STUDY-MODE - Practice Exam 7 Flashcards
A Jungian “archetype” is best described as:
Select one:
A. an organized constellation of feelings, thoughts, and perceptions.
B. a structural component of the collective unconscious.
C. the “mask” adopted by a person in response to social demands.
D. a significant event that occurred during childhood.
According to Carl Jung, the psyche consists of a number of different, but interrelated, elements. For Jung, the major division in the psyche is between the personal unconscious and the collective (transpersonal) unconscious, with each containing unique elements.
a. Incorrect This better describes Jung’s notion of “complexes” (e.g., mother complex), which exist in the personal unconscious.
b. CORRECT An archetype is a universal thought form that is deposited in the mind when an experience has been constantly repeated for many generations. Numerous archetypes reside in the collective unconscious, including the archetypes of birth, death, the earth mother, and the wise old man.
c. Incorrect This best describes the “persona,” which is acquired in response to social demands as well as archetypal needs.
d. Incorrect This is not an accurate description of archetypes.
The correct answer is: a structural component of the collective unconscious.
When working with Native American/Alaskan Native clients, an effective intervention would involve coordination with traditional healers (if appropriate), incorporation of members of the extended family, and a(n):
Select one:
A. insight-oriented approach.
B. reality therapy or a solution-focused approach.
C. combination of client-centered and behavioral approaches.
D. combination of Adlerian and rational-emotive approaches.
Answer C is correct. There is some disagreement among the experts about the optimal therapeutic approach for members of this population; however, it depends on several factors including the client’s level of acculturation. D. W. Sue and D. Sue (Counseling the culturally different, New York, John Wiley & Sons, 1999) recommend a combination of client-centered and behavioral approaches.
The correct answer is: combination of client-centered and behavioral approaches.
The primary target of “advocacy consultation” is best described as:
Select one:
A. worker well-being.
B. the child’s best interests.
C. interpersonal conflicts.
D. social change.
Advocacy consultation, unlike other consultation modes, focuses on social systems rather than individuals or small groups.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT As noted by J. C. Conoley (Consultation in schools: Theory, research, procedures, Academic Press, New York, 1981), a distinctive characteristic of advocacy consultation is that it is based on an “explicit value orientation that targets social change in the direction of power equalization” (p. 162).
The correct answer is: social change.
A practitioner of nonsexist therapy:
Select one:
A. interprets a client’s behavior in terms of social, political, and cultural forces.
B. stresses the egalitarian nature of the therapeutic relationship.
C. views gender as a key determinant of behavior.
D. uses non-biased techniques designed to promote personal growth.
Nonsexist therapy and feminist therapy share several characteristics. For the exam, you want to be familiar with their major similarities and differences, which are described in the Clinical Psychology chapter of the written study materials.
a. Incorrect This is characteristic of feminist therapy but not nonsexist therapy.
b. Incorrect A nonsexist therapist may or may not emphasize an egalitarian relationship depending on his/her theoretical orientation. Therefore, this is not the best answer.
c. Incorrect For nonsexist therapists, gender is only one of many personal characteristics that affect behavior and are relevant to counseling.
d. CORRECT Of the answers given, this is the best one. As its name implies, nonsexist therapy involves using nonsexist (unbiased) techniques. In addition, its focus is on personal growth.
The correct answer is: uses non-biased techniques designed to promote personal growth.
Among the groups listed below, admission rates for psychiatric hospitalization are highest for which of the following?
Select one:
A. never married men
B. married men
C. divorced men
D. widowers
Of the choices given, never married men have the highest rate of psychiatric hospitalization for both men and women. Other factors to consider for admission rates include age (with the highest proportion between age 25 to 44) and race (with whites representing the largest number of psychiatric inpatients).
a. CORRECT This is the correct response. See the Clinical Psychology chapter for additional information on psychiatric hospitalization rates.
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: never married men
A family therapist using Minuchin’s structural approach is most likely to be interested in which of the following?
Select one:
A. communication styles
B. transgenerational processes
C. boundaries
D. exceptions
As its name implies, Minuchin’s structural family therapy focuses on the structural characteristics of the family.
a. Incorrect Although communication patterns provide clues about family structure, this is not the best response of those given.
b. Incorrect This sounds more like Bowenian family therapy.
c. CORRECT Minuchin considered maladaptive behavior to be the result of overly rigid or permeable boundaries between family members.
d. Incorrect Exceptions are of interest to solution-focused therapists.
The correct answer is: boundaries
In structural family therapy, “joining” depends on:
Select one:
A. the motivation of family members to change.
B. the permeability of the boundaries between family members.
C. the therapist’s ability to remain neutral.
D. the therapist’s ability to adapt to the family.
As described by Minuchin, joining is both a diagnostic and restructuring technique. It involves relating to family members and the family system by, for example, adopting its communication style.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT In order to join the family, the therapist must be able to adapt or accommodate to its style.
The correct answer is: the therapist’s ability to adapt to the family.
As defined by Carl Jung, individuation refers to:
Select one:
A. being able to separate one’s intellectual and emotional functioning.
B. differentiating between self and object.
C. experiencing a state of anonymity.
D. integrating parts of the self to create a unique identity.
For the exam, you want to be familiar with all of the terms that are referred to in the four answers to this question.
a. Incorrect This answer describes Bowen’s concept of differentiation. According to Bowen, the greater a person’s differentiation, the better able he/she is to resist becoming emotionally fused with other family members.
b. Incorrect This answer refers to Mahler’s separation-individuation phase of early development.
c. Incorrect This describes deindividuation which is used to explain why a person may be more willing to act aggressively or in other uncharacteristic ways when acting as a member of a group than when acting alone.
d. CORRECT As defined by Jung, individuation is the goal of psychological development and involves integrating the conscious and the unconscious elements of the psyche.
The correct answer is: integrating parts of the self to create a unique identity.
William Cross (1971, 1991) used which of the following terms to describe the transformational process that involves a shift from a non-Afrocentric to an Afrocentric identity? Select one:
A. Afrocentrism
B. nigrescence
C. integrative awareness
D. racination
Knowing the original name of Cross’s Black Racial Identity Development Model - i.e., the Nigrescence Identity Development Model - would have helped you identify the correct answer to this question.
a. Incorrect Afrocentrism refers to a worldview that emphasizes Africa and African people, especially in terms of their influence on culture and history.
b. CORRECT Cross (1971) originally used the French term for “turning black” (i.e., nigrescence) as the name for his identity development model, and he described Black identity development as involving a transformation from a pre-existing non-Afrocentric identity to an Afrocentric identity.
c. Incorrect Integrative awareness is the final stage in Atkinson, Morten, and Sue’s (1998) Racial/Cultural Identity Development Model.
d. Incorrect The term racination is sometimes used to describe the reverse of deracination, which refers to removing or displacing someone or something from its natural environment.
The correct answer is: nigrescence
The most common informal caregivers for older adults with chronic health conditions are family members. More specifically, the most common primary caregiver is:
Select one:
A. the spouse or adult daughter.
B. the adult daughter or son.
C. a same-gender sibling.
D. another relative.
The most common informal caregiver depends on the availability of family members and the gender of the individual requiring caregiving. However, some generalizations can be drawn from the research.
a. CORRECT The research has found that the spouse is the most common primary caregiver, with the children adopting a secondary role. However, when there is no spouse, a daughter is most likely to assume the role of primary caregiver. See, e.g., S. H. Zarit and D. J. Eggebeen, Parent-child relationships in adulthood and later years, in M. H. Bornstein (Ed.), Handbook of parenting: Children and parenting (Vol. 1, pp. 135-164), Hillsdale, NJ, Lawrence Erlbaum, 2002.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: the spouse or adult daughter.
Which of the following would probably be LEAST useful when a therapist is working with an Asian or Asian American client?
Select one:
A. identifying therapy goals during the initial session
B. establishing an egalitarian relationship with the client early in therapy
C. making use of “relationship questions” that elicit information about the client’s interactions with others
D. asking the client to try to identify exceptions to the presenting problem
It is “dangerous” to make generalizations about the best treatment approach for any group of clients, but the licensing exam may include a question that requires you to do so.
a. Incorrect A direct approach that focuses on specific goals is considered useful for Asian American clients.
b. CORRECT An egalitarian relationship is usually contraindicated because of “the Asian norms of deference to authority and modesty in the presence of superiors” (H. Kitano and M. Maki, Continuity, change, and diversity, in P. B. Pedersen, et al., Counseling across cultures, Thousand Oaks, Sage Publ., 1995).
c. Incorrect Focusing on relationships is a good approach.
d. Incorrect Identifying strengths is also useful.
The correct answer is: establishing an egalitarian relationship with the client early in therapy
First-and second-grade children who have been identified as being at risk for academic underachievement are provided with a special after-school program. This is an example of:
Select one:
A. primary prevention.
B. secondary prevention.
C. tertiary prevention.
D. crisis intervention.
Interventions aimed at identified individuals that have as their goal the reduction of the severity and/or prevalence of a disorder are categorized as secondary preventions.
a. Incorrect As defined by many authorities, primary preventions are aimed at populations rather than at specific individuals who have been identified as being at-risk.
b. CORRECT Since the school program is being given to identified individuals (children who have been identified as being at risk for academic problems), this qualifies as a form of secondary prevention.
c. Incorrect Tertiary preventions are more rehabilitative in nature.
d. Incorrect Clearly, this program is not a form of crisis intervention.
The correct answer is: secondary prevention.
Polly Pathos is seeing Dr. Genial for her depressive symptoms. As a practitioner of Interpersonal Therapy (IPT), Dr. Genial will most likely:
Select one:
A. help Polly gain insight into how interpersonal experiences during childhood are contributing to Polly’s problems in the present.
B. focus on clarifying how Polly’s current relationships and her expectations about them are contributing to her symptoms.
C. have Polly participate in a family therapy group that targets the dysfunctional interaction patterns that contribute to symptoms.
D. help Polly identify and understand how interpersonal “schemas” are inhibiting her ability to actualize her full potential.
Interpersonal Therapy is a brief form of therapy that was originally developed as a treatment for depression but has since been applied to other disorders.
a. Incorrect See explanation for response b.
b. CORRECT The focus of interpersonal therapy is on the link between current interpersonal problems and depressive symptoms. Interpersonal therapy targets one or more of the following areas: grief, interpersonal role disputes, role transitions, interpersonal deficits.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: focus on clarifying how Polly’s current relationships and her expectations about them are contributing to her symptoms.
Research on the use of hypnosis to recover repressed memories suggests that:
Select one:
A. memories recalled under hypnosis are both more accurate and more detailed than other memories.
B. memories recalled under hypnosis are about as reliable as other memories.
C. memories recalled under hypnosis are less reliable than other memories and may be more susceptible to distortion.
D. memories recalled under hypnosis are almost always confabulated.
It has been difficult to check the accuracy of “repressed memories” that have been retrieved under hypnosis, and there is not a great deal of empirical research on this topic. However, the research on memory suggests that memories are often constructed (or reconstructed) to some degree rather than simply recalled and that hypnosis can exacerbate this process.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This is the best conclusion that can be drawn about repressed memories retrieved under hypnosis. While some memories may be accurate, care must be taken in accepting memories retrieved under hypnosis since hypnosis seems to make people particularly susceptible to suggestion and to believing that false memories are, in fact, true.
d. Incorrect See explanation for response c.
The correct answer is: memories recalled under hypnosis are less reliable than other memories and may be more susceptible to distortion.
From the perspective of Gestalt therapy, an optimal “contact boundary” is semipermeable and coterminous with the actual self. Introjection is one type of boundary disturbance. It occurs when:
Select one:
A. the contact boundary is located far in the environment.
B. the contact boundary is located deep within the self.
C. the contact boundary is turned back against the self.
D. the contact boundary is extremely rigid.
Introjection occurs when a person incorporates aspects of another person into him/herself.
a. Incorrect This is projection.
b. CORRECT The boundary is located inside one, thereby allowing others to be incorporated into the self.
c. Incorrect This is retroflection.
d. Incorrect This is deflection.
The correct answer is: the contact boundary is located deep within the self.
According to Helms’s White Identity Development Model, the reintegration stage is characterized by:
Select one:
A. a realization that whites have a responsibility for racism.
B. adoption of a “culture-blind” perspective.
C. embracing white identity while rejecting racist views of minorities.
D. adopting a belief in white superiority and minority inferiority.
Helms’s model of White identity development includes six statuses:
CDRPIA
- contact
- disintegration
- reintegration (Adopting a belief in white superiority and minority inferiority.)
- pseudo-independence
- immersion-emersion (A realization that whites have a responsibility for racism.) (Embracing white identity while rejecting racist views of minorities.)
- autonomy.
a. Incorrect This is more characteristic of immersion-emersion and autonomy statuses.
b. Incorrect This is not characteristic of any of the stages described by Helms.
c. Incorrect This is characteristic of immersion-emersion status.
d. CORRECT The disintegration phase, which is marked by considerable conflict, may be resolved by adopting traditional racist views, which in turn characterizes the reintegration phase.
The correct answer is: adopting a belief in white superiority and minority inferiority.
According to Margaret Mahler’s object relations theory, the development of a sense of self is the result of a separation-individuation process that begins at about _____ months of age.
Select one:
A. 2 to 3
B. 4 to 5
C. 8 to 10
D. 12 to 14
Mahler distinguishes between two phases that contribute to the development of a unique sense of self: symbiosis and separation-individuation.
a. Incorrect An infant is in the symbiosis phase at this age.
b. CORRECT Separation-individuation is triggered by the child’s ability to separate from his/her primary caregiver. The process begins at about 4 to 5 months of age when a child who is being held by his/her caregiver is able to lean away to scan the environment.
c. Incorrect This age is very important for the separation-individuation process because the child is now able to crawl away from his/her caregiver. However, the process begins prior to 8 to 10 months of age.
d. Incorrect See explanation above.
The correct answer is: 4 to 5
When working with older adults, it is important to remember that:
Select one:
A. psychotherapy, especially insight-oriented therapy, is generally ineffective.
B. there is greater variability among older people than younger people on a range of characteristics.
C. a therapeutic alliance is particularly difficult to establish, especially when the therapist is young.
D. all of the above.
When working with older adults, it is important to remember that there is greater variability among older people than younger people on a range of characteristics (physical health, cognitive skills, income, etc.).
a. Incorrect See explanation above.
b. CORRECT See explanation above. Additional information about providing therapy to older adults is provided in the Clinical Psychology chapter of the written study materials.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: there is greater variability among older people than younger people on a range of characteristics.
George Kelly is associated with which of the following?
Select one:
A. Reality Therapy
B. Personal Construct Therapy
C. Existential Therapy
D. Solution Focused Therapy
George Kelly developed Personal Construct Therapy (PCT) in the 1950s as both a theory of personality and approach to therapy.
a. Incorrect See explanation for response b.
b. CORRECT Personal Construct Therapy (also known as “constructive alternativism”) is based on the premise that people construe (construct) their own experiences. His approach was very influential in the development of narrative-constructivist approaches to therapy. Additional information about Personal Construct Therapy is provided in the Clinical Psychology chapter of the written study materials.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: Personal Construct Therapy
Research comparing the use of mental health services by heterosexual adults and gay/lesbian adults has generally found that:
Select one:
A. gay men are more likely than heterosexual men to use mental health services, but lesbian women are less likely than heterosexual women to do so.
B. lesbian women are more likely than heterosexual women to use mental health services, but gay men are less likely than heterosexual men to do so.
C. gay men and lesbian women are more likely than their heterosexual counterparts to use mental health services.
D. gay men and lesbian women are less likely than their heterosexual counterparts to use mental health services.
A number of studies have confirmed a disparity in mental health service use by heterosexual adults and gay/lesbian adults.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT A frequently cited investigation of mental health service use by gay and lesbian adults was conducted by S. D. Cochran, J. G. Sullivan, and V. M. Mays [Presence of mental disorders, psychological distress, and mental health service use among lesbian, gay, and bisexual adults in the United States, Journal of Consulting and Clinical Psychology, 71(1), 53-64, 2003]. Their results (which have been subsequently replicated by several other researchers) indicated that gay and lesbian adults have higher levels of perceived need for mental health services and are more likely to use mental health services.
d. Incorrect See explanation for response c.
The correct answer is: gay men and lesbian women are more likely than their heterosexual counterparts to use mental health services.
When working with an African American client exhibiting “healthy cultural paranoia,” an Anglo therapist would be best advised to:
Select one:
A. refer the client to an African American therapist.
B. use a culturally sensitive approach that ameliorates the client’s paranoia.
C. help the client bring feelings of suspiciousness, frustration, and antipathy toward whites into conscious awareness.
D. help the client understand that his/her behavior is manifestation of resistance.
C. R. Ridley presents a “typology of black client self-disclosure,” which relates the willingness to self-disclose to four levels of “paranoia”: intercultural nonparanoic disclosure; functional paranoiac; healthy cultural paranoiac; and confluent paranoiac (Clinical assessment of the nondisclosure of the black client, American Psychologist, 39(11), 1234-1244, 1984).
a. Incorrect This is probably the best course of action, according to Ridley, for the confluent paranoiac but isn’t necessary for the individual experiencing healthy cultural paranoia.
b. Incorrect This isn’t the best response since healthy cultural paranoia may not need to be “ameliorated.”
c. CORRECT Ridley recommends that therapists confront the meaning of the client’s cultural paranoia by bringing his/her feelings into conscious awareness and then help the client clarify when it is appropriate or inappropriate to self-disclose.
d. Incorrect This is not the course of action recommended by Ridley.
The correct answer is: help the client bring feelings of suspiciousness, frustration, and antipathy toward whites into conscious awareness.
A psychotherapist is most likely to say that which of the following is the greatest source of stress in his or her work?
Select one:
A. isolation
B. overwork
C. the general passive nature of his/her work
D. the lack of therapeutic success
A survey of psychotherapists conducted in the early 1980s indicated that therapists expect their work to be stressful but also expect that their efforts will be appreciated and have positive results.
a. Incorrect In their survey of therapists, B. A. Farber and L. J. Helfetz (The process and dimensions of burnout in psychotherapists, Professional Psychology, 13(2), 293-301, 1982) found that isolation was cited by only 11.1% of their respondents as a major source of stress.
b. Incorrect Only 22.2% of respondents said that overwork was a major problem.
c. Incorrect About 13% of respondents cited this as a source of stress.
d. CORRECT The overwhelming majority of respondents (73.7%) said the major source of stress in their work was the lack of therapeutic success.
The correct answer is: the lack of therapeutic success
Freud (1984) introduced the concept of “defense” in his description of hysteria and attributed hysteria to which of the following defense mechanisms?
Select one:
A. projection
B. reaction formation
C. sublimation
D. repression
Freud’s initial explanation for hysteria was that it represents an attempt to eliminate memories related to early psychic trauma from consciousness.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Repressions is considered the most basic defense mechanism because it underlies all others. It was the initial defense mechanism identified by Freud, and he used it to explain the etiology of hysteria.
The correct answer is: repression
In family therapy, the adolescent daughter complains that she doesn’t think she can change her attitudes toward school and feels that doing what the therapist has requested is pointless. The therapist responds by saying, “Well, in that case, I think you shouldn’t even try.” The therapist’s response is an example of which of the following?
Select one:
A. reactance
B. restraining
C. positioning
D. prescription
In the situation described in the question, the therapist is using a paradoxical technique.
a. Incorrect Reactance is not a paradoxical technique but refers to the tendency of people to do the opposite of what they are asked to do, especially when they feel their personal freedom is being threatened.
b. CORRECT This technique (telling a client not to change) is referred to as restraining.
c. Incorrect Positioning involves exaggerating the severity of the symptom.
d. Incorrect Prescription involves instructing the client to deliberately engage in the target behavior, usually in an exaggerated form (e.g., “nag your spouse for at least three hours each evening”).
The correct answer is: restraining
Freud and the object relations theorists share in common an emphasis on the role of _________________ in personality development.
Select one:
A. the superego
B. innate sexual and aggressive drives
C. early childhood experiences
D. separation and individuation
Object relations theory shares a number of assumptions in common with Freudian theory but differs in its emphasis on the need for interpersonal relationships (versus needs related to sex and aggression).
a. Incorrect This is true about Freudian theory but not about object relations theory.
b. Incorrect This characterizes Freudian theory.
c. CORRECT Object relations theorists, like Freud, believe that early childhood experiences are critical to personality development. They also posit a stage theory of development, but they view interpersonal relations as the primary contributor to personality.
d. Incorrect This applies only to object relations theory.
The correct answer is: early childhood experiences
A couple comes to therapy complaining that their conversations always end up as arguments. In talking with the couple, you realize that a common pattern is for one partner to make an offensive comment to the other and for the other partner to respond with an even more offensive remark. This pattern of communication is referred to as:
Select one:
A. symmetrical.
B. complementary.
C. mystification.
D. pseudohostility.
In this situation, the husband and wife are mirroring each other’s behavior in what is sometimes referred to as a “one-upsmanship” game.
a. CORRECT Symmetrical communication is characterized by equality between the partners. It can lead to conflict and competition (symmetrical escalation) when each partner tries to “one-up” the other.
b. Incorrect Complementary interactions are based on inequality with one partner assuming a dominant role and the other a subordinate position.
c. Incorrect Mystification refers to masking what is really going on through denial in order to maintain the status quo.
d. Incorrect Pseudohostility occurs when real conflicts are denied and obscured by superficial bickering.
The correct answer is: symmetrical.
A person who experiences cataplexy as part of his narcoleptic attacks will most likely try to avoid:
Select one:
A. afternoon naps.
B. expressing strong emotions.
C. fluctuations in salt intake.
D. eye strain.
Cataplexy involves bilateral loss of muscle tone.
a. Incorrect See explanation for response b.
b. CORRECT Cataplexy is usually triggered by intense emotions. Consequently, people with cataplexy often attempt to control their emotional expressiveness.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: expressing strong emotions.
PET scans of people with _______________ show that these individuals often have increased activity levels in the orbitofrontal cortex, cingulate cortex, and caudate nucleus.
Select one:
A. Posttraumatic Stress Disorder
B. Narcolepsy
C. Obsessive-Compulsive Disorder
D. Schizophrenia
Knowing that the caudate nucleus is one component of the basal ganglia and that the basal ganglia are involved in voluntary movement and that the orbitofrontal cortex and cingulate cortex mediate emotional reactions may have helped you identify the correct response to this question.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Activity in these areas of the brain is higher in individuals with OCD, especially during provocation of symptoms. In contrast, drug and behavioral treatments for OCD reduce activity in these areas.
d. Incorrect See explanation for response c.
The correct answer is: Obsessive-Compulsive Disorder
The mean age of onset of motor tics in Tourette’s Disorder is:
Select one:
A. 1 to 3 years.
B. 5 to 7 years.
C. 9 to 11 years.
D. 12 to 14 years.
For individuals with Tourette’s Disorder, the onset of motor tics ordinarily precedes the onset of vocal tics.
a. Incorrect See explanation for response b.
b. CORRECT The reported mean age of onset of MOTOR tics varies, but a commonly reported range is between 5 and 7 years. The onset of VOCAL tics is usually later, with a mean age of 11 years. See, e.g., A. Carroll and A. Robertson, Tourette Syndrome: A practical guide for teachers, parents, and carers, New York, David Fulton Publishers, 2003.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: 5 to 7 years.
The onset of bulimia often follows a period of moderate dieting, which has been linked to low blood levels of tryptophan. Low levels of tryptophan, in turn, are associated with:
Select one:
A. lower-than-normal levels of brain serotonin.
B. higher-than-normal levels of brain serotonin.
C. lower-than-normal levels of brain dopamine.
D. higher-than-normal levels of brain dopamine.
Even if you are unfamiliar with the link between tryptophan and serotonin, you would have been able to choose the correct response if you know that the SSRIs have been found effective for treating bulimia.
a. CORRECT Tryptophan is a precursor of serotonin, and a rapid drop in plasma levels of tryptophan is known to precede a decrease in brain levels of tryptophan and serotonin.
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: lower-than-normal levels of brain serotonin.
The World Health Organization’s International Pilot Study of Schizophrenia (IPSS) and Determinants of Outcome Study have compared patients with Schizophrenia from non-Western developing countries to those from Western industrialized countries. This research has found that patients from developing and industrialized countries tend to differ in terms of:
Select one:
A. age and gender ratios.
B. course and outcomes.
C. symptom profiles.
D. gender and prognosis.
The World Health Organization studies have been reviewed by a number of investigators including K. Lin and A. Kleinman (Psychopathology and clinical course of Schizophrenia: A cross-cultural perspective, Schizophrenia Bulletin, 14(4), 555-567, 1988). The outcomes of these studies are consistent with research conducted by other investigators.
a. Incorrect See explanation for response b.
b. CORRECT The IPSS found course and outcome differences in patients from developing and industrialized countries; patients from developing countries were much more likely to exhibit an acute onset of symptoms, a shorter clinical course, and a complete remission of symptoms. Age, gender, and symptom profile were not found to differ in consistent ways.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: course and outcomes.
A 48-year-old woman is admitted to the emergency room of a hospital, complaining of chest pain and shortness of breath. While being interviewed, she is very restless and often gets up to pace back and forth. She says she has had similar “attacks” in the past, but that this one is the worst. She also states that the attacks sometimes occur when she’s concerned about getting bad news; but, most of the time, they don’t seem to be related to anything and they make her feel like she’s “going to die.” Assuming that there is no medical explanation for the woman’s symptoms, the most likely DSM-5 diagnosis is which of the following?
Select one:
A. Illness Anxiety Disorder
B. Specific Phobia
C. Panic Disorder
D. Panic Disorder without Agoraphobia
Answer C is correct: A DSM-5 diagnosis of Panic Disorder requires recurrent unexpected panic attacks with at least one attack being followed by one month of persistent concern about having additional attacks or about their consequences and/or involving a significant maladaptive change in behavior related to the attack.
Answer A: Illness Anxiety Disorder involves a preoccupation with having a serious illness, an absence of somatic symptoms or the presence of mild somatic symptoms, a high level of anxiety about one’s health, and performance of excessive health-related behaviors or a maladaptive avoidance of doctors, hospitals, etc.
Answer B: Specific Phobia is characterized by intense fear of or anxiety about a specific object or situation, with the individual either avoiding the object or situation or enduring it with marked distress.
Answer D: Panic Disorder without Agoraphobia is not a DSM-5 diagnosis.
The correct answer is: Panic Disorder
In terms of long-term effects, the most successful treatment for a DSM diagnosis of Enuresis is:
Select one:
A. fluid restriction and night lifting.
B. the night alarm.
C. a synthetic antidiuretic drug.
D. an antidepressant drug.
All of the treatments listed have been found useful for Enuresis, but only one has good long-term effects.
a. Incorrect While these interventions reduce symptoms initially, the benefits are usually short-term.
b. CORRECT The night alarm, which is the current version of the bell-and-pad, is successful in about 80% of cases, and, of the treatments listed, it has the best long-term effects.
c. Incorrect Although synthetic antidiuretics have good short-term effects, relapse rates are high once the drug is discontinued.
d. Incorrect A high relapse rate is also associated with antidepressants, which is why they are rarely used alone in the treatment of Enuresis.
The correct answer is: the night alarm.
Which of the following is most likely to be an effective treatment for PTSD?
Select one:
A. cognitive processing therapy
B. multisystemic therapy
C. critical incident stress debriefing
D. mentalization-based therapy
Answer A is correct: Cognitive processing therapy (CPT) has been found to be an effective treatment for PTSD. It integrates psychoeducation, exposure, and cognitive restructuring.
Answer B: Multisystemic therapy (MT) is also known as multisystemic treatment and is a comprehensive intervention that targets individual, family, school, peer group, and community factors that are maintaining conduct problems. It is considered especially useful for youth in mid- to late-adolescence who have exhibited the more serious symptoms of Conduct Disorder and are at-risk for out-of-home placement.
Answer C: Critical incident stress debriefing (CISB) is a type of psychological debriefing that involves providing treatment to the victims of a trauma within 72 hours of the event whether or not they have exhibited symptoms, and it is usually administered during a single lengthy session. Research on its effects suggests that it may actually worsen symptoms of PTSD by interfering with the normal recovery process.
Answer D: Mentalization-based therapy (MBT) has been found to be an effective treatment for Borderline Personality Disorder.
The correct answer is: cognitive processing therapy
Among older adults, major surgery, congestive heart failure, and pneumonia are all associated with an increased risk for which of the following?
Select one:
A. dyskinesia
B. dementia
C. delirium
D. dystonia
The risk for delirium is affected by age, with children and older adults being at highest risk.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The conditions listed in the question are among those that are associated with an increased risk for delirium for older adults. (Note that one of the most common causes of delirium for members of this population is intoxication with prescription drugs.)
d. Incorrect See explanation for response c.
The correct answer is: delirium
A new client joins a clinician’s grief group and tells everyone that his wife died and that he “just can’t get over it.” He says they were married 25 years and were planning on traveling around the world when she became ill. The man complains of not sleeping, eating very little, and not wanting to spend time with friends. The clinician is more likely to assign a DSM-5 diagnosis of Uncomplicated Bereavement to the man than a diagnosis of Major Depressive Disorder if:
Select one:
A. the man’s feeling of loss is accompanied by bouts of anxiety, a sense of emptiness, and intrusive thoughts of his wife and their relationship.
B. the man’s symptoms have dissipated in intensity over time and occur primarily when he thinks about his wife and their relationship.
C. the man has had persistent symptoms for less than two months.
D. the man’s wife died less than six months ago and he considers his reaction to her death to be normal.
Answer B is correct: Uncomplicated Bereavement is not a mental disorder but is included in the DSM-5 with Other Conditions That May Be a Focus of Clinical Attention. It involves a feeling of emptiness or loss that tends to decrease in intensity over days to weeks and is associated with thoughts or reminders of the deceased.
Answer A: See explanation for answer B.
Answer C: The DSM-5 does not specify a particular duration of symptoms as a requirement for a diagnosis of Uncomplicated Bereavement.
Answer D: Although the DSM-5 identifies viewing one’s reaction to the death as normal as an indicator of Uncomplicated Bereavement, it does not specify a particular interval of time since the death occurred as a requirement for its diagnosis.
The correct answer is: the man’s symptoms have dissipated in intensity over time and occur primarily when he thinks about his wife and their relationship.
Kegel exercises are used to:
Select one:
A. decrease performance anxiety.
B. treat insomnia.
C. establish a state of relaxation.
D. increase muscle tone.
Kegel exercises are used to restore muscle tone in the perineal area.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Arnold Kegel developed the Kegel exercise to help women regain control over urination after childbirth. The exercise also helps increase sensitivity during intercourse.
The correct answer is: increase muscle tone.
Jacob, age 14, is being seen by a school clinician for repeated angry outbursts at school. He is persistently irritable, constantly argues with adults, has a history of behavioral referrals, and recently changed schools after being expelled for threatening a teacher. Jacob’s parents also report outbursts at home. He is failing in school, and his parents are thinking of sending him to a wilderness camp where he can “get some sense knocked into him.” The most likely DSM-5 diagnosis for Jacob is which of the following?
Select one:
A. Intermittent Explosive Disorder
B. Oppositional Defiant Disorder
C. Bipolar II Disorder
D. Disruptive Mood Dysregulation Disorder
Answer D is correct: Disruptive Mood Dysregulation Disorder involves severe, recurrent temper outbursts with a persistent irritable or angry mood between outbursts on most days.
Answer A: A persistent irritable mood between temper outbursts is not characteristic of Intermittent Explosive Disorder.
Answer B: Oppositional Defiant Disorder differs from Disruptive Mood Dysregulation Disorder primarily in terms of the severity, frequency, and chronicity of the temper outbursts, with Disruptive Mood Dysregulation Disorder having more severe, frequent, and chronic symptoms. When the criteria for both disorders are met, a diagnosis of Disruptive Mood Dysregulation Disorder is assigned.
Answer C: The essential feature of Bipolar II Disorder is hypomania (a distinct period of abnormally elevated, expansive, or irritable mood accompanied by increased activity or energy). Although people with Disruptive Mood Dysregulation Disorder are irritable, they do not exhibit the increased energy that is characteristic of Bipolar II Disorder. Also, the mood disturbance associated with Bipolar Disorder is episodic in nature, whereas the mood disturbance associated with Disruptive Mood Dysregulation Disorder is persistent.
The correct answer is: Disruptive Mood Dysregulation Disorder
Cataplexy is:
Select one:
A. a movement disorder in which involuntary muscle contractions produce repetitive twisting movements.
B. a sudden loss of muscle tone that can produce muscle weakness, loss of voluntary muscle control, or postural collapse.
C. a condition involving postural rigidity and a lack of response to external stimuli.
D. a loss of the ability to perform skilled, coordinated movements in the absence of motor or sensory deficits.
Cataplexy is associated with narcolepsy.
a. Incorrect This describes dystonia.
b. CORRECT Cataplexy is often precipitated by strong emotion and causes flaccid paralysis (loss of muscle tone).
c. Incorrect This describes catalepsy, which is a symptom of Schizophrenia and epilepsy and can be produced by hypnosis.
d. Incorrect This describes apraxia.
The correct answer is: a sudden loss of muscle tone that can produce muscle weakness, loss of voluntary muscle control, or postural collapse.
Tom, a 35-year-old television repairman, becomes extremely upset whenever his boss and co-workers say something unfavorable about his work and is very uncomfortable whenever he feels he is being watched at work. He reports having only one close friend who he says he is very afraid of losing. Tom rarely leaves the house except to go to work, and he tells you that one of the reasons is because he is not a very good driver and he fears he’ll get into a car accident. Based on this information, the best diagnosis for Tom is:
Select one:
A. Schizoid Personality Disorder.
B. Schizotypal Personality Disorder.
C. Avoidant Personality Disorder.
D. Dependent Personality Disorder.
Tom’s behavior is characterized by social discomfort and extreme sensitivity to negative evaluations.
a. Incorrect Although some of Tom’s symptoms are also suggestive of Schizoid Personality Disorder, this is not the best answer since Tom seems to desire close relationships (i.e., he says he is worried about losing his best friend). Also, people with Schizoid Personality Disorder appear indifferent to criticism.
b. Incorrect Schizotypal Personality Disorder entails behaviors that are similar to those associated with Schizophrenia but are less severe and transient.
c. CORRECT Based on the information given, the best diagnosis is Avoidant Personality Disorder, which entails sensitivity to criticism, avoidance of social activities, embarrassment, and distress at the inability to form close personal relationships.
d. Incorrect Dependent Personality Disorder is characterized by a pattern of dependent and submissive behaviors.
The correct answer is: Avoidant Personality Disorder.
The most common precursor of Bulimia Nervosa during adolescence is:
Select one:
A. academic failure.
B. dieting.
C. sexual abuse.
D. peer rejection.
A number of factors have been linked to Bulimia, and, unfortunately, the literature is not entirely consistent with regard to these factors.
a. Incorrect Although academic (and interpersonal) problems are associated with this disorder, they are less consistent predictors than dieting.
b. CORRECT L. K. G. Hsu notes that Bulimia and other eating disorders almost always begin with dieting (Eating disorders, New York, Guilford, 1993). He proposes that “dieting provides the entree into an eating disorder” (p. 76), especially when dieting is combined with other high-risk factors such as depression or social anxiety, low self-concept, and poor identity formation.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: dieting.
Epidemiological studies on rates of various mental disorders in urban and rural areas in the United States have found that:
Select one:
A. for most mental disorders, the rates are significantly higher in urban areas.
B. for most mental disorders, the rates are significantly higher in rural areas.
C. some disorders are more common in rural or in urban areas, but the differences in rates are usually not statistically significant.
D. some disorders are more common in rural or in urban areas, and the differences in rates are usually statistically significant.
This is a difficult question to answer since the reported rates of various mental disorders in rural and urban areas vary somewhat from study to study.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Overall, the best conclusion that can be drawn is that there are few consistent (or statistically significant) differences in the rates of mental disorders in urban and rural areas. For example, a recent Healthcare for Communities (HCC) survey of 9,585 individuals living in rural and urban areas found no significant differences in the prevalence of the major types of mental illness (L. Tang et al., Report on the Survey Method for the Household Survey of Healthcare for Communities, 1997-1998, Los Angeles, Health Sciences Research Center, UCLA, 2001). This lack of significant differences between rates in rural and urban areas is consistent with the findings of the Epidemiologic Catchment Area Study and the National Comorbidity Survey.
d. Incorrect See explanation for response c.
The correct answer is: some disorders are more common in rural or in urban areas, but the differences in rates are usually not statistically significant.
In contrast to most organic forms of amnesia, Dissociative Amnesia usually:
Select one:
A. affects only memory for events that occurred before the trauma that precipitated the amnesia.
B. affects memory for events that occurred both before and after the trauma that precipitated the amnesia.
C. affects the ability to acquire new information from the time of the trauma that precipitated the amnesia to the present.
D. affects memory for events that occurred at the time of the trauma that precipitated the amnesia and for a circumscribed period following the trauma.
Dissociative Amnesia is a type of functional (psychogenic) amnesia that is often associated with a traumatic event and is characterized by an inability to remember important personal information with gaps in memory being related to the traumatic event.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect In most cases of Dissociative Amnesia, the individual does not have trouble acquiring new information once the trauma that precipitated the memory loss is over. In other words, the anterograde amnesia is usually related to the traumatic event and for events that occurred during a circumscribed period following the trauma.
d. CORRECT Memory loss in Dissociative Amnesia is most often anterograde - i.e., it typically involves the trauma and, in some cases, other events that occurred during a circumscribed period following the trauma. Retrograde amnesia (loss of memory for events prior to the trauma) is rare in Dissociative Amnesia; and, when it occurs, the loss of past memories is often reversed through hypnosis.
The correct answer is: affects memory for events that occurred at the time of the trauma that precipitated the amnesia and for a circumscribed period following the trauma.
Ella E. age 10, often says she doesn't want to go to school because she's afraid some of the children in her class will be "mean" to her. She seems overly concerned about her ability to perform well at school and in social situations and has trouble finishing her homework and other tasks because she keeps re-doing them because she wants them to be "perfect." Ella frequently says she has a headache and has trouble falling asleep at night. Her mother tries to keep Ella from watching the news because she's unwilling to go out of the house whenever there's a story about a local murder or accident. Based on these symptoms, the best diagnosis for Ella is: Select one:
A. Separation Anxiety Disorder.
B. Agoraphobia.
C. Generalized Anxiety Disorder.
D. Specific Phobia.
This child is expressing excessive worry about multiple situations.
a. Incorrect A diagnosis of Separation Anxiety Disorer requires evidence of excessive anxiety concerning separation from those to whom the child is attached. This evidence is not provided in the description given in this question.
b. Incorrect The question does not indicate that the child has a fear of being in places where escape might be difficult or embarassing or where help might not be available if panic-like symptoms develop, which are the essential features of Agoraphobia.
c. CORRECT Generalized Anxiety Disorder involves excessive worry or anxiety about a number of events or activities that the person finds difficult to control. Children with this disorder are often perfectionistic, filled with self-doubt, and typically exhibit physical signs of anxiety (e.g., headaches, stomachaches).
d. Incorrect Specific Phobia is characterized by a marked and persistent fear of a specific object or situation. The child’s fears in this case are broader than this and, therefore, Generalized Anxiety Disorder is the better diagnosis.
The correct answer is: Generalized Anxiety Disorder.
Marlatt and Gordon’s (1985) relapse prevention model focuses on:
Select one:
A. situations antecedent to relapse.
B. the perceived consequences of relapse.
C. controlled drinking.
D. contingency management.
Marlatt and Gordon’s approach to the definition and treatment of addictions is classified as a social learning approach that combines behavioral and cognitive principles.
a. CORRECT According to Marlatt and Gordon, relapse is a failure to maintain a behavior change after treatment and is best avoided by identifying and dealing with its antecedents.
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: situations antecedent to relapse.
For a person with Bipolar Disorder, the risk for suicide is greatest:
Select one:
A. when depressive symptoms are most severe.
B. when depressive symptoms have become less severe.
C. shortly after the onset of a depressive episode.
D. shortly after the onset of a manic episode.
There is some evidence that the risk for suicide is related to the severity of symptoms.
a. Incorrect See explanation for response b.
b. CORRECT According to some experts, the risk for suicide is greatest when depressive symptoms begin to lift. Apparently, this is because, at this time, suicidal ideation has not subsided and the individual has the increased energy and planning ability required to carry out a suicide plan. See, e.g., H. N. Holmes (ed.), Professional guide to diseases, Springhouse, PA, Springhouse, 2001.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: when depressive symptoms have become less sever
Which of the following is categorized as a “negative symptom” of Schizophrenia?
Select one:
A. avolition
B. loosening of associations
C. catatonia
D. perceptual disturbances
The symptoms of Schizophrenia are classified as positive or negative. Additional information about these symptoms is provided in the Abnormal Psychology chapter of the written study materials.
a. CORRECT Avolition is an inability to initiate and persist in action and is classified as a negative symptom.
b. Incorrect Loosening of associations is classified as a positive symptom.
c. Incorrect Catatonia is a type of disorganized behavior and is classified as a positive symptom.
d. Incorrect Perceptual disturbances (hallucinations and delusions) are positive symptoms.
The correct answer is: avolition
Longitudinal research conducted by Strauss and Carpenter (1991) has found that, for patients with Schizophrenia, prognosis with regard to future employment is best predicted by:
Select one:
A. frequency of social contacts.
B. symptom severity.
C. employment history.
D. duration of hospitalization.
Answer C is correct: This issue was investigated by W. Strauss and J. Carpenter in their longitudinal study of individuals with Schizophrenia [The prediction of outcome in Schizophrenia IV: Eleven-year follow-up of the Washington IPSS cohort, The Journal of Nervous and Mental Disease, 179(9), 517-525, 1991]. A key finding of their study was that the various domains of functioning are relatively independent - previous employment is the best predictor of current employment, past symptom severity is the best predictor of current symptom severity, etc.
The correct answer is: employment history.
During her first session, Jane, age 43, tells the clinician that she needs to work on anxiety and relationship issues. She says she divorced her second husband 11 months ago and has been dating a man she met at church for a month but thinks he’s going to “dump” her because of her physical problems. Jane has Type 2 diabetes, which is well-managed with medication. However, she complains of frequent stomach problems, severe headaches, and back pain and says she spends a lot of time researching diseases on the Internet to try to figure out what’s wrong with her besides diabetes. Jane has been evaluated by a physician who told her that, other than diabetes, she does not have any medical problems. What DSM-5 diagnosis should the clinician consider first?
Select one:
A. Somatic Symptom Disorder
B. Factitious Disorder
C. Illness Anxiety Disorder
D. Psychological Factors Affecting Other Medical Condition.
Answer A is correct: Jane’s symptoms are consistent with Somatic Symptom Disorder, which is included in the DSM-5 with Somatic Symptom and Related Disorders. The essential feature of this disorder is the presence of multiple somatic symptoms that cause distress or disruption in one’s daily life.
Answer B: Factitious Disorder is characterized by falsification of physical or psychological symptoms or induction of an illness or injury that is associated with an identified deception. No information given in the question suggests that Jane is faking or causing her symptoms.
Answer C: Illness Anxiety Disorder is characterized by excessive worry about being or becoming ill and usually does not include somatic symptoms or includes only symptoms of mild intensity.
Answer D: The diagnosis of Psychological Factors Affecting Other Medical Conditions is assigned when a person’s psychological problems affect the course of a medical condition or interfere with its treatment. Jane’s symptoms do not seem to be interfering with her management of her diabetes.
The correct answer is: Somatic Symptom Disorder
John is a 35-year-old graphic designer who is seeking help for his fear of public speaking. Due to a recent promotion, he is now required to make regular “pitches” to prospective clients. Previously, his work was mostly “behind the scenes,” and he’s afraid that he will “blow it” when making presentations and look incompetent and silly to his co-workers and the clients. John is considering asking to be demoted so that he won’t have to make presentations. He states that public speaking has been a problem for him since high school, and that he feels like he’s having a panic attack whenever he has to speak in front of a group. The most likely DSM-5 diagnosis for John is:
Select one:
A. Social Anxiety Disorder
B. Panic Disorder
C. Specific Phobia
D. Generalized Anxiety Disorder
Answer A is correct: John’s symptoms meet the diagnostic criteria for Social Anxiety Disorder, which is diagnosed when the individual experiences marked fear or anxiety of fear of scrutiny by others in one or more social situations that is out of proportion to the actual threat posed by the situation. Since John’s symptoms occur only when he speaks in public, the specifier “performance only” would be added to his diagnosis.
Answer B: Panic Disorder is characterized by sudden, unexpected panic attacks. John’s panicky feelings are clearly linked to a specific stressor (public speaking) and, therefore, are not unexpected.
Answer C: Specific Phobia is characterized by marked fear or anxiety about a specific object or situation; whereas, the fear or anxiety associated with Social Anxiety Disorder is related to a fear of scrutiny by others.
Answer D: Generalized Anxiety Disorder involves excessive anxiety and worry about multiple events or activities and the anxiety and worry are not necessarily due to a fear of scrutiny by others. John’s anxiety and worry are related to a single activity (public speaking) and to a fear of scrutiny by others, so Social Anxiety Disorder is the appropriate diagnosis.
The correct answer is: Social Anxiety Disorder
Although no single structural abnormality of the brain explains the majority of cases of Schizophrenia, _____________ has been most frequently found in patients with this disorder.
Select one:
A. enlargement of the frontal lobes
B. enlargement of the ventricles
C. atrophy of the cerebellum
D. atrophy of the right hemisphere
Several structural brain abnormalities have been linked to Schizophrenia, although no single abnormality has been found to underlie the majority of cases.
a. Incorrect See explanation for response b.
b. CORRECT A minority of patients (15 to 30%) exhibit enlargement of the lateral and third ventricles, which is the largest percent found to have any of the structural abnormalities identified so far. Other abnormalities found in an even smaller percent of patients include smaller-than-normal hippocampus and amygdala.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: enlargement of the ventricles
Approximately 80% of children with ADHD continue to have symptoms of the disorder as adolescents. However, in adolescence, symptoms of ____________ typically decrease.
Select one:
A. hyperactivity
B. inattention
C. hyperactivity and inattention
D. inattention and impulsivity
The studies have found that the majority of children with ADHD continue to have symptoms in adolescence but that the symptoms change somewhat.
a. CORRECT Hyperactivity typically decreases in adolescence, while impulsivity (especially verbal and emotional impulsivity) and inattention continue. In addition, during adolescence, ADHD is often masked by other problems such as oppositionality, learning difficulties, low self-esteem, and deficits in social skills. See, e.g., G. Kewley, Attention deficit hyperactivity disorder: What can teachers do?, New York, Routledge, 2011.
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: hyperactivity
A white middle-aged man is at highest risk for suicide if he:
Select one:
A. has been divorced for 10 years, overtly expresses aggression and hostility, and is unwilling to talk about his suicidal feelings.
B. has been divorced for 6 years, exhibits a constriction of affect, and has a peptic ulcer.
C. has been divorced for 3 years, overtly expresses aggression and hostility, and is unwilling to talk about his suicidal feelings.
D. has been divorced for 1 year, exhibits a constriction of affect, and has a peptic ulcer.
Knowing that divorce is related to increased risk for suicide, with the risk being greatest during the first year, would have helped you answer this question correctly.
a. Incorrect Unwillingness to talk about suicidal feelings is more characteristic of older adults than middle-aged adults.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The more recent the divorce, the greater the risk for suicide. A higher risk in adulthood is also associated with constriction of affect (versus overt expression) and the presence of certain illnesses including a peptic ulcer. See, for example, S. J. Blumenthal and D. J. Kupfer, Suicide over the life cycle: Risk factors, assessment, and treatment of suicidal patients, American Psychiatric Press, Washington, DC, 1990.
The correct answer is: has been divorced for 1 year, exhibits a constriction of affect, and has a peptic ulcer.
Which of the following is not an empirically supported treatment for primary insomnia?
Select one:
A. stimulus control therapy
B. sleep restriction
C. cognitive therapy
D. habit reversal training
A number of non-pharmacological treatments have been identified as empirically validated treatments for primary insomnia. For a review of the research, see C. M. Morin et al., Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004), Sleep, 29(11), 1398-1414, 2006.
a. Incorrect Stimulus control therapy is a commonly used treatment for insomnia and has been confirmed by the research to be an effective approach. It incorporates several strategies that help make the individual’s bed and bedroom serve as cues for sleep.
b. Incorrect Sleep restriction has also been found to be an effective treatment for insomnia. When using this technique, the amount of time allotted for sleep is initially restricted to create a “sleep debt” and the amount of time spent sleeping is then gradually lengthened.
c. Incorrect Cognitive therapy for insomnia involves identifying and replacing dysfunctional thoughts and attitudes that underlie the person’s sleep problems.
d. CORRECT Habit reversal training is used to eliminate habits and other undesirable repetitive behaviors including tics, trichotillomania, and stuttering.
The correct answer is: habit reversal training
Recent research investigating treatments for Generalized Anxiety Disorder suggests that the most effective intervention is:
Select one:
A. EMDR.
B. systematic desensitization.
C. stress inoculation training.
D. cognitive-behavioral therapy.
A number of well-designed studies on interventions for Generalized Anxiety Disorder confirm that the best treatment is cognitive or cognitive-behavioral in nature.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The studies have consistently found that a multicomponent cognitive or cognitive-behavioral approach is most effective for Generalized Anxiety Disorder. See, e.g., D. H. Barlow, J. Esler, and A. Vitali, Psychosocial treatments for panic disorders, phobias, and generalized anxiety disorder, in P. E. Nathan and J. M. Gorman (eds.), A guide to treatments that work, New York, Oxford University Press, 1998.
The correct answer is: cognitive-behavioral therapy.
In contrast to Korsakoff’s Syndrome, Alzheimer’s disease is associated with:
Select one:
A. more severe anterograde amnesia.
B. greater confabulation.
C. less severe working memory impairment.
D. a wider range of cognitive deficits.
Korsakoff’s syndrome and Alzheimer’s disease share several symptoms.
a. Incorrect This response is imprecise and not the best one – e.g., how is anterograde amnesia measured and what stage of Alzheimer’s is being compared to Korsakoff’s syndrome? Also, an essential feature of Korsakoff’s syndrome is severe anterograde amnesia.
b. Incorrect Confabulation is an essential feature of Korsakoff’s syndrome.
c. Incorrect Alzheimer’s disease is actually associated with more severe working memory deficits than Korsakoff’s syndrome is.
d. CORRECT Korsakoff’s syndrome is characterized by disproportionate memory deficits relative to other types of cognitive impairment [M. D. Kopelman, The Korsakoff Syndrome, British Journal of Psychiatry, 166(2), 154-173, 1995]. In contrast, Alzheimer’s disease involves memory impairment plus severe impairments in other aspects of cognitive functioning.
The correct answer is: a wider range of cognitive deficits.
Dr. A., a psychologist, provides office space and secretarial services to Dr. B., a newly-licensed psychologist, in exchange for 25% of the fee that Dr. B. collects from his clients. Dr. A. begins referring clients to Dr. B. and charges him 35% for the referred clients. This is:
Select one:
A. unethical because the arrangement violates APA’s prohibition against “fee splitting.”
B. unethical because the percentage that Dr. A. is charging Dr. B. is exploitative.
C. ethical only if the larger fee for referred clients reflects increased costs to Dr. A. for making referrals to Dr. B.
D. ethical because the arrangement does not violate the provisions of the Ethics Code regarding referral fees.
Although referral fees are not entirely prohibited by the Ethics Code, there are some restrictions.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT It is ethical to pay a fee for a referral when the fee reflects the person’s expenses for making the referral. However, charging more for referred patients than non-referred patients when there are no additional costs would be unacceptable.
d. Incorrect See explanation for response c.
The correct answer is: ethical only if the larger fee for referred clients reflects increased costs to Dr. A. for making referrals to Dr. B.
Dr. Weiner, a psychologist, is conducting a research study and obtains subjects for his study by placing advertisements in a local newspaper. Dr. Weiner informs potential subjects about all aspects of the study and tells them that they should not agree to participate unless they are willing to stay for its duration (six sessions over a six-week period), since once they sign up, they will not be permitted to withdraw from the study. According to APA’s Ethics Code, the proposed arrangement is:
Select one:
A. clearly ethical.
B. ethical as long as the withdrawal restriction is included in the informed consents that all subjects must sign.
C. ethical as long as the withdrawal restriction has been determined to be crucial to the study.
D. unethical.
A researcher must respect the participants’ right to withdraw at any time for any reason in the course of a study.
a. Incorrect A withdrawal restriction such as the one described in the question is unethical.
b. Incorrect Under no conditions is such a withdrawal restriction ethical.
c. Incorrect Under no conditions is such a withdrawal restriction ethical.
d. CORRECT This answer is in line with Standard 8.02 of the APA’s Ethics Code.
The correct answer is: unethical.
A research psychologist designs a study that involves hospitalized psychiatric patients who have legal guardians. Before beginning the study, he obtains signed consents from the legal guardians. The psychologist has acted:
Select one:
A. unethically since he has breached the patients’ confidentiality.
B. ethically as long as the patients are allowed to withdraw from the study at any time.
C. ethically as long as he has also obtained assent from the patients.
D. ethically, since all a psychologist must obtain in this situation is the informed consent of legal guardians.
This issue is addressed in Standard 3.10 of the APA’s Ethics Code.
a. Incorrect Ethical guidelines require that informed consent be obtained from the patients’ legal guardians in this situation.
b. Incorrect Standard 8.02(a) dictates that participants have the right to withdraw from research at any time. However, this is not the best answer since it does not address the question’s underlying ethical issue; i.e., the need for psychologists to obtain assent from participants who are legally incapable of giving informed consent.
c. CORRECT This answer is consistent with the requirements of the Ethics Code – i.e., when research participants are not legally capable of giving informed consent (either because they are mentally incompetent or minors), consent must be obtained from their legal guardians, and the participants should be provided with understandable information and their assent to participate should be obtained.
d. Incorrect See explanation for response c.
The correct answer is: ethically as long as he has also obtained assent from the patients.
You are working in a correctional facility and are asked to evaluate a prisoner to determine his eligibility for parole. In this situation, you should:
Select one:
A. conduct the evaluation as requested since it is part of your job.
B. conduct the evaluation only if you believe it will serve a useful dispositional function.
C. conduct the evaluation after reminding the prisoner that anything he says can be shared with prison authorities.
D. refuse to conduct the evaluation unless it has been court-ordered.
Relatively little has been written about ethical considerations in correctional facilities, so few guidelines are available. However, APA published recommendations in a 1978 issue of the American Psychologist that apply to this situation (Report of the task force on the role of the psychologist in the criminal justice system, American Psychologist, 33, 1099-1133, 1978).
a. Incorrect See explanation for response b.
b. CORRECT Recommendation 3 of the above-cited document states that “Other than for legitimate research purposes, psychological assessments of offenders should be performed only when the psychologist has a reasonable expectation that such assessments will serve a useful therapeutic or dispositional function.”
c. Incorrect APA recommends that the “ideal level of confidentiality of therapeutic services in criminal justice settings should be the same as the level of confidentiality that exists in voluntary non-institutional settings.” Although there certainly are exceptions to confidentiality in prison settings that would not apply elsewhere, it’s not true that a prisoner has no right to confidentiality, which this response implies.
d. Incorrect See explanation above.
The correct answer is: conduct the evaluation only if you believe it will serve a useful dispositional function.
You receive a letter from the attorney of a former client requesting that you send test information to her from the client’s file. The requested information will be used in a court case and includes the test questions, the client’s responses to those questions, and the client’s test scores. The attorney’s letter is accompanied by a signed release from the client. To be consistent with ethical requirements, you should:
Select one:
A. release all test information as requested.
B. release only a summary of the client’s test information.
C. release the clients responses and test scores but not the test questions.
D. refuse to release any information to anyone other than a mental health professional.
Answer C is correct: Standards 9.04 and 9.11 of the APA’s Ethics Code distinguish between test data and test material and state that test data may be provided to an attorney or other person listed in a client’s release but that test material should not be released because doing so may constitute a breach of test integrity and security. As defined in Standard 9.11, test material includes “manuals, instruments, protocols, and test questions or stimuli.” Of the answers given, this one is most consistent with the provisions of the APA’s Ethics Code and with Paragraph IV.11 of the Canadian Code of Ethics for Psychologists.
The correct answer is: release the clients responses and test scores but not the test questions.
Dr. K. has just started working at a community mental health center. Several of his new clients belong to an ethnic minority group that he has not had prior experience working with. Dr. K. should:
Select one:
A. refuse to see the clients because he has not had adequate experience.
B. see the clients only if he has completed appropriate coursework on cross-cultural counseling.
C. ask the clients if they desire a referral and, if so, refer them to another therapist.
D. see the clients but obtain appropriate supervision or consultation.
During the course of his/her career, a therapist will ordinarily want to acquire new skills and will want to expand his/her practice to include new kinds of clients. This is particularly true for Dr. K. since he is working at a clinic where some clients are apparently members of minority groups.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The ethical guidelines recommend that therapists seek appropriate supervision or consultation when working with clients who belong to an unfamiliar group or population. In some situations, a referral would be an appropriate course of action, but supervision or consultation seems best in this case.
The correct answer is: see the clients but obtain appropriate supervision or consultation.
During the third therapy session, a client confides to her psychologist that she was once a sex worker. The psychologist is offended by this type of behavior, feels incapable of dealing with the client objectively, and terminates therapy immediately. His action is:
Select one:
A. unethical because it represents abandonment of the client.
B. ethical because he could not deal with the client objectively.
C. unethical because a therapist should not allow personal opinions to interfere with professional activities.
D. ethical since he has seen the client in therapy for only a few sessions.
During the course of therapy, a therapist may occasionally feel incapable of providing a client with the services the client needs. When such situations arise the therapist should handle them in an appropriate, professional manner. If the therapist feels that he/she must terminate therapy, he/she should do so with extreme care. The therapist should be careful not to “blame” the client, and an appropriate referral should be made.
a. CORRECT This situation clearly represents abandonment of the client. Although a therapist might feel it necessary to terminate therapy due to personal beliefs, termination must be handled in a professional, sensitive manner. A therapist must evaluate his/her feelings carefully, and arrange for a referral if necessary. Abrupt termination is not appropriate.
b. Incorrect Although termination might have been appropriate in this situation, the therapist did not handle the termination properly.
c. Incorrect Although it is important that therapists remain objective, a therapist cannot always prevent his/her personal feelings from affecting therapy. When these feelings interfere with the quality of the therapy, the therapist needs to take action necessary to protect the interests of the client.
d. Incorrect The situation described was not handled appropriately and clearly constitutes an ethical violation.
The correct answer is: unethical because it represents abandonment of the client.
A psychologist in private practice who has been sued once in the past by a client for malpractice and who fears being sued again decides to limit his practice to clients whose problems are not highly associated with higher rates of malpractice claims. This is:
Select one:
A. unethical if he is competent to treat these clients.
B. ethical only if he is willing to see these clients in emergencies and other unusual circumstances.
C. ethical as long as he makes appropriate referrals.
D. ethical as long as he makes his policy clear at the outset of treatment.
Although you may feel the therapist’s decision is “not quite right,” therapists are not required to see patients they do not want to see.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This issue is addressed by R. I. Simon in Clinical psychiatry and the law (American Psychiatric Press, Washington, DC, 1992). Although Simon is discussing the obligations of psychiatrists, the same principles apply to psychologists: Self-employed mental health professionals do not have a legal or ethical duty to enter into professional relationships. While the psychologist’s decision may seem unfair, he is free to serve the clients he chooses. He should, however, make appropriate referrals. (Note that the Ethics Code does require psychologists not to discriminate on the basis of race, gender, or any other basis proscribed by law. Litigious clients do not fall into this category, however.)
d. Incorrect See explanation for response c.
The correct answer is: ethical as long as he makes appropriate referrals.
Dr. Tartuffe is conducting a survey to obtain the information needed to compare therapists who have and have not had a sexual relationship with a client. The results of his survey will most likely indicate that therapists who say they have been sexually involved with a client:
Select one:
A. are also more likely to have been sexually involved with their own supervisor.
B. are also more likely to have had non-sexual dual relationships with their clients.
C. are also more likely to make use of therapeutic touch in therapy.
D. are not distinguishable from those who have not been sexually involved with a client in terms of sex with their own supervisor, non-sexual dual relationships, or the use of therapeutic touch.
The characteristics of therapists who have and have not had sexual relationships with their clients were assessed by a survey conducted by D. H. Lamb and S. J. Catanzaro (Sexual and nonsexual boundary violations involving psychologists, clients, supervisees, and students: Implications for professional practice, Professional Psychology: Research and Practice, 29(5), 498-503, 1998).
a. Incorrect See explanation for response b.
b. CORRECT Lamb and Catanzaro found that psychologists who had sex with their clients were no more likely to have had sex with their supervisors than psychologists who did not have sex with their clients. However, psychologists reporting sexual relationships with their clients also reported more nonsexual dual relationships. (The issue of therapeutic touch was not examined in the survey, and there is no evidence to support response c.)
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: are also more likely to have had non-sexual dual relationships with their clients.
You have been seeing a couple in therapy for six months. The wife calls you and says she wants to start seeing you for individual sessions also. You should:
Select one:
A. bring up this possibility in the next couples session.
B. tell her you cannot see her individually until couples therapy is over.
C. refer her to another therapist for individual therapy.
D. make an appointment with her to determine if her problem warrants individual therapy.
Standard 10.02 of the Ethics Code makes it clear that, in couples therapy, psychologists must avoid potentially conflicting roles. One way to ensure that conflicts do not occur is to clarify one’s policies and responsibilities. It may or may not be the psychologist’s policy to provide individual therapy while also providing conjoint therapy, and this should have been clarified at the onset of therapy. Also, a referral may be appropriate, but the issue should first be discussed in conjoint therapy.
a. CORRECT Bringing up the issue in the next couples therapy session would be the best initial course of action.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: bring up this possibility in the next couples session.
Dr. Raj provided treatment to a client in State X where Dr. Raj resides and works. Treatment ended six months ago and the client has since moved to State Y. Dr. Raj receives a subpoena from the client’s attorney who also resides and works in State Y. The subpoena requires Dr. Raj to provide testimony at a trial involving the former client. Dr. Raj:
Select one:
A. is not required to appear since the subpoena is from another state.
B. must appear and testify as requested as long as the client has signed a release of information.
C. must appear as long as the subpoena was issued by the court.
D. should contact an attorney to determine if he must appear as requested.
This is really a question of law and depends on applicable laws regarding jurisdiction. So, the best thing to do would be to consult a lawyer to determine whether it is necessary to comply with the subpoena.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT In his book on legal matters, R. Woody concludes that the appropriate course of action in this type of situation would be to consult an attorney to determine the legal authority of the subpoena (Legally safe mental health practice: Psycholegal questions and answers, Madison, CT, Psychosocial Press, 1997).
The correct answer is: should contact an attorney to determine if he must appear as requested.
Dr. Lane, a psychologist, is conducting a research study on peer pressure, and the study’s participants will be 120 fifth-grade students. The study will involve a 30-minute interview with each student and observation of the students during their lunch hour. Before beginning the study, Dr. Lane should:
Select one:
A. obtain an informed consent from each student.
B. obtain an informed consent from each student’s parent.
C. obtain an informed consent from appropriate school personnel.
D. obtain the assent of each student and an informed consent from each student’s parent.
Standard 3.10(b) of the APA’s Ethics Code is relevant to this situation.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This answer is consistent with Standard 3.10(b), which states: “For persons who are legally incapable of giving informed consent, psychologists nevertheless (1) provide an appropriate explanation, (2) seek the individual’s assent, (3) consider such persons’ preferences and best interests, and (4) obtain appropriate permission from a legally authorized person, if such substitute consent is permitted or required by law.” This requirement applies to minors and to adults who have been declared legally incompetent.
The correct answer is: obtain the assent of each student and an informed consent from each student’s parent.
An undergraduate student is asked by a professor to assist in a new research project. The student will help with the literature review and data analysis. According to the Ethics Code, when the research is published, the student should, at a minimum:
Select one:
A. be listed as a co-author.
B. be mentioned in an introductory statement or a footnote.
C. be mentioned in the abstract.
D. receive a letter of recommendation from the professor.
The Ethics Code mandates that contributors to research be given appropriate credit.
a. Incorrect The researcher has the option to list the student as a co-author but this is not required.
b. CORRECT At a minimum, the student should be acknowledged for his/her assistance in a footnote or introductory statement.
c. Incorrect The abstract is not an appropriate section to recognize research assistants. An abstract provides the reader with a brief summary of the research and its results.
d. Incorrect Although it is possible that the student may request a letter of recommendation, the teacher is not ethically bound to comply with the students’ wishes because of his/her assistance in the research project.
The correct answer is: be mentioned in an introductory statement or a footnote.
An employee is receiving counseling from a psychologist through his company’s employee assistance program. In this situation, the psychologist can let the employee’s supervisor know that the employee is receiving treatment:
Select one:
A. under no circumstance.
B. only if the employee was referred to the program by the supervisor.
C. as long as the employee has signed an authorization for release of confidential information.
D. as long as no other information about the treatment is given to the supervisor.
Confidentiality is a critical issue in employee assistance programs (EAPs). Under normal circumstances, information about an employee’s condition or treatment is not revealed without the employee’s consent.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Confidentiality may be breached in the context of EAPs in those situations that it can be breached in other contexts (e.g., when a client has signed an authorization or is believed to be a danger to him/herself or to others).
d. Incorrect See explanation for response c.
The correct answer is: as long as the employee has signed an authorization for release of confidential information.
The only time a client is able to see you is during her lunch hour, which requires her session to be limited to 30 minutes because of the distance she must travel to get to your office. When you bill her insurance company, however, you bill for the entire hour. This is:
Select one:
A. ethical since the shorter sessions are being provided at the client’s request.
B. ethical since your policy is to always bill clients for an entire hour.
C. unethical.
D. a legal, but not an ethical, issue.
The action described in this question represents insurance fraud which is both illegal and unethical.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This is the best answer of those given. Providing any inaccurate information to the insurance company would represent insurance fraud.
d. Incorrect See explanation for response c.
The correct answer is: unethical.
Dr. Greene, a psychologist in private practice, sets his clients’ fees according to their ability to pay as determined by their yearly income. As a result, some of his clients are paying a very low fee or no fee, while others are paying a fee that is considerably above-average for the location of his practice. Dr. Greene’s fee policy is:
Select one:
A. illegal in most states and clearly unethical.
B. legal in most states but unethical.
C. both legal and ethical.
D. ethical but illegal in most states.
Sliding scale fees are legally and ethically acceptable as long as the fee arrangement is made clear from the onset of therapy.
a. Incorrect Sliding scale fees are not unethical and illegal.
b. Incorrect Sliding scale fees are not unethical.
c. CORRECT Sliding scale fees are a common practice and are both legal and ethical.
d. Incorrect Sliding scale fees are not illegal.
The correct answer is: both legal and ethical.
As defined in the APA’s Ethics Code, uninvited in-person solicitation of business by a psychologist is:
Select one:
A. acceptable as long as the solicitation is not coercive.
B. acceptable when it involves providing disaster or community outreach services.
C. acceptable as long as the person’s “best interests” are of paramount concern.
D. never acceptable.
The uninvited in-person solicitation of business is addressed in Standard 5.06 of the APA’s Ethics Code.
a. Incorrect See explanation for response b.
b. CORRECT Standard 5.06 generally prohibits psychologists from engaging in uninvited in-person solicitation of business. However, it also notes that the prohibition does NOT preclude psychologists from “providing disaster or community outreach services.”
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: acceptable when it involves providing disaster or community outreach services.
A psychologist is hired by a defense attorney to evaluate a defendant to determine the appropriateness of the insanity defense. During the first meeting with the defendant, the psychologist explains the purpose of the evaluation. The defendant says he doesn’t want to cooperate with the evaluation because of the limits on confidentiality. The psychologist should:
Select one:
A. obtain a court order before evaluating the defendant.
B. obtain as much information from the defendant as possible and explain to the court why the evaluation is not complete.
C. explain to the defendant that privilege is waived in this situation and that the evaluation is in his best interests.
D. postpone the evaluation and notify the defense attorney of the defendant’s concerns.
This issue is addressed in the Specialty Guidelines for Forensic Psychology.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This response is most consistent with “common sense” and with the provisions of Paragraph 6.03.01 of the Specialty Guidelines.
The correct answer is: postpone the evaluation and notify the defense attorney of the defendant’s concerns.
Dr. Bernard is designing a longitudinal study on drug use in high schools. Since the study is longitudinal, it will be necessary to maintain records containing participants’ identities. A colleague of Dr. Bernard’s reminds him of a similar situation in which the investigator was subpoenaed to appear in court to testify against a participant who had been involved in illegal activities. The investigator refused to testify in order to maintain the participant’s confidentiality and was imprisoned. What should Dr. Bernard do in order to avoid a similar dilemma:
Select one:
A. if subpoenaed by the court, testify, since legal requirements override ethical considerations.
B. if subpoenaed by the court, testify only after obtaining the consent of the participant.
C. warn participants prior to participation in the study about the possibility of a breach of confidentiality and obtain informed consents.
D. design the study so that the names of participants are maintained in a separate file by a third party.
Standard 8.02(a) of APA’s Ethics Code states that psychologists “… psychologists inform participants about … reasonably foreseeable factors that may be expected to influence their willingness to participate such as potential risks, discomfort, or adverse effects … limits of confidentiality.”
a. Incorrect To some degree, this answer correctly describes a psychologist’s legal obligations in this situation. After being subpoenaed by the court, a psychologist usually asserts privilege. If privilege is not recognized, the psychologist usually must testify in order to avoid being held in contempt of court. However, this is not the best answer in that it does not deal with how the psychologist can “avoid this dilemma.” If the psychologist testifies, he has fulfilled his legal obligation without having dealt with his ethical obligation regarding confidentiality.
b. Incorrect Legally, a psychologist who has been subpoenaed by the court must testify (if the court does not recognize privilege) whether or not he has the consent of his client. Thus, this course of action would not resolve the dilemma between the psychologist’s legal and ethical obligations.
c. CORRECT This is most in accord with the above-cited Standard, and it represents a balance between the psychologist’s legal and ethical obligations. If he informs participants of the limits of confidentiality, they will give their consent to participate with full awareness of the possibility that the psychologist or his files might be subpoenaed.
d. Incorrect This course of action does not reduce the possibility that either the records or the psychologist will be subpoenaed.
The correct answer is: warn participants prior to participation in the study about the possibility of a breach of confidentiality and obtain informed consents.
The Publication Manual of the American Psychological Association states that some abbreviations do not require explanation in text. These include all of the following except:
Select one:
A. IQ.
B. HIV.
C. APA.
D. ESP.
The Publication Manual states that abbreviations that appear as word entries in the Webster’s Collegiate Dictionary (i.e., those without the label “abbr”) do not require explanation in text.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT You may have been able to recognize this as the correct answer as long as you recalled that “APA” can stand for several organizations including the American Psychological Association and the American Psychiatric Association. Therefore, you would need an explanation the first time that it’s used. The abbreviations listed in the other answers are provided in the Publication Manual as examples of abbreviations that do not require an explanation.
d. Incorrect See explanation for response c.
The correct answer is: APA.
A new client says she wants you to give her an IQ test so that she can use the results to join MENSA. You administer the test, but she obtains an IQ score of only 105. The client asks you to give her the test results so that she can destroy them, and she informs you that she is going to be retested by another psychologist. You should:
Select one:
A. give the original record of the test results to the client as requested.
B. destroy the original record of the test results yourself.
C. tell the client you will forward the original record to the other psychologist.
D. give the client a summary of the test results and retain the original record in your files.
This issue is addressed by R. Woody in Legally safe mental health practice: Psycholegal questions and answers, Madison, CT, Psychosocial Press, 1997. Woody notes that “No records, be they test results or otherwise, should ever be destroyed simply because one person, be it client or therapist, does not like the content” (p. 68).
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The client has the right to information about her test results, but the record itself belongs to the therapist, who has a “limited property right” in the document. In addition, records are to protect both the client and the therapist, and destroying a record at the request of the client would not necessarily be in the best interests of either the client or therapist.
The correct answer is: give the client a summary of the test results and retain the original record in your files.
A psychologist has been seeing a couple in therapy for six months and they have recently decided to get a divorce. The psychologist is asked by the husband to testify on his behalf in a court custody hearing. The psychologist should:
Select one:
A. refuse to testify.
B. agree to testify as long as she does not reveal confidential information about the wife.
C. agree to testify only if the wife gives consent for her to do so.
D. agree to testify only if she will be testifying for both parties.
This is fairly straightforward. When working with a couple, the couple is considered the client and the welfare of the client must always come first.
a. CORRECT As a general rule, a therapist should not provide services to one member of a couple when the couple has been the client. Even if the wife consents, it is not possible to foresee a situation that might put her welfare in jeopardy if the therapist testifies on behalf of the husband (response c). The action described in response d could similarly put the therapist in a very awkward position and jeopardize the welfare of one or both of the parties.
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: refuse to testify.
Which of the following would a managed care organization consider most useful for reducing its risk for legal liability?
Select one:
A. capitation
B. behavioral health “carve outs”
C. credentialing of providers
D. utilization review
Of the procedures listed in the responses, only one would be likely to reduce a managed health care organization’s risk for legal liability.
a. Incorrect Capitation refers to contracting for a set of services on the basis of a predetermined fee. It reduces the organization’s costs but does not protect it from legal liability.
b. Incorrect Behavioral health “carve outs” involve contracting behavioral health care services that are separate from the services provided for other health care. It is not associated with risk management.
c. CORRECT Credentialing providers helps ensure that providers are competent to provide services and thereby reduces the risk for legal liability (i.e., it contributes to risk management).
d. Incorrect Utilization review is another cost containment technique and may involve denying payment for services that are not deemed necessary by the managed health care organization.
The correct answer is: credentialing of providers
The attorney of a former client of yours requests that you provide her with test data and other information included in the client’s file. You should:
Select one:
A. provide the information since the request comes from the client’s attorney.
B. provide the information as requested only if you feel it is in the best interests of the client.
C. provide the information as requested only if the client has signed a release.
D. refuse to provide the information unless the client has signed a release and you believe the attorney is qualified to interpret the information.
Release of client information to a third party is addressed in Ethics Code Standard 9.04.
a. Incorrect See explanation for response c.
b. Incorrect The best interests of the client are certainly of concern, but this is not the best answer because it overlooks the client’s confidentiality.
c. CORRECT Standard 9.04 states that psychologist may withhold test data “to protect a client/patient or others from substantial harm” but that does not seem relevant to this situation. Therefore, the psychologist should release the test data as requested once the client has signed a release.
d. Incorrect See explanation for response c.
The correct answer is: provide the information as requested only if the client has signed a release.
The reviewer for a managed health care organization decides that additional services for one of your clients are not medically necessary. You strongly disagree with her decision because you believe your client’s condition is likely to worsen without additional therapy sessions. The client cannot afford to pay for therapy sessions himself. To act ethically and to minimize your legal liability in this situation, you should:
Select one:
A. carefully explain to the client the reason for termination and have him sign a waiver of responsibility.
B. provide the client with the names of several therapists who you know provide services at a low fee.
C. see the client at no fee for several sessions before terminating therapy.
D. file an appeal with the managed health care organization.
An important aspect of managed health care are the ethical and legal dilemmas that it can create.
a. Incorrect This action would not be ethical and basically constitutes abandonment of the client.
b. Incorrect Although a referral might be the action that is eventually taken, in most cases, it would not be the best first course of action from either an ethical or legal perspective.
c. Incorrect If it becomes necessary to end the therapeutic relationship, providing the client with free sessions during the termination period would be an ethical course of action. However, this is not the best answer of those given.
d. CORRECT In his discussion of “Legal Liability and Managed Care,” P. S. Appelbaum concludes that a psychologist’s ethical and legal obligation in cases such as this one is to appeal the reviewer’s decision (American Psychologist, 48(3), 251-7, 1993).
The correct answer is: file an appeal with the managed health care organization.
Dr. Able, a psychologist, has been seeing a client for five months and feels that the client may not be benefitting from treatment. When she mentions this to him, the client says he is quite satisfied with the progress of therapy. Based on this information, Dr. Able’s best course of action would be to:
Select one:
A. continue seeing the client in therapy since the client is satisfied.
B. tell the client that she is ethically required to refer him to another therapist.
C. obtain supervision to ensure that her treatment is effective.
D. consult with another psychologist to discuss the situation.
When psychologists believe that a client is not benefitting from treatment, special consideration must be given to the situation.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Although referral (response b) might be acceptable, it is not necessary as a first course of action in this case given the circumstances. Instead, consultation would be a better action since it would help the therapist determine if his evaluation of the situation is correct.
The correct answer is: consult with another psychologist to discuss the situation.
To be consistent with ethical requirements, when a psychologist realizes that a dual (multiple) relationship is unavoidable, the psychologist should:
Select one:
A. discuss the situation with the affected person “as early as is feasible.”
B. consult with a member of the Ethics Committee to determine the best course of action.
C. take reasonable steps to resolve the issue in a way that protects the best interests of the affected person.
D. file a complaint against him/herself with the Ethics Committee.
This issue is addressed by Standard 3.05(b) of the APA’s Ethics Code.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Standard 3.05(b) states that: “If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.” This answer is most consistent with the actual language of the Code and, therefore, is the correct response.
d. Incorrect See explanation for response c.
The correct answer is: take reasonable steps to resolve the issue in a way that protects the best interests of the affected person.
A legal guardian has been appointed by the court for a 9-year-old child after his biological parents are found guilty of child abuse. The legal guardian brings the child to you for treatment. You should:
Select one:
A. obtain permission from both of the child’s biological parents before providing treatment.
B. obtain permission from one of the child’s biological relatives before providing treatment.
C. obtain permission from the court before providing treatment.
D. provide the treatment to the child as requested by the guardian.
In most cases, the biological parents are the legal guardians of a minor child; in this case, the court has appointed a legal guardian.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The child’s legal representative in this case, the court-appointed guardian, has the right to request treatment for the child. Approval from the court of the child’s biological parents or relatives is not necessary.
The correct answer is: provide the treatment to the child as requested by the guardian.
Dr. Billings, a psychologist, asks a graduate student to help him with a research project. The student does most of the initial library research, administers the tests and interviews to subjects, and writes some of the article that Dr. Billings will submit to a professional journal. When the article is published, Dr. Billings should make sure that the graduate student is:
Select one:
A. listed as the first author.
B. listed as a co-author.
C. acknowledged in a footnote.
D. acknowledged in an introductory statement.
Standard 8.12(b) of 2002 the Ethics Code states that publication credits “accurately reflect the relative scientific or professional contributions of the individuals involved, regardless of their relative status.”
a. Incorrect First authorship is reserved for the principal contributor who, in this case, seems to be the psychologist.
b. CORRECT The graduate student has written some of the article and, therefore, should be listed as a co-author.
c. Incorrect Minor contributions are often acknowledged in a footnote or introductory statement. However, the student made a substantial contribution to the article and the journal article.
d. Incorrect See explanation for response c.
The correct answer is: listed as a co-author.
The purpose of a __________ is to guide the development of a program so that its final version maximizes the likelihood that the program will achieve its goals.
Select one:
A. summative evaluation
B. formative evaluation
C. needs assessment
D. functional assessment
For the exam, you want to be familiar with the difference between formative and summative evaluations so that you can answer questions like this one.
a. Incorrect A summative evaluation is conducted after a training program has been developed and administered to trainees in order to assess the program’s outcomes.
b. CORRECT Formative evaluations are conducted while a training program is being developed (“formed”) to obtain the information needed to determine what modifications are required.
c. Incorrect A needs assessment is conducted to determine if performance problems can be alleviated by providing training and, if so, to identify the content of a training program.
d. Incorrect A functional assessment (also known as a functional behavioral assessment) is conducted to identify the functions that a behavior serves in order to identify ways of modifying that behavior.
The correct answer is: formative evaluation
In contrast to Maslow’s need hierarchy theory, Alderfer’s ERG theory:
Select one:
A. places motivation within a satisfaction/dissatisfaction framework.
B. proposes that needs emerge in a predictable order.
C. assumes that needs may become more (rather than less) important as they are fulfilled.
D. has received little support as an explanation for motivation in the workplace.
ERG theory is a modification of Maslow’s need hierarchy theory. Among other things, it reduces Maslow’s five needs to three: existence, relatedness, and growth.
a. Incorrect This sounds like Herzberg’s two-factor theory.
b. Incorrect This is a characteristic of Maslow’s (not Alderfer’s) theory.
c. CORRECT This is an assumption of ERG theory and the opposite of what Maslow’s theory predicts.
d. Incorrect Alderfer’s theory has actually received more support than Maslow’s.
The correct answer is: assumes that needs may become more (rather than less) important as they are fulfilled.
Abraham Maslow derived his need hierarchy theory from:
Select one:
A. his experiences as a clinical psychologist.
B. his experience as an organizational consultant.
C. a review of the literature on motivation.
D. the principles of psychodynamic theory.
During his work as a clinical psychologist, Maslow noticed that people are motivated by different needs.
a. CORRECT Maslow derived his theory about the need hierarchy and self-actualization from his observations of therapy clients, work with college students, and study of people he believed to be highly productive (e.g., Abraham Lincoln, Thomas Jefferson, Eleanor Roosevelt).
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: his experiences as a clinical psychologist.
Bazerman, Tenbrunsel, and Wade-Benzoni’s (1998) distinction between the “should self” and the “want self” is most useful for understanding which of the following?
Select one:
A. ethical decision-making
B. affiliation preferences
C. employee satisfaction
D. adolescent egocentrism
Brazerman et al. distinguish between two competing selves - the “should self,” which is rational and cool-headed, and the “want self,” which is emotional and hot-headed. [Bazerman, M. H., Tenbrunsel, A. E., & K. A. Wade-Benzoni, Negotiating with yourself and losing: Understanding and managing conflicting internal preferences, Academy of Management Review, 23, 225-241, 1998.]
a. CORRECT The distinction between the “should self” and “want self” has been applied to ethical, business, and other types of decision-making. With regard to ethical decision-making, the should self refers to our ethical intentions and the belief that we should act in ways that are consistent with our ethical principles. In contrast, the want self applies to our actual behavior and reflects self-interest and a relative disregard for ethical concerns.
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: ethical decision-making
An advantage of the “paired comparison” technique is that it:
Select one:
A. helps reduce certain rater/observer biases.
B. provides helpful information for employee feedback.
C. is less time-consuming to complete than other techniques.
D. is more acceptable to employees and supervisors than other methods.
The paired comparison technique is a relative method for assessing performance that entails comparing an employee to other employees on predefined dimensions of job performance.
a. CORRECT One advantage of relative measures is that they help reduce rater biases.
b. Incorrect This is the opposite of what is true.
c. Incorrect This is the opposite of what is true.
d. Incorrect Employees tend to dislike relative measures because they do not want to be compared to other employees.
The correct answer is: helps reduce certain rater/observer biases.
