Kaplan and Sadock, Chapter 31.1: Child Psychiatry
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
Allostasis
• ANSWER: It is the process of achieving stability in the face of adverse
environmental events.
Rationale: Allostasis involves physiological adaptation to stressors to
maintain homeostasis.
Adverse Childhood Experiences
• ANSWER: Are likely to alter the trajectory of development in a given
individual.
Rationale: ACEs (abuse, neglect, household dysfunction) correlate with
lifelong health and mental health outcomes.
Parasomnias such as somniloquism, somnambulism, enuresis are common at
what ages?
• ANSWER: 3-6 years old
Rationale: These non-REM parasomnias peak in preschool/early school age
due to central nervous system immaturity.
In what stage of sleep do parasomnias (somnambulism, sleep terrors) occur?
• ANSWER: Stage 4 (NREM slow-wave sleep)
Rationale: Disorders of arousal arise from deep NREM sleep, typically in
the first third of the night.
T/F: Somniloquism, somnambulism, enuresis and other forms of parasomnias
indicate emotional trouble or underlying psychopathology.
• ANSWER: False
Rationale: Most childhood parasomnias are benign and outgrown; they do
not necessarily indicate psychopathology.
T/F: Lack of birth spacing is correlated with low birth weight.
, • ANSWER: True
Rationale: Short interpregnancy intervals (<18 months) increase risk of
preterm birth and low birth weight.
People in certain competitive occupational areas such as architecture,
accounting and engineering tend to be which birth order?
• ANSWER: Firstborn
Rationale: Firstborns often exhibit higher achievement motivation and
conscientiousness, traits common in these fields.
Which birth order children tend to be conservative and conformists?
• ANSWER: Firstborn
Rationale: Firstborns are more likely to identify with parental authority and
traditional values.
Allostasis differs from homeostasis in that allostasis involves:
• ANSWER: Active adaptation to predicted and unpredictable stressors
Rationale: Homeostasis maintains stability; allostasis achieves stability
through change.
Which of the following is a known Adverse Childhood Experience (ACE)?
• ANSWER: Parental incarceration
Rationale: Standard ACE categories include abuse, neglect, household
mental illness, divorce, domestic violence, substance abuse, and
incarceration.
A 4-year-old child frequently walks and talks during sleep but has no recall.
This is most consistent with:
• ANSWER: Benign childhood parasomnia (somnambulism/somniloquy)
Rationale: NREM parasomnias are common, not indicative of
psychopathology, and usually resolve by adolescence.
A 7-year-old who had never wet the bed begins wetting the bed after starting
school. This is best described as:
• ANSWER: Secondary enuresis
Rationale: Secondary enuresis occurs after at least 6 months of dryness;
often triggered by stress.
, The most effective first-line treatment for nocturnal enuresis in a 7-year-old
without daytime symptoms is:
• ANSWER: Enuresis alarm plus behavioral interventions
Rationale: Alarms have the highest long-term cure rate; medication
(desmopressin) is second-line.
A child with enuresis also has daytime urgency, frequency, and dysuria. The
most likely diagnosis is:
• ANSWER: Voiding dysfunction or urinary tract infection
Rationale: Daytime symptoms suggest an organic cause; requires urologic
workup.
The peak age for diagnosis of autism spectrum disorder is:
• ANSWER: 3-4 years
Rationale: Although parents may notice signs earlier, reliable diagnosis is
often made by age 3-4.
Which of the following is an early red flag for autism at 18 months?
• ANSWER: No babbling or pointing
Rationale: Lack of joint attention (pointing, showing) and absence of
babbling are key early indicators.
A 2-year-old lines up toys, does not respond to name, and has no single words.
The most appropriate next step is:
• ANSWER: Referral for developmental evaluation (e.g., M-CHAT and
autism assessment)
Rationale: Early intervention improves outcomes; immediate evaluation is
indicated.
The estimated heritability of autism spectrum disorder is approximately:
• ANSWER: 80-90%
Rationale: Twin studies show high concordance in monozygotic twins.
A child with autism who has been making eye contact and using phrases loses
these skills at 18 months. This pattern is called:
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
Allostasis
• ANSWER: It is the process of achieving stability in the face of adverse
environmental events.
Rationale: Allostasis involves physiological adaptation to stressors to
maintain homeostasis.
Adverse Childhood Experiences
• ANSWER: Are likely to alter the trajectory of development in a given
individual.
Rationale: ACEs (abuse, neglect, household dysfunction) correlate with
lifelong health and mental health outcomes.
Parasomnias such as somniloquism, somnambulism, enuresis are common at
what ages?
• ANSWER: 3-6 years old
Rationale: These non-REM parasomnias peak in preschool/early school age
due to central nervous system immaturity.
In what stage of sleep do parasomnias (somnambulism, sleep terrors) occur?
• ANSWER: Stage 4 (NREM slow-wave sleep)
Rationale: Disorders of arousal arise from deep NREM sleep, typically in
the first third of the night.
T/F: Somniloquism, somnambulism, enuresis and other forms of parasomnias
indicate emotional trouble or underlying psychopathology.
• ANSWER: False
Rationale: Most childhood parasomnias are benign and outgrown; they do
not necessarily indicate psychopathology.
T/F: Lack of birth spacing is correlated with low birth weight.
, • ANSWER: True
Rationale: Short interpregnancy intervals (<18 months) increase risk of
preterm birth and low birth weight.
People in certain competitive occupational areas such as architecture,
accounting and engineering tend to be which birth order?
• ANSWER: Firstborn
Rationale: Firstborns often exhibit higher achievement motivation and
conscientiousness, traits common in these fields.
Which birth order children tend to be conservative and conformists?
• ANSWER: Firstborn
Rationale: Firstborns are more likely to identify with parental authority and
traditional values.
Allostasis differs from homeostasis in that allostasis involves:
• ANSWER: Active adaptation to predicted and unpredictable stressors
Rationale: Homeostasis maintains stability; allostasis achieves stability
through change.
Which of the following is a known Adverse Childhood Experience (ACE)?
• ANSWER: Parental incarceration
Rationale: Standard ACE categories include abuse, neglect, household
mental illness, divorce, domestic violence, substance abuse, and
incarceration.
A 4-year-old child frequently walks and talks during sleep but has no recall.
This is most consistent with:
• ANSWER: Benign childhood parasomnia (somnambulism/somniloquy)
Rationale: NREM parasomnias are common, not indicative of
psychopathology, and usually resolve by adolescence.
A 7-year-old who had never wet the bed begins wetting the bed after starting
school. This is best described as:
• ANSWER: Secondary enuresis
Rationale: Secondary enuresis occurs after at least 6 months of dryness;
often triggered by stress.
, The most effective first-line treatment for nocturnal enuresis in a 7-year-old
without daytime symptoms is:
• ANSWER: Enuresis alarm plus behavioral interventions
Rationale: Alarms have the highest long-term cure rate; medication
(desmopressin) is second-line.
A child with enuresis also has daytime urgency, frequency, and dysuria. The
most likely diagnosis is:
• ANSWER: Voiding dysfunction or urinary tract infection
Rationale: Daytime symptoms suggest an organic cause; requires urologic
workup.
The peak age for diagnosis of autism spectrum disorder is:
• ANSWER: 3-4 years
Rationale: Although parents may notice signs earlier, reliable diagnosis is
often made by age 3-4.
Which of the following is an early red flag for autism at 18 months?
• ANSWER: No babbling or pointing
Rationale: Lack of joint attention (pointing, showing) and absence of
babbling are key early indicators.
A 2-year-old lines up toys, does not respond to name, and has no single words.
The most appropriate next step is:
• ANSWER: Referral for developmental evaluation (e.g., M-CHAT and
autism assessment)
Rationale: Early intervention improves outcomes; immediate evaluation is
indicated.
The estimated heritability of autism spectrum disorder is approximately:
• ANSWER: 80-90%
Rationale: Twin studies show high concordance in monozygotic twins.
A child with autism who has been making eye contact and using phrases loses
these skills at 18 months. This pattern is called:
