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Chapter 7: Acute and Posttraumatic Stress Disorders, Dissociative Disorders, and Somatic Symptom Disorders Multiple Choice 1. Which of the following is a good definition of dissociation? a. separation from loved ones b. withdrawal from intimate relationships and social isolation c. disruption of the mental processes of memory, consciousness, identity, and perception d. the disengagement of physiological from psychological processes Answer: c. 2. An event that involves actual or threatened death, or serious injury to self or others, and creates intense feelings of fear, helplessness, or horror is defined by DSM-5 as involving a. feelings of numbness. b. stress. c. traumatic stress. d. eustress. Answer: c. 3. You are asked to review the DSM diagnostic criteria for traumatic stress disorders. Under which category will you find these disorders? a. trauma- and stressor-related disorders b. psychotic disorders c. anxiety disorders d. psychophysiological disorders Answer: a. 4. Which of the following events would fit the DSM description of situations that could lead to posttraumatic stress disorder? a. The car Ted was driving spun out of control and almost fell off a bridge; in the car, Ted waited helplessly to be rescued. b. While driving on the interstate, Kevin passes the site of a serious bus accident that is commemorated by a stone monument. c. The roller coaster ride was faster and had more turns than Alice had been told before she agreed to go on the ride with her friends. d. The newspaper account of a bank robbery and the resulting gun fight between the robbers and police contained more vivid details than Frank expected. Answer: a. 5. Ray has the diagnosis of acute stress disorder; Bob has been diagnosed as suffering from posttraumatic stress disorder. What is a major difference in their conditions? a. Bob has had symptoms for longer than Ray has had symptoms. b. Ray's symptoms are the result of a social stressor, not a natural stressor. c. Bob's symptoms involve a greater level of autonomic nervous system activation. d. Ray is likely to have more trouble sleeping than Bob, who is more likely to have appetite difficulties. Answer: a. 6. Your textbook discusses the case of Stephanie, who is a victim of rape. For months after her assault, Stephanie was constantly on the lookout for new threats. This condition is called a. hypersensitivity. b. hypovigilance. c. hypervigilance. d. Korsokov's syndrome. Answer: c. 7. Which arousal or reactivity symptom(s) most sharply differentiates acute stress disorder from posttraumatic stress disorder? a. reckless or self-destructive behavior b. somatic behavior c. factitious behavior d. re-experiencing behavior Answer: a. 8. The medical records of a patient at the local mental health center indicate that she has experienced a general numbing of responsiveness or detachment from others. Based on this symptom, which of the following is the most likely diagnosis in her case? a. pain disorder b. conversion disorder c. somatic symptom disorder d. acute stress disorder Answer: d. 9. Which of the following is a common characteristic of acute stress disorder and posttraumatic stress disorder? a. flashbacks b. sleepwalking c. multiple personalities d. increased parasympathetic nervous system arousal Answer: a. 10. A psychologist wants to collect some information from individuals who have been diagnosed as suffering either acute stress disorder or posttraumatic stress disorder. Which of the following could provide the best indication of the presence of certain symptoms in these individuals? a. They are asked to keep track of their calorie intake for a period of two months. b. They are asked to fill out a questionnaire asking for basic demographic information. c. They are videotaped as they wait to be interviewed and react to an expected loud noise. d. They are asked to proceed to another building on campus and their speed of walking is measured. Answer: c. 11. Marjorie has just experienced a traumatic event; she is feeling cut off from herself and her environment and reports feeling like a robot. A mental health professional would say that Marjorie is experiencing a. derealization. b. depersonalization. c. amnesia. d. flashbacks. Answer: b. 12. On what group was the first focus of research on posttraumatic stress disorder as the aftermath of traumatic events? a. rape victims b. Vietnam War veterans c. World War II veterans d. victims of natural disaster Answer: b. 13. A psychologist is interviewing a client who reports having experienced a severe trauma; before making a diagnosis of posttraumatic stress disorder, the psychologist would want to find evidence that the client is experiencing a. dissociative symptoms. b. persistent symptoms of increased arousal. c. depression. d. physical symptoms, such as headaches or stomach distress. Answer: b. 14. Acute stress disorder (ASD) was not included in early editions of DSM. Its inclusion in DSM-5 was justified in part because ASD a. is more severe than PTSD. b. lasts longer than PTSD. c. may predict future PTSD. d. is more treatable than PTSD. Answer: c. 15. To meet the DSM-5 criteria for PTSD, an individual must not only experience a traumatic event, but he must also a. exhibit the presence of one (or more) intrusion symptoms associated with that traumatic event. b. experience an inability to recall the event. c. suffer depression and substance abuse. d. maintain a belief that he was responsible for the event. Answer: a. 16. Which of the following variables predicted lower rates of posttraumatic stress disorder in emergency workers after Hurricane Katrina? a. hardiness b. extraversion c. responsibility d. sensation seeking Answer: a. 17. As a clinician, you would be most concerned about the probability of posttraumatic stress disorder in a victim of which of the following? a. rape b. natural disaster c. minor car crash d. expected death of a loved one Answer: a. 18. Which of the following is a description of what has been termed secondary victimization in cases of rape? a. Family members often ignore the victim. b. Multiple diagnoses are often made following a rape. c. Many cases of rape involve multiple crimes such as robbery. d. Various professionals exhibit a degree of insensitivity to rape victims. Answer: d. 19. A psychologist is talking about the self-blame that occurs in cases of rape. What factors tend to influence such reactions to rape? a. cultural myths that suggest women provoke rape b. deep seated tendencies to punish oneself for past deeds c. a natural physiological reaction to restore a sense of justice d. pre-existing disorders such as obsessive-compulsive disorder Answer: a. 20. A recent study found that ____ percent of rape survivors had thoughts of suicide? a. 5 b. 10 c. 33 d. 66 Answer: c. 21. What accounts for the reports of higher incidence rates of posttraumatic stress disorder in recent research? a. the inclusion of ASD along with PTSD b. recognition that traumatic stresses like rape are common c. redefining "trauma" as involving more ordinary forms of stress d. the inclusion of adjustment disorders along with PTSD Answer: b. 22. A national study found that approximately ___ percent of the people in the United States suffered from PTSD at some point. a. 2 b. 7 c. 12 d. 15 Answer: b. 23. What is the single most common traumatic event that can lead to PTSD? a. rape b. losing a job c. combat exposure d. sudden unexpected death of a loved one Answer: d. 24. Which of the following is the best description of the development of posttraumatic stress disorder (PTSD)? a. Some individuals are predisposed to develop PTSD, and there is nothing they can do to stop its emergence. b. The severity of the traumatic event is the most important factor in the development of PTSD. c. PTSD develops in individuals who have inherited certain physiological patterns, regardless of their level of exposure to trauma. d. PTSD results from the interaction of a traumatic event occurring to individuals with certain risk factors such as a history of mental disorder or a susceptibility to PTSD. Answer: d. 25. A person with acute stress disorder is most likely to develop posttraumatic stress disorder when a. the trauma is especially severe. b. the trauma involves the possibility of death. c. symptoms of numbing, depersonalization, and reliving the trauma are present. d. the person develops a complete amnesia for the traumatic event. Answer: c. 26. The National Comorbidity Study found that the course of posttraumatic stress disorder is best described as follows: a. The person fully recovers. b. Symptoms tend to diminish gradually. c. Most people with PTSD report symptoms of the disorder 10 years later. d. PTSD usually leads to severe alcohol and drug problems. Answer: b. 27. Research on social factors and the risk of posttraumatic stress disorder suggests a role of social support in the etiology of posttraumatic stress disorder (PTSD). It was found that veterans a. who didn't face the embarrassment of being treated as heroes had lower rates of PTSD. b. from units that encouraged independence had lower rates of PTSD. c. who did not receive social support on their return had high rates of PTSD. d. who had high social support through the Veterans Administration still had high rates of PTSD. Answer: c. 28. What do the results from the study of twins who served in Vietnam suggest in regard to the biological factors in the cause of PTSD? a. Genetic factors account for little in PTSD. b. Level of exposure did not predict PTSD symptoms. c. Genetic factors were most significant in accounting for arousal/anxiety symptoms. d. Individual risk of exposure to trauma was not affected by genetic influences. Answer: c. 29. Twin research shows that _______________ account(s) for IQ deficits that have been mistakenly attributed to brain damage due to trauma. a. preexisting differences b. damage caused by drug treatment of the PTSD c. abnormal biological adaptations to stress d. environmental differences Answer: a. 30. Research on social factors and the risk for PTSD focuses primarily on the nature of the trauma, the individual’s level of exposure to it, and __________________. a. genes b. unconscious disassociation c. levels of cortisol d. the availability of social support following the trauma Answer: d. 31. Following September 11, New York City college students had lower rates of PTSD if they were better at enhancing and suppressing emotional expression. This is an example of what psychologist Edna Foa calls emotional processing, which involves three key stages. Which of the following is one of her stages? a. Victims need to engage in specialized counseling as soon as possible after the event. b. Victims must engage emotionally with their traumatic memories. c. Victims need to find a way to forget about their chaotic experience. d. Victims must come to believe that the world is a terrible place. Answer: b. 32. When people with PTSD are able to integrate the experience of trauma and find some broader reason or higher value for enduring it, they are engaging in the task of a. emotional reintegration. b. meaning making. c. intellectualizing. d. denying the reality of their pain. Answer: b. 33. The term given to positive changes resulting from trauma is a. posttraumatic growth. b. hardiness. c. integration. d. meaning making. Answer: a. 34. With respect to the value of critical incident stress debriefing (CISD), a. CISD almost always prevents future PTSD. b. there is no evidence that CISD prevents PTSD. c. CISD is never harmful to those who receive it. d. CISD should not be offered until several days after the trauma. Answer: b. 35. Which of the following types of medication is most often prescribed for PTSD? a. antianxiety medications b. antihypertensive medications c. antidepressant medications d. stimulant medications Answer: c. 36. Jane has been diagnosed with PTSD and has begun seeing a psychotherapist. Which of the following will be the most important strategy for her therapist to employ to achieve long-term benefit? a. reexposure to the traumatic event b. stress-inoculation training c. emotional distancing d. reactivation of defense mechanisms Answer: a. 37. Your friend has just come from a therapist who has recommended eye movement desensitization and reprocessing for posttraumatic stress disorder. Because you are taking a course in abnormal psychology, your friend asks what you think. Based on the literature, what would you say? a. This technique is based on operant conditioning principles and seems quite effective. b. This technique does not seem to have a theoretical basis, and the limited effectiveness it does show may be due to the fact that it involves exposure. c. Classical conditioning provides the theoretical rationale for this technique that has had mixed results. d. Because the eyes are the "window on the mind," this technique explores hidden meanings related to traumatic events and has been extremely successful. Answer: b. 38. What event seemed to trigger Dallae's case of dissociative fugue reported in your textbook? a. poor grades b. her parents' divorce c. recovered memories of sexual abuse d. the breakup of a longstanding relationship Answer: a. 39. Which symptom of dissociative fugue can be used to distinguish fugue from the other dissociative disorders? a. malingering b. identity confusion c. purposeful, unplanned travel d. inability to remember details of the past Answer: c. 40. The name "hysteria" (Greek for "uterus") reflects the erroneous idea that somatic symptom and dissociative disorders were caused by a. confused sexual identity. b. women's frustrated desires to have children. c. gynecological dysfunctions that cause fevers. d. women misinterpreting mild symptoms as catastrophic. Answer: b. 41. Jean Charcot influenced the thinking of Sigmund Freud and Pierre Janet. Specifically, Freud and Janet were influenced by Charcot's a. views on gynecology. b. integration of multiple personalities. c. use of hypnosis to treat and induce hysteria. d. discovery of biological causes of somatic symptom disorders. Answer: c. 42. What is the view of contemporary psychology regarding unconscious processes? a. These processes do not exist. b. These processes only play a role in abnormal emotion and cognition. c. These processes only play a role in normal emotion and cognition. d. These processes play a role in both normal and abnormal emotion and cognition. Answer: d. 43. Epstein has suggested that we have two systems of information processing: a rational system that uses abstract, logical knowledge and a(n) ________________ system that uses intuitive knowledge to respond more quickly. a. illogical b. unconscious c. right brain d. experiential Answer: d. 44. Why are studies that seem to demonstrate the phenomenon of implicit memory important? a. They indicate that memory can only affect behavior when there is conscious remembering. b. They show that unconscious mental processes really do not exist. c. They represent a research technique that enables scientists to study unconscious processes. d. They provide objective evidence for the existence of a dissociative disorder. Answer: c. 45. Some psychologists do not see hypnosis as an altered state of consciousness. How are they likely to view being hypnotized? a. a form of depersonalization b. a form of dissociative amnesia c. a sign of predisposition to dissociation d. a response to suggestion and expectations Answer: d. 46. What is a cause of dissociative amnesia? a. malingering b. brain injury c. emotional distress d. neurotransmitter imbalance Answer: c. 47. After Linda witnessed a violent crime, she could not recall anything that happened before the trauma. Linda's experience is an example of a. fugue. b. dementia. c. regressive amnesia. d. dissociative amnesia. Answer: d. 48. While in his bedroom, Zack suddenly feels as if he is in a strange and unfamiliar place. Later, he experiences the feeling that his body does not belong to him. What is Zack experiencing? a. fugue b. deja vu c. depersonalization d. identity disorder Answer: c. 49. While, in DSM-5, fugue and dissociative amnesia are in the category of dissociative disorders, and ASD and PTSD are classified as trauma- and stressor-related disorders, many psychologists believe there is an important link between these separately categorized disorders. Which of the following provides evidence of such a link? a. They are all closely tied to the phenomenon of recovered memories. b. They all usually involve a clear and sudden trauma that, for most people, would be followed by a rapid return to normal psychological functioning. c. They all involve some significant distortions of reality. d. They are all chronic disorders from which a return to normal psychological functioning is very unlikely. Answer: b. 50. One of the greatest controversies in psychology today is the issue of recovered memories. Some individuals argue that such memories reveal past sexual abuse; others disagree. What is one of the concerns for those who raise questions about recovered memories? a. Therapists may be suggesting the existence of such memories to their clients. b. Many people cannot tell the difference between reality and what they may have dreamed. c. Some psychotic individuals are reporting their delusions as examples of claimed sexual abuse. d. Some clients are deliberately creating memories of sexual abuse in order to sue individuals against whom they have held grudges. Answer: a. 51. George Franklin was convicted of the murder of an 8-year-old that occurred over 20 years earlier. What aspect of this case is of interest to psychologists? a. Franklin claimed he committed the murder while in a dissociative state. b. His daughter's recovered memories were the basis for Franklin's conviction. c. A polygraph was used to identify those who were telling the truth about the murder. d. Franklin was covering up for a crime committed by his daughter who developed dissociative fugue. Answer: b. 52. Neisser and Harsch interviewed people about how they learned about the explosion of the space shuttle Challenger, and what they were doing at the time. They interviewed people at the time of the explosion, and then three years later. What did they find at the three-year follow-up? a. leading questions led to false memories b. hardly anyone remembered what they were doing c. about one-third had vivid but inaccurate memories d. nearly everyone showed accurate memories of where they were Answer: c. 53. The essential feature of behavior that will lead to diagnosis of dissociative fugue is a. hearing voices outside of oneself. b. dissociative hallucinations. c. gradual dissociation. d. sudden unexpected travel. Answer: d. 54. What is the most common form of dissociative amnesia? a. selective b. regressive c. continuous d. generalized Answer: a. 55. The famous case study by Thigpen and Cleckley (1957) that started the public’s fascination with the idea of multiple personality disorder, now called dissociative identity disorder, became a book and movie called a. Michelle Remembers. b. Eve Black and Eve White. c. The Three Faces of Eve. d. The Shining. Answer: c. 56. Which of the following individuals is going through a depersonalization experience? a. Peter, who believes the world is out to get him b. Abigail, who has amnesia for her name and identity c. Ronald, who believes he has more than one personality d. Terry, who has the sensation of floating above her body Answer: d. 57. Multiple personality disorder is now known as a. depersonalization. b. selective amnesia. c. dissociative fugue. d. dissociative identity disorder. Answer: d. 58. For a class assignment, students are required to read the book The Three Faces of Eve. The professor says he will offer extra credit to any student who can point out one of the inaccuracies in the book. Which of these students is going to earn extra credit? a. Melissa says Eve was suffering from schizophrenia. b. Andy says that Eve had more than three personalities. c. Bill says that Eve lied to become a celebrity. d. Zelda says Eve suffered from epileptic seizures that led her to engage in odd behaviors at times. Answer: b. 59. Research suggests many reasons to disbelieve the claims that dissociative disorders are prevalent but overlooked. Which of the following reasons presented in your textbook supports disbelieving these claims? a. Most cases of DID are diagnosed by a large group of advocates from varied mental health backgrounds. b. The increase in the frequency of the diagnosis correlated with the release of a popular book and movie. c. DID is frequently diagnosed outside of Canada and the United States. d. The diagnosis of DID has been associated with specific religious groups. Answer: b. 60. Some psychologists believe the increase in the diagnosis of dissociative identity disorder in recent years in the United States reflects a "fad" because a. the diagnosis is made mostly by younger doctors. b. the diagnosis is extremely rare in Great Britain. c. insurance companies will now cover its treatment. d. the growing interest in psychic phenomena has stimulated belief in the disorder. Answer: b. 61. Some epidemiological studies, using instruments like the Dissociative Experiences Questionnaire (DEQ), have reported high rates of dissociative symptoms, but these studies are viewed skeptically because a. dissociative symptoms cannot be measured based on self-reports. b. the symptoms measured by the DEQ are far less dramatic than those found in dissociative disorders. c. there is no agreement as to what dissociative symptoms should be measured. d. people with real dissociative disorders are not able to complete the DEQ. Answer: b. 62. Not all psychologists agree that dissociative identity disorder is a psychological disorder. What is the most commonly asserted alternative hypothesis used to explain behavior described as "dissociative identity disorder"? a. The patient has an affective disorder. b. The patient has organic brain dysfunction. c. The patient responds to expectations by role playing. d. The patient is under the influence of psychoactive drugs. Answer: c. 63. Why did some experts doubt the claim that Kenneth Bianchi, the "Hillside Strangler," had multiple personality disorder? a. An expert in hypnosis tricked Bianchi into feigning new symptoms. b. There was no known trauma during his childhood. c. Bianchi did not know the names of the personalities. d. Bianchi's poor verbal skills made his responses difficult to comprehend. Answer: a. 64. What disorder did Kenneth Bianchi (the "Hillside Strangler") feign in his attempt to explain his participation in several murders? a. depersonalization b. dissociative fugue c. dissociative amnesia d. dissociative identity disorder Answer: d. 65. To test the role-playing hypothesis of dissociative identity disorder (DID), Nicholas Spanos and colleagues conducted analogue experiments in which they asked college students to play the role of an accused murderer. What have these studies shown? a. Role playing causes dissociative identity disorder b. The symptoms of DID can be induced through hypnosis c. The ease of role-taking correlates with risk for DID d. Most individuals deny having a "hidden part," even under hypnosis Answer: b. 66. There is dispute about the importance of trauma as a factor in the etiology of dissociative identity disorder (DID) because a. there is no agreement as to what actually constitutes trauma. b. studies of the long-term consequences of child physical or sexual abuse have found little evidence of dissociation. c. it is not possible to confirm whether a person has ever experienced any trauma. d. most people diagnosed with DID deny having ever experienced a trauma. Answer: b. 67. What is the basis for the controversy about the role of trauma in the etiology of dissociative identity disorder? a. patients' reluctance to disclose trauma b. poor reliability of the definition of trauma c. concern about the validity of retrospective reports d. case histories that show few cases associated with trauma Answer: c. 68. Iatrogenesis refers to a. state-dependent learning. b. inability to recognize faces. c. emotional reliving of past experiences. d. treatment that causes, not cures, a disorder. Answer: d. 69. What is the main objective in treating patients with dissociative identity disorder? a. stop abreaction b. reduce depersonalization c. induce amnesia for all but one personality d. reintegrate the different personalities into a whole Answer: d. 70. What term is used to describe the emotional reliving of past traumatic experiences? a. abreaction b. dissociation c. iatrogenesis d. prosopagnosia Answer: a. 71. Which of the following is characteristic of somatic symptom disorders? a. They are the result of malingering. b. They have no clear biological cause. c. The symptoms are hypnotically induced. d. The disorders consist of the presentation of impossible symptoms. Answer: b. 72. What aspect of somatic symptom disorders make them different from medical disorders? a. They make sense neurologically. b. They are due to an actual physical illness. c. They are unrelated to psychological factors. d. They cannot be explained by a known organic cause. Answer: d. 73. The sudden onset of paralysis in one arm without a clear biological cause is an example of a. malingering. b. depersonalization. c. somatic symptom disorder. d. dissociative disorder. Answer: c. 74. What do dissociative and somatic symptom disorders have in common? a. They both involve malingering. b. They have the same biological cause. c. They both involve a degree of dissociation. d. People with these disorders also have personality disorders. Answer: c. 75. Which category of disorders is often associated with unnecessary medical treatment? a. somatic symptom disorders b. adjustment disorders c. dissociative disorders d. schizophrenic disorders Answer: a. 76. Which of the following is a problem associated with somatic symptom disorders? a. unnecessary surgery b. stress-related illnesses c. amnesia due to organic brain dysfunction d. legal difficulties due to having more than one personality Answer: a. 77. The symptoms of conversion disorder often resemble a. flu-like symptoms. b. neurological diseases. c. gastrointestinal problems. d. dissociative identity disorder. Answer: b. 78. Terry is unable to see, even though a medical examination reveals no physical problems with her eyes or brain. What is the most likely diagnosis? a. illness anxiety disorder b. dissociative fugue c. conversion disorder d. psychosomatic disorder Answer: c. 79. Alice has lost sensitivity to pain only on the left side of her face. Why is it reasonable to suspect that Alice suffers from conversion disorder? a. Conversion disorder often involves loss of sensitivity to pain. b. Conversion disorder does not usually involve bilateral symptoms. c. There is no possible organic explanation for why someone would lose pain sensation in the face. d. The nerves involved in pain sensation do not divide the face neatly in half. Answer: d. 80. If a patient with somatic symptom disorder is described as presenting symptoms in a histrionic manner what has the clinician concluded? a. The physical symptoms do not make anatomical sense. b. The patient's report is filled with suspicious gaps of memory. c. The patient's symptoms are consistent with "la belle indifference." d. The symptoms were presented in a vague but seductive and dramatic manner. Answer: d. 81. A flippant lack of concern about symptoms, called "la belle indifference," is sometimes observed in patients with a. pain disorder. b. schizophrenia. c. somatic symptom disorder. d. psychosomatic illness. Answer: c. 82. A history of multiple, somatic complaints in the absence of organic impairments is characteristic of a. conversion disorder. b. psychosomatic illness. c. somatic symptom disorder. d. body dysmorphic disorder. Answer: c. 83. When Bob noticed a pain in his thigh, he was convinced it was the first sign of bone cancer. Although X-rays revealed no sign of cancer, Bob sought the opinions of several other physicians who agreed with the original opinion. What mental disorder might Bob's behavior indicate? a. a mood disorder b. illness anxiety disorder c. conversion disorder d. catatonic schizophrenia Answer: b. 84. When faced with the results of medical tests that indicate that their symptoms have no medical cause, what is the typical response of individuals with illness anxiety disorder? a. They become delusional, believing that the physician is lying. b. They accept the results and then generally enter counseling. c. They accept the results, but worry that the tests are wrong. d. They become extremely afraid and have panic attacks. Answer: c. 85. Frank is experiencing a lot of pain. His condition would be classified as a somatic symptom disorder in DSM-5 if a. Frank’s pain is the expected result of a medical condition. b. the pain is chronic. c. Frank is faking or intentionally producing the pain. d. psychological factors are judged to be significant. Answer: d. 86. What part of the body is the most frequent preoccupation of individuals with body dysmorphic disorder? a. brain b. sense organs c. facial features d. internal organs Answer: c. 87. Which of these people is most likely to receive the diagnosis of body dysmorphic disorder? a. Teresa, who is 25 pounds overweight b. Mike, whose blindness has no physical cause c. Amy, who experiences gastrointestinal problems when she is stressed d. Kevin, who imagines he has a serious defect in his physical appearance Answer: d. 88. Which of these disorders is as much as 10 times more likely to occur in women than men? a. pain disorder b. illness anxiety disorder c. conversion disorder d. somatic symptom disorder Answer: d. 89. Rick walks into the emergency room and asks to see a doctor. He explains that he has a fever, but he does not report that he gave himself an injection of dirty water that is probably responsible for his fever. Without this information, the medical staff cannot determine the cause of Rick's fever, so they admit him for observation. Rick is delighted because he enjoys the "sick role." After numerous tests are run, the staff is still puzzled, so they call for a psychiatric consult. The psychiatrist should consider the diagnosis of __________ disorder. a. factitious b. somatic symptom c. bipolar mood d. psychosomatic. Answer: a. 90. You overhear several students discussing a news report on Munchausen syndrome. Because you are taking a course in abnormal psychology, you recognize this syndrome to be an example of a(n)__________ disorder. a. anxiety b. psychotic c. traumatic d. factitious Answer: d. 91. Hannah's doctors are convinced that her physical symptoms are not real, but they cannot decide whether this is an instance of malingering or factitious disorder. What factor will best help them to choose between these two possibilities? a. the severity of her symptoms b. how long her symptoms have been affecting her c. whether she is achieving some specific external gain d. whether she seeks or refuses medical treatment Answer: c. 92. Which of these individuals is most likely to suffer from somatic symptom disorder? a. Eight-year-old Alice, who is from an upper socioeconomic background and is in grade-school at this time b. Sixty-five-year-old Harry, who is from a lower socioeconomic background and has two college degrees c. Fifty-year-old John, who is from an upper socioeconomic background and has a doctoral degree in education d. Twenty-two-year-old Mary, who is from a lower socioeconomic background and has eight years of education Answer: d. 93. People who suffer from somatic symptom disorder also commonly suffer from a. delusions. b. nightmares. c. depression. d. factitious disorder. Answer: c. 94. In a family with somatic symptom disorder, the male relatives are at increased risk for antisocial personality disorder. What are the underlying characteristics that tie these disorders together? a. mania and psychasthenia b. extraversion and agreeableness c. sensation seeking and irresponsibility d. absence of inhibition and high negative emotion Answer: d. 95. Which disorder is related to antisocial personality disorder and is more common in women? a. anorexia nervosa b. somatic symptom disorder c. sadistic personality disorder d. dissociative identity disorder Answer: b. 96. The Williams family is sitting down for Thanksgiving dinner. Mary Williams starts describing her many different somatic complaints. Then, Aunt Helen adds her own long list of complaints. Somatic symptom disorder seems to run in the female members of this family. The male relatives in this family may have an elevated risk for which disorder? a. panic disorder b. bipolar disorder c. schizophreniform disorder d. antisocial personality disorder Answer: d. 97. Under what circumstances is a physical complaint assumed to be part of a somatic symptom disorder? a. There are gaps in memory. b. The symptoms are gastrointestinal in nature. c. Various known physical causes are ruled out. d. There is a history of other psychiatric problems. Answer: c. 98. Which of the following is a significant problem in confirming a diagnosis of somatic symptom disorder? a. Patients don't always tell the truth about symptoms. b. A true somatic illness will often be detected only later, after medical treatment has been exhausted. c. There is no objective measure of a person's pain. d. Somatic symptom disorders overlap substantially with mood disorders. Answer: b. 99. The diagnosis of somatic symptom disorder is sometimes mistakenly made in cases where there are actually undetected physical illnesses, especially a. sensory deficits. b. ulcers or colitis. c. cardiovascular diseases. d. neurological diseases. Answer: d. 100. What was Sigmund Freud's original conclusion concerning reports of child sexual abuse by patients with conversion disorders? a. The trauma causes conversion. b. The conversion precedes child abuse. c. Memories of sexual abuse are fantasies. d. Mental illness causes errors in memory. Answer: a. 101. In psychoanalytic theory, the symptoms of somatic symptom and dissociative disorders provide primary gain. This means that the symptoms a. allow benefits such as missing work. b. help the patient learn the sick role. c. are more easily treated than other problems. d. protect the conscious mind from painful conflicts. Answer: d. 102. What is one of the major findings of research on memory and retrospective reports? a. Parents report more negative memories than children report. b. Anxiety is associated with long-term memory impairments. c. Depressed people erroneously recall more negative events. d. Specific memories are more reliable than global memories. Answer: d. 103. What element would make for an adequate test of the hypothesized relationship between child abuse and dissociative disorder? a. retrospective analysis b. prospective research with objective measures c. accurate prevalence rates for child sexual abuse d. intensive case studies of patients with multiple personality disorder Answer: b. 104. Which of the following is an example of a retrospective report? a. a teen describing how he likes high school b. an adult describing what high school was like c. evaluation of high school students' work by several sources d. a child describing what she expects high school to be like Answer: b. 105. Donna has a somatic symptom disorder. According to a cognitive behavior therapist, how is her disorder likely to be perpetuated? a. getting attention and getting to miss work b. stigma from a society that labels her mentally ill c. complications from associated anxiety or depression d. negative self-statements that reduce her self-esteem Answer: a. 106. The medical records of a patient contain the word alexithymia. Assuming the word is accurate, what can we conclude about this patient? a. He has difficulty recognizing and expressing emotions. b. He has been hostile and will not cooperate in his treatment. c. He is feigning an illness in order to take on the sick role. d. He does not take responsibility for his actions and constantly blames others. Answer: a. 107. According to the social view of the etiology of somatic symptom disorders, these disorders are more common in nonindustrial societies and among the poorly educated in the United States. Why do people in these communities tend to develop these disorders? a. They view therapists with great suspicion. b. They typically live in very crowded conditions. c. They learn to express emotions as physical symptoms. d. They are subjected to more pollution and discrimination. Answer: c. 108. Barbara suffers from a conversion disorder and has recently begun treatment with a Freudian therapist. What is this therapist most likely to emphasize in treating Barbara? a. encouraging her to recall psychologically painful events b. teaching her how to put her feelings into words c. eliminating the reinforcers for her symptoms d. showing her how her symptoms do not make anatomical sense Answer: a. 109. How would a therapist use cognitive behavioral approaches to treat chronic pain? a. use pain as a punisher b. reward successful coping and life adaptation c. reduce reinforcement for the sick role d. induce relaxation by using biofeedback Answer: b. 110. Which group of medications has been found to produce more relief from the symptoms of body dysmorphic and pain disorders than placebo? a. SSRIs b. anticonvulsants c. antianxiety drugs d. marijuana type drugs Answer: a. 111. What is one reason for the limited research on the psychological treatment of somatic symptom disorders? a. Most of these patients deny having any symptoms. b. These people tend to see physicians, not psychologists. c. The high rate of dissociation among these people makes assessment very difficult. d. Psychological treatment is usually seen as unnecessary. Answer: b. 112. What is the major recommendation for the medical management of patients with somatic symptom disorder? a. use medication to reduce anxiety b. confront the patient's irrational thinking c. use repeated medical procedures to reassure the patient d. establish a strong and consistent physician-patient relationship Answer: d. 113. Norman's primary care physician is convinced that his symptoms are due to a somatic symptom disorder, and the physician is encouraging Norman to accept a referral to a mental health professional. Norman is likely to a. accept the referral willingly. b. drop out of all forms of treatment. c. reject the referral despite negative test results. d. reject the referral because he is faking and does not want to be found out. Answer: c. Short Answer 114. _________ is defined in DSM-5 as an event that involves actual or threatened death, or serious injury to self or others, and creates intense feelings of fear, helplessness, or horror. Answer: Trauma 115. Sudden memories during which a trauma is replayed in images or thoughts—often at full emotional intensity—are known as __________ . Answer: flashbacks 116. Considered a dissociative symptom, __________ is a marked sense of unreality about yourself and the world around you. Answer: Derealization 117. Many people with PTSD also suffer from other mental disorders, such as depression, anxiety, and/or drug abuse. This is known as __________ . Answer: comorbidity 118. Women are most likely to develop PTSD as a result of rape. For men, the leading cause is a result of __________ . Answer: combat and war 119. Some individuals experience positive changes as a result of living through a traumatic event. Psychologists label this __________ growth. Answer: posttraumatic 120. __________ disorders are characterized by persistent, maladaptive disruptions in the integration of memory, consciousness, or identity. Answer: Dissociative 121. Summarized in your textbook, the case study called "Dallae’s Journey" involves a dissociative __________ . Answer: fugue 122. Psychologists disagree as to the nature of hypnosis. Some see it as an altered state of consciousness, while others see it as merely an example of a social _________ . Answer: role 123. Exceeding normal forgetfulness, ___________ amnesia involves a sudden inability to recall extensive and important personal information. Answer: dissociative 124. ___________ disorders involve the creation of a disorder by its treatment. Answer: Iatrogenic 125. ____________ disorders are characterized by unusual physical symptoms that occur in the absence of a known physical illness. Answer: Somatic symptom 126. Today, a somatic symptom disorder that is much more common than the type seen by Freud or Charcot is __________ disorder, characterized by a history of multiple somatic complaints in the absence of organic impairments. Answer: somatic symptom 127. Body __________ disorder is a different type of somatic symptom disorder in which the patient is preoccupied with some imagined defect in appearance. Answer: dysmorphic 128. Freud recognized that individuals who exhibited various psychological symptoms could gain certain advantages such as sympathy or an excuse to avoid work. He labeled this "secondary gain." Cognitive behavioral psychologists would call this process positive __________ . Answer: reinforcement Essay 129. Identify the major clusters of symptoms used in diagnosing acute stress disorder and posttraumatic stress disorder. Give an example of each. Answer: (1) Re-experiencing: visualizing the trauma over and over or in dreams or in flashbacks (sudden, repeated, intrusive memories during which the memory is replayed in thoughts or images); (2) avoidance: avoidance of stimuli associated with the trauma (including thoughts or feelings); (3) arousal or anxiety: increased arousal and anxiety evident in trouble falling or staying asleep or difficulty maintaining concentration; (4) dissociative symptoms (likely to occur in acute stress disorder): becoming less aware of surroundings following a traumatic event or depersonalization (feeling cut off from oneself) or derealization (a marked sense of unreality about oneself). 130. How and why has the definition of traumatic events changed from earlier versions of DSM to the current DSM? What have surveys revealed about traumatic events? Answer: Earlier versions of DSM defined trauma as an event "outside the range of usual human experience." Recent research has revealed that many traumatic events are common in the United States. Now, DSM defines traumatic events as (1) the experience of an event involving actual or threatened death or injury to self or others, and (2) a response of intense fear, helplessness, or horror in reaction to the event. A study of a random sample of over 2,000 adults living in the Detroit area found that almost 90 percent of the participants reported having experienced at least one traumatic stressor in their lives. About 9 percent of the participants developed PTSD following the trauma. 131. Discuss cognitive behavior therapy methods used to treat posttraumatic stress disorder (PTSD). Answer: The most effective types of treatments for PTSD involve a reexposure to the events or stimuli that caused the trauma in the first place. A study of prolonged exposure to traumatic stimuli found it to be more effective in relieving symptoms than relaxation and supportive counseling. Similarly, a method that involves imagining nightmares while awake, called imagery rehearsal therapy, was also found to relieve symptoms. Other cognitive techniques are also employed, such as challenging faulty assumptions like “no one cares,” but it is the exposure to the events that seem to have the most consistent therapeutic effect. 132. Recovered memories from early childhood have become an important and controversial issue. Discuss the reasons for this controversy and the research evidence that casts doubt on some reports of "recovered memories." Answer: (1) Memory research indicates that most memories from preschool are forgotten. (2) Therapists rarely doubt their patients' memories and may ask leading questions or set up expectations that induce false memories. (3) Research indicates high rates of erroneous memories for important events, such as where people were on the day the space shuttle Challenger blew up . 133. Explain why dissociative identity disorder is such a controversial diagnosis. Answer: Dissociative identity disorder (DID) is being diagnosed with much greater frequency in recent years, with some studies suggesting unbelievably high prevalence rates. Most cases of DID are diagnosed by only a handful of clinicians, and the number of personalities claimed to exist has grown rapidly. Dissociative disorders are rarely diagnosed outside of the U.S. and Canada. It is even possible that the disorder does not exist, that it is only created by the power of suggestion, or that it represents a form of role enactment. 134. Describe the association between antisocial personality disorder and somatic symptom disorder. Answer: The two disorders do not typically occur in the same individual, but they often are found in different members of the same family. Since antisocial personality is far more common among men, while somatic symptom disorders have the opposite pattern, some have speculated that the two problems are flip sides of the same coin. Antisocial personality disorder may be the male expression of high negative emotion and the absence of inhibition, whereas somatic symptom disorder is the female expression of the same characteristics. 135. Explain the effect of social factors on the role of learning in the etiology of somatic symptom disorders. Answer: The social learning perspective would suggest that somatic symptom disorders are caused by learning. There is a concept called “learning the sick role” in which behaving as if sick is acquired through observation of others, some of whom are actually ill. Once the patient is in a sick role, operant conditioning may take over. People take care of you, do things for you and reduce demands made of you, all of which can act as either positive or negative reinforcement and increase the behavior in question. Getting attention acts generally as positive reinforcement, while receiving reduced demands acts generally as negative reinforcement. 136. Discuss a "state dependent learning" model as a possible cause of a dissociative disorder. Answer: State dependent learning is a process where learning that takes place in one state of affect or consciousness is best recalled in the same state of affect or consciousness. Research has shown that if a memory is acquired in a state of fear, then in the future, it sometimes serves as a trigger for those memories that have become associated with that particular emotion. A person who behaves in a certain way, under certain conditions, but then later forgets the events, may have formed an autonomous cluster of memories associated with a particular state or emotional set. If this is the case, then the person has developed independent personalities that are themselves state dependent. Test Bank for Abnormal Psychology Thomas F. Oltmanns, Robert E. Emery 9780205997947, 9780205970742, 9780134899053, 9780134531830
