Chapter 4: Classification and Assessment of Abnormal Behavior Multiple Choice 1. A psychologist conducts an interview and administers several psychological tests in order to evaluate the nature of a person's problem and to formulate a treatment plan. What term is used to describe this process? a. diagnosis b. assessment c. validation d. ego analysis Answer: b. 2. In the field of mental health, a clinician’s decision to assign a diagnosis when a person’s behavior meets the specific criteria for a particular type of disorder is important because it tells the clinician a. that the person’s problems are similar to those experienced by others. b. what caused the person’s problems. c. exactly how the problems can best be treated. d. that the person’s problems are unique. Answer: a. 3. What is a diagnosis? a. an explanation of the etiology of a problem b. an estimate of the chances of a full recovery c. a description of behavior as fitting the criteria for a particular type of disorder d. a mental health professional's estimate of the impact of family conflict on a disorder Answer: c. 4. In the case of Michael presented in your text, which of these is one of the keys that should lead a mental health professional to suspect that Michael suffers from obsessive-compulsive disorder? a. Michael's symptoms fall into a recognized pattern. b. There is a significant family history of conflict. c. Michael expresses a need to be alone. d. Michael has trouble communicating his thoughts. Answer: a. 5. One advantage of a dimensional system of classification is that it allows scientists to a. make all-or-none decisions. b. arrive at a specific diagnosis. c. record subtle distinctions. d. go beyond what people say. Answer: c. 6. A system that classifies mental disorders on the basis their qualitative differences is known as a a. class approach. b. dimensional approach. c. categorical approach. d. measurement approach. Answer: c. 7. In the classification of intellectual ability, psychologists determine how much intelligence a person has on a particular set of tasks; such a classification system is known as a. archetypal. b. dimensional. c. categorical. d. diagnostic. Answer: b. 8. A classification system that focuses on how much of a given characteristic an individual exhibits is called a. categorical. b. measurement based. c. classificatory. d. dimensional. Answer: d. 9. The development of scientific classification systems proceeds in an orderly fashion over several years from the first steps involving description to later stages involving a. diagnosis. b. theory. c. dimensions. d. categories. Answer: b. 10. The most likely theories for the cause of mental disorders involve a. biological systems only. b. psychological systems only. c. social systems only. d. interactions involving biological, psychological, and social systems. Answer: d. 11. Mental disorders are currently classified on the basis of a. causal mechanisms. b. biological features. c. descriptive features. d. theoretical relatedness. Answer: c. 12. Currently there are two classification systems for mental disorders used in the world; the DSM, used mostly in North America, and the __________ , used in most other parts of the world. a. WHO b. ICD c. DSM-TR d. PCL Answer: b. 13. The current Diagnostic and Statistical Manual of the American Psychiatric Association is also called the a. DSM-APA b. DSM-IV-TR c. DSM-5 d. DSM-TR Answer: c. 14. Which organizations publish the two most widely recognized diagnostic systems for mental disorder? a. American Psychiatric Association and World Health Organization b. American Psychiatric Association and American Psychological Association c. National Institute of Mental Health and the American Medical Association d. American Medical Association and the National Association for the Mentally Ill Answer: a. 15. In the 1950s and 1960s, mental health clinicians using early editions of the DSM who independently evaluated the same client a. usually arrived at the same diagnosis. b. frequently disagreed with one another. c. relied heavily on psychological tests. d. tended to prefer the term "problems in living." Answer: b. 16. Labeling theory is a perspective on mental disorders that focuses on a. interrater reliability in diagnosis. b. identification of biological causes of mental disorders. c. social factors that influence the assignment of a diagnosis. d. validity of including certain symptoms in criteria for diagnosis. Answer: c. 17. According to labeling theory, a psychiatric diagnosis serves to a. identify etiological factors. b. eliminate bias due to social factors. c. clarify the nature of a psychiatric disorder. d. create a social role that perpetuates abnormal behavior. Answer: d. 18. A patient was just released from a psychiatric hospital where he has spent the last five years. A social worker spends some time trying to help him prepare for what she calls stigma. What was the focus of these sessions? a. negative attitudes that result in various forms of discrimination b. the tendency for most mental patients to cease taking their medications c. the tendency for the public to provide too much assistance to former mental patients d. a government effort to assist former mental patients by providing group living arrangements Answer: a. 19. DSM-5 diagnoses are grouped under 22 primary headings based on a. presumed causes. b. biological factors. c. descriptive similarity. d. theoretical assumptions. Answer: c. 20. Modern classification systems in psychiatry were introduced a. by biologists and then adapted by psychiatrists. b. by clinical psychologists working for the World Health Organization. c. by Freud before WWII. d. shortly after WWII. Answer: d. 21. A clinician is using DSM-5 to arrive at a diagnosis for Michael, whose case is presented in your text; to justify a diagnosis of obsessive-compulsive disorder, the clinician will have to a. conduct extensive psychological tests. b. refer Michael to a physician. c. compare Michael symptoms to a specific set of criteria. d. arrange for Michael to undergo a brain scan. Answer: c. 22. In DSM-5, clinical disorders are defined largely in terms of a. compulsive behaviors b. symptomatic behaviors. c. necessity of inpatient therapy. d. comorbidity. Answer: b. 23. How are disorders grouped in DSM-5? a. by similar kinds of symptoms b. by the length of time the symptoms have been present c. by similar levels of disturbance in the individual d. by the number of symptoms an individual is experiencing Answer: a. 24. In order to meet the criteria for obsessive-compulsive disorder, a person’s compulsive rituals must take more than one hour each day. Moreover, the symptoms cannot be due to drug use or the presence of other disorders. What aspects of the DSM system are illustrated by these diagnostic criteria? a. reliable and valid criteria b. primary and secondary criteria c. inclusion and exclusion criteria d. etiological diagnosis and assessment Answer: c. 25. In DSM, clinical disorders are classified based on a. axes from I - V. b. alphabetization. c. descriptive features and symptoms. d. they are not classified, because labeling creates problems for individuals. Answer: c. 26. DSM-5 encourages clinicians to consider the influence of cultural factors in both the expression and recognition of symptoms of mental disorders. This is especially challenging when a. the clinician and the person with the problem do not share the same cultural background. b. the clinician and the person with the problem share the same cultural background. c. cultural background does not factor into the diagnostic equation. d. the clinician and the person with the problem share the same faith. Answer: a. 27. Michael, whose case serves as an example in your textbook, was diagnosed with obsessive-compulsive disorder (OCD). Which of the following pointed toward that diagnosis? a. He performed repetitive counting rituals in response to obsessive thoughts. b. He considered his obsessive concerns to be logical. c. His relationships with his friends were unlimited and satisfying. d. His rituals interfered with his family’s routine. Answer: d. 28. The Diagnostic and Statistical Manual is published by a. the World Health Organization. b. the American Psychiatric Association. c. the Center for Disease Control. d. the American Psychological Society. Answer: b. 29. A categorical approach assumes that a. all distinctions among members of different categories are quantitative. b. all distinctions among members of different categories are qualitative. c. the question of “how much” of a characteristic that a person displays can be answered. d. we cannot make “all or none” decisions. Answer: b. 30. Oscar has recently lost a loved one; a mental health professional who is trying to be sensitive to the cultural context of Oscar's problem will want to know a. what Oscar has learned about how grief should be displayed. b. how depressed Oscar is. c. whether Oscar suffers from some chemical imbalance. d. whether Oscar's family has a history of depression. Answer: a. 31. In the DSM, the behavior referred to as ataques de nervios is viewed as an example of a. paranoid schizophrenia. b. panic disorder. c. a culture-free syndrome. d. a culture-bound syndrome. Answer: d. 32. Culture-bound syndromes in DSM are also known as idioms of distress because they represent a. different forms of speech. b. unique manners of expressing emotion. c. the non-professional term for mental disorders. d. non-existent or imagined forms of psychopathology. Answer: b. 33. Which of the following seems to be a key feature of ataques de nervios? a. delusions b. hallucinations c. loss of control d. a need to sleep for long periods Answer: c. 34. One theory to explain ataques de nervios is that it may be a culturally sanctioned way of expressing a. fear of darkness. b. disagreement with the cultural group. c. distress in response to a threat to the family. d. fear of death. Answer: c. 35. Your text suggests the possibility that the eating disorder known as bulimia could be listed as a culture-bound syndrome; what fact best supports this view? a. Eating rituals vary between cultures. b. Bulimia is found primarily in developed Western cultures. c. Bulimia is a rare condition. d. The prevalence of eating disorders does not vary between countries. Answer: b. 36. The two principal criteria used to evaluate a classification system like DSM-5 are a. reactivity and sensitivity. b. reliability and validity. c. inclusiveness and disclusiveness. d. cultural specificity and cultural universality. Answer: b. 37. Two clinical psychologists each interview and diagnose a group of patients. The extent to which they agree on the diagnosis of each patient is called a. utility. b. validity. c. coverage. d. reliability. Answer: d. 38. When we ask whether a category or diagnosis is useful, we are asking about its a. kappa. b. coverage. c. validity. d. reliability. Answer: c. 39. "Kappa" is a measure of interrater reliability that describes a. the proportion of time raters agree exactly. b. the proportion of agreement beyond chance agreement. c. whether certain diagnoses are used disproportionately. d. whether a clinician is equally accurate with all diagnoses. Answer: b. 40. A team of researchers has developed a structured interview to diagnose a new type of personality disorder. A series of trials to check the reliability of the structured interview yields a kappa of .75. How should the researchers view this result? a. The kappa is so low they decide to abandon the project. b. The kappa is not at an acceptable level but encouraging for a new instrument that can be improved. c. Kappa is not the appropriate measure to be used when evaluating the reliability of a new diagnostic category. d. The kappa is at an acceptable level for well-established diagnostic instruments, so the interview is ready to be used in clinical settings. Answer: d. 41. If you had to briefly summarize the results of research on diagnostic reliability of mental disorders, which of the following sentences would do the job? a. "The reliability has increased with few exceptions." b. "We should not accept the assumption that the diagnostic categories in DSM-5 are used reliably." c. "The highest reliability is found for the specific examples of each of the major categories." d. "There is good reliability for personality disorders but lower reliability for other disorders." Answer: b. 42. Your text describes a study of the reliability of diagnoses for several types of mental disorders which concludes that a. clinicians do not use psychological testing. b. more categories of mental disorder should be introduced. c. the diagnostic categories of the DSM are not always used reliably by clinicians. d. psychiatrists and psychologists fail to cooperate. Answer: c. 43. Which of the following disorders have especially low diagnostic reliability? a. attention deficit b. posttraumatic stress c. autism spectrum d. generalized anxiety Answer: d. 4.3: What is the difference between reliability and validity? 44. You are part of a team designing a study to see if a given DSM category tends to run in families. Concerned with contributing factors to the onset of a disorder, your team is looking for evidence of __________ validity. a. genetic b. test-retest c. reliable d. etiological Answer: d. 45. Videotapes of 10-year-old children are being used to determine if their social interactions are related to the development of schizophrenia in adulthood. What type of validity is the focus of interest here? a. prognostic b. predictive c. concurrent d. test-retest Answer: b. 46. The case of Michael presented in your text illustrates comorbidity because a. Michael suffers from more than one disorder. b. Michael suffers from a life-threatening disorder. c. Michael's disorder resulted from family conflict. d. Michael shares the disorder with other members of his family. Answer: a. 47. In DSM-5, disorders are defined in the terms of a. relationships with family members. b. the individual. c. the individual’s place in a chosen culture. d. the relationship between the client and the therapist. Answer: b. 48. According to the National Comorbidity Survey, what percentage of people who qualify for a diagnosis of one mental disorder in their lifetime are likely to meet the criteria for two or more disorders? a. less than 5 percent b. almost 100 percent c. a little more than 50 percent d. no more than 20 percent Answer: c. 49. A clinician has met with a client who presents symptoms that would meet the criteria for several disorders; according to DSM, the clinician would a. pick the most severe disorder to diagnose. b. pick the disorder that appeared first to diagnose. c. diagnose each disorder that fits the client's symptoms. d. have to decide which disorder was the most treatable. Answer: c. 50. The three primary goals that guide most assessment procedures are a. making predictions, planning treatments, and evaluating treatments. b. pinpointing etiology, testing etiology, and planning treatments c. pinpointing etiology, evaluating etiology, and making predictions. d. deciding on a diagnosis, testing the diagnosis, and pinpointing etiology. Answer: a. 51. Based on their assessment, clinicians want to generalize, or draw inferences about the person's behavior in the natural environment, but a. clinicians are unable to generalize accurately. b. clinicians must rely on specific samples of a person's behavior. c. only psychophysiological tests allow for such generalizations. d. only objective tests allow for such generalizations. Answer: b. 52. A psychologist wants to obtain a measure of children's attention spans under quiet conditions. She arranges for a group of children to meet individually with a research assistant who reads each child a list of numbers and then asks the child to repeat the numbers in reverse order. A week later the children repeat this task. The psychologist finds that the scores that each child received at week one and at week two tend to be very similar. She concludes that this test has high a. validity. b. split-half reliability. c. interrater reliability. d. test-retest reliability. Answer: d. 53. Split-half reliability is a measure of a test's a. validity. b. internal consistency. c. interrater consistency. d. test-retest consistency. Answer: b. 54. Which of the following is the best word or phrase to explain the validity of an assessment procedure? a. meaning b. consistency c. reliability d. predictability Answer: a. 55. What are the most commonly used psychological assessment procedures? a. IQ tests b. interviews c. rating scales d. personality tests Answer: b. 56. Paul Meehl has suggested that when clinicians mistakenly pay attention to vague, superficial, or stereotyped statements by clients, and fail to pay to attention to subtler but more important evidence, they are victims of the cognitive error he has labeled the a. cognitive dissonance effect. b. unreliability bias. c. Barnum effect. d. diagnostic fallibility crisis. Answer: c. 57. One goal of nondirective interviews is to a. incorporate talk therapy. b. specify in advance the possible etiologies of the client’s problems. c. explain the diagnosis to the client. d. help people clarify their subjective feelings. Answer: d. 58. A clinical psychologist is interviewing a client and asks a series of questions. Later the same psychologist interviews another client and asks the same series of questions in the same order. What type of interview is the psychologist using? a. primary b. objective c. projective d. structured Answer: d. 59. Structured diagnostic interviews are used extensively in conjunction with the DSM-5 classification system. The main advantage of using these tools is a. some clients are unwilling to provide a rational description of their own problems b. to reduce the need to establish rapport c. some clients are unable to provide a rational description of their own problems d. flexibility Answer: d. 60. What is one of the advantages of structured interviews in assessing clients? a. Scoring is based on empirical research. b. Structured interviews do not require training. c. The interviewer can probe further when necessary. d. The structured interview has a strict time limit that provides more time for other diagnostic tests. Answer: c. 61. What is one of the limitations of structured interviews? a. There is no room for clinical judgment. b. They are based only on open-ended questions. c. Information provided by the client can be distorted. d. The interviewer cannot control the course of the interview. Answer: c. 62. Using observation as part of a clinical interview can help the interviewer to a. clearly understand issues that are hidden in the client’s unconscious.. b. understand the client’s hidden behaviors not performed in front of the interviewer . c. both confirm and question the client's self-report. d. help the client change her self-report. Answer: c. 63. A client is asked to respond to items such as "How much distress do your obsessive thoughts cause you?" by using numbers from 0 to 4. What type of assessment is being used? a. rating scale b. behavioral coding c. projective testing d. self-report inventory Answer: a. 64. A researcher wants to compare the use of rating scales to behavioral coding systems. After making the comparison, he concludes that behavioral coding systems tend to a. be less reliable. b. be more qualitative. c. require more subjective judgment. d. require less inference by the observer. Answer: d. 65. Alice has been experiencing a number of symptoms of anxiety for several months. A psychologist decides to assess her symptoms by using a behavioral coding system. What is Alice likely to be asked to do? a. evaluate the symbolism of each of her symptoms b. record the presence of specific symptoms during 30-minute segments throughout the day c. rate the level of anxiety she feels on a scale ranging from very anxious to not anxious d. discuss her symptoms while a psychologist checks instruments designed to measure her pulse and breathing Answer: b. 66. Self-monitoring refers to a. clinicians looking out for their own biases. b. children learning to regulate their own behavior. c. adult clients keeping records of their own behavior. d. the importance of the clinician's presence in formal observation. Answer: c. 67. Reactivity refers to the a. effects of personal judgment on observers' ratings. b. tendency for observers to rate less severity over time. c. tendency for a person to change her behavior when she knows she is being observed. d. tendency for a person to reveal less in a structured interview than on a questionnaire. Answer: c. 68. What is the benefit of personality tests in psychological assessment? a. The same stimuli are used every time the test is given. b. It is more useful to assess personality than specific behaviors. c. People are generally unable to describe their own personalities. d. They do not have to be administered and interpreted by trained clinicians. Answer: a. 69. Carol is asked to complete a questionnaire made up of more than 500 true-false items. What test is she taking? a. Visual Analogue Test b. Thematic Apperception Test c. Wechsler Adult Intelligence Test d. Minnesota Multiphasic Personality Inventory Answer: d. 70. After reviewing the manual for scoring the MMPI-2, Elizabeth decides that the scoring can best be described as a. reactive. b. objective. c. subjective. d. projective. Answer: b. 71. A psychologist is reviewing results of the MMPI-2 test administered to a client who was mandated by a judge to seek therapy. The psychologist is concerned that the client may not have answered the questions consistently and honestly. Which part of the MMPI-2 will be of special interest to this psychologist? a. validity scales b. actuarial scales c. projective scales d. reliability scales Answer: a. 72. Several questions on the MMPI-2 contain questions that almost everyone is likely to answer in the same way; these questions are included to catch unsophisticated attempts to avoid answering honestly and are scored on the a. D or Deception Scale. b. L or Lie Scale. c. T or Truth Scale. d. O or Obfuscation Scale. Answer: b. 73. Ray is suspicious and has the unrelenting delusion that agents of a foreign government are following him with the intention of killing him. If Ray were administered the MMPI-2, you expect that he would have a high score on the scale measuring a. hysteria. b. paranoia. c. ego identity. d. narrow-mindedness. Answer: b. 74. An actuarial procedure of interpretation of psychological tests relies on a. subjective ratings of clinical interviews. b. current behavior rather than past behavior. c. psychoanalytic interpretation of test results. d. probability statements derived from empirical research. Answer: d. 75. An advantage of the MMPI-2 in clinical assessment is that it a. provides an in-depth measure of a small number of critical dimensions. b. gives the clinician ample opportunity to ask additional questions. c. covers a wide range of problems in an efficient manner. d. allows clinicians to include their own professional judgments. Answer: c. 76. What is one of the limitations of the MMPI-2 as a personality measure? a. It relies on subjective scoring. b. It is limited to use with the normal personality. c. There is little research on its reliability or validity. d. People who are acutely psychotic often have difficulty reading and comprehending. Answer: d. 77. One empirical finding about the MMPI-2 scales is that an individual's scores change over time. This finding could indicate a(n) a. high level of statistical significance to the scales. b. individual’s temperament. c. lack of reliability to the scales. d. high validity concerning the scales. Answer: c. 78. Projective tests a. are objectively scored. b. are used mostly by cognitive behavioral therapists. c. involve the presentation of stimuli that elicit standardized responses. d. involve the presentation of ambiguous stimuli. Answer: d. 79. A psychologist administers a series of projective tests to a client. Which major theoretical orientation is most consistent with this psychologist's preference in assessment methods? a. behavioral b. biological c. humanistic d. psychodynamic Answer: d. 80. What is the primary assumption of projective personality tests? a. Self-report checklists are more efficient than interviews. b. Visual processing errors often indicate a schizophrenic process. c. Individuals would project unconscious feelings onto ambiguous stimuli. d. A person's future goals reveal a lot about motivation, emotion, and personality. Answer: c. 81. As originally designed, the scoring of the Rorschach was a. the client's level of verbal expressiveness. b. the way the client’s descriptions took into account shapes and colors. c. based on emotions expressed by patients while looking at the cards. d. largely impressionistic and placed considerable emphasis on the person’s response. Answer: d. 82. Recent advances in the scoring of projective tests focus on a. the clinical experience of the clinician scoring the test. b. the form of the client's answers rather than the content. c. the content of the client's answers rather than the form. d. an objective score of the frequency of categories of responses. Answer: b. 83. The textbook suggests that which of the following is a potential advantage of a projective test? a. Some people feel less comfortable talking with someone than they do completing a lengthy questionnaire such as the MMPI. b. The results of projective tests are subject to interpretation and bias. c. While there are problems with both the reliability and validity of projective tests, they are still slightly better on both of these measures than tests such as the MMPI. d. If a person’s relationships with others have some unconscious cognitive or emotional component, this information may be obtained in a way that is not possible through direct interviewing methods or observational studies. Answer: d. 84. What is the main advantage of projective personality tests over other forms of personality tests? a. objective scoring b. based on extensive research c. efficient self-administration d. can provide details about a patient's unique view of the world Answer: d. 85. What is one of the limitations of projective personality testing? a. They provide little information on normal individuals or children. b. They focus on unconscious factors. c. Clients easily see through the testing. d. Standardized procedures leave little room for clinical judgment. Answer: a. 86. Recent advances in brain imaging have allowed clinicians to make scientifically useful comparisons in the relative size of the chambers in the brain that are filled with cerebrospinal fluid. These chambers are called a. lobes. b. ventricles. c. cerebrospinal spaces. d. meninges. Answer: b. 87. You are attempting to diagnosis a patient, and you would like a view of her brain. You are interested in static structures, not function, so your two choices of scanning techniques are CT scans and a. MRI. b. fMRI. c. EEG. d. TAT. Answer: a. 88. fMRI is a new and exciting method of imaging brains that is based on the physiological observation that a. the magnetic properties of neurons change as they release neurotransmitters. b. the magnetic properties of blood changes as a function of the level of oxygen it is carrying. c. the magnetic resonance of brain regions changes with age and experience. d. blood flow can be measured directly by the magnetic properties of the vessels containing the blood. Answer: b. 89. PET and fMRI scans have found valuable information about the biological components of OCD including over-activity in a. occipital lobe. b. caudate and the orbital prefontal cortex. c. cerebellum. d. Broca’s area. Answer: b. 90. One of the main advantages of modern brain imaging techniques is that they may a. illuminate the relationship between brain activity and mental problems. b. reduce the cost of clinical assessments. c. be used to validate the diagnostic information derived from projective techniques. d. eliminate the need for costly interview techniques in the diagnostic process. Answer: a. 91. One of the main limitations of modern brain imaging techniques in the field of abnormal psychology is that a. very few hospitals in the United States have access to these tools. b. they are quite unreliable in their measures. c. the images are not of sufficient quality to allow for diagnostic use. d. they lack the normative information that would allow them to be used for diagnosis. Answer: d. 92. Currently, brain imaging techniques are used mostly for research, but are being used in the assessment and treatment of a. dissociative identity disorder b. bulimia c. depression d. Alzheimer’s disease Answer: d. 93. Procedures such as fMRI and PET can help research investigators explore the relationship between brain functions and a. an individuals’ likelihood of becoming depressed later in life. b. specific mental disorders. c. social deficits. d. likelihood of malingering. Answer: b. 94. The newest and most exciting method of imaging brain functions involves a. MRI b. fMRI c. TPD d. PET Answer: b. 95. What is a limitation of the use of psychological assessment? a. There is little variability in people's psychological reactions. b. There is a high correlation among different autonomic response systems. c. Psychological reactivity and stability vary from person to person. d. They provide little information beyond what patients can report of themselves. Answer: c. 96. In clinical practice, brain imaging techniques can be used to rule out various neurological conditions that might explain behavioral or cognitive deficits. These conditions include a. high blood pressure and low T counts. b. bulimia and anorexia. c. brain tumors and vascular disease. d. malingering and somatoform disorders. Answer: c. Short Answer 97. A __________ approach to classification assumes that distinctions among members of different categories are qualitative. Answer: categorical 98. A __________ approach focuses on how much of a diagnostic characteristic an individual exhibits. Answer: dimensional 99. ___________ refers to rejection or isolation of an individual resulting from a stamp or label. Answer: Stigma 100. Recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress are called __________ . Answer: obsessions 101. In reliability research, the statistic that is used to measure agreement between clinicians is known as __________. Answer: kappa 102. Psychological __________ is the process of gathering information in an attempt to understand a patient. Answer: assessment 103. In a client’s intake interview, the clinician reads him a set specific questions about his symptoms in a particular order. He is being given a __________ interview. Answer: structured 104. Behavioral __________ systems focus on the frequency of specific behavioral events during assessment. Answer: coding 105. The scale on the MMPI-2 that measures physical symptoms that cannot be traced to a medical illness is called the __________ scale. Answer: hysteria 106. A recent advance in brain imaging allows details of both the structure and function of the brain to be seen. This method is _________ . Answer: fMRI Essay 107. Explain how the term "diagnosis" in psychopathology does not have the same meaning that it has in other fields, and explain the significance of this difference. Answer: In many fields, diagnosis refers to causal analysis. It means that one can look underneath to pinpoint the origins of the problem. In this way, the diagnosis leads directly to the problem's solution. In the field of psychopathology, assigning a diagnosis does not mean that we understand the etiology of the person's problem. Assigning a diagnosis of a mental disorder simply identifies the nature of the problem without implying exactly how the problem came into existence. A diagnostic label does not provide an explanation, and thus does not lead directly to a specific solution. 108. Compare and contrast a dimensional classification system with a categorical classification system, such as the current DSM-5. Answer: The current DSM-5 is based on a categorical system. It attempts to treat mental disorders as physical disorders. It assumes that there are disease entities, such as schizophrenia, unipolar depression, OCD, etc., that are discrete, that are caused by a specific etiological process, and that are qualitatively different from each other. The DSM lays out the behaviors and signs to look for and then spells out when to assign an individual to a discrete category. If the DSM were a dimensional system, such as “intelligence,” it would assume that an individual was possessed of various properties and assign each individual an estimate of how much of a given property they demonstrate. An individual may demonstrate a significant level of delusional thinking, somewhat less intellectual impairment, varying degrees of unhappiness, etc. This system may or may not result in a definitive or categorical diagnosis. 109. During the 1950s and 1960s, psychiatric classification systems were widely criticized. Discuss some of the reasons for this criticism. Answer: (1) low reliability and interrater consistency; (2) the ideas that people who are diagnosed as mentally ill actually are having "problems in living" and are not "sick"; (3) the problems of self-fulfilling prophecies: those who are diagnosed live up to the expectations of the "sick" role. Patients may be stigmatized by being labeled. 110. What are two major uses of a classification system for abnormal behavior? Answer: (1) matching clients' problems with the most effective treatment; (2) searching for knowledge, and the possibility of identifying unique disorders and their causes so that treatments can later be developed. 111. Describe the different ways in which diagnosis can be useful (valid). Mention two types of validity. Answer: (1) meaningful or important: provides information and communication value; can provide evidence that leads to a theory of the cause of a disorder; (2) etiological validity: provides information on cause; (3) concurrent validity: agrees with information about behavior in other situations and from other sources; (4) predictive: provides information about the predictable course of the disorder, and later status and behavior. 112. Describe the three primary goals of clinical assessment procedures, and give an example of each. Answer: (1) making predictions: will this person engage in violence if he or she is released from jail? (2) plan interventions: does this person have the intelligence level necessary to benefit from insight-oriented therapy? (3) evaluate treatment effectiveness: has this person's depression decreased over the course of therapy? 113. A psychologist is diagnosing a patient and wants to measure the patient's prefrontal brain metabolism levels while the patient is told to concentrate on her obsessions. The psychologist uses fMRI to measure prefrontal brain metabolism levels before, during, and after her patient concentrates on obsessions. She finds that her patient’s concentration on obsessions is correlated with increases in prefrontal brain metabolism levels, and she concludes that her patient has obsessive-compulsive disorder. Discuss the grounds on which such a conclusion would be criticized, and describe what else the psychologist might do to diagnose her patient. Answer: Physiological assessment is not sufficient because (1) any individual autonomic response has a low correlation with other autonomic responses; (2) individuals vary in their reactivity, and for some, thinking about obsessions may be associated with great increases in prefrontal brain activity while for others, there may be no increase; and (3) some people with OCD do not exhibit increased metabolism rates in the prefrontal cortex, while others without OCD do exhibit increased metabolism in this brain region. The psychologist's assessment of her patient's condition could include (1) other physiological measures; (2) the psychologist's observations of her patient; (3) measures from some form of rating scale or self-report inventory. 114. Describe some disadvantages of the current DSM-5 classification system. Answer: The current DSM is widely used and recognized, but that very acceptance may mean that new ways of looking at and conceptualizing mental illness may be overlooked. Most patients don’t fit neatly into one category; they exhibit a variety of symptoms that vary over time and with changing circumstances. If we categorize them, are we overlooking other, possibly more important aspects of their problem? The problem of comorbidity is identified by many clinicians and researchers. The National Comorbidity Study suggests that a small subgroup of individuals exhibit three or more diagnoses and that this group accounts for a significant percentage of serious diagnoses. In addition, the DSM has difficulty handling change over time. There is a tendency to label individuals, while periodic changes to the nature of disorders go unnoticed. It is not unusual for an individual to be mainly anxious one day and mainly unhappy a few days later. Test Bank for Abnormal Psychology Thomas F. Oltmanns, Robert E. Emery 9780205997947, 9780205970742, 9780134899053, 9780134531830
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