Chapter 15: Treatments for Schizophrenia and Other Severe Mental Disorders

The proportion of patients taking antipsychotic medication who eventually develop Tardive dyskinesia is closest to:

10 percent.

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:

1950s.

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 member from the Hearing Voices Network.

In behavioral terms, what is a token?

A reinforcer.

New-wave cognitive-behavioral therapies are MOST similar to:

Acceptance and Commitment Therapy.

An individual who displays serious psychotic symptoms, but would not benefit from being sent to a large state psychiatric for a long period of time, would best be served by:

Aftercare.

Antipsychotic drugs were discovered accidentally when researchers were trying to develop:

Antihistamines.

If one could use only a single treatment for schizophrenia and wanted the MOST effective treatment, one should choose:

Antipsychotic drugs.

A token economy approach to treatment is based on principles from the abnormal behavior:

Behavioral view.

Research suggests that an effective treatment plan for schizophrenia should include:

Biological treatments and psychological treatments.

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:

Case manager.

The MOST widely used atypical antipsychotic drug is:

Clozaril.

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:

Cognitive-behavioral therapy.

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?

Cognitive-behavioral therapy.

In the treatment of schizophrenia, a case manager's primary goal is to help with:

Coordination of services.

A family with a high level of expressed emotion may display a great deal of:

Criticism.

If a schizophrenic were making involuntary tic-like movements of the tongue, mouth, face, or whole body, smacking the lips, and making sucking and chewing movements, one would suspect the patient:

has been taking antipsychotic medication for a long time.

Based on research studies, your BEST chance at receiving a prescription for an atypical antipsychotic medication would be if you:

have private insurance and are treated by a psychiatrist.

What is the MOST accurate advice you could give someone thinking about taking traditional antipsychotic medication for their schizophrenia?

"Although these drugs will probably work, there are significant side effects."

Tardive dyskinesia can be overlooked because:

it has symptoms that are similar to schizophrenia.

Social therapy appears to play the STRONGEST role in:

lessening the possibility of relapse in those recovering from schizophrenia.

The goal of family therapy is:

to help the family better support the schizophrenic patient.

The most successful way to eliminate tardive dyskinesia is:

to stop the antipsychotic medication.

The MAIN contribution of Philippe Pinel to the care of those with sever mental illnesses was to:

treat patients with sympathy and kindness.

The usual way of dealing with troublesome or violent schizophrenic people in institutions in the first half of the twentieth century was to:

use physical restraint.

Therapists who advice 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:

ways of coping with hallucinations.

Most patients who lived on the hospital wards in state mental hospitals in the mid-1900s:

were schizophrenics.

Schizophrenics who receive 24-hour supervision in a community setting, usually following a milieu approach, are receiving:

Halfway house services.

Imagine that your neighbor, who is being treated for schizophrenia, says that she has a 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:

"Try atypical antipsychotics; they should work best."

Someone says to you, "Homeless people scare me. They're all crazy." What is your BEST response?

"Unfortunately, about a third of homeless people are mentally ill."

"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 a doctor?

"Use an atypical antipsychotic drug."

The schizophrenia symptom most likely to be relieved by antipsychotic drugs is:

Delusions.

Who was the first physician responsible for developing the prefrontal lobotomy for use on human patients?

Egas Moniz

If you and your family were receiving support, encouragement, and advice from other families with schizophrenic members, you would MOST likely be participating in:

Family psycho-educational programs.

Helen was just discharged from a public 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:

Halfway house.

What was the dominant way of treating schizophrenia people during the first half of the twentieth century?

Institutionalization

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:

Interpreting their hallucinations.

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?

Likely; although the coordination of those services is a problem.

If you were looking for people who have schizophrenia, where would you MOST likely find them?

Living on their own, unsupervised.

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 know as:

Milieu Therapy.

Which therapy is based on the premise that when you change the social environment, you can change the patient?

Milieu Therapy.

A person who is experiencing a potentially fatal reaction to an antipsychotic drug involving muscle rigidity and autonomic nervous system dysfunction is displaying:

Neuroleptic malignant syndrome.

The neuroleptic side effect marked by muscle rigidity, fever, altered consciousness, and autonomic dysfunction is called:

Neuroleptic malignant syndrome.

Schizophrenics who are working in a sheltered workshop are receiving:

Occupational training.

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.

On average, atypicals cost more.

A person lives at home but spends his day at a mental health facility. The facility might be described as providing:

Partial hospitalization.

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:

Partial hospitalization.

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:

Sheltered workshop.

A patient who receives help in finding work. in finding a place to live, and in taking medication correctly is probably receiving:

Social Therapy.

Long-term mental patients frequently developed anger, aggressiveness, and loss of interest in personal appearance. This condition has been called:

Social breakdown syndrome.

Patients who develop extreme withdrawal, anger, physical aggressiveness, and loss of personal hygiene as a result of poor institutional care were showing a pattern known as:

Social breakdown syndrome.

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:

Social breakdown syndrome.

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:

Tardive dyskinesia.

One of the unwanted and later side effects of antipsychotic medication is:

Tardive dyskinesia.

Why were lobotomies so enthusiastically accepted by the medical community in the 1940s and 1950s?

The inventors of this procedure were gifted and dedicated physicians.

What is the concern regarding the changes produced by token economies?

The person may have learned new behaviors without changing his/her distorted thinking.

The first antipsychotic drug to be approved for use in the United States was:

Thorazine.

Maxwell Jones (1953) created an approach to psychotherapy of the institutionalized in London called:

The therapeutic community.

What do Parkinson-like symptoms, neuroleptic malignant syndrome, and tardive dyskinesia have in common?

They all involve disruption of motor control.

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:

Token Economy.

The Americans Walter Freeman and James Watts "improved" the procedure developed by Egas Moniz by developing the:

Transorbital Lobotomy.

Why do some therapists believe psychotherapy is unsuccessful in treating schizophrenia?

Unmedicated schizophrenics are too far removed from reality to form the relationship needed.

The belief that many people heat voices and that this can be a meaningful, non-pathological experience is held by:

a member of the Hearing Voices Network.

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. clozapine

If a patient's chart said the patient had extrapyramidal side effect, you would expect to see the patient showing primarily ________________ dysfunction. a. motor b. cognitive c. emotional d. language

a. motor

A person attending an HVN (Hearing Voices Network) meeting, can expect to get the message that:

all interpretations of voices are equally valid.

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:

antipsychotic drugs.

The discovery of antihistamine drugs in the 1940s indirectly led to the development of:

antipsychotic drugs.

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. can be exchanged for a variety of rewards.

Which of the following antipsychotic drugs appears to work at serotonin receptors? a. Haldol b. clozapine c. chlorpromazine d. the phenothiazines

b. clozapine

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. transorbital lobotomy

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. was aimed at returning patients with mental disorders to their communities.

Frieda Fromm-Reichmann's approach to psychotherapy with schizophrenic patients was to:

build a sense of trust in the patient.

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. People with schizophrenia different diagnosis can exhibit psychosis; it's not limited to schizophrenia

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. They are successful at changing the patient's behavior.

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. They were overcrowded and understaffed.

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. Token economy programs do not change the behavior of the most severely ill patients.

Milieu therapy is based primarily on the principles of _______________ psychology. a. cognitive b. behavioral c. humanistic d. psychodynamic

c. humanistic

A patient who is called a resident who lives ina 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. milieu

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. vocational rehabilitation.

The term "neuroleptic" is applied to drugs that:

can mimic symptoms of neurological disorders.

Therapists who advise clients to resist following orders from their hallucinatory voices are using a technique from the cognitive-behavioral approach that involves:

challenging the ideas about the power of hallucinations.

The LOWEST number of extrapyramidal side effects is seen after taking:

clozapine.

In the original Community Mental Health Act, the place where individuals would be treated was a:

community mental health center.

Which of the following drugs has antipsychotic properties? a. Prozac b. Valium c. imipramine d. haloperidol

d. Haloperidol

Mindfulness is MOST similar to which of the following therapies: a. family b. medical/biological c. milieu d. cognitive-behavioral

d. cognitive-behavioral

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. research opportunites

Families with HIGH levels of "expressed emotion":

express negative emotions like hostility and criticism.

If relatives of a schizophrenic come to have more realistic expectations, reduce their guilt, and work on establishing better communication, they are probably receiving:

family therapy.

Compared to African Americans, white Americans are:

more likely to receive atypical antipsychotic drugs for both schizophrenia and other psychotic disorders.

If one were taking antipsychotic drugs for schizophrenia, one would expect the drugs to:

need to be taken even after the symptoms have been alleviated.

Advantages of atypical antipsychotics over conventional medications include:

newer medications produce fewer extrapyramidal effects.

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:

not eliminated the delusions and hallucinations, but improved the patient's ability to imitate normal behavior.

The technique for treating mental patients that was pioneered by Egas Moniz was:

the Lobotomy.

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 sever mental disorders, you would probably be attending:

the National Alliance for the Mentally Ill.