Free MCAT-style practice, 7A
MCAT Psychological Disorders Practice Questions
Ten free MCAT-style practice questions on anxiety, mood, schizophrenia spectrum, personality, trauma and neurocognitive disorders and their biology, with full explanations.
Quick concept primer
The DSM-5-TR classifies psychological disorders by symptom criteria, and many MCAT questions turn on two details: duration and the type of episode. Major depressive disorder needs at least five symptoms for two weeks, one of them depressed mood or loss of interest. Bipolar I needs a single manic episode, while bipolar II needs hypomania plus a major depressive episode. On the psychotic spectrum, duration separates brief psychotic disorder (under one month), schizophreniform disorder (one to six months) and schizophrenia (six months or more). Acute stress disorder lasts three days to a month after a trauma, and PTSD lasts longer than a month.
The biopsychosocial model treats disorders as the product of genes, brain chemistry, thinking patterns and social context. The dopamine hypothesis links positive symptoms of schizophrenia to excess mesolimbic dopamine. Parkinson disease reflects loss of dopamine neurons in the substantia nigra, and Alzheimer disease shows amyloid plaques, tau tangles and loss of acetylcholine. Personality disorders are grouped into clusters A (odd), B (dramatic) and C (anxious).
Traps: factitious disorder is faking illness without an outside reward, while malingering is faking for a concrete gain. Identical twin concordance below 100 percent shows that genes are not the whole story.
10 practice questions
Question 1
A 24-year-old man develops auditory hallucinations, disorganized speech and social withdrawal. His symptoms, including the early warning signs, last a total of three months, and he then returns fully to his previous level of functioning. No mood episode or substance use is involved. Which diagnosis best fits?
- Schizophrenia
- Brief psychotic disorder
- Delusional disorder
- Schizophreniform disorder
Show answer and explanation
Answer: D. Schizophreniform disorder
Schizophreniform disorder has the same core symptoms as schizophrenia but lasts at least one month and less than six months. Schizophrenia requires signs of disturbance for at least six months, and brief psychotic disorder lasts less than one month. Delusional disorder involves delusions without prominent hallucinations or disorganized speech.
Question 2
Four adults, none with any history of mania or hypomania, describe recent symptoms. Each reports marked impairment at work, and none of the symptoms is due to a substance or a medical condition.
| Person | Symptoms present | Duration |
|---|---|---|
| 1 | Loss of interest, insomnia, fatigue, poor concentration, weight loss | 10 days |
| 2 | Insomnia, fatigue, poor concentration, restlessness, weight loss, guilt | 4 weeks |
| 3 | Depressed mood, insomnia, fatigue, poor concentration, guilt | 3 weeks |
| 4 | Depressed mood, fatigue, guilt, poor concentration | 6 weeks |
Who meets the symptom and duration criteria for a major depressive episode?
- Person 1 only
- Person 2 only
- Person 3 only
- Persons 2, 3 and 4
Show answer and explanation
Answer: C. Person 3 only
A major depressive episode needs five or more symptoms over at least two weeks, including depressed mood or loss of interest. Person 3 meets all three conditions. Person 1 lasted only 10 days, Person 2 has six symptoms but neither depressed mood nor loss of interest, and Person 4 has only four symptoms.
Question 3
A woman is hospitalized after nine days of very little sleep, racing thoughts, reckless spending and grandiose plans. She has never had a major depressive episode. Which diagnosis is most appropriate?
- Bipolar I disorder
- Bipolar II disorder
- Cyclothymic disorder
- Major depressive disorder with anxious distress
Show answer and explanation
Answer: A. Bipolar I disorder
A single manic episode, lasting at least a week or requiring hospitalization, is enough for bipolar I disorder, and no depressive episode is required. Bipolar II requires hypomania plus a major depressive episode and never includes full mania. Cyclothymic disorder involves two years of milder mood swings below full episode thresholds.
Question 4
A nurse repeatedly injects herself with insulin to cause low blood sugar, then seeks hospital care. She gains no money, time off or legal advantage, and she hides what she is doing. Which diagnosis best fits?
- Malingering
- Factitious disorder
- Illness anxiety disorder
- Functional neurological symptom disorder
Show answer and explanation
Answer: B. Factitious disorder
Factitious disorder involves deliberately producing or faking illness with no obvious outside reward, apparently to occupy the patient role. Malingering requires a clear external incentive such as money or avoiding work. Illness anxiety is worry about having an illness with few symptoms, and functional neurological symptom disorder involves symptoms that are not deliberately produced.
Question 5
A researcher compares a typical antipsychotic that blocks dopamine D2 receptors with a placebo in patients with schizophrenia. According to the dopamine hypothesis, which outcome is most likely in the drug group?
- Greater improvement in flat affect and avolition than in hallucinations
- No change in any symptom, because schizophrenia does not involve dopamine
- Reduced hallucinations and delusions, with a risk of movement side effects
- Improved memory caused by increased acetylcholine release
Show answer and explanation
Answer: C. Reduced hallucinations and delusions, with a risk of movement side effects
Excess dopamine activity in the mesolimbic pathway is linked to positive symptoms, so D2 blockade mainly reduces hallucinations and delusions. Blocking D2 in the nigrostriatal pathway can cause extrapyramidal side effects such as rigidity and tremor. Typical antipsychotics do little for negative symptoms like flat affect, and they do not act by raising acetylcholine.
Question 6
All of the following are Cluster B personality disorders EXCEPT
- avoidant personality disorder
- antisocial personality disorder
- borderline personality disorder
- narcissistic personality disorder
Show answer and explanation
Answer: A. avoidant personality disorder
Cluster B, the dramatic, emotional or erratic group, contains antisocial, borderline, histrionic and narcissistic personality disorders. Avoidant personality disorder, marked by social inhibition and fear of rejection despite a wish for closeness, belongs to Cluster C, the anxious group, along with dependent and obsessive-compulsive personality disorders.
Question 7
A hypothetical twin study reports concordance rates for a disorder.
| Twin type | Pairs studied | Pairs in which both twins are affected |
|---|---|---|
| Identical (monozygotic) | 200 | 92 |
| Fraternal (dizygotic) | 200 | 30 |
Which conclusion is best supported?
- The disorder is caused entirely by genes.
- The disorder is caused entirely by the shared family environment.
- Genes contribute substantially, and nongenetic factors also matter.
- Fraternal twins share more genes than identical twins.
Show answer and explanation
Answer: C. Genes contribute substantially, and nongenetic factors also matter.
Identical concordance is 92 / 200 = 46 percent versus 30 / 200 = 15 percent for fraternal twins, so greater genetic similarity brings greater risk. If genes were the whole cause, identical twins would be concordant nearly 100 percent of the time, so the environment must matter too. Identical twins share essentially all their genes, about twice the fraternal share.
Question 8
Two weeks after a serious car crash, a man has intrusive memories of it, avoids driving, sleeps poorly and startles easily. Which diagnosis is most appropriate at this point?
- Posttraumatic stress disorder
- Generalized anxiety disorder
- Specific phobia
- Acute stress disorder
Show answer and explanation
Answer: D. Acute stress disorder
Acute stress disorder covers trauma-related symptoms lasting from three days to one month after the event. PTSD requires the symptoms to last more than one month, so it cannot yet be diagnosed. Generalized anxiety disorder involves at least six months of broad worry, and a specific phobia is not defined by trauma-linked intrusive memories.
Question 9
A 68-year-old man shows a resting tremor of the hand, slowed movements and a shuffling gait, while his memory is largely intact. Which neural change most likely underlies these symptoms?
- Loss of dopamine-producing neurons in the substantia nigra
- Loss of acetylcholine neurons with amyloid plaques in the cortex
- Degeneration of the caudate nucleus caused by a CAG repeat expansion
- Demyelination of white matter in the spinal cord
Show answer and explanation
Answer: A. Loss of dopamine-producing neurons in the substantia nigra
Resting tremor, bradykinesia and shuffling gait are typical of Parkinson disease, caused by loss of dopamine neurons in the substantia nigra that project to the striatum. Plaques with cholinergic loss describe Alzheimer disease, which begins with memory loss. Caudate degeneration from a CAG expansion is Huntington disease, which produces chorea, and demyelination suggests multiple sclerosis.
Question 10
A clinician explains a patient's depression by pointing to his consistently negative beliefs about himself, about the world and about his future, and plans therapy to challenge those beliefs. Which theorist's model is she applying?
- Martin Seligman
- Aaron Beck
- Carl Rogers
- Sigmund Freud
Show answer and explanation
Answer: B. Aaron Beck
Aaron Beck described the cognitive triad of negative views of the self, the world and the future, and developed cognitive therapy to test and change those thoughts. Seligman's account of depression centers on learned helplessness and pessimistic explanatory style. Rogers developed client-centered therapy, and Freud's psychoanalytic theory explains symptoms through unconscious conflict.