Test Three
Questions
1. In juvenile diabetes, depression is an independent risk factor for ALL of the following EXCEPT:
A. Diabetic retinopathy
B. Repeat hospitalization
C. Adaptation to disease
D. Prolactin elevation
E. Metabolic control
2. Lithium levels above which point can affect multiple organs and be fatal?
A. 4.0 mEq/L
B. 3.2 mEq/L
C. 2.5 mEq/L
D. 1.6 mEq/L
E. 1.2 mEq/L
3. True or False: The number needed to treat is always a whole number, rounded off to an integer.
A. True
B. False
4. In the biopsychosocial model of formulation, which of the following components belong in the biological realm?
A. Inborn temperament
B. Patterns of behavior
C. Emotional development
D. Family constellation
E. Patterns of cognition
5. According to Kolvin, which of the following is FALSE for childhood onset schizophrenia?
A. It is episodic in nature
B. Children with this condition have poorer premorbid social functioning
C. Children with this condition have poorer premorbid language functioning
D. Transient autistic symptoms are commonly seen in toddler years
E. All of the above
6. ALL of the following are examples of commonly used language test batteries EXCEPT:
A. Clinical Evaluation of Language Fundamentals
B. Oral and Written Language Scales
C. Test of Early Language Development—4
D. Vineland Adaptive Behavior Scales—2
E. Preschool Language Scale—4
7. Classic characteristics of language in verbal children with autism spectrum disorders include ALL of the following EXCEPT:
A. Echolalia
B. Failure to use pronoun reversals
C. Monotonous intonation
D. Nonreciprocal speech
E. Poor syntax
8. The Edinburgh High Risk Study has focused on the identification of a range of characteristics that identify individuals who are at increased risk for the development of schizophrenia. These characteristics include:
A. Situational anxiety, depression, isolated hallucinations, social withdrawal, schizotypal features, and lower verbal intelligence quotient (IQ) scores
B. Situational anxiety, depression, lower performance IQ scores, social withdrawal, schizotypal features, and isolated hallucinations
C. Isolated hallucinations, mania, lower performance IQ scores, social withdrawal, and schizotypal features
D. Chronic delusions, situational anxiety, isolated hallucinations, decreased verbal IQ, and social withdrawal
9. The most current consensus recommendations from experts in pediatric bipolar disorder suggest medication taper may be considered once remission has been maintained for:
A. 6 months
B. 12 to 24 months
C. 24 to 36 months
D. >36 months
E. After adolescence
10. True or False: Although often described as involuntary, research suggests that tics are not analogous to other involuntary movements, such as choreas or dystonias.
A. True
B. False
11. Which of these patients could be diagnosed with pica?
A. A toddler who eats his own hair
B. A teenager with autism who eats raw potatoes
C. A severely retarded adult who eats feces
D. A normally developed adult who eats his own fingernails
E. All of the above
12. Which of the following is true of hearing impairment in children under the age of 18 years in the United States?
A. It affects 5% of children in this age group
B. The most common form is the result of inner ear infection
C. Acquired hearing loss is responsible for 60% of permanent hearing impairment
D. Genetic defects are the most common cause of permanent sensorineural hearing loss
E. All of the above
13. Relaxation training for children typically involves ALL of the following techniques EXCEPT:
A. Progressive muscle relaxation
B. Deep breathing
C. Systematic desensitization
D. Pleasant imagery
14. The most dramatic piece of legislation for children and families in recent years is the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 in which government effectively reduced public entitlements to cash benefits resulting in ALL of the following EXCEPT:
A. States are granted greater flexibility in the use of federal welfare funds
B. States are obliged to impose work requirements for those receiving federal assistance
C. States are obliged to provide a basic health care plan for children under the poverty line
D. States are obliged to impose a 5-year lifetime limit for federal assistance
15. When a clinician interviews a child with severe visual impairment, and the child gazes in his or her direction, the clinician is more likely to ascribe which of the following to the child:
A. Intelligence
B. Developmental delay
C. Anxiety
D. Sexual reactivity
E. A personality disorder
16. True or False: A recent pharmacokinetic study of paroxetine showed that children metabolize this selective serotonin reuptake inhibitor (SSRI) more slowly than adults do.
A. True
B. False
17. In a major study, Treatment for Adolescents with Depression Study, fluoxetine was found to be:
A. Less efficacious than both placebo and cognitive-behavioral therapy (CBT)
B. As efficacious as both placebo and CBT
C. More efficacious than both placebo and CBT
D. Unapprovable for the treatment of depression in children and adolescents
18. The Individual with Disabilities Education Act defines “emotional disturbance,” previously known as “serious emotional disturbance,” as:
A. An inability to learn that cannot be explained by intellectual, sensory, or health factors
B. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers
C. Inappropriate types of mood or behavior under normal circumstances
D. A tendency to develop physical symptoms or fears associated with personal or school problems
E. All of the above
19. Major changes in family, school, and neighborhoods, along with successes in preventive medicine, such as immunizations, accounted for the emergence of which field?
A. Child and adolescent psychiatry
B. Psychiatry
C. Pediatrics
D. Developmental behavioral pediatrics
E. Internal medicine
20. True or False: Electroconvulsive therapy is the treatment of choice for catatonia if pharmacological management fails.
A. True
B. False
21. Preschool children often have fears and worries because:
A. Their capacity for imagination is increasing
B. There is little differentiation between fantasy and reality
C. They are preoccupied with the constancy of important people in their lives
D. They feel simultaneously powerful and helpless
E. All of the above
22. True or False: The Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV does not require evidence of conduct disorder prior to age 15 years for a diagnosis of antisocial personality disorder.
A. True
B. False
23. What is the treatment of night terrors?
A. Reassure the child
B. Wake the child
C. Have the child sleep with the parents as needed
D. Mirtazapine
E. Hydroxyzine
24. According to Freud, development in the school-aged child is characterized by:
A. A sexually dormant interlude
B. An attempt to master the basics of the industry of society, by building on academic abilities
C. An opportunity for society to correct the influence of the family
D. Establishment of the superego
E. None of the above
25. Meta-analysis is a research synthesis of a set of studies that uses what statistic to indicate the strength of relationship between a treatment (or other independent variable) and the dependent variables?
A. Analysis of variance
B. Multiple regression
C. T-test
D. Effect size
E. None of the above
26. Morphometric magnetic resonance imaging studies of subjects with trichotillomania support findings for decreased volumes in the:
A. Left frontal cortex
B. Right frontal cortex
C. Left parietal cortex
D. Right parietal cortex
27. True or False: The electroencephalogram pattern during rapid eye movement sleep is low voltage, fast, and resembles the electroencephalogram of wakefulness.
A. True
B. False
28. Anna Freud’s classic, The Ego and the Mechanisms of Defense, enumerated several patterns of defense already in the analytic literature, including repression and reaction formation, but which of the following mechanisms of defense did she discover?
A. Identification with the aggressor
B. Regression
C. Projection
D. Sublimation
E. Undoing
29. What is the typical starting dose of paroxetine for children?
A. 5 to 10 mg
B. 25 to 50 mg
C. 12.5 to 25 mg
D. 10 to 20 mg
E. 75 to 100 mg
30. At about 7 to 9 months, a shift of qualitative reorganization occurs in infants as they develop a sense of intersubjectivity, which consists of:
A. The understanding that they are connected to, but not in complete union with, their caregivers
B. The understanding that others can understand their thoughts, feelings, gestures, and sounds
C. The understanding that others can see the things from their perspective
D. The understanding that even when others cannot be seen or heard, they still exist
31. True or False: The first code of ethics of the American Medical Association was based upon Thomas Percival’s Code of Medical Ethics.
A. True
B. False
32. Placebo-controlled studies have shown the efficacy of which tricyclic antidepressant in children and adolescents with obsessive-compulsive disorder (OCD)?
A. Desipramine
B. Clomipramine
C. Imipramine
D. Amitriptyline
E. Nortriptyline
33. At higher doses, venlafaxine selectively inhibits which of the following neuronal functions?
A. Serotonin reuptake
B. Dopamine reuptake
C. Norepinephrine reuptake
D. A and B
E. A and C
34. Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood onset psychiatric disorders affecting approximately what percentage of children worldwide?
A. 0.5% to 1%
B. 1% to 2%
C. 3% to 5%
D. 5% to 6%
E. 5% to 12%
35. Two groups of subjects are initially free of disease. One group has experienced the exposure and the other group has not. What type of study is this?
A. Case-control
B. Cross-sectional
C. Ecological
D. Cohort
36. Which of the following statements is TRUE?
A. The negative outcome of abuse cannot be avoided
B. Psychotropic medications are more often prescribed for children in social service care than those in the community
C. Most children and adults involved in maltreatment receive mental health services
D. The Adoption and Safe Family Act of 1997 recommended that abused children who were removed from their homes be in permanent placement by the end of the first year
E. Parental substance abuse rarely affects the management of child maltreatment
37. Neuroanatomical structures that have been implicated in tic disorders include ALL of the following EXCEPT:
A. Corticostriatal thalamocortical circuit
B. Basal ganglia
C. Medulla oblongata
D. Cortex
E. Globus pallidus
38. Maternal smoking during pregnancy is associated with later behavioral problems in the child. Which of the following is a confounding factor?
A. Fetal development
B. Birth weight
C. Maternal antisocial behavior
D. The father
E. None of the above
39. Case reports identify which of the following as a comorbid occurrence with gender identity disorder, one that might conceivably be linked by traits of behavioral rigidity and obsessionality?
A. Schizophrenia
B. Bipolar disorder
C. Parent-child relational problem
D. Pervasive developmental disorder, not otherwise specified
E. Psychological factors affecting medical condition
40. The DSM-III classified conduct disorder by dividing it into four subgroups according to whether children were socialized or undersocialized, and aggressive or nonaggressive, but how does DSM-IV classify conduct disorder?
A. By degree of legal involvement
B. By degree of antisocial behaviors
C. By age of onset
D. By lack of remorse
E. By degree of externalizing behaviors
41. True or False: The system-of-care model places the child and family at the center of the clinical process and as full partners at all levels of system planning.
A. True
B. False
42. True or False: The course of borderline personality disorder (BPD) is highly stable with symptoms persistent.
A. True
B. False
43. ALL of the following psychotropic medications have narrow therapeutic indices for clinical effectiveness, but significant adverse effects with toxicity EXCEPT:
A. Lithium
B. Oxcarbazepine
C. Valproate
D. Carbamazepine
E. Nortriptyline
44. True or False: A forensic evaluation affords the opportunity for therapeutic treatment for those clients who may not necessarily have access to psychiatric services.
A. True
B. False
45. A method of coping that uses strategies that avoid confronting pain, such as avoidance, denial, and wishful thinking is known as:
A. Active coping
B. Accommodative coping
C. Inhibited coping
D. Passive coping
E. None of the above
46. The President’s New Freedom Commission on Mental Health Report (2003) presented six major goals for a transformed mental health system, including which of the following:
A. Elimination of disparities in mental health care
B. Privatization of Medicaid mental health services
C. Reduction of the intrusion of technology to access mental health care
D. Screening of high school students’ mental health
E. Increasing Americans’ understanding of mental health’s limited impact on overall health
47. In studies of 3-year olds and preschool aggression, what percentage displays little or no aggression?
A. 92%
B. 76%
C. 53%
D. 38%
E. 28%
48. Epidemiological studies suggest the percentage of children suffering “extreme functional impairments” from psychiatric disorders is in what range?
A. 0.5% to 0.75%
B. 1% to 2%
C. 3% to 6%
D. 5% to 9%
E. 10% to 14%
49. Which of the following statements describing the psychoanalytic concept of resistance in the therapeutic process is FALSE? It is a defense against:
A. Affects
B. Repression
C. Undesirable self-representations
D. Unwanted drive derivatives
50. True or False: IQ scores are predictive of academic abilities in school-aged children.
A. True
B. False
51. The DSM-IV includes ALL of the following categories EXCEPT:
A. Disorder of verbal expression
B. Disorder of written expression
C. Learning disorder, not otherwise specified
D. Mathematics disorder
E. Reading disorder
52. Which of the following is the statistic of choice to describe the center of a distribution if data are normally distributed?
A. Mean
B. Median
C. Mode
D. None of the above
53. True or False: IQ is stable from infancy.
A. True
B. False
54. Approximately what fraction of individuals with posttraumatic stress disorder (PTSD) experience one or more comorbid lifetime diagnoses?
A. Three-fourths
B. Two-thirds
C. One-third
D. One-half
E. One-fourth
55. Which of the following is true of the genetics of homosexuality?
A. Monozygotic male twins have concordance rates between 22% and 30%
B. Monozygotic female twins have concordance rates of 48%
C. Dizygotic male twins have concordance rates between 52% and 66%
D. Dizygotic female twins have concordance rates of 48%
E. All of the above
56. Compared to healthy controls, the rates of psychological disorders in children with chronic medical illness are:
A. Lower than children without a chronic medical illness
B. The same as children without a chronic medical illness
C. Two to four times the rate of children without a chronic medical illness
D. Four to six times the rate of children without a chronic medical illness
57. Which of the following is the normal milestone for a child’s ability to eat solid food?
A. 2 months
B. 4 months
C. 6 months
D. 8 months
E. 12 months
58. Psychometric tests are based on their reliability and validity. What is the least acceptable score of the reliability coefficient generally recommended for diagnostic tests?
A. 0.40
B. 0.60
C. 0.80
D. 0.90
E. 5.0
59. Typically, impairment resulting from psychopathology is assessed in four domains and includes each of the following EXCEPT:
A. Interpersonal relationships
B. Academic/work performance
C. Social and leisure activities
D. Family relationships
E. Ability to enjoy and obtain satisfaction from life
60. Which of the following statements about serving snacks in a group is FALSE?
A. It is a nurturing, tangible support
B. Promotes more intimate, relaxed interactions that often help task accomplishment
C. The food should be voted on by the group, with the leaders retaining veto power
D. Dietary restrictions should be accommodated by the entire group whenever possible
E. Protests about the snack selection should be understood as part of the group attempting to establish and maintain its trust in the group leadership
61. Which of the following statements is NOT a DSM-IV criterion for Asperger’s disorder?
A. Impairment in social interaction
B. Restricted, repetitive and stereotyped patterns of behavior, interests, and activities
C. Clinically significant general delay in language
D. Lack of clinically significant cognitive delay
E. Does not meet criteria for another specific pervasive developmental disorder
62. Studies by Hetherington and colleagues found that the long-term effects of divorce and remarriage appear to be related to a number of factors including ALL of the following EXCEPT:
A. Child’s development status
B. Child’s sex
C. Child’s temperament
D. The degree of amicability in the divorce proceedings
E. The availability of support systems
63. The world’s first statute regarding adoption was passed in:
A. Massachusetts 1851
B. California 1943
C. New York 1789
D. Virginia 1865
E. Kansas 1918
64. True or False: A personality disorder cannot be diagnosed in a child.
A. True
B. False
65. The proton magnetic resonance spectroscopy study conducted by Thomas and colleagues in children with schizophrenia showed which one of the following?
A. The ratio of N-acetylaspartate (NAA) to creatine was significantly lower in the frontal lobes of children with schizophrenia
B. The ratio of NAA to creatine was significantly lower in the parietal lobes of children with schizophrenia
C. The ratio of NAA to creatine was significantly lower in the occipital lobes of children with schizophrenia
D. The ratio of NAA to creatine was significantly higher in the occipital lobes of children with schizophrenia
E. The ratio of NAA to creatine was equivocal in the occipital lobes of children with schizophrenia
66. Besides psychosocial dwarfism, other disorders involving short stature, include ALL of the following EXCEPT:
A. Intrauterine growth retardation
B. Hypopituitarism
C. Turner’s syndrome
D. Fragile X syndrome
E. The osteochondrodystrophies
67. Which TWO of the following are risk factors for Stevens-Johnson syndrome while on lamotrigine therapy?
A. Acute discontinuation
B. Rapid dose escalation
C. Fluoxetine cotreatment
D. Carbamazepine cotreatment
E. Valproate cotreatment
68. In resilience research, what is the conceptual definition of vulnerability factors?
A. The factors that propagate or produce the risk condition
B. The factors that exacerbate the negative effects of the risk condition
C. The factors that indicate the inherent weaknesses in the individual
D. The factors that hinder positive adaptation in spite of the risk condition
E. All of the above
69. True or False: The proportion of adolescents in poor and near-poor families without insurance decreased between 1995 and 2002.
A. True
B. False
70. True or False: Less than half of the National Institute of Mental Health funded intervention proposals and programs include a family component.
A. True
B. False
71. In the field of infant assessments, one of the most commonly used instruments following the Piagetian model is the Infant Psychological Development Scale, which assesses an infant’s ability to perform ALL of the following EXCEPT:
A. Grasp object permanence
B. Understand means-ends
C. Respond to social cues
D. Understand cause-effect relationships
E. Imitate vocalizations and gestures
72. In the treatment of ADHD with atomoxetine, doses above which amount are not likely to produce additional benefit?
A. 0.6 mg/kg
B. 0.8 mg/kg
C. 1.0 mg/kg
D. 1.2 mg/kg
E. 1.4 mg/kg
73. Higher rates of suicide are found in both children and adults with epilepsy. Which epilepsy in adults accounts for the highest rate?
A. Parietal lobe
B. Frontal lobe
C. Absence
D. Rolandic
E. Temporal lobe
74. True or False: Children with less language ability may exhibit greater levels of physical aggression than their more verbal peers.
A. True
B. False
75. Which TWO of the following organizations were formed specifically for the mission of education and training?
A. Association for Academic Psychiatry
B. American Association of Psychiatric Clinics for Children
C. American Association of Directors of Psychiatric Residency Training
D. American Academy of Child & Adolescent Psychiatry
E. American Academy of Psychiatrics
76. A study by Richard Green of 66 feminine boys and 56 control boys examined sexual orientation in fantasy and behavior, initially at 7 years of age and again at 19 years of age. Which statement(s) capture(s) the findings?
A. 75% to 80% of the previously feminine boys were bisexual or homosexual at follow up
B. 0% to 4% of the control boys were bisexual or homosexual
C. Of those available at follow up, only one youth at the age of 18 years was gender dysphoric to the extent of considering sex reassignment surgery
D. All of the above
77. What are the most common compulsions in adolescents?
A. Cleaning rituals
B. Repeating actions (doing and undoing)
C. Checking rituals
D. None of the above
E. All of the above
78. Hermine von Hug-Hellmuth was credited as the first to undertake psychoanalytic therapy of children and adolescents. What was the most significant observation she made regarding the therapy and the expression of unconscious conflict in children as compared with adults?
A. That regression was a common component of the therapy
B. That children require therapeutic aids in expression of unconscious conflict
C. That spontaneous play could stand in the place of verbal communications
D. That a working alliance with parents was essential for child improvement
E. That free association unfolds in similar ways
79. True or False: In interviewing adolescents, clinicians can decrease resistance by beginning the history taking by inquiring first about the adolescent’s interests, strengths, and musical preferences.
A. True
B. False
80. Which of the following types of therapy groups requires substantial cognitive growth and ability in its members, especially regarding emotionally charged topics?
A. Social skills group
B. Support group
C. Didactic group
D. Goal-focused group
E. All of the above
81. True or False: When genes are expressed, for example, as in the transcription of growth hormone, they are expressed in all cell lineages that have the gene.
A. True
B. False
82. Which professional organization established in 1924 attempted to unify the disciplines of psychiatric diagnosis and child treatment by bringing together psychiatrists, psychologists, social workers, and the judiciary interested in child guidance?
A. American Academy of Child & Adolescent Psychiatry
B. American Board of Psychiatry and Neurology
C. American Association of Psychiatric Clinics for Children
D. American Orthopsychiatric Association
83. Angelman and Prader-Willi syndromes, disorders of genomic imprinting, share ALL of the following features EXCEPT:
A. Both are rare disorders with a prevalence of 1 in 10,000 births
B. Both are the result of deletions from maternally derived chromosomes
C. Individuals with both disorders are hypotonic as infants
D. Individuals with both disorders have some degree of mental retardation (MR)
E. Both disorders are caused by a deletion on chromosome 15 or by receiving two copies of chromosome 15 from one parent
84. True or False: A psychoanalytic finding indicates that parental harshness appears to weaken the superego functions of the child.
A. True
B. False
85. Symptoms frequently reported in children with conversion disorder include ALL of the following EXCEPT:
A. Nonepileptic seizures
B. Paralysis or paresis
C. Sensory symptoms
D. Gait disturbances
E. Auras
86. The possibility of which adverse event cautions against the abrupt discontinuation of clonidine?
A. Seizures
B. Orthostatic hypotension
C. Rebound hypertension
D. Withdrawal dyskinesia
E. None of the above
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