EPPP Study

Question 1

Cigarette smokers face barriers to quitting, including:

Answer 1

fear of failure, fear of withdrawal symptoms, and fear of gaining weight

Weight gain during the first few months post-cessation is common, and some withdrawal symptoms include irritability, anger, anxiety, impaired concentration, depressed mood, and insomnia.

Question 2

involves episodic binge eating followed by induced vomiting, the use of laxatives or diuretics, and/or excessive exercising.

Answer 2

Bulimia

Question 3

disorder involves repeated regurgitation and rechewing of food.

Answer 3

Rumination

Question 4

A 35-year old client has a history of relationship problems. Although he usually makes a good first impression, his friendships don’t last very long. He attributes this problem to the fact that other people are jealous of what he has accomplished. The client has a great idea that will “revolutionize the field of telemarketing,” but, so far, no one has recognized the potential importance of his contribution. He left his wife six months ago and spends very little time with his two-year old son. He has been busy “doing what he wants to do,” which has included moving into an expensive condominium, buying a new sports car, and dating as many attractive women as possible. These characteristics are most suggestive of:

Answer 4

Narcissistic Personality Disorder

Question 5

The man’s primary symptoms are grandiosity and lack of empathy. These are core features of Narcissistic Personality Disorder.

Answer 5

Narcissistic Personality Disorder

Question 6

a pattern of excessive emotionality and attention-seeking.

Answer 6

Histrionic Personality Disorder

Question 7

presence of pervasive social and interpersonal deficits and eccentricities in cognition, perception, and behavior.

Answer 7

Schizotypal Personality Disorder

Question 8

To reduce the risk of relapse for a 23-year-old man who has been hospitalized with a diagnosis of Schizophrenia and who will now be returning home to live with his parents, the best intervention would be:

Answer 8

family therapy plus pharmacotherapy

The therapeutic effects of antipsychotic drugs are augmented when they are combined with family therapy. One target of family therapy is high expressed emotion by family members, which has been linked to an increased risk for relapse. Research results have demonstrated that family therapy is more effective than individual therapy as an intervention for schizophrenia.

Question 9

frican Americans have a higher incidence of hallucinations and delusions that may be associated with other disorders such as

Answer 9

mania, depression, and alcohol abuse.

More recent research findings suggest that higher rates of Schizophrenia among African Americans are most likely attributable to the misdiagnosis of hallucinations and delusions.

Question 10

Intense narcoleptic “sleep attacks” are often accompanied by:

Answer 10

cataplexy

Narcolepsy involves frequent intense periods of irresistible sleep. Narcolepsy sleep attacks may include cataplexy, which is a sudden loss of muscle tone.

Question 11

caused by long-term use of neuroleptic drugs, which are used to treat psychiatric conditions.

Answer 11

Tardive dyskinesia

Question 12

a degenerative disease of the nervous system.

Answer 12

Ataxia

Question 13

Symptoms of Disruptive Mood Dysregulation Disorder may be comorbid with other mental health disorders. However, this diagnosis cannot coexist with:

Answer 13

Oppositional Defiant Disorder, Intermittent Explosive Disorder, or Bipolar Disorder

Disruptive Mood Dysregulation Disorder (DMDD) involves severe recurrent temper outbursts. This diagnosis CANNOT coexist with Oppositional Defiant Disorder (ODD), Intermittent Explosive Disorder, or Bipolar Disorder, though it can coexist with others, including Major Depressive Disorder, Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, or Substance Use Disorders. Thus, individuals whose symptoms meet the criteria for both DMDD and ODD should only be given the diagnosis of DMDD.

Question 14

The presence of which of the following is more suggestive of a diagnosis of Malingering than of Factitious Disorder?

Answer 14

The motive for symptom production is to obtain an external reward.

The motivation underlying the production of symptoms in Malingering is to obtain an external reward (e.g., to obtain a drug or avoid a specific activity). In Factitious Disorder, symptoms are produced or faked even in the absence of an external reward for doing so. Symptoms are intentionally produced in both disorders

Question 15

Reported concordance rates for Schizophrenia for identical (monozygotic) twins range from:

Answer 15

45 to 50%

A genetic contribution to Schizophrenia is supported by research showing that, as genetic similarity increases, concordance rates increase. The reported concordance rates for Schizophrenia vary somewhat from study to study, but most report a rate between 45-50% for identical twins.

Question 16

Dysphoria, vivid and frightening dreams, insomnia or hypersomnia, fatigue, psychomotor agitation or retardation, and increased appetite are most suggestive of __________ Withdrawal.

Answer 16

Stimulant

Question 17

involves a dysphoric mood, increased appetite, and insomnia; however, its other characteristic symptoms are irritability, anxiety, impaired concentration, and restlessness.

Answer 17

Tobacco Withdrawal

Question 18

dysphoric mood; however, additional symptoms include nausea and vomiting, muscle aches, diarrhea, and fever.

Answer 18

Opioid Withdrawal

Question 19

It is often difficult to distinguish between delirium, dementia (major neurocognitive disorder), and depression in older adults. However, the presence of which of the following suggests that delirium is the appropriate diagnosis?

Answer 19

A disturbance in attention and awareness

A diagnosis of delirium requires a disturbance in attention and awareness plus a disturbance in cognition (e.g., memory deficit, disorientation, perceptual abnormality). Memory impairment is characteristic of all three disorders.

Question 20

Deficits in executive cognitive functioning are characteristic of

Answer 20

dementia.

Question 21

The primary advantage of the DSM’s use of polythetic criteria sets is that this approach:

Answer 21

reflects the heterogeneity of symptoms characteristic of many diagnoses

Most diagnoses in the DSM-5 have a polythetic criterion set, which means that an individual is required to exhibit only a subset of the diagnostic criteria for a specific diagnosis to be assigned the diagnosis. An assumption underlying the use of polythetic criteria sets in the DSM-5 is that people with the same disorder are heterogeneous, presenting with different constellations of symptoms. In other words, while individuals with the same diagnosis share some symptoms, they may differ regarding others.

Question 22

occurs when a person believes that his or her thoughts, words, or actions will affect a specific outcome in a way that defies laws of cause and effect.

Answer 22

Magical thinking

Question 23

belief that events, objects, or other people have a special or unusual significance for oneself.

Answer 23

Idea of reference

Question 24

diagnosed when a person’s symptoms are a reaction to an identifiable psychosocial stressor, when symptoms have persisted for no more than six months since the termination of the stressor or its consequences, and when the symptoms are interfering with the person’s occupational and/or social functioning or the distress is out of proportion to the severity or intensity of the stressor.

Answer 24

Adjustment Disorder

Question 25

the development of specific symptoms (e.g., re-experiencing of the trauma, avoidance of stimuli associated with the trauma, and increased arousal) following exposure to a trauma that involves experiencing or witnessing threatened or actual death, severe injury, or sexual violence.

Answer 25

Post-Traumatic Stress Disorder (PTSD)

Question 26

Which of the following is an example of a delusion of reference?

Answer 26

A 30-year old woman thinks that a weekly radio program is being broadcast directly to her.

A person is experiencing a delusion of reference when he/she believes that events, objects, or other people in the immediate environment have unusual or particular significance for him or her.

Question 27

A 45-year old man believes that a group of co-workers is conspiring against him.

Answer 27

persecutory delusion.

Question 28

A 22-year old woman thinks that her thoughts are being controlled by aliens.

Answer 28

delusion of being controlled.

Question 29

A 28-year old man believes that act of thinking about his mother’s death will cause her to die.

Answer 29

magical thinking.

Question 30

One of the earliest signs of Alzheimer’s disease is:

Answer 30

impaired recent memory

Alzheimer’s disease involves a relatively predictable progression of symptoms, with impairment of recent memory (anterograde amnesia) often being one of the first signs reported by relatives or clinical observers of patients with this diagnosis.

Question 31

associated with Korsakoff’s syndrome and other memory disorders caused by damage to certain areas of the brain. It occurs when an individual makes false statements to fill in gaps in memory,

Answer 31

confabulation

Question 32

characteristic of the middle stage of Alzheimer’s disease.

Answer 32

Fluent aphasia

Question 33

middle-stage symptom of Alzheimer’s disease.

Answer 33

Retrograde amnesia

Question 34

Use of __________ may produce Intoxication, which is characterized by mood lability, impaired judgment, slurred speech, impaired coordination, and deficits in memory and attention.

Answer 34

sedatives

The symptoms listed in the question are characteristic of Sedative, Hypnotic, or Anxiolytic Intoxication.

Question 35

hypervigilance, psychomotor agitation, tachycardia, elevated blood pressure, and nausea and vomiting.

Answer 35

Intoxication due to amphetamine or other stimulant

Question 36

anxiety, impaired judgment, social withdrawal, tachycardia, and increased appetite.

Answer 36

Cannabis Intoxication

Question 37

characterized by initial euphoria followed by apathy, dysphoria, and psychomotor retardation or agitation.

Answer 37

Opioid Intoxication

Question 38

Regarding Schizophrenia, expressed emotion has been linked to:

Answer 38

a high risk for relapse

Expressed emotion refers to the attitudes and behaviors that family members express toward a patient who has been diagnosed with Schizophrenia (or other disorder). The family’s expressed emotion is an important factor during the recovery process for patients with symptoms of Schizophrenia. A high degree of negative expressed emotion (which involves hostility and criticism or emotional over-involvement) is associated with an increased risk for relapse.

Question 39

Which of the following is likely to be the most effective treatment for a client with Generalized Anxiety Disorder (GAD)?

Answer 39

Psychoeducation, relaxation training, and cognitive therapy

Multicomponent cognitive-behavioral therapy is usually the preferred empirically supported treatment for GAD. Of the answers given, this is the only one that includes both behavioral and cognitive techniques.

Question 40

used to eliminate self-reinforcing behaviors such as substance abuse, gambling, and paraphilias

Answer 40

Covert sensitization

Question 41

Chronic otitis media in early childhood has been linked to:

Answer 41

Specific Learning Disorder

Otitis media is an infection of the middle ear. It can cause hearing loss and speech and language problems and has been linked to reading and other learning disorders.

Question 42

As described in the DSM-5, the primary difference between a manic episode and hypomanic episode is that in the latter:

Answer 42

there is no marked impairment in social or occupational functioning

Mania and hypomania both involve an abnormally and persistently elevated, expansive, or irritable mood, However, a manic episode (but not a hypomanic episode) involves impairment in functioning, requires hospitalization to avoid danger to self or others, or includes psychotic symptoms.

A manic episode lasts at least one week while a hypomanic episode lasts at least four days.

Question 43

The assessment of patients with Alzheimer’s disease is an ongoing process due to its degenerative nature and the consequent need to alter the treatment plan. During the fourth or fifth year of the disease, an assessment is most likely to reveal:

Answer 43

impairments in recent and remote memory, delusions, fluent aphasia, and restlessness

Alzheimer’s disease is a degenerative disease with symptoms that become progressively worse over time. The symptoms described in this response are characteristic during the 2nd through 10th years.

Question 44

mild to moderate impairment in remote memory, anomia, irritability, and sadness

Answer 44

These symptoms are more common during the first one to three years of Alzheimer’s disease

Question 45

severe impairments in intellectual functioning, apathy, confusion, and limb rigidity

Answer 45

These are late-stage symptoms (8 to 12 years) of Alzheimer’s disease.

Question 46

Alan A., age 10, and his parents are referred to you by Alan’s pediatrician. Based on your interview with Alan’s parents, you determine that the boy’s behavior at home is consistent with a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). To confirm this diagnosis, you would most likely:

Answer 46

contact Alan’s teacher to discuss the nature of his behavior at school

The diagnosis of ADHD requires the presence of symptoms of inattention and/or hyperactivity-impulsivity in at least two settings. Talking to Alan’s teacher would determine if he exhibits signs of this disorder at school.

The use of drugs as a diagnostic tool is not an empirically supported strategy. Because stimulants can have adverse side effects, they should be prescribed with caution. Furthermore, they have similar effects on individuals who do not report symptoms of ADHD and, therefore, a positive response would not necessarily confirm the diagnosis.

Question 47

administer standardized IQ and achievement tests to Alan to determine if there are significant discrepancies in scores

Answer 47

This would be useful for confirming a diagnosis of a learning disorder.

Question 48

A cognitive therapist is treating a 20-year-old woman who has received a diagnosis of Anorexia Nervosa. The therapist’s first priority will be to give the woman graded task assignments designed to increase her food intake. Another initial intervention will be to:

Answer 48

use Socratic questioning to facilitate modification of her beliefs about weight and food

The first step in the treatment of Anorexia is always to help the individual gain weight to avoid or reduce medical complications. This initial phase may require hospitalization. Cognitive-behavioral therapy is then used to facilitate modification of beliefs about weight and food, including the value of being thin and the consequences of eating.

Question 49

Lee L., age 33, is brought to therapy by his sister. She reports that following the loss of his home in a fire two weeks ago, Lee has experienced hallucinations, is incoherent, and is uncharacteristically aggressive and sloppy in appearance. In this situation, before assigning a diagnosis of Brief Psychotic Disorder, you would want to rule out alternative explanations for Lee’s symptoms. Therefore, you would want to determine if Lee:

Answer 49

has been using alcohol or drugs

Although Lee’s history and symptoms are suggestive of Brief Psychotic Disorder, you would want to rule out other explanations, including the possibility that his symptoms are due to an alcohol- or drug-induced psychotic disorder. Note that this question is asking you to identify the information that would rule out (not confirm) a diagnosis of Brief Psychotic Disorder.

Question 50

A young man can’t recall certain personal information, such as where he lives and who he lives with, but he says he has just started working as a dishwasher at a local diner. Presence of which of the following would help confirm that the man is experiencing a dissociative fugue?

Answer 50

You learn that the man has recently traveled unexpectedly from another state and has assumed a new identity.

A dissociative fugue is characterized by apparently purposeful travel or wandering that is associated with an inability to recall one’s past. In the DSM-5, dissociative fugue is a specifier for Dissociative Amnesia.

Question 51

For a diagnosis of Panic Disorder, the individual must have experienced:

Answer 51

recurrent unexpected panic attacks

For a DSM-5 diagnosis of Panic Disorder, the individual must have experienced two or more unexpected panic attacks.

Question 52

According to research on PTSD prevention, single-session psychological debriefing (PD) immediately following exposure to a traumatic event:

Answer 52

is not effective when used alone and may actually increase the risk for PTSD

Although single-session PD has been utilized for the prevention of PTSD following exposure to a traumatic event, the research has generally not supported its use for this purpose. Systematic reviews have led to the conclusion that single-session psychological debriefing is not effective for reducing the risk for PTSD when used alone and, for some individuals, may have negative effects. As a result, researchers have recommended that PD be used cautiously and as part of a comprehensive treatment program.

Question 53

A diagnosis of Vascular Neurocognitive Disorder requires:

Answer 53

evidence of cerebrovascular disease

As its name implies, the diagnosis of Vascular Neurocognitive Disorder requires evidence of cerebrovascular disease - i.e., the symptoms must be consistent with a vascular etiology, and evidence of a cerebrovascular disease must be present on a physical exam, neuroimaging, etc.

Question 54

a disturbance in attention and awareness

Answer 54

A disturbance in attention and awareness is characteristic of Delirium.

Question 55

In adults, Obsessive-Compulsive Disorder is:

Answer 55

about equally common in males and females

The gender ratio for Obsessive-Compulsive Disorder is related to age. In adults, the gender ratio for this disorder is about equal. However, in children, it is more common in boys than in girls because the average age of onset is earlier for males than for females.

Question 56

A drug that reduces the effects of dopamine would have which effect on the symptoms of Schizophrenia?

Answer 56

Decrease or eliminate symptoms

The traditional antipsychotics tend to have a greater impact on the positive symptoms than on the negative symptoms of Schizophrenia.

Question 57

A woman believes that advertisements on television contain personal messages to her from her ex-husband, who is currently living in another country. If the woman meets the diagnostic criteria for Delusional Disorder, which subtype best fits the nature of her delusion?

Answer 57

Unspecified

The woman’s belief is considered a delusion of reference. The DSM-5 does not provide a specific subtype of Delusional Disorder for delusions of reference. Therefore, a person who expresses this kind of delusion would be assigned the unspecified subtype.

Question 58

a belief that another person, usually of higher status, is in love with the individual.

Answer 58

erotomanic delusion

Question 59

reflects an inflated sense of worth, power, knowledge, etc.

Answer 59

grandiose delusion

Question 60

belief that one is being attacked, harassed, persecuted, etc.

Answer 60

Persecutory delusions

Question 61

Abnormal melatonin levels have been linked to which of the following?

Answer 61

Seasonal Affective Disorder

Melatonin is a hormone released by the pineal gland and it is involved in the regulation of circadian rhythms. Seasonal Affective Disorder seems to have some relation to circadian rhythms, and there is evidence that higher-than-normal levels of melatonin play a role in the production of the symptoms of this syndrome. Note that, in the DSM-5, this condition is indicated as a specifier for Major Depressive Disorder: “with seasonal pattern”.

Question 62

When developing a treatment plan for an 11-year-old with Conduct Disorder, you will most likely include which of the following interventions?

Answer 62

Parent management training

As with many disorders, a multimodal approach is generally most effective for Conduct Disorder and ordinarily includes parent management training and/or other family intervention.

Question 63

Which of the following is true about hallucinations?

Answer 63

The sensory experience may or may not be perceived as real by the individual.

A hallucination is a sensory perception that seems real but occurs without external stimulation of the relevant sensory organ. The person experiencing a hallucination may or may not be aware that the perceived stimulus is not real.

Question 64

A 71-year old retired college professor obtains a score of 90 on an IQ test, exhibits deficits in both judgment and abstract thinking, and has significant memory loss, of which he does not seem to be aware. His wife says that in the past year he “just hasn’t seemed like himself.” Based on these symptoms, the most likely diagnosis is:

Answer 64

Alzheimer’s disease

Question 65

associated with chronic alcoholism

Answer 65

Korsakoff’s syndrome

Question 66

a term used to describe Major Depressive Disorder that has prominent cognitive symptoms.

Answer 66

Pseudodementia

Question 67

Grandiosity is NOT a characteristic symptom of which of the following disorders?

Answer 67

Schizoid Personality Disorder

Grandiosity involves an exaggerated sense of self-importance. It is characteristic of three of the four disorders listed in the answers to this question. Schizoid Personality Disorder is characterized by restricted emotional experience and expression. Although people with this disorder may seem self-absorbed, they do not exhibit grandiosity.

Question 68

Dissociative Amnesia most commonly involves:

Answer 68

retrospective gaps in memory

Dissociative Amnesia is characterized by an inability to recall important personal information that is often related to a traumatic event.

Question 69

Washing and/or cleaning rituals associated with Obsessive-Compulsive Disorder (OCD) would probably be best treated with:

Answer 69

exposure with response prevention

Note that this question is asking about the treatment of compulsions, not obsessions. Exposure with response prevention is the treatment of choice for compulsions. It is often combined with CBT, relaxation training, and/or pharmacotherapy.

Question 70

Which of the following paraphilias is characterized by intense sexually arousing fantasies, sexual urges, or behaviors that involve touching or rubbing against a nonconsenting person?

Answer 70

Frotteuristic Disorder

Paraphilias involve intense sexually arousing fantasies, sexual urges, or behaviors related to unusual objects, activities, or situations. Note that in the DSM-5, paraphilias are referred to as Paraphilic Disorders. The information in the question accurately describes Frotteuristic Disorder.

Question 71

involves sexual arousal from observing an unsuspecting person who is naked or engaging in sexual activity.

Answer 71

Voyeuristic Disorder

Question 72

involves sexual urges, fantasies, or behaviors surrounding sexual activity with a prepubescent child.

Answer 72

Pedophilic Disorder

Question 73

characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving the use of nonliving objects (e.g., shoes, gloves).

Answer 73

Fetishistic Disorder

Question 74

Which of the following is a negative symptom of Schizophrenia?

Answer 74

Disorganized speech

Negative symptoms include restrictions in range and intensity of emotional expression (affective flattening), restrictions in fluency and productivity of thought and speech (alogia), and restrictions in the initiation of goal-directed behavior (avolition).

Question 75

Narcissistic, Borderline, and Histrionic Personality Disorders share which of the following characteristics?

Answer 75

Affective instability

Affective instability is a characteristic shared by all three disorders. Knowing that the three Personality Disorders listed in the question all involve dramatic, emotional, and/or erratic behaviors would have helped you identify the correct answer to this question. For the exam, you want to be familiar with the major characteristics of Personality Disorders. Additionally, it is important to note that individuals may be diagnosed with one personality disorder while presenting with traits of another that do not meet full diagnostic criteria.

Question 76

Cataplexy:

Answer 76

is usually triggered by strong emotion

Cataplexy is a symptom of Narcolepsy. In most cases, an episode of cataplexy is triggered by anger, surprise, laughter, or other strong emotion.

Question 77

The primary feature that distinguishes Acute Stress Disorder from Posttraumatic Stress Disorder is:

Answer 77

the shorter duration of symptoms in the former disorder

The name of one of the disorders - Acute Stress Disorder - may have helped you identify the correct answer to this question. The symptoms of Acute Stress Disorder must have a duration no longer than one month. When symptoms last for more than one month and meet the criteria for PTSD, the diagnosis is updated to PTSD.

Question 78

Longitudinal studies have found that the symptoms of Borderline Personality Disorder tend to be most severe during the:

Answer 78

early adult years

Longitudinal research has shown that the symptoms of Borderline Personality Disorder are ordinarily most severe during early adulthood, although most individuals with this disorder continue to have some degree of impairment throughout their lives.

Question 79

A young man who has received a diagnosis of Antisocial Personality Disorder is most likely to have exhibited which of the following during childhood?

Answer 79

Cruelty to animals

Antisocial Personality Disorder is characterized by failure to conform to social norms, lying, lack of regard for others, irresponsibility, and/or an absence of remorse. Cruelty to animals is one symptom of Conduct Disorder, which is a precursor to Antisocial Personality Disorder.

Question 80

Tobacco Withdrawal is characterized by which of the following symptoms?

Answer 80

Depressed mood, insomnia, and increased appetite

Tobacco Withdrawal is one of the Substance-Induced Disorders you are likely to encounter on the licensing exam. It is characterized by the symptoms listed in this answer, and the rapid onset of these symptoms is thought to be a primary reason that regular smokers find it so difficult to stop smoking.

Question 81

Autonomic hyperactivity, psychomotor agitation, and nausea or vomiting

Answer 81

These are symptoms of Alcohol Withdrawal.

Question 82

Apathy, impaired judgment, and dizziness

Answer 82

These are symptoms of Inhalant Intoxication.

Question 83

Affective blunting, muscle weakness, and elevated or lowered blood pressure

Answer 83

These are symptoms of Stimulant Intoxication.

Question 84

Which of the following would be most useful for monitoring the progression of Alzheimer’s disease?

Answer 84

Cognitive tests

Several techniques are used to track the progression of Alzheimer’s disease, and the best answer to this question would be “all of the above”. Unfortunately, in this question, this choice is not an option. However, since the core features of Alzheimer’s disease are disturbances in memory and other cognitive functions, the best way to follow its progression is with repeated measurement of cognitive abilities. Note that many of the newer techniques for assessing patients with this disorder incorporate other modes of assessment in addition to cognitive tests (e.g., interviews with family members, direct observations of the patient’s behavior).

Question 85

Sleep terror episodes:

Answer 85

result in a panicky scream

Sleep terror episodes are characterized by an abrupt awakening from sleep that usually begins with a panicky scream or cry. Sleep terror is a type of Non-REM Sleep Arousal Disorder specifier.

Sleep terrors usually begin during stage 3 or 4 of Non-REM sleep. The individual usually does not have a detailed memory of a dream upon awakening and may have amnesia for the episode or dream.

Question 86

Compared to children and adolescents in the general population, children and adolescents who are diagnosed with a learning disorder have:

Answer 86

a higher rate of psychopathology

Although the specific diagnoses that commonly co-occur with a learning disorder are relatively limited in number, the rates of these diagnoses are higher than the rates in the general population. For example, the prevalence rate for ADHD is 3 to 5% in the general population but between 20 and 30% for children with a learning disorder. Other common co-diagnoses include Oppositional Defiant Disorder, Conduct Disorder, and Major Depressive Disorder.

Question 87

Electroconvulsive shock therapy (ECT):

Answer 87

s considered useful for treating depression that involves suicidal preoccupation

ECT was originally used as a treatment for Schizophrenia; however, it is now used primarily as a treatment for severely depressed individuals who have not responded to other forms of treatment. Although its effects are still not understood, ECT continues to be used to treat depression, especially severe forms involving suicidal preoccupation and vegetative symptoms. Some studies suggest that ECT is more effective in these cases than are antidepressant drugs.

Question 88

In prepubertal children, Major Depressive Disorder is:

Answer 88

about equally common in boys and girls

The gender ratio for Major Depressive Disorder is related to age: In adolescents and adults, the disorder is more common in females than in males, but in prepubertal children, the rates are about equal for boys and girls.

Question 89

The diagnosis of Bulimia Nervosa requires which of the following?

Answer 89

Binge eating and inappropriate compensatory behavior for at least three months

Bulimia Nervosa involves recurrent episodes of binge eating followed by behaviors aimed at preventing weight gain - e.g., purging, excessive exercise, and/or the use of laxatives. The DSM-5 diagnostic criteria for the disorder include binge eating and inappropriate compensatory behavior for at least three months.

Question 90

Brittany S., age 34, is often very irritable with family members and friends, has trouble controlling her anger, gets drunk at least twice a week, has a history of frequent job changes and brief sexual affairs, and often complains that she is bored. Based on these symptoms, the most likely diagnosis is _____ Personality Disorder.

Answer 90

Borderline

Brittany’s behavior is characterized by instability - which, unfortunately, is characteristic of three of the four disorders listed. Therefore, you must consider her other symptoms to identify the most likely diagnosis. Brittany’s symptoms are most consistent with the diagnostic criteria for Borderline Personality Disorder, which is characterized by instability in self-image, interpersonal relationships, and affect. Additional symptoms may include irritability and/or intense anger and marked impulsivity in at least two areas, such as substance abuse and sexual behaviors.

Question 91

A 12-year old who has received a diagnosis of Oppositional Defiant Disorder is LEAST likely to exhibit which of the following?

Answer 91

Stealing from friends and family members

Oppositional Defiant Disorder (ODD) is one of the diagnoses that “sounds like” what it is – i.e., it involves oppositional behaviors. Stealing from friends and family members is more indicative of Conduct Disorder.

Question 92

Vivid dreamlike images that occur at the beginning of sleep are called:

Answer 92

hypnagogic hallucinations

Dreamlike imagery at the onset of sleep is a normal phenomenon in many people and is also associated with sleep deprivation, Narcolepsy, and several other conditions. The description presented in this question accurately describes hypnagogic hallucinations.

Question 93

occur just after awakening.

Answer 93

Hypnopompic hallucinations

Question 94

flashes of white or colored lights that originate from the retina or occipital cortex.

Answer 94

Release hallucinations

Question 95

Which of the following drugs is most likely to be prescribed to alleviate the symptoms of Obsessive-Compulsive Disorder?

Answer 95

A drug that blocks serotonin reuptake

Research results indicate that antidepressant medications that block the reuptake of serotonin are effective for temporary relief of OCD symptoms. Since the discontinuation of these drugs typically results in the return of symptoms, they are typically used in combination with other interventions.

Question 96

A person diagnosed with Tourette’s Disorder is most likely to have:

Answer 96

obsessive-compulsive symptoms

you want to be familiar with the common associated features of Tourette’s Disorder, which are described in the Abnormal Psychology chapter of the written study materials. According to the DSM-5, OCD and ADHD are the most frequent co-existing disorders in individuals with a diagnosis of Tourette’s. Although academic performance is often impaired, learning disorders are less common than obsessive-compulsive symptoms in individuals with Tourette’s. Low IQ is not commonly associated with Tourette’s.

Question 97

Korsakoff syndrome has been attributed to which of the following?

Answer 97

Thiamine deficiency

You are likely to encounter a question about Korsakoff’s syndrome on the licensing exam. It is associated with long-term alcohol use and is correlated with thiamine deficiency. Korsakoff’s syndrome is included in the DSM-5 as Alcohol-Induced Major Neurocognitive Disorder and it involves disorientation, memory loss, and confabulation.

Question 98

The pathological and apparently senseless repetition of a word or phrase just spoken by another person is called:

Answer 98

echolalia

You may have guessed accurately because the correct term sounds like its meaning. The description in this question defines echolalia, which is a symptom of autism and several other disorders.

Question 99

impoverished speech.

Answer 99

Alogia

Question 100

inability to produce speech sounds due to damage to the larynx or mouth.

Answer 100

Aphonia

Question 101

meaningless imitation of the movements of another person.

Answer 101

Echopraxia

Question 102

Social isolation associated with Avoidant Personality Disorder is most related to:

Answer 102

fear of embarrassment and rejection

Avoidant Personality Disorder is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and oversensitivity to negative evaluations. People who are diagnosed with Avoidant Personality Disorder tend to desire intimate relationships but avoid them because they fear rejection, humiliation, etc.

Question 103

excessive self-preoccupation

Answer 103

Excessive self-preoccupation is more characteristic of Narcissistic Personality Disorder.

Question 104

a lack of interest in close personal relationships

Answer 104

A lack of interest in social relationships is characteristic of Schizoid Personality Disorder.

Question 105

In the DSM-5, the feeling that one is an outside observer of one’s mental processes or body is called:

Answer 105

depersonalization

Depersonalization is characterized by a feeling of detachment or estrangement from oneself or feeling like an observer of one’s thoughts, feelings, etc.

Question 106

refers to confusion about time of day, date, place, etc.

Answer 106

Disorientation

Question 107

are false, but firmly sustained beliefs, based on incorrect inferences about external reality.

Answer 107

Delusions

Question 108

involves sudden, unexpected travel away from home with an inability to recall some or all of one’s past.

Answer 108

a fugue state

Question 109

If one child in a family experiences symptoms of Schizophrenia, what is the likelihood that his or her biological sibling will also develop symptoms of this disorder?

Answer 109

0.1

Although the reported concordance rates for Schizophrenia vary somewhat from study to study, 10% is most often reported in the literature for biological siblings.

Question 110

Alterations in perception are most associated with which of the following disorders?

Answer 110

Panic Disorder

Perceptual distortions (depersonalization and derealization) are potential symptoms of a panic attack.

Question 111

Lead poisoning, toxoplasmosis, and toxocara are possible complications of which of the following disorders?

Answer 111

Pica

Pica involves a persistent consumption of a nonnutritive substance. Lead poisoning can result when the substance is paint; toxoplasmosis or toxocara may occur when the substance is feces or dirt.

Question 112

The tendency to sexualize all relationships, have irrational emotional outbreaks, be highly suggestible, and exhibit overly dramatic and chaotic behaviors is most suggestive of which of the following Personality Disorders?

Answer 112

Histrionic

Question 113

involves a preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency.

Answer 113

Obsessive-Compulsive Personality Disorder

Question 114

involves a pervasive pattern of grandiosity, need for admiration, and lack of empathy.

Answer 114

Narcissistic Personality Disorder

Question 115

characterized by a pervasive pattern of detachment from social relationships and a restricted range of emotional expression.

Answer 115

Schizoid Personality Disorder

Question 116

If a client exhibits psychotic symptoms, it is important to keep in mind that Schizophreniform Disorder is a more appropriate diagnosis than Schizophrenia when:

Answer 116

the duration of symptoms is less than six months

The essential features of Schizophreniform Disorder and Schizophrenia are very similar, and the key distinguishing factor is the duration of symptoms. When the duration of symptoms is between one and six months, a diagnosis of Schizophreniform Disorder is appropriate.

Question 117

During your first session with John B., age 33, he reports feeling hopeless and very sad for the past three or four weeks and says he does not feel like doing anything. John tells you that he has lost his appetite and has been eating only one meal a day. He says that he thinks he has a fatal disease and is going to die soon and that he often hears Satan’s voice at night telling him he is going to go to hell when he dies. Based on these symptoms, the most likely diagnosis is:

Answer 117

Major Depressive Disorder with mood-congruent psychotic features

John’s symptoms (e.g., hopelessness, sadness, loss of appetite) are most suggestive of Major Depressive Disorder. Furthermore, the presence of delusions and hallucinations that are congruent with his mood is best captured by the specifier: “with mood-congruent psychotic features.”

Question 118

The most effective treatment for Tobacco Use Disorders in terms of both short- and long-term effects combines:

Answer 118

nicotine replacement therapy with behavioral interventions

Based on empirical evidence, a multimodal intervention that combines nicotine replacement therapy, multicomponent behavior therapy, and support and assistance from a clinician has been the most successful approach for smoking cessation.

Question 119

Edward M., age 36, says he rarely experiences strong emotions, describes himself as a “loner,” and states that he does not care what other people think of him. Based on these symptoms, the most likely diagnosis for Edward is _________ Personality Disorder.

Answer 119

Schizoid

Question 120

avoids social relationships due to a fear of being embarrassed or humiliated.

Answer 120

Avoidant Personality Disorder

Question 121

involves interpersonal deficits, cognitive or perceptual distortions, and behavioral eccentricities.

Answer 121

Schizotypal Personality Disorder

Question 122

involves a preoccupation with orderliness, perfectionism, and control.

Answer 122

Obsessive-Compulsive Personality Disorder

Question 123

Compared to adults experiencing nonpathological anxiety, an adult who is diagnosed with Generalized Anxiety Disorder (GAD) is:

Answer 123

more likely to experience his/her worries as more difficult to control

GAD is characterized by excessive anxiety and worry about multiple events and activities. In contrast to individuals with nonpathological anxiety, those with symptoms of GAD are more likely to report that they cannot control their worrying.

Question 124

A Latinx client who is diagnosed with Major Depressive Disorder is most likely to say that his symptoms include which of the following?

Answer 124

Headaches, sleep problems, and nervousness

Culture may influence the experience and manifestation of depression and other mental disorders. “Nervios” is a common idiom of distress for Latinos and may be indicative of depression or another diagnosis. It is manifested primarily in terms of somatic complaints such as headaches, sleep problems, and nervousness.

Question 125

A problem of the heart

Answer 125

Individuals from Middle Eastern cultures may describe depression as a “problem of the heart”.

Question 126

Weakness, tiredness, and an imbalance

Answer 126

These terms may be used by members of Chinese and other Asian cultures to describe depression.

Question 127

Amy B. has recently received a diagnosis of Obsessive-Compulsive Personality Disorder. Her symptoms most likely include:

Answer 127

being overly concerned about adhering to rules and schedules

Obsessive-Compulsive Personality Disorder is characterized by a persistent preoccupation with orderliness, perfectionism, and control. The symptoms described in this answer are consistent with a diagnosis of Obsessive-Compulsive Personality Disorder.

Question 128

feeling helpless and distressed when she is alone

Answer 128

These symptoms are characteristic of Dependent Personality Disorder.

Question 129

experiencing uncontrollable, recurrent thoughts and images

Answer 129

These are symptoms of Obsessive-Compulsive Disorder (OCD)

Question 130

being preoccupied with concerns about being blamed or criticized by others

Answer 130

These symptoms are characteristic of Avoidant Personality Disorder.

Question 131

The diagnosis of Adjustment Disorder requires the development of symptoms within ___ month(s) of the onset of the stressor.

Answer 131

three

The DSM-5 requires that symptoms develop within three months of the onset of the stressor and that symptoms do not persist for more than six months after the stressor or its consequences have ended.

Question 132

Habit reversal is most likely to be used as a treatment for:

Answer 132

stuttering

Habit reversal combines three strategies: awareness training, regulated breathing, and social support. This intervention is used to treat stuttering, tics, and nervous habits.

Question 133

Orgasmic reconditioning is considered to be an effective treatment for which of the following disorders?

Answer 133

Paraphilic Disorders

Orgasmic reconditioning was developed based on the assumption that orgasm reinforces sexual fantasies, and it is used to replace the stimuli that produce an organism. It is one of the techniques used to treat Paraphilic Disorders and involves having the individual replace an unacceptable sexual fantasy with a more acceptable one while masturbating.

Question 134

Clinicians have implemented several relapse prevention models to treat substance use and other addictive disorders. According to Marlatt and Gordon’s (1985) model, the most effective way to increase the likelihood of recovery after relapse is to:

Answer 134

shift attention from internal to external antecedents

Marlatt and Gordon’s (1985) model emphasizes the impact of cognitive and situational factors on relapse. Their Relapse Prevention Therapy (RPT) describes addiction as an “overlearned habit pattern” and proposes that the risk for relapse is reduced when a person views a lapse as the result of specific, external, and controllable factors, versus internal, stable, and global factors.

Question 135

Which of the following is listed in the DSM-5 as a diagnostic (versus associated) feature for Antisocial Personality Disorder?

Answer 135

Lack of remorse

A diagnosis of Antisocial Personality Disorder (APD) requires a pervasive pattern of disregard for and violation of the rights of others. For this diagnosis, the DSM-5 requires the presence of at least three of seven characteristic behaviors. One of the seven is a lack of remorse.

Question 136

To investigate diagnostic overshadowing, a researcher will design a study that assesses:

Answer 136

whether a therapist’s knowledge that a client has a Mood Disorder reduces the likelihood that the therapist will consider or recognize that the client also has another disorder

The term diagnostic overshadowing was initially used to describe the tendency of health professionals to attribute all behavioral, emotional, and social problems of individuals with an Intellectual Disability to that diagnosis. The study described in this answer would address the effects of having one diagnosis on the likelihood that other diagnoses would be considered and, therefore, would be useful for investigating diagnostic overshadowing.

Question 137

Which of the following seems to be the key element in treating Agoraphobia?

Answer 137

In vivo exposure

n vivo exposure with response prevention is the treatment of choice for Agoraphobia.

Question 138

The presence of which of the following symptoms would suggest a diagnosis of Conduct Disorder rather than a diagnosis of Oppositional Defiant Disorder?

Answer 138

Frequent lying and running away from home

Conduct Disorder involves a pattern of behavior in which the basic rights of others, and major age-appropriate social norms or rules, are violated. Lying and running away are characteristics of Conduct Disorder. Behaviors associated with Oppositional Defiant Disorder are less severe and include negativism, defiance, and hostility.

Question 139

Based on their meta-analysis of the existing literature, Faraone, Biederman, and Mick (2005) concluded that up to _____ percent of children with ADHD meet the criteria for a diagnosis of ADHD in partial remission as young adults.

Answer 139

60

Results from a meta-analysis by Faraone and colleagues demonstrated that 15% of children who are diagnosed with ADHD continue to meet full diagnostic criteria as young adults, and up to 60% meet the criteria for ADHD in partial remission.

Question 140

When using the DSM-5, __________ is coded when a clinician wants to indicate why a client’s symptoms do not meet the criteria for a specific disorder.

Answer 140

other specified disorder

When using the DSM-5, other specified disorder is coded when the clinician wants to indicate the reason that the client’s symptoms do not meet the criteria for a specific diagnosis - e.g., other specified bipolar disorder, short-duration manic episodes.

Question 141

A diagnosis of Schizoaffective Disorder requires the presence of delusions and hallucinations for at least __________ without symptoms of a depressive or manic episode.

Answer 141

two weeks

As its name suggests, Schizoaffective Disorder is characterized by concurrent psychotic and mood symptoms. However, for the diagnosis, the individual must have experienced a period of at least two weeks of psychotic symptoms without prominent mood symptoms.

Question 142

Hypofrontality in individuals with Schizophrenia has been linked to which of the following?

Answer 142

Negative symptoms

Some brain imagining studies have linked hypofrontality (decreased activity in the prefrontal cortex) to the negative symptoms of Schizophrenia.

Question 143

Many individuals with Major Depressive Disorder have EEG abnormalities during sleep that include which of the following?

Answer 143

Decreased REM latency

Approximately 40 to 60% of outpatients who meet the criteria for a major depressive episode demonstrate EEG abnormalities during sleep, including decreased REM latency (i.e., an earlier onset of REM sleep).

Question 144

For an individual diagnosed with Bipolar I Disorder, who is intolerant of or nonresponsive to lithium carbonate, the most appropriate medication would most likely be which of the following?

Answer 144

Carbamazepine

Lithium is ordinarily the first-line pharmacological treatment for Bipolar I Disorder. However, an anticonvulsant (e.g., carbamazepine, valproic acid, gabapentin) is often prescribed when an individual is intolerant to Lithium or has non-responsive symptoms.

Question 145

beta-blocker that is used to treat hypertension and to alleviate the physical symptoms of anxiety.

Answer 145

Propranolol

Question 146

a benzodiazepine that is used to treat anxiety, alcohol withdrawal, and chronic insomnia.

Answer 146

Lorazepam

Question 147

a cholinesterase inhibitor that is used to treat cognitive impairment in individuals with mild to moderate Alzheimer’s disease.

Answer 147

Donepezil

Question 148

For a DSM-5 diagnosis of Separation Anxiety Disorder in adults, symptoms must have a duration of ________ or more.

Answer 148

six months

For a diagnosis of Separation Anxiety Disorder, the DSM-5 requires a duration of symptoms of at least four weeks for children and adolescents or typically six months or more for adults.

Question 149

The DSM-5 diagnosis of Reactive Attachment Disorder requires which of the following?

Answer 149

Evidence that symptoms are related to extreme insufficient care

Reactive Attachment Disorder involves a consistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers. A child with this diagnosis has experienced a pattern of extremes of insufficient care as evidenced by neglect, repeated changes in primary caregivers, or rearing in unusual settings that interfere with attachment.

Question 150

Which of the following diagnoses involves a preoccupied fear of having a serious disease despite an absence of symptoms of the disease?

Answer 150

Illness Anxiety Disorder

A DSM-5 diagnosis of Illness Anxiety Disorder requires a preoccupation with having a serious illness, an absence of somatic symptoms or the presence of mild somatic symptoms, a high level of anxiety about health, and either performance of excessive health-related behaviors or maladaptive avoidance of medical care.

Question 151

involves the presence of one or more somatic symptoms that cause distress or a significant disruption in daily life accompanied by excessive thoughts, feelings, or behaviors related to the symptoms.

Answer 151

Somatic Symptom Disorder

Question 152

involves a falsification or induction of symptoms that are associated with an identified deception, and the behavior occurs in the absence of obvious external rewards.

Answer 152

Factitious Disorder

Question 153

A DSM-5 diagnosis of Erectile Disorder requires the presence of characteristic symptoms for a minimum duration of approximately _____ months.

Answer 153

six

The DSM-5 requires the presence of characteristic symptoms for a minimum duration of approximately six months for all Sexual Dysfunction diagnoses except Substance/Medication-Induced Sexual Dysfunction.

Question 154

An individual diagnosed with Neurocognitive Disorder due to Alzheimer’s disease has excess neurofibrillary tangles in the:

Answer 154

hippocampus

A definitive diagnosis of Alzheimer’s disease requires an autopsy or brain biopsy that confirms the presence of neuritic plaques and neurofibrillary tangles in the medial temporal structures (i.e., entorhinal cortex, hippocampus, and amygdala). Neurofibrillary tangles are most dense in the hippocampus, which plays an important role in memory consolidation.

Question 155

The severity level (mild, moderate, severe, or extreme) for a DSM-5 diagnosis of Bulimia Nervosa is based on which of the following?

Answer 155

Average number of weekly episodes of inappropriate compensatory behavior

The DSM-5 provides specifiers for Bulimia Nervosa for the course (in partial remission or full remission) and severity (mild, moderate, severe, or extreme) based on an average number of weekly episodes of inappropriate compensatory behavior.

Question 156

Current body mass index

Answer 156

Anorexia Nervosa severity level is diagnosed based on current body mass index.

Question 157

Lovaas and his colleagues used which of the following to teach nonspeaking children with autism to communicate?

Answer 157

Shaping and discrimination training

Lovaas’s method for teaching nonverbal children to talk combined modeling, shaping, and discrimination training. Modeling and shaping were used to gradually teach a child to say a word or simple sentence, and discrimination training was then used to teach the child when to use the word or sentence.

Question 158

an extension of classical conditioning in which a conditioned stimulus is treated as an unconditioned stimulus and paired with a new neutral stimulus so that the neutral stimulus eventually becomes a conditioned stimulus and elicits the conditioned response when presented alone.

Answer 158

Higher-order conditioning

Question 159

an operant technique that is used to eliminate undesirable behavior. It involves having the individual correct the consequences of the undesirable behavior (restitution) and/or practice corrective behaviors (positive practice).

Answer 159

Overcorrection

Question 160

a cognitive-behavioral technique in which the individual learns to modify maladaptive thoughts and behaviors by using covert self-statements.

Answer 160

Self-instructional training

Question 161

Evaluating an individual’s functioning in conceptual, social, and practical domains will help you determine the appropriate severity level for which of the following diagnoses?

Answer 161

Intellectual Disability

The DSM-5 distinguishes between four levels of severity for Intellectual Disability (mild, moderate, severe, and profound). Severity is based on the individual’s functioning in conceptual, social, and practical domains.

Question 162

Lewinsohn’s behavioral theory emphasizes the role of which of the following in the etiology of depression?

Answer 162

A low rate of response-contingent positive reinforcement

Lewinsohn’s theory of depression is based on the principles of operant conditioning. In this model, depression is attributed to a low rate of response-contingent reinforcement for social and other behaviors, which results in the extinction of behaviors. Additionally, this leads to pessimism, low self-worth, social isolation, and other features of depression that reduce the likelihood of positive reinforcement.

Question 163

Negative self-statements about oneself, the world, and the future

Answer 163

Beck identified a depressive cognitive triad consisting of negative beliefs about oneself, the world, and the future.

Question 164

A tendency to attribute negative life events to global, stable, and internal factors

Answer 164

In his original learned helplessness model, Seligman proposed that depression is caused by the tendency to attribute negative events to global, stable, and internal factors.

Question 165

A DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder requires an onset of symptoms prior to ___ years of age.

Answer 165

10

The diagnosis of Disruptive Mood Dysregulation Disorder cannot be assigned for the first time before the individual is six years of age or after he/she is 18 years of age, and the age of onset must be before age 10.

Question 166

In recent years, the highest suicide rate among all age groups in the United States has been found in:

Answer 166

Native Americans/Alaskan Natives

The CDC (2018) has reported the highest rates of suicide among Non-Hispanic Native Americans/Alaskan Native males, followed by White Non-Hispanic males.

Question 167

During her first session with Dr. Hank Hess, Stephanie B. tells him that she experiences severe anxiety whenever she is in an elevator because she’s afraid she won’t be able to escape or get help if she develops a panic attack. Which of the following would help confirm a DSM-5 diagnosis of Agoraphobia for Stephanie?

Answer 167

She tells Dr. Hess that she also experiences severe anxiety when using public transportation, which has limited her visits to friends and family members.

The DSM-5 diagnosis of Agoraphobia requires that the individual experience marked fear or anxiety in at least two of the following situations: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being part of a crowd, and being outside the home alone. Additionally, the individual must fear or avoid these situations due to a concern that escape might be difficult or help will be unavailable in the event one develops panic-like, incapacitating, or embarrassing symptoms.

Question 168

Research has shown that when a diagnosis of Generalized Anxiety Disorder (GAD) is comorbid with other psychiatric disorders, symptoms tend to be more severe. Various studies have also demonstrated that about _____ percent of people who have a lifetime diagnosis with GAD have a comorbid psychiatric disorder.

Answer 168

80 to 90

GAD is highly comorbid with other psychiatric disorders, with studies reporting comorbidity rates ranging from about 80 to 90%.

Question 169

Mia M., age 28, has just received a diagnosis of Obsessive-Compulsive Disorder. She tells her therapist that she knows that this disorder is often treated with medication but that she does not want to take a drug because of the side effects. Which of the following would likely be the most effective treatment for Mia?

Answer 169

Exposure with response prevention

Exposure with response prevention (ERP) is an empirically supported and first-line treatment for OCD.

Question 170

originally developed as a treatment for depression. Although it is now used to treat other disorders as well

Answer 170

Interpersonal therapy

Question 171

form of psychodynamic therapy that was developed as a treatment for Borderline Personality Disorder.

Answer 171

Mentalization-based therapy (MBT)

Question 172

form of cognitive-behavioral therapy that, as its name suggests, is used to treat Panic Disorder

Answer 172

Panic control therapy

Question 173

Janice J., age 23, shares that she has to be at work by 8:30 a.m. but she wakes up each workday by 5:30 a.m. so that she can wash her face and apply make-up to cover up her “bad skin.” Often, this involves removing and reapplying the make-up several times and causes her to be late for work two or three times a month. At work, she takes frequent bathroom breaks so she can check her face in the mirror and re-apply make-up. Janice says she is always “broke” because she spends so much of her salary on skin-care products and at tanning salons. She is afraid that if people see her without make-up they won’t want to have anything to do with her, and as a result, she avoids all social activities that will not allow her to frequently check her face. Janice has seen two dermatologists in the past six months and both have reassured her that her skin is fine, that she does not have acne, and that the scar above her eyebrow is not noticeable because it’s so small and is usually covered by her bangs. The most likely diagnosis for Janice is:

Answer 173

Body Dysmorphic Disorder

Body Dysmorphic Disorder involves a preoccupation with a defect or flaw in appearance that appears minor or is unobservable to others. The person performs repetitive behaviors or mental acts related to the defect or flaw (e.g., mirror checking, excessive grooming), and the preoccupation causes clinically significant distress or impaired functioning.

Question 174

are preoccupied with having or acquiring a serious illness.

Answer 174

Illness Anxiety Disorder

Question 175

have one or more somatic symptoms that cause distress or a significant disruption in daily life and are accompanied by excessive thoughts, feelings, or behaviors that are related to the symptoms.

Answer 175

Somatic Symptom Disorder

Question 176

involves the development of emotional or behavioral symptoms in response to one or more identifiable psychosocial stressors

Answer 176

Adjustment Disorder

Question 177

The specifier “with delayed expression” is appropriate for a DSM-5 diagnosis of PTSD when the individual’s symptoms do not meet all diagnostic criteria for the disorder until at least _____ after exposure to the traumatic event.

Answer 177

6 months

The specifier “with delayed expression” is applied to the diagnosis of PTSD when the individual does not meet full diagnostic criteria until at least six months after the traumatic event.

Question 178

In the DSM-5, dissociative fugue is:

Answer 178

a specifier for Dissociative Amnesia

Question 179

Which of the following is NOT a DSM-5 symptom of a Substance Use Disorder?

Answer 179

Recurrent legal problems related to substance use

Recurrent legal problems are not a symptom of a Substance Use Disorder in the DSM-5.

Question 180

The most frequent co-diagnosis for children with a learning disorder is ADHD, with approximately _____% of children with a learning disorder also receiving the latter diagnosis.

Answer 180

20 to 30

Children with a learning disorder often have a co-diagnosis of ADHD, ODD, and/or a mood disorder. Research results have demonstrated that the most common co-diagnosis is ADHD, with approximately 20 to 30% of children with a learning disorder also receiving a diagnosis of ADHD.

Question 181

Ella E. age 10, often says she doesn’t want to go to school because she’s afraid some of the children in her class will be “mean” to her. She seems overly concerned about her ability to perform well at school and in social situations. Moreover, she has trouble finishing her homework and other tasks because she keeps re-doing them since she wants them to be “perfect.” Ella frequently says she has a headache and has trouble falling asleep at night. Her mother tries to keep Ella from watching the news because she is unwilling to leave the house whenever she hears a story about a local murder or accident. Based on these symptoms, the best diagnosis for Ella is:

Answer 181

Generalized Anxiety Disorder

Ella is expressing excessive worry about multiple situations. Generalized Anxiety Disorder involves excessive worry or anxiety about several events or activities that the person finds difficult to control. Children with this disorder are often perfectionistic, filled with self-doubt, and typically exhibit physical signs of anxiety (e.g., headaches, stomachaches).

Question 182

requires evidence of excessive anxiety concerning separation from those to whom the child is attached

Answer 182

Separation Anxiety Disorder

Question 183

the child has a fear of being in places where escape might be difficult or embarrassing, or where help might not be available if panic-like symptoms develop.

Answer 183

Agoraphobia

Question 184

characterized by a marked and persistent fear of a specific object or situation

Answer 184

Specific Phobia

Question 185

In children, Generalized Anxiety Disorder (GAD) most often entails excessive worry about:

Answer 185

school or sports performance

There are some age-related differences in the symptoms of Generalized Anxiety Disorder. Children diagnosed with GAD most commonly worry about school and sports performance or natural disasters and other catastrophic events.

Question 186

Based on recent research results, the most effective intervention for Generalized Anxiety Disorder is:

Answer 186

Cognitive-Behavioral Therapy

CBT is an empirically supported treatment for Generalized Anxiety Disorder, and it consists of several components including psychoeducation, relaxation training, cognitive restructuring, exposure, and relapse prevention.

Question 187

an intervention that is typically implemented to treat symptoms of Post-traumatic Stress Disorder.

Answer 187

EMDR

Question 188

developed by Wople in the 1950s and this intervention is most often utilized to treat specific phobias.

Answer 188

Systematic desensitization

Question 189

a cognitive-behavioral intervention, which has been used to treat symptoms of anxiety, PTSD, aggression, and pain. However, CBT is a better response as it is more general (encompassing various interventions) and it has been empirically validated as a treatment for Generalized Anxiety Disorder.

Answer 189

Meichenbaum’s (1993) Stress Inoculation Training (SIT)

Question 190

A DSM-5 diagnosis of Bipolar II Disorder requires the presence or history of:

Answer 190

at least one major depressive episode and one hypomanic episode

For the exam, you want to be familiar with the diagnostic criteria for both Bipolar Disorders. The diagnosis of Bipolar II Disorder requires the presence or history of at least one major depressive episode and one hypomanic episode.

Question 191

An electrolyte imbalance is a possible complication of Bulimia Nervosa. The danger of this complication lies in the fact that it can lead to:

Answer 191

cardiac arrhythmia and arrest

Electrolyte imbalances caused by vomiting and the use of laxatives and diuretics can have serious consequences, including, in extreme cases, cardiac arrhythmia and arrest.

Question 192

Sue and Sue (2003) describe worldview - or the way that people perceive, evaluate, and react to the situations they encounter - in terms of locus of control and locus of responsibility. According to these investigators, the worldview of Caucasian middle-class therapists is characterized by an:

Answer 192

internal locus of control and internal locus of responsibility

Sue and Sue’s model distinguishes between four worldviews that reflect varying combinations of internal and external locus of control and locus of responsibility. Sue and Sue note that mainstream American culture “can be described as the epitome of the individual-centered approach that emphasizes uniqueness, independence, and self-reliance” (p. 277). These qualities reflect an internal locus of control and an internal locus of responsibility (IC-IR).

Question 193

Sue and Sue proposed that members of a racial minority group are more likely to exhibit an

Answer 193

internal locus of control and external locus of responsibility (IC-ER) as they have become more aware of their own racial and cultural identity and the impact of oppression on their lives.

Caucasian therapists are said to most often embody an IC-IR worldview and are noted as having the greatest difficulty when working with members of a racial minority group who have an IC-ER worldview.

Question 194

In her discussion of African American middle-class families, Boyd-Franklin (1989) noted that, in terms of family roles, these families tended to be:

Answer 194

egalitarian

Nancy Boyd-Franklin discusses this area of research in her book Black Families in Therapy: A Multisystems Approach, New York, Guilford Press, 1989. Boyd-Franklin found that the structure of the African American middle-class family often reflected equal sharing of power by the spouses as well as more permeable boundaries in general. For example, these families were open to influences from the extended family and the African American community.

Question 195

According to Herek (2004), which of the following individuals is most likely to discriminate against someone who identifies as gay?

Answer 195

An Asian heterosexual male massage therapist with a high level of sexual prejudice

Although the retiree is older and identified as having a high level of sexual prejudice, his sexual orientation is not identified. Thus, this is not the best answer. According to Herek, a high level of sexual prejudice in an individual who is heterosexual correlates with an increased likelihood of discrimination against those who are gay.

Question 196

A psychotherapist is most likely to say that which of the following is the greatest source of stress in his or her work?

Answer 196

The lack of therapeutic success

A survey of psychotherapists conducted in the early 1980s indicated that therapists expect their work to be stressful but also expect that their efforts will be appreciated and have positive results. The overwhelming majority of respondents (73.7%) said the major source of stress in their work was the lack of therapeutic success.

Question 197

Which of the following is of the LEAST concern when utilizing telepsychology?

Answer 197

Which technological devices will provide the best services

While technology should be considered, it is not as significant as the factors listed in the other responses.

While telepsychology has the potential to be easily available, there are also several difficulties and risks that may be involved with its use, such as confidentiality and privacy, how to obtain informed consent, whether the psychologist can practice across state lines, awareness of differences in local laws as they pertain to the use of telepsychology, etc.

Question 198

The triangular model of supervision puts emphasis on:

Answer 198

providing service to clients

Question 199

__________ and __________ make up the base of the triangular model, while the ____________ is at the core, however, the primary emphasis is on

Answer 199

Organizational policies (answer A) and professional knowledge (answer B) make up the base of the triangular model, while the supervisory relationship (answer C) is at the core, however, the primary emphasis is on providing service to the clients.

The triangular model of supervision emphasizes client service.

Question 200

Which of the following would be an unethical use of technology?

Answer 200

Storing recorded sessions on an unencrypted videoconferencing system

According to APA guidelines on telepsychology, psychologists must protect patient information stored or streamed on devices. Using an unencrypted system increases the risk of exposing patient information.

Question 201

Which of the following is not an essential component of training in supervision?

Answer 201

Completion of a supervision course that includes feedback of recorded sessions

While this would likely prove to be invaluable, the APA guidelines for clinical supervision do not list this as an essential component of training in supervision. The guidelines rather indicate that formal education and training in supervision should include instruction in didactic seminars, continuing education, or supervised supervision.

Question 202

A functional analysis involves:

Answer 202

examining the antecedents and consequences of behavior

Functional analysis entails examination of the purpose of behavior with the assumption that behavior cannot be understood in isolation. Functional analysis is a behavioral model based on stimulus-response learning mechanisms. Functional analysis focuses on behavior rather than cognitions.

Question 203

Yalom’s 11 curative factors include

Answer 203

altruism, cohesion, universality, interpersonal learning input and output, guidance, catharsis, identification, family re-enactment, self-understanding, instillation of hope, and existential factors.

Question 204

The process that occurs in group psychotherapy when the leader’s own unconscious, involuntary, inappropriate, and temporarily gratifying response becomes entangled in the therapeutic relationship with a group member to the extent that this obstructs or even destroys the leader’s objectivity is known as:

Answer 204

countertransference

Experts have noted that the group leader’s role may be impacted by collective projective processes or the shared transferences of participants. This has the potential to result in non-therapeutic countertransference enactments. The leader’s ability to manage these internal reactions and respond therapeutically is related to positive treatment outcomes.

Question 205

a technique that is at times used in psychodrama. It involves having two individuals exchange roles for the purpose of working through an interpersonal issue.

Answer 205

Role reversal

Question 206

occurs when a group member indirectly expresses a thought, feeling, or desire behaviorally rather than verbally.

Answer 206

acting out

Question 207

According to Helms, racism is a central part of being White in America, and her White Racial Identity Development Model proposes that identity development involves two phases:

Answer 207

abandoning racism and developing a nonracist White identity.

According to Helms, her White Racial Identity Development Model proposes that identity development involves two phases: abandoning racism (statuses 1-3) and developing a nonracist White identity (statuses 4-6). Each status is characterized by a different information-processing strategy (IPS), which refers to the methods the individual uses to reduce discomfort related to racial issues.

Question 208

The original version of Cross’s (1971) Black Racial (Nigrescence) Identity Development Model described identity development as nvolving a shift from

Answer 208

Black self-hatred to Black self-acceptance and consisted of five stages.

Question 209

distinguishes between five stages that people
experience as they attempt to understand themselves in terms of their own culture, the dominant culture, and the oppressive relationship between the two cultures. Each stage reflects changes in how the person views the self, others of the same racial/cultural group, members of other racial/cultural groups, and members of the dominant group.

Answer 209

The Racial/Cultural Identity Development Model

Question 210

Troiden’s Homosexual (Gay/Lesbian) Identity Development Model include:

During this stage, the individual becomes more certain of his/her homosexuality and may deal with this realization in a variety of ways – e.g., by trying to “pass” as heterosexual, by aligning him/herself with the homosexual community, or by acting in ways consistent with society’s stereotypes about homosexuality.

During this stage, at the onset of puberty, the individual realizes that he/she is attracted to people of the same sex and attributes those feelings to homosexuality, which leads to turmoil and confusion.

During this stage, which is usually characteristic of middle childhood, the individual feels different from his/her peers.

Answer 210

Identity Assumption

Identity Confusion

Sensitization

Question 211

Someone advocating an etic rather than an emic approach to therapy would:

Answer 211

utilize a universal approach

An etic approach is based on the assumption that universal principles apply across cultures. In other words, the etic approach is universalistic, while an emic approach is relativistic.

Question 212

based on the awareness that cultures vary and, consequently, cannot always be understood from the perspective of universal principles. work from the perspective of the client. utilize a universal approach. utilize a relativistic approach.

Answer 212

an emic approach.

Question 213

A member of a racial/cultural minority group who adopts the values, attitudes, and customs of his/her own minority culture but withdraws from the dominant culture is labeled as

Answer 213

separated.

Question 214

clinicians interpret reality via their own biased cultural lens and disregard both their own bias and existing cultural differences.

Answer 214

According to Wrenn (1985) culturally encapsulated clinicians

Question 215

According to Helms, a parallel interaction occurs between a White therapist and a client when:

Answer 215

both have similar levels of racial identity

According to Helms, a parallel interaction occurs when the therapist and client have the same or similar levels of racial/cultural identity. Although parallel interactions can produce mutual understanding and respect, they can also lead to inertia, especially when the therapist and client are at less advanced stages of identity development.

Question 216

the clients level of racial identity is at least one level more advanced than that of the therapist

Answer 216

Helms referred to this as a regressive interaction.

Question 217

the therapists level of racial identity is at least one level more advanced than that of the client

Answer 217

Helms referred to this as a progressive interaction.

Question 218

the racial identity of the therapist and client represent opposite attitudes towards race

Answer 218

Helms referred to this as a crossed interaction.

Question 219

A U.S. study of WWI era German immigrants found that those who experienced discrimination were more likely to:

Answer 219

assimilate

The four response options consist of Berry’s categories of acculturation. Fouka (2019) conducted a study that concluded that when faced with increased discrimination, Germans often increased their efforts to assimilate (ex. by Americanizing their names). Assimilation is Berry’s second acculturation status. Those in this status accept the majority culture while relinquishing their own culture.

Question 220

Colonial mentality has been found to be associated with:

Answer 220

more depressive symptoms

According to David & Okazaki (2006) colonial mentality is a “form of internalized oppression in which the colonized culture and society are considered inferior to the culture and society of the colonizer.” Recent studies have found that colonial mentality is a determinant of depression symptoms among Puerto Rican, Filipino, and Ghanaian adults.

Question 221

According to Ridley (1984), cultural paranoia is:

Answer 221

a healthy reaction to racism

Ridley (1984) notes that distrust of White mental health professionals by members of ethnic minority groups is related to the fact that professionals often misinterpret a healthy, adaptive response to racism (cultural paranoia) as pathology (functional paranoia).

Question 222

Historical trauma is:

Answer 222

a type of trauma that emanates from experiences of massive group trauma

The term historical trauma was coined by Maria Yellow Horse Braveheart in the 1980s. It is defined as “cumulative emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma experiences” (Braveheart, 2003).

Question 223

The framework for integrating cultural humility into therapy includes:

Answer 223

building the therapeutic alliance; repairing cultural ruptures; navigating value differences

Cultural humility advocates that therapists commit to lifelong learning which entails self-examination and self-awareness.

Mosher, Hook, Captari, Davis, Deblaere, & Owen (2017) proposed a four-part framework for integrating cultural humility in therapy which includes: engaging in critical self-examination and self-awareness, building the therapeutic alliance, repairing cultural ruptures, and navigating value differences.

Question 224

Which of the following is considered essential knowledge for a culturally competent therapist?

Answer 224

understanding the dynamics and impact of oppression and racism; being able to understand the worldview of their clients; being aware of barriers that prevent minorities from utilizing mental health services in their community

Question 225

What family therapy prioritizes the first session of therapy and has four stages: the social stage, the problem stage, the interaction stage, and the goal-setting stage?

Answer 225

Strategic Family Therapy

Strategic family therapy, developed by Jay Haley, considers the first session of therapy to be an important determinant of the course of therapy, and the first session involves four stages. In the social stage, the therapist observes the interactions of family members and encourages the involvement of all members. In the problem stage, the therapist gathers information about what brought the family to therapy. In the interaction stage, the therapist observes the family members discussing the identified problem. In the goal-setting stage, the therapist and family members agree on a contract that defines the goals for therapy.

Question 226

posits that all families have an implicit structure that determines how family members relate to each other. Therapy techniques joining, evaluating the family structure, and restructuring the family.

Answer 226

Structural family therapy, developed by Salvador Minuchin

Question 227

has a clinical practice model with three distinct phases: engagement and motivation, behavior change, and generalization.

Answer 227

Functional family therapy, developed by James Alexander

Question 228

describes the functioning of family members in terms of differentiation of self, emotional triangles, and the family projection process. This therapy usually includes only two family members so the therapist can become the third member in the therapeutic triangle.

Answer 228

Extended family systems therapy, developed by Murray Bowen

Question 229

Which of the statements below regarding motivational interviewing (MI) is accurate:

Answer 229

MI was initially designed as a brief intervention for problem drinking; MI stresses self-responsibility and a collaborative working relationship between therapist and client; MI avoids arguing with clients and reframes resistance as a healthy response

The assumptions and procedures of motivational interviewing were derived from Rogers’ client-centered therapy and Bandura’s notion of self-efficacy. With regard to client-centered therapy, motivational interviewing stresses therapist empathy, reflective listening, and responding to client resistance in a nonconfrontational manner.

MI was first used as a treatment for alcohol addiction but has since been applied to other problems including cigarette smoking, eating disorders, diabetes, and pain management. MI addresses self-responsibility in that it is centered around a client’s own motivation to change. It is client-centered in nature; thus, the therapist-client relationship is key. MI is non-confrontational in nature, and thus positively reframes resistance.

Question 230

A man, who smokes two packs a day, says he has decided to stop smoking the day after his birthday, which is two weeks away. According to Prochaska and DiClemente (1992), this man is in which of the following stages of the change process?

Answer 230

Preparation

Prochaska and DiClemente (1992) distinguish between six stages in the change process. These include the four listed in the responses plus maintenance and termination stages. In the preparation stage, the person has a clear intent to take action in the near future.

Question 231

During this stage, the individual has little insight into the need for change.

Answer 231

Precontemplation

Prochaska and DiClemente (1992) distinguish between six stages in the change process. These include the four listed in the responses plus maintenance and termination stages. In the preparation stage, the person has a clear intent to take action in the near future.

Question 232

During this stage, the individual has little insight into the need for change.

Answer 232

Precontemplation

Question 233

the person is aware of the need for change and is considering change but has not yet committed to it.

Answer 233

Contemplation

Question 234

the person actually takes steps to bring about change. (In the maintenance stage, he/she consolidates the change and takes steps to prevent relapse.)

Answer 234

Action

Question 235

According to past research, matching a therapy client to his/her therapist in terms of race:

Answer 235

is a more accurate predictor of treatment length than treatment outcome

The research on ethnic matching is far from consistent. However, most studies have found that it has a greater impact on premature termination from therapy than on its outcomes. Members of some groups are more likely than others to benefit from client-therapist matching in terms of ethnicity. When there are benefits, however, they are usually (but not always) for dropout rates rather than for therapy effectiveness.

Question 236

During the first session with a woman who is the victim of spousal abuse, a feminist therapist would most likely:

Answer 236

help the woman identify and rehearse an “escape plan” to use when her husband becomes abusive

The key phrase in this question is “during the first session.” According to Walker, a leading advocate of feminist therapy, a primary goal during the crisis intervention (first) phase of therapy is to help the abused woman rehearse an escape plan (Feminist therapy with victims/survivors of interpersonal violence, in L. B. Rosewater and L. E. A. Walker (Eds.), Handbook of feminist therapy, 1985).

Although helping female clients recognize the impact of oppressive social and political forces on their attitudes and behaviors is an important part of feminist therapy, it would probably not be the first step in therapy when the presenting problem is spousal abuse.

Question 237

When considering concurrent individual and group therapy for a client it is important to keep in mind that:

Answer 237

individual therapy may decrease participation and involvement in group therapy

For many therapists, it is common practice to combine individual and group therapy. However, there may be some drawbacks to this approach. Yalom (1975) and others caution that individual therapy can “drain off” clinical material from group therapy and thereby decrease involvement and participation in group therapy.

Question 238

Consultation is distinct from supervision in that supervision involves:

Answer 238

administrative responsibility

Unlike consultants, supervisors have administrative responsibility for and are in a position of power over the supervised.

Question 239

a type of transference that occurs when a past unresolved conflict related to a particular type of client or circumstance is evoked by and interferes with the consultee’s current situation.

Answer 239

Theme interference

Question 240

As defined by Sue and Zane, gift giving might involve all of the following except:

Answer 240

waiving a late fee

Sue and Zane note that gift-giving is a common ritual in Asian cultures and propose that it has beneficial effects on the involvement and motivation of Asian and non-Asian therapy clients, especially when it occurs during initial therapy sessions. Waiving a late fee would not be considered gift-giving as defined by Sue and Zane given that doing so does not directly advance the client’s treatment goals.

Normalizing a client’s problems is one example of gift-giving described by Sue and Zane.
Sue and Zane also listed collaboratively setting treatment goals as an example of gift-giving.
Facilitating the acquisition of a new skill would also be an example of Sue and Zane’s concept of gift-giving.

Question 241

As defined by Sue and Zane, gift giving might involve:

Answer 241

normalization; goal setting; skill acquisition

Question 242

Sue and Zane (1987) note that gift giving is a common ritual in Asian cultures and propose that it has:

Answer 242

beneficial therapeutic effects

Sue and Zane indicated that gift-giving has beneficial effects on the involvement and motivation of Asian and non-Asian therapy clients.

Question 243

Past research suggests that the best approach when working with African American families involves:

Answer 243

adopting a multisystems approach

Past research suggests that therapy with African American families is usually most effective when it takes into account social, political, socioeconomic, and other contextual factors. Thus, a multisystems (ecostructural) approach has been recommended by several experts for therapists working with African American families (e.g., Aponte, 1994; Boyd-Franklin, 1989).

Question 244

A family therapist instructs a family member to continue performing the target behavior and to do so in an exaggerated way. This technique is referred to as:

Answer 244

prescribing

In this situation, the therapist is prescribing the symptom. Prescribing involves instructing the client to maintain and/or exaggerate the target symptom.

Question 245

involves shifting the meaning or frame of reference of symptomatic behavior.

Answer 245

Reframing

Question 246

the therapist accepts and exaggerates the client’s assertions about his/her problems.

Answer 246

positioning

Question 247

A therapist is most likely to say that which of the following is the most stressful type of client behavior?

Answer 247

Suicidal statements

Therapists experience stress and burnout for several reasons. Not surprisingly, the most difficult situation–i.e., the one requiring an immediate response–is the one that is associated with the greatest stress. Surveys of therapists have revealed that suicidal ideation and threats are considered the most stress-producing client behaviors.

Question 248

The primary targets of interpersonal therapy include:

Answer 248

role disputes, role transitions, unresolved grief, and interpersonal deficits

Interpersonal therapy (IPT) is a brief structured manual-based therapy that was originally developed as a treatment for depression but has since been applied to other disorders. Its primary targets are the four problem areas listed in this response.

Question 249

personal constructs, fixed roles, repertory grids, and self-characterization sketches

Answer 249

personal construct therapy

Question 250

boundary disturbances, unfinished business, and transference fantasies

Answer 250

Gestaltian concepts.

Question 251

Bateson, Jackson, Haley, and Weakland (1956) identified double-bind communication as an etiological factor for which of the following disorders?

Answer 251

Schizophrenia

As described by Bateson et al. (1956), double-bind communication occurs when a family member receives contradictory injunctions (messages) from another family member and is unable to comment on those injunctions or escape from them. The title of Bateson et al.’s 1956 paper was Toward a Theory of Schizophrenia. Their double-bind hypothesis provided an alternative to psychodynamic theory regarding the development of this disorder and proposed that the recipient of double-bind communication learns to escape the discomfort it creates by responding with similarly distorted and contradictory messages. Eventually, the individual becomes unable to understand the true meaning of his/her own messages and those of others.

Question 252

In an enmeshed family in which an over-controlling father constantly nags and yells at his 18-and 15-year old sons, a structural family therapist is most likely to do which of the following?

Answer 252

Manipulate the family’s mood by mimicking the father’s behavior in an exaggerated manner.

Minuchin’s structural approach to family therapy utilizes techniques to alter the family’s structure. Minuchin’s structural family therapy can be characterized as “manipulative, unyielding, and crisis provoking” (Goldenberg & Goldenberg, (1985), Family therapy: An overview, p. 185). It uses a number of techniques to restructure a family’s transactional patterns including marking boundaries, escalating stress, utilizing symptoms, and manipulating mood. When using the latter technique, the therapist might imitate, in an exaggerated way, the family’s style in order to point out their dysfunctional patterns.

Question 253

One criticism of Minuchin’s approach is that it does not emphasize

Answer 253

fostering insight and understanding.

Question 254

developed by Bowen and is used primarily by family systems (Bowenian) therapists in order to clarify a family’s multigenerational relationship systems.

Answer 254

genogram

Question 255

used primarily by communications family therapists, was an outgrowth of research on the pathological double-bind conducted by Don Jackson and his colleagues.

Answer 255

therapeutic double-bind

Question 256

Supervision can be distinguished from consultation in that:

Answer 256

supervisors are in a position of power over supervisees

Unlike consultants, supervisors have administrative responsibility for and are in a position of power over the supervised.

Question 257

Practitioners of Gestalt psychotherapy consider a client’s desire to talk about his/her past as:

Answer 257

a way for the client to avoid coming to terms with the present

Knowing that Gestalt therapists focus on the here-and-now in therapy would have helped you identify the correct response to this question.

Gestalt therapists do not deny the significance of the past. However, in therapy, they encourage clients to stay in the present even when discussing past events or feelings since focusing on the past is viewed as a way to avoid the present.

Question 258

Cultural humility can be distinguished from cultural competence in that it emphasizes all of the following except:

Answer 258

acquiring factual knowledge related to various cultural groups with the goal of being an expert in multicultural competence

This description is more in line with the traditional notion of cultural competence which is distinguished from cultural humility. One significant criticism of the traditional notion of cultural competence is that it overemphasizes trite knowledge acquisition that often stereotypes cultural groups rather than lending to a nuanced understanding of cultural diversity.

Proponents of cultural humility hold that this concept balances necessary knowledge acquisition with “a greater emphasis on a life-long commitment; encourages nurturing of self-evaluation and critique; addresses power imbalances; promotes interpersonal sensitivity; requires an attitude of openness and egolessness; involves supportive interaction; entails maintaining an interpersonal stance that is other-oriented; necessitates learning from differences” (Campinha-Bacote, 2018).

Question 259

The Racial/Cultural Identity Development Model proposed by Atkinson, Morten, and Sue (1993) is based on the assumption that the stages of identity development reflect changes in:

Answer 259

one’s attitudes toward members of minority and dominant cultures

Each stage of the Racial/Cultural Identity Development Model is characterized by a different set of attitudes toward members of one’s own minority group, members of other minority groups, and members of the dominant group.

Question 260

A group of previously identified high-risk individuals are presented with a screening test in order to determine who is likely to benefit from intervention is an example of _________ prevention.

Answer 260

secondary

Question 261

From the perspective of Gestalt therapy, introjection is:

Answer 261

a boundary disturbance

Gestalt therapists use the term introjection to describe an overly permeable boundary between the person and the environment. From this perspective, neurotic behavior is often the result of a disturbance in the boundary between the person and his/her external environment.

Question 262

The main difference between Freud’s and Perls’ conceptualization of defense mechanisms is that Freud viewed defense mechanisms as an id-ego interaction; however, Perls viewed defense mechanisms as a

Answer 262

boundary disturbance.

Question 263

Research on Yalom’s (1985) curative factors in group therapy indicates that which of the following factors are likely to be cited as most important by group members?

Answer 263

Cohesion, interpersonal learning, catharsis, self-understanding

Yalom and others have conducted research to identify the curative factors that group members consider most important. Although the results of research on Yalom’s curative factors vary, depending on the type of therapy group, these four factors are often cited as most critical by group therapy members.

Question 264

A practitioner of which of the following is most likely to agree that the therapist’s role is to bring unconscious issues that exist within a family to a conscious level?

Answer 264

Object relations family therapy

Practitioners of psychodynamic psychotherapy are interested in the impact of unconscious issues on current behavior. Object relations family therapy is a psychodynamic therapy that links intrapsychic phenomena to current family relationships.

Question 265

Berry (1987) would assert that a member of a racial/cultural minority group who adopts the values, attitudes, and customs of his/her own minority culture but rejects those of the dominant (majority) is:

Answer 265

separated

Berry (1987) distinguishes between four levels of acculturation including integration, assimilation, separation, and marginalization. A person in the separation category rejects the majority culture and identifies with his/her own minority culture.

Question 266

A person who identifies with his/her own minority culture but also adopts aspects of the majority culture

Answer 266

integrated

Question 267

when he/she adopts the characteristics of the majority culture and rejects his/her own minority culture.

Answer 267

assimilated

Question 268

People recalling childhood memories of a trauma for the first time while under hypnosis will usually:

Answer 268

believe the accuracy of the memories while under hypnosis and will likely continue to believe them when no longer hypnotized whether or not the memories are true

One of the problems with the use of hypnosis to recall memories is that people tend to be more certain about the accuracy of those memories, whether they are true or false. The research has shown that people are often more willing to accept false memories when those memories have been retrieved under hypnosis.

Question 269

Therapist effects include:

Answer 269

the therapist’s ethnicity; years of experience; the therapist’s office set up

For research purposes, therapist effects refer to the collective impact that a clinician has on client outcome independent of the treatment modality or therapeutic technique utilized. Any possible impact that a therapist has on treatment outcome, with the exception of the two aforementioned variables, are classified as ‘therapist effects’.

Question 270

A 14-year old boy engages in “acting-out” behaviors whenever his parents begin talking about separating, and his actions temporarily disrupt their discussion and plans. From the perspective of family therapy, the boy’s behavior is best described as:

Answer 270

an attempt to restore homeostasis

In this situation, the boy is trying to prevent a change in the family’s status. Homeostasis is the tendency of a system to maintain the status quo. In the situation described in the question, the boy’s behavior is serving to maintain the family system by keeping his parents together.

Question 271

occurs when a family member (the scapegoat) is placed in a role that exposes him/her to blame, criticism, etc.

Answer 271

Scapegoating

Question 272

causes change in a system, while negative feedback serves to maintain the status quo. The boy’s behavior is an example of negative feedback because it keeps the family together.

Answer 272

Positive feedback

Question 273

The new clients of Dr. Blanco, a Euro-American therapist, are an Asian family consisting of a grandmother, mother and father, and two children, ages 16 and 10. During an initial session with this family, Dr. Blanco would be best advised to:

Answer 273

assess each family member’s level of acculturation before developing a treatment plan

For the exam, you want to be familiar with the general guidelines for working with members of diverse populations provided in the Clinical Psychology chapter. An initial step when working with clients from culturally diverse groups is to identify the client’s stage of racial/ethnic identity development, degree of acculturation, and worldview (beliefs, values, attitudes, etc.).

Question 274

During the course of group therapy, some members begin to express anger toward a female member because they feel she is “hiding behind a facade” rather than revealing her true self. Other members say she should be left alone. According to Irvin Yalom, this type of conflict:

Answer 274

should be expressed and then processed to clarify its meaning to members

Yalom views conflict as a normal part of group therapy and considers it to be a useful therapeutic tool if handled correctly. According to Yalom, the therapeutic use of conflict in group therapy involves two stages: experience (affective expression) and understanding of that experience.

Question 275

A feminist therapist is likely to view which of the following as an important aspect or goal of therapy?

Answer 275

Identifying the sociopolitical and interpersonal forces that underlie a woman’s symptoms; Reconstructing the therapeutic process so that the traditional pattern of dependence is not recreated in the therapeutic relationship; Using the therapeutic relationship as an opportunity to model appropriate behavior

For feminist therapists, a primary goal of therapy is helping the client understand and appropriately respond to forces in the environment that impact the client’s life. Feminist therapists are more likely to avoid labeling aspects of the personality as “masculine” or “feminine”.

Question 276

According to Ridley, when working with an African American client exhibiting “healthy cultural paranoia”, an Anglo therapist would be best advised to:

Answer 276

help the client bring feelings of suspiciousness, frustration, and antipathy toward whites into conscious awareness

Ridley presents a “typology of black client self-disclosure,” which relates the willingness to self-disclose to four levels of “paranoia”: intercultural nonparanoic disclosure; functional paranoiac; healthy cultural paranoiac; and confluent paranoiac (Clinical assessment of the nondisclosure of the black client, American Psychologist, 39(11), 1234-1244, 1984). Ridley recommends that therapists confront the meaning of the client’s cultural paranoia by bringing his/her feelings into conscious awareness and then help the client clarify when it is appropriate or inappropriate to self-disclose.

Question 277

Ledley, Foa, & Huppert (2005) consulted with David Clark to develop a comprehensive CBT treatment manual for which of the following disorders?

Answer 277

Social phobia

Deborah Ledley, Edna Foa, and Jonathan Hubbert consulted with David Clark to publish a 2005 treatment manual entitled Comprehensive Cognitive Behavior Therapy for Social Phobia. This publication was revised by Herbert, Forman, & Yuen in 2009.

Question 278

Marsha Linehan is well-known for her manualized publications which address CBT and DBT treatment of

Answer 278

borderline personality disorder.

Question 279

A Milan systemic family therapist will emphasize the use of which of the following in therapy?

Answer 279

Circular questions

A primary goal of Milan systemic family therapy is to “help family members see their choices and to assist them in exercising their prerogative of choosing” (Gelcer, McCabe, & Smith-Resnick, 1990, p. 22). For systemic therapists, questions are not only a means for obtaining information but also act as a therapeutic intervention. Circular questions help define and clarify confused ideas and behaviors and introduce new information to family members.

Question 280

refers to the concept that a phenomenon is simultaneously a whole and its parts.

Answer 280

holon

Question 281

A therapist replicates problems with her supervisor that are manifested by her client in therapy during supervision. What accurately describes this phenomenon?

Answer 281

Parallel process

Parallel process occurs in clinical supervision when the therapist (supervisee) behaves toward the supervisor in ways that mirror how the client is behaving toward the therapist.

Question 282

occurs when the client and therapist have the same (or similar) levels of racial/cultural identity.

Answer 282

parallel interaction

Question 283

a form of supervision that emphasizes providing service to clients that includes organizational policies, professional knowledge, and the supervisory relationship.

Answer 283

triangular model

Question 284

According to Carl Rogers, which of the following factors would be necessary and sufficient for therapeutic change to occur?

Answer 284

Empathy; Genuineness; Unconditional positive regard

ccording to Rogers, the therapist’s role is to provide the client with three facilitative conditions including empathy, genuineness, and unconditional positive regard. He proposed that these conditions enable the client to return to his/her natural tendency for self-actualization. The instillation of hope is one of Yalom’s curative factors. While Rogers likely would not have diminished the value of instilling and holding hope for clients, he did not include this factor as one of the three facilitative conditions for change.

Question 285

According to Irvin Yalom, which of the following individuals is the poorest candidate for a heterogeneous outpatient therapy group?

Answer 285

A sociopath

Yalom (1985) identified several types of people who are and are not likely to benefit from group therapy. According to Yalom, heterogeneous outpatient groups are inappropriate for sociopaths (although these individuals may benefit from homogeneous groups in inpatient or other controlled settings).

Question 286

According to Gregory Herek, ______________ refers to “cultural ideologies that promote and perpetrate antipathy, hostility, and violence against homosexuals.”

Answer 286

heterosexism

Herek attributes violence against “homosexuals” to heterosexism which he defines as an “ideological system that denies, denigrates, and stigmatizes among nonheterosexual forms of behavior, identity, relationships, or community” (p. 150). [Psychological heterosexism and anti-gay violence: The social psychology of bigotry. In G. M. Herek & K. T. Berrill, Hate crimes: Confronting violence against lesbians and gay men (pp. 149-169), Newbury Park, Sage, 1992]. For the exam, you want to be familiar with the terms Herek uses as alternatives to homophobia – i.e., sexual stigma, heterosexism, and sexual prejudice.

Question 287

From the perspective of Freudian psychoanalysis, anxiety is due to:

Answer 287

the occurrence of an internal or external threat

Freud’s personality theory emphasizes conflicts between internal instincts and the external demands of reality. Answer D is the best description of Freud’s conceptualization of anxiety as it is the only response that addresses both internal and external threats.

Question 288

a threat to one’s unified self-concept

Answer 288

This is Roger’s view of anxiety.

Question 289

__________ can be viewed as a phenomenon that provides a therapist with opportunities to “hear” the message behind a client’s overt behavior.

Answer 289

countertransference

Freud viewed countertransference as an obstacle to the progress of therapy, but other psychodynamic theorists have redefined it as a potential source of useful information about clients.

Question 290

describes it as the process of associating oneself with other people and assuming their attitudes, behaviors, etc.

Answer 290

identification

Question 291

is the type of thinking that is a function of the id and is guided by the pleasure principle.

Answer 291

Primary process

Question 292

a boundary disturbance that involves incorporating another person’s values and beliefs into one’s own personality without fully understanding them.

Answer 292

Introjection

Question 293

A young man has been sober for eight months and is actively engaging in behaviors to prevent his relapse of alcohol use. According to the transtheoretical model of change (Prochaska, Norcross, & DiClemente, 1994), what stage of change best reflects this person?

Answer 293

Maintenance

According to the transtheoretical model, a person in the maintenance stage has maintained a change of behavior for at least six months and is taking steps to prevent relapse.

Question 294

feels that there is no risk for relapse and is not actively taking steps for relapse prevention.

Answer 294

termination stage

Question 295

person takes active and concrete steps for behavior change. For this person, the initial steps taken toward sobriety may have been in the action stage, but his current circumstances are better reflected by the maintenance stage.

Answer 295

action stage

Question 296

Helms’s (1995) White Racial Identity Development Model distinguishes between six statuses. The first status is:
Select one:

Answer 296

contact

Question 297

final stage in Cross’s Black Racial Identity Development Model.

Answer 297

Internalization

Question 298

The final stage of the Racial/ Cultural Identity Development Model.

Answer 298

Integrative awareness

Question 299

Gerald Caplan (1970) described a consultee’s objectivity as one of the targets of consultee-centered case consultation. According to Caplan, which of the following is a potential cause of a consultee’s lack of objectivity?

Answer 299

Theme interference

Caplan states that the primary targets of consultee-centered case consultation are the consultee’s skills, knowledge, and/or objectivity. Caplan defines theme interference as a type of transference that occurs when a consultee’s unresolved conflict related to a particular type of client or situation interferes with his/her objectivity when working with similar clients or in similar situations.

Question 300

occurs when a therapist (supervisee) replicates problems and symptoms with the supervisor that are being manifested by the therapist’s client.

Answer 300

Parallel process

Question 301

According to Herek (2000) which group of individuals is most likely to have higher levels of sexual prejudice than the general population?

Answer 301

Heterosexual male retirees with high school diplomas who live in Florida

Research relating to the correlates of sexual prejudice has generally evidenced higher levels of sexual prejudice among heterosexual men versus heterosexual women, individuals who are older, those with fewer years of formal education, residents of Southern states, Midwestern states, or rural areas, and those who have limited contact with the LGBTQ+ community (Herek, 2000). Studies have also found correlations between higher levels of sexual prejudice and authoritarianism, affiliation with a fundamentalist religious denomination, and conservative political views. Choice B is the best answer as it presents two of the above correlates (level of education and Southern region).

Question 302

A therapist instructs a client who suffers from insomnia to polish his hardwood floors for at least two hours whenever he wakes up during the night. Apparently this therapist is familiar with the work of:

Answer 302

Milton Erickson

The task described in the question is an example of an “ordeal”. For the exam, you should have paradoxical techniques and ordeals associated with Milton Erickson and Jay Haley (who was strongly influenced by Erickson).

Question 303

From the perspective of general systems theory, if an open system is faced with an unexpected threat, it will:

Answer 303

defend against or adapt to it

Systems theory underlies family therapy, in which a family is viewed as an open system that interacts with the environment. Open systems respond to input by modifying or elaborating structural elements. Under some conditions, the system will react in a way that maintains homeostasis; in other conditions, the system changes or adapts to the new input.

Consistent with systems theory, family therapists view the family as primarily an open system. An open system continuously receives input from and discharges output to the environment and is more adaptable to change.

Question 304

A “teleological” approach is most closely associated with which theorist?

Answer 304

Adler

A teleological approach views behavior and personality as being “pulled” by a subjective future rather than being “pushed” by an objective past (e.g., by heredity or environmental events). A distinguishing characteristic of Adler’s approach is its teleological explanation for behavior. Adler believed that behavior is determined by future goals.

Question 305

viewed behavior as the result of the past consequences of the behavior.

Answer 305

Skinner

Question 306

a family therapist who regards severe mental disorders (e.g., Schizophrenia) as the result of a multigenerational transmission process.

Answer 306

Bowen

Question 307

viewed current behavior as the result of innate factors and past experiences.

Answer 307

Freud

Question 308

Madelyn strongly dislikes her older sister, Maxine, but goes out of her way to be nice to Maxine whenever they get together for family gatherings. From a psychoanalytic perspective, Madelyn is exhibiting which of the following defense mechanisms?

Answer 308

Reaction formation

Defense mechanisms are used by the ego to prevent conscious awareness of anxiety-producing impulses, thoughts, and desires. Although defense mechanisms vary with regard to their processes and manifestations, they all represent a distortion or denial of reality and operate unconsciously. Reaction formation involves acting in a manner opposite to one’s inclinations; i.e., defending against a disturbing impulse by actively expressing its opposite.

Question 309

involves a return or retreat to a previous stage of development.

Answer 309

Regression

Question 310

involves ascribing the thoughts and behaviors of others to oneself in order to better control one’s affective responses to those thoughts and behaviors.

Answer 310

Introjection

Question 311

involves a transfer of unacceptable feelings associated with one object to a more acceptable or safe object.

Answer 311

Displacement

Question 312

To incorporate the value of personalismo into therapy, a therapist will:

Answer 312

display genuine interest in the client by asking about his/her family and work or school

Personalismo sounds like what it is - i.e., communication that fosters warmth, rapport, and a personal connection. Although formalismo (a formal communication style) is generally preferred by Latino/Hispanic clients during initial therapy sessions, personalismo is preferred once the therapeutic alliance has been established.

Question 313

A: Integrating members of the extended family into the intervention would be consistent with the value of

Answer 313

familismo.

Question 314

As defined by Jung, “individuation” refers to:

Answer 314

the integration of conscious and unconscious aspects of the psyche

Individuation is a key concept in Jung’s personality theory. Jung described individuation as a lifelong process that consists of integrating or harmonizing components of the conscious and unconscious.

Question 315

A practitioner of existential therapy is most likely to say that “existential anxiety” is:

Answer 315

a normal reaction to the constant threat of death

Existential therapies are derived from existential philosophy and share an emphasis on the human conditions of depersonalization, loneliness, and isolation. For existential therapists, behaviors commonly perceived as “maladaptive” are a natural part of being human. Existential anxiety, for example, is conceptualized as a normal response to the constant threat of nonbeing (death).