COUC 546 Exam 4 V2 | COUC 546 Psychopathology | Actual Q&A with
Rationale (COUC546 Exam 4) | Liberty University
1. A 25-year-old male presents with a pervasive pattern of detachment from social
relationships and a restricted range of expression of emotions. He expresses no desire for
close relationships, including being part of a family. Which diagnosis is most appropriate?
A. Schizotypal Personality Disorder
B. Avoidant Personality Disorder
C. Schizoid Personality Disorder
D. Paranoid Personality Disorder
Answer: C
Explanation: Schizoid Personality Disorder is characterized by a pervasive pattern of
detachment and limited emotional expression. Unlike Avoidant Personality Disorder,
individuals with Schizoid PD do not desire social contact. This diagnosis requires that the
pattern is not better explained by another mental disorder like Schizophrenia.
2. Which criterion is mandatory for a diagnosis of Antisocial Personality Disorder?
A. Evidence of Attention-Deficit/Hyperactivity Disorder before age 12
B. The individual is at least 21 years of age
C. Evidence of Conduct Disorder with onset before age 15
D. A history of at least one manic episode
Answer: C
Explanation: To diagnose Antisocial Personality Disorder, there must be evidence of
Conduct Disorder with onset before age 15. The individual must also be at least 18 years
old to receive the diagnosis officially. This requirement highlights the developmental
trajectory of antisocial behaviors from childhood into adulthood.
3. A patient exhibits a pervasive pattern of instability in interpersonal relationships, self-
image, and affects, along with marked impulsivity. They report chronic feelings of emptiness
and recurrent suicidal behavior. What is the likely diagnosis?
A. Borderline Personality Disorder
B. Histrionic Personality Disorder
C. Narcissistic Personality Disorder
D. Dependent Personality Disorder
,Answer: A
Explanation: Borderline Personality Disorder is defined by instability in relationships,
self-image, and mood. The presence of chronic emptiness and self-harming behaviors are
core features of the DSM-5-TR criteria. Effective treatment often involves Dialectical
Behavior Therapy (DBT) to address emotional dysregulation.
4. In Neurodevelopmental Disorders, Intellectual Disability (Intellectual Developmental
Disorder) severity is determined by which of the following?
A. IQ test scores alone
B. Educational attainment levels
C. The presence of comorbid physical disabilities
D. Adaptive functioning in conceptual, social, and practical domains
Answer: D
Explanation: The DSM-5 moved away from using IQ scores as the primary determinant for
severity levels in Intellectual Disability. Instead, severity (Mild, Moderate, Severe,
Profound) is based on adaptive functioning across several life domains. This shift
emphasizes the level of support an individual requires in daily life.
5. A 10-year-old child demonstrates a persistent pattern of inattention and hyperactivity that
interferes with functioning in both school and home settings. Symptoms have been present
for 8 months. What is the most likely diagnosis?
A. Oppositional Defiant Disorder
B. Attention-Deficit/Hyperactivity Disorder
C. Autism Spectrum Disorder
D. Specific Learning Disorder
Answer: B
Explanation: ADHD requires a persistent pattern of inattention and/or hyperactivity-
impulsivity for at least 6 months. Symptoms must be present in two or more settings, such
as home and school, and have an onset prior to age 12. Clinicians must rule out other
disruptive behavior disorders before finalizing this diagnosis.
6. Which disorder is characterized by a disturbance in attention and awareness that develops
over a short period of time and tends to fluctuate in severity during the course of a day?
A. Major Neurocognitive Disorder
B. Delirium
C. Mild Neurocognitive Disorder
, D. Alzheimer’s Disease
Answer: B
Explanation: Delirium is a medical emergency characterized by an acute disturbance in
attention and cognition. It typically fluctuates in severity and is caused by a physiological
consequence of another medical condition or substance. Unlike dementia, delirium has a
rapid onset and is often reversible if the underlying cause is treated.
7. A 70-year-old male shows significant cognitive decline in executive function and memory.
He can no longer manage his finances or medications independently. This represents which of
the following?
A. Mild Neurocognitive Disorder
B. Age-related cognitive decline
C. Major Neurocognitive Disorder
D. Dissociative Amnesia
Answer: C
Explanation: Major Neurocognitive Disorder is diagnosed when there is significant
cognitive decline from a previous level of performance. The critical factor is that the
cognitive deficits interfere with independence in everyday activities. If the deficits did not
interfere with independence, the diagnosis would be Mild Neurocognitive Disorder.
8. Which Paraphilic Disorder involves the act of observing an unsuspecting person who is
naked, in the process of disrobing, or engaging in sexual activity?
A. Exhibitionistic Disorder
B. Frotteuristic Disorder
C. Sexual Sadism Disorder
D. Voyeuristic Disorder
Answer: D
Explanation: Voyeuristic Disorder involves recurrent and intense sexual arousal from
observing an unsuspecting person in private situations. To meet the diagnosis, the
individual must have acted on these urges with a nonconsenting person or experience
significant distress. The behavior must have persisted for at least 6 months.
9. A person who experiences intense sexual arousal from the exposure of their genitals to an
unsuspecting person would be diagnosed with:
A. Exhibitionistic Disorder
B. Voyeuristic Disorder
Rationale (COUC546 Exam 4) | Liberty University
1. A 25-year-old male presents with a pervasive pattern of detachment from social
relationships and a restricted range of expression of emotions. He expresses no desire for
close relationships, including being part of a family. Which diagnosis is most appropriate?
A. Schizotypal Personality Disorder
B. Avoidant Personality Disorder
C. Schizoid Personality Disorder
D. Paranoid Personality Disorder
Answer: C
Explanation: Schizoid Personality Disorder is characterized by a pervasive pattern of
detachment and limited emotional expression. Unlike Avoidant Personality Disorder,
individuals with Schizoid PD do not desire social contact. This diagnosis requires that the
pattern is not better explained by another mental disorder like Schizophrenia.
2. Which criterion is mandatory for a diagnosis of Antisocial Personality Disorder?
A. Evidence of Attention-Deficit/Hyperactivity Disorder before age 12
B. The individual is at least 21 years of age
C. Evidence of Conduct Disorder with onset before age 15
D. A history of at least one manic episode
Answer: C
Explanation: To diagnose Antisocial Personality Disorder, there must be evidence of
Conduct Disorder with onset before age 15. The individual must also be at least 18 years
old to receive the diagnosis officially. This requirement highlights the developmental
trajectory of antisocial behaviors from childhood into adulthood.
3. A patient exhibits a pervasive pattern of instability in interpersonal relationships, self-
image, and affects, along with marked impulsivity. They report chronic feelings of emptiness
and recurrent suicidal behavior. What is the likely diagnosis?
A. Borderline Personality Disorder
B. Histrionic Personality Disorder
C. Narcissistic Personality Disorder
D. Dependent Personality Disorder
,Answer: A
Explanation: Borderline Personality Disorder is defined by instability in relationships,
self-image, and mood. The presence of chronic emptiness and self-harming behaviors are
core features of the DSM-5-TR criteria. Effective treatment often involves Dialectical
Behavior Therapy (DBT) to address emotional dysregulation.
4. In Neurodevelopmental Disorders, Intellectual Disability (Intellectual Developmental
Disorder) severity is determined by which of the following?
A. IQ test scores alone
B. Educational attainment levels
C. The presence of comorbid physical disabilities
D. Adaptive functioning in conceptual, social, and practical domains
Answer: D
Explanation: The DSM-5 moved away from using IQ scores as the primary determinant for
severity levels in Intellectual Disability. Instead, severity (Mild, Moderate, Severe,
Profound) is based on adaptive functioning across several life domains. This shift
emphasizes the level of support an individual requires in daily life.
5. A 10-year-old child demonstrates a persistent pattern of inattention and hyperactivity that
interferes with functioning in both school and home settings. Symptoms have been present
for 8 months. What is the most likely diagnosis?
A. Oppositional Defiant Disorder
B. Attention-Deficit/Hyperactivity Disorder
C. Autism Spectrum Disorder
D. Specific Learning Disorder
Answer: B
Explanation: ADHD requires a persistent pattern of inattention and/or hyperactivity-
impulsivity for at least 6 months. Symptoms must be present in two or more settings, such
as home and school, and have an onset prior to age 12. Clinicians must rule out other
disruptive behavior disorders before finalizing this diagnosis.
6. Which disorder is characterized by a disturbance in attention and awareness that develops
over a short period of time and tends to fluctuate in severity during the course of a day?
A. Major Neurocognitive Disorder
B. Delirium
C. Mild Neurocognitive Disorder
, D. Alzheimer’s Disease
Answer: B
Explanation: Delirium is a medical emergency characterized by an acute disturbance in
attention and cognition. It typically fluctuates in severity and is caused by a physiological
consequence of another medical condition or substance. Unlike dementia, delirium has a
rapid onset and is often reversible if the underlying cause is treated.
7. A 70-year-old male shows significant cognitive decline in executive function and memory.
He can no longer manage his finances or medications independently. This represents which of
the following?
A. Mild Neurocognitive Disorder
B. Age-related cognitive decline
C. Major Neurocognitive Disorder
D. Dissociative Amnesia
Answer: C
Explanation: Major Neurocognitive Disorder is diagnosed when there is significant
cognitive decline from a previous level of performance. The critical factor is that the
cognitive deficits interfere with independence in everyday activities. If the deficits did not
interfere with independence, the diagnosis would be Mild Neurocognitive Disorder.
8. Which Paraphilic Disorder involves the act of observing an unsuspecting person who is
naked, in the process of disrobing, or engaging in sexual activity?
A. Exhibitionistic Disorder
B. Frotteuristic Disorder
C. Sexual Sadism Disorder
D. Voyeuristic Disorder
Answer: D
Explanation: Voyeuristic Disorder involves recurrent and intense sexual arousal from
observing an unsuspecting person in private situations. To meet the diagnosis, the
individual must have acted on these urges with a nonconsenting person or experience
significant distress. The behavior must have persisted for at least 6 months.
9. A person who experiences intense sexual arousal from the exposure of their genitals to an
unsuspecting person would be diagnosed with:
A. Exhibitionistic Disorder
B. Voyeuristic Disorder
