MFT Exam with 100% Correct Answers
Alex, age 32, has been a "hermit" all his life. He lives with his family, spends most of his
time alone in his room listening to music, and says he never feels particularly happy or
unhappy. Six months ago, Alex was diagnosed with Brief Psychotic Disorder. Alex has
never had a close relationship and says he does not mind. His symptoms are most
suggestive of which of the following?
Select one:
a. Schizophreniform Disorder.
b. Major Depressive Disorder.
c. Schizoaffective Disorder.
d. Schizoid Personality Disorder. - ANSWER-Alex's symptoms are not explained by
Brief Psychotic Disorder or other psychotic disorder and suggest that another diagnosis
is appropriate.Answer D is correct: Alex's life-long isolation, indifference to social
relationships, and lack of strong emotions are consistent with a diagnosis of Schizoid
Personality Disorder.Answer A is incorrect: Schizophreniform Disorder is characterized
by symptoms similar to those associated with Schizophrenia except that their duration is
one month to less than six months. Because Alex was diagnosed with Brief Psychotic
Disorder, we know that the duration of his psychotic symptoms did not exceed one
month. Moreover, he is not currently experiencing psychotic symptoms.Answer B is
incorrect: You can rule out Major Depressive Disorder since there are no obvious
symptoms of a major depressive episode. In addition, Alex's symptoms have been life-
long.Answer C is incorrect: Schizoaffective Disorder requires a combination of psychotic
symptoms and mood episodes.
The correct answer is: Schizoid Personality Disorder.
The symptoms of Oppositional Defiant Disorder are categorized in three groups in the
DSM-5. These groups are:
Select one:
a. destruction of property, deceitfulness or theft, and serious violations of rules.
b. negativistic, defiant, and hostile behavior.
c. deceitfulness or dishonesty, irritability or aggressiveness, and failure to conform to
social norms.
d. angry or irritable mood, argumentative or defiant behavior, and vindictiveness. -
ANSWER-Answer D is correct: Angry/irritable mood, argumentative/defiant behavior,
and vindictiveness are the three categories of symptoms included in the DSM-5 for
Oppositional Defiant Disorder.
Answer A is incorrect: These are three of the four categories of symptoms included in
the DSM-5 for Conduct Disorder (the fourth is aggression to people and animals).
The correct answer is: angry or irritable mood, argumentative or defiant behavior, and
vindictiveness.
,Marissa is 23 and has come to you because she is finding it difficult to care about her
graduate work in accounting, her job, or her hobbies of tennis and sailing. In addition,
she complains that she is feeling real despair for the first time in her life. She is irritable
with friends and is having trouble sleeping. She does state, however, that she is happy
she has lost her appetite. She has felt this way for three weeks. Your first action with the
client would be which of the following?
Select one:
a. consultation with a physician
b. assessment of her potential for suicide
c. contacting her family
d. behavioral therapy to relieve her depression - ANSWER-You were asked to identify
your first action.
Answer B is correct: The client's feelings of despair suggest that the first intervention
should be an assessment of potential for suicide.
Answer A is incorrect: Note that this suggests "consultation" with a physician. Had this
suggested referral for a medical evaluation, it would also have been an important first
step.
Answer C is incorrect: If you assessed that Marissa's potential for suicide was high, you
could contact her family to enlist their help in protecting her from a suicide attempt, and
you could do this without Marissa's permission if necessary. Before you have performed
a suicide assessment, however, this action, without prior written permission from
Marissa, would represent an unethical breach of her confidentiality. (You might,
alternatively, have interpreted "contacting her family" as suggesting a means of
collecting collateral information for your assessment; here too, however you would need
to get Marissa's written permission beforehand in order to avoid an unethical breach of
confidentiality.)
Answer D is incorrect: This might be effective later but it certainly isn't the best first step,
as it ignores the possibility that this client might be suicidal.
The correct answer is: assessment of her potential for suicide
Your client is an 11-year-old boy who has a history of behavioral problems. At school,
the boy disturbs his classmates whenever the teacher asks the students to work
independently on assignments in the classroom. He talks, makes noises, and throws
paper wads and pencils to disrupt the other students and avoid doing his own work. He
is easily annoyed and often loses his temper. The most likely DSM-5 diagnosis for this
boy is which of the following?
Select one:
a. Oppositional Defiant Disorder
b. ADHD
c. Conduct Disorder
d. Intermittent Explosive Disorder - ANSWER-Answer A is correct: Although the
information provided is too limited to make a firm diagnosis (e.g., you don't know the
duration of the boy's symptoms or how he behaves at home and in other settings),
Oppositional Defiant Disorder (ODD) is the most likely diagnosis. The boy has a history
of behavioral problems and appears to be deliberately annoying others and resisting or
defying his teacher's requests, and he is easily annoyed and often loses his temper. As
,described in the DSM-5, ODD is characterized by a pattern of angry/irritable mood,
argumentative/defiant behavior, or vindictiveness. The boy's symptoms do not meet the
criteria for inattention or hyperactivity-impulsivity required for a diagnosis of ADHD and
aren't sufficiently severe for a diagnosis of Conduct Disorder or Intermittent Explosive
Disorder.
The correct answer is: Oppositional Defiant Disorder
Which of the following is not a DSM-5 diagnostic criterion for Conversion Disorder?
Select one:
a. one or more symptoms that involve an alteration in sensory or motor functioning
b. evidence of incompatibility between the symptoms and known medical conditions
c. symptoms are not better explained by a medical condition or other mental disorder
d. evidence that the symptoms are related to a psychological need or conflict. -
ANSWER-Answer D is correct: The DSM-IV-TR requirement for evidence that
symptoms are associated with psychological factors has been removed as a diagnostic
criterion for Conversion Disorder in the DSM-5.
Answers A, B, and C: These answers describe the DSM-5's diagnostic criteria for
Conversion Disorder.
The correct answer is: evidence that the symptoms are related to a psychological need
or conflict.
Your new client, a college freshman, says she sometimes has an "out of body"
experience in which she is watching what she is doing from outside herself. She
describes a recent experience in which she was in her dorm room writing a paper when
she realized she couldn't feel her fingers on the computer keyboard or her feet on the
floor and then suddenly felt like she was watching herself from the ceiling. The client
says that these episodes make her feel like she's "going crazy" and are interfering with
her ability to attend class and complete course assignments. The client's symptoms are
most suggestive of a DSM-5 diagnosis of:
Select one:
a. Delusional Disorder
b. Dissociative Fugue
c. Depersonalization or Derealization Disorder
d. Depersonalization Disorder - ANSWER-Answer C is correct:
Depersonalization/Derealization Disorder is characterized by recurrent episodes of
depersonalization (a sense of unreality, detachment, or being an outside observer of
one's thoughts, feelings, etc.) and/or derealization (a sense of unreality or detachment
involving one's surroundings) that cause clinically significant distress or impaired
functioning.
Answer A is incorrect: Delusional Disorder involves one or more delusions that last at
least one month. As defined in the DSM-5, a delusion is "a false belief based on
incorrect inference about external reality that is firmly held despite what almost
everyone else believes and despite what constitutes incontrovertible and obvious proof
or evidence to the contrary" (p. 819).
, Answer B is incorrect: A dissociative fugue is characterized by apparently purposeful
travel with an inability to recall some or all of one's past and is included in the DSM-5 as
a specifier for Dissociative Amnesia.
Answer D: is incorrect: Depersonalization Disorder is a DSM-IV-TR diagnosis and has
been renamed Depersonalization/Derealization Disorder in DSM-5.
The correct answer is: Depersonalization or Derealization Disorder
Bipolar I Disorder is distinguished from Bipolar II Disorder by the presence of which kind
of episode?
Select one:
a. Manic episode
b. Psychotic episode
c. Mixed episode
d. Depressed episode - ANSWER-This is another straightforward recall question about
diagnosis.Answer A is correct: The presence of a manic episode rules out Bipolar II
Disorder. The criteria for diagnosing Bipolar I Disorder include one or more manic
episodes.Answer B is incorrect: With psychotic features is a specifier for Bipolar I
Disorder, but psychotic episodes are not one of the types of episodes associated with
the Bipolar Disorders.
The correct answer is: Manic episode
A client is angry at his neighbor for cutting down a large tree that gave the client privacy
in his backyard. The client is agitated and tense as he describes this event and says
that he and the neighbor had a heated argument about it the day before, in which the
neighbor called him a "loser." The client has a history of poor impulse control, including
stealing and excessive alcohol use. He has been arrested on several occasions for bar
fights, which he initiated, and has spent time in jail. Which of the following is the BEST
predictor of the potential that this client may act violently toward his neighbor?
Select one:
a. The nature of the recent provocation
b. The client's poor impulse control
c. The client's agitation and tension
d. The client's past violent behavior - ANSWER-Answer D is correct: All of the factors
listed in the answers are indicators of an increased risk for violent behavior, but the best
predictor of future violent behavior is past violent behavior.
The correct answer is: The client's past violent behavior
Steve and Irene, a middle-aged, middle-class couple, come to see you. Steve
complains that he has to fix dinner for himself and the kids and then gets them ready for
bed. He then goes to bed alone, while Irene "moans and groans on the couch about
some made-up dizziness." Steve berates her in the session, calling her, "a liar and a
lazy, good-for-nothing woman." In exploring Irene's view of the problem, you learn that
Irene feels faint, dizzy, has double vision, and feels weak and nauseated just before her
husband comes home from work. She finds she must lie down and does not recuperate
until after Steve has gone to bed. She then feels better which is consistent with her
doctors being unable to find any physical problem with her. This has been going on for
Alex, age 32, has been a "hermit" all his life. He lives with his family, spends most of his
time alone in his room listening to music, and says he never feels particularly happy or
unhappy. Six months ago, Alex was diagnosed with Brief Psychotic Disorder. Alex has
never had a close relationship and says he does not mind. His symptoms are most
suggestive of which of the following?
Select one:
a. Schizophreniform Disorder.
b. Major Depressive Disorder.
c. Schizoaffective Disorder.
d. Schizoid Personality Disorder. - ANSWER-Alex's symptoms are not explained by
Brief Psychotic Disorder or other psychotic disorder and suggest that another diagnosis
is appropriate.Answer D is correct: Alex's life-long isolation, indifference to social
relationships, and lack of strong emotions are consistent with a diagnosis of Schizoid
Personality Disorder.Answer A is incorrect: Schizophreniform Disorder is characterized
by symptoms similar to those associated with Schizophrenia except that their duration is
one month to less than six months. Because Alex was diagnosed with Brief Psychotic
Disorder, we know that the duration of his psychotic symptoms did not exceed one
month. Moreover, he is not currently experiencing psychotic symptoms.Answer B is
incorrect: You can rule out Major Depressive Disorder since there are no obvious
symptoms of a major depressive episode. In addition, Alex's symptoms have been life-
long.Answer C is incorrect: Schizoaffective Disorder requires a combination of psychotic
symptoms and mood episodes.
The correct answer is: Schizoid Personality Disorder.
The symptoms of Oppositional Defiant Disorder are categorized in three groups in the
DSM-5. These groups are:
Select one:
a. destruction of property, deceitfulness or theft, and serious violations of rules.
b. negativistic, defiant, and hostile behavior.
c. deceitfulness or dishonesty, irritability or aggressiveness, and failure to conform to
social norms.
d. angry or irritable mood, argumentative or defiant behavior, and vindictiveness. -
ANSWER-Answer D is correct: Angry/irritable mood, argumentative/defiant behavior,
and vindictiveness are the three categories of symptoms included in the DSM-5 for
Oppositional Defiant Disorder.
Answer A is incorrect: These are three of the four categories of symptoms included in
the DSM-5 for Conduct Disorder (the fourth is aggression to people and animals).
The correct answer is: angry or irritable mood, argumentative or defiant behavior, and
vindictiveness.
,Marissa is 23 and has come to you because she is finding it difficult to care about her
graduate work in accounting, her job, or her hobbies of tennis and sailing. In addition,
she complains that she is feeling real despair for the first time in her life. She is irritable
with friends and is having trouble sleeping. She does state, however, that she is happy
she has lost her appetite. She has felt this way for three weeks. Your first action with the
client would be which of the following?
Select one:
a. consultation with a physician
b. assessment of her potential for suicide
c. contacting her family
d. behavioral therapy to relieve her depression - ANSWER-You were asked to identify
your first action.
Answer B is correct: The client's feelings of despair suggest that the first intervention
should be an assessment of potential for suicide.
Answer A is incorrect: Note that this suggests "consultation" with a physician. Had this
suggested referral for a medical evaluation, it would also have been an important first
step.
Answer C is incorrect: If you assessed that Marissa's potential for suicide was high, you
could contact her family to enlist their help in protecting her from a suicide attempt, and
you could do this without Marissa's permission if necessary. Before you have performed
a suicide assessment, however, this action, without prior written permission from
Marissa, would represent an unethical breach of her confidentiality. (You might,
alternatively, have interpreted "contacting her family" as suggesting a means of
collecting collateral information for your assessment; here too, however you would need
to get Marissa's written permission beforehand in order to avoid an unethical breach of
confidentiality.)
Answer D is incorrect: This might be effective later but it certainly isn't the best first step,
as it ignores the possibility that this client might be suicidal.
The correct answer is: assessment of her potential for suicide
Your client is an 11-year-old boy who has a history of behavioral problems. At school,
the boy disturbs his classmates whenever the teacher asks the students to work
independently on assignments in the classroom. He talks, makes noises, and throws
paper wads and pencils to disrupt the other students and avoid doing his own work. He
is easily annoyed and often loses his temper. The most likely DSM-5 diagnosis for this
boy is which of the following?
Select one:
a. Oppositional Defiant Disorder
b. ADHD
c. Conduct Disorder
d. Intermittent Explosive Disorder - ANSWER-Answer A is correct: Although the
information provided is too limited to make a firm diagnosis (e.g., you don't know the
duration of the boy's symptoms or how he behaves at home and in other settings),
Oppositional Defiant Disorder (ODD) is the most likely diagnosis. The boy has a history
of behavioral problems and appears to be deliberately annoying others and resisting or
defying his teacher's requests, and he is easily annoyed and often loses his temper. As
,described in the DSM-5, ODD is characterized by a pattern of angry/irritable mood,
argumentative/defiant behavior, or vindictiveness. The boy's symptoms do not meet the
criteria for inattention or hyperactivity-impulsivity required for a diagnosis of ADHD and
aren't sufficiently severe for a diagnosis of Conduct Disorder or Intermittent Explosive
Disorder.
The correct answer is: Oppositional Defiant Disorder
Which of the following is not a DSM-5 diagnostic criterion for Conversion Disorder?
Select one:
a. one or more symptoms that involve an alteration in sensory or motor functioning
b. evidence of incompatibility between the symptoms and known medical conditions
c. symptoms are not better explained by a medical condition or other mental disorder
d. evidence that the symptoms are related to a psychological need or conflict. -
ANSWER-Answer D is correct: The DSM-IV-TR requirement for evidence that
symptoms are associated with psychological factors has been removed as a diagnostic
criterion for Conversion Disorder in the DSM-5.
Answers A, B, and C: These answers describe the DSM-5's diagnostic criteria for
Conversion Disorder.
The correct answer is: evidence that the symptoms are related to a psychological need
or conflict.
Your new client, a college freshman, says she sometimes has an "out of body"
experience in which she is watching what she is doing from outside herself. She
describes a recent experience in which she was in her dorm room writing a paper when
she realized she couldn't feel her fingers on the computer keyboard or her feet on the
floor and then suddenly felt like she was watching herself from the ceiling. The client
says that these episodes make her feel like she's "going crazy" and are interfering with
her ability to attend class and complete course assignments. The client's symptoms are
most suggestive of a DSM-5 diagnosis of:
Select one:
a. Delusional Disorder
b. Dissociative Fugue
c. Depersonalization or Derealization Disorder
d. Depersonalization Disorder - ANSWER-Answer C is correct:
Depersonalization/Derealization Disorder is characterized by recurrent episodes of
depersonalization (a sense of unreality, detachment, or being an outside observer of
one's thoughts, feelings, etc.) and/or derealization (a sense of unreality or detachment
involving one's surroundings) that cause clinically significant distress or impaired
functioning.
Answer A is incorrect: Delusional Disorder involves one or more delusions that last at
least one month. As defined in the DSM-5, a delusion is "a false belief based on
incorrect inference about external reality that is firmly held despite what almost
everyone else believes and despite what constitutes incontrovertible and obvious proof
or evidence to the contrary" (p. 819).
, Answer B is incorrect: A dissociative fugue is characterized by apparently purposeful
travel with an inability to recall some or all of one's past and is included in the DSM-5 as
a specifier for Dissociative Amnesia.
Answer D: is incorrect: Depersonalization Disorder is a DSM-IV-TR diagnosis and has
been renamed Depersonalization/Derealization Disorder in DSM-5.
The correct answer is: Depersonalization or Derealization Disorder
Bipolar I Disorder is distinguished from Bipolar II Disorder by the presence of which kind
of episode?
Select one:
a. Manic episode
b. Psychotic episode
c. Mixed episode
d. Depressed episode - ANSWER-This is another straightforward recall question about
diagnosis.Answer A is correct: The presence of a manic episode rules out Bipolar II
Disorder. The criteria for diagnosing Bipolar I Disorder include one or more manic
episodes.Answer B is incorrect: With psychotic features is a specifier for Bipolar I
Disorder, but psychotic episodes are not one of the types of episodes associated with
the Bipolar Disorders.
The correct answer is: Manic episode
A client is angry at his neighbor for cutting down a large tree that gave the client privacy
in his backyard. The client is agitated and tense as he describes this event and says
that he and the neighbor had a heated argument about it the day before, in which the
neighbor called him a "loser." The client has a history of poor impulse control, including
stealing and excessive alcohol use. He has been arrested on several occasions for bar
fights, which he initiated, and has spent time in jail. Which of the following is the BEST
predictor of the potential that this client may act violently toward his neighbor?
Select one:
a. The nature of the recent provocation
b. The client's poor impulse control
c. The client's agitation and tension
d. The client's past violent behavior - ANSWER-Answer D is correct: All of the factors
listed in the answers are indicators of an increased risk for violent behavior, but the best
predictor of future violent behavior is past violent behavior.
The correct answer is: The client's past violent behavior
Steve and Irene, a middle-aged, middle-class couple, come to see you. Steve
complains that he has to fix dinner for himself and the kids and then gets them ready for
bed. He then goes to bed alone, while Irene "moans and groans on the couch about
some made-up dizziness." Steve berates her in the session, calling her, "a liar and a
lazy, good-for-nothing woman." In exploring Irene's view of the problem, you learn that
Irene feels faint, dizzy, has double vision, and feels weak and nauseated just before her
husband comes home from work. She finds she must lie down and does not recuperate
until after Steve has gone to bed. She then feels better which is consistent with her
doctors being unable to find any physical problem with her. This has been going on for
