Abnormal Psychology An Integrative Approach 5th Edition by David H. Barlow – Test Bank A+

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Indicate the answer choice that best completes the statement or answers the question.

1. Which of the following individuals possesses the most characteristics associated with somatic symptom disorder? a. Clarissa, a 17-year-old female described as impulsive b. Nirmala, a 10-year-old female described as impulsive c. James, a 16-year-old male described as emotionally dependent d. Marco, a 45-year-old male described as extremely emotionally sensitive

2. According to the autohypnotic model, who may be able to use dissociation as a defence against extreme trauma? a. people who have frequent “out-of-body” experiences b. people who have had head injury and resulting brain damage c. people who are highly suggestible d. people who have certain neurological disorders, such as seizure disorders

3. Tracey has localized amnesia, what does she likely have no memory of? a. events prior to a trauma b. anything, including who she is c. events following a trauma d. selective events, particularly those involving trauma

4. In a study conducted by Loftus and colleagues (1996), individuals were told about false events that had supposedly occurred when they were children. What did the results of this study reveal? a. Individuals with previously diagnosed disorders can be convinced of events that never happened. b. People cannot be convinced of events that did not happen. c. People can become quite convinced they experienced events that never happened. d. People can become convinced of events that did not happen, but only during hypnosis or other dissociative states.

5. Jake has somatic symptom disorder, his brother Kyle has a disorder that is often observed in family members of people with somatic symptom disorder. What disorder does Kyle most likely have? a. body dysmorphic disorder b. illness anxiety disorder c. antisocial personality disorder d. panic disorder

6. Pat has dissociative identity disorder and lives with her parents. Her parents observe her “switch” from one personality to another on a regular basis. How do her parents describe the “switches”? a. “They are usually instantaneous.” b. “They are subtlety done by the host personality.” c. “They usually occur at the will of the original personality.” d. “They are usually gradual.”

7. Ian is experiencing dissociation. Before this problem occurred, Ian was healthy and well-adjusted. What likely happened in Ian’s recent past? a. a minor illness b. an episode of binge drinking c. an extremely stressful event d. a period of major depression

8. Jenna, a recently married young woman, described episodes of “spacing out.” During these episodes, she feels as if she is observing herself from outside of her body. Her experiences seem “dream-like,” and she reports feeling completely separated from what is going on around her. What diagnosis best fits Jenna’s symptoms? a. stress associated with being newly married b. post-traumatic episodes c. detachment disorder d. depersonalization disorder

9. According to Ross (1997) and others, what is the average number of alter personalities (i.e., in addition to the original personality) in individuals with dissociative identity disorder? a. 5 b. 15 c. 25 d. 50

10. What do we call the model that suggests that most symptoms of dissociative identity disorder can be accounted for by therapists who inadvertently suggest the existence of alters to suggestible individuals? a. the observational learning model b. the psychosocial model c. the sociocognitive model d. the therapeutic induction model

11. The diagnostic criteria for dissociative identity disorder include a fragmentation of identity and: a. a history of sexual abuse b. a lack of awareness about the distinct personalities c. the existence of three or more alter personalities d. amnesia for important personal information

12. With regard to dissociative identity disorder, what does the term “alter” mean? a. the most complete personality, apart from the original personality b. the most dominant of the personalities c. a different personality from the original personality of the individual d. the ability to switch to other personalities at will

13. Gail tells Bill that she has experienced dissociation before and goes on to describe it in detail. What sorts of experiences did Gail likely describe to Bill? a. numbness in her hands b. extreme withdrawal from the external world c. experiencing gross misrepresentations of external reality d. feeling detached from herself and her surroundings

14. Which of the following is a central feature of illness anxiety disorder? a. the interpretation of harmful stimuli as nonthreatening b. the interpretation of almost any physical sensation or symptom as threatening c. a distrust of medical personnel d. more acute physical sensations than someone without hypochondriasis

15. If Jane has illness anxiety disorder, how frequently can we expect her to see her physician and how will she feel as a result of these visits? a. She will rarely see her physician, but she will continue to believe that she is quite ill. b. She will often see her physician, but she will continue to be anxious about her health anyway. c. She will almost never see her physician because she does not trust physicians. d. She will often see her physician, and she will feel completely reassured that there is nothing wrong with her health.

16. Jill is constantly worried that she will get sick. Although she feels fine now and believes that she is healthy, she still worries endlessly about developing a serious illness. What would Jill most likely be diagnosed with? a. somatic symptom disorder b. body dysmorphic disorder c. illness phobia d. illness anxiety disorder

17. Anne feels as though she has a lump in her throat, but the doctors can find no obstructions. What diagnosis is a psychiatrist most likely to give Anne? a. la belle indifférence b. globus hystericus c. echerichia coli d. malingering

18. Angie has dissociative identity disorder (DID). What is most likely part of Angie’s history? a. drugs and alcohol abuse b. delusions c. child abuse d. a family history of DID

19. In dissociative amnesia, memory loss can be partial or total. How long does it generally last? a. It is permanent. b. It lasts a fleeting moment. c. It is brief. d. It can be temporary or lifelong.

20. What is the average length of time between an individual’s first symptoms of dissociative identity disorder and the identification and diagnosis of the disorder by a professional? a. less than a month b. one year c. seven years d. 20 years

21. Rebecca has depersonalization derealization disorder. Which of the following complaints will Rebecca MOST likely report to her doctor? a. memory loss b. detachment c. an inability to compare their own experience to reality d. hallucinations

22. What sort of sexual behaviour do “alters” exhibit? a. They rarely have sexual relationships. b. They usually have sex more frequently than the host. c. They will have sexual relationships if it is beneficial to the host personality for them to do so. d. There is no set pattern of sexual activity in alters.

23. In 2003, Kenneth Mackay was convicted of murdering Crystal Paskemin in Saskatoon. Although he admitted to having run over the victim with his truck, which he claims was an accident, his defence lawyer argued that Mackay had no memory of burning the victim’s body because of the trauma of the accident. What did a memory expert testify in court that Mackay might have suffered? a. a dissociative fugue state b. dissociative amnesia c. an episode of extreme depersonalization d. a dissociative trance state

24. In dissociative identity disorder, what is the “host” personality? a. It is usually the one that “nurtures” the other personalities. b. It is usually the one that is the most frequently seen of the personalities. c. It is usually the one that is the most aggressive of the personalities. d. It is usually the one that asks for treatment and becomes the patient.

25. When would Paul be most likely to be diagnosed with a somatic symptom disorder with predominant pain? a. if he is convinced that he has a serious illness because of the pain experienced b. if he has physical reasons for pain but psychological factors play a major role as well c. if he has physical reasons for pain, but knowingly exaggerates the pain to gain sympathy, attention, or some other benefit d. if he has an unrealistic fear of experiencing pain or discomfort

26. Martin wants to help his wife, Joann, with her somatic symptom disorder. So he asks his friend Joe, who is a psychiatrist, for help. Joe tells Martin the best therapy for Joann is: a. hypnosis b. Prozac c. traditional psychotherapy d. cognitive behavioural therapy

27. Dr. Banks has chosen a treatment for Amy’s illness anxiety disorder based on its proven effectiveness. Which treatment did she most likely select? a. operant conditioning b. cognitive-behavioural treatment c. emotional restructuring d. psychosurgery

28. What is the essential element of illness anxiety disorder? a. dissociation b. anxiety c. depression d. physical pain or discomfort

29. Joel has both somatic symptom disorder and antisocial personality disorder, and his psychiatrist explains that this makes sense because both involve: a. genetic defects and poor nutrition b. poor modelling by parents and other authority figures c. parental psychopathology d. pleasure seeking and impulsivity

30. Greta occasionally has sensations of detachment from her surroundings, as if she were in a dream. This feeling of unreality most often occurs when she is overtired. What diagnosis best fits Greta’s symptoms? a. conversion hysteria b. a dissociative experience c. neurosis d. dysmorphic disorder

31. Which of the following is NOT a learning experience of those with illness anxiety disorder? a. being rewarded by parents when expressing bodily concerns b. observing parents express concern about bodily symptoms c. having a relative who is a health care worker d. being instructed that bodily concerns are dangerous

32. Dr. Arnold follows the sociocognitive explanation of alter personalities in dissociative identity disorder. Which statement would Dr. Arnold most like make about the development of alters? a. “The creation of alters is directly influenced by dysfunctional patterns of family communication.” b. “The creation of alters is the result of hypnotically inserted (false) memories.” c. “The creation of alters is the result of social reinforcement by the therapist.” d. “The creation of alters are consciously and voluntarily simulated by suggestible individuals.”

33. Darren was in a fugue state for six months. What did he likely do in that six months? a. travelled, assumes a new identity while remembering who he really was b. felt compelled to travel but did not experience memory loss c. experienced memory loss and identity confusion, but did not travel d. travelled, experienced memory loss, and experienced identity confusion

34. Which of the following characterizes the disorder Munchausen syndrome by proxy (or factitious disorder by proxy)? a. deliberate actions directed toward making a child sick b. a parent developing the same symptoms that the child has c. a parent lying to a doctor (e.g., saying that the child has had symptoms that never really existed) d. convincing a child to lie to a doctor about factitious symptoms

35. Mark injured his back at work several years ago. Although he was treated and considered healed by his physicians, he still complains of severe and debilitating back pain. Other than some minor scar tissue, his doctors can’t find anything that could be causing more than some minor stiffness. What is Mark’s most likely diagnosis? a. somatic symptom disorder with predominant pain due to a general medical condition b. somatic symptom disorder due to primarily psychological factors c. somatic symptom disorder with predominant pain due to psychological factors d. somatic symptom disorder with predominant pain due to psychological factors and a general medical condition

36. You hear two colleagues talking, and one of them states that a friend has just been diagnosed with illness anxiety disorder. What is your colleague’s friend’s age and gender most likely to be? a. The friend is likely to be a woman in her early 60s. b. The friend is likely to be a man in his mid-40s to late 50s. c. The friend is likely to be a young adolescent girl. d. The friend is just as likely to be a man or women, at any age in the adult life cycle.

37. A person who is blind but has no underlying cause for their blindness may be suffering from which of the following? a. conversion disorder b. illness anxiety disorder c. detachment disorder d. dissociative disorder

38. During a dissociative fugue state, which of the following is it NOT uncommon for individuals to do? a. take on a new identity b. speak in a different tone of voice and use different physical gestures than they did previously c. commit suicide d. brutally assault people

39. Fred has been having seizures, but tests show no known cause. What is the most likely diagnosis for Fred? a. conversion disorder b. malingering c. illness anxiety disorder d. dissociative disorder

40. Mary, who is 40, appears to believe she is a 20-year-old woman. Suddenly, however, she starts to speak and behave very differently, and says she no longer thinks of herself as “Mary.” Instead, she claims to be Elise, a 10-year-old child. What has Mary most likely just experienced? a. an alter trance b. a switch c. a conversion reaction d. a host reaction

41. Frank complained to his doctor that he had weakness in his legs and difficulty keeping his balance, with the result that he fell frequently. Medical examinations revealed no physical problems. What is this type of conversion symptom called? a. globus hystericus b. aphasia c. aphonia d. astasia-abasia

42. Joe just ate six chili-dogs and drank a litre of soda. If Joe had illness anxiety disorder, how would he probably interpret any resulting stomach discomfort? a. as yet another sign of numerous vague, chronic “infections” that have plagued him for years, which no one seems to be able to properly diagnose b. as a sign that something is probably seriously wrong with his stomach, and he would calmly phone in “sick” to work c. as a sign that something is seriously wrong with his stomach and, feeling very anxious, he would immediately call his doctor d. as a sign that someone is trying to poison him

43. What is one factor that helps explain who is likely to develop dissociative identity disorder following childhood trauma? a. number of siblings b. number of abusers c. suggestibility d. socioeconomic status

44. Andrew tells Paul that he has been diagnosed with globus hystericus? What symptom did Andrew most likely complain about to his doctor? a. blurred vision b. the sensation of a lump in his throat c. unexplained lumps all over the body d. generalized numbness

45. When is a dissociative trance disorder diagnosed? a. only when the trance is undesirable and considered pathological in the individual’s culture b. only when the trance causes harm to the individual or others c. whenever an individual repeatedly enters a trance state d. only when the trance is unpredictable in terms of when it appears (e.g., if individual goes into a trance without prior religious ritual)

46. In some ways, for those patients with dissociative identity disorder (DID) and who have suffered horrific childhood abuse, DID can be seen as an adaptive response. Why? a. The patient receives a great deal of attention for the past abuse he or she suffered. b. Overall, mental health is improved. c. Psychologically, at least, the child can escape an intolerable situation. d. Family problems are identified and acknowledged for the first time.

47. Illness anxiety disorder is essentially an emotional disturbance. What triggers it? a. dysfunctional family interactions b. misinterpretation of mostly normal physical sensations c. physical pathology d. misinterpretations of severe or unusual physical sensations

48. Which of the following is classified as a somatoform disorder? a. derealization b. conversion disorder c. dissociative disorder d. hysterical disorder

49. If someone complains of pain when no medical cause can be found, what will their pain be like? a. The pain can be real even if it goes away with psychological treatment. b. If psychological treatment eliminates the pain, the pain cannot have been real in the first place. c. The pain usually goes away when the person is sleeping, which is a key indication that the pain is not real. d. Unlike true pain, the pain originates from the brain and not the part of the body that feels injured.

50. Dr. Little has a new patient who has just developed dissociative identity disorder. Which of the following people is most likely Dr. Little’s patient? a. a 13-year-old girl b. a 9-year-old girl c. a 3-year-old girl d. a 17-year-old girl

51. In the absence of any physical trauma to the brain or drug intoxication, what is the most likely cause of sudden loss of ability to recall important personal information? a. depersonalization disorder b. dissociative fugue c. dissociative amnesia d. retrograde amnesia

52. Doctors suspect that Allen has somatic symptom disorder. What symptoms is Allen most likely displaying? a. problems with his sensory-motor systems. b. problems with his cognitive functioning. c. problems with his digestive system. d. problems regulating emotions under stress.

53. Susan has a sick daughter who has been in and out of hospital four times in the last six months, but no cause for her illnesses can be found. At first, the doctors suspect that Susan may have Munchausen syndrome by proxy, however, Susan exhibits a behaviour that contradicts that diagnosis. What is that behaviour? a. appearing extremely concerned and caring toward the child b. purposefully making the child sick c. helping medical staff to discover the true nature of the child’s illness d. developing a positive relationship with medical staff

54. In dissociative identity disorder, who is usually the first personality to seek treatment? a. the person’s original personality b. someone other than the person’s original personality c. the most aggressive personality d. the first alter personality to develop

55. Which of the following disorders is most likely to involve self-injury? a. malingering b. factitious illness disorder c. illness anxiety disorder d. conversion disorder

56. What is the fundamental goal of treatment for dissociative identity disorder? a. to help the patient to more successfully repress the traumatic memories b. to relieve the depression and anxiety that frequently accompanies this disorder c. to identify cues or triggers that provoke memories of the trauma or dissociation and to neutralize them d. to develop more effective coping strategies for future negative events

57. In 1962, Anna was diagnosed with “hypochondriasis”. What disorder would she be diagnosed with today? a. blood-injection-injury disorder b. somatic health disorder c. illness anxiety disorder d. persistent health delusional disorder

58. What research evidence contradicted Freud’s explanation of the cause of conversion disorder? a. Conversion disorder patients display la belle indifférence. b. There is great variability in the amount of concern that conversion disorder patients display regarding their symptoms. c. La belle indifférence is a myth, and few patients show it. d. Conversion disorder patients actually are quite concerned with their symptoms.

59. Somatic symptom disorder and antisocial personality disorder share several features; for example, they are both associated with lower socioeconomic status. What other feature is common to both disorders? a. drug and alcohol abuse b. being male c. suicide attempts d. legal problems

60. When do conversion disorder symptoms generally appear? a. following a death b. following a period of depression. c. shortly after a distressing physical injury d. following a serious illness

61. Mark has a seizure disorder and has developed some dissociative symptoms. Gary has dissociative symptoms but no seizure disorder. What likely differs between Mark and Gary? a. Mark’s disorder is unlikely to be the result of psychological trauma. b. Mark won’t have clinical anxiety. c. Mark’s dissociative symptoms won’t be linked to physiology. d. The reason for Mark’s disorder is likely a mystery.

62. What is the common aspect of all somatoform disorders? a. a pathological belief that one’s appearance is ugly b. a pathological concern with appearance or functioning of the body c. a pathological concern with the meaning of a physical pain d. a pathological belief that a serious medical condition will cause death

63. Gisele has somatic symptom disorder. Which of the following MOST likely describes Gisele? a. she has schizophrenia b. she has illness anxiety disorder c. she is unmarried d. she is wealthy

64. Vince has been under a lot of stress. One morning he awakens to find he is totally blind. At his physician’s office, Vince says he is upset by the loss of his eyesight, but he appears to be totally calm. Which of the following can best explain Vince’s lack of emotional reaction? a. malingering b. la belle indifférence c. emotional compensation d. Munchausen syndrome

65. Kelly shows up at an emergency room demanding immediate treatment for bleeding and abdominal cramps. Later, hospital workers find evidence that Kelly injected herself with a blood thinner to cause the bleeding and then she faked the cramps just to gain admission to the hospital. Kelly denies everything and leaves the hospital to find someone who will “treat me properly!” What condition does Kelly most likely have? a. illness anxiety disorder b. Munchausen syndrome c. conversion disorder d. somatization disorder

66. Somatization disorder and antisocial personality disorder are often associated with gender. Which of the following best describes this relationship? a. Somatization disorder is more common among males, and it reflects high dependency. b. Somatization disorder is more common among females, and it reflects high dependency. c. Somatization disorder is more common among males, and it reflects high aggression. d. Somatization disorder is more common among females, and it reflects high aggression.

67. Which of the following is important when treating conversion disorder? a. removing any benefits that patients receive for limitations imposed by the disorder b. applying a strict behavioural program that includes reinforcement for each display of progress and punishment when necessary c. conducting an in-depth exploration of psychological conflicts concerning the patient’s relationships d. regressing the patient to the early stages of psychosexual development, where the conflicts originated

68. In the “Hillside Strangler” case, what did Kenneth Bianchi claim to be suffering from? a. dissociative identity disorder b. dissociative trance disorder c. dissociative fugue d. dissociative derealization

69. What happens during interpersonality amnesia? a. Specific events experienced by one personality are remembered only by that personality and not others. b. Some alter personalities have total recall of past events, whereas some other personalities have only partial recall of past events. c. Traumatic events experienced by one personality are remembered only by that personality and not others. d. Specific events experienced by one personality are not remembered by that personality but are recalled by alter personalities.

70. On the basis of research into and debate about the issue of recovered memories, what official position has the Canadian Psychiatric Association taken? a. The mental health profession is in no position to judge the validity of recovered childhood memories of abuse. b. Childhood memories later recovered in adulthood are of questionable reliability and should never be accepted without corroboration. c. There is no evidence whatsoever to support the notion of recovered memories of childhood abuse. d. There is overwhelming evidence to support the validity of recovered childhood memories.

71. In many areas of the world, what are dissociative symptoms, such as sudden changes in personality, attributed to? a. possession by a spirit important in the particular culture b. being in league with the devil c. hallucinogenic substances used in some spiritual rituals d. punishment from God

72. What is the meaning of the word “soma”? a. fantasy b. demonic c. illness d. body

73. Which of the following statements best describes what is known regarding the accuracy of recovered memories? a. There is evidence that false memories can be created but there is no evidence of selective amnesia for early traumatic experiences. b. There is no evidence that false memories can be created or that individuals develop selective amnesia for early trauma. c. There is no evidence that false memories can be created but there is evidence that individuals can develop selective amnesia for early trauma. d. There is evidence that false memories can be created and that selective amnesia can occur for early traumatic experiences.

74. Which of the following provides evidence for the influence of social and cultural factors in conversion disorder? a. Conversion disorder tends to occur in lower socioeconomic groups where there is less medical knowledge. b. Conversion disorder is being diagnosed more frequently in our society. c. Conversion disorder is almost exclusively experienced by women. d. Conversion disorder tends to occur more frequently in wealthy populations who have easy access to sophisticated medical tests.

75. Which of the following predicts the development of illness anxiety disorder? a. never experiencing true illness as a child b. having suicidal thoughts or past family history of suicide c. a major depressive episode d. realizing the benefits of being the ill person

76. Mark has intense anxiety about his health. He focuses on slight changes in his heartbeat and greatly exaggerates minor aches and pains. He frequently visits multiple doctors because he resents doctors telling him that nothing is physically wrong with him. What condition does Mark appear to have? a. somatic symptom disorder b. conversion disorder c. illness anxiety disorder d. Munchausen syndrome

77. What is the main difference between a dissociative fugue and dissociative amnesia? a. Fugue involves travel; dissociative amnesia does not necessarily involve travel. b. Fugue states are the result of trauma; dissociative amnesia is the result of guilty feelings. c. Fugue states are associated with anxiety; dissociative amnesia is not. d. Memories return after a fugue state but not after an occurrence of dissociative amnesia..

78. Why is it difficult to describe effective treatments for conversion disorder? a. Extensive research has found drugs work for some patients while cognitive-behavioural therapy works for others. b. Extensive research has found that there are no effective treatments for the disorder. c. Research in the 1970s suggested drug treatments worked; however, recent research suggests that drug treatments do not work. d. There have been very few systematic, controlled studies evaluating treatment.

79. How did Freud explain conversion disorder? a. He argued that people with the disorder had converted unconscious conflicts into defence mechanisms expressed as physical symptoms. b. He argued that people with the disorder experienced real physical illness as a result of internal conflict. c. He argued that people with the disorder experienced physical symptoms as a result of the superego. d. He argued that people with the disorder converted unconscious conflicts into physical symptoms.

80. Cathy claims to have 16 different personalities, each with its own unique traits and memories, living inside her. If her claims are accurate, what condition is she most likely suffering from? a. dissociative depersonalization b. dissociative identity disorder c. dissociative fugue d. dissociative trance disorder

81. While patients with panic disorder and patients with illness anxiety disorder both tend to misinterpret bodily sensations, how do the two kinds of patients differ? a. Those with panic disorder have imagined physical sensations, while those with illness anxiety disorder experience real physical sensations. b. Those with panic disorder tend to fear immediate catastrophe, while those with illness anxiety disorder tend to fear long-term illness. c. Those with panic disorder tend to ignore the symptoms of their first attacks, while those with illness anxiety disorder tend to seek immediate medical treatment following the first indication of pain. d. Those with panic disorder have real physical sensations, while those with illness anxiety disorder experience sensations that are “all in their minds.”

82. Which two disorders have been historically linked by the term hysteria? a. conversion disorders with the schizophrenias b. somatoform disorders with their subtypes c. dissociative disorders and somatization disorder d. somatoform disorders and dissociative disorders

83. What is the main reason that dissociative identity disorder (DID) patients tend to have many additional psychological disorders? a. The more personalities associated with the DID, the more additional disorders will develop. b. Most DID patients abuse drugs and alcohol, which leads to other disorders. c. Most have suffered horrible child abuse, which leads to many problems in later life. d. They appear to have an extreme genetic vulnerability to psychopathology.

84. Suriya has dissociative identity disorder and is starting treatment. She asked her psychiatrist what the treatment will involve. What is the psychiatrist likely to say? a. addressing the patient’s negative thoughts about the abuse b. confrontation of the abuser c. integration of the personality fragments d. hypnotic regression of the host and each alter

85. What is one reason that dissociative identity disorder can be misdiagnosed as a psychotic disorder? a. Both disorders are in the same DSM 5 category. b. Mental health professionals generally do not believe that dissociation is possible. c. Auditory hallucinations (hearing voices) are very common in both. d. Substance abuse makes it difficult to differentiate these disorders.

86. In the Williams (1994) study involving 129 women who had documented cases of sexual abuse as children, what percentage of these women reported having no recollection of the abuse incident? a. 0 percent b. 38 percent c. 72 percent d. 100 percent

87. What is another name for somatic symptom disorder? a. Briquet’s syndrome b. Munchausen syndrome by proxy c. imagined ugliness d. koro

88. In their study of individuals suffering from depersonalization, what did Charbonneau and O’Connor (1999) find in the majority of cases? a. The age of onset was in the 20s. b. Onset occurred following a traumatic life event, sexual abuse, or giving birth. c. These individuals eventually developed symptoms of schizophrenia. d. There were additional dissociative disorders.

89. Which of the following would be typical for a patient suffering from a conversion disorder? a. the ability to identify everything in the visual field even though the patient reports that she is blind b. great concern with the loss of function and belief that it is a symptom of a potentially fatal disease c. the ability to avoid walking into things even though he reports being unable to see anything d. the ability to see some bright objects when calm, but suffering complete loss of sight during a stressful period or emergency

90. Auditory hallucinations (hearing voices) occur in people with dissociative identity disorder (DID) and those with psychotic disorders. How do these hallucinations in DID patients differ from those in patients with psychotic disorders? a. DID patients report that the voices are from familiar figures in their past, such as parents. b. DID patients report that the voices are coming from outside their own heads. c. DID patients report that the voices are coming from inside their own heads. d. DID patients report that the voices frequently tell the patient to kill or harm others.

91. If left untreated, what course does dissociative identity disorder usually take across the life span? a. Its form does not change substantially, but the frequency of switching increases with age. b. The natures of the alter personalities change as the person ages, but the number of them stays about the same. c. The number of alter personalities stays about the same, but the host personality becomes increasingly aggressive. d. Its form does not change substantially, but the number of alter personalities increases substantially.

92. Craig suddenly notices that the world looks weird to him. Some objects look bigger than normal and others look smaller. Cars passing by seem oddly shaped and people appear dead or mechanical. What is Craig experiencing? a. classic early psychosis symptoms b. depersonalization c. derealization d. mania

93. Henry has illness anxiety disorder. What are his symptoms? a. when he is truly ill he represses the knowledge b. when he feels normal bodily sensations he interprets them as a sign of a serious illness c. when he has a real physical illness it is exaggerated to the point where Henry can only focus on the pain d. Henry has an unrealistic fear of infection and disease

94. While driving alone in her car, Sally suddenly looks around and, for a moment, she can’t remember where she is, how she arrived at this point on the road, or even why she is driving her car. What is Sally experiencing? a. neurotic distortion b. derealization c. depersonalization d. early onset psychosis

95. Sue has dissociative identity disorder. What does she most likely also have? a. depression b. at least one other psychological disorder c. antisocial personality disorder d. a history of problems with the law

96. When interviewing 129 women with documented histories of childhood sexual abuse, what did Williams (1994) find? a. Thirty-eight percent of the women did not recall the abuse. b. The woman remembered minute details of the abuse. c. Seventy-five percent of the women did not recall the abuse. d. Almost none of the women recalled the abuse.

97. What is the nature of an alter personality? a. It is usually distinct from the person’s host personality. b. It is usually partially similar to the person’s host personality. c. It is usually the opposite of the host personality in every way. d. In some people it is distinct; in other people it is partially similar to the host personality.

98. What is the most common type of dissociative disorder in non-Western cultures? a. dissociative amnesia b. trance and possession c. dissociative derealisation disorder d. Depersonalization-derealization disorder

99. Both psychological and physical processes are involved in the perception of pain. Explain how this makes the DSM 5 diagnosis of somatic symptom disorder with predominant pain particularly difficult and partially subjective.

100. Describe the similarities and differences between illness anxiety disorder and somatic symptom disorder.

101. Describe the treatment that is generally used to treat patients with dissociative identity disorder. What is the rationale for each part of the treatment?

102. Discuss some of the ways in which it is sometimes difficult to distinguish between conversion reactions, real physical disorders, and malingering (faking). Describe some of the ways that can help a clinician make an accurate diagnosis.

103. Describe the relationship between post-traumatic stress disorder and dissociative identity disorder. How are the two disorders similar? How are they different?

104. Explain the current thinking regarding the environmental and psychological mechanisms in the development of dissociative identity disorder.

105. Describe the differences and similarities between depersonalization and derealization.

106. Shannon brings an extremely long list of physical complaints, with which she is inordinately preoccupied, to all of her frequent appointments with medical practitioners. However, extensive medical examinations have shown no physical basis for these complaints. With which disorder would Shannon likely be diagnosed? Provide at least three areas of functioning that therapy should address for the most effective treatment of Shannon’s disorder. Include a rationale for each recommendation.

107. A 30-year-old woman “recovers” memories of childhood sexual abuse, the existence of which she was previously unaware. Explain what is currently known about the accuracy of recovered memories. Can we determine whether these memories are accurate?

108. Discuss the similarities and the differences between somatoform disorders and dissociative disorders, as understood historically and also currently, in terms of psychological features.

Answer Key

1. a

2. c

3. d

4. c

5. c

6. a

7. c

8. d

9. b

10. c

11. d

12. c

13. d

14. b

15. b

16. d

17. b

18. c

19. d

20. c

21. b

22. a

23. b

24. d

25. b

26. a

27. b

28. b

29. d

30. b

31. c

32. c

33. d

34. a

35. d

36. d

37. a

38. a

39. a

40. b

41. d

42. c

43. c

44. b

45. a

46. c

47. b

48. b

49. a

50. b

51. c

52. a

53. c

54. b

55. b

56. c

57. c

58. d

59. c

60. c

61. a

62. b

63. d

64. b

65. b

66. b

67. a

68. a

69. a

70. b

71. a

72. d

73. d

74. a

75. d

76. c

77. a

78. d

79. d

80. b

81. b

82. d

83. c

84. c

85. c

86. b

87. a

88. b

89. c

90. c

91. a

92. c

93. b

94. c

95. b

96. a

97. d

98. b

99. Student responses will vary.

100. Student responses will vary.

101. Student responses will vary.

102. Student responses will vary.

103. Student responses will vary.

104. Student responses will vary.

105. Student responses will vary.

106. Student responses will vary.

107. Student responses will vary.

108. Student responses will vary.

Chapter 7

Indicate the answer choice that best completes the statement or answers the question.

1. Karen had a baby about ten months ago. Ever since, she has had a poor appetite and poor self-esteem, been unable to sleep (even when the baby wasn’t waking her), and been unable to concentrate for any length of time. What Karen is most likely experiencing? a. major depression, single episode b. postpartum depression c. depression d. postpartum psychosis

2. Last year, Debbie experienced a three-month period of depressed mood, feelings of worthlessness, difficulty concentrating, recurrent thoughts of death, sleep difficulties, and loss of energy. Four weeks ago, she began to experience the same severe symptoms. What is Debbie’s most likely diagnosis? a. major depressive disorder, recurrent b. dysphoric mania c. dysthymia, recurrent d. major depressive disorder, chronic

3. Jason had cyclothymia and was not treated for it. He now has been diagnosed with another, more serious disorder. What disorder is that most likely to be? a. antisocial personality disorder b. major depression c. bipolar I disorder d. borderline personality disorder

4. Which of the following statements best describes the terms used to differentiate mood disorders? a. Cyclothymic is to dysthymic as manic is to hypomanic. b. Cyclothymic is to dysthymic as major depressive is to bipolar. c. Cyclothymic is to dysthymic as bipolar is to major depressive. d. Cyclothymic is to dysthymic as bipolar I is to bipolar II.

5. Jack has experienced recurrent episodes of major depressive disorder. In the intervals between the episodes, he does not seem to return to “normal.” In fact, during those periods, he has been diagnosed as dysthymic. What condition does Jack most likely have? a. bipolar disorder b. atypical depression c. dysfunctional dysthymia d. double depression

6. Seligman and his colleagues conducted a course in which university students at risk for depression were taught cognitive and social problem-solving skills. What criterion was used to determine whether students in the study were at risk for depression? a. a low score on a test of learned helplessness b. a poor response to antidepressant medication c. a pessimistic cognitive style d. a family history of depression

7. If a person has symptoms of major depression, anxiety, or panic, what are you more likely to find in their family than in the family of someone without depression, anxiety, or panic? a. people with major depression but not panic b. people with major depression or panic but not anxiety c. people with major depression, anxiety, or panic d. people with panic or anxiety but not depression

8. Four people have just experienced the death of a spouse. Which of them is most likely to have a pathological grief reaction? a. Alice, whose husband committed suicide b. Beth, who was highly dependent on her late husband c. Claire, who has no family support d. Diane, who had a highly conflicted relationship with her late husband

9. Mack almost always draws conclusions that emphasize the negative rather than the positive. What is Mack exemplifying? a. overgeneralization b. learned helplessness c. delta commentary d. arbitrary inference

10. Which class of drugs includes the antidepressant medications known as imipramine (Tofranil) and amitriptyline (Elavil)? a. tricyclics b. tranquilizers c. MAO inhibitors d. SSRIs

11. Although electroconvulsive therapy has been a controversial issue for decades, it is an effective treatment for depression. In which of the following cases is it especially effective? a. when patient response to antidepressant medication is poor b. when patients are noncompliant in taking their antidepressant medication c. when symptoms of depression are mild d. when a bipolar patient is currently experiencing a manic episode

12. Prevalence rates for mood disorders in Canadian studies vary widely, from 4.1 percent in the Ontario Health Survey to 10.3 percent and 11 percent in surveys in Toronto and Calgary, respectively. What is epidemiologist psychiatrist Roger Bland’s explanation regarding these varying rates? a. different research methods b. cultural differences in the reporting of mood symptoms c. differences in health care systems d. varying levels of sunlight across regions of Canada

13. Which disorder puts adolescents at a higher risk for aggression, sexual promiscuity, and accidental injury? a. bipolar disorder b. major depression c. cyclothymia d. dysthymia

14. Which herbal treatment has recently gained considerable interest as a treatment for depression? a. milk thistle b. St. John’s wort (hypericum) c. gingko biloba d. saw palmetto

15. Patient X has rapid cycling bipolar I disorder. Patient X is MOST likely: a. an adolescent b. male c. elderly d. female

16. Current research into neurotransmitter systems has produced the “permissive hypothesis.” What does this hypothesis state? a. The norepinephrine system regulates serotonin levels; if norepinephrine is low, depression will occur. b. The absolute levels of neurotransmitters are more significant in mood regulation than the overall balance of the various neurotransmitters. c. Low levels of serotonin are sufficient to explain the etiology of mood disorders. d. When serotonin levels are low, other neurotransmitter systems become dysregulated and contribute to mood irregularities.

17. Which of the following describes what is known regarding drug treatment for depression? a. Drug treatments for mood disorders are effective for adults, but drug treatments are seldom effective with children. b. Drug treatments that are effective for adults are equally effective for children. c. Drug treatments for mood disorders that are effective for adults are even more effective for children. d. Drug treatments for mood disorders are effective for adults but have sometimes caused sudden deaths in children.

18. Why does the Canadian National Population Health Survey suggest that men and women have different rates of depression? a. Women tend to experience less overall stress in their work situations. b. Men tend to experience less overall stress in their work situations. c. Work-related depression is rarely reported by women. d. Different types of work demands predict depression in women versus men.

19. For several years now, 20-year-old Cynthia has been considered by her family and friends to be moody, high-strung, explosive, or hyperactive, yet never out of control. What is Cynthia’s most likely diagnosis? a. cyclothymia b. mania c. major depressive disorder d. dysthymia

20. About 10 percent of major depression episodes last as long as two years; however, most are time-limited. Approximately how long do they usually last? a. three months b. six months c. nine months d. one year

21. Jane is diagnosed with bipolar II disorder. Which of the following can we expect her to experience? a. She will experience hypomanic episodes and major depressive episodes. b. She will experience manic episodes and major depressive episodes. c. She will experience hypomanic episodes alternating with mild depressive symptoms. d. She will experience hypomanic episodes predominantly.

22. Dr. Yu is giving a lecture on depression. She emphasizes that: a. the best treatment for depression is always medication b. depression is mostly a problem of university-aged women and the elderly c. depression does not increase the risk of suicide d. depressive symptoms occur in most people at some point in their lives

23. Angela belongs to an online support group for mothers with postpartum depression. Recently, ten mothers in the group have had their second child. How many of the mothers are likely to experience postpartum depression following these new births? a. 1 b. 2 c. 5 d. 8

24. Jackie has depression and is having a particularly hard time with anhedonia. What does this mean? a. Jackie cannot concentrate. b. Jackie feels of worthless. c. Jackie can’t experience pleasure. d. Jackie has an altered pattern of sleep.

25. One symptom of depression is an increase in sleeping. What other symptoms related to sleep occur in depression? a. decreased delta (slow wave) sleep, the deepest stage of sleep b. stages of deepest sleep occurring earlier in the sleep cycle c. less intense REM activity d. slower onset of REM sleep

26. Assuming that the prescribed medication is effective, what is the advantage of combining medication and psychosocial treatments for patients with depression? a. Patients may benefit from both rapid drug action and the psychosocial protection against recurrence or relapse. b. Depressed patients can usually stop taking their antidepressant medication after several sessions of psychosocial treatment. c. The same psychologist can provide the psychosocial therapy and prescribe the necessary medication. d. The therapeutic effects of medication are gradual, allowing the patient to learn coping skills while the drugs begin working.

27. How do depressive disorder, recurrent and major depressive disorder, and a single episode of depression differ? a. They differ in terms of gender prevalence; more males have the recurrent episode type. b. They differ in terms of gender prevalence; more females have the single episode type. c. They differ in the severity of symptoms. d. They differ in terms of family history of depression.

28. Wendy usually says, “It’s all my fault,” when anything goes wrong. Which dimension of the depressive attributional style is she reflecting? a. hopeless b. global c. stable d. internal

29. Mike has bipolar I disorder. Which of the following medications has most likely been prescribed for him? a. an anticonvulsant b. lithium c. Prozac d. St. John’s Wort

30. Which of the following is NOT an important reason for identifying the pattern of mood disorder known as “double depression”? a. It usually has a problematic future course. b. It is associated with severe psychopathology. c. It is often misdiagnosed as bipolar II disorder and inappropriately treated with lithium. d. It has very high rates of relapse and recurrence.

31. If Sarah has a low level of serotonin in her system, will she show symptoms of depression? a. Yes, as long as the levels of other neurotransmitters are low as well. b. She will only if the levels are low compared to other neurotransmitters. c. No, low levels of serotonin are linked to mania, not depression. d. No, serotonin is not linked to depression.

32. Which of the following is NOT a goal achieved by psychosocial treatments used for bipolar disorder? a. managing marital and job difficulties b. helping families understand symptoms c. increasing compliance with medication regimens such as lithium d. learning how to recognize and prevent manic symptoms from developing

33. David is with his sister Debbie, who is having a hypomanic episode. He is trying to estimate how many days he will need to take off work to stay with Debbie, what estimate would you give him? a. two days b. four days c!. six days d! twelve days

34. Andrew has been diagnosed with mania. Which of the following symptoms might Andrew be exhibiting? a. grandiosity b. visual hallucinations c. hypersomnia d. hypoactive behaviour

35. Although glorifying and romanticizing suicide in the media contributes to copycat suicides, which of the following is more likely? a. that the person copying the suicide is trying to impress others b. that the person copying the suicide is doing it as a cry for help c. that the person copying the suicide is not really serious about the suicide attempt d. that the person copying the suicide is vulnerable due to an existing psychological disorder

36. Which of the following individuals is showing signs of cyclothymic disorder? a. Abe, who alternates between depression and hypomania every three months b. Ben, who seems to be either depressed or manic but neither his depression nor his manic meet the clinical criteria for a disorder c. Claire, who alternates between depression and mania with a month of neutral mood in between d. Diane, who alternates between manic and hypomanic states at irregular intervals

37. Sima experiences dysphoric mania. What type of manic episodes will Sima experience? a. manic episodes related to a medical condition b. very mild manic episodes c. extremely severe manic episodes d. manic episodes accompanied by depression or anxiety

38. Consider Aaron Beck’s depressive cognitive triad. Which of the following is NOT one of the factors that individuals think negatively about? a. their future b. their past c. themselves d. their immediate world

39. Which of the following is NOT typically involved in therapeutic approaches used to help the bereaved? a. re-experiencing the emotions associated with the death b. talking about the deceased loved one c. examining unexpressed hostility toward the loved one d. finding meaning in the loss

40. A student who has been doing very well in class receives a minor critical comment on an essay she wrote. The student thinks, “This is terrible. I’m probably going to fail the course.” What is this type of cognitive error in thinking? a. overgeneralization b. dissociating c. splitting d. arbitrary inference

41. Ambrose has just been prescribed selective serotonin reuptake inhibitor (SSRI). Which of the following medications may have been prescribed to Ambrose? a. Prozac b. hypericum c. Thorazine d. Valium

42. Sarah has major depressive disorder, and her doctor says that she is the average age for someone with major depression. How old is Sarah most likely to be? a. 15 years old b. 25 years old c. 35 years old d. 45 years old

43. What distinguishes bipolar I disorder from bipolar II disorder? a. only bipolar I disorder includes episodes of clinical depression b. only bipolar I disorder has episodes of mania c. only bipolar II disorder is linked to cyclothymic disorder d. only bipolar I disorder involves periods of hypomania

44. What do we call the phenomenon where individuals who are biologically vulnerable to depression have a tendency to place themselves in high-risk, stressful environments? a. humoral theory b. the cognitive-behavioural model c. a stress-depression linkage effect d. the reciprocal gene–environment model

45. Reports in the 1990s suggested that the use of Prozac might lead to suicidal preoccupations, paranoid reactions, and occasionally, violence. According to your textbook, what do more recent findings suggest? a. They substantiate the early claims. b. They suggest that the benefits outweigh substantial risks. c. They indicate that the risks of suicide are no greater than with any other antidepressant. d. They show that Prozac is associated with far less risk of suicide than other antidepressants.

46. According to the text, the average length of a major depressive episode if left untreated is: a. 5 months b. 7 months c. 9 months d. 12 months

47. Kelly has just been prescribed a tricyclic antidepressant for her depression. When can she expect to start feeling benefits from the medication? a. immediately b. within 24 hours c. two to eight weeks from now d. three months from now

48. Which of the following is a side effect of tricyclic antidepressants? a. sexual dysfunction b. insomnia c. excessive urination d. weight loss

49. Anne has major depression and her friend Gail is experiencing mania. Both are refusing drug treatment. If both Anne and Gail began feeling symptoms on the same day, what can you predict about when the symptoms will end? a. Anne’s symptoms will go away first. b. Gail’s symptoms will go away first. c. Anne’s and Gail’s symptoms will end around the same time. d. When untreated, the duration of both depression and mania is highly variable so a prediction cannot be made.

50. Which of the following is NOT an associated characteristic of early onset of dysthymia (before age 21)? a. greater chronicity b. genetic influence c. better prognosis d. poorer response to treatment

51. Marieke has dysthymic disorder while Jackie has major depressive disorder. How will the experiences of the two women differ? a. Marieke will have episodic symptoms of depression. b. Marieke will have longer-lasting symptoms of depression. c. Marieke will have more severe symptoms of depression. d. Marieke will have have temporary symptoms of depression.

52. Why is the antidepressant medication lithium also referred to as a mood stabilizer? a. because it increases the availability of both dopamine and norepinephrine in the brain b. because it increases thyroid functioning, which results in improved mood stabilization c. because it helps to prevent manic episodes d. because it elevates serotonin levels, which prevents depression

53. It can be difficult to diagnose depression in older adults because the presentation of mood disorders is often complicated by another variable. What is that variable? a. substance abuse b. symptoms of menopause c. the presence of medical illnesses or symptoms of dementia d. family members who are unwilling to admit there are psychological problems in their elderly relatives

54. Ms. Barr experienced the death of a close friend three months ago. She is so depressed that she has no appetite or energy, and she is suicidal. What would most mental health professionals conclude that Ms. Barr is experiencing? a. a depressive episode that is unrelated to the loss, because it has been three months b. a grief reaction within normal limits c. a pathological grief reaction d. a grief reaction that is considered within normal limits unless she actually attempts suicide

55. Bipolar II disorder is characterized by major depressive episodes alternating with hypomanic episodes, while bipolar I disorder is characterized by alternating episodes of major depression and another symptom. What is the other symptom? a. dysthymia b. mania c. cyclothymic disorder d. periods of remission

56. The best evidence that genes have something to do with mood disorders comes from twin studies. The concordance rates of identical twins are compared with those of fraternal twins. What have studies shown the concordance rates in mood disorders are associated with? a. age at first episode; the higher the age of onset, the higher the concordance rate b. severity; if one twin has had three or more major depressive episodes, the chances of his or her twin presenting with a mood disorder is greater c. age at first episode; the lower the age of onset, the higher the concordance rate d. response to treatment; if one twin responded poorly to treatment, the chances of his or her twin presenting with a mood disorder is greater

57. Victoria has had a history of depressive episodes in the past. Recently, her mother died. What would you predict about Victoria? a. Victoria’s past clinical history is unrelated to the development of an abnormal grief reaction. b. Victoria would be more likely to develop a pathological grief reaction than someone without a past history of depression. c. If Victoria had a lot of repressed anger toward her mother, she is more likely to develop an abnormal grief reaction. d. Victoria would have a grief reaction that is considered within normal limits unless she had previously attempted suicide.

58. When is the rapid-cycling specifier added to the diagnosis of bipolar disorder? a. when the patient has had at least two episodes within a year b. when the patient has had at least four episodes within a year c. when the patient has had at least six episodes within a year d. when the patient has had at least eight episodes within a year

59. Recent research suggests that it might be possible to “psychologically immunize” at-risk children against depression. What intervention was provided to form the basis of this position? a. Children who were at risk for depression were given art therapy before they entered puberty. b. Children who were at risk for depression were given family counselling before they entered puberty. c. Children who were at risk for depression were taught cognitive and social problem-solving skills before they entered puberty. d. Children who were at risk for depression were treated with psychoanalytic therapy before they entered puberty.

60. What was one step taken in Canada that was associated with long-lasting reductions in suicide rates? a. restrictive gun-control legislation in the 1970s b. extensive drug-control legislation in the 1960s c. making suicide attempts illegal in the 1970s d. funding more research studies of suicide beginning in the 1960s

61. Research has found that low levels of a neurotransmitter may be related to increased risk of suicide. What is that neurotransmitter? a. serotonin b. norepinephrine c. adrenalin d. GABA

62. Jerry experienced a manic episode six months ago, which was followed by a major depressive episode. What would he most likely be diagnosed with? a. cyclothymic disorder b. rapid cycling disorder c. bipolar II disorder d. bipolar I disorder

63. Kathy informed her doctor that she has had three major depressive episodes, which were separated by a two-month period when she did not feel depressed. What is Kathy’s most likely diagnosis? a. dysthymic disorder b. major depressive disorder, single episode c. major depressive disorder, recurrent d. double depression

64. When referring to the mood disorders, which of the following terms would family most likely use to describe cyclothymia? a. moody b. depressing c. hyperactive d. focused

65. In severe cases of depression in which the episode lasts five years or longer, approximately what percentage of patients can be expected to recover? a. 18 percent b. 38 percent c. 53 percent d. 98 percent

66. In 1989, Abramson and his colleagues revised Seligman’s theory of learned helplessness, which had focused on specific attributions as the crucial factor in depression. What did Abramson and his colleagues change the focus to? a. repressed anger b. lack of control c. a sense of hopelessness d. a feeling of failure

67. Which of the following puts you at the greatest risk for committing suicide if you are an Inuit in Nunavik? a. being male b. being between 24 and 36 c. being female d. a history of criminal behaviour

68. Which of the following behaviours is NOT likely to lead to hospitalization for mania? a. recurrent thoughts of suicide b. self-destructive buying sprees c. taking extreme physical risks d. violent behaviour

69. Jenny has experienced long-standing feelings of depression. During the past 20 days, she has experienced a depressed mood, feelings of emptiness, and significant weight loss. Jenny confided in a neighbour that she is considering suicide. What is Jenny MOST likely suffering from? a. major depressive disorder, postpartum type b. major depressive disorder, rapid cycling type c. double depression d. cyclothymia

70. Dr. Thompson is observing Reid’s behaviour and notes that Reid is displaying a “flight of ideas”. What does Dr. Thompson mean when she uses this phrase? a. extremely creative thinking b. inability to concentrate c. talking about grandiose plans d. rapid speech expressing many subjects at once

71. Where does a great deal of what we know about the risk factors for suicide come from? a. clinical experience b. psychological autopsies c. neurochemical analyses d. twin and adoption studies

72. Dr. Klein studies suicide and is interested in cultural and gender differences in suicide rates. She is collaborating with a researcher from a country where suicide rates are higher for women than for men. Where is her colleague from? a. China b. Canada c. The United States d. Taiwan

73. According to Martin Seligman, people become anxious and depressed because they believe that they have no control over the stress in their lives. Which model of depression is this? a. learned helplessness theory b. control theory c. hopelessness bias theory d. cognitive-behavioural theory

74. In their study of individuals who experienced a marital separation or divorce, but who had no previous history of severe depression, what did Bruce and Kim (1992) find? a. a higher rate of depression in men b. a higher rate of depression in women c. an approximately equal and a significant rate of depression for males and females d. no serious symptoms of depression in either males or females

75. Hannah and Greg are the same age and were both laid off from their jobs recently. What can you predict about the likelihood of each of them developing depression? a. Hannah is more likely to develop depression than Greg. b. Greg is more likely to develop depression than Hannah. c. Hannah and Greg are equally likely to develop depression. d. Whether Hannah or Greg is more likely to develop depression will depend entirely on their genetic makeup.

76. Who would be at the greatest risk for committing suicide? a. Mark, who has depression and a substance abuse disorder b. Angela, who has depression and anxiety c. Chris, who has bipolar II disorder d. Dave, who has dysthymia

77. Darren wants to help reduce suicides in his town. He decides to try to find ways to tackle something that is associated with approximately one-quarter to one-half of all suicides. What might Darren’s plan be? a. to reduce alcohol use among citizens b. to reduce gun ownership among citizens c. to reduce work stress among citizens d. to reduce divorce among citizens

78. Allison’s family has been told Allison has the most severe form of depression. What disorder has Allison been diagnosed with? a. cyclothymia b. dysthymia c. profound depression d. major depressive disorder

79. Which personality disorder is impulsive suicidal behaviour often a symptom of? a. borderline personality disorder b. obsessive-compulsive personality disorder c. paranoid personality disorder d. schizoid personality disorder

80. It has been ten days since Diana’s mother died. Diana doesn’t eat, she has lost interest in her usual activities, and she takes no pleasure in anything she does. All she can do is think about the past and wish she could be with her mother. What is Diana suffering from? a. impacted grief reaction b. pathological grief c. complicated grief d. pathological grief reaction

81. Thirty-five-year-old Rick recently formulated an elaborate plan to cure AIDS with vitamin therapy. To provide funding, he withdrew all his money from his bank and purchased thousands of jars of vitamins and small boxes to put them in. When he appeared at a hospital emergency room loudly demanding names of patients with AIDS, Rick was hospitalized for psychiatric observation. What is Rick’s most likely diagnosis? a. hypomanic episode b. schizophrenic mania c. depressive psychosis d. manic episode

82. Although the mood-stabilizing drug lithium is the preferred treatment for bipolar disorder, patient compliance has been a problem. Why do patients often stop taking their lithium, even though it is effective in stabilizing their moods? a. They become anxious that the drug is too toxic. b. They cannot organize their daily routine and forget their medication. c. They start to have panic attacks. d. They miss the euphoric feelings that mania produces.

83. According to recent research on the development of depression, what type of vulnerability to depression do dysfunctional attitudes (a negative outlook) and hopelessness attributions (explaining things negatively) constitute? a. cognitive vulnerability b. biological vulnerability c. sociological vulnerability d. behavioural vulnerability

84. Despite having many successes, which of the following people struggles with depression but is determined to decrease the high rates of suicide among young people in many Canadian Aboriginal communities? a. Sarah McLachlan b. Zindel Segal c. James Bartleman d. Margaret Trudeau

85. In a randomly assigned, controlled study, previously suicidal, hospitalized young adults were helped to develop social competence and more adaptive coping skills, and to recognize the emotional triggers that precipitate suicide attempts. A two-year follow-up indicated continued reductions in suicidal ideation and behaviour. What is the significance of this study? a. It has been expanded into the first empirically supported psychological treatment for suicidal behaviour. b. None of the patients in the study committed suicide. c. None of the patients committed suicide after the study was completed. d. It is the first psychological treatment for suicidal behaviour in which medication was not used.

86. How are MAO inhibitors and tricyclic antidepressants similar? a. They both result in the pooling of neurotransmitters at the synapse. b. They both have an effectiveness rate of about 60%. c. They are both more effective in men than women. d. They both result in similar side effects including increased sex drive and loss of appetite.

87. A friend states he is mildly depressed but he’s not sure, and he asks if there is any kind of laboratory test that could determine whether or not someone is depressed. What would you tell him? a. Cortisol levels are decreased in depression; he could have his cortisol levels checked by a blood test. b. Currently, there is no way of diagnosing depression with a laboratory test. c. The dexamethasone suppression test (DST) can be used only to diagnose severe cases of depression. d. The dexamethasone suppression test (DST) is a biological test for depression.

88. Dr. Hammond is frustrated because he is having the same problem with the medical treatment he has prescribed for three different patients with bipolar disorder. What is the most likely source of Dr. Hammond’s frustration? a. His patients are taking too much medication during a severe manic state. b. His patients are stopping the medical treatment and becoming depressed. c. His patients are having problems with addiction to the medication while in a manic state. d. His patients often stop taking the medication in order to bring on a manic state.

89. Which of the following is characteristic the manic state? a. anhedonia b. hyposensitivity c. irritability d. decreased energy

90. Jamie is six years old and has been diagnosed with dysthymic disorder. What disorder is Jamie highly likely to develop as he gets older? a. cyclothymia b. mania c. major depressive disorder d. bipolar disorder

91. Which of the following was dropped as an exclusion for a diagnosis of depression when the DSM 5 was published? a. a recent stressful event b. the recent birth of a child c. a concurrent diagnosis of an anxiety disorder d. the recent death of a loved one

92. Liz is in a very downcast mood. She has lost weight, has no appetite, and is constantly fatigued. She has lost interest in most of her regular activities and hobbies, and they no longer give her any joy. She seems indifferent to her family and friends and has recurrent thoughts of suicide. What does Liz appear to be suffering from? a. bipolar disorder b. dysthymia disorder c. cyclothymia disorder d. major depressive disorder

93. At what age is the gender difference in the prevalence of depression the greatest? a. childhood b. adolescence c. middle adulthood d. old age

94. Interpersonal psychotherapy (IPT) helps depressed patients resolve relationship problems. Which of the following issues is NOT a likely focus of IPT? a. death of a loved one b. deficits in social skills c. marital conflict d. problems in past relationships

95. Isaac has bipolar I disorder and does not take medication. He has just started a manic episode. How long will the episode likely last? a. two to six weeks b. four to eight weeks c. two to six months d. six to nine months

96. There is some evidence to suggest that many famous creative people have suffered from bipolar disorders. What has this finding led Richards and colleagues (1988) to speculate? a. Mania is at the heart of all creativity. b. The genetic vulnerability to mood disorders is associated with a predisposition to creativity. c. Creative endeavours may create sufficient stress such that they contribute to the development of mood disorders. d. The same gene that causes bipolar disorder causes creativity.

97. Hannah has just been diagnosed with depression. How long is her depressive episode likely to last? a. three months b. nine months c. two years d. more than two years

98. According to several studies, which of the following has been found to show a strong association with depression in women? a. a tendency to engage in activities that take their minds off negative feelings b. a history of childhood sexual abuse c. the size of their extended families d. brain damage

99. Jeremy has just been diagnosed with rapid-cycling manic-depressive episodes. How many manic episodes must Jeremy have had in the past year?? a. at least two b. at least four c. at least six d. at least ten

100. Explain the differences between mania and hypomania in terms of symptoms and severity.

101. Compare and contrast the clinical symptoms of major depression and mania. Explain what is meant by dysphoric (or mixed) mania.

102. Compare the symptoms, frequency, and treatment of depression in children/adolescents and the elderly, as it compares to depression in young and middle-aged adults.

103. Explain the neurobiological basis of depression. Describe the role of specific neurotransmitters implicated in mood disorders.

104. Explain how a grief reaction can become a pathological disorder. Describe the psychological and social factors that predict who will develop a pathological grief reaction.

105. Explain the differences between bipolar I disorder and bipolar II disorder, referring to the nature of episodes associated with each.

106. Explain Aaron Beck’s cognitive theory of depression. What is the “cognitive triad”? Give examples of the different types of cognitive errors.

107. Discuss the pattern of gender differences in the various mood disorders. Explain some of the proposed psychosocial theories of gender differences in depression.

108. Compare and contrast dysthymia and cyclothymia, and explain how each differs from either major depression or bipolar disorder. Explain what is meant by “double depression.”

109. Describe several of the medical and psychological treatments for depression. Compare the treatments in terms of effectiveness.

110. Discuss the relationship between suicide and psychological disorders such as depression, substance abuse, and personality disorders. Describe the significance of stressful life events in suicidal behaviour.

Answer Key

1. b

2. a

3. c

4. c

5. d

6. c

7. c

8. b

9. d

10. a

11. a

12. a

13. a

14. b

15. d

16. d

17. d

18. d

19. a

20. c

21. a

22. d

23. c

24. c

25. a

26. a

27. d

28. d

29. b

30. c

31. b

32. d

33. b

34. a

35. d

36. b

37. d

38. b

39. c

40. a

41. a

42. b

43. b

44. d

45. c

46. c

47. c

48. a

49. b

50. c

51. b

52. c

53. c

54. c

55. b

56. b

57. b

58. b

59. c

60. a

61. a

62. d

63. c

64. a

65. b

66. c

67. a

68. b

69. c

70. d

71. b

72. a

73. a

74. a

75. b

76. a

77. a

78. d

79. a

80. c

81. d

82. d

83. a

84. c

85. a

86. a

87. b

88. d

89. c

90. c

91. d

92. d

93. b

94. d

95. c

96. b

97. b

98. b

99. b

100. Student responses will vary.

101. Student responses will vary.

102. Student responses will vary.

103. Student responses will vary.

104. Student responses will vary.

105. Student responses will vary.

106. Student responses will vary.

107. Student responses will vary.

108. Student responses will vary.

109. Student responses will vary.

110. Student responses will vary.