COUC 546 Exam 2 V1 | COUC 546
Psychopathology | Actual Q&A with
Rationale (COUC546 Exam 2) | Liberty
University
1. A 24-year-old male presents with a period of at least one week where he experienced an
abnormally elevated mood, decreased need for sleep, and inflated self-esteem. He was
recently hospitalized after spending his entire savings on a fleet of luxury cars. Which
diagnosis is most appropriate?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with Psychotic Features
Answer: B
Rationale: The presence of a manic episode, which lasts at least one week and involves
significant functional impairment or hospitalization, is the hallmark of Bipolar I Disorder.
Unlike Bipolar II, Bipolar I does not require a history of a Major Depressive Episode for
diagnosis, though one is often present. The severity of the patient’s behavior and the
subsequent hospitalization clearly distinguish this from a hypomanic episode.
,2. A client reports feeling ‘down in the dumps’ for the majority of the day, more days than
not, for the past 2.5 years. She denies any history of manic or hypomanic episodes and has
never been without symptoms for more than two months. What is the most likely diagnosis?
A. Persistent Depressive Disorder (Dysthymia)
B. Major Depressive Disorder, Chronic
C. Cyclothymic Disorder
D. Adjustment Disorder with Depressed Mood
Answer: A
Rationale: Persistent Depressive Disorder requires a depressed mood for most of the day,
for more days than not, for at least two years in adults. The patient’s report of a 2.5-year
duration without a symptom-free period exceeding two months aligns perfectly with DSM-
5-TR criteria. This diagnosis consolidates what were previously known as chronic major
depressive disorder and dysthymic disorder.
3. Which of the following criteria is necessary to distinguish Bipolar II Disorder from Bipolar I
Disorder?
A. The presence of at least one hypomanic episode and at least one major depressive
episode, with no history of mania.
B. The presence of at least one manic episode.
C. The presence of psychotic features during a depressive episode.
D. A symptom duration of at least two years.
,Answer: A
Rationale: Bipolar II Disorder is defined by a clinical course characterized by the
occurrence of one or more Major Depressive Episodes and at least one Hypomanic Episode.
Crucially, there must never have been a manic episode to meet criteria for Bipolar II. If a
manic episode occurs at any point, the diagnosis is automatically upgraded to Bipolar I
Disorder.
4. A 10-year-old child exhibits severe, recurrent temper outbursts that are grossly out of
proportion to the situation. These outbursts occur three or more times per week, and the
child’s mood between outbursts is persistently irritable. What diagnosis should be
considered?
A. Oppositional Defiant Disorder
B. Bipolar I Disorder
C. Disruptive Mood Dysregulation Disorder
D. Pediatric Major Depressive Disorder
Answer: C
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) was introduced to address
the overdiagnosis of Bipolar Disorder in children. The core features are chronic, severe
irritability and frequent temper outbursts in children aged 6 to 18. Symptoms must be
present for 12 or more months and must manifest in at least two settings.
, 5. In the DSM-5-TR, how is the ‘Bereavement Exclusion’ handled regarding a diagnosis of
Major Depressive Disorder (MDD)?
A. The exclusion was removed; clinicians must use clinical judgment to distinguish
between normal grief and a Major Depressive Episode.
B. Bereavement is considered a separate disorder from MDD.
C. A diagnosis of MDD cannot be made within 2 months of the loss of a loved one.
D. Bereavement-related depression is automatically classified as Persistent Depressive
Disorder.
Answer: A
Rationale: The DSM-5 removed the bereavement exclusion that previously prevented
clinicians from diagnosing MDD shortly after the death of a loved one. This change
acknowledges that while grief is a normal reaction to loss, it can also precipitate a Major
Depressive Episode in vulnerable individuals. Clinicians are encouraged to distinguish
between the ‘emptiness’ of grief and the ‘persistent’ low mood and self-loathing associated
with MDD.
6. A patient experiences recurrent, unexpected panic attacks and has spent the last month
worrying about having another attack and changing his behavior to avoid potential triggers.
He has no fear of open spaces. What is the diagnosis?
A. Panic Disorder
B. Agoraphobia
Psychopathology | Actual Q&A with
Rationale (COUC546 Exam 2) | Liberty
University
1. A 24-year-old male presents with a period of at least one week where he experienced an
abnormally elevated mood, decreased need for sleep, and inflated self-esteem. He was
recently hospitalized after spending his entire savings on a fleet of luxury cars. Which
diagnosis is most appropriate?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with Psychotic Features
Answer: B
Rationale: The presence of a manic episode, which lasts at least one week and involves
significant functional impairment or hospitalization, is the hallmark of Bipolar I Disorder.
Unlike Bipolar II, Bipolar I does not require a history of a Major Depressive Episode for
diagnosis, though one is often present. The severity of the patient’s behavior and the
subsequent hospitalization clearly distinguish this from a hypomanic episode.
,2. A client reports feeling ‘down in the dumps’ for the majority of the day, more days than
not, for the past 2.5 years. She denies any history of manic or hypomanic episodes and has
never been without symptoms for more than two months. What is the most likely diagnosis?
A. Persistent Depressive Disorder (Dysthymia)
B. Major Depressive Disorder, Chronic
C. Cyclothymic Disorder
D. Adjustment Disorder with Depressed Mood
Answer: A
Rationale: Persistent Depressive Disorder requires a depressed mood for most of the day,
for more days than not, for at least two years in adults. The patient’s report of a 2.5-year
duration without a symptom-free period exceeding two months aligns perfectly with DSM-
5-TR criteria. This diagnosis consolidates what were previously known as chronic major
depressive disorder and dysthymic disorder.
3. Which of the following criteria is necessary to distinguish Bipolar II Disorder from Bipolar I
Disorder?
A. The presence of at least one hypomanic episode and at least one major depressive
episode, with no history of mania.
B. The presence of at least one manic episode.
C. The presence of psychotic features during a depressive episode.
D. A symptom duration of at least two years.
,Answer: A
Rationale: Bipolar II Disorder is defined by a clinical course characterized by the
occurrence of one or more Major Depressive Episodes and at least one Hypomanic Episode.
Crucially, there must never have been a manic episode to meet criteria for Bipolar II. If a
manic episode occurs at any point, the diagnosis is automatically upgraded to Bipolar I
Disorder.
4. A 10-year-old child exhibits severe, recurrent temper outbursts that are grossly out of
proportion to the situation. These outbursts occur three or more times per week, and the
child’s mood between outbursts is persistently irritable. What diagnosis should be
considered?
A. Oppositional Defiant Disorder
B. Bipolar I Disorder
C. Disruptive Mood Dysregulation Disorder
D. Pediatric Major Depressive Disorder
Answer: C
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) was introduced to address
the overdiagnosis of Bipolar Disorder in children. The core features are chronic, severe
irritability and frequent temper outbursts in children aged 6 to 18. Symptoms must be
present for 12 or more months and must manifest in at least two settings.
, 5. In the DSM-5-TR, how is the ‘Bereavement Exclusion’ handled regarding a diagnosis of
Major Depressive Disorder (MDD)?
A. The exclusion was removed; clinicians must use clinical judgment to distinguish
between normal grief and a Major Depressive Episode.
B. Bereavement is considered a separate disorder from MDD.
C. A diagnosis of MDD cannot be made within 2 months of the loss of a loved one.
D. Bereavement-related depression is automatically classified as Persistent Depressive
Disorder.
Answer: A
Rationale: The DSM-5 removed the bereavement exclusion that previously prevented
clinicians from diagnosing MDD shortly after the death of a loved one. This change
acknowledges that while grief is a normal reaction to loss, it can also precipitate a Major
Depressive Episode in vulnerable individuals. Clinicians are encouraged to distinguish
between the ‘emptiness’ of grief and the ‘persistent’ low mood and self-loathing associated
with MDD.
6. A patient experiences recurrent, unexpected panic attacks and has spent the last month
worrying about having another attack and changing his behavior to avoid potential triggers.
He has no fear of open spaces. What is the diagnosis?
A. Panic Disorder
B. Agoraphobia
