MQC from Readings

Question 1

What is the main argument in Shapiro’s (2002) paper?

1. A scientific approach should inform all the work of clinical psychologists
2. Psychologists no longer use validated methods of assessment or treatment
3. Clients who have Generalised Anxiety Disorder should be treated with CBT
4. CBT should be taught to all students undergoing training in clinical psychology
5. The scientist-practitioner model is the gold standard when treating mental disorders

Answer 1

A

Question 2

What is Wakefield’s (1992) definition of a mental disorder?

1. Mental disorder is a condition considered undesirable according to social norms or ideals
2. Mental disorder is a condition that causes some harm to the person as judged by social norms, and results in the inability of some internal mechanism to perform its natural function
3. Mental disorder is characterised by an identifiable lesion of the brain or a dysfunction in any part of the body
4. Mental disorder is a condition that results in the failure of a person’s internal mechanisms
5. Mental disorder is the manifestation of a behavioural, psychological or biological dysfunction in the person, and is associated with present distress or disability

Answer 2

B

Question 3

3. In Wakefield’s (1992) paper on The Concept of Mental Disorder, mental disorder is defined as having a ‘value component’ and a ‘factual component’. What do these components refer to?
4. Statistical deviance (value) and violation of social norm (factual)
5. Violation of social norms (value) and statistical deviance (factual)
6. Dysfunction (value) and harm (factual)
7. Harm (value) and dysfunction (factual)
8. Beliefs (value) and dysfunction (factual)

Answer 3

D

Question 4

4. According to Wakefield (2013), why was the multiaxial system eliminated from the DSM-5?
5. An emerging body of research does not support the use of a multiaxial system
6. The multiaxial system causes confusion amongst clinicians and researchers
7. The significance of Personality Disorders have been undermined by the multiaxial system
8. Mental disorders cannot be classified in discrete categories
9. There is a need to make psychiatry more like general medicine and general medicine does not use a multiaxial system

Answer 4

E

Question 5

5. As outlined in Wakefield’s (2013) paper, which of the following is a major change in the DSM-5?
6. The chapter ordering reflects disorders over the life cycle
7. PTSD is no longer recognised as an anxiety disorder
8. The diagnostic criteria for Bipolar Disorder now only requires a mood shift
9. All of the above
10. A & B

Answer 5

E

Question 6

6. What is Wakefield’s (2013) main concluding argument in his paper on the major changes and controversies of the DSM-5?
7. The DSM-5 gives a comprehensive and all-inclusive account of psychopathology and all the criticisms of the DSM-IV-TR have now been addressed
8. The DSM-5 revision was a somewhat flawed process and a missed opportunity since some issues were addressed but not others
9. The DSM-5 is not a revision at all since the DSM-IV-TR gives a better account of the current understanding of mental disorders
10. Scientists and clinicians now have a very clear understanding of psychopathology
11. The DSM-5 was premature in its publication and should have undergone further revision before the edition was released

Answer 6

B

Question 7

7. According to the APA Presidential Task Force on Evidence-Based Practice (2006), evidence-based practice involves the integration of which three components?
8. Best available research; client’s values, characteristics and circumstances; clinical expertise
9. Understanding of mental disorder; client’s cultural background; clinical expertise
10. Best available research; efficacy studies; clinical practice
11. Understanding of mental disorder; efficacy and effectiveness studies; clinical expertise
12. Client’s values, characteristics and circumstances; clinical expertise; clinical practice

Answer 7

A

Question 8

8. According to Bryan (2007), which of the following are important measures to be taken when providing treatment for suicidal clients?
9. Use assessment measures as a routine component of the treatment process
10. Work collaboratively with the client
11. Ensure that you maintain a good therapeutic relationship
12. All of the above
13. None of the above

Answer 8

D

Question 9

9. The purpose of Clark’s (1986) paper, A Cognitive Approach to Panic, was to:
10. Present a cognitive model for the development and maintenance of panic attacks, and provide a review of research that is consistent with this model
11. Present a cognitive model for the development and maintenance of panic attacks, and provide counter-arguments for why it is more encompassing than a physiological model
12. Present a cognitive model for the development and maintenance of panic attacks, and discuss reasons as to why it is important to target negative self-beliefs during treatment
13. Provide a critical analysis of the cognitive model of panic, and argue for the adoption of a cognitive-behavioural approach
14. Provide a critical analysis of the cognitive model of panic, and suggest a revision by including anticipation of future panic attacks as a maintaining factor

Answer 9

A

Question 10

10. Which of the following is the correct sequence in the development of a panic attack according to Clark’s (1986) model?
11. Trigger à body sensations à apprehension à catastrophic interpretation à panic
12. Trigger à apprehension à perceived threat à catastrophic interpretation à panic
13. Trigger à perceived threat à apprehension à body sensations à catastrophic interpretation à panic
14. Trigger à anticipation of future panic à body sensations à apprehension à catastrophic interpretation à panic
15. Trigger à catastrophic interpretations à body sensations à apprehension à perceived threat à panic

Answer 10

C

Question 11

11. In Nock’s (2010) paper on self-injury, what are common elements shared by self-injury and indirectly harmful behaviours (e.g. drinking alcohol and eating high-fat foods)?
12. The behaviours attempt to modify one’s affective/cognitive/social experience
13. Individuals engage in the behaviours with the intention to die
14. The behaviours cause bodily harm
15. A & B
16. A & C

Answer 11

E

Question 12

12. According to Nock’s (2010) model of self-injury, which of the following are considered NSSI-Specific Vulnerability Factors for self-injury?
13. Self-punishment hypothesis; Implicit identification hypothesis; Pragmatic hypothesis
14. Social learning hypothesis; Helping hand hypothesis; Pain analgesia hypothesis
15. Explicit identification hypothesis; Social learning hypothesis; Pragmatic hypothesis
16. Pain analgesia hypothesis; Social indication hypothesis; Pragmatic hypothesis
17. Self-punishment hypothesis; Pragmatic hypothesis; Emotional release hypothesis

Answer 12

A

Question 13

13. What is the main finding of Choy et al.’s (2007) paper on the treatment of specific phobia in adults?
14. The most robust treatment is cognitive therapy for the majority of specific phobias
15. The most robust treatment is in vivo exposure therapy for the majority of specific phobias
16. Treatment gains for specific phobia are generally maintained for up to 3 years
17. The best treatment for claustrophobia is applied muscle tension
18. Different types of specific phobia appear to respond equally to the same type of treatment

Answer 13

B

Question 14

14. What 3 processes discussed in Clark’s (1999) paper could you use to explain to your client with an anxiety disorder why their anxiety is being maintained?
15. Avoidance behaviours; selective retrieval of threat-confirming information; panic
16. Avoidance behaviours; attentional bias for threat cues; selective retrieval of threat-confirming information
17. Safety-seeking behaviours; attentional bias for threat cues; negative self-talk
18. Safety-seeking behaviours; attention for threat cues; selective retrieval of negative information
19. Safety-seeking behaviours; meta-cognitive worry; negative self-talk

Answer 14

D

Question 15

15. According to Lingam and Scott (2002), what is the most accurate subjective method to measure client medication adherence?
16. Client self-report
17. Clinician report based on clinical interview
18. Counting pills
19. Monitoring blood plasma concentration
20. Administration of questionnaire

Answer 15

A

Question 16

16. What was the main finding of Lingham and Scott’s (2002) literature review on medication adherence in affective disorders?
17. Clients with affective disorders typically show partial adherence to medication
18. The most important predictor of non-adherence in bipolar disorder is the presence of a comorbid disorder
19. Estimates of medication non-adherence for unipolar/bipolar disorders range from 10-60%
20. Patients with psychotic disorders have the highest level of medication non-adherence
21. Only 40% of all publications on the treatment of affective disorders explore factors associated with medication non-adherence

Answer 16

C

Question 17

17. What was the main finding of Wells et al.’s (1995) study on in-situation safety behaviours and the maintenance of social anxiety disorder?
18. Exposure with an increase in safety behaviours was more effective at reducing anxiety than exposure with NO decrease in safety behaviours
19. Exposure with an increase in safety behaviours was less effective at reducing anxiety than exposure with NO decrease in safety behaviours
20. Exposure with a decrease in safety behaviours was more effective at reducing anxiety than exposure with NO decrease in safety behaviours
21. Exposure with a decrease in safety behaviours was less effective at reducing anxiety than exposure with NO decrease in safety behaviours
22. Exposure with a decrease in safety behaviours showed no significant advantage over exposure with NO decrease in safety behaviours

Answer 17

C

Question 18

18. What was the purpose of Wells and King’s (2006) paper?
19. To evaluate a new form of cognitive therapy (i.e. metacognitive therapy) based on the metacognitive model of GAD
20. To provide research evidence that supports the components and mechanisms included in the metacognitive model of GAD
21. To critique the metacognitive model for GAD and propose a cognitive-behavioural model
22. To conduct an RCT comparing cognitive-behavioural therapy to metacognitive therapy in treating GAD
23. To establish that metacognitive therapy should be the gold standard treatment for GAD

Answer 18

A

Question 19

19. What was the main finding from Wells and King’s (2006) paper?
20. The efficacy of metacognitive therapy is comparable to cognitive-behavioural therapy in the treatment of GAD
21. Metacognitive therapy appears to have promising results with all clients showing significant improvement in anxiety measures at post-treatment
22. Cognitive-behavioural therapy is not as effective as metacognitive therapy in the treatment of GAD
23. Metacognitive therapy was more effective at reducing clients’ anxiety levels post-treatment when compared to the control condition
24. Cognitive-behavioural therapy has longer lasting benefits than metacognitive therapy in the treatment of GAD

Answer 19

B

Question 20

20. How would you explain the results from Barlow et al.’s (2000) study to a client?
21. “CBT appears to be the best treatment for panic disorder since imipramine doesn’t show any benefits”
22. “Engaging in CBT and taking imipramine at the same time is always the most effective way of treating panic disorder”
23. “Taking imipramine appears to be the best treatment for panic disorder”
24. “Imipramine appears to produce the best quality of response in the short-term but CBT has more durable effects for panic disorder in the long-term”
25. “CBT appears to have the best immediate effects for panic disorder but taking imipramine makes these effects even better in the long run”

Answer 20

D

Question 21

21. Which of the following statements best summaries the purpose of Barlow et al.’s (2000) study on treatments for panic disorder?
22. To establish that CBT and imipramine is more effective than each of the therapies alone
23. To evaluate the effectiveness of CBT by comparing it to a placebo
24. To compare CBT and imipramine and see which treatment is more effective
25. To evaluate whether administration of imipramine by a psychologist is effective
26. To evaluate whether imipramine, CBT or a combination of both therapies is the most efficacious in the treatment of panic disorder

Answer 21

E

Question 22

22. Which of the following is considered a weakness or limitation of Barlow et al.’s (2000) study on treatments for panic disorder?
23. It included a placebo condition
24. It used imipramine, which is a TCA and not the first-line treatment that is currently recommended
25. 18 participants dropped out during the course of treatment so it is unclear how generalisable the findings are
26. The study design was a double-blind randomised controlled trial
27. Only one outcome measure was used (i.e. the Panic Disorder Severity Scale)

Answer 22

B

Question 23

23. In Sanchez-Meca et al.’s (2010) paper on psychological treatments for panic disorder with or without agoraphobia, which 3 techniques in combination give the most consistent evidence for the treatment of panic disorder?
24. Exposure; relaxation training; breathing retraining
25. Systematic desensitisation; cognitive restructuring; breathing retraining
26. Anxiety management training; psychoeducation; exposure
27. Relaxation training; event de-catastrophising; cognitive challenging
28. Exposure and response prevention; cognitive restructuring; breathing retraining

Answer 23

A

Question 24

24. What are the main treatment implications of Sanchez-Meca et al.’s (2010) meta-analytic findings for panic disorder?
25. It is beneficial to include interoceptive exercises and anxiety management techniques when carrying out cognitive therapy for panic disorder
26. The inclusion of interoceptive exercises will help to reduce relapse
27. Clients who have panic disorder should not be taught interoceptive exercises or relaxation techniques since this will encourage them to focus on their internal sensations
28. The inclusion of homework or a follow-up program is not beneficial in the treatment of panic disorder
29. Anxiety management training is more effective than in vivo exposure when treating clients with panic disorder

Answer 24

A

Question 25

25. In Ameringen et al.’s (2014) paper on revisions to OCD in the DSM-5, which 2 specifiers are discussed as additions to the diagnostic criteria?
26. Severity; tic-related
27. Severity; with mixed features
28. Insight; tic-related
29. Insight; with anxious features
30. Insight; severity

Answer 25

C

Question 26

26. According to Ameringen et al. (2014), which of the following options best describes why OCD was placed in a new category in the DSM-5?
27. Longitudinal evidence shows that OCD has a different trajectory to other anxiety disorders
28. OCD differs from anxiety disorders on a range of factors including course of illness, comorbidity, genetic risk factors, and treatment response
29. Individuals with OCD respond to non-serotonergic agents whereas individuals with anxiety disorders do not respond to these agents, suggesting that there is a different biological basis to these mental disorders
30. OCD is characterised by obsessions and compulsions, which is not characteristic of any other anxiety disorders
31. Individuals with OCD do not respond to treatments that are considered effective for other anxiety disorders

Answer 26

B

Question 27

27. According to Ameringen et al. (2014), what is a treatment implication for the insight specifier in hoarding disorder?
28. Individuals with good insight should take control of sorting and discarding their own possessions
29. Individuals with poor insight should engage in motivational interviewing prior to undergoing psychological treatment
30. Individuals with good insight should be able to benefit more from CBT and thus, require less treatment sessions than those with poor insight
31. Individuals with poor insight would benefit from the inclusion and involvement of close family or friends during treatment
32. Individuals with poor insight would not benefit from the inclusion and involvement of close family or friends during treatment since this can exacerbate their distress

Answer 27

B

Question 28

28. How would you explain the results of Foa et al.’s (2007) study on treatments for OCD to a client?
29. “Taking clomipramine has been shown to have better outcomes than engaging in exposure and ritual prevention”
30. “Exposure and ritual prevention appears to be the best treatment because clients generally have bad side effects when they take clomipramine”
31. “Taking clomipramine whilst doing exposure and ritual prevention does not seem to have any added benefits”
32. “There was no difference between the clomipramine and placebo condition so taking clomipramine doesn’t seem to have any benefits”
33. “You should take clomipramine because exposure and ritual prevention generally causes too much distress in clients”

Answer 28

C

Question 29

What is a strength of Foa et al.’s (2007) study on treatments for OCD?

1. The study was conducted in 1 treatment centre
2. The study used 2 measures of OCD symptom severity
3. The study did not include a placebo
4. The study compared 4 different OCD treatments
5. The study was a randomised controlled trial

Answer 29

E

Question 30

30. What was the concluding argument of Foa et al.’s (1989) paper on Behavioural/Cognitive Conceptualizations of Post-Traumatic Stress Disorder?
31. Information processing theories can better account for the development of PTSD than traditional S-R learning theories
32. Predictable and controllable events are necessary but not sufficient conditions in the development of PTSD
33. Only trauma experiences considered ‘high intensity’ give rise to PTSD
34. Traditional S-R learning theories can better account for the development of PTSD than information processing theories
35. Clinicians need to use a cognitive-behavioural framework when treating PTSD

Answer 30

A

Question 31

31. According to Jacobson et al. (2001), what is the purpose of behavioural activation?
32. To encourage clients to increase positive events in their lives and access sources of positive reinforcement, which act as a natural antidepressant
33. To force clients to engage in activity so they can feel better
34. To motivate clients and resolve their ambivalence about the reasons as to why they are not engaging in any positive behaviours
35. To modify clients’ thinking about their behaviours and challenge any negative core beliefs, which may be impeding their ability to engage in positive behaviours
36. To encourage clients to decrease negative events in their lives and access sources of positive reinforcement, which act as a natural antidepressant

Answer 31

A

Question 32

32. Why did the researchers in Jacobson et al.’s (2001) paper begin to focus on the use of behavioural activation as a stand-alone treatment for depression?
33. They are behaviourists and they do not believe that cognitive therapy is effective
34. They created a model for depression that incorporates behavioural activation and found that the current literature shows strong support for this model
35. They found that behavioural activation was as effective at preventing relapse in clients with depression as cognitive therapy
36. They conducted a large clinical trial which found that behavioural activation is better than cognitive therapy for the treatment of depression
37. They found that clients who underwent behavioural activation were more receptive to treatment than those who underwent cognitive therapy

Answer 32

C

Question 33

33. Which of the following behavioural activation strategies are recommended in Jacobson et al.’s (2001) paper on behavioural activation?
34. Graded task assignment; routine regulation
35. Attention to experience; systematic desensitisation
36. Mindfulness; breathing retraining
37. Graded task assignment; exposure
38. Exposure; attention to experience

Answer 33

A

Question 34

34. Which of the following best describes the early formulation of the Behavioural Approach System (BAS) dysregulation theory presented in Urosevic et al.’s (2008) paper?
35. The BAS system, which is involved in avoiding reward, is regulated in people with bipolar disorder such that an underactive BAS results in manic symptoms whereas an overactive BAS results in depressive symptoms
36. The BAS system, which is involved in avoiding reward, is dysregulated in people with bipolar disorder such that an underactive BAS results in manic symptoms whereas an overactive BAS results in depressive symptoms
37. The BAS system, which is involved in approach to reward, is regulated in people with bipolar disorder such that an overactive BAS results in manic symptoms whereas an underactive BAS results in depressive symptoms
38. The BAS system, which is involved in approach to reward, is dysregulated in people with bipolar disorder such that an overactive BAS results in manic symptoms whereas an underactive BAS results in depressive symptoms
39. None of the above

Answer 34

D

Question 35

35. According to Urosevic et al. (2008), how was the Behavioural Approach System (BAS) dysregulation theory expanded?
36. Includes a behavioural element (i.e. avoidance) to explain how manic/hypomanic and depressive episodes develop
37. Provides a conceptual framework for understanding how clients develop bipolar disorder
38. Includes post-event processing of BAS-relevant information, which gives rise to a dysregulated BAS state
39. Explains how underactive and overactive BAS states are generated with specific emphasis on the role of neurobiological correlates
40. Provides an explicit causal chain for explaining how manic/hypomanic and depressive episodes develop, which include the role of cognitive appraisals

Answer 35

E