Test Four
Questions
1. In interpersonal psychotherapy, clinical depression is conceptualized with which of the following THREE components?
A. Symptom formation
B. Gradual exposure
C. Transference
D. Social functioning
E. Personality
2. Which of the following is the principal metabolite of dopamine?
A. Vanillylmandelic acid
B. 3-Methoxy-4-hydroxy-phenyl glycol
C. Homovanillic acid
D. Monoamine oxidase (MAO)
E. L-Dopa
3. When is sexual preference established typically?
A. At birth
B. During middle childhood
C. In adolescence
D. In college
E. By age 3
4. Which of the following treatment programs has significant empirical support for adolescents with depression?
A. Multisystemic therapy
B. Dialectical-behavior therapy
C. Interpersonal psychotherapy (IPT)
D. Electroconvulsive therapy
E. Mentalization-based treatment
5. True or False: In preschool children with attention deficit hyperactivity disorder (ADHD), the inattentive subtype is more common.
A. True
B. False
6. What proportion of children in sub-Saharan Africa are infected with HIV?
A. One-half
B. One-third
C. Three-fourths
D. One-quarter
E. One-fifth
7. Which of the following statements is true?
A. The mean length of sleep for high school students is approximately 12.3 hours a night
B. Adolescents experience an increase in appetite, referred to as developmental hyperphagia, which is seen across species
C. The sleep phase shift seen in adolescence occurs due to earlier night-onset and earlier morning-termination of melatonin secretion
D. Adolescents with sleep problems are less likely to develop learning difficulties or have impaired academic performance
8. What is the range suggested by epidemiological studies for the percentage of children with diagnosable psychiatric disorders?
A. 1% to 2%
B. 3% to 5%
C. 5% to 10%
D. 10% to 20%
E. 20% to 30%
9. In assessing a child who presents with somatic symptoms it is important to:
A. Enlist the patient’s view by making a statement such as “nothing is wrong, so what do you think is wrong?”
B. Refrain from asking about prior treatment experiences, which have likely been alienating or discouraging
C. Try to convey over time how the symptoms are purely psychological
D. Explore timing, context, and social reinforcement of any symptoms
E. See the child before the parents
10. True or False: More than 50% of children who experiment with drugs go on to become regular users.
A. True
B. False
11. Which of the following statements reflects the result of epidemiological findings?
A. Children are more accurate reporters of their externalizing symptoms and parents more accurate reporters of their child’s internalizing symptoms
B. Children are more accurate reporters of their internalizing symptoms and parents more accurate reporters of their child’s externalizing symptoms
C. Children and parents are more accurate reporters of the child’s internalizing symptoms and other adults are better reporters of externalizing symptoms
D. Children and parents are more accurate reporters of the child’s externalizing symptoms and other adults are better reporters of internalizing symptoms
E. None of the above
12. In the multisite study, Treatment of ADHD in Children with Tourette’s syndrome (TACT), 136 children (ages 7-14) with ADHD and a chronic tic disorder were randomized to one of four treatments: clonidine, methylphenidate, clonidine and methylphenidate, or placebo. What was the major result of the study?
A. Clonidine treatment was superior to placebo on teacher and parent measures of ADHD
B. Methylphenidate treatment was superior to placebo on teacher and parent measures of ADHD
C. Combined treatment with clonidine and methylphenidate was superior to placebo on teacher and parent measures of ADHD
D. All three active treatments were superior to placebo on teacher and parent measures of ADHD
E. None of the above
13. True or False: There is a higher rate of psychosis among patients with epilepsy.
A. True
B. False
14. ALL of the following are reasons why scores among tests assessing psychological functioning may vary EXCEPT:
A. The scores on the tests are reported in different units of measurement
B. The tests lack enough easy items to discriminate between low scorers and enough hard items to assess upper levels of ability
C. The tests may not be correlated or only moderately related
D. Scores may improve because of familiarity with the test or test items or prior exposure
E. The tests may have the same content despite differing in their name
15. Speece and Brent concluded that most studies found the age of acquisition of the three concepts of death they reviewed—irreversibility, nonfunctionality, and universality—to occur between:
A. Ages 3 and 5
B. Ages 5 and 7
C. Ages 8 and 10
D. Ages 10 and above
16. What is the minimum acceptable level of reliability for a neuropsychological or psychological test?
A. 95%
B. 85%
C. 80%
D. 75%
E. 60%
17. Which of the following is true of acute otitis media and its sequelae?
A. It affects about 10% of children ages 6 to 24 months
B. It is very uncommon after age 6 years
C. About 10% of children with acute otitis media have a middle ear effusion 1 month after an episode of infection
D. Surgical insertion of primary ear care tubes is indicated when middle ear effusion associated hearing loss is greater than 5 dB
E. All of the above
18. ALL of the following represent the community-based system-of-care principles outlined by the Child and Adolescent Service System Program initiative, EXCEPT:
A. Treatment of children who are seriously emotionally disturbed, as exhibited by the presence of an Axis I diagnosis under the Diagnostic and Statistical Manual of Mental Disorders (DSM)
B. Treatment of children who are seriously emotionally disturbed, as exhibited by the child’s inability to function in at least one of his or her life domains (school, home, society)
C. Access to a comprehensive array of services
D. Treatment in the least restrictive environment possible
E. Focus on access to mental health expertise rather than reliance on community resources
19. In the 1980s, which federal program assisted all 50 states in the development of an infrastructure for publicly funded community-based services?
A. The Community Health Act
B. The Help, Not Hate, Your Neighbor Act
C. The Homer Simpson Donut Act
D. The Child and Adolescent Service System Program
E. The Child and Adolescent Mental Health Act
20. Which of the following terms defines the patterns of behaviors, acquired and transferred over time, which prescribe the norms, customs, roles, and values inherent in political, economic, religious, and social aspects of family life?
A. Culture
B. Ethnicity
C. Cultural context
D. Cultural identity
E. Cultural mask
21. The diagnosis of which of the following was the first major clinical application of diffusion tensor imaging, a relatively new neuroimaging modality?
A. Bipolar disorder
B. Glial brain tumors
C. Childhood autism
D. Temporal lobe seizures
E. Ischemic stroke
22. True or False: When a child learns two languages, each language is represented in its own language center.
A. True
B. False
23. According to DSM-IV-TR, a person with a diagnosis of moderate mental retardation would have which of the following.
A. An IQ of 90
B. An IQ of 75
C. An IQ of 60
D. An IQ of 45
E. An IQ of 30
24. True or False: An estimate for the prevalence of a condition can be obtained by the proportion of subjects who score significantly above the cutoff on a screening phase instrument.
A. True
B. False
25. Each of the following has randomized controlled trials supporting its efficacy for anxiety disorders in children EXCEPT:
A. Fluvoxamine
B. Clonazepam
C. Fluoxetine
D. Sertraline
E. Paroxetine
26. The Pediatric OCD (Obsessive-Compulsive Disorder) Treatment Study (POTS), the largest pediatric trial of cognitive-behavioral therapy (CBT) for OCD to date, found which of the following results with regard to efficacy?
A. CBT + SSRI > CBT alone > SSRI alone
B. CBT + SSRI > SSRI alone > CBT alone
C. CBT + SSRI > CBT alone = SSRI alone
D. CBT + SSRI = SSRI alone > CBT alone
E. CBT alone > CBT + SSRI > SSRI alone
27. In a review of 22 studies on fire behavior in children and adolescents, researchers found that 82% of identified firesetters were male, and the average age of these children was:
A. 5 years
B. 10 years
C. 13 years
D. 16 years
E. 18 years
28. In infant and toddler assessments, the TWO most common types of scoring used to provide a representation of the child’s performance relative to other children are:
A. Standard scores
B. t-scores
C. Age equivalent scores
D. Deviation scores
E. z-scores
29. An assessment of the adaptive behavior of a child or adolescent patient provides information about which of the following?
A. What potential of doing the child has in day-to-day life
B. What the child is capable of doing in day-to-day life
C. What the child actually does in day-to-day life
D. How adaptive the child can be in the face of adverse circumstances
E. How resilient the child can be in the face of adverse circumstances
30. Which of the following accounts for most in the success of solid organ transplantations?
A. Increased health insurance coverage for transplantations
B. Increased psychosocial supports for parents allowing for better management
C. The introduction of cyclosporine in 1980
D. The improvement of sutures
E. More pleasant healthcare staff
31. True or False: Linkage analysis assesses the probability that a given phenotype and a particular genetic marker (or series of markers) are transmitted together from one generation to another.
A. True
B. False
32. A number of practical behavioral treatments can be implemented for patients with ADHD even upon first contact, which include ALL of the following EXCEPT:
A. Star charts for target behaviors
B. Clearly established house rules
C. Written or pictorial instructions
D. Gradual exposure to the offending stimulus
E. Contingent rewards for accomplishing tasks
33. Which of the following best characterizes the epidemiology of suicide among males 15 to 24 years old?
A. A rapid rise began in the 1960s, peaked in 1977, and has declined since
B. A rapid rise began in the 1980s and continues
C. A decline since the 1950s
D. Intermittent peaks every 10 to 20 years corresponding with economic recessions over the past five decades
E. None of the above
34. ALL of the following are true of a child by age 5 EXCEPT:
A. Interested in sexual differences
B. Enjoys the company of other children
C. Engages in interactional play with rules
D. Names and copies a triangle
E. Judges peers by their qualities
35. Which of the following statistics would most likely be used in associational research?
A. Histogram
B. Correlation
C. t-test
D. Analysis of variance
E. Frequency distribution
36. Regarding the etiology of Asperger’s disorder, which of the following statements is TRUE?
A. In some cases, up to one-third of immediate family members have significant social difficulties
B. There is no associated familial relationship
C. There is a decreased risk for depression and anxiety in family members
D. Autism and Asperger’s disorder are not etiologically related
E. Females are more affected than males
37. Which of the following is the appropriate measure of central tendency for ordinallevel data (i.e., ordered data but not normally distributed)?
A. Mean
B. Median
C. Mode
D. None of the above
38. Which of the following is the most compelling theory for enuresis?
A. Children with enuresis have difficulty concentrating the urine that they produce at night
B. Children with enuresis are scared of their caregivers
C. Children with enuresis do not like waking up to go to the bathroom
D. Children with enuresis have the regressive desire to be in diapers
E. None of the above
39. Around what age does pretend play begin?
A. 18 months
B. 24 months
C. 4 years
D. 5 years
E. 6 years
40. What type of variable interacts with an independent variable to cause the change in the dependent variable?
A. Active independent variable
B. Moderator variable
C. Extraneous variable
D. Attribute independent variable
E. Mediator variable
41. True or False: A semistructured clinical interview gives the interviewer latitude in the specific form of questions used.
A. True
B. False
42. Some studies document that ALL of the following factors are predictive of chronic delinquency in youth EXCEPT:
A. Low socioeconomic status
B. Poor academic performance
C. Convicted parents
D. Low intelligence
E. Poor parental childrearing
43. True or False: A therapeutic group should avoid containing only one representative of any critical attribute or category, including race, religion, ethnicity, gender, or level of diagnostic severity.
A. True
B. False
44. The most frequent comorbidities with oppositional defiant disorder and conduct disorder are ALL of the following EXCEPT:
A. ADHD
B. Major depressive disorder
C. Substance abuse
D. Psychotic disorder, not otherwise specified
45. Which of the following medications has the single highest association with incidental suicidal ideation?
A. Paroxetine
B. Fluoxetine
C. Bupropion
D. Imipramine
E. Venlafaxine
46. What is the prevalence of anxiety disorders in children and adolescents?
A. 4% to 20%
B. 1% to 10%
C. 5% to 50%
D. Less than 3%
47. When a clinician interviews a child with deafness, what is a common response on the clinician’s part?
A. Exaggeration of positive affect to engage child
B. Feelings of dominance
C. Intellectualization of affect
D. Rationalization
E. Speaking in a soft voice
48. What percentage of affected individuals with neurofibromatosis have an intellectual disability?
A. 15%
B. 33%
C. 50%
D. 66%
E. 90%
49. True or False: One historical development that fueled mental health professionals’ interest in social policy was the recognition that children develop within the social context.
A. True
B. False
50. Child psychiatric epidemiology started in the mid-1960s with:
A. Dutch population surveys
B. Scandinavian school surveys
C. The Danish juvenile delinquency registry
D. British Isle of Wight surveys
E. None of the above
51. For very young children showing some early symptoms of a disorder, which diagnostic system is considered by some to be more appropriate than the DSM?
A. Diagnostic System Zero to Three, Revised
B. Diagnostic System for Infants and Toddlers
C. Diagnostic and Statistical Manual for Mental Disorders, which begin in infancy
D. Diagnostic and Statistical Manual for Emotional or Behavioral Impairments, which begin in infancy
E. International Classification of Diseases
52. In psychoanalytic thought, object relations theories use a metapsychology organized around the concept of which of the following?
A. Mechanisms of defense
B. The tripartite model
C. Freud’s dual drive theory
D. Internal representational world
E. Erikson’s stages of development
53. True or False: The incidence of seizure disorders in children with autism increases through adolescence.
A. True
B. False
54. True or False: The best predictor of longer term consequences for the psychosocial adjustment of children of divorce is their initial response to the divorce.
A. True
B. False
55. Which of the following is the most widely used measure of the development of infants and toddlers in both clinical and research settings?
A. Bayley Scales of Infant Development—II
B. Mullen Scales of Early Learning
C. Battelle Developmental Inventory
D. Brigance Diagnostic Inventory of Early Development—Revised
E. Early Learning Accomplishment Profile for Infants
56. What did both of the Surgeon General’s Conference on Children’s Mental Health in 2000 and the President’s New Freedom Commission on Mental Health in 2003 acknowledge regarding child and adolescent psychiatry?
A. The workforce of child psychiatrists requires more training
B. The shortage of child psychiatrists is a national crisis
C. Child psychiatrists should adhere to a multisystemic model
D. The workforce of child psychiatrists is overworked and underpaid
E. Child psychiatry should be included in mental health parity for insurance reimbursement
57. Taking information out of context and ignoring relevant details describes which of the following cognitive errors?
A. Arbitrary inference
B. Selective abstraction
C. Ignoring evidence
D. Overgeneralization
E. Absolutism
58. ALL of the following symptoms are common presentations of Munchhausen syndrome by proxy in Rosenberg and Sheridan’s reviews EXCEPT:
A. Diarrhea
B. Fracture
C. Fever
D. Seizure
E. Apnea
59. Which of the following is true in providing child psychiatric services as part of a consultative service to early care and education programs?
A. The child can be observed in a natural setting, which includes peer interactions
B. The clinician must focus solely on classroom-specific reduction of particular behaviors
C. The clinician can observe the child without the need for collateral information from parents or other caregivers
D. Children generally behave similarly at home and in child care programs
60. Which of the following best characterizes the prognosis in pediatric OCD?
A. 60% of children with OCD will improve such that they no longer meet criteria
B. 40% of children with OCD will recover
C. 60% of children with OCD will continue to meet criteria for the disorder or have subthreshold symptoms
D. None of the above
E. A, B, and C
61. In the biopsychosocial model of formulation, which of the following components belong in the psychological realm?
A. Inborn temperament
B. Constitution
C. Emotional development
D. Family constellation
E. Intelligence
62. Some psychotropic medications follow zero-order (or nonlinear) kinetics, best described by which of the following statements?
A. The amount of drug eliminated is variable regardless of plasma level
B. The amount of drug eliminated per unit of time is fixed regardless of the plasma level
C. The amount of drug eliminated is proportional to the CYP 450 system being utilized
D. The amount of drug eliminated is proportional to its amount circulating in the bloodstream
63. The following examples would lead you to consider which diagnosis? Running for class president, despite having no friends; early-afternoon anxiety attached with persecutory delusions, followed by successful participation in a soccer game in the afternoon; chronic complaints of boredom; describing teacher as “girlfriend.”
A. ADHD
B. Somatization disorder
C. Borderline personality disorder
D. Phase of life problem
E. No diagnosis
64. True or False: In psychoanalytic thought, ego functions conceptualize the inner voice of conscience, which maintains ideals and values, observing and criticizing any shortfall of the self.
A. True
B. False
65. Although ethical codes in medicine date back to the fifth century BC, they received scant attention in the modern medical literature until the 1990s. Greater awareness and interest in medical ethics can be attributed to ALL of the following EXCEPT:
A. An increasingly consumer-centered approach to medicine with its emphasis on patient rights
B. High-technology medical developments that offer a multitude of choices yet also introduce the need for health care rationing and decisions about prolonging life
C. An increasingly diverse populace with multiple moral codes in the postmodern era
D. Changes in the delivery of health care that has altered the autonomy of the physician and challenges traditional ethical codes
66. The five AREST principles followed by mental health professionals to help children and families who are victims of a catastrophe include ALL of the following EXCEPT:
A. Anticipate
B. Redifferentiate
C. Empower
D. Supervise and assess
E. Terminate
F. Treat
67. ALL of the following are Phase I metabolic reactions involved in the biotransformation of drugs EXCEPT:
A. Hydroxylation
B. Conjugation
C. Reduction
D. Hydrolysis
68. Heavy use of cannabis can be detected in the urine for how long?
A. 1 day
B. 3 days
C. 5 days
D. 7 days
E. 10 days
69. True or False: Paroxetine can cause birth defects.
A. True
B. False
70. What is likely the most common preoccupation in adolescents with body dysmorphic disorder?
A. Hair
B. Teeth
C. Legs
D. Skin
E. Eyes
71. ALL of the following statements about the diagnosis of reactive attachment disorder (RAD) are true EXCEPT:
A. The identified patient must have a developmental age of at least 9 months
B. Pervasive development disorder is an exclusion criterion according to DSM
C. Hypervigilance is a common symptom for both posttraumatic stress disorder (PTSD) and RAD
D. Large head circumference may be conducive to the diagnosis of RAD with autisticlike features
E. Failure to thrive is not a criterion in the diagnosis of RAD
72. Which of the following is the normal milestone for a child’s ability to use a cup to drink?
A. 18 months
B. 15 months
C. 12 months
D. 10 months
E. 6 months
73. Reassessment and contemporaneous documentation of the need for continuation of restraints must be done how often for children ages 9 to 17?
A. Every half hour
B. Every hour
C. Every one and a half hours
D. Every two hours
E. Whenever the child is calm enough for a reassessment
74. A landmark study by Avshalom Caspi and colleagues showed reduced likelihood of antisocial behavior in maltreated children with the presence of a genotype conferring what?
A. High levels of a serotonin transporter
B. Low levels of a serotonin transporter
C. High levels of prefrontal dopamine receptors
D. High levels of MAO A enzyme
E. Low levels of MAO A enzyme
75. ADHD has a high rate of comorbid psychiatric disorders including ALL of the following EXCEPT:
A. Oppositional defiant disorder
B. Conduct disorder
C. Anxiety disorder
D. Learning disorder
E. Dysthymic disorder
76. The incidence of maternal depression can lead to disengaged parenting practices resulting in poor development. In one study, what was the incidence of depression in single mothers with young children?
A. Twice the national average
B. Three times the national average
C. Equal to the national average
D. Less than the national average
77. Atomoxetine has ALL of the following black box warnings EXCEPT:
A. Hepatitis
B. Increased aggression
C. Increased hostility
D. Increased suicidal thinking
E. Seizures
78. Zucker and Bradley summarized data from six follow-up reports on 55 boys with gender identity disorder. Which of the following conclusions from this study is accurate?
A. 90% were classified as homosexual
B. 30% were classified as heterosexual
C. 80% were classified as homosexual
D. 50% were classified as heterosexual
E. None of the above
79. Each of the following answer options are intellectual considerations associated with cancer, using Chesler and Barbarin’s model of stress and coping, EXCEPT:
A. How do children become aware that they have a serious situation and that they have a condition about which they ought to worry?
B. What conclusions do children draw from the many verbal and nonverbal cues displayed by parents, relatives, and medical staff?
C. What do children make of the rapidity with which family members will come from afar to visit?
D. How are siblings provided information so that they are not left to imagining the worst?
E. How will children with cancer do their schoolwork?
80. True or False: In official diagnostic systems such as the DSM-IV, etiological factors are included in classification.
A. True
B. False
81. True or False: A stepparent can obtain custody in place of a natural parent.
A. True
B. False
82. True or False: Boys with gender identity disorder have more externalizing than internalizing symptoms.
A. True
B. False
83. Which of the following large studies evaluated the long-term treatment with methylphenidate (and other medications to a lesser degree) on 576 children with ADHD?
A. Pediatric OCD Treatment Study
B. Multimodal Treatment Study of Children with ADHD (MTA) Study
C. Treatment for Adolescents with Depression Study (TADS)
D. Children and Adolescents Anxiety Multimodal Treatment Study
E. Research Units on Pediatric Psychopharmacology
84. True or False: In forensic evaluations, the practice of accepting retainer fees or contingency fees is equally ethical.
A. True
B. False
85. What is a common sleep disorder in adolescence?
A. Circadian rhythm sleep disorder
B. Narcolepsy
C. Somnambulism
D. Night terrors
86. Fonagy and colleagues assert that security of attachment is linked to what?
A. The caregiver’s soothing statements
B. The caregiver’s affective attunement
C. The caregiver’s mental health
D. The caregiver’s mentalizing capacity
E. The caregiver’s affective stability
87. Rather than viewing obsessions and compulsions as separate entities, several investigators consider that OCD might be better viewed as consisting of four or more subtypes. In one model, the four subtypes are ALL of the following EXCEPT:
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