AbPsych Neuro Disorders

Question 1

Which of the following is not required for a DSM-5 diagnosis of intellectual disability (intellectual developmental disorder)?
A. Full-scale IQ below 70.
B. Deficits in intellectual functions confirmed by clinical assessment.
C. Deficits in adaptive functioning that result in failure to meet developmental
and sociocultural standards for personal independence and social responsibility.
D. Symptom onset during the developmental period.
E. Deficits in intellectual functions confirmed by individualized, standardized
intelligence testing

Answer 1

Correct Answer: A. Full-scale IQ below 70.

Question 2

A 7-year-old boy in second grade displays significant delays in his ability to reason, solve problems, and learn from his experiences. He has been slow to develop reading, writing, and mathematics skills in school. These skills lagged behind peers through development, although he is making slow progress. These deficits significantly impair his ability to play in an age-appropriate manner with peers and to begin to acquire independent skills at home. He requires ongoing assistance with basic skills (dressing, feeding, and bathing himself; doing any type of schoolwork) on a daily basis. Which of the following diagnoses best fits this presentation?
A. Childhood-onset major neurocognitive disorder.
B. Specific learning disorder.
C. Intellectual disability (intellectual developmental disorder).
D. Communication disorder.
E. Autism spectrum disorder

Answer 2

Correct Answer: C. Intellectual disability (intellectual developmental disorder).

Question 3

Which of the following statements about intellectual disability (intellectual developmental disorder) is false?

A. Individuals with intellectual disability have deficits in general mental abilities and impairment in everyday adaptive functioning compared with age and gender-matched peers from the same linguistic and sociocultural group.
B. For individuals with intellectual disability, the full-scale IQ score is a valid assessment of overall mental abilities and adaptive functioning, even if subtest scores are highly discrepant.
C. Individuals with intellectual disability may have difficulty managing their behavior, emotions, and interpersonal relationships and maintaining motivation in the learning process.
D. Intellectual disability is generally associated with an IQ of 2 standard deviations from the population mean, equating to an IQ score of about 70 or below (r5 points).
E. Assessment procedures for intellectual disability must take into account factors that may limit performance, such as sociocultural background, native language, associated communication/language disorder, and motor or
sensory handicap.

Answer 3

Correct Answer: B. For individuals with intellectual disability, the full-scale IQ score is a valid assessment of overall mental abilities and adaptive functioning, even if subtest scores are highly discrepant.

Question 4

Which of the following statements about the diagnosis of intellectual disability
(intellectual developmental disorder) is false?
A. An individual with an IQ of less than 70 would receive the diagnosis if there were no significant deficits in adaptive functioning.
B. An individual with an IQ above 75 would not meet diagnostic criteria even if there were impairments in adaptive functioning.
C. In forensic assessment, severe deficits in adaptive functioning might allow for a diagnosis with an IQ above 75.
D. Adaptive functioning must take into account the three domains of conceptual, social, and practical functioning.
E. The specifiers mild, moderate, severe, and profound are based on IQ scores.

Answer 4

Correct Answer: E. The specifiers mild, moderate, severe, and profound are based on IQ scores.

Question 5

Which of the following is not a diagnostic feature of intellectual disability (intellectual developmental disorder)?
A. A full-scale IQ of less than 70.
B. Inability to perform complex daily living tasks (e.g., money management,
medical decision making) without support.
C. Gullibility, with naiveté in social situations and a tendency to be easily led
by others.
D. Lack of age-appropriate communication skills for social and interpersonal
functioning.
E. All of the above are diagnostic features of intellectual disability

Answer 5

Correct Answer: A. A full-scale IQ of less than 70.

Question 6

Which of the following statements about adaptive functioning in the diagnosis
of intellectual disability (intellectual developmental disorder) is true?
A. Adaptive functioning is based on an individual’s IQ score.
B. “Deficits in adaptive functioning” refers to problems with motor coordination.
C. At least two domains of adaptive functioning must be impaired to meet Criterion B for the diagnosis of intellectual disability.
D. Adaptive functioning in intellectual disability tends to improve over time,
although the threshold of cognitive capacities and associated developmental disorders can limit it.
E. Individuals diagnosed with intellectual disability in childhood will typically continue to meet criteria in adulthood even if their adaptive functioning improves.

Answer 6

Correct Answer: D. Adaptive functioning tends to improve over time, although the threshold of cognitive capacities and associated developmental
disorders can limit it.

Question 7

Which of the following statements about the developmental course of intellectual disability (intellectual developmental disorder) is true?
A. Delayed motor, language, and social milestones are not identifiable until after the first 2 years of life.
B. Intellectual disability caused by an illness (e.g., encephalitis) or by head
trauma occurring during the developmental period would be diagnosed as
a neurocognitive disorder, not as intellectual disability (intellectual developmental disorder).
C. Intellectual disability is always nonprogressive.
D. Major neurocognitive disorder may co-occur with intellectual developmental disorder.
E. Even if early and ongoing interventions throughout childhood and adulthood lead to improved adaptive and intellectual functioning, the diagnosis
of intellectual disability would continue to apply.

Answer 7

Correct Answer: D. Major neurocognitive disorder may co-occur with intellectual developmental disorder.

Question 8

A 10-year-old boy with a history of dyslexia, who is otherwise developmentally normal, is in a skateboarding accident in which he experiences severe
traumatic brain injury. This results in significant global intellectual impairment
(with a persistent reading deficit that is more pronounced than his other newly
acquired but stable deficits, along with a full-scale IQ of 75). There is mild impairment in his adaptive functioning such that he requires support in some areas of functioning. He is also displaying anxious and depressive symptoms in
response to his accident and hospitalization. What is the least likely diagnosis?
A. Intellectual disability (intellectual developmental disorder).
B. Traumatic brain injury.
C. Specific learning disorder.
D. Major neurocognitive disorder due to traumatic brain injury.
E. Adjustment disorder

Answer 8

Correct Answer: D. Major neurocognitive disorder due to traumatic brain injury.

Question 9

In which of the following situations would a diagnosis of global developmental delay be inappropriate?
A. The patient is a child who is too young to fully manifest specific symptoms
or to complete requisite assessments.
B. The patient, a 7-year-old boy, has a full-scale IQ of 65 and severe impairment in adaptive functioning.
C. The patient’s scores on psychometric tests suggest intellectual disability (intellectual developmental disorder), but there is insufficient information
about the patient’s adaptive functional skills.
D. The patient’s impaired adaptive functioning suggests intellectual developmental disorder, but there is insufficient information about the level of cognitive impairment measured by standardized instruments.
E. The patient’s cognitive and adaptive impairments suggest intellectual developmental disorder, but there is insufficient information about age at onset of the condition.

Answer 9

Correct Answer: B. The patient, a 7-year-old boy, has a full-scale IQ of 65 and severe impairment in adaptive functioning

Question 10

A 3½-year-old girl with a history of lead exposure and a seizure disorder demonstrates substantial delays across multiple domains of functioning, including
communication, learning, attention, and motor development, which limit her
ability to interact with same-age peers and require substantial support in all activities of daily living at home. Unfortunately, her mother is an extremely poor
historian, and the child has received no formal psychological or learning evaluation to date. She is about to be evaluated for readiness to attend preschool.
What is the most appropriate diagnosis?
A. Major neurocognitive disorder.
B. Developmental coordination disorder.
C. Autism spectrum disorder.
D. Global developmental delay.
E. Specific learning disorder.

Answer 10

Correct Answer: D. Global developmental delay.

Question 11

A 5-year-old boy has difficulty making friends and problems with initiating
and sustaining back-and-forth conversation; reading social cues; and sharing
his feelings with others. He makes good eye contact, has normal speech intonation, displays facial gestures, and has a range of affect that generally seems
appropriate to the situation. He demonstrates an interest in trains that seems
abnormal in intensity and focus, and he engages in little imaginative or symbolic play. Which of the following diagnostic requirements for autism spectrum disorder are not met in this case?
A. Deficits in social-emotional reciprocity.
B. Deficits in nonverbal communicative behaviors used for social interaction.
C. Deficits in developing and maintaining relationships.
D. Restricted, repetitive patterns of behavior, interests, or activities as manifested by symptoms in two of the specified four categories.
E. Symptoms with onset in early childhood that cause clinically significant
impairment.

Answer 11

Correct Answer: B. Deficits in nonverbal communicative behaviors used for social interaction.

Question 12

Which of the following statements about the development and course of autism spectrum disorder (ASD) is false?
A. Symptoms of ASD are typically recognized during the second year of life
(12–24 months of age).
B. Symptoms of ASD are usually not noticeable until 5–6 years of age or later.
C. First symptoms frequently involve delayed language development, often
accompanied by lack of social interest or unusual social interactions.
D. ASD is not a degenerative disorder, and it is typical for learning and compensation to continue throughout life.
E. Because many normally developing young children have strong preferences and enjoy repetition, distinguishing restricted and repetitive behaviors that are diagnostic of ASD can be difficult in preschoolers.

Answer 12

Correct Answer: B. Symptoms are not typically noticeable until 5–6 years of age or later.

Question 13

Which of the following was a criterion symptom for autistic disorder in DSMIV that was eliminated from the diagnostic criteria for autism spectrum disorder in DSM-5?
A. Stereotyped or restricted patterns of interest.
B. Stereotyped and repetitive motor mannerisms.
C. Inflexible adherence to routines.
D. Persistent preoccupation with parts of objects.
E. None of the above.

Answer 13

Correct Answer: D. Persistent preoccupation with parts of objects.

Question 14

A 7-year-old girl presents with a history of normal language skills (vocabulary
and grammar intact) but is unable to use language in a socially pragmatic manner to share ideas and feelings. She has never made good eye contact, and she
has difficulty reading social cues. Consequently, she has had difficulty making
friends, which is further complicated by her being somewhat obsessed with
cartoon characters, which she repetitively scripts. She tends to excessively
smell objects. Because she insists on wearing the same shirt and shorts every
day, regardless of the season, getting dressed is a difficult activity. These symptoms date from early childhood and cause significant impairment in her functioning. What diagnosis best fits this child’s presentation?
A. Asperger’s disorder.
B. Autism spectrum disorder.
C. Pervasive developmental disorder not otherwise specified (NOS).
D. Social (pragmatic) communication disorder.
E. Rett syndrome.

Answer 14

Correct Answer: B. Autism spectrum disorder.

Question 15

A 15-year-old boy has a long history of nonverbal communication deficits. As
an infant he was unable to follow someone else directing his attention by pointing. As a toddler he was not interested in sharing events, feelings, or games
with his parents. From school age into adolescence, his speech was odd in tonality and phrasing, and his body language was awkward. What do these
symptoms represent?
A. Stereotypies.
B. Restricted range of interests.
C. Developmental regression.
D. Prodromal schizophreniform symptoms.
E. Deficits in nonverbal communicative behaviors.

Answer 15

Correct Answer: E. Deficits in nonverbal communicative behaviors.

Question 16

A 10-year-old boy demonstrates hand-flapping and finger flicking, and he repetitively flips coins and lines up his trucks. He tends to “echo” the last several
words of a question posed to him before answering, mixes up his pronouns (refers to himself in the second person), tends to repeat phrases in a perseverative
fashion, and is quite fixated on routines related to dress, eating, travel, and
play. He spends hours in his garage playing with his father’s tools. What do
these behaviors represent?
A. Restricted, repetitive patterns of behaviors, interests, or activities characteristic of autism spectrum disorder.
B. Symptoms of obsessive-compulsive disorder.
C. Prototypical manifestations of obsessive-compulsive personality.
D. Symptoms of pediatric acute-onset neuropsychiatric syndrome (PANS).
E. Complex tics.

Answer 16

Correct Answer: A. Restricted, repetitive patterns of behaviors, interests, or activities characteristic of autism spectrum disorder.

Question 17

A 25-year-old man presents with long-standing nonverbal communication
deficits, inability to have a back-and-forth conversation or share interests in an
appropriate fashion, and a complete lack of interest in having relationships
with others. His speech reflects awkward phrasing and intonation and is mechanical in nature. He has a history of sequential fixations and obsessions with
various games and objects throughout childhood; however, this is not currently a major issue for him. This patient meets criteria for autism spectrum
disorder; true or false?

Answer 17

TRUE

Explanation: This young man presents with all three symptoms in Criterion A; his symptoms satisfy Criterion C, which requires childhood onset; and he meets Criterion D, which requires clinically significant impairment in functioning. Although he has only one symptom in Criterion B (stereotyped or repetitive speech) and the diagnosis requires two, the fact that he has a history of fixations and obsessions satisfies the criteria, such that he does qualify for a diagnosis of autism spectrum disorder.

Question 18

Which of the following is not characteristic of the developmental course of children diagnosed with autism spectrum disorder?
A. Behavioral features manifest before 3 years of age.
B. The full symptom pattern does not appear until age 2–3 years.
C. Developmental plateaus or regression in social-communicative behavior is
frequently reported by parents.
D. Regression across multiple domains occurs after age 2–3 years.
E. First symptoms often include delayed language development, lack of social
interest or unusual social behavior, odd play, and unusual communication
patterns.

Answer 18

Correct Answer: D. Regression across multiple domains occurs after age 2–3
years.

Question 19

A 5-year-old girl has some mild food aversions. She enjoys having the same
book read to her at night but does not become terribly upset if her mother asks
her to choose a different book. She occasionally spins around excitedly when
her favorite show is on. She generally likes her toys neatly arranged in bins but
is only mildly upset when her sister leaves them on the floor. These behaviors
should be considered suspicious for an autism spectrum disorder; true or
false?
A. True.
B. False

Answer 19

Correct Answer: B. False.

Explanation: The girl described in the question meets none of the criteria for
autism spectrum disorder. Because many typically developing young children
have strong preferences and enjoy repetition (e.g., eating the same foods,
watching the same video multiple times), distinguishing restricted and repetitive behaviors that are diagnostic of autism spectrum disorder can be difficult
in preschoolers. The clinical distinction is based on the type, frequency, and intensity of the behavior (e.g., a child who daily lines up objects for hours and is
very distressed if any item is moved).

Question 20

A 21-year-old man, not previously diagnosed with a developmental disorder, presents for evaluation after taking a leave from college for psychological reasons. He makes little eye contact, does not appear to pick up on social cues, has become disinterested in friends, spends hours each day on the computer surfing the Internet and playing games, and has become so sensitive to smells that he keeps multiple air fresheners in all locations of the home. He reports that he has had long-standing friendships dating from childhood and high school (corroborated by his parents). He reports making many friends in his fraternity at college. His parents report good social and communication skills in childhood, although he was quite shy and was somewhat inflexible and ritualistic
at home. What is the least likely diagnosis?
A. Depression.
B. Schizophreniform disorder or schizophrenia.
C. Autism spectrum disorder.
D. Obsessive-compulsive disorder.
E. Social anxiety disorder (social phobia)

Answer 20

Correct Answer: C. Autism spectrum disorder.

Question 21

Which of the following characteristics is generally not associated with autism
spectrum disorder?
A. Anxiety, depression, and isolation as an adult.
B. Catatonia.
C. Poor psychosocial functioning.
D. Insistence on routines and aversion to change.
E. Successful adaptation in regular school settings.

Answer 21

Correct Answer: E. Successful adaptation in regular school settings.

Question 22

Which of the following disorders is generally not comorbid with autism spectrum disorder (ASD)?
A. Attention-deficit/hyperactivity disorder (ADHD).
B. Rett syndrome.
C. Selective mutism.
D. Intellectual disability (intellectual developmental disorder).
E. Stereotypic movement disorder.

Answer 22

Correct Answer: C. Selective mutism.

Question 23

A 7-year-old boy is having behavioral and social difficulties in his secondgrade class. Although he seems to be able to attend and is doing “well” from
an academic standpoint (though seemingly not what he is capable of), he is
constantly interrupting, fidgeting, talking excessively, and getting out of his
seat. He has friends, but he sometimes annoys his peers because of his difficulty sharing and taking turns and the fact that he is constantly talking over them. Although he seeks out play dates, his friends tire of him because he wants to play sports nonstop. At home, he can barely stay in his seat for a meal and is unable to play quietly. Although he shows remorse when the consequences of his behavior are pointed out to him, he can become angry in response and seems nevertheless unable to inhibit himself. What is the most
likely diagnosis?
A. Bipolar disorder.
B. Autism spectrum disorder.
C. Generalized anxiety disorder.
D. Attention-deficit/hyperactivity disorder, predominantly hyperactive/impulsive.
E. Specific learning disorder

Answer 23

Correct Answer: D. Attention-deficit/hyperactivity disorder, predominantly hyperactive/impulsive.

Question 24

A 37-year-old Wall Street trader schedules a visit after his 8-year-old son is diagnosed with attention-deficit/hyperactivity disorder (ADHD), combined inattentive and hyperactive. Although he does not currently note motor
restlessness like his son, he recalls being that way when he was a boy, along
with being quite inattentive, being impulsive, talking excessively, interrupting,
and having problems waiting his turn. He was an underachiever in high school
and college, when he inconsistently did his work and had difficulty following rules. Nevertheless, he never failed any classes, and he was never evaluated by a psychologist or psychiatrist. He works about 60–80 hours a week and often gets insufficient sleep. He tends to make impulsive business decisions, can be impatient and short-tempered, and notes that his mind tends to wander both in one-on-one interactions with associates and his wife and during business meetings, for which he is often late; he is forgetful and disorganized. Nevertheless, he tends to perform fairly well and is quite successful, although he can occasionally feel overwhelmed and demoralized. What is the most likely
diagnosis?
A. Major depressive disorder.
B. Generalized anxiety disorder.
C. Specific learning disorder.
D. ADHD, in partial remission.
E. Oppositional defiant disorder

Answer 24

Correct Answer: D. ADHD, in partial remission.

Question 25

A 5-year-old hyperactive, impulsive, and inattentive boy presents with hypertelorism, highly arched palate, and low-set ears. He is uncoordinated and
clumsy, he has no sense of time, and his toys and clothes are constantly strewn
all over the house. He has recently developed what appears to be a motor tic
involving blinking. He enjoys playing with peers, who tend to like him, although he seems to willfully defy all requests from his parents and kindergarten teacher, which does not seem to be due simply to inattention. He is delayed
in beginning to learn how to read. What is the least likely diagnosis?
A. Autism spectrum disorder.
B. Developmental coordination disorder.
C. Oppositional defiant disorder (ODD).
D. Specific learning disorder.
E. Attention-deficit/hyperactivity disorder (ADHD).

Answer 25

Correct Answer: A. Autism spectrum disorder.

Question 26

What is the gender ratio of attention-deficit/hyperactivity disorder (ADHD) in
children?
A. Male:female ratio of 2:1.
B. Male:female ratio of 1:1.
C. Male:female ratio of 3:2.
D. Male:female ratio of 5:1.
E. Male:female ratio of 1:2.

Answer 26

Correct Answer: A. Male:female ratio of 2:1.

Question 27

Which of the following is not associated with attention-deficit/hyperactivity
disorder (ADHD)?
A. Reduced school performance.
B. Poorer occupational performance and attendance.
C. Higher probability of unemployment.
D. Elevated interpersonal conflict.
E. Reduced risk of substance use disorders.

Answer 27

Correct Answer: E. Reduced risk of substance use disorders.

Question 28

Which of the following is not associated with attention-deficit/hyperactivity
disorder (ADHD)?
A. Social rejection.
B. Increased risk of developing conduct disorder in childhood and antisocial
personality disorder in adulthood.
C. Increased risk of Alzheimer’s disease.
D. Increased frequency of traffic accidents and violations.
E. Increased risk of accidental injury.

Answer 28

Correct Answer: C. Increased risk of Alzheimer’s disease.

Question 29

A 5-year-old boy is consistently moody, irritable, and intolerant of frustration.
In addition, he is pervasively and chronically restless, impulsive, and inattentive. Which diagnosis best fits his clinical picture?
A. Attention-deficit/hyperactivity disorder (ADHD).
B. ADHD and disruptive mood dysregulation disorder (DMDD).
C. Bipolar disorder.
D. Oppositional defiant disorder (ODD).
E. Major depressive disorder (MDD).

Answer 29

Correct Answer: B. ADHD and DMDD.

Question 30

Which of the following statements about comorbidity in attention-deficit/hyperactivity disorder (ADHD) is true?
A. Oppositional defiant disorder co-occurs with ADHD in about half of children with the combined presentation and about a quarter of those with the
predominantly inattentive presentation.
B. Most children with disruptive mood dysregulation disorder do not also
meet criteria for ADHD.
C. Fifteen percent of adults with ADHD have some type of anxiety disorder.
D. Intermittent explosive disorder occurs in about 5% of adults with ADHD.
E. Specific learning disorder very seldom co-occurs with ADHD.

Answer 30

Correct Answer: A. Oppositional defiant disorder co-occurs with ADHD in about half of children with the combined presentation and about a quarter of those with the predominantly inattentive presentation.

Question 31

Specific learning disorder is defined by persistent difficulties in learning academic skills, with onset during the developmental period. Which of the following statements about this disorder is true?
A. It is part of a more general learning impairment as manifested in intellectual disability (intellectual developmental disorder).
B. It can usually be attributed to a sensory, physical, or neurological disorder.
C. It involves pervasive and wide-ranging deficits across multiple domains of
information processing.
D. It can be caused by external factors such as economic disadvantage or lack
of education.
E. It replaces the DSM-IV diagnoses of reading disorder, mathematics disorder, disorder of written expression, and learning disorder not otherwise
specified.

Answer 31

Correct Answer: E. It replaces the DSM-IV diagnoses of reading disorder, mathematics disorder, disorder of written expression, and learning disorder not otherwise specified.

Question 32

Which of the following statements about developmental coordination disorder
(DCD) is true?
A. The disorder is usually not diagnosed before the age of 7 years.
B. Symptoms have usually improved significantly at 1-year follow-up.
C. In most cases, symptoms are no longer evident by adolescence.
D. DCD has no clear relationship with prenatal alcohol exposure, preterm
birth, or low birth weight.
E. Cerebellar dysfunction is hypothesized to play a role in DCD.

Answer 32

Correct Answer: E. Cerebellar dysfunction is hypothesized to play a role in
DCD.

Question 33

At her child’s third office visit, the mother of an 8-year-old boy with a 6-month
history of excessive eye blinking and intermittent chirping says that she has
noticed the development of grunting sounds since he started school this term.
What is the most likely diagnosis?
A. Tourette’s disorder.
B. Provisional tic disorder.
C. Temporary tic disorder.
D. Persistent (chronic) vocal tic disorder.
E. Transient tic disorder, recurrent.

Answer 33

Correct Answer: B. Provisional tic disorder.

Question 34

A 5-year-old girl is referred to your care with a DSM-IV diagnosis of chronic
motor or vocal tic disorder. Under DSM-5, she would meet criteria for persistent (chronic) motor or vocal tic disorder. Which of the following statements
about her new diagnosis under DSM-5 is false?
A. She may have single or multiple motor or vocal tics, but not both.
B. Her tics must persist for more than 1 year since first tic onset without a ticfree period for 3 consecutive months to meet diagnostic criteria.
C. Her tics may wax and wane in frequency but have persisted for more than
1 year since first tic onset.
D. She has never met criteria for Tourette’s disorder.
E. A specifier may be added to the diagnosis of persistent (chronic) motor or
vocal tic disorder to indicate whether the girl has motor or vocal tics.

Answer 34

Correct Answer: B. Her tics must persist for more than 1 year since first tic onset without a tic-free period for 3 consecutive months to meet diagnostic criteria.