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B. The social smile is the first of these to appear in the infant.

1. C. The initial bonding between mother and child can be adversely affected by illness of the child, low birth weight, separation of the mother and child, and problems in the mother and father relationship. There is no evidence that a pregnancy longer than term adversely affects bonding.

2. A. The principal psychological task of infancy is the formation of an intimate attachment to the mother.

3. D. During latency, peers become more important to the child and the family becomes less important.

4. E. Identity crises frequently develop during late – not early – adolescence.

5. E. Prematurity puts a child at risk for a variety of developmental problems as well as for child abuse.

6. E. All are correct.

7. E. Infant monkeys reared by surrogate artificial mothers have many social problems and are more likely to be adversely affected if they are male.

8. B. Stranger anxiety develops in normal infants at 7 to 9 months of age and is seen less frequently in children exposed to multiple caregivers.

9. A. The toddler years are Erikson’s stage of autonomy vs. shame and doubt.

10. C. In the preschool child, fantasy can be distinguished from reality although the line between them may not be sharply drawn. Generally, the child does not begin to think abstractly until the end of latency or early adolescence.

11. E. All are correct.

12. D. The average age of first sexual intercourse in the United States is 16 years (statistics from late 1980s). In general, teenagers are irresponsible in the use of contraceptives and nearly 50% of unmarried mothers are teenagers. Teenagers give birth to about 600,000 babies per year.

13. C. Teenagers who become pregnant frequently are from divorced homes, are depressed, show poor future planning, and have low academic goals for themselves.

14. B. The unconditioned stimulus produces an unconditioned response that does not have to be learned.

15. B. Modeling involves adopting the behavior of someone admired or respected.

16. D. In learning by operant conditioning, past history of the organism is not important.

17. B. Spontaneous recovery occurs after extinction when the conditioned response reappears in the absence of stimulus.

18. A. In operant conditioning, nonreflexive behaviors are elicited in response to rewards. The focus of operant conditioning is an observable behavior. Motivational state and prior historical factors are not important.

19. E. Operant conditioning is associated primarily with the work of B.F. Skinner.

20. B. The most open-ended of these questions, “Tell me about the pain,” gives little structure to the patient and can therefore elicit the most information.

21. A. Facilitation is used by the interviewer to encourage the patient to elaborate on an answer. The phrase “Please go on” is such a facilitative statement.

22. D The statement “You look terrified” calls the patient’s attention to his or her own response or body language.

23. B Deliberate misuse of medication is rarely the reason for noncompliance with medical advice.

24. D Transference reactions are unconscious

25. C Although a patient’s attitude toward the physician is very important, there is no clear association between compliance and a patient’s sex, marital status, race, religion, socioeconomic status, intelligence, or educational level.

26. A Compliance is associated with older physician age, written instructions for taking medications, simple treatment regimen, decreased waiting room time, and how ill the patient feels.

27. D Positive as well as negative life events cause stress to the individual

28. E Sexual or physical abuse is a catastrophic stressor in the life of a child or adolescent

29. B The passive-aggressive personality type may ask for help from the physician and then not comply with the physician’s advice.

30. A Physiologic consequences of stress include rapid release of ACTH followed by release of corticosteroids. Corticosteroids, in turn, can alter immune functions and may suppress the immune response. Stress is also associated with increased heart rate, respiratory rate, blood pressure, body oxygen consumption, and skin conductance and resistance.

31. B During the toddler years, the favorite word is “no.”

32. C Imaginary companions are common during the preschool years.

33. D The child acquires the capacity for logical thought during latency.

34. E A sense of independent self, Erikson’s stage of identity consolidation versus role confusion, develops during adolescence.

35. E

36. B

37. A

38. C

39. E Of the defense mechanisms listed, denial is the least mature.

40. B The ego functions to maintain a relationship to the external world.

41. C People are seen as being totally bad or totally good when an individual uses the defense mechanism of splitting.

42. B When unacceptable feelings are expressed in actions, an individual is acting out.

43. D When an individual uses the defense mechanism of identification, his or her behavior is patterned after that of another person.

44. A An individual uses rationalization to make an irrational feeling appear reasonable.

45. D In modeling, an individual adopts the behavior of someone admired or respected.

46. B In aversive conditioning, an unwanted behavior is paired with a painful stimulus.

47. C When the conditioned response reappears in the absence of a stimulus it is known as spontaneous recovery.

48. A In operant conditioning, a nonreflex behavior serves as a reward of punishment.

49. E There is no clear association between compliance and a patient’s sex, marital status, race, religion, socioeconomic status, intelligence, or educational level. However, compliance has been associated with a good doctor-patient relationship, older physician age, and written rather than verbal instructions for taking medication.

50. C Both morbidity and mortality are higher in psychiatric populations

51. E Psychological stress is associated with a variety of illnesses, including hyperthyroidism, diabetes mellitus, immune disorders, and arthritis.

52. D Of the listed life stressors, divorce is the most and changing residences the least severe.

53. D

54. E

55. C

56. B

57. A

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