Week 5 - Schizophrenia and the psychotic disorders

Question 1

The DSM-5 describes psychosis through:

A) A single, clear-cut definition
B) Various symptoms and criteria across different disorders
C) Only in relation to schizophrenia
D) A set of fixed, universally agreed-upon symptoms

Answer 1

B) Various symptoms and criteria across different disorders

(There is still no universally agreed-upon definition of psychosis)

Question 2

In the DSM-5, psychotic disorders are conceptualized in terms of SEVERITY and the presence of which FIVE CORE SYMPTOMS?

A) Anxiety, mood swings, paranoia, aggression, and cognitive impairment
B) Delusions, hallucinations, disorganized thinking, grossly disorganized behavior, and negative symptoms
C) Depression, hallucinations, obsessive thoughts, memory loss, and confusion
D) Mania, apathy, disorganized speech, social withdrawal, and suicidal thoughts

Answer 2

B) Delusions, hallucinations, disorganized thinking, grossly disorganized behavior, and negative symptoms

Question 3

In schizophrenia, what do positive symptoms entail?

A) The absence of normal behaviors
B) Cognitive impairments
C) The addition of disturbances such as hallucinations, delusions, and disorganization in thought and behavior
D) Emotional flatness and withdrawal

Answer 3

C) The addition of disturbances such as hallucinations, delusions, and disorganization in thought and behavior

Question 4

In schizophrenia, which type of symptoms refer to deficits in psychological processes such as avolition, affective flattening, and alogia?

A) Positive symptoms
B) Cognitive symptoms
C) Negative symptoms
D) Mood symptoms

Answer 4

C) Negative symptoms

Question 5

The state of highly disorganized thinking, formally known as ________ __________ or loosening of associations, is characteristic of individuals with schizophrenia.

A) Cognitive impairment
B) Thought disorder
C) Emotional detachment
D) Behavioral dysfunction

Answer 5

B) Thought disorder

Question 6

The inability to initiate or persist with important activities is known as ________ and is a negative symptom of schizophrenia.

A) Alogia
B) Anhedonia
C) Avolition
D) Affective flattening

Answer 6

C) Avolition

Question 7

Which scenario involving John best illustrates avolition in schizophrenia?

A) John struggles to understand abstract concepts
B) John feels persistent sadness and has lost interest in hobbies
C) John is unable to start or complete essential daily tasks such as going to work or maintaining hygiene
D) John experiences auditory hallucinations

Answer 7

C) John is unable to start or complete essential daily tasks such as going to work or maintaining hygiene

Question 8

The term used to describe broad range of disturbances of bodily movement, such as excessive restlessness or slowed movement, is:

A) Avolition
B) Catatonia
C) Motor Disturbance
D) Disorganized thinking

Answer 8

C) Motor Disturbance

(Catatonia is a more specific condition with well-defined symptoms, whereas motor disturbances can be a symptom of many different underlying conditions)

Question 9

Which scenario best illustrates a motor disturbance such as psychomotor agitation?

A) Michael remains in a fixed posture for long periods
B) Michael shows excessive restlessness, pacing around the room, and fidgeting
C) Michael experiences persistent sadness and loss of interest in hobbies
D) Michael has trouble understanding abstract concepts

Answer 9

B) Michael shows excessive restlessness, pacing around the room, and fidgeting

Question 10

Distortions of reality where individuals believe they are seeing or hearing things that are not actually present.

Answer 10

Hallucinations

(reported by app 75% of patients with schizophrenia)

Question 11

What is considered the most distressing psychotic symptom, such as hearing voices (reported by 65-70% of patients)?

A) Delusions
B) Auditory Hallucinations
C) Disorganized thinking
D) Negative symptoms

Answer 11

B) Auditory Hallucination

Question 12

The severe reduction or complete absence of emotional responses to the environment, which is a negative symptom of schizophrenia, is known as:

A) Avolition
B) Alogia
C) Anhedonia
D) Affective flattening

Answer 12

D) Affective flattening

Question 13

Which scenario best illustrates affective flattening in schizophrenia?

A) Emily has intense mood swings and frequently changes her emotional responses
B) Emily maintains a blank facial expression, speaks in a monotone voice, and shows no emotional reaction to significant news
C) Emily is highly reactive to emotionally charged events and shows vivid emotional expressions
D) Emily experiences auditory hallucinations that affect her emotional state

Answer 13

B) Emily maintains a blank facial expression, speaks in a monotone voice, and shows no emotional reaction to significant news

Question 14

The deficiency in the quantity of speech, which is a negative symptom of schizophrenia, is known as:

A) Affective flattening
B) Avolition
C) Alogia
D) Anhedonia

Answer 14

C) Alogia

Question 15

Which scenario best illustrates alogia in schizophrenia?

A) John provides very brief responses to questions, such as “Fine,” without elaboration
B) John frequently engages in elaborate and detailed conversations
C) John shows intense emotional reactions during conversations
D) John demonstrates excessive and repetitive speech patterns

Answer 15

A) John provides very brief responses to questions, such as “Fine,” without elaboration

“poverty of speach”

Question 16

The psychotic symptom that entails perceptual experiences that are not real and can occur in any sensory modality (e.g., hearing voices or seeing things that are not present) is known as:

A) Delusion
B) Hallucination
C) Thought disorder
D) Affective flattening

Answer 16

B) Hallucination

Question 17

Which aspect of psychotic disorders, often leading to increased need for treatment, including early intervention and prevention, involves difficulties with interaction and engagement in activities?

A) Cognitive decline
B) Social isolation and participation
C) Emotional instability
D) Motor disturbances

Answer 17

B) Social isolation and participation

Question 18

Voices heard in psychotic disorders are typically critical and ______, but comforting voices are also reported.

A) Pleasant
B) Neutral
C) Hostile/Threatening
D) Encouraging

Answer 18

C) Hostile/Threatening

Question 19

In addition to aural hallucinations, hallucinations can occur in other modalities such as:

A) Visual, olfactory, gustatory, tactile, somatic
B) Emotional, auditory, cognitive, behavioral, social
C) Cognitive, motor, affective, sensory, interpretive
D) Visual, auditory, affective, cognitive, social

Answer 19

A) Visual, olfactory, gustatory, tactile, somatic

Question 20

Which scenario best illustrates a visual hallucination?

A) Sarah hears a voice speaking to her but sees no one present
B) Sarah feels a sensation of a hand on her shoulder that isn’t actually there
C) Sarah smells a rotting odor that others do not detect
D) Sarah sees a figure of a person in her room who is not actually there

Answer 20

D) Sarah sees a figure of a person in her room who is not actually there

Question 21

Which scenario best illustrates an olfactory hallucination?

A) Sarah hears a voice speaking to her but sees no one present
B) Sarah feels a sensation of a hand on her shoulder that isn’t actually there
C) Sarah smells a rotting odor that others do not detect
D) Sarah sees a figure of a person in her room who is not actually there

Answer 21

C) Sarah smells a rotting odor that others do not detect

Question 22

Which scenario best illustrates a gustatory hallucination?

A) Mark hears voices that no one else can hear
B) Mark sees objects that are not actually present
C) Mark constantly tastes a metallic flavor in his mouth despite having no cause for it
D) Mark feels as though a hand is touching his shoulder when no one is there

Answer 22

C) Mark constantly tastes a metallic flavor in his mouth despite having no cause for it

Question 23

Which scenario best illustrates a tactile hallucination?

A) Lisa sees objects that are not actually there
B) Lisa hears voices speaking to her but no one else can hear them
C) Lisa feels as though bugs are crawling on her skin, although there are none
D) Lisa smells a rotting odor that others do not detect

Answer 23

C) Lisa feels as though bugs are crawling on her skin, although there are none

Question 24

Which scenario best illustrates a somatic hallucination?

A) Tom hears a voice talking to him but sees no one
B) Tom tastes a metallic flavor in his mouth with no apparent cause
C) Tom feels as though his internal organs are being manipulated or something is moving inside his body
D) Tom sees objects that others cannot see

Answer 24

C) Tom feels as though his internal organs are being manipulated or something is moving inside his body

Question 25

Which type of hallucinations involves specific instructions to the patient, such as directing them to harm themselves or others?

A) Visual
B) Auditory
C) Command
D) Somatic

Answer 25

C) Command

(reported by 33 and 74 per cent of voice hearers)

Question 26

Which scenario best illustrates command hallucinations?

A) Jane sees a figure in her room that is not actually there
B) Jane hears a voice instructing her to harm herself, which causes her significant distress
C) Jane tastes a metallic flavor in her mouth with no apparent cause
D) Jane feels as though bugs are crawling on her skin, although there are none

Answer 26

B) Jane hears a voice instructing her to harm herself, which causes her significant distress

Question 27

Which class of substances includes LSD and MDMA (ecstasy), known for producing perceptual illusions and distortions?

A) Stimulants
B) Depressants
C) Hallucinogens
D) Opioids

Answer 27

C) Hallucinogens

Question 28

How beliefs and coping strategies regarding hallucinations (e.g. good vs. bad voices) can affect distress levels?

A) It has no impact on distress
B) It determines the frequency of the voices
C) It influences the level of distress, with bad voices causing more distress
D) It affects the duration of the hallucinations

Answer 28

C) It influences the level of distress, with bad voices causing more distress

Question 29

Which statement is accurate about hallucinations?

A) They are always a reliable symptom of psychotic disorders
B) They can be experienced by the general population without requiring treatment
C) They only occur in psychotic disorders
D) They always indicate a need for hospitalization

Answer 29

B) They can be experienced by the general population without requiring treatment (e.g. due to sleep deprivation, severe fatigue, substance use)

(Hallucinations are not reliable symptom of psychotic disorders)

Question 30

Which psychotic symptom involves a strongly held belief that is inconsistent with widely accepted beliefs and persists despite evidence to the contrary?

A) Hallucination
B) Delusion
C) Thought disorder
D) Affective flattening

Answer 30

B) Delusion

(The belief is not one ordinarily accepted
by other members of the person’s culture or subculture e.g. religion)

Question 31

Which type of delusion involves a false belief that someone is seeking to harm the individual or their interests?

A) Grandiose delusion
B) Somatic delusion
C) Paranoid delusion
D) Religious delusion

Answer 31

C) Paranoid delusion

(e.g. believing that the Australian Security Intelligence Organisation [ASIO] is tracking the individual’s emails and phone calls)

Question 32

Which scenario best illustrates a paranoid delusion?

A) John believes he has special abilities to influence world events
B) John thinks his coworkers are plotting against him and trying to harm his career, despite no evidence
C) John is convinced that he has a serious medical condition with no physical symptoms
D) John believes that he is being watched by aliens who are communicating with him

Answer 32

B) John thinks his coworkers are plotting against him and trying to harm his career, despite no evidence

Question 33

Which type of delusion involves the belief that environmental stimuli have a special, personal significance?

A) Grandiose delusion
B) Paranoid delusion
C) Delusion of reference
D) Somatic delusion

Answer 33

C) Delusion of reference

(e.g. messages of a highly personal nature are being conveyed via neutral sources, commonly via electronic media (e.g., that advertisements on Facebook contain coded warnings to the individual)

Question 34

Which scenario best illustrates a delusion of reference?

A) Maria believes that the news anchors are sending her personal messages through their broadcast
B) Maria thinks she has special powers to influence world events
C) Maria is convinced that someone is secretly plotting against her
D) Maria believes she has a serious medical condition with no symptoms

Answer 34

A) Maria believes that the news anchors are sending her personal messages through their broadcast

Question 35

Which type of delusion involves a false belief about the appearance or functioning of one’s body?

A) Grandiose delusion
B) Paranoid delusion
C) Delusion of reference
D) Somatic delusion

Answer 35

D) Somatic delusion

(e.g. belief of having cancer and seeking extensive medical help).

Question 36

Which scenario best illustrates a somatic delusion?

A) Tom believes that he has a special connection with the stars
B) Tom thinks that his internal organs are rotting, despite no medical evidence
C) Tom is convinced that everyone is plotting against him
D) Tom believes that he can control the weather with his mind

Answer 36

B) Tom thinks that his internal organs are rotting, despite no medical evidence

Question 37

Which type of delusion involves a false belief about oneself, such as inflated worth, power, or relationships with famous people?

A) Paranoid delusion
B) Somatic delusion
C) Delusion of reference
D) Grandiose delusion

Answer 37

D) Grandiose delusion

(associated also with bipolar disorder)

(reported by 20–60% of patients)

Question 38

Which scenario best illustrates a grandiose delusion?

A) Sarah believes she is a famous celebrity with the power to influence world events
B) Sarah thinks her coworkers are plotting against her
C) Sarah is convinced that her internal organs are malfunctioning
D) Sarah believes that the news anchors are sending her personal messages

Answer 38

A) Sarah believes she is a famous celebrity with the power to influence world events

Question 39

Which scale measures the degree of preoccupation, distress, conviction, and life disruption caused by delusional beliefs?

A) Hamilton Rating Scale
B) Beck Depression Inventory
C) Psychotic Symptom Rating Scale (PSYRATS)
D) Positive and Negative Syndrome Scale (PANSS)

Answer 39

D) Positive and Negative Syndrome Scale (PANSS)

Question 40

The PSYRATS is used to measure which aspects of delusional beliefs?

A) Only the degree of preoccupation and distress
B) Only the level of conviction
C) Only the disruption to the person’s life
D) All of the above

Answer 40

D) All of the above

Question 41

In clinical practice, the severity of formal thought disorder is assessed through the person’s:

A) Emotions
B) Speech
C) Behavior
D) Memory

Answer 41

B) Speech

Question 42

When assessing formal thought disorder, a clinician listens for disturbances in the coherence of:

A) Emotions
B) Behavior
C) Speech
D) Memory

Answer 42

C) Speech

Question 43

Which term describes a marked decrease in reactivity to the environment, including unusual postures or repetitive movements?

A) Disorganized behavior
B) Catatonic behavior
C) Hyperactive behavior
D) Affective behavior

Answer 43

B) Catatonic behavior

Question 44

Which scenario best illustrates catatonic behavior?

A) Jane repeatedly performs the same hand movements and remains motionless for hours
B) Jane speaks rapidly and changes topics frequently
C) Jane is overly energetic and cannot sit still
D) Jane exhibits extreme mood swings without any noticeable pattern

Answer 44

A) Jane repeatedly performs the same hand movements and remains motionless for hours

Question 45

Disturbances in thought form are categorized into:

A) Cognitive and Affective
B) Positive and Negative
C) Internal and External
D) Verbal and Non-verbal

Answer 45

B) Positive and Negative

(the addition of disturbed thought processes and
deficits in thoughts processes)

Question 46

Which of the following are examples of positive disturbances in thought form?

a) Delusions

b) Loose Associations

c) Flight of Ideas

d) Tangentiality/Derailment

e) All of the above

Answer 46

e) All of the above

Question 47

What does “Loose Associations” refer to in the context of thought disturbances?

a) Disorganized thinking with loosely connected ideas

b) Fixed, false beliefs resistant to reasoning

c) Rapidly shifting from one topic to another with loosely connected ideas

d) Off-topic responses in speech

Answer 47

a) Disorganized thinking with loosely connected ideas

Question 48

What does “Flight of Ideas” refer to in the context of thought disturbances?

a) Rapidly shifting topics with loose connections

b) Disorganized thinking with loosely connected ideas

c) Off-topic responses in speech

d) Fixed, false beliefs resistant to reasoning

Answer 48

a) Rapidly shifting topics with loose connections

Question 49

What does “Tangentiality” refer to in the context of thought disturbances?

a) A pattern of speech where responses deviate significantly from the original question, often discussing unrelated topics

b) Rapidly shifting topics with only loose connections between ideas

c) Disorganized thinking where ideas are only loosely connected, leading to incoherent speech

d) Believing in fixed, false ideas that are resistant to contrary evidence

Answer 49

a) A pattern of speech where responses deviate significantly from the original question, often discussing unrelated topics

(deviates from the topic but still staying close to the topic, unlike derailment which is rapid shift between unrelated topics)

Question 50

Which of the following best illustrates Tangentiality?

a) When asked about his daily routine, John talks about his favorite movies and travel experiences.

b) John describes his daily activities in detail when asked about his routine.

c) John provides a brief, direct answer about his daily routine.

d) John discusses a related topic but stays somewhat on track with his daily routine.

Answer 50

a) When asked about his daily routine, John talks about his favorite movies and travel experiences.

Question 51

Which of the following best describes derailment in the context of schizophrenia?

a) A pattern of speech where responses are relevant but deviate significantly from the main topic.

b) A speech pattern characterized by rapid shifts between unrelated topics with minimal logical connection.

c) The use of newly invented words that are not understood by others.

d) A significant reduction in the quantity of speech or content.

Answer 51

b) A speech pattern characterized by RAPID shifts between unrelated topics with minimal logical connection.

Question 52

Therapist: John what are your plans for the upcoming weekend?

John: “So, I was thinking of going to the park this weekend. I love spending time outdoors. Did you see the latest episode of that show with the talking animals? Oh, and did you know that the moon landing happened in 1969? It’s fascinating how they managed to… Oh, I need to buy some new shoes.”
This is an example of:

a) Alogia
b) Derailment
c) Tangentiality
d) Poverty of Though

Answer 52

b) Derailment

Question 53

Which of the following are negative thought form disturbances?

a) Alogia

b) Poverty of Thought Content

c) Concrete Thinking

d) All of the above

Answer 53

d) All of the above

Alogia: Reduced speech or thought productivity.

Poverty of Thought Content: Limited or vague content in thoughts.

Concrete Thinking: Difficulty with abstract thinking and overly literal interpretation.

Question 54

Which scenario best illustrates a positive disturbance in thought form?

A) Paul frequently shifts topics in conversation without logical connections
B) Paul struggles to initiate conversations and often has trouble following a train of thought
C) Paul’s speech is slow and sparse, with limited verbal output
D) Paul has trouble understanding the meanings of words and phrases

Answer 54

A) Paul frequently shifts topics in conversation without logical connections

Question 55

Which of the following best describes clang associations?

a) Speech where topics are loosely connected but still relevant to the conversation

b) Speech where the connections between words are based on their sounds rather than their meaning

c) A pattern of speech with rapid topic shifts and minimal logical connection

d) Speech characterized by off-topic responses that are somewhat related to the original question

Answer 55

b) Speech where the connections between words are based on their sounds rather than their meaning

Question 56

Allan responds to a question by saying, “More, door, core, and floor, I’m not sure but I adore a good score.”

Which of the following describes the example provided?

a) Loose Associations – Ideas are loosely connected but related to the topic.

b) Clang Associations – Words are connected based on their sound rather than their meaning.

c) Flight of Ideas – Rapidly shifting from one topic to another with minimal connection.

d) Tangentiality – Responses are off-topic but still somewhat relevant to the question.

Answer 56

b) Clang Associations – Words are connected based on their sound rather than their meaning.

Question 57

What is passivity phenomena?

a) The experience of seeing or hearing things that are not present

b) The belief that one’s thoughts are being controlled or influenced by external sources

c) Speaking in a disorganized and fragmented manner

d) Having strong beliefs that are resistant to reason but not related to external control

Answer 57

b) The belief that one’s thoughts are being controlled or influenced by external sources

Question 58

Which of the following best describes thought insertion and thought withdrawal?

a) The sensation of seeing or hearing things that are not present

b) The belief that thoughts are being placed into or taken out of one’s mind by external forces

c) The experience of having disorganized and fragmented speech

d) The belief in having unusual but self-originated ideas

Answer 58

b) The belief that thoughts are being placed into or taken out of one’s mind by external forces

Question 59

According to the DSM-5, catatonia can be diagnosed as:

A) A feature of a mental disorder or as a catatonic disorder due to another medical condition
B) Only a feature of schizophrenia
C) Only due to a medical condition without a mental disorder
D) A temporary reaction to stress without a specific diagnosis

Answer 59

A) A feature of a mental disorder or as a catatonic disorder due to another medical condition

(either a feature of a mental disorder including brief psychotic disorder, schizophreniform disorder, schizophrenia or schizoaffective disorder or as a catatonic disorder in its own right due to another medical condition)

Question 60

How many symptoms from the list are required for a diagnosis of catatonia?

A) 2
B) 3
C) 5
D) 7

Answer 60

B) 3

Question 61

12 symptoms of catatonia:
1. stupor (no psychomotor activity; not actively relating to the environment)
2. catalepsy (maintaining a rigid body posture or rigidity of the limbs even when this would normally require some effort to do so)
3. waxy flexibility (a tendency to remain in a posture even when limbs are moved into place by another person)
4. mutism (little or no verbal response)
5. negativism (opposition or no response to instructions or external stimuli)
6. posturing (spontaneous and active maintenance of posture)
7. mannerism (odd, circumstantial caricature of normal actions)
8. stereotypy (repetitive, abnormally frequent, non-goal-directed movements such as repeatedly taking a step back and forth on the spot)
9. agitation (not influenced by external stimuli)
10. grimacing (odd facial movements such as baring of the teeth in the absence of provocation)
11. echolalia (mimicking another’s speech)
12. echopraxia (mimicking another’s movements).

Question 62

How responsive is catatonia to treatment for schizophrenia, and what does this suggest?

A) Highly responsive, indicating it’s not separate from other psychotic symptoms
B) Less responsive, suggesting a potentially separate neurobiological basis
C) Fully resolved by antipsychotic treatment alone
D) Only responsive to psychotherapy

Answer 62

B) Less responsive, suggesting a potentially separate neurobiological basis

Question 63

The decrease in prevalence of catatonic symptoms in schizophrenia over the past 50 years is likely due to:

A) Increased awareness and recognition of catatonia
B) Changes in diagnostic criteria
C) Certain medications and poor recognition in clinical practice
D) A decrease in overall schizophrenia cases

Answer 63

C) Certain medications and poor recognition in clinical practice

Question 64

What term is used to describe symptoms that are necessary for a diagnosis?

A) Secondary features
B) Core features
C) Associated features
D) Peripheral features

Answer 64

B) Core features

Question 65

Question 66

Which disorder is characterized by symptoms lasting at least SIX MONTHS, including at least ONE MONTH of delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and/or negative symptoms?

A) Schizophreniform disorder
B) Brief psychotic disorder
C) Schizoaffective disorder
D) Schizophrenia

Answer 66

D) Schizophrenia

Question 67

Which of the following scenarios best illustrates Schizophrenia?

a) Sarah has experienced delusions, hallucinations, and disorganized speech for over six months, with significant functional impairment, and no mood episodes.

b) Lisa has had symptoms of paranoia and hallucinations for four months, with no significant impairment in her daily life.

c) Tom shows symptoms of mood disturbances along with psychotic symptoms for six months, with no disorganized speech.

d) Emily experiences occasional delusions and hallucinations for two months, with good overall functioning.

Answer 67

a) Sarah has experienced delusions, hallucinations, and disorganized speech for over six months, with significant functional impairment, and NO MOOD EPISODES.

Explanation:

Schizophrenia is characterized by the presence of multiple symptoms including delusions, hallucinations, and disorganized speech that persist for more than six months and significantly impair daily functioning.

Question 68

Which disorder is characterized by pervasive social and interpersonal deficits, cognitive or perceptual distortions, and eccentricities of behavior beginning before early adulthood?

A) Schizoid personality disorder
B) Paranoid personality disorder
C) Schizotypal personality disorder
D) Avoidant personality disorder

Answer 68

C) Schizotypal (personality) disorder

Question 69

Which of the following is an example of a behavior someone with schizotypal personality disorder might exhibit?

a) Unusual beliefs such as magical thinking or telepathy

b) Severe discomfort in close relationships

c) Perceptual distortions such as sensing the presence of others when alone

d) Odd appearance or behavior

e) All of the above

Answer 69

e) All of the above

Question 70

Which disorder is equivalent to schizophrenia but with a duration of ONE TO SIX MONTHS?
A) Schizoaffective disorder
B) Brief psychotic disorder
C) Schizophreniform disorder
D) Delusional disorder

Answer 70

C) Schizophreniform disorder

Question 71

Which of the following scenarios best illustrates Schizophreniform Disorder?

a) John has experienced delusions, hallucinations, and disorganized speech for five months without significant mood disturbances.

b) Lisa has had persistent delusions and hallucinations for eight months, along with significant mood swings.

c) Tom exhibits symptoms of paranoia and disorganized speech for three weeks, with no other significant symptoms.

d) Emily experiences mood episodes and psychotic symptoms for seven months, including hallucinations and delusions.

Answer 71

a) John has experienced delusions, hallucinations, and disorganized speech for five months without significant mood disturbances.

Explanation:

Schizophreniform Disorder is characterized by the presence of psychotic symptoms (delusions, hallucinations, disorganized speech) for at least ONE MONTH BUT LESSS THAN SIX MONTHS, WITHOUT significant MOOD DISTURBANCES.

Question 72

Which disorder involves the co-occurrence of SCHIZOPHRNIA SYMPTOMS and a MAJOR MOOD EPISODE, with at least a TWO WEEK PERIOD OF DELUSIONS OR HALUCINATIONS WITHOUT MOOD DISTURBANCE, and MOOD SYMPTOMS PRESENT FOR THE MAJORITY OF THE DISORDER’S DURATION?

A) Schizophreniform disorder
B) Brief psychotic disorder
C) Schizoaffective disorder
D) Major depressive disorder with psychotic features

Answer 72

C) Schizoaffective disorder

Question 73

Which of the following scenarios best illustrates Schizoaffective Disorder?

a) Tom experiences frequent depressive episodes with feelings of sadness and worthlessness, and during these times, he also hears voices. His psychotic symptoms only occur during depressive episodes.

b) Sara has persistent psychotic symptoms, including delusions and hallucinations, but no mood episodes. Her psychotic symptoms have been present for several years.

c) Emily experiences alternating periods of depression and mania, and during these periods, she also has hallucinations and delusions. Her psychotic symptoms are also present for two weeks outside of her mood episodes.

d) Michael has episodes of elevated mood with increased energy, during which he experiences hallucinations. However, he does not have depressive episodes and his psychotic symptoms are always present during manic periods.

Answer 73

c) Emily experiences alternating periods of depression and mania, and during these periods, she also has hallucinations and delusions. Her psychotic symptoms are also present for two weeks outside of her mood episodes.

Explanation:

Schizoaffective Disorder involves MOOD EPISODES (depressive or manic) occurring SIMULTANOUSLY WITG PSYCHOTIC SYMPTOMS. Additionally, PSYCHOTIC SYMPTOMS should be present for at least TWO WEEKS OUTSIDE OF MOOD DISORDER> This scenario fits the criteria for Schizoaffective Disorder.

Question 74

A 30-year-old individual presents with persistent auditory hallucinations and paranoid delusions. For at least a two-week period, they experienced these psychotic symptoms without significant mood disturbance. However, over the past year, they have also had several episodes of major depression, characterized by pervasive sadness and loss of interest in activities. Mood symptoms have been prominent and have impacted their daily functioning. What is the most likely diagnosis for this individual?

A) Schizophreniform disorder
B) Brief psychotic disorder
C) Schizoaffective disorder
D) Major depressive disorder with psychotic features

Answer 74

C) Schizoaffective disorder

Question 75

The DELUSIONS have been present for AT LEAST ONE MONTH or longer is consistent with ________ disorder.

Answer 75

delusional

Question 76

A 40-year-old individual has been experiencing persistent delusions for at least one month. The delusions involve a belief that they are being spied on by a secret organization, despite no evidence to support this belief. The individual does not exhibit other significant psychotic symptoms such as hallucinations or disorganized speech. What is the most likely diagnosis for this individual?

A) Schizophrenia
B) Schizophreniform disorder
C) Delusional disorder
D) Brief psychotic disorder

Answer 76

C) Delusional disorder

Question 77

Which of the following best describes a scenario consistent with schizophreniform disorder?

A) A person with hallucinations and delusions for six months or more
B) A person with disorganized speech and behavior for less than one month
C) A person experiencing delusions and hallucinations for four months, impacting daily functioning
D) A person with mood swings and psychotic symptoms lasting more than one year

Answer 77

C) A person experiencing delusions and hallucinations for four months, impacting daily functioning

Question 78

Which describes Brief Psychotic Disorder?

A) Lasts over a month but under six months, with return to baseline functioning.
B) Lasts less than a month with return to premorbid functioning.
C) Lasts over six months with delusions, hallucinations, and disorganized speech.
D) Includes mood symptoms and significant functional impairment.

Answer 78

B) Lasts less than a month with return to premorbid functioning.

Question 79

Which scenario best illustrates Brief Psychotic Disorder?

A) Alex has delusions and hallucinations for three months but does not return to baseline functioning.
B) Mia experiences hallucinations for five days following a stressful event, with full recovery to her previous level of functioning.
C) Jordan has ongoing psychotic symptoms with mood disturbances for over six months.
D) Taylor has persistent delusions and disorganized speech for two months with significant functional impairment.

Answer 79

B) Mia experiences hallucinations for five days following a stressful event, with full recovery to her previous level of functioning.

Question 80

Which of the following best describes a Psychotic Disorder Due to Another Medical Condition?

A) Psychotic symptoms that are a direct result of substance use or withdrawal.
B) Persistent hallucinations or delusions without any underlying medical condition.
C) Prominent hallucinations or delusions directly caused by another medical condition.
D) Psychotic symptoms occurring in response to severe stress or trauma.

Answer 80

C) Prominent hallucinations or delusions directly caused by another medical condition.

Question 81

Which scenario best illustrates a Psychotic Disorder Due to Another Medical Condition?

A) Sarah experiences delusions due to long-term substance abuse.
B) Kevin has hallucinations following a traumatic life event but no medical issues.
C) Maria develops severe psychotic symptoms as a result of brain tumor, which improve after tumor was removed
D) Tom experiences persistent delusions without any identifiable physical or medical cause.

Answer 81

C) Maria develops severe psychotic symptoms as a result of brain tumor, which improve after tumor was removed

Question 82

Which scenario best illustrates a Substance/Medication-Induced Psychotic Disorder?

A) Lisa has persistent hallucinations that started during a period of severe stress, with no substance use involved.
B) Mark develops psychotic symptoms due to a severe brain injury.
C) Emily has delusions related to a major depressive episode.
D) Daniel has hallucinations as a result of a high dose of cocaine, which resolve after the drug is metabolized.

Answer 82

D) Daniel has hallucinations as a result of a high dose of cocaine, which resolve after the drug is metabolized.

(Delusions and/or hallucinations that develop during or soon after substance intoxication or withdrawal or after exposure to medication)

Question 83

Symptoms of psychosis that cause clinically significant distress or impaired functioning but do not meet full criteria for any other psychotic disorders are classified as __________.

A) Brief Psychotic Disorder
B) Delusional Disorder
C) Psychotic Disorder Not Otherwise Specified (NOS)
D) Schizophreniform Disorder

Answer 83

C) Psychotic Disorder Not Otherwise Specified (NOS)

(e.g., persistent auditory hallucinations in the absence of other psychotic features).

Question 84

Which scenario best fits Psychotic Disorder Not Otherwise Specified (NOS), (clinician MUST SPECIFY why criteria for another disorder is not met)?

A) Jane has paranoia and hallucinations causing distress but does not meet full criteria for schizophrenia.

B) John has hallucinations due to alcohol withdrawal.

C) Lisa’s delusions are part of a depressive episode.

D) Mark has brief hallucinations after a traumatic event.

Answer 84

A) Jane has paranoia and hallucinations causing distress but does not meet full criteria for schizophrenia.

Question 85

Symptoms of psychosis that cause clinically significant distress or impaired functioning but which do not meet full criteria for any other psychotic disorders (the clinician is NOT REQIRED TO SPECIFY the reasons why the criteria for this diagnosis are met)

Answer 85

Unspecified schizophrenia spectrum and other
psychotic disorder

Question 86

According to the DSM-5, schizophrenia is diagnosed when there are TWO OR MORE of the following SYMPTOMS present for a significant proportion of time during a SIX month period:

• Delusions
• Hallucinations
• Disorganized speech
• Grossly disorganized or catatonic behavior
• Negative symptoms

Answer 86

(continuous signs of schizophrenia must have been consistently present for at least six months. This six-month period may have entailed a gradual deterioration in functioning, but must include at least one month of the psychotic symptoms)

Question 87

Which of the following symptoms must be present for the diagnosis of schizophrenia, according to DSM-5?

A) Delusions
B) Hallucinations
C) Disorganized speech
D) At least one of the above

Answer 87

D) At least one of the above

Question 88

DSM-IV-TR specified that only one symptom needed to be present if it took a specific form (e.g., auditory hallucinations that kept up a running commentary on the person’s behaviour or thoughts or if there were two or more voices conversing with each other).
The DSM-IV-TR also stipulated some subtypes of schizophrenia that have been dropped from the DSM-5.

Answer 88

Changes from DSM-IV compared to DSM-5

Question 89

What is one reason why suicide rates are very high among people diagnosed with a psychotic disorder, such as schizophrenia?

A) Presence of psychotic symptoms
B) Depression
C) High levels of medication adherence
D) Low levels of stress

Answer 89

B) Depression

(5–10 per cent of people diagnosed with schizophrenia commit suicide)

Question 90

The risk of suicide have _____ (increased/decreased)
significantly for individuals diagnosed with schizophrenia over the previous 100 years.

Answer 90

Increased

Question 91

What are the possible reasons for the increased risk of suicide in individuals with psychotic disorders?

A) Brief hospitalisation
B) Unwanted side effects of antipsychotic medications
C) Effects of withdrawal from antipsychotic medications
D) All of the above

Answer 91

D) All of the above

Question 92

What is true about the relationship between schizophrenia and social phobia and PTSD?

A) Social phobia and PTSD are uncommon in individuals with schizophrenia.
B) The risk of developing PTSD as a consequence of psychotic symptoms or treatment is lower in people with a history of childhood trauma.
C) Social phobia and PTSD are common in individuals with schizophrenia.
D) PTSD is unrelated to schizophrenia.

Answer 92

C) Social phobia and PTSD are common in individuals with schizophrenia.

(the risk of developing PTSD as a consequence of psychotic symptoms or treatment is higher in people who have PTSD from the experience of childhood trauma)

Question 93

What percentage of patients with psychosis report substance abuse (cannabis), which is a predictor of increased risk of relapse if use persists?

A) 10%
B) 15%
C) 23%
D) 30%

Answer 93

C) 23%

(research shows that cannabis may induce psychosis)

Question 94

Emil Kraepelin, a professor of psychiatry in Munich, Germany, in the late 1800s, identified the disorder ‘dementia praecox’ or ‘senility of the young’, which is the early term for:

A) Major Depressive Disorder
B) Bipolar Disorder
C) Schizophrenia
D) Post-Traumatic Stress Disorder

Answer 94

C) Schizophrenia

Question 95

The term ‘schizophrenia,’ introduced by Eugen Bleuler, is derived from the Greek words ‘schizein,’ meaning ‘to split,’ and ‘phren,’ meaning:

A) Body
B) Emotion
C) Mind
D) Spirit

Answer 95

C) Mind

(Split mind)

Question 96

In contrast to Kraepelin, Bleuler conceptualised manic depression and schizophrenia as occurring on a continuum rather than arguing for a categorical distinction between these two diagnoses. The legacy of both of these pioneers of empirical research in psychosis can be
seen in the modern diagnostic criteria for schizophrenia in the DSM-5, which include thought disorder (disorganised speech) and a deterioration in functioning.

Answer 96

Kurt Schneider, another German professor of psychiatry, argued that symptoms specific to schizophrenia—the so-called ‘first rank symptoms’—could be
identified, and these symptoms maintained a privileged place up until the DSM-IV-TR. They included
hearing voices arguing, hearing voices commenting on the individual’s actions and bizarre delusions including passivity phenomena.

Question 97

The lifetime prevalence of schizophrenia is approximately -% and is more prevalent in _____ (men/women).

A) 0.5-1%, women
B) 1-2%, men
C) 2-3%, women
D) 1-2%, men

Answer 97

B) 1-2%, men

Question 98

The peak period of onset for psychotic disorders is during:

a) Early childhood and middle age
b) Late adolescence and early adulthood
c) Late adulthood and middle age
d) Early adulthood and late childhood

Answer 98

b) Late adolescence and early adulthood

Question 99

Which of the following phases involves the period before any signs of the disorder become apparent or where subtle early signs or vulnerabilities may be present?

a) Premorbid phase
b) Prodromal phase
c) Recovery phase
d) Acute phase

Answer 99

a) Premorbid phase

Question 100

Which phase of psychotic disorders is characterized by more noticeable symptoms and deterioration in functioning?

a) Premorbid phase
b) Prodromal (acute) phase
c) Recovery phase
d) Residual phase

Answer 100

b) Prodromal (acute) phase

(duration varies between individuals and can go from absent to many years)

Question 101

The risk of further episodes of psychosis remains high during the first ____ years after treatment is commenced, with relapse rates approximately ____%.

a) 1 to 3 years; 60-70%
b) 2 to 5 years; 80-90%
c) 3 to 7 years; 70-80%
d) 5 to 10 years; 50-60%

Answer 101

b) 2 to 5 years; 80-90%

Question 102

During prodromal phase the symptoms are typical of psychotic disorders?

True/False

Answer 102

False

Symptoms are not specific for psychotic disorders but other mental conditions too (depressed mood, anxiety)

Question 103

‘Prodromal schizophrenia’ has been excluded from current DSM-5 due to unspecificity of symptoms and uncertainty they precede acute phase.

True/False

Answer 103

True

Question 104

Challenges including re-integrating into social, recreational and vocational pursuits and high unemployment rates are typical of _______ (early/late) recovery phase.

Answer 104

late

Question 105

Early detection approach or ‘at-risk mental state’, has been pioneered at the EPPIC in Melbourne under the leadership of Patrick McGorry.
True/False

Answer 105

True

(e.g. regular screening for prodromal symptoms in adolescents)

Question 106

What does the term Duration of Untreated Psychosis (DUP) refer to?

a) The length of time from the onset of symptoms to the start of treatment
b) The delay related to the time taken to respond to treatment once it commences
c) The duration of psychotic symptoms before diagnosis
d) The period between diagnosis and the initiation of therapy

Answer 106

b) The delay related to the time taken to respond to treatment once it commences

(the longer the DUP, the longer the patient’s symptoms take to improve with treatment)

Question 107

Acute psychotic episodes/phase are characterised by:

a) The emergence of persistent positive and negative symptoms that clearly identify the condition as a psychotic disorder
b) A gradual onset of symptoms with minimal impact on functioning
c) Stable mood with occasional minor disturbances
d) The presence of only positive symptoms without negative symptoms

Answer 107

a) The emergence of persistent positive and negative symptoms that clearly identify the condition as a psychotic disorder

Question 108

As the person begins to reflect on their diagnosis and its significance for their future, problems with depression and social anxiety may emerge for the first time during which phase?

a) Premorbid phase
b) Prodromal (acute) phase
c) Early recovery phase
d) Late recovery phase

Answer 108

c) Early recovery phase

Question 109

Question 110

The cognitive model of psychosis proposed by Morrison focuses on how cognitive processes contribute to the development and maintenance of psychotic symptoms. According to this model, psychotic symptoms, such as delusions and hallucinations, are understood as being influenced by:

a) Neurobiological abnormalities
b) Environmental stressors
c) Cognitive distortions and biases
d) Genetic predispositions

Answer 110

c) Cognitive distortions and biases

(e.g. if the person receives a mail delivery and notices that the envelope has a government return address, they might interpret this as evidence of a conspiracy against them, despite no actual evidence to support this belief. This cognitive distortion leads to the development and maintenance of the delusion, illustrating how cognitive biases can contribute to psychotic symptoms)

Question 111

Which of the following is associated with the recurrence of psychosis?

A) Discontinuation of antipsychotic medication
B) Use of cannabis and amphetamines
C) Poorer premorbid adjustment
D) Conflictual interpersonal relationships (Expressed Emotion)
E) All of the above

Answer 111

E) All of the above

Question 112

EE (emotional expression) is now a well-established predictor of psychotic relapse. True/False

Answer 112

True
(2-3 times higher relapse rate in high EE families)

Question 113

Which of the following is typically measured using standardized methods of observing and rating patterns of family interactions, including high levels of criticism, hostility, and emotional over-involvement?

A) Cognitive Behavioral Therapy
B) Expressed Emotion
C) Medication Adherence
D) Social Support

Answer 113

B) Expressed Emotion

Question 114

Reduced ______ to _______ (less than 35 hours per week) contact with family and being on mediation is found to reduce relapse rates.

Answer 114

face to face
(reduced EE)

Question 115

Question 116

More severe and persisting forms of psychosis are known to be associated with:

A) an earlier and more gradual onset of symptoms,
B) substance abuse,
C) longstanding personality traits which might compromise the individual’s capacity to cope with stress
D) All of the above

Answer 116

D) All of the above

Question 117

The concordance rate
for schizophrenia between monozygotic
twins (share the same genes) and dizygotic twins (share 50 per cent of genes) is the same.

True/False

Answer 117

False

(higher for monozygotic twins)

Question 118

Which gene-environmental factors contribute to the development of psychosis?

A) Maternal infection during fetal development
B) Exposure to trauma in early childhood
C) Exposure to illicit substances in adolescence
D) Living in an urban environment/stress reactivity
E) All of the above

Answer 118

E) All of the above

Question 119

Which neurotransmitter has been the most widely investigated in schizophrenia research, although multiple neurotransmitters are likely involved?

A) Serotonin
B) Norepinephrine
C) Dopamine
D) Glutamate

Answer 119

C) dopamine

Question 120

What does the revised dopamine hypothesis suggest about schizophrenia?

A) Schizophrenia is linked to higher dopamine levels.
B) Schizophrenia is linked to excessive numbers of or oversensitive dopamine receptors.
C) Schizophrenia is caused by a deficiency in dopamine levels.
D) Schizophrenia is related to irregular dopamine production.

Answer 120

B) Schizophrenia is linked to excessive numbers of or oversensitive dopamine receptors

(rather than higher dopamine levels)

Question 121

Negative symptoms (e.g., a lack of speech, affect, and behavior) are associated with loss of grey and white matter and tissue in the __________ cortex.

A) Pre-frontal
B) Occipital
C) Temporal
D) Parietal

Answer 121

A) Pre-frontal

Question 122

Fluid-filled spaces in the brain that are larger than normal and suggest a deterioration in brain tissue are known as:

A) Ventricular enlargement
B) Cystic degeneration
C) Hydrocephalus
D) Subdural hematomas

Answer 122

A) Ventricular enlargement

Question 123

Individuals with no family history of psychotic disorders were found to have significantly smaller volumes of the left:

A) Amygdala
B) Prefrontal cortex
C) Hippocampus
D) Thalamus

Answer 123

C) Hippocampus

(structural changes
in the hippocampus appear to predate the onset of psychosis (at least among those without a family history of psychosis) and may worsen over the course of the illness)

Question 124

Biological abnormality relevant to psychosis is the:

A) Dopamine-serotonin system
B) Serotonin-norepinephrine pathway
C) Hypothalamic-pituitary-adrenal (HPA) axis
D) Endocannabinoid system

Answer 124

C) Hypothalamic-pituitary-adrenal (HPA) axis

(important biological system in the physiological response to stress)

Question 125

Which hypotheses explain changes in HPA axis function?

A) Environmental factors and genetic factors.

B) Only environmental factors.

C) Only genetic factors.

D) Neither environmental factors nor genetic factors.

Answer 125

A) Environmental factors and genetic factors.

(1) that environmental factors (such as exposure to cannabis or high levels of conflict in relationships) affect the HPA axis; or
(2) that the genes associated with the risk
for schizophrenia

Question 126

Urban environment, migration, being
socially excluded and experiences of childhood abuse are examples of ________ factors which increase vulnerability to psychotic disorders.

Answer 126

social

Question 127

Psychotic disorders are relatively rare and more prevalent in men than women.

True/False

Answer 127

True

Question 128

Which major endocrine gland produces the largest number of different hormones and controls other endocrine glands?

A) Thyroid gland

B) Adrenal gland

C) Pituitary gland

D) Pancreas

Answer 128

C) Pituitary gland

Question 129

Within the DSM-5,
psychosis is best conceptualised:

as a neurological disorder

along a continuum of severity

as a categorical disorder

as a disorder of adolescence

Answer 129

along a continuum of severity

(The DSM-5 recognizes that psychosis can vary in severity and can be part of a broader spectrum of mental health conditions. This perspective acknowledges that psychotic experiences can range from mild to severe and can occur across different disorders, rather than being categorized strictly as a single, discrete disorder. The continuum model helps in understanding the variability in symptoms and their impact on functioning)

Question 130

Significantly larger volumes of the __________ (indicating higher levels of stress hormones) were found in high-risk individuals who developed psychosis compared with high-risk patients who did not go on to develop psychosis.

A) Hippocampus

B) Pituitary

C) Prefrontal cortex

D) HPA axis

Answer 130

B) Pituitary

Question 131

Once a comprehensive assessment has been completed and psychosis is accurately diagnosed, acute phase treatments focus on:

A) Immediate reduction of symptoms and associated distress.

B) Long-term rehabilitation and support.

C) Preventing relapse and managing chronic symptoms.

D) Only psychological therapy.

Answer 131

A) Immediate reduction of symptoms and associated distress.

Question 132

Consumers of psychiatric services have developed their own empowering recovery model of psychosis, with a strong emphasis upon:

A) Recovery, the strengths of the individual, and the reduction of stigma.

B) Medication management and hospitalizations.

C) Strict adherence to clinical guidelines and protocols.

D) Avoidance of personal responsibility and self-management.

Answer 132

A) Recovery, the strengths of the individual, and the reduction of stigma.

Question 133

Approximately ______ of people diagnosed with schizophrenia report experiencing hallucinations.

50%
20%
75%
100%

Answer 133

75%

Question 134

The key difference in the nature of hallucinations experienced by the general population and those experienced by people with schizophrenia is:

the need for intervention

the age of onset

persistence over time

the type of hallucination

Answer 134

persistence over time
(In the general population, hallucinations, such as those experienced in sleep deprivation or extreme stress, are typically transient and do not persist long-term. In contrast, hallucinations in individuals with schizophrenia are more persistent, frequent, and disruptive, often becoming a chronic aspect of the disorder that significantly impacts their daily life and functioning).

Question 135

Erica burns all of her rubbish, will pay for groceries only in cash, and uses false names on facebook to ensure that the malevolent forces of the Third Wheel don’t locate her. Erica is likely suffering from:

nihilistic delusions
delusions of reference
paranoid delusions
delusions of grandeur

Answer 135

paranoid delusions
(Paranoid delusions involve beliefs that one is being persecuted or targeted by malevolent forces. Erica’s behaviors, such as burning her rubbish, paying only in cash, and using false names to avoid detection, suggest she believes that she is being watched or threatened by the “Third Wheel,” which aligns with paranoid delusions).

Question 136

_________ (primary/secondary) delusions are those that occur in the absesnce of a psychological or other identifiable trigger.

Answer 136

Primary
(They are typically spontaneous and not secondary to other psychological conditions or external events, meaning they arise without an obvious external cause and are a direct manifestation of the individual’s psychotic disorder)

Question 137

Emily believes she is being persecuted by a secret organization that is monitoring her every move. No external events or triggers have been identified. What type of delusion does this describe?

a) Secondary Delusion

b) Primary Delusion

c) Bizarre Delusion

d) Mood Congruent Delusion

Answer 137

b) Primary Delusion

Question 138

John believes he is being watched by a secret organization. As a result, he starts to think that everyone in his neighborhood is part of this organization. John’s belief that his neighbors are involved in the conspiracy is an example of:

a) Primary Delusion

b) Mood Congruent Delusion

c) Secondary Delusion

d) Bizarre Delusion

Answer 138

c) Secondary Delusion

Question 139

Which of the following is not a symptom of psychosis as defined by the DSM-5?

delusions

grossly disorganised thinking

hallucinations

grossly organised behaviour

Answer 139

grossly organised behaviour

(this term is not typically used to describe symptoms of psychosis. Instead, the DSM-5 uses terms like “grossly disorganized or catatonic behavior” to describe disorganized and impaired behavior associated with psychotic disorders)

Question 140

The primary difference between tangentiality and derailment of speech is:

the degree of relevance of speech content

how long it takes the speaker to reach his/her point

how many nonsense words are used in a sentence

how much the words used sound like each other

Answer 140

the degree of relevance of speech content
(tangentiality involves answers that are still somewhat related to the topic, derailment involves a significant loss of coherence and relevance in the speech)

Question 141

When upset or confused, Ali often hears the calming, supportive voice of his recently deceased partner. Ali would likely be diagnosed with:

nothing

psychosis

command hallucinations

auditory hallucinations

Answer 141

nothing
(Reason: This would be considered culturally appropriate, and so no diagnosis is warranted)

Question 142

Thought insertion and thought withdrawal are examples of:

hallucinations

delusions

passivity phenomena

grossly disorganised thinking

Answer 142

passivity phenomena
(Passivity phenomena involve the experience of one’s thoughts, feelings, or actions being controlled or influenced by external forces.

Thought insertion refers to the belief that thoughts have been placed into one’s mind by an external source.
Thought withdrawal involves the belief that thoughts have been taken out of one’s mind by an external force).

Question 143

Hallucinations can occur in the context of:

Multiple select question.

migraine

REM sleep

carbon monoxide poisoning

complex partial seizures

Answer 143

migraine

complex partial seizures

Question 144

___________ is associated with earlier onset of psychotic illness and poorer overall functioning in the longer term.

Answer 144

Catatonia

Question 145

Rebecca has been hearing a repetitive, unidentifiable voice that has been keeping up a running commentary on her every move. She has interpreted this voice as evidence that she is being monitored by ASIO. This interpretation is an example of a(n):

auditory hallucination

command hallucination

primary delusion

secondary delusion

Answer 145

secondary delusion
(Secondary delusions are false beliefs that arise as a result of an underlying experience, such as hallucinations. In this case, the auditory hallucination (the running commentary) leads Rebecca to form a delusional belief (being monitored by ASIO). The hallucination itself is primary, but the interpretation or belief about the voice (that she is being monitored) is a secondary delusion).

Question 146

Allan is experiencing an episode of psychosis. He shows evidence of disorganised thinking through his speech. For example, when asked how he was feeling, he replied ‘for sure, more, door, good to the core’. This is an example of:

echolalia

clang associations

derailment

tangentiality

Answer 146

clang associations
(involve speech in which the connections between words are based on their sounds rather than their meaning. In this case, Allan’s response appears to be driven by the rhyming or phonetic similarity of the words (“more,” “door,” “core”) rather than coherent content or relevance to the question asked)

Question 147

Hallucinations are perceptual experiences that occur in the absence of _________ input.

Answer 147

sensory

Question 148

Negative symptoms of psychosis can be difficult to distinguish from:

Multiple select question.

depression

medication side effects

normal lack of motivation

bipolar disorder

Answer 148

depression

medication side effects

(Bipolar disorder is less commonly confused with negative symptoms of psychosis, as it generally involves mood episodes (mania or depression) along with psychotic features, which are distinct from the negative symptoms seen in schizophrenia or other psychotic disorders)

Question 149

Primary delusions are theoretically _________ (easier/harder) to treat using psychological methods.

Answer 149

harder

(Primary delusions are deeply ingrained beliefs that are not based on any external evidence or influence. They often arise from a direct distortion in thinking and can be resistant to change because they are not based on external reality but rather on internal cognitive distortions. This makes them more challenging to address with psychological methods compared to secondary delusions)

Question 150

Within the DSM-5,
____________ is classified as the most severe psychotic disorder.

Answer 150

schitzophrenia

Question 151

Errol was recently diagnosed as having experienced a brief psychotic disorder. Which of the following symptoms is Errol most likely to have experienced?

hallucinations for an afternoon

paranoia about leaving the oven on

delusions for a fortnight

intoxication

Answer 151

delusions for a fortnight
(lasting for at least one day but less than one month)

Question 152

Which of the following factors would NOT be considered a core feature of a psychotic disorder?

significant impact of symptoms for at least one month

limited insight into the disturbance in the midst of a psychotic episode

a decline in personal functioning and achievement

having experienced multiple psychotic episodes

Answer 152

having experienced multiple psychotic episodes

(A single episode of psychosis can be sufficient for diagnosis, dependent upon other symptoms)

Question 153

Which of the following is NOT a symptom of disorganised behaviour?

posturing

derailment

agitation

catalepsy

Answer 153

derailment
( symptom of disorganised thinking)

Question 154

Which of the following is NOT a negative symptom of psychosis?

aggression

alogia

affective flattening

avolition

Answer 154

aggression

(positive symptom)

Question 155

Individuals diagnosed with a psychotic disorder often experience reduced quality of life due to declines in:

Multiple select question.

occupational functioning

relationship functioning

intellectual functioning

emotional functioning

Answer 155

occupational functioning

relationship functioning

emotional functioning

Question 156

Reasons for an increased risk of suicide for people diagnosed with a psychotic disorder include:

Multiple select question.

medication side effects

social isolation

comorbid depression

increased lethality of methods

Answer 156

medication side effects

social isolation

comorbid depression

Question 157

The key feature of
________ disorder is the presence of delusions for at least one month.

Answer 157

delusional

Question 158

Eugen Bleuler coined the term ______________ to describe the symptom of loosening associations between thought structures.

Answer 158

schizophrenia

Question 159

Less well-recognised health risks associated with psychotic disorders include:

Multiple select question.

emphysema
diabetes
asthma
obesity

Answer 159

diabetes

obesity

Question 160

Due to the high degree of overlap between the symptoms of various psychotic disorders of varying severity, researchers are arguing for a _______ versus categorical approach to diagnosis.

Answer 160

dimentional

Question 161

Which of the following disorders was not categorised along with psychotic disorders until the DSM-5?

delusional disorder

bipolar disorder

schizophrenia

schizotypal disorder

Answer 161

schizotypal disorder
(In earlier editions of the DSM, schizotypal personality disorder was categorized under personality disorders rather than psychotic disorders. The DSM-5, however, includes schizotypal personality disorder within the broader category of psychotic disorders due to its features that are closely related to psychotic symptoms, such as eccentric behavior and thoughts, and significant cognitive or perceptual distortions)

Question 162

Unemployment is estimated to affect approximately _____ of individuals with a psychotic disorder.

90–100%

10–20%

70–80%

40–50%

Answer 162

40–50%

Question 163

The peak period of onset for psychotic disorders is late
____________and
early ___________.

Answer 163

adolescence
adulthood

Question 164

The prodromal phase of a psychotic disorder is typified by:

the presence of marked positive and negative symptoms that impact functioning

the presence of risk factors for psychotic episodes

a gradual decline in functioning across multiple domains

depression, anxiety and delusions

Answer 164

a gradual decline in functioning across multiple domains

(the presence of marked positive and negative symptoms that impact functioning is more typical of the acute phase)

Question 165

Due to the __________
and associated emotional harm often associated with a diagnosis of schizophrenia, some researchers advocate a change of label or diagnostic process.

Answer 165

stigma

Question 166

Which of the following researchers is credited with first formally identifying schizophrenia?

Eugen Bleuler

Richard Bentall

Kurt Schneider

Emil Kraepelin

Answer 166

Emil Kraepelin

Question 167

Gerard was born in a metropolitan area to migrant parents. Ailish was born in a small country town, to sixth-generation Australian parents. According to researchers, and all other factors being equal, who is at greater risk of developing schizophrenia?

They share an equal risk

It cannot be determined

Gerard

Ailish

Answer 167

Gerard

Question 168

The course of psychosis during which there are active, intense symptoms is called the
_______ phase.

Answer 168

acute

Question 169

The risk of relapse following the first episode of psychosis is highest during the first:

2–5 years

1–2 years

5–6 years

6–9 years

Answer 169

2–5 years

Question 170

Which of the following factors are associated with enduring psychosis?

Multiple select question.

being female

early onset

genetic vulnerability

comorbid substance use

Answer 170

early onset

comorbid substance use

Question 171

The most consistent brain abnormality found in individuals with schizophrenia is

global loss of white matter

enlarged hippocampus

impaired executive function

enlarged ventricles

Answer 171

enlarged ventricles

(hippocampus is smaller not larger)

Question 172

Jarli recently experienced auditory hallucinations, delusions of reference and alogia. His doctor thinks he may have schizophrenia, and sends him for an MRI to assist with diagnosis. If Jarli has schizophrenia, what is his doctor likely to notice on the MRI?

Multiple select question.

reduced hippocampal volume

increased white matter in the pre-frontal cortex

enlarged ventricles

increased dopaminergic activity

Answer 172

reduced hippocampal volume

enlarged ventricles

Question 173

Indigenous populations in Australia and New Zealand experience higher rates of psychosis. Researchers suggest this is due to

gene–environment interactions

reduced access to medical care

social factors

genetic factors

Answer 173

social factors

(many Indigenous populations experience more adverse social conditions than non-Indigenous populations and this can increase the risk of psychosis due to increased stress, and associated risk factors)

Question 174

High levels of
_______ ________, or EE, is associated with increased risk of relapse.

Answer 174

expressed
emotion

Question 175

Researchers have identified that excessive dopamine is associated with:

positive symptoms of psychosis

causing schizophrenia

protecting against the development of schizophrenia

negative symptoms of psychosis

Answer 175

positive symptoms of psychosis

(Dopamine dysregulation, particularly excessive dopamine activity in certain brain areas, is closely linked to the positive symptoms of psychosis, such as hallucinations, delusions, and disorganized thinking. This is a key element in the dopamine hypothesis of schizophrenia, which suggests that increased dopaminergic activity contributes to these symptoms)

Question 176

Individuals with enduring psychosis are more likely to experience:

Multiple select question.

financial stability

homelessness

physical health conditions

unemployment

Answer 176

homelessness

physical health conditions

unemployment

Question 177

_______ has been identified as a key psychosocial risk factor for triggering psychosis.

Answer 177

Stress

Question 178

Cognitive models of psychosis emphasise the ______________ of culturally inappropriate thoughts as the basis of the disorder.

Answer 178

misinterpretation

Question 179

When investigating differences between the brains of those with and without psychotic disorders, researchers rely heavily on:

positron emission topography

transmagnetic stimulation

magnetic resonance imaging

computed tomography

Answer 179

magnetic resonance imaging

Question 180

The theory of hallucinations that has received the most empirical support is that which suggests people who experience psychosis:

experience confusion between internally and externally generated behaviours

experience a dysfunction in verbal self-monitoring

are able to imagine particularly vivid sounds

experience deficits in the vividness of sound

Answer 180

experience a dysfunction in verbal self-monitoring
(This theory posits that individuals with psychosis may have difficulty distinguishing between internally generated speech (thoughts) and external speech (real sounds). This dysfunction in self-monitoring can lead to the experience of auditory hallucinations, where the individual might perceive their own internal thoughts as external voices. This model helps explain why the content of these hallucinations can be distressing or confusing, as they are experienced as coming from an external source rather than being recognized as self-generated)

Question 181

Researchers have found that delusions are more likely to be experienced by those who

externalise success

externalise failure

have inflated self-esteem

have low self-esteem

Answer 181

externalise failure

(Externalizing failure refers to attributing personal failures or negative events to external factors rather than internal ones. This cognitive style can be associated with delusions, particularly those involving paranoia or beliefs that one is being targeted or persecuted. People who externalize failure might be more prone to developing delusions as they attribute negative outcomes to external sources rather than their own actions or shortcomings)

Question 182

Although often misperceived as a causal factor, __________ ________ can be a trigger for a psychotic episode.

Answer 182

illicit
substances

Question 183

Children of parents with schizophrenia may be at greater risk of _________ when their parents are experiencing active psychosis.

Answer 183

neglect

Question 184

Researchers propose that thought disorder is due to problems with information ________.

Answer 184

storage

Question 185

The theory of auditory hallucinations that has received most research support states that hallucinations result from:

noticing clear intentions to speak

deficits in the vividness of auditory imagery

extreme vividness of auditory imagery

confusing internally and externally generated speech

Answer 185

confusing internally and externally generated speech

Question 186

Researchers have found that individuals with delusions are more likely to make _________
errors in tasks of general reasoning.

Answer 186

cognitive

Question 187

The majority of acute interventions will include the use of ________,

Answer 187

medication

Question 188

The ______- ______ model of psychosis is the overarching model that informs the treatment of psychotic disorders.

Answer 188

diathesis - stress

Question 189

Researchers have found which of the following to be the most effective treatment during the prodromal phase of psychosis?

cognitive behaviour therapy + medication

social support

medication

cognitive behaviour therapy

Answer 189

cognitive behaviour therapy

Question 190

Within the context of schizophrenia, thought disorders are generally more prominent when discussing:

high-frequency words

the effectiveness of medication

highly emotional content

the disorder itself

Answer 190

highly emotional content
(Emotional content can exacerbate disorganized thinking, leading to more noticeable disruptions in speech and thought processes. For instance, individuals may struggle with coherent expression or logical organization of thoughts when discussing topics that evoke strong emotions, which can further highlight the disorganized nature of their thinking)

Question 191

The most extensively researched treatment for psychosis focuses on which phase of intervention?

relapse prevention

premorbid

acute

prodromal

Answer 191

acute

Question 192

A key focus of interventions for schizophrenia is to:

encourage resumption of everyday activities

involve family members

improve tardive dyskinesia

reduce reliance on medication

Answer 192

encourage resumption of everyday activities

Question 193

As a method of relapse prevention, CBT approaches for the management of schizophrenia have been found to
________ social function.

Answer 193

improve

Question 194

_________ is an alternative antipsychotic often prescribed to those with enduring psychosis.

Answer 194

Clozapine

Question 195

The consumer recovery model emphasises the role of ___________
between the consumer and clinician in shaping treatment.

Answer 195

collaboration

Question 196

Even with ongoing medication use, up to ______ of individuals with schizophrenia will experience relapse

60%

30%

40%

50%

Answer 196

40%

Question 197

A primary limitation of current treatment options for individuals with psychosis is the:

lack of insight into their personal treatment needs

limited access to effective treatments

lack of effective treatments

high cost of treatment

Answer 197

limited access to effective treatments

Question 198

Which aspect of treatment for psychosis is recommended at every stage of the process?

medication + cognitive behaviour therapy

family therapy

cognitive behaviour therapy

medication

Answer 198

cognitive behaviour therapy

Question 199

Many individuals who have experienced psychosis prefer to be referred to as:

consumers

clients

schizophrenic

patients

Answer 199

consumers

Question 200

In the absence of medication, it is estimated that ______ of individuals with psychosis will relapse within one year of hospitalisation.

73%

65%

41%

57%

Answer 200

65%

Question 201

Eugen Bleuler invented the term ‘schizophrenia’, referring to:

a.
the loosening of connections between thought structures.

b.
split personality, which he believed was common in this illness.

c.
the social stigma that is commonly experienced.

d.
All of the given options are correct.

e.
None of the given options is correct.

Answer 201

a.
the loosening of connections between thought structures.

Question 202

The consumer recovery model of psychosis and serious mental illness focuses on the:

a.
need for consumers to ‘shop around’ until they have the right doctor.

b.
need for more information about antipsychotic medication.

c.
need for 24-hour access to mobile crisis teams.

d.
importance of doctors’ decision making in the treatment process.

e.
rights, choices and individuality of people with mental illnesses.

Answer 202

e.
rights, choices and individuality of people with mental illnesses.

Question 203

Which of the following best describes the prodromal phase of a psychotic disorder?

a.
the period of normality before any mental problems occur

b.
the gradual period of deterioration in mental status, before the onset of acute symptoms of psychosis

c.
the period during which acute symptoms of psychosis occur

d.
the early recovery period

e.
the relapse period

Answer 203

b.
the gradual period of deterioration in mental status, before the onset of acute symptoms of psychosis

Question 204

A serious side effect of neuroleptic medication is:

a.
anhedonia.

b.
worsening of positive symptoms.

c.
worsening of negative symptoms.

d.
tardive dyskinesia

e.
All of the given options are correct.

Answer 204

d.
tardive dyskinesia

Question 205

The dimensional approach to psychosis argues that:

a.
psychotic diagnoses represent arbitrarily defined categories.

b.
psychotic experiences are normally distributed across the population.

c.
there is no clear cut-off point between those diagnosed with schizophrenia and those who are not.

d.
All of the given options are correct.

e.
None of the given options is correct.

Answer 205

d.
All of the given options are correct.

Question 206

During the early recovery phase of psychosis:

a.
problems with depression and social anxiety may emerge.

b.
patients may express that they were traumatised by their experience of psychosis.

c.
patients may either respond defensively to the past experience of psychosis or try to make sense of their experiences.

d.
family members may remain distressed and worried.

e.
All of the given options are correct.

Answer 206

e.
All of the given options are correct.

Question 207

Formal thought disorder includes the following except:

a.
lack of coherence of thought.

b.
circumstantiality.

c.
catalepsy.

d.
derailment.

e.
echolalia.

Answer 207

c.
catalepsy.

Question 208

Large-scale surveys suggest that psychotic experiences are:

a.
very rare in the general population.

b.
normally distributed across the general population.

c.
very common in the general population.

d.
common among those of higher socioeconomic status.

e.
None of the given options is correct.

Answer 208

b.
normally distributed across the general population.

Question 209

Psychotic delusions are usually categorised in terms of their:

a.
sensory modality.

b.
content and bizarreness.

c.
persistence.

d.
response to treatment.

e.
frequency.

Answer 209

b.
content and bizarreness.

Question 210

What are the criteria for identifying individuals in the prodromal phase of psychosis?

a.
less severe features, such as suspicious thinking

b.
transient psychotic features

c.
deterioration in general psychological health

d.
family history of psychosis

e.
All of the given options are correct.

Answer 210

e.
All of the given options are correct.

Question 211

Which of the following is true of individuals who return home to a family with high expressed emotion after a psychotic episode?

a.
They are more likely than others to relapse.

b.
They receive high levels of emotional support from their families.

c.
They are more likely than others to relapse and they receive high levels of emotional support from their families.

d.
They are neither more likely than others to relapse nor to receive high levels of emotional support from their families.

e.
They are less likely than others to relapse.

Answer 211

a.
They are more likely than others to relapse.

Question 212

Which of these is not a first-rank symptom of schizophrenia, according to Schneider’s classification system?

a.
bizarre delusions including passivity phenomena

b.
elevated mood

c.
hearing voices arguing

d.
hearing voices commenting on the individual’s actions

e.
disorganised speech

Answer 212

b.
elevated mood

Question 213

For people with long-term psychosis and persistent positive symptoms, provision of cognitive behaviour therapy (CBT) as well as medication is likely to:

a.
reduce psychotic symptoms during CBT treatment.

b.
have long-term benefits after CBT treatment ceases.

c.
reduce psychotic symptoms during CBT treatment and have long-term benefits after CBT treatment ceases.

d.
neither reduce psychotic symptoms during CBT treatment nor have long-term benefits after CBT treatment ceases.

e.
reduce psychotic symptoms but have no long-term benefits after CBT treatment ceases.

Answer 213

c.
reduce psychotic symptoms during CBT treatment and have long-term benefits after CBT treatment ceases.

Question 214

The strongest research support for the existence of familial genetic factors for schizophrenia comes from:

a.
twin studies.

b.
family studies.

c.
research into the role of neurotransmitters.

d.
research into structural brain abnormalities.

e.
adoption studies.

Answer 214

e.
adoption studies.

Question 215

An individual with schizophrenia who believes that the television newsreader is sending coded messages to him/her is demonstrating what type of delusion?

a.
grandiose delusion

b.
narcissistic delusion

c.
delusion of reference

d.
paranoid delusion

e.
nihilistic delusion

Answer 215

c.
delusion of reference