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77 Cards in this Set

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Which of the following is not required for a DSM-5 diagnosis of intellectual disability (intellectual developmental disorder)?




A.Full-scale IQ below 70.




B.Deficits in intellectual functions confirmed by clinical assessment.




C.Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence.




D.Symptom onset during the developmental period.




E.Deficits in intellectual functions confirmed by individualized, standardized intelligence testing.

A. Full-Scale IQ of 70
Which of the following statements about intellectual disability (intellectual developmental disorder) is false?

A.Individuals with intellectual disability have deficits in general mental abilities and impairment in everyday adaptive functioning compared with age- and gender-matched peers from the same linguistic and sociocultural group.

B.For individuals with intellectual disability, the full-scale IQ score is a valid assessment of overall mental abilities and adaptive functioning, even if subtest scores are highly discrepant.

C.Individuals with intellectual disability may have difficulty in managing their behavior, emotions, and interpersonal relationships and in maintaining motivation in the learning process.

D.Intellectual disability is generally associated with an IQ that is 2 standard deviations from the population mean, which equates to an IQ score of about 70 or below.

E.Assessment procedures for intellectual disability must take into account factors that may limit performance, such as sociocultural background, native language, associated communication/language disorder, and motor or sensory handicap.
B. For individuals with intellectual disability, the full-scale IQ score is a valid assessment of overall mental abilities and adaptive functioning, even if subtest scores are highly discrepant.
Which of the following statements about the development and course of autism spectrum disorder (ASD) is false?

A.Symptoms of ASD are typically recognized during the second year of life (12-24 months of age).

B.Symptoms of ASD are usually not noticeable until 5-6 years of age or later.

C.First symptoms frequently involve delayed language development, often accompanied by lack of social interest or unusual social interactions.

D.ASD is not a degenerative disorder, and it is typical for learning and compensation to continue throughout life.

E.Because many normally developing young children have strong preferences and enjoy repetition, distinguishing restricted and repetitive behaviors that are diagnostic of ASD can be difficult in preschoolers.
B. Symptom are not typically noticeable until 5-6 years of age or later.

Which of the following is not a criterion for the DSM-5 diagnosis of attention-deficit/hyperactivity disorder (ADHD)?


A.Onset of several inattentive or hyperactive-impulsive symptoms prior to age 12 years.



B.Manifestation of several inattentive or hyperactive-impulsive symptoms in two or more settings (e.g. at home, school, or work; with friends or relatives; in other activities).



C.Persistence of symptoms for at least 12 months.



D.Clear evidence that symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.



E.Inability to explain symptoms as a manifestation of another mental disorder (e.g. mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

C. Persistence of symptoms for at least 12 months

Which of the following statements about development of and risk factors for intellectual disability is true?

A.Intellectual developmental disorder should not be diagnosed in the presence of a known genetic syndrome, such as Lesch-Nyhan or Prader-Willi syndrome.

B.Etiologies are confined to perinatal and postnatal factors and exclude prenatal events.

C.In severe acquired forms of intellectual developmental disorder, onset may be abrupt following an illness (e.g., meningitis) or head trauma occurring during the developmental period.

D.When intellectual disability results from a loss of previously acquired cognitive skills, as in severe traumatic brain injury (TBI), only the TBI diagnosis is assigned.

E.Prenatal, perinatal, and postnatal etiologies of intellectual developmental disorder are demonstrable in approximately 33% of cases.
C. In severe acquired forms of intellectual developmental disorder, onset may be abrupt following an illness (e.g., meningitis) or head trauma occurring during the developmental period.
A 7-year-old boy in second grade displays significant delays in his ability to reason, solve problems, and learn from his experiences. He has been slow to develop reading, writing, and mathematics skills in school. All through development, these skills lagged behind peers, although he is making slow progress. These deficits significantly impair his ability to play in an age-appropriate manner with peers and to begin to acquire independent skills at home. He requires ongoing assistance with basic skills (dressing, feeding, and bathing himself; doing any type of schoolwork) on a daily basis. Which of the following diagnoses best fits this presentation?

A.Childhood-onset major neurocognitive disorder

B.Specific learning disorder

C.Intellectual disability (intellectual developmental disorder)

D.Communication disorder

E.Autism spectrum disorder
C. Intellectual disability (intellectual developmental disorder)
A 7-year-old girl presents with a history of normal language skills (vocabulary and grammar intact) but is unable to use language in a socially pragmatic manner to share ideas and feelings. She has never made good eye contact, and she has difficulty reading social cues. Consequently, she has had difficulty making friends, which is further complicated by her being somewhat obsessed with cartoon characters, which she repetitively scripts. She tends to excessively smell objects. Because she insists on wearing the same shirt and shorts every day, regardless of the season, getting dressed is a difficult activity. These symptoms date from early childhood and cause significant impairment in her functioning. What diagnosis best fits this child’s presentation?

A.Asperger’s disorder

B.Autism spectrum disorder

C.Pervasive developmental disorder not otherwise specified

D.Social (pragmatic) communication disorder

E.Rett syndrome
B. Autism spectrum disorder
A 3 ½ year old girl with a history of lead exposure and seizure disorder demonstrates substantial delays across multiple domains of functioning, including communication, learning, attention, and motor development, which limit her ability to interact with same-age peers and required substantial support in all activities of daily living a home. Unfortunately, her mother is an extremely poor historian, and the child has received no formal psychological or learning evaluation to date. She is about to be evaluated for readiness to attend preschool. What is the most appropriate diagnosis?

A.Major neurocognitive disorder.

B.Developmental coordination disorder.

C.Autism spectrum disorder.

D.Global developmental delay.

E.Specific learning disability.
D.Global developmental delay.
A 15 year old boy has a long history of nonverbal communication deficits. As an infant he was unable to follow someone else directing his attention by pointing. As a toddler, he was not interested in sharing events, feelings, or games with his parents. From school age into adolescence, his speech was odd in tonality and phrasing, and his body language was awkward. What do these symptoms represent?

A.Stereotypes.

B.Restricted range of interests.

C.Developmental regression.

D.Prodromal schiophreniform symptoms.

E.Deficits in nonverbal communicative behaviors.
E. Deficits in nonverbal communicative behaviors.
An irritable 8 year-old child has a history of temper outbursts both at home and at school. What characteristic mood feature must be also present to qualify him for a diagnosis of disruptive mood dysregulation disorder?

A.The child’s mood between outbursts is typically euthymic.

B.The child’s mood between outbursts is typically hypomanic.

C.The child’s mood between outbursts is typically depressed.

D.The child’s mood between outbursts is typically irritable or angry.

E.The mood symptoms and temper outbursts must not have persisted for more than 6 months.
D. The child’s mood between outbursts is typically irritable or angry.
A 14-year-old boy describes himself as feeling “down” all of the time for the past year. He remembers feeling better while he was at camp for 4 weeks during the summer, however, the depressed mood returned when he came home. He reports poor concentration, feelings of hopelessness, and low self-esteem but denies suicidal ideation or changes in his appetite or sleep. What is the most likely diagnosis?

A.Major depressive disorder

B.Disruptive mood dysregulation disorder

C.Depressive episodes with short-duration hypomania

D.Persistent depressive disorder (dysthymia) with early onset

E.Schizoaffective disorder
D.Persistent depressive disorder (dysthymia) with early onset
A 9-year-old boy cannot go to sleep without having a parent in his room. While falling asleep, he frequently awakens to check that a parent is still there. One parent usually stays until the boy falls asleep. If he wakes up alone during the night, he starts to panic and gets up to find his parents. He also reports frequent nightmares in which he or his parents are harmed. He occasionally calls out that he saw a strange figure peering into his dark room. The parents usually wake in the morning to find the boy asleep on the floor in their room. They once tried to leave him with a relative so they could go on a vacation; however he became so distressed in anticipation of this that they canceled their plans. What is the most likely diagnosis?

A.Specific Phobia Disorder

B.Nightmare disorder

C.Delusional Disorder

D.Separation Anxiety

E.Agoraphobia

D. Separation Anxiety

A 25-year-old man presents with long-standing nonverbal communication deficits, inability to have a back-and-forth conversation or share interests in an appropriate fashion, and a complete lack of interest in having relationships with others. His speech reflects awkward phrasing and intonation and is mechanical in nature. He has a history of sequential fixations and obsessions with various games and objects throughout childhood; however, this is not currently a major issue for him. This patient meets criteria for autism spectrum disorder: true or false?

A.True

B.False
A. True
What DSM-5 diagnostic provision is made for depressive symptoms following the death of a loved one?

A. Depressive symptoms lasting less than 2 months after the loss of a loved one are excluded from receiving a diagnosis of major depressive episode.

B. To qualify for a diagnosis of major depressive episode, the depression must start no less than 12 weeks following the loss

C. To qualify for a diagnosis of major depressive episode, the depressive symptoms in such individuals must include suicidal ideation.

D. Depressive symptoms following the loss of a loved one are not excluded from receiving a major depressive episode diagnosis if the symptoms otherwise fulfill the diagnostic criteria.

E. Depressive symptoms following the loss of a loved one are excluded from receiving a major depressive episode diagnosis
D. Depressive symptoms following the loss of a loved one are not excluded from receiving a major depressive episode diagnosis if the symptoms otherwise fulfill the diagnostic criteria.
A 50-year-old man presents with persistently depressed mood for several weeks that interferes with his ability to work. He has insomnia and fatigue, feels guilty, has thoughts that he would be better off dead, and has thought about how he could die without anyone knowing it was a suicide. His wife informs you that he requests sex several times a day and that she thinks he may be going to massage parlors regularly, both of which are changes from his typical behavior. He has told her he has ideas for a better internet, and he has invested thousands of dollars in software programs that he cannot use. She notes that he complains of fatigue but sleeps only 1 or 2 hours each night and seems to have tremendous energy during the day. Which diagnosis best fits this client?

A. Manic episode

B. Hypomanic episode

C. Major depressive episode

D. Major depressive episode, with mixed features

E. Major depressive episode, with atypical features
D. Major depressive episode, with mixed features
Which of the following statements about the prevalence of major depressive disorder in the United States is true?

A. the 12-month prevalence is 17%

B. Females and males have equal prevalence at all ages.

C. Females have increased prevalence at all ages.

D. The prevalence in 18- to 29-year-olds is three times higher than in 60-year-olds

E. The prevalence in 60-year-olds is three times higher than that in 18- to 29-year-olds
D. The prevalence in 18- to 29-year-olds is three times higher than in 60-year-olds
Which of the following statements about diagnostic markers for major depressive disorder (MDD) is true?

A. No laboratory test has demonstrated sufficient sensitivity and specificity to be used as a diagnostic tool for MDD.

B. Several diagnostic laboratory tests exist, but no commercial enterprise will offer them to the public.

C. Diagnostic tests have been withheld for fear that people testing positive for MDD may attempt suicide.

D. Tests that exist are adequate diagnostically but are not covered by health insurance.

E. Only functional magnetic resonance imaging (fMRI) provides absolute diagnostic reliability for MDD.
A. No laboratory test has demonstrated sufficient sensitivity and specificity to be used as a diagnostic tool for MDD.
A 14-year-old boy describes himself as feeling “down” all of the time for the past year. He remembers feeling better while he was at camp for 4 weeks during the summer; however, the depressed mood returned when he came home. He reports poor concentration, feelings of hopelessness, and low self-esteem, but denies suicidal ideation or changes in his appetite or sleep. What is the most likely diagnosis?

A. Major depressive disorder

B. Disruptive mood dysregulation disorder

C. Depressive episodes with short-duration hypomania

D. Persistent depressive disorder (dysthymia), with early onset

E. Schizoaffective disorder
D. Persistent depressive disorder (dysthymia), with early onset
A 32-year-old man reports 1 week of feeling unusually irritable. During this time, he has increased energy and activity, sleeps less, and finds it difficult to sit still. He also is more talkative than usual and is easily distractible, to the point of finding it difficult to complete his work assignments. A physical examination and laboratory workup are negative for any medical cause of his symptoms and he takes no medications. What diagnosis best fits this clinical picture?

A. Manic episode

B. Hypomanic episode

C. Bipolar I disorder, with mixed features

D. Major depressive episode

E. Cyclothymic disorder
A. Manic episode
Approximately what percentage of individuals who experience a single manic episode will go on to have recurrent mood episodes?

A. 90%

B. 50%

C. 25%

D. 10%

E. 1%
A. 90%
A 25-year-old graduate student presents to a social worker complaining of 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 recalls a similar episode 1 year ago that lasted about 2 months before improving without treatment. She also reports several episodes of increased energy in the past 2 years; these episodes usually last 1-2 weeks, during which time she is very productive, feels more social and outgoing, and tends to sleep less, although she feels energetic during the day. Friends tell her that she speaks more rapidly during these episodes but that they do not see it as off-putting and in fact think she seems more outgoing and clever. She has no medical problems and does not take any medications or abuse drugs or alcohol. What is the most likely diagnosis?

A. Bipolar I, current episode depressed

B. Bipolar II, current episode depressed

C. Bipolar I, current episode unspecified

D. Cyclothymic disorder

E. Major depressive disorder
B. Bipolar II, current episode depressed
A 9-year-old boy cannot go to sleep without having a parent in his room. While falling asleep, he frequently awakens to check that a parent is still there. One parent usually stays until the boy falls asleep. If he wakes up alone during the night, he starts to panic and gets up to find his parents. He also reports frequent nightmares in which he or his parents are harmed. He occasionally calls out that he saw a strange figure peering into his dark room. The parents usually wake in the morning to find the boy asleep on the floor of their room. They once tried to leave him with a relative so they could go on vacation; however, he became so distressed in anticipation of this that they cancelled their plans. What is the most likely diagnosis?

A.Specific phobia

B.Nightmare disorder

C.Delusional disorder

D.Separation anxiety disorder

E.agoraphobia
D. Separation anxiety disorder
A 50-year-old man reports episodes in which he suddenly and unexpectedly awakens from 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, which is well controlled with hydrochlorothiazide. 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.Anxiety disorder due to another medical condition (hypertension)

B.Substance/medication-induced anxiety disorder

C.Panic disorder

D.Sleep terrors

E.Panic attacks
C. Panic disorder

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 became extremely nervous when she had to leave the house unaccompanied. 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.Specific phobia, situational type
B.Social anxiety disorder (social phobia)
C.Posttraumatic stress disorder
D.Agoraphobia
E.Adjustment disorder

D. Agoraphobia

Although onset of a specific phobia can occur at any age, specific phobia most typically develops during which age period?

A.Childhood

B.Late adolescence to early adulthood

C.Middle age

D.Old age

E.Any age
A. Childhood
When called on at school, a 7-year-old boy will only nod or write in response. The family of the child is surprised to hear this from the teacher, because the boys speaks normally when at home with his parents. The child has achieved appropriate developmental milestones, and a medical evaluation indicates that he is healthy. The boy is unable to give any explanation for his behavior, but the parents are concerned that it will affect his school performance. What diagnosis best fits this child’s symptoms?

A.Separation anxiety disorder

B.Autism spectrum disorder

C.Agoraphobia

D.Selective mutism

E.Communication disorder
D. Selective mutism
Which of the following characteristics of generalized anxiety disorder is especially common in children who have the disorder?

A.Complaining of physical aches and pains

B.Excessively preparing for activities

C.Avoiding activities that may provoke anxiety

D.Seeking frequent reassurance from others

E.Delaying or procrastinating before activities
D. Seeking frequent reassurance from others
In what aspect of generalized anxiety disorder do men and women most commonly differ?

A.Course

B.Symptom profile

C.Degree of impairment

D.Patterns of co-morbidity

E.Age at onset
D. Patterns of comorbidity
What is the primary difference in the clinical expression of generalized anxiety disorder across age groups?

A.Content of worry

B.Degree of Worry

C.Patterns of co-morbidity

D.Predominance of cognitive versus somatic symptoms

E.Severity of impairment
A. Content of worry
In social anxiety disorder (social phobia), the object of an individual’s fear is the potential for which of the following?

A.Social or occupational impairment

B.Harm to self or others

C.Embarrassment

D.Separation from objects of attachment

E.Incapacitating symptoms
C. Embarrassment
Social anxiety disorder (social phobia) differs from normal shyness in that the disorder leads to which of the following?

A.Social or occupational dysfunction

B.Marked social reticence

C.Avoidance of social situations

D.Derealization or depersonalization

E.Pervasive social deficits with poor insight
A. Social or occupational dysfunction
Critical psychiatry sees mental disorders as:

A.Social constructions

B.Reified essentialist entities

C.Related to relationships and the environment

D.More dimensional than categorical

E.All of the above
E.All of the above
Which of the following reactions to a traumatic event was required for DSM-IV diagnosis of post-traumatic stress disorder (PTSD) but is not required for the DSM-5 diagnosis?

A.Intense fear, helplessness, or horror

B.Insomnia or hypersomnia

C.Avoidance

D.A foreshortened sense of the future

E.Flashbacks
A. Intense fear, helplessness, or horror
A 25-year-old woman tells you that a little more than 3 months ago she was accosted on her way home. The attacker told her he had a gun, was going to rape her, and would shoot her if she resisted. He walked her toward an alley. She was sure he would kill her afterward no matter what she did, so she pushed away from him, aware she might be shot. She escaped unharmed. She describes not being able to fall asleep for the first 2 nights after the attack and of avoiding that particular street for 2 days. She thinks the attacker might have touched her breasts but cannot remember for sure. She has recently started feeling anxious all of the time and is tearful, and she has stopped going to work. She fears that something about her makes her “look like a victim.” What is the most likely diagnosis?

A.Posttraumatic stress disorder

B.Acute stress disorder

C.Adjustment disorder

D.Dissociative amnesia

E.Personality disorder
C. Adjustment disorder

Which of the following experiences would NOT qualify as exposure to a traumatic event (Criterion A) in the diagnosis of acute stress disorder or posttraumatic stress disorder?
A.Hearing that one’s brother was killed in combat
B.Hearing that one’s close childhood friend survived a motor vehicle accident but is paralyzed
C.Hearing that one’s child has been kidnapped
D.Hearing that one’s company has suddenly closed
E.Hearing that one’s spouse has been shot

D. Hearing that one’s company has suddenly closed

After a routine chest X ray, a 53-year-old man with a history of heavy cigarette use is told that he has a suspicious lesion in his lung. A bronchoscopy confirms the diagnosis of adenocarcinoma (cancer). The man delays scheduling a follow-up appointment with the oncologist for more than 2 weeks, describes feeling as if “all of this is not real,” is having nightly dreams of seeing his own tombstone, and is experiencing intrusive flashbacks to the moment when he heard the physician saying “The tests strongly suggest that you have cancer of the lung.” He is tearful and is convinced he will die. He also feels intense guilt that his smoking caused the cancer and expresses the thought that he “deserves” to have cancer. What diagnosis best fits this clinical picture?

A.Acute stress disorder

B.Post-traumatic stress disorder

C.Adjustment disorder

D.Major depressive disorder

E.Generalized anxiety disorder
C. Adjustment disorder
A 5-year-old child was present when her babysitter was sexually assaulted. Which of the following symptoms would be most suggestive of post-traumatic stress disorder (PTSD) in this child?

A. Playing normally with toys.

B. Having dreams about princesses and castles.

C. Taking the clothes off her dolls while playing.

D. Expressing no fear when talking about the event.

E. Talking about the event with her parents.
C. Taking the clothes off her dolls while playing.
How does the 12-month prevalence of posttraumatic stress disorder (PTSD) in the United States compare with that in European and Latin American countries?

A.It is much lower than that in other countries.

B.It is much higher than in other countries.

C.It is equal to that in other countries.

D.It is somewhat higher than in other countries.

E.It is somewhat lower than in other countries.
D. It is somewhat higher than in other countries.
How do the diagnostic criteria for PTSD in pre-school children differ from those for PTSD in people older than 6 years?

A.The preschool criteria incorporate simpler language than can be understood by children 6 years or younger.

B.The preschool criteria require one or more intrusion symptoms, one symptom representing either avoidance or negative alterations in cognition and mood, and two or more arousal/reactivity symptoms, whereas criteria for older people require symptoms in all four categories.

C.The criteria for people older than 6 require one or more intrusion symptoms, one symptom representing either avoidance or negative alteration in cognition or mood, and two or more arousal/reactivity symptoms, whereas the preschool criteria require symptoms in all four categories.

D.The preschool criteria require that the child directly experiences the trauma, whereas the criteria for older people do not have this requirement.

E.The preschool criteria include only one type of traumatic exposure as a qualifying traumatic event.
B. The preschool criteria require one or more intrusion symptoms, one symptom representing either avoidance or negative alterations in cognition and mood, and two or more arousal/reactivity symptoms, whereas criteria for older people require symptoms in all four categories.
While collaborating on a presentation to their customers, the members of a sales team become increasingly frustrated with their team leader. The leader insists that the members of the team adhere to his strict rules for developing the project. This involves approaching the task in sequential manner such that no new task can be begun until their prior one is perfected. When other members suggest alternative approaches, the leader becomes frustrated and insists that the team stick to his approach. Although the results are inarguably of high quality, the team is convinced that they will not finish in time for the scheduled presentation. When voicing these concerns to the leader, he suggests that the real problem is that the other members simply don’t share his high standards. Which of the following disorders would best explain the behavior of this team leader?

A.Narcissistic personality disorder

B.Obsessive-Compulsive disorder

C. Avoidant personality disorder

D.Obsessive-compulsive personality disorder

E.Unspecified personality disorder
D. Obsessive-Compulsive Personality Disorder
Individuals with obsessive-compulsive personality disorder are primarily motivated by a need for which of the following?

A.Efficiency

B.Admiration

C.Control

D.Intimacy

E.Autonomy
C. Control
A 36-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 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 people will laugh at her if she makes any mistakes. On reviewing past evaluations, her boss notes that there are only minor critiques and her overall evaluations have been very positive. Which of the following personality disorders would best explain this woman’s lack of job advancement?

A.Narcissistic personality disorder

B.Avoidant personality disorder

C.Obsessive-Compulsive personality disorder

D.Schizoid personality disorder

E.Borderline personality disorder
B. Avoidant personality disorder
A cardiologist requests a social work consultation for her patient, a 46-year-old man, because even though he is adherent to treatment, she is concerned that he “seems crazy.” On evaluation, the patient makes poor eye contact, tends to ramble, and makes unusual word choices. He is modestly disheveled and wears clothes with mismatched colors. He expresses odd beliefs about supernatural phenomena, but these beliefs do not seem to be of delusional intensity. Collateral information from his sister elicits the observation that “He’s always been like this – weird. He keeps to himself, and likes it that way.” Which of the following conditions best explains this man’s odd behaviors and beliefs?

A.Schizoid personality disorder

B.Schizotypal personality disorder

C.Paranoid personality disorder

D.Delusional disorder

E.Schizophrenia
B. Schizotypal personality disorder
Which of the following statements about the development, course, and prognosis of borderline personality disorder is true?

A.The risk of suicide in individuals with BPD increases with age.

B.A childhood history of neglect, rather than abuse, is unusual in individuals with BPD.

C.Follow-up studies of individuals with BPD identified in outpatient clinics have shown that 10 years later, as many as half of these individuals no longer meet full criteria for the disorder.

D.Individuals with BPD have relatively low rates of improvement in social or occupational functioning.

E.There is little variability in the course of BPD.
C. Follow-up studies of individuals with BPD identified in outpatient clinics have shown that 10 years later, as many as half of these individuals no longer meet full criteria for the disorder.
A 25-year-old man has a childhood history of repeated instances of torturing animals, setting fires, stealing, running away from home, and school truancy, beginning at the age of 9. As an adult he has a history of repeatedly lying to others, engaging in petty thefts, con games, and frequent fights; and using aliases to avoid paying child support. There is no history of manic, depressive, or psychotic symptoms. He is dressed in expensive clothing and displays and expensive wristwatch for which he demands admiration. He expresses feelings of specialness and entitlement; the belief that he deserves exemption from ordinary rules; feelings of anger that his special talents have not been adequately recognized by others; devaluation, contempt, and lack of empathy for others; and lack or remorse for his behavior. What is the appropriate diagnosis?

A.Antisocial personality disorder

B.Malignant narcissism

C.Narcissistic PD

D.Antisocial PD and narcissistic PD

E.Other specified PD (mixed personality features)
D. Antisocial PD and narcissistic PD
Which of the following presentations is characteristic of borderline personality disorder?

A.A pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.

B.A pattern of submissive and clinging behavior related to an excessive need to be taken care of.

C.A pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity

D.A pattern of grandiosity, need for admiration, and lack of empathy

E.A pattern of excessive emotionality and attention seeking.
C. A pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity
Which of the following is characteristic of paranoid personality disorder?

A.A pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

B.A pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent.

C.A pattern of submissive and clinging behavior related to an excessive need to be taken care of.

D.A pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity.

E.A pattern of grandiosity, need for admiration, and lack of empathy.
B. A pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent.
Which of the following presentations is characteristic of narcissistic personality disorder?

A.A pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

B.A pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.

C.A pattern of submissive and clinging behavior related to an excessive need to be taken care of.

D.A pattern of instability in interpersonal relationships, self-image, affects, and marked impulsivity.

E.A pattern of grandiosity, need for admiration, and lack of empathy.
E. A pattern of grandiosity, need for admiration, and lack of empathy.
A 25-year-old medical student presents to the student health service at 7 A.M. complaining of having a “panic attack.” He reports that he stayed up all night studying for his final gross anatomy exam, which starts in an hour, but he feels too anxious to go. He reports vomiting twice. The client is restless and appears flushed, with visible muscle twitching. He is urinating excessively, has tachycardia (rapid heart rate), and his electrocardiogram shows premature ventricular complexes. His thoughts and speech appear to be rambling in nature. What is the most likely diagnosis?

A.Panic disorder

B.Amphetamine intoxication, amphetamine-like substance

C.Caffeine intoxication

D.Cocaine intoxication

E.Alcohol withdrawal
C. Caffeine intoxication
Which substance use disorder of an illicit substance is the most prevalent in the United States?

A.Alcohol use disorder

B.Caffeine use disorder

C.Cannabis use disorder

D.Opioid use disorder

E.Stimulant use disorder
C. Cannabis use disorder
A 25-year-old woman is brought to the emergency department by her friends after a party. They report that the woman has been ingesting some unknown pills earlier in the evening. She became increasingly confused throughout the course of the night. She eventually had a witnessed seizure on the street, prompting activation of emergency medical services. Vital signs indicate that the client is tachycardic and hypertensive. On evaluation, she is observed to be thin with dilated pupils. She is smiling to herself, is fidgety, and is oriented to self, place, and date. When queried about auditory hallucinations, the client admits that she is hearing voices but is unconcerned, stating “I only hear them while I’m partying.” Which diagnosis best fits this person?

A.Stimulant-induced manic episode

B.Stimulant-induced psychotic disorder

C.Stimulant intoxication, with perceptual disturbances

D.Other hallucinogen-induced psychotic disorder

E.Other hallucinogen intoxication.
C. Stimulant intoxication, with perceptual disturbances
A 45-year-old man with a long-standing history of heavy alcohol use is referred for evaluation after his recent admission to the hospital for acute hepatitis (inflammation of the liver). The client reports that he drank almost daily in college. Over the past 10 years, he has gradually increased his nightly alcohol intake from a single 6-pack to two 12-packs of beer, and this nightly drinking habit has resulted in his frequently oversleeping and missing work. He has tried to moderate his alcohol use on numerous occasions with little success, particularly after developing complications associated with alcohol cirrhosis (liver disease). The client admits that he becomes anxious and gets hand tremors when he doesn’t drink. The client meets the criteria for which of the following diagnoses?

A.Alcohol abuse

B.Alcohol dependence

C.Alcohol use disorder, mild

D.Alcohol use disorder, moderate

E.Alcohol use disorder, severe
E.Alcohol use disorder, severe
A 27-year-old woman presents for social work evaluation after almost hitting someone with her car while driving under the influence of marijuana. She reports that she was prompted to seek treatment by her husband, with whom she has had several conflicts over the last year about her ongoing marijuana use. She has continued to smoke two joints daily and drive under the influence of marijuana since this event. What is the appropriate diagnosis?

A.Cannabis use

B.Cannabis dependence

C.Cannabis intoxication

D.Cannabis use disorder

E.Unspecified cannabis-related disorder
D.Cannabis use disorder
Which of the following symptoms is a recognized consequence of the abrupt termination of daily or near-daily cannabis use?

A.Hallucinations

B.Delusions

C.Hunger

D.Irritability

E.Apathy
D.Irritability
Which of the following is NOT a recognized alcohol-related disorder in DSM-5?

A.Alcohol dependence

B.Alcohol use disorder

C.Alcohol intoxication

D.Alcohol withdrawal

E.Alcohol-induced sexual dysfunction
A.Alcohol dependence
The Criterion A symptoms listed for other hallucinogen use disorder are the same as those listed for use disorders of most other substance classes, with one exception. Which of the following is NOT a recognized symptom associated with hallucinogen use?

A.Withdrawal

B.Tolerance

C.A persistent desire or unsuccessful efforts to cut down or control use of the substance.

D.Recurrent use of the substance in situations in which it is physically hazardous.

E.Craving, or a strong desire or urge to use the substance.
A.Withdrawal
Which of the following is the only NON-substance-related disorder to be included in the DSM-5 chapter “Substance-Related and Addictive Disorders”?

A.Gambling disorder

B.Internet gaming disorder

C.Electronic communication addiction disorder

D.Compulsive computer use disorder

E.Compulsive shopping
A. Gambling disorder
Which of the following statements about alcohol withdrawal is TRUE?

A.Fewer than 10% of individuals undergoing alcohol withdrawal experience dramatic symptoms such as severe autonomic hyperactivity, tremors, or alcohol withdrawal delirium.

B.Delirium occurs in the majority of individuals who meet criteria for alcohol withdrawal.

C.Approximately 80% of all clients with alcohol use disorder will experience alcohol withdrawal

D.Tonic-clonic seizures occur in about 15% of individuals who meet criteria for alcohol withdrawal.

E.Alcohol withdrawal symptoms typically begin between 24 and 48 hours after alcohol use has been stopped or reduced.
A. Fewer than 10% of individuals undergoing alcohol withdrawal experience dramatic symptoms such as severe autonomic hyperactivity, tremors, or alcohol withdrawal delirium.
There is a requirement for a major depressive or manic episode to be part of the symptom picture for a diagnosis of schizoaffective disorder. In order to separate schizoaffective disorder from depressive or bipolar disorder with psychotic features, which of the following symptoms must be present for at least two weeks in the absence of a major mood episode at some point during the lifetime duration of the illness?

A.Delusions or hallucinations

B.Delusions or paranoia

C.Regressed behavior

D.Projective identification

E.Binge eating
A. Delusions or hallucinations
How common is schizoaffective disorder relative to schizophrenia?

A.Much more common

B.Twice as common

C.Equally common

D.One-half as common

E.One-third as common
E.One-third as common
A 30-year-old single woman reports having experienced auditory hallucinations 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 with pharmacotherapy and psychotherapy, the psychotic symptoms persist for another month before resolving. What diagnosis best fits this clinical picture?

A.Brief psychotic disorder

B.Schizoaffective disorder

C.Major depressive disorder

D.Major depressive disorder with psychotic features

E.Bipolar I disorder, current episode manic, with mixed features
B. Schizoaffective disorder
Which of the following statements about the incidence of schizoaffective disorder is TRUE?

A.The incidence is equal in women and men

B.The incidence is higher in men

C.The incidence is higher in women

D.The incidence rates are unknown

E.The incidence rates vary based on seasonality of birth
C. The incidence is higher in women
A 55-year-old man with a known history of alcohol dependence and schizophrenia is brought to the emergency department because of frank delusions and visual hallucinations. Which of the following would NOT be a diagnostic possibility for inclusion in the differential diagnosis?

A.Schizophrenia

B.Substance/medication-induced psychotic disorder

C.Alcohol dependence

D.Psychotic disorder due to another medical condition

E.Borderline personality disorder with psychotic features
E. Borderline personality disorder with psychotic features.
A 65-year-old man with systemic lupus erythematosus who is being treated with corticosteroids witnesses a serious motor vehicle accident. He begins to have disorganized speech, which lasts several days before resolving. What diagnosis best fits this clinical picture?

A.Schizophrenia

B.Psychotic disorder associated with Systemic lupus erythematosus

C.Steroid-induced psychosis

D.Brief psychotic disorder, with marked stressor

E.Schizoaffective disorder
D. Brief psychotic disorder, with marked stressor
Which of the following client presentations would NOT be classified as psychotic for the purpose of diagnosing schizophrenia?

A.A client is hearing a voice that tells him he is a special person

B.A client believes he is being followed by a secret police organization that is focused exclusively on him

C.A client has a flashback to a war experience that feels like it is happening again

D.A client cannot organize his thoughts and stops responding in the middle of an interview.

E.A client presents wearing an automobile tire around his waist and gives no explanation
C. A client has a flashback to a war experience that feels like it is happening again
What is the most common type of delusion?

A.Somatic delusion of distorted body appearance

B.Grandiose delusion

C.Thought insertion

D.Persecutory delusion

E.Former life regression
D. Persecutory delusion
Which of the following statements about violent or suicidal behavior in schizophrenia is FALSE?

A.About 5-6% of individuals with schizophrenia die by suicide

B.Persons with schizophrenia frequently assault strangers in a random fashion

C.Compared with the general population, persons with schizophrenia are more frequently victims of violence

D.Command hallucinations to harm oneself sometimes precede suicidal behaviors

E.Youth, male gender, and substance abuse are factors that increase the risk for suicide for people with schizophrenia
B. Persons with schizophrenia frequently assault strangers in a random fashion
Which of the following statements about gender differences in schizophrenia is TRUE?

A.Women with schizophrenia tend to have fewer psychotic symptoms than do men over the course of the illness

B.A first onset of schizophrenia after age 40 is more likely in women than in men

C.Psychotic symptoms in women tend to burn out with age to a greater extent than they do in men

D.Negative symptoms and affective flattening are more frequently observed in women than men with schizophrenia

E.The overall incidence of schizophrenia is higher in women than it is in men
B. A first onset of schizophrenia after age 40 is more likely in women than in men
Which of the following statements about negative symptoms of schizophrenia is false?

A.Negative symptoms are easily distinguished from medication side effects such as sedation.

B.Negative symptoms include diminished emotional expression.

C.Negative symptoms can be difficult to distinguish from medication side effects such as sedation.

D.Negative symptoms include reduced peer or social interaction.

E.Negative symptoms include decreased motivation for goal-directed activities.
A.Negative symptoms are easily distinguished from medication side effects such as sedation.
Female sexual interest/arousal disorder requires a lack of, or significantly reduced, sexual arousal, as manifested by at least three of six possible indicators. Which of the following is not one of these six indicators?

a.No/reduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate.

b.Absent/reduced sexual excitement/pleasure during sexual activity with the opposite sex.

c.Absent/reduced genital or non-genital sensations during sexual activity in almost all or all sexual encounters.

d.Absent/reduced interest in sexual activity.

e.Absent/reduced sexual/erotic thoughts or fantasies.
B. Absent/reduced sexual excitement/pleasure during sexual activity with the opposite sex.
In all of the sexual dysfunctions except substance/medication-induced sexual dysfunction, symptoms must be present for what minimum duration to qualify for the diagnosis.

a. Approximately 1 month.

b. Approximately 3 months.

c. Approximately 6 months.

d. Approximately 1 year.

e. Approximately 2 years.
C. Approximately 6 months
A 35-year old man with new-onset diabetes presents with a 6-month history of inability to maintain an erection. His erectile dysfunction had a sudden onset: he was fired from his job a month before the symptoms began. His serum glucose is well controlled with oral hypoglycemic medication. What is the appropriate DSM-5 diagnosis?

a. Sexual dysfunction due to a general medical condition.

b. Erectile disorder.

c. Adjustment disorder.

d. Unspecified sexual dysfunction.

e. No diagnosis
B. Erectile disorder.
Which of the following factors should be considered during assessment and diagnosis of a sexual disorder?

a. Partner factors.

b. Relationship factors.

c. Cultural or religious factors.

d. Individual vulnerability factors, psychiatric comorbidity, or stressors.

e. All of the above.
E. All of the above.
A 30-year old woman comes to your office and reports that she is there only because her mother pleaded with her to see you. She tells you that although she has a good social network with friends of both sexes, she has never had any feelings of sexual arousal in response to men or women, does not have any erotic fantasies, and has little interest in sexual activity. She has found other like-minded individuals, and she and her friends accept themselves as asexual. What is the appropriate diagnosis, if any?

a. Female sexual interest/arousal disorder, lifelong, mild.

b. Female sexual interest/arousal disorder, lifelong, severe.

c. Hypoactive sexual desire disorder.

d. No diagnosis, because she does not have the minimum number of symptoms required (Criteria A) for female sexual interest/arousal disorder.

e. No diagnosis, because she does not have clinically significant distress or impairment.
E. No diagnosis, because she doesn’t have clinically significant distress or impairment.
Which of the following statements about the diagnoses of premature (early) ejaculation and delayed ejaculation is true?

a. Criterion A for both diagnoses includes a specific time period following penetration during which ejaculation must or must not have occurred.

b. Criterion A for both diagnoses specifies “partnered sexual activity.”

c. Early ejaculation, but not delayed ejaculation, may be diagnosed even when there is no clinically significant distress.

d. Estimated and measured intravaginal ejaculatory latencies are poorly correlated.

e. For both diagnoses, the severity is based on the level of distress experienced by the individual.
B. Criterion A for both diagnoses specifies “partnered sexual activity.”
Which of the following conditions would be appropriately diagnosed as “other specified sexual dysfunction”?

a. Substance/medication-induced sexual dysfunction.

b. Sexual aversion.

c. Erectile dysfunction.

d. Female arousal interest/arousal disorder.

e. Delayed ejaculation.
b. Sexual aversion.
Which of the following statements about sexual dysfunction occurring in the context of substance or medication use is true?

a. It is more frequently caused by buprenorphine than by methadone.

b. It occurs more commonly in 3,4-methylenedioxymethamphetamine (MDMA) abusers than in heroin abusers.

c. It occurs in approximately 50% of patients taking antipsychotics.

d. Less than 10% of individuals with orgasm delay from antidepressants will experience spontaneous remission of the dysfunction within 6 months.

e. The overall incidence and prevalence of medication-induced sexual dysfunction are well delineated, based on extensive research.
C. It occurs in approximately 50% of patients taking anti-psychotics.