Deck 4: Clinical Assessment and Diagnosis

Question 1

1-20. While neurological assessment procedures evaluate the brain's physical properties, neuropsychological assessment focuses on

A) brain activity.
B) brain functioning.
C) client performance.
D) self-reported changes in cognitive and perceptual functioning.

Answer 1

client performance.

Question 2

Psychological assessment refers to the

A) procedures used to summarize a client's problem.
B) process used to arrive at a diagnosis.
C) development of a treatment plan.
D) determination of how environmental factors impact the course of a disorder.

Answer 2

procedures used to summarize a client's problem.

Question 3

Dr. Vera says, "It may only provide a limited view of a person's problems, but it is important for planning appropriate treatment. Administratively, it is essential so that a facility can know what kinds of problems clients need help with. Even if we don't want to do it, insurance claims require it." What is Dr. Vera is referring to?

A) Formal diagnosis
B) Screening activities
C) Taking a personal history
D) Assessment

Answer 3

Formal diagnosis

Question 4

1-18. The fMRI technique cannot currently be used as a diagnostic tool. This is because

A) the images it produces aren't sharp enough.
B) the devices needed for the technique aren't readily available.
C) it is very difficult to interpret the results.
D) it has been shown to have very low reliability.

Question 5

1-16. One advantage of nuclear magnetic resonance imaging (MRI) over the CAT scan is that the MRI

A) is not an invasive procedure.
B) provides better differentiation and clarity.
C) measures the metabolic processes of the brain.
D) does not require a claustrophobic cylinder-shaped machine.

Question 6

What role does the social context play in assessment?

A) Social context is not considered during assessment, only during diagnosis.
B) An evaluation of the environment in which the client lives is necessary in order to understand the demands she faces, as well as the supports that are present.
C) Environmental factors are usually the proximal cause of mental disorders and frequently need to be addressed before any form of treatment commences.
D) The social context need only be considered when a course of treatment is being selected; significant others in the client's life should be the primary decision makers.

Question 7

1-11. Which of the following statements about reliability and validity is true?

A) Reliable tests are usually valid.
B) Valid tests are usually reliable.
C) There is no relationship between reliability and validity.
D) In order for a test to be reliable, it must be valid.

Question 8

1-14. Which of the following makes it possible to see all but the most minute abnormalities of brain structure?

A) CAT scan
B) EEG
C) MRI
D) PET scan

Question 9

1-19. Dr. Kim is a psychologist who uses a number of tests to measure a person's cognitive, perceptual, and motor performance to detect brain damage. Dr. Kim is probably a specialist in using

A) neuropsychological assessment.
B) functional magnetic resonance imaging.
C) computerized axial tomography.
D) functional electroencephalograms.

Question 10

Which of the following statements regarding assessment is true?

A) Assessment should focus only on the client's current level of functioning.
B) An adequate assessment includes a determination of the amount of danger the client poses to himself and others.
C) An adequate assessment should include as much information as possible.
D) Assessment necessarily involves the gathering of data about the client from multiple sources.

Question 11

Why is it important to have an appropriate classification of the presenting problem?

A) A formal diagnosis may be needed for insurance purposes.
B) A determination of the range of presenting symptoms is needed to ensure proper placement in a treatment facility.
C) A recognition of what type of disorder is present will aid in the development of an effective treatment plan.
D) All of the above.

Question 12

1-17. Dr. Bruce says "Its beneficial features are the ability to map ongoing psychological activities of the brain without injecting radioactive substances into the patient's body. In addition, they are much more widely available procedures than what was used before." What is Dr. Bruce describing?

A) Positron emission tomography (PET) scans
B) Functional magnetic resonance imaging (fMRI)
C) Electroencephalograms (EEGs)
D) Computerized axial tomography (CAT) scans

Question 13

1-13. Which of the following would be used to reveal a dysrhythmia in brain activity?

A) CAT scan
B) EEG
C) MRI
D) PET scan

Question 14

1-10. A valid test

A) measures what it is designed to measure.
B) yields consistent results.
C) is standardized.
D) rarely is reliable.

Question 15

1-12. Unlike the medical practitioner, the mental health professional's assessment process

A) must be completed prior to beginning treatment.
B) rarely has "lab work" that can confirm an initial impression.
C) rarely includes a complex process where many contributing factors must be investigated.
D) usually involves a rapid conclusion about how to explain and treat the client's complaint.

Question 16

Which of the following is a true statement about assessment and professional orientation?

A) Regardless of whether a therapist is behaviorally or psychodynamically oriented, the same basic assessment procedures are employed.
B) The focus of the assessment will be largely determined by the professional orientation of the clinician.
C) While some assessment procedures will vary, a biological screening and administration of a personality test are components of all assessments.
D) The assessment techniques employed will serve to reveal the causal factors that are most consistent with the clinician's orientation.

Question 17

1-15. Dr. Smith believes that a decrease in frontal lobe function underlies the cognitive deficits seen in schizophrenia. He has hypothesized that effective drug therapy serves to selectively increase metabolic activity in this part of the brain. Which of the following is Dr. Smith most likely to use to test his hypothesis?

A) Computerized axial tomography (CAT) scans
B) Magnetic resonance imaging (MRI)
C) Positron emission tomography (PET) scans
D) An electroencephalogram (EEG)

Question 18

Which of the following demonstrates reliability?

A) An IQ test is effective in predicting the academic performance of both males and females.
B) Scores on an IQ test are not affected by mood.
C) Scores on two different intelligence tests are highly correlated.
D) When an IQ test is administered to the same person repeatedly, the results do not differ.

Question 19

A person comes to a mental health professional with a certain complaint. The professional attempts to understand the nature and extent of the problem. This process is called

A) diagnosis.
B) assessment.
C) clinical treatment.
D) screening.

Question 20

The need for rapport between a clinician and a client means

A) that the clinician and the client must feel friendly toward each other.
B) that someone who is court ordered will be an easy client.
C) clients don't need to be given any feedback about their test performance.
D) the client must feel comfortable with the clinician and the assessment.

Question 21

1-39. Psychological tests

A) are extremely reliable and valid.
B) are dependent on the competence of the clinician who interprets them.
C) are far superior to clinical observation for making diagnoses.
D) can arrive at a person's diagnosis without the need for an interview.

Question 22

1-23. In which of the following circumstances would a psychosocial assessment clearly need to be used?

A) Mr. Harvey has been having problems with his memory since his stroke.
B) After a change in her hormone treatment regimen, Hillary began to show severe mood swings.
C) Ever since the divorce, James has been sleeping less and less.
D) Since the car accident, Jill has had nightmares.

Question 23

1-25. Under what circumstances is a structured interview most likely to be used?

A) When consistent information is needed for research purposes
B) When an accurate diagnosis is needed to ensure appropriate treatment
C) When the behavior of the client is erratic
D) When the information provided in an unstructured interview is found to lack reliability

Question 24

1-26. Which of the following is a drawback of a structured interview?

A) Important information is asked about in the same way.
B) Information from one is hard to compare to information from another.
C) Interviews may include questions about areas that are of no concern to the patient.
D) Each person who uses interviews, uses them in different ways.

Question 25

1-27. Which of the following best illustrates high reliability?

A) An interviewer modifies the way she asks questions to fit the style of the client.
B) Two interviewers diagnose the same disorder after talking to the same client.
C) A clinician accurately predicts that a client will become violent when reunited with this family.
D) A clinician uses both medical information to decide a diagnosis.

Question 26

1-40. Intelligence and personality tests can best be described as

A) indirect means of assessing psychological characteristics.
B) unstructured means of assessing behavior.
C) direct means of assessing behavior.
D) observational means of assessing behavior.

Question 27

1-34. A behaviorally oriented clinician tells her alcohol dependent client: "Here is a checklist I want you to fill out each day. Whenever you feel you need a drink, you should indicate what you were thinking, where you were, who you were with, and whether you went ahead and drank." What procedure is the clinician using?

A) Self-monitoring
B) Rating scales
C) Self-analysis
D) Mental status exam

Question 28

1-28. Dr. White is doing research in which she must diagnose clients at a mental health clinic. Because diagnostic reliability is of great concern in research, she will most likely establish diagnoses by using

A) open-ended interviews.
B) standardized structured interviews.
C) the mental status exam.
D) time-limited interviews that last the same length of time for each client, although the questions may differ.

Question 29

1-30. Shanna goes to Dr. Henderson for a first interview. He diagnoses her with a depressive disorder. She then goes to Dr. Smithson, because her friend recommended her. Dr. Smithson diagnoses Shanna with an anxiety disorder. This demonstrates a problem with

A) structured interviews.
B) multiaxial diagnosis.
C) reliability.
D) flexibility.

Question 30

1-37. Joanne says that she cannot say "no" to her intrusive mother. Her therapist has her pretend to engage in such an interaction to assess how weak Joanne's assertiveness skills really are. This illustrates the use of

A) a rating scale.
B) role-playing.
C) "thought reports."
D) structured interviewing.

Question 31

1-21. Because his psychologist suspects he might have substantial brain damage, Tony was given a five-hour battery of tests that included listening to rhythmic beats presented by tape recorder and putting different shaped blocks into grooves while blindfolded. The procedure Tony experienced is called the

A) Rorschach.
B) MMPI-2.
C) Halstead-Reitan battery.
D) functional Magnetic Resonance Imaging (fMRI) test.

Question 32

1-22. Ed has suffered a head injury in a car accident. He is referred to a psychologist to see what types of impairment now exist and to get some suggestions for treatment. The best assessment strategy would be

A) a CAT scan.
B) neuropsychological tests.
C) a PET scan.
D) an fMRI.

Question 33

1-35. Which of the following is NOT a reason for using rating scales in clinical observation and self reports?

A) To increase reliability
B) To provide structure
C) To decrease objectivity
D) To allow standardized comparisons to be made

Question 34

1-33. In which of the following circumstances would a clinician be most likely to use self-monitoring?

A) When other forms of clinical observation have yielded no evidence of abnormal behavior
B) To find out what situations are likely to illicit problematic behavior
C) To evaluate the quality of the social environment
D) When analogue situations have not served to provoke the provoke a demonstration of the presenting problem

Question 35

1-29. The reliability of the assessment interview may be enhanced by the use of

A) a flexible, open-ended interview rather than a structured interview.
B) the TAT.
C) the Rorschach test.
D) rating scales.

Question 36

1-24. A psychosocial assessment typically begins with

A) a physical examination.
B) an assessment of global level of functioning.
C) administration of the MMPI.
D) an interview.

Question 37

1-36. Danielle is having problems with drinking. She goes to a psychologist who gives her a form to fill out. It has a list of statements about drinking and problems associated with drinking. She is to rate each item between 1 and 3 - 1 meaning it is not a problem for her, 3 meaning it is a very big problem for her and 2 is in between. This is an example of

A) a rating scale.
B) a structured interview.
C) an analogue situation.
D) self-monitoring.

Question 38

1-31. A clinical psychologist notes that a client wears his clothes inside out, that his hair is matted, and there is dirt under his fingernails. This information is known as

A) clinical observation.
B) self-monitoring.
C) a dynamic formulation.
D) an observational decision tree.

Question 39

1-38. The use of standardized psychological tests

A) has made clinical observation a rarely used method of assessment.
B) permits the clinician to determine how a client's behavior compares to some reference group.
C) enables anyone to make accurate psychiatric diagnoses, provided they are trained in the interpretation of such tests.
D) has made the diagnosis of mental illness an objective process.

Question 40

1-32. Dr. Lo asks Julie to pretend that he is her father as part of his psychosocial assessment of Julie. Which of the following would this be an example of?

A) an unstructured interview
B) an analogue situation
C) projective assessment
D) self-monitoring

Question 41

1-47. The aim of a projective test is to

A) predict a person's future behavior.
B) assess the way a patient perceives ambiguous stimuli.
C) compare a patient's responses to those of persons who are known to have mental disorders.
D) assess the role of organic factors in a patient's thinking.

Question 42

1-52. Research by Exner and others has shown that the Rorschach

A) is a test with weak reliability and absolutely no validity.
B) is just as effective at identifying areas of brain damage as MRIs and PET scans.
C) can be scored by computer, thereby increasing its reliability.
D) is one of the least frequently researched clinical instruments despite its widespread use.

Question 43

1-43. Which of the following statements about individually administered IQ tests is correct?

A) They typically take less than an hour to give and interpret.
B) They have low reliability.
C) Many settings and cases don't require the kind of detailed knowledge they give.
D) They are expensive.

Question 44

1-60. What does it mean if Carol scores high on the Schizophrenia scale of the MMPI?

A) Carol has schizophrenia.
B) Carol's responses on this scale were similar to those of the Minnesota normals.
C) Carol is 30% more likely to develop schizophrenia than those who scored lower.
D) Carol's answers were comparable to those given by a group of schizophrenics.

Question 45

1-55. Which of the following would best address recent criticisms of the TAT?

A) Make the images less ambiguous
B) Allow more time for the client to respond
C) Use more modern pictures
D) Rely only on manuals for interpretation

Question 46

1-41. What would determine whether the WISC-III or the WAIS-III is used to test intelligence?

A) The suspected level of impairment
B) The amount of time available for test administration
C) The age of the client
D) Whether organic brain damage is present

Question 47

1-59. The empirical keying approach to making a test like the MMPI involves

A) subjective scoring of test items to assign items to different groups.
B) the creation of ambiguous stimuli where there are many possible responses.
C) picking items that differentiate between different groups, no subjective judgment is needed.
D) using theoretically based concepts to develop questions for different groups.

Question 48

1-45. Which of the following would be an example of a projective technique?

A) A troubled teen is asked to select statements that she feels describe her.
B) An alcoholic is told to record the times at which she feels the greatest desire for a drink.
C) An elderly woman is asked to recall the day her father died.
D) A child is asked to draw her family.

Question 49

1-51. Which statement about the Rorschach is accurate?

A) The ambiguous stimuli it employs are pictures of people interacting in an unclear way.
B) A considerable amount of training is required to administer and score it accurately.
C) It assesses the kind of specific behavioral deficits that most mental health facilities require today.
D) It is the quickest projective tests to administer and score.

Question 50

1-53. The Thematic Apperception Test (TAT) has been used to assess all of the following EXCEPT

A) needs.
B) intelligence.
C) perception of reality.
D) fantasies.

Question 51

1-56. Which of the following statements about projective tests is correct?

A) Interpretation is based on standardized criteria
B) Client responses are limited to closed-ended responses
C) They require respondents to be able to read and write in English
D) They are time-consuming

Question 52

1-44. Which of the following is an unstructured approach to studying personality?

A) WISC-III
B) the BPRS
C) the Stanford-Binet
D) the TAT

Question 53

1-50. Which of the following best explains why the Rorschach is less likely to be used today?

A) Other projective approaches have been found to be more reliable.
B) Treatment facilities often require other types of information than the Rorschach provides and insurance companies do not pay for it.
C) It is inexpensive and time efficient in comparison to other projective techniques.
D) The Rorschach is only useful as a means of aiding clients in self-discovery; it has no true clinical utility.

Question 54

1-49. Which of the following is a projective testing method that has been adapted for computer interpretation?

A) The Rorschach Test
B) The MMPI
C) The Thematic Apperception Test
D) The sentence completion test

Question 55

1-57. The MMPI is

A) a structured approach to personality assessment.
B) the most commonly used test of intelligence.
C) a rating scale used to determine how comparable one is to individuals with various psychiatric diagnoses.
D) a recently developed objective approach to personality assessment.

Question 56

1-48. Which of the following is a type of test that tries to find ways in which a person's personality and past experiences cause them to understand and perceive their world?

A) Structured interviews
B) Objective tests
C) Neuropsychological tests
D) Projective tests

Question 57

1-42. There are two general categories of psychological tests used in clinical practice. They are

A) intelligence tests and personality tests.
B) projective tests and sentence completion tests.
C) neuropsychological tests and standardized tests.
D) intelligence tests and rating scales.

Question 58

1-46. "Projective" and "objective" are two types of ________ tests.

A) neuropsychological
B) intelligence
C) personality
D) psychodynamically oriented

Question 59

1-58. Which of the following is an objective test?

A) Rorschach Test
B) Thematic Apperception Test
C) Sentence-Completion Test
D) MMPI-2

Question 60

1-54. Several clinicians look at the TAT results of a hospitalized patient. The patient described the characters on the card as not speaking to each other. One clinician says this means the patient has a lot of unresolved anger. Another says it means the patient has a lot of social anxiety. The third says he thinks it means the patient is uninterested in people and prefers to be alone. This demonstrates the following problem with the TAT:

A) Scoring and interpretation is very subjective.
B) The pictures on the cards are new and updated.
C) The amount of time it takes to score and interpret it.
D) The lack of training of clinicians on using it.

Question 61

1-65. One limitation of the MMPI-2 is that it

A) cannot detect whether an individual is attempting to distort his or her responses.
B) requires a clinical interview as a supplement to the test itself.
C) is based on factor analysis, which often leads to measures that sacrifice validity for the sake of reliability without intending to do so.
D) requires an individual to be literate.

Question 62

1-64. A key feature of the MMPI-2 is that

A) the clinical scales measure the same properties of personality organization as they always have.
B) the validity scales have been discarded.
C) it has merged the adult and adolescent forms into one.
D) it now includes open-ended questions to examine cognitive distortions.

Question 63

1-73. Dr. Hunter is studying depression. He decides that he will divide his subjects into depressed and nondepressed groups using information about their response to a loss. He has found that 96% of people feel hopeless and sad for about 3 weeks after a loss. So he decides that any subject who has continued to feel this way for more than 3 weeks will be considered depressed. He is using a

A) categorical approach.
B) dimensional approach.
C) prototypal approach.
D) discrimination approach.

Question 64

1-72. If a diagnosis is made by comparing subjects to a "model" of an illness, which type of classification scheme is being used?

A) Categorical
B) Dimensional
C) Prototypical
D) Evolutionary

Question 65

1-78. During an assessment interview, Dr. Poole noted that Jane's boss at work was harassing her. On which of the five axes of the DSM would this information be noted?

A) Axis II
B) Axis III
C) Axis IV
D) Axis V

Question 66

1-66. Computers are excellent devices for storing information on large numbers of people's characteristics and test score patterns. Whenever a person turns up with a specific test score pattern, the computer can print out an appropriate description. This illustrates

A) actuarial procedures.
B) content interpretation.
C) rational analysis.
D) factor analysis.

Question 67

1-62. The text presented the case study of Andrea C, a twenty-one-year-old student from Colombia. The MMPI-2 computer-based report was typical of such reports because

A) there was a large discrepancy between the report based on the MMPI and that based on the MMPI-2.
B) the report was invalid because Esteban is a member of an ethnic minority.
C) the report provided diagnostic and treatment considerations.
D) the report was not used appropriately in Esteban's treatment.

Question 68

1-69. Why is classification a necessary first step in developing an understanding about abnormal behavior?

A) Abnormal behavior is not abnormal until it has been classified as such.
B) Communication about abnormal behavior cannot be effective unless what is being discussed is clear.
C) Only through development of a classification system can abnormal and normal behavior be differentiated.
D) Unless an adequate classification system exists, all descriptions of abnormality will necessarily be subjective.

Question 69

1-76. Which of the following is an example of a symptom?

A) The client's hands would not stop shaking.
B) The client reported hearing voices.
C) A large lesion was visible on the CAT scan.
D) Her children reported that she had not been sleeping well.

Question 70

1-79. Disorders that begin by adolescence or early adulthood, persist for long periods of time, and affect many areas of a person's life are listed on

A) Axis II.
B) Axis III.
C) Axis IV.
D) Axis V.

Question 71

1-70. Which of the following is an assumption of a categorical approach to abnormal behavior?

A) Both normal and abnormal behavior lie on a continuum.
B) Each disorder has unique symptoms.
C) Disorders that share common symptoms have a common etiology.
D) All behavior is the product of numerous interacting influences.

Question 72

1-61. Mike decides he is going to try to look mentally ill when he goes for his disability evaluation. He takes the MMPI-2. He most likely

A) will be able to fake mental illness convincingly.
B) will still come out normal on the test.
C) will be caught by specialized scales on the test.
D) will come out seeming very insightful.

Question 73

1-77. Since it was first published, the DSM has

A) become more objective.
B) decreased in size.
C) abandoned attempts to operationalize diagnosis.
D) removed procedures originally employed to differentiate between psychological and biological causal factors.

Question 74

1-75. Symptoms are to signs as ________ is to ________.

A) subjective; objective
B) complaints; treatment
C) assessment; diagnosis
D) projective; objective

Question 75

1-63. Why was the MMPI-2 needed?

A) The original MMPI did not offer age-adjusted sub-scales.
B) The original MMPI did not permit subjects to select "other."
C) The original MMPI was not able to detect problems such as substance abuse and marital discord.
D) The original MMPI was created over 50 years ago.

Question 76

1-71. Which approach to the classification of abnormal behavior uses statistical criteria to differentiate between normal and abnormal?

A) Categorical
B) Dimensional
C) Prototypical
D) Situational

Question 77

1-74. While the DSM is designed to be a categorical classification scheme,

A) in practice diagnoses are made on a dimensional basis.
B) the high rate of comorbidity makes categorization impossible.
C) the lack of objective criteria make accurate diagnosis impossible.
D) the existing criteria tend to lead to a prototypal approach.

Question 78

1-67. One of the problems with actuarial data for an instrument like the MMPI is that

A) it too frequently suggests that a client is "comorbid" for as many as three or more different disorders.
B) there are only as many profiles as there are clinical scales.
C) the profiles of many subjects do not "fit" the profile types for which actuarial data are available.
D) while the profiles that are generated have high reliability they often have very low validity.

Question 79

1-80. Despite his condition, Jim went to work every day. On which of the five axes of the DSM would this information be found?

A) Axis II
B) Axis III
C) Axis IV
D) Axis V

Question 80

1-68. Which of the following is NOT a factor to keep in mind when evaluating test results?

A) A focus on potentially important environmental factors
B) Cultural biases of the test
C) Not enough data about a person
D) The theoretical orientation of the clinician