Chapter 6: Panic, Anxiety, Obsessions, and Their Disorders Multiple-Choice Questions 1. Neurotic behavior a. is maladaptive and means that a person is out of touch with reality. b. is a current term, used to describe many disorders in the DSM-5. c. is what we now refer to as "hysteria." d. is maladaptive but means that a person is not out of touch with reality. Answer: d. is maladaptive but means that a person is not out of touch with reality. 2. DSM-III classification, which omited the concept of neurosis, was an improvement because a. each category now has a specific effective treatment. b. now anxiety disorders are identified regardless of whether anxiety symptoms are expressed. c. diagnostic criteria are now based on shared, observable symptoms and are more clearly defined. d. each category is made up of symptoms that have one causal origin. Answer: c. diagnostic criteria are now based on shared, observable symptoms and are more clearly defined. 3. Fear is a basic emotion that involves a. concern about the future. b. the activation of the "fight or flight" response. c. negative thoughts, but not a change in physiological arousal. d. a complex blend of negative mood and self-preoccupation. Answer: b. the activation of the "fight-or-flight" response. 4. Which of the following would be an example of anxiety? a. Julie jumped when she saw the snake. b. Hilda dreaded walking home alone. c. Carl was certain that the food was poisoned. d. The voices in Paul's head told him he should be afraid. Answer: b. Hilda dreaded walking home alone. 5. The main way to tell someone is having an uncued panic attack rather than is in a state of fear is a. whether he or she thinks about what is happening. b. whether he or she shows physiological changes such as increased heart rate. c. if he or she has a subjective belief that something awful is about to happen. d. if he or she feels a strong urge to flee. Answer: c. if he or she has a subjective belief that something awful is about to happen. 6. Which of the following is a typical symptom of panic attacks? a. Hallucinations b. Delusions c. Fear of dying d. Paranoia Answer: c. Fear of dying 7. Which of the following is one of the five primary types of anxiety disorders recognized in the DSM-5? a. hypochondriasis b. agoraphobia c. dissociative fugue d. bipolar disorder Answer: b. agoraphobia 8. What is one of the major ways the anxiety disorders differ from each other? a. Whether they have a genetic component. b. Whether they are treatable. c. Whether there are more fear/panic symptoms or anxiety symptoms involved. d. Whether the disorder is associated with other anxiety disorders. Answer: c. Whether there are more fear/panic symptoms or anxiety symptoms involved. 9. Neuroticism a. is a tendency to experience negative mood states. b. is simply another term for anxiety. c. is a tendency to believe negative things about oneself. d. is a tendency to feel anxious. Answer: a. is a tendency to experience negative mood states. 10. Gradual exposure to feared cues is a. an old treatment for anxiety disorders that is no longer used. b. a common component of treatment for all anxiety disorders. c. likely to make someone with an anxiety disorder worse in the long term. d. a useful treatment for phobias but not other anxiety disorders. Answer: b. a common component of treatment for all anxiety disorders. 11. Individuals who suffer from phobias a. are likely to believe that their fear is justified. b. suffer from uncued panic attacks. c. are unlikely to have other psychological diagnoses. d. have a disproportionate fear of some specific object. Answer: d. have a disproportionate fear of some specific object. 12. Martin is afraid to fly. He knows his boss wants him to take a trip for the business. Martin feels miserable, because he wants to keep his job but cannot even imagine getting on a plane. The most likely diagnosis for Martin is a. agoraphobia without history of panic disorder. b. social phobia. c. specific phobia, situation type. d. panic disorder with agoraphobia. Answer: c. specific phobia, situation type. 13. Why do people with phobias continue to avoid the thing they fear? a. Avoidance is reinforced by anxiety reduction. b. There is something wrong with their fight or flight system. c. They are cognitively unable to make any other decision due to their disorder. d. Their low self-esteem causes them to choose not to fight their fear. Answer: a. Avoidance is reinforced by anxiety reduction. 14. Which of the following is associated with a unique physiological response pattern? a. agoraphobia b. blood-injection-injury phobia c. obsessive-compulsive disorder d. generalized anxiety disorder Answer: b. blood-injection-injury phobia 15. An evolutionary psychologist might say, "The unique physiological response in this disorder, involving fainting at the sight of the feared object, may have evolved because fainting might inhibit further attack from a predator." What disorder is being discussed? a. blood-injection-injury phobia b. agoraphobia with panic attacks c. social phobia d. animal phobia Answer: a. blood-injection-injury phobia 16. Which of the following phobias is a 10-year-old boy most likely to suffer from? a. animal phobia b. driving phobia c. claustrophobia d. social phobia Answer: a. animal phobia 17. Which of the following explanations for Diana's scissors phobia would Freud be most likely to offer? a. Constant warnings about the importance of not running with scissors have generalized to an overall fear of scissors. b. Diana suffers from womb envy, creating an unconscious desire to harm her pregnant mother. c. Diana's mother is a seamstress and Diana unconsciously wants to kill her. d. Diana once saw her brother seriously injured by a sharp object. Answer: c. Diana's mother is a seamstress and Diana unconsciously wants to kill her. 18. When Charissa was a young child, she stepped on a bee and was stung. Since that time, she has been terrified of flying insects and runs away if she sees any. What form of learning is this? a. defense mechanism b. vicarious conditioning c. observational learning d. classical conditioning Answer: d. classical conditioning 19. When Kenneth was a young boy he went to a dentist who treated him uncaringly and inflicted a good deal of pain. Even years later, he has an uncontrollable and intense fear of not only dentists but physicians, too. This best illustrates how phobias might be the result of a. generalization in classical conditioning. b. observational conditioning. c. secondary gain. d. the inflation effect. Answer: a. generalization in classical conditioning. 20. Nicole's mother is terribly afraid of snakes. Although Nicole has never actually seen a snake, her mother has told her time and again to be careful to look for them when she is walking. Now Nicole has an intense fear of snakes and refuses to walk in the grass. This is an example of a. vicarious conditioning of a phobia. b. classical conditioning of a phobia. c. operant conditioning of a phobia. d. unconscious displacement of anxiety onto a phobic object. Answer: a. vicarious conditioning of a phobia. 21. When do phobias like claustrophobia and driving phobia begin? a. Adolescence b. Childhood c. Middle adulthood d. Late adulthood Answer: a. Adolescence 22. Casey and Josh have both been bitten by strange dogs. Casey has a dog of his own at home that he loves. Josh has little experience with dogs. Which is likely to develop a phobia? a. Both boys are likely to develop a phobia because of the traumatic nature of the event. b. Casey is more likely to develop a phobia because his schema of dogs has been violated. c. Casey is less likely to develop a phobia because he has had lots of earlier positive experiences with dogs. d. It will depend on which boy is more sensitive to pain. Answer: c. Casey is less likely to develop a phobia because he has had lots of earlier positive experiences with dogs. 23. Wendy went swimming in the ocean last week and became mildly fearful when she swallowed a lot of water and felt as though she would drown. Just yesterday someone told her that a shark was seen in the water at the same time she was swimming. Now she is petrified of going into the ocean. This best illustrates a. the observational learning explanation for phobias. b. the inability of the phobic person to direct his or her attention away from a feared object. c. the "inflation effect." d. classically conditioned generalization based on direct experience. Answer: c. the "inflation effect." 24. Which of the following is likely to maintain or strengthen conditioned fears over time? a. a genetic vulnerability to phobias b. overestimating the likelihood that the event will reoccur c. having previously experienced a less traumatic event d. viewing the trauma as uncontrollable and inescapable Answer: b. overestimating the likelihood that the event will reoccur 25. Which of the following illustrates how cognitive variables may act to maintain acquired fears? a. Jane no longer went to the park due to her fear of dogs. b. Karen would think happy thoughts whenever she drove over a bridge. c. Ryan's fear of heights caused him to always wonder just how high up he was in a building. d. Melvin knew that his heart was racing because he was afraid. Answer: c. Ryan's fear of heights caused him to always wonder just how high up he was in a building. 26. Evolutionary preparedness explains a. why phobic people are likely to maintain their avoidance behavior. b. how the inflation effect works. c. why cognitive variables are so important in phobias. d. why some types of phobias are much more common than others. Answer: d. why some types of phobias are much more common than others. 27. What has research on the preparedness theory of phobias found? a. Fear responses cannot be conditioned to fear-irrelevant stimuli. b. Acquired fear responses can be elicited with subliminal exposure to fear-relevant stimuli. c. Prepared fears are innate. d. There are cross-cultural differences in the stimuli people are "prepared" to fear. Answer: b. Acquired fear responses can be elicited with subliminal exposure to fear-relevant stimuli. 28. It is fairly easy to condition monkeys and humans to fear snakes but almost impossible to condition either to fear a flower. This supports the ___________ theory of phobias. a. classical conditioning b. vicarious conditioning c. preparedness d. psychoanalytic Answer: c. preparedness 29. From an evolutionary perspective, what concept explains the easy acquisition of a fear of spiders or snakes? a. vicarious conditioning b. defense mechanisms c. prepared learning d. behavioral inhibition Answer: c. prepared learning 30. Which of the following provides evidence against a role for inherited factors in the development of phobias? a. the high concordance rate seen in fraternal twins b. the impact of nonshared environmental factors c. the preparedness hypothesis d. the early onset of many phobic reactions Answer: b. the impact of nonshared environmental factors 31. Lauren is phobic of birds. Her therapist shows her how to approach a bird in a cage. The therapist then takes the bird out, pets it and feeds it. She then encourages Lauren to do the same behaviors. This type of procedure is called a. exposure therapy. b. classical conditioning. c. participant modeling. d. virtual reality therapy. Answer: c. participant modeling. 32. Which of the following seems to be the best treatment for phobias? a. exposure therapy b. psychoanalysis c. cognitive restructuring d. family therapy Answer: a. exposure therapy 33. Virtual reality environments a. permit the use of a combination of exposure therapy, participant modeling, and stress inoculation. b. have been shown to be effective in treating agoraphobia. c. appear to be more effective in treating phobias than live exposure to the feared stimulus. d. allow exposure therapy to be conducted in a simulated setting. Answer: d. allow exposure therapy to be conducted in a simulated setting. 34. Kayla has just started college and wants to make friends. She refuses to go to large parties because she is afraid that she will blush and sweat, and that other people will laugh at her. She is fine when talking to people in one-on-one settings. Kayla's most likely diagnosis is a. social phobia. b. specific phobia, situational type. c. agoraphobia without history of panic disorder. d. generalized social phobia. Answer: a. social phobia. 35. Social phobia a. is characterized by significant fear of most social situations. b. and antisocial personality commonly are comorbid disorders. c. involves a fear of one or more specific social situations. d. typically develops in childhood. Answer: c. involves a fear of one or more specific social situations. 36. The individual with generalized social phobia a. has a specific phobia for all social situations. b. exhibits a fear of most social situations. c. typically has a fear of public speaking, using a public restroom, and restaurants. d. is likely to receive a diagnosis of generalized anxiety disorder. Answer: b. exhibits a fear of most social situations. 37. Most individuals diagnosed with social phobia a. can identify the origin of their social phobia. b. have no other anxiety or mood disorders. c. are men. d. abuse alcohol. Answer: a. can identify the origin of their social phobia. 38. Studies of preparedness and social phobia a. find that angry faces act as fear-relevant stimuli. b. reveal that an explicit perception of threat is necessary to evoke a sympathetic response. c. do not provide justification for the seemingly irrational nature of social phobia. d. provide an explanation for why such a maladaptive behavioral response persists. Answer: a. find that angry faces act as fear-relevant stimuli. 39. Behaviorally inhibited young children are more likely to develop specific phobias. This is an example of a ___________ causal factor. a. conditioning b. preparedness c. cognitive d. biological Answer: d. biological 40. Individuals with social phobia are likely to a. be aggressive. b. attribute events in their lives to external factors. c. have been raised in a permissive environment. d. attribute negative life events to internal, global, and stable factors. Answer: b. attribute events in their lives to external factors. 41. Cognitive approaches to social phobia focus on a. extinguishing problematic behavioral responses. b. challenging automatic thoughts. c. identifying the underlying cause of the phobia. d. minimizing symptoms. Answer: b. challenging automatic thoughts. 42. Panic attacks, by definition, a. are seen in individuals with panic disorder. b. are unexpected ("uncued"). c. require the presence of at least 4 of 13 characteristic symptoms. d. are 30-60 minutes in duration. Answer: c. require the presence of at least 4 of 13 characteristic symptoms. 43. Which of the following is necessary for a diagnosis of panic disorder? a. Uncued panic attacks b. Depersonalization c. Panic attacks, cued and uncued, consisting of at least 6 of the 13 symptoms of a panic attack d. Derealization Answer: a. Uncued panic attacks 44. When Jill experienced her first panic attack, she felt as if she were outside of herself, watching herself struggle to catch her breath. Jill's sense of not being part of herself is one of the symptoms of a panic attack known as a. derealization. b. depersonalization. c. dissociative fugue. d. personality disintegration. Answer: b. depersonalization. 45. Compared to anxiety, panic is a. less focused. b. longer lasting. c. slower to develop. d. more intense. Answer: d. more intense. 46. Panic disorders are often misdiagnosed because a. the symptoms overlap so much with major depression. b. the symptoms are so chronic and mild, they do not seem like serious forms of psychopathology. c. patients are so embarrassed by their problems, they do not make them known to professionals. d. symptoms are so somatic they are treated by physicians for medical problems. Answer: d. symptoms are so somatic they are treated by physicians for medical problems. 47. Agoraphobia is best described as a fear of a. going to the dentist. b. being alone. c. being judged by people. d. experiencing a panic attack. Answer: d. experiencing a panic attack. 48. ___________ was once thought to be a fear of crowded places, but now is seen as a complication of having panic attacks in public. a. Agoraphobia b. Claustrophobia c. Generalized anxiety disorder d. General social phobia Answer: a. Agoraphobia 49. Mrs. B. tells her psychologist, "I cannot leave a certain region around my home without having terrible fears. I am terribly worried when I am in a car or bus. I am afraid I will have another one of those terrifying experiences." What disorder does Mrs. B probably have and what experience is she talking about? a. The disorder is specific phobia, the experience is a panic attack. b. The disorder is agoraphobia, the experience is a panic attack. c. The disorder is obsessive-compulsive disorder, the experience is an obsession. d. The disorder is generalized anxiety disorder, the experience is anxiety. Answer: b. The disorder is agoraphobia, the experience is a panic attack. 50. In order to qualify as a full-blown panic attack, which of the following must be present? a. one or two panic symptoms, most of which are physical b. at least four of thirteen symptoms, most of which are physical c. slow onset of at least four to thirteen symptoms d. slow onset with one to two symptoms developing over the course of an hour Answer: b. at least four of thirteen symptoms, most of which are physical 51. Panic disorder is best described as a(n) ___________ condition. a. chronic b. acute c. dissociative d. inherited Answer: a. chronic 52. James began having panic attacks immediately after his mother died suddenly. As they became more frequent, he began to fear going into public situations where they might occur. Now he is unable to leave his apartment and has others go out to shop for him. What is unusual about this case? a. It is unusual for a person with severe agoraphobia to be a man. b. It is unusual for panic attacks to begin after a stressful life event. c. It is unusual for fear of panic attacks to lead to agoraphobia. d. There is nothing unusual about this case. Answer: a. It is unusual for a person with severe agoraphobia to be a man. 53. Which of the following is a sociocultural explanation for the higher incidence of anxiety disorders in women? a. Historically, women have had to stay and care for young. Thus, a hypervigilant state was adaptive. b. Women have a natural tendency to be more cautious than men. c. High levels of male hormones lead to aggression and fearlessness. d. It is more acceptable for women to exhibit fear. Answer: d. It is more acceptable for women to exhibit fear. 54. Approximately ___ to ___ of people with severe agoraphobia are women. a. 10; 20 b. 30; 40 c. 60; 70 d. 80; 90 Answer: d. 80; 90 55. Agoraphobics are highly likely to have all of the following EXCEPT a. PTSD. b. alcohol abuse. c. depression. d. neurotic personality disorder. Answer: d. neurotic personality disorder. 56. Most first panic attacks a. follow some distressing event. b. are uncued. c. are followed by the development of panic disorder. d. last more than an hour. Answer: a. follow some distressing event. 57. Research using panic provocation agents has revealed a. the neurobiological basis for panic disorder. b. that there is no biological explanation for panic disorder. c. flaws in the studies using sodium lactate infusion. d. that there are probably multiple biological explanations for panic disorder. Answer: d. that there are probably multiple biological explanations for panic disorder. 58. What is thought to explain the effectiveness of the SSRIs in treating panic disorder? a. They increase serotonergic activity. b. They increase noradrenergic activity. c. They decrease serotonergic activity. d. They decrease noradrenergic activity. Answer: d. They decrease noradrenergic activity. 59. Which brain structure is recognized as playing a central role in panic attacks? a. Amygdala b. Cerebellum c. Hippocampus d. Locus coeruleus Answer: a. Amygdala 60. "Repeated stimulation of the limbic system by discharges from the locus coeruleus may lower the threshold for later experiences of anxiety. Then, through learning, controlled by the prefrontal cortex, the person actively avoids fearful situations." This quotation most clearly refers to the biological processes involved in a. obsessive-compulsive disorder. b. panic disorder with agoraphobia. c. generalized anxiety disorder. d. social phobia. Answer: b. panic disorder with agoraphobia. 61. Betty is hyper-aware of such bodily sensations as heart rate and respiration rate. When she perceives heart or breathing as getting faster she becomes afraid that she is having a heart attack. These thoughts make her symptoms worse and she has a panic attack. Betty's pattern of thinking best illustrates a. cognitive theory of panic. b. the psychoanalytic theory of panic. c. the importance of perceived control in panic disorder. d. the role of the locus coeruleus in panic. Answer: a. cognitive theory of panic. 62. Anxiety sensitivity is a. a fear of open spaces. b. a belief that anxiety will kill. c. a trait-like belief that certain bodily symptoms may have harmful consequences. d. a fear that situations in which panic attacks occur will be devastating. Answer: c. a trait-like belief that certain bodily symptoms may have harmful consequences. 63. Catastrophizing, fear of standing in line, and fear of crowded places are characteristic of which of the following? a. social phobia b. generalized anxiety disorder c. obsessive-compulsive disorder d. agoraphobia Answer: d. agoraphobia 64. Which of the following statements is correct in regard to the role of cognitions in panic? a. Panic can be prevented in a panic provocation study by explaining what will happen. b. Panic clients are more likely to interpret bodily sensations as catastrophic events. c. Only individuals who tend to catastrophize develop panic disorder. d. Cognitive therapy is less effective than emotive therapy for panic disorder. Answer: b. Panic clients are more likely to interpret bodily sensations as catastrophic events. 65. The cognitive model does not account for a. nocturnal panic attacks. b. the effectiveness of cognitive-behavioral therapies. c. findings from panic provocation studies. d. evidence of a role for genes in anxiety disorders. Answer: a. nocturnal panic attacks. 66. High levels of anxiety sensitivity a. increase the risk of all types of anxiety disorder. b. are seen in all who develop agoraphobia. c. predict the development of spontaneous panic attacks. d. can be effectively treated with drugs that minimize noradrenergic function. Answer: c. predict the development of spontaneous panic attacks. 67. Why do many people with panic disorder continue to believe they are having a heart attack despite the fact that they never have had one? a. They continue to go through classical conditioned learning experiences each time they have a panic attack. b. They tend to engage in "safety behaviors" that they believe are the reason the catastrophe didn't happen. c. They tell themselves that physicians may have missed earlier heart attacks. d. They have such a high level of fear that learning is not possible. Answer: b. They tend to engage in "safety behaviors" that they believe are the reason the catastrophe didn't happen. 68. Which of the following are the antidepressants most widely prescribed today for the treatment of panic disorder? a. SSRIs b. Tricyclics c. Anxiolytics d. Benzodiazepines Answer: a. SSRIs 69. Harold's panic attacks have become so severe that he has finally sought treatment. He sees a psychiatrist who writes Harold a prescription that should offer him some immediate relief. Which of the following drugs is Harold most likely to have been prescribed? a. SSRIs b. Tricyclics c. Monamine oxidase inhibitors d. Benzodiazepines Answer: d. Benzodiazepines 70. Quentin is seeking medication to treat his panic disorder. Due to Quentin's history of substance abuse, his doctor hesitates. After some consideration, the doctor is most likely to write Quentin a prescription for a ________, confident that abuse won't be an issue. a. SSRI b. tricyclic c. monamine oxidase inhibitor d. benzodiazepine Answer: a. SSRI 71. While in treatment for panic disorder, Leroy is asked to engage in behaviors that activate the sympathetic nervous system. In other words, Leroy is engaging in behaviors that produce the physical sensation of fear. What type of treatment does this appear to be? a. Exteroceptive exposure b. Interoceptive exposure c. Anxiety sensitivity training d. Cognitive reconditioning Answer: b. Interoceptive exposure 72. Amber feels anxious almost all the time. She finds herself worrying that her husband will leave her (although he has never shown any indication that he would), that she chose the wrong job, that her children might not be safe at their school, and that she might get sick and leave her family in financial ruin. She calls her husband almost every day to find out when he will be home. She complains to her physician that she is always tired but cannot sleep or relax. Amber's most likely diagnosis is a. generalized anxiety disorder. b. generalized social phobia. c. panic disorder with agoraphobia. d. obsessive compulsive disorder. Answer: a. generalized anxiety disorder. 73. According to the psychoanalytic view, what makes generalized anxiety disorder (GAD) different from specific phobias? a. Defense mechanisms are not functional in GAD. b. Different defense mechanisms are employed by those with GAD and those with specific phobias. c. The underlying conflict in GAD is between the ego and the superego, while it is between the id and ego in specific phobias. d. Individuals with specific phobias suffer from self-hate and project this emotion on the feared stimulus. Answer: a. Defense mechanisms are not functional in GAD. 74. Derek's moods have always seemed to be unpredictable and irrational. Nancy, who has been diagnosed with generalized anxiety disorder, never knows when he is going to come home and yell at her and the kids. In family therapy it is revealed that Derek's moods are really not irrational, but a reflection of the day's sales at his store. Which of the following would be most likely to decrease Nancy's anxiety? a. Derek can commit more money to advertising so as to increase sales. b. Derek and Nancy should separate. c. Derek could call home each day and let Nancy know how the day went. d. Derek should sell the business. Answer: c. Derek could call home each day and let Nancy know how the day went. 75. Which of the following have studies of control in humans and monkeys provided support for? a. Genes play only a minimal role in the development of generalized anxiety disorder. b. Early experiences with mastery and control may serve as protective factors, decreasing the likelihood of developing generalized anxiety disorder. c. Exposure to uncontrollable events does not increase the chances of developing generalized anxiety disorder. d. The comorbidity of specific phobias and generalized anxiety disorder. Answer: b. Early experiences with mastery and control may serve as protective factors, decreasing the likelihood of developing generalized anxiety disorder. 76. Which of the following is NOT one of the benefits that those with GAD commonly believe they derive from worrying? a. If I worry about it now, I won't be as upset when it happens. b. If I worry about it, it is less likely to happen. c. If I worry about it, I won't have to think about other things that are even worse. d. If I worry about it, I'll be more prepared when it does happen. Answer: a. If I worry about it now, I won't be as upset when it happens. 77. One of the main functions that worry seems to serve in generalized anxiety disorder is a. it keeps people distracted from what is really bothering them. b. it keeps people with the disorder feeling happier than if they didn't worry. c. it prevents people with the disorder from developing depression. d. it keeps people from feeling the emotional and physiological consequences of anxiety. Answer: d. it keeps people from feeling the emotional and physiological consequences of anxiety. 78. One of the main problems with the worry in generalized anxiety disorders is a. it keeps people distracted from what is really bothering them. b. it is a form of avoidance and prevents extinction. c. it increases the effects of operant conditioning on their fears. d. it keeps people with the disorder feeling happier than if they don't worry. Answer: b. it is a form of avoidance and prevents extinction. 79. Neurobiological factors involved in panic disorder and generalized anxiety disorder provide evidence for the hypothesis that a. both disorders are caused by an excess of the GABA neurotransmitter. b. fear and anxiety are fundamentally distinct. c. the two disorders are genetically identical. d. panic may be an acute version of generalized anxiety disorder. Answer: b. fear and anxiety are fundamentally distinct. 80. What disorder does GAD appear to be most related to? a. PTSD b. Panic disorder c. Specific phobia d. Major depression Answer: d. Major depression 81. The effectiveness of Valium (or benzodiazepines) in treating GAD supports the hypothesis that a. a serotonin deficiency underlies GAD. b. heightened autonomic arousal causes the anxiety of those with GAD. c. a GABA deficiency underlies GAD. d. anxiety increases noradrenergic activity. Answer: c. a GABA deficiency underlies GAD. 82. If a pharmaceutical company were looking for a drug that would maximally treat generalized anxiety disorder they would want one that a. suppressed the activity of the locus coeruleus in the brain stem and the central Gray in the midbrain. b. decreased GABA levels while increasing norepinephrine. c. increased GABA levels while regulating serotonin. d. decreased serotonin levels and suppressed activity in the locus coeruleus. Answer: c. increased GABA levels while regulating serotonin. 83. Which of the following is a disadvantage of treating GAD with a benzodiazepine? a. A therapeutic response is not seen for several weeks. b. There is a high risk of overdose. c. Such drugs are frequently misused. d. The somatic symptoms are not treated. Answer: c. Such drugs are frequently misused. 84. Persistent and recurrent thoughts are a. compulsions. b. delusions. c. hallucinations. d. obsessions. Answer: d. obsessions. 85. Most people with obsessive-compulsive disorder a. experience obsessions, but compulsions are relatively rare. b. experience compulsions, but obsessions are relatively rare. c. experience both obsessions and compulsions. d. develop compulsions in childhood, and obsessions in adolescence or adulthood. Answer: c. experience both obsessions and compulsions. 86. Which of the following is characteristic of the obsessions seen in OCD? a. The obsessions serve to alleviate the anxiety created by the compulsions. b. The obsessions are clearly related to a traumatic life event. c. The obsessions are rarely related to the compulsions exhibited. d. Individuals with OCD know that their obsessions are irrational. Answer: d. Individuals with OCD know that their obsessions are irrational. 87. Tara believes that it is extremely important to be clean. She cleans her kitchen and bathroom daily and the rest of the house at least once every few days. She uses antibacterial soap and sterile water to clean. She says she wants people to be able to eat off her floors. Tara is very proud of her house and the way she keeps it. She a. has obsessive compulsive disorder. b. has specific phobia, situational type. c. generalized anxiety disorder. d. has no disorder. Answer: d. has no disorder. 88. Jessica spends much of her day counting or saying certain words to herself. When she is not doing this, she is checking whether she left her doors unlocked. These symptoms illustrate a. compulsions. b. obsessions. c. both obsessions (the counting and saying words) and compulsions (the checking). d. neither obsessions nor compulsions. Answer: a. compulsions. 89. Mark feels the need to tap everything within his arms reach twice. He doesn't have any particular thoughts associated with this, he just becomes anxious if he doesn't do it, because "something bad might happen." Mark a. does not have obsessive compulsive disorder. b. has obsessive compulsive disorder. c. has an unusual type of specific phobia. d. has no disorder. Answer: b. has obsessive compulsive disorder. 90. Which of the following is necessary for a diagnosis of OCD? a. The presence of compulsive behaviors b. A persistent awareness of the irrational nature of the obsessions experienced c. Evidence of psychosis d. The symptomatic behavior causes distress Answer: d. the symptomatic behavior causes distress 91. Dagmar is a musician and she loves the fact that she constantly hears new melodies in her head. In fact, she cannot remember a time when she did not hear music. Why is this NOT an example of an obsession? a. Obsessions must be accompanied by ritualistic actions. b. Obsessions must come on suddenly in response to a stressful life event. c. Obsessions must be voluntary thoughts that a person knows are irrational. d. Obsessions must be intrusive thoughts the person finds disturbing. Answer: d. Obsessions must be intrusive thoughts the person finds disturbing. 92. Which of the following is unique about OCD, as compared to other anxiety disorders? a. It afflicts more men than women. b. The incidence is about equal for men and women. c. It usually begins in childhood. d. It is a culture-bound disorder. Answer: b. The incidence is about equal for men and women. 93. Which of the following is true of obsessive-compulsive disorder? a. Nearly six times more women than men suffer from OCD. b. This disorder tends to begin in adolescence or early adulthood, but is not uncommon in children. c. Once thought to be a fairly common disorder, with new diagnostic criteria, it is seen as quite rare. d. Although most people have both obsessive thoughts and compulsive rituals, rarely are the two issues related. Answer: b. This disorder tends to begin in adolescence or early adulthood, but is not uncommon in children. 94. Which of the following is a common type of obsession seen in OCD? a. Fear of contamination b. Counting over and over c. Hand washing d. Double checking locked doors Answer: a. Fear of contamination 95. What of the following are among the most common obsessive thoughts in people with OCD? a. Worry about humiliating oneself in public b. Fear of contamination and fear of harming others c. Being the victim of crime and having a panic attack in public d. Desire to get intoxicated on drugs and alcohol Answer: b. Fear of contamination and fear of harming others 96. Which of the following is one of the five primary types of compulsive acts seen in individuals with OCD? a. Cleaning b. Fear of contamination c. Fear of danger d. Scanning Answer: a. Cleaning 97. What do all of the compulsions seen in OCD have in common? a. They all take 15-20 minutes to perform. b. All involve counting. c. They are engaged in as means of alleviating tension. d. There is little desire to engage in the compulsion. Answer: c. They are engaged in as means of alleviating tension. 98. Some things seem to be consistent across all the different forms that obsessive-compulsive disorder takes. These include a. a tendency to have an aggressive, impulsive personality. b. an overwhelming fear that something terrible will happen to the person or to others for which they are responsible. c. a strong resistance to depressive and other mood disorders. d. an inability to see that the compulsive actions they engage in are unnecessary and ridiculous. Answer: b. an overwhelming fear that something terrible will happen to the person or to others for which they are responsible. 99. According to the behavioral viewpoint, compulsions are repeated because a. they act of engaging in the behavior is pleasurable. b. they serve to reduce anxiety. c. they are reflexive responses that can't be controlled. d. they permit the expression of repressed urges. Answer: b. they serve to reduce anxiety. 100. Which of the following is a true statement about Mowrer's two-process theory of avoidance learning? a. It provides an explanation for the development of all anxiety disorders. b. While it suggests mechanisms for the development of GAD, it does not account for the development of panic disorder and OCD. c. It does not account for the effectiveness of extinction procedures in the treatment of OCD. d. It has not been helpful in explaining why people with OCD develop obsessions in the first place and why some people never develop compulsive behaviors. Answer: d. It has not been helpful in explaining why people with OCD develop obsessions in the first place and why some people never develop compulsive behaviors. 101. Mowrer's two-process theory of avoidance learning provides a theoretical rationale for an effective treatment for obsessive-compulsive disorder. What is this treatment? a. response activation therapy b. exposure prevention therapy c. response provocation therapy d. exposure therapy with response prevention Answer: d. exposure therapy with response prevention 102. The fact that dirt and contamination were threats to our ancestors suggests a. that preparedness theory may help explain obsessive-compulsive disorder. b. that fear of these things is rational. c. that obsessive-compulsive disorder probably exists in many species, not just humans. d. that obsessive-compulsive disorder is one of the oldest disorders in existence. Answer: a. that preparedness theory may help explain obsessive-compulsive disorder. 103. Which of the following provides a unique challenge when trying to eliminate the obsessions seen in OCD? a. The client is likely to feel that his or her concerns are justified. b. Attempting to not think about something may lead to thinking about it more. c. Obsessions are likely to only be experienced under certain environmental conditions. d. Medications are ineffective in suppressing obsessions. Answer: b. Attempting to not think about something may lead to thinking about it more. 104. Thought-action fusion is a. a psychotic symptom that helps distinguish between anxiety disorders and psychotic disorders. b. support for the preparedness theory of obsessive-compulsive disorder. c. the belief that thinking about something is as bad as actually doing it. d. the reason why trying to suppress unwanted thoughts often causes an increase in those thoughts. Answer: c. the belief that thinking about something is as bad as actually doing it. 105. Research on the role of genetics in the development of OCD suggests that a. there may be "neurotic" personality factors that increase susceptibility to OCD. b. altered serotonergic functioning is inherited. c. genes do not play a role in OCD. d. an abnormality on the X chromosome underlies OCD. Answer: a. there may be "neurotic" personality factors that increase susceptibility to OCD. 106. As discussed in your text, much evidence now suggests a number of biological causal factors in obsessive-compulsive disorder including a. a minimal or absent genetic contribution. b. abnormalities in the functioning of the basal ganglia. c. abnormalities in dopamine systems. d. decreased activity in the orbital frontal cortex. Answer: b. abnormalities in the functioning of the basal ganglia. 107. Anxiety disorders a. exist only in technologically advanced cultures. b. probably exist in all societies, but take different forms in different cultures. c. are especially prevalent in Japan, where strong pressures exist to compete and succeed. d. involve different causal factors in different cultures. Answer: b. probably exist in all societies, but take different forms in different cultures. Fill-in-the-Blank Questions 1. The basic emotion that involves activation of the "fight-or-flight" response is __________. Answer: fear 2. _____________ are persistent and strong fears triggered by specific objects or situations that are unreasonable. Answer: Specific phobias 3. That humans have evolved to fear certain objects or situations because they pose real threats is called __________ learning. Answer: prepared 4. One of the best behavioral treatments for specific phobias is __________ therapy. Answer: exposure 5. The __________ is the part of the brain that plays a central role in panic attacks. Answer: amygdala 6. The role of worry is now central to our understanding of __________. Answer: generalized anxiety disorder Short Answer Questions 1. What are the three components of fear? Answer: Modern definitions of fear define fear as a basic emotion, characterized by physiological, cognitive, and behavioral components. The sympathetic nervous system is activated by a fear-producing stimulus, a feeling of fear is experienced, and there is some appropriate behavioral response, such as running away. 2. What differences in life experiences can lessen the likelihood that someone will develop a phobia? Answer: Previous positive or nontraumatic experiences with the conditioned stimulus (e.g., if lots of good experiences with dogs, less likely to develop a phobia after being bitten), observing a no fearful other approaching the situation or object, and having a feeling of control or ability to escape from a traumatic event will lessen the likelihood. 3. How do cognitions help maintain phobias? Answer: Phobic people are constantly on the alert for their phobic object or situation, or for relevant stimuli. Nonphobic people tend to focus their attention away from these things. Phobic people overestimate the probability that the feared object will be followed by something bad, which may strengthen the fear over time. 4. Describe how a phobia could be learned through vicarious conditioning. Answer: Phobias can be learned by watching another person who has a phobia. Watching that person behave with fear around the feared object or situation can cause distress in the observer and lead to learning of the phobia. 5. Describe the purpose of exposure therapy for specific phobia. Answer: To place people in the situation they fear for long enough that extinction occurs and their fear subsides. 6. What do the results of panic provocation agents tell us about panic disorder? Answer: That no one neurobiological mechanism could explain the results, so there may be multiple different biological causes of panic. 7. How do "safety behaviors" contribute to the persistence of panic disorder? Answer: Panic disorder often persists despite infrequent panic attacks and no occurrence of dire consequences as a result of a panic attack. This may be explained by the use of "safety behaviors," behaviors that the individual engages in before or during an attack. When nothing catastrophic occurs, it is attributed to the use of the safety behaviors, as opposed to the lack of any real danger. 8. What is necessary for a diagnosis of generalized anxiety disorder? Answer: In order to be diagnosed with generalized anxiety disorder (GAD), an individual must exhibit worry on the majority of days over at least a 6-month period. The worry must not be associated with another disorder and it must be perceived as difficult to control. In addition to the experience of worry, at least three of the following six symptoms must be present: (1) restlessness or edginess, (2) a feeling of being easily tired, (3) problems concentrating, (4) irritability, (5) muscle tension, and (6) sleep disturbance. 9. What role might a lack of safety signals play in the development and maintenance of generalized anxiety disorder? Answer: It is well-established that a lack of predictability and control creates stress. Safety signals are environment cues that signal when it is appropriate to relax. For example, if you knew your boss was always in a good mood on Friday, it might be safe to relax and not worry about a mistake you made. The fact that it is Friday would serve as a safety signal. The rest of the week, however, you should feel anxious about having made a mistake. When safety signals are present, it signals that one can relax. In the absence of such signals, anxiety prevails, providing a possible explanation for generalized anxiety disorder. 10. What benefit do those with GAD derive from worrying? Answer: Research has revealed that worrying does have a positive effect on those with GAD. While it does not prevent catastrophe, when those with GAD worry, emotional and physiological responses to negative stimuli are suppressed. In other words, the act of worrying about an event lessens the impact of that event if and when it does occur. 11. What are obsessions? Compulsions? Give an example of each. Answer: Obsessions are persistent, recurrent, intrusive thoughts. Examples include contamination and fear of harming self or others. Compulsions are repetitive behaviors or mental acts the person feels driven to perform in a ritualistic way. They are usually in response to an obsession and done to reduce anxiety. Examples include washing and checking. Essay Questions 1. Discuss the difference between fear and anxiety. Answer: Fear is a basic emotion that involves activation of the sympathetic nervous system, preparing the body for action. Fear is a response to a threat that we are faced with; fear is a reaction to a stimulus that is before us. Anxiety is not a basic emotion, but a combination of emotions and thoughts that are directed toward some anticipated event. Thus, fear is a reaction to a stimulus and anxiety is a more cognitive reaction to some dreaded event. Fear is a reaction to something in front of us, while anxiety is a dread of some future event. 2. How do cognitive factors affect the onset and maintenance of social phobia? Explain and provide 3 specific examples to illustrate your understanding. Answer: Cognitive factors play a role in both the onset and maintenance of social phobia. It has been suggested that those who develop social phobias may tend to expect that others will reject them or view them negatively, setting the stage for a fear of any situation in which one will be evaluated. An expectation that one will behave in a socially unacceptable fashion can also contribute to the development of social phobia, as well as increase the chance that one's behavior will be unacceptable. Thus, both negative expectations of how one will be perceived and how one will act can contribute to social phobia. These cognitive distortions may then maintain social phobia by increasing social awkwardness and a belief in negative evaluations. There is also some evidence to suggest that perceptions of uncontrollability and unpredictability, possibly resulting from social defeat, may also play a role in the development of social phobia. 3. Discuss the theory of evolutionary preparedness and how it may apply to specific phobia, social phobia and obsessive-compulsive disorder. Answer: Our evolutionary history has affected the stimuli we are most likely to fear. People and primates seem genetically prepared to quickly associate certain objects with fear rather than other objects. While there are many types of specific phobias, most involve animals and situations that were a threat to our ancestors. Those primates and humans who had this rapid acquisition of fear were more likely to survive and pass on their genes. The fear itself is not inherited, the tendency to make certain connections quickly is. It was also advantageous to acquire fears of social stimuli that signaled danger - angry or contemptuous faces. So social phobias may have an evolutionary basis. The most common obsession in OCD - contamination and dirt - was also a threat to our ancestors and may have the same type of preparedness component. 4. Compare the comprehensive learning theory and the cognitive theory of panic disorder. Answer: The comprehensive learning theory suggests that initial panic attacks cause conditioning of anxiety to internal and external cues. Anxiety then is created in the presence of these cues, leading to more panic attacks. Because anxiety is conditioned to internal cues, panic attacks can seem to come out of nowhere. The internal cues that resemble panic attacks can cause an attack, regardless of how the person is actually feeling at the time. The cognitive theory suggests that people with panic disorder are highly sensitive to body sensations and tend to catastrophize in response to unusual sensations. This causes a vicious circle ending in a panic attack. The difference here is that it is the meaning people attribute to their symptoms that cause the panic. It is not necessary for people to make any attributions in the learning theory. So the learning theory is a better explanation for panic attacks that occur without any negative thoughts, such as during sleep. 5. Discuss the findings of cross-cultural research on the anxiety disorders. Provide at least two examples of disorders that illustrate the role of culture. Answer: As with most disorders, cultural influences are seen in the anxiety disorders. While most emotional responses are universal, the stimuli that elicit emotional reactions will vary and how emotions are expressed varies. In the case of anxiety disorders, the prevalence of the different types of disorders varies with culture. Differences in sources of anxiety are easily found. Nigerians, for example, are likely to be concerned about fertility and maintaining a large family. In some Asian cultures Koro, a fear of the penis shrinking and disappearing, may be seen,. Both of these sources of anxiety are clearly related to the value the culture places on procreating, a concern not seen in most Western societies. Social phobia takes different forms across cultures, being characterized by a fear of embarrassing one's self in some and a fear of embarrassing others in some. Thus, the anxiety disorders are very much impacted by culture in numerous ways. Test Bank for Abnormal Psychology: DSM 5 James N. Butcher, Jill M. Hooley, Susan M. Mineka 9780205965090, 9780205944286
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