Clinical Psych Practice Exam 2 Q's - Lorenz

Tolerance and Withdrawal are two diagnostic criteria for Alcohol Use Disorder in DSM-5.

a. True

b. False

E

Substance withdrawal refers to ________, whereas substance tolerance refers to __________.

a. Physiological dependence; significant harmful consequences

b. Significant harmful consequences; physiological dependence

c. Physical and psychological effects when a person stops taking a substance; larger

substance amounts being required to achieve the same effect

d. Larger substance amounts being required to achieve the same effect; physical and

psychological effects when a person stops taking a substance

C

Which of the following statements is FALSE?

a. College students with alcohol problems are more likely to select social networks with

similar drinking patterns.

b. Alcohol Use Disorder is associated with stronger positive expectations about alcohol's

effects on behavior.

c. College students with alcohol problems are more likely to have peers who have more

alcohol problems.

d. Approximately half of the variability in whether a person develops Alcohol Use Disorder

is associated with genes.

e. None of the above.

E

How many harmful consequences must have been present (at a minimum) to receive a diagnosis of

Alcohol Abuse in DSM-IV?

a. One

b. Two

c. Three

d. Four

e. Five

A

Alcohol Use Disorder in DSM-5 added legal problems as a diagnostic criterion.

a. True

b. False

B

Substance Abuse refers to significant tolerance and withdrawal symptoms.

a. True

b. False

B

Craving was added as a diagnostic criterion for Alcohol Use Disorder in DSM-5.

a. True

b. False

A

. Which of the following is FALSE?

a. DSM-IV distinguished alcohol dependence from alcohol abuse

b. In DSM-IV, alcohol abuse had low inter-rater reliability

c. In DSM-IV, alcohol abuse criteria could be met because a person was arrested for

getting a DUI (driving under the influence)

d. In DSM-IV, alcohol dependence and alcohol abuse appeared to be unidimensional

e. None of the above

E

. Which of the following is TRUE?

a. The prevalence of Alcohol Use Disorder is lower among those younger than 18 than

among those 18 or older.

b. The prevalence of Alcohol Use Disorder in the last year has declined substantially among

those over 26 over the last 20 years.

c. Full-time college students between the ages of 18 and 22 engage in more binge drinking

and heavy drinking than those of the same age who are not full-time college students.

d. A and C

e. A, B, and C

D

The cutoffs for "binge drinking" for men and women (i.e., number of drinks consumed in a 2-hour

period) are ______ and ______ drinks, respectively.

a. 2 and 3

b. 3 and 2

c. 4 and 5

d. 5 and 4

e. None of the above

D

The distinction between Alcohol Abuse and Dependence was maintained in DSM-5.

a. True

b. False

B

Concerns about the Alcohol Abuse diagnosis in DSM-IV included:

a. Low reliability

b. Low generalizability

c. Receipt of an abuse diagnosis is based primarily on whether persons fail to fulfill important

obligations

d. A and B

e. A, B, and C

A

. In DSM-5, Alcohol Use Disorder replaced Alcohol Abuse and Dependence diagnoses in DSM-IV.

a. True

b. False

A

According to DSM-5, Alcohol Use Disorder can be diagnosed if only one criterion has been met.

a. True

b. False

B

. Which of the following statements is TRUE?

a. The prevalence of Alcohol Use Disorder in the last year is highest among those 26 and

older.

b. Over 75% of those aged 18-25 engaged in binge drinking in the last month.

c. A greater percentage of those aged 18-22 who do not attend college, relative to their

peers attending college, drinks alcohol, binge drinks, and engages in heavy drinking.

d. The prevalence of Alcohol Use Disorder in the last year has declined substantially among

those 18 to 25 over the last 20 years

D

Which of the following is TRUE?

a. There are no genetic influences on alcohol use disorder.

b. Negative expectations about alcohol's effects are associated with increased

consumption and problems.

c. Persons who drink more and have more alcohol problems are more likely to have peers

who drink more and have more alcohol problems.

d. A and B

e. A, B, and C

C

Thought Question. What was the rationale for the modifications to alcohol-related diagnoses in

DSM-5?

Alcohol Abuse and Dependence were distinguished in DSM-IV, but receipt of the Alcohol Abuse

diagnosis frequently was based on only a single criterion (hazardous use - typically drinking while

driving), and both reliability and validity were poor. In DSM-5, these two diagnoses have been

replaced with a single Alcohol Use Disorder. Two symptoms must be present to receive the

diagnosis, and a graded severity of the disorder is indicated by the number of present symptoms.

Thought Question. How do you think a severe case of Alcohol Dependence, according to DSM-IV,

would be diagnosed in DSM-5?

The client would receive a diagnosis of Alcohol Use Disorder, presumably with a severe specification

because it seems likely that 6 or more symptoms would be present.

Which of the following statements is/are FALSE?

a. Fear is apprehension or worry about a future threat.

b. Both fear and anxiety can be adaptive.

c. Fear can trigger a flight-or-fight response.

d. Moderate levels of anxiety increase preparedness/performance.

e. C and D

A

Cultural competence of mental-health professionals necessitates knowing how anxiety and other

psychological problems may present differently in different cultures or sub-cultures.

a. True

b. False

A

Which of the following statements about a panic attack is TRUE?

a. Panic attacks are always cued or triggered.

b. Panic attacks are present only in panic disorder.

c. A panic attack is a sudden fear response in the presence of an immediate threat.

d. A panic attack is a false alarm of the fear system.

e. None of the above

D

Persons with panic disorder fear _______, whereas persons with specific phobia fear ______.

a. Social situations; trauma-related memories

b. Uncontrollable worries; social situations

c. Panic attacks; specific objects or situations

d. Trauma-related memories; uncontrollable thoughts

e. None of the above.

C

Which of the following statements is TRUE?

a. Exposure therapy tends to increase avoidance behavior

b. Clients work their way up a hierarchy of feared stimuli in exposure therapy

c. A critical component of evidence-based treatment of anxiety is gradual exposure to

feared stimuli

d. B and C

e. A, B, and C

D

Uncontrollable worry that lasts at least 6 months is characteristic of

a. Generalized anxiety disorder

b. Obsessive-compulsive disorder

c. Acute stress disorder

d. Specific phobia

e. Social anxiety disorder

A

Which of the following is FALSE?

a. The Disability-adjusted life years (DALYs) are lower for anxiety than depression

b. The lifetime prevalence of major depressive disorder is lower than for the anxietyrelated disorders

c. Women are more likely to struggle with both depression and anxiety than men

d. Neuroticism plays a role in both depression and anxiety

e. None of the above.

E

Repetitive, intrusive, uncontrollable thoughts or urges are characteristic of

a. Generalized anxiety disorder

b. Obsessive-compulsive disorder

c. Acute stress disorder

d. Specific phobia

e. Social anxiety disorder

B

Which of the following statement is FALSE?

a. The comorbidity of anxiety-related disorders with major depressive disorder (MDD)

challenges the validity of the DSM.

b. A majority of those diagnosed with major depressive disorder (MDD) are not diagnosed with

an anxiety-related disorder.

c. A majority of those diagnosed with an anxiety-related disorder also are diagnosed with

major depressive disorder (MDD).

d. A majority of those diagnosed with one anxiety-related disorder are diagnosed with

another.

e. The comorbidity of anxiety-related disorders with major depressive disorder (MDD) has led

to the development of transdiagnostic theories of anxiety and depression.

B

Which of the following statements about DSM-5 is/are TRUE?

a. Obsessive compulsive disorder is no longer officially an anxiety disorder.

b. Acute stress disorder is no longer officially an anxiety disorder.

c. Generalized anxiety disorder is retained in DSM-5 as an official diagnosis.

d. Posttraumatic stress disorder is no longer officially an anxiety disorder.

e. All of the above are true.

E

Which of the following is TRUE?

a. Avoidance of the conditioned stimuli that are feared in an anxiety-related disorder is

typically maintained by operant conditioning

b. Avoidance is negatively reinforced by reduced anxiety

c. The anxiety/fear associated with an anxiety-related disorder may be initially "learned"

by classical conditioning

d. Conditioned stimuli are initially neutral stimuli that become feared via classical

conditioning

e. All of the above

E

Which of the following are potential implications of the comorbidity of major depressive and

anxiety-related disorders?

a. We may not need to distinguish depression and anxiety in the next version of the DSM

b. We may be able to collapse some anxiety-related disorders together in the next version

of the DSM

c. It might be useful to adopt a dimensional, rather than a categorical, approach to mood

and anxiety-related disorders in the next version of the DSM

d. All of the above

e. Neither A, B, nor C

D

The heritability of panic disorder is 50%, which means that

a. 50% of those with a specific gene will develop panic disorder at some point in their lives

b. 50% of persons will be diagnosed with panic disorder at some point in their lives

c. 50% of persons currently are diagnosed with panic disorder

d. 50% of the variability in whether a person has panic disorder is genetically determined

e. None of the above.

D

Biopsychosocial influences on both anxiety-related disorders and major depressive disorder (MDD)

include

a. Genes

b. Decreased cortisol levels

c. An underactive amygdala

d. A and B

e. A, B, and C

A

Exposure therapy for agoraphobia might involve gradual exposure to ______.

a. Feared objects or animals

b. Memories of a traumatic experience

c. Negative evaluation by others

d. Places where escaping or getting help would be difficult if anxiety symptoms occurred

e. None of the above

D

Which of the following is FALSE?

a. Exposure therapy to feared stimuli is typically gradual

b. Exposure therapy reduces distorted cognitions

c. Exposure therapy increases avoidance behavior

d. Exposure therapy is an evidence-based approach to treating anxiety-related disorders

C

Biopsychosocial influences are generally similar for anxiety-related disorders and major depressive

disorder (MDD).

a. True

b. False

A

Stressful live events precede the onset of major depressive disorder (MDD) in a major of cases, but

not the onset of anxiety-related disorders in a major of cases.

a. True

b. False

B

According to the diathesis-stress model of anxiety-related disorders, stress mediates the effect of

diatheses on anxiety.

a. True

b. False

B

Both depression and anxiety show genetic influences, but the genetic influences for depression are

polygenic, where they are more associated with single genes for anxiety

a. True

b. False

B

Persons diagnosed with anxiety-related disorders tend to

a. Underestimate the probability of a negative event.

b. Show lower levels of neuroticism

c. Show reduced vigilance for disorder-relevant information.

d. Catastrophize about the inability to handle negative events.

e. All of the above.

D

According to a conditioning model of anxiety disorders, a person develops a conditioned response to

a neutral stimulus that is paired with a highly aversive stimulus.

a. True

b. False

A

Which of the following is TRUE? a. The amygdala is overactive among those with anxiety-related disorders, but not with depression b. The GABA neurotransmitter plays a role in depression, but not in anxiety c. Both depression and anxiety are associated with elevated levels of cortisol d. A and B e. A, B, and C

C

Suppose that a veteran of the war in Afghanistan developed post-traumatic stress disorder (PTSD)

after seeing several friends killed during a gun battle at night. He now is terrified of loud noises and

darkness, and he sleeps with the lights on. According to a conditioning model,

a. The loss of his friends during the gun battle is the Unconditioned Stimulus (UCS)

b. Loud noises and darkness are the Unconditioned Stimuli (UCSes)

c. The terror the vet experienced during the gun battle is the Conditioned Response (CR)

d. A and B

e. A, B, and C

A

In the previous question, the vet's avoidance of darkness is positively reinforced.

a. True

b. False

B

Both anxiety and fear can be broken down into subjective (cognitive, emotional), physiological, and

behavioral components.

a. True

b. False

A

After surviving a horrible car accident, Marcus becomes terrified of driving and avoids driving or

riding in cars. Which of the following statements are TRUE?

a. His avoidance of cars is negatively reinforced.

b. Cars are Conditioned Stimuli (CSes).

c. His post-accident terror in response to cars is a Conditioned Response (CR).

d. The car accident is an Unconditioned Stimulus (UCS).

e. All of the above.

E

Post-traumatic stress disorder (PTSD) can be diagnosed once the duration of symptoms is greater

than two weeks.

a. True

b. False

B

True or False: The marked comorbidity of anxiety and depression suggests that transdiagnostic

treatment approaches may prove helpful.

a. True

b. False

A

True or False: Women on average show higher rates of depression and anxiety than men.

a. True

b. False

A

The personality trait of neuroticism may play a causal role in both anxiety and depression.

a. True

b. False

A

Low levels of serotonin and norepinephrine neurotransmitters are implicated in both anxiety and

depression

a. True

b. False

A

Thought Question. What implications does the similarity of the etiologies of anxiety and depression potentially have for future versions of the DSM?

The similarity of the biological, social, and psychological causes of anxiety-related disorders and

major depression challenges the validity of the current diagnostic system (DSM-5) and suggests that

it might be more accurate to combine the anxiety-related and major depressive disorders in future

versions of the DSM

Thought Question. Suppose that a client comes to see you for treatment of debilitating public speaking anxiety, because he is unable to give class presentations and his grades are suffering. He attributes his social anxiety in part to a humiliating public-speaking experience he had in junior high, in which fellow students laughed at him when he made several mistakes while presenting a project to the class. How would you interpret the development of his social anxiety from the perspective of conditioning theory?

Being laughed at during the original public-speaking experience was a UCS, and his feelings of

humiliation and embarrassment were URs. Public-speaking subsequently became a CS for the CR of

marked social anxiety. Avoidance of speaking in public has been negatively reinforced, because

avoidance reduces his distress

Thought question: There is significant comorbidity of depression and anxiety disorders. Consider the

relevance of the operant conditioning theory introduced in the anxiety disorder lecture to the

following case: A woman experiencing symptoms of major depressive disorder recently lost her job.

In the morning, when she thinks about getting out of bed to search for a job, she has distressing

thoughts about her inability to find work and how pointless her job search has been. According to

operant conditioning, what is likely to happen next? What type of reinforcement does this

exemplify? What would you predict about her likelihood of getting out of bed the following

morning?

In operant conditioning, the general principle of negative reinforcement indicates that removing an

unpleasant stimulus will provide the individual with relief, thus decreasing the likelihood that the

person will engage in the behavior that brings them into contact with the unpleasant stimulus.

Therefore, after considering getting out of bed and experiencing the thoughts about her inability to

find work and the pointless job search (the unpleasant stimuli), she is likely to stay in bed, which will

provide her with relief (she will no longer be faced with the pressure of finding a job, and therefore

will feel relief). According to negative reinforcement, engaging in this behavior that provided relief

from distress is likely to happen again; therefore, the following morning, she is likely to remain in

bed again

True or False: In order to meet criteria for a diagnosis of major depression, a client needs to report

both depressed mood and loss of pleasure in usual activities.

a. True

b. False

B

True or False: The highest rates of suicide are among Caucasian females over age 75.

a. True

b. False

B

Which of the following is TRUE?

a. Anxiety-related disorders are associated with more disability-adjusted life years (DALYs)

lost than major depressive disorder.

b. The current prevalence of major depressive disorder is approximately 16.6%.

c. Rates of major depressive disorder first begin to increase during late adolescence.

d. Major depressive disorder is associated with a single-gene abnormality.

e. None of the above

E

True or False: In DSM-5, persons struggling with bereavement cannot receive a diagnosis of major

depressive disorder.

a. True

b. False

B

Which of the following is FALSE?

a. Suicide is more common among those who are divorced than those who are single,

widowed, or married

b. Suicidal attempts are more common among women, but completed suicides are more

common among men

c. Suicide rates are particularly high for non-Cacausian males over 75

d. A and C

e. A, B, and C

C

Nonsuicidal self injury

a. may result in unintended death

b. may result in intended death

c. is intended to cause injury

d. is not intended to cause injury

e. A and C

f. A and D

g. B and C

E

True or False: Twice as many women as men are diagnosed with depression.

a. True

b. False

A

True or False: The lifetime prevalence of schizophrenia is the percentage of people who are

suffering from schizophrenia right now.

a. True

b. False

B

Which of the following are potential etiological influences on suicide?

a. Perfectionism

b. High levels of serotonin

c. Genes

d. Alcohol abuse

e. C and D

f. B, C, and D

E

The gender difference in depression begins

a. When males and females are toddlers

b. When males and females are young adolescents

c. When males and females become young adults

d. When males and females have children

e. When males and females become older adults

B

True or False: Earlier onset of depression improves prognosis.

a. True

b. False

B

The biopsychosocial model serves as

a. A single gene explanation for psychopathology

b. A neurobiological explanation for psychopathology

c. An interpersonal dispute explanation for psychopathology

d. An organizational framework for understanding the etiology of psychopathology

e. A cultural explanation for psychopathology

D

Which of the following biological factors is not considered to have a biological influence on

depression, according to lecture?

a. Neuroendocrine System

b. Neurophysiology

c. Neurotransmitter Systems

d. Genes

e. None of the above

E

True or False: Behavior genetics helps us establish the heritability of mental illness but does not tell

us which genes are responsible for the mental illness.

a. True

b. False

A

True or False: If heritability is .15 for bipolar disorder, this means that 15% of the variation in

whether persons have bipolar disorder is attributable to genetic influences.

a. True

b. False

A

Molecular genetics is concerned with , whereas behavior genetics is more

concerned with .

a. Combining molecules, shaping behavior

b. Identifying specific genes, determining general heritability of characteristics

c. The molecular composition of genes, how genes behave in the cell

d. Developing drugs, behavioral interventions

e. Cloning genes, training cloned animals

B

Which of the following is NOT true about genetic research in psychopathology?

a. Single gene explanations for psychopathology are in decline.

b. Genetic influences on psychopathology are usually polygenic.

c. Genetic influences on psychopathology remain constant across development and typically

do not interact with the environment.

d. Large samples typically are needed to detect genetic effects on psychopathology

C

Which of the following is FALSE?

a. Low levels of dopamine and norepinephrine are implicated in MDD

b. MDD is characterized by reduced activity in the prefrontal cortex

c. The hippocampus tends to be smaller in those with MDD

d. Those with MDD tend to show chronic under-reactivity of the HPA axis

e. None of the above

D

The neurotransmitters implicated in depression include:

a. GABA

b. Serotonin

c. Dopamine

d. A and B

e. A, B, and C

f. B and C

F

True or false: People with depression typically have an overactive HPA and decreased levels of

cortisol, indicating that they are over-responsive to stress.

a. True

b. False

B

True or false: Depression is very often preceded by a stressful event, but stressful events do not

necessarily lead to depression.

a. True

b. False

A

Which of the following is a diathesis (or are diatheses) for depression?

a. Chronically elevated levels of cortisol

b. Negative cognitive style

c. Low levels of social support

d. Female gender

e. All of the above

E

Which of the following is TRUE?

a. A negative cognitive style is implicated in major depression

b. The cognitive triad refersto positive views about oneself, the world, and the future.

c. Cognitive therapy targets a negative cognitive style

d. All of the above

e. A and C

E

True or False: Gender differences in rumination may account in part for the gender difference in

major depression.

a. True

b. False

A

Suicide is a leading cause of death among adolescents and young adults.

a. True

b. False

A

True or False: Persons with major depressive disorder (MDD) tend to have less supportive social

networks.

a. True

b. False

A

Suicidal ideation refers to .

a. Cutting behaviors

b. Creating a suicidal plan

c. Non-suicidalself-injury

d. Thoughts of one's own death or killing oneself

e. Thoughts of killing others

D

Which of these is a risk factor for completing suicide?

a. Being divorced

b. Being African American

c. Being female

d. A and B

e. None of the above

A

True or False: The relationship between social support and major depressive disorder is

bidirectional.

a. True

b. False

A

Suicidal intent refers to , whereas suicidal ideation refers to .

a. A method the person could use to kill oneself; resolution to execute a suicidal plan

b. Thoughts about killing oneself; a method the person could use to kill oneself

c. Execution of a suicidal plan; thoughts about killing oneself

d. Resolution to execute a suicidal plan; thoughts about killing oneself

D

Why might persons engage in non-suicidal self injury?

a. To diminish intense negative feelings

b. To commit suicide

c. To obtain support from others

d. A and C

e. A, B, and C

D

The single best predictor of a completed suicide is

a. Socioeconomic status

b. A previous suicide attempt

c. Age group

d. Career

e. Ethnicity

B

Which person(s) are at higher risk of suicide, other things being equal?

a. Sexual minority adolescents

b. Veterans

c. Those who identify as American Indian or Alaska Native

d. Terminally ill

e. All of the above

E

Which of the following is NOT associated with suicidality?

a. Hopelessness

b. Impulsivity

c. Fear of a specific object

d. Emotional Reactivity

e. Lonelines

C

True or False: Economic hardship, abuse, and serious illness increase risk ofsuicide.

a. True

b. False

A

True or False: Men are more likely than women to attempt suicide.

a. True

b. False

B

True or False: MDD is associated with abnormalities in the structure and functioning of some brain

regions.

a. True

b. False

A

According to the diathesis stress model of MDD,

a. Stress and a diathesis interact to influence MDD

b. Stress mediates the effect of a diathesis on MDD

c. A diathesis mediates the effect of stress on MDD

d. Stress moderates the effect of a diathesis on MDD

e. A and D

E

Only a small percentage of persons who make a suicide attempt have a diagnosable mental illness.

a. True

b. False

B

True or False: The current prevalence of depression is lower than the lifetime prevalence of

depression.

a. True

b. False

A

True or False: Stressful life events are related to the onset of most disorders in the DSM.

a. True

b. False

A

The following brain structures have been implicated as neurophysiological influences in depression.

a. Prefrontal cortex

b. Hippocampus

c. Amygdala

d. Anterior cingulate

e. All of the above

E

Suppose that you conceptualize a client's depression as resulting from an interaction of a recent

physical assault and a longstanding negative cognitive style. From the perspective of the diathesisstress model, the longstanding negative cognitive style would be considered a potential diathesis.

a. True

b. False

A

Major depression can be diagnosed even in the absence of significant distress or impairment, if

enough symptoms are present.

a. True

b. False

B

Major depression is associated with greater impact and impairment than other mental and

behavioral disorders.

a. True

b. False

A

Major depression is assumed to be caused in part by low levels of serotonin, norepinephrine, and

dopamine.

a. True

b. False

A

Persons diagnosed with major depression tend to show

a. Higher levels of social support

b. Single-gene abnormalities

c. Lower levels of cortisol

d. Elevated activation of the amygdala

e. All of the above

D