Deck 3: Assessment and Diagnosis

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Question
Your text presents the case of Kathy Buckley, a comedienne and inspirational speaker, misdiagnosed in childhood as having mental retardation. When accurately diagnosed some time later, what was found to be the actual disorder?

A) Schizophrenic disorder
B) Depressive disorder
C) Hearing loss
D) Blindness
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Question
Mary, a 19-year old college sophomore, has been referred to a psychologist by her physician. Mary has a high level of anxiety and complains of intrusive thoughts that interfere with her ability to study for exams. She also reports having severe migraine headaches before exams. Most likely, the psychologist will

A) assume that the migraines are triggered by the stress of Mary's worries about exams and will assess her test-taking skills.
B) disregard his theoretical approach and use behavioral assessments that have been proved effective in anxiety-reduction cases.
C) conduct a brief assessment because of Mary's young age and the simplicity of the case.
D) consider Mary's medical state, age, and symptoms in selecting appropriate assessment tools.
Question
A screening device is able to indicate a problem when it is present and accurately indicate the absence of a problem when none exists. In psychological terms, this would constitute

A) screening specificity.
B) screening sensitivity.
C) differential diagnosis.
D) sensitivity and specificity.
Question
The process of assessment first involves an evaluation of what procedures and instruments to administer as well as

A) determining which measures of biological function, cognition, emotion, and behavior to use.
B) obtaining feedback from relatives using structured interviews.
C) determining the number, order, and timing of tests to be administered.
D) considering the patient's potential for completing the tests within a given time frame.
Question
Clinical assessments are important as they lead to a diagnosis. The diagnosis is often needed in order to gain which of the following?

A) medical evaluation
B) clinical evaluation
C) insurance company reimbursement
D) labels for client use
Question
The case of 82 year-old Pauline, presented in your text, highlights

A) the importance of developing treatment plans that include the patient's family.
B) the complex interplay of psychological, biological, and social factors that affect an individual's psychological functioning.
C) the significant impact a physical disorder may have on the older patient's memory functions.
D) the difficulty inherent in selecting appropriate assessment measures for elderly patients.
Question
The theoretical orientation of a person conducting a psychological assessment affects the

A) selection of assessment tools, but not the interpretation of data resulting from testing.
B) range and scope of the assessment.
C) selection of assessment tools, but only for very young children.
D) estimated amount of time the assessment process will take.
Question
A new psychological test is able to detect anxiety in patients; it accurately identifies both the absence and presence of anxiety. This would mean that the test

A) has high false positive rates and high false negative rates.
B) has high false positive rates but low false negative rates.
C) is low in false positive rates and low in false negative rates.
D) is low in false positive rates but high in false negative rates.
Question
The Guilford Test of Marital Discord is administered to a newly married young woman who is being seen in psychotherapy. The results indicate that the woman is very unhappy in her marriage. Knowing that testing literature reports that the test has a high rate of false positives, a good clinician would

A) be cautious of the results, as a high false positive rate means that the test may have inaccurately identified a problem when none existed.
B) be confident in the results, as the patient's score exceeded a cut-off score.
C) want to retest the young woman with the same instrument to reduce the false positive rate, which is most likely due to chance.
D) be cautious because the young woman may not be answering questions honestly to hide her marital problems.
Question
Miguel is a 24-year-old married man who was referred by his physician to a psychologist for assessment. In order for the psychologist to release information to Miguel's doctor,

A) the psychologist would want to ensure that the information is accurate and reviewed by Miguel before it is released.
B) the psychologist would want to clear the release with Miguel's wife for legal reasons.
C) Miguel would have to provide permission for the release of information to his doctor.
D) Miguel would waive his right to confidentiality since his physician made the original referral and the assessment is part of his medical record.
Question
A community screening for depression might identify

A) people at risk for depression if they are not treated.
B) the people in a cohort who might benefit from a particular type of therapy.
C) the number of people likely to recover without any psychological treatment.
D) what a specific cohort's cut-off score should be, considering all risk factors.
Question
In some branches of medicine, diagnosis refers to the identification of a physical illness and may be made on the basis of laboratory tests. In psychology, however, a diagnosis is

A) made on the basis of a single behavior, if significant.
B) made only after consultation with the primary physician.
C) based more on the presence of clusters of symptoms.
D) based on several significant epidemiological factors.
Question
What do the cases described in the text of the 46-year old woman who had hallucinations due to epilepsy and Kathy Buckley, the comedienne and inspirational speaker, have in common?

A) Both were able to succeed in their occupations without having to spend time in psychiatric hospitals.
B) Both were accurately diagnosed in early childhood as having dual diagnoses.
C) Both were misdiagnosed as having organic depressive reactions.
D) Both were misdiagnosed as having psychological disorders.
Question
A major purpose of a diagnosis is to

A) aid communication among researchers and clinicians.
B) help patients understand the root cause of their problems.
C) assist the referral source in making a differential diagnosis.
D) communicate the psychologist's theoretical orientation to treatment.
Question
In the clinical assessment process, referral questions aid in the determination of

A) the goals of assessment and the psychological tests or measurements to be administered.
B) an appropriate placement for the patient upon discharge.
C) how long the therapeutic process will take.
D) the best way to psychologically triage the individual for further testing.
Question
Morgan obtains a score on a screening device for depression, which indicates the presence of significant depression. Morgan's psychologist is most likely to do what at this point in the assessment process?

A) Refer Morgan for in-patient hospitalization
B) Recommend further evaluation
C) Repeat the testing to determine reliability
D) Begin therapy given the immediate risk
Question
During the course of a physical exam, a physician suspects his patient may be depressed. In order to explore this diagnostic possibility, the physician uses a "brief screening device" for depression. The doctor probably

A) used the AUDIT to determine their level of depression.
B) asked the patient two questions about feelings of hopelessness and feelings related to the enjoyment of activities from a two-item screening instrument.
C) used the General Health Questionnaire (GHQ) to assess the degree to which the patient's depression was affecting general health.
D) asked the patient to rate his degree of depression using the Checklist of Mood States (CMS).
Question
During the college's health fair, the Counseling Center offers confidential testing to evaluate a student's risk for substance abuse. According to your text, this assessment process is typically known as a

A) prospective evaluation.
B) screening.
C) differential risk measurement.
D) risk evaluation.
Question
In making a differential diagnosis, the psychologist performing the assessment gathers data from multiple sources and completes a process that is more extensive than a screening in order to determine the

A) likelihood that the patient has one disorder as opposed to another.
B) likelihood that a psychological disorder is present.
C) presence or absence of an organic basis for a specific disorder.
D) presence or absence of psychosocial factors contributing to multiple disorders.
Question
The Center for Epidemiologic Studies-Depression Scale (CES-D) has usefulness in assessing

A) children of depressed parents who are at high risk for depression.
B) prevalence rates of depression within a specific group.
C) community members who are depression-resistant.
D) sources of stress leading to depression in community members.
Question
From a practical standpoint, accurate diagnoses direct the psychologist toward

A) appropriate treatment modalities.
B) understanding the physiological roots of all disorders.
C) a deeper understanding of stressors precipitating the disorder.
D) the best way to avoid malpractice charges.
Question
In using the same test more than once during the course of therapy, the psychologist is most likely trying to gauge the course of symptoms over time or

A) the acceptability of the treatment recommendations.
B) the effect of treatment.
C) the validity of the diagnosis.
D) the baseline frequency of symptoms.
Question
When considering a "normative" approach to interpreting a patient's score on an assessment instrument, the psychologist is interested in comparing the patient's score with

A) scores of all persons who have taken the test.
B) earlier scores for the same patient.
C) scores of a comparable subgroup.
D) scores of persons not in treatment.
Question
On psychological tests, the standard deviation gives an indication of

A) the distance between an obtained score and the average score of the normative group.
B) the distance between the scores of a referent group and the scores of a normative group.
C) the number of points required for a person's score to fall within the "normal" range.
D) the number of standard points required for a person's score to demonstrate improvement.
Question
Data from more than 136 studies support the conclusion that _______ were more accurate than __________.

A) clinical judgments; statistical predictions
B) statistical predictions; clinical judgments
C) clinical judgments; psychometric scores
D) psychometric scores; statistical predictions
Question
A psychologist in the counseling center interviews a student in crisis who is having suicidal thoughts. As part of the assessment process, the psychologist administers a test designed to evaluate potential suicide risk. Which type of validity is the psychologist relying on in this scenario?

A) Statistical validity
B) Face validity
C) Predictive validity
D) Construct validity
Question
The Reliable Change Index (RCI) is a measure of

A) the change in a patient's condition from the beginning to the end of therapy.
B) the predicted change in a patient's behavior compared with that of similar patients.
C) the degree of change in a patient's condition estimated to be attributable to non-therapeutic factors
D) the degree of change a therapist might expect based on a particular form of treatment.
Question
Which of the following is a psychometric properties of an assessment instrument?

A) significance
B) sensitivity
C) standardization
D) specificity
Question
Which of the following best captures the meaning of reliability?

A) A test consistently produces the same score for the same person.
B) Test scores vary over time but stay within 2 standard deviations of the mean.
C) Test scores of different people are highly correlated.
D) Interrater agreement is low.
Question
A psychologist is conducting an assessment of a child who appears to have high distractibility in a classroom setting. The psychologist is interested in what happens just before the child is distracted from a task, how the child behaves during the distracted period, and what happens immediately after the task disruption. In assessing the relationship between situational influences and behavior, the psychologist is using a(n) _____ analysis.

A) topical
B) functional
C) structural
D) internal
Question
Marjorie has been in treatment for panic disorder for six months. The psychologist has asked her to retake a variety of assessment measures that she originally had taken at the beginning of treatment. In order to gain the best measure of therapeutic success, her psychologist would want to include assessment measures

A) of limited scope to restrict sensitivity.
B) representing a range of outcomes.
C) that evaluate symptom severity only.
D) that serve as screening tools.
Question
A construct validity score represents

A) whether two independent practitioners agree on a diagnosis.
B) the degree to which a test accurately assesses a specific concept and not other related concepts.
C) a test's ability to discriminate a patient who is trying to fake symptoms.
D) the percent of test-takers who show reliable scores on a test measuring an related constructs.
Question
William was treated for anxiety related to test-taking. At the end of his therapy, he reported fewer anxiety symptoms and a better ability to manage his fear of failure. Most probably, William's progress will be viewed as _______ at termination.

A) clinically significant
B) a partial failure
C) treatment resistant
D) clinically insignificant
Question
Dr. Winston is interested in determining if his patient's score on a psychometric instrument measuring resilience is comparable to the scores of other persons in his age group. Given this interest, Dr. Winston would compare his patient's score to scores for a _______ group.

A) related
B) comparative
C) normative
D) relative
Question
Sean is participating in a clinical assessment. The psychologist is asking him questions about the severity of his symptoms and how they have persisted or changed over time. Sean is also asked about behaviors related to personality strengths and weaknesses. The psychologist might also consider including both a personality assessment and

A) neuropsychological tests.
B) physiological assessment tools.
C) neurobehavioral tests.
D) functional-analytic tests.
Question
Dr. A and Dr. B are studying the effects of war on posttraumatic stress disorder. They both administer the same interview to the same soldiers returning from war. Which of the following psychometric test properties is being addressed in this example?

A) Test-retest reliability
B) Interrater agreement
C) Referent reliability
D) Normative agreement
Question
Clinical assessments made for the purpose of diagnosis typically include an evaluation of the problem behavior's symptoms and severity, patterns of symptoms over time, and

A) a clinical judgment as to the need for a second opinion.
B) a mental status exam by a collaborating psychiatrist.
C) an evaluation of the patient's strengths and weaknesses.
D) an estimation of the length of treatment time.
Question
Under what conditions might a clinician find a clinical judgment, rather than statistical data, useful?

A) When there are no relevant statistical data upon which to rely.
B) When the clinician's intuition leads her away from the statistical data.
C) When the training of the therapist lends itself more readily to clinical judgment than to empirical studies.
D) When the statistical data point to the efficacy of a treatment in which the clinician is not trained.
Question
In the self-referent approach to interpreting a score, a person's score today

A) predicts the person's score without treatment.
B) predicts the person's score following treatment.
C) is compared with an earlier score on a different test.
D) is compared with an earlier score on the same test.
Question
Clinical assessments for outcome evaluation may be repeated over time during treatment in order to

A) determine the patient's changing attitudes toward the therapist.
B) be certain the problem behavior has been identified.
C) recheck the accuracy of the diagnosis.
D) evaluate a patient's progress.
Question
The content and style of questions used in a clinical interview are guided by the

A) presenting problem and the nature of the patient's difficulty.
B) presenting problem.
C) clinician's theoretical orientation.
D) clinician's theoretical orientation and presenting problem.
Question
Although Dr. Johnson has been trained in Exner's comprehensive system for scoring and interpreting the Rorschach Inkblot Test, he does not use the test as part of his clinical test battery. Having reviewed the literature, Dr. Johnson found that

A) the test has questionable test reliability, its normative data are outdated, and it has limited validity.
B) the test has significant test reliability and validity but the normative data are outdated.
C) the projective nature of the test makes it useful for screening severe pathology, but it results in false negatives when used with normal individuals.
D) the test has appropriate validity properties, but its projective nature limits its use for scientist-practitioners.
Question
Which of the following is an example of an open-ended interview question?

A) "Tell me more about it."
B) "Do you have periods of feeling blue or hopeless?"
C) "How frequently do you miss class?"
D) "Is your family supportive of your decision to seek treatment?"
Question
Tests such as the Dementia Rating Scale (DRS)

A) are designed to evaluate the degree to which depression impacts memory.
B) require teachers to provide observational data for students in grade school.
C) are intended to assess symptoms unique to a specific developmental segment of patients.
D) may not be appropriate for use with older persons.
Question
Neuropsychological tests are inappropriate for assessing

A) motor skills.
B) learning abilities.
C) language.
D) temperament.
Question
Why would scientist-practitioners choose to use a projective test with inadequate normative data?

A) They do not subscribe to such rigid psychometric requirements as empirically oriented psychologists.
B) They may find them useful to "get the patient talking" in the initial stages of therapy.
C) They find that patients often relate better to unstructured tests than to structured tests.
D) They take less time to score and less training to administer than self-report measures of psychopathology.
Question
Desmond is being seen by a psychologist for assessment. As part of the process, he was given a series of pictures and asked to make up a story about each image. The examiner then interpreted the stories according to his theoretical orientation. What projective test was given to Desmond?

A) Rorschach Picture Test
B) Thematic Apperception Test
C) Wechsler Adult Intelligence Scale Picture Completion Subtest
D) Projective Open-Ended Story Test
Question
Jose is asked to complete an assessment measure that focuses on depression. The instructions given on the instrument state, "Rate each of the following items using the following scale: Always, Frequently, Sometimes, or Never." Which of the following types of assessment instruments is Jose being asked to complete?

A) Subjective response measure
B) Self-report measure
C) Clinician-rated measure
D) Objective response measure
Question
Of the many factors influencing the choice of assessment tools, one of the most important factors affecting a clinician's choice is the

A) length of time it takes to administer an assessment tool.
B) difficulty of scoring a test.
C) availability of computer-scoring services for validity.
D) person's age and developmental status.
Question
The Millon Clinical Multiaxial Inventory (MCMI), a test designed to measure personality styles, pathological syndromes, and symptom disorders, has adequate reliability and validity but it

A) takes longer to complete than the MMPI.
B) lacks fit with the DSM system and categories.
C) relies heavily on open-ended questions.
D) assesses only severe cases of specific disorders.
Question
Empirical keying as a test construction approach utilizes statistical analyses of items and patterns of scores that

A) discriminate between a behavior and psychoanalytic perspective.
B) discriminate among groups along various clinical dimensions.
C) discriminate between reliable diagnostic categories and unreliable diagnostic categories.
D) predict successful treatment outcomes for hospitalized patients.
Question
William is concerned about appearing "psychologically healthy" when taking a test. Having sensed this patient's veiled intent during part of the clinical interview, the psychologist decides to use a personality test that might validate his clinical hunch. Which of the following test is the clinician likely to choose?

A) Global Assessment of Functioning Scale
B) Millon Clinical Multiaxial Inventory
C) Minnesota Multiphasic Personality Inventory
D) Wisconsin Card Sorting Test
Question
Selecting the best set of instruments to address the clinician's questions depends on the goals of assessment, the properties of the instruments, and the

A) referral source's theoretical orientation.
B) persons available to provide additional information through interviews.
C) amount of time available for the assessment.
D) nature of the patient's difficulties.
Question
Both structured and unstructured clinical interviews are used for screening, diagnosis, treatment planning, and

A) reliability monitoring.
B) outcome evaluation.
C) establishing construct validity.
D) field testing.
Question
Which of the following statements is TRUE of both the Global Assessment of Functioning Scale and the General Health Questionnaire?

A) Both measurements rely on the clinician's evaluation of functioning.
B) Both measurements are useful in assessing change in patients' conditions.
C) Both measurements are only useful for inpatient populations.
D) Both measurements lack reliability but provide valid measures of functioning.
Question
Mr. Smith is a 67-year-old insurance salesman who is being admitted to an inpatient facility for substance abuse treatment. Using the Global Assessment of Functioning Scale, the clinician evaluates Mr. Smith to be functioning at a level of 45. What is the clinician communicating in assigning this score?

A) Mr. Smith's symptoms are transient and expectable reactions to a psychosocial stressor.
B) Mr. Smith's functioning is good in all areas, especially given his current condition.
C) Mr. Smith may have serious symptoms or serious impairment in areas of overall functioning.
D) Mr. Smith's case does not provide enough information to evaluate his general level of functioning.
Question
While a major benefit of the unstructured interview lies in its flexibility, a major drawback exists in the

A) amount of time required to complete it.
B) potential unreliability of conclusions drawn from it.
C) resistance of the patient to answer all questions contained in it.
D) inability of the client to articulate symptoms.
Question
Researchers from the Center for Phobic Disorders have received a research grant to investigate the efficacy of a cognitive-behavioral approach to treatment. In selecting an interview instrument, the investigators will give important consideration to whether

A) two different interviewers would reach the same conclusion about the same person.
B) the same patient would respond in the same way to both an unstructured and structured interview.
C) the interview questions are gender-sensitive.
D) training is required on both forms A and B of the unstructured interview.
Question
The Leiter International Performance Scale-Revised was developed in response to

A) the cultural bias inherent in language.
B) the cultural biases found in geometric shapes.
C) the lack of "culture fairness" in non-verbal intelligence tests.
D) the cultural bias existing in clinicians' theoretical orientation.
Question
The construction of the 567-item Minnesota Multiphasic Personality Inventory (MMPI) took a novel approach to test construction known as

A) empirical keying.
B) discrimination keying.
C) diagnostic keying.
D) predictive validity keying.
Question
Which statement is TRUE concerning the DSM 5?

A) The DSM-5 downplays the influence of culture on abnormal behavior.
B) The DSM-5 includes more disorders than did DSM-IV.
C) The DSM-5 adopts a dimensional rather than a categorical approach to abnormal behavior.
D) The DSM-5 incorporates a developmental approach to abnormal behavior.
Question
Geraldine has completed an IQ test. In reviewing the test results, the psychologist observes that the patient's Verbal Comprehension Index (VCI) is significantly lower than her Perceptual Reasoning Index (PRI). Given this information, which of the following tests has the psychologist administered to Geraldine?

A) Stanford-Binet Intelligence Scale
B) Wechsler Adult Intelligence Scale-IV
C) Luria-Nebraska Intelligence Test
D) Simon Intelligence Test for Adults
Question
Current IQ test scores are standardized using a mean of ______ and a standard deviation of __________.

A) 115; 15
B) 100; 10
C) 115; 10
D) 100;15
Question
The intelligence quotient or IQ was originally determined by

A) dividing a child's chronological age by his mental age.
B) taking the child's mental age and dividing it by his chronological age.
C) using the mental age as a gauge of natural intelligence.
D) comparing a child's score with those obtained by peers.
Question
If a psychologist wanted to test the effectiveness of a behavioral intervention for test anxiety, she would most likely choose what sort of assessment?

A) Projective test
B) Unstructured interview
C) Open-ended-sentence completion test
D) Test for the specific symptoms
Question
In the technique known as behavioral observation, the first step is

A) choosing an observer who can work without bias.
B) defining the behavior so that it can be closely observed and reliably monitored.
C) determining whether the patient can keep reliable records of his or her own behavior.
D) testing possible observers to see if they can be sufficiently attentive in a natural environment.
Question
Select the statement that is TRUE of the DSM classification system.

A) It continues to include important diagnostic information such as assumptions about the causes of each disorder.
B) It undergoes revision based on new research and field studies regarding disorders.
C) The number of diagnostic categories continues to decline as new research data emerges on disorders.
D) The system uses broad categories of underlying conflicts to explain the causes of maladaptive reactions.
Question
The 5ᵗʰ edition of the Stanford-Binet Test is believed to be

A) a valid test for the prediction of academic success in boys but not girls.
B) less valid than the earlier version of the test because of biases in ethnicity.
C) a "culture free" test of intelligence and useful for measuring persons falling in the low range of intellectual functioning.
D) appropriate for identifying people who fall at both the high and low ends of the intelligence continuum.
Question
The Wisconsin Card Sorting Test (WCST) assesses an individual's ability to set shift, or display flexibility, in thinking as the goal of a task changes. As a "frontal lobe test," it is able to discriminate

A) and detect only subcortical lesions.
B) a frontal lesion from a nonfrontal lesion in a patient.
C) persons at risk for a seizure disorder.
D) violent versus nonviolent patients.
Question
A patient comes to a clinician with complaints of depression and anxiety. Given the DSM-5 rule of no symptom appearing in more than one category, what would likely be the diagnostic result?

A) The rule would not affect the diagnosis.
B) No diagnosis would be entered given the contradictory information.
C) Comorbid diagnoses would be recorded.
D) The International Classification of Diseases-10 would be used.
Question
Joe comes to the counseling center with complaints of "overwhelming anxiety" in social situations. After an initial interview, the psychologist asks Joe to complete a homework assignment: identify the nature of the situations in which he is anxious. He is asked to recall what happens just before he becomes anxious and what happens immediately after he becomes anxious. What would the psychologist be trying to find out about Joe's anxiety attacks?

A) The internal, enduring states maintaining the emotional reaction
B) The negative reinforcers present before the anxiety is experienced
C) The classically conditioned extinction response that precedes the behavior
D) The antecedents and consequences of the behavior that are maintaining it
Question
The Wechsler Intelligence Scale for Children (WISC) assesses intelligence in which of the following age ranges?

A) 6-16 years
B) 2 1/2-7 years
C) 7-12 years
D) 7-14 years
Question
About what percentage of all persons receiving a primary diagnosis have symptoms that meet the criteria for a second diagnosis?

A) 30
B) 10
C) 50
D) 25
Question
Modern thinkers regard intelligence as a multifaceted and complex concept. Consequently, many psychologists believe that its measurement

A) should be limited to assessing memory, attention, perception, reasoning, and verbal comprehension in adults only.
B) should not be restricted to testing memory, attention, perception, reasoning, and verbal comprehension.
C) should be done only within the context of a complete psychological assessment.
D) should not focus on performance differences between various groups and cultures.
Question
The Halstead-Reitan Neuropsychological Battery is used by clinicians to evaluate the

A) presence of brain damage.
B) symptoms of a severe personality disorder.
C) client's emotional intelligence level along neuropsychological dimensions.
D) level of brain dysfunction due to substance abuse.
Question
According to your text, the hormone oxytocin may be responsible for our ability to

A) form close relationships.
B) recall emotional events.
C) form sensory memories.
D) discriminate physiological sensations.
Question
Whereas the earliest version of the DSM reflected a _____ perspective on abnormal behavior, the current DSM-5 reflects a _____ perspective on abnormal behavior.

A) biomedical; developmental
B) biomedical; psychodynamic
C) psychodynamic; developmental
D) psychodynamic; cognitive
Question
Rachael is asked to record her cigarette cravings as they occur each day over the course of a week. She writes down how often she feels the urge to smoke, how long the cravings last, and her behavior and thoughts about each episode. Within a behavioral paradigm, this activity recording would be known as

A) behavioral analysis.
B) self-monitoring.
C) functional monitoring.
D) antecedent analysis.
Question
The Brief Psychiatric Rating Scale (BPRS) is a clinician-administered scale that

A) measures a broad range of psychological symptoms.
B) focuses on the patient's perceptions of his or her progress in treatment.
C) uses 21 items to assess psychological functioning in inpatient populations.
D) is used exclusively with psychiatric patients.
Question
In psychophysiological assessment, the psychologist is interested in evaluating brain and nervous system reactions that result from the presentation of some stimulus. For example, during relaxation training, the therapist would expect the patient's EEG to reveal a higher level of ______ waves in the relaxation state, but normal patterns of _________ prior to training.

A) beta; delta
B) delta; alpha
C) alpha; beta
D) theta; delta
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Deck 3: Assessment and Diagnosis
1
Your text presents the case of Kathy Buckley, a comedienne and inspirational speaker, misdiagnosed in childhood as having mental retardation. When accurately diagnosed some time later, what was found to be the actual disorder?

A) Schizophrenic disorder
B) Depressive disorder
C) Hearing loss
D) Blindness
Hearing loss
2
Mary, a 19-year old college sophomore, has been referred to a psychologist by her physician. Mary has a high level of anxiety and complains of intrusive thoughts that interfere with her ability to study for exams. She also reports having severe migraine headaches before exams. Most likely, the psychologist will

A) assume that the migraines are triggered by the stress of Mary's worries about exams and will assess her test-taking skills.
B) disregard his theoretical approach and use behavioral assessments that have been proved effective in anxiety-reduction cases.
C) conduct a brief assessment because of Mary's young age and the simplicity of the case.
D) consider Mary's medical state, age, and symptoms in selecting appropriate assessment tools.
consider Mary's medical state, age, and symptoms in selecting appropriate assessment tools.
3
A screening device is able to indicate a problem when it is present and accurately indicate the absence of a problem when none exists. In psychological terms, this would constitute

A) screening specificity.
B) screening sensitivity.
C) differential diagnosis.
D) sensitivity and specificity.
sensitivity and specificity.
4
The process of assessment first involves an evaluation of what procedures and instruments to administer as well as

A) determining which measures of biological function, cognition, emotion, and behavior to use.
B) obtaining feedback from relatives using structured interviews.
C) determining the number, order, and timing of tests to be administered.
D) considering the patient's potential for completing the tests within a given time frame.
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5
Clinical assessments are important as they lead to a diagnosis. The diagnosis is often needed in order to gain which of the following?

A) medical evaluation
B) clinical evaluation
C) insurance company reimbursement
D) labels for client use
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6
The case of 82 year-old Pauline, presented in your text, highlights

A) the importance of developing treatment plans that include the patient's family.
B) the complex interplay of psychological, biological, and social factors that affect an individual's psychological functioning.
C) the significant impact a physical disorder may have on the older patient's memory functions.
D) the difficulty inherent in selecting appropriate assessment measures for elderly patients.
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7
The theoretical orientation of a person conducting a psychological assessment affects the

A) selection of assessment tools, but not the interpretation of data resulting from testing.
B) range and scope of the assessment.
C) selection of assessment tools, but only for very young children.
D) estimated amount of time the assessment process will take.
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8
A new psychological test is able to detect anxiety in patients; it accurately identifies both the absence and presence of anxiety. This would mean that the test

A) has high false positive rates and high false negative rates.
B) has high false positive rates but low false negative rates.
C) is low in false positive rates and low in false negative rates.
D) is low in false positive rates but high in false negative rates.
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9
The Guilford Test of Marital Discord is administered to a newly married young woman who is being seen in psychotherapy. The results indicate that the woman is very unhappy in her marriage. Knowing that testing literature reports that the test has a high rate of false positives, a good clinician would

A) be cautious of the results, as a high false positive rate means that the test may have inaccurately identified a problem when none existed.
B) be confident in the results, as the patient's score exceeded a cut-off score.
C) want to retest the young woman with the same instrument to reduce the false positive rate, which is most likely due to chance.
D) be cautious because the young woman may not be answering questions honestly to hide her marital problems.
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10
Miguel is a 24-year-old married man who was referred by his physician to a psychologist for assessment. In order for the psychologist to release information to Miguel's doctor,

A) the psychologist would want to ensure that the information is accurate and reviewed by Miguel before it is released.
B) the psychologist would want to clear the release with Miguel's wife for legal reasons.
C) Miguel would have to provide permission for the release of information to his doctor.
D) Miguel would waive his right to confidentiality since his physician made the original referral and the assessment is part of his medical record.
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11
A community screening for depression might identify

A) people at risk for depression if they are not treated.
B) the people in a cohort who might benefit from a particular type of therapy.
C) the number of people likely to recover without any psychological treatment.
D) what a specific cohort's cut-off score should be, considering all risk factors.
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12
In some branches of medicine, diagnosis refers to the identification of a physical illness and may be made on the basis of laboratory tests. In psychology, however, a diagnosis is

A) made on the basis of a single behavior, if significant.
B) made only after consultation with the primary physician.
C) based more on the presence of clusters of symptoms.
D) based on several significant epidemiological factors.
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13
What do the cases described in the text of the 46-year old woman who had hallucinations due to epilepsy and Kathy Buckley, the comedienne and inspirational speaker, have in common?

A) Both were able to succeed in their occupations without having to spend time in psychiatric hospitals.
B) Both were accurately diagnosed in early childhood as having dual diagnoses.
C) Both were misdiagnosed as having organic depressive reactions.
D) Both were misdiagnosed as having psychological disorders.
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14
A major purpose of a diagnosis is to

A) aid communication among researchers and clinicians.
B) help patients understand the root cause of their problems.
C) assist the referral source in making a differential diagnosis.
D) communicate the psychologist's theoretical orientation to treatment.
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15
In the clinical assessment process, referral questions aid in the determination of

A) the goals of assessment and the psychological tests or measurements to be administered.
B) an appropriate placement for the patient upon discharge.
C) how long the therapeutic process will take.
D) the best way to psychologically triage the individual for further testing.
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16
Morgan obtains a score on a screening device for depression, which indicates the presence of significant depression. Morgan's psychologist is most likely to do what at this point in the assessment process?

A) Refer Morgan for in-patient hospitalization
B) Recommend further evaluation
C) Repeat the testing to determine reliability
D) Begin therapy given the immediate risk
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17
During the course of a physical exam, a physician suspects his patient may be depressed. In order to explore this diagnostic possibility, the physician uses a "brief screening device" for depression. The doctor probably

A) used the AUDIT to determine their level of depression.
B) asked the patient two questions about feelings of hopelessness and feelings related to the enjoyment of activities from a two-item screening instrument.
C) used the General Health Questionnaire (GHQ) to assess the degree to which the patient's depression was affecting general health.
D) asked the patient to rate his degree of depression using the Checklist of Mood States (CMS).
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18
During the college's health fair, the Counseling Center offers confidential testing to evaluate a student's risk for substance abuse. According to your text, this assessment process is typically known as a

A) prospective evaluation.
B) screening.
C) differential risk measurement.
D) risk evaluation.
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19
In making a differential diagnosis, the psychologist performing the assessment gathers data from multiple sources and completes a process that is more extensive than a screening in order to determine the

A) likelihood that the patient has one disorder as opposed to another.
B) likelihood that a psychological disorder is present.
C) presence or absence of an organic basis for a specific disorder.
D) presence or absence of psychosocial factors contributing to multiple disorders.
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20
The Center for Epidemiologic Studies-Depression Scale (CES-D) has usefulness in assessing

A) children of depressed parents who are at high risk for depression.
B) prevalence rates of depression within a specific group.
C) community members who are depression-resistant.
D) sources of stress leading to depression in community members.
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21
From a practical standpoint, accurate diagnoses direct the psychologist toward

A) appropriate treatment modalities.
B) understanding the physiological roots of all disorders.
C) a deeper understanding of stressors precipitating the disorder.
D) the best way to avoid malpractice charges.
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22
In using the same test more than once during the course of therapy, the psychologist is most likely trying to gauge the course of symptoms over time or

A) the acceptability of the treatment recommendations.
B) the effect of treatment.
C) the validity of the diagnosis.
D) the baseline frequency of symptoms.
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23
When considering a "normative" approach to interpreting a patient's score on an assessment instrument, the psychologist is interested in comparing the patient's score with

A) scores of all persons who have taken the test.
B) earlier scores for the same patient.
C) scores of a comparable subgroup.
D) scores of persons not in treatment.
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24
On psychological tests, the standard deviation gives an indication of

A) the distance between an obtained score and the average score of the normative group.
B) the distance between the scores of a referent group and the scores of a normative group.
C) the number of points required for a person's score to fall within the "normal" range.
D) the number of standard points required for a person's score to demonstrate improvement.
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25
Data from more than 136 studies support the conclusion that _______ were more accurate than __________.

A) clinical judgments; statistical predictions
B) statistical predictions; clinical judgments
C) clinical judgments; psychometric scores
D) psychometric scores; statistical predictions
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26
A psychologist in the counseling center interviews a student in crisis who is having suicidal thoughts. As part of the assessment process, the psychologist administers a test designed to evaluate potential suicide risk. Which type of validity is the psychologist relying on in this scenario?

A) Statistical validity
B) Face validity
C) Predictive validity
D) Construct validity
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27
The Reliable Change Index (RCI) is a measure of

A) the change in a patient's condition from the beginning to the end of therapy.
B) the predicted change in a patient's behavior compared with that of similar patients.
C) the degree of change in a patient's condition estimated to be attributable to non-therapeutic factors
D) the degree of change a therapist might expect based on a particular form of treatment.
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28
Which of the following is a psychometric properties of an assessment instrument?

A) significance
B) sensitivity
C) standardization
D) specificity
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29
Which of the following best captures the meaning of reliability?

A) A test consistently produces the same score for the same person.
B) Test scores vary over time but stay within 2 standard deviations of the mean.
C) Test scores of different people are highly correlated.
D) Interrater agreement is low.
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30
A psychologist is conducting an assessment of a child who appears to have high distractibility in a classroom setting. The psychologist is interested in what happens just before the child is distracted from a task, how the child behaves during the distracted period, and what happens immediately after the task disruption. In assessing the relationship between situational influences and behavior, the psychologist is using a(n) _____ analysis.

A) topical
B) functional
C) structural
D) internal
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31
Marjorie has been in treatment for panic disorder for six months. The psychologist has asked her to retake a variety of assessment measures that she originally had taken at the beginning of treatment. In order to gain the best measure of therapeutic success, her psychologist would want to include assessment measures

A) of limited scope to restrict sensitivity.
B) representing a range of outcomes.
C) that evaluate symptom severity only.
D) that serve as screening tools.
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32
A construct validity score represents

A) whether two independent practitioners agree on a diagnosis.
B) the degree to which a test accurately assesses a specific concept and not other related concepts.
C) a test's ability to discriminate a patient who is trying to fake symptoms.
D) the percent of test-takers who show reliable scores on a test measuring an related constructs.
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33
William was treated for anxiety related to test-taking. At the end of his therapy, he reported fewer anxiety symptoms and a better ability to manage his fear of failure. Most probably, William's progress will be viewed as _______ at termination.

A) clinically significant
B) a partial failure
C) treatment resistant
D) clinically insignificant
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34
Dr. Winston is interested in determining if his patient's score on a psychometric instrument measuring resilience is comparable to the scores of other persons in his age group. Given this interest, Dr. Winston would compare his patient's score to scores for a _______ group.

A) related
B) comparative
C) normative
D) relative
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35
Sean is participating in a clinical assessment. The psychologist is asking him questions about the severity of his symptoms and how they have persisted or changed over time. Sean is also asked about behaviors related to personality strengths and weaknesses. The psychologist might also consider including both a personality assessment and

A) neuropsychological tests.
B) physiological assessment tools.
C) neurobehavioral tests.
D) functional-analytic tests.
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36
Dr. A and Dr. B are studying the effects of war on posttraumatic stress disorder. They both administer the same interview to the same soldiers returning from war. Which of the following psychometric test properties is being addressed in this example?

A) Test-retest reliability
B) Interrater agreement
C) Referent reliability
D) Normative agreement
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37
Clinical assessments made for the purpose of diagnosis typically include an evaluation of the problem behavior's symptoms and severity, patterns of symptoms over time, and

A) a clinical judgment as to the need for a second opinion.
B) a mental status exam by a collaborating psychiatrist.
C) an evaluation of the patient's strengths and weaknesses.
D) an estimation of the length of treatment time.
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38
Under what conditions might a clinician find a clinical judgment, rather than statistical data, useful?

A) When there are no relevant statistical data upon which to rely.
B) When the clinician's intuition leads her away from the statistical data.
C) When the training of the therapist lends itself more readily to clinical judgment than to empirical studies.
D) When the statistical data point to the efficacy of a treatment in which the clinician is not trained.
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39
In the self-referent approach to interpreting a score, a person's score today

A) predicts the person's score without treatment.
B) predicts the person's score following treatment.
C) is compared with an earlier score on a different test.
D) is compared with an earlier score on the same test.
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40
Clinical assessments for outcome evaluation may be repeated over time during treatment in order to

A) determine the patient's changing attitudes toward the therapist.
B) be certain the problem behavior has been identified.
C) recheck the accuracy of the diagnosis.
D) evaluate a patient's progress.
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41
The content and style of questions used in a clinical interview are guided by the

A) presenting problem and the nature of the patient's difficulty.
B) presenting problem.
C) clinician's theoretical orientation.
D) clinician's theoretical orientation and presenting problem.
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42
Although Dr. Johnson has been trained in Exner's comprehensive system for scoring and interpreting the Rorschach Inkblot Test, he does not use the test as part of his clinical test battery. Having reviewed the literature, Dr. Johnson found that

A) the test has questionable test reliability, its normative data are outdated, and it has limited validity.
B) the test has significant test reliability and validity but the normative data are outdated.
C) the projective nature of the test makes it useful for screening severe pathology, but it results in false negatives when used with normal individuals.
D) the test has appropriate validity properties, but its projective nature limits its use for scientist-practitioners.
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43
Which of the following is an example of an open-ended interview question?

A) "Tell me more about it."
B) "Do you have periods of feeling blue or hopeless?"
C) "How frequently do you miss class?"
D) "Is your family supportive of your decision to seek treatment?"
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44
Tests such as the Dementia Rating Scale (DRS)

A) are designed to evaluate the degree to which depression impacts memory.
B) require teachers to provide observational data for students in grade school.
C) are intended to assess symptoms unique to a specific developmental segment of patients.
D) may not be appropriate for use with older persons.
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45
Neuropsychological tests are inappropriate for assessing

A) motor skills.
B) learning abilities.
C) language.
D) temperament.
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46
Why would scientist-practitioners choose to use a projective test with inadequate normative data?

A) They do not subscribe to such rigid psychometric requirements as empirically oriented psychologists.
B) They may find them useful to "get the patient talking" in the initial stages of therapy.
C) They find that patients often relate better to unstructured tests than to structured tests.
D) They take less time to score and less training to administer than self-report measures of psychopathology.
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47
Desmond is being seen by a psychologist for assessment. As part of the process, he was given a series of pictures and asked to make up a story about each image. The examiner then interpreted the stories according to his theoretical orientation. What projective test was given to Desmond?

A) Rorschach Picture Test
B) Thematic Apperception Test
C) Wechsler Adult Intelligence Scale Picture Completion Subtest
D) Projective Open-Ended Story Test
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48
Jose is asked to complete an assessment measure that focuses on depression. The instructions given on the instrument state, "Rate each of the following items using the following scale: Always, Frequently, Sometimes, or Never." Which of the following types of assessment instruments is Jose being asked to complete?

A) Subjective response measure
B) Self-report measure
C) Clinician-rated measure
D) Objective response measure
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49
Of the many factors influencing the choice of assessment tools, one of the most important factors affecting a clinician's choice is the

A) length of time it takes to administer an assessment tool.
B) difficulty of scoring a test.
C) availability of computer-scoring services for validity.
D) person's age and developmental status.
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50
The Millon Clinical Multiaxial Inventory (MCMI), a test designed to measure personality styles, pathological syndromes, and symptom disorders, has adequate reliability and validity but it

A) takes longer to complete than the MMPI.
B) lacks fit with the DSM system and categories.
C) relies heavily on open-ended questions.
D) assesses only severe cases of specific disorders.
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51
Empirical keying as a test construction approach utilizes statistical analyses of items and patterns of scores that

A) discriminate between a behavior and psychoanalytic perspective.
B) discriminate among groups along various clinical dimensions.
C) discriminate between reliable diagnostic categories and unreliable diagnostic categories.
D) predict successful treatment outcomes for hospitalized patients.
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52
William is concerned about appearing "psychologically healthy" when taking a test. Having sensed this patient's veiled intent during part of the clinical interview, the psychologist decides to use a personality test that might validate his clinical hunch. Which of the following test is the clinician likely to choose?

A) Global Assessment of Functioning Scale
B) Millon Clinical Multiaxial Inventory
C) Minnesota Multiphasic Personality Inventory
D) Wisconsin Card Sorting Test
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53
Selecting the best set of instruments to address the clinician's questions depends on the goals of assessment, the properties of the instruments, and the

A) referral source's theoretical orientation.
B) persons available to provide additional information through interviews.
C) amount of time available for the assessment.
D) nature of the patient's difficulties.
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54
Both structured and unstructured clinical interviews are used for screening, diagnosis, treatment planning, and

A) reliability monitoring.
B) outcome evaluation.
C) establishing construct validity.
D) field testing.
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55
Which of the following statements is TRUE of both the Global Assessment of Functioning Scale and the General Health Questionnaire?

A) Both measurements rely on the clinician's evaluation of functioning.
B) Both measurements are useful in assessing change in patients' conditions.
C) Both measurements are only useful for inpatient populations.
D) Both measurements lack reliability but provide valid measures of functioning.
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56
Mr. Smith is a 67-year-old insurance salesman who is being admitted to an inpatient facility for substance abuse treatment. Using the Global Assessment of Functioning Scale, the clinician evaluates Mr. Smith to be functioning at a level of 45. What is the clinician communicating in assigning this score?

A) Mr. Smith's symptoms are transient and expectable reactions to a psychosocial stressor.
B) Mr. Smith's functioning is good in all areas, especially given his current condition.
C) Mr. Smith may have serious symptoms or serious impairment in areas of overall functioning.
D) Mr. Smith's case does not provide enough information to evaluate his general level of functioning.
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57
While a major benefit of the unstructured interview lies in its flexibility, a major drawback exists in the

A) amount of time required to complete it.
B) potential unreliability of conclusions drawn from it.
C) resistance of the patient to answer all questions contained in it.
D) inability of the client to articulate symptoms.
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58
Researchers from the Center for Phobic Disorders have received a research grant to investigate the efficacy of a cognitive-behavioral approach to treatment. In selecting an interview instrument, the investigators will give important consideration to whether

A) two different interviewers would reach the same conclusion about the same person.
B) the same patient would respond in the same way to both an unstructured and structured interview.
C) the interview questions are gender-sensitive.
D) training is required on both forms A and B of the unstructured interview.
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59
The Leiter International Performance Scale-Revised was developed in response to

A) the cultural bias inherent in language.
B) the cultural biases found in geometric shapes.
C) the lack of "culture fairness" in non-verbal intelligence tests.
D) the cultural bias existing in clinicians' theoretical orientation.
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60
The construction of the 567-item Minnesota Multiphasic Personality Inventory (MMPI) took a novel approach to test construction known as

A) empirical keying.
B) discrimination keying.
C) diagnostic keying.
D) predictive validity keying.
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61
Which statement is TRUE concerning the DSM 5?

A) The DSM-5 downplays the influence of culture on abnormal behavior.
B) The DSM-5 includes more disorders than did DSM-IV.
C) The DSM-5 adopts a dimensional rather than a categorical approach to abnormal behavior.
D) The DSM-5 incorporates a developmental approach to abnormal behavior.
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62
Geraldine has completed an IQ test. In reviewing the test results, the psychologist observes that the patient's Verbal Comprehension Index (VCI) is significantly lower than her Perceptual Reasoning Index (PRI). Given this information, which of the following tests has the psychologist administered to Geraldine?

A) Stanford-Binet Intelligence Scale
B) Wechsler Adult Intelligence Scale-IV
C) Luria-Nebraska Intelligence Test
D) Simon Intelligence Test for Adults
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63
Current IQ test scores are standardized using a mean of ______ and a standard deviation of __________.

A) 115; 15
B) 100; 10
C) 115; 10
D) 100;15
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64
The intelligence quotient or IQ was originally determined by

A) dividing a child's chronological age by his mental age.
B) taking the child's mental age and dividing it by his chronological age.
C) using the mental age as a gauge of natural intelligence.
D) comparing a child's score with those obtained by peers.
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65
If a psychologist wanted to test the effectiveness of a behavioral intervention for test anxiety, she would most likely choose what sort of assessment?

A) Projective test
B) Unstructured interview
C) Open-ended-sentence completion test
D) Test for the specific symptoms
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66
In the technique known as behavioral observation, the first step is

A) choosing an observer who can work without bias.
B) defining the behavior so that it can be closely observed and reliably monitored.
C) determining whether the patient can keep reliable records of his or her own behavior.
D) testing possible observers to see if they can be sufficiently attentive in a natural environment.
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67
Select the statement that is TRUE of the DSM classification system.

A) It continues to include important diagnostic information such as assumptions about the causes of each disorder.
B) It undergoes revision based on new research and field studies regarding disorders.
C) The number of diagnostic categories continues to decline as new research data emerges on disorders.
D) The system uses broad categories of underlying conflicts to explain the causes of maladaptive reactions.
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68
The 5ᵗʰ edition of the Stanford-Binet Test is believed to be

A) a valid test for the prediction of academic success in boys but not girls.
B) less valid than the earlier version of the test because of biases in ethnicity.
C) a "culture free" test of intelligence and useful for measuring persons falling in the low range of intellectual functioning.
D) appropriate for identifying people who fall at both the high and low ends of the intelligence continuum.
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69
The Wisconsin Card Sorting Test (WCST) assesses an individual's ability to set shift, or display flexibility, in thinking as the goal of a task changes. As a "frontal lobe test," it is able to discriminate

A) and detect only subcortical lesions.
B) a frontal lesion from a nonfrontal lesion in a patient.
C) persons at risk for a seizure disorder.
D) violent versus nonviolent patients.
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70
A patient comes to a clinician with complaints of depression and anxiety. Given the DSM-5 rule of no symptom appearing in more than one category, what would likely be the diagnostic result?

A) The rule would not affect the diagnosis.
B) No diagnosis would be entered given the contradictory information.
C) Comorbid diagnoses would be recorded.
D) The International Classification of Diseases-10 would be used.
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71
Joe comes to the counseling center with complaints of "overwhelming anxiety" in social situations. After an initial interview, the psychologist asks Joe to complete a homework assignment: identify the nature of the situations in which he is anxious. He is asked to recall what happens just before he becomes anxious and what happens immediately after he becomes anxious. What would the psychologist be trying to find out about Joe's anxiety attacks?

A) The internal, enduring states maintaining the emotional reaction
B) The negative reinforcers present before the anxiety is experienced
C) The classically conditioned extinction response that precedes the behavior
D) The antecedents and consequences of the behavior that are maintaining it
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72
The Wechsler Intelligence Scale for Children (WISC) assesses intelligence in which of the following age ranges?

A) 6-16 years
B) 2 1/2-7 years
C) 7-12 years
D) 7-14 years
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73
About what percentage of all persons receiving a primary diagnosis have symptoms that meet the criteria for a second diagnosis?

A) 30
B) 10
C) 50
D) 25
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74
Modern thinkers regard intelligence as a multifaceted and complex concept. Consequently, many psychologists believe that its measurement

A) should be limited to assessing memory, attention, perception, reasoning, and verbal comprehension in adults only.
B) should not be restricted to testing memory, attention, perception, reasoning, and verbal comprehension.
C) should be done only within the context of a complete psychological assessment.
D) should not focus on performance differences between various groups and cultures.
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75
The Halstead-Reitan Neuropsychological Battery is used by clinicians to evaluate the

A) presence of brain damage.
B) symptoms of a severe personality disorder.
C) client's emotional intelligence level along neuropsychological dimensions.
D) level of brain dysfunction due to substance abuse.
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76
According to your text, the hormone oxytocin may be responsible for our ability to

A) form close relationships.
B) recall emotional events.
C) form sensory memories.
D) discriminate physiological sensations.
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77
Whereas the earliest version of the DSM reflected a _____ perspective on abnormal behavior, the current DSM-5 reflects a _____ perspective on abnormal behavior.

A) biomedical; developmental
B) biomedical; psychodynamic
C) psychodynamic; developmental
D) psychodynamic; cognitive
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78
Rachael is asked to record her cigarette cravings as they occur each day over the course of a week. She writes down how often she feels the urge to smoke, how long the cravings last, and her behavior and thoughts about each episode. Within a behavioral paradigm, this activity recording would be known as

A) behavioral analysis.
B) self-monitoring.
C) functional monitoring.
D) antecedent analysis.
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79
The Brief Psychiatric Rating Scale (BPRS) is a clinician-administered scale that

A) measures a broad range of psychological symptoms.
B) focuses on the patient's perceptions of his or her progress in treatment.
C) uses 21 items to assess psychological functioning in inpatient populations.
D) is used exclusively with psychiatric patients.
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80
In psychophysiological assessment, the psychologist is interested in evaluating brain and nervous system reactions that result from the presentation of some stimulus. For example, during relaxation training, the therapist would expect the patient's EEG to reveal a higher level of ______ waves in the relaxation state, but normal patterns of _________ prior to training.

A) beta; delta
B) delta; alpha
C) alpha; beta
D) theta; delta
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Unlock Deck
Unlock for access to all 133 flashcards in this deck.