SPEX SPEX Exam 4 — Questions and Answers
Question 1: Which of the following best explains why base rates are critical when interpreting psychological test results?
- Low base rates reduce the positive predictive value of a test even when sensitivity is high (Correct answer)
- High base rates always increase the reliability of a test
- Base rates are only relevant for projective tests
- Ignoring base rates increases statistical power
Correct answer: Low base rates reduce the positive predictive value of a test even when sensitivity is high
When a condition is rare (low base rate), even a highly sensitive test will produce many false positives, dramatically lowering positive predictive value and affecting clinical decisions.
Question 2: A psychologist is treating a client who discloses they are a licensed pharmacist currently diverting controlled substances. The psychologist's primary ethical obligation is to:
- Assess for substance use disorder and explore reporting options given laws and ethics guidelines (Correct answer)
- Immediately report to the state pharmacy board without further assessment
- Maintain strict confidentiality since no third party is directly identified
- Terminate therapy and refer the client to another provider
Correct answer: Assess for substance use disorder and explore reporting options given laws and ethics guidelines
The psychologist must assess the clinical situation, consult relevant ethics and legal guidelines, and consider whether mandatory reporting applies, balancing confidentiality with public safety.
Question 3: Which approach is the gold standard evidence-based treatment for Posttraumatic Stress Disorder (PTSD)?
- Prolonged Exposure (PE) or Cognitive Processing Therapy (CPT) (Correct answer)
- Supportive counseling with psychoeducation only
- Benzodiazepine pharmacotherapy combined with relaxation training
- Eye movement desensitization without cognitive components
Correct answer: Prolonged Exposure (PE) or Cognitive Processing Therapy (CPT)
Both Prolonged Exposure and Cognitive Processing Therapy have the strongest empirical support for PTSD treatment, endorsed by major clinical guidelines including the VA/DoD and APA.
Question 4: What is the primary purpose of conducting a functional behavioral assessment (FBA) before designing an intervention for a child with challenging behavior?
- To identify the antecedents and consequences that maintain the behavior (Correct answer)
- To determine whether medication is needed
- To assign a DSM-5 diagnosis to the child
- To measure the child's cognitive ability
Correct answer: To identify the antecedents and consequences that maintain the behavior
An FBA identifies the function of behavior (e.g., attention, escape, sensory) by examining antecedents and consequences, enabling function-based rather than symptom-only interventions.
Question 5: Which of the following measurement concepts refers to the degree to which a test measures what it is intended to measure?
- Validity (Correct answer)
- Reliability
- Standardization
- Normalization
Correct answer: Validity
Validity refers to the extent to which a test accurately measures the construct it is designed to assess, encompassing content, criterion, and construct validity.
Question 6: During a telehealth session, a client in another state discloses active suicidal ideation with a plan. The psychologist's first obligation is to:
- Verify the client's location and apply the emergency protocols of the state where the client is physically located (Correct answer)
- Apply only the psychologist's home state laws since the license is held there
- Terminate the session and call 911 in the psychologist's home state
- Refer the client to an online crisis chat service
Correct answer: Verify the client's location and apply the emergency protocols of the state where the client is physically located
In telehealth emergencies, the laws of the state where the client is physically located govern duty-to-protect obligations, requiring the psychologist to know the client's location and those applicable laws.
Question 7: A researcher wants to establish that a new CBT protocol for depression causes improvements rather than merely correlates with them. The strongest research design to accomplish this is:
- Randomized controlled trial (RCT) with active control condition (Correct answer)
- Cross-sectional survey with large sample
- Open-label case series with pre/post measures
- Correlational study using validated depression measures
Correct answer: Randomized controlled trial (RCT) with active control condition
An RCT with random assignment and an active control condition is the gold standard for establishing causal relationships between treatment and outcome by controlling for confounds.
SPEX SPEX Exam 4
Which of the following best explains why base rates are critical when interpreting psychological test results?