STUDY-MODE - Practice Exam 8 Flashcards
When using Atkinson, Morten, and Sue’s (1993) Racial/Cultural Identity Development Model, a person’s stage of identity development is determined by:
Select one:
A. identifying his/her degree of acceptance of the minority and majority cultures.
B. assessing the amount of contact he/she normally has with members of the minority and majority cultures.
C. assessing his/her attitudes toward the minority and majority cultures.
D. evaluating his/her reaction to racial oppression.
Atkinson et al.’s model distinguishes between five stages:
Conformity Dissonance Resistance/immersion Introspection Integrative awareness.
Additional information about these stages is provided in the Clinical Psychology chapter of the written study materials.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Each stage in this model is characterized by a different combination of attitudes toward one’s own minority group, other minority groups, and the majority (dominant) group.
d. Incorrect See explanation for response c.
The correct answer is: assessing his/her attitudes toward the minority and majority cultures.
An African American individual in the immersion substage of the immersion-emersion stage of Cross’s (1991) Black Racial Identity Development Model will exhibit which of the following?
Select one:
A. a lack of interest in race or racial issues
B. identification with the White (dominant) culture
C. functional paranoia
D. intense involvement in African American culture
Cross’s (1991) Black Racial Identity Development Model distinguishes between four stages:
Pre-encounter
Encounter
Immersion-emersion
Internalization
a. Incorrect A lack of interest in race is characteristic of the pre-encounter stage.
b. Incorrect African American individuals in the assimilation substage of the pre-encounter stage have adopted a mainstream (White) identity.
c. Incorrect Ridley (1984) used the term functional paranoia to refer to an unhealthy condition that is characterized by mistrust and suspicion. A person in the immersion-emersion stage is more likely to exhibit cultural paranoia, which Ridley defined as a healthy reaction to racism.
d. CORRECT An African American individual in the immersion substage is immersed in African American culture, which is evident in his/her interests, speech, style of dress, actions, choice of friends, etc. This individual also feels a great deal of rage toward Whites. During the emersion substage, the person’s intense emotions subside but he/she continues to reject White culture and begins to develop a more sophisticated African American identity.
The correct answer is: intense involvement in African American culture
Research by Sue and his colleagues (1991) found that matching therapist and client in terms of race/ethnicity:
Select one:
A. improves treatment outcomes and reduces premature termination for Asian, Hispanic, African American, and Caucasian clients.
B. reduces premature termination for Asian, Hispanic, African American, and Caucasian clients but has no effect for members of these groups on other treatment outcomes.
C. improves treatment outcomes and reduces premature termination for members of some groups but not for others.
D. has no effect on treatment outcomes or premature termination for Asian, Hispanic, African American, or Caucasian clients.
Research by Sue et al. (1991) and others has produced inconsistent results with regard to the impact of therapist-client matching and treatment outcomes.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT For example, Sue et al. found that therapist-client matching in terms of race/ethnicity improved outcomes for Asian and Hispanic clients and reduced premature termination rates for Caucasian clients.
d. Incorrect See explanation for response c.
The correct answer is: improves treatment outcomes and reduces premature termination for members of some groups but not for others.
An African American client feels that the primary obstacle in his life is racism and that there’s nothing he can do to change the problems he is experiencing. As defined by Sue (1978), this individual has an:
Select one:
A. internal locus of control and internal locus of responsibility.
B. external locus of control and internal locus of responsibility.
C. internal locus of control and external locus of responsibility.
D. external locus of control and external locus of responsibility.
Even if you are unfamiliar with Sue’s conceptualization of worldview, you probably could have identified the correct response by considering the information provided in the question.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This individual has an external locus of responsibility (he can’t do anything about his problems) and an external locus of control (he believes his problems are due to racism).
The correct answer is: external locus of control and external locus of responsibility.
As defined by Gerald Caplan, the target of consultee-centered case consultation is the consultee’s skills, knowledge, abilities, and/or objectivity. Caplan describes which of the following as a potential cause of a consultee’s lack of objectivity?
Select one:
A. projective identification
B. diagnostic overshadowing
C. parallel process
D. theme interference
Caplan distinguishes between four types of mental health consultation: client-centered case consultation, consultee-centered case consultation, program-centered administrative consultation, and consultee-centered administrative consultation.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Caplan defines theme interference as a type of transference that occurs when a consultee’s unresolved conflict related to a particular type of client or situation interferes with his/her current performance with similar clients or in similar situations.
The correct answer is: theme interference
The primary advantage of manual-guided treatment is that the use of manuals:
Select one:
A. standardizes treatment delivery so that, in research, treatment effects can be more clearly ascertained.
B. substantially improves treatment outcomes across different clients, diagnoses, and contexts.
C. reduces the legal liability of clinicians for “treatment errors.”
D. ensures that the procedures used to evaluate treatment effectiveness are valid.
Manual-guided treatments provide manuals that specify the theoretical underpinnings of the treatment and treatment goals and present specific therapeutic guidelines and strategies.
a. CORRECT Treatment manuals were initially developed to standardize treatments so that their effects could be empirically evaluated and to provide training guidelines for therapists.
b. Incorrect The research on this issue is inconsistent and but has generally not found manual guided treatments to have substantially better outcomes than treatments that are not guided by the use of a manual.
c. Incorrect This has not been identified as an outcome of the use of treatment manuals.
d. Incorrect This is not one of the benefits of treatment manuals.
The correct answer is: standardizes treatment delivery so that, in research, treatment effects can be more clearly ascertained.
Providing social skills training to children whose aggressive behaviors have already had a substantial adverse impact on their family and peer relations and school performance is an example of:
Select one:
A. primary prevention.
B. secondary prevention.
C. tertiary prevention.
D. behavioral prevention.
Three types of prevention are distinguished in the literature - primary, secondary, and tertiary.
a. Incorrect Primary preventions are aimed at reducing the development and incidence of mental disorders.
b. Incorrect Secondary preventions target individuals who have just begun to exhibit symptoms of a disorder in order to prevent the disorder from becoming more serious.
c. CORRECT Tertiary preventions are aimed at individuals who have already developed a disorder. Their goal is to reduce the risk for chronicity and relapse and any other problems related to the disorder.
d. Incorrect This is a “made up” term.
The correct answer is: tertiary prevention.
As defined by Minuchin, triangulation is a:
Select one:
A. healthy adaptation by family members to unexpected change.
B. way for family members to avoid dealing with stress or conflict.
C. method used by the therapist to diagnose the family structure.
D. method used by the therapist to reduce stress in the family.
Minuchin described triangulation as a type of rigid triad.
a. Incorrect See explanation for response b.
b. CORRECT Triangulation is occurring when the parents are in conflict and both try to recruit a child to their side as a means of avoiding or reducing the conflict between them.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: way for family members to avoid dealing with stress or conflict.
Why does the most pervasive modern form of supervision tend to be the triangular model?
Select one:
A. Because organizational policies and professional knowledge form the foundation, while the relationship with the supervisor forms the core.
B. Because the relationship with the supervisor and professional experience form the foundation while care of clients forms the core.
C. Because the relationship with the clients and counseling theory form the foundation and the organizational policies form the core.
D. Because the relationship with the organization and the supervisor literature form the foundation and personal experience form the core.
The correct answer is A. One of the common modern forms of supervision is a triangular model where the organizational policies and professional knowledge form the foundation, the supervisor relationship is at the core, and the ultimate emphasis on providing service to the clients. Answers B, C and D are incorrect as these various answer models are not models of supervision based on the triangular model.
The correct answer is: Because organizational policies and professional knowledge form the foundation, while the relationship with the supervisor forms the core.
Virginia Satir’s approach to family therapy emphasizes:
Select one:
A. styles of communication.
B. family projection processes.
C. boundary disturbances.
D. transferences between family members.
Virginia Satir’s emphasis on communication reflects her affiliation with the Mental Research Institute in Palo Alto.
a. CORRECT Satir distinguishes between five communication styles–placater, blamer, super-reasonable, irrelevant, and congruent.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: styles of communication.
A solution-focused therapist is working with a family whose conversations frequently escalate to intense arguments. The therapist will most likely:
Select one:
A. reduce tension during therapy sessions by having family members talk directly to her rather than to each other.
B. appoint one family member to act as “referee” whenever the family fights at home.
C. ask the family members if they can remember a time when they were able to talk to each other for an extended period without arguing.
D. instruct the family members to argue with each other for at least one hour each evening.
Not surprisingly, solution-focused therapists focus on solutions.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Solution-focused therapists use “exceptions” as one way of identifying possible solutions to the family’s problem.
d. Incorrect See explanation for response c.
The correct answer is: ask the family members if they can remember a time when they were able to talk to each other for an extended period without arguing.
Which of the following is LEAST likely to be true about a 55-year-old Asian client?
Select one:
A. When she smiles, this is more likely to indicate confusion or embarrassment than pleasure.
B. She will be uncomfortable discussing personal details about her family relationships.
C. When she avoids eye contact, this will communicate respect rather than inattention or disrespect.
D. She will respond best to an indirect, unstructured therapeutic approach.
It is very important not to overgeneralize the characteristics of members of culturally diverse groups. However, the licensing exam sometimes includes questions like this one that require you to do so.
a. Incorrect Among Asians and Asian Americans, a smile is more likely to signal embarrassment or confusion than pleasure.
b. Incorrect Asians are generally uncomfortable discussing personal details about family members.
c. Incorrect Avoidance of eye contact is a sign of respect in the Asian culture.
d. CORRECT Although not all Asian and Asian American clients will prefer a direct, structured approach (rather than an indirect, unstructured approach), this is often the preferred strategy.
The correct answer is: She will respond best to an indirect, unstructured therapeutic approach.
A cigarette smoker says that she has decided to quit smoking in the next three to four weeks and has started developing a plan for doing so. According to the transtheoretical (stages-of-change) model, this person is in which of the following stages?
Select one:
A. preparation
B. contemplation
C. precontemplation
D. action
The transtheoretical model predicts that an intervention is most effective when it matches the individual’s stage of change.
a. CORRECT From the perspective of the transtheoretical model, a person is in the preparation stage when he/she has a clear intent to take action in the immediate future (usually defined as within the next month).
b. Incorrect A person in the contemplation stage is planning to take steps to change in the more distant future (usually defined as within the next six months).
c. Incorrect A person in the precontemplation stage has no intention of changing in the foreseeable future.
d. Incorrect People in the action phase have already started making changes in their lives.
The correct answer is: preparation
When 11-year old Samantha plays with her 5-year old brother Sam, she often assumes the role of “mother” and teaches Sam how to do things. Sam cooperates by doing what Samantha instructs him to do. The interaction between Samantha and her brother is best described as:
Select one:
A. complementary.
B. symmetrical.
C. parallel.
D. disengaged.
In this situation, Samantha is the “teacher” while her younger brother is the “student.”
a. CORRECT Complementary transactions are transactions between unequals - e.g., between a dominant and a subordinate person.
b. Incorrect Symmetrical transactions occur between equals.
c. Incorrect Parallel transactions are a combination of complementary and symmetrical transactions.
d. Incorrect The term “disengaged” is not used to describe the type of transaction presented in this question.
The correct answer is: complementary.
Research suggests that the underutilization of mental health services by Asian Americans results from:
Select one:
A. cultural values that encourage resolution of problems within the family.
B. a lower incidence of mental health problems.
C. cultural values that stress personal independence.
D. a distaste for the formality involved in therapy relationships.
The research has generally found that Asian Americans underutilize traditional mental health services.
a. CORRECT Asian Americans often adhere to traditional cultural values that encourage the resolution of problems within the family. Reasons for preferring assistance from family members include the stigma associated with mental illness and seeking outside help and a lack of culturally competent mental health services.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: cultural values that encourage resolution of problems within the family.
Howard et al.’s (1986) phase model proposes that a client’s progress in therapy occurs in three predictable phases. These are:
Select one:
A. unfreezing, changing, and refreezing.
B. remoralization, remediation, and rehabilitation.
C. engagement, exploration, and evaluation.
D. contemplation, action, and termination.
For the exam, you want to be familiar with Howard et al.’s (1986) phase model and dose dependent effect, which are both described in the Clinical Psychology chapter of the AATBS written study materials.
a. Incorrect These are the three stages in Lewin’s force field model of organizational change.
b. CORRECT As described by Howard et al.,
1. Remoralization is an improvement in the subjective sense of well-being
2. Remediation is a reduction in symptoms and
3. Rehabilitation involves improvements in overall functioning.
c. Incorrect These are not the phases identified by Howard and colleagues.
d. Incorrect These are three of the six phases of the transtheoretical model of change.
The correct answer is: remoralization, remediation, and rehabilitation.
During the first session with an American Indian family consisting of a grandmother, mother, father, and three children, an Anglo-American therapist would be best advised to:
Select one:
A. refer the family to an American Indian therapist.
B. ensure that she establishes a “value-free” environment.
C. assess each family member’s level of acculturation before developing a treatment plan.
D. treat the family like any other family unless there is a clear reason to do otherwise.
You may have been able to identify the correct response to this question through the process of elimination.
a. Incorrect This may be unnecessary if the therapist has appropriate training or seeks consultation.
b. Incorrect American Indian clients are likely to distrust a therapist who attempts to establish a “value-free” environment.
c. CORRECT An initial step when working with clients from culturally diverse groups is to identify the client’s stage of racial/ethnic identity development, degree of acculturation, and worldview (beliefs, values, attitudes, etc.).
d. Incorrect APA guidelines discourage adopting a “colorblind” approach and, instead, require psychologists to always consider the impact of culture on the therapeutic process.
The correct answer is: assess each family member’s level of acculturation before developing a treatment plan.
What is a unique challenge that comes from using Evidence-Based Therapies in public mental health services settings?
Select one:
A. No universal guidelines provided by the government.
B. No standardized supervision or training literature.
C. No procedures for selecting supervisors or trainers.
D. No testing applications to verify licensing authenticity.
The correct answer is B. A significant portion of the training and supervision literature within the field of clinical psychology does not often address the unique challenges that arise in training in the public mental health service settings. A comprehensive model for providing training in EBTs that can apprise local and larger scale implementation and facilitate training partnerships with publicly funded or community-based agencies and practitioners of EBTs has been demonstrated to be most effective. Answers A, C and D are incorrect as government guidelines, lack of procedures and lack of testing applications are not related to any unique challenges with employing evidence-based therapies in public mental health based settings.
The correct answer is: No standardized supervision or training literature.
In recent years, psychologists have attempted to become more sensitive to the uniqueness of each culture. This sensitivity is most consistent with:
Select one:
A. an emic approach.
B. an etic approach.
C. an etic-emic synthesis.
D. neither an etic nor an emic approach.
An emic approach is characterized by an awareness that each culture possesses unique characteristics.
a. CORRECT An emic approach recognizes cultural differences and the impact of those differences on behaviors, attitudes, etc.
b. Incorrect An etic approach applies universal principles that are derived from one culture to all cultures.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: an emic approach.
A Bowenian therapist would use a genogram to:
Select one:
A. examine family relationships over several generations.
B. identify genetic (biological) contributions to maladaptive behavior.
C. examine interactions between a family and its environment.
D. evaluate the progress and outcome of therapy.
Being familiar with the major concerns and assumptions of Bowen’s extended family systems therapy would have helped you identify the correct answer to this question even if you’re unfamiliar with a genogram.
a. CORRECT As originally described by Bowen, a genogram is a schematic diagram of a family’s relationships and usually includes at least three generations. A primary purpose of a genogram is to identify behavior patterns that recur in the family.
b. Incorrect See explanation for response a.
c. Incorrect This describes an ecomap. Although some authors use the terms ecomap and genogram interchangeably, this question is asking specifically about the use of a genogram by a Bowenian therapist, so response a is the best answer.
d. Incorrect See explanation for response a.
The correct answer is: examine family relationships over several generations.
A therapist can expect that an Asian American client will be LEAST likely to do which of the following?
Select one:
A. use silence as a way of communicating respect
B. use smiling to express disapproval or disagreement
C. avoid expressing strong emotions
D. avoid eye contact when listening to the therapist
Asian Americans are a heterogeneous group and caution must be taken in drawing general conclusions about their behaviors. However, several generalizations are made in the multicultural counseling literature. See, e.g., D. W. Sue and D. Sue, Counseling the culturally different, New York, John Wiley & Sons, 1999.
a. Incorrect Asian Americans tend to demonstrate respect for authorities by “not speaking until spoken to.”
b. CORRECT For some Asian Americans, smiling may demonstrate uneasiness or embarrassment, while, for others, smiling is avoided because it is considered a sign of weakness.
c. Incorrect This is characteristic of Asian Americans.
d. Incorrect This is also characteristic of Asian Americans.
The correct answer is: use smiling to express disapproval or disagreement
During the fourth session, a therapy client says he “is already feeling much better.” Most likely:
Select one:
A. this is simply a transitory placebo effect.
B. this reflects the initial development of insight.
C. the client is beginning to feel more hopeful about his situation.
D. the client is starting to benefit from newly acquired coping skills.
This is a difficult question because you don’t know what research or theory is being asked about. However, responses b, c, and d correspond to the stages identified by Howard et al.’s (1996) phase model of therapeutic effectiveness. Additional information about this model is provided in the Clinical Psychology chapter of the written study materials.
a. Incorrect Although this is a possibility, response b is a better answer since the question specifically mentions that the client’s remark occurs during the fourth session of therapy. A placebo effect could occur at any time during therapy.
b. Incorrect According to the phase model, insight is not achieved until the third stage of therapy (rehabilitation), which usually does not begin until after the 16th therapy session.
c. CORRECT According to Howard and his colleagues, during the first few sessions of therapy, a client experiences an increase in hopefulness. This stage is referred to as REMORALISATION.
d. Incorrect During the second phase of therapy (remediation), the client acquires new coping skills and experiences real symptom relief.
The correct answer is: the client is beginning to feel more hopeful about his situation.
A practitioner of Minuchin’s structural family therapy uses which of the following to alter the hierarchical relationships within a family system or subsystem?
Select one:
A. unbalancing
B. tracking
C. reframing
D. mimesis
For the exam, you want to be familiar with the four techniques listed in the answers to this question.
a. CORRECT Unbalancing is a restructuring technique that is used by structural family therapists to change hierarchical relationships between family members. It may involve affiliating with a family member, ignoring a family member, or entering into a coalition with a family member against another member.
b. Incorrect Tracking is a joining technique and involves following the verbal and nonverbal content of the family’s communications by, for example, asking clarifying questions, showing interest in what they’re saying, and connecting things they’ve said in the past to current interactions.
c. Incorrect Reframing is a paradoxical technique that involves offering an alternative interpretation of the meaning of a behavior or event.
d. Incorrect Mimesis is another joining technique and involves adopting the family’s affective and communication style.
The correct answer is: unbalancing
Interpreting the defenses against anxiety that underlie a client’s current maladaptive behavior patterns would be of most interest to a practitioner of:
Select one:
A. solution-focused therapy.
B. object relations therapy.
C. reality therapy.
D. personal construct therapy.
Defenses are of interest to psychodynamic psychotherapists.
a. Incorrect Solution-focused therapy adopts a here-and-now orientation and focuses on identifying solutions to problems.
b. CORRECT As a psychodynamic therapy, object relations therapy utilizes many traditional psychodynamic strategies. It focuses on the impact of unconscious processes that impact the client’s current relationships and involves identifying and interpreting the client’s defenses and transferences.
c. Incorrect Reality therapy focuses on current issues and current problems.
d. Incorrect Personal construct therapy combines cognitive, behavioral, and humanistic concepts and focuses on the impact of the individual’s perspective on his/her experience of the world.
The correct answer is: object relations therapy.
Studies comparing the age at which gays and lesbians first disclose their sexual orientation to a friend, family member, or other person have found that:
Select one:
A. the average age of disclosure for gay men is 2 to 3 years earlier than the average age of disclosure for lesbians.
B. the average age of disclosure for gay men is 5 to 6 years earlier than the average age of disclosure for lesbians.
C. the average age of disclosure for lesbians is 3 to 4 years earlier than the average age of disclosure for gay men.
D. the average ages of disclosure for gay men and lesbians are not significantly different.
This is a difficult question because this issue has been investigated in only a few empirical studies.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT In a recent study, R. C. Savin-Williams and L. M. Diamond compared the sexual identity milestones for gay males and lesbians and found that, in terms of disclosure, the average age was not substantially different. They also report the results of previous research, which is generally consistent with their findings. Note that Savin-Williams and Diamond did find significant differences for initial same-sex sexual contact and first self-labeling as gay or lesbian, with the average age for both milestones being lower for gay men than for lesbians [Sexual identity trajectories among sexual-minority youths: Gender comparisons, Archives of Sexual Behavior, 29, 607-627, 2000].
The correct answer is: the average ages of disclosure for gay men and lesbians are not significantly different.
Self-in-relation therapy is an approach to:
Select one:
A. family therapy that emphasizes the multiple transferences that affect current relationships among family members.
B. group therapy that focuses on interpersonal interpretations and misinterpretations that affect individual functioning.
C. feminist therapy that emphasizes the role of the mother-son versus mother-daughter relationship in creating gender differences in behavior.
D. biopsychosocial therapy that recognizes the interacting impact of biological and sociocultural factors on male and female development.
Self-in-relation therapy was developed at the Stone Center for Developmental Services and Studies at Wellesley College. See, e.g., J. V. Jordan et al., Women’s growth in connection: Writings from the Stone Center, Guilford Press, NY, 1991.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Object relations theory was an important influence on self-in-relation theory. However, self-in-relation theory extends the object relations approach by considering the impact of same versus opposite gender in caregiver-infant relationships on development, especially on development of the relational self.
d. Incorrect See explanation for response c.
The correct answer is: feminist therapy that emphasizes the role of the mother-son versus mother-daughter relationship in creating gender differences in behavior.
According to Hamburger et al. (1996), psychopathic personality traits interact with biological sex to produce Antisocial Personality Disorder in males and __________ Personality Disorder in females.
Select one:
A. Histrionic
B. Narcissistic
C. Borderline
D. Schizoid
The DSM Cluster B personality disorders share a number of characteristics and sometimes co-occur but differ in terms of gender ratios.
a. CORRECT Hamburger et al. proposed that Antisocial Personality Disorder (APD) and Histrionic Personality Disorder (HPD) represent gender-related manifestations of the same biological predisposition toward psychopathy. Note, however, that the research has not been entirely supportive of this hypothesis. [M. E. Hamburger, S. O. Lilienfeld, and M. Hogben, Psychopathy, gender, and gender roles: Implications for antisocial and histrionic personality disorders, Journal of Personality Disorders, 10(1), 41-55, 1996.]
b. Incorrect See explanation for response a.
c. Incorrect APD and Borderline Personality Disorder (BPD) also share a number of symptoms (e.g., impulsivity, manipulativeness, and problems with relationships) and are viewed by some experts as gender-related manifestations of a similar pathology. However, this question is asking about Hamburger et al.’s hypothesis, which describes APD and HPD (not BPD) as sharing underlying psychopathic personality traits.
d. Incorrect See explanation for response a.
The correct answer is: Histrionic
Research investigating the benefits of psychological treatments for children, adolescents, and adults with cystic fibrosis is very limited. However, the existing studies suggest that which of the following approaches is likely to be most beneficial for treating depression, anxiety, pain, and stress associated with this illness?
Select one:
A. cognitive-behavioral therapy
B. client-centered therapy
C. solution-focused therapy
D. reality therapy
a. CORRECT Very few studies have been conducted on psychological interventions for patients with cystic fibrosis, and the majority of these have focused on children. However, most of the existing studies investigated the impact of behavioral therapy or cognitive-behavioral therapy and have found that these interventions are beneficial for alleviating psychological problems associated with the disorder. Therefore, of the answers given, this is the best one. See, e.g., H. Oxley and A. K. Webb, How a clinical psychologist manages the problems of adults with cystic fibrosis, Journal of the Royal Society of Medicine, 98 (Suppl. 45), 37-46, 2005.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: cognitive-behavioral therapy
During the course of a mental status exam, a 36-year old man takes a great deal of time to answer the examiner’s questions because he often focuses on unnecessary details and makes parenthetical remarks. When he is not interrupted, the man usually does get around to answering the examiner’s question. The man’s speech illustrates which of the following?
Select one:
A. circumstantiality
B. loosening of associations
C. confabulation
D. derailment
The important thing to note in the description of the man’s speech is that he does eventually get back to the point.
a. CORRECT Circumstantiality refers to speech that is indirect and delayed in reaching the point because of unnecessary, tedious details and parenthetical remarks.
b. Incorrect Loosening of associations involves a complete lack of connectedness between utterances and the loss of the original point.
c. Incorrect Confabulation involves a fabrication of facts or events to compensate for memory loss.
d. Incorrect Derailment is another term for loosening of associations.
The correct answer is: circumstantiality
A DSM-5 diagnosis of Intermittent Explosive Disorder requires the presence of:
Select one:
A. verbal aggression or physical aggression toward property, animals, or other people that does not cause injury or destruction or behavioral outbursts that do cause injury or destruction.
B. physical aggression that is injurious to animals or people or destructive to property.
C. physically aggressive acts that are precipitated by an irritable mood and that cause injury to people or animals or destruction to property.
D. aggressive acts that cause injury to people or animals or destruction to property and are accompanied by a lack of remorse or guilt.
Answer A is correct: The DSM-5 diagnosis of Intermittent Explosive Disorder requires recurrent behavioral outbursts that reflect a failure to control aggressive impulses as manifested by verbal aggression or physical aggression toward property, animals, or other people that does not result in destruction or injury or behavioral outbursts that do result in destruction of property or injury of people or animals.
Answer B: This is not a requirement for a DSM-5 diagnosis of Intermittent Explosive Disorder.
Answer C: The aggressive acts associated with Intermittent Explosive Disorder are due to a failure to control aggressive impulses but are not necessarily precipitated by an irritable mood. Also, as noted above, aggression can be verbal or physical.
Answer D: The diagnosis of Intermittent Explosive Disorder does not require that aggression be accompanied by a lack of remorse or guilt.
The correct answer is: verbal aggression or physical aggression toward property, animals, or other people that does not cause injury or destruction or behavioral outbursts that do cause injury or destruction.
A drug that ____________ would be most useful for treating Bulimia Nervosa.
Select one:
A. increases sensitivity to cortisol
B. reduces glutamate levels
C. decreases sensitivity to acetylcholine
D. increases serotonin levels
Bulimia Nervosa has been linked to lower-than-normal levels of serotonin.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Bulimia has been found to be responsive to drugs that increase serotonin levels (e.g., an SSRI).
The correct answer is: increases serotonin levels
When treating a client with a paraphilia, which of the following techniques would be most useful for replacing the inappropriate stimulus that currently elicits sexual arousal with a more appropriate stimulus?
Select one:
A. covert sensitization
B. flooding (in vivo exposure)
C. habit reversal training
D. orgasmic reconditioning
This question is asking about the technique that would change the cue (stimulus) that produces sexual arousal for a client with a paraphilia.
a. Incorrect When using covert sensitization to eliminate an undesirable behavior, the individual repeatedly imagines engaging in that behavior (or a stimulus associated with it) and then imagines an aversive consequence of engaging in the behavior. Eventually, as a result of this pairing, thinking about the undesirable behavior will produce an aversive response. For example, if a person is sexually aroused by exposing himself to women in public places, covert sensitization might involve having him imagine exposing himself to a woman on the subway and then imagine that he is arrested by the police for doing so, convicted of a sex crime, and sent to jail.
b. Incorrect Flooding is used primarily to reduce anxiety responses and has not been found to be an effective treatment for paraphilias.
c. Incorrect Habit reversal training is used to reduce habits such as nail-biting, thumb-sucking, and hair pulling and has not been found to be an effective treatment for paraphilias. Habit reversal training is used to increase the individual’s awareness of his/her habit and replace the habit with alternative behaviors.
d. CORRECT When using orgasmic reconditioning, the client is “reconditioned” to masturbate to a more appropriate stimulus. This is accomplished by having the client begin to masturbate while fantasizing about the inappropriate stimulus and then switch his fantasy to the more appropriate stimulus.
The correct answer is: orgasmic reconditioning
The use of functional brain imaging techniques to study ADHD has linked its symptoms to lower-than-normal levels of metabolic activity in the:
Select one:
A. prefrontal cortex and basal ganglia.
B. prefrontal cortex and ARAS.
C. entorhinal cortex and SCN.
D. entorhinal cortex and thalamus.
Knowing the functions of the brain areas listed in the responses and the core symptoms of ADHD would have helped you choose the correct answer to this question even if you are unfamiliar with the brain-imaging research.
a. CORRECT The prefrontal cortex is involved in executive cognitive functions (e.g., planning, decision-making, attention), while the basal ganglia are involved in the regulation of movement and consist of several structures including the caudate nucleus and globus pallidus. Abnormalities in these structures have been linked to ADHD.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: prefrontal cortex and basal ganglia.
Borderline Personality Disorder is most commonly diagnosed in individuals ages:
Select one:
A. 19 through 34.
B. 29 through 44.
C. 39 through 54.
D. 49 through 64.
Knowing that the symptoms of Borderline Personality Disorder tend to dissipate with increasing age would have helped you identify the correct answer to this question.
a. CORRECT The rates of BPD are highest during the young adult years. Although individuals with this disorder often continue to exhibit some symptoms throughout their life, by age 40, many no longer meet the diagnostic criteria for BPD.
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: 19 through 34.
Research looking at the relationship between “expressed emotion” and Schizophrenia has found that:
Select one:
A. negative expressed emotion is often an early sign of the disorder.
B. expressed emotion is related more to the negative than the positive symptoms of the disorder.
C. a high degree of negative expressed emotion by family members is associated with a high-risk for relapse for a person with this disorder.
D. an extremely high or extremely low level of expressed emotion by family members is an environmental factor that increases the risk for the development of this disorder.
In the context of Schizophrenia, negative expressed emotion refers to excessive criticism or hostility or, at the other extreme, emotional overinvolvement and overprotectiveness.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The research has consistently linked negative expressed emotion by family members to a high risk of relapse and rehospitalization for a family member with Schizophrenia.
d. Incorrect See explanation for response c.
The correct answer is: a high degree of negative expressed emotion by family members is associated with a high-risk for relapse for a person with this disorder.
The ApoE4 gene on chromosome 19 has been linked to an increased risk for:
Select one:
A. Alzheimer’s disease.
B. Huntington’s disease.
C. diabetes mellitus.
D. multiple sclerosis.
Research has identified a link between Alzheimer’s disease and specific genes on several chromosomes including chromosome 19.
a. CORRECT The ApoE4 gene on chromosome 19 has been associated with an increased risk for both heart disease and late-onset Alzheimer’s disease. Note that, even if you were not familiar with the ApoE4 gene, knowing that Alzheimer’s disease has been linked to abnormalities on chromosome 19 would have helped you identify this as the correct answer.
b. Incorrect Huntington’s disease is an autosomal dominant gene disorder. It has not been linked to the ApoE4 gene.
c. Incorrect Diabetes mellitus is due to insufficient insulin or the inability of cells to use insulin. It has not been linked to the ApoE4 gene.
d. Incorrect The cause of multiple sclerosis is unknown but may entail a combination of biological and environmental factors.
The correct answer is: Alzheimer’s disease.
Adults with ADHD are most likely to:
Select one:
A. be excessively perfectionistic in their work.
B. prefer jobs that involve routine, repetitive tasks.
C. avoid relationships, especially sexual relationships.
D. frequently change jobs and intimate partners.
Knowing that ADHD in adulthood is associated with prominent symptoms of inattention and impaired social and occupational functioning would have helped you identify the correct answer to this question.
a. Incorrect Because of their impulsivity (e.g., tendency to make quick decisions) and attention deficits, adults with ADHD are not likely to be perfectionistic.
b. Incorrect This is the opposite of what is true. A person with ADHD gets bored easily and would not prefer routine, repetitive tasks.
c. Incorrect Adults with ADHD often have trouble maintaining relationships but do not avoid them. With regard to sexual relationships, adults with ADHD tend to have more sexual partners than adults without ADHD and may engage in more impulsive or risky sexual behaviors.
d. CORRECT The research has found that adults with ADHD change jobs and intimate partners more often than do individuals without the disorder.
The correct answer is: frequently change jobs and intimate partners.
A 33-year-old man tells his therapist that, since his involvement in a serious car accident two months ago, he has been feeling sad every day; has had no appetite; feels tired all of the time and sleeps for 10 to 12 hours each night; isn’t interested in spending time with his friends and family; and feels guilty about the accident, even though it wasn’t his fault. He also says that, because he’s having trouble concentrating at work and getting to work on time, he’s afraid he’s going to be fired. Based on these symptoms, the most likely diagnosis is:
Select one:
A. Bipolar II Disorder.
B. Major Depressive Disorder.
C. Adjustment Disorder.
D. Acute Stress Disorder.
The nature, number, and duration of the man’s symptoms suggest that the best diagnosis is Major Depressive Disorder.
a. Incorrect See explanation for response b.
b. CORRECT The nature, number, and duration of the man’s symptoms are consistent with a diagnosis of Major Depressive Disorder: He is experiencing a depressed mood and has at least five other characteristic symptoms of this disorder; his symptoms have lasted for more than two weeks; and he is experiencing impaired occupational functioning as the result of his symptoms.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: Major Depressive Disorder.
When using the DSM-5, the diagnosis of Delusional Disorder requires the presence of:
Select one:
A. one or more delusions for at least one month.
B. one or more non-bizarre delusions for at least one month.
C. one or more bizarre delusions for at least one month.
D. one or more bizarre or non-bizarre delusions for at least three months.
Answer A is correct: The DSM-5 diagnosis of Delusional Disorder requires the presence of one or more delusions that last at least one month.
The correct answer is: one or more delusions for at least one month.
Anna, age 34, tells you that she is convinced that she is extremely overweight even though her body mass index is within normal limits. She says that she’s mostly concerned about her “fat thighs and stomach” which make her feel ugly and that she’s afraid to go out in public because she thinks people will ridicule her. If a DSM-5 diagnosis of Body Dysmorphic Disorder is the appropriate diagnosis for Anna, further questioning of Anna will confirm that:
Select one:
A. her self-evaluations are unduly influenced by her body weight and shape.
B. she performs repetitive behaviors or mental acts related to her concerns about her weight.
C. she is preoccupied with having or acquiring a serious illness related to her weight.
D. she exhibits impairments in cognitive functioning.
Answer B is correct: The performance of repetitive behaviors or mental acts related to the individual’s concerns was added to the DSM-5 as a diagnostic criterion for Body Dysmorphic Disorder.
Answer A: Self-evaluations that are unduly influenced by body weight and shape is a diagnostic criterion for Bulimia Nervosa and would not confirm a diagnosis of Body Dysmorphic Disorder.
Answer C: A preoccupation with having or acquiring a serious illness is characteristic of Illness Anxiety Disorder and would not confirm a diagnosis of Body Dysmorphic Disorder.
Answer D: The DSM-5 notes that executive dysfunction (impaired higher-order cognitive skills) is an associated symptom of Body Dysmorphic Disorder. Because it is an associated symptom rather than a diagnostic criterion, it would not be as useful as performing repetitive behaviors or mental acts for confirming a diagnosis of Body Dysmorphic Disorder.
The correct answer is: she performs repetitive behaviors or mental acts related to her concerns about her weight.
Which of the following is true about the difference between Obsessive-Compulsive Personality Disorder and Obsessive-Compulsive Disorder (OCD)?
Select one:
A. Obsessions and compulsions in Obsessive-Compulsive Personality Disorder are less severe than those in OCD but began in early adulthood and are present in a variety of contexts.
B. Obsessions and compulsions in Obsessive-Compulsive Personality Disorder (but not in OCD) are experienced by the individual as ego-syntonic.
C. The diagnosis of Obsessive-Compulsive Personality Disorder (but not OCD) requires the presence of obsessions and compulsions prior to age 21.
D. The diagnosis of OCD (but not Obsessive-Compulsive Personality Disorder) requires the presence of obsessions and/or compulsions.
The name “Obsessive-Compulsive Personality Disorder” is misleading because the disorder is NOT characterized by obsessions or compulsions.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Obsessive-Compulsive Personality Disorder is characterized by a preoccupation with orderliness, perfectionism, and control. The diagnosis does not require the presence of obsessions and/or compulsions.
The correct answer is: The diagnosis of OCD (but not Obsessive-Compulsive Personality Disorder) requires the presence of obsessions and/or compulsions.
In children, Generalized Anxiety Disorder:
Select one:
A. usually first develops after a recent loss such as parental divorce or death of a family member.
B. is usually manifested as autonomic hyperarousal and other prominent physical symptoms.
C. is often manifested as excessive concern about performance or competence at school.
D. typically involves crying, tantrums, freezing, and clinging to family members, especially among those under 7 years of age.
The symptoms of Generalized Anxiety Disorder (GAD) are somewhat age-related.
a. Incorrect This is not characteristic of GAD.
b. Incorrect Autonomic hyperarousal is actually somewhat less in GAD than in other Anxiety Disorders.
c. CORRECT Children with GAD often worry excessively about their competence or the quality of their performance and this worry is frequently related to schoolwork and performance in sports activities.
d. Incorrect This is characteristic of children with Social Phobia.
The correct answer is: is often manifested as excessive concern about performance or competence at school.
The reduction of parasuicidal behaviors is a primary and explicit target of which of the following?
Select one:
A. stress inoculation training
B. self-control therapy
C. eye movement desensitization and reprocessing
D. dialectical behavior therapy
Parasuicide refers to deliberate burning, cutting, and other self-injurious behaviors and suicidal gestures that do not cause death or are done without the intent to cause death.
a. Incorrect As its name implies, stress inoculation training focuses on helping individuals acquire the skills they need to deal more effectively with stress. Although some of the skills addressed in stress inoculation training might be useful for reducing parasuicidal behaviors, these behaviors are not “a primary and explicit target” of treatment.
b. Incorrect Self-control therapy is a behavioral intervention that is used primarily to reverse undesirable habits (e.g., overeating, smoking) and has also been found to be an effective treatment for depression. However, parasuicidal behaviors are not a primary target of self-control therapy.
c. Incorrect EMDR was initially developed as a treatment for PTSD. Parasuicidal behaviors are not a primary target of EMDR.
d. CORRECT DBT was developed as a treatment for Borderline Personality Disorder and explicitly targets parasuicidal behaviors, a common feature of this disorder. For example, skills training is one component of DBT and includes teaching the client strategies to help regulate his/her emotions and better tolerate distress, which decreases the likelihood of parasuicidal behaviors.
The correct answer is: dialectical behavior therapy
Bartlett Barmicide says he’s continued having hallucinations (“flashbacks”) several months after he stopped using a drug. He also states that he realizes that this is probably due to the drug. Bartlett most likely used which of the following?
Select one:
A. an inhalant
B. methamphetamine
C. cocaine
D. mescaline
Knowing that mescaline is an hallucinogen would have helped you identify the correct answer to this question.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The DSM diagnosis of Hallucinogen Persisting Perception Disorder is characterized by re-experiencing perceptual disturbances reminiscent of those experienced during earlier Hallucinogen Intoxication. Of the substances listed in the answers, only mescaline is a type of hallucinogen.
The correct answer is: mescaline
The DSM-5 diagnoses of Bipolar I and Bipolar II Disorder both require that the person has had at least one episode involving an abnormally persistent elevated, expansive, or irritable mood:
Select one:
A. and persistently increased goal-directed activity or energy.
B. with a lack of awareness of his/her illness and the need for treatment.
C. that is sufficiently severe to cause a marked impairment in functioning or require hospitalization.
D. and at least one episode involving a depressed mood or a loss of interest or pleasure in all or most activities.
Answer A is correct: The DSM-5 diagnostic criteria for Bipolar I and Bipolar II disorder include at least one episode involving an abnormally persistent elevated, expansive, or irritable mood with the presence of persistently increased goal-directed activity or energy.
Answer B: A lack of awareness of the illness and the need for treatment is an associated symptom of Bipolar I disorder but is not a diagnostic criterion for either disorder.
Answer C: For a diagnosis of Bipolar I Disorder, symptoms must be sufficiently severe to cause marked impairment in functioning or hospitalization to prevent harm to self or others or include psychotic features. For a diagnosis of Bipolar II Disorder, symptoms must not be severe enough to cause marked impairment in functioning or necessitate hospitalization.
Answer D: The diagnosis of Bipolar II Disorder requires the presence of both hypomanic and major depressive episodes, but the diagnosis of Bipolar I Disorders requires only the presence of one or more manic episodes (although it may include hypomanic and/or major depressive episodes).
The correct answer is: and persistently increased goal-directed activity or energy.
One difference between Generalized Anxiety Disorder and nonpathological anxiety is that Generalized Anxiety Disorder is more likely to be accompanied by physical symptoms. In addition, a person with Generalized Anxiety Disorder:
Select one:
A. feels he or she caused the problems underlying current worries.
B. makes repeated, but unsuccessful, attempts to avoid anxiety-arousing stimuli.
C. experiences anxiety that is unrelated to specific events or actions.
D. finds it difficult to control his or her worrying.
Generalized Anxiety Disorder (GAD) is characterized by excessive anxiety and worry about a number of events or activities.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect Although worry may occur without a precipitant, it is often related to specific events or activities.
d. CORRECT One of the diagnostic criteria for GAD is that the person finds it difficult to control his/her anxiety and worry.
The correct answer is: finds it difficult to control his or her worrying.
Gray and McNaughton’s (2000) revised version of reinforcement sensitivity theory proposes that there are three systems of neural circuitry that explain differences in personality. Which of the following is not one of these systems?
Select one:
A. fight-flight-freeze system
B. behavioral activation system
C. attachment-detachment system
D. behavioral inhibition system
J. A. Gray and N. McNaughton’s (2000) revised version of reinforcement sensitivity theory (RST) distinguishes between three brain systems (FFFS, BAS, and BIS) that are responsible for individual differences in responses to punishing and rewarding events and help explain differences in personality and psychopathology (The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system, Oxford, Oxford University Press, 2000).
a. Incorrect The fight-flight-freeze system (FFFS) is one of the systems identified by RST. It mediates reactions to conditioned and unconditioned aversive stimuli and, in terms of personality, is associated with fear proneness and avoidance which can lead to phobic reactions and panic.
b. Incorrect According to Gray and McNaughton, the behavioral activation system (BAS) mediates reactions to conditioned and unconditioned appetitive (rewarding) stimuli. With regard to personality, the BAS is associated with optimism, impulsivity, and a reward orientation which can lead to addictive behaviors and high risk, impulsive behaviors (such as those associated with mania).
c. CORRECT An attachment-detachment system is not one of the three systems identified by RST.
d. Incorrect The behavioral inhibition system (BIS) is the third system identified by RST. It’s responsible for resolving goal conflicts, including conflicts between BAS-mediated approach behaviors and FFFS-mediated avoidance behaviors. Associated personality characteristics are worry proneness and anxious rumination which can lead to Generalized Anxiety Disorder and OCD.
The correct answer is: attachment-detachment system
Generalized Anxiety Disorder (GAD) has been found to have a high comorbidity rate and, according to the results of the National Comorbidity Survey Replication, the most common co-diagnosis is:
Select one:
A. Obsessive-Compulsive Disorder.
B. Posttraumatic Stress Disorder.
C. Social Phobia.
D. Separation Anxiety Disorder.
Answer C is correct: The National Comorbidity Survey Replication (NCS-R) found that GAD frequently co-occurs with Mood Disorders, Substance-Related Disorders, and other Anxiety Disorders [Kessler, R. C. et al., Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication, Archives of General Psychiatry, 62, 617-709, 2005]. Although reported comorbidity rates for GAD vary somewhat from study to study, in the NCS-R, the highest correlation (.47) was found between GAD and Social Phobia. (Note that the earlier National Comorbidity Survey found the highest correlation for GAD and Simple Phobia, but this question is asking about the NCS-R.)
Answer A: The NCS-R reports a correlation of .33 between GAD and OCD.
Answer B: The NCS-R reports a correlation of .44 between GAD and PTSD.
Answer D: The NCS-R reports a correlation of .36 between GAD and Separation Anxiety Disorder.
The correct answer is: Social Phobia.
A diagnosis of Persistent Depressive Disorder requires the presence of a depressed mood on most days for at least ________ for adults and at least ________ for children and adolescents.
Select one:
A. one year; six months
B. 18 months; one year
C. two years; one year
D. 36 months; 18 months
Answer C is correct: The duration requirement is the same for Cyclothymic Disorder and Persistent Depressive Disorder (Dysthymia) - at least two years for adults and one year for children and adolescents.
Answers A, B, and D: See explanation for response C.
The correct answer is: two years; one year
A DSM diagnosis of Bipolar II Disorder requires the presence or history of:
Select one:
A. at least one major depressive episode and one hypomanic episode.
B. at least one major depressive episode and one mixed episode.
C. two or more mixed episodes without a manic, hypomanic, or major depressive episode.
D. two or more hypomanic episodes.
For the exam, you want to be familiar with the diagnostic criteria for both Bipolar Disorders.
a. CORRECT The diagnosis of Bipolar II Disorder requires the presence or history of major depressive and hypomanic episodes.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: at least one major depressive episode and one hypomanic episode.
One approach to distinguishing between depression and anxiety involves considering three dimensions of emotion – negative affect, positive affect, and autonomic arousal. From this perspective, compared to depression, anxiety involves:
Select one:
A. a similar level of negative affect and autonomic arousal but a higher level of positive affect.
B. a similar level of negative affect but a higher level of both autonomic arousal and positive affect.
C. a lower level of negative affect, a similar level of autonomic arousal, and a higher level of positive affect.
D. a similar level of both negative and positive affect but a higher level of autonomic arousal.
Considering the characteristics of depression and anxiety might have helped you choose the correct response to this question even if you are unfamiliar with the research.
a. Incorrect See explanation for response b.
b. CORRECT As described in the Abnormal Psychology chapter of the written study materials, this is the difference reported by L. A. Clark et al., Temperament, personality, and the mood and anxiety disorders, Journal of Abnormal Psychology, 103, 92-102, 1994.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: a similar level of negative affect but a higher level of both autonomic arousal and positive affect.
About 10 to 15% of new mothers develop postpartum major depression in the first few days or weeks following delivery. In addition, up to _____% of new mothers exhibit “baby blues,” a less severe condition that involves mood swings and sleep disturbances.
Select one:
A. 30
B. 40
C. 50
D. 80
The reported rates for post-partum (baby) blues and depression vary in the literature. However, most authorities agree that the majority of new mothers do experience some degree of post-partum “blues.”
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Up to 80% is the percent commonly cited in the literature.
The correct answer is: 80
When using the DSM-5, a diagnosis of Major Neurocognitive Disorder requires the presence of a significant decline in:
Select one:
A. social and occupational functioning from premorbid functioning.
B. cognitive functioning that interferes with independence in everyday activities.
C. at least three areas of cognitive functioning.
D. the ability to perform activities of daily living.
Answer B is correct: The DSM-5 distinguishes between Major and Mild Neurocognitive Disorders. The diagnosis of a Major Neurocognitive Disorder requires a significant decline from a previous level of cognitive functioning that interferes with independence in everyday activities; while the diagnosis of a Mild Neurocognitive Disorder requires a modest decline from a previous level of cognitive functioning that does not interfere with independence in everyday activities.
Answers A, C, and D: See explanation for answer B.
The correct answer is: cognitive functioning that interferes with independence in everyday activities.
Your client is convinced that, for the past three months, the government has been tapping his phone, reading his emails, and having someone follow him. He states that he believes that, at one point, he was drugged by “an agent” and was “out for a day or two.” The client works as a computer programmer for a medical records company, has been married for three years, and has one child. He says that, despite the government’s interference in his life, everything else seems to be okay. What is the most likely DSM-5 diagnosis for this client?
Select one:
A. Paranoid Personality Disorder
B. Brief Psychotic Disorder
C. Delusional Disorder
D. Schizophrenia
Answer C is correct: The client’s symptoms are most suggestive of Delusional Disorder, persecutory type.
Answer A: The client has a single delusional belief that is limited to the government being out to get him rather than a pervasive tendency to behave, feel, and perceive the world as hostile and persecutory, which would be more indicative of a personality disorder.
Answer B: Despite his delusion about the government, the client appears to be functioning well at work and home. Brief Psychotic Disorder would cause greater impairment in functioning, and its diagnosis requires a duration of one day to less than one month.
Answer D: The nature of the client’s symptoms and their duration do not meet the diagnostic criteria for Schizophrenia.
The correct answer is: Delusional Disorder
Studies suggest that the ______________ of Obsessive-Compulsive Disorder are similar across cultures.
Select one:
A. prevalence rates
B. prevalence rates and age of onset
C. prevalence rates, age of onset, and gender distribution
D. prevalence rates, age of onset, gender distribution, and comorbidity
The studies have generally found that OCD does not differ significantly across different cultures.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The DSM-5 notes that prevalence rates, age of onset, gender distribution, comorbidity, and symptom structure of OCD are similar across cultures (APA, 2013, p. 140). However, the content of obsessions and compulsions may be affected by cultural factors.
The correct answer is: prevalence rates, age of onset, gender distribution, and comorbidity
Statistics on the risk for suicide among adolescents from single-parent and dual-parent families show that:
Select one:
A. there is no relationship between family configuration and risk for suicide.
B. girls (but not boys) from single-parent families are at higher risk than girls from dual-parent families.
C. boys (but not girls) from single-parent families are at higher risk than boys from dual-parent families
D. girls and boys from single-parent families are both at higher risk than girls and boys from dual-parent families.
One of the most consistent findings is that, for adolescents, living in a single-parent family increases the risk for suicide.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The linkage between a single-parent family and risk for a suicide in adolescents was recently confirmed in a large-scale study in Sweden, which compared 65,085 children from single-parent homes with 921,257 children from two-parent homes and found that the rate of suicide attempts was 2 times greater for girls from single-parent homes and 2.3 times greater for boys from single-parent homes [G. R. Weitoft et al., Mortality, severe morbidity, and injury in children living with single parents in Sweden: A population-based study, The Lancet, 361(9354), 289-295, 2003].
The correct answer is: girls and boys from single-parent families are both at higher risk than girls and boys from dual-parent families.
The fee for a 23-year-old woman suffering from depression is being paid by her parents. In terms of confidentiality, in this situation:
Select one:
A. the parents are the holders of the privilege since they are paying the therapist’s fee.
B. the parents should be supplied with general information about their daughter’s progress since they are paying the therapist’s fee and, therefore, are the “users” of the therapist’s services.
C. the therapist should relate only the information she believes the parents will understand.
D. the therapist should, at the onset of treatment, establish a policy about confidentiality jointly with the daughter and her parents.
In a case similar to the one described in this question (APA Casebook, 1987), the parents filed a complaint against the psychologist when he would not release information to them about their daughter. The Ethics Committee decided that the psychologist acted ethically by not releasing the information since he had clarified this policy in advance with the parents and the daughter at the onset of treatment.
a. Incorrect Payment of fees does not give a party the right to information about a client’s progress in therapy.
b. Incorrect Once again, payment of fees does not mean that the parents need to be given information (specific or general) unless this has been explicitly decided upon by all parties.
c. Incorrect This response does not address the issue of confidentiality presented by the question.
d. CORRECT This is the most ethical alternative and, as noted above, was decided by the Ethics Committee to be an ethical course of action.
The correct answer is: the therapist should, at the onset of treatment, establish a policy about confidentiality jointly with the daughter and her parents.
When attempting to expand your private practice, it is important to keep in mind that in-person solicitations:
Select one:
A. are always unethical.
B. are unethical only when they target individuals receiving similar services from another professional.
C. are unethical only when they include deceptive or misleading information.
D. are unethical when they include deceptive information or when the person solicited is susceptible to undue influence.
Although the APA’s prohibitions against solicitation of clients have been limited by the requirements of the Federal Trade Commission, APA still considers certain types of business solicitations unethical.
a. Incorrect In-person solicitations might be ethically acceptable in some situations (e.g., when they are “invited” solicitations).
b. Incorrect This type of solicitation might also be acceptable in some situations.
c. Incorrect This is not the most complete response of those given.
d. CORRECT This is most consistent with Standard 5.06 of the Ethic Code: Solicitations are unethical when they include deceptive or false information or when their targets are individuals who are vulnerable to undue influence.
The correct answer is: are unethical when they include deceptive information or when the person solicited is susceptible to undue influence.
A pharmaceutical company asks a psychologist to help it design and conduct a research study on one of its new drugs. The company representative says the company will publish the results of the study only if they are favorable to the drug. The psychologist should:
Select one:
A. agree to participate only if he is able to approve the final report.
B. agree to participate only if the company gives him appropriate authorship credit for his work.
C. agree to participate since it is up to the company to decide what to publish and who to list as an author.
D. not agree to participate in designing or conducting the study.
This situation is not explicitly covered by the Ethics Code. However, several Standards and General Principles are applicable. Principle A, for example, states that “psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons.”
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Standard 5.01 also applies to this situation. It states that “psychologists do not knowingly make public statements that are false, deceptive, or fraudulent concerning their research, practice, or other work activities or those of persons or organizations with which they are affiliated.” Agreeing with the company’s decision to publish only supportive data would be supporting a form of deception (and would not be in the best interests of the potential users of the drug). Therefore, this response is most consistent with the “spirit” of the Ethics Code.
The correct answer is: not agree to participate in designing or conducting the study.
Research on sexual and nonsexual dual relationships between therapists and their clients has found that:
Select one:
A. male therapists engage in more sexual dual relationships, but female therapists engage in more nonsexual dual relationships.
B. the rates of sexual dual relationships are higher among those with less professional experience.
C. in a sexual dual relationship, the client is, on the average, 10 years younger than the therapist.
D. therapists who undergo personal therapy are less likely to become sexually involved with their clients.
As noted in the chapter on ethics and professional issues in the written study materials, several surveys have been conducted to determine factors related to sexual misconduct by mental health professionals.
a. Incorrect Male therapists are involved in substantially more sexual and nonsexual dual relationships than female therapists.
b. Incorrect This is not necessarily true. Some research indicates higher rates among the more experienced.
c. CORRECT The average age of therapists who become involved in sexual dual relationships is 42 or 43 (depending on which study you read), while the average age of the client is 32 or 33. See K. S. Pope, Sexual feelings in psychotherapy: Explorations for therapists and therapists-in-training, American Psychological Association, Washington, DC, 1993.
d. Incorrect The research is not entirely consistent on this issue. Most studies have found either that there is no effect of therapy or that therapy is associated with an increased risk for sexual involvement.
The correct answer is: in a sexual dual relationship, the client is, on the average, 10 years younger than the therapist.
You receive an order from the court to conduct a presentencing evaluation of a defendant who has been convicted of murder. You should:
Select one:
A. obtain a signed release of information from the defendant before conducting the evaluation.
B. discuss the limits of confidentiality with the defendant even though a release of information is not legally required in this situation.
C. say nothing about confidentiality since a release of information is not legally required and discussing confidentiality may decrease the defendant’s willingness to be truthful.
D. proceed with the evaluation since a release of confidentiality will have already been obtained by the court.
In general, the results of an evaluation are not revealed without the individual’s consent. However, this is modified when the evaluation is being conducted in response to a court-order.
a. Incorrect See explanation for response b.
b. CORRECT This issue is addressed by G. B. Melton et al. in their discussion of court-ordered evaluations (Psychological evaluations for the court, New York, Guilford, 1987). They note that the therapist-patient privilege does not apply when the therapist-patient relationship “is the creation of the court” (p. 46), which is the case in a court-ordered evaluation. However, from an ethical perspective, you should always warn an individual of the limits of confidentiality.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: discuss the limits of confidentiality with the defendant even though a release of information is not legally required in this situation.
A colleague of yours has just attended a seminar on Culture and Ethics where several experts argued that it is inappropriate for psychologists to attempt to obtain a signed written informed consent from members of certain cultural groups prior to their participation in therapy. As an ethical psychologist, you tell your colleague that it:
Select one:
A. is always necessary to obtain a signed written consent from therapy clients regardless of their ethnic/cultural background.
B. is always necessary to obtain either a signed written consent or a signed waiver of consent from all therapy clients regardless of their ethnic/cultural background.
C. is acceptable to document an informed consent from therapy clients in an alternative way only when those clients are illiterate.
D. may be acceptable to document an informed consent from therapy clients in an alternative way, especially when a signed consent would be inappropriate for the client.
An ongoing discussion in the literature is related to the need to consider modifying the informed consent process for members of ethnic/cultural groups who may find written consents objectionable or may want to include family members in the consent process. See, e.g., L. O. Gostin, Informed consent, cultural sensitivity, and respect for persons, Journal of the American Medical Association, 274(10), 844-845, 1995.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Standard 3.10(c) of the APA’s Ethics Code and Standard I.22 of the Canadian Code of Ethics apply to this situation: Standard 3.10(c) states that “Psychologists appropriately document written or oral consent, permission, and assent”; and Standard I.22 states that psychologists “accept and document oral consent, in situations in which signed consent forms are not acceptable culturally or in which there are other good reasons for not using them.” (Note, however, that legal requirements or institutional regulations may differ, and psychologists should check applicable laws and regulations before deciding to forego a written consent.)
The correct answer is: may be acceptable to document an informed consent from therapy clients in an alternative way, especially when a signed consent would be inappropriate for the client.
The APA’s Ethical Principles of Psychologists and Code of Conduct:
Select one:
A. clearly prohibits a psychologist from having sexual relationships with students and supervisees under any circumstances.
B. clearly prohibits a psychologist from having sexual relationships with a student or supervisee when he/she is in a position of authority over that person.
C. prohibits a psychologist from having sexual relationships with students and supervisees indirectly through the “dual relationship” clause.
D. does not address the issue of sexual relationships with students and supervisees.
For the exam, you want to be familiar with the provisions of the Ethics Code regarding sexual relations with supervisees and students so that you can answer questions like this. For additional information on this issue, see the Ethics and Professional Issues chapter of the written study materials.
a. Incorrect See explanation for response b.
b. CORRECT Standard 7.07 states that, “Psychologists do not engage in sexual relationships with students or supervisees who are in their department, agency, or training center or over whom psychologists have or are likely to have evaluative authority.”
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: clearly prohibits a psychologist from having sexual relationships with a student or supervisee when he/she is in a position of authority over that person.
During the second therapy session with a client, she admits that she has beaten her 7-year-old son on two occasions. She is very remorseful, promises never to do it again, and says she will continue coming to therapy to get the help she needs. You should:
Select one:
A. continue seeing the woman in therapy and contact the authorities only if you believe she is capable of hitting her son again.
B. continue seeing the woman and make a report to the authorities only if she stops coming to therapy.
C. explain that you are obligated to make a report and call the authorities while she is in your office.
D. say nothing to the client about making a report but call the authorities as soon as possible after the therapy session ends.
In this situation, you would be legally required to make a report to the appropriate authorities.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The experts generally agree that it is often preferable to involve the client in the reporting process (e.g., to make the report when the client is present). Consequently, this is the best answer of those given.
d. Incorrect See explanation for response c.
The correct answer is: explain that you are obligated to make a report and call the authorities while she is in your office.
A Mexican American client tells his psychologist that he wants to consult a curandero about the problems he is having. To be consistent with the requirements of the APA’s Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations, the psychologist should:
Select one:
A. explain any concerns she has about the incompatibility of her approach with the approach of a traditional folk healer.
B. find out as much about curanderos as possible and incorporate what she learns into her treatment of the client.
C. refer the client to a therapist who is more familiar with traditional Mexican culture.
D. support the client in his desire to work with a curandero and express her willingness to collaborate.
This issue is addressed in Paragraph 5 of the Guidelines.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Paragraph 5(b) states that “effective psychological intervention may be aided by consultation with and/or inclusion of religious/spiritual leaders/practitioners relevant to the client’s cultural and belief systems.” This response is most consistent with this provision.
The correct answer is: support the client in his desire to work with a curandero and express her willingness to collaborate.
Following the death of his mother, Dr. Beasley, a clinical psychologist, finds he is having trouble sleeping, has lost his appetite, and is having some trouble concentrating when listening to his clients during therapy sessions. In this situation, to fulfill the requirements of the APA’s Ethics Code, Dr. Beasley should:
Select one:
A. begin therapy to work through his bereavement.
B. temporarily suspend his practice until he feels better and refer his clients to another therapist.
C. temporarily reduce his caseload to a more manageable level.
D. seek consultation to determine if he should temporarily suspend his practice or take some other course of action.
To be consistent with the provisions of the Ethics Code, Dr. Beasley should seek competent professional assistance to help him determine if he should suspend, terminate, or otherwise modify his clinical practice because of his current personal problems.
a. Incorrect This is a possible course of action for Dr. Beasley, but answer d is a better answer because it addresses the ethical issue of what Dr. Beasley should do to best protect the welfare of his clients.
b. Incorrect This course of action might also be acceptable, but it is not the best answer.
c. Incorrect While this might be an acceptable action, answer d is a better answer.
d. CORRECT Dr. Beasley’s first course of action should be to seek advice to help him decide what to do.
The correct answer is: seek consultation to determine if he should temporarily suspend his practice or take some other course of action.
Dr. Rafael, a licensed psychologist, requires his Psychology 101 students to participate in two research studies conducted by graduate students or professors at the university as part of the course requirements. This requirement:
Select one:
A. is unethical under any circumstances.
B. is ethical only if students are aware of the requirement prior to enrolling in the class.
C. is ethical only if students are given a choice of alternative assignments.
D. is ethical as long as the research has been approved by the university’s Institutional Review Board.
This issue is addressed in Standard 8.04(b) of the APA’s Ethics Code.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This answer is consistent with Standard 8.04(b), which states that, “when research participation is a course requirement or an opportunity for extra credit, the prospective participant is given the choice of equitable alternative activities.”
d. Incorrect See explanation for response c.
The correct answer is: is ethical only if students are given a choice of alternative assignments.
With regard to terminating the life of animals used in research studies, the APA’s Ethics Code:
Select one:
A. permits this practice only when an animal is suffering.
B. permits this practice only in the “most unusual circumstances.”
C. permits this practice when it is appropriate and done in a way that minimizes pain.
D. prohibits this practice.
This situation is addressed in Standard 8.09(g) of the Ethics Code.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Standard 8.09(g) states that “when it is appropriate that an animal’s life be terminated, psychologists proceed rapidly, with an effort to minimize pain and in accordance with accepted procedures.”
d. Incorrect See explanation for response c.
The correct answer is: permits this practice when it is appropriate and done in a way that minimizes pain.
You are a psychodynamic psychotherapist and are seeing a client who has several problems. One of these problems has been found to respond best to a behavioral technique that you are unfamiliar with. You should:
Select one:
A. seek supervision while applying the technique.
B. take a class on the technique.
C. make a referral to a behavioral therapist.
D. discuss the issue with the client and decide what she wants to do.
There really isn’t enough information given in this question to choose the best course of action, but keep in mind that you always want to be somewhat conservative when answering ethics questions on the exam.
a. Incorrect This might be adequate in some situations. The question states, however, that you’re a “psychodynamic psychotherapist,” so you may not be interested in adding a behavioral technique to your repertoire. This may also be inadequate if the problem is a very serious one.
b. Incorrect Obviously, in most situations, this would not be adequate.
c. CORRECT Given the limited information; this is the best answer. Since you don’t have the training or skills needed to provide the optimal treatment to the client, referral would be the best course of action. (Of course, you can continue treating the client for her other problems.)
d. Incorrect This would not be a good course of action.
The correct answer is: make a referral to a behavioral therapist.
An ongoing debate in the literature centers on a therapist’s responsibility when working with a client who is HIV-positive and is engaging in risky sexual behavior. A central issue in this debate is:
Select one:
A. social responsibility.
B. client abandonment.
C. foreseeability of harm.
D. vicarious liability.
As noted in the chapter on ethics and professional issues in the written study materials, this issue is often discussed within the framework of the Tarasoff decision.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT In discussing this topic, S. Knapp and L. VandeCreek, for example, note that three issues are involved in the duty to protect: a fiduciary relationship, an identifiable victim, and the foreseeability of harm. They note that the “issue of foreseeability creates the greatest problems with the duty to protect with HIV-positive patients because the research has not identified all the risk factors involved in HIV transmission” (Application of the duty to protect to HIV-positive patients, Professional Psychology: Research and Practice, 21(3), 161-166, 1990).
d. Incorrect See explanation for response c.
The correct answer is: foreseeability of harm.
Dr. E. Dict has been seeing Jay Bird, a prisoner at the local jail, in therapy for the past five months. The parole board contacts Dr. Dict to request that he evaluate Bird for an upcoming parole hearing. Dr. Dict should:
Select one:
A. agree to evaluate Bird since he is best qualified to evaluate him fairly.
B. agree to evaluate Bird only if Bird agrees to the arrangement.
C. agree to evaluate Bird only if he feels that Bird is eligible for parole.
D. refuse to evaluate Bird for the parole hearing.
The APA’s guidelines require psychologists to avoid dual (multiple) relationships.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This type of situation is addressed in the Specialty Guidelines for Forensic Psychology and the Ethics Code, which require psychologists to avoid dual relationships whenever objectivity, exploitation, and other issues related to effectiveness are of concern, which would be the case in this situation. The two roles – therapist and forensic evaluator – clearly conflict and should be avoided.
The correct answer is: refuse to evaluate Bird for the parole hearing.
Dr. X has been asked to administer a psychological test to an individual who requires special accommodations because of a physical disability. The test was not developed or normed for individuals with this disability. The APA’s Guidelines for Test User Qualifications recommend that, in this situation, psychologists:
Select one:
A. refuse to administer the test.
B. refuse to administer the test unless there are no alternative methods of assessment.
C. exercise “special care” when administering and scoring the test and interpreting its results.
D. obtain legal advice on relevant legal requirements regarding the administration and use of the test.
The APA’s position on this issue is summarized by S. M. Turner, S. T. DeMers, H. R. Fox, and G. M. Reed in APA’s Guidelines for Test User Qualifications: An executive summary (American Psychologist, 56, 1099-1113, 2001).
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT In their summary, Turner et al. note that there may be legal requirements that apply to the administration and use of tests when an individual requires special accommodations. To ensure that these requirements are met, psychologists should consider them and, when appropriate, “obtain legal advice on legal and regulatory requirements regarding appropriate administration of tests and use of test data when assessing individuals with disabilities” (p. 1103). Note that Standard 10.2 of the Standards for Educational and Psychological Testing also addresses this issue and requires test users who do not have adequate knowledge or experience in modifying tests for individuals with disabilities to seek guidance from a consultant or supervisor who has expertise.
The correct answer is: obtain legal advice on relevant legal requirements regarding the administration and use of the test.
The Buckley Amendment:
Select one:
A. establishes the right of the school psychologist to determine who should have access to information included in school records.
B. establishes the right of parents to inspect the school records of their children.
C. establishes the right of patients or their legal representatives to have access to their hospital records.
D. requires that parental consent be obtained before a student can be subjected to a psychological or psychiatric examination.
The Buckley Amendment is another name for the Family Education Rights and Privacy Act (FERPA).
a. Incorrect See explanation for response b.
b. CORRECT Among other things, the Buckley Amendment states that any school district may be denied federal funds if parents of students (or other legal guardians) or students who have reached the age of majority are not given access to their school records. It also prohibits disclosure of school records to unauthorized individuals without parental consent. See the chapter on ethics and professional issues in the written study materials for additional information on the Buckley Amendment.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: establishes the right of parents to inspect the school records of their children.
The APA’s Ethics Code requires that informed consents be:
Select one:
A. in writing.
B. in writing whenever the individual is not a minor.
C. documented.
D. signed by the individual or his/her legal guardian.
Although written, signed consents are advisable in both therapy and research, they are not required by the Ethics Code.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Paragraph 3.10(d) of the Code states that “Psychologists appropriately document written or oral consent, permission, and assent.”
d. Incorrect See explanation for response c.
The correct answer is: documented.
A former therapy client calls you and expresses an interest in becoming friends. The former client suggests that you meet at a local restaurant for lunch. You remember that the client shared many of your interests, and that, at the time of therapy, you were aware that he/she was someone you would like to know better. As an ethical psychologist, you:
Select one:
A. meet the former client for lunch only if the therapeutic relationship was terminated more than two years ago.
B. meet the former client for lunch only if the therapeutic relationship was terminated more than two years ago and you believe that a relationship is not clinically contraindicated and is not likely to be exploitative.
C. meet the client for lunch to clarify and discuss any potential conflicts and then proceed with caution.
D. do not meet the client for lunch and explain why a friendship would not be in the client’s best interests.
Friendships with former clients are covered by the multiple relationship clause in the Ethics Code. In most situations, a psychologist would want to avoid friendships with former clients.
a. Incorrect See explanation for responses b and d.
b. Incorrect The two-year limit applies to sexual relationships, which this question is not addressing.
c. Incorrect See explanation for response d.
d. CORRECT Most experts agree that friendships with former clients should be avoided since this sets up an unequal situation and precludes the possibility that the former client can return for therapy in the future.
The correct answer is: do not meet the client for lunch and explain why a friendship would not be in the client’s best interests.
Dr. Street, a clinical psychologist, has been treating Bob B. for about five months. Bob originally came to therapy to resolve the depression he had been experiencing since his divorce and, in the past few weeks, Dr. Street has noticed a marked improvement in Bob’s symptoms. During one session, Bob says that, for some time, he has been having trouble going anywhere that requires him to use an elevator since being confined in small spaces with other people makes him very anxious. He says he has had this problem for some time, but that it seems to have gotten worse recently. Dr. Street has not had much experience in treating phobic reactions and therefore decides to refer Bob to a behavioral therapist. However, even though Bob has started behavioral therapy with another therapist, Dr. Street continues to see Bob in order to continue working on Bob’s depression. In terms of ethical practices, this arrangement is:
Select one:
A. unethical since Dr. Street should have offered Bob a choice of therapists.
B. unethical since Dr. Street should terminate his relationship with Bob while Bob is receiving treatment from another therapist.
C. ethical as long as the therapists cooperate with one another during the course of Bob’s treatment.
D. ethical but therapeutically questionable since Bob’s phobia is probably related to his divorce.
Dr. Street’s actions are consistent with the provisions of the Ethics Code. He has recognized his professional limitations and has taken action to ensure that his client receives the best possible treatment.
a. Incorrect Referral to a specific professional is not prohibited although it would be advisable, when appropriate, to give the client a choice of alternatives. This, however, is not the best answer of those given.
b. Incorrect Seeing a client who is seeing another professional is only a problem when the client is receiving similar services from the other professional, which is not the case in this situation.
c. CORRECT As noted above, Dr. Street has acted in an ethical and responsible manner by referring Bob to another therapist and will continue to do so as long as he cooperates with the other therapist during the course of Bob’s treatment.
d. Incorrect There is insufficient information to support this conclusion.
The correct answer is: ethical as long as the therapists cooperate with one another during the course of Bob’s treatment.
Dr. Colombu, a licensed psychologist, is working in a community mental health center. The parents of a 15-year old girl bring their daughter for counseling. The parents will, of course, be paying Dr. Colombu’s fee. As an ethical psychologist, Dr. Colombu should:
Select one:
A. caution the girl that, since she is a minor, anything she says may be told to her parents.
B. advise the parents that he is required to maintain confidentiality and that he will not be able to advise them of anything the girl says during therapy sessions without her consent.
C. clearly establish with the girl and her parents prior to therapy what the policy will be with regard to sharing information with the parents.
D. use his discretion with regard to what information to reveal to the girl’s parents and what information to keep confidential.
The therapeutic relationship would be best served if the policy regarding confidentiality is established with both the parents and the child at the onset of therapy.
a. Incorrect Although this may not violate ethical or legal guidelines, answer c describes a better course of action.
b. Incorrect See explanation for response c.
c. CORRECT Parents have a legal right to information about their child in most situations but providing them with all information is not necessarily the best course of action from a clinical standpoint. Therefore, this is the best course of action since it takes the welfare of the child as well as the legal rights of the parents into consideration.
d. Incorrect See explanation given above.
The correct answer is: clearly establish with the girl and her parents prior to therapy what the policy will be with regard to sharing information with the parents.
If a psychologist is requested by a defense attorney to evaluate and testify about a defendant for the purpose of establishing the defense of insanity, the psychologist should:
Select one:
A. obtain an order from the court before agreeing to evaluate the defendant.
B. evaluate the defendant and testify as requested but inform the defendant of the purpose of the evaluation and of the limits of confidentiality before doing so.
C. evaluate the defendant as requested and not be concerned about informing the defendant of the limits of confidentiality since privilege is waived in this situation.
D. refuse to evaluate the defendant because psychologists are not qualified to determine if a person is “insane.”
Claiming insanity as a defense is one of the times when privilege is waived. However, precautions regarding confidential information must still be taken.
a. Incorrect This isn’t necessary.
b. CORRECT Although the psychologist would want to refrain from concluding whether or not the defendant is “insane,” he/she can testify about the client’s mental state at the time of the crime. Also, while privilege is waived when a defendant claims insanity, the defendant should be informed of the limits of confidentiality prior to the evaluation.
c. Incorrect See explanation for response b.
d. Incorrect Psychologists should not conclude whether or not a person is “insane,” but they can draw conclusions about a person’s mental status, which the court then uses to make a determination of insanity.
The correct answer is: evaluate the defendant and testify as requested but inform the defendant of the purpose of the evaluation and of the limits of confidentiality before doing so.
Dr. Prattle is asked by a local radio station if she would be interested in doing a “talk show” on Saturday mornings. On the show, she will respond to people who call the station. To be consistent with the provisions of the Ethics Code, Dr. Prattle should:
Select one:
A. refuse to appear on the show.
B. avoid giving direct advice of a psychological nature to callers.
C. be sure that callers understand that their conversations with her do not constitute a therapeutic relationship.
D. be sure that she has adequate malpractice insurance.
As noted by M. B. Canter, et al. (1994), in their discussion of the Ethics Code, the ethical requirements with regard to media psychology are “still evolving.” However, since this question refers specifically to the Code, the best answer is the one that best resembles the Code’s language.
a. Incorrect It’s not necessary to refuse to do the show, but certain precautions should be taken.
b. Incorrect Discussions of media psychology in the literature have generally concluded that advice is actually better than therapy in this context.
c. CORRECT Of the responses, this one comes closest to the language of Standard 5.04 (Media Presentations). Moreover, Canter, et al. note that on radio talk shows, the psychologist should be sure that he/she clearly distinguishes between “media psychology” and “therapy” (Ethics for psychologists: A commentary on the APA Ethics Code, Washington, DC, APA, 1994).
d. Incorrect This is probably a good idea, but not the best response to this question!
The correct answer is: be sure that callers understand that their conversations with her do not constitute a therapeutic relationship.
Which of the following best describes the requirements of the ethics codes published by the American and Canadian Psychological Associations?
Select one:
A. Subjects do not have to be debriefed about the nature of a research study following their participation unless doing so is required by the institutional review board.
B. Subjects do not have to be debriefed about the nature of a research study following their participation unless the study involved the use of deception.
C. Subjects must be debriefed about the nature of a research study following their participation in a way that minimizes harm.
D. Subjects must always be debriefed about the nature of a research study immediately following their participation.
The debriefing of research subjects is addressed in Standards 8.07 and 8.08 of the APA’s Ethics Code and Principles II and III of the Canadian Code of Ethics.
a. Incorrect See explanation for answer c.
b. Incorrect See explanation for answer c.
c. CORRECT This answer is most consistent with the requirements of the American and Canadian codes: Standard 8.08(c) of the APA’s Ethics Code states that, “when psychologists become aware [during the debriefing] that research procedures have harmed a participant, they take reasonable steps to minimize the harm.” And Principle II.44 of the Canadian Code of Ethics states that psychologists must “debrief research subjects in such a way that any harm caused can be discerned, and act to correct any resultant harm.”
d. Incorrect Neither code states that debriefing must be provided to subjects immediately following their participation. The Canadian Code of Ethics does not address the timing of debriefing, and Standard 8.07(c) of the APA’s Ethics Code requires psychologists to debrief subjects “as early as is feasible” when the study involved deception, which may be at the conclusion of their participation or at the end of data collection. In addition, Standard 8.08(b) allows psychologists to delay or withhold information that is normally provided during debriefing when there is a scientific or humane justification for doing so.
The correct answer is: Subjects must be debriefed about the nature of a research study following their participation in a way that minimizes harm.
Dr. Watson is one of three organizational psychologists who have been hired by a large corporation to conduct research on the selection of top-level managers. The psychologists’ research has provided some evidence that “anal retentive” managers are the least effective managers in the company. Prior to submitting the project report, which recommends that the company screen candidates for top management positions for “anal retentiveness,” Dr. Watson approaches the Project Director, who is also an industrial psychologist, and argues that, although there is some evidence that there is a relationship between anal retentiveness and management effectiveness, the evidence is insufficient to justify eliminating potential managers on the basis of this characteristic alone. Despite Dr. Watson’s protest, the Project Director refuses to review the report and submits it to the company. Dr. Watson decides to go to the company’s management to point out the possible limitations of the report’s recommendations. Which of the following statements best describes the ethical issue in this situation?
Select one:
A. Watson clearly acted unethically by directly contacting management and thereby compromising the Project Director’s relationship with the company.
B. Watson acted unethically by not consulting with the Ethics Committee before taking further action against the Project Director after his refusal to review the report.
C. Watson acted unethically by directly contacting management and the Project Director acted unethically by not reviewing the report.
D. Watson acted ethically but the Project Director acted unethically by not reviewing the report.
Watson acted ethically and responsibly by attempting to prevent distortion of psychological findings, while the Project Director acted unethically by not reviewing the data contained in the report in light of Watson’s protest and thereby possibly providing the company with misleading information.
a. Incorrect Although direct contact with company mananagement may seem extreme, this is not the best answer of those given.
b. Incorrect Watson’s responsibility did not stop after discussing the matter with the Project Director.
c. Incorrect Although the Project Director acted unethically, Watson’s behavior was ethical.
d. CORRECT This response is most consistent with the requirements of Standards 1.04 and 1.05 of the Ethics Code (which apply to resolving ethical violations by colleagues) and Standard 5.01 (which requires psychologists to avoid making false, deceptive, or misleading statements).
The correct answer is: Watson acted ethically but the Project Director acted unethically by not reviewing the report.
A psychologist is hired by a defendant’s attorney to evaluate the defendant for a possible insanity defense. Prior to conducting the evaluation, the psychologist:
Select one:
A. should inform the defendant that all information provided during the evaluation is confidential and will be revealed only to his attorney.
B. should inform the defendant that information will be provided only to his attorney unless the defendant and his attorney decide to use the results of the evaluation to support an insanity defense.
C. should inform the defendant that information related to his mental state at the time he committed the crime is not confidential and will be provided to the court and the opposing attorney.
D. should inform the defendant that any information he provides during the course of the evaluation will be revealed not only to his attorney but also to the court and the opposing attorney.
When hired by a defendant’s attorney to evaluate the defendant for a court case, the limits of confidentiality must be discussed prior to conducting the evaluation.
a. Incorrect See explanation for response b.
b. CORRECT In this situation, the client should be advised that information will be shared only with his attorney unless the client and his attorney decide to use it to support an insanity or similar defense. See, e.g., G. B. Melton et al., Psychological evaluation for the courts, New York, Guilford Press, 1997.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: should inform the defendant that information will be provided only to his attorney unless the defendant and his attorney decide to use the results of the evaluation to support an insanity defense.
Results of Pope’s (1992) survey of APA members indicated that which of the following issues was cited most frequently as being ethically troubling or challenging?
Select one:
A. fees
B. sexual matters
C. confidentiality
D. the conduct of colleagues
This is a straightforward question. Unfortunately, it requires you to be familiar with the results of a specific survey, although you might have been able to rely on your own experience and those of your colleagues.
a. Incorrect Fees were mentioned by 14% of respondents as being ethically troublesome in a recent study conducted by S. Pope (Ethical dilemmas as encountered by members of the APA: A national survey, American Psychologist, 47(3), 397-411, 1992).
b. Incorrect Only 4% of respondents listed sexual issues as a problem.
c. CORRECT Confidentiality was listed by 18% of respondents as an ethically troubling issue.
d. Incorrect The conduct of colleagues was listed as a problem by 4% of respondents.
The correct answer is: confidentiality
A client you have been seeing for two months suddenly informs you that this will be his last session. You believe this is not a good time for the client to stop therapy and are concerned about the potential negative consequences of doing so. You should:
Select one:
A. allow the client to quit.
B. provide the client with appropriate referrals.
C. discuss with him the reasons you believe he should continue and recommend that he re-think his decision.
D. inform him that you are not responsible for any negative consequence of terminating prematurely.
Obviously, a client has a right to discontinue treatment. This creates an ethical dilemma, however, when the therapist believes that termination is ill-advised.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This is the best response of those given. In this situation, the therapist would want to discuss the possible risks of terminating therapy at this time and encourage the client to re-think his decision. Although the action described in answer b would also be important, it should follow a discussion about the possible consequences of leaving.
d. Incorrect See explanation for response c.
The correct answer is: discuss with him the reasons you believe he should continue and recommend that he re-think his decision.
You are working in a community mental health center that employs two other psychologists, a social worker, and a psychiatrist. One Saturday, as you’re talking to your neighbor over the backyard fence, she tells you that the wife of one of your co-workers (one of the psychologists) is a close friend of hers and has told her that her husband (the psychologist) has started to physically abuse her. As an ethical psychologist, your best course of action would be to:
Select one:
A. tell the neighbor to have your co-worker’s wife call your office to set up an appointment.
B. call the wife of the co-worker yourself to confirm the charge before filing a complaint with the Ethics Committee.
C. discuss the situation with the accused co-worker as soon as possible.
D. report the matter to the director of the mental health center (the psychiatrist).
As a psychologist, one of your duties is to ensure that your colleagues are acting ethically in their professional roles. In this case, the man’s alleged behavior is related to his personal life. However, his personal problems may be interfering with his ability to provide services to his clients. Moreover, his behavior could have adverse consequences on the public trust in psychologists or in the profession of psychology.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Of the responses given, this one is most in line with “common sense” and with the spirit of the Ethics Code. Although the psychologist’s behavior does not involve a client, it is possible that his personal problems are having an indirect impact on his work. Of the responses given, this one is the best answer because it represents the most direct approach to resolving the problem.
d. Incorrect See explanation for response c.
The correct answer is: discuss the situation with the accused co-worker as soon as possible.
To be consistent with the requirements of the Uniform Guidelines on Employee Procedures, when it is determined that a selection procedure is having an adverse impact, an employer must:
Select one:
A. stop using the procedure for making selection decisions.
B. use the procedure only in conjunction with other validated measures.
C. obtain the consent of each applicant before using the procedure.
D. validate that the procedure is job-related.
When it is determined that a selection procedure is having an adverse impact, the employer cannot continue using it unless he/she can demonstrate that doing so is a business necessity.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT An employer can show that continued use of the selection procedure is a business necessity by demonstrating that (a) the measure is valid by establishing its relationship to successful job performance and (b) there are no alternate methods that would have less adverse impact.
The correct answer is: validate that the procedure is job-related.
When using a ___________________, the rater is provided with a list of behavioral examples and asked to indicate whether the ratee’s performance is equal to, worse than, or better than the performance described in each example.
Select one:
A. critical incident technique
B. behavioral observation scale
C. forced-choice method
D. mixed standard scale
The mixed standard scale (Blanz and Ghiselli, 1971) was originally designed to reduce rater biases. Note that, if you’re unfamiliar with this technique, you may have been able to identify it as the correct answer to this question using the process of elimination.
a. Incorrect See explanation for response d. (Although the mixed standard scale uses critical incidents, it is not the same as the “critical incident technique.”)
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT When using the mixed standard scale, three critical incidents representing good, average, and poor performance for several dimensions of job performance are identified. They are then listed in the rating scale in a random order, and the rater indicates, for each incident, whether the rater’s performance is equal to, worse than, or better than the described behavior.
The correct answer is: mixed standard scale
Yerkes and Dodson’s (1908) “inverted-U” hypotheses predicts that:
Select one:
A. moderate levels of group cohesiveness are associated with the highest levels of performance.
B. moderate levels of arousal are associated with the highest levels of performance.
C. performance is a function of task complexity, level of arousal, and learned habits.
D. performance is the result of an interaction between motivation, ability, and task difficulty.
The inverted-U theory hypothesis is also known as the Yerkes-Dodson Law and has been applied to a number of activities including academic learning and sports performance. The Yerkes-Dodson 1908 study is a classic in the field and is likely to be asked about on the exam.
a. Incorrect See explanation for response b.
b. CORRECT The inverted-U hypothesis predicts that, for every activity, there is an optimum level of arousal and that arousal above or below that level has a negative impact on performance. Of the answers given, this one best describes this hypothesis.
c. Incorrect This answer describes an assumption underlying Hull’s (1943) drive theory.
d. Incorrect This answer does not accurately describe the inverted-U hypothesis.
The correct answer is: moderate levels of arousal are associated with the highest levels of performance.
In training, providing “identical elements” is most useful for:
Select one:
A. maximizing overlearning.
B. reducing the probability of proactive and retroactive interference.
C. ensuring transfer of training.
D. providing opportunities for active practice.
The term “identical elements” refers to similarities in the learning and performance environments.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Transfer of training is maximized when learning conditions are similar to performance conditions (i.e., when they are similar in terms of task, equipment, environment, etc.).
d. Incorrect See explanation for response c.
The correct answer is: ensuring transfer of training.
According to John D. Krumboltz (1996), career development and career choice are related primarily to:
Select one:
A. needs and drives.
B. early childhood experiences.
C. ego identity development.
D. social learning.
Krumboltz proposes that career decisions are based on what the individual has learned.<p>
a. Incorrect See explanation for response d.</p><p>
b. Incorrect See explanation for response d.</p><p>
c. Incorrect See explanation for response
d. CORRECT Krumboltz’s emphasis is on social learning – i.e., modeling and other aspects of the social environment – and his theory is referred to as the Social Learning Theory of Career Decision Making (SLTCDM). Additional information about Krumboltz’s theory is provided in the Industrial-Organizational Psychology chapter of the written study materials.
The correct answer is: social learning.</p>
