Deck 7: Anxiety Disorders With Likely Onset in Childhood

Question 1

Sharon's 10‐year‐old daughter is driving her crazy. Ever since they had a minor accident in the car, Cindy is afraid of getting into the car. Unfortunately, Cindy's school is two miles from home and her fears have generalized to anything that looks like a vehicle, including the school bus. Cindy has not been to school for the past three days because there is no way to get her there. Sharon knows that you are taking a course in child psychopathology and asks you how you can help her get Cindy to school.
a) What is the best treatment approach for helping Cindy cope with her fear of riding in vehicles?
b) Knowing what you know about fears and phobias, develop a plan that would help to get Cindy to school in a way that is the most humane. Outline the necessary parts and stages that this plan would include.
c) If you had to get Cindy to school tomorrow for state‐wide testing, what is the quickest way to get Cindy to school, and what is this technique called?

Answer 1

a)Exposure Treatments/Systematic Desensitization
b) Plan should include
1) establishment of fear hierarchy (5 to 7 steps)
2) training in relaxation techniques
3) pairing of relaxation with hierarchy steps
c) Flooding. Force her into the car and get her to the school in enough time for her to settle down for the test.

Question 2

Name four of the most common types of specific phobias, and give an example of each.

Answer 2

Animal Type (animals, insects)
Natural environment (thunder, lightning
Blood‐injection‐injury (needles, inoculations)
Situational type (flying, elevators, small spaces)
Other (clowns, choking, falling)

Question 3

Researchers have identified two potential pathways to developing an anxiety disorder or problem. Identify the two pathways, and isolate the characteristics and predisposing factors associated with each pathway.

Answer 3

Cumulative Risk Pathway & Precipitating Event Pathway
* Cumulative Risk: Transactional approach
Child Characteristics (e.g., inhibited temperament, genetic traits) Environmental Characteristics (e.g., instability, parenting style) Predisposing Factors: Heredity & Genetic
* Precipitating Event: Behavioral Approach
Environmental Characteristics (e.g., traumatic events, repeated exposure to negative events Predisposing Factors: Parenting style or response, number and intensity of events

Question 4

Penny is generally an anxious person. But on this particular day, she was feeling fine and was actually in a very relaxed mode. It was a beautiful day and she decided to walk to school rather than take the school bus. On her way, she happened to see a cat by the side of the road. The cat seemed lost and in distress. Penny put her school bag down on the ground and went over to the cat, attempting to pick the animal up to console it. However, the cat was so distressed that it scratched Penny in the face and nearly hit her eye. Penny dropped the cat and ran home. The scratch was painful and disfiguring. In addition, because her parents and neighbors were not able to locate the cat or its owner, Penny had to undergo very painful procedures to detect and protect her from potential rabies. Ever since that day, Penny has been terrified of cats. Using a classical conditioning paradigm, explain how Penny became terrified of cats. Be sure to include the following terms in your answer: neutral stimulus (NS), neutral response (NR), unconditioned
stimulus (UCS) unconditioned response, (UCR), conditioned stimulus (CS), conditioned response
(CR).

Question 5

What are the diagnostic criteria for Separation Anxiety Disorder, and how is early onset distinguished from late onset?

Question 6

Anxiety disorders share features of chronic worry and often involve all of the following, except

A) withdrawal, avoidance, or escape.
B) physiological arousal.
C) melancholia.
D) negative self?appraisals.

Question 7

The category of Anxiety Disorders of Childhood and Adolescence originally appeared in which of the following revisions of the DSM?

A) DSM?II (1968)
B) DSM?III (1980)
C) DSM?III?R (1987)
D) DSM?IV (1994)

Question 8

Which of the following was not one of the original three Anxiety Disorders of Childhood and Adolescence?

A) overanxious disorder
B) simple phobia
C) separation anxiety disorder
D) avoidant disorder

Question 9

Currently, which of the following disorders appears under Disorders First Diagnosed in Infancy and Childhood in the DSM?IV?TR?

A) specific phobia
B) obsessive compulsive disorder
C) separation anxiety disorder
D) all of the above

Question 10

Which of the following disorders would be most likely to occur in a very young child?

A) melancholia
B) panic disorder
C) specific phobia
D) obsessive compulsive disorder

Question 11

According to Vasey and Dadds (2001), the cumulative risk pathway is used to explain how anxiety develops

A) as a learned response to an event.
B) from a number of predisposing factors and exposure to repeated situations that cause anxiety.
C) as repeated exposure to an event.
D) All of the above.

Question 12

All of the following factors can be responsible for maintaining an anxious response, except

A) avoidance of the anxiety?provoking situation.
B) parental responses of overprotection.
C) parental responses of over control.
D) All of the above can be responsible for maintenance of anxiety.

Question 13

The term clinical utility was used by Silverman and Ollendick (2005) to refer to

A) how assessment instruments will serve to inform treatment.
B) how outcomes can inform assessment.
C) the validity of assessment instruments.
D) the reliability of assessment instruments.

Question 14

Which is a common childhood fear associated with Early School Age?

A) fear of strangers
B) fear of health/authority
C) fear of monsters and the dark
D) fear of thunder and lightning

Question 15

Which of the following was not one of the recommended instruments for the assessment of anxiety disorders in children and adolescents (Silverman & Saavedra, 2004)?

A) Revised Children's Manifest Anxiety Scale (RCMAS)
B) The Weschler Anxiety Scale for Children and Youth (WAS)
C) Stait?Trait Anxiety Inventory for children (STAIC)
D) The Fear Survey Schedule for Children?Revised (FSSC?R)

Question 16

Etiology for specific phobias is best described by

A) heredity.
B) child characteristics (genetics and temperament).
C) environmental characteristics (family dynamics, experiences).
D) both b and c.

Question 17

Which of the following is not one of the most common phobias?

A) animals and insects
B) heights and storms
C) water and lakes
D) elevators and bridges

Question 18

I am walking in the park and a snake falls out of a tree and lands on my head. I am panic?stricken because I am very frightened of snakes. The next day, I am afraid to go to the park. In this scenario, the park has become

A) unconditioned stimulus.
B) conditioned stimulus.
C) unconditioned response.
D) conditioned response.

Question 19

After the event which has happened above, I am now also afraid to go for a walk into the forest or my own treed backyard. The explanation for why I am now afraid of the forest and my treed backyard is one of

A) stimulus discrimination.
B) stimulus regeneration.
C) stimulus generalization.
D) stimulus proximity.

Question 20

I am sitting on an airplane and the passenger beside me begins to shake and tremble; saying "Oh, no…Oh…No." She then takes out her prayer beads and starts reciting a prayer over and over again. All of a sudden, I am shaking and feeling very uncomfortable, worried that the plane might crash. The best concept that can explain my suddenly developed fear is one of

A) catastrophizing.
B) claustrophobia.
C) contagion effect.
D) consequent conditioning.

Question 21

Which of the following is false regarding specific phobias?

A) Approximately 20% of the population experiences specific phobias.
B) Females are twice as likely to experience phobias than males.
C) Females fear animals most.
D) Males fear heights most.

Question 22

According to Ollendick & King (1998), the best treatment for phobic disorders in children involves

A) participant modeling.
B) anti?anxiety medications.
C) reinforced practice.
D) both a and c.

Question 23

A researcher asks participants to view pictures of houses, faces, animals, and snakes. One group is presented with houses and faces and a second group is presented with pictures of animals and snakes. Each person is given a mild shock when the target pictures are shown from an array of photographs. One week later, individuals continue to respond with anxiety only to the pictures of snakes and animals. The researcher concludes that he has provided support for the theory of

A) reflex conditioning.
B) preparedness.
C) involuntary reflexes.
D) contagion effect.

Question 24

Sally's mother tells her that if she does her homework, she will receive an increase in her allowance. This is an example of

A) positive reinforcement.
B) negative punishment.
C) positive punishment.
D) negative reinforcement.

Question 25

You have a significant fear of dogs. I ask you to list your fears of dogs from the least to most fearful event you can imagine. This is an example of

A) fear scaffolding.
B) fear hierarchy.
C) fear approximation.
D) fear chaining.

Question 26

Sally is afraid of clowns. One time she saw a clown and had a panic attack. As a result, Sally will not go to the circus. She has turned down invitations from friends, classmates, and her family . Sally's refusals to visit the circus are being strengthened because avoiding the circus reduces the risk of being anxious. This is an example of

A) positive reinforcement.
B) negative punishment.
C) positive punishment.
D) negative reinforcement.

Question 27

Susy is seven years old and is afraid to leave the house. She fears that something dreadful will happen to her mother when she is away. She has refused to go to school and has nightmares on most nights, so she is afraid to sleep alone. Susy most likely suffers from

A) panic disorder with agoraphobia.
B) social phobia.
C) generalized anxiety disorder.
D) separation anxiety disorder.

Question 28

Which of the following is true regarding school refusal?

A) 75% of those who refuse to attend school have Separation Anxiety Disorder (SAD).
B) 75% of those with SAD will have school refusal.
C) 33% of those who refuse to attend school have SAD.
D) 33% of those with SAD will have school refusal.

Question 29

Carey had SAD as a child. When she gets older, say in her teens, what disorder would you predict that she would be most vulnerable to?

A) social phobia
B) panic attacks and agoraphobia
C) generalized anxiety disorder
D) obsessive compulsive disorder

Question 30

All of the following are true about the Coping Cat Program, except

A) it serves children 7?16 years of age.
B) it targets SAD, GAD, and Social Phobia.
C) it uses the acronym SCARED to outline key points and stages in the program.
D) it involves 16?18 sessions.

Question 31

Generalized anxiety disorder (GAD) is often referred to as

A) avoidant anxiety.
B) latent anxiety.
C) manifest anxiety.
D) free floating anxiety.

Question 32

In addition to "excessive worry," a diagnosis of GAD in children requires

A) one somatic symptom.
B) 3 somatic symptoms.
C) 4 somatic symptoms.
D) 2 somatic symptoms.

Question 33

Studies report that initial onset of GAD is most likely between which ages?

A) 2?5 years
B) 9?14 years
C) 8?10 years
D) 13?16 years

Question 34

Younger and older age of onset of GAD has been associated with which comorbidity?

A) Younger onset is associated with SAD and ADHD.
B) Older onset is associated with ADHD and Conduct Disorder.
C) Older onset is associated with SAD and ADHD.
D) Younger onset is associated with specific phobias.

Question 35

Although different models propose different etiology for GAD, genetics are thought to account for up to ____ of etiology.

A) 15? 20%
B) 30? 40%
C) 50? 60%
D) 10? 15%

Question 36

The neurotransmitter most likely implicated in GAD is

A) serotonin.
B) norepinephrine.
C) GABA.
D) dopamine.

Question 37

Juan's therapist believes that his GAD developed as an outcome of his interpretations of his world as a threatening place. Juan's therapist likely supports which of the following psychological models?

A) behavioral
B) cognitive
C) psychodynamic
D) none of the above

Question 38

In their study of anxious children, anxious parents, and cognitive behavioral therapy (CBT), Cobban, Dadds, & Spence (1998) found that

A) anxious children benefited from CBT alone.
B) the children did not benefit from CBT, unless parents were also enrolled in CBT.
C) the children did not benefit from CBT unless their parents were also enrolled in CBT and Parent Anxiety Management (PAM).
D) none of the above are true.

Question 39

In their review of evidence?based treatments for childhood disorders, Ollendick and King (2004) found

A) significantly more treatment programs for child anxiety than any other childhood disorder.
B) no well?established treatment programs identified for anxiety disorders, other than specific phobia.
C) no well?established treatment programs identified for specific phobia.
D) well?established treatment programs for GAD, SAD and Social Phobia.

Question 40

The Coping Cat Program has been revealed to be an effective way to reduce anxiety in children in

A) randomized clinical trials of individual therapy.
B) randomized clinical trials of group therapy.
C) family?focused formats.
D) all of the above.