, Question 1
A researcher finds that a new 12-item depression scale correlates r = .82 with
the BDI-II but shows a coefficient alpha of .58. Which psychometric
conclusion is most defensible?
A. The scale demonstrates adequate convergent validity but insufficient
internal consistency for individual clinical decision-making.
B. The high correlation with the BDI-II compensates for low alpha,
supporting clinical use.
C. The scale has acceptable internal consistency because alpha exceeds
.50.
D. The scale's low alpha indicates poor test-retest reliability.
Correct Answer: A - The scale demonstrates adequate convergent
validity but insufficient internal consistency for individual clinical
decision-making.
RATIONALE
High correlation with an established measure supports convergent
validity, but alpha of .58 is below the conventional .70 (or .90 for
individual decision-making) threshold. Alpha indexes internal
consistency, not test-retest reliability, and low alpha cannot be offset
by convergent correlations. Thus A is the only defensible conclusion.
Question 2
A client with panic disorder reports that after two sessions of interoceptive
exposure, their panic attacks have ceased. The therapist decides to discontinue
exposure and move to cognitive restructuring. This decision is most
problematic because:
A. Cognitive restructuring is contraindicated before exposure is complete.
B. Premature discontinuation of exposure may prevent extinction learning
and increase relapse risk.
C. Interoceptive exposure should always be followed by in vivo exposure
Page 2
, first.
D. Panic attacks typically resolve spontaneously, so treatment was
unnecessary.
Correct Answer: B - Premature discontinuation of exposure may
prevent extinction learning and increase relapse risk.
RATIONALE
Exposure-based treatments require sufficient trials for fear extinction
and generalization; stopping after two sessions risks return of fear.
Cognitive restructuring is not contraindicated but is typically
integrated, not a replacement. In vivo exposure is often added
concurrently, not a mandatory prerequisite, and spontaneous remission
is not assumed.
Question 3
A neuropsychologist evaluates a patient with suspected Alzheimer's disease.
Which pattern of performance on the Wechsler Memory Scale-IV and Trail
Making Test is most consistent with early-stage Alzheimer's versus vascular
dementia?
A. Severe immediate recall deficits with relative preservation of
executive function.
B. Patchy deficits with stepwise progression and focal executive
impairment.
C. Global, uniform decline across all cognitive domains.
D. Isolated language impairment with intact memory.
Correct Answer: A - Severe immediate recall deficits with relative
preservation of executive function.
Page 3
, RATIONALE
Alzheimer's disease typically presents with prominent episodic
memory encoding deficits (immediate and delayed recall) while
executive function may be relatively spared early. Vascular dementia
more often shows patchy, stepwise decline with early executive
dysfunction. Global uniform decline is late-stage, and isolated
language impairment suggests primary progressive aphasia.
Question 4
During a therapy session, a client discloses intent to seriously harm a specific
identifiable person. The therapist practices in a state with a mandatory
duty-to-protect statute. Which action is most legally and ethically appropriate?
A. Maintain confidentiality and attempt to persuade the client to
hospitalize voluntarily.
B. Warn the intended victim and notify law enforcement, consistent with
the statute.
C. Document the threat but take no action because the client has not yet
acted.
D. Consult with a colleague and wait for the next session to reassess risk.
Correct Answer: B - Warn the intended victim and notify law
enforcement, consistent with the statute.
RATIONALE
Under Tarasoff-derived mandatory duty-to-protect statutes, the
clinician must take reasonable steps to protect the identifiable victim,
typically warning the victim and notifying authorities. Confidentiality
is overridden by the duty. Waiting or merely documenting fails the
legal standard, and voluntary hospitalization persuasion is insufficient
when the statute mandates action.
Page 4
A researcher finds that a new 12-item depression scale correlates r = .82 with
the BDI-II but shows a coefficient alpha of .58. Which psychometric
conclusion is most defensible?
A. The scale demonstrates adequate convergent validity but insufficient
internal consistency for individual clinical decision-making.
B. The high correlation with the BDI-II compensates for low alpha,
supporting clinical use.
C. The scale has acceptable internal consistency because alpha exceeds
.50.
D. The scale's low alpha indicates poor test-retest reliability.
Correct Answer: A - The scale demonstrates adequate convergent
validity but insufficient internal consistency for individual clinical
decision-making.
RATIONALE
High correlation with an established measure supports convergent
validity, but alpha of .58 is below the conventional .70 (or .90 for
individual decision-making) threshold. Alpha indexes internal
consistency, not test-retest reliability, and low alpha cannot be offset
by convergent correlations. Thus A is the only defensible conclusion.
Question 2
A client with panic disorder reports that after two sessions of interoceptive
exposure, their panic attacks have ceased. The therapist decides to discontinue
exposure and move to cognitive restructuring. This decision is most
problematic because:
A. Cognitive restructuring is contraindicated before exposure is complete.
B. Premature discontinuation of exposure may prevent extinction learning
and increase relapse risk.
C. Interoceptive exposure should always be followed by in vivo exposure
Page 2
, first.
D. Panic attacks typically resolve spontaneously, so treatment was
unnecessary.
Correct Answer: B - Premature discontinuation of exposure may
prevent extinction learning and increase relapse risk.
RATIONALE
Exposure-based treatments require sufficient trials for fear extinction
and generalization; stopping after two sessions risks return of fear.
Cognitive restructuring is not contraindicated but is typically
integrated, not a replacement. In vivo exposure is often added
concurrently, not a mandatory prerequisite, and spontaneous remission
is not assumed.
Question 3
A neuropsychologist evaluates a patient with suspected Alzheimer's disease.
Which pattern of performance on the Wechsler Memory Scale-IV and Trail
Making Test is most consistent with early-stage Alzheimer's versus vascular
dementia?
A. Severe immediate recall deficits with relative preservation of
executive function.
B. Patchy deficits with stepwise progression and focal executive
impairment.
C. Global, uniform decline across all cognitive domains.
D. Isolated language impairment with intact memory.
Correct Answer: A - Severe immediate recall deficits with relative
preservation of executive function.
Page 3
, RATIONALE
Alzheimer's disease typically presents with prominent episodic
memory encoding deficits (immediate and delayed recall) while
executive function may be relatively spared early. Vascular dementia
more often shows patchy, stepwise decline with early executive
dysfunction. Global uniform decline is late-stage, and isolated
language impairment suggests primary progressive aphasia.
Question 4
During a therapy session, a client discloses intent to seriously harm a specific
identifiable person. The therapist practices in a state with a mandatory
duty-to-protect statute. Which action is most legally and ethically appropriate?
A. Maintain confidentiality and attempt to persuade the client to
hospitalize voluntarily.
B. Warn the intended victim and notify law enforcement, consistent with
the statute.
C. Document the threat but take no action because the client has not yet
acted.
D. Consult with a colleague and wait for the next session to reassess risk.
Correct Answer: B - Warn the intended victim and notify law
enforcement, consistent with the statute.
RATIONALE
Under Tarasoff-derived mandatory duty-to-protect statutes, the
clinician must take reasonable steps to protect the identifiable victim,
typically warning the victim and notifying authorities. Confidentiality
is overridden by the duty. Waiting or merely documenting fails the
legal standard, and voluntary hospitalization persuasion is insufficient
when the statute mandates action.
Page 4
