PRITE Question Banks - My Psych Board

Example Single Response Multiple Choice- Click to see answer!

T.S. is a 23-year-old University student who has been recently diagnosed with body dysmorphic disorder (BDD). He is completely convinced that his legs and arms are too skinny, causing people to always look at him. This preoccupies him most of the day and is affecting his social and academic life significantly. Which would be the most appropriate treatment for this patient?

A Risperidone plus exposure response prevention therapy (ERP)

B Fluoxetine plus olanzapine

C Sertraline plus ERP

D Citalopram plus pimozide

E Electroconvulsive therapy

Example Single Response Multiple Choice- Answer

Correct Answer- C Sertraline plus ERP

Explanation:

Body dysmorphia disorder (BDD) is one of the obsessive-compulsive related disorders (OCRD) in the DSM that is characterized by excessive preoccupation with a perceived flaw in one’s appearance. For moderate-to-severe cases, patients require SSRIs and ERP (Choice C). SSRIs are considered first line in the management of OCRDs and are given at larger doses and for longer durations. ERP for this patient would involve working to eliminate ritual body checking/picking behavior and avoidance behaviors (such as looking in mirrors) commonly found in BDD, thereby teaching the patient how to tolerate distress, and providing corrective information that challenges the existing fear response. Antipsychotics have not been found to be efficacious with BDD, even in patients with delusional insight (Choice A and B). Pimozide is largely not used due to its high risk of QTc prolongation and torsade de pointes (Choice D). Electroconvulsive therapy has a role in suicidal and catatonic depression but is not indicated in this case (Choice E).

REF:
1- Fang, A., Matheny, N. L., & Wilhelm, S. (2014). Body dysmorphic disorder. The Psychiatric Clinics of North America, 37(3), 287-300.

Example Multiset Vignette

Levi is a 25-year-old patient coming to see his counselor for his weekly psychotherapy session. Levi has been struggling with recurrent alcohol use that has led to consequences in his personal and professional life. Levi has been diagnosed with alcohol use disorder and has been seeing a therapist weekly as part of court-mandated therapy.

Q1 “You don’t get it, not only do I not have a problem with drinking, but it’s one of the few things I actually like doing and helps make me feel better,” Levi says. The counselor respond, “Unless you drink, you don’t feel happy.” He answers, “It’s not unhappy, exactly. I just feel bad all the time otherwise,” he says. “That seems like a really rough situation to be in.” the counselor answers. What principle of Motivational Interviewing (MI) is the counselor enacting in this conversation?

A Support self-efficacy and optimism

B Adjust to resistance rather than opposing it

C Express empathy through reflective listening

D Avoid arguments and direct confrontation

E Develop discrepancy between client goals and behaviors

Example Multiset Vignette Continued

Q2 “There’s still the fact that I don’t have a problem here,” Levi tells you. “You don’t believe there are significant consequences associated with you drinking,” the counselor states. “No, the problem is everyone else,” he says. The counselor asks Levi about his current attempt at remaining sober. “I don’t see the point. It’s been a few days, but it just isn’t worth it to me. Tell me why that would be worth my time and efforts.” What response would be most effective?

A “You feel like there are other things that are more important for you to focus on right now.”

B “I’ll tell you why this is beneficial to you.”

C “It’s not my job to convince you, you need to figure this out on your own.”

D “I believe you have the best interest at heart here, you’re probably right.”

E “Didn’t you go to jail last month because of drinking?”

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Example Single Response Multiple Choice- Click to see answer!

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Example Multiset Vignette

Example Multiset Vignette Continued

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