Deck 18: Multicultural Diagnosis and Conceptualization

Question 1

__________ impact(s) the concept of normalcy in the diagnosis of individuals who are receiving mental health services.

A) Culture
B) Gender
C) Risk of the abuse of power by practitioners
D) All of the above.

Answer 1

All of the above.

Question 2

In North America, practitioners' constructs of personality and psychopathology reflect White, male, Anglo-Germanic, Protestant individuals who are formally educated and middle class. This is an example of

A) culture bound variables in diagnosis.
B) social comparison in diagnosis.
C) culture and gender sensitivity in diagnosis.
D) the founding fathers variable of diagnosis.

Answer 2

culture bound variables in diagnosis.

Question 3

Overdiagnosis has been common for members of the following populations except

A) White males.
B) African Americans.
C) lesbians.
D) gay men.

Answer 3

White males.

Question 4

Feminist analysis requires the client to be responsible for

A) solving his/her presenting concerns to a large degree.
B) providing all information regarding the presenting concern.
C) providing information regarding his/her cultural norms.
D) receiving quality care and visiting the national mental health organization websites to understand the process.

Question 5

The __________ perspective asserts that the anger, depression, and discontent that result from the challenging and stressful life circumstances of women or other disadvantaged groups are reframed as medical or psychiatric symptoms.

A) cross-cultural
B) gender
C) feminist
D) collectivist

Question 6

Substance abuse and gambling disorders have a higher prevalence rate in

A) White women.
B) Asian women.
C) men in general.
D) women in general.

Question 7

Women have higher prevalence rates of

A) substance abuse.
B) sexually related disorders.
C) anxiety disorders.
D) general medical conditions.

Question 8

Regarding prevalence rates and diagnosis among school age children,

A) there are greater differences between boys and girls in the elementary years.
B) girls have higher rates of diagnosis in the elementary years.
C) there is no difference between girls and boys during the adolescent years.
D) boys are more frequently diagnosed in the elementary years.

Question 9

According to the feminist perspective, early versions of the DSM as well as subsequent versions have been influenced by masculine-based assumptions regarding health and illness. This assumption is an example of

A) gender bias in diagnosis.
B) sex bias in diagnosis.
C) female bias in diagnosis.
D) male bias in diagnosis.

Question 10

According to research, sex bias in diagnosis results in women having higher prevalence rates of __________ disorders due to social conventions rather than medical disease.

A) mood
B) impulse control
C) sexually related
D) personality

Question 11

Research on diagnosis and sex differences have found that social positions influence

A) the clinical presentation of individuals based upon whether they are in subordinate or dominant positions.
B) the social condition of an individual but don't influence the presentation of symptoms.
C) only men's presentation of symptoms.
D) neither women nor men in the adult years. Social positions are only a variable in adolescents.

Question 12

If a counselor is going to provide a comprehensive assessment, the counselor should consider __________ instead of solely identifying the criteria of various disorders and selecting the best fit.

A) referring to a clinician's thesaurus to look up all areas related to the possible diagnosis
B) presenting the current symptoms the client possesses to a clinical team for a collaborative decision from all clinical team members
C) understanding the "total" person (mind and body) of the individual who is seeking services
D) understanding insurance procedures before providing the client with a diagnosis

Question 13

Should a practitioner be the only individual who provides information regarding a client's diagnosis when conducting a comprehensive assessment?

A) Yes, the practitioner has worked with the client and is abreast of the clinical interview data.
B) No, the practitioner should include all involved in the clinical relationship, including the client.
C) Yes, the practitioner can do so as long as the practitioner is abreast of all cultural considerations.
D) No, the practitioner must have the diagnosis approved by the clinical director of the organization to ensure all areas of the assessment have been evaluated and the diagnosis is appropriate.

Question 14

Diagnosis is best described as

A) a constructive, dynamic process of meaning making which should incorporate all descriptions and explanations of the presenting concern.
B) a process that requires the understanding of the DSM and the ability to provide the appropriate diagnosis.
C) a static, logical process in which the practitioner provides a diagnosis based upon the client's presenting concern.
D) a procedure that requires a significant number of clinical hours to ensure the practitioner has the appropriate skills.

Question 15

The universal diagnostic model implies that all diagnostic categories and descriptions

A) can be applied to all people regardless of situations and cultural variables.
B) cannot be applied to all people regardless of situations and cultural variables.
C) should apply to all sexes regardless of situations, or sex and gender role variables.
D) should not be applied to all sexes regardless of situations and cultural variables.

Question 16

The culturally specific diagnostic model states that all diagnostic categories and descriptions

A) can be applied to all people regardless of situations and cultural variables.
B) cannot be applied to all people regardless of situations and cultural variables.
C) should apply to all sexes regardless of situations, or sex and gender role variables.
D) should not be applied to all sexes regardless of situations and cultural variables.

Question 17

An accurate assessment of emotion or behavior is NOT possible without an assessment of

A) DSM criteria.
B) feminist perspective.
C) cultural schemas.
D) DSM prevalence rates for a disorder.

Question 18

Mental health professionals' ethical codes prohibit discrimination on the basis of

A) age.
B) race.
C) disability.
D) All of the above.

Question 19

Framing the normal difficulties and developmental struggles of everyday life in a negative way is referred to as

A) psychologizing.
B) pathologizing.
C) patholocating.
D) psycholocating.

Question 20

With regard to sampling bias, all but which of the following has been raised as a concern?

A) Research has ignored many of the people most in need of counseling services.
B) Sampling has included a disproportionate representation of the sexes.
C) The validity of the DSM's personality disorders is strong.
D) Sampling bias raises questions about who has the power to define illness and, thus, social control.

Question 21

Culture does all of the following EXCEPT

A) interprets the beliefs and customs of a social group.
B) explains how individuals cope with distress.
C) prescribes or determines a diagnosis.
D) predicts how certain people may be misdiagnosed.

Question 22

According to a feminist model, diagnostic labels and impressions can be influenced by all of the following stereotypes EXCEPT

A) etiology of disorder assumptions.
B) racist assumptions.
C) homophobic assumptions.
D) classist assumptions.

Question 23

Young girls' disorders are often overlooked or untreated because of

A) the lack of ability to observe young girls' distress when it is present due to internalized issues.
B) the traditional notion that it is less important for girls to succeed academically.
C) Both of the above.
D) None of the above.

Question 24

Which of the following is an example of traditional gender roles?

A) Women are emotional, less aggressive, and easily influenced.
B) Men are strong, independent, and goal-oriented.
C) Both of the above.
D) None of the above.

Question 25

__________ disorders are more likely to represent social conventions.

A) Sleep
B) Sexually related
C) Personality
D) Eating

Question 26

All of the following are examples of ways that women's contextual distress can be alleviated EXCEPT

A) providing affordable, quality childcare.
B) offering free education.
C) opening up employment for women.
D) changing the definitions of proper female behavior.

Question 27

The DSM tends to focus more on

A) explanations than problems.
B) problems than solutions.
C) resolutions than problems.
D) All of the above.

Question 28

When using the DSM, __________ should be considered during assessment.

A) individual symptoms
B) family interactions
C) functional abilities
D) All of the above

Question 29

Culturally sensitive assessment involves assessing

A) cultural systems/structures.
B) cultural values.
C) gender socialization.
D) All of the above.

Question 30

Feminist theorists contend that all of the following causes of problems are overemphasized EXCEPT

A) Social and cultural context
B) Biology
C) Personality traits
D) Life experiences

Question 31

The DSM-5 has significantly affected the way counselors diagnose mental disorders by replacing the ________ system with _________ assessments.

A) dimensional; axial
B) dimensional; categorical
C) categorical and axial; dimensional
D) None of the above

Question 32

The DSM-5 contains more than 67 _______ that will require score validation, including cross-cultural validation.

A) multiple diagnoses
B) emerging measures
C) unspecified categories
D) binary categories

Question 33

Category fallacy is

A) synonymous with binary classification.
B) the application of diagnostic categories to cultural groups for which they were not developed and have never been validated.
C) Both of the above.
D) None of the above.

Question 34

The _______ is an emerging measure included in the DSM-5 that helps the clinician understand the cultural context and factors of the client's presenting problem, as well as the client's perception of the problem.

A) cultural formulation interview
B) work group
C) binary classification system
D) All of the above

Question 35

A major criticism of the recently added diagnosis of disruptive mood dysregulation disorder (DMDD) is

A) that the symptoms demonstrate typical childhood behavior.
B) the serious underdiagnosis of the disorder.
C) the similarities to borderline personality disorder.
D) All of the above.

Question 36

Children under the age of 13 are often _______ with attention deficit/hyperactivity disorder (ADHD), while adolescents are often _______ with conduct disorders and substance use disorders.

A) underdiagnosed; underdiagnosed
B) underdiagnosed; overdiagnosed
C) overdiagnosed; underdiagnosed
D) overdiagnosed; overdiagnosed

Question 37

Women in North America are ______ men to experience depression in their lives.

A) as likely as
B) twice as likely as
C) four times as likely as
D) less likely than

Question 38

An environmental factor that may account for the high rates of depression and other disorders in women is

A) the greater restrictiveness of women's roles.
B) a lack of social networks and supports.
C) more frequent experiences of gender-based discrimination.
D) All of the above.

Question 39

Which of the following statements is NOT considered a potential benefit of diagnosis?

A) Diagnosis contributes to a common language that facilitates communication among those involved in the clients' treatment.
B) Diagnosis provides a framework for describing complex phenomena.
C) Diagnosis treats all clients the same with a universal perspective.
D) Diagnosis increases one's understanding of the symptoms.

Question 40

Which of the following questions should culturally sensitive counselors ask themselves before diagnosing a client?

A) What do I know (and not know) about this client's cultural heritage?
B) How acculturated is the client?
C) What are my stereotypes, beliefs, and biases about this culture?
D) All of the above.

Question 41

Significant correlations have been found between premenstrual dysphoric disorder (PMDD) and history of

A) sexual abuse.
B) domestic violence.
C) depression and anxiety.
D) All of the above.

Question 42

Feminists hold the position that

A) personal issues should be separated from political or social aspects.
B) the personal cannot be separated from the political or social.
C) therapy is viewed as a social, not political, process.
D) therapy is viewed as a political, not social, process.

Question 43

All of the following statements regarding sex bias in diagnosis are true EXCEPT

A) Knowing a client's sex may influence the diagnostic process.
B) Female and male clients may receive different diagnoses even when they present with identical symptoms.
C) Sex bias in diagnosis is decreasing consistently.
D) Female clients who acted in unfeminine ways received strong negative reactions.

Question 44

Culture is inextricably linked with

A) normal behavior.
B) abnormal behavior.
C) Both of the above.
D) None of the above.

Question 45

Research indicates that African Americans have been ______ with psychosis and _____ with depression.

A) underdiagnosed; underdiagnosed
B) underdiagnosed; overdiagnosed
C) overdiagnosed; underdiagnosed
D) overdiagnosed; overdiagnosed

Question 46

What steps might you take to ensure the highest professional and ethical conduct when working with a client and considering diagnosis?

Question 47

How will you address your own values when providing a client with a diagnosis? How will you keep from imposing your value and belief system on your client (consider your non-verbal behavior)?

Question 48

When working with your client, how will you demonstrate a respect for diverse populations?

Question 49

Some mental health professionals struggle with providing diagnoses to clients who are members of diverse populations for whom a history of misdiagnosis is prevalent. How will you address your feelings?

Question 50

Review your professional code of ethics and discuss how the materials covered in this chapter impact your decisions about the ethical mandates on client assessment, diagnosis, and counseling members of diverse communities.

Question 51

It is important to allow an individual who is seeking counseling services to share his/her culture. How could you initiate a discussion about culture and diversity while gathering assessment data?

Question 52

List all of the variables to consider when conducting case conceptualizations and making diagnoses.

Question 53

Select the theoretical orientation of your choice and discuss how your theoretical orientation can incorporate cross-cultural considerations in diagnosis and case conceptualizations.

Question 54

Reflect upon and write about your professional and personal development. Reflect upon the variables that make for sound ethical practice in diagnosis and case conceptualization. Consider areas of strength you have and areas of needed professional development. How will you seek professional development opportunities?

Question 55

Describe culturally astute strategies for accurate assessment of a client's affect or behavior.

Question 56

Describe the ethical considerations (i.e., the cultural framework of the client's identity, cultural explanations of illness, cultural meanings of adaptive functioning and social context, help-seeking behavior, and cultural elements in the counselor-client relationship) that, as a counselor, you will need to contemplate for a specific cultural group you wish to work with.

Question 57

Reflect on your own cultural biases and assumptions in regard to one or more cultures different than your own.

Question 58

Provide one example of a situation of overdiagnosis, underdiagnosis, or misdiagnosis of a client, and discuss how this situation could have been avoided and can be resolved.

Question 59

What do counselors need to know about sampling bias in order to be effective?

Question 60

As a counselor, what do you think is a key element of culture that should be considered when making a diagnosis? Explain.

Question 61

Give one example of how a diagnosis can affect a client in a negative way relative to his or her culture.

Question 62

In addition to the DSM, what are other types of assessment tools and how can counselors use them to effectively diagnose a client? List the pros and cons of each.