How Children Develop 5th Edition

Siegler Test Bank

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1. Walter Mischel's procedure in which preschool children were asked to wait for a
considerable amount of time in order to receive a greater number of treats was designed
to assess which characteristic?
A) intelligence
B) attentiveness
C) delay of gratification
D) social competence

2. The ability of preschoolers to delay gratification has NOT been found to be associated
with:
A) academic competence 10 years later.
B) ability to deal with frustration 10 years later.
C) decreased drug use in adulthood.
D) clear learning experiences.

3. Which statement is supported by Mischel's findings on delay of gratification?

A) Preschoolers' ability to delay gratification does not predict adjustment beyond
preschool.
B) The ability to delay gratification is related to SAT scores and rational thinking in
adolescence.
C) The ability to delay gratification is based primarily on parental socialization.
D) Delay of gratification cannot be reliably tested until approximately age 8.

4. Developmental psychologists do NOT define emotions as:

A) subjective feelings.
B) the desire to take action.
C) the physiological correlates of feelings.
D) smiles that are directed at people.

5. Which statement BEST represents developmentalists' view of emotions and feelings?

A) Emotions are a part of feelings.
B) Feelings constitute one of the components to emotion.
C) Emotions and feelings are synonyms; they have the same meaning.
D) Emotions and feelings are entirely separate; neither is part of the other.

6. Which statement BEST represents developmentalists' view of emotions and cognitions?

A) Emotion is a part of cognition.
B) Emotion includes cognitive responses to thoughts or experiences.
C) Emotion usually occurs before cognition.
D) Emotion and cognition are entirely separate; they typically occur independently.

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 7. Discrete emotions theory holds that:
A) the basic emotions are innate and distinct from early in life.
B) emotional facial expressions must be learned.
C) a select few emotions are present at birth, and the others are a function of
experience.
D) children must learn to fear strangers.

8. Theorists who take a functionalist approach to understanding emotional development

propose that emotions:
A) have little impact on cognition.
B) are innate and thus are unaffected by socialization.
C) promote action toward a goal.
D) do not emerge until a child has a sense of self.

9. Which statement would MOST likely be made by a theorist who takes a functionalist
approach to understanding emotional development?
A) The purpose of anger is to initiate movement to eliminate an obstacle to one's goal.
B) Developmental changes in the experience of joy/pleasure are due to accumulating
social experiences.
C) Distinct emotions are innate and present from early in life.
D) There is a direct link between the inner emotional state of fear and the facial
expression that accompanies it.

10. The FIRST clear sign of happiness in infants is:

A) the expression of love toward the mother.
B) the social smile.
C) laughter.
D) smiling.

11. Social smiles tend to emerge by the _____ month of life.

A) 1st
B) 2nd
C) 3rd
D) 6th

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12. Which scenario describes a social smile?
A) Newborn Timmy smiles during his sleep.
B) At 3 months, Indira smiles when her father talks to her.
C) Alexa smiles at 1 month when her mother strokes her cheek.
D) All of the scenarios describe a social smile.

13. Which statement about infant smiling is TRUE?

A) All infant smiling is reflexive.
B) Infants' smiling induces parents to have more positive social interactions with
them.
C) Young infants rarely smile at strangers.
D) Infants are unlikely to smile at auditory stimuli.

14. Which of these stimuli is LEAST likely to elicit a smile in a 2-month-old infant?
A) a smiling stranger
B) an interesting object
C) being able to control a particular event
D) a parent's tickle on the tummy

15. Which stimulus is LEAST likely to elicit a smile in a 7-month-old infant?

A) a smiling stranger
B) an interesting object
C) being able to control a particular event
D) a parent's tickle on the tummy

16. During late in the 1st year of life, children are _____ to laugh at unexpected events
and/but are _____ to take pleasure in making other people laugh.
A) likely; likely
B) likely; unlikely
C) unlikely; likely
D) unlikely; unlikely

17. The FIRST negative emotion that is apparent in infants is:

A) anger.
B) sadness.
C) fear.
D) distress.

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18. Separation anxiety or distress due to separation from the parent who is the child's
primary caregiver emerges around
A) 4 months of age
B) 5 months of age
C) 7 months of age
D) 8 months of age

19. Which statement about negative emotions is TRUE?

A) Negative emotions are easily interpreted.
B) Negative emotions decline in response to situations between age 3 and 6 years.
C) Infants show a wide variety of highly discernible facial expressions.
D) Infants display only generalized distress.

20. Which emotion is thought to have an evolutionary basis as it helps humans avoid
potential poisons or disease-causes bacteria?
A) surprise
B) sadness
C) anger
D) disgust

21. When infants realize they can control a particular event they experience
A) sadness
B) surprise
C) disgust
D) happiness

22. The initial signs of fear develop at approximately _____ months of age.
A) 6 to 7
B) 2 to 3
C) 4 to 5
D) 8 to 9

23. Which statement about infants' fear of strangers is CORRECT?

A) Infants' fear of strangers occurs in early infancy and quickly disappears.
B) All infants experience fear of strangers to a similar degree across a variety of
contexts.
C) Infants' fear of strangers occurs well after the start of separation anxiety.
D) Infants' fear of strangers emerges at around the age of 6 or 7 months.

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24. Roger, who is 10 months old, is sitting on the floor of his room happily playing with his
toys. The phone rings, and his mother leaves the room to get it. Roger begins to cry.
Roger is experiencing:
A) separation anxiety.
B) loneliness.
C) fear of strangers.
D) jealousy.

25. Which child is MOST likely to experience separation anxiety in the situation described?
A) 5-month-old Anton, who is placed in a car seat by his parent who then disappears
from his view
B) 13-month-old Jordan, who walks away from her parent into another room
C) 23-month-old Ellie, who is playing on the floor when her parent leaves the room
D) 15-month-old Sebastian, who is placed into his crib by his parent who then leaves
the room

26. Which child is LEAST likely to experience separation anxiety in the situation
described?
A) 8-month-old Gianna, who is placed in a car seat by her parent who then disappears
from her view
B) 13-month-old Nolan, who walks away from his parent into another room
C) 10-month-old Evan, who is playing on the floor when his parent leaves the room
D) 15-month-old Cecile, who is placed into her crib by her parent who then leaves the
room

27. _____ decreases the likelihood that an infant will experience separation anxiety in a
particular situation.
A) Being between the ages of 11 and 13 months
B) Crawling away from a parent (rather than the parent departing)
C) Living in a non-Western culture
D) All of these

28. Which statement about the development of anger is TRUE?

A) Infants are incapable of experiencing anger.
B) During the first year of life, it is easy to differentiate between infants' anger and
distress.
C) By their first birthday, children often express anger toward other people.
D) Anger develops later than the self-conscious emotions.

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29. Which statement about older infants' displays of sadness is NOT true?
A) Infants often display sadness in the same contexts in which they display anger.
B) Displays of sadness are less frequent than displays of anger.
C) Infants show anger but not sadness when they are unable to control their
environment.
D) Infants are capable of experiencing sadness.

30. Which child who has healthy family relationships is LEAST likely to display negative
emotions?
A) 12-month-old Kiana
B) 20-month-old Trey
C) 26-month-old Riley
D) 36-month-old Amaris

31. Which emotion is self-conscious?

A) anger
B) shame
C) fear
D) sadness

32. Some researchers believe that self-conscious emotions do not emerge until the second
year of life because these emotions depend on children's understanding that:
A) other people experience emotions as well.
B) important others can evaluate them.
C) they themselves are entities distinct from other people.
D) guilt is an appropriate reaction to bad behavior.

33. Self-conscious emotions are different from other emotions in that they:
A) relate to our consciousness of others' reactions to us.
B) are more easily discerned from facial expressions.
C) develop earlier.
D) are always focused on other people.

34. Which of the following is not a self-conscious emotion?

A) Guilt
B) Fear
C) Surprise
D) Pride

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35. Twins Sheree and Caitlin, who are 3 years old, each just successfully completed a
jigsaw puzzle. Sheree's puzzle was simple, and she completed it easily. Caitlin's puzzle
was more difficult, and it took a lot of effort for her to complete it. Which twin is more
likely to experience pride in her accomplishment?
A) Sheree is more likely than is Caitlin to experience pride.
B) Caitlin is more likely than is Sheree to experience pride.
C) Sheree and Caitlin are equally likely to experience pride.
D) Neither Sheree nor Caitlin is likely to experience pride because they are both too
young.

36. Zoe, who is 3 years old, has broken a dish and feels as if she wants to hide. She is
primarily experiencing:
A) anger.
B) embarrassment.
C) guilt.
D) shame.

37. _____ is/are NOT a characteristic of guilt.

A) Feelings of remorse
B) Regret about one's behavior
C) Empathy for the injured party
D) Feelings of exposure and degradation

38. Feelings of _____ include a focus on oneself.

A) guilt
B) shame
C) both guilt and shame
D) neither guilt nor shame

39. Which instruction would be BAD advice for parents who want to encourage their child
to respond to his or her wrongdoings with guilt rather than shame?
A) Communicate love and respect for the child.
B) Emphasize the badness of the behavior, rather than of the child.
C) Teach the child to understand the consequences of his or her actions for others.
D) Criticize the child for his or her actions.

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40. Which parental practice in response to a child doing something wrong is likely to
influence the child to feel shame over guilt?
A) telling the child that he or she did a mean thing, rather than that he or she is mean
B) publicly humiliating the child
C) helping the child to understand the consequences of his or her actions for others
D) communicating respect and love in disciplinary situations

41. Which parental practice in response to a child doing something wrong is likely to
influence the child to feel guilt over shame?
A) saying “You're a bad boy”
B) publicly humiliating the child
C) helping the child to understand the consequences of his or her actions for others
D) removing expressions of love in disciplinary situations

42. In comparison with U.S. children, Japanese children are LESS likely to experience
which emotion as a consequence of personal success?
A) shame
B) pride
C) guilt
D) embarrassment

43. Many cultural variations in children's experiences of self-conscious emotions appear to

be associated with cultural differences in the:
A) importance placed on the individual versus the importance placed on the social
group.
B) level of emotional maturity expected of children.
C) age at which children understand that they themselves are entities separate from
others.
D) distinction among shame, guilt, and embarrassment.

44. The causes of which type of emotion tend NOT to change as children develop?
A) anger
B) pride
C) happiness
D) self-conscious emotions

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45. Of types of stimuli that elicit particular emotional responses, frequency of particular
emotions, and intensity of emotional responses, which change during childhood?
A) types of stimuli
B) types of stimuli and frequency of particular emotions
C) types of stimuli and intensity of emotional responses
D) types of stimuli, frequency of particular emotions, and intensity of emotional
responses

46. The anxieties and fears of 3-year-old Alexander are most likely to involve:
A) pleasing teachers.
B) being physically attacked.
C) being separated from his mother.
D) ghosts and monsters.

47. Elementary school children are less likely to be afraid of monsters than preschool
children because older children have:
A) better night vision.
B) a better understanding of reality.
C) better language skills.
D) more coping skills.

48. In comparison with preschool children, children in elementary school are:

A) more understanding of how, when, and why emotions occur.
B) less likely to be worried about real-life issues.
C) more emotionally negative.
D) more likely to be angry at someone who harms them accidentally.

49. Which statement about the association between emotional development and cognitive
development is TRUE?
A) Emotions are independent of cognition, and therefore the two are unassociated.
B) Cognitive development influences children to become less emotional as they
develop from infancy through adolescence.
C) Cognitive changes influence the types of stimuli that elicit particular emotional
responses.
D) None of the statements is true.

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50. _____ is an emotional reaction to a sudden, unexpected event.
A) Happiness
B) Fear
C) Surprise
D) Disgust

51. This emotion involves a cognitive understanding that something is not as it usually is,
rather than just a physical reaction to being startled.
A) happiness
B) fear
C) surprise
D) disgust

52. Most infants begin to express surprise by _____ months of age.

A) 3
B) 6
C) 8
D) 10

53. While expressions of surprise tend to be brief, they usually transform into which
emotional expression?
A) happiness
B) fear
C) surprise
D) disgust

54. This emotional experience is thought to have an evolutionary basis, as it helps humans
avoid potential poisons or disease-causing bacteria.
A) happiness
B) fear
C) surprise
D) disgust

55. This is a prominent system for coding emotions in infants that link particular facial
expressions and facial muscle movements with specific emotions.
A) REM
B) AFFEX
C) AREM
D) SFEX

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56. A 4-month-old infant is habituated to pictures of people expressing surprise. The infant
is then presented with a picture of a person expressing happiness. The infant is likely to:
A) display no renewed interest in the pictures, as infants this young are unable to
differentiate between emotions.
B) dishabituate to the new picture but not comprehend the difference in meaning
between the first set of pictures and the new picture.
C) dishabituate to the new picture and comprehend the emotional meaning of the
facial expressions.
D) cry, as the happy face is likely to elicit fear in an infant this age.

57. The emotion of which child would be the EASIEST for other children to understand?
A) Mia, who feels disappointment at getting a sweater for her birthday but who puts
on a happy face anyway
B) J. T., who feels ashamed about lying to his parents about breaking his father's new
pen
C) Kerry, who is saddened by a reminder of her pet's death
D) Jing, who is happy because he is going to the park with his friend

58. Social referencing refers to:

A) the ability to understand others' emotions.
B) the use of a caregiver's cues to decide how to respond to an ambiguous situation.
C) smiles directed at people rather than at objects.
D) patterns of sociability and emotionality learned from significant others.

59. Which scenario is an example of social referencing?

A) Jessica sucks her thumb when her brother takes away her favorite doll.
B) Jose smiles when he opens a gift from his grandmother, even though he does not
like the new shirt she has given him.
C) Stacey hears her parents arguing and begins to cry.
D) Henry looks up at his mother after he falls and, on seeing her content expression,
gets up without crying.

60. Bart, an 11-month-old, is playing on the floor of his room when his older brother steers
a remote-control car (that Bart has never seen) toward him. Bart immediately looks up
at his father, who is on the verge of yelling, “Stop, it's going to hit Bart.” Bart then
breaks into quickly flowing tears. Bart has engaged in:
A) emotional regulation.
B) self-socialization.
C) social referencing.
D) display rules.

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61. To be able to engage in social referencing, infants need to be able to:
A) label emotions.
B) understand the causes of emotions.
C) comprehend the meaning of emotions.
D) view emotions.

62. Infants 12 months old are _____ to comprehend the emotional tone of others' faces,
and/but are _____ to comprehend the emotional tone of others' voices.
A) able; able
B) able; unable
C) unable; able
D) unable; unable

63. Which emotion is identified EARLIEST by children?

A) disgust
B) shame
C) happiness
D) anger

64. Which list is the chronological order (from earliest to latest) in which children are able
to identify emotions in others?
A) anger/fear, happiness, sadness, self-conscious emotions
B) happiness, self-conscious emotions, sadness, anger/fear
C) happiness, sadness, anger/fear, self-conscious emotions
D) self-conscious emotions, anger/fear, happiness, sadness

65. Which emotion is identified LATEST by children?

A) disgust
B) shame
C) happiness
D) anger

66. In regard to the ability of young children to identify emotions, young children are:
A) essentially unable to identify others' emotions.
B) best at identifying happiness, and they have difficulty differentiating among
negative emotions until they are older.
C) best at identifying sadness, and they have difficulty differentiating among positive
emotions until they are older.
D) able to differentiate among positive emotions and among negative emotions
equally well.

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67. The ability to discriminate and identify different emotions in others:
A) is associated with social competence.
B) is associated with lower levels of behavioral problems.
C) helps children responds appropriately to others' emotions.
D) is positively associated with increased self-esteem.

68. At 2 years old, Greg is told a story about Jimmy, a boy whose favorite toy has just been
broken. When Greg is asked what Jimmy is feeling, Greg is likely to indicate:
A) happiness.
B) sadness.
C) shame.
D) that he is unable to predict Jimmy's emotion.

69. At 4 years old, Doug is told a story about Jimmy, a boy whose favorite toy has just been
broken. When Doug is asked what Jimmy is feeling, Doug is likely to indicate:
A) happiness.
B) sadness.
C) shame.
D) that he is unable to predict Jimmy's emotion.

70. Which ability is typical of a 3-year-old child?

A) identifying the causes of others' negative emotions
B) labeling others' self-conscious emotions
C) identifying the causes of others' positive emotions
D) fully understanding how others' memories of past emotional events can trigger the
same emotions

71. Which child is MOST likely to mention emotions such as pride, shame, embarrassment,
and jealousy in conversation?
A) 2-year-old Penny
B) 5-year-old Jake
C) 6-year-old Breanne
D) 8-year-old Stacey

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72. Which capability develops LATEST?
A) identifying the causes of others' negative emotions
B) labeling others' self-conscious emotions
C) fully understanding how others' memories of past emotional events can trigger the
same emotions
D) understanding emotional ambivalence

73. The aspect of emotional understanding that develops LATEST is understanding:

A) of emotional ambivalence.
B) that one can feel two negative emotions simultaneously.
C) the difference between real and false emotions.
D) the distinction between fear and anger.

74. The understanding that a person can have mixed feelings about something, as when a
person is happy to receive a gift but is angry that it is not what was expected, develops
at approximately what age?
A) 5 years
B) 8 years
C) 10 years
D) 12 years

75. When children were told a story about a child who felt one way but tried to hide her
emotions and pretend to feel another way, approximately _____ percent of 3- and
4-year-olds and approximately _____ percent of 5-year-olds understood the difference
between real and false emotions.
A) 20; 20
B) 20; 50
C) 50; 80
D) 80; 100

76. A social group's informal norms about the demonstration of emotion and when and
where they should be suppressed or masked are referred to as:
A) display rules.
B) social referencing.
C) demonstration motives.
D) emotion regulation.

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77. Which behavior is an example of the use of a display rule?
A) Maddie covers her eyes when she is feeling shy.
B) Damon tries not to look scared on the roller coaster.
C) Jasmine stops her temper tantrum because her mother threatens punishment.
D) Warren looks at his grandmother to see if she looks angry before he jumps off the
couch.

78. Which goal is NOT a motive to use a display rule?

A) to prevent hurting someone's feelings
B) to protect oneself from looking bad
C) to get information about an ambiguous event
D) to make someone else feel good

79. The set of abilities that researchers have proposed are key to competent social
functioning is referred to as:
A) attachment.
B) emotional regulation.
C) emotional intelligence.
D) empathy.

80. _____ is NOT considered to be part of emotional intelligence.

A) Persistence
B) Ability to delay gratification
C) Empathy
D) Verbal fluency

81. _____ is considered to be part of emotional intelligence.

A) Processing speed
B) Ability to control impulses
C) Reasoning
D) Verbal fluency

82. Which statement is NOT true of adolescents who were high in emotional intelligence as
children?
A) They have fewer mental health problems.
B) They have lower risk behaviors.
C) They have better strategies for coping with stress.
D) They have increased antisocial behaviors.

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83. The process of initiating, inhibiting, or modulating emotions in order to accomplish
one's goals is referred to as emotional:
A) restriction.
B) constriction.
C) repression.
D) regulation.

84. Emotional self-regulation does NOT include:

A) eliminating subjective negative feelings.
B) modulating one's interpretation of evocative situations.
C) appropriately inhibiting facial expressions related to one's feelings.
D) initiating actions related to one's feelings.

85. The development of emotional regulation is NOT characterized by a(n):

A) decrease in reliance on other people.
B) decrease in the experience of negative emotions.
C) increase in the use of planful problem solving.
D) increase in the use of effective regulating strategies.

86. Newborns' emotions are MOST frequently regulated in which way?

A) by intentionally averting their gaze in distressing situations
B) through self-soothing
C) through other people's attempts to soothe and distract the baby
D) by initiating the “fight or flight” response

87. Baby Rachel sucks her thumb and rubs the ribbons in her baby doll's hair in response to
fear-provoking situations. Baby Rachel is engaging in:
A) gaze aversion.
B) self-comforting.
C) emotional restriction.
D) mental distraction.

88. In general, the development of emotional regulation is NOT characterized by:

A) decreasing reliance on others for help in regulating emotions.
B) increasing ability to select appropriate strategies.
C) increasing use of cognitive strategies.
D) decreasing control over physiological reactions.

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89. Children's decreased reliance on parents for help with emotional regulation as they get
older does NOT reflect:
A) their increased ability to negotiate ways to resolve situations.
B) increasing maturation of neurological systems.
C) changes in adults' expectations of them.
D) changes in the temporal lobe.

90. In terms of emotional regulation, as they get older, children:

A) are better able to select appropriate strategies.
B) rely on their parents more.
C) use behavioral strategies to a greater extent.
D) engage in co-regulation more.

91. Children start to show awareness of adults' demands and begin to regulate themselves
accordingly at about _____ of age.
A) 9 to 12 months
B) 15 to 18 months
C) 1 to 2 years
D) 3 to 4 years

92. _____ is an example of a cognitive emotional regulation strategy.

A) Repetitive rubbing of a special object such as a blanket
B) Averting one's attention to a nondistressing object
C) Downplaying the importance of the situation
D) Having a temper tantrum

93. The mother of Jasmine, a 6-year-old, has promised her daughter new crayons if she
waits patiently while her mother shops. Which cognitive strategy might Jasmine use to
regulate her emotions?
A) repeatedly stroking the hem of her shirt
B) waiting for her mother to soothe her
C) distracting herself by playing with another toy
D) negotiating with her mother to get the new crayons early, rather than late, in the
shopping trip

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94. Emil, who is 4 years old, has a doctor's appointment today and he knows he will need to
get a shot. Which behavior is Emil LEAST likely to display in response to this negative
situation?
A) having a temper tantrum
B) realizing that this situation cannot be controlled and try to distract himself by
thinking about the lollipop he will get following the shot
C) refusing to stop playing with his toys as his mother is trying to get him ready to go
to the doctor's office
D) telling his mother he does not need the shot

95. Which emotional regulation strategy would an older child be LEAST likely to attempt?
A) trying to see negative things in a positive light
B) mental distraction
C) self-comforting
D) thinking about the meaning of events in a different light

96. The process by which a caregiver provides the needed comfort or distraction to help a
child reduce his or her distress is called:
A) co-regulation.
B) self-comforting behavior.
C) self-distraction.
D) co-distraction.

97. Repetitive actions that regulate arousal by providing a mildly positive physical sensation
is called:
A) co-regulation.
B) self-comforting behavior.
C) self-distraction.
D) co-distraction.

98. Looking away from an upsetting stimulus in order to regulate one's level of arousal is
referred to as:
A) co-regulation.
B) self-comforting behavior.
C) self-distraction.
D) co-distraction.

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 99. A set of skills that help individuals achieve their goals in interpersonal interactions
while maintaining positive relations with others is referred to as:
A) emotional regulation.
B) delay of gratification.
C) intelligence.
D) social competence.

100. Children who exhibit _____ are LEAST likely to be socially competent.
A) control of emotions
B) planning of strategies to resolve upsetting situations
C) avoidance of stressful situations altogether
D) delay of gratification

101. Individual differences in emotional, motor, and attentional reactivity and self-regulation
that occur early in life are referred to as:
A) personality.
B) socialization.
C) temperament.
D) emotional regulation.

102. Part of the definition of temperament is that individual differences are:

A) entirely genetic.
B) biologically based.
C) environmentally based.
D) unrelated to genetics.

103. Which temperamental style was NOT identified by Thomas and Chess in their New
York Longitudinal Study?
A) slow to warm up
B) easy
C) difficult
D) quick to calm down

104. Thomas and Chess labeled babies who took a long time to adjust to new experiences,
tended to react negatively and intensely to stimuli and events, and were irregular in their
eating and sleeping habits as:
A) slow to warm up.
B) easy.
C) difficult.
D) quick to calm down.

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105. Which condition is NOT a characteristic of difficult babies, as classified by Thomas and
Chess?
A) irregular body functions
B) difficult at first but became easier with time
C) slow to adjust to new situations
D) intensely emotional

106. Which statement about the stability of temperament is TRUE?

A) Temperament, by definition, is a style exhibited primarily during infancy and thus
does not persist into childhood.
B) All temperamental dimensions are stable from infancy into later childhood.
C) No aspects of temperament are stable from the prenatal period into infancy.
D) Some aspects of temperament tend to be more stable than others.

107. Recent theorists have proposed that infant temperament is captured by several
dimensions. Which item is NOT one of those dimensions?
A) difficulty level
B) fear
C) activity level
D) smiling and laughter

108. Which dimension is NOT considered to be part of temperament?

A) emotional intelligence
B) activity level
C) smiling and laughter
D) attention span

109. Which methodology has NOT been used to classify young children on their
temperamental style?
A) laboratory observations
B) parental reports of children in various contexts
C) interviews of children
D) brain activity assessment

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110. Professor Lorry is conducting a study on infant temperament. Which method of
measuring temperament will NOT provide her with confidence in her assessments?
A) laboratory observation
B) EEG
C) parental reports
D) a combination of laboratory observation, EEG, and parental reports

111. Research on the physiological bases of temperament has demonstrated that _____ are
associated with temperament?
A) heart rate and respiratory characteristics but not brain activation patterns
B) brain activation patterns but not heart rate and respiratory characteristics
C) both brain activation patterns and heart rate and respiratory characteristics
D) neither brain activation patterns nor heart rate and respiratory characteristics

112. Children with difficult temperaments are more likely than children with other
temperaments to exhibit _____ when they become adolescents and young adults.
A) illegal behaviors
B) depression
C) possession of wide circle of friends
D) social withdrawal

113. As a young child, Riley exhibited intense negative emotions and had a great deal of
trouble controlling them. Chris, on the other hand, was even-keeled and predictable. As
adults, Riley is likely to be:
A) more academically successful than is Chris.
B) less socially competent than is Chris.
C) more prone to phobias than is Chris.
D) similar to Chris, as the qualities exhibited in young childhood rarely carry over to
adulthood.

114. Which statement about the later adjustment of children with difficult temperaments and
those exhibiting behavioral inhibition is TRUE?
A) Children with difficult temperaments and children exhibiting behavioral inhibition
both tend to have similar adjustment problems in adolescence and adulthood.
B) Behaviorally inhibited children tend to have no later adjustment problems.
C) Girls with difficult temperaments and boys who are behaviorally inhibited tend to
have fewer problems than do girls who are behaviorally inhibited and boys with
difficult temperaments.
D) Children with difficult temperaments and children exhibiting behavioral inhibition
both tend to have later adjustment problems, but the types of problems they tend to
have are different.

Page 21
115. The notion that children's later adjustment depends on how well suited adults' parenting
style is to their children's temperament is referred to as:
A) goodness of fit.
B) environment over biology influence.
C) easy temperament effect.
D) attachment of the child.

116. Which statement about children's temperament and parenting style is TRUE?
A) Temperament is almost entirely biological, so parenting style has little influence on
it.
B) Children with similar temperaments exhibit different patterns of adjustment
depending on their family environment.
C) Children's temperament has little influence on parents' child-rearing practices.
D) Temperament and personality are fully developed at birth.

117. Kylie has a difficult temperament. Her parents' child-rearing practices:

A) will have little impact on her later social adjustment.
B) may become less benign and more punitive over time.
C) are unlikely to change her behavior.
D) will have little effect on her emotion regulation.

118. Twin and adoption studies have demonstrated that:

A) there is no genetic component to temperament.
B) temperament is entirely due to genetic factors.
C) identical twins are more similar than are fraternal twins on many aspects of
temperament.
D) stepsiblings are more similar than are biological siblings on many aspects of
personality.

119. Twin and adoption studies have demonstrated that:

A) there is no genetic component to temperament.
B) temperament is entirely due to genetic factors.
C) genes account for a small portion of variation in temperament.
D) genes account for a substantial portion of variation in some aspects of
temperament.

Page 22
120. Recent studies of the connection between specific genes and aspects of temperament
have demonstrated that:
A) most temperamental capacities have no genetic component.
B) genetic temperamental tendencies are sometimes more likely to be expressed when
the family environment is suboptimal and sometimes when it is optimal.
C) individual differences in positive emotions tend to be more genetically based than
are individual differences in negative emotions.
D) Recent studies have demonstrated all of these.

121. A circumstance in which the same temperament characteristics that puts some children
at high risk for negative outcomes when exposed to a harsh home environment also
causes them to blossom when their home environment is positive is called:
A) differential susceptibility.
B) goodness of fit.
C) social competence.
D) display rule.

122. Charlie is a happy child who plays well with other children and gets angry only rarely.
Which scenario is MOST likely to also be true of Charlie?
A) Charlie is from a wealthy family.
B) Charlie is from a poor family.
C) Charlie is securely attached to his parents.
D) Charlie is insecurely attached to his parents.

123. Compared with children who have poor-quality relationships with their parents, those
who have high-quality relationship with their parents:
A) do not differ on any measure of emotional development.
B) develop more positive emotion.
C) are more advanced in their understanding of emotion.
D) develop more positive emotion and are more advanced in their understanding of
emotion.

124. The direct and indirect influence that parents have on their children's standards, values,
and ways of thinking is referred to as:
A) emotion socialization.
B) discipline.
C) emotional regulation.
D) social referencing.

Page 23
125. Which family is MOST likely to raise a child who is socially skilled, understands others'
emotions, and is generally well adjusted?
A) a family in which negative emotions are particularly prevalent
B) a family in which positive emotions are particularly prevalent
C) a family in which an equal level of positive and negative emotions are expressed
D) a family in which all negative emotions in the home involve the adults and not the
children

126. Trevor's parents frequently argue and display a great deal of negative emotion in
Trevor's presence. As a result, Trevor is NOT likely to:
A) believe that he angers other people.
B) experience higher than average levels of negative emotions.
C) think that high levels of negative emotions in relationships are normal and
appropriate.
D) demonstrate secure attachment to both of his parents.

127. Compared with supportive parents, parents who react in an unsupportive manner when
their children are upset are more likely to have children who are:
A) emotionally competent.
B) socially competent.
C) prone to aggression.
D) successful in school.

128. The study by Judy Dunn discussed in the text demonstrated that discussions of emotions
with family members at ages 2 and 3 were associated at age 6 with:
A) understanding of others' emotions.
B) worrying and anxiety.
C) secure attachment.
D) emotional intensity.

129. Lia is less emotionally competent than other children her age, a problem that causes her
much difficulty with her peers. Which circumstance is NOT a possible cause of Lia's
poor emotional competence?
A) Lia's parents express a great deal of negative emotion in their home.
B) Lia's parents feel unable to cope with her negative emotions.
C) Lia's parents commonly talk to her about emotions.
D) Lisa was born with this characteristic and it cannot be changed.

Page 24
130. Compared with other children, those who regulate their emotions well and are
academically competent have parents who respond to their children's negative emotions
with:
A) teasing.
B) disregard.
C) support.
D) threats.

131. Which statement is the BEST advice to give parents who would like to foster positive
emotional development in their children?
A) Demonstrate that others experience the emotions that children themselves feel by
expressing a wide variety of intense emotions.
B) Teach children about the circumstances in which emotions should and should not
be expressed and the consequences of expressing and not expressing them.
C) Ensure that children will be able to relate to the discussion by talking to children
about anger during a serious family conflict.
D) Discuss the futility of displaying negative emotion so that children will understand
parents' disapproval of these displays.

132. Emotion coaching does NOT include:

A) discussing children's emotions.
B) helping children express emotions appropriately.
C) guiding children to learn ways of coping with emotions.
D) ensuring that children understand the differences between the various
self-conscious emotions.

133. Compared with European American infants, Chinese and Chinese American infants cry
and smile to a(n) _____ extent in response to evocative events.
A) much greater
B) slightly greater
C) lesser
D) equal

134. The effects of _____ on differences in temperament across cultural groups _____ been
supported by scientific evidence.
A) neither cultural practices nor genetic factors; has
B) both cultural practices and genetic factors; have
C) cultural practices; have not
D) genetic factors; have not

Page 25
135. The differences in the responses of Japanese and American preschoolers when they
were asked what they would do if they were hit or saw another child knocking down
their block tower may be related to the higher value American culture places on:
A) interdependence.
B) self-assertion.
C) maintaining harmonious interpersonal relationships.
D) emotional control.

136. Which dimension is probably LEAST affected by cultural norms and practices?
A) the experience of basic emotions
B) expression of anger
C) amount of crying by infants
D) feelings of pride

137. Which statement about the origins of cultural differences in emotion is TRUE?
A) Parental socialization plays a large part in the development of emotions that are
appropriate to the culture.
B) Differences in emotional experience appear to be nearly entirely due to
environmental, as opposed to genetic, differences.
C) Differences in emotional expression appear to be largely due to genetic differences.
D) Emotional experiences have equivalent meanings across cultures.

138. Which statement about the origins of cultural differences in emotion is TRUE?
A) Parental socialization plays a minor part in the development of emotions that are
appropriate to the culture.
B) Differences in emotional experience appear to be entirely due to environmental, as
opposed to genetic, differences.
C) Differences in emotional expression appear to be largely due to genetic differences.
D) The same emotional experience may have different meanings across cultures.

139. Which statement is MOST likely to be true across a variety of cultures?

A) Children whose parents are dismissive of their negative emotions tend to be
particularly emotionally negative.
B) Parents who tease their children and promote their expression of anger tend to do
so without thoughts of the consequences of these practices.
C) Children who do not regulate their negative emotions well tend to have problems in
their interpersonal relationships.
D) None of these statements is likely to be true across a variety of cultures.

Page 26
140. Chinese parents frequently try to induce _____ in their children.
A) embarrassment
B) shame
C) guilt
D) pride

141. Which child is LEAST likely to grow up to be emotionally and socially competent?
A) a Buddhist child living in Nepal whose parents criticize him when he expresses
negative emotion
B) an African American child living in a dangerous neighborhood whose parents
encourage angry responses to conflict
C) a Japanese child who frequently expresses intense negative emotion
D) a European American child who has a firm understanding of her own and others'
emotions

142. Children's sense of well-being both internally and externally is referred to as:
A) mental health.
B) toxic stress.
C) emotion socialization.
D) differential susceptibility.

143. _____ is a physiological reaction to some change or threat in the environment.

A) Stress
B) Rumination
C) Mental disorder
D) Equifinality

144. When children are in situations or environments that they perceive to be frightening,
threatening, or overwhelming they can experience:
A) stress.
B) rumination.
C) a mental disorder.
D) trauma.

145. Which factor is NOT part of the stress response?

A) increased heart rate
B) decreased perspiration
C) secretion of stress hormones
D) increased blood flow to the brain

Page 27
146. Higher levels of cortisol are:
A) associated with lower levels of depression.
B) associated with extreme fearful responses.
C) associated with easy temperamental characteristics.
D) typically caused by maltreatment.

147. Which factor has NOT been related to individual differences in children's cortisol
levels?
A) internalizing problems
B) emotion regulation
C) behavioral problems
D) empathy

148. Which statement is NOT true regarding stress?

A) Stress can be a common experience in childhood and adolescence.
B) Periodic stress can serve the adaptive function of mobilizing the child to take
actions to reduce the stimulus that is provoking the anxiety.
C) Stress becomes problematic when it is chronic.
D) Stress always leads to the development of a mental disorder.

149. Which factor is NOT associated with experiencing traumatic stress?

A) unusually high levels of negative emotions
B) pepression
C) posttraumatic stress disorder
D) extracurricular activities

150. The experience of overwhelming levels of stress without support from adults to help
mitigate the effects of that stress is referred to as:
A) toxic stress.
B) traumatic stress.
C) rumination.
D) mental disorder.

151. Which factor is NOT a source of toxic stress for children?

A) physical abuse or neglect
B) poverty and maternal deprivation
C) exposure to war
D) extracurricular activities

Page 28
152. What is the general conclusion regarding the relationship between exposure to adverse
childhood experiences and problems in adulthood?
A) The likelihood of experiencing a mental or physical health problem for white males
decreased as exposure to adverse child experiences increased.
B) The likelihood of experiencing a mental or physical health problem decreased as
exposure to adverse child experiences increased.
C) The likelihood of experiencing a mental or physical health problem increased as
did exposure to adverse childhood experiences, regardless of gender, race, and
education level.
D) There is no relationship between adverse childhood experiences and problems in
adulthood.

153. Chronic conditions that may persist throughout childhood and into adulthood are called:
A) toxic stress.
B) mental disorders.
C) rumination.
D) equifinality.

154. The concept that various causes can lead to the same mental disorder is called:
A) equifinality.
B) multifinality.
C) rumination.
D) mental disorder.

155. The concept that certain risk factors do not always lead to a mental disorder is called:
A) equifinality.
B) multifinality.
C) rumination.
D) mental disorder.

156. _____ is a mental disorder that involves a sad or irritable mood along with physical and
cognitive changes that affect the child or adolescent's ability to behave and interact in a
normal way.
A) Depression
B) Anxiety
C) Stress
D) Psychosis

Page 29
157. Which factor is NOT a physical or cognitive symptom of depression?
A) difficulties sleeping
B) significant changes in weight
C) irritability
D) inability to concentrate

158. Thoughts of suicide may occur in those who suffer from this mental disorder.
A) anxiety
B) depression
C) stress
D) psychosis

159. About what percentage of children and adolescents suffer from depression?
A) 3%
B) 7%
C) 11%
D) 15%

160. Which individual is MOST likely to suffer from depression?

A) Brandon, who is 10 years old
B) Sam, who is 7 years old
C) Rebecca, who is 13 years old
D) John, who is 18 years old

161. Which factor is NOT a “nature” influence on the development of depression?

A) elevated levels of cortisol
B) activation in the prefrontal cortex and amygdala
C) a heritability index of 40%
D) low levels of parental sensitivity

162. Which statement is NOT true of those suffering from depression?

A) Those with depression have an unrealistic expectation about themselves and social
relationships.
B) Depressed individuals tend to engage in equifinality.
C) Depressed individuals tend to ruminate about negative life events.
D) Difficult peer relationships are both a cause and outcome of depression.

Page 30
163. _____ involve(s) the inability to regulate the emotions of fear and worry.
A) Anxiety disorders
B) Depression
C) Toxic stress
D) Psychosis

164. Which brain structures are associated with experiencing an anxiety disorder?
A) the hypothalamus and the thalamus
B) the frontal lobe and the hypothalamus
C) the amygdala and the hippocampus
D) the temporal lobe and the amygdala

165. Which factor is NOT needed for separation anxiety to be considered a mental disorder?
A) severity
B) temporary
C) persistence
D) interference with behavior

166. Children and adolescents with an anxiety disorder may also suffer from:
A) panic attacks.
B) phobias.
C) both panic attacks and phobias.
D) neither panic attacks nor phobias.

167. About what percentage of children and adolescents suffer from an anxiety disorder?
A) 3%
B) 7%
C) 12%
D) 15%

168. When do anxiety disorders typically develop?

A) during toddlerhood
B) during childhood
C) during adolescence
D) during young adulthood

Page 31
169. Children with this temperament are more likely to develop an anxiety disorder.
A) fearful
B) easy
C) slow-to-warm-up
D) slow-to-calm-down

170. Which method is NOT a manner in which children can learn to associate certain people
or events with fear and anxiety?
A) conditioning
B) observation
C) instruction
D) direction

171. Which parental behavior has NOT been associated with the development of an anxiety
disorder in children?
A) overprotection
B) overinvolvement
C) encouraging children to engage in risky behaviors
D) monitorization

172. What type of therapy is common for treating depression among children and
adolescents?
A) cognitive behavioral therapy
B) drug therapy
C) psychotherapy
D) exposure therapy

173. _____ is a psychotherapeutic approach that is very effective in treating depression and
anxiety in children.
A) Cognitive behavioral therapy
B) Drug therapy
C) Psychotherapy
D) Exposure therapy

174. The gender difference in _____ is NOT an important contributor to the difference in
rates of depression in adolescent females and males.
A) academic achievement
B) likelihood of rumination
C) concern with physical appearance
D) difficulty with the biological changes of adolescence

Page 32
175. Extensively discussing emotional problems with a peer is referred to as:
A) rumination.
B) co-rumination.
C) reiteration.
D) co-reiteration.

176. Which situation is LEAST likely to contribute to an increase in depressive symptoms?

A) early puberty in girls
B) early puberty in boys
C) late puberty in girls
D) late puberty in boys

Page 33
Answer Key
1. C
2. D
3. B
4. D
5. B
6. B
7. A
8. C
9. A
10. D
11. C
12. B
13. B
14. B
15. A
16. A
17. C
18. D
19. B
20. D
21. D
22. A
23. D
24. A
25. D
26. B
27. B
28. C
29. C
30. D
31. B
32. C
33. A
34. C
35. B
36. D
37. D
38. B
39. D
40. B
41. C
42. B
43. A
44. D

Page 34
45. D
46. D
47. B
48. A
49. C
50. C
51. C
52. B
53. A
54. D
55. B
56. B
57. D
58. B
59. D
60. C
61. C
62. A
63. C
64. C
65. B
66. B
67. C
68. D
69. B
70. C
71. D
72. D
73. A
74. C
75. C
76. A
77. B
78. C
79. C
80. D
81. B
82. D
83. D
84. A
85. B
86. C
87. B
88. D
89. D
90. A

Page 35
 91. A
92. C
93. D
94. B
95. C
96. A
97. B
98. C
99. D
100. C
101. C
102. B
103. D
104. C
105. B
106. D
107. A
108. A
109. C
110. D
111. C
112. A
113. B
114. D
115. A
116. B
117. B
118. C
119. D
120. B
121. A
122. C
123. D
124. A
125. B
126. D
127. C
128. A
129. C
130. C
131. B
132. D
133. C
134. B
135. B
136. A

Page 36
137. A
138. D
139. C
140. B
141. C
142. A
143. A
144. A
145. B
146. B
147. D
148. D
149. D
150. A
151. D
152. C
153. B
154. A
155. B
156. A
157. C
158. B
159. A
160. C
161. D
162. C
163. A
164. C
165. B
166. C
167. B
168. B
169. A
170. D
171. D
172. B
173. A
174. A
175. B
176. C

Page 37
Another random document with
no related content on Scribd:
spasmodic attacks, and the diagnosis of hysteria was made. She
remained in the hospital about four weeks. On leaving she again
went into service. She was readmitted June 9, 1880, in an
unconscious or semi-conscious condition. She had been on a picnic,
and while swinging was taken with an attack of spasm and
unconsciousness. During two hours after admission she had a series
of convulsions. After this she had similar attacks two or three times a
week, or even oftener.

I first saw her about the middle of January, 1881. She had an
hysterical face, but was possessed of considerable intelligence, and
when questioned talked freely about herself. The most prominent
physical symptom that could be discovered was a large tremor,
affecting the left arm, forearm, and hand. This was constant, and had
been present since her admission to the hospital. The left half of her
body was incompletely anæsthetic, the anæsthesia being especially
marked in the left forearm. Ovarian hyperæsthesia could not at this
time be made out. She was, however, hyperæsthetic over the
occipital portion of the scalp and the cervico-dorsal region of the
spine. Pressure or manipulation of these regions would in a few
moments bring on an attack of spasm. The attacks, however, usually
occurred without any apparent exciting cause.

For a period of from six to twelve hours before an attack she usually
felt dull, melancholy, and strange in the head. Frequently she had
noises like escaping steam in her ears, but more in the right ear than
in the left. She complained of cardiac palpitations. She usually had
pain in the small of her back. Her limbs felt weak and tired. Just as
the attack was coming on her eyes became heavy and misty, her
head felt as if it was sinking backward, and if not supported she
would fall in the same direction.

On several occasions I had the opportunity of watching every phase

of the attack or series of attacks, the spasms continuing sometimes
from one to four or five hours. The order of events was not always
the same, and yet a general similarity could usually be seen in the
successive stages of the phenomena. I will try to give an outline of
the different stages and phases as observed on an occasion when
the seizures were severe.

FIG. 18.

After lying down, the first noticeable manifestation was a twitching of

the eyelids and of the muscles of the forehead and mouth. Her head
was next moved from side to side, and she looked around vaguely.
Respiration became irregular. In a few moments a convulsive tremor
passed down her body and limbs. Her arms were now carried
outward slightly from the body, the hands being partly clenched. The
lower extremities were straightened, the left foot and leg being
carried over the right (Fig. 18). Her limbs were rigid. Her mouth was
closed, the teeth being ground together. Consciousness was lost,
and respiration seemed to stop.

FIG. 19.
A series of strong convulsive movements next ensued. Her entire
body was tossed up and down and twisted violently from side to
side. Sometimes she assumed a position of opisthotonos. Her whole
body was then again lifted and hurled about by the violence of the
movements. A few seconds later she became quiet but rigid, in the
position shown in Fig. 19, corresponding to the position of crucifixion
of the French writers.

FIG. 20.
Soon she assumed the position represented by Fig. 20, and the
convulsions were renewed with violence, the patient's limbs and
body being frequently tossed about and the latter sometimes curved
upward. After these movements had continued a brief period the
patient became calm and partially relaxed; but the respite was not
long. A series of still more remarkable movements began, chiefly
hurling and lifting of the body. Eventually, and apparently as a climax
to a succession of efforts directed to this end, she sprang into the
position of extreme opisthotonos represented in Fig. 21. This sketch,
by Taylor, is a very faithful view of her exact position. She remained
thus arched upward for a minute, or even more. A series of springing
and vibratory movements followed, the body frequently arching.

FIG. 21.

As the spasms left she sat up on her bed, and at first looked around
with a bewildered expression. She turned her head a little to one
side and seemed to gaze fixedly at some object. Her expression was
slightly smiling. When spoken to she looked straight at the one
addressing her, but without appearing to know what was said, and
the next moment the former position and attitude were resumed.
After a few minutes she lay down muttering incoherently, and in
about a quarter of an hour fell asleep.
I have simply described one attack. Sometimes she would have
several in succession, or the spasmodic manifestations would be
repeated several times in a regular or an irregular manner. Strong
pressure in the ovarian regions usually would not cut short the
spasms. They could be stopped, however, by etherization or by
active faradization of the limbs or trunk. She did not always conduct
herself in the same manner in the period which succeeded the
spasms. Sometimes, after getting into the sitting posture, instead of
smiling, she would look enraged and speak a few words. The
following expressions were noted on one occasion: “You know it!
Yes, you do! Yes! yes!” Often she was heard to mutter for hours after
the attack. Her lips would sometimes be seen to be moving without
any words being heard. Sooner or later she would fall into sound
sleep which would last several hours.

During the spasms she seemed to be entirely unconscious of her

surroundings. To a looker-on her movements seemed sometimes to
have the appearance of design, but I soon convinced myself that
such was not the case. She was insensitive to painful or other
impressions. Her expression was blank and unchanging. She said
that the only thing that she remembered about the attacks was that
she heard a strange, confused sound; this was most probably just as
she was returning to consciousness.

Numerous remedies were tried without any apparent effect. These

included sodium and potassium bromides, iron, zinc salts,
physostigma, cimicifuga, camphor, ether, etc. A uterine examination
was made, but nothing especially calling for local treatment was
found. She was placed upon equal parts of tincture of valerian and
tincture of iron in half-teaspoonful doses three times daily. Capsules
of apiol were also ordered to be taken three times daily just before
and during her menstrual period. Her menses became more profuse
and continued longer. The attacks began to diminish in frequency,
and became less severe. In March, not having had a seizure for
several weeks, she left the hospital and again went into service. Six
months elapsed and she had no attack. She reports occasionally at
my office. She says that she feels entirely well. The tremor of the left
upper extremity entirely disappeared. She continued to take valerian
and iron for four months, but stopped the apiol after the second or
third menstrual period.

With this case before us the phenomena of the disease can be more
readily grasped. I will necessarily make free use of the labors of
Richer in my description of symptoms.

Hystero-epileptic attacks usually, although not always, have distinct

prodromes. These have been more thoroughly studied and reported
by Richer than by any other author. They are classed by him under
the four heads of psychical affections, including hallucinations,
affections of the organic functions, motor affections, and affections of
sensibility. The patient's condition is changing; she is listless,
irritable, melancholy, despairing, slovenly. Sometimes she is noisy,
sometimes mute. At times she is full of wild excitement.
Hallucinations of sight sometimes come on at this period—most
commonly visions of cats, rats, spiders, etc. These visions of
animals, as first pointed out by Charcot, in passing before the
patients run from the left to the right or from the right to the left,
according as the hemianæsthesia is situated on the left or on the
right. Hallucinations of hearing, as of music, threats, demands,
whistling, trumpeting, etc., also occur, chiefly on the hemianæsthetic
side. These hallucinations are worse at night. Sometimes at night the
patients are the victims of imaginary amours. Want of appetite,
perverted taste, nausea and vomiting, flatulence, tympanites,
ptyalism, unusual flow of urine, feelings of oppression, hiccough,
laughing, barking, loss of voice, palpitation of the heart, and
flushings are among some of the many disorders of the organic
functions which are sometimes present during the prodromal period.
Loss of muscular power or a species of ataxia, peculiar limited
spasmodic movements, contracture, first of one limb and then of
another, may be observed. Charcot, Bourneville, Regnard, and
Richer, all give admirable illustrations of different forms of
contracture. In one case the right arm and wrist are flexed, and the
hand held at the level of the shoulder with fingers extended.
Anæsthesia—total, unilateral, or local, tactile, of pain, temperature,
etc.—may also occur. Sometimes achromatopsia or color-blindness
shows itself; sometimes deafness in one ear is present. Tenderness
over the ovarian region is often an immediate precursor. To Charcot
we owe the most careful study of these symptoms.

Among the most interesting prodromic affections of sensibility are

the hysterogenic or hystero-epileptogenic zones. These have been
well studied and described by Richer, from whose work Figs. 22 and
23 have been taken. Brown-Séquard has shown that animals
rendered epileptic by lesions of the spinal cord, medulla oblongata,
or nerves are sometimes attacked with convulsions spontaneously,
but it is also possible to provoke these attacks by exciting a certain
region of the skin which he designates as the epileptogenic zone.
This zone, situated on the same side of the body as the nervous
lesion, has its seat about the angle of the lower jaw, and extends
toward the eye and the lateral region of the neck. The skin of this
region is a little less sensitive than that of the opposite side, but
touching it most lightly provokes epileptic convulsions. The simple
act of breathing or blowing on it brings about the same result.

Something analogous to this epileptogenic zone has been noticed

among hystero-epileptics, and has been pointed out by several
writers. Richer gives the particulars of a number of cases. In one
patient the hyperæsthetic zone was between the two shoulder-
blades. Simply touching this region was sufficient to provoke an
attack, and this was more easily done if near the time of a
spontaneous seizure. After the grave attacks the excitability would
seem to be exhausted, and pressure in the zone indicated would not
cause any convulsive phenomena. A second case presented a
similar condition. If touched over the dorsal spine between the
shoulders, she felt a violent pain in the belly, then a sense of
suffocation, which brought on at once loss of consciousness. In a
third patient the hysterogenic zone was different. It was double. It
was necessary to touch two symmetrical points situated to the
outside and a little below the breasts in order to bring on the hystero-
epileptic convulsions. Touching one of these points did not produce
any result. Other cases are given in detail, but a glance at the two
figures (22 and 23) will show some of the principal hysterogenic
zones both for the anterior and posterior surfaces of the body. A
zone of ovarian hyperæsthesia was common to all the patients. It did
not differ essentially from the other hysterogenic zones. If the
ovarian hyperæsthesia existed along with other hysterogenic points,
the excitation of the ovarian region was always the most efficacious.
The hysterogenic zones always occupy the same place in the same
case. They are found on the trunk exclusively; they are more
frequently in front than behind; in front they occupy lateral positions,
and are often double and symmetrical; behind they are more often
single and median; they exist more frequently to the left than to the
right, and the unilateral zones have always been met with on the left
side.

FIG. 22.
Principal Hysterogenic Zones, anterior surface of the body: a, a′,
supramammary zones; b, mammary zones; c, c′, infra-axillary zones; d,
d′, e, inframammary zones; f, f′, costal zones; g, g′, iliac zones; h, h′,
ovarian zones (after Richer).

FIG. 23.
 Principal Hysterogenic Zones, posterior surface of the body: a, superior
dorsal zone; b, inferior dorsal zone; c, posterior lateral zone (after
Richer).

The hysterogenic zones bear no constant relation to the

hemianæsthesia. It is true that the ovarian pain is most often seated
on the hemianæsthetic side, but sometimes it is present on the
opposite side. They are not at all times equally excitable. They are
more so when the convulsive attack is imminent.

Ovarian pressure gives rise to the spasmodic attacks: the same

pressure arrests them. What is true of ovarian compression is
equally true of all the hysterogenic zones. A light touch brings on the
convulsions, which have scarcely commenced when they can be
stopped by a new excitation of the same point.

As already stated, the attack of hystero-epilepsy, having fully begun,

is divided by Richer into distinct periods. Although these are seldom
seen in perfection, it is necessary to have some clear idea of their
phenomena in order to view the affection comprehensively. They
were seen well developed in the case given. These periods are—(1)
The epileptoid period; (2) the period of contortions and of great
movements; (3) the period of emotional attitudes; (4) the period of
delirium.

In the first or epileptoid period of the hystero-epileptoid attack, which

receives its name from its resemblance to true epilepsy, various
phases always reproduce themselves in the same order. Loss of
consciousness and arrest of respiration, muscular tetanization in
various positions, followed by clonic spasms, and, finally, muscular
resolution, are the successive phenomena of this period, which
usually lasts several minutes. Loss of consciousness is complete
during this period. Muscular tetanization shows itself in movements
large and small, sometimes of the whole body. The trunk may
become as stiff as a bar of iron; the face is sometimes cyanosed,
puffed; froth even appears, which it is well to remember, as this is
considered by some as absolutely diagnostic of epilepsy. Many
positions may be assumed. The important significant features of the
tonic phase of period are muscular tetanization with loss of
consciousness and respiratory spasm. In the clonic phase
movements at first rapid and short, later larger and more general,
ensue, and are accompanied by whistling inspiration, jerking
expiration, hiccoughs, noisy deglutition. The phase of muscular
resolution comes on, in which the patient completely relaxes;
sometimes a true stertor occurs. The epileptoid period usually lasts
altogether several minutes, the first two phases usually occupying
about one minute.

In the period of contortions and great movements wonderful attitudes

and contortions are observed in one phase, and in another great
movements. One of the attitudes particularly fashionable with
hystero-epileptics is the arched position, in which the body is curved
backward in the form of an arch so as to rest only on the head and
feet. Sometimes the patient may rest on the belly or side, the
remainder of the body preserving its curved position; the body may
indeed assume almost any strange and seemingly impossible
attitude. The so-called great movements are executed by the entire
body or by a part of the body only; they are of great variety;
sometimes they are movements of salutation; sometimes the
semiflexed legs are projected upward, etc. Often the phase of great
movements is marked at its beginning by a piercing cry; loss of
consciousness is not the rule.

The period of emotional attitudes or statuesque positions is the most

dramatic stage of a highly dramatic disease. Hallucinations ravish
and transport the patient: sometimes they are gay, sometimes they
are sad. The dramatic positions assumed are in consonance with the
patient's hallucinations. The patient reproaches, opposes,
supplicates, is angry, is furious; she assumes positions of
supplication on her knees, becomes menacing, and even strikes. In
the great works of Bourneville, of Regnard, and of Richer many
cases are related at great length and with vivid details. Camera and
pencil are frequently called in to assist the pen in presenting scenes
which read as if drawn from an exciting drama or novel. Among the
expressions and attitudes which they have succeeded in
photographing are those illustrating emotions of menace, appeal,
amorous supplication, erotism, ecstasy, mockery, beatitude.

After the period of the emotional attitude consciousness returns, but

only in part, and for a time the patient remains a prey to a delirium
whose character varies. This delirium may be concerned with
subjects the most varied; it may be gay, sad, furious, religious, or
obscene. It is mingled with hallucinations; voices are heard;
sometimes are seen personages who are known; sometimes the
scenes are purely imaginary. During this fourth period the patients
will sometimes make the most astounding statements and
accusations. They will wrongfully charge theft, abuse, etc. upon
others; they believe in the reality of their hallucinations, and, what is
more important, they will sometimes persist in this belief after the
attack is over. The third and fourth periods are sometimes
confounded. When the four periods described succeed each other in
order, they constitute a regular and complete attack of hystero-
epilepsy.

By comparing the notes upon the case detailed with the description
given of the typical hystero-epileptic attack, it will be seen that the
different periods, and even the phases, can be made out with but
little difficulty. After a few moments of convulsive movements and
irregular breathing the patient was attacked with muscular
tetanization, arrested respiration, and loss of consciousness. Tonic
convulsions followed, and then immobilization in certain positions.
Next came the clonic spasms and resolution. In the period of
contortions the arched position is one more extreme than any
represented by the illustrations of the French authors, although it is
closely approximated by some of their illustrations. After this position
of opisthotonos had been taken a succession of springing and lifting
movements occurred, probably corresponding to the phase of great
movements. The period of emotional attitudes was very clearly
represented by the position assumed, the expression of
countenance, and sometimes by the words uttered. Even the period
of delirium was imperfectly represented by the mutterings of the
patient, which were sometimes long continued after the attack.
 FIG. 24.

A beautiful illustration of one of the positions assumed by a hystero-

epileptic is shown in Fig. 24 from Allan McLane Hamilton's treatise
on Nervous Diseases. The patient, æt. eighteen, represented in the
figure had suffered from hystero-epileptic attacks since the beginning
of the menstrual period. Usually, she had severe but distinct epileptic
seizures, and afterward an hystero-epileptic paroxysm. The muscles
of her back were rigidly contracted in opisthotonos. Her arms were
drawn over her chest, and her forearms slightly flexed and crossing
each other. Her thumbs were bent in and covered by her other
fingers, which were rigidly flexed. Her toes were also flexed, and her
right foot presented the appearance called by Charcot le pied bot
hystérique, or hysterical club-foot.

As has already been stated, hystero-epilepsy of irregular, imperfect,

or abortive type is most commonly observed in this country, or at
least in the Middle States, of which my own knowledge and
experience are greatest. As has been demonstrated by Richer and
Charcot, the irregular type may be of any form, from a paroxysm with
a scarcely detectible convulsive seizure and scarcely recognizable
loss of consciousness up to frightful attacks which from their terrible
nature have been termed demoniacal, and in which occur the wildest
phenomena of movement, frightful contortions and contractions, with
grimaces and cries of fury and rage. Sometimes the movements
show a violence beyond description. These frightful seizures are of
extreme rarity in America. Sometimes attacks of ecstasy or attacks
of delirium are the predominating or almost the only feature. The
epileptoid attack, so far as my experience has gone, is the most
prevalent variety of hystero-epilepsy. Epileptoid attacks are simply
the result of the predominance and modification of the first or
epileptoid period of the typical grave attack. Richer has described
several varieties.

I have seen a number of cases of the epileptoid variety or other

irregular forms. These cases have presented a few or many of the
symptoms of grave hysteria, such as anæsthesia, analgesia,
hyperæsthesia, blindness, aphonia, paralysis, contracture, etc., and
have also had attacks of tonic and clonic spasm, with complete or
partial loss of consciousness. The phenomena of the periods of
contortions and great movements, of emotional attitudes, and of
delirium have been, however, altogether or almost entirely absent.
These epileptoid attacks have varied somewhat in different cases.

The following are the notes of three cases observed by me:8

8 Published in Journal of Nervous and Mental Disease, vol. ix., No. 4, October, 1882.

M——, æt. twenty-seven, a widow, admitted to the Philadelphia

Hospital February 4, 1882, was married thirteen years before, when
only fourteen years of age, and remained in comparatively good
health for four years after her marriage, during which time she had
three children, all of whom died in early infancy. Four years after her
marriage, while carriage-riding, she for the first time had a spasm.
According to her story, the seizure was very severe; she lost
consciousness, and passed from one spell into another for an hour
or more. She had a second attack within two weeks, and since has
had others at intervals of from one week to three or four months.
Four years ago she passed into a condition of unconsciousness or
lethargy in which she remained for three days. On coming out of this
state she found that the left half of her body was paralyzed and that
she was speechless. In two weeks she recovered her speech and
the paralysis disappeared. On June 15, 1881, she gave birth to a
male child. On the night of the 16th she became delirious, and on the
17th she again lost her speech and had a paralytic seizure, the
paralysis now affecting both legs. She recovered her speech in a few
days, but the paralysis remained. Her babe lived, and with her was
admitted to the hospital. He had had seven attacks of spasm at
intervals of about a month. The patient's mother was for a time
insane, and had been an inmate of an insane asylum for some
months since her first epileptiform attack.

She was carefully examined on the day of her admission. She was
bright, shrewd, and observant. She gave an account of her case in
detail, and said she was a puzzle to the doctors. Both legs were
entirely helpless; the feet were contractured in abduction and
extension, assuming the position of talipes equino-varus; the legs
and thighs were strongly extended, the latter being drawn together
firmly. The left upper extremity was distinctly weaker than the right,
but all movements were retained. She had no grasping power in the
left hand. She was completely anæsthetic and analgesic below the
knees, and incompletely so over the entire left half of the body. Pain
was elicited on pressure over the left ovary and over the lower dorsal
and lumbo-sacral region of the spine. Both knee-jerks were
exaggerated.

I lectured on this patient at my clinic at the hospital, stating that I

believed the case to be one of hystero-epilepsy, and only needed to
see an attack of spasm to confirm the diagnosis. Up to this time she
had not had a seizure since admission. She had, however, been
complaining for several days of peculiar sensations in the head and
of severe headache. She had also been more irritable than usual,
and said that she felt as if something was going to happen to her.
The same afternoon, Dr. Rohrer, the resident physician in charge of
the patient, was sent for, and found her in a semi-conscious state.
She did not seem to know what was going on around her, but was
not in a stupor. Her pulse was 114 to 120; respirations were 20 to 22,
regular. The corneæ responded on being touched. Some twitching
movements of the eyeballs and eyelids were noticed; the thumb and
forefinger of the left hand also moved, as if rubbing something
between them.
In a few moments an epileptoid paroxysm ensued. She became
unconscious and rigid. The lower extremities were strongly extended
in the equino-varus position already described. The arms were
extended at her sides, the wrist being partly flexed and rotated
outward, the hands clenched. Her face, at first pale, became deeply
congested. Her trunk became rigid in a position of partial
opisthotonos. Brief clonic spasms followed, then resolution, the
whole seizure not lasting more than from two to three minutes. She
lay for a minute or two unmindful of anything or anybody, and then
sat up and looked around wildly. She dropped back again and began
to mumble, as if she wished to speak, but could not. Paper and
pencil were given to her, and she wrote that she was conscious, but
could not speak. Her temperature, taken at this time, was 99.8° F.

Attacks similar to the one just described occurred at irregular

intervals for two days. On their cessation she was speechless, and
the permanent symptoms already detailed—the anæsthesia,
paralysis, etc.—were deepened. During the attacks but little
treatment was employed; hypodermic injections of morphia and
potassium bromide by the mouth were, however, administered. After
the attack the valerianate of iron by the mouth, faradization of the
tongue, and galvanization of the legs below the knees with weak
currents, were ordered. Her speech returned in a week. For about a
month she showed no other signs of improvement; then she began
to mend slowly, gradually using her limbs more and more. On May
11, 1882, she was discharged, and walked out of the hospital with
her child in her arms, apparently perfectly well. During the last month
of her stay no treatment was used but mild galvanization every other
day.

Mrs. A——, æt. forty-five, was seen by me in consultation. For some

months at her menstrual period she had been out of sorts. At times
she had had hallucinations of sight. For several weeks she had been
troubled more or less with a feeling of numbness and heaviness in
the left arm and leg, particularly in the latter, and also with diffused
pain in the head and a sensation of aching and dragging in the back
of the neck. For three weeks, off and on, she had had diarrhœa,
which had weakened her considerably. She awoke one morning
feeling badly and yawning every few minutes. She passed into a
condition of unconsciousness with attacks of spasm. I did not see
her on this the first day of her severe illness, but obtained from the
physician in attendance some particulars as to the character of her
seizures. Evidently the condition was similar to that presented by the
last case, that described by Richer as the epileptoid status, in which
tonic and clonic spasm and resolution are repeated again and again.
Attack after attack occurred for nine or ten hours, sometimes one
immediately following another, sometimes an interval of several
minutes or of half an hour or more intervening. Respiration was
partially arrested. Tonic spasm predominated; the limbs became rigid
in various positions; sometimes the neck and trunk were strongly
bent backward, producing partial opisthotonos. While the body and
limbs remained tetanized they were thrown into various positions
(clonic phase of an epileptoid attack). Although she answered
questions addressed to her by her physician between the spells, she
did not recognize him until evening, after the spasms had ceased,
and then was not aware that he had been in attendance during the
day, although he had been with her almost constantly. Leeching and
dry cupping to the back of the neck were employed, and potassium
bromide and tincture of valerianate of ammonia were given.

Early on the morning of the next day she had another attack of
unconsciousness and spasm, in which I had the opportunity of
seeing her. The spasm amounted only to a slight general muscular
tetanization. The whole attack lasted probably from half a minute to a
minute. The following day, at about the same hour, another
paroxysm occurred, having a distinct but brief tonic, followed by a
clonic, phase, in which both the head and body were moved. The
next day, also at nearly the same hour, she had an attack of
unconsciousness or perverted consciousness without spasm. She
had a similar seizure at 4 P.M. For two days succeeding she had no
attacks; then came a spell of unconsciousness. After this she had
one or two slight attacks, at intervals of a few days, for about two
weeks.
Between the attacks the condition of the patient was carefully
investigated. On lifting her head suddenly she had strange
sensations of sinking, and sometimes would partially lose
consciousness. She complained greatly of pain in the head and
along the spine. Her mental condition, so far as ability to talk,
reason, etc. was concerned, was good, but any exertion in this
direction easily fatigued her and rendered her restless. She had at
times hallucinations of animals, which she thought she saw passing
before her from left to right. The left upper and lower extremities
showed marked loss of power. The paralysis of the left leg was quite
positive, and a slight tendency to contracture at the knee was
exhibited. She was for two weeks entirely unable to stand. The knee-
jerks were well marked. Left unilateral sweating was several times
observed.

A zone of tenderness was discovered in the occipital region and

nape of the neck, and she had also left ovarian hyperæsthesia. Left
hemianæsthesia was present, head, trunk, and limbs being affected.
She complained of dimness of vision in the left eye, and examination
by the attending physician and myself showed both amblyopia and
achromatopsia, she was unable to read print of any size or to
distinguish any colors with the left eye, although she could tell that
objects were being moved before the eye. A distinguished
ophthalmologist was called in consultation. An ophthalmoscopic
examination showed a normal fundus. Each eye was tested for near
vision. It was found that she could read quite well with the right eye,
and not at all with the left. While reading at about sixteen inches a
convex glass of three inches focus was placed in front of the right
eye, but she still continued to read fluently. A few minutes later,
however, on retesting, she could not read or distinguish colors with
the left eye. Sometimes toward evening her feet would become
slightly œdematous. Examination of the urine showed neither
albumen nor sugar. The heart-sounds were normal.

Owing to the apparent periodicity of the attacks quinine in large

doses was administered, and seemed to act beneficially. In addition,
valerianate of zinc and iron, strychnia, and other nerve-tonics were