chapter 8
Research finds that people with depersonalization/derealization disorder have an elevated risk of developing one of several other different disorders, including which of the following? a. Obsessive-compulsive disorder b. Schizophrenia c. Anorexia nervosa d. Dissociative amnesia
b. Schizophrenia
All of the following are associated with DID except ________ depression. hallucinations. psychosis. substance abuse.
psychosis.
Which of the following is most commonly true of the host identity in DID? It does not answer to the person's actual name. It is always the most well-adjusted of the identities. It is the second or third alter to develop. It is not the original identity.
It is not the original identity.
Which of the following is an explanation for the increased prevalence of DID? a. Increased public awareness of DID. b. The increased incidence of verbal abuse. c. Changes in the diagnostic criteria for PTSD. d. Therapists can seek greater insurance reimbursement for DID patients.
a. Increased public awareness of DID.
Allen Frances, who served as the chair of the task force that developed DSM-IV, has called the new DSM-5 somatic symptom disorder a ________ a. "loosely defined and fatally flawed" diagnosis and recommended that clinicians not use it. b. "much needed revision that focuses on real psychological symptoms" that should be a useful category for practicing clinicians. c. "significant improvement over the separate, narrowly defined categories used in the DSM-IV." d. "cumbersome product that relies too heavily on identifiable physical conditions for diagnosis."
a. "loosely defined and fatally flawed" diagnosis and recommended that clinicians not use it.
What percentage of the general population reports having experienced somatic (physical) symptoms in the past week? a. 80% b. 70% c. 60% d. 50%
a. 80%
How is a conversion seizure different from an epileptic seizure? a. A conversion seizure does not resemble an epileptic seizure on an EEG. b. Patients show more confusion after a conversion seizure. c. Patients have no loss of memory after an epileptic seizure. d. Patients do not lose bowel or bladder control after an epileptic seizure.
a. A conversion seizure does not resemble an epileptic seizure on an EEG.
What is the major commonality of the different somatic symptom disorders? a. Bodily symptoms that cause significant psychological distress and impairment b. A loss of contact with reality and a tendency to respond to an internally generated fantasy world c. The presence of two or more fully formed identities within the same individual d. A lack of control over physical functions, such as eating, sleeping, and sexual behaviors
a. Bodily symptoms that cause significant psychological distress and impairment
Which of the following was once viewed as form of "hysteria"? a. Conversion disorder b. Dissociative identity disorder c. Dissociative fugue d. Hypochondriasis
a. Conversion disorder
Matthew has been under significant stress at his job. He is concerned about his well-being because he has episodes at work and home where friends, family, and places seem as though they are unreal or dreamlike. Matthew's reality testing, however, is intact. What DSM diagnosis best fits with Matthew's experiences? a. Derealization b. Dissociative amnesia c. Depersonalization d. Conversion reaction
a. Derealization
__________ disorders are a group of conditions that involve disruptions in a person's normally integrated functions of consciousness, memory, identity, or perception. a. Dissociative b. Somatic symptom c. Psychotic d. Obsessive-compulsive
a. Dissociative
Although Charlie remembered most of the main issues of the meeting, he had no recollection of the decision to eliminate the department that he headed. Which disorder would be in effect? a. Dissociative disorder b. Conversion disorder c. Factitious disorder d. Somatic symptom disorder
a. Dissociative disorder
Angela's Uncle Leo, an accountant, disappeared from his home in Dover, Delaware, after his wife died from a lengthy illness. He was later found working in a casino in Las Vegas, Nevada. When located, Leo had no memory of who he was or how he got to Las Vegas. He had assumed a name, rented an apartment, and managed his daily affairs in Las Vegas without any problems. What diagnosis best fits with Leo's behaviors? a. Dissociative fugue b. Dissociative identity disorder c. Derealization d. Depersonalization
a. Dissociative fugue
Jill did not remember the accident happening or her graduation a couple of months before. What form of memory loss is this characteristic of? a. Episodic b. Semantic c. Retrograde d. Short term
a. Episodic
Which of the following types of memory is typically the only type of memory affected by dissociative amnesic reactions? a. Episodic and/or autobiographical memory b. Procedural and/or implicit memory c. Semantic memory d. Short-term memory
a. Episodic and/or autobiographical memory
Which disorder would include intentionally taking drugs in order to stimulate various real illnesses? a. Factitious disorder b. Malingering c. Dissociative identity disorder d. Somatization disorder
a. Factitious disorder (fact- drugs )
Maya is 32 years of age, and is irritated that her sister is getting so much attention around her upcoming wedding. In order to get more attention for herself, Maya begins feigning the symptoms of a major illness. She even has herself hospitalized for this phantom sickness. What psychological disorder are these symptoms of? a. Factitious disorder b. Malingering c. Somatic symptom disorder d. Illness anxiety disorder
a. Factitious disorder (faking)
Caroline's daughter Hailey, age 5, has spent much of her life in and out of the hospital. She often presents in the emergency room with complaints of diarrhea, constipation, and generalized abdominal pain. Hailey is thin, pale, and always appears malnourished. Extensive testing in the hospital has revealed no physical cause for Hailey's problems. Caroline seems to enjoy talking with the health care staff and the attention she receives as the mother of a sick child. The staff notes that Hailey always recovers quickly and has a rapid weight gain while hospitalized. Some of the staff wonders if Caroline is intentionally making Hailey ill. If the staff is correct, which of the following diagnoses would be appropriate for Caroline? a. Factitious disorder imposed on another b. Malingering c. Dissociative disorder d. Somatic symptom disorder
a. Factitious disorder imposed on another (using one person to get attention)
When hypochondriasis occurs with no or only very mild physical symptoms, what would be the correct DSM-5 diagnosis? a. Illness anxiety disorder b. Somatic symptom disorder c. Conversion disorder d. Body dysmorphic disorder
a. Illness anxiety disorder
________ memory refers to stored information that people cannot consciously recall. a. Implicit b. Explicit c. Eidetic d. Flashbulb
a. Implicit
Which of the following has been demonstrated about the effects of dissociative amnesias on memory? a. Implicit memory is generally intact. b. Explicit memory is rarely affected. c. Episodic memory is not compromised. d. Semantic memory is most dramatically affected.
a. Implicit memory is generally intact.
Which of the following statements correctly identifies the difference between factitious disorder and malingering? a. In the case of factitious disorder, the person receives no tangible external rewards. With malingering, the person is motivated by external incentives such as avoiding situations perceived as stressful or personal responsibilities. b. In the case of factitious disorder, the person is motivated by external incentives such as avoiding situations perceived as stressful or personal responsibilities. With malingering, the person receives no tangible external rewards. c. Malingering represents unconscious desires that the patient is unaware of. Factitious disorder describes a conscious, deliberate act on the part of the patient to obtain gain. d. Neuroimaging reveals that factitious disorder engages activity in the cingulate gyrus of the brain. Malingering engages activity in the left temporal lobe.
a. In the case of factitious disorder, the person receives no tangible external rewards. With malingering, the person is motivated by external incentives such as avoiding situations .
Alan fell off a ladder at work and claims his back is in intense pain, even though medical tests find nothing wrong. He does not like to talk about it and keeps quiet other than his report to his attorney. Caleb fell off a ladder at work and claims he hurt his back, too, even though medical tests find nothing wrong. He talks about it all of the time in great detail. Which diagnosis would seem to fit each man? a. Malingering in Alan and conversion disorder in Caleb b. Malingering in Alan, factitious disorder in Caleb c. Factitious disorder in Alan, malingering in Caleb d. Conversion disorder in Alan, malingering in Caleb
a. Malingering in Alan and conversion disorder in Caleb
Which of the following personality traits are considered risk factors for developing somatic symptom disorder? a. Negative affect, absorption, and alexithymia b. Negative affect, lability of affect, and alexithymia c. Flat affect, narcissism, and alexithymia d. Flat affect, stoicism, and alexithymia
a. Negative affect, absorption, and alexithymia
What major change has been made to the category of somatic symptom and related disorders in DSM-5? What major change has been made to the category of somatic symptom and related disorders in DSM-5? a. No distinction has been made between medically explained and medically unexplained symptoms. b. The duration for which the symptoms must be present before a diagnosis is made has been extended to 12 months. c. The clinical specifics of "with normal premorbid functioning and "without normal premorbid function" have been added. d. An exclusion criterion has been added, removing this diagnosis for anyone who is currently using and/or abusing psychoactive drugs.
a. No distinction has been made between medically explained and medically unexplained symptoms.
Which of the following is a way to distinguish between someone with conversion disorder and someone who is malingering? a. People with conversion disorder are very willing to talk about their symptoms; malingerers will be more cautious. b. People with conversion disorder will be very cautious about talking about their symptoms; malingerers are very willing to talk about them. c. People with conversion disorder are usually very defensive; malingerers will try to seem very open and trusting. d. If their symptoms are shown to be inconsistent, people with conversion disorder become very defensive while malingerers do not.
a. People with conversion disorder are very willing to talk about their symptoms; malingerers will be more cautious.
Which of the following statements is most typical of individuals with DID? a. Periods of "lost time." b. Socially inept as a child. c. Aware of separate personalities prior to beginning treatment. d. Tends to express emotional distress in complaints about her body.
a. Periods of "lost time."
Which of the following best describes the symptoms associated with Amok? a. Persons afflicted exhibit violent, aggressive, or homicidal behavior which is directed at other people and objects. b. Afflicted persons fear that their genitals are retracting into their body. c. Persons afflicted with this syndrome experience visual and auditory hallucinations or paranoia. d. Afflicted persons feel they have been given a curse believed to be cast by a malevolent glare from another person.
a. Persons afflicted exhibit violent, aggressive, or homicidal behavior which is directed at other people and objects.
Lenny's wife, Morgan, has been diagnosed with DID. According to Morgan, she has discovered in therapy that she was abused by her father. Lenny feels Morgan's memories are false memories, and have resulted from leading questions and suggestive techniques used by her psychotherapist. Theoretically, what perspective reflects Lenny's concerns? a. Sociocognitive theory b. Psychodynamic theory c. Posttraumatic theory d. Neodissociation theory
a. Sociocognitive theory
What would be most helpful to a person with somatic symptom disorder? a. Staying physically active despite the pain. b. Restricting physical activity as much as possible. c. Getting a great deal of sympathy and attention. d. Being allowed to avoid unpleasant tasks while he or she is in pain.
a. Staying physically active despite the pain.
In DSM-5, the diagnostic criteria for DID have been modified to include pathological possession. How has this change affected the DSM? a. The change makes the diagnosis of DID more inclusive and applicable to a broader range of cultural groups. b. The change enables the clinician to distinguish between the forms of possession found in religious experiences and those of a pathological form. c. The inclusion of pathological possession has led some of the developers of the DSM-5 to be concerned about the validity of this concept. d. The change distinguishes between observed behaviors associated with schizophrenia and those associated with DID.
a. The change makes the diagnosis of DID more inclusive and applicable to a broader range of cultural groups.
The sensory symptoms or deficits found with persons with conversion disorder are most often found in which of the following sensory systems? a. Visual b. Vestibular c. Olfactory d. Gustatory
a. Visual
For individuals with DID, alters are not in any meaningful sense personalities but rather reflect ________ a. a failure to integrate various aspects of a person's identity, consciousness, and memory. b. negative introjects established in the patient during childhood. c. difficulties that the patient has with distinguishing reality from fantasy. d.characteristics of individuals that may have befriended the patient during childhood
a. a failure to integrate various aspects of a person's identity, consciousness, and memory.
Most current forms of psychotherapy for DID are based on the assumption that the disorder was caused by ________ a. abuse. b. a tendency for the patient to engage in an overly active fantasy life. c. poor treatment techniques administered by therapists lacking in appropriate training. d.early separation from the mother
a. abuse.
The inability to learn new information is known as ________ a. anterograde amnesia. b. retrograde amnesia. c. continuous amnesia. d. generalized amnesia.
a. anterograde amnesia.
Amnesia caused by organic brain pathology is more likely to be classified as _________ amnesia, whereas amnesia that occurs following intolerably stressful circumstances is more likely to be __________ amnesia. a. anterograde; retrograde b. retrograde; anterograde c. posttraumatic; retrograde d. anterograde; posttraumatic
a. anterograde; retrograde
Connor is able to talk only in a whisper, although he can usually cough in a normal manner. This type of vocal symptom pattern, found with cases of conversion disorder, is referred to as ________ a. aphonia. b. alexia. c. dysarthria. d. spasmodic dysphonia.
a. aphonia.
If Ronald is typical of people with somatic symptom disorder, he may ________ a. avoid accepting a psychological explanation for his problems. b. avoid visiting a physician. c. have bizarre delusions about his body rotting out. d. feel relieved when his doctor tells him he is healthy.
a. avoid accepting a psychological explanation for his problems.
For an individual to be diagnosed with somatic symptom disorder, he or she must ________ a. be experiencing distressing chronic somatic symptoms and exhibit dysfunctional thoughts, feelings, and/or behaviors. b. have no documented medical reason for their somatic concerns and exhibit difficulties in meeting the demands of daily living. c. exhibit debilitating physical symptoms and demonstrate no dysfunctional thoughts, feelings, and/or behaviors. d. have an onset of symptoms before age 18 and be experiencing dysfunctional thoughts, feelings, and/or behaviors.
a. be experiencing distressing chronic somatic symptoms and exhibit dysfunctional thoughts, feelings, and/or behaviors.
The disorder involving the experience of sudden loss of the sense of self is ________ a. depersonalization disorder. b. psychogenic amnesia. c. disidentity disorder. d. derealization disorder.
a. depersonalization disorder.
Stephanie has repeated experiences where she feels she is floating above her physical body. These experiences come on suddenly and leave Stephanie feeling unreal. The DSM-5 diagnosis that best corresponds to Stephanie's experience is ________ a. depersonalization. b. dissociative identity disorder. c. derealization. d. dissociative amnesia.
a. depersonalization.
The diagnosis of somatic symptom disorder is ________ and contains no assumptions about _________. a. descriptive, cause b. definitive, treatment c. superceded by a diagnosis of hypochondria, treatment d. superceded by a diagnosis of malingering, consequences
a. descriptive, cause
Andrew often cannot remember what went on during his history class. He finds the class boring and daydreams during the lecture. He is so involved in his daydreaming that, frequently, he is unaware when the class has ended and is surprised when he hears classmates leaving the room. Andrew's behavior is an example of ________ a. dissociation. b. a conversion reaction. c. explicit memory. d. abreaction.
a. dissociation. no awareness.
Gerard became amnesic, wandered away from home and assumed a completely new identity as a shoe salesman. He suffers from ________ a. dissociative fugue . b. dissociative identity disorder. c. malingering identity disorder. d. depersonalization.
a. dissociative fugue (new place new life )
Sociocognitive theory ________ a. explains why symptoms of DID are often not seen until after treatment is initiated. b. explains why the number of alters is usually constant. c. can't account for the role that trauma appears to play in DID. d. does not explain the phenomenon of "lost time."
a. explains why symptoms of DID are often not seen until after treatment is initiated.
Somatization disorder, as defined in DSM-5, ________ a. has been subsumed into somatic symptom disorder b. involves multiple symptoms involving one body part or function. c. involves the fear of having multiple different diseases. d. involves having pain in at least four different areas of the body.
a. has been subsumed into somatic symptom disorder
Individuals with illness anxiety disorder _________ a. have high anxiety about developing or having an illness. However, if somatic symptoms are present, they are mild in intensity. b. develop the disorder after having been treated for a serious or life-threatening illness. c. may become suspicious or delusional in their beliefs about the treatment they are receiving. d. often come from families where a family member has a long-term debilitating illness.
a. have high anxiety about developing or having an illness. However, if somatic symptoms are present, they are mild in intensity.
Important to understanding somatic symptom disorders is the fact that the affected patients ________ a. have no control over their symptoms, but are not trying to intentionally deceive others. b. have no control over their symptoms, but are trying to intentionally deceive others. c. are overwhelmed by anxiety, but are not trying to deceive others. d. have control over their symptoms, but are using symptoms as a way of meeting a strong desire to be cared for by others.
a. have no control over their symptoms, but are not trying to intentionally deceive others.
In cases of dissociative identity disorder, the identity that is most frequently encountered and carries the person's real name is called the ________ a. host. b. alter. c. substitute. d. factitious identity.
a. host.
According to the revisions made for DSM-5, most people previously diagnosed with __________ will be diagnosed with somatic symptom disorder. a. hypochondriasis b. factitious disorder c. somatization disorder d. body dysmorphic disorder
a. hypochondriasis
An important goal of psychotherapy for persons with DID is to ________ a. integrate the patient's personalities into one identity that is better able to cope with current stressors. b. enable the patient to release alters and mourn their passing. c. assist the patient in acknowledging and accepting past childhood trauma. d. help the patient eliminate sources of secondary gain that may develop as a result of having alters.
a. integrate the patient's personalities into one identity that is better able to cope with current stressors.
One of the major criticisms of the diagnostic criteria of somatic symptom disorder _______ a. is that the new diagnostic criteria appear far too loose and could lead to many people being mislabeled as having a mental disorder. b. points out that older adults will be disproportionately labeled because this population often experiences a range of physical symptoms that are difficult to assign diagnosis to. c. concerns the possibility that immigrants and members of non-dominant cultural groups will be overdiagnosed. d . focuses on the extensive criteria that must be met in order to be diagnosed.
a. is that the new diagnostic criteria appear far too loose and could lead to many people being mislabeled as having a mental disorder.
In the study mentioned in the text, the German man who had dissociative fugue denied that he could speak German. However, he learned German-English word pairs much faster than control words. This supports that ________ a. mainly episodic memory is lost; implicit memory stays intact. b. mainly implicit memory is lost; episodic memory stays intact. c. both episodic and implicit memory are affected. d. most people with dissociative fugue are faking.
a. mainly episodic memory is lost; implicit memory stays intact.
Consciously faking symptoms is characteristic of ________ a. malingering. b. hypochondriasis. c. somatization disorder. d. somatic symptom disorder. e. Answer: a. malingering.
a. malingering
When a person intentionally creates his own physical symptoms in order to get some sort of external gain—disability benefits, avoidance of military service, or extended time off from his job—he is demonstrating the symptoms of __________. a. malingering b. Munchausen's syndrome by proxy c. factitious disorder d. somatic symptom disorder
a. malingering faking for external gain
Kilstrom (2005) and others have pointed out that conversion disorders are different from the other somatic symptom disorders in that conversion symptoms _________, while somatic symptom disorders do not. a. nearly always resemble neurological problems in their clinical presentation b. present with symptoms of depersonalization c. involve retrograde memory problems d. frequently involve experiences of implicit perception
a. nearly always resemble neurological problems in their clinical presentation
About 20 percent of persons diagnosed with conversion disorder present the symptom of la belle indifference. This term refers to the fact that ________ a. patients exhibit very little anxiety and fear, behaviors that would normally be expected in people with symptoms such as paralysis or blindness. b. patients are distressed by the symptoms, so much so that they are unable to talk. c. many patients presenting with conversion disorder attempt to minimize the inconvenience of the symptoms they are experiencing. d. secondary gain plays a big role in sustaining the symptoms such as paralysis or blindness.
a. patients exhibit very little anxiety and fear, behaviors that would normally be expected in people with symptoms such as paralysis or blindness.
According to cognitive-behavioral formulations, somatic symptom disorder can be viewed as a disorder of both ________ a. perception and cognition. b. insufficient dopamine availability in the brain and cognitive processes. c. emotional expression and physical state. d. mind and body.
a. perception and cognition.
Implicit perception can be defined as ________ a. perception in the absence of awareness. b. remembering things one cannot consciously recall. c. recall of information with a direct awareness of how the information was learned. d. perceiving while being fully aware of previous experiences of that which is being perceived.
a. perception in the absence of awareness.
Recent studies have compared the behavior of people diagnosed with DID with the behavior of people who are asked (after appropriate training) to simulate DID. Individuals diagnosed with DID differed from simulators in that ________ a. persons with DID showed more cognitive processing problems. b. persons with DID were less sensitive to external stimulation such as noises or temperature. c. persons with DID reported fewer pathological symptoms. d. the simulators typically presented with more elaborate personalities.
a. persons with DID showed more cognitive processing problems.
The original theory dealing with the origins of DID was that DID had its roots in a patient's childhood and that DID was the result of an attempt to cope with an overwhelming sense of hopelessness and powerlessness in the face of repeated traumatic abuse. This theory is called _______ _ a. posttraumatic theory. b. neo-dissociation theory. c. trauma recapitulation theory. d. object discontinuity theory.
a. posttraumatic theory.
Zack, diagnosed with somatic symptom disorder, is participating in a form of cognitive therapy where his therapist has instructed him to not engage in checking his body as he routinely does and to not seek constant reassurance from others. Zack's therapist is using the technique of ________ a. response prevention. b. thought stopping. c. behavioral experiment. d. imagery-based prevention.
a. response prevention.
With the general public, the diagnosis of dissociative identity disorder (DID) is often confused with the diagnosis of __________ as a result of the use of the phrase ______________. a. schizophrenia; "split personality" b. borderline personality disorder; "split personality" c. schizophrenia; "cracked personality" d. paranoid personality disorder; "deranged personality" Answer: a. schizophrenia; "split personality"
a. schizophrenia; "split personality"
Burke, et al. (2014) conducted a study involving 10 women with conversion disorder. The findings revealed that when the anesthetic body part was stimulated, there was decreased activation in somatosensory cortex but increased activation in areas such as the anterior cingulate cortex and the insula. These results support the notion that ________ a. sensory areas of the brain may be inhibited by overactive emotion-based processing areas of the brain. b. motor areas of the brain are less important as survival mechanisms than are the emotion-related regions of the brain. c. biochemical processes associated with conversion disorders may reroute neural messages to other areas of the brain such as emotional processing centers. d. limbic structures are more involved in sensation and physical movement than previously thought.
a. sensory areas of the brain may be inhibited by overactive emotion-based processing areas of the brain.
Catastrophizing about minor bodily sensations is characteristic of individuals with ________ a. somatic symptom disorder. b. hypochondriasis and conversion disorder. c. dissociative fugue and somatization disorder. d. dissociative fugue and conversion disorder.
a. somatic symptom disorder.
Dysfunctional assumptions about symptoms and diseases are a component of a cognitive-behavioral explanation of ________ a. somatic symptom disorder. b. dissociative fugue. c. somatization disorder. d. depersonalization disorder.
a. somatic symptom disorder.
When hypochondriasis is accompanied by significant physical symptoms, the DSM-5 diagnosis will be ________ a. somatic symptom disorder. b. illness anxiety disorder. c. somatoform disorder. d. conversion disorder.
a. somatic symptom disorder.
Brain-imaging data was evaluated for nine individuals diagnosed with dissociative amnesia. The imaging suggested that, for these diagnosed individuals, there was a ________ a. subtle loss of function in the right anterior hemisphere. b. loss in hippocampal volume with a slight increase in volume of the amygdala. c. significant functional change in the prefrontal cortex. d. reduced functioning in the temporal region.
a. subtle loss of function in the right anterior hemisphere.
With conversion disorders, Freud thought that the reduction in anxiety and intrapsychic conflict was _______________, but noted that patients often also experienced ___________ as well. a. the "primary gain" that maintained the condition; "secondary gain" such as receiving sympathy and attention from loved ones b. "primary gain" that returned the repressed thought to an unconscious level; "secondary gain" such as having unconscious needs met in new, indirect ways c. under the direction of the superego; energy and influence from the id d. the result of the conversion holding libidinal forces at bay; undefined psychic energy
a. the "primary gain" that maintained the condition; "secondary gain" such as receiving sympathy and attention from loved ones
A promising treatment of dissociative disorders involves administering rTMS (repetitive transcranial magnetic stimulation) to the temporo-parietal junction, an area of the brain involved in ________ a. the experience of a unified self and body. b. executive functions and planning behavior. c. regulation of emotions associated with pleasure. d. regulation of choice behavior and emotion.
a. the experience of a unified self and body.
Conversion disorder is characterized by _________ a. the presence of neurological symptoms in the absence of a neurologic diagnosis. b. chronic distressing somatic symptoms accompanied by dysfunctional thoughts, feelings, and/or behaviors. c. mild somatic symptoms accompanied by intense worry about illness. d. disruptions in a person's normally integrated functions of consciousness, memory, identity, or perception.
a. the presence of neurological symptoms in the absence of a neurologic diagnosis.
The historical roots of the DSM-IV category of somatoform disorders date back to ________ a. the psychoanalytic concept of hysteria and the work of Freud, Breuer, and Janet. b. early classical conditioning theorizing by Watson and the belief that behaviors associated with somatoform disorders were a product of faulty learning. c. the humanist perspective championed by Rogers and Maslow which suggests that somatoform disorders develop in response to blocking self-actualization. d. medical models that looked at abnormalities in limbic system structures.
a. the psychoanalytic concept of hysteria and the work of Freud, Breuer, and Janet.
It has been suggested that some of the increase in the prevalence of DID is artifactual and has occurred because ________ a. therapists looking for evidence of DID in patients may suggest the existence of alter identities. b. neuroimaging techniques are able to verify different brain responses when comparing the host to alter personalities. c. beginning with the DSM-III in 1980, the diagnostic criteria became more inclusive of symptoms normally attributed to other diagnoses. d. popular movies and books have generated a large interest in the subject of DID.
a. therapists looking for evidence of DID in patients may suggest the existence of alter identities
In the DSM-IV, depersonalization and derealization used to be treated as ________ a. two separate disorders. b. both associated with psychogenic amnesia. c. forms of malingering. d. conversion disorders.
a. two separate disorders.
When it comes to the effectiveness of treatment for dissociative disorders, we know ________ a. very little. b. that medications are ineffective, but that psychotherapy is quite helpful. c. that depersonalization is much more effectively treated than amnesia. d. that antidepressant medications are most effective in treating dissociative identity disorder.
a. very little.
For how long must the preoccupation with a real or imagined illness persist before a diagnosis of illness anxiety disorder can be made? a. 1 year b. 6 months c. 3 months d. 1 month
b. 6 months
Which of the following disorders was once the most frequently diagnosed disorder among soldiers in World War I? a. Acute anxiety disorder b. Conversion disorder c. Dissociative identity disorder d. Hypochondriasis
b. Conversion disorder
Following the rejection of his latest novel, Jim experienced an inability to make some movements with his right hand. While he was unable to write, he could scratch and make other simple motions with his affected hand. Two weeks later he was able to write again. What is unique about Jim's case of conversion disorder? a. Jim had some ability to move his hand. b. Jim is male, and most people with this disorder are women. c. Jim's symptoms subsided after only two weeks. d. Jim only lost the ability to move his right hand.
b. Jim is male, and most people with this disorder are women.
John and Ira eat dinner together after work. Several hours later, each starts to feel nausea and stomach pains. John has a somatic symptom disorder, Ira does not. Most likely ________ a. both men will think that the food they ate made them sick. b. John will think that he has stomach cancer and Ira will think the food he ate made him sick. c. John will think the food he ate made him sick and Ira will not think anything at all. d. Ira will think he has stomach cancer and John will think the food he ate made him sick.
b. John will think that he has stomach cancer and Ira will think the food he ate made him sick.
After learning of her father's death, Sophia felt dazed and confused but still retained her sense of self. When speaking of her response to the news, she said she felt like she was in a movie watching the events happening to her. Despite this strange feeling, she understood what was happening and did the things that she needed to do. What can be said of Sophia's response to her father's death? a. Her response is not typical and suggests that she is suffering from acute stress disorder. b. She experienced an instance of derealization. c. She had a psychotic break. d. She experienced an instance of depersonalization.
b. She experienced an instance of derealization.
Dan's various medical complaints and hospital stays finally led him to see a psychiatrist. After a thorough medical and psychological evaluation, the 28-year-old teacher and father of two was diagnosed with both depression and somatic symptom disorder. What is atypical about this case summary? a. Such diagnoses are usually made in adolescence. b. Somatic symptom disorder is seen much more commonly in women. c. Somatization disorder and depression are rarely comorbid disorders. d. It is rare for an individual with somatization disorder to marry and have children.
b. Somatic symptom disorder is seen much more commonly in women.
Which of the following is true of opposite sex alters in DID? a. They are rare. b. They are quite common. c. When they do occur, they usually assume the role of host. d. They occur most commonly when sexual abuse has occurred.
b. They are quite common.
The most common kind of speech-related conversion reaction is ________ a. alexia b. aphonia c. apraxia d. alogia
b. aphonia like symphony
Brigid has been diagnosed with dissociative identity disorder. Brigid is the host personality. We can expect that the alter identities ________ a. are very much like Brigid. b. are strikingly different from Brigid. c. only "come out" when there is no stress in the environment. d. are very much like one another.
b. are strikingly different from Brigid.
In __________, one's sense of the reality of the outside world is lost. a. derealization b. dissociation c. a fugue d. depersonalization
b. dissociation
In soap operas, characters often forget their past experience following some trauma. They don't merely forget the traumatic event, they forget who they are, where they came from—they lose almost all memory of their lives. They then move to a new place and start a new identity. This would best be described as an instance of ________ a. anterograde amnesia. b. dissociative fugue. c. continuous amnesia. d. generalized amnesia.
b. dissociative fugue. ( new place new identity)
About 25 percent of people with illness anxiety disorder would have been diagnosed as having ________, according to the DSM-IV. a. conversion disorder b. hypochondriasis c. illness anxiety disorder d. somatization disorder
b. hypochondriasis
Dissociative identity disorder was formerly known as ________ a. psychogenic amnesia. b. multiple personality disorder. c. conversion hysteria. d. neurasthenia.
b. multiple personality disorder.
DID is a condition in which aspects of memory such as identity and consciousness are _________ a. overly integrated. b. no longer integrated. c. implicitly segregated. d. shared by separate people.
b. no longer integrated.
Research on somatic symptom disorder has shown that people with the disorder tend to ________ a. ignore information about illness. b. overestimate the dangerousness of diseases. c. underestimate the dangerousness of diseases. d. overestimate their ability to handle being ill.
b. overestimate the dangerousness of diseases.
In an individual with DID, "switches" between identities ________ a. usually take several days. b. produce gaps in memory. c. occur symmetrically, such that all identities share equal control. d. are controlled by the host identity.
b. produce gaps in memory.
Ryan has diabetes but has no trouble functioning. One day, his wife informs him that she is leaving him. Ryan suddenly develops terrible pain in his back, to the point he is unable to get out of bed. His wife agrees to stay for "a while" to take care of him. Ryan probably has ________ a. somatization disorder. b. somatic symptom disorder c. pain disorder associated with both psychological factors and a general medical condition. d. body dysmorphic disorder.
b. somatic symptom disorder . bad situation put people dysfunctional. somatic disorder
Studies of individuals with DID compared to those trained to simulate the disorder ________ a. support the trauma model more than the sociocognitive model. b. support the sociocognitive model more than the trauma model. c. definitively demonstrate that DID is faked, whether intentionally or unintentionally. d. suggest that DID is faked, but only unconsciously.
b. support the sociocognitive model more than the trauma model.
The DSM-5 recognizes how many types of pathological dissociation? a. 1. b. 2. c. 3. d. 8.
c. 3.
Conversion disorders are found in approximately _____ of people referred for treatment at neurology clinics. a. 1% b. 3% c. 5% d. 6%
c. 5%
Which of the following statements would be an example of those thoughts associated with a person suffering from somatic symptom disorder? a. A sore throat is nothing to worry about unless there is a temperature along with it, then it is a big problem. b. A sore throat is serious and requires a trip to the doctor. If the doctor tests and finds nothing, it is okay. c. A sore throat is a major problem. It could be cancer or some other deadly disease no matter what the doctor says. d. A sore throat could be a serious sign of cancer, but it would be important to wait until the doctor says one way or the other before panicking.
c. A sore throat is a major problem. It could be cancer or some other deadly disease no matter what the doctor says.
What do somatic symptom disorder and the dissociative disorders have in common? a. Both are characterized by physical complaints. b. Both are more common in men. c. Both appear to be ways of avoiding anxiety. d. Both have onset during early childhood.
c. Both appear to be ways of avoiding anxiety.
Which of the following summarizes the posttraumatic theory for the origin of DID? a. Therapists unwittingly reinforce role-playing of alter identities. b. Genetically programmed tendencies to dissociate are triggered by stress. c. Children deal with severe abuse by creating alters who provide an "escape." d. The rewards of avoiding punishment from the legal system induces people to fake symptoms.
c. Children deal with severe abuse by creating alters who provide an "escape."
Why has the term "multiple personality disorder" been replaced with "dissociative identity disorder"? a. The old term was often used to refer to both schizophrenia and DID, thus a new term was needed to end this confusion. b. The word "multiple" suggested the presence of more identities than were commonly observed. c. Fully developed personalities are not present in DID, just varying expressions of different aspects of the patient's personality. d. A new diagnostic term was wanted to remove some of the stigma associated with the old term and its presentation in the media.
c. Fully developed personalities are not present in DID, just varying expressions of different aspects of the patient's personality.
In what way was Freud's view of conversion disorder consistent with learning theories? a. Freud proposed that faulty thinking underlies the symptoms of conversion disorder. b. He advocated treating conversion disorder by punishing the problem behaviors. c. He believed that the symptoms of conversion disorder were maintained by the relief from anxiety they provided. d. Freud believed that those with conversion disorder were suffering bodily symptoms due to a conflict between their inner desires and the demands placed on them by society (the environment).
c. He believed that the symptoms of conversion disorder were maintained by the relief from anxiety they provided.
A nurse in an emergency room sees many illnesses and reported illnesses. A group of psychology students are listening to her speak and one asks her what might be one way to tell the difference between a conversion disorder and a true organic disturbance. Which of the following would be a valid answer? a. The patient will show some signs of an illness but not enough signs. b. The patient will not be able to use muscles that are "damaged." c. The patient shows no signs of atrophy in damaged areas. d. The patient shows the signs of illness under hypnosis.
c. The patient shows no signs of atrophy in damaged areas.
An in-depth study by Lewis and colleagues of 12 convicted murderers diagnosed with dissociative identity disorder looked into their backgrounds. The study found strong evidence that each was severely abused, both physically and sexually. Why does the text refer to this study as "flawed." a. Malingerers were studied separately from the larger group of DID sufferers. b. Malingerers were excluded from the study. c. There was no control group of murderers without DID. d. There was no control group of DID sufferers who were not murderers.
c. There was no control group of murderers without DID.
Individuals with somatic symptom disorders ________ a. intentionally fake their illnesses in order to obtain some special treatment. b. generally have a physical cause for their illness. c. believe that their symptoms are real and serious. d. usually have little concern over their state of health.
c. believe that their symptoms are real and serious.
Somatization disorder and hypochondriasis are similar in DSM-5 in that ________ a. both involve patients thinking they have a physical disease. b. both involve patients thinking that they can easily cope with their symptoms. c. both disorders have been subsumed into somatic symptom disorder d. both involve patients reacting to physical symptoms by becoming more physically active.
c. both disorders have been subsumed into somatic symptom disorder
Once a dissociative fugue ends, people ________ a. can remember everything that has happened to them. b. remember who they are but cannot remember their past. c. can remember their past but cannot remember what happened during the fugue. d. can remember their past but keep their new identity.
c. can remember their past but cannot remember what happened during the fugue.
The most effective treatment to date for somatic symptom disorder ________ a. increases psychological distress. b. results in only temporary changes in psychological symptoms. c. decreases healthcare expenditures. d. has not been shown to effect physical functioning.
c. decreases healthcare expenditures.
The current prevalence of conversion disorder is ________ a. decreasing as sophistication about disorders decreases. b. increasing as sophistication about disorders increases. c. decreasing as sophistication about disorders increases. d. consistent with previous eras.
c. decreasing as sophistication about disorders increases.
Assuming a new identity in a new place is characteristic of ________ a. depersonalization disorder. b. all forms of dissociative amnesia. c. dissociative fugue. d. dissociative identity disorder.
c. dissociative fugue.
A person with two or more well-developed identities has the disorder called ________ a. fugue state. b. depersonalization disorder. c. dissociative identity disorder. d. localized psychogenic amnesia.
c. dissociative identity disorder.
A person with illness anxiety disorder has a preoccupation with ________ a. making other people sick. b. having an anxiety attack. c. having or acquiring a serious illness. d. small objects that appear at night on the horizon.
c. having or acquiring a serious illness.
A new disorder in DSM-5 is ________ a. conversion disorder. b. hypochondriasis. c. illness anxiety disorder. d. somatization disorder.
c. illness anxiety disorder.
The treatment goal for most therapists who treat dissociative identity disorder is ________ a. acceptance of the alter personalities. b. reduction in the impact of distress and impairment. c. integration of the alter personalities. d. self-understanding of the causes for the alter personalities.
c. integration of the alter personalities.
Dissociation ________ a. only occurs in people with a dissociative disorder. b. is a sign that something is seriously wrong. c. is extremely common and not necessarily pathological. d. is extremely rare and not necessarily pathological.
c. is extremely common and not necessarily pathological.
Recent estimates suggest that about 50 percent of those with DID have ________ a. only two identities. b. two alters, in addition to the host identity. c. more than 10 identities. d. as many as 200 identities.
c. more than 10 identities.
There is debate as to the relationship between DID and abuse because ________ a. few of those who develop DID have a history of abuse. b. there is little evidence of a link between trauma and psychopathology. c. other factors correlated with abuse may be the true causal factors in DID. d. most reports of abuse are faked.
c. other factors correlated with abuse may be the true causal factors in DID.
Evan is terrified because he is convinced that he has a terminal heart condition. He has consulted with several physicians who have found no evidence of any heart disease. Evan continues to feel terrified even when the doctors find no physical problem. His diagnosis is probably ________ a. somatization disorder. b. pain disorder. c. somatic symptom disorder. d. malingering.
c. somatic symptom disorder.
Which of the following best explains why conversion disorder is a less common diagnosis today than it was historically? a. Advances in the psychiatric profession have decreased the prevalence of all disorders linked to traumatic events. b. Those once diagnosed with conversion disorder are now more likely to be diagnosed with PTSD. c. Today's psychiatrists tend to view this diagnosis as one that lacks reliability and validity, thus they are hesitant to even consider it as a diagnostic option. d. Advances in the medical field have made patients more sophisticated about medical and psychological disorders.
d. Advances in the medical field have made patients more sophisticated about medical and psychological disorders.
According to sociocognitive theory, ________ a. the mind separates due to some traumatic experience and is never fully integrated, resulting in the multiple identities observed in DID. b. the alters in DID develop as a means of escaping from some form of trauma. c. DID has a factitious origin. d. DID may develop when a suggestive patient is treated by an overzealous clinician.
d. DID may develop when a suggestive patient is treated by an overzealous clinician.
When a person experiences dissociative amnesia, one main type of memory is usually affected. Which? a. Semantic memory (pertaining to language and concepts) b. Procedural memory (how to do things) c. Perceptual memory (the representation of things in images) d. Episodic memory (the events we have experienced)
d. Episodic memory (the events we have experienced)
Munchausen's syndrome by proxy is a variant of which of the following disorders? a. Conversion disorder b. Body dysmorphic disorder c. Hypochondriasis d. Factitious disorder
d. Factitious disorder
What is one reason why the prevalence of DID has been increasing? a. Children in today's society are far more likely to experience severe trauma than they were in the past. b. DID has only recently received full acceptance from the psychiatric community and thus professionals are now using this diagnosis. c. As of 1980 most insurance companies had to accept DID as a billable diagnosis. d. It may be that the prevalence of DID has not changed at all, but that clinicians may unknowingly encourage the emergence of new identities.
d. It may be that the prevalence of DID has not changed at all, but that clinicians may unknowingly encourage the emergence of new identities.
Which of the following is most suggestive of dissociative identity disorder? a. Grace's feelings about James switched from positive to negative instantly. b. Peter could not explain why he didn't complete the project. c. Delilah was never able to make up her mind. d. Kyla could not recall where she had been or what she had done all day.
d. Kyla could not recall where she had been or what she had done all day. (no remember nothing)
Which of the following is characterized by a reluctance to discuss symptoms? a. Conversion b. Hypochondriasis c. Somatic symptom d. Malingering
d. Malingering
Octavia has been diagnosed with dissociative identity disorder (DID). She has 17 different "alters," which are strikingly different from her host personality. Some of her alters are not full personalities, but fragments and memories. Some of the alters are children. What aspect of this case is unusual? a. It is unusual for a person with DID to have seventeen alters. b. It is unusual for a person with DID to have alters that are very different from the host personality. c. It is unusual for a person with DID to have fragmentary alters. d. No aspect of this case is unusual.
d. No aspect of this case is unusual.
Which of the following is in the DSM-5? a. Hypochondriasis b. Somatization disorder c. Pain disorder d. Somatic symptom disorder
d. Somatic symptom disorder
There has been little systematic research conducted on dissociative amnesia and fugue, yet some studies have revealed new information. Which of the following is the source of this information? a. Experiments using medication b. Checking reports from doctors' offices c. Testing personality traits of individuals who have experienced these issues d. Use of different brain imaging methods to determine where loss of function occurs
d. Use of different brain imaging methods to determine where loss of function occurs
An example of dissociative trance disorder is ________ a. a person who enters into a trance state more than once. b. a person who believes that he or she can voluntarily be possessed by a spirit and enjoys allowing this to happen. c. a person who often feels as though the world around him or her isn't real, although he or she knows it is. d. a person who believes he or she is at times possessed by a spirit and is extremely upset because of this.
d. a person who believes he or she is at times possessed by a spirit and is extremely upset because of this. (spirit involved--> dissociate trance disorder)
All of the following were diagnosed as somatic symptom disorders in the DSM-IV except ________ a. hypochondriasis b. somatization disorder c. pain disorder d. fugue disorder
d. fugue disorder
Jeremy suffers from dissociative amnesia. He probably ________ a. remembers only events from the past and does not remember skills he learned more recently. b. can perform only simple tasks, regardless of the complex work that he was able to do previously . c. is able to recognize close friends and relatives but not acquaintances. d. had trouble remembering information stored before a traumatic incident.
d. had trouble remembering information stored before a traumatic incident.
Sara notices a lump on her side. She goes to her physician because she is worried that it is cancer. The physician sends her for a biopsy. During the three weeks between first noticing the lump and getting her results that it is not cancer, Sara was almost unable to function. She felt constant anxiety and thought constantly about having cancer. After she found out that she did not have cancer, Sara felt much better. Sara ________ a. has hypochondriasis. b. has conversion disorder. c. has somatization disorder. d. has no mental disorder.
d. has no mental disorder.
Your textbook authors report that rigorously designed and controlled studies on the treatment of dissociative identity disorder ________ a. have only examined psychodynamic forms of treatment. b. are widespread. c. demonstrate the effectiveness of cognitive-behavior therapy. d. is virtually nonexistent.
d. is virtually nonexistent.
Earl falls at work. The initial medical tests showed no major physical problems. However, Earl calls the next day and tells his boss that he is unable to use his right leg because it is paralyzed. He also informs his boss that he plans to sue the company. Earl most likely ________ a. has conversion disorder. b. has somatization disorder. c. has factitious disorder. d. is malingering.
d. malingering
Response prevention has been used in the treatment of ________ a. dissociative identity disorder. b. factitious disorder. c. malingering. d. somatic symptom disorder.
d. somatic symptom disorder.
Conditions involving physical complaints or disabilities occurring in the absence of any physical pathology that could account for them are ________ a. hypochondriacal disorders. b. anxiety disorders. c. dissociative disorders. d. somatic symptom disorders. e. Answer: d. somatic symptom disorders.
d. somatic symptom disorders.
