STUDY-MODE - Practice Exam 5 Flashcards
A structural family therapist would use a family map to:
Select one:
A. facilitate interactions between family members during a therapy session.
B. help family members recognize differences in their perceptions.
C. identify family values, life themes, and significant life events.
D. clarify the nature of the boundaries between family subsystems.
Knowing that boundaries are a key focus of Minuchin’s structural family therapy would have helped you identify the correct answer to this question.
a. Incorrect This describes the goal of enactment.
b. Incorrect This is a goal of circular questions, which are used by Milan systematic family therapists.
c. Incorrect Identifying and using family values, life themes, and significant life events in conversations during therapy is referred to as tracking.
d. CORRECT A family map is used to help make a structural diagnosis of a family by clarifying its boundaries, coalitions, alignments, etc.
The correct answer is: clarify the nature of the boundaries between family subsystems.
From a “control systems” perspective, when established control mechanisms are no longer effective due to radical changes in the environment, new mechanisms must be sought or developed. These new mechanisms will help the system adapt to environmental changes by providing:
Select one:
A. negative feedback.
B. positive feedback.
C. formative evaluations.
D. summative evaluations.
Although it’s probably not clear because of the way this question is worded, this information is relevant to family therapy, which incorporates the principles of cybernetics.
a. Incorrect From a control systems (cybernetics) perspective, negative feedback maintains a system in a steady state. Negative feedback is not useful, however, when the system is faced with extreme changes in the environment.
b. CORRECT Although, under normal circumstances, positive feedback induces change and can result in “runaways,” when the system must adapt to radical changes in the environment, it is positive feedback that makes adaptation possible.
c. Incorrect Formative evaluation is not relevant to control systems.
d. Incorrect Summative evaluation is not relevant to control systems.
The correct answer is: positive feedback.
Experts on cross-cultural counseling note that, when working with African American clients, it is important to recognize that their past experiences in a racist society are likely to have fostered feelings of powerlessness. Consequently, a good strategy for a therapist is to adopt a:
Select one:
A. non-directive, less active approach.
B. problem-solving, time-limited approach.
C. color-blind approach.
D. neutral, educative approach.
In general, experts in the field of cross-cultural counseling agree that goal-directed therapies are most effective with members of most minority groups.
a. Incorrect See explanation for response b.
b. CORRECT According to M. K. Ho, “Regardless of the nature of the family’s problem(s), Black families are likely to be most responsive to problem-solving, time-limited family therapy approaches” (Family therapy with ethnic minorities, Newbury Park, Sage Publications, 1987).
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: problem-solving, time-limited approach.
From the perspective of Freudian psychoanalytic theory, the defense mechanism of _______________ is viewed as underlying all other defense mechanisms.
Select one:
A. regression
B. repression
C. sublimation
D. projection
The goal of all of the defense mechanisms can be said to be keeping unwanted thoughts and impulses out of consciousness.
a. Incorrect Regression occurs when an individual reverts to behaviors characteristic of an earlier stage in life in order to avoid anxiety-producing impulses.
b. CORRECT Repression involves pushing unacceptable id impulses into the unconscious. Repression can be viewed as the most “basic” of the defense mechanisms since the goal of all defense mechanisms is to make unwanted impulses unconscious.
c. Incorrect Sublimation involves channeling unwanted impulses into socially-acceptable endeavors. It is considered the most “advanced” of the defense mechanisms.
d. Incorrect Projection occurs when an individual attributes his/her unwanted impulses to other people.
The correct answer is: repression
Prochaska, Norcross, and DiClemente’s (1994) transtheoretical model distinguishes between 10 different change processes and proposes that the most effective combination of processes depends on a client’s stage of change. For example, they recommend consciousness raising, dramatic relief, and environmental re-evaluation as useful strategies for helping clients transition into the __________ stage.
Select one:
A. maintenance
B. conformity
C. action
D. contemplation
The transtheoretical model distinguishes between six stages of change:
Precontemplation Contemplation Preparation Action Maintenance Termination.
a. Incorrect The optimal combination of change processes for clients in the maintenance stage is supportive (helpful) relationships, commitment, countering, environmental control, and social liberation.
b. Incorrect Conformity is not one of the stages of change identified by Prochaska, Norcross, and DiClemente.
c. Incorrect The most effective change processes for clients in the action stage are the same as those for clients in the maintenance stage (answer a).
d. CORRECT Prochaska, Norcross, and DiClemente recommend this combination of change processes for helping clients transition from the precontemplation to the contemplation stage.
The correct answer is: contemplation
An African American therapy client exhibiting the “split-self syndrome” as a response to racial oppression will most likely:
Select one:
A. exhibit a high degree of detachment from his family and neighborhood.
B. avoid contacts with Whites.
C. evaluate himself against White standards.
D. exhibit a high degree of “functional paranoia.”
Chronic exposure to racial oppression can have several consequences, one of which is the development of the “split-self syndrome” (see, e.g., J. Landrum-Brown, Black mental health and racial oppression, in D. S. Ruiz and J. P. Comer, Handbook of mental health and mental disorder among Black Americans, Greenwood Press, NY, 1990).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT According to Landrum-Brown, the split-self syndrome “is a result of accepting a polarized, hierarchical manner of thinking and accepting negative racial messages.” For African Americans, one manifestation of this syndrome is evaluating oneself against White standards.
d. Incorrect See explanation for response c.
The correct answer is: evaluate himself against White standards.
Cultural universalism is to cultural relativism as:
Select one:
A. emic is to etic.
B. etic is to emic.
C. alloplastic is to autoplastic.
D. autoplastic is to alloplastic.
An ongoing debate in the literature is about the degree to which psychological principles are universal versus specific in terms of their application to individuals from different cultures.
a. Incorrect See explanation for response b.
b. CORRECT An etic approach is based on the assumption that universal principles apply across cultures while an emic approach is based on the assumption that cultures vary and, consequently, cannot always be understood from the perspective of universal principles. In other words, the etic approach is universalistic, while an emic approach is relativistic.
c. Incorrect The terms alloplastic and autoplastic are used to describe different types of interventions: Alloplastic interventions focus on changing the individual’s situation, while autoplastic interventions focus on changing the individual.
d. Incorrect See explanation for response c.
The correct answer is: etic is to emic.
In the context of Freudian psychoanalysis, the goal of confrontation is to:
Select one:
A. reduce the client’s resistance.
B. clarify a client’s statements.
C. help the client see a behavior in a new way.
D. foster the development of transference.
Freudian psychoanalysis can be conceptualized as involving four processes:
Confrontation
Clarification
Interpretation
Working through.
a. Incorrect See explanation for response c.
b. Incorrect This sounds more like the goal of clarification.
c. CORRECT When using confrontation, the therapist makes a statement or asks a question that connects the client’s behavior to an unconscious motivation or conflict.
d. Incorrect This is not the goal of confrontation.
The correct answer is: help the client see a behavior in a new way.
A parent complains that her 11-year old seems motivated primarily by his strong needs for attention and power and desire to get even with anyone who he thinks has wronged him. Therapy based on the work of which of the following individuals would be best suited to this boy’s problems?
Select one:
A. Carl Jung
B. Fritz Perls
C. Heinz Kohut
D. Alfred Adler
Although the boy’s problems would probably be helped by a number of different types of therapy, the approach of only one of the individuals listed is directly associated with the specific issues described in the question.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT According to Adler, people are motivated primarily by the need to belong (i.e., by social interest). However, this need may be misdirected into one of four goals – attention, power, revenge, or to display inadequacy.
The correct answer is: Alfred Adler
According to Helms (1990), the ability of Whites to develop a healthy racial identity is most closely related to:
Select one:
A. identification with a particular White culture (e.g., Irish, Swedish, French).
B. stage of ego-identity development.
C. level of self-monitoring.
D. the extent of racism in the society.
Each of the stages of Helms’s White Racial Identity Development reflects a different position with regard to acceptance or rejection of racism.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT J. Helms’s model reflects her belief that “the development of white identity in the United States is closely intertwined with the development and progress of racism in this country” (Black and White racial identity: Theory, research, and practice, Westport, CT, Greenwood, 1990, p. 49).
The correct answer is: the extent of racism in the society.
Penny Pallid is an Anglo American teacher and Cameron Chroma, her student, is African American. According to Helms’s interaction model, Ms. Pallid will be LEAST effective in teaching Cameron if she is in the __________ stage of racial identity development and Cameron is in the __________ stage.
Select one:
A. reintegration; pre-encounter
B. pseudo-independent; pre-encounter
C. contact; immersion
D. pseudo-independent; encounter
This question is asking about Helms’s proposal that outcomes in clinical and other relationships are affected by the stage of racial identity development of each participant. See J. Helms, Applying the interaction model to social dyads, in J. Helms (Ed.), Black and White racial identity: Theory, research and practice, New York, Greenwood Press, 1990.
a. Incorrect As defined by Helms, this is an example of a parallel relationship and is likely to result in a stable, harmonious interaction.
b. Incorrect This is an example of a progressive relationship. It provides the greatest opportunity for growth for the student.
c. CORRECT This is an example of a crossed relationship. It is the most conflicted type and is characterized by disharmony, fear, and “warfare.” It is least likely to promote the student’s growth.
d. Incorrect This is another example of a progressive relationship.
The correct answer is: contact; immersion
In the context of cognitive-behavioral family therapy (Schwebel and Fine, 1994), “family ___________” refers to a set of cognitions that family members possess and that shape how they understand and approach family life.
Select one:
A. prototype
B. map
C. script
D. schema
Even if you are unfamiliar with cognitive-behavioral family therapy, familiarity with cognitive-behavioral therapy in general should have helped you select the correct answer to this question
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Schemas are a key concept in cognitive-behavioral therapy and in cognitive-behavioral family therapy. However, in the latter, they are conceptualized more narrowly as the cognitive frameworks that family members have about family functioning. See A. Schwebel and M. Fine, Understanding and helping the family: A cognitive-behavioral model, Hillsdale, NJ, Erlbaum, 1994.
The correct answer is: schema
Gregory Herek (2000) proposes that the terms "sexual prejudice," "sexual stigma," and "heterosexism" be used as substitutes for: Select one:
A. heterosexual bias.
B. homophobia.
C. homosexism.
D. sexism.
For the exam, you want to be familiar with Herek’s definitions for the terms listed in this question. These are described in the Clinical Psychology chapter of the written study materials.
a. Incorrect See explanation for response b.
b. CORRECT Herek argues that the terms listed in this question are more useful than homophobia because homophobia is an ambiguous and imprecise term.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: homophobia.
As described by Sue and Zane (1987), when working with Asian American clients, “gift-giving”:
Select one:
A. is discouraged because it tends to foster dependency on the therapist.
B. is discouraged because it can create a harmful multiple relationship.
C. is encouraged during the final therapy sessions to help clients maintain therapeutic gains.
D. is encouraged during the initial therapy sessions to help reduce premature termination from therapy.
S. Sue and N. Zane point out that ethnic minority clients (especially Asian American clients) often expect to obtain some meaningful benefit early in therapy and tend to be skeptical about its long-term benefits. They recommend “gift-giving” during the initial therapy sessions as a useful strategy for increasing credibility and preventing premature termination [The role of culture and cultural techniques in psychotherapy: A critique and reformulation, American Psychologist, 42(1), 37-45, 1987].
a. Incorrect See explanation for answer d.
b. Incorrect See explanation for answer d.
c. Incorrect See explanation for answer d.
d. CORRECT Examples of “gifts” that can be given during initial therapy sessions include normalizing the client’s distress, instilling a sense of hopefulness, and identifying concrete and mutually agreed upon goals.
The correct answer is: is encouraged during the initial therapy sessions to help reduce premature termination from therapy.
An educational psychologist with expertise in the areas of intellectual and learning disabilities is hired by a school district to assist a teacher who is having difficulty working effectively with newly “mainstreamed” students. The psychologist will work directly with the teacher to help him acquire the skills he needs to work with these students but will have little or no direct contact with the students. This is best described as a type of:
Select one:
A. client-centered case consultation.
B. consultee-centered case consultation.
C. program-centered administrative consultation.
D. consultee-centered administrative consultation.
Gerald Kaplan distinguishes between the four types of consultation listed in the answers to this question. Additional information about the types is provided in the Clinical Psychology chapter of the written study materials.
a. Incorrect In client-centered case consultation, the consultant assists the consultee with a particular client or student.
b. CORRECT In consultee-centered case consultation, the focus is on the consultee, and the consultant helps the consultee acquire the knowledge or skills needed to work effectively with a particular type of clients or students.
c. Incorrect This type of consultation involves working with one or more administrators to resolve problems related to an existing program.
d. Incorrect This type of consultation involves assisting one or more administrators acquire the knowledge and skills they need to be more effective in developing, implementing, and/or evaluating future programs.
The correct answer is: consultee-centered case consultation.
Surveys have found that women in which of the following groups report the highest lifetime rate of victimization by an intimate partner?
Select one:
A. White Americans
B. African Americans
C. Asians/Pacific Islanders
D. American Indians/Alaska Natives
Statistics on the lifetime rates of victimization by an intimate partner are reported by P. Tjaden and N. Thoennes in Extent, nature and consequences of intimate partner violence: Findings from the National Violence Against Women Study, U. S. Department of Justice, 2000.
a. Incorrect Tjaden and Thoennes report a lifetime rate of victimization by an intimate partner of 24.8% for White females (i.e., 24.8% of White females in their sample reported having been the victim of intimate partner rape, physical assault, or stalking).
b. Incorrect For African American females, these investigators obtained a rate of 29.1%.
c. Incorrect For Asian/Pacific Islander females, Tjaden and Thoennes obtained a rate of 15.0%.
d. CORRECT Tjaden and Thoennes report a lifetime rate for American Indians/Alaska Natives of 37.5%. They note that this higher rate for American Indian/Alaska Native women is consistent with previous research but state that it is not clear whether the rate is actually due to more violent experiences or an increased willingness to report them.
The correct answer is: American Indians/Alaska Natives
Smith, Glass, and Miller’s (1980) use of meta-analysis involved:
Select one:
A. counting the number of psychotherapy outcome studies that found a statistically significant difference between treatment and no-treatment groups.
B. statistically comparing the number of psychotherapy outcomes studies that did and did not find significant treatment effects.
C. determining the average magnitude of the outcome of psychotherapy across a large number of outcome studies.
D. using initial symptom severity and type and duration of treatment to predict average treatment outcome.
Smith et al. combined the results of 475 studies on the effectiveness of psychotherapy (Smith, M. L., Glass, G. V., & Miller, R. L., The benefits of psychotherapy, Baltimore, Johns Hopkins University Press, 1980).
a. Incorrect This response describes the “box score” method, not meta-analysis.
b. Incorrect This response describes using an inferential statistical test to compare outcome data for two groups.
c. CORRECT When using meta-analysis, the outcomes of each study are converted to a common metric - i.e., an effect size - and an average effect size is calculated.
d. Incorrect This response describes multiple regression.
The correct answer is: determining the average magnitude of the outcome of psychotherapy across a large number of outcome studies.
A therapist who believes the therapeutic change process should focus on altering the client’s environment is adopting which of the following approaches?
Select one:
A. alloplastic
B. autoplastic
C. emic
D. etic
To answer this question, you must be familiar with the definitions for the terms listed in the responses.
a. CORRECT Alloplastic refers to changing or adapting to the environment by effecting changes in the environment.
b. Incorrect Autoplastic (“self-change”) refers to changing or adapting to the environment by altering one’s own behaviors or responses.
c. Incorrect Adopting an emic perspective involves focusing on the intrinsic distinctions that are meaningful to members of a particular culture or society.
d. Incorrect Adopting an etic perspective involves focusing on extrinsic distinctions that have meaning for the observer of the culture or society.
The correct answer is: alloplastic
From the perspective of object-relations theory, projective identification is illustrated by which of the following?
Select one:
A. A woman who doesn’t want to own her feelings of love and hate manipulates another person into experiencing them.
B. A child kicks and pushes his mother away from him even though he actually longs for her attention.
C. A man continuously interprets his wife’s behavior as an attempt to “mother” him.
D. A therapist reacts to lower-SES clients in ways consistent with stereotypes she formed during her internship.
Klein introduced the notion of projective identification and defined it as a mechanism that is revealed in fantasies in which the subject inserts the self (in part or whole) into the object in order to possess or control the object. It can be considered a type of projection.
a. CORRECT Projective identification underlies a number of pathological conditions and is responsible for severe difficulties in establishing one’s own identity and in feeling secure enough to establish relationships with others. See, e.g., C. Cooper, Psychodynamic therapy: The Kleinian approach, in W. Dryden (Ed.), Handbook of individual therapy, London, Sage, 1996.
b. Incorrect This is an example of splitting.
c. Incorrect This sounds more like transference.
d. Incorrect This is an example of theme interference.
The correct answer is: A woman who doesn’t want to own her feelings of love and hate manipulates another person into experiencing them.
Ho (1987) and others have recommended the use of a(n) __________ approach when working with African American therapy clients.
Select one:
A. ecostructural
B. solution-focused
C. narrative
D. ethnographic
Ho, Boyd-Franklin, and others recommend that interventions with African-American clients (especially those from low-income backgrounds) incorporate multiple systems including the immediate family, extended family, social service agencies, and church.
a. CORRECT While Boyd-Franklin refers to this approach as a “multisystems model,” Ho uses the term “ecostructural.” See, e.g., M. K. Ho, Family therapy with ethnic minorities, Newbury Park, Sage, 1987.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: ecostructural
A therapist instructs a client who suffers from insomnia to polish his hardwood floors for at least two hours whenever he wakes up during the night. Apparently this therapist is familiar with the work of:
Select one:
A. Luigi Boscolo.
B. Milton Erickson.
C. Salvador Minuchin.
D. Marquis de Sade.
The task described in the question is an example of an “ordeal.”
a. Incorrect Luigi Boscolo is affiliated with the Milan systemic school of family therapy, which is not associated with the use of ordeals.
b. CORRECT For the exam, you should have paradoxical techniques and ordeals associated with Milton Erickson and Jay Haley (who was strongly influenced by Erickson).
c. Incorrect The use of ordeals is more associated with Erickson and Haley than with Minuchin.
d. Incorrect See explanation for response b.
The correct answer is: Milton Erickson.
Melanie Klein considered the actions of children during play therapy to be equivalent to an adult client’s free associations. Anna Freud, in commenting on Klein’s conclusions:
Select one:
A. agreed that play therapy could be used as a substitute for free association.
B. argued that the actions of children during play therapy are better considered a form of “acting out.”
C. argued that the actions of children during play therapy are better interpreted as a form of resistance.
D. concluded that play therapy is counterproductive in the analysis of children.
Anna Freud regarded play therapy as a useful tool in the analysis of children but rejected Klein”s use of play therapy as a substitute for free association.
a. Incorrect See explanation for response b.
b. CORRECT In her paper “Acting Out” (The Writings of Anna Freud, Volume IX), Freud notes that, in pre-latency children, motor actions are the legitimate media of expression and communication of impulses; and, consequently, during that period, play is a form of “acting out.”
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: argued that the actions of children during play therapy are better considered a form of “acting out.”
As defined in Atkinson, Morten, and Sue’s (1993) Racial/Cultural Identity Development Model, a person who has contradictory appreciating and depreciating attitudes toward both his/her own culture and the dominant (majority) culture is in which of the following stages?
Select one:
A. resistance
B. dissonance
C. conformity
D. disintegration
The stages of Atkinson, Morten, and Sue’s Racial/Cultural Identity Development Model are characterized by different combinations of attitudes toward oneself, one’s own racial/cultural minority group, other minority groups, and the dominant (majority) group.
a. Incorrect The resistance/immersion stage is characterized by a preference for one’s own group.
b. CORRECT The dissonance stage is characterized by conflicting attitudes toward one’s own group and the majority group.
c. Incorrect A person in the conformity stage prefers the dominant group.
d. Incorrect Disintegration is not one of the stages in the Atkinson, Morten, and Sue model.
The correct answer is: dissonance
The various approaches to behavior family therapy differ with regard to goals and strategies but most share a focus on which of the following?
Select one:
A. helping family members develop new meanings for problematic behaviors.
B. using resistance and paradox to alter maladaptive behaviors.
C. altering transactional patterns as a means of fostering insight.
D. enhancing problem-solving and communication skills.
Behavioral approaches to family therapy combine principles of operant conditioning, social learning theory, and social exchange theory.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Behavioral family therapies focus on observable behaviors and use contingent reinforcement and other behavioral techniques to modify behaviors, especially those related to problem-solving and communication.
The correct answer is: enhancing problem-solving and communication skills.
From a psychoanalytic perspective, a phobia is:
Select one:
A. a fear of death or “non-being.”
B. an externalization of a forbidden impulse.
C. a projection of a “disowned self.”
D. a projection of shame and guilt.
From the perspective of Freudian theory, a phobia is a manifestation of neurotic anxiety, which is aroused by a perception of danger from the instincts.
a. Incorrect Although some phobias might be related to a fear of death (Freud did talk about a “death instinct”), this is not the best answer of those given.
b. CORRECT The object of a phobia is considered to be related in some way to (and symbolic of) a forbidden instinctual impulse. By expressing the impulse in an external symbolic form, the individual is better able to avoid it.
c. Incorrect This does not describe Freud’s view of phobias.
d. Incorrect Shame and guilt are words that are associated with Freud, but this is not the best answer to this question.
The correct answer is: an externalization of a forbidden impulse.
During a group therapy session, a few group members complain that some of the members have not been disclosing information about themselves. Other members become defensive and say that they don’t feel like they should be required to talk about themselves. A therapist relying on the approach advocated by Irvin Yalom (1985) would:
Select one:
A. regard the conflict as a normal stage of group development and not intervene.
B. interpret the conflict as resistance.
C. encourage members to discuss the meaning of the conflict for them.
D. clarify the function of self-disclosure in therapy.
Yalom views group therapy as a social microcosm that provides opportunities to work through problems in new, more adaptive ways.
a. Incorrect Although Yalom views conflict as an expected part of the group process, this is not the best response. See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This is most consistent with Yalom’s belief that group therapy provides several “curative factors” including interpersonal learning and self-understanding.
d. Incorrect See explanation for response c.
The correct answer is: encourage members to discuss the meaning of the conflict for them.
Research investigating the effectiveness of SSRIs as a treatment for Alcohol Dependence suggests that these drugs:
Select one:
A. reduce alcohol consumption for individuals with either early or late onset Alcohol Dependence.
B. are more likely to reduce alcohol consumption for individuals with early (versus late) onset Alcohol Dependence.
C. are more likely to reduce alcohol consumption for individuals with late (versus early) onset Alcohol Dependence.
D. have no effect on alcohol consumption regardless of the onset of Alcohol Dependence.
Studies suggest that the effects of SSRIs on Alcohol Dependence are related to several factors including the onset of symptoms, the severity of symptoms, and the presence of comorbid psychopathology.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Several investigators distinguish between two subtypes of alcoholism (Type A and Type B) and have found that the effects of the SSRIs on alcohol consumption are related to subtype. Type A alcoholics have a later onset of alcohol problems, fewer alcohol-related symptoms, and fewer or less severe symptoms of comorbid psychopathology. In contrast Type B alcoholics have an earlier onset of alcohol problems, more severe alcohol-related symptoms, and more severe comorbid psychopathology. The studies have generally found that SSRIs are more likely to have beneficial short- and long-term effects on alcohol consumption for Type A alcoholics and to have no effect or adverse effects for Type B alcoholics. See, e.g., W. Dundon et al., Treatment outcomes in Type A and Type B Alcohol Dependence six months after serotonergic pharmacotherapy, Alcoholism: Clinical and Experimental Research, 28(7), 1065-1073, 2004.
d. Incorrect See explanation for response c.
The correct answer is: are more likely to reduce alcohol consumption for individuals with late (versus early) onset Alcohol Dependence.
For children with a learning disorder, the most frequent co-diagnosis is ADHD, with approximately _____% of children with a learning disorder also receiving the latter diagnosis.
Select one:
A. 5 to 10
B. 20 to 30
C. 45 to 50
D. 65 to 75
Children with a learning disorder often have a co-diagnosis of ADHD, Tourette’s Disorder, and/or a mood disorder.
a. Incorrect See explanation for response b.
b. CORRECT The studies have found that the most common co-diagnosis is ADHD, with about 20 to 30% of children with a learning disorder also receiving a diagnosis of ADHD.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: 20 to 30
As described in the DSM-5, the five core symptoms of the Schizophrenia Spectrum Disorders are:
Select one:
A. delusions, hallucinations, negative symptoms, impaired cognition, and disorganized speech.
B. disorganized thinking, delusions, hallucinations, negative symptoms, and depersonalization or derealization.
C. hallucinations, negative symptoms, grossly disorganized or abnormal motor behavior, delusions, and disorganized thinking.
D. grossly disorganized or abnormal motor behavior, hallucinations, negative symptoms, affective instability, and delusions.
Answer C is correct: Hallucinations, negative symptoms (e.g., diminished emotional expression, avolition), grossly disorganized or abnormal motor behavior, delusions, and disorganized thinking are the five core symptoms of Schizophrenia and other Schizophrenia Spectrum Disorders.
Answer A: Impaired cognition is an associated feature of Schizophrenia but is not one of the five core symptoms of the Schizophrenia Spectrum Disorders.
Answer B: Depersonalization and derealization are associated symptoms of Schizophrenia but are not the core symptoms of the Schizophrenia Spectrum Disorders.
Answer D: Affective instability is characteristic of Schizoaffective Disorder, which has the same symptoms as Schizophrenia with the addition of a disturbance in mood.
The correct answer is: hallucinations, negative symptoms, grossly disorganized or abnormal motor behavior, delusions, and disorganized thinking.
Research on relapse following smoking cessation has found which of the following to be true?
Select one:
A. On the average, smokers gain 17.5 pounds during the first year after quitting smoking.
B. Although many smokers want to quit, only about 9% successfully quit each year.
C. Smoking cessation interventions are significantly more effective for women than for men.
D. About two-thirds of smokers who quit on their own or with the assistance of an intervention relapse within three months of quitting.
The plethora of research on smoking cessation and relapse has not produced entirely consistent results, but a number of generalizations can be made.
a. Incorrect Most authors report an average weight gain of about 5 or 6 pounds. See, e.g., R. C. Klesges et al., Smoking, body weight, and effects on smoking behavior: A comprehensive review of the literature, Psychological Bulletin, 106(2), 204-230, 1989.
b. Incorrect According to Reducing tobacco use: A report of the Surgeon General – 2000, only 2.5% of quitters are successful each year. (Available at www.cdc.gov/tobacco.)
c. Incorrect According to Women and Smoking: A report of the Surgeon General, there are no consistent gender differences in the effectiveness of various interventions for smoking. (Available at www.cdc.gov/tobacco.)
d. CORRECT This is the statistic reported by T. P. Carmody in Nicotine dependence: Psychosocial approaches to the prevention of smoking relapse, Psychology of Addictive Behaviors, 7(2), 96-102, 1993.
The correct answer is: About two-thirds of smokers who quit on their own or with the assistance of an intervention relapse within three months of quitting.
The nocturnal-only subtype of Enuresis:
Select one:
A. is more common in girls and occurs most often during REM sleep.
B. is more common in girls and occurs most often during non-REM sleep.
C. is more common in boys and occurs most often during REM sleep.
D. is more common in boys and occurs most often during non-REM sleep.
The nocturnal-only subtype of Enuresis requires that the repeated voiding of urine into bed or clothes occurs only during nighttime sleep. It also requires that the individual have a chronological age of at least five years or an equivalent developmental level and that symptoms occur at least twice a week for at least three consecutive months or cause clinically significant distress or impairment in functioning.
a. Incorrect See explanation for answer d.
b. Incorrect See explanation for answer d.
c. Incorrect See explanation for answer d.
d. CORRECT The nocturnal-only subtype occurs most often during the first third of the night during non-REM, slow-wave sleep and is more common in boys than girls.
The correct answer is: is more common in boys and occurs most often during non-REM sleep.
According to Aaron Beck, the core link between depression and suicide is:
Select one:
A. learned helplessness.
B. lack of social support.
C. severe symptoms.
D. feelings of hopelessness.
Beck has conducted longitudinal research to identify the best predictors of suicide among depressed individuals. When answering questions about Beck, keep in mind that he focuses primarily on distorted cognitions rather than on overt behaviors or other external phenomena.
a. Incorrect Learned helplessness is associated with Seligman.
b. Incorrect Other investigators have linked lack of social support to depression, but this is not something that Beck stresses.
c. Incorrect Beck actually found that severity of symptoms was not a very accurate predictor of suicide.
d. CORRECT In one study, Beck found that scores on his hopelessness scale accurately predicted suicide in 91% of cases. See A. T. Beck et al., Hopelessness and eventual suicide: A 10-year prospective study of patients hospitalized with suicidal ideation, American Journal of Psychiatry, 142(5), 559-563, 1985.
The correct answer is: feelings of hopelessness.
The symptoms of PTSD are grouped in the DSM-5 in terms of which of the following clusters?
Select one:
A. re-experiencing, avoidance/numbness, and arousal
B. re-experiencing, dissociation, avoidance, and arousal
C. intrusion, avoidance, cognition and mood, and arousal and reactivity
D. intrusion, withdrawal/avoidance, cognition, and mood
Answer C is correct: In the DSM-5, the major symptom clusters for PTSD are intrusion symptoms, persistent avoidance of stimuli associated with the trauma, negative alterations in cognition and mood, and marked alterations in arousal and reactivity. (Note that, for adults, adolescents, and children over age 6, persistent avoidance and alterations in cognition and mood are separate categories but are combined into a single category for children age 6 and under.)
The correct answer is: intrusion, avoidance, cognition and mood, and arousal and reactivity
Phyllis P., a 32-year-old administrative assistant, is constantly seeking approval from others and, when she is criticized even for a minor offense, she becomes very hurt and angry. At office parties Phyllis is especially seductive with male co-workers and physically affectionate with female co-workers, and she often behaves in ways that make her the center of attention. Based on this information, the most likely diagnosis for Phyllis is:
Select one:
A. Histrionic Personality Disorder.
B. Narcissistic Personality Disorder.
C. Borderline Personality Disorder.
D. Schizotypal Personality Disorder.
For the exam, you want to be familiar with the essential features of the Personality Disorders so that you can answer questions like this one. This information is provided in the Abnormal Psychology chapter of the written study materials.
a. CORRECT Phyllis’s symptoms reflect excessive emotionality and attention-seeking. These symptoms are most consistent with a diagnosis of Histrionic Personality Disorder, which entails constant seeking of approval and attention, exaggerated emotions, and seductiveness.
b. Incorrect Although Narcissistic Personality Disorder also involves oversensitivity to criticism, people with this disorder are less involved with others.
c. Incorrect The essential features of Borderline Personality Disorder are a pervasive pattern of instability of self-image, interpersonal relationships, and affects, as well as marked impulsivity. Although Phyllis’ mood seems somewhat unstable, she does not have some of the other characteristics of this disorder such as unstable interpersonal relationships, suicide threats, or marked identity disturbance.
d. Incorrect Schizotypal Personality Disorder is characterized by a pattern of difficulties in interpersonal relationships and peculiarities in ideation, appearance, and behavior.
The correct answer is: Histrionic Personality Disorder.
A child with dyslexia who has not responded to interventions that target his reading problems would receive a DSM-5 diagnosis of:
Select one:
A. Academic Skills Disorder with impaired reading.
B. Reading Disorder.
C. Learning Disorder NOS.
D. Specific Learning Disorder with impairment in reading.
Answer D is correct: The appropriate diagnosis for dyslexia is Specific Learning Disorder with the specifier “impairment in reading.”
The correct answer is: Specific Learning Disorder with impairment in reading.
Of the following, the best predictor of suicide is generally considered to be:
Select one:
A. lack of social support.
B. increase in somatic symptoms.
C. family history of suicide.
D. prior suicide attempt(s).
Once again, the best predictor of future behavior is past behavior.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT One of the most frequently cited facts in the literature on the predictors of suicide is that a previous suicide attempt is often the best predictor of death by suicide, with reported rates ranging from 40 to 80% of people who commit suicide having made one or more previous attempts.
The correct answer is: prior suicide attempt(s).
Of the following, which is most true about adolescents who have a history of repeated suicide attempts?
Select one:
A. The failure of their attempts is usually due to a lack of access to lethal means.
B. Their continued threats to commit suicide are of minimal concern because very few adolescent repeat attempters actually complete suicide.
C. The real purpose of their suicide attempts is often to exert power in situations in which they feel powerless.
D. Their suicide attempts are often a self-imposed extension of the physical abuse they have experienced since early childhood.
Several factors have been linked to an increased risk for suicide among adolescents.
a. Incorrect Lack of access to lethal means has not been identified as an explanation for repeated attempts among adolescents. In fact, one pattern that has been identified is a trend toward increasing lethality with each attempt.
b. Incorrect Suicide attempts should always be taken seriously regardless of the person’s past history. Many people with a history of attempts do ultimately kill themselves.
c. CORRECT Among adolescent repeat attempters, the purpose of the attempts is often interpersonal (conflicts with family members) and/or instrumental (an attempt to obtain attention). Thus, the attempts can be viewed as a desire to claim power in situations in which the adolescent feels powerless.
d. Incorrect Although childhood abuse is certainly linked with a number of problems (including depression and suicide), this particular dynamic (the attempt reflecting an extension of abuse) has not been identified as a causal agent in repeated suicide attempts among adolescents.
The correct answer is: The real purpose of their suicide attempts is often to exert power in situations in which they feel powerless.
Your new client is a 20-year-old college student who says she’s failing her classes because of her anxiety. She states that she has to force herself to leave her dorm room to go to class, and when she does, she avoids the “quad” and other large open spaces because she’s afraid she’ll have a panic attack. The client tells you that, when in large open spaces, she can’t breathe and her heart races, she feels like she’s going to die, and she’s afraid that no one will help her if she has an attack. She says that she experiences the same problem when she’s part of a crowd and avoids going anywhere where there’s likely to be a “lot of people,” which has made it hard for her to have a social life. Based on this information, the most likely DSM-5 diagnosis for this client is:
Select one:
A. Panic Disorder with Agoraphobia
B. Agoraphobia
C. Agoraphobia without History of Panic Disorder
D. Specific Phobia, situational type
Answer B is correct: A DSM-5 diagnosis of Agoraphobia requires the presence of marked fear of or anxiety about at least two of five situations (using public transportation, being in open spaces, being in enclosed spaces, standing in line or being part of a crowd, and being outside the home alone). The individual fears or avoids these situations due to a concern that escape might be difficult or help will be unavailable in case he/she develops incapacitating or embarrassing symptoms; and the situations nearly always provoke fear or anxiety and are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety.
Answers A and C: Panic Disorder with Agoraphobia and Agoraphobia Without History of Panic Disorder are not DSM-5 diagnoses.
Answer D: It can be difficult to differentiate Agoraphobia from Specific Phobia, situational type; but, when the individual’s fear is limited to only one of the situations associated with Agoraphobia and is due to something other than a fear that escape might be difficult or help will be unavailable when symptoms occur, the diagnosis is Specific Phobia, situational type.
The correct answer is: Agoraphobia
Studies investigating dissociation in children have found that:
Select one:
A. maltreated children and nonmaltreated children exhibit similar levels of dissociation.
B. maltreated children exhibit more dissociative symptoms than nonmaltreated children do and this difference is apparent during the preschool years.
C. maltreated children exhibit more dissociative symptoms than nonmaltreated children do but this difference is not apparent until the elementary school years.
D. maltreated children exhibit more dissociative symptoms than nonmaltreated children do but this difference is not apparent until the middle-school years.
The research has shown that signs of dissociation are apparent in infancy and that the capacity to dissociate increases rapidly during the preschool years. See, e.g., F. Putnam, Dissociation in children and adolescents: A developmental perspective, New York, Guilford Press, 1997.
a. Incorrect See explanation for response b.
b. CORRECT The studies have shown that, when compared to their nonmaltreated peers, maltreated preschool children exhibit more dissociation than nonmaltreated children do.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: maltreated children exhibit more dissociative symptoms than nonmaltreated children do and this difference is apparent during the preschool years.
When deciding on an intervention plan for a client with Agoraphobia, it is important to keep in mind that which of the following seems to be the key element in treating this disorder?
Select one:
A. counterconditioning
B. progressive relaxation
C. in vivo exposure
D. cognitive restructuring
Most of the research on Agoraphobia and other phobic disorders has found the behavioral and cognitive-behavioral techniques to be most effective. However, the specific technique that is most effective depends on the exact nature of the disorder.
a. Incorrect Counterconditioning underlies systematic desensitization, which has not been identified as an effective treatment for Agoraphobia.
b. Incorrect Although relaxation might be a useful adjunct to in vivo exposure, it is not an effective treatment when used alone.
c. CORRECT In vivo exposure with response prevention has been consistently found to be an effective intervention for Agoraphobia.
d. Incorrect Cognitive restructuring has not been found to be particularly effective for Agoraphobia.
The correct answer is: in vivo exposure
The DSM-5 includes the World Health Organization Disability Assessment Schedule 2.0 (WHODAS) as a means for assessing disability in adults ages 18 years and older. The WHODAS uses a 5-point Likert scale to assess functioning in which the following domains?
Select one:
A. self-care, life activities, cognitive skills, mood and affect, physical health, and interpersonal relationships
B. understanding and communicating, getting around, self-care, getting along with people, life activities, and participation in society
C. affect, personality functioning, substance use, cognition, personal relationships, and reality testing
D. communication skills, activities of daily living, interpersonal skills, motor skills, cognition, and affect
Answer B is correct: The WHODAS is used to assess level of disability in the six domains listed in this answer (understanding and communicating, getting around, self-care, getting along with people, life activities, and participation in society).
Answers A, C, and D: See explanation above.
The correct answer is: understanding and communicating, getting around, self-care, getting along with people, life activities, and participation in society
Which of the following is least likely to be associated with Tourette’s Disorder?
Select one:
A. a learning disorder
B. obsessive-compulsive symptoms
C. ADHD
D. Separation Anxiety Disorder
Tourette’s Disorder is characterized by motor and vocal tics that produce significant impairment in social, occupational, or other important areas of functioning. According to the DSM, commonly associated disorders include obsessive-compulsive symptoms, Attention-Deficit/Hyperactivity Disorder, and a learning disorder. Separation Anxiety Disorder is least likely to be associated with Tourette’s Disorder.
The correct answer is: Separation Anxiety Disorder
Although stuttering in children is often difficult to treat, there is some evidence that ____________ is the most effective approach.
Select one:
A. stress inoculation
B. covert sensitization
C. regulated breathing
D. dialectical behavior therapy
Several studies have found regulated breathing to be effective for people who stutter.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Regulated breathing involves instructing the person to stop speaking when a stuttering episode occurs and to take a deep breath before continuing. It is often combined with awareness training and social support and, in this format, is referred to as habit reversal training.
d. Incorrect See explanation for response c.
The correct answer is: regulated breathing
The research suggests that a person with Alcohol Use Disorder is most likely to meet the diagnostic criteria for which of the following?
Select one:
A. Borderline Personality Disorder
B. Paranoid Personality Disorder
C. Antisocial Personality Disorder
D. Avoidant Personality Disorder
The studies have found that at least 50% of individuals with Alcohol or other Substance Use Disorder also meet the criteria for at least one personality disorder, with the DSM Cluster B personality disorders being most prevalent.
a. Incorrect See explanation for answer c.
b. Incorrect See explanation for answer c.
c. CORRECT Most studies have found that Antisocial and Borderline Personality Disorders are the personality disorders that co-occur most frequently with Alcohol Use Disorder, with Antisocial Personality Disorder being more common than Borderline Personality Disorder. See, e.g., K. J. Sher, J. A. Martinez, and A. K. Littlefield, Alcohol use and alcohol use disorders, in D. H. Barlow (ed.), Oxford handbook of clinical psychology (pp. 405-445), New York, Oxford University Press, 2014.
d. Incorrect See explanation for answer c.
The correct answer is: Antisocial Personality Disorder
Of the following aspects of memory, which is least likely to be adversely affected by mild to moderate Alzheimer’s disease?
Select one:
A. working memory
B. procedural memory
C. episodic memory
D. semantic memory
Certain aspects of memory are more likely than others to be adversely affected during the early stages of Alzheimer’s disease.
a. Incorrect Impairments in working memory are evident in the early stages of Alzheimer’s disease.
b. CORRECT Procedural memory is not substantially affected by mild to moderate Alzheimer’s disease, although it may show impairments in the later stages.
c. Incorrect Deficits in episodic memory are the most obvious memory deficits in the early stages of Alzheimer’s disease.
d. Incorrect Deficits in certain aspects of semantic memory are usually evident in the early stages of Alzheimer’s disease and become more severe and widespread as the disease progresses.
The correct answer is: procedural memory
Delirium shares many symptoms with Schizophrenia, Schizophreniform Disorder, and certain other psychotic disorders, such as disordered thinking, hallucinations, and delusions. Thus, the differential diagnosis of these disorders is often difficult. Generally speaking, however, Delirium can be distinguished from the psychotic disorders because:
Select one:
A. the symptoms of Delirium tend to be random and haphazard while the symptoms of the psychotic disorders are ordinarily systematized.
B. the onset of symptoms in Delirium is insidious while the onset of symptoms in psychotic disorders is usually rapid.
C. clouding of consciousness is rare in Delirium but common in the psychotic disorders.
D. the psychotic disorders involve hallucinations and delusions but these symptoms are never present in Delirium.
Delirium is almost always caused by a general medical condition or substance use, and its symptoms include disturbances in attention and awareness and other cognitive abilities.
a. CORRECT A difference between Delirium and the psychotic disorders is that the symptoms of Delirium tend to be random and haphazard while the symptoms of the psychotic disorders are often systematized.
b. Incorrect The onset of Delirium is usually rapid.
c. Incorrect Delirium is associated with a clouding of consciousness and a fluctuating course.
d. Incorrect Hallucinations and delusions may be present in Delirium; however, they are less systematized (i.e., more random and haphazard) than those associated with the psychotic disorders.
The correct answer is: the symptoms of Delirium tend to be random and haphazard while the symptoms of the psychotic disorders are ordinarily systematized.
As a treatment for erectile dysfunction, sildenafil citrate (Viagra) exerts its therapeutic effects by increasing:
Select one:
A. androgen levels.
B. blood flow to the penis.
C. sensory sensitivity in the penis.
D. sexual desire.
Viagra was the first oral medication approved by the FDA to treat erectile dysfunction.
a. Incorrect Viagra and similar medications (Levitra, and Cialis) do not affect androgen levels but, instead, promote erection by acting directly on penile tissue.
b. CORRECT These drugs are PDE-5 inhibitors, which relax the smooth muscle in the penis and thereby increase blood flow.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: blood flow to the penis.
In their prospective study of patients who underwent sex reassignment surgery, Smith et al. (2005) found that:
Select one:
A. the majority of patients no longer expressed gender dysphoria following surgery.
B. the majority of patients continued to express gender dysphoria following surgery.
C. the majority of patients expressed an increase in gender dysphoria following surgery.
D. the majority of female-to-male (but not male-to-female) patients expressed an increase in gender dysphoria following surgery.
This is a difficult question because it’s asking about a particular study. However, being generally familiar with the research on outcomes of sex reassignment surgery would have helped you identify the correct response.
a. CORRECT Y. Smith and colleagues found that the 162 adults in their study reported that they no longer experienced gender dysphoria following sex reassignment surgery, and the majority were functioning well psychologically, socially and sexually [Sex reassignment: Outcomes and predictors of treatment for adolescent and adult transsexuals, Psychological Medicine, 35(1), 89-99, 2005]. The outcomes of this study are consistent with the findings of other recent research.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: the majority of patients no longer expressed gender dysphoria following surgery.
Historically, which of the following has (have) been considered the “hallmark” of addiction?
Select one:
A. a “craving” for the substance
B. denial
C. impairments in social and occupational functioning
D. tolerance and withdrawal
Although the term addiction is not used in the DSM, it is frequently found in the literature where it usually refers to physical dependence. (The term “dependence” was introduced as an alternative to “addiction” by the World Health Organization in 1964.)
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The repeated administration of certain drugs can result in physical dependence (addiction), which is characterized by tolerance and withdrawal symptoms when drug use is abruptly stopped.
The correct answer is: tolerance and withdrawal
A number of studies investigating the progression of HIV infection have evaluated the impact of demographic factors. With regard to age, these studies have most consistently found that, among adults:
Select one:
A. age is unrelated to HIV disease progression.
B. younger age is associated with a more rapid HIV disease progression.
C. middle age is associated with a more rapid HIV disease progression.
D. older age is associated with a more rapid HIV disease progression.
HIV prognosis has been linked to several psychosocial risk factors including age.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT In a study conducted by Farinpour and colleagues, 1,231 HIV-seropositive men, ages 21 to 66, were followed for approximately 13 years after baseline testing. The results of the study indicated that age, general intellectual functioning, and somatic symptoms of depression were significant predictors of HIV progression and survival - i.e., older age, lower IQ, and the presence of somatic symptoms of depression were associated with a more rapid progression to AIDS, HIV-related dementia, and death. [Farinpour, R., et al., Psychosocial risk factors of HIV morbidity and mortality: Findings from the Multicenter Aids Cohort Study (MACS), Journal of Clinical and Experimental Neuropsychology, 25(5), 654-670, 2003.] These findings are consistent with the results of other studies.
The correct answer is: older age is associated with a more rapid HIV disease progression.
Which of the following is listed in the DSM as a diagnostic (versus associated) feature for Antisocial Personality Disorder?
Select one:
A. inflated sense of self
B. lack of remorse
C. lack of empathy
D. superficial charm
A diagnosis of Antisocial Personality Disorder (APD) requires a pervasive pattern of disregard for and violation of the rights of others.
a. Incorrect Inflated sense of self is listed as an associated feature in the DSM, not a diagnostic feature.
b. CORRECT For this diagnosis, the DSM requires the presence of at least three of seven characteristic behaviors. One of the seven is a lack of remorse.
c. Incorrect Lack of empathy is another associated feature of APD.
d. Incorrect Superficial charm is also a common associated feature.
The correct answer is: lack of remorse
- Failure to obey laws and norms by engaging in behavior which results in criminal arrest, or would warrant criminal arrest
- Lying, deception, and manipulation, for profit or self-amusement,
- Impulsive behavior
- Irritability and aggression, manifested as frequently assaults others, or engages in fighting
- Blatantly disregards safety of self and others,
- A pattern of irresponsibility and
- Lack of remorse for actions (American Psychiatric Association, 2013)
When treating a patient with Delirium, a priority is to identify and then treat or remove its cause. In addition, it is important to:
Select one:
A. make sure that the patient is provided with adequate stimulation.
B. keep the patient in a quiet room where he/she can be monitored by a family or staff member.
C. administer a neuroleptic to reduce the patient’s disorientation and agitation.
D. make sure family members and friends visit regularly
Answer B is correct: Delirium is characterized by disorientation and confusion, so an important goal is provide an environment that decreases disorientation. For example, it is important to reduce distractions and to provide a quiet, well-lit room and constant monitoring.
Answer A: Although “adequate stimulation” could be taken to mean stimulation that is appropriate for a disoriented state, this response is too vague and not as good as answer B.
Answer C: Neuroleptics may or may not be appropriate, depending on the cause of the Delirium.
Answer D: With a delirious patient, you want to provide a consistent environment, so regular visits by different people would probably be contraindicated.
The correct answer is: keep the patient in a quiet room where he/she can be monitored by a family or staff member.
Hypomania is associated with alterations in functioning that often include:
Select one:
A. a marked increase in both efficiency and creativity.
B. a marked decrease in both efficiency and creativity.
C. a marked increase in efficiency but a marked decrease in creativity.
D. a marked increase in creativity but a marked decrease in efficiency.
Hypomania is characterized by an abnormally and persistently elevated, expansive, or irritable mood.
a. CORRECT A hypomanic episode is not severe enough to cause marked impairment in functioning but, in some individuals, causes a change in functioning that involves a marked increase in efficiency, accomplishments, or creativity.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: a marked increase in both efficiency and creativity.
According to the DSM-5, the lifetime prevalence of Schizophrenia in the general population is approximately:
Select one:
A. .01%.
B. 0.5%.
C. 5%.
D. 10%
Estimates of the prevalence of Schizophrenia in the population vary, depending on country, race/ethnicity, and other factors.
a. Incorrect See explanation for response b.
b. CORRECT A lifetime prevalence rate of 0.3% and 0.7% is the rate reported in the DSM-5. Since 0.5% falls within this range, this is the best answer.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: 0.5%.
HIV infection is often described in the literature in terms of three stages. The second stage is characterized by a strong immune system response and:
Select one:
A. swollen glands but other few symptoms.
B. flu-like symptoms.
C. the onset of numerous opportunistic infections.
D. impaired concentration, attention, and motor activity.
The three stages of HIV infection (at least according to some experts) are: primary HIV infection, clinically asymptomatic stage, and symptomatic HIV infection.
a. CORRECT The second (middle) stage lasts for about eight to ten years and involves few, if any, clinical symptoms. During this asymptomatic stage, the immune system in fighting the virus.
b. Incorrect Flu-like symptoms are characteristic of the initial stage.
c. Incorrect Numerous opportunistic symptoms develop during the third stage.
d. Incorrect These symptoms are characteristic of the middle stage of AIDS Dementia Complex, a form of dementia that begins in the late stage of HIV infection.
The correct answer is: swollen glands but other few symptoms.
Your new client says that she has great difficulty letting go of things to the point that her apartment has become dangerous because of the clutter and that her husband is threatening to leave her if she doesn’t clean up her mess. The woman states that she’s always been a “collector” but that it “got out of control” after her son died two years ago. When determining whether to assign a diagnosis of Hoarding Disorder or Obsessive-Compulsive Disorder (OCD) to the client, you should keep in mind that:
Select one:
A. Individuals with OCD who hoard in response to an obsession or compulsion are distressed by their hoarding behaviors, while those with Hoarding Disorder experience distress when they discard hoarded items.
B. For individuals with Hoarding Disorder, hoarding behaviors are ego-dystonic; for those with OCD, the behaviors are ego-syntonic.
C. Individuals with OCD who hoard in response to an obsession or compulsion are likely to acquire less bizarre items than those with Hoarding Disorder.
D. In contrast to people with OCD, those with Hoarding Disorder have little or no insight into their behavior.
Answer A is correct: When hoarding is associated with a typical obsession or compulsion (e.g., to avoid harm or contamination), it is usually experienced as unwanted and distressful. In contrast, people with Hoarding Disorder accumulate possessions because they feel a need to save them or because of their aesthetic or sentimental value, and they experience distress when required to discard them.
Answer B: The opposite is true. Hoarding is ego-syntonic for people with Hoarding Disorder - i.e., they consider their behaviors normal (for them) and are not particularly disturbed by their hoarding. For people with OCD, symptoms are ego-dystonic and experienced as disturbing and unacceptable.
Answer C: People with OCD who hoard in response to an obsession or compulsion are more likely than people with Hoarding Disorder to collect bizarre items (hair, feces, trash, etc.).
Answer D: The insight of people with Hoarding Disorder or OCD varies, and the DSM-5 provides the following specifiers for both disorders: with good or fair insight, with poor insight, and with absent insight/delusional beliefs.
The correct answer is: Individuals with OCD who hoard in response to an obsession or compulsion are distressed by their hoarding behaviors, while those with Hoarding Disorder experience distress when they discard hoarded items.
Tarasoff v. Regents of the University of California (1976) established:
Select one:
A. a psychotherapist’s duty to waive confidentiality when a client poses a danger to him/herself.
B. a psychotherapists duty to protect an intended victim from a therapy clients violent actions.
C. the right of students or the parents of students to inspect and, when appropriate, to modify students academic records.
D. the right of students with disabilities to have test procedures modified to fit their abilities.
Although the original 1974 Tarasoff decision established a “duty to warn” the intended victim of a therapy client, that decision was superseded by the 1976 rehearing of the case which established a “duty to protect” the intended victim. Answer B is correct: According to 1976 California Supreme Court ruling, a psychotherapist has a duty to protect an intended victim of a therapy client by taking one of several actions: warning “the intended victim or others likely to apprise the victim of the danger, … [notifying} the police, or [taking] whatever other steps are reasonably necessary under the circumstances.”
The correct answer is: a psychotherapists duty to protect an intended victim from a therapy clients violent actions.
Dr. Burgher is the only psychologist in a small town. His daughter’s girl scout leader wants to begin seeing Dr. Burgher to work through some family-related problems. As an ethical psychologist, Dr. Burgher should:
Select one:
A. refuse to see the woman because to do so would constitute a “multiple relationship.”
B. see the woman since he is the only psychologist in town and her problems are unrelated to her role as girl scout leader.
C. determine the seriousness of the woman’s problems and base his decision about seeing the woman on the outcome of that evaluation.
D. assess the potential for exploitation and loss of objectivity and base his decision about seeing the woman on the outcome of that assessment.
Standard 3.05 of the Ethics Code addresses multiple relationships. Keep in mind that, while multiple relationships should ordinarily be avoided, they are not absolutely prohibited.
a. Incorrect Because the psychologist is the only one in town, you’d want some additional information before deciding that he should not see his daughter’s girl scout leader.
b. Incorrect This might be acceptable, but you’d want the response to mention something about the psychologist’s ethical responsibilities in this situation.
c. Incorrect This is one of the factors that a psychologist might consider in this situation but is certainly not the only one.
d. CORRECT This is the best answer of those given because it reiterates the actual language of the Ethics Code.
The correct answer is: assess the potential for exploitation and loss of objectivity and base his decision about seeing the woman on the outcome of that assessment.
Dr. Bettina B.’s new clients are a Japanese family that consists of a grandmother, mother, father, and two children. The grandmother and father speak limited English and the mother has offered to act as an interpreter. In this situation, the psychologist should:
Select one:
A. allow the mother to act as an interpreter.
B. allow the mother to act as an interpreter only if she is highly proficient in both Japanese and English.
C. allow the mother to act as an interpreter only if the grandmother and father agree to this arrangement.
D. not allow the mother to act as an interpreter.
This situation is addressed in Standard 2.05 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 2.05 states that psychologists who use the services of others, such as interpreters, “take reasonable steps to … avoid delegating work to persons who have a multiple relationship with those being served that would likely lead to exploitation or loss of objectivity.” In this situation, the mother’s relationship with the grandmother and her husband may bias her translations and interfere with the therapist’s ability to form therapeutic relationships with family members.
The correct answer is: not allow the mother to act as an interpreter.
A client of yours is currently suing her employer for race discrimination. You receive a subpoena from the employer’s attorney requiring you to appear at a deposition to provide information about the client. When you discuss this with the client, she tells you she does not want you to provide the employer with any information from her therapy sessions. You should:
Select one:
A. provide the requested information at the deposition since privilege is waived in this situation.
B. attend the deposition but provide only that information you believe to be germane to the case.
C. refuse to attend the deposition without a court order.
D. ask your attorney to contact the employer’s attorney to discuss the situation.
There are several actions that can be taken when a subpoena is received. Asserting the privilege is certainly one possibility but is not necessarily the best first course of action.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Of the responses given, this is the best choice. When a client does not want confidential information revealed, the requesting party can be contacted to see if the request can be rescinded or modified, thereby avoiding further legal steps. Of course, another alternative would be to attend the deposition and assert the privilege, but this may be less desirable than first attempting to work out a compromise that is agreeable to all parties and it is not given as an option.
The correct answer is: ask your attorney to contact the employer’s attorney to discuss the situation.
Greenberg and Shuman (1997) identify ten “irreconcilable conflicts” between therapeutic and forensic relationships. Which of the following is one of the differences described by these authors between the roles of therapist and forensic evaluator?
Select one:
A. In a therapeutic relationship, the psychologist’s role is that of care provider; in a forensic relationship, the psychologist’s role is more neutral.
B. In both a therapeutic and forensic relationship, the relationship is structured primarily by the client.
C. In a therapeutic relationship, information provided by the client is typically scrutinized for accuracy; in a forensic relationship, information provided by the litigant is rarely scrutinized for accuracy.
D. In both a therapeutic and forensic relationship, the relationship between client and therapist is rarely adversarial.
Answer A is correct. Even if you are unfamiliar with the Greenberg and Shuman article, you may have been able to identify the correct response as long as you are familiar with the roles and ethical obligations of forensic psychologists. A. Greenberg and D. W. Shuman note that a psychologist does adopt the role of a care provider in a therapeutic relationship. However, in a forensic relationship, a psychologist does not adopt the role of advocate but instead is neutral, detached, and objective [Irreconcilable conflict between therapeutic and forensic roles, Professional Psychology: Research and Practice, 28(1), 50-57, 1997].
The correct answer is: In a therapeutic relationship, the psychologist’s role is that of care provider; in a forensic relationship, the psychologist’s role is more neutral.
Which of the following most accurately describes current laws related to a health professional’s obligation when the professional learns that a client or patient who has tested positive for the HIV virus has not told his/her partner of the diagnosis and is having unsafe sex with the partner?
Select one:
A. All 50 states have laws that require health professionals to breach confidentiality in this situation.
B. All 50 states have laws that require health professionals not to breach confidentiality in this situation.
C. All 50 states have laws that allow health professionals to determine whether or not to breach confidentiality in this situation.
D. The laws regarding breach of confidentiality by health professionals in this situation vary from state to state.
As noted in the chapter on ethics and professional issues in the written study materials, the laws on this issue vary from jurisdiction to jurisdiction.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Some states prohibit health practitioners from notifying partners of patients with HIV/AIDS, while others require them to do so.
The correct answer is: The laws regarding breach of confidentiality by health professionals in this situation vary from state to state.
A psychologist who has been seeing a prison inmate in therapy is asked by the parole board to evaluate the inmate to determine his readiness for parole. The psychologist should:
Select one:
A. agree to do so since she is already familiar with the inmates readiness for parole.
B. agree to do so only if the inmate agrees and signs a waiver of confidentiality.
C. agree to do so only if she has the expertise necessary to make an informed parole recommendation.
D. decline to conduct the evaluation because doing so would constitute a multiple relationship.
This issue is addressed in the APA’s Specialty Guidelines for Forensic Psychology and by L. E. Weinberger and S. Sreenivassan in Ethical principles of correctional psychology in W. O’Donohue & K. Ferguson (Eds.), Handbook of professional ethics for psychologists, Thousand Oaks, CA, Sage Publ., 2003.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Weinberger and Sreenivassan state that, when a psychologist is acing as an individual’s (inmate’s) therapist “and is then asked (regardless by whom) to function as the individual’s evaluator, the psychologist is engaging in a multiple relationship” if he/she agrees to do so (p. 367).
The correct answer is: decline to conduct the evaluation because doing so would constitute a multiple relationship.
Al A., a lonely, single, middle-aged psychologist and college professor, is invited to a play by a graduate student, Betty B., who Al finds sexually attractive. Betty has returned to school after a 15-year absence and has been divorced for three years. If Al accepts Betty’s invitation, he will:
Select one:
A. be acting unethically because the Ethics Code prohibits professors from dating students.
B. not be acting unethically as long as he doesn’t become sexually involved with Betty.
C. not be acting unethically as long as Betty is a graduate student in a department other than the one Al teaches in.
D. not be acting unethically because this situation is not covered by the Ethics Code.
Dating students is addressed by two Standards of the APA’s Ethics Code: Standard 3.05 discourages multiple relationships and Standard 7.07 prohibits sexual relationships with students over whom a psychologist has direct or evaluative authority.
a. Incorrect The Ethics Code does not explicitly prohibit psychologists from dating all students but only those over whom they have evaluative authority. It also prohibits multiple relationships only when the relationship may harm or exploit the other person.
b. Incorrect If Betty is a graduate student in the psychology department and/or is likely to be in one of Al’s classes, dating her would be prohibited by the multiple relationship clause.
c. CORRECT If Betty is a student in another department, it would likely be acceptable for Al to accompany her to the play and become involved with her.
d. Incorrect As noted above, this situation is covered by the Ethics Code.
The correct answer is: not be acting unethically as long as Betty is a graduate student in a department other than the one Al teaches in.
Which of the following sections of the APA’s Ethical Principles of Psychologists and Code of Conduct provide(s) “aspirational goals to guide psychologists toward the highest ideals of psychology”?
Select one:
A. Introduction and Preamble
B. Preamble only
C. Preamble and General Principles
D. Ethical Standards
The correct answer is C. The Ethics Code is divided into four sections: Introduction, Preamble, General Principles, and Ethical Standards. As defined in the Ethics Code, the purpose of both the Preamble and General Principles is to provide “aspirational goals.”
a. The Introduction “discusses the intent, organization, procedural considerations, and scope of application of the Ethics Code.”
d. The Ethical Standards “set forth enforceable rules.”
The correct answer is: Preamble and General Principles
You are asked by one of the parties in a custody case to offer an opinion as to the best custody arrangement for the couple’s child at an upcoming hearing. The party making the request believes you are the best person to offer an opinion since you have been seeing the child in therapy since her parents separated 12 months ago. You should:
Select one:
A. agree to the request and make sure that you base your opinion on the best interests of the child.
B. agree to the request only if you are also able to evaluate both parents.
C. agree to the request only if both parents sign a consent.
D. refuse to do so.
This issue is addressed in the APA’s Guidelines for Child Custody Evaluations in Family Law Proceedings.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The Guidelines states that psychologists must avoid multiple relationships. For example, they should avoid assuming an evaluative role in custody cases where they already have established a therapeutic relationship with the child and/or the child’s parents.
The correct answer is: refuse to do so.
When asked to testify in court regarding a defendant’s potential for future violence, it is important to remember that the best predictor of future violence is:
Select one:
A. nature and level of psychopathology.
B. inability to control anger.
C. the presence of certain family factors.
D. past history of violent behavior.
Research suggests that when mental health practitioners predict a high risk for future violence, they are wrong about two out of three times.
a. Incorrect In general, the risk of dangerousness among psychiatric patients is not substantially different than the risk among the general population.
b. Incorrect This is true only if a lack of control over anger has led to violent behavior in the past.
c. Incorrect Reliance on family history alone will lead to too many false positives.
d. CORRECT As common sense might suggest, past behavior is indeed the best predictor of future behavior (see, e.g., R. I. Simon, Clinical psychiatry and the law, Washington, DC: American Psychiatric Press, 1992).
The correct answer is: past history of violent behavior.
A patient experiencing chronic pain tells you that her physician has prescribed an opioid analgesic. She also says she doesn’t want to take the drug because her brother is an ex-drug addict and she has had problems with alcohol in the past. You should:
Select one:
A. continue to explore her feelings about drug addiction in subsequent therapy sessions.
B. support her decision and explore alternative methods of pain relief such as biofeedback and relaxation training.
C. suggest that you discuss the issue with her physician and obtain a waiver of confidentiality so that you can do so.
D. reassure her that the use of an opioid for pain is unlikely to result in addiction as long as the drug is taken as prescribed
This is a difficult question because none of the answers is necessarily optimal (you’d want more information before deciding what to do) or entirely incorrect. However, one response best addresses the requirements of the Ethics Code.
a. Incorrect This answer doesn’t address the client’s immediate problem.
b. Incorrect This violates the Ethics Code by not addressing the need to consult and cooperate with other professionals.
c. CORRECT Of the responses given, this one is the best. The Ethics Code requires psychologists to consult and “psychologists cooperate with other professionals in order to serve their clients/patients effectively and appropriately” (Standard 3.09).
d. Incorrect Although this statement is accurate, it doesn’t address ethical requirements related to either client welfare or cooperation with other professionals.
The correct answer is: suggest that you discuss the issue with her physician and obtain a waiver of confidentiality so that you can do so.
One of your current clients is a 31-year old man who was sexually abused as a child. During the fifth session, he tells you that he’s been having fantasies about sexual contacts with children. He says he has not acted on these feelings but is concerned about them. You should:
Select one:
A. advise him that you are required to make a report with the authorities.
B. attempt to determine the degree of risk that he will act on his fantasies.
C. tell him that this is not unusual for someone who has been sexually abused and continue to work on this issue in therapy.
D. contact his wife to see if she has noticed any changes in the behavior of their three children.
A psychologist is required to report suspected or known cases of child abuse. From the information presented in this question, however, there is no reason to suspect that abuse has actually occurred.
a. Incorrect See explanation for response b.
b. CORRECT This is the best response of those given. Obviously, the man’s fantasies are a “red flag” that must be taken seriously and dealt with directly.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: attempt to determine the degree of risk that he will act on his fantasies.
Dr. Baron is the only licensed psychologist in a small mental health clinic. The other professionals working at the clinic include the director, who is a psychiatrist, and two social workers. Dr. Baron has just accepted a job at another clinic in a neighboring town. With regard to his client files, Dr. Baron would be best advised to:
Select one:
A. leave the files with the director.
B. take the files with him.
C. ask the clients what they would like done with the files.
D. destroy the files.
Standard 6.02(c) of the APA’s Ethics Code requires psychologists to make sure that the confidentiality of their records is protected in the event of their withdrawal from a position.
a. CORRECT Of the responses given, this one makes the most sense, especially since the director is a mental health professional.
b. Incorrect This might cause inconvenience to the clients and may be inconsistent with the clinic’s policy.
c. Incorrect This may violate clinic policy and would not be the best way to ensure that client confidentiality is maintained. It is your responsibility, as a psychologist, to ensure the security of client records.
d. Incorrect Obviously, this is wrong.
The correct answer is: leave the files with the director.
A psychiatrist seeks to consult with you about a client of hers because of your expertise in the area of concern to the client. In this situation:
Select one:
A. you should not discuss the case until a waiver has been obtained from the client.
B. you should not discuss the case until you have had a chance to evaluate the client yourself.
C. you can discuss the case with the psychiatrist without a waiver as long as the identity of the client is not revealed.
D. you need to get a waiver from the client only if you will also be providing services directly to him.
Standard 4.06 of the Ethics Code applies to this situation.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT A consent is required in consultation situations only when the identity of the client will be revealed.
d. Incorrect See explanation for response c.
The correct answer is: you can discuss the case with the psychiatrist without a waiver as long as the identity of the client is not revealed.
Which of the following is not a necessary condition for a claim of malpractice against a therapist:
Select one:
A. the therapist must have had a duty to the client.
B. the therapist must have acted in a negligent or otherwise improper manner.
C. there must be a causal relationship between the therapist’s negligence and the harm claimed by the client.
D. there must be no “reasonable doubt” that an alternative course of action (treatment) was available.
Legally, three conditions must be met for a claim of malpractice. These are defined by answers a, b, and c.
a. Incorrect This is a condition for malpractice.
b. Incorrect This is a condition for malpractice.
c. Incorrect This is a condition for malpractice.
d. CORRECT This is not a condition for malpractice.
The correct answer is: there must be no “reasonable doubt” that an alternative course of action (treatment) was available.
Privilege:
Select one:
A. can be waived by the client.
B. can be waived by the client’s therapist.
C. can be waived only by the court.
D. is waived by the attorney in a legal proceeding.
Privilege refers to a client’s right to confidentiality in legal proceedings. Privilege is legally defined and belongs to the client. For additional information on privilege, see the chapter on ethics and professional issues in the written study materials.
a. CORRECT The client is the holder of the privilege and can waive privilege.
b. Incorrect A therapist can “assert the privilege” but he/she cannot waive it.
c. Incorrect There are legal exceptions to privilege, but the court cannot “waive” privilege.
d. Incorrect As noted above, only the client can waive privilege.
The correct answer is: can be waived by the client.
You have been working with a couple to resolve their marital conflicts. Despite months of intensive therapy, the couple has come to the conclusion that it is in everyone’s best interests to end their marriage. The couple has a 12-year-old daughter and has asked you to perform a custody evaluation for the divorce proceedings. You should:
Select one:
A. perform the custody evaluation as long as you are no longer providing therapy to the couple.
B. perform the custody evaluation only if you obtain consent from both parents to do so.
C. perform the custody evaluation after clarifying your roles and responsibilities with all parties.
D. not perform the custody evaluation.
This issue is addressed in APA’s (2010) Guidelines for Child Custody Evaluations in Family Law Proceedings.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This answer is most consistent with Paragraph II.7 of APA’s Guidelines, which states “psychologists strive to avoid conflicts of interest and multiple relationships in conducting evaluations.” It is also consistent with the ethical requirements regarding multiple relationships provided in Standard 3.05 of the APA’s Code of Ethics and the Values Statement of Paragraph III of the Canadian Code of Ethics.
The correct answer is: not perform the custody evaluation.
Dr. R. B. Traight obtains the permission from a child’s mother and father before beginning an evaluation that will be used by the court to help determine custody rights. Before the evaluation is completed, however, the mother withdraws her consent. Dr. Traight should:
Select one:
A. make a custody recommendation on the basis of the information he has already obtained.
B. continue the evaluation since the father has not withdrawn his consent.
C. continue the evaluation since both parents gave their consent prior to beginning the evaluation.
D. contact the court to determine the appropriate course of action.
Normally, a psychologist would not evaluate a child without the consent of both parents.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Given the limited information provided in this question, this is the best response of those given. Whenever one parent does not give consent (or withdraws his/her consent) for an evaluation in a custody case, the psychologist should seek guidance from the court on how to proceed.
The correct answer is: contact the court to determine the appropriate course of action.
You receive a phone call from Hermann H., age 28, who says he is “totally miserable” because of the recent breakup with his girlfriend and that he would like to begin therapy with you. During the first session with Hermann, you find out that his political views are completely repugnant to you, and you feel that you would not enjoy working with him. As an ethical psychologist, you should:
Select one:
A. consult with another psychologist during the course of treatment to make sure your feelings don’t interfere with your objectivity.
B. discuss the difference in political views with Hermann only if they become relevant to the psychotherapy process.
C. see Hermann in therapy until his current crisis is over and then make a referral if necessary.
D. provide Hermann with appropriate referrals.
Answer D is correct. Psychologists are not required to see every client who seeks their services - and, to do so, would be unethical if the client’s characteristics interfere with the provision of adequate services. It’s evident objectivity is already impaired as the case scenario indicates the psychologist doesn’t think he’ll like working with this client, therefore a referral is the best option based on the information provided. Of the responses given, answer D describes the action that is in the best interests of both the client and you (the psychologist).
Answer C: The information presented in the question does not suggest that the client is experiencing a crisis, therefore answer C is incorrect.
The correct answer is: provide Hermann with appropriate referrals.
Dr. Callow is a licensed psychologist who has recently been hired by a mental health clinic. Several of his new patients are members of a culturally diverse group that he has not worked with before. His training, however, is appropriate for the services he will provide. As an ethical psychologist, Dr. Callow should:
Select one:
A. refuse to work with these patients.
B. take a relevant APA-approved continuing education course.
C. obtain consultation from a therapist who does have experience with members of this group.
D. see the patients and seek consultation only if he experiences any problems during the course of therapy.
Several Standards of the Ethics Code apply to this situation. For example, Standard 2.01(b) states that when differences in race or ethnicity might affect a psychologist’s ability to work, he/she obtains “the training, experience, consultation, or supervision necessary to ensure the competence of [his/her] services.”
a. Incorrect Since it appears that expertise in working with members of this culturally-diverse group is important for his position at the mental health clinic, it would be better for Dr. Callow to gain that expertise.
b. Incorrect Taking a course does not seem to be sufficient in this situation.
c. CORRECT Of the answers given, this one seems to represent the most ethical course of action. It is consistent with the requirements of Standard 2.01(c), which states that “Psychologists planning to provide services, teach, or conduct research involving populations, areas, techniques, or technologies new to them undertake relevant education, training, supervised experience, consultation, or study.” Even though he has had no prior experience with members of this group, consultation would be the best course of action for Dr. Callow because he is competent to provide the type of treatment.
d. Incorrect See explanation for response c. It would be better for Dr. Callow to seek consultation prior to treating these populations, and not “only” if a problem arises.
The correct answer is: obtain consultation from a therapist who does have experience with members of this group.
Dr. Strait is invited to a holiday party at a fellow psychologist’s house. While there, he notices that one of the guests is a current therapy client of the other psychologist. Dr. Strait’s best course of action would be to:
Select one:
A. leave the party in protest.
B. contact the ethics committee as soon as possible.
C. discuss the issue with the psychologist immediately.
D. discuss the issue with the psychologist at a later time.
The information provided in the question suggests that the psychologist is engaging in a multiple (dual) relationship with a client.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d. (Also note that Dr. Strait would have to obtain permission from the client before revealing his/her name to the Ethics Committee, which also makes this a less desirable answer than response d.)
c. Incorrect See explanation for response d.
d. CORRECT Standard 1.04 of the Ethics Code requires psychologists to take action when they believe another psychologist has acted unethically. Based on the information given in the question, this would be the best course of action - i.e., Dr. Strait should discuss the matter with the psychologist to determine the circumstances (e.g., the client may have come to the party without an invitation).
The correct answer is: discuss the issue with the psychologist at a later time.
With regard to the provision of “pro bono” services, the APA’s Ethics Code:
Select one:
A. prohibits free services.
B. advises against free services.
C. recommends free services.
D. mandates free services.
General Principle B (Fidelity and Responsibility) of the Ethics Code applies in this situation. It states that “Psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage.”
a. Incorrect The Ethics Code clearly does not prohibit the provision of free services.
b. Incorrect The Ethics Code does not advise against providing free services.
c. CORRECT Of the responses given, this one best describes the requirements of the Ethics Code since the General Principles are aspirational (not enforceable) guidelines.
d. Incorrect Principle F only encourages psychologists to provide services for which they receive “little or no personal advantage.” It does not mandate that psychologists provide free services.
The correct answer is: recommends free services.
Which of the following is true about the use of hypnotically induced testimony in legal proceedings?
Select one:
A. Hypnotically induced testimony is permitted in all jurisdictions as long as the hypnotherapist is licensed or certified.
B. Hypnotically induced testimony is permitted in all jurisdictions only when there is no contradictory evidence.
C. Hypnotically induced testimony is permitted in some jurisdictions under specific conditions (e.g., when corroborating evidence is available).
D. Hypnotically induced testimony is not permitted in any jurisdiction under any conditions.
The studies have generally found memories elicited under hypnosis to be unreliable, and laws regarding the admissibility of hypnotically induced testimony in legal proceedings are consistent with these findings.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Of the answers given, this one best describes the current status of the admissibility of hypnotically induced testimony in legal proceedings. Many jurisdictions have adopted a “per se exclusion” that excludes testimony about memories that first occurred during or after hypnosis. In other jurisdictions, a “totality of circumstances test” is used, which requires that certain guidelines or conditions be met so that it is unlikely that hypnosis impacted the individual’s memory.
d. Incorrect See explanation for response c.
The correct answer is: Hypnotically induced testimony is permitted in some jurisdictions under specific conditions (e.g., when corroborating evidence is available).
When conducting research with human participants, a psychologist should be aware that:
Select one:
A. participants must be debriefed promptly after their participation in the study.
B. participants must be debriefed after their participation in a study only when the study involved deception.
C. participants must be debriefed promptly if possible or, if necessary to delay the debriefing, psychologists must reduce the risk for harm.
D. the decision to debrief is left to the psychologist and involves considering the risk for harm to participants if they are not debriefed.
This issue is addressed in Standard 8.08 of the Ethics Code.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Research participants should be promptly provided with “appropriate information about the nature, results, and conclusions of the research.” When there must be a delay in providing such information, “psychologists take reasonable measures to reduce the risk of harm.”
d. Incorrect See explanation for response c.
The correct answer is: participants must be debriefed promptly if possible or, if necessary to delay the debriefing, psychologists must reduce the risk for harm.
For a client or former client to successfully bring a charge of malpractice against a psychologist, he/she must show that:
Select one:
A. the psychologist practiced in a way that could have led or did lead to harm.
B. the psychologist knowingly or deliberately acted in a way that led to harm.
C. the psychologist’s actions were the cause of a demonstrable injury.
D. the psychologist did not adequately warn the client of the possible negative consequences of the treatment.
Some experts describe malpractice in terms of four basic elements: The psychologist must owe a duty of care to the plaintiff; there must have been a breach of that duty; the breach must have led to demonstrable injury; and the psychologist’s acts must have been the cause of that injury.
a. Incorrect The psychologist’s behaviors must have actually led to harm.
b. Incorrect A psychologist doesn’t have to knowingly or deliberately cause harm in order to be found guilty of malpractice.
c. CORRECT This response addresses the third and fourth elements of a malpractice claim.
d. Incorrect This is not a requirement for a claim of malpractice.
The correct answer is: the psychologist’s actions were the cause of a demonstrable injury.
The Introduction and Applicability section of the APA’s Ethics Code notes that the APA may take action against a member after his/her:
Select one:
A. conviction of a felony.
B. conviction of a felony or misdemeanor.
C. conviction of a felony or misdemeanor only when the offense is clearly related to the psychologists professional role.
D. conviction of a felony only when the offense resulted in a loss or suspension of licensure.
The Introduction and Applicability section of the Ethics Code states that the Code “applies only to psychologists’ activities that are part of their scientific, educational, or professional roles as psychologists.” However, this section also identifies exceptions to this general rule.
a. CORRECT The Introduction and Applicability section states that the APA “may take action against a member after his or her conviction of a felony, expulsion or suspension from an affiliated state psychological association, or suspension or loss of licensure.” It does not place qualifications on these exceptions and it does not apply to misdemeanors.
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: conviction of a felony.
Based on APA’s guidelines, the best overall conclusion that can be drawn about dual relationships in forensic settings is that psychologists:
Select one:
A. should always avoid dual relationships.
B. should avoid dual relationships whenever possible
C. may participate in dual relationships only when the client has consented to the arrangement.
D. may participate in dual relationships only when they are the result of a court order.
Dual relationships in forensic (and other) settings are not completely prohibited by the Ethics Code or other APA guidelines. However, special precautions must always be taken when embarking on a dual relationship.
a. Incorrect The prohibition against dual relationships is not an absolute one and, in fact, APA guidelines mention some specific dual relationships that might be acceptable.
b. CORRECT This answer is most consistent with Paragraph 4.02 of the Specialty Guidelines for Forensic Psychology, which states: “Forensic practitioners strive to recognize the potential conflicts of interest and threats to objectivity inherent in multiple relationships. Forensic practitioners are encouraged to recognize that some personal and professional relationships may interfere with their ability to practice in a competent and impartial manner and they seek to minimize any detrimental effects by avoiding involvement in such matters whenever feasible or limiting their assistance in a manner that is consistent with professional obligations.
c. Incorrect Even though a client grants permission for the psychologist to engage in a dual relationship, the client’s information about the possible consequences may be limited. Consequently, it is up to the psychologist to determine whether the dual relationship is appropriate when the client has consented.
d. Incorrect APA guidelines are less restrictive with regard to dual relationships than this response indicates.
The correct answer is: should avoid dual relationships whenever possible
Alan A. has been receiving treatment from Dr. Larry L., a psychiatrist, for several months. Dr. L. suspects that Alan’s self-esteem problems may be related to a learning disability that has caused academic and occupational failures throughout Alan’s life and, to confirm his suspicions, refers Alan to Dr. Nancy N., a psychologist, for psychological assessment. During the course of testing, Alan tells Dr. N. that he is unhappy with the treatment he is receiving from Dr. L. and asks if he can begin therapy with her instead. As an ethical psychologist, Dr. N.’s best course of action would be to:
Select one:
A. make an appointment with Alan to discuss the reasons for his dissatisfaction with Dr. L.
B. make an appointment with Alan but call Dr. L. to discuss Alan’s decision.
C. make an appointment with Alan but suggest that he call Dr. L. to inform him of his decision.
D. recommend to Alan that he discuss the matter with Dr. L. before making an appointment with her.
Standard 10.04 of the Ethics Code requires psychologists to “carefully consider the treatment issues and the potential client’s/patient’s welfare” when requested to provide services to a client who is receiving similar services from another professional.
a. Incorrect If Dr. N. took this action, she would be ignoring her obligation to Dr. L. This might be the appropriate course of action if Alan’s reason for his dissatisfaction was related to an ethical or legal violation, but there is no reason to believe that this is the case in this situation.
b. Incorrect If Dr. N. takes this action, she would not only be ignoring her obligation to Dr. L but would also be breaching the confidentiality of Alan.
c. Incorrect Although it might be acceptable to see Alan with the provision that he also discuss his termination with Dr. L., because of the nature of the professional relationship between Dr. L. and Dr. N., the better course of action would be for Alan to first discuss his desire to terminate therapy with Dr. L.
d. CORRECT Because of the nature of their professional relationship, Dr. N.’s best course of action would be to recommend to Alan that he discuss his dissatisfaction and possible termination with Dr. L. before beginning treatment with her.
The correct answer is: recommend to Alan that he discuss the matter with Dr. L. before making an appointment with her.
Of the “big five” personality traits, ____________ has most consistently been linked to job performance across a variety of jobs.
Select one:
A. emotional stability
B. agreeableness
C. conscientiousness
D. openness to experience
The big five personality traits are extraversion/introversion, emotional stability, agreeableness, conscientiousness, and openness to experience.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This was the conclusion reached, for example, by M. R. Barrick and M. K. Mount, based on their meta-analysis of the research (The big five personality dimensions and job performance: A meta-analysis, Personnel Psychology, 1991, 44, 1-25).
d. Incorrect See explanation for response c.
The correct answer is: conscientiousness
In his well-known 1973 study, Rosenhan had several “pseudopatients” admit themselves to psychiatric hospitals with complaints of auditory hallucinations. Which of the following is most useful for explaining the results of Rosenhan’s study?
Select one:
A. central tendency error
B. Hawthorne effect
C. contrast effect
D. halo effect
In Rosenhan’s study, mental health professionals responded to (“rated”) pseudopatients on the basis of their original diagnoses regardless of their subsequent behaviors. The response of mental health professionals in this study can be interpreted as a rater bias.
a. Incorrect Central tendency error is a rater bias that occurs when a rater tends to rate all individuals in the middle range of a rating scale. This would not explain the response of mental health professionals in this study.
b. Incorrect The Hawthorne effect predicts that organizational change, regardless of its intent or content, produces a positive effect on worker motivation and/or performance and does not explain the response of mental health professionals in the Rosenhan study.
c. Incorrect The contrast effect refers to the perception of heightened difference between two stimuli when they are juxtaposed or when one immediately follows the other. In interview situations, a contrast effect occurs when an interviewer’s assessment of an interviewee is affected by his/her impressions of previous interviewees. The contrast effect does not explain the results of Rosenhan’s study.
d. CORRECT The halo effect is a rater bias that occurs when a rater’s ratings of an individual on one or several dimensions are affected by his/her rating on another dimension. The halo effect does explain the response of mental health professionals in this study; i.e., the mental health professionals continued to “rate” pseudopatients on the basis of their first ratings (diagnosis), regardless of the patients’ subsequent behaviors.
The correct answer is: halo effect
According to Maslow’s theory of motivation, when a person’s prepotent need is ungratified:
Select one:
A. the person becomes less motivated.
B. the person may “regress” to a lower-level need.
C. the ungratified need continues to be a primary motivator.
D. the ungratified need continues to be a primary motivator only when there is a good chance that it will eventually be satisfied.
Maslow’s theory predicts that only ungratified needs motivate behavior and that progression through the need hierarchy always goes from lower-order needs to higher-order needs.
a. Incorrect This is the opposite of what Maslow’s theory predicts.
b. Incorrect This is predicted by Alderfer’s ERG theory, not Maslow’s theory.
c. CORRECT According to Maslow, an ungratified need is the primary source of motivation.
d. Incorrect This isn’t predicted by Maslow’s theory.
The correct answer is: the ungratified need continues to be a primary motivator.
According to McClelland (1975), the need for power can be described in terms of which of the following two types?
Select one:
A. instrumental and hostile
B. referent and coercive
C. explicit and implicit
D. personal and socialized
McClelland described motivation as being determined by three fundamental needs – needs for affiliation, achievement, and power.
a. Incorrect Instrumental and hostile are two types of aggression distinguished in the literature.
b. Incorrect Referent and coercive are two of the bases of social power identified by French and Raven.
c. Incorrect Explicit and implicit are not the types of power described by McClelland.
d. CORRECT McClelland distinguished between personal and socialized power. People with a high need for personal power have a strong desire to dominate others, while those with a high need for socialized power are more concerned about using their influence to benefit others. According to McClelland, a high need for socialized power is associated with effectiveness as a manager.
The correct answer is: personal and socialized
Investigators have identified “five robust dimensions” of personality that appear to underlie all others: extraversion vs. introversion; agreeableness; conscientiousness; emotional stability; and openness to experience. Of these, which is most predictive of performance for all types of jobs and all types of performance measures?
Select one:
A. emotional stability
B. conscientiousness
C. openness to experience
D. agreeableness
This question addresses the results of a meta-analysis of the research by M. R. Barrick and M. K. Mount (The big five personality dimensions and job performance: A meta-analysis, Personnel Psychology, 44, 1-26, 1991).
a. Incorrect Contrary to the predictions of Barrick and Mount, emotional stability was not found to be a good predictor of job performance, apparently because unstable people don’t keep their jobs.
b. CORRECT As predicted, conscientiousness was found to be a valid predictor for jobs ranging from professional to semiskilled.
c. Incorrect Openness to experience is related to training proficiency.
d. Incorrect Agreeableness seems to be related to some jobs but not others.
The correct answer is: conscientiousness
