Chapter 15

Antipsychotic drugs were discovered accidentally when researchers were trying to develop: A) antihistamines. B) analgesics. C) sedatives. D) antibiotics.

A

If you and your family were receiving support, encouragement, and advice from other families with schizophrenic members, you would MOST likely be participating in: A) family psychoeducational programs. B) family milieu therapy. C) joint drug treatment. D) psychodynamic therapy.

A

If you went to a meeting of a group lobbying for better care for the mentally ill and made up primarily of family members of people with severe mental disorders, you would probably be attending: A) the National Alliance for the Mentally Ill. B) the Association for Retarded Citizens. C) the Society for Social Workers and Case Managers. D) the Halfway House Paraprofessional Affiliates.

A

Most patients who lived on the hospital wards in state mental hospitals in the mid-1900s: A) were schizophrenics. B) were given individual "talk" therapy with no success. C) interacted well with each other but not with staff members. D) were in fact violent criminals.

A

Rather than seeking to eliminate hallucinations and delusions, which form of therapy helps people learn to reinterpret their hallucinations and change their reactions to the hallucinations? A) cognitive-behavioral. B) milieu. C) insight. D) medical.

A

The goal of family therapy is: A) to help the family better support the schizophrenic patient. B) to help the patient move out of the family home and live on his or her own. C) to help the family display higher levels of expressed emotion. D) to help patients return to the hospital more quickly.

A

A patient who receives help in finding work, in finding a place to live, and in taking medication correctly is probably receiving: A) milieu therapy. B) social therapy. C) family therapy. D) insight therapy.

B

Community mental health centers are designed to provide all of the following EXCEPT: A) inpatient emergency care. B) medication and psychotherapy. C) vocational rehabilitation. D) coordination of other community services.

C

The Americans Walter Freeman and James Watts "improved" the procedure developed by Egas Moniz by developing the: A) prefrontal lobotomy. B) prefrontal leucotomy. C) transorbital lobotomy. D) complete prefrontal lobectomy

C

Mindfulness is MOST similar to which of the following therapies? A) family B) medical/biological C) milieu D) cognitive-behavioral

D

The usual way of dealing with troublesome or violent schizophrenic people in institutions in the first half of the twentieth century was to: A) use drugs. B) beat them. C) ignore them. D) use physical restraint.

D

Which of the following drugs has antipsychotic properties? A) Prozac B) Valium C) imipramine D) haloperidol

D

The LOWEST number of extrapyramidal side effects is seen after taking: A) clozapine. B) haloperidol. C) thioridazine. D) chlorpromazine.

A

In the treatment of schizophrenia, a case manager's primary goal is to help with: A) coordination of services. B) services. C) trained professionals. D) access to medication.

A

85. Schizophrenics who receive 24-hour supervision in a community setting, usually following a milieu approach, are receiving: A) coordinated services. B) partial hospitalization. C) halfway house services. D) occupational training.

C

If relatives of a schizophrenic come to have more realistic expectations, reduce their guilt, and work on establishing better communication, they are probably receiving: A) milieu therapy. B) social therapy. C) family therapy. D) insight therapy.

C

Imagine that your neighbor, who is being treated for schizophrenia, says that she has mostly negative symptoms of schizophrenia and is afraid of the extrapyramidal side effects of medication. She asks you what she should do. Your BEST response is: A) "Avoid all types of medication and stick to insight therapy." B) "Try conventional antipsychotic drugs; they should work best." C) "Try atypical antipsychotics; they should work best." D) "Any medication should work about as well as any other medication."

C

In behavioral terms, what is a token? A) a stimulus B) motivation C) a reinforcer D) punishment

C

Long-term mental patients frequently developed anger, aggressiveness, and loss of interest in personal appearance. This condition has been called: A) psychosis. B) schizophrenia. C) social breakdown syndrome. D) neuroleptic malignant syndrome.

C

One of the unwanted and later side effects of antipsychotic medications is: A) paralysis. B) hyperactivity. C) tardive dyskinesia. D) Parkinson's disease.

C

Several people with schizophrenia work at a recycling center, where on-time behavior is expected, and payment is made solely for work completed. The people do not compete with each other. MOST likely, this work takes place at a: A) halfway house. B) community mental health center. C) sheltered workshop. D) community employment center.

C

Some hospitalized mental patients whose original symptoms of schizophrenia improved were nonetheless unable to return to society because of the negative effects of their care. This syndrome is called: A) schizophrenogenesis. B) hyperinstitutionalization. C) social breakdown syndrome. D) downward drift.

C

Someone says to you, "Homeless people scare me. They're all crazy." What is your BEST response? A) "It's true that most homeless people experience a serious mental illness." B) "That's a big myth. Virtually no homeless people are truly mentally ill." C) "Unfortunately, about a third of homeless people are mentally ill." D) "You should be scared. Mentally ill homeless people are usually violent."

C

The MAIN contribution of Philippe Pinel to the care of those with severe mental illnesses was to: A) develop state hospitals for people who couldn't afford private care. B) use antipsychotic drugs in highly controlled settings. C) treat patients with sympathy and kindness. D) promote deinstitutionalization.

C

The belief that many people hear voices and that this can be a meaningful, nonpathological experience is held by: A) a representative from a pharmaceutical company. B) a psychiatrist practicing insight therapy. C) a member of the Hearing Voices Network. D) someone setting up a token economy program.

C

The discovery of antihistamine drugs in the 1940s indirectly led to the development of: A) lithium. B) antianxiety drugs. C) antipsychotic drugs. D) antidepressant drugs.

C

The first antipsychotic drug to be approved for use in the United States was: A) Haldol. B) Prozac. C) Thorazine. D) Mellaril.

C

Theorists propose that institutionalized patients deteriorate because they are deprived of opportunities to develop self-respect and independence. The therapy that counters this effect by creating an environment that encourages self-respect and responsibility is known as: A) token therapy. B) social therapy. C) milieu therapy. D) environmental enhancement.

C

Therapists who make statements such as, "It's not a real voice; it's my illness," are using a technique from the cognitive-behavioral approach that involves: A) education about the biological causes of hallucinations. B) ways of coping with unpleasant sensations. C) interpreting their hallucinations. D) challenging ideas about the power of hallucinations.

C

What do Parkinson-like symptoms, neuroleptic malignant syndrome, and tardive dyskinesia have in common? A) They are all symptoms of schizophrenia. B) They all result mostly from taking the newer antipsychotic drugs. C) They all involve disruption of motor control. D) They all can be treated with conventional antipsychotic drugs.

C

What is the MOST accurate advice you could give someone thinking about taking traditional antipsychotic medication for their schizophrenia? A) "Try psychotherapy first; it often works just as well." B) "If you have negative symptoms of schizophrenia, you can expect better results from medication." C) "Although these drugs will probably work, there are significant side effects." D) "Although these drugs work well, you probably

C

Which of the following BEST describes the effectiveness of token economy strategies? A) They are ineffective in the long run. B) They reverse the progress of schizophrenia. C) They are successful at changing the patient's behavior. D) They are successful in altering the patient's distorted thinking.

C

Which of the following is NOT a criticism of the token economy approach? A) Many studies of effectiveness do not include a control group, confounding the treatment with attention. B) Although token economy programs can change patients' delusional statements, they may not be changing delusional thoughts. C) Token economy programs do not change the behavior of the most severely ill patients. D) It is difficult for patients to make the transition from a token economy program to the community.

C

Which of the following is TRUE of state mental hospitals in the United States in the mid- twentieth century? A) They were built as places to warehouse, isolate, and punish mental patients. B) They were built in large cities so patients could stay in contact with the "real" world. C) They were overcrowded and understaffed. D) Although successful treatments were available, they were too expensive to be used.

C

Which of the following statements MOST accurately reflects current thinking about psychosis and schizophrenia? A) Psychotic behavior is best labeled as schizophrenia. B) Schizophrenia and psychosis are two distinctly different syndromes. C) People with different diagnoses can exhibit psychosis; it's not limited to schizophrenia. D) People with bipolar disorder or major depression don't exhibit psychosis; only people with schizophrenia do.

C

Who is most likely to offer the advice, "If you have the urge to yell at your 'voices' in public, do so with a cell phone up to your ear."? A) a representative from a pharmaceutical company. B) a psychiatrist practicing insight therapy. C) a member of the Hearing Voices Network. D) someone setting up a token economy program.

C

Why do some therapists believe psychotherapy is unsuccessful in treating schizophrenia? A) Schizophrenia increases the strength of most ego defense mechanisms. B) Insurance does not cover psychotherapy for patients diagnosed as schizophrenic. C) Unmedicated schizophrenics are too far removed from reality to form the relationship needed. D) Excessive dopamine interferes with the process of free association that is requisite to the success of psychotherapy.

C

If one were treated by therapists who believed that patients needed to live in a social climate that promoted productive activity, self-respect, and individual responsibility, one would be likely to be living in the: A) 1920s. B) 1930s. C) 1940s. D) 1950s.

D

If you are being treated for schizophrenia and are learning to distract yourself from the voices you hear and to reinterpret them as just a symptom of your disorder rather than reality, you are MOST likely receiving: A) psychotherapy. B) newer antipsychotic drugs. C) family therapy. D) cognitive-behavioral therapy.

D

In the original Community Mental Health Act, the place where individuals would be treated was a: A) day center. B) halfway house. C) sheltered workshop. D) community mental health center.

D

Maxwell Jones (1953) created an approach to psychotherapy of the institutionalized in London called: A) oral therapy. B) group therapy. C) a token economy. D) the therapeutic community.

D

New-wave cognitive-behavioral therapies are MOST similar to: A) milieu therapy. B) exposure and response prevention. C) covert sensitization. D) Acceptance and Commitment Therapy.

D

Research suggests that an effective treatment plan for schizophrenia should include: A) biological treatments but not psychological treatments. B) biological treatments but not sociocultural treatments. C) sociocultural treatments and psychological treatments only. D) biological treatments and psychological treatments.

D

Schizophrenics who are working in a sheltered workshop are receiving: A) coordinated services. B) partial hospitalization. C) halfway house services. D) occupational training.

D

The Community Mental Health Act stipulated that patients with mental disorders should receive all of the following except ______ without leaving their communities. A) inpatient treatment B) preventative care C) outpatient therapy D) research opportunities

D

The neuroleptic side effect marked by muscle rigidity, fever, altered consciousness, and autonomic dysfunction is called: A) dystonia. B) akathisia. C) tardive dyskinesia. D) neuroleptic malignant syndrome.

D

The person most responsible for coordinating community service and providing practical help with problem-solving social skills, and ensuring that medications are being taken properly is a: A) psychiatrist. B) clinical psychologist. C) nurse practitioner. D) case manager.

D

The term "neuroleptic" is applied to drugs that: A) cure psychosis. B) cure schizophrenia. C) have potency against depression. D) can mimic symptoms of neurological disorders.

D

Therapists who advise clients to resist following orders from their hallucinatory voices are using a technique from the cognitive-behavioral approach that involves: A) education about the biological causes of hallucinations. B) ways of coping with unpleasant sensations. C) reattribution of their hallucinations. D) challenging ideas about the power of hallucinations.

D

What is the concern regarding the changes produced by token economies? A) Many studies of token economies are methodologically flawed. B) Some patients can function in normal life but deteriorate in the hospital. C) The skills learned in the hospital may not generalize to the outside world. D) The person may have learned new behaviors without changing his distorted thinking.

D

An individual who displays serious psychotic symptoms, but would not benefit from being sent to a large state psychiatric hospital for a long period of time, would best be served by: A) short-term hospitalization in a local psychiatric unit. B) aftercare. C) a halfway house. D) a sheltered workshop.

A

If a patient's chart said the patient had extrapyramidal side effects, you would expect to see the patient showing primarily ______ dysfunction. A) motor B) cognitive C) emotional D) language

A

If a person being treated for schizophrenia goes each day to a center where the focus is on improving social skills and receiving therapy, the person is participating in: A) partial hospitalization. B) a sheltered workshop. C) a residential center. D) a support group.

A

If one could use only a single treatment for schizophrenia and wanted the MOST effective treatment, one should choose: A) antipsychotic drugs. B) psychodynamic therapy. C) milieu therapy. D) electroconvulsive therapy.

A

If you were looking for people who have schizophrenia, where would you MOST likely find them? A) living on their own, unsupervised B) in halfway houses C) on the street D) in jail

A

Social therapy appears to play the STRONGEST role in: A) lessening the possibility of relapse in those recovering from schizophrenia. B) preventing the development of schizophrenia. C) treating the positive symptoms of schizophrenia. D) giving families skills to treat their relative with schizophrenia.

A

The MOST widely used atypical antipsychotic drug is: A) Clozaril. B) Xanax. C) Thorazine. D) Prozac.

A

The most successful way to eliminate tardive dyskinesia is: A) to stop the antipsychotic medication. B) to use anti-Parkinsonian drugs to treat the side effects. C) to ignore it; it will go away eventually. D) to increase the dose of antipsychotic medication.

A

The schizophrenic symptom most likely to be relieved by antipsychotic drugs is: A) delusions. B) flat affect. C) lack of speech. D) lack of purpose.

A

What was the dominant way of treating schizophrenic people during the first half of the twentieth century? A) institutionalization B) outpatient services C) individual psychotherapy D) treatment with neuroleptic drugs

A

Which of the following drugs appears to act more at D-1 and D-4 dopamine receptors than at D-2 dopamine receptors? A) clozapine B) Thorazine C) haloperidol D) chlorpromazine

A

Which therapy is based on the premise that when you change the social environment, you can change the patient? A) milieu therapy B) insight therapy C) family therapy D) the token economy

A

Who was the first physician responsible for developing the prefrontal lobotomy for use on human patients? A) Egas Moniz B) Eliot Valenstein C) Walter Freeman D) Carlyle Jacobsen

A

If you were working with a patient who displayed muscle tremors and rigidity, facial tics, and tardive dyskinesia, you would suspect that the person was receiving: A) electroconvulsive therapy. B) antipsychotic drugs. C) milieu therapy. D) psychodynamic therapy.

B

Patients who developed extreme withdrawal, anger, physical aggressiveness, and loss of personal hygiene as a result of poor institutional care were showing a pattern known as: A) institutional deterioration. B) social breakdown syndrome. C) chronic back ward syndrome. D) schizophrenic failure to thrive.

B

Tardive dyskinesia can be overlooked because: A) its symptoms are always very subtle. B) it has symptoms that are similar to schizophrenia. C) the symptoms are manifest in different ways in different patients. D) the symptoms do not begin until after the actual brain damage has taken place.

B

The proportion of patients taking antipsychotic medication who eventually develop tardive dyskinesia is closest to: A) 1 percent. B) 10 percent. C) 20 percent. D) 50 percent.

B

The technique for treating mental patients that was pioneered by Egas Moniz was: A) ECS therapy. B) the lobotomy. C) the use of drugs. D) the cingulotomy

B

Therapists who advise clients to apply special breathing and relaxation techniques in response to their hallucinatory voices are using a technique from the cognitive-behavioral approach that involves: A) education about the biological causes of hallucinations. B) ways of coping with hallucinations. C) interpreting their hallucinations. D) challenging ideas about the power of hallucinations.

B

Tokens: A) are given by patients to other patients whom they admire. B) can be exchanged for a variety of rewards. C) are given as punishment when a patient behaves unacceptably. D) have a great street value.

B

Which of the following antipsychotic drugs appears to work at serotonin receptors? A) Haldol B) clozapine C) chlorpromazine D) the phenothiazines

B

Why were lobotomies so enthusiastically accepted by the medical community in the 1940s and 1950s? A) They were based on sound experimental studies with animals. B) The inventors of this procedure were gifted and dedicated physicians. C) There were relatively few of them and side-effects were mild. D) They could be used to control criminals as well as mental patients.

B

Helen was just discharged from a public mental health facility. She went to live with a group of other former patients in a group-living arrangement. There were staff members to help out but the former patients controlled most of the day-to-day activities. Helen's living arrangement is a: A) day center. B) halfway house. C) short-term hospital. D) sheltered workshop.

B

A family with a high level of expressed emotion may display a great deal of: A) concern. B) criticism. C) joyfulness. D) underinvolvement.

B

A person who is experiencing a potentially fatal reaction to an antipsychotic drug involving muscle rigidity and autonomic nervous system dysfunction is displaying: A) Parkinson-like symptoms. B) neuroleptic malignant syndrome. C) tardive dyskinesia. D) akathisia.

B

Based on research studies, your BEST chance at receiving a prescription for an atypical antipsychotic medication would be if you: A) have Medicare and go to a family practitioner. B) have private insurance and are treated by a psychiatrist. C) are a minority and are treated at the community mental health center. D) are white and poor.

B

Deinstitutionalization: A) did not reduce substantially the number of people in state mental hospitals. B) was aimed at returning patients with mental disorders to their communities. C) resulted in a high level of community care being offered throughout the United States. D) provided medication to schizophrenics, but not to other mental patients.

B

During a ______ a needle is inserted into the brain through the eye socket and is then rotated to destroy brain tissue. A) prefrontal lobotomy B) transorbital lobotomy C) singular nigra lobotomy D) facial-cranial lobotomy

B

Frieda Fromm-Reichmann's approach to psychotherapy with schizophrenic patients was to A) challenge patients' statements. B) build a sense of trust in the patient. C) alter the psychotic person's behavior. D) encourage specific life adjustments by providing community support services.

B

A hospitalized patient no longer talks about delusions and hallucinations, thanks to participating in a token economy program. However, critics of the token economy program would say that the token economy program has: A) worsened the negative symptoms of the disorder. B) treated the schizophrenia without medication. C) not eliminated the delusions and hallucinations, but improved the patient's ability to imitate normal behavior. D) changed a Type I disorder into a Type II disorder.

C

A patient who is called a resident who lives in a therapeutic community and actively works with staff members to create a life that is as much like that outside the hospital as possible, is probably receiving ______ therapy. A) token economy B) custodial C) milieu D) lobotomy

C

A person lives at home but spends his day at a mental health facility. The facility might be described as providing: A) aftercare. B) coordinated services. C) partial hospitalization. D) short-term hospitalization.

C

A third-grade teacher gives students stickers throughout the school day when they engage in appropriate behaviors. At the end of the day, students can trade in their stickers for treats from the class "treasure chest." This program is MOST similar to which form of therapy used for institutionalized people with schizophrenia? A) milieu therapy B) insight therapy C) token economy D) partial hospitalization

C

A token economy approach to treatment is based on principles from the abnormal behavior. A) cognitive view B) biological view C) behavioral view D) humanistic view

C

A woman has been treated with chlorpromazine for several years. Lately she seems to be chewing gum all the time and her arms are always in motion. She has begun to display twitching facial tics. This is an example of: A) dystonia. B) akathisia C) tardive dyskinesia. D) neuroleptic malignant syndrome.

C

Advantages of atypical antipsychotic drugs over conventional medications include: A) newer medications are cheaper and more easily available. B) newer medications treat Type I symptoms better. C) newer medications produce fewer extrapyramidal effects. D) newer medications focus better on dopamine receptor sites in the brain.

C

Compared to African Americans, white Americans are: A) more likely to receive conventional antipsychotic drugs for both schizophrenia and other psychotic disorders. B) more likely to receive conventional antipsychotic drugs for schizophrenia, and more likely to receive atypical antipsychotic drugs for other psychotic disorders. C) more likely to receive atypical antipsychotic drugs for both schizophrenia and other psychotic disorders. D) more likely to receive atypical antipsychotic drugs for schizophrenia, and more likely to receive conventional antipsychotic drugs for other psychotic disorders.

C

"I want to maximize the antipsychotic effect of a drug while minimizing its undesirable side effects," says a doctor. What's the BEST advice you can give the doctor? A) "Unfortunately, effective doses of conventional and atypical antipsychotic drugs both produce a lot of undesirable side effects." B) "Fortunately, effective doses of both conventional and atypical antipsychotic drugs do not produce a lot of undesirable side effects." C) "Use a conventional antipsychotic drug." D) "Use an atypical antipsychotic drug."

D

56. Why aren't atypical antipsychotic drugs universally prescribed for people with schizophrenia? After all, more people with schizophrenia show improvement with atypical antipsychotic drugs than with conventional antipsychotics. A) On average, atypicals produce more cases of tardive dyskinesia. B) On average, atypical cause more extrapyramidal symptoms. C) Most atypicals produce life-threatening agranulocytosis. D) On average, atypicals cost more.

D

A disturbed individual kills a number of people in a mass shooting. The shooter is found to be mentally ill. How likely is it that such an individual will have received mental health services in the past year? A) very likely; almost all mentally ill people do receive services B) very unlikely; although services are available, mentally ill people do not take advantage of them C) so-so; about 50 percent of people with mental illnesses receive services D) likely; although the coordination of those services is a problem

D

A person attending an HVN (Hearing Voices Network) meeting, can expect to get the message that: A) voices can be eliminated through proper treatment and medication. B) auditory hallucinations are a diagnosable sign of schizophrenia. C) family support is the best way to deal with schizophrenia. D) all interpretations of voices are equally valid.

D

Families with HIGH levels of "expressed emotion": A) are very supportive and loving. B) display all kinds of emotions, positive and negative. C) are emotionally distant. D) express negative emotions like hostility and criticism.

D

If a schizophrenic were making involuntary ticlike movements of the tongue, mouth, face, or whole body, smacking the lips, and making sucking and chewing movements, one would suspect the patient: A) was taking too much antipsychotic medication. B) was taking too little antipsychotic medication. C) had been taking antipsychotic medication for a short time. D) had been taking antipsychotic medication for a long time.

D

If one were taking antipsychotic drugs for schizophrenia, one would expect the drugs to: A) be most effective against negative symptoms of schizophrenia. B) be most effective against positive symptoms of schizophrenia. C) be given in higher doses to women than to men. D) need to be taken even after symptoms have been alleviated.

D