Marisa's Missed Dx and Psychopath ?'s

Question 1

Question ID #7195: Anxiety and depression share which of the following symptoms?

A. anhedonia
B. somatic arousal
C. obsessive thoughts
D. negative affect

Answer 1

D. negative affect

Question 2

Question ID #7198: Behavioral treatment for obsessions would most likely involve:
Select one:

A. deliberate exposure and thought stopping.
B. relaxation training and assertiveness training.
C. contingency contracting and paradoxical intent.
D. systematic desensitization and differential reinforcement for other behaviors.

Answer 2

A. deliberate exposure and thought stopping

Question 3

Question ID #71: Which of the following factors is associated with the worst prognosis for Schizophrenia?
Select one:

A. male, positive symptoms, and late onset
B. male, negative symptoms, and early onset
C. female, negative symptoms, and early onset
D. female, positive symptoms, and late onset

Answer 3

B. male, negative symptoms, and early onset

Question 4

Question ID #7204: When a person with deep dyslexia is presented with the written word “cat,” he is most likely to respond with which of the following?

Select one:
A. tac
B. dog
C. at 
D. I don't know

Answer 4

B. dog

Question 5

Question ID #7207: Research by Foa et al. (1999) found which of the following treatments most effective for post-traumatic stress disorder?
Select one:

A. prolonged exposure
B. stress inoculation training
C. response prevention
D. prolonged exposure combined with stress inoculation training

Answer 5

A. prolonged exposure

Question 6

Question ID #7208: Which of the following types of headaches is most likely to be exacerbated by jarring motions, bending forward, and lifting?
Select one:

A. tension
B. cluster
C. sinus
D. migraine

Answer 6

D. migraine

Question 7

Question ID #7209: Chronic alcoholism may cause cognitive impairments. Specifically, following prolonged, heavy drinking, a person is most likely to exhibit:
Select one:

A. greater deficits in visuospatial skills than in verbal skills.
B. greater deficits in verbal skills than in visuospatial skills.
C. a comparable pattern of deficits in visuospatial and verbal skills.
D. deficits in either visuospatial or verbal skills, depending on whether the person is left- or right-brain dominant.

Answer 7

A. greater deficits in visuospatial skills than in verbal skills.

Question 8

Question ID #7211: An adolescent exhibiting foreclosure is most likely to respond in which of the following ways when asked about her career choice?
Select one:

A. I haven’t given my career much thought yet.
B. My father, who’s a lawyer, has convinced me that I’d make a good lawyer too.
C. I’ve given that a lot of thought and I think being a veterinarian best suits my interests.
D. That’s something that’s been bothering me lately and I’m worried that I’m never going to be able to reach a decision.

Answer 8

B. My father, who’s a lawyer, has convinced me that I’d make a good lawyer too.

Question 9

Question ID #7214: Research on gender differences in anxiety has most often found that:
Select one:

A. females have more general anxiety than males
B. males have more general anxiety than females
C. females have more social and general anxiety than males Incorrect
D. males have more social and general anxiety than females

Answer 9

Correct Answer is: A
The results of a meta-analysis on gender differences concluded that females (across all age groups) have a higher level of general anxiety than males. Males scored very slightly higher than females in level of social anxiety, although this difference was not significant (A. Feingold, Gender Differences in Personality: A Meta-Analysis. Psychological Bulletin, 1994, 116(3), 429-456).

Question 10

Question ID #7215: As a treatment for Obsessive-Compulsive Disorder, in vivo exposure:
Select one:

A. is effective only when maximal anxiety is invoked during exposure sessions.
B. is most effective when exposure is massed (versus distributed) but involves a gradual increase in the intensity of anxiety arousal.
C. is most effective when exposure is combined with response prevention.
D. is most effective when exposure is distributed (versus massed) and is combined with response prevention.

Answer 10

Correct Answer is: C
While in vivo exposure has been found superior to exposure in imagination for Simple Phobia and Agoraphobia, the difference is less clear for OCD (both seem effective). In addition, gradual exposure and maximal exposure (flooding) seem to be about equally effective as are massed or distributed exposure sessions. However, there is evidence that the benefits of exposure are maximized when it is combined with response prevention. [For a review of the literature, see P. Emmelkamp, Behavior therapy with adults, in A. E. Bergin and S. L. Garfield (eds.), Handbook of Psychotherapy and Behavior Change, New York, John Wiley, 1994.]
Additional Information: Treatment (Obsessive-Compulsive Disorder)

Question 11

Question ID #7217: From Wolpe’s classical conditioning perspective, neurotic depression:
Select one:

A. is a conditioned response that can be alleviated through extinction trials in which the neutral (conditioned) stimulus is repeatedly presented without the depression-inducing (unconditioned) stimulus.
B. is a response to anxiety and can, therefore, be alleviated by using systematic desensitization to eliminate the anxiety.
C. is due to attributional biases that, through conditioning, have become associated with certain types of events and can be eliminated through reattribution training.
D. results when there is an absence of response contingent reinforcement and is best treated by counterconditioning in which depression is paired with a variety of pleasure-producing (unconditioned) stimuli.

Answer 11

Correct Answer is: B
Even if you are unfamiliar with Wolpe’s explanation of depression, you may have been able to pick the right answer to this question as long as you have him associated with systematic desensitization. Wolpe distinguished between several types of depression. He linked neurotic depression to anxiety and considered systematic desensitization to be an effective treatment.
Additional Information: Systematic Desensitization

Question 12

Question ID #7218: The research has shown that the extent and severity of the long-term problems associated with ADHD are strongly related to whether or not the child also had:
Select one:

A. symptoms of depression.
B. a learning disability.
C. conduct problems.
D. a “difficult” temperament.

Answer 12

Correct Answer is: C
The studies have consistently shown that the combination of hyperactivity and conduct problems is most associated with antisocial behavior and other serious problems in adulthood.
Additional Information: Attention-Deficit/Hyperactivity Disorder (ADHD)

Question 13

Question ID #7223: A child diagnosed with Attention-Deficit/Hyperactivity Disorder is most likely to also be diagnosed with:
Select one:

A. Tourette’s Disorder
B. Conduct Disorder
C. Enuresis
D. Obsessive-Compulsive Disorder

Answer 13

Correct Answer is: B
Attention-Deficit/Hyperactivity Disorder (ADHD) is highly comorbid with Conduct Disorder. Between 30% and 50% of children with ADHD also meet the criteria for Conduct Disorder, with the highest comorbidity rates among the two subtypes marked by hyperactivity-impulsivity (Hyperactive-Impulsive and Combined Types). The percentage of patients with Conduct Disorder who also have ADHD is nearly 70%. (T. P. Beauchaine, E. S. Katkin, Z. Strassberg, & J. Snarr. Disinhibitory psychopathology in male adolescents: Discriminating Conduct Disorder from Attention-Deficit/ Hyperactivity Disorder through concurrent assessment of multiple autonomic states. Journal of Abnormal Psychology, 2001, 110(4), 610-624).
If you incorrectly selected Tourette’s Disorder, you may have been thinking of the reverse relationship. That is, among those with Tourette’s Disorder the comorbidity of ADHD is at least 50%; however, most patients with ADHD do not have Tourette’s Disorder.

Question 14

Question ID #7234: The primary associated feature of the Somatoform Disorders is
Select one:

A. panic attacks.
B. anxiety and depression.
C. addiction to analgesics or mild tranquilizers.
D. somatic delusions.

Answer 14

Correct Answer is: B
The Somatoform Disorders (such as Somatization Disorder, Conversion Disorder, Somatoform Pain Disorder, Hypochondriasis, and Body Dysmorphic Disorder) are characterized by physical symptoms which have no known physical cause and are believed to be caused by psychological factors. The DSM identifies anxiety and depression as associated features of each of these disorders. You might have gone for addiction to analgesics or tranquilizers, since it seems to make sense. However, excessive use of analgesics (which are not addictive anyway) is identified as a possible associated feature of Somatoform Pain Disorder only.

Question 15

Question ID #7235: Which of the following appears to be related to abnormal regulation of melatonin levels?
Select one:

A. Schizoaffective Disorder
B. Bipolar Disorder
C. Mood Disorder with Melancholic Features
D. Mood Disorder with Seasonal Pattern

Answer 15

Correct Answer is: D
Mood Disorder With Seasonal Pattern (better known is Seasonal Affective Disorder) is diagnosed when the person displays onset and remission of Major Depressive Episodes at characteristic times of the year. In most cases, onset is in fall or winter and remission is in spring. It is believed that Seasonal Affective Disorder is related to abnormal regulation of melatonin secretions. The fact that Seasonal Affective Disorder often responds to light therapy (exposing the patient to bright light for about two hours either before sunrise or after sundown) lends support to this hypothesis, since melatonin levels are affected by light-dark cycles.

Question 16

Question ID #7236: Which of the following disorders is most likely to respond to pharmacotherapy alone?
Select one:

A. Bipolar I Disorder.
B. Major Depressive Disorder
C. Obsessive-Compulsive Disorder.
D. Anorexia Nervosa.

Answer 16

Correct Answer is: A
Pharmacotherapy (specifically, Lithium therapy in most cases) is the treatment of choice for manic-depressive illnesses such as Bipolar I Disorder. Pharmacotherapy may be supplemented with adjunctive psychotherapy (e.g., to provide support and coping skills). However, psychotherapy is not considered that useful in treating the core symptoms of Bipolar I Disorder. By contrast, although the disorders in the other choices are commonly treated with medication, they also respond to psychotherapy.

Question 17

Question ID #7240: A family with an elderly parent who is in the early stages of Alzheimer’s Dementia presents for a initial consultation. The best intervention on the part of a psychologist would be to
Select one:

A. work with the elderly patient on memory exercises.
B. refer the family to a support group.
C. begin family therapy to explore how the patient’s diagnosis has affected family subsystems. Incorrect
D. work with the identified patient in individual therapy.

Answer 17

Correct Answer is: B
Psychological treatment of Alzheimer’s focuses primarily on optimizing the patient’s immediate environment and providing support for the patient and his or her family. Both these goals can be met at least to some extent through a referral to a support group.

Question 18

Question ID #7245: Which of the following statements is true about the results of meta-analyses investigating the effectiveness of cognitive therapy in the treatment of depression?
Select one:

A. Cognitive therapy is more effective than insight-oriented and interpersonal therapy, but less effective than anti-depressant medication. Incorrect
B. Cognitive therapy is more effective than insight-oriented therapy but equal in effectiveness to interpersonal therapy and anti-depressant medication.
C. Cognitive therapy is more effective than anti-depressant medication and insight-oriented therapy, but equal in effectiveness to interpersonal therapy.
D. Cognitive therapy is more effective than insight-oriented therapy, interpersonal therapy, and anti-depressant medication.

Answer 18

Correct Answer is: B
Though some individual studies have found cognitive therapy to be the most effective treatment for depression, the results of meta-analyses (such as the one conducted by the National Institute of Mental Health) indicate that cognitive therapy, interpersonal therapy, and anti-depressant medications are about equal in efficacy in the treatment of depression. All three treatments are superior to psychodynamic, or insight-oriented, therapies.

Question 19

Question ID #7246: The preferred treatment for Agoraphobia is
Select one:

A. implosive therapy.
B. systematic desensitization
C. in-vivo exposure with response prevention.
D. participant modeling.

Answer 19

Much research supports the generally accepted conclusion that in-vivo exposure with response prevention is the preferred psychological treatment for Agoraphobia.

Question 20

Question ID #7247: Generalized tonic-clonic seizures are associated with
Select one:

A. grand mal epilepsy.
B. petit mal epilepsy.
C. Jacksonian epilepsy.
D. temporal lobe epilepsy

Answer 20

Generalized tonic-clonic seizure is the name for what was previously referred to as grand mal seizure; thus, this choice “grand mal epilepsy” is the best answer. These seizures involve episodes of violent shaking, during which the person becomes blue and stiff. There may also be an increase in heart rate and blood pressure. Generalized tonic-clonic seizures may last up to an hour, and afterward the person falls into a deep sleep.

Question 21

Question ID #7252: Relapse by smokers who have stopped smoking is most likely to be triggered by the presence of smoking cues in one’s surroundings or
Select one:

A. positive affect.
B. negative affect.
C. inactivity.
D. coffee consumption.

Answer 21

Correct Answer is: B
According to S. Shiffman et al., the most common precipitants of relapse are the presence of smoking cues and negative affect (First lapses to smoking: Within-subjects analysis of real-time reports, Journal of Consulting and Clinical Psychology, 64(2), 366-389).

Question 22

Question ID #7255: One of the highest correlations with smoking cessation outcome is related to
Select one:

A. gender.
B. level of dependence.
C. age.
D. duration of smoking.

Answer 22

Correct Answer is: B
The greater the level of dependence on nicotine, the harder it is to stop smoking (American Psychiatric Association, Practice Guidelines for the Treatment of Nicotine Dependence, Washington, DC, 1996).
In terms of gender, and age, females and males and older and younger adults generally do equally well in treatment. The duration of smoking* is not really a factor (* incorrect options); it is far more critical to determine the amount of smoking in order to determine dependence.

Question 23

Question ID #7256: General symptoms that may accompany the third stage of Alzheimer’s Dementia include
Select one:

A. apathy and emotional blunting.
B. depression and anomia.
C. irritability and anger.
D. paranoia and labile mood.

Answer 23

Correct Answer is: A
These symptoms are characteristic of the third stage of Alzheimer’s Dementia according to many authors. The symptoms vary considerably from person to person and may include personality, behavioral, and cognitive changes.
The symptoms of depression and anomia* and irritability and anger* are often seen during the first stage. Paranoia and labile mood* are characteristic of the second.

Question 24

Question ID #7267: The primary triggers of relapse in individuals attempting to quit smoking are withdrawal symptoms and
Select one:

A. emotional factors such as negative affect.
B. environmental factors such as the presence of other smokers.
C. the use of alcohol, caffeine, or other substances that were associated with smoking in the person’s past.
D. events that are attributed to external, uncontrollable, and global factors.

Answer 24

Correct Answer is: A
Research suggests that the primary physical factor in maintaining smoking is avoidance of withdrawal, and the primary psychological factor is regulation of emotional states. Specifically, smoking functions to minimize negative affects and evoke positive affects. This is why the most common triggers of relapse are withdrawal symptoms and negative affects.

Question 25

Question ID #7268: The differential diagnosis between Schizoid Personality Disorder and Avoidant Personality Disorder is based on
Select one:

A. degree of isolation.
B. odd behaviors.
C. self-centeredness.
D. fear of rejection.

Answer 25

Correct Answer is: D
Schizoid Personality Disorder is characterized by a pattern of indifference to social relations and a limited range of emotional expression in social situations. Avoidant Personality Disorder is characterized by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Individuals with both these disorder are likely to avoid social relationships. However, those with Avoidant Personality Disorder do so due to timidity and fear of criticism, disapproval, or rejection. Individuals with Schizoid Personality Disorder, by contrast, do so out of indifference to social relationships and a preference for solitary activities.

Question 26

Question ID #7279: Depression is often accompanied by memory deficits and other cognitive problems. Memory deficits most often involve:
Select one:

A. recall memory.
B. recognition memory.
C. implicit memory.
D. recall and recognition memory but not implicit memory.

Answer 26

Correct Answer is: A
Memory impairment is one of the characteristics that is useful for distinguishing depression (pseudodementia) from dementia. In depression, recall memory is affected but recognition memory is not; in dementia, recall and recognition memory are both impaired.

Question 27

Question ID #7282: Research on epilepsy has found that tonic-clonic seizures are associated with:
Select one:

A. greater cognitive impairment than other types of seizures.
B. less cognitive impairment than other types of seizures.
C. cognitive impairment only when seizures are idiopathic.
D. cognitive impairment only when seizures are secondary to known pathology.

Answer 27

Correct Answer is: A
One of the complications of epilepsy is that repeated seizures are correlated, in some cases, with cognitive declines. This is especially true of tonic-clonic seizures regardless of whether they are idiopathic or secondary to (symptomatic of) another disorder.

Question 28

Question ID #7286: A difference between tangentiality and circumstantiality is that:
Select one:

A. in circumstantiality, the person is delayed in reaching the point, whereas in tangentiality, the person avoids reaching the point at all.
B. in tangentiality, the person is delayed in reaching the point, whereas in circumstantiality, the person avoids reaching the point at all.
C. tangentiality is speech that is not understandable, due to the lack of a meaningful connection between words or sentences; by contrast, circumstantial speech is understandable.
D. circumstantiality is speech that is not understandable, due to the lack of a meaningful connection between words or sentences; by contrast, tangential speech is understandable.

Answer 28

Correct Answer is: A
If you were not familiar with the term “tangentiality,” thinking about the phrase “going off on a tangent” might have helped you. Tangentiality is defined as responding to a question in an oblique or irrelevant way; in other words, the person avoids the point entirely. Circumstantiality, by contrast, is a pattern of speech that is delayed in reaching the point due to much irrelevant detail or many parenthetical remarks. Eventually, however, the point is reached.

Question 29

Question ID #73: After reviewing the research on the effectiveness of vocational rehabilitation for patients with Schizophrenia, one could conclude that the single best predictor of future employment is:
Select one:

A. SES
B. level of education
C. symptom severity
D. previous job history

Answer 29

Correct Answer is: D
The research regarding the effectiveness of vocational rehabilitation programs for those with Schizophrenia and other severe mental illness is mixed; however, the most consistent finding is that past employment history is the best predictor of future employment. [See A. Lehman, Vocational Rehabilitation in Schizophrenia, Schizophrenia Bulletin, 1995, 21 (4), 645-656).]

Question 30

Question ID #75: Among adults who were diagnosed with ADHD during childhood, we could expect that
Select one:

A. their children will have a 25% chance of developing ADHD
B. up to 70% will continue to exhibit signs of the disorder throughout their lives
C. the symptoms will manifest in the same ways in those who continue to have the disorder
D. by the time they reach adulthood, they will not exhibit further symptoms of the disorder

Answer 30

Correct Answer is: B
Research studies have found that between 30% and 70% of children with ADHD continue to exhibit signs of the disorder throughout their lives. Studies have also found a strong genetic basis for ADHD. One study found that the risk of a child developing ADHD is 57% if one of their parents has the disorder [See J. Biederman, et al. High risk for attention deficit hyperactivity disorder among children with parents with childhood onset of the disorder: A pilot study. American Journal of Psychiatry, 1995, 152, 431-435.]

Question 31

Question ID #77: Caution is necessary when considering Ritalin for a hyperactive child who has
Select one:

A. a family history of Tourette’s Syndrome.
B. a family history of drug abuse.
C. a co-diagnosis of a Learning Disorder.
D. a co-diagnosis of Conduct Disorder.

Answer 31

Correct Answer is: A
Some hyperactive children develop motor tics when taking methylphenidate. Leading experts warn that the drug should not be used (or should be used with caution) when a child has a pre-existing Tic Disorder or a family history of a Tic Disorder.

Question 32

Question ID #82: Based on the existing research, the optimal treatment for PTSD is:
Select one:

A. EMDR. Incorrect
B. prolonged exposure.
C. stress inoculation training.
D. prolonged exposure plus stress inoculation training

Answer 32

Correct Answer is: B
Usually a combined treatment is the best, but in the case of PTSD, the research suggests that prolonged exposure is the best treatment. While stress inoculation training is also effective alone, it doesn’t seem to add much to prolonged exposure.

Question 33

Question ID #83: A PET scan of the brain of a patient diagnosed as schizophrenic would be most useful for:
Select one:

A. obtaining a record of electrical activity in the cerebral cortex.
B. assessing blood flow in the frontal lobes.
C. detecting a tumor or other structural abnormality in the brainstem.
D. distinguishing between schizophrenic subtypes.

Answer 33

Correct Answer is: B
Positron Emission Tomography (PET) is a functional (versus structural) brain imaging technique that provides information about the metabolic and chemical activities of the brain such as cerebral blood flow.

Question 34

Question ID #84: The incidence of OCD is:
Select one:

A. the same for males and females across all ages
B. about twice as common in males than females
C. higher among boys but about equal among adult males and females
D. higher among girls but about equal among adult males and females Incorrect

Answer 34

Correct Answer is: C
Obsessive-Compulsive Disorder has an earlier peak onset for males than females. For males the peak onset is between ages 6 and 15, and for females it is between ages 20 and 29. The incidence is, therefore, higher among boys than girls but in adulthood the incidence is about the same.

Question 35

Question ID #86: The incidence of Major Depressive Disorder in adult females compared to adult males is 2:1. This gender difference:
Select one:

A. is the same for children under 10 years of age
B. is opposite for children under 10 years of age
C. does not become evident until mid-adolescence
D. does not become evident until early adulthood

Answer 35

Correct Answer is: C
Prior to puberty the incidence of Major Depressive Disorder is about equal for boys and girls; however, at puberty the gender differences emerge with the disorder occurring twice as often in females than males [S. Nolen-Hoeksema and J.S. Girgus, The emergence of gender differences in depression during adolescence, Psychological Bulletin, 1994, 115, 424-443].

Question 36

Question ID #90: The presence of which of the following suggests the diagnosis is Social Phobia rather than Agoraphobia?
Select one:

A. social situations are avoided due to fear of humiliation or embarrassment
B. an absence of the physiological symptoms associated with a panic attack
C. anxiety that is perceived as excessive and temporarily controllable
D. increased anxiety in feared situations when accompanied by a trusted companion

Answer 36

Correct Answer is: D
Individuals with Agoraphobia typically prefer to be with a trusted companion when in the feared situation, whereas, individuals with Social Phobia may feel more anxious due to the potential scrutiny by a companion.
social situations are avoided due to fear of humiliation or embarrassment

This choice does not adequately differentiate the disorders since in both Social Phobia and Agoraphobia there is a fear of humiliation or embarrassment and an avoidance of those situations, although in Agoraphobia the fear is not limited to social situations.c

Question 37

Question ID #91: A mother complains that her 10-year-old son has been misbehaving a lot lately. He refuses to do anything he is asked, has been staying out late at night, starting fights with his classmates, and has been caught lying on numerous occasions. The mother states that his misbehavior began about 18 months ago when his parents separated. Based on these symptoms, his most likely diagnosis is:
Select one:

A. Adjustment Disorder with Disturbance of Conduct
B. Conduct Disorder
C. Oppositional Defiant Disorder Incorrect
D. Child Antisocial Behavior

Answer 37

Correct Answer is: B
The boy’s symptoms meet the criteria for Conduct Disorder. There is a pattern of behavior in which major age-appropriate norms or rules are violated.
Adjustment Disorder* can only be considered if the symptoms do not meet the diagnostic criteria for another disorder. His symptoms are more severe than is characteristic of Oppositional Defiant Disorder* and are not just isolated incidents of antisocial behavior as seen in Child Antisocial Behavior* (* incorrect options).