Understanding Multiple Personality Disorders

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1. The phenomenon of Multiple Personality Disorder was first examined:
  a. Approximately 100 years ago

  b. By the pioneers of psychiatric medicine
  c. In Europe only

  d. A and B

2. Multiple Personality Disorder (MPD) occurs:

  a. In women only
  b. in 1.2% of general psychiatric population
  c. About as frequently as schizophrenia

  d. B and C
3. The increase in attention to MPD and reported cases since 1970 is attributed to all but the following:
  a. An increased awareness of child abuse
  b. More individuals have MPD now than at any other time in history

  c. More objective and sophisticated case studies and investigations

4. All but the following is true of dissociation:
  a. It is a coping mechanism that develops when normal coping mechanisms are depleted.

  b. In this state the individual withdraws consciousness while the brain encodes information about the event in a fashion that reduces the shock to the individual.
  c. The individual is conscious of doing this and is able to perform it at will

  d. The result of dissociation is that the event is not completely experienced by the individual.

5. The most extreme level of dissociation is called:
  a. Posttraumatic Stress Disorder

  b. Multiple Personality Disorder

  c. Hyper-Dissociation
  d. Borderline Personality Disorder
6. Which of the following is true of Multiple Personality Disorder:
  a. It is the result of trauma which is far greater than normal human stress and surpasses the individual’s ability to cope
  b. The trauma causes the young developing mind to fragment into different selves

  c. A separate consciousness, or personality, is developed which stores the traumatic information

  d. All of the above

7. MPD begins:
  a. In adolescence

  b. In adult women, between the ages of twenty and forty

  c. In childhood, between the ages of two and eight

8. A history of childhood physical or sexual abuse:
  a. Is found in 97% - 98% of MPD cases

  b. Is a minor factor in the etiology of MPD
  c. Is found to be traumatic, but not sufficient to cause MPD

9. The individual with MPD:
  a. Is completely aware of the other personalities

  b. Has a very dramatic presentation with obvious switching between personalities

  c. Often has a very subtle presentation, where switching is apparent only to those who know the individual well

10. The higher percentage of reported cases among females is most likely due to:
  a. A higher incidence of childhood abuse among girls than boys

  b. Women tend to respond to emotional trauma by performing harmful acts against themselves, which leads them into treatment
  c. Men tend to respond to emotional trauma by performing acts of violence against others, thereby ending up in the criminal justice system
  d. B and C

11. The severity of dissociation is related to:
  a. The age of the individual when the abuse experience began

  b. The relationship of the abuser to the child

  c. The frequency of the abuse

  d. All of the above

12. With depersonalization:
  a. The person has the feeling they are an outside observer to themselves

  b. Fears they are going insane

  c. Must practice taking things less personally
  d. All of the above

  e. A and B

13. Which of the following is not true of depersonalization?
  a. The child is able to absolve him/herself of the guilt surrounding the abuse by experiencing the event as happening to someone else.
  b. It is not helpful to the child experiencing the abuse.
  c. It allows the child to continue to live in the abusive environment without emotional collapse.

  d. It is seen as a helpful coping mechanism for the child at the time of abuse, but a problem in later adult life.

14. Multiple Personality Disorder:
  a. Is at the furthest extreme of the continuum of dissociation
  b. Is characterized by sudden, unexpected travel away from home

  c. Is often associated with victims of cult abuse

  d. A and C

15. An average number of personalities for someone with MPD:
  a. Ranges from eight to thirteen
  b. Is usually well over 100

  c. Increases as the person ages

16. The various personalities:
  a. Are experienced by the individual as separate and distinct entities.

  b. Share the same memories and feelings about the abuse experience

  c. Have been created to perform different functions or roles in the person’s life

  d. A and C

17. The host personality is:
  a. The personality who has executive control of the body the greatest percentage of time.

  b. May or may not be the legal personality.

  c. The personality perceived by the system as capable of keeping the system intact.

  d. All of the above.

18. The presenting personality is:
  a. The same as the host.

  b. The personality who presents for treatment.

  c. Is only experienced during the first contact with a therapist, then disappears.

19. The most common personality found among MPD patients is:
  a. The presenting personality

  b. A nurturing parent figure

  c. A terrified child

  d. An animal

20. Co-consciousness refers to:
  a. The ability to go into a hypnotic trance
  b. The awareness of one personality to the others

  c. The ability to remember the abuse

21. Switching can be brought on by:
  a. Vague memories of abuse
  b. Stress in the individual’s life
  c. Conflict between the alters
  d. All of the above
22. Protective personalities:
  a. Are always male.
  b. Are of very little use in therapy.
  c. Were created to protect the original or other personalities from intolerable conditions.
23. The internal self-helper personality:

  a. Is the rational part of the system
  b. Is extremely helpful in therapy
  c. Is able to assist the therapist in working with the various alters

  d. All of the above
24. The manifestation of the various alter personalities can seem fantastic and unbelievable. It is important to:
  a. Give the patient a reality check and lt him or her know that these personalities do not really exist.

  b. Remember that to the patient each personality is a separate and real entity and must be given respect as such.

  c. Tell the patient they no longer need these alters and to stop switching.

25. Prior to receiving an accurate diagnosis and appropriate treatment, the average MPD patient:
  a. Receives three erroneous diagnoses

  b. Usually ends up in jail

  c. Has spent up to 50% of his or her life in a hospital

  d. All of the above

26. Diagnosis of MPD is made difficult by:
  a. The secretiveness of these patients
  b. The existence of concomitant behaviors and disorders
  c. Cycles of overt versus convert behavior
  d. All of the above

  e. None of the above

27. The amnesia which exists in MPD is due to:

  a. A head injury

  b. Drug and alcohol abuse

  c. Alter activity and an absence of co-consciousness
  d. All of the above
28. Which of the following are signs and symptoms of MPD?

  a. Body memories.

  b. Periods of amnesia, particularly of childhood.
  c. Objects in one’s possession which cannot be accounted for.

  d. All of the above.

29. The most common differential diagnoses of MPD are:
  a. Borderline personality disorder and depression.
  b. Borderline personality disorder and schizophrenia.
  c. Schizophrenia and anti-social personality.

30. The difference(s) between schizophrenia and MPD is/are:

  a. Schizophrenics hear voices outside the head most of the time, and MPD patients usually hear them inside the head.

  b. Schizophrenics have an intact sense of reality and MPD patients do not.
  c. A and B.

31. Which of the following are considered appropriate diagnostic tools for diagnosing MPD?
  a. Suggesting the patient write in a diary thirty minutes per day.

  b. Direct questioning about traumatic events.
  c. Hypnosis.
  d. All of the above.
  e. A and C.

32. Classic MPD is described as:
  a. A patient with at least 15 alter personalities.
  b. Overt behavior that fits the diagnostic criteria for MPD on an ongoing basis for periods of months, years, or even a lifetime.
  c. The disorder first studied by psychiatric pioneers one hundred years ago.
  d. All of the above.
33. Possession form MPD:
  a. Is a variant form of MPD where the most evident alter presents as a demon or devil.

  b. Can easily be mistaken for psychotic conditions.
  c. Is a form of MPD where the patient is obsessive about his or her possessions.

  d. A and B

34. Covert MPD:
  a. Is the form most characteristic of patients with MPD.
  b. Is characterized by patients who feel as though their lives are out of control and that their actions are imposed upon them by a power unseen.

  c. Includes such forms as Phenocopy and somatoform MPD.
  d. All of the above.
35. Pseudo False Positive MPD:

  a. Was commonly seen one hundred years ago and is not uncommon.
  b. Is not true MPD.

  c. Was used as a desperate attempt of the patient to convince the clinician of the presence of MPD.

  d. Is only seen in patients born in the 1970’s and 1980’s.

36. The various alters can create difficulty in treatment by:
  a. Continual switching.

  b. Harming another alter for sharing information.
  c. Withdrawing the patient from therapy.

  d. All of the above.

37. In a double-bind set up the patient:
  a. Sets up situations to cause the therapist to appear abusive or uncaring.

  b. Is to perform certain tasks for diagnostic tests.

  c. Will test the therapist’s trustworthiness.

  d. All of the above.

38. Braun’s 13-Point approach to treatment includes:

  a. Medication, integration, graduation.
  b. Communication with alters, contracting, new coping skills.

  c. Solidifying skills, follow-up, termination of therapy.

  d. All of the above.
39. In Resolution and Integration:
  a. The patient’s heightened sensitivity allows for greater coordination of body movements.
  b. The patient is ready to terminate therapy.

  c. Personalities blend rather than continue power struggles.

  d. The patient learns new ways of coping with stress.

40. Though the goal of treatment is integration, sometimes all that can be achieved is:
  a. Helping the patient to find a support group.
  b. To eliminate the conflict between personalities so that they can work collaboratively.
  c. For the patient to be aware of the diagnosis of MPD.

41. Integration is described as three stable months of:

  a. Continuity of contemporary memory.
  b. Absence of overt behavioral signs of multiplicity.
  c. Absence of alter personalities on hypnotic re-exploration.
  d. All of the above.
42. The recommended treatment of choice for MPD is:
  a. Biofeedback
  b. Behavior modification
  c. Psychoanalytic psychotherapy

  d. Freudian analysis
43. Hospitalization of the MPD patient is sometimes required:
  a. To protect the patient from harmful impulses.
  b. To access memories from reluctant alters.
  c. To receive support from other MPD patients.
  d. All of the above.

  e. A and B.

44. Group therapy is generally contraindicated for the MPD patient because:
  a. They are very sensitive to the issues of others.
  b. They can become overwhelmed and disrupt the group.

  c. MPD patients don’t like group therapy.

  d. A and B.

45. Abreactive therapy:
  a. Employs hypnosis to guide the patient back into a memory and to re-experience it as though it were actually happening.
  b. Is a dangerous technique.

  c. Is the process of assisting the alter personalities to communicate with one another.
  d. All of the above.

46. Medication should be used:

  a. To treat the core psychopathology of MPD.

  b. To treat the co-existing symptoms and conditions which interfere with the progress of therapy.
  c. Never with a MPD patient.

  d. To prevent the patient from switching.
47. Primary to the nursing role in working with MPD patients is:

  a. Playing the role of the abuser.
  b. Creating an environment that is supportive, accepting, and protective.
  c. Helping the patient to re-enact the trauma.

  d. Enforcing strict rules and limits.
48. When switching occurs:
  a. Nursing staff should be alarmed and notify the physician immediately.
  b. Offer the patient medication.
  c. Nursing staff need not be alarmed and can reassure the patient that the alter is out for a reason.

  d. Work with the patient using abreaction techniques.

49. In a dissociative crisis the nurse can help the patient by:
  a. Insuring patient safety.
  b. Notifying other staff in case assistance is needed.

  c. At the completion of the memory, summarizing the experience as valid and painful.

  d. All of the above.

50. If the patient’s behavior threatens to become out of control, the nurse should:
  a. Count down the out of control alter and count up an alter who can keep the system safe.

  b. Call for security immediately.

  c. Give the patient a tranquilizer STATE.

  d. Put the patient in restraints.