Test Bank for Nietzel • Speltz McCauley • Bernstein Abnormal Psychology Prepared by Susan K Fuhr Weber State University Allyn and Bacon Boston • London • Toronto • Sydney • Tokyo • Singapore Copyright © 1998 by Allyn & Bacon A Viacom Company 160 Gould Street Needham Heights, MA 02194 Internet: www.abacon.com America Online: keyword: College Online All rights reserved The contents, or parts thereof, may be reproduced for use with Abnormal Psychology by Michael T Nietzel, Matthew L Speltz, Elizabeth A McCauley, and Douglas A Bernstein, provided such reproductions bear copyright notice, but may not be reproduced in any form for any other purpose without written permission from the copyright owner ISBN 0-205-26283-X Printed in the United States of America 10 02 01 00 99 98 97 TABLE OF CONTENTS Preface Chapter ABNORMAL BEHAVIOR: PAST AND PRESENT PERSPECTIVES Chapter ASSESSMENT AND DIAGNOSIS 33 Chapter DISORDERS OF INFANCY, CHILDHOOD, and ADOLESCENCE 58 Chapter DEVELOPMENTAL DISORDERS AND LEARNING DISABILITIES 85 Chapter STRESS, SLEEP, AND ADJUSTMENT DISORDERS 110 Chapter PSYCHOLOGICAL FACTORS AND HEALTH 134 Chapter ANXIETY DISORDERS 155 Chapter DISSOCIATIVE AND SOMATOFORM DISORDERS 181 Chapter MOOD DISORDERS AND SUICIDE 205 Chapter 10 SCHIZOPHRENIA 238 Chapter 11 COGNITIVE DISORDERS 263 Chapter 12 PERSONALITY DISORDERS 281 Chapter 13 SUBSTANCE-RELATED DISORDERS 309 Chapter 14 SEXUAL AND GENDER IDENTITY DISORDERS 339 Chapter 15 BIOLOGICAL TREATMENT OF MENTAL DISORDERS 365 Chapter 16 PSYCHOTHERAPY 385 Chapter 17 ALTERNATIVES TO INDIVIDUAL PSYCHOTHERAPY 410 Chapter 18 LEGAL AND ETHICAL ISSUES IN MENTAL DISORDERS 431 Preface Given the popularity of the undergraduate course in abnormal psychology as well as the exigencies imposed by large class sizes in most colleges and universities, many instructors employ multiple choice exams as a primary means of evaluating student learning I have tried to produce a diverse array of such questions, along with a few short answer/essay items at the end of each chapter I hope you find them useful as you create exams for your course Each item is presented with several descriptive qualifiers, listed just below the item number For instance, here is an item from Chapter 7: Ans C App p 217 E * Ans C App p 217 E * > > > > > Dr Seshachari is treating a client who is diagnosed with one of the most common anxiety disorders Which of the following would this be? a generalized anxiety b panic disorder c social phobia d obsessive-compulsive disorder chapter number item number correct answer type of item: APPLIED (App), CONCEPTUAL (Con), FACTUAL (Fac) page reference for answer item difficulty: EASY (E), MODERATE (M), CHALLENGING (C)1 indicates item is found in the student Practice Tests (20 per chapter) Each chapter has at least 65% Applied items and roughly 15% Conceptual and 15% Factual I would very much appreciate your feedback and suggestions as you use these items Please contact me by email: sfuhr@weber edu I would like to express my thanks to the several individuals without whose aid and support this project would not have come to fruition To Doug Bernstein, thank you for recommending me and providing all-important social support via the electronic highway And hearty thanks to Sue Gleason, my stalwart, always reassuring editor who's been a pleasure to work with About 250 items in this bank were written, and my own writing reviewed, by some of Weber State University's brightest and best students: Danny May, Bryce Warren, Shayne Palmer, Angie Wehr, and Todd Woodward And Amanda Allman, of Illinois, was a saving grace toward the end of the project, writing several items for the last three chapters Thanks Amanda And now that I've written, rewritten, and edited the last item, I can tell my long-neglected spouse that I'll soon be back to normal (whatever that is!) Susan K Fuhr, Ph D Weber State University Ogden, Utah 84408-1202 I encourage you to bear in mind that because this is a new testbank for a new text, these difficulty levels are rationally based and await empirical item analysis Your own choices for class coverage and emphases will affect the accuracy of these recommended levels Chapter ABNORMAL BEHAVIOR: PAST AND PRESENT PERSPECTIVES 1 Ans D Fac p E Which facet of your text's definition of "abnormal behavior" is universally accepted? a individual disturbance of behavior or physical functioning b psychological distress or impaired functioning c a kind of disturbance that is unexpected in the culture d None of the above apply Ans C App p E If you were a citizen of ancient Egypt, what would you be most likely to cite as the cause of Nelson McGrath's behavior? a weakness of character b bodily illness c evil d irrational thoughts & perceptions Ans D Fac p E Evidence from cultures around 3500 to 3000 B C suggests that a model would have been used to explain abnormal behavior a medical b humanistic c rationalistic d demonological Ans C App p M How might an early Mesopotamian individual be treated if she or he demonstrated bizarre actions, strange speech, and extremely unusual beliefs? a bloodletting with leeches b confinement to an asylum c trephining d a special diet to restore bodily imbalances Ans B Fac p M Ancient Chinese and Hebrew civilizations employed several methods in the treatment of abnormal individuals Which approach, however, was NOT common? a exercise and special diet b special care in asylums c faith healing d concoctions to poison spirits and demons Ans A App p E The movie "An American Werewolf in London" reflects a belief in which of the following? a lycanthropy b hysteria c tarantism d stigmata diaboli 1 Ans D App p E In your historical review of early approaches to understanding abnormality, to whom would you credit the birth of the medical tradition? a Roman philosophers b Islamic scholars c Egyptian healers d Greek physicians Ans C Con p M * If you assert that humans are primarily rational beings who gain knowledge through reasoning and recollection to discover universal truths, to whom you clearly owe an intellectual debt? a Hippocrates b Avicenna c Plato d Descartes Ans C Con p M Marc considers himself an empirical scientist of psychology, gathering and evaluating information from perceptual experiences Which Greek philosopher set forth the intellectual foundation for Marc's perspective? a Plato b Hippocrates c Aristotle d Galen 10 Ans B Fac p E Which humorous Greek is considered the father of medicine? a Galen b Hippocrates c Epictetus d Aristotle 11 Ans A App p E An ancient Greek was diagnosed as suffering from melancholia This individual was probably given a special diet as well as purgatives in order to treat an imbalance of a black bile b phlegm c yellow bile d blood Which of the following descriptive terms would best reflect Hippocrates' approach to abnormality? a madness b evil c illness d sinfulness 12 Ans C Con p E 13 Ans D App p M You are Galen's medical assistant What aspect of human psychology would you be studying? a rational thinking processes b social behavior c intelligence d temperament 14 Ans A Fac p E What sort of intervention would Epictetus most likely recommend for a disordered individual? a a talking cure b laxatives and purgatives c prayer and faith healing d commitment to a restful asylum 15 Ans B Con p M "It's not what your boyfriend said to you that's upset you; it's the way you interpreted his comments that is bothering you " Which of the following philosophers would most heartily agree? a Aristotle b Epictetus c Avicenna d St Vitus 16 Ans D App p M Stacy is a graduate student in clinical psychology and is learning the tools and techniques of psychotherapy Her belief that these verbally-based methods will help her future clients is most similar to the view of the treatment of disorders a European Middle Ages' b ancient Hebrews' c ancient Egyptians' d classical Greek and Romans' Aaron lives in a feudal society, marked by frequent wars and economic crises He also believes that abnormality is the work of the Devil What is the most likely year that Aaron is alive in Western Europe? a 120 B C b 410A D c 755A D d 1480 A D 17 Ans C App p C 18 Ans C App p M A magical potion made up of eye of newt, heart of a cat, and the ovary of a goat killed on a Saturday midnight would probably be offered to a psychotic person during what historical age? a Renaissance b classical Greco-Roman c early European Middle Ages d late Islamic Middle Ages 19 Ans A Con p M The text The Canon of Medicine provided a bridge between the philosophy of and the of the Renaissance a Aristotle; science * b Plato; rationalistic theology c Socrates; medical practices d Hippocrates; science 20 Ans D Fac p E Although the rationalistic, naturalistic philosophy of the Greeks was lost during the Dark Ages of Europe, where were their works preserved? a China b Spain c Indonesia d Islam 21 Ans B Con p C What commonality exists between the work of Greek physicians, Islamic physicians, and the monasteries of Europe? a They emphasized a supernatural approach to understanding causes of abnormality b They provided sanctuaries for disordered individuals c They pioneered psychological treatment methods that spurred the development of Renaissance asylums d They combined magic, common sense, and herbal remedies to treat disordered individuals 22 Ans B Fac p E When and to whom would you credit the first use of hospitals for the specialized treatment of mental disorders? a 4th century Roman physicians b 8th century Islamic physicians c 12th century European monks d 16th century Renaissance physicians 23 Ans A App p E Whether caused by naturalistic or demonic forces, if you joined a group of people jumping and dancing, tearing off clothing, and frolicking in the streets, what form of madness would you be displaying? a tarantism b Dance de Diaboli c folie en masse d lycanthropy 24 Ans B App p E If you consulted the Malleus Maleficarum in the late 1400's, what was your goal? a reconciliation of the teachings of the church and the values of humanism b the detection, exposure, and purging of witches c potions and incantations for the treatment of disordered individuals in asylums d an understanding of the physical, mechanical workings of the human body 25 Ans D Fac p E Which of the following represents a strong backlash to the increasing influence of the secular world in the early years of the Renaissance? a The Canon of Faith b Paracelsus' study of abnormal behavior c greater value placed on humanism d Malleus Maleficarum 26 Ans A Con p C Which item does not belong with the other three? a moral treatment b advent of humanism c advent of the printing press d Copernicus' cosmology 27 Ans D App p M * You live in a time in which books are becoming more readily available, heretics are saying that the sun is the center of the universe, and humankind is becoming a topic of study worthy in its own right With whom are you living? a Plato and Hippocrates b Avicenna and Galen c Tuke and Pinel d Copernicus and Paracelsus Which of the following represents the correct order of predominant themes from the Greeks to the Middle Ages to the Renaissance? a theological > psychological > rational b psychological > rational > theological c rational > theological > psychological d supernatural > theological > psychological 28 Ans C Con p 5-7 M 29 Ans A Con p M "I think, therefore I am " The author of this phrase asserted that human mental activity could be thought of in mechanical, physical terms Who was he? a Descartes b Epictetus c Copernicus d Chiarugi 30 Ans D App p M You are a modem student in a field of study whose first member risked the wrath of the church by condemning the practices in the Malleus Maleficarum In what field are you studying? a clinical psychology b family medicine c philosophy d psychiatry 31 Ans A App p M If you were a mentally disordered person in the 16th century, to whom would you mm for humane help? a Weyer b Tuke c Sprenger d Pinel 32 Ans B Fac p E The word "bedlam" derives its meaning from a the strange "magical" treatments carried out in early monastery asylums b the deplorable conditions found in prison-like Renaissance hospitals for the insane c the name of the city in which the first mental hospital was founded d the early bedrest treatment used for acutely disturbed patients in asylums 18.53 Ans D App p 628 M Felicia heard that a group home for people with mental retardation would be placed in her neighborhood Felicia tells you she is worried that her home price will drop, and she wishes the city would something According to the text, you should suggest that Felicia a ask the city to require group homes to locate only in certain zones b ask the city to impose a special permit process for establishing such homes c file a petition signed by the neighbors with the state d nothing to prevent this event 18.54 Ans D App p 628 M Thomas is a young man living in poverty who has been accused of murder His family insists that he is severely mentally ill Which of the following rights is extended to Thomas? a He will be provided a state-funded psychiatrist to serve as an expert witness b If found guilty, he cannot be executed if he is considered incompetent at the time of execution c He will be committed for treatment for one year before his case is heard in court d both a and b 18.55 Ans C App p 629 M Harry was convicted of murder and sentenced to death Ten years later, Harry has become delusional and no longer understands why he is being held nor what is going to happen The state most likely execute Harry, because a will; he was not delusional when he committed the crime b will; he was not delusional when originally sentenced c will not; he doesn't understand what the death penalty is for d will not; he has a right to treatment 18.56 Ans A App p 629 M For which of the following prison inmates would a sentence of execution not be carried out? a Werner, who because of his mental disorder does not understand why he is to be executed b Sarah, who was mentally ill at the time of her offense and has been successfully treated c Benny, who is suffering from borderline personality disorder and is a danger to himself d both a and c 18.57 Ans A App p 630 E After getting a bachelor's degree in psychology, Lois began advertising her services as a psychologist Soon she received a notice stating that she did not have the education and training required to use that title Lois violated a certification laws b privilege laws c the McNaughton rule d ethics laws 440 18.58 Ans A App p 630 E Dr Horowitz has just completed graduate school and is ready to start a private therapy practice Before Dr Horowitz can start his practice, what types of laws does he have to know and comply with? a licensure and certification laws b practice regulation laws c ethics and confidentiality laws d malpractice and training laws 18.59 Ans C App p 630 M Dr Horvat agrees that certification and licensure laws may protect individuals from charlatans and unskilled professionals However, like some other practitioners, he questions whether a states that not have such laws are putting their citizens in danger b these laws should include confidentiality issues c nontraditional professionals are being economically disadvantaged d such laws should specify the parameters of "effective" therapy 18.60 Ans D App p 630 M Sonya is on trial for the murder of her husband It is alleged that Sonya confessed her guilt to Pastor Upton The court MOST likely will a force Pastor Upton to reveal the contents of their conversations, b force Sonya to reveal the contents of their conversations c recognize the conversations as confidential, d recognize the conversations as privileged 18.61 Ans A Fac p 630 M In a b c d 18.62 Ans C App p 630 E Dr Galtberg is legally protected from disclosing information about his clients except in certain prescribed cases What is the term for this protection? a client-therapist contract b confidentiality c privilege d censure 18.63 Ans B App p 630 M During couple counseling, Haile told her therapist that her boyfriend knew she had a sexually transmitted disease from a previous relationship Haile was shocked later in the week when her parents knew about it, but they said the therapist was right to call them According to your text, the therapist a should not have told them, because of the Tarasoff ruling b should not have told them, because it is a breach of confidentiality c should have told them only if they are paying for the therapy d should have told them only if Haile lives with them 18.64 Ans A Con p 630 M Which of the following terms does not belong with the other three? a privilege b ethical obligation c federal protection only d confidentiality each state of the U.S., privilege exists between a minister and parishioner a parent and child, a therapist and client both a and c 441 18.65 In 1996, a Supreme Court decision was made that was very important to the area Ans D of legislation and mental health This case ensured the protection of confidential Fac communications between a therapist and a client in federal cases What was the p 630 name of the case? E a Tarasojfv Regents of the University of California b O'Conner v Donaldson c Carter v Altress d Jaffe v Redmond 18.66 Ans C App p 630 M Dr Redcloud is a psychotherapist treating a client who is involved in a court case Under which of the following conditions will their confidentiality be legally protected? a if the legal charge involved in the case is a misdemeanor rather than a felony b in any case heard in a U.S state court c in any case heard in federal court d when the case does not involve abuse of a minor or other violent offense 18.67 Ans B App p 631 M In her first session with each client, Dr Fuhr describes the nature of confidentiality and her commitment to maintaining this aspect of the therapy relationship However, there are some limitations to confidentiality, and these include each of the following EXCEPT a the client is imminently suicidal and will not agree to hospitalization that Dr Fuhr deems necessary b the client reports that she/he is currently buying and using illegal substances c the client is abusing a child or a disabled adult d the client includes her/his mental condition as part of a court case, and Dr Fuhr is called as a witness Dr Natchez has a new adult client diagnosed with borderline personality disorder Under which condition below might Dr Natchez be required to breach client-therapist confidentiality? a if his client claims that his abusive parent has broken the law in the past b if his client claims that he knows that a friend or acquaintance has committed murder c if his client indicates that he is abusing other people d if his client threatens to terminate treatment prematurely Dr Serano is treating an admitted pedophile When treatment ends, Dr Serano plans to testify in court about the client's mental state Why is this permissible on legal and ethical grounds? a Dr Serano is conducting a court-ordered psychological evaluation b Pedophiles are a menace to society and have forfeited their legal rights c It was first permitted in past cases such as the Ake v Oklahoma that set this precedent d It is not permissible; it is a serious breach of confidentiality 18.68 Ans C App p 631 M * 18.69 Ans A App p 631 E 442 18.70 Ans B Fac p 631 M According to your text, in cases such as Tarasoff \ Regents of the University of California what issues are the court systems weighing against each other? a the importance of a client's safety against the right of society to see justice done b the importance of a client's right to confidentiality against society's interest in protecting itself from danger c the importance of a victim's right for safety against the client's right to fair treatment d the importance of a victim's right to see justice done against the client's right to confidentiality 18.71 Ans D Con p 631 M Which of the following descriptions does not belong with the other three? a "The protective privilege ends where the public peril begins." b Confidentiality must be broken when a client intends to harm another person, c The Tarasoff decision set the precedent for the breaking of confidentiality when a client is potentially dangerous to another person d Therapists are ethically required to directly warn intended victims of their client's intentions 18.72 Ans A App p 631 M Dr Berler's client has indicated that she intends to shoot the woman with whom her husband is having an affair What must Dr Berler at this point? a take whatever action is necessary to protect the intended victim b call the intended victim and warn her of the client's intentions c seek voluntary or involuntary commitment for her client d inform the police of the client's intentions 18.73 Ans B Fac p 632 M Why was John Hinckley, Jr.'s psychiatrist not held liable for damages when his client attempted to assassinate President Reagan? a He had been able to get his client to undergo voluntary hospitaliaation, but Hinckley later carried out his plan b The laws of his state did not require that he take steps to protect the client's victim c He took the step of informing the President's Secret Service, but the attempt was not be prevented d He had excellent legal representation and successfully defended himself against the Tarasoff requirement 18.74 Ans B App p 632 E Dr Payne is facing a problem with a certain client of his This client has been convicted in the past of spouse abuse, and has recently expressed a high level anger directed toward his wife and children What is Dr Payne's dilemma? a deciding whether he should refer his client for appropriate medication b predicting whether this client will be dangerous in the future c deciding how to protect himself from a future malpractice suit should his client file one in anger d deciding how to circumvent legislation requiring him to report his client to the police so that he can deliver more effective treatment * 443 18.75 Ans C App p 632 M * 18.76 Ans A App p 632 E Ramone is trying to predict the dangerousness of one of his clients Which of the following factors will enhance his accuracy? a Ramone is a licensed, doctoral level psychologist rather than a bachelor's level social worker b Ramone attempts to predict the client's dangerousness in the next weeks rather than in the next year c Ramone receives information about his client's history of violence d all of the above Dr Aram, a trained psychotherapist, is dealing with a client who may be potentially dangerous Based on empirical findings, what are his chances of predicting this client's future level of dangerousness compared to a layperson's chances? a about the same b much better c only slightly better d worse 18.77 Ans D App p 632-3 C Dr Lutece believes his schizophrenic client with paranoid delusions may become violent toward his family at some point Each of the following factors complicates Dr Lutece's ability to accurately predict this behavior EXCEPT a the relative rareness of dangerous behavior in the general population b Dr Lutece's desire to avoid a false negative outcome c limited knowledge about the client's day-to-day environments d research evidence that suggests Dr Lutece's predictions are not better than those based on chance 18.78 Ans A App p 633 M Dr Jacobs' San Diego mental health practice has not been affected much by the Tarasojfv Regents of the University of California case According to your text, why may this be so? a Dr Jacobs was breaking confidentiality to warn victims or the police before Tarasoffv Regents of the University of California happened b Dr Jacobs' practice deals with common mental health problems, and because Tarasoff dealt with marginal cases, his practice is not included in its requirements c Potentially dangerous clients have become much less likely to seek treatment knowing that their confidentiality may be jeopardized d Dr Jacobs works only with adolescent clients and is therefore exempt from breaking confidentiality when clients threaten others 18.79 Ans B App p 634 M In order for a family to successfully sue Ms Richards for failing to prevent the suicide of their mother, each of the following elements must be present EXCEPT a Ms Richards must be shown to have violated a standard of care in treating their mother b Ms Richards' was not a member of the APA and thus was not bound by its ethical principles c Ms Richards' negligence must be shown to be the cause of the mother's suicide d Ms Richards and the mother had to have been in a special professional relationship * 444 18.80 Ans D App p 634 E Dr Vasquez is facing a malpractice suit Which of the cases below is LEAST likely to be the one he is facing? a failing to prevent a client from committing suicide b failing to inform individuals of potential harm posed toward them by a client c engaging in sexual intimacy with a client as part of her treatment for sexual dysfunction d failing to correctly diagnose a comorbid substance abuse disorder in a severely depressed or anxious client 18.81 Ans B Fac p 620,31,34 M Which of the following events did NOT occur during the 1960s? a an increase in the number of malpractice claims against psychologists b the Tarasoff decision c reforms in state civil commitment laws d increasing numbers of public mental hospital patients being discharged 18.82 Ans A Con p 634 M Which of the following does NOT necessarily belong with the other three? a client suicide b violation of standard of care c sexual contact with client d malpractice 18.83 Ans C Fac p 634 E What percentage of mental health professionals report having engaged in sexually intimate behavior with a client? a less than one percent b over twenty percent c two to ten percent d eight to fifteen percent 18.84 Ans A App p 634 E Which of the following therapists is MOST likely to commit the offense of having sexual contact with a client? a Mitch, who has done so previously b Laura, who has done so previously c Ricardo, who has not done so previously d Melba, who has not done so previously 18.85 Dr Calderon saw a client for a few sessions while she was dealing with grief over Ans C the loss of her mother Sometime later, Dr Calderon and the former client ran App into each other at an art museum, and they began dating shortly thereafter p 635 According to current APA guidelines, at least must have passed between M the termination of therapy and their romantic relationship * a months b year c years d It is not ethically permissible to have an intimate relationship with former clients 445 18.86 Ans B App p 635 E Nancy has engaged in sex with her psychotherapist Which statement below is the most likely to be FALSE? a The therapist is putting his own needs before Nancy's, b The increased level of intimacy has increased the effectiveness of the therapy c The therapist will find it difficult to be objective while making judgments about Nancy d Nancy's therapist is being exploitive 18.87 Ans D App p 635 M Which of the following cases is NOT likely to be a target of a malpractice suit regarding repressed memory therapy? a A therapist helps a client remember abuse that occurred when the client was months old b A client recalls her childhood sexual abuse after two years of intensive hypnotherapy c A therapist uses sodium amytal to help a client recall her history of sexual and physical abuse that occurred at age d none of the above 18.88 Ans A App p 636 E * If you were a therapist, what factor below would have the greatest regulatory impact on your practice? a third party payers b ethical standards c regulatory legislation, such as Tarasoff and other state cases d malpractice suits 18.89 Ans B Con p 636 M What factor is MOST likely to determine the standards of care that therapists are expected to follow today? a court decisions b third-party payers c malpractice suits d ethical standards 18.90 Ans C App p 636 E Carolyn is a member of a managed care system Her insurance company pays a set fee each month for each of its members for mental health care In other words, Carolyn's insurance company is participating in a system a fixed-cost b flat fee c capitation d utilization 18.91 Ans D Fac p 637 E Who conducts a managed care system's utilization review of therapy? a a client's therapist b a therapist's clinical supervisor c an independent mental health professional hired by the company d a case manager who is typically not a mental health professional 446 18.92 Ans B App p 637 E Your health care service utilizes a capitation plan What type of treatments will this plan MOST favor? a thorough assessments that inform careful therapy planning b medications and short-term therapy c insight-oriented psychotherapy d 20-session cognitive-behavioral therapy 18.93 Ans A App p 637 M You are a therapist, and you have committed an ethical violation What type of violation is it LEAST likely to be? a practicing in an area in which you are not competent b a breach of confidentiality c sexual intimacy with a client d a dispute over financial matters 18.94 Ans B App p 637-8 M Dr Smith has been found guilty of the ethical violation of having a sexual relationship with a client Which of the following consequences is NOT associated with this violation? a public reprimand b an arrest c forfeiture of his state licensure d expulsion from the APA 18.95 Ans B Fac p 638 E Although the practice is controversial, it is estimated that psychologists and psychiatrists provide expert witness testimony in % of all federal civil trials a b c 15 d 22 18.96 Ans D App p 638 E Dr Jackson is testifying in a trial in which an individual is being evaluated for involuntary hospitalization Dr Jackson is a psychologist a civil b community c litigation d forensic 18.97 Ans C Fac p 640 E Which of the following psychologists is MOST likely to charge rates of $300 to $400 per hour of service? a a psychodynamic therapist providing individual therapy b a clinical psychologist conducting a complete psychological evaluation c a forensic psychologist providing expert testimony d a forensic psychologist providing inpatient treatment to a defendant deemed criminally incompetent 447 18.98 Ans C App p 640 E Shara's attorney is wondering if Shara adequately understands the nature of the judicial proceedings she is about to undergo The attorney is concerned that Shara is not really able to participate in her own defense In other words, the attorney questions her a criminal culpability b legal state of mind c competence to stand trial d sufficiency for judicial review 18.99 Ans B Fac p 640 M If a defendant's mental state is an issue in a court case, it is necessary to first determine before raising the question of a intelligence; competence b competence; insanity c the adequacy of the McNaughton mle; the Durham rule d wrongfulness; mental defect 18.100 Ans D App p 640 E Mr Lawrence is evaluating whether his mentally disordered client is competent to stand trial Mr Lawrence could consider each of the following issues EXCEPT a Can my client consult meaningfully with me as I prepare this case? b Does my client understand what will happen during the trial? c Will my client be able to participate meaningfully in his own defense? d Does the client understand the wrongfulness of the crime? 18.101 Ans D Fac p 640 E Which court representative is responsible for raising the question of criminal competence? a the defense attorney b the judge c the prosecution d any of the above 18.102 Ans B App p 640 E Mr Padgett has been found incompetent to stand trial What will happen next? a Mr Padgett's court case will be dismissed, and he will be committed for indefinite treatment b Mr Padgett will be involuntarily committed to a forensic hospital unit until such time as he can stand trial c Mr Padgett will be assigned a special advocate who will work with the defendent and his lawyer throughout the trial d Mr Padgett will be evaluated according to the ALI mle, and the prosecution will determine whether the case actually proceeds to trial 18.103 Ans A App p 640 E Dr Elsley is a forensic psychologist specializing in the treatment of defendants found incompetent for trial If her results are similar to those found in the research literature, she can expect that at least of every 10 patients will ultimately be found competent a b c d * 448 18.104 Ans A Con p 640 E Who is ultimately responsible for deciding a defendant's sanity or insanity? a the court b a clinical psychologist c a forensic psychologist d any of the above 18.105 Ans B Con p 640 E Which of the following persons does not belong with the other three? a Archie Brawner b Prosenjit Poddar c Daniel McNaughton d Monte Durham 18.106 Ans C App p 640-1 M first James is accused of attempted murder If his sanity is being judged against the legal rule established in the mid 1800s, the court will focus on James' a inability to participate effectively in his own defense b cognitive and volitional appreciation of the criminality of his action c failure to understand the wrongfulness of his crime as he committed it d diagnosable psychopathology leading to an inability to inhibit criminal actions 18.107 Ans D App p 641 M * "Due to bipolar disorder symptoms of psychotic severity, my client was unable to distinguish right from wrong when she stole large sums of money and purchased several firearms and explosives, believing she needed to protect herself from her enemies." Which rule(s) for assessing insanity is(are) reflected in this statement? a ALI b McNaughton c Durham d both b and c 18.108 Ans B Con p 641 M A psychiatrist is testifying in relation to a criminal defendant's insanity plea This expert witness asserts that the defendant has a severe mental illness that caused the criminal action This evidence is MOST critical to the rule a mens rea b Durham c McNaughton d ALI 18.109 Ans C App p 641 E Nena is a second-year law student As she learns about the insanity defense, she will find that the rule is virtually never used today a McNaughton b GBMI c Durham d ALI 18.110 Ans D Con p 641 M Which of the following represents a CORRECT chronological ordering of the primary standards used to define insanity? a Durham : McNaughton : ALI b McNaughton : ALI : Brawner c the product test : ALI : Durham d McNaughton : Durham : ALI 449 18.111 Ans A App p 641 M 18.112 Ans B App p 641 M Carter was a defendant whose attorney entered a plea of insanity in Carter's 1980 manslaughter case If Carter's case was heard in a federal court, the rule was used a ALI b McNaughton c Durham d IDRA "While my client had a dim awareness that her assault on her sister was wrong, she was unable to control her actions due to her psychotic mental condition." This defense attomey is addressing the test of insanity a Durham b ALI c mens rea d McNaughton 18.113 Ans C Fac p 641 M Although a study in Wyoming found the public believed that the insanity defense was used in about of all criminal cases, its actual prevalence is a one third; 1.0 percent b one quarter; 01 percent c one half; 005 percent d one half; 3.5 percent 18.114 Ans D App p 641 M * Ms Strickland is an attorney considering the use of the insanity defense for her client How would you advise her? a She will probably be most likely to win such a case if the defendant committed a violent crime after discontinuing psychotropic medications b She should only recommend this if her client has the funds to pay for a very expensive defense process c She should pursue this only in a federal court where experts can forcefully persuade the jury by giving a clear opinion about the defendant's insanity d She is extremely unlikely to win such a case and should carefully consider other options 18.115 Ans A App p 642 C Erik has just been judged NGRI Which of the following is LEAST likely? a Erik is much more likely to be rearrested or rehospitalized after his release than is the average criminal b Erik will be hospitalized for a longer period of time than will an NGRI defendant who committed a less serious offense c His presiding judge will use more stringent criteria in deciding his release than the release of a civilly committed patient d Erik was held to the standard of the McNaughton rule rather than the ALI rule 18.116 Ans B Fac p 642 E Which of the following characteristics is MOST clearly related to potential for violence? a serious mental illness b active psychotic symptoms c lowSES d borderline intellectual functioning 450 18.117 Ans D App p 642 M Which of the following persons is able to use and can afford to pay for an insanity defense? a Letisha, a middle-class black female b Mason, an upper-middle-class white male c Benito, a lower-class Italian American male d all of the above 18.118 Ans C Con p 643 M In a student's report on the presence of mental health experts in trials involving questions of the defendant's sanity, which statement should be omitted? a The media coverage of such trials may contribute to the field's credibility, given the frequent disagreement amongst those experts b These experts, despite the IDRA, may exert too much influence on the judicial process c Such experts typically cannot contribute valid assessment and diagnostic evidence for the use of juries or judges d Experts offer opinions of a defendant's past state of mind and present dangerousness that may be no better than those of a layperson 18.119 Ans D Con p 643 M Suppose you were serving on a jury that has been asked to consider the GBMI verdict Which of the following issues is LEAST likely to complicate your deliberations? a You will have to distinguish between mental illness that leads to insanity and mental illness that does not b You realize that the defendant may not receive adequate treatment due to hospital overcrowding c You are skeptical of the conflicting expert testimony presented by psychiatrists and psychologists d You must follow the ALI rule, in its IDRA revision, which limits this verdict to schizophrenic defendants only 18.120 Ans A App p 643 M Miyoko has been found GBMI in her criminal trial This means mat a her lawyer employed the insanity defense b she will receive treatment before being placed in the general prison population, c her trial could have taken place in any state in the U.S d the Durham rule guided the jury's deliberations 18.121 In the wake of the John Hinckley, Jr trial, several changes occurred in the use of Ans B the insanity defense Which of the following is NOT among them? Fac a The burden of proof moved from the prosecution to the defense p 643 b The use of the GBMI verdict was expanded for use in cases where the M insanity plea was not raised * c The ALI rule was changed to be essentially equivalent to the earlier McNaughton rule, d Experts were prohibited from giving any conclusions about a defendant's sanity 451 18.122 Ans D App p 644-5 M Which of the following jurors is LEAST likely to be influenced by an expert's opinion on a defendant's insanity? a Marta, who hears only diagnostic testimony b Duretha, who hears diagnostic testimony and a penultimate opinion c Ayita, who hears diagnostic testimony and both a penultimate and ultimate opinion d none of the above 18.123 Ans D Fac p 645 M Which of the following types of instruction is MOST likely to influence jurors' verdicts in an insanity case? a ALI b IDRA c no instructions at all d none of the above 18.124 Ans A Con p 645 E Which of the following legal principles is fundamental to the other three? a mens rea b the McNaughton rule c IDRA reforms d the ALI rule 18.125 Ans B App p 645 M Jerome is being tried for a crime that he committed without forethought or intention, as a result of a mental disorder Regardless of the state in which his case is heard, what principle(s) must be considered by jurors? a IDRA rules b mens rea c ALI rule d McNaughton rale SHORT ANSWER / ESSAY 18.126 In order to balance the tradition of parens patriae with greater attention to individual patient rights, today's laws require what conditions to be met before a person is hospitalized against her or his will? The person is mentally ill; the person is an imminent danger to self or others as a result of mat mental illness; appropriate treatment for the disorder is available at the proposed site of commitment; and hospitalization must represent the least restrictive alternative available for that treatment 452 18.127 Why is deinstitutionalization, the so-called shift from inpatient to outpatient treatment, a misleading phenomenon? The measurement of "average inpatients" is usually taken from average daily census counts but does not reflect the fact that hospital stays are shorter but also more frequent today The total number of admissions to all types of hospitals for mental health care has actually increased more than 30% from the late 1960s to the late '80s The census decline, moreover, has occurred primarily in state and county mental hospitals while treatment in private hospitals has increased in the past 10 years, as has treatment in general hospitals, specialized substance abuse units, residential units, and other inpatient programs 18.128 What two criteria are most commonly used to make decisions about civil commitment? Mental illness and grave disability 18.129 What is the difference between privilege and confidentiality? To what situations these apply? Privilege is a legal protection given to the communication between certain parries (minister/parishioner, lawyer/client, husband/wife, physician/patient), based on the assumption that these relationships could not survive without guaranteed nondisclosure Confidentiality is not a legal requirement but an ethical obligation in which a therapist pledges not to disclose a client's reports during therapy Confidentiality can be broken if the following conditions occur: the client needs involuntary hospitalization; the client raises her/his mental condition as part of a legal proceeding; the client is undergoing court-ordered evaluation; the client is abusing others; or the client intends to harm a specific person 18.130 What is the most common basis for malpractice claims against psychotherapists? For what reasons is this therapist behavior unethical and problematic? Sexual contact/intimacy Clients themselves report the experience to be harmful; the therapist is necessarily putting his/her own needs before those of the client; the therapist is unlikely to maintain objectivity in her/his treatment decisions and interventions; the therapist is taking advantage of the fact that the client may be in a state of crisis that impairs their ability to make sound judgments; and the relationship is exploitative because of me therapist's greater power and control 18.131 List the factors that help regulate the practice of psychotherapy Legislation, including certification and licensure laws, precedents set by court cases (e.g., Tarasoff), and privilege; malpractice lawsuits; third party reimbursement plans and utilization reviews; ethical standards 453 18.132 What are the four approaches for defining insanity that have been used in state and federal courts in the U.S.? Describe the central feature(s) of each mle, and indicate how it is used in the U.S today McNaughton mle: emphasizes the understanding of right from wrong; is used in about 20 states in the U.S Durham: emphasizes the presence of mental defect/mental disorder; no longer used ALI (aka Brawner): emphasizes defendant's substantial, not absolute, lack of appreciation for the wrongfulness of an act in terms of cognitive, emotional, and volitional components; used in about half of the states Insanity Defense Reform Act (IDRA): moves burden of proof to defense, omits volitional component of the ALI, prohibits experts from giving ultimate opinions; used in all federal courts since 1984 454