amygdala Answer: D 68) Janice has a phobia of dogs and decides to consult with a behaviour therapist in order to get some

help. The therapist first teaches her a muscle relaxation technique. After she has learned this, they create a list of increasingly fearful situations involving dogs. Starting with the least feared situation, the therapist has Janice imagine it and then use her relaxation training to eliminate any anxiety that arises. This therapist is using the general technique called systematic desensitization, and the list that they have created is an example of .

A) flooding B) a stimulus hierarchy C) a positive reinforcer D) aversive conditioning Answer: B 69) Counterconditioning and stimulus hierarchies are most central to which of the following therapeutic

interventions?

A) rational-emotive therapy C) systematic desensitization

B) exposure therapy D) aversion therapy

Answer: C 70) Systematic desensitization focuses on the process of learning a response that is incompatible with

anxiety. This is based on the concept of A) counterconditioning C) aversive conditioning

.

B) a stimulus hierarchy D) response prevention

Answer: A

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71) Eugene has a terrible fear of being in a boat. Eugene works for the Coast Guard doing an

administrative job, but he knows he will have to get over this fear in order to receive a promotion.

His boss offered to pay for a behavioural therapy. Eugene, who was extremely anxious, wanted the least anxiety provoking behavioural therapy, chose: A) standard exposure therapy B) systematic desensitization C) aversion therapy D) rational-emotive therapy Answer: B 72) In this therapy, a previously positive conditioned stimulus (CS) is paired with a noxious

unconditioned stimulus in an attempt to eliminate the undesirable behaviour evoked by the CS. This is: A) negative exposure therapy B) systematic desensitization C) avoidance therapy D) aversion therapy Answer: D 73) As part of a smoking cessation program, Paul receives an injection of a nausea-inducing drug and

then is asked to smoke a cigarette. Even though he knows he is receiving the drug, it is hoped that Paul will associate the nausea symptoms with smoking and will thus smoke less. This example best demonstrates the procedures typically used in: A) avoidance therapy.

B) negative exposure therapy.

C) aversion therapy.

D) electroconvulsive therapy (ECT).

Answer: C 74) Russell is an alcoholic who wants to quit drinking. When he seeks help from a therapist, he is given

a drug that will cause nausea if he drinks alcohol. Russell's therapist is using a type of therapy called: A) aversion therapy B) virtual reality therapy C) token economy D) systematic desensitization Answer: A 75) Beatrice would like to stop her habit of biting her fingernails. In order to do this, she covers the ends

of her fingertips, including her nails, with a bitter tasting antibacterial spray. When Beatrice puts her fingernail in her mouth she is met with a noxious taste and removes her nail immediately from her mouth. In this case, the bitter taste might be considered the: A) conditioned stimulus (CS) B) conditioned response (CR) C) unconditioned response (UCR) D) unconditioned stimulus (UCS) Answer: D 76) Because its effects often do not generalize well from the treatment setting to the real world, many

researchers believe that would be more effective if it were used in concert with learning specific coping skills programs that focus on avoiding relapse.

A) aversion therapy B) systematic desensitization C) exposure therapy D) cognitive therapy Answer: A

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77) Which of the following therapies represent the application of operant principles to psychological

disorders?

A) behaviour modification C) exposure therapy

B) aversion therapy D) rational-emotive therapy

Answer: A 78) Jake is staying in a large halfway house for recovering addicts. Every time he successfully finishes

his chores around the house, helps a roommate, or does any other appropriate behaviour, he receives a token. These tokens can be later exchanged for privileges such as staying out past curfew or going to a movie theatre. This system is an example of: A) a client-centred approach B) counterconditioning C) behaviour modification D) malingering Answer: C 79) Jake is staying in a large halfway house for juvenile substance abusers. Every time he successfully

finishes his chores around the house, helps a roommate, or does any other appropriate behaviour, he receives a token. These tokens can be later exchanged for privileges such as staying out past curfew or going to a movie theatre. The goal of this system is to eventually have these positive behaviours: A) get him released from the halfway house B) receive a minimal number of tokens for the same tasks C) be controlled by self-reinforcement processes and social reinforcers D) illustrate an economic lesson Answer: C 80) Token economies are based on the systematic application of: A) positive reinforcement.

B) counterconditioning.

C) punishment.

D) negative reinforcement.

Answer: A 81) Token economies are often used in behaviour modification and attempt to modify behaviour by

using .

A) negative reinforcement C) punishment

B) positive reinforcement D) relaxation training

Answer: B 82) When discussing token economies, a common example is such positive reinforcement systems have

been used to treat people with: A) depression.

B) schizophrenia.

C) alcoholism.

Answer: B

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83) Dr. Roth is working in a clinic with children with developmental delays and decides to implement a

new program to encourage more positive behaviours. Whenever children engage in specific behaviours (such as saying, "Thank you," taking turns with a friend, and co-operating with another child on a project), they are rewarded with stickers that can later be turned in for various prizes that they enjoy. Dr. Roth is using which of the following therapeutic techniques?

A) negative reinforcement B) a token economy C) exposure therapy D) higher order classical conditioning Answer: B 84) Which of the following would most likely be considered the least favoured way of modifying

behaviour because of the potential negative side effects?

A) positive reinforcement B) punishment C) extinction D) negative reinforcement Answer: B 85) Questions such as, "Are there other less painful options available?" and "How damaging is the

specific behaviour to the individual and/or society/" are most relevant to the use of which of the following treatments for abnormal behaviour?

A) punishment B) exposure therapy C) aversion therapy D) token economies Answer: A 86) Research has revealed that punishment is an effective way to modify abnormal behaviour with: A) people suffering from extreme depression

B) schizophrenics

C) social phobics

D) self-injurious autistic children

Answer: D 87) Modelling plays the most important role in which of the following therapies?

A) cognitive therapy

B) social skills training

C) exposure therapy

D) rational-emotive therapy

Answer: B 88) Theresa has an important job interview tomorrow. In the past, she has not appeared confident and

wants to learn how to avoid that for this interview. Theresa asks her mother to play the role of a person being interviewed so that Theresa might learn how another person would respond to typical job interview type questions. Hopefully, Theresa will learn from her mother's example and successfully land the new job. This is an example of: A) positive reinforcement B) the psychodynamic approach C) aversion therapy D) social skills training Answer: D

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89) A person with a strong phobia of spiders watches a person approach and handle a large tarantula

without any fear or anxiety. After seeing this, the person with the phobia starts to think that perhaps he has the skills necessary to do the same thing, and after a few trials by himself, he is soon able to handle the spider. This example best demonstrates the therapeutic technique called: A) modelling.

B) counterconditioning.

C) a stimulus hierarchy.

D) systematic desensitization.

Answer: A 90) The key factor involved in the effectiveness of modelling for treating psychological disorders is

.

A) physical relaxation

B) counterconditioning

C) self-efficacy

D) exposure

Answer: C 91) Research has demonstrated that a fundamental factor underlying the effectiveness of social skills

training is increased: A) self-efficacy.

C) self-regulation.

B) self-esteem.

D) self-reinforcement.

Answer: A 92) Learning new abilities by observing and then copying a model is most central in which of the

following approaches?

A) interpersonal therapy C) social skills training

B) cognitive therapy D) rational-emotive therapy

Answer: C 93) Which of the following is NOT one of the 'third wave' cognitive-behavioural therapies?

A) mindfulness-based treatments

B) dialectical behaviour therapy

C) modelling and social skills training

D) acceptance and commitment therapy

Answer: C 94) A treatment developed specifically for the treatment of borderline personality disorder is: A) dialectical behaviour therapy

B) modelling and social skills training

C) acceptance and commitment therapy

D) mindfulness-based treatments

Answer: A 95) Melanie is being taught mediation techniques to develop a tranquil state and to focus on her

sensations, thoughts, and feelings, allowing them to come and go without a struggle. Melanie's therapist is using what type of approach to therapy?

A) acceptance and commitment therapy B) dialectical behaviour therapy C) mindfulness-based treatments D) modelling and social skills training Answer: C

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96) Acceptance and commitment therapy uses

as a vehicle for change.

B) mindfulness D) relaxation techniques

A) operant conditioning C) modelling Answer: B

97) The virtual reality simulations derived not from the authenticity of the computerized images but

from integration of perception and action is the characteristic of .

A) presence B) situational realism C) clarity D) vividness Answer: A 98) Great flexibility and an increased sense of what is called "presence" are characteristics of A) systematic desensitization

B) aversion therapy

C) psychodynamic therapy

D) virtual reality

Answer: D 99) Virtual reality technology has primarily been used in the treatment of which of the following

disorders?

A) schizophrenia and conversion disorders B) somatoform disorders C) mood disorders D) phobias and post-traumatic stress disorder (PTSD) Answer: D 100) According to Sue and Zane, the biggest cultural barrier to therapy for ethnic minorities is: A) poverty that prevents ethnic minorities from having health insurance or being able to afford

therapy.

B) cultural norms that are against turning to people outside one's culture for therapy.

C) the lack of culturally-compatible, competent therapists.

D) mental-health service centres that are located outside of the areas where underserved people live.

Answer: C 101) All of the following were mentioned as barriers to therapy for ethnic minorities EXCEPT: A) poverty and unemployment make it difficult to afford therapy.

B) the lack of culturally competent therapists.

C) cultural norms against turning to people outside one's culture for help.

D) the lack of ethnically diverse therapists.

Answer: D 102) The ability to balance a broad knowledge of a particular culture with the individual characteristics

and needs of a client who may differ from a stereotype is important to: A) a social skills trainer B) a culturally competent therapist C) an interpersonal therapist D) a rational-emotive therapist Answer: B

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103) Betty is disturbed that Meiko, the young Taiwanese exchange student living with her this year, is

very submissive and refuses to stand up for herself at school. Betty has been told by the principal that Meiko is being bullied at school. In seeking help for Meiko, Betty should consider as the best option.

A) a culturally competent therapist B) modelling and observational skills C) social skills training D) a rational-emotive therapist Answer: A 104) When working with a psychotherapy client who is from a different culture, Dr. Johnson uses her

knowledge of the person's culture and ethnicity to work with the client, but is careful not to overgeneralize and blindly follow her stereotypes. Which of the following labels best describes Dr. Johnson?

A) Dr. Johnson appears to be ethnically diverse.

B) Dr. Johnson appears to be culturally insensitive.

C) Dr. Johnson appears to be culturally competent.

D) Dr. Johnson appears to be eclectic.

Answer: C 105) All of the following were mentioned as factors that may account for the higher prevalence of certain

disorders in women EXCEPT: A) sexism.

B) norms against seeking help from mental-health professionals.

C) the demands of multiple social roles.

D) poverty.

Answer: B 106) Which of the following psychological disorders are most prevalent in women in Western cultures

compared with men?

A) dissociative identity disorder C) schizophrenia

B) somatoform disorders D) anxiety disorders

Answer: D 107) The question, "Which types of therapy, administered by which kinds of therapists to which kinds of

clients having which kinds of problems, produce which kinds of effects?" is known as the: A) eclecticism question.

B) accuracy question.

C) specificity question.

D) precision question.

Answer: C

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108) Ursula has been feeling very anxious for over a month now, so much so that she is finding it

difficult to get her work finished on time and hard to meet her social obligations. Although Ursula knows that psychotherapy works, what she wants to know is what kind of therapist she should see for the problems she is experiencing. Ideally, Ursula would like the answer to: A) have a therapist meet the standards of scientific rigor B) the generalization question C) reflect her beliefs in her choice of therapist D) the specificity question Answer: D 109) A clinical researcher is particularly interested in learning whether systematic desensitization is more

or less effective with particular people suffering from anxiety. To do this, he collects personality measures from people receiving this treatment and looks to see whether certain personality traits are associated with the effectiveness of the outcome. With regard to the "specificity question," this study is most concerned with studying the importance of: A) different types of client variables.

B) different types of therapies.

C) different types of eclecticism.

D) different types of therapist variables.

Answer: A 110) Carl Rogers's work demonstrating the importance of empathy, unconditional positive regard, and

genuineness is most consistent with the "specificity question" goal that addresses the role of the different types of in psychotherapy.

A) clients B) treatment effects C) therapists D) therapies Answer: C 111) In a psychotherapy outcome study assessing the effectiveness of a new treatment for agoraphobia, a

behavioural therapist would likely be most interested in which of the following client measures?

A) ratings of clients made by their partners B) direct behavioural observations of the clients C) therapists' ratings of the clients' anxiety levels D) the clients' self-reports of anxiety Answer: B 112) A humanistic therapist would most likely assume that which of the following would be the best

measure of improvement in a psychotherapy outcome study?

A) therapists' ratings of clients' improvement B) direct observations of the clients' behaviours C) clients' self-reports on their improvement D) ratings of the clients made by significant others Answer: C

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113) Psychotherapy outcome measures can differ along which two dimensions?

A) the source of the data and the self-relatedness of the measure B) the focus and the effectiveness of the measure C) the self-relatedness and the focus of the measure D) the source of the data and the focus of the measure Answer: D 114) Designing good psychotherapy research is challenging for all of these reasons EXCEPT: A) there are many variables in psychotherapy research that cannot be completely controlled.

B) different measures of the effects of psychotherapy may yield conflicting indications of the

degree and direction of change.

C) there are a few discrete variables in psychotherapy research that can be controlled.

D) measures of the effects of psychotherapy differ in the variables assessed and the source of the

data.

Answer: C 115) The process in which some individuals experience complete symptom reduction in the absence of

any treatment is known as: A) automatic adjustment.

C) the placebo effect.

B) spontaneous remission.

D) natural recovery.

Answer: B 116) Without treatment, a sizeable percentage of people suffering from depression eventually get better

within 5 to 10 months. It is most likely that these improvements are a product of: A) the placebo effect.

B) self-help groups or books.

C) spontaneous remission.

D) self-directed exposure.

Answer: C 117) Don has been suffering from some intense feelings of anxiety and decides to seek some help from a

psychotherapist. Unfortunately, there is long waiting list and the first available appointment is 9 weeks away. Disappointed, Don decides to put his name on the waiting list anyway. A few weeks pass and even though he has done nothing to address the problem, Don's anxiety symptoms begin to fade and eventually disappear. This example best demonstrates the phenomenon called: A) the placebo effect.

B) spontaneous remission.

C) the deterioration effect.

D) insight.

Answer: B

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118) Dr. Stone designs a study to test the effectiveness of a new treatment for anxiety disorders. After

making sure that her participants are roughly similar on important demographic variables, people are randomly assigned to receive either the new therapy or another therapy technique that has already been proven to be effective. Which of the following statements best describes Dr. Stone's study?

A) Her study uses randomized clinical trials with a placebo control group.

B) Her study does not use randomized clinical trials, but it does have a placebo control group.

C) Her study does not use randomized clinical trials, and it does not have a placebo control group.

D) Her study uses randomized clinical trials, but does not have a placebo control group.

Answer: D 119) Dr. Axworthy is conducting a test of a new treatment for borderline personality disorder. One

randomly determined group of people suffering from the disorder receives the new treatment. To control for client expectations, another group receives a psychotherapy treatment that has consistently been shown not to be effective. Which of the following most accurately classifies this second group of study participants?

A) It is a meta-analysis group.

B) It is a control group.

C) It is a no-treatment group.

D) It is a placebo control group.

Answer: D 120) The American Psychological Association's (APA) guidelines that psychotherapy research should

include a treatment manual that specifies in detail the therapeutic techniques to be used by therapists is likely to be the most objectionable to which of the following types of therapists?

A) a psychodynamic therapist B) a cognitive therapist C) a behaviour modification therapist D) a rational-emotive therapist Answer: A 121) Based on the fact that this type of therapy is easy to capture in a manual format, research on

empirically validated treatments has largely been conducted on therapies associated with the approach.

A) psychodynamic B) cognitive-behavioural C) humanistic D) sociocultural Answer: B 122) A determinant of how long the effects of a particular therapy last is best gauged by the use of: A) placebo control groups.

B) control groups.

C) randomized clinical trials.

D) follow-up data.

Answer: D 123) Researchers that simultaneously examine many different research studies and draw conclusions

about the overall effectiveness of a particular treatment are using the technique called A) correlational analysis B) common factors C) meta-analysis D) factor analysis Answer: C

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124) Meta-analysis is used to: A) evaluate the internal validity of a particular study.

B) insure that a sample is representative of the population from which it is drawn.

C) evaluate the external validity of a particular study.

D) combine the results from different studies examining the same topic.

Answer: D 125) A psychologist specializes in a research area where there is an ongoing debate about the

effectiveness of a particular treatment. In order to gain more information, this psychologist reviews approximately 50 studies that have utilized this particular treatment, and using this information, the psychologist finds that the vast majority of the studies found the treatment to be effective. This psychologist has just completed a(n): A) meta-analysis.

B) quasi-experimental study.

C) correlational study.

D) experimental study.

Answer: A 126) In review studies making use of the meta-analysis technique, as a measure of treatment

effectiveness, it is common for researchers to calculate the statistic.

A) common factors B) factor strength C) effect size

D) correlation

Answer: C 127) Dr. James is considering learning a new therapeutic technique, but is unsure as to its effectiveness.

She decides to conduct an extensive review of studies conducted in the last 20 years that have examined this particular therapy tool. After much work and a few calculations, she determines that the average person who received this treatment had a more favourable outcome than 85 percent of people who did not receive the treatment. Dr. James is conducting a meta-analysis study, and the percentage that she calculated is known as the statistic.

A) correlation B) treatment factor C) effect size D) common factors Answer: C 128) A 1977 meta-analysis by Smith and Glass concluded that the average person receiving

psychotherapy showed more positive outcomes than 75 percent of non-treated individuals. Modern meta-analyses of the effectiveness of therapy have generated percentages that are .

A) significantly lower B) significantly higher C) roughly equivalent D) not comparable Answer: C 129) Meta-analysis of brief psychodynamic therapy outcome studies indicated that: A) symptom reduction was as high in the absence of any treatment as it was for any form of

psychotherapy.

B) psychotherapy clients showed, on average, 10 to 15 percent more improvement than did control

cases.

C) different forms of psychotherapy seemed to differ little in effectiveness.

D) different forms of psychotherapy seemed to differ significantly in effectiveness.

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130) Modern meta-analysis comparing the effectiveness of various types of therapies have concluded

that: A) behavioural and psychodynamic therapies are the most effective.

B) most therapies are no more effective than receiving no-treatment at all.

C) with some exceptions, most therapies are equally effective.

D) client-centred therapies are the most effective.

Answer: C 131) Openness concerns a willingness to invest in therapy and to take the risks required to make changes.

This is considered to be an important A) self-relatedness B) client

variable associated with treatment outcomes.

C) therapist D) empathy

Answer: B 132) Dr. Sholl has recently started therapy with a new client, Roger. Roger appears to be a great therapy

client because he is able to reflect and talk about the thoughts and feelings that are related to his difficulties. In addition, he is able to attend to and discuss issues related to his relationship with Dr. Sholl and has shown that he can take what he learns in therapy and generalize it to his life. Roger best demonstrates which of the following important psychotherapy client characteristics?

A) openness B) empathy C) self-relatedness D) genuineness Answer: C 133) In terms of the factors affecting the outcome of therapy, client self-relatedness refers to: A) the client's ability to be detached within the therapeutic relationship.

B) the client's ability to experience and understand internal states.

C) the client's ability to remain effected by situations outside of therapy.

D) the client's ability to experience and understand external states.

Answer: B 134) Besides openness and self-relatedness, the third important characteristic of the client that is

associated with psychotherapy outcomes is: A) transference.

C) insight.

B) empathy.

D) the nature of the problem.

Answer: D 135) The fact that certain forms of psychotherapy are better suited than others for treating specific types

of psychological disorders is most relevant to which of the following important client characteristics?

A) the nature of the psychological problem B) the willingness to take risks in therapy C) the amount of insight he/she possesses D) the ability to reflect on thoughts and feelings Answer: A

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136) Which of the following was considered to be the most important factor impacting the outcome of

psychotherapy?

A) common factors C) client factors

B) therapy variables D) the therapeutic relationship

Answer: D 137) The fact that vastly different types of therapies often produce similar outcomes has led some

researchers to search for similar elements shared by each of the approaches that may account for their common successes. These elements are called: A) shared components B) common factors C) meta-factors D) joint components Answer: B 138) With regard to the conditions that contribute to the effectiveness of psychotherapy, faith in the

therapist and the opportunity to practise new behaviours are both examples of what are called: A) common factors.

B) positive transferences.

C) placebo effects.

D) spontaneous remissions.

Answer: A 139) No matter what the therapeutic technique is, characteristics that tend to contribute to the success of a

therapy are: A) the skill and experience of the therapist C) common factors

B) extroversion and stability D) positive attributes

Answer: C 140) All of the following were presented as examples of common factors that might explain the similar

effectiveness of various forms of therapy EXCEPT: A) increased optimism and self-efficacy.

B) a protective environment where clients feel safe.

C) self-relatedness and openness.

D) faith in the therapist.

Answer: C 141) Of the alternatives below, a factor NOT shared by diverse forms of therapy is: A) an opportunity for the client to practise new behaviours.

B) an alternative way for clients to look at themselves and their problems.

C) a belief on the part of clients that they are receiving help.

D) guidance on how clients can overcome their problems.

Answer: D

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142) After completing a successful therapy experience, a client reflects that one of the things that she

found most helpful about therapy was the different explanations offered by her therapist that allowed her to feel more at ease about herself and her problems. This example best demonstrates which of the following common factors thought to be responsible for the general effectiveness of psychotherapy?

A) a place to practise new behaviours B) increased optimism and self-efficacy C) providing alternative ways of looking at things D) faith in the therapist Answer: C 143) Some researchers argue that it is important to examine

in evaluating studies. That is, success should be measured by comparing clients to individuals within the normal range of responses on measures.

A) meta-analyses B) clinical significance C) statistical significance D) effect size Answer: B

144) Meta-analysis conducted to test the effectiveness of therapy provides evidence for: A) spontaneous remission

B) differential effectiveness

C) clinical significance

D) the dodo bird verdict

Answer: D 145) Dr. Jackson is creating a study to evaluate the usefulness of a new therapy treatment for borderline

personality disorder. She personally trains all of the therapists who will be used in her study and creates a detailed treatment manual that gives specific instructions regarding how all therapists are supposed to address various issues. What should be the next phase of her study?

A) treatment phase B) preparation phase C) assessment phase D) participant screening phase Answer: D 146) In the research survey conducted by Seligman in cooperation with "Consumer Reports," how many

of the respondents reporting mental-health problems sought professional help?

A) 60% B) 20% C) 40% Answer: C

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147) Seligman's "Consumer Reports" survey found what regarding the utility of psychotherapy?

A) Many of respondents did not feel the therapy was helpful and were dissatisfied with the

treatment received.

B) While many of respondents were satisfied by the treatment received, they still did not find the treatment particularly helpful.

C) While many of the respondents reported being helped by the therapy, they were still dissatisfied with the treatment received.

D) Many of respondents reported being helped by the therapy and were satisfied by the treatment received.

Answer: D 148) Research comparing the effectives of different types of psychotherapies to drug treatments found

which type of treatment was the most effective for treating depression?

A) behavioural activation therapy B) all three types of treatment were more effective compared to the placebo treatment C) cognitive therapy D) drug therapy Answer: A 149) Surveys suggest that among people between the ages of 18 and 74 those who use anti-anxiety drugs

to treat their symptoms of anxiety are approximately A) 15 percent B) 25 percent

.

C) 10 percent

D) 5 percent

Answer: A 150) The problem of having anxiety symptoms return when treatment is stopped is most problematic for

which of the following therapies?

A) behaviour modification C) rational-emotive therapy

B) cognitive therapy D) anti-anxiety medications

Answer: D 151) A drug is used to treat a psychological disorder that slows down the excitatory synaptic activity in

the nervous system by enhancing the activity of gamma-aminobutyric acid (GABA), a major inhibitory transmitter. It is most likely that this drug is a(n): A) antipsychotic drug.

B) anti-anxiety drug.

C) tricyclic antidepressant.

D) selective serotonin reuptake inhibitor, or SSRI. Answer: B 152) Joel has been having some severe psychological problems. His therapist decided that the best course

of treatment would include both psychotherapy and a tranquilizing drug. Given that this treatment is the optimal one, Joel is most likely suffering from: A) mania B) an anxiety disorder C) multiple personality disorder D) a major depressive disorder Answer: B 25

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153) Tricyclics, monoamine oxidase (MAO) inhibitors, and selective serotonin reuptake inhibitors

(SSRIs) were all mentioned as drug treatments for which of the following disorders?

A) depression B) anxiety C) somatoform disorders D) schizophrenia Answer: A 154) A drug used to treat a psychological disorder achieves its effect by increasing the activity of both

norepinephrine and serotonin in the nervous system. This drug is most likely a(n): A) tricyclic antidepressant.

B) selective serotonin reuptake inhibitor (SSRI).

C) antipsychotic drug.

D) anti-anxiety drug.

Answer: A 155) Joanne has been having some severe psychological problems. Her therapist decided that the best

course of treatment would include both psychotherapy and a selective serotonin reuptake inhibitor.

Given that this treatment is the optimal one, Joanne is most likely suffering from: A) a somatoform disorder B) depression C) schizophrenia D) major life events problems Answer: B 156) After conducting several neurological tests, a researcher evaluating the impact of a drug on the

nervous system concludes that the drug is increasing the activity of the neurotransmitter serotonin.

Given this information, one thing we can be sure of is that this drug is not: A) a tricyclic antidepressant.

B) a monoamine oxidase (MAO) inhibitor.

C) a selective serotonin reuptake inhibitor (SSRI).

D) an antipsychotic drug.

Answer: D 157) Antipsychotic medications achieve their effects by blocking the activity of: A) norepinephrine.

B) dopamine.

C) gama-aminobutyric acid (GABA).

D) serotonin.

Answer: B 158) A person receives a drug that blocks the activity of dopamine. It is most likely that this drug is an

antipsychotic drug and that the person being treated has been diagnosed with .

A) a dissociative disorder B) an anxiety disorder C) schizophrenia D) a somatic symptom disorder Answer: C

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159) Tardive dyskinesia is one of the side effects of which of the following drugs?

A) monoamine oxidase (MAO) inhibitors B) tricyclics C) selective serotonin reuptake inhibitors (SSRIs) D) antipsychotic drugs Answer: D 160) One of the side effects of antipsychotic medications is the disorder called tardive dyskinesia. The

symptoms of this disorder include: A) dramatic shifts in personality.

B) grotesque movements of the face and tongue.

C) sweating, insomnia, and sexual dysfunction.

D) intense anxiety, nausea, and restlessness.

Answer: B 161) The promising new medication called clozapine is an antipsychotic drug that does not appear to

produce the negative symptoms that are common with other drugs of this type that contribute to .

A) spontaneous remission B) insomnia and sexual dysfunction C) nausea and restlessness D) tardive dyskinesia Answer: D 162) The primary assumption behind the initial use of electroconvulsive therapy (ECT) was that epilepsy

and

rarely occur in the same person.

A) conversion disorder

B) depression

C) bipolar disorder

D) schizophrenia

Answer: D 163) Justine has been successfully treated with a series of electroconvulsive therapy treatments for

.

A) severe depression

B) dissociative identity disorder

C) generalized anxiety disorder

D) schizophrenia

Answer: A 164) Though initially created for use with schizophrenia, electroconvulsive therapy (ECT) is best suited

for individuals suffering from A) depression C) somatic symptom disorder

.

B) dissociative identity disorder D) anxiety

Answer: A 165) Electroconvulsive therapy (ECT) is often used for depression when: A) the depression is dysthymic in nature.

B) it occurs with an anxiety disorder.

C) mania is also involved.

D) there is a high risk of suicide.

Answer: D

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166) A lobotomy and a cingulotomy are both particular types of: A) somatoform disorders.

B) drug therapies.

C) psychosurgery.

D) brain disorders.

Answer: C 167) Prefrontal lobotomies were originally used to treat people suffering from: A) severe depression.

B) tardive dyskinesia.

C) psychotic and violent behaviour.

D) anxiety disorders that did not respond to drugs or psychotherapy.

Answer: C 168) All of the following are negative side effects associated with the use of lobotomies EXCEPT: A) seizures.

B) grotesque facial and tongue movements.

C) memory and reasoning impairment.

D) stupor and listlessness.

Answer: B 169) A cingulotomy would most likely be used to treat which of the following disorders or problems?

A) obsessive-compulsive disorder

B) schizophrenia

C) antisocial personality disorder

D) violent behaviour

Answer: A 170) A cingulotomy is a last-resort treatment for obsessive-compulsive disorder and involves: A) inserting an instrument through the eye socket to severe the connection between the frontal

lobes and the subcortical structures of the brain B) severing a bundle of nerve fibres that connect the frontal lobes with the limbic system C) the administration of anti-anxiety drugs D) the administration of an electric shock to the brain Answer: B 171) After having tried numerous pharmacological treatments and years of unsuccessful psychotherapies,

as a last resort attempt to treat her unbearable obsessive-compulsive disorder, Janis agreed to a(n) .

A) electroconvulsive therapy B) brain transplant C) cingulotomy

D) lobotomy

Answer: C 172) Transferring the primary focus of treatment for patients suffering from extreme and chronic mental

disorders from the hospital to the community is the primary goal of .

A) social skills training B) interpersonal therapy C) deinstitutionalization D) behaviour modification Answer: C

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173) The impetus for the deinstitutionalization movement came from: A) concerns about the financial burden on the health care system.

B) concerns about the deterioration of patients' life skills during hospitalization.

C) concerns about the "revolving door phenomenon."

D) concerns about the long-term effects of the antipsychotic drug therapies often administered

during hospitalization.

Answer: B 174) One of the problems associated with deinstitutionalization is related to the fact that the majority of

hospital admissions involve people who have previously been hospitalized. This is called: A) spontaneous remission B) psychological regression C) the deterioration effect D) the revolving door phenomenon Answer: D 175) Inadequate funding of community-based mental-health treatment facilities has resulted in: A) greater use of antipsychotic medications.

B) a growing population of disturbed and homeless people.

C) overburdened mental health care departments in hospitals D) fewer repeated hospitalizations.

Answer: B 176) A company offers its employees a class in stress management and relaxation techniques in the hopes

that it will ultimately help employees by eliminating the environmental causes of behaviour disorders. Such an intervention program would best be classified as an example of: A) biologically focused prevention.

B) competency-focused prevention.

C) culturally focused prevention.

D) situation-focused prevention.

Answer: D 177) In order to reduce the effects of psychological disorders, prevention might include: A) an intense exercise regime

B) decreasing work related success

C) increasing personal coping skills

D) modelling normal behaviours

Answer: C 178) Which of the following would best be classified as an example of competency-focused prevention?

A) environmental and policy changes in a company that are intended to reduce stress B) a program designed to improve family functioning and provide children with enriched home

environments C) a program designed to reduce the risk of post-traumatic stress disorder (PTSD) in women who

have been the victims of rape D) a program providing better educational opportunities to children who are from marginalized populations Answer: C

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TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.

179) According to the text, the two elements that are combined in the treatment of behaviour disorders

are a helping relationship and some kind of technique or intervention.

Answer:

True

False

180) All mental-health professionals must graduate from psychology graduate school program with either

a master's degree or a Ph.D. Answer:

True

False

181) One of the primary functions of free association in psychoanalysis is to gain access to unconscious

material.

Answer:

True

False

182) When a therapy client responds to a therapist as if she was a significant person from the client's past,

psychoanalytic theorists technically refer to this as resistance.

Answer:

True

False

183) Although more expensive and time-consuming, long-term classical psychoanalysis still tends to

produce better therapeutic outcomes than briefer psychodynamic therapies do.

Answer:

True

False

184) In brief psychodynamic therapies, the therapist is typically more focused and active than in

traditional psychoanalysis.

Answer:

True

False

185) Carl Rogers's concept of unconditional positive regard specifically refers to the ability of the

therapist to be able to view the world through the client's eyes.

Answer:

True

False

186) Carl Rogers and Fritz Perls were similar in that both are considered to be humanistic theorists who

believed that people have an inherent tendency towards self-healing.

Answer:

True

False

187) In Albert Ellis's "ABCD" model, the "B" stands for the client's maladaptive behaviours.

Answer:

True

False

188) The cognitive therapy approach of Aaron Beck is currently considered to be the

non-pharmacological treatment of choice for depression.

Answer:

True

False

189) Exposure therapy is based almost entirely on the principles of operant conditioning.

Answer:

True

False

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190) Systematic desensitization attempts to treat anxiety disorders by teaching clients a response that is

considered to be incompatible with anxiety.

Answer:

True

False

191) Systematic desensitization differs from exposure therapy in that systematic desensitization is based

on the principle of extinction while exposure therapy is based on the principle of counterconditioning.

Answer:

True

False

192) When considering the use of token economies, therapists almost always ask whether other, less

painful approaches are available and whether the negative behaviour involved poses a serious risk to either the individual or society.

Answer:

True

False

193) Punishment is never used as a therapeutic technique.

Answer:

True

False

194) One of the key assumptions of social skills training is that the skills deficits of a particular

individual may be reflective of disordered relationships in the family system.

Answer:

True

False

195) Acceptance and commitment therapy includes the process of mindfulness as a vehicle for change.

Answer:

True

False

196) Being knowledgeable about a client's culture and/or ethnicity while at the same time not

inappropriately stereotyping a client are both important aspects of being a culturally competent therapist.

Answer:

True

False

197) Hans Eysenck analyzed data collected from health insurance companies and concluded that it

provided clear empirical support for the validity of psychotherapy.

Answer:

True

False

198) With a few small exceptions, meta-analysis conducted on the efficacy of various psychological

treatments have revealed that most therapies are equally effective.

Answer:

True

False

199) Faith in the therapist and the opportunity to practise new behaviours are both thought to be

important client factors that are associated with psychotherapy outcomes.

Answer:

True

False

200) Most anti-anxiety drugs achieve their effects by slowing the synaptic activity in the nervous system.

One way of doing this is by increasing the activity of the neurotransmitter gama-aminobutyric acid (GABA).

Answer:

True

False

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201) Antidepressant drugs work by decreasing the activity of certain neurotransmitters.

Answer:

True

False

202) Tardive dyskinesia is a negative side effect associated with the use of antipsychotic drugs.

Answer:

True

False

203) One of the disorders that is thought to respond well to the use of electroconvulsive therapy (ECT) is

severe depression.

Answer:

True

False

204) Electroconvulsive therapy (ECT) can be useful in treating severe depression, but has also been

found to relieve anxiety disorders.

Answer:

True

False

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

205) As part of a smoking cessation program, Paul receives an injection of a nausea-inducing drug and

then is asked to smoke a cigarette. Even though he knows he is receiving the drug, it is hoped that Paul will associate the nausea symptoms with smoking and will thus smoke less. This example best demonstrates the procedures typically used in: A) electroconvulsive therapy (ECT) B) avoidance therapy C) negative exposure therapy D) aversion therapy E) cessation therapy Answer: D 206) Dr. Sherman is working in a clinic with children with developmental delays and decides to

implement a new program to encourage more positive behaviour. Whenever children engage in specific behaviour (such as saying, "Thank you," taking turns with a friend, and cooperating with another child on a project), they are rewarded with stickers that can later be turned in for various prizes that they enjoy. Dr. Sherman is using which of the following therapeutic techniques?

A) higher order classical conditioning B) unconditional positive regard C) negative reinforcement D) a token economy E) modeling Answer: D 207) Which of the following therapies would require that you to see a psychiatrist?

A) behavioural B) drug therapy C) humanistic D) cognitive E) psychodynamic Answer: B 32

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208) When working with a psychotherapy client who is from a different culture, Dr. Johnson uses her

knowledge of the person's culture and ethnicity to work with the client, but is careful not to overgeneralize and blindly follow her stereotypes. Which of the following labels best describes Dr. Johnson?

A) Dr. Johnson appears to be eclectic B) Dr. Johnson appears to be ethnically diverse C) Dr. Johnson appears to be an interpersonal therapist D) Dr. Johnson appears to be culturally competent E) Dr. Johnson appears to be culturally insensitive Answer: D 209) In a psychotherapy outcome study assessing the effectiveness of a new treatment for agoraphobia, a

behavioural therapist would likely be MOST interested in which of the following client measures?

A) the clients' self-reports of anxiety B) direct behavioural observations of the clients C) ratings of clients made by their partners D) therapists' ratings of the clients' anxiety levels E) the clients' self-reported behavioural changes Answer: B 210) Openness concerns willingness to invest in therapy and to take the risks required to make changes.

This is considered to be an important A) therapist B) empathy C) self-monitoring D) client E) self-relatedness

variable associated with treatment outcomes.

Answer: D 211) A drug is used to treat a psychological disorder that slows down the synaptic activity in the nervous

system by enhancing the postsynaptic activity of gamma-aminobutyric acid (GABA), a major inhibitory transmitter. It is most likely that this drug is a(n): A) selective serotonin reuptake inhibitor (SSRI) B) anti-anxiety drug C) antipsychotic drug D) tricyclic antidepressant E) none of these Answer: B

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212) Many antipsychotic medications achieve their effects by blocking the activity of: A) dopamine B) gamma-aminobutyric acid (GABA) C) serotonin D) epinephrine E) norepinephrine Answer: A 213) A cingulotomy is a last-resort treatment for obsessive-compulsive disorder and involves: A) the administration of an electric shock to the brain B) severing a bundle of nerve fibers that connect the frontal lobes with the limbic system C) severing the corpus callosum D) the administration of anti-anxiety drugs E) inserting an instrument through the eye socket to severe the connection between the frontal

lobes and the subcortical structures of the brain Answer: B 214) A company offers its employees a class in stress management and relaxation techniques in the hopes

that it will ultimately help employees remain healthier and miss less time at work. Such an intervention program would best be classified as an example of: A) situation-focused prevention B) relationally-focused prevention C) culturally-focused prevention D) competency-focused prevention E) biologically-focused prevention Answer: D 215) Two treatment elements that are combined in the management of all psychological disorders are: A) transference and countertransference B) interpretation and insight C) the therapeutic relationship and psychological techniques D) medications and psychological techniques E) medications and behaviour modification Answer: C 216) Which of the following mental health professionals receives his or her training in medical school?

A) a marriage and family counselor B) a clinical psychologist C) a psychiatrist D) a counseling psychologist E) none of these mental health professionals receive his or her training in medical school Answer: C

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217) Helping people achieve great insight, which is an awareness of the underlying dynamics of their

problems, is the primary therapeutic goal of: A) behaviour modification B) humanistic therapy C) psychoanalysis D) Both cognitive therapy and behaviour modification have this as the primary therapeutic goal.

E) cognitive therapy Answer: C 218) While listening to his patient talk about her favourite memories from childhood, Dr. Yang begins to

notice that whenever his patient's thoughts approach her sister, she quickly changes the topic and talks about something else. When Dr. Yang begins probing her memories and thoughts about her sister, his client starts missing therapy appointments often cancelling without notice. This defensive manoeuvre is known as .

A) modeling B) free association C) transference D) resistance E) countertransference Answer: D 219) In psychoanalytic theory, any statement made by the therapist that is intended to help the client gain

insight into their behaviour or dynamics is called: A) an explanation B) an explication C) an interpolation D) an interpretation E) a clarification Answer: D 220) The assumption that psychological disorders are produced by the blockage or frustration of natural

tendencies for growth is most consistent with the: A) behavioural approach B) humanistic approach C) cognitive approach D) psychodynamic approach E) socio-cognitive approach Answer: B

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221) All of the following were mentioned by Carl Rogers as important and essential therapist

characteristics EXCEPT: A) empathy B) genuineness C) unconditional positive regard D) congruence E) all of these are important therapist characteristics according to Carl Rogers Answer: D 222) This therapy is often conducted in a group format, it sometimes incorporates role playing, and it can

be rather confrontational. This is A) rational-emotive B) Gestalt C) behavioural marital D) client-centered E) cognitive therapy

therapy.

Answer: B 223) Although they are rather similar, one difference between cognitive therapy and rational-emotive

therapy is that the former concentrates on automatic thoughts, while the latter is concerned with .

A) irrational thoughts B) controlled thoughts C) irrational feelings D) positive thoughts E) negative feelings Answer: A 224) Which of the following pays the least amount of attention to internal factors such as thoughts,

feelings, or unconscious dynamics?

A) cognitive therapies B) behaviour therapies C) psychodynamic therapies D) humanistic therapies E) Gestalt therapies Answer: B 225) You are interested in pursuing psychodynamic therapy, but you have a time constraint (no more than

20 sessions). Which of the following therapies should you try?

A) mindfulness treatments B) Gestalt therapy C) interpersonal therapy D) psychoanalysis E) social skills training Answer: C 36

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226) Your therapist suggests that it would be a good idea if you try the empty-chair technique in your

next session. What kind of therapy are you in?

A) Gestalt B) mindfulness C) behavioural D) token economy E) rational emotive Answer: A 227) According Ellis's rational-emotive ABCD model, what does the "C" stand for?

A) climate B) consequences C) conditioning D) culture E) cognitions Answer: B 228) Let's say that you have a strong fear of flying. To treat this fear, your therapist asks you to imagine

being in a plane and flying until you are no longer showing anxiety. Your therapist has just used the technique of A) transference.

B) aversion therapy.

C) implosion.

D) counterconditioning.

E) flooding.

Answer: C 229) The basic principle behind systematic desensitization is A) counterconditioning.

B) dialectical therapy.

C) flooding.

D) in vivo modification.

E) token economy.

Answer: A 230) Dr. Jordan specializes in dialectical behaviour therapy. Consequently, her clients will most likely

have a diagnosis of A) phobia.

B) borderline personality disorder.

C) schizophrenia.

D) panic disorder.

E) depression.

Answer: B

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231) Interestingly, it may not matter what type of therapy you actually use. For a wide variety of

disorders, outcomes are essentially the same. This finding has been called the A) dose-response effect.

B) dodo bird verdict.

C) spontaneous verdict.

D) placebo effect.

E) significance verdict.

Answer: B 232) You are treating a patient for unipolar depression and decide to proscribe drugs. In order to

minimize any side effects of the drug, your best choice to prescribe would be a(n) A) MAO inhibitor.

B) antipsychotic.

C) SSRI. D) tricyclic.

E) GABA inhibitor.

Answer: C 233) On your regular rounds of the hospital, you notice a patient displaying tardive dyskinesia. Most

likely, this patient would be suffering from A) dissociative identity disorder.

B) schizophrenia.

C) unipolar depression.

D) bipolar disorder.

E) an anxiety disorder.

Answer: B 234) One of your patients is suffering from a severe disorder and nothing else has worked. Consequently,

you recommend electroconvulsive therapy. Most likely, your patient was suffering from A) borderline personality disorder.

B) dissociative identity disorder.

C) depression.

D) an anxiety disorder.

E) schizophrenia.

Answer: C 235) One of your patients is suffering from a severe disorder and nothing else has worked. Consequently,

you recommend a cingulotomy. Most likely, your patient was suffering from A) dissociative identity disorder.

B) a somatoform disorder.

C) obsessive-compulsive disorder.

D) schizophrenia.

E) a severe phobia.

Answer: C

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236) You are treating a patient for schizophrenia. In considering drug treatment, you probably think about

the possible side effect called A) dependency B) induced psychosis C) GABA blockage D) hyper attentiveness E) tardive dyskinesia Answer: E 237) Of the following behavioural treatments for disorders, which one is based on operant conditioning?

A) aversion therapy B) systematic desensitization C) flooding D) counterconditioning E) implosion therapy Answer: A 238) As a psychodynamic therapist using classical psychoanalysis, what should you be looking for to

determine when you have touched upon the patient's real problem?

A) transference B) resistance C) positive regard D) sexual references in word association tasks E) aggressive themes in dreams Answer: B 239) One of your patients is suffering from severe depression. Nothing seems to help. Standard drugs are

not effective. Moreover, your patient has become suicidal. What might you try next?

A) an injection of tryptophan B) a higher dosage of an antipsychotic drug C) psychoanalysis D) ECT E) removal of the amygdala Answer: D 240) You are advising a client on the type of therapy to seek out for the effective treatment of his

borderline personality disorder. The best treatment you could suggest would be A) flooding.

B) psychoanalysis.

C) rational-emotive therapy.

D) client-centred therapy.

E) dialectical behaviour therapy.

Answer: E

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241) Your therapist asks you to imagine your significant other sitting in an empty chair in the room. You

are supposed to have a conversation with him or her. Most likely, your therapist follows which of the following traditions?

A) Client-centred B) Psychoanalytic C) Gestalt D) Behaviouristic E) Biological Answer: C 242) As a psychodynamic therapist, your belief is that you should see patients once or twice a week and

actually have a conversation with them. Most likely, you are practicing A) psychoanalysis B) interpersonal therapy C) transference analysis D) Gestalt therapy E) dialectical behaviour therapy Answer: B 243) Let's say that you work for a drug company. You are trying to develop a new drug for the treatment

of schizophrenia. Which of the following neurotransmitters are you likely to target?

A) dopamine B) acetylcholine C) norepinephrine D) serotonin E) GABA Answer: D 244) Let's say that you work for a drug company. You are trying to develop a new drug for the treatment

of anxiety. Which of the following neurotransmitters are you likely to target?

A) GABA B) norepinephrine C) acetylcholine D) serotonin E) dopamine Answer: A 245) Let's say that you work for a drug company. You are trying to develop a new drug for the treatment

of mental disorders. This drug will replace a tricyclic. What disorder are you working on?

A) dissociative identity B) personality C) schizophrenia D) depression E) anxiety Answer: D 40

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246) Your doctor has just prescribed a new drug for the treatment of your mental disorder. You're not

sure what exactly the drug does, but you know it effectively raises the level of serotonin. Most likely, you are suffering from A) bipolar disorder B) schizophrenia C) anxiety D) depression E) dissociative identity Answer: D 247) Your doctor has just prescribed a new drug for the treatment of your mental disorder. You're not

sure what exactly the drug does, but you know it effectively lowers the level of serotonin. Most likely, you are suffering from A) depression B) anxiety C) bipolar disorder D) dissociative identity E) schizophrenia Answer: E 248) Your doctor has just prescribed a new drug for the treatment of your mental disorder. You're not

sure what exactly the drug does, but you know it effectively lowers the level of GABA. Most likely, you are suffering from A) schizophrenia B) bipolar disorder C) anxiety D) dissociative identity E) depression Answer: C 249) Whether you suffer from schizophrenia or depression, it is likely that any drug you are on will target A) serotonin B) norepinephrine C) GABA D) glutamate E) acetylcholine Answer: A

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250) During your psychoanalytic therapy session, you begin to treat the therapist with feelings of intense

affection. You even think that perhaps you are falling in love. In psychodynamic terms, this can be explained by A) negative transference B) positive transference C) positive resistance D) negative resistance E) interpretation Answer: B 251) Of the following, which one is not a variable that would affect the outcome of therapy?

A) quality of the relationship with the therapist B) self-relatedness C) openness D) a low dose-response effect E) "fit" to the therapy being used Answer: D 252) In discussing the effectiveness of behavioural therapy, cognitive therapy, and humanistic therapy

with a colleague, she suggests that the outcome is related to the dodo bird verdict. What does she mean?

A) none of the three will work for this disorder B) behavioural therapy will be better because it focuses on extinction C) humanistic therapy will be more effective because it is social by nature D) gender variables are unlikely to affect the outcome E) all three are likely to be equally effective Answer: E 253) Gestalt therapy is very directive. But if you had to classify it, Gestalt therapy is really a form of A) humanistic therapy B) dialectical behaviour therapy C) psychodynamic therapy D) cognitive therapy E) behaviour therapy Answer: A 254) A friend of yours is in therapy. He comments that the therapist uses a variety of techniques

including mindfulness. What type of therapy is he receiving?

A) ECT B) psychodynamic therapy C) cognitive therapy D) humanistic therapy E) dialectical behaviour therapy Answer: E

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255) You are watching a discussion between two therapists. Therapist A stresses the importance of

self-defeating irrational thoughts, while Therapist B talks about developing a stimulus hierarchy and finding a response that is incompatible with anxiety. Most likely, Therapist A practices , while Therapist B follows the tradition.

A) interpersonal therapy; biological B) dialectical behaviour therapy; Gestalt C) rational-emotive therapy; behavioural D) psychoanalysis; humanistic E) Gestalt therapy; psychodynamic Answer: C 256) One of your friends feels very awkward when asking someone out on a date. You suggest that

perhaps he should watch you and then try to copy your behaviour. Your suggestion is very similar to A) flooding B) using a token economy C) mindfulness training D) Gestalt therapy E) social skills training Answer: E 257) You like the psychodynamic approach, but do not want to be in therapy for more than 20 sessions.

Which of the following should you try?

A) client-centred therapy B) implosion therapy C) interpersonal therapy D) mindfulness training E) systematic desensitization Answer: C 258) One of your patients is suffering from depression. As you consider a drug to prescribe, you are

concerned about your patient's high blood pressure and the fact that she really likes to eat cheese.

Which of the following antidepressant drugs should you avoid?

A) any drug that increases GABA activity B) an SSRI C) an MAO inhibitor D) a tricyclic E) all of these should be avoided Answer: C

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259) You have just finished reading an article on the use of virtual reality (VR) for the treatment of mental

disorders. It seems to work very well. Most likely, VR was used for the treatment of A) schizophrenia B) depression C) borderline personality disorder D) phobias E) dissociative identity disorder Answer: D 260) You are treating a patient with a diagnosis of schizophrenia. The drugs seem quite effective in

reducing his symptoms. Most likely, the drug is reducing his A) tardive dyskinesia symptoms B) positive symptoms C) negative symptoms D) dissociation E) altered mood Answer: B 261) Your therapist focuses on modelling as an effective treatment technique. What kind of therapy is she

using?

A) behavioural B) social skills training C) psychodynamic D) humanistic E) cognitive Answer: B 262) During your therapy session, your therapist engages in a process called interpretation. Most likely,

your therapist believes in A) the cognitive perspective B) the humanist perspective C) the psychodynamic perspective D) the Gestalt approach E) the behavioural perspective Answer: C

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263) A good friend of yours has just been through some difficult times. He sees a therapist who

prescribes a drug that effectively enhances the action of GABA. Most likely, your friend is suffering from A) schizophrenia B) anxiety C) dissociative identity disorder D) depression E) bipolar disorder Answer: B 264) Let's say that you have a strong fear of flying. To treat this fear, your therapist asks you to enter a

plane and fly until you are no longer showing anxiety. Your therapist has just used the technique of A) systematic desensitization B) implosion C) counterconditioning D) flooding E) aversion therapy Answer: D 265) Let's say that you have a strong fear of flying. To treat this fear, your therapist asks you to enter a

plane and fly until you are no longer showing anxiety. This treatment technique is based on the behavioural principle of A) positive reinforcement B) response gradient C) generalization D) extinction E) higher order conditioning Answer: D ESSAY. Write your answer in the space provided or on a separate sheet of paper.

266) What two therapeutic elements combine in the treatment of behaviour disorders?

Answer: Answers will vary 267) Who do people usually consult with when they are dealing with mental-health problems? What

percentage of the population has consulted with a professional counsellor or therapist?

Answer: Answers will vary 268) What are the different types of mental-health professionals?

Answer: Answers will vary 269) What is the major therapeutic goal in psychoanalysis?

Answer: Answers will vary

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270) How are free association and dream analysis used in psychoanalysis?

Answer: Answers will vary 271) How do resistance and transference reflect underlying conflicts?

Answer: Answers will vary 272) What are interpretations, and how are they used by analysts?

Answer: Answers will vary 273) What two research results favour the use of brief therapies over classical psychoanalysis? How do

brief psychodynamic therapies differ from classical psychoanalysis?

Answer: Answers will vary 274) What is the goal of humanistic therapies, and how do the therapies try to achieve this goal?

Answer: Answers will vary 275) Define the three important therapist attributes described by Rogers.

Answer: Answers will vary 276) How is Gestalt therapy derived from Gestalt psychology principles?

Answer: Answers will vary 277) Note the similarities and differences of Rogers's and Perls's approaches to therapy. What factor may

have accounted for the decline in popularity of Gestalt therapy?

Answer: Answers will vary 278) What do ABCD stand for in rational-emotive therapy, and how is this model used in therapy?

Answer: Answers will vary 279) Which disorders have responded most favourably to Beck's cognitive therapy? What is the focus of

the therapy in these disorders?

Answer: Answers will vary 280) What basic assumptions about psychological disorders are made by the behavioural approach to

therapy?

Answer: Answers will vary 281) What are the classical and operant conditioning procedures used in exposure therapy? How was this

procedure used to treat agoraphobics?

Answer: Answers will vary 282) How does systematic desensitization differ from exposure in terms of its (a) underlying principle

and (b) specific techniques?

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283) How does classical conditioning underlie aversion therapy? What additional training can enhance its

effectiveness?

Answer: Answers will vary 284) How do token economies work, and what evidence exists for their effectiveness?

Answer: Answers will vary 285) Under what conditions is punishment used as a behaviour modification technique? What evidence is

there for its effectiveness?

Answer: Answers will vary 286) How is modelling used in social skills training? How is self-efficacy involved in its effectiveness?

Answer: Answers will vary 287) Describe the three 'third wave' cognitive-behavioural therapies. How effective are they?

Answer: Answers will vary 288) Which specific attributes of VR make it potentially useful in therapy? What evidence is there that

VR can work therapeutically?

Answer: Answers will vary 289) What factors serve as barriers to therapy for ethnic minorities?

Answer: Answers will vary 290) What skills are found in culturally competent therapists?

Answer: Answers will vary 291) What factors might account for the greater prevalence of psychological disorders in women?

Answer: Answers will vary 292) What is the "specificity question" in psychotherapy research?

Answer: Answers will vary 293) What types of measures are used to assess the outcome of therapy?

Answer: Answers will vary 294) What are some of the challenges in designing good psychotherapy research?

Answer: Answers will vary 295) Describe Eysenck's challenge to therapy effectiveness and the data on which it was based.

Answer: Answers will vary

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296) Summarize desirable standards for designing psychotherapy research studies with regard to design,

treatment standardization, and follow-up.

Answer: Answers will vary 297) How is meta-analysis used to assess therapy effects? What have meta-analyses shown about overall

effectiveness and the effects of different forms of therapy?

Answer: Answers will vary 298) What client variables are important to treatment outcome?

Answer: Answers will vary 299) Which therapist factors affect treatment outcome?

Answer: Answers will vary 300) Define and give examples of common factors in psychotherapy.

Answer: Answers will vary 301) What were the major findings of the CR survey? On what bases were its conclusions criticized?

Answer: Answers will vary 302) How do anti-anxiety drugs achieve their effects? Do they have any drawbacks?

Answer: Answers will vary 303) How do the three classes of antidepressant drugs achieve their effects biologically? How effective

are they compared to/combined with therapy?

Answer: Answers will vary 304) How do antipsychotic drugs achieve their effects?

Answer: Answers will vary 305) What is tardive dyskinesia, and how is it caused?

Answer: Answers will vary 306) Which disorders do and do not respond favourably to ECT? Answer: Answers will vary 307) What were the rationale and effects of prefrontal lobotomy?

Answer: Answers will vary 308) What is a cingulotomy and with what disorders is it used?

Answer: Answers will vary 309) What is the rationale for deinstitutionalization? What prevents it from achieving its goals?

Answer: Answers will vary 48

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310) Define the two major approaches to prevention.

Answer: Answers will vary 311) Describe the psychoanalytic approach to therapy. In your discussion, be sure to include the major

techniques and concepts of the approach.

Answer: Answers will vary 312) Describe the essential components of the humanistic approach to psychotherapy. According to Carl

Rogers, what are the three key characteristics that a therapist should have? Describe Fritz Perls approach to therapy and compare and contrast it with Rogers's.

Answer: Answers will vary 313) Describe the therapeutic approach of Albert Ellis. Discuss the components of his ABCD model and

explain how people normally interpret the causes of their negative emotions. What types of thoughts did Ellis specifically try to address and change and how did he do this?

Answer: Answers will vary 314) Using the principles of classical conditioning, explain how a dog phobia might occur. Be sure to use

the appropriate classical conditioning labels. Describe how a therapist could use 1) extinction therapy and 2) systematic desensitization to treat this psychological disorder.

Answer: Answers will vary 315) Suppose you are working with some challenging and difficult children who have a hard time

behaving themselves. For instance, they don't clean up after themselves, they frequently get into verbal arguments or physical fights, and they often refuse to obey adults. Design a token economy system that is intended to change their behaviour. What are two types of punishment that you could use to change their behaviour? What are the disadvantages of using punishment and of the two different types, which type of punishment is generally best to use?

Answer: Answers will vary 316) Discuss some of the limitations of our current models of psychotherapy. What are three cultural

barriers that limit the utilization of psychotherapy by ethnic minorities? What kinds of skills should a culturally competent therapist have?

Answer: Answers will vary 317) What is the "specificity question" and how is it used in modern psychotherapy research? If you were

interested in designing a study to examine the effectiveness of a new treatment for depression, what are some different ways that you could assess the effectiveness of your treatment?

Answer: Answers will vary

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318) Suppose you have created a new psychotherapy treatment for anxiety and are interested in

evaluating it. Propose a study using randomized clinical trials and a placebo control group. Be sure to mention how you plan to measure improvement or change and how you are going to deal with standardization, follow-up, and any ethical issues in your design.

Answer: Answers will vary 319) What are the three types of factors that have been investigated with regard to the effectiveness of

psychotherapy? Discuss two or three specific examples of each Answer: Answers will vary 320) What are the three different classes of antidepressant drugs and how does each one function to

reduce the symptoms of depression? Compared to psychotherapy, how effective are these medications? What are some short-and long-term issues associated with the use of these drugs to treat depression?

Answer: Answers will vary 321) Describe in detail aversion therapy. In your response be sure to note the underlying principle on

which it is based, provide a description of what it entails, and include a discussion of its effectiveness.

Answer: Answers will vary 322) What has research found comparing drug to psychological treatments for the treatment of

depression? Include in your answer an evaluation of the quality of the research study that was described.

Answer: Answers will vary 323) What is ECT? In your answer summarize what ECT is, describe why it was originally developed,

discuss the conditions for which it is currently used, and cite the criticisms that have been made against its use.

Answer: Answers will vary

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W.Docs Chapter 17 Mental Health and the Law

TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière]

Answer Key Testname: UNTITLED1

1) A 2) C 3) C 4) A 5) B 6) C 7) D 8) A 9) A 10) C 11) D 12) A 13) B 14) A 15) B 16) A 17) B 18) C 19) B 20) D 21) D 22) B 23) A 24) D 25) A 26) B 27) B 28) D 29) C 30) A 31) D 32) C 33) A 34) B 35) C 36) D 37) A 38) A 39) B 40) C 41) C 42) C 43) C 44) A 45) D 46) C 47) A 48) A 49) A 50) C 51

W.Docs Chapter 17 Mental Health and the Law

TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière]

Answer Key Testname: UNTITLED1

51) C 52) C 53) C 54) B 55) A 56) D 57) B 58) D 59) D 60) B 61) A 62) A 63) A 64) C 65) B 66) B 67) D 68) B 69) C 70) A 71) B 72) D 73) C 74) A 75) D 76) A 77) A 78) C 79) C 80) A 81) B 82) B 83) B 84) B 85) A 86) D 87) B 88) D 89) A 90) C 91) A 92) C 93) C 94) A 95) C 96) B 97) A 98) D 99) D 100) C 52

W.Docs Chapter 17 Mental Health and the Law

TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière]

Answer Key Testname: UNTITLED1

101) D 102) B 103) A 104) C 105) B 106) D 107) C 108) D 109) A 110) C 111) B 112) C 113) D 114) C 115) B 116) C 117) B 118) D 119) D 120) A 121) B 122) D 123) C 124) D 125) A 126) C 127) C 128) C 129) C 130) C 131) B 132) C 133) B 134) D 135) A 136) D 137) B 138) A 139) C 140) C 141) D 142) C 143) B 144) D 145) D 146) C 147) D 148) A 149) A 150) D 53

W.Docs Chapter 17 Mental Health and the Law

TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière]

Answer Key Testname: UNTITLED1

151) B 152) B 153) A 154) A 155) B 156) D 157) B 158) C 159) D 160) B 161) D 162) D 163) A 164) A 165) D 166) C 167) C 168) B 169) A 170) B 171) C 172) C 173) B 174) D 175) B 176) D 177) C 178) C 179) TRUE 180) FALSE 181) TRUE 182) FALSE 183) FALSE 184) TRUE 185) FALSE 186) TRUE 187) TRUE 188) TRUE 189) FALSE 190) TRUE 191) FALSE 192) FALSE 193) FALSE 194) FALSE 195) TRUE 196) TRUE 197) FALSE 198) TRUE 199) FALSE 200) TRUE 54

W.Docs Chapter 17 Mental Health and the Law

TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière]

Answer Key Testname: UNTITLED1

201) FALSE 202) TRUE 203) TRUE 204) FALSE 205) D 206) D 207) B 208) D 209) B 210) D 211) B 212) A 213) B 214) D 215) C 216) C 217) C 218) D 219) D 220) B 221) D 222) B 223) A 224) B 225) C 226) A 227) B 228) C 229) A 230) B 231) B 232) C 233) B 234) C 235) C 236) E 237) A 238) B 239) D 240) E 241) C 242) B 243) D 244) A 245) D 246) D 247) E 248) C 249) A 250) B 55

W.Docs Chapter 17 Mental Health and the Law

TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière]

Answer Key Testname: UNTITLED1

251) D 252) E 253) A 254) E 255) C 256) E 257) C 258) C 259) D 260) B 261) B 262) C 263) B 264) D 265) D 266) Answers will vary 267) Answers will vary 268) Answers will vary 269) Answers will vary 270) Answers will vary 271) Answers will vary 272) Answers will vary 273) Answers will vary 274) Answers will vary 275) Answers will vary 276) Answers will vary 277) Answers will vary 278) Answers will vary 279) Answers will vary 280) Answers will vary 281) Answers will vary 282) Answers will vary 283) Answers will vary 284) Answers will vary 285) Answers will vary 286) Answers will vary 287) Answers will vary 288) Answers will vary 289) Answers will vary 290) Answers will vary 291) Answers will vary 292) Answers will vary 293) Answers will vary 294) Answers will vary 56

W.Docs Chapter 17 Mental Health and the Law

TB-Abnormal Psychology;An Integrative Approach[6E,Lalumière]

Answer Key Testname: UNTITLED1

295) Answers will vary 296) Answers will vary 297) Answers will vary 298) Answers will vary 299) Answers will vary 300) Answers will vary 301) Answers will vary 302) Answers will vary 303) Answers will vary 304) Answers will vary 305) Answers will vary 306) Answers will vary 307) Answers will vary 308) Answers will vary 309) Answers will vary 310) Answers will vary 311) Answers will vary 312) Answers will vary 313) Answers will vary 314) Answers will vary 315) Answers will vary 316) Answers will vary 317) Answers will vary 318) Answers will vary 319) Answers will vary 320) Answers will vary 321) Answers will vary 322) Answers will vary 323) Answers will vary

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TEST BANK

TEST BANK