Test Two
Questions
1. True or False: Duplications and deletions in the human genome are quite frequent in normal individuals, except for regions known to contain genes with important biological functions.
A. True
B. False
2. When is the anticipated publication date of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V)?
A. 2001
B. 2012
C. 2010
D. 2016
E. 2014
3. True or False: Despite popular perception, exceedingly few school districts actively avoid the mandates of federal laws such as the Individual with Disabilities Education Act.
A. True
B. False
4. In psychoanalytic thought, which of the following terms refers to the psychological mechanisms that cling to the intrapsychic status quo and seek to prevent change?
A. Transference
B. Countertransference
C. Observing ego
D. Resistance
E. Working alliance
5. Which of the following is least likely to be seen on imaging studies in childhood onset schizophrenia?
A. Increased lateral ventricular volume
B. Decreased gray matter volume
C. Decreased volume of the cerebellum
D. Reduced volumes of temporal lobe structures
E. Increased basal ganglia volume
6. How many genes are on the 46 chromosomes typically found in humans?
A. 100
B. 500
C. 15,000
D. 35,000
E. 100,000
7. Review of studies of delirium in adults suggests EACH of the following is a core symptom of delirium EXCEPT:
A. Perceptual disturbances
B. Attentional deficits
C. Memory deficits
D. Thought process abnormalities
E. Sleep-wake cycle disturbances
8. True or False: The Brazelton Neonatal Behavioral Assessment Scale, second edition (NBAS-2), has been shown to predict infant-parent attachment and subsequent infant development within the first year.
A. True
B. False
9. Which of the following is a primary parameter in assessing rapid eye movement or nonrapid eye movement sleep?
A. Cardiac
B. Respiratory
C. Episodic limb movement
D. Muscle tone
10. Neuroleptic malignant syndrome has a mortality rate of up to 9% in children and adolescents. Which step is necessary when the syndrome is identified?
A. Administration of dantrolene
B. Starting intravenous fluids, specifically normal saline
C. Application of cooling blankets
D. Discontinuation of the antipsychotic medication
E. Administration of an antipyretic
11. In the Four Ps model of psychiatric formulation, which domain of factors is concerned with the features that describe a patient’s strengths, resilience, and supports?
A. Predisposing
B. Precipitating
C. Perpetuating
D. Protective
12. ALL of the following have been implicated in obsessive-compulsive disorder (OCD), EXCEPT:
A. Serotonin
B. Dopamine
C. Glutamate
D. Choline
13. Chronic medical illnesses associated with weight loss include ALL of the following EXCEPT:
A. Crohn’s disease
B. Hyperthyroidism
C. Prader-Willi syndrome
D. Diabetes mellitus
E. Addison’s disease
14. Family systems theorists have sometimes viewed pediatric somatoform disorders as:
A. Disrupting the parental hierarchy
B. Oppositional defiance
C. A conflict between the superego and the id
D. A way to avoid conflict
15. How is narcolepsy diagnosed definitively?
A. A good history
B. Observation in the home, with recording by parents, if possible
C. Treatment response to stimulants
D. Multiple Sleep Latency Test
16. Having a child wash their soiled clothing after a toileting accident is an example of:
A. Overcorrection
B. Response cost
C. Negative reinforcement
D. Extinction
E. Classical conditioning
17. Smyke and Zeanah developed which of the following approaches in assessing attachment disorders?
A. Disturbances of Attachment Interview
B. Preschool Assessment of Attachment
C. Attachment Q-Set
D. Child Attachment Interview
E. Narrative Story Stem Techniques
18. What is the genetic mutation in Fragile X?
A. Point mutation
B. Small deletion
C. Large deletion
D. Gene duplication
E. Triplet repeat
19. Amphetamine use can be detected in the urine for how long?
A. Less than 24 hours
B. 24 to 72 hours
C. 3 to 5 days
D. 1 week
20. Research reveals how teachers rate boys and girls from families with an absent father as more _______ compared with children from intact mother-father families.
A. shy
B. depressed
C. aggressive
D. inattentive
21. What is a well recognized problem of retrospective case-control studies?
A. Selection bias
B. Recall bias
C. Missing data
D. Sampling errors
E. Sampling size
22. Borderline personality disorder is often comorbid with ALL of the following EXCEPT:
A. Major depression
B. Schizotypal personality disorder
C. Posttraumatic stress disorder (PTSD)
D. Eating disorders
E. Substance use
23. True or False: Resilience is evident when an individual achieves success in a single domain despite the presence of significant risk or adversity.
A. True
B. False
24. Which part of the neuron is responsible for synthesizing nearly all cell-specific proteins, including transporters, receptors, and the enzymes needed for neurotransmitter production?
A. Axon
B. Dendrites
C. Cell body
D. Nerve terminal
E. Synapse
25. What is the overlap of epileptiform and nonepileptiform seizure disorders?
A. Up to 20% of children with intractable epilepsy also have nonepileptic seizures
B. Up to 15% of children on a pediatric epilepsy unit will have nonepileptic seizures
C. Up to 50% of children on a pediatric epilepsy unit who have nonepileptic seizures will also have epileptic seizures
D. Nonepileptic seizures in children can be difficult to delineate from true epilepsy
E. All of the above
26. In which year did the American Board of Psychiatry and Neurology recognize child psychiatry as a subspecialty and establish standards for its training?
A. 1876
B. 1911
C. 1945
D. 1957
E. 1982
27. The term “learning disabled” refers to children who have ALL of the following disorders in development EXCEPT:
A. Attention
B. Communication skills
C. Language
D. Reading
E. Speech
28. What is the treatment of encopresis?
A. Psychoeducation and bowel catharsis
B. Psychoeducation, bowel catharsis, daily dose of laxatives or mineral oil, and parent management training
C. Psychoeducation, bowel catharsis, daily dose of laxatives or mineral oil, and daily timed intervals on the toilet with rewards for success
D. Psychoeducation, bowel catharsis, and morning timed intervals on the toilet with rewards for success
29. Which one of the following is true of PTSD in children according to Sack et al.?
A. Diagnostic status does not relate to functional status
B. Children with PTSD never show a delayed onset of symptoms
C. In most children with PTSD, symptoms dissipate within 1 year
D. In children with PTSD, symptoms of depression worsen over time
E. All of the above
30. The most common formulation used in psychiatry is the biopsychosocial model developed by whom?
A. Meyer
B. Engel
C. Kraepelin
D. Freud
E. Jaspers
31. Often, the major source of mental health referrals to the emergency department is:
A. Parents
B. Child protective services
C. Schools
D. Outpatient psychiatrists
E. Community agencies
32. Which of the following is the normal milestone for speech development regarding a child’s ability to speak in sentences?
A. 5 years
B. 4 years
C. 3 years
D. 2 years
E. 1 year
33. True or False: A diagnosis of acute stress disorder within the first month is necessary for the diagnosis of PTSD.
A. True
B. False
34. True or False: In several studies, researchers have concluded that there is a powerful, though indirect, link between poverty and mental health disorders in children.
A. True
B. False
35. True or False: A psychoanalytic finding indicates that the harshness and rigidity of a person’s superego is directly proportional to the parental severity during childhood.
A. True
B. False
36. True or False: The mother and father’s attitudes and behaviors toward their child is the key element that fosters the development of gender identity disorder (GID).
A. True
B. False
37. For patients with GID seen for the first time in adolescence, there are two subgroups. Select answer D or E.
A. Male and female youth who have very clear childhood onset of GID, which has persisted into adolescence. Almost all the youth in this group have a homosexual orientation (sexually attracted to members of their own birth sex)
B. Male and female youth who have very clear childhood onset of GID, which has persisted into adolescence. Almost all the youth in this group have a heterosexual orientation (sexually attracted to members of the opposite birth sex)
C. Male youth without cross-gender history in childhood who express the desire to be the opposite sex, voiced only during the beginning of adolescence or later. These youth often have a heterosexual, bisexual, or asexual orientation
D. A and B
E. A and C
38. True or False: The response rates of selective serotonin reuptake inhibitors (SSRIs) in OCD are comparable, and clomipramine is superior by a significant margin.
A. True
B. False
39. True or False: Placement in a long-term residential facility serves as one way to achieve permanency in children who were removed from their homes.
A. True
B. False
40. True or False: Trichotillomania is more common in females.
A. True
B. False
41. The pruning of cortical synapses that occurs in adolescence:
A. Can lead to the loss of up to 30,000 synapses per second
B. Results in the loss of 95% of the cortical synaptic connections present before puberty
C. Affects inhibitory synapses preferentially
D. Is accompanied by increases in brain glucose metabolism, oxygen utilization, and blood flow
42. Which of the following models of classification focuses on the total context of the individual person?
A. Dimensional
B. Categorical
C. Ideographic
D. Archetypal
43. Regarding Tourette’s syndrome (TS) and comorbid conditions, which of the following is TRUE?
A. Children with combined TS and attention deficit hyperactivity disorder (ADHD) have less psychiatric morbidity than those with ADHD alone
B. Children with combined TS and ADHD are at greater risk for disruptive behaviors and impairments than those with TS alone
C. There is no qualitative difference between TS comorbid with OCD and OCD without TS
D. Tic-related OCD tends to have a later age of onset compared with nontic-related OCD
E. Tic-related OCD tends to be less responsive to antipsychotics and more responsive to serotonin reuptake inhibitors
44. True or False: Females with ADHD have a higher rate of unwed pregnancy than those who do not.
A. True
B. False
45. Multiple lines of evidence support the role of which neurotransmitter in the etiology of ADHD and in the response to treatment?
A. Serotonin
B. Substance P
C. Dopamine
D. Norepinephrine
E. Glutamate
46. Which of the following is an example of policy?
A. Federal or state legislation
B. Position statements from American Academy of Child & Adolescent Psychiatry
C. Governmental procedures developed to guide provision of services
D. Governing rules of the American Psychiatric Association (APA)
E. All of the above
47. If the APA confirms an ethical violation by a psychiatrist, there are four possible sanctions that the APA can issue, including ALL of the following EXCEPT:
A. Admonishment
B. Reprimand
C. Suspension
D. Expulsion
E. Appeal
48. Which of the following best describes child psychiatric emergencies?
A. Emergencies can be characterized as a mismatch between needs and resources
B. Emergencies represent a parent’s inability to provide adequate support
C. Emergencies usually have an element of school dysfunction as a contributing factor
D. Emergencies represent the lack of outpatient resources
E. None of the above
49. True or False: In psychoanalytic thought, drive is a term that encompasses the mental representations of the instinctual forces.
A. True
B. False
50. Logical operations are a crucial developmental stage because
A. They are necessary for conducting social interactions
B. They are necessary to mastering basic reading skills
C. They are necessary to mastering basic mathematics skills
D. A and C only
E. A, B, and C
51. Which of the following statements about stuttering is false?
A. Most cases of stuttering are due to learned behavior rather than due to a biological component
B. Most children recover within the first 1 to 2 years after their stuttering was first noted
C. People who stutter have been found to show laryngeal behavior different from that in normal speakers
D. The risk of stuttering among first-degree relatives is more than three times the population risk
E. Treatments for stuttering, like anti-anxiety medications, have not been found to be effective
52. The periods of infancy and toddlerhood are defined as the first 3 years of postpartum life. Infancy refers to specifically what period in a child’s life?
A. The period up to 6 months before object permanency begins
B. The period up to 18 months before expressive verbal communication begins
C. The period up to 12 months before independent walking begins
D. The period up to 24 months before toilet training begins
53. What was a conclusion of the Fort Bragg study, a large, randomized trial of a systemof-care approach?
A. Children who received intensive, coordinated services fared no better than children who received traditional services
B. Children who received intensive, coordinated services fared better than children who received traditional services
C. Children who received intensive, coordinated services displayed more acting-out behaviors than those who received traditional services
D. Children who received intensive, coordinated services displayed fewer acting-out behaviors than those who received traditional services
54. The blockade of which part of the dopaminergic neuron is the major mechanism of action of most antipsychotic medications?
A. D1 receptor
B. D2 receptor
C. Dopamine transporter
D. Monoamine oxidase
E. D3 receptor
55. A patient has experienced a major depressive episode during the past 12 months but has now remitted. The patient will:
A. Be best characterized as partially remitted, given duration of time criteria
B. Contribute to the numerator in an incidence study
C. Contribute to the numerator in a 12-month prevalence study
D. Is likely to experience another depressive episode
E. All of the above
56. Which of the following enzymes are involved in Phase II metabolic reactions?
A. CYP 1A
B. UGT 1
C. CYP 2C
D. CYP 2E
E. CYP 3A
57. Which TWO of the four functionally distinct pharmacokinetic phases are primarily responsible for terminating the action of the pharmacological agent?
A. Absorption
B. Metabolism
C. Distribution
D. Excretion
58. A child psychiatrist reports suspected abuse by a father and tells the mother she should withhold visitations from the father. The father could sue the clinician:
A. True
B. False
59. What are common potential errors in documentation from a liability perspective?
A. Raising a diagnostic question and not following through or not following up on the results
B. Overlooking discrepancies among professionals in the progress notes; for example, a nurse’s suicide assessment that differs from the child psychiatrist’s
C. Signing off on a trainee’s note by declaring “agree with the above”
D. Recording psychodynamic considerations in the progress notes
E. All of the above
60. Which TWO of the following side effects are relatively common with lithium treatment?
A. Glomerular damage
B. Polyuria
C. Hypothyroidism
D. Polydipsia
E. Seizures
61. True or False: There is only one standardized measure that specifically assesses for symptoms of acute stress disorder in children.
A. True
B. False
62. Which of the following is true of suicides in sexual minority youth in the United States?
A. Suicide is the third leading cause of death among sexual minority youth
B. About 10% of sexual minority youth commit suicide annually
C. Gay minority youth are two to three times more likely to commit suicide than other youth
D. Sexual orientation has an independent association with suicide attempts for female minority youth
E. All of the above
63. If a child is deaf and her family chooses to proceed with cochlear implants, when is the best age to undergo the procedure?
A. Under 2 years
B. Under 3 years
C. Under 4 years
D. Under 5 years
E. Under 6 years
64. According to Thabet and Vostanis, which one of the following is the most important predictor of general mental health problems in children exposed to conflict in the Gaza strip?
A. Parental alcohol consumption
B. Low socioeconomic status
C. Parental mental illness
D. Living in the inner city
E. Single parent family
65. True or False: Academically, children with nonverbal learning disability (NLD or NVLD) show better arithmetic skills relative to reading and spelling skills.
A. True
B. False
66. The half-life of lithium in adults is approximately 24 hours, but in children what is the approximate half-life?
A. 36 hours
B. 32 hours
C. 28 hours
D. 26 hours
E. 18 hours
67. True or False: Brains of toddlers with autism have been observed to be smaller in size than toddlers without autism.
A. True
B. False
68. True or False: Issues of confidentiality between children and parents should not be emphasized in child psychiatric treatment.
A. True
B. False
69. What percentage of children diagnosed with cancer in the United States are expected to survive their disease and treatment?
A. 15%
B. 30%
C. 45%
D. 60%
E. 75%
70. Which of the following represent(s) goal(s) of Bowen family systems?
A. Increased differentiation
B. Detriangulation
C. Improved ability to manage anxiety
D. Resolution of cutoff
E. All of the above
71. Which of the following is true of aggressive behavior in preschool children?
A. Verbal aggression increases as children gain more language skills
B. Aggression is typically focused on social situations
C. Physically aggressive behavior usually subsides by age 3 or 4
D. A and C
E. None of the above
72. Which of the following statements describes the minimal effective concentration of a drug?
A. The blood plasma concentration likely to produce a toxic effect
B. The blood plasma concentration needed to achieve steady-state levels
C. The blood plasma concentration likely to produce a clinical effect
D. The blood plasma concentration found with minimal dosing
73. Between 1965 and 1998, the father’s share of child care in the home has:
A. Doubled
B. Halved
C. Remained the same
D. Tripled
74. ALL of the following statements are true EXCEPT:
A. Pornographic photography of children is generally considered a form of sexual abuse
B. About one-third of child maltreatment reports are substantiated
C. “False memories” during the interview of an abused child can be minimized by using open-ended questions
D. Screening for abuse/neglect is not a necessary part of all mental health evaluations
E. It is a good practice to notify the guardian about the clinician’s decision to report suspected maltreatment
75. ALL of the following are obsessions typically found in adolescents EXCEPT:
A. Dirt and germs
B. Fear of an ill fate befalling loved ones
C. Exactness or symmetry
D. Religious scrupulosity
E. Sexual preoccupations
76. Which publication of Sigmund Freud is considered the beginning of the discipline of psychodynamic psychotherapy for children?
A. Totem and Taboo
B. Little Hans
C. The Rat Man
D. The Interpretation of Dreams
E. Civilization and Its Discontents
77. True or False: Every human being is capable of self-determination.
A. True
B. False
78. True or False: In psychoanalytic thought, the psychological maneuver by which the ego accomplishes inhibition against an internal danger is termed repression.
A. True
B. False
79. The crisis intervention model, exemplified by the Home-builders approach emphasizes among other elements:
A. Concrete services, such as food and clothing
B. Aversive conditioning
C. Negative reinforcement
D. Punishment
E. Shaping
80. Which of the following statements is FALSE regarding the cultural formulation in the DSM-IV?
A. It is a key component of the biopsychosocial assessment and diagnosis of mental disorders
B. It has five main themes
C. It serves as a sensitive instrument for culturally diverse and multicultural groups
D. It includes the cultural identity of the patient
E. It includes the cultural explanations of the patient’s illness
81. True or False: Oxcarbazepine like carbamazepine can induce its own metabolism.
A. True
B. False
82. In which year did the American Academy of Child Psychiatrists expand to include the treatment of adolescents in its scope and influence, hence becoming the American Academy of Child & Adolescent Psychiatry, as it is known today?
A. 1942
B. 1959
C. 1963
D. 1974
E. 1989
83. What provides for most of the biosynthetic capacity in the early human embryo?
A. mRNA synthesized by the mother
B. mRNA synthesized by the father
C. Maternal DNA
D. Paternal DNA
E. mRNA synthesized by the mother and father
84. In 1925, Arnold Gesell published the Gesell Development Schedules to assess normal maturational development systematically in infants and toddlers. This groundbreaking research was different from prior efforts in ALL of the following ways EXCEPT:
A. Infant cognition tests sought to identify deviance, whereas Gesell’s work sought to document normal development
B. Gesell’s model conceptualized development as occurring simultaneously in multiple domains as opposed to a singular test for intelligence quotient (IQ)
C. Gesell’s model took into account environmental influences upon the developmental trajectory as opposed to viewing IQ as a static and stable trait
D. Gesell Development Schedules were able to predict infant IQ at later stages in development
85. In a study of child care centers in four states, one major finding was that most centers are mediocre in quality and “sufficiently poor to interfere with children’s emotional and intellectual development.” Moreover, what percentage of infants and toddlers in center-based care were found to be at risk because of poor health and safety standards?
A. 40%
B. 30%
C. 20%
D. 10%
E. 5%
86. Which of the following definitions best describes the statistic of absolute risk reduction?
A. The number of patients that needs to be treated with an intervention to prevent one additional bad outcome
B. Proportion of patients with an undesired consequence in the intervention group compared with the control group
C. Proportion of patients in the control group with bad outcome compared to patients in the intervention group with bad outcome
D. None of the above
87. True or False: The DSM-IV diagnosis of pyromania represents a category of firesetting that is somewhat common in children.
A. True
B. False
88. True or False: Projective techniques in psychological testing are based on the premise that responses to and interpretations of ambiguous stimuli provide insight into the examinee’s unconscious mental processes, such as needs, motives, and conflicts.
A. True
B. False
89. What is construct 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 with 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
90. What is one of the primary sources of psychological pain for children with cancer?
A. Their siblings
B. Their pets
C. Their grandparents
D. Their parents
E. School reentry
91. Which of the following is the only Food and Drug Administration approved, nonstimulant medication for the treatment of ADHD?
A. Desipramine
B. Guanfacine
C. Clonidine
D. Atomoxetine
E. Bupropion
92. True or False: The relative volume of extracellular water is higher in children and tends to decrease with development.
A. True
B. False
93. ALL of the following brain areas have been implicated in the symptomatology of autism EXCEPT:
A. Frontal lobe
B. Temporal lobe
C. Amygdala
D. Limbic system
E. Occipital lobe
94. In which part of the night are night terrors most likely to occur?
A. First third
B. Second third
C. Last third
D. At any time of night
E. Just before waking after a night’s sleep
95. On average, what percentage of students ages 14 and older diagnosed with learning disabilities graduate with a regular high school diploma?
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