Psychopathology Exam 2

Quiz 5-8

After thinking, “What if I accidentally caused someone to become ill?” Maya repeatedly asks her family members to reassure her that she did nothing wrong. In this example, the reassurance seeking is best understood as:

a compulsion because the behavior is used to reduce distress associated with the intrusive concer

Alex repeatedly washes his hands after touching objects in public because he is afraid of becoming contaminated. Which statement best describes the relationship between the obsession and compulsion?

The washing is performed to reduce distress associated with the intrusive contamination concern.

Which behavior is least consistent with the symptom pattern of OCD?

Organizing a desk because the person enjoys having a neat workspace

Sam spends several hours each day performing rituals and believes the rituals are necessary, but reports little emotional distress about them. Which consideration is most important when determining whether the symptoms may meet criteria for OCD?

Whether the symptoms are time-consuming, cause clinically significant distress, or interfere with functioning

Chris occasionally has a thought about accidentally harming a family member and finds the thought disturbing. Which feature would most strongly support classifying the thought as an obsession?

The thought is intrusive, unwanted, and causes significant distress.

A person repeatedly performs a ritual that has no realistic connection to preventing the feared event, but the ritual briefly reduces distress. Which explanation best fits the behavior?

The temporary reduction in distress can help maintain the compulsive behavior.

A baseball player taps the bat three times before every at-bat and reports no distress when unable to do so. Which feature would most clearly distinguish this ritual from an OCD-related compulsion?

The ritual does not cause significant distress or interfere with functioning.

According to the course materials, body dysmorphic disorder occurs at substantially higher rates in some clinical populations than in the general population. Which range is reported for people seeking outpatient care for OCD, social phobia, and other disorders?

Approximately 10–40%

A person with body dysmorphic disorder repeatedly seeks cosmetic procedures to correct a perceived physical flaw but remains dissatisfied with the same feature after each procedure. Which explanation best accounts for this pattern?

Cosmetic procedures are unlikely to resolve the problem because the person's distress is driven primarily by the preoccupation with the perceived flaw rather than the physical feature itself.

A 15-year-old becomes increasingly preoccupied with a minor facial imperfection and begins checking mirrors repeatedly. Why is adolescence a particularly common period for body dysmorphic disorder to develop?

Concerns about physical appearance commonly become especially prominent during adolescence.

A person with body dysmorphic disorder insists that a barely noticeable facial feature is severely deformed, despite reassurance from others. Which statement best describes the role of insight in body dysmorphic disorder?

Poor or absent insight can occur, so the person may be convinced that the perceived flaw is genuinely severe

Which finding best distinguishes hoarding disorder from simply having a large collection of possessions?

The person has persistent difficulty discarding items and the accumulation compromises living spaces.

Which statement about hoarding disorder is consistent with the course materials?

It affects approximately 2–5% of adults and symptoms may worsen with age.

What is the most direct distinction between trichotillomania and excoriation disorder?

Trichotillomania involves hair pulling, whereas excoriation disorder involves skin picking.

When distinguishing among OCD, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder, which feature is most useful?

The focus of the preoccupation or repetitive behavior and its relationship to distress or impairment

While watching television, a person suddenly notices that they have been pulling hair without having consciously decided to do so. Which pattern of hair pulling does this example best illustrate?

Automatic hair pulling

Which hypothesis has been proposed to help explain why excoriation disorder may occur or persist?

Skin picking may function as a coping response to elevated turmoil, arousal, or stress.

Why can repetitive behaviors in OCD be difficult to change even when the person recognizes that they interfere with daily life?

The behaviors can provide short-term relief even when they contribute to long-term impairment.

Which situation best illustrates the difference between acute and chronic stress?

A person experiences a sudden car accident, while another experiences financial insecurity for several years.

Two employees have similar workloads, but one has very little control over how the work is performed. Which concept best captures this combination of demands and limited control?

Job strain

Research examining the effects of desirable and undesirable life events has suggested that:

Undesirable or negative events may be more strongly associated with poor outcomes such as depression than desirable or positive events.

Which explanation is most consistent with the course materials for how early adversity may contribute to later health problems?

Early adversity can affect developing brain, hormonal, and immune systems involved in regulating responses to stress.

What pattern has been found between the number of adverse childhood experiences (ACEs) and later health and psychological problems?

Greater numbers of ACEs are associated with greater risk for a range of physical and psychological problems, with risk generally increasing as ACE exposure increases.

According to the course materials, which statement best describes things that may help reduce the effects of ACE-related stress responses later in life?

Supportive relationships and adaptive stress-management strategies may help calm stress responses and, over time, downregulate the HPA axis.

Compared with many other psychiatric disorders, the risk of suicide among people with body dysmorphic disorder is:

Elevated, with people with BDD showing a high risk for suicidal thoughts and behaviors.

Research comparing exposure-based treatments with present-centered therapy (PCT) for PTSD suggests that the treatments differ in their short- and long-term outcomes. Which statement best reflects these findings?

Exposure-based treatments generally produce faster improvement, but longer-term outcomes can be similar, while PCT has somewhat lower dropout rates.

Paul's spouse died 14 months ago. He experiences persistent yearning for his spouse, feels that part of his identity died with his spouse, feels that life is meaningless without his spouse, and has become disconnected from others. These symptoms are causing substantial impairment and exceed what would be expected given his cultural context. Which diagnosis should be considered?

Prolonged grief disorder

Which statement best captures the distinction among PTSD, acute stress disorder, and adjustment disorder?

PTSD and acute stress disorder require traumatic exposure, whereas adjustment disorder involves an identifiable stressor that does not have to be traumatic.

A person develops trauma-related symptoms three weeks after a serious assault. She has intrusive memories, nightmares, avoidance, hypervigilance, sleep problems, and several dissociative symptoms. She has at least nine qualifying symptoms overall. Which diagnosis best fits this presentation?

Acute stress disorder

During ERP, a person touches an object she considers contaminated and does not wash her hands afterward. Her anxiety remains high for several minutes. What does this tell the therapist about whether the exposure is working?

The exposure may still produce therapeutic learning even though anxiety remains elevated.

Which statement best describes the inhibitory learning model of exposure?

Exposure creates new learning that competes with previously learned fear associations.

A person with PTSD is considering EMDR. Which statement is most consistent with the assigned video?

EMDR has been shown to improve PTSD symptoms, although there is debate about whether the eye movements themselves provide a unique therapeutic benefit.

Which of the following situations would not meet the type of traumatic exposure required for PTSD or acute stress disorder?

A person learns that a close friend died suddenly from a heart attack.

Why does response prevention play an important role in exposure and response prevention for OCD?

It prevents short-term anxiety reduction from continuing to reinforce compulsive behaviors.

Six days after being seriously injured in a workplace accident, Jordan reports recurrent distressing memories, nightmares, avoidance of the workplace, emotional detachment, difficulty experiencing positive emotions, irritability, exaggerated startle, and difficulty sleeping. The symptoms are interfering with his ability to work. Which diagnosis is most consistent with this presentation?

Acute stress disorder

Which feature most clearly distinguishes acute stress disorder from PTSD?

Acute stress disorder requires at least 9 symptoms from any combination of symptom categories.

Research on genetic vulnerability to PTSD has found that some of the genetic influences associated with PTSD overlap with genetic influences associated with other mental disorders. Which group of disorders was identified as sharing this genetic vulnerability?

Major depressive disorder, anxiety disorders, and panic disorder

A client with PTSD is reluctant to participate in an exposure-based treatment that requires detailed discussion of the trauma. Her therapist instead uses a treatment that focuses on recognizing PTSD symptoms, keeping track of current problems, and developing ways to address difficulties in daily life. Which treatment is being described?

Present-centered therapy

Maya witnessed a serious motor-vehicle accident six weeks ago. Since the accident, she has had recurrent distressing memories and nightmares about what happened. She avoids driving and refuses to discuss the accident. She has developed persistent beliefs that the world is dangerous, feels detached from people she used to be close to, and has difficulty experiencing positive emotions. She is also constantly on guard, is easily startled, and has difficulty sleeping. These symptoms are causing significant problems at work and in her relationships.

Which symptom cluster is represented by Maya's persistent beliefs that the world is dangerous, feeling detached from people she used to be close to, and difficulty experiencing positive emotions?

Negative changes in cognition and mood

Daniel witnessed a violent assault three months ago. Since then, he has experienced recurrent intrusive memories of the assault and makes a deliberate effort to avoid places and conversations that remind him of it. He also has difficulty sleeping, is easily startled, and feels constantly on guard. He reports that these symptoms interfere with his work and relationships. However, he does not report any other symptoms. Which is the most appropriate conclusion based on the information provided?

Daniel does not meet full criteria for PTSD because the negative cognition/mood cluster is not represented.

A student avoids giving presentations because she believes she cannot tolerate the anxiety that comes with speaking in front of others. According to the ERP material, what is one reason avoidance can maintain anxiety?

Avoidance prevents the person from learning that the feared situation can be tolerated.

After being laid off from a job she had held for 12 years, Elena begins experiencing persistent anxiety, frequent crying, and difficulty concentrating. She is increasingly withdrawn from friends and has been struggling to keep up with responsibilities at home. Her symptoms began about six weeks after she lost her job and have caused significant problems in her daily life. Which diagnosis is most consistent with Elena's presentation?

Adjustment disorder

After being seriously injured in a workplace accident, Jordan reports recurrent distressing memories, nightmares, avoidance of the workplace, emotional detachment, difficulty experiencing positive emotions, irritability, exaggerated startle, and difficulty sleeping. The symptoms are interfering with his ability to work.

Suppose Jordan's symptoms continue for six weeks. Which diagnosis would be most appropriate?

Post-traumatic stress disorder

Maya witnessed a serious motor-vehicle accident six weeks ago. Since the accident, she has had recurrent distressing memories and nightmares about what happened. She avoids driving and refuses to discuss the accident. She has developed persistent beliefs that the world is dangerous, feels detached from people she used to be close to, and has difficulty experiencing positive emotions. She is also constantly on guard, is easily startled, and has difficulty sleeping. These symptoms are causing significant problems at work and in her relationships. Which diagnosis is most consistent with Maya's presentation?

Post-traumatic stress disorder

Why is cultural context particularly important when evaluating whether a person's response to a stressor is disproportionate?

Cultural factors can influence how distress is expressed and what responses are considered expected.

Following a traumatic event, a person becomes unusually watchful for danger, reacts intensely to unexpected noises, and has difficulty sleeping. These symptoms are most characteristic of which PTSD cluster?

Changes in arousal and reactivity

Which approach would be most consistent with an effective psychological treatment for OCD in a person who becomes extremely anxious when touching objects they believe may be contaminated?

Help the person gradually face feared situations while reducing reliance on compulsive behaviors.

A person notices that thinking about a traumatic experience brings up intense fear and distress. They avoid places, activities, and conversations that remind them of what happened. Which statement best describes the likely long-term effect of this pattern?

Avoiding trauma reminders reduces distress in the short term, which reinforces avoidance and prevents the person from learning that they can tolerate the associated thoughts and feelings.

Which of the following is NOT identified as a factor associated with heightened risk for developing PTSD following exposure to a traumatic event?

Being male

A person meets criteria for acute stress disorder following a traumatic event. Which statement about the relationship between acute stress disorder and PTSD is most accurate?

People with acute stress disorder are at increased risk for PTSD, but ASD does not necessarily develop into PTSD.

A parent spends hours worrying that her teenager will be injured while out with friends. When the teenager returns safely, the parent concludes that her worrying helped prevent something bad from happening. What process may help maintain this pattern of worry?

Reinforcement when the feared outcome does not occur

Which of the following is NOT identified as a potential cause or contributing factor for separation anxiety disorder?

Experiencing difficulty adjusting to changes in daily routines

A 30-year-old reports excessive worry about health, finances, work, and family for four months. She has difficulty controlling the worry and reports restlessness, irritability, and muscle tension. Which additional information would be most important before diagnosing GAD?

Whether the worry has persisted for at least six months

Which statement best describes the prevalence of specific phobia in the US reported in the reading?

About 8.7% experience it within a one-year period

A therapist asks a client with a specific phobia to gradually approach increasingly difficult situations involving the feared stimulus rather than continuing to avoid it. Which treatment principle is being used?

Exposure

Which general statement about anxiety disorders is supported by the reading?

Approximately 25–30% of the U.S. population meets criteria for at least one anxiety disorder during their lifetime

Which of the following is true regarding medication and cognitive-behavioral therapy (CBT) for anxiety disorders?

Both medication and CBT can reduce anxiety, but CBT tends to produce more durable treatment effects.

A client notices a rapid heartbeat after climbing stairs and immediately thinks, “I am having a heart attack.” The thought increases fear, which increases the client's physical sensations. Which process is illustrated?

Catastrophic interpretation of bodily sensations

A client has worried for eight months about work performance, finances, the health of family members, and everyday responsibilities. The worry is difficult to control and is accompanied by muscle tension, irritability, and poor sleep. Which diagnosis best fits this pattern?

Generalized anxiety disorder

Which finding would most strongly distinguish an isolated panic attack from panic disorder?

The attack is followed by at least one month of concern or maladaptive behavioral change

A person with a blood-injection-injury phobia becomes pale and feels faint when seeing a needle. Which feature distinguishes this type of phobia from many other phobias?

The person experiences a marked decrease in heart rate and blood pressure rather than the increased physiological arousal typically associated with fear.

A child has never been bitten by a spider but develops a strong fear after repeatedly watching an older sibling react fearfully whenever a spider appears. Which learning pathway is illustrated?

Vicarious learning through modeling

A seven-year-old becomes extremely distressed whenever separated from a parent, worries that the parent will be harmed, refuses to sleep away from the parent, and complains of stomachaches before school. Which diagnosis best fits?

Separation anxiety disorder

A person with social anxiety cannot avoid a work meeting, so she sits in the back, avoids eye contact, rehearses every sentence silently, and asks others questions to keep attention away from herself. What do these behaviors illustrate?

Safety behaviors

A client has recurrent unexpected panic attacks and interprets normal bodily sensations as signs of serious physical danger. Which brain region and neurotransmitter are specifically implicated in the biological account of panic disorder?

Locus coeruleus and norepinephrine

Which neurotransmitters are associated with anxiety?

GABA, serotonin, and norepinephrine are all implicated in anxiety

A patient with panic disorder is prescribed a medication that rapidly reduces acute anxiety symptoms. The clinician discusses tolerance and dependence and plans to use the medication for a limited period. Which medication class is most consistent with this description?

Benzodiazepines

A person avoids shopping malls, buses, and large outdoor events. The person is not primarily afraid of crowds themselves but worries that if panic-like symptoms occur, leaving or obtaining help would be difficult. Which diagnosis is most consistent with this pattern?

Agoraphobia

A client has persistent fear of flying and avoids air travel. During a flight, the client sometimes experiences panic attacks, but the fear is specifically tied to flying. Which diagnosis best fits the pattern?

Specific phobia

A child with selective mutism also has marked fear of being evaluated negatively by classmates. Which relationship between the two conditions is supported by the reading?

Selective mutism is very strongly associated with social anxiety disorder

Which statement best reflects the relationship between socioeconomic status and anxiety described in the reading?

Low socioeconomic status may itself create stress while mental illness can also make economic circumstances worse

Which of the following correctly compares the lifetime prevalence of experiencing a panic attack with the lifetime prevalence of panic disorder?

Approximately 23% of people experience a panic attack, compared with 4.7% who meet criteria for panic disorder.

A researcher compares how readily children learn fears of spiders versus flowers after the stimuli are paired with an aversive event. The children more readily develop fear of spiders. Which concept best explains this finding?

Prepared learning

Why can safety behaviors maintain social anxiety even though they may reduce anxiety during a social interaction?

They prevent the person from learning that feared negative outcomes may not occur

Alex has GAD and spends much of the evening worrying about work, finances, family members' health, and other everyday responsibilities. When an upcoming work presentation is added to these concerns, Alex spends hours imagining everything that could go wrong. After repeatedly thinking through possible problems, Alex feels somewhat more prepared and less vulnerable to an unexpected outcome. Which explanation of worry best fits Alex's pattern?

Worry provides a sense of control over uncertain outcomes.

Two people describe experiences that differ from typical expectations about gender. One identifies as transgender and is comfortable with their identity. The other experiences persistent distress related to incongruence between their experienced gender and sex assigned at birth. Which interpretation best reflects the diagnostic framework discussed in class?

The second person's distress may be relevant to gender dysphoria, whereas transgender identity alone does not establish the diagnosis.

A person reports low sexual desire that has persisted for eight months and causes significant personal distress. Their partner reports being dissatisfied with the frequency of sexual activity as well. Which conclusion is most appropriate?

The duration and distress warrant assessment, but the clinician must also evaluate the specific symptom pattern and possible contributing factors.

A person has difficulty obtaining and maintaining an erection in most sexual encounters. The problem has persisted for seven months and causes distress. Which additional information would be particularly relevant to the assessment?

Whether medical conditions, medications, or other contextual factors may explain or contribute to the symptoms.

A person reports persistent pain during attempted vaginal penetration, anticipatory fear of pain, and involuntary tightening of pelvic-floor muscles. The symptoms have lasted several months and cause distress. Which diagnosis best fits the symptom pattern?

Genito-pelvic pain/penetration disorder.

A person reports reaching orgasm much less frequently than they would like. Another person reports ejaculation occurring sooner than desired during partnered sexual activity. Which principle is most useful in distinguishing the relevant diagnoses?

The clinician should identify the specific aspect of sexual response affected and assess its duration, frequency, and clinical significance.

Two people report substantially different levels of interest in sexual activity. One is distressed by a persistent change in their own desire; the other is comfortable with their level of interest but experiences conflict with a partner. Which distinction is most important?

A clinician should distinguish the individual's own symptoms and distress from dissatisfaction arising primarily from differences between partners.

An adult couple engages in consensual activities involving dominance, submission, and physical restraint. Neither person reports clinically significant distress or impairment related to these activities. Which interpretation is most appropriate?

The activities alone do not establish a paraphilic disorder; the relevant diagnostic criteria and context must be considered.

A 22-year-old repeatedly experiences intense sexual arousal from secretly observing unsuspecting people who are naked or undressing. The person has engaged in this behavior over the past eight months and reports no distress or impairment related to the urges. Which statement best describes the diagnostic criteria for voyeuristic disorder?

The person can meet criteria because acting on the urges involving a nonconsenting person can satisfy the additional criterion, even without distress or impairment.

A 25-year-old experiences recurrent, intense sexual arousal from exposing their genitals to unsuspecting strangers. The pattern has persisted for eight months. Which diagnosis best fits the person's reported pattern of sexual arousal?

Exhibitionistic disorder, because the arousal involves exposing one's genitals to unsuspecting people.

A person repeatedly experiences sexual arousal from touching or rubbing against nonconsenting people in crowded public places. Which diagnosis most directly corresponds to the focus of the arousal?

Frotteuristic disorder.

A person reports recurrent, intense sexual arousal involving lace underwear. The pattern has persisted for eight months, but the person reports no clinically significant distress or impairment related to the interest. Which conclusion is most appropriate?

The interest is consistent with the focus of fetishistic disorder, but the information provided does not establish that the person meets the full diagnostic criteria.

An individual regularly cross-dresses and reports that doing so is comfortable and consistent with their self-expression. They do not report clinically significant distress or impairment related to the behavior. Which conclusion is most appropriate?

Cross-dressing alone does not establish transvestic disorder.

A clinician is assessing a person for a possible paraphilic disorder. Which combination of information is most useful for distinguishing among the diagnoses?

The specific focus of arousal, its duration, and the applicable criteria involving distress, impairment, or nonconsenting behavior.

According to the Week 8 material, treatment for people convicted of sexually abusing children generally focuses on changing behavior rather than eliminating sexual attraction. Which statement best reflects the goal of this approach?

Treatment aims to reduce the likelihood of future offenses, even if the person's underlying sexual attraction does not change.

Which statement best describes the relationship between pedophilic disorder and sexually abusing children?

Not everyone who sexually abuses a child has pedophilic disorder, and not everyone with pedophilic disorder has sexually abused a child.

Which of the following statements about childhood sexual abuse is NOT true, according to the Week 8 Lumen reading?

Approximately 50% of children who experience sexual abuse are abused by strangers they have never met.

A behavioral treatment program attempts to reduce an unwanted sexual behavior by having a person imagine the behavior followed by a highly disturbing consequence. Which technique is being used?

Covert sensitization.

A man with pedophilic disorder is participating in a treatment program intended to reduce the risk of future sexual offenses. The treatment team uses cognitive-behavioral therapy to address distorted beliefs, improve self-control, and help him identify situations that may increase his risk of offending. The team also considers medication to reduce sexual drive. Which statement best reflects the treatment approach described in the Lumen readings?

Psychological treatment and medication may be combined to help manage sexual urges and reduce the risk of reoffending, even if the underlying attraction is not significantly reduced.

A student argues that a person should not receive a diagnosis of a paraphilic disorder unless the person is distressed by the sexual interest or experiences impairment in daily functioning. Which response best addresses the student's claim?

The student is incorrect because, for certain paraphilic disorders, acting on sexual urges involving a nonconsenting person can satisfy a diagnostic criterion even when the person does not report clinically significant distress or impairment.

Which statement best distinguishes the diagnostic requirements for many paraphilic disorders from those for the anxiety, obsessive-compulsive, and trauma- and stressor-related disorders covered in this course?

Paraphilic disorders may involve persistent atypical sexual arousal, with criteria that can include distress or impairment or acting on urges involving a nonconsenting person; the other disorders have their own specified symptom and diagnostic requirements.