STUDY-MODE - Practice Exam 4 Flashcards
Carl Jung identified which of the following as the source of psychic energy?
Select one:
A. libido
B. archetypes
C. persona
D. personal unconscious
Jung believed that all psychic phenomena are manifestations of energy.
a. CORRECT In contrast to Freud, Jung described libido as the source of all psychic energy (rather than as the source of sexual energy only).
b. Incorrect Archetypes are inherited images, ideas, and emotions that reside in the collective unconscious and predispose us to view the world in certain ways.
c. Incorrect As defined by Jung, the persona refers to the aspects of oneself (usually the ideal aspects of oneself) that are presented to others.
d. Incorrect Jung distinguished between the collective and the personal unconscious and defined the latter as the aspect of the unconscious that contains lost or repressed perceptions of personally experienced events.
The correct answer is: libido
When working with an African American family, the best approach is likely to be which of the following?
Select one:
A. focusing initially on parent-child subsystems
B. relying on nondirective, nonstructured techniques
C. adopting a multisystems approach
D. working initially with the parents only
Because of the impact of environmental factors on African Americans, therapy is usually most effective when it takes into account social, political, socioeconomic, and other contextual factors.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT A multisystems (ecostructural) approach has been recommended by several experts for therapists working with African American families (e.g., Aponte, 1994; Boyd-Franklin, 1989). Information about this approach is provided in the Clinical Psychology chapter of the written study materials.
d. Incorrect See explanation for response c.
The correct answer is: adopting a multisystems approach
Role disputes, role transitions, unresolved grief, and interpersonal deficits are the primary targets of:
Select one:
A. interpersonal therapy.
B. reality therapy.
C. solution-focused therapy.
D. narrative therapy.
Of the therapies listed in the answers, only one explicitly targets the problem areas listed in the question.
a. CORRECT Interpersonal therapy (IPT) is a brief structured manual-based therapy that was originally developed as a treatment for depression but has since been applied to other disorders. Its primary targets are the four problem areas listed in this question.
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: interpersonal therapy.
From the perspective of structural family therapy, a therapist’s failure to __________ is likely to produce resistance among family members.
Select one:
A. form a therapeutic triangle
B. join the family
C. act as a “blank screen”
D. remain disengaged from the family’s emotional system
Familiarity with Minuchin’s terminology would have helped you choose the correct answer to this question.
a. Incorrect Bowen (not Minuchin) forms a therapeutic triangle with two family members in therapy.
b. CORRECT Minuchin considers joining to be a prerequisite for restructuring the family.
c. Incorrect Minuchin does not view the therapist’s role to be that of a “blank screen.”
d. Incorrect The “family emotional system” is a term most associated with Bowen.
The correct answer is: join the family
During your first session with a Japanese client, you decide that your primary goals are to normalize the client’s problems and instill a sense of hope. According to Sue and Zane (1987), these goals are:
Select one:
A. examples of “gift-giving.”
B. ways of establishing ascribed credibility.
C. ways of fostering “amae.”
D. manifestations of “cultural expressiveness.”
Sue and Zane argue that therapy outcome for members of minority groups is enhanced by two factors – credibility and giving [S. Sue and N. Zane, The role of culture and cultural techniques in psychotherapy: A critique and reformulation, American Psychologist, 42(1), 37-45, 1987].
Answer A is correct. Gift-giving is an important ritual in interpersonal relations in Asian cultures, but Sue and Zane feel that, in therapy, it is useful for other minority clients as well, especially for reducing premature termination from treatment. In therapy, giving can take several forms including the normalization of the client’s problems and installation of hope.
The correct answer is: examples of “gift-giving.”
For Irvin Yalom (1985), seeing a client in both individual therapy and group therapy is inadvisable because:
Select one:
A. the client will spend too much time in individual therapy discussing problems that arise during the group.
B. the client will terminate individual therapy prematurely because of the benefits he/she is deriving from the group.
C. participation in individual therapy may decrease the client’s involvement and participation in the group.
D. participation in both individual and group therapy is likely to be too anxiety-evoking for most clients.
Yalom (1985), an expert on group therapy, has explicitly addressed this issue.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Yalom generally discourages seeing a client in both individual and group therapy because he feels that the client’s participation in individual therapy will detract from his participation in the group.
d. Incorrect While this may be true for some clients, it is not the primary objection of Yalom and other experts.
The correct answer is: participation in individual therapy may decrease the client’s involvement and participation in the group.
During the first therapy session with a husband and wife who are experiencing marital problems, a therapist requests that, during the next week, they identify things in their relationship that they want to continue. Most likely, this therapist is a practitioner of:
Select one:
A. psychoeducational family therapy.
B. behavioral marital therapy.
C. interpersonal therapy.
D. solution-focused therapy.
The therapist has given the couple a task that will help them focus on the positive aspects of their relationship.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT In the context of solution-focused therapy, this assignment is an example of a “formula task.” Its purpose is to help the couple identify positive aspects of their relationship that, in turn, can lead to solutions to their marital difficulties.
The correct answer is: solution-focused therapy.
In her discussion of African American middle-class families, Boyd-Franklin (1989) notes that, in terms of family roles, these families tend to be: Select one:
A. patriarchal.
B. matriarchal.
C. egalitarian.
D. linear.
Nancy Boyd-Franklin discusses this issue in her book Black Families in Therapy: A Multisystems Approach, New York, Guilford Press, 1989.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The structure of the African American middle-class family often reflects equal sharing of power by the spouses as well as more permeable boundaries in general. For example, these families are open to influences from the extended family and the African American community.
d. Incorrect See explanation for response c.
The correct answer is: egalitarian.
Which of the following illustrates “diagnostic overshadowing”?
Select one:
A. A therapist lists an inaccurate diagnosis on an insurance form because she knows the insurance company will be unwilling to pay for therapy for the correct diagnosis.
B. A therapist does not recognize a co-existing clinical disorder in an intellectually disabled patient because of the salience of the intellectual disability.
C. A therapist misdiagnoses a patient because the salience of an atypical symptom causes her to overlook the patient’s other symptoms.
D. A therapist’s own cultural beliefs and values impede her ability to recognize how cultural differences impact diagnosis and treatment.
Diagnostic overshadowing was originally described by S. Reiss and colleagues in connection with the assessment of people with an intellectual disability (Emotional disturbance and mental retardation: Diagnostic overshadowing, American Journal on Mental Deficiency, 87, 396-402, 1982). It has since been applied to other situations and diagnoses.
a. Incorrect See explanation for response b.
b. CORRECT Overshadowing occurs when the salience of one disorder or condition “overshadows” consideration or recognition of another disorder.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: A therapist does not recognize a co-existing clinical disorder in an intellectually disabled patient because of the salience of the intellectual disability.
According to Sue and Zane (1987), in terms of ensuring good treatment outcomes, the most important factor in culturally sensitive therapy is:
Select one:
A. demonstrating cultural knowledge.
B. using culture-specific techniques.
C. using techniques that establish credibility.
D. being authentic and empathic.
Sue and Zane note that, when discussing cross-cultural counseling, most authors focus on cultural knowledge and the use of culture-specific techniques. These investigators argue, however, that these factors are only the means to an end, which is establishing credibility [S. Sue and N. Zane, The role of culture and cultural techniques in psychotherapy: A critique and reformulation, American Psychologist, 42(1), 37-45, 1987].
a. Incorrect Sue and Zane recognize the importance of cultural knowledge but argue that it is not sufficient to ensure positive outcomes in cross-cultural counseling.
b. Incorrect These authors also recognize the usefulness of culture-specific techniques but, again, view them as insufficient by themselves.
c. CORRECT According to Sue and Zane, the therapist’s credibility is a key determinant of therapy outcome. Cultural knowledge and the use of culture-specific techniques are beneficial only to the extent that they contribute to the therapist’s credibility.
d. Incorrect Sue and Zane don’t address the issues of authenticity and empathy.
The correct answer is: using techniques that establish credibility.
Savin-Williams and Diamond (2000) investigated the sexual identity trajectories among sexual-minority youth and found that:
Select one:
A. adolescent females had an earlier onset of all milestones.
B. adolescent males had an earlier onset of all milestones.
C. adolescent females had an earlier onset of all milestones except first same-sex attraction.
D. adolescent males had an earlier onset of all milestone except first disclosure of sexual orientation to another person.
R. C. Savin-Williams and L. M. Diamond compared the sexual identity trajectories of male and female sexual-minority youth in terms of four milestones - first same-sex attraction, self-labeling, first same-sex sexual contact, and first disclosure [Sexual identity trajectories among sexual-minority youths: Gender comparisons, Archives of Sexual Behavior, 29(6), 607-627, 2000].
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Males had an earlier onset than females for all milestones except first disclosure of sexual orientation to another person (age at first disclosure was not significantly different for males and females).
The correct answer is: adolescent males had an earlier onset of all milestone except first disclosure of sexual orientation to another person.
A therapy client states that she believes she may have been sexually abused as a child but has no explicit memories of the abuse. She asks her therapist - who often uses hypnosis in his practice - to hypnotize her as a means of retrieving those memories. The psychologist is familiar with the statement issued by the APA’s Working Group on Investigation of Memories of Child Abuse. Consequently, the psychologist will:
Select one:
A. agree to hypnotize the woman but be careful not to ask leading questions.
B. agree to hypnotize the woman and then attempt to corroborate any memories of abuse the woman recalls while under hypnosis.
C. advise the woman that hypnosis is not an appropriate procedure for retrieving memories because it is likely to produce false recollections of abuse.
D. refer the woman to another psychologist who uses hypnosis but is unfamiliar with the woman’s suspicions so that the procedure will be more objective.
The use of hypnosis for the purpose of recalling repressed memories is addressed in the document titled Final conclusions of the American Psychological Association Working Group on Investigation of Memories in Childhood Abuse [Psychology, Public Policy, and Law, 4(4), 933-940, 2000].
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This response is most consistent with the conclusions drawn in the above-named document. (It is also consistent with research showing that hypnosis tends to elicit false memories.)
d. Incorrect See explanation for response c.
The correct answer is: advise the woman that hypnosis is not an appropriate procedure for retrieving memories because it is likely to produce false recollections of abuse.
Which of the following programs best exemplifies a primary prevention program?
Select one:
A. use of personality tests as screening devices to identify high-risk individuals so those individuals can be provided with appropriate treatment
B. use of public education programs to inform the public about the negative effects of alcohol abuse
C. training of primary school teachers to recognize early signs of behavior disorders
D. use of educational programs to improve community attitudes toward former mental patients
There are three types of prevention programs: Primary prevention programs are designed to prevent a mental disorder from occurring; secondary prevention programs are designed to detect disorders early so that appropriate treatments can be applied; and tertiary prevention programs are aimed at preventing the recurrence or worsening of existing disorders.
a. Incorrect When a program involves identifying high-risk individuals so that those individuals can be provided with an intervention, it is classified as a secondary prevention program.
b. CORRECT An educational program designed to prevent alcohol abuse before it occurs is an example of a primary prevention program.
c. Incorrect Prevention programs that involve the early identification of disorders are classified as secondary prevention programs.
d. Incorrect A program designed to improve community attitudes toward former mental patients (presumably to ensure that the patients remain in the community) is an example of a tertiary prevention program.
The correct answer is: use of public education programs to inform the public about the negative effects of alcohol abuse
D. W. Sue (1978) describes “worldview” in terms of two independent dimensions – locus of control and locus of responsibility. From this perspective, an Anglo-American therapist with an internal locus of control and internal locus of responsibility is most likely to experience problems when working with an African American client who has an:
Select one:
A. external locus of control and internal locus of responsibility.
B. external locus of control and external locus of responsibility.
C. internal locus of control and external locus of responsibility.
D. internal locus of control and internal locus of responsibility.
Answer C is correct. Sue uses his model of worldview to describe issues and problems that Anglo-American therapists may face when working with clients from culturally diverse backgrounds. D. W. Sue and D. Sue discuss this issue in Counseling the culturally different, New York, John Wiley & Sons, 1999. They conclude that an IC-ER worldview is likely to “pose the most difficult problems for the IC-IR white therapist” (p. 180) because the client is likely to challenge the therapist’s authority, view the therapist as part of the “establishment that has oppressed minorities” (p. 181), be reluctant to self-disclose, and prefer adopting an active role in the therapy process.
The correct answer is: internal locus of control and external locus of responsibility.
Cross’s (1991, 2001) Black Racial Identity Development Model includes four stages, the last of which is:
Select one:
A. autonomy.
B. internalization.
C. incorporation.
D. integrative awareness.
The current version of Cross’s model includes the following four stages:
PRE-ENCOUNTER
ENCOUNTER
IMMERSION-EMMERSION INTERNALISATION
For additional information on this model, see the Clinical Psychology chapter of the written study materials.
a. Incorrect See explanation for response b.
b. CORRECT The final stage of Cross’s model - i.e., internalization - is characterized by the development of “inner security” as identity conflicts are resolved along with increasing biculturalism/multiculturalism.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: internalization.
A person-centered (Rogerian) therapist would most likely respond to a client’s transference by:
Select one:
A. interpreting it.
B. challenging it.
C. disregarding it.
D. reflecting it.
Transference is not expected to develop in person-centered therapy, at least not at the intense level that it does in psychodynamic therapy.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Transference in person-centered therapy is essentially accepted and disregarded rather than interpreted as it is in many other forms of therapy. This is consistent with the here-and-now approach of person-centered therapy.
d. Incorrect See explanation for response c.
The correct answer is: disregarding it.
Under hypnosis, a person is LEAST likely to:
Select one:
A. experience alterations of memory, perception, and mood
B. believe just about anything, no matter how preposterous.
C. do things he/she is otherwise fundamentally opposed to doing.
D. stop feeling pain (even severe pain) to a greater degree than if he/she had been given a pain killer.
Hypnosis has been defined as a state of increased suggestibility brought about by certain procedures.
a. Incorrect Hypnosis may involve experiencing alterations of memory, perception, and mood in response to suggestions.
b. Incorrect Hypnotized people are typically willing to accept even absurd suggestions (e.g., the suggestion that there is a pink elephant in the room).
c. CORRECT Although hypnotized people are suggestible, they will not engage in behaviors that they would otherwise refuse to perform.
d. Incorrect This is true for at least some individuals. The research has found that hypnotism can be a very effective pain killer; sometimes even more effective than acupuncture, morphine, aspirin, and other pain relievers.
The correct answer is: do things he/she is otherwise fundamentally opposed to doing.
Which of the following minimizes deviation and thereby helps a family (or other system) maintain the status quo?
Select one:
A. negative feedback
B. positive feedback
C. joining
D. paradox
From a family systems perspective, feedback refers to the return or provision of information to the system about the consequences of an event or action.
a. CORRECT Negative feedback acts to maintain a system’s current level of functioning or homeostasis.
b. Incorrect Positive feedback produces a change in the system.
c. Incorrect Joining is a technique used by structural family therapists and involves blending with the family by, for example, adopting its communication and affective style.
d. Incorrect The question does not describe paradox.
The correct answer is: negative feedback
Cross’s (1991) Black Racial Identity Development Model predicts that an African American in the pre-encounter stage of identity development will:
Select one:
A. exhibit a great deal of confusion and turmoil related to race.
B. have adopted a mainstream (White) identity.
C. be hostile to members of all racial/ethnic minority groups.
D. exhibit “healthy cultural paranoia”.
Cross’s model divides the pre-encounter stage into two substages: assimilation and anti-Black.
a. See explanation for response b.
b. CORRECT Adoption of a mainstream identity is characteristic of the assimilation substage, which is the first substage in the pre-encounter stage.
c. Incorrect This is not predicted by Cross’s model.
d. Incorrect This is also not predicted by Cross’s model.
The correct answer is: have adopted a mainstream (White) identity.
Issues related to attachment, safety, and security would be of most interest to a practitioner of:
Select one:
A. object relations family therapy.
B. Milan systemic family therapy.
C. reality therapy.
D. Adlerian therapy.
Of the therapeutic approaches listed, only one prioritizes the importance of attachment, safety, and security.
a. CORRECT Early attachment and issues related to safety and security are key concerns for practitioners of object relations psychotherapy.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: object relations family therapy.
A client describes a recurring dream of his to his therapist in which the client’s parents are standing on top of a stairway and refuse to let him climb up to the bedroom. If the therapist is a practitioner of Gestalt Therapy, she will probably:
Select one:
A. analyze the content of the dream.
B. ask the client to discuss his relationship with his parents.
C. see the dream as indicative of the client’s current progress in therapy.
D. see the dream as representing parts of the client’s personality that need to be integrated.
The major goals of Gestalt Therapy are to help a client achieve self-responsibility and function as a systematic whole. Dream work is one of the many techniques Gestaltians use.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT A goal of Gestalt Therapy is to integrate the separate, fragmented parts of a client’s personality into a unified whole. In line with this goal, Gestaltians see elements of recurring dreams as representations of parts of the self that have not been fully accepted and integrated.
The correct answer is: see the dream as representing parts of the client’s personality that need to be integrated.
What are the three approaches to healthcare?
Select one:
A. The Group Model, Open Model, and Regency Model.
B. The Stanford Model, Dual Model, and House Model.
C. The Open Model, Bismarck Model, and Balanced Model.
D. The Private Model, Beveridge Model, and Bismarck Model.
The correct answer is D. There are three approaches to healthcare: the private model, the Beveridge model (public funds), and the Bismarck model (mix of public and private funds). Answers A, B and C are incorrect as they do not relate to healthcare approaches.
The correct answer is: The Private Model, Beveridge Model, and Bismarck Model.
Ridley (1984) addressed the distrust that often exists between African American clients and their therapists and proposed that the therapist’s ethnicity is the MOST important factor for:
Select one:
A. a confluent paranoiac.
B. a cultural paranoiac.
C. a nonparanoiac.
D. a dissonant paranoiac.
Ridley’s model distinguishes between:
nonparanoics
functional paranoics
healthy cultural paranoics and
confluent paranoics.
a. CORRECT A confluent paranoiac exhibits high cultural and functional paranoia, and his or her nondisclosure in therapy is due to a combination of pathology and the effects of racism. According to Ridley, these clients do better with a therapist of the same racial/ethnic group.
b. Incorrect A cultural paranoiac does not possess views as extreme as a confluent paranoiac and may benefit from a White or African American therapist.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: a confluent paranoiac.
For Minuchin, scapegoating and overprotection of a child by the child’s mother and father are both forms of:
Select one:
A. triangulation.
B. detouring.
C. a stable coalition.
D. marital skew.
Minuchin describes three types of “rigid triangles” that all involve boundary disturbances.
a. Incorrect Minuchin uses the term triangulation to refer to the situation in which the child’s loyalty to one parent means rejection of the other parent.
b. CORRECT As defined by Minuchin, detouring occurs when the tension between husband and wife is reduced through the attention they pay to the child. This attention can involve either blaming the child for the family’s problems (scapegoating) or overprotection of the child who is identified by them as ill or weak.
c. Incorrect A stable coalition occurs when the child and a parent consistently “gang up” against the other parent.
d. Incorrect Marital skew is a term used by Lidz to describe situations in which a dominant partner has serious pathology, while the other partner is dependent and provides support.
The correct answer is: detouring.
From the Freudian perspective, interpretation:
Select one:
A. is appropriate only during the final “working through” phase of therapy.
B. is most useful when it evokes material at the deepest level of the unconscious.
C. helps the client uncover and gain insight into unconscious material.
D. involves restating and clarifying the client’s statements in clearer terms.
Interpretation is a key process in Freudian psychoanalysis and is applied to free associations, dreams, resistances, etc.
a. Incorrect Interpretations are made throughout therapy.
b. Incorrect The opposite is true. Interpretation is most successful when it addresses unconscious material that is just below the surface.
c. CORRECT This is the most accurate description of interpretation.
d. Incorrect This is a better description of clarification than intepretation.
The correct answer is: helps the client uncover and gain insight into unconscious material.
Smith, Glass, and Miller (1980) used meta-analysis to combine the results of 475 psychotherapy outcome studies published between 1941 and 1976 and obtained a mean effect size of ___, which indicated that the average therapy client was “better off” than about 80% percent of individuals who needed therapy but did not receive it.
Select one:
A. 0.4
B. 0.55
C. 0.85
D. 0.98
For the licensing exam, you want to be familiar with the Smith, Glass, and Miller (1980) study as well as with the interpretation of an effect size, which indicates the difference between average individuals in the treatment and control groups on the outcome measure in terms of standard deviation units.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT If you didn’t remember the effect size reported by Smith et al., being familiar with the areas under the normal curve may have helped you identify the correct answer to this question: In a normal distribution, 84% of cases fall below the score that is one standard deviation above the mean. Therefore 80% of cases will fall below the score that is slightly below one standard deviation above the mean.
d. Incorrect See explanation for response c.
The correct answer is: 0.85
The National Institute of Mental Health Multimodal Treatment Study of ADHD (MTA) compared the effectiveness of four treatments - medication management alone, behavioral treatment alone, combined medication and behavioral treatment, and routine community care. The results of the initial study indicated that:
Select one:
A. behavioral treatment alone is as effective as medication alone.
B. medication alone or behavioral treatment alone is as effective as the combined treatment.
C. medication alone or the combined treatment is more effective than behavioral treatment alone or routine community care.
D. behavioral treatment alone or the combined treatment is more effective than medication alone or routine community care.
Overall, the initial MTA results indicated that the combination treatment or medication management alone were significantly more effective than intensive behavioral treatment alone or routine community care.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Of the answers given, this is the best one. The initial results (which is what this question is asking about) found that medication management alone and the combined treatment had similar effects (and better effects than behavioral treatment alone or routine community care) for alleviating the core symptoms of ADHD. However, follow-up studies found that the superiority of medication alone and the combined treatment was true for short-term effects but not long-term effects. See, e.g., P. S. Jensen et al., Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): Implications and applications for primary care providers, Journal of Developmental & Behavioral Pediatrics, 2001, 22(1), 60-73.
d. Incorrect See explanation for response c.
The correct answer is: medication alone or the combined treatment is more effective than behavioral treatment alone or routine community care.
Stead et al.’s (2012) review of the literature found that ________ is the most effective form of nicotine replacement therapy for treating cigarette smoking.
Select one:
A. nicotine gum
B. nicotine nasal spray
C. nicotine tablet/lozenge
D. nicotine patch
L. F. Stead et al. evaluated the effectiveness nicotine gum, the nicotine patch, nicotine tablets/lozenges, nicotine inhaler, and nicotine nasal spray and found that all forms of nicotine replacement therapy were more effective than a placebo for reducing cigarette smoking
a. Incorrect See explanation for answer b.
b. CORRECT These investigators found that, of the nicotine replacement therapies, nicotine nasal spray was most effective and nicotine gum was least effective (Nicotine replacement therapy for smoking cessation, Cochrane Database Systematic Reviews, CD000146, 2012).
c. Incorrect See explanation for answer b.
d. Incorrect See explanation for answer b.
The correct answer is: nicotine nasal spray
The parents of 4-year-old Walter report that, even as a baby, he didn’t like to be held, which they attributed to colic. They report that he still doesn’t like to be touched and that he doesn’t like to play with other children and “seems to be in his own world” much of the time. When not engaged in an activity (he only likes playing with cars and dominos), Walter rocks constantly and has a hard time sitting still, but he can focus for hours when he’s lining up his toy cars or dominos. Walter’s cognitive development and language acquisition have been normal, but he does seem to have some trouble reading social cues. Which DSM-5 diagnosis should be considered first for Walter?
Select one:
A. Autism Spectrum Disorder
B. Asperger’s Disorder
C. Stereotypic Movement Disorder
D. Pervasive Developmental Disorder NOS
Answer A is correct: Autism Spectrum Disorder involves persistent deficits in social communication and interaction and restricted, repetitive patterns of behavior, interests, and activities.
Answer B: Asperger’s Disorder is not a diagnosis in the DSM-5.
Answer C: Although Walter engages in stereotypic movements (rocking), he exhibits other symptoms that are consistent with Autism Spectrum Disorder (limited interests, difficulties with social reciprocity).
Answer D: Pervasive Developmental Disorder NOS is not a diagnosis in the DSM-5.
The correct answer is: Autism Spectrum Disorder
For people with Specific Phobia, blood-injection-injury type:
Select one:
A. relaxation techniques are the treatment-of-choice.
B. relaxation techniques have good short-term but poor long-term effects.
C. relaxation techniques are most effective when they include in vivo exposure to feared stimuli.
D. relaxation techniques are normally contraindicated.
Specific Phobia, blood-injection-injury type is associated with a unique physiological reaction to feared stimuli and, therefore, requires a treatment approach that differs from those used with other forms of the disorder.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT For people with the blood-injection-injury type, feared stimuli produce an initial increase in heart rate and blood pressure, which is immediately followed by a drop in both and fainting. In contrast, people with other types of Specific Phobia experience only an increase in heart rate and blood pressure. Because of the physiological response associated with the blood-injection-injury type, treatment involves tensing (rather than relaxing) muscles in the presence of feared stimuli.
The correct answer is: relaxation techniques are normally contraindicated.
Because research has found low to moderate inter-rater reliability for the diagnosis of __________, there is some controversy among experts regarding its validity.
Select one:
A. Specific Phobia
B. Generalized Anxiety Disorder
C. Panic Disorder
D. Obsessive Compulsive Disorder
Inter-rater reliability has been found to be a problem for a number of diagnoses, including some of the Anxiety Disorders.
a. Incorrect See explanation for response b.
b. CORRECT Reported inter-rater reliability coefficients for Generalized Anxiety Disorder (GAD) vary, but tend to be lower than those reported for other Anxiety Disorders. The primary reasons for the low inter-rater reliability for GAD are disagreements regarding the severity of symptoms (i.e., what constitutes “excessive anxiety and worry”) and whether it should be the primary or secondary diagnosis. See, e.g., L. A. Papp and M. S. Kleber, Phenomenology of Generalized Anxiety Disorder, in D. J. Stein and E. Hollander (Eds.), Textbook of anxiety disorders (pp. 109-118), Washington, D.C., American Psychiatric Press, 2002. Note that low inter-rater reliability has also been reported for PTSD.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: Generalized Anxiety Disorder
A client with Borderline Personality Disorder is most likely to respond to her therapist in which of the following ways?
Select one:
A. with hostility and suspiciousness about the therapist’s intentions
B. in an inappropriately sexually provocative manner
C. in a manner that fluctuates between argumentativeness/hostility and excessive admiration
D. in a consistently demanding manner and with hypersensitivity to criticism
A key distinguishing characteristic of the various Personality Disorders is the nature of the individual’s interpersonal relationships.
a. Incorrect This sounds more like Paranoid Personality Disorder.
b. Incorrect This is characteristic of Histrionic Personality Disorder.
c. CORRECT Instability in relationships is a primary feature of Borderline Personality Disorder. People with this disorder may be overly complimentary and flattering toward a person one day and extremely hostile and critical the next.
d. Incorrect This sounds more likely Narcissistic Personality Disorder.
The correct answer is: in a manner that fluctuates between argumentativeness/hostility and excessive admiration
When shown the word “hot” a patient says “cold” and when shown the word “rock” the patient says “stone.” These errors are most suggestive of:
Select one:
A. surface dyslexia.
B. deep dyslexia.
C. pure alexia.
D. literal alexia.
Alexia and dyslexia are terms used to describe reading disorders.
a. Incorrect Surface dyslexia is characterized by reading without comprehension due to an inability to read words that are irregularly spelled (e.g., light, sword).
b. CORRECT Deep dyslexia involves several reading errors including semantic paralexia, which is characterized by the substitution of words with similar meanings (e.g., cold for hot).
c. Incorrect Pure alexia is also known as “word blindness” and refers to an inability to read words, even when they have been written by the person him/herself.
d. Incorrect People with literal alexia can read whole words but not individual letters.
The correct answer is: deep dyslexia.
A psychologist develops a theory of alcohol abuse that describes it as the result of a combination of a genetic predisposition toward alcoholism and exposure to certain environmental factors. The psychologist’s theory is best described as an example of the ____________ model.
Select one:
A. psychogenic
B. sociogenic
C. diathesis-stress
D. SORC
The psychologist’s theory views alcohol abuse as the result of a combination of biological and environmental factors.
a. Incorrect As its name implies, the psychogenic model focuses on the psychological contributions to a disorder.
b. Incorrect The sociogenic model focuses on societal factors that contribute to a disorder, such as societal norms, stereotypes, and institutional biases.
c. CORRECT The diathesis-stress model reflects a biopsychosocial perspective and conceptualizes disorders as the result of a combination of biological, psychological, and environmental (social) factors. More specifically, it proposes that disorders are due to a combination of predispositional factors (the diathesis) and exposure to certain life stressors.
d. Incorrect The SORC model is used by cognitive-behavioral therapists as the framework for assessment. Use of this model involves considering the situation in which the problem occurs (S); the observations (thoughts, assumptions, and beliefs) made by the client in response to the situation (O); the client’s emotional, psychological, and behavioral responses to his/her observations (R); and the consequences of those responses (C).
The correct answer is: diathesis-stress
As defined in the DSM-5, a diagnosis of ADHD, predominantly inattentive presentation is assigned when a child exhibits:
Select one:
A. at least six symptoms of inattention and no symptoms of hyperactivity-impulsivity.
B. at least six symptoms of inattention and fewer than six symptoms of hyperactivity-impulsivity.
C. at least eight symptoms of inattention and fewer than four symptoms of hyperactivity-impulsivity.
D. at least eight symptoms of inattention and fewer than eight symptoms of hyperactivity-impulsivity.
Answer B is correct: The DSM-5 distinguishes between three subtypes of ADHD: predominantly inattentive presentation, predominantly hyperactive-impulsive presentation, and combined presentation. The number of symptoms listed in this answer (at least six symptoms of inattention and fewer than six symptoms of hyperactivity-impulsivity) is the requirement for the predominantly inattentive type. For the predominantly hyperactive-impulsive presentation, the requirement is at least six symptoms of hyperactivity-impulsivity and less than six symptoms of inattention; and for the combined presentation, the requirement is at least six symptoms of inattention and at least six symptoms of hyperactivity-impulsivity. (Note that, for individuals over age 17, the minimum number of symptoms for the diagnosis of each subtype is five rather than six.)
Answers A, C, and D: See explanation for answer B.
The correct answer is: at least six symptoms of inattention and fewer than six symptoms of hyperactivity-impulsivity.
Studies examining the risk factors for recidivism among juvenile offenders has identified which of the following as being the BEST predictor of re-offending?
Select one:
A. IQ
B. socioeconomic status
C. age at first offense
D. history of maltreatment/abuse
Risk and protective factors for recidivism among juvenile offenders was investigated by C. Schwalbe et al. [North Carolina Assessment of Risk (NCAR): Reliability and predictive validity with juvenile offenders, Journal of Offender Rehabilitation, 40(1/2), 1-22, 2004.]
a. Incorrect Schwalbe et al. report a correlation of .142 between IQ and re-offense.
b. Incorrect These investigators report a correlation of .065 for SES and re-offense.
c. CORRECT Schwalbe et al. found the strongest correlation (r = -.346) between age at first offense and reoffense (the younger the age the first offense, the higher the risk for recidivism).
d. Incorrect These authors report a correlation of .112 between history of maltreatment and re-offense.
The correct answer is: age at first offense
The DSM-5 requires that which of the following be ruled out as the cause of an individual’s symptoms before assigning a diagnosis of a sexual dysfunction?
Select one:
A. other mental disorders, physiological/medical factors, and partner factors
B. a nonsexual mental disorder, severe relationship distress, and the effects of a substance, medication, or other medical condition
C. a nonsexual mental disorder, the effects of a substance/medication, and a lack of information about sexuality
D. other mental disorder/condition, the effects of a substance/medication, and psychosocial factors
Answer B is correct: The following is included as a diagnostic criterion for a DSM-5 diagnosis of Erectile Disorder, Premature Ejaculation, and other sexual dysfunctions: “The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.”
Answers A, C, and D: See explanation above.
The correct answer is: a nonsexual mental disorder, severe relationship distress, and the effects of a substance, medication, or other medical condition
With regard to substance use, “tolerance” is characterized by:
Select one:
A. the need to increase the amount of the drug to achieve desired effects or the development of withdrawal symptoms when the amount of the drug is not increased.
B. the need to increase the amount of the drug to achieve desired effects accompanied by a persistent craving for the drug.
C. the need to increase the amount of the drug to achieve desired effects or a markedly diminished effect of the drug with continued use of the same amount.
D. the need to increase the amount of the drug to avoid withdrawal symptoms accompanied by a persistent craving for the drug.
Answer C is correct: Tolerance is one of the symptoms of Substance Use Disorder, and this answer accurately describes tolerance.
The correct answer is: the need to increase the amount of the drug to achieve desired effects or a markedly diminished effect of the drug with continued use of the same amount.
Following her divorce nine months ago, Melody, age 29, developed intermittent abdominal pain and frequent morning headaches. She’s concerned that these symptoms mean that she has cancer or other life threatening illness, and constant worry about her health has made it difficult for her to care for her children, spend time with her friends, and concentrate at work. Assuming that a physical exam has ruled out a physical cause for her symptoms, the most likely DSM-5 diagnosis for Melody is:
Select one:
A. Somatoform Disorder NOS
B. Conversion Disorder with mixed symptoms
C. Pain Disorder
D. Somatic Symptom Disorder with predominant pain
Answer D is correct: The most likely diagnosis for Melody is Somatic Symptom Disorder, which is characterized by the presence of one or more somatic symptoms accompanied by excessive thoughts, feelings, or behaviors related to the symptoms. Because her symptoms involve only pain, the specifier “with predominant pain” is appropriate.
Answer A: Somatoform Disorder NOS is not a DSM-5 diagnosis.
Answer B: A diagnosis of Conversion Disorder requires the presence of symptoms that involve a disturbance in voluntary motor or sensory functioning and suggest a serious neurological or other medical condition with evidence that the symptoms are incompatible with recognized neurological and medical conditions.
Answer C: Pain Disorder is not a DSM-5 diagnosis.
The correct answer is: Somatic Symptom Disorder with predominant pain
Research on the effectiveness of the SSRIs has found that:
Select one:
A. a higher dose of an SSRI is usually required when treating OCD than when treating depression.
B. a lower dose of an SSRI is usually required when treating OCD than when treating depression.
C. a moderate dose of an SSRI is usually required when treating OCD but the correct dose for depression depends on the severity of symptoms.
D. a moderate dose of an SSRI is usually required when treating depression but the correct dose for OCD depends on the severity of symptoms.
The SSRIs have been identified as effective treatments for several disorders including Obsessive Compulsive Disorder (OCD) and Major Depressive Disorder.
a. CORRECT The research on SSRI dosage is limited and not entirely consistent. However, based on their meta-analysis of the studies, H. Bloch and colleagues concluded that a higher dose is required when treating OCD than when treating depression [Meta-analysis of the dose response relationship of SSRI in obsessive-compulsive disorder, Molecular Psychiatry, 15(8), 850-855, 2010].
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: a higher dose of an SSRI is usually required when treating OCD than when treating depression.
Which of the following is most true about Conduct Disorder?
Select one:
A. Individuals with childhood-onset type are more likely than those with adolescent-onset type to develop adult Antisocial Personality Disorder.
B. Individuals with adolescent-onset type are more likely than those with childhood-onset type to develop adult Antisocial Personality Disorder.
C. The majority of individuals with Conduct Disorder receive a diagnosis of Antisocial Personality Disorder in adulthood, regardless of age of onset.
D. Conduct Disorder is normally associated with Antisocial Personality Disorder only when there is a family history of antisocial behavior.
According to the DSM, the long-term outcomes for Conduct Disorder vary but, for the majority of individuals, it remits by adulthood.
a. CORRECT This is the best answer since there is evidence that an early onset of symptoms places the child at greatest risk for Antisocial Personality Disorder in adulthood.
b. Incorrect Adolescent onset is less associated with antisocial behavior in adulthood.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: Individuals with childhood-onset type are more likely than those with adolescent-onset type to develop adult Antisocial Personality Disorder.
Studies investigating the genetic contribution to major depression have found that:
Select one:
A. the risk for depression is significantly higher for biological offspring who have one parent with depression than for those who have two parents with the disorder.
B. the risk for depression is significantly higher for biological offspring who have two parents with depression than for those who have only one parent with the disorder.
C. the risk for depression is about the same for biological offspring who have either one parent or two parents with depression.
D. the risk for depression is significantly higher for biological offspring who have a mother with depression than for those who have a father with depression.
Although the research has confirmed a genetic contribution to depression, results related to the link between depression for parents and their biological offspring are contrary to what might be expected.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The studies have confirmed that having a biological parent with depression increases an offspring’s risk for major depression as well as a number of other disorders. However, the risk for depression is similar regardless of whether the child has one parent or two parents with major depression. See, e.g., Lieb, R. et al., Parental major depression and the risk of depression and other mental disorders in offspring: A prospective-longitudinal community study, Archives of General Psychiatry, 59, 365-374, 2002.
d. Incorrect The research has generally found that, in terms of rates of major depression, maternal and paternal depression affects offspring similarly. In the Lieb et al. study, the rate for depression was somewhat higher for the biological children of fathers with depression but the rates for children of fathers or mothers with the disorder were not significantly different.
The correct answer is: the risk for depression is about the same for biological offspring who have either one parent or two parents with depression.
In Alzheimer’s disease, neuron loss occurs throughout the brain. However, the greatest loss is in which of the following areas?
Select one:
A. medial temporal lobe
B. anterior parietal lobe
C. medial occipital lobe
D. posterior frontal lobe
The distinctive characteristics of Alzheimer’s disease are neuron loss, neurofibrillary tangles (tangles of protein), and amyloid plaques (clumps of scar tissue).
a. CORRECT The medial temporal lobe includes the entorhinal cortex, amygdala, and hippocampus, which are involved in memory and are most affected by Alzheimer’s disease.
b. Incorrect It is the posterior (not anterior) parietal lobe that is affected by Alzheimer’s.
c. Incorrect The occipital lobe is not one of the brain areas substantially affected by this disorder.
d. Incorrect The prefrontal area of the frontal cortex is affected more than the posterior area.
The correct answer is: medial temporal lobe
As described in the DSM-5, level of severity of Alcohol Use Disorder and other Substance Use Disorders is based on:
Select one:
A. degree of functional impairment.
B. number of symptoms.
C. the presence of tolerance and/or withdrawal.
D. the degree of distress caused by use of the substance.
Answer B is correct: The DSM-5 distinguishes between three levels of severity of the Substance Use Disorders based on the number of symptoms: mild (2 or 3 symptoms); moderate (4 or 5 symptoms); severe (6 or more symptoms).
Answers A, C, and D: See explanation for answer B.
The correct answer is: number of symptoms.
Individuals who receive a diagnosis of which of the following Personality Disorders are most likely to no longer meet all of the diagnostic criteria for the disorder when they reach middle age?
Select one:
A. Schizotypal Personality Disorder
B. Antisocial Personality Disorder
C. Paranoid Personality Disorder
D. Avoidant Personality Disorder
Although Antisocial Personality Disorder (APD) is considered to be chronic, symptoms often decrease or remit with increasing age.
a. Incorrect See explanation for response b.
b. CORRECT The reduction in symptoms in APD by middle age most often involves a decrease in criminal behaviors while other characteristic symptoms - especially problems related to interpersonal relationships - persist to some degree. See, e.g., J. Paris, Personality disorders over time: Implications for therapy, American Journal of Psychotherapy, 58(4), 420-429, 2004.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: Antisocial Personality Disorder
Presence of which of the following symptoms would help confirm a DSM diagnosis of Inhalant Intoxication?
Select one:
A. increased appetite, dry mouth, and tachycardia
B. unsteady gait, slurred speech, and tremor
C. nausea, vomiting, and muscle aches
D. fatigue, vivid and unpleasant dreams, and increased appetite
Answer B is correct: Symptoms of Inhalant Intoxication include dizziness, nystagmus, incoordination, slurred speech, unsteady gait, lethargy, depressed reflexes, psychomotor retardation, tremor, generalized muscle weakness, blurred vision, stupor or coma, and euphoria.
Answer A: Increased appetite, dry mouth, and tachycardia are symptoms of Cannabis Intoxication.
Answer C: Nausea, vomiting, and muscle aches are symptoms of Opioid Withdrawal.
Answer D: Fatigue, vivid and unpleasant dreams, and increased appetite are symptoms of Stimulant Withdrawal.
The correct answer is: unsteady gait, slurred speech, and tremor
It is often difficult to distinguish between Major and Mild Neurocognitive Disorder, Delirium, and Major Depressive Disorder in older adults. However, the presence of which of the following suggests that Delirium is the appropriate DSM-5 diagnosis?
Select one:
A. deficits in memory
B. fatigue or loss of energy
C. impaired attention and awareness
D. flight of ideas
Answer C is correct: As described in the DSM-5, the essential feature of Delirium is a disturbance in attention and awareness plus an additional disturbance in cognition (e.g., memory deficit, disorientation, language impairment, deficit in visuospatial ability, or perceptual distortion).
Answer A: Memory impairment is characteristic of all three disorders and, therefore, is not useful for distinguishing between them.
Answer B: Fatigue or a loss of energy is characteristic of Major Depressive Disorder.
Answer D: Flight of ideas is characteristic of manic and hypomanic episodes.
The correct answer is: impaired attention and awareness
Annabelle, age 32, is brought to a clinician by her sister who says she thinks Annabelle is in a cult. She states that Annabelle used to be a very fun-loving, intellectually curious, and affectionate individual, but since she became affiliated with this group over two years ago, she “doesn’t seem to be the same person.” The clinician notices that Annabelle is very quiet, doesn’t make eye contact, and appears “zoned out.” When her sister reaches out to touch her, Annabelle flinches as if in pain. Annabelle states that she’s a “new person” now and can “see reality for what it really is.” Based on this information, the most likely DSM-5 diagnosis for Annabelle is:
Select one:
A. Other Specified Dissociative Disorder
B. Posttraumatic Stress Disorder
C. Schizoid Personality Disorder
D. Major Depressive Disorder
Answer A is correct: Of the diagnoses listed, Other Specified Dissociative Disorder is the best fit. This diagnosis is assigned when the individual has some dissociative symptoms (in this case, appearing zoned out and the radical change in her personality as reported by her sister) that do not meet the full criteria for one of the other dissociative disorders. Because Annabelle’s symptoms appear to be related to her association with a cult, the full diagnosis would be Other Specified Dissociative Disorder with identity disturbance due to prolonged and intense coercive persuasion.
Answer B: While PTSD should be considered as a possibility (the client may have been subjected to abuse in the group), no information is provided in the question suggesting that she has the classic symptoms of PTSD such as intrusive thoughts, avoidance, and alterations in arousal and reactivity.
Answer C: The diagnosis of a Personality Disorder requires a persistent pattern of maladaptive behavior with an onset in adolescence or early adulthood. From her sister’s description, Annabelle was previously fun-loving, intellectually curious, and affectionate, and the personality change occurred after she joined the cult.
Answer D: Major Depressive Disorder is a condition to consider in this case given the client’s “shut down” presentation. However, the information provided in the question is not sufficient for this to be the most likely diagnosis.
The correct answer is: Other Specified Dissociative Disorder
For a person with Social Anxiety Disorder, panic attacks are:
Select one:
A. the result of interoceptive conditioning.
B. cued by specific social situations.
C. infrequent and nearly always unexpected.
D. indicative of a co-diagnosis of Panic Disorder.
Social Anxiety Disorder is also known as Social Phobia and is characterized by anxiety associated with one or more specific social situations.
a. Incorrect Interoceptive conditioning refers to classical conditioning that involves internal cues and is not a distinguishing characteristic of the panic attacks associated with Social Anxiety Disorder.
b. CORRECT A person with Social Anxiety Disorder may experience panic attacks but these attacks are related to known feared situations and are expected rather than unexpected. When the individual experiences recurrent unexpected panic attacks, the appropriate diagnosis is likely to be Panic Disorder or co-morbid Panic Disorder and Social Anxiety Disorder.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: cued by specific social situations.
Eliana, age 32, tells you that she often has trouble concentrating on her work and falling asleep at night because she’s constantly worrying about having cancer. She states that her older sister had surgery for breast cancer last year and her mother’s sister and uncle both had lung cancer. Eliana says she gets a physical exam every six months and has been reassured by the doctor that she’s okay; but she knows that, for some people, there are no symptoms of cancer until it’s too late to do anything about it. Eliana also tells you that she keeps checking her breasts for lumps and gets scared whenever she coughs because she thinks it might be an early sign of lung cancer. Eliana’s symptoms are most suggestive of which of the following DSM-5 disorders?
Select one:
A. Body Dysmorphic Disorder
B. Somatic Symptom Disorder
C. Hypochondriasis
D. Illness Anxiety Disorder
Answer D is correct: Illness Anxiety Disorder is characterized by a preoccupation with having a serious illness, an absence of somatic symptoms or the presence of mild somatic symptoms, a high level of anxiety about one’s health, and performance of excessive health-related behaviors (care-seeking type) or maladaptive avoidance of doctors, hospitals, etc. (care-avoidant type).
Answer A: Body Dysmorphic Disorder is characterized by a preoccupation with a defect or flaw in appearance that appears minor or is unobservable to others.
Answer B: Somatic Symptom Disorder involves the presence of somatic symptoms, while Illness Anxiety Disorder is characterized by the absence of somatic symptoms or the presence of only minimal symptoms. Eliana is worried about her health but does not actually have physical symptoms.
Answer C: Hypochondriasis is not a DSM-5 diagnosis.
The correct answer is: Illness Anxiety Disorder
A person with Dissociative Amnesia is unable to recall anything that happened to her during the first few hours after she was physically assaulted. As defined in the DSM, this is referred to as:
Select one:
A. localized amnesia.
B. selective amnesia.
C. anterograde amnesia.
D. retrograde amnesia.
Dissociative Amnesia can take one of several form - e.g., localized, selective, and generalized.
a. CORRECT The loss of memory for personal information limited to a circumscribed period of time is referred to as localized amnesia.
b. Incorrect Selective amnesia refers to a loss of memory for some, but not all, events during a circumscribed period.
c. Incorrect Anterograde amnesia is a general term that refers to the inability to form new memories and does describe the woman’s loss of memory. However, because it does not refer specifically to memory loss associated with Dissociative Amnesia, it is not the best answer to this question.
d. Incorrect Retrograde amnesia refers to a loss of memory for information already stored in long-term memory.
The correct answer is: localized amnesia.
Which of the following is characterized by intense sexually arousing fantasies, sexual urges, or behaviors that involve touching or rubbing against a nonconsenting person.
Select one:
A. fetishism
B. frotteurism
C. exhibitionism
D. trichotillomania
Paraphilias (Paraphilic Disorders in DSM-5) involve intense sexually arousing fantasies, sexual urges, or behaviors related to unusual objects, activities, or situations.
a. Incorrect Fetishism is characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving the use of nonliving objects (e.g., shoes, gloves).
b. CORRECT The information in the question accurately describes frotteurism.
c. Incorrect Exhibitionism involves intense sexual arousal from exposure of one’s genitals to an unexpecting person.
d. Incorrect Trichotillomania is an impulse control disorder that involves recurrent pulling of one’s own hair, causing noticeable hair loss.
The correct answer is: frotteurism
Project MATCH compared motivational enhancement therapy (MET), cognitive-behavioral coping skills therapy (CBT), and twelve-step facilitation (TSF) as treatments for alcoholism and found that:
Select one:
A. MET, CBT, and TSF had similar effects on drinking.
B. the effects of CBT on drinking were significantly greater than the effects of MET or TSF.
C. the effects of MET on drinking were significantly greater than the effects of CBT or TSF.
D. CBT and MET had significant effects on drinking only when combined with TSF.
Project MATCH was a five-year longitudinal study conducted by the National Institute on Alcohol Abuse and Alcoholism in the 1990s. It compared the effectiveness of MET, CBT, and TSF on two measures of alcohol consumption (percentage of days abstinent and average number of drinks per day) and tested the hypothesis that treatments are most effective when they are matched to certain patient characteristics.
a. CORRECT The study found that the three treatments had nearly identical positive effects on both outcome measures but that few patient-treatment matches resulted in an improvement in outcomes. Also, a subsequent analysis of the data by R. B. Cutler and D. A. Fishbain suggested that the apparent treatment effects were actually the result of selection effects - i.e., were due to the fact that individuals who were more likely to continue drinking dropped out of the study, while individuals who were more likely to stop drinking stayed in the study (Are alcoholism treatments effective? The Project MATCH data, BMC Public Health, 5, 75, 2005).
b. Incorrect See explanation for answer a.
c. Incorrect See explanation for answer a.
d. Incorrect See explanation for answer a.
The correct answer is: MET, CBT, and TSF had similar effects on drinking.
A physician is most likely to prescribe which of the following for a 36-year old man who has just received a diagnosis of Premature Ejaculation?
Select one:
A. a drug that stimulates dopamine receptors
B. a drug that inhibits GABA receptors
C. a drug that inhibits the reuptake of serotonin
D. a drug that stimulates the reuptake of endorphins
Premature ejaculation has been linked to low serotonin levels.
a. Incorrect Increased dopamine activity can cause or exacerbate premature ejaculation.
b. Incorrect GABA helps reduce anxiety. Therefore, it would likely be more effective to stimulate (rather than inhibit) GABA receptors.
c. CORRECT SSRIs (e.g., dapoxetine) are currently used to treat premature ejaculation.
d. Incorrect Endorphins have not been linked to premature ejaculation.
The correct answer is: a drug that inhibits the reuptake of serotonin
Research investigating the effectiveness of neurofeedback as a treatment for ADHD has generally found which of the following?
Select one:
A. It is not an effective approach for most individuals with this disorder.
B. It is an effective approach and exerts its strongest impact on symptoms of inattention and impulsivity.
C. It is an effective approach and exerts its strongest impact on symptoms of hyperactivity.
D. It is an effective approach only when used in conjunction with a central nervous system stimulant.
The results of recent research on the effects of neurofeedback (EEG biofeedback) as a nonpharmacological treatment for ADHD are summarized in a meta-analysis conducted by M. Arns, S. de Ridder, U. Strehl, M. Breteler, and A. Coenen [Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis, Clinical EEG and Neuroscience, 49(3), 180-189, 2009].
a. Incorrect See explanation for response b.
b. CORRECT Arns et al.’s meta-analysis produced a large effect size for inattention and impulsivity and a medium effect size for hyperactivity. Their results also indicated that the positive effects of neurofeedback remained stable or improved over a two-year period.
c. Incorrect See explanation for response b.
d. Incorrect The studies suggest that neurofeedback has benefits for about 70 to 80% of individuals with ADHD and that its effects are similar to those for stimulant medication. In other words, neurofeedback does not have to be combined with a stimulant drug but is effective when used alone.
The correct answer is: It is an effective approach and exerts its strongest impact on symptoms of inattention and impulsivity.
Functional brain imaging of a patient with mild-to-moderate Alzheimer’s disease is most likely to find which of the following?
Select one:
A. increased metabolism in the frontal lobes and basal ganglia
B. decreased metabolism in the prefrontal cortex and thalamus
C. reduced metabolism in the hippocampus and entorhinal cortex
D. increased metabolism in the hippocampus and amygdala
Knowing that atrophy in the hippocampus has been linked to the memory loss associated with Alzheimer’s disease would have helped you identify the correct answer to this question.
a. Incorrect Increased metabolism in the frontal lobes and basal ganglia has been linked to Obsessive-Compulsive Disorder.
b. Incorrect Decreased metabolism in the prefrontal cortex and thalamus has been linked to Schizophrenia.
c. CORRECT Neuronal degeneration in the medial temporal structures (entorhinal cortex, hippocampus, and amygdala) has been linked to Alzheimer’s disease. On a PET scan, this is manifested as reduced metabolism in these structures.
d. Incorrect Increased metabolism in the hippocampus and amygdala has not been linked to Alzheimer’s disease.
The correct answer is: reduced metabolism in the hippocampus and entorhinal cortex
A school psychologist is contacted by the father of one of the school’s students. He informs the psychologist that the family is moving to another state and requests that she provide him with a copy of his child’s records. The psychologist should:
Select one:
A. provide a copy of the records to the father as requested because he has a legal right to them.
B. provide a copy of the records to the father in a sealed envelope that is marked “confidential” and instruct him to give it to the school psychologist at the new school.
C. request the name and address of the new school and forward the records to the school psychologist once the family has moved.
D. refuse to release a copy of the records because they are the property of the school.
Although parents do have a legal right to examine school records, this does not mean they should necessarily be given a copy of them.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The action described in this answer is most consistent with Paragraph 2.3.7 of the APA’s General Guidelines for Providers of Psychological Services, requirements related to confidentiality provided in the Ethics Code, and the provisions of the Family Education Rights and Privacy Act (FERPA).
d. Incorrect See explanation for response c.
The correct answer is: request the name and address of the new school and forward the records to the school psychologist once the family has moved.
When working in military settings, a clinical psychologist should keep in mind that:
Select one:
A. clients should be informed of potential limits to confidentiality at the outset of the delivery of services.
B. confidential client information should not be revealed to military personnel without a client’s consent except when the client is a danger to self or others.
C. client confidentiality is treated in the same way that it is treated in other settings only when the client is self-referred.
D. legal and ethical requirements related to confidentiality are suspended as required by military rules and policies.
Department of Defense rules and policies may require breaches of confidentiality that would, in other situations, be unethical and illegal.
a. CORRECT Normally, client confidentiality should not be breached even in military settings. However, under certain circumstances (defined by the Department of Defense), military personnel may have access to confidential client information. APA has determined that breaches of confidentiality are acceptable in this situation when two conditions have been met: (1) a previous process has already addressed any options that would uphold the psychologist’s ethical responsibilities (i.e., whenever the ethical issue in question has been addressed previously), and (2) the conditions of the Department of Defense’s regulations have clearly been met (in most circumstances, a breach is required only when there is a demonstrable “need to know”). For a brief discussion of this issue, see the American Psychologist, 49(7), p. 665, 1994.
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: clients should be informed of potential limits to confidentiality at the outset of the delivery of services.
Following a review of the case, an HMO decides to deny further payment for sessions for a current client of yours. You believe that the client would benefit from additional therapy. You should:
Select one:
A. comply with the HMO’s request as long as the limits of treatment were discussed with the client at the onset of therapy.
B. continue to provide therapy to the client without compensation if necessary until other arrangements can be made.
C. consult with the client about her options in this situation.
D. file a complaint against the HMO.
An issue frequently addressed in the literature on managed care is the problem created when the managed care entity decides to discontinue coverage.
a. Incorrect It would be inappropriate both legally and ethically for a psychologist to cooperate immediately with an HMO’s decision if he/she believes that additional care is needed.
b. Incorrect This may not be necessary in this situation and may not even be required in other situations, especially when there are other options.
c. CORRECT Of the responses given, this is the best one. The psychologist should discuss the client’s options with him/her (one of which might be to file an appeal).
d. Incorrect If the psychologist believed that termination of services is contraindicated, he/she could file an appeal with the HMO (not a complaint).
The correct answer is: consult with the client about her options in this situation.
Dr. Dilemma is contacted by an insurance company, which wants information about a previous client of hers. The client’s fee was paid by the insurance company when he was seeing her, and the insurance company now wants information for part of its regular peer review process. Dr. Dilemma’s best course of action would be to:
Select one:
A. provide the insurance company with the information it requests.
B. provide the insurance company with the information it requests only after ensuring that the company will take steps to protect the client’s confidentiality.
C. provide the insurance company with the information it requests in a way that allows the client’s identity to be concealed.
D. refuse to release any information to the company unless she feels it is in the client’s best interests.
Problems related to confidentiality constituted one of the original objections to the peer review process. Insurance companies and other third-party payers have, however, been fairly responsible in finding ways to maintain the confidentiality of clients.
a. Incorrect See explanation for response b.
b. CORRECT Normal confidentiality requirements are relaxed in cases of peer review because of the necessity to provide review committees with information about clients. However, confidentiality is always an issue when releasing information about a client and, consequently, this would be the best course of action.
c. Incorrect Given the nature of the situation, this would not be possible. Even if it were, it would probably not be acceptable to the insurance company. In cases of peer review, the practice is for the insurance company to safeguard the client’s confidentiality (e.g., by removing the client’s name from the clinical information before passing it on to the committee).
d. Incorrect See explanation for response b. (In this situation, as in others involving the release of information, you would want to release only information you deem to be relevant.)
The correct answer is: provide the insurance company with the information it requests only after ensuring that the company will take steps to protect the client’s confidentiality.
When a research study requires participants to be deceived about its real purpose prior to their participation, they:
Select one:
A. do not have to be told the true purpose of the study as long as the deception was justified by the prospective value of the study.
B. do not have to be told the true purpose of the study unless not to do so would be likely to cause them psychological harm.
C. must be debriefed about the true purpose of the study immediately after their participation.
D. should be debriefed about the true purpose of the study as soon as possible after their participation.
This issue is addressed in Standard 8.07 of the APA’s Ethics Code and Principle III.26 of the Canadian Code of Ethics.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for resposne d.
c. Incorrect See explanation for response d.
d. CORRECT This answer is most consistent with ethical requirements. For example, Standard 8.07(c) of the Ethics Code states that “psychologists explain any deception that is an integral feature of the design and conduct of an experiment to participants as early as is feasible, preferably at the conclusion of their participation but no later than at the conclusion of the data collection.”
The correct answer is: should be debriefed about the true purpose of the study as soon as possible after their participation.
During an initial session with a client, the client tells Dr. Paphian that he and his wife have not been getting along well lately, and he thinks they may need couples counseling. As the client describes his wife, Dr. Paphian realizes that he had a brief affair with her ten years ago (prior to her marriage). Dr. Paphian should:
Select one:
A. make an appointment with the wife and discuss the matter with her before agreeing to see the couple together in therapy.
B. see the husband in individual therapy only and refer them to another therapist for couples therapy.
C. see the couple in therapy but not bring up the issue of his previous relationship unless the wife does.
D. not see the husband or the couple in therapy but, instead, make a referral to another therapist.
This situation is covered by the Ethic Code Standard 10.07, which prohibits psychologists from providing therapy to former sexual partners.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Seeing the couple in therapy would clearly violate the requirements of Ethical 10.07. Seeing the husband only is not as directly addressed by the Code, but certainly would represent a situation that might impair your objectivity or otherwise interfere with effectively performing your functions as a psychologist (Ethical Standard 3.05). It would also not be consistent with the requirement that psychologists avoid and minimize harm to clients (Ethical Standard 3.04).
The correct answer is: not see the husband or the couple in therapy but, instead, make a referral to another therapist.
When a psychologist’s work with clients will be supervised:
Select one:
A. the client must be told about this arrangement.
B. the client must be told about this arrangement and be given the supervisor’s name.
C. the client must be told about this arrangement only if his/her identity cannot be disguised in discussions with the supervisor.
D. the client must be told about this arrangement and, when the supervisor has legal responsibility for the case, must also be given the supervisor’s name.
This issue is addressed by Standard 10.01(c) of the Ethics Code.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect This sounds more like the requirement for consultation.
d. CORRECT The requirements for consultation and supervision are different and, even in a supervisory relationship, the information that must be given to the client varies, depending on the exact nature of the supervision. A client must always be told when a psychologist is being supervised, but need be told the supervisor’s name when the supervisor is legally responsible for the case.
The correct answer is: the client must be told about this arrangement and, when the supervisor has legal responsibility for the case, must also be given the supervisor’s name.
Dr. Acedia receives a phone call from a woman who he was sexually involved with for six months. The affair ended four years ago and Dr. Acedia has had little contact with the woman since that time. The woman says she is having trouble getting over the death of her younger sister and would like to begin counseling with Dr. Acedia. According to the Ethics Code:
Select one:
A. it is acceptable for Dr. Acedia to work with the woman in therapy since they are no longer involved in a relationship.
B. it is acceptable for Dr. Acedia to work with the woman in therapy since the relationship ended more than two years ago.
C. it is acceptable for Dr. Acedia to work with the woman in therapy only if he determines that to do so is not clinically contraindicated and will not be exploitative.
D. it is not acceptable for Dr. Acedia to work with the woman in therapy.
The issue of therapy with former sex partners is covered by Standard 10.07 of the APA’s 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 that “Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies.”
The correct answer is: it is not acceptable for Dr. Acedia to work with the woman in therapy.
You hear a rumor that one of your co-workers has a habit of sexually harassing the younger female employees. You start paying closer attention to his behavior and discover that the rumors are not unfounded. Your best course of action in this situation would be to:
Select one:
A. maintain a record of your observations and present them to the company’s Director.
B. approach the young women who have been harassed and suggest they file a complaint with the Ethics Committee.
C. discuss your observations and the rumors you have heard with the co-worker.
D. do nothing since your co-worker’s behaviors are basically harmless.
Standard 3.04 of the Ethics Code requires that psychologists attempt to minimize harm against individuals with whom psychologists work, and Standards 1.04 and 1.05 require psychologists to take action when a colleague is acting unethically.
a. Incorrect Maintaining a record of your observations is not necessarily something you would need to do. Also, making a report to the Director of the organization would, in most cases, not be the best initial course of action.
b. Incorrect This might be acceptable. A problem, though, is there is nothing in the question that says your co-worker is a psychologist or other professional. Be sure to read carefully!
c. CORRECT This is always a best first course of action if you feel comfortable in confronting the individual who has allegedly acted unethically.
d. Incorrect As a psychologist, you have a responsibility to take action when you see a colleague sexually harassing co-workers and others.
The correct answer is: discuss your observations and the rumors you have heard with the co-worker.
A psychologist wants to assess a client with a test that has not yet been validated for the client’s ethnic group. To be consistent with the provisions of the Ethics Code, the psychologist:
Select one:
A. should explain the limitations of the test results to the client.
B. should assess the client only if the test results are “imminently needed.”
C. should assess the client only if the assessment has been approved by the insurance company.
D. should not assess the client using the test under any circumstances.
Psychologists use assessment instruments whose validity and reliability have been established for use with members of the population tested. When such validity or reliability has not been established, psychologists describe the strengths and limitations of test results and interpretation [Ethical Standard 9.02(b)].
a. CORRECT This answer is most consistent with the requirements of the Ethics Code.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: should explain the limitations of the test results to the client.
You suspect a colleague of violating ethical guidelines. To be consistent with the provisions of the Ethics Code, you should:
Select one:
A. report the colleague to the local Ethics Committee immediately.
B. report the colleague to the local Ethics Committee only if the ethical violation is a serious one.
C. attempt to handle the situation informally by discussing the violation with the colleague and file a report only if he is uncooperative.
D. either handle the situation informally or file a report, depending on which course of action you believe is most appropriate.
The provisions of the Ethics Code allow psychologists to use their own discretion about the best course of action in cases where another psychologist is suspected of acting unethically.
a. Incorrect See the explanation for response d.
b. Incorrect See the explanation for response d.
c. Incorrect See the explanation for response d.
d. CORRECT Psychologists can either attempt to resolve an ethical infraction informally or file a complaint with the Ethics Committee, depending on which course of action they deem most appropriate. (Of course, it is always necessary to consider client confidentiality first before taking any action, but none of the responses given address this issue.)
The correct answer is: either handle the situation informally or file a report, depending on which course of action you believe is most appropriate.
An expert witness is recognized by the court to be qualified to offer opinions on a specific issue. To qualify as an expert witness, a psychologist must:
Select one:
A. have a valid professional license.
B. have a relevant doctoral degree from an accredited school.
C. have appropriate education, training, and experience.
D. be certified as a forensic psychologist by the ABPP.
An expert witness is ordinarily approved by the court through the process of voir dire during which the witness’s education, training, and experience are examined.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Requirements for expert testimony are provided in state and federal law. For example, Federal Rule of Evidence 702 states: “A witness who is qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion or otherwise if: (a) the expert’s scientific, technical, or other specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue; (b) the testimony is based on sufficient facts or data; (c) the testimony is the product of reliable principles and methods; and (d) the expert has reliably applied the principles and methods to the facts of the case.”
d. Incorrect See explanation for response c.
The correct answer is: have appropriate education, training, and experience.
Dr. Baron’s husband owns an advertising agency that caters to small businesses. One of Dr. Baron’s clients has just started a new business and tells Dr. Baron that he’s in need of someone to handle his advertising. If Dr. Baron recommends her husband, this is:
Select one:
A. acceptable since her husband’s business is unrelated to her work as a therapist.
B. acceptable as long as Dr. Baron never discusses the client with her husband.
C. acceptable as long as Dr. Baron discusses the possible consequences of the situation with the client.
D. unacceptable because of Dr. Baron’s therapeutic relationship with the client.
This issue is not addressed directly by the Ethics Code. However, the general “spirit” of the Code is not to become involved with a therapy client in any way that is outside the scope of the therapeutic relationship.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT R. Woody addresses this issue in Legally safe mental health practice: Psycholegal questions and answers (Madison, CT, Psychosocial Press, 1997). He argues that any recommendations to a client should be limited to issues that are within the “perimeter of treatment” and that do not benefit the therapist beyond his/her customary fee.
The correct answer is: unacceptable because of Dr. Baron’s therapeutic relationship with the client.
During your first session with a client, she reveals that she’s been seeing another therapist for the past four months. The woman seems unsure about why she has come to see you. Your best course of action would be to:
Select one:
A. continue seeing the client and help her clarify her motives and goals for coming to see you.
B. explain to the client that it would be unethical to see her while she is receiving similar services from another therapist and discontinue seeing her.
C. contact the other therapist to see if your services are redundant and, if they are, tell the client you cannot continue seeing her while she is seeing the other therapist.
D. help the client clarify her reasons for seeing both you and the other therapist and then evaluate whether it is appropriate for her to continue seeing both of you.
This is a fairly easy question. You’d want to make sure that you’ve read all of the responses before answering, however, since response a is not entirely incorrect but response d is better.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Although psychologists are not prohibited from seeing clients who are receiving services from another mental health professional, a psychologist would not want to duplicate the services of another professional for an extended period of time. From both a clinical and ethical perspective, the best course of action would be to help the woman clarify her goals and needs with regard to the services provided by you and the other therapist and then determine the best course of action.
The correct answer is: help the client clarify her reasons for seeing both you and the other therapist and then evaluate whether it is appropriate for her to continue seeing both of you.
The use of a collection agency to collect delinquent fees from a former client is:
Select one:
A. unethical and illegal.
B. unethical but legal.
C. ethical under certain circumstances.
D. always ethical.
A therapist, like anyone else, has a right to be paid for his/her services.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The use of a collection agency is not unethical as long as certain precautions are taken: Ideally, the client should be told at the outset of therapy what the therapist’s policy is regarding the collection of delinquent fees. Even more important, the client should be notified of the intention to use a collection agency if delinquent fees are not paid within a specified period of time (See Standard 6.04(e) in the Ethics Code).
d. Incorrect See explanation for response c.
The correct answer is: ethical under certain circumstances.
You are hired by a university to teach a graduate seminar in the psychology department. In terms of the Ethics Code, you are explicitly required to do which of the following?
Select one:
A. ensure that the course content reflects the most recent research in the area
B. ensure that accurate information about the seminar is available to all interested parties
C. ensure that the seminar content is consistent with the interests and needs of the students
D. ensure that the grading and evaluation of students is fair
The issue addressed by this question is covered in Ethical Standard 7.02 of the Ethics Code.
a. Incorrect This is generally a good idea but it is not explicitly required by the Code. Also, there would be times when it would not apply - e.g., when the seminar is covering the history of clinical psychology.
b. CORRECT Of the responses given, only this one represents the explicit requirements of the Ethics Code.
c. Incorrect Although student interests and needs are a consideration when defining course content, they are certainly not the only consideration. Also, this is not explicitly required by the Code.
d. Incorrect Again, this is a good idea, but it is not specifically stated in the Ethics Code.
The correct answer is: ensure that accurate information about the seminar is available to all interested parties
With regard to sexual harassment, the APA’s Ethical Principles of Psychologists and Code of Conduct:
Select one:
A. prohibits denying employment, tenure, or promotion to an individual because he/she has filed a sexual harassment charge.
B. prohibits denying employment, tenure, or promotion to an individual because he/she has filed or is the subject of a sexual harassment charge.
C. prohibits denying employment, tenure, or promotion to an individual because he/she has filed or is the subject of a sexual harassment charge or has been found guilty of sexual harassment.
D. none of the above.
This issue is addressed in Standard 1.08 of the Ethics Code.
a. Incorrect See explanation for response b.
b. CORRECT This response best summarizes the provisions of Standard 1.08. While the Code prohibits denying a person employment, tenure, or promotion solely on the basis of having filed or been the subject of a sexual harassment charge, the Code also states that, “This does not preclude taking action based upon the outcome of such proceedings or considering other appropriate information.”
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: prohibits denying employment, tenure, or promotion to an individual because he/she has filed or is the subject of a sexual harassment charge.
A therapist has been seeing a couple for several weeks. Although they seem reluctant to bring in their 13 year old daughter, the therapist finally convinces them that the problems they have been experiencing seem to be related to their daughter and that it would be good to include her in therapy sessions. It soon becomes clear that the girl has been sexually abused by her father. When the therapist confronts the man about this, he admits that he molested his daughter on two occasions but says that he has not done so in over a year. The girl confirms that this is true. The parents plead with the therapist not to make a report to the authorities and promise that they will continue in treatment to make sure that the father doesn’t sexually abuse the girl again. The therapist decides to comply with the wishes of the parents since the abuse occurred in the past and the family is apparently committed to obtaining psychological help. Which of the following statements best describes the ethical and legal issues in this case?
Select one:
A. The therapist is acting ethically and legally since he is clearly taking the welfare of his clients into consideration.
B. The therapist is acting ethically since the abuse has occurred in the past but may be acting illegally.
C. The therapist is acting unethically and illegally by not making a report to the appropriate authorities.
D. There is not enough information to make a judgment in this case.
In their discussion of a similar case, COPS (American Psychologist, July 1988) concluded that “in view of APA policy statements and guidelines and relevant state laws pertaining to the reporting of child abuse, the psychologist was obligated to report the abuse to the appropriate state social service authorities. Failing to do so violated both professional standards and legal obligations.”
a. Incorrect A psychologist is legally and ethically bound to report cases of child abuse.
b. Incorrect The fact that the abuse occurred in the past does not free a psychologist from the responsibility of making a report to the appropriate authorities.
c. CORRECT The psychologist’s failure to make a child abuse report in this situation violates ethical and legal requirements.
d. Incorrect There is sufficient information to conclude that a report should have been made.
The correct answer is: The therapist is acting unethically and illegally by not making a report to the appropriate authorities.
During the first therapy session with a new client, you realize that he is the father of a young woman you have been seeing in therapy for three months. The daughter is 22 years old and no longer lives with her parents. The most relevant ethical issue in this situation is:
Select one:
A. confidentiality.
B. multiple relationship.
C. nonmaleficience.
D. informed consent.
This is a straightforward question that may have seemed “too obvious.” When taking the exam, be sure not to sabotage your ability to choose the correct response to an easy item by assuming that it is a “trick question.”
a. Incorrect See explanation for response b.
b. CORRECT Multiple relationships occur when a psychologist is involved in more than one role with a person (and at least one role is a professional relationship) or has a professional relationship with one person and becomes involved in a relationship with another individual who is related to that person. In most situations, multiple relationships should be avoided.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: multiple relationship.
A psychologist is working in the employee assistance program (EAP) of a large corporation. She is approached by a supervisor who referred an employee to the EAP several weeks ago when the employee was having problems at home that began interfering with her job performance. The employer now wants to know if the employee has been receiving counseling from the psychologist and, if so, how the sessions are going. In fact, the employee has seen the psychologist four times and has another session scheduled for the next week. The psychologist should:
Select one:
A. inform the supervisor that she has seen the employee but provide no information about the employee’s treatment.
B. inform the supervisor that she has seen the employee and provide a summary of the employees progress with regard to the reason for the referral.
C. remind the supervisor of the need to maintain confidentiality and provide him with no information about the employee.
D. tell the supervisor that she will have to get permission from the employee before providing the supervisor with any information about the employees progress.
Overall, confidentiality in an EAP is dealt with in the same way it is handled elsewhere.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The confidentiality of clients of EAPs may be breached only in legally defined situations - e.g., when the client signs a release or is believed to be a danger to him/herself or others. Therefore, the psychologist would not even want to say anything that indicates whether or not she is seeing the employee (answer d).
The literature has changed a bit regarding this issue. The Ethics and Professional Issues chapter provides this discussion about the issue:
Employee assistance programs (EAPs): Confidentiality may be breached in the context of an EAP in the same situations that it can be breached in other contexts - that is, when the client signs an authorization for release of confidential information and in situations when disclosing confidential information without an authorization is permitted or required by law (e.g., when the client is believed to be a danger to him/herself or others).
The correct answer to this question is most consistent with this excerpt.
d. Incorrect See explanation for response c.
The correct answer is: remind the supervisor of the need to maintain confidentiality and provide him with no information about the employee.
Which of the following best describes the requirements of the ethics codes of the American and Canadian Psychological Associations with regard to obtaining informed consent from research participants?
Select one:
A. An informed consent is always required unless the study will involve deception and the deception meets ethical guidelines.
B. An informed consent is not required as long as participants will be debriefed at the end of the study.
C. An informed consent may not be required when the study is unlikely to cause harm or is exempted by legal or institutional regulations.
D. An informed consent is always required.
Informed consents are addressed in Standards 8.02 and 8.05 of the APA’s Ethics Code and Principles I.19 and I.20 of the Canadian Code of Ethics.
a. Incorrect An informed consent cannot be obtained when a study involves deception, but there are other circumstances when an informed consent is not necessary, so this is not the best answer.
b. Incorrect Debriefing is not a substitute for obtaining an informed consent.
c. CORRECT This answer best describes ethical requirements regarding dispensing with informed consents in research.
d. Incorrect Informed consents are not always required.
The correct answer is: An informed consent may not be required when the study is unlikely to cause harm or is exempted by legal or institutional regulations.
Of the cases processed by the APA’s Ethics Committee as the result of revocation of a psychologist’s license by a state licensing board, the most common complaint processed by the committee is which of the following?
Select one:
A. loss of licensure in another jurisdiction
B. sexual misconduct
C. breach of confidentiality
D. issues related to competence
The correct answer is: B. A review of the reports of the APA’s Ethics Committee published in the American Psychologist from 2000 through 2008 reveals that sexual misconduct with an adult is the most frequent reason for the complaints processed by the Ethics Committee; followed by, in order, inappropriate practice involving child custody, nonsexual dual relationship, and inappropriate practice involving insurance or fees.
The correct answer is: sexual misconduct
A psychologist conducts a custody evaluation for a divorce proceeding. In terms of making a specific recommendation about custody, the psychologist should:
Select one:
A. avoid making a recommendation and, instead, leave the final decision to the court.
B. make a recommendation only if the assessment has involved procedures that have been validated for this purpose.
C. make a recommendation only if he/she was not retained by one of the parents but was retained by the court.
D. make a recommendation only if it is based on adequate psychological data and consideration of the best interests of the child.
There are no prohibitions against making recommendations in custody situations. However, a psychologist must always be very careful about recommendations that may have an important impact on the lives of others.
a. Incorrect Making specific recommendations is not always prohibited.
b. Incorrect While this is important, it is not the best answer of those given.
c. Incorrect This doesn’t really make any sense since, in many cases, the psychologist will have been hired by one of the parties rather than by the court.
d. CORRECT This is the closest to the provisions of APA’s Guidelines for Child Custody Evaluations in Family Law Proceedings.
The correct answer is: make a recommendation only if it is based on adequate psychological data and consideration of the best interests of the child.
You receive a subpoena duces tecum requiring you to testify about a current client at a trial and to bring specific documents from the client’s file. You contact the client who states that he does not want you to testify or release his records. You should:
Select one:
A. notify the court that you will not be appearing at the trial because the client has not given you permission to do so.
B. contact the attorney who issued the subpoena to request that you be released from it.
C. advise the attorney who issued the subpoena that you will not be appearing at the trial because the client has not given permission for you to release confidential information.
D. do nothing further until you receive an order from the court.
A subpoena legally requires a psychologist to appear at a designated time at a deposition or trial. When the client invokes the privilege, the subpoena is still valid and the psychologist must appear unless he/she has been released from it.
a. Incorrect See explanation for response b.
b. CORRECT This issue is addressed by S. H. Behnke and J. T. Hilliard (The essentials of Massachusetts mental health law, W. W. Norton, New York, 1998). They note that, when the client invokes the privilege, the psychologist should contact the client’s attorney or his/her own attorney to discuss the matter. In addition, the psychologist can contact the attorney who issued the subpoena to request to be released from it. Unless the psychologist receives a written release, he/she must appear as requested (but, of course, will not reveal confidential information without the client’s consent). Additional information about responding to a subpoena is provided in the Ethics and Professional Issues chapter of the written study materials.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: contact the attorney who issued the subpoena to request that you be released from it.
To be consistent with ethical requirements, when asked by a client’s insurance company to electronically transfer confidential information about the client to the company, you should:
Select one:
A. refuse to do so.
B. also send a written (non-electronic) copy of the information to the company.
C. make sure the records are clearly marked “confidential.”
D. make sure that personal identifiers are coded or removed.
Standard 6.02(b) of the APA’s Ethics Code states that, “If confidential information concerning recipients of psychological services is entered into databases or systems of records available to persons whose access has not been consented to by the recipient, psychologists use coding or other techniques to avoid the inclusion of personal identifiers.”
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Since you wouldn’t have control over who sees the records once they’ve been transmitted, this course of action would most likely ensure that client information is kept confidential. You would probably also want to mark the information as confidential but this would not be adequate.
The correct answer is: make sure that personal identifiers are coded or removed.
A clinical psychologist routinely administers personality tests to her clients to assist in diagnosis. She also uses the test data in her ongoing research project. This is:
Select one:
A. ethical as long as the identity of the clients is not made available to the research project.
B. ethical as long as the research is exempt from an informed consent.
C. unethical unless she gets each client’s consent to participate in the research study.
D. unethical since this represents a multiple relationship.
It would be necessary to obtain an informed consent from the clients before conducting the assessment, and the informed consent must include “an explanation of the nature and purpose of the assessment” [Standard 9.03(a)].
a. Incorrect This would not be sufficient.
b. Incorrect Psychological testing ordinarily does require a consent both in therapy and research settings, and, even when a formal consent is not required, appropriate information about the purpose of testing is mandated.
c. CORRECT The clients believe that they are being tested for diagnostic and treatment purposes. To use the test data for other reasons without their consent would be unethical.
d. Incorrect Dual (multiple) relationships are, of course, discouraged but are not entirely prohibited. There is no information provided in the question that suggests that this situation would constitute a potentially harmful multiple relationship, so this is not the best answer.
The correct answer is: unethical unless she gets each client’s consent to participate in the research study.
During a court-ordered evaluation of a defendant to determine his competence to stand trial, the defendant reveals information that confirms his guilt. The psychologist conducting the evaluation should:
Select one:
A. include this information in his evaluation report since the evaluation was court-ordered.
B. include the information in his evaluation report because privilege is waived whenever a defendant’s mental status is part of the defense.
C. include only information relevant to the defendant’s competence in the evaluation report.
D. not provide any information to the court without a waiver of confidentiality from the defendant or his attorney.
A competence to stand trial hearing is conducted to determine a defendant’s current mental status. Although defendants cannot ordinarily be forced to provide incriminating evidence against themselves (as provided by the Fifth Amendment), most jurisdictions do compel defendants to undergo a competence evaluation if the court determines it is appropriate.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The defendant is protected in this situation by laws that prohibit the use of evaluation data to determine the defendant’s guilt without his/her consent. In discussing this issue, G. B. Melton et al. conclude that the therapist’s best course of action is not to include any possibly incriminating evidence in the competency report but, instead, to include only information relevant to determining the defendant’s competence to stand trial (Psychological evaluations for the court, New York, Guilford, 1987).
d. Incorrect See explanation for response c.
The correct answer is: include only information relevant to the defendant’s competence in the evaluation report.
Which of the following is a correct use of HIV- or AIDS-related language?
Select one:
A. AIDS virus
B. AIDS-infected person
C. HIV virus
D. person with HIV
Several organizations have published guidelines for referring to HIV and AIDS. The following information is from the Style Sheet for HIV published by the Joint United Nations Programme on HIV/AIDS.
a. Incorrect There is no “AIDS virus.” People with AIDS are infected with the human immunodeficiency virus (HIV).
b. Incorrect People are infected with HIV, not AIDS.
c. Incorrect HIV includes the word “virus,” so HIV virus is redundant.
d. CORRECT This phrase is consistent with the Joint United Nation’s Style Sheet as well as with the APA’s Publication Manual guidelines for the use of nonbiased language.
The correct answer is: person with HIV
The duty to warn/protect established by the Tarasoff decision applies to:
Select one:
A. clients who are a danger to themselves.
B. clients who have committed a past crime against a person or property.
C. clients who are a danger to an identifiable person or, in some jurisdictions, an identifiable class (group) of persons.
D. clients who may pose a danger to others because of past violent behavior or their current mental state.
The application of the Tarasoff decision remains controversial and continues to be modified by case law.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This response best describes the current status of Tarasoff. Most jurisdictions that have adopted this ruling require psychologists to warn/protect an identifiable potential victim of a client; and, in some jurisdictions, this has been extended to an identifiable class of victims. Additional information about the Tarasoff decision is provided in the chapter on ethics and professional issues in the written study materials.
d. Incorrect See explanation for response c.
The correct answer is: clients who are a danger to an identifiable person or, in some jurisdictions, an identifiable class (group) of persons.
An organizational psychologist conducts a(n) \_\_\_\_\_\_\_\_\_ to determine the relative worth of a job compared to other jobs. Select one: A. utility analysis B. needs assessment C. performance appraisal D. job evaluation
For the exam, you want to be familiar with several “vocabulary words” that describe important activities in organizational settings.
a. Incorrect Utility refers to the feasibility of a measure, often in terms of its costs.
b. Incorrect A needs assessment (analysis) is conducted to identify training needs.
c. Incorrect A performance appraisal is an assessment of an employee’s job performance.
d. CORRECT Job evaluations are conducted for the purpose of establishing the worth of a job so that an appropriate wage can be defined for that job.
The correct answer is: job evaluation
An assumption underlying the notion of “groupthink” is that:
Select one:
A. pressures toward uniformity limit task effectiveness.
B. increasing cohesiveness results in more extreme decisions.
C. excessive pressures toward conformity produce reactance.
D. lack of familiarity with task demands leads to maintenance of the status quo.
Groupthink is characterized by a decrease in willingness to consider divergent points of view, resulting in inappropriate decisions and actions (although not necessarily more extreme ones).
The correct answer is A.
According to Janis (1972, 1982), groupthink results when groups become excessively cohesive. For information on other conditions that contribute to groupthink, see the Industrial-Organizational chapter of the written study materials.
The correct answer is: pressures toward uniformity limit task effectiveness.
A company decides to change the way it pays its sales force by moving away from uncertain commissions to a more predictable salary. According to Maslow’s need hierarchy theory, this change will have the greatest impact on employees whose most prepotent need is which of the following?
Select one:
A. growth
B. esteem
C. safety
D. existence
Maslow distinguished between five basic needs: physiological, safety, social, esteem, and self-actualization.
a. Incorrect Growth is not one of Maslow’s needs.
b. Incorrect Esteem needs are satisfied by providing employees with opportunities that maximize self-respect and the approval and recognition of others.
c. CORRECT Safety needs are satisfied by providing employees with a secure environment. In the situation described in this question, the company is reducing uncertainty by providing a salary and, thereby, improving employees’ sense of security.
d. Incorrect Existence is not one of Maslow’s needs.
The correct answer is: safety
A needs assessment ordinarily consists of three components. These are:
Select one:
A. evaluative, formative, and summative analysis.
B. job, person, and organizational analysis.
C. unfreezing, changing, and refreezing.
D. knowledge, skills, and abilities.
A needs assessment is conducted in organizations to determine training needs.
a. Incorrect See explanation for response b.
b. CORRECT A comprehensive needs assessment includes an analysis of the job requirements, the people performing the job, and the goals of the organization. Additional information about needs assessment is provided in the Industrial-Organizational Psychology chapter of the written study materials.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: job, person, and organizational analysis.
The owner of a company has decided that, to determine how well employees are performing, employees will be watched while performing their jobs for a predetermined period of time. Based on the relevant research, you predict that the employees’ performance during the period of observation will:
Select one:
A. be inhibited if the task is easy.
B. be inhibited if the task is complex.
C. be enhanced whether the task is easy or complex.
D. be inhibited whether the task is easy or complex.
It has been found that, in certain circumstances, the presence of others inhibits task performance (social inhibition), while in other circumstances, the presence of others facilitates task performance (social facilitation).
a. Incorrect When the task is simple or well-learned, the presence of others tends to enhance task performance.
b. CORRECT The presence of others tends to inhibit performance when the task is complex or unfamiliar.
c. Incorrect See explanations for responses a and b.
d. Incorrect See explanations for responses a and b.
The correct answer is: be inhibited if the task is complex.
