Deck 6: Panic, Anxiety, and Their Disorders

Question 1

1-19. When Kenneth was a young boy he went to a dentist who treated him uncaringly and inflicted a good deal of pain. Even years later, he has an uncontrollable and intense fear of not only dentists but physicians, too. This best illustrates how phobias might be the result of

A) generalization in classical conditioning.
B) observational conditioning.
C) secondary gain.
D) the inflation effect.

Answer 1

generalization in classical conditioning.

Question 2

1-20. Nicole's mother is terribly afraid of snakes. Although Nicole has never actually seen a snake, her mother has told her time and again to be careful to look for them when she is walking. Now Nicole has an intense fear of snakes and refuses to walk in the grass. This is an example of

A) vicarious conditioning of a phobia.
B) classical conditioning of a phobia.
C) operant conditioning of a phobia.
D) unconscious displacement of anxiety onto a phobic object.

Answer 2

vicarious conditioning of a phobia.

Question 3

1-17. Which of the following explanations for Diana's scissors phobia would Freud be most likely to offer?

A) Constant warnings about the importance of not running with scissors have generalized to an overall fear of scissors.
B) Diana suffers from womb envy, creating an unconscious desire to harm her pregnant mother.
C) Diana's mother is a seamstress and Diana unconsciously wants to kill her.
D) Diana once saw her brother seriously injured by a sharp object.

Answer 3

Diana's mother is a seamstress and Diana unconsciously wants to kill her.

Question 4

1-13. Why do people with phobias continue to avoid the thing they fear?

A) Avoidance is reinforced by anxiety reduction.
B) There is something wrong with their fight or flight system.
C) They are cognitively unable to make any other decision due to their disorder.
D) Their low self-esteem causes them to choose not to fight their fear.

Question 5

Which of the following is a typical symptom of panic attacks?

A) Hallucinations
B) Delusions
C) Fear of dying
D) Paranoia

Question 6

1-12. Martin is afraid to fly. He knows his boss wants him to take a trip for the business. Martin feels miserable, because he wants to keep his job but cannot even imagine getting on a plane. The most likely diagnosis for Martin is

A) agoraphobia without history of panic disorder.
B) social phobia.
C) specific phobia, situation type.
D) panic disorder with agoraphobia.

Question 7

1-16. Which of the following phobias is a 10-year-old boy most likely to suffer from?

A) Animal phobia
B) Blood-injury phobia
C) Claustrophobia
D) Agoraphobia

Question 8

1-14. Which of the following is associated with a unique physiological response pattern?

A) Agoraphobia
B) Blood-injection-injury phobia
C) Obsessive-compulsive disorder
D) Generalized anxiety disorder

Question 9

1-18. When Charissa was a young child, she stepped on a bee and was stung. Since that time, she has been terrified of flying insects and runs away if she sees any. According to the classical conditioning model, the bee was

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

Question 10

1-10. Gradual exposure to feared cues is

A) an old treatment for anxiety disorders that is no longer used.
B) a common component of treatment for all anxiety disorders.
C) likely to make someone with an anxiety disorder worse in the long term.
D) a useful treatment for phobias but not other anxiety disorders.

Question 11

1-11. Individuals who suffer from phobias

A) are likely to believe that their fear is justified.
B) suffer from uncued panic attacks.
C) are unlikely to have other psychological diagnoses.
D) avoid the feared stimulus.

Question 12

Which of the following is one of the seven primary types of anxiety disorders recognized in the DSM-IV-TR?

A) Hypochondriasis
B) Obsessive-compulsive disorder
C) Dissociative fugue
D) Bipolar disorder

Question 13

Fear is a basic emotion that involves

A) concern about the future.
B) the activation of the "fight or flight" response.
C) negative thoughts, but not a change in physiological arousal.
D) a complex blend of negative mood and self-preoccupation.

Question 14

1-15. An evolutionary psychologist might say, "The unique physiological response in this disorder, involving fainting at the sight of the feared object, may have evolved because fainting might inhibit further attack from a predator." What disorder is being discussed?

A) Blood-injection-injury phobia
B) Agoraphobia with panic attacks
C) Social phobia
D) Animal phobia

Question 15

The new DSM classification, which omits the concept of neurosis, is an improvement because

A) each category now has a specific effective treatment.
B) now anxiety disorders are identified regardless of whether anxiety symptoms are expressed.
C) diagnostic criteria are now based on shared, observable symptoms and are more clearly defined.
D) each category is made up of symptoms that have one causal origin.

Question 16

Neurotic behavior

A) is maladaptive and means that a person is out of touch with reality.
B) is a current term, used to describe many disorders in the DSM-IV-TR.
C) is what we now refer to as "hysteria."
D) is maladaptive but means that a person is not out of touch with reality.

Question 17

What is one of the major ways the anxiety disorders differ from each other?

A) Whether they have a genetic component.
B) Whether they are treatable.
C) Whether there are more fear/panic symptoms or anxiety symptoms involved.
D) Whether the disorder is associated with other anxiety disorders.

Question 18

The main way to tell someone is having an uncued panic attack rather than is in a state of fear is

A) whether he or she thinks about what is happening.
B) whether he or she shows physiological changes such as increased heart rate.
C) if he or she has a subjective belief that something awful is about to happen.
D) if he or she feels a strong urge to flee.

Question 19

Which of the following would be an example of anxiety?

A) Julie jumped when she saw the snake.
B) Hilda dreaded walking home alone.
C) Carl was certain that the food was poisoned.
D) The voices in Paul's head told him he should be afraid.

Question 20

Neuroticism

A) is a tendency to experience negative mood states.
B) is simply another term for anxiety.
C) is a tendency to believe negative things about oneself.
D) is a tendency to feel anxious.

Question 21

1-23. Wendy went swimming in the ocean last week and became mildly fearful when she swallowed a lot of water and felt as though she would drown. Just yesterday someone told her that a shark was seen in the water at the same time she was swimming. Now she is petrified of going into the ocean. This best illustrates

A) the observational learning explanation for phobias.
B) the inability of the phobic person to direct his or her attention away from a feared object.
C) the "inflation effect."
D) classically conditioned generalization based on direct experience.

Question 22

1-39. Behaviorally inhibited young children are more likely to develop specific phobias. This is an example of a ________ causal factor.

A) conditioning
B) preparedness
C) cognitive
D) biological

Question 23

1-26. Evolutionary preparedness explains

A) why phobic people are likely to maintain their avoidance behavior.
B) how the inflation effect works.
C) why cognitive variables are so important in phobias.
D) why some types of phobias are much more common than others.

Question 24

1-25. Which of the following illustrates how cognitive variables may act to maintain acquired fears?

A) Jane no longer went to the park due to her fear of dogs.
B) Karen would think happy thoughts whenever she drove over a bridge.
C) Ryan's fear of heights caused him to always wonder just how high up he was in a building.
D) Melvin knew that his heart was racing because he was afraid.

Question 25

1-21. When do phobias like claustrophobia and driving phobia begin?

A) Adolescence
B) Childhood
C) Middle adulthood
D) Late adulthood

Question 26

1-29. Which of the following statements about Mineka, Cook, and colleagues' animal studies is correct?

A) Laboratory-reared monkeys develop a phobic-like fear of snakes only after actually being bitten by snakes.
B) Observationally conditioned fear responses were acquired quickly but did not last more than a day or two.
C) Observationally acquired fear responses were undiminished after three months.
D) Observationally acquired fear responses cannot be acquired simply by watching videotapes of fearful monkeys.

Question 27

1-34. Kayla has just started college and wants to make friends. She refuses to go to large parties because she is afraid that she will blush and sweat, and that other people will laugh at her. She is fine when talking to people in one-on-one settings. Kayla's most likely diagnosis is

A) social phobia.
B) specific phobia, situational type.
C) agoraphobia without history of panic disorder.
D) generalized social phobia.

Question 28

1-38. Studies of preparedness and social phobia

A) find that angry faces act as fear-relevant stimuli.
B) reveal that an explicit perception of threat is necessary to evoke a sympathetic response.
C) do not provide justification for the seemingly irrational nature of social phobia.
D) provide an explanation for why such a maladaptive behavioral response persists.

Question 29

1-36. The individual with generalized social phobia

A) has a specific phobia for all social situations.
B) exhibits a fear of most social situations.
C) typically has a fear of public speaking, using a public restroom, and restaurants.
D) is likely to receive a diagnosis of generalized anxiety disorder.

Question 30

1-33. Virtual reality environments

A) permit the use of a combination of exposure therapy, participant modeling, and stress inoculation.
B) have been shown to be effective in treating agoraphobia.
C) appear to be more effective in treating phobias than live exposure to the feared stimulus.
D) allow exposure therapy to be conducted in a simulated setting.

Question 31

1-27. What has research on the preparedness theory of phobias found?

A) Fear responses cannot be conditioned to fear-irrelevant stimuli.
B) Acquired fear responses can be elicited with subliminal exposure to fear-relevant stimuli.
C) Prepared fears are innate.
D) There are cross-cultural differences in the stimuli people are "prepared" to fear.

Question 32

1-37. Most social phobics

A) can identify the origin of their social phobia.
B) have no other anxiety or mood disorders.
C) are men.
D) abuse alcohol.

Question 33

1-31. Lauren is phobic of birds. Her therapist shows her how to approach a bird in a cage. The therapist then takes the bird out, pets it and feeds it. She then encourages Lauren to do the same behaviors. This type of procedure is called

A) exposure therapy.
B) classical conditioning.
C) participant modeling.
D) virtual reality therapy.

Question 34

1-40. Social phobics are likely to

A) be aggressive.
B) attribute events in their lives to external factors.
C) have been raised in a permissive environment.
D) attribute negative life events to internal, global, and stable factors.

Question 35

1-30. Which of the following provides evidence against a role for inherited factors in the development of phobias?

A) The high concordance rate seen in fraternal twins
B) The impact of nonshared environmental factors
C) The preparedness hypothesis
D) The early onset of many phobic reactions

Question 36

1-35. Social phobia

A) is characterized by significant fear of most social situations.
B) and antisocial personality commonly are comorbid disorders.
C) involves a fear of one or more specific social situations.
D) typically develops in childhood.

Question 37

1-24. Which of the following is likely to maintain or strengthen conditioned fears over time?

A) A genetic vulnerability to phobias
B) Overestimating the likelihood that the event will reoccur
C) Having previously experienced a less traumatic event
D) Viewing the trauma as uncontrollable and inescapable

Question 38

1-28. It is fairly easy to condition monkeys and humans to fear snakes but almost impossible to condition either to fear a flower. This supports the ________ theory of phobias.

A) classical conditioning
B) vicarious conditioning
C) preparedness
D) psychoanalytic

Question 39

1-22. Casey and Josh have both been bitten by strange dogs. Casey has a dog of his own at home that he loves. Josh has little experience with dogs. Which is likely to develop a phobia?

A) Both boys are likely to develop a phobia because of the traumatic nature of the event.
B) Casey is more likely to develop a phobia because his schema of dogs has been violated.
C) Casey is less likely to develop a phobia because he has had lots of earlier positive experiences with dogs.
D) It will depend on which boy is more sensitive to pain.

Question 40

1-32. Which of the following seems to be the best treatment for phobias?

A) Exposure therapy
B) Psychoanalysis
C) Cognitive restructuring
D) Family therapy

Question 41

1-57. Research using panic provocation agents has revealed

A) the neurobiological basis for panic disorder.
B) that there is no biological explanation for panic disorder.
C) flaws in the studies using sodium lactate infusion.
D) that there are probably multiple biological explanations for panic disorder.

Question 42

1-54. Approximately ___ to ___ of people with severe agoraphobia are women.

A) 10; 20
B) 30; 40
C) 60; 70
D) 80; 90

Question 43

1-49. Mrs. B. tells her psychologist, "I cannot leave a certain region around my home without having terrible fears. I am terribly worried when I am in a car or bus. I am afraid I will have another one of those terrifying experiences." What disorder does Mrs. B probably have and what experience is she talking about?

A) The disorder is specific phobia, the experience is a panic attack.
B) The disorder is agoraphobia, the experience is a panic attack.
C) The disorder is obsessive-compulsive disorder, the experience is an obsession.
D) The disorder is generalized anxiety disorder, the experience is anxiety.

Question 44

1-48. ________ was once thought to be a fear of crowded places, but now is seen as a complication of having panic attacks in public.

A) Agoraphobia
B) Claustrophobia
C) Generalized anxiety disorder
D) General social phobia

Question 45

1-56. Most first panic attacks

A) follow some distressing event.
B) are uncued.
C) are followed by the development of panic disorder.
D) last more than an hour.

Question 46

1-42. Panic attacks, by definition,

A) are seen in individuals with panic disorder.
B) are unexpected ("uncued").
C) require the presence of at least 4 of 13 characteristic symptoms.
D) are 30-60 minutes in duration.

Question 47

1-60. "Repeated stimulation of the limbic system by discharges from the locus coeruleus may lower the threshold for later experiences of anxiety. Then, through learning, controlled by the prefrontal cortex, the person actively avoids fearful situations." This quotation most clearly refers to the biological processes involved in

A) obsessive-compulsive disorder.
B) panic disorder with agoraphobia.
C) generalized anxiety disorder.
D) social phobia.

Question 48

1-51. Panic disorder is best described as a(n) ________ condition.

A) chronic
B) acute
C) dissociative
D) inherited

Question 49

1-43. Which of the following is necessary for a diagnosis of panic disorder?

A) Uncued panic attacks
B) Depersonalization
C) Panic attacks, cued and uncued, consisting of at least 6 of the 13 symptoms of a panic attack
D) Derealization

Question 50

1-41. Cognitive approaches to social phobia focus on

A) extinguishing problematic behavioral responses.
B) challenging automatic thoughts.
C) identifying the underlying cause of the phobia.
D) minimizing symptoms.

Question 51

1-46. Panic disorders are often misdiagnosed because

A) the symptoms overlap so much with major depression.
B) the symptoms are so chronic and mild, they do not seem like serious forms of psychopathology.
C) patients are so embarrassed by their problems, they do not make them known to professionals.
D) symptoms are so somatic they are treated by physicians for medical problems.

Question 52

1-59. Which brain structure is recognized as playing a central role in panic attacks?

A) Amygdala
B) Cerebellum
C) Hippocampus
D) Locus coeruleus

Question 53

1-50. Limited symptom attacks are

A) a characteristic of panic disorder.
B) panic attacks consisting of fewer than four symptoms.
C) unpredictable somatic ailments.
D) typically seen in individuals with agoraphobia with panic.

Question 54

1-47. Agoraphobia is best described as a fear of

A) going to the dentist.
B) being alone.
C) being judged by people.
D) experiencing a panic attack.

Question 55

1-52. James began having panic attacks immediately after his mother died suddenly. As they became more frequent, he began to fear going into public situations where they might occur. Now he is unable to leave his apartment and has others go out to shop for him. What is unusual about this case?

A) It is unusual for a person with severe agoraphobia to be a man.
B) It is unusual for panic attacks to begin after a stressful life event.
C) It is unusual for fear of panic attacks to lead to agoraphobia.
D) There is nothing unusual about this case.

Question 56

1-44. When Jill experienced her first panic attack, she felt as if she were outside of herself, watching herself struggle to catch her breath. Jill's sense of not being part of herself is one of the symptoms of a panic attack known as

A) derealization.
B) depersonalization.
C) dissociative fugue.
D) personality disintegration.

Question 57

1-45. Compared to anxiety, panic is

A) less focused.
B) longer lasting.
C) slower to develop.
D) more intense.

Question 58

1-53. Which of the following is a sociocultural explanation for the higher incidence of anxiety disorders in women?

A) Historically, women have had to stay and care for young. Thus, a hypervigilant state was adaptive.
B) Women have a natural tendency to be more cautious than men.
C) High levels of male hormones lead to aggression and fearlessness.
D) It is more acceptable for women to exhibit fear.

Question 59

1-55. Agoraphobics are highly likely to have all of the following EXCEPT

A) avoidant personality disorder.
B) alcohol abuse.
C) depression.
D) neurotic personality disorder.

Question 60

1-58. What is thought to explain the effectiveness of the SSRIs in treating panic disorder?

A) They increase serotonergic activity.
B) They increase noradrenergic activity.
C) They decrease serotonergic activity.
D) They decrease noradrenergic activity.

Question 61

1-77. One of the main functions that worry seems to serve in generalized anxiety disorder is

A) it keeps people distracted from what is really bothering them.
B) it keeps people with the disorder feeling happier than if they didn't worry.
C) it prevents people with the disorder from developing depression.
D) it keeps people from feeling the emotional and physiological consequences of anxiety.

Question 62

1-65. The cognitive model does not account for

A) nocturnal panic attacks.
B) the effectiveness of cognitive-behavioral therapies.
C) findings from panic provocation studies.
D) evidence of a role for genes in anxiety disorders.

Question 63

1-80. What disorder does GAD appear to be most related to?

A) PTSD
B) Panic disorder
C) Specific phobia
D) Major depression

Question 64

1-62. Anxiety sensitivity is

A) a fear of open spaces.
B) a belief that anxiety will kill.
C) a trait-like belief that certain bodily symptoms may have harmful consequences.
D) a fear that situations in which panic attacks occur will be devastating.

Question 65

1-72. Amber feels anxious almost all the time. She finds herself worrying that her husband will leave her (although he has never shown any indication that he would), that she chose the wrong job, that her children might not be safe at their school, and that she might get sick and leave her family in financial ruin. She calls her husband almost everyday to find out when he will be home. She complains to her physician that she is always tired but cannot sleep or relax. Amber's most likely diagnosis is

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

Question 66

1-73. According to the psychoanalytic view, what makes generalized anxiety disorder (GAD) different from specific phobias?

A) Defense mechanisms are not functional in GAD.
B) Different defense mechanisms are employed by those with GAD and those with specific phobias.
C) The underlying conflict in GAD is between the ego and the superego, while it is between the id and ego in specific phobias.
D) Individuals with specific phobias suffer from self-hate and project this emotion on the feared stimulus.

Question 67

1-71. While in treatment for panic disorder, Leroy is asked to engage in behaviors that activate the sympathetic nervous system. In other words, Leroy is engaging in behaviors that produce the physical sensation of fear. What type of treatment does this appear to be?

A) Exteroceptive exposure
B) Interoceptive exposure
C) Anxiety sensitivity training
D) Cognitive reconditioning

Question 68

1-61. Betty is hyper-aware of such bodily sensations as heart rate and respiration rate. When she perceives heart or breathing as getting faster she becomes afraid that she is having a heart attack. These thoughts make her symptoms worse and she has a panic attack. Betty's pattern of thinking best illustrates

A) cognitive theory of panic.
B) the psychoanalytic theory of panic.
C) the importance of perceived control in panic disorder.
D) the role of the locus coeruleus in panic.

Question 69

1-75. Which of the following have studies of control in humans and monkeys provided support for?

A) Genes play only a minimal role in the development of generalized anxiety disorder.
B) Early experiences with mastery and control may serve as protective factors, decreasing the likelihood of developing generalized anxiety disorder.
C) Exposure to uncontrollable events does not increase the chances of developing generalized anxiety disorder.
D) The comorbidity of specific phobias and generalized anxiety disorder.

Question 70

1-68. Which of the following are the antidepressants most widely prescribed today for the treatment of panic disorder?

A) SSRIs
B) Tricyclics
C) Anxiolytics
D) Benzodiazepines

Question 71

1-70. Quentin is seeking medication to treat his panic disorder. Due to Quentin's history of substance abuse, his doctor hesitates. After some consideration, the doctor is most likely to write Quentin a prescription for a ________, confident that abuse won't be an issue.

A) SSRI
B) tricyclic
C) monamine oxidase inhibitor
D) benzodiazepine

Question 72

1-64. Which of the following statements is correct in regard to the role of cognitions in panic?

A) Explaining what will happen during a panic attack is insufficient to Panic can be prevented in a panic provocation study by explaining what will happen.
B) Panic clients are more likely to interpret bodily sensations as catastrophic events.
C) Only individuals who tend to catastrophize develop panic disorder.
D) Cognitive therapy is less effective than emotive therapy for panic disorder.

Question 73

1-76. Which of the following is NOT one of the benefits that those with GAD commonly believe they derive from worrying?

A) If I worry about it now, I won't be as upset when it happens.
B) If I worry about it, it is less likely to happen.
C) If I worry about it, I won't have to think about other things that are even worse.
D) If I worry about it, I'll be more prepared when it does happen.

Question 74

1-67. Why do many people with panic disorder continue to believe they are having a heart attack despite the fact that they never have had one?

A) They continue to go through classical conditioned learning experiences each time they have a panic attack.
B) They tend to engage in "safety behaviors" that they believe are the reason the catastrophe didn't happen.
C) They tell themselves that physicians may have missed earlier heart attacks.
D) They have such a high level of fear that learning is not possible.

Question 75

1-69. Harold's panic attacks have become so severe that he has finally sought treatment. He sees a psychiatrist who writes Harold a prescription that should offer him some immediate relief. Which of the following drugs is Harold most likely to have been prescribed?

A) SSRIs
B) Tricyclics
C) Monamine oxidase inhibitors
D) Benzodiazepines

Question 76

1-79. Neurobiological factors involved in panic disorder and generalized anxiety disorder provide evidence for the hypothesis that

A) both disorders are caused by an excess of the GABA neurotransmitter.
B) fear and anxiety are fundamentally distinct.
C) the two disorders are genetically identical.
D) panic may be an acute version of generalized anxiety disorder.

Question 77

1-78. One of the main problems with the worry in generalized anxiety disorders is

A) it keeps people distracted from what is really bothering them.
B) it is a form of avoidance and prevents extinction.
C) it increases the effects of operant conditioning on their fears.
D) it keeps people with the disorder feeling happier than if they don't worry.

Question 78

1-66. High levels of anxiety sensitivity

A) increase the risk of all types of anxiety disorder.
B) are seen in all who develop agoraphobia.
C) are a diathesis for panic attacks.
D) can be effectively treated with drugs that minimize noradrenergic function.

Question 79

1-63. "Fear of fear," fear of anger and depression, and fear of internal bodily sensations are all cognitive causal explanations for

A) social phobia.
B) generalized anxiety disorder.
C) obsessive-compulsive disorder.
D) agoraphobia.

Question 80

1-74. Derek's moods have always seemed to be unpredictable and irrational. Nancy, who has been diagnosed with generalized anxiety disorder, never knows when he is going to come home and yell at her and the kids. In family therapy it is revealed that Derek's moods are really not irrational, but a reflection of the day's sales at his store. Which of the following would be most likely to decrease Nancy's anxiety?

A) Derek can commit more money to advertising so as to increase sales.
B) Derek and Nancy should separate.
C) Derek could call home each day and let Nancy know how the day went.
D) Derek should sell the business.