DSM 5 Test B Part 2 Flashcards
- Which of the following is the most accurate statement regarding selective mutism?
- It is a communication disorder in the DSM-5 category of neurodevelopmental disorders.
- It is typically an act of defiance and may be effectively treated with behavior modification.
- It is an anxiety disorder and may be treated with guided imagery.
- It results from trauma and treatment typically involves therapy focused on overcoming the trauma.
Correct Answer: 3. It is an anxiety disorder and may be treated with guided imagery.
Feedback: Selective mutism (SM) involves a consistent failure to speak in specific social situations when speaking is expected (e.g., the classroom), in spite of speaking in other situations (e.g., at home). As a result, this disturbance interferes with educational or occupational achievement, or with social communication. Selective mutism is an anxiety disorder. The failure to speak in children with selective mutism (SM) is related to fear and anxiety, not willfulness or disobedience (ruling out Response 2). Typical treatments include some combination of behavioral therapy, cognitive behavioral therapy, individual therapy, family therapy, and medication. Behavioral therapy for SM usually includes desensitization and relaxation protocols, of which guided imagery is sometimes a part (Response 3, correct answer). SSRIs (e.g., Paxil) are commonly prescribed for their anti-anxiety effects, although other antidepressants are sometimes used. Selective mutism is not considered a communication disorder, an example of which includes childhood-onset fluency disorder (stuttering). The communication disorders are listed in the DSM-5 category of neurodevelopmental disorders (Response 1). Selective mutism is also not related to a history of trauma (ruling out Response 4).
- People suffering from amnesia may experience impairment in all of the following cognitive functions except:
- immediate memory.
- anterograde memory.
- long-term memory.
- source memory.
Correct Answer: 1. immediate memory.
Feedback: Studies have indicated that immediate memory, which is another name for sensory memory, tends to remain intact in amnesia. All the other types of memory listed may be impaired in amnesia. Anterograde memory (Response 2) refers to the ability to remember new information. Source memory (Response 4) refers to the ability to remember the context in which material was learned.
- Marlatt’s approach to the treatment of substance abuse:
- is an abstinence-based model akin to AA which views relapse as a setback.
- sees relapse as a natural part of recovery that can be minimized but not avoided.
- focuses on treating the whole family as a dysfunctional unit, rather than simply working with the identified patient.
- sees substance use as a defense against experiencing painful underlying affect.
Correct Answer: 2. sees relapse as a natural part of recovery that can be minimized but not avoided.
Feedback: Marlatt is a Cognitive Behavioral Therapist who is well known for his model of relapse prevention. Unlike AA and other abstinence-based programs, he attempts to minimize the effects of relapses by teaching recovering addicts to view them as inevitable experiences which can be learned from. Part of his model also includes encouraging addicts to attribute relapses to external factors rather than to internal ones. High risk factors are identified for relapses (e.g., boredom or marital arguments) and new methods for dealing with them are developed (e.g., listening to music or calling a friend).
- Criterion contamination refers to:
- obtaining a spuriously high validity coefficient because ratings on the criterion are contaminated by knowledge of ratings on a predictor.
- obtaining an underestimate of the validity coefficient because criterion ratings are contaminated by knowledge of predictor ratings.
- carryover effects of measuring people repeatedly on the same criterion following successive exposure to a series of interventions.
- the tendency for criterion-related validity to be contaminated when reliability is unacceptably low.
Correct Answer:1. obtaining a spuriously high validity coefficient because ratings on the criterion are contaminated by knowledge of ratings on a predictor.
Feedback: Criterion contamination occurs when the rating given on the criterion is affected by knowledge of the score on the predictor. For example, in an attempt to correlate IQ with grades, criterion contamination would occur if the teacher giving the grades (the criterion) had knowledge of his students’ IQ scores (the predictor). The teacher might inflate the grades of the high IQ students as compared to the low IQ students, causing a spuriously (falsely) high correlation between IQ and grades. Response 2, then, is the opposite of what actually occurs. Carryover effects (Response 3) are a threat to external validity when repeated measures are used, and are not relevant here. Response 4 makes little sense as worded. Reliability always affects validity and very low reliability would always pose a problem.
- When a child misbehaves, you remove her from all potentially reinforcing stimuli. Your behavior is based on:
- classical extinction.
- operant extinction.
- reciprocal inhibition.
- the Premack principle.
Correct Answer: 2. operant extinction.
The question describes the technique of “time out” which is based on operant extinction. Operant extinction occurs when reinforcement is withheld. Initially, there may be a “response burst” or “extinction burst” during which the behavior actually increases but, eventually, extinction leads to the termination of the behavior. In the Premack Principle (Response 4), participating in a high frequency behavior (watching TV) is made contingent on emitting a low frequency behavior (cleaning the bedroom). You might have been able to eliminate classical extinction (Response 1) by recognizing that issues of reinforcement are not part of the classical conditioning paradigm. Classical extinction occurs when the conditioned stimulus is repeatedly presented without the unconditioned stimulus, thereby loosening the pairing of the conditioned stimulus with the conditioned response. According to the concept of reciprocal inhibition (Response 3), also a term from classical conditioning, two incompatible responses cannot be experienced at the same time (e.g., anxiety and relaxation); instead, the stronger response will inhibit the weaker one.
- As compared to a person on a variable interval schedule of reinforcement, a person on a variable ratio schedule:
- will respond at a fairly constant low rate.
- will show brief post-reinforcement pauses.
- can better predict when reinforcement will take place.
- will have his or her behavior show greater resistance to extinction.
- will have his or her behavior show greater resistance to extinction.
Feedback: Variable ratio schedules are most resistant to extinction. In other words, when responses are no longer reinforced, the person on the variable ratio schedule of reinforcement will continue to respond at higher rates and for a longer time than people on any other schedule of reinforcement. Under both types of variable schedules of reinforcement, a person responds in a fairly steady manner, however, the response rate is higher for variable ratio as compared to variable interval (ruling out Response 1). Fixed schedules result in post-reinforcement pauses (Response 2). Only in a fixed schedule can the person predict when reinforcement will take place; variable schedules of reinforcement by their nature result in unpredictability in terms of when reinforcement will take place (Response 3).
- Which of the following statements is true regarding the course of ADHD?
- Persons diagnosed with the disorder as children continue to experience the full disorder in adulthood.
- Children with ADHD that are treated with stimulants are at increased risk for drug and alcohol problems.
- Use of stimulant medications improves the long-term course of the disorder.
- Children with aggression or unremitting severe symptoms of ADHD are at increased risk for developing antisocial personality disorder.
- Children with aggression or unremitting severe symptoms of ADHD are at increased risk for developing antisocial personality disorder.
Feedback: Research suggests that the risk of developing antisocial personality disorder is greater for children with ADHD who have concomitant aggressive symptoms or who have symptoms of ADHD that severely impair functioning. While a significant proportion of children with ADHD remain impaired into adulthood, for others, the disorder remits by adulthood (ruling out Response 1). There is no indication that use of stimulants raises the risk of future drug and alcohol use disorders (Response 2). The research so far has not suggested that use of
- A 72-year-old client with long-standing, uncontrolled hypertension recently experienced a stroke, with resulting weakness of her left hand and arm. The client would probably also demonstrate:
- left visual field damage and visuospatial deficits.
- right visual field damage and visuospatial deficits.
- left visual field damage and language deficits.
- right visual field damage and language deficits.
Correct Answer: 1. left visual field damage and visuospatial deficits.
Feedback: The weakness in the left arm and hand would indicate damage to the right hemisphere, since each side of the body is controlled by the opposite hemisphere. Damage to the right hemisphere would affect functioning on the left side of the body, therefore this person can be expected to have deficits in the left visual field, as well as deficits in visuospatial abilities (the latter function is also controlled by the right hemisphere). Response 2 is only partially correct; the person would have visuospatial deficits, but not right visual field damage. Language deficits (Responses 3 and 4) would be expected with damage to the left hemisphere, not the right.
- According to Sue & Sue’s Racial/Cultural Identity Development Model, a client who is more comfortable with his or her own race and less comfortable with others is likely to be in the stage of:
- dissonance.
- introspection.
- conformity.
- immersion.
Correct Answer: 4. immersion.
Feedback: In the stage called resistance and immersion, the culturally different person experiences a strong sense of identification with, and commitment to, his or her minority group, and rejects the dominant values of society and culture. In the conformity (Response 3) stage, which is the first stage of this model, the minority person is distinguished by unequivocal preference for the dominant culture’s values and the tendency to adopt negative stereotypes about his or her own minority culture as well as all other minority groups. In the dissonance stage (Response 1), the person experiences a growing awareness that not all values of the dominant group are beneficial, which leads to questioning and challenging of attitudes and beliefs. In the introspection stage (Response 2), the person begins to discover that the level of intensity of negative feelings directed toward the majority culture is draining, and also recognizes that many elements of the majority culture are highly functional and desirable.
- Howard’s meta-analytic studies of psychotherapy outcome have found that by the end of six months of treatment ____ percent of client’s are measurably improved:
- 25.
- 50.
- 90.
Correct Answer: 3. 75
Feedback: Howard et al (1986) found that 50% of patients were measurable improved by the end of the eighth session (Response 2), and that 75% of patients were measurably improved by the end of six months.
- According to Piaget, when a child is not able to see that there is the same amount of water when it is poured from a container of one shape into a container of a different shape, he is in the pre-operational state. This is a consequence of:
- irreversibility.
- centration.
- conservation.
- phenomenalistic causality.
Correct Answer: 1. irreversibility.
Feedback: According to Piaget’s Stage Theory, one of the characteristics of the pre-operational stage is irreversibility (Response 1) which refers to the inability to mentally undo something. In this case, the water was poured into a different container in front of the child, who was then unable to think back to the initial stage of the action. Centration (Response 2) is another aspect of the pre-operational stage and refers to the tendency to focus on only one aspect when observing a stimulus. In this situation, centration is also occurring, when the child focuses only on the level of the water. Nevertheless, irreversibility is the better answer because the key difficulty the child experiences in this scenario is the inability to think back to the initial situation. Phenomenalistic causality (Response 4) is also associated with the pre-operational stage and involves a sense of magical thinking where events that co-occur in time are thought to be causally connected. Conservation (Response 3) is the ability to recognize that objects conserve their characteristics regardless of a change in shape or form, a development associated with the concrete operational stage. In this scenario the child is unable to conserve.
- According to Herzberg’s two-factor theory, job context factors have an effect on:
- dissatisfaction but not satisfaction
- satisfaction but not dissatisfaction.
- both satisfaction and dissatisfaction.
- neither satisfaction nor dissatisfaction.
Correct Answer: 1. dissatisfaction but not satisfaction
Feedback: Herzberg’s two-factor or motivator-hygiene theory proposes that there are different sources of satisfaction and dissatisfaction in the workplace. He divides needs into upper and lower level needs. Lower level needs, also called hygiene factors or dissatisfiers, relate to job context, such as pay, working conditions, and supervision. They result in dissatisfaction when they are not adequate, but do not produce satisfaction. Upper level needs, called motivators or satisfiers, relate to job content and include needs for achievement, responsibility, and opportunity. It is thought that meeting these needs increases satisfaction and motivation, but failing to meet these needs does not result in dissatisfaction.
- Thermal biofeedback is commonly used to treat migraine headaches. In general, the research has demonstrated that:
- thermal biofeedback is more effective than relaxation procedures.
- relaxation procedures are more effective than thermal biofeedback.
- thermal biofeedback paired with relaxation is more effective than self-monitoring.
- thermal biofeedback is as effective as self-monitoring.
Feedback: Most research has found that relaxation training and biofeedback are about equally effective in the treatment of migraine headaches (ruling out Responses 1and 2). In clinical practice and research, the two treatments are often combined, sometimes called biofeedback-assisted relaxation training. This combined treatment has been shown to be quite effective, and to be more effective than self-monitoring (Response 4). [In research on treatment of migraine headaches, self-monitoring is commonly the control condition.] Although biofeedback combined with relaxation training is probably more effective than either approach alone, the research has not yet demonstrated this conclusively.
Correct Answer: 3. thermal biofeedback paired with relaxation is more effective than self-monitoring.
- Which theorist believes that maladaptive behavior results from people’s attempts to make up for perceived or real disabilities as children?
- Freud.
- Adler.
- Horney.
- Jung.
Correct Answer: 2. Adler.
Feedback: Adler originated the notion of the inferiority complex. He believed that children experience a sense of inadequacy, based on both real and perceived limitations. To overcome these feelings of inadequacy and achieve a sense of mastery, they develop a lifestyle (personality), which can be either adaptive or maladaptive. In Adlerian therapy, the lifestyle is examined: mistaken goals and faulty assumptions are discovered and, ideally, modified to be more personally and socially constructive. Adlerian Psychology is also known as Individual Psychology.
- According to research, bullying is best thought of as:
- a normal aspect of childhood.
- a risk factor for other violent behaviors.
- an indication of underlying depression and low self-esteem.
- an indication of conduct disorder or antisocial personality disorder.
Correct Answer: 2. a risk factor for other violent behaviors.
Feedback: According to the research conducted by the National Institute of Child Health and Human Development, bullying may suggest involvement in other violent behavior at present or involvement in more violent behaviors in the future (e.g., carrying a weapon, fighting). Victims of bullying may also be at risk for engaging in violent behaviors themselves. Experts do not consider bullying to be a normal aspect of childhood (ruling out Response 1). There is mixed support for the idea that bullying indicates depression or self-esteem problems (Response 3), with this idea generally falling out of favor among experts. Antisocial personality disorder (Response 4) cannot be diagnosed until a person is at least 18 years old, and requires evidence of conduct disorder prior to age 15. Bullying is one criterion of conduct disorder; however, the diagnosis requires that additional criteria are met (e.g., destruction of property, deceitfulness or theft, serious violation of rules).
- It is thought that self-mutilation among survivors of sexual abuse:
- is rare, but may be a precursor to suicide.
- may be an attempt to elicit additional support and empathy from the therapist.
- may be an attempt to cope with emotional pain.
- may be an attempt to seek secondary gain.
Correct Answer: 3. may be an attempt to cope with emotional pain.
Feedback: Some patients who self-mutilate report that the infliction of physical pain is an attempt to deaden the overwhelming emotional pain experienced. By contrast, others note that the infliction of physical pain is the only means they have to feel anything when they are in a numbed, emotionless state – the pain actually helps them to feel more alive. Thus, self-mutilation among survivors of sexual abuse appears to be an attempt to cope with pain. Self-mutilation is common in survivors of sexual assault, and typically does not suggest suicidality (ruling out Response 1). Self-mutilation is not an attempt to elicit support (Response 2), nor is it an attempt to seek secondary gain (e.g., financial compensation/disability).
- Your patient has been overlooked for a promotion, and complains about “stupid management who can’t see my talent.” His response could best be described as:
- emic.
- etic.
- alloplastic.
- autoplastic.
Correct Answer: 3. alloplastic.
Feedback: Alloplastic reactions to stress involve trying to change the external environment or blaming the external environment, as the patient does in this scenario. Autoplastic reactions to stress involve trying to change oneself or blaming oneself (Response 4). If the patient were using an autoplastic defense, he might say that he wasn’t as smart as the other employees or that he was going to try to improve his performance. Some theorists argue that people with personality disorders use alloplastic defenses whereas neurotic people use autoplastic defenses. Emic and etic are terms borrowed from anthropology to describe different approaches to human behavior. Etic (Response 2), refers to a non-culture specific approach that looks for universal principles, described in the work of Maslow. Emic (Response 1) involves a culture specific approach, as seen in the work of Carol Gilligan.
- When running an ANOVA, a pooled error term is justified when:
- sample size is unequal.
- variance is equal.
- all cells have the same number of subjects.
- homoscedasticity is violated.
Correct Answer: 2. variance is equal
Feedback: This is a difficult question, requiring an advanced understanding of statistics. It is best to simply know that a pooled error term is used when there is homogeneity of variance (i.e., the variance is equal). When variance is not equal, a separate error term should be used. Homoscedasticity also refers to equal variance. If it were violated (Response 4), the variance would not be equal and a pooled error term could not be used. A mnemonic here might be: when things are equal, they can be pooled together; when unequal, they must be treated separately. Sample size (Response 1) and the number of subjects per cell (Response 3) are not the determining factors in the use of a pooled error term.
- A child is diagnosed with specific learning disorder with impairment in mathematics but actually does not have the disorder. The most likely explanation for this misdiagnosis is:
- the student’s lack of interest in math.
- the student’s being a girl.
- poor instruction by the teacher.
- peer pressure.
Correct Answer: 3. poor instruction by the teacher
Feedback: According to the DSM-5, a specific learning disorder with impairment in mathematics is diagnosed when a student’s performance on an individually administered test of math achievement is substantially below what would be expected based on age. The criterion for substantially below is an achievement test score that is at least 1.5 standard deviations (SD) below the population mean for age (below the 7th percentile), not better accounted for by intellectual disabilities. Math achievement is highly dependent on the quality of instruction; a significant number of children diagnosed with specific learning disorder with impairment in mathematics do not have a disorder but simply have not received appropriate instruction.
- You receive a subpoena for your records. Your best course of action would be to:
- comply with the subpoena if your client consents to the release of the records.
- comply with the subpoena and release the records to the judge.
- bring the records to the court at the appointed time.
- seek legal consultation.
Feedback: When you receive a subpoena for your records, you must bring them to court at the appointed time. You could release the records if the client consents (Response 1). If the client does not want the records released, you would assert privilege, rather than turn over the records (Response 2), and the judge would decide if the situation warrants an exception to privilege or not. You may want to seek legal consultation (Response 4), but this alone is not sufficient.
Correct Answer: 3. bring the records to the court at the appointed time.
- In a single-subject research design, which of the following is the most significant problem?
- Autocorrelation.
- Multicollinearity.
- Regression to the mean.
- Practice effects.
Correct Answer: 1. Autocorrelation.
Feedback: When the same subject is measured repeatedly, the measures demonstrate a high degree of correlation, which is termed autocorrelation. Autocorrelation can either appear to enhance or to decrease the effect of the independent variable. Multicollinearity (Response 2) is a problem in multiple regression analysis when the predictors are highly correlated. Response 3 and 4 are general threats to internal validity and are not relevant here. While single-subject designs do involve repeatedly measuring subjects, the measures are not always tests (e.g., the measure can be frequency of observed behavior); hence, practice effects (Response 4) are not always a problem.
- A company wants to make major changes in customer relations and hires a consultant to help implement these changes according to the principles of organizational development. This consultant meets with certain employees who are resistant to the recent changes to help them implement the new customer relations procedures. This is an example of:
- program-centered administrative consultation.
- consultee-centered administrative consultation.
- consultee-centered case consultation.
- client-centered case consultation.
Correct Answer: 2. consultee-centered administrative consultation
Feedback: This scenario depicts an example of consultee-centered administrative consultation. In this situation, the consultant is working with employees in order to improve the implementation of a program. In addition, this consultant is specifically addressing the employees’ attitudes toward how the program is being conducted. In program-centered administrative consultation (Response 1), the focus is on the program itself, for example, how to develop a program for customer relations. In consultee-centered case consultation (Response 3), the consultant works with the consultee on his or her difficulties with patients. In client-centered case consultation (Response 4), the focus is on helping the consultee with a particular patient.
- Brainstorming is most likely to be effective when done:
- in a large group format.
- by individuals independently.
- in a small group format.
- in the presence of the company president.
Correct Answer: 2. by individuals independently.
Feedback: Overall, it has been found that when people brainstorm alone, they come up with better solutions than when they brainstorm in a group.
- The Primary Mental Abilities Test:
- is a multifaceted test of intelligence.
- is a test that predicts vocational success.
- is a broad-based aptitude test.
- is a test of both short- and long-term memory.
Correct Answer: 1. is a multifaceted test of intelligence.
Feedback: The Primary Mental Abilities Test was developed by Thurstone, and is a multifaceted test of intelligence (Response 1) which is based on the premise that intelligence is multifactored (e.g., verbal comprehension, reasoning, perceptual speed).