47.272 Abnormal Psychology                        Final Exam

Exams must be typed. Completed exams must be submitted by 11:30 a.m., Friday, May 25.  Late exams will not be accepted.

Clearly designate by number each question you answer.  Make sure that you do not repeat yourself; you cannot get credit for using the same information in more than one answer.  Be sure that your answers are based on and include explicit reference to substantive material that you have learned in this course.  Wherever possible, use appropriate technical terms and make reference to specific concepts, theories, principles, research studies, etc.  In other words, don't just rely on your common sense, and don't just throw out some clever sounding "psychobabble." As always, answers must be in your own words; do not quote from the readings, and do not discuss this exam with other students or in any way use their words or ideas.

1. Read the following brief summary of a recent case from my files, but imagine that you are the psychologist and that this is your case, not mine.  The summary below is taken from information gathered during an initial office visit:
 

Carol is 39 years old.  She states that she called to make this appointment with you because she is worried about feeling increasingly anxious and depressed for the past several months, ever since she began to believe that her husband was an alcoholic.  A working mother of two teenage children, Carol expresses her concern that she is not functioning well at work and fears that she might lose her job.  She is terrified at the prospect that her marriage might be falling apart, and she worries about how her children are doing and whether her problems with her husband might “scar them for life.” She feels like she is not being a very good mother and is concerned that she might be on the verge of a “breakdown.”

In response to your questions, Carol also acknowledges that she has had other "rough" periods in her life, though she is not sure that she has ever felt exactly this way before. When asked by you to describe herself, Carol states that she thinks of herself as "weak," because she has always tended to rely on others and to let others make her decisions for her. Referring to herself as "painfully shy," Carol reports that she did not have a lot of friends when she was younger, and that she always lacked self-confidence. In high school, she linked up with a bad crowd, desperately seeking acceptance, and this led to a period of what she describes as “experimental” alcohol and drug use.

She says she dated very little and was very uncomfortable with boys.  In fact, she says sadly, she married her husband not so much because she was "madly in love" with him, but because she figured he was the only one who would ever ask her.  She says that she thinks maybe she married him also because she dreaded the thought of spending her life as a “spinster.”

Asked about her family growing up, Carol says she sees herself as just like her mother, who also experienced serious marital problems and who was psychiatrically hospitalized while in her 30s. She also states that she has often thought that maybe her own father had been an alcoholic, though he was never actually diagnosed or in treatment.  She mentions two older siblings, who she says were always much smarter and have been far more successful in their lives.

When asked by you to say more about her current difficulties, Carol says that she has not been sleeping well and also that she has lost some weight.  She worries a lot about her marriage and what her husband, who works long hours, is doing when he's away.  She suspects that he is out drinking, and she also fears that maybe he has cheated on her. At the same time, she blames herself, saying that she's not been a very good sexual or romantic partner.  With some additional probing from you, Carol reluctantly admits that maybe she tends to drink more than she should. To top it all off, Carol complains of feeling physically very weak ("like I'm recovering from the flu or something"), but she has not seen a doctor because she's afraid of what she might discover.

a) What do you think is the most appropriate DSM Axis I diagnosis for Carol?  Justify your diagnosis not only in terms of the information provided, but also by indicating what else would have to be true of Carol for your diagnosis to be legitimate. Be sure to use explicit DSM criteria to support your choice.
b) DSM allows for more than one diagnosis.  If you were to decide that Carol warrants an additional Axis I diagnosis, what would it be?  Again, justify your diagnosis both on the basis of what you know about Carol as well as by describing what else would have to be true to support your diagnosis, using explicit DSM criteria.
c) What diagnosis might you give Carol on Axis II, and explain the possible relationship that might exist between her Axis II diagnosis and her Axis I problems.
d) How important do you think it is that you have diagnosed Carol correctly?  Give at least one reason why you should emphasize making the right diagnosis.
e) In terms of your experience trying to arrive at a diagnosis for this case, discuss why diagnosis maybe isn't so important or valid.
f) Consider again your primary diagnosis of Carol. Drawing on current theory and research for that area of psychopathology, describe one specific possible cause for her condition and justify your choice.

Select one (1) of the following and answer in a thoughtful essay of no more than 750 words.

2. Throughout this semester, we have learned that there is a great deal of emphasis on the possible role of brain chemistry in the etiology of many forms of psychopathology.  Select two specific forms of psychopathology (two specific mental disorders) for which you believe there is particularly strong evidence of a so-called  “chemical imbalance”, and then describe and explain those factors and some of the research evidence that points to their importance.

3. In recent years, psychologists have identified several possible ways in which many forms of psychopathology might be influenced by learning and by cognitive factors.  Select two specific theories which emphasize the role of learning and/or cognition, and then explain how each theory might help us to understand a specific form of psychopathology or a specific mental disorder.

4. All too often, people want to explain mental disorders in terms of one simple cause (a defective gene or some early trauma or positive reinforcement or the influence of the mass media, etc.).  However, it seems much more likely that mental disorders result from multiple combinations of different factors.  Select one specific disorder or form of psychopathology and then show how our understanding of its etiology might depend on an integration of a biological factor, a psychological factor and a socio-cultural factor.

5. People with psychological problems who know they need professional help often become confused when trying to figure out what sort of help to seek.  Look back at the case of Carol, and then briefly summarize what some of her treatment options are and why she might want to consider or avoid a particular type of treatment. Also explain some of the reasons why figuring out what works can be so confusing, as well as why it might not be all that critical which treatment she chooses.

REMEMBER TO IDENTIFY YOUR ANSWERS BY THE APPROPRIATE NUMBER FOR EACH QUESTION
 

Copyright ©1998 Beverly J. Volicer and Steven F. Tello, UMass Lowell.  You may freely edit these pages  for use in a non-profit, educational setting.  Please include this copyright notice on all pages.