Behavioral Health: Personality Disorders

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  • 1/80 Questions

    A male goes to the clinic for follow-up treatment. He states that he takes his medicine exactly every 8 hours and keeps a record of how many pills he takes at what time and shows this to his doctor. He even wakes up in the middle of the night worrying if he missed a time. He is worried that maybe the medicine is not going to take effect because he took one of the pills 15 minutes late. What kind of disorder does this male have?

    • Schizotypal Personality Disorder
    • Dependent Personality Disorder
    • Obsessive-Compulsive Personality Disorder
    • Schizoid Personality Disorder
    • Histrionic Personality Disorder
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About This Quiz

A whole quizzie on Personality disorders, woooo hoooo!
I got all of these case studies from Exam-master test questions on the LRC website, and the rest of the information from the powerpoint presentation! :)
After doing this quiz, it will probably be helpful to go over the case studies that we did writing assignments on earlier in the term, because she said those might be on the test. . . If you aren't all "case-studied" out by the time you are done with this quizzie!
It will be helpful to read the extra information on some of the questions after you submit the answer, because the Exam-master website explains things in a way that's very easy to understand!

Behavioral Health: Personality Disorders - Quiz

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  • 2. 

    Violating the rights of others and being unable to conform to the norms of society is symptomatic of:

    • Paranoid Personality Disorder

    • Antisocial Personality Disorder

    • Schizotypal Personality Disorder

    • Borderline Personality Disorder

    • Dissociative Fugue

    Correct Answer
    A. Antisocial Personality Disorder
    Explanation
    Violating the rights of others and being unable to conform to the norms of society are key characteristics of Antisocial Personality Disorder. People with this disorder often exhibit a disregard for the rights and feelings of others, engage in impulsive and irresponsible behavior, and have a lack of remorse for their actions. They may also have a history of criminal behavior, deceitfulness, and manipulation. This behavior is not seen in the other listed disorders, making Antisocial Personality Disorder the most appropriate answer.

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  • 3. 

    A female patient of yours is a dramatic actress. She is good at her work, but it seems that one reason she is so good is that she is dramatic in her life as well. All of her emotions are expressed to the extreme, whether she is preparing dinner or reacting to stress. She is sexually provocative as well, and you have no doubt that when she says "Darling, my life is just the life of the party!," she is speaking the truth. If a diagnosis were going to be made for this patient, you would probably first consider:

    • Paranoid Personality Disorder

    • Schizoid Personality Disorder

    • Schizotypal Personality Disorder

    • Antisocial Personality Disorder

    • Histrionic Personality Disorder

    Correct Answer
    A. Histrionic Personality Disorder
    Explanation
    People with Histrionic Personality Disorder are characterized by their excessive emotionality and attention-seeking. Five of the following criteria must be present: a need to be the center of attention, inappropriate sexual behavior such as seductiveness or provocativeness, shallow emotions which change quickly, excessively emotional speech, exaggerated emotional expression, and a history of believing that relationships with others are more intimate than they really are.

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  • 4. 

    A 32-year-old Hispanic man comes to your general practice office for the first time. In the course of taking his history, the man mentions several times that he feels exploited by his employees and that he doubts their loyalty to his company. "In fact," he says, "I have even overheard them talking about how they would change the company if I were no longer in charge." He says he is consequently reluctant to confide in others, especially in his business partner, and he even wonders if he should be telling you all this since you have just met. Based on this information alone, you might suspect that his man is suffering from which personality disorder?

    • Paranoid Personality Disorder

    • Schizoid Personality Disorder

    • Schizotypal Personality Disorder

    • Antisocial Personality Disorder

    • Histrionic Personality Disorder

    Correct Answer
    A. Paranoid Personality Disorder
    Explanation
    The correct choice is Paranoid PD, because the patient presents with at least four of the criterion symptoms, including suspicion without cause, preoccupation with the loyalty or trustworthiness of others, reluctance to confide in others, misinterpretation of benign events, or perception that remarks made to them are threatening.
    The only other choice that is a similar disorder is Schizoid PD. The reason this is not the correct diagnosis is because individuals with Schizoid PD tend to tbe socially isolated, display restricted affect, and almost always prefer to be alone. These individuals do not do well in jobs that require social performance.

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  • 5. 

    A 45-year-old male comes to see you. He is a middle manager in a large corporation. He states that he is feeling extremely stressed out. You ask him what he means by stressed out. He states that he has too many things to do and he cannot organize all of his tasks. He states that even his lists are no longer working for him. He has so many tasks to do that he spends half of his day writing and re-writing his lists until they are perfect. He hasn't taken a vacation for almost five years. His family complains that they never see him because he is always at work. During the interview he keeps muttering to himself that he cannot take time off because there is too much work to do. His boss came in to talk to him the other day and he just blew up at him. He says that he cannot handle the pressure anymore. He said he would delegate tasks to his staff, but they do not pay attention to the details the way he does and don't seem to put a high priority on the tasks. When his boss hands him a task to do, he does not leave the office until that task is perfectly done. The client is stiff as he sits in your office and adjusts his tie several times to make sure it is perfectly centered. What is the most likely diagnosis for this client?

    • Narcissistic Personality Disorder

    • Obsessive-Compulsive Personality Disorder

    • Avoidant Personality Disorder

    • Dependent Personality Disorder

    • Generalized Anxiety Disorder

    Correct Answer
    A. Obsessive-Compulsive Personality Disorder
    Explanation
    The client experiences a preoccupation with lists and organization, excessive devotion to work, an inability to delegate tasks, and a need for perfectionism. Those with generalized anxiety disorder do not necessarily experience the extreme attention to detail and perfectionist attitude of those with OCPD. A Narcissitic Personality Disorder person would believe they have already achieved perfection, and are not as self-critical as those with OCPD.

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  • 6. 

    A 25-year-old male comes to see you after breaking up with his girlfriend. He is in a panic. He tells you that he has never been on his own and wants to know what you think he should do. He says he does not understand why his girlfriend broke up with him. He always did everything that she asked of him and never disagreed with her. "All I wanted to do was make her happy," he told you. You asked him if his ex-girlfriend gave him a reason for the break up. He stated that she told him that she was tired of making all of the decisions in the relationship such as where to go for dinner, which apartment they should choose, etc. She told him that he never helped her make any of the decisions that they should make together. The client tells you that he must find a new girlfriend quick or his whole life will fall apart. What is the most likely DSM-IV Axis II diagnosis for this patient?

    • Depression

    • Borderline Personality Disorder

    • Narcissistic Personality Disorder

    • Dependent Personality Disorder

    • Histrionic Personality Disorder

    Correct Answer
    A. Dependent Personality Disorder
    Explanation
    This patient displays difficulty expressing disagreement with others; going to excessive lengths to please others; discomfort or helplessness when alone; an urgency in seeking another relationship; and difficulty making decisions without the advice of others.
    This patient's symptoms are in reaction to his current situation and he does not report any symptoms of depression (suicidal ideation, depressed mood, or changes in sleep or appetite).
    You can rule out Borderline Personality Disorder, because those patient's typically react to abandonment with anger, rage, and threatening behavior.
    You can rule out Histrionic Personality Disorder because those patients are often flamboyant and demand attention from others.
    You can rule out Narcissistic Personality Disorder because they typically have an inflated sense of self, seek to please themselves, and are arrogant. Whereas, Dependent Personality Disorder patients, such as the man in the above case study, seek to please others, have a deflated self of sense, and seek nurturance from others.

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  • 7. 

    Submissive and clinging behavior is most closely associated with which of the following personality disorders?

    • Borderline Personality Disorder

    • Avoidant Personality Disorder

    • Dependent Personality Disorder

    • Paranoid Personality Disorder

    • Narcissistic Personality Disorder

    Correct Answer
    A. Dependent Personality Disorder
    Explanation
    Dependent Personality Disorder is featured by a pervasive need to be cared for that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood. It is generally marked by a need to urgently seek relationships as a source of comfort, preoccupation with fear of being left alone, and a tendency to go to excessive lengths in obtaining nurturance and support from others.

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  • 8. 

    TRUE OR FALSE?? Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder are considered the same thing.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Patients with OCD have obsessions, compulsions, and hoarding tendencies that are to the extreme that could present a danger to themselves and others. The OCPD patient, on the other hand, expresses a commitment to perfection, are self-critical, and has a discomfort with warm emotions. The OCPD patient is able to devote themselves to work and productivity, and exclude leisure activities. They are moral, inflexible, and preoccupied with making lists and organization. These patients are also unwilling to delegate duties to others and may be miserly because they fear the possibility of catastrophes.

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  • 9. 

    A woman brings her 25-year-old son to your office for evaluation. She says that he never goes out and she complains that "it is high time he finds himself a girlfriend." In discussing this with the man in private, he reveals that he has never felt comfortable around other people because he feels too much pressure to "perform." He fears rejection. This man is probably suffering from which type of personality disorder?

    • Obsessive-Compulsive Personality Disorder

    • Narcissistic Personality Disorder

    • Borderline Personality Disorder

    • Dependent Personality Disorder

    • Avoidant Personality Disorder

    Correct Answer
    A. Avoidant Personality Disorder
    Explanation
    Avoidant personality disorder is characterized by social inhibition and feelings of inadequacy. Individuals who suffer from this disorder are extremely sensitive to negative feedback from others. They avoid social activities due to their fear of having to participate.

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  • 10. 

    A 20-year-old male is referred by his school for behaviors that they feel are about to cause him to be expelled from school. He has been in trouble with the law for theft, bringing a weapon to school and his mother reports that he hangs around with a gang of boys that have been stealing cars and damaging property belonging to others. What would be your provisional diagnosis?

    • Avoidant Personality Disorder

    • Histrionic Personality Disorder

    • Narcissistic Personality Disorder

    • Antisocial Personality Disorder

    • Borderline Personality Disorder

    Correct Answer
    A. Antisocial Personality Disorder
    Explanation
    Persons with Antisocial Personality Disorder present with a history of theft, damaging property, physical cruelty to animals or people, forcing sex, using weapons to cause injury, starting fights, and threatening or stalking people.

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  • 11. 

    A man in his mid-30s calls to make an appointment for counseling, stating that his relationship of 5 years just broke off, at his partner's insistence. He says that he is unsure what to do because he has not been without a significant other for more than a week or so since high school. You determine that the man is not suicidal or homicidal, but from his responses to your questions you get the sense that this man's sense of loss will persist long after a normal period of adjustment, unless he enters into a new relationship. You think this because you are guessing that this man has this type of personality disorder

    • Obsessive-Compulsive Personality Disorder

    • Narcissistic Personality Disorder

    • Borderline Personality Disorder

    • Dependent Personality Disorder

    • Avoidant Personality Disorder

    Correct Answer
    A. Dependent Personality Disorder
    Explanation
    Individuals with Dependent Personality Disorder tend to be clinging and submissive in their behaviors because their need to be taken care of is so pervasive. They have difficulty making everyday decisions without consulting others, they agree with others even if they believe the person to be wrong, due to their intense fear of rejection. They have difficulty doing things on their own and their most pervasive fear is that of being abandoned.

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  • 12. 

    A 44-year-old male lives alone, in a rooming house, and has visited you in a community clinic over many years. He is generally suspicious of everyone's motives toward him, usually finding malevolence in even the most ordinary comments and actions. He has never married because he has yet to find a woman who could remain faithful to him for "even a month or two, let alone a lifetime."The male's older sister is also a patient of the clinic and has said that he "has always been that way, since he was a kid. He thinks everyone is mean to him, and he never forgets any wrongs done." Most of the time, "he feels that he is being watched and followed," but is nonetheless able to work consistently. Based on this information, what might be a likely psychiatric diagnosis to consider?

    • Borderline Personality Disorder

    • Paranoid Personality Disorder

    • Schizoid Personality Disorder

    • Schizotypal Personality Disorder

    • Antisocial Personality Disorder

    Correct Answer
    A. Paranoid Personality Disorder
    Explanation
    Within Cluster A, Paranoid Personality Disorder manifests as pervasive distrust of others and constant suspiciousness toward their motives. Interpretations of others' behavior made by these individuals will usually include maliciousness, hidden meanings, jealousy, and long-term grudges.

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  • 13. 

    A 40-year-old male comes to see you at the insistence of his wife. He states that there is nothing wrong with him, but if seeing a psychiatrist will shut his wife up, then he is willing to do it. The client is a very successful businessman. He tells you that his wife recommended he see a therapist, but he stated that if he was going to receive counseling then he wanted to see a psychiatrist because they have more education. The patient states that his wife is frustrated because they have no friends, and that the client is too picky about people. Upon further elaboration the client says that he is not going to spend time with just anyone, and that spending time with people less educated and intelligent then himself was a waste of time. When asked about his job, the client states that it is okay, but he is under appreciated. He says that without him the company would never make any money, but that nobody ever recognizes how important he is to the company. What DSM-IV diagnosis do you suspect for this client?

    • Borderline Personality Disorder

    • Histrionic Personality Disorder

    • Antisocial Personality Disorder

    • Narcissistic Personality Disorder

    • Obsessive-Compulsive Personality Disorder

    Correct Answer
    A. Narcissistic Personality Disorder
    Explanation
    This client is experiencing an inflated sense of self, believes he has special abilities, will only associate with those of "high status," and he believes that he deserves special recognition.

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  • 14. 

    An essential feature of Borderline Personality Disorder (BPD) is

    • Instability of relationships

    • Long-term drug use

    • Paranoia

    • Theatricality

    • Lack of remorse

    Correct Answer
    A. Instability of relationships
    Explanation
    Instability of social and interpersonal relationships is the cornerstone of Borderline Personality Disorder (BPD). Constantly fighting to avoid real or imagined abandonment, BPD's alternate between extremes of idealizing and devaluing those who attempt to get involved with them.
    Long-term drug use is more related to a Substance Abuse Disorder.
    Paranoia is an essential feature of Paranoid Personality Disorder.
    Theatricality is central to a diagnosis of Histrionic Personality Disorder.
    Lack of remorse may be present in Antisocial Personality Disorder.

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  • 15. 

    A woman in her mid-thirties has a history of difficulty in social relationships. She is highly demanding and hyperfocused on her appearance. When she wants a haircut she refuses to wait for an appointment demanding she receive immediate service regardless of others waiting ahead of her. She frequently ignores her boyfriend at social functions and is observed flirting with other men, even though he goes out of his way to try to please her. As a result of these behaviors, she has few if any close friends. This description is most indicative of which condition?

    • Obsessive-Compulsive Personality Disorder

    • Avoidant Personality Disorder

    • Narcissistic Personality Disorder

    • Manic Depressive Disorder

    • Schizoid Personality Disorder

    Correct Answer
    A. Narcissistic Personality Disorder
    Explanation
    The patient's presentation is actually most consistent with Schizotypal Personality Disorder, characterized by a lifelong pattern of indifference to others as well as detachment and social isolation. Although isolated, patients are not usually unhappy with their lack of social contact. The personality traits of a Narcissist include an overblown sense of self-importance and self-centeredness with little concern for the needs of other people. As a result, people with NPD often antagonize people who try to befriend them and therefore have trouble maintaining long-term relationships. Irresponsible or erratic behavior is uncommon in patients with this condition.

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  • 16. 

    Matt is an active, physically strong, and exceptionally tall 18-year-old 12th grader who stays out late at night with his friends, despite his parents forbidding it. He ran away from home several times when he was younger and is truant from school frequently. His grades are poor and he has been left back and placed in special education classes. The school psychologist gave him a diagnosis of Conduct Disorder when he was 13. When he attends school now, he threatens and intimidates students and teachers and seems to enjoy getting into fights. He has attacked one student with a brick and boasts that he carries a knife and has a gun hidden on school grounds. Matt has never expressed feelings of remorse for his actions. A good talker, he often engages in conning his teachers and enjoys the attention it seems to get from the other kids. A favorite weekend activity in which Matt has been engaging for the past several years is shoplifting. Your diagnosis would be:

    • Oppositional Defiant Disorder

    • Conduct Disorder

    • Antisocial Personality Disorder

    • Disruptive Behavior Disorder Not Otherwise Specified (NOS)

    • Attention-Deficit/Hyperactivity Disorder (NOS)

    Correct Answer
    A. Antisocial Personality Disorder
    Explanation
    Conduct disorder is commonly a precursor to Antisocial Personality Disorder.
    A diagnosis of Antisocial PD requires evidence of a Conduct Disorder before age 15. This patient meets all requirements of Antisocial PD including failure to conform to social norms relative to lawful behavior, repeated lying or conning other for personal profit or pleasure, impulsivity, aggressiveness around physical attacks, irresponsibility, and lack of remorse for hurting or mistreating others or stealing.
    ADHD is not an appropriate diagnosis because the patient doesn't show any signs of inattention of hyperactivity-impulsivity, although there may be a learning disorder present.
    Oppositional Defiant Disorder would not be the correct diagnosis either because this patient fails to meet the criteria for frequent loss of temper, arguing with adults, refusing to comply with requests, blaming, vindictiveness, and hostility.
    He may have some of the symptoms from each category, but his prominent symptoms are shown in the way he conducts himself and violates the rights of others.

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  • 17. 

    A 26-year-old female presents asking for a new employment physical. She is a new patient to your office, having recently moved to the area. On taking her social history, she reveals that she is quite sad because she feels isolated and lonely. You ask whether she has attended any local places of worship or tried any other things to foster new relationships, but she has not, saying that she is afraid no one will like her. She admits that she has always been shy and never had many friends, which has been painful for her. In addition, she is afraid to begin her new job because she fears that she will perform poorly and is afraid that others will reject her. Which type of personality disorder does this patient have?

    • Schizoid Personality Disorder

    • Avoidant Personality Disorder

    • Borderline Personality Disorder

    • Antisocial Personality Disorder

    • Paranoid Personality Disorder

    Correct Answer
    A. Avoidant Personality Disorder
    Explanation
    Avoidant Personality Disorder is common. These patients are exceedingly timid, shy, lonely, and hypersensitive to rejection. They have low self-esteem and often would rather avoid personal contact than face any potential social rejection. Additionally, they have a strong desire for acceptance and affection, and thus are very distressed by their isolation and inability to relate comfortably to others. Patients with this type of PD often have increased rates of anxiety and depression as well.

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  • 18. 

    Which Cluster includes the "Mad" and "Weird" Personality Disorders including Paranoid, Schizoid, and Schizotypal?

    • Cluster A

    • Cluster B

    • Cluster C

    • Cluster D

    Correct Answer
    A. Cluster A
    Explanation
    There's no such thing as Cluster D!!

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  • 19. 

    Tom is a 28-year old, single, high-school educated truck driver who has been working for the same company for 10 years. He has had few raises and puts in overtime whenever he is asked. Rarely dating, Tom lives with his parents who handle his money, pay his bills, and purchase his clothing for him. Tom got his job through an uncle who told his parents it would be a good place for him to work. You diagnose him with:

    • Dependent Personality Disorder

    • Schizoid Personality Disorder

    • Schizotypal Personality Disorder

    • Borderline Personality Disorder

    • Antisocial Personality Disorder

    Correct Answer
    A. Dependent Personality Disorder
    Explanation
    People with Dependent PD allow others to make most of the decisions in their lives, both minor and major. Many adults depend on their parents or spouse to make decisions as to where to live, work, and with whom to socialize. They may not feel capable of functioning independently and will agree to things which they feel are wrong for them rather than risk losing the support of this individual. If involved in a marriage or relationship which ends, they will quickly seek another to provide them with the support they need.

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  • 20. 

    Which Cluster includes the "Bad" and "Wild" Personality Disorders including Antisocial, Borderline, Histrionic, and Narcissistic?

    • Cluster A

    • Cluster B

    • Cluster C

    • Cluster D

    Correct Answer
    A. Cluster B
    Explanation
    There's no such thing as Cluster D!!

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  • 21. 

    Samantha is the perfect homemaker. She loves to clean and spend much of her time looking around her home for things which may require straightening or dusting. Unable to relax, she has been accused of being a perfectionist and, in fact, finds it hard to enjoy golf with her husband because she finds he doesn't take it seriously enough. While her home is extremely neat and clean, her attic contains boxes filled with old buttons, magazines, food coupons, and bits of string and broken lamps because, as she says, "you never know, you may need them". Extremely careful with her money, she is overly concerned with being left with no money and feels it is only right that people save as much as possible, even if it means denying her family little things they would like, such as an occasional movie. Her diagnosis would be:

    • Borderline Personality Disorder

    • Dependent Personality Disorder

    • Obsessive-Compulsive Personality Disorder

    • Obsessive-Compulsive Disorder

    • Anxiety Disorder NOS

    Correct Answer
    A. Obsessive-Compulsive Personality Disorder
    Explanation
    To make this diagnosis you have to differentiate between OCD and OCPD. Patients with OCD have obsessions, compulsions, and hoarding tendencies that are to the extreme that could present a danger to themselves and others. The OCPD patient, on the other hand, expresses a commitment to perfection, are self-critical, and has a discomfort with warm emotions. The OCPD patient is able to devote themselves to work and productivity, and exclude leisure activities. They are moral, inflexible, and preoccupied with making lists and organization. These patients are also unwilling to delegate duties to others and may be miserly because they fear the possibility of catastrophes.

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  • 22. 

    Excessive emotionality and attention-seeking best characterizes which of the following personality disorders?

    • Borderline Personality Disorder

    • Narcissistic Personality Disorder

    • Histrionic Personality Disorder

    • Antisocial Personality Disorder

    • Avoidant Personality Disorder

    Correct Answer
    A. Histrionic Personality Disorder
    Explanation
    The central component of Histrionic Personality Disorder is a pervasive display of emotions and attention-seeking behavior, starting in early adulthood. Generally, such an individual has a need to be the center of attention in social circles, may engage in seductive and/or provocative behavior, displays shallow expression of emotions, employs excessively expressionistic speech, is dramatic and self-dramatizing, uses physical appearance to obtain attention, is suggestible by others, and considers relationships to be closer than they actually are.

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  • 23. 

    Which Cluster includes the "Sad" and "Anxious" Personality Disorders including Avoidant, Dependent, and Obsessive-Compulsive?

    • Cluster A

    • Cluster B

    • Cluster C

    • Cluster D

    Correct Answer
    A. Cluster C
    Explanation
    There's no such thing as Cluster D!!

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  • 24. 

    Sarah has always had a problem with her peers from childhood to the present. She has never had a friend in whom she felt she could confide because she suspects the motives of everyone. When any remark is made as a joke, she takes it personally and has a tendency to carry a grudge. Sarah feels that she is the constant butt of attacks on her reputation and this has caused a great deal of difficulty in any on-going relationship she has had with a man. She is always questioning their fidelity without grounds to do so. It has resulted in most of the relationships breaking up rather quickly and Sarah feels she's been cheated by life. There is no history of psychotic illness, no mood disorder, no familial history of psychosis, or serious medical illness and Sarah is in good physical health for her age. You would say she is suffering from:

    • Paranoid Personality Disorder

    • Dependent Personality Disorder

    • Borderline Personality Disorder

    • Avoidant Personality Disorder

    • Narcissistic Personality Disorder

    Correct Answer
    A. Paranoid Personality Disorder
    Explanation
    Although most prevalent in males, Paranoid Personality Disorder is found in 0.5 to 2.5% of the general population of the U.S. It's characteristics include an unknown etiology starting in childhood, but some evidence links it to chronic Schizophrenia and Delusional Disorder (Persecutory type). These individuals believe that others are constantly making unjust remarks about them, berating their reputation, attempting to exploit them, and they cannot trust their friends, mates, or sexual partners.

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  • 25. 

    Which of the following disorders is distinguishable by marked eccentricities and odd beliefs?

    • Schizoid Personality Disorder

    • Antisocial Personality Disorder

    • Borderline Personality Disorder

    • Paranoid Personality Disorder

    • Schizotypal Personality Disorder

    Correct Answer
    A. Schizotypal Personality Disorder
    Explanation
    Schizotypal Personality Disorder is characterized by marked eccentricities and odd beliefs. People with this disorder often have unusual thoughts, perceptions, and behaviors. They may have superstitious beliefs, magical thinking, and peculiar speech patterns. They may also have difficulty forming and maintaining close relationships. While other personality disorders may have some overlapping symptoms, Schizotypal Personality Disorder is specifically known for its pronounced eccentricities and odd beliefs.

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  • 26. 

    A 70-year-old woman is referred to you to be seen in a nursing facility. She was recently evicted by an apartment building for odd and eccentric behavior. The previous property manager reports that the patient would wear winter clothing in the summer time, would stay off to herself and never socialize with other peers in the building, and would not want people to enter her apartment for any reason. At the nursing home, she presents with the same behavior, and even talks of communicating with aliens and going to another planet. She is alert and oriented, has no history of serious medical problems, other than arthritis and hypertension and scores perfectly on the mental status exam. What would be your likely diagnosis?

    • Paranoid Personality Disorder

    • Schizoid Personality Disorder

    • Schizotypal Personality Disorder

    • Antisocial Personality Disorder

    • Borderline Personality Disorder

    Correct Answer
    A. Schizotypal Personality Disorder
    Explanation
    Schizotypal Personality Disorder characteristics include: behavior that is influenced by magical thinking, telepathy, aliens, unusual perceptions or bodily delusions, odd behavior and appearance, extreme anxiety in social situations, and affect that is blunted or inappropriate to the topic at hand.

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  • 27. 

    A woman in her early 50's is being seen at a behavioral health clinic. She has been encouraged by her family and her employer to attend. The primary reason is that "she has serious problems relating to other people." Most people describe her as especially solitary, indifferent, and emotionally cold. They feel that her quality of life suffers from this lack of social inclination, and that problems with loneliness may worsen as she gets older. She has always been single and has never had any friends to speak of, even as a child. What is the most likely provisional diagnosis from the DSM-IV based in this information?

    • Borderline Personality Disorder

    • Paranoid Personality Disorder

    • Schizoid Personality Disorder

    • Schizotypal Personality Disorder

    • Antisocial Personality Disorder

    Correct Answer
    A. Schizoid Personality Disorder
    Explanation
    Schizoid Personality Disorder is characterized by detachment, indifference towards others, and marked coldness of emotion. These patients are often life-long loners.

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  • 28. 

    Marked impulsivity, patterns of instability in interpersonal relationships, self-image, and affect together define which of the following personality disorders?

    • Narcissistic Personality Disorder

    • Dependent Personality Disorder

    • Avoidant Personality Disorder

    • Histrionic Personality Disorder

    • Borderline Personality Disorder

    Correct Answer
    A. Borderline Personality Disorder
    Explanation
    BPD is specifically marked by unstable relationships, self-image, affect, and impulsivity. It begins in early adulthood.

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  • 29. 

    Which of the following personality disorders is described as the "loner" and has no desire or interest in having any type of social relationships?

    • Antisocial Personality Disorder

    • Schizotypal Personality Disorder

    • Schizoid Personality Disorder

    • Avoidant Personality Disorder

    • Paranoid Personality Disorder

    Correct Answer
    A. Schizoid Personality Disorder
    Explanation
    People with Schizoid Personality Disorder lack interpersonal relationships because they have no desire to get close to people. Avoidant Personality Disorder is different because those people are sad that they don't have social connections but are too AFRAID of social criticism and rejection that they avoid social situations.

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  • 30. 

    What diagnosis before the age of 15 is necessary for an adult to be diagnosed with Antisocial Personality Disorder?

    • Oppositional Defiant Disorder

    • ADHD

    • Conduct Disorder

    • Rumination

    • Enuresis

    Correct Answer
    A. Conduct Disorder
    Explanation
    Conduct Disorder is the necessary diagnosis before the age of 15 for an adult to be diagnosed with Antisocial Personality Disorder. Conduct Disorder is a childhood disorder characterized by a persistent pattern of violating societal norms and the rights of others. It involves behaviors such as aggression, destruction of property, deceitfulness, and violation of rules. Antisocial Personality Disorder is a more severe and persistent form of conduct disorder that continues into adulthood. Therefore, a history of Conduct Disorder is essential for the diagnosis of Antisocial Personality Disorder in adults.

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  • 31. 

    TRUE OR FALSE?? More MEN than WOMEN are diagnosed with Borderline Personality Disorder.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    False!! Its the other way around, more women are diagnosed with Borderline Personality Disorder.

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  • 32. 

    Joanne is a 35-year old single female, who is very concerned that she will be abandoned by her boyfriend. She has always been very intense in her relationships, many times alternating between idealization and devaluation, often is highly impulsive, and engages in reckless driving and casual sex. When left alone, her thoughts turn to suicide and she has made several gestures in the past. Her mood ranges from intense dysphoria to anger and she sometimes suffers from feelings of dissociation. Your diagnosis would be

    • Paranoid Personality Disorder

    • Dependent Personality Disorder

    • Borderline Personality Disorder

    • Histrionic Personality Disorder

    • Schizoid Personality Disorder

    Correct Answer
    A. Borderline Personality Disorder
    Explanation
    Borderline Personality Disorder is characterized by intense feelings with marked fluctuations from idealization to devaluation, concerns of abandonment, impulsivity in at least two areas which are self-damaging (ie: spending, sex, substance abuse, reckless driving, binge eating), suicidal behavior, gestures, threats, or self-mutilating behavior, chronic feelings of emptiness, and occasionally, dissociative symptoms.
    The histrionic personality is similar, although this patient didn't present with any patterns of craving to be the center of attention, using her physical appearance to get attention, self-dramatization, or being easily influenced by others.

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  • 33. 

    A 20-year-old woman comes to therapy after being released from the emergency department. She was brought in by her significant other, after making superficial cuts on her wrists in response to a fight they had, during which the significant other walked out. She is tearful and vehemently angry at her partner. However, she is also comforted to know that the relationship is not over. The partner relates that this has happened several times before, and that it seems that if the relationship ever did end, that the girl would "kill herself once and for all." You suspect that your patient is suffering from a personality disorder. Which of the options would be best to consider first?

    • Obsessive-Compulsive Personality Disorder

    • Narcissistic Personality Disorder

    • Borderline Personality Disorder

    • Dependent Personality Disorder

    • Avoidant Personality Disorder

    Correct Answer
    A. Borderline Personality Disorder
    Explanation
    Borderline Personality Disorder is most often associated with a pattern of unstable interpersonal relationships. Self-image is poor, affect is often labile or depressed, and these individuals are highly impulsive- especially with regard to self-destructive behaviors. Individuals with BPD are chronically bored and empty-feeling. They alternate between overly idealizing others and devaluing them. Their emotions are intense. Although individuals with BPD are said to have a need to be taken care of, they have difficulty accepting the help of others, because they mistrust their intentions.

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  • 34. 

    A 23-year-old female comes to see you for the first time. She states that her mom thought she should see a doctor for "her problem." When asked about "her problem" the client states that she just doesn't like being around people and prefers to be alone. Her mom does not believe that this is normal. When asked how long she has felt this way, the client states that she progressively isolated herself from others more and more, beginning about 6 years ago. She states that she has no hobbies, and prefers to just sit in her room or maybe put together a puzzle. She wishes that she could just disappear sometimes so that she does not have to talk to anyone. This client has no history of alcohol or drug use, and has never had sexual intercourse. She stated that she has no desire to have intimacy with another person. She denies having any delusions or hallucinations, nor has she ever experienced mania or depression. She states that she really doesn't feel anything. The client expresses very little emotion throughout the course of the interview. What DSM-IV diagnosis is most appropriate for this client?

    • Autism

    • Schizotypal Personality Disorder

    • Schizoid Personality Disorder

    • Paranoid Personality Disorder

    • Avoidant Personality Disorder

    Correct Answer
    A. Schizoid Personality Disorder
    Explanation
    This client expresses a lack of desire for social relationships, a preference for solitary activities, little interest in most activities or intimacy, and has demonstrated a flattened affect. The onset of symptoms is occurring in the beginning of adulthood (which rules out Autism), and she is not experiencing any psychotic symptoms or paranoid ideations. Since she avoids social situations due to a lack of DESIRE, this differentiates her from a diagnosis of Avoidant Personality Disorder, in which the person isolates themselves due to a FEAR of social situations.

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  • 35. 

    You have been working with a 25-year-old male who states that he feels sad all of the time. He states that he feels lonely, and that all of his relationships seem to fail. His last relationship ended just a few weeks ago and had only lasted about nine weeks. He says his relationships always start out great. He and his love interest will spend endless hours together discussing every detail of their lives. He states that a few weeks into the relationship, things always change. His girlfriends always pull away from him, and they stop respecting his needs. He often tells his girlfriends that if they leave him, he will kill himself. These threats are frequently followed by intense displays of anger. He has been hospitalized three times, once for overdosing on medication, and twice for superficial cuts to his arm. When asked about his parents, the client states that he rarely speaks with them. They do not seem to understand him or care about him as much as they do his siblings. Although this patient has had some college, he never seems to be able to settle on a major. He has a poor work history, frequently jumping from one career to next. He states that sometimes the jobs seem like more than he can handle, and he just wants something that does not require so much concentration. He further explains that he does not feel like getting up in the morning and has difficulty forcing himself to go to work. He frequently has difficulty sleeping and often spends hours tossing and turning in bed. He says he gets up in the morning feeling just as tired as he was when he went to bed. In accordance with the DSM-IV, what is the Axis II diagnosis for this patient?

    • Histrionic Personality Disorder

    • Schizotypal Personality Disorder

    • Dependent Personality Disorder

    • Antisocial Personality Disorder

    • Borderline Personality Disorder

    Correct Answer
    A. Borderline Personality Disorder
    Explanation
    Axis II diagnoses consist of personality disorders and mental retardation. This patient probably has an Axis I disorder such as dysthymic disorder or major depressive disorder. However, since the question asks for which Axis II diagnosis is appropriate, the best fitting would be Borderline Personality Disorder.
    This client is experiencing unstable personal relationships, an unstable sense of self, unpredictable and unstable moods, and difficulty controlling his anger. He also expresses a sense of devaluation in his personal relationships. This case study shows that the client has made suicidal threats and attempts in order to manipulate others or make them feel guilty. Borderline Personality Disorder patients are different than Dependent Personality Disorder patients in their reaction to abandonment. BPD patients react to abandonment with an outward expression of anger, whereas DPD patients react with increased submissiveness. The fact that the patient is often self-destructive and displays angry disruptions in close relationships, differentiates him from a patient with a Histrionic Personality Disorder.

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  • 36. 

    Isolation is common among those with Schizoid Personality Disorder or Avoidant Personality Disorder. The distinction in this isolation between the two types of personality disorders is that someone with Avoidant Personality Disorder...

    • Prefers isolation

    • Is unhappy with isolation

    • Lacks warmth

    • Has restricted emotions

    • Is egotistical

    Correct Answer
    A. Is unhappy with isolation
    Explanation
    People with Avoidant Personality Disorder are afraid of rejection, and therefore, develop a lifestyle of isolation. They would like to have more friends, but feel inept to become socially involved.
    Those with Schizoid Personality Disorder PREFER isolation and are unconcerned for others' opinions about them. They have a restricted range of emotions and lack warmth; thereby keeping others at bay.
    The narcissist is a very social creature with egotistical and arrogant behaviors.

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  • 37. 

    Which of the following types of therapies uses techniques of free association, interpretation of defenses and conflicts among the ego, id and superego, external reality, and the interpretation of dreams?

    • Group therapy

    • Cognitive therapy

    • Psychoanalytic therapy

    • Biofeedback

    • Hypnosis

    Correct Answer
    A. Psychoanalytic therapy
    Explanation
    Psychoanalytic therapy uses techniques of free association, interpretation of defenses and conflicts among the ego, id and superego, external reality, and the interpretation of dreams. This approach was developed by Sigmund Freud and aims to explore the unconscious mind and bring repressed thoughts and emotions to the surface. The therapist helps the individual gain insight into their unconscious processes and unresolved conflicts, which can lead to personal growth and healing. Group therapy, cognitive therapy, biofeedback, and hypnosis do not specifically focus on these techniques and principles.

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  • 38. 

    A diagnosis of Schizoid Personality Disorder instead of Schizophrenia would be made in the absence of:

    • Social withdrawal

    • Psychosis

    • Flattened affect

    • Drug abuse

    • Active symptoms

    Correct Answer
    A. Psychosis
    Explanation
    For a diagnosis of Schizophrenia, one must have an active case of bizarre delusions or hallucinations. Social withdrawal goes along with Schizoid PD. Flattened affect is true in both disorders. Drug abuse is not associated with either disorder, and would therefore have to be rules out before making either diagnosis. Active symptoms is a vague, made-up answer.

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  • 39. 

    What are the two personality disorders that have "assertiveness training" as part of their treatment plan?

    • Dependent and Narcissistic

    • Avoidant and Antisocial

    • Antisocial and Borderline

    • Avoidant and Dependent

    • Narcissistic and Antisocial

    Correct Answer
    A. Avoidant and Dependent
    Explanation
    The two personality disorders that have "assertiveness training" as part of their treatment plan are Avoidant and Dependent. Assertiveness training helps individuals with Avoidant personality disorder to improve their self-confidence and overcome their fear of rejection. It also assists individuals with Dependent personality disorder to develop assertiveness skills and become more self-reliant, reducing their excessive need for others to make decisions for them.

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  • 40. 

    Which of the following therapy options was developed by Freud and involves the concepts of Transference (displacement of attitudes and feelings from the past onto the analyst), and Resistance (unconscious ideas are repressed from reaching awareness because they are unacceptable for some reason)?

    • Group therapy

    • Cognitive therapy

    • Psychoanalytic therapy

    • Biofeedback

    • Hypnosis

    Correct Answer
    A. Psychoanalytic therapy
    Explanation
    Psychoanalytic therapy was developed by Freud and involves the concepts of Transference and Resistance. Transference refers to the displacement of attitudes and feelings from the past onto the analyst, while Resistance refers to the repression of unconscious ideas from reaching awareness because they are unacceptable. This therapy aims to bring these unconscious thoughts and emotions into conscious awareness, allowing the individual to gain insight into their behaviors and emotions.

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  • 41. 

    Frances, an only child, is a 20-year-old receptionist in a wholesale dress house who feels that she hasn't been discovered yet by the fashion world. She has done some showroom modeling for customers and is always daydreaming that she will be swept off her feet by the next wealthy man who comes through the door. Eating in the local restaurants, she always takes the opportunity to complain about the clumsy waiters, the inept service, or the poor quality of the food. Frances engages in a rich fantasy life in which she is adored and loved by crowds of onlookers and where she gets even with all the people whom she perceives have been mean to her. She would be diagnosed with:

    • Histrionic Personality Disorder

    • Narcissistic Personality Disorder

    • Borderline Personality Disorder

    • Dependent Personality Disorder

    • Immature Personality Disorder

    Correct Answer
    A. Narcissistic Personality Disorder
    Explanation
    Symptoms for this diagnosis include a grandiose sense of self-importance, preoccupied with fantasies of unlimited success, a belief of being special, a sense of entitlement, lacking in empathy, and an arrogant attitude toward others.

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  • 42. 

    Aversion therapy, such as might be used to treat a habitual sex offender, is designed to change an individual's behavior by making the consequences of a maladaptive behavior extremely unpleasant. This is an example of:

    • Psychoanalytic Psychotherapy

    • Cognitive Therapy

    • Behavioral Therapy

    • Family Therapy

    • Group Therapy

    Correct Answer
    A. Behavioral Therapy
    Explanation
    Behavioral therapy is similar to cognitive therapy in the sense that it does not account for the unconscious. Importance is placed on changing maladaptive patterns of behavior that are believed to result from learning the behaviors from others. Behaviors can be changed by reinforcing new behaviors or providing consequences to continuing maladaptive behaviors.

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  • 43. 

    Which of the following is consistent with Histrionic Personality Disorder?

    • Excessively expressionistic speech which is lacking in detail

    • Unstable interpersonal relationships

    • Identity disturbance

    • Self-mutilating behavior

    • Transient paranoid ideation

    Correct Answer
    A. Excessively expressionistic speech which is lacking in detail
    Explanation
    Histrionic Personality Disorder is a pattern of excessive emotionality and attention seeking, which often includes a need to be the center of attention, sexually seductive behavior, rapidly shifting emotions, impressionistic speech, and an overestimation of the intimacy of personal relationships. All of the other choices are more consistent criteria for Borderline Personality Disorder.

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  • 44. 

    Which of the following criteria is consistent with Schizoid Personality Disorder?

    • Desire for close personal relationships

    • Takes little pleasure in activities

    • Odd beliefs and magical thinking

    • Paranoid thoughts

    • Eccentric behavior

    Correct Answer
    A. Takes little pleasure in activities
    Explanation
    Schizoid Personality Disorder consists of detachment from social relationships and a restricted range of emotional expression. Persons with this personality structure do not desire close relationships, have little interest in others, and enjoy very little. Schizotypal Personality Disorder, by contrast, consists of odd thoughts and behavior combined with a reduced CAPACITY for social relationships and an excessive social anxiety.

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  • 45. 

    Which of the following signs and symptoms would RULE OUT the diagnosis of Schizotypal personality disorder?

    • Odd thinking

    • Symptoms occurring only at home

    • Social anxiety

    • Symptoms not evident in childhood

    • Magical thinking

    Correct Answer
    A. Symptoms occurring only at home
    Explanation
    Schizotypal Personality Disorder is a pervasive pattern of social deficits and cognitive and perceptual disturbances, which develops in early adulthood. (It therefore would not only be seen at home). Odd thinking, illusions, severe social anxiety, paranoid thoughts, and other disturbed thinking processes are evident, but not severe enough to warrant the diagnosis of schizophrenia.

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  • 46. 

    Maryann is a showroom model in New York City, where she models shoes. It is extremely important that she not get any marks on her ankles or legs and she takes very good care of her entire body. Twice a week, although she can hardly afford it, she has a massage and goes to the dermatologist to have hair removed on her legs and face. An attractive, blonde-haired woman of 23, she has completed secretarial school, which she refers to as "business college". Maryann is waiting to meet a rich millionaire in the showroom and wants to get married and live in a house in Connecticut with a full staff. Her boss tolerates her chronic lateness and excessive demands because she is attractive and, although she can be very condescending, his customers seem to find her amusing. When asked about her work, she always tells people she is a model and expects to be signed by a major agency very shortly. She is very unhappy because she feels unrecognized and envys the models in the magazines. You might diagnose her with

    • Histrionic Personality Disorder

    • Dependent Personality Disorder

    • Borderline Personality Disorder

    • Schizotypal Personality Disorder

    • Narcissistic Personality Disorder

    Correct Answer
    A. Narcissistic Personality Disorder
    Explanation
    Narcissistic Personality Disorder individuals do not fear abandonment, engage in self-destructive behavior, or have a problem with self-image. They do, however, have a grandiose sense of self-importance, are preoccupied with fantasies of success, power, love, require excessive admiration, show a sense of entitlement, and envy others while showing an arrogant manner.

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  • 47. 

    A 40-year-old male computer programmer comes to your office in a frantic state. He states that he is stalking out one of his friends, has been dangerously drinking and is under the influence of alcohol quite often, has a history of picking up strangers, reports a series of suicidal attempts, and seems to call in sick when he feels like it. He has no medical history and does not appear depressed. From talking to another therapist, this patient seems to have a history of self-damaging behaviors. What would be your provisional diagnosis?

    • Schizoid Personality Disorder

    • Schizotypal Personality Disorder

    • Paranoid Personality Disorder

    • Borderline Personality Disorder

    • Antisocial Personality Disorder

    Correct Answer
    A. Borderline Personality Disorder
    Explanation
    Borderline personality characteristics include: unstable impulse control, early adult life instability in interpersonal relationships, frantic attempts to prevent abandonment, identity disturbance, self damaging behavior, self mutilating behavior, severe reactivity to moods, chronic feelings of being no good, and anger and paranoid behavior which may last for short or long periods of time.

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  • 48. 

    A middle-aged woman comes to your office after missing her first appointment. When she rescheduled she said that she was not able to get to your office because she had no friends to ask for a ride. Today her daughter was able to drive her. She is dressed in a very colorful outfit with a very large hat that is pink with long ears. She says she really does not like going out in public, but when she does, this hat protects her from other people. You do not laugh, but you ask questions to determine whether she has a form of schizophrenia, or perhaps which of the following personality disorders?

    • Paranoid Personality Disorder

    • Schizoid Personality Disorder

    • Schizotypal Personality Disorder

    • Antisocial Personality Disorder

    • Histrionic Personality Disorder

    Correct Answer
    A. Schizotypal Personality Disorder
    Explanation
    Although superficially similar to Paranoid Personality Disorder, Schizotypal Personality Disorder is characterized more by pervasive social and interpersonal deficits that result in extreme discomfort with close relationships. Five or more of the following symptoms are present in the Schizotypal patient: ideas of reference (but not full blown delusions), odd beliefs or magical thinking, illusions or unusual perceptual experiences (but not classic hallucinations), odd thinking and speech, eccentric behavior or appearance, paranoid thinking or suspiciousness of others, no close friends, and social anxiety related to paranoid fears, rather than to negative feelings about oneself. Some of these symptoms are similar, but not nearly as severe as the symptoms of Schizophrenia.

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  • 49. 

    Which of the following types of therapy include cognitive errors that include overgeneralizing, selective abstraction, excessive responsibility, assuming temporal causality, self-references, catastrophizing, and dichotomous thinking?

    • Cognitive therapy

    • Group therapy

    • Behavioral therapy

    • Psychoanalytic therapy

    • Biofeedback

    Correct Answer
    A. Cognitive therapy
    Explanation
    Cognitive therapy includes cognitive errors such as overgeneralizing, selective abstraction, excessive responsibility, assuming temporal causality, self-references, catastrophizing, and dichotomous thinking. This type of therapy focuses on identifying and challenging these distorted thinking patterns in order to promote more realistic and adaptive thoughts and beliefs. By addressing these cognitive errors, cognitive therapy aims to improve individuals' emotional well-being and overall functioning.

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  • Current Version
  • Jan 15, 2025
    Quiz Edited by
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  • Oct 03, 2009
    Quiz Created by
    Saraholson7

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