One of the biggest complaints on Reddit and Student Doctor Network forums is that practice questions from prep programs don't match the real EPPP. People score 90% on practice, then bomb the actual exam.

The problem isn't that they didn't study enough. It's that they practiced with the wrong type of questions. Most free EPPP practice questions online are definition-recall: "What is classical conditioning?" The real EPPP is almost entirely application-based: "A psychologist is working with a client who... What is the most appropriate next step?"

These 50 questions are written to match the style and difficulty of the actual EPPP. They're organized by domain, and every question includes a detailed explanation of why the correct answer is correct and why the other options fall short.

Use these to benchmark where you stand. If you're getting a domain mostly right, it's probably not where you should focus your study time. If you're getting a domain mostly wrong, that's your opportunity zone.

How to Use These Questions

Don't just read through them. Treat this like a mini-diagnostic:

1. Answer each question before reading the explanation
2. Track your score by domain
3. After finishing, calculate your opportunity score for each domain: (% wrong) times (domain weight)
4. Focus your study time on the domains with the highest opportunity scores

If you want the full adaptive experience with thousands of questions that adjust to your weak areas, try thePsychology.ai free for 7 days.

---

Biological Bases of Behavior (approximately 12% of the EPPP)

Question 1

A 45-year-old patient with a history of alcohol use disorder presents with severe anterograde amnesia, confabulation, and relatively preserved long-term memories from before the onset of symptoms. Which brain structure is most likely damaged?

A) Prefrontal cortex B) Hippocampus C) Mammillary bodies D) Amygdala

Answer: C) Mammillary bodies

This presentation is classic Korsakoff syndrome, which results from thiamine (vitamin B1) deficiency associated with chronic alcohol use. The mammillary bodies, part of the diencephalon and Papez circuit, are the primary structures damaged. While the hippocampus (B) is involved in memory formation, Korsakoff's specifically involves mammillary body and thalamic damage. The confabulation component is a hallmark that distinguishes this from other amnesias. The prefrontal cortex (A) damage would produce executive dysfunction, not this specific memory pattern. Amygdala (D) damage would affect emotional memory and fear conditioning.

Question 2

A psychiatrist is considering prescribing a medication that works primarily by blocking the reuptake of serotonin and norepinephrine for a patient with major depressive disorder. Which neurotransmitter system side effect should the psychiatrist most carefully monitor given the norepinephrine component?

A) Weight gain from increased appetite B) Elevated blood pressure C) Tardive dyskinesia D) Serotonin syndrome

Answer: B) Elevated blood pressure

SNRIs (serotonin-norepinephrine reuptake inhibitors) like venlafaxine and duloxetine increase norepinephrine activity, which can raise blood pressure through sympathetic nervous system activation. This is a dose-dependent effect that requires monitoring. Weight gain (A) is more associated with medications affecting histamine receptors (like mirtazapine or certain antipsychotics). Tardive dyskinesia (C) is associated with dopamine-blocking antipsychotics, not SNRIs. Serotonin syndrome (D) is a concern with serotonergic medications but is related to the serotonin component, not the norepinephrine component, and the question specifically asks about the norepinephrine-related side effect.

Question 3

A researcher is studying a patient who, after a stroke affecting Broca's area, can understand language but produces speech that is effortful, nonfluent, and missing function words. The patient says "want... coffee... morning" instead of "I want coffee this morning." This pattern is best described as:

A) Wernicke's aphasia B) Broca's aphasia C) Conduction aphasia D) Global aphasia

Answer: B) Broca's aphasia

Broca's aphasia (expressive aphasia) involves nonfluent, effortful speech with intact comprehension. The speech is often telegraphic, missing function words and grammatical markers while preserving content words. Wernicke's aphasia (A) involves fluent but meaningless speech with impaired comprehension. Conduction aphasia (C) involves fluent speech with intact comprehension but difficulty repeating phrases, associated with arcuate fasciculus damage. Global aphasia (D) involves impairment in both production and comprehension.

Question 4

A neuropsychologist is evaluating a patient who sustained damage to the ventromedial prefrontal cortex. Which behavioral change would be most expected?

A) Inability to form new declarative memories B) Poor decision-making in situations involving risk and reward despite intact intellectual functioning C) Difficulty recognizing familiar faces D) Loss of the ability to plan and execute sequential motor tasks

Answer: B) Poor decision-making in situations involving risk and reward despite intact intellectual functioning

This describes the pattern seen in cases like Phineas Gage and studied extensively by Damasio (the somatic marker hypothesis). Ventromedial PFC damage impairs the ability to integrate emotional signals into decision-making, leading to poor real-world choices despite normal performance on standard cognitive tests. Inability to form new memories (A) relates to hippocampal/medial temporal lobe damage. Difficulty recognizing faces (C) suggests prosopagnosia from fusiform gyrus damage. Loss of sequential motor planning (D) suggests premotor or supplementary motor area damage.

Question 5

A patient taking an SSRI for depression reports that the medication has been effective for mood but has caused significant sexual dysfunction. The prescribing physician considers switching to a different antidepressant with a lower risk of sexual side effects. Which medication would be the most appropriate alternative?

A) Paroxetine B) Fluoxetine C) Bupropion D) Sertraline

Answer: C) Bupropion

Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) that does not affect serotonin, which makes it the antidepressant least likely to cause sexual dysfunction. In fact, it's sometimes added to SSRIs specifically to counteract sexual side effects. Paroxetine (A), fluoxetine (B), and sertraline (D) are all SSRIs and carry similar or higher risks of sexual dysfunction. Paroxetine actually has the highest rate of sexual side effects among SSRIs.

Question 6

A 70-year-old patient presents with resting tremor, bradykinesia, and rigidity. These symptoms are most directly related to degeneration of neurons in which brain structure?

A) Caudate nucleus B) Substantia nigra C) Cerebellum D) Basal forebrain

Answer: B) Substantia nigra

This is a classic presentation of Parkinson's disease, which results from degeneration of dopaminergic neurons in the substantia nigra pars compacta. These neurons project to the striatum (caudate and putamen) via the nigrostriatal pathway. While the caudate nucleus (A) is part of the affected circuit, the primary degeneration occurs in the substantia nigra. The cerebellum (C) is involved in coordination, and cerebellar damage produces ataxia, not the resting tremor and rigidity of Parkinsonism. The basal forebrain (D) contains cholinergic neurons that degenerate in Alzheimer's disease.

---

Cognitive-Affective Bases of Behavior (approximately 13% of the EPPP)

Question 7

A psychologist is working with a client who avoids flying after a turbulent flight experience. The client reports intense fear not only of airplanes but now also of airports, packed suitcases, and the sound of jet engines overhead. This pattern is best explained by:

A) Operant conditioning through positive reinforcement B) Stimulus generalization following classical conditioning C) Observational learning D) Cognitive restructuring failure

Answer: B) Stimulus generalization following classical conditioning

The turbulent flight (UCS) elicited fear (UCR), and the airplane became the conditioned stimulus (CS). Stimulus generalization occurs when the conditioned response (fear) extends to stimuli that are similar to or associated with the original CS: airports, suitcases, and jet engine sounds. Operant conditioning through positive reinforcement (A) doesn't explain the acquisition of the fear, though avoidance behavior could be maintained through negative reinforcement. Observational learning (C) would require watching someone else experience the trauma. Cognitive restructuring failure (D) is a therapeutic concept, not an acquisition mechanism.

Question 8

A researcher presents participants with a list of 20 words and tests immediate free recall. Participants most reliably remember words from the beginning and end of the list but not the middle. A distractor task inserted between presentation and recall would most affect memory for which portion of the list?

A) The beginning of the list (primacy effect) B) The middle of the list C) The end of the list (recency effect) D) All portions equally

Answer: C) The end of the list (recency effect)

The serial position effect includes both primacy (better recall of early items) and recency (better recall of late items). The recency effect is attributed to items still being held in short-term/working memory at the time of recall. A distractor task disrupts short-term memory, eliminating the recency effect while leaving the primacy effect relatively intact. Primacy items (A) have already been transferred to long-term memory through rehearsal and are less affected by a distractor task. The middle items (B) are already poorly recalled and wouldn't be differentially affected. The distractor doesn't affect all portions equally (D) because primacy and recency rely on different memory systems.

Question 9

A client tells their therapist, "I failed one exam, so I'm going to fail all my exams. I'll never graduate." According to Beck's cognitive model, this thinking pattern best represents:

A) Arbitrary inference B) Overgeneralization C) Magnification D) Personalization

Answer: B) Overgeneralization

Overgeneralization involves drawing a broad conclusion from a single event. Failing one exam becomes "I'll fail all exams" and "I'll never graduate." Arbitrary inference (A) involves drawing a conclusion without supporting evidence or in the face of contradictory evidence. Magnification (C) involves exaggerating the importance of an event. Personalization (D) involves attributing external events to oneself without basis. While there's overlap among cognitive distortions, the key pattern here is extrapolating from one instance to a sweeping conclusion, which is the hallmark of overgeneralization.

Question 10

A psychologist is studying a 4-year-old who watches an adult model aggressively hit a Bobo doll. Later, when placed in a room with the same doll, the child imitates the aggressive behavior even though the child was never directly reinforced for doing so. This finding is most relevant to:

A) Classical conditioning B) Operant conditioning C) Social learning theory D) Instinct theory

Answer: C) Social learning theory

This describes Bandura's classic Bobo doll experiment, which demonstrated observational learning (modeling). The child learned the behavior by watching the model without any direct reinforcement, which cannot be explained by classical conditioning (A, which requires pairing of stimuli) or traditional operant conditioning (B, which requires direct reinforcement of the learner's behavior). The key insight of social learning theory is that organisms can learn new behaviors through observation alone. Instinct theory (D) would suggest the behavior is innate, not learned.

Question 11

A cognitive psychologist asks participants to judge whether a robin or a penguin is "more of a bird." Most participants rate the robin as more representative of the category "bird." This finding is best explained by:

A) Availability heuristic B) Prototype theory C) Exemplar theory D) Representativeness heuristic

Answer: B) Prototype theory

Prototype theory (Rosch) proposes that people categorize objects by comparing them to an abstract, idealized representation (prototype) of the category. A robin more closely matches the prototype of "bird" (flies, small, perches in trees) than a penguin does. Availability heuristic (A) involves judging frequency or probability based on how easily examples come to mind. Exemplar theory (C) is plausible but proposes categorization based on specific remembered instances rather than an abstract prototype. Representativeness heuristic (D) involves judging probability based on how closely something matches a stereotype, which is related but more specific to probability judgments than category membership.

Question 12

A client experiences intense anxiety when thinking about an upcoming presentation. The psychologist teaches them to pair the anxiety-provoking thought with deep breathing and progressive muscle relaxation. Over several sessions, the client reports reduced anxiety when thinking about presentations. This technique is best described as:

A) Flooding B) Systematic desensitization C) Aversion therapy D) Stress inoculation training

Answer: B) Systematic desensitization

Systematic desensitization (Wolpe) pairs anxiety-provoking stimuli with a competing relaxation response (reciprocal inhibition). The client learns to associate the feared stimulus with relaxation rather than anxiety. Flooding (A) involves prolonged exposure to the feared stimulus at full intensity without relaxation, relying on extinction. Aversion therapy (C) pairs an undesirable behavior with an aversive stimulus. Stress inoculation training (D, Meichenbaum) involves education about stress, skill rehearsal, and graduated application, which is a broader cognitive-behavioral approach rather than the specific pairing of relaxation with feared stimuli.

---

Social and Cultural Bases of Behavior (approximately 12% of the EPPP)

Question 13

A psychologist is conducting a group therapy session and notices that members are making riskier recommendations than any individual member would make alone. This phenomenon is best explained by:

A) Groupthink B) Group polarization C) Social loafing D) Deindividuation

Answer: B) Group polarization

Group polarization (formerly called "risky shift") occurs when group discussion leads members to adopt more extreme positions than they held individually. If individuals were already leaning toward risk, the group moves further toward risk. Groupthink (A) involves pressure toward conformity and poor decision-making in highly cohesive groups, but it's specifically about suppressing dissent rather than amplifying existing tendencies. Social loafing (C) involves reduced effort in group settings. Deindividuation (D) involves loss of self-awareness in groups, leading to impulsive behavior, which is a different mechanism than group discussion amplifying pre-existing attitudes.

Question 14

A Korean American client consistently avoids direct eye contact with the therapist and speaks indirectly about family conflicts. The therapist, who is European American, initially interprets this as avoidance or resistance. A culturally competent conceptualization would consider that:

A) The client likely has social anxiety disorder B) Indirect communication and averted gaze may reflect cultural values of respect and collectivism C) The client is demonstrating an insecure attachment style D) The therapist should directly confront the avoidance to build a stronger alliance

Answer: B) Indirect communication and averted gaze may reflect cultural values of respect and collectivism

In many East Asian cultures, direct eye contact with authority figures can be considered disrespectful, and indirect communication about family matters reflects collectivist values that prioritize group harmony over individual expression. Interpreting these behaviors through a Western lens as social anxiety (A), insecure attachment (C), or resistance requiring confrontation (D) represents a culturally biased formulation. Culturally competent practice requires understanding behavior within its cultural context before applying diagnostic labels.

Question 15

A psychologist is studying conformity and presents participants with an obviously incorrect answer given by confederates. Approximately 75% of participants conform at least once across trials. If the psychologist modifies the study so that one confederate gives the correct answer, what is the expected effect?

A) Conformity rates increase due to information overload B) Conformity rates decrease significantly C) Conformity rates remain unchanged D) Conformity rates increase due to reactance

Answer: B) Conformity rates decrease significantly

This refers to Asch's conformity experiments. A key finding was that the presence of even one dissenting confederate (an "ally") dramatically reduced conformity, dropping it from about 37% (per trial) to around 5%. The presence of a single dissenter breaks the unanimity of the group, which is a critical factor in conformity pressure. Having someone else disagree gives the participant social support for their own accurate perception.

Question 16

A manager notices that workers on an assembly line produce less per person when working in a group of 10 compared to when working in pairs. This decrease in individual effort is best explained by:

A) Social facilitation B) Social inhibition C) Social loafing D) Diffusion of responsibility in emergencies

Answer: C) Social loafing

Social loafing (Latane, Williams, & Harkins) is the tendency for individuals to exert less effort when working collectively than when working individually or in small groups. It increases with group size and occurs particularly in tasks where individual contributions are not identifiable. Social facilitation (A) refers to improved performance on simple tasks in the presence of others. Social inhibition (B) is impaired performance on complex tasks in the presence of others. Diffusion of responsibility (D) specifically applies to bystander intervention in emergencies, though it shares a similar mechanism with social loafing.

Question 17

According to Sue and Sue's racial/cultural identity development model, a person of color who actively rejects the values of the dominant culture and immerses themselves in their own cultural heritage is most likely in which stage?

A) Conformity B) Dissonance C) Resistance and immersion D) Integrative awareness

Answer: C) Resistance and immersion

In the resistance and immersion stage, individuals actively reject dominant culture values and deeply embrace their own cultural group's values, history, and identity. This often follows the dissonance stage (B), where the individual first begins questioning their previously held views about both cultures. Conformity (A) involves preference for dominant culture values. Integrative awareness (D) represents a later stage where the individual develops a secure sense of cultural identity while appreciating aspects of other cultures and recognizing both oppression and individual differences.

Question 18

A researcher finds that participants rate an ambiguous essay more negatively when told it was written by an African American author compared to when told it was written by a European American author. This finding best illustrates:

A) Explicit prejudice B) Aversive racism C) Symbolic racism D) Institutional racism

Answer: B) Aversive racism

Aversive racism (Gaertner & Dovidio) describes the phenomenon where individuals who consciously endorse egalitarian values still demonstrate racial bias in ambiguous situations where discrimination can be attributed to non-racial factors. The ambiguous nature of the essay quality allows bias to operate while maintaining a non-prejudiced self-image. Explicit prejudice (A) involves conscious, deliberate bias. Symbolic racism (C) involves opposition to racial policies framed in non-racial terms. Institutional racism (D) refers to systemic policies and practices that disadvantage racial groups.

---

Growth and Lifespan Development (approximately 12% of the EPPP)

Question 19

A 14-month-old child explores a new playroom while periodically checking back with the caregiver. When the caregiver leaves, the child shows moderate distress. Upon the caregiver's return, the child seeks proximity, is quickly soothed, and returns to exploring. According to Ainsworth, this pattern indicates:

A) Secure attachment B) Anxious-ambivalent attachment C) Avoidant attachment D) Disorganized attachment

Answer: A) Secure attachment

This describes the Strange Situation protocol. Secure attachment is characterized by using the caregiver as a secure base for exploration, showing appropriate distress upon separation, and being easily comforted upon reunion before returning to play. Anxious-ambivalent (B) children show intense distress upon separation and are difficult to soothe upon reunion, often showing ambivalence (seeking contact while also resisting). Avoidant (C) children show little distress upon separation and actively avoid the caregiver upon return. Disorganized (D) children show contradictory, confused behaviors upon reunion (approaching while looking away, freezing).

Question 20

According to Piaget, a 5-year-old who believes the moon follows them as they walk is demonstrating:

A) Object permanence B) Egocentrism C) Centration D) Animism

Answer: D) Animism

Animism is the tendency to attribute life and intentional behavior to inanimate objects, characteristic of the preoperational stage (ages 2-7). The child believes the moon is deliberately following them, attributing intentional movement to a non-living object. While egocentrism (B) is also characteristic of the preoperational stage, it refers to the inability to take another's perspective, not attributing life to objects. Centration (C) involves focusing on one dimension of a problem while ignoring others. Object permanence (A) is achieved in the sensorimotor stage and refers to understanding that objects continue to exist when out of sight.

Question 21

A developmental psychologist is assessing moral reasoning in an 8-year-old. The child says stealing is wrong "because you'll get punished." According to Kohlberg, this reasoning reflects which level?

A) Preconventional, Stage 1 B) Preconventional, Stage 2 C) Conventional, Stage 3 D) Conventional, Stage 4

Answer: A) Preconventional, Stage 1

Stage 1 (obedience and punishment orientation) defines morality in terms of avoiding punishment. The child doesn't consider the inherent wrongness of stealing or its effect on others; the action is wrong solely because of its punitive consequences. Stage 2 (B) involves instrumental purpose ("What's in it for me?"). Stage 3 (C) involves "good boy/good girl" orientation based on social approval. Stage 4 (D) involves maintaining social order and following laws because they maintain societal functioning.

Question 22

A psychologist is assessing an 80-year-old client who reports feeling content with her life despite acknowledging regrets and missed opportunities. She states, "I made mistakes, but I've lived a good life." According to Erikson, this reflects successful resolution of which psychosocial stage?

A) Generativity vs. stagnation B) Intimacy vs. isolation C) Integrity vs. despair D) Identity vs. role confusion

Answer: C) Integrity vs. despair

Erikson's eighth and final stage, integrity vs. despair, occurs in late adulthood. Successful resolution involves looking back on life with a sense of fulfillment and acceptance, even while acknowledging imperfections and regrets. The client's ability to hold both regret and contentment reflects ego integrity. Despair would manifest as overwhelming regret, bitterness, and fear of death. Generativity vs. stagnation (A) is the seventh stage (middle adulthood). Intimacy vs. isolation (B) is the sixth stage (young adulthood). Identity vs. role confusion (D) is the fifth stage (adolescence).

Question 23

A 7-year-old is shown two identical glasses of water. The water from one glass is poured into a taller, narrower glass. The child correctly states that the amount of water has not changed. According to Piaget, this child has achieved:

A) Object permanence B) Conservation C) Formal operational thought D) Reversibility only

Answer: B) Conservation

Conservation is the understanding that quantity remains the same despite changes in appearance. It's a key achievement of the concrete operational stage (approximately ages 7-11). The child can now mentally reverse the transformation (pouring the water back) and consider multiple dimensions simultaneously (height and width). Object permanence (A) is achieved much earlier, in the sensorimotor stage. Formal operational thought (C) involves abstract and hypothetical reasoning, which is beyond what this task requires. Reversibility (D) is one of the cognitive operations that supports conservation, but conservation is the more complete concept being demonstrated here.

Question 24

A school psychologist notices that a 10-year-old who previously excelled academically has become withdrawn, avoids challenges, and says "I'm just not smart." According to Erikson, this presentation suggests difficulty with which psychosocial stage?

A) Initiative vs. guilt B) Industry vs. inferiority C) Identity vs. role confusion D) Trust vs. mistrust

Answer: B) Industry vs. inferiority

The industry vs. inferiority stage (approximately ages 6-12) involves developing a sense of competence through mastery of skills, particularly in school settings. When children fail to develop a sense of industry, they develop feelings of inferiority and inadequacy, which matches this child's avoidance of challenges and negative self-assessment. Initiative vs. guilt (A) occurs earlier (ages 3-6) and involves the ability to plan and initiate activities. Identity vs. role confusion (C) is an adolescent stage. Trust vs. mistrust (D) is the earliest stage occurring in infancy.

---

Assessment and Diagnosis (approximately 14% of the EPPP)

Question 25

A psychologist administers a personality test to the same individual two weeks apart and obtains very different results each time. This finding most directly raises concerns about the test's:

A) Content validity B) Construct validity C) Test-retest reliability D) Internal consistency

Answer: C) Test-retest reliability

Test-retest reliability measures the consistency of test results over time. Obtaining very different results on two administrations of the same test to the same person indicates poor temporal stability. Content validity (A) refers to whether test items adequately sample the domain being measured. Construct validity (B) refers to whether the test measures the theoretical construct it claims to measure. Internal consistency (D) measures whether items on the test are measuring the same construct (within a single administration). Only test-retest reliability addresses consistency across time points.

Question 26

A psychologist is interpreting MMPI-3 results for a client. The client's F scale (Infrequent Responses) is significantly elevated. The most appropriate first step is to:

A) Conclude the client has severe psychopathology B) Consider whether the profile may be invalid due to overreporting or random responding C) Ignore the F scale and interpret the clinical scales as usual D) Diagnose the client with a factitious disorder

Answer: B) Consider whether the profile may be invalid due to overreporting or random responding

An elevated F scale indicates the client endorsed many items that are rarely endorsed by the normative sample. This pattern can reflect random or inconsistent responding, a "cry for help" or overreporting of symptoms, genuine severe psychopathology, or reading difficulties. Before interpreting the clinical scales, the psychologist must evaluate profile validity. Jumping to severe psychopathology (A) or factitious disorder (D) without first evaluating validity is premature. Ignoring the validity scale (C) would be a fundamental interpretive error.

Question 27

A neuropsychologist is choosing between two screening tests for cognitive impairment. Test A has a sensitivity of 95% and specificity of 60%. Test B has a sensitivity of 70% and specificity of 95%. For an initial screening where the primary goal is to avoid missing cases, which test is more appropriate?

A) Test B, because higher specificity reduces false positives B) Test A, because higher sensitivity reduces false negatives C) Either test, as sensitivity and specificity are equally important in screening D) Neither test without knowing the base rate

Answer: B) Test A, because higher sensitivity reduces false negatives

In screening contexts, the primary goal is to identify all potential cases (minimizing false negatives/missed cases), which means prioritizing sensitivity. Test A with 95% sensitivity will miss only 5% of true cases. Those who screen positive can then undergo more specific diagnostic testing. Test B's higher specificity (A) would be more valuable in confirmatory/diagnostic testing where you want to avoid false positives. While base rate (D) affects predictive values, it doesn't change which test is more appropriate for the stated screening goal.

Question 28

A client obtains a Full Scale IQ of 100 on the WAIS-IV with a 95% confidence interval of 95-105. The psychologist can most accurately state that:

A) The client's true IQ is exactly 100 B) There is a 95% probability that the client's true IQ falls between 95 and 105 C) If tested repeatedly, 95% of the obtained scores would fall between 95 and 105 D) The client is of exactly average intelligence

Answer: C) If tested repeatedly, 95% of the obtained scores would fall between 95 and 105

This is a common conceptual trap. The confidence interval is constructed around the obtained score using the standard error of measurement. The frequentist interpretation is that if the individual were tested many times, 95% of the confidence intervals constructed would contain the true score. Option B represents a common misinterpretation (the Bayesian interpretation that many people intuitively apply but isn't technically correct in classical test theory). Option A ignores measurement error entirely. Option D conflates a single score with a definitive characterization of ability.

Question 29

A psychologist is evaluating a 9-year-old for a learning disability. Achievement testing reveals reading scores significantly below what would be expected based on the child's measured cognitive ability. Before diagnosing a specific learning disorder, the psychologist should also:

A) Verify that the discrepancy is at least two standard deviations B) Rule out that the difficulties are better explained by intellectual disability, sensory deficits, inadequate instruction, or other factors C) Confirm that the child fails to respond to evidence-based intervention (RTI) D) Both B and C are appropriate considerations depending on the diagnostic framework used

Answer: D) Both B and C are appropriate considerations depending on the diagnostic framework used

The DSM-5 requires that learning difficulties are not better accounted for by intellectual disabilities, uncorrected sensory problems, other mental/neurological disorders, psychosocial adversity, inadequate instruction, or lack of proficiency in the language of instruction. The Response to Intervention (RTI) model is also widely used in school settings and is referenced in IDEA. Both exclusionary criteria (B) and RTI (C) are legitimate approaches depending on the framework. A strict IQ-achievement discrepancy model (A) is no longer the sole criterion and has been largely replaced by more comprehensive approaches.

Question 30

A researcher develops a new measure of depression and correlates scores with the Beck Depression Inventory, obtaining r = 0.85. The researcher also shows that the new measure does not correlate significantly with a measure of physical fitness (r = 0.05). These findings provide evidence for:

A) Content validity and face validity B) Convergent validity and discriminant validity C) Predictive validity and concurrent validity D) Internal consistency and test-retest reliability

Answer: B) Convergent validity and discriminant validity

Convergent validity is established when a measure correlates highly with other measures of the same construct (the new depression measure correlating with the BDI at r = 0.85). Discriminant validity is established when a measure does not correlate with measures of theoretically unrelated constructs (low correlation with physical fitness). Together, these provide evidence for construct validity. Content validity (A) requires expert evaluation of item representativeness. Predictive validity (C) requires predicting future outcomes. Internal consistency (D) involves item-level correlations within the measure.

---

Treatment, Intervention, and Prevention (approximately 14% of the EPPP)

Question 31

A psychologist is working with a client who has OCD characterized by contamination fears and excessive handwashing. The most empirically supported first-line treatment is:

A) Systematic desensitization with relaxation training B) Exposure and response prevention (ERP) C) Cognitive therapy focusing on challenging irrational beliefs about contamination D) EMDR

Answer: B) Exposure and response prevention (ERP)

ERP is the gold-standard behavioral treatment for OCD. It involves exposing the client to feared stimuli (contamination triggers) while preventing the compulsive response (handwashing). This allows habituation and extinction of the anxiety response. Systematic desensitization (A) uses a gradual anxiety hierarchy with relaxation, but the relaxation component can actually interfere with extinction learning in OCD. Pure cognitive therapy (C) can be helpful as an adjunct but alone is less effective than ERP for OCD. EMDR (D) is primarily supported for PTSD, not OCD.

Question 32

A therapist notices that their client with borderline personality disorder frequently alternates between idealizing the therapist ("You're the only one who understands me") and devaluing them ("You're useless, just like everyone else"). The therapist conceptualizes this pattern as splitting and maintains a consistent, validating stance. This approach is most consistent with:

A) Classical psychoanalysis B) Dialectical behavior therapy C) Person-centered therapy D) Psychodynamic therapy informed by object relations theory

Answer: D) Psychodynamic therapy informed by object relations theory

Splitting (alternating between idealization and devaluation) is a key concept in object relations theory (Kernberg, Klein). Understanding this defense mechanism and maintaining a consistent therapeutic stance in response is a hallmark of object relations-informed psychodynamic treatment. Classical psychoanalysis (A) would use free association and interpretation with a more neutral, abstinent stance. DBT (B) addresses splitting indirectly through dialectical thinking but doesn't conceptualize it in object relations terms. Person-centered therapy (C) emphasizes unconditional positive regard but doesn't use the splitting framework.

Question 33

A client presents with panic disorder with agoraphobia. After psychoeducation, the therapist guides the client through interoceptive exposure exercises, inducing physical sensations similar to panic (spinning in a chair to create dizziness, breathing through a straw to create breathlessness). The primary goal of these exercises is to:

A) Teach the client to avoid panic-inducing situations B) Reduce the client's catastrophic interpretation of physical sensations C) Condition a relaxation response to physical arousal D) Determine the medical cause of the panic symptoms

Answer: B) Reduce the client's catastrophic interpretation of physical sensations

Interoceptive exposure is a key component of CBT for panic disorder (Clark, Barlow). By deliberately inducing feared bodily sensations in a safe context, the client learns that the sensations themselves are not dangerous. This breaks the cycle of catastrophic misinterpretation ("My heart is racing, so I must be having a heart attack") that maintains panic disorder. The goal is not avoidance (A), which would maintain the disorder. It's not primarily about relaxation conditioning (C). And it's a psychological intervention, not medical assessment (D).

Question 34

A therapist is working with a couple where one partner says "You never listen to me" and the other responds defensively with "That's not true, you're always criticizing me." The therapist asks the first partner to rephrase using an "I" statement: "I feel unheard when I'm talking and you're looking at your phone." This intervention is most characteristic of:

A) Gottman method couples therapy B) Emotionally focused therapy (EFT) C) Structural family therapy D) Strategic family therapy

Answer: A) Gottman method couples therapy

The Gottman method specifically addresses the "Four Horsemen" (criticism, contempt, defensiveness, stonewalling) and uses interventions like softened startup and "I" statements to replace criticism with specific complaints. EFT (B) focuses on attachment needs and emotional bonding cycles rather than communication skills per se. Structural family therapy (C, Minuchin) focuses on family organization, boundaries, and hierarchies. Strategic family therapy (D, Haley) uses directives and paradoxical interventions to address specific problems.

Question 35

A psychologist is conducting a risk assessment for a client who has expressed suicidal ideation. Which combination of factors would indicate the highest acute risk?

A) Passive ideation, depressed mood, female sex, history of one prior attempt B) Active ideation with a specific plan and access to means, recent loss, male sex, history of multiple prior attempts C) Passive ideation, substance use history, family history of depression, unemployment D) Active ideation without a plan, chronic pain, social isolation, age 25

Answer: B) Active ideation with a specific plan and access to means, recent loss, male sex, history of multiple prior attempts

Acute suicide risk assessment considers multiple factors. Active ideation with a specific plan and access to lethal means represents the highest immediate risk. Additional factors that elevate risk include: recent significant loss (precipitant), male sex (higher completion rates), and multiple prior attempts (strongest single predictor of future attempts). Option A includes passive ideation, which is lower risk. Options C and D include risk factors but lack the combination of active planning, means access, and multiple prior attempts that characterize the highest acute risk.

Question 36

A client with generalized anxiety disorder has been in CBT for 12 sessions with moderate improvement. The therapist is considering treatment modifications. Which approach has the strongest evidence as a next step?

A) Switch entirely to psychodynamic therapy B) Add acceptance-based strategies (worry exposure, mindfulness, values clarification) C) Increase session frequency to three times per week D) Discontinue therapy and recommend medication only

Answer: B) Add acceptance-based strategies (worry exposure, mindfulness, values clarification)

Acceptance-based behavioral therapy for GAD (Roemer & Orsillo) has demonstrated efficacy for GAD and can complement traditional CBT. When standard CBT produces partial response, integrating acceptance-based strategies (from ACT and ABBT) can address the experiential avoidance and intolerance of uncertainty that maintain worry. Switching entirely to another modality (A) abandons the gains made. Increasing frequency (C) lacks evidence as a modification strategy for partial responders. Discontinuing therapy (D) ignores the partial improvement and the possibility of augmentation.

---

Research Methods and Statistics (approximately 8% of the EPPP)

Question 37

A researcher wants to determine whether a new therapy reduces depression more than a wait-list control. Participants are randomly assigned to treatment or wait-list. Depression is measured before and after the 8-week intervention period. The most appropriate statistical analysis is:

A) Paired samples t-test B) Independent samples t-test on post-test scores C) Mixed-design ANOVA (group x time) D) Chi-square test

Answer: C) Mixed-design ANOVA (group x time)

A mixed-design (split-plot) ANOVA is most appropriate because the study has one between-subjects factor (treatment vs. wait-list) and one within-subjects factor (pre-test vs. post-test). The critical test is the group-by-time interaction, which reveals whether the groups changed differently over time. A paired t-test (A) would only analyze within-group change for one group. An independent t-test on post-scores (B) ignores pre-test differences. A chi-square (D) is for categorical data, not continuous depression scores.

Question 38

A researcher finds a statistically significant correlation of r = 0.15 between exercise frequency and GPA in a sample of 2,000 college students (p < 0.01). The most appropriate interpretation is:

A) Exercise has a meaningful causal effect on academic performance B) The relationship is statistically significant but practically small, explaining about 2% of the variance C) The large sample size means the finding is both statistically and practically significant D) The correlation is too small to be real and is likely a Type I error

Answer: B) The relationship is statistically significant but practically small, explaining about 2% of the variance

With r = 0.15, the coefficient of determination (r-squared) is 0.0225, meaning exercise frequency accounts for approximately 2.25% of the variance in GPA. The large sample size (N = 2,000) provides sufficient power to detect even small effects as statistically significant, but statistical significance does not imply practical significance. Causation cannot be inferred from correlation (A). Large samples don't automatically make effects meaningful (C). The finding is likely real (not Type I error) given the p-value, but it's small in practical terms (D is incorrect because the effect is real, just small).

Question 39

A clinical psychologist conducts a study comparing CBT, medication, and their combination for treating anxiety. Thirty participants are randomly assigned to one of three conditions (10 per group). After treatment, the psychologist runs three separate independent t-tests to compare each pair of conditions. The primary statistical concern with this approach is:

A) Insufficient power due to small sample sizes B) Inflated Type I error rate due to multiple comparisons C) Violation of the homogeneity of variance assumption D) Inability to detect interaction effects

Answer: B) Inflated Type I error rate due to multiple comparisons

Running three separate t-tests instead of a one-way ANOVA inflates the familywise Type I error rate. With three comparisons at alpha = 0.05, the probability of at least one Type I error increases to approximately 1 - (0.95)^3 = 0.14, nearly three times the intended alpha level. The appropriate approach is to first conduct an omnibus ANOVA and then use post-hoc tests with appropriate corrections (Tukey, Bonferroni, etc.) if the omnibus test is significant. While small sample size (A) is a legitimate concern, it's not the primary statistical issue with the analytical approach described.

Question 40

A researcher is studying the relationship between therapist experience (in years) and client outcomes (symptom improvement scores) while controlling for initial symptom severity. The most appropriate analysis is:

A) Pearson correlation B) Partial correlation or multiple regression C) One-way ANOVA D) Factor analysis

Answer: B) Partial correlation or multiple regression

The researcher wants to examine the relationship between two continuous variables (therapist experience and client outcomes) while statistically controlling for a third continuous variable (initial severity). Partial correlation removes the influence of initial severity from both variables. Multiple regression can achieve the same goal by entering both therapist experience and initial severity as predictors. Pearson correlation (A) doesn't control for confounding variables. ANOVA (C) is for comparing group means, not examining continuous relationships. Factor analysis (D) identifies latent variables from observed correlations, which isn't the research question.

Question 41

A psychology journal reports a study with a Cohen's d of 0.80. This effect size is conventionally interpreted as:

A) Small B) Medium C) Large D) Cannot be interpreted without knowing the sample size

Answer: C) Large

Cohen's conventions for d are: small = 0.20, medium = 0.50, large = 0.80. A d of 0.80 means the two groups differ by 0.80 standard deviations, which is considered a large effect. Effect size is independent of sample size (D is incorrect). Sample size affects statistical significance and confidence intervals around the effect size, but the effect size itself is a standardized measure of the magnitude of the difference. These conventions are guidelines, and practical significance depends on context, but 0.80 is universally categorized as a large effect by Cohen's criteria.

Question 42

A researcher surveys 500 psychologists about job satisfaction and finds that 80% report high satisfaction. However, only 25% of the psychologists who received the survey responded. This finding is most threatened by:

A) Social desirability bias B) Nonresponse bias C) Hawthorne effect D) Confirmation bias

Answer: B) Nonresponse bias

With only a 25% response rate, the sample is likely not representative of the full population. Psychologists who are more satisfied with their jobs may have been more willing to complete a satisfaction survey, inflating the reported satisfaction rate. This is nonresponse bias (also called self-selection bias). Social desirability (A) could also inflate satisfaction reports, but the 75% non-response rate is the more fundamental threat. The Hawthorne effect (C) involves behavior change due to being observed. Confirmation bias (D) is a cognitive bias in interpreting evidence, not a sampling issue.

---

Ethical, Legal, and Professional Issues (approximately 15% of the EPPP)

Question 43

A psychologist receives a subpoena for a client's therapy records. The client has not provided authorization for release. The psychologist's most appropriate first step is:

A) Comply immediately with the subpoena, as it is a legal order B) Refuse the subpoena entirely, citing client privilege C) Contact the client to discuss the subpoena and consult with an attorney about the legal obligations D) Release only the diagnosis and treatment dates

Answer: C) Contact the client to discuss the subpoena and consult with an attorney about the legal obligations

A subpoena is not the same as a court order. A subpoena is a request, and psychologists have an obligation to protect client confidentiality. The appropriate first steps are to notify the client, discuss options, and consult with an attorney (or the client's attorney) about whether the subpoena can be challenged, whether privilege applies, and what information, if any, must be disclosed. Immediately complying (A) may violate confidentiality. Outright refusal (B) may have legal consequences if the subpoena is valid. Releasing partial information (D) without proper authorization or legal guidance is also inappropriate.

Question 44

A psychologist who provides therapy to a child in a custody dispute is asked by the child's attorney to provide an opinion about which parent should have custody. The most ethical response is:

A) Provide the custody recommendation based on observations from therapy B) Decline to offer a custody opinion and explain the role conflict between therapist and evaluator C) Provide the recommendation but note it is based on limited information D) Refer the attorney to the child's other parent's therapist for a second opinion

Answer: B) Decline to offer a custody opinion and explain the role conflict between therapist and evaluator

The APA Ethics Code and Specialty Guidelines for Forensic Psychology emphasize avoiding dual roles. A treating therapist has a therapeutic relationship with the client and lacks the objectivity, collateral information, and evaluation methodology required for a custody evaluation. Offering custody opinions from the therapist role conflates treatment and forensic evaluation functions. The psychologist should explain this role limitation and, if needed, recommend that the court appoint an independent custody evaluator. Providing the opinion with a disclaimer (C) doesn't resolve the fundamental role conflict.

Question 45

A psychologist discovers during treatment that their client is being investigated by the psychologist's close friend who is a detective. The psychologist finds this does not affect their objectivity. According to the APA Ethics Code, the psychologist should:

A) Continue treatment since objectivity is not affected B) Terminate the therapeutic relationship immediately C) Consider whether the relationship could reasonably be expected to impair objectivity, and if so, take appropriate steps including referral D) Disclose the relationship to the client and continue if the client consents

Answer: C) Consider whether the relationship could reasonably be expected to impair objectivity, and if so, take appropriate steps including referral

The APA Ethics Code (Standard 3.05, Multiple Relationships) states that psychologists must consider whether a multiple relationship could reasonably be expected to impair their objectivity, competence, or effectiveness, or risk exploitation or harm. The standard is not whether the psychologist believes they are currently unaffected, but whether the situation could reasonably impair their functioning. The psychologist's self-assessment of objectivity (A) is insufficient. Immediate termination (B) may not be necessary if steps can be taken to manage the situation. Simply disclosing and continuing (D) doesn't adequately address the potential impairment.

Question 46

A psychologist in private practice receives a phone call from a distressed individual requesting an immediate appointment. During the call, the individual mentions they are currently a client of another psychologist. The most appropriate response is:

A) Schedule the appointment and begin treatment immediately B) Refuse to see the individual and tell them to contact their current psychologist C) Schedule the appointment but first attempt to contact the current psychologist with the client's permission to coordinate care D) See the individual only for crisis intervention and refuse ongoing treatment

Answer: C) Schedule the appointment but first attempt to contact the current psychologist with the client's permission to coordinate care

The APA Ethics Code (Standard 10.04) addresses providing services to those already receiving mental health services. The psychologist should carefully consider the treatment issues and the client's welfare. With the client's consent, contacting the current provider helps minimize confusion and conflict, ensures continuity of care, and addresses the client's needs responsibly. Refusing entirely (B) may not serve the client's welfare if they're in distress. Starting treatment without coordination (A) risks splitting and duplicative care. Limiting to crisis intervention only (D) may be appropriate in some situations but doesn't address the coordination obligation.

Question 47

A psychologist working in a state with mandatory reporting laws suspects that their adult client is being physically abused by their spouse. The client explicitly asks the psychologist not to report. Under most state mandatory reporting statutes, the psychologist:

A) Must report suspected abuse regardless of the client's wishes, as mandatory reporting overrides confidentiality B) Is not required to report because mandatory reporting laws typically apply only to child abuse, elder abuse, and abuse of dependent adults C) Should follow the client's wishes, as client autonomy overrides reporting obligations D) Should report only if the abuse rises to the level of life-threatening injury

Answer: B) Is not required to report because mandatory reporting laws typically apply only to child abuse, elder abuse, and abuse of dependent adults

Most state mandatory reporting statutes specifically cover child abuse/neglect, elder abuse, and abuse of dependent/vulnerable adults. Abuse between competent adults (domestic violence/intimate partner violence) is generally not subject to mandatory reporting in most jurisdictions, though laws vary by state. The psychologist should work with the client on safety planning and provide information about resources. Option A overstates the reporting obligation. Option C ignores that there are situations where reporting is mandatory. Option D applies an incorrect threshold.

Question 48

A psychologist conducts an assessment and writes a report that includes test data (raw scores, scaled scores, and the client's specific responses). A non-psychologist attorney requests the complete report including all test data. The psychologist should:

A) Release the complete report including test data, as the attorney has a right to it B) Withhold the entire report to protect test security C) Release the report but consider releasing test data only to a qualified professional to protect test security D) Release only the summary and conclusions, permanently withholding all test data

Answer: C) Release the report but consider releasing test data only to a qualified professional to protect test security

The APA Ethics Code (Standard 9.04, Release of Test Data) requires psychologists to provide test data when required by law or client release, but also recognizes the obligation to protect test security (Standard 9.11). The best practice is to release the report's interpretations and conclusions while arranging for raw test data to be released to another qualified professional who can interpret it and explain it to the attorney. This balances the client's right to their information, legal requirements, and the obligation to maintain test security. Complete withholding (B, D) may violate legal obligations. Unrestricted release (A) may compromise test security.

---

Mixed Domain Questions

Question 49

A psychologist is designing a prevention program for adolescent depression in a school district. The program will be offered to all students regardless of current symptom level. This type of intervention is classified as:

A) Indicated prevention B) Selective prevention C) Universal prevention D) Tertiary prevention

Answer: C) Universal prevention

Universal prevention targets an entire population regardless of risk status. Since the program is offered to all students without screening for symptoms or risk factors, it's universal. Selective prevention (B) targets individuals at elevated risk (e.g., children of depressed parents). Indicated prevention (A) targets individuals already showing early signs or symptoms. Tertiary prevention (D) focuses on reducing the impact of an existing disorder, essentially treatment and rehabilitation.

Question 50

A psychologist notices that a new supervisee becomes anxious and deferential whenever receiving feedback, even when the feedback is positive. The supervisee later reveals a history of harsh criticism from a previous supervisor. The psychologist conceptualizes this as the supervisee transferring previous relational patterns onto the supervisory relationship. In providing feedback to this supervisee, the psychologist should:

A) Avoid giving any critical feedback to prevent triggering anxiety B) Interpret the transference directly and explore the supervisee's childhood experiences C) Provide feedback in a clear, specific, and supportive manner while acknowledging the dynamic and normalizing the supervisee's response D) Refer the supervisee to personal therapy and postpone all feedback until treatment is complete

Answer: C) Provide feedback in a clear, specific, and supportive manner while acknowledging the dynamic and normalizing the supervisee's response

The supervisor's role is to support professional development, which requires ongoing feedback. Avoiding feedback entirely (A) fails the supervisee's training needs. Deep exploration of childhood experiences (B) crosses the boundary between supervision and therapy. Postponing all feedback (D) halts professional development. The appropriate approach recognizes the relational dynamic, provides a corrective experience through clear and supportive feedback delivery, and maintains the supervisory frame. If the supervisee's anxiety significantly impairs their clinical work, a recommendation for personal therapy may be appropriate as an adjunct, not a replacement for supervision.

---

Score Yourself

Track your results by domain:

Domain	Questions	Your Score
Biological Bases	1-6	/6
Cognitive-Affective	7-12	/6
Social/Cultural	13-18	/6
Growth/Lifespan	19-24	/6
Assessment/Diagnosis	25-30	/6
Treatment/Intervention	31-36	/6
Research Methods	37-42	/6
Ethics/Legal	43-48	/6
Mixed	49-50	/2

Now calculate your opportunity score for each domain: take the number you got wrong, divide by the total questions in that domain, and multiply by the domain's exam weight. The domains with the highest opportunity scores are where you should focus your study time.

These 50 questions are a snapshot. If you want adaptive practice that continuously identifies your weak areas and adjusts to close those gaps, try thePsychology.ai free for 7 days. Our question bank mirrors the application-based style of the real EPPP, and the adaptive engine does the opportunity score math for you after every session.