PSYCHOPATHOLOGY

1. Hani was unable to tell the difference between right

and wrong. Which of the following definitions

of abnormal behavior is described in this example?

(A) maladaptive

(B) insanity

(C) commitment

(D) statistical

(E) personal

2. The behavioral approach attributes the cause

of abnormal behavior to

(A) internal conflict from early childhood trauma

(B) the result of neurochemical imbalances

(C) poor self-concept

(D) reinforcement of maladaptive behaviors

learned through experience

(E) irrational and illogical perceptions of reality

3. Which of the following best characterizes a person

experiencing obsessive-compulsive disorder?

(A) Anna, who hyperventilates whenever she is

trapped in an elevator

(B) Ben, who returns home seven times to see if

he has turned off the stove

(C) Katia, who complains constantly about feeling sick and goes to many different doctors
(D) Kabir, who keeps remembering the plane crash

that killed the other members of his family

(E) Miguel, who wanders about town in a daze,

not sure who he is or how he got there

4. A soldier who experiences sudden blindness

after seeing his buddies killed in battle is best

diagnosed with

(A) a phobic disorder

(B) hypochondriasis

(C) bipolar disorder

(D) dissociative fugue

(E) conversion disorder

5. A common feature among people diagnosed with

dissociative identity disorder is

(A) early childhood sexual or physical abuse

(B) repeated physical complaints

(C) relatives suffering from bipolar disorder

(D) excess of dopamine

(E) hallucinations and delusions

6. Which of the following is NOT characteristic

of the manic state of bipolar disorder?

(A) inflated ego

(B) excessive talking

(C) shopping sprees

(D) fearlessness
(E) too much sleep

7. Paranoid personality disorder is characterized by

(A) unwarranted suspiciousness and mistrust

of other people

(B) lack of interest in social relationships

(C) unusual preoccupation with rules and

schedules

(D) instability revolving around problems

of mood and thought processes

(E) pleasure-seeking, shallow feelings, lack

of conscience

8. When Herb physically abuses his dates, he considers himself good with the ladies, has little

remorse for his actions, and has had repeated

trouble with authority figures. His likely diagnosis is

(A) autism

(B) narcissistic personality disorder

(C) antisocial personality disorder

(D) borderline personality disorder

(E) schizophrenia

9. A delusion is a

(A) phobia of being in social situations

(B) misperception of auditory and visual stimuli

(C) faulty and disordered thought pattern

(D) first indication of dissociative disorders

(E) characteristic of people suffering from

10. DSM-IV is most helpful for

(A) identifying the causes of psychological

disorders

(B) recommending treatment for psychological

disorders

(C) classifying psychological disorders

(D) distinguishing between sanity and insanity

(E) suggesting where consumers can get help for

mental health issues

11. All of the following are classified as anxiety

disorders EXCEPT

(A) phobias

(B) post-traumatic stress

(C) panic

(D) obsessive-compulsive disorder

(E) hypochondriasis

12. Which of the following is a negative symptom

of schizophrenia?

(A) delusional thinking

(B) incoherent speech

(C) hyperexcitability

(D) hearing voices

(E) flat affect

13. Which of the following disorders is most closely

(A) histrionic personality

(B) dependent personality

(C) paranoid schizophrenia

(D) bipolar disorder

(E) major depression

14. Estrella always goes shopping with Maria.

Because she has no confidence in her own

decisions, she lets Maria decide what she should

buy, and pays for clothes for Maria with money

she was saving for a haircut. Estrella shows signs

of which of the following personality disorders?

(A) histrionic

(B) dependent

(C) antisocial

(D) obsessive-compulsive

(E) narcissistic

PSYCHOTHERAPY

1. Jenna is telling her therapist about the dream she

had last night and her therapist begins to interpret it for her. Which approach to psychotherapy

does Jenna’s therapist probably represent?

(A) group

(B) behavioral
(C) Gestalt

(D) cognitive

(E) biomedical

2. In contrast to a clinical psychologist, a psychiatrist

is more likely to

(A) engage in an eclectic approach

(B) use a biomedical treatment

(C) recognize the importance of group therapy

with patients having the same disorder

(D) treat clients in community mental health

centers exclusively

(E) see patients with less serious mental health

problems

3. Which of the following disorders is most likely to

be treated with electroconvulsive therapy as a last

resort?

(A) schizophrenia

(B) obsessive-compulsive disorder

(C) dissociative identity disorder

(D) major depression

(E) antisocial personality disorder

4. Tommy came to Dr. Chambers seeking help with

his fear of heights. First, Dr. Chambers asked

Tommy to list all of the situations concerning

heights that led to his fear response. After they

most fear-provoking, Dr. Chambers had Tommy

listen to soothing music and slowly relaxed him

as he imagined each step. Which of the following

best describes Dr. Chambers’s treatment?

(A) the exposure technique of flooding

(B) systematic desensitization

(C) rational emotive therapy

(D) aversive conditioning

(E) the social cognitive technique of modeling

5. The goal of psychoanalytic therapy is

(A) to change maladaptive behavior to more

socially acceptable behavior

(B) to change negative thinking into more positive attributions

(C) to attain self-actualization

(D) to unite the mind and body elements into a

whole

(E) to bring unconscious conflicts to conscious

awareness and gain insight

6. Proactive preventive services available from many

community mental health centers include all

of the following EXCEPT

(A) 24-hour hotline services

(B) mental health screening for depression

(C) prenatal care for mothers in low-income

(D) psychoanalytic therapy

(E) outreach programs for at-risk children

7. An unplanned social change that occurred as

a result of deinstitutionalization was

(A) the rise of a multitude of group homes to

provide care for these former patients

(B) a rise in the number of better psychotropic

drugs to treat schizophrenia and bipolar illness

(C) an increase in the number of schizophrenics

among the homeless population in urban

centers

(D) an increase in the use of the insanity plea to

avoid long-term incarceration

(E) an increase in the number of mental hospitals

across the nation

8. Vic is encouraged to take charge of the therapy

session and his therapist uses an active listening

approach to mirror back the feelings he hears

from him. Which therapy is most likely being

described?

(A) client-centered therapy

(B) cognitive therapy

(C) psychodynamic therapy

(D) existential therapy

9. The antidepressants Prozac, Paxel, and Zoloft

work to

(A) block dopamine receptors

(B) decrease the level of acetylcholine in the

bloodstream

(C) break down the MAO enzymes

(D) decrease the amount of GABA at the postsynaptic neuron

(E) block the reuptake of serotonin

10. All of the following are potential benefits

of group therapy EXCEPT

(A) it is often more economical than 1:1 treatment

(B) it does not require the services of a mental

health professional

(C) clients with similar problems can provide

helpful insight and feedback to peers

(D) group members can see how their problems

might impact others

(E) it may reduce the resistance of patients who

have experienced difficulties in 1:1 settings

11. Drew’s depression seems an outgrowth of his

belief that everyone should like him. If his therapist were to utilize REBT, how might he proceed

in treating Drew’s depression?

(A) He would suggest a mild antidepressant drug

like Prozac to elevate his mood state.

regard and encourage him to open up about

his feelings.

(C) He would challenge Drew’s belief so that in

defending it Drew will recognize just how

absurd it sounds.

(D) Using the cognitive triad of Self, World, and

Future, he would determine Drew’s assumptions in all three areas.

(E) He would search Drew’s early childhood for

the root cause of this distortion of reality.

12. Antabuse is a drug that, when paired with alcohol

in the bloodstream, brings about extreme nausea.

For many motivated alcoholics, this has proven

to be an effective treatment. Under which

umbrella of psychotherapy would it most likely

be used?

(A) insight therapy

(B) aversive conditioning

(C) Gestalt therapy

(D) self-help therapy

(E) flooding exposure therapy

13. Andre suffers from mood swings, alternating

from wild episodes of euphoria and spending

sprees to motionless staring and hopelessness. A

drug to treat his condition is

(B) Haldol

(C) Xanax

(D) Thorazine

(E) Ritalin

14. The belief of ancient Greeks such as Hippocrates

and Galen about the cause of abnormal behavior

was closest to which of the following modern

approaches to psychology?

(A) psychoanalytic

(B) behavioral

(C) humanistic

(D) cognitive

(E) biomedical

238 ❯ STEP 4. Review the Knowledge You Need to Score High

15. After conducting a meta-analysis of over 475 outcome studies on the effectiveness of
psychotherapies, psychologists concluded that

(A) evidence supported its efficacy

(B) psychotherapy is no more effective than talking to a friend

(C) the potential to do further harm to the

patient with psychotropic drugs outweighs its

effectiveness

(D) psychotherapy proves no more beneficial

than no treatment at all

(E) of all treatments, psychoanalysis proved the

most beneficial over all other types of therapy

PSYCHOPATHOLOGY

1. B—Insanity is a legal definition of abnormal behavior. It means that a person, at the

time he or she committed a crime, could not distinguish between right and wrong.

2. D—The behavioral approach sees abnormal behavior as a result of faulty reinforcement

of maladaptive behavior.

3. B—Ben shows checking behavior, a common problem associated with obsessive–

compulsive disorder. His obsessive thought is that he may have left the stove on, and

the ritualistic behavior or compulsion is the need to return home and “check” to make

sure that it has been turned off.

4. E—A conversion disorder is characterized by excessive anxiety that has been transformed into a
physical symptom without an organic or biological cause. The blindness

probably does not disturb the soldier as much as it would if it were physiological,

because it protects him from having to “see” any other friends die in battle.

5. A—Childhood sexual or physical abuse is a common feature found in those diagnosed

with dissociative identity disorder. Psychoanalytically trained professionals believe that,

as a result of the trauma, the child “dissociates” as a defense mechanism and that the

amnesia experienced by one or more of the personalities is massive repression.

6. E—Mania in the patient with bipolar disorder is characterized by little need for sleep.

Sleep deprivation may actually trigger this phase of the disorder, and frequently during

the manic cycle the patient gets 2 hours of sleep or less.

7. A—People diagnosed with paranoid personality disorder tend to be unduly suspicious

and to mistrust others. They are overly sensitive and prone to jealousy.

8. C—Herb is clearly antisocial, and the lack of remorse or a guilty conscience for hurting others is a chief
indicator of this personality disorder. It is difficult to treat people
with this disorder.

9. C—A delusion is a disordered thought pattern characteristic of psychotic disorders like

schizophrenia. Someone with paranoid schizophrenia might have delusions of

grandeur, persecution, or reference.

10. C—DSM-IV is a handbook that lists common symptoms of psychological disorders,

which help professionals in the classifying and diagnosing of patients. It does not list

either causes or treatments.

11. E—Hypochondriasis is classified as a somatoform disorder characterized by physical

symptoms for which there is no demonstrable physical cause, and by unrealistic interpretation of
physical signs as evidence of serious diseases.

12. E—Flat affect is a negative symptom, a lack of any particular mood state. Each of the

other answers shows a positive symptom of schizophrenia, one that is present.

13. C—Excessive dopamine is associated with positive symptoms of schizophrenia, such as

hallucinations and delusions.

14. B—Estrella seems excessively lacking in self-confidence. She subordinates her own

needs by buying clothes for Maria, and allows Maria to make decisions for her. These

are characteristics of dependent personality disorder.

PSYCHOTHERAPY

1. C—Gestalt therapy includes the use of dream interpretation. What Jenna reported was

the manifest content of her dream and what her analyst attempts to interpret is the

latent or hidden meaning to help her gain insight into her problems.

2. B—Psychiatrists are medical doctors who can prescribe medications and are more likely

to use a somatic treatment than to utilize another psychotherapy. Clinical psychologists

are often eclectic and have good training in many of the therapies currently used.

3. D—Major depression. For patients who are potentially suicidal, ECT can be a fairly
quick and effective treatment. Its mechanism in the brain is still not entirely

understood.

4. B—Dr. Chambers first worked with Tommy to create an anxiety hierarchy of Tommy’s

fears, and then attempted to use the counterconditioning therapy of systematic desensitization to
prevent the phobic response, which is incompatible with relaxation.

5. E—The goal of psychoanalysis is to uncover the hidden childhood trauma and make

this unconscious conflict conscious so that the patient can gain insight into the problem. Psychoanalysis
does not offer a cure; rather it offers the patient better understanding of the source of the problem.

6. D—Psychoanalytic therapy is a long, expensive type of therapy that cannot be provided

at community mental health centers.

7. C—Deinstitutionalization was intended to result in better services for patients closer to

their homes. Unexpectedly, former clients did not continue to seek out services and

went off their medications. They now are part of the growing homeless population in

America, making up 40% of that adult population according to some estimates. Many

are suffering from some form of schizophrenia.

8. A—Vic is most likely engaging in client-centered or person-centered therapy.

Therapists take a nondirective approach and encourage clients to discuss their feelings

in a nonjudgmental setting. Through active listening, therapists help clients become

aware of their feelings, clarify their emotions, and take responsibility for future growth

toward full potential.

9. E—Prozac is one of a category of drugs called SSRIs, selective serotonin reuptake

inhibitors. By increasing the length of time serotonin stays in the synaptic cleft, serotonin becomes more
available. Many sufferers of depression see mood improvement in

about 2 weeks. The SSRIs have fewer side effects than the older tricyclic and MAO

inhibitors.

10. B—Group therapy is effective for all of the reasons given, with the exception that it

does utilize a trained professional. Psychotherapists are necessary in this dynamic

11. C—REBT, devised by Albert Ellis, can be a very confrontational cognitive treatment.

The hope is that by facing the irrationality of their belief systems, clients like Drew will

become more rational in how they view the world.

12. B—Antabuse is an aversive therapy because of the punishing effects of the nausea,

which, through repeated pairings, leads to the extinction of the desire for alcohol. As in

all classically conditioned therapies, occasional pairing of the alcohol and Antabuse will

be necessary to maintain its effectiveness over the long term.

13. A—A psychiatrist would prescribe lithium carbonate for Andre’s symptoms of bipolar

disorder. Though the chemical nature of mania is not completely understood, the

metal lithium is effective with many patients. However, care must be taken to avoid

lithium poisoning. Some patients might still suffer depressive symptoms, and a combination of an
antidepressant drug with lithium is often used.

14. E—Both medical doctors, Galen and Hippocrates pursued the belief that imbalances

in the body were the bases for abnormal behavior, much as the biomedical approach

today believes that neurochemical and hormonal balances underlie disorders.

15. A—Though there have been conflicting individual studies, meta-analysis of 475 studies found that
psychotherapy was effective in treating psychological disorders. Although

cognitive-behavioral approaches to therapy are popular today for treating a wide variety of disorders,
no single treatment has been found more effective for all types of

mental health problems.