Name: Essentials of Abnormal Psychology 7th Edition By V. Mark Durand - Test Bank
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Complete Test Bank With Answers

Sample Questions Posted Below

1. Which the following is classified as a somatic symptom or related disorder?

	a.	*obsessive-compulsive disorder.*
	b.	*Illness anxiety disorder.*
	c.	*dissociative identity disorder.*
	d.	*body dysmorphic disorder.*

*ANSWER:*	b
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

2. The common aspect of all somatic symptom disorders is a set of

	a.	*Irrational beliefs about supernatural influences on one’s health.*
	b.	*Irrational judgments of one’s own physical attractiveness.*
	c.	*excessive or maladaptive responses to physical symptoms or to associated health concerns.*
	d.	*excessive or maladaptive responses to pain only.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*OTHER:*	*TYPE: Conceptual*

3. Illness anxiety disorder is present when

	a.	*normal bodily sensations are interpreted by the patient as a sign of a serious illness.*
	b.	*real physical illness is exaggerated to the point where the patient can only focus on the pain.*
	c.	*the patient has an unrealistic fear of contacting germs.*
	d.	*the patient is truly ill but does not trust the medical establishment enough to seek treatment.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

4. Shelley experiences persistent feelings of detachment from herself, as if she were observing herself from outside her body. The experience is so intense that she often has trouble remembering who she is and functioning in a coherent manner. Shelley most likely suffers from:

	a.	*Severe anxiety attacks.*
	b.	*A dissociative disorder.*
	c.	*Persistent depression.*
	d.	*Illness anxiety disorder.*

*ANSWER:*	b
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

5. Joe just ate six chilidogs and drank a liter of soda. If Joe suffers from illness anxiety disorder, he would probably interpret any resulting stomach discomfort as

	a.	*his own fault for eating so much.*
	b.	*the result of poor quality food.*
	c.	*gas pains from overeating.*
	d.	*a sign that something is seriously wrong with his stomach.*

*ANSWER:*	d
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Applied*

6. Since Jane suffers from illness anxiety disorder, we can expect her to see her physician

	a.	*often and feel completely reassured that there is nothing wrong with her health.*
	b.	*rarely but continue to believe that she is quite ill.*
	c.	*almost never because she does not trust physicians.*
	d.	*often but continue to be anxious about her health anyway.*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*

7. Jill is constantly worried that she will get sick. Although she feels fine now and believes that she is healthy, she still worries endlessly about developing a serious illness. Most likely Jill would be diagnosed with

	a.	*Generalized anxiety disorder.*
	b.	*Illness anxiety disorder.*
	c.	*a specific phobia of germs.*
	d.	*Body dysmorphic disorder.*

*ANSWER:*	b
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Applied*

8. With regard to a diagnosis of illness anxiety disorder, women are

	a.	*as equally likely as men to be diagnosed.*
	b.	*less likely than men to be diagnosed.*
	c.	*more likely than men to be diagnosed.*
	d.	*more likely than men to be diagnosed during middle to late adulthood, but no more likely than men to be diagnosed during teen years and early adulthood.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*OTHER:*	*TYPE: Factual*

9. Illness anxiety disorder is also known as (and previously listed in the DSM as)

	a.	*Hypochondriasis*
	b.	*Illness psychosis*
	c.	*Fictitious disorder.*
	d.	*Dissociation.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

10. All of the following have been implicated in the development and maintenance of somatic symptom disorders EXCEPT

	a.	*the additional attention one receives when sick.*
	b.	*a specific hypochondriac gene.*
	c.	*the high incidence of disease in the family during the hypochondriac’s childhood.*
	d.	*stressful life events*

*ANSWER:*	b
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*

11. A main difference between somatic symptom disorder and illness anxiety disorder is

	a.	*Somatic symptom disorder has a real medical basis and illness anxiety disorder does not*
	b.	*Somatic symptom disorder is heritable and illness anxiety is not*
	c.	*Somatic symptom disorder is associated with physical exacerbation of real symptoms, whereas illness anxiety disorder is associated with distorted beliefs about normal bodily function*
	d.	*None; the two terms refer to the same disorder in DSM-5.*

*ANSWER:*	c
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Conceptual*

12. Somatic symptom disorder and illness anxiety disorder have all of the following in common EXCEPT

	a.	*They are both outdated terms that are no longer officially part of the DSM*
	b.	*They are both associated with frequent visits to the doctor*
	c.	*Disease conviction is a core feature of both disorders*
	d.	*For both, the essential problem is anxiety*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Conceptual*

13. With regard to the treatment of hypochondriasis, some research supports the use of

	a.	*classical conditioning and operant conditioning.*
	b.	*psychoanalysis.*
	c.	*cognitive-behavioral treatment and stress management.*
	d.	*humanistic therapy.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*

14. Concerning one recent study of selective serotonin reuptake inhibitor treatments for hypochondriasis, the most accurate statement among the following is that

	a.	*they are effective.*
	b.	*they are not effective.*
	c.	*they appear to be effective, as does CBT, but only CBT was significantly different from a placebo condition.*
	d.	*neither the drug treatment nor CBT were found to be significantly more effective than a placebo condition.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*OTHER:*	*TYPE: Factual*

15. Which of the following is NOT a part of cognitive-behavioral therapy for hypochondriasis in Barsky and Ahern’s 2005 clinical trial?

	a.	*Reassurance to the patients that their symptoms did not reflect a serious illness*
	b.	*Identifying and challenging illness-related misinterpretations of physical sensations*
	c.	*Purposely “creating” symptoms by focusing attention on certain body areas*
	d.	*Coaching on seeking less reassurance regarding patients’ illness concerns*

*ANSWER:*	a
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Somatoform Disorders*
*OTHER:*	*TYPE: Factual*

16. The cause for somatic symptom and related disorders is most likely

Stressful life events

	a.	*biological*
	b.	*psychological*
	c.
	d.	*all of the above*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*

17. Which of the following are typical characteristics of patients with somatization disorder?

	a.	*Female and impulsive*
	b.	*Female and sexually conservative*
	c.	*Male and impulsive*
	d.	*Male and aggressive*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

18. Which of the following statements is true with regard to the treatment of somatic symptom disorders?

	a.	*Cognitive-behavioral treatment has been demonstrated in several studies to be a very effective treatment.*
	b.	*It is relatively easy to treat as long as the patient is willing to participate in therapy.*
	c.	*Primary care physicians can usually treat patients by educating and reassuring patients.*
	d.	*They are difficult to treat and there are no treatments with proven effectiveness.*

*ANSWER:*	d
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*

19. Psychological factors affecting other medical conditions is considered

	a.	*A somatic symptom disorder*
	b.	*The cause for conversion disorder*
	c.	*The result of conversion disorder*
	d.	*An archaic term for illness anxiety*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*

20. “Functional neurological symptom disorder” is associated with which disorder in the DSM-5?

	a.	*conversion disorder.*
	b.	*Illness anxiety disorder*
	c.	*Somatic symptom disorder*
	d.	*None of the above.*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

21. Loss of physical functioning without any physical cause is most likely a case of

	a.	*conversion disorder.*
	b.	*Illness anxiety disorder.*
	c.	*Somatic symptom disorder*
	d.	*None of the above.*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

22. George has completely lost his sight during the past year, but medical experts can find no physical reason for his blindness. This could be an example of

	a.	*Somatic symptoms disorder.*
	b.	*Illness anxiety*
	c.	*conversion disorder.*
	d.	*dissociative disorder.*

*ANSWER:*	c
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Applied.*

23. Min has been experiencing repeated seizures, but none of the neurologists he has visited could find any abnormal EEG activity. He is likely exhibiting a case of

Dissociative disorder

	a.	*Psychogenic non-epileptic seizures*
	b.	*Globus hystericus*
	c.	*Aphonia*
	d.

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Applied.*

24. Historically, “hysteria” was thought to be the result of a

	a.	*dysfunctional ovary.*
	b.	*tense vagina.*
	c.	*wandering uterus.*
	d.	*flip-flopped fallopian tubes.*

*ANSWER:*	c
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*
*NOTES:*	*NEW*

25. Conversion disorder patients were conceptualized by Freud as

	a.	*converting unconscious conflicts into physical symptoms.*
	b.	*converting unconscious conflicts into defense mechanisms.*
	c.	*experiencing physical symptoms as a result of the superego.*
	d.	*experiencing internal conflicts as a result of physical illness.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Conceptual*

26. Conversion disorder symptoms generally appear

	a.	*out of the blue.*
	b.	*following a physical injury to the affected area.*
	c.	*following a traumatic event.*
	d.	*in women with repressed sexuality.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

27. Which of the following would be typical for a patient suffering from a conversion disorder?

	a.	*Ability to avoid walking into things even though the patient reports being unable to see anything*
	b.	*Ability to see some bright objects when calm but suffering complete loss of sight during a stressful period or emergency*
	c.	*Performance far below average when asked to name objects in the visual field when the patient reports blindness*
	d.	*Ability to name everything in the visual field even though the patient reports blindness*

*ANSWER:*	a
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*

28. Which of the following statements is correct regarding diagnosing a patient’s symptoms as a conversion disorder?

	a.	*It is quite apparent when a patient is malingering (faking), but it is difficult to determine whether symptoms are due to real physical disorders or a conversion disorder.*
	b.	*It is quite apparent when a symptom is due to a real physical disorder, but it is impossible to determine the difference between a conversion disorder and patient malingering (faking).*
	c.	*It is very difficult to determine whether symptoms are due to malingering (faking), real physical disorders, or conversion disorder.*
	d.	*The act of diagnosing a conversion disorder can sometimes immediate alleviate the symptoms.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*

29. Which of the following statements is true about factitious disorders?

	a.	*Patients are usually revealed to be harboring a reason for malingering*
	b.	*The symptoms are uncontrollable.*
	c.	*There is no obvious reason for voluntarily producing symptoms.*
	d.	*All of the above*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*p. 184*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*
*NOTES:*	*NEW*

30. An example of factitious disorder imposed on another is

	a.	*deliberate actions directed toward making a child sick.*
	b.	*a parent lying to a doctor, e.g., saying that the child has had symptoms that never really existed.*
	c.	*a parent developing the same symptoms that the child exhibits.*
	d.	*convincing a child to lie to a doctor about factitious symptoms.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

31. Factitious disorders are a set of conditions that

	a.	*fall somewhere between malingering and conversion disorders.*
	b.	*are completely under voluntary control like malingering.*
	c.	*are a manifestation of physical symptoms mostly due to anxiety*
	d.	*Are one form of typical child abuse*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*
*NOTES:*	*NEW*

32. Parents suspected of Munchausen Syndrome by Proxy show all of the following typical behaviors EXCEPT

	a.	*helping medical staff to discover the true nature of the child’s illness.*
	b.	*developing a positive relationship with medical staff.*
	c.	*appearing extremely concerned and caring toward the child.*
	d.	*purposefully making the child sick.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

33. In factitious disorders, the patient

	a.	*voluntarily makes up symptoms with no apparent motivation.*
	b.	*is unaware that he/she is making up symptoms.*
	c.	*truly experiences symptoms with no apparent physical cause.*
	d.	*makes up symptoms in an effort to avoid work or to receive some other benefit.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

34. Catharsis is

	a.	*the process of placing a tube into the bladder to release urine.*
	b.	*an unconscious behavioral process.*
	c.	*a purging of emotionally traumatic events.*
	d.	*none of the above*

*ANSWER:*	c
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*
*NOTES:*	*NEW*

35. The modern view of the causes of conversion disorder is

	a.	*completely different from Freud’s ideas of the etiology of this disorder.*
	b.	*somewhat similar to the causes that Freud described for this disorder.*
	c.	*a combination of genetic predisposition and neurobiological trauma.*
	d.	*based on social learning theory.*

*ANSWER:*	b
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Conceptual*

36. Which of the following is NOT an accurate statement regarding conversion disorder symptoms?

	a.	*They uniquely belong to Western culture*
	b.	*They are common aspects of some religious/healing rituals*
	c.	*They do not constitute a disorder unless they persist and interfere with an individual’s functioning*
	d.	*Some individuals who exhibit them are held in high esteem because they are sometimes are seen as contact with God*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Conceptual*

37. With regard to Freud’s explanation of “la belle indifference” (the observation that conversion disorder patients are not concerned about their symptoms), research suggests that

	a.	*conversion disorder patients do display “la belle indifference,” but Freud’s explanation of primary gain is not supported.*
	b.	*Freud’s explanation is essentially correct, since there is great variability in the amount of concern that conversion disorder patients display regarding their symptoms.*
	c.	*conversion disorder patients actually are quite concerned with their symptoms, so Freud’s explanation of primary gain is not supported.*
	d.	*“la belle indifference” is a myth, thus validating Freud’s explanation of primary gain.*

*ANSWER:*	c
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*

38. Evidence for the influence of social and cultural factors in conversion disorder includes the fact that conversion disorder

	a.	*is almost exclusively experienced by women.*
	b.	*is being diagnosed more frequently in our society.*
	c.	*tends to occur in lower socioeconomic groups where there is less medical knowledge.*
	d.	*tends to occur in wealthy areas where there is easy access to sophisticated medical tests.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*

39. Freud called the reduction in anxiety by converting unconscious conflicts into physical symptoms

	a.	*primary narcissism.*
	b.	*secondary narcissism.*
	c.	*primary gain.*
	d.	*secondary gain.*

*ANSWER:*	c
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*
*NOTES:*	*NEW*

40. In treating conversion disorder, which of the following statements is true?

	a.	*Clients respond well to CBT.*
	b.	*Clients respond well to hypnosis.*
	c.	*Clients respond well when hypnosis and CBT are combined.*
	d.	*Clients do not respond well to any treatment.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*
*NOTES:*	*NEW*

41. According to your textbook, the following statement is true about the treatment of conversion disorder:

	a.	*the principle treatment strategy for conversion disorder is to identify and attend to the traumatic or stressful life event.*
	b.	*the use of medication is generally supported in the treatment of conversion disorder.*
	c.	*social support and attention are the most effective method of treatment for conversion disorder.*
	d.	*in treating conversion disorder, Freudian methods to access the unconscious are the most effective.*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*

42. Your textbook authors describe a treatment plan for conversion disorder involving

	a.	*in-depth exploration of psychological conflicts.*
	b.	*regression to the early psychosexual stages of development.*
	c.	*application of a strict behavioral program that includes reinforcement for each display of progress and punishment when necessary.*
	d.	*removal of any benefits that patients receive for limitations imposed by the disorder.*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Somatoform Disorders*
*OTHER:*	*TYPE: Conceptual*

43. Dissociation is likely to happen

	a.	*After an extremely stressful or a traumatic event*
	b.	*When there is potential secondary gain*
	c.	*When there is primary gain*
	d.	*when a patient is malingering*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Somatoform Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*

44. The experience of dissociation occurs in

	a.	*psychotic disorders only.*
	b.	*individuals with dissociative disorders only.*
	c.	*only in those individuals who have experienced great personal trauma.*
	d.	*certain psychological disorders but also in non-disordered people at times.*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

45. In healthy, well-adjusted individuals, dissociation typically occurs following

	a.	*calm, reflective periods.*
	b.	*participation in a group activity.*
	c.	*reading or any activity that requires great concentration.*
	d.	*stress or a traumatic event.*

*ANSWER:*	d
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

46. Depersonalization is defined as

	a.	*altered perception including loss of the sense of one’s own reality.*
	b.	*altered perception involving loss of the sense of reality of the external world.*
	c.	*vivid hallucinations.*
	d.	*the feeling that one is no longer a person.*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

47. Derealization is defined as

	a.	*vivid hallucinations.*
	b.	*altered perception involving loss of the sense of one’s own reality.*
	c.	*altered perception involving loss of the sense of reality of the external world.*
	d.	*the feeling that one is no longer a person.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

48. Brain imaging studies have found that depersonalization is associated with all of the following EXCEPT

	a.	*Deficits in perception*
	b.	*Deficits in emotion regulation*
	c.	*Dysregulation in the HPA axis*
	d.	*Dysregulation of the visual cortices*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

49. Jason suddenly notices that the world looks weird to him. Some objects look bigger than normal and others look smaller. Cars passing by seem oddly shaped, and people appear dead or mechanical. Joe is experiencing

	a.	*derealization.*
	b.	*depersonalization.*
	c.	*classic early psychosis symptoms.*
	d.	*mania.*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Applied*

50. While driving alone in her car, Sarah suddenly looks around and, for a moment, can’t remember where she is, how she arrived at this point on the road, or even why she is driving her car. Sarah is experiencing

	a.	*derealization.*
	b.	*depersonalization.*
	c.	*the early stages of what will eventually become a severe psychotic disorder.*
	d.	*symptoms of a mood disorder.*

*ANSWER:*	b
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Applied*

51. The diagnosis of derealization-depersonalization disorder is

	a.	*often co-occuring with other disorders*
	b.	*quite rare and only applicable to those diagnosed with psychosis*
	c.	*fairly common, since many people experience derealization and depersonalization.*
	d.	*fairly common and applied to anyone who is frightened by an experience of derealization or depersonalization.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Conceptual*

52. In dissociative amnesia, the individual typically has no memory of

	a.	*any events.*
	b.	*events prior to a trauma.*
	c.	*selective events or emotional tone attached to them, particularly those involving trauma.*
	d.	*events following a trauma.*

*ANSWER:*	c
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Conceptual*

53. In dissociative fugue, the term fugue relates to

	a.	*confusion.*
	b.	*flight or travel.*
	c.	*loss of consciousness.*
	d.	*hallucination.*

*ANSWER:*	b
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

54. During a fugue state, patients diagnosed with dissociative fugue

	a.	*travel and typically experience memory loss during their trip.*
	b.	*travel involuntarily but do not experience memory loss.*
	c.	*temporarily lose memory of who they are but are able to recover their sense of identity after the fugue state.*
	d.	*Permanently lose memory of who they are and seldom recover any sense of their own identity.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

55. During a dissociative fugue state, it is not uncommon for individuals to

	a.	*commit suicide.*
	b.	*see the world as a strange and foreign place.*
	c.	*take on a new identity.*
	d.	*Involuntarily contact friends and family.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

56. ________ is a dissociative disorder that is not found in Western cultures and appears to have some similarities to dissociative fugue.

	a.	*Amok*
	b.	*Exorcism*
	c.	*Trance*
	d.	*Voodoo*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

57. In non-Western cultures, trance and possession are

	a.	*extremely rare.*
	b.	*never considered a disorder.*
	c.	*the most common forms of dissociative disorders.*
	d.	*the rarest forms of dissociative disorders.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

58. Individuals with dissociative identity disorder generally

	a.	*Take on only one other distinct personality.*
	b.	*suffer a loss of their own identity that lasts several years.*
	c.	*maintain complete awareness of all of their personalities.*
	d.	*have several distinct personalities.*

*ANSWER:*	d
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

59. The defining feature of dissociative identity disorder is that aspects of the individual’s personality are

	a.	*fixated.*
	b.	*completely suppressed.*
	c.	*dissociated.*
	d.	*Dissociative Disorders*

*ANSWER:*	c
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

60. With regard to dissociative identity disorder, the term alter refers to ________ within the individual.

	a.	*the “host” personality*
	b.	*a dangerous personality*
	c.	*the most recent personality to emerge*
	d.	*a different personality*

*ANSWER:*	d
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

61. In dissociative identity disorder, the “host” personality is usually the one that

	a.	*is the most aggressive of the personalities.*
	b.	*asks for treatment and becomes the patient.*
	c.	*earns income for the individual.*
	d.	*is sexually provocative.*

*ANSWER:*	b
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

62. In dissociative identity disorder, the “host” personality usually

	a.	*is of a gender opposite to that of the individual.*
	b.	*becomes overwhelmed trying to hold all of the personality fragments together.*
	c.	*is the “leader” of the multiple identities*
	d.	*is well aware of each personality and everything that happens while each personality is active.*

*ANSWER:*	b
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

63. The existence of a cross-gendered alter in dissociative identity disorder is

	a.	*common.*
	b.	*rare.*
	c.	*present in every patient.*
	d.	*almost never seen in this disorder.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

64. One aspect of the DSM-5 criteria for diagnosis of dissociative identity disorder is

	a.	*patient awareness of the distinct personalities.*
	b.	*existence of three or more personality fragments.*
	c.	*amnesia.*
	d.	*history of abuse.*

*ANSWER:*	c
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

65. Vanessa, who is 40, apparently believes that she is a 20-year-old woman. Suddenly, however, she starts to speak and behave very differently, and says she no longer thinks of herself as “Vanessa.” Instead, she claims to be Elise, a 10-year-old child. It is likely that Vanessa has just experienced a

	a.	*switch.*
	b.	*dissociative fugue.*
	c.	*conversion reaction.*
	d.	*Manic episode.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Applied*

66. A switch

	a.	*usually occurs instantaneously.*
	b.	*is the transition from one personality to another in dissociative identity disorder.*
	c.	*may exhibit physical transformations.*
	d.	*all of the above*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*
*NOTES:*	*NEW*

67. Which of the following statements is FALSE about dissociative identity disorder?

	a.	*Once established, the disorder lasts a lifetime without treatment.*
	b.	*For prevalence rates, the ratio of females to males is approximately 9 to 1.*
	c.	*The frequency of switching increases with age.*
	d.	*The form that the disorder takes does not differ substantially over the lifespan.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*
*NOTES:*	*NEW*

68. The causes of dissociative identity disorder appear to be

	a.	*physical abuse.*
	b.	*sexual abuse.*
	c.	*witness to a traumatic event.*
	d.	*any of the above*

*ANSWER:*	d
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*
*NOTES:*	*NEW*

69. Some theorists suggest that dissociative identity disorder is an extreme subtype of

	a.	*dissociative amnesia.*
	b.	*obsessive-compulsive disorder.*
	c.	*posttraumatic stress disorder.*
	d.	*antisocial personality disorder.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Conceptual*
*NOTES:*	*NEW*

70. Which of the following statements is true about dissociative identity disorder?

	a.	*DID is easy to fake.*
	b.	*DID is absolutely impossible to fake.*
	c.	*Dissociative symptoms may be the result of sleep deprivation*
	d.	*DID is made up of false memories.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*
*NOTES:*	*NEW*

71. The process of changing from one personality to another generally occurs ________ in most patients with dissociative identity disorder.

	a.	*slowly*
	b.	*quickly*
	c.	*rarely*
	d.	*only after many warning signs that a change is about to occur*

*ANSWER:*	b
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

72. Regarding evidence for the scientific validity of dissociative identity disorder, the most accurate statement is that

	a.	*most patients are faking.*
	b.	*research suggests that faking dissociative experiences is possible.*
	c.	*it is virtually impossible to fake the types of changes that occur in dissociative identity disorder.*
	d.	*objective tests can always determine which patients are faking dissociative identity disorder.*

*ANSWER:*	b
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

73. Comparisons of optical functioning in the various personalities of dissociative identity disorder patients show changes that would be

	a.	*easy to fake.*
	b.	*absolutely impossible to fake.*
	c.	*consistent with an individual who was trying to fake.*
	d.	*difficult to fake.*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

74. Which of the following statements is the most accurate?

	a.	*While DID symptoms can be faked or developed through suggestion, many physiological changes observed in DID patients would be very difficult to fake.*
	b.	*DID symptoms and the many physiological changes observed in DID patients can be developed through suggestion and are easily faked.*
	c.	*While physiological changes associated with DID are relatively easy to fake, the symptoms of DID are very difficult to fake or to develop through suggestion.*
	d.	*Almost all cases of DID are probably faked or developed through therapist suggestion.*

*ANSWER:*	a
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Conceptual*

75. The average number of alters observed in individuals with dissociative identity disorder is

	a.	1
	b.	2
	c.	*15*
	d.	*100*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

76. Dissociative identity disorder is most commonly found in

	a.	*females.*
	b.	*males.*
	c.	*children.*
	d.	*elderly.*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

77. The average length of time between an individual’s first symptoms of dissociative identity disorder and the identification and diagnosis of the disorder by a professional is

	a.	*1 year.*
	b.	*20 years.*
	c.	*less than 1 month.*
	d.	*7 years.*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

78. Without treatment, it is expected that dissociative identity disorder will last

	a.	*10 years.*
	b.	*a lifetime.*
	c.	*several months.*
	d.	*20 years.*

*ANSWER:*	b
*DIFFICULTY:*	*Difficult*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

79. Sue has dissociative identity disorder. It is extremely likely that she also has

	a.	*at least one other psychological disorder.*
	b.	*a problem with her weight.*
	c.	*a history of problems with the law.*
	d.	*no desire to get better.*

*ANSWER:*	a
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Conceptual*

80. One comorbidity study found that the average number of additional psychological disorders that individuals with dissociative identity disorder are diagnosed with is

	a.	*one.*
	b.	*two.*
	c.	*four.*
	d.	*seven or more.*

*ANSWER:*	d
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Factual*

81. The main reason why dissociative identity disorder patients tend to have many additional psychological disorders is that

	a.	*the number of personalities increases the number of disorders.*
	b.	*the severe trauma of childhood leads to many problems in later life.*
	c.	*they seek attention.*
	d.	*they are substance abusers.*

*ANSWER:*	b
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Conceptual*

82. The common feature in almost every case of dissociative identity disorder is

	a.	*hallucinations and delusions.*
	b.	*unrelenting substance abuse.*
	c.	*a history of body dysmorphic disorder.*
	d.	*a history of severe child abuse.*

*ANSWER:*	d
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

83. Of the following, which child would be most likely to develop dissociative identity disorder later in life?

	a.	*Mary, who has a few good friends*
	b.	*Susan, who lives in a chaotic, unsupportive family*
	c.	*Cindy, who has a learning disability*
	d.	*Jody, who has attention deficit hyperactivity disorder*

*ANSWER:*	b
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Conceptual*

84. The experience of dissociation (feelings of unreality; blunting of emotional experience and physical pain) during or immediately following a life-threatening situation is

	a.	*a sign of psychopathology.*
	b.	*extremely rare in non-disordered individuals.*
	c.	*not well documented.*
	d.	*a normal reaction.*

*ANSWER:*	d
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

85. One of the individual differences that appears to help explain who is likely to develop dissociative identity disorder following childhood trauma is

	a.	*physical health.*
	b.	*suggestibility.*
	c.	*number of siblings.*
	d.	*number of abusers.*

*ANSWER:*	b
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Conceptual*

86. In studies conducted by Elizabeth Loftus and her colleagues, individuals were told about false events that had supposedly occurred when they were children. The results of these studies indicate that

	a.	*people cannot be convinced of events that did not happen.*
	b.	*people can become quite convinced of events that never happened.*
	c.	*only individuals with diagnosable disorders can be convinced of events that never happened.*
	d.	*people can become convinced of events that did not happen only during hypnosis or other dissociative states.*

*ANSWER:*	b
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Conceptual*

87. Putname et al. (1986) examined 100 cases of dissociative identity disorder, and found that ________ percent of the subjects had experienced significant trauma.

	a.	*25*
	b.	53
	c.	*97*
	d.	*100*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

88. The victims most likely to have amnesia as a result of trauma are those who

	a.	*suffered infrequent and relatively minor abuse.*
	b.	*suffered frequent but relatively minor abuse.*
	c.	*were victims of severe abuse and trauma.*
	d.	*were victims of natural disasters.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA1.3.a(3) – Use basic psychological terminology, concepts, and theories to explain behavior and mental processes*
*OTHER:*	*TYPE: Conceptual*

89. The general treatment plan for dissociative identity disorder patients usually centers on

	a.	*integration of the personality fragments.*
	b.	*hypnotic regression of the host and each alter.*
	c.	*confrontation of the abuser.*
	d.	*the typical substance abuse treatment model.*

*ANSWER:*	a
*DIFFICULTY:*	*Easy*
*REFERENCES:*	*Dissociative Disorders*
*OTHER:*	*TYPE: Factual*

90. The part of the treatment plan for dissociative identity disorder that is similar to the treatment plan for posttraumatic stress disorder is

	a.	*integration of personality fragments through psychoanalysis.*
	b.	*use of antipsychotic medications.*
	c.	*reliving and reprocessing the trauma, similar to treatments for PTSD.*
	d.	*hypnotic regression to early life experiences.*

*ANSWER:*	c
*DIFFICULTY:*	*Moderate*
*REFERENCES:*	*Dissociative Disorders*
*LEARNING OBJECTIVES:*	*ABNO.DURA.16.APA4.2.b(3) – Accurately self-assess performance quality by adhering to external standards*
*OTHER:*	*TYPE: Factual*

91. Describe the similarities and differences between illness anxiety disorder and somatic symptom disorder.

ANSWER:

Sample Answer: Somatic symptom disorder shares some features with illness anxiety disorder, including a history of family illness or injury during childhood. But this history is a minor factor at best because countless families experience chronic illness or injuries without passing on severe anxiety of being ill or the sick role to children. Something else contributes strongly to somatic symptom disorder.

In illness anxiety disorder, as we know it today, severe anxiety is focused on the possibility of having a serious disease. The threat seems so real that reassurance from physicians does not seem to help. In illness anxiety disorder, the individual is preoccupied with bodily symptoms, misinterpreting them as indicative of illness or disease. Almost any physical sensation may become the basis for concern for individuals with illness anxiety disorder.

In somatic symptom disorder, patients go to the doctor with seemingly endless lists of somatic complaints for which he could find no medical basis. Despite the doctor’s negative findings, patients return shortly with either the same complaints or new lists containing slight variations.

Individuals with illness anxiety disorder most often take immediate action on noticing a symptom by calling the doctor or taking medication. People with somatic symptom, on the other hand, do not feel the urgency to take action but continually feel weak and ill, and they avoid exercising, thinking it will make them worse.

92. Describe the differences and similarities between depersonalization and derealization.

ANSWER:

Sample Answer: During an episode of depersonalization, your perception alters so that you temporarily lose the sense of your own reality, as if you were in a dream and you were watching yourself. During an episode of derealization, your sense of the reality of the external world is lost. Things may seem to change shape or size; people may seem dead or mechanical. These sensations of unreality are characteristic of the dissociative disorders because, in a sense, they are a psychological mechanism whereby one “dissociates” from reality. Depersonalization is often part of a serious set of conditions in which reality, experience, and even identity seem to disintegrate.

93. Joe, who suffers from illness anxiety disorder (aka hypochondriasis), comes from a very concerned and loving family that takes his physical complaints quite seriously. Describe three treatment approaches (and their level of effectiveness) that may help Joe get better.

ANSWER:

Sample Answer: Clinical reports indicate that reassurance and education seems to be effective in some cases—“surprisingly” because, by definition, patients with hypochondriasis are not supposed to benefit from reassurance about their health. However, reassurance is usually given only briefly by family doctors who have little time to provide the ongoing support and reassurance that might be necessary. Mental health professionals may well be able to offer reassurance in a more effective and sensitive manner, devote sufficient time to all concerns the patient may have, and attend to the “meaning” of the symptoms.

Evaluations of more robust treatments have now appeared. CBT focused on identifying and challenging illness-related misinterpretations of physical sensations and on showing patients how to create “symptoms” by focusing attention on certain body areas. Bringing on their own symptoms persuaded many patients that such events were under their control. Patients were also coached to seek less reassurance regarding their concerns. CBT was more effective after treatment and at each follow-up point for both symptoms of hypochondriasis and overall changes in functioning and quality of life. But results were still “modest,” and many eligible patients refused to enter treatment because they were convinced their problems were medical rather than psychological.

A few recent reports suggest that drugs may help some people with hypochondriasis. Not surprisingly, these same types of drugs (antidepressants) are useful for anxiety and depression. In one study, CBT and the drug paroxetine (Paxil), a serotonin-specific reuptake inhibitor (SSRI), were both effective, but only CBT was significantly different from a placebo condition.

94. Describe the relationship between posttraumatic stress disorder and dissociative identity disorder. How are the two disorders similar? How are they different?

ANSWER:

Sample Answer: DID seems similar in its etiology to PTSD. One perspective suggests that DID is an extreme subtype of PTSD, with a much greater emphasis on the process of dissociation than on symptoms of anxiety, although both are present in each disorder. While a sense of depersonalization or dissociation may be a symptom of PTSD, it would not be adequate for a diagnosis of DID because the other symptoms of a dissociative disorder would not be present. Some evidence also shows that the “developmental window” of vulnerability to the abuse that leads to DID closes at approximately 9 years of age. After that, DID is unlikely to develop, although severe PTSD might. If true, this is a particularly good example of the role of development in the etiology of psychopathology.

95. A 30-year-old woman “recovers” memories of childhood sexual abuse, the existence of which she was seemingly and previously unaware. Explain what is currently known about the accuracy of recovered memories. Can we determine whether these memories are accurate?

ANSWER:

Sample Answer: A controversial issue in abnormal psychology involves the extent to which memories of early trauma, particularly sexual abuse, is really accurate or not. Some argue that these memories are simply the result of strong suggestions by therapists, others believe they reflect memories that were repressed and must be re-experienced to relieve suffering. It turns out memory can be altered through suggestion, therefore the use of recovered memories legally has been especially problematic. Children in particular may be affected by how questions about past events are phrased. Further research is required to resolve these issues.

96. Describe some ways that a person with a conversion disorder might differ from an individual with a biologically caused physical malfunction.

ANSWER:

Sample Answer: Conversion disorders

generally have to do with physical malfunctioning, such as paralysis, blindness, or difficulty speaking (aphonia), without any physical or organic pathology to account for the malfunction. Most conversion symptoms suggest that some kind of neurological disease is affecting sensory–motor systems, although conversion symptoms can mimic the full range of physical malfunctioning. For this reason, and because the term conversion implies a specific etiology for which there is limited evidence, the name changed to “functional neurological disorder” (with “functional” referring to a symptom without organic cause) in the DSM-5..

Conversion disorders provide some of the most intriguing, sometimes astounding, examples of psychopathology. What could possibly account for somebody going blind when all visual processes are normal, or experiencing paralysis of the arms or legs when there is no neurological damage? Conversion symptoms are often precipitated by marked stress. C.V. Ford (1985) noted that the incidence of marked stress preceding a conversion symptom occurred in 52 to 93 percent of the studied patients. Often, this stress takes the form of a physical injury. In one large survey, 324 out of 869 patients (37 percent) reported prior physical injury. Thus, if the clinician cannot identify a stressful event preceding the onset of the conversion symptom, the clinician might more carefully consider the presence of a true physical condition.

In addition, although people with conversion symptoms can usually function normally, they seem truly unaware either of this ability or of sensory input. For example, individuals with the conversion symptom of blindness can usually avoid objects in their visual field, but they will tell you they can’t see the objects. Similarly, individuals with conversion symptoms of paralysis of the legs might suddenly get up and run in an emergency and then be astounded they were able to do this. It is possible that at least some people who experience miraculous cures during religious ceremonies may have been suffering from conversion reactions. These factors may help in distinguishing between conversion and organically based physical disorders, but clinicians sometimes make mistakes, although it is not common with modern diagnostic techniques. In any case, ruling out medical causes for the symptoms is crucial to making a diagnosis of conversion.

97. Describe the treatment that is generally used to treat patients with dissociative identity disorder. What is the rationale for each part of the treatment?

ANSWER:

Sample Answer: The strategies that therapists use today in treating DID are based on accumulated clinical wisdom. The fundamental goal is to identify cues or triggers that provoke memories of trauma, dissociation, or both and to neutralize them. More important, the patient must confront and relive the early trauma and gain control over the horrible events, at least as they recur in the patient’s mind. To instill this sense of control, the therapist must skillfully, and slowly, help the patient visualize and relive aspects of the trauma until it is simply a terrible memory instead of a current event. Because the memory is unconscious, aspects of the experience are often not known to either the patient or the therapist until they emerge during treatment. Hypnosis is often used to access unconscious memories and bring various alters into awareness. Because the process of dissociation may be similar to the process of hypnosis, the latter may be a particularly efficient way to access traumatic memories. DID seems to run a chronic course and seldom improves spontaneously, which confirms that current treatments, primitive as they are, have some effectiveness.

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