DSM-5 SELF-EXAM QUESTIONS

TEST QUESTIONS FOR THE

DIAGNOSTIC CRITERIA

DSM-5 INTRODUCTION D. The Unspecified designation is used

when the individual presents with
1. DSM-IV employed a multiaxial diagnosis symptomatology of disorders in two or
system. Which of the following statements more diagnostic classes.
best describes the multiaxial system in DSM- E. The Unspecified designation is used
5? when the clinician believes the condition
is of a temporary nature.
A. There is different multiaxial system in
DSM-5.
B. The multiaxial system in DSM-IV has
been retained in DSM-5.
C. DSM-5 has moved to a nonaxial
documentation of diagnosis.
D. Axis I (Clinical Disorders) and Axis II
(Personality Disorders) have been
retained in DSM-5.
E. Axis IV (Psychosocial and Environmental
Problems) and Axis V (Global
Assessment of Functioning) have been
retained in DSM-5.

2. True or False: The Global Assessment of

Functioning (GAF) Scale (DSM-IV Axis V)
remains a separate category that should be
coded in DSM-5.

A. True.
B. False.

3. To enhance diagnostic specificity, DSM-5

replaced the previous “not otherwise
specified” (NOS) designation with two options
for clinical use: Other Specified [disorder] and
Unspecified [disorder]. Which of the following
statements about use of the Unspecified
designation is true?

A. The Unspecified designation is used

when the clinician chooses not to specify
the reason that criteria for a specific
disorder were not met.
B. The Unspecified designation is used
when there is no recognized Other
Specific disorder (e.g., recurrent brief
depression, sexual aversion)
C. The Unspecified designation is used
when the individual has fewer than three
symptoms of any of the recognized
disorders within the diagnostic class.

ANSWERS:
1-3. CBA

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CHAPTER 1: NEURODEVELOPMENTAL any type of schoolwork) on a daily basis. What is
DISORDERS the appropriate severity rating for this patient’s
current presentation?
1.1 Which of the following is not required for
DSM-5 diagnosis of intellectual disability A. Mild.
(intellectual developmental disorder)? B. Moderate.
C. Severe.
A. Full-scale IQ below 70. D. Profound.
B. Deficits in intellectual functions confirmed by E. Cannot be determined without IQ score.
clinical assessment.
C. Deficits in adaptive functioning that result in 1.3 Which of the following statement about
failure to meet developmental and intellectual disability (intellectual development
sociocultural standards for personal disorder) is false?
independence and social responsibility.
D. Symptom onset during the developmental A. Individuals with intellectual disability have
period. deficits in general mental abilities and
E. Deficits in intellectual functions confirmed by impairment in everyday adaptive functioning
individualized, standardized intelligence compared with age- and gendered-matched
testing. peers from the same linguistic and
sociocultural group.
1.2 A 7-year-old boy in second grade displays B. For individuals with intellectual disability, the
significant delays in his ability to reason, solve full-scale IQ score is a valid assessment of
problems, and learn from his experiences. He has overall mental abilities and adaptive
been slow to develop reading, writing, and functioning, even if subtest scores are highly
mathematics skills in school. All through discrepant.
development, these skills lagged behind peers, C. Individuals with intellectual disability may
although he is making slow progress. These have difficulty in managing their behavior,
deficits significantly impair his ability to play in an emotions, and interpersonal relationships
age-appropriate manner with peers and to begin and in maintaining motivation in the learning
to acquire independent skills at home. He process.
requires ongoing assistance with basic skills D. Intellectual disability is generally associated
(dressing, feeding, and bathing himself; doing with an IQ that is 2 standard deviations from
any type of schoolwork) on a daily basis. Which the population mean, which equates to an IQ
of the following diagnoses best fits this score of about 70 or below (±5 points).
presentation? E. Assessment procedures for intellectual
disability must take into account factors that
A. Childhood-onset major neurocognitive may limit performance, such as sociocultural
disorder. background, native language, associated
B. Specific learning disorder. communication/language disorder, and
C. Intellectual disability (intellectual motor or sensory handicap.
development disorder).
D. Communication disorder. 1.4 Which of the following statements about
E. Autism spectrum disorder. the diagnosis of intellectual disability (intellectual
developmental disorder) is false?
1.3 A 7-year-old boy in second grade
displays significant delays in his ability to reason, A. An individual with an IQ of less than 70 would
solve problems, and learn from his experiences. receive the diagnosis if there were no
He has been slow to develop reading, writing, and significant deficits in adaptive functioning.
mathematics skills in school. All through B. An individual with an IQ above 75 would not
development, these skills lagged behind peers, meet diagnostic criteria even if there were
although he is making slow progress. These impairments in adaptive functioning.
deficits significantly impair his ability to play in an C. In forensic assessment, severe deficits in
age-appropriate manner with peers and to begin adaptive functioning might allow for diagnosis
to acquire independent skills at home. He with an IQ above 75.
requires ongoing assistance with basic skills
(dressing, feeding, and bathing himself; doing

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D. Adaptive functioning must take into account E. Individuals diagnosed with intellectual
the three domains of conceptual, social, and disability in childhood will typically continue to
practical functioning. meet criteria in adulthood even if their adaptive
E. The specifiers mild, moderate, severe, and functioning improves.
profound are based on IQ scores.
1.8 Which of the following statements about
1.5 Which of the following statements about the development of and risk factors for intellectual
diagnosis of intellectual disability (intellectual disability (intellectual developmental disorder) is
developmental disorder) is false? true?

A. An individual with an IQ of less than 70 would A. Intellectual developmental disorder should not
receive the diagnosis if there were no significant be diagnosed in the presence of a known genetic
deficits in adaptive functioning. syndrome, such as Lesch-Nyhan or Prader-Willi
B. An individual with an IQ above 75 would not syndrome.
meet diagnostic criteria even if there were B. Etiologies are confined to perinatal and
impairments in adaptive functioning. postnatal factors and exclude prenatal events.
C. In forensic assessment, severe deficits in C. In severe acquired forms of intellectual
adaptive functioning might allow for a diagnosis developmental disorder, onset may be abrupt
with an IQ above 75. following an illness (e.g., meningitis) or head
D. Adaptive functioning must take into account trauma occurring during the developmental
the three domains of conceptual, social, and period.
practical functioning. D. When intellectual disability results from a loss
E. The specifiers mild, moderate, severe, and of previously acquired cognitive skills, as in
profound are based on IQ scores. severe traumatic brain injury (TBI), only the TBI
diagnosis is assigned.
1.6 Which of the following is not a diagnostic E. Prenatal, perinatal, and postnatal etiologies of
feature of intellectual disability (intellectual intellectual developmental disorder are
developmental disorder)? demonstrable in approximately 33% of cases.

A. A full-scale IQ of less than 70. 1.9 Which of the following statements about the
B. Inability to perform complex daily living tasks developmental course of intellectual disability
(e.g., money management, medical decision (intellectual developmental disorder) is true?
making) without support.
C. Gullibility, with naiveté in social situations and A. Delayed motor, language, and social
a tendency to be easily led by others. milestones are not identifiable until after the first
D. Lack of age-appropriate communication skills 2 years of life.
for social and interpersonal functioning. B. Intellectual disability caused by an illness (e.g.,
E. All of the above are diagnostic features of encephalitis) or by head trauma occurring during
intellectual disability. the developmental period would be diagnosed as
a neurocognitive disorder, not as intellectual
1.7 Which of the following statements about disability (intellectual developmental disorder).
adaptive functioning in the diagnosis of C. Intellectual disability is always nonprogressive.
intellectual disability (intellectual developmental D. Major neurocognitive disorder may co-occur
disorder) is true? with intellectual developmental disorder.
E. Even if early and ongoing interventions
A. Adaptive functioning is based on an throughout childhood and adulthood lead to
individual's IQ score. improved adaptive and intellectual functioning,
B. "Deficits in adaptive functioning" refers to the diagnosis of intellectual disability would
problems with motor coordination. continue to apply.
C. At least two domains of adaptive functioning
must be impaired to meet Criterion B for the 1.10 The DSM-5 diagnosis of intellectual
diagnosis of intellectual disability. developmental disorder includes severity
D. Adaptive functioning in intellectual disability specifiers—Mild, Moderate, Severe, and
tends to improve over time, although the Profound—with which to indicate the level of
threshold of cognitive capacities and associated supports required in various domains of adaptive
developmental disorders can limit it. functioning. Which of the following features would

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not be characteristic of an individual with a D. The patient's impaired adaptive functioning
"Severe" level of impairment? suggests intellectual developmental disorder, but
there is insufficient information about the level of
A. The individual generally has little cognitive impairment measured by standardized
understanding of written language or of concepts instruments.
involving numbers, quantity, time, and money. E. The patient's cognitive and adaptive
B. The individual's spoken language is quite impairments suggest intellectual developmental
limited in terms of vocabulary and grammar. disorder, but there is insufficient information
C. The individual requires support for all activities about age at onset of the condition.
of daily living, including meals, dressing, bathing,
and toileting. 1.13 Which of the following statements about
D. In adulthood, the individual may be able to global developmental delay is true?
sustain competitive employment in a job that
does not emphasize conceptual skills. A. The diagnosis is typically made in children
E. The individual cannot make responsible younger than 5 years of age.
decisions regarding the well-being of self or B. The etiology can usually be determined.
others. C. The prevalence is estimated to be between
0.5% and 2%.
1.11 A 10-year-old boy with a history of dyslexia, D. The condition is progressive.
who is otherwise developmentally normal, is in a E. The condition does not generally occur with
skateboarding accident in which he experiences other neurodevelopmental dis-orders.
severe traumatic brain injury. This results in
significant global intellectual impairment (with a 1.14 A 3½-year-old girl with a history of lead
persistent reading deficit that is more pronounced exposure and a seizure disorder demonstrates
than his other newly acquired but stable deficits, substantial delays across multiple domains of
along with a full-scale IQ of 75). There is mild functioning, including communication, learning,
impairment in his adaptive functioning such that attention, and motor development, which limit her
he requires support in some areas of functioning. ability to interact with same-age peers and
He is also displaying anxious and depressive require substantial support in all activities of daily
symptoms in response to his accident and living at home. Unfortunately, her mother is an
hospitalization. What is the least likely diagnosis? extremely poor historian, and the child has
received no formal psychological or learning
A. Intellectual disability (intellectual evaluation to date. She is about to be evaluated
developmental disorder). for readiness to attend preschool. What is the
B. Traumatic brain injury. most appropriate diagnosis?
C. Specific learning disorder.
D. Major neurocognitive disorder due to traumatic A. Major neurocognitive disorder.
brain injury. B. Developmental coordination disorder.
E. Adjustment disorder. C. Autism spectrum disorder.
D. Global developmental delay.
1.12 In which of the following situations would a E. Specific learning disorder.
diagnosis of global developmental delay be
inappropriate? 1.15 A 5-year-old boy has difficulty making
friends and problems with initiating and
A. The patient is a child who is too young to fully sustaining back-and-forth conversation; reading
manifest specific symp or to complete requisite social cues; and sharing his feelings with others.
assessments. He makes good eye contact, has normal speech
B. The patient, a 7-year-old boy, has a full-scale into-nation, displays facial gestures, and has a
IQ of 65 and severe impairment in adaptive range of affect that generally seems appropriate
functioning. to the situation. He demonstrates an interest in
C. The patient's scores on psychometric tests trains that seems abnormal in intensity and focus,
suggest intellectual disability (in-tellectual and he engages in little imaginative or symbolic
developmental disorder), but there is insufficient play. Which of the following diagnostic
information about the patient's adaptive requirements for autism spectrum disorder are
functional skills. not met in this case?

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A. Deficits in social-emotional reciprocity. season, getting dressed is a difficult activity.
B. Deficits in nonverbal communicative behaviors These symptoms date from early childhood and
used for social interaction. cause significant impairment in her functioning.
C. Deficits in developing and maintaining What diagnosis best fits this child's presentation?
relationships.
D. Restricted, repetitive patterns of behavior, A. Asperger's disorder.
interests, or activities as manifested by symptoms B. Autism spectrum disorder.
in two of the specified four categories. C. Pervasive developmental disorder not
E. Symptoms with onset in early childhood that otherwise specified (NOS).
cause clinically significant impairment. D. Social (pragmatic) communication disorder.
E. Rett syndrome.
1.16 Which of the following statements about the
development and course of autism spectrum 1.19 A 15-year-old boy has a long history of
disorder (ASD) is false? nonverbal communication deficits. As an infant he
was unable to follow someone else directing his
A. Symptoms of ASD are typically recognized attention by pointing. As a toddler he was not
during the second year of life (12-24 months of interested in sharing events, feelings, or games
age). with his parents. From school age into
B. Symptoms of ASD are usually not noticeable adolescence, his speech was odd in tonality and
until 5-6 years of age or later. phrasing, and his body language was awkward.
C. First symptoms frequently involve delayed What do these symptoms represent?
language development, often accompanied by
lack of social interest or unusual social A. Stereotypies.
interactions. B. Restricted range of interests.
D. ASD is not a degenerative disorder, and it is C. Developmental regression.
typical for learning and compensation to continue D. Prodromal schizophreniform symptoms.
throughout life. E. Deficits in nonverbal communicative
E. Because many normally developing young behaviors.
children have strong preferences and enjoy
repetition, distinguishing restricted and repetitive 1.20 A 10-year-old boy demonstrates hand-
behaviors that are diagnostic of ASD can be flapping and finger flicking, and he repetitively
difficult in preschoolers. flips coins and lines up his trucks. He tends to
"echo" the last several words of a question posed
1.17 Which of the following was a criterion to him before answering, mixes up his pronouns
symptom for autistic disorder in DSM-IV that was (refers to himself in the second person), tends to
eliminated from the diagnostic criteria for autism repeat phrases in a perseverative fashion, and is
spectrum disorder in DSM-5? quite fixated on routines related to dress, eating,
travel, and play. He spends hours in his garage
A. Stereotyped or restricted patterns of interest. playing with his father's tools. What do these
B. Stereotyped and repetitive motor mannerisms. behaviors represent?
C. Inflexible adherence to routines.
D. Persistent preoccupation with parts of objects. A. Restricted, repetitive patterns of behaviors,
E. None of the above. interests, or activities characteristic of autism
spectrum disorder.
1.18 A 7-year-old girl presents with a history of B. Symptoms of obsessive-compulsive disorder.
normal language skills (vocabulary and grammar C. Prototypical manifestations of obsessive-
intact) but is unable to use language in a socially compulsive personality.
pragmatic manner to share ideas and feelings. D. Symptoms of pediatric acute-onset
She has never made good eye contact, and she neuropsychiatric syndrome (PANS).
has difficulty reading social cues. Consequently, E. Complex tics.
she has had difficulty making friends, which is
further complicated by her being somewhat 1.21 A 25-year-old man presents with long-
obsessed with cartoon characters, which she standing nonverbal communication deficits,
repetitively scripts. She tends to excessively inability to have a back-and-forth conversation or
smell objects. Because she insists on wearing the share interests in an appropriate fashion, and a
same shirt and shorts every day, regardless of the complete lack of interest in having relationships

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with others. His speech reflects awkward C. Level 1 (requiring support) for social
phrasing and intonation and is mechanical in communication, and level 2 (requiring substantial
nature. He has a history of sequential fixations support) for restricted, repetitive behaviors.
and obsessions with various games and objects D. Level 3 (requiring very substantial support) for
throughout childhood; however, this is not social communication, and level 1 (requiring
currently a major issue for him. This patient meets support) for restricted, repetitive behaviors.
criteria for autism spectrum disorder; true or E. Level 2 (requiring substantial support) for
false? social communication, and level 1 (requiring
support) for restricted, repetitive behaviors.
A. True.
B. False. 1.24 Which of the following is not a specifier
included in the diagnostic criteria for autism
1.22 A 9-year-old girl presents with a history of spectrum disorder?
intellectual impairment, a structural language
impairment, nonverbal communication deficits, A. With or without accompanying intellectual
disinterest in peers, and inability to use language impairment.
in a social manner. She has extreme food and B. With or without associated dementia.
tactile sensitivities. She is obsessed with one C. With or without accompanying language
particular computer game that she plays for hours impairment.
each day, and she scripts and imitates the D. Associated with a known medical or genetic
characters in this game. She is clumsy, has an condition or environmental factor.
odd gait, and walks on her tiptoes. In the past E. Associated with another neurodevelopmental,
year she has developed a seizure disorder and mental, or behavioral disorder.
has begun to bang her wrists against the wall
repetitively, causing bruising. On the other hand, 1.25 Which of the following is not characteristic of
she plays several musical instruments in an the developmental course of children diagnosed
extremely precocious manner. Which feature of with autism spectrum disorder?
this child's clinical presentation fulfills a criterion
symptom for DSM-5 autism spectrum disorder? A. Behavioral features manifest before 3 years of
age.
A. Motor abnormalities. B. The full symptom pattern does not appear until
B. Seizures. age 2-3 years.
C. Structural language impairment. C. Developmental plateaus or regression in
D. Intellectual impairment. social-communicative behavior is frequently
E. Nonverbal communicative deficits. reported by parents.
D. Regression across multiple domains occurs
1.23 An 11-yearold girl with autism spectrum after age 2-3 years.
disorder displays no spoken language and is E. First symptoms often include delayed
minimally responsive to overtures from others. language development, lack of social interest or
She can be somewhat inflexible, which interferes unusual social behavior, odd play, and unusual
with her ability to travel, do schoolwork, and be communication patterns.
managed in the home; she has some difficulty
transitioning; and she has trouble organizing and 1.26 A 5-year-old girl has some mild food
planning activities. These problems can usually aversions. She enjoys having the same book
be managed with incentives and reinforcers. read to her at night but does not become terribly
What severity levels should be specified in the upset if her mother asks her to choose a different
DSM-5 diagnosis? book. She occasionally spins around excitedly
when her favorite show is on. She generally likes
A. Level 3 (requiring very substantial support) for her toys neatly arranged in bins but is only mildly
social communication, and level 1 (requiring upset when her sister leaves them on the floor.
support) for restricted, repetitive behaviors. These behaviors should be considered
B. Level 1 (requiring support) for social suspicious for an autism spectrum disorder; true
communication, and level 3 (requiring very or false?
substantial support) for restricted, repetitive
behaviors. A. True.
B. False.

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1.27 Which of the following is not representative A. Attention-deficit / hyperactivity disorder
of the typical developmental course for autism (ADHD).
spectrum disorder? B. Rett syndrome.
C. Selective mutism.
A. Lack of degenerative course. D. Intellectual disability (intellectual
B. Behavioral deterioration during adolescence. developmental disorder).
C. Continued learning and compensation E. Stereotypic movement disorder.
throughout life.
D. Marked presence of symptoms in early 1.31 Which of the following is not a criterion for
childhood and early school years, with the DSM-5 diagnosis of attention-
developmental gains in later childhood in areas deficit/hyperactivity disorder (ADHD)?
such as social interac-tion.
E. Good psychosocial functioning in adulthood, A. Onset of several inattentive or hyperactive-
as indexed by independent living and gainful impulsive symptoms prior to age 12 years.
employment. B. Manifestation of several inattentive or
hyperactive-impulsive symptoms in two or more
1.28 A 21-year-old man, not previously settings (e.g., at home, school, or work; with
diagnosed with a developmental disorder, friends or rela-tives; in other activities).
presents for evaluation after taking a leave from C. Persistence of symptoms for at least 12
college for psychological rea-sons. He makes months.
little eye contact, does not appear to pick up on D. Clear evidence that symptoms interfere with,
social cues, has become disinterested in friends, or reduce the quality of, so-cial, academic, or
spends hours each day on the computer surfing occupational functioning.
the Internet and playing games, and has become E. Inability to explain symptoms as a
so sensitive to smells that he keeps multiple air manifestation of another mental disorder (e.g.,
fresheners in all locations of the home. He reports mood disorder, anxiety disorder, dissociative
that he has had long-standing friendships dating disorder, personality disorder, substance
from childhood and high school (corroborated by intoxication or withdrawal).
his parents). He reports making many friends in
his fraternity at college. His parents report good 1.32 The parents of a 15-year-old female tenth
social and communication skills in child-hood, grader believe that she should be doing better in
although he was quite shy and was somewhat high school, given how bright she seems and the
inflexible and ritualistic at home. What is the least fact that she received mostly A's through eighth
likely diagnosis? grade. Her papers are handed in late, and she
makes careless mistakes on examinations. They
A. Depression. have her tested, and the WAIS-IV results are as
B. Schizophreniform disorder or schizophrenia. follows: Verbal IQ, 125; Perceptual Reasoning
C. Autism spectrum disorder. Index, 122; Full-Scale IQ, 123; Working Memory
D. Obsessive-compulsive disorder. Index, 55th percentile; Processing Speed Index,
E. Social anxiety disorder (social phobia). 50th percentile. Weaknesses in executive
function are noted. During a psychiatric
1.29 Which of the following characteristics is evaluation, she reports a long history of failing to
generally not associated with autism spectrum give close attention to details, difficulty sustaining
disorder? attention while in class or doing homework, failing
to finish chores and tasks, and significant
A. Anxiety, depression, and isolation as an adult. difficulties with time management, planning, and
B. Catatonia. organization. She is forgetful, often loses things,
C. Poor psychosocial functioning and is easily distracted. She has no history of
D. Insistence on routines and aversion to change. restlessness or impulsivity, and she is well liked
E. Successful adaptation in regular school by her peers. What is the most likely diagnosis?
settings. to details, difficulty sustaining attention while in
class or doing homework, failing to finish chores
1.30 Which of the following disorders is generally and tasks, and significant difficulties with time
not comorbid with autism spectrum disorder management, planning, and organization. She is
(ASD)? forgetful, often loses things, and is easily
distracted. She has no history of restlessness or

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impulsivity, and she is well liked by her peers. during business meetings, for which he is often
What is the most likely diagnosis? late; he is forgetful and disorganized.
Nevertheless, he tends to perform fairly well and
A. Adjustment disorder with anxiety. is quite successful, although he can occasionally
B. Specific learning disorder. feel overwhelmed and demoralized. What is the
C. Attention-deficit / hyperactivity disorder, most likely diagnosis?
predominantly inattentive.
D. Developmental coordination disorder. A. Major depressive disorder.
E. Major depressive disorder. B. Generalized anxiety disorder.
C. Specific learning disorder.
1.33 A 7-year-old boy is having behavioral and D. ADHD, in partial remission.
social difficulties in his second-grade class. E. Oppositional defiant disorder.
Although he seems to be able to attend and is
doing "well" from an academic standpoint (though 1.35 A 5-year-old hyperactive, impulsive, and
seemingly not what he is capable of), he is inattentive boy presents with hypertelorism,
constantly interrupting, fidgeting, talking highly arched palate, and low-set ears. He is
excessively, and getting out of his seat. He has uncoordinated and clumsy, he has no sense of
friends, but he sometimes annoys his peers time, and his toys and clothes are constantly
because of his difficulty sharing and taking turns strewn all over the house. He has recently
and the fact that he is constantly talking over developed what appears to be a motor tic
them. Although he seeks out play dates, his involving blinking. He enjoys playing with peers,
friends tire of him because he wants to play sports who tend to like him, although he seems to
nonstop. At home, he can barely stay in his seat willfully defy all requests from his parents and
for a meal and is unable to play quietly. Although kindergarten teacher, which does not seem to be
he shows remorse when the consequences of his due simply to inattention. He is delayed in
behavior are pointed out to him, he can become beginning to learn how to read. What is the least
angry in response and seems nevertheless likely diagnosis?
unable to inhibit himself. What is the most likely
diagnosis? A. Autism spectrum disorder.
B. Developmental coordination disorder.
A. Bipolar disorder. C. Oppositional defiant disorder (ODD).
B. Autism spectrum disorder. D. Specific learning disorder.
C. Generalized anxiety disorder. E. Attention-deficit/ hyperactivity disorder
D. Attention-deficit/ hyperactivity disorder, (ADHD).
predominantly hyperactive/ im-pulsive.
E. Specific learning disorder. 1.36 What is the prevalence of attention-deficit/
hyperactivity disorder (ADHD) in children?
1.34 A 37-year-old Wall Street trader schedules a
visit after his 8-year-old son is diagnosed with A. 8%.
attention-deficit/ hyperactivity disorder (ADHD), B. 10%.
combined inattentive and hyperactive. Although C. 2%.
he does not currently note motor restlessness like D. 0.5%.
his son, he recalls being that way when he was a E. 5%.
boy, along with being quite inattentive, being
impulsive, talking excessively, interrupting, and 1.37 What is the prevalence of attention-deficit /
having problems waiting his turn. He was an hyperactivity disorder (ADHD) in adults?
underachiever in high school and college, when
he inconsistently did his work and had difficulty A. 8%.
following rules. Nevertheless, he never failed any B. 10%.
classes, and he was never evaluated by a C. 2.5%.
psychologist or psychiatrist. He works about 60- D. 0.5%.
80 hours a week and often gets insufficient sleep. E. 5%.
He tends to make impulsive business decisions,
can be impatient and short-tempered, and notes
that his mind tends to wander both in one-on-one
interactions with associates and his wife and

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1.38 What is the gender ratio of attention-deficit / A. Bipolar disorder.
hyperactivity disorder (ADHD) in children? B. Specific learning disorder.
C. Attention-deficit/ hyperactivity disorder
A. Male: female ratio of 2:1. (ADHD).
B. Male: female ratio of 1:1. D. Adjustment disorder with mixed anxiety and
C. Male: female ratio of 3:2. depressed mood.
D. Male: female ratio of 5:1. E. Separation anxiety disorder.
E. Male: female ratio of 1:2.
1.43 A 5-year-old boy is consistently moody,
1.39 Which of the following is a biological finding irritable, and intolerant of frustration.
in individuals with attention-deficit/hyperactivity In addition, he is pervasively and chronically
disorder (ADHD)? restless, impulsive, and inattentive. Which
diagnosis best fits his clinical picture?
A. Decreased slow-wave activity on
electroencephalograms. A. Attention-deficit/ hyperactivity disorder
B. Reduced total brain volume on magnetic (ADHD).
resonance imaging. B. ADHD and disruptive mood dysregulation
C. Early posterior to anterior cortical maturation. disorder (DMDD).
D. Reduced thalamic volume. C. Bipolar disorder.
E. Both B and C. D. Oppositional defiant disorder (ODD).
E. Major depressive disorder (MDD).
1.40 Which of the following is not associated with
attention-deficit/ hyperactivity disorder (ADHD)? 1.44 Which of the following statements about
comorbidity in attention-deficit/hyperactivity
A. Reduced school performance. disorder (ADHD) is true?
B. Poorer occupational performance and
attendance. A. Oppositional defiant disorder co-occurs with
C. Higher probability of unemployment. ADHD in about half of children with the combined
D. Elevated interpersonal conflict. presentation and about a quarter of those with the
E. Reduced risk of substance use disorders. predominantly inattentive presentation.
B. Most children with disruptive mood
1.41 Which of the following is not associated with dysregulation disorder do not also meet criteria
attention-deficit/hyperactivity disorder (ADHD)? for ADHD.
C. Fifteen percent of adults with ADHD have
A. Social rejection. some type of anxiety disorder.
B. Increased risk of developing conduct disorder D. Intermittent explosive disorder occurs in about
in childhood and antisocial personality disorder in 5% of adults with ADHD.
adulthood. E. Specific learning disorder very seldom co-
C. Increased risk of Alzheimer's disease. occurs with ADHD.
D. Increased frequency of traffic accidents and
violations. 1.45 Specific learning disorder is defined by
E. Increased risk of accidental injury. persistent difficulties in learning academic skills,
with onset during the developmental period.
1.42 A 15-year-old boy has developed Which of the following statements about this
concentration problems in school that have been disorder is true?
associated with a significant decline in grades.
When interviewed, he explains that his mind is A. It is part of a more general learning impairment
occupied with worrying about his mother, who as manifested in intellectual disability (intellectual
has a serious autoimmune disease. As his grades developmental disorder).
falter, he becomes increasingly demoralized and B. It can usually be attributed to a sensory,
sad, and he notices that his energy level drops, physical, or neurological disorder.
further compromising his ability to pay attention in C. It involves pervasive and wide-ranging deficits
school. At the same time, he complains of feeling across multiple domains of information
restless and unable to sleep. What is the most processing.
likely diagnosis? D. It can be caused by external factors such as
economic disadvantage or lack of education.

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E. It replaces the DSM-IV diagnoses of reading A. Prevalence rates range from 5% to 15%
disorder, mathematics disorder, disorder of among school-age children across languages
written expression, and learning disorder not and cultures.
otherwise specified. B. Prevalence in adults is approximately 4%.
C. Specific learning disorder is equally common
1.46 In distinction to DSM-IV, DSM-5 classifies all among males and females.
learning disorders under the diagnosis of specific D. Prevalence rates vary according to the range
learning disorder, along with the requirement to of ages in the sample, selection criteria, severity
"specify all academic domains and subskills that of specific learning disorder, and academic
are impaired" at the time of assessment. Which of domains inves-tigated.
the following statements about specific learning E. Gender ratios cannot be attributed to factors
disorder is false? such as ascertainment bias, definitional or
measurement variation, language, race, or
A. There are persistent difficulties in the socioeconomic status.
acquisition of reading, writing, arithmetic, or
mathematical reasoning skills during the formal 1.49 Which of the following statements about
years of schooling. comorbidity in specific learning disorder is true?
B. Current skills in one or more of these academic
areas are well below the average range for the A. Attention-deficit/ hyperactivity disorder (ADHD)
individual's age, gender, cultural group, and level does not co-occur with specific learning disorder
of education. more frequently than would be expected by
C. There usually is a discrepancy of more than 2 chance.
standard deviations (SD) between achievement B. Speech sound disorder and specific language
and IQ. impairments are not commonly comorbid with
D. The learning difficulties significantly interfere specific learning disorder.
with academic achievement, occupational C. Identified clusters of co-occurrences include
performance, or activities of daily living that severe reading disorders; fine motor problems
require these academic skills. and handwriting problems; and problems with
E. The learning difficulties cannot be acquired arithmetic, reading, and gross motor planning.
later in life. D. The co-occurrence of specific learning
disorder and specific language impairments has
1.47 Which of the following statements about the been shown in up to 20% of children with
diagnosis of specific learning disorder is false? language problems.
E. Co-occurring disorders generally do not
A. Specific learning disorder is distinct from influence the course or treatment of specific
learning problems associated with a learning disorder.
neurodegenerative cognitive disorder.
B. If intellectual disability (intellectual 1.50 Which of the following statements about
developmental disorder) is present, the learning developmental coordination disorder (DCD) is
difficulties must be in excess of those expected. true?
C. An uneven profile of abilities is typical in
specific learning disorder. A. Some children with DCD show additional
D. Attentional difficulties and motor clumsiness (usually suppressed) motor ac-tivity, such as
that are subthreshold for at-tention-deficit/ choreiform movements of unsupported limbs or
hyperactivity disorder or developmental mirror movements.
coordination disorder are frequently associated B. The prevalence of DCD in children ages 5-11
with specific learning disorder. years is 1%-3%.
E. There are four formal subtypes of specific C. In early adulthood, there is improvement in
learning disorder. learning new tasks involving complex/automatic
motor skills, including driving and using tools.
1.48 Which of the following statements about D. DCD has no association with prenatal
prevalence rates for specific learning disorder is exposure to alcohol or with low birth weight or
false? preterm birth.
E. Impairments in underlying
neurodevelopmental processes have not been
found to primarily affect visuomotor skills.

@wundterhooman
 1.54 Which of the following is a DSM-5 diagnostic
1.51 Which of the following statements about criterion for Tourette's disorder?
developmental coordination disorder (DCD) is
true? A. Tics occur throughout a period of more than 1
year, and during this period there was never a tic-
A. The disorder is usually not diagnosed before free period of more than 3 consecutive months.
the age of 7 years. B. Onset is before age 5 years.
B. Symptoms have usually improved significantly C. The tics may wax and wane in frequency but
at 1-year follow-up. have persisted for more than
C. In most cases, symptoms are no longer 1 year since first tic onset.
evident by adolescence. D. Motor tics must precede vocal tics.
D. DCD has no clear relationship with prenatal E. The tics may occur many times a day for at
alcohol exposure, preterm birth, or low birth least 4 weeks, but no longer than 12 consecutive
weight. months.
E. Cerebellar dysfunction is hypothesized to play
a role in DCD. 1.55 At her child's third office visit, the mother of
an 8-year-old boy with a 6-month history of
1.52 Which of the following is not a criterion for excessive eye blinking and intermittent chirping
the DSM-5 diagnosis of stereotypic movement says that she has noticed the development of
disorder? grunting sounds since he started school this term.
What is the most likely diagnosis?
A. Motor behaviors are present that are repetitive,
seemingly driven, and apparently purposeless. A. Tourette's disorder.
B. Onset of the behaviors is in the early B. Provisional tic disorder.
developmental period. C. Temporary tic disorder.
C. The behaviors result in self-inflicted bodily D. Persistent (chronic) vocal tic disorder.
injury that requires medical treatment. E. Transient tic disorder, recurrent.
D. The behaviors are not attributable to the
physiological effects of a substance or 1.56 A 5-year-old girl is referred to your care with
neurological condition or better explained by a DSM-IV diagnosis of chronic motor or vocal tic
another neurodevelopmental or mental disorder. disorder. Under DSM-5, she would meet criteria
E. The behaviors interfere with social, academic, for persistent (chronic) motor or vocal tic disorder.
or other activities. Which of the following statements about her new
diagnosis under DSM-5 is false?
1.53 Which of the following statements about the
developmental course of stereotypic movement A. She may have single or multiple motor or vocal
disorder is false? tics, but not both.
B. Her tics must persist for more than 1 year since
A. The presence of stereotypic movements may first tic onset without a tic-free period for 3
indicate an undetected neuro-developmental consecutive months to meet diagnostic criteria.
problem, especially in children ages 1-3 years. C. Her tics may wax and wane in frequency but
B. Among typically developing children, the have persisted for more than
repetitive movements may be stopped when 1 year since first tic onset.
attention is directed to them or when the child is D. She has never met criteria for Tourette's
distracted from performing them. disorder.
C. In some children, the stereotypic movements E. A specifier may be added to the diagnosis of
would result in self-injury if protective measures persistent (chronic) motor or vocal tic disorder to
were not used. indicate whether the girl has motor or vocal tics.
D. Whereas simple stereotypic movements (e.g.,
rocking) are common in young typically 1.57 A highly functional 20-year-old college
developing children, complex stereotypic student with a history of anxiety symptoms and
movements are much less common attention-deficit/hyperactivity disorder, for which
(approximately 3% 4%). she is prescribed lisdexamfetamine (Vyvanse),
E. Stereotypic movements typically begin within tells her psychiatrist that she has been
the first year of life. researching the side effects of her medication for
one of her class projects. In addition, she says

@wundterhooman
that for the past week she has been feeling understanding nonverbal social cues. What is the
stressed by her schoolwork, and her friends have most likely diagnosis?
been asking her why she intermittently bobs her
head up and down multiple times a day. What is A. Selective mutism.
the most likely diagnosis? B. Global developmental delay.
C. Speech sound disorder.
A. Provisional tic disorder. D. Avoidant personality disorder.
B. Unspecified tic disorder. E. Unspecified anxiety disorder.
C. Unspecified anxiety disorder.
D. Obsessive-compulsive personality disorder. 1.61 A 6-year-old boy is failing school and
E. Unspecified stimulant-induced disorder. continues to struggle significantly with grammar,
sentence construction, and vocabulary. When he
1.58 Which of the following is not a DSM-5 speaks, he also interjects "and" in between all his
diagnostic criterion for language disorder? words. His teacher reports that he requires more
verbal redirection than other students in order to
A. Persistent difficulties in the acquisition and use stay on task. He is generally quiet and does not
of language across modalities due to deficits in cause trouble otherwise. Which of the following
comprehension or production. diagnoses would be on your differential?
B. Language abilities that are substantially and
quantifiably below those expected for age. A. Language disorder.
C. Symptom onset in the early developmental B. Expressive language disorder.
period. C. Childhood-onset fluency disorder.
D. Inability to attribute difficulties to hearing or D. Attention-deficient / hyperactivity disorder
other sensory impairment, motor dysfunction, or (ADHD).
another medical or neurological condition. E. A and D.
E. Failure to meet criteria for mixed receptive-
expressive language disorder or a pervasive 1.62 Which of the following types of disturbance
developmental disorder. in normal speech fluency/ time patterning
included in the DSM-IV criteria for stuttering was
1.59 Which of the following statements about omitted in the DSM-5 criteria for childhood-onset
speech sound disorder is true? fluency disorder (stuttering)?

A. Speech sound production must be present by A. Sound prolongation.

age 2 years. B. Circumlocution.
B. "Failure to use developmentally expected C. Interjections.
speech sounds" is assessed by comparison of a D. Words produced with an excess of physical
child with his or her peers of the same age and tension.
dialect. E. Sound and syllable repetitions.
C. The difficulties in speech sound production
need not result in functional impairment to meet 1.63 A 14-year-old boy in regular education tells
diagnostic criteria. you that he thinks a girl in class likes him. His
D. Symptom onset is in the early developmental mother is surprised to hear this, because she
period. reports that, since a young age, he has often
E. Both A and C are true. struggled with making inferences or
understanding nuances from what other people
1.60 A mother brings her 4-year-old son to you for say. The teacher has also noticed that he
an evaluation with concerns that her son has sometimes misses nonverbal cues. He tends to
struggled with speech articulation since very get along better with adults, perhaps because
young. He has not sustained any head injuries, is they are not as likely to be put off by his overly
otherwise healthy, and has a normal IQ. His formal speech. When he makes jokes, his peers
preschool teacher reports that she does not do not always find the humor appropriate.
always understand what he is saying and that Although he enjoys spending time with his best
other children tease him by calling him a "baby" friend, he can be talkative and struggles with
due to his difficulty with communication. He does taking turns in conversation. What is the most
not have trouble relating to other people or likely diagnosis?

@wundterhooman
A. Social (pragmatic) communication disorder. B. Obsessive-compulsive and related disorders.
B. Asperger's disorder. C. Other movement disorders.
C. Autism spectrum disorder. D. Depressive disorders.
D. Social anxiety disorder. E. All of the above.
E. Language disorder.
1.68 By what age should most children have
1.64 A 15-year-old boy with a prior diagnosis of acquired adequate speech and language ability
Tourette's disorder is referred to your care. His to understand and follow social rules of verbal
mother tells you that during middle school he was and nonverbal communication, follow rules for
teased for having vocal and motor tics. Since conversation and storytelling, and change
starting ninth grade, his tics have become less language according to the needs of the listener or
frequent. Currently, only mild motor tics remain. situation?
What is the appropriate DSM-5 diagnosis?
A. Ages 2-3 years.
A. Tourette's disorder. B. Ages 3-4 years.
B. Persistent (chronic) motor tic disorder. C. Ages 4-5 years.
C. Provisional tic disorder. D. Ages 5-6 years.
D. Unspecified tic disorder. E. Ages 6-7 years.
E. Persistent (chronic) vocal tic disorder.
1.69 Having a family history of which of the
1.65 Tics typically present for the first time during following psychiatric disorders increases an
which developmental stage? individual's risk of social (pragmatic)
communication disorder?
A. Infancy.
B. Prepuberty. A. Social anxiety disorder (social phobia).
C. Latency. B. Autism spectrum disorder.
D. Adolescence. C. Attention-deficit/ hyperactivity disorder
E. Adulthood. (ADHD).
D. Specific learning disorder.
1.66 A 7-year-old boy who has speech delays E. Either B or D.
presents with long-standing, repetitive hand
waving, arm flapping, and finger wiggling. His 1.70 A 6-year-old boy with a history of mild
mother reports that she first noticed these language delay is brought to your office by his
symptoms when he was a toddler and wonders mother, who is concerned that he is being teased
whether they are tics. She says that he tends to in school because he misinterprets nonverbal
flap more when he is engrossed in activities, such cues and speaks in overly formal language with
as while watching his favorite television program, his peers. She tells you that her son was in an
but will stop when called or distracted. Based on early intervention program, but his written and
the mother's report, which of the following spoken language is now at grade level. The boy
conditions would be highest on your list of does not have a history of repetitive movements,
possible diagnoses? sensory issues, or ritualized behaviors. Although
he prefers constancy, he adapts fairly well to new
A. Provisional tic disorder. situations. Addition-ally, he has a long-standing
B. Persistent (chronic) motor or vocal tic disorder. interest in trains and cars and is able to recite for
C. Chorea. you all the car models he memorized from a book
D. Dystonia. on the history of transportation. Which of the
E. Motor stereotypies. following disorders would be a primary
consideration in the differential diagnosis?
1.67 Assessment of co-occurring conditions is
important for understanding the overall functional A. Social (pragmatic) communication disorder.
consequence of tics on an individual. Which of the B. Autism spectrum disorder.
following conditions has been associated with tic C. Global developmental delay.
disorders? D. Language disorder.
E. A and B.
A. Attention-deficit/ hyperactivity disorder
(ADHD).

@wundterhooman
1.71 Below what age is it difficult to distinguish a D. Motor movements are not associated with this
language disorder from normal developmental disorder.
variations? E. None of the above.

A. Age 2 years.
B. Age 3 years.
C. Age 4 years.
D. Age 5 years.
E. Age 6 years.

1.72 Which of the following psychiatric diagnoses

is strongly associated with language disorder?

A. Attention-deficit/ hyperactivity disorder.

B. Developmental coordination disorder.
C. Autism spectrum disorder.
D. Social (pragmatic) communication disorder.
E. All of the above.

1.73 Which of the following statements about the

development of speech as it applies to speech
sound disorder is false?

A. Most children with speech sound disorder

respond well to treatment.
B. Speech sound production should be mostly
intelligible by age 3 years.
C. Most speech sounds should be pronounced
clearly and accurately according to age and
community norms before age 10 years.
D. Lisping may or may not be associated with
speech sound disorder.
E. It is abnormal for children to shorten words
when they are learning to talk.

1.74 Which of the following would likely not be an

important condition to rule out in the differential
diagnosis of speech sound disorder?

A. Normal variations in speech.

B. Hearing or other sensory impairment.
C. Dysarthria.
D. Depression.
E. Selective mutism.

1.75 Which of the following statements about the

development of childhood-onset fluency disorder
(stuttering) is true? ANSWERS:
1-10. ACBBE ADCDD
A. Stuttering occurs by age 6 for 80%-90% of 11-20. DBADB BDBEA
affected individuals. 21-30. AEABD BBCEC
B. Stuttering always begin abruptly and is 31-40. CCDDA ECABE
noticeable to everyone. 41-50. CDBAE CECCA
C. Stress and anxiety do not exacerbate 51-60. ECECB BBEDC
disfluency. 61-70. ECAAB EECEA
71-75. CEEDA

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