Exam 3 Psych 210 DSMS Multiple Choice (1.5 each) Identify the choice that best completes the statement or answers the question. 1, A32-year-old man has regularly experienced panie attacks when out of his home alone and when on the bus. He now avoids leaving home for fear of experiencing these attacks. What is the most appropriate diagnosis? ‘Two separate disorders: Panic disorder and agoraphobia, Adjustment disorder Specific phobia Agoraphobia with a panie attack specificer Generalized anxeity disorder 2. Vince is extremely impressed with himself. Although he has only achieved a moderate amount of success, he thinks of himself as being uniquely special and deserving of the best of everything. Vince fantasizes frequently about great wealth and fame and does not really pay much attention to other people except to note how they react to him. Vinee should be diagnosed with _ personality disorder. narcissistic histrionie schizoid avoidant . antisocial 3, Inaddition to preoccupations with a perceived body flaw, which of the following behaviors would be most suggestive of a diagnosis of body dysmorphic disorder (BDD)? a Losing an unhealthy amount of weight in order to improve one’s appearance. . Repetitive mirror checking in response to the preoccupation, ¢. Experiencing discomfort with one’s priinary or secondary sex character 4. Consulting a psychiatrist because of the distress caused by the preoccupation. 4, A25-year-old woman describes a lifetime history of being “scared of heights.” She becomes uncomfortable when higher than three stories and whenever traveling becomes preoccupied with knowing the heights of buildings. On finding herself at a significant clevation, she has severe anxicty symptoms such as trembling, lightheadedness, numbness and tingling, and a fear of dying. Which of the following is the most likely diagnosis? a. social phobia b. specific phobia panic disorder histrionic personality disorder generalized anxiety disorder esaege paogs pee5. A48-year-old man presents to a psychiatrists, stating that he was pressured by his wife to seck help. He explains that he likes to collect wine, and he does not see a problem with this; he claims that many of the wine are quite valuable and a potential investment. On further questioning, the admits that he rarely drinks the wines, because it “never seems the right time.” He has never sold or given away and wine because he finds it hard to part with the bottles, He has had to use increasing portions of his house for storage of the wine, Which along with the financial hardship , is his wife's primary concern, He admit that many of the wine bottles have probably spoiled because he cannot afford to properly store the wine’and the bottles have sat for years on the shelves. What is the most appropriate diagnosis? a, Narcissistic personality disorder b. Obsessive-Compulsive disorder ¢. Delusional disorder 4; Normal collecting behavior ©, Hoarding disorder 6. A4S-yeat-old man comes to sec his primary care physician with a chief complaint of fatigue lasting for the past 6 months, The man states that he goes to sleep easily enough but then wakes up repeatedly throughout the night. He has had this problem with sleep since his wife left him 6 months ago. On questioning, he reports drinking 6-12 beers a day, as well as several ounces of hard liquor. He says that ittakes more alcohol than usual “to get me relaxed.” The patient claims he has experienced several blackouts caused by drinking during the past month, He admits that he often has a drink of alcohol first thing in the morning to keep him from feeling shaky. Despite his wife leaving him and his receiving several reprimands at work for tardiness and poor performance, hte has been unable to stop drinking. (On mental status examination, the patient is alert and oriented to person, place, and time. He appears rather haggard, but his hygienc is good. His speech is of normal rate and tone, and he is cooperative with the physician. His mood is noted to be depressed, and his affect is congruent, although full-range. Otherwise, no abnormalities are noted ‘What is the most likely diagnosis for this patient according to DSM-5? Alcohol withdrawal Primary insomnia Alcohol dependence Alcohol intoxication Alcohol use disorder 7. Social anxiety disorder differs from normative shyness in that the disorder leads to which of the following? a, Avoidance of social situation b, Social or occupational dysfunction c. Separation from others 4d. Embarrassment epeege 2 of 188 10. uM. A.21-year-old woman comes to the student counseling center with complaints of being depressed and {feeling anxious, She states that two weeks ago, while in class, she was called on by the teacher and gave the wrong answer, She said that she felt “humiliated” and has not come back to the classroom since then, She desezibes a lifelong history of being painfully shy. She admitted that she would like to have a boyfriend but that she is afraid to meet anyone because“I'll get dumped.” She describes herself as “socially retarded” and never meets anyone new. She has two close friends and does go out to dinner with them weekly, which she enjoys. She denies trouble sleeping or with her appetite, although she does admit to feeling ashamed of her “social ineptitude.” She's worried that she'll be unable to finish college because of her problems. What is the most likely diagnosis? avoidant personality disorder schizoid personality disorder adjustment disorder paranoid personality disorder antisocial personality disorder ‘Which of the following patient presentations would NOT be classified as psychotic for the purpose of diagnosing schizophrenia? a. A patient believes he is being followed by a seoret police organization that is focused exclusively on him. b. A patient is hearing a voice that tells him he is a special person. ©, A patient has loose associations dA patient has a flashback to a war experience that feels like it is happening again. e. A patient cannot organize his thoughts and stops responding in the middle of an interview. Barton, a 33-year-old librarian, is devastated by criticism or disapproval, no matter how minor it is, and as a consequence, is very uncomfortable around other people, especially at work. He seems very shy and is easily embarrassed, and his range of emotional expression seems very restricted, Barton tells you he wishes he could be closer to other people. He says that he has felt this way for as long as he can remember. The best diagnosis is: Borderline Personality Disorder Schizoid Personality Disorder Antisocial Personality Disorder Generalized Anxiety Disorder Avoidant Personality Disorder Without understanding the thought process motivating the patient's behavior, it would probably be impossible to determine whether a patient had personality disorder or personality disorder. borderline; histrionic schizoid; avoidant dependent; narcissistic narcissistic; antisocial eee oe esaege aes 3 of 1812, A 24-year-old male initially presents with acute auditory hallucinations and is treated with medication, Four days later he arrives at your office for evaluation. You observe that he is neatly dressed, avoids eye contact, and gives very short answers to your initial questions. Which of the following questions would be most beneficial for determining his degree of negative symptoms? a, How often have you visited with friends in the past week? b, Have the voices you've heard persisted or retumed? ¢. Have you ever thought about hurting yourself or someone else? d. Inthe past week have you had difficulty concentrating? e. Sinee you last saw me, have you had uncontrollable muscle movements? CASE A17 year old male is brought to the emergency department after being found in the basement of his home by his parents during the middle of a school day. ‘The parents came home after receiving a call from the school reporting that their son had not attended schoo! for 4 days, He was furiously working on a project he claimed would solve the fuel crisis. He has started returning from school after his parents left for work because his science teacher would no longer let him use the school laboratory after school hours. The patient was involved in an altercation with the school janitor after being asked to leave the school because it was so late, The patient claimed that the janitor was a foreign spy trying to stop his progress. ‘The parents are very proud of their son’s interest in science but admit that he has been more difficult to ‘manage lately. He can’t stop talking about his project, and others cannot get a word in edgewise. For the past few weeks, he reads late into the night and gets minimal sleep. Despite this, he seems to have plenty of energy and amazes his parents’ friends with detailed plans of how he is going to save the world. His friends have not been able to tolerate his increased interest in his project. His train of thought is difficult to follow. He paces around the examination room, saying “[J am] anxious to get back to my project before it is too late.” Although he has no suspects in mind, he is concerned that his life may be in danger because of the importance of his work. 13. Which medication might work well for this client? a. Lithium b. Nardil ©. Risperidone 4. Effexor ©. Sertraline 14, What diagnosis is most appropriate for this client? major depressive disorder Bipolar II Bipolar I no diagnosis Cyelothymie disorder eepoe 4 of 1815. 16. 18, 19. ‘A.19-year-old woman is referred to a psychiatrist by her primary care doctor after she admits that she recurrently shaves her eyebrows to the point of scarring. She states that her natural eyebrows are “bushy” and “repulsive” and that she “looks like a caveman.” A photograph of the woman before she began this activity shows a normal-looking teenager. What might be the appropriate diagnosis? a. Adjustment disorder b. Agoraphobia ¢. Body dystnorphic disorder 4. Specific phobia €. Obsessive-compulsive disorder ‘A research study involving adults with psychosis looked at their facial expressions in home movies taken when they were children, The researchers were trying to determine if the development of schizophrenia could be predicted by facial expressions showing limited emotional reactions. This research study focused on the negative symptom called: a. emotional effect syndrome b. alogia ©. affective flattening d._ associative splitting A 37-year-old woman has felt very depressed, and has had difficulty sleeping for the’‘last 3 weeks. She also reports having repeated thoughts of death and dying, some suicidal ideation, and finds that she “can’t stop erying”. The symptoms have significantly interfered with her ability to work, The patient has had no previous history of depression or mania, What diagnosis, if any, can be given to the patient based on this information? a. Bipolar It b. Major Depressive Disorder ©. Bipolar I 4, no disorder or condition ¢. Persistent Depressive Disorder Which of the following stressful situations would meet Criterion A for the diagnosis of acute stress disorder (ASD)? a. - Finding out that one’s spouse has been fired. b. Receiving a serious medical diagnosis. ©. Being ina subway train that gets stuck between stations. d. Béing in the cross fire of a police shootout but not beinig harmed. ¢. . Failing an importent final exam. Criteria for borderline personality disorder include each of the follo Frequent displays of temper A lack of ability to function as a responsible parent ‘A pattern of unstable interpersonal relationships. Recurrent suicidal threats or gestures Chronic feelings of emptiness or boredom ig except passe 5 of 1820. Glenn has been suffering from a condition in which he feels better than good. In these cases he gets himself in to trouble, spends too much money, has racing thoughts, and seems to feel a pressure to keep talking. Sometimes, Glenn feels quite different from this and has a down mood, problems sleeping, docsn’t seem to have things that he really likes to do, thinks about death a lot, and has no appetite. His doctor is tryinig to decide which medicine to give to Glenn that will help both of these clusters of symptoms. Which medication might hefp Glenn the most? a, Lamotrigine b. Parnate Lithium d._ Risperidone fe. Effexor 21. A.37-year-old man presents to your office complaining of auditory hallucinations that have worsened over the last several months, He notes that the devil has been telling him that he is “no good,” and that he “will not amount to anything,” During the last several months, the patient has reported he has been fecling “depressed” and has been sleeping poorly. He has no desire to get out of bed and has lost interest in even watching sports (normally one of his favorite activities). The patient states that even, ‘when his mood is improved, he still cannot “get the voices out of my head.” He denies using any drugs or alcohol. Which diagnosis, best accounts for this patients symptoms? bipolar I disorder schizoaffective disorder bipolar HI disorder schizophrenia major depression 22. Match the following term with its definitions: catatonia a, delusions of grandeur or persecution . silly and immature behavior c. early madness 4. alternating immobility and agitated excitement 23, Megan has been feeling better than good for the past week. She has been productive at work and mote socially active than ever before, The symptoms don't seem to get her into trouble, and there is no evidence of any substance use or any previous depression. What disorder would a psychologist likely assign to Megan? a. Hypomanic disorder Bipolar disorder Major depressive disorder ‘No disorder or condition Adjustment disorder ve eee ppes 6 of 1824. A patient places a call afer hours to the practice you are covering. You do not have access to the patient’s chart but learn that the history suggest that the patient has experienced low moods that don’t meet criteria for depression as well ds better than good moods where she does not get herself into trouble, During these high periods she only sleeps 4 hours but feels rested, is more talkative than usual, and has a flight of ideas. These two mood states have been alternating back and forth for the last S ‘years, In making a decision about the patient’s medication you quickly recognize the diagnosis. Which of the following choices best categorizes the diagnosis? Double depression Bipolar IIf disorder Cyclothymia Bipolar If disorder Bipolar I disorder 25. Automatic thoughts are fixed and cannot be changed. a ‘Tre b. False 26. Which of the following statements best describes how panic attacks differ from panic disorder? a. Panic attacks require fewer symptoms for a definitive diagnosis b. Panic attacks are discrete, occur suddenly, and are usually less severe . Panic attacks are unexpected 4. Panic attacks represent a symptom and can occur with other disorders 27. Tardive dyskinesia can result from which of the following medications? a. modafinil b. Haloperido! c Lithium 4d. Effexor ©. Nardil 28. Which of the following is a sleep state where a person may act out their dreams? Sleep attacks Sleepwalking sleep paralysis Cataplexy REM sleep behavior disorder Pee re eae ge 7 of 1829. A 45-year-old man was admitted to a cardiac intensive care unit after suffering a heart.attack. 24 hours afer admission, the consulting physician is called in to make an evaluation because the patient is trying to sign himself out against medical advice. When a psychiatrist enters the patient’s room, she finds him, getting dressed and yelling at the top of his lungs, “I won't be treated in this manner! How dare you!” ‘The patient doés agree to sit down and speak with the psychiatrist, however. He tells her that staf’ ‘members are simply rude and do not treat him. “in the manner to which he is accustomed.” He says that he is a small-business owner, but that he is on the way up and “as soon as people realize my full potential, [will be a millionaire.” He cannot understand why the staff will not bring food up from an outside 4 star restaurant for him because the food in hospital is so bad, He asked the psychiatrist whether, after the interview, she will get some food for him, and he becomes angry when she declines. He then eyes her new, expensive watch. On mental status examination, the psychiatrist finds no disorder of thought process or content, and the patient is oriented for person, place, and time. What is the most likely diagnosis? a, dependent personality disorder b, narcissistic personality disorder ce. OCD d._histrionie personality disorder e. antisocial personality disorder 30. A thirty-year-old single woman reports having experienced auditory and persecutory delusions for 2 months, followed by a full major depressive episode with sad mood, anhedonia, and suicidal ideation lasting 3 months, Although the depressive episode resolves the psychotic symptoms persist. What diagnosis best fits this clinical picture? Schizophrenia Brief psychotic disorder. Major depressive disorder. Major depressive disorder with psychotic features. Schizoaffective disorder. 31. Hlenty is viewed by many as a workaholic and not very social. He is at his desk every moming at 7:30 and takes few breaks (although these breaks are always at the same time every day). Henry is known to be a perfectionist. The problem is that he does not seem to get much accomplished since he spends so much time making sure that everything is perfect before moving on to the next task. Henry appears to peegs suffer from personality disorder. a. avoidant b. obsessive-compulsive c, antisocial d. schizoid 32, Cognitive therapists call cognitions “automatic thoughts” because a, they “automatically” create emotions b. they arise instantly without any effort c. they “automatically” create situations 8 of 1833. A 21-year old college student has been hearing voices telling him to hurt himself for more than a year. Haloperidol (Haldol) 60/mg/d for 3 weeks have reduced the voices. Despite'a reduction in the voices, he remains isolated from family and friends, and his mood appears to be non responsive to the things that happen to him. Why is this the case? No medicine will help all of these symptoms. The isolation and non-responsiveness are side effects of the Haldol. Haldol is not a good medication for schizophrenia. A medication like modafinil would work better. ‘A medication like risperidone (Risperdal) would work better. 34, The DSM-5 criteria for Brief Psychotic Disorder indicate that the duration of an episode of the disturbance must be at least one day but not more than: a one month b. one year c, 6 months d. one week 35, 35-year-old man is in danger of losing his job because it requires frequent long-range traveling and for ‘the past year he has avoided flying. Two years earlier he was on a particularly turbulent flight, and although he was not in any real danger, he was convinced that the pilot minimized the risk and that the plane almost crashed. He flew again 1 month later and, despite having a smooth flight, the anticipation of turbulence was do distressing that he experienced a panic attack during the flight; he has not flown since. What’s the most appropriate diagnosis? a. Agoraphobia b. Social Anxiety disorder ©, Acute stress disorder 4, Specific phobia . Panic Disorder 36. A 28-year-old woman comes to her intemist with a chief complaint of muscle tension. She states that she has experienced a considerable amount of muscle tension during her entire life, but that it has become increasingly worse over the past seven months, She describes herself as a worrier, and since her first child was bom last year, her worrying has increased, She’s not able to stop worrying even when she actively tries to do so. She worries about a whole host of issues -- the status of US relations with ‘other countries, whether or not she and her husband can afford to put their child through college, her hhusband’s health, and the stock market. The patient also report symptoms of restlessness and insomnia. She can fall asleep without a problem but wakes up in the middle of the night and cannot fall asleep again. She denies any substance use other than an occasional glass of wine on the weekends. Both she and her husband work as lawyers, although the patient has had difficulty concentrating on her job since her child was born, What is the most likely diagnosis? a generalized anxiety disorder b, adjustment disorder ©. obsessive compulsive disorder , agoraphobia €. acute stress disorder Sap sP 9 of 1837. 38. 39. 40. 4l ‘A.36-year-old man was referred to an employment assistance agency because he has trouble making timely decisions and is often late with important work. The patient has angrily complied with this request although he does not believe that anything is wrong with him, He describes himself as “so devoted to my work that I make others look bad,” believing that this is why he’s been singled out for attention. The patient says that he has worked for the company for four years and during that time has put anywhere from 10 to 12 hours of work per day. He admits that he often misses deadlines and claims that “they are unreasonable deadlines for the quality’of work that I provide.” He states, “if' more people in the country were like me, we would get a lot more done ~ there are too many lazy slobs and people who don’t follow the rules.” He points out that his office is always perfectly neat, and he says, “{ know where every dollar I ever spent went.” On mental status examination, the patient does not reveal any abnormalities in mood, thought processes, or thought content. His manner is notable for his rigidity and stubbornness. What is the most likely diagnosis? a, obsessive-compulsive personality disorder b.: obsessive-compulsive disorder c: acute stress disorder 4. antisocial personality disorder Jane is diagnosed with Bipolar II disorder. You can expect that she will experience: a. hypomanic episodes b. neither manic nor hypomanic episodes ©. full manic episodes 4, both manic and hypomanic episodes Humanistic psychology places an emphasis on a, free will and freedom of choice b. loneliness and despair ©. reinforcement and consequences d. unconscious motivation In CBT the hypothesis is that a, There’s no knowing where feclings come from b. Feelings come on by themselves c. Situations dictate feelings 4. Feelings are created based upon your thoughts Which of the following behaviors or states would be highly unusual in an individnal with schizoid personality disorder? a. Lacking desire for sexual experiences with others b, An angry outburst at a colleague who criticizes his work. c. Difficulty working in a collaborative work environment, 4d. Drifting with regard to life goals e. Tuming down an invitation to a party 10 of 1842. A 38-year-old woman exhibits the following symptoms: a history of unstable romantic relationships and friendships, indecisiveness about her career and other life goals, a fear of being alone, feelings of depersonalization, and frequent shifts in mood. Based on these symptoms, the best diagnosis is Histrionic Personality Disorder Antisocial Personality Disorder Schizoid Personality Disorder Borderline Personality Disorder e. Narcissistic Personality Disorder 43, A 36-year-old man was referred to an employment assistance agency because he has trouble making timely decisions and is often late with important work. The patient has angrily complied with this request although he does not believe that anything is wrong with him, He describes himself as “so devoted to my work that I miake others look bad,” believing that this is why he’s been singled out for attention. The patient says that he has worked for the company for four years and during that time has put anywhere from 10 to 12 hours of work per day. He admits that he often misses deadlines and claims that “they are unreasonable deadiines for the quality of work that I provide.” He states, “if more people in the country were like me, we would get a lot more done ~- there are too many lazy slobs and people who don’t follow the rules.” He points out that his office is always perfectly neat, and he says, “{ know where every dollar I ever spent went.” pegs (On mental status examination, the patient does not reveal any abnormalities in mood, thought processes, or thought content. His manner is notable for his rigidity and stubbornness. What is the most likely diagnosis? a. acute stress disorder b. obsessive-compulsive personality disorder ©. obsessive-compulsive disorder 4. antisocial personality disorder LL of 1844, A 21 year-old man is brought to the emergeney department by the police after he was found sitting in the middle ofa busy street. By way of explanation, the patient states, “The voices told me to do it.” The patient says that for the past year he has felt that “people are not who they say they are.” He began to isolate himself in his room and dropped out of school. He claims that he hears voices telling him to do “bad things.” There are often two are three Voices talking, and they often comment to each other about his behavior. He denies that he currently uses drugs or alcohol, although he reports that he occasionally smoked marijuana in the past, He says that he has discontinued this practice of the past 6 ‘months because “it makes the voices louder.” He denies any medical problems and is taking no medication. On mental status examination, the patient is noted to be dirty and disheveled, with poor hygiene. He appears somewhat nervous in his surroundings and paces around the examination room, always with his back to a wall. He states that his mood is “okay.” His affect is congruent, although flat. His speech is of normal rate, rhythm, and tone. His thought processes are tangential, and lose associations are occasionally noted. His thought content is positive for delusions and auditory hallucinations. He denies any suicidal or homicidal ideation ‘What is the most likely diagnosis for this patient? multiple personality disorder (dissociative identity disorder) schizoaffective disorder schizophrenia delusional disorder brief psychotic disorder 45. Benzodiazepines, or "minor" tranquilizers, such as Valium and Librium are effective in reducing the symptoms of: a, depression b. anxiety ©. schizophrenia d._ hysteria 46. A 65-year-old woman reports being housebound despite feeling physically healthy, Several years ago, she fell while shopping although she sustained no injuries, the situation was so upsetting that she become extremely nervous when she had to leave her house unaccompanied, for fear that she would have a panic attack. Because she has no children and few friends whom she can ask to accompany her, she is very distressed that she has few opportunities to venture outside her home, What is the most likely diagnosis? a. social anxiety disorder b, Panic Disorder c. Agoraphobia ._ specific phobia, situational type e. Adjustment disorder spose 12 of 1847, Plastic surgery for body dysmorphic patients generally results in: a. an improyed self-image b. little, if any, patient satisfaction substantial relief from the current concern 4. the client feeling physically ill 48, Ifyou are Lea’s therapist and she makes threats about wanting to hurt others, you ONLY have a duty to warn potential victims if Lea's threats ___ a. involve children, b. occur within 90 days in the past. ¢. are in the immediate future, 4d. are specific threats against specific people. €. are sexual in nature. 49, A32-year-old woman reports sudden, unexpected episodes of intense anxiety accompanied by headaches, a rapid pulse, nausea, and shortness of breath. During the episodes she fears that she is ying, and she has presented several times to the emergence departments. Each time she hus been told that she is medically healthy; she is usually reassured for a time, but on the occurrence of a new episode she again becomes concerned that she has some severe medical problem, She denies any use of drugs or alcohol. What is the most likely explanation for her symptoms a. Caffeine intoxication b. OCD ©. Panic disorder 4. Specific phobia €. Agoraphobia 50, While intoxicated at a Mardi Gras celebration, a 19-year-old woman lifts her blouse to expose her bra as, a float goes by to get beads. The event appears on a cable news program watched by friends of her parents, who inform her parents. They insist that she get a psychiatric evaluation. She denies any other similar events in her life. She is currently extremly anxious and distressed--to the point of being unable to focus on her work at college, about her parents’ anger al her and their refusal to allow her to attend parites or go away on vacation, What is the most appropriate diagnosis? Voyeuristic disroder. Avoidant personality disorder. Exhibitionistic disorder. Frotteuristic disorder. Antisocial personality disorder. ‘Adjustment disorder. mepege 13 of 1851, A 46-year-old man presents with a year’s long belief that someone is following him and using the events from his life to create a blockbuster movie, Although he feels frustrated at being taken advantage of, he denies any significant depressive symptoms and is often able to enjoy playing cards with his, friends. What is the most likely diagnosis? a, major depression with psychotic features b, delusional disorder c. schizophrenia d. psychosis secondary to a general medical condi €. schizoaffective disorder 52. A 16-year-old student is brought to the emergency department by her parents. She says that for the past six weeks, she feels as if she “Just can’t cope wit all the pressure at school.” She broke up with her boyftiend six weeks ago. Since that time, she cannot sleep more than three or four hours a night, She lost 15 pounds without trying to, and her appetite decreased. She says that nothing interests her and that she cannot even concentrate long enough to read a magazine, much less her textbooks, Her energy level is low. She is not doing things with her friends like she was in the past and says that when she is, with them “things aren’t fun like they used to be.” She tends to be irritable and angry with slight provocations. ‘On mentel status examination, she’s observed to be a well-dressed teenager with good hygiene. She notes that her mood is very depressed, 2 on a scale of 1 to 10. Her affect is dysphoric and constricted, She admits to hearing a voice telling her that she is “no good.” She has heard this voice at least daily for the past week. She admits having had thoughts of suicide frequently over the past several days and denies that she would act on these thoughts because it would be a “sin.” She does not have a suicide plan, No delusions are present, and she is alert and oriented to person, place, and time, What is the most likely diagnosis? a. schizoaffective disorder delusional disorder schizophrenia major depression with psychotic features brief psychotie disorder : 53. In social anxiety disorder, the object of an individual’s fear is the potential for which of the following? embarrassment incapacitating symptoms social impairment harm to self or others separation from people gaeg saege 14 of 1854, A27-year-old woman states that for approximately 6 months she has believed that Jimmy Fallon is in love with her. She insists that he has professed his intentions to marry her through messages in his nightly talk show, She has written numerous letters to him and loitered around his homie, resulting in several arrests, Other that this, she functions well and denies any hallucinations. ‘What is the most likely diagnosis? delusional disorder schizoaffective disorder no disorder or condition brief psychotic disorder schizophrenia 55. Mary-is in therapy with Dr. David Bums. Dr, Burns wants Mary to participate in a therapeutic technique where Mary would answer out loud to the automatic thoughts she had about herself. Mary doesn’t want to do this technique because she thinks it would be too difficult. This technique is called a. mood log b. double standard technique c. feared fantasy technique 4. unconditional positive regard externalization of voices technique 56, A 28-year-old man describes a persistent fear of speaking in public. Although he does not have difficulty with one on one situations, when he’s giving a lecture he becomes extremely anxious worrying, that he will be humiliated. He relates one episode in which he was forced to speak at the last minute, ‘which resulted in his experiencing panic, shaking, abdominal cramps, and a fear that he would defecate on himself. Because of this problem, he has been held back from promotion at his place of business, Which of the following is the most likely diagnosis? avoidant personality disorder caffeine intoxication : specific phobia social anxiety disorder e. generalized anxiety disorder 57.” A 26-year-old computor programmer without a past psychiatric history has been married for 4 years. His wife is expecting their first child. She reports that 8 months ago the patient became preoccupied with the idea that she became pregnant by another man, During this time, he began missing work and isolating himself in the bedroom. His affect has progressively become more blunted, He urged her to have an abortion and she refused. The patient denies any history of substance abuse, and his recent medical evaluation was within normal limits. Which of the following is this most appropriate diagnosis? enorR pese Brief psychotic disorder Schizophrenia Adjustment disorder Mood disorder with psychotic features, Delusional disorder epege 15 of 1858. Tim is seeing a psychologist who asks Tim about his true feelings and wishes, because she is concerned that these may not be similar to the image he projects to others, She also explained to him that itis his subjective reality that is important and she knows that ‘Tim’s “wise mind” will reveal what decisions Tim should make. The psychologist's view is consistent with which family of therapy? a. Freudian b, client centered therapy c. pure behaviorism d. CBT 59. One of the symptoms of a mood disorder is called anhedonia which means: a. a feeling of worthlessness b, analtered patter of sleep ¢, an inability to experience pleasure d. indecisiveness 60. Criterion A4 of posttraumatic stress disorder requires “Experiencing repeated or extreme exposure to adversive details of the traumatic event.” Which of the following would NOT qualify as an experiencing ‘trauma under this criterion? a. A social worker interviewing children who have been sexually abused and obtaining the details of the abuse. b. A psychologist working with victims of torture who are seeking political asylum in the United States. ©. Acollege student ata film festival watching a series of violent movies. 4. -A soldier sifting through the rubble of a collapsed building retrieve remains of comrades. €. A police officer reviewing surveillance videotapes of homicides to identify perpetrators, 61. A.26-year-old woman is approached by her new boss, who has noticed that despite working for her employer for many years, she has not advanced beyond an entry level position, The boss hears that she is a good employee who works long hours. The woman explains that she has not asked for a promotion because she knows she’s not as good as the other employees and doesn’t think she deserves it, She explains her long hours by saying that she is not very smart and has to check over all her work, because she’s afraid that people will laugh at her if she makes any mistakes. On reviewing her past evaluations, her boss notes that there are only minor problems and her overall evaluations have been vory positive. Which of the following personality disorders would best explain this woman’s lack of job advancement? Avoidant personality disorder. Obsessive-compulsive personality disorder. Borderline personality disorder. Narcissistic personality disorder. Schizoid personality disorder. eaeges 16 of 1862. 63. 64, 65. 66. ‘A 50-year-old man reports episodes in which he suddenly and unexpectedly awakens fiom sleep feeling a surge of intense fear that peaks within minutes. During this time, he feels short of breath and has heart palpitations, sweating, and nausea. His medical history is significant only for hypertension (high blood pressure) which is well controlled with medication. As a result of these symptoms, he has begun to have anticipatory anxiety associated with going to sleep. What is the most likely explanation for his symptoms? a. Agoraphobia b. Sleep attacks ©. Panic disorder 4d. Panic attacks . In CBT a mood log is used in order to a, recognize and challenge automatic thoughts , keep track of the symptoms of hypomania, mania, and depression c. keep track of the rational thoughts that pop into the client’s head 4d, find ways to make automatic thoughts more automatic First generation antipsychotic medications are particularly effective in the treatment of: hallucinations anhedonia and affective flattening movement disorders Avolition e. withdrawal A.35-year-old woman with no significant past medical or psychiatric history is brought to the hospital by police after crashing her car. You notice that she is slurring her speech, her gait is unsteady, and she demands her car keys so she ean drive home. On cognitive examination, she has difficulty paying attention, and tests of her memory show difficulty on immediate recall. Her vital signs are all within normal limits, She says (and her husband confirms) that she had a few drinks earlier in the night, which is unusual for her. What’s the best diagnosis according to DSM-5 a, Alcohol Abuse b. Alcohol Dependence ¢. Alcohol use disorder d. Alcohol intoxication Alcohol withdrawal Which of the following would be useful inredueing a patient's delusions? a Mentos b. none of the above ©. Xanax ._ Effexor e. Haldol Re gee 17 of 1867. A36-year-old man with a past history of a major depressive episode is brought into the emergency room by the police after stopping trafic on the highway proclaiming that he is the “Messiah.” His wife is contacted who states that he has been walking throughout the house all night for the last four nights, talking “nonstop,” and starting many home repair projects. Which of the following is the most likely diagnosis? bipolar I major depressive disorder bipolar I manic disorder social anxiety disorder Q 62 CO) \L () 63 peeges 18 of 18D:A Exam 3 Psych 210 DSMS Answer Section MULTIPLE CHOICE LA ‘The man has panic disorder, not just panic attacks, and he also has agoraphobia. In a specific phobia the fear would be of the situation itself rather than the possibility of having a panic attack. A 3. B People with BDD are excessively preoccupied with perceived defeets in their appearance that are either not apparent or only slightly apparent to other individuals. In addition to the preoccupation, individuals ‘engage in excessive and repetitive behaviors and /or mental acts associated with the preoccupation, including repetitive checking of their appearance in a mirror, excessive grooming, and comparing their appearance with that of others. BDD does not include a primary preoccupation with weight, which is instead associated with eating disorders, Insight varies, but individual with BDD are not likely to see it as a psychiatric disorder 4B Specific phobia is the most likely diagnosis for this woman, Although she is panic attacks, they are the direct result of being in a high place. Her fears are actually of a situation, heights, rather than having further panic attacks. 5 E Although wine collecting is not in itself pathological, in this case the client difficulty parting with or drinking the wine, the fact that his acquisition exceeds his ability to store the wine, and his wife’s distress make hoarding disorder the best diagnosis. Hoarding disorder describes a syndrome in which an individual has difficulty partying with possessions, to the point that the possessions present an unsafe or unhygienie situation, 6 E 7B 8A 9D Schizophrenia spectrum and other psychotic disorders are defined by abnormalities in one or more of the following domains delusions, hallucinations, disorganized thinking, grossly disorganized or abnormal motor behaviors (including catatonia) and negative symptoms, ‘A flashback to a traumatic experiences is an intense, emotionally laden memory but does not reach the evel of psychotic symptom, 0. E ul. B 12. AwD:A 13, A Of these, Lithium is the best choice. It will help with both the manic and depressive phases of a Bipolar condition. 14, C ‘The client shows clear evidence of a manic episode that is causing distress and impairment. Even without an accompanying depressive episode, you can diagnosis this as Bipolar I. 15. € 16. C 17. D Answer: no diagnosis. The criteria for Major Depressive Episode requires that the patient have 5 of the 9 symptoms for at least 2 weeks. This patient has bet the duration criteria. However, she only reports 3 symptoms: depression, insomnia, and recurrent thoughts of death with suicidal ideation, 18, D ‘The essential feature of ASD is the development of characteristic symptoms lasting from 3 days to 1 month following exposure to one or more traumatic events, Stressful events that do not involve threats or danger to the self do not qualify for Criterion A 19. B 20. C Of these medicines only Lithium is a true bipolar medication, the other medications will either help only his depressive symptoms or his symptoms of mania, 21. B 22, D 23. D 24, C Cyelyothymia is hypomania and low moods that don’t meet the critiera for depression. 25, B 26. D 27. B 28, E As the name suggests REM sleep behavior disorders occur during the REM of dreaming part of sleep. 29. B 30. E During this period of illness, the woman’s symptoms concurrently met criteria for a major depressive episode and criterion A for schizophrenia, Auditory hallucinations and delusions were present both before and after the depressive phase. The total period of illness lasted for about 6 months, with psychotic symptoms alone present for the initial 2 months, 31. 3B 32. B 33. E 2 of 634. A 35, D Specific phobia is characterized by the marked fear or anxiety of a specific object or situation, which is perceived as being dangerous. This differs from agoraphobia, in which the focus of the anxiety is on the possibility of having panic or other incapacitating symptoms, or social anxiety disorder in which the focus is on being serutinized by others. Trauma-related disorders should be considered in the differential diagnosis; however, the lack of any real danger makes this unlikely and the time course is not compatible with the criteria for acute-stress disorder. 36.4 This patient has a long history of being a worker, and her work has increased over the past seven months following the birth of a child, She worries about many problems in multiple categories, She is both cognitive and smail semantic symptoms. She’s unable to control her worrying, and is interfering with her work she denies medical or substance use violence. His clinical picture is classic for generalized anxiety disorder 37. A This patient's difficulties fit a person disorder and that he did he is inflexible in his thinking or behavior, which causes problems in social work settings. This man came into the employees this program because of problems he was having at work: rigidity, stubbornness, and difficulty making decisions and keeping to deadlines. Typically, as in this case, the patient’s disorder is the use of atomic; that is, he does not recognize his problems as originating from within himself for other blames him and others in the outside world, Also, he stingy with his money, although he worked many hours a week. He seems somewhat moralistic about others and about their work habits, 38. A 39. A 40. D . 41, B One of the hallmarks of schizoid personality disorder is the reduced expression of emotion in interpersonal settings, often making them appear indifferent to criticism from others. It is also typical of individual with schizoid personality disorder to choose solitary experiences and avoid social events, ‘They may have difficulty in collaborative work environments because of their lack of social skills, but can thrive in jobs with considerable social isolation, like a nighttime warehouse security guard. 2. D 4B. B This patient’s difficulties fit a person disorder and that he did he is inflexible in his thinking or behavior, ‘which causes problems in social work settings. This man came into the employees this program because of problems he was having at work: rigidity, stubbornness, and difficulty making decisions and keeping 10 deadlines. Typically, as in this case, the patient’s disorder is the use of atomic; that is, he does not recognize his problems as originating from within himself for other blames him and others in the outside world. Also, he stingy with his money, although he worked many hours a week. He seems somewhat moralistic about others and about their work habits. 44. 3 of 64s. 46. 47. 48, 49, 50. 54, 55. 56. 58. 59. 60. DA B ‘You would only use a benzo for anxiety...not the other disorders c ‘The essential feature of agoraphobia is marked fear or anxiety triggered by real or anticipated exposure to.a variety of situations from which escape or help might not be available, B D c ‘The presence of sudden, unexpected panic attacks in the absence of a medical disorder is the main feature of panic disorder. IN addition to worries about the attacks, many individuals report broader concerns about health and mental health outcomes. ingle episode of exposing ehrself while intoxicated does not qualify for a diagnosis of tionsitic distoder because she does not meet the diagnostic criteria—specifically, a 6 moth history of “recurrent and intense sexual arousal from the exposure of ones” genitals to an unusspecting person, sted by fantasises, urges, or behaviors (Criteria A), Her current distress is related not tot he exhibitonistic net but rather to her parents” attidue and behavior. Because the distress interferes with her functioning, she meet criteria for adjustment disorder. ‘The central fear in social anxiety disorder is the fear of humiliation, embarrassment, or offence of others. A E D ‘The most likely diagnosis for this man a social phobia, Although he suffers from panic attacks, they are not unprovoked as in panic disorder because they occur in response to public speaking. His fear is not of having further panie attacks would rather of being embarrassed for humiliate E B c c ‘The criterion does not apply to exposure through electro unless the exposure is work related. media, television, movies, or pictures, 4 of 6IDA 61. A Avoidant personality disorder is characterized by feelings of inadequacy, hypersensitivity to criticism, and a need for reassurance. As a result, a person with avoidant personality disorder tends to be reluctant {o take risks or engage in challenging activities, which results in interpersonal and occupational impairment. People with narcissistic personality disorder or borderline personality disorder may also be highly sensitive to criticism, buta key feature of narcissistic personality disorder is grandiosity, and that of borderline personality disorder is an unstable self-image, rather than persistently low self esteem. Long work hours and rechecking work can be seen with obsessive-compulsive personality disorder, but in that disorder the cause is a perfectionist or rigid style of approach not a fear of criticism or humiliation. People with schizoid personality disorder are generally relatively indifferent to criticism from others. 62. C Panic disorder involves recurrent, unexpected panic attacks. Panic attacks are a syndrome, not a disorder, and can occur with a variety of disorders. Nocturnal panic attacks associated with sleep are an example of an unexpected panic attack. 63. A 64. A 65. D ALCOHOL INTOXICATION ‘A. Recent ingestion of aleohol, B. Clinically significant problematic behavioral or psychological changes (e.g., inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning) that developed during, or shortly afer, alcohol ingestion, C. One (or more) of the following signs, developing during, or shortly after, alcohol use: 1. Slurred speech 2, Incoordination 3. Unsteady gait 4. Nystagmus 5. Impairment in attention or memory 6. Stupor or coma D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder or intoxication with another substance, 5 of 666. EB Haldol is an antipsychotic..it's useful for reducing the positive symptoms of psychosis. like a delusion page 622-623 on A ‘The most likely diagnosis for this man is bipolar disorder, most recent episode that. He is classic symptoms and signs of illness, such as the increased need for sleep, talkativeness, increased activity, risky behavior, and delusions of grandeur he also has a history of a major depressive episode. 6 of 6