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5. Anxiety Disorder and Obsessive-Compulsive and Related Disorders Multiple-Choice Questions 1. A severe anxiety reaction approaching sheer terror is called a(n) ______. A. nervous breakdown B. acute stressor C. panic attack D. fit of fright Answer: C 2. A generalized state of apprehension or foreboding is called ______. A. tension B. stress C. anxiety D. arousal Answer: C 3. Anxiety disorders affect ___________ adults in the United States. A. One in ten B. One in fifty C. One in twenty D. One in five Answer: D 4. A class of psychological disorders characterized by excessive or maladaptive anxiety reactions is ______ disorders. A. somatoform B. anxiety C. dissociative D. personality Answer: B 5. Maris is plagued by a constant sense of dread and apprehension about the future. His thinking is jumbled, confused and he has difficulty concentrating. Physically, he is jittery, agitated, and constantly feels nauseated. He is so worried about his own bodily sensations and the fear that he is “losing control,” that he has difficulty focusing on anything else. His symptoms are most suggestive of ______. A. a dissociative disorder B. a psychotic disorder C. an anxiety disorder D. a personality disorder Answer: C 6. According to the textbook, anxiety is characterized by a wide range of symptoms that cut across ______________ domains. A. physical, behavioral, and cognitive B. developmental, psychosocial, and emotional C. physical, behavioral, and mental D. sociocultural, developmental, and cognitive Answer: A 7. Which of the following disorders was classified as an anxiety disorder in the DSM-IV but has moved to a new diagnostic category in the DSM-5? A. obsessive-compulsive disorder B. panic disorder C. agoraphobia D. social phobia Answer: A 8. Robin worries constantly, has a nagging sense of dread or apprehension about the future, and is keenly aware of and preoccupied with her body’s sensations. Which domain of anxiety do Robin’s symptoms represent? A. psychosocial B. cognitive C. behavioral D. emotional Answer: B 9. Every time David enters an airport terminal, he feels lightheaded. His heart races and his stomach hurts. If David has an anxiety disorder, his symptoms would be classified in the _______ domain of anxiety. A. behavioral B. cognitive C. physical D. emotional Answer: C 10. In the DSM-5, acute stress disorder and posttraumatic stress disorder are classified as ______. A. Trauma- and Stressor-related Disorders. B. Neurotic Disorders C. Anxiety Disorders D. Dissociative Disorders Answer: A 11. The term "neurosis" was coined by ______. A. Sigmund Freud B. Anton Mesmer C. William Cullen D. Emil Kraepelin Answer: C 12. The term ______ derives from roots meaning "an abnormal or diseased condition of the nervous system." A. anxiety B. neurosis C. psychosis D. mania Answer: B 13. A neurosis was originally seen as an affliction of the ______. A. nervous system B. muscular system C. spirit or soul D. heart Answer: A 14. Freud's psychodynamic view was that ______ resulted from the threatened emergence of unacceptable, anxiety-evoking ideas into conscious awareness. A. neurosis B. psychosis C. mania D. personality disorders Answer: A 15. For Freud, neurotic disorders represented ways the ego attempts to defend itself against ______. A. psychosis B. depression C. anxiety D. confusion Answer: C 16. Freud's assumptions about neuroses formed the basis of ______ edition(s) of the DSM. A. the first B. the first two C. the first three D. all five Answer: B 17. The term representing disorders that involve loss of touch with reality and are typified by bizarre behaviors, hallucinations, and beliefs, and are generally severe in nature is ______. A. neurosis B. psychosis C. organic disorder D. mania Answer: B 18. Dick has episodes of sheer terror when riding on subway trains. He breaks into a cold sweat and often feels like he is having a heart attack. During these attacks he imagines that he is completely losing control of himself. Dick's disorder is best described as a ______ disorder. A. panic B. obsessive-compulsive C. generalized anxiety D. posttraumatic stress Answer: A 19. The essential feature of a panic disorder is ______. A. well-defined phobic reactions to specific stimuli B. occurrences of repeated, unexpected panic attacks C. constant worry without a known cause D. behavior dominated by rituals performed in order to avoid anxiety Answer: B 20. Bert is standing in a shopping mall when he begins having difficulty breathing. He feels his heart pounding, feels weak and dizzy, and notices that he is perspiring heavily. He feels like he might be having a heart attack. At the very least, he senses he is losing control and is afraid that if he's not having a heart attack, he is going "crazy." Assuming that Bert is not having an actual heart attack, he is most likely suffering from ______. A. generalized anxiety disorder B. a social phobia C. a panic attack D. acute stress disorder Answer: C 21. There is a stronger bodily component in the symptoms of _________ than to the symptoms of other forms of anxiety disorders. A. panic disorder B. generalized anxiety disorder C. social phobia D. obsessive-compulsive disorder Answer: A 22. Which symptom is characteristic of a panic attack? A. paranoia B. heavy perspiration C. uncontrollable crying D. auditory hallucinations Answer: C 23. One reason panic attacks can be so frightening is that they often mimic the symptoms of ______. A. heart attacks B. epileptic seizures C. strokes D. meningitis Answer: A 24. Panic attacks usually reach a peak of intensity in about ______. A. 1 minute or less B. 10 to 15 minutes C. 30 minutes or less D. an hour or more Answer: B 25. Panic attack sufferers tend to be keenly aware of their ______. A. surroundings B. physical weakness C. head pain and dizziness D. changes in heart rate Answer: D 26. Because of the symptoms of panic attacks, it would be warranted for people with panic disorder to seek ______. A. physical therapy B. more exercise C. financial advice D. a medical evaluation Answer: D 27. Which of the following is true of panic attacks? A. They can last for up to a few hours. B. They are often accompanied by visual hallucinations. C. They are always preceded by an awareness of symptoms. D. They are initially triggered by a specific object or situation. Answer: A 28. Panic disorder is often associated with ______. A. obsessive-compulsive disorder B. dissociative fugue C. agoraphobia D. claustrophobia Answer: C 29. An excessive, irrational fear of being in public without the availability of escape or help is ______. A. acrophobia B. agoraphobia C. claustrophobia D. panic disorder Answer: B 30. In order to be diagnosed with panic disorder in the DSM system, panic sufferers must experience repeated unexpected attacks and at least ______ of the attacks must be followed by at least a month of persistent fear of future attacks or of the consequences of an attack. A. one B. two C. three D. four Answer: A 31. Stephanie is driving in her car and singing along with the radio. She is feeling happy when suddenly she begins to tremble and sweat, then her heart starts pounding and she feels nauseous. Most likely, Stephanie ______. A. has agoraphobia B. has generalized anxiety disorder C. is experiencing a panic attack. D. is having a heart attack Answer: C 32. About ______ percent of otherwise healthy people may experience an isolated panic attack in a given year. A. 10 B. 30 C. 50 D. 70 Answer: A 33. About ______ percent of Americans develop a panic disorder at some point their lives. A. 5 B. 25 C. 45 D. 65 Answer: A 34. The onset of panic disorder is usually in one's ______. A. early or late childhood B. late childhood or early adolescence C. late adolescence through mid-30s D. forties and fifties Answer: C 35. Women are ______ as likely as men to experience panic attacks. A. half B. equally C. twice D. ten times Answer: C 36. A person who has repeated and unexpected episodes of being afraid he or she is losing control or going crazy most likely suffers from ______. A. a generalized anxiety disorder B. a panic disorder C. agoraphobia D. schizophrenia Answer: B 37. A(n) ______ may involve feeling light-headed, trembling, chest pains, and feeling a sense of unreality about one's surroundings. A. panic attack B. psychotic disorder C. obsessive-compulsive disorder D. generalized anxiety attack Answer: A 38. During a panic attack, epinephrine and norepinephrine are released by ______. A. the parasympathetic nervous system B. cortisol C. the adrenal glands D. GABA Answer: C 39. During a panic attack, the adrenal glands ______. A. shut down B. release only epinephrine C. release only norepinephrine D. release both epinephrine and norepinephrine Answer: D 40. People with panic disorder misattribute changes in ______ to dire underlying causes. A. their environmental surroundings B. temperature C. mood D. internal bodily sensations Answer: D 41. Donald Klein has proposed that a defect in the brain’s ______ may be an important basis for panic reactions. A. speed of reaction to visual and auditory stimuli B. memory for past traumas C. respiratory alarm system D. hippocampus Answer: C 42. ______ is a neurotransmitter which helps tone down the stress response. A. GABA B. Cortisol C. Norepinephrine D. Epinephrine Answer: A 43. People with panic disorder show abnormally low levels of ______ in some parts of the brain. A. epinephrine B. norepinephrine C. ACTH D. GABA Answer: D 44. A class of medications which enhances GABA’s calming effect are ______. A. phenothiazines B. benzodiazepines C. neuroleptics D. hallucinogenics Answer: B 45. The prevailing understanding of the causes of panic disorder reflects a combination of ________ A. biochemical and anatomical brain anomalies B. cognitive and biological factors C. cognitive and emotional factors D. repressed psychological material and social prohibitions Answer: B 46. The cognitive proneness to panic disorders has been labelled ______. A. chronic vigilance B. anxiety sensitivity C. neurotic thought pattern D. uncontrolled worry Answer: B 47. When compared to Asian and Hispanic students, Caucasian students show ______ levels of anxiety sensitivity and the anxiety sensitivity was ______ strongly connected to panic attacks. A. lower, less B. higher, less C. lower, more D. higher, more Answer: C 48. The lowest levels of anxiety sensitivity have been found in ______ students. A. Alaskan native B. Asian C. American Indian D. Caucasian Answer: D 49. The most popular treatments for panic disorder are drug therapy and ______ therapy. A. psychodynamic B. relationship C. cognitive-behavioral D. desensitization Answer: C 50. Lindsay has a panic disorder. Along with psychotherapy, she is likely to be prescribed ______ medication. A. antipsychotic B. antidepressant C. mood stabilizer D. antihistamine Answer: B 51. With your new knowledge of abnormal psychology, your roommate, who has a panic disorder, asks you about which medications are used to treat panic disorder. She mentions four medications; which one is used to treat panic disorder? A. Straterra B. Paxil C. Seroquel D. Tegretol Answer: C 52. Which of the following represents a significant limitation of drug treatment for panic disorder? A. Patients may attribute clinical improvement to the drugs and not to their own resources. B. Drugs interfere with administering quick, effective treatment by masking symptoms of more severe psychological disorders that, on the surface, resemble panic disorder. C. The types of drugs that are used to treat panic disorder all have potential for addiction. D. These drugs may cause tardive dyskinesia as a serious side effect. Answer: A 53. Troublesome side effects have been noted in panic disordered clients taking antidepressant medications such as clomipramine (Anafranil) and the SSRIs paroxetine (Paxil) and sertraline (Zoloft). These side effects include ____________. A. tardive dyskinesia B. heavy sweating and heart palpitations C. weight gain D. spikes in blood pressure Answer: B 54. Exposing panic-prone people to the sensations that precede panic attacks to help them build up a tolerance to the sensations and to teach them that the sensations do not necessarily signal an oncoming attack is a technique most likely to be used by a ______ therapist. A. cognitive-behavioral B. social learning C. psychodynamic D. humanistic Answer: A 55. In some treatment programs, people with panic disorder are encouraged to ______________ in order to learn how to cope with the panic. A. intentionally induce panicky symptoms B. carry a paper breathing bag with them at all times C. develop quiet, calming hobbies such as painting D. join support groups Answer: A 56. ________ is a technique used with persons with panic disorder that aims at restoring a normal level of carbon dioxide in the blood by having clients ________ A. Mindfulness training; breathe slowly through the nose B. Transcendental meditation; visualize relaxing scenes with their eyes closed C. Breathing retraining; breathe slowly and deeply from the abdomen D. Guided breathing; breathe slowly and deeply from the abdomen Answer: C 57. Clients with panic disorder are often advised to breathe into a paper bag in order to reduce symptoms. The use of the bag _____________. A. is helpful for clients who become nauseated B. allows the client to focus on something other than panic symptoms C. traps carbon dioxide in the bag which may induce calm by restoring a more optimal balance between oxygen and carbon dioxide. D. controls the amount of oxygen available to the client and creates a situation much like passing out Answer: C 58. The word phobia derives from the Greek word “phobos,” meaning ______. A. caution B. avoidance C. fear D. distance Answer: C 59. Persistent fears of objects or situations that are disproportionate to the threat posed by them are the central feature of a(n) ______ disorder. A. panic B. phobic C. generalized anxiety D. obsessive-compulsive Answer: B 60. Nancy is terrified of heights. She avoids high places whenever possible because she experiences overwhelming fear when she is in such an environment. Nancy never has this problem in any other situation and does not worry about it until she is forced to go to a high place. She is best diagnosed as having a(n) ______ disorder. A. panic B. phobic C. generalized anxiety D. obsessive-compulsive Answer: B 61. Most phobias involve fears of ______. A. unusual objects B. unusual situations C. legitimately dangerous situations D. ordinary events Answer: D 62. Persistent, excessive fears of certain objects or situations are called ______. A. specific phobias B. social phobias C. complex phobias D. agoraphobia Answer: A 63. Tony has an excessive, unrealistic fear of snakes. His phobia is ______. A. a specific phobia B. a social phobia C. a complex phobia D. agoraphobia Answer: A 64. Ebony has an excessive, unrealistic fear of heights. Her phobia is called ______. A. claustrophobia B. hydrophobia C. acrophobia D. agoraphobia Answer: C 65. Mel has an excessive, unrealistic fear of tight, enclosed spaces. His phobia is ______. A. agoraphobia B. acrophobia C. claustrophobia D. hydrophobia Answer: C 66. Which of the following statements is true of phobias? A. They usually involve fears of out-of -the-ordinary things. B. Phobic individuals do not usually recognize that their fears are excessive or unreasonable. C. Different types of phobias usually appear at different ages. D. Phobic individuals experience fear typical proportional to the actual threat posed by what they fear. Answer: C 67. Agoraphobia often follows the development of panic attacks beginning in _________. A. middle age B. adulthood C. early childhood D. adolescence Answer: A 68. Which of the following phobias tends to develop during childhood? A. agoraphobia B. claustrophobia C. animal phobia D. social phobia Answer: C 69. Which of the following phobias tends to develop at the oldest age? A. agoraphobia B. claustrophobia C. animal phobia D. social phobia Answer: A 70. The specific phobia with the latest average age of onset is ______. A. dental phobia B. claustrophobia C. blood phobia D. animal phobia Answer: B 71. Phobias are typically accompanied by ______ behaviors. A. antisocial B. aggressive C. autistic D. avoidance Answer: D 72. Specific phobias affect about ________ people at some point in their lives. A. 1% B. 5% C. 9% D. 15% Answer: C 73. Marcy has a persistent fear that she is going to publicly embarrass or humiliate herself with some unintended behavioral mistake. She is overly critical of her own behavior, fears criticism by others, and experiences overarousal in interactions with others. She is best diagnosed as having ______. A. a specific phobia B. a social phobia C. a complex phobia D. agoraphobia Answer: B 74. Intense, unrealistic fears of being judged negatively by others when in public situations are called ______. A. specific phobias B. social phobias C. complex phobias D. agoraphobia Answer: B 75. Marcia always feels as if a thousand eyes are watching every move she makes, just waiting to find a flaw. She is preoccupied with the impression she makes on others and usually assumes she has made a negative one. As a result, she often avoids situations in which she will have to deal with large numbers of people. She is best described as having ______. A. a specific phobia B. social anxiety disorder C. a complex phobia D. agoraphobia Answer: B 76. People with _______________ anxiety disorder have such an intense fear of social situations that they may avoid them altogether or endure them only with great distress. A. generalized B. social C. interpersonal D. phobic Answer: B 77. Brian suffers from speech anxiety. This is a type of ______. A. specific anxiety B. social anxiety C. generalized anxiety D. agoraphobia Answer: B 78. Diane is so afraid that her potential dates will reject her after she goes out with them, that she refuses to go out on any dates at all. This is a type of ______. A. specific anxiety B. social anxiety C. complex phobia D. interpersonal anxiety disorder Answer: B 79. National representative surveys suggest that ______ of US adults are affected by social anxiety disorder at some point in their lives. A. 1% B. 5% C. 10% D. 15% Answer: B 80. People with social anxiety often try to “medicate” themselves with ________ when preparing for social interactions. A. marijuana B. tranquilizers or alcohol C. benzodiazepines and coffee D. opioids or central nervous system depressants Answer: B 81. The average age for the onset of social anxiety disorder is about age _________. A. 7 B. 10 C. 15 D. 30 Answer: C 82. Social anxiety disorder generally begin in ______. A. infancy B. adolescence C. early adulthood D. middle adulthood Answer: B 83. Social anxiety tends to follow a ______ course in life. A. sporadic but temporary B. sporadic and persistent C. chronic but temporary D. chronic and persistent Answer: D 84. Researcher Bernardo Carducci states that shy people often become successful by which of the following methods? A. By changing who they are and the way the act. B. By thinking less about themselves and more about others. C. By focusing on having a few close friends who have a high tolerance for shy behavior. D. By choosing a career where they can work independently. Answer: B 85. The term “agoraphobia” is derived from Greek words meaning fear of _______. A. public speaking B. being observed while eating C. combat D. the marketplace Answer: D 86. Fear of places and situations in which it might be difficult or embarrassing to escape in case of a panic or anxiety attack is called ______. A. a simple phobia B. a social phobia C. a complex phobia D. agoraphobia Answer: D 87. Danielle has an excessive, unrealistic fear of shopping in crowded stores and walking through crowded streets. She has ______. A. claustrophobia B. a social phobia C. acrophobia D. agoraphobia Answer: D 88. Sarah is afraid to leave her house. She is terrified that if she steps outside her door something awful is going to happen to her. She has ______. A. a simple phobia B. a social phobia C. a complex phobia D. agoraphobia Answer: D 89. Agoraphobia is often but not always associated with __________. A. panic disorder B. generalized anxiety disorder C. social anxiety disorder D. specific phobia Answer: A 90. Agoraphobia generally begins in ______. A. early childhood B. late childhood C. early adolescence D. late adolescence Answer: D 91. Many people with agoraphobia learn to avoid situations which might trigger ______. A. embarrassment B. a panic attack C. anticipatory anxiety D. stress Answer: B 92. From the psychodynamic perspective, anxiety disorders are viewed as ______. A. being acquired through conditioning and observational learning B. the result of dysfunctional ways of thinking C. being developed as a result of genetic factors D. sexual or aggressive impulses that are nearing the level of awareness Answer: D 93. According to the psychodynamic perspective, phobias develop through the use of ______. A. denial B. projection C. rationalization D. regression Answer: B 94. James suffers from acrophobia. According to the psychodynamic perspective, his fear of heights probably represents an unconscious ______. A. wish to jump B. sexual fantasy C. homicidal impulse D. desire for his mother Answer: A 95. The two-factor model of how phobias are acquired was developed by ______. A. Freud B. Woody & Rachman C. Skinner D. Mowrer Answer: D 96. With Mowrer’s two-factor model, the fear component is acquired through _______. A. operant conditioning B. classical conditioning C. aversive conditioning D. continuous reinforcement Answer: B 97. Many people with phobias had experiences in which the phobic object or situation was associated with ____________. A. aversive experiences B. negative reinforcement C. neutral experiences D. arousing but not necessarily aversive experiences Answer: D 98. The two-factor model states that the fear component of a phobia is acquired by ______. A. classical conditioning B. operant conditioning C. modeling D. both classical and operant conditioning Answer: A 99. According to the two-factor model, the avoidance component of a phobia is acquired by ______. A. classical conditioning B. operant conditioning C. modeling D. both classical and operant conditioning Answer: B 100. According to the two-factor model, a phobia is acquired and maintained by ______. A. modeling B. operant conditioning C. classical conditioning D. classical and operant conditioning Answer: D 101. Mowrer’s two-factor model assumes that the avoidance component of phobias is acquired and maintained through ______. A. positive reinforcement B. aversive conditioning C. punishment D. negative reinforcement Answer: D 102. A set of interconnected brain structures that are located below the cerebral cortex and are involved in such functions as memory formation and the processing of emotional surprises is called the ______. A. hindbrain B. limbic system C. corpus callosum D. reticular activating system Answer: B 103. An almond-shaped part of the limbic system that functions as sort of an “emotional computer” for evaluating whether stimuli represent a threat or danger is the ______. A. hippocampus B. thalamus C. amygdala D. hypothalamus Answer: C 104. The part of the brain that sends an “all clear” message to the brain’s emotional centers, helping to calm us down, is the ______. A. prefrontal cortex B. pons C. hippocampus D. medulla Answer: A 105. Greater excitability of the ______ may explain why people with phobic disorders experience more fear in response to threatening cues from the environment. A. hippocampus B. cingulate gyrus C. amygdala D. cerebellum Answer: C 106. The idea that people may have inherited a tendency to develop phobias that had survival value in the past, even if they no longer do today is central to ______. A. prepared stimulation B. prenatal conditioning C. prepared conditioning D. observational learning Answer: C 107. The idea that some people are genetically predisposed to acquire phobic responses to certain classes of stimuli is called ______. A. prepared stimulation B. prenatal conditioning C. prepared conditioning D. observational learning Answer: C 108. Which one of the following is a factor in proneness to phobias? A. Lower activation of the frontal lobes of the brain B. Lower levels of cortisol in the bloodstream C. Hypoarousal of the central nervous system D. Self-defeating thoughts and irrational beliefs Answer: D 109. People with dental phobia tend to ______ the anticipated pain they will experience on visits to the dentist. A. avoid thinking about B. exaggerate C. minimize D. speak to the dentist about Answer: B 110. Jack believes that it is awful and horrible when he is turned down for a date. According to a research finding, Jack would be expected to have more ______ than peers who do not catastrophize such rejections. A. social anxiety B. anger at women C. generalized anxiety D. social withdrawal Answer: A 111. Systematic desensitization was developed by ______. A. Skinner B. Lazarus C. Wolpe D. Bandura Answer: C 112. Zelda visits a therapist for treatment of her anxiety. Her therapist teaches her to relax on a couch while working her way through a fear-stimulus hierarchy. Eventually, Zelda is able to remain calm in each of the situations presented in the hierarchy. Her therapist used a technique called ______. A. chain breaking B. response prevention C. cue controlled conditioning D. systematic desensitization Answer: D 113. As part of systematic desensitization, the phobic client must learn ______. A. heightened imagination B. relaxation techniques C. graduated extinction D. logical progression Answer: B 114. The goal of systematic desensitization is to ______ a phobia. A. moderate B. suppress C. extinguish D. transform Answer: C 115. Kevin is afraid of elevators. His therapist has him stand outside an elevator until he remains calm. Then, Kevin stands inside the elevator with the door open. He then stands in it with the door closed. Then, he rides it up one floor. Eventually he rides it to the top of the building and back down while remaining calm. Kevin's therapist used ______ to treat his phobia. A. gradual exposure B. response prevention C. systematic desensitization D. cue-controlled relaxation Answer: A 116. ______ is the treatment for a specific phobia. A. Aversive conditioning B. Response prevention C. Paradoxical intent D. Gradual exposure Answer: D 117. Gradual exposure is a _________ technique for treating agoraphobia. A. learning-based B. psychodynamic C. biological D. sociocultural Answer: A 118. A type of exposure therapy in which a subject is exposed to intensely anxiety-provoking situations is called ______. A. gradual exposure B. systematic desensitization C. flooding D. overexposure Answer: C 119. The therapy that uses computer-generated environments is called ______ therapy. A. paradoxical simulation B. parallel universe C. virtual reality D. systematic electronic exposure Answer: C 120. Virtual reality therapy has been successfully used to help treat ______. A. various types of phobias B. posttraumatic stress disorder C. panic disorder D. obsessive-compulsive disorder Answer: A 121. In one study, 92% of subjects overcame a fear of ______ with virtual reality therapy. A. snakes B. flying C. enclosed places D. heights Answer: B 122. Which of the following is considered necessary for virtual reality therapy to be effective? A. The client must apply progressive muscular relaxation when confronting the feared object or experience. B. The client must be willing to accept the artificiality of the virtual environment. C. There must be physiological changes to reflect anxiety during the experience. D. The client must have past experience with gaming or other virtual worlds. Answer: C 123. A therapist points out to her client that the client's social phobia results from irrational needs for social approval and extreme perfectionism. The therapist is following a treatment approach most like that of ______. A. Skinner B. Ellis C. Lazarus D. Wolpe Answer: B 124. Jack's therapist helps him overcome his social anxiety disorder by pinpointing his self-defeating thoughts and generating sensible alternatives to those thoughts. This technique is called ______. A. gradual exposure B. cognitive restructuring C. chain breaking D. perceptual blocking Answer: B 125. Practitioners of cognitive-behavioral therapy combine ______ with cognitive restructuring to treat social phobia. A. systematic desensitization B. muscular relaxation C. flooding D. exposure treatment Answer: D 126. Ralph visits a therapist for treatment of his social anxiety disorder. His therapist points out how Ralph is making errors in how he judges situations and people's responses to him. He points out that Ralph dwells on his own weaknesses and flaws, and catastrophizes disappointments into disasters. Ralph's therapist is most likely a ______ therapist. A. psychoanalytic B. humanistic C. psychodynamic D. cognitive Answer: D 127. Research evidence supports the use of ______ drugs in treating social anxiety disorder. A. analgesic B. anti-psychotic C. anti-depressant D. anti-inflammatory Answer: C 128. Megan has social anxiety disorder. An effective treatment for her might include psychotherapy and ______. A. light therapy B. an antidepressant C. exposure and response prevention D. Central Nervous System depressant Answer: B 129. Betsy has had persistent "free floating" anxiety for about 9 months. She finds herself worrying about her children, her career, her marriage, and her friends even though nothing appears to be wrong with any of them. She is best described as suffering from a(n) ______ disorder. A. panic B. phobic C. generalized anxiety D. obsessive-compulsive Answer: C 130. Robert has had persistent anxiety for about 13 months. He has also suffered from shakiness, feeling "keyed up," insomnia, irritability, and chronic muscle tension. He is best diagnosed as having a(n) ______ disorder. A. panic B. phobic C. generalized anxiety D. obsessive-compulsive Answer: C 131. The central feature of a generalized anxiety disorder is ______. A. fear of dying B. worry C. trembling D. depression Answer: B 132. Generalized anxiety disorder (GAD) is characterized by excessive anxiety and worry that is _____________. A. specific to an object or event that the individual has had an aversive experience with B. not limited to any one object, situation, or activity C. limited to health and safety concerns D. limited to concerns about the well-being of immediate family members Answer: B 133. Chronic worry is a central feature of ______. A. schizophrenia B. panic disorder C. depression D. generalized anxiety disorder Answer: D 134. Chad is on the dean's list in college and he is also one of the best athletes on the football team. Despite his successes, Chad worries about his grades and finds his mind going blank at times. He is also beginning to have difficulty falling asleep. Most likely, Chad has ______. A. a generalized anxiety disorder B. a panic disorder C. social anxiety disorder D. a specific phobia Answer: A 135. A person who feels "keyed up" and worries about minor things has characteristics of ______. A. depression B. agoraphobia C. generalized anxiety disorder D. panic attacks Answer: C 136. Which of the following disorders is most likely to accompany generalized anxiety disorder? A. depression B. borderline personality disorder C. conversion disorder D. bipolar affective disorder Answer: A 137. Which of the following disorders has been noted as co-occurring with generalized anxiety disorder? A. schizophrenia B. obsessive-compulsive disorder C. schizoid personality disorder D. conversion disorder Answer: B 138. Generalized anxiety tends to initially arise during the ______. A. pre-teen years through the mid-teens B. mid-teens through the mid-20s C. mid-20s through the mid-30s D. mid-30s through the mid-40s Answer: B 139. Researchers are hopeful that _________ could potentially enhance the effects of learning-based treatments such as cognitive-behavioral therapy. A. Seroquel B. D-cycloserine C. Ritalin D. Prozac Answer: B 140. Which of the following medications has recently been shown to speed up the extinction of fear responses in rats? A. Seroquel B. Propranolol C. D-cycloserine D. Prozac Answer: C 141. Generalized anxiety disorder affects about ______ of the adult population at some point in their lives. A. 4 percent B. 14 percent C. 24 percent D. 34 percent Answer: A 142. Men are ______ as likely as women to experience generalized anxiety disorder. A. half B. equally C. twice D. 4 times Answer: A 143. Generalized anxiety responds to medications that specifically target ______. A. ACTH B. GABA C. serotonin D. glutamine Answer: C 144. A drug that has been approved for treatment of GAD is ______. A. Ritalin B. Wellbutrin C. Paxil D. Lexapro Answer: C 145. Cognitive-behavior therapists often treat generalized anxiety with ______. A. gradual exposure B. decatastrophizing C. aversive conditioning D. chain breaking Answer: B 146. Cognitive-behavior therapists are likely to treat generalized anxiety with which of the following treatments? A. aversive conditioning B. electroconvulsive therapy C. negative reinforcement D. a token economy Answer: A 147. Compared to European Americans, African Americans have ______ rates of social anxiety disorder and ______ of generalized anxiety disorder. A. lower, lower B. higher, lower C. lower, higher D. higher, higher Answer: A 148. Compared to European Americans, Latinos have ______ rates of social anxiety disorder and ______ of generalized anxiety disorder. A. lower, lower B. higher, lower C. lower, higher D. higher, higher Answer: A 149. Which of the following groups has the highest lifetime rates of panic disorder? A. European Americans B. Latinos C. African Americans D. Asian Americans Answer: A 150. Which of the following groups has the highest lifetime rates of social anxiety disorder? A. European Americans B. Latinos C. African Americans D. They all have equal rates. Answer: A 151. Which of the following culture-bound syndromes have features similar to panic attacks? A. koro B. ataque de nervios C. Dhat D. animus nervosa Answer: B 152. The DSM-5 category of Obsessive–Compulsive and Related Disorders contains which of the following disorders? A. kleptomania B. excoriation (skin picking) disorder C. erotomanic disorder (“stalking”) D. compulsive gambling Answer: B 153. Corinne is plagued by fears that she is going to be “contaminated” by some germ-infested object she happens to touch, then will develop some horrible illness and die. As a result, she engages in elaborate hand-washing rituals. She spends several hours a day at the sink and washes her hands after touching anybody or anything that might have dirt or germs. Her symptoms are most suggestive of ______ disorder. A. obsessive-compulsive B. generalized anxiety C. panic D. an acute stress reaction Answer: A 154. Todd spends hours checking and rechecking the doors and windows to his house to make sure they are completely locked and secured before he leaves for work in the morning. This is the only way he can prevent himself from being overwhelmed by anxiety and fears he left something unlocked as he drives to the office. Todd is suffering from ______ disorder. A. phobic B. panic C. obsessive-compulsive D. generalized anxiety Answer: C 155. A criterion for obsessive-compulsive disorder is that the symptoms must occupy more than ______. A. 5 hours per week B. 2 hours per day C. 1 hour per day D. 10 hours per week Answer: C 156. An intrusive, recurrent thought or image that an individual cannot control is known as a(n) ______. A. delusion B. hallucination C. obsession D. compulsion Answer: C 157. All day long, Ted keeps hearing in his mind the jingle to a television commercial he watched last night. Though he doesn't even like the jingle, he cannot seem to get it out of his head and it is beginning to get him angry. In fact, each time he thinks of the song, he gets more and more upset. Ted's thoughts of the television jingle are a(n) ______. A. delusion B. hallucination C. obsession D. compulsion Answer: C 158. For months, as Rod drives to work, he has been plagued by worries that he forgot to lock the door, close the windows, or turn off the stove in his house. Several times he has even had to return home and double-check the house before he could get rid of these troubling fears. Rod's worries represent ______. A. delusions B. hallucinations C. obsessions D. compulsions Answer: C 159. An irresistible, repetitive urge to engage in a specific behavior, usually to relieve anxiety, is a(n) ______. A. delusion B. abreaction C. obsession D. compulsion Answer: D 160. Corinne engages in elaborate hand-washing rituals. She feels that she must spend several hours a day at the sink washing her hands after touching anybody or anything that might have dirt or germs. Her behaviors are ______. A. compulsions B. abreactions C. obsession D. delusions Answer: A 161. Bud does not feel that he can leave for work each morning until he spends hours checking and rechecking to make sure that he has shut off all the appliances and locked the windows and doors of his home. Bud's behaviors represent ______. A. delusions B. a specific phobia C. obsessions D. compulsions Answer: D 162. Len is constantly anxious. To relieve his anxiety, he counts silently to himself. He may count his breaths per minute, or he may just count the seconds as they tick by. Just the act of counting seems to relieve his anxiety. Len's counting behaviors represent a(n) ______. A. delusion B. compulsion C. obsession D. abreaction Answer: B 163. Most compulsions involve ______ rituals. A. religious and sexual B. sexual and cleaning C. cleaning and checking D. checking and religious Answer: C 164. Obsessive-compulsive disorder afflicts between ______ percent of American adults at some point in their lives. A. 2-3 B. 6-7 C. 10-11 D. 14-15 Answer: A 165. Women are ______ as likely as men to be afflicted with obsessive-compulsive disorder. A. half B. equally C. twice D. four times Answer: B 166. From a psychodynamic perspective, obsessions represent ______. A. acts that help keep unconscious impulses repressed B. self-defeating thoughts that perpetuate anxiety C. the two-factor model D. the leakage of unconscious impulses into consciousness Answer: D 167. From the psychodynamic perspective, compulsions are acts which ______. A. symbolically fulfill unconscious sexual desires B. help to keep unconscious impulses repressed C. represent a failure of the ego to cope with the real world effectively D. represent a failure of the superego to establish realistic moral standards Answer: B 168. Many children with obsessive-compulsive disorder have a history of ______. A. enuresis or bedwetting B. sibling rivalry C. tic disorders D. sexual abuse Answer: C 169. A neurotransmitter in the brain implicated in some cases of obsessive-compulsive disorder is ______. A. GABA B. glutamate C. thyroxin D. ACTH Answer: B 170. Abnormal activity in the ______ lobes of the brain has been implicated in obsessive- compulsive disorder. A. frontal B. temporal C. parietal D. occipital Answer: A 171. The worry circuit is ______. A. a region of the brainstem thought to be involved in activating the nervous system and repetitive thoughts B. a neural route involving the olfactory bulb and pungent smells C. a neural network signaling danger possibly involving the prefrontal cortex and the amygdala D. an electronic simulation of anxiety disorders Answer: C 172. Heightened arousal in the worry circuit is suspected of playing a key role in ______. A. panic disorder B. specific phobia C. obsessive-compulsive disorder D. posttraumatic stress disorder Answer: C 173. “Obsessions give rise to anxiety/distress and compulsions temporarily ______ it.” A. exacerbate B. accompany C. reduce D. maintain Answer: C 174. Each of the following is true of people with obsessive-compulsive disorder EXCEPT ______. A. they tend to be perfectionistic B. they may show signs of memory impairment C. they tend to be under focused on their thoughts D. they tend to exaggerate the risk that unfortunate events will occur Answer: C 175. Behavior therapy for obsessive-compulsive disorder usually involves a combination of exposure with ______. A. flooding B. response prevention C. aversive conditioning D. stimulus prevention Answer: B 176. The ______ antidepressants have therapeutic effects in treating obsessive-compulsive disorder. A. SSRI-type B. MAO inhibitor-type C. tricyclic-type D. eclectic-type Answer: A 177. Drugs that boost levels of the neurotransmitter ______ in the brain have shown effectiveness in treating obsessive-compulsive disorder. A. GABA B. serotonin C. epinephrine D. norepinephrine Answer: B 178. The class of drugs most commonly used to treat obsessive-compulsive disorder is ______. A. antianxiety drugs B. analgesics C. antidepressants D. neuroleptics Answer: C 179. Drugs like Prozac that operate on the serotonin system, are effective in treating ______. A. obsessive-compulsive disorder B. schizophrenia C. conversion disorder D. autistic disorder Answer: A 180. People with __________ are preoccupied with an imagined or exaggerated physical defect in their appearance. A. somatization disorder B. body dysmorphic disorder C. an adjustment disorder D. a personality disorder Answer: B 181. Todd is preoccupied with a small bump on his nose that he thinks is “huge and grotesque.” Daily, he spends hours in front of the mirror examining his perceived defect. Todd would most likely be diagnosed with ______. A. An adjustment disorder B. hypochondriasis C. an impulse control disorder D. body dysmorphic disorder Answer: D 182. A technique called __________ involves surgically implanting electrodes in specific areas of the brain and stimulating the electrodes and surrounding brain tissue by a pacemaker-like device placed in the chest wall. A. repetitive transcranial magnetic stimulation B. deep brain stimulation C. magnetic resonance stimulation D. positron emission stimulation Answer: B 183. Deep brain stimulation has shown promising results in treating _________, and research indicates that it may also be helpful in treating __________. A. depression; OCD B. OCD; depression C. depression; personality disorders D. PTSD; depression Answer: A 184. Body dysmorphic disorder is thought to be __________. A. extremely rare B. rare C. relatively common D. very common Answer: C 185. The most accurate description of the prognosis for individuals with body dysmorphic disorder is that __________. A. recovery often occurs within one year B. recovery often occurs but generally takes five years or more C. seldom occurs, but when it does it happens within two years D. seldom occurs, but when it does it generally takes five years or more Answer: B 186. _______ is often used in treating body dysmorphic disorder. A. exposure therapy with response prevention B. aversive counterconditioning C. systematic desensitization D. antianxiety medication Answer: A 187. Which of the following is an example of a response prevention technique that might be used in treating individuals with body dysmorphic disorder? A. Encouraging clients to check their perceived defect in the mirror to challenge the validity of their perception B. Encouraging clients to avoid excessive grooming C. Having clients intentionally reveal their perceived defect in public, rather than concealing it with makeup or clothing D. Having clients install mirrors in their homes Answer: C 188. Exposure therapy with response prevention is often combined with ___________ to treat body dysmorphic disorder. A. systematic desensitization B. aversive counterconditioning C. antianxiety medication D. cognitive restructuring Answer: D 189. Shanika has been diagnosed with body dysmorphic disorder. Her therapist is treating the disorder by having her reveal her imagined defect, a small skin blemish, in public without concealing it with clothing or makeup. Her therapist is using a technique called _________ to treat Shanika. A. systematic desensitization B. aversive counterconditioning C. a “shame attacking” exercise D. exposure therapy Answer: D 190. fMRI scans have revealed that individuals with BDD have higher activation in brain regions governing __________. A. analytic and evaluative tasks B. holistic processing C. emotional processing D. inhibitory processing Answer: A Dysmorphic Disorder 191. _______ is characterized by the accumulation of and need to retain stacks of unnecessary and seemingly useless possessions, causing personal distress or making it difficult to maintain habitable living space. A. Accumulation disorder B. Hoarding disorder C. Dependency disorder D. Attachment disorder Answer: B 192. Hoarding disorder affects about ______ of the general population. A. 2-5 percent B. 8-10 percent C. 24-28 percent D. 30-34 percent Answer: A 193. It is believed that individuals with hoarding disorder accumulate things _________. A. to cope with an existential fear of death B. as a passive-aggressive way to indicate dissatisfaction with intimate relationships C. to cope with childhood trauma D. to gain a sense of security Answer: D 194. Which of the following is a difference between obsessive-compulsive disorder (OCD) and hoarding disorder? A. Obsessional thinking in hoarding disorder is not as intrusive as it is in OCD. B. Obsessional thinking in OCD is not as intrusive as it is in hoarding disorder. C. Distress associated with hoarding is not due to conflicts with other people. D. People who hoard typically do not experience pleasure from collecting possessions. Answer: A True-False Questions 195. It is normal to be anxious about some aspects of life. Answer: True 196. Anxiety is characterized by a wide range of symptoms that cut across physical, behavioral, and cognitive domains. Answer: True 197. In the DSM-5, obsessive-compulsive disorder continues to be classified as an anxiety disorder. Answer: False 198. The term neurosis derives from roots meaning “an abnormal or diseased condition of the nervous system.” Answer: True 199. The term “neurosis” has been in all five editions of the DSM. Answer: False 200. Panic attacks have stronger bodily components than other anxiety disorders. Answer: True 201. Some people who experience panic attacks believe they are having a heart attack, even though there is nothing wrong with their heart. Answer: True 202. Panic attacks usually develop gradually over several hours. Answer: False 203. Initially, panic attacks are triggered by a specific object or situation. Answer: False 204. Some people are suddenly overtaken by feelings of panic, even though there is no external threat. Answer: True 205. Catastrophic misinterpretations of bodily sensations may set into motion a spiraling cycle of anxiety that culminates in full-fledged panic attacks. Answer: True 206. Antidepressants can be helpful in treating some anxiety disorders. Answer: True 207. The same drugs used to treat schizophrenia are also used to treat panic attacks. Answer: False 208. The word "phobia" comes from the Greek word "phobos," meaning "fear." Answer: True 209. Most phobics do not realize their fears are excessive. Answer: False 210. Phobias usually involve fears of the ordinary events in life, not the extraordinary. Answer: True 211. Claustrophobia seems to develop later than most other specific phobias, with a mean age of onset of 20 years. Answer: True 212. Anxiety disorders in general and phobic disorders in particular are more common in men than in women. Answer: False 213. Some anxiety in unfamiliar social situations is normal and adaptive. Answer: True 214. Some people are so fearful of leaving their homes they are unable to venture outside even to mail a letter. Answer: True 215. Agoraphobia is one of the least incapacitating anxiety disorders. Answer: False 216. Agoraphobia is more common in women than in men. Answer: True 217. Panic attacks have been associated with agoraphobia. Answer: True 218. Freud believed that an obsession regarding fear of knives may be a projection of one's own destructive impulses. Answer: True 219. The two factors of the two-factor model are classical and operant conditioning. Answer: True 220. Phobic avoidance behavior is acquired and maintained by means of classical conditioning. Answer: False 221. Genetics factors can predispose people to have anxiety disorders. Answer: True 222. Biological factors play little, if any role in anxiety disorders. Answer: False 223. We may be genetically predisposed to acquire fears of objects that posed a danger to ancestral humans. Answer: True 224. According to cognitive theory, phobias symbolize unconscious conflicts. Answer: False 225. Overprediction of fear may have survival value. Answer: True 226. People with many anxiety disorders are more likely than others to display irrational beliefs. Answer: True 227. Systematic desensitization involves in-vivo exposure to threatening events to help overcome anxiety. Answer: False 228. Systematic desensitization is based on the assumption that phobias are genetically inherited. Answer: False 229. Gradual exposure involves in-vivo confrontation of threatening events to help overcome anxiety. Answer: True 230. People with generalized anxiety disorder tend to be chronic, lifelong worriers. Answer: True 231. Generalized anxiety disorder tends to be a temporary problem that fades over time. Answer: False 232. It may take an hour or more for people with obsessive-compulsive disorder to leave the house. Answer: True 233. Very few compulsions actually involve ritualistic behavior. Answer: False 234. Compulsions appear to cause the anxiety associated with obsessive thoughts. Answer: False 235. Obsessional thinking helps relieve anxiety. Answer: False 236. Many compulsives show deficits in memory tasks. Answer: True 237. Some people with body dysmorphic disorder try to correct their perceived “defect” with unpleasant medical procedures including unnecessary plastic surgery. Answer: True 238. The treatment of choice for body dysmorphic disorder is anti-obsessional medication. Answer: False 239. Hoarding disorder affects an estimated 20% of the general population. Answer: False 240. Unpleasant, intrusive thoughts are found in equal intensity in hoarding disorder and obsessive-compulsive disorder. Answer: False Essay Questions 241. Describe the three domains of anxiety and provide an example of each domain. Answer: Three domains of anxiety and examples: 1. Cognitive domain: • Description: Involves thoughts, worries, and cognitive distortions associated with anxiety. • Example: Constantly worrying about future events or potential dangers, even when there is no immediate threat. 2. Emotional domain: • Description: Involves feelings and emotions experienced during anxiety-provoking situations. • Example: Feeling intense fear, apprehension, or dread before a job interview or public speaking engagement. 3. Physical domain: • Description: Involves physiological symptoms and bodily sensations associated with anxiety. • Example: Experiencing rapid heartbeat, sweating, trembling, and shortness of breath during a panic attack or when confronted with a phobic object or situation. Understanding these domains helps in recognizing the multidimensional nature of anxiety disorders and tailoring interventions that address cognitive, emotional, and physical symptoms. 242. Discuss historical changes in the classification of anxiety disorders focusing on the origins of the term, term changes, and the relevance of these terms to the DSM. Answer: Historical changes in the classification of anxiety disorders: Origins of the term: • The term "anxiety" originates from the Latin word "anxietas," meaning distress or trouble. It was historically used to describe a general state of unease or apprehension. Changes in terms: • Over time, the classification and understanding of anxiety disorders have evolved: • Early classifications often grouped anxiety symptoms with other mental health conditions under broad categories like "neuroses." • The term "anxiety disorder" gained prominence as diagnostic criteria and classifications became more refined. • DSM revisions (e.g., DSM-III, DSM-IV, DSM-5) introduced specific categories such as generalized anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD), and specific phobias. Relevance to the DSM: • The DSM (Diagnostic and Statistical Manual of Mental Disorders) provides a standardized framework for diagnosing mental health conditions, including anxiety disorders. • It reflects changes in diagnostic criteria, terminology, and understanding of anxiety disorders based on research and clinical practice. • Terms like "panic disorder," "social anxiety disorder," and "specific phobia" help clinicians categorize and treat specific manifestations of anxiety based on symptomatology and severity. Understanding the historical context and changes in terminology enhances diagnostic accuracy, treatment planning, and research efforts in anxiety disorders. 243. Define and describe the cardinal features of panic disorder. Answer: Cardinal features of panic disorder: Definition: • Panic disorder is characterized by recurrent and unexpected panic attacks, which are sudden periods of intense fear or discomfort that peak within minutes. Cardinal features: 1. Panic attacks: • Description: Sudden and overwhelming episodes of intense fear or discomfort. • Duration: Typically peaks within minutes and may include physical symptoms such as palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, and feelings of unreality or detachment. • Frequency: Recurrent panic attacks are a hallmark of panic disorder. 2. Persistent concern or worry about future attacks: • Description: Individuals with panic disorder often worry about the implications or consequences of having another panic attack. • Anticipatory anxiety: Fear of having panic attacks in situations where escape might be difficult or embarrassing (e.g., public places). 3. Significant behavioral changes: • Avoidance: Avoidance of situations or places where panic attacks have occurred or where escape might be challenging. • Interference: Fear and avoidance behaviors may significantly interfere with daily functioning, social activities, and relationships. Recognizing these cardinal features is essential for accurate diagnosis and effective treatment planning for individuals with panic disorder. Early intervention, cognitive-behavioral therapies, and pharmacotherapy are common approaches to managing symptoms and improving quality of life. 244. Describe the theoretical explanations of and treatment approaches used for panic disorder. Answer: Theoretical Explanations: Panic disorder is often explained through several theoretical perspectives: 1. Biological Explanations: Focus on genetic factors, neurochemical imbalances (particularly involving serotonin and norepinephrine), and abnormalities in brain circuits related to fear and anxiety (such as the amygdala and the locus coeruleus). 2. Psychological Explanations: Emphasize the role of conditioning and learning processes. For instance, panic attacks may be triggered and reinforced by associative learning where certain situations or bodily sensations become linked with fear responses. 3. Cognitive Explanations: Highlight cognitive biases and distortions, such as catastrophic thinking (believing the worst will happen), misinterpretation of bodily sensations (seeing them as signs of imminent danger), and attentional biases towards threat cues. Treatment Approaches: Effective treatments for panic disorder typically include: 1. Cognitive Behavioral Therapy (CBT): This approach focuses on restructuring cognitive distortions and modifying maladaptive behaviors. Techniques such as cognitive restructuring, interoceptive exposure (gradual exposure to feared bodily sensations), and situational exposure are commonly used. 2. Medications: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are often prescribed to alleviate symptoms of panic disorder. Benzodiazepines may be used in the short-term for acute symptom relief, although they carry risks of dependence. 3. Combined Therapies: Some individuals benefit from a combination of CBT and medication, particularly in severe cases or when symptoms are not adequately controlled by one approach alone. 4. Mindfulness-Based Interventions: Techniques such as mindfulness meditation and acceptance and commitment therapy (ACT) can help individuals manage anxiety and reduce the impact of panic attacks. 5. Psychodynamic Therapy: While less commonly used, psychodynamic approaches may explore underlying unconscious conflicts contributing to panic symptoms. Overall, the treatment approach for panic disorder often involves a combination of psychotherapy and pharmacotherapy tailored to the individual's specific symptoms and needs. 245. Explain what phobias are, describing their common features. Also, define and describe specific phobia, social phobia, and agoraphobia. Answer: Phobias: Phobias are persistent, irrational fears of specific objects, situations, or activities that lead to avoidance behaviors. They are characterized by: • Excessive Fear: The fear is disproportionate to the actual danger posed by the object or situation. • Avoidance: Individuals actively avoid encountering the feared stimulus or endure it with intense anxiety or distress. • Interference: Phobias can significantly interfere with daily life, causing distress and impairment in occupational, social, or other important areas of functioning. Specific Phobia: A specific phobia involves an intense fear of a specific object or situation, such as heights (acrophobia), animals (zoophobia), flying (aviophobia), or receiving an injection (trypanophobia). Social Phobia (Social Anxiety Disorder): Social phobia, or social anxiety disorder, entails a marked fear or anxiety about social situations where the individual may be exposed to scrutiny or judgment by others. This fear typically leads to avoidance of social interactions or performance situations. Agoraphobia: Agoraphobia involves fear or anxiety about being in situations where escape might be difficult or help might not be available if panic-like symptoms occur. People with agoraphobia often avoid situations such as crowded places, public transportation, or being outside of the home alone. 246. Describe the theoretical explanations and treatment approaches for phobias. Answer: Theoretical Explanations: Phobias are explained through various theoretical lenses: 1. Behavioral Explanations: Emphasize classical conditioning (associating a neutral stimulus with fear), operant conditioning (avoidance behaviors reinforced by anxiety reduction), and observational learning (acquiring fears by observing others). 2. Cognitive Explanations: Focus on cognitive biases and distortions, such as overestimation of threat, catastrophic thinking, and selective attention to fear-related stimuli. 3. Evolutionary Explanations: Suggest that some phobias may have evolved as adaptive responses (e.g., fear of heights) that became maladaptive when excessively triggered. Treatment Approaches: Effective treatments for phobias include: 1. Exposure Therapy: The cornerstone of treatment, exposure therapy involves gradual, systematic exposure to the feared stimulus in a controlled setting until anxiety diminishes (extinction). This can be done in vivo (real-life exposure) or imaginal (virtual or imagined exposure). 2. Cognitive Behavioral Therapy (CBT): Incorporates cognitive restructuring to challenge and change irrational thoughts about the feared stimulus. This helps individuals develop more realistic appraisals and coping strategies. 3. Mindfulness-Based Interventions: Techniques such as mindfulness meditation can help individuals tolerate anxiety-provoking situations and reduce the impact of phobic reactions. 4. Medications: While not always first-line, medications such as SSRIs may be prescribed for individuals with severe phobias, particularly when there is co-occurring anxiety or mood disorders. 5. Virtual Reality Therapy: Increasingly used, virtual reality can provide a safe and controlled environment for exposure therapy, especially for specific phobias like fear of flying or heights. 6. Self-Help Strategies: Techniques such as systematic desensitization (pairing relaxation techniques with gradual exposure) and self-directed exposure exercises can be effective for mild phobias. In summary, understanding panic disorder and phobias involves exploring both theoretical explanations and evidence-based treatment approaches that address the complex interplay of biological, psychological, and environmental factors contributing to these anxiety disorders. 247. Define generalized anxiety disorder and describe its symptoms and prevalence. Answer: Definition: Generalized anxiety disorder (GAD) is characterized by excessive worry and anxiety about a wide range of events or activities. Individuals with GAD often find it difficult to control their worry, which may be accompanied by physical symptoms and can significantly impact daily functioning. Symptoms: Symptoms of GAD include: • Persistent and excessive worry about various aspects of life (e.g., work, health, family). • Restlessness or feeling on edge. • Fatigue. • Difficulty concentrating or mind going blank. • Irritability. • Muscle tension. • Sleep disturbances (difficulty falling asleep or staying asleep). These symptoms must persist for at least six months and cause significant distress or impairment in social, occupational, or other important areas of functioning to meet diagnostic criteria. Prevalence: GAD is one of the most common anxiety disorders, with a lifetime prevalence estimated to be around 5-7% in the general population. It is more commonly diagnosed in women than men. Onset can occur at any age, but it often begins in childhood or adolescence and can persist into adulthood if untreated. 248. Describe the theoretical explanations and treatment approaches for generalized anxiety disorder. Answer: Theoretical Explanations: Several theoretical perspectives help explain generalized anxiety disorder: 1. Biological Explanations: Genetic factors may predispose individuals to GAD. Neurotransmitter imbalances (particularly involving serotonin and norepinephrine) and abnormalities in brain structures such as the amygdala (involved in fear response) and prefrontal cortex (involved in emotion regulation) are also implicated. 2. Cognitive Explanations: GAD is associated with cognitive biases such as excessive attention to threat cues, catastrophic thinking (expecting the worst), and intolerance of uncertainty. Individuals with GAD may also have difficulty disengaging from threat-related stimuli. 3. Behavioral Explanations: GAD may be reinforced by avoidance behaviors that temporarily reduce anxiety, but reinforce the belief that the feared outcomes are dangerous. Treatment Approaches: Effective treatments for generalized anxiety disorder include: 1. Cognitive Behavioral Therapy (CBT): CBT for GAD focuses on cognitive restructuring (identifying and challenging irrational thoughts), relaxation techniques, and problem-solving skills training. The aim is to reduce worry and anxiety through changing maladaptive thought patterns and behaviors. 2. Mindfulness-Based Therapies: Techniques such as mindfulness meditation and acceptance and commitment therapy (ACT) help individuals develop non-judgmental awareness of their thoughts and feelings, which can reduce anxiety and improve coping. 3. Medications: Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly prescribed to alleviate symptoms of GAD. Benzodiazepines may be used in the short-term for acute symptom relief, but they carry risks of dependence and are not recommended for long-term use. 4. Combination Therapies: Some individuals benefit from a combination of CBT and medication, particularly in severe cases or when symptoms are not adequately controlled by one approach alone. 5. Lifestyle Changes: Regular physical activity, healthy sleep habits, and stress management techniques can also be beneficial in managing symptoms of GAD. 249. Define and obsessions, compulsions, and obsessive-compulsive disorder, and describe its symptoms and prevalence. Answer: Definition: Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by the presence of obsessions and/or compulsions that are time-consuming, cause significant distress, or interfere with daily functioning. Obsessions: Obsessions are intrusive and unwanted thoughts, urges, or images that cause distress or anxiety. Common themes include fears of contamination, doubts about safety, a need for symmetry or order, aggressive or taboo thoughts, and excessive religious or moral doubts. Compulsions: Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rigid rules. These behaviors are aimed at preventing or reducing distress or preventing a feared event. Common compulsions include excessive cleaning or handwashing, checking, counting, repeating actions, and mental rituals. Symptoms: Symptoms of OCD include: • Presence of obsessions (thoughts, urges, or images) and/or compulsions (behaviors or mental acts). • Attempts to ignore or suppress obsessions or to neutralize them with other thoughts or actions. • The obsessions or compulsions are time-consuming (taking more than one hour per day) or cause significant distress or impairment in functioning. Prevalence: OCD affects approximately 1-2% of the population worldwide. It can occur at any age but often begins in childhood, adolescence, or early adulthood. OCD tends to be chronic if untreated, with symptoms waxing and waning over time. In summary, understanding generalized anxiety disorder and obsessive-compulsive disorder involves recognizing their defining features, exploring theoretical explanations from various perspectives, and considering evidence-based treatment approaches that address the complex nature of these anxiety disorders. 250. Describe the theoretical explanations and treatment approaches for obsessive-compulsive disorder. Answer: Theoretical Explanations: Several theoretical perspectives help explain OCD: 1. Biological Explanations: Genetic factors play a role in OCD, with individuals often having a family history of the disorder. Neurotransmitter imbalances, particularly involving serotonin, are implicated. Abnormalities in brain structures such as the orbitofrontal cortex, anterior cingulate cortex, and striatum are also observed in individuals with OCD. 2. Cognitive Explanations: OCD is associated with cognitive distortions such as inflated responsibility (belief that one is responsible for preventing harm), intolerance of uncertainty (discomfort with ambiguity), and overestimation of threat. Individuals may engage in cognitive rituals (mental acts) to reduce anxiety associated with obsessions. 3. Behavioral Explanations: OCD symptoms can be reinforced through operant conditioning (reduction in anxiety following compulsive behaviors) and classical conditioning (associating neutral stimuli with fear or anxiety). Treatment Approaches: Effective treatments for OCD include: 1. Cognitive Behavioral Therapy (CBT): Specifically, Exposure and Response Prevention (ERP) is the most evidence-based psychotherapy for OCD. ERP involves gradual and systematic exposure to feared situations or thoughts (exposures) without engaging in compulsive behaviors (response prevention). This process helps individuals learn that anxiety decreases over time without engaging in rituals. 2. Medications: Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for OCD. They help alleviate symptoms by increasing serotonin levels in the brain. 3. Combination Therapy: Some individuals may benefit from a combination of CBT and medication, particularly in severe cases or when symptoms are not adequately controlled by one approach alone. 4. Deep Brain Stimulation (DBS): In severe, treatment-resistant cases, DBS has shown promise in reducing OCD symptoms by modulating brain circuits involved in the disorder. 5. Mindfulness-Based Interventions: Techniques such as mindfulness meditation and acceptance and commitment therapy (ACT) can help individuals manage distress associated with OCD symptoms and improve overall functioning. In summary, OCD is a complex disorder with multiple contributing factors, including biological, cognitive, and behavioral elements. Treatment typically involves a combination of psychotherapy, medication, and supportive interventions tailored to individual needs. 251. Describe the symptoms and treatment of body dysmorphic disorder. Answer: Symptoms: Body dysmorphic disorder (BDD) is characterized by preoccupation with perceived defects or flaws in physical appearance that are not observable or appear slight to others. Symptoms include: • Excessive concern with one or more perceived flaws in physical appearance. • Repetitive behaviors (e.g., checking mirrors, grooming excessively) or mental acts (e.g., comparing oneself to others) in response to appearance concerns. • Significant distress or impairment in social, occupational, or other important areas of functioning. • Avoidance of social situations or excessive grooming rituals as a result of perceived defects. Treatment: Treatment approaches for BDD typically include: 1. Cognitive Behavioral Therapy (CBT): CBT for BDD focuses on cognitive restructuring (challenging and changing distorted beliefs about appearance), exposure and response prevention (gradual exposure to feared situations without engaging in rituals), and behavioral experiments to test appearance-related beliefs. 2. Medications: Selective serotonin reuptake inhibitors (SSRIs) are often prescribed to reduce symptoms of BDD, particularly when combined with psychotherapy. 3. Supportive Therapies: Supportive therapies such as mindfulness-based interventions and supportive psychotherapy can help individuals manage distress associated with BDD symptoms and improve overall quality of life. In severe cases or when individuals do not respond adequately to first-line treatments, referral to specialized clinics or services may be necessary for comprehensive care. 252. Describe the clinical features of and treatment for hoarding disorder. Answer: Clinical Features: Hoarding disorder is characterized by persistent difficulty discarding or parting with possessions, regardless of their actual value. Key clinical features include: • Excessive accumulation of possessions that clutter living areas and compromise the intended use of spaces (e.g., rooms cannot be used for their intended purpose due to clutter). • Distress or impairment in social, occupational, or other important areas of functioning due to hoarding behaviors. • Difficulty in discarding items due to perceived need to save them or distress associated with discarding them. • Hoarding behaviors often start early and worsen over time, leading to severe clutter and unsafe living conditions. Treatment: Effective treatments for hoarding disorder typically include: 1. Cognitive Behavioral Therapy (CBT): Cognitive-behavioral interventions for hoarding (CBT-H) focus on cognitive restructuring (challenging beliefs about possessions and acquiring), motivational interviewing, and exposure and sorting exercises to facilitate discarding. 2. Skills Training: Practical skills training in organization and decision-making can help individuals develop more adaptive strategies for managing possessions and reducing clutter. 3. Medications: While not specifically approved for hoarding disorder, SSRIs may be prescribed to alleviate symptoms of anxiety or depression that often co-occur with hoarding. 4. Home Visits and Supportive Interventions: Collaborative efforts involving social workers, occupational therapists, and professional organizers may be necessary to assist with decluttering and improving living conditions. In severe cases, particularly when hoarding poses health or safety risks, intensive interventions such as crisis intervention or legal involvement may be required to address immediate concerns. 253. Describe the differences between hoarding disorder and obsessive-compulsive disorder. Answer: Hoarding Disorder: • Primary Feature: Persistent difficulty discarding possessions, regardless of their actual value. • Motivation: Driven by a perceived need to save items and distress associated with discarding them. • Impact: Often leads to severe clutter that compromises living spaces and daily functioning. • Insight: Individuals with hoarding disorder may have limited insight into the problem and may not recognize the clutter as problematic. • Treatment Focus: Treatment primarily focuses on reducing hoarding behaviors and improving organization skills. Obsessive-Compulsive Disorder (OCD): • Primary Feature: Presence of obsessions (intrusive thoughts, urges, or images) and/or compulsions (repetitive behaviors or mental acts). • Motivation: Driven by anxiety or distress and aimed at reducing discomfort or preventing feared outcomes. • Impact: Obsessions and compulsions can interfere with daily life but typically do not lead to severe clutter as in hoarding disorder. • Insight: Individuals with OCD usually have insight into their symptoms and recognize obsessions or compulsions as excessive or irrational. • Treatment Focus: Treatment focuses on reducing obsessions and compulsions through exposure and response prevention (ERP) and/or medication. In summary, while hoarding disorder and OCD share some overlapping features, they are distinct disorders with different primary symptoms, motivations, impacts, levels of insight, and treatment approaches. Understanding these differences is crucial for accurate diagnosis and effective treatment planning. Test Bank for Abnormal Psychology in a Changing World Jeffrey S. Nevid, Spencer A. Rathus, Beverly Greene 9780205965014, 9780135821688, 9780134458311, 9780205961719, 9780130052162

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