Title: Obsessive-Compulsive and Stressor-Related Disorders
Course: Question bank check

Q: The results of family and twin studies suggest that one of the main causes of obsessive-compulsive disorder is/are
- a traumatic experience. (Incorrect. Though OCD symptoms may appear in those diagnosed with post-traumatic stress disorder, research does not indicate that trauma plays a significant role in causing OCD.)
- a learned fear of germs. (Incorrect. This fear is a possible symptom of OCD and not a causation. The symptoms of OCD have been theorized to be learned responses, acquired and sustained as the result of a combination of two forms of learning: classical conditioning and operant conditioning.)
- a brain injury that affects the orbitofrontal cortex. (Incorrect. Though OCD symptoms may appear in those diagnosed with traumatic brain injury, research does not indicate that head trauma causes OCD.)
- genetics. (Correct! Studies have implicated about two dozen potential genes that may be involved in OCD; these genes regulate the function of three neurotransmitters: serotonin, dopamine, and glutamate.)
A: genetics.

Q: Kyle is always concerned about harming himself or other people. He feels as if he were going crazy because these thoughts are very intrusive. To be sure that he doesn’t harm himself or anyone else, he feels compelled to hide or store away sharp objects such as knives and pizza cutters. His symptoms suggests that he might be suffering from a(n)
- generalized anxiety disorder. (Incorrect. Generalized anxiety disorder is characterized by constant anxiety that is not associated with a particular object or event.)
- anxiety disorder. (Incorrect. Anxiety disorders are characterized by intense, incapacitating fear and apprehension.)
- specific phobia. (Incorrect. A specific phobia is an irrational and unabating fear of a particular object, activity, or situation.)
- obsessive-compulsive disorder. (Correct! People with obsessive-compulsive disorder (OCD) experience thoughts and urges that are intrusive and unwanted (obsessions) and/or the need to engage in repetitive behaviors or mental acts (compulsions).)
A: obsessive-compulsive disorder.

Q: Whenever Tania eats at a restaurant, she thinks about the number of people who may have touched her silverware. When no one is looking, she puts the silverware into her pocket, goes to the ladies room, and washes the silverware in hot water several times, without ever feeling like they are clean. Tania might be suffering from
- body dysmorphic disorder. (Incorrect. Body dysmorphic disorder involves an excessive preoccupation with an imagined defect in physical appearance.)
- an anxiety disorder. (Incorrect. Anxiety disorders are characterized by intense, incapacitating fear and apprehension.)
- generalized anxiety disorder. (Incorrect. Generalized anxiety disorder is characterized by constant anxiety that is not associated with a particular object or event.)
- obsessive-compulsive disorder. (Correct! People with obsessive-compulsive disorder (OCD) experience thoughts and urges that are intrusive and unwanted (obsessions) and/or the need to engage in repetitive behaviors or mental acts (compulsions).)
A: obsessive-compulsive disorder.

Q: Marc is 30 years old and thinks that the bald spot on his head makes him look old and unattractive. He is overly conscious of his appearance and spends a lot of time looking in the mirror to see if his bald spot is visible. He has also tried many treatments, such as topical creams and steroid injections, to get his hair to grow back. He has spent a lot of time and money on various remedies, but none have been successful. Now he avoids social gatherings. Marc displays signs of
- social phobia. (Incorrect. Social phobia is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impaired ability to function in at least some aspects of daily life. These fears can be triggered by perceived or actual scrutiny from others. Body dysmorphic disorder is often associated with low quality of life and frequently is comorbid with major depressive disorder, substance use disorders, obsessive-compulsive disorder (OCD), and social phobias.)
- delusional disorder. (Incorrect. Delusional disorder is a generally rare mental illness in which a person presents delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect. Delusions are a specific symptom of psychosis.)
- generalized anxiety disorder. (Incorrect. Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive, uncontrollable, and often irrational worry about events or activities. Worry often interferes with daily functioning, and sufferers are overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties.)
- body dysmorphic disorder. (Correct! An individual with body dysmorphic disorder (BDD) is preoccupied with a perceived flaw in their physical appearance that is either nonexistent or barely noticeable to other people. BDDs perceived physical defects cause the person to think they are unattractive, ugly, hideous, or deformed. These preoccupations can focus on any bodily area, but they typically involve the skin, face, or hair.)
A: body dysmorphic disorder.

Q: Which example below best demonstrates how someone might exhibit symptoms of body dysmorphic disorder?
- Paulo has recently started a new exercise routine and now all he talks about is working out, protein drinks, and burning fat. His friends think he’s overdoing it and though he admits this is his new obsession, he doesn’t want to stop. He enjoys how the workout makes him feel and often glances at his reflection in car windows or storefronts. (Incorrect. Though Paulo is obsessed with his workout, there’s no indication he is doing this because he’s ashamed of his body or trying to fix a flaw that no one else sees. Additionally, he doesn’t display any other common symptoms of BDD, such as avoiding social situations, seeking cosmetic procedures to fix perceived defects in appearance, etc.)
- Davina considers herself a cosmetic fanatic and has an extensive collection of mascaras, eye shadows, lipsticks, etc. She is often experimenting with different colors to find the perfect look and always carries a compact mirror everywhere she goes. She never leaves the house without makeup, even to check the mail. (Incorrect. Though Davina may be self-conscious without makeup, there’s nothing else to indicate she’s obsessed with body image or feels ashamed by her appearance. Remember, BDD is a mental health disorder in which a person can’t stop thinking about one (or more) perceived defects or flaws in their appearance.)
- Malik has a difficult time leaving his home to enjoy outings with his friends because they always want to go to bars or sports arenas; places that Malik views as filthy. He is very concerned about contaminants and washes his hands so frequently that, on occasion, they become raw and he needs to apply a special ointment to heal them. Additionally, when he does leave the house, it’s never without hand sanitizer. (Incorrect. These are symptoms of obsessive-compulsive disorder (frequent/constant hand washing and fear of contamination or dirt). Though Malik’s OCD affects him in a way that he is socially isolating more, there are no other symptoms to indicate BDD.)
- Kit is 53 years old and works as a nurse in a retirement home. She never married and has always felt that men were turned off because of the shape of her nose, which she considers to be unusually large and crooked. Despite being reassured by friends and family members that her nose looks normal and that she is fairly attractive, she is overly conscious of the shape of her nose and thinks it negatively affects her overall appearance. (Correct! BDDs perceived physical defects cause the person to think they are unattractive, ugly, hideous, or deformed. These preoccupations can focus on any bodily area, but they typically involve the skin, face, or hair. Kit’s belief that the shape of her nose is a flaw in her physical appearance, so much so that men find her unattractive whereas her friends and family consider her nose normal, is a symptom of body dysmorphic disorder. Past research also found that individuals with BDD are less likely to be married than those without BDD.)
A: Kit is 53 years old and works as a nurse in a retirement home. She never married and has always felt that men were turned off because of the shape of her nose, which she considers to be unusually large and crooked. Despite being reassured by friends and family members that her nose looks normal and that she is fairly attractive, she is overly conscious of the shape of her nose and thinks it negatively affects her overall appearance.

Q: Aliya is overly conscious about a mole on her cheek that she has had since birth. She usually spends several hours during the day before the mirror re-applying make-up on the mole. Even though friends and family reassure her that the mole is barely visible, Aliya wants to have plastic surgery to remove it. Aliya's behavior is most likely to be associated with which of the following disorders?
- hypochondriasis. (Incorrect. Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness.)
- social phobia. (Incorrect. Social phobia is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impaired ability to function in at least some aspects of daily life. These fears can be triggered by perceived or actual scrutiny from others. Body dysmorphic disorder is often associated with low quality of life and frequently is comorbid with major depressive disorder, substance use disorders, obsessive-compulsive disorder (OCD), and social phobias.)
- Munchausen’s syndrome. (Incorrect. Munchausen’s syndrome, is a factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves.)
- body dysmorphic disorder. (Correct! Many patients with BDD seek unnecessary dermatologic, dental, and other cosmetic interventions in hopes of removing their perceived flaws. These procedures typically have poor outcomes and lead to patient distress, often worsening symptoms and leading to patient dissatisfaction and loss of self-esteem. Some patients undergo repeated surgeries without achieving the expected outcome.)
A: body dysmorphic disorder.

Q: Doris is a shy, eccentric 60-year-old woman living alone following the death of her mother, with whom she had lived for her whole life. At her mother’s funeral, her brother Todd and his wife Cynthia try to persuade her to sell the house, especially the possessions that Doris has collected and saved over the years. Most of the items are of no value, except for sentimental reasons they cannot understand. The clutter has become hazardous, as Doris herself can hardly move through the house. There isn’t anywhere to sit anymore, but Doris can manage to get to her bed, where she spends most of her time. One day, fed up, Todd and Cynthia arrive with Doris's therapist, planning on decluttering her house, but when Cynthia tries to throw out a pencil, Doris angrily throws them out of her house. Which of the following disorders is Doris likely to have?
- OCD (Incorrect. Although hoarding was traditionally considered to be a symptom of OCD, considerable evidence suggests that hoarding represents an entirely different disorder. People with hoarding disorder (HD) cannot bear to part with personal possessions, regardless of how valueless or useless these possessions are.)
- Separation anxiety disorder (Incorrect. Separation anxiety disorder (SAD) is an anxiety disorder in which an individual experiences excessive anxiety regarding separation from home and/or from people to whom the individual has a strong emotional attachment (e.g., a parent, a caregiver, a significant other, or siblings). It is most common in infants and small children, typically between the ages of six to seven months to three years, although it may pathologically manifest itself in older children, adolescents, and adults.)
- Panic disorder (Incorrect. Panic disorder is an anxiety disorder characterized by recurring, unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something terrible is going to happen. The maximum degree of symptoms occurs within minutes.)
- Hoarding disorder (Correct! People with hoarding disorder (HD) cannot bear to part with personal possessions, regardless of how valueless or useless these possessions are. Hoarders accumulate excessive amounts of usually worthless items that clutter their living areas. Often, the quantity of cluttered items is so excessive that the person is unable to use their kitchen or sleep in their bed. People who suffer from this disorder have great difficulty parting with items because they believe the items might be of some later use or because they form a sentimental attachment to the items.)
A: Hoarding disorder

Q: Richard, a 60-year-old gardener lives alone in his one-bedroom shack amid stacks of newspapers loomed just at shoulder height, topped with magazines, bottles, cartons, and grocery packaging. Alarmingly, around the gas cooker where he makes his frugal repast of boiled eggs and toast, a pile of paper and packaging fills this area of his home from floor to ceiling. Most of the things he has collected have no value, nonetheless he has severe anxiety at the thought of throwing them out, even if they represent a fire risk, putting his life in danger. He was referred to a community mental health team and diagnosed with
- obsessive compulsive disorder. (Incorrect. Although hoarding was traditionally considered to be a symptom of OCD, considerable evidence suggests that hoarding represents an entirely different disorder. People with hoarding disorder (HD) cannot bear to part with personal possessions, regardless of how valueless or useless these possessions are.)
- antisocial personality disorder. (Incorrect. Some people seem to have no regard for others and can cause harm to them without any regret or feelings of guilt. When this behavior is pervasive, a person may have a chronic mental health condition known as antisocial personality disorder. Sometimes people with antisocial personality disorder are called “sociopaths.”)
- major depressive disorder. (Incorrect. Major depressive disorder (MDD), also known simply as depression, is a mental disorder characterized by at least two weeks of pervasive low mood. Low self-esteem, loss of interest in normally enjoyable activities, low energy, and pain without a clear cause are common symptoms.)
- hoarding disorder. (Correct! People with hoarding disorder (also referred to as “pathological collecting”) have severe anxiety over discarding possessions. While hoarders have an urge to collect and save items, they often have difficulty organizing the items, resulting in hazardous clutter. Homes of individuals with HD may present a health hazard to themselves and others due to health code violations, fire risk, infestations, or community expenses incurred from the cost of cleaning out the home or eviction from the home.)
A: hoarding disorder.

Q: Which of the following individuals is most likely to have hoarding disorder based on the description of symptoms alone?
- Celeste’s mother read to her every night and their favorite movie was Beauty and the Beast—mostly because of the scene showing Beast’s enormous library that he gifts to Belle. They frequented the library and local book shops and collected many books throughout her childhood. Celeste was only a teenager when her mother died, and since then, she’s continued to collect books and has a hard time leaving a bookstore without making a purchase. Now, in her thirties, her friends try to convince her to hold a garage sale because she has so many books. They complain there’s not enough space to “hang out” in the living room because Celeste has three bookshelves where she could have another couch, but she refuses. (Incorrect. Though Celeste may have a large collection (and it’s possible some of this is due to grief issues with her mother’s death), there’s nothing to indicate that it is affecting her socially, emotionally, or occupationally. Nothing in the scenario suggests that discarding these items would bring great anxiety, nor that she is unable to function in her own home (i.e., use the kitchen, sleep in the bedroom, etc).)
- Donny and his wife have been fighting over the last several months regarding his new hobby of refurbishing old furniture. He insists that this could be a lucrative side business but she feels it’s another obsession that will continue to take over the garage and consume his time. There is no room in the garage to park the car anymore, and now there’s an antique dresser taking up space in the bedroom. He believes she’s just a “clean freak” who constantly gets rid of things she considers they “don’t need” and has been frustrated she doesn’t check with him first. Tools he needed—that he often left lying around—have gone missing, which ended up creating a financial burden because he would simply buy another one when he couldn’t find it immediately. (Incorrect. Though Donny’s side hustle may be causing marital problems and likely leading to some clutter, there are no symptoms of hoarding disorder present (i.e., difficulty discarding possessions, due to strong urges to save items and/or distress associated with letting items go, an accumulation of possessions that take up space in the home or workplace, to the extent that the intended use of these areas is no longer possible).)
- Laila moved into her father’s home shortly after he passed away. She’d inherited the house and all her father’s possessions. Her dad was known to hoard items and Laila has become overwhelmed with the number of things piled up in the home—especially since she’s moved her own possessions into the same house. She feels anxious amid the clutter but has become so depressed she doesn’t feel she can do anything about it. When a friend offered to help, she finally started sorting through everything, but each time she picks up an item of her dad’s, it suddenly feels difficult to discard it because she feels she is really discarding a part of her father. (Incorrect. Though her dad may have had a hoarding disorder, Laila likely does not. It’s more likely she is experiencing grief and loss over the death of her parent than difficulty discarding items due to an underlying hoarding disorder.)
- Sheri is a 49-year-old woman who has suffered depression and anxiety. She lives alone and works in a hospital gift shop. She has problems getting organized and has a hard time throwing away business papers, newspapers, and magazines. Her apartment is filled with books, stationery, crafts, plastic packages, cardboard boxes, and all sorts of other things. She has little room to live. Ashamed by the state of her apartment, she has told no one about her behavior and never invites anyone into her apartment. This has gone on for 10 years. (Correct! Sheri’s hoarding is very concerning at this point—the fact that she’s saved so many items, to the point where she has little room to live, and feels severe distress at the thought of discarding them, are classic symptoms of hoarding disorder.)
A: Sheri is a 49-year-old woman who has suffered depression and anxiety. She lives alone and works in a hospital gift shop. She has problems getting organized and has a hard time throwing away business papers, newspapers, and magazines. Her apartment is filled with books, stationery, crafts, plastic packages, cardboard boxes, and all sorts of other things. She has little room to live. Ashamed by the state of her apartment, she has told no one about her behavior and never invites anyone into her apartment. This has gone on for 10 years.

Q: Madison is a nine-year-old girl who often pulls out her own hair one hair at a time, and these hair-pulling episodes can last for hours at a time. She is unable to stop pulling out her hair, despite the development of several bald patches on her head. Which of the following impulse-control disorders is Madison most likely to have?
- obsessive-compulsive disorder (Incorrect. People with obsessive-compulsive disorder may also engage in compulsive hair-pulling, but In DSM-5, trichotillomania belongs to the category that includes obsessive-compulsive and related disorders.)
- body dysmorphic disorder (Incorrect. With body dysmorphic disorder, people remove hair to try to improve what they see as a problem in how they look.)
- low self-esteem (Incorrect. Self-esteem is an individual's subjective evaluation of their own worth. Self-esteem encompasses beliefs about oneself (for example, "I am unloved," "I am worthy") as well as emotional states, such as triumph, despair, pride, and shame. Low self-esteem is not a mental disorder.)
- trichotillomania (Correct! Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hairpulling, is a psychological disorder characterized by a long-term urge that results in the pulling out of one’s hair. This occurs to such a degree that hair loss can be seen. Trichotillomania most commonly begins in childhood or adolescence. Children are less likely to pull from areas other than the scalp.)
A: trichotillomania

Q: Jesse is diagnosed with obsessive-compulsive disorder. He acknowledges that he pulls his hair when he feels anxiety. He sees his broken hairs when he looks in the mirror. His psychologist, who prefers habit reversal therapy, has asked him to start counting numbers from 100 in the reverse order whenever he felt an intense urge to act on the impulse to pull out his hair. Which of the following comorbid disorders is being treated in this instance?
- generalized anxiety disorder (Incorrect. Generalized anxiety disorder is characterized by constant anxiety that is not associated with a particular object or event.)
- body dysmorphic disorder (Incorrect. With body dysmorphic disorder, people remove hair to try to improve what they see as a problem in how they look. Here, Jesse acknowledges that he pulls his hair when he feels anxiety.)
- low self-esteem (Incorrect. Self-esteem is an individual's subjective evaluation of their own worth. Self-esteem encompasses beliefs about oneself (for example, "I am unloved," "I am worthy") as well as emotional states, such as triumph, despair, pride, and shame. Low self-esteem is not a mental disorder.)
- trichotillomania (Correct! TTM occurs more commonly in those with obsessive-compulsive disorder. Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair and on examination, broken hairs may be seen. Habit reversal therapy (HRT) has been shown to be effective, and sometimes includes components of acceptance and commitment therapy and dialectical behavior therapy as well.)
A: trichotillomania

Q: Liana has been pulling out her hair for two years. This habit occurs to such a degree that her hair loss can be seen. All her efforts to stop pulling her hair typically fail. Which of the following disorders is Liana most likely to have?
- social anxiety disorder (Incorrect. Social anxiety disorder, also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impaired ability to function in at least some aspects of daily life.)
- generalized anxiety disorder (Incorrect. Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive, uncontrollable, and often irrational worry about events or activities. Worry often interferes with daily functioning, and sufferers are overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties.)
- body dysmorphic disorder (Incorrect. Body dysmorphic disorder (BDD), is characterized by the obsessive idea that some aspect of one's own body part or appearance is severely flawed and therefore warrants exceptional measures to hide or fix it.)
- trichotillomania (Correct! A diagnosis of trichotillomania includes recurrent hairpulling and repeated attempts to stop hairpulling.)
A: trichotillomania

Q: When Aidymarie feels stressed, she often has an urge to pick, squeeze, or scratch at her face. When she engages in this behavior, she feels a sense of relief. A psychologist might assess whether or not Aidymarie has
- trichotillomania. (Incorrect. Trichotillomania is diagnosed when episodes of hairpulling last for hours or occur throughout the day. Often the person will pluck one hair out at a time, leaving bald patches on the scalp or other areas of the body. There is, however, a sense of relief following the episode.)
- obsessive-compulsive disorder. (Incorrect. Obsessive-compulsive disorder (OCD) is a disorder in which a person has certain thoughts repeatedly (called "obsessions") or feels the need to perform certain routines repeatedly (called "compulsions") to an extent that generates distress or impairs general functioning. Common compulsions include hand washing, counting of things, and checking to see if a door is locked.)
- body dysmorphic disorder. (Incorrect. Body dysmorphic disorder (BDD), is characterized by the obsessive idea that some aspect of one's own body part or appearance is severely flawed and therefore warrants exceptional measures to hide or fix it.)
- excoriation disorder. (Correct! Prior to an episode of skin-picking, a person often feels stressed; during these moments of anxiety and tension, there is an urge to pick, squeeze, or scratch at the skin—whether it be the face, scalp, or other region of the body, usually at the site of a perceived skin defect. When picking, the person may feel a sense of relief.)
A: excoriation disorder.

Q: Excoriation disorder has a high rate of comorbidity with other psychiatric conditions, especially with
- eating disorders. (Incorrect. Excoriation disorder has a high rate of comorbidity with other psychiatric conditions, especially with mood and anxiety disorders.)
- conduct disorders. (Incorrect. Studies have shown the following rates of psychiatric conditions found in patients with excoriation disorder: trichotillomania (38.3%), substance abuse (38%), major depressive disorder (approximately 31.7% to 58.1%), anxiety disorders (approximately 23% to 56%), obsessive-compulsive disorder (approximately 16.7% to 68%), and body dysmorphic disorder (approximately 26.8% to 44.9%).)
- personality disorders. (Incorrect. Studies have shown the following rates of psychiatric conditions found in patients with excoriation disorder: trichotillomania (38.3%), substance abuse (38%), major depressive disorder (approximately 31.7% to 58.1%), anxiety disorders (approximately 23% to 56%), obsessive-compulsive disorder (approximately 16.7% to 68%), and body dysmorphic disorder (approximately 26.8% to 44.9%).)
- mood and anxiety disorders. (Correct! Studies have shown the following rates of psychiatric conditions found in patients with excoriation disorder: trichotillomania (38.3%), substance abuse (38%), major depressive disorder (approximately 31.7% to 58.1%), anxiety disorders (approximately 23% to 56%), obsessive-compulsive disorder (approximately 16.7% to 68%), and body dysmorphic disorder (approximately 26.8% to 44.9%).)
A: mood and anxiety disorders.

Q: Sheila, a 26-year-old single female, who lives with her family, was admitted to an outpatient department of psychiatry. Sheila suffered from childhood sexual abuse when she was nine years old. The abuse lasted for four years. She presented complaints of excessive skin scratching of the fingers, forearms, and upper back for the last three years. However, in the past two years, the picking has been a daily routine, which was associated with emotional stress, followed by a feeling of relief after picking. She had been treated by her general practitioner and dermatologist for approximately two years, although none of the therapies provided a complete clinical result. Eventually, Sheila was diagnosed as having
- post-traumatic stress disorder. (Incorrect. Post-traumatic stress disorder (PTSD can develop after a person is exposed to a traumatic event, such as sexual assault; however, symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in how a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event.)
- borderline personality disorder. (Incorrect. Borderline personality disorder (BPD is characterized by a long-term pattern of unstable relationships, distorted sense of self, and strong emotional reactions. It is true, however, that BPD typically begins by early adulthood and that those affected often engage in self-harm and other dangerous behavior, but the symptoms presented in this case are specific to excoriation disorder.)
- obsessive-compulsive disorder. (Incorrect. Obsessive-compulsive disorder (OCD) is a disorder in which a person has certain thoughts repeatedly (called "obsessions") or feels the need to perform certain routines repeatedly (called "compulsions") to an extent which generates distress or impairs general functioning. Common compulsions include hand washing, counting of things, and checking to see if a door is locked.)
- excoriation (skin-picking) disorder. (Correct! Excoriation (skin-picking) disorder is classified as an obsessive-compulsive and related disorder, and criteria for diagnosis include recurring skin-picking episodes that result in skin lesions and repeated attempts to stop the behavior. The symptoms cause clinically significant distress or impairment (affecting the person socially, occupationally, emotionally, etc.) and are not caused by a substance (drug or otherwise) or dermatological condition, nor are they better explained by another psychiatric disorder.)
A: excoriation (skin-picking) disorder.

Q: Kim, a nursing assistant who worked in a nursing home, worked long hours for little pay in a difficult facility. Her supervisor was domineering, unpleasant, and unsupportive; he was disrespectful of Kim’s personal time, frequently informing her at the last minute she must work several additional hours after her shift ended or that she must report to work on weekends. Kim did not feel as though her hard work was appreciated, either by supervisory staff or by the residents of the home. She was very unhappy over her low pay, and she felt that many of the residents treated her disrespectfully. After several years, Kim dreaded going to work in the morning, and she gradually developed a callous, hostile attitude toward many of the residents. What Kim experienced is known as
- a daily hassle. (Incorrect. Daily hassle are the minor irritations and annoyances that are part of our everyday lives (e.g., rush-hour traffic, lost keys, obnoxious coworkers, inclement weather, arguments with friends or family) that can build on one another and leave us just as stressed as life-changing events.)
- a chronic stressor. (Incorrect. Chronic stressors are events that persist over an extended period of time (e.g., long-term unemployment or imprisonment))
- an acute stressor. (Incorrect. Acute stressors are stressful, brief events that may cause a person to experience overwhelming feelings even after the event has ended, though the symptoms usually resolve within a month or so.)
- job burnout. (Correct! Job burnout is a general sense of emotional exhaustion and cynicism in relation to one’s job and occurs frequently among those in human service jobs. Job burnout is often precipitated by feelings of having invested considerable energy, effort, and time into one’s work while receiving little in return (e.g., little respect or support from others or low pay).)
A: job burnout.

Q: Some stressors involve traumatic events or situations in which a person is exposed to actual or threatened death or serious injury. Stressors in this category include which of the following?
- death of a close family member (Incorrect. This would be considered a life change, an event or situation that requires us to make changes in our ongoing lives and require time as we adjust to those changes. Other examples include marriage, divorce, and moving.)
- falling on an icy sidewalk and breaking your leg (Incorrect. Although traumatic, this event would be considered an acute stressor because it involves a brief, focal event that sometimes continues to be experienced as overwhelming well after the event has ended but does not threaten one’s life.)
- imprisonment (Incorrect. Imprisonment can be considered a chronic stressor, an event that persists over an extended period of time, but does not threaten one’s life.)
- terrorist attacks (Correct! Some stressors involve traumatic events or situations in which a person is exposed to actual or threatened death or serious injury. Stressors in this category include exposure to military combat, threatened or actual physical assaults (e.g., physical attacks, sexual assault, robbery, childhood abuse), terrorist attacks, natural disasters (e.g., earthquakes, floods, hurricanes), and automobile accidents.)
A: terrorist attacks

Q: Sam is a 54-year-old man whose wife died recently. Within the same year, he was diagnosed with chronic obstructive pulmonary disease. Six months following, he was dismissed from work as a construction worker because he could keep up with demands of the job. He had to sell his house and move to a different city. Sam became socially isolated and lost his appetite. If Sam were to take the Social Readjustment Rating Scale, the score might indicate that he is at risk for developing
- job burnout. (Incorrect. Job burnout is a general sense of emotional exhaustion and cynicism in relation to one’s job and occurs frequently among those in human service jobs. Job burnout is often precipitated by feelings of having invested considerable energy, effort, and time into one’s work while receiving little in return (e.g., little respect or support from others or low pay).)
- panic disorder. (Incorrect. Extensive research has demonstrated that accumulating a high number of life change units within a brief period of time (one or two years) is related to a wide range of physical illnesses (even accidents and athletic injuries) and mental health problems, but not one in particular.)
- a personality disorder. (Incorrect. Extensive research has demonstrated that accumulating a high number of life change units within a brief period of time (one or two years) is related to a wide range of physical illnesses (even accidents and athletic injuries) and mental health problems, but not one in particular.)
- mental health problems. (Correct! Extensive research has demonstrated that accumulating a high number of life change units within a brief period of time (one or two years) is related to a wide range of physical illnesses (even accidents and athletic injuries) and mental health problems.)
A: mental health problems.

Q: Rasheem is a 31-year-old man who was discharged from the army in 2015 after serving two tours of duty in Iraq. He has been experiencing significant difficulty sleeping and has nightmares. During his second tour, he experienced trauma he has never spoken with anyone about, but he talks about having intrusive memories of the traumatic events. He avoids anything that makes him think of his time in combat and he spends much of his time alone because seeing friends makes him feel irritable, and he doesn’t want to snap at anyone. He is easily startled by noise and motion and is unnecessarily hypervigilant. His wife urges him to see a psychologist because he is “not the man that she married.” The psychologist most likely diagnosed Rasheem with
- acute stress disorder. (Incorrect. Acute stress disorder refers to the initial traumatic symptoms that arise immediately after a traumatic event. Acute stress disorder is not fatal, but it may bring about post-traumatic stress disorder if not correctly addressed. PTSD refers to the long-term aftermath of trauma.)
- borderline personality disorder. (Incorrect. Borderline personality disorder (BPD), is characterized by a long-term pattern of unstable relationships, distorted sense of self, and strong emotional reactions. Those affected often engage in self-harm and other dangerous behavior. They may also struggle with a feeling of emptiness, fear of abandonment, and detachment from reality. Symptoms of BPD may be triggered by events considered normal to others.)
- agoraphobia. (Incorrect. Agoraphobia is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives his or her environment to be unsafe with no easy way to escape. These situations can include open spaces, public transit, shopping centers, or simply being outside the home.)
- PTSD. (Correct! To diagnose PTSD, an individual must experience at least some symptoms among four different categories for at least a month after a traumatic event: intrusion symptoms (recurrent/distressing memories), avoidance of stimuli related to the event, negative changes in mood, and changes in arousal/reactivity.)
A: PTSD.

Q: Connie was a victim of domestic violence for 10 years. She decided to do exposure therapy when she started having flashbacks of the trauma she had experienced. Her husband had severely abused her and she had had several hospitalizations as a result of kicks to her abdomen, stab wounds, and burns. One day, two years after leaving the abusive relationship, she recalled “feeling the pain of her broken arm” that had already healed. Connie was being treated for which disorder?
- panic disorder (Incorrect. Although Exposure therapy has been scientifically demonstrated to be a helpful treatment or treatment component for a range of problems, including, Panic Disorder, the symptoms Connie describes does not indicate that diagnosis.)
- OCD (Incorrect. Although there are a variety of behavioral therapies for treating OCD, almost all of them focus on exposing you to those things that you fear most, such as germs or an upsetting thought. However, the symptoms that Connie describes does not indicate OCD.)
- agoraphobia (Incorrect. The symptoms Connie describes doesn’t indicate agoraphobia. Agoraphobia is characterized by intense anxiety or fear of places or situations in which escape might be difficult or help might not be available in the event of a panic attack or panic -like symptoms.)
- post-traumatic stress disorder (Correct! Traumatic events that involve harm by others carry greater risk than do other traumas (e.g., natural disasters) in developing PTSD. Exposure therapy is a well-established treatment for Post-traumatic Stress Disorder (PTSD) that requires the patient to focus on and describe the details of a traumatic experience. Exposure methods include confrontation with frightening, yet realistically safe, stimuli that continues until anxiety is reduced.)
A: post-traumatic stress disorder

Q: For the past 12 years, Ryan has suffered from flashbacks in which he relives the horrors of his nine months of active duty while he was deployed in Iraq. While in Iraq, Ryan witnessed and experienced a number of traumatic incidents. He spoke about fellow soldiers who were killed and injured in service and talked about survivor’s guilt. One of his most vivid memories involves a convoy that he witnessed being hit by improvised explosive devices. He has flashbacks that occur unexpectedly in the middle of the day, and Ryan is thrown back into the emotional reality of his war experiences. Ryan has found that alcohol provides the only escape that he needs when he feels distressed about the flashbacks. Ryan has developed which disorder?
- acute stress disorder (Incorrect. Acute stress disorder refers to the initial traumatic symptoms that arise immediately after a traumatic event. Acute stress disorder is not fatal, but it may bring about post-traumatic stress disorder, or PTSD, if not correctly addressed. PTSD refers to the long-term aftermath of trauma.)
- borderline personality disorder (Incorrect. Borderline personality disorder (BPD) is characterized by a long-term pattern of unstable relationships, distorted sense of self, and strong emotional reactions. Those affected often engage in self-harm and other dangerous behavior. They may also struggle with a feeling of emptiness, fear of abandonment, and detachment from reality. Symptoms of BPD may be triggered by events considered normal to others.)
- agoraphobia (Incorrect. Agoraphobia is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape. These situations can include open spaces, public transit, shopping centers, or simply being outside the home.)
- PTSD (Correct! For a person to be diagnosed with PTSD, he or she be must exposed to, witness, or experience the details of a traumatic experience, one that involves actual or threatened death, serious injury, or sexual violence. These experiences can include such events as combat. Symptoms of PTSD include intrusive and distressing memories of the event, flashbacks, avoidance of stimuli connected to the event, persistently negative emotional states (e.g., guilt), feelings of detachment from others, irritability, proneness toward outbursts, and an exaggerated startle response (jumpiness). For PTSD to be diagnosed, these symptoms must occur for at least one month.)
A: PTSD

Q: Audrey was a victim of molestation when she was 18 years old. Her medical evaluation revealed that she possesses two short versions of a gene that regulates the neurotransmitter serotonin. Audrey is at a significantly higher risk of developing
- excoriation disorder. (Incorrect. People who experience childhood adversity and/or traumatic experiences during adulthood are at significantly higher risk of developing PTSD if they possess one or two short versions of a gene that regulates the neurotransmitter serotonin.)
- generalized anxiety disorder. (Incorrect. People who experience childhood adversity and/or traumatic experiences during adulthood are at significantly higher risk of developing PTSD if they possess one or two short versions of a gene that regulates the neurotransmitter serotonin.)
- agoraphobia. (Incorrect. People who experience childhood adversity and/or traumatic experiences during adulthood are at significantly higher risk of developing PTSD if they possess one or two short versions of a gene that regulates the neurotransmitter serotonin.)
- PTSD. (Correct! People who experience childhood adversity and/or traumatic experiences during adulthood are at significantly higher risk of developing PTSD if they possess one or two short versions of a gene that regulates the neurotransmitter serotonin.)
A: PTSD.

Q: Which of the following elevates the risk for developing PTSD?
- social support (Incorrect. Research has shown that social support following a traumatic event can reduce the likelihood of PTSD.)
- high levels of intelligence (Incorrect. High levels of intelligence is a protective factor and low levels of intelligence is a risk factor for developing PTSD.)
- community involvement (Incorrect. Individuals who became involved in the community were less likely to develop PTSD, and they were more likely to experience a remission of PTSD than were those who were less involved.)
- severity of the trauma (Correct! Severe trauma, especially trauma inflicting by another person, seriously elevates the risk for developing PTSD.)
A: severity of the trauma

Q: PTSD learning models suggest that some symptoms are developed and maintained through
- insecurities associated with not feeling safe, which hinder a person from reaching self-actualization. (Incorrect. This perspective is associated with humanism.)
- a personal conflict between the id and superego. (Incorrect. These ideas would be associated with the psychodynamic perspective.)
- having an external locus of control. (Incorrect. Having an external locus of control—the belief that the outcomes of events in your life are outside of your own control—seems to play a role in PTSD, but this is not the best example of a learning model that causes PTSD.)
- classical conditioning. (Correct! PTSD learning models suggest that some symptoms are developed and maintained through classical conditioning. The traumatic event may act as an unconditioned stimulus that elicits an unconditioned response characterized by extreme fear and anxiety. Cognitive, emotional, physiological, and environmental cues accompanying or related to the event are conditioned stimuli. These traumatic reminders evoke conditioned responses (extreme fear and anxiety) similar to those caused by the event itself.)
A: classical conditioning.

Q: Lashon was violently attacked in a dark parking lot after work a week ago. Her assaulter took her purse and her car and left her for dead. She is constantly re-experiencing the event through images, dreams, thoughts, and flashbacks. She finds herself avoiding situations that might make her think about the trauma, but she is still so anxious that she cannot concentrate or sleep. Lashon is likely suffering from
- obsessive-compulsive disorder. (Incorrect. The diagnostic symptoms do not suggest obsessive-compulsive disorder (OCD), which is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over.)
- post-traumatic stress disorder. (Incorrect. Lashon experienced a traumatic event with symptoms similar to that of PTSD. Though it could develop into PTSD, it has only been two days and wouldn’t be classified as PTSD until symptoms last more than a month.)
- agoraphobia. (Incorrect. The diagnostic symptoms do not suggest agoraphobia, which is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape. These situations can include open spaces, public transit, shopping centers, or simply being outside the home.)
- acute stress disorder. (Correct! Lashon experienced a traumatic event two days ago with many symptoms of acute stress disorder. Acute stress disorder is similar to PTSD, but describes a disorder that lasts between three days and one month of a traumatic event. After one month, a diagnosis of acute stress disorder would be considered PTSD. The diagnostic symptoms are similar to that of PTSD; intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred.)
A: acute stress disorder.

Q: Elijah is a 25-year-old sales clerk in a sporting goods store who was psychologically healthy until two weeks ago when he survived a wildfire that destroyed his apartment building. He was treated and released within several hours from the emergency room. Since the fire, Elijah has been tormented by vivid images of waking to see his apartment filled with smoke. He described himself as having irritable behavior and angry outbursts (with little or no provocation) toward his friends. At other times, he felt as if he were in a daze, seemingly numb. Elijah continued to experience these symptoms for several weeks, after which they gradually subsided. His symptoms suggest that he might have been suffering from
- obsessive-compulsive disorder. (Incorrect. The diagnostic symptoms do not suggest obsessive-compulsive disorder (OCD), which is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over.)
- post-traumatic stress disorder. (Incorrect. Elijah experienced a traumatic event with symptoms similar to that of PTSD, intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event. Though it could develop into PTSD, it has only been two weeks and wouldn’t be classified as PTSD until symptoms last more than a month.)
- agoraphobia. (Incorrect. The diagnostic symptoms do not suggest agoraphobia, which is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape. These situations can include open spaces, public transit, shopping centers, or simply being outside the home.)
- acute stress disorder. (Correct! Elijah experienced a traumatic event two weeks ago with symptoms of acute stress disorder, such as recurrent, involuntary, and intrusive distressing memories of the fire, being in a daze, and irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. Acute stress disorder is similar to PTSD, but describes a disorder that lasts between three days and one month of a traumatic event.)
A: acute stress disorder.

Q: The anxiety disorder that is similar to PTSD, but describes a disorder that lasts between three days and one month of a traumatic event, is referred to as
- obsessive-compulsive disorder. (Incorrect. Obsessive-compulsive disorder is related to anxiety disorders (such as panic disorder or generalized anxiety disorder) but it has its own definition. Obsessive-compulsive disorder (OCD) is defined by the presence of obsessions, compulsions, or both in a person.)
- generalized anxiety disorder. (Incorrect. Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry about a number of different things. People with GAD may anticipate disaster and may be overly concerned about money, health, family, work, or other issues.)
- agoraphobia. (Incorrect. Agoraphobia is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape. These situations can include open spaces, public transit, shopping centers, or simply being outside the home.)
- acute stress disorder. (Correct! Acute stress disorder is a disorder occurring for three days or one month following a traumatic experience marked by intrusion, negative mood changes, dissociation, avoidance, and changes in arousal. After one month, a diagnosis of acute stress disorder would be considered PTSD.)
A: acute stress disorder.

Q: Farzad recently moved several states away from home to live on campus as a freshman. He grew up in a tight-knit family in a small, rural community where he had close friends and positive relationships. He’d chosen this university because it hadn’t seemed overwhelmingly large but now that he’s here, in a new living situation, surrounded by people he doesn’t know, he feels overwhelmed anyway. Always a straight-A student, Farzad is halfway through the semester and having difficulty with his courses. He had a panic attack right before a midterm exam and was referred to counseling by his professor. At the counseling center, he talks to a therapist about feelings of sudden depression, anxiety, and the physical symptoms that he can’t explain: chest pain, fatigue, and frequent headaches. His therapist explains he is likely experiencing
- panic disorder. (Incorrect. Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. If Farzad had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, he then would be diagnosed with a condition called panic disorder.)
- social phobia. (Incorrect. The defining feature of social phobia is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation.)
- acute stress disorder. (Incorrect. Acute stress disorder is an intense, unpleasant, and dysfunctional reaction beginning shortly after an overwhelming traumatic event and lasting less than a month.)
- adjustment disorder. (Correct! Adjustment disorder is a disorder involving a significant stress response occurring within three months of a stressor and marked by significant impairment but not meeting criteria for other disorders. Though symptoms vary, they usually include anxiety, depression, feelings of hopelessness, suicidal thoughts, and these symptoms follow a stressful event, such as moving away far away from home and feeling overwhelmed by the new living situation.)
A: adjustment disorder.

Q: Select the best response regarding the treatment of adjustment disorder.
- Medications, such as selective serotonin reuptake inhibitors (SSRIs), have been proven to be the most effective in treating symptoms of adjustment disorder (AD). (Incorrect. One study found that AD sufferers received similar interventions to those with other psychiatric diagnoses, including psychological therapy and medication. However, there has been little systematic research regarding the best way to manage individuals with an adjustment disorder. Because natural recovery is the norm, it has been argued that there is no need to intervene unless levels of risk or distress are high.)
- Psychotherapy, also called talk therapy, is considered the most effective, first-choice treatment for adjustment disorder (AD). (Incorrect. Psychotherapy, or talk therapy, may help people overcome adjustment disorder. A person may meet one-to-one with a psychotherapist to work through emotional and mental symptoms of the disorder. However, there has been little systematic research regarding the best way to manage individuals with an adjustment disorder. However, AD sufferers with depressive or anxiety symptoms may benefit from treatments usually used for depressive or anxiety disorders.)
- Meditation can help manage stress and anxiety, therefore proving to be the best treatment of adjustment disorder (AD). (Incorrect. There has been little systematic research regarding the best way to manage individuals with an adjustment disorder. However, AD sufferers with depressive or anxiety symptoms may benefit from treatments usually used for depressive or anxiety disorders.)
- There has been little systematic research regarding the best way to manage individuals with an adjustment disorder. However, AD sufferers with depressive or anxiety symptoms may benefit from treatments usually used for depressive or anxiety disorders. (Correct! One study found that AD sufferers received similar interventions to those with other psychiatric diagnoses, including psychological therapy and medication. However, there has been little systematic research regarding the best way to manage individuals with an adjustment disorder. Because natural recovery is the norm, it has been argued that there is no need to intervene unless levels of risk or distress are high.)
A: There has been little systematic research regarding the best way to manage individuals with an adjustment disorder. However, AD sufferers with depressive or anxiety symptoms may benefit from treatments usually used for depressive or anxiety disorders.

Q: Tianna was a sixteen-year-old Hispanic female who was living in a shelter after being removed from her aunt's house by the child welfare agency. She was living in the shelter for three months. During her interview with a counselor, she reported feelings of worry and anxiety and stated she was very sad. She felt sad every day almost all day long, and her sadness got worse after going to the shelter. She also complained of poor concentration and feelings of hopelessness and she said; “I feel like I will be sad for the rest of my life." Tianna may be experiencing
- major depressive disorder. (Incorrect. Major depression is usually not caused by an outside stressor like in the case of Tianna. Once Tianna is able to adapt to the situation, her symptoms may go away.)
- social phobia. (Incorrect. The defining feature of social phobia is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation.)
- acute stress disorder. (Incorrect. Acute stress disorder is usually associated with a more intense stressor and involves different experiences, such as flashbacks.)
- adjustment disorder. (Correct! AD is a result of subjective and emotional distress triggered as consequences of a meaningful change in life. Though symptoms vary, they usually include anxiety, depression, feelings of hopelessness, suicidal thoughts, and these symptoms follow a stressful event, such as adapting to this new living situation in the shelter.)
A: adjustment disorder.

Q: There are four types of attachment styles, according to attachment theory. These are
- secure attachment, avoidant attachment, disorganized attachment, and reactive attachment disorder. (Incorrect. All the answers are correct except for reactive attachment disorder. This is a disorder arising from childhood neglect, not an attachment style.)
- secure attachment, avoidant attachment, insecure-avoidant attachment, and resistant attachment. (Incorrect. The missing attachment style is disorganized attachment. Avoidant attachment and insecure-avoidant attachment are the same.)
- secure attachment, avoidant attachment, disinhibited attachment, and resistant attachment. (Incorrect. The missing attachment style is disorganized attachment, not to be confused with disinhibited social engagement disorder, which is not an attachment style but a disorder.)
- secure attachment, avoidant attachment, resistant attachment, and disorganized attachment. (Correct! Of the four attachment styles, secure attachment is the most common and healthiest form.)
A: secure attachment, avoidant attachment, resistant attachment, and disorganized attachment.

Q: In which type of attachment is the attachment figure used as a secure base to explore the environment and sought out in times of stress?
- avoidant attachment (Incorrect. With avoidant attachment (or insecure-avoidant), the child is unresponsive to the parent, does not use the parent as a secure base, and does not care if the parent leaves. The toddler reacts to the parent the same way they react to a stranger. When the parent does return, the child is slow to show a positive reaction. Ainsworth theorized that these children were most likely to have a caregiver who was insensitive and inattentive to their needs.)
- resistant attachment (Incorrect. In cases of resistant attachment (or insecure-resistant/ambivalent), children tend to show clingy behavior, but then they reject the attachment figure’s attempts to interact with them. These children do not explore the toys in the room, appearing too fearful. During separation, they become extremely disturbed and angry with the parent. When the parent returns, the children are difficult to comfort. Resistant attachment is thought to be the result of the caregivers’ inconsistent level of response to their child.)
- disorganized attachment (Incorrect. Children with disorganized attachment freeze, run around the room in an erratic manner, or try to run away when the caregiver returns. This type of attachment is seen most often in kids who have been abused or severely neglected. Research has shown that abuse disrupts a child’s ability to regulate their emotions.)
- secure attachment (Correct! The most common type of attachment—also considered the healthiest—is called secure attachment. In this type of attachment, the toddler prefers their parent over a stranger. The attachment figure is used as a secure base to explore the environment and is sought out in times of stress. Securely attached children have caregivers who are sensitive and responsive to their needs.)
A: secure attachment

Q: Which type of attachment is seen most often in kids who have been abused or severely neglected?
- resistant attachment (Incorrect. Resistant attachment is thought to be the result of the caregivers’ inconsistent level of response to their child.)
- insecure-avoidant attachment (Incorrect. With avoidant attachment (or insecure-avoidant), the child is unresponsive to the parent, does not use the parent as a secure base, and does not care if the parent leaves. The toddler reacts to the parent the same way they react to a stranger. When the parent does return, the child is slow to show a positive reaction. Ainsworth theorized that these children were most likely to have a caregiver who was insensitive and inattentive to their needs.)
- secure attachment (Incorrect. Securely attached children have caregivers who are sensitive and responsive to their needs.)
- disorganized attachment (Correct! Research has shown that abuse disrupts a child’s ability to regulate their emotions. Children with disorganized attachment freeze, run around the room in an erratic manner, or try to run away when the caregiver returns. This type of attachment is seen most often in kids who have been abused or severely neglected.)
A: disorganized attachment

Q: Which type of attachment is thought to be the result of a caregiver's inconsistent level of response to their child?
- avoidant attachment (Incorrect. With avoidant attachment (or insecure-avoidant), the child reacts to the parent the same way they react to a stranger. Ainsworth theorized that these children were most likely to have a caregiver who was insensitive and inattentive to their needs.)
- secure attachment (Incorrect. Securely attached children have caregivers who are sensitive and responsive to their needs)
- disorganized attachment (Incorrect. Disorganized attachment is seen most often in kids who have been abused or severely neglected.)
- resistant attachment (Correct! Resistant attachment is thought to be the result of the caregivers’ inconsistent level of response to their child. Infants of this attachment category have excessive distress upon separations from an attachment figure such as a caregiver, and when the caregiver returns, tend to continue their distress and do not use their caregivers as a secure base.)
A: resistant attachment

Q: Jake is a 4-year-old adopted boy who at the age of two years and four months was brought by his adoptive mother to a child psychiatrist with symptoms of irritability, fearfulness, emotional dysregulation, and attachment issues. The child would rarely or minimally seek comfort when distressed, nor did he respond to comfort from the adoptive mother when distressed. Little is known about Jake’s early history. There is suspicion that his mother was neglectful with feeding and frequently left him crying, unattended, or with strangers. He was taken away from his mother’s care at seven months due to neglect and placed with his aunt, who after two months decided she was unable to take care of him. Given the abuse pattern of neglect and repeated changes of primary caregivers in Jake’s early years, the psychiatrist diagnosed him with
- disinhibited social engagement disorder. (Incorrect. Disinhibited social engagement disorder (DSED) is one of the most pervasive clinical sequel of severe neglect. However, in young children, it is characterized by overly familiar verbal or physical behavior, willingness to depart with an unfamiliar adult without hesitation, and a tendency to fail to track or check back with a caregiver in unfamiliar settings. DSED is also referred to as indiscriminant friendliness, indiscriminant sociability, or disinhibited social behavior because affected children exhibit overly familiar behavior or seek comfort and support from relatively unfamiliar adults even in the presence of a familiar caregiver.)
- rumination disorder. (Incorrect. Rumination disorder involves the regular regurgitation of food that occurs for at least one month. Regurgitated food may be re-chewed, re-swallowed, or spit out.)
- autism spectrum disorder. (Incorrect. Autism spectrum disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors.)
- reactive attachment disorder. (Correct! Reactive attachment disorder (RAD) as a stressor-related disorder caused by social neglect during childhood (meaning a lack of adequate caregiving). RAD is characterized by markedly disturbed and developmentally inappropriate ways of relating socially in most contexts. It can take the form of a persistent failure to initiate or respond to most social interactions in a developmentally appropriate way, known as the inhibited form.)
A: reactive attachment disorder.

Q: One of the main differences between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) is
- Children with DSED don’t experience patterns of extreme insufficiency in care, such as social neglect, constant changes of caregiver, and being raised in various, unusual settings. Additionally, they are more outgoing than children with RAD. (Incorrect. Both children with DSED and RAD experience a pattern of extremes regarding insufficient care. However, the part of this answer that was correct, is that those with DSED do tend to be more outgoing.)
- Children with DSED exhibit patterns of emotionally withdrawn behavior toward adult caregivers as well as social and emotional disturbance such as minimal social responsiveness to others, limited positive affect, and episodes of unexplained irritability or sadness. (Incorrect. This is true of children with RAD, not DSED. Children with DSED tend to be more outgoing and are likely to have little to no fear of walking off with an unfamiliar adult to an unfamiliar setting.)
- Children with RAD have an uninhibited form of attachment, which manifests as a lack of inhibitions, resulting from extreme patterns of insufficient care by a caregiver. (Incorrect. This best describes those with DSED. The main difference between the two is that RAD is the “inhibited” or withdrawn form of behavior, whereas DSED is known as the uninhibited form of behavior. Children with DSED are less withdrawn than those with RAD; whereas children with RAD are less likely to engage with others socially, even when a caregiver is trying to comfort them, a child with DSED will exhibit behavior that is outgoing—to the point of walking off with a stranger.)
- Children with DSED are more outgoing and more likely to talk to strangers than those with RAD. They may have little to no fear of interacting with people they don’t know, to the point where they will venture away with them to somewhere new and unfamiliar. (Correct! Children with DSED are less withdrawn than those with RAD; whereas children with RAD are less likely to engage with others socially, even when a caregiver is trying to comfort them, a child with DSED will exhibit behavior that is outgoing—to the point of walking off with a stranger.)
A: Children with DSED are more outgoing and more likely to talk to strangers than those with RAD. They may have little to no fear of interacting with people they don’t know, to the point where they will venture away with them to somewhere new and unfamiliar.

Q: Isabella is a 5-year-old child who was placed with a foster family after years of abuse and neglect. She has adjusted to her foster family, but her foster parents notice that she tends to engage in overly familiar behavior with people she has never even met—like running toward a neighbor that she has never met and jumping into his/her arms. A psychologist might assess whether Isabella has
- reactive attachment disorder. (Incorrect. In reactive attachment disorder, there is the presence of internalizing, withdrawn behavior, and depressive symptoms.)
- post-traumatic stress disorder. (Incorrect. Intrusions, dissociation, and avoidance are important categories of symptoms for PTSD. They are not present in this scenario.)
- separation anxiety disorder. (Incorrect. Separation anxiety disorder (SAD) is an anxiety disorder in which an individual experiences excessive anxiety regarding separation from home and/or from people to whom the individual has a strong emotional attachment (e.g., a parent, a caregiver, a significant other, or siblings).)
- disinhibited social engagement disorder. (Correct! Disinhibited social engagement disorder (DSED) is a persistent failure to respond to most social interactions in a developmentally appropriate way, which manifests as a lack of inhibitions or externalizing behavior. Those diagnosed with DSED appear outgoing and they show intense excitement or a lack of inhibition over meeting or interacting with strangers or unfamiliar adults.)
A: disinhibited social engagement disorder.

Q: Which of the following statements best describe the psychodynamic perspective in regards to OCD?
- People with OCD believe that thinking about something bad is the same as doing it; therefore, they perform rituals to try and neutralize or stop the obsessive thoughts. (Incorrect. This perspective is known as cognitive theory.)
- People with OCD have learned to fear a neutral stimulus through conditioning; they participate in rituals that reduce their anxiety. Since this reduction in stress is a relief, it acts as a “reward” for their behavior, thus reinforcing it. (Incorrect. This describes the behavioral perspective.)
- People with OCD have experienced a severely traumatic event that acted as an unconditioned stimulus that elicited an unconditioned response characterized by extreme fear and anxiety. This unconditioned response becomes a conditioned response when anything occurs that triggers a reminder of the event. (Incorrect. This describes the symptoms of PTSD from the behaviorist perspective (not OCD).)
- People with OCD have unconscious conflict that they are trying to cope with, and this conflict comes from a clash between the id (usually a sexual or aggressive urge) and the superego (the desire to do the right thing and follow socially acceptable behavior). (Correct! This best describes the psychodynamic perspective. When there is an imbalance of the interacting parts of our personality, the psychodynamic approach says that we are likely suffering from neurosis (a tendency to experience negative emotions), anxiety disorders, or unhealthy behaviors.)
A: People with OCD have unconscious conflict that they are trying to cope with, and this conflict comes from a clash between the id (usually a sexual or aggressive urge) and the superego (the desire to do the right thing and follow socially acceptable behavior).

Q: The cognitive model of OCD, as proposed by Paul Salkovskis, proposes that everyone will experience intrusive thoughts from time to time, but those with OCD falsely assume that
- they must deny themselves socially acceptable pleasures. (Incorrect. This idea comes from the psychodynamic perspective.)
- they are trapped in a vicious, never-ending cycle. (Incorrect. This comes from the humanistic perspective, with its emphasis on the potential for good and self-actualization in all people, and those suffering OCD are likely undergoing an existential crisis.)
- stress can only be reduced through compulsions. (Incorrect. This comes from the behavioral approach.)
- thinking about an action is the same as doing it. (Correct! The idea that thinking about an action is the same as doing it, is known as thought-action fusion. If someone with OCD has the sudden thought of robbing a bank, their mind acts as if they’ve already done it—the thought, in turn, is just as bad as the action itself.)
A: thinking about an action is the same as doing it.

Q: Buddy has been diagnosed with OCD and is always concerned about his lucky numbers. Whenever he looks at dates on a calendar or chooses a day to do a particular activity, he is excessively preoccupied with lucky and unlucky numbers. From the humanistic perspective, how would this behavior be explained?
- Ron falsely assumes that he should exercise control over his thoughts. (Incorrect. This explanation comes from the cognitive perspective.)
- Ron has an unconscious conflict that he is trying to stop or cope with. (Incorrect. This statement best describes the psychodynamic perspective.)
- Ron has abnormalities in the brain regions that cause OCD symptoms. (Incorrect. This explanation comes from the biological perspective and research that suggests that the orbitofrontal cortex is part of a series of brain regions that, collectively, is called the OCD circuit.)
- Ron is attempting to work toward self-actualization, but finds himself stuck and unable to move forward. (Correct! From the humanistic perspective, with its emphasis on the potential for good and self-actualization in all people, those suffering OCD are likely undergoing an existential crisis. People with these disorders are attempting to work toward self-actualization, but find themselves stuck and unable to move forward. For those with OCD, it manifests in obsessions and compulsions: they are trapped in a vicious, never-ending cycle, unable to move higher on Maslow’s hierarchy.)
A: Ron is attempting to work toward self-actualization, but finds himself stuck and unable to move forward.

Q: Which psychological perspective best matches with the following statement?

The meanings linked to PTSD show cultural variations: in individualistic cultures, appraisals about a vulnerable or inadequate self are common; in collectivistic cultures, appraisals about social functioning or evaluation by others are common.
- psychodynamic perspective (Incorrect. This approach emphasizes unconscious psychological processes; unacceptable urges and desires are kept in our unconscious through a process called repression.)
- behavioral perspective (Incorrect. This theory focuses on observable behavior. Behaviorists believe that people behave in a consistent manner based on prior learning.)
- humanist perspective (Incorrect. Humanism emphasizes the potential for good that is innate to all humans. The idea behind this is that as long as basic needs necessary for survival were met (e.g., food, water, and shelter), higher-level needs (e.g., social needs) would motivate behavior.)
- sociocultural perspective (Correct! This viewpoint looks at a person’s behaviors and symptoms in the context of their culture and background.)
A: sociocultural perspective

Q: For PTSD, and other stress-related disorders, researchers have found that both genetics and environment play important roles in one’s risk for developing PTSD due to trauma. But, genes may not be the only thing affecting the risk factor for PTSD. Recent studies have shown
- that people with PTSD show more brain activity in the orbitofrontal cortex areas. (Incorrect. People with OCD show more brain activity in these areas when asked to do things that provoke symptoms, such as looking at crookedly hung pictures or touching a dirty counter; because of this, it is believed that abnormalities in these regions may be the cause for OCD symptoms.)
- that smoking exaggerates the reduction of hippocampal volume in patients with PTSD. (Incorrect. Alcoholism exaggerates the reduction of hippocampal volume in patients diagnosed with PTSD.)
- that patients diagnosed with PTSD have a larger hippocampus than those who do not have a history of trauma. (Incorrect. Patients diagnosed with PTSD have a smaller hippocampus than those who do not have a history of trauma, on average.)
- that smaller hippocampal volume has been correlated with PTSD. (Correct! Genes may not be the only thing affecting the risk factor for PTSD. Recent studies have shown that smaller hippocampal volume has been correlated with PTSD—the relationship between PTSD and smaller volume in this region of the brain is associated with negative effects of the stress hormone.)
A: that smaller hippocampal volume has been correlated with PTSD.

Q: In regards to PTSD, what is the cognitive theory approach?
- The differences in how conditionable individuals are help to explain differences in the development and maintenance of PTSD symptoms. (Incorrect. This statement comes from the behavioral perspective.)
- The belief that the outcomes of events in your life are in your own control seems to provide a protective role in people subjected to traumatic experiences. (Incorrect. This statement comes from the sociocultural perspective, which views that locus of control plays a role in susceptibility to PTSD.)
- The belief that events in one’s life are controlled by outside forces, tends to instill a sense of helplessness and lack of control in victims of trauma. (Incorrect. This statement comes from the sociocultural perspective, which views the role of religion and strong beliefs in karma that are highly predominant in people with external locus of control.)
- Traumatic events disrupt a person’s perspective on life and the world around them, which ultimately creates a negative viewpoint that has lasting damage, resulting in chronic stress symptoms seen in PTSD. (Correct! When you can’t help but view the world as an unpredictable, dangerous place, it’s hard to move forward without high levels of stress. People with PTSD may have a hard time believing that anyone or anything can be trusted, to the point where they may even struggle with their own self-worth.)
A: Traumatic events disrupt a person’s perspective on life and the world around them, which ultimately creates a negative viewpoint that has lasting damage, resulting in chronic stress symptoms seen in PTSD.

Q: James is diagnosed with trichotillomania. His therapist, who prefers behavioral treatment, has asked him to start counting numbers from 100 in the reverse order whenever he feels an intense urge to pull out his hair. According to James's therapist, such a therapy would help him to get rid of the undesirable habit by learning a new response. Which of the following is being used in this instance?
- exposure and response prevention (Incorrect! Research also shows that this type of CBT, called exposure and response prevention, is effective in reducing compulsive behaviors in OCD, even in people who did not respond well to SRI medication. In ERP, the patient first identifies the things that trigger obsessive thoughts, such as external situations like people, places, or thoughts. Therapists then examine the distress caused in those situations and what the feared outcome will be if they do not perform rituals to lower the distress. Ultimately, it means spending time in the very situation that triggers compulsions, but then being prevented from undertaking the usual resulting compulsion.)
- acceptance and commitment therapy (ACT) (Incorrect. ACT focuses more on altering the way obsessions and anxiety are experienced. ACT sees inner experiences, such as obsessions and anxiety, as part of our lives. ACT focuses on finding a way to allow obsessions and anxiety to come and go without interfering with the way one lives his or her life. Thus, greater functioning can be achieved without a change in severity or frequency of obsessions or anxiety.)
- rational emotive behavior therapy (REBT) (Incorrect. Rational emotive behavior therapy (REBT) is a short-term form of psychotherapy that helps you identify self-defeating thoughts and feelings; challenge the rationality of those feelings; and replace them with healthier, more productive beliefs.)
- habit reversal training (Correct! In HRT, the individual learns a new response to compete with troublesome behaviors caused by a number of conditions, such as hair-pulling and skin-picking disorders.)
A: habit reversal training

Q: Which form of therapy has the highest rate of success in treating trichotillomania, and other body-focused repetitive behaviors, and involves learning a new response to compete with troublesome behaviors?
- acceptance and commitment therapy (ACT) (Incorrect. ACT more on altering the way obsessions and anxiety are experienced. ACT sees inner experiences, such as obsessions and anxiety, as part of our lives. ACT focuses on finding a way to allow obsessions and anxiety to come and go without interfering with the way one lives his or her life. Thus, greater functioning can be achieved without a change in severity or frequency of obsessions or anxiety.)
- rational emotive behavior therapy (REBT) (Incorrect. Rational emotive behavior therapy (REBT) is a short-term form of psychotherapy that helps you identify self-defeating thoughts and feelings, challenge the rationality of those feelings, and replace them with healthier and more productive beliefs.)
- exposure and response prevention (Incorrect! In ERP, the patient first identifies the things that trigger obsessive thoughts, such as external situations like people, places, or thoughts. Therapists then examine the distress caused in those situations and what the feared outcome will be if they do not perform rituals to lower the distress. Ultimately, it means spending time in the very situation that triggers compulsions, but then being prevented from undertaking the usual resulting compulsion.)
- habit reversal training (HRT) answer (Correct! Habit reversal training (HRT) has the highest rate of success in treating trichotillomania and other BFRRs. Habit reversal training (HRT) is a multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders. It consists of five components: awareness training, competing response training, contingency management, relaxation training, and generalization training. HRT has also been shown to be a successful adjunct to medication as a way to treat trichotillomania. With HRT, the individual is trained to learn to recognize their impulse to pull and also teach the individual to redirect this impulse.)
A: habit reversal training (HRT) answer

Q: Kenya locks the door ten times after coming inside because she fears an intrusion. She recently started working with a therapist to discuss this fear, evaluate and rank its severity, and practice imagining ways to tolerate the distress she feels when she doesn’t check the locks. Eventually Kenya performed exercises where she kept the doors unlocked without going near the door and started learning strategies to cope with the distress. Which type of therapy is the therapist using with Kenya?
- habit reversal training (HRT) (Incorrect. Habit reversal training brings attention to the behavior so the person can gain better self-control and awareness. A person will work with a therapist to come up with a different behavior to replace the old, unwanted behavior and practice performing this new behavior.)
- acceptance and commitment therapy (ACT) (Incorrect. ACT focuses more on altering the way obsessions and anxiety are experienced. ACT sees inner experiences, such as obsessions and anxiety, as part of our lives. ACT focuses on finding a way to allow obsessions and anxiety to come and go without interfering with the way one lives his or her life. Thus, greater functioning can be achieved without a change in severity or frequency of obsessions or anxiety.)
- rational emotive behavior therapy (REBT) (Incorrect. Rational emotive behavior therapy (REBT) is a short-term form of psychotherapy that helps you identify self-defeating thoughts and feelings, challenge the rationality of those feelings, and replace them with healthier and more productive beliefs.)
- exposure and response prevention (Correct! Research also shows that this type of CBT, called exposure and response prevention, is effective in reducing compulsive behaviors in OCD, even in people who did not respond well to SRI medication. In ERP, the patient first identifies the things that trigger obsessive thoughts, such as external situations like people, places, or thoughts. Therapists then examine the distress caused in those situations and what the feared outcome will be if they do not perform rituals to lower the distress. Ultimately, it means spending time in the very situation that triggers compulsions, but then being prevented from undertaking the usual resulting compulsion.)
A: exposure and response prevention

Q: Jizaya, a victim of rape, is being treated by her psychologist through a technique called eye movement desensitization reprocessing (EMDR), followed by virtually exposing her to her most feared and hated situation. These methods of psychological treatment are most effective for
- agoraphobias. (Incorrect. The psychologist is most likely focusing on the trauma that Jizaya experienced. Agoraphobia is a fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong. Although EMDR has also been found to effectively treat other mood and anxiety disorders, including depression, phobias, and panic disorder, agoraphobia treatment usually involves a combination of treatment methods: therapy, medication, and lifestyle changes. Systematic desensitization can provide lasting relief to the majority of patients with panic disorder and agoraphobia.)
- acute stress disorders. (Incorrect. EMDR is primarily used to overcome symptoms associated with post-traumatic stress disorder (PTSD). There is a close relationship between acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). Some people develop PTSD after having ASD. Doctors usually recommend CBT as the first-line treatment for people with ASD. CBT involves working with a trained mental health professional to develop effective coping strategies. Mindfulness-based interventions teach techniques for managing stress and anxiety. These can include meditation and breathing exercises. A healthcare professional may prescribe antidepressants or anticonvulsants to help treat a person’s symptoms.)
- specific phobias. (Incorrect. EMDR is primarily used to overcome symptoms associated with post-traumatic stress disorder (PTSD). EMDR has also been found to effectively treat other mood and anxiety disorders, including depression, phobias, and panic disorder. The best treatment for specific phobias is a form of psychotherapy called exposure therapy.)
- post-traumatic stress disorders. (Correct! EMDR is included in several evidence-based guidelines for the treatment of post-traumatic stress disorder (PTSD). As of 2020, the American Psychological Association lists EMDR as an evidence-based treatment for PTSD, but stresses that “the available evidence can be interpreted in several ways,” and notes there is debate about the precise mechanism by which EMDR appears to relieve PTSD symptoms with some evidence EMDR may simply be a variety of exposure therapy. This form of treatment is a hybrid of many different types of interventions, such as imaginal exposure as well as free association.)
A: post-traumatic stress disorders.

Q: Josyel is asked by his therapist to talk about his traumatic experience and as he does, he tries to keep up with her finger as it moves back and forth rapidly. The therapist explained to him that this process will help him reprocess his memories to lessen the fear he has surrounding the traumatic event. What type of therapy is being used here?
- virtual reality therapy (Incorrect. Virtual reality therapy consists of viewing a computerized combat or war scene on a visor screen.)
- cognitive behavioral therapy (CBT) (Incorrect. The most widely practiced approach for treating PTSD is cognitive behavioral therapy (CBT), but a session begins with the individual closing their eyes and recalling the trauma as if the event is presently occurring. The clients retell all their emotions and physical senses while the event happened. Josyel’s session involves rapid eye movement while discussing his traumatic experience.)
- systematic desensitization (Incorrect. Systematic desensitization is a behavioral technique whereby a person is gradually exposed to an anxiety-producing object, event, or place while being engaged in some type of relaxation at the same time in order to reduce the symptoms of anxiety.)
- eye movement desensitization and reprocessing (EMDR) (Correct! This describes the practice of eye movement desensitization and reprocessing (EMDR).)
A: eye movement desensitization and reprocessing (EMDR)

Q: Kadir is being treated for PTSD. He begins therapy by making a script of his traumatic memories, and then undergoes six sessions of viewing a computerized combat or war scene on a visor screen. The computerized scenes closely resemble the real combat environment that he experienced during deployment. During the sessions, he is able to converse with the therapist while actively re-experiencing his memories. What type of therapy is being used here?
- cognitive behavioral therapy (CBT) (Incorrect. The most widely practiced approach for treating PTSD is cognitive behavioral therapy (CBT), but a session begins with the individual closing their eyes and recalling the trauma as if the event is presently occurring. The clients retell all their emotions and physical senses while the event happened.)
- eye movement desensitization and reprocessing (EMDR) (Incorrect. With this form of psychotherapy, the person being treated is asked to recall distressing images while the therapist directs the patient in one type of bilateral stimulation, such as side-to-side eye movements or hand tapping)
- relapse prevention therapy (Incorrect. Relapse prevention therapy is a type of cognitive-behavioral therapy developed for the treatment of problem drinking. It primarily treats addiction and substance abuse, but also treats mental health disorders like depression, OCD, and more.)
- virtual reality therapy (VRT) (Correct! Virtual reality therapy consists of viewing a computerized combat or war scene on a visor screen. The computerized scenes closely resemble a real combat environment experienced by soldiers during deployment.)
A: virtual reality therapy (VRT)

Q: Shania is suffering from PTSD following her experiences of losing a friend in combat while being deployed with the Air Force. Her therapist specializes in memory reconsolidation. What might her therapist do to help Shania reduce the anxiety she feels related to her experiences?
- Shania’s therapist might have her participate in a simulation activity and then talk about her feelings and responses to the activity. (Incorrect. This might be a helpful exercise, but it is not specific to memory reconsolidation, which attempts to “overwrite” the original memory.)
- Her therapist might have her keep a journal throughout the day whenever she remembers something about her deployment. (Incorrect. Keeping a log is sometimes helpful in treatment methods, but this is not specific to memory reconsolidation.)
- Shania’s therapist might have her undergo hypnosis to forget the original memory of losing her friend. (Incorrect. Memories cannot simply be erased. Memory reconsolidation works to “overwrite” the original memory with a less significant emotional response.)
- Her therapist might have her explain the experience in detail, then immediately work on techniques to reduce the emotional impact of the memory. (Correct. Memory consolidation works by “replacing” the original memory with something less emotionally triggering.)
A: Her therapist might have her explain the experience in detail, then immediately work on techniques to reduce the emotional impact of the memory.

Q: Tracy is being treated for depression and post-traumatic stress disorder (PTSD). Her therapist has asked her to recall a recent happy experience. Tracy answers, “When I was visiting my friends last weekend,” but then she is unable to recall or describe any particular events or interactions during that visit that were enjoyable or rewarding. The memory distress that Tracy is showing is called
- fronto-temporal dementia. (Incorrect. Frontotemporal dementia is an umbrella term for a group of uncommon brain disorders that primarily affect the frontal and temporal lobes of the brain. These areas of the brain are generally associated with personality, behavior, and language.)
- blocking. (Incorrect. This refers to the experience in which the answer is right on the tip of your tongue—but you just can't think of it. Blocking occurs when a memory is properly stored in your brain, but something is keeping you from retrieving it. Researchers do not know whether memory blocks reflect the overall slowing of memory retrieval that occurs with age or if they occur for some other reason. In any case, people are able to retrieve about half of blocked memories within minutes.)
- persistence. (Incorrect. Those with PTSD have persistent, unwanted memories. Research has shown that depressed people are given to ruminating over unpleasant events in their lives or mistakes that they believe they have made. The persistence of memories about traumatic events, negative feelings, and ongoing fears is another form of memory problem. Some of these memories accurately reflect horrifying events, while others may be negative distortions of reality.)
- overgeneralized autobiographical memory (OGM). (Correct! Problems with memory are at the core of many psychological disorders. For example, people suffering from both clinical-level depression and post-traumatic stress disorder (PTSD) often have difficulty remembering details of specific memories, especially for happy experiences. The memory distress is called overgeneralized autobiographical memory (OGM).)
A: overgeneralized autobiographical memory (OGM).

Q: In a therapy session, Gail, who has a phobia of dogs, is asked to stand near a dog. This action reactivates her fear response. The therapist exposes her to dogs repeatedly while giving her support. Gail was never bit or harmed during these sessions. Eventually the fear response was reduced and she was less afraid of dogs. What specific technique is the therapist using?
- “reinstatement” in the application of reconsolidation therapy (Incorrect. In a reconsolidation therapy session, reinstatement means having the person retrieve an emotionally powerful memory. If the person avoids fully reactivating the memory in its complete painful form, then reduction of the emotional impact will be impossible. The emotion may be fear or anxiety or some other strong negative response.)
- “imaginal exposure” in the application of cognitive behavioral therapy (Incorrect. Imaginal exposure occurs in session with the patient describing the event in detail in the present tense with guidance from the therapist. Together, patient and therapist discuss and process the emotion raised by the imaginal exposure in session. The patient is recorded while describing the event so that she or he can listen to the recording between sessions, further process the emotions, and practice the breathing techniques.)
- “Systematic desensitization” in the application of behavioral therapy. (Incorrect. Systematic desensitization was among the earliest behavioral treatments studies for PTSD. It involves pairing imaginal exposure with relaxation, so that the anxiety elicited by the confrontation with the feared stimuli is inhibited by relaxation.)
- “extinction of the fear response” in the application of reconsolidation therapy (Correct! In a reconsolidation therapy session, in order to extinguish or reduce a fear response, a person with a phobia (e.g., fear of spiders or dogs or heights) might (a) have the fear response reactivated (have them stand near a spider or dog or on a high perch) and then, (b) through continuous or repeated exposure to the source of fear with support from the therapist and without bad consequences when reactivating the fear response (not getting bitten or not falling), show a reduction of the fear response.)
A: “extinction of the fear response” in the application of reconsolidation therapy

Q: Seventeen-year-old Sheri often felt very depressed and hopeless. She had several oddities at home—rearranging cutlery and turning light switches on and off—and these oddities caused annoyance with family members. She had always tried to live up to every standard (academic, religious, familial) that was placed upon her. Before every exam, she lined up her pencils, erasers, and notebooks exactly the same way, each two fingers apart. She felt a strong urge to complete this task because if she didn’t, she would fail her exam. At times, the thought of failing and believing that she is a failure and therefore incapable of success made her ill. Her mother took her to see a counselor. What could be Sheri’s diagnosis?
- adjustment disorder (Incorrect. There’s no indicator that Sheri experienced an adjustment she couldn’t cope with; though it’s likely she had difficulty adjusting to various circumstances, these symptoms are more indicative of OCD, which includes obsessions (unwanted thoughts: in this case, fear of failure and believing that she is a failure and incapable of success) and rituals (arranging pencils a certain way, rearranging cutlery, and turning light switches on and off).)
- body dysmorphic disorder (Incorrect. BDD is a disorder in which an individual has a flawed perception about their body. Sheri’s symptoms don’t involve a desire to change something about herself as much as she is trying to change the environment around her so she doesn’t become a failure. She has obsessions (unwanted thoughts: in this case, fear of failure, believing that she is a failure and incapable of success) and rituals (arranging pencils a certain way, rearranging cutlery, and turning light switches on and off), which are characteristic of OCD.)
- reactive attachment disorder (Incorrect. RAD is a stressor-related disorder caused by social neglect during childhood. Sheri’s difficulties stem from her obsessions and rituals, which are characteristic of OCD. There are no other symptoms to indicate an attachment disorder.)
- obsessive-compulsive disorder (Correct! Sheri shows signs of obsessions (unwanted thoughts: in this case, fear of failure and believing that she is a failure and is incapable of success) and rituals (arranging pencils a certain way, rearranging cutlery, and turning light switches on and off).)
A: obsessive-compulsive disorder

Q: Maurice is a 15-year-old high-school student referred for treatment by his health teacher, who became worried by Mark's irrational concern about getting ill and vomiting. The teacher had discussed vomiting as an involuntary response to illness. From that class forward, Maurice would shun anyone who appeared to be sick at school. His friends wondered why he wasn’t talking to them. He became so obsessed with getting ill that he also started carrying hand sanitizer everywhere he went and avoided the school restrooms. He would no longer touch food that he thought might be contaminated by germs. What is the probable diagnosis for Maurice?
- social anxiety disorder (Incorrect. Children with social anxiety disorder struggle with excessive self-consciousness that goes beyond common shyness. Kids with social anxiety disorder worry so much about being judged negatively by others that they stop doing the things that they need (and want) to do for fear of embarrassing themselves.)
- body dysmorphic disorder (Incorrect. BDD is a disorder in which an individual has a flawed perception about their body. Maurice’s symptoms don’t involve a desire to change something about himself as much as he is trying to change his behaviors and the environment around him so he doesn’t come in contact with germs.)
- reactive attachment disorder (Incorrect. RAD is a stressor-related disorder caused by social neglect during childhood. Maurice’s difficulties stem from his obsessions and repetitive behaviors.)
- obsessive-compulsive disorder (Correct! Of the children who are diagnosed with OCD, most will experience contamination obsessions. No one knows exactly why a person develops certain obsessions. It has been suggested, however, that life experience and what one cares or feels passionate about may be a contributing factor.)
A: obsessive-compulsive disorder

Q: A 5-year-old boy loses his beloved uncle suddenly to an accident. Six months later, he developed problems sleeping and bedwetting. He complained of stomach aches. He always felt nervous and watchful (on guard), as if something bad were going to happen to him or his family. He began to worry about dying at a young age. He lost interest in the things he used to enjoy, like playing with friends or video gaming. To his parents, he seemed to be more aggressive than before, even violent at times. This behavior was unusual for him. He refused categorically to ride in a car, and going out in public with family became an ordeal. These symptoms seem to suggest which of the following disorders?
- disinhibited social engagement disorder (Incorrect. Disinhibited social engagement disorder (DSED) is an attachment disorder. It may make it difficult for children to form deep, meaningful connections to others. It's one of two attachment disorders that affect children younger than 18 years—the other condition is reactive attachment disorder (RAD).)
- reactive attachment disorder (Incorrect. RAD is characterized by markedly disturbed and developmentally inappropriate ways of relating socially in most contexts. It can take the form of a persistent failure to initiate or respond to most social interactions in a developmentally appropriate way.)
- autism spectrum disorder (ASD) (Incorrect. Individuals on the autistic spectrum experience difficulties with social communication and interaction and also exhibit restricted, repetitive patterns of behavior, interests, or activities.)
- post-traumatic stress disorder (Correct! PTSD is often associated with soldiers and others on the front lines of war. But anyone—even kids—can develop it after a traumatic event. Traumas that might bring on PTSD include the unexpected death of a family member. PTSD in children can look a little different. Younger kids can show more fearful, regressive behaviors and aggressive behaviors. They may have lasting feelings of anxiety or physical reactions. Symptoms usually begin within the first month after the trauma, but they may not show up until months or even years have passed.)
A: post-traumatic stress disorder