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Chapter 11: Substance-Related Disorders Multiple-Choice Questions 1. Why does it make sense to view addiction as a mental disorder? a. The symptoms reflect behaviors that involve the pathological need for a substance. b. The most effective treatments are psychological. c. Neurochemical imbalances underlie the problematic behaviors observed. d. Substance abuse frequently develops in an attempt to self-medicate negative mood states. Answer: a. The symptoms reflect behaviors that involve the pathological need for a substance. 2. Unlike psychoactive substance abuse, psychoactive substance dependence usually involves a. physiological symptoms such as tolerance and withdrawal. b. continued use despite social and occupational problems. c. pathological use of the substance. d. the use of substances that laws prohibit one from buying or using. Answer: a. physiological symptoms such as tolerance and withdrawal. 3. Henry used to become intoxicated after six drinks. Now he needs ten or twelve to get the same effect. This is an example of a. a psychoactive substance abuse disorder. b. tolerance. c. withdrawal symptoms. d. an organic impairment. Answer: b. tolerance. 4. The occurrence of withdrawal symptoms a. indicates that substance abuse has developed. b. is necessary for a diagnosis of substance abuse. c. is seen when use of any psychoactive substance is terminated. d. signals that the body has adjusted to the presence of the drug. Answer: d. signals that the body has adjusted to the presence of the drug. 5. Which of the following is a consequence of organic impairment resulting from long-term substance use, as opposed to being a consequence of drug toxicity? a. Alcohol amnestic disorder b. Alcoholic intoxication c. Amphetamine delusional disorder d. Cannabis delirium Answer: a. Alcohol amnestic disorder 6. Judd has been drinking heavily for a number of years. When he is not drinking, he experiences profuse sweating and shakes. This indicates that Judd a. has an organic impairment. b. has withdrawal symptoms when he abstains from alcohol. c. cannot be diagnosed with substance dependence. d. has developed a tolerance for alcohol. Answer: b. has withdrawal symptoms when he abstains from alcohol. 7. Which of the following is a diagnosis found in the DSM-5? a. Alcoholism b. Alcoholic Syndrome Disorder c. Substance-Interdependence Disorder d. Alcohol Use Disorder Answer: d. Alcohol Use Disorder 8. Which of the following statements about alcohol problems is accurate? a. The lifetime prevalence for alcoholism in the United States is about 30 percent. b. The average life span of an alcoholic is twelve years shorter than the average citizen. c. Although alcohol impairs motor behavior, it does not lower performance on complex cognitive tasks. d. Alcohol abuse is a "pure" disorder, with less than 5 percent of alcohol abusers having a coexisting mental disorder. Answer: b. The average life span of an alcoholic is twelve years shorter than the average citizen. 9. Which of the following statements is true about alcohol use? a. Alcoholism is extremely serious but rarely fatal. b. Alcoholism is more common in women that in men. c. Alcoholism increases the risk of suicide. d. Alcoholism is strongly associated with accidental death, but not with violent acts. Answer: c. Alcoholism increases the risk of suicide. 10. Which mental disorder is most commonly comorbid with alcoholism? a. Panic disorder b. Obsessive compulsive disorder c. Dissociative amnesia d. Depression Answer: d. Depression 11. Observed changes in drinking patterns suggest that in the future a. the ratio of male to female problem drinkers will increase. b. the ratio of male to female problem drinkers will decrease. c. the proportion of blacks that are problem drinkers will increase. d. the proportion of blacks that are problem drinkers will decrease. Answer: b. the ratio of male to female problem drinkers will decrease. 12. Of the following, who is most likely to be an alcoholic? a. A woman with no criminal history b. A woman with multiple children c. A male with a personality disorder d. A male with multiple children Answer: c. A male with a personality disorder 13. Alcohol's effects on ___________ explain its ability to impair judgment. a. dopamine b. epinephrine c. glutamate d. endogenous opioids Answer: c. glutamate 14. At low levels, alcohol's effect on the brain is ________; at higher levels, alcohol's effect is ________. a. to inhibit glutamate (an excitatory neurotransmitter); release opium-like endorphins b. too minimal to have an impact; massive and excitatory c. depressive; excitatory d. to activate the brain's “pleasure centers”; depress brain functioning Answer: d. to activate the brain's "pleasure centers"; depress brain functioning 15. Alcoholic blackouts a. cause hangovers. b. are seen only with heavy drinking. c. can occur with just moderate drinking. d. only happen when alcohol dependence has developed. Answer: c. can occur with just moderate drinking. 16. What evidence is there that the legal definition of alcohol intoxication (a blood alcohol content of 0.08) should be changed? a. Most alcohol-related accidents occur at much lower blood alcohol levels. b. Most alcohol-related accidents occur at much higher blood alcohol levels. c. Few people show any impairment at this blood alcohol level. d. Judgment becomes impaired long before this blood alcohol level is reached. Answer: d. Judgment becomes impaired long before this blood alcohol level is reached. 17. The typical course of alcohol-related disorder a. is always a continuous and gradual decline. b. is a rapid decline followed by abstinence. c. is a gradual decline followed by increasing physical problems. d. is varied but often progresses from early to late stage disorder. Answer: d. is varied but often progresses from early to late stage disorder. 18. Passing out from a high blood level of alcohol a. may actually be a safety device. b. means a person has not yet developed tolerance. c. means that a person’s blackouts have worsened and increased over time. d. may be the result of an allergic reaction to alcohol. Answer: a. may actually be a safety device. 19. Which of the following is a misconception about alcohol? a. A person with a strong will cannot become an alcoholic. b. Alcohol can interfere with sleep. c. Mixing different types of alcohol does not make people more drunk than the same amount of a single type. d. Drinking coffee does not counteract the effects of alcohol. Answer: a. A person with a strong will cannot become an alcoholic. 20. Which of the following best explains why women tend to not "hold their booze" as well as men? a. Women tend to eat less. b. Women metabolize alcohol less quickly than men. c. Women usually drink more quickly than men. d. Women tend to drink mixed drinks, while men prefer beer. Answer: b. Women metabolize alcohol less quickly than men. 21. Cirrhosis of the liver a. is a rare complication of alcoholism. b. is due to an allergic-type reaction of the body to alcohol. c. is caused by overworking the liver trying to assimilate large amounts of alcohol. d. is debilitating but rarely fatal. Answer: c. is caused by overworking the liver trying to assimilate large amounts of alcohol. 22. Heavy drinking during pregnancy, especially the early part, often causes a. Down syndrome in the child. b. incomplete fusion of the spinal canal in the child. c. aggressiveness and withdrawal in the child. d. premature birth and higher rates of still-births. Answer: c. aggressiveness and withdrawal in the child. 23. Malnutrition a. does not occur in alcoholics since alcohol provides both calories and nutrients. b. only occurs when alcoholics are destitute and not able to afford to purchase food. c. may occur in alcoholics since alcohol interferes with the body's ability to use nutrients. d. is rare among alcoholics because alcohol is most commonly consumed with food. Answer: c. may occur in alcoholics because alcohol interferes with the body's ability to use nutrients. 24. Bertha has been drinking to excess for many years. She is malnourished. This is because a. alcohol has few calories. b. alcohol impairs the body's ability to utilize nutrients. c. alcoholism impairs her ability to choose healthy foods. d. alcoholism causes people to lose their appetites. Answer: b. alcohol impairs the body's ability to utilize nutrients. 25. Alcohol amnestic disorder may occur due to a. low thiamine levels. b. decreased GABA levels. c. high opioid levels. d. impaired serotonergic functioning. Answer: a. low thiamine levels. 26. Alcohol withdrawal delirium a. occurs when alcohol and other drugs are used simultaneously. b. most commonly occurs in alcoholics who suffer from a mood or personality disorder. c. typically lasts from three to six days. d. is characterized by dissociative and amnesic symptoms. Answer: c. typically lasts from three to six days. 27. Your text describes two commonly recognized psychotic reactions to alcohol. They are a. alcoholic tolerance and alcoholic withdrawal. b. what used to be called "alcohol dependence" and "alcohol withdrawal." c. what used to be called "delirium tremens" and "Korsakoff's psychosis." d. alcohol intoxication and alcohol amnestic disorder. Answer: c. what used to be called "delirium tremens" and "Korsakoff's psychosis." 28. Korsakoff's psychosis is now known as a. alcoholic withdrawal. b. alcohol withdrawal delirium. c. delirium tremens. d. alcohol amnestic disorder. Answer: d. alcohol amnestic disorder. 29. When John stopped drinking after his last week-long binge, he became very ill. He was disoriented, hallucinating, and paranoid. John seems to be experiencing a. a severe hangover. b. alcohol withdrawal delirium. c. alcohol amnestic disorder. d. alcohol-induced psychosis. Answer: b. alcohol withdrawal delirium. 30. Betty was admitted to the hospital in a state of withdrawal from alcohol. She was diagnosed with alcohol withdrawal delirium (formerly known as delirium tremens). She most likely showed which of the following behaviors? a. Delusions of grandeur and an inability to get to sleep b. Disorientation for time and place and vivid hallucinations c. Severe memory deficit and the tendency to falsify reporting events (confabulation) d. Prolonged sleep followed by convulsions and heart failure Answer: b. Disorientation for time and place and vivid hallucinations 31. The central feature of alcohol amnestic disorder is a. the presence of hallucinations. b. a deep sleep, following which the individual has no memory of past events. c. acute fear and extreme suggestibility. d. a memory defect for recent events. Answer: d. a memory defect for recent events. 32. Concerning the causes of alcoholism, a. there are probably several different patterns of causes associated with several different types of alcohol dependence. b. there is strong evidence that individuals at risk for alcohol dependence inherit a faulty metabolism. c. most research evidence points to genetic liability as the primary cause of alcohol dependence in men, but not in women. d. the causes of alcohol dependence are primarily psychosocial rather than biological in nature. Answer: a. there are probably several different patterns of causes associated with several different types of alcohol dependence. 33. All drugs that people become dependent upon a. are socially acceptable. b. act on pleasure pathways in the brain. c. provide the user with renewed energy. d. produce withdrawal symptoms when use is ceased. Answer: b. act on pleasure pathways in the brain. 34. What is the role of the mesocorticolimbic dopamine pathway (MCLP)? a. It is the area of the brain that is activated by drugs and that produces euphoria. b. It is the area of the brain that is destroyed by alcohol and leads to amnestic disorder. c. It metabolizes all psychoactive drugs. d. It explains why genetically vulnerable individuals have altered brain wave patterns. Answer: a. It is the area of the brain that is activated by drugs and that produces euphoria. 35. Studies of the genetics of alcoholism a. have not provided support for the notion that a susceptibility to alcoholism can be inherited. b. are not able to determine if the tendency of alcoholism to "run in families" is a result of environmental or biological factors. c. suggest that an inherited altered sensitivity to alcohol might create a vulnerability to alcohol abuse. d. have identified the gene that causes alcoholism. Answer: c. suggest that an inherited altered sensitivity to alcohol might create a vulnerability to alcohol abuse. 36. James has two alcoholic parents. Research suggests that his risk for alcoholism is a. nearly 100 percent. b. greater than if he had one alcoholic parent. c. no greater than if he had one alcoholic parent. d. about 10 percent higher than if he had no alcoholic parents. Answer: b. greater than if he had one alcoholic parent. 37. Men who are at high risk for becoming alcoholics a. experience more pleasure when they ingest alcohol than non-alcoholic men. b. experience greater lessening of feelings of stress after alcohol consumption than non-alcoholic men. c. tend to be more impulsive than the general population. d. respond less dramatically to alcohol related-cues than non-alcoholic men. Answer: b. experience greater lessening of feelings of stress after alcohol consumption than non-alcoholic men. 38. Which of the following men has an alcohol-risk personality? a. Tim, who is shy, anxious, and withdrawn. b. Brian, who is organized, detail-oriented, and ambitious. c. Sean, who is impulsive, risk-taking, and poor at planning. d. Art, who is frequently depressed and has a low level of self-esteem. Answer: c. Sean, who is impulsive, risk-taking, and poor at planning. 39. Rates of alcoholism among Asian populations are ___________ than among European peoples. This fact may be related to ________. a. higher; genetic differences in the sensitivity of the MCLP b. higher; genetic differences in the ability to metabolize alcohol c. lower; religious differences in the acceptability of alcohol d. lower; a mutant enzyme that leads to hypersensitive reactions to alcohol Answer: d. lower; a mutant enzyme that leads to hypersensitive reactions to alcohol 40. The "alcohol flush reaction" a. is seen during alcohol withdrawal. b. produces a spike in blood pressure and body temperature. c. results from an inability to metabolize alcohol. d. might explain the reduced rate of alcoholism seen among Native American peoples. Answer: c. results from an inability to metabolize alcohol. 41. One limitation on the findings of genetic influences on alcoholism is that a. not enough research has been done using twins. b. there are so many cultural differences in the use of alcohol that it blurs the genetic differences. c. there have not been enough studies of the majority of children of alcoholics (those who do not become alcoholics). d. there has been too much of a focus on the study of the non-alcoholic children of alcoholics. Answer: c. there have not been enough studies of the majority of children of alcoholics (those who do not become alcoholics). 42. Which of the following is a common personality characteristic of those who later abuse alcohol? a. overly sensitive to the feelings of others b. high tolerance for frustration c. strong need for praise and admiration d. over-certainty of ability to fulfill expected gender roles Answer: c. strong need for praise and admiration 43. Which parenting skill or parental behavior is most associated with adolescent substance use? a. Overindulging children by giving them too many gifts and privileges b. Restricting children from any form of experimentation with alcohol and other drugs c. Restricting the expression of positive emotions d. Lack of monitoring the adolescent's activities Answer: d. Lack of monitoring the adolescent's activities 44. Persons at high risk for developing alcohol-related problems tend to be more ___________ than those at low risk. a. impulsive b. vain c. dependent d. submissive Answer: a. impulsive 45. Which statement about alcohol abuse disorders and other psychological disorders is accurate? a. Since alcohol has a negative effect on neurotransmitters, it is extremely rare for people with schizophrenia to become alcohol or drug dependent. b. Since alcohol has an anti-anxiety effect, most of the people who are alcohol dependent and have another disorder suffer from generalized anxiety disorder. c. The personality disorder most often associated with alcohol abuse is antisocial personality disorder. d. The personality disorder most often associated with alcohol abuse is obsessive compulsive personality disorder. Answer: c. The personality disorder most often associated with alcohol abuse is antisocial personality disorder. 46. The individual with which of the following diagnoses is most likely to also abuse alcohol? a. Borderline personality disorder b. Antisocial personality disorder c. Dissociative identity disorder d. Somatization disorder Answer: b. Antisocial personality disorder 47. Rosa comes to you for treatment of her alcohol abuse. You suspect that she might have some other disorder as well. Why is it important for you to evaluate her status? a. Treating another disorder, when present along with alcohol abuse, usually clears up the excessive drinking as well. b. Her genetic liability may be much stronger if the alcohol abuse is the only disorder. c. The other disorder should be treated first. d. The co-occurrence of another mental disorder has a very significant effect on treatment outcome. Answer: d. The co-occurrence of another mental disorder has a very significant effect on treatment outcome. 48. According to the tension-reduction explanation for alcoholism, a. alcoholics drink more because they are under greater stress. b. all those who experience stress-reduction following alcohol consumption are at an increased risk for alcoholism. c. alcoholics do not get "high" when they drink, they merely experience a decrease in negative mood states. d. alcohol's ability to alleviate tension should be enhanced in those with a genetic susceptibility to alcoholism. Answer: b. all those who experience stress-reduction following alcohol consumption are at an increased risk for alcoholism. 49. The tension-reduction model of alcoholism a. does not explain why some excessive drinkers are able to maintain control over their drinking while others are not. b. suggests that alcoholism is environmentally determined. c. proposes that alcoholism is an incurable disease. d. provides an explanation for the role that personality traits play in the development of alcohol abuse. Answer: a. does not explain why some excessive drinkers are able to maintain control over their drinking while others are not. 50. The reciprocal influence model of alcohol use suggests that a. expectancies of social benefit can influence adolescents to begin or to continue drinking. b. the final common pathway of alcohol use is motivation. c. alcoholics are especially intolerant of stress, and thus susceptible to the tension-reducing properties of alcohol. d. marital partners may enable one another to continue drinking. Answer: a. expectancies of social benefit can influence adolescents to begin or to continue drinking. 51. The reciprocal influence model is best described as a ___________ explanation for teen drinking. a. behavioral b. cognitive c. psychodynamic d. sociocultural Answer: b. cognitive 52. The reciprocal influence model suggests that a. teens will start drinking early no matter what. b. it may be possible to interrupt the cycle by changing expectancies about drinking. c. it would be hard to interrupt the cycle because most teens’ expectancies about drinking are accurate. d. even with different expectancies, teens still drink. Answer: b. it may be possible to interrupt the cycle by changing expectancies about drinking. 53. Problematic drinking behavior commonly develops during a. a period of great success in an individual's life. b. old age. c. crisis periods in a marriage or other intimate personal relationship. d. the transition to middle age. Answer: c. crisis periods in a marriage or other intimate personal relationship. 54. A moderating variable is a. something that makes a person more or less likely to inherit a disorder such as alcoholism. b. something that influences the connection between two other variables. c. something that causes alcoholics not to have as strong a reaction to alcohol as earlier. d. something that causes some alcoholics not to have as much impairment as others. Answer: b. something that influences the connection between two other variables. 55. An example of a moderating influence would be a. the effect of time on outcome expectancy about alcohol. b. a wife enabling her husband to continue drinking by making excuses for him. c. a gene that reduces the chances of a person becoming an alcoholic. d. the impact of therapy on the divorce and suicide rates of alcoholics. Answer: a. the effect of time on outcome expectancy about alcohol. 56. Bill is an alcoholic. His wife, Marge, has a lot of ready excuses she uses to explain to his boss, their friends, and their children to explain his frequent absences. This is an example of a. how marriages of alcoholics often last a long time. b. why treatment needs to include identifying factors that may encourage drinking. c. how marriage can increase the risk of alcoholism. d. why most alcoholics rate their marriages as successful. Answer: b. why treatment needs to include identifying factors that may encourage drinking. 57. Binge drinking in college a. is not as common as most people think. b. leads to alcoholism later in life. c. can lead to many alcohol-related health and life problems. d. leads to more problems for men than women. Answer: c. can lead to many alcohol-related health and life problems. 58. The incidence of alcoholism among Muslims and Mormons is low because a. individuals who practice these religions are likely to live in areas where alcohol is not readily available. b. these religions prohibit alcohol consumption. c. members of both groups are likely to have inherited an inability to metabolize alcohol properly. d. strong family and community bonds protect these populations from all psychological disorders. Answer: b. these religions prohibit alcohol consumption. 59. Which of the following countries has the highest per capita rate of alcohol consumption? a. Argentina b. France c. Germany d. United States Answer: b. France 60. Which of the following is the most significant barrier to getting an alcoholic into treatment? a. The availability of alcohol b. The detoxification process c. Overcoming denial d. Finding a suitable treatment program Answer: c. Overcoming denial 61. Why might opiate antagonists be used in the treatment of alcoholism? a. To minimize withdrawal b. To minimize cravings c. To make alcohol aversive d. To prevent alcohol from acting on the brain's reward system Answer: b. To minimize cravings 62. What complicates the use of Antabuse in the treatment of alcoholism? a. While it lessens cravings, it does nothing to improve negative mood states. b. There is a risk of dependence. c. It has to be administered intravenously. d. Exposure to all alcohol must be avoided. Answer: d. Exposure to all alcohol must be avoided. 63. Randy has been dependent on alcohol for at least ten years. Drinking has ruined his marriage, his occupational standing, and his health. If a friend told Randy that he needed to enter treatment, and Randy responded the way most alcohol dependent people do, he would probably say a. "Alcohol is my enemy but I don't think I am strong enough to combat it." b. "I have an addictive personality and without help, I will never overcome my addiction." c. "You have a very good point; I need to do some serious thinking about getting treatment." d. "Who do you think you are attacking me? You are the one with the problem." Answer: d. "Who do you think you are attacking me? You are the one with the problem." 64. Adam and Beth are both being treated for alcohol dependence by being given medications. Adam's medication makes him vomit if he drinks after taking it. Beth's medication reduces her craving for alcohol. Most likely Adam is taking ________; Beth is taking ________. a. methadone; Naltrexone b. Naltrexone; methadone c. methadone; Antabuse d. Antabuse; Naltrexone Answer: d. Antabuse; Naltrexone 65. The first stage in the treatment of any form of substance dependence is a. group psychotherapy. b. treating physical withdrawal symptoms. c. the use of Antabuse. d. the administration of antidepressants. Answer: b. treating physical withdrawal symptoms. 66. Aversive conditioning for alcoholics a. punishes the alcoholic for drinking by making him or her sick after drinking. b. uses educational and life skills training to help the alcoholic understand the negative aspects of drinking. c. includes family members to try to help the alcoholic understand the harm his or her behaviors have done. d. involves pairing alcohol with something unpleasant like electric shock. Answer: d. involves pairing alcohol with something unpleasant like electric shock. 67. Controlled drinking - teaching alcoholics to drink in moderation - a. has been generally accepted as a useful treatment. b. is incorporated in Brief Motivational Intervention c. works better than complete abstinence. d. seems to work well for all types of alcoholics. Answer: b. is incorporated in Brief Motivational Intervention. 68. "I am a person who has an affliction-I cannot drink like social drinkers. Spiritual change may help me in recovering from my addiction, but I will be an alcoholic for life." The person who said this would feel most comfortable in ________. a. relapse prevention b. Alcoholics Anonymous c. aversive conditioning treatment d. a replacement program Answer: b. Alcoholics Anonymous 69. In contrast to some other treatment programs, Alcoholics Anonymous a. offers both group and one-on-one support. b. is successful, but only with severe alcoholics who have "hit bottom." c. uses primarily psychodynamic interventions, although advocates of AA would disagree. d. has a low dropout rate. Answer: a. offers both group and one-on-one support. 70. Which statement about Project MATCH is accurate? a. It showed that matching a client's personality to a form of treatment makes no difference. b. It proved that treatment based on Alcoholics Anonymous is superior to other forms of treatment. c. It showed that treatments only work when they are carefully matched with the personality profiles of the clients in them. d. It proved that therapists must establish warm relationships with their clients in order for therapy to be effective. Answer: a. It showed that matching a client's personality to a form of treatment makes no difference. 71. Which type of treatment for alcoholism has been found to be most effective? a. Inpatient treatment b. Outpatient treatment c. Twelve-step programs d. All were about equal Answer: d. All were about equal 72. The abstinence violation effect is a. the relapse rate percentage used in treatment outcome studies of addicts. b. the effect that physiologically addicting drugs have in making continued abstinence difficult. c. the tendency of an abstainer to relapse completely after a minor transgression. d. the Alcoholics Anonymous phrase for relapsing. Answer: c. the tendency of an abstainer to relapse completely after a minor transgression. 73. What type of treatment focuses primarily on clients learning to recognize situations that are likely to trigger drinking? a. Alcoholics Anonymous b. Motivational Enhancement Therapy c. Relapse Prevention Treatment d. Abstinence Violation Prevention Answer: c. Relapse Prevention Treatment 74. Which of the following is a narcotic? a. Alcohol b. Codeine c. Marijuana d. Tobacco Answer: b. Codeine 75. Who has the highest self-reported quit rate among smokers? a. Young adults who have just started smoking b. People who used nicotine replacement such as gum c. People who were hospitalized for cancer or lung problems d. People who underwent cognitive behavior treatment Answer: c. People who were hospitalized for cancer or lung problems 76. Why are estimates of the prevalence of drug dependence likely to be inaccurate? a. Many people who think they have a problem don't. b. Twelve-step programs have become the treatment of choice. c. Treatment is often not available when it is sought. d. Many people do not seek help. Answer: d. Many people do not seek help. 77. Which of the following is both a stimulant and a hallucinogen? a. Amphetamine b. Cocaine c. Ecstasy d. Mescaline Answer: c. Ecstasy 78. Which of the following drugs is MDMA structurally similar to? a. Methamphetamine and LSD b. Cocaine and mescaline c. Methamphetamine and mescaline d. Cocaine and LSD Answer: c. Methamphetamine and mescaline 79. Drug abuse and dependence are most common in what age group and in what type of community? a. Childhood; rural communities b. Adolescence and young adulthood; college communities c. Middle age; affluent suburban communities d. Adolescence and young adulthood; affluent suburban communities Answer: b. adolescence and young adulthood; college communities 80. Opium and heroin a. were originally used by physicians as pain relievers. b. have always been two of the most abused illegal drugs. c. induce euphoria but do not reduce pain. d. control pain only if they are used to cause unconsciousness. Answer: a. were originally used by physicians as pain relievers. 81. In 2005, which of the following accounted for 10 percent of all drug-related emergency room admissions? a. Cocaine b. Ecstasy c. Barbiturates d. Heroin Answer: d. Heroin 82. Opium and its derivatives a. typically take several months to produce physiological cravings. b. cause withdrawal symptoms within approximately 8 hours of the last dose. c. always cause near fatal withdrawal symptoms. d. cause amnesia with long-term use. Answer: b. cause withdrawal symptoms within approximately 8 hours of the last dose. 83. Which of the following makes treatment of dependence on heroin especially challenging? a. The severity of the withdrawal b. The likely involvement of the user in a drug-using subculture c. The lack of a means of minimizing cravings d. The high probability that the user is also dependent on other drugs Answer: b. The likely involvement of the user in a drug-using subculture 84. The main reason addicts gave for using heroin was a. pleasure. b. pain reduction. c. depression. d. mental illness. Answer: a. pleasure. 85. Endorphins a. have been found to play a role in ending drug use. b. are opium-like substances produced by the body. c. are opium-like substances created synthetically to replace heroin. d. are overproduced in the brains of addicts. Answer: b. are opium-like substances produced by the body. 86. The use of methadone in the treatment of heroin dependence is comparable to a. using naltrexone to treat alcoholism. b. using Antabuse to treat alcoholism. c. using a nicotine patch to aid in smoking cessation. d. using antidepressants as an aid to smoking cessation. Answer: c. using a nicotine patch to aid in smoking cessation. 87. Tina has been using cocaine for many months. She decides to stop. She can expect a. to have no withdrawal symptoms. b. to have a strong psychological need for the drug but no withdrawal symptoms. c. to have increased heart rate, memory problems, and possibly death. d. to have depression, fatigue, disturbed sleep, and increased dreaming. Answer: d. to have depression, fatigue, disturbed sleep, and increased dreaming. 88. "Crack" is a form of a. amphetamine. b. cocaine. c. ecstasy. d. methamphetamine. Answer: b. cocaine. 89. Which statement about crack cocaine use is accurate? a. Because crack cocaine is inexpensive, users do not have the life problems seen in other addicted populations. b. Chronic users develop sexual dysfunctions and a disinterest in sex. c. Fetal crack syndrome is as distinct and damaging as fetal alcohol syndrome. d. Because crack cocaine is associated with passivity and depression, chronic users are less likely to die a violent death than other addicted populations. Answer: b. Chronic users develop sexual dysfunctions and a disinterest in sex. 90. Children of mothers who use crack a. are likely to have fetal crack syndrome. b. usually have no physical or mental problems. c. are at risk for being mistreated by their mothers. d. are at higher risk for anxiety disorders and ADHD. Answer: c. are at risk for being mistreated by their mothers. 91. Benzedrine is a(n) a. amphetamine. b. appetite stimulant. c. narcotic. d. cough suppressant. Answer: a. amphetamine. 92. Today physicians occasionally prescribe amphetamines for which of the following reasons? a. Weight gain. b. Staying awake, such as to drive or study. c. Treating narcolepsy. d. Treating depression in children. Answer: c. Treating narcolepsy. 93. Amphetamine psychosis resembles a. acute hypertension. b. Korsakoff's syndrome. c. paranoid schizophrenia. d. borderline personality disorder. Answer: c. paranoid schizophrenia. 94. Which of the following has legitimate medical uses, but is associated with both physiological and psychological dependence and lethal overdoses? a. Cocaine b. Barbiturates c. Heroin d. LSD Answer: b. Barbiturates 95. Which of the following is most likely to be used to produce sleep? a. Barbiturates b. Mescaline c. Morphine d. Codeine Answer: a. Barbiturates 96. Impaired memory and concentration, sluggishness, lack of motor coordination, and brain damage are side effects associated with excessive use of a. stimulants. b. antihistamines. c. sedatives. d. antidepressants. Answer: c. sedatives. 97. Which of the following people is most likely to be dependent on barbiturates? a. A teenaged boy who is often impulsive and aggressive b. An undereducated member of a minority group who has antisocial personality disorder c. An anxious young adult who takes the drugs to feel more confident d. Middle-aged and older persons who cannot get to sleep without them Answer: d. Middle-aged and older persons who cannot get to sleep without them 98. Barbiturate withdrawal a. is similar to withdrawal from cocaine and opium. b. is more dangerous and long-lasting than most drugs. c. causes psychological distress but no withdrawal symptoms. d. lasts for a short time but is very painful. Answer: b. is more dangerous and long-lasting than most drugs. 99. Barbiturate withdrawal a. usually last several months. b. are purely psychological. c. are far less serious than opiate withdrawal. d. can be minimized by administering another drug. Answer: d. can be minimized by administering another drug. 100. The drug that can create a state most like psychosis is a. amphetamine. b. LSD. c. heroin. d. marijuana. Answer: b. LSD. 101. An involuntary reoccurrence of perceptual distortions can occur weeks or months after taking a particular drug. The phenomenon is called ________; the drug is called ________. a. amphetamine psychosis; amphetamine b. a flashback; LSD c. a rush; LSD d. a blackout; alcohol Answer: b. a flashback; LSD 102. Brendan has been using marijuana daily for more than six years. If he stops using the drug, we may expect a. withdrawal-like symptoms such as nervousness and changes in sleeping and eating. b. a period of extreme depression and lethargy, but no physiological symptoms. c. a potentially lethal withdrawal phase. d. slowed reaction times, increased heart rate, and memory dysfunction. Answer: a. withdrawal-like symptoms such as nervousness and changes in sleeping and eating. 103. “Spice,” “K2,” and “Blaze” are names for __________. a. MDMA b. LSD c. Synthetic marijuana d. Cannabis Answer: c. Synthetic marijuana Fill-in-the-Blank Questions 1. Substance abuse usually involves an excessive use of a substance, while __________ usually involves a marked physiological need for the substance. Answer: substance dependence 2. An alcohol-related psychosis that was previously called Korsakoff's syndrome is __________. Answer: alcohol amnestic disorder 3. The __________ is the center of psychoactive drug activation in the brain. Answer: mesocorticolimbic dopamine pathway (MCLP) 4. A processed derivative of cocaine is __________. Answer: crack 5. __________ are an opium-like substance that the body produces. Answer: Endorphins Short Answer Questions 1. Name and describe the two factors that are seen when a person has a physiological need for a psychoactive substance. Answer: Tolerance: the need for increased amounts of the substance to gain the desired effect. Withdrawal: physical symptoms such as sweating or tremors that occur when a person abstains from the substance. 2. What is alcohol's effect on the brain at low doses? What is its effect at high doses? Answer: At low doses, alcohol activates the brain's "pleasure center," which releases endorphins and produces a sense of well-being. At higher doses, alcohol depresses the excitatory neurotransmitter, glutamate, which slows brain activity. The effect is that it impairs learning, judgment, and self-control. At higher levels coordination, speech, and vision are impaired. Eventually, a person passes out. If he or she does not, at concentrations above 0.55 percent, alcohol poisoning is fatal. 3. Nutritional deficiencies are common in alcoholics. Provide two different reasons for this. Answer: Alcohol is high in calories, but has no real nutritional value. Thus, the alcoholic may not eat properly. Alcohol also compromises the body's ability to use ingested nutrients, so even if food high in nutritional value is ingested, the nutrients will not be fully available to the body. 4. What causes alcohol amnestic disorder? Answer: Alcohol amnestic disorder, also known as Korsakoff's syndrome, is a result of a lack of vitamin B (thiamine). 5. How do substances such as alcohol and cocaine have an overpowering hold on people, sometimes after only a few uses? Answer: 1. Ability to activate areas of pleasure in the brain. 2. People's biological makeup, such as genes, and their environmental influences make them more susceptible. 6. What factors might be inherited that put one at greater risk for developing alcoholism? Answer: It has been demonstrated that personality variables such as impulsiveness and emotional instability might be associated with a greater likelihood of developing alcoholism. Physiological differences in responses to alcohol have also been seen in pre-alcoholic men with a family history of alcoholism. It may be that those who are vulnerable to alcoholism derive more pleasure from alcohol use and/or may have a larger conditioned response to alcohol-related cues. 7. Why does the tension reduction hypothesis fail to explain the development of alcohol dependence? Answer: If the sole explanation for the development of alcoholism could be accounted for by the ability of alcohol to alleviate stress, the incidence of alcoholism would be much higher than it is. 8. What evidence is there that cultural attitudes play a role in the development of alcohol abuse? Answer: Cultural factors can either decrease or increase the likelihood of alcohol abuse. Muslims and Mormons prohibit alcohol use, and Orthodox Jews limit its use to religious rituals. All three groups have very low rates of alcoholism. In Europe, where half the alcohol in the world is consumed, alcohol abuse is a big problem. France has the highest per capita alcohol consumption and death rate from cirrhosis. 9. Name and describe the effects of two medications used in the treatment of alcohol dependence. Answer: Disulfiram (Antabuse): This drug deters drinking because it causes violent vomiting if a person drinks after having it in the system. Naltrexone: This opiate antagonist helps reduce the craving for alcohol and lowers the incentive to drink. 10. Describe and give an example of the abstinence violation effect? Answer: Just as when one cheats on a diet there may be a tendency to engage in a binge, the same is often seen when the abstinent alcoholic slips. A single drink, a violation of abstinence, is likely to result in a binge, and a loss of many gains achieved in treatment as the violation of abstinence is viewed as a sign of failure. 11. Briefly characterize the personality of the typical compulsive gambler. Answer: He or she is immature, rebellious, unconventional, perhaps somewhat psychopathic, unrealistic, sensation seeking, and makes extensive use of rationalizations. He or she is probably experiencing difficulty at home and at work. This person has a strong need for adulation and recognition. Certain ethnic groups, including Southeast Asian refugees, are at higher risk. Essay Questions 1. Identify and describe the disorders that an "addict" might be diagnosed with according to the DSM-5. Answer: While the DSM-5 does not include diagnoses of addict or alcoholic, it combines the distinctions of substance abuse and substance dependence into one new label,for each substance (e.g., alcohol use disorder). Substance abuse involves pathological use of a substance resulting in potentially hazardous behavior, or in continued use despite a persistent social, psychological, occupational, or health problem. Substance dependence is characterized by evidence of physiological dependence. When physiological dependence has developed, tolerance and/or withdrawal are seen. Other features of substance dependence include taking larger amounts of the substance than intended, having an inability to cut down use, spending more time on drug-related activities and less on important social and occupational activities, and continued use despite knowledge of physical of psychological problems caused by the drug. For example, in the DSM-5 diagnosis of alcohol use disorder an individual would only need to meet two of these criteria (as they pertain to alcohol) to receive the diagnosis. 2. What do all abused substances have in common? What are some inherited factors that might lead to an increased vulnerability to substance abuse? Answer: It would be expected that abused substances would share some common effects on the brain, and there is evidence of this. It appears that drugs such as alcohol, cocaine, and opium all act on a system in the brain that is involved in pleasure. Thus, these drugs act on a system in the brain that normally serves to reward behaviors that are beneficial. While psychoactive drugs may have similar effects in the brain of everyone, there is evidence that those with a genetic predisposition for substance abuse may show an altered response to drugs. Males who are genetically predisposed to develop alcoholism, for example, appear to feel greater stress reduction than others when they drink alcohol and show other physiological differences in how they respond to alcohol. It is believed that these differences can explain the observed role of genes in the development of substance use disorders. Altered drug responsiveness, as well as personality traits, may be inherited and result in a greater risk of substance abuse and dependence. 3. What is the evidence for and against genetics in alcoholism? Answer: Having one or two parents with alcoholism increases the risk of a child also having it. Adopted children whose biological parent had alcoholism had higher risk than if their biological parent did not have alcoholism, even if their adoptive parent did. Differences have been found in pre-alcoholic men - men with alcoholic parents who are not yet alcoholic - such as different physiological reactions to alcohol and greater conditioned response to alcohol cues. Certain ethnic groups have abnormal physiological reactions to alcohol that seem to make them more or less likely to develop alcoholism. However, genetics cannot fully explain the patterns and changes in alcoholism. Most children of alcoholics do not become alcoholic, regardless of whether they were raised by their parents. Some studies have found no differences in the children of alcoholics and the children of non-alcoholics. 4. Describe two psychosocial causal factors in the development of alcohol abuse and dependence. Answer: Two of: 1. Failures in parental guidance - alcoholic parents model the behavior, provide limited guidance and training. 2. Psychological vulnerability – emotionally immature, expecting a lot of the world, needing lots of praise, low frustration tolerance, impulsivity, and feeling inadequate to fulfill expected gender roles seem to describe an alcoholic personality. These people have higher risk of developing alcoholism. Also the presence of antisocial personality disorder increases risk. 3. Stress and tension reduction can reinforce drinking behavior. 4. Expectations of social success - the reciprocal influence model - can increase risk. 5. Relationship problems can increase drinking. Test Bank for Abnormal Psychology: DSM 5 James N. Butcher, Jill M. Hooley, Susan M. Mineka 9780205965090, 9780205944286

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