Deck 9: Culture and Mental Health

Question 1

What is the main resource used by health and mental health professionals in the United States to diagnose mental disorders?

A) The Diagnostic and Statistical Manual of Mental Disorders (DSM)
B) The World Health Organization (WHO)
C) The International Statistical Classification of Diseases and Related Health Problems (ICD)
D) The Chinese Classification of Mental Disorders (CCMD)

Answer 1

A

Question 2

Research on the cross-cultural use of diagnostic systems around the world showed

A) psychiatrists around the world generally agree that the DSM is accurate for use in diagnosing their patients.
B) most psychiatrists around the world use the DSM to diagnose their patients.
C) a significant number of psychiatrists around the world question the applicability of global diagnostic systems like the DSM to the patients they serve.
D) psychiatrists in the United States agreed that the DSM was difficult to apply across cultures.

Answer 2

C

Question 3

Diagnostic categories in the DSM focus on

A) theoretical explanations for the various disorders.
B) behavioral descriptions of symptoms.
C) physiological manifestation of symptoms.
D) the cultural context of symptoms

Answer 3

B

Question 4

Research studies show that African Americans are more likely to be diagnosed with ________ than their European American counterparts who report the same symptoms.

A) a mood disorder
B) schizophrenia
C) borderline personality disorder
D) an anxiety disorder

Question 5

How does culture influence mental health?

A) The types of symptoms experienced
B) The way symptoms are expressed
C) The individual level of comfort in seeking help
D) All of the above

Question 6

Which of the following statements is TRUE about culture and mental health?

A) All disorders are expressed in the same way, regardless of culture.
B) Culture influences the client, but not the therapist.
C) Culture influences how clients cope with their problems.
D) All symptoms have the same meaning across cultures.

Question 7

When it comes to culture, the DSM

A) has always systematically included culture.
B) provides no guidance for how to deal with cultural issues.
C) now identifies key areas a therapist should cover in making a cultural assessment of a client and his or her issues.
D) advises therapists to ignore culture as irrelevant when diagnosing clients.

Question 8

_______________ are disorders that occur only in certain cultures.

A) Somatization disorders
B) Cultural syndromes
C) Multicultural syndromes
D) The International Statistical Classification of Disorders

Question 9

___________________ are specific ways of expressing troubling thoughts, behaviors, and emotions within a particular culture.

A) Cultural idioms of distress
B) Cultural syndromes
C) Mental disorders
D) The Cultural Formulation Interviews

Question 10

In some cultures, mental illness is believed to be caused by possession by evil spirits. This is an example of a

A) cultural syndrome
B) cultural explanation or perceived cause
C) cultural diagnosis
D) cultural idiom of distress

Question 11

Instead of saying she feels depressed, Anala's grandmother keeps complaining that her "heart hurts." This is an example of a

A) Cultural syndrome
B) Cultural explanation or perceived cause
C) Cultural diagnosis
D) Cultural idiom of distress

Question 12

Visits from spirits and a fear of being hexed or bewitched

A) should always be seen as symptoms of psychosis.
B) should always be seen as symptoms of depression.
C) are normal symptoms experienced by people in most cultures.
D) may be acceptable and understood experiences in some cultures.

Question 13

Which of the following statements is FALSE regarding culture and the expression of psychological symptoms?

A) Symptoms are the same regardless of culture.
B) Symptoms can vary with age.
C) Symptoms can vary by gender.
D) Symptoms can vary by ethnicity.

Question 14

________________ refers to the current rate of a disorder at a given point in time, while ________________ is the number of new cases of a disorder diagnosed in a given period of time.

A) Incidence; prevalence
B) Syndrome; disorder
C) Prevalence; incidence
D) Expression; experience

Question 15

What was the primary focus of the Collaborative Psychiatric Epidemiology Studies (CPES)?

A) To prove that ethnic minorities have higher rates of mental disorders than European Americans
B) To investigate cultural and ethnic influences on mental health
C) To validate the diagnostic categories of the DSM
D) To research culture-bound syndromes

Question 16

The largest and most comprehensive of the three CPES studies was the

A) National Comorbidity Survey Replication (NCS-R).
B) Epidemiologic Catchment Area Study (ECA).
C) National Latino and Asian American Study of Mental Health (NLAAS).
D) National Study of American Life (NSAL).

Question 17

According to the National Comorbidity Survey Replication (NCS-R), what percentage of U.S. residents experience a diagnosable mental disorder at some time in their life?

A) More than half (57.4%)
B) About one third (33.1%)
C) About one tenth (9.7%)
D) About three fourths (74.2%)

Question 18

According to the National Comorbidity Survey Replication (NCS-R), what are the most common disorders for U.S. residents?

A) Anxiety disorders
B) Substance abuse
C) Impulse control disorders
D) Mood disorders

Question 19

In general, what did the findings of the NCS-R indicate about ethnic group differences in the rates of mental disorder?

A) Non-Hispanic Blacks tended to have higher rates of mental disorder
B) Hispanics tended to have higher rates of mental disorder.
C) Both minority groups have lower rates of mental disorder than Non-Hispanic Whites.
D) There were no significant differences in rates of mental disorder between the groups.

Question 20

According to the findings of the NCS-R, there was only one instance in which a minority group had a higher rate of mental disorder than Non-Hispanic Whites. What was this?

A) Substance abuse for non-Hispanic Blacks
B) Bipolar disorder for non-Hispanic Blacks
C) Depression for Hispanics
D) Generalized anxiety disorder for Hispanics

Question 21

According to the findings of the NCS-R, which group experiences the lowest rates of mental disorder in most categories?

A) Non-Hispanic Whites
B) Hispanics
C) Asians
D) Non-Hispanic Blacks

Question 22

Which large epidemiologic study primarily focuses on the rates of use of illegal drugs, alcohol, and tobacco in the United States?

A) The National Comorbidity Study (NCS)
B) The Epidemiologic Catchment Area Study (ECA)
C) The National Survey on Drug Use and Health (NSDUH)
D) The Collaborative Psychiatric Epidemiology Studies (CPES)

Question 23

According to the National Survey on Drug Use and Health (NSDUH), which racial/ethnic group had the lowest overall rates of substance use?

A) American Indian/Alaska Natives
B) Blacks
C) Whites
D) Asians

Question 24

According to the National Survey on Drug Use and Health (NSDUH), which racial/ethnic group had the highest overall rates of substance use?

A) American Indian/Alaska Natives
B) Blacks
C) Whites
D) Asians

Question 25

The common expectation is that ethnic minority groups would have higher rates of mental disorder due to the social disadvantages and stressors they experience. What does the research say about this?

A) The most recent findings do not support this expectation because ethnic minority groups tend to have overall lower rates of mental disorder compared to Non-Hispanic Whites.
B) The most recent research findings support this expectation in that ethnic minority groups tend to have higher rates of mental disorder compared to Non-Hispanic Whites.
C) The results are inconclusive, with no consistent significant differences found between the ethnic groups in the rates of mental disorder.
D) The most recent research results suggest that Non-Hispanic Whites have lower rates of mental disorder compared to ethnic minority groups.

Question 26

According to the findings from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AISUPERPFP), Native Americans seem to be at higher risk for what disorders?

A) Schizophrenia and major depression
B) Dissociative disorders
C) All anxiety disorders
D) PTSD and alcohol dependence

Question 27

In general, Brave Heart et al. (2016) found ____________ rates of mental disorders for American Indians and Alaska Natives (AI/AN).

A) lower
B) higher
C) similar
D) inconclusive

Question 28

Brave Heat et al. (2016) found that the differences in rates of mental disorder between American Indians and Alaska Natives (AI/AN) and European Americans were ___________ for women.

A) even greater
B) even lower
C) the same
D) no different

Question 29

Based on the findings from the CDC Behavioral Risk Factor Surveillance System (BRFSS) telephone survey, which group reported the most frequent mental distress?

A) African Americans
B) Asians
C) Hispanics
D) Native Americans

Question 30

_____________________ seems to be a particularly serious problem for Native Americans, with their rates double the national average.

A) Schizophrenia
B) Opiate abuse
C) Suicide
D) Obsessive-compulsive disorder

Question 31

Besides Native Americans, another ethnic group neglected in the large epidemiologic studies on mental health are

A) Asians
B) Arab Americans
C) African Americans
D) Non-Hispanic Whites

Question 32

All of the following are problems with the large epidemiological studies on mental health except

A) the small sample sizes for some groups.
B) they ignore within-group differences.
C) the accuracy of diagnoses for members of different cultural groups.
D) the large sample sizes for all the ethnic groups.

Question 33

The CPES studies sought to improve on the earlier epidemiologic studies by

A) including significantly larger numbers of participants from ethnic minority groups.
B) examining factors not included in the earlier studies, such as educational level and immigrant status.
C) conducting paper-and-pencil surveys instead of face-to-face interviews.
D) both a and b

Question 34

What is the "immigrant paradox"?

A) The tendency for immigrants to report lower levels of mental disorder than those born in the United States
B) The tendency for immigrants to hang on to their culture of origin
C) The tendency for immigrants to report higher levels of mental disorder than those born in the United States
D) The finding that there are no significant differences in the rates of mental disorder between immigrants and those born in the United States

Question 35

Which of the following disorders has differential rates across cultures, suggesting that cultural factors, such as poverty and violence, may play a greater role than genetics in its cause?

A) Schizophrenia
B) Major depression
C) Bipolar disorder
D) Panic disorder

Question 36

Which of the following disorders may be influenced most by cultural differences?

A) Schizophrenia
B) Bipolar disorder
C) Posttraumatic stress disorder
D) Panic disorder

Question 37

What disorder is characterized by re-experiencing an event through intrusive memories, dreams, or flashbacks?

A) Major depression
B) Agoraphobia
C) Posttraumatic stress disorder
D) Panic disorder

Question 38

Which of the following immigrant groups might have the highest rates of posttraumatic stress disorder?

A) British
B) Brazilian
C) Iraqi
D) Mexican

Question 39

Prevalence rates for PTSD among refugee populations vary widely, with average rates ranging from:

A) 4% to 10%
B) 1% to 99%
C) 75% to 85%
D) 11% to 40%

Question 40

The highest rates of PTSD among refugees seemed most related to experiences with:

A) family conflicts.
B) hunger.
C) torture.
D) rape.

Question 41

What is the BEST conclusion about the overall rates of mental disorder between men and women?

A) Women have lower rates of depression.
B) Men have lower rates of substance abuse.
C) There are significant differences in the rates of mental disorder between men and women.
D) There are no overall differences in the rates of mental disorder between men and women, but there are gender differences in the specific types of disorders experienced.

Question 42

___________ have higher rates of mood and anxiety disorders, and ____________ have higher rates of substance abuse and impulse control disorders.

A) Women; men
B) Children; senior citizens
C) Men; women
D) Latino/a Americans; African Americans

Question 43

A(n) _________________ disorder is one where feelings are focused on the self.

A) internalizing
B) externalizing
C) interdependent
D) extra-sensitive

Question 44

A(n) ________________ disorder is one where feelings are projected outward and expressed through overt behaviors.

A) internalizing
B) externalizing
C) ethnocentric
D) interpersonal

Question 45

According to the study by Martin, Neighbors, and Griffith (2013), what is one possible reason men and women are diagnosed with different disorders?

A) The measures used to diagnose mental disorders may not accurately capture the different ways in which men and women express psychological symptoms.
B) Men and women are genetically different.
C) Men and women encounter different social experiences.
D) Men are more willing to disclose their psychological symptoms.

Question 46

Based on available research evidence, what is one possible explanation for why men and women experience different disorders?

A) They encounter the same social experiences.
B) They are biologically different.
C) The rates are the same, even when you vary social conditions.
D) They have different kinds of reactions to the same circumstances.

Question 47

Which of the following is NOT a cultural syndrome?

A) Brain fag
B) Ataque de nervios
C) Taijin kyofusho
D) Impulse control disorder

Question 48

What cultural syndrome is characterized by uncontrollable shouting, crying, trembling, and fainting spells?

A) Brain fag
B) Ataque de nervios
C) Taijin kyofusho
D) Posttraumatic stress disorder

Question 49

What cultural syndrome is characterized by extreme anxiety that one's body or its functions are offensive to others?

A) Brain fag
B) Ataque de nervios
C) Taijin kyofushu
D) Body dysmorphic disorder

Question 50

The inclusion of cultural concepts of distress in DSM-5

A) helps to avoid misdiagnosis.
B) yields information that helps increase our understanding of the impact of culture on mental health.
C) helps build rapport and improve relationships between mental health professionals and consumers.
D) All of the above

Question 51

Binge-eating disorder is characterized by all of the following except

A) vomiting or purging.
B) consumption of large amounts of food in one sitting.
C) eating until feeling uncomfortably full.
D) feelings of lack of control, embarrassment, disgust, and guilt.

Question 52

In the CPES studies, which racial ethnic group demonstrated the highest rates of any type of binge eating?

A) African Americans
B) Latino/as
C) Asians
D) European Americans

Question 53

What appears to be the most consistent finding in the literature regarding eating-related problems and ethnic group membership?

A) African Americans have higher rates of eating-related problems.
B) Whites have higher rates of eating-related problems.
C) Latino/as have higher rates of eating-related problems.
D) Asians have higher rates of eating-related problems.

Question 54

Which of the following groups tends to have higher rates of eating-related problems?

A) Whites
B) African Americans
C) Asians
D) Latino/as

Question 55

Informal ethnic group comparison from CPES data on the rates of eating disorders suggest that Asians are higher than the other groups only on

A) anorexia nervosa.
B) body dysmorphic disorder.
C) binge-eating disorder.
D) obesity.

Question 56

What was the conclusion of the meta-analytic study conducted by Wilde, Emery, and Simons (2001) on eating-related problems and ethnic group membership?

A) African American women had higher rates of eating-related problems.
B) Asian women had higher rates of eating-related problems.
C) Latina women had higher rates of eating-related problems.
D) White women had higher rates of eating-related problems.

Question 57

Which eating disorder seems to have more of a genetic base?

A) Bulimia nervosa
B) Anorexia nervosa
C) Body dysmorphic disorder
D) Social phobia

Question 58

Why was the term culture-bound syndromes dropped in DSM-5?

A) Because of the recognition that all forms of distress are shaped by local cultural, social, political, and economic forces
B) Because research shows that culture does not have a significant impact on mental disorders
C) Because the same mental disorders are found across cultures
D) Because while the expression of a mental disorder may be different across cultures, the underlying causes are the same

Question 59

While eating disorders appear to be more common among Whites, why do some researchers think they are on rise in non-White, non-Western cultures?

A) Because of poor nutrition in those cultures
B) Because of the restricted diet in those cultures
C) Because of increased exposure to Western standards of beauty
D) Because of increased exposure to Western foods

Question 60

It is generally accepted that ethnic minorities tend to ____________ mental health services.

A) overutilize
B) criticize
C) underutilize
D) none of the above-There are no ethnic group differences in use of mental health services.

Question 61

Several studies reveal that ethnic minorities are more likely to terminate therapy after _______ session(s) than European Americans.

A) 1
B) 5
C) 10
D) 3

Question 62

Research on Asian Americans show that about _____________ who requested an intake appointment from a mental health program failed to show up for this initial session.

A) one fourth
B) one tenth
C) half
D) one third

Question 63

Woodward et al. (2009) found that about _________ of participants in their sample with a DSM diagnosis had used some form of alternative treatment (e.g., acupuncture, herbal remedies, prayer) in the previous 12 months.

A) 1%
B) 52%
C) 34%
D) 68%

Question 64

Woodward et al. (2009) found that ________________ are more likely to use prayer and other spiritual practices to cope with mental health issues than non-Hispanic Whites.

A) Hispanics
B) African Americans
C) Asians
D) Native Americans

Question 65

Mojtabai et al. (2011) found that the majority of people in the general population with common mental disorders (e.g., anxiety, depression, substance abuse) did not seek help because

A) they couldn't afford it.
B) it was too difficult to get an appointment.
C) they didn't think they needed help.
D) they didn't believe psychotherapy would be helpful.

Question 66

According to Sue and Sue (2016), all of the following are barriers to effective multicultural counseling and therapy except

A) culture-bound values.
B) class-bound values.
C) language variables.
D) culture-bound syndromes.

Question 67

_____________ are core beliefs of one culture that may be inappropriate for another culture.

A) Culture-bound values
B) Class-bound values
C) Language variables
D) Culture-bound syndromes

Question 68

Popular theories of human development emphasize individuation, or the development of an autonomous, independent self. This is in direct conflict with many collectivistic cultures that emphasize the development of an interdependent self, where one's self-image is directly connected to the family and community. This is an example of the ____________ values of psychology.

A) class-bound
B) language-bound
C) culture-bound
D) college-bound

Question 69

Jennie could not get to her therapy sessions because she did not have a car. This is an example of how _____________ can be a barrier to treatment.

A) culture-bound values
B) class-bound values
C) language variables
D) ethnocentrism

Question 70

Capodilupo (2016) suggests that ______________ may be the reason why clients of color tend to terminate after their first therapy session.

A) microaggressions
B) stereotype threats
C) cultural syndromes
D) language variables

Question 71

When Kiana went to see Alan, a psychiatrist, for therapy, she felt frustrated by Alan's curiosity about her ethnicity and sexuality, and his assumptions about her as an "angry Black woman." According to Capodilupo (2016), Kiana probably did not return to therapy with Alan because:

A) she couldn't afford it.
B) she was resistant to Alan's interpretations of her behavior.
C) she experienced several microaggressions in her first session with Alan.
D) Alan told her he wasn't qualified to work with her.

Question 72

Therapists may create barriers to treatment for culturally diverse clients by:

A) falling prey to their own stereotypes, biases, and prejudices.
B) being resistant to seeing the harm they do because they perceive themselves as moral, just, fair-minded people, and decent people.
C) unconsciously pushing clients away because of their own lack of familiarity and discomfort with culturally diverse clients.
D) All of the above.

Question 73

Lana described how her counselor could not understand why she would place her brother's business before her own studies. Which barrier to multicultural counseling does this illustrate?

A) Insight required
B) Focus on the individual
C) Emphasis on verbal communication
D) Emphasis on self-disclosure

Question 74

Which of the following is NOT a key element of multicultural counseling and therapy (MCT)?

A) In MCT the role of the therapist is broadened to include teaching, consulting, and advocacy.
B) MCT advocates the use of both universal modes of helping that cut across cultures and culture-specific approaches that incorporate the values, practices and beliefs of the client's particular cultural group.
C) MCT advocates a shift from collectivistic to more individualistic perspectives.
D) MCT advocates a shift in focus from individual client change to altering social systems (e.g., education, employment, government, business, society).

Question 75

Multicultural counseling and therapy (MCT) seeks to strike a balance between _________ and ___________ modes of helping.

A) universal; culture-specific
B) client; therapist
C) Freudian; Cognitive-Behavioral
D) therapy; counseling

Question 76

Who developed the "talking cure" that formed the basis for almost all modern approaches to counseling and psychotherapy?

A) Sue and Sue
B) Josef Breuer
C) Terrence Roberts
D) Sigmund Freud

Question 77

From a cultural perspective, what is the difficulty with the current popularity of cognitive behavioral approaches to psychotherapy?

A) Their emphasis on uncovering the underlying motives and causes of behavior
B) Their emphasis on behavioral expressiveness, such as assertiveness and direct confrontation
C) Their emphasis on insight as a curative factor in psychotherapy
D) None of the above-Cognitive behavioral therapy is an effective approach for individuals from all cultures.

Question 78

What is the Japanese concept of shikata ga nai?

A) "It is out of my control; nothing can be done."
B) "I am, therefore we are."
C) A balance between opposite forces.
D) The belief that one's body odor is offensive to others.

Question 79

Kim et al. (2010) found that Latinx people who were more proficient in English were more likely to seek mental health services than those who lacked English proficiency. However, this difference did not occur for

A) Asians
B) Black Caribbeans
C) Native Americans
D) Arab Americans

Question 80

Which of the following is NOT a method used for providing culturally appropriate mental health services?

A) Training mental health professionals to work with clients from different cultural backgrounds
B) Developing separate services and modes of treatment for members of different cultural groups
C) Applying all traditional models of therapy to every cultural group
D) Providing services in the native language of clients