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Chapter 13: Schizophrenia and Other Psychotic Disorders Multiple-Choice Questions 1. Psychosis is a striking and essential feature of schizophrenia. Psychosis means a. a tendency to be unpredictably violent. b. a significant loss of contact with reality. c. an inability to know right from wrong. d. an abrupt shift in personality from one pattern to another. Answer: b. a significant loss of contact with reality. 2. Schizophrenia occurs in about ___________ of the general population. a. 1 out of 1,000 b. 1 out of 100 c. 1 out of 10 d. 1 out of 10,000 Answer: b. 1 out of 100 3. Which of the following accounts for the belief that schizophrenia is becoming more common in males than females? a. Males are more likely to hallucinate than females so may be overdiagnosed. b. Men are more likely to seek treatment. c. Females with schizophrenia have less severe symptoms so may be misdiagnosed. d. Women respond better to treatment than men. Answer: c. Females with schizophrenia have less severe symptoms so may be misdiagnosed. 4. Which of the following people has the highest risk of developing schizophrenia? a. A person who came from New Guinea b. Someone who was physically abused as a child c. A person whose father was over 50 when he/she was born d. Someone who has a history of depression Answer: c. A person whose father was over 50 when he/she was born 5. The majority of cases of schizophrenia begin in a. late adulthood or old age. b. late adolescence or early adulthood. c. late childhood or early adolescence. d. there is no age where the majority of cases begin. Answer: b. late adolescence or early adulthood. 6. The term "demence precoce" was used by Benedict Morel to describe schizophrenia and to also explain the a. lack of brain damage that characterizes the brain of most schizophrenics. b. effectiveness of psychological treatments for schizophrenia. c. transient nature of most schizophrenias. d. difference between schizophrenia and dementias of old age. Answer: d. difference between schizophrenia and dementias of old age. 7. One disadvantage of early descriptions of schiziophrenia, such as Kraepelin's use of the term "dementia praecox," is that a. they assumed that what we call schizophrenia only occurred in elderly patients. b. they were actually describing Alzheimer's dementia, not schizophrenia. c. they did not distinguish between the varying types of schizophrenia that we know about today. d. they assumed the intellectual functioning of patients remained constant even as their bodies aged. Answer: c. they did not distinguish between the varying types of schizophrenia that we know about today. 8. When Bleuler coined the term "schizophrenia," the kind of split he believed was central to the disorder was a. a division of personality within the person. b. a divergence between the person's chronological age and his or her intellectual performance. c. an inability to make an intimate connection with other people. d. a break with reality. Answer: d. a break with reality. 9. Kraepelin used the term "praecox" to convey that schizophrenia typically develops early in life. The actual age of onset of the condition a. typically is during the early teenage years. b. typically is during the mid-twenties. c. typically is during the mid-thirties. d. typically is during the mid-forties. Answer: b. typically is during the mid-twenties. 10. Joe has a delusional belief. When people argue with him, a. he admits he could be wrong. b. he only admits he is wrong after being shown more proof than most people would need. c. he doesn't admit he is wrong to other people, but he admits it to himself. d. he doesn't admit he could be wrong, no matter what proof he is shown. Answer: d. he doesn't admit he could be wrong, no matter what proof he is shown. 11. Delusions are a. perceptions with no basis in reality. b. only seen in schizophrenia. c. necessary for a diagnosis of schizophrenia. d. disturbances in the content of thought. Answer: d. disturbances in the content of thought. 12. Which of the following is an example of a delusion? a. Bob thought the CIA was controlling his thoughts. b. The voices in Jaimie's head told him not to trust the priest. c. Tracy did not think she could get pregnant the first time she had sex. d. Carla saw and felt bugs crawling up her arm. Answer: a. Bob thought the CIA was controlling his thoughts. 13. Sterling believes that the TV special that was on last night was shown to tell her that she should break up with her boyfriend. She is absolutely certain this is true and plans to do it. This type of belief is an example of a a. thought broadcasting delusion. b. delusion of reference. c. made feelings delusion. d. thought insertion delusion. Answer: b. delusion of reference. 14. How common are delusions in schizophrenia? a. They are experienced by approximately 50 percent of schizophrenics. b. Delusions are an essential feature of schizophrenia; the presence of delusions is required for a diagnosis of schizophrenia. c. Over 90 percent of those with schizophrenia experience delusions. d. While hallucinations are a common occurrence in schizophrenia, delusions are rare. Answer: c. Over 90 percent of those with schizophrenia experience delusions. 15. Hallucinations are a. sensory experiences with no basis in reality. b. only seen in schizophrenia. c. necessary for a diagnosis of schizophrenia. d. disturbances in the content of thought. Answer: a. sensory experiences with no basis in reality. 16. Which of the following is an example of the most common type of hallucination seen in schizophrenia? a. Bill was convinced that his mother was inserting evil thoughts into his mind. b. Sondra tried to ignore the voices in her head. c. Ned believed he was Elvis. d. Rachel would frequently see her husband, even though he had been dead for several years. Answer: b. Sondra tried to ignore the voices in her head. 17. What type of hallucinations are the most common? a. Auditory b. Tactile c. Visual d. Gustatory Answer: a. Auditory 18. Neuroimaging studies of hallucinating patients suggest that auditory hallucinations a. are actually heard. b. are usually drug induced. c. may reflect a cognitive error. d. activate the brain areas involved in speech comprehension. Answer: c. may reflect a cognitive error. 19. People with schizophrenia may have difficulty with the form of thought - in other words, their thoughts do not make sense. The observable sign of this is a. a delusion. b. a hallucination. c. disorganized speech. d. disorganized behavior. Answer: c. disorganized speech. 20. "My father and I swiggered to the beach yesterday." This is an example of a a. delusion. b. auditory hallucination. c. negative symptom. d. neologism. Answer: d. neologism. 21. Which of the following is an example of a negative symptom of schizophrenia? a. Julia heard voices that told her she was evil. b. Karen no longer socialized with her friends. c. Ellen suspected that her husband had poisoned her food. d. Georgia's speech sounded normal, but made no sense. Answer: b. Karen no longer socialized with her friends. 22. Which of the following is an example of a negative symptom? a. Hallucinations b. Emotional unresponsiveness c. Emotional turmoil d. Delusions Answer: b. Emotional unresponsiveness 23. Negative symptoms a. are those that are harmful. b. are more disturbing to the patient than positive symptoms. c. are a common side effect of antipsychotic medications. d. are characterized as an absence or deficit of normal behaviors. Answer: d. are characterized as an absence or deficit of normal behaviors. 24. Over the course of the disorder, most individuals with schizophrenia a. show either positive-syndrome or negative-syndrome types. b. show the Type II form exclusively. c. develop the "disorganized" form of the disorder. d. display a mix of positive and negative symptoms. Answer: d. display a mix of positive and negative symptoms. 25. Which of the following is most likely seen in an individual with paranoid schizophrenia? a. Have delusions of reference b. Exhibit primarily negative symptoms c. Show more significant cognitive impairments than are seen in the other subtypes d. Respond poorly to treatment Answer: a. Have delusions of reference 26. Which of the following people is more likely exhibiting paranoid schizophrenia? a. The teen who has been in a catatonic state for several days b. The woman who believes she is being persecuted because she is Helen of Troy c. The man who shows little emotion, and who makes no sense when he speaks d. The mother of three who first showed signs of schizophrenia in her teens and now is unable to care for herself or her children. Answer: b. The woman who believes she is being persecuted because she is Helen of Troy 27. Disorganized schizophrenia a. is most commonly seen in women. b. is characterized by disorganized speech. c. usually develops in late adulthood. d. responds well to treatment. Answer: b. is characterized by disorganized speech. 28. Which of the following is likely a sign of disorganized schizophrenia? a. Dillon believes he is God, but will respond to any direction he is given. b. Peter appears to feel no emotion and tends to make odd facial expressions and movements. c. Kyle constantly is asking for a doctor as he is convinced that his stomach is going to explode. d. Trista fears for her life because the pictures on the wall have told her that she is not safe. Answer: b. Peter appears to feel no emotion and tends to make odd facial expressions and movements. 29. Which of the following statements is correct about changes for the diagnosis of schizophrenia in the DSM-5? a. Schizophrenia will not be included in the DSM-5 b. Subtypes of schizophrenia were removed but the diagnosis of schizophrenia will remain c. Only the paranoid subtype remains d. Only the catatonic subtype remains Answer: b. Subtypes of schizophrenia were removed but the diagnosis of schizophrenia will remain 30. Moira is schizophrenic. She giggles a lot, acts silly, and talks "baby talk." She experiences frequent auditory hallucinations and bizarre delusions. Moira most likely belongs to the ___________ subtype of schizophrenia. a. disorganized b. undifferentiated c. residual d. catatonic Answer: a. disorganized 31. Patients in a catatonic stupor a. are highly suggestible. b. experience overwhelming hallucinations. c. exhibit both echopraxia and echolalia. d. show pronounced motor signs. Answer: d. show pronounced motor signs. 32. DeJuan is highly suggestible and automatically obeys the commands of his brother. He sometimes stands in the same strange posture for hours despite his hands and feet becoming swollen due to immobility. This has been going on for over a year. Which diagnosis does this best illustrate? a. schizophrenia b. schizoaffective disorder c. schizotypal disorder d. schizophreniform disorder Answer: a. schizophrenia 33. Which of the following best describes the person with paranoid schizophrenia? a. Jake, who shows bizarre behavior, delusions, and disordered speech but has normal emotions. b. Lincoln, whose schizophrenia involves a chronic pattern of wild excitement followed by muteness and immobility. c. Constance, whose speech is incoherent and filled with invented words but whose emotions are inconsistent and inappropriate for the situation. d. Pauline, who is convinced that her husband is poisoning her food and can hear voices (that others cannot hear) calling her a liar and a thief. Answer: d. Pauline, who is convinced that her husband is poisoning her food and can hear voices (that others cannot hear) calling her a liar and a thief. 34. There is some debate as to whether ___________ is a variant of schizophrenia or a form of mood disorder. a. residual type b. schizoaffective disorder c. schizophreniform disorder d. undifferentiated type Answer: b. schizoaffective disorder 35. Julia clearly had psychotic symptoms. As she also showed symptoms of bipolar disorder, she was ultimately diagnosed with a. residual type. b. schizoaffective disorder. c. schizophreniform disorder. d. undifferentiated type. Answer: b. schizoaffective disorder. 36. Virginia exhibits a variety of schizophrenic symptoms including delusions, auditory hallucinations, and formal thought disorder. She has been symptomatic for a little more than a month. Virginia qualifies for a diagnosis of a. paranoid schizophrenia. b. schizoaffective disorder, manic type. c. undifferentiated schizophrenia. d. schizophreniform disorder. Answer: d. schizophreniform disorder. 37. Which of the following could be described as "short-term" schizophrenia? a. Undifferentiated schizophrenia b. Schizoaffective disorder c. Delusional disorder d. Schizophreniform disorder Answer: d. Schizophreniform disorder 38. The individual diagnosed with schizophreniform disorder a. has a mild case of schizophrenia combined with signs of a mood disorder. b. usually exhibits symptoms of schizophrenia that last for at least a month but less than 6 months. c. is likely to take actions based on their delusions. d. experiences a schizophrenia-like psychosis that lasts for less than a month. Answer: b. usually exhibits symptoms of schizophrenia that last for at least a month but less than 6 months. 39. Harold and Tanya both have a wide range of schizophrenic symptoms. Harold's symptoms have lasted for eight months; Tanya's have lasted only eight weeks. According to the DSM-5, their diagnoses should be a. schizophrenia for Harold; schizophreniform disorder for Tanya. b. disorganized schizophrenia for Harold; schizophrenia for Tanya. c. schizoaffective disorder for Harold; schizophreniform disorder for Tanya. d. schizophreniform disorder for Harold; brief psychotic disorder for Tanya. Answer: a. schizophrenia for Harold; schizophreniform disorder for Tanya. 40. What is the major difference between a diagnosis of schizophrenia and schizophreniform disorder? a. The presence of delusions and hallucinations b. The age of the person when they develop the disorder c. The degree of emotional instability and disconnection from other people d. The duration of symptoms Answer: d. The duration of symptoms 41. Individuals with delusional disorder differ from those with schizophrenia in that a. they behave relatively normally other than the delusions. b. their delusions are not well-formed. c. they know their delusions are delusions. d. they rarely act on their delusions. Answer: a. they behave relatively normally other than the delusions. 42. Which of the following statements most clearly summarizes our understanding of schizophrenia? a. The relative influence of nature and nurture has been established. b. While much is known about the causes of schizophrenia, there are many questions still to be answered. c. The role of genes in schizophrenia is negligible. d. Schizophrenia is primarily caused by expressed emotion in families. Answer: b. While much is known about the causes of schizophrenia, there are many questions still to be answered. 43. Most of the evidence suggests that, if schizophrenia is inherited, it a. is due to an abnormality on Chromosome 21. b. involves one or two genes. c. is a sex-linked, recessive condition. d. involves a multitude of genes that work in concert. Answer: d. involves a multitude of genes that work in concert. 44. In genetic studies, a "proband" or "index case" is someone who a. is related to someone with the disorder of interest. b. shows signs of the disorder of interest. c. shares at least 25 percent of his or her genes with an affected subject. d. has the disorder of interest. Answer: d. has the disorder of interest. 45. Both of Mary's parents have been diagnosed with schizophrenia. Bob has an identical twin who has schizophrenia. Who is more likely to develop schizophrenia and why? a. Bob, because he is male and has a family history of schizophrenia. b. Mary, because all of her genes come from her parents and they both have the disease. c. Bob, because he has inherited the same susceptibility that his twin is expressing. d. Mary, because females are more susceptible than males to the genetic forms of schizophrenia. Answer: c. Bob, because he has inherited the same susceptibility that his twin is expressing. 46. "Familial" does not mean the same thing as "genetic" because a. families don't always share genes. b. families share both genes and the environment. c. genes are not expressed in every generation. d. the strength of the correlations seen in familial concordance patterns does not allow any conclusions to be made. Answer: b. families share both genes and the environment. 47. Studies of family concordance patterns for schizophrenia have found a. little evidence of increased concordance with increased gene-sharing. b. such strong correspondence between gene-sharing and diagnosis that environmental factors have been ruled out. c. strong correspondence between gene-sharing and diagnosis but only for males. d. that the more genetically related you are to someone with schizophrenia, the greater your risk of the disorder. Answer: d. that the more genetically related you are to someone with schizophrenia, the greater your risk of the disorder. 48. Lori just found out that she is pregnant. Her husband has schizophrenia. What is her unborn child's risk of developing schizophrenia? a. 1 percent b. 10 percent c. 50 percent d. 90 percent Answer: b. 10 percent 49. If schizophrenia were exclusively a genetic disorder, a. anyone with schizophrenia in his or her family history would develop schizophrenia. b. the concordance rate for monozygotic twins would be 100 percent. c. marrying a schizophrenic would not increase the likelihood of developing schizophrenia. d. numerous cures would now be available. Answer: b. the concordance rate for monozygotic twins would be 100 percent. 50. Studies of the offspring of nonschizophrenic co-twins from discordant twin pairs suggest that a. environmental factors play a more important role than genetic factors in the origin of schizophrenia. b. genetic factors cause schizophrenia, while environmental factors are essentially unimportant. c. a genetic predisposition to schizophrenia may remain unexpressed in some individuals unless it is released by some unknown environmental factors. d. the heritability of schizophrenia involves the transmission of a single dominant gene. Answer: c. a genetic predisposition to schizophrenia may remain unexpressed in some individuals unless it is released by some unknown environmental factors. 51. Adoption studies are typically used a. to establish the primary role that the environment plays in most disorders. b. to separate the effects of nature and nurture. c. to assess the effectiveness of long-term treatment protocols. d. in order to isolate the environmental factors that "trigger" a disorder. Answer: b. to separate the effects of nature and nurture. 52. The Danish adoption studies have been criticized for a. not treating the subjects found to have schizophrenia. b. not assessing the child-rearing environments of the index and control groups. c. only studying males. d. not confirming the family history of the subjects. Answer: b. not assessing the child-rearing environments of the index and control groups. 53. When adoption studies of schizophrenia contain all the necessary controls and measurements, a. the role of genes is found to be negligible. b. index subjects are more likely to develop schizophrenia than the control subjects. c. the environment is found to be a more important determinant of psychological health than family history. d. no significant effects are seen. Answer: b. index subjects are more likely to develop schizophrenia than the control subjects. 54. Communication deviance a. may be an environmental risk factor for the development of schizophrenia. b. is an early indication of schizophrenia. c. is not seen in control adoptees. d. and disordered speech are the same thing. Answer: a. may be an environmental risk factor for the development of schizophrenia. 55. Studies of adopted children who were at high-risk for developing schizophrenia found that which of the following appeared to increase the likelihood that these children would show high levels of thought disorders? a. Vague, confusing, and unclear communication b. Physical abuse c. Permissive parenting d. Divorce Answer: a. Vague, confusing, and unclear communication 56. Adopted children who were high risk for schizophrenia, who were raised in healthy families, a. showed the same risk for schizophrenia as those adopted into dysfunctional families - genes were the most important factor. b. showed higher risk for schizophrenia than those adopted into dysfunctional families - they had trouble fitting in with the family. c. showed lower risk for schizophrenia than those adopted into dysfunctional families - a good environment may protect people with genetic vulnerabilities from developing schizophrenia. d. showed lower risk for schizophrenia than those adopted into dysfunctional families - the environment causes people to develop schizophrenia, not genes. Answer: c. showed lower risk for schizophrenia than those adopted into dysfunctional families - a good environment may protect people with genetic vulnerabilities from developing schizophrenia. 57. Linkage analysis a. is being used to help locate genes associated with schizophrenia. b. is being used to identify family risk factors. c. is being used to find the connections between stress and schizophrenia. d.is being used to show problems in connections between neurons. Answer: a. is being used to help locate genes associated with schizophrenia. 58. Which of the following is a plausible explanation for how maternal influenza might lead to schizophrenia later in life? a. The flu virus may lie dormant in the brain until adolescence when it becomes active and initiates the degeneration that results in the symptoms of schizophrenia. b. The flu exposure may alter the fetal genes such that a susceptibility to schizophrenia is now part of the child's genetic makeup. c. Maternal antibodies could cross the placenta and interfere with brain development such that the risk of developing schizophrenia is enhanced later in life. d. The flu virus frequently has long-term effects on the behavior of affected individuals; maternal infection with influenza may result in an environment that is likely to trigger schizophrenia in the susceptible individual. Answer: c. Maternal antibodies could cross the placenta and interfere with brain development such that the risk of developing schizophrenia is enhanced later in life. 59. The finding that prenatal viral exposure, rhesus incompatibility, and early nutritional deficiency are associated with an increased risk of developing schizophrenia indicates that a. genes do not play a role in vulnerability to schizophrenia. b. anything that interferes with normal brain development might lead to a greater risk of schizophrenia. c. environmental factors are more important than genetic factors when it comes to determining who is likely to develop schizophrenia. d. the results of twin studies reflect the impact of a shared prenatal environment, not shared genes. Answer: b. anything that interferes with normal brain development might lead to a greater risk of schizophrenia. 60. Which of the following has been found to lead to an increased risk of developing schizophrenia? a. Prenatal alcohol exposure. b. Prenatal influenza exposure. c. Alcohol use during middle adulthood. d. Influenza exposure between ages 5 and 10. Answer: b. Prenatal influenza exposure. 61. Schizophrenia is best described as a a. genetically influenced single gene disorder. b. genetically influenced multiple gene disorder. c. genetically determined single gene disorder. d. genetically determined multiple gene disorder. Answer: b. genetically influenced multiple gene disorder. 62. Studies of monochorionic and dichorionic twins a. offer further evidence of the role of the prenatal environment in schizophrenia. b. suggest that schizophrenia is more heritable than previously thought. c. indicate that the risk of developing schizophrenia is not altered by the prenatal environment. d. establish that genetic relatedness to an affected individual has nothing to do with one's risk of developing schizophrenia. Answer: a. offer further evidence of the role of the prenatal environment in schizophrenia. 63. The fact that a significant number of monozygotic twins share the same placenta, while no dizygotic twins do, suggests that a. we may have overestimated the influence of genetics in schizophrenia. b. being a monozygotic twin is a risk factor for schizophrenia. c. genetic influences are even more important than previously thought. d. monozygotic twins have a form of genetic schizophrenia while dizygotic twins have an environmentally caused form. Answer: a. we may have overestimated the influence of genetics in schizophrenia. 64. Based on current research, which statement is most justified? a. Genetics play such a strong role, they are a sufficient condition for schizophrenia. b. Genetics increase a person's vulnerability to develop schizophrenia. c. Genetics may not be sufficient for schizophrenia, but everyone who develops schizophrenia must have some number of "schizophrenia genes." d. Genetics cannot play a significant role in the cause of schizophrenia because most people with the disorder have no close relatives who have it. Answer: b. Genetics increase a person's vulnerability to develop schizophrenia. 65. Enlarged brain ventricles a. are seen in all schizophrenics. b. suggest that there has been a loss of brain tissue. c. are more commonly seen in the brains of paranoid schizophrenics. d. can be used to confirm a diagnosis of schizophreniform disorder. Answer: b. suggest that there has been a loss of brain tissue. 66. Compared to his nonschizophrenic identical twin, Matthew (who is schizophrenic) is more likely to a. have been born with physical birth defects. b. have been considered "different" or "odd" in childhood. c. have a higher intelligence level on IQ tests. d. be artistically or musically talented. Answer: b. have been considered "different" or "odd" in childhood. 67. What is the value of research that monitors children at high risk for schizophrenia for a long time? a. It can identify the specific genes responsible for the disorder. b. It can identify factors that precede breakdown and aid in intervention efforts. c. It can separate the impact of genetics from that of subtle neurological impairment. d. It can identify the factors that improve treatment outcome. Answer: b. It can identify factors that precede breakdown and aid in intervention efforts. 68. Based on developmental studies of children who later developed schizophrenia, a. it is usually impossible to detect early signs of the disorder. b. the first signs are usually delusions or hallucinations. c. the first signs are usually seen in the way children move. d. the first signs are usually seen in speech problems. Answer: c. the first signs are usually seen in the way children move. 69. What are endophenotypes? a. Abnormally shaped cells in the brain b. Neurotransmitters that are slightly different in chemical composition than normal c. Measurable traits that are thought to be linked to specific genes that might be important in schizophrenia d. Specific chromosomes that are thought to be important in the genetic transmission of schizophrenia Answer: c. Measurable traits that are thought to be linked to specific genes that might be important in schizophrenia 70. Why might Kraepelin's idea that schizophrenia was similar to dementia not be as far from the truth as previously thought? a. Evidence suggests that there sometimes are progressive changes in brain volume over time in people with schizophrenia. b. The symptoms of the two disorders overlap tremendously. c. On autopsy, people with schizophrenia show the same smoothing of the brain as is seen in people with dementia. d. The same biological treatments work for both disorders. Answer: a. Evidence suggests that there sometimes are progressive changes in brain volume over time in people with schizophrenia. 71. Which of the following is a brain area that has been shown to be involved in schizophrenia? a. Parietal lobe b. Occipital lobe c. Hippocampus d. Hypothalamus Answer: c. Hippocampus 72. Ursula has been diagnosed with schizophrenia. If PET scans were done to measure her brain's activity, which area would probably be underactive? a. The visual cortex b. The deepest portions of the brain, the medulla and reticular activating system c. The frontal lobes d. The hypothalamus and pituitary Answer: c. The frontal lobes 73. People with schizophrenia often show poor performance on tasks like the Wisconsin Card Sorting Task, which is thought to indicate a dysfunction of the a. parietal lobe. b. occipital lobe. c. temporal lobe. d. frontal lobe. Answer: d. frontal lobe. 74. Aberrant salience means that a. enlarged brain ventricles cause people with schizophrenia to be unable to concentrate. b. a large amount of communication deviance in the family can cause a person with schizophrenia to relapse. c. dysregulated dopamine can cause people with schizophrenia to pay too much attention to stimuli that are not actually important. d. people with schizophrenia often show unusual motor behaviors. Answer: c. dysregulated dopamine can cause people with schizophrenia to pay too much attention to stimuli that are not actually important. 75. There is a new trend to focus on dopamine receptor sensitivity rather than on dopamine itself because a. there is strong evidence that people with schizophrenia have too much dopamine. b. there is no strong evidence that people with schizophrenia have too much dopamine. c. the is strong evidence that people with schizophrenia have used too many drugs. d. there is only one type of dopamine receptor. Answer: b. there is no strong evidence that people with schizophrenia have too much dopamine. 76. Glutamate is an excitatory neurotransmitter that researchers suspect might be involved in schizophrenia because a. it makes dopamine. b. it causes the ventricles to enlarge. c. it is missing in the brains of people with schizophrenia. d. alterations in glutamate levels can produce schizophrenic-like symptoms in normal subjects. Answer: d. alterations in glutamate levels can produce schizophrenic-like symptoms in normal subjects. 77. Studies on neurocognition have found that people with schizophrenia a. are unable to pay attention on demand b. can't control their thoughts from jumping from topic to topic. c. have abnormal neurochemical changes in response to negative thoughts. d. get too focused on one thing and tune out the rest of the real world. Answer: a. are unable to pay attention on demand 78. A mother constantly demands that her son show her how much she is loved, but when he tries to hug her she yells at him to be more discreet. No matter what the child does, he is wrong. Further, the mother prohibits him from commenting on this paradox. What does this interaction pattern best illustrate? a. Double-bind communication b. Loosening of associations c. Fragmented thinking d. Expressed emotion Answer: a. Double-bind communication 79. One aspect of family environment that has been found to be important in schizophrenia is a. the level of expressed emotion. b. the level of parental grief over their child's illness. c. if the mother is cold and aloof. d. if lots of double-bind communications are used. Answer: a. the level of expressed emotion. 80. What is a stressor that has been found to increase the risk of developing schizophrenia? a. Being an identical twin b. Being raised in an isolated rural area c. Being a recent immigrant d. Living alone Answer: c. Being a recent immigrant 81. Most people with schizophrenia a. are cured. b. remain hospitalized for the rest of their lives. c. continue to show signs of illness. d. develop other disorders. Answer: c. continue to show signs of illness. 82. The best predictor of overall functioning over time for someone with schizophrenia is a. how much impairment the person suffers. b. how severe the person’s positive symptoms are. c. how severe the person’s negative symptoms are. d. how much therapy the person gets. Answer: c. how severe the person’s negative symptoms are. 83. First-generation antipsychotics a. work by blocking dopamine receptors. b. are not effective. c. produce few side effects. d. include Risperdal and Zyprexa. Answer: a. work by blocking dopamine receptors. 84. The first-generation antipsychotics seem to work because they block dopamine. This is supported by the new research findings that a. patients report they feel better right away, although there isn't any actual clinical changes occurring. b. changes in symptoms occur without any side effects. c. changes in symptoms begin to occur weeks after starting to take the medications, rather than immediately. d. changes in symptoms begin to occur very quickly after starting the medications, not weeks later as previously thought. Answer: d. changes in symptoms begin to occur very quickly after starting the medications, not weeks later as previously thought. 85. Extrapyramidal side effects a. are involuntary movements that result mainly from taking first-generation antipsychotic drugs. b. are often fatal side-effects from second-generation antipsychotic drugs. c. are an increase in mood (reduction in depression) that occurs in people with schizoaffective disorder. d. are voluntary, unusual movements that result mainly from taking second-generation antipsychotic drugs. Answer: a. are involuntary movements that result mainly from taking first-generation antipsychotic drugs. 86. Which of the following is true about second generation antipsychotics in the treatment of schizophrenia? a. They are more effective than first generation antipsychotics. b. They work by decreasing frontal lobe activity. c. They prevent prenatal brain damage. d. They are no more effective than first generation antipsychotics. Answer: d. They are no more effective than first generation antipsychotics 87. Social-skills training for people with schizophrenia a. has been very successful in reducing symptoms. b. tries to help people learn a trade so they can earn a living. c. tries to help people gain the skills they need for daily living outside the hospital. d. tries to help cure people of schizophrenia. Answer: c. tries to help people gain the skills they need for daily living outside the hospital. 88. Which type of training has an emphasis on helping patients deal with their neurocognitive deficits? a. Cognitive remediation training b. Social skills training c. Case management d. Family therapy Answer: a. Cognitive remediation training 89. Cognitive-behavioral treatment for people with schizophrenia a. tries to help people learn a trade so they can earn a living. b. tries to help people gain the skills they need for daily living. c. tries to help people find the services they need in the community. d. tries to help people question their delusions to help reduce their intensity. Answer: d. tries to help people question their delusions to help reduce their intensity. 90. One-on-one psychotherapy for people with schizophrenia a. shows very little promise. b. seems to be very effective when combined with medication. c. is an effective replacement for medication. d. has many side effects. Answer: b. seems to be very effective when combined with medication. Fill-in-the-Blank Questions 1. The lifetime prevalence for schizophrenia is __________ percent. Answer: one 2. ______________ are false beliefs that are firmly held despite clear evidence to the contrary. Answer: Delusions 3. ______________ are sensory experiences that seem true to the individual, but are not in the external world. Answer: Hallucinations 4. The subtype of schizophrenia that might include feeling like the government is conspiring to capture you is the __________ type. Answer: paranoid 5. The subtype of schizophrenia that has includes bizarre behavior and disorganized speech is the _________ type. Answer: disorganized 6. The DSM-5 diagnosis for someone who has features of schizophrenia and a severe mood disorder is __________ disorder. Answer: schizoaffective 7. _____________ are discrete, stable, and measurable traits that are thought to be genetic. Answer: Endophenotypes 8. The most important neurotransmitter implicated in schizophrenia is __________. Answer: dopamine Short Answer Questions 1. What is thought to explain the delayed onset of schizophrenia in women? Answer: While the average age of onset of schizophrenia for males is 25, for women it is 29. There is some reason to believe that estrogen may serve to protect the female brain. It has been observed that women with schizophrenia experience more psychotic symptoms when estrogen levels are low or dropping, consistent with this hypothesis. 2. What is a delusion? What type of delusions is most common in schizophrenia? Answer: A delusion is a thought, a cognition, with no basis in reality. Common delusions involve believing that one's actions or thoughts are being controlled by some external force, that one's thoughts are being broadcasted, and that thoughts are being inserted into one's mind. These delusions are all consistent with the disorganized thoughts commonly seen in schizophrenia. 3. What is catatonia? Is catatonia a positive or negative symptom? Explain your answer. Answer: Catatonia is a negative symptom of schizophrenia as it is characterized by an absence of normal behavior. The patient with catatonia may have virtually no movement or speech, or he or she may freeze and hold an awkward position for an extended period of time. 4. Explain and give examples of positive symptoms of schizophrenia. Answer: Positive symptoms involve the presence of abnormal behavior. Hallucinations, delusions, disorganized speech, and bizarre behavior are all examples of positive symptoms. 5. What is schizoaffective disorder? Answer: The individual diagnosed with schizoaffective disorder exhibits symptoms of both schizophrenia and an affective disorder; he or she experiences both psychosis and extremes of mood. It is not clear whether this disorder is best thought of as a form of mood disorder or a form of schizophrenia. 6. What are two types of prenatal experience associated with increased risk of schizophrenia? Answer: Two of: 1. flu virus - elevated risk in children whose mothers had the flu during the second trimester. 2. Rh incompatibility - elevated risk in children. 3. Early prenatal nutritional deficiency. All compromise fetal development, especially brain development. 7. How is dopamine theorized to impact schizophrenia? Answer: Dopamine may play a role in how much attention people pay to stimuli. Too much may make people pay too much attention to irrelevant stimuli (aberrant salience) and contribute to thought disorder. 8. Esther lives with her parents. She frequently has relapses into schizophrenia. If her family is characterized by expressed emotion, what behaviors can we expect of her parents that induce relapse? Answer: They are emotionally overinvolved in Esther's life and at the same time excessively critical of her. Expressed emotion would be especially intense if Esther's parents believe that Esther can control her schizophrenic symptoms and chooses not to. Conflict is likely to be two-way between Esther and her parents. In addition, hostility in the family is the third factor that increases relapse. 9. Why is immigration associated with an increased risk of schizophrenia? Answer: Probably because of the increased stressors, especially that of facing discrimination and social disadvantage. 10. What factors help predict prognosis for schizophrenia? Answer: Where someone lives - people in less industrialized nations have better prognoses. Essay Questions 1. Define positive and negative symptoms for schizophrenia. Give examples of each. Answer: A common way of describing schizophrenia is by categorizing its symptoms as either positive or negative. Positive symptoms are abnormal behaviors, unusual perceptions, or thoughts that are present, while negative symptoms involve the absence of something normal. Thus, inappropriate emotion would be a positive symptom and a lack of emotion would be a negative symptom. It should be noted, however, that a single individual is likely to exhibit both types of symptoms. 2. What are schizoaffective disorder and schizophreniform disorder? Answer: These are not considered formal subtypes of schizophrenia in DSM-5, bit distinct disorders Schizoaffective disorder is a category for individuals who have characteristics of both schizophrenia and bipolar or major depressive disorder, such that a differential diagnosis cannot be made. Schizophreniform disorder is diagnosed when schizophrenic symptoms are present but have not lasted for six months. An individual may be rediagnosed as schizophrenic after six months. 3. What important aspect of the adoptive family was missing from early studies? What did later studies find when they did include it? Answer: Early studies did not examine child rearing adequacy of the adoptive family. Newer studies found that communication deviance - how understandable and easy to follow the speech of family members was - was related to risk of schizophrenia. Children with a biological risk for schizophrenia who were adopted into families with high communication deviance had an increased risk of the disease. If the child had no genetic predisposition for schizophrenia, communication deviance did not make a difference in risk. Most interestingly, if a genetic risk existed and the child was adopted into a family with low communication deviance, that child's risk for schizophrenia was actually lower than the other groups! 4. What is the evidence for and against the dopamine hypothesis? Answer: Early antipsychotic drugs that blocked dopamine receptors reduced psychotic symptoms. Amphetamine psychosis - due to increased dopamine. Drugs that raise dopamine, for example, Parkinson's drugs, caused psychotic-like side effects. However, no strong evidence that people with schizophrenia have increased levels of dopamine has been found. 5. What role does the family play in schizophrenia? Answer: While it was once thought that features of the home environment "caused" schizophrenia, such simplistic explanations have been discarded. At one time it was believed that inconsistent emotional signals from a parent led to schizophrenia; this "double-bind" hypothesis has not been supported. While there is little or no evidence to support a role for the family environment in the development of the disorder, it has been shown that communication patterns can predict relapse. In other words, familial interactions that are stressful can contribute to relapse. A recurrence of symptoms is more likely in a home that is high in expressed emotion. The elements of expressed emotion are criticism, hostility, and emotional overinvolvement. Test Bank for Abnormal Psychology: DSM 5 James N. Butcher, Jill M. Hooley, Susan M. Mineka 9780205965090, 9780205944286

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