Deck 12: Trauma-Related Disorders and Child Maltreatment

Question 1

Zeke sometimes finds his thoughts wandering to the image of a gun pointing at him,the trauma he'd experienced 6 months ago.This is an example of ______.

A) an intrusive symptom
B) negative alterations in feeling
C) negative alterations in thoughts
D) physiological reactivity

Answer 1

an intrusive symptom

Question 2

A child has been trapped in a well for two days.Once firefighters arrive on the scene,they tell the child,"We are working to help you.We are going to send down some food and drinks and a blanket to keep you warm while we work on getting you out.Your mom and dad are up here with us and they are ok." This approach is consistent with which of the following?

A) trauma-focused CBT
B) eye movement desensitization and reprocessing
C) psychological first aid
D) needs-based physiological approach

Answer 2

psychological first aid

Question 3

Changing the negative thoughts and beliefs of sexually abused youths can best be accomplished by which of the following?

A) cognitive restructuring
B) classical conditioning
C) social modeling
D) positive reinforcement

Answer 3

cognitive restructuring

Question 4

Carlos was recently in a car crash in which his friend was killed.Sometimes,Carlos reports feeling that he is walking through a dream instead of the real world.This is an example of which of the following?

A) an intrusive symptom
B) a dissociative symptom
C) a negative alteration in cognition
D) an alteration in physical arousal

Question 5

The course of PTSD ______.

A) is usually more persistent in children with the condition than for adults with the condition
B) is usually more persistent in adults with the condition than for children with the condition
C) shows that treatment is essential for individuals of all ages to recover from PTSD
D) shows that treatment for PTSD affects the duration of the disturbance but not the likelihood of recovery

Question 6

Which of the following is a component of the HPA axis?

A) hippocampus
B) amygdala
C) pituitary
D) angular gyrus

Question 7

Direct exposure to trauma is ______.

A) necessary for a diagnosis of PTSD
B) necessary for a diagnosis of PTSD in those under age 6
C) associated with a greater risk of PTSD than indirect exposure to trauma
D) associated with lower rates of recovery from PTSD than is indirect exposure to trauma

Question 8

A negative alteration in cognition or mood symptom is required for which of the following?

A) for any diagnosis of PTSD
B) for any diagnosis of PTSD with dissociation
C) for a diagnosis of PTSD in those over the age of 6
D) for a diagnosis of severe PTSD

Question 9

Which of the following is the primary product of the HPA axis?

A) norepinephrine
B) testosterone
C) white blood cells
D) cortisol

Question 10

Which of the following is true about EMDR as a treatment for children?

A) It has never been experimentally evaluated.
B) It involves dreaming about traumatic events while in Rapid Eye Movement (REM) sleep.
C) It has been shown to be more effective than placebo in adults, but the mechanism by which it works is unknown.
D) It has been shown to be effective in adults but harmful in children.

Question 11

Which of the following is NOT among the reasons PTSD merits treatment?

A) Many youths who no longer meet full diagnostic criteria for PTSD still show subthreshold symptoms.
B) Individuals who no longer meet full diagnostic criteria for PTSD may spread it through their social networks; thus treatment for an individual with the potential to develop PTSD may provide additional benefit to those around him or her.
C) Early treatment might prevent PTSD or facilitate recovery if it's already developed.
D) Depression and suicidal ideation are sometimes comorbid with PTSD.

Question 12

Which of the following is the primary goal of supportive therapy for children who have experienced physical abuse or neglect?

A) to help children foster a basic sense of trust in their caregivers
B) to help children cope with feelings and memories associated with maltreatment and improve their sense of self and relationships with others
C) to help improve the quality of care that parents give to their children
D) to identify and correct cognitive distortions in the children's view of themselves and their caregivers

Question 13

A child whose aunts and uncles in a faraway city had had their home torn apart by a hurricane said,"I'm afraid that a hurricane will come and ruin our house too.Did you see the news with all the cats and dogs in the flood afterward? I don't want my dog to end up like that !" This is an example of which type of cognitive appraisal?

A) personalization
B) distancing
C) problem-focused
D) escape-avoidance

Question 14

Shaken baby syndrome is which of the following?

A) a severe form of physical abuse
B) a typical reaction to reactive attachment disorder
C) a typical cause of reactive attachment disorder
D) a mild type of injury that can result from repeated falls in infancy

Question 15

Cognitive restructuring for adolescents who have experienced sexual abuse is based on the finding that many of these youths report negative thoughts about which of the following?

A) themselves, others, and the world
B) the past, the present, and the future
C) themselves, their parents, and their siblings
D) their peers, their teachers, and their academic future

Question 16

The effectiveness of Psychological First Aid has ______.

A) been demonstrated by multiple randomized controlled studies of the entire treatment package
B) been assumed from enhanced coping responses fostered by several of its components, which themselves have been researched
C) not ever been examined empirically
D) only been examined empirically in adults

Question 17

Trauma occurs in about ______ of youths and about ______ of them will develop symptoms of PTSD.

A) 10%; one-third
B) 30%; one-third
C) 30%; nearly all
D) 10%; nearly all

Question 18

Research on the risks for PTSD has indicated which of the following?

A) Children without any siblings are at highest risk.
B) Children whose parents have divorced are at highest risk.
C) Children with elevated anxiety/depression before being introduced to trauma are at highest risk.
D) Children with developmental delays are at highest risk.

Question 19

Molly,a 12-year-old girl of Irish descent living in Ohio,learned that a group of girls from Somalia had been kidnapped by the extremist group Boko Haram.She later watched multiple news stories about this and read about what had happened to some of the girls who had escaped and told their stories.Can this be considered a traumatic event for Molly?

A) Yes.
B) No, because the individuals are in another country.
C) No, because she did not know the individuals involved personally.
D) No, because she did not personally witness the kidnapping.

Question 20

Which of the following individuals is statistically least likely to experience PTSD?

A) a child from a war-torn country
B) a child who has experienced years of physical abuse
C) a child who witnessed her mother beat her father at least weekly for years
D) a child who was caught in a building fire

Question 21

Which of the following is NOT a standard component of a safety plan?

A) learning to identify warning signs of abuse
B) complying with all parental requests to avoid abuse
C) engaging in an immediate behavior to keep the child safe
D) going to a trusted adult for help

Question 22

Insitutitions in which children without parents or primary caregivers are placed often share the following characteristics EXCEPT which of the following?

A) high child-to-caregiver ratios
B) caregivers neglecting children's physical health
C) caregivers providing little warmth, sensitivity, and responsiveness
D) high caregiver turnover

Question 23

Brian really,really doesn't want to go to the dentist.He tells his mom,"If you make me go,it's child abuse!" "In fact," Brian's mom says,"I have to bring you to the dentist.If I don't,it's child abuse." Specifically,it would be which of the following?

A) physical neglect
B) medical neglect
C) spurning
D) physical abuse

Question 24

Which of the following is true about the definition of child sexual abuse?

A) While there is disagreement on what constitutes sexual abuse, all experts agree that all children under the age of 18 can be child victims.
B) While the precise age of the child who can be subject to child sexual abuse varies from state to state, all experts agree that any physical contact for the sexual gratification of adults constitutes sexual abuse, and that contact is necessary for it to be considered abusive.
C) While states vary about the degree of sexual contact needed to constitute sexual abuse, all experts agree that sexual acts are abusive in children because they, by definition, cannot give consent.
D) There is disagreement on what constitutes a "child", what constitutes "sexual" and what constitutes "abuse" among experts.

Question 25

A father who repeatedly calls a child a "sissy" when he cries,and does so in front of his friends or in public,is perpetrating what kind of psychological abuse?

A) spurning
B) terrorizing
C) isolating
D) denying emotional responsiveness

Question 26

What made the Bucharest Early Intervention Project a prospective,randomized controlled study?

A) It used random assignment to place children in one of three different child-rearing conditions to assess outcomes.
B) It used random selection to gather participants.
C) It used random assignment to place children in one of two child-rearing conditions, one of which was a new intervention, and compared their outcomes with the outcomes of children living with their families.
D) It looked at how children naturally split into two groups on the basis of their behavior and then examined what factors may have contributed to those differences.

Question 27

Reactive attachment disorder involves which of the following?

A) children who have experienced overly intrusive parenting styles
B) children producing attachment behaviors too frequently or at unexpected times
C) children not seeking or responding to comfort
D) children having excessive emotional reactions, being either excessively happy or excessively sad or anxious

Question 28

Which of the following is the most effective treatment for children with DSED,once children have entered foster care?

A) improving the quality of the foster parent-child attachment relationship
B) cognitive-behavioral therapy for parents and children
C) treatment for behavioral control issues
D) No effective treatments specifically targeted toward children with DSED have yet been tested.

Question 29

Tina's mother,Georgia,often threatens Tina with harm when she misbehaves.For instance,Georgia has Tina hold her hand over a hot stove burner for several minutes at a time,not ever touching the flame,but as a reminder that at any minute Georgia could plunge Tina's hand into the fiery ring.Would this be considered physical abuse?

A) Yes, in all states.
B) Yes, in states that have a physical harm standard.
C) Yes, in states with the endangerment standard.
D) No, in all states.

Question 30

The results of the Bucharest Early Intervention Project indicated which of the following?

A) No children who were raised in the orphanage had developed an attachment.
B) More children raised in the orphanage showed signs of RAD than showed signs of DSED.
C) The more sensitive and responsive the care children received, the fewer signs of RAD the children showed.
D) children who were placed with a family after age 24 months showed no benefit of being with a foster family, while those who were placed with a family before the age of 12 months did.

Question 31

The Attachment and Biobehavioral Catch-Up (ABC)program to treat reactive attachment disorder includes which of the following components?

A) Teaching parents to persist in nurturing their children, even when the children resist these efforts.
B) Teaching parents to only provide warmth and nurturance only when the child indicates he or she wants it to give the child a greater sense of autonomy and control.
C) Teaching parents to rely on authority figures, such as the therapists, when challenging situations arise.
D) Teaching parents to use musical and social cues to know when to switch activities.

Question 32

As described in the text,what were the results of a study of 82 children and adolescents with histories of sexual abuse who participated in different treatments (Cohen et al.,2005)?

A) Only children who participated in trauma-focused CBT showed improvement.
B) Only children who participated in supportive therapy showed improvement.
C) Both children who participated in trauma-focused CBT and supportive therapy showed improvement to the same degree, but since supportive therapy is less expensive and time-consuming, this is considered the optimal treatment.
D) Both children who participated in trauma-focused CBT and supportive therapy showed improvement, but children were more likely to complete trauma-focused CBT and showed fewer problems at 12-month follow-up than those who participated in supportive therapy.

Question 33

In what way is a friendly,sociable child different than one with disinhibited social engagement disorder (DSED)?

A) All friendly, sociable children display stranger anxiety at some point between 6 months and 2 years old.
B) Friendly, sociable children "check back" with their caregivers.
C) Friendly, sociable children provide verbal rationalizations for their behavior with strangers (such as, "That man reminds me of Daddy!").
D) Friendly, sociable children, particularly girls, almost always show more resistance toward unfamiliar males, while this distinction is not made by children with DSED.

Question 34

The Dozier,Dozier,and Manni (2002)diary study of new foster parents indicated all EXCEPT which of the following?

A) Parents and infants began forming attachments within the first few days of the children's placement in the foster homes.
B) Children who came from foster homes where there was less physical contact, such as hugging, were less likely to form attachments to their foster parents.
C) Secure attachments were most likely to form when the foster parent relationship was begun before age 10 months.
D) There was a bidirectional interaction between mothers and babies.

Question 35

Trauma-focused CBT for those who have experienced sexual abuse proceeds in eight steps that can be remembered by which acronym?

A) RECOVERY
B) PRACTICE
C) MOVING ON
D) PRIORITY

Question 36

What is the purpose of a trauma narrative?

A) to ensure the child does not blame himself or herself for abuse
B) to serve as a variation of exposure therapy
C) to improve the child's self-efficacy
D) to ensure that writing skills are in tact

Question 37

The Bucharest Early Intervention Project indicated all of the following regarding DSED EXCEPT ______.

A) DSED was more common among those in the Romanian orphanage than was RAD
B) quality of care was not consistently associated with DSED signs and symptoms
C) securely attached infants sometimes showed signs and symptoms of DSED
D) infants with signs of DSED were likely to show signs of depression in later childhood

Question 38

A youth who has been subjected to sexual abuse is in treatment.In this part of treatment,her therapist is working on getting her to change her actions to change her mood.They've discovered that performing various stretches seems to reduce her negative emotions.In which treatment is she most likely participating?

A) trauma-focused CBT, phase one
B) trauma-focused CBT, phase two
C) trauma-focused CBT, phase three
D) cognitive restructuring

Question 39

What was formerly called anaclitic depression is most closely related to which condition in the DSM-5?

A) reactive attachment disorder
B) disinhibited social engagement disorder
C) acute stress disorder
D) Posttraumatic stress disorder

Question 40

Which of the following is the sensitive period for attachment formation?

A) 0 to 6 months
B) 6 to 12 months
C) 12 to 18 months
D) 18 to 24 months

Question 41

Prevention of DSED is best accomplished by placing a child in a foster home by age 6 months.

Question 42

Which of the following sexualized behaviors is more common in children who have experienced sexual abuse than in those who have not?

A) toddlers engaging in self-stimulation
B) preschoolers looking at adults while naked or undressing
C) kindergartners asking parents sex-related questions
D) young school-age children showing sexual play with dolls

Question 43

Nestor's mom frequently physically abuses him.Now,Nestor is showing behavior problems at school.When he's interviewed by the school counselor he says,"The other kids are always trying to start something." His teacher agrees to keep an eye on it.She doesn't notice the other students behaving in a particularly cruel or ostracizing way toward Nestor.Which of the following likely best explains Nestor's perception?

A) social modeling from his mom's aggressive behavior
B) hostile attributional bias
C) deficits in social problem-solving
D) deficits carrying through on optimal action plans

Question 44

Supportive therapy is designed to cope with feelings and memories associated with abuse and improve self-worth and relationships.Which of the following components is NOT a main focus of treatment?

A) attachment to caregivers
B) behavioral regulation
C) self-perceptions
D) perceptions of the world and others

Question 45

Children who experience parental neglect are which of the following?

A) more likely to develop behavior problems because they often have no friends
B) more likely to develop behavior problems because they often have friends who have also been rejected and who are more likely to exhibit delinquent behavior
C) less likely to develop behavior problems because the intermittent parental monitoring of their parents is particularly effective in eliminating bad behavior
D) less likely to develop behavior problems because parental responsibilities, such as caring for younger siblings, usually fall to them

Question 46

Children cannot be diagnosed with reactive attachment disorder if they have had appropriate care.

Question 47

Preschoolers must show clinically significant distress to be diagnosed with PTSD.

Question 48

Which of the following is NOT a common problem associated with physical abuse?

A) bruises, scars
B) oppositional defiant disorder
C) conduct disorder
D) ADHD

Question 49

Infants who are mistreated by their primary caregiver will often fail to form an attachment to them.

Question 50

Children with DSED usually do not have difficulty forming an attachment with a primary caregiver once one provides consistent and sensitive care.

Question 51

People need to show anxiety or distress during or immediately after the event in order to qualify for a diagnosis of PTSD.

Question 52

Child abuse is considered a mental disorder in the DSM-5.

Question 53

Children who engage in overly sexualized behavior have almost certainly been sexually abused.

Question 54

Collectively,studies of parent training techniques for parents who had engaged in child maltreatment found which of the following?

A) Parent training is the most efficacious treatment.
B) The combination of traditional parent training and parent-child interaction therapy was most efficacious.
C) The combination of traditional parent training and group-based parent training was most efficacious.
D) Parent-child interaction therapy with a brief motivational session was most effective.

Question 55

Trauma-focused CBT has been found to be more effective than no treatment in randomized controlled studies of children with PTSD caused by sexual abuse.

Question 56

Which of the following statements is best supported by the research on the relationship between mood problems and child abuse?

A) Youths who experience physical abuse or are neglected around the onset of puberty are more likely to develop mood problems than those who experience abuse or neglect at other ages.
B) Children who experience psychological abuse are more likely to develop mood problems than those who have experienced other kinds of abuse.
C) Among those who have experienced child abuse, girls are more likely to suffer mood problems than boys.
D) Researchers believe that internal models of the world as a dangerous place in which only the strong survive is the type of attribution most likely to result in mood problems.

Question 57

A therapist is working with a parent who has engaged in child maltreatment.The parent says,"He is always sassing me and needs to learn better." The therapist helps the parent see that 100% compliance is not a realistic goal and asks her to provide evidence both for and against her distorted belief that he is "always sassing." This therapist is most likely using which technique?

A) parent-child interaction therapy
B) group therapy
C) cognitive-behavioral family therapy
D) eye-movement desensitization training

Question 58

According to a recent meta-analysis,sexual abuse is which of the following?

A) the most common form of abuse
B) more common among girls than boys
C) most typically perpetrated by strangers
D) more common in the south of the United States than in other regions

Question 59

Fostering trust in supportive therapy with maltreated children is typically the easy part of treatment because these children are so starved for attention,affection,and attachment.

Question 60

One successful cognitive treatment technique for parents who have exhibited child maltreatment in the past is to attribute their children's acting out to which of the following?

A) the child
B) the parent
C) situational factors
D) nothing-attributions of any kind are shown to be harmful

Question 61

How does a supportive therapeutic relationship help children who have been maltreated change their conceptions about the world and their place in it?

Question 62

Heidi was at a school dance when she threw up all over the dance floor.She later described this event as traumatic.Does it meet the definition of trauma? Why or why not?

Question 63

To be diagnosed with PTSD,a person must have a negative alteration of mood symptom,irrespective of the person's age.

Question 64

In what ways is attachment universal? In what ways is it not?

Question 65

What changes in institutions can result in lower rates of RAD and DSED in children?

Question 66

Why are there different PTSD criteria for preschoolers than for adults?

Question 67

Can escape-avoidance coping ever be seen as an adaptive coping strategy?

Question 68

The number of youths in the United States subjected to abuse or neglect is reported to be approximately 1.3%.Is this number an accurate representation of the true rate of abuse or neglect? Why or why not?

Question 69

Mindy,age 16,and her boyfriend,Jake,age 18,are hiding their relationship.Jake is worried that he might be accused of sexual abuse because Mindy is under 18.Is Jake's worry realistic? Why or why not?

Question 70

Therapists recommend safety plans be written with and confirmed by parents in all cases.