1.

Which concept refers to the

breakdown in cognitive, emotional, RCCD, 2019

or behavioral functioning?
A. Psychological Deviance
B. Psychological Dysfunction
C. Psychological Distress
D. Psychological Disability
DYSFUNCTION DEVIANCE
RCCD, 2019

Psychological Disorder
behavioral, psychological, or biological
dysfunctions that are unexpected in their
cultural context and associated with
present distress and impairment in
functioning, or increased risk of suffering,
death, pain, or impairment.

DISTRESS DISABILITY
2. According to Hippocrates, too much
_____ led to irritability and RCCD, 2019

anxiousness, whereas too much _____

led to melancholia.
A. yellow bile; black bile
B. blood; black bile
C. yellow bile; phlegm
D. phlegm; blood
 Humoral Theory
• Hippocrates - 4 humors (body fluids) RCCD, 2019

• ―chemical imbalance‖ approach

HUMOR MANIFESTS AS
Sanguine ruddy Blood (Heart) Cheefulness, optimism,
complexion insomnia, delirium

Melancholic Black bile (Spleen) Depression

Phlegmatic Phlegm Apathy, Sluggishness,
Calm under stress

Choleric Yellow bile or Choler Hot-tempered,

(Liver) anxiousness, irritability
3. Who came to be known as the first to
specialize in the study of mental illness RCCD, 2019

and is now considered the founder of

the modern study of psychopathology?
A. Johann Weyer
B. Thomas Szasz
C. George Mora
D. Joseph Wolpe
 JOHANN WEYER
RCCD, 2019

• Father of modern study of

psychopathology

• Mind was as susceptible to

sickness, as the body was

• Against witch persecutions

 THOMAS SZASZ
• The Myth of Mental Illness RCCD, 2019

• Individual traits or
behaviors that society
defines as unacceptable

• Labeling harms, degrades,

escape social
responsibilities
• Treatment & Diagnosis –
social control
 GEORGE MORA
• Normality in context RCCD, 2019

• Relativity of normality

Autonormal - normal in own society

Autopathological - abnormal by own society

Heteronormal - normal by members of another society

Heteropathological - unusual or pathological by
members of another society
4. Who conducted a "double blind"
experiment to ascertain the RCCD, 2019

effectiveness of animal magnetism

therapy?
A. Philippe Pinel
B. Anton Mesmer
C. Benjamin Rush
D. Benjamin Franklin
 BENJAMIN FRANKLIN
RCCD, 2019

Double-blind experiment to
refute animal magnetism

Both groups got better

Mesmerism is nothing
more than a strong
suggestion
 ANTON MESMER
Father of hypnosis RCCD, 2019

Suggested to his patients

that their problems was
caused by blockage of an
undetectable body fluid
found in living organisms
(animal magnetism)

―Magnetizers‖
―Mesmerism‖
 PHILIPPE PINEL
Father of modern psychiatry RCCD, 2019

Introduced moral therapy and

made French mental
institutions more humane.
First identified Antisocial PD
(manie sans délire) as a
―medical‖ problem
Described cases of
schizophrenia
 BENJAMIN RUSH
RCCD, 2019
Father of American Psychiatry

Introduced moral therapy at

the Pennsylvania hospital

Reading, talking, taking

patients on regular walks

Therapeutic for doctors to

give small gifts to patients
now and then.
5. Which of the following is included in the
DSM? RCCD, 2019

A. A discussion of the various causes of

mental disorders
B. A means of identifying different mental
disorders
C. A description of the necessary and
sufficient conditions for mental illness
D. A description of all of the possible
treatments for each disorder
5. Which of the following is included in the
DSM? RCCD, 2019

A. A discussion of the various causes of

mental disorders
B. A means of identifying different mental
disorders
C. A description of the necessary and
sufficient conditions for mental illness
D. A description of all of the possible
treatments for each disorder
DIAGNOSTIC AND STATISCAL MANUAL
FOR MENTAL DISORDERS
RCCD, 2019

Increase cultural sensitivity

Deepen the clinician’s

understanding of the client

Increase awareness of the

neurobiology underpinning mental
disorders

Role of social and contextual

factors associated with psychiatric
symptoms.
RCCD, 2019
6. Which among the following
disorders may be classified under
RCCD, 2019

Axis II of DSM IV-TR?

A. Autism Spectrum Disorder
B. Conduct Disorder
C. Mental Retardation
D. Oppositional Defiant Disorder
 MULTI-AXIAL CLASSIFICATION
RCCD, 2019

• Axis I (Principal Disorder)- All disorders except

those in Axis II
• Axis II - Mental Retardation
Personality Disorders
• Axis III- General Medical Condition
• Axis IV – Psychosocial and Environmental
Stressors
• Axis V - Global Assessment of Functioning (GAF)
7. Carlito was diagnosed with schizotypal personality
disorder in 2007. However, in the following years, his
symptoms became worse. In 2017, he was given a new RCCD, 2019

diagnosis, schizophrenia. Which of the following statements

would be true in terms of the multiaxial system?
A. In 2007, schizotypal personality disorder is under axis II,
while in 2017, schizophrenia is coded under axis I
B. In 2007, schizotypal personality disorder is under axis II,
while in 2017, multiaxial diagnosis is removed
C. In 2007, schizotypal personality disorder is under axis I,
while in 2017, multiaxial diagnosis is removed
D. In 2007, schizotypal personality disorder is under axis I,
while in 2017, schizophrenia is coded under axis II
CHANGES FROM DSM-IV TO DSM 5
RCCD, 2019
8. In the DSM IV-TR, a GAF
score of 0 would most likely
RCCD, 2019

mean?
A. Inadequate information
B. Persistent danger
C. Pervasive danger
D. No symptoms
8. In the DSM IV-TR, a GAF
score of 0 would most likely
RCCD, 2019

mean?
A. Inadequate information
B. Persistent danger GAF 1-10
C. Pervasive danger
D. No symptoms GAF 91-100
9. Which of the following is the most notable
change reflected with the release of DSM- 5? RCCD, 2019

A. The inclusion of cross cutting measures

B. The removal of the multiaxial diagnostic
system
C. The expansion of dimensional axes for rating
severity, intensity frequency, or duration
D. Augmentation of the personality disorders
category that increases the number of
diagnoses from 10 to 15
CHANGES IN DSM IV-TR to DSM-5
RCCD, 2019
C Culture and Gender Emphasis
H Hybrid Model
A Abandoned Multi-axial System
D Developmental Perspective

Di Dimensionality
Siya Spectrum Perspective

B Biologically-based Diagnosis
A Arabic not Roman Numeral
D Description Enhanced
10. What is the most prevalent
grouping of psychological disorder? RCCD, 2019

A. Depressive disorders
B. Anxiety disorders
C. Substance Related and Addictive
Disorders
D. Personality Disorders
RCCD, 2019
RCCD, 2019
11. The Kessler et al. (1994) National
Comorbidity Survey reported that 48% of their RCCD, 2019

sample had at least one disorder during their

life, and 29% had experienced a disorder in the
prior year. The first result is an estimate of
_____, and the second, an estimate of ______.
A. epidemiology; prevalence
B. morbidity; incidence
C. incidence; annual epidemiology
D. lifetime prevalence; incidence
 Epidemiology
RCCD, 2019

Morbidity - disease, injury, disability

Sex Ratio - percentage of males and females

Prevalence - number of active cases in a population during

any given period of time
• Point Prevalence - specific period of time
• Period Prevalence - at some time during a given period
• Lifetime Prevalence - at some point in life
Incidence - new cases over specified period of time
Mortality - death
12. To check for the cognition of a patient
during a mental status examination, asking RCCD, 2019

a patient to interpret a proverb is used as a

way of assessing which of the following
domains?
A. Abstract thinking
B. Insight
C. Intelligence
D. Judgment
 Mental Status Exam
Relatively brief preliminary test of a client’s
RCCD, 2019

judgment, orientation to time and place, and

emotional and mental state

FIVE CATEGORIES (TAMIS):

1. Thought process
2. Appearance and behavior
3. Mood and affect
4. Intellectual functioning
5. Sensorium
 Cognition
Abstract thinking RCCD, 2019

-Ability to shift voluntarily from one aspect of a

situation to another and to think symbolically

Judgment
- Ability to comprehend the meaning of events
and to appreciate the consequences of
actions.
-Asking standard circumstances
 Cognition
RCCD, 2019

Insight
-Conscious understanding of forces that have
led to a particular feeling, action, or situation.

Intelligence
-Capacity for learning, recalling, integrating,
and applying knowledge and experience.
13. Which of the following would best
describe a patient who says ―Peter RCCD, 2019

paid plenty for piping. Plenty for piping

paid Peter‖?
A. Verbigeration
B. Neologism
C. Word Salad
D. Clang association
 Content of Speech
RCCD, 2019

Verbigeration
-Stereotyped repetition of words/phrases that
may or may not have meaning to the listener

Clang association
-Ideas that are related to one another based on
sound of rhyming
 Content of Speech
Neologism RCCD, 2019

-Coining new words or inappropriate use of

words
-Personal understanding

Word salad
-Incoherent, essentially incomprehensible,
mixture of words and phrases
-Advanced cases of schizophrenia
 Given Example of?
―I will take a pill if I go up the Clang association RCCD, 2019
hill but not my name is Jill, I
don’t want to kill‖
―I am afraid of grittiz. If there Neologism
are any grittiz here, I will have
to leave. Are you a grittiz?‖
―I want to go home, go home, Verbigeration
go home‖
―Tramway flogging into my Word salad
question, are you why is it thirty
letters down under peanut
butter, what is it‖
14. A psychiatric patient who, although
coherent, never gets to the point has a RCCD, 2019

disturbance in the form of thought

called as?
A. Thought Blocking
B. Tangentiality
C. Thought Deprivation
D. Circumstantiality
Tangentiality
RCCD, 2019

-Wandering from the topic and never

returning to it or providing
information required

Circumstantiality
-Overinclusion of trivial or irrelevant
details that impede the sense of
getting to the point
 RCCD, 2019

Blocking
• Abrupt interruption in the train of
thinking before a thought or idea is
finished.
• It is also known as thought deprivation
15. During clinical interviews, which
type of affect is commonly manifested RCCD, 2019

by individuals with obsessive-

compulsive personality disorder?
A. Labile affect
B. Flat affect
C. Inappropriate affect
D. Constricted affect
Obsessive-Compulsive Personality
Disorder RCCD, 2019

A pervasive pattern of
preoccupation with
orderliness,
perfectionism, and
mental and
interpersonal control, at
the expense of flexibility,
openness, and
efficiency.
Obsessive-Compulsive Personality
Disorder RCCD, 2019

During interview…
• Stiff, formal, rigid demeanor
• Constricted affect
• Usually serious
• Answers are unusually detailed
16. Which of the following is
another name for the ―Alice in RCCD, 2019

Wonderland‖ effect?
A. Dysmegalopsia
B. Dysphasia
C. Dysphagia
D. Dysmetria
 Dysmegalopsia
(“Alice in Wonderland” effect) RCCD, 2019

• Distortion in which the

size and shape of
objects is
misperceived.
• Temporal and Parietal
lobe lesions
 Dysphasia
RCCD, 2019

• Difficulty in comprehending oral

language (reception dysphasia) or in
trying to express verbal language
(expressive dysphasia).
• Acquired lesion of the brain
 Dysmetria
RCCD, 2019

• Impaired ability to
gauge distance
relative to
movements.

• It is commonly seen in
neurological deficits.
17. During the fight-or-flight
response, which of the following is RCCD, 2019

secreted by the pituitary gland?

A. Cortisol
B. Catecholamines
C. Adrenocorticotrophic hormone
D. Corticotrophin-Releasing
Hormone
HPA Axis
RCCD, 2019
18. Which part of the autonomic
nervous system is primarily RCCD, 2019

responsible for our emergency or

alarm response to stress?
A. Enteric
B. Somatic
C. Sympathetic
D. Parasympathetic
RCCD, 2019
RCCD, 2019
SYMPATHETIC OR PARASYMPATHETIC?
RCCD, 2019
19. Jenna suffered damage to her
cerebellum as a result of an automobile RCCD, 2019

accident. Which of Jenna's abilities is likely

to be impaired?
A. Ability to form and retrieve memories
B. Responsiveness to rewarding
environmental stimuli
C. Her playing of the violin
D. Maintenance of arousal and attention
 CEREBELLUM
RCCD, 2019

• ―Little brain‖

• Muscular movement
• Balance
• Posture
• Learning motor skills
19. Jenna suffered damage to her cerebellum
as a result of an automobile accident. Which of RCCD, 2019

Jenna's abilities is likely to be impaired?

A. Ability to form and retrieve memories
(hippocampus)
B. Responsiveness to rewarding
environmental stimuli (nucleus accumbens)
C. Her playing of the violin
D. Maintenance of arousal and attention
(reticular formation)
20. Which of the following disorders
is included in the ―Anxiety RCCD, 2019

Disorders‖ chapter of DSM-5?

A. Obsessive-compulsive disorder
B. Acute stress disorder
C. Panic disorder with agoraphobia
D. Separation anxiety disorder
21. Which of the following is a component
of normal anxiety? RCCD, 2019

A. The fear is unrealistic given the

circumstances.
B. The fear subsides when the threat ends.
C. The amount of fear is out-of-proportion
to the actual threat.
D. There is a great deal of anticipatory
anxiety about the future.
Anxiety disorders
• Features of excessive
fear and anxiety and
related behavioral
disturbances.
Fear
• Emotional response to
real or perceived
imminent threat
Anxiety
• Anticipation of future
threat
22. Which of the following would
require unexpected panic attacks RCCD, 2019

are required for its diagnostic

criteria?
A. Generalized anxiety disorder
B. Panic disorder
C. Specific phobia
D. All of the above
 Panic Disorder
A. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense
fear or intense discomfort that reaches a peak within minutes, and during which time
RCCD, 2019
four (or more) of the following symptoms occur;
Note: The abrupt surge can occur from a calm state or an anxious state.
1. Palpitations, pounding heart, or accelerated heart rate.
2. Sweating.
3. Trembling or shaking.
4. Sensations of shortness of breath or smothering.
5. Feelings of choking.
6. Chest pain or discomfort.
7. Nausea or abdominal distress.
8. Feeling dizzy, unsteady, light-headed, or faint.
9. Chills or heat sensations.
10. Paresthesias (numbness or tingling sensations).
11. Derealization (feelings of unreality) or depersonalization (being detached from
oneself).
12. Fear of losing control or ―going crazy.‖
13. Fear of dying.
 Panic Disorder

B. At least one of the attacks has been followed by 1 RCCD, 2019

month (or more) of one or both of the following:

1. Persistent concern or worry about additional
panic attacks or their consequences
(e.g., losing control, having a heart attack, ―going
crazy‖).
2. A significant maladaptive change in behavior
related to the attacks (e.g., behaviors designed to
avoid having panic attacks, such as avoidance of
exercise or unfamiliar situations).
23. Kimberly has a persistent and
excessive fear of flying. She realizes that RCCD, 2019

this is unrealistic and is interfering with

her career opportunities. Which diagnosis
would Kimberly receive?
A. Panic disorder
B. Agoraphobia
C. Generalized anxiety disorder
D. Specific phobia
 Specific Phobia
A. Marked fear or anxiety about a specific object or situation RCCD, 2019
(e.g., flying, heights, animals, receiving an injection, seeing
blood).
B. The phobic object or situation almost always provokes
immediate fear or anxiety.
C. The phobic object or situation is actively avoided or endured
with intense fear or anxiety.
D. The fear or anxiety is out of proportion to the actual danger
posed by the specific object or situation and to the
sociocultural context.
E. The fear, anxiety, or avoidance is persistent, typically lasting
for 6 months or more.
 Agoraphobia
A. Marked fear or anxiety about two (or more) of the following five
RCCD, 2019
situations:
1. Using public transportation (e.g., automobiles, buses, trains,
ships, planes).
2. Being in open spaces (e.g., parking lots, marketplaces, bridges).
3. Being in enclosed places (e.g., shops, theaters, cinemas).
4. Standing in line or being in a crowd.
5. Being outside of the home alone.

B. The individual fears or avoids these situations because of thoughts

that escape might be difficult or help might not be available in the event
of developing panic-like symptoms or other incapacitating or
embarrassing symptoms (e.g., fear of falling in the elderly; fear of
incontinence).
24. In explaining phobia, which type of
learning suggests that over the course of RCCD, 2019

evolution, we have become highly prepared

for learning certain types of objects or
situations that may contribute to the survival
of species?
A. Evolutionary Learning
B. Selective Learning
C. Observational Learning
D. Prepared Learning
 Prepared Learning
RCCD, 2019
• An ability that has been adaptive for
evolution, allowing certain
associations to be learned more
readily than others.

• Females - as early as 11 months of

age (Rakison, 2009)

• Higher incidence for spider and

snake phobia
25. According to Sigmund Freud, which
postulated defense mechanisms are RCCD, 2019

necessary in phobias?
A. Regression, condensation, and
projection
B. Regression, repression, and isolation
C. Repression, displacement, and
avoidance
D. Repression, projection, and
displacement
 Defense Mechanisms and
Phobia RCCD, 2019

Sexual drive Anxiety Ego

(strong (repression
incestuous (fear of not
coloring) castration) successful)

Avoidance Displacement
(keep out of its way to
(transposed to a
seemingly
Auxiliary
escape suffering from
serious anxiety)
unimportant,
irrelevant object)
defenses
26. Which of the following is
considered a culture-specific RCCD, 2019

symptom of panic attacks?

A. Headaches
B. Fear of going crazy
C. Shortness of breath
D. Heat sensations
 Panic Attack
Four or more
1. Palpitations, pounding heart, or accelerated heart rate. RCCD, 2019

2. Sweating.
3. Trembling or shaking.
4. Sensations of shortness of breath or smothering.
5. Feelings of choking.
6. Chest pain or discomfort.
7. Nausea or abdominal distress.
8. Feeling dizzy, unsteady, light-headed, or faint.
9. Chills or heat sensations.
10. Paresthesias (numbness or tingling sensations).
11. Derealization (feelings of unreality) or depersonalization (being
detached from oneself).
12. Fear of losing control or ―going crazy.‖
13. Fear of dying.
27. What is the primary difference
in the clinical expression of RCCD, 2019

generalized anxiety disorder across

age groups?
A. Content of worry
B. Degree of worry
C. Patterns of comorbidity
D. Severity of impairment
 Generalized Anxiety Disorder
RCCD, 2019

Adults
○ Everyday, routine life circumstances
○ Personal health
○ Well-being of their family

Children and adolescents

○ Competence or the quality of their performance
○ School or sports performance

Focus of worry may shift from one concern to another

28. In social anxiety disorder (social
phobia), the object of an individual’s RCCD, 2019

fear is the potential for which of the

following?
A. Social or occupational impairment
B. Embarrassment
C. Separation from objects of
attachment
D. Incapacitating symptoms
28. In social anxiety disorder (social
phobia), the object of an individual’s fear is RCCD, 2019

the potential for which of the following?

A. Social or occupational impairment
(result)
B. Embarrassment
C. Separation from objects of attachment
(Separation Anxiety Disorder)
D. Incapacitating symptoms (Agoraphobia)
 Social Anxiety Disorder
(Social Phobia) RCCD, 2019

A. Marked fear or anxiety about one or more social

situations in which the individual is exposed to
possible scrutiny by others.

B. The individual fears that he or she will act in a

way or show anxiety symptoms that will be
negatively evaluated (i.e., will be humiliating or
embarrassing: will lead to rejection or offend
others).
29. Which of the following types of
specific phobia is most likely to be
RCCD, 2019

associated with vasovagal fainting?

A. Animal type
B. Natural environment type
C. Blood-injection-injury type
D. Situational type
 Specific Phobia (Specifiers)
1. Blood-Injection-Injury type RCCD, 2019

﹡ Marked drop in blood pressure  fainting

﹡ Different physiological reaction
﹡ Strong vasovagal syncope
﹡ Average age of onset: 9 years old

2. Situational type (elevators, planes, enclosed spaces)

﹡ Fear of public transportation or enclosed places
﹡ Only need 1; Agoraphobia needs 2 + Criterion B
﹡ Specific to situational phobic stimulus
﹡ Average age of onset: mid-teens to mid-20’s
 Specific Phobia (Specifiers)

3. Natural environment type (heights, storms, water) RCCD, 2019

﹡ Events occurring in nature

﹡ Peak age of onset: 7 years old

4. Animal type
﹡ Fears of animals and insects
﹡ Concept of Prepared Learning
﹡ Age of onset: 7 years old

5. Other
﹡ May include fear of choking, vomiting, loud sounds,
costumed characters
30. Which of the following twin pairs would
probably be most concordant for a phobia? RCCD, 2019

A. MZ twins who have a relatively high level of

GABA in their limbic system
B. MZ twins who have a relatively low level of
GABA in their limbic system
C. DZ twins who have a relatively low level of
GABA in their limbic system
D. DZ twins who have a relatively high level of
GABA in their limbic system
 Specific Phobia
RCCD, 2019
Limbic system
 Most implicated with anxiety
 Mediator bet brainstem & cortex

Neurotransmitters:
 High Norepinephrine
 Low GABA
 Low Serotonin

High CRF  HPA Axis activation

31. In the DSM-5, what is the minimum
duration of required to make a
RCCD, 2019

diagnosis of obsessive-compulsive
disorder?
A. 6 months
B. 2 weeks
C. 1 month
D. No duration mentioned
 Obsessive-Compulsive Disorder
RCCD, 2019

CRITERION B:

The obsessions or compulsions are time-

consuming (e.g., take more than 1 hour per day)
or cause clinically significant distress or
impairment in social, occupational, or other
important areas of functioning.
32. Which of the following statements does not reflect
obsessive-compulsive disorder? RCCD, 2019

A. Compulsions can be either repetitive behaviors or

mental acts.
B. People with OCD are considered to be psychotic
because they cannot control their thoughts and
behaviors.
C. Obsessions can be thoughts, images, ideas, or
impulses.
D. People with OCD are aware of how irrational their
thoughts and behaviors are.
 Obsessive-Compulsive Disorder
RCCD, 2019
A. Presence of obsessions, compulsions, or both:

Obsessions are defined by (1) and (2):

1. Recurrent and persistent thoughts, urges, or images that
are experienced, at some time during the disturbance, as
intrusive and unwanted, and that in most individuals cause
marked anxiety or distress.
2. The individual attempts to ignore or suppress such
thoughts, urges, or images, or to neutralize them with
some other thought or action (i.e., by performing a
compulsion).
 Obsessive-Compulsive Disorder
Compulsions are defined by (1) and (2): RCCD, 2019

1. Repetitive behaviors (e.g., hand washing, ordering,

checking) or mental acts (e.g., praying, counting,
repeating words silently) that the individual feels driven to
perform in response to an obsession or according to rules
that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or
reducing anxiety or distress, or preventing some dreaded
event or situation; however, these behaviors or mental
acts are not connected in a realistic way with what they
are designed to neutralize or prevent, or are clearly
excessive.
33. From a psychodynamic perspective,
which of the following defense
RCCD, 2019

mechanisms is not used to explain

obsessive-compulsive disorder?
A. Isolation
B. Introjection
C. Undoing
D. Reaction Formation
 OCD and Defense Mechanisms
Isolation RCCD, 2019

 Disown their unwanted thoughts  foreign

intrusions
Undoing
 Cancel out their undesirable impulses.
 Ex: Repeated hand washing
Reaction Formation
 Lifestyle that directly opposes their unacceptable
impulses.
 Ex: Compulsive kindness and devotion
34. A therapist gives an assignment to a woman
with a cleaning compulsion: ―Do not mop the floor RCCD, 2019

of your bathroom for a week. After this, clean it

within three minutes, using an ordinary mop. Use
this mop for other chores as well without cleaning
it.‖ Which type of behavioral therapy is being
utilized?
A. Exposure and ritual prevention
B. Systematic desensitization
C. Thought stopping
D. Implosion therapy
 Exposure and response prevention
(or exposure and ritual prevention) RCCD, 2019

 Victor Meyer (1966)

 Clients are repeatedly exposed to objects or

situations that produce anxiety, obsessive fears, and
compulsive behaviors.

 Told to resist performing the behaviors they feel so

bound to perform.
 Self-help Procedures
 Assign homework in exposure and response RCCD, 2019

prevention
 Systematic Desensitization
Joseph Wolpe RCCD, 2019

Fear/Stimulus hierarchy +
Relaxation Training

Reciprocal inhibition
 Incompatible
physiological responses
evoked at same time
35. According to Freud, obsessive-
compulsive disorder reflects a RCCD, 2019

regression to which psychosexual

stage of development?
A. Oral
B. Anal
C. Phallic
D. Urethral
 Anal Stage and OCD
Sigmund Freud RCCD, 2019

 Intense rage and shame as a result of negative toilet-

training experiences.

Feelings of insecurity
 Early rage reactions (Erikson, Sullivan, Horney)

Repeatedly need to express their strong aggressive id

impulses while at the same time knowing they should
try to restrain and control the impulses.
36. In excoriation (skin-picking)
disorder, which of the following is the RCCD, 2019

most typical motivation for the skin-

picking behavior?
A. Appearance concerns
B. Symmetry concerns
C. Boredom
D. Fear of infection
36. In excoriation (skin-picking)
disorder, which of the following is the RCCD, 2019

most typical motivation for the skin-

picking behavior?
A. Appearance concerns (Body
Dysmorphic Disorder)
B. Symmetry concerns (OCD)
C. Boredom
D. Fear of infection (OCD)
 Body-focused repetitive behaviors
RCCD, 2019

 Not triggered by obsessions or

preoccupations
Preceded or accompanied by various emotional
states
﹡ Feelings of anxiety or boredom
﹡ Increasing sense of tension
﹡ Lead to gratification, pleasure, or a sense of
relief
 Body-focused repetitive behaviors

Trichotillomania (hair-pulling disorder) RCCD, 2019

﹡ Recurrent pulling out of one's hair resulting in hair

loss
﹡ Repeated attempts to decrease or stop hair pulling.
﹡ Most common sites are scalp, eyebrows, and eyelids.

Excoriation (skin-picking) disorder

﹡ Recurrent picking of one's skin resulting in skin
lesions
﹡ Repeated attempts to decrease or stop skin picking.
37. In terms of DSM IV-TR classification,
Posttraumatic Stress Disorder (PTSD) has been RCCD, 2019

placed under Anxiety Disorders. However in the

DSM-5, it was reclassified under which
category?
A. Dissociative Disorders
B. Somatic Symptom and Related Disorders
C. Obsessive Compulsive and Related
Disorders
D. Trauma and Stressor Related Disorders
 Trauma-and-Stressor Related
Disorders RCCD, 2019

Most prominent clinical characteristics:

 Dissociative symptoms
 Externalizing angry and aggressive symptoms
 Anhedonic and dysphoric symptoms

Variable expressions of clinical distress following

exposure to catastrophic or aversive events
38. Which of the following statements is
not true about acute stress disorder? RCCD, 2019

A. It occurs in response to traumas like

PTSD.
B. It occurs within one month of exposure
to a stressor.
C. It must last longer than four weeks.
D. It often includes dissociative symptoms.
 Acute Stress Disorder
RCCD, 2019

Criterion C:
Duration of the disturbance (symptoms in Criterion B)
is 3 days to 1 month after trauma exposure.

Note: Symptoms typically begin immediately after the

trauma, but persistence for at least 3 days and up to a
month is needed to meet disorder criteria.
39. Which of the following situations may not
qualify for a diagnosis of either an acute stress RCCD, 2019

disorder or post-traumatic stress disorder?

A. Lily, a 23-year old girl who was recently raped.
B. Gio, a 12-year old boy who saw his
grandfather die.
C. Cardo, a 43-year old man who is a first-aid
responder to gruesome emergency situations.
D. Derek, a 22-year old who likes to watch videos
of accidents.
 PTSD AND ASD Criterion A
A. Exposure to actual or threatened death, serious injury, or sexual
violation in one (or more) of the following ways: RCCD, 2019

1. Directly experiencing the traumatic event(s).

2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that the event(s) occurred to a close family member or
close friend.
Note: In cases of actual or threatened death of a family member or
friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of
the traumatic event(s) (e.g., first responders collecting human
remains, police officers repeatedly exposed to details of child
abuse).
Note: This does not apply to exposure through electronic media,
television, movies, or pictures, unless this exposure is work
related.
POST TRAUMATIC STRESS DISORDER
39. Which of the following situations may not
qualify for a diagnosis of either an acute stress RCCD, 2019

disorder or post-traumatic stress disorder?

A. Lily, a 23-year old girl who was recently raped.
(A.1)
B. Gio, a 12-year old boy who saw his grandfather
die. (A.2)
C. Cardo, a 43-year old man who is a first-aid
responder to gruesome emergency situations. (A.4)
D. Derek, a 22-year old who likes to watch videos of
accidents.
40. Which of these is the most
common form of child
RCCD, 2019

maltreatment?
A. Neglect
B. Physical abuse
C. Sexual abuse
D. Abandonment
 Neglect
Most prevalent form of child maltreatment RCCD, 2019

Failure to provide adequate care and protection for children

Physical
﹡ Failure to provide necessary food, shelter, or supervision
Medical
﹡ Failure to provide necessary medical or mental health treatment
Educational
﹡ Failure to educate a child or attend to his or her special education
needs
Emotional
﹡ Inattention to a child’s emotional needs or psychological care or
letting the child use alcohol or drugs
 Physical Abuse
Any act that results in a RCCD, 2019

nonaccidental physical injury

Single episode or of repeated

episodes
Examples:
﹡ Beating
﹡ Punching
﹡ Kicking
﹡ Biting
﹡ Burning
﹡ Poisoning
 Psychological Abuse
Nonaccidental verbal or symbolic acts by RCCD, 2019

a child's parent or caregiver that result,

or have reasonable potential to result, in
significant psychological harm to the
child.

Impair emotional development or sense

of self-worth

Examples:
Constant verbal assaults (criticism,
threats)
Rejection (withholding of love, support,
or guidance)
 Sexual Abuse
Sexual act involving a child that is RCCD, 2019

intended to provide sexual

gratification to a parent, caregiver, or
other individual who has
responsibility for the child.

Incest
﹡ Most commonly reported cases of
child sexual abuse
﹡ Sexual abuse occurring among
family members
41. In the diagnostic criteria of Reactive
Attachment Disorder and Disinhibited Social RCCD, 2019

Engagement Disorder, which of the following

characteristic is shared by both?
A. Reduced or absent reticence in
approaching and interacting with unfamiliar
adults
B. Limited positive affect
C. Inhibited, emotionally withdrawn behavior
D. Extremes of insufficient care
41. In the diagnostic criteria of Reactive
Attachment Disorder and Disinhibited Social RCCD, 2019

Engagement Disorder, which of the following

characteristic is shared by both?
A. Reduced or absent reticence in approaching
and interacting with unfamiliar adults (DSED)
B. Limited positive affect (RAD)
C. Inhibited, emotionally withdrawn behavior
(RAD)
D. Extremes of insufficient care
 Reactive Attachment Disorder
A. A consistent pattern of inhibited, emotionally withdrawn behavior RCCD, 2019

toward adult caregivers, manifested by both of the following:

1. The child rarely or minimally seeks comfort when distressed.
2. The child rarely or minimally responds to comfort when
distressed.
B. A persistent social and emotional disturbance characterized by at
least two of the following:
1. Minimal social and emotional responsiveness to others.
2. Limited positive affect.
3. Episodes of unexplained irritability, sadness, or fearfulness that
are evident even during nonthreatening interactions with adult
caregivers.
 Disinhibited Social Engagement Disorder
A. A pattern of behavior in which a child actively approaches RCCD, 2019
and interacts with unfamiliar adults and exhibits at least two
of the following:
1. Reduced or absent reticence in approaching and
interacting with unfamiliar adults.
2. Overly familiar verbal or physical behavior (that is not
consistent with culturally sanctioned and with age-
appropriate social boundaries).
3. Diminished or absent checking back with adult caregiver
after venturing away, even in unfamiliar settings.
4. Willingness to go off with an unfamiliar adult with minimal
or no hesitation.
 Disinhibited Social Engagement Disorder

B. The behaviors in Criterion A are not limited to impulsivity (as in RCCD, 2019

attention-deficit/hyperactivity disorder) but include socially

disinhibited behavior.
C. The child has experienced a pattern of extremes of insufficient care as
evidenced by at least one of the following:
1. Social neglect or deprivation in the form of persistent lack of having
basic emotional needs for comfort, stimulation, and affection met by
caregiving adults.
2. Repeated changes of primary caregivers that limit opportunities to
form stable attachments (e.g., frequent changes in foster care).
3. Rearing in unusual settings that severely limit opportunities to form
selective attachments (e.g., institutions with high child-to-caregiver
ratios).
42. Dissociative amnesia most often
involves which of the following types of RCCD, 2019

amnesia?
A. Continuous amnesia
B. Localized or selective amnesia for
specific events
C. Generalized amnesia
D. Systematized amnesia
 Dissociative Amnesia
RCCD, 2019
A. An inability to recall important autobiographical
information, usually of a traumatic or stressful nature, that
is inconsistent with ordinary forgetting.

Note: Dissociative amnesia most often consists of localized

or selective amnesia for a specific event or events; or
generalized amnesia for identity and life history.

Specify if ;
With dissociative fugue: Apparently purposeful travel or
bewildered wandering that is associated with amnesia for
identity or for other important autobiographical information
 DISSOCIATIVE AMNESIA
RCCD, 2019

1. Localized amnesia
An inability to recall any of the events that
occurred over a limited period of time.

2. Selective amnesia
An inability to recall some of the events that
occurred over a limited period of time.
 DISSOCIATIVE AMNESIA
RCCD, 2019

3. Generalized amnesia
A complete loss of memory for one's life history

4. Continuous amnesia
Forgets each new event as it occurs

5. Systematized amnesia
Loses memory for a specific category of information
43. Chris suffered a car accident a few months
ago. After the accident, he now experiences RCCD, 2019

difficulty remembering what was said to him and

forgetting what he just did, like taking
medications. Despite this, he has complete recall
of the memories he had prior to the accident.
Chris may probably have?
A. Selective Amnesia
B. Anterograde Amnesia
C. Retrograde Amnesia
D. Localized Amnesia
 AMNESIAS
RCCD, 2019

Anterograde amnesia
The inability to remember new information acquired
after the event that triggered amnesia

Retrograde amnesia
A lack of memory about events that occurred before
the event that triggered amnesia.
44. According to family and genetic
studies, which personality disorder is RCCD, 2019

strongly linked to somatic symptom

disorder?
A. Avoidant Personality Disorder
B. Dependent Personality Disorder
C. Paranoid Personality Disorder
D. Antisocial Personality Disorder
 Similarity of ASPD and SSD
RCCD, 2019

 Both begin early in life

 Typically run a chronic course
 Predominate among lower socioeconomic
classes
 Difficult to treat
 Associated with marital discord, drug and
alcohol abuse, and suicide attempts
ASPD and SSD
RCCD, 2019
45. Which of the following is a theory for the cause of
Illness Anxiety Disorder? RCCD, 2019

A. Symptoms are viewed as a request for admission

to the sick role made by a person facing challenges in
his or her life
B. Persons with hypochondriasis have low thresholds
for and low tolerance of physical discomfort
C. Aggressive and hostile wishes toward others are
transferred (through repression and displacement)
into physical complaints
D. All of the above
RCCD, 2019
 Illness Anxiety Disorder
RCCD, 2019
A. Preoccupation with having or acquiring a serious
illness.
B. Somatic symptoms are not present or, if present, are
only mild in intensity. If another medical condition is
present or there is a high risk for developing a medical
condition (e.g., strong family history is present), the
preoccupation is clearly excessive or
disproportionate.
C. There is a high level of anxiety about health, and the
individual is easily alarmed about personal health
status.
46. Bella’s son was recently bitten by a snake.
Although she tried to hit the snake with her fist before RCCD, 2019

it reached her child, Bella was unable to prevent it

from biting him. Her son is fine, but Bella’s hand has
become paralyzed. However, examination and testing
show no physical damage to her hand. Bella’s
paralysis may reflect which DSM-5 disorder?
A. Illness Anxiety Disorder
B. Somatic Symptom Disorder
C. Conversion Disorder
D. Pain Disorder
 Conversion Disorder
(Functional Neurological Symptom Disorder)
RCCD, 2019

A. One or more symptoms of altered voluntary motor or sensory

function.
B. Clinical findings provide evidence of incompatibility between
the symptom and recognized neurological or medical
conditions.
C. The symptom or deficit is not better explained by another
medical or mental disorder.
D. The symptom or deficit causes clinically significant distress
or impairment in social, occupational, or other important
areas of functioning or warrants medical evaluation.
47. Which personality disorder is
commonly associated with factitious RCCD, 2019

disorder?
A. Histrionic Personality Disorder
B. Paranoid Personality Disorder
C. Schizotypal Personality Disorder
D. Obsessive-Compulsive Personality
Disorder
 Associated Personality Disorders
RCCD, 2019
Histrionic Personality Disorder
 Attention seeking and dramatic flair
 But not all persons with histrionic have a dramatic
flair; many are withdrawn and bland.

Borderline Personality Disorder

 Patients’ chaotic lifestyles, history of disturbed
interpersonal relationships, identity crises,
substance abuse, self-damaging acts, and
manipulative tactics.
48. Which of the following is given if
a patient consciously fakes
RCCD, 2019

symptoms and has associated

external gain?
A. Hypochondriasis
B. Munchausen syndrome
C. Illness Anxiety Disorder
D. Malingering
 V65.2 (Z76.5) Malingering
RCCD, 2019

Not a DSM-5 Diagnosis

Essential features:
 Intentional production of false or grossly
exaggerated physical or psychological
symptoms
 External incentives
 V65.2 (Z76.5) Malingering
Malingering should be strongly suspected if any combination of RCCD, 2019

the following is noted:

1. Medicolegal context of presentation (e.g., the individual is
referred by an attorney to the clinician for examination, or
the individual self-refers while litigation or criminal charges
are pending).
2. Marked discrepancy between the individual's claimed
stress or disability and the objective findings and
observations.
3. Lack of cooperation during the diagnostic evaluation and in
complying with the prescribed treatment regimen.
4. The presence of antisocial personality disorder.
49. Which defense mechanism is
most commonly used in
RCCD, 2019

depression?
A. Undoing
B. Isolation
C. Projection
D. Introjection
 Introjection and Depression
Loved one dies or Symbolic/Imagined Loss
RCCD, 2019

(A person equates other kinds of events with the loss of a loved one)

Regression (oral stage)

Introjection
(Merge their own identity with that of the person they have lost, and so
symbolically regain the lost person)
50. Which of the following individuals would
least likely to develop major depressive RCCD, 2019

disorder in his or her lifetime?

A. An identical twin of a patient with major
depressive disorder who committed suicide
B. A 19-year-old woman who was raped 3
weeks ago
C. A 12-year-old girl mourning the death of her
mother
D. A 10-year-old boy diagnosed with dysthymia
 Major Depressive Disorder
Childhood onset of dysthymia RCCD, 2019

 Extremely high rates of depression and bipolar

disorder in adulthood.

Monozygotic twins
 Two- to fourfold increase in concordance rates for
mood disorders

Parental loss before adolescence

 Well-documented risk factor for adult-onset
depression
Major Depressive Disorder
RCCD, 2019
51. Which of the following substances
has been implicated in mood disorders RCCD, 2019

with a seasonal pattern?

A. Estrogen
B. Gonadotropin-releasing hormone
(GnRH)
C. Luteotropic hormone (LTH)
D. Melatonin
 Melatonin and SAD
RCCD, 2019

 Synthesized from serotonin

 Production is stimulated in the dark

 Increased production of melatonin might trigger

depression in vulnerable people

 May affect the sleep–wake cycle

 Phototherapy and SAD
RCCD, 2019

Exposure to 2 hours of bright

light (2,500 lux)
immediately on awakening.

If the light exposure is

effective, the patient
begins to notice a lifting of
mood within 3 to 4 days
and a remission of winter
depression in 1 to 2 weeks.
52. In which of the following
aspects does cyclothymic disorder
RCCD, 2019

differ from bipolar I disorder?

A. Duration
B. Severity
C. Age at onset
D. Pervasiveness
 Cyclothymic Disorder
RCCD, 2019

Essential feature of cyclothymic disorder:

 Chronic, fluctuating mood disturbance
involving numerous periods of hypomanic
symptoms and periods of depressive
symptoms that are distinct from each other
but do not meet full criteria.
RCCD, 2019
53. Which of the following neurotransmitters are
implicated in mood disorders? RCCD, 2019

I. epinephrine
II. serotonin
III. acetycholine
IV. norepinephrine
V. dopamine
A. II, IV, V
B. I, IV, V
C. II, III, IV
D. II, III, V
 PERMISSIVE HYPOTHESIS
RCCD, 2019
﹡ LOW Serotonin – ―permitted‖ to become dysregulated
○ Affects DOPAMINE & NOREPINEPHRINE

﹡ LOW Serotonin
﹡ LOW Norepinephrine
DEPRESSION
﹡ LOW Dopamine

﹡ LOW Serotonin
﹡ HIGH Norepinephrine MANIA
﹡ HIGH Dopamine
54. Which of the following statements is true in
explaining depression? RCCD, 2019

A. The reformulated learned helplessness theory

dropped the notion of causal attributions and focused,
instead, on perceived control.
B. The negative cognitive triad refers to negative views
of one's self, the world, and one's childhood.
C. Depressed people overestimate the amount of
control they have over situations that are actually
uncontrollable.
D. A pessimistic attributional style is one that is
internal, stable, and global for negative events.
Learned helplessness theory
RCCD, 2019
 Reformulated Learned Helplessness Theory
(Learned Helplessness Theory Of Depression)
RCCD, 2019
55. Kennedy et al. (2007), treated individuals with major
depressive disorder with either a psychological treatment,
RCCD, 2019
cognitive behavioral treatment (CBT), or venlafaxine
(antidepressant). Which of the following statements reflect
the results of this study?
A. CBT facilitated a ―top down change‖ wherein changes in
thinking patterns in the cortex affected the emotional brain
B. Drugs (venlafaxine) facilitated a ―bottom up‖ change
wherein higher areas of the cortex are the last to be affected
by change
C. No changes were observed as to how the various
treatments work on MDD.
D. Both A and B are correct
56. Which of the following individuals would be
at risk for committing an anomic suicide, RCCD, 2019

according to Durkheim?
A. Kristine, an accountant who was laid-off at
work due to economic depression
B. Kenneth, a fresh college graduate who
recently inherited a great deal of money
C. Kardo, a father who was wrongly accused of
smuggling drugs and was sent to prison
D. All of the above
 Anomic Suicide
RCCD, 2019

1. Periods of economic depression

2. Periods of population change
3. Increased immigration
4. Major change in a person’s immediate
surroundings (ex: sudden inheritance)
5. Removal from society (ex: prison)
57. Which of the following is a
diagnostic term applied to the specific RCCD, 2019

substance abused that results from the

prolonged use of the substance?
A. Substance Intoxication
B. Substance Abuse
C. Substance Withdrawal
D. Substance Use Disorder
 Substance Use Disorder
RCCD, 2019

Substance use disorder is the diagnostic

term applied to the specific substance
abused (e.g., alcohol use disorder, opioid
use disorder) that results from the
prolonged use of the substance.
 General Guidelines:
Substance Use Disorder RCCD, 2019
 Substance Intoxication
RCCD, 2019

Substance intoxication is the diagnosis

used to describe a syndrome (e.g., alcohol
intoxication or simple drunkenness)
characterized by specific signs and
symptoms resulting from recent ingestion
or exposure to the substance.
 Substance Withdrawal
RCCD, 2019

Substance withdrawal is the diagnosis

used to describe a substance specific
syndrome that results from the abrupt
cessation of heavy and prolonged use of a
substance (e.g., opioid withdrawal).
58. Which type of dependence is
characterized by the emphasis of RCCD, 2019

substance-seeking activities and related

evidence of pathological use patterns?
A. Habituation
B. Physical Dependence
C. Behavioral Dependence
D. Psychological Dependence
 Dependence
Behavioral dependence
RCCD, 2019
 Substance-seeking activities and related evidence
of pathological use patterns are emphasized

Physical dependence
 Physical (physiological) effects of multiple
episodes of substance use.

Psychological dependence (habituation)

 Continuous or intermittent craving (i.e., intense
desire) for the substance to avoid a dysphoric
state.
59. Which personality disorder is
usually comorbid in patients with RCCD, 2019

substance abuse or substance

dependence?
A. Borderline Personality Disorder
B. Histrionic Personality Disorder
C. Paranoid Personality Disorder
D. Antisocial Personality Disorder
 ASPD and Substance Use Disorders
RCCD, 2019

35 to 60 percent of patients meet the

diagnostic criteria for Antisocial Personality
Disorder

 Likely to use more illegal substances

 More psychopathology
 Less satisfied with their lives
 More impulsive, isolated, and depressed
60. Which of the following would be a correct definition of
a binge drinking episode? RCCD, 2019
A. When people consume five or more drinks on a single
occasion, it is called a binge drinking episode.
B. When people consume four or more drinks on a single
occasion, it is called a binge drinking episode
C. When people consume five or more drinks on multiple
successive occasions, it is called a binge drinking
episode
D. When people consume four or more drinks on multiple
successive occasions, it is called a binge drinking
episode
 Binge Drinking
RCCD, 2019

When people consume five or more drinks on a single

occasion, it is called a binge drinking episode.
US Statistic: 22.5-23%

Racial Differences:
 Asians: lowest level (11.6%)
 American Indians: highest level (24.3%)

Heavy drinkers
 Binge drinking for five times each month
 Males outnumber females by at least 3 to 2.
61. Which of the following is
currently considered as the most
RCCD, 2019

powerful natural stimulant?

A. Amphetamines
B. Cocaine
C. Caffeine
D. Opium
 Cocaine
RCCD, 2019

 Central active ingredient of the coca plant

 Most powerful natural stimulant now known (Acosta,

Haller, & Schnoll, 2011, 2005).
 Euphoric rush (like heroin)

 Increases dopamine, serotonin, and norepinephrine

Crashing
 Depression-like letdown upon cessation of effects
 Headaches, dizziness, and fainting
 Cocaine
Freebasing RCCD, 2019

 Pure cocaine basic alkaloid is

chemically separated, or
―freed,‖ from processed
cocaine, vaporized by heat from
a flame, and inhaled through a
pipe.

Crack
 Powerful form of freebase
cocaine that has been boiled
down into crystalline balls.
62. Which opioid drug is connected
to what is known as ―soldiers’ RCCD, 2019

disease‖ during the American Civil

War?
A. Morphine
B. Heroin
C. Methadone
D. Opium
 Opiods (Narcotics)
 Opium and derived drugs (ex: heroin, morphine, and
RCCD, 2019
codeine)
Injection (―mainlined‖) - Most common method of narcotic
use
 Rush - a spasm of warmth and ecstasy that is
sometimes compared with orgasm.
 High or nod - several hours of a pleasant feeling

Depress CNS (emotion control)

Endorphins—neurotransmitters that help relieve pain and

reduce emotional tension
63. Which class of substance does
not have a pattern of intoxication, RCCD, 2019

according to the DSM-5?

A. Caffeine
B. Tobacco
C. Hallucinogens
D. Inhalants
 Tobacco-Related Disorders

 DSM-5 does not describe an intoxication pattern RCCD, 2019

for tobacco-related disorders.

Withdrawal symptoms
 Depressed mood, insomnia, irritability, anxiety,
difficulty concentrating, restlessness, and
increased appetite and weight gain.

Rate of relapse - equivalent among those using

alcohol, heroin, and cigarettes
64. Which class of substance RCCD, 2019

does not have a pattern of use,

according to the DSM-5?
A. Caffeine
B. Tobacco
C. Hallucinogens
D. Inhalants
 Caffeine Withdrawal
RCCD, 2019

Headache
﹡ Hallmark feature of caffeine
withdrawal
﹡ Diffuse, gradual in development,
throbbing, severe, and sensitive
to movement

Caffeine is the most widely used

behaviorally active drug in the world
Caffeine Withdrawal
RCCD, 2019
65. Korsakoff's syndrome is caused
partly by __ and is a form of __ amnesia RCCD, 2019

A. head injury; organic anterograde

B. severe alcohol abuse; psychogenic
retrograde
C. head injury; psychogenic retrograde
D. severe alcohol abuse; organic
retrograde
 Korsakoff’s syndrome
RCCD, 2019
 Deficiency of vitamin B (thiamine)
 Marked by extreme confusion, memory
loss, and other neurological symptoms
 Cannot remember the past or learn new
information

Confabulating
 Reciting made-up events to fill in the gaps.
66. According to the DSM-5, all of these
features are required for a diagnosis of RCCD, 2019

anorexia except for?

A. Intense fear of gaining weight and being fat
B. Distorted body image or sense of their
body shape
C. Maintenance of normal body weight
D. Restriction of behaviors that promote
healthy body weight
 Anorexia Nervosa
A. Restriction of energy intake relative to requirements
leading to a significantly low body weight in the context of
RCCD, 2019

age, sex, developmental trajectory, and physical health.

Significantly low weight is defined as a weight that is less
than minimally normal, or, for children and adolescents,
less than that minimally expected. (*Rewording of DSM-IV
criterion to focus on behavior, not refusal to maintain body
weight)

B. Intense fear of gaining weight or becoming fat, or persistent

behavior that interferes with weight gain, even though at a
significantly low weight.
(*Addition of behavioral clause, as many deny fear)
 Anorexia Nervosa
RCCD, 2019
C. Disturbance in the way in which one's body weight
or shape is experienced, undue influence of body
weight or shape on self-evaluation, or persistent lack
of recognition of the seriousness of the current low
body weight.

(*Criterion D – Amenorrhea – deleted; many exhibit

some menstrual activity, does not apply to pre-
menarchal females, post-menarchal females, those
taking modern oral contraceptives, and males)
 Bulimia Nervosa
RCCD, 2019
A. Recurrent episodes of binge eating. An episode of binge
eating is characterized by both of the following:

1. Eating, in a discrete period of time (for example, within any

2-hour period), an amount of food that is definitely larger
than most people would eat during a similar period of time
and under similar circumstances.

2. A sense of lack of control over eating during the episode

(for example, a feeling that one cannot stop eating or
control what or how much one is eating).
 Bulimia Nervosa
B. Recurrent inappropriate compensatory behavior in order to RCCD, 2019
prevent weight gain, such as self-induced vomiting; misuse of
laxatives, diuretics, or other medications, fasting; or excessive
exercise.

C. The binge eating and inappropriate compensatory behaviors

both occur, on average, at least once a week for 3 months.
(*change from twice per week for past two months)

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of

anorexia nervosa. (*Removal of purging/non-purging subtype)
67. According to Fallon and Rozin's (1985) study of
college students' perceptions of actual and ideal
body shapes for females, which of the following
RCCD, 2019

represents a correct ordering from thinnest to

heaviest?
A. Male's attractive: female's ideal: female's attractive
B. Female's ideal: male's attractive: female's
attractive
C. Male's attractive: female's attractive: female's
current
D. Female's ideal: female's attractive: male's
attractive
Men - rated their ideal body weight as heavier than the weight
females thought most attractive in men
Women - rated their current figures as much heavier than what RCCD, 2019
they judged the most attractive, which in turn, was rated as
heavier than what they thought was ideal
68. According to Stice and colleagues
(1999), efforts of adolescents to have RCCD, 2019

weight-reduction (which may lead to some

eating disorders) are more likely to result
in?
A. Weight gain than weight loss
B. Weight loss
C. Stable body weight
D. Decreased food craving
 Stice and colleagues (1999)
Girls who attempted dieting RCCD, 2019

faced more than 300% greater

risk of obesity than those who
did not diet.

Repeated cycles of ―dieting‖

seems to produce stress-
related withdrawal symptoms,
resulting in more eating than
would have occurred without
dieting.
69. Kyla told her professor that she sometimes
experiences seeing vivid dreamlike images of RCCD, 2019

hooded figures standing beside her bed before

the onset of her sleep. Which of the following
will her professor most likely identify the
experience as?
A. Autoscopic hallucinations
B. Hypnagogic hallucinations
C. Ictal hallucinations
D. Hypnopompic hallucinations
HYPNAGOGIC HALLUCINATIONS
RCCD, 2019
• Vivid perceptual experience occurring at sleep onset
• Visual, tactile, kinetic, auditory phenomena

HYPNOPOMPIC HALLUCINATIONS
• Vivid perceptual experience occurring upon awakening
• Visual, tactile, kinetic, auditory phenomena
• In between REM stage and awakening
AUTOSCOPIC HALLUCINATIONS
RCCD, 2019
• Hallucinations of one’s own physical self.
• Stimulate the delusion that one has a double (doppelganger)
• Near-death out-of body experiences

ICTAL HALLUCINATIONS
• Part of seizure activity
• Typically brief, lasting only seconds to minutes, and
stereotyped.
• Simple images (flashes of light)
• Elaborate (past experiences)
70. Which of the following is not a
type of dyssomnia? RCCD, 2019

A. Hypersomnolence Disorder
B. Narcolepsy
C. Breathing-Related Sleep
Disorder
D. Nightmare Disorder
 Two Major Categories
(Sleep-Wake Disorders) RCCD, 2019

Dyssomnias
 Difficulties in getting enough sleep,
problems with sleeping when you want to
and complaints about the quality of sleep.

Parasomnias
 Abnormal behavioral or physiological
events that occur during sleep
RCCD, 2019
333
71. Which of the following is not a
hallmark characteristic of people RCCD, 2019

diagnosed with narcolepsy?

A. Cataplexy
B. Sleep Paralysis
C. Hypnagogic hallucinations
D. Dystonia
 Hallmark Features of Narcolepsy
1. Daytime sleepiness RCCD, 2019

2. Cataplexy - sudden loss of muscle tone

 Usually preceded by strong emotion
 Sudden onset of REM sleep

3. Sleep paralysis - a brief period after awakening when they

can’t move or speak that is often frightening to those who go
through it.

4. Hypnagogic hallucinations - vivid and often terrifying

experiences that begin at the start of sleep and are said to be
unbelievably realistic
72. According to previous genetic research
with Doberman pinschers and RCCD, 2019

Labrador retrievers, who inherited

narcolepsy, suggest that narcolepsy is
associated with a cluster of genes on which
chromosome?
A. Chromosome 6
B. Chromosome 14
C. Chromosome 19
D. Chromosome 4
 Narcolepsy
RCCD, 2019

Chromosome 6
 Autosomal recessive trait

Significant loss of a certain type of nerve

cell (hypocretin neurons)
 Role in wakefulness
73. Which type of sleep apnea involves
complete cessation of respiratory activity RCCD, 2019

for brief periods and is often associated

with certain central nervous system
disorders?
A. Central Sleep Apnea
B. Obstructive Sleep Apnea Hypopnea
C. Sleep-Related Hypoventilation
D. Mixed Sleep Apnea
 Central Sleep Apnea
RCCD, 2019

 Complete cessation of respiratory activity for brief

periods
 Associated with certain central nervous system
disorders
 Wake up frequently during the night but they tend
not to report excessive daytime sleepiness and
often are not aware of having a serious breathing
problem.
Obstructive sleep apnea hypopnea syndrome
RCCD, 2019

 Airflow stops despite continued activity by the

respiratory system
 Snoring is commonly reported
 Most common in males
 Occurs in 10% to 20% of the population

 Obesity
 Increasing age
 Use of MDMA (ecstasy)
Sleep-related Hypoventilation
RCCD, 2019

 Decrease in airflow without a complete

pause in breathing.

 Increased carbon dioxide (CO2) levels

74. Which of the following is a type of
non–rapid eye movement (REM) sleep RCCD, 2019

arousal disorder in DSM-5?

A. Sleep terrors
B. Nightmare disorder
C. Fugue
D. Obstructive sleep apnea hypopnea
NON-RAPID EYE MOVEMENT SLEEP
AROUSAL DISORDERS
RCCD, 2019
75. Which phase of the human sexual
response cycle is described when women RCCD, 2019

and men experience pleasure and

increased blood flow to the genitalia?
A. Desire
B. Excitement
C. Orgasm
D. Resolution
RCCD, 2019
RCCD, 2019
76. A 35-year-old woman tells her therapist that she has recently
become intensely aroused while watching movies in which people are
tortured and that she regularly fantasizes about torturing people while RCCD, 2019

masturbating. She is not distressed by these thoughts and denies ever

having acted on these new fantasies, though she fantasizes about these
activities several times a day. Which of the following best summarizes
the diagnostic implications of this patient’s presentation?
A. She meets all of the criteria for sexual sadism disorder
B. She does not meet the criteria for sexual sadism disorder because
the fantasies are not sexual in nature
C. She does not meet the criteria for sexual sadism disorder because
she has never acted on the fantasies
D. She does not meet the criteria for sexual sadism disorder as the
diagnosis is only made in men
Paraphilia vs. Paraphilic Disorder
RCCD, 2019
77. A 30-year-old woman comes to your office and reports that she is
there only because her mother pleaded with her to see you. She tells
RCCD, 2019
you that although she has a good social network with friends of both
sexes, she has never had any feelings of sexual arousal in response to
men or women, does not have any erotic fantasies and has little
interest in sexual activity. She has found other like-minded individuals,
and she and her friends accept themselves as asexual. What is the
appropriate diagnosis, if any?
A. Female sexual interest/arousal disorder, lifelong, mild
B. Female sexual interest/arousal disorder, lifelong, severe
C. No diagnosis, because she does not have the minimum number of
symptoms required for female sexual interest/arousal disorder
D. No diagnosis, because she does not have clinically significant
distress or impairment
78. Which of the following terms best
describes the diagnostic approach
RCCD, 2019

proposed in the Alternative DSM-5

Model for Personality Disorders?
A. Categorical
B. Dimensional
C. Hybrid
D. Polythetic
 Approaches to Classification
Classical (or pure) categorical approach RCCD, 2019

○ Classification method founded on the assumption of clear-cut

differences among disorders, each with a different known
cause

Dimensional Approach
○ Note variety of cognitions, moods, and behaviors with which the
patient presents and quantify them on a scale

Prototypical Approach
○ Identify certain essential characteristics but also allows certain
non-essential variations that does not change the classification
○ Currently used by DSM-5
 Hybrid model
RCCD, 2019

 In DSM-5, the categorical personality disorders are

virtually unchanged from the previous edition.

 However, an alternative ―hybrid‖ model has been

proposed in Section III

 A more dimensional profile of personality trait

expression is also proposed for a trait-specified
approach.
79. Which of the following is a RCCD, 2019

domain of the Alternative DSM-5

Model for Personality Disorders?
A. Neuroticism
B. Extraversion
C. Disinhibition
D. Agreeableness
RCCD, 2019
80. According to the DSM-5, which concept
under ―cultural concepts of distress‖ refer to the RCCD, 2019

clusters of symptoms and attributions that tend

to co-occur among individuals in specific
cultural groups, communities, or contexts and
that are recognized locally as coherent patterns
of experience?
A. Cultural syndromes
B. Cultural idioms of distress
C. Cultural explanations
D. Perceived causes
 Cultural concepts of distress RCCD, 2019

 Ways that cultural groups experience, understand,

and communicate suffering, behavioral problems,
or troubling thoughts and emotions.

Three main types of cultural concepts:

 Cultural syndromes
 Cultural idioms of distress
 Cultural explanations or perceived causes
 Cultural syndromes
RCCD, 2019

Clusters of symptoms and attributions that tend

to co-occur among individuals in specific
cultural groups, communities, or contexts and
that are recognized locally as coherent
patterns of experience.
 Cultural explanations or
perceived causes RCCD, 2019

Labels, attributions, or features of an

explanatory model that indicate culturally
recognized meaning or etiology for
symptoms, illness, or distress.
 Cultural idioms of distress
RCCD, 2019

Ways of expressing distress that may not

involve specific symptoms or syndromes,
but that provide collective, shared ways of
experiencing and talking about personal or
social concerns.
81. Which of the following are major defense
mechanisms associated with histrionic RCCD, 2019

personality disorder?
I. Repression
II. Dissociation
III. Isolation
IV. Projective Identification
A. III & IV
B. I & II
C. I & III
D. II & III
 Defense Mechanisms and
Histrionic Personality Disorder RCCD, 2019
82. Which of the following is not a
defense mechanism used by RCCD, 2019

individuals with obsessive-compulsive

personality disorder?
A. Rationalization
B. Isolation
C. Reaction Formation
D. Projective Identification
Defense Mechanisms and OCPD
RCCD, 2019
83. In a folie à deux, which personality
disorder is commonly seen on the RCCD, 2019

person who internalizes the delusional

system of the other?
A. Histrionic Personality Disorder
B. Schizotypal Personality Disorder
C. Paranoid Personality Disorder
D. Dependent Personality Disorder
Folie à Deux and DPD
RCCD, 2019
84. What is the central difference between
a diagnosis of CD versus antisocial RCCD, 2019

personality disorder?
A. The severity of aggressive and
destructive behaviors
B. The age of the diagnosed individual
C. The severity of parental criminal
behavior
D. The presence of substance abuse
 Antisocial Personality Disorder
RCCD, 2019

A. A pervasive pattern of disregard for and violation of the rights

of others, occurring since age 15 years, as indicated by three
(or more) of the following:
1. Failure to conform to social norms with respect to lawful
behaviors, as indicated by repeatedly performing acts that are
grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of
aliases, or conning others for personal profit or
pleasure.
3. Impulsivity or failure to plan ahead.
 Antisocial Personality Disorder
4. Irritability and aggressiveness, as indicated by repeated RCCD, 2019

physical fights or assaults.

5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated
failure to sustain consistent work behavior or honor
financial obligations.
7. Lack of remorse, as indicated by being indifferent to or
rationalizing having hurt, mistreated, or stolen
from another.
B. The individual is at least age 18 years.
C. There is evidence of conduct disorder with onset before age
15 years.
 Conduct Disorder
A. A repetitive and persistent pattern of behavior in RCCD, 2019

which the basic rights of others or major age-

appropriate societal norms or rules are violated, as
manifested by the presence of at least three of the
following 15 criteria in the past 12 months from any of
the categories below, with at least one criterion present
in the past 6 months:
Four Categories:
1. Aggression to people and animals
2. Destruction of Property
3. Deceitfulness or Theft
4. Serious Violations of Rules
 Conduct Disorder
RCCD, 2019

B. The disturbance in behavior causes clinically

significant impairment in social, academic, or
occupational functioning.

C. If the individual is age 18 years or older, criteria

are not met for antisocial personality disorder.
85. In schizophrenia spectrum and other
psychotic disorders, four domains are RCCD, 2019

considered as psychotic symptoms. Which

of the following is not considered a
psychotic symptom?
A. Delusions
B. Anhedonia
C. Hallucinations
D. Disorganized speech
POSITIVE AND NEGATIVE SYMPTOMS
OF SCHIZOPHRENIA RCCD, 2019
86. Which among the following set of
symptoms would most likely warrant a RCCD, 2019

diagnosis of schizophrenia, given that

each would have persisted for a period of
6 months?
A. Avolition and Incoherence
B. Catatonia, Anhedonia, Alogia
C. Delusions and Hallucinations
D. Both A and C
 Schizophrenia (Criterion A)
RCCD, 2019
A. Two (or more) of the following, each present for a
significant portion of time during a 1-month period (or
less if successfully treated). At least one of these must
be (1), (2), or (3):
1. Delusions.
2. Hallucinations.
3. Disorganized speech (e.g., frequent derailment or
incoherence).
4. Grossly disorganized or catatonic behavior.
5. Negative symptoms (i.e., diminished emotional
expression or avolition).
87. Which of the following patient presentations
would not be classified as psychotic for the purpose RCCD, 2019

of diagnosing schizophrenia?
A. A patient is hearing a voice that tells him he is a
special person
B. A patient believes he is being followed by a secret
police organization that is focused exclusively on him
C. A patient has a flashback to a war experience that
feels like it is happening again
D. A patient presents wearing an automobile tire
around his waist and gives no explanation
RCCD, 2019
88. Harry Stack Sullivan’s explanation of
schizophrenia includes all of the following RCCD, 2019

except?
A. The patient’s massive anxiety creates a sense
of unrelatedness.
B. Pathological anxiety is transformed into
prototaxic distortions.
C. Distortions are usually persecutory in nature.
D. The source of pathological anxiety results from
cumulative experiential traumas during
development.
 Harry Stack Sullivan’s view on
schizophrenia RCCD, 2019

 Disturbance in interpersonal relatedness

 Massive anxiety  sense of unrelatedness 

parataxic distortions (usually persecutory).

 Schizophrenia as an adaptive method

89. In the etiology of schizophrenia,
Theodore Lidz described abnormal family RCCD, 2019

behaviors as possible explanation. Which

family pattern happens if one parent is overly
close to a child of the opposite gender?
A. Schism Family
B. Skewed Family
C. Pseudomutual Family
D. Pseudohostile Family
 Schisms and Skewed Families
RCCD, 2019

Schism Family
 Schism between the parents, one parent is overly
close to a child of the opposite gender.

Skewed Family
 Skewed relationship between a child and one
parent involves a power struggle between the
parents and the resulting dominance of one
parent.
Pseudohostile and Pseudomutual Family
RCCD, 2019
 Proposed by Lyman Wynne
 Suppression of emotional expression
Pseudohostile Family
 Argues, postures aggressively, and appears
fragmented while underneath, being extremely
close and having very few secrets.
 Closeness – blurring of ego boundaries
Pseudomutual Family
 Façade of happiness to disguise internal conflict
90. In schizoaffective disorder, the Criterion A
requires an uninterrupted period of illness RCCD, 2019

during which Criterion A for schizophrenia is

met. Which of the following additional
symptoms must be present to fulfill diagnostic
criteria for schizoaffective disorder?
A. Dysthymia
B. Major Depressive Episode
C. Hypomania
D. Cyclothymia
 Schizoaffective Disorder
A. An uninterrupted period of illness during which RCCD, 2019

there is a major mood episode (major depressive or

manic) concurrent with Criterion A of
schizophrenia.
Note: The major depressive episode must
include Criterion A1: Depressed mood.
B. Delusions or hallucinations for 2 or more weeks
in the absence of a major mood episode
(depressive or manic) during the lifetime duration of
the illness.
91. Elize was diagnosed with Asperger’s
syndrome when she was a child. If she is now RCCD, 2019

rediagnosed using the DSM-5 and found to

have the same symptoms, which label would
replace her former diagnosis?
A. Intellectual disability
B. Learning disorder
C. Autism spectrum disorder
D. Attention-deficit/hyperactivity disorder
 Autism Spectrum Disorder
A. Deficits in social communication and social RCCD, 2019

interaction
B. Restricted repetitive behaviors, interests, and
activities (RRBs).
Four previously separate disorders:
1. Autistic disorder (autism)
2. Asperger’s disorder
3. Childhood disintegrative disorder
4. Pervasive developmental disorder not otherwise
specified.
92. Sophie, a newborn baby, flings her
arms and legs upwards when there is RCCD, 2019

sudden noise or movement in her body.

Which reflex is Sophie demonstrating?
A. Moro reflex
B. Babinski reflex
C. Palmar reflex
D. Rooting reflex
93. Within attention deficit/hyperactivity
disorder, which of the following is not RCCD, 2019

classified as a problem relating to poor

attention?
A. Does not seem to listen
B. Fidgetiness
C. Easily distracted
D. Loses and misplaces objects
94. Which of the following abilities
does the term theory of mind refer RCCD, 2019

to?
A. Lack of meta-cognition
B. Understand one's own and other
people's mental states
C. Foreshadowing events
D. None of the above
95. Which of the following is
another name for Broca’s
RCCD, 2019

aphasia?
A. Fluent aphasia
B. Jargon aphasia
C. Global aphasia
D. Expressive aphasia
 Aphasias
RCCD, 2019

Broca’s aphasia (Expressive aphasia)

 Disturbance of speech in which understanding
remains intact but the ability to speak is
grossly impaired.

Wernicke’s aphasia (Fluent aphasia )

 Inability to understand the spoken word
 Fluent but incoherent speech is present
 Aphasias
Jargon aphasia RCCD, 2019

 Words that are produced are neological or

nonsensical.
 Speech is fluent and effortless with proper
grammar, but the patient has difficulty with noun
selection.

Global aphasia
 All aspects of spoken and written language are
impaired in both expression and comprehension.
96. Sheila visited her grandmother during
summer vacation. During her stay, she noticed RCCD, 2019

that her grandmother gradually fails to

recognize commonly used household objects.
Which of the following best reflects her
condition?
A. Agnosia
B. Apraxia
C. Alogia
D. Aphasia
RCCD, 2019
97. In the Mini Mental State Inpatient
Consultation Form, asking the patient follow RCCD, 2019

a three-stage command ―Take a piece of

paper in your right hand, fold it in half, and
put it on the floor‖ is under which domain?
A. Orientation
B. Registration
C. Recall
D. Language
RCCD, 2019
98. Which of the following
disorders is transmitted by a
RCCD, 2019

single dominant gene?

A. Huntington's disease
B. Parkinson's disease
C. Alzheimer's disease
D. Pick's disease
98. Which of the following disorders is
transmitted by a single dominant gene? RCCD, 2019

A. Huntington's disease (chromosome

4)
B. Parkinson's disease
C. Alzheimer's disease (chromosome 1,
14, 19, 21)
D. Pick's disease (chromosome 1, 18)
 Huntington’s Disease
 Genetic disorder that initially affects motor RCCD, 2019

movements, typically in the form of chorea,

involuntary limb movements Just as with
Parkinson’s disease, only a portion of

 Neurocognitive disorder—somewhere between

20% and 80

 Neurocognitive disorder due to Huntington’s

disease  subcortical pattern
99. Which of the following is the RCCD, 2019

fundamental element of the DSM?

A. Syndrome
B. Symptoms
C. Signs
D. None of the above
Syndrome
○ Fundamental element of DSM
○ Constellation of symptoms that occur together,
RCCD, 2019

appear temporally, and appear in many

individuals
○ No direct implications in terms of underlying
pathology

Symptoms
○ Simplest level of analyzing a presenting problem
○ Subjective, observed by the patient, and cannot
be measured directly
Disorder
○ Disruption to regular bodily structure and RCCD, 2019

function
○ Mental disorder is a syndrome
○ No direct implication of etiology

Disease
○ Resulting from a pathophysiological response
to external or internal factors
○ Underlying etiology is known
○ Highest level of conceptual understanding
100. Which of the following is/are RCCD, 2019

required to make a diagnosis,

according to the DSM?
A. Minimum number of symptoms
B. Minimum duration of symptoms
C. Clinical significance
D. All of the above
 Clinical Assessment and Diagnosis
Clinical Assessment RCCD, 2019

○ Systematic evaluation and measurement of psychological,

biological, and social factors in an individual presenting
with a possible psychological disorder
Diagnosis
○ Process of determining whether a presenting problem
meets the established criteria for a specific psychological
disorder.
Requirements (Bourgeis, 2000):
○ Minimum number of symptoms
○ Minimum duration of symptoms
○ Clinical significance (impairment and distress)