COUC 546 Exam 4 V3 | COUC 546 Psychopathology | Actual Q&A with
Rationale (COUC546 Exam 4) | Liberty University
1. A 24-year-old female presents with a pervasive pattern of instability in interpersonal
relationships, self-image, and affects. She reports frequent bouts of intense anger and has a
history of non-suicidal self-injury. Which diagnosis is most likely?
A. Histrionic Personality Disorder
B. Antisocial Personality Disorder
C. Borderline Personality Disorder
D. Dependent Personality Disorder
Answer: C
Explanation: Borderline Personality Disorder is defined by instability in relationships,
self-image, and emotion. The presence of self-harming behavior is a common clinical
feature used to distinguish it from other Cluster B disorders. Clinicians must also identify
efforts to avoid real or imagined abandonment.
2. Which characteristic is essential for a diagnosis of Antisocial Personality Disorder in a 25-
year-old male?
A. Extreme social anxiety and fear of rejection
B. A history of psychotic episodes in early childhood
C. Evidence of Conduct Disorder with onset before age 15
D. The presence of visual hallucinations during conflicts
Answer: C
Explanation: To diagnose Antisocial Personality Disorder, the individual must be at least
18 years old. There must also be documented evidence that Conduct Disorder began before
the age of 15. This longitudinal requirement distinguishes antisocial behavior from adult-
onset criminal activity.
3. An elderly patient experiences a sudden, fluctuating disturbance in attention and
awareness that developed over two days. This clinical picture is most consistent with:
A. Delirium
B. Vascular Dementia
C. Major Neurocognitive Disorder
D. Alzheimer’s Disease
,Answer: A
Explanation: Delirium is characterized by an acute onset and a fluctuating course of
cognitive impairment. Unlike Major Neurocognitive Disorder, it often involves a direct
physiological consequence of a medical condition. It is a medical emergency that requires
immediate identification of the underlying cause.
4. Which of the following is a key diagnostic criterion for Schizotypal Personality Disorder?
A. Preference for being alone and lack of interest in sex
B. Odd beliefs or magical thinking that influences behavior
C. Excessive need to be taken care of by others
D. Preoccupation with details, rules, and schedules
Answer: B
Explanation: Schizotypal Personality Disorder involves acute discomfort in close
relationships along with cognitive or perceptual distortions. Magical thinking, such as belief
in clairvoyance or telepathy, is a hallmark of this condition. It is classified within Cluster A,
the ‘odd or eccentric’ cluster.
5. A 9-year-old boy consistently fails to pay close attention to details, loses school
assignments, and is easily distracted. These symptoms have been present for 8 months in
both home and school settings. What is the most likely diagnosis?
A. Oppositional Defiant Disorder
B. Autism Spectrum Disorder
C. Specific Learning Disorder
D. Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation
Answer: D
Explanation: ADHD requires symptoms of inattention or hyperactivity-impulsivity to be
present for at least six months. These symptoms must manifest in two or more settings,
such as home and school. The predominantly inattentive presentation is diagnosed when
sufficient inattention criteria are met but hyperactivity criteria are not.
6. In Neurocognitive Disorders, the distinction between ‘Major’ and ‘Mild’ is primarily based
on:
A. The age of the patient at the time of onset
B. The specific brain region affected by the pathology
C. The presence of genetic markers for Alzheimer’s
D. Whether the cognitive deficits interfere with independence in everyday activities
, Answer: D
Explanation: Major Neurocognitive Disorder requires a significant decline that interferes
with independence in activities of daily living (ADLs). Mild Neurocognitive Disorder
involves a modest decline that does not interfere with the capacity for independence. This
functional assessment is critical for determining the level of care needed.
7. A client presents with a preoccupation with orderliness, perfectionism, and mental and
interpersonal control, at the expense of flexibility and efficiency. Which disorder is this?
A. Obsessive-Compulsive Disorder
B. Narcissistic Personality Disorder
C. Obsessive-Compulsive Personality Disorder
D. Avoidant Personality Disorder
Answer: C
Explanation: Obsessive-Compulsive Personality Disorder (OCPD) is characterized by a
rigid adherence to rules and perfectionism. Unlike OCD, OCPD does not necessarily involve
true obsessions or compulsions. It is often ego-syntonic, meaning the individual views their
behavior as rational and desirable.
8. Autism Spectrum Disorder (ASD) criteria require deficits in which two main domains?
A. Memory and motor skills
B. Social communication/interaction and restricted, repetitive patterns of behavior
C. Inattention and hyperactivity
D. Reading comprehension and mathematical reasoning
Answer: B
Explanation: ASD is defined by persistent deficits in social communication and social
interaction across multiple contexts. Additionally, the individual must exhibit restricted,
repetitive patterns of behavior, interests, or activities. These symptoms must be present in
the early developmental period for a diagnosis to be made.
9. A 30-year-old male is unwilling to get involved with people unless he is certain of being
liked and shows restraint within intimate relationships because of the fear of being shamed.
This is consistent with:
A. Schizoid Personality Disorder
B. Paranoid Personality Disorder
C. Social Anxiety Disorder
D. Avoidant Personality Disorder
Rationale (COUC546 Exam 4) | Liberty University
1. A 24-year-old female presents with a pervasive pattern of instability in interpersonal
relationships, self-image, and affects. She reports frequent bouts of intense anger and has a
history of non-suicidal self-injury. Which diagnosis is most likely?
A. Histrionic Personality Disorder
B. Antisocial Personality Disorder
C. Borderline Personality Disorder
D. Dependent Personality Disorder
Answer: C
Explanation: Borderline Personality Disorder is defined by instability in relationships,
self-image, and emotion. The presence of self-harming behavior is a common clinical
feature used to distinguish it from other Cluster B disorders. Clinicians must also identify
efforts to avoid real or imagined abandonment.
2. Which characteristic is essential for a diagnosis of Antisocial Personality Disorder in a 25-
year-old male?
A. Extreme social anxiety and fear of rejection
B. A history of psychotic episodes in early childhood
C. Evidence of Conduct Disorder with onset before age 15
D. The presence of visual hallucinations during conflicts
Answer: C
Explanation: To diagnose Antisocial Personality Disorder, the individual must be at least
18 years old. There must also be documented evidence that Conduct Disorder began before
the age of 15. This longitudinal requirement distinguishes antisocial behavior from adult-
onset criminal activity.
3. An elderly patient experiences a sudden, fluctuating disturbance in attention and
awareness that developed over two days. This clinical picture is most consistent with:
A. Delirium
B. Vascular Dementia
C. Major Neurocognitive Disorder
D. Alzheimer’s Disease
,Answer: A
Explanation: Delirium is characterized by an acute onset and a fluctuating course of
cognitive impairment. Unlike Major Neurocognitive Disorder, it often involves a direct
physiological consequence of a medical condition. It is a medical emergency that requires
immediate identification of the underlying cause.
4. Which of the following is a key diagnostic criterion for Schizotypal Personality Disorder?
A. Preference for being alone and lack of interest in sex
B. Odd beliefs or magical thinking that influences behavior
C. Excessive need to be taken care of by others
D. Preoccupation with details, rules, and schedules
Answer: B
Explanation: Schizotypal Personality Disorder involves acute discomfort in close
relationships along with cognitive or perceptual distortions. Magical thinking, such as belief
in clairvoyance or telepathy, is a hallmark of this condition. It is classified within Cluster A,
the ‘odd or eccentric’ cluster.
5. A 9-year-old boy consistently fails to pay close attention to details, loses school
assignments, and is easily distracted. These symptoms have been present for 8 months in
both home and school settings. What is the most likely diagnosis?
A. Oppositional Defiant Disorder
B. Autism Spectrum Disorder
C. Specific Learning Disorder
D. Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation
Answer: D
Explanation: ADHD requires symptoms of inattention or hyperactivity-impulsivity to be
present for at least six months. These symptoms must manifest in two or more settings,
such as home and school. The predominantly inattentive presentation is diagnosed when
sufficient inattention criteria are met but hyperactivity criteria are not.
6. In Neurocognitive Disorders, the distinction between ‘Major’ and ‘Mild’ is primarily based
on:
A. The age of the patient at the time of onset
B. The specific brain region affected by the pathology
C. The presence of genetic markers for Alzheimer’s
D. Whether the cognitive deficits interfere with independence in everyday activities
, Answer: D
Explanation: Major Neurocognitive Disorder requires a significant decline that interferes
with independence in activities of daily living (ADLs). Mild Neurocognitive Disorder
involves a modest decline that does not interfere with the capacity for independence. This
functional assessment is critical for determining the level of care needed.
7. A client presents with a preoccupation with orderliness, perfectionism, and mental and
interpersonal control, at the expense of flexibility and efficiency. Which disorder is this?
A. Obsessive-Compulsive Disorder
B. Narcissistic Personality Disorder
C. Obsessive-Compulsive Personality Disorder
D. Avoidant Personality Disorder
Answer: C
Explanation: Obsessive-Compulsive Personality Disorder (OCPD) is characterized by a
rigid adherence to rules and perfectionism. Unlike OCD, OCPD does not necessarily involve
true obsessions or compulsions. It is often ego-syntonic, meaning the individual views their
behavior as rational and desirable.
8. Autism Spectrum Disorder (ASD) criteria require deficits in which two main domains?
A. Memory and motor skills
B. Social communication/interaction and restricted, repetitive patterns of behavior
C. Inattention and hyperactivity
D. Reading comprehension and mathematical reasoning
Answer: B
Explanation: ASD is defined by persistent deficits in social communication and social
interaction across multiple contexts. Additionally, the individual must exhibit restricted,
repetitive patterns of behavior, interests, or activities. These symptoms must be present in
the early developmental period for a diagnosis to be made.
9. A 30-year-old male is unwilling to get involved with people unless he is certain of being
liked and shows restraint within intimate relationships because of the fear of being shamed.
This is consistent with:
A. Schizoid Personality Disorder
B. Paranoid Personality Disorder
C. Social Anxiety Disorder
D. Avoidant Personality Disorder
