Test Five
Questions
1. The kappa statistic is commonly used to assess agreement across raters. Values above what number are considered to represent high levels of agreement?
A. 0.005
B. 0.60
C. 0.01
D. 0.75
E. 1.0
2. Four categories of techniques are generally employed in the child psychiatric interview, which include engagement, projective, direct questioning, and interactive techniques. Which of the following describes projective techniques?
A. Techniques to put the child at ease so that the child will provide accurate and meaningful clinical information
B. Techniques to allow the child to reveal underlying themes or issues that the child may be unable to verbalize directly
C. Techniques to clarify particular points or to elicit specific information
D. Techniques to clarify how the child relates to as well as accepts or integrates input from others
3. A 4-year-old boy displays extreme sadness and distress when he must say good-bye to his preschool teacher at the end of the school year. Which of the following would be most helpful in the transition?
A. Introducing the boy to his next, new teacher right away
B. Visiting with the preschool teacher after the farewell
C. Preventing any further contact between the boy and his teacher in the future
D. Telling the boy that his teacher left because of his bad behavior
E. Reassuring the boy that he will have many teachers in the future
4. True or False: Psychiatric disorders such as schizophrenia, bipolar disorder and Tourette’s syndrome (TS) appear to exhibit mendelian patterns of inheritance.
A. True
B. False
5. Which of the following is NOT one of the diagnostic criteria for gender identity disorder (GID)?
A. A strong and persistent cross-gender identification
B. Persistent discomfort with his or her sex preference
C. The disturbance is not concurrent with a physical intersex condition
D. The disturbance causes clinically significant distress and impairment in social, occupational, or other important areas of functioning
6. In the treatment of selective mutism, introducing the child gradually and systematically into situations in which the child already speaks is an example of:
A. Prompting
B. Shaping
C. Situational fading
D. Individual fading
E. Backwards chaining
7. In which part of the brain are about half of all noradrenergic neurons located?
A. Substantia nigra
B. Locus coeruleus
C. Hippocampus
D. Amygdala
E. Thalamus
8. A developmental pediatrician is asked to evaluate a 24-month-old girl referred for regression in development. Her parents describe normal prenatal and perinatal development before recent loss of purposeful hand movements. DNA analysis is likely to reveal?
A. Deletion on chromosome 15
B. Disruption at the “fragile” site on the X chromosome
C. Mutation in the LIS-1 gene
D. Deletion on chromosome 7
E. MeCP2 gene mutation
9. The 5-year training program in pediatrics, general psychiatry, and child and adolescent psychiatry, better known as the “Triple Board” began as a pilot training experiment in which year?
A. 1946
B. 1964
C. 1985
D. 1992
E. 2000
10. Which of the following marks the start of adolescence?
A. Gonadarche
B. Adrenarche
C. High school
D. Breast development
11. Which of the following statements is TRUE?
A. By age 2, many children with autism show clear repetitive behaviors
B. By school age, many children with autism become more socially responsive
C. Language skills of children with autism never improve
D. Early intervention studies show no improvement in independent functioning
E. Two-thirds of adults with autism achieve independence
12. In a survey of 785 adolescent and adult females, which ethnic group had the highest rate of anorexia nervosa?
A. Asian-Americans
B. African-Americans
C. European-Americans
D. Latino-Americans
E. None, they were all found to be within the mean
13. What is the lifetime prevalence of bipolar disorder in the offspring of parents with bipolar disorder?
A. 5% to 15%
B. 15% to 25%
C. 20% to 35%
D. 35% to 50%
E. Over 50%
14. In McHugh and Slavney’s four perspectives in psychiatric assessment that serves as an alternative to the biopsychosocial approach to formulation, which component addresses “what a patient is”?
A. Disease
B. Dimension
C. Behavior
D. Life story
15. In the study of sexual orientation, what part of the brain, in both animals and humans, has received particular interest?
A. Hypothalamus
B. Caudate nucleus
C. Medulla
D. Mamillary bodies
E. Hippocampus
16. Which of the following elements compose psychic reality?
A. Thoughts
B. Feelings
C. Fantasies
D. Perceptions of the external world
E. All of the above
17. Each of these is a model for psychiatric consultation to pediatrics EXCEPT:
A. Resource consultation
B. Process-educative consultation
C. Collaborative team
D. Family systems consultation
E. Administrative
18. True or False: Video surveillance of the mother and the child in the hospital has proved to be helpful in diagnosing Munchhausen syndrome by proxy.
A. True
B. False
19. True or False: According to International Classification of Diseases (ICD)-10, conduct disorder is not diagnosed if attention deficit hyperactivity disorder (ADHD) symptoms are present.
A. True
B. False
20. ALL of the following may be a medical consequence of taking anabolic steroids EXCEPT:
A. Premature growth stoppage
B. Mood swings
C. Psychosis
D. Development of male sexual characteristics in women
E. Enlarged testicles
21. When is the best time to begin discussing with a child that he or she was adopted?
A. When they are in late elementary school
B. When they are preadolescent
C. When they are adolescent
D. When they ask whether they are adopted
E. Early in life
22. True or False: It is not unethical to use human subjects as a means to accomplish goals of research.
A. True
B. False
23. Posttraumatic stress disorder (PTSD) symptoms in children are more likely to occur when there are additional stressors after the traumatic event including ALL of the following EXCEPT:
A. Dislocation
B. Reexperiencing
C. Loss
D. Separation from significant caregivers
24. In interpersonal psychotherapy for depressed adolescents (IPT-A), just as in the adult version (IPT), there are four identified problem areas upon which the therapy can focus. These four areas include ALL of the following EXCEPT:
A. Conduct issues
B. Grief
C. Interpersonal disputes
D. Role transitions
E. Interpersonal deficits
25. In any given year, how many children under 15 will have epilepsy?
A. One in 100
B. One in 200
C. One in 300
D. One in 500
E. One in 1,000
26. Which of the following sources is the BEST option for a forensic psychiatrist seeking ethical guidelines for a forensic evaluation?
A. American Academy of Child & Adolescent Psychiatry
B. American Academy of Psychiatry and the Law
C. American Psychiatric Association
D. Local and state statutes
E. None of the above
27. Which of the following is NOT TRUE of children with childhood onset schizophrenia?
A. Higher rates of early language impairment
B. Higher rates of early social abnormalities
C. Higher rates of early motor abnormalities
D. Higher rates of cardiac abnormalities
E. All of the above
28. At higher doses, venlafaxine can be associated with the risk of which side effect in a dose-dependent relationship?
A. Urinary retention
B. QTc lengthening
C. Seizures
D. Diastolic hypertension
E. Systolic hypertension
29. Acute depression, intense anger, anxiety about future relationships, and social withdrawal can be characteristic of which group experiencing parental divorce?
A. Preschool children
B. Middle-school children
C. Adolescents
D. Boys
E. Girls
30. Children acquire skills best when:
A. They are under stress or trauma
B. Teachers have few expectations
C. Caregivers present them with tasks that are slightly too difficult to accomplish independently
D. No adult assistance is available
31. Multisystemic therapy, and the home-based service model within which it is delivered, differs from intensive, home-based family preservation programs that employ the crisis intervention model in several ways. These differences include:
A. Individual treatment of each family member
B. Master’s level clinicians supervised by doctoral-level clinicians
C. An assigned family aid who is from the same community as the family
D. Flexibility of theoretical framework
E. Inflexibility of treatment framework
32. In defining the clinical skills essential for infant assessment, three techniques are central. Which of the following is NOT one of the techniques?
A. Basic psychometric statistics
B. Interviewing skills
C. Observation of children and caregiver-child interactions
D. Synthesis of the information gathered during the evaluation
33. A child with deafness is likely to experience delays in ALL of the following areas EXCEPT:
A. Cognitive/academic
B. Social
C. Emotional
D. Gross motor
E. Language
34. Which of the following is a side effect of FK506, an immunosuppressant?
A. Delirium
B. Akinetic mutism
C. Seizure
D. Auditory hallucinations
E. All of the above
35. Which of the following is most likely to be a direct prevention-minded treatment?
A. Family therapy
B. Couples therapy
C. Individual therapy
D. Group therapy
36. A survey conducted by the National Association of State Fire Marshals in the late 1990s determined that children were responsible for roughly how many fires set annually?
A. 1,000
B. 5,000
C. 10,000
D. 25,000
E. 100,000
37. True or False: According to available evidence, group cognitive-behavioral therapy (CBT) involving other family members is as effective as individual CBT.
A. True
B. False
38. As a child psychiatrist, when you receive a subpoena you should provide any documents requested:
A. If the patient (or guardian) who holds the privilege to the health information has consented to its release
B. If there is a court order to release the information
C. As soon as possible, as a court order is presumed in the subpoena
D. After consulting with your attorney
E. A or B
39. True or False: In the group of individuals with mental retardation who have no known “organic” cause, disproportionately more persons are poor, from minority backgrounds, and of low intelligence quotient (IQ) parents.
A. True
B. False
40. True or False: In middle and high school students with ADHD, the inattentive subtype is more common.
A. True
B. False
41. True or False: Boys with gender identity disorder (GID) seem to have an aversion for rough and tumble play.
A. True
B. False
42. Drummond conducted the first systematic follow-up of girls with GID, evaluating 25 girls with a mean age of 8.8 years with a follow-up mean of 23.2 years. What conclusion was found?
A. 3 had persistent GID
B. 6 had persistent GID
C. 9 had persistent GID
D. 12 had persistent GID
E. 15 had persistent GID
43. In contrast to the more clinically oriented, categorical approach, multivariate or dimensional approaches to diagnosis offer ALL of the following advantages in the diagnosis of children and adolescents EXCEPT:
A. They assess various behaviors and dimensions of behavior rather than single pathognomonic features
B. They consider a dichotomous understanding of psychopathology
C. They encompass symptom coding in other than a dichotomous fashion
D. They utilize various rating scales and checklists based on self, parent, and teacher reports, or direct observation
44. ALL of these situations represent the potential establishment of a doctor-patient relationship with its ensuing fiduciary and legal obligations EXCEPT:
A. Responding to a nonpatient’s e-mail with therapeutic advice
B. Therapeutic advice given to an acquaintance at a dinner party
C. Responding to a prospective patient’s e-mail with a referral to someone in the patient’s geographic area
D. Working with the parents of a child in separate sessions without the child
E. Setting up of an appointment with a prospective patient, whom you have never seen, by the office staff for an initial evaluation
45. The Brazelton Neonatal Behavioral Assessment Scale, second edition, a neonatal assessment test, is intended to assess ALL of the following capacities in the neonate EXCEPT:
A. Neurobehavioral organization
B. Adjustment to the ex utero environment
C. Whether the neonate can be weaned from supplemental oxygen
D. Ability to respond to the stress of labor and delivery
46. Prior to initiating a trial of lithium, a child may warrant which of the following?
A. Physical examination
B. Complete blood cell count
C. Electrolyte levels
D. Blood urea nitrogen level
E. All of the above
47. How does parental education relate to children’s school achievement?
A. Directly, through parents’ drive to succeed
B. Directly, through parental evaluation of the teaching environment
C. Indirectly, though reading and providing a warm and supportive environment
D. Indirectly, through parental knowledge of discipline
E. Parental education is not related to children’s school achievement
48. Which of the following statistics would most likely be used in a randomized experimental study?
A. Histogram
B. Correlation
C. Analysis of variance
D. Frequency distribution
E. Multiple regression
49. True or False: Fluoxetine has a metabolite that is psychoactive.
A. True
B. False
50. The concerns of young children about privacy are quite different from older children and adolescents. Which TWO of the following notions of privacy are the first to develop in young children?
A. Informational privacy
B. Territorial privacy
C. Possessional privacy
D. Clique privacy
51. The direct and indirect cost of mental illness for the total population of the United States was estimated in 1996 to be what amount?
A. $350 million
B. $2 billion
C. $780 million
D. $150 billion
E. $12 billion
52. ALL of the following should be considered when a child presents with enuresis EXCEPT:
A. Urinary tract infection
B. Constipation
C. Bladder physiology
D. Thyroid-stimulating hormone between 0.5 and 3.5 mIU/L
53. The period of the day that is the time of greatest risk for youth-on-youth violence during weekdays occurs between:
A. Early morning and the start of school
B. After midnight and early morning
C. After dinner and before midnight
D. End of the school day and early evening
54. Which of the following statements likely represents the better approach to managing an aggressive patient in the emergency room?
A. Firmly but gently say: “You are here for a psychiatric evaluation and you will not leave until it is completed”
B. “You have been here a while, would you like something to eat or drink?”
C. “You will not use vulgar language here”
D. “You have to calm down”
E. “Have you thought about what your mother goes through?”
55. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR, a person with a diagnosis of mild mental retardation would have which of the following?
A. IQ of 85
B. IQ of 75
C. IQ of 60
D. IQ of 45
E. IQ of 30
56. True or False: There have been two randomized, placebo-controlled trials for selective serotonin reuptake inhibitors in the treatment of trichotillomania. At least one trial demonstrated significant improvement over placebo.
A. True
B. False In the following questions, match the defenses commonly exhibited by children in psychodynamic therapy with their appropriate descriptions.
57. Denial
58. Displacement
59. Externalization
60. Reaction formation
61. Repression
62. Suppression
63. Somatization
64. Turning passive to active
A. The exclusion of unacceptable ideas, fantasies, affects, or impulses from consciousness
B. The attribution of internal conflicts to the external environment and a search for external solutions
C. The management of affects and impulses stirred by a passive experience with an active, more powerful “other” by playing out in action or story the active “other’s” role; this includes the process of identification with the aggressor
D. The transfer of tension from drives or affects into disturbances of bodily functions or rhythms
E. The disavowal of intolerable external reality factors or the disavowal of thoughts, feelings, wishes, or needs that is apparent to an observer
F. The conscious effort to control and conceal unacceptable impulses; the exception to the rule that defenses are unconscious processes
G. The transfer of emotions, ideas, or wishes from the original object to a more acceptable substitute
H. The adoption of affects, ideas, or behaviors that are the opposites of impulses harbored either consciously or unconsciously
65. The diagnostic criteria for bulimia include ALL of the following EXCEPT:
A. Recurrent episodes of binge eating
B. A body mass index <3rd percentile
C. Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; excessive exercise
D. These symptoms occur at least twice a week on average and persist for at least 3 months
E. The disturbance does not occur exclusively during episodes of anorexia nervosa
66. When a credible and appropriate referral to mental health services is offered by a pediatrician, how many families follow-up with a mental health clinician?
A. Three-quarters
B. Half
C. Less than half
D. Nearly all
E. Nearly none
67. The first structured parent-report diagnostic interview specifically designed for preschool-age children became available in which year?
A. 1919
B. 1959
C. 1978
D. 1992
E. 2000
68. Which edition of the DSM officially introduced the category of conduct disorder?
A. DSM-I
B. DSM-II
C. DSM-III
D. DSM-IV
E. DSM-IV-TR
69. True or False: Boys have greater innate capability for mathematics than girls do.
A. True
B. False
70. True or False: Medically unexplained physical symptoms and complaints are exceptionally common in children and adolescents.
A. True
B. False
71. There are approximately 7,000 child and adolescent psychiatrists in the United States. What is the estimated number of psychiatrists needed to provide care for seriously psychiatrically ill children and youth?
A. 35,000
B. 30,000
C. 20,000
D. 15,000
E. 5,000
72. “I will never lose any weight because I just ate a cookie” is an example of which of the following cognitive errors:
A. Catastrophizing
B. Overgeneralization
C. Arbitrary inference
D. Absolutism
E. Personalization
73. ALL of the following individual risk factors are associated with the development of disruptive behavior disorders EXCEPT:
A. Depression
B. Below average IQ
C. Difficult temperament
D. Reading problems
E. Language impairment
74. Which of the following represents a well-known epidemiological survey in the United States?
A. The Blue Ridge Mountain Surveys
B. The Great Plains Surveys
C. The California Coast Surveys
D. The Mid-Atlantic Surveys
E. The Great Smoky Mountains Surveys
75. ALL of these are generally sound principles in the management of functional somatic symptoms EXCEPT:
A. When the diagnostic formulation is clear it should be discussed frankly with the patient and family together
B. Once the diagnosis is made additional medical workup should be avoided in the absence of new information or change in clinical status
C. Do not emphasize that functional somatic symptoms are reactions to adversity and stress
D. The judicious use of placebo treatment can help limit doctor shopping
E. Avoid communicating any sense of unease about the diagnosis
76. Which of the following statements is TRUE regarding disorders of communication?
A. A speech disorder is a disruption in oral communication, whereas a language disorder is a disruption in written communication
B. Delays in language development are the least common presenting symptom in preschool children
C. The prevalence estimate of language difficulty is higher for boys than for girls
D. The prevalence of primary language disorders is higher in school age than in preschool children
E. There are several biological markers of specific-language impairments (SLI) that have been identified
77. Trichotillomania was a term first coined:
A. In 2000 BC
B. In 50 BC
C. In the 17th century
D. In the late 19th century
E. In 1956
78. True or False: Sleepwalkers are able to perform complex behaviors, such as leaving the house and taking a drive.
A. True
B. False
79. True or False: A screening measure in speech and language evaluation should focus one area of concern.
A. True
B. False
80. True or False: In infant assessments, age equivalent scores represent an estimate of the chronological age at which the typically developing infant would demonstrate the skills being assessed.
A. True
B. False
81. True or False: One major focus in resilience research is to identify vulnerability and protective factors that modify the negative effects of adverse life circumstances.
A. True
B. False
82. A clinical interview in which the questions are prespecified and the presence or absence of psychopathology lies with the person being interviewed is called what?
A. Semistructured interview
B. Fully structured interview
C. Respondent-based interview
D. Interviewer-based interview
E. Glossary-based interview
83. True or False: In order for the diagnosis of PTSD to be given, there must be one symptom involving reexperiencing the traumatic event.
A. True
B. False
84. An assessment of factors, supports, or modifications enhancing a child’s performance in communication is called what?
A. Norm-referenced assessment
B. Assessment of baseline function
C. Authentic assessment
D. Dynamic assessment
E. Criterion-referenced assessment
85. Which of the following is a Phase II metabolic reaction involved in the biotransformation of drugs?
A. Hydroxylation
B. Conjugation
C. Reduction
D. Hydrolysis
86. A brain state elicited by a threat, a stimulus for which an organism will extend effort to avoid, is called:
A. Fear
B. Anxiety
C. Reverberating limbic loop
D. Reverberating amygdala loop
87. Which of the following describes variables related to peer relations?
A. Secure attachment relationships have not been associated with higher levels of social competence
B. Parental provision of peer play opportunities is associated with more positive peer relationships
C. Peer-interaction skills are not related to the child’s ability to regulate his individual temperament
D. None of the above
E. A to C
88. Which of the following treatment programs has significant empirical support as a behavioral and family systems approach for juvenile offenders?
A. Multisystemic therapy
B. IPT
C. Electroconvulsive therapy
D. Dialectical-behavior therapy
E. CBT
89. What distinguishes obsessive-compulsive disorder (OCD) in children from other psychiatric diagnoses?
A. Children are not that ill
B. Academic achievement is often preserved
C. Peer relationships are not affected
D. Parents are quick to seek treatment
E. There is limited genetic transmission
90. True or False: Synapses change shape as learning proceeds.
A. True
B. False
91. True or False: In comparison with positron emission tomography, single photon emission computed tomography can detect slower kinetic processes in the body because of the longer half-life of its tracers.
A. True
B. False
92. In psychoanalytic thought, the therapist is considered a model for the child’s development of the capacity for self-observation as the therapist acts as an interested and thoughtful observer. Which of the following describes this concept?
A. Transference
B. Observing ego
C. Mechanisms of defense
D. Internalization
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