Abnormal Ch17

For every $1 spent on prevention of substance abuse, $__ is saved in future treatment costs

$10

Describe universal prevention efforts

-General public -Biological: Improve diet/exercise -Psychosocial: Problem solving skills, express emotions constructively, engage in satisfying relationships, healthy identity development, preparedness -Sociocultural: Make community safe and attractive Ex: Legal restrictions on alcohol age, school based efforts preventing drug use

Describe indicated prevention

-High risk individuals with minimal but detectable symptoms -Ex: Screening for depression in school, those at higher risk are put in group based intervention program

Describe selective prevention efforts

-Specific subgroup of the population that's at higher risk -Healthy eating aimed at girls subject to ED -Alcohol and drug advertisements to children

What % of contested felony cases end with a successful NGRI verdict

0.0005%

__% of practitioners failed to correctly identify their state's duty to warn law

76%

Describe the ALI standard and IDRA

ALI: Combines M'Naghten and I.I.; Because of a mental disorder, couldn't control behavior IDRA: Shifted the burden of proof to the prosecution of the defense

Fourteen-year-old Chuck and 17-year-old Tyler attend a D.A.R.E. presentation at their high school. Based on evaluative research, how might the program influence the incidence of substance abuse by Chuck and Tyler? Chuck and Tyler will not be deterred from using alcohol or other drugs. Chuck will be less likely than Tyler to engage in substance abuse. Chuck and Tyler will commit to abstaining from alcohol and other substances. Tyler will be less likely than Chuck to engage in alcohol or drug use.

Chuck and Tyler will not be deterred from using alcohol or other drugs.

Who was mental health america founded by?

Clifford Beers

Describe the outcome of these court rulings: Dixon vs. Weinberger Memmel vs Mundy Addington vs Texas Washington vs Harper

Dixon vs Weinberger: Right to less restrictive treatment *Chris Weinberger is free/not restricted Memmel vs Mundy: Right to due process *Ted bUNDY (like mundy) had court hearings Addington vs Texas: Need for confinement must be based on demonstrative evidence *In math, when adding you demonstrate your work Washington vs Haper: Limitations on patients rights to refuse psychotropic medication *When psychotic, often hyper (like Haper)

What is the Tarasoff decision?

Duty to warn

What did the national mental health act do?

Establish the NIMH

What states don't have NGRI?

Idaho, Montana, Kansas, Utah

Is insanity a legal or clinical term?

Legal

Describe the M'Nagthen Rule and the Irrestiable Impulse rule

M'Nagthen: Knowing right from wrong Irrestiable impulse: Lost power to control actions

Aimee has just graduated from college, and wants to spend a few years volunteering in her community before she goes on to graduate school. After doing some research, she finds an organization that was founded by Clifford Beers in 1909. She's particularly interested in the group's emphasis on recruiting, training, and placing volunteers for service in treatment and aftercare programs. What is this group that Aimee is going to join? the National Institute on the Teaching of Psychology (NITOP) the Alliance for the Mentally Ill (AMI) the National Institute on Drug Abuse (NIDA) Mental Health America

Mental Health America

What are the most effective prevention programs?

Multicomponent

What agency formed in 1946 in Washington, D.C., was originally designed to conduct research and training, administer grants for such activities elsewhere in the country, and help state and local communities improve their own attempts to provide services? National Institute of Mental Health (NIMH) Federal Emergency Management Agency (FEMA) the Centers for Disease Control and Prevention (CDC) Substance Abuse and Mental Health Services Administration (SAMHSA)

National Institute of Mental Health (NIMH)

Describe the Durham rule, is it still in effect today?

Not responsible for an unlawful act if it was the product of a mental disorder. Abolished by all states except New Hampshire

Which of the following is an element of "milieu therapy"? Teaching social skills and problem solving. Challenging irrational thoughts. Patients are encouraged to participate in making decisions. Systematic desensitization.

Patients are encouraged to participate in making decisions.

Which of the following might be a component of a biologically based universal strategy for preventing mental illness? Determining whether or not there is a family history of mental illness Reducing the amount of high-fat junk food in diets Identifying people with a particular disorder and referring them for help Offering tuberculosis testing

Reducing the amount of high-fat junk food in diets

After learning about the low rates of treatment among people with mental health problems, Frankie realizes she wants to help. However, she does not want to give up her dream of becoming a biologist. Through which of the following ways could Frankie still pursue this issue? To help, she must switch fields and pursue clinical psychology. One person cannot really make a difference, so she should focus her energy on a more manageable issue. To help, she must switch fields and pursue psychiatry. She could start volunteering at a mental hospital or community mental health center in her spare time.

She could start volunteering at a mental hospital or community mental health center in her spare time.

Who was the ICD published by?

WHO

Describe the outcomes of these court rulings: Wyatt vs Stickney Souder vs Brennan O'Connor vs Donaldson

Wyatt vs Stickney: Right to receive treatment *Stick to treatment Souder vs Brennan: Right to compensation for work *Soldier (looks like souder) get compensated for service O'Connor vs Donaldson: Freedom from custodial confinement if not dangerous *McDonald's has custodians, confined in restaurant

Today, __________ understand the laws in their state regarding duty-to-protect laws. a minority of practicing clinicians a majority of practicing clinicians all practicing clinicians a minority of lawyers

a minority of practicing clinicians

When attempting to demonstrate that a person poses a risk of engaging in behaviors that could be dangerous to themselves or others, what is one of the most predictive risk factors? an education below the eighth grade level a history of interest in violent media (e.g., television, video games, comic books) a past history of violence discontinuation of mood-stabilizing medications

a past history of violence

Susan is the director of a federally funded program that assists at-risk teens with building communication skills, enhancing academic skills, and exploring career possibilities. As what type of Institute of Medicine (IOM) strategy would Susan's program be classified? a selective intervention an affiliative intervention an indicated intervention a universal intervention

a selective intervention

A live-in facility that serves as a home base for former hospital patients as they transition back to independent functioning in the community is called a(n) __________ program. aftercare secondary tertiary care step-by-step

aftercare

Given the relatively high rates of readmission to inpatient hospitals, __________ was/were created to facilitate continuity of care and help smooth the transition from this high level of psychiatric care to community living. aftercare programs social skills training milieu therapy readjustment therapy

aftercare programs

Why have most states instituted safeguards to ensure due process for people who are subject to a petition for civil commitment? because there is no question whether the person committed the crime of which they are accused, only whether they were mentally competent at the time the crime occurred because civil commitment is based on the conclusions of others about a person's capabilities or potential for dangerous actions because research has found a very hostile bias on the part of judges and juries against the people who are subject to such petitions because people in such a circumstance are unable to afford their own legal representation

because civil commitment is based on the conclusions of others about a person's capabilities or potential for dangerous actions

The Americans with Disabilities Act mandates that people with psychiatric problems __________. cannot be discriminated against must not be required to work more than 6 hours per day must be provided with a quiet and stress-free work environment should be allowed to take time off from work without penalty in order to attend psychotherapy sessions

cannot be discriminated against

Persons who are judged to be dangerous based on their psychological state may, through the process of a __________, be confined in a hospital for psychiatric care. competency commitment restraining order competency detainment civil commitment

civil commitment

Larger corporations provide __________ in order to actively provide mental health services to employees and their family members. health maintenance organizations (HMOs) employee assistance programs (EAPs) social services managed health care

employee assistance programs (EAPs)

In some cases, inpatient treatments focus on creating a therapeutic community in which all aspects of the environment are considered a component of the treatment. This is referred to as __________. community therapy milieu therapy aftercare therapy psychosocial therapy

milieu therapy

It is increasingly agreed upon that __________ is/are the most effective in preventing complex problems, including adolescent drug and alcohol use. school-based programs family-therapy D.A.R.E. multicomponent programs

multicomponent programs

A psychologist is asked to provide expert testimony regarding whether they believe a patient might be dangerous to themselves or someone else in the future. The psychologist is likely to __________. over-predict their level of dangerousness under-predict their level of dangerousness accurately predict their level of dangerousness report being unable to accurately predict their level of dangerousness

over-predict their level of dangerousness

Predicting dangerousness is most comparable to __________. reviewing for a comprehensive examination calculating your taxes at the end of the year preparing a team for a sports competition preparing a weather forecast

preparing a weather forecast

Having skills for effective problem solving, possessing an accurate set of assumptions about oneself, and being prepared for problems one is likely to encounter at various life stages are all requirements for ________ psychosocial health. biological health. cultural adjustment. being a candidate for deinstitutionalization.

psychosocial health.

Prevention efforts that are aimed at a specific subgroup of the population considered at-risk for developing mental health problems are called __________ interventions. tertiary selective universal indicated

selective

The underlying basis of the insanity defense is ________ people who have a mental illness cannot ever form the intent needed to commit a crime, so shouldn't be punished. even if they had the required intent for a crime, the mentally ill still shouldn't be punished. some people who have a mental illness are not able to fully comprehend their behavior, so are not able to form the needed intent for a crime, so should not be punished. people who have a mental illness should not be punished.

some people who have a mental illness are not able to fully comprehend their behavior, so are not able to form the needed intent for a crime, so should not be punished.

Which volume, published by the World Health Organization, enables clinicians and researchers in different countries to use a uniform set of diagnostic categories? the Worldwide Psychopathology Index (WPI) the Transcultural Categorization of Mental Illness (TCMI) the International Classification of Diseases (ICD) the Diagnostic and Statistical Manual of Mental Disorders (DSM)

the International Classification of Diseases (ICD)

Community-based treatment often involves residential programs that are run by __________. the residents themselves trained mental health clinicians state supported social services agencies trained paraprofessionals called Human Services Workers

the residents themselves

What are the roles of the NIMH?

1. Conduct and support research 2. Support training of professionals 3. Helps communities plan, establish and maintain more effective programs 3. Provide information to public and scientific community

Being mentally ill isn't a sufficent enough cause for psychiatric admittance against their will. What else do you need?

1. Dangerous to themselves or others 2. Incapable of providing for basic needs 3. Unable to make responsible decisions regarding treatment 4. In need of treatment at a hospital

Describe the 3 components of Milieu Therapy

1. Staff expectations clearly indicated to patients 2. Patients involved in decision making 3. All patients belong to social groups for support and encouragement

How many recruits were rejected from serving in WWII because of psychiatric reasons?

2/7

According to a 2006 report by the Institute of Medicine, only __________ percent of those who face substance abuse or dependency and __________ percent of people with serious mental illness actually receive treatment for their problems. 20; 40 30; 60 50; 75 5; 25

20; 40

Which of the following scenarios could lead to sufficient grounds for involuntary commitment? A patient does not want to be hospitalized, but they are in a severe episode of depression and they only get up to use the bathroom and get one meal a day. A patient does not want to be hospitalized, but they are in a manic state and frequently engaging in dangerous behaviors (e.g., standing on the top of a tall building and saying they can fly). A patient does not want to be hospitalized, but they are using alcohol frequently and they are not able to quit drinking despite trying to several times. A patient does not want to be hospitalized, but they are on the internet gaming constantly, and they were recently fired for missing too many days of work.

A patient does not want to be hospitalized, but they are in a manic state and frequently engaging in dangerous behaviors (e.g., standing on the top of a tall building and saying they can fly).

Dana, age 28, is receiving inpatient treatment after a severe episode of depression. Partway through treatment, she learns that her mother is sick and Dana now wants to leave treatment to be with her. Although she is still experiencing substantial symptoms of depression, she can take care of herself and is not a danger to anyone. Her treatment team believes that she needs more treatment, and they advise that she does not leave treatment until it is completed. Which of the following represents what will most likely happen to Dana? Because of the right to refuse treatment, she will be allowed to leave the treatment facility within 72 hours. Because of the need for confinement, she will not be allowed to leave the treatment facility until her treatment is completed. The decision will depend on how well she conveys her desires to her treatment team. Because of the right to receive treatment, she will not be allowed to leave the treatment facility until her treatment team believes she has shown substantial improvement.

Because of the right to refuse treatment, she will be allowed to leave the treatment facility within 72 hours.

Which of the following is most likely to help reduce rates of mental illness in the U.S.? primarily focusing our efforts on identifying novel treatment approaches for mental illness in addition to work in treatments and prevention programs, working to reduce international conflicts and tensions primarily focusing our efforts on predicting who will experience mental illness rather than designing and testing new treatments, focusing efforts on reducing political conflict in the U.S.

in addition to work in treatments and prevention programs, working to reduce international conflicts and tensions

Under the __________, the accused is considered not criminally responsible for their unlawful actions if it was due to their mental illness. This rule has been abandoned by all states except New Hampshire because it is quite broad. federal insanity defense reform ACT irresistible impulse rule Durham rule American Law Institute standard

Durham rule

What are the functions of professional organizations?

Ex: APA, APS, APS, AMA -Application of insights to social problems -Establish and renew training qualifications, set standards for grad/undergrad programs, set clinical standards/insepctions, investigate unethical conduct

What was the result of the 1972 ruling in the case Wyatt v. Stickney? Individuals with mental illness or intellectual disabilities do not have a right to receive treatment. Therapists are at low risk of a lawsuit if they fail to inform others of the risk their client poses. Individuals with mental illness or intellectual disabilities have a right to receive treatment. The Tarasoff ruling has been abandoned in two-thirds of the United States.

Individuals with mental illness or intellectual disabilities have a right to receive treatment.

Which of the following best describes a key reason that the Tarasoff decision was so controversial? It requires therapists to break confidentiality with their patients. It requires therapists to do additional work on top of their traditional requirements. It requires patients to tell their therapists when they are at risk of hurting themselves or someone else. It requires therapists to value the lives of their patients over the lives of others.

It requires therapists to break confidentiality with their patients.

Which of the following is true regarding the use of mental health resources in private industry? Psychological services are provided on an extremely limited basis, even at the most elite private corporations. Private industry typically does not acknowledge the importance of mental health-promoting factors in the work place and therefore dramatically underutilizes mental health resources. Primary prevention programs have been routinely used in private industry for many decades. Many companies have recently begun providing psychological services through employee assistance programs.

Many companies have recently begun providing psychological services through employee assistance programs.

Which of the following most accurately describes the number of people receiving treatment for mental illness? Increased federal funding spent on mental health care has led to greater receipt of treatment by people suffering from mental illnesses. Most people in the U.S. receive treatment for their symptoms of mental illness. Most people seek some form of treatment for their symptoms of mental illness, but only a minority experience symptom reductions. Only a minority of people in the U.S. receive treatment for their symptoms of mental illness.

Only a minority of people in the U.S. receive treatment for their symptoms of mental illness.

Which fundamental principle underlies the insanity defense? People who cannot comprehend or control their criminal behavior should not be punished, and they have the right to refuse treatment as desired. People who cannot comprehend or control their criminal behavior should not be punished, unless they commit a serious crime (e.g., murder). People who cannot comprehend or control their criminal behavior should not be punished. People who cannot comprehend or control their criminal behavior should be provided with less severe punishments.

People who cannot comprehend or control their criminal behavior should not be punished.

Imagine there is a survey asking about drug and alcohol use that every sophomore student at your college must complete. Students who are currently using alcohol and other substances, and who experience interference in daily life because of this substance use, are chosen to complete an anonymous intervention program involving completion of online sessions. The goal of the intervention is to decrease continued use and prevent the use of other drugs. What type of intervention program is this an example of? universal intervention psychosocial intervention indicated intervention selective intervention

indicated intervention

Reggie is living in a state facility because of severe psychiatric symptoms that prevent him from living on his own. His psychiatrist recommends that he receive ECT (electroconvulsive therapy) because of the long, unremitting course of his debilitating symptoms. Reggie is concerned about the potential side effects of ECT, and he does not want to start this form of treatment. Which of the following most accurately represents Reggie's options in this scenario? Reggie can refuse ECT regardless of his psychiatrist's recommendations or concerns. Reggie cannot refuse ECT if his psychiatrist believes this is the best option. Reggie can refuse ECT unless Reggie has tried several other unsuccessful treatments and his psychiatrist believes this is the only way he will improve. Reggie can refuse ECT, but if he does, his psychiatrist can withdraw all other forms of treatment he is receiving.

Reggie can refuse ECT regardless of his psychiatrist's recommendations or concerns.

Kiera is a sophomore in college who is going through a very difficult semester. Her grandmother passed away; she has an extremely busy academic schedule with five classes, all of which seem to have unrelenting workloads; and she feels distant from all of her friends. She has been feeling sad and empty for a few weeks and isn't sure what to do. She knows that she's struggling, but her difficulties don't feel as severe as those of others she's known who sought mental health treatment. Which of the following is true about Kiera seeking mental health care at this time? It is shameful to start seeing a therapist when going through normal stressors like this. If she goes to see a therapist, she will have to tell her parents. Starting to see a therapist could help her gain skills to get through this difficult and stressful time. If she goes to see a therapist, they will tell her that her problems are not severe enough to require therapy.

Starting to see a therapist could help her gain skills to get through this difficult and stressful time.

As a result of a court case in California, the duty-to-warn rule—also called the __________ ruling (after the plaintiff in the case)—specified a therapist's responsibility in cases where there has been an explicit threat on a specific person's life. WIC-5150 Tarasoff Poddar University of California

Tarasoff

__________ funds research on mental disorders and assists communities in establishing effective mental health services. The National Association for Mental Health (NAMH) The National Institute on Mental Health (NIMH) The American Psychological Association (APA) Health Maintenance Organization (HMO)

The National Institute on Mental Health (NIMH)

__________ was established in 1948 as an international congress of nongovernmental organizations and individuals that work to promote international cooperation among governmental and nongovernmental mental health agencies. The International Alliance for the Mentally Ill The International Mental Health Alliance The World Health Organization The World Federation for Mental Health

The World Federation for Mental Health

__________ ruling states that patients cannot be held within a hospital against their will if there is clear and convincing evidence that they are not dangerous to themselves or to others. The right to refuse psychotropic treatment The right to live in a community The right to receive treatment The freedom from custodial confinement

The freedom from custodial confinement

Which of the following best describes current practices regarding therapists' "duty to warn"? Duty to warn is discretionary in all states. All but one state, Maryland, have adopted a duty to warn law. All 50 states have adopted a clear duty to warn law. There are state-specific laws regarding duty to warn, and it tends to be quite controversial.

There are state-specific laws regarding duty to warn, and it tends to be quite controversial.

What does the Arc advocate for?

Those with intellectual and developmental disabilities

Who are likely to be less compliant with aftercare programs?

Unskilled employment Nonpsychotic symptoms Have committed a crime More transient

Over the past four decades, there have been __________ patients living in psychiatric hospitals than there were previously. more severe more fewer less severe

fewer

In a verdict of __________, the charged person is sent directly to a treatment facility and, once found rational, remains in the custody of the correctional department until the full sentence has been served. guilty but mentally ill (GBMI) criminally insane (CI) not guilty by reason of insanity (NGRI) not competent but convictable (NCBC)

guilty but mentally ill (GBMI)

Effectiveness studies have found that the Drug Abuse Resistance Education Program (D.A.R.E.) __________. has an overall positive influence in deterring substance use is more effective with girls than with boys in deterring substance use is effective with deterring substance use during the middle school years but not during high school and beyond has limited success in deterring substance use

has limited success in deterring substance use

Dr. Wilcox is working with a government agency to implement psychosocial strategies aimed at enhancing the psychosocial health of a community's residents. What would be the first requirement for such psychosocial health? helping people make sure that they have the necessary education and training to hold a job that pays an adequate wage helping people acquire accurate frames of reference upon which to build their identities helping people to be adequately prepared for the kinds of problems that they are likely to encounter at different life stages helping people develop skills needed for effective problem solving, expressing emotions effectively, and engaging in satisfying relationships with others

helping people develop skills needed for effective problem solving, expressing emotions effectively, and engaging in satisfying relationships with others

Troy has been struggling with depression for the past few months. It recently became worse as he stopped attending his classes, had a big fight with his roommate, and was dumped by his boyfriend for not returning his calls. He became so overwhelmed, that he told his resident advisor that he had nothing to live for and he is planning to kill himself. Which of the following represents the type of psychiatric care that Troy will likely receive given his symptoms? community-based treatment through an aftercare program inpatient care at a psychiatric hospital outpatient treatment residential care at a psychiatric hospital

inpatient care at a psychiatric hospital

Results of Wyatt v. Stickney led to which of the following rights of patients, helping to decrease the degree to which state hospitals were more of a holding facility than a place of therapy and care? the right to refuse treatment the right to receive treatment the right to receive compensation for work the right to sue a hospital doing a poor job

the right to receive treatment

In order for community-based aftercare for psychiatric patients to be successful, __________. there must be a crisis intervention component milieu methods must be used, rather than social-learning methods the facilities must be run by mental health professionals the staff must provide a secure environment

the staff must provide a secure environment

The World Health Organization estimates that mental disorders affect more than 200 million people worldwide. Contributing to these numbers is __________. the HIV epidemic the world refugee crisis the Ebola crisis globalization

the world refugee crisis

Increasingly, there are public health campaigns involving TV commercials and advertisements that seek to promote exercising, eating healthy, and decreasing general stress. These programs are promoting good health habits to improve physical well-being. This kind of intervention is considered __________. universal indicated tertiary selective

universal

The irresistible impulse rule holds that someone may not be responsible for their acts even if they knew at the time of the criminal behavior __________, if __________. what they were doing was wrong; they lost power to control their actions what they were doing was wrong; their behavior was a product of their mental illness what they were doing was illegal; they truly believed they should do it what they were doing was illegal; they could not conform their behavior to the law's requirements

what they were doing was wrong; they lost power to control their actions