Deck 8: Exposure Therapies

Question 1

The therapeutic relationship for an implosive therapist ideally involves all of the following EXCEPT:

A)establishing a trusting relationship to maximize treatment cooperation.
B)being genuine and ongoing empathy.
C)offering empathy during the evaluation phase to help develop effective scenes.
D)helping clients stay with threatening stimuli.

Answer 1

B

Question 2

The most common and distinctive characteristics of the exposure therapies involve:

A)direct confrontation with feared stimuli and associated intense emotions.
B)use of contingencies to reduce problem behaviors.
C)avoidance of problem-activating situations and images and reinforcement of alternative coping strategies.
D)response inhibition.

Answer 2

A

Question 3

As a sophomore in a competitive liberal arts college,Peter decided to seek therapy for his test anxiety.He described a process of proactively weaving complex lies to avoid taking in-class exams,and typically negotiated either a take-home test or out-of-class make-up exam.He was able to describe the onset of these avoidance behaviors and how they had become increasingly ritualized in an effort to avoid the considerable anxiety tests provoked.While immediately relieved whenever he successfully negotiated a less anxiety provoking alternative,he became increasingly depressed by the amount of effort and time this took,and the toll it was taking on his relationships with classmates and professors who began to confront him on these avoidance behaviors.This case is an example of which phenomenon?

A)Generalization process
B)Neurotic paradox
C)Two-factor learning dilemma
D)Response prevention

Answer 3

B

Question 4

A middle-aged woman presents for therapy with a history of early childhood trauma perpetrated by abusive parents.She now reports that she is unable to tolerate any close social ties as much as she longs for them,and becomes highly anxious whenever people begin to "get close." From a learning theory perspective,this might be best explained by the process of:

A)generalization.
B)operant conditioning.
C)stimulus discrimination.
D)extinction.

Question 5

At its heart,the goal of implosive therapy is to:

A)decrease reliance on avoidance responses to help people face their most frightening images,feelings,and thoughts.
B)flood people with positive imagery to counter aversive images.
C)replace maladaptive avoidance responses with more adaptive avoidance responses.
D)release the life energy bound up in characterological muscular armor.

Question 6

The therapeutic strategy of exposure therapy is to:

A)facilitate generalization of avoidance responses.
B)reverse the reinforcement contingencies.
C)extinguish long-term anxiety.
D)reduce extinction effects.

Question 7

Stampfl locates the core of psychopathology in:

A)clients' inability to inhibit distressing images.
B)sexual repression and social oppression.
C)the flooding of aversive feelings and memories.
D)learned avoidance responses that reduce anxiety.

Question 8

Exposure therapies typically terminate sessions once habituation is achieved.Habituation is defined as a:

A)10% reduction in reactivity to fear-producing stimuli.
B)25% reduction in reactivity to fear-producing stimuli.
C)50% reduction in reactivity to fear-producing stimuli.
D)75% reduction in reactivity to fear-producing stimuli.

Question 9

Foa asserts which of the following as an important component of treatments for PTSD?

A)Enhancing avoidance of re-exposure to the trauma
B)Education that the trauma was an isolated event and is not likely to recur
C)Imaginal exposure to the trauma in a controlled,safe treatment setting
D)Immediate in vivo exposure to the site of the trauma

Question 10

Mowrer's (1947)notion that classically conditioned anxiety functions as the drive stimulus that activates an avoidance response,while the anxiety reduction functions to reinforce the instrumental avoidance is known as:

A)operant conditioning.
B)classical conditioning.
C)the two-factor theory of learning.
D)instrumental conditioning.

Question 11

Avoidance responses are said to be learned or conditioned because they:

A)are associated with higher levels of anxiety.
B)function to reduce or minimize anxiety,and thus are self-reinforcing.
C)can be easily generalized.
D)inhibit facing distressing feelings,thoughts,or images.

Question 12

The failure of maladaptive anxiety to extinguish despite its clearly self-defeating nature is known as the:

A)exposure dilemma.
B)two-factor learning theory.
C)process of generalization.
D)neurotic paradox.

Question 13

One way to conceptualize fear reduction during exposure is from conditioning theories.An alternative conceptualization advanced by Foa and her colleagues involves:

A)emotional reprocessing.
B)desensitization.
C)in vivo reprocessing.
D)cognitive restructuring.

Question 14

This same women further reported many memories of running home from school excited to tell her parents about the day's events and longing to have contact with them to only find her parents passed out from alcohol abuse or unpredictably and frighteningly abusive toward her.Not surprisingly,she reported panic-like bouts of anxiety before coming to her second and third therapy sessions and whenever she seemed to be looking forward to potentially satisfying social connections and thus worked hard to avoid thinking about such experiences.This is known as:

A)phobic avoidance.
B)negative reinforcement.
C)implosion repression.
D)avoidance repression.

Question 15

Learning theories of anxiety and trauma disorders hold that:

A)avoidance produces many fears through classical conditioning.
B)the unconditioned response is rational,while later conditioned responses are not.
C)avoidance is negatively reinforced by anxiety reduction.
D)operant conditioning accounts for the generalization of fears.

Question 16

One of the most challenging aspects of conducting implosive therapy is that it requires a therapist:

A)to face horrifying and frightening scenes from their own past.
B)to terminate distressing images at specific points in the anxiety cycle.
C)to intensify distressing images or scenes to evoke maximal levels of anxiety and stay with it until the anxiety and other emotions dissipate.
D)to terminate the exposure to distressing scenes at the peak of anxiety.

Question 17

Practically speaking,according to the textbook authors,implosive therapists may benefit from:

A)reinforcement of their own socialized tendencies to avoid eliciting anxiety in others.
B)facing anxiety-provoking scenes from one's own life.
C)self-implosion on every aversive scene developed to be presented to the patient.
D)psychoanalysis to resolve inner conflicts that may interfere with presenting a neutral stance.

Question 18

Exposure methods can vary along which dimension(s)?

A)Whether to engage in gradual or intensive exposure
B)Whether to present feared stimuli imaginally or in vivo
C)Whether to prevent avoidance responses totally or partially
D)All of the above

Question 19

The two-factor theory explains the development of anxiety or trauma disorders in terms of:

A)repression and avoidance.
B)arousal and phobic behaviors.
C)reinforcement and punishment.
D)classical and operant conditioning.

Question 20

Systematic desensitization can be conceptualized as an example of:

A)gradual,in vivo exposure.
B)incremental,imaginal exposure.
C)intense,imaginal exposure.
D)gradual emotional flooding.

Question 21

Meta-analysis of nine treatment outcome studies of repeated exposure to preingestion cues for alcohol dependent adults has documented:

A)little effectiveness.
B)modest positive findings.
C)mixed and equivocal findings.
D)reasonably strong support.

Question 22

Shapiro's Eye Movement Desensitization and Reprocessing had its origins with the discovery that:

A)spontaneous rapid eye movements accompanied disturbing images and thoughts,after which the thoughts disappeared.
B)rapid eye movements have been shown to be central to the process of healing from trauma.
C)rapid eye movements occur during certain phases of sleep cycle known to be associated with disturbing dreams or nightmares.
D)rapid eye movements formed the central process underlying successful desensitization.

Question 23

A key aspect of the therapeutic relationship in EMDR is:

A)to maximize ongoing empathy over the course of treatment.
B)to insure that clients will not dissociate.
C)to refrain from providing empathic statements during processing phase.
D)to maximize the interweave of clinician-derived statements with client-generated material to facilitate processing.

Question 24

Exposure therapy has been found to be effective with each of the following EXCEPT:

A)PTSD.
B)OCD.
C)social anxiety disorder.
D)mood disorders.

Question 25

The phase of EMDR that focuses on increasing the accessibility and strength of alternative positive cognitions is known as:

A)desensitization.
B)installation.
C)emotional reprocessing.
D)SUD.

Question 26

In EMDR,the directed eye movements are believed to be a means of:

A)erasing the distressing images or thoughts.
B)distraction away from the distressing images or thoughts.
C)enhancing focus on the most disturbing feature of a traumatic memory.
D)activating the information processing system.

Question 27

A half-dozen meta-analyses have concluded that EMDR is more effective than no treatment and:

A)less effective than prolonged exposure.
B)equally effective as prolonged exposure.
C)more effective than prolonged exposure.
D)much more effective than prolonged exposure.

Question 28

From a behavioral perspective,EMDR would most likely be criticized on the basis of:

A)a poorly specified theoretical rationale.
B)having reversed the order of treatment validation and widespread clinician training.
C)having conducted only uncontrolled outcome studies.
D)having failed to demonstrate any empirical support for this treatment approach.

Question 29

Meta-analyses of exposure therapies for PTSD show that exposure therapies generally are:

A)more effective than medications and equally effective to alternative treatments.
B)equally effective to medications,and slightly less effective than other treatments.
C)less effective than medications,but more effective than non-exposure treatments.
D)more effective than medications and non-exposure treatments.

Question 30

To date,controlled studies of virtual reality for the treatment of anxiety problems have shown:

A)that in vivo exposure is significantly better.
B)that virtual reality exposure is significantly better.
C)a trend favoring in vivo exposure.
D)a trend favoring virtual reality.

Question 31

According to the textbook authors,EMDR's central processes of change involve:

A)consciousness raising and catharsis.
B)catharsis and cognitive restructuring.
C)consciousness raising and counterconditioning.
D)counterconditioning and cognitive restructuring.

Question 32

According to Shapiro,EMDR presumably achieves its beneficial effects by:

A)desensitization according the traditional behavioral model.
B)accessing traumatic memories and accelerating information reprocessing.
C)implosion in the context of directed eye movements.
D)accelerating the alteration of negative cognitions.

Question 33

Results from a few initial studies of cue exposure treatment for alcohol dependence were:

A)promising.
B)disappointing.
C)equivocal.
D)highly successful.

Question 34

To date,controlled studies of virtual reality for the treatment of anxiety problems have shown:

A)small effect sizes.
B)medium effect sizes.
C)large effect sizes.
D)very large effect sizes.

Question 35

The criticism that implosive therapy,while based on a respectable theory and evidence regarding the extinction process,would do well to eliminate pseudoscientific concepts like dynamic or hypothesized avoidance cues and to focus solely on symptom stimuli would most likely be advanced by which therapy?

A)Behavioral
B)Psychoanalytic
C)Integrative
D)Contextual

Question 36

EMDR postulates that psychopathology originates with:

A)incongruous eye movements associated with disturbing images.
B)emotional reactivity to disturbing or traumatic memories.
C)blockage in the nervous system's information processing ability.
D)pathological cognitive structures which cause retraumatizing eye movements.

Question 37

Across studies,when exposure therapies are compared with no treatment,medication therapies,and/or alternative therapies for anxiety and trauma-related disorders,results have consistently indicated that:

A)exposure therapy is much more successful than all other interventions and no treatment.
B)exposure therapy is more effective than no treatment and several alternative therapies,and at least comparable to medication treatments.
C)exposure therapy is more effective than no treatment and most medication therapies,but mostly comparable to alternative therapies.
D)exposure therapy is more effective than no treatment,but largely equivalent to medication and alternative therapies.

Question 38

Requiring clients to endure perverse imagery and silly exercises amounts to a mechanistic treatment of people in exposure therapies conducted by therapists who prefer to do things to people rather than being with traumatized individuals is a criticism most likely to be leveled by which therapy perspective?

A)Behavioral
B)Contextual
C)Humanistic
D)Integrative

Question 39

Exposure therapy can be conducted in each of the following ways EXCEPT:

A)in vivo.
B)observing others.
C)imaginal.
D)virtually.

Question 40

Exposure therapies for specific phobias has been shown to produce:

A)large effects compared to no treatment,and medium effects compared to placebo and nonexposure treatments.
B)medium effects compared to no treatment,and small effects compared to placebo and nonexposure treatments.
C)large effects compared to no treatment,and small effects compared to placebo and nonexposure treatments.
D)medium effects compared to no treatment,placebo and nonexposure treatments.

Question 41

Edna Foa's exposure therapy for PTSD is derived from:

A)emotional processing theory.
B)eye movement desensitization and reprocessing theory.
C)the two-factor theory of learning theory.
D)adaptive information processing theory.

Question 42

Dismantling research designs:

A)break down a therapy into its constituents.
B)focus on mediating variables.
C)compare one therapy to another.
D)eliminate nonspecific factors.

Question 43

The research base supporting the use of EMDR has been:

A)broadly applied to a range of anxiety disorders.
B)largely concentrated on trauma/PTSD.
C)broadly applied to anxiety,mood and personality disorders.
D)largely focused on the treatment of panic disorder and specific phobias.

Question 44

Study designs that focus on understanding the specific active ingredients of a multicomponent therapy are called:

A)treatment comparison studies.
B)randomized controlled trials.
C)dismantling studies.
D)mediation studies.