MFT Practice Exam - DSM 5 More Flashcards
Question
Answer
<p>Autism Spectrum disorder now encompasses which of the following DSM-IV diagnostic categories?</p>
<p>a. Pervasive developmental disorder.</p>
<p>b. Asperger's Disorder.</p>
<p>c. Childhood Disintegrative Disorder</p>
<p>d. All of the above.</p>
<p>The correct answer is: d. All of the above. ASD now encompasses the previous DSM-IV autistic disorder (autism), Asperger's disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. ASD is characterized by 1) deficits in social communication and social interaction and 2) restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present.</p>
<p>The DSM-V has a new approach to the axial assessment system of the DSM-IV TR. Which of the following best represents these changes?</p>
<p>a. Separate notations for important psychosocial and contextual factors and disability.</p>
<p>b. Axis II and V codes merged.</p>
<p>c. Axes I, II, and III from DSM IV are collapsed into one category.</p>
<p>d. a. and c.</p>
<p>The correct answer is: d. The DSM-V has collapsed the first 3 Axes from the DSM-IV TR into a single category and now requires separate notations for significant psychosocial and contextual factors as well as disability.</p>
<p>The DSM-V diagnostic categories pay special attention to development by</p>
<p>a. the incorporation of Maslow's Hierarchy of needs as being key to identifying the degree of development stress.</p>
<p>b. how they present in children and adolescents.</p>
<p>c. following Erikson’s Stages of Individual Development.</p>
<p>d. focusing on each stage of the family life cycle.</p>
<p>The correct answer is: b. How they present in children and adolescents. The DSM-V now gives specific examples of how a diagnosis might present in childhood, adolescence, and adulthood. A key shift within the DSM-V is its focus on earlier diagnoses and prevention.</p>
<p>The DSM-V has evolved from the DSM-IV TR in a variety of ways and now</p>
<p>a. assesses development across the life span.</p>
<p>b. has added new contingencies to the Axes.</p>
<p>c. has added subcategories to the V-codes.</p>
<p>d. focuses on specific stage of life through use of the new D-codes.</p>
<p>The correct answer is: a. assesses development across the life span. The DSM-V now looks at normal develop across the lifespan. Diagnoses arranged in lifespan fashion, with disorders usually diagnosed earlier in life placed first within the organization of chapters.</p>
<p>The DSM-V Dimensional Concepts address such things as</p>
<p>a. Measurement of distress, disability, and severity</p>
<p>b. family etiology and disorder rankings.</p>
<p>c. V-code norms.</p>
<p>d. stages of a disorder and risk of recidivism</p>
<p>The correct answer is: a. Measurement of distress, disability, and severity. The Dimension Concepts found with the DSM-V measure levels of stress, degree of disability and severity of the disorder.</p>
<p>Revisions to the DSM-V are designed to produce more accurate diagnostic criteria and nosology. Which of the following is the DSM-V's revisions main goal?</p>
<p>a. More accurate treatment.</p>
<p>b. All of the above.</p>
<p>c. Earlier treatment.</p>
<p>d. Earlier diagnosis.</p>
<p>The correct answer is: b. All of the above. The DSM-V attempts to identify disorders much earlier across the life span, which should provide more accurate and earlier treatment.</p>
<p>Prior to the DSM, the "Statistical Manual for the Use of Institutions for the Insane " was developed by</p>
<p>a. the NASW.</p>
<p>b. the APA and AMA.</p>
<p>c. the AMA.</p>
<p>d. the National Commission on Mental Hygiene.</p>
<p>The correct answer is: d. the National Commission on Mental Hygiene. Prior to the DSM being developed in 1952, in 1917 the APA in conjunction with the National Commission on Mental Hygiene developed the Statistical Manual for the Use of Institutions for the Insane which included 22 diagnoses. DSM IV TR</p>
<p>One of the changes from the DSM-IV TR to the DSM-V is how a disordered is named and classified. Which of the following is the incorrect ICD-9 classification?</p>
<p>a. Childhood-Onset Fluency Disorder (Stuttering) 315.35</p>
<p>b. Communication Disorders.</p>
<p>c. Childhood-Onset Fluency Disorder (Stuttering) F80.81 V</p>
<p>d. All of the above.</p>
<p>The correct answer is: c. Childhood-Onset Fluency Disorder (Stuttering) F80.81. This is an exception question and worded in a tricky way , so here you are looking for the old classification which requires you to know the new ICD-10 classification format, which is the F80.81 response. If this was an example of an Adult-Onset Fluency disorder, the new DSM-V classification would be F98.5, all example of the current ICD-10.</p>
<p>The DSM-V has replaced important language as required by what is commonly known as Rosa's Law (Public Law 111-256).This federal statute changed</p>
<p>a. who is a mandated reporter.</p>
<p>b. what constitutes domestic violence in a marriage.</p>
<p>c. the use of the term mental retardation to intellectual disability. V</p>
<p>d. the guidelines for discrimination.</p>
<p>The correct answer is: c. the use of the term mental retardation to intellectual disability. The term mental retardation was used in DSM-IV. However, intellectual disability is the term that has come into common use over the past two decades among medical, educational, and other professionals, and by the lay public and advocacy groups. Moreover, a federal statue in the United States (Public Law 111-256, Rosa's Law) replaces the term "mental retardation with intellectual disability. Despite the name change, the deficits in cognitive capacity beginning in the developmental period, with the accompanying diagnostic criteria, are considered to constitute a mental disorder.</p>
<p>The DSM-V now uses a "spectra” approach. Which of the following might now be classified on a spectrum?</p>
<p>a. Obsessive-Compulsive Disorders.</p>
<p>b. Schizophrenia Disorders.</p>
<p>c. Sociopathic Disorders.</p>
<p>d. Eating Disorders.</p>
<p>The correct answer is: b. Schizophrenia Disorders. The DSM-V now looks a variety of disorders across a spectrum, a prime example being that of the Autism Spectrum and Schizophrenia Spectrum.</p>
<p>The Beavers System approach to family assessment includes:</p>
<p>a. defining how the family structure maintains ineffective patterns.</p>
<p>b. tracking interactional patterns that maintain the problem.</p>
<p>c. family reports on cohesion and adaptability.</p>
<p>d. interactional competence scales and interactional style scales.</p>
<p>The correct answer is: d. interactional competence scales and interactional style scales. These are clinical rating scales used to measure interactional competence (normal, mid-range, highly dysfunctional families), e.g., overt power, parental coalition, closeness, clarity of expression, etc. and interactional style (centrifugal vs. centripetal families), i.e., dependency, adult conflict, social presentation, etc.</p>
<p>The Beavers Model integrates FST with developmental theory, classifying families on two axis. The first identifies the stylistic quality of family interaction, the second axis classifies the family as:</p>
<p>a. Cohesive or Adaptive.</p>
<p>b. Optimal, Adequate, Midrange, Borderline or Severely Disturbed.</p>
<p>c. Centripetal or Centrifugal.</p>
<p>d. Open, Closed, Random or Synchronous.</p>
<p>The correct answer is: b. Optimal, Adequate, Midrange, Borderline or Severely Disturbed. While both centripetal and centrifugal are dimensions of Beaver's Model, they are the range on the first axis, not the second. The Optimal-Severely Disturbed range is from the second axis. key: Beavers, centripetal, centrifugal, stylistic quality of family interaction, family types</p>
<p>A technique developed by the Milan Model that utilizes a third person’s perspective on a subsystem or other dyads within the system is known as:</p>
<p>a. circular questioning.</p>
<p>b. externalizing.</p>
<p>c. highlighting.</p>
<p>d. joining.</p>
<p>The correct answer is: a. circular questioning. Discussion: Circular Questioning was developed by the Milan associates to draw the connections and distinctions between family members or members of the larger client system. This interviewing technique releases information into the system in a manner that encourage new ways of viewing the problem. Karl Tomm further developed this technique as a means to challenge beliefs (problems) that seemed to be embedded in a person and is in some ways, the precursor to the Narrative technique of externalizing the problem. Highlighting and joining are structural techniques, externalizing is a narrative technique.</p>
<p>All of the following variables are measured by the GARF except:</p>
<p>a. subscales of Problem Solving/Interactional.</p>
<p>b. subscales of Emotional climate.</p>
<p>c. subscales of Organization.</p>
<p>d. subscales of Interactional Competence Scale.</p>
<p>The correct answer is: d. subscales of Interactional Competence Scale. Discussion: The GARF (Global Assessment of Relational Functioning) was developed for the DSM IV by Wyman Lynne. The subscales of Interactional Competence Scale contains skills in negotiating goals, rules, and routines; adaptability in stress; communication skills; and ability to resolve conflict. It is a variable measured by the Beavers System model. The subscale of Organization contains maintenance of interpersonal roles and subsystem boundaries, hierarchical functioning, coalitions and distribution of power, control, and responsibility. The subscales of Emotional climate measures tone and range of feelings; quality of caring, empathy, involvement, and attachment/commitment; sharing of values; mutual affective responsiveness, respect, and regard; and quality of sexual functioning.</p>
<p>A mother calls the therapist sounding very panicky, wanting an immediate appointment. At the first session, the mother states that her 12-year-old son Sam has just been caught in the bathroom of a neighbor's home with a 6-year-old boy. The 6-year-old says that Sam was playing with his bum and kissing his penis. When confronted by his mother, Sam admitted to having played with the boy on 4 previous occasions. The neighbor boy's parents have banned Sam from their home and informed other parents and the school about his perversion. Sam's mother called a psychiatrist prior to calling you who she says stated, "You can put him into therapy and give him drugs, but it’s probably already too late." You begin seeing Sam and his family. In working with this family, you are asked by the parents, "Does this mean our son is gay?" The most likely response a family therapist might make to such a question is:</p>
<p>a. “Yes, it is very likely that he has made an early sexual identity choice.</p>
<p>b. “Only if he continues to molest other children.</p>
<p>c. “At this stage of development, it is not unusual for children to be sexually inquisitive and that this does not necessarily have any bearing on sexual identity.</p>
<p>d. to carefully explain that there is a high likelihood that some sort of sexual trauma may have occurred to their son.</p>
<p>The correct answer is: d. to carefully explain that there is a high likelihood that some sort of sexual trauma may have occurred to their son. most appropriate clinical response. Knowledge Domain: 5. Family Assessment Practice Domain: 1. Joining/Assessment/Diagnosis Type of Question: Vignette Glossary Link Keyword: Ethics</p>
<p>All of the following are examples of insider models of assessment except:</p>
<p>a. FES.</p>
<p>b. FACES</p>
<p>c. GARF.</p>
<p>d. SAFE.</p>
<p>The correct answer is: c. GARF. Discussion: The concept of insider models refers to assessments that are generated by client self- reports, while the concept outsider models refers to clinical rating scales used by a therapist/observer. The Global Assessment of Relational Functioning (GARF) measure the following variables: Problem Solving/Interactional, Organization & Emotional Climate.
Family Adaptability and Cohesion Evaluation Scales (FACES III) developed by David Olson, measure the variables: cohesion & adaptability.
Family Environment Scale (FES) developed by Moos & Moos measure the variables: cohesion, expressiveness, conflict, independence, achievement orientation, intellectual-cultural orientation, active-recreational orientation, moral-religious emphasis, organization, & control.
Systemic Assessment of the Family Environment (SAFE) developed by Lynelle Yingling measures the variables: dyadic marital/executive subsystem organizational structure & interactional processes, nuclear family subsystem organizational structure and interactional processes and extended family subsystem organizational structure and interactional processes.</p>
<p>Mr. Oesco comes to therapy with his son Josh. Mr. Oesco, and his wife are divorced. He and Josh live together, and Mrs. Oesco and her daughter Jessica live in another state. The presenting problem appears to be Josh’s anger at his mother and his refusal to conform to the visitation arrangement set up by the court when the Oesco’s divorced. Josh appears to have a good relationship with his sister which at times presents a problem to his father and mother.
In assessing this family, the majority of family therapists would most likely do all of the following except:</p>
<p>a. focus on the circular causality of the symptom.</p>
<p>b. identify family of origin patterns that are transmitted across generations.</p>
<p>c. observe family member’s patterns of interaction.</p>
<p>d. consider the family’s development stage of the family life cycle.</p>
<p>The correct answer is: b. identify family of origin patterns that are transmitted across generations. Discussion: The key words here are majority of family therapists. Only transgenerational therapists would identify family of origin patterns.</p>
<p>Olson's Circumplex Model of family functioning is based on the intersection of two basic family dimensions. They are:</p>
<p>a. affect and meaning.</p>
<p>b. enmeshment and disengagement.</p>
<p>c. entropy and negentropy.</p>
<p>d. cohesion and adaptability.</p>
<p>The correct answer is: d. cohesion and adaptability. Olson's Circumplex Model offers a way of classifying families according to two dimensions to describe healthy functioning families. "Family cohesion" represents the emotional bond that family members feel toward each other and "family adaptability" represents the family's ability to change in accordance with changing circumstances. The model hypothesizes that both dimensions have a curvilinear relationship with family health. Healthy families will be balanced on both of these dimensions. (Nichols, p. 567). FACES = Family Adaptability & Cohesion Evaluation Scales. The other answers can be eliminated as follows: Enmeshment and disengagement: a Structural model of measuring family functioning, Entropy and negentropy: GST theory, entropy is the measure of disorder or randomness in a system. Negentropy is the opposite, the amount of orderliness in a system. Affect and meaning: Kantor's model.</p>
<p>Mr. & Mrs. W. were worried about their youngest daughter. They described her as isolating herself from her friends, acting somewhat listless, having a significant weight gain, and not sleeping. These symptoms best describe:</p>
<p>a. bipolar disorder.</p>
<p>b. dysthymia.</p>
<p>c. malaise.</p>
<p>d. schizoid affective disorder.</p>
<p>The correct answer is: b. dysthymia. Discussion: The above symptoms are indicative of dysthymia as described in DSM IV.</p>
<p>Olson’s Circumplex Model refers to specific levels of flexibility which include all of the following except:</p>
<p>a. Disengaged</p>
<p>b. Cohesion.</p>
<p>c. Symmetry</p>
<p>d. Emeshed.</p>
<p>The correct answer is: d. disengaged. Discussion: In Olson’s Circumplex Model, the concept of disengaged is a level of cohesion, not flexibility.</p>
<p>A 50-year-old man seeks individual therapy on the advice of his lawyer. The man is quick to share that he is the owner of a very successful company that he built from the ground up and that revolutionized how people function. He explains that he and his wife are going through a divorce. He states, “she never showed me the respect, love or attention I deserved. And even though she wants custody of the kids, she has no right to ask for any of my hard-earned money.” He explains that he is “revered” at work, and while he is always working hard, it’s worth the sacrifices because his staff and professional community recognize his talents and importance. Which of the following diagnoses should the therapist consider for this client?</p>
<p>a. Histrionic Personality Disorder</p>
<p>b. Narcissistic Personality Disorder</p>
<p>c. Bipolar Disorder</p>
<p>d. Antisocial Personality Disorder</p>
<p>The correct answer is: The correct answer is B. According to the DSM 5, Narcissistic Personality Disorder is characterized by an ongoing pattern of grandiosity, continual need for admiration, and lack of empathy for others. We see this very clearly in the vignette. The client is divorcing his wife for her failure to see him as he sees himself. He seems to need respect, attention and love. In addition, his description of his company and it’s effect on society are illustrative of a sense of self-importance. Finally, the client’s description of how he is perceived by others at work and within his professional community. Answer A is incorrect. For Histrionic Personality Disorder you need to see the client engaging in attention-seeking behaviors–cute or overly sexualized. Bipolar Disorder is a differential diagnosis for Narcissistic Personality Disorder. Grandiosity is also present with mania and depressive symptoms are likely when a person’s ego is injured. The grandiosity can be seen in the vignette, but there are no depressive symptoms. Finally, answer D, Antisocial Personality Disorder is incorrect. We do not see behaviors that indicate a pervasive disregard for rules, or the rights of others. There is a disregard for his wife and children (not wanting to give money). However, it is very specific, not pervasive, and is a response to her harming his ego.</p>
<p>A developmental psychologist is investigating movement abnormalities as an early symptom of autism. Her research team is collecting data about crawling techniques from videotapes of 9-month-olds. To increase standardization of data collection, she should</p>
<p>a. provide clear definitions of each crawling style with videotaped examples.</p>
<p>b. expand her study to include 12-month-olds.</p>
<p>c. collect data only on children with clinically significant crawling deficiencies.</p>
<p>d. have her research team collect data in person instead of by watching videotapes.</p>
<p>The correct answer is: a. provide clear definitions of each crawling style with videotaped examples..</p>
<p>Alicia spends hours every day reading about geography. She spends most of her time alone, and when she talks, she speaks mostly about geography. To decide if she qualifies for an autistic spectrum diagnosis, a psychologist would need to know</p>
<p>a. how many hours she spends studying geography each day.</p>
<p>b. what percentage of the population shares her interest in geography.</p>
<p>c. whether friends and family members share her interest in geography.</p>
<p>d. whether she is showing signs of distress or functional impairment.</p>
<p>The correct answer is: d. whether she is showing signs of distress or functional impairment.</p>
<p>The DSM-5 is used for</p>
<p>a. treating anxiety disorders.</p>
<p>b. identifying the cause of mental problems.</p>
<p>c. classifying psychological disorders.</p>
<p>d. distinguishing between biological and environmental causes of disorders.</p>
<p>The correct answer is: c. classifying psychological disorders.</p>
<p>A psychologist would be more likely than a psychiatrist to</p>
<p>a. conduct medical exams before starting therapy.</p>
<p>b. treat people for depression.</p>
<p>c. perform diagnostic evaluations.</p>
<p>d. conduct research on child development.</p>
<p>The correct answer is: d. conduct research on child development.</p>
<p>Marsha is receiving treatment for addiction because she shops constantly has run up a significant credit card balance. Her insurance company refuses to pay for treatment because they have concerns about the \_\_\_\_\_\_\_ of a shopping addiction diagnosis.</p>
<p>a. standardization</p>
<p>b. validity</p>
<p>c. reliability</p>
<p>d. fallibility</p>
<p>The correct answer is: b. validity.</p>
<p>A woman continues to suffer from severe depression and suicidality after a year of cognitive-behavioral therapy and multiple medication trials. The next treatment recommendation is likely to be</p>
<p>a. psychosurgery.</p>
<p>b. systematic desensitization.</p>
<p>c. electroconvulsive therapy.</p>
<p>d. monoamine therapy.</p>
<p>The correct answer is: c. electroconvulsive therapy.</p>
<p>For the past six months, Julie has been exhausted, hopeless, and unable to enjoy her normal activities. She has no interest in spending time with friends and is having a hard time keeping up at work. The most likely diagnosis is</p>
<p>a. unipolar depression.</p>
<p>b. schizotypal personality disorder.</p>
<p>c. seasonal affective disorder.</p>
<p>d. dissociative disorder.</p>
<p>The correct answer is: a. unipolar depression.</p>
<p>Which of the following statements about suicide is most accurate?</p>
<p>a. Most suicides are planned well in advance.</p>
<p>b. SSRIs may increase suicide risk for teenagers.</p>
<p>c. Suicide rates spike around the winter holidays.</p>
<p>d. Most suicidal people do not meet diagnostic criteria for depression.</p>
<p>The correct answer is: b. SSRIs may increase suicide risk for teenagers..</p>
<p>Refer to the figure. Which of the MRI images above are most likely to be scans of people with schizophrenia?</p>
<p>a. 1 and 2</p>
<p>b. 1 and 4</p>
<p>c. 2 and 3</p>
<p>d. 3 and 4</p>
<p>The correct answer is: b. 1 and 4.</p>
