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2024年全國醫(yī)學英語水平考試（METS四級）經(jīng)典試題及答案一
1). Self-Disclosure and Mental Health Service Use in Socially Anxious Adolescents■Anxiety disorders are the most prevalent class of mental disorders in adolescents and affect approximately one third of this age group.Social Anxiety Disorder (SAD)， with a prevalence of 9% during adolescence， is the second most common anxiety disorder after Specific Phobia.SAD is also one of the most impairing adolescent anxiety disorders.( )In addition， SAD is often chronic and persists into adulthood， leading to increased likelihood of suicide attempts， decreased occupational functioning， and lower quality of life.■The high prevalence of social anxiety disorder and its related impairment have fostered the development of several effective clinic based treatments for youth with SAD.( )According to a recent epidemiological study， only 12% of socially anxious adolescents received services， with alcohol abuse being the only non-anxiety disorder associated with a lower service utilization rate ( 11.9%).Another study investigating the types of services utilized by socially anxious adolescents found that 22.7% made initial treatment contact with a physician or counselor， but did not provide information about whether they received ongoing therapy.■Considering the low rates of service use and the potential for long term impairment，( )Several epidemiological and clinical treatment studies have examined whether demographic characteristics (e.g.，age， gender， ethnicity， and SES) are associated with treatment utilization.Studies of socially phobic adults show that Caucasians and individuals with higher socioeconomic status ( SES) and education are relatively more likely to access treatment.■Research conducted with anxious youth has yielded inconsistent results.Some studies report that older age and youth from Caucasian families with higher SES have a higher likelihood of obtaining treatment， though a large longitudinal community study found no effects for age or race.( )but has been documented in investigations .conducted with youth in need of services for any type of mental disorders.■Illness specific factors (e.g.， severity， age of onset) may also play an important role whether youth receive services.Studies of anxious and depressed adults have shown that symptom severity， subjective level of distress， and onset of anxiety and mood disorders during childhood predict higher treatment utilization.There is a dearth of research examining the association of illness specific factors and service utilization in anxious youth；( )Parental perception of children′s illness severity was a significant predictor of service use among youth presenting to a community clinic with various mental disorders， but clinician-rated severity， impairment， and age of onset have been largely overlooked.■Available research suggests that even among those who receive treatment， there is substantial delay in treatment initiation following disorder onset.Studies of adults with varying types of anxiety， mood， and substance abuse disorders have shown median delays ranging from 6 to 14 years.An investigation of anxious adults diagnosed with either SAD，generalized anxiety disorder (GAD)， or panic disorder with or without agoraphobia (PD)found significantly longer delays seeking treatment from a specialty mental health clinic for adults with SAD，with a mean of 13.9 years， compared to 7 years for adults with GAD，and 6.6 years for adults with PD.( )■A large cross-sectional survey of adolescents and adults with a variety of mental disorders found that childhood or adolescent onset associated with significantly longer time to treatment delays than adult onset.( )Wang et al.also suggest that children with early- onset disorders may develop maladaptive coping strategies that ultimately interfere with accessing treatment (e.g.， developing extreme social withdrawal or substance abuse).Lengthy time to-treatment delays remain an important source of unmet need for mental health care， and further investigation of treatment delays in adolescents with anxiety is necessary to address this problem.( )
A.however， symptom severity and impairment have been found to predict treatment utilization in youth with externalizing disorders
B.This difference may be due to the fact that parents or other adults are responsible for seeking treatment for the child， so that only those with the most serious disorders or vigilant parents may receive timely care
C.Gender has not consistently emerged as a significant predictor of service utilization in anxious youth，
D.Despite these successful efforts， social anxiety disorder is among the least likely of all mental disorders to be treated
E.Social anxiety disorder is associated with disturbances in school performance，loneliness， and depressed mood
F.Several important steps must occur for youth to access services
G.it is important to understand factors that might facilitate or inhibit mental health treatment for anxious individuals
H.These results are consistent with the range of treatment delays across disorders and underscore that treatment initiation for SAD tends to be associated with delays at the high end of this range

正確答案：A