PSY366 Chapters 4 -5
Dr. Patel saw a patient who reported being victimized. The patient reported that he attempts to avoid reminders of the trauma and has intrusive thoughts, difficulty sleeping, gaps in memory, depression, and anxiety. He reports having difficulty working since the event. To determine the appropriate diagnosis, which question should Dr. Patel ask the patient? "How long have you had the symptoms?" "How have you been feeling?" "How distressing are your symptoms?" "Do you have trouble sleeping?"
"How long have you had the symptoms?"
Brandi has been diagnosed with social anxiety disorder, and she has certain beliefs about herself that are a part of her anxiety. According to cognitive theorists, which belief does Brandi NOT hold about herself? "If my social behavior is not perfect, terrible consequences will follow." "I must perform perfectly in social situations." "I am unattractive." "I am socially skilled, but no one notices."
"I am socially skilled, but no one notices."
Which is a basic irrational assumption held by sufferers of generalized anxiety disorder, according to Albert Ellis? "The world is safe until proven unsafe." "One should be thoroughly competent, adequate, and achieving in all possible respects if one is to be considered worthwhile." "All situations are seen as learning opportunities unless they are dangerous.'' "One should always look for the positives in all aspects of one's life."
"One should be thoroughly competent, adequate, and achieving in all possible respects if one is to be considered worthwhile."
In dissociative identity disorder, the average number of subpersonalities per patient is _____ for women and _____ for men. 8; 4 10; 5 15; 8 18; 8
15; 8
Around _____ percent of women who are exposed to a serious trauma may develop a stress disorder, compared to ______ percent of men
20; 8
What is the rate at which rape victims are MORE likely to abuse drugs? 3 times 6 times 13 times 26 times
26 times
According to the text, as many as _____ percent of all people develop obsessive-compulsive disorder at some point during their lives. 6 12 3 9
3
Surveys indicate that at least ________ percent of people in the United States experience one of the stress disorders in any given year.
3.5
It appears that between ___________ percent of torture victims develop PTSD.
30 and 50
Studies have shown that as many as _______ percent of victims of serious traffic accidents may develop PTSD within a year of the accident.
40
Of people with social anxiety disorder, _____ percent are women. 40 50 60 75
60
Studies indicate that as many as _______ percent of all cases of acute stress disorder develop into PTSD
80
In one study, ___________ percent of rape victims fully qualified for a clinical diagnosis of acute stress disorder when they were observed around 12 days after the assault.
94
Metacognitive theory, developed by _____, suggests that people with generalized anxiety disorder implicitly hold both positive and negative beliefs about worrying. Adrian Wells Carol Gilligan Albert Ellis Albert Bandura
Adrian Wells
_____ drugs are used to control the tension that many veterans experience. Antidepressants Antianxiety Mood stabilizers Antipsychotics
Antianxiety
___________ medications may reduce the occurrence of nightmares, panic attacks, flashbacks, and feelings of depression
Antipsychotic
Julie was MOST likely prescribed which benzodiazepine for her generalized anxiety disorder. Ativan Zoloft Valtrate Prozac
Ativan
_____ theory suggests that people with generalized anxiety disorder have a greater bodily arousal than other people and that worrying actually serves to reduce this arousal, perhaps by distracting the individuals from their unpleasant physical feelings. Avoidance The intolerance of uncertainty Metacognitive Uncertainty
Avoidance
_____ theory suggests that, as a species, humans are preprogrammed to fear certain things. Behavioral-evolutionary Biological Cognitive Behavioral
Behavioral-evolutionary
_____ is NOT used by theorists to explain dissociative amnesia and dissociative identity disorder. Biological abnormality Repression State-dependent learning Self-hypnosis
Biological abnormality
Cari and her brother, Michael, were sexually abused as children. Cari was repeatedly abused, whereas her brother was victimized once. Which statement BEST explains their risk for stress and other comorbid disorders? Michael is at greater risk for developing other disorders along with a stress disorder. Cari is less at risk for developing a stress disorder because her abuse was chronic. Cari is at greater risk because she is female and has a history of chronic abuse. Michael is at greater risk for a stress disorder because he is male.
Cari is at greater risk because she is female and has a history of chronic abuse.
Carol's therapist used hypnosis, regression therapy, and dream interpretation to help her recover traumatic memories of childhood sexual abuse. She was able to recall incidents of abuse with vivid detail, including the sights, smells, and sounds in her environment as the abuse occurred. Critics of the repressed memory concept would maintain all of these EXCEPT: Carol unknowingly formed false memories. Carol's recalled memories may be the result of suggestibility. Carol purposefully formed false memories. Carol's false memories became increasingly familiar as a result of therapy discussions.
Carol purposefully formed false memories.
_____ is/are released by the adrenal glands at times of stress. Serotonin Corticosteroids Insulin ACH
Corticosteroids
Smith, a combat veteran who was diagnosed with PTSD, reports problems with distressing nightmares, irritability, anxiety, and intrusive thoughts. His therapist has him engage in a process requiring him to move his eyes from side to side in a rhythmic manner while flooding his mind with images from the war. The technique being used was: virtual reality therapy. gradual exposure. EMDR. cognitive therapy.
EMDR. (Eye Movement Desensitization and Reprocessing)
_____ tends to be helpful in the treatment of social anxiety disorder. Flooding Exposure therapy Modeling Emotive-irrational behavior therapy
Exposure therapy
_____ amnesia involves the individual experiencing the loss of memory extending back to times long before the upsetting period. Continuous Localized Generalized Selective
Generalized
___________ involves the individual experiencing the loss of memory extending back to times long before the upsetting period.
Generalized amnesia
Dante almost got hit by a car while he was in the pedestrian crosswalk. His heart rate quickened, and chemicals were released into his bloodstream so that he could mobilize his large muscles and quickly vacate the crosswalk. Which systems were involved in allowing him to accomplish this response? HPA and SNS HPA and PNS HPA and endocrine HPA and immune
HPA and SNS
This is one route by which the brain and body produce arousal and fear
HPA pathway (hypothalamic pituitary adrenal)
Which group appears to have a greater vulnerability to posttraumatic stress disorder?
Hispanic Americans
Which statement is NOT true about depersonalization-derealization disorder? It is characterized by persistent memory loss. Those with this disorder may have episodes where their surroundings seem unreal. Those with this disorder may have periods of sensing that they are detached from their body. It is not characterized by memory loss.
It is characterized by persistent memory loss.
Lourdes has been diagnosed with obsessive-compulsive disorder and has been prescribed medication. The medication has been effective. Lourdes has recently learned that she will be laid off from her job and will no longer be able to afford her medication. According to the text, which is MOST likely to occur to Lourdes with regard to her disorder? Lourdes will be able to switch to a cheaper over-the-counter medicine. She will be committed to a psychiatric facility. The medication will have re-wired her brain so that Lourdes will be symptom-free even without the drugs. It is likely that she will relapse.
It is likely that she will relapse
Jonathan is a 12-year-old child, and his father, Cory, is 40. Which statement is TRUE regarding their hypnotic suggestibility? Cory is more suggestible. Jonathan is more suggestible. Jonathan is equally as suggestible as Cory. Cory and Jonathan's suggestibility cannot be compared.
Jonathan is more suggestible.
Angie watched on television as Jose lost his arm in a shark attack. Which statement would BEST reflect their risk for developing PTSD? Jose is at greater risk due to the severity and direct nature of his exposure to the event. Angie is at greater risk due to the severity and direct nature of her exposure to the event. Jose and Angie are equally likely to develop PTSD. Angie is at lesser risk because she is female.
Jose is at greater risk due to the severity and direct nature of his exposure to the event.
Who is MOST likely to be diagnosed with a specific phobia? Elijah, who fears blood and is a college student Anna, who fears heights and works a full-time job Derek, who fears dogs and is self-employed Leeann, who fears enclosed spaces and is unemployed
Leeann, who fears enclosed spaces and is unemployed
___________ is the most common type of dissociative amnesia.
Localized amnesia
A person who witnesses the death of a friend and begins experiencing distressful memories of the events, insomnia, persistent anger, and social detachment months after the event would receive a diagnosis of: PTSD. acute stress disorder. anxiety. depression.
PTSD.
Kramer recalled several life events under hypnosis that could not be verified, discrediting this myth about hypnosis. People remember more accurately under hypnosis. Hypnotized people adhere to their usual values. Hypnosis is dangerous. Hypnotized people are fully awake.
People remember more accurately under hypnosis.
Julio has been diagnosed with obsessive-compulsive disorder and has been prescribed an antidepressant. With this medicine, Julio's obsessions and compulsions have been cut in half. Julio is MOST likely taking: a statin. Prozac. ibuprofen. Singulair.
Prozac
Timothy was frightened by a loud noise and wet his pants. This response is BEST explained by the fact that a relaxed bladder is a consequence of _____ activation. ANS SNS HPA PNS
SNS
Zoe works a demanding, full-time job as a corporate CEO. She has two young children who demand her attention, and she feels responsible for taking good care of her children. She prides herself on being a multitasker and maintains a flexible work schedule. She also hired a nanny to help with the children. Which statement reflects why Zoe is not likely to experience a negative stress response? She can handle her job. She sees herself as being capable and has resources to cope with her situation. She has a nanny. She sees the situation as unimportant.
She sees herself as being capable and has resources to cope with her situation.
Connie suffers from PTSD. If she follows the typical pattern of treatment-seeking behavior among those affected, which statement would be TRUE? She will not seek treatment when she first develops the disorder. She will seek treatment immediately. She will not experience symptoms. She will get better without treatment.
She will not seek treatment when she first develops the disorder.
What is the major difference between the sympathetic and parasympathetic nervous systems? The SNS stimulates the release of hormones; the PNS inhibits hormones. The SNS dilates the pupils; the PNS constricts them. The PNS dilates the pupils; the SNS constricts them. The SNS leads to a state of arousal; the PNS has a calming effect.
The SNS leads to a state of arousal; the PNS has a calming effect.
Women who were pregnant during the 9/11 attacks and went on to develop PTSD also had higher than average cortisol levels. Which of these statements is TRUE about the babies of these women who were born after the attacks? The children did not have any biochemical abnormalities. The children had lower than average cortisol levels. The children had higher than average cortisol levels. The children had higher than average norepinephrine levels.
The children had higher than average cortisol levels.
Which statement BEST reflects why some people have unusually strong biochemical reactions to stress? They are high in resiliency. They come from stressor-laden environments. Their social and family support systems are weak. The propensity to react in this manner is inherited.
The propensity to react in this manner is inherited.
Compared to victims of trauma with weak social support systems, which statement is TRUE about those victims who feel loved, cared for, and accepted? They are equally likely to develop acute stress disorder or PTSD. They are less likely to develop acute stress disorder or PTSD. They are more likely to develop PTSD. They are more likely to develop acute stress disorder.
They are less likely to develop acute stress disorder or PTSD.
Keni had a bad car accident and could not recall the events leading up to the accident. Her psychiatrist gave her an injection of sodium amobarbital to help her regain her lost memories. Which statement is NOT true about the use of these types of medications to regain memories? They do not always work. They increase arousal. They are called truth serums. They are likely to be combined with other approaches.
They increase arousal.
According to the sociocultural model, who is MOST likely to develop generalized anxiety disorder? Sandor, who works a minimum wage job, but receives subsidized income because of a disability Keela, a college student working part-time Verna, who lives with her two children in post-earthquake Haiti Charles, an educated businessman who lives in an affluent neighborhood
Verna, who lives with her two children in post-earthquake Haiti
Dane was in a boating accident where his wife drowned. He is unable to recall the day of the event, but physicians cannot find a physical reason why his memory is impaired. Dane likely has: a psychological stress disorder. a dissociative disorder. PTSD. a medical disorder.
a dissociative disorder.
Malachi was diagnosed with PTSD and persistently has intrusive thoughts and severe anxiety. Biological studies would suggest that this is due to: decreased cortisol levels. abnormal dopamine levels. a dysfunctional hippocampus and amygdala. a brain stem abnormality.
a dysfunctional hippocampus and amygdala.
Leni is terrified of clowns to the extent that even when she thinks about them, it makes her nervous and agitated. Leni will go to great lengths to avoid clowns. Leni MOST likely would be diagnosed with: generalized anxiety disorder. obsessive-compulsive disorder (OCD). posttraumatic stress disorder. a phobia.
a phobia
Kari had a very close relationship with her father. She was extremely distressed when he died during her childhood and has no recollection of the day of his death. Psychodynamic theorists would attribute her dissociative amnesia to: a single episode of massive repression. a single episode of denial. massive episodes of denial. multiple episodes of massive repression.
a single episode of massive repression.
Shane is a combat soldier who recently returned home after suffering an injury and having his leg amputated after stepping on an active mine. He experiences a wide range of symptoms, such as heightened arousal, anxiety and mood problems, memory and orientation difficulties, and behavioral disturbance. He MOST likely suffers from: a mood disorder. psychosis. a dissociative disorder. a trauma and stressor-related disorder.
a trauma and stressor-related disorder.
Kiva is a competent first responder and has an excellent response team to deal with emergencies. She effectively handles emergencies with little stress reactions. This is likely due to her perceived: sociocultural status. financial stability. ability and resources to cope effectively. social support.
ability and resources to cope effectively.
Luke was mugged and experienced anxiety, insomnia, worry, and intrusive thoughts about the mugging. His symptoms improved within four weeks, qualifying him for a diagnosis of: acute stress disorder. dissociative disorder. PTSD. depressed mood.
acute stress disorder.
Anthony and Vincent were in a bad car accident that resulted in a fatality. Both men became anxious and depressed, had trouble sleeping, had intrusive thoughts, and avoided driving or talking about the accident within a week of the accident. Anthony's symptoms ended three weeks later, but Vincent's symptoms persisted for months. Anthony likely has a diagnosis of _____, whereas Vincent has _____. PTSD; acute stress disorder acute stress disorder; depression acute stress disorder; PTSD PTSD; depression
acute stress disorder; PTSD
Stephen was diagnosed with prostate cancer last year and has been extremely anxious while coping with his medical condition. The distress he feels is interfering with his productivity at work. Stephen would likely receive one of the following diagnoses. adjustment disorder with depressed mood adjustment disorder with anxiety acute stress disorder PTSD
adjustment disorder with anxiety
Shelley's divorce became final two months ago, and since this time she has experienced a depressed mood and has had difficulty sleeping. The most likely diagnosis for Shelley is: PTSD. acute stress disorder. adjustment disorder with anxiety. adjustment disorder with depressed mood.
adjustment disorder with depressed mood.
Bo turned left at an intersection and was nearly hit by an oncoming car. As he drove away from the intersection, neurotransmitters in his hypothalamus were released, triggering his pituitary gland to release _____. He began to perspire and he felt his heartbeat racing. norepinephrine adrenocorticotropic hormone epinephrine cortisol
adrenocorticotropic hormone
Eduardo was driving home from work when he approached a traffic jam that came to a standstill on a bridge. The traffic did not move, and he began to feel anxious that he could not escape the traffic or the bridge. Last week, he experienced something similar when he was in a long line at a discount store. He now has developed an extreme fear of leaving home to risk facing one of these "inescapable" situations. Eduardo is MOST likely suffering from: agoraphobia. obsessive-compulsive disorder. depression. posttraumatic stress disorder.
agoraphobia
Kevin suffers from _____ and is afraid to leave the house and travel to public places or other locations where escape might be difficult. flooding agoraphobia systematic desensitization obsessive-compulsive disorder
agoraphobia
Within a year, the LEAST common occurring anxiety disorder is: specific phobia. social anxiety disorder. agoraphobia. panic disorder.
agoraphobia
Herschel had gaps in his memory that he could not explain. His wife explained that there were times when he didn't seem to know who she was and became angry and violent. She mentioned other times when he seemed timid, like a child. These different personality states are called: secondary personalities. developmental personalities. alternate personalities. multiple personalities.
alternate personalities.
Lisa lost her job two years ago and has had trouble finding employment and supporting her family. For the past six months, she and her children have lived in homeless shelters. She recently found out that her mother passed away, and on her most recent visit to the doctor she was diagnosed with cancer. Because of the number of stressful events she has encountered, she is particularly vulnerable to which type of disorder? a dissociative disorder sadness suicide an anxiety disorder
an anxiety disorder
According to psychodynamic theorists, Sigmund Freud traced obsessive-compulsive disorder to the _____ stage of development. oral anal phallic genital
anal
Shontae was diagnosed with PTSD following her return from a tour in Afghanistan. Due to her repeated nightmares, flashbacks, and bouts of depression, her psychiatrist would likely prescribe: antidepressant medication. a sleep aid. antianxiety medication. antipsychotic medication.
antidepressant medication.
Individuals do not have to make themselves breathe due to the functioning of this system. autonomic nervous system parasympathetic nervous system endocrine system sympathetic nervous system
autonomic nervous system
People who judge their work demands as reasonable and feel competent to meet their deadlines on time will probably: feel stressed. avoid a stress response to this event. have a stress reaction. like their job.
avoid a stress response to this event.
Kennedy was sexually assaulted. She refused to think about the event and tried to push away any memories or reminders of the assault. These behaviors are symptoms of: reduced responsiveness. avoidance. guilt. reexperiencing.
avoidance.
Together, the sympathetic and parasympathetic nervous systems: multiply one another's effects. prevent arousal and fear. aggravate fear reactions. balance one another and control arousal and fear.
balance one another and control arousal and fear.
"When I was young, I met a large dog. I was not afraid of the dog, but as I tried to pet it, the dog snarled and jumped at me. I have been afraid of dogs ever since." A therapist who assumes that this sentence describes a phobia acquired from classical conditioning MOST likely favors which model of abnormality? psychodynamic behavioral humanistic-existential cognitive
behavioral
Children who are wary of new people, environments, and objects and are always on guard against potential threats show a pattern of: behavioral inhibition. social phobia. a slow-to-warm-up personality. classically conditioned fears.
behavioral inhibition.
Cyan has not left her house in two years. As part of her therapy, her therapist has set up several gradual steps designed to enable Cyan to leave her home. Using a series of reinforcements, Cyan is first rewarded for standing with her front door open, then she is rewarded for standing on her front porch, and then for standing at the bottom of her front porch steps. Cyan's therapist MOST likely is a: humanistic therapist. cognitive therapist. psychoanalyst. behaviorist.
behaviorist
Parents who rescue their inhibited child by answering questions on their child's behalf or allowing their child to stay home from school when the child feels nervous are: being overprotective and likely promoting lifelong anxiety in their child. helping the anxious child. modeling effective coping strategies for the child. using evocative parenting.
being overprotective and likely promoting lifelong anxiety in their child.
A therapist is helping Mark with his social anxiety disorder by indicating his dysfunctional beliefs and expectations regarding the social realm. These can include all of the following EXCEPT: believing that he is always in danger of behaving incompetently in social situations. believing that he is an unattractive social being. believing that he is socially skilled and perfect. believing that he has no control over feelings of anxiety that emerge in social situations.
believing that he is socially skilled and perfect
In extreme cases of _____, the sufferer may undergo numerous plastic surgeries to correct perceived flaws. body dysmorphic disorder hoarding disorder trichotillomania excoriation disorder
body dysmorphic disorder
Vicktor spends an enormous amount of time on his appearance. He will often wake early in the morning to perfectly groom his hair, in some cases rewashing it when he cannot achieve the hairstyle that he desires. Even when he feels confident that his hair is perfect he will constantly check it in any available mirror and correct any perceived flaws. Vicktor would MOST likely be diagnosed with _____, according to the DSM-5. trichotillomania excoriation disorder hoarding disorder body dysmorphic disorder
body dysmorphic disorder
Which of the following is NOT a type of compulsion mentioned in the textbook? balance checking cleaning breaking
breaking
Sammie was raped by an acquaintance at a party three years ago. Since that time, she has been hypervigilant and reluctant to date. She has withdrawn from friends and prefers to be alone. The thought of going to a party makes her anxious, so she declines all social invitations. Her prolonged response to the trauma experienced indicates that extraordinary stress can lead to symptoms that: readily improve. can make it impossible to live a normal life. do not have lasting effects. get better over time.
can make it impossible to live a normal life.
Alyse is planning her wedding and making plans to move into a new home with her new husband. She feels stress because the demands of both situations require that she: change. be happy. give up her freedom. focus on her family.
change.
Walda is a sociocultural theorist, so she does NOT believe that _____ is a factor in generalized anxiety disorder. poverty a lack of educational opportunities childhood spanking a lack of job opportunities
childhood spanking
Which of these does NOT represent a situation that would typically cause PTSD? chronic illness natural disaster rape combat
chronic illness
In his classic experiment, John B. Watson paired a rat with a loud noise to induce a fear response in a little boy. Eventually, after pairing the rat and the noise together often enough, the little boy only had to see the rat to become fearful. This is an example of how _____ can potentially cause a phobia. association learning operant conditioning modeling classical conditioning
classical conditioning
Last summer, Jorge was fishing near a pond when he was nearly bitten by an alligator. Ever since, he has had a fear of standing water, a situation his cognitive behavioral theorist says was caused by: modeling. exposure treatment. classical conditioning. operant conditioning.
classical conditioning
Dr. Granite works with veterans experiencing stress disorders. He guides the veterans to examine and change their dysfunctional attitudes and styles of interpretation that have emerged as a result of their traumatic experiences. Dr. Granite uses _____ therapy. exposure cognitive behavioral drug
cognitive
Keona holds unrealistically high standards about herself and her ability to speak in public. She constantly judges herself as poorer than she really is, and, as a result, she either makes excuses not to speak in public or flatly refuses to do so. Which theory best supports Keona's diagnosis of social anxiety disorder? biological humanistic behavioral cognitive
cognitive
Natasha has been diagnosed with generalized anxiety disorder. Her therapist has been working with her to educate her about the role of worrying. Natasha is trying to understand what triggers her worrying and how worrying is not a positive way to control her life. Natasha's therapist's techniques are rooted in which theoretical perspective? cognitive humanistic psychodynamic sociocultural
cognitive
Zulfa thinks about the cleanliness of her face and compulsively washes her face many times a day. Her therapist has diagnosed her with obsessive-compulsive disorder. He has begun to educate Zulfa about the ways in which her unwanted thoughts about cleanliness and her compulsions to wash her face are counterproductive. Zulfa is now trying to identify, challenge, and change her obsessions and compulsions. Her therapist's strategies are rooted in the _____ perspective. biological cognitive behavioral psychodynamic
cognitive
The leading treatments for dissociative amnesia include all of the following EXCEPT:
cognitive therapy (include; psychodynamic therapy, hypnotic therapy, and drug therapy)
More and more individuals with obsessive-compulsive disorder are now being treated with a combination of drug and _____ therapy. cognitive-behavioral psychodynamic biofeedback dysmorphic
cognitive-behavioral
Rayne has been diagnosed with obsessive-compulsive disorder. Her therapist plans on addressing the two major features of obsessive-compulsive disorder—obsessions and compulsions—while simultaneously using various techniques to help correct any distorted thinking Rayne may have and adjust any maladaptive behavior that Rayne is exhibiting. Rayne's therapist is MOST likely following the _____ perspective. cognitive-behavioral behavioral psychodynamic cognitive
cognitive-behavioral
This type of therapy has been found to be at least as helpful as medication for treating panic disorder. cognitive-behavioral psychodynamic existential humanistic
cognitive-behavioral
Excessive behaviors such as cleaning, checking, counting, and touching are examples of: behavioral maladaptations. obsessions. compulsions. cognitive distortions.
compulsions
Josh fears contamination of dirt and insects in his apartment. He stores his garbage bag in his refrigerator and cleans constantly. He repeatedly checks that the garbage bag is still in the refrigerator and that it is securely tied. Josh's behaviors are called: taijin kyofusho. phobias. obsessions. compulsions.
compulsions
A child is bitten by a vicious dog in a park. The child is later very afraid of the park. According to classical conditioning, the park is a(n): unconditioned response. unconditioned stimulus. conditioned response. conditioned stimulus.
conditioned stimulus
Ten-year-old Caden encounters a vicious dog that begins growling at him. Which is NOT among the physiological responses that one might expect to occur in Caden's body? dilation of the pupils constriction of the bronchi accelerated heartbeat release of glucose
constriction of the bronchi
A 29-year-old woman witnessed a murder while she was away on a study-abroad trip. She forgets new and ongoing experiences as well as what happened before and after witnessing the tragic event. The type of amnesia she has is: selective. localized. continuous. generalized.
continuous.
What is the BIGGEST fear in today's world? terrorist attacks not having enough money corruption of government officials death of loved ones
corruption of government officials
A tornado hit the small town of Idabel, Oklahoma. Many homes were destroyed, and the residents experienced a wide range of cognitive, emotional, and physical responses to the natural disaster. One would expect that their HPA systems would signal their adrenal cortices to release this hormone. norepinephrine epinephrine ACTH cortisol
cortisol
Felicia was taken to the hospital to be examined after she was raped. Which of these would the doctor expect to find in her urine? serotonin cortisol glucose elevated white blood cell levels
cortisol
Researchers have found abnormal activity in the hormone _____ and the neurotransmitter _____ in the urine, blood, and saliva of survivors of severe stresses. insulin; norepinephrine cortisol; norepinephrine cortisol; serotonin cortisol; dopamine
cortisol; norepinephrine
Zena has a phobia; she imagines the frightening event while the therapist describes it. Zena moves through the entire list, pairing her relaxation responses with each feared item. Because the first item is only mildly frightening, it is usually only a short while before Zena is able to relax totally in its presence. Over the course of several sessions, Zena moves up the ladder of her fears until she reaches and overcomes the one that frightens her most of all. The therapist is using a process called: modeling. in vivo desensitization. flooding. covert desensitization.
covert desensitization
Ten-year-old Malachi sees a dog a few feet away that begins barking. Malachi's SNS is activated. As Malachi approaches and the dog recognizes him, the dog starts wagging its tail. Malachi pets the dog. Which of the following responses might one expect to occur after Malachi begins to play with the dog? release of glucose dilation of bronchi decreased heartbeat dilation of pupils
decreased heartbeat
Shelly feels as though she has become separated from her body and is observing herself from the outside. Her hands feel foreign to her, and they look smaller than usual. Occasionally, her mind seems to be floating a few feet above her. Based on this information, Shelly might suffer from: dissociative fugue. dissociative amnesia. depersonalization-derealization disorder. dissociative identity disorder.
depersonalization-derealization disorder.
The MOST common theme for people troubled by obsessive thinking appears to be: violence or aggression. dirt or contamination. religion and sexuality. orderliness or neatness.
dirt or contamination
This disorder is marked by an inability to recall important personal events and information. dissociative amnesia dissociative identity disorder somatization disorder dissociative fugue
dissociative amnesia
John has started seeing a therapist to help him cope with the death of his wife. When asked to recall her passing, he can remember her being shot by an armed robber, but he can't remember preparing for the funeral or the funeral itself. Given this information, it is likely that John is suffering from: dissociative identity disorder. adjustment disorder. dissociative amnesia. dissociative fugue.
dissociative amnesia.
Kerry has a loss of memory that struck him as being more than forgetful. He could not remember important personal events that happened in his life. He found the symptoms distressing, and his physical labs and tests could not identify a cause for his memory loss. He likely has: PTSD. a medical disorder. dissociative amnesia. a psychological stress disorder.
dissociative amnesia.
This disorder involves a person traveling to a new location and assuming a new identity, simultaneously forgetting his or her past
dissociative fugue
People with dissociative identity disorder differ from those with dissociative amnesia, including dissociative fugue, in that they: typically recover spontaneously. do not typically recover without treatment. do not require treatment. are not benefited by hypnosis.
do not typically recover without treatment.
Jasper occasionally has episodes where he feels his mind is floating a few feet above him. This sensation is known as: dissociation. doubling. separating. detachment.
doubling.
Jon was robbed at gunpoint. Which system released hormones into his bloodstream and on to the various organs in his body? endocrine system parasympathetic nervous system autonomic nervous system sympathetic nervous system
endocrine system
Who experiences stress? professional athletes combat veterans everyone victims of crime
everyone
A new mother who sees motherhood as overwhelming and feels she does not have enough support to care for her child is likely to: become ill. feel happy. experience a stress response. feel hopeless.
experience a stress response.
People who were arrested and interrogated by police after being shot at or terrorized by extremists for three days have a higher risk of developing complex PTSD, which means they: had high levels of resiliency. experienced multiple traumatic events distally related. had poor support networks. experienced multiple traumatic events in close proximity.
experienced multiple traumatic events in close proximity.
Constantine suffers from obsessive-compulsive disorder (OCD). He spends multiple hours cleaning and recleaning various areas of his house to the point that he cannot carry out other daily tasks such as cooking or taking care of his family. Constantine is aware of the amount of time he engages in his compulsions; however, every time he attempts to stop, he MOST likely: becomes obsessed with something else. experiences an increase in anxiety. becomes distracted by dirt. experiences overwhelming depression.
experiences an increase in anxiety
Ashley visits a tanning bed at least once a day. She does this because she feels that the world, and especially her boyfriend, will not accept her unless she maintains her deep tan. She is seeing a therapist for this problem, and he has assigned homework. Ashley must not visit a tanning bed for seven days. The objective is to show Ashley that she will still be accepted even if she does not maintain her deep tan. This type of treatment is called: exposure and response prevention. compulsion prevention. undoing. neutralization.
exposure and response prevention
Leigh was diagnosed with posttraumatic stress disorder (PTSD) following a history of chronic sexual abuse. She has difficulty relating to her own kids and is distrustful and suspicious of her husband. She avoids intimacy with him, and as her children approach the age of her abuse, she is unwilling to leave them alone with their father. Which area of functioning is her PTSD affecting? family personal social occupational
family
Which of the following factors has NOT been found to increase anxiety? overprotective parenting poverty peer pressure family harmony
family harmony
Carson was hiking through Yosemite National Park when he rounded a corner and found a big black bear. Which of the following would be an appropriate response? anxiety posttraumatic stress disorder generalized anxiety fear
fear
The term phobia comes from the Greek word for: worry. pain. anxiety. fear.
fear
Which of the following symptoms is LEAST likely to occur in a soldier who was exposed to numerous combat situations, including an explosion that seriously wounded him? insomnia depression feelings of persecution hypervigilance
feelings of persecution
Studies have found that people who scored high on anxiety-sensitivity surveys are up to _____ times more likely than others to develop panic disorder. two three four five
five
A young veteran who experiences frightening flashbacks and nightmares of combat is asked by his therapist to imagine one of the scenes in great detail and to hold onto the image until his anxiety stops. Which behavioral exposure technique is the therapist using? flooding cognitive reframing EMDR gradual desensitization
flooding
Austin's therapist is forcing him to face his fear of snakes without any relaxation training or gradual buildup. This exposure treatment is known as: free association. modeling. flooding. systematic desensitization.
flooding
Dr. Coogler has her patients imagine a stressful event in great detail until the anxiety brought on by the event has stopped. This form of exposure therapy is called: EMDR. imagination therapy. flooding. cognitive therapy.
flooding.
An individual experiencing depersonalization-derealization disorder would be UNLIKELY to: feel mechanical, dreamlike or dizzy. have their body parts feel foreign to them and perceive other people as being removed, mechanical, or dead. have distorted judgments about time and space. forget important personal events and information.
forget important personal events and information.
One morning, Charles wakes up to find himself in an unfamiliar location. After turning on the local news, he realizes that he's in California, but, as far as he can remember, he's never left New York. The phone next to his bed rings, and he is greeted by an unfamiliar woman who calls him Rick. Although he insists that he is Charles, she insists that he is Rick, asserting that they've been dating for several weeks. Based on this information, Charles is likely suffering from dissociative: jamais vu. Déjà vu. fusion. fugue.
fugue.
Although poverty and various societal pressures may help create a climate in which _____ disorder is more likely to develop, sociocultural variables are not the only factors at work. social anxiety panic generalized anxiety obsessive-compulsive
generalized anxiety
Carlie is studying for her final exams on a daily basis. Unfortunately, she is finding it harder and harder to concentrate. She has not been sleeping very well, and even when she is confident she knows the material, she constantly doubts herself and thinks that she is not capable of doing well. Furthermore, she is finding that her anxiety and self-doubt have begun to affect other aspects of her life. She struggles to keep up with other parts of life, such as laundry and grocery shopping. Carlie's situation is an example of: obsessive-compulsive disorder. panic disorder. posttraumatic stress disorder. generalized anxiety disorder.
generalized anxiety disorder
Marta presents with excessive worry, is easily fatigued, restless, irritable, and has not been sleeping well. Marta MOST likely is suffering from: social phobia. obsessive-compulsive disorder. panic disorder. generalized anxiety disorder.
generalized anxiety disorder
Ivy has dissociative amnesia and cannot recall personal events extending back to times long before the upsetting period that caused the amnesia. The form of dissociative amnesia that she has is: generalized. localized. selective. continuous.
generalized.
An individual working in the World Trade Center was rescued by a first responder during the terrorist attack on the United States that occurred on September 11, 2001 (9/11). The first responder died in the process of helping the individual. Which symptom of PTSD might the individual experience as a result of surviving? insomnia guilt an exaggerated startle response avoidance of anything that reminded the individual of the event
guilt
Desmond has been diagnosed with social anxiety disorder, and he has certain beliefs about himself that are a part of his anxiety. According to cognitive theorists, Desmond MOST likely believes that: if he messes up, no one will notice. he does well with meeting new people. he has no social skills. he is attractive.
he has no social skills
A therapist diagnosed Selma with social anxiety disorder; he tied her dysfunctional cognitions and behaviors to all of these factors EXCEPT: her eating disorder. genetic predispositions. biological abnormalities. traumatic childhood experiences.
her eating disorder
Chris was in a car accident where his car teetered on the edge of a bridge while he awaited assistance. Neurotransmitters in his hypothalamus were released, triggering the firing of neurons throughout his brain and the release of chemicals throughout his body. His heartbeat quickened, his pupils dilated, and his respiration increased. His physiological response was due to: his constricted bronchi. the car accident. his brain interpreting the situation as dangerous. activation of his parasympathetic nervous system.
his brain interpreting the situation as dangerous.
Monty felt neglected as a child. Although his physical needs were met, he lacked attention from his parents. Consequently, he joined the army as soon as he graduated high school. He served two years in Iraq and was discharged after being injured in combat. He returned home and could not find employment for over two years, and he was socially withdrawn because he could not relate to his friends. Which aspect of his life was MOST likely to trigger a stress disorder? his combat history emotional neglect his social life his chronic unemployment
his combat history
Garnett is a habitual collector. She cannot pass up an opportunity to buy or collect (even from the garbage) anything related to horses. She has numerous pictures, statues, and toys that depict horses. They cover the shelves of her book cases and her dining room table. Any available spot in her home, including the floor, is covered with horses. The mere mention of getting rid of some of them sends Garnett into a state of anxiety and agitation. According to the DSM-5, Garnett would be diagnosed with: excoriation disorder. trichotillomania. body dysmorphic disorder. hoarding disorder.
hoarding disorder
Fadil has been visiting a therapist for the treatment of his generalized anxiety disorder. Fadil realizes that his anxiety may stem in part from the fact that he is too self-judgmental. He is not sure if the therapy is affecting his anxiety, but he does feel that his therapist genuinely cares about him and his recovery. His therapist's techniques are MOST likely rooted in the _____ perspective. sociocultural psychodynamic humanistic cognitive
humanistic
Jewel is often critical of herself and her ability to perform even the most basic tasks. She has tried to change her negative views about herself but self-deprecating thoughts always seem to break through, and her anxiety increases no matter the situation. Jewel's therapist believes that this is the root of her generalized anxiety disorder. Jewel's therapist is MOST likely following the _____ perspective. psychodynamic humanistic cognitive biological
humanistic
This psychological perspective holds that generalized anxiety disorder may develop when a person repeatedly denies her true thoughts, emotions, and behavior, making her unable to fulfill her potential. sociocultural psychodynamic biological humanistic
humanistic
Rory's therapist is helping him come to terms with who he is by unconditionally supporting Rory and showing Rory complete acceptance. Rory's therapist is MOST likely a: humanistic therapist. behavioral therapist. psychoanalyst. cognitive therapist.
humanistic therapist
While playing baseball with his friends, Reyes was almost hit in the face with a fast ball. Neurotransmitters in his _____ were released, triggering the firing of neurons throughout his brain and the release of chemicals throughout his body. His heart beat quickened, his pupils dilated, and his respiration increased. adrenal medulla adrenal cortex hypothalamus pituitary gland
hypothalamus
Victor suffers from dissociative _____. He has three subpersonalities: Dirk, the studious introvert; Calvin, the animal-loving child; and Alana, the outgoing socialite. fusion identity disorder fugue amnesia
identity disorder
_____ exposure is found to be more effective than _____ exposure in treating specific phobias. In vivo; covert Covert; in vivo Prepared; virtual Virtual; prepared
in vivo; covert
The _____ theory suggests that people with generalized anxiety disorder believe that any possibility of a negative event occurring, no matter how slim the chance, means that the event is apt to occur. tolerance of certainty intolerance of uncertainty intolerance of certainty tolerance of uncertainty
intolerance of uncertainty
Fear is to _____, as anxiety is to _____. known; unknown youth; elderly imaginary; real men; women
known; unknown
The onset of social anxiety disorder MOST often occurs in: early childhood to late childhood. late adolescence to early adulthood. late childhood to early adolescence. early to late adulthood.
late childhood to early adolescence
Cari lives in an underdeveloped, third-world country in a rural area where she and her family struggle to find work and live in poverty. Cari's life circumstances reflect a(n): turning-point event. traumatic event. long-term problem. everyday hassle.
long-term problem.
Initially, cognitive-behavioral theorists suggested that generalized anxiety disorder is primarily caused by _____ assumptions. preferred maladaptive basic passive
maladaptive
Parker is seeing a cognitive-behavioral therapist to reduce the overwhelming anxiety he feels in his daily life. His therapist tells him that generalized anxiety disorder is primarily caused by _____, allowing treatment to focus on Parker's dysfunctional thinking. maladaptive assumptions knowing that negative events may occur holding both positive and negative beliefs about worrying greater bodily arousal
maladaptive assumptions
Dr. Bloom uses drugs and exposure techniques with his patients who are combat veterans coping with PTSD, but he uses group therapy approaches with his patients who are survivors of rape. His treatment approaches highlight how today's treatment procedures: use combined approaches. are specific to each trauma. may vary from trauma to trauma. are consistent across traumas.
may vary from trauma to trauma.
Dr. Napolitano is petting a cat in front of her client Marian, who is afraid of cats. She then encourages Marian to pet the cat as well. This is known as: free association. modeling. systematic desensitization. flooding.
modeling
Rayden's mother is afraid of roller coasters. Any time the family would visit an amusement park, Rayden's mother would refuse to go near any of the roller coasters. Even if she had never been on one of the coasters, Rayden's mother would constantly ask whether there were hills, and if they were big hills or little hills. Eventually, Rayden himself began to ask these questions and refused to go on any of the roller coasters. Behaviorists might explain Rayden's behavior through the process of: modeling. classical conditioning. operant conditioning. systematic desensitization.
modeling
Sean, who has dissociative identity disorder, has several subpersonalities, each of whom are aware of one another and interact with one another. This pattern is referred to as: coconscious. one-way amnesic. mutually cognizant. mutually amnesic.
mutually cognizant.
Requesting special reassurance from others, deliberately thinking "good" thoughts, washing one's hands, or checking for possible sources of danger are known as _____ acts. ritualizing neutralizing naturalizing pluralizing
neutralizing
What term is used for the rush of fear that people experience when they realize they are disconnected from the world, friends, and family? social phobia nomophobia agoraphobia phonophobia
nomophobia
Which chemical acts as a neurotransmitter in the brain and as a hormone when released by the adrenal medulla into the bloodstream? serotonin dopamine GABA norepinephrine
norepinephrine
Excessive and repeated wishes, impulses, images, or doubts are called: compulsions. obsessions. behavioral maladaptation. cognitive distortions.
obsessions
A person with _____ disorder has recurrent and unwanted thoughts, a need to perform repetitive and rigid actions, or both conditions. posttraumatic stress obsessive-compulsive panic generalized anxiety
obsessive-compulsive
Jawan's parents rush in too quickly to prevent her from experiencing distress, repeatedly allow Jawan to avoid social engagements, answer questions on her behalf, and let her stay home from school when she feels nervous. This is a common form of: normal parenting. overprotective parenting. independent parenting. nonprotective parenting.
overprotective parenting
Miriam has been experiencing recurring periods of shortness of breath, sweating, trembling, faintness, and a feeling of unreality for more than a month. Miriam may be suffering from: obsessive-compulsive disorder (OCD). generalized anxiety disorder. panic disorder. flooding.
panic disorder
Benita is home alone one evening when she hears a noise coming from the kitchen. Once she explores the kitchen, she realizes that it was just her dog who tipped over the garbage can. Her heart rate slows down due to the activation of her _____ nervous system. parasympathetic sympathetic endocrine autonomic
parasympathetic
When faced with stressors, the hypothalamus signals the nearby _____ gland. pituitary adrenal pineal thyroid
pituitary
In which disorder do extraordinary stress and trauma play a central role? posttraumatic stress disorder generalized anxiety disorder panic disorder obsessive-compulsive disorder
posttraumatic stress disorder
Caden suffers from dissociative identity disorder. He has three alternate personalities: Mike, who enjoys football; Steve, who enjoys ballet; and Jeremy, who enjoys business. Although critics of this disorder would characterize Caden as having many interests, the gaps in his memory would suggest that his subpersonalities differ in: preferences. abilities. physiological responses. identifying features.
preferences.
Jolene has been diagnosed with obsessive-compulsive disorder. She spends an inordinate amount of time checking her home for small cracks and crevices where insects could enter. Before she goes to bed, she checks that all of the cracks she has identified are securely covered with duct tape. She has begun treatment with a therapist and together they are trying to overcome some of her underlying conflicts by using free-association techniques. Jolene's therapist's strategy comes from which theoretical perspective? cognitive biological psychodynamic behavioral
psychodynamic
Jordan was severely abused as a child. She came to fear the world as dangerous and pretended to be another person who looked on safely from afar. She unconsciously disowned her own thoughts about wanting her parents dead by assigning them to other personalities. This is a view espoused by the _____ perspective. behavioral humanistic cognitive psychodynamic
psychodynamic
Matika is a therapist who is treating a client with generalized anxiety disorder. She believes that her client's anxiety stems from overprotective parents. During their therapy sessions, Matika uses methods such as free association and dream analysis. Matika's beliefs and strategies for generalized anxiety disorder stem from the _____ perspective. sociocultural psychodynamic humanistic cognitive
psychodynamic
Cree attends sessions with other veterans who have PTSD to share experiences and feelings in a supportive atmosphere so as to develop insights about her experiences. Cree is attending this type of session, whose name is used interchangeably with group therapy and which is called: rap groups. Veterans Outreach. support groups. veteran support groups.
rap groups
Taylor was diagnosed with PTSD after returning from two tours of service in Iraq. She recently began experiencing problems in her marriage. Her partner complained that the closeness they once shared had changed and that Taylor had become distant and unaffectionate. This reflects which symptom associated with PTSD? reexperiencing the traumatic event reduced responsiveness avoidance increased arousal
reduced responsiveness
On a rainy night, Jeremy was robbed at gunpoint and shot. Years later, when it rains, he still has flashbacks of the event. This means that Jeremy is: hyperalert. showing symptoms of reduced responsiveness. reexperiencing the event. avoiding the traumatic event.
reexperiencing the event.
Therapists try to help clients with dissociative identity disorder with all of these EXCEPT: recovering the gaps in their memory. recognizing fully the nature of their disorder. repressing their memories. integrating their subpersonalities into one functional personality.
repressing their memories.
Psychodynamic theorists believe that dissociative disorders are caused by:
repression.
Donnisha received a diagnosis of acute stress disorder a week after she was the victim of a sexual assault. After receiving therapy for over a month, her symptoms persisted. Her psychologist should: keep her diagnosis of acute stress disorder. revise her disorder to both acute stress and PTSD. change the specifier of her diagnosis to chronic. revise her diagnosis to PTSD.
revise her diagnosis to PTSD.
Roni often felt like she was in a trance during her abusive childhood. Theorists of this perspective would suggest that Roni mentally separated herself from her body and fulfilled a wish to be someone else, a process called: repression. state-dependent learning. self-hypnosis. self-deception.
self-hypnosis.
Chantelle was sexually abused by her stepfather as a child. Consequently, she married as a teenager so that she could leave home, but she had a difficult time adjusting to her new life. She got employed at a job making minimum wage, and she felt discriminated against by her boss. Which aspect of her life was MOST likely to trigger a stress disorder? marriage job sexual abuse discrimination
sexual abuse
In the psychodynamic view, dissociative amnesia is a(n) ___________ episode of massive repression.
single
Overall, about half of all cases of PTSD improve within ___________ months.
six
Olfactotherapy uses which of the following to help elicit memories from clients? music visual stimuli smells and vibrations of essential oils client's belongings
smells and vibrations of essential oils
Jim, who has been diagnosed with PTSD, has problems dating due to his inability to emotionally connect with others since returning home from his service in Afghanistan. His problems reflect the impact of PTSD on which area of functioning? social occupational family personal
social
Fozia was first diagnosed with social phobia several years ago. She visited a therapist because of her extreme anxiety about speaking in front of other students in her classes. The DSM-5 made changes to terminology, so Fozia's diagnosis now is referred to as: agoraphobia. social anxiety disorder. a specific phobia. a generalized anxiety disorder.
social anxiety disorder
Jomary does not like to speak in front of others; in fact, she cannot tolerate public speaking because she worries that she will embarrass herself. Jomary may be suffering from: social anxiety disorder. agoraphobia. a specific phobia. psychosocial speaking phobia.
social anxiety disorder
Helga is participating in a therapy session in which she is role-playing and rehearsing desirable behaviors that she can perform when dealing with other people. Helga is engaging in _____ training. rational-emotive skills exposure skills desirability social skills vocational skills
social skills
Margo is a psychological theorist who is conducting research with low-income people who have been diagnosed with generalized anxiety disorder. She has found that anxiety problems in this group of people are related to problems involving poverty and poor job and educational opportunities. Margo's findings support the _____ perspective. cognitive sociocultural psychodynamic humanistic
sociocultural
The majority of phobias fall under this category: situational. specific. special. simple.
specific
Learning that becomes associated with the conditions under which it occurred, so that it is best remembered under the same conditions, is known as _____ learning. state-dependent state-independent state-effective state-internal
state-dependent
Smith works 60 hours a week and has to commute 45 minutes in one direction during peak traffic. These are examples of the _____ of life. stressors turning-point events long-term problems traumatic events
stressors
Arnold suffers from dissociative identity disorder. He has three _____: Craig, the studious introvert; Danny, the animal-loving child; and Vera, the outgoing socialite. substitute personalities superpersonalities suprapersonalities subpersonalities
subpersonalities
Anika is home alone one evening when she hears a noise coming from the kitchen. Her heart rate increases, and her mouth becomes dry. Her _____ nervous system has become activated. autonomic parasympathetic endocrine sympathetic
sympathetic
Individuals who are hypersensitive to stressful events and react to mild stressors with increased fear may have an overactive _____ nervous system. autonomic sympathetic parasympathetic central
sympathetic
You are home alone one evening when you hear some noises coming from the kitchen. Your heart rate increases and your mouth becomes dry. Your reactions are BEST explained by the activation of your _____ system. sympathetic nervous parasympathetic nervous cardiovascular endocrine
sympathetic nervous
Terri was raped when she was out jogging one night. Although this happened two years ago, she is hypervigilant and reluctant to leave home. This demonstrates how stress reactions to extraordinary trauma can cause: symptoms that linger. mood changes. changes in cognitive functions. symptoms that go away quickly.
symptoms that linger.
The hypothalamus activates these two important systems when the brain interprets a situation as dangerous. the autonomic nervous system and the endocrine system the autonomic nervous system and the exocrine system the autonomic nervous system and the endorphin system the somatic nervous system and the endocrine system
the autonomic nervous system and the endocrine system
This is the system of glands located throughout the body that help control important activities such as growth and sexual activity
the endocrine system
These are the nerve fibers that slow organ functioning after stimulation and return other bodily processes to normal
the parasympathetic nervous system
Those with a phobia are generally comfortable with their feared object or situation as long as: it is the result of a traumatic event. they avoid the object or situation or do not think about the object or situation. other people also fear the same object or situation. it only involves an animal.
they avoid the object or situation or do not think about the object or situation
Tom was the victim of a hate crime. His home was invaded, and his property was destroyed. He was beaten badly and humiliated. Now, whenever someone knocks on his door, he becomes anxious. He cannot sleep at night and often feels angry and irritable. His responses can be attributed to: anger. trauma and extraordinary stress. social withdrawal. insomnia.
trauma and extraordinary stress.
Extraordinary stress and trauma trigger a wide range of symptoms in: trauma- and stressor-related disorders. medical conditions. mood disorders. substance use disorders.
trauma- and stressor-related disorders.
LaKeisha was raped by an acquaintance at a party three years ago. Since then, she has been hypervigilant and reluctant to date. She has withdrawn from friends and prefers to be alone. The thought of going to a party makes her anxious, so she declines all social invitations. Her symptoms are most likely caused by: an anxiety disorder. social phobia. a mood disorder. trauma.
trauma.
In a number of international studies, _____ of participants given cognitive-behavioral treatments become free of panic attacks. one-third one-half two-thirds three-fourths
two-thirds
The situations that differentiate PTSD from anxiety disorders: are common to everyone. cause physical harm. are social situations. would be traumatic for anyone.
would be traumatic for anyone.
