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42 Cards in this Set
- Front
- Back
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Edgar E., age 24, told his family that is gay two months ago, and, since then, his father has refused to talk to him. Also, six weeks ago, a man Edgar recently became involved with told him he will soon be moving to another state. Edgar says that, since these events occurred, he’s been feeling depressed and hasn't been able to sleep well and that his performance at work has declined and he's afraid he’s going to be fired. Edgar also states that he hasn't felt like spending time with his friends and has been staying home alone much more than usual lately. Based on these symptoms, the most likely diagnosis for Edgar is:
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The information presented in the question suggests that Edgar’s symptoms are the result of two specific stressors: his father's rejection of him and the loss of his friend/lover.
Adjustment disorder is diagnosed when a person's symptoms are a reaction to an identifiable psychosocial stressor; when symptoms have persisted for no more than six months since the termination of the stressor or its consequences; and when the symptoms are either interfering with the person's occupational and/or social functioning or are in excess of what might be expected. |
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Dyspareunia is the likely diagnosis for which of the following individuals?
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a male or female who experiences persistent genital pain during intercourse.
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For several months, Thomas T., age 33, has been able to attain an erection in the morning when he first wakes up but cannot do so at any other time of the day. Thomas is concerned about his “manliness” and his ability to satisfy his wife who is usually “in the mood” in the evenings but not in the morning. Assuming that Thomas’s symptoms are not being caused by a medical condition or drug use, the most likely diagnosis is:
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male erectile dysfunction.
Thomas is experiencing an inability to attain an erection at certain times of the day. The pattern of erectile dysfunction varies from individual to individual. Like Thomas, some men are able to achieve an erection only on awakening, while others are unable to attain an erection in any circumstance. Male orgasmic disorder is the appropriate diagnosis when a man experiences a recurrent delay in or absence of an orgasm following a normal sexual excitement phase. Hypoactive sexual desire disorder is characterized by deficient or absent sexual fantasies or desire for sexual activity that causes marked distress or interpersonal difficulty. |
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According to the catecholamine hypothesis:
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depression is due to a deficiency in norepinephrine.
Knowing that the catecholamines include epinephrine, norepinephrine, and dopamine would have helped you identify the correct response to this question. ccording to the catecholamine hypothesis, at least some types of depression are due to a lower-than-normal level of norepinephrine. |
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During the course of a mental status exam, a 36-year old man takes a great deal of time to answer the examiner's questions because he often focuses on unnecessary details and makes parenthetical remarks. When he is not interrupted, the man usually does get around to answering the examiner's question. The man's speech illustrates which of the following?
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The important thing to note in the description of the man’s speech is that he does eventually get back to the point.
Circumstantiality refers to speech that is indirect and delayed in reaching the point because of unnecessary, tedious details and parenthetical remarks. |
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The feeling that one is an outside observer of one's mental processes or body is referred to as:
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This question describes feelings of detachment or estrangement from oneself.
Depersonalization refers to “an alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one’s mental processes or body” (DSM-IV-TR, p. 822). When depersonalization co-occurs with intact reality testing and significant distress or impaired functioning, a diagnosis of depersonalization disorder may be appropriate. Dissociation refers to a “disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment” (DSM-IV-TR, p. 822). Although depersonalization disorder is a type of dissociative disorder, depersonalization is a better response to this question. |
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Chronic otitis media in early childhood has been linked to:
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Chronic otitis media can lead to hearing loss and speech and language problems and has been linked to reading and other learning disabilities.
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After witnessing the sexual assault of her best friend nine weeks ago, Cali C., age 22, says she’s been having frequent “flashbacks” of the assault, doesn’t feel like “doing anything,” is having trouble sleeping, feels detached from her friends and family members, and is easily irritated. Cali’s symptoms began about 10 days after the assault occurred. Based on these symptoms, the most likely diagnosis for Cali is:
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PTSD, acute
Cali developed symptoms characteristic of PTSD and acute stress disorder after experiencing a traumatic event. Her symptoms began 10 days after the assault and have lasted for over one month. PTSD is diagnosed when the duration of symptoms is more than one month; and the specifier “acute” is appropriate when the duration of symptoms is less than three months. Acute stress disorder is diagnosed when the duration of symptoms is between two days and four weeks. |
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With regard to conversion disorder, “secondary gain” refers to:
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securing support from the environment or avoiding an unpleasant activity.
The DSM identifies primary and secondary gain as factors that contribute to and/or maintain conversion disorder. keeping an internal conflict out of conscious awareness refers to primary gain adopting a "sick role" describes the motivation attributed to factitious disorder |
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One of the earliest signs of dementia of the Alzheimer’s type is:
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Dementia of the Alzheimer’s type involves a relatively predictable progression of symptoms.
Impairment in recent memory (anterograde amnesia) is usually the one of the first signs reported by relatives or clinical observers of patients with Alzheimer’s dementia. Confabulation is associated with memory disorders (e.g., Korsakoff Syndrome) caused by damage to certain areas of the brain. It involves an inability to distinguish between actual memories and imagined or false memories and is not an early sign of Alzheimer’s dementia. Fluent aphasia is characteristic of the middle stage of Alzheimer’s dementia. Gegenhaltin is a late-occurring symptom of some forms of dementia and involves irregular stiffening of the limbs. |
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For adolescents who are hospitalized with major depressive disorder, which of the following is LEAST predictive of future bipolar disorder?
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a gradual onset of depressive symptoms.
A number of factors have been found to predict the development of bipolar disorder in individuals who have their first episode of major depressive disorder as adolescents or young adults. An acute (versus gradual) onset of depressive symptoms in adolescence or early adulthood is associated with an increased risk for bipolar disorder. A family history of a mood disorder is a good predictor of bipolar disorder. |
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Apraxia, a symptom of dementia, involves which of the following?
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inability to execute voluntary motor movements.
The diagnosis of dementia requires some degree of memory impairment and aphasia, apraxia, agnosia, and/or impaired executive functioning. A person with apraxia has difficulty executing voluntary motor movements that is not due to problems in muscle strength or a lack of cooperation. Aphasia refers to deficits in written and/or spoken language. Ataxia is characterized by incoordination, clumsiness, and a lack of balance. Agnosia is the inability to recognize or identify familiar objects, people, or sounds. |
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Anna A., age 48, is referred to you by a physician who can find no physical explanation for her complaints, which include headaches, fatigue, loss of appetite, and impaired concentration. When you interview Anna, she tells you that her symptoms began two to three weeks ago. Anna is afraid she has cancer despite the doctor's lack of findings, and she says she’s having trouble sleeping and working because she’s so worried about her health. Based on these symptoms, the most likely diagnosis for Anna is which of the following?
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MDD
Anna is experiencing a combination of physical and cognitive symptoms. Sleep and appetite disturbances, physical complaints, and concern about one's physical health in the absence of a physical explanation for one’s symptoms are most suggestive of major depressive disorder. Conversion disorder involves symptoms suggestive of a neurological disorder or general medical condition but that are believed to be due to or maintained by psychological factors (i.e., to primary and secondary gain). An individual with conversion disorder is often indifferent to his/her symptoms. Somatization Disorder has an onset prior to age 30 and involves the presence of multiple somatic symptoms that have persisted for several years and cannot be explained by physical factors. The onset and duration of Anna’s symptoms do not support a diagnosis of somatization disorder. |
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Vivid dreamlike images that occur at the beginning of sleep are referred to as:
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hypnagogic hallucinations
Dreamlike imagery at the onset of sleep is a normal phenomenon in many people but is also associated with sleep deprivation, narcolepsy, and several other conditions. Hypnopompic hallucinations occur just after awakening. |
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In recent decades, the greatest increase in suicide rates has been for those aged:
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10-14
In recent years there has been an increase in suicide rates for both young people and older adults. Although the rates for older adults have also increased in the past two decades (with older white males having the highest rates), the increase has been greatest for those aged 10 through 14. |
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The prognosis for schizophrenia has been linked to several factors. Which of the following is NOT associated with a better prognosis?
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male gender
The course of schizophrenia varies from individual to individual, but the disorder is usually chronic and complete remission is rare. However, research has identified several factors that are associated with a better prognosis. Female gender is associated with a better prognosis. An acute and late onset is associated with a better prognosis. The presence of a precipitating event is also associated with a better prognosis. A family history of schizophrenia is associated with a poor prognosis; but a family history of a mood disorder is associated with a better prognosis. |
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Alterations in perception are most associated with which of the following disorders?
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panic disorder
Alterations in perception are associated with only one of the disorders listed in the answers. Perceptual distortions (depersonalization and derealization) are potential symptoms of a panic attack, which is the essential feature of panic disorder. |
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The diagnosis of antisocial personality disorder in an adult requires evidence of physical aggression toward people or animals, destruction of property, theft, and serious violation of rules prior to ___ years of age.
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15
As defined in the DSM, a diagnosis of antisocial personality disorder requires that the person be at least 18 years of age, that there is evidence of conduct disorder prior to age 15, and that the person has exhibited at least three characteristic symptoms involving the violation of the rights of others since the age of 15 (e.g., deceitfulness, impulsivity). The symptoms listed in the question are signs of conduct disorder. As noted above, for a diagnosis of antisocial personality disorder, the individual must have evidence of conduct disorder prior to age 15. |
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The use of clomipramine in the treatment of OCD:
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has both antidepressant and anti-obsessional effects for as long as the drug is administered.
Research has shown that some antidepressants – including the tricyclic clomipramine – not only reduce the depressive symptoms that often accompany OCD but also reduce obsessions. Although clomipramine has been shown to have antidepressant and anti-obsessional effects when used to treat OCD, symptoms usually re-emerge soon after the drug is stopped. For this reason, clomipramine is rarely used alone but, instead, in conjunction with some form of therapy. |
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Dalal D., age 21, displays several active psychotic symptoms including persecutory delusions, auditory hallucinations, incoherence, and loosening of associations. Assuming that her symptoms started suddenly three months ago and that she has no previous history of similar symptoms, your tentative diagnosis would be which of the following?
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schizophreniform disorder
The disorders listed in the answers to this question share several characteristics but also differ in terms of duration and/or certain key symptoms. Although Dalal’s symptoms suggest schizophrenia, their duration does not meet the DSM criterion (a duration of least 6 months) for a diagnosis of this disorder. Dalal’s symptoms and their duration are most suggestive of schizophreniform disorder. (If her symptoms persist for over six months, the diagnosis would be changed to schizophrenia.) |
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For children and adolescents, a diagnosis of cyclothymic disorder requires the presence of symptoms for at least:
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12 mos
Cyclothymic disorder is a chronic disturbance of mood involving hypomanic episodes and periods of depressed mood for an extended period of time. The diagnosis of cyclothymic disorder requires the presence of symptoms for at least two years in adults and one year in children and adolescents. |
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In prepubertal children, major depressive disorder is:
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about equally common in boys and girls.
The gender ratio for major depressive disorder differs for adults and children. According to DSM-IV-TR, major depressive disorder is about twice as common in adolescent and adult females as it is in adolescent and adult males. However, in prepubertal children, the rates are about equal for boys and girls. |
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Washing and/or cleaning rituals associated with obsessive compulsive disorder (OCD) would probably be best treated with:
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Exposure with response prevention and participant modeling
Note that this question is asking about the treatment of compulsions, not obsessions. Exposure with response prevention is usually the treatment-of-choice for compulsions. It is often combined with participant modeling (and pharmacotherapy). Thought stopping is more useful for obsessions. |
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“Habit reversal” is most likely to be used as a treatment for:
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stuttering
The technique known as habit reversal combines three strategies – awareness training, regulated breathing, and social support. Habit reversal is used to treat stuttering but not the other disorders listed in the answers. Note that alternative versions of this technique are used to treat tics and nervous habits such as nail-biting and thumb-sucking. |
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Which of the following is NOT true about children with ADHD?
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They respond differently to stimulant medications than other children.
ADHD is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity. The stimulant drugs have similar attention-increasing effects in individuals with and without ADHD. |
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A cognitive therapist is treating a 20-year old woman who has received a diagnosis of anorexia nervosa. The therapist's first priority will be to give the woman graded task assignments designed to increase her food intake. In addition, an initial intervention will be to:
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foster the woman''s doubt about her belief that she is accomplishing something by staying thin.
Approaches to treating anorexia vary, even among cognitive therapists. However, by definition, cognitive therapy entails addressing the cognitions that underlie or support a disorder. Of the strategies given in the answers, this one is most similar to Garner and Bemis’s (1982) approach, which is based on Beck’s cognitive therapy. According to Garner and Bemis, an initial step in treatment is to foster doubt in the client about his or her assumption that it is worth the time and effort to deny one's appetite in order to stay thin. This is followed by addressing the validity of the anorectic's beliefs regarding the consequences of becoming fat and the conviction that thinness is a primary determinant of self-worth and personal value. |
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Research investigating comorbidity in children suggests that, when depression occurs in conjunction with ____________, the depression is often associated with a different course and a different family background than when it occurs alone.
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conduct disorder
This is a difficult question that requires you to be an expert on childhood depression. For these kinds of questions, if you don't know the answer, don't spend too much time trying to figure them out: Make an “educated guess” and move on to the next question. Some experts suggest that depression occurring in conjunction with conduct disorder is actually a different type of depression since it is associated with a lower rate of depression in adulthood as well as with a lower rate of depression among relatives. |
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Which of the following groups is at highest risk for completed suicide?
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white men aged 85 and older
Age and race are both related to the risk for completed suicide. For most age groups, the rates for completed suicide are highest for White males; and White males over the age of 85 have a rate that is about six times higher than the overall national rate |
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As defined by the DSM, a diagnosis of attention-deficit/hyperactivity disorder (ADHD) requires which of the following?
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duration of symptoms of at least 6 months
As its name implies, attention-deficit hyperactivity disorder involves a pervasive, age-inappropriate pattern of inattention and/or hyperactivity-impulsivity. Of the diagnostic criteria listed in the answers, a duration of symptoms of at least 6 months is the only one required by the DSM for a diagnosis of ADHD. Markedly impaired academic performance is an associated feature of ADHD, not a diagnostic criterion. The diagnosis requires an onset of at least some signs of the disorder prior to age 7. |
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Dr. Bekke, a cognitive-behavioral therapist, is most likely to rely on which of the following when working with a client exhibiting dissociative symptoms and chronic arousal following involvement in a life-threatening traumatic event?
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stress inoculation and prolonged exposure
This is really a two-part question: First you have to recognize that the disorder is either PTSD or acute stress disorder and then know how a cognitive-behavioral therapist would treat these disorders. In describing the cognitive treatment of PTSD, C. V. Daneau and E. B. Foa recommend the use of stress inoculation when symptoms primarily involve chronic arousal; prolonged exposure when dissociative symptoms predominate; and both techniques when the individual presents with the full clinical picture of this disorder. This recommendation is consistent with recent cognitive-behavioral approaches to the treatment of PTSD and acute stress disorder, which rely on a multimodal strategy that incorporates anxiety management techniques, exposure, and cognitive restructuring. |
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A diagnosis of vascular dementia requires:
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evidence of cerebrovascular disease.
As its name implies, vascular dementia is caused by cerebrovascular disease. The diagnosis of vascular dementia requires evidence of cerebrovascular disease – i.e., the presence of focal neurological signs or laboratory evidence. |
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Which of the following would be most useful for monitoring the progression of Alzheimer's dementia?
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cognitive tests
The core features of dementia are disturbances in memory and other cognitive functions Not surprisingly, then, the best way to follow the progression of Alzheimer’s dementia is through repeated measurement of cognitive abilities. Note that many of the newer techniques for assessing patients with this disorder also incorporate other modes of assessment (e.g., interviews with family members, direct observations of the patient’s behavior). |
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Unilateral electroconvulsive shock therapy (ECT) to the right hemisphere would most likely produce:
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predominantly anterograde amnesia involving nonverbal material.
Knowing that, in most people, the left hemisphere mediates verbal memories while the right hemisphere mediates nonverbal memories would have helped narrow the responses to a and c. a. CORRECT ECT can produce both anterograde and retrograde amnesia but anterograde amnesia predominates. Consequently, following unilateral ECT to the right hemisphere, a person will have the most trouble forming new nonverbal memories. |
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Rett’s disorder:
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is a pervasive developmental disorder that involves a characteristic pattern of symptoms following a period of normal development.
Rett’s disorder is often not noticeable in the first several (6-12) months of life. The earliest signs of the disorder include head growth deceleration, the loss of previously acquired purposeful hand movements, and the loss of expressive language. |
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The presence of which of the following is more suggestive of a diagnosis of malingering than of factitious disorder?
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The motive for symptom production is to obtain an external reward.
The motivation underlying the production of symptoms in malingering is to obtain an external reward (e.g., to obtain a drug or avoid a specific activity). In factitious disorder, the motive is to adopt the "sick role." |
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Alzheimer’s
(mnemonic) |
Anterograde amnesia is usually first sign
Life expectancy decrease Zapped (loss of acetylcholinergic neurons) Hereditary disease Entire hippocampus becomes affected Identified by neurofibrillary tangles Mutation in amyloid genes associated with disease Entohinal areas degenerate first Retrograde amnesia develops Senile plaques at synapses |
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Alzheimer’s Phases - ABCD
(mnemonic) |
Alzheimer’s Phases - ABCD
Amnesic Behavioral Cortical/Continence Decerebrate |
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Depression = SIG
(mnemonic) |
Depression = SIG (Stable, Internal, Global)
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Major Depression Criteria - DEAD SWAMP
(mnemonic) |
Major Depression Criteria - DEAD SWAMP
Depressed mood most of day Energy loss or fatigue Anhedonia Death thoughts (recurrent) Sleep disturbances (insomnia, hypersonmia) Worthlessness or excessive guilt Appetite or weight change Mentation decreased (concentration, indecisive) Psychomotor agitation or retardation |
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Manic Episode
"DIGGITS" (mnemonic) |
Manic Episode
"DIGGITS" Distractibility Involvement (in pleasurable activities with potential for painful consequences) Goal-directed activity (increase) Grandiosity (or inflated self-esteem) Ideas ("flight of ideas" or experience that thoughts are racing) Talkative (more than usual; pressured speech) Sleep (decreased need) |
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Schizophrenia’s 4As
(mnemonic) |
Schizophrenia’s 4As
Ambivalence Affective incongruence Associative loosening Autism |
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Parkinson Disease - SMART
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Parkinson Disease - SMART
Shuffling gait Mask like face Akinesia Rigidity Tremor |
