STUDY MODE - Practice Exam 3 Flashcards
Studies on effective treatments for Bulimia Nervosa have found that:
Select one:
A. cognitive behavioral therapy alone and treatment with an SSRI alone are about equally effective but, in most cases, combining the two treatments does not improve outcomes.
B. cognitive behavioral therapy alone and treatment with an SSRI alone are about equally effective and, in many cases, combining the two treatments improves outcomes.
C. treatment with an SSRI alone is superior to cognitive behavior therapy alone but, for some patients, combining the two treatments improves outcomes.
D. cognitive behavioral therapy alone is superior to treatment with an SSRI alone but, for some patients, combining the two treatments improves outcomes.
Of the treatments for Bulimia Nervosa, cognitive behavioral therapy (CBT) has been most extensively studied and consistently found to be an effective approach.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The studies have found that an SSRI alone is not as effective as CBT alone. However, an SSRI may be useful when administered in conjunction with CBT when CBT alone has not been sufficiently effective. See, e.g., A. J. Zhu and B. T. Walsh, Pharmacologic treatment for eating disorders, Canadian Journal of Psychiatry, 47, 227-234, 2002.
The correct answer is: cognitive behavioral therapy alone is superior to treatment with an SSRI alone but, for some patients, combining the two treatments improves outcomes.
Following the death of her pet cat, Puff, six-year-old Jane constantly follows and clings to her mother and becomes extremely upset whenever her mother leaves the house. Jane says she can’t go to school because she has a stomachache or other physical ailment. The most likely diagnosis for Jane is:
Select one:
A. Adjustment Disorder.
B. Reactive Attachment Disorder.
C. Separation Anxiety Disorder.
D. Acute Stress Disorder.
The girl’s core symptom is anxiety related to separation.
a. Incorrect Adjustment Disorder is diagnosed when symptoms do not meet the criteria for another mental disorder, which is not the case in this situation.
b. Incorrect Reactive Attachment Disorder involves markedly disturbed and developmentally inappropriate social relatedness.
c. CORRECT The girl’s anxiety is tied to separation from an attachment figure (her mother), which is the primary characteristic of Separation Anxiety Disorder. This disorder is often triggered by a stressor such as the death of a relative or pet and is manifested as somatic symptoms and school phobia.
d. Incorrect The diagnosis of Acute Stress Disorder requires exposure to an extreme stressor and a specific pattern of symptoms - e.g., avoidance of reminders of the event, distressing memories of the event, derealization.
The correct answer is: Separation Anxiety Disorder.
_______________ is the likely DSM diagnosis for a mother when her child’s persistent vomiting stops whenever the child is removed from the mother’s care for several days.
Select one:
A. Malingering
B. Factitious Disorder
C. Ganser syndrome
D. folie a deux
Answer B is correct: The major feature of Factitious Disorder is the intentional production or feigning of physical or psychological symptoms in oneself or another person. The information provided in the question suggests that the mother is inducing her child’s symptoms. (Note that, when symptoms are produced in another person, the diagnosis is Factitious Disorder Imposed on Another.)
Answer A: Malingering involves the intentional production, faking, or gross exaggeration of physical or psychological symptoms in oneself in order to obtain an external reward.
c. Incorrect Ganser Syndrome is not a DSM diagnostic category. A person with this disorder mimics behaviors he/she believes are typical of psychosis (e.g., providing obviously wrong answers to questions).
d. Incorrect Folie a deux is also known as shared psychotic disorder and involves the development of a delusion in a person who has a close personal relationship with another person who already has a delusion.
The correct answer is: Factitious Disorder
The most commonly prescribed treatment for moderate to severe obstructive sleep apnea is:
Select one:
A. tracheostomy.
B. oral appliances.
C. adaptive servo-ventilation (ASV).
D. continuous positive airway pressure (CPAP)
Sleep apnea involves brief, repeated interruptions in breathing during sleep that last for 10 seconds or more. The most common type is obstructive sleep apnea, which is caused by a relaxation of soft tissue at the back of the throat that blocks the passage of air in the nose and throat.
a. Incorrect Tracheostomy is a type of surgery that is sometimes used to alleviate severe forms of sleep apnea when other treatments have failed.
b. Incorrect Oral appliances (e.g., dental appliances that reposition the lower jaw and tongue) are generally less effective than CPAP and are sometimes used to treat mild cases of obstructive sleep apnea.
c. Incorrect ASV is an airflow device that is used to treat central and mixed sleep apnea.
d. CORRECT CPAP involves the use of a nasal mask that produces a continuous flow of air that forces the airways open. It is the most common treatment for moderate to severe obstructive sleep apnea.
The correct answer is: continuous positive airway pressure (CPAP).
Regular use of morphine or other opioid can quickly result in the development of tolerance and dependence. When this occurs, abrupt cessation of the drug produces a withdrawal syndrome that is characterized by:
Select one:
A. blackouts and seizures.
B. flu-like symptoms.
C. rebound anxiety and rebound insomnia.
D. delirium tremens.
Morphine withdrawal closely resembles a moderately severe case of the flu.
a. Incorrect Blackouts and seizures are not characteristic of the withdrawal syndrome associated with morphine.
b. CORRECT Common withdrawal symptoms include nausea, vomiting, diarrhea, abdominal and muscle cramps, runny nose and eyes, chills, and insomnia.
c. Incorrect Rebound anxiety and rebound insomnia are associated with withdrawal from a benzodiazepine. (“Rebound” occurs when the initial symptom - i.e., the symptom for which the drug was prescribed - returns in a more severe form when the drug is withdrawn.)
d. Incorrect Delirium tremens (confusion and visual hallucinations) are severe symptoms that may result from abrupt withdrawal from alcohol.
The correct answer is: flu-like symptoms.
Research on characteristics associated with successful smoking cessation suggests that which of the following individuals is most likely to relapse following an attempt to stop smoking cigarettes?
Select one:
A. a 51 year old married man who started smoking at age 32
B. a 25 year old single man who started smoking at age 16
C. a 34 year old married woman who started smoking at age 25
D. a 42 year old divorced woman who started smoking at age 20
Answer B is correct: Researchers have identified a number of factors that predict successful smoking cessation.
Successful quitters are more likely to be male, age 35 or older, married or living with a partner, and have started smoking at a later age. Therefore, of the individuals described in the answers to this question, a 25-year-old man who is single and started smoking at age 16 is least likely to be a successful quitter.
The correct answer is: a 25 year old single man who started smoking at age 16
For a DSM-5 diagnosis of Binge-Eating Disorder, an individual must have engaged in binge-eating, on average:
Select one:
A. once a week for at least one month.
B. once a week for at least three months.
C. twice a week for at least one month.
D. twice a week for at least three months.
Answer B is correct: For this diagnosis, the DSM-5 requires binges to have occurred, on average, once a week for a minimum of three months.
Answers A, C, and D: See explanation for answer B.
The correct answer is: once a week for at least three months.
Recent research has shown that single-session Psychological Debriefing (PD):
Select one:
A. is as effective as, or in some cases more effective than, multiple-session PD for preventing PTSD.
B. is as effective as multiple-session PD for preventing PTSD only when the session is sufficiently long to elicit a cathartic reaction.
C. is effective for preventing PTSD only when it is administered within 24 hours following exposure to the traumatic event.
D. is not effective for preventing PTSD and may actually exacerbate PTSD symptoms.
Although single-session Psychological Debriefing (PD) is utilized as a prevention for PTSD, recent empirical research has not been supportive of its use.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d. (Also note that there is some evidence that multiple-session PD may be ineffective as well.)
c. Incorrect See explanation for response d.
d. CORRECT B. T. Litz et al., for example, conclude from their review of the research that there is sufficient empirical evidence to indicate that PD should not be provided to individuals immediately after a trauma. The studies they reviewed showed that one-session PD is not effective and, in some cases, actually increases the likelihood of PTSD symptoms. (Early intervention for trauma: Current status and future directions, Clinical Psychology: Science and Practice, 9, 112-134, 2002.)
The correct answer is: is not effective for preventing PTSD and may actually exacerbate PTSD symptoms.
The symptoms of Borderline Personality Disorder are:
Select one:
A. usually most severe during the early adult years.
B. usually most severe during middle age.
C. usually most severe during older adulthood.
D. stable in terms of severity over the adult years
Borderline Personality Disorder is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and affect and marked impulsivity.
a. CORRECT Longitudinal studies have confirmed that the symptoms of BPD are ordinarily most severe during the early adulthood years. See, e.g., J. Paris, Implications of long-term outcome research for the management of patients with Borderline Personality Disorder, Harvard Review of Psychiatry, 10(6), 315-323, 2002.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: usually most severe during the early adult years.
Which of the following is not categorized as an Anxiety Disorder in the DSM-5?
Select one:
A. Obsessive-Compulsive Disorder
B. Separation Anxiety Disorder
C. Panic Disorder
D. Agoraphobia
Answer A is correct: Obsessive-Compulsive Disorder is included in the DSM-5 with Obsessive-Compulsive and Related Disorders, which also includes Body Dysmorphic Disorder, Hoarding Disorder, Trichotillomania, and Excoriation Disorder.
Answers B, C, and D: The following diagnoses are categorized as Anxiety Disorders in the DSM-5: Separation Anxiety Disorder, Selective Mutism, Specific Phobia, Social Anxiety Disorder, Panic Disorder, Agoraphobia, and Generalized Anxiety Disorder.
The correct answer is: Obsessive-Compulsive Disorder
A 31-year old male client presents with delusions and auditory hallucinations. His wife says that his symptoms developed soon after the sudden death of his mother nearly three weeks ago. The tentative diagnosis is:
Select one:
A. Schizophrenia.
B. Schizophreniform Disorder.
C. Brief Psychotic Disorder.
D. Schizoaffective Disorder.
Answer C is correct: The diagnosis of Brief Psychotic Disorder requires the presence of one or more of four characteristic symptoms with at least one symptom being delusions, hallucinations, or disorganized speech and with symptoms being present for at least one day but less than one month. Symptoms often develop after exposure to an overwhelming stressor but this is not required for the diagnosis.
Answer A: A diagnosis of Schizophrenia requires the presence of at least two active-phase symptoms for at least one month with at least one symptom being delusions, hallucinations, or disorganized speech plus continuous signs of the disorder for at least six months.
Answer B: Schizophreniform Disorder has symptoms that are similar to those of Schizophrenia but with a duration between one and six months.
Answer D: Schizoaffective Disorder is the appropriate diagnosis when the individual has a history of concurrent symptoms of Schizophrenia and a manic or major depressive episode with at least two weeks without prominent mood symptoms.
The correct answer is: Brief Psychotic Disorder.
A delusion of the erotomanic type is illustrated by which of the following?
Select one:
A. A woman is convinced that her pastor at church is madly in love with her even though he has told her that he’s not.
B. A woman believes that every man she comes into contact with wants to have sexual relations with her.
C. A man is preoccupied with sexual fantasies about a co-worker who has shown no interest in him.
D. A man is concerned about reaching orgasm far too quickly even though his wife repeatedly reassures him that he doesn’t have this problem.
A delusion of the erotomanic type involves a false belief that another person, usually of higher status, is in love with the individual.
a. CORRECT Of the situations described, this one comes closest to an erotomanic delusion.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: A woman is convinced that her pastor at church is madly in love with her even though he has told her that he’s not.
The wife of an alcoholic is told she is “co-dependent.” This means that she:
Select one:
A. also has a drinking problem.
B. overtly or covertly supports her husband’s drinking.
C. is happy only when her husband is not drinking.
D. exaggerates the impact and severity of her husband’s problem.
The term co-dependent was originally applied to people who are emotionally involved with alcoholics, but is now more widely used to refer to people who support any addiction of another person.
a. Incorrect See explanation for response b.
b. CORRECT Definitions of co-dependence vary from author to author, but this description comes closest to most currently accepted definitions. Co-dependents overtly or covertly support, and thereby help maintain, the addiction of another person.
c. Incorrect See explanation for response b. (Note that, while there may be some truth to responses c and d in some cases, they do not describe co-dependence as accurately as response b.)
d. Incorrect See explanation for response b.
The correct answer is: overtly or covertly supports her husband’s drinking.
For some adolescents and adults, it may be difficult to distinguish ADHD from OCD due to an overlap in symptoms. ADHD may be difficult to distinguish from Obsessive-Compulsive Disorder because the individual with ADHD:
Select one:
A. may be preoccupied with multiple worries that interfere with his/her ability to concentrate and complete tasks.
B. may attempt to compensate for his/her attention deficits by developing repetitive routines.
C. tends to avoid performance situations that are likely to produce high levels of anxiety.
D. exhibits oppositional behavior and low frustruation tolerance, as manifested by excessive irritability or temper outbursts.
Eliminating answers that contain symptoms that are not characteristic of ADHD or OCD would have helped you identify the correct answer to this question.
a. Incorrect Preoccupation with multiple worries is characteristic of Generalized Anxiety Disorder (not OCD). Also, for individuals with ADHD, problems with concentration are not due to excessive worrying.
b. CORRECT Some adolescents and adults with ADHD attempt to compensate for their organizational and attentional impairments by developing repetitive routines that may resemble obsessive-compulsive behaviors. See, e.g., A. L. Robin and R. A. Barkley, ADHD in adolescents, New York, Guilford Press, 1999.
c. Incorrect Children with ADHD do not usually experience performance-related anxiety.
d. Incorrect Oppositional behaviors and low frustration tolerance are associated features of ADHD but are not characteristic of OCD.
The correct answer is: may attempt to compensate for his/her attention deficits by developing repetitive routines.
A DSM-5 diagnosis of Acute Stress Disorder requires a duration of symptoms of:
Select one:
A. two days to four weeks with an onset immediately after exposure to the trauma.
B. three days to one month with an onset within four weeks after exposure to the trauma.
C. two days to two months.
D. three days to one month.
Answer D is correct: For a diagnosis of Acute Stress Disorder, the DSM-5 requires that symptoms have a duration of three days to one month. It notes that symptoms typically begin immediately after exposure to the trauma but does not require that they do so.
The correct answer is: three days to one month.
For individuals with Schizophrenia, the poorest prognosis is associated with which of the following?
Select one:
A. female gender, younger age at onset, and predominant negative symptoms
B. female gender, older age at onset, and predominant positive symptoms
C. male gender, younger age at onset, and predominant negative symptoms
D. male gender, older age at onset, and predominant positive symptoms
As noted in the Abnormal Psychology chapter of the written study materials, prognosis for Schizophrenia has been linked to a number of factors including gender, age, type of onset, predominant symptoms, the presence of a precipitating event, and family history.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT A better prognosis is associated with female gender, later age at onset, and positive symptoms (which are more responsive to drug treatment).
d. Incorrect See explanation for response c.
The correct answer is: male gender, younger age at onset, and predominant negative symptoms
Research on high expressed emotion has linked it to a ___________ for several psychiatric disorders including Schizophrenia, Bipolar Disorder, Major Depressive Disorder, and Eating Disorders.
Select one:
A. high risk for relapse
B. better response to pharmacotherapy
C. lower motivation for treatment
D. increased potential for misdiagnosis
High expressed emotion refers to the hostility, criticism, and emotional over-involvement that family members express toward a patient with a mental disorder and has been linked to negative outcomes for several psychiatric disorders.
a. CORRECT High expressed emotion was originally linked to a higher risk for relapse for patients with Schizophrenia and was subsequently linked to relapse and other negative outcomes for other psychiatric disorders as well. See, e.g., R. L. Butzlaff and J. M. Hooley, Expressed emotion and psychiatric relapse: A meta-analysis, Archives of General Psychiatry, 55, 547-552, 1998.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: high risk for relapse
A number of investigators have attempted to identify the factors that reduce the likelihood that a woman will seek or remain in substance abuse treatment. Of the factors that have been studied, which of the following has most often been identified as a primary barrier to substance-abuse treatment for women?
Select one:
A. child and childcare concerns
B. sexual harassment from male counselors
C. denial of a substance abuse problem
D. a perception that treatment is ineffective
This is a difficult question since all of the factors listed in the answers have been identified as barriers to the treatment of women for substance abuse. However, only one of the factors is consistently cited by experts as a primary or most frequently mentioned barrier.
a. CORRECT The research has confirmed that women with substance abuse problems are more likely than men to be caring for dependent children; and factors related to children are frequently cited by women as barriers to substance abuse treatment: Many women are concerned about custody issues (i.e., that their children will be taken away from them); others are concerned about childcare while they receive treatment. With regard to the latter, a recent United Nations report on substance abuse treatment concludes that a “lack of childcare is probably the most consistent factor restricting women’s treatment access identified in the literature” [United Nations Office on Drugs and Crime, Substance abuse treatment and care for women: Case studies and lessons learned, New York, United Nations, 2004, p. 18].
b. Incorrect Although sexual harassment of women has been identified as a problem at some treatment centers, it is not the factor that has “most often” been identified as a barrier to treatment.
c. Incorrect Women are more likely to express shame and guilt about their substance abuse than to deny that they have an abuse problem.
d. Incorrect Concerns about treatment effectiveness may deter some women from seeking treatment for substance abuse problems, but this factor has not been identified as a primary barrier to treatment. In fact, there is evidence that women who have received treatment describe it as being effective [e.g., L. Nelson-Zlupko et al., Women in recovery: Their perceptions of treatment effectiveness, Journal of Substance Abuse Treatment, 13(1), 51-59, 1996].
The correct answer is: child and childcare concerns
A 33-year old married woman with one biological child receives a diagnosis of Schizophrenia. Her husband has no symptoms or family history of the disorder. Which of her relatives is at greatest risk for receiving the same diagnosis?
Select one:
A. parent
B. biological sibling
C. adopted sibling
D. child
Research on the concordance rates for Schizophrenia have supported a genetic etiology of the disorder. See I. I. Gottesman, Schizophrenic genesis, New York, Philosophy Library, 1991.
a. Incorrect The concordance rate for a parent of an individual who receives a diagnosis of Schizophrenia is about 6%.
b. Incorrect The concordance rate for biological siblings is about 9%.
c. Incorrect The concordance rate for an adopted sibling would be about the same as the concordance rate for members of the general population - i.e., 1%.
d. CORRECT The concordance rate for a biological offspring of one schizophrenic parent is 13%.
The correct answer is: child
A clinician notices that her client, age 28, experiences frequent periods in which she is very irritable, sensitive, anxious, and self-deprecating; but that, between these times, the client seems to be fairly well-adjusted and even-tempered. When the clinician asks the client about these mood changes, the client says she has always become very moody during the week before her menstrual period. The client’s symptoms are most suggestive of which of the following DSM-5 disorders?
Select one:
A. Dysmenorrhea
B. Cyclothymic Disorder
C. Premenstrual Syndrome
D. Premenstrual Dysphoric Syndrome
Answer D is correct: More information would be needed to assign a diagnosis of Premenstrual Dysphoric Syndrome. However, of the diagnoses listed in the answers, this one is most consistent with the information provided in the question.
Answer A: Dysmenorrhea is a medical condition that is characterized by physical pain during menstruation.
Answer B: While the client’s symptoms are cyclical, they do not meet the diagnostic criteria for Cyclothymic Disorder, which involves alternating periods of hypomanic and depressive symptoms.
Answer C: Premenstrual Syndrome is not a DSM-5 diagnosis.
The correct answer is: Premenstrual Dysphoric Syndrome
The assessment of patients with Alzheimer’s disease is an ongoing process due to the degenerative nature of the disease and the consequent need to alter the nature of the treatment plan. During the 4th or 5th year of the disorder, an assessment is most likely to find which of the following?
Select one:
A. deficits in new learning with remote memory mildly to moderately impaired; anomia; sadness
B. severe impairments in recent and remote memory; fluent aphasia; indifference or irritability; restlessness
C. severe impairments in memory and executive functioning; motor rigidity; confusion and delusions
D. severely disturbed intellectual functioning; limb rigidity and flexion posture; apathy; seizures
As noted in the Abnormal Psychology chapter of the written study materials, the progression of Alzheimer’s disease can be described in terms of three stages.
a. Incorrect These symptoms are more common during the first two to three years (first stage).
b. CORRECT These are characteristic symptoms during the 3rd through 10th years (middle stage).
c. Incorrect These are symptoms of the third stage (8 to 12 years).
d. Incorrect These are third stage symptoms (in addition, seizures are not necessarily associated with this disorder).
The correct answer is: severe impairments in recent and remote memory; fluent aphasia; indifference or irritability; restlessness
During your first session with Mr. and Mrs. Desvelo, Mr. Desvelo says his wife has insisted that he get “some help” with his sleep problems. Mrs. Desvelo states that she’s awakened by his frightening screams at least once a week, usually a few hours after they go to sleep, and that this is having a negative effect on her mood and their relationship. Mr. Desvelo has no history of trauma or substance abuse, and he says he recently had a physical and his health is good. In response to your questions, Mrs. Desvelo tells you that her husband sometimes wakes up when he screams and seems agitated but usually goes right back to sleep and doesn’t respond to her attempts to calm him; and Mr. Desvelo says that, in the morning, he has no memory of the episode and usually can’t recall having had any dreams. Mr. Desvelo’s symptoms are most suggestive of which of the following DSM-5 diagnoses?
Select one:
A. Nightmare Disorder
B. Sleep Terror Disorder
C. Rapid Eye Movement Sleep Behavior Disorder
D. Non-Rapid Eye Movement Sleep Arousal Disorder
Answer D is correct: A person with Non-Rapid Eye Movement Sleep Arousal Disorder, sleep terror type experiences sleep terror episodes that are usually accompanied by a panicky scream. The person shows signs of autonomic arousal, usually does not fully awaken, is unresponsive to the efforts of others to comfort him/her, rarely remembers any dreams he/she may have had, and has amnesia for the episode on awakening in the morning.
Answer A: A person with Nightmare Disorder awakens easily and completely and reports having had a vivid dream involving a threat to survival or security.
Answer B: Sleep Terror Disorder is not a DSM-5 diagnosis.
Answer C: Rapid Eye Movement Sleep Behavior Disorder involves episodes of arousal during REM sleep that are usually associated with vocalizations and/or complex motor behaviors that are consistent with the person’s dream. Upon awakening, the person is alert and oriented.
The correct answer is: Non-Rapid Eye Movement Sleep Arousal Disorder
As defined in the DSM-5, the essential feature of Delirium is:
Select one:
A. impaired ability to transfer information from short- to long-term memory.
B. a disturbance in attention and awareness.
C. a disturbance in psychomotor behavior.
D. disorientation.
Answer B is correct: According to the DSM-5, the core features of Delirium are impaired awareness and a disturbance in attention (e.g., impaired ability to focus, sustain, and shift attention).
Answers A, C, and D: Although Delirium may involve impaired memory, a disturbance in psychomotor behavior, and/or disorientation, these symptoms are not essential features of the disorder.
The correct answer is: a disturbance in attention and awareness.
Naasir N. states that he often can’t keep himself from falling asleep during the day and, as a result, has injured himself several times at work and recently started taking the bus to work because he’s afraid he’ll fall asleep while driving. He says that he often experiences weakness in his legs right before he falls asleep during the day and has vivid, sometimes frightening dreams just before he wakes up. Naasir says that he likes to have a few beers in the evening and on weekends but that this seems to increase his daytime sleepiness. He reports that he has very vivid dreams at night and usually wakes up several times each night but is able to quickly fall asleep again. Based on these symptoms, the most likely diagnosis for Naasir is:
Select one:
A. sleep apnea.
B. alcohol-induced sleep disorder.
C. primary hypersomnia.
D. narcolepsy.
Naasir is exhibiting sleep attacks with cataplexy (weakness in his legs) and hypnopompic hallucinations (vivid dreamlike hallucinations on awakening).
a. Incorrect Sleep apnea is a breathing-related sleep disorder that involves an episodic cessation of breathing that may or may not be due to an upper airway obstruction.
b. Incorrect Naasir’s daytime sleep attacks and cataplexy are not characteristic of alcohol-induced sleep disorder.
c. Incorrect Naasir’s symptoms are more characteristic of narcolepsy than of primary hypersomnia, which involves more persistent daytime sleepiness (rather than discrete sleep attacks), few or no dreams during daytime naps, an absence of cataplexy, and fewer disturbances in nocturnal sleep.
d. CORRECT Naasir’s daytime sleep attacks are characteristic of narcolepsy, which can be exacerbated by alcohol and is often accompanied by frequent awakening and vivid dreams at night.
The correct answer is: narcolepsy.
For a diagnosis of ADHD, the DSM requires:
Select one:
A. a minimum of six characteristic symptoms for at least six months.
B. a minimum of eight characteristic symptoms for at least four months.
C. a minimum of six characteristic symptoms for at least four months.
D. a minimum of eight characteristic symptoms for at least six months.
The exam does include some straightforward questions like this one.
a. CORRECT A diagnosis of ADHD requires at least six symptoms of inattention and/or six symptoms of hyperactivity/impulsivity for at least six months, resulting in impairment in at least two settings.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: a minimum of six characteristic symptoms for at least six months.
Major Depressive Disorder has been linked to all of the following sleep disturbances except:
Select one:
A. reduced Stage 3 and Stage 4 sleep.
B. increased slow-wave (non-REM) sleep.
C. decreased REM latency.
D. decreased sleep continuity.
Major Depressive Disorder is associated with several abnormalities in the sleep cycle.
a. Incorrect Reduced Stage 3 and Stage 4 sleep is characteristic of depression.
b. CORRECT Depression is associated with decreased (not increased) slow-wave sleep.
c. Incorrect Decreased REM latency (earlier onset of REM sleep) is characteristic of depression.
d. Incorrect Decreased sleep continuity is common in individuals with Major Depressive Disorder.
The correct answer is: increased slow-wave (non-REM) sleep.
The best conclusion about the etiology of Major Depressive Disorder is that:
Select one:
A. genetic factors play a more substantial role than environmental factors, with a dominant gene being the most likely causal agent.
B. genetic factors play a more substantial role than environmental factors, with a recessive gene being the most likely causal agent.
C. genetic factors play a substantial role in only a small number of cases of this disorder.
D. genetic and environmental factors both play a substantial role in the development of this disorder.
Family, twin, and adoption studies have confirmed a genetic contribution to Major Depressive Disorder. However, these studies have shown that the heritability of this disorder is in the 31 to 42% range, which indicates that environmental factors also play an important role. See, e.g., P. F. Sullivan, M. C. Neale, and K. S. Kendler, Genetic epidemiology of major depression: Review and meta-analysis, American Journal of Psychiatry, 157, 1552-1562, 2000.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Based on their review of the research, Sullivan et al. conclude that Major Depressive Disorder is a complex and heterogeneous condition that results from a combination of genetic and environmental factors. They suggest that a genetic vulnerability to this disorder might be expressed only when the individual is also exposed to certain environmental events.
The correct answer is: genetic and environmental factors both play a substantial role in the development of this disorder.
Information on which of the following would be most useful for determining whether a client’s impotence has a physiological or psychological etiology?
Select one:
A. the presence of nocturnal erections
B. the experience of pain during intercourse
C. the client’s level of performance anxiety
D. the presence of diabetes
Impotence may have a variety of causes, including psychological, medical, substance-induced, or a combination of factors.
a. CORRECT While the results of an NPT (nocturnal penile tumescence) test are not always conclusive (some men with psychologically-based impotence do not have erections at night), of the responses listed, this is the best answer.
b. Incorrect Information on pain during intercourse would not necessarily help distinguish between a physiological and psychological etiology.
c. Incorrect Although performance anxiety underlies many sexual dysfunctions, it may also be present in medically and substance-induced sexual disorders and, therefore, would not be a useful diagnostic tool for distinguishing between physiologically and psychologically caused sexual dysfunctions.
d. Incorrect Diabetes may be a cause of impotence, but its absence would not help determine if a man’s impotence is due to physiological or psychological factors.
The correct answer is: the presence of nocturnal erections
For a DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder, the onset of symptoms must be prior to ___ years of age.
Select one:
A. 6
B. 10
C. 12
D. 18
Answer B is correct: The diagnosis of Disruptive Mood Dysregulation Disorder cannot be assigned for the first time before an individual is six years old or after he/she is 18 years old, and the age of onset must be before age 10.
Answers A, C, and D: See explanation for answer B.
The correct answer is: 10
The mother of a 35-year-old man says that, for the past five weeks, he has been acting very uncharacteristically. He seems perplexed and nervous much of the time, his tone of voice varies between flat and shrill, and his speech is sometimes like “word salad.” The mother says that sometimes it seems like he is listening to voices or sounds that she cannot hear. Based on this information, the most likely diagnosis is:
Select one:
A. Schizophrenia.
B. Schizoid Personality Disorder.
C. Schizoaffective Disorder.
D. Schizophreniform Disorder.
As noted in the Abnormal Psychology chapter of the written study maerials, Schizophrenia and other psychotic disorders share a number of characteristics. However, one distinguishing feature is the duration of symptoms.
a. Incorrect A diagnosis of Schizophrenia requires a duration of symptoms for at least six months.
b. Incorrect Schizoid Personality Disorder, like other personality disorders, is characterized by a persistent (long-term) pattern of dysfunctional behaviors. This man has had symptoms for only five weeks.
c. Incorrect The name “Schizoaffective” tells you that this disorder combines symptoms of schizophrenia and the affective (mood) disorders. The symptoms given in this question do not suggest a mood disturbance.
d. CORRECT Symptoms of Schizophreniform Disorder are similar to those associated with Schizophrenia but have a duration of less than six months.
The correct answer is: Schizophreniform Disorder.
Irvin Yalom (1985) described the group therapist's role primarily as which of the following? Select one:
A. a “blank screen”
B. a neutral observer
C. a coach
D. a participant/model
Yalom views the therapist as both a “technical expert” and an “active participant/model.”
a. Incorrect See explanation above.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. CORRECT Yalom advocates responsible self-disclosure by the therapist, for example, because it facilitates the therapist’s participation in the group and allows the therapist to act as a model of desirable behavior.
The correct answer is: a participant/model
A therapist who has adopted an etic perspective:
Select one:
A. believes that mental disorders may be manifested differently by people from different cultural groups.
B. believes that mental disorders are manifested in similar ways by all people, regardless of their cultural group.
C. adopts a psychodynamic model to describe the causes of mental disorders.
D. adopts a behavioral model to describe the causes of mental disorders.
The terms “etic” and “emic” were originally used by linguists and anthropologists but were subsequently adopted by mental health professionals interested in cross-cultural counseling.
a. Incorrect This describes an emic (“culturally specific”) view of mental disorders.
b. CORRECT A therapist adopting an etic (“culturally universal”) view considers mental disorders to be universal and, therefore, essentially the same in terms of symptoms among individuals from different cultures.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: believes that mental disorders are manifested in similar ways by all people, regardless of their cultural group.
During a therapy session, Dad, who is normally soft-spoken and mild-mannered, becomes very agitated and starts yelling. The oldest daughter becomes upset and says, “Please stop, you’re scaring Johnny” (the 6-year old son). Dad stops yelling and becomes calm again. This is an example of:
Select one:
A. positive feedback.
B. scapegoating.
C. family homeostasis.
D. the double-bind.
In this situation, the daughter’s reaction to her father’s uncharacteristic behavior serves to return the situation to its usual state.
a. Incorrect Positive feedback serves to change or disrupt the family’s status quo.
b. Incorrect A scapegoat is the family member who is blamed for the family’s problems.
c. CORRECT Homeostasis refers to the tendency of systems (including family systems) to maintain the status quo. In this situation, the daughter’s reaction is acting as negative feedback, which causes the father to act more characteristically.
d. Incorrect Double-bind communication involves a mixed (contradictory) message and has been implicated in the development of schizophrenia.
The correct answer is: family homeostasis.
In an attempt to live up to mainstream standards of beauty, a member of a racial minority alters her appearance in order to “look White.” This is best described as an example of:
Select one:
A. racial stereotypes.
B. racial stigmatization.
C. internalized racism.
D. interpersonal racism.
Several types of racism are distinguished in the literature. Two of these are internalized racism and interpersonal racism (answers c and d). Others include cultural, structural, and institutional racism. See, e.g., P. Figueroa, Education and the social construction of “race,” London, Routledge, 1991.
a. Incorrect Racial stereotypes are overgeneralized beliefs about individuals based on their race.
b. Incorrect Racial stigmatization refers the process of stigmatizing (shaming, disgracing) individuals on the basis of their race.
c. CORRECT Internalized racism refers to the internalization of negative beliefs, attitudes, and stereotypes related to race. It is also known as individual racism and, when it involves acceptance of negative views by a member of the stigmatized group, it is also referred to as internalized oppression and may be expressed as rejecting one’s own culture and attempting to act or look like members of the dominant culture.
d. Incorrect Interpersonal racism refers to the expression of racism between individuals and is manifested, for example, by social exclusion, unfair treatment, and harassment.
The correct answer is: internalized racism.
From the perspective of traditional psychoanalysis, transference is:
Select one:
A. an impediment to therapy progress.
B. a form of resistance.
C. a form of catharsis.
D. an ego defense mechanism.
Transference is considered a key component of psychoanalysis, and the interpretation of a client’s transference helps guide him/her toward insight.
a. Incorrect See explanation for response b.
b. CORRECT From the perspective of psychoanalysis, at the core of transference is resistance, or an unwillingness to relinquish one’s fantasy that one’s infantile wishes will be gratified.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: a form of resistance.
After several sessions with her therapist, a client starts acting toward the therapist as though he were the client’s father. Assuming that the therapist is a practitioner of Gestalt therapy, he is most likely to respond to this transference by:
Select one:
A. ignoring it.
B. temporarily assuming the role of the client’s father.
C. helping the client see the difference between her transference and reality.
D. helping the client understand how her past relationship with her father is affecting her current relationships with men.
Gestalt therapy, unlike psychanalytic psychotherapy, focuses on the here-and-now rather than on the past. Thus, a Gestalt therapist is not likely to encourage a client’s transference which brings an outside (and often past) relationship into the current therapeutic situation.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT In Gestalt therapy, when a client exhibits transference, the therapist helps the client “come to his senses” by enabling him to “see and experience in vivid concrete detail the discrepancies between transference fantasies and reality … to cut for a moment through the filtering fog of fantasy which he maintains around himself and experience the reality of the person who sits across from him” (J. Fagan and I. Shepherd, Gestalt therapy now, Palo Alto: Science and Behavior Books, 1970, pp. 123-4).
d. Incorrect See explanation for response “c”.
The correct answer is: helping the client see the difference between her transference and reality.
A systemic family therapist uses “circular questioning” in order to:
Select one:
A. obtain unbiased information from family members.
B. help family members recognize differences in their perceptions.
C. refocus the attention of family members to the here-and-now.
D. obtain information about the family’s transactional patterns and style.
The goal of many of the techniques used by systemic family therapists is to provide family members with the information they need to identify solutions to their problems.
a. Incorrect See explanation for response b.
b. CORRECT As defined by systemic family therapists, circular questions are used to help family members identify similarities and differences in their perceptions about events and relationships.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: help family members recognize differences in their perceptions.
The stages of change (transtheoretical) model identifies two factors as the primary predictors of successful transition from one stage to the next. These are:
Select one:
A. perceived self-efficacy and decisional balance.
B. locus of control and level of commitment.
C. motivation and persuasibility.
D. outcome expectancies and outcome value
The stages of change model identifies several factors that impact a person’s willingness to alter a problematic behavior.
a. CORRECT These are the two factors that are identified by the stages of change model as predictors of movement from one stage to the next. Perception of self-efficacy refers to the belief that one is capable of taking the steps needed to change, while decisional balance refers to the balance between the perceived pros and cons of changing. The cons of changing outweigh the pros during the precontemplation and contemplation stages; the cons and pros are about equal during the preparation stage; and the pros outweigh the cons during the action and maintenance stages.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: perceived self-efficacy and decisional balance.
The research has found that the more widely that lesbians disclose their sexual orientation to others, the more likely they will:
Select one:
A. experience an increase in anxiety.
B. engage in greater anonymous socializing.
C. report higher levels of self-esteem.
D. report less support from family members.
Disclosure of sexual orientation by lesbians (“coming out”) was investigated by K. M. Jordan and R. H. Deluty who found that it was associated with a number of positive outcomes [Coming out for lesbian women: Its relation to anxiety, positive affectivity, self-esteem, and social support, Journal of Homosexuality, 35(2), 41-63, 1998].
a. Incorrect This is the opposite of what is true. Jordan and Deluty found that disclosure was associated with a lower level of anxiety.
b. Incorrect This is also the opposite of what Jordan and Deluty found - i.e., their results indicated that the more widely lesbians disclosed their sexual orientation to others, the less likely they were to engage in anonymous socializing (e.g., going to gay and lesbian bars to spend time with people they did not know).
c. CORRECT The results of the Jordan and Deluty study indicated that the more widely lesbian women disclosed their sexual orientation, the lower their anxiety, the greater their positive affectivity, and the higher their self-esteem.
d. Incorrect This is also the opposite of what is true. Jordan and Deluty found that disclosure to family members was associated with greater family support.
The correct answer is: report higher levels of self-esteem.
A primary goal of Minuchin’s structural family therapy is to:
Select one:
A. increase differentiation in family members by identifying and restructuring family triangles.
B. replace rigid and diffuse boundaries with clear boundaries.
C. balance separation and togetherness.
D. align boundaries with family systems and subsystems.
You may have been able to narrow the responses given for this question by knowing that “boundaries” are a key target in Minuchin’s approach.
a. Incorrect For the exam, you want to have the term “differentiation” associated with Bowen.
b. CORRECT From the perspective of structural family therapy, family dysfunction can be traced to boundaries that are overly rigid or diffuse. (“Clear” boundaries are appropriate and functional boundaries.)
c. Incorrect Although alterations in boundaries may have this effect, this response does not describe Minuchin’s approach as well as response b does.
d. Incorrect “Aligning boundaries” does not describe Minuchin’s approach as well as response b does.
The correct answer is: replace rigid and diffuse boundaries with clear boundaries.
A structural family therapist’s interventions when working with a triangulated family will be designed to:
Select one:
a. foster insight in order to establish more appropriate hierarchies and boundaries.
b. create stress in order to unbalance the family’s homeostasis.
c. dilute the tension between family members in order to reduce triangulation.
d. alter the family’s implicit and explicit rules in order to increase differentiation.
Your answer is incorrect.
As its name suggests, structural family therapy is concerned with restructuring the family.
a. Incorrect - See explanation for response b.
b. CORRECT - Before the family’s structure can be altered, its homeostatic state must be unbalanced so that family members are more susceptible to change. This is accomplished by interjecting some type of stress into the family.
c. Incorrect - See explanation for response b.
d. Incorrect - See explanation for response b.
The correct answer is: create stress in order to unbalance the family’s homeostasis.
A number of studies have found that African American patients are less likely than White patients to complete advance directives. This research also indicates that this is due to:
Select one:
A. a low level of trust in the health care system.
B. techniques that help the therapist communicate empathy
C. reliance on family members to make end-of-life decisions.
D. the belief that advance directives violate cultural or religious values.
Several studies have found a relationship between race/ethnicity and end-of-life decisions. See, e.g., J. Kwak and W. E. Haley, Current research findings on end-of-life decision making among racially or ethnically diverse groups, The Gerontologist, 45(5), 634-641, 2005.
a. CORRECT- African American patients are less likely than White patients to complete advance directives, and this seems to be due primarily to lack of knowledge and/or mistrust in the healthcare system, with the latter being attributable to previous personal experiences and awareness of past abuses by healthcare providers (e.g., the Tuskegee syphilis study).
b. Incorrect- Concerns about “bringing bad luck” may account for the unwillingness of some Chinese adults to complete advance directives.
c. Incorrect- Reliance on family members to make end-of-life decisions has not been identified as a reason why African American patients are reluctant to complete advance directives.
d. Incorrect- There is some evidence that Native Americans may reject advance directives because they violate cultural values and beliefs (e.g., they are counter to the preference for avoiding negative thoughts and actions).
The correct answer is: a low level of trust in the health care system.
“Culturally encapsulated” therapists:
Select one:
A. have become immersed in another culture at the expense of their own culture.
B. exhibit an overt type of racism while denying that they are prejudiced against members of other cultures.
C. define the reality of their clients according to their own cultural assumptions.
D. maximize cultural differences by consistently distinguishing between “us” and “them.”
The term “cultural encapsulation” was introduced by C. Gilbert Wrenn in 1962 in his discussion of the limited perspective of counselors (The culturally encapsulated counselor, Harvard Educational Review, 32(4), 444-449, 1962).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Although different authors use this term somewhat differently, this comes closest to the definition provided by Wrenn, who viewed counselors as existing in a “cocoon of pretended reality” that reflects encapsulation within their own culture.
d. Incorrect See explanation for response c.
The correct answer is: define the reality of their clients according to their own cultural assumptions.
The concept of triangulation is central to general systems theory and can be found in the work of Bowen, Minuchin, Satir, and others. Although these theorists differ somewhat in their definition of triangulation, in general, it is said to be occurring when:
Select one:
A. to reduce tension between them, a two-person system draws in a third party.
B. to reduce tension between them, the members of a two-person system focus their attention on a third party.
C. to avoid dealing with the conflict between them, a two-person system forms an alliance against a third person.
D. to reduce conflict, two members of a three-person system assume a submissive role when interacting with the third dominant member.
Different theorists have somewhat different definitions for the term “triangulation.” The best answer to this question, therefore, is the one that is most general.
a. CORRECT This is the best response of those given. As a general term, triangulation refers to the formation of a three-person system by two people in order to reduce the stress and conflict between them.
b. Incorrect Minuchin described three types of triangles - stable coalition, triangulation, and detouring. This response describes detouring.
c. Incorrect This is a type of triangle but is too specific to be the correct answer to this question.
d. Incorrect This isn’t an accurate definition of triangulation.
The correct answer is: to reduce tension between them, a two-person system draws in a third party.
The traditional explanation for the beneficial effects of acupuncture is that it promotes healing by:
Select one:
A. restoring the flow of energy in the body.
B. creating a state of mental calmness.
C. altering the balance between cell growth and cell death.
D. restoring balance between the sympathetic and parasympathetic nervous systems.
The use of acupuncture is based on the assumption that blockages or imbalances in the flow of qi (vital life energy) within the body produce illness.
a. CORRECT The traditional explanation for acupuncture is that the insertion of fine metallic needles into specific areas of the body unblocks the flow of qi.
b. Incorrect This describes the effects of meditation and other relaxation techniques.
c. Incorrect This is one of the explanations for the effects of magnetic therapy.
d. Incorrect This has not been identified as an explanation for the effects of acupuncture.
The correct answer is: restoring the flow of energy in the body.
A strategic family therapist is most likely to use which of the following therapeutic techniques in dealing with a husband and wife who complain that they are constantly arguing with each other?
Select one:
A. obtain a detailed family history from each partner
B. ask the couple to identify the benefits they obtain from arguing
C. tell the couple to argue for at least two hours each evening
D. work individually with the partner who is most “differentiated”
Strategic family therapy is most associated with Jay Haley, who was strongly influenced by the communication school of family therapy and by the work of Milton Erickson.
a. Incorrect Haley focuses more on the present, especially communication patterns occurring in the present.
b. Incorrect This is not characteristic of strategic family therapy.
c. CORRECT Haley relies heavily on paradoxical techniques (like the one described in this response), which are also employed by communication family therapists and Milton Erickson.
d. Incorrect This sounds more like Bowenian family therapy.
The correct answer is: tell the couple to argue for at least two hours each evening
A young man who hates his mother consistently lavishes her with praise and gifts. A Freudian would interpret this behavior as a manifestation of which of the following defense mechanisms?
Select one:
A. sublimation
B. displacement
C. psychological reactance
D. reaction formation
Psychoanalysts distinguish between a number of defense mechanisms. In most cases, their names can help you remember what they involve.
a. Incorrect Sublimation occurs when energy connected to an unacceptable impulse is redirected into socially acceptable actions.
b. Incorrect Displacement occurs when a dangerous or threatening impulse is redirected toward a safer source or object.
c. Incorrect Psychological reactance is not a defense mechanism. It was originally described by Brehm (1966) and occurs when people act in direct contradiction to a rule or request because they feel their personal freedom is being threatened.
d. CORRECT Reaction formation involves converting dangerous feelings or impulses into their opposite.
The correct answer is: reaction formation
Open-ended questions, affirmations, reflective listening, and summary statements are considered the principle skills or strategies of:
Select one:
A. solution-focused therapy.
B. reality therapy.
C. motivational interviewing.
D. interpersonal therapy.
The acronym OARS is used to identify the principle skills of motivational interviewing and stands for open-ended questions, affirmations, reflective listening, and summary statements.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Although the four strategies identified in this question would probably be useful for most types of therapy, they have been explicitly identified as the principle strategies of motivational interviewing. These techniques are considered useful for increasing a client’s motivation. For example, “What things about your use of alcohol would you like to change?” is an open-ended question that would enhance the client’s motivation by helping him clarify his thoughts and feelings about drinking.
d. Incorrect See explanation for response c.
The correct answer is: motivational interviewing.
A practitioner of motivational interviewing would most likely emphasize use of which of the following in therapy?
Select one:
A. paradoxical techniques that foster resistance
B. techniques that help the therapist communicate empathy
C. confrontational techniques that address the client’s excuses and irresponsibilities
D. techniques that help the client identify “problem exceptions”
The primary goal of motivational interviewing is to help clients resolve their ambivalence about change. To do so, it relies primarily on a client-centered approach.
a. Incorrect Paradoxical techniques designed to foster resistance are often used by practitioners of family therapy (especially strategic family therapists) but are not commonly used by practitioners of motivational interviewing.
b. CORRECT Empathy is a key element of motivational interviewing. Methods used by the therapist to communicate empathy include simple reflection, double-sided reflection, amplified reflection, and summary statements.
c. Incorrect Confrontational techniques that address a client’s excuses and irresponsibilities are used by reality therapists.
d. Incorrect Techniques that help the client identify exceptions to his/her problems are used by solution-focused therapists.
The correct answer is: techniques that help the therapist communicate empathy
Traditional American Indian social organization and decision-making is best described as:
Select one:
A. linear.
B. bilateral.
C. nuclear.
D. collateral.
Among American Indians, the family and social network includes both biological and nonbiological members.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT As a group, American Indians place greater emphasis on the family and the tribe than on the self and this is reflected in their social organization and decision-making process, which have been described as “consensual collateral.”
The correct answer is: collateral.
The notion that there are three major life tasks - friendship, occupation, and love - is MOST consistent with the philosophy of:
Select one:
A. Perls.
B. Berne.
C. Rogers.
D. Adler.
The three tasks listed in the question (friendship, occupation, and love) all involve social interactions. Of the individuals listed, one is most associated with an emphasis on social factors (i.e., social interest).
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Adler believed that people are motivated primarily by an innate social interest and that the goal in life is to act in ways that fulfill social responsibilities.
The correct answer is: Adler.
_____________________ is a client-centered counseling approach that facilitates behavior change by helping clients explore and resolve their ambivalence about change.
Select one:
A. Solution-focused therapy
B. Motivational interviewing
C. Reality therapy
D. Transactional analysis
Of the therapies listed in the answers, only one is based on a client-centered approach and specifically targets a client’s ambivalence.
a. Incorrect See explanation for response b.
b. CORRECT The description in this question is consistent with the description of motivational interviewing provided by its founders, S. Rollnick and W. Miller. According to these investigators, ambivalence is “the principal obstacle to be overcome in triggering change” (What is motivational interviewing?, Behavioral and Cognitive Psychotherapy, 23, 325-334, 1995).
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: Motivational interviewing
Research evaluating the effectiveness of various forms of psychotherapy for older adults has found that:
Select one:
A. older adults respond less well than younger adults to most forms of psychotherapy.
B. older adults respond much better than younger adults to most forms of psychotherapy.
C. older adults respond to a comparable degree as younger adults to most forms of therapy, although older adults may respond more slowly.
D. older adults respond to a comparable degree as younger adults to most forms of therapy, although older adults may respond more quickly.
Studies comparing the effectiveness of various psychotherapeutic techniques for older and younger adults have generally revealed few significant differences.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This is the conclusion reached by the American Psychological Association in its Guidelines for Psychological Practice with Older Adults [American Psychologist, 59(4), 236-260, 2004]. This document also notes, however, that tailoring an intervention to the specific needs of an older client may increase its effectiveness.
d. Incorrect See explanation for response c.
The correct answer is: older adults respond to a comparable degree as younger adults to most forms of therapy, although older adults may respond more slowly.
Which of the following was responsible for the genesis of Gerald Caplan’s development of mental health consultation?
Select one:
A. recognition that traditional psychoanalysis was not helpful for many of his clients
B. recognition that an internal consultant was needed in many organizations to address employees’ mental health problems
C. recognition that the mental health of many more individuals can be improved through indirect services
D. recognition that preventive efforts do not target the appropriate populations
Caplan discusses the origins of his mental health consultation in his article, Caplanian mental health consultation: Historical background and current status [Consulting Psychology Journal, 46(4), 2-12, 1994].
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Caplan’s consultation approach grew out of his experiences at residential institutions in Israel in 1949. He quickly recognized that it was not feasible to provide direct services to patients due to their large number and, consequently, developed an indirect approach (consultation) that increased his ability to ensure that patients received adequate treatment.
d. Incorrect See explanation for response c.
The correct answer is: recognition that the mental health of many more individuals can be improved through indirect services
According to Troiden (1988), homosexual identity development involves which of the following stages?
Select one:
A. confusion, comparison, acceptance, synthesis
B. feeling different, confusion, assumption, integration
C. dissonance, immersion, introspection, integrated awareness
D. dissonance, acceptance, assumption, integration
There are several models of gay/lesbian identity development. This question is asking about Troiden’s model.
a. Incorrect These are four of the six stages of gay/lesbian identity development proposed by Cass (1979): confusion, comparison, tolerance, acceptance, pride, and synthesis.
b. CORRECT These are the four stages proposed by Troiden. For additional information about these stages, see the Clinical Psychology chapter of the written study materials.
c. Incorrect These are four of the stages in Atkinson, Morten, and Sue’s racial/cultural identity development model.
d. Incorrect This response combines stages from the models proposed by Cass and Troiden.
The correct answer is: feeling different, confusion, assumption, integration
It is important when choosing a treatment approach for a client belonging to a particular ethnic or other minority group to remember that individuals belonging to the same group exhibit diverse characteristics. However, research does suggest that, overall, Asian and Asian American clients prefer:
Select one:
A. a directive, structured counseling approach.
B. an unstructured, insight-oriented counseling approach.
C. a client-centered counseling approach.
D. a self-directed counseling approach.
Research on Asian and Asian American individuals (see, e.g., Higginbotham, 1977; Sue and Sue, 1983) suggests that they under-utilize mental health services for several reasons. One reason is a dislike of ambiguous, unstructured counseling processes.
a. CORRECT Asian and Asian American clients tend to prefer more direct counseling services such as academic and vocational counseling over psychiatric services.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: a directive, structured counseling approach.
While attending a psychology conference, a colleague reports that he has developed a new assessment evaluation for suicide risk. You believe that this test may help you in your clinical practice. However, you learn that this test is labeled, “For Research Purposes Only,” at this time. Given this information, what is the appropriate course of action?
Select one:
A. You would not use the new test.
B. You learn as much as possible about this new test, and then use it if it seems appropriate to do so.
C. You can use the new test if you obtain the appropriate consent from a client before using the new test.
D. You can use the new test if it is used in conjunction with other data.
Since tests should only be used in the context in which they have been validated, it would not be appropriate to use a test labeled, “For Research Purposes Only,” in the clinical setting.
a. CORRECT You would not use the new test because this test should only be used “For Research Purposes Only.”
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: You would not use the new test.
When a therapist is a trainee and his or her supervisor has legal responsibility for treatment being provided by the therapist, the therapist must:
Select one:
A. obtain a waiver of confidentiality from a client prior to discussing the case with his/her supervisor.
B. let a client know that he/she is a student intern and that a supervisor will be reviewing the case.
C. let a client know that he/she is a student intern and provide the client with the supervisor’s name.
D. let a client know that he/she is a student intern and introduce the client to the supervisor.
This issue is covered by Standard 4.01 of the Ethics Code.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Standard 4.01 requires that clients be informed whenever a therapist’s work will be supervised and, moreover, that the client be given the supervisor’s name when “the supervisor has legal responsibility for the case.”
d. Incorrect See explanation for response c.
The correct answer is: let a client know that he/she is a student intern and provide the client with the supervisor’s name.
The APA’s (2002)Ethical Principles of Psychologists and Code of Conduct states that when conducting a psychological assessment of a client, an informed consent:
Select one:
A. is required in all situations.
B. is required in all situations and must be in written format and signed by the client.
C. is required except in certain circumstances.
D. is required except in certain circumstances and, when required, must be in written format and signed by the client.
Informed consent in assessment is addressed in several standards of the Ethics Code, including Standard 9.03.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT In most situations an informed consent is necessary when conducting psychological assessments. However, the Ethics Code lists three exceptions to this requirement: (1) when the test is mandated by law or government regulation; (2) when informed consent is implied because testing is routine; and (3) when the purpose of testing is to evaluate competence. Note also that Standard 3.10(d) requires that informed consents be “documented” but does not require them to be in written format and signed.
d. Incorrect See explanation for response c.
The correct answer is: is required except in certain circumstances.
In its statement on Legal Liability Related to Confidentiality and the Prevention of HIV Transmission, the American Psychological Association (1991) recommends that:
Select one:
A. psychologists be legally required to protect the partners of patients with HIV/AIDS.
B. psychologists be legally required to protect the partners of patients with HIV/AIDS as long as psychologists are also protected from civil and criminal liability for doing so.
C. psychologists be legally required to protect the partners of patients with HIV/AIDS but only after they obtain the patients permission to do so.
D. psychologists not be legally required to protect the partners of patients with HIV/AIDS.
The APA’s position on partner notification is consistent with its emphasis on maintaining client confidentiality.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The APA’s (1991) position is that “a legal duty to protect third parties from HIV infection should not be imposed.” However, in its statement, the APA also recommends that, if such legislation is passed, it should permit disclosure only when (1) the psychologist knows of an identifiable third party who is at significant risk for infection; (2) knows that the third party is unaware of the risk; (3) has urged the client to notify the patient but the client has refused to do so; and (4) the psychologist is legally protected from civil or criminal liability for doing so.
The correct answer is: psychologists not be legally required to protect the partners of patients with HIV/AIDS.
After speaking at a workshop at a large university, Dr. A., a renowned expert on eating disorders, is approached by a woman who asks him about her daughter who she believes is beginning to exhibit symptoms of anorexia nervosa. Dr. A. gives the woman the phone numbers of three therapists in the area who have experience with this disorder. Six months later, Dr. A. finds out that the woman is planning to file a malpractice suit against him: During that time, her daughter received treatment from one of the therapists on Dr. A.’s list but became much worse and is currently hospitalized. The woman feels that Dr. A. is responsible for not adequately warning her of the potential course of her daughter’s disorder. In terms of malpractice:
Select one:
A. Dr. A. is guilty because he had a “duty to warn” the woman about possible complications of anorexia nervosa.
B. Dr. A. is guilty because he apparently did not give the woman adequate referrals.
C. Dr. A. is not guilty because he gave the woman the names of several therapists.
D. Dr. A. is not guilty because he didn’t have a professional relationship with the woman or her daughter.
Legally, the following elements must be present before a malpractice suit is possible: (1) the psychologist must have a professional relationship with the individual with a resulting duty to him/her; (2) there must be some negligence or dereliction of that duty by the psychologist; and (3) some harm must have come to the individual as a result of the psychologist’s negligence or dereliction.
a. Incorrect A “duty to warn” is not relevant to this situation. A psychologist has a duty to warn a client’s potential victim when the client expresses his/her intention to harm a specific person.
b. Incorrect There is not sufficient information to conclude that Dr. A.’s referrals were inadequate, and, even if they were, this would not constitute malpractice.
c. Incorrect Although this is a good idea, it is not relevant to malpractice.
d. CORRECT Dr. A. clearly does not have a professional relationship with the woman or her daughter and, therefore, is not guilty of malpractice.
The correct answer is: Dr. A. is not guilty because he didn’t have a professional relationship with the woman or her daughter.
A slightly overweight psychological assistant wants to lose 15 pounds. The psychologist who employs her is a well-known authority on the use of behavioral techniques for weight reduction. Therefore, the assistant asks the psychologist if he will accept her as a client. The assistant is willing and able to pay the full fee for the treatment program. If the psychologist agrees to accept his assistant as a client, he will have:
Select one:
A. acted ethically since this situation is not covered by the Ethics Code.
B. acted ethically since the assistant is going to pay for the treatment.
C. acted ethically since the psychologist did not solicit the assistant as a client.
D. acted unethically because his dual roles as therapist and employer may create a conflict.
Standard 3.05(a) of APA’s Ethics Code states that a psychologist “refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”
a. Incorrect This situation clearly constitutes a multiple relationship, which is prohibited by the Ethics Code.
b. Incorrect Regardless of whether or not the assistant pays for treatment, the situation would constitute a multiple relationship.
c. Incorrect Solicitation, or lack thereof, has no bearing on the inappropriateness of establishing a multiple relationship.
d. CORRECT Accepting an assistant, or any other employee, as a client would represent a multiple relationship, as defined above. Such relationships should be avoided when possible.
The correct answer is: acted unethically because his dual roles as therapist and employer may create a conflict.
Dr. Kairos receives a phone call from the father of a 7-year old girl whom he has been seeing in therapy for several months. The father wants Dr. Kairos to call the child’s school and provide the school psychologist with the results of her recent evaluation of the child’s cognitive functioning. The school psychologist is going to meet with the principal within the hour to discuss the possibility of placing the girl in a special education class. Dr. Kairos should:
Select one:
A. explain that she cannot provide the information without a signed release of information from the father.
B. agree to provide the information only if she believes the school psychologist is qualified to interpret it.
C. agree to provide the information and document the father’s permission to release it to the school psychologist by placing a note in the girl’s file.
D. agree to provide the information but follow up the phone conversation with a written report to the school psychologist.
The Ethics Code states that consent to reveal confidential information must be obtained, but it does not require that the consent be in writing. However, it would be in the best interests of everyone to document the father’s consent.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Given the “emergency” nature of the situation, this is the best course of action. It is also one that is supported by M. Vasquez in Implications of the 1992 Ethics Code for the practice of individual psychotherapy, Professional Psychology: Research and Practice, 25(4), 321-328, 1994. She states that a “psychologist should document the consent [to disclose confidential information] either through a form signed by the client or in a progress note” (p. 326).
d. Incorrect See explanation for response c.
The correct answer is: agree to provide the information and document the father’s permission to release it to the school psychologist by placing a note in the girl’s file.
According to the APA’s Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations, when the linguistic skills of a psychologist do not match the client’s language, the psychologist:
Select one:
A. must make a referral.
B. may ask the client to bring an interpreter.
C. should retain the services of a translator who has the appropriate cultural/linguistic knowledge and professional training.
D. should make a referral or, if not feasible, should retain an appropriate translator.
Paragraph 6 of the Guidelines addresses this situation.
a. Incorrect This isn’t a completely accurate description of the requirements of the Guidelines.
b. Incorrect This is not recommended in the Guidelines.
c. Incorrect This is partially correct.
d. CORRECT When language is a problem, a referral is the best course of action. When this is not feasible (there is no one to refer the client to), a psychologist can retain the services of an appropriate translator.
The correct answer is: should make a referral or, if not feasible, should retain an appropriate translator.
A woman calls you asking for information about her son who is a current client of yours. You have been seeing the son in individual therapy since he was 17. He is now 18-1/2 and has just started college. This mother is paying for her son’s therapy. You should:
Select one:
A. provide the woman with the information she has requested about her son.
B. provide the woman only with information that is relevant to the purpose of her request.
C. provide the woman only with that part of the record that pertains to her son before he turned 18.
D. provide the woman with information only with the permission of her son.
In most jurisdictions, the age of majority is 18.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Since the son has reached the age of majority, his mother’s right to access to his records has ceased, and his permission is required to provide her with any information from his records.
The correct answer is: provide the woman with information only with the permission of her son.
Quality assurance is least concerned with:
Select one:
A. cost-effectiveness of services.
B. availability of services.
C. client satisfaction with services.
D. the outcomes of services.
Although quality assurance means different things to different people, in general, it refers to the quality of services.
a. CORRECT Cost effectiveness is the target of utilization review rather than quality assurance (although, in the long-run, improved quality may also reduce costs). Responses b, c, and d all describe factors that contribute to the quality of services.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: cost-effectiveness of services.
The owner of a small electronics firm hires you to administer standardized cognitive ability tests to job applicants and asks you to teach her how to administer and score the tests herself. You should:
Select one:
A. agree to do so only if you are able to provide the owner with adequate training.
B. agree to do so only if you will be able to supervise the owner.
C. agree to do so only if the owner signs a confidentiality agreement.
D. not agree to do so.
Standard 9.07 of the Ethics Code applies to this situation.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Standard 9.07 states that “psychologists do not promote the use of psychological assessment techniques by unqualified persons.” This response is most consistent with this requirement.
The correct answer is: not agree to do so.
Regarding the care and use of animals in research, the APA’s Ethics Code addresses all the following EXCEPT:
Select one:
A. individuals under the supervision of psychologists.
B. the termination of an animal subject’s life.
C. security measures used to protect the laboratory.
D. compliance with state and federal laws.
Standard 8.09 focuses on the “humane care and use of animals in research.”
a. Incorrect Supervision is addressed in 8.09(b): “Psychologists trained in research methods and experienced in the care of laboratory animals supervise all procedures involving animals and are responsible for ensuring appropriate consideration of their comfort, health, and humane treatment.”
b. Incorrect Termination of animals is addressed in 8.09(g): “When it is appropriate that the animal’s life be terminated, it is done rapidly, with an effort to minimize pain, and in accordance with accepted procedures.”
c. CORRECT The security of the laboratory is not explicitly discussed in the ethical standards.
d. Incorrect Standard 8.09(a) requires psychologists who use animals in research to comply with federal, state, and local laws and regulations.
The correct answer is: security measures used to protect the laboratory.
A psychologist has just started working at a mental health clinic. Several of the clients who are referred to him belong to an ethnic minority group that he has not worked with before. He should:
Select one:
A. inform the clients of his limited experience and discuss their options with them.
B. consult with a senior member of the clinic.
C. read relevant research on the needs of members of this group.
D. refer the clients to a more qualified therapist.
There is nothing in the question that says the minority clients have problems that are unfamiliar to the therapist, that their well-being will be jeopardized by seeing this therapist, or that there is any other reason why a referral would be the best course of action.
a. Incorrect Of the responses given, this is not the best one. In certain situations, admitting a lack of expertise is appropriate, but as a general strategy for a particular kind of client, it would not be a good policy.
b. CORRECT This is always a good course of action in any situation involving uncertainty about one’s competence.
c. Incorrect This would be insufficient.
d. Incorrect This is not really a wrong answer but is not suggested by the conditions of the question. You’d want to consider this course of action in situations where it would be clearly in the best interests of the clients to do so.
The correct answer is: consult with a senior member of the clinic.
You are asked by the court to evaluate a 70-year old woman to help determine her competence. She is apparently disoriented and confused and has substantial memory loss. You have recently taken a weekend workshop on the use of a new computerized assessment technique for people with symptoms like those exhibited by this woman, and you feel this method of assessment would be especially valid in this situation. Further, you had taken the workshop specifically because you want to expand your practice by being qualified to conduct competency-related evaluations for the court. Your best course of action would be to:
Select one:
A. use the program to assess the woman.
B. use the program to assess the woman but, when testifying in court, discuss the potential limitations of your conclusions.
C. use the program to assess the woman but confirm your conclusions before testifying by consulting with the developer of the assessment technique.
D. refer the woman to someone who is more familiar with this type of evaluation.
During the course of their careers, psychologists ordinarily add new skills and techniques. Special precautions must be taken, however, when first applying these skills and techniques to clients.
a. Incorrect The information given in the question suggests that you do not have sufficient experience with the new technique to accept the responsibility of using it to evaluate a woman for the purpose of a court decision regarding her competence.
b. Incorrect See explanation for response d. Even though it is important to report possible limitations of one’s conclusions or recommendations, this would not be adequate in this situation.
c. Incorrect When using a new technique, supervision is a good idea. However, because the results of the assessment will be used to make an important decision about this woman, consultation would not be adequate in this case.
d. CORRECT Of the responses given, this is the best answer. Until you’ve had experience using the technique, it would be best not to use it to evaluate a woman as part of a competency proceeding.
The correct answer is: refer the woman to someone who is more familiar with this type of evaluation.
You are asked to conduct a court-ordered evaluation of a defendant in a criminal case. In terms of an informed consent, you:
Select one:
A. must obtain informed consent from the defendant prior to the evaluation.
B. must obtain informed consent from the defendant or his attorney prior to the evaluation.
C. do not have to obtain informed consent but must notify the defendant of the purposes and intended uses of the evaluation.
D. do not have to provide information to the defendant about the evaluation unless he or his attorney request that you do so.
This situation is covered by the APA’s Specialty Guidelines for Forensic Psychology (APA, 2012).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Although an informed consent is not required when an evaluation is court-ordered, it is necessary to inform the defendant of the purpose of the evaluation and of the limits on confidentiality.
d. Incorrect See explanation for response c.
The correct answer is: do not have to obtain informed consent but must notify the defendant of the purposes and intended uses of the evaluation.
Dr. Cooper is appointed by the court to evaluate a 42-year old man who is the defendant in a court proceeding. With regard to privilege, Dr. Cooper should be aware that:
Select one:
A. the defendant is the holder of the privilege and must sign a waiver of confidentiality before any information is given to the court.
B. Dr. Cooper is the holder of the privilege in this situation and it is his responsibility to determine what information to release to the court.
C. privilege is waived in this situation but Dr. Cooper should inform the defendant of the limits on confidentiality.
D. privilege is waived in this situation and Dr. Cooper can decide if it is appropriate to inform the defendant of the limits on confidentiality.
There are many reasons why a court might appoint a psychologist to evaluate a party in a court case. In these situations, privilege is waived, and the individual must be informed of the limits of confidentiality.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Obviously, the evaluation would serve no useful purpose if the court did not have the right to access the information obtained during the course of the evaluation. Consequently, this is one of the exceptions to the privilege requirement. A psychologist should, however, always inform the individual of the limits of confidentiality in this situation.
d. Incorrect See explanation for response c.
The correct answer is: privilege is waived in this situation but Dr. Cooper should inform the defendant of the limits on confidentiality.
Dr. Cal Amity is asked to provide crisis intervention services to individuals who were affected by a tornado that destroyed many homes in a nearby community. Dr. Amity has not had experience providing assistance to people who have been traumatized by a natural disaster, but there is no one else in the area who has experience and is available to see these individuals. As an ethical psychologist, Dr. Amity should:
Select one:
A. provide services only if he is supervised by another professional who has adequate training.
B. provide services to these individuals but stop when the crisis has ended or other services become available.
C. provide services to these individuals but use only interventions that he has experience using.
D. refuse to provide the services.
This situation is addressed by Standard 2.02 of the APA’s Ethics Code.
a. Incorrect See explanation for response b.
b. CORRECT Standard 2.02 states that, in emergency situations, a psychologist may provide services to individuals for whom other mental health services are not available and for which the psychologist does not have necessary training in order to ensure that the individuals receive necessary services. However, the psychologist must discontinue providing services when the emergency has ended or when appropriate services become available.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: provide services to these individuals but stop when the crisis has ended or other services become available.
During the third therapy session, a client reveals to you that he has been seeing another psychologist for the past six months. The client claims that this therapist doesn’t seem to be “doing any good,” and that he feels you’ll be better able to help him. As an ethical psychologist, you should:
Select one:
A. call the psychologist and inform her of the situation but only with the client’s consent.
B. tell the client you will continue therapy with him but discuss the implications of the situation.
C. tell the client you cannot continue therapy with him unless he terminates therapy with the other psychologist.
D. continue seeing the client but suggest that it would be best if he terminates therapy with the other psychologist.
Standard 10.04 of the Ethics Code states that, “In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client’s/patient’s welfare.”
a. Incorrect You need not contact the other psychologist, irrespective of the client’s consent, unless you have reason to suspect that she has acted unethically (which is not suggested in this question).
b. CORRECT This is most consistent with the requirements of the Ethics Code. The best thing to do in this situation would be to discuss the implications of continuing therapy with the client while he is seeing another therapist. In addition, you should encourage the client to discuss this matter with the other therapist.
c. Incorrect It may become necessary to do this if, after a period of time, the client is continuing to see you and the other therapist and you are both providing him with essentially the same services, but it is probably not the best first course of action.
d. Incorrect Telling the client that it would be best for him to stop therapy with the other therapist is not required by the Ethics Code. It does not take the best interests of the client (or other therapist) into consideration.
The correct answer is: tell the client you will continue therapy with him but discuss the implications of the situation.
You receive a letter from the Ethics Committee asking for information about a former client who has filed a complaint against her current therapist. You stopped seeing the client over seven years ago. You should:
Select one:
A. not comply with the Committee’s request initially and claim privilege on behalf of your client.
B. cooperate with the Committee’s request by sending them the information you believe is relevant to the case.
C. cooperate with the Committee’s request by sending them the information you believe is relevant to the case after confirming that the client has signed a release.
D. inform the Committee that the information you have about the client is obsolete and that you’re ethically obligated not to forward it to them.
This situation is addressed by Standard 1.06 of the APA’s Ethics Code.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT When contacted by the Ethics Committee, a psychologist must cooperate fully. However, as noted in Standard 1.06, a psychologist is also obligated to “address any confidentiality issues.” (If you believe the information is obsolete, you should make a note of that when you forward the information to the Committee.)
d. Incorrect See explanation for response c.
The correct answer is: cooperate with the Committee’s request by sending them the information you believe is relevant to the case after confirming that the client has signed a release.
Mental health professionals are sometimes called upon to assist the court in assessing a person’s potential for violent behavior. In general, the predictions made by psychologists and psychiatrists yield an abundance of:
Select one:
A. false negatives.
B. false positives.
C. true negatives.
D. true positives.
According to several authorities, mental health professionals tend to overpredict the potential for violence; i.e., they tend to predict that a person will be violent when, in fact, he/she will not.
a. Incorrect False negatives are individuals who are predicted to be nonviolent but who actually are violent.
b. CORRECT As noted above, mental health professionals tend to overpredict violence. Individuals who are identified as violent but, in reality, are not violent are referred to as “false positives.”
c. Incorrect True negatives are individuals who are predicted to be nonviolent and actually are not.
d. Incorrect True positives are individuals are predicted to be violent and are.
The correct answer is: false positives.
A client has missed the last three appointments and has not paid for the past five. You receive a letter from a state in-patient facility requesting information about the client who is now a patient there because of a suicide attempt. The request includes a valid release of information. According to the Ethics Code, you are acting ethically in this situation if you:
Select one:
A. notify the client that you will release the information only after an acceptable arrangement has been made for his unpaid bill.
B. agree to release only a summary of your records until an acceptable arrangement has been made for his unpaid bill.
C. provide the hospital with the information it has requested.
D. use your own discretion as to the best course of action.
Feedback
This issue is addressed in Standard 6.03 of the APA’s Ethics Code, which states that “psychologists may not withhold records under their control that are requested and needed for a client’s/patient’s emergency treatment solely because payment has not been received.”
a. Incorrect See explanation above.
b. Incorrect See explanation above.
c. CORRECT Since the client is currently a patient at the facility for a suicide attempt, you can assume that the records are needed for “emergency treatment” and that the ethical course of action is to provide the records as requested.
d. Incorrect See explanation above.
The correct answer is: provide the hospital with the information it has requested.
A client who terminated therapy with Dr. Demit several months ago calls to request an appointment because he has become very depressed and is feeling suicidal. In the past few months, Dr. Demit has been reducing her practice because she is getting ready to retire. The best course of action in this situation is for Dr. Demit to:
Select one:
A. see the man until the crisis has passed and then provide him with appropriate referrals.
B. explain to the man that she is about to retire and refer him to a colleague.
C. provide the man with several referrals and ask him to let her know if none of them works out.
D. provide the man with several referrals and tell him she is willing to consult with the new therapist.
Although this situation is not explicitly covered by the Ethics Code, Standard 3.04 states that psychologists “take reasonable steps to avoid harming their clients/patients ….”
a. CORRECT The best way to protect this client from harm would be to see him until the crisis has passed. After that, it would be acceptable to provide him with referrals.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: see the man until the crisis has passed and then provide him with appropriate referrals.
You receive a phone call from a person who you were intimately (including sexually) involved with for a short period of time. Your relationship ended in a mutually agreeable way and now this person wants to start therapy with you. In terms of the requirements of the Ethics Code:
Select one:
A. it would be ethical to begin therapy as long as at least two years have passed since the end of the relationship.
B. it would be ethical to begin therapy as long as it is clear that there is no risk for harm or exploitation.
C. it would be ethical to begin therapy as long as you discuss the potential for conflicts at the outset and the risk for harm to the client is minimal.
D. it would not be ethical to begin therapy.
This issue is clearly addressed in the Ethics Code.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Standard 10.07 states “Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies.”
The correct answer is: it would not be ethical to begin therapy.
The provisions of APA’s General Guidelines for Providers of Psychological Services require that “Professional Psychologists” have:
Select one:
A. a masters or doctoral degree in psychology.
B. a masters or doctoral degree in psychology plus appropriate professional experience.
C. a doctoral degree in psychology from a regionally accredited university or professional school.
D. an appropriate license or certificate in psychology.
As noted in the chapter on ethics and professional issues in the written study materials, the APA’s General Guidelines requires Professional Psychologists to have a doctoral degree in psychology from a regionally accredited university or professional school.
a. Incorrect See explanation above.
b. Incorrect See explanation above.
c. CORRECT This is a correct description of the requirements of the General Guidelines.
d. Incorrect Licensure is not mandated by APA’s General Guidelines or Specialty Guidelines.
The correct answer is: a doctoral degree in psychology from a regionally accredited university or professional school.
The term “insanity” is:
Select one:
A. a legal term.
B. a psychiatric term.
C. a psychological term that refers to psychotic disorders.
D. a term used only by nonprofessionals.
In the past, the term “insanity” was used by psychiatrists and psychologists to denote a severe mental disorder, but it is now used only as a legal term only.
a. CORRECT An “insane” person is an individual who has been judged in a court of law to be so psychologically deranged that he or she cannot be held responsible for criminal behavior.
b. Incorrect This is no longer true.
c. Incorrect This is no longer true.
d. Incorrect Although the term “insanity” is often used by nonprofessionals, it is also a legal term.
The correct answer is: a legal term.
With regard to ethical guidelines, exposing animal subjects in a research study to stress or pain:
Select one:
A. is prohibited under any circumstances.
B. is prohibited except in the “most unusual circumstances.”
C. is permitted when the stress or pain is minimized and applied in a humane way.
D. is permitted when alternative procedures are unavailable and the stress or pain is justified by the prospective value of the study’s results.
This issue is addressed in Standard 8.09(g) of the APA’s Ethics Code and Principle II.46 of the Canadian Code of Ethics.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect Although minimizing stress and pain and applying stress or pain in a humane way would be important, this would be not be sufficient if alternative procedures are available and/or if causing stress or pain is not justified by the prospective value of the study’s results. Therefore, this is not the best answer of those given.
d. CORRECT Of the answers given, this one is most consistent with the provisions of the APA’s Ethics Code and the Canadian Code of Ethics.
The correct answer is: is permitted when alternative procedures are unavailable and the stress or pain is justified by the prospective value of the study’s results.
A psychologist should be aware that client records:
Select one:
A. are protected by law and can never be disclosed without the client’s consent.
B. are the property of the psychologist and cannot be disclosed without his/her consent.
C. are the joint property of the psychologist and client and cannot be disclosed without the consent of both.
D. are not always free from disclosure, regardless of the wishes of the client or the psychologist.
The physical record is ordinarily the property of the psychologist (or organization where the psychologist works), while the information contained in the record is the property of the client.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT - There are situations that require a psychologist to disclose certain information contained in a client’s record (e.g., in cases of known or suspected child abuse), even without the client’s consent. Therefore, this answer is most consistent with ethical guidelines and legal requirements.
The correct answer is: are not always free from disclosure, regardless of the wishes of the client or the psychologist.
A psychologist is hired to perform a court-ordered evaluation of a defendant in a criminal case. The psychologist discusses the purpose of the evaluation with the defendant who then says he does not want to cooperate. According to the Specialty Guidelines for Forensic Psychology (APA, 2012), the psychologist should:
Select one:
A. remind the defendant that he has no choice since the evaluation is court-ordered.
B. refuse to conduct the evaluation unless he obtains an informed consent from the defendant.
C. refuse to conduct the evaluation unless he obtains an informed consent from either the defendant or the defendant’s attorney.
D. postpone the evaluation and advise the defendant to contact his attorney.
The best course of action is addressed in Paragraph 6.03.02 of the Specialty Guidelines.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT When an evaluation is court-ordered, it is not necessary to obtain an informed consent. However, the subject of the evaluation should be informed of its purpose. If he/she does not want to be evaluated, the psychologist “may consider a variety of options including postponing the examination, advising the examinee to contact his or her attorney, and notifying the retaining party about the examinee’s unwillingness to proceed.”
The correct answer is: postpone the evaluation and advise the defendant to contact his attorney.
Dr. Fran Flummox is asked by the plaintiff’s attorney to serve as an expert witness on behalf of the plaintiff in a malpractice suit. The attorney asks Dr. Flummox if she would be willing to waive her usual fee and accept a proportion of the anticipated settlement instead. As an ethical psychologist, Dr. Flummox:
Select one:
A. may agree to do so because accepting a contingent fee is acceptable in this situation.
B. should agree to do so only if the contingent fee will represent the fair market value of her services.
C. should agree to do so only if she determines that accepting the contingent fee is in the best interests of the plaintiff.
D. should refuse to do so because psychologists should avoid accepting contingent fees in this situation.
This issue is addressed in Paragraph 5.02 of the APA’s Specialty Guidelines for Forensic Psychology.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Of the responses given, this one is most consistent with the requirements of Paragraph 5.02, which states: “Forensic practitioners seek to avoid undue influence that might result from financial compensation or other gains. Because of the threat to impartiality presented by the acceptance of contingent fees and associated legal prohibitions, forensic practitioners strive to avoid providing professional services on the basis of contingent fees.”
The correct answer is: should refuse to do so because psychologists should avoid accepting contingent fees in this situation.
Research comparing younger and older workers has found that:
Select one:
A. younger workers tend to be more satisfied than older workers are.
B. younger workers have more realistic expectations about their jobs than older workers do.
C. younger workers are more concerned about pay and job security than older workers are.
D. younger workers expect more personal fulfillment from their jobs than older workers do.
Research has generally shown that job satisfaction tends to increase with age, especially among White employees.
a. Incorrect This is the opposite of what is true.
b. Incorrect This is the opposite of what is true.
c. Incorrect This is not what has been found by the research.
d. CORRECT The lower satisfaction of younger employees has been attributed to their greater expectations for personal fulfillment from their jobs.
The correct answer is: younger workers expect more personal fulfillment from their jobs than older workers do.
As described by Krumboltz (1996), career counseling involves:
Select one:
A. assessing the individual’s self-concept and then identifying careers that match his/her self-concept.
B. helping the individual transition from the anticipation/preoccupation phase to the implementation phase of career development.
C. instilling an attitude of self-development in the individual so that he/she can adapt to changing work requirements in the future.
D. helping the individual successfully accomplish the tasks of his/her current stage of career development.
Krumboltz’s approach to career counseling is based on social learning theory.
a. Incorrect This sounds more like Super’s theory.
b. Incorrect This sounds more like the theory of Tiedeman and O’Hara.
c. CORRECT In contrast to many other career development theories, Krumboltz’s theory does not focus on matching individual characteristics to the characteristics of the job or organization. Instead, he argues that the purpose of career counseling is to help the individual develop attitudes and skills that will enable him/her to adapt to changing work requirements.
d. Incorrect This sounds more like Super’s theory.
The correct answer is: instilling an attitude of self-development in the individual so that he/she can adapt to changing work requirements in the future.
Regarding self-assessments that are utilized to promote organizational development, what is key when implementing the findings?
Select one:
A. Stakeholders of the organization are included in the discovery process.
B. Lower level management of the organization is included in the discovery process.
C. Only the CEO and executive officers should be included in the discovery process.
D. Only management should be included in the discovery process.
The correct answer is A. Self-Assessments are appropriate when the objective is organizational development. Implementation of findings is most successful when stakeholders of the organization are included in the discovery process. Answers B, C and D are incorrect as stakeholders of the company include those in all levels of management as well as those who are not in management too.
The correct answer is: Stakeholders of the organization are included in the discovery process.
To use the Taylor-Russell tables to evaluate a new selection test, you need information about which of the following?
Select one:
A. predictor cutoff, criterion cutoff, and hit rate
B. base rate, hit rate, and selection ratio
C. base rate, selection ratio, and validity coefficient
D. base rate, hit rate, and predictor cutoff
The Taylor-Russell tables are used to estimate a predictor’s “positive hit rate.”
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT To find an estimated hit rate using these tables, it is necessary to have three pieces of information: the base rate, the selection ratio, and the predictor’s validity coefficient.
d. Incorrect See explanation for response c.
The correct answer is: base rate, selection ratio, and validity coefficient
Fiedler and Garcia’s (1987) cognitive resource theory predicts that the relationship between leader intelligence and leader effectiveness is moderated by:
Select one:
A. the leader’s stress level.
B. the leader’s self-efficacy beliefs.
C. the employees’ motivation.
D. the employees’ experience.
F. E. Fiedler and J. E. Garcia’s cognitive resource theory (CRT) attempts to explain the low correlations that have been found between leader intelligence and leader performance (New approaches to leadership: Cognitive resources and organizational performance, New York, Wiley, 1987).
a. CORRECT According to CRT, the impact of a leader’s experience and intelligence on the leader’s performance is moderated by the leader’s level of stress. It predicts that (1) a leader’s intellectual ability correlates positively with performance in low-stress situations but negatively in high-stress situations and (2) a leader’s experience correlates negatively with performance in low-stress situations but positively in high-stress situations.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: the leader’s stress level.
