ITEM ANALYSIS

1. Stem: It refers to the specific behaviors that are characteristics of a particular genetic
disorder.

Key: C. Behavioral phenotype

Distractor 1: A. Characteristic phenotype

Distractor 2: B. Behavioral genotype

Distractor 3: D. Characteristic genotype

Explanation: Behavioral phenotype is the specific behaviors that are considered as a

characteristic of a particular genetic disorder (e.g.Lesch-Nyhan syndrome).

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 38)

Item Difficulty Index = 0. 3636

Item Discrimination Index: 0. 333333

2. Stem: Astrid is a 11 year old kid who reportedly has issues regarding her behavior. She talks
excessively to her classmates, and often interrupts someone who is talking. Her classmate
also reported Astrid using her toys without asking, and loses the toy after playing with it.
Astrid’s teacher also observed that Astrid is easily distracted by the actions around her and
seems uninterested when she is talking to Astrid. This has been going on for more than 5
months. But according to Astrid’s parents, she’s doing okay when she is at home, but often
forgets her daily activities assigned by them. What diagnosis is necessary for Astrid’s
behavior?

Key: A. Combined Presentation ADHD

Distractor 1: B. Intermittent Explosive Disorder

Distractor 2: C. Specific Learning Disorder

Distractor 3: D. No diagnosis

Explanation: Combined Presentation ADHD is the answer because Astrid’s situation meets the
criteria for Attention Deficit Hyperactivity Disorder. Her situation has six symptoms and is
on-going for more than five months, which is what the DSM-5 stated to be diagnosed as
ADHD.
It is not Intermittent Explosive Disorder since this type of behavior is not seen at home. It is
also not in Specific Learning Disorder because this disorder only occurs in school.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 59)

Item Difficulty Index = 0.6969

Item Discrimination Index = - 0. 333333

3. Stem: Peter has been struggling to rest ever since he saw a face making unusual expressions
everytime he begins to feel relaxed. He is restless for the past 3 weeks even though it
occurred only thrice. Other than that, Peter said he is doing okay and is just restless when he
remembers the face he saw. What is the possible diagnosis for Peter in his situation?

Key: D. Brief Psychotic Disorder

Distractor 1: A. Schizopreniform Disorder

Distractor 2: B. Catatonic Disorder

Distractor 3: C. Delusional Disorder

Explanation: Brief Psychotic Disorder is the answer because in this disorder, there should be a
presence of one or more symptoms. In Peter’s case, he just has one symptom for the disorder
and that is hallucination. The event only occurred thrice in a month and does meet the criteria
for Brief Psychotic Disorder.

It is not Schizopreniform Disorder because the symptoms that Peter may experience have to be
two (2). It is not Catatonic Disorder since there are no present symptoms from Peter. It is not
Delusional Disorder because Peter has only experienced this event in a span of three weeks.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 94)

Item Difficulty Index = 0.6666

Item Discrimination Index = 0.888889

4. Stem: According to Kevin’s parents, he is having nightmares about being separated from his
mother. He is also getting nauseous when his mother leaves him for about five minutes in
the mall to go to the comfort room. He is also reluctant to attend school in fear of being
kidnapped. This has been going for the past 3 months and Kevin’s parents are worried for
him. What is the possible diagnosis for Kevin?
Key: B. Separation Anxiety Disorder

Distractor 1: A. Panic disorder

Distractor 2: B. Social Anxiety Disorder

Distractor 3: C. Generalized Anxiety Disorder

Explanation: Separation Anxiety Disorder is the answer because there are three occurring
symptoms from Kevin and his situation has been going on for three months, which meets the
criteria for Separation Anxiety Disorder.

It is not Panic Disorder because Kevin is worried about being away from his mother rather
than worrying about an unexpected panic attack. It is not Social Anxiety Disorder because
even though he does not want to go to school, Kevin’s reason is still because of being away
from his mother, and not the avoidance due to fear of being judged. It is not Generalized
Anxiety Disorder because the anxiety that Kevin experiences is just from being away with his
mother, and not other cases.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 191)

Item Difficulty Index = 0.8787

Item Discrimination Index = 0.111111

5. Stem: A patient was referred to you. The patient, Ray, was found digging in a graveyard
naked. There he was picked up by the police and sent to the hospital. Upon arrival, he kept
saying how he lost his fiancée and would always refer to her in the past tense. You found
visible injection marks on his arms, his toxicology reports returned negative for any drugs,
but there are traces of glutaraldehyde, an embalming fluid. You also found out that he
cannot feel anything. Ray then claims that he cannot feel because he is invisible. Someone
then called for you and claimed to be Ray’s fiancée. She reported that a week ago, he was
fine, but he suddenly stopped taking calls, stopped going to work, and disappeared. Minutes
later, you found out that Ray was not in his bed and missing. He was then found lying in the
morgue. As his clinician, what diagnosis best fits Ray?

Key: D. Cotard’s Syndrome

Distractor 1: A. Delusional disorder somatic type

Distractor 2: B. Depersonalization/derealization disorder

Distractor 3: C. Capgras Syndrome

Explanation: Cotard’s Syndrome is the answer because of Ray’s claim of being invisible, the
embalming fluid, and the morgue. The symptoms Ray is exhibiting are consistent with
someone who believes they do not exist and that they are dead which is the inclusion criteria
for Cotard’s syndrome.

(A) Delusional Disorder somatic type is not the answer because the duration of Ray’s delusion
does not meet the 6 months criteria of the disorder. (B) Depersonalization/derealization
Disorder is also not the answer because Ray does not meet any of the criteria for the disorder.
(C) Capgras syndrome is not the answer because it is the false belief that someone significant
to them has been replaced by someone identical, which is different from what Ray is
experiencing.

Reference: David, B., Durand, V. M., Hofman, S. G. (2018). Schizophrenia Spectrum and
Other Psychotic Disorders: Clinical Description, Symptoms, and Subtypes. Abnormal
Psychology: An Integrative Approach (8th ed., pp. 488-489). Cengage Learning

Sahoo, A., Josephs, K. A. (2017). A Neuropsychiatric Analysis of the Cotard Delusion. The
Journal of Neuropsychiatry and Clinical Neurosciences.
https://doi.org/10.1176/appi.neuropsych.17010018

Item Difficulty Index = 0.54

Item Discrimination Index = 0.444444

6. Stem: Mrs. Remus, a 35-year-old female, was red flagged by several hospitals because they
believed she had been abusing her child. Mrs. Remus had been rushing her daughter to
different hospitals with vague symptoms, but all her tests always came back negative.
Mindy had a history of bronchopulmonary dysplasia when she was two years old, so Mrs.
Remus still carries her infant nebulizer with her wherever they go. The doctors believed that
Mrs. Remus had been faking or causing her daughter’s sickness to gain attention for herself.
In her interview, Mrs. Remus admitted to having a terrible birth experience. During her
daughter's birth, she reported that her daughter wasn’t breathing when she came out. She
also reported that the doctors took Mindy away and put different tubes on her. Also, she
claimed that whenever she sees and hears the machines, she thinks her daughter is dying. If
you were the clinician, how would you diagnose Mrs. Remus?

Key: C. Post-Traumatic Stress Disorder

Distractor 1: Factitious Disorder Imposed on Another

Distractor 2: Histrionic Disorder

Distractor 3: Generalized Anxiety Disorder

Explanation: Post-traumatic is the answer because of the traumatic experience Mrs. Remus had
undergone when she gave birth to her baby and watched it almost die. Ms. Remus exhibits
hypervigilance which manifests as her constantly worrying over the health of her child. The
reason why Mrs. Remus always rushes her daughter to the hospital whenever she notices
something wrong with her.

(A) Factitious is not the answer because as stated in the question Ms. Remus had experienced a
traumatic situation that led her to be in constant worry over the health of her child. Moreover,
in the interview, Mrs. Remus expressed fear and genuine worry over her child. (B) Histrionic
is not the answer because Ms. Remus did not meet the full criteria to be diagnosed with the
disorder, as her behavior caused the attention to be directed to her daughter and not to herself.
(D) GAD is not the answer because Ms. Remus did not meet the full criteria, as the center of
her worry is directed toward the well-being of her child.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 271)

Item Difficulty Index = 0.12

Item Discrimination Index = 0.333333

7. Stem: Helen has been in therapy with Dr. Block for the past three years for dependent
personality disorder. When she first came to therapy, she was in an abusive marriage and
complained that her adult children treated her poorly and that people in her life “walked all
over her.” Helen has attended therapy religiously, been a “model” patient, and generally
done everything Dr. Block suggested. At this time in her life, she is divorced, more
assertive with her children, and generally feels better about herself. Her current therapy
sessions are often centered on everyday decisions for which she anxiously seeks Dr. Block’s
advice. The most appropriate next therapy step is?

Key: B. working to reduce Helen’s reliance on Dr. Block.

Distractor 1: A. immediate termination

Distractor 2: C. a​ behavioral plan to increase Helen’s socialization

Distractor 3: D. ​exploration of the issues that made Helen seek therapy initially

Explanation: Working to reduce Helen’s reliance on Dr. Block is the answer because as seen in
the question the client is doing better through the therapy, however, because of the disorder the
client has relied on her therapist which is why the proper step of the therapy should be
reducing the reliance of the client to her therapist and possibly for her to learn to make her own
decisions with the suggestions of others.

(A) Immediate termination is not the answer because the client has not expressed the desire
for termination. Moreover, the client has not made anything that could cause the therapist to
terminate the therapy sessions. (C) A behavioral plan to increase Helen’s socialization is not
the answer because the client has not expressed her concern about not being able to socialize
but the client complains of being mistreated and being “walked over”. (D) Exploration of the
issues that made Helen seek therapy initially is not the answer because the client’s issue has
been addressed as she has been attending therapy and has been doing what her therapist
suggested which led her to be more assertive and feel better about herself.

Reference: David, B., Durand, V. M., Hofman, S. G. (2018). Schizophrenia Spectrum and
Other Psychotic Disorders: Clinical Description, Symptoms, and Subtypes. Abnormal
Psychology: An Integrative Approach (8th ed., pp. 488-489). Cengage Learning

Item Difficulty Index = 0.5757

Item Discrimination Index: 0.888889

8. Stem: Langdon is a male rocker who wears outlandish makeup and women’s clothing when
performing on stage. This behavior is considered

Key: B. Less abnormal than that of an accountant who starts to do so because it is

consistent with his professional success.

Distractor 1: A. More abnormal than that of an accountant who starts to do so because

rockstars are supposed to be very masculine

Distractor 2: ​C. Just as abnormal as that of an accountant who starts to do so because

abnormality is defined by the individual himself

Distractor 3: D. Less abnormal than that of an accountant who starts to do so because it is

common for artists to wear makeup

Explanation: Less abnormal than that of an accountant who starts to do so because it is

consistent with his professional success is the answer because the behavior of Langdon
wearing outlandish makeup and wearing women’s clothing is consistent with his success as a
performer as it is a way to garner attention from his audience, then an accountant who should
wear appropriate clothing as they work in a bank or company.
Option A is not the answer because saying that rock stars are supposed to be masculine is
stereotyping, not all rock stars are male there are also females. Option C is not the answer
because it is not abnormal for rock stars to dress in exaggerated ways as doing that might be
their way to appeal to the audience. Option D is not the answer because it has been
generalized, not all artists wear outlandish makeup and women’s clothing when performing.

Reference: David, B., Durand, V. M., Hofman, S. G. (2018). Abnormal behavior in Historical
Context: Understanding Psychopathology. Abnormal psychology : An Integrative Approach
(8th ed., pp. 5). Cengage Learning

Item Difficulty Index = 0.42

Item Discrimination Index = 0.444444

9. Stem: In what way does individuals with schizoaffective disorder differ from people with
schizophrenia?

Key: D. They experience psychotic symptoms for 2 or more weeks, and major mood
episodes present for most of the active and residual portions of the illness.

Distractor 1: A. They experience psychotic symptoms and major mood disorders present for
most of the active and residual portions of the illness for 2 or more weeks.

Distractor 2: B. They experience delusions, but not hallucinations for 2 or more weeks.

Distractor 3: C. They experience hallucinations, but not delusions for 2 or more weeks

Explanation: In this question, we are looking for the differential diagnosis of schizoaffective
disorder and schizophrenia. But before we go further to their differential diagnosis, it is
necessary that we know the similar symptoms of the two disorders. As we all know, there are
five similar symptoms of schizophrenia and schizoaffective disorders. These are
hallucinations, delusions, catatonic behavior, negative symptoms, and disorganized speech.
The criterion B of schizoaffective disorder states that delusion or hallucination must be present
for 2 or more weeks in the absence of a major mood episode. However, the criterion C of
schizoaffective disorder is the main factor which separates it from schizophrenia. According to
the DSM - 5, the symptoms that meet major mood episodes must be present for most of the
total duration of the active and residual portions of the illness. In short, mood disorder is not a
dominant part of schizophrenia, but for schizoaffective disorder the mood episodes (depression
and/or mania) is a critical part of diagnosing the said disorder.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 105)
Item Difficulty Index = 0.4848

Item Discrimination Index = 0.555556

10. Stem: A nine-year-old boy named Sevi cannot sleep without the presence of his father in
his room. While falling asleep, he frequently awakens to check that his father is still there. If
suddenly he wakes up in the middle of the night without his father beside him, he will cry
loudly and start to panic. Sevi also told his father that he experiences frequent nightmares
where evil people will do harmful things to them. In addition, he sometimes saw a strange
figure peeking into his room when the lights were off. When his father wakes up in the
morning, he typically finds Sevi sleeping on the floor of their room. Sevi’s parents tried to
leave him in his grandparent’s house since they had a meeting internationally. However, Sevi
became upset in anticipation of this that his parents opted to join the meeting virtually. Sevi is
most likely to be diagnosed with?

Key: D. Separation anxiety Disorder

Distractor 1: A. Specific Phobia

Distractor 2: B. Nightmare Disorder

Distractor 3: C. Delusional Disorder

Explanation: Excessive anxiety about being detached from home or attachment figures
(parents, caregivers and so on.) is the key feature of separation anxiety disorder. It appears
before the age of 18 nevertheless, this could persist into adulthood. Unwillingness to go
outside the residence or stay in a room without the presence of a parent is the common
symptoms of this disorder. In other cases, childrens might experience having difficulty
sleeping and might even insist on having a parent sleep or stay with them. Childrens tend to
share unfavorable incidents that might keep their attachment figure stay with them, and they
may have strange dreams about these concerns along with unexpected perceptional
perspectives, notably at night or in the dark. Moreover, Sevi’s fear is centered on the thought
of his parents leaving him.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 190-191)

Item Difficulty Index = 0.60

Item Discrimination Index = -0.222222

 11. Stem: Mr. and Mrs. Delos Santos have been married for almost six years; however, Mrs.
Delos Santos cannot bear a child since she was diagnosed with cardiomyopathy. Instead of
risking the health condition of Mrs. Delos Santos, they decided to adopt a 6-year-old girl
named Enola. According to the foster home, Enola has been placed in different foster homes
for the past three years. Despite the history of Enola, they still adopt her. However, they
noticed that Enola had repeatedly approached strangers while in the park, and she was willing
to join them without hesitation. Mrs. Delos Santos consulted a psychologist and requested an
evaluation of Enola’s behavior. If you are the psychologist, you will diagnose Enola with what
kind of disorder?

Key: B. Disinhibited social engagement Disorder

Distractor 1: A. Attention - deficit/hyperactivity Disorder (ADHD)

Distractor 2: C. Autism spectrum Disorder (ASD)

Distractor 3: D. Separation anxiety Disorder (SAD)

Explanation: DSED is a behvaioral disorder that is common for childrens who came from
different foster homes or relative care that experienced insufficient childcare. With Enola’s
situation, she came from different foster homes for the past three years and was overly
impulsive in joining strangers, but has . According to the DSM 5, to diagnosed DSED we have
to consider the three critical criteria which are it involves a culturally insensitive and entirely
comfortable attitude with random people (Criterion A), a child must have a socially
disinhibited behavior (Criterion B) not just like an ADHD impulsive behavior, and a child
must experienced pattern of insufficient care like deprivation of emotional needs for comfort,
repeated changes of primary caregivers, and rearing in unusual settings.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 268)

Item Difficulty Index: 0.6969

Item Discrimination Index: 0.777778

12. Stem: A 28-year-old woman named came Arriane visits her psychologist because she
experiences a sad mood every month in anticipation of her painful menstruation. The pain she’s
experiencing also starts on the 1st day of menstruation and continues for several days, but she
does not experience any discomfort during other days of the month. Arriane tried home
remedies and other treatments; however, none of these relieved her. If you are to diagnose
Arriane, what appropriate diagnosis is she experiencing?

Key: C. Dysmenorrhea

Distractor 1: A. Premenstrual dysphoric Disorder

Distractor 2: B. Premenstrual Syndrome

Distractor 3: D. Factitious Disorder

Explanation: When a woman is having their menstruation, it is important to take note of the
hormonal changes they might experience physically and emotionally. Based on the problem,
Arriane experiences a sad mood every month in the anticipation of her menstrual cycle.
However, the symptom of painful menstruation she is experiencing only happens on the 1st day
of her period up to several days. In order to diagnose Arriane with Premenstrual dysphoric
disorder, her symptoms must begin “before” the onset of her menstruation that might persist
into her first few days of menstrual period. However on Arriane’s situation she experiences the
symptom on the first day of her menstrual period up to several days which lead to the diagnosis
of Dysmenorrhea (a painful menstruation) that begins with the onset of menses.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., 174)

Item Difficulty Index = 0.45

Item Discrimination Index = 0.888889

13. Stem: Among the following, who is the least likely to be diagnosed with obsessive
compulsive disorder?
Key: A. Anna, a new cashier in a supermarket who counts the money inside her assigned
cash register multiple times a day. This is because she constantly worries about ending
her shift with a shortfall on her daily takings. 
Distractor 1: B. Betty who spends a lot of time checking their stove if the burners are properly
turned off as she is concerned it will explode and cause harm to her family. 
Distractor 2: Christian who have distressing sexual thoughts about peeping to the girl's
restroom but whenever this occurs, he will just close his eyes and pray silently. 
Distractor 3: Dalia, your co-worker who constantly washes and sanitizes her hands whenever
she touches something thinking she might acquire a virus. 
Explanation: In this question, the answer that we are looking for is the least likely meaning,
the one who has the slightest possibility of being diagnosed with OCD. Option A is the answer
because Anna is a cashier in a supermarket, it is normal for her to always worry about her
daily takings and count the money inside her assigned cash register. Additionally, she is also
new to the said job. Therefore, she is not yet used to the work causing her to be more cautious.
Option B, C, and D have obsession or recurrent thoughts and compulsion or repetitive
behaviors that are related to their thoughts. Option B’s obsession is the explosion of the stove
that may cause harm to her family which she tried to eliminate by spending a lot of time on
checking their stove and burner. Option C’s obsession is about his distressing sexual thoughts
that he tried to prevent by praying. Option D’s obsession is about contamination thus, to
relieve such anxiety, she constantly washes and sanitizes her hands. Although, Option D can
be normal only if the context mentioned is during this time of pandemic or a specific virus
specifically the COVID-19 is indicated.
Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of
mental disorders (5th ed., pp. 237)
Item Difficulty Index = 0.15
Item Discrimination Index = 0.2222222

14. Stem: More than a month ago, Emily Rose started seeing a demon. She believes that
demons are trying to get her soul married to one of the evil spirits. Despite having such
symptoms, she was still able to do her daily routine. What is her condition?
Key: D. Emily Rose is having a delusional disorder.
Distractor 1: A. Emily Rose is an atheist.
Distractor 2: B. Emily Rose is having a brief psychotic disorder. 
Distractor 3: C. Emily Rose is having a Schizophreniform disorder.
Explanation: D. Emily Rose is having a delusional disorder is the answer because she is
having a delusion about demons trying to get her soul married to one of the evil spirits.
Although she has hallucination, its content is still relevant to her delusion which was
particularly mentioned in the DSM-V. Moreover, criteria C in delusional disorder mentioned
that functioning should not be impaired. This is particularly indicated in this item whereas
Emily Rose was still able to do her daily routine. Option A is not the answer because being an
atheist is normal and it refers to people who do not believe in God which is not significant to
the context of the question. Option B and C is not the answer because there is no functional
impairment. Also in Option B., the duration of brief psychotic disorder is only about 1 day to
less than a month which it is mentioned in this question that the symptoms occur for more than
a month already.
Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of
mental disorders (5th ed., pp. 90-91)
Item Difficulty Index = 0.64
Item Discrimination Index = 0.333333

15. Stem: An 18-year-old Filipina came to you complaining about her consistent urge to move
her legs when she is resting. She felt like there is something crawling in her legs especially at
night which causes her lack of sleep. This has been happening for almost 4 months already.
What will be your diagnosis for her condition?
Key: A. Restless Leg Syndrome
Distractor 1: B. Disruptive Sleep Syndrome
Distractor 2: C. Somatic Symptom Disorder
Distractor 3: D. She is normal. This is just a mannerism which is known as "kuyakoy" in the
Philippines. 
Explanation: Option A. Restless leg syndrome is the answer because the Filipina has the urge
to move her legs accompanied by a sensation that something is crawling in her legs which
occur especially at night causing her functional distress mainly sleeping. These are all
symptoms of restless leg syndrome. Also, it met the criteria B pertaining to a 3-month long
duration of the said symptoms whereas in this case it persists for 4 months. Option B is not the
answer because there is no such disorder called disruptive sleep syndrome provided in the
DSM-V. Option C somatic symptom disorder is not the answer because there are no physical
symptoms like pain, shortness of breath and other health related concerns that are mentioned
only sensations in her leg. Furthermore, the duration for somatic symptoms is not met as it
should be more than 6 months. Option D is not the answer because her symptoms are not
normal as it disrupts her sleep. “Kuyakoy” is only a normal mannerism when someone is not
doing anything. It does not impair one’s functioning.
Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of
mental disorders (5th ed., pp. 410)
Item Difficulty Index = 0.70
Item Discrimination Index = 0.555556

16. Stem: A 6-year-old boy develops an excessive fear of removing his genital part by his
father due to his unconscious sexual desires toward his mother. If you are Freud, what term
will best fit to describe his condition? 
Key: B. Castration Anxiety
Distractor 1: A. Penis Envy
Distractor 2: C. Paraphilic
Distractor 3: D. Specific Phobia
Explanation: B. Castration Anxiety is the answer because this is a phenomenon that Freud
included in his concept of psychosexual stages of development particularly in phallic stage
between 3 to 6 years old that pertains to an intense fear of getting their penis removed by their
father as a punishment for having lust toward their mother. A. Penis Envy is not the answer
because this is only applicable to girls whereas Freud perceived them as desiring to become
his father/brother hence the term. Both C. Paraphilic and D. Specific Phobia are not the answer
because such options are not included in Freud’s theory. C. Paraphilic pertains to persistent
abnormal sexual interests while D. Specific Phobia pertains to irrational fear towards
something that are less likely/not dangerous at all.
Reference: Barlow, D. H., Durand, V. M., & Hoffman, S. G. (2018). Abnormal Psychology: An
Integrative Approach (8th ed., pp. 21) Cengage Learning.
Item Difficulty Index = 0.88
Item Discrimination Index = 0.111111

17. Stem: Maria is a graduating student. Her classmates have always described her as an
optimistic, jolly and approachable person. During the last month of their 2nd semester, Maria
was not coming to school. Her classmates got worried and tried to contact her and her parents.
Her parents told them that Maria refuses to talk with anyone and she doesn't feel like eating or
drinking. She also said that she feels nothing and she is not herself. What is her diagnosis?

Key: B. Depersonalization/Derealization Disorder

Distractor 1: A. Major Depressive Disorder

Distractor 2: C. Dysthymia

Distractor 3: D. She is just experiencing graduation blues

Explanation: It was mentioned in the situation that Maria is exhibiting the Criterion A1 (e.g. she
feels nothing and she is not herself). Depersonalization is characterized by persistent or
recurrent experiences of feeling of unreality or detachment from one’s whole self or entire
being including the feelings. Maria is also presenting an impairment in social functioning (i.e
She was not coming to school for a month, contrary to her behavior before). That is why the
answer is B. Depersonalization/Derealization Disorder. It is not considered as MDD because
the symptoms already progressed to Depersonalization with the given time frame. The diagnosis
is not Dysthymia (PDD) because the Criterion A and B should’ve been evident for more than 2
months at a time, Maria has only a month. Definitely, this is not just a graduation blues.

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 160-168, 302)

Item Difficulty Index = 0.3939

Item Discrimination Index =0.777778

18. Stem: A woman is sexually aroused from being beaten, choked with a collar and humiliated
during sexual intercourse with her partner for over a year. What kind of Paraphilic Disorder
does she has?

Key: B. Sexual Masochism Disorder

Distractor 1: A. Sexual Sadism Disorder

Distractor 2: C. Transvestic Fetishism

Distractor 3: D. Asphyxiophilia

Explanation: The answer is B. Sexual Masochism Disorder because she is being aroused from
being humiliated, beaten and choked during sexual intercourse. It is not the letter D.
Asphyxiophilia because it is a specifier for Sexxual Masochism Disorder. It's not A. Sexual
Sadism Disorder because it is the opposite, it is the intense sexual arousal for inflicting pain to
others. It is also not the letter C. Transvestic Fetishism because the right term is Transvestic
Disorder with Fetishism.

References: American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5th ed., pp. 694-695)

Item Difficulty Index = 0.8181

Item Discrimination = 0.333333

19. Stem: A patient diagnosed with MDD is experiencing weakness and loss of strength even
when doing light activities such as walking. She is experiencing…

Key: A. Adynamia

Distractor 1: B. Cataplexy

Distractor 2: C. Anhedonia

Distractor 3: D. Catalepsy

Explanation: The correct answer is A. Adynamia. It is described as the weakness and

fatigability associated with mood. It is most often associated with depression, same goes to the
patient. Cataplexy is temporary loss of muscle tone and weakness precipitated by a variety of
emotional states. Anhedonia is a loss of interest in, and withdrawal from all pleasurable
activities. Catalepsy is a general term for an immobile position that is constantly maintained.

Reference: David, B., Durand, V. M., Hofman, S. G. (2018). Mood Disorders and Suicide: An
Overview of Depression and Mania; Additional Defining Criteria for Depressive Disorders.
Abnormal Psychology: An Integrative Approach (8th ed., pp. 218, 223)

Shulova-Piryatinsky, I. (2011). Adynamia. SpringerLink. Retrieved October 15, 2022, from

https://link.springer.com/referenceworkentry/10.1007/978-0-387-79948-3_1875?error=cookies
_not_supported&code=c29556eb-b5df-4e85-aeb0-e8cf4efecb9f

Narcolepsy Fact Sheet | National Institute of Neurological Disorders and Stroke. (n.d.).
Retrieved October 15, 2022, from https://www.ninds.nih.gov/narcolepsy-fact-sheet

Item Difficulty Index = 0.63

Item Discrimination Index = 0.666667

20. Stem: Emma is experiencing a significant loss in weight in a span of 3 months due to the
intense fear of being called fat. This is an example of…

Key: D. Syndrome

Distractor 1: A. Sign

Distractor 2: B. Symptoms

Distractor 3: C. Score

Explanation: The correct answer is D. Syndrome. Emma is experiencing a group of signs and
symptoms that occur together that constitutes a recognizable condition which is Anorexia
Nervosa. It is not a Sign nor a Symptom because objective findings and subjective complaints
were not mentioned. Score is just a literal distractor.

Reference: Clinical Signs - Humpath.com - Human pathology. (n.d.-b). Retrieved October 15,
2022, from https://www.humpath.com/spip.php?article22915

Item Difficulty Index = 0.03

Item Discrimination Index = 0.111111