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Chapter 1 Practice Exam Questions

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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 1: Introduction: Historical and Scientific Considerations LEARNING GOALS 1. Be able to explain the meaning of stigma as it applies to people with mental illness. 2. Be able to describe and compare different definitions of abnormality. 3. Be able to explain how the causes and treatments of mental illness have changed over the course of history. 4. Be able to describe the historical forces that have helped to shape our current view of mental illness, including biological, psychoanalytic, and behavioral views. 5. Be able to describe the different mental health professions, including the training involved and the expertise developed. Summary  The study of psychopathology is a search for the reasons why people behave, think, and feel in abnormal—unexpected, sometimes odd, and possibly self- defeating—ways. Unfortunately, people who exhibit abnormal behavior or have a mental illness are often stigmatized. Reducing the stigma associated with mental illness remains a great challenge for the field.  In evaluating whether a behavior is abnormal, psychologists consider several different characteristics, including personal distress, disability, violation of social norms, and dysfunction. Each characteristic tells something about what can be considered abnormal, but none by itself provides a fully satisfactory definition. The DSM-IV-TR definition includes all of these characteristics.  Since the beginning of scientific inquiry into abnormal behavior, supernatural, biological, and psychological points of view have vied for attention. More supernatural viewpoints included early demonology, which posited that mentally ill people are possessed by demons or evil spirits, leading to treatments such as exorcism. Early biological viewpoints originated in the writings of Hippocrates. After the fall of Greco-Roman civilization, the biological perspective became less prominent in Western Europe, and demonological thinking gained ascendancy, as evidenced by the persecution of so-called witches. Beginning in the fifteenth century, mentally ill people were often confined in asylums, such as Bethlehem; treatment in asylums was generally poor or nonexistent, until various humanitarian reforms were instituted. Early systems of classifying mental disorders led to a reemergence of the biological perspective in the eighteenth and nineteenth centuries. In the twentieth century, genetics and mental illness became an important area of inquiry, though the findings from genetic studies were used to the detriment of the mentally ill during the eugenics movement.  Psychological viewpoints emerged in the nineteenth century from the work of Charcot and the seminal writings of Breuer and Freud. Freud’s theory emphasized stages of psychosexual development and the importance of unconscious processes, such as repression and defense mechanisms that are traceable to early- childhood conflicts. Therapeutic interventions based on psychoanalytic theory make use of techniques such as free association and the analysis of transference in attempting to overcome repressions so that patients can confront and understand their conflicts and find healthier ways of dealing with them. Later theorists such as Jung and Adler made various modifications in Freud’s basic ideas and emphasized different factors in their perspectives on therapy.  Behaviorism suggests that behavior develops through classical conditioning, operant conditioning, or modeling. B. F. Skinner introduced the ideas of positive and negative reinforcement and showed that operant conditioning can shape behavior. Behavior therapists try to apply these ideas to change undesired behavior, thoughts, and feelings.  There are a number of different mental health professions, including clinical psychologist, counseling psychologist, psychiatrist, psychoanalyst, social worker, and psychopathologist. Each involves different training programs of different lengths and with different emphases on research, psychological assessment, psychotherapy, and psychopharmacology. 1. Which of the following is NOT a characteristic of stigma? a.Alabel applied to a group of people that distinguishes them from others. b. Alabel applied to a group of people that breaks the law. c. The label is linked to deviant or undesirable attributes of society. d. People with the label face unfair discrimination. Answer: B Type: Factual Page: 3 2. Mental illness in the 21 century a. is conceptualized mostly from a psychoanalytic perspective. b. remains stigmatized. c. is largely treated by the cathartic method. d. is seldom treated with psychotherapy. Answer: B Type: Factual Page: 3 3. An illustration of abnormal behavior would be a. soiling oneself at least once a month at age 14. b. experiencing anxiety while leaving the house. c. experiencing hallucinations. d. All of the above are examples of abnormal behavior. Answer: D Type:Applied Page: 5-6 4. The best definition of abnormal behavior takes all of the following into account EXCEPT a. personal distress. b. violations of norms. c. disability. d. syndromes. Answer: D Type: Factual Page: 5-6 5. Which is a limitation of “harmful dysfunctions” as a definition of abnormality? a. It ignores the personal suffering of disturbed individuals. b. Many dysfunctional mechanisms are not harmful. c. Harmful dysfunctions also have an impact on others. d. The dysfunctional mechanisms are largely unknown. Answer: D Type:Applied Page: 6 6. Variations in cultural background make it difficult to define abnormal behavior as simply behavior which a. involves a deviation from social norms. b. leads to dysfunction. c. improves after therapy. d. causes personal distress. Answer:AType:Applied Page: 5-6 7. Defining abnormal behavior on the basis of personal distress is problematic for which reason? a. High levels of distress and suffering are normal in modern society. b. Some abnormal behavior does not involve personal distress. c. It ignores suffering that family members of disturbed people experience. d. It does not apply to physiological disorders. Answer: B Type: Factual Page: 5 8. Cindy is an accomplished lawyer who sought psychological help in dealing with the stresses of balancing work and family responsibilities. Which definition of abnormality applies to Cindy? a. harmful dysfunction b. violation of social norms c. personal distress d. disability Answer: C Type:Applied Page: 5 9. After presenting characteristics of abnormality, the text concludes that a. research is needed to identify which characteristic is best. b. different characteristics apply to various psychopathologies. c. personal distress is the most useful characteristic. d. together the characteristics give a partial definition of abnormality. Answer: D Type Factual Page: 7 10. Demonology is the a. practice of exorcism. b. devil worship and satanic cults that some ascribed to causing mental illness. c. idea that an evil being may live in a person and control his or her mind and body. d. practice of drilling a hole in a person’s head to allow evil spirits to escape. Answer: C Type: Factual Page: 8 11. Hippocrates’early views on abnormality contributed to an enduring emphasis on a. natural causes. b. spirituality. c. humors. d. classification. Answer:AType: Factual Page: 8 12. Hippocrates influenced psychology by a. distinguishing medicine from religion and magic. b. debunking the notion that the four humors were related to disorders. c. reforming mental hospitals. d. suggesting mental illness was punishment from God. Answer:AType: Factual Page: 8 13. Expelling evil spirits by chanting and torture is known as a. somatic therapy. b. exorcism. c. witchcraft. d. trephining. Answer: B Type: Factual Page: 8 14. Hippocrates suggested which of the following treatments for mental illness? a. application of leaches b. herbal remedies c. prayer and chants by faith healers d. relaxation and care in choosing foods Answer: D Type: Factual Page: 8 15. Hippocrates' view of mental illness was superior to demonology in that it a. promoted a scientific study of abnormal behavior. b. made connections between brain and behavior more clearly determined. c. allowed for clearer description of symptoms. d. All of the above are correct. Answer: D Type: Factual Page: 8 16. Which of the following best describes treatment of disordered people during the Dark Ages? a. Monks in monasteries prayed over them. b. They were chained in early asylums. c. They were condemned as witches and tortured. d. They were given bed rest, fed simple foods, and forced to subscribe to clean living. Answer:AType: Factual Page: 9 17. A detailed re-examination of the witch hunts during the Middle Ages revealed that a. Most of the accused were not mentally ill. b. Mental illness was more common during that time period. c. Most witches were psychotic. d. Many more men than women were accused, tortured and put to death. Answer:AType: Factual Page: 9 18. During the witch hunts of the inquisition most insane people were a. burned as witches. b. confined in lunatic hospitals. c. cared for in monasteries. d. set out to roam the streets. Answer: B Type: Factual Page: 9 19. The 'Malleus Maleficarum' was a a. witch hunt manual. b. ceremonial guide used by witches. c. treatment manual used in early mental hospitals. d. Freudian perspective on mental illness. Answer:AType: Factual Page: 9 20. Edith was accused of being a witch in 1532. She most likely lived in a. Russia. b. Panama. c. Europe. d. Japan. Answer: C Type:Applied Page: 9 21. Through the use of modern analyses, it was found that the majority of the witches of the latter MiddleAges were psychotic because a. they were delusional. b. they actively hallucinated. c. both a and b. d. None of the above are correct; the majority of these witches are now thought to have not been psychotic. Answer: D Type: Factual Page: 9 22. Which of the following suggests that many "witches" condemned during the inquisition were, in fact, mentally disordered individuals? a. The inquisitors themselves read letters from witches. b. The witches were typically from lower social classes. c. The witches "confessed" to delusions and hallucinations. d. The witches were labeled insane by the courts of the times. Answer: C Type: Factual Page: 9 23. In the MiddleAges, mental illness a. was believed to be associated with magical powers. b. was treated with more compassion than in modern times. c. resulted in the sufferer being confined to an asylum.. d. resulted in burning at the stake. Answer: C Type: Factual Page: 10 24. Early asylums were developed a. for the confinement and care of the mentally ill. b. to protect people from witch hunts. c. after the discovery of syphilis. d. centuries before leprosy hospitals. Answer:AType: Factual Page: 10 25. What treatment was provided by early asylums? a. moral treatment b. torture until they admitted they were witches c. confinement with no clear treatment program d. attendants talked to them in quiet, religious retreats Answer: C Type: Factual Page: 10-11 26. Some of the first asylums for the mentally ill a. performed lobotomies on patients. b. were associated with medical care, and thus were more humane. c. relied heavily on talk therapy. d. were tourist attractions. Answer: D Type: Factual Page: 10-11 27. Bedlam a. originated from observations of ritualistic chantings of 'witches'. b. was a common practice of witches that involved trances and casting spells. c. is the term associated with the chaotic conditions at early asylums. d. is the practice of prescribing total bed rest for mentally ill people. Answer: C Type:Applied Page: 10 28. In 1791, John was committed to an asylum in the United States. Which treatment was he likely to experience there? a. a form of group therapy b. bloodletting c. moral treatment d. hypnosis Answer: B Type:Applied Page: 10-11 29. Who is associated with creating more humane environments at mental hospitals? a. Emil Kraepelin b. Joseph Breuer c. Philippe Pinel d. John Watson Answer: C Type: Factual Page: 11 30. Treatment for the mentally ill became more humane when a. treatment was introduced that focused on the individual. b. asylums were abolished. c. abnormal behavior was seen as based upon medical problems. d. specialty hospital wards were created for the mentally ill within general care facilities. Answer:AType: Factual Page: 12 31. Moral treatment” was largely abandoned because of the development of a. psychoanalysis. b. improved medications. c. large impersonal hospitals. d. scandals at retreat centers. Answer: C Type: Factual Page: 12 32. An advantage of moral treatment was a. the use of drugs like opium and cannibis. b. that discharge rates were very high. c. that limits were established to restrict the number of patients hospitalized at any given time. d. that attendants took complete care and responsibility for each patient. Answer: C Type: Factual Page: 12 33. Moral treatment involved a. herbal remedies that may have been toxic. b. fighting social inequities. c. encouraging patients to engage in purposeful activities. d. frightening the individual. Answer: C Type: Factual Page: 12 34. Elizabeth was receiving moral treatment while in an early asylum. Which of the following treatments was she least likely to receive? a. medication b. physical restraints c. purposeful work activities d. menial tasks Answer: B Type: Applied Page: 12 35. Moral treatment of the mentally disordered was abandoned because a. Pinel and others encouraged more humane treatment approaches. b. modern psychological treatments became more effective. c. evolving legal standards prohibited religion-based treatment approaches. d. individual attention was impossible in large, medically oriented institutions. Answer: D Type: Factual Page: 12 36. The York Retreat was an early mental hospital. Arecent evaluation of records there showed a. treatment was highly effective. b. torturous methods of treatment were routinely used. c. some innovative somatic therapies were developed. d. fewer than one-third of patients improved. Answer: D Type: Factual Page: 12 37. Dorothea Dix is famous for a. greatly improving the standard of care for people with mental illness. b. overseeing the creation of over thirty state hospitals for the mentally ill. c. providing moral treatment to many people with mental illness. d. All of the above are correct. Answer: B Type: Factual Page: 12 38. In comparison to early asylums, present-day mental hospitals a. provide a great deal of stimulation. b. provide intensive individual therapy. c. are primarily custodial. d. are well-staffed with nurses and psychiatrists, but have few psychologists. Answer: C Type: Factual Page: 13 39. Emil Kraepelin a. showed that hypnosis blocks pain. b. described the human anatomy. c. developed a classification system of mental disorders. d. pioneered the free association method. Answer: C Type: Factual Page: 14 40. The current classification system for mental illness was heavily influenced by which of the following individuals? a. Sigmund Freud b. Emil Kraepelin c. Philippe Pinel d. Franz Mesmer Answer: B Type: Factual Page: 14 41. When a group of symptoms typically co-occur, they are called a. syndromes. b. mental disorders. c. diagnoses. d. clusters. Answer:AType: Factual Page: 14 42. General paresis is best described as a. an early term for schizophrenia. b. hysterical paralysis with no medical cause. c. a deterioration of mental and physical health in associated with syphilis. d. a blood-letting technique. Answer: C Type: Factual Page: 15 43. The germ theory of disease, which states that disease is caused by infection of the body by tiny organisms, was put forth by a. Emil Kraepelin. b. FranzAnton Mesmer. c. Jean Charcot. d. Louis Pasteur. Answer: D Type: Factual Page: 15 44. The discovery of the cause of syphilis was important to the field of mental illness for which reason? a. Syphilis was widely feared and exacerbated mental illness. b. It increased interest in determining biological causes for mental illness. c. More asylum patients were diagnosed with syphilis. d. It highlighted the need for valid diagnostic systems. Answer: B Type: Factual Page: 2815 45. Psychopathology has been dominated by biological hypotheses because of the a. dominance of nonmedical professionals in the area. b. discovery of the link between general paresis and syphilis. c. general lack of other theories. d. identification of brain dysfunction in schizophrenia. Answer: B Type: Factual Page: 15 46. The germ theory of disease a. shows the link between syphilis and mental illness. b. explains the cause of schizophrenia and depression. c. disproved biological hypotheses. d. shows the link between influenza and adjustment disorder. Answer:AType: Factual Page: 15 47. Germ theory a. suggested that syphilis was the result of excessive vices, such as tobacco and alcohol use. b. proposed that the disease is due to an infection from minute organisms. c. hypothesized that infections result in schizophrenia and dementia. d. helped to identify factors that prevent manic depression. Answer: B Type: Factual Page: 15 48. An adherent for biological approaches would suggest which of the following treatments for depression? a. antidepressant medication b. psychotherapy c. relaxation therapy d. hypnosis Answer:AType:Applied Page: 16 49. Biological causes for mental illness were st
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