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Predictive values depend on disease prevalence. With sensitivity and specificity held constant, positive predictive value (PPV)—the probability that someone who tests positive actually has the condition—increases as prevalence rises, because true positives become a larger proportion of all positives. Conversely, in low-prevalence settings, even a highly specific test yields more false positives relative to true positives, reducing PPV. Negative predictive value (NPV) shows the opposite pattern, tending to decrease as prevalence increases because false negatives form a larger slice of all negatives. Sensitivity (true-positive rate) and specificity (true-negative rate) are properties of the test itself and are unaffected by prevalence, but predictive values are properties of the test in a population context. Bayes’ theorem formalizes these relationships by weighting the likelihood ratio of the test with the pretest probability (base rate). Understanding these dynamics is critical for clinical decision-making, referral thresholds, and public health screening strategies, and is a frequent EPPP topic linking statistical reasoning to evidence-based practice.

Vygotsky’s sociocultural theory emphasizes the role of social interaction in cognitive development. The zone of proximal development (ZPD) is the gap between what a child can do independently and what they can do with guidance from a more knowledgeable other (e.g., teacher, peer). This is where optimal learning occurs. Independent performance (A) is below the ZPD, while tasks beyond reach even with help (B) lie above it. Critical periods (D) refer to biological windows of heightened sensitivity, not ZPD. Scaffolding, a related concept, describes the support provided within the ZPD, which is gradually removed as competence increases. On the EPPP, Vygotsky’s theory highlights the importance of cultural tools, language, and guided learning in development, contrasting with Piaget’s more stage-based model.

ADHD (inattentive type) requires ≥6 symptoms of inattention for at least 6 months in at least 2 settings, with functional impairment. Symptoms include distractibility, forgetfulness, and disorganization. Autism Spectrum Disorder (A) involves deficits in social communication and restricted behaviors. Specific Learning Disorder (C) involves difficulties with academic skills. ODD (D) is characterized by defiance and irritability. On the EPPP, candidates must differentiate ADHD subtypes from learning and behavioral disorders based on symptoms and context.

Spontaneous recovery occurs when a previously extinguished conditioned response reemerges after a rest period, even without new pairings of the conditioned and unconditioned stimulus. Extinction (A) reduces the response due to lack of reinforcement. Generalization (C) is responding to similar stimuli. Discrimination (D) is distinguishing between stimuli. On the EPPP, candidates must distinguish extinction from spontaneous recovery to demonstrate knowledge of classical conditioning principles.

Carl Rogers’ Client-Centered Therapy emphasizes the therapeutic relationship as the primary agent of change. Core conditions include unconditional positive regard, empathic understanding, and therapist congruence. Cognitive Therapy (A) targets maladaptive beliefs. Gestalt Therapy (C) emphasizes awareness and experiential techniques. Behavioral Therapy (D) modifies behavior through learning principles. Rogers’ approach is non-directive, empowering clients to self-actualize. On the EPPP, candidates should recognize humanistic therapies by their emphasis on relational factors and conditions of worth.