Test Seven
Questions
1. An infant or toddler developmental test may be useful for ALL of the following purposes EXCEPT:
A. Diagnosis
B. Assessment of intelligence quotient (IQ)
C. Screening
D. Early intervention planning
2. Investigators cured a child’s rabbit phobia by systematically exposing the child to a rabbit while pairing the exposures with the incompatible response of eating food. This was one of the earliest demonstrations of which of the following techniques?
A. Counter conditioning
B. Operant conditioning
C. Systematic desensitization
D. Aversive counterconditioning
E. Covert sensitization
3. True or False: Disruptive disorders accompanied by Attention Deficit Hyperactivity Disorder (ADHD) feature much more aggression than when ADHD is absent.
A. True
B. False
4. True or False: Medications may be administered in an inpatient unit in emergency circumstances, but permission must be obtained by the patient’s guardian for standing medications.
A. True
B. False
5. What are the dizygotic twin concordance rates for autism spectrum disorders ?
A. 3% to 15%
B. 16% to 25%
C. 33% to 45%
D. 50% to 65%
E. 70% to 85%
6. Children with a medical illness who are in the early stages of Piaget’s concrete operations:
A. May identify themselves as bringing about their own illness as a punishment for misdeeds
B. May use abstract reasoning to help them understand their bodies’ internal structure
C. May suck their thumbs
D. Cry with the approach of an unknown clinical provider
7. Raising a child with cancer may alter a parent’s ability to parent effectively. ALL of these are typical issues EXCEPT:
A. Over protectiveness
B. Difficulty with maintaining consistent discipline
C. Difficulty expressing appropriate anger toward the child
D. Concerns about spoiling the child
E. Excessive focus on the here and now rather than the future
8. True or False: Compared to a group of children who had committed murder, children ages 10 through 17 who set fires were found to have lower rates of previous violent offenses.
A. True
B. False
9. A major conference held in 1944 under the auspices of the Commonwealth Fund provided a standard set of skill areas that should be mastered by psychiatrists who treat children and their families, which included ALL of the following EXCEPT:
A. Heredity and genetics
B. Growth and development
C. Psychodynamics
D. Working with parents
E. Community organizations
F. Administration
10. What is the most frequent complaint made about child and adolescent psychiatrists by pediatricians?
A. Too deliberative and cogitative without sufficient practical action taken
B. Prescribe psychotropics too readily
C. Too talkative during calls to the pediatrician’s office
D. Do not seem to agree as a field on diagnostic entities
E. Poor communication
In the following questions, match the terms to their proper definition:
11. Face validity
12. Predictive validity
13. Construct validity
A. Whether the category has meaning in terms of what it purports to assess
B. A judgment about whether the description of a category appears to represent the diagnostic construct reasonably
C. Whether some aspect of subsequent course or response to treatment is predicted
14. True or False: Aggressive behaviors such as hitting, biting, and smashing objects are common in 4- to 8-year olds and decrease with age.
A. True
B. False
15. True or False: A child’s narrative abilities are known to be highly related to success in the school curriculum.
A. True
B. False
16. Which person or group is often forgotten when a child is diagnosed with cancer or other serious medical illness?
A. Grandparents
B. Siblings
C. The child himself
D. Peers
E. Pets
17. True or False: Epilepsy in children has a lower association with psychiatric disorders than does diabetes, another chronic condition.
A. True
B. False
18. ALL of the following have been observed in boys with gender identity disorder, EXCEPT:
A. Increased rates of left-handedness
B. Increased rates of blue eyes
C. Increased sibling ratio of brothers to sisters
D. Late birth order
E. Decreased rates of activity level
19. An adolescent who uses substances is most likely to present with which of the following stages of change according to the Motivational Interviewing model?
A. Precontemplative
B. Contemplative
C. Preparation
D. Maintenance
E. Action
20. Why does carbamazepine, compared with most other psychotropic medications, generally take a greater time to reach steady-state concentration?
A. It is dosed initially at lower amounts
B. It induces its own metabolism
C. Grapefruit juice inhibits its metabolism
D. Its plasma half-life is shorter
E. It takes six or seven half-lives to achieve steady-state concentration
21. A notable finding of psychological autopsy studies is that approximately what percentage of children and adolescents who committed suicide had a psychiatric disorder?
A. 10%
B. 30%
C. 50%
D. 70%
E. 90%
22. A chart review by Eland of 25 children undergoing major surgery—traumatic amputation, nephrectomy, cleft palate repair—in the 1970s, found what number of children received NO postoperative analgesia care at any point in their hospital stay?
A. 0
B. 4
C. 7
D. 10
E. 13
23. True or False: Forensic psychiatry constitutes the practice of medicine.
A. True
B. False
24. Which of the following statements regarding prevalence of tic disorders is TRUE?
A. Transient tics are rare in children
B. Girls are more affected than boys by a ratio of 2:1
C. Estimates of the prevalence of Tourette’s syndrome are narrow in range
D. Studies estimate the prevalence of tic disorders in school age children is between 4% and 24%
E. Estimates of the prevalence of Tourette’s syndrome in studies using Diagnostic and Statistical Manual of Mental Disorders (DSM)-III criteria show higher rates than in studies using DSM-IV-TR criteria
25. True or False: Class activation programs are an example of a type of school-based intervention after disasters.
A. True
B. False
26. An example of parallel play is
A. One child playing with a shovel while another child plays with a truck
B. Two children playing a board game together
C. One child copying another child’s drawing
D. Two children playing separately in a sandbox but in close proximity to one another
E. One child following an older child’s example
27. Rapid eye movement never follows a period of wakefulness EXCEPT:
A. When narcolepsy is present
B. In an infant
C. After hypnotic drug use
D. A and B
E. A and C
28. To meet the criteria for enuresis a child must display a frequency and duration of:
A. At least two times per week for 3 months’ duration
B. At least three times per week for 3 months’ duration
C. At least two times per week for 6 months’ duration
D. At least three times per week for 3 months’ duration
29. Problems with planning and organizing can greatly affect which academic skill?
A. Reading and spelling
B. Mathematics
C. Written language
D. Oral language
E. None of the above
30. According to the US Department of Education, the term “specific learning disability” includes children who have learning problems from ALL of the following conditions EXCEPT:
A. Developmental aphasia
B. Dyslexia
C. Mental retardation
D. Minimal brain dysfunction
E. Perceptual handicaps
31. Which of the following is true about the prevalence of ever having had sexual intercourse?
A. It is about 90% by the ninth grade
B. It is unrelated to gender or ethnicity
C. It is about two-thirds by the twelfth grade
D. It has never been studied
32. ALL of the following laboratory tests should be considered for a child or adolescent patient with an eating disorder EXCEPT:
A. Complete blood cell count
B. Electrocardiogram
C. Throat culture
D. Electrolytes
33. Comorbidities associated with obesity in children and adolescents include ALL of the following EXCEPT:
A. Hypertension
B. Nocturnal enuresis
C. Type 2 diabetes
D. Pseudotumor cerebri
E. All of the above are associated with obesity
34. What is the estimated heritability of ADHD as derived from extensive data gathered from twin and adoption studies over the past 30 years?
A. 5%
B. 15%
C. 25%
D. 55%
E. 75%
35. In one psychoanalytic approach to the tripartite model, the functions of the ego are divided into basic categories, which include ALL of the following EXCEPT:
A. Reality testing
B. Object relations
C. Regulation of affect
D. Defensive activity
E. Acting as conscience
36. In developmental psychopathology research, risk is defined in terms of statistical probabilities. Accordingly, what is the BEST definition of a high-risk condition?
A. A condition that results in significant delay during critical periods of development
B. A condition that prolongs the trajectory of development leading to immature behavior at older ages
C. A condition that carries high odds for measured maladjustment in critical domains
D. Risk factors such as community violence, domestic violence, and physical or sexual abuse
E. All of the above
37. Most typically, prepubertal depression has a set of risk factors and course similar to conduct disorder, which includes ALL of the following attributes EXCEPT:
A. Family discord
B. Increased risk of antisocial disorder
C. Depression in adult life
D. Parental substance abuse
E. Parental criminality
38. Which one of the following was the most common comorbid condition seen during the National Institute of Mental Health screening for childhood onset schizophrenia (COS)?
A. Depression
B. ADHD
C. Obsessive-compulsive disorder (OCD)
D. Bipolar disorder
E. Alcohol abuse
39. Which of the following is the only imaging modality available that provides a quantitative index of intraneuronal current flow?
A. Electroencephalography
B. Magnetoencephalography
C. Diffusion tensor imaging
D. Functional magnetic resonance imaging
E. Single photon emission computed tomography
40. Which of the following is the BEST definition of resilience?
A. A phenomenon or process reflecting relatively positive adaptation despite experiences of significant adversity or trauma
B. A phenomenon or process that plots the trajectory of productivity and success in life despite overwhelming odds
C. A phenomenon or process that allows certain individuals to be immune to dysthymia, depression or other internalizing disorders despite adversity
D. A phenomenon or process that nurtures a proactive approach to life’s problems
E. None of the above
41. Interpersonal psychotherapy (IPT) is a brief, time-limited psychotherapy developed in the late 1960s for the treatment of what type of patient?
A. Bipolar outpatients
B. Psychotic inpatients
C. Depressed outpatients
D. Bipolar inpatients
E. Depressed inpatients
42. The diagnosis of trichotillomania requires both behavioral and psychological components, including tension prior to hair pulling and gratification during or after it. Hair pulling without psychological components has what prevalence in the general population?
A. 1%
B. 4%
C. 8%
D. 12%
E. 16%
43. What is one factor that delayed the development of in-home, community, and family-based services?
A. The psychoanalytic movement
B. The lack of trained clinicians in family theory
C. McCarthyism and the fear that community-based services represented socialist principles
D. The lack of a federalist approach
E. The increased availability of health insurance, which did not pay for community-based services
44. The most up-to-date current legal principle guiding child custody and placement in divorce as described in the Uniform Marriage and Divorce Act is:
A. The tender years doctrine
B. Psychological parent determination
C. Best interests of the child
D. DNA verification
E. Assignment and weighing of a number of genetic and psychosocial risk and protective factors
45. Of the following, which one is most likely to be considered a “normal dysfluency” which, by itself, would not be considered a red flag for persistent stuttering:
A. Repetition of a sound
B. Repetition of a syllable
C. Repetition of a word
D. Silent blocks
E. Sound prolongations
46. Over the last decade, as a proportion of all pediatric emergency visits, the number of child psychiatric emergencies presenting to hospitals has:
A. Increased
B. Remained the same
C. Decreased
D. Increased for adolescents and decreased for children
E. Increased for children and decreased for adolescents
47. How many symptoms from each domain (inattentive and hyperactive-impulsive) are required to meet the DSM-IV criterion for criterion for ADHD, Combined Type?
A. 2 and 4
B. 4 and 4
C. 6 and 6
D. 5 and 7
E. 8 and 8
48. What is the suspected prevalence for Gender Identity Disorder?
A. 1% or less
B. 2%
C. 3%
D. 4%
E. 5%
49. Which of the following is the normal milestone for speech development regarding a child’s ability to speak his first words?
A. 24 months
B. 18 months
C. 14 months
D. 12 months
E. 8 months
50. Neuropsychological investigations of OCD suggest impairment is strongest for ALL of the following EXCEPT:
A. Executive functions of set shifting and motor inhibition
B. Nonverbal memory
C. Visual motor integration
D. Visual-spatial memory
E. Auditory memory
51. Which cluster of symptoms of posttraumatic stress disorder (PTSD) is the LEAST frequently endorsed in young children?
A. Avoidance cluster
B. Reexperiencing cluster
C. Hyperarousal cluster
D. None of the above
52. Which of the following is NOT TRUE of fragile X syndrome?
A. All males who carry the abnormal gene are mentally retarded
B. The disorder is the second most common cause of mental retardation
C. Clinical symptoms include facial abnormalities
D. Abnormal speech patterns are present in a majority of cases
E. The disorder is a result of a triple repeat expansion
53. True or False: Most abused children develop borderline personality disorder in adulthood.
A. True
B. False
54. True or False: Compared to the low potency antipsychotics, haloperidol is much less likely to cause extrapyramidal symptoms.
A. True
B. False
55. The Accreditation Council for Graduate Medical Education is responsible for setting training requirements for all specialties and subspecialties that have been approved by the American Board of Medical Specialties and consists of representatives from ALL of the following organizations EXCEPT:
A. American Medical Association
B. Association of American Medical Colleges
C. American Hospital Association
D. Council of Medical Specialty Societies
E. American Psychiatric Association
56. The “three-way interaction” model proposed by Kaufman to explain the elevated risk for depression among abused children includes: maltreatment, the 5-HTTLPR, genotype, and:
A. Monoamine oxidase-A genotype
B. Monoamine oxidase-B genotype
C. Alcohol dehydrogenase genotype
D. Brain-derived neurotrophic factor genotype
E. Small hippocampal volume
57. True or False: The age at which an infant begins to walk is a good predictor of developmental outcomes.
A. True
B. False
58. A child with absence or petit mal seizures may have:
A. Abnormal glial cell architecture in the limbic system
B. Inconsistent frequency but typical spike and wave morphology
C. Abnormal background with 5 Hz spike and wave morphology
D. A normal background and with onset of hyperventilation 3 Hz spike and wave morphology
59. True or False: Interpersonal conflicts with parents are the most common antecedent to adolescent suicide attempts.
A. True
B. False
60. Drugs that are basic in pH in the general circulation, when bound to plasma protein, bind to which molecule?
A. Very low-density lipoproteins
B. Alpha-1 acid glycoprotein
C. Platelets
D. Albumin
E. High-density lipoprotein
61. What is the prevalence of OCD in adults?
A. 0.5% to 3%
B. 1% to 5%
C. 2% to 8%
D. 5% to 10%
E. Over 10%
62. What is a potential known side effect of oxcarbazepine?
A. Elevated creatinine
B. Decreased urine output
C. Enuresis
D. Nightmares
E. Hyponatremia
63. ALL of the following are programs that have been shown to prevent behavioral disorders EXCEPT:
A. The Incredible Years
B. Good Behavior Game
C. Nurse-Family Partnership
D. Stop and Think
64. Which of the following statements is FALSE?
A. Persons with severe mental retardation come to diagnosis at a younger age than those with mild mental retardation
B. Persons with severe mental retardation more frequently have related medical conditions than those with mild mental retardation
C. Persons with mild mental retardation are usually of typical appearance without dysmorphic features
D. Persons with mild mental retardation have increased rates of psychopathology relative to nondisabled populations
E. Persons with mild mental retardation have a wider range of behavioral and psychiatric problems relative to those in normative samples
65. By the end of fifth grade, which of the following is typical?
A. Creative play is imitative
B. Egocentricity
C. Secondary sexual changes
D. Mild synkinesis
E. Self-referential drawings
66. True or False: Communication disorders in children are frequently associated with a variety of conditions, deficits, or disorders.
A. True
B. False
67. True or False: The legal term of privilege refers only to the patient’s right to bar disclosure of information obtained during treatment in judicial or quasijudicial proceedings.
A. True
B. False
68. Concrete operations include the following:
A. Conservation
B. Classification
C. Centration
D. A and B
E. None of the above
69. Which of the following approaches were used that led to the determination of a lack of an association between autism and the measles, mumps, and rubella vaccine?
A. Patient registry
B. Cohort
C. Case-control
D. Ecological
E. All of the above
70. True or False: In the percentile score format of reporting psychological and neuropsychological test scores, the scores between the 25th and 75th percentile are all within the average range.
A. True
B. False
71. Which of the following rare but serious adverse effects is associated with trazodone, a potent 5HT2a antagonist?
A. Priapism
B. Hepatoxicity
C. Neutropenia
D. Renal insufficiency
E. Pulmonary edema
72. Genetic association studies most closely resemble
A. Cohort studies
B. Ecological studies
C. Naturalistic studies
D. Case-control studies
73. What is content validity?
A. The extent to which an instrument is representative of the universe of empirical indicators that are related to the concept measured
B. The most empirical form of validity, which allows an index to be compared to an independent external criterion thought to assess the same concept
C. The extent to which individual items or measures intercorrelate or group together to produce derived higher order constructs
D. None of the above
74. Behavioral differences in children with autism may include ALL of the following EXCEPT:
A. Stereotypies such as hand flapping and toe walking
B. Desire for variety in the environment
C. Preoccupation with inanimate objects or parts of objects
D. Sensitivity to nonspeech sounds
E. Attachment to unusual objects
75. Which of the following statements best describes objective countertransference as termed by Winnicott?
A. Natural reactions to a patient’s provocative behavior
B. Intrapsychic conflicts stirred in the therapist by the patient
C. Reactions to the patient arising from the therapist’s unresolved conflicts
D. Reactions in the patient toward the therapist as earlier, important relationships are reactivated and projected upon the therapist
76. What is the population-based prevalence of encopresis?
A. 4% of 5- to 6-year olds
B. 10% of 5- to 6-year olds
C. 1.5% of 11- to 12-year olds
D. A and C
E. B and C
77. Which edition of the DSM for mental disorders first came out with a multiaxial diagnostic classification?
A. DSM-I
B. DSM-II
C. DSM-III
D. DSM-III-R
E. DSM-IV
78. True or False: Meta-analysis reviews of clinical trials involving therapeutic interventions for adolescent youth provide a better interpretation of data if the possible confounding factor of large numbers of adolescent girls enrolled in studies is considered and addressed.
A. True
B. False
79. True or False: All children with Munchhausen syndrome by proxy are sensitive to separation from their perpetrators.
A. True
B. False
80. Statistical power describes the probability of which scenario in null hypothesis testing?
A. To reject the null hypothesis when in fact it is true
B. To not reject the null hypothesis when it is false
C. To not reject the null hypothesis when it is true
D. To reject the null hypothesis when it is false
E. None of the above
81. Which one of the following is true of children with both deafness and blindness?
A. Approximately 3% to 6% have Usher’s syndrome
B. 75% have intellectual impairment
C. Rubella accounts for 75% of cases
D. Brain abnormalities are found in 75% of children
E. All of the above
82. Self-regulatory disturbances in an infant or toddler can compromise their normal development. Which of the following is NOT an example of a disturbance in self-regulation?
A. Sleep disturbance
B. Apathetic, withdrawn, and no expression of affect
C. Excessive crying or irritability
D. Low frustration tolerance
E. Self-stimulatory or unusual movements such as head banging
83. Which treatment has the best available evidence in increasing cognitive, communicative, and social skills in autism?
A. Psychotherapy
B. Family therapy
C. Social skills group
D. Psychopharmacology
E. Educational intervention
84. True or False: Bupropion can be effective in children and adolescents with ADHD.
A. True
B. False
85. During the termination phase of interpersonal psychotherapy for depressed adolescents (IPT-A), the tasks of this phase include ALL of the following EXCEPT:
A. Clarification of warning symptoms of future depressive episodes
B. Identification of successful strategies that were used in therapy
C. Generalization of skills to future situations
D. Discussion of the links between thoughts and emotions
E. Emphasis on mastery of new interpersonal skills
86. ALL of the following confers risk for or is associated with suicidal behaviors EXCEPT:
A. Physical abuse
B. Sexual abuse
C. Homosexual orientation of females
D. Family adversity
E. Low levels of cerebral spinal fluid 5-hydroxyindoleacetic acid in adolescents
87. The correlation coefficient, r, often used to evaluate reliability of tests or measures, indicates the strength of a relationship between two variables. The values of the correlation coefficient, r, range between which two numbers?
A. 0 and 100
B. 0 and +1
C. −1 and +1
D. 0 to 7
E. −10 to +10
88. In the management of attachment disorders, the model of Circle of Security refers to:
A. Play therapy
B. Group therapy
C. Seclusion intervention
D. Group safe home
E. Case management
89. Which of the following is NOT true of culture-bound syndrome?
A. It consists of disturbances in mood, behavior, or belief systems that appear restricted to a particular cultural context
B. Symptoms are frequently viewed as exotic or as covert illness phenomena occurring in the context of a local culture
C. It is a pattern of behavior that is understood locally as a meaningful manifestation of distress, acceptable within the cultural context
D. Such symptoms signal distress and activate a culturally specific response to the situation
E. It represents an uncommon socialization process for that cultural subgroup
90. An interviewer-based interview which provides extensive sets of definitions of symptoms and/or detailed guidance on the conduct of the interview is called what?
A. Semistructured interview
B. Fully structured interview
C. Respondent-based interview
D. Interviewer-based interview
E. Glossary-based interview
91. N-Methyl-D-aspartate receptors bind which of the following neurotransmitters?
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