Assorted Pertinent Topics - Part 2 of 2 Flashcards
Cognitive therapy was developed by:
AARON BECK
Cartesian dualism from the theories of René Descartes refers to
POTENTIAL OF HUMAN NATURE FOR BOTH GOOD AND EVIL
Normal autism, symbiosis, differentiation, and practicing are among the developmental subphases of separation and individuation proposed by what theorist?
MARGARET MAHLER
Melanie Klein differed from Freud in her emphasis on what factor?
EARLY OBJECT RELATIONS
According to Holmes & Rahe, what life event is assoc w highest stress/disruption?
DEATH OF A SPOUSE
Mental competency of an elderly patient is determined by: (7x)
JUDICIAL HEARING
Testamentary capacity refers to person’s ability to (4x)
MAKE A WILL
What is primary role of psychiatric expert witness (4x)
RENDER OPINION BASED ON SCIENTIFIC KNOWLEDGE
Child custody determinations in most jurisdictions are made using what principle? (4x)
THE BEST INTEREST OF THE CHILD
Sufficient to establish that a person is incompetent to stand trial (3x)
FAILURE TO UNDERSTAND THE CHARGES ONE IS FACING
Constitutional and common law dictate that mental health care provided to prisoners be at or above the level of services that should be available to them if they were in the community. The “necessaries” doctrine is justified by what principle? (x2)
TREATMENT MUST BE PROVIDED TO THOSE WHO ARE PREVENTED FROM SEEKING THEIR OWN MEDICAL CARE.
What is the first step when determining whether or not a criminal defendant is not guilty by reason of insanity? (2x)
DETERMINE THE LEGAL INSANITY STANDARD TO BE USED.
When evaluating for competence to proceed in a criminal matter, the psychiatric evaluator should focus on which aspect of the defendant? (2x)
CURRENT MENTAL FUNCTIONING
What is most important to evaluate “competence”? (2x)
“WHAT DO YOU THINK WILL HAPPEN IF YOU DON’T UNDERTAKE THIS TREATMENT?”
Medication can be administered without a patient’s consent under which of the following circumstances? (2x)
AN EMERGENCY SITUATION EXISTS AND CAN BE DOCUMENTED
In malpractice suits against psychiatrists, the most common allegation? (2x)
INCORRECT TREATMENT
What is the legal process that asks the court to immediately evaluate if a pt has been hospitalized w/o due process of law? (2x)
WRIT OF HABEAS CORPUS
What documentation will legally protect a psychiatrist, if pt dies by suicide? (2x)
DETERMINE THE LEGAL INSANITY STANDARD TO BE USED
Most common factor in cases of termination of parental right: (2x)
NEGLECT BY THE PARENT
75 y/o pt with AD started on quetiapine 12.5 mg bid for agitation> according Omnibus Budget Reconciliation Act, the MD must: (2x)
ATTEMPT TO DECREASE OR STOP THE MED DOSE AT LEAST EVERY 3 MONTHS.
A lawsuit charges that a psychiatric facility prematurely discharged a patient who was not approved for further stay by the managed care company. The final legal responsibility generally falls to the (x2):
PSYCHIATRIST
What is an unethical fee arrangement for a forensic psychiatrist (x2)?
PERCENTAGE OF PLAINTIFFS AWARD
Mental Health Parity and Addiction Equity Act of 2008 made which guidelines for substance use treatment
EQUALIZED VISIT LIMITS FOR BEHAVIORAL HEALTH AND MEDICAL CONDITIONS IN A SIMILAR CATEGORY OF COVERAGE
Which is a mandate of the affordable care act designed to increase mental health service access?
PROHIBITION ON PRE-EXISTING CONDITION DENIALS DUE TO HX OF MENTAL DISORDER
Capacity eval component for referral to mental health court
UNDERSTAND THAT THE CHOICE OF THE OPTION INVOLVES WAIVING CERTAIN CONSTITUTIONAL RIGHTS
HIPAA allows PCP and psychiatrist to discuss?
CAN DISCUSS THE CASES THAT PCP IS INVOLVED WITH
Pt seen psychiatrist once, then psychiatrist only calls to follow-up, but doesn’t take on pt care.
PATIENT ABANDONMENT
Situations where patients can be forced antipsychotics: include emergencies, treating symptoms threatening others or self’s safety and..?
RESTORING A CRIMINAL DEFENDANT TO STAND TRIAL
Licensing requirements in telepsychiatry
ONLY IN THE STATE WHERE PATIENT IS LOCATED
APA positions on gun possession in psych patients
INDIVIDUALS WHO PRESENT AN INCREASED RISK OF VIOLENCE SHOULD BE BANNED FROM OWNING GUNS
Psychiatrist wants to talk to a another physician patient provides verbal consent but not written what does HIPAA say
MAY DISCUSS THE CASE TO ADVANCE TREATMENT DECISION
Most ethical action when psychiatrist receives subpoena for records pertaining to patient arrested for selling marijuana
OPPOSE SUBPOENA DUE TO LACK OF PT CONSENT
Dementia pt with durable power of attorney, decisions need to be made by?
ASSIGNED DECISION MAKER
Psychiatrist to eval pt with bipolar DO who is exhibiting threatening behavior while inpt on CCU for cardiac ischemia. Pt was incarcerated for assaulting and officer, disturbing the peace and firearms violations. Pt verbally threatens to track down his ex-girlfriend and “teach her a lesson she’ll never forget.” Psychiatrist has legal responsibility to…
INFORM POLICE THAT PT IS IN POTENTIAL DANGER
After a pt assaults a roommate on a psych inpt unit the tx team decides to have pt arrested and transferred to jail. Decision is based on …?
DUTY TO OTHER HOSPITALIZED PTS
Individual w/ schizophrenia arrested after breaking into grocery store would be found incompetent to stand trial if s/he:
BELIEVES ALL LAWYERS ARE DEMONS AND REFUSES TO SPEAK TO THEM
Pt arrested for possession of cocaine, spends 2 days in jail, after missing apps with subs abuse counselor. Intervention is referred to as…?
DRUG COURT
Rogers v. commissioner (1983) is a legal case that addressed the right to refuse antipsychotic meds in non-emergency situations. Based on this ruling, pts previously adjudicated as incompetent may not refuse meds in which situation?
THERE IS A COURT-APPROVED SUBSTITUTED JUDGMENT TX PLAN
In order to be judged competent to stand trial, a defendant must be able to consult with the lawyer w/ a reasonable degree of rational understand and possess what?
A FACTUAL AND RATIONAL UNDERSTANDING OF PROCEEDINGS AGAINST HIM/HER
Patient threatens criminal behavior toward property of another. Legal obligation of psychiatrist?
NONE
What situation requires the psychiatrist to step out of usual tx relationship to protect the pt or others from harm?
CHILD ABUSE
Constitutional and common law dictate prisoners must receive care at the level or above care they would receive if they were in the community. This “necessaries” doctrine is justified by which of the following principles?
TREATMENT MUST BE PROVIDED TO THOSE WHO ARE PREVENTED FROM SEEKING THEIR OWN MEDICAL CARE
Pt attempted suicide during a crisis which was worsened by pt’s feelings about being unable to reach vacationing psychiatrist who did not provide coverage. What is the psychiatrist’s vulnerability?
ABANDONMENT
When documenting suicide risk assessment, key strategy is to discuss …
WHY THE PSYCHIATRIST REJECTED ALTERNATIVE WAYS OF RESPONDING
Which of the following is the most common reason for malpractice claims?
INCORRECT TREATMENT
Psychiatrist provides psychotherapy to 22 y/o pt who lives w/ parents and dx w/ anxiety and depression. Pt reports the father threw 13 y/o sibling across the room. Sib was not injured. Multiple similar episodes. What is appropriate response for the psychiatrist?
TELL PT THAT THE PSYCHIATRIST MUST REPORT THE ABUSE TO CHILD PROTECTIVE SERVICES.
Appropriate substance abuse treatment in the clinical setting has been addressed in landmark legal cases. What is the consensus?
IT IS AMONG THE RIGHTS GRANTED AS IT IS CONSIDERED A PSYCHIATRIC DISORDER
Which tools can be used when a person wishes to assign a surrogate to make healthcare decisions during future periods of mental incapacity?
ADVANCE DIRECTIVE
Pt has psychotherapist. Pt referred to psychiatrist who prescribes medication. Psychiatrist’s responsibility to pt
TO FOLLOW UP BY SEEING PT AT APPROPRIATE SCHEDULED INTERVALS AND BY COMMUNICATING REGULARLY W/ PSYCHOLOGIST ABOUT PT’S CLINICAL STATUS AND TX PLAN
80 y/o pt was admitted to a nursing home, an employee of the facility notified the pt about the state’s laws on advance directives. During that session, the patient most likely received information about which of the following issues:
THE LIVING WILL
29 y/o severely depressed with SI. Threatens to kill his wife and daughter to “take them with me.” Legal responsibility:
NOTIFY THE WIFE
Pt who suffers from a serious mental d/o is a defendant in a criminal matter. Even if pt understands the nature and objectives of court proceedings, pt may be found not competent to stand trial under:
BEING UNABLE TO ASSIST ATTORNEY IN THE DEFENCES
The most accurately describes the primary function of a mental health court:
DIRECTS MENTALLY ILL DEFENDANTS TO TX RATHER THAN PUNISHMENT
Which characterizes the defendant’s competency to stand trial in criminal proceedings?
IS PRESUMED UNLESS THE ISSUE IS RAISED
Initial step when child is referred for evaluation:
CONSENT FOR EVAL FROM GUARDIAN
Pt is admitted to ICU. Pt can communicate but is deemed incompetent. Which of the following advance directives should be used to inform the hospital staff of pt wishes?
LIVING WILL
24yohomelesswithSIrequestshospitalization.Thisis3rd visitinspanof2weeks.Ptis organized, coherent. When asked what would be different with this hospitalization, attacks the doctor. Best next step of action?
CALL LAW ENFORCEMENT
Which should raise Psych MD’s index of suspicion for malingering in cases of litigation in which financial compensation is at issue?
VAGUELY DEFINED SYMPTOMS
Criterion for a covered disability under Americans with Disabilities Act:
SUBSTANTIALLY LIMITS ONE OR MORE MAJOR LIFE ACTIVITIES
What determines disability?
IMPAIRMENT AFFECTS ABILITY TO MEET PERSONAL, SOCIAL, OR OCCUPATIONAL NEEDS
Pt getting psych exam to determine suitability for a job must be informed:
EXAM IS NOT CONFIDENTIAL
In determining the disclosure of psychiatric treatment information in court, which of the following individuals is considered to hold privilege:
PATIENT
Psychiatrist agrees to prescribe medication to a pt who receives ongoing psychotherapy from another mental health professional. What is the psychiatrist’s liability in this treatment arrangement?
PSYCHIATRIST RETAINS FULL RESPONSIBILITY FOR THE PATIENT’S CARE
Pt has intractable OCD, with profound morbidity, and considers brain surgery. The surgeon must disclose this in order to obtain a valid informed consent:
THE INFORMATION MOST PATIENTS WOULD WANT TO KNOW.
A psych consultation is requested for a patient whom the medical team believes is manufacturing symptoms of an illness. Which of the following factors would be most consistent with a diagnosis of malingering?
FINANCIAL INCENTIVE FOR ILLNESS
Which of the following patients would automatically be considered as lacking the capacity to give informed consent for medical procedures?
A PATIENT WITH ALZHEIMER’S DEMENTIA WHO HAS A STATE DESIGNATED GUARDIAN
Patient refusing IV antibiotics, what is a reason he would not have capacity to do this?
DOES NOT UNDERSTAND CONSEQUENCES OF REFUSING TREATMENT
Most important finding for a psychiatrist to consider in disability determination:
DEGREE OF FUNCTIONAL IMPAIRMENT
A resident is discharging a patient and notes a significant omission in the resident’s last, handwritten progress note. Which of the following is the best course of action?
WRITE AN ADDENDUM TO THE PROGRESS NOTE WITH THE CURRENT DATE
In forensic psychiatry, the term “standard of care” refers to the use of treatments that are:
USED BY AVERAGE REASONABLE PRACTITIONERS
In evaluating a patient’s competence to consent to a medical treatment, the degree of strictness with which the examining psychiatrist considers the question is most affected by which of the following factors?
THE RISK-BENEFIT RATIO OF THE TREATMENT
Informed consent is NOT required in which of the following forensic evaluations?
COMPETENCY TO STAND TRIAL
What documentation will legally protect a psychiatrist, if pt dies by suicide?
AN SUICIDE RISK ASSESSMENT AND PROTECTIVE FACTORS.
Several states established that the verdict guilty but mentally ill to be an option when a defendant pleads not guilty by reason of insanity because:
WHEN COMPARED TO GUILTY, GUILTY BUT MENTALLY ILL IS INTENDED TO ENSURE ACCESS TO TREATMENT BUT IS ESSENTIALLY SIMILAR
The rule that finds people not guilty by reason of insanity due to mental illness that impaired their knowledge of the nature quality and consequences of their actions or they were incapable of realizing that these acts were wrong is called what?
M’NAGHTEN RULE
The criminal defendant tells the psychiatrist doing a forensic eval “I know that killing my father was illegal.” However, the defendant delusionally believed that the father was being tortured by demons and killing him was the moral thing to do. The defendant is unable to do what?
APPRECIATE THE WRONGFULNESS OF HIS CONDUCT
At the beginning of a radio talk show a psychiatrist states he is not entering into a doctor- patient relationship with any of the callers. Hereby he does not have _____ towards a patient in case of a malpractice suit.
DUTY
A patient requests an alternative tx for depression. His psychiatrist does not practice this tx himself but refers the pt to one who does. In 6mo the pt has complications from the tx and sues the 1st psychiatrist for malpractice. Which element of malpractice is missing in this case?
DUTY
Best protection against malpractice lawsuit:
MAINTAINING GOOD DOCTOR-PT RELATIONSHIP
Pt who recently delivered a baby BIB to ER, Pt is agitated, labile, and demanding to leave because she said her baby is being poisoned. This condition is considered a psych emergency because of its associated w/?
INFANTICIDE
Standard of care refers to treatments that are
USED BY AVERAGE REASONABLE PRACTITIONERS
Lawsuits against psychiatrist most frequently arise from issues concerning:
SUICIDE ATTEMPTS
The four basic elements that must be proven in order to sustain a claim of malpractice against a physician include a duty of care owed to the patient, negligence, causation, and what?
HARM TO THE PATIENT
Best defense against medical malpractice?
PATIENT DID NOT SUFFER A BAD OUTCOME
Patient’s confidentiality after death
USUALLY MUST BE MAINTAINED
Medical resident consults psychiatry because a 38 y/o F pt refused dialysis secondary to “antisocial personality” and the resident wants you to convince her to stay for treatment. Your answer is:
WILL ASSESS PT’S COMPETENCY TO MAKE ONE’S OWN MEDICAL DECISION
The most relevant issue for a geriatric or forensic psychiatrist in cases were the finances of an elderly are in dispute between partner and children is:
WHETHER THE ELDERLY HAS A MENTAL DISORDER AND WHETHER IS ADEQUATELY TREATED
When should a schizophrenic admitted to a medical hospital for evaluation of chest pain have a formal assessment of decision-making capacity?
WHEN THERE IS REASON TO BELIEVE THAT THE PATIENT LACKS THE ABILITY TO UNDERSTAND, APPRECIATE, OR REASON LOGICALLY WITH THE INFO RELEVANT TO HEALTHCARE DECISIONS
The most appropriate time to discuss advance directive is:
AT THE TIME OF ADMISSION TO THE HOSPITAL
If pt is incompetent to make decision and has durable power of attorney, treatment recommendations will have to approved by the:
ASSIGNED DECISION MAKER
Pt’s dementia progressed to the point that the pt’s driving is affected. In addition to talking to pt, the MD should
CONSULT STATE LAW ABOUT OBLIGATIONS FOR REPORTING THE PT’S CONDITION.
78 y/o w/ deteriorating personal hygiene, significant weight loss. Signs voluntary admission form but later forgets doing this. Potentially resectable masses in lung and brain requiring further consent for surgical and oncological treatment. Consents but cannot explain reason for surgery. Legally, psychiatrist should:
URGENTLY REQUEST PROBATE COURT APPOINT GUARDIAN WITH POWER TO MAKE TREATMENT DECISIONS
Guardian of a pt with MR with medication-refractory epilepsy insists that the pt should have epilepsy surgery. Neurosurgeon believes the seizure focus can be resected, but there’s a >50% chance of RUE paralysis which outweighs potential benefit from freedom from seizures. Guardian insists on surgery. Which describes physician responsibility in this case?
SHOULD PERFORM THE SURGERY ONLY UNDER COURT ORDER
What characterizes the majority of defendants with psychiatric disorders who are found unfit to stand trial?
THEY CAN REGAIN FITNESS IN LESS THAN 90 DAYS
An attorney requests psychiatric consultation when his defendant wants the worst possible outcome from the trial because he feels he deserves the worst punishment possible. What direction should you take for this case?
PROBABLY MEETS CRITERIA FOR FINDING OF INCOMPETENCE TO PROCEED
What distinguishes forensic from general psych evaluation?
MAINTENANCE OF CONFIDENTIALITY
16 y/o caught for shoplifting jeans. No hx of stealing, jeans not her size. Pt frightened, remorseful, insomnia, failing grades, avoiding friends. Raped 2 months earlier, family insisted she not tell anyone. Understand stealing as:
A CRY FOR HELP
US Supreme Court Decision Washington v Harper 1990, the right to refuse treatment is limited for prison inmates because:
PRISON SECURITY CONCERNS OUTWEIGH INDIVIDUAL AUTONOMY INTERESTS
Pt w/ severe GI disease requests a surgical procedure with questionable efficacy and a relatively high risk of negative effects. Level of competency a psychiatrist would require to find pt competent to make treatment decision?
RATIONAL CONSIDERATION OF ALTERNATIVES
Pts who are committed to psychiatric treatment institutions in most states are presumed to:
BE COMPETENT TO MAKE THEIR OWN DECISIONS
Both mens rea and actus reus are required for which of the following?
CONVICTION OF A CRIME
During an evaluation for competency to stand trial, a defendant tells the court- appointed forensic psychiatrist about being involved in an unsolved crime. The psychiatrist should do what?
AVOID A DETAILED DESCRIPTION OF THE DEFENDANT’S PAST OFFENSE HISTORY
Pt consumed a large amount of alcohol and discharged a firearm, wounding a neighbor. Pt remember nothing of the incident. What is true about the pt’s criminal responsibility per the insanity defense?
VOLUNTARY INTOXICATION DOES NOT EXCUSE THE CRIMINAL BEHAVIOR
What risk management strategy for dealing with a pt with SI is most likely to be rejected as invalid in a subsequent malpractice lawsuit?
A “NO-HARM” OR SUICIDE PREVENTION CONTRACT BETWEEN THE PT AND THE THERAPIST.
Pt w/ severe depression is interviewed for enrollment in an experimental trial. Pt has failed multiple medications and several courses of ECT. The pt is competent but clearly distressed at the time of consent for treatment. Next step?
PRESENT INFORMATION SEVERAL TIMES USING DIFFERENT METHODS AND FEEDBACK TESTING
Murder trial, defendant states “I think murder is wrong but killing a spy from Mars who is trying to steal the secret of life is right.” This poses a problem for what type of evaluation of criminal responsibility?
M’NAUGHTEN RULE
The National Practitioner Data Bank contains reports about which of the following types of physician problems?
MALPRACTICE SETTLEMENTS WHERE NO WRONG WAS ADMITTED
A demented patient who is driving problematically. What do you do?
CONSULT STATE LAW ABOUT REPORTING
To prove medical malpractice, the plaintiff must establish duty, dereliction, damages and direct causation by what part of proof
PREPONDERANCE OF EVIDENCE
Which statement demonstrates that a patient is incompetent to stand trial?
“I AM A WIZARD AND THEREFORE HAVE DIPLOMATIC IMMUNITY”
Mother of 8 yo wants ADHD eval, kids’ parents are divorced, mom reports she has primary
custody, will not sign ROI for child’s dad, what is the next step?
REQUEST MOM PROVIDE COPY OF DIVORCE
In evaluating the sanity of a criminal defendant, the forensic psychiatrist should focus on current state of mind, or state of mind at time of offense?
STATE OF MIND AT TIME OF OFFENSE
A psychiatrist working in a primary care clinic is contacted by the PCP for informal “curbside” consultation and provides recs without evaluating the pt. What is recommended to minimize liability?
CARE OF THE PATIENT REMAINS UNDER THE DIRECTION OF THE PCP WHO ALSO REMAINS IN CHARGE OF ORDERING MEDICATIONS OR ADDITIONAL SERVICES
Primary purpose of mental health courts
DIVERT OFFENDERS WITH MENTAL ILLNESS AWAY FROM INCARCERATION
To whom is specific consent needed to share individually identifiable health information under HIPAA
AN INVESTIGATOR FOR THE PURPOSE OF CONDUCTING EPIDEMIOLOGICAL RESEARCH
HIPPA limits disclosure of patient health information without patient’s consent except for…?
PAYMENT
Radio listener sues psychiatrist after he sustains a fall and concussion after using a friend’s alprazolam following a broadcast where psychiatrist mentions alprazolam is often prescribed for insomnia:
PSYCHIATRIST WILL WIN BECAUSE A DOCTOR- PATIENT RELATIONSHIP WAS NOT ESTABLISHED
A 21 year old hospitalized for a first episode of psychosis. Parents want to be involved in care but pt does not want the team to speak to his parents due to his delusions. According to HIPAA, how much information can be shared?
PROVIDE INFORMATION GIVEN THE LACK OF CAPACITY AND LIKELY BENEFIT
Physician involvement prohibited in which aspect of the death penalty without a commutation order:
RESTORATION OF COMPETENCE TO BE EXECUTED
What is the most prominent lobbying and support organization for families of people with severe psychiatric disorders?
NATIONAL ALLIANCE FOR THE MENTALLY ILL
A neighbor asked a psychiatrist that lives next to him about increasing his prozac to 20mg because of increased depression. This establishes what between the neighbor and psychiatrist?
PATIENT-PHYSICIAN RELATIONSHIP
What is the main concept of the Mental Health Parity and Addiction Equity Act of 2008?
MENTAL HEALTH INSURANCE BENEFITS CANNOT BE LESS FAVORABLE THAN MEDICAL OR SURGICAL INSURANCE BENEFITS
Most common triggering factor for malpractice claims in psychiatric care
SUICIDE
A patient w/ hx of psychosis is arrested for shoplifting and must be evaluated for “competency to stand trial.” What is relevant: ability to waive Miranda rights, intent at time of crime, understanding of illegality of behavior, working effectively with counsel, or decision making if actively psychotic
CAN THE PERSON WORK EFFECTIVELY WITH COUNSEL?
Best reported outcome of mental health courts
QUICKER ACCESS TO COMMUNITY TREATMENT
What is associated with better transition of care at end of life?
PRESENCE OF IDENTIFIED CARE PERSON
This must be established in medical malpractice for plaintiff to prevail?
BREACH OF DUTY CAUSING HARM
Absent gross negligence, dereliction of duty in a malpractice trial is typically established by which of the following?
TESTIMONY OF EXPERT WITNESS
According to Erikson, person >65 w sense of satisfaction that life was productive/worthwhile has successfully managed psychosocial task of developing: (4x)
INDUSTRY VS INFERIORITY
Erikson theorized that a successful developmental task in the 40-60 y/o group is to? (3x)
FEEL USEFUL TO SOCIETY THROUGH BEHAVIORS THAT PROTECT FUTURE GENERATIONS
According to Erikson, the predominant emotional issue in normal, school-aged children is: (3x)
PERSONAL WORTH AND COMPETENCE
11 y/o boy has frequent episodes of ulcerative colitis requiring frequent hospitalization. While in the hospital, mother never leaves his side and responds to questions for him, often referring to disease as “our disease.” According to Minuchin’s theory of family interactions, this is: (3x)
ENMESHED
A child with autism is placed in a therapeutic foster home where a consistent response is made to a given action with the goal of improving the child’s functioning. This technique derives from which of the following learning theories? (x2)
BEHAVIORISM
Erikson’s psychosocial stage in which a person invest energy into establishing, caring for, and guiding in the next generation? (2x)
GENERATIVITY VS STAGNATION
10 y/o pt reports he collects baseball cards. Child is excited b/c he is only one in his peer group who owns several cards. According to Erickson, what developmental task are most relevant for this child? (2x)
INDUSTRY VS. INFERIORITY
Learned helplessness is a model for: (2x)
DEPRESSION
Freud’s psychological theory of development (2x)
DRIVE THEORY
Psychic determinism is (2x)
BEHAVIORS RESULT FROM UNCONSCIOUS MIX OF DRIVES, DEFENSES, OBJECT RELATIONSHIPS, SELF-DISTURBANCES
8 y/o boy sees 2 bottles w same amount of liquid. The content of one is poured in shorter wider glass and the other to a longer narrow glass. When asked which has more liquid he says it’s the same. According to Piaget he is exhibiting: (2x)
CONSERVATION
Pt in individual psychotx describes hatred for a “mean, unfair” boss. This time pt adds, “but actually, I have heard my boss talking to others in the office, and he seems pretty much ok – even his voice sounds so different from the way I hear him in my head!” According to Fonagy, pt is demonstrating which mental activity? (2x)
MENTALIZATION
Winnicott defined his concept of holding environment as the (x2) :
SAFE CONTEXT PROVIDED BY CONSISTENT AND RELIABLE PARENTING
A female child performs a dance for her mother and basks in the gleam of her mother’s eyes. According to self-psychology, the child is having an experience of (x2):
MIRRORING
According to psychoanalytic theory, the term primary process thinking refers to mental activity exemplified by? (2x)
UNCONSCIOUS THOUGHTS THAT DO NOT MAINTAIN LOGICAL CONNECTIONS
A 23 yo pt began psychotherapy due to feelings of inadequacy and depression in the context of working in a coffee shop since graduating from college and deferring medical school acceptance. The pt has been having conflicts with parents over his ambivalence in becoming a physician. Which of the following is the most likely developmental task with which the pt is struggling? (2x)
IDENTITY
What is a pre-contemplative stage statement for tobacco cessation?
“HAVE YOU HEARD ABOUT THE HEALTH BENEFITS OF QUITTING?”
In Heinz Kohut’s theories of self-psychology, what is meant by the term “self-objects”?
OTHER PEOPLE IN THE ENVIRONMENT WHO PERFORM PARTICULAR FUNCTIONS FOR THE SELF
Recently retired woman with recent life transitions has regrets about job and daughter. Wants meaningful last few decades. What develop stage?
EGO INTEGRITY VS DESPAIR
According to the theory of self-psychology, a major cause of mental illness is:
ABSENCE OF AGE-SPECIFIC MIRRORING RESPONSES
Biological consequences of psychological stress are documented to affect…
ALTERATION OF NEURO-IMMUNO-ENDOCRINE FUNCTION
Psychological function of a medication
ACTS AS A CONTAINER FOR THE PATIENT’S PROJECTED ANXIETIES ABOUT BEING DEFECTIVE
According to sociobiologic theory, what term describes behaviors at the level of the individual that maximize fitness at the level of the gene?
ALTRUISM
As conceptualized by self-psychology, which of the following is the most problematic reaction a patient can have when attempting to fulfill a self-object need?
SHAME
Kohut’s theory of personality is based on:
THE INDIVIDUAL’S NEED FOR EMPATHIC INTERACTIONS WITH SELF-OBJECTS.
Gender is best understood as referring to:
WAYS IN WHICH CULTURES DIFFERENTIATE ROLES BASED ON SEX
According to Winnicott’s theory of the development of an infant’s assertiveness and sense of competence what best describes the critical function of the holding environment?
ENCOURAGES SPONTANEITY WHILE PROTECTING THE CHILD FROM HARM
According to Thomas & Chess’ categories of temperament, the difficult child shows what characteristics?
INTENSE EXPRESSIONS OF MOOD
According to classical psychoanalytic theory, what factor primarily accounts for the polarization of same sex peer groups?
UTILIZATION OF DEFENSE MECHANISMS TO AVOID SEXUAL IMPULSES
Which of the following describes core narcissistic character pathology according to Kernberg’s model?
A FUSION OF THE IDEAL SELF, THE IDEAL OBJECT, AND THE REAL SELF RESULTING IN THE DEVALUATION OF OTHERS
3 y/o girl hurts herself w/ a tricycle. Then she hit the tricycle and asks, “Why did you hurt me?” Which thought process does this behavior exemplify?
ANIMISM
Experimental subjects were asked to make a judgment but gave a wrong answer in spite of knowing the right one because they didn’t want to disagree with responses of other participants. This phenomenon is:
CONFORMITY
Resilient individuals who do well in developmental course through life despite being at high risk for negative outcomes are thought to be protected in adulthood most by:
HAVING THE ABILITY TO FIND, USE AND INTERNALIZE SOCIAL SUPPORTS
According to theories of infant socialization, successful attachment most likely promotes survival through which of the following?
CREATING A BOND SO THAT THE ADULT WILL PROTECT THE INFANT FROM DANGER
According to C.G. Jung, anima refers to:
MAN’S UNDERDEVELOPED FEMININITY
29 y/o complains about mistreatment from boyfriend. Proud of generous nature but complains how little she gets back. Therapist finds it hard to make her self-reflective about her role in this, gets frustrated and fatigued. Patient displays
MASOCHISM
Early behaviorist theory promoted what
OBJECTIVE PSYCHOLOGICAL RESEARCH
What term describes the role that others perform for the individual in regard to mirroring, idealizing, and twinship needs?
SELF-OBJECT
The fundamental developmental need of all persons for mirroring, validation, and affirmation is central to which psychoanalytic theory?
SELF PSYCHOLOGY
Activity level, regularity, approach-withdrawal to new situations, adaptability, persistence are examples of:
TEMPERAMENTAL VARIABLES
Studies in which monkeys are raised in varying degrees of isolation have been important in contributing to what theories of human development?
THE SIGNIFICANCE OF ATTACHMENT
Which of following statements identifies what both traditional healing and modern psychotherapeutic practices may have in common:
THE THERAPIST HELPS THE PATIENT EXPERIENCE AN EMERGING SENSE OF LEARNING AND MASTERY OVER THE PROBLEM
What is achieved in Piaget’s stage of concrete operations?
CONSERVATION
4 y/o child upset when ice cream melts. 10 y/o puts it in freezer and tells him it will be ok. 4 y/o insists it is ruined. Piaget’s concept of this is:
CONSERVATION (ALSO REVERSIBILITY)
Animistic thinking is characteristic of which of Piaget’s stages of cognitive development?
PREOPERATIONAL THOUGHT
According to Kohlberg, moral judgment made by older school-age children are based largely on which of the following?
PLEASING THOSE IN AUTHORITY
Masturbation in adults as viewed by contemporary psychiatry is best described as:
PSYCHOPATHOLOGICAL ONLY IF IT IS COMPULSIVE
Therapy intervention most frequently assoc w Kohut’s self-psychology:
EMPATHIC VALIDATION
According to Kohlberg, the highest level of moral reasoning is based on consideration of
UNIVERSAL ETHICAL PRINCIPLES
Winnicott’s notion of capacity to be alone in presence of another person pertains to:
MAINTENANCE OF ONE’S IDENTITY AMONGST OTHERS
Per Piaget, Conservation is the ability to do what?
UNDERSTAND THAT OBJECTS OR QUANTITIES REMAIN THE SAME DESPITE A CHANGE IN PHYSICAL APPEARANCE
With respect to Rotter’s social learning theory, which of the following statements best describes having an internal locus of control?
BEHAVIOR IS SHAPED BY AN INDIVIDUAL’S EXPECTATION THAT IT WILL REALIZE A VALUED GOAL.
According to Freud, which of the following is considered to be the most salient feature of normal psychosexual development in children between 1-3 years of age?
CHILD-PARENT STRUGGLES ABOUT THE NEED TO DELAY GRATIFICATION OF DESIRES
According to Winnicott, which is an essential component of parenting infants?
BEING SENSITIVE TO THE CHILD’S INSTINCT FOR EXPLORATION AND GROWTH
According to Psychoanalytic Theory, the term Primary Process Thinking refers to mental activity exemplified by which of the following?
UNCONSCIOUS THOUGHTS THAT DO NOT MAINTAIN LOGICAL CONNECTIONS
Which is a first rank symptom according to Kurt Schneider?
VOICES ARGUING
During therapy, therapist coughs while patient is speaking. Pt angrily states, “if you disagree with me just tell me, but don’t be a passive aggressive jerk!” Therapist interprets that pt is consistently treating the therapist like aggressor. Which best describes this therapy modality?
TRANSFERENCE FOCUSED PSYCHOTHERAPY
Achieving sense of self-control and free will, struggling between cooperation and willfulness (Erikson)
AUTONOMY VS. SHAME AND DOUBT
Compulsions & obsessions are related to development disturbance during which of Erikson’s psychosocial stages?
AUTONOMY VS. SHAME AND DOUBT
Eriksonian phase correspond w/ Freud’s anal phase
AUTONOMY VS. SHAME AND DOUBT
In what developmental period does a child see he/she is a child of his/her parents & that parents have a relationship to each other not solely related to their roles as parents?
PHALLIC
According to Freud, what is a dream that is remembered on wakening?
MANIFEST DREAM
Classical psychoanalytic theory says pleasure an adult might take in controlling others/making order of chaos relates to which psychosexual stage of development?
ANAL RETENTIVE
According to contemporary psychoanalytic theory, from birth to 18 months, children experience an emerging “self” as a result of what event?
BIOLOGICAL PROCESSES AND BODILY SENSATIONS COME TO HAVE A PSYCHOLOGICAL MEANING
What is the combination of several unconscious impulses, wishes, or feelings that are attached to a single dream image?
CONDENSATION
Freud says depression is anger turned inward against self due to:
IDENTIFICATION WITH THE LOST OBJECT
Freud says that boys resolve oedipal complex by:
IDENTIFYING WITH FATHERS
What developmental period does the child realize he/she is the child of his/her parents and the child’s parents have a relationship with one another?
LATENT
Freud believed pt had fantasies of incest with opposite-sex parents coupled with feelings of jealousy toward the same-sex parent during which stage:
PHALLIC
According to Freud, which psychosexual stage is associated with a primary erotic focus on the genital area and unconscious fantasies of sexual involvement with the opposite-sex parent?
PHALLIC
Which ego defense is seen when an adolescent belittles parents in order to defend against regressive pull toward childhood?
REVERSAL OF AFFECT
This model divides the mind into conscious, preconscious, and unconscious?
TOPOGRAPHICAL
Pt able to recall his address after being prompted to do so. According to Sigmund Freud, this information is stored at what level of the topographic model?
PRECONSCIOUS
Exploration of transference needed for reparative emotional experience, what is this psychotherapeutic treatment called?
PSYCHOANALYTIC PSYCHOTHERAPY
Tendency for groups to arrive at more extreme decisions than for individual group members alone
GROUP POLARIZATION
Father is dying. Pt is not a drinker, but went from bar to bar drinking dad’s favorite drink. Bars are similar to those dad used to go to. Best interpretation of this behavior:
IDENTIFICATION WITH OR INCORPORATION OF PATIENT’S FATHER
What represents major goal of psychotherapy as conceptualized by self-psychology?
IMPROVING THE ABILITY TO USE THE APPROPRIATE AFFIRMING RESPONSES FROM OTHERS
24 y/o pt w tetraplegia after MVA showing no signs of grief or acknowledgement of poor prognosis, no significant depressive/anxious Sx. What psych intervention preferred? What psychotherapeutic school of thought emphasizes how a pt has managed feelings of envy/rage w particular emphasis on defense mechanisms?
SUPPORT BUT DO NOT CONFRONT THE PT ABOUT THE MEDICAL REALITIES EGO PSYCHOLOGY
Which of the following models divide the mind into conscious, the preconscious, and the unconscious?
TOPOGRAPHICAL
Pt w/ hx of EtOH dependence BIB wife, who states that pt’s long term use of ETOH has resulted in marital separation and persistent unemployment. Pr refuses to stop drinking. Psych MD asks pt about his perspective regarding his use of ETOH, pt responds, “It may be a problem.” Psych MD suggests Tx and pt says,”I will think about it.” According to the stages of change model, which stage?
PRECONTEMPLATION
Pt sadly reports receiving a college rejection letter, and then disparagingly predicts that all the other colleges applied to will reject him as well. This is an example of:
OVERGENERALIZATION AND ALL-OR-NONE THINKING
Primary process thinking is characterized as …
MENTATION FOCUSED ON DRIVES AND WISH FULFILLMENT
Pt with depression recounts to the psychiatrist events of the last week and describes many unpleasant experiences, concerns about the sadness of some friends, and a reluctance to read the newspaper because “all the news is bad.” In cognitive psychology, which of the following formulations best accounts for this patient’s presentation?
SELECTIVE ATTENTION BIAS
Replaced use of hypnosis by Freud:
FREE ASSOCIATION
Attribution processes are defined primarily as individual:
CAUSAL EXPLANATIONS OF EVENTS AND PERSONAL EXPERIENCES
Menninger’s triangle of insight provides a framework for identifying links between the patient’s current interpersonal relationships, early-life interactions with family members or other important caregivers, and the transferential relationship with the therapist. What is this process?
WORKING THROUGH
Theory of kindling of depressive episodes is supported by what phenomena in some?
RECURRENT WITHOUT A STRESSOR
Learned helplessness is based on principles of:
CLASSICAL CONDITIONING
Which are the dimensions of the Five Factor Model of Personality?
NEUROTICISM, EXTRAVERSION, OPENNESS, AGREEABLENESS, CONSCIENTIOUSNESS
22 y/o pt presents to psych for treatment of “internet addiction.” Pt noticed a pattern of increasing time spent on the internet, need for better computer equipment, and feelings of anger and dysphoria when unable to access the Internet. Explain concepts of tolerance and withdrawal in this syndrome?
BOTH TOLERANCE AND WITHDRAWAL TO INTERNET USE CAN DEVELOP
Way to consider “learning styles” in which developing curriculum is best supported by literature
USE SUPPLEMENTAL MATERIAL DESIGNED TO ADDRESS THE NEEDS OF ALL TYPES OF LEARNERS
Ainsworth strange situation experiment evaluated what?
ATTACHMENT BETWEEN PARENT AND CHILD
Which psychodynamic theory emphasizes individuals ability to understand their own and others internal states as explanation for behavior?
MENTALIZATION THEORY
Which psychodynamic theorists posited that development occurs in sequential clearly defined stages and that each stage must be resolved for development to proceed smoothly?
ERIC ERIKSON
In which stage of Piaget’s theory of cognitive development do children first understand conservation of volume?
CONCRETE OPERATIONAL
According to Winnicott, if mother can’t provide “holding” environment for infant, infant will develop what defensive process?
FALSE SELF
According to Melanie Klein, a child who perceives the mother as an integrated person who is responsible for both good and bad experiences at the same time is said to be:
IN THE DEPRESSIVE POSITION
