AP Psychology Mental and Physical Health — Worked Answer Explanations

Unit 5 · 12 questions explained

Below is a complete answer key for our AP Psychology Mental and Physical Health practice questions. For each question you'll find the correct choice, a full written explanation of how to get there, and — for every wrong answer — a short note on exactly why it's tempting and where it goes wrong. Reading these straight through is one of the fastest ways to find the gaps in a unit before exam day.

Prefer to test yourself first? Take the timed Mental and Physical Health practice test and come back here to review, or head back to the Mental and Physical Health unit overview.

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Question 1 · Easy
The DSM-5 is the primary tool used by mental health professionals in the United States to:
- A
  Prescribe medication dosages for psychiatric disorders
  Why not A: Medication prescribing is guided by pharmacology and clinical judgment, not the DSM-5, which is a diagnostic classification system.
- B
  Classify and diagnose psychological disorders using standardized criteriaCorrect
- C
  Assess intelligence and academic achievement levels
  Why not C: Intelligence and achievement testing use separate instruments (e.g., WISC, WAIS, Stanford-Binet); the DSM-5 is for diagnosing mental disorders.
- D
  Determine the causes of psychological disorders through biological testing
  Why not D: The DSM-5 uses descriptive criteria (symptoms, duration, functional impairment) rather than biological tests to classify disorders.
Explanation
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, provides standardized diagnostic criteria for mental disorders. Clinicians use it to ensure consistent diagnosis across practitioners and settings, facilitate communication, guide treatment planning, and qualify patients for insurance coverage. The DSM-5 shifted from a multiaxial system to a single-axis approach and incorporated dimensional assessments.

Key takeaway
DSM-5: standardized classification and diagnostic criteria for psychological disorders in clinical and research settings.
Question 2 · Easy
Which of the following best describes the hallmark features of major depressive disorder (MDD) according to DSM-5 criteria?
- A
  Alternating episodes of intense elation (mania) and deep depression lasting at least two years
  Why not A: Alternating mania and depression describes bipolar disorder; two-year duration is the criterion for cyclothymia or persistent depressive disorder.
- B
  Persistent depressed mood or loss of interest for at least two weeks, causing significant impairmentCorrect
- C
  Recurrent unexpected panic attacks with persistent worry about future attacks
  Why not C: Recurrent unexpected panic attacks with anticipatory anxiety describe panic disorder, not major depressive disorder.
- D
  Intrusive thoughts and compulsive rituals that reduce anxiety
  Why not D: Intrusive obsessions and compulsive rituals are the hallmarks of obsessive-compulsive disorder (OCD), not depression.
Explanation
DSM-5 criteria for Major Depressive Disorder require five or more depressive symptoms (e.g., depressed mood, loss of interest/anhedonia, sleep changes, fatigue, concentration difficulties, feelings of worthlessness, suicidal ideation) present during the same two-week period, with at least one of the symptoms being depressed mood or anhedonia. Symptoms must cause clinically significant distress or functional impairment and not be attributable to substances or another medical condition.

Key takeaway
MDD hallmarks: depressed mood or anhedonia for 2+ weeks with 5+ depressive symptoms causing significant impairment.
Question 3 · Easy
A therapist treats a patient with anxiety disorder by teaching deep breathing and relaxation, then gradually exposing the patient to feared stimuli from least to most anxiety-provoking. This technique is called:
- A
  Flooding (implosive therapy)
  Why not A: Flooding exposes the patient to the most feared stimulus immediately and intensely without a gradual hierarchy; the description specifically mentions gradual exposure.
- B
  Aversion therapy
  Why not B: Aversion therapy pairs an undesired behavior with an unpleasant stimulus to reduce it (e.g., treating alcohol addiction with nausea-inducing drugs); it does not involve building a fear hierarchy.
- C
  Systematic desensitizationCorrect
- D
  Token economy
  Why not D: Token economy is an operant conditioning technique using symbolic rewards for desired behaviors; it is not an exposure-based anxiety treatment.
Explanation
Systematic desensitization, developed by Joseph Wolpe, is a behavioral therapy based on classical conditioning principles. It combines deep relaxation training with gradual exposure to feared stimuli through an anxiety hierarchy. The relaxation response becomes conditioned to the feared stimulus, replacing the anxiety response (counterconditioning). It is among the most effective evidence-based treatments for phobias, PTSD, and anxiety disorders.

Key takeaway
Systematic desensitization: counterconditioning anxiety through pairing relaxation with a gradual hierarchy of feared stimuli.
Question 4 · Easy
Hans Selye's General Adaptation Syndrome (GAS) describes the body's response to prolonged stress in three sequential stages. In the correct order, these stages are:
- A
  Resistance → Alarm → Exhaustion
  Why not A: This places resistance before alarm, reversing the first two stages; the initial response to a stressor is always the alarm reaction.
- B
  Alarm → Exhaustion → Resistance
  Why not B: This incorrectly places exhaustion before resistance; the body first mounts coping resources (resistance) before resources are depleted (exhaustion).
- C
  Alarm → Resistance → ExhaustionCorrect
- D
  Exhaustion → Alarm → Resistance
  Why not D: Exhaustion is the final stage when coping resources are depleted; it does not precede the initial alarm response.
Explanation
Selye's GAS describes a three-stage biological stress response: (1) Alarm — the initial fight-or-flight activation (HPA axis, sympathetic nervous system, cortisol surge); (2) Resistance — the body mobilizes and attempts to cope with the ongoing stressor while returning to a more normal state; (3) Exhaustion — prolonged stress depletes physiological resources, increasing vulnerability to illness, depression, and organ damage. The GAS explains why chronic stress harms physical health.

Key takeaway
Selye's GAS sequence: Alarm → Resistance → Exhaustion; exhaustion from chronic stress leads to health breakdown.
Question 5 · Medium
A client with post-traumatic stress disorder works with a therapist who uses EMDR (Eye Movement Desensitization and Reprocessing). The therapist also helps the client identify distorted thoughts like 'I am permanently ruined.' This cognitive component is most closely associated with which therapy approach?
- A
  Client-centered (humanistic) therapy
  Why not A: Client-centered therapy (Rogers) emphasizes empathy, unconditional positive regard, and genuine understanding — not cognitive restructuring of distorted thoughts.
- B
  Psychoanalytic therapy
  Why not B: Psychoanalytic therapy focuses on unconscious conflicts, free association, and dream analysis — not the direct identification and challenging of cognitive distortions.
- C
  Cognitive-behavioral therapy (CBT)Correct
- D
  Drug therapy (pharmacotherapy)
  Why not D: Drug therapy involves biological interventions (medications) to reduce symptoms; it does not involve talking about thought patterns.
Explanation
Cognitive-behavioral therapy (CBT), integrating Beck's cognitive therapy and behavioral techniques, targets both maladaptive cognitions (distorted beliefs like 'I am permanently ruined') and behaviors. For PTSD, CBT-based approaches like Cognitive Processing Therapy specifically help patients identify and restructure trauma-related cognitive distortions. The behavioral component might include exposure exercises. CBT is the most empirically supported psychological treatment across multiple disorders.

Key takeaway
CBT targets cognitive distortions (thoughts) and maladaptive behaviors simultaneously; it is the most evidence-based psychotherapy for many disorders.
Question 6 · Medium
A patient is diagnosed with schizophrenia. Which cluster of symptoms is categorized as 'positive symptoms' in DSM-5?
- A
  Flat affect, alogia (poverty of speech), and avolition (lack of motivation)
  Why not A: These are negative symptoms — the absence or reduction of normal functions (emotion, speech, motivation). Negative symptoms are harder to treat and have a worse prognosis.
- B
  Hallucinations, delusions, and disorganized speechCorrect
- C
  Cognitive deficits in attention, working memory, and processing speed
  Why not C: Cognitive impairments are recognized features of schizophrenia but are categorized separately from the positive/negative symptom framework.
- D
  Depressed mood, sleep disturbances, and suicidal ideation
  Why not D: These are depressive symptoms; when they occur alongside schizophrenia features, the diagnosis may be schizoaffective disorder, but they are not positive symptoms of schizophrenia per se.
Explanation
In schizophrenia, positive symptoms are excesses or additions to normal functioning — things that are present but should not be: hallucinations (false perceptions, most often auditory), delusions (fixed false beliefs, e.g., persecution, grandiosity), and disorganized speech/behavior. Negative symptoms are deficits — things that are absent but should be present: flat affect, alogia, avolition, anhedonia, asociality. Positive symptoms respond better to antipsychotic medications; negative symptoms are more persistent.

Key takeaway
Schizophrenia positive symptoms: hallucinations, delusions, disorganized speech (excesses); negative symptoms: flat affect, avolition, alogia (deficits).
Question 7 · Medium
A psychiatrist prescribes an SSRI (selective serotonin reuptake inhibitor) to a patient with depression. At the synaptic level, this medication works by:
- A
  Blocking dopamine receptors on the postsynaptic neuron
  Why not A: Blocking dopamine receptors is the mechanism of antipsychotics (e.g., haloperidol) used to treat schizophrenia, not SSRIs for depression.
- B
  Increasing serotonin synthesis in the presynaptic neuron
  Why not B: SSRIs do not increase synthesis; they prevent reuptake. The drug acts on transport proteins, not on biosynthesis enzymes.
- C
  Blocking the reuptake transporter so serotonin remains in the synapse longerCorrect
- D
  Mimicking serotonin by binding directly to postsynaptic serotonin receptors
  Why not D: Agonist drugs mimic neurotransmitters by binding receptors, but SSRIs work on the presynaptic reuptake mechanism, not by acting as serotonin mimics.
Explanation
SSRIs (e.g., fluoxetine/Prozac, sertraline/Zoloft) inhibit the serotonin reuptake transporter (SERT) on the presynaptic neuron. Normally, after serotonin is released into the synapse and acts on receptors, it is taken back up into the sending neuron for recycling. By blocking this transporter, SSRIs allow serotonin to remain in the synaptic cleft longer and stimulate postsynaptic receptors more persistently, effectively increasing serotonergic transmission.

Key takeaway
SSRIs block serotonin reuptake transporters, increasing serotonin availability in the synapse — the mechanism underlying antidepressant effects.
Question 8 · Medium
Albert Ellis developed Rational Emotive Behavior Therapy (REBT) based on his ABC model. In this model, 'B' stands for:
- A
  Behavior — the observable actions taken in response to events
  Why not A: Behavior is important in CBT broadly, but in Ellis's ABC model, B specifically refers to beliefs, not behaviors.
- B
  Biology — the physiological arousal accompanying emotional distress
  Why not B: Ellis's model is cognitive-focused; biology is not one of the three components of the ABC framework.
- C
  Beliefs — the rational or irrational thoughts about the activating eventCorrect
- D
  Background — the early childhood experiences shaping personality
  Why not D: Background history is a psychodynamic focus; Ellis explicitly argued against dwelling on past causes — REBT targets current irrational beliefs.
Explanation
In Ellis's ABC model: A = Activating event (the situation); B = Beliefs (irrational or rational thoughts about the event); C = Consequences (emotional and behavioral outcomes). Crucially, Ellis argued that A does not directly cause C — B causes C. People disturb themselves with irrational beliefs ('I must be loved by everyone or I am worthless'). REBT teaches clients to dispute (D) these irrational beliefs to achieve a new emotional effect (E). This is the cognitive foundation for modern CBT.

Key takeaway
Ellis's REBT ABC model: A (activating event) → B (beliefs) → C (consequences). Irrational beliefs (B) cause emotional distress, not the events themselves.
Question 9 · Hard
Research on optimism and health outcomes consistently shows that dispositional optimists have better immune function and recover more quickly from surgery. The biopsychosocial model best explains this finding by noting that:
- A
  Optimism directly increases the number of T-cells produced, independent of behavior or psychology.
  Why not A: The relationship is mediated by behavior and psychological factors; optimism does not directly and independently control immune cell production through a simple causal pathway.
- B
  Psychological states influence biological health outcomes through behavioral and neuroendocrine pathways.Correct
- C
  Health outcomes are determined entirely by genetics and biological factors regardless of psychological state.
  Why not C: This describes a purely biomedical model, which the biopsychosocial model explicitly rejects by incorporating psychological and social factors.
- D
  Optimism is a learned behavior reinforced by health professionals during clinical interactions.
  Why not D: This operant conditioning explanation does not account for the psychoneuroimmunology research showing how cognitive-emotional states affect biology.
Explanation
The biopsychosocial model (Engel) holds that health and illness are determined by biological, psychological, and social factors interacting together. Optimism improves health through multiple pathways: cognitively (reducing appraisal of threat), behaviorally (better health behaviors, treatment adherence), and neuroendocrine-immune (lower cortisol, healthier HPA axis response). Psychoneuroimmunology — the study of how psychological states affect immune function — directly bridges the psychological and biological levels.

Key takeaway
Biopsychosocial model: psychological states (optimism/pessimism) affect physical health through behavioral, neural, and hormonal pathways.
Question 10 · Hard
A clinical psychologist is asked whether a particular psychological test measures what it claims to measure — for example, whether a test labeled 'social anxiety scale' actually captures social anxiety and not general neuroticism. The psychologist is evaluating the test's:
- A
  Reliability
  Why not A: Reliability refers to the consistency of the test's results across time and administrations — not whether it measures the right construct.
- B
  Standardization
  Why not B: Standardization means the test is administered and scored uniformly across participants; it is a procedural quality, not a measure of whether the test captures the intended construct.
- C
  Construct validityCorrect
- D
  Predictive validity
  Why not D: Predictive validity asks whether the test predicts a future criterion (e.g., does the test predict therapy dropout rates?) — not whether it correctly measures the underlying theoretical construct.
Explanation
Construct validity is the degree to which a test actually measures the theoretical construct it purports to measure. In this case: does the social anxiety scale capture social anxiety specifically, rather than a broader trait like neuroticism? Establishing construct validity involves convergent validity (correlates with related measures) and discriminant validity (does not correlate with unrelated constructs). Reliability is necessary but not sufficient for validity — a test can be consistently wrong.

Key takeaway
Construct validity: does the test measure the specific theoretical construct it claims to measure? Reliable ≠ valid.
Question 11 · Hard
In the diathesis-stress model of psychological disorders, a person develops a disorder when:
- A
  They are exposed to a severe stressor with no prior biological vulnerability
  Why not A: A stressor alone, without a pre-existing vulnerability (diathesis), is insufficient in this model; both components are required.
- B
  A genetic or biological vulnerability (diathesis) is activated by sufficient environmental stressCorrect
- C
  Their neurotransmitter imbalances reach a clinical threshold regardless of environmental factors
  Why not C: This describes a purely biological model; the diathesis-stress model is explicitly interactive, requiring an environmental trigger to activate the vulnerability.
- D
  They learn maladaptive behaviors through repeated classical conditioning
  Why not D: Classical conditioning is a behavioral explanation for specific learned fear responses, not the diathesis-stress framework that explains disorder onset via vulnerability × environment interaction.
Explanation
The diathesis-stress model proposes that psychological disorders develop through an interaction between a predisposing vulnerability (diathesis — genetic, neurobiological, or psychological) and environmental stressors. Neither the diathesis nor the stress alone is sufficient — the disorder emerges when stress exceeds the threshold set by the diathesis. This model explains why not everyone exposed to trauma develops PTSD, and why some people with genetic risk for depression never develop it without significant life stress.

Key takeaway
Diathesis-stress model: disorder = predisposing vulnerability (diathesis) × environmental stressor; neither alone is sufficient.
Question 12 · Hard
A study finds that cancer patients who participate in a structured social support group have significantly longer survival times than those who do not. Critics argue the study may confound social support with the effects of patients discussing healthier behaviors. To control for this alternative explanation, the researchers should:
- A
  Use a larger sample size to increase statistical power.
  Why not A: A larger sample increases the ability to detect real effects but does not eliminate the confound — the alternative explanation (health behavior discussion) remains uncontrolled regardless of sample size.
- B
  Add a control group that meets socially but discusses topics unrelated to health behaviors.Correct
- C
  Measure survival time using a blinded assessor to prevent experimenter bias.
  Why not C: Blinding assessors controls for measurement bias on the dependent variable but does not separate social support from health-behavior discussion as the active ingredient.
- D
  Survey participants about whether they found the groups helpful.
  Why not D: Self-report of perceived helpfulness does not isolate the mechanism of action; both groups could find their respective groups helpful for different reasons.
Explanation
To isolate the effect of social support per se from the confound of health behavior discussions, the researchers need an active control group that receives the same social contact (controlling for social support benefits) without the health behavior content. This is a dismantling strategy: the experimental group gets full treatment; the control group gets social contact minus the specific ingredient under investigation. If the full-treatment group still outperforms the control, health discussion must be adding something beyond mere social contact.

Key takeaway
To isolate a treatment component, use an active control that matches all other features except the ingredient being tested — a dismantling design.