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1-Which of the following statements apply to Z Codes (other…
1-Which of the following statements apply to Z Codes (other conditions that may be a focus of attention)?
Select one:
a. Typical, expected, or normative reactions to life stressors
b. Mental health disorders
c. Adjustment disorder with depressed mood is one example of a Z code.
d. Behaviors, emotions, or experiences that are atypical or non-normative.
2-Those who adjust more easily to life stressors are characterized by:
Select one:
a. Only navigating one, rather than multiple, stressors
b. Strong support system and meaningful relationships
c. Overall, good functioning prior to the stressor
d. All of the above
3-To qualify for adjustment disorder:
Select one:
a. the person’s response must be viewed as an expected, typical, or normative response to a life stressor.
b. the symptoms must occur within 2 months of the stressor
c. the symptoms must last less than 6 months after the termination of the stressor or its consequences
d. the person cannot experience significant impairment in functioning
4-All of the following are common goals in the treatment of adjustment disorders EXCEPT:
Select one:
a. strengthen coping skills.
b. develop problem-solving skills to reduce the impact of the stressor.
c. use intensive flooding techniques to expose the person to multiple threatening stimuli simultaneously that are associated with the disorder.
d. use acceptance or relaxation techniques to reduce the person’s response to stressors that cannot be removed.
5-The prognosis for women with adjustment disorders is not very promising.
Select one:
True
False
6-All of the following are characteristics of disruptive mood dysregulation disorder (DMDD) EXCEPT.
Select one:
a. Three or more temper outbursts per week
b. The criteria must be met for at least one year in two or more settings
c. The outbursts can be verbal or behavioral
d. The diagnosis must be given prior to the age of 6
7-The best initial treatment approach for children with mood disorders (e.g., DMDD) should involve _____ and _____:
Select one:
a. psychotherapy; parent psychoeducation
b. anti-manic (mood stabilizing) medication; trauma-focused CBT
c. stimulant medication; exposure and response prevention therapy
d. anti-psychotic medication; psychoanalytic therapy
8-The diagnosis of major depressive disorder requires at least __ symptoms of depression for at least __.
Select one:
a. 3; 1 month
b. 6; 6 months
c. 5; 2 weeks
d. 5; 1 month
9-What DSM-5 diagnostic provision is made for depressive symptoms following the death of a loved one?
Select one:
a. Depressive symptoms lasting less than 2 months after the loss of a loved one are excluded from receiving a diagnosis of MDD.
b. To qualify for a diagnosis of MDD, the depression must start no less than 12 weeks following the loss.
c. To qualify for a diagnosis of MDD, the depressive symptoms must include suicidal ideation.
d. Depressive symptoms following the loss of a loved one are not excluded from receiving an MDD diagnosis, if the symptoms otherwise fulfill the diagnostic criteria.
10-The diagnosis of major depressive disorder could include any of these symptoms EXCEPT:
Select one:
a. loss of energy
b. elevated or euphoric mood
c. change in eating or sleeping habits
d. decreased ability to concentrate or make decisions
11-All of the following are evidence-supported treatments for major depressive disorder EXCEPT:
Select one:
a. behavior activation therapy
b. interpersonal therapy
c. transference focused therapy
d. cognitive therapy
12-Medication along with psychotherapy is often a treatment recommendation for each of the following situations EXCEPT:
Select one:
a. when depression is mild.
b. when depression is recurrent.
c. when depression is chronic
d. when psychotic symptoms accompany the depression.
13-All of the following are characteristics of persistent depressive disorder EXCEPT:
Select one:
a. depressed mood plus two or more additional symptoms of depression
b. it must be triggered by the loss of a loved one
c. two or more years of depression symptoms for adults
d. one or more years of depression for children and adolescents
14-Which of the following can be a challenge when treating those with persistent depressive disorder?
Select one:
a. Their depression fluctuates so much and is so fleeting, that it is difficult for them to describe it.
b. They have been depressed for a long time and are accustomed to the symptoms; they may see little hope for change or improvement
c. The person’s self-esteem is such that they feel anything is possible.
d. The depression symptoms generally fade after a couple of sessions, so they lose motivation for treatment.
15-Substances, medications, or medical conditions can cause depression-like symptoms.
Select one:
True
False
16-All of the following are possible symptoms of a manic episode EXCEPT:
Select one:
a. increased talkativeness
b. decreased need for sleep
c. decreased energy
d. inflated self-esteem
17-A hypomanic episode can include or lead to:
Select one:
a. psychotic symptoms
b. hospitalization
c. significant impairment in functioning
d. none of the above
18-For the diagnosis of bipolar II disorder, a person must have experienced both a ___ and a ___.
Select one:
a. manic episode; hypomanic episode
b. hypomanic episode; major depressive episode
c. manic episode; major depressive episode
d. major depressive episode; psychotic episode
19-With bipolar II disorder, functional impairment is mainly related to the ____ symptoms.
Select one:
a. depression
b. manic
c. hypomanic
d. hypervigilant
20-The specifier of ‘with rapid cycling’ for bipolar disorder requires the occurrence of four or more separate mood episodes in the preceding 12-month period of time.
Select one:
True
False
21-Cyclothymic disorder involves a combination of hypomanic episodes and major depressive episodes.
Select one:
True
False
22-All of the following are associated with cyclothymic disorder EXCEPT:
Select one:
a. mood instability and reactivity in social interactions
b. the depression symptoms are likely to be the more problematic aspect of the disorder
c. symptoms must be limited to less than 6 months
d. over the course of the disorder, the person has not been symptom free for more than 2 months
23-All of the following are associated with family-focused therapy (FFT) for bipolar disorder EXCEPT:
Select one:
a. family members learn how to communicate effectively with each other
b. those with bipolar disorder and their family members learn to better understand the disorder
c. family members learn how to increase their expressed emotion (EE) so they become a high EE family
d. FFT has been found to decrease relapse and re-hospitalization rates of bipolar disorder
24-The FDA has approved certain mood stabilizing and other medications for use with bipolar disorder. Which of the following statements best describes the role these medications play in treatment?
Select one:
a. These medications are to be added after a course of 6 months of psychotherapy.
b. These medications are only recommended when 6 months of psychotherapy has been ineffective.
c. These medications form the foundation of evidence-based practice for bipolar disorder and are generally used from the very beginning of treatment.
d. Antidepressant medications have been found to be superior to mood stabilizing medications for bipolar disorder and should be the first medication tried after a 6 month course of psychotherapy.
25-Which of the following factors is associated with a worse prognosis for bipolar disorder?
Select one:
a. Higher education level
b. Rapid-cycling pattern
c. Less severe depressive episode
d. Being married or in a committed relationship
26-Which one of the following is most characteristic of paranoid personality disorder?
Select one:
a. magical thinking and eccentric behaviors
b. distrust and suspiciousness about the motivations of others
c. excessive shyness and sensitivity
d. indifferent to criticism and displays flat affect
27-Two characteristics of schizoid personality disorder are _____ and ____.
Select one:
a. seeking close interpersonal contact with others; a lack of interest in intimate relationships
b. avoiding close interpersonal contact with others; a desire to have intimate relationships
c. avoiding close interpersonal contact with others; a lack of interest in intimate relationships
d. seeking close interpersonal contact with others; a desire to have intimate relationships
28-Individuals with obsessive compulsive personality disorder are primarily motivated by a need for which of the following:
Select one:
a. Admiration
b. Control
c. Intimacy
d. To avoid abandonment
29-A common characteristic of those with borderline personality disorder is:
Select one:
a. difficulty in regulating emotions.
b. instability of self-identity.
c. impulsivity (e.g., overeating, shopping, drug use).
d. All of the above
30-Of the following, which is the most important initial objective for therapists when working with those with borderline personality disorder?
Select one:
a. Convey the boundaries around your availability and determine the frequency of sessions.
b. Assess the potential for self-harm/suicide and develop a safety plan with the client.
c. Request permission to meet with their family members to learn more about their childhood.
d. Make a referral for a medication evaluation.
31-Which of the following therapies have strong research support for the treatment of borderline personality disorder?
Select one:
a. Dialectical behavior therapy
b. Gestalt therapy
c. Person-centered therapy
d. Reality therapy
32-Which of the following is characteristic of histrionic personality disorder?
Select one:
a. Acute discomfort in relationships, perceptual distortions, and eccentricities of behavior.
b. Submissive and clinging behavior related to a need to be taken care of.
c. Instability in interpersonal relationships, self-image, and emotions.
d. Excessive emotionality and attention seeking.
33-All of the following are possible symptoms of avoidant personality disorder EXCEPT:
Select one:
a. A fear of negative evaluation and being judged by others
b. A total lack of interest in having relationships
c. Participate in social situations only when the person is assured of being liked
d. Feelings of inferiority or social ineptness
34-All of the following are possible symptoms of dependent personality disorder EXCEPT:
Select one:
a. Avoid disagreements for fear of being rejected or losing support
b. Preoccupied with fears of being left to care for oneself
c. Excessive need for reassurance from others
d. Self-injurious impulses or behavior
35-The overall goal/objective of therapy when working with those with dependent personality disorder is:
Select one:
a. to improve their self-reliance and autonomy.
b. to transfer their dependence on others to the therapist.
c. to provide them with reassurance.
d. to determine the source of their dependency.
36-Regarding the diagnosis of a delusional disorder, which of the following statements is FALSE:
Select one:
a. It involves the presence of one or more delusions for at least a one-month duration.
b. The delusions can be considered either bizarre or non-bizarre in nature.
c. Delusions are easily amenable to change when are simply presented with evidence that conflicts with their beliefs.
d. Persecutory delusions are the most common type.
37-Samuel is convinced that he has a special romantic relationship with a famous movie star. However, he has never met her and she has not responding to any of his efforts to contact her. This is most consistent with which of the following delusions?
Select one:
a. Somatic
b. Jealous
c. Erotomanic
d. Thought withdrawal
38-Julie has a fixed, unwavering belief that she was murdered by her father in childhood. The circumstances around the murder are among the issues she wishes to discuss with her therapist. This belief of having been murdered in childhood, while simultaneously believing that she remains alive, is an example of a:
Select one:
a. Non-bizarre delusion
b. Bizarre delusion
39-A hallucination is a:
Select one:
a. fixed belief that is not amenable to change in spite of conflicting evidence
b. derailment in speech resulting in loose associations, tangential responses, or incoherence
c. perception-like experience that occurs in the absence of an external stimulus
d. decrease in reactivity to the environment, resistance to instructions, lack of response, or rigid posture
40-Which of the following is true regarding brief psychotic disorder?
Select one:
a. The duration is less than that required for schizophreniform.
b. The psychotic symptoms must last more than 1 month.
c. 2 or more psychotic symptoms are required.
d. The symptoms are relatively brief because they are due to drug intoxication.
41-During which of the following ages does the first psychotic episode usually occur for someone with schizophrenia?
Select one:
a. 40s
b. 30s
c. 20s
d. 10-15
42-When working with clients with delusions, a recommended strategy for therapists is to:
Select one:
a. place the initial focus directly on the delusions, rather than secondary symptoms like insomnia.
b. participate in and validate the delusions so the person feels understood.
c. discuss the delusions enough to understand them, then gently suggest alternative explanations.
d. strongly confront and challenge the person about the delusions.
43-Hallucinations and delusions are considered _____ symptoms while flat affect or inability to experience pleasure are _____ symptoms.
Select one:
a. negative; active
b. positive; negative
c. positive; neutral
d. neutral; negative
44-Which of the following symptom combinations, if present for one month, would meet Criterion A for schizophrenia?
Select one:
a. Auditory and tactile hallucinations
b. Disorganized behavior and avolition (low motivation)
c. Persecutory delusions and diminished emotional expression (flat affect)
d. Paranoid and grandiose delusions
45-Schizophreniform is very much like schizophrenia except that schizophreniform:
Select one:
a. Does not have an active psychotic phase
b. Requires fewer psychotic symptoms than schizophrenia
c. Requires greater impairment than schizophrenia
d. Lasts less time than schizophrenia
46-The three possible phases of schizophrenia are:
Select one:
a. brief psychotic disorder, schizophreniform, schizophrenia
b. acute, advanced, chronic
c. prodromal, active, residual
d. predromal, acute, remission
47-All of the following have been found to be possible risk factors for schizophrenia EXCEPT:
Select one:
a. being a fourth-generation immigrant
b. family history of schizophrenia
c. use of cannabis and stimulants
d. childhood trauma
48-Which of the following is NOT a strongly supported treatment for schizophrenia?
Select one:
a. Social skills training
b. Family psychoeducation
c. Cognitive behavioral therapy (CBT)
d. Confrontational rational therapy (CRT)
49-Which of the following statements describe a way in which schizoaffective disorder can be differentiated from bipolar disorder?
Select one:
a. Schizoaffective disorder involves only depressive episodes, never manic episodes
b. In bipolar disorder, psychotic symptoms do not last longer than one month.
c. In bipolar disorder, psychotic symptoms only occur during a major mood episode
d. In bipolar disorder, psychotic symptoms are always mood congruent.
50-An irritable 8-year-old child has a history of temper outbursts both at home and at school. Which of the following must be present to qualify for a diagnosis of disruptive mood dysregulation disorder?
Select one:
a. The mood between outbursts is typically euthymic.
b. The mood between outbursts is typically hypomanic.
c. The mood between outbursts is typically depressed.
d. The mood between outbursts is typically irritable or angry.
51-A 14-year-old boy has been feeling ‘down’ routinely for over a year. He also reports poor concentration, fatigue, and low self-esteem during this period of time. He has not experienced suicidal ideation or any changes in sleep or appetite. There is no medical, substance, or medication explanation for these symptoms. Of the following diagnoses, which one is the most likely?
Select one:
a. Major depressive disorder
b. Disruptive mood dysregulation disorder
c. Persistent depressive disorder
d. Adjustment disorder with depressed mood
52-A 30-year-old man reports over two years of persistently depressed mood, accompanied by a loss of pleasure in all activities, thoughts that he’d be better off dead, feelings of worthlessness, and an inability to make decisions. During this same period of time, he has been sleeping more than usual and feels low energy during the day. There is no medical, substance, or medication explanation for these symptoms. Of the following diagnoses, which one is the most likely?
Select one:
a. Major depressive episode
b. Cyclothymic disorder
c. Major depressive disorder, with melancholic features
d. Persistent depressive disorder, with persistent major depressive episode
e. Bipolar II disorder
53-A few months ago, a 45-year-old woman was diagnosed with multiple sclerosis. She now experiences a depressed mood (daily for the past two months), insomnia, poor appetite, trouble concentrating, and suicidal ideation. Which of the following diagnoses needs to be explored first and ruled out before formalizing a diagnosis and treatment?
Select one:
a. Persistent depressive disorder
b. Depressive disorder due to a medical condition (multiple sclerosis)
c. Adjustment disorder with depressed mood
d. Uncomplicated bereavement
54-A 25-year-old graduate student reports feeling down and ‘not enjoying anything.’ Her symptoms began about a month ago, along with insomnia and poor appetite. She has little interest in activities and is having difficulty attending to her schoolwork. She had a similar episode a year ago that lasted about 2 months. She also describes having experienced several episodes of an ‘up mood’ during the past two years. These episodes last 1-2 weeks, during which she is very productive, feels more social and outgoing, tends to sleep less (but still feels energetic during the day). Friends say that she speaks more rapidly during these times. These up times do not lead to significant impairment or psychotic symptoms and they don’t require hospitalization. Medical, substance, and medication causes for these symptoms have been ruled out. What is the most likely diagnosis?
Select one:
a. Bipolar I disorder, current episode depressed
b. Bipolar II disorder, current episode hypomanic
c. Cyclothymic disorder
d. Bipolar II disorder, current episode depressed
e. Major depressive disorder
55- A 50-year-old man with a prior history of a depressive episode is given an antidepressant by his family doctor to help some recent depressive symptoms. He stopped the medication after 2 days because he no longer felt depressed. Two weeks later, his doctor contacts you for a consultation because, since taking the medication, the man has experienced extreme euphoria, increased energy, racing thoughts, psychomotor agitation, distractibility, rapid speech, and less need for sleep. His functioning has become significantly impaired. These symptoms have persisted way beyond the time when the medication would have metabolized out of his system. No other medical conditions or substances are involved. The most likely diagnosis is:
Select one:
a. Substance/medication-induced bipolar and related disorder
b. Bipolar II disorder
c. Cyclothymic disorder
d. Bipolar I disorder
56- A 30-year-old woman reports auditory hallucinations and persecutory delusions for 2 months, followed by a co-occurring major depressive episode (MDE). The psychotic symptoms and MDE co-occur for 3 ½ months and then the depression symptoms resolved. However, the psychotic symptoms have persisted on their own for another month. Medical, substance, and medication causes for these symptoms have been ruled out. What is the most likely diagnosis?
Select one:
a. Brief psychotic disorder
b. Major depressive disorder with psychotic features
c. Schizoaffective disorder
d. Major depressive
57-A 60-year-old man witnesses a serious car accident that involved a fatality. He begins to have disorganized speech, which lasts for about a week before resolving. Which of the following diagnoses best fits?
Select one:
a. Schizophrenia
b. Brief psychotic disorder, with marked stressor
c. Brief disorganized speech disorder
d. Schizophreniform
58- A 32-year-old man arrives at the emergency room in a panic. He has been unable to get in touch with his sister and believes she was killed in a plane on a trip to New York. When asked how he got the news, he said he and his sister are very close and the information came to him in the form of a premonition. After he was put in touch with his sister by phone, she shared that her flight had simply been delayed. He was relieved to discover that she is still alive and he is no longer concerned. Which of the following statements best fit this situation?
Select one:
a. He had a delusional belief because he believed his sister was dead without solid evidence.
b. He had a grandiose delusion, because he believed he could know things through a premonition.
c. He does not have a delusional belief, because he quickly changed his belief when presented with new evidence.
d. He had a nihilistic delusion, because his belief involved an untrue, imagined catastrophe.
59- Motivational interviewing:
Select one:
a. Is generally incorporated at the end of treatment.
b. Is designed to help support a client’s readiness for change.
c. Is not utilized for clients who are ambivalent about treatment.
d. Has not been found useful for substance use or eating disorders.
