Barkley Psychiatric Disorders
Exam Exam Questions With
Correct Answers (Verified
Answers) Plus Rationales
2026 Q&A | Instant
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1. A 24-year-old patient has had depressed mood, anhedonia,
fatigue, insomnia, guilt, impaired concentration, and recurrent
thoughts of death for 3 weeks. Which diagnosis is most consistent
with this presentation?
A. Adjustment disorder
B. Bipolar II disorder
C. Major depressive disorder
D. Persistent depressive disorder
Rationale: Major depressive disorder requires at least 2 weeks of
depressive symptoms causing clinically significant distress or
impairment, including depressed mood or anhedonia.
2. Which symptom is required for a diagnosis of major depressive
disorder?
A. Insomnia
B. Fatigue
C. Weight loss
D. Depressed mood or anhedonia
,Rationale: At least one of the core symptoms must be depressed
mood or markedly diminished interest or pleasure.
3. A patient reports episodes of intense fear that peak within several
minutes and include palpitations, dyspnea, trembling, and fear of
dying. These episodes are most characteristic of:
A. Generalized anxiety disorder
B. Panic attacks
C. Social anxiety disorder
D. Somatic symptom disorder
Rationale: Panic attacks are abrupt surges of intense fear or
discomfort accompanied by multiple physical and cognitive
symptoms.
4. Which neurotransmitter system is most directly associated with
the therapeutic action of selective serotonin reuptake inhibitors?
A. Dopamine
B. GABA
C. Serotonin
D. Acetylcholine
Rationale: SSRIs primarily inhibit serotonin reuptake, increasing
serotonergic neurotransmission.
5. A patient has experienced excessive anxiety and worry about
multiple areas of life nearly every day for 8 months. Which diagnosis
is most likely?
A. Panic disorder
B. Social anxiety disorder
C. Generalized anxiety disorder
D. Specific phobia
Rationale: Generalized anxiety disorder involves excessive anxiety
and worry about multiple domains occurring more days than not for
at least 6 months.
,6. Which medication class is generally considered first-line
pharmacotherapy for generalized anxiety disorder?
A. Stimulants
B. Typical antipsychotics
C. SSRIs or SNRIs
D. Barbiturates
Rationale: SSRIs and SNRIs are commonly used first-line because of
their efficacy and more favorable long-term safety profile.
7. A patient develops intrusive thoughts about contamination and
repeatedly washes their hands for hours each day. Which diagnosis is
most likely?
A. Illness anxiety disorder
B. Obsessive-compulsive disorder
C. Delusional disorder
D. Generalized anxiety disorder
Rationale: OCD is characterized by obsessions, compulsions, or both
that are time-consuming or cause significant distress or impairment.
8. Which is an example of an obsession?
A. Repeated handwashing
B. Checking a lock repeatedly
C. Counting objects according to a ritual
D. Recurrent intrusive fear of contamination
Rationale: Obsessions are intrusive, recurrent thoughts, urges, or
images; compulsions are repetitive behaviors or mental acts
performed in response.
9. Which intervention is particularly effective for OCD?
A. Supportive psychotherapy alone
B. Exposure and response prevention
C. Psychoanalysis alone
D. Light therapy
, Rationale: Exposure and response prevention, a form of CBT, is an
evidence-based treatment for OCD.
10. A patient has an intense fear of flying that leads to avoidance of
airplanes. Which diagnosis is most likely?
A. Panic disorder
B. Agoraphobia
C. Specific phobia
D. GAD
Rationale: Specific phobia involves marked fear of a specific object or
situation with active avoidance.
11. A patient avoids social situations because of fear of being
embarrassed or negatively evaluated. Which diagnosis is most likely?
A. Agoraphobia
B. Social anxiety disorder
C. OCD
D. Panic disorder
Rationale: Social anxiety disorder involves marked fear of social or
performance situations because of concern about scrutiny or
negative evaluation.
12. Which antidepressant class is associated with the greatest
concern for fatal toxicity in overdose?
A. SSRIs
B. SNRIs
C. Tricyclic antidepressants
D. Mirtazapine
Rationale: TCAs can cause severe cardiac conduction abnormalities,
arrhythmias, seizures, and coma in overdose.
13. A patient taking an SSRI develops agitation, diaphoresis,
hyperreflexia, clonus, and fever after starting another serotonergic
medication. What condition should be suspected?
Exam Exam Questions With
Correct Answers (Verified
Answers) Plus Rationales
2026 Q&A | Instant
Download Pdf
1. A 24-year-old patient has had depressed mood, anhedonia,
fatigue, insomnia, guilt, impaired concentration, and recurrent
thoughts of death for 3 weeks. Which diagnosis is most consistent
with this presentation?
A. Adjustment disorder
B. Bipolar II disorder
C. Major depressive disorder
D. Persistent depressive disorder
Rationale: Major depressive disorder requires at least 2 weeks of
depressive symptoms causing clinically significant distress or
impairment, including depressed mood or anhedonia.
2. Which symptom is required for a diagnosis of major depressive
disorder?
A. Insomnia
B. Fatigue
C. Weight loss
D. Depressed mood or anhedonia
,Rationale: At least one of the core symptoms must be depressed
mood or markedly diminished interest or pleasure.
3. A patient reports episodes of intense fear that peak within several
minutes and include palpitations, dyspnea, trembling, and fear of
dying. These episodes are most characteristic of:
A. Generalized anxiety disorder
B. Panic attacks
C. Social anxiety disorder
D. Somatic symptom disorder
Rationale: Panic attacks are abrupt surges of intense fear or
discomfort accompanied by multiple physical and cognitive
symptoms.
4. Which neurotransmitter system is most directly associated with
the therapeutic action of selective serotonin reuptake inhibitors?
A. Dopamine
B. GABA
C. Serotonin
D. Acetylcholine
Rationale: SSRIs primarily inhibit serotonin reuptake, increasing
serotonergic neurotransmission.
5. A patient has experienced excessive anxiety and worry about
multiple areas of life nearly every day for 8 months. Which diagnosis
is most likely?
A. Panic disorder
B. Social anxiety disorder
C. Generalized anxiety disorder
D. Specific phobia
Rationale: Generalized anxiety disorder involves excessive anxiety
and worry about multiple domains occurring more days than not for
at least 6 months.
,6. Which medication class is generally considered first-line
pharmacotherapy for generalized anxiety disorder?
A. Stimulants
B. Typical antipsychotics
C. SSRIs or SNRIs
D. Barbiturates
Rationale: SSRIs and SNRIs are commonly used first-line because of
their efficacy and more favorable long-term safety profile.
7. A patient develops intrusive thoughts about contamination and
repeatedly washes their hands for hours each day. Which diagnosis is
most likely?
A. Illness anxiety disorder
B. Obsessive-compulsive disorder
C. Delusional disorder
D. Generalized anxiety disorder
Rationale: OCD is characterized by obsessions, compulsions, or both
that are time-consuming or cause significant distress or impairment.
8. Which is an example of an obsession?
A. Repeated handwashing
B. Checking a lock repeatedly
C. Counting objects according to a ritual
D. Recurrent intrusive fear of contamination
Rationale: Obsessions are intrusive, recurrent thoughts, urges, or
images; compulsions are repetitive behaviors or mental acts
performed in response.
9. Which intervention is particularly effective for OCD?
A. Supportive psychotherapy alone
B. Exposure and response prevention
C. Psychoanalysis alone
D. Light therapy
, Rationale: Exposure and response prevention, a form of CBT, is an
evidence-based treatment for OCD.
10. A patient has an intense fear of flying that leads to avoidance of
airplanes. Which diagnosis is most likely?
A. Panic disorder
B. Agoraphobia
C. Specific phobia
D. GAD
Rationale: Specific phobia involves marked fear of a specific object or
situation with active avoidance.
11. A patient avoids social situations because of fear of being
embarrassed or negatively evaluated. Which diagnosis is most likely?
A. Agoraphobia
B. Social anxiety disorder
C. OCD
D. Panic disorder
Rationale: Social anxiety disorder involves marked fear of social or
performance situations because of concern about scrutiny or
negative evaluation.
12. Which antidepressant class is associated with the greatest
concern for fatal toxicity in overdose?
A. SSRIs
B. SNRIs
C. Tricyclic antidepressants
D. Mirtazapine
Rationale: TCAs can cause severe cardiac conduction abnormalities,
arrhythmias, seizures, and coma in overdose.
13. A patient taking an SSRI develops agitation, diaphoresis,
hyperreflexia, clonus, and fever after starting another serotonergic
medication. What condition should be suspected?
