Abnormal Psychology 16th Edition -James N. Butcher – Hooley-Mineka -Test Bank

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Abnormal Psychology 16th Edition -James N. Butcher -Test Bank

 

Sample  Questions

 

Chapter 7: Mood Disorders and Suicide

 

Multiple-Choice Questions

 

7.1-1. What do all mood disorders have in common?

  1. The presence of a negative mood state.
  2. They are at least 6 months in duration.
  3. The presence of irrational thoughts.
  4. They are characterized by emotional extremes.

Difficulty: 1

Question ID: 7.1-1

Page Ref: 212

Topic: Mood Disorders and Suicide

Skill: Conceptual

Answer: d. They are characterized by emotional extremes.

 

7.1-2. What are the two key moods involved in mood disorders?

  1. Anger and depression
  2. Sadness and anxiety
  3. Mania and depression
  4. Anger and mania

Difficulty: 1

Question ID: 7.1-2

Page Ref: 212

Topic: Mood Disorders: An Overview

Skill: Factual

Answer: c. Mania and depression

 

7.1-3. Which of the following is true of major depressive episode?

  1. It does not begin until adolescence.
  2. It is equally common in men and women.
  3. It occurs five times as often in elderly people as in middle-aged adults.
  4. It is the most prevalent mood episode.

Difficulty: 1

Question ID: 7.1-3

Page Ref: 212

Topic: Mood Disorders: An Overview

Skill: Factual

Answer: d. It is the most prevalent mood episode.

 

7.1-4. In order to meet the criteria for a major depressive episode, a person MUST have

  1. a depressed mood or loss of pleasure most of the day for at least 2 weeks.
  2. significant weight loss.
  3. intense irritability.
  4. insomnia.

Difficulty: 2

Question ID: 7.1-4

Page Ref: 213

Topic: Mood Disorders: An Overview

Skill: Factual

Answer:

  1. a depressed mood most of the day for at least 2 weeks.

 

 

7.1-5. “Normal”feelings of depression becomes a mood disorder when

  1. there is no identifiable cause for it.
  2. the degree of impairment is judged severe enough to warrant a diagnosis.
  3. it lasts for more than a month.
  4. it ceases to be justified and adaptive.

Difficulty: 1

Question ID: 7.1-5

Page Ref: 213-214

Topic: What Are Mood Disorders?

Skill: Conceptual

Answer: b. the degree of impairment is judged severe enough to warrant a diagnosis.

 

7.1-6. Two months after her husband’s death, Connie was still not herself. She often forgot to feed the dog, was late for work on a regular basis, and had not yet thrown out his clothes. Which of the following diagnoses could apply to Connie according to the DSM-5?

  1. adjustment disorder with depressed mood
  2. dysthymia
  3. postpartum depression
  4. major depressive disorder

Difficulty: 1

Question ID: 7.1-6

Page Ref: 215

Topic: Unipolar Mood Disorders/Depressions That Are Not Mood Disorders

Skill: Applied

Answer: d. major depressive disorder

 

7.1-7. “Postpartum blues” are

  1. a serious disorder.
  2. common, usually brief, and not a disorder.
  3. a subtype of Major Depressive Disorder.
  4. serious, brief, and a type of unipolar depression.

Difficulty: 1

Question ID: 7.1-7

Page Ref: 216

Topic: Unipolar Mood Disorders/Depressions That Are Not Mood Disorders

Skill: Factual

Answer: b. common, usually brief, and not a disorder.

 

7.1-8. In which of the following disorders must symptoms be present for at least 2 years in order for a diagnosis to be made?

  1. Dysthymia
  2. Bipolar I disorder
  3. Major depressive disorder
  4. Bipolar II disorder

Difficulty: 1

Question ID: 7.1-8

Page Ref: 217

Topic: Unipolar Mood Disorder/Dysthymic Disorder

Skill: Factual

Answer: a. Dysthymia

 

7.1-9. How does dysthymia compare to major depressive disorder?

  1. Symptoms are much more severe than in major depressive disorder.
  2. Symptoms change from day to day, with lots of days with normal functioning in between dysthymic episodes.
  3. There are many more symptoms required to meet dysthymia than to meet major depressive disorder.
  4. Symptoms are mild to moderate but last for much longer than in major depressive disorder.

Difficulty: 2

Question ID: 7.1-9

Page Ref: 217

Topic: Unipolar Mood Disorder/Dysthymic Disorder

Skill: Conceptual

Answer: d. Symptoms are mild to moderate but last for much longer than in major depressive disorder.

 

7.1-10. What is the most important characteristic used to distinguish dysthymia from major depression?

  1. the length of time the person has had the symptoms
  2. how severe the symptoms are
  3. whether there are occasional brief periods of normal moods during the disorder
  4. the types of symptoms the person has

Difficulty: 2

Question ID: 7.1-10

Page Ref: 217

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Conceptual

Answer: c. whether there are occasional brief periods of normal moods during the disorder

 

7.1-11. Sean describes himself as having hardly ever being happy. He occasionally feels okay, but it never lasts more than a day or so. He has trouble sleeping, doesn’t eat much, and feels like nothing will ever change in his life. He says this has been going on for as long as he can remember. The best diagnosis for Sean is

  1. cyclothymia.
  2. dysthymia.
  3. major depressive disorder.
  4. bipolar II.

Difficulty: 2

Question ID: 7.1-11

Page Ref: 217

Topic: Unipolar Mood Disorders/Dysthymic Disorder

Skill: Applied

Answer: b. dysthymia.

 

7.1-12. Which of the following is a symptom of major depressive disorder?

  1. Checking and rechecking things
  2. appetite and weight loss
  3. Running thoughts
  4. Impulsive spending

Difficulty: 3

Question ID: 7.1-12

Page Ref: 218

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Applied

Answer: b. appetite and weight loss

 

7.1-13. George, a 22-year-old mechanic, always seems to have a cloud over his head. For the past three weeks, he has had problems sleeping and he has little appetite or enjoyment of food. While he may sometimes seem to be relatively content for short periods of time, this happens very rarely and it never lasts for more than a week. If George were to seek help for his negative mood state, which of the following diagnoses would he most likely receive?

  1. Adjustment disorder with depressed mood
  2. Chronic adjustment disorder with depressed mood
  3. Bipolar II
  4. Major depressive disorder

Difficulty: 1

Question ID: 7.1-13

Page Ref: 218

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Applied

Answer: d. Major depressive disorder

 

7.1-14. Brittany came to a therapist complaining that she just doesn’t enjoy life lately. She says that for the past couple of months, she finds she just doesn’t feel like doing the things that she used to love to do. She has also lost a lot of weight and sleeps much more than usual but still feels tired all the time. She says she just can’t concentrate on anything. However, she denies feeling sad. Brittany’s most likely diagnosis is

  1. dysthymic disorder.
  2. bipolar II disorder.
  3. major depressive disorder.
  4. no disorder.

Difficulty: 2

Question ID: 7.1-14

Page Ref: 218

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Applied

Answer: c. major depressive disorder.

 

7.1-15. Depression

  1. can occur even in infants and very young children.
  2. is extremely rare in childhood.
  3. cannot occur in childhood.
  4. can occur in childhood in females but not in males.

Difficulty: 2

Question ID: 7.1-15

Page Ref: 219

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: a. can occur even in infants and very young children.

 

7.1-16. Depression during adolescence

  1. is much rarer than during childhood.
  2. has little effect on adult functioning.
  3. can affect a person into young adulthood.
  4. is decreasing in prevalence.

Difficulty: 2

Question ID: 7.1-16

Page Ref: 220

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: c. can affect a person into young adulthood.

 

7.1-17. Herbert awakens early in the morning and feels more depressed in the morning than the evening. He has lost all interest in activities and derives no pleasure from things that used to please him. If he is suffering from major depression, Herbert’s symptoms suggest the subtype called

  1. mood-congruent.
  2. melancholic.
  3. dysthymic.
  4. postpartum.

Difficulty: 1

Question ID: 7.1-17

Page Ref: 220

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Applied

Answer: b. melancholic.

 

7.1-18. A person who shows psychotic depression that involves mood-congruent thinking

  1. is diagnosed as having “double depression.”
  2. usually responds rapidly to anti-depressant medications.
  3. rarely shows the symptoms of melancholia.
  4. has a poorer prognosis than others with major depression.

Difficulty: 1

Question ID: 7.1-18

Page Ref: 220

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: d. has a poorer prognosis than others with major depression.

 

7.1-19. Sam has been diagnosed with major depressive disorder. He tells you that he is certain the world will end next Tuesday because everyone in it is so wicked. He refuses to consider that he might be wrong. Sam has

  1. mood congruent delusions.
  2. mood incongruent delusions.
  3. atypical features.
  4. melancholic features.

Difficulty: 2

Question ID: 7.1-19

Page Ref: 220

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Applied

Answer: a. mood congruent delusions.

 

7.1-20. What is meant by the phrase “double depression”?

  1. Symptoms are consistent with two different subtypes of major depression.
  2. The individual has been diagnosed with an anxiety disorder and a mood disorder.
  3. Symptoms of both typical and atypical depression are exhibited.
  4. An individual with dysthymia later develops major depressive disorder as well.

Difficulty: 1

Question ID: 7.1-20

Page Ref: 221

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: d. An individual with dysthymia later develops major depressive disorder as well.

 

7.1-21. Kerry suffers from depression. He is experiencing delusions that his brain is deteriorating and that he is aging quickly. These delusions

  1. clearly suggest a diagnosis of schizophrenia.
  2. are typical of depressive delusions because they are mood congruent.
  3. suggest that he is suffering from a bipolar rather than a unipolar disorder.
  4. are most likely to persist after the depression remits.

Difficulty: 1

Question ID: 7.1-21

Page Ref: 220

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: b. are typical of depressive delusions because they are mood congruent.

 

7.1-22. Margaret has been suffering with dysthymia for several years and has sought treatment on several occasions. About one month ago she developed more severe symptoms of depression, which have been maintained almost daily. The condition she is experiencing is best described as

  1. double depression.
  2. chronic melancholia.
  3. adjustment disorder with bipolar features.
  4. recurring melancholic depression.

Difficulty: 1

Question ID: 7.1-22

Page Ref: 221

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: a. double depression.

 

7.1-23. Deena has major depressive disorder. Most days she feels very sad, but when her sister came and told Deena she was going to be an aunt, Deena felt happy for a little while. She has been gaining weight and sleeping much of the day. Deena most likely has

  1. melancholic features.
  2. double depression.
  3. atypical features.
  4. psychotic features.

Difficulty: 2

Question ID: 7.1-23

Page Ref: 220

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Applied

Answer: c. atypical features.

 

7.1-24. A recurrent depressive episode

  1. is preceded by one or more previous episodes.
  2. suggests that chronic major depression has developed.
  3. typically lasts 2-3 weeks.
  4. is characteristic of all forms of bipolar disorder.

Difficulty: 1

Question ID: 7.1-24

Page Ref: 219

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: a. is preceded by one or more previous episodes.

 

7.1-25. The average duration of an untreated episode of depression is

  1. 6-9 months.
  2. 1 year.
  3. 2 years.
  4. unknown as individuals not seeking treatment haven’t been studied.

Difficulty: 1

Question ID: 7.1-25

Page Ref: 219

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: a. 6-9 months.

 

7.1-26. Which of the following is a true statement about the recurrence of depressive symptoms?

  1. If a recurrence is not experienced within 1 year after an initial depressive episode, recurrence is highly unlikely.
  2. Most individuals diagnosed with major depression will exhibit a recurrence.
  3. Those with depression with psychotic features are less likely to experience a recurrence.
  4. Clients are usually asymptomatic between depressive episodes.

Difficulty: 1

Question ID: 7.1-26

Page Ref: 219

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: b. Most individuals diagnosed with major depression will exhibit a recurrence.

 

7.1-27. A rapid return of symptoms immediately after drug treatment is terminated is a common example of ________; a return to depressive symptoms after a period of spontaneous remission of symptoms is called a ________.

  1. melancholia; recurrence
  2. recurrence; relapse
  3. relapse; recurrence
  4. mood-congruent depression; mood-incongruent depression

Difficulty: 2

Question ID: 7.1-27

Page Ref: 219

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Conceptual

Answer: c. relapse; recurrence

 

7.1-28. Seasonal affective disorder is best described as a ________ depressive disorder.

  1. mood-congruent
  2. minor
  3. psychotic
  4. recurrent

Difficulty: 1

Question ID: 7.1-28

Page Ref: 221

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: d. recurrent

 

7.1-29. Over the past two years, Kelly has experienced depressive episodes three different times. Two of the three episodes occurred in the winter and the third occurred last fall. It is now winter and Kelly’s depressive symptoms once again are consistent with major depressive disorder. Which of the following diagnoses should she be given?

  1. dysthymic disorder
  2. chronic major depressive disorder
  3. recurrent major depressive disorder
  4. recurrent major depressive disorder with a seasonal pattern

Difficulty: 2

Question ID: 7.1-29

Page Ref: 221

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Applied

Answer: d. recurrent major depressive disorder with a seasonal pattern

 

 

7.1-30. Which of the following statements is supported by research on the role of genetic influences in unipolar disorder?

  1. The more severe the depressive disorder, the greater the genetic contribution.
  2. Twin studies do not consistently find evidence of an inherited susceptibility to depression.
  3. Genes play a more significant causal role in bipolar disorders than they do in unipolar disorders.
  4. Bipolar and unipolar disorders are equally heritable.

Difficulty: 2

Question ID: 7.1-30

Page Ref: 221

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Conceptual

Answer: a. The more severe the depressive disorder, the greater the genetic contribution.

 

7.1-31. The finding that people with one type of serotonin transporter gene and childhood maltreatment had higher rates of depression than either those without the gene or those with the gene without the maltreatment suggests that

  1. childhood maltreatment causes depression.
  2. only one type of gene causes depression.
  3. either or a gene or certain environmental factors need to be present to cause depression.
  4. both a gene and certain environmental factors need to be present to cause depression.

Difficulty: 2

Question ID: 7.1-31

Page Ref: 222

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Factual

Answer: d. both a gene and certain environmental factors need to be present to cause depression.

 

7.1-32. Which of the following is true about the monoamine hypothesis of depression?

  1. Alternative theories have replaced this theory.
  2. It has not been replaced by a compelling alternative.
  3. This theory remains the standard of current and accurate information.
  4. This theory has been continuously updated to meet current research.

Difficulty: 2

Question ID: 7.1-32

Page Ref: 223

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Applied

Answer: b. It has not been replaced by a compelling alternative

 

7.1-33. Drugs that alter the availability of norepinephrine and serotonin are not clinically effective in the treatment of depression for several weeks. Which of the following does this finding suggest?

  1. These neurotransmitters are not involved in depression.
  2. It is overactivity of these neurotransmitters that underlies depression, not underactivity.
  3. That the effectiveness of antidepressants is a placebo effect, as opposed to a result of a biochemical manipulation.
  4. Changes in neurotransmitter function, as opposed to neurotransmitter level, cause depression.

Difficulty: 2

Question ID: 7.1-33

Page Ref: 223

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Conceptual

Answer: d. Changes in neurotransmitter function, as opposed to neurotransmitter level, cause depression.

 

7.1-34. Individuals who do not show a decrease in cortisol levels in response to an injection of dexamethasone

  1. have a severe form of depression.
  2. are likely to be suffering from both major depression and a personality disorder.
  3. will not respond well to pharmacological treatment.
  4. have an HPA axis that is not functioning normally.

Difficulty: 2

Question ID: 7.1-34

Page Ref: 223

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Factual

Answer: d. have an HPA axis that is not functioning normally.

 

7.1-35. Which of the following is most likely to be seen in children who are at risk for depression?

  1. decreased left hemisphere activity
  2. decreased right hemisphere activity
  3. increased serotonin levels
  4. increased GABA levels

Difficulty: 2

Question ID: 7.1-35

Page Ref: 224

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Applied

Answer: a. decreased left hemisphere activity

 

7.1-36. Which of the following is a brain area that has been found to exhibit abnormalities in depressed patients?

  1. amygdala
  2. basal ganglia
  3. posterior cingulate cortex
  4. medulla oblangata

Difficulty: 3

Question ID: 7.1-36

Page Ref: 225

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Factual

Answer: a. amygdala

 

7.1-37. Many people who are depressed

  1. show very little REM sleep, instead they spend large amounts of time in the deeper stages (3 and 4) of sleep.
  2. do not enter REM sleep until much later in the night than normal and have smaller amounts of REM sleep throughout the night than normal.
  3. enter REM sleep earlier than normal and have larger amounts of REM sleep early in the night.
  4. enter REM sleep at a normal time, but have very slow and mild rapid eye movements and have less overall time in REM sleep than normal.

Difficulty: 2

Question ID: 7.1-37

Page Ref: 225-226

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Factual

Answer: c. enter REM sleep earlier than normal and have larger amounts of REM sleep early in the night.

 

7.1-38. The fact that bright light may be an effective treatment for seasonal affective disorder suggests that

  1. this is a not a real form of depression as any response to light is merely a placebo effect.
  2. this form of depression is produced by a malfunctioning biological clock that needs resetting.
  3. changes in circadian rhythms underlie most forms of depression.
  4. seasonal affective disorder is a unique entity that should not be categorized with other forms of unipolar depression.

Difficulty: 2

Question ID: 7.1-38

Page Ref: 226

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Applied

Answer: b. this form of depression is produced by a malfunctioning biological clock that needs resetting.

 

7.1-39. Independent life events are those that

  1. only affect one area of a client’s functioning.
  2. are out of the client’s control.
  3. are linked causally to the behavior or personality of the client.
  4. affect the client and not those around him or her.

Difficulty: 2

Question ID: 7.1-39

Page Ref: 227

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Conceptual

Answer: b. are out of the client’s control.

 

7.1-40. John’s erratic behavior finally ruined his marriage. What kind of life event would this be described as?

  1. acute
  2. chronic
  3. dependent
  4. independent

Difficulty: 2

Question ID: 7.1-40

Page Ref: 227

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: c. dependent

 

7.1-41. Which of the following is true?

  1. Most first time episodes of depression are preceded by a very stressful life event.
  2. Both first time and recurrent episodes of depression are usually preceded by a very stressful life event.
  3. Even mildly stressful events are associated with the onset of episodes of depression.
  4. Mildly stressful events are only associated with the onset of first time depression, not with recurrent episodes.

Difficulty: 2

Question ID: 7.1-41

Page Ref: 227

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: a. Most first time episodes of depression are preceded by a very stressful life event.

 

7.1-42. A review of several studies found that ________ increased the likelihood of developing a more severe depression.

  1. experiencing a stressful life event
  2. being in an intimate relationship
  3. working outside of the home
  4. having religious faith

Difficulty: 2

Question ID: 7.1-42

Page Ref: 227

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Conceptual

Answer: a. experiencing a stressful life event

 

7.1-43. Which of the following is an example of a COGNITIVE diathesis for depression?

  1. neuroticism
  2. optimism
  3. attributing negative events to internal causes
  4. attributing negative events to external causes

Difficulty: 2

Question ID: 7.1-43

Page Ref: 228

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: c. attributing negative events to internal causes

 

7.1-44. Which of the following reactions to poor test performance suggests a cognitive diathesis for depression?

  1. I’ll do better next time.
  2. I’ll never understand this.
  3. Why didn’t I study more?
  4. That test was way too hard.

Difficulty: 1

Question ID: 7.1-44

Page Ref: 228

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: b. I’ll never understand this.

 

7.1-45. Joanne tends to blow up at people and then feel guilty. She worries a lot. She complains that she just doesn’t really find anything exciting and life is boring.

Joanne

  1. shows evidence of neuroticism and low positive affectivity, and has a high risk of developing depression.
  2. shows evidence of neuroticism and has a moderate risk of developing depression.
  3. shows evidence of introversion, and has a mild risk of developing depression.
  4. shows no evidence of any kind that would increase her risk for developing depression.

Difficulty: 2

Question ID: 7.1-45

Page Ref: 228

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: a. shows evidence of neuroticism and low positive affectivity, and has a high risk of developing depression.

 

7.1-46. Parental loss only results in a vulnerability to depression when

  1. the loss is due to death.
  2. poor parental care is a consequence of the loss.
  3. the loss is not explained adequately to the child.
  4. both parents are lost at an early age.

Difficulty: 1

Question ID: 7.1-46

Page Ref: 229

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: b. poor parental care is a consequence of the loss.

 

7.1-47. According to Freud, depression

  1. and grief are the same thing.
  2. must be treated with introjection.
  3. is a consequence of loss.
  4. reflects fixation in the anal stage.

Difficulty: 1

Question ID: 7.1-47

Page Ref: 229

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: c. is a consequence of loss.

 

7.1-48. Freud suggested that depression

  1. was actually a healthy adaptation to stress.
  2. was a result of overly high self-esteem.
  3. involved the anal stage of development.
  4. was anger turned inward.

Difficulty: 2

Question ID: 7.1-48

Page Ref: 229

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: d. was anger turned inward.

 

7.1-49. Which of the following is a behavioral explanation for depression?

  1. lack of environmental reinforcers
  2. insecure attachment
  3. pessimistic tendencies
  4. reliance on depressogenic schemas

Difficulty: 1

Question ID: 7.1-49

Page Ref: 229

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: a. lack of environmental reinforcers

 

7.1-50. Depressogenic schemas

  1. are inherited.
  2. predispose a person to develop depression.
  3. serve a protective function and are readily modified by positive life experiences.
  4. ensure that a low rate of reinforcement will be experienced.

Difficulty: 2

Question ID: 7.1-50

Page Ref: 230

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: b. predispose a person to develop depression.

 

7.1-51. A therapist with a ________ orientation would emphasize the depressed person’s need to improve his or her social skills.

  1. interpersonal
  2. psychodynamic
  3. cognitive
  4. sociocultural

Difficulty: 1

Question ID: 7.1-51

Page Ref: 236

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Conceptual

Answer: a. interpersonal

 

7.1-52. Beck’s negative cognitive triad involves feeling negatively about

  1. helplessness, hopelessness, and sorrow.
  2. one’s self, one’s experiences, and one’s future.
  3. one’s past, one’s present, and one’s future.
  4. one’s family, one’s self, and one’s friends.

Difficulty: 2

Question ID: 7.1-52

Page Ref: 230

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: b. one’s self, one’s experiences, and one’s future.

 

7.1-53. Debbie receives her paper back from her instructor. It is marked with an A grade and has several positive comments. The instructor also suggested Debbie reword one small section. Debbie becomes extremely upset and tells her friends her instructor hated the paper and wants her to redo it. This is an example of

  1. selective abstraction.
  2. dichotomous thinking.
  3. arbitrary inference.
  4. learned helplessness.

Difficulty: 2

Question ID: 7.1-53

Page Ref: 230

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: a. selective abstraction.

 

7.1-54. Selective abstraction

  1. is a tendency to think in extremes.
  2. is a tendency to jump to conclusions based on little or no evidence.
  3. is part of Beck’s cognitive triad.
  4. is a tendency to focus on one negative detail of a situation while ignoring other aspects.

Difficulty: 2

Question ID: 7.1-54

Page Ref: 230

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Conceptual

Answer: d. is a tendency to focus on one negative detail of a situation while ignoring other aspects.

 

7.1-55. Which of the following is an example of arbitrary inference?

  1. Life is so unfair.
  2. If she won’t go out with me, I’ll die.
  3. She looked at me funny. She hates me.
  4. Why should I even try? She’ll definitely reject me.

Difficulty: 2

Question ID: 7.1-55

Page Ref: 231

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: c. She looked at me funny. She hates me.

 

7.1-56. While there is much support for some elements of Beck’s cognitive theory,

  1. treatments based on his view of depression are not effective.
  2. findings supporting it as a causal hypothesis are limited.
  3. it does not account for the known biological aspects of depression.
  4. is does not account for sex differences in depression.

Difficulty: 2

Question ID: 7.1-56

Page Ref: 231-232

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Conceptual

Answer: b. findings supporting it as a causal hypothesis are limited.

 

7.1-57. No matter what prisoners try to do, they cannot escape. Eventually, they become passive and depressed. This illustrates the central idea in the ________ theory of depression.

  1. attribution
  2. depressogenic schema
  3. learned helplessness
  4. behavioral

Difficulty: 1

Question ID: 7.1-57

Page Ref: 232

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: c. learned helplessness

 

7.1-58. Jacob and Matt both flunk their math test. Jacob says to his friends that there is no point in his continuing in the course because, although Jacob feels highly about himself, he suspects that the teacher just doesn’t like him. Matt says he is going to drop the course because he is just stupid in math. According to the reformulated learned helplessness theory,

  1. Matt is more likely to become depressed than Jacob.
  2. Matt is more likely to feel helpless than Jacob.
  3. Jacob is more likely to become depressed than Matt.
  4. Jacob is more likely to feel helpless than Matt.

Difficulty: 2

Question ID: 7.1-58

Page Ref: 232

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: a. Matt is more likely to become depressed than Jacob.

 

7.1-59. Which of the following is the type of attribution that is most likely to cause depression?

  1. I am never going to make it through this course because it is too early in the morning and I’m having trouble getting up.
  2. I am never going to make it through this course because I’m stupid and I just can’t learn the material.
  3. I am never going to make it through this course because the professor is unfair.
  4. I am never going to make it through this course because I just don’t feel like studying lately.

Difficulty: 2

Question ID: 7.1-59

Page Ref: 232

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: b. I am never going to make it through this course because I’m stupid and I just can’t learn the material.

 

7.1-60. Abramson revised the learned helplessness theory to suggest that

  1. the worldview dimension of attributions is the most important to depression.
  2. hopelessness is needed to produce depression, helplessness is not important.
  3. the number of negative life events someone experiences is more important than his or her attributions for those events.
  4. the pessimistic attributional style people have about negative events produces depression.

Difficulty: 2

Question ID: 7.1-60

Page Ref: 232

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: d. the pessimistic attributional style people have about negative events

produces depression.

 

7.1-61. Which of the following statements about rumination is true, according to the ruminative response styles theory?

  1. Rumination is a protective factor against depression.
  2. People who ruminate a great deal tend to have more lengthy periods of depressive symptoms.
  3. Gender differences in depression are explained by ruminative styles.
  4. Biological factors have been most clearly linked to the development of rumination in those who do not have a family history of mood disorders.

Difficulty: 2

Question ID: 7.1-61

Page Ref: 233-234

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Conceptual

Answer: b. People who ruminate a great deal tend to have more lengthy periods of depressive symptoms.

 

7.1-62. When a nondepressed student lives with a depressed roommate, which of the following often results?

  1. frequent verbal fights, which may even become physical
  2. increased depression and hostility in the roommate who was not originally depressed
  3. a decrease in depression in the depressed roommate
  4. increased caretaking by the nondepressed roommate, but only after the nondepressed roommate becomes depressed

Difficulty: 2

Question ID: 7.1-62

Page Ref: 236

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: b. increased rejection and hostility in the roommate who was not originally depressed

 

7.1-63. Which of the following is a major risk factor for panic disorder, depression, and other anxiety disorders?

  1. the presence of neuroticism
  2. the presence of positive affect
  3. the presence of helplessness
  4. the presence of rumination

Difficulty: 1

Question ID: 7.1-63

Page Ref: 234

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: a. the presence of neuroticism

 

7.1-64. A relationship between depression and marital dissatisfaction

  1. has yet to be established.
  2. only exists due to the submissive behavior of depressed wives.
  3. is only seen when depression leads to substance abuse.
  4. is well-established.

Difficulty: 1

Question ID: 7.1-64

Page Ref: 236

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Conceptual

Answer: d. is well-established.

 

7.1-65. Which statement best describes the relationship between mood disorders and domestic distress?

  1. Critical comments trigger negative affect in the spouse.
  2. Women who are depressed avoid their partners.
  3. Whenever there is a problem, it is caused by a man who, in a manic episode, is unaware of the nature of his behavior or even who he is attacking.
  4. Men become violent as a way of protecting themselves when their wives, who suffer from depressive episodes, become impulsively aggressive.

Difficulty: 2

Question ID: 7.1-65

Page Ref: 236

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Conceptual

Answer: a. Critical comments trigger negative affect in the spouse.

 

7.1-66. Childhood depression

  1. has been clearly linked to genetic factors.
  2. is more likely in children with a depressed parent.
  3. has not been associated with parental depression.
  4. can usually be causally related to marital discord.

Difficulty: 1

Question ID: 7.1-66

Page Ref: 237

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Factual

Answer: b. is more likely in children with a depressed parent.

 

7.1-67. A hypomanic episode is best described as a

  1. mild manic episode.
  2. short manic episode.
  3. manic episode characterized by inactivity.
  4. manic episode followed by symptoms of a mild depression.

Difficulty: 1

Question ID: 7.1-67

Page Ref: 238

Topic: Bipolar Disorders

Skill: Conceptual

Answer: a. mild manic episode.

 

7.1-68. The main difference between a manic episode and a hypomanic episode is

  1. whether the person also experiences depression.
  2. the number of symptoms the person has.
  3. whether the person has irritable mood.
  4. the amount of social and occupational impairment.

Difficulty: 1

Question ID: 7.1-68

Page Ref: 238

Topic: Bipolar Disorders

Skill: Conceptual

Answer: d. the amount of social and occupational impairment.

 

7.1-69. Bipolar disorder is to major depression as ________ is to ________.

  1. dysthymia; cyclothymia
  2. cyclothymia; dysthymia
  3. mania; hypomania
  4. hypomania; mania

Difficulty: 1

Question ID: 7.1-69

Page Ref: 238

Topic: Bipolar Disorders/Cyclothymic Disorder

Skill: Factual

Answer: b. cyclothymia; dysthymia

 

7.1-70. Which of the following is necessary for a diagnosis of cyclothymia?

  1. The occurrence of two or more episodes of major depression
  2. Unremitting symptoms for a period of at least two years
  3. Clinically significant distress or impairment
  4. The occurrence of at least one episode of anxiety

Difficulty: 2

Question ID: 7.1-70

Page Ref: 238

Topic: Bipolar Disorders/Cyclothymic Disorder

Skill: Factual

Answer: c. clinically significant distress or impairment

 

7.1-71. Which of the following would eliminate a potential diagnosis of cyclothymia?

  1. Gil had been showing both hypomanic and depressed symptoms for over three years.
  2. Carol was absolutely convinced that her mother wanted to kill her, although there was no evidence for this.
  3. Bob’s most recent hypomanic episode lasted 3 days.
  4. Between her more recent episodes, Carla functioned quite well for 3 weeks.

Difficulty: 1

Question ID: 7.1-71

Page Ref: 238

Topic: Bipolar Disorders/Cyclothymic Disorder

Skill: Applied

Answer: b. Carol was absolutely convinced that her mother wanted to kill her, although there was no evidence for this.

 

7.1-72. Lori has periods of dejection and apathy that are not as severe as are seen in major depression. She also has periods when she abruptly becomes elated and has little need for sleep. Her symptoms never reach the level of psychosis, but the mood swings have been recurrent for over four years. The best diagnosis for Lori is

  1. schizoaffective disorder.
  2. bipolar I disorder.
  3. recurrent dysthymia.
  4. cyclothymia.

Difficulty: 2

Question ID: 7.1-72

Page Ref: 238

Topic: Bipolar Disorders/Cyclothymic Disorder

Skill: Applied

Answer: d. cyclothymia.

 

7.1-73. Which of the following is necessary for a diagnosis of bipolar I disorder?

  1. the occurrence of two or more episodes of major depression
  2. unremitting symptoms for a period of at least two years
  3. symptoms of psychosis
  4. the occurrence of at least one manic episode

Difficulty: 2

Question ID: 7.1-73

Page Ref: 239

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: d. the occurrence of at least one manic episode

 

7.1-74. Although bipolar I disorder is described as “bipolar,”

  1. a depressed episode is not necessary for a diagnosis.
  2. few patients show both manic and depressed symptoms.
  3. both depressed and manic symptoms typically occur simultaneously.
  4. a year or two commonly passes between manic and depressed episodes.

Difficulty: 2

Question ID: 7.1-74

Page Ref: 239

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: a. a depressed episode is not necessary for a diagnosis.

 

7.1-75.  A diagnosis of bipolar I disorder indicates that the person has met DSM-5 criteria for

  1. an episode of mania.
  2. an episode of mania or major depression.
  3. an episode of hypomania and a major depression.
  4. an episode of mania and psychois.

Difficulty: 1

Question ID: 7.1-75

Page Ref: 239

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: a. an episode of mania.

 

7.1-76. Angela has had several periods of extremely “up” moods. They last for a couple of weeks and she has gotten into trouble several times. During those times she doesn’t sleep, spends way too much money, gets involved in bad business decisions, talks quickly and thinks even more quickly and believes she can do anything. The best diagnosis for Angela is

  1. manic disorder.
  2. bipolar II disorder.
  3. bipolar I disorder.
  4. cyclothymic disorder.

Difficulty: 2

Question ID: 7.1-76

Page Ref: 239

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Applied

Answer: c. bipolar I disorder.

 

7.1-77. Which statement about bipolar I disorder is accurate?

  1. The depressive phase is more likely to involve psychotic features than in major depressive disorder.
  2. The onset of bipolar symptoms are never associated with seasons of the year as they are in unipolar depression.
  3. Single episodes of the disorder are extremely rare.
  4. Manic and depressive phases are always separated by lengthy intervals of normal mood.

Difficulty: 1

Question ID: 7.1-77

Page Ref: 241-242

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: c. Single episodes of the disorder are extremely rare.

 

7.1-78. A diagnosis of bipolar II disorder indicates that the person has experienced

  1. an episode of mania.
  2. an episode of mania or major depression.
  3. an episode of hypomania and an episode of major depression.
  4. an episode of mania and an episode of major depression.

Difficulty: 1

Question ID: 7.1-78

Page Ref: 240

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: c. an episode of hypomania and an episode of major depression.

 

7.1-79. Carleen comes to therapy because she is feeling sad. Carleen says her she has often had periods of extreme sadness in the past and they typically last between 6 and 8 months. During those times she overeats, has trouble sleeping, feels exhausted all the time, and thinks a lot about dying. At other times, however, Carleen says she feels wonderful. During those times, which last about a week, she gets a lot done, feels as if she could do anything, talks a lot and quickly, doesn’t sleep, but doesn’t feel tired. Carleen says her “up” times are great and have never caused her any trouble. Carleen’s most likely diagnosis is

  1. major depressive disorder.
  2. dysthymia.
  3. bipolar I.
  4. bipolar II.

Difficulty: 2

Question ID: 7.1-79

Page Ref: 240

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Applied

Answer: d. bipolar II.

 

7.1-80. Which of the following is a true statement about rapid cycling in bipolar disorders?

  1. It is seen in men more than women.
  2. It occurs in only those with Bipolar II disorder.
  3. Lithium may trigger a cycling episode.
  4. It is seen in 5-10 percent of those with bipolar disorder.

Difficulty: 2

Question ID: 7.1-80

Page Ref: 241

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: d. It is seen in 5-10 percent of those with bipolar disorder.

 

7.1-81. Why is it not wise to treat an individual who has a bipolar disorder with a tricyclic antidepressant?

  1. The unpleasant side effects cause many to stop taking them.
  2. Individuals with bipolar disorder may or may not exhibit symptoms of depression.
  3. The drugs used to treat unipolar disorders do not alter the activity of the neurotransmitters that are affected in bipolar disorder.
  4. The combination of antidepressants and lithium is likely to be lethal.

Difficulty: 2

Question ID: 7.1-81

Page Ref: 247

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: a. The unpleasant side effects cause many to stop taking them.

 

7.1-82. The National Comorbidity Survey-Replication indicated ________percent of people with mood disorders receive no treatment or inadequate care.

  1. 40
  2. 50
  3. 60
  4. 70

Difficulty: 1

Question ID: 7.1-82

Page Ref: 246

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: c. 60

 

7.1-83. Which of the following is true?

  1. Neither unipolar nor bipolar disorder have a strong genetic contribution.
  2. Unipolar and bipolar disorders have an equally strong genetic contribution.
  3. Unipolar disorder is more strongly inherited than bipolar disorder.
  4. Bipolar disorder is more strongly inherited than unipolar disorder.

Difficulty: 2

Question ID: 7.1-83

Page Ref: 242

Topic: Causal Factors in Bipolar Disorders/Biological Causal Factors

Skill: Conceptual

Answer: d. Bipolar disorder is more strongly inherited than unipolar disorder.

 

7.1-84. Efforts to find the gene or genes that underlie bipolar disorder suggest that

  1. multiple genes are involved.
  2. the underlying gene is on the Y chromosome.
  3. the underlying gene is on the X chromosome.
  4. there is a genetic basis for bipolar disorder, but not for cyclothymia.

Difficulty: 1

Question ID: 7.1-84

Page Ref: 242

Topic: Causal Factors in Bipolar Disorders/Biological Causal Factors

Skill: Conceptual

Answer: a. multiple genes are involved.

 

7.1-85. Which of the following neurochemical profiles has been associated with manic episodes?

  1. High serotonin, high norepinephrine, high dopamine
  2. Low serotonin, high norepinephrine, high dopamine
  3. Low serotonin, low norepinephrine, high dopamine
  4. Low serotonin, high norepinephrine, low dopamine

Difficulty: 2

Question ID: 7.1-85

Page Ref: 242-243

Topic: Causal Factors in Bipolar Disorders/Biological Causal Factors

Skill: Factual

Answer: b. Low serotonin, high norepinephrine, high dopamine

 

7.1-86. Knowing what we know about the neurotransmitter imbalances in bipolar disorder, a physician should give which of the following pieces of advice?

  1. “Eat lots of foods that are rich in norepinephrine.”
  2. “Don’t take drugs that increase dopamine levels because they can produce manic-like behavior.”
  3. “Stay away from drugs that include lithium because bipolar is associated with excessive lithium activity.”
  4. “If you can keep your serotonin levels normal, you do not have to worry about having a manic episode.”

Difficulty: 1

Question ID: 7.1-86

Page Ref: 243

Topic: Causal Factors in Bipolar Disorders/Biological Causal Factors

Skill: Applied

Answer: b. “Don’t take drugs that increase dopamine levels because they can produce manic-like behavior.”

 

7.1-87. Reynaldo has been diagnosed with bipolar disorder. The most effective drug for him is

  1. one that will increase his dopamine levels.
  2. one that will counteract the effect of sodium in his nerve cells.
  3. lithium.
  4. dexamethasone.

Difficulty: 1

Question ID: 7.1-87

Page Ref: 243

Topic: Treatments and Outcomes/Pharmacotherapy

Skill: Applied

Answer: c. lithium.

 

7.1-88. The effectiveness of lithium in the treatment of bipolar disorder

  1. supports the hypothesized role of serotonin in this disorder.
  2. is inconsistent with the established effects of dopamine on mood states.
  3. supports the role of dopamine in mania.
  4. suggests that it is not neurotransmitter function that is disrupted in bipolar disorder, but neurotransmitter levels.

Difficulty: 2

Question ID: 7.1-88

Page Ref: 243

Topic: Causal Factors in Bipolar Disorders/Biological Causal Factors

Skill: Conceptual

Answer: c. supports the role of dopamine in mania.

 

7.1-89. Which of the following is a hormonal abnormality associated with both bipolar disorder and unipolar depression?

  1. decreased thyroid hormone levels
  2. increased thyroid hormone levels
  3. decreased cortisol levels
  4. increased cortisol levels

Difficulty: 1

Question ID: 7.1-89

Page Ref: 243

Topic: Causal Factors in Bipolar Disorders/Biological Causal Factors

Skill: Factual

Answer: d. increased cortisol levels

 

7.1-90. Stressful life events

  1. do not trigger manic episodes.
  2. appear to increase the time to recovery from a manic episode.
  3. do not generally precipitate an initial manic episode, but tend to play more of a role over time.
  4. play no role in the development or progression of bipolar II disorder.

Difficulty: 1

Question ID: 7.1-90

Page Ref: 244

Topic: Causal Factors in Bipolar Disorders/Psychological Causal Factors

Skill: Factual

Answer: b. appear to increase the time to recovery from a manic episode.

 

7.1-91. A sophisticated prospective study of the role of stressful life events in bipolar disorder by Ellicott, Hammen, and colleagues found that

  1. low levels of stress protected an individual against manic episodes.
  2. stress did not play a lesser role with the occurrence of more episodes.
  3. high levels of stress were not associated with the occurrence of manic or depressive episodes.
  4. low levels of stress protected an individual against depressive episodes.

Difficulty: 1

Question ID: 7.1-91

Page Ref: 244

Topic: Causal Factors in Bipolar Disorders/Psychological Causal Factors

Skill: Factual

Answer: b. stress did not play a lesser role with the occurrence of more episodes.

 

7.1-92. Recent research on relapse among bipolar patients suggests that

  1. stressful life events have very little influence.
  2. personality styles interact with stress to increase the likelihood of relapse.
  3. relapse is most likely among those with unrealistically positive attributional styles.
  4. the more frequently a person has bipolar episodes, the less likely stressful events are able to induce a relapse.

Difficulty: 1

Question ID: 7.1-92

Page Ref: 244

Topic: Causal Factors in Bipolar Disorders/Psychological Causal Factors

Skill: Factual

Answer: b. personality styles interact with stress to increase the likelihood of relapse.

 

7.1-93. Cross-cultural studies of mood disorders are made difficult due to

  1. the variability in the prevalence of bipolar disorders.
  2. the variability in the prevalence of unipolar disorders.
  3. the lack of clear-cut distinctions between bipolar and unipolar disorders.
  4. differences in diagnostic practices.

Difficulty: 2

Question ID: 7.1-93

Page Ref: 244

Topic: Sociocultural Factors Affecting Unipolar and Bipolar Disorders

Skill: Factual

Answer: d. differences in diagnostic practices.

 

7.1-94. Which of the following might explain why rates of depression are low in China and Japan?

  1. Mental illnesses are not stigmatized, thus those who are depressed receive much social support and do not seek treatment.
  2. The heavy emphasis on the individual decreases the likelihood of blaming the self for failure.
  3. Symptoms of depression tend to be discussed as somatic.
  4. Blunted emotions characterize Asian peoples, so both positive and negative emotional extremes are rare.

Difficulty: 2

Question ID: 7.1-94

Page Ref: 244

Topic: Sociocultural Factors Affecting Unipolar and Bipolar Disorders

Skill: Conceptual

Answer: c. Symptoms of depression tend to be discussed as somatic.

 

7.1-95. Selective serotonin reuptake inhibitors

  1. were the first antidepressants to be developed.
  2. are more effective than the tricyclic antidepressants.
  3. may lead to sexual problems.
  4. act to stabilize the mood swings of those with bipolar disorder.

Difficulty: 1

Question ID: 7.1-95

Page Ref: 248

Topic: Treatments and Outcomes/Pharmacotherapy

Skill: Factual

Answer: c. may lead to sexual problems.

 

7.1-96. Jill’s marriage has suffered ever since the birth of her second child. Since the birth, she has been depressed and has had little interest in intimacy with her husband. Jill feels unattractive with the additional weight she carries since the birth and has been rejecting her husband’s advances. After discussing her feelings with Dr. Tora, Dr. Tora has decided to prescribe her an antidepressant. Considering the problems she has been having in her marriage, which of the following is Dr. Tora most likely to prescribe?

  1. imipramine
  2. Prozac
  3. bupropion
  4. venlafaxine

Difficulty: 3

Question ID: 7.1-96

Page Ref: 248-249

Topic: Treatments and Outcomes/Pharmacotherapy

Skill: Applied

Answer: c. bupropion

 

7.1-97. Lithium

  1. is more effective than antidepressants at treating bipolar depression.
  2. has both antimanic and antidepressant effects.
  3. is an anticonvulsant.
  4. is well-tolerated by most bipolar patients.

Difficulty: 1

Question ID: 7.1-97

Page Ref:  248

Topic: Treatments and Outcomes/Pharmacotherapy

Skill: Factual

Answer: b. has both antimanic and antidepressant effects.

 

7.1-98. Quentin is severely depressed and presents an immediate and serious suicidal risk. In the past he has not responded to tricyclics. A wise course of action is to treat him with

  1. Prozac because it can reduce symptoms in 12-24 hours.
  2. electroconvulsive therapy because it can rapidly reduce symptoms.
  3. lithium because suicide is almost always accompanied by manic episodes.
  4. anticonvulsants such as carbamazepine and valproate because they can prevent future depressions.

Difficulty: 1

Question ID: 7.1-98

Page Ref: 249

Topic: Treatments and Outcomes/Alternative Biological Treatments

Skill: Applied

Answer: b. electroconvulsive therapy because it can rapidly reduce symptoms.

 

7.1-99. Transcranial magnetic stimulation

  1. is a biological test for altered brain waves in bipolar disorder.
  2. is a noninvasive biological test for changes in brain function in depression.
  3. is a noninvasive biological treatment for manic episodes.
  4. is a noninvasive biological treatment for depression.

Difficulty: 2

Question ID: 7.1-99

Page Ref: 249

Topic: Treatments and Outcomes/Alternative Biological Treatments

Skill: Factual

Answer: d. is a noninvasive biological treatment for depression.

 

7.1-100. Nadia has been depressed for several months. She is considering cognitive therapy. What advice would you give her?

  1. “Cognitive therapy is much less effective than interpersonal therapy and takes much longer, too.”
  2. “Many studies have shown the usefulness of cognitive therapy and it seems to prevent relapse.”
  3. “Drug treatment is much more effective than cognitive therapy and has less likelihood of relapse.”
  4. “The only way that cognitive therapy is of any value is if it is coupled with family therapy.”

Difficulty: 2

Question ID: 7.1-100

Page Ref: 250

Topic: Treatments and Outcomes/Psychotherapy

Skill: Applied

Answer: b. “Many studies have shown the usefulness of cognitive therapy and it seems to prevent relapse.”

 

7.1-101. Behavior activation treatment

  1. focuses on implementing cognitive changes.
  2. combines pharmacotherapy and behavioral therapy.
  3. combines interpersonal therapy and behavioral methodology.
  4. emphasizes activity and involvement in interpersonal relationships.

Difficulty: 2

Question ID: 7.1-101

Page Ref: 251

Topic: Treatments and Outcomes/Psychotherapy

Skill: Conceptual

Answer: d. emphasizes activity and involvement in interpersonal relationships.

 

7.1-102. Diane’s treatment for depression included training in meditation techniques that helped her become aware of her unwanted negative thoughts and to accept them as just thoughts. She was undergoing

  1. mindfulness-based cognitive therapy.
  2. psychodynamic therapy.
  3. behavioral activation therapy.
  4. transcranial magnetic stimulation.

Difficulty: 2

Question ID: 7.1-102

Page Ref: 251

Topic: Treatments and Outcomes/Psychotherapy

Skill: Applied

Answer: a. mindfulness-based cognitive therapy.

 

7.1-103. One factor that is especially likely to produce depression relapse is

  1. family members ignoring the depressed behavior expressed by the depressed individual.
  2. excessive attention from family members.
  3. family members discussing the depressed individual’s negative thoughts and feelings with him or her.
  4. behavior by a spouse that can be interpreted as criticism.

Difficulty: 2

Question ID: 7.1-103

Page Ref: 252

Topic: Treatments and Outcomes/Psychotherapy

Skill: Factual

Answer: d. behavior by a spouse that can be interpreted as criticism.

 

7.1-104. Which statement about the risk of suicide is true?

  1. Depressed people are no more likely to commit suicide than nondepressed people.
  2. The risk of suicide is greatest at the lowest point in a depression.
  3. About half of people who complete suicide do so in the recovery phase of a depressive episode.
  4. Suicide is most likely when a person in a manic episode is getting “high.”

Difficulty: 1

Question ID: 7.1-104

Page Ref: 252

Topic: Suicide

Skill: Factual

Answer: c. About half of people who complete suicide do so in the recovery phase of a depressive episode.

 

7.1-105. Which of the following is most likely to attempt suicide?

  1. A 25-year-old single man
  2. A 25-year-old single woman
  3. A 25-year-old divorced man
  4. A 25-year-old divorced woman

Difficulty: 2

Question ID: 7.1-105

Page Ref: 253

Topic: The Clinical Picture and the Causal Pattern/Who Attempts and Who Commits Suicide?

Skill: Applied

Answer: d. a 25-year-old divorced woman

 

7.1-106. The majority of individuals who ATTEMPT suicide are ________ and the majority of those who COMPLETE suicide are ________.

  1. women and people between age 18 and 24; men and people over age 65
  2. men and people over age 65; women and people between age 18 and 24
  3. adolescents; the elderly
  4. the elderly; adolescents

Difficulty: 1

Question ID: 7.1-106

Page Ref: 253

Topic: The Clinical Picture and the Causal Pattern/Who Attempts and Who Commits Suicide?

Skill: Factual

Answer: a. women and people between age 18 and 24; men and people over age 65

 

7.1-107. The director of a city health department wants to know who is most likely to complete suicide in her city. The group with the highest risk is

  1. teenagers, especially depressed girls.
  2. elderly men with chronic physical illnesses.
  3. young women who were recently separated or divorced.
  4. college-educated people.

Difficulty: 1

Question ID: 7.1-107

Page Ref: 253

Topic: The Clinical Picture and the Causal Pattern/Who Attempts and Who Commits Suicide?

Skill: Applied

Answer: b. elderly men with chronic physical illnesses.

 

7.1-108. Childhood suicide

  1. is common.
  2. has been declining since the early 1950s.
  3. is the third most common cause of death in the US for 15 to19 year-olds
  4. most commonly is seen in victims of early onset schizophrenia.

Difficulty: 1

Question ID: 7.1-108

Page Ref: 254

Topic: The Clinical Picture and the Causal Pattern/Suicide in Children

Skill: Factual

Answer: c. is one of the top ten causes of death for children in the United States.

 

7.1-109. Which of the following is most likely to attempt, but not complete, suicide?

  1. 14-year-old Joan who has been depressed since her parent’s divorce
  2. Charlie, a 16-year-old with a history of petty crimes
  3. 12-year-old Paul who receives constant rejection from the girls at school and has an overprotective mother
  4. Crystal, a 14-year-old substance abusing teen who has been diagnosed with attention deficit disorder

Difficulty: 1

Question ID: 7.1-109

Page Ref: 254

Topic: The Clinical Picture and the Causal Pattern/Suicide in Adolescents and

Young Adults

Skill: Applied

Answer: a. 14-year-old Joan who has been depressed since her parent’s divorce

 

7.1-110. Melissa is severely depressed and wants to commit suicide. If she is typical of most individuals who commit suicide,

  1. she is determined to kill herself and will choose a lethal means such as a gun to ensure that she is successful.
  2. she is ambivalent about committing suicide.
  3. she will change her mind at the last minute and reexamine her problems in a more objective fashion.
  4. she will show no outward signs of her distress.

Difficulty: 2

Question ID: 7.1-110

Page Ref: 257

Topic: Suicidal Ambivalence

Skill: Applied

Answer: b. she is ambivalent about committing suicide.

 

7.1-111. According to your textbook, which of the following statements is true about the relationship between religion and rate of suicide?

  1. Suicide rates in Catholic countries are high but are low in Islamic countries.
  2. Suicide rates in Catholic countries are low but are high in Islamic countries.
  3. Suicide rates in both Catholic and Islamic countries are low.
  4. Suicide rates in both Catholic and Islamic countries are high.

Difficulty: 2

Question ID: 7.1-110

Page Ref: 257

Topic: Suicidal Ambivalence

Skill: Applied

Answer: c. Suicide rates in both Catholic and Islamic countries are low.

 

Fill-in-the-Blank Questions

 

7.2-1. Two types of mood disorders are __________ and bipolar depressive disorders

Difficulty: 1

Question ID: 7.2-1

Page Ref: 213

Topic: Mood Disorders: An Overview

Skill: Factual

Answer: unipolar

 

7.2-2. The diagnosis of __________ occurs when symptoms are similar to a manic episode but are milder.

Difficulty: 1

Question ID: 7.2-2

Page Ref: 213

Topic: Mood Disorders: An Overview

Skill: Factual

Answer: hypomanic episode

 

7.2-3. A major depressive episode is considered to be __________ when the symptoms do not remit for over 2 years.

Difficulty: 2

Question ID: 7.2-3

Page Ref: 219

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: chronic

 

7.2-4. The hormone __________ has been found to be elevated in most patients hospitalized with major depressive disorder.

Difficulty: 2

Question ID: 7.2-4

Page Ref: 223

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Factual

Answer: cortisol

 

7.2-5. A different kind of depression related to the total amount of light a person receives is often called __________ .

Difficulty: 1

Question ID: 7.2-5

Page Ref: 226

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Factual

Answer: seasonal affective disorder

 

Short Answer Questions

 

7.3-1. What are the four phases of the grieving process?

Difficulty: 1

Question ID: 7.3-1

Page Ref: 215

Topic: Unipolar Mood Disorders/Depressions That Are Not Mood Disorders

Skill: Factual

Answer: The normal response to the loss of spouse or close family member begins with a numbing and disbelief. This is followed by a yearning for the person that may possibly last for months. Eventually, despair is seen and then, finally, some adaptation and reorganization such that life can continue without the departed loved one.

 

7.3-2. What is anaclitic depression?

Difficulty: 2

Question ID: 7.3-2

Page Ref: 219

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Factual

Answer: Anaclitic depression or despair is a form of depression seen in infants separated from their attachment figure for a prolonged period of time. There is some debate, however, as to whether the behavior displayed is merely a normal reaction to loss.

 

7.3-3. What type of psychotic symptoms might be seen in someone suffering from major depression?

Difficulty: 2

Question ID: 7.3-3

Page Ref: 220

Topic: Unipolar Mood Disorders/Major Depressive Disorder

Skill: Applied

Answer: The presence of psychotic symptoms indicate that a break with reality has occurred and involves the presence of hallucinations and/or delusions. The psychotic symptoms seen in depression are mood-congruent, they are symptoms that are consistent with being depressed. The depressed individual, for example, might believe that their friends and family want them dead.

 

7.3-4. What changes in sleep are seen in depression?

Difficulty: 2

Question ID: 7.3-4

Page Ref: 225-226

Topic: Causal Factors in Unipolar Mood Disorders/Biological Causal Factors

Skill: Applied

Answer: Over half of depressed patients experience some form of insomnia. In addition to having problems getting to sleep or staying asleep, the sleep of the depressed is not normal. More time is spent in REM sleep and REM sleep is entered more quickly, leading to a reduction in the amount of time spent in other forms of deep sleep. The observed alterations in sleep suggest a general disturbance in biological rhythms.

 

7.3-5. What are independent and dependent life events? What is their importance?

Difficulty: 2

Question ID: 7.3-5

Page Ref: 227

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal

Factors

Skill: Factual

Answer: Independent – stressful events that are not a result of a person’s behavior or

character, dependent – are a result of those things, at least partly. Dependent events are

especially important in the onset of major depression.

 

7.3-6. Describe the hopelessness theory of depression.

Difficulty: 2

Question ID: 7.3-6

Page Ref: 232

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal

Factors

Skill: Conceptual

Answer: Having a pessimistic attributional style along with negative life events is not enough to produce depression. A state of hopelessness is needed as well. Hopelessness expectancy is the perception that one has no control over a situation that is about to occur as well as an absolute belief that what is going to happen is going to be bad.

 

7.3-7. What is the difference between bipolar I and bipolar II disorder?

Difficulty: 2

Question ID: 7.3-7

Page Ref: 239-240

Topic: Bipolar Disorders/Bipolar Disorders (I and II)

Skill: Factual

Answer: A diagnosis of bipolar I is made when there has been a manic episode. This diagnosis is made with or without the occurrence of a bout of major depression. In bipolar II, there is at least one episode of major depression and a hypomanic episode. If the individual with bipolar II exhibits a manic episode, a diagnosis of bipolar I is warranted.

 

7.3-8. In what way do the symptoms of depression in Western and non-Western societies differ?

Difficulty: 1

Question ID: 7.3-8

Page Ref: 244-245

Topic: Sociocultural Factors Affecting Unipolar and Bipolar

Disorders/Symptoms

Skill: Conceptual

Answer: While the Western constellation of depressive symptoms is primarily psychological, in many cultures the symptoms tend to be more somatic. In those cultures in which there is great stigma associated with mental illness and/or a lack of emotional expressiveness, depression may manifest itself in symptoms such as weight loss, sleep disturbances, and sexual dysfunction. In addition, the feelings of guilt and worthlessness that characterize depression in individualistic cultures may not be seen in more communal cultures.

 

7.3-9. Discuss the risk factors for adolescent suicide.

Difficulty: 2

Question ID: 7.3-9

Page Ref: 254

Topic: The Clinical Picture and Causal Pattern/Suicide in Adolescents and

Young Adults

Skill: Applied

Answer: Mood disorders, conduct disorder and substance abuse all increase the risk of both nonfatal and fatal suicide attempts. If the adolescent has 2 or more of these, the risk for completion of suicide is extremely high. Antidepressant medications slightly increase the risk as well.

 

7.3-10. What are the warning signs of student suicide in college or university?

Difficulty: 2

Question ID: 7.3-10

Page Ref: 255

Topic: Suicide/7.3 Warning Signs for Student Suicide

Skill: Factual

Answer: Marked change in mood and behavior, especially withdrawal, decline in self-esteem, not taking care of personal hygiene, uncharacteristically impulsive behaviors, not attending classes. Many students communicate their impulses. Often the behavior is a reaction to the break-up of a romance.

 

 

Essay Questions

 

7.4-1. What are the two main forms of mood disorder? How are these disorders further characterized?

Difficulty: 1

Question ID: 7.4-1

Page Ref: 213

Topic: Mood Disorders: An Overview

Skill: Factual

Answer: The two main forms of mood disorder are unipolar, in which a person only experiences depression, and bipolar, in which a person has mood swings that range from hypomania or mania to depression. A person with bipolar disorder, however, may not exhibit any depression. The mood disorders are differentiated in terms of severity — the number of areas of life that are impaired and the degree of impairment, and duration — whether the disorder is acute, chronic, or intermittent. In addition, each type of mood disorder is further divided into multiple subtypes. GRADING RUBRIC – 8 points total – 4 points for correct identification, 2 points each for 2 aspects of how they are classified.

 

7.4-2. Discuss Beck’s cognitive theory of depression.

Difficulty: 2

Question ID: 7.4-3

Page Ref: 230

Topic: Causal Factors in Unipolar Mood Disorders/Psychological Causal Factors

Skill: Applied

Answer: Beck’s theory is that thinking preceded and caused depression. First, people hold dysfunctional beliefs that predispose them to depression. These are rigid, extreme, and unhelpful beliefs about the world. They create automatic, negative thoughts that center around the cognitive triad – the self, the world, and the future. Negative beliefs and feelings about the triad are maintained by cognitive errors such as all or none reasoning and arbitrary inference. This theory has been well supported as an explanation for many aspects of depression, but evidence confirming it as a cause of depression is mixed. GRADING RUBRIC – 10 points.

 

7.4-3. Distinguish between cyclothymic disorder, bipolar I disorder and bipolar II disorder. How are these disorders alike and how are they different?

Difficulty: 2

Question ID: 7.4-3

Page Ref: 237-240

Topic: Bipolar Disorders/Cyclothymic Disorder/Bipolar Disorders (I & II)

Skill: Factual

Answer: Cyclothymia is best described as a less severe, yet chronic, version of bipolar disorder. While the individual with bipolar I disorder exhibits a full manic state, the individual with cyclothymia exhibits hypomania. People with bipolar II have full major depressive episodes, people with cyclothymia have depressive symptoms but not full episodes. In cyclothymia the lows and the highs do not rise to the level that is needed for a diagnosis of major depressive episode or manic episode, respectively. The disorders differ in that there need not be any depressive symptoms in bipolar I disorder, although this is usually the case as pure mania is rare. Only bipolar I involves manic episodes. GRADING RUBRIC: 10 points – Descriptions of each disorder 2 points each, note the difference in severity 2, note the major differences 2.

 

Chapter 8: Somatic Symptom and Dissociative Disorders

 

Multiple-Choice Questions

 

8.1-1. Conditions involving physical complaints or disabilities occurring in the absence of any physical pathology that could account for them are

  1. hypochondriacal disorders.
  2. anxiety disorders.
  3. dissociative disorders.
  4. somatic symptom disorders.

Difficulty: 1

Question ID: 8.1-1

Page Ref: 264

Topic: Somatic Symptom and Dissociative Disorders

Skill: Factual

Answer: d. somatic symptom disorders.

 

8.1-2. Individuals with somatic symptom disorders

  1. intentionally fake their illnesses in order to obtain some special treatment.
  2. generally have a physical cause for their illness.
  3. believe that their symptoms are real and serious.
  4. usually have little concern over their state of health.

Difficulty: 1

Question ID: 8.1-2

Page Ref: 264

Topic:  Somatic Symptom and Related Disorders

Skill: Factual

Answer: c. believe that their symptoms are real and serious.

 

8.1-3. Consciously faking symptoms is characteristic of

  1. malingering.
  2. hypochondriasis.
  3. somatization disorder.
  4. somatic symptom disorder.

Difficulty: 1

Question ID: 8.1-3

Page Ref: 264

Topic: What Are Somatic Symptom and Related Disorders

Skill: Factual

Answer: a. malingering.

 

8.1-4. All of the following are diagnosed as somatic symptom disorders EXCEPT

  1. hypochondriasis
  2. somatization disorder
  3. pain disorder
  4. fugue disorder

Difficulty: 1

Question ID: 8.1-4

Page Ref: 265

Topic: Somatic Symptom and Related Disorders

Skill: Factual

Answer: d. fugue disorder

 

8.1-5. Evan is terrified because he is convinced that he has a terminal heart condition. He has consulted with several physicians about it who have found no evidence of any heart disease. Interestingly, Evan continues to feel terrified even when the doctors find no physical problem. His diagnosis is probably

  1. somatization disorder.
  2. pain disorder.
  3. hypochondriasis.
  4. malingering.

Difficulty: 2

Question ID: 8.1-5

Page Ref: 265-266

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Applied

Answer: c. hypochondriasis.

 

8.1-6. John and Ira eat dinner together after work. Several hours later, each starts to feel nausea and stomach pains. John is a hypochondriac, Ira is not. Most likely

  1. both men will think that the food they ate made them sick.
  2. John will think that he has stomach cancer and Ira will think the food he ate made him sick.
  3. John will think the food he ate made him sick and Ira will not think anything at all.
  4. Ira will think he has stomach cancer and John will think the food he ate made him sick.

Difficulty: 1

Question ID: 8.1-6

Page Ref: 265-266

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Applied

Answer: b. John will think that he has stomach cancer and Ira will think the food he ate made him sick.

 

8.1-7. If Ronald is typical of people with hypochondriasis, he will

  1. avoid accepting a psychological explanation for his problems.
  2. avoid visiting a physician.
  3. have bizarre delusions about his body rotting out.
  4. feel relieved when his doctor tells him he is healthy.

Difficulty: 1

Question ID: 8.1-7

Page Ref: 266-267

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Applied

Answer: a. avoid accepting a psychological explanation for his problems.

 

8.1-8. Sara notices a lump on her side. She goes to her physician because she is worried that it is cancer. The physician sends her for a biopsy. During the three weeks between first noticing the lump and getting her results that it is not cancer, Sara was almost unable to function. She felt constant anxiety and thought constantly about having cancer. After she found out that she did not have cancer, Sara felt much better. Sara

  1. has hypochondriasis.
  2. has conversion disorder.
  3. has somatization disorder.
  4. has no mental disorder.

Difficulty: 2

Question ID: 8.1-8

Page Ref: 265-266

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Applied

Answer: d. has no mental disorder.

 

8.1-9. People with hypochondriasis tend to rely on maladaptive thoughts that increase their vulnerability to this somatic symptom issue. Which of the following statements would be an example of those thoughts?

  1. A sore throat is nothing to worry about unless there is a temperature along with it, then it is a big problem.
  2. A sore throat is serious and requires a trip to the doctor. If the doctor tests and finds nothing, it is okay.
  3. A sore throat is a major problem. It could be cancer or some other deadly disease no matter what the doctor says.
  4. A sore throat could be a serious sign of cancer, but it would be important to wait until the doctor says one way or the other before panicking.

Difficulty: 1

Question ID: 8.1-9

Page Ref: 267

Topic: Somatic Symptom and Related Disorders/ Hypochondriasis

Skill: Conceptual

Answer: c. A sore throat is a major problem. It could be cancer or some other deadly disease no matter what the doctor says.

 

8.1-10. According to the revisions made for the DSM-5, most people previously diagnosed with ______________ will be diagnosed with somatic symptom disorder.

  1. hypochondriasis
  2. factitious disorder
  3. somatization disorder
  4. body dysmorphic disorder

Difficulty: 2

Question ID: 8.1-10

Page Ref: 265

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Factual

Answer: a. hypochondriasis

 

8.1-11. Dysfunctional assumptions about symptoms and diseases are a component of a cognitive-behavioral explanation of

  1. hypochondriasis.
  2. dissociative fugue.
  3. somatization disorder.
  4. depersonalization disorder.

Difficulty: 1

Question ID: 8.1-11

Page Ref: 267

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Factual

Answer: a. hypochondriasis.

 

8.1-12. Research on hypochondriasis has shown that people with the disorder tend to

  1. ignore information about illness.
  2. overestimate the dangerousness of diseases.
  3. underestimate the dangerousness of diseases.
  4. overestimate their ability to handle being ill.

Difficulty: 2

Question ID: 8.1-12

Page Ref: 267

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Factual

Answer: b. overestimate the dangerousness of diseases.

 

8.1-13. Response prevention has been used in the treatment of

  1. dissociative identity disorder.
  2. factitious disorder.
  3. malingering.
  4. hypochondriasis.

Difficulty: 3

Question ID: 8.1-13

Page Ref: 267

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Conceptual

Answer: d. hypochondriasis

 

8.1-14. Catastrophizing about minor bodily sensations is characteristic of individuals with both

  1. hypochondriasis and somatization disorder.
  2. hypochondriasis and conversion disorder.
  3. dissociative fugue and somatization disorder.
  4. dissociative fugue and conversion disorder.

Difficulty: 2

Question ID: 8.1-14

Page Ref: 268-269

Topic: Somatic Symptom and Related Disorders/ Somatization Disorder

Skill: Factual

Answer: a. hypochondriasis and somatization disorder.

 

8.1-15. Somatization disorder, as defined in DSM-IV,

  1. has been subsumed into somatic symptom disorder
  2. involves multiple symptoms involving one body part or function.
  3. involves the fear of having multiple different diseases.
  4. involves having pain in at least four different areas of the body.

Difficulty: 2

Question ID: 8.1-15

Page Ref: 268

Topic: Somatic Symptom and Related Disorders/Somatization Disorder

Skill: Factual

Answer: a. has been subsumed into somatic symptom disorder

8.1-16. Somatization disorder and hypochondriasis are similar in that

  1. both think they have a physical disease.
  2. both think that they can easily cope with their symptoms.
  3. both pay more attention to bodily sensations and see them as symptoms.
  4. both react to physical symptoms by becoming more physically active.

Difficulty: 2

Question ID: 8.1-16

Page Ref: 268

Topic: Somatic Symptom and Related Disorders/Somatization Disorder

Skill: Conceptual

Answer: c. both pay more attention to bodily sensations and see them as symptoms.

 

8.1-17. Somatization disorder and hypochondriasis differ because

  1. in somatization disorder, people have physical symptoms involving one body part or function, in hypochondriasis, people are concerned about having an organic disease.
  2. in somatization disorder, people are concerned about having an organic disease, in hypochondriasis, people have physical symptoms involving one body part or function.
  3. in somatization disorder, people are concerned about having an organic disease, in hypochondriasis, people are concerned about multiple different physical symptoms.
  4. in somatization disorder, people are concerned about multiple different physical symptoms, in hypochondriasis, people are concerned about having an organic disease.

Difficulty: 2

Question ID: 8.1-17

Page Ref: 268

Topic: Somatic Symptom and Related Disorders/Somatization Disorder

Skill: Conceptual

Answer: d. in somatization disorder, people are concerned about multiple different physical symptoms, in hypochondriasis, people are concerned about having an organic disease.

 

8.1-18. Dan’s various medical complaints and hospital stays finally led him to psychiatrist. After a thorough medical and psychological evaluation, the twenty-eight-year-old teacher and father of two was diagnosed with both depression and somatization disorder. What is atypical about this case summary?

  1. Such diagnoses are usually made in adolescence.
  2. Somatization disorder is seen much more commonly in women.
  3. Somatization disorder and depression are rarely comorbid disorders.
  4. It is rare for an individual with somatization disorder to marry and have children.

Difficulty: 2

Question ID: 8.1-18

Page Ref: 268

Topic: Somatic Symptom and Related Disorders/Somatization Disorder

Skill: Applied

Answer: b. Somatization disorder is seen much more commonly in women.

 

8.1-19. The most effective treatment to date for somatization disorder

  1. increases psychological distress.
  2. results in only temporary changes in psychological symptoms.
  3. decreases healthcare expenditures.
  4. has not been shown to effect physical functioning.

Difficulty: 2

Question ID: 8.1-19

Page Ref: 269

Topic: Somatic Symptom and Related Disorders/Somatization Disorder

Skill: Factual

Answer: c. decreases healthcare expenditures.

 

8.1-20. Ryan has diabetes but has no trouble functioning. One day, his wife informs him that she is leaving him. Ryan suddenly develops terrible pain in his back, to the point he is unable to get out of bed. His wife agrees to stay for “a while” to take care of him. Ryan probably has

  1. somatization disorder.
  2. pain disorder associated with psychological factors.
  3. pain disorder associated with both psychological factors and a general medical condition.
  4. body dysmorphic disorder.

Difficulty: 2

Question ID: 8.1-20

Page Ref: 269

Topic: Somatic Symptom and Related Disorders/Pain Disorder

Skill: Applied

Answer: b. pain disorder associated with psychological factors.

 

8.1-21. Why is the timeframe of 6 months important in diagnosing pain disorder?

  1. It determines whether the symptoms are acute or chronic
  2. It determines whether the pain is real or imagined
  3. It determines whether the pain is localized or generalized
  4. It determines whether there is a psychological condition present that plays a causal role

Difficulty: 2

Question ID: 8.1-21

Page Ref: 269

Topic: Somatic Symptom and Related Disorders/Pain Disorder

Skill: Factual

Answer: a. It determines whether the symptoms are acute or chronic

 

8.1-22. What would be most helpful to a person with pain disorder?

  1. Staying physically active despite the pain.
  2. Restricting physical activity as much as possible.
  3. Getting a great deal of sympathy and attention.
  4. Being allowed to avoid unpleasant tasks while he or she is in pain.

Difficulty: 2

Question ID: 8.1-22

Page Ref: 269

Topic: Somatic Symptom and Related Disorders/Pain Disorder

Skill: Factual

Answer: a. Staying physically active despite the pain.

 

8.1-23. People with pain disorder tend to

  1. seem indifferent to their symptoms.
  2. have fewer somatic symptoms.
  3. report more pain than people whose somatic symptom pain disorder is related to a medical condition.
  4. be consistent in their report of pain, regardless of the stress they feel.

Difficulty: 1

Question ID: 8.1-23

Page Ref: 270

Topic: Somatic Symptom and Related Disorders/Pain Disorder

Skill: Factual

Answer: b. have fewer somatic symptoms.

 

8.1-24. A new disorder in DSM-5 is:

  1. conversion disorder.
  2. hypochondriasis.
  3. illness anxiety disorder.
  4. somatization disorder.

Difficulty: 1

Question ID: 8.1-24

Page Ref: 270

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: a. conversion disorder.

 

8.1-25. Which of the following was once viewed as form of “hysteria”?

  1. conversion disorder
  2. dissociative identity disorder
  3. dissociative fugue
  4. hypochondriasis

Difficulty: 1

Question ID: 8.1-25

Page Ref: 271

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: a. conversion disorder

 

8.1-26. In what way was Freud’s view of conversion disorder consistent with behavioral theories?

  1. Freud proposed that faulty thinking underlies the symptoms of conversion disorder.
  2. He advocated treating conversion disorder by punishing the problem behaviors.
  3. He believed that the symptoms of conversion disorder were maintained by the relief from anxiety they provided.
  4. Freud believed that those with conversion disorder were suffering bodily symptoms due to a conflict between their inner desires and the demands placed on them by society (the environment).

Difficulty: 2

Question ID: 8.1-26

Page Ref: 271

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Conceptual

Answer: c. He believed that the symptoms of conversion disorder were maintained by the relief from anxiety they provided.

 

8.1-27. The current prevalence of conversion disorder is

  1. decreasing as sophistication about disorders decreases.
  2. increasing as sophistication about disorders increases.
  3. decreasing as sophistication about disorders increases.
  4. not changing.

Difficulty: 2

Question ID: 8.1-27

Page Ref: 272

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: c. decreasing as sophistication about disorders increases.

 

8.1-28. The most common kind of speech-related conversion reaction is

  1. alexia
  2. aphonia
  3. apraxia
  4. alogia

Difficulty: 2

Question ID: 8.1-28

Page Ref: 273

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: b. aphonia

 

8.1-29. What is a pseudoseizure?

  1. A seizure that looks exactly like a seizure on EEG but cannot be explained.
  2. A seizure that resembles an epileptic seizure but is different.
  3. A faking seizure with little thrashing.
  4. Any seizure that cannot be explained.

Difficulty: 2

Question ID: 8.1-29

Page Ref: 273

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: b. A seizure that resembles an epileptic seizure but is different.

 

8.1-30. Which of the following disorders was once the most frequently diagnosed disorder among soldiers in World War I?

  1. acute anxiety disorder
  2. conversion disorder
  3. dissociative identity disorder
  4. hypochondriasis

Difficulty: 2

Question ID: 8.1-30

Page Ref: 272

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: b. conversion disorder

 

8.1-31. Which of the following best explains why conversion disorder is a less common diagnosis today than it was historically?

  1. Advances in the psychiatric profession have decreased the prevalence of all disorders linked to traumatic events.
  2. Those once diagnosed with conversion disorder are now more likely to be diagnosed with PTSD.
  3. Today’s psychiatrists tend to view this diagnosis as one that lacks reliability and validity, thus they are hesitant to even consider it as a diagnostic option.
  4. Advances in the medical field have made patients more sophisticated about medical and psychological disorders.

Difficulty: 2

Question ID: 8.1-31

Page Ref: 272

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Conceptual

Answer: d. Advances in the medical field have made patients more sophisticated about medical and psychological disorders.

 

8.1-32. Following the rejection of his latest novel, Jim experienced an inability to make some movements with his right hand. While he was unable to write, he could scratch and make other simple motions with his affected hand. Two weeks later he was able to write again. What is unique about Jim’s case of conversion disorder?

  1. Jim had some ability to move his hand.
  2. Jim is male, and most people with this disorder are women.
  3. Jim’s symptoms subsided after only two weeks.
  4. Jim only lost the ability to move his right hand.

Difficulty: 2

Question ID: 8.1-32

Page Ref: 272

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Applied

Answer: b. Jim is male, and most people with this disorder are women.

 

8.1-33. Which of the following is a way to distinguish between someone with conversion disorder and someone who is malingering?

  1. People with conversion disorder are very willing to talk about their symptoms, malingerers will be more cautious.
  2. People with conversion disorder will be very cautious about talking about their symptoms, malingerers are very willing to talk about them.
  3. People with conversion disorder are usually very defensive, malingerers will try to seem very open and trusting.
  4. If their symptoms are shown to be inconsistent, people with conversion disorder become very defensive while malingerers do not.

Difficulty: 2

Question ID: 8.1-33

Page Ref: 275-276

Topic: Somatic Symptom and Related Disorders/Distinguishing Somatization, Pain, and Conversion Disorders

Skill: Conceptual

Answer: a. People with conversion disorder are very willing to talk about their symptoms, malingerers will be more cautious.

 

8.1-34. Earl falls at work. The initial medical tests showed no major physical problems. However, Earl calls the next day and tells his boss that he is unable to use his right leg because it is paralyzed. He also informs his boss that he plans to sue the company. Earl most likely

  1. has conversion disorder.
  2. has somatization disorder.
  3. has factitious disorder.
  4. is malingering.

Difficulty: 2

Question ID: 8.1-34

Page Ref: 274-275

Topic: Somatic Symptom and Related Disorders/Distinguishing Somatization, Pain, and Conversion Disorders

Skill: Applied

Answer: d. is malingering.

 

8.1-35. A nurse in an emergency room sees many illnesses and reported illnesses. A group of psychology students are listening to her speak and one asks her what might be one way to tell the difference between a conversion disorder and a true organic disturbance. Which of the following would be a valid answer?

  1. The patient will show some signs of an illness but not enough signs.
  2. The patient will not be able to use muscles that are “damaged.”
  3. The patient shows no signs of atrophy in damaged areas.
  4. The patient shows the signs of illness under hypnosis.

Difficulty: 2

Question ID: 8.1-35

Page Ref: 274-275

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Applied

Answer: c. The patient shows no signs of atrophy in damaged areas.

 

8.1-36. Munchausen’s syndrome by proxy is a variant of which of the following disorders?

  1. conversion disorder
  2. body dysmorphic disorder
  3. hypochondriasis
  4. factitious disorder

Difficulty: 2

Question ID: 8.1-36

Page Ref: 275

Topic: Somatic Symptom and Related Disorders/Distinguishing Somatization, Pain, and Conversion Disorders from Malingering and Factitious Disorder

Skill: Applied

Answer: d. factitious disorder.

 

8.1-37. Alan fell off a ladder at work and claims he is in intense back pain, even though medical tests find nothing wrong. He does not like to talk about it and keeps quiet other than his report to his attorney. Caleb fell off a ladder at work and claims he hurt his back too even though medical tests find nothing wrong. He talks about it all of the time in great detail. Which diagnosis would seem to fit each man?

  1. malingering in Alan and conversion disorder in Caleb
  2. malingering in Alan, factitious disorder in Caleb
  3. factitious disorder in Alan, malingering in Caleb
  4. conversion disorder in Alan, malingering in Caleb

Difficulty: 2

Question ID: 8.1-37

Page Ref: 275

Topic: Somatic Symptom and Related Disorders/ Distinguishing Somatization, Pain, and Conversion Disorders from Malingering and Factitious Disorder

Skill: Conceptual

Answer: a. malingering in Alan and conversion disorder in Caleb

 

8.1-38. Which of the following disorders is characterized by a reluctance to discuss symptoms?

  1. conversion
  2. hypochondriasis
  3. somatic symptom
  4. malingering

Difficulty: 2

Question ID: 8.1-38

Page Ref: 275-276

Topic: Somatic Symptom and Related Disorders/Distinguishing Somatization, Pain, and Conversion Disorders from Malingering and Factitious Disorder

Skill: Factual

Answer: d. malingering

 

8.1-39.  Which disorder would include intentionally taking drugs in order to stimulate various real illnesses?

  1. Munchausen’s syndrome
  2. malingering
  3. dissociative identity disorder
  4. somatization disorder

Difficulty: 1

Question ID: 8.1-39

Page Ref 275

Topic: Somatic Symptom and Related Disorders/Distinguishing Somatization, Pain, and Conversion Disorders from Malingering and Factitious Disorder

Skill: Factual

Answer: a. Munchausen’s syndrome

 

8.1-40. What do the somatic symptom and dissociative disorders have in common?

  1. Both are characterized by physical complaints.
  2. Both are more common in men.
  3. Both appear to be ways of alleviating anxiety.
  4. Both have onset during early childhood.

Difficulty: 2

Question ID: 8.1-40

Page Ref: 276

Topic: Dissociative Disorders

Skill: Factual

Answer: c. Both appear to be ways of alleviating anxiety.

 

8.1-41. Dissociation

  1. only occurs in people with a dissociative disorder.
  2. is a sign that something is seriously wrong.
  3. is extremely common and not necessarily pathological.
  4. is extremely rare and not necessarily pathological.

Difficulty: 2

Question ID: 8.1-41

Page Ref: 276

Topic: Dissociative Disorders

Skill: Factual

Answer: c. is extremely common and not necessarily pathological.

 

8.1-42. After learning of her father’s death, Sophia felt dazed and confused but still retained her sense of self. When speaking of her response to the news, she said she felt like she was in a movie watching the events happening to her. Despite this strange feeling, she understood what was happening and did the things that she needed to do. What can be said of Sophia’s response to her father’s death?

  1. Her response is not typical and suggests that she is suffering from acute stress disorder.
  2. She experienced an instance of derealization.
  3. She had a psychotic break.
  4. She experienced an instance of depersonalization.

Difficulty: 2

Question ID: 8.1-42

Page Ref: 276

Topic: Dissociative Disorders/Depersonalization Disorder

Skill: Applied

Answer: b. She experienced an instance of derealization.

 

8.1-43. The disorder involving the experience of sudden loss of the sense of self is

  1. depersonalization disorder.
  2. psychogenic amnesia.
  3. disidentity disorder.
  4. derealization disorder.

Difficulty: 1

Question ID: 8.1-43

Page Ref: 276

Topic: Dissociative Disorders/Depersonalization Disorder

Skill: Factual

Answer: a. depersonalization disorder.

 

8.1-44. The inability to learn new information is known as

  1. anterograde amnesia.
  2. retrograde amnesia.
  3. continuous amnesia.
  4. generalized amnesia.

Difficulty: 2

Question ID: 8.1-44

Page Ref: 278

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Factual

Answer: a. anterograde amnesia.

 

8.1-45. In soap operas, characters often forget their past experience following some trauma. They don’t merely forget the traumatic event, they forget who they are, where they came from – they lose almost all memory of their lives. They then move to a new place and start a new identity. This would best be described as an instance of

  1. anterograde amnesia.
  2. dissociative fugue.
  3. continuous amnesia.
  4. generalized amnesia.

Difficulty: 2

Question ID: 8.1-45

Page Ref: 279

Topic: Dissociative Disorders

Skill: Applied

Answer: b. dissociative fugue.

 

8.1-46. Although Charlie remembered most of the main issues of the meeting, he had no recollection of the decision to eliminate the department that he headed. Which disorder would be in effect?

  1. dissociative disorder
  2. conversion disorder
  3. factitious disorder
  4. somatic symptom disorder

Difficulty: 2

Question ID: 8.1-46

Page Ref: 279

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Applied

Answer: a. dissociative disorder

 

 

8.1-47. Jeremy suffers from dissociative amnesia. He probably

  1. remembers only events from the past and does not remember skills he learned more recently.
  2. can perform only simple tasks, regardless of the complex work that he was able to do previously.
  3. is able to recognize close friends and relatives but not acquaintances.
  4. had trouble remembering information stored before a traumatic incident.

Difficulty: 2

Question ID: 8.1-45

Page Ref: 278

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Applied

Answer: d. had trouble remembering information stored before a traumatic incident.

 

8.1-48. Jill did not remember the accident happening or her graduation a couple of months ago. What form of memory loss is this characteristic of?

  1. episodic
  2. semantic
  3. retrograde
  4. short term

Difficulty: 2

Question ID: 8.1-48

Page Ref: 278

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Applied

Answer: a. episodic

 

8.1-49. Gerard became amnesic, wandered away from home and assumed a completely new identity as a shoe salesman. He suffers from

  1. dissociative fugue.
  2. dissociative identity disorder.
  3. malingering identity disorder.
  4. depersonalization.

Difficulty: 1

Question ID: 8.1-49

Page Ref: 279

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Applied

Answer: a. dissociative fugue.

 

8.1-50. Assuming a new identity in a new place is characteristic of

  1. depersonalization disorder.
  2. all forms of dissociative amnesia.
  3. dissociative fugue.
  4. dissociative identity disorder.

Difficulty: 2

Question ID: 8.1-50

Page Ref: 279

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Factual

Answer: c. dissociative fugue.

 

8.1-51. Once a dissociative fugue ends, people

  1. can remember everything that has happened to them.
  2. remembers who they are but cannot remember their past.
  3. can remember their past but cannot remember what happened during the fugue.
  4. can remember their past but keep their new identity.

Difficulty: 2

Question ID: 8.1-51

Page Ref: 279

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Factual

Answer: c. can remember their past but cannot remember what happened during the fugue.

 

8.1-52. When a person experiences dissociative amnesia, one main type of memory is usually affected. Which?

  1. Semantic memory (pertaining to language and concepts)
  2. Procedural memory (how to do things)
  3. Perceptual memory (the representation of things in images)
  4. Episodic memory (the events we have experienced)

Difficulty: 1

Question ID: 8.1-52

Page Ref: 279

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Factual

Answer: d. Episodic memory (the events we have experienced)

 

8.1-53. In the study mentioned in the text, the German man who had dissociative fugue denied that he could speak German. However, he learned German-English word pairs much faster than control words. This supports that

  1. mainly episodic memory is lost, implicit memory stays intact.
  2. mainly implicit memory is lost, episodic memory stays intact.
  3. both episodic and implicit memory are affected.
  4. most people with dissociative fugue are faking.

Difficulty: 3

Question ID: 8.1-53

Page Ref: 280

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Conceptual

Answer: a. mainly episodic memory is lost, implicit memory stays intact.

 

8.1-54. Which of the following has been demonstrated about the effects of dissociative amnesias on memory?

  1. Implicit memory is generally intact.
  2. Explicit memory is rarely affected.
  3. Episodic memory is not compromised.
  4. Semantic memory is most dramatically affected.

Difficulty: 1

Question ID: 8.1-54

Page Ref: 280

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Factual

Answer: a. Implicit memory is generally intact.

 

8.1-55. There has been little systematic research conducted on dissociative amnesia and fugue, yet some studies have revealed new information. Which of the following would be a source of this information?

  1. experiments using medication
  2. checking reports from doctors’ offices
  3. testing personality traits of individuals who have experienced these issues
  4. use of different brain imaging methods to determine where loss of function occurs

Difficulty: 3

Question ID: 8.1-55

Page Ref: 279

Topic: Dissociative Disorders/Dissociative Amnesia and Dissociative Fugue

Skill: Conceptual

Answer: d. use of different brain imaging methods to determine where loss of function occurs

 

8.1-56. Dissociative identity disorder was formerly known as

  1. psychogenic amnesia.
  2. multiple personality disorder.
  3. conversion hysteria.
  4. neurasthenia.

Difficulty: 1

Question ID: 8.1-56

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: b. multiple personality disorder.

 

8.1-57. Which of the following is most suggestive of dissociative identity disorder?

  1. Grace’s feelings about James switch from positive to negative instantly.
  2. Peter could not explain why he didn’t complete the project.
  3. Delilah was never able to make up her mind.
  4. Kyla could not recall where she had been or what she had done all day.

Difficulty: 1

Question ID: 8.1-57

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Applied

Answer: d. Kyla could not recall where she had been or what she had done all day.

 

8.1-58. A person with two or more well-developed identities has the disorder called

  1. fugue state.
  2. depersonalization disorder.
  3. dissociative identity disorder.
  4. localized psychogenic amnesia.

Difficulty: 1

Question ID: 8.1-58

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: c. dissociative identity disorder.

 

8.1-59. Which of the following is most commonly true of the host identity in DID?

  1. It does not answer to the person’s actual name.
  2. It is always the most well-adjusted of the identities.
  3. It is the second or third alter to develop.
  4. It is not the original identity.

Difficulty: 2

Question ID: 8.1-59

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: d. It is not the original identity.

 

8.1-60. Which of the following is true of opposite sex alters in DID?

  1. They are rare.
  2. They are quite common.
  3. When they do occur, they usually assume the role of host.
  4. They occur most commonly when sexual abuse has occurred.

Difficulty: 1

Question ID: 8.1-60

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: b. They are quite common.

 

8.1-61. Brigid has been diagnosed with dissociative identity disorder. Brigid is the host personality. We can expect that the alter identities

  1. are very much like Brigid.
  2. are strikingly different from Brigid.
  3. only “come out” when there is no stress in the environment.
  4. are very much like one another.

Difficulty: 1

Question ID: 8.1-61

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Applied

Answer: b. are strikingly different from Brigid.

 

8.1-62 Octavia has been diagnosed with dissociative identity disorder (DID). She has seventeen different “alters,” which are strikingly different from her host personality. Some of her alters are not full personalities, but fragments and memories. Some of the alters are children. What aspect of this case is unusual?

  1. It is unusual for a person with DID to have seventeen alters.
  2. It is unusual for a person with DID to have alters that are very different from the host personality.
  3. It is unusual for a person with DID to have fragmentary alters.
  4. No aspect of this case is unusual.

Difficulty: 2

Question ID: 8.1-62

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Applied

Answer: d. No aspect of this case is unusual.

 

8.1-63. In the individual with DID, “switches” between identities

  1. usually take several days.
  2. produce gaps in memory.
  3. occur symmetrically, such that all identities share equal control.
  4. are controlled by the host identity.

Difficulty: 1

Question ID: 8.1-63

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: b. produce gaps in memory.

 

8.1-64. The text presented the case of Mary Kendall, who suffered from dissociative identity disorder. She is typical of individuals with this disorder in that

  1. she has periods of “lost time.”
  2. she was socially inept as a child.
  3. she was aware of her separate personalities prior to beginning treatment.
  4. she tended to express her emotional distress in complaints about her body.

Difficulty: 2

Question ID: 8.1-64

Page Ref: 282

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Conceptual

Answer: a. she has periods of “lost time.”

 

8.1-65. All of the following are associated with DID except

  1. depression.
  2. hallucinations.
  3. psychosis.
  4. substance abuse.

Difficulty: 2

Question ID: 8.1-65

Page Ref: 281-282

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: c. psychosis.

 

8.1-66. Why has the term “multiple personality disorder” been replaced with “dissociative identity disorder”?

  1. The old term was often used to refer to both schizophrenia and DID, thus a new term was needed to end this confusion.
  2. The word “multiple” suggested the presence of more identities than were commonly observed.
  3. Fully developed personalities are not present in DID, just varying expressions of different aspects of the patient’s personality.
  4. A new diagnostic term was wanted to remove some of the stigma associated with the old term and its presentation in the media.

Difficulty: 2

Question ID: 8.1-66

Page Ref: 281

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Conceptual

Answer: c. Fully developed personalities are not present in DID, just varying expressions of different aspects of the patient’s personality.

 

8.1-67. Recent estimates suggest that about 50 percent of those with DID have

  1. only two identities.
  2. two alters, in addition to the host identity.
  3. over ten identities.
  4. as many as two hundred identities.

Difficulty: 2

Question ID: 8.1-67

Page Ref: 283

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: c. over ten identities.

 

8.1-68. What is one reason why the prevalence of DID has been increasing?

  1. Children in today’s society are far more likely to experience severe trauma than they were in the past.
  2. DID has only recently received full acceptance from the psychiatric community and thus professionals are now using this diagnosis.
  3. As of 1980 most insurance companies had to accept DID as a billable diagnosis.
  4. It may be that the prevalence of DID has not changed at all, but that clinicians may unknowingly encourage the emergence of new identities.

Difficulty: 2

Question ID: 8.1-68

Page Ref: 283

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Conceptual

Answer: d. It may be that the prevalence of DID has not changed at all, but that clinicians may unknowingly encourage the emergence of new identities.

 

8.1-69. Which of the following is an explanation for the increased prevalence of DID?

  1. Increased public awareness of DID.
  2. The increased incidence of verbal abuse.
  3. Changes in the diagnostic criteria for PTSD.
  4. Therapists can seek greater insurance reimbursement for DID patients.

Difficulty: 2

Question ID: 8.1-69

Page Ref: 283

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Applied

Answer: a. Increased public awareness of DID.

 

8.1-70. Experimental studies of DID find that interpersonality amnesia exists for

  1. all types of memories.
  2. explicit memories.
  3. implicit memories.
  4. conditioned responses.

Difficulty: 1

Question ID: 8.1-70

Page Ref: 284

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: b. explicit memories.

 

8.1-71. Studies of the brains of individuals with DID

  1. find no differences in brain activity associated with different identities.
  2. support the assertion that DID is a real disorder.
  3. do not indicate any explanation for interpersonal amnesia.
  4. have provided no consistent findings.

Difficulty: 1

Question ID: 8.1-71

Page Ref: 284

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Conceptual

Answer: b. support the assertion that DID is a real disorder.

 

8.1-72. There is debate as to the relationship between DID and abuse because

  1. few of those who develop DID have a history of abuse.
  2. there is little evidence of a link between trauma and psychopathology.
  3. other factors correlated with abuse may be the true causal factors in DID.
  4. most reports of abuse are faked.

Difficulty: 1

Question ID: 8.1-72

Page Ref: 285

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: c. other factors correlated with abuse may be the true causal factors in DID.

 

8.1-73. According to sociocognitive theory,

  1. the mind separates due to some traumatic experience and is never fully integrated, resulting in the multiple identities observed in DID.
  2. the alters in DID develop as a means of escaping from some form of trauma.
  3. DID has a factitious origin.
  4. DID may develop when a suggestive patient is treated by an overzealous clinician.

Difficulty: 2

Question ID: 8.1-73

Page Ref: 286

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Conceptual

Answer: d. DID may develop when a suggestive patient is treated by an overzealous clinician.

 

8.1-74. Which of the following summarizes the posttraumatic theory for the origin of DID?

  1. Therapists unwittingly reinforce role-playing of alter identities.
  2. Genetically programmed tendencies to dissociate are triggered by stress.
  3. Children deal with severe abuse by creating alters who provide an “escape.”
  4. The rewards of avoiding punishment from the legal system induces people to fake symptoms.

Difficulty: 1

Question ID: 8.1-74

Page Ref: 285

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Conceptual

Answer: c. Children deal with severe abuse by creating alters who provide an “escape.”

 

8.1-75. Sociocognitive theory

  1. explains why symptoms of DID are often not seen until after treatment is initiated.
  2. explains why the number of alters is usually constant.
  3. can’t account for the role that trauma appears to play in DID.
  4. does not explain the phenomenon of “lost time.”

Difficulty: 2

Question ID: 8.1-75

Page Ref: 286

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Conceptual

Answer: a. explains why symptoms of DID are often not seen until after treatment is initiated.

 

8.1-76. A recent in-depth study by Lewis and colleagues of 12 convicted murderers diagnosed with dissociative identity disorder looked into their backgrounds. The study found strong evidence that

  1. each was a pathological liar long before showing signs of dissociative disorder.
  2. disordered thinking was associated with abnormal brain functioning.
  3. each was severely abused, both physically and sexually.
  4. each had vivid memories of being tortured and neglected by strangers.

Difficulty: 2

Question ID: 8.1-76

Page Ref: 287

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Factual

Answer: c. each was severely abused, both physically and sexually.

 

8.1-77. An example of dissociative trance disorder is

  1. a person who enters into a trance state more than once.
  2. a person who believes that he or she can voluntarily be possessed by a spirit and enjoy allowing this to happen.
  3. a person who often feels as though the world around him or her isn’t real, although he or she knows it is.
  4. a person who believes he or she is at times possessed by a spirit and is extremely upset because of this.

Difficulty: 2

Question ID: 8.1-77

Page Ref: 288

Topic: Dissociative Disorders/Sociocultural Factors in Dissociative

Disorders

Skill: Factual

Answer: d. a person who believes he or she is at times possessed by a spirit and is extremely upset because of this.

 

8.1-78. When it comes to the effectiveness of treatment for dissociative disorders, we know

  1. very little.
  2. that medications are worthless, but that psychotherapy is quite effective.
  3. that depersonalization is much more effectively treated than amnesia.
  4. that antidepressant medications are most effective in treating dissociative identity disorder.

Difficulty: 1

Question ID: 8.1-78

Page Ref: 288

Topic: Dissociative Disorders/Treatment and Outcomes

Skill: Factual

Answer: a. very little.

 

8.1-79. The treatment goal for most therapists who treat dissociative identity disorder is

  1. acceptance of the alter personalities.
  2. reduction in the impact of distress and impairment.
  3. integration of the alter personalities.
  4. self-understanding of the causes for the alter personalities.

Difficulty: 1

Question ID: 8.1-79

Page Ref: 289

Topic: Dissociative Disorders/Treatment and Outcomes

Skill: Factual

Answer: c. integration of the alter personalities.

 

8.1-80. Your textbook authors report that rigorously designed and controlled studies on the treatment of dissociative identity disorder

  1. have only examined psychodynamic forms of treatment.
  2. are widespread.
  3. demonstrate the effectiveness of cognitive-behavior therapy.
  4. are nonexistent.

Difficulty: 1

Question ID: 8.1-80

Page Ref: 289

Topic: Dissociative Disorders/Treatment and Outcomes

Skill: Factual

Answer: d. are nonexistent.

 

 

Fill-in-the-Blank Questions

 

8.21. When a person intentionally produces symptoms and is motivated by incentives, this is known as __________ .

Difficulty: 1

Question ID: 8.2-1

Page Ref: 266

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Factual

Answer: malingering

 

8.2-2. ______________is the disorder in the DSM-5 used to replace  hypochondriasis without somatic symptoms.

Difficulty: 1

Question ID: 8.2-2

Page Ref: 270

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Factual

Answer: Illness anxiety disorder

 

8.2-3. _____________ is the disorder in which a person has many different physical symptoms from different areas of the body and the symptoms cannot be explained by medical findings.

Difficulty: 1

Question ID: 8.2-3

Page Ref: 265

Topic: Somatic Symptom and Related Disorders/Somatization Disorder

Skill: Factual

Answer: Somatic symptom disorder

 

8.2-4. ____________is the diagnosis given when a person has persistent and severe pain in one or more areas of the body, and it is not feigned or does not have medical causes.

Difficulty: 1

Question ID: 8.2-4

Page Ref: 269

Topic: Somatic Symptom and Related Disorders/Pain Disorder

Skill: Factual

Answer: Pain disorder

 

8.2-5.  Pain disorder is easier to treat than somatization disorder because it is less ______.

Difficulty: 1

Question ID: 8.2-5

Page Ref: 270

Topic: Somatic Symptom and Related Disorders/Pain Disorder

Skill: Factual

Answer: complex

 

8.2-6. ______ involves a pattern in which symptoms or deficits affecting the senses or motor behavior strongly suggest that the patient has a medical or neurological condition.

Difficulty: 1

Question ID: 8.2-6

Page Ref: 270

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: Conversion disorder

Short Answer Questions

 

8.31. Explain the difference between somatic symptom and dissociative disorders. Why are these disorders commonly considered at the same time?

Difficulty: 1

Question ID: 8.3-1

Page Ref: 276

Topic: Dissociative Disorders

Skill: Conceptual

Answer: Somatic symptom disorders are characterized by physical complaints, thought to be manifestations of some psychological problem. In contrast, dissociative disorders involve some separation of the functioning of consciousness, memory, identity, or perception. Again, the underlying cause for the observed distortions is some psychological abnormality. Both were once classified as neuroses and are thought to have anxiety as their underlying cause.

 

8.3-2. How do people with hypochondriasis typically relate to physicians?

Difficulty: 2

Question ID: 8.3-2

Page Ref: 266

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Applied

Answer: They repeatedly visit physicians seeking medical advice, but their concerns that they have a dread illness are not reduced when the doctors find nothing wrong. In fact, they often are disappointed that no physical problem has been found.

 

8.3-3. Discuss two of the causal factors of hypochondriasis.

Difficulty: 2

Question ID: 8.3-3

Page Ref: 266-267

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Factual

Answer: 1. Misinterpretations of bodily sensations – overfocus on symptoms, perceiving them as more dangerous than they are, look for confirming evidence and discount disconfirming evidence. 2. Dysfunctional beliefs about themselves – believe will be unable to cope with illness, see self as weak and unable to tolerate exercise. 3. Secondary reinforcements – current and past history – special comfort, relieved of responsibilities.

 

8.3-4. Briefly describe somatization disorder.

Difficulty: 1

Question ID: 8.3-4

Page Ref: 268

Topic: Somatic Symptom and Related Disorders/Somatization Disorder

Skill: Factual

Answer: Somatization characterized by multiple complaints of physical ailments over a long period of time, with onset before the age of thirty. These physical symptoms cannot be adequately explained by organic causes and result in either medical treatment or significant life impairment. The patient must report pain symptoms at different sites or involving different functions, two gastrointestinal symptoms, one sexual symptom, and one pseudoneurological symptom such as memory problems or loss of sensation.

 

8.3-5. Explain the difference between somatization disorder and hypochondriasis.

Difficulty: 2

Question ID: 8.3-5

Page Ref: 267-268

Topic: Somatic Symptom and Related Disorders/Hypochondriasis

Skill: Conceptual

Answer: Only people with hypochondria believe they have an organic disease. People with hypochondria usually have only a few symptoms, people with somatization disorder have multiple symptoms.

 

8.3-6. Can a person who has an actual medical condition be diagnosed with pain disorder? Why or why not?

Difficulty: 2

Question ID: 8.3-6

Page Ref: 269

Topic: Somatic Symptom and Related Disorders/Pain Disorder

Skill: Applied

Answer: In pain disorders, pain reports that are out of proportion to an established medical condition that might cause some pain. Another type is when there is no medical condition or its existence is of minimal causal significance in the pain complaint. But psychological factors must be important.

 

8.3-7. Distinguish between the primary and secondary gains experienced by those with conversion disorder.

Difficulty: 2

Question ID: 8.3-7

Page Ref: 271

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Conceptual

Answer: Primary gains refer to the alleviation of anxiety or avoidance of stressful situations that results from the conversion symptoms. External “rewards” for the physical complaints experienced are those external factors that maintain the behaviors, such as sympathy and extra attention.

 

8.3-8. What factors tend to be associated with the onset of conversion disorder?

Difficulty: 2

Question ID: 8.3-8

Page Ref: 271-272

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: An individual typically experiences an intolerable stressor. Conversion symptoms then develop and provide an escape from the unwanted situation, although the individual sees no connection between the situation and the symptoms. Guilt, self-punishment, and the opportunity for financial compensation following injury are also associated with the origin of conversion disorder.

 

8.3-9. What are some ways to distinguish between conversion disorder and a true physical problem?

Difficulty: 2

Question ID: 8.3-9

Page Ref: 274-275

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: Symptoms don’t conform to the normal symptoms of the disorder, the selective nature of the dysfunction and symptoms can be changed under hypnosis.

 

8.3-10. What is the difference between malingering and factitious disorder?

Difficulty: 2

Question ID: 8.3-10

Page Ref: 274-275

Topic: Somatic Symptom and Related Disorders/Conversion Disorder

Skill: Factual

Answer: Both disorders involve the conscious faking of physical symptoms. The malingerer, however, has a clear reason for the faked symptoms, while the individual with factitious disorder apparently is making complaints for no apparent external cause. The child who feigns illness to miss school is malingering, while the teen who adopts the “sick role” for the attention he gains may meet the diagnostic criteria for factitious disorder.

 

8.3-11. What is the main goal of treatment for DID?

Difficulty: 2

Question ID: 8.3-11

Page Ref: 289

Topic: Dissociative Identity Disorder/Treatment and Outcomes in Dissociative Disorders

Skill: Conceptual

Answer: The goal of treatment in DID is usually the reintegration of the alters. As

DID develops due to a dissociation of aspects of the self, a true remission would

involve a complete integration of the various identities into a cohesive whole.

Hypnosis is commonly used in an attempt to achieve this goal.

 

 

Essay Questions

 

8.4-1. Explain the similarities and the difference between conversion disorder, factitious disorder, and malingering.

Difficulty: 2

Question ID: 8.4-1

Page Ref: 274-276

Topic: Somatic Symptom and Related Disorders/Distinguishing Somatization, Pain, and Conversion Disorders from Malingering and Factitious Disorder

Skill: Conceptual

Answer: Similarities – all involve physical symptoms with no physical cause. All involve some gain. Differences – only in conversion disorder are the symptoms involuntary, in factitious and malingering the person is consciously faking. While all can involve gain, the main type of gain is different. In conversion disorder the main gain is avoiding or escaping a stressful situation without taking responsibility for doing so. In factitious disorder, the person enjoys the sick role. In malingering, the gain is typically monetary, e.g. a law suit. GRADING RUBRIC – 10 points – 4 for similarities, 6 for differences.

 

8.4-2. Describe the three diagnostic criteria for excessive thoughts, feelings, or behavior related to somatic symptoms that the DSM-5 identifies  for a diagnosis of Somatic Symptom Disorder.

Difficulty: 3

Question ID: 8.4-2

Page Ref: 265

Topic: Somatic Symptom and Related Disorders

Skill: Factual

Answer:

The focus in DSM-5 is on there being at least one of the following three

features: (1) disproportionate and persistent thoughts about the

seriousness of one’s symptoms; (2) persistently high level of anxiety

about health or symptoms; and/or (3) excessive time and energy

devoted to these symptoms or health concerns GRADING RUBRIC – 6 points, 2 for each criteria

 

8.4-3. What is dissociative fugue? Under what circumstances is this disorder likely to develop?

Difficulty: 1

Question ID: 8.4-3

Page Ref: 278-279

Topic: Dissociative Disorders/Dissociative Amnesia and

Dissociative Fugue

Skill: Factual

Answer: Dissociative fugue has been described as a walking amnesia. In this form of amnesia, an individual not only forgets his or her history, but he or she also leaves. The individual with dissociative fugue may actually leave his or her home and begin a new life elsewhere with a new identity. Such an extreme means of dealing with anxiety is most commonly seen when faced with a situation that both intolerable and inescapable. GRADING RUBRIC – 4 points for explaining disorder, 2 points for identifying when it occurs.

 

8.4-4. Discuss the various controversies surrounding the role of abuse in the development of DID. What evidence is there to suggest that abuse does play a causal role in DID?

Difficulty: 2

Question ID: 8.4-4

Page Ref: 283-286

Topic: Dissociative Disorders/Dissociative Identity Disorder

Skill: Conceptual

Answer: While a history of abuse is often reported by those diagnosed with DID, it can only be said that abuse may play a nonspecific causal role on the development of DID. While abuse is common in those with DID, there are many other environmental factors that may accompany an abusive situation that may play a more significant role in DID. Furthermore, if abuse were the true “cause” of DID, it would be expected that DID would be even more common than it is. There is also the possibility that many of the reported cases of abuse by those with DID may not have actually occurred. Thus, while abuse is often frequently reported by those with DID, the conclusion that abuse plays a causal role is not warranted. GRADING RUBRIC – 10 points – 2 for stating that abuse can’t be said to play a causal role, 4 points each for two explanations of this conclusion.

 

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