ISPP EPPP 8

31. Damage to the prefrontal cortex is most likely to cause: a. impaired motor coordination b. impaired memory and attention c. alterations in the sleep/wake cycle d. "psychic blindness"

31. B-- The prefrontal cortex is associated with a variety of cognitive functions, including attention and certain aspects of memory. An individual with damage to the prefrontal cortex may exhibit distractibility, impaired working memory, a reduced attention span, and impaired prospective memory. "Psychic blindness" (d.) is associated with Kluver-Bucy syndrome, which is caused by damage to certain areas of the temporal lobes.

72. The most effective behavioral technique to reduce a school-aged child's temper tantrums is: a. modeling b. extinction c. positive reinforcement d. negative reinforcement

72. B-- Extinction is the elimination or reduction in the frequency of a response achieved by the removal of the reinforcement maintaining the response. The extinction of temper tantrums would entail ignoring the child's behavior or not reinforcing it with attention. This technique has been found to be effective for reducing temper tantrums. Positive (c.) and negative (d.) reinforcement are used to strengthen behaviors. Modeling (a.) is used to teach new behaviors.

10. Perseverating is an indication of damage in the: a. Temporal lobe b. frontal lobe c. parietal lobe d. occipital lobe

10. B-- Difficulty in interpreting feedback from the environment is one of the most common characteristics of frontal lobe damage. Perseverating or uncontrollable repetition of a particular response, risk taking, lack of social consciousness and non-compliance with rules are examples of this type of deficit.

4. The mother of a 22-year-old client of yours calls to inform you that your client has died. The mother requests a copy of your client's therapy records. You should: a. release the records to her b. refuse to release the records c. release the records only after obtaining a signed release from the mother d. release the records only after obtaining a signed release from the executor or administrator of the client's estate

4. D-- Most state laws provide a deceased person's executor or administrator the right to access confidential records of the client. The deceased person's executor or administrator must be legally designated as the deceased's representative, usually by a probate court. Without such a designation, records should not be released.

85. Individuals with the diagnosis of Seasonal Affect Disorder are most likely to respond to light if they experience: a. atypical symptoms such as carbohydrate craving and hypersomnia b. melancholic symptoms such as insomnia and weight loss c. incomplete summer remission d. more chronic forms of depression

85. A-- Research on the use of light therapy for the treatment of various forms of depression has yielded the findings that for true SAD, atypical symptoms such as carbohydrate craving and hypersomnia predict a robust response, whereas melancholic symptoms such as insomnia and weight loss are generally less responsive to light (See: Terman et al., American Journal of Psychiatry, 1996, 153,:423-9). Additionally, a clear onset period with complete remission in the spring and summer months is the SAD phenotype that is most likely to respond to light. Whereas patients with more chronic forms of depression or incomplete summer remission are less likely to have a robust response, they may benefit to some extent (See: Lam et al., Journal of Affective Disorders, 2001, 63, 123-32).

75. Specific Phobia, Blood-Injection-Injury Type is characterized by each of the following EXCEPT: a. a strong vasogal response b. onset in late adolescence c. more common in women than men d. strong familial patterns

75. B-- Specific Phobia, Blood-Injection-Injury Type, sometimes referred to as health phobia, is described in the DSM-IV-TR as "specified if the fear is cued by seeing blood or an injury or by receiving and injection or other invasive medical procedure. This subtype is highly familial (d.) and is often characterized by a strong vasogal response (a.)." The age of onset is usually early childhood and may occur at a younger age for women than men. In contrast to the other Specific Phobias' usual physiological response of acceleration of heart rate and elevation in blood pressure, 75% of individuals with Specific Phobia, Blood-Injection-Injury Type report a history of a vasogal fainting response. The physiological response involves a brief acceleration of heart rate and elevation in blood-pressure followed by a deceleration and drop in blood pressure.

58. The kappa statistic is used to evaluate reliability when data are: a. interval or ratio (continuous) b. nominal or ordinal (discontinuous) c. metric d. nonlinear

B-- The kappa statistic is used to evaluate inter-rater reliability, or the consistency of ratings assigned by two raters, when data are nominal or ordinal. Interval and ratio data is sometimes referred to by the term metric.

67. Screening for cognitive deficits associated with Alzheimer's dementia and other conditions with the Mini Mental Status Exam (MMSE) tends to result in a disproportionate number of: a. false positives for African-African and other minorities. b. true positives for individuals from lower socioeconomic backgrounds. c. false negatives for African Americans and other minorities. d. true negatives for individuals with lower levels of education.

67. A-- Due to the tendency to overestimate cognitive deficits among African Americans and other minority groups, the MMSE results in a disproportionate number of false positives. Research indicates the MMSE also overestimates cognitive deficits for individuals with lower socioeconomic backgrounds and lower levels of education. When controlling for education level and socioeconomic status, research findings have been mixed on whether the racial bias persists or can be eliminated. (See: Lampley-Dallas, V. T. (2001). Neuropsychological screening tests in African Americans, Journal of the National Medical Association, 93(9), 323-328.)

90. After losing several hundred dollars gambling at the casino, Jack decides to increase the amount he places on each subsequent bet in hopes of making his money back. This decision is best explained by: a. satisficing. b. loss aversion. c. bounded rationality. d. cognitive dissonance.

90. B-- Kahneman and Tversky's (1979) Prospect Theory contains the notion of loss aversion which refers to the tendency to be influenced more by potential losses than potential gains or to base decisions more heavily on the fear of loss than the hope of gain. In contrast to commonly held beliefs that people are adverse to risk and make decisions based on logic, Kahneman and Tversky found that people are adverse to loss, not risk. This explains why gamblers will take riskier and riskier decisions after suffering a loss in hopes of making their money back, that is, to avoid realizing an actual loss. Satisficing (a.) refers to the decision-making style of using the minimal amount of information to reach a "good enough" solution. Bounded rationality (c.) is part of Herbert Simon's (administrative) model of decision making, which proposes that decision makers are not always completely rational in making choices. Instead, time and resources limit their consideration of alternatives, so they tend to consider alternatives only until a satisfactory one is identified. Cognitive dissonance (d.) theory predicts that, when we have two conflicting cognitions (e.g., I like the club but they don't want me"), we'll be motivated to reduce the tension that this causes by changing one of our cognitions.

1. Which is the most common anticholinergic side-effect? a. Light tremor b. Blurred vision c. Diarrhea d. Weight loss

1. B-- Anticholinergic effects may be either central or peripheral. Central side effects are cerebral and include impaired concentration, confusion, attention deficit, and memory impairment. Peripheral side effects include dry mouth, constipation, urinary retention, bowel obstruction, dilated pupils, blurred vision, increased heart rate, and decreased sweating. Light tremor (a.) and diarrhea (c.) are not associated side-effects, and while dry mouth may affect appetite and result in weight loss (d.), it is not considered an anticholinergic side-effect either.

13. A MANOVA is used to statistically analyze data when: a. a study includes two or more independent variables b. a study includes two or more dependent variables c. there are more than two levels of a single independent variable d. a study includes at least one independent variable that is a between-groups variable and another independent variable that is a within-subjects variable

13. B-- A MANOVA (multivariate analysis of variance) is used to analyze the effects of one or more independent variables on two or more dependent variables that are each measured on an interval or ratio scale. A factorial ANOVA (a.) is used to analyze data when a factorial design, which includes two or more independent variables, is used and the dependent variable is measured on an interval or ratio scale. A one-way ANOVA (c.) is used when a study has one independent variable and more than two independent groups. The split-plot (mixed) ANOVA (d.) is the appropriate technique when at least one independent variable is a between-groups variable and another independent variable is a within-subjects variable.

88. According to Maslow, there are five levels of human needs that are represented in a hierarchical order. The stage that follows physiological needs is: a. order b. safety c. acceptance d. self-actualization

88. B-- Maslow's five basic needs, arranged in hierarchical order of importance, are physiological, safety, social, esteem and self-actualization.

9. 15 year old Susan was initially diagnosed with Bulimia-Nervosa (Purging Type). Her self-evaluation is unduly influenced by her body shape and weight. She worries about gaining weight, has been binging and purging on a daily basis for almost a year and her weight has steadily dropped to less than 85% of a minimally normal level. Her therapist reassesses Susan's diagnosis. The salient feature to consider in the differential diagnosis of Anorexia-Nervosa (Binge-Eating/Purge Type) is her: a. fear of gaining weight or getting fat b. cognitive distortions associated with body image c. continuation of binging and purging despite weight loss d. denial of seriousness of current body weight

9. C-- Individuals with Bulimia-Nervosa, unlike those with Anorexia-Nervosa, Binge-Eating/Purge Type, are able to maintain body weight at or above a minimally normal weight for height and age. Anorexia-Nervosa is characterized by a refusal to maintain a minimal normal body weight, with the threshold of underweight being less than 85% of weight expected. Susan's weight falls below this threshold and her continuation of binging and purging despite weight loss meets the refusal criteria of Anorexia. It is also important to consider her fears of gaining weight (a.) and denial of seriousness of her current weight (d.), especially with respect to treatment planning. Disturbances in perception of body shape and weight (b.), and an over influence of weight and shape on self-evaluation are essential features of both disorders.

59. A baby uses his/her hand to grab a toy and then squeezes it which produces an interesting sound, and this leads to the baby repeating the action. This is an example of what Piaget described as a: a. primary circular reaction b. secondary circular reaction c. tertiary circular reaction d. reflexive circular reaction

B-- Most of the cognitive development that occurs during the sensorimotor stage, according to Piaget, is the result of circular reactions - wherein a child learns to do something that produces an interesting or pleasurable experience which originally had happened by chance. Primary circular reactions (a.) center around the baby's own body and involve simple motor actions like thumb sucking. Secondary circular reactions are actions involving an other person or object and are predominate from 4 to 8 months of age. Tertiary circular reactions (c.) involve seeing what occurs when an original action is varied on an external object. This is predominate from 12 to 18 months of age. Piaget associated reflexes (d.) with cognitive development from birth to 1 month of age.

52. Which of the following best describes the ethical requirements of a licensed clinical psychologist who tests positive for HIV? a. inform clients of his/her medical condition "as early as is feasible" b. obtain supervision to ensure that the medical condition does not interfere with the performance of work-related duties c. refrain from initiating any professional activities that might be adversely affected by the medical condition d. there is no obligation to take precautions or special actions in this situation

C-- Being diagnosed with HIV, when considering the ethical obligations of a psychologist, would be considered a health-related personal issue. Personal problems, including emotional, social, health-related and other personal issues, are addressed in Standard 2.06: Psychologists "refrain from initiating an activity when they know or should know there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner." If a psychologist thinks the condition may impair his/her ability to provide effective services or perform work-related duties then the psychologist would "take appropriate measures." However, there is no evidence that this is the case, so (b.) is not the best answer. Informing clients of the condition (a.) is not necessary and may not be in the best interests of some of the clients to do so.

11. An organization is considering different selection techniques and comparing the respective predictive validity of each. The validity of structured interviews as predictors of performance: a. are the most valid across different jobs b. are no more valid than unstructured interviews when used alone c. is increased when the interview includes both structured and unstructured items d. is increased when the interview is used in combination with a measure of general mental ability

11. D-- Summarizing the predictive validity of interviews and other selection techniques in a meta-analysis of the research, Schmidt and Hunter (1998) report measures of general mental ability are the most valid predictors across different jobs (a.). For structured and unstructured interviews, they note corrected validity coefficients of .51 and .38, respectively (b.). When an interview is combined with another selection procedure, especially a general mental ability test, the predictive validity of interviews is increased [The validity and utility of selection measures in personnel psychology: Practical and theoretical implications of 85 years of research findings, Psychological Bulletin, 124(2), 262-274].

12. Early-onset of obsessive compulsive disorder (OCD) can occur in children as young as preschool age. Presentation of the disorder in young children differs from older children, adolescents, and adults in that: a. young children become obsessed with particular toys, games, people, or songs instead of checking, ordering or cleaning types of behavior b. compulsive symptoms are more pronounced and obsessive symptoms may be different or not reported by young children c. obsessive symptoms are more pronounced and compulsive symptoms may not be exhibited by young children d. greater subjective distress typically accompanies the disorder in young children

12. B-- Obsessions and compulsions begin at about the same age in individuals with late-onset of OCD. In children with early-onset OCD, however, compulsions typically have an earlier onset than obsessions. Research indicates early childhood onset is associated with: compulsions onset 1-2 years before the onset of obsessions; male preponderance; higher rate of comorbid diagnoses, especially tic disorders; a greater familial loading for OCD; higher frequencies of repeating compulsions and higher frequencies of hoarding obsessions and compulsions. For a small subgroup of children, their OCD is associated with streptococcal infection which is characterized by prepubertal onset, neurological abnormalities, and an abrupt onset of symptoms or episodic course. According to the DSM-IV-TR (p. 459), washing, checking and ordering rituals are particularly common in children (a.) and the problem is usually identified by parents. (See: Geller, D., Biederman, J., Jones, J., Park, K., Schwartz, S., Shapiro, S., & Coffey, B. (1998). Is juvenile obsessive-compulsive disorder a developmental subtype of the disorder? A review of the pediatric literature. Journal of the American Academy of Child and Adolescent Psychiatry; 37: 420-427.)

14. According to this type of psychotherapy, feelings are acknowledged and accepted as uncontrollable and the focus is on taking constructive action, not the alleviation of discomfort or the attainment of some ideal feeling state. a. Naikan therapy b. Network therapy c. Morita therapy d. Rational-emotive therapy (RET)

14. C-- Morita Therapy, sometimes referred to as the psychology of action, is a Japanese therapeutic intervention developed by Japanese psychologist Shoma Morita in the early part of the twentieth century originally to treat anxiety and neurosis. Morita therapy doesn't deal with the past, inner dynamics, or with emotions directly as a prerequisite to change. Emphasis is on learning to accept the internal fluctuations of thoughts and feelings and ground behavior in reality and the purpose of the moment. The focus is on the external environment, behavior, and distinguishing what is and is not controllable. All emotions are accepted as valid, pain is inevitable and there is no attempt to control or govern feelings. Concrete effort to take action, with or without success and despite the accompanying emotions, is encouraged. Progress is measured by degree of responsiveness to behavioral demands and in the effort for self improvement. Like cognitive behavioral therapy, Morita therapy deals with changing behaviors and dysfunctional cognitive processes through reframing the meaning of anxiety, focusing on attitudinal blocks to behavior and taking personal responsibility for behavior. Another Japanese approach, Naikan Therapy (a.), or the psychology of reflection, is based on clients asking themselves three questions: what have I received from? What have I given to? What troubles or difficulties have I caused to? Through such self-reflection, a client's awareness of the role they play in the relationship or situation, the amount of support they've received, and an appreciation for others is said to be increased. It is often combined with use of Morita Therapy. In Network Therapy (b.), the client's family, friends, and relatives (i.e. the client's network) are brought together, through the therapist's initiative, to implement the therapeutic process. Rational-emotive therapy (d.), views irrational thoughts as the cause of clients? problems and that the maintenance of problems is due primarily to self-indoctrination. (See: Ishiyama, F. I. (1990). A Japanese perspective on client inaction: Removing attitudinal blocks through Morita therapy. Journal of Counseling and Development, 68, 566-570. and Goddard, K. (1991) Morita therapy: A literature review. Transcultural Psychiatric Research Review. 28(2); 93-115.)

15. Which of the following procedures summarizes and identifies key variables that describe the consequences of HR programs to improve decision making? a. utilization review b. utility analysis c. concurrent review d. quality management

15. B-- Based on the logic that decision making will be improved by using a decision-support framework that explicitly considers the costs and benefits of human resources (HR) decisions, a utility analysis summarizes and identifies key variables that describe the consequences of HR programs. Utility analysis has most frequently been studied as applied to selection procedures although other cost/benefit analyses have been applied to HR interventions such as recruitment, training, performance feedback, promotion, turnover/layoff management and more recently, new policy implementation. Studies have purported to identify, with a high degree of precision, the financial payback to be realized through investments designed to improve employee productivity. Advances in utility analysis application and related research have been limited due to an inability to develop an agreed-upon method to estimate the dollar value of job performance and its standard deviation (SDy). The challenge arises in uniformly evaluating human inputs, actions, and/or the outcomes of those actions as well as the uncertainty of task characteristics, relationships, and levels of task independence across positions and organizations. Utilization Review (a.) is a cost containment procedure involving an evaluation of patients' use of services to identify any unnecessary or inappropriate use of health care resources. Concurrent review (c.) describes the utilization review conducted during the course of treatment. Quality management (d.) is another name for quality assurance. (See: Boudreau, J.W. & Ramstad, P.M. (2001). Strategic I/O Psychology and Utility Analysis. In W. Borman, R. Klimoski & D. Ilgen (Eds.), Handbook of Industrial and Organizational Psychology, New York, NY: John Wiley and Sons; Latham, G.P., & Whyte, G. (1994). The futility of utility analysis. Personnel Psychology, 47, 31-46. and Boudreau, J.W. (1991). Utility analysis for decisions in human resource management. In M.D. Dunnette & L.M. Hough (Eds.), Handbook of industrial and organizational psychology (Vol. 2, pp. 621-745). Palo Alto, CA: Consulting Psychologists Press.)

16. Cohen's d is a method for calculating an effect size. Which of the following is required to use this method? a. the means of the experimental and control groups b. the median scores for the pre- and post-tests c. the actual and predicted scores for the outcome measure d. the standard error of estimate of the criterion

16. A-- Cohen's d is calculated by subtracting the mean of the control group from the mean of the experimental group and dividing the result by the control group standard deviation or by a pooled standard deviation. It indicates the magnitude of the effect of a treatment in terms of the difference between the means of the experimental (treatment) and control (no treatment) groups.

17. While Sleep Terror Disorder and Sleepwalking Disorder are similar in terms of sleep and EEG patterns, there are behavioral differences that distinguish them. Sleepwalking Disorder, in contrast to Sleep Terror Disorder,: a. is accompanied by high levels of autonomic arousal during the episode b. is associated with prominent, organized motor activity during the episode c. is not associated with amnesia for the episode when the individual awakens in the morning d. is not associated with a family history of Sleepwalking and/or Sleep Terror Disorder

17. B-- Both Sleep Terror Disorder and Sleepwalking Disorder have been linked to a family history (d.) and are associated with amnesia for the episode upon awaking in the morning (c). Sleepwalking Disorder is usually associated with low levels of autonomic arousal (a.) and is characterized by prominent, organized motor activity such as walking around, talking, and eating. Both disorders do involve motor activity, although the activity associated with Sleep Terror Disorder is less organized and usually involves resisting being touched or held and sitting up.

18. A young child starts to act out while waiting for the food to be served at a restaurant, according to systems theory, in order to the restore the family to its previous state of equilibrium, the parent will: a. use negative feedback to restore homeostasis b. use negative feedback to unbalance the system further and bring the child back into line c. use positive feedback to restore homeostasis d. use positive feedback to correct the child's behavior

18. A-- In systems theory, feedback refers to information from within the system which results in changes in either the existing homeostasis or the maintenance or restoration of homeostasis. Positive feedback alters the system to accommodate novel input or a new state of equilibrium and negative feedback maintains or restores the status quo of the system. If a child misbehaves while the family is at a restaurant, negative feedback occurs when the parent corrects the misbehaving and restores homeostasis.

19. A company wants its clerical employees to be very efficient, accurate and fast. Examinees are given a perceptual speed test on which they indicate whether two names are exactly identical or slightly different. The reliability of the test would be best assessed by: a. test-retest b. Cronbach's coefficient alpha c. split-half d. Kuder-Richardson Formula 20

19. A-- Perceptual speed tests are highly speeded and are comprised of very easy items that every examinee, it is assumed, could answer correctly with unlimited time. The best way to estimate the reliability of speed tests is to administer separately timed forms and correlate these, therefore using a test-retest or alternate forms coefficient would be the best way to assess the reliability of the test in this question. The other response choices are all methods for assessing internal consistency reliability. These are useful when a test is designed to measure a single characteristic, when the characteristic measured by the test fluctuates over time, or when scores are likely to be affected by repeated exposure to the test. However, they are not appropriate for assessing the reliability of speed tests because they tend to produce spuriously high coefficients.

2. Research on the relationship between self-esteem, biological sex and gender-role suggests: a. biological sex has a greater impact than gender role on self-esteem in children b. biological sex has a greater impact than gender role on self-esteem in males c. a combination of masculine and feminine characteristics and preferences is associated with the highest levels of self- esteem in males d. a combination of masculine and feminine characteristics and preferences is associated with the highest levels of self- esteem in children

2. D-- D. J. A. Hall and A. G. Halberstadt's original research found gender-role identity to have a greater impact than biological sex on self-esteem in children and that androgyny (both masculine and feminine preferences and characteristics) is associated with the highest levels of self-esteem in both boys and girls (See: J. A. Hall & A. G. Halberstadt. Masculinity and femininity in children: Development of the Children's Personal Attributes Questionnaire, Developmental Psychology, 1980, 16, 270-280]. Subsequent studies supported these findings and some have also found that masculinity, to a somewhat lesser degree, is associated with higher levels of self-esteem than femininity in both boys and girls.

20. The basic assumption of Howard Gardner's theory of intelligence is reflected best in which of the following statements a. Intelligence is best defined in terms of the ability to deal with abstract concepts. b. Intelligence assessment requires the use of simple quantified measures such as paper-and-pencil tests. c. In assessing intelligence, learning to be an efficient processor of information is more important than genetic factors. d. In assessing intelligence, the society in which a person lives evaluates how intelligent a person is thought to be.

20. D-- Howard Gardner initially defined intelligence as an ability to solve real-life problems, to generate new problems, and to create something meaningful or offer a service that is valued within a person's culture or local community. He developed the theory of multiple intelligences which currently lists eight intelligences: linguistic, logical-mathematical, musical intelligence, bodily-kinesthetic, spatial, interpersonal, intrapersonal and naturalist.

44. The tendency of sports teams to win more often when they are playing on their home court is referred to as the "home advantage." This phenomenon is best explained by: a. home court familiarity b. expectations of the players c. social support from fans d. demoralization of the visiting team

44. C-- The home advantage in team sports has generated various explanations; however, it most consistently has been linked to a supportive home audience. (See: B. Schwartz and S. F. Barsky, The home advantage, Social Forces, 1977, 55, 641-661; and K. S. Courneya and A. V. Carron, The home advantage in sports competitions: A literature review, Journal of Sport & Exercise Psychology, 1992, 14, 13-27.)

21. Which of the following is NOT one of the levels of Kirkpatrick's training evaluation model? a. learning b. reaction c. results d. return on investment

21. D-- Donald Kirkpatrick's (1959, 1998) model for evaluating training and learning programs includes four levels: reaction, learning, behavior and result. Each level of evaluation is used to assess the effectiveness of training programs and the effects of the training on the employees. Level 1 (b.) evaluations focus on the individual's response to the training or intervention. Level 2 (a.) measures what has been learned, often using pre/post-tests or end-of-course tests. Level 3 evaluations assess the impact of the intervention on the individual's behavior or performance in the workplace and level 4 (c.) measure the impact of training on the organization's results. (See: Kirkpatrick, D.L. (1998). Evaluating Training Programs: The Four Levels (3rd ed.). San Francisco, California: Berrett-Koehler.) Return on investment (ROI), is a "level 5" evaluation, proposed by Jack Phillips, used to calculate the return on investment of an intervention or training. Phillips' Five Level ROI is an expansion of Kirkpatrick's model and encourages ROI evaluations for each of the first four levels. (See: Phillips, J.J. (2000). Return on investment in training and performance improvement programs. Woburn, MA: Butterworth-Heinemann.)

22. The best initial strategy for teaching complex motor skills that require speed and accuracy to be successfully performed is to: a. emphasize accuracy over speed b. emphasize speed over accuracy c. emphasize accuracy and speed equally d. emphasize an alternation between speed and accuracy

22. B-- Research on speed and accuracy in learning complex motor skills suggests the best approach is to emphasize speed of performance initially although, to a certain degree, the optimal approach depends on the specific skill. (See: Engelhorn, R. (1997). Speed and accuracy in the learning of a complex motor skills, Perceptual and Motor Skills, 85, 1011-1017.)

23. Howard et al.'s (1993) phase model of psychotherapy change does NOT include: a. remoralization b. reexamination c. remediation d. rehabilitation

23. B-- The phase model of psychotherapy, an extension of the dose-response model of treatment response, was first proposed by Howard et al. in 1993 and is a client stage model that outlines a progressive, 3-stage sequence of change. The first phase, remoralization, focuses on the client's subjective well-being and occurs during the first few sessions. The second phase, remediation, focuses on symptom reduction and generally occurs between the 5th and 15th sessions. The third and final phase is rehabilitation which focuses on life functioning gains and emerges more gradually. According to this model, effective courses of treatment are initially characterized by a restored subjective sense of well-being then, as a function of this improvement, the client may benefit from interventions to provide symptom reduction or relief (e.g., decrease difficulty concentrating or sleep disruption) and finally, is able to either resume their former level of role functioning (e.g., doing well at work) or initiate new roles (e.g., obtaining a new job). (See: Howard, K. I., Lueger, R. J., Maling, M. S., & Martinovich, Z. (1993). A phase model of psychotherapy outcome: Causal mediation of change. Journal of Consulting and Clinical Psychology, 61, 678-685. and K. Howard et al., Evaluation of psychotherapy: Efficacy, effectiveness, and patient progress, American Psychologist, 51, 1059-1064, 1996.)

24. Which of the following sections of the 2002 Ethical Principles of Psychologists and Code of Conduct "discusses the intent, organization, procedural considerations, and scope of application of the Ethics Code." a. Introduction only b. Introduction and Preamble c. Preamble only d. General Principles and Ethical Standards

24. A-- The 2002 Ethics Code is divided into four sections: Introduction, Preamble, General Principles, and Ethical Standards. The Introduction "discusses the intent, organization, procedural considerations, and scope of application of the Ethics Code." The purpose of both the Preamble and General Principles is to provide "aspirational goals to guide psychologists toward the highest ideals of psychology." The Ethical Standards "set forth enforceable rules."

25. In addition to improved interpersonal relationships, a primary goal of interpersonal therapy (ITP) is: a. alleviating or reducing symptoms. b. satisfying needs in responsible ways. c. resolving underlying conflicts. d. living in an authentic, meaningful way.

25. A-- Based on a medical model, interpersonal therapy (ITP) views mental disorders as illnesses and focuses on symptom reduction in addition to improving interpersonal relationships.

26. A serious complication of binging and purging involves a low level of serum potassium that can lead to kidney failure and cardiac arrest. This condition is called: a. hyponatremia. b. hypokalemia. c. hypoglycemia. d. hypercapnia.

26. B-- Certain behaviors associated with bulimia, namely frequent vomiting and laxative use, can lead to serious medical complications, including electrolyte disturbances. Hypokalemia is the name given to the condition that involves low levels of serum potassium. Hyponatremia (a.) involves less than normal concentration of sodium in the blood; hypoglycemia (c.) is characterized by less than normal amounts of glucose in the blood; and hypercapnia (d.) involves greater than normal amounts of carbon dioxide in the blood.

27. The tendency to attribute all behavioral, social and emotional problems to a diagnosis or psychopathology while alternative explanations and comorbid diagnoses are often not considered is referred to as: a. diagnostic overshadowing b. psychosocial masking c. intellectual distortion d. baseline exaggeration

27. A-- Research by Reiss et al. (1982) found mental disorders in individuals with mental retardation are often unrecognized, undiagnosed, and untreated. The underestimation was proposed to be the result of a phenomenon called "diagnostic overshadowing," where the presence of mental retardation decreases the diagnostic significance of an accompanying mental health disorder. Or as an example with slow learners there may be the reverse case of diagnostic overshadowing. That is, professionals ignore the real world influences of low intelligence such as poor coping skills, poor social skills, repeated failure experiences and the risk factors associated with poverty and attribute all behavioral, social and emotional problems to psychopathology. The other response choices are three of four non-specific factors associated with mental retardation that influence the diagnostic process: intellectual distortion (c.), emotional symptoms are difficult to elicit because of deficits in abstract thinking and in receptive and expressive language skills; psychosocial masking (b.), the effect of disabilities or limited social experiences on the content of psychiatric symptoms; cognitive disintegration, the tendency to become disorganized under emotional stress or a decreased ability to tolerate stress leading to anxiety-induced decompensation; and baseline exaggeration (d.), the fact that chronic maladaptive behaviors may significantly increase in severity or frequency during a period of emotional stress or after the onset of psychiatric illness. (See: Reiss, S., Levitan, G.W., Szyszko, J. (1982). Emotional Disturbance and Mental Retardation: Diagnostic Overshadowing. American Journal of Mental Deficiency, 86(6), 567-74.)

28. A highly differentiated profile on the Self-Directed Search inventory signifies: a. all six section scores on the instrument are high. b. half of the section scores on the instrument are high and the other half low. c. two of the section scores on the instrument are high and are opposites on the personality hexagon. d. only one of the section scores on the instrument is high.

28. D-- According to Holland (1997), differentiation is defined as the level of definition or distinctness of a profile and can be thought of as the difference between an individual's highest and lowest summary scale score on the SDS. A highly differentiated profile would only have a high point code on one of the six types. Profile elevation is the sum of the six section scores on the instrument, so (a.) would be an example of high profile elevation.

29. During the first of structural family therapy's three steps, which of the following techniques is most useful? a. constructing a family map b. relabeling and reframing c. enactment d. tracking and mimesis

29. D-- Structural family therapy entails three overlapping steps: joining, evaluating/diagnosing, and restructuring. Joining is the initial step in structural family therapy. Tracking (identifying and using the family's values, life themes, etc.) and mimesis (adopting the family's behavioral and affective style) are methods used to join the family system. Constructing a family map (a.) is a technique used for the structural diagnosis of the family. Relabeling and reframing (b.) are restructuring techniques. Enactment (c.) is used to facilitate diagnosis and restructuring of the family.

3. The factor loading for Test A and Factor II is .80 in a factor matrix. This means that: a. only 80% of variability in Test A is accounted for by the factor analysis b. only 64% of variability in Test A is accounted for by the factor analysis c. 80% of variability in Test A is accounted for by Factor II d. 64% of variability in Test A is accounted for by Factor II

3. D-- The correlation coefficient for a test and an identified factor is referred to as a factor loading. To obtain a measure of shared variability, the factor loading is squared. This example, the factor loading is .80, meaning that 64% (.80 squared) of variability in the test is accounted for by the factor. The other identified factor(s) probably also account for some variability in Test A, which is why (b.) is not the best answer.

30. The director at the training agency, where you are a supervisor, has promised two new interns that they will have plenty of testing experience as part of their training. In order to meet quota, you are under a great deal of pressure to bill many hours. One intern has a great deal of previous testing experience and the other intern has very little. The majority of the testing cases are given to the more experienced intern, and as a result this intern is given the majority of your time and attention. This situation is: a. ethical b. unethical c. unethical because you are exploiting the more experienced intern d. unethical because the less experienced intern is not getting the training as it was described to him by the director of the clinic

30. A-- There is no indication that the more experienced intern is being exploited (response "C") and while the interns are not receiving an equal number of testing opportunities, the situation is not unethical solely because the less experienced intern is getting fewer testing cases and/or attention. The director stated the interns would have "plenty of testing experience," not necessarily an equal amount of testing cases, time, or attention. Additionally, the definition of plenty is relative to the individual intern, their previous education, training, and experience. Another relative term in the question to consider is "majority." It would be unethical to have the intern with very little testing experience perform more than his/her current level of competency (Standard 2.05(2): Delegation of Work to Others). Note: this intern is receiving test cases, time, and attention - just not the "majority" of cases and attention.

45. Brain imaging techniques have identified abnormalities in which areas among people with Tourette Syndrome, Autistic Disorder, and Obsessive-Compulsive Disorder? a. frontal lobes and thalamus b. frontal lobes and basal ganglia c. parietal lobes and amygdale d. parietal lobes and thalamus

45. B-- Research has consistently implicated pathology in the basal ganglia and frontal lobes in all three disorders.

32. A factorial design, unlike a two group design: a. allows more independent variables to be studied b. requires a larger sample c. shows the effect of an independent variable on the dependent variable d. cannot detect a curvilinear relationship between variables

32. A-- In a two group design, one group is exposed to a treatment and another, control group, is not exposed or gets a different treatment. The results of both groups are tested in order to compare the effects of treatment. A factorial design is a design with more than one independent variable. In this design, the independent variables are simultaneously investigated to determine the independent and interactive influence they have on the dependent variable. The effect of each independent variable on the dependent variable (c.) is called a main effect and in a factorial design there are as many main effects as there are independent variables. An interaction effect between two or more independent variables occurs when the effect that one independent variable has on the dependent variable depends on the level of the other independent variable. At least three levels must be used to predict a curvilinear relationship (d.).

33. The three dimensions of situational control identified by Fiedler include all of the following except: a. leader-employee relations b. position or legitimate power c. role expectations d. task structure

33. C-- Fiedler's Contingency Model states leaders have a dominant leadership style that is resistant to change and distinguishes between two types of leaders - high LPC leaders (person-oriented, more focused on maintaining good interpersonal relationships) and low LPC leaders (task-oriented, more focused on successful task performance). Changes in the structure of the situation can improve the chances of success as the leader's success is contingent on the situation, task to be completed, leader's style or personality, and the maturity of the group. Fielder proposes task-oriented (low-LPC) leaders are most effective when the leader has either low or high situational control and person-oriented (high-LPC leaders) are most effective when situational control is moderate. According to Fielder, situational control is determined by: leader-member relations, task-structure, and leader position power.

34. The behavior therapy technique for reducing arousal to inappropriate stimuli by first masturbating to orgasm while imagining appropriate stimuli and then continuing to masturbate while fantasizing about paraphilic images after orgasm is called: a. Orgasmic Reconditioning b. Satiation Therapy c. Systematic Desensitization d. Aversive Conditioning

34. B-- When treating individuals with paraphilias, behavior therapies are used based on the reasoning that maladaptive behavior has been learned and can therefore be unlearned. Orgasmic reconditioning (a.) instructs a client to begin masturbating while fantasizing about the inappropriate stimulus then switch from the paraphilic to more appropriate fantasies at the moment of masturbatory orgasm. Systematic desensitization (c.) pairs slow, systematic exposure to anxiety-inducing situations with relaxation training. Aversive conditioning (d.) substitutes a negative response for a positive response to inappropriate stimuli such as through pairing paraphilic urges with negative experiences, for example electric shocks or unpleasant odors.

35. A psychologist sees clients at a facility where fees are capitated. What does this mean? a. providers are paid a fee each time a service is performed b. clients are billed according to their ability to pay c. clients are required to meet a deductible before their insurance will pay d. providers receive a fixed dollar amount over a specific period of time to cover the service needs of a fixed number of clients

35. D-- The term "capitation" refers to a fixed amount of money paid per person, not by the visit or procedure. Managed care companies usually express capitation in terms of cost per member per month. As stated in response "D," providers are paid a specific dollar amount, for a specific time period, to cover the service needs of a specific number of people. If a provider exceeds his or her capitated payment, he or she may not be able to cover his or her costs and, consequently, may limit his or her services

36. Which of the following is not a characteristic of Western culture-bound values? a. cause-effect approach b. openness and intimacy c. clear distinction between mental and physical well-being d. strict adherence to a schedule

36. D-- Sue and Sue (1999) described three premises from the Western perspectives of counseling, based on the assumption of individualism, that can have an effect on the therapeutic relationship. They are identified as class-bound values, culture-bound values and language variables. Class-bound values include valuing of time boundaries or a strict adherence to time schedules, an ambiguous and unstructured approach to problem solving, and the emphasis on long- range goals and solutions. Culture-bound values focus on individualism versus collectivism, cause and effect relationships for client problems (a.), emphasis on emotional/verbal expressiveness, active participation and openness to discussing intimate aspects of the client's life (b.), and the separation of physical and mental well-being (c.). Language variables are those in which standard English and verbal communication are stressed.

37. A psychology program requires its students to attend group therapy. This is permissible if: a. the therapy is only provided by the program's faculty b. the students are given the option of obtaining individual therapy in lieu of group therapy c. the program does not require approval of the therapist's credentials d. the students are given the option of receiving therapy from therapists not affiliated with the program

37. D-- APA's 2002 Ethics Standard 7.05 permits undergraduate and graduate programs to have individual or group therapy as a program or course requirement. However, the students must be allowed "the option of selecting such therapy from practitioners unaffiliated with the program." Contrary to C, programs are not prohibited from approving credentials of the outside therapist.

38. When an animal's normal response rate is restricted, that behavior becomes more preferred and therefore reinforcing. This is a description of: a. probability-differential theory b. response deprivation theory c. matching law d. maximizing law

38. B-- All of the response choices are explanations or theories of operant/instrumental conditioning. Timberlake and Allison's response deprivation theory proposes when an animal's normal response rate (e.g., eating food) is restricted (e.g., by food deprivation), that behavior becomes more preferred and therefore reinforcing. The probability-differential theory (a.), also known as the Premack Principle, claims that an activity will have reinforcing properties when its probability of occurrence is greater than that of the behavior it is intended to reinforce. Herrnstein's matching law (c.), based on economic principles of costs and rewards, predicts that when an animal can choose from two or more simultaneously available reinforcement contingencies, that responding to each contingency will be proportional to the reinforcement on each schedule. In contrast, the maximizing law (d) proposes an animal will respond in a manner to achieve the maximum rate/number of rewards possible.

39. The acronym BASIC I.D is associated with: a. Frankl b. Lazarus c. Prochaska and DiClemente d. Beutler

39. B-- Lazarus' MultiModal Therapy (MMT), Beutler's eclectic psychotherapy and Prochaska and DiClemente's transtheoretical or Stages of Change theory (c.) are eclectic models that integrate interventions from various theories of psychotherapy. According to Lazarus' MMT, the acronym BASIC ID represents the categories of interrelated aspects of personality which need to be addressed for effective treatment: behavior, affect, sensation, imagery, cognition, interpersonal relationships, and the need for drugs or other biological functioning. Technically eclectic and theoretically drawing mainly from a broad-based social and cognitive learning theory, multimodal therapy is essentially psychoeducational, contends that many problems arise from misinformation and missing information and focuses on results or outcomes. In addition to use of a range of techniques, multimodal clinicians tailor treatment to meet the individual client's needs (i.e., different relationship styles, individual, couples or group therapy) holding that "the correct method delivered within and geared to the context of the client's interpersonal expectancies, will augment treatment adherence and enhance therapeutic outcomes." (See: Lazarus, A. A. (2006). Multimodal therapy: A seven-point integration. In G. Stricker & J. Gold (Eds.). A casebook of psychotherapy integration. Washington, DC: APA Books.) Beutler's eclectic psychotherapy (d.) is based on the paradigm of specific treatments for specific conditions and that the therapist, therapist-client relationship and interactions variables are more important than specific techniques. Frankl's Logotherapy (a.), is a distinct branch of humanistic/existential psychotherapy and consists of three cornerstones: freedom of will, will to meaning and the meaning of life (Frankl 1967, 1986). These are also the cornerstones of existential analysis which refers to the analytical therapeutic process involved in addressing an individual's spiritual and existential needs. Logotherapy states the primary motivational force in human beings is the search for a meaning in life. (See: Frankl, V. E. (1986). The doctor and the soul: From psychotherapy to logotherapy (Revised and expanded). New York: Vintage Books.)

40. An adult who positively describes his childhood relationship with his parents but his childhood memories either do not support or contradict the positive description would most likely be categorized as _____________ on the Adult Attachment Interview. a. autonomous b. avoidant c. preoccupied d. dismissing

40. D-- The Adult Attachment Interview (AAI) assesses an individual's childhood relationships with his or her mother and father and classifies the individual's attachment style as autonomous, preoccupied, or dismissing. Individuals presenting inconsistent and incoherent descriptions of their childhood relationships with parents are categorized as dismissing. Examinees that supply coherent descriptions of their childhood relationships categorized as autonomous (a.) and individuals who may be preoccupied with a parent and become very confused or angry when describing their childhood relationships with parents are classified as preoccupied.

41. Which of the following disorders is associated with individuals having amyloid plaques and neurofibrillary tangles and in some cases when advanced, dementia? a. Multiple sclerosis b. Parkinson's disease c. Lewy body dementia d. Niemann-Pick disease

41. B-- Although Parkinson's disease is primarily a movement disorder, many individuals with the disease also have amyloid plaques and neurofibrillary tangles like those found in Alzheimer's Disease (AD) and some develop symptoms of dementia when the disease is advanced. It is unknown if Parkinson's and AD may be related in a yet-unknown way or simply coexist in some people. Lewy body dementia (LBD) (c.) is one of the most common types of progressive dementia. In LBD, cells die in the brain's cortex and the substantia nigra with many of the remaining nerve cells containing abnormal structures called Lewy bodies that are the hallmark of the disease. LBD usually occurs sporadically and individuals with LBD live an average of 7 years after symptoms begin. Symptoms include memory impairment, poor judgment, confusion, visual hallucinations, parkinsonian symptoms such as a shuffling gait and flexed posture, and day-to-day fluctuations in the severity of symptoms. Lewy bodies are often found in the brains of people with Parkinson's and AD, suggesting that LBD may be linked with the two or the diseases may sometimes coexist in the same person. Niemann-Pick disease (d.) is a group of inherited disorders that affect metabolism. Individuals with Niemann-Pick disease cannot properly metabolize cholesterol and other lipids so excessive amounts of cholesterol accumulate in the liver and spleen and excessive amounts of other lipids accumulate in the brain. These diseases usually begin in young school-age children but may also appear during the teen years or early adulthood. Symptoms may include dementia, confusion, and problems with learning and memory.

42. A managed care company asks a psychologist to conduct a study on the relative effectiveness of a 10-week therapy program for depression vs. a 20-week therapy program. The company plans to publish the results of the research if no significant difference is found but will not publish the results if the longer therapy program is more effective. The psychologist should: a. agree to conduct the study because it is within the company's rights to publish or not publish their research findings b. agree to conduct the study if the psychologist is able to approve any article submitted for publication c. agree to conduct the study only if all research participants are appropriately debriefed at the conclusion of the study d. refuse to conduct the study

42. D-- Ethical Standard 5.01 states, "Psychologists do not knowingly make public statements that are false, deceptive, or fraudulent, concerning their research, practice, or other work activities or those of persons or organizations with which they are affiliated." Although in this case the psychologist is asked not to publish data, this would still be deceptive. It also is inconsistent with General Principle A of the Ethics Code which states that, "psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons.... Because psychologists' scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, financial, social, organizational, or political factors that might lead to misuse of their influence."

43. Tumors, head injuries, viral infection, vascular or other neurological disorders that damage the medial temporal region of the brain affect: a. retrograde and anterograde memory b. retrograde memory and general intellectual abilities c. anterograde memory and general intellectual abilities d. retrograde and anterograde memory and general intellectual abilities

43. A-- Neurological disorders that damage the medial temporal region can cause organic amnesia. In organic amnesia, anterograde amnesia (an impaired ability to form new permanent memories) is often the outstanding cognitive impairment, though retrograde amnesia (impairment of memory for events that occurred before the onset of amnesia) can also occur. Despite the severe impairment in new learning ability, general intellectual or language abilities and short-term memory are generally intact.

54. One commonality between Skinner and Freud is a(n) _______ view of behavior. a. deterministic b. holistic c. phenomenological d. adaptive

A-- Freud and Skinner differ on almost every dimension, with their main difference involving the origin of causation however they have a commonality in their reliance on determinism. Skinner maintained that all behavior is environmentally controlled through reinforcement contingencies, whereas Freud contended the primary cause of behavior is internal, unconscious mental mechanisms or psychic determinism.

46. A person calls into a radio talk show psychic, hears the psychic's reading and says "that is exactly my situation." This is NOT an example of: a. subjective validation b. functional fixedness c. the Barnum effect d. the Forer effect

46. B-- Functional fixedness refers to the tendency to think of objects only in terms of their usual functions. Subjective validation (a.) is the process of validating words, initials, statements or signs as accurate because one is able to find them personally meaningful and significant. The other two response choices are frequently used interchangeably to describe the tendency of people to accept vague and general personality descriptions as uniquely applicable to themselves without realizing that the same description could be applied to just about anyone. Specifically, the Barnum effect (c.) is the name given to a type of subjective validation in which a person finds personal meaning in statements that could apply to many people; and the Forer effect (d.) refers to the tendency of people to rate such statements as highly accurate for them personally. (See: Dickson, D.H., & Kelly, I.W. (1985) "The 'Barnum effect' in personality assessment: A review of the literature," Psychological Reports, 57, 367-382. and Forer, B.R. (1949) "The fallacy of personal validation: A classroom demonstration of gullibility," Journal of Abnormal Psychology, 44, 118-121.)

5. Research utilizing functional brain imaging techniques has shown a biological basis for Attention Deficit/Hyperactivity Disorder (ADHD) and has linked it to abnormalities in the following brain structures: a. parietal lobe, hypothalamus, and corpus callosum b. parietal lobe, striatum, and amygdale c. frontal lobe, thalamus, and amygdale d. frontal lobe, striatum, and cerebellum

5. D-- Recent research has established a biological basis for Attention Deficit/Hyperactivity Disorder (ADHD) with abnormalities in the right frontal lobe, striatum, and cerebellum most consistently implicated in this disorder. Other areas of the brain, including certain regions of the parietal lobe, have been linked to ADHD to a lesser extent. Using the core symptoms of ADHD and functions of the major brain structures, you may have determined the frontal lobes (mediates higher-order functions), the striatum (part of the basal ganglia and composed of the caudate nucleus and the putamen) and cerebellum (involved in motor activity) are the areas linked to this disorder. (See: J. Giedd et al., Brain imaging of attention deficit/hyperactivity disorder, Annals of New York Academy of Sciences, 2001, 931, 33-49.)

6. In a meta-analysis of the relationship between self-efficacy beliefs and achievement outcomes, Stajkovic and Luthans (1998) found self-efficacy was positively and strongly related to work-related performance and: a. the relationship between self-efficacy and work-related performance is moderated by task complexity b. the relationship between self-efficacy and work-related performance is moderated by locus of performance c. the relationship between self-efficacy and work-related performance is moderated by task complexity and locus of performance d. the relationship between self-efficacy and work-related performance is not influenced by task complexity or locus of performance

6. C-- The results of Stajkovic and Luthans' meta-analysis found self-efficacy positively related to work-related performance and that the relationship is moderated by task complexity and situational factors present in work environments. The two moderators appear to weaken the relationship between self-efficacy and work-related performance, with the relationship weakest for the higher levels of task complexity and field settings. Situational factors and organizational practices identified as influences on the relationship between self-efficacy and performance include: accuracy of task descriptions, definitions and circumstances of the tasks; instruction on necessary technical means and how to use them for successful task performance; physical distractions in the work environment; training programs that enhance employees self-efficacy beliefs of what they can do with the skills they already possess; developing effective behavioral and cognitive coping strategies, becoming more task-diagnostic, conceptualizing ability as an incremental skill; timing of program implementation; clarity and objectivity of performance standards; and personal consequences contingent on performance. (See: Stajkovic, A. D., & Luthans, F. (1998). Self-efficacy and work-related performances: A meta-analysis. Psychological Bulletin, 124, 240-261.)

61. A client presents as cool, calm, and collected however has an underlying rage and by the end of the session, the therapist feels angry. This is an example of: a. parallel process. b. projective identification. c. introjection. d. diagnostic overshadowing.

61. B-- Projective identification is a defense mechanism in which one or more parts of the self are falsely attributed to another, which are then unconsciously accepted by the recipient, and the projector then identifies with the projected part in the other. Recreating the supervisee-client relationship in the supervisee-supervisor relationship through a combination of transference, countertransference, and projection is referred to as parallel process (a.). Introjection (c.) involves absorbing the values or behaviors of others, including the larger society, without really understanding or assimilating those values or behaviors. Introjection represents a disturbance in the boundary between self and others — the person does or believes things that are not reflective of a self that is clearly distinct from others in the environment. Diagnostic overshadowing (d.) refers to the tendency to attribute all of a client's emotional, behavioral, and social problems to one salient characteristic instead of considering other, alternative explanations.

62. Sibling relationships during preadolescence are most likely to be characterized by: a. competitiveness and cooperation. b. detachment and distance. c. closeness and conflict. d. hostility and conflict.

62. C-- Research indicates sibling relationships often involve both positive and negative aspects or contradictions however closeness and conflict seems to be particularly characteristic of sibling relationships during preadolescence.

63. According to the National Comorbidity Survey (NCS) findings, the median delay in getting treatment across all psychological disorders is approximately: a. a year b. 2-3 years c. 6-7 years d. a decade

63. D-- D. R.C. Kessler and colleagues surveyed 9,282 English-speaking respondents, aged 18 and older, to estimate "the severity and persistence of mental disorders, and the degree to which they impair individuals and families, and burden employers and the U.S. economy." Results from the National Comorbidity Survey Replication (2005) indicate: half of all lifetime cases of mental illness start by age 14; at some point in their life, approximately half of Americans will meet the criteria for a DSM-IV disorder; a relatively small proportion of cases are serious cases with high comorbidity; 60 percent of those with a psychological disorder got no treatment at all over a 12 month period and the median delay in getting treatment across all mental disorders is nearly a decade. (See: Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 62(6), 593-602.)

64. In some plagiarism cases, writers may be using what they perceive to be their original ideas, consequently failing to credit the ideas to the proper source, while they are actually retrieved thoughts from memory. This is an example of a phenomenon known as: a. source amnesia b. source misattribution c. cryptomnesia d. false fame effect

64. C-- There are several reasons for errors in memory. Source misattributions (b.) occur when individuals misremember the time, place, person, or circumstances involved with a memory. Cryptomnesia (c.) is an example which occurs when a person perceives the recovery of information from memory as being an original idea of their own. Another example of source misattribution is the false fame effect (d.) in which subjects remembered the names but could not recall where they had encountered the names so they concluded that the individuals were famous. Source amnesia (a.) is an episodic memory disorder where source or contextual information surrounding facts are severely distorted and/or unable to be recalled. An individual remembers some factual information, yet forgets the contextual information related to the fact such as when, where, and with whom the fact was learned.

65. Recent findings indicate there is a type of cells in the premotor cortex which are activated when a person executes object-directed actions of a certain general type, and when the individual sees another individual performing actions of the same type. These cells are called: a. imitation neurons b. experiential neurons c. mirror neurons d. simulation neurons

65. C-- Mirror neurons are a class of neurons that are activated by action observation, or when an individual witnesses actions performed by others (e.g., observing someone being hit by a ball), the individual's brain simulates as if it is performing the same specific actions (e.g., being hit by a ball). This experiential insight or "gut-feeling" is proposed to be due to neural underpinnings. Specifically, an embodied simulation - which is an unconscious, automatic, and pre-reflexive functional mechanism for the modeling of objects, agents, and events. Action observation differs from motor imagery. In motor imagery, an internal event or deliberate act of will triggers the simulation process, whereas in action observation it is an external event. While there are different patterns of brain activation, there is a commonality in the activation of parietal and premotor cortical networks in both simulations of action. Current research is investigating the role the mirror neuron system plays in empathy, Autism and Schizophrenia. (See: Gallese, V. and Goldman, A. (1998). Mirror neurons and the simulation theory of mind-reading. Trends in Cognitive Sciences, 12, 493-501. and Rizzolatti, G., Fadiga, L., Gallese, V. and Fogassi, L. (1996). Premotor cortex and the recognition of motor actions. Cognitive Brain Research, 3, 131-141. and Rizzolatti, G. and Craighero, L. (2004). The mirror neuron system. Annual Review of Neuroscience, 27, 169-192.)

66. The findings from longitudinal research on divorce risk factors by John M. Gottman and his colleagues indicate: a. suppression of negative affect is associated with a high risk of divorce b. suppression of negative and positive affect is associated with a high risk of early divorce c. criticism, defensiveness, contempt and stonewalling predicts a high risk of early divorce d. criticism, defensiveness, contempt and stonewalling predicts a high risk of later divorce

66. C-- Longitudinal research by John M. Gottman and his colleagues investigated the interactions between married couples that predict divorce. The results indicated a combination of criticism, defensiveness, contempt and stonewalling, referred to as the "four horseman of the Apocalypse," is associated with a high risk for early divorce. This is considered to be the first seven years of marriage, which is when half of all divorces are known to occur. The suppression of affect, both positive and negative, is predictive of later divorce or the period during which the first child reaches 14 years of age. (See: Gottman, J.M. & Levenson, R.W. (2000). The Timing of Divorce: Predicting When a Couple Will Divorce Over a 14-Year Period. Journal of Marriage and the Family, 62, 737-745.)

68. At the beginning of group therapy, all members signed a contract to maintain confidentiality. If one of the members breaks confidentiality it is: a. an ethical violation b. a legal violation c. a moral violation d. an ethical, moral and possible legal violation

68. C-- In the context of group therapy, a moral responsibility to respect confidentiality extends beyond the therapist to each group participant. However, while there may be a moral obligation to maintain confidentiality, there isn't an ethically enforceable obligation. The Ethics Code, Standard 4.02, addresses the limitations of confidentiality and Standard 10.01, Informed Consent in Therapy, addresses the need to discuss the limits of confidentiality at the beginning of (group) therapy. In group work agreements, therapists clearly define confidentiality and the parameters for the specific group being entered, explain the importance, and discuss the difficulties related to confidentiality involved in group therapy. Since confidentiality cannot be guaranteed by the therapist, group members have provided "implied consent" to the release of the information by voluntarily agreeing to participate. In most states, group members are not legally obligated to maintain confidences.

69. The misinformation effect refers to the impairment in memory for the past that occurs after exposure to misleading information. Research on susceptibility and resistance to this effect has found: a. the impairing effect of misleading information gets weaker over time b. subjects misled just before testing tend to perform better than those who are misled just after witnessing the event c. warnings about potential misinformation may inhibit its impairing effect d. the passage of time appears to increase discrepancy detection ability

69. C-- According to Loftus' Discrepancy Detection principle, susceptibility to misinformation is inversely related to the ability to notice discrepancies. Therefore, if an individual is aware that post-event information may not be correct then the probability of the misinformation effect is reduced. Warning individuals before they receive post-event information that it might be inaccurate or misleading, increases vigilance and the likelihood that discrepancies between actual and suggested events will be spotted. Resistance to post-event suggestion is greatest when an individual has a strong, accurate original memory. Consistent information also improves memory performance. Research indicates greater susceptibility to misinformation is associated with: the passage of time, it lowers discrepancy detection ability (d.) and the impairing effect of misleading information gets stronger over time (a.); longer retention times, which decrease memory performance; timing of reporting/testing, individuals misled immediately before being tested tend to perform worse than those misled immediately after witnessing the event (b.). Age is also associated with varying susceptibility to misinformation with young children more susceptible than older children and adults and the elderly more susceptible than are younger adults. (See: Loftus, E. (2005). Planting misinformation in the human mind: A 30-year investigation of the malleability of memory. Learning and Memory; 12, 361-366.)

7. A 38 year-old woman is dependent on the prescription pain medications oxycodone and hydrocodone. She is referred to a physician's office for medication-assisted treatment of her opioid addiction. Which of the following is most likely to be administered in the induction phase of treatment? a. methadone b. buprenorphine c. naltrexone d. LAAM (1-alpha-acetyl-methadol)

7. B-- The Drug Treatment Act of 2000 allows doctors to treat opioid dependence in their practices with FDA-approved opioid medication. In 2002, the FDA approved two medications for use in opioid addiction treatment: buprenorphine monotherapy (Subutex) and a buprenorphine/naloxone combination (Suboxone). Buprenorphine, an opioid partial agonist, activates receptors to a lesser degree than full agonists (i.e., morphine and heroin) and its effects reach a ceiling effect at moderate doses - not increasing, even with increases in dosage. At low doses, it has enough agonist effect to enable opioid-addicted individuals to discontinue misuse of opioids without experiencing withdrawal symptoms. Under certain circumstances and in high doses, it can block the effects of full opioid agonists and precipitate opioid withdrawal syndrome like an opioid antagonist. Buprenorphine carries a lower risk of abuse, addiction, and side effects than full agonists. Subutex (buprenorphine) is more often used at the beginning of treatment and withdrawal syndrome can be precipitated in individuals maintained on it. Suboxone, containing the opioid antagonist naloxone, (c.) was designed to decrease the potential for abuse by injection and is more often used in maintenance treatment of opiate addiction. Both methadone (a.) and LAAM (l-alpha-acetyl-methadol) (d.) are effectively used to treat opioid addiction however they are not available in practice settings other than Opioid Treatment Programs (OTPs) (i.e., methadone clinics). (See: Kissin, W., McLeod, C., Sonnefeld, J., & Stanton, A. (in press). Experiences of a national sample of qualified addictions specialists who have and have not prescribed buprenorphine for opioid dependence. Journal of Addictive Diseases. http://buprenorphine.samhsa.gov/index.html)

70. Research on gender differences in judgments of sexual harassment indicate: a. men and women are equally as likely to judge a sexually-toned behavior as sexual harassment regardless of the severity of the behaviors. b. men and women are equally as likely to judge a sexually-toned behavior as sexual harassment but only in severe cases. c. men are more likely than women to judge a sexually-toned behavior as sexual harassment but only in severe cases. d. women are more likely than men to judge a sexually-toned behavior as sexual harassment regardless of the severity of the behaviors.

70. B-- Sexual harassment research has consistently found that males and females are equally as likely to judge a sexually-toned behavior as sexual harassment in severe cases; however, there are significant gender differences in judgments in mild to moderate cases of harassment. Studies have continually found females are more likely than males to rate mild to moderately severe or sexually-ambiguous behaviors as constituting sexual harassment. (See: C. W. Williams et al., An attributional (causal dimensional) analysis of perceptions of sexual harassment, Journal of Applied Social Psychology, 1995, 25, 1169-1183.)

71. The responses of interviewees, when using a structured interview, are evaluated by: a. interviewer subjectivity b. "utility analysis" c. pre-specified criteria d. "subject matter experts" consensus

71. C-- In a structured interview, a series of job-related questions with predetermined "correct" answers are used consistently with all interviewees for a particular job. An advantage of this technique is the provision of individual item scores and a total score that are derived from prespecified criteria. To predict job performance, the interview score can then be combined with scores on other selection procedures in a multiple regression equation or similar technique. Another advantage of the structured interview is that it reduces the impact of interviewer subjectivity (a.). A utility analysis (b.) considers the procedure's validity coefficient, employee job performance variability (typically in dollar value of output or mean output), and the selection ratio to evaluate the practical value of a selection procedure. Subject matter experts (d.) are one of several methods for determining scores to responses to a structured interview.

73. When performing cognitive tests, most older adults are able to best perform at what time of day: a. morning b. early afternoon c. late afternoon d. evening

73. A-- May and Hasher (1998) referred to the beneficial effect of matching task demands and preferred time of day as the "synchrony effect." Acknowledging age and individual differences in arousal patterns, research has found there are large differences in circadian cycles between young and older adults. The optimal time of day for successful completion of certain cognitive tasks for young children and individuals in late adulthood is primarily morning. There appears to be a shift beginning about the age of 12 away from morningness towards the peak arousal and task performance levels for young adults to the evening. Eventually, the life-span trend for time of day preference appears to come full circle. The research shows that synchrony between individual preferences and the time of testing is a powerful effect and that only highly practiced responses are invariant across the day - all others are affected. It is noted that attentional regulation over both incoming information and outgoing responses are particularly vulnerable to time of day effects. (See: May, C. P., & Hasher, L. (1998). Synchrony effects in inhibitory control over thought and action. Journal of Experimental Psychology: Human Perception and Performance, 24(2), 363-379. See: Hasher, L., Goldstein D., & May, C.P. (in press). It's about time: Circadian rhythms, memory and aging. In C. Izawa & N. Ohta (Eds.), Human learning and memory: Advances in theory and application. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.)

74. Different regression line slopes in a scatterplot suggests: a. differential validity b. a lack of factorial validity c. divergent validity d. a lack of convergent validity

74. A-- The slope of a regression line for a test is directly related to the test's criterion-related validity: The steeper the slope, the greater the validity. A test has differential validity when it has different validity coefficients for different groups, which is what is suggested by different regression line slopes in a scatterplot. Factorial validity (a.) refers to the extent a test or test item correlates with factors expected to be correlated with in a factor analysis. The extent a test does not correlate with measures of an unrelated construct is referred to as divergent validity (c.). Convergent validity (d.) refers to the degree a test correlates with measures of the same or a similar construct.

76. Cultural differences and factors have an influence on the manifestation of client symptoms. If a psychologist assumes an Asian client's somatic complaints are really reflective of a mental disorder it is an example of: a. demand characteristics b. diagnostic overshadowing c. the fundamental attribution bias d. self-perception bias

76. B-- Diagnostic overshadowing is a term to describe when a therapist's ability to recognize or consider other symptoms or conditions is "overshadowed" by one aspect of a client's symptoms or condition. Demand characteristics (a.) are unintentional cues in the experimental environment or manipulation that allow participants to guess the hypothesis and, as a result, participants may behave differently than they would under normal conditions. The fundamental attribution bias (c.) refers to the tendency to overestimate dispositional (personality) factors and underestimate situational factors in explaining the behavior of others. Self-perception bias (d.) refers to an individual inferring what their internal state is by perceiving how they are acting in a given situation.

77. Which of the following have NOT been associated with higher levels of sexual prejudice according to findings on heterosexuals' attitudes toward gays and lesbians? a. younger age b. male gender c. authoritarianism d. fundamentalist religious views

77. A-- Studies on heterosexuals attitudes toward gay and lesbians indicate that older age is predictive of higher levels of sexual prejudice along with high levels of authoritarianism (c.), fundamentalist religious views (d.) and male gender, especially toward gays (versus lesbians). (See: Herek, G. M. (2000). The psychology of sexual prejudice, Current directions in psychological science, 9(1), 19-22.)

78. Lewinsohn's behavioral model hypothesized depression is the result of: a. a distorted perception of reality b. low self-esteem and pessimism c. a high rate of response-contingent punishment d. a low rate of response-contingent reinforcement

78. D-- Based on operant conditioning, Lewinsohn's theory proposes depression is associated with a low rate of response-contingent positive reinforcement. A low rate of reinforcement results in a low rate of social and other behaviors due to a lack of reinforcement which essentially extinguishes the contingent behaviors. The model also proposes the low rate of reinforcement elicits depressive behaviors, such as dysphoria, fatigue, and other somatic symptoms as well as cognitive symptoms such as low self -esteem, pessimism, and feelings of guilt. (See: Lewinsohn, P. M. (1974). A behavioral approach to depression. In R. J. Friedman & M. M. Katz (Eds.), Psychology of depression: Contemporary theory and research (pp. 157-178). Oxford, England: John Wiley & Sons.)

79. Fetal alcohol spectrum disorders (FASDs) is a term used: a. for clinical diagnosis of prenatal alcohol exposure b. to describe the differentiation of effects between fetal alcohol syndrome and fetal alcohol effects c. to describe the range of effects from prenatal alcohol exposure for conditions that have some but not all of the clinical signs of fetal alcohol syndrome (FAS) d. to describe the range of effects from prenatal alcohol exposure

79. D-- Fetal alcohol spectrum disorders (FASDs) is an umbrella term describing the range of effects that can occur in an individual exposed to alcohol during pregnancy including physical, mental, behavioral effects, and/or learning disabilities. FASDs include FAS as well as other conditions in which individuals have some, but not all, of the clinical signs of FAS (c.). The term FAE has been used to describe behavioral and cognitive problems in children who were exposed to alcohol prenatally, but who do not have all of the diagnostic features of FAS. In 1996, the Institute of Medicine (IOM) replaced FAE with the terms alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD). ARND describes the mental and behavioral impairments such as learning disabilities, poor school performance, poor impulse control, and problems with memory, attention and/or judgment. ARBD describes the malformations of the skeletal system and major organ systems such as defects of the heart, kidneys, bones, and/or auditory system. The term FASDs is not intended for use as a clinical diagnosis (a.).

8. A therapist is working with a newly arrived refugee client about her difficulties in acculturation. The therapist does not have firsthand experience as a refugee or immigrant, however, knows what it is like to move from one city to another, transfer employment, lose work, and experience the loss of family or friends. That the therapist is able to understand, accept, and feel the client's situation, while simultaneously maintaining a separate sense of cultural self is an example of: a. cultural encapsulation b. cultural universality c. active empathy d. cultural empathy

8. D-- Cultural empathy means a therapist understands and appreciates cultural differences in a way that extends the boundaries of traditional empathy, retaining his or her separate cultural identity while simultaneously aware of and accepting the cultural values and beliefs of the client. It is a way of relating interpersonally with the ability to accurately understand the experience of culturally diverse clients and the ability to communicate this understanding effectively with an attitude of concern across cultures. Cultural encapsulation (a.), according to Gilbert Wrenn (1962), refers to when a therapist defines reality according to one set of cultural assumptions, becomes insensitive to cultural variations, disregards evidence disproving their assumptions, depends on technique-oriented or quick-fix solutions to problems and judges others from their own self-reference criteria. Cultural universality (b.) refers to the assumption that Western concepts of normality and abnormality can be considered universal and equally applicable across all cultures. Active empathy (c.) refers to when therapists actively communicate appreciation about all aspects of clients' lives.

80. The extinction of responding to one cue results in an increase in responding to the other is a phenomenon known as: a. cue deflation b. overshadowing c. potentiation d. backward blocking

80. A-- The cue deflation effect happens when the extinction of a response to one cue leads to an increased reaction to the other conditioned stimulus (CS). It sometimes occurs in a situation where two simultaneous CSs of different salience are paired with an UCS. The extinction of responding to the more salient (overshadowing) CS sometimes produces increased CR strength to the less salient CS. Overshadowing (b.) is when two CSs are presented simultaneously and followed by an UCS, the more salient CS is more strongly conditioned than the less salient. In contrast, potentiation refers to when the salient CS enhances the conditioning of the less salient CS. In backward blocking, a conditioned response to the second stimulus is reduced. Two CSs are simultaneously paired with an UCS and then only one of those CSs continues to be paired with the UCS.

81. Which of the following is NOT one of Baumgartner's incorporation phases of an HIV/AIDS diagnosis into identity? a. post-immersion turning point b. post-diagnosis turning point c. disclosure d. stabilization

81. D-- Informed by narrative and transformational learning approaches to identity development, Lisa Baumgartner's study (2001) on the incorporation of an HIV/AIDS diagnosis into one's identity identified a six-phase process including: diagnosis, post-diagnosis turning point, immersion, post-immersion turning point, integration and disclosure. The diagnosis phase involved the common reactions of shock, fear, denial, and relief. Post-diagnosis turning point (b.) was associated with social interaction or a "catalyst experience." In the immersion phase, people became immersed in the HIV/AIDS community; the HIV/AIDS identity was central and they educated others. Whereas the post-immersion turning point phase caused a revaluation of priorities. The integration phase was associated with decentralizing (internal experience of the HIV/AIDS identity) and balancing, such as engaging in activities unrelated to HIV/AIDS. Disclosure was woven throughout the process however initially individuals only told significant others, then made public disclosures, and finally made situational disclosures on a need-to-know basis. (See: Baumgartner, L. M. (2002) Living and Learning with HIV/AIDS: Transformational Tales Continued. Adult Education Quarterly, Vol. 53, No. 1, 44-59.)

82. Which of the following best describes a DSM-IV-TR diagnostic criterion for delirium? a. clouding of consciousness b. impaired memory c. executive functioning deficits d. emotional lability

82. A-- Clouding of consciousness is often used to describe a disturbance in consciousness which is a diagnostic criterion for delirium. The diagnosis of delirium requires a disturbance in consciousness that cannot be better accounted for by dementia along with a change in cognition or the presence of perceptual abnormalities (e.g., illusions or hallucinations). Memory disturbances (b.), especially an inability to form new memories, are common in delirium but are not required for the diagnosis. Impaired executive functioning (c.) is more characteristic of dementia than of delirium and not required for the diagnosis of delirium. Emotional lability (d.) or rapid and unpredictable shifts in emotions is not required for the diagnosis although is an associated feature of delirium.

83. National surveys comparing rural and urban areas rates of mental disorders indicate: a. prevalence rates are not statistically different b. prevalence rates are significantly higher in rural areas for most mental disorders c. prevalence rates are significantly higher in urban areas for most mental disorders d. prevalence rates are statistically different with some disorders more common in rural or urban areas

83. A-- While study to study reported rates of mental illness have varied somewhat, the most consistent finding is that there are few statistically significant differences in the rates of mental disorders in urban and rural areas. Epidemiological surveys like the National Comorbidity Survey, the Epidemiologic Catchment Area Study and a recent Healthcare for Communities (HCC) survey of 9,585 individuals living in rural and urban areas, found no significant differences in the prevalence of the major types of mental illness (See: Tang, L., et al., (2001), Report on the Survey Method for the Household Survey of Healthcare for Communities, 1997-1998, Los Angeles, Health Sciences Research Center, UCLA).

84. Michael has a high-pressure legal career that involves frequent altercations with opposing counsel and ongoing stress. He commonly reacts to the stress of anger by clenching his teeth and generally tensing up. His therapist suggests biofeedback and would most likely recommend which type of biofeedback? a. EDR b. EEG c. EMG d. HRV

84. C-- Biofeedback is the process of identifying physiological variables, or responses, for the purpose of helping an individual develop greater sensory awareness and is achieved by using electronic instrumentation to monitor responses then providing the information to the individual to improve their physiological control of responding. Electromyogram (EMG) biofeedback, measures impulses in the muscles and indicates the degree of relaxation or contraction/tension. It is commonly used for conditions such as stress, tension headaches, chronic pain, muscle stiffness, incontinence, urinary urgency and frequency, and when muscles are healing. Electrodermal response (EDR) biofeedback (a.), also referred to as galvinic skin response training (GSR), measures skin surface changes, giving feedback on the relation between emotional state and the activity of the sympathetic system via sweat gland activity, and is utilized for stress and hyperhidrosis (excessive sweating). Electroencephalogram (EEG) or neurofeedback (b.) provides information on brainwave activity and patterns. It is often used in the treatment of attention deficit hyperactivity disorder, depression, and epilepsy to improve attention, reduce impulsivity and promote recovery from head injuries and strokes. Heart rate variability (HRV), sometimes referred to as electrocardiogram (ECG), biofeedback (d.) monitors heart rate and cardiac reactivity from sensors placed on a person's fingers or wrist. It is useful for managing stress, high blood pressure, anxiety, and heartbeat irregularities. Other recognized types of biofeedback include: thermal or skin temperature (ST) biofeedback, which involves skin temperature and blood flow control; Respiratory Feedback (RFB), which involves control of breathing type and frequency; and Respiratory Sinus Arrhythmia (RSA); which involves the synchronous control of heart rate and respiration, in which there is a small rise in heart rate during inhalation and a corresponding decrease during exhalation. Depending on the reason for biofeedback, more than one type is often used. For example in this question, Michael might also use EDR to control his general stress response in addition to EMD to control the muscle tensing and teeth clenching responses. Behavioral skills training such as relaxation training, guided imagery and stress-coping techniques are also frequently used in addition to the actual biofeedback.

86. The APA's position on notification of partners of clients/patients with HIV/AIDS is consistent with its emphasis on: a. duty to protect b. confidentiality c. informed consent d. protection from civil or criminal liability

86. B-- The American Psychological Association's position on partner notification is consistent with the emphasis on maintaining client confidentiality. Specifically, it recommends "a legal duty to protect third parties from HIV infection should not be imposed." In its statement, Legal Liability Related to confidentiality and the Prevention of HIV Transmission, the APA (1991) also addresses the possibility of such legislation passing and recommends disclosure should be permitted only when (1) there is a known identifiable third party at significant risk for infection; (2) the third party is unaware of the risk; (3) the client has been urged to tell the partner and has refused to do so; and (4) the psychologist is protected legally from civil or criminal liability for disclosing.

87. A heuristic strategy that makes judgments only on the obvious characteristics of the problem, not requiring additional information and solves the problem based on the initial facts presented is: a. working backward. b. representativeness. c. means-end analysis. d. availability.

87. B-- Heuristics represent a "best guess" strategy to solving problems. They can involve a systematic evaluation of the problem or represent cognitive short-cuts for problem solving. While a solution is not guaranteed and errors can occur, heurustics can provide a solution in less time than algorithms. The working backward (a.) heuristic, commonly used in systems of formal logic, is a strategy that finds a solution by literally using the end point to suggest connections to the starting point. The means-end analysis (c.) divides a problem into a series of sub-problems, with solution of the sub-problems then leading to a solution to the entire problem. The availability (d.) heuristic uses information easily remembered or observed and solutions are based on the most recent information that can be brought to mind.

89. Stephanie was in a major auto accident and, as a result, is showing little brain activity and cannot live without the assistance of a respirator. After a year without any signs of improvement, Stephanie's parents decide to have the respirator turned off. Stephanie dies less than 2 days later. This is an example of: a. active euthanasia b. passive euthanasia c. voluntary euthanasia d. involuntary euthanasia

89. B-- Euthanasia is generally classified as "active" or "passive," and as either "voluntary" or "involuntary." The difference between "active" and "passive" euthanasia is that in passive euthanasia, something is not done that would have preserved the patient's life whereas in active euthanasia, something is done to end the patient's life. The classic example of passive euthanasia is a "do not resuscitate order." Another common method of euthanasia, which is also routinely considered passive euthanasia, is withholding food and fluids. Active euthanasia (a.) involves taking specific steps to cause the patient's death, such as injecting the patient with an overdose of pain-killers or sleeping pills. Voluntary euthanasia (c.) is when the patient requests that action be taken to end his life, or that life-saving treatment be stopped, with full knowledge that this will lead to his death. Involuntary euthanasia (d.) is when a patient's life is ended without the patient's knowledge and consent. In practice, this usually means that the patient is unconscious, unable to communicate, or is too sick and weak to be aware of what is happening or to take any action on his own behalf. Euthanasia differs from "assisted suicide." In assisted suicide, a patient is provided with the means to end his own life, but the provider does not administer it. For example, if a doctor gives an injection of morphine sufficient to cause a patient's death, this is euthanasia. However, if the doctor puts the hypodermic needle beside the patient's bed, explains what it is, and leaves, then later the patient injects himself, this is considered assisted suicide.

47. Chronic pain treatment with tricyclic antidepressants is most effective for: a. neuropathic pain and headaches b. neuropathic and musculoskeletal pain c. headaches and musculoskeletal pain d. neuropathic pain, headaches and musculoskeletal pain

A-- Chronic pain research estimates 50-90% of patients can be expected to achieve at least 50% pain relief with antidepressants, with others achieving less pain relief. Tricyclic antidepressants, such as amitriptyline (Elavil), have been found to be most effective particularly if the pain is neuropathic (pain in a numb area, burning or shooting pain) or one of the headache syndromes. SSRI antidepressants have also been found to be effective at preventing headaches, including migraines, but are considered less effective. It is theorized these medications may reduce migraines by affecting the level of serotonin and other brain chemicals. Individuals do not have to have depression to take and benefit from these drugs. A therapeutic trial of antidepressants may follow the failure of conventional analgesics or be used in addition to conventional analgesics. This can be particularly effective in cancer patients who have pain at multiple pain sites, some nociceptive and some neuropathic. (See: McQuay, H. J., Tramer, M., Nye, B.A., Carroll, D., Wiffen, P. J., Moore, R. A. (2000). A systematic review of antidepressants in neuropathic pain. Pain. 1996, 68(2-3), 217-227. and Barkin, R.L., Fawcett, J. (2000). The management challenges of chronic pain: the role of antidepressants. American Journal of Therapy, 7(1),31-47.)

51. Post-concussional syndrome (PCS): a. refers to somatic and psychological symptoms associated with head trauma. b. refers to somatic symptoms due to psychological factors following head trauma. c. is associated with cases of severe head trauma. d. is associated with poorer prognosis for full recovery.

A-- Post-concussional syndrome (PCS) refers to somatic and psychological symptoms associated with head trauma including dizziness, impaired memory and concentration, headache, fatigue, depression, irritability, visual impairment, and sleep disturbances. Symptoms of PCS are experienced by up to 50% of individuals with mild brain injury and it is rare in moderate to severe cases (c.). The majority of individuals with post-concussional syndrome fully recover with their symptoms resolving within three to six months of the trauma. Psychological and physiological factors appear to cause the symptoms of PCS and the associated deficits are often more serious than the individual realizes. Psychological factors include: premorbid personality characteristics, the subjective interpretation of the injury, access to social support and desire for secondary gain. (See: Ryan, L. M. & Warden, D.M. (2003). Post concussion syndrome, International Review of Psychiatry,15(4), 310-316.)

55. During the course of a research experiment, subjects witness someone who is apparently hurt, needing immediate help, and are unable to help or know if the person is assisted. The subjects become immediately distressed. In this situation: a. debriefing occurs at the conclusion of participation b. group debriefing occurs at the conclusion of collection of data c. debriefing occurs when subjects become distressed d. debriefing occurs at the conclusion of research

A-- This question involves deception in research, distress and debriefing. Due to the use of deception and the resultant participant distress, debriefing immediately following participation is the best option as described by Standard 8.07(c) Deception in Research: "Psychologists explain any deception that is an integral feature of the design and conduct of an experiment to participants as early as is feasible, preferably at the conclusion of their participation, but no later than at the conclusion of the data collection." The Ethics Code on Debriefing, Standard 8.08(a), notes, "Psychologists provide a prompt opportunity for participants to obtain appropriate information about the nature, results, and conclusions of the research, and they take reasonable steps to correct any misconceptions that participants may have of which the psychologists are aware," and in Standard 8.08(c) "When psychologists become aware that research procedures have harmed a participant, they take reasonable steps to minimize the harm."

60. Organizational justice research indicates: a. procedural justice is the best predictor of work performance and of counterproductive work behavior, but all justice forms are related to organizational citizenship behaviors. b. distributive justice is the best predictor of work performance and counterproductive work behavior, but all justice forms are related to organizational citizenship behaviors. c. procedural and distributive justice are the best predictors of work performance and counterproductive work behavior, but interactional justice is the best predictor of organizational citizenship behaviors. d. procedural and distributive justice are the best predictors of work performance, counterproductive work behavior, and organizational citizenship behaviors.

A-- While there is no current consensus over the dimensions of justice in the organizational justice literature, two meta-analyses that used three and four-construct concepts found overlapping results on justice dimensions that predicted different outcomes. Cohen-Charash & Spector (2001) used a three-construct concept (distributive, procedural, and interactional) of justice to investigate the role of justice in organization outcomes. (See: Cohen-Charash, Y. & Spector, P.E. (2001). The Role of Justice in Organizations: A Meta-Analysis. Organizational Behavior and Human Decision Processes, Vol 86; 2, November, 278-321.) Whereas Colquitt et al.'s (2001) meta-analysis reviewed 25 years of organizational justice research focusing on the operationalizations of justice using the dimensions of distributive, procedural, informational, and interpersonal justice. Despite the differences, results from both indicated procedural justice is the best predictor of work performance and counterproductive work behavior. Organizational citizenship behaviors were found to be related to all dimensions of justice in both studies and noted in Colquitt et al as support for interactional justice to be distinguished as two specific types of interpersonal treatment: interpersonal and informal justice. (See: Colquitt, J. A., Conlon, D. E., Wesson, W. J., Porter, C. O. L. H., & Ng, K. Y. (2001). Justice at the millennium: A meta-analytic review of 25 years of organizational justice research. Journal of Applied Psychology, 86, 425-445.)

57. In Gestalt therapy, introjection, projection, deflection, confluence and retroflection are examples of: a. layers of neurosis b. resistances to contact c. natural anxiety d. neurotic anxiety

B-- Gestalt therapy focuses on the "here and now" which encourages clients to gain awareness and full experiencing in the present. The term contact refers to interacting with nature and others without losing one's individuality. Resistances to contact are the defenses that one develops as a self-protective attempt to avoid the anxiety necessitated by change and prevents full experiencing in the present. The question lists the five defenses or types of resistance to contact. The five layers of neurosis (a.), proposed by Perls (1969) to describe the process of working through neurosis are: phony, phobic, impasse, and implosive, explosive. Neurotic anxiety (d.) is the result of not facing normal anxiety.

48. When trying to prove causation, a researcher mismatches levels of data and tries to apply statistics at one level to infer to data of another level. This is referred to as: a. tautology b. teleology c. ecological fallacy d. latent coding

C-- Ecological fallacy is a logic error that occurs when trying to prove causation, levels of data are mismatched and statistics are applied at one level to infer to data of another level. Tautology (a.) is a logic error based on circular reasoning, meaning that something is true by definition or the dependent variable is simply a restatement of the independent variable. Teleology (b.) is a logic error which explains a phenomenon by saying that it was some spirit or higher power that causes the relationship. Latent coding (d.) occurs when a researcher reads into the meaning of the content he/she is analyzing to get data rather than simply taking it at face value. This is in contrast to manifest coding which occurs in content analysis when coding content is based on the face-value rather than looking into the meaning.

50. When a child finds and uses clues from the context of a sentence to learn the meaning of a new word, this is referred to as: a. prosodic bootstrapping b. phonological bootstrapping c. syntactic bootstrapping d. semantic bootstrapping

C-- In the area of language development and acquisition, "bootstrapping" refers to how a child must somehow "lift him/herself up by his/her bootstraps" to begin formulating a grammar for the language. Syntactic bootstrapping proposes that the sentence structure surrounding a new word provides clues to its meaning and, in this case, the language-learning child uses his/her developed syntactic knowledge to help learn the meaning of new words. Semantic bootstrapping (d.) refers to the idea that children utilize conceptual knowledge to create grammatical categories. Under this approach, the meanings of words are used to identify the semantic category and then are inferred or "bootstrapped" to the syntax. Prosodic bootstrapping (a.) suggests children find and use clues to syntactic structure of language in the prosodic (intonation, stress) characteristics of the speech they hear. Phonological bootstrapping (b.) refers to the hypothesis that clues to the grammar of language are found in phonological (sound) properties of the speech heard. (See: Pinker, S. (1987). The Bootstrapping Problem in Language Acquisition. In B. MacWhinney (Ed.), Mechanisms of Language Acquisition. Hillsdale, NJ: Erlbaum. And: Weissenborn, J. & Hohle, B. (Eds.) (2001). Approaches to bootstrapping: Phonological, lexical, syntactic and neurophysiological aspects of early language acquisition. Amsterdam/Philadelphia: John Benjamins.)

56. To ensure that providers meet and maintain health plan participation requirements, managed care organizations (MCOs) use _____________________ as a review process. a. clinical audit b. concurrent review c. credentialing d. quality management

C-- The formal process for determining if a provider meets and maintains the standards of qualification, as well as providing some legal protection for the managed care organization, is referred to as credentialing. Clinical audit (response "A") is a quality assurance method. Concurrent review (response "B") describes the utilization review conducted during the course of treatment. Quality management (response "D") is another name for quality assurance.

53. Troiden's (1989) model of homosexual identity development indicates: a. females typically realize that they are homosexual at a younger age than males. b. females and males typically realize they are homosexual at about the same age. c. males typically begin to "come out" as homosexual at a younger age than females. d. males and females typically begin to "come out" as homosexual at about the same age.

C-- Troiden's model distinguishes between four age-related stages: sensitization, identity confusion (self-recognition), identity assumption, and identity commitment. Sensitization begins before puberty and consists of homosexual feelings or experiences without an understanding of them in terms of self-identity. Identity confusion, sometimes referred to as self-recognition, is when an individual realizes that he or she may be homosexual. This usually develops in adolescent males around 17 years and in females around 18 years of age. During identity assumption, the individual comes out as a homosexual - typically from 19-21 years for males and 21-23 for females. Identity commitment is characterized by the individual adopting a homosexual lifestyle - which usually occurs from 21-24 years for males and 22-23 for females.

49. According to Kohlberg, which of the following best describes moral reasoning and moral behavior: a. there is no relation between moral reasoning and moral action b. there is a positive relation between moral reasoning and moral action at all stages c. the strongest relation between moral reasoning and action is at the lower stages d. the strongest relation between moral reasoning and action is at the higher stages

D-- Kohlberg's stage theory of moral development focuses on moral judgment and makes a distinction between moral judgment and moral action. Moral development is said to be enhanced by social experiences that produce cognitive conflict and provide the individual with an opportunity to take the perspective of others. Kohlberg proposes the higher the moral reasoning, the more likely moral action is and the greater consistency is between moral judgment and action because the higher stages increasingly employ more stable and general standards. (See: Kohlberg, L., & Candee, D. (1984). The relation of moral judgment to moral action. In W. Kurtines & J. L. Gewirtz (Eds.), Morality, moral behavior and moral development: Basic issues in theory and research, 52-73. New York: Wiley Interscience.)