Deck 3: Clinical Assessment, Diagnosis, and Treatment Approaches

Question 1

A psychosocial assessment typically begins with

A) adminstration of the MMPI.
B) an interview.
C) an assessment of global level of functioning.
D) a physical examination.

Answer 1

an interview.

Question 2

Cultural competence involves

A) an assessment of an individual's ability to cope within the majority culture.
B) being able to ignore cultural differences when making a diagnosis.
C) using testing procedures that have been adapted to and validated for different cultures.
D) only treating clients who come from the same cultural background.

Answer 2

using testing procedures that have been adapted to and validated for different cultures.

Question 3

Dr. Smith believes that a decrease in frontal lobe function underlies the cognitive deficits seen in schizophrenia. He has hypothesized that effective drug therapy serves to selectively increase metabolic activity in this part of the brain. Which of the following is Dr. Smith most likely to use to test his hypothesis?

A) magnetic resonance imaging MRI).
B) an electroencephalogram EEG).
C) positron emission tomography PET) scans.
D) computerized axial tomography CAT) scans.

Answer 3

positron emission tomography PET) scans.

Question 4

Shanna goes to Dr. Henderson for a first interview. He diagnosis her with a depressive disorder. She then goes to Dr. Smithson, because her friend recommended her. Dr. Smithson diagnoses Shanna with an anxiety disorder. This demonstrates a problem with

A) multiaxial diagnosis.
B) reliability.
C) structured interviews.
D) flexibility.

Question 5

Under what circumstances is a structured interview most likely to be used?

A) When an accurate diagnosis is needed to ensure appropriate treatment.
B) When the behavior of the client is erratic.
C) When the information provided in an unstructured interview is found to lack reliability.
D) When consistent information is needed for research purposes.

Question 6

One advantage of nuclear magnetic resonance imaging MRI) over the CAT scan is that the MRI

A) measures the metabolic processes of the brain.
B) is not an invasive procedure.
C) provides better differentiation and clarity.
D) does not require a claustrophobic cylinder-shaped machine.

Question 7

What role does the social context play in assessment?

A) Social context is not considered during assessment, only during diagnosis.
B) Environmental factors are usually the proximal cause of mental disorders and frequently need to be addressed before any form of treatment commences.
C) An evaluation of the environment in which the client lives is necessary in order to understand the demands he faces, as well as the supports that are present.
D) The social context need only be considered when a course of treatment is being selected; significant others in the client's life should be the primary decision makers.

Question 8

Which of the following best illustrates high reliability?

A) A clinician accurately predicts that a client will become violent when reunited with this family.
B) A clinician uses both medical eg. MRI) and psychological eg. MMPI-2) information to decide a diagnosis.
C) Two interviewers diagnose the same disorder after talking to the same client.
D) An interviewer modifies the way she asks questions to fit the style of the client.

Question 9

Neuropsychological tests

A) can be given only through means of a highly standardized battery of tests.
B) are more effective at locating specific sites of brain damage than fMRIs or PET scans.
C) use the measurement of performance on perceptual-motor tasks to give clues about impairment after brain injury.
D) can be given only through means of a highly individualized array of tests.

Question 10

Which of the following is a drawback of a structured interview?

A) Each person that uses them uses them in different ways.
B) They may include questions about areas that are of no concern to the patient.
C) Important information may be missed.
D) Information from one is hard to compare to information from another.

Question 11

While neurological assessment procedures evaluate the brain's physical properties, neuropsychological assessment focuses on

A) client performance.
B) self-reported changes in cognitive and perceptual functioning.
C) brain functioning.
D) brain activity.

Question 12

A person comes to a mental health professional with a certain complaint. The professional attempts to understand the nature and extent of the problem. This process is called

A) screening.
B) assessment.
C) diagnosis.
D) clinical treatment.

Question 13

Dr. Bruce says "Its beneficial features are the ability to map ongoing psychological activities of the brain without injecting radioactive substances into the patient's body. In addition, they are much more widely available procedures than what was used before." What is Dr. Bruce describing?

A) computerized axial tomography CAT) scans
B) electroencephalograms EEGs)
C) positron emission tomography PET) scans
D) functional magnetic resonance imaging fMRI)

Question 14

In which of the following circumstances would a psychosocial assessment clearly need to be used?

A) Mr. Harvey has been having problems wit h his memory since his stroke.
B) Since the car accident, Jill has had nightmares.
C) After a change in her hormone treatment regimen, Hillary began to show severe mood swings.
D) Ever since the divorce, James has been sleeping less and less.

Question 15

Ed has suffered a head injury in a car accident. He is referred to a psychologist to see what types of impairment now exist and to get some suggestions for treatment. The best assessment strategy would be

A) neuropsychological tests.
B) a CAT scan.
C) an fMRI.
D) a PET scan.

Question 16

Which of the following would be used to reveal a dysrhythmia in brain activity?

A) EEG
B) MRI
C) CAT scan
D) PET scan

Question 17

Unlike the medical practitioner, the mental health professional's assessment process

A) usually involves a rapid conclusion about how to explain and treat the client's complaint.
B) rarely has "lab work" that can confirm an initial impression.
C) must be completed prior to beginning treatment.
D) rarely includes a complex process where many contributing factors must be investigated.

Question 18

Which of the following statements regarding assessment is true?

A) An adequate assessment should include as much information as possible to allow the clinician to determine how the individual is functioning now and to predict how she will respond to various forms of treatment.
B) Assessment should focus only on the client's current level of functioning.
C) An adequate assessment consists of a diagnostic label and a determination of the amount of danger the client poses to himself and others.
D) Assessment necessarily involves the gathering of data about the client from multiple sources.

Question 19

Psychological assessment refers to the

A) determination of how environmental factors impact the course of a disorder.
B) process used to arrive at a diagnosis.
C) development of a treatment plan.
D) procedures used to summarize a client's problem.

Question 20

Dr. Kim is a psychologist who uses a number of tests to measure a person's cognitive, perceptual, and motor performance to detect brain damage. Dr. Kim is probably a specialist in using

A) neuropsychological assessment.
B) functional electroencephalograms.
C) computerized axial tomography.
D) functional magnetic resonance imaging.

Question 21

There are two general categories of psychological tests used in clinical practice. They are

A) intelligence tests and personality tests.
B) projective tests and sentence completion tests.
C) intelligence tests and rating scales.
D) neuropsychological tests and standardized tests.

Question 22

Which of the following is NOT a reason for using rating scales?

A) to decrease objectivity
B) to provide structure
C) to allow standardized comparisons to be made
D) to increase reliability

Question 23

Which of the following would best address recent criticisms of the TAT?

A) allow more time for the client to respond
B) rely more heavily on manuals for interpretation
C) make the images less ambiguous
D) use more modern pictures

Question 24

Which of the following is a projective testing method that has been adapted for computer interpretation?

A) the MMPI
B) the sentence completion test
C) the Rorschach Test
D) the Thematic Apperception Test

Question 25

Which of the following best explains why the Rorschach is less likely to be used today?

A) Treatment facilities often require other types of information than the Rorschach provides.
B) Other projective approaches have been found to be more reliable.
C) It is more costly and time consuming than other projective techniques.
D) The Rorschach is only useful as a means of aiding clients in self-discovery; it has not true clinical utility.

Question 26

In which of the following circumstances would a clinician be most likely to use self-monitoring?

A) When a client is unable to describe their presenting problem.
B) When other forms of clinical observation have yielded no evidence of abnormal behavior.
C) To evaluate the quality of the social environment.
D) To find out what situations are likely to illicit problematic behavior.

Question 27

A clinical psychologist notes that a client wears his clothes inside out, that his hair is matted, and there is dirt under his fingernails. This information is known as

A) an observational decision tree.
B) clinical observation.
C) a dynamic formulation.
D) self-monitoring.

Question 28

Intelligence and personality tests can best be described as

A) unstructured means of assessing behavior.
B) direct means of assessing behavior.
C) indirect means of assessing psychological characteristics.
D) observational means of assessing behavior.

Question 29

Reasons individually administered IQ tests may not be used include all of the following EXCEPT

A) they take several hours to give and interpret.
B) many settings and cases don't require the kind of detailed knowledge they give.
C) they have low reliability.
D) they are expensive.

Question 30

The Thematic Apperception Test TAT) has been used to assess all of the following EXCEPT

A) fantasies.
B) perception of reality.
C) needs.
D) intelligence.

Question 31

What would determine whether the WISC-III or the WAIS-III is used to test intelligence?

A) the age of the client
B) the amount of time available for test administration
C) the suspected level of impairment
D) whether or not organic brain damage is present

Question 32

Which of the following is NOT a criticism of projective tests?

A) subjective
B) client responses are limited
C) time-consuming
D) difficult to interpret

Question 33

"Projective" and "objective" are two types of tests.

A) intelligence
B) psychodynamically-oriented
C) personality
D) neuropsychological

Question 34

A behaviorally-oriented clinician tells her alcohol dependent client: "Here is a checklist I want you to fill out each day. Whenever you feel you need a drink, you should indicate what you were thinking, where you were, who you were with, and whether you went ahead and drank." What procedure is the clinician using?

A) self-monitoring
B) mental status exam
C) screening activity
D) self-analysis

Question 35

Danielle is having problems with drinking. She goes to a psychologist who gives her a form to fill out. It has a list of statements about drinking and problems associated with drinking. She is to rate each item between 1 and 3 1 meaning it is not a problem for her, 3 meaning it is a very big problem for her and 2 is in-between. This is an example of

A) a mental status exam.
B) self-monitoring.
C) a structured interview.
D) a rating scale.

Question 36

Research by Exner and others has shown that the Rorschach

A) is one of the least frequently researched clinical instruments despite its widespread use.
B) is a test with weak reliability and absolutely no validity.
C) is just as effective at identifying areas of brain damage as MRIs and PET scans.
D) can be scored by computer, thereby increasing its reliability.

Question 37

Which of the following is an unstructured approach to studying personality?

A) the TAT
B) WISC-III
C) the Stanford-Binet
D) the BPRS

Question 38

Several clinician's look at the TAT results of a hospitalized patient. The patient described the characters on the card as not speaking to each other. One clinician says this means the patient has a lot of unresolved anger. Another says it means the patient has a lot of social anxiety. The third says he thinks it means the patient is uninterested in people and prefers to be alone. This demonstrates the following problem with the TAT:

A) the amount of time it takes to score and interpet it.
B) scoring and interpretation is very subjective.
C) the pictures on the cards are old and dated.
D) the lack of training of clinicians on using it.

Question 39

Which statement about the Rorschach is accurate?

A) It is the quickest projective tests to administer and score.
B) It assesses the kind of specific behavioral deficits that most mental health facilities require today.
C) A considerable amount of training is required to administer and score it accurately.
D) The ambiguous stimuli it employs are pictures of people interacting in an unclear way.

Question 40

The aim of a projective test is to

A) assess the role of organic factors in a patient's thinking.
B) predict a person's future behavior.
C) assess the way a patient perceives ambiguous stimuli.
D) compare a patient's responses to those of persons who are known to have mental disorders.

Question 41

Why was the MMPI-2 needed?

A) The original MMPI was created over 50 years ago.
B) The original MMPI did not offer age-adjusted sub-scales.
C) The original MMPI did not permit subjects to select "other."
D) The original MMPI was not able to detect problems such as substance abuse and marital discord.

Question 42

Which of the following is an objective test?

A) Sentence-Completion Test
B) Rorschach Test
C) Thematic Apperception Test
D) MMPI-2

Question 43

Symptoms are to signs as ________ is to _.

A) subjective; objective
B) complaints; treatment
C) projective; objective
D) assessment; diagnosis

Question 44

Which of the following is a disadvantage of psychotherapy?

A) It is ineffective in treating severe mental disorders.
B) It is generally less effective than talking out your problems with a friend or family member.
C) It takes time.
D) It is significantly more expensive than all other forms of treatment.

Question 45

Which of the following statements about reliability and validity is true?

A) There is no relationship between reliability and validity.
B) In order for a test to be reliable, it must be valid.
C) Reliable tests are usually valid.
D) Valid tests are usually reliable.

Question 46

A key feature of the MMPI-2 is that

A) it has merged the adult and adolescent forms into one.
B) it now includes open-ended questions to examine cognitive distortions.
C) the clinical scales measure the same properties of personality organization as they always have.
D) the validity scales have been discarded.

Question 47

The empirical keying approach to making a test like the MMPI involves

A) subjective scoring of test items to assign items to different groups.
B) picking items that differentiate between different groups, no subjective judgment is needed.
C) the creation of ambiguous stimuli where there are many possible responses.
D) using theoretically-based concepts to develop questions for different groups.

Question 48

One criticism of diagnostic labels is that

A) the multiaxial system is so complicated to use that few people are able to use it well.
B) there are so many different systems of diagnosis that it is hard to understand what an individual diagnosis means.
C) they can influence both other people's and the diagnosed person's perception of themselves in negative ways.
D) they make other information unnecessary, so restrict the type of services that insurance will cover.

Question 49

Which of the following is an example of a symptom?

A) her children reported that she had not been sleeping well
B) a large lesion was visible on the CAT scan
C) the client reported hearing voices
D) the client's hands would not stop shaking

Question 50

One limitation of the MMPI-2 is that it

A) requires a clinical interview as a supplement to the test itself.
B) cannot detect whether an individual is attempting to distort his or her responses.
C) requires an individual to be literate.
D) is based on factor analysis, which often leads to measures that sacrifice validity for the sake of reliability without intending to do so.

Question 51

A valid test

A) rarely is reliable.
B) measures what it is designed to measure.
C) is standardized.
D) yields consistent results.

Question 52

Which of the following demonstrates reliability?

A) When an IQ test is administered to the same person repeatedly, the results do not differ.
B) Scores on two different intelligence tests are highly correlated.
C) Scores on an IQ test are not affected by mood.
D) An IQ test is effective in predicting the academic performance of both males and females.

Question 53

Despite his condition, Jim went to work every day. On which of the five axes of the DSM would this information be found?

A) Axis V
B) Axis IV
C) Axis III
D) Axis II

Question 54

During an assessment interview, Dr. Poole noted that Jane's boss at work was harassing her. On which of the five axes of the DSM would this information be noted?

A) Axis IV
B) Axis II
C) Axis V
D) Axis III

Question 55

Jane has been diagnosed with schizotypal personality disorder. Jane's distorted view of the world, however, does not prevent her from working and living a relatively normal life. Which of the following terms best describes Jane's condition?

A) recurrent
B) acute
C) chronic
D) episodic

Question 56

Why is classification a necessary first step in developing an understanding about abnormal behavior?

A) Communication about abnormal behavior can not be effective unless what is being discussed is clear.
B) Only through development of a classification system can abnormal and normal behavior be differentiated.
C) Unless an adequate classification system exists, all descriptions of abnormality will necessarily be subjective.
D) Abnormal behavior is not abnormal until it has been classified as such.

Question 57

What does it mean if Carol scores high on the Schizophrenia scale of the MMPI?

A) Carol is 30% more likely to develop schizophrenia than those who scored lower.
B) Carol's responses on this scale were similar to those of the Minnesota normals.
C) Carol has schizophrenia.
D) Carol's answers were comparable to those given by a group of schizophrenics.

Question 58

Disorders that begin by adolescence or early adulthood, persist for long periods of time and affect many areas of a person's life are listed on

A) Axis V.
B) Axis II.
C) Axis III.
D) Axis IV.

Question 59

Drugs that block dopamine receptors are most likely to be used to

A) distort perception.
B) stabilize mood.
C) alleviate depression.
D) decrease the intensity of hallucinations.

Question 60

The MMPI is

A) a recently developed objective approach to personality assessment.
B) a rating scale used to determine how comparable one is to individuals with various psychiatric diagnoses.
C) the most commonly used test of intelligence.
D) a structured approach to personality assessment.

Question 61

For bipolar patients, the risk of relapse after discontinuing lithium is

A) not much higher than when people remain on the medication.
B) roughly 50 percent within six months.
C) extremely unlikely.
D) about 15 percent, but only for people who have experienced repeated bouts with mania.

Question 62

Which of the following is NOT a problem with the benzodiazepines?

A) psychological dependence
B) risk of withdrawal symptoms if the patient stops them suddenly
C) tardive dyskinesia
D) high relapse rates when stopped

Question 63

The time course of the effects of antidepressant medications suggests that

A) changes in cellular functioning are necessary to alleviate the symptoms of depression.
B) low dopamine levels are the underlying problem in depression.
C) the effectiveness of the TCAs and SSRIs is largely a placebo effect.
D) altered synaptic activity is not the source of a depressed mood state.

Question 64

Psychological and physiological dependence is a well-documented danger of using

A) lithium.
B) neuroleptics.
C) antipsychotics.
D) anxiolytics.

Question 65

While most antianxiety drugs act on ________, Buspar acts primarily on _.

A) serotonin; GABA
B) GABA; serotonin
C) GABA; epinephrine
D) serotonin; epinephrine

Question 66

Because much of Donald's depression is a result of his lack of a healthy sexual relationship with his wife, Dr. Jones figured that the best drug to treat him with would be

A) Prozac.
B) Zoloft.
C) Welbutrin.
D) Chlorpromazine.

Question 67

Why are the SSRIs the most commonly used antidepressants today?

A) They are not addictive.
B) Their side effects are more tolerable than those of the first generation antidepressants.
C) They are more effective than the classic tricyclic antidepressants.
D) Because they only have minimal effects on dopamine, they are less likely to produce side effects.

Question 68

Suzanne is taking a benzodiazepine to treat her anxiety. She should be concerned that

A) when taken in high dosages, the drugs have potentially serious effects on a woman's reproductive ability.
B) she may become physically dependent on the drug.
C) while her anxiety is likely to be diminished, her adaptive behaviors also are likely to become impaired.
D) mania is a relatively common side effect.

Question 69

Oscar has been prescribed the following drugs over the years: Valium, Serax, Xanax, and Ativan. We can guess that Oscar has had problems with

A) mood swings.
B) depression and anger control.
C) positive symptom schizophrenia.
D) anxiety and insomnia.

Question 70

The new antianxiety drug Buspar has the advantage that

A) it works faster than the other drugs.
B) it has a low potential for abuse.
C) it works on more anxiety disorders than the other drugs.
D) it works better than other antianxiety drugs.

Question 71

The conventional antipsychotic drugs have a problematic side effect involving abnormal movement. This side effect is called

A) monoamine oxidase.
B) agranulocytosis.
C) atypical neuroleptics.
D) tardive dyskinesia.

Question 72

The main use of lithium is for

A) major depressive disorder.
B) personality disorders.
C) anxiety disorders.
D) bipolar disorder.

Question 73

Valium exerts its anxiolytic effects by increasing the activity of

A) dopamine.
B) GABA.
C) epinephrine.
D) acetylcholine.

Question 74

Julia has just been prescribed a monoamine oxidase inhibitor to treat her depression. What warning should her doctor give her?

A) You may find that you can't achieve orgasm.
B) Stay out of the sun.
C) Don't try to drive a car.
D) Be careful what you eat.

Question 75

The process by which lithium reduces the likelihood of mood swings

A) is a combination of re-uptake inhibition and receptor site blockades among serotonin and dopamine tracts.
B) involves changes in stress hormones including cortisol.
C) is unknown at this time.
D) alters GABA levels, although exactly how it does this is unknown.

Question 76

Lithium was once used

A) to alleviate constipation.
B) as a salt substitute.
C) as an appetite suppressant.
D) to treat anxiety.

Question 77

The use of lithium in the United States was delayed due to

A) the stigma associated with mental illness.
B) the fact that it could not be patented.
C) its addiction potential.
D) a lack of evidence to demonstrate that it was effective.

Question 78

A major advantage of the atypical antipsychotic drugs is that

A) they have a low risk of movement related side effects.
B) they work better than the conventional ones.
C) they work for more people than the conventional ones.
D) they last longer than the conventional ones.

Question 79

A doctor prescribing lithium should NEVER say:

A) "In order for this drug to work, you need to take quantities that are within the range of potentially dangerous side effects."
B) "We are going to 'target dose' your lithium: when you feel symptoms coming on, take your medication."
C) "Along with the benefits of mood stabilization you may experience increased thirst and weight gain along with a sense of lethargy."
D) "This drug has a narrow range of effectiveness, so you need to have your blood levels monitored often."

Question 80

Prozac is a

A) monoamine oxidase inhibitor.
B) GABA agonist.
C) selective serotonin reuptake inhibitor.
D) neuroleptic.