BEHAVIORAL SCIENCE NBME
CERTIFICATION SCRIPT 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◍ Twin concordance study design:measurement/example:.
Answer: design:- compares the frequency with which both monozygotic
twins or both dizygotic twins develop the same
diseasemeasurement/example: - measures heritability and influence of
environmental factors (nature vs nuture)
◍ Malingering vs factitious disease.
Answer: malingering: Faking for secondary gain (money, compensation,
etc)factitious: faking for primary gain (Munchausen and Munchausen by
Proxy)
◍ Absolute Risk Reduction.
Answer: The difference in risk (not the proportion) attributable to the
intervention as compared to a controlExample:If 8% of people who receive
a placebo vaccine develop the flu vs 2% of people who receive a flui
vaccine then ARR = 8% - 2% = 6% = 0.06
◍ When do post-partum mood disturbances occur?Define the following
variations:Maternal (postpartum) "blues"Postpartum depressionPostpartum
Psychosis.
Answer: When do post-partum mood disturbances occur?- onset within 4
weeks of deliveryDefine the following variations:Maternal (postpartum)
"blues":- 50-85% incidence rate- depressed affect, tearfulness, fatigue 2-3
days after delivery- usually resolves in 10 d- RX is supportivePostpartum
depression:- 10-15% incidence rate- depressed affect, anxiety, poor
concentration- RX: CBT and SSRIsPostpartum Psychosis:- 0.1-0.2% -
psychosis, increased risk with hx of bipolar or psychotic disorder- RX:
, hospitalization and atypical antipsychotics. If not helping, ECT OK.
◍ Observer-expectancy biasdefinition:examples:strategy to reduce bias:.
Answer: definition:- researcher's belief in the efficacy of a treatment
changes the outcome of that treatment (e: Pygmalion Effect; self-fulfilling
prophecy)examples:- observer expecting to see signs of improvement is
more likely to document positive outcomesstrategy to reduce bias:-
blinding- use of placebo
◍ ECTused for?SE?pregnancy?.
Answer: used for?:- treatment refractory depression, depression with
psychotic symptoms, and acutely suicidal patients- produces grand-mal
seizure in an anesthetized patientSE?:- disorientation- temporary headache-
partial antero/retrograde amnesia usually resolving in 6 monthspregnancy?:-
safe in pregnancy
◍ What is the power of a study?How can it be calculated?.
Answer: What is the power of a study?- power is the ability of a study to
detect a difference between groups when such a difference truly exists-
power relates to Type II error (beta) which is the probability of concluding
there is no difference between groups when one truly existsHow can it be
calculated?Power = 1 - Beta
◍ design:measurement/example:.
Answer: design:measurement/example:
◍ Operant conditioning?What is reinforcement vs punishment vs extinction?.
Answer: Learning in which particular action is followed by a desired reward
or removal of aversive stimulus. Usually deals with voluntary
responses.Reinforcement: target behavior is followed by a desirable
rewardPunishment: repeated application of aversive stimulus or removal of
desired reward to extinguish unwanted behaviorExtinction: discontinuation
of reinforcement eventually eliminates behavior.
◍ Manic Episodedefinition?diagnosis?.
Answer: Distinct period of abnormally and persistently elecated, expansive
, or irritable mood and abnormally and persistently increased activity or
energy lasting more than 1 week diagnosis requires hospitalization or at
least 3 of the following: remember DIG FAST- distractability- irresponsible-
grandiosity- increased activity/agitated- decreased need for SLEEP- talk
(pressured speech)
◍ Compare primary VS secondary VS tertiary VS quaternary disease
prevention.
Answer: Primary:- prevent disease BEFORE it occurs (HPV
vaccination(Secondary:- screen early for and manage existing but
asymptomatic disease (ie: PAP smear for cervical cancer)Tertiary:-
treatment to reduce complications from disease that is on-going or has long
term effects (ie: chemotherapy)Quaternary:- identifies patients at risk of
unecessary treatment, protecting from the harms of new interventions
◍ Cross-sectional studydesign:primary ?:measurement/example:.
Answer: design:- collects data from group of people to assess frequency of
disease (and related risk factors) are a particular point in time - asks "What
is happening?"measurement/example: - disease prevalence- can show risk
factor associated with disease - does not establish causality
◍ Attributable risk.
Answer: The difference in risk between exposed and unexposed groups or
the proportion of disease occurrences that are attributable to the exposure
Example:- if risk for lung cancer is 21% in smokers and 1% in nonsmokers
than the attributable risk of lung cancer of smoking is 20%
◍ Adoption Studydesign:measurement/example:.
Answer: design:- compares siblings raised by biological vs non-biological
parentsmeasurement/example: - heritability and influence of environmental
factors
◍ Bipolar Disorder (manic depression)Type IType IICyclothymic Disorder.
Answer: Bipolar Disorder (manic depression)Type I: presence of at least 1
manic episode +/- hypomanic or depressive episodeType II: presence of
hypomanic and depressive episodeRX: mood stabilizers (lithium, VPA,
CERTIFICATION SCRIPT 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◍ Twin concordance study design:measurement/example:.
Answer: design:- compares the frequency with which both monozygotic
twins or both dizygotic twins develop the same
diseasemeasurement/example: - measures heritability and influence of
environmental factors (nature vs nuture)
◍ Malingering vs factitious disease.
Answer: malingering: Faking for secondary gain (money, compensation,
etc)factitious: faking for primary gain (Munchausen and Munchausen by
Proxy)
◍ Absolute Risk Reduction.
Answer: The difference in risk (not the proportion) attributable to the
intervention as compared to a controlExample:If 8% of people who receive
a placebo vaccine develop the flu vs 2% of people who receive a flui
vaccine then ARR = 8% - 2% = 6% = 0.06
◍ When do post-partum mood disturbances occur?Define the following
variations:Maternal (postpartum) "blues"Postpartum depressionPostpartum
Psychosis.
Answer: When do post-partum mood disturbances occur?- onset within 4
weeks of deliveryDefine the following variations:Maternal (postpartum)
"blues":- 50-85% incidence rate- depressed affect, tearfulness, fatigue 2-3
days after delivery- usually resolves in 10 d- RX is supportivePostpartum
depression:- 10-15% incidence rate- depressed affect, anxiety, poor
concentration- RX: CBT and SSRIsPostpartum Psychosis:- 0.1-0.2% -
psychosis, increased risk with hx of bipolar or psychotic disorder- RX:
, hospitalization and atypical antipsychotics. If not helping, ECT OK.
◍ Observer-expectancy biasdefinition:examples:strategy to reduce bias:.
Answer: definition:- researcher's belief in the efficacy of a treatment
changes the outcome of that treatment (e: Pygmalion Effect; self-fulfilling
prophecy)examples:- observer expecting to see signs of improvement is
more likely to document positive outcomesstrategy to reduce bias:-
blinding- use of placebo
◍ ECTused for?SE?pregnancy?.
Answer: used for?:- treatment refractory depression, depression with
psychotic symptoms, and acutely suicidal patients- produces grand-mal
seizure in an anesthetized patientSE?:- disorientation- temporary headache-
partial antero/retrograde amnesia usually resolving in 6 monthspregnancy?:-
safe in pregnancy
◍ What is the power of a study?How can it be calculated?.
Answer: What is the power of a study?- power is the ability of a study to
detect a difference between groups when such a difference truly exists-
power relates to Type II error (beta) which is the probability of concluding
there is no difference between groups when one truly existsHow can it be
calculated?Power = 1 - Beta
◍ design:measurement/example:.
Answer: design:measurement/example:
◍ Operant conditioning?What is reinforcement vs punishment vs extinction?.
Answer: Learning in which particular action is followed by a desired reward
or removal of aversive stimulus. Usually deals with voluntary
responses.Reinforcement: target behavior is followed by a desirable
rewardPunishment: repeated application of aversive stimulus or removal of
desired reward to extinguish unwanted behaviorExtinction: discontinuation
of reinforcement eventually eliminates behavior.
◍ Manic Episodedefinition?diagnosis?.
Answer: Distinct period of abnormally and persistently elecated, expansive
, or irritable mood and abnormally and persistently increased activity or
energy lasting more than 1 week diagnosis requires hospitalization or at
least 3 of the following: remember DIG FAST- distractability- irresponsible-
grandiosity- increased activity/agitated- decreased need for SLEEP- talk
(pressured speech)
◍ Compare primary VS secondary VS tertiary VS quaternary disease
prevention.
Answer: Primary:- prevent disease BEFORE it occurs (HPV
vaccination(Secondary:- screen early for and manage existing but
asymptomatic disease (ie: PAP smear for cervical cancer)Tertiary:-
treatment to reduce complications from disease that is on-going or has long
term effects (ie: chemotherapy)Quaternary:- identifies patients at risk of
unecessary treatment, protecting from the harms of new interventions
◍ Cross-sectional studydesign:primary ?:measurement/example:.
Answer: design:- collects data from group of people to assess frequency of
disease (and related risk factors) are a particular point in time - asks "What
is happening?"measurement/example: - disease prevalence- can show risk
factor associated with disease - does not establish causality
◍ Attributable risk.
Answer: The difference in risk between exposed and unexposed groups or
the proportion of disease occurrences that are attributable to the exposure
Example:- if risk for lung cancer is 21% in smokers and 1% in nonsmokers
than the attributable risk of lung cancer of smoking is 20%
◍ Adoption Studydesign:measurement/example:.
Answer: design:- compares siblings raised by biological vs non-biological
parentsmeasurement/example: - heritability and influence of environmental
factors
◍ Bipolar Disorder (manic depression)Type IType IICyclothymic Disorder.
Answer: Bipolar Disorder (manic depression)Type I: presence of at least 1
manic episode +/- hypomanic or depressive episodeType II: presence of
hypomanic and depressive episodeRX: mood stabilizers (lithium, VPA,
