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PSY 600 - Final Exam
questions with answers
What is the essential feature of separation anxiety disorder? What is the necessary duration of symptoms? (DSM 190-1) - CORRECT ANSWERS ✔✔The essential feature of this condition is excessive fear or anxiety concerning separation from home or attachment figures. Duration is 4 weeks in children, 6 or more months in adults. What is involved in a specific phobia (Criteria A)? Examples? How do the terms "almost always," "actively avoided or endured," and "out of proportion" apply? Duration? (DSM 197-8) - CORRECT ANSWERS ✔✔Marked fear or anxiety about a specific object or situation (e.g. flying, heights, animals, seeing blood). "Almost always, actively avoided/endured, out of proportion" apply as additional diagnostic criteria which indicate panic occurs nearly every time phobic stimulus present and that individual intentionally behaves in ways designed to prevent/minimize contact with phobic stimulus. Fear is out of proportion to actual danger that object/situation poses. What are the first 2 DSM criteria for social anxiety disorder (social phobia)? Note the terms "almost always," "avoided/endured," and "out of proportion." What is the
"performance only" specifier? (DSM 202) - CORRECT ANSWERS ✔✔The first two criteria for this condition are: Criteria A - Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Criteria B - Fear that individual will act in a way or show anxiety symptoms that will be negatively evaluated (embarrassing, rejection from others).// "Almost always, actively avoided/endured, out of proportion" apply as additional diagnostic criteria.// The "performance only" specifier describes performance fears that are typically most impairing in their professional lives (e.g. musicians, dancers, athletes, etc.) or in roles that require regular public speaking. Performance only individuals do not fear/avoid nonperformance social situations. Are the panic attacks in panic disorder expected or unexpected? Is one attack sufficient? In addition to panic attacks, what else has to occur for 1 or more months (Criterion B)? What has to be "ruled out" to arrive at the diagnosis of panic disorder (Criterion D)? (DSM 208-9) - CORRECT ANSWERS ✔✔Panic attacks in panic disorder are unexpected. // Attacks must be recurrent. // In addition to panic attacks, either one or both must be present: 1- persistent concern about the attacks/consequences or 2- a significant maladaptive change in behavior. //
Unexpected panic attacks are those for which there is no obvious cue or trigger at the time of occurrence (e.g. relaxing or asleep). What are 2 types of settings/situations involved in agoraphobia? What is the source of perceived threat for a person with agoraphobia? Note the strategies of avoidance, companion, or endurance. What is meant by "panic-like symptoms"? (DSM 217-
- CORRECT ANSWERS ✔✔Two types of settings/situations involved in this condition are: using public transportation (e.g. buses, trains) being in open spaces (e.g. parking lots, bridges.// The source of perceived threat is escape might be difficult or help not available in event of developing panic-like symptoms or other incapacitating or embarrassing symptoms.// The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety.// "Panic-like symptoms" refer to any of the 13 symptoms included in the criteria for panic attack (e.g. dizziness, faintness, and fear of dying). What are characteristics of generalized anxiety disorder? (DSM
- How does this diagnosis seem different from specific phobia or social anxiety disorder? - CORRECT ANSWERS ✔✔Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities. 3 or more
symptoms from list of 6: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance.// This diagnosis is different from social anxiety disorder in that SAD have anticipatory anxiety about being evaluated by others vs GAD worry whether or not they are being evaluated. When is a diagnosis of substance/medication-induced anxiety disorder given? (DSM 226) (See "Associated Features" DSM 228- 9). When does "anxiety disorder due to another medical condition apply? (DSM 230) - CORRECT ANSWERS ✔✔-Criterion A: Panic attacks or anxiety is predominant in the clinical picture -Criterion B: There is evidence from the history, physical exam, or lab findings that both:
- Symptoms in Criteria A developed during or soon after substance intoxication or withdrawal or after exposure to medication - and -
- Involved substance/medication is capable of producing the symptoms in Criterion A. This diagnosis is given (vs substance intoxication or substance withdrawal) only when symptoms in Criterion A predominate in the clinical picture and they are sufficiently severe to warrant clinical attention.// This condition applies when Criterion A is present along with Criterion B, which is: There is evidence from the history, physical examination, or lab findings that the disturbance is the direct pathophysiological consequence of another medical condition.
ANSWERS ✔✔Medication does not cure the problem and may actually reinforce that the fear is real. How treatable are specific phobias compared to other anxiety disorders? (Pg. 188) - CORRECT ANSWERS ✔✔The prognosis for specific phobia is the best of any of the anxiety disorders, with 70% to 85% of people experiencing significant improvement. How common is social anxiety disorder? (Pg. 188) - CORRECT ANSWERS ✔✔Social anxiety disorder affects about 6.8 million adult American's and is the third most common mental condition after depression and alcohol use disorder. What are a couple of preferred characteristics of a therapist working with social anxiety disorder? Describe the components of the treatment plan for social anxiety disorder. (Pg. 191) - CORRECT ANSWERS ✔✔Preferred characteristics for therapists working with this disorder include empathy, collaboration, and care not to appear critical or rejecting. Therapists may need to slow down the process, examine their own beliefs about change, and praise clients for their efforts and the progress that has been made. // Treatment is a combination of exposure and cognitive restructuring. Treatment consists of 12-20 weeks of treatment and includes:
- Psychoeducation about the cause of onset and maintenance of fears in social anxiety disorder
- Exposure to gradually more fearful situations
- Cognitive restructuring to recognize and self-manage troublesome thoughts
- Between session assignments (e.g., read- ing, experiments to generalize learning) How common are panic attacks? How many people meet the criteria for panic disorder? (Pg. 194) - CORRECT ANSWERS ✔✔Panic attacks are very common, the 12-month prevalence rate in the United States is over 12% of the adult population, and it has been estimated that as many as 50% of adults will experience at least one panic attack in their lifetime.// Fewer than 3% of the U.S. population will meet the criteria for panic disorder. How can therapists help by "normalizing," reassuring, and providing psychoeducation? (Pg. 195) - CORRECT ANSWERS ✔✔Normalizing & reassuring can help provide motivation to engage in yet another treatment. Psychoeducation is helpful because people who understand the physiology of a panic attack are less likely to be terrified when another occurs.
focus on how the client contributes to maintaining maladaptive schemas. Emotional processing and exposure to feared stimuli should be included in the treatment plan and in many cases will probably be related to feared emotional processing. Briefly define obsessions and compulsions. Are both required for the diagnosis of OCD? (DSM 235 & 237). - CORRECT ANSWERS ✔✔Presence of obsessions, compulsions, or both: Obsessions are defined by (1) and (2):
- Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
- The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion). Compulsions are defined by (1) and (2):
- Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
- The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or
situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive. Note: Young children may not be able to articulate the aims of these behaviors or mental acts. 2 common obsessions and 2 compulsions in OCD (See class handout)? - CORRECT ANSWERS ✔✔2 common obsessions: contamination (germs/dirt) & perfectionistic (possessions in order) 2 common compulsions: checking (locks/stoves) & counting (repeat behavior specific # of times) How is the "maladaptive" part of OCD defined? (Criterion B) Note the "insight" specifiers. (DSM 237) - CORRECT ANSWERS ✔✔The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. // -With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true. -With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true.
result in? What percentage qualify for "with excessive acquisition?" (DSM 247-8) - CORRECT ANSWERS ✔✔Those with this condition acquire and maintain so many possessions because of perceived need to save items and distress associated with discarding them. // Accumulation results in congestion and clutter of active living areas and substantially compromises their intended use. Causes clinically significant distress/impairment. // Approximately 80-90% with this condition display excessive acquisition. For trichotillomania, what else is required besides hair removal? What are the most common sites on the body? (DSM 251) - CORRECT ANSWERS ✔✔Besides hair removal, this condition also requires repeated attempts to decrease or stop hair pulling, hair pulling causes clinically significant distress or impairment in important areas of functioning. What must the skin picking in excoriation result in? In addition to skin picking, what else do those diagnosed with excoriation tend to do to their skin? (DSM 254) - CORRECT ANSWERS ✔✔Skin picking must result in skin lesions. // In addition to skin picking, those with this condition also tend to engage in skin rubbing, squeezing, lancing, and biting. What is the recommended treatment for OCD? What has been found to be more effective than medication? Describe the exposure portion of treatment of ERP. What is the prevention
part? Why is it important not to terminate the exposure while the person's level of distress is high? (Pg. 224) - CORRECT ANSWERS ✔✔answer Which is more likely - full recovery or partial remission? What are some factors associated with positive prognosis of OCD treatment? (Pgs. 225-226) - CORRECT ANSWERS ✔✔answer How can group therapy be helpful in treating body dysmorphic disorder? (Pg. 228) - CORRECT ANSWERS ✔✔answer What prevents people from seeking treatment for hoarding disorder? How can a therapist enhance motivation? (Pg. 230) - CORRECT ANSWERS ✔✔answer What forms the basis for most CBT interventions for trichotillomania? (Pg. 234) - CORRECT ANSWERS ✔✔answer Describe the 4 ways in which those with PTSD may have had exposure to actual or threatened death, serious injury, or sexual violence. (DSM 271) - CORRECT ANSWERS ✔✔4 ways include: Directly experiencing traumatic event, Witnessing (in person) an event as it occurred to others, Learning that a traumatic event occurred to a close family member of friend, or Experiencing
does not meet PTSD Criterion A (e.g., spouse leaving, being fired). Note the similarities in the trauma exposure and subsequent symptoms between PTSD and acute stress disorder? What is the duration difference? (DSM 281) - CORRECT ANSWERS ✔✔Similarities in trauma exposure for PTSD & acute stress disorder include exposure to actual or threatened death, serious injury, or sexual violence / presence of intrusion symptoms, negative mood, marked change in arousal (reckless/hyper- vigilance). // Duration for PTSD is more than 1 month. Duration for acute stress disorder is 3 days to 1 month. When should treatment begin for PTSD? In general, what are some of the main goals for effective treatment of trauma-related disorder? In prolonged exposure therapy, to what will the person be exposed? (Pg. 257) - CORRECT ANSWERS ✔✔answer Name and briefly describe three modes of intervention in the treatment of PTSD. (Pgs. 257-259) - CORRECT ANSWERS ✔✔answer What types of trauma are more likely to cause the development of acute stress disorder? Less likely? (Pg. 260) - CORRECT ANSWERS ✔✔answer
Please note that information on adjustment disorders was included in questions for week one (Pgs. 260-267) - CORRECT ANSWERS ✔✔look this up For an alcohol use disorder, the problematic pattern of use is manifested by how many symptoms over what period of time? (DSM 490) These 4 groupings may be helpful: impaired control, social impairment, risky use, and pharmacological criteria (DSM 483). Note at least 1 symptom within each grouping from the 11 listed. (DSM 490-1) - CORRECT ANSWERS ✔✔At least two symptoms occurring within a 12 months period. // PIC-SIR - Physical, Impaired Control, Social Impairment, Risky Use // Note the mild, moderate, and severe specifiers. (DSM 491) - CORRECT ANSWERS ✔✔ANSWER Differentiate alcohol use disorder from nonpathological use. (DSM496) - CORRECT ANSWERS ✔✔ANSWER Under alcohol intoxication, what is meant by clinically significant problematic behavior or psychological changes? List 3 common symptoms of alcohol intoxication. (DSM497) - CORRECT ANSWERS ✔✔ANSWER
What is the goal of motivational enhancement therapy? (Pg. 426 & 435) How is client-provided assessment data used? (435) How did you see these approach demonstrated in the video designed to facilitate movement from the pre-contemplative to contemplative stage. - CORRECT ANSWERS ✔✔ANSWER What are two behavioral techniques that have been found to be the most effective for treating alcohol use disorder? (Pg. 426) - CORRECT ANSWERS ✔✔ANSWER What is involved in relapse prevention? (Pg. 427) - CORRECT ANSWERS ✔✔ANSWER Under prevention programs, review the Celebrating Families! initiative. What does it work to achieve? (Pg. 427-428) - CORRECT ANSWERS ✔✔ANSWER First time users of cannabis with an underlying genetic predisposition or frequent users of cannabis are at risk for developing the symptoms of ____? What is the relapse rate for a cannabis user? How many treatment attempts do users generally attempt? (Pg. 433, 435) - CORRECT ANSWERS ✔✔ANSWER
What are 4 components of a combination intervention for the treatment of opioid use disorder? (Pg. 440-441) - CORRECT ANSWERS ✔✔ANSWER Describe two common pathways that lead to the onset of sedative, hypnotic, or anxiolytic related disorder. (Pg. 443) - CORRECT ANSWERS ✔✔ANSWER Of all the classes of drugs ________ are the most likely to produce symptoms that mimic those of mental disorders. (Pg. 444) - CORRECT ANSWERS ✔✔ANSWER Review criteria A-C for anorexia nervosa (DSM 338/339). - CORRECT ANSWERS ✔✔answer Differentiate the 2 specifiers of "restricting type" and "binge- eating/purging type. What measure is used to determine level of severity? (DSM 339) - CORRECT ANSWERS ✔✔ANSWER Describe the difference between Anorexia Nervosa (binge-eating/purging type) and Bulimia Nervosa? (DSM 344) - CORRECT ANSWERS ✔✔ANSWER
