Cognitive-Behavioral Treatment for Generalized Anxiety Disorder

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. The fundamental nature of GAD as defined in the DSM-IV in 1994 is which of the following:
  1. persistent anxiety for one month
  2. worry is difficult to control
  3. minimum duration of symptoms for six months
  4. having motor tension and hyperactivity as symptoms

a) 1 and 2
b) 1 and 4
c) 2 only
d) 2 and 3
e) 3 and 4

2. The walking wounded worry excessively but can accomplish most of their daily activities, maintain acceptable levels of well-being, and a quality of life.

a) TRUE
b) FALSE

3. The cardinal feature of GAD in the DSM-IV is:

a) excessive and uncontrolled worry and anxiety about various situations
b) excessive worry about minor matters with physical symptoms
c) inability to focus on activities of daily living due to restlessness
d) agitation, chronic fatigue, and inability to sleep are the primary physical symptoms

4. In primary care facilities, GAD is:

a) most frequent among women
b) prevalent in 2 to 4 % of the population
c) the second most frequent of all mental disorders
d) more common in the community than in primary care settings

5. According to Rapee, 1991, individuals with GAD:

a) may wait over 25 years before presenting for treatment
b) experience symptoms between the ages of 11 and 20
c) have a 38 % chance of remission after five years of treatment
d) is most common in older adults with declining health

6. Which of the following mood disorders are the most common comorbid conditions with GAD:

a) panic disorder and alcoholism
b) major depression and PTSD
c) phobias and dysthymia
d) schizophrenia and sleep disorders

7. GAD clients overuse primary care resources such as physicians, nurses, and medical specialists.

a) TRUE
b) FALSE

8. Intolerance of uncertainty is:
  1. involuntary thinking
  2. highest among people with depression
  3. the central feature of the model
  4. stressful and upsetting to individuals

a) 1 only
b) 2 and 4
c) 3 only
d) 3 and 4
e) 1 and 2

9. There are five types of positive beliefs about worry. The fifth belief is the best predictor of excessive worry which is:

a) worrying shows that one is a responsible and caring person
b) worrying helps find solutions to problems
c) worrying decreases one’s negative reaction should that event occur
d) worrying prevents bad things from happening
e) worrying increases motivation to get things done

10. The problem-solving process can be broken down into two major constituents which are:

a) assessing the problem and evaluating the outcomes
b) problem orientation and problem-solving skills
c) planning actions and implementing those actions to solve a problem

11. Enhancement effects are observed when an individual experiences an increase in the target thought ____ attempted suppression whereas rebound effects are witnessed when a person experiences an increase in the target thought _____ suppression.

a) before, during
b) preceding, after
c) during, following

12. The feeling of uncontrollability that is characteristic of GAD is called the chaining effect and can be addressed through the:

a) analogy of a freight train
b) comparison of the fear of falling
c) frustration of being lost
d) sense of not belonging

13. The final criterion required to ascribe a diagnosis of GAD is:

a) having the six somatic symptoms
b) whether the worry is longstanding with bouts of depression
c) how excessive is the worry and does it interfere with sleep
d) the presence of significant distress or interference in the individual’s life as a result of symptoms

14. When a client worries about school, work, and social situations, there may be an underlying fear of negative evaluation which could be diagnosed as:

a) panic disorder
b) a specific phobia
c) social anxiety disorder
d) a depressive disorder

15. A dysthymic disorder is less severe, but more chronic form of depression with symptoms present for at least two years.

a) TRUE
b) FALSE

16. The main advantage to a structural diagnostic interview is:

a) the information establishes a baseline
b) the clinician is less likely to make the mistake of not going beyond presenting complaints
c) that drifting away from the criteria is less likely
d) it can take as little as 20 minutes to administer

17. Self-report questionnaires are extremely useful because they are:
  1. informative
  2. practical
  3. inexpensive
  4. flexible

a) 1 and 2
b) 1 only
c) 3 and 4
d) 4 only

18. The ultimate goal of the treatment package is to help clients:

a) recognize when worry is excessive and controlling
b) know when to seek professional help
c) develop a greater tolerance for uncertainty in their life

19. The worry themes involves two categories which are:
  1. worries about details, especially when under pressure
  2. worries excessively and is unable to stop
  3. worries about current problems
  4. worries about hypothetical situations

a) 1 and 2
b) 2 and 3
c) 1 and 3
d) 3 and 4
e) 1 and 4

20. An achievable goal for Module 2 is for clients to achieve certainty in their lives as a means of worrying less.

a) TRUE
b) FALSE

21. A second goal of Module 3 is for clients to think about:

a) what it means to worry less
b) the usefulness of worry
c) identifying factors that cause worry

22. The two discrete elements in Module 4 of the treatment are:

a) recognizing stressful situations and the length of worry
b) understanding the problem and identifying the impact
c) improving problem orientation and applying problem solving skills
d) identifying when worry is problematic and how to minimize it

23. In Module 5, the client is exposed to the mental image of a threatening situation and the:

a) mental preparation that worry is of no value in most cases
b) subjective feelings and physiological indices of anxiety
c) relaxation techniques to decatastrophize

24. The goal of Module 6 is for clients to maintain their gains and increase progress over time.

a) TRUE
b) FALSE

25. Avoidance, procrastination, and impulsive problem solving has ___consequences.

a) emotional
b) cognitive
c) behavioral

26. The final guideline to attaining a goal is:

a) evaluate the process
b) implement the strategies
c) review methods to maintain the goal
d) be aware of the timeline

27. Statistical comparisons of mean effects have disadvantages, one of which is:

a) if observed changes are clinically significant
b) the effects may be observed or the result of chance
c) the magnitude of an effect cannot be measured
d) a client’s progress has variances

28. From this study the results were 60% of the participants met conditions for high-end state functioning immediately following treatment and at one-year follow-up. The majority of clients benefited greatly in short and long term:

a) Study 1: Cognitive Behavioral Therapy and Wait-List Control
b) Study 2: Group Cognitive Behavioral Therapy and Wait-List Control
c) Study 3: CBT, Applied Relaxation, and Wait-Control List
d) Study 4: CBT and Medication Discontinuation

29. Epidemiological surveys have found that over _____ % of individuals with GAD have at least one additional Diagnostic and Statistical Manual of Mental Diagnosis disorders.

a) 90
b) 80
c) 65
d) 50
e) 35

30. A common error therapists make when using manuals is applying the manual in a rigid and inflexible manner.

a) TRUE
b) FALSE

31. When insurance companies and managed health-care organizations cover less than 10 treatments, the therapist can:

a) cover all modules in a shorter time
b) offer a scaled-down version depending on the type of worry
c) ask the client to select the modules that would be most beneficial