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Chapter 13: Schizophrenia Spectrum and Other Psychotic Disorders Multiple Choice 1. Ted is taking notes in an abnormal psychology course; the topic today is the diagnosis of schizophrenia. When Ted reviews the material next week, how might he summarize the material on the symptoms used to identify schizophrenia? a. No single symptom is indicative of schizophrenia. b. Delusions and hallucinations define the disorder. c. Psychosis is not found in any condition other than schizophrenia. d. The negative symptoms indicate the absence of schizophrenia. Answer: a. 2. What is the long-term outcome for people with schizophrenia? a. Most people recover. b. Most people do not recover completely. c. Males have a higher recovery rate than females. d. Those who develop the disorder while young rarely recover completely. Answer: b. 3. The most common age when symptoms of schizophrenia may initially appear is a. before age three. b. between six and ten years old. c. in adolescence and early adulthood. d. after age 40. Answer: c. 4. The experience of most schizophrenics may be seen as falling into three phases: prodromal, active, and a. terminal. b. residual. c. acute. d. chronic. Answer: b. 5. When does the prodromal phase of schizophrenia occur? a. after the active phase b. at the point of greatest disturbance c. before active psychotic symptoms are present d. when the patient is treated with neuroleptic medications Answer: c. 6. In January, Rita was beginning to perform poorly at work; she was neglecting her appearance, becoming withdrawn, and exhibiting odd behaviors. In June, Rita showed the full‑blown symptoms of schizophrenia. Her behavior in January can be considered part of which phase of the disorder? a. active b. residual c. prodromal d. undifferentiated Answer: c. 7. The phase of schizophrenia in which the most dramatic symptoms of psychosis have improved, but in which the person continues to be impaired in various ways, is labeled a. prodromal. b. active. c. residual. d. acute. Answer: c. 8. Marvin has a long history of schizophrenia. His doctors say that he is currently in the residual phase; from this we can conclude that he a. has recovered. b. has recently suffered an acute relapse. c. continues to be impaired in various ways. d. is experiencing hallucinations but not delusions. Answer: c. 9. Schizophrenic symptoms, sometimes called psychotic symptoms, that include hallucinations and delusions are known as a. positive symptoms. b. negative symptoms. c. aberrant symptoms. d. hallucinatory symptoms. Answer: a. 10. Which of the following is an example of a positive symptom of schizophrenia? a. flat affect b. hallucinations c. social withdrawal d. lack of initiative Answer: b. 11. During an interview, a patient says he frequently hears the voice of his sister coming from his image in the bathroom mirror. The psychologist who is conducting the interview most likely writes that the patient presents evidence of a. delusions. b. hallucinations. c. negative symptoms. d. loose associations. Answer: b. 12. The feature that hallucinations in schizophrenia share in common is a. visual experience. b. auditory experience. c. the voice of God. d. sensory experience. Answer: d. 13. What are delusions? a. examples of disorganized speech b. rigidly held, idiosyncratic beliefs c. sensory experiences in the absence of external stimuli d. lifelong convictions that are limited to one's cultural group Answer: b. 14. When patients who are suffering delusions are confronted with contradictory evidence, they a. defend their beliefs with conviction. b. concede their error but then develop new delusions. c. defend their beliefs but only half-heartedly, knowing they are in error. d. are unable to engage in coherent speech. Answer: a. 15. How do positive and negative symptoms compare in terms of their course over time? a. Negative symptoms fluctuate. b. Negative symptoms are more stable. c. Positive symptoms get steadily worse. d. Positive symptoms steadily improve. Answer: b. 16. Which of the following is considered one of the earliest signs that someone may eventually meet the criteria for schizophrenia? a. insomnia b. social isolation c. loose associations d. auditory hallucinations Answer: b. 17. Monty, who has been diagnosed as suffering from schizophrenia, shows only the slightest smile when happy or the slightest frown when upset. His limited emotional expressiveness is called a. catatonia. b. anhedonia. c. dissociation. d. diminished emotional expression. Answer: d. 18. What term is used to describe patients who feel no joy or excitement, even while doing things they formerly enjoyed? a. anhedonia b. blunted affect c. affective disorder d. inappropriate affect Answer: a. 19. Avolition refers to a. indecisiveness and a lack of willpower. b. lack of speech. c. loose associations. d. inappropriate affect. Answer: a. 20. Which statement is true about anhedonia? a. It is found in schizophrenia and also in severe depression. b. Anhedonia is a transitory feature for most people with schizophrenia. c. It refers to the inability to understand speech. d. Anhedonia is unique to schizophrenia. Answer: a. 21. What is another term for disorganized speech? a. delusion b. catatonia c. thought disorder d. tardive dyskinesia Answer: c. 22. Which of the following individuals exhibits behavior that would be described by the term disorganized speech? a. Harold, who uses words in peculiar ways b. Pat, who tends to overuse the past tense c. Susan, whose speech contains some grammatical errors d. Rebecca, who discusses strong convictions about preposterous ideas Answer: a. 23. During an interview, a patient suffering from schizophrenia gives answers that seem to be responses to the questions but are entangled in irrelevant details. What term is used to describe this phenomenon? a. alogia b. hallucination c. perseveration d. tangentiality Answer: d. 24. What aspect of the symptoms of schizophrenia is described by the term "loose associations"? a. social withdrawal b. shifting topics too abruptly c. disruptions in neurotransmitter functioning d. lack of relation between cognitive and emotional symptoms Answer: b. 25. Catatonic behavior refers to disturbances in a. speech. b. motor function. c. emotional expression. d. capacity for intimacy. Answer: b. 26. Tania suffers from schizophrenia, and hospital staff have observed that she has been purposelessly pacing back and forth and rubbing her hands together in a special pattern for several hours. Tania is exhibiting a. paranoia. b. catatonic behavior. c. motor fluidity. d. dementia. Answer: b. 27. Mark is a patient who has been diagnosed with catatonic behavior. Which of these symptoms might characterize his condition? a. He appears frozen, like a mannequin. b. He answers "Bohemia" to every question asked. c. He believes he sees his dead father in the room. d. He writes to the CIA about Napoleon's attempts to capture him. Answer: a. 28. Melissa begins giggling when discussing a recent car accident in which her brother was killed, and she cries when telling a joke she heard on television. What term do we for this behavior? a. anhedonia b. catatonia c. delusional thinking d. inappropriate affect Answer: d. 29. The term “schizophrenia” was coined by a. DSM-5. b. Sigmund Freud. c. B.F. Skinner. d. Eugen Bleuler. Answer: d. 30. “Schizophrenia” refers to the splitting of mental associations. As an unfortunate result of this choice of terms, laypeople often think “schizophrenia” refers to a. major depression. b. memory loss. c. anorexia nervosa. d. dissociative identity disorder. Answer: d. 31. DSM-5 requires a minimum of _____ symptom(s) in order to diagnose schizophrenia. a. one b. two c. three d. five Answer: b. 32. In order to diagnose schizophrenia, DSM-5 requires that active-phase symptoms be present for a significant portion of time during a period of a. one week. b. one month. c. three months. d. one year. Answer: b. 33. DSM-5 states that continuous signs of the disturbance, which can include prodromal or residual symptoms as well as active-phase symptoms, must persist for at least _____ month(s) in order to diagnose schizophrenia a. one b. three c. six d. nine Answer: c. 34. If a person displays psychotic symptoms for at least one month but less than six months, the DSM-5 diagnosis would be a. schizophrenia. b. grossly disorganized disorder. c. autism spectrum disorder. d. schizophreniform disorder. Answer: d. 35. Adrian, a graduate student, is learning to use DSM-5 and is surprised to find that there are no official subtypes of schizophrenia given, even though he remembers seeing them in previous DSM versions. Which of the following statements is true regarding this discrepancy? a. The previous subtypes were strong predictors of the course of the disorder. b. Recent genetic evidence showed that the subtypes were etiologically distinct syndromes. c. Evidence has shown that the previous subtypes were not qualitatively different disorders. d. The subtypes were valid. Answer: c. 36. To diagnose an illness as schizophrenia, DSM-5 requires that ________ be ruled out. a. hallucinations b. silly, child-like behaviors c. negative symptoms d. other medical conditions that could cause the disturbance Answer: d. 37. Mood disorders present ________ need not be ruled out for a DSM-5 diagnosis of schizophrenia. a. for a majority of the total duration of the active and residual periods of the illness b. for the total duration of the illness c. for a minority of the total duration of the active and residual periods of the illness d. concurrently with active-phase symptoms for the length of the illness Answer: c. 38. Which of these individuals is most likely to receive the diagnosis of delusional disorder? a. Beverly, whose behavior is normal apart from the fact that she believes the pope is trying to poison her food b. Carol, who meets the full symptomatic criteria for schizophrenia c. David, who displays disorganized speech d. Eileen, who displays catatonic and negative symptoms of schizophrenia Answer: a. 39. If the physiological effects of a drug of abuse are involved in the disturbance, the DSM-5 diagnosis a. is still schizophrenia. b. should be schizophreniform disorder. c. cannot be schizophrenia. d. would be bipolar disorder. Answer: c. 40. In terms of duration, schizophreniform disorder falls between ________ and schizophrenia. a. autism spectrum disorder b. the residual phase of schizophrenia c. brief psychotic disorder d. major depression Answer: c. 41. The long-term prognosis for patients who experience brief psychotic disorder is a. very poor. b. guarded. c. fair. d. good. Answer: d. 42. Your textbook suggests that there is a great irony involved in research on schizophrenia, noting that a. the original physician who developed the diagnostic category was later diagnosed with schizophrenia himself. b. for over 100 years, we have known that the diagnostic category we now recognize as schizophrenia may well be composed of many different kinds of mental disorders. c. we have had a clear model of the cause of schizophrenia for over 100 years, but we have still not identified an effective treatment. d. schizophrenia is really another name for bipolar disorder. Answer: b. 43. The best predictor of schizophrenia symptom severity at follow-up is a. the age of the patient. b. the severity of psychotic symptoms at initial assessment. c. previous social adjustment. d. the subtype of schizophrenia. Answer: b. 44. Schizoaffective disorder involves a. split personality. b. emotionally-based delusions. c. "cut off" emotions and lack of expressiveness. d. the overlapping of symptoms of schizophrenia with those of mood disorder with psychotic features. Answer: d. 45. What diagnostic category is used to describe individuals who experience transient symptoms of schizophrenia and then complete recovery? a. catatonia b. anhedonia c. split personality d. brief psychotic disorder Answer: d. 46. Two patients are in the local mental hospital: one is diagnosed with delusional disorder and the other with schizophrenia. What is the major difference between these two patients? a. The patient with delusional disorder shows evidence of a mood disorder. b. The patient with schizophrenia has negative, but not positive symptoms. c. The patient with schizophrenia has no history of schizophrenia in the family. d. The behavior of the patient with delusional disorder is not bizarre, and other than in areas related to his delusions, he experiences no social or occupational impairment. Answer: d. 47. According to DSM-5, brief psychotic disorder refers to psychotic symptoms lasting how long? a. less than twenty-four hours b. one day to one month c. one month to six months d. six months to twelve months Answer: b. 48. After reviewing the results of the follow-up research conducted by Manfred Bleuler, what conclusion could we reach concerning the outcome of schizophrenia? a. The long-term prospects for people with this disorder remains dismal in most cases. b. About half of those diagnosed with schizophrenia will either recover or exhibit at least some significant improvement. c. Contrary to general opinion, schizophrenia is more of an episodic disorder from which recovery rates tend to be quite high. d. The deterioration that occurs in schizophrenia is not reversible, and consequently few, if any, people will make any meaningful recovery. Answer: b. 49. Worldwide, how many people out of every 100 will experience or display symptoms of schizophrenia at some time during their lives? a. 1 b. 5 c. 10 d. 15 Answer: a. 50. Rich always heard that there are no gender differences in the rate of schizophrenia; however, he has just been told that closer inspection yields certain differences of interest. Which of the following describes some of those differences? a. Men have more positive symptoms and a more chronic course. b. Men develop the disorder earlier and have a more chronic course. c. Women develop the disorder later and have a more chronic course. d. Women have more negative symptoms and a less chronic course. Answer: b. 51. Cross-cultural studies of the rate of schizophrenia show a. higher rates in Western cultures. b. higher rates in rural populations. c. higher rates in urban populations. d. higher rates in poor societies. Answer: b. 52. Cross-cultural studies of the rate of schizophrenia in various types of communities found that clinical outcomes were significantly better in developing countries such as Nigeria and India. What aspect of life in these cultures has been hypothesized to account for these outcomes? a. less stressful lifestyles b. milder forms of schizophrenia c. greater tolerance and acceptance of people with schizophrenia d. racial differences in response to medication and dietary factors Answer: c. 53. What do studies of concordance rates for schizophrenia in monozygotic (MZ) and dizygotic (DZ) twins show? a. almost 100 percent concordance in MZ twins, 0 percent in DZ b. very low rates of concordance in either type of twin c. consistent evidence of higher concordance in DZ than MZ d. consistent evidence of higher concordance in MZ than DZ Answer: d. 54. What evidence suggests that the development of schizophrenic disorders is not entirely explained by genetics? a. None of the twin studies have found a concordance rate that even approaches 100 percent. b. DZ twins are not 100 percent concordant. c. Concordance rates for MZ twins are less than for DZ twins. d. Concordance rates for DZ twins are less than for MZ twins. Answer: a. 55. Leonard Heston conducted an adoption study of the possible causes of schizophrenia. What was the major finding in his study? a. There was no evidence of a genetic influence on schizophrenia. b. Adopted individuals had higher rates of schizophrenia regardless of the mental health status of their parents. c. An individual’s childhood environment has a much greater impact on the incidence of schizophrenia than do genetic factors. d. Adopted children whose birth mothers were schizophrenic developed schizophrenia at a higher rate than did children born to normal mothers. Answer: d. 56. A research report refers to the “spectrum of schizophrenia disorders.” Which of the following best illustrates this concept? a. Mood disorders with psychotic features are similar to schizophrenia. b. The rate of schizophrenia depends on the types of viruses that are prevalent in a given environment. c. A family with a member suffering from schizophrenia is at higher risk for disorders such as schizoaffective disorder. d. Efforts to understand one's place in the world lead many to experience an existential crisis that appears similar to schizophrenia. Answer: c. 57. In the search for genetic contributions to schizophrenic disorders, attention is being paid to a form of the COMT gene (called the Val allele), which seems to a. decrease the rate of apoptosis. b. alter the functioning of the amygdala. c. affect the transmission of dopamine in the prefrontal cortex. d. alter GABA activity. Answer: c. 58. What have researchers discovered from their examinations of the pregnancy and birth records of people who later develop schizophrenia? a. Their mothers experienced more complications at the time of labor and delivery. b. Their mothers experienced fewer complications at the time of labor and delivery. c. Their mothers experienced more complications during pregnancy but not at the time of labor and delivery. d. Their mothers experienced fewer complications during pregnancy. Answer: a. 59. What is one of the indirect lines of evidence supporting the hypothesis that viral infections play a role in the etiology of some cases of schizophrenia? a. The rates of schizophrenia tend to be elevated during periods of famine. b. There is a slightly elevated rate of schizophrenia among people born in the winter months. c. There is a correlation between indices of air pollution and rates of schizophrenia around the world. d. High doses of drugs designed to fight viral infections can reduce some of the symptoms of schizophrenia. Answer: b. 60. What has research shown concerning the link between schizophrenia and the lateral ventricles of the brain? a. On average, schizophrenics have enlarged lateral ventricles. b. All patients with schizophrenia have enlarged lateral ventricles. c. Enlarged lateral ventricles are found only in schizophrenia. d. Enlarged lateral ventricles predict early onset of schizophrenia. Answer: a. 61. Based on the results of magnetic resonance imaging (MRI), what areas of the brain have been found to be smaller in people with schizophrenia as compared to those without the disorder? a. corpus callosum and pons b. parts of the limbic system c. cerebellum and basal ganglia d. prefrontal cortex and medulla Answer: b. 62. Studies using magnetic resonance imaging (MRI) have found diminished size of structures in the limbic systems of schizophrenics' brains. Why is this finding potentially important? a. The limbic system integrates cognition and emotion. b. The limbic system coordinates eye tracking and visual perception. c. The limbic system is the seat of consciousness and sense of identity. d. Abstract reasoning and problem solving are organized in the limbic system. Answer: a. 63. In a study of identical twins by the National Institute of Mental Health, when one twin had schizophrenia and the other did not, the schizophrenic twin always showed reduced activity in which lobe of the brain when compared to the unaffected co-twin? a. occipital b. frontal c. parietal d. medulla Answer: b. 64. A study was done in the Netherlands following World War II that looked at the causes of schizophrenia. Based on the finding of this study, a logical social policy would be one that a. assisted pregnant mothers with nutrition. b. taught communication skills to young families. c. provided housing for poor families. d. discouraged pregnancy during wartime. Answer: a. 65. Measures of blood flow in various areas of the cerebral cortex show that while working on various tasks, schizophrenic patients do not show expected increases in blood flow to the a. cerebellum and corpus callosum. b. occipital lobes and parietal lobes. c. prefrontal cortex and temporal lobes. d. lateral ventricles and corpus callosum. Answer: c. 66. The neurological impairments found in schizophrenic patients have also been studied in the unaffected twins of schizophrenic patients. Compared to the neurological impairments of "well" twins, the neurological impairments in their schizophrenic twins are a. marked by more activity in the occipital lobe. b. marked by a larger hippocampus and smaller amygdala. c. marked by a smaller hippocampus and amygdala. d. about the same as the "well" twin. Answer: c. 67. The newspaper contains a report of a research team in Europe that has found a brain area in a group of schizophrenic patients that is smaller than the same area in normal individuals. The article was written by a well-known science writer who has a keen understanding of schizophrenia. What is he likely to conclude? a. Dietary factors account for most differences in brain size. b. A complex disorder such as schizophrenia is not likely to be traced to a single brain site. c. The differences are probably the result of differences in the size of the individuals that made up the respective groups. d. Most such differences have been found to be the result of drug treatments for the disorder and not reflections of some underlying cause. Answer: b. 68. Evidence for the role of the environment in the etiology of schizophrenia is a. non-existent. b. questionable. c. anecdotal. d. compelling. Answer: d. 69. The current emphasis on using brain imaging procedures with patients suffering from schizophrenia is based on the belief that such procedures a. can assist with diagnosis. b. might help identify the neuropathology that causes schizophrenia. c. allow us to determine which medication will be of greatest benefit to the patients. d. will show that schizophrenia is actually a form of split personality. Answer: b. 70. One of the first neurochemical theories of schizophrenia focused on altered activity of which of the following systems? a. serotonin b. dopamine c. norepinephrine d. estrogen Answer: b. 71. Current neurochemical hypotheses regarding schizophrenia focus on a. dopamine deficiencies. b. excessive levels of dopamine. c. a broad array of neurotransmitters. d. dietary deficiencies. Answer: c. 72. Which of the following describes the relationship between the rate of schizophrenia and social class found in studies done in Chicago over 70 years ago? a. The highest rates are found in the upper classes. b. The highest rates are found in the lower classes. c. The highest rates are found in the middle classes. d. The rates of schizophrenia are similar across classes. Answer: b. 73. What does the social causation hypothesis propose as the cause of the high rate of schizophrenia in the lower classes in the United States? a. inappropriate mothering b. labeling and rejection by society c. stressful events and poor health care d. high negative emotions in lower class families Answer: c. 74. According to the social selection hypothesis, the rate of schizophrenia is higher in the lower classes in the United States because a. the stresses of living in poverty trigger schizophrenic symptoms. b. poor health care and nutrition trigger schizophrenic symptoms. c. schizophrenics are less able to find or hold good jobs. d. only poor schizophrenics are labeled as mentally ill. Answer: c. 75. High rates of schizophrenia are found in groups that have a. migrated to a new country. b. stayed in the same small town or village for their whole lifetime. c. moved within a given country frequently. d. frequently changed career goals. Answer: a. 76. Expressed emotion refers to a. family members being negative and intrusive. b. family members showing acceptance and caring. c. the appropriateness of a schizophrenic person's affect. d. the schizophrenic person's stated desire to engage in social relations. Answer: a. 77. What conclusion is warranted concerning the causal role of disturbed communication in families? a. Disturbed communication is a significant cause of schizophrenia. b. Disturbed communication does not cause people to develop schizophrenia. c. Disturbed communication is responsible for the onset of schizophrenia, but not for its continuation. d. Disturbed communication is a cause of schizophreniform disorder but not schizophrenia. Answer: b. 78. Expressed emotion in families is thought to influence the a. development of schizophrenia. b. probability of relapse by schizophrenic patients. c. content of delusions shown by schizophrenic patients. d. display of positive or negative symptoms by schizophrenic patients. Answer: b. 79. Which of the following symptoms of schizophrenia is most difficult for family members to accept and tolerate? a. delusions b. withdrawal c. hallucinations d. disorganized speech Answer: b. 80. Which of the following conclusions about expressed emotion (EE) is most accurate? a. EE is a significant cause of schizophrenia. b. EE is a poor predictor of relapse in schizophrenic patients. c. EE is a better predictor of outcome for mood and eating disorders than it is for schizophrenia. d. EE is a significant cause of both schizophrenia and mood disorders. Answer: c. 81. Research seems to show that expressed emotion tends to be more common in Western than in non-Western or developing countries. What aspect of schizophrenia has this observation been used to explain? a. less severe long-term outcomes in developing countries b. differences in the content of delusions from culture to culture c. differences in the types of symptoms commonly seen in various cultures d. more positive response to drug treatments of schizophrenia in developing countries Answer: a. 82. In psychopathology research, groups of schizophrenic patients are sometimes compared to groups of "patient controls." In such research, patient controls are used to a. determine whether certain factors are specific to schizophrenia or apply to other disorders. b. identify the differences between people with schizophrenia and people without mental disorder. c. control for differences between subjects in severity of illness. d. control for subject and experimenter bias. Answer: a. 83. A component or trait that lies somewhere on the pathway between the genotype, which lays the foundation for the disorder, and full-blown symptoms of the disorder is known as a. anhedonia. b. a phenotype. c. a schizotype. d. an endophenotype. Answer: d. 84. Researchers are focusing on the discovery of a specific measure, such as a biochemical assay or a psychological test, and they are interested in knowing whether it might be useful in identifying people who are predisposed to schizophrenia. These researchers are looking for what type of marker? a. vulnerability b. schizotypic c. phenotypic d. genotypic Answer: a. 85. For a specific test to function as a vulnerability marker for schizophrenia, it is necessary that the proposed test a. distinguishes between those who have schizophrenia and those who do not. b. measures the level of dopamine and serotonin. c. be designed to accommodate the communication difficulties typical of schizophrenia. d. is used only with people who have no family history of schizophrenia. Answer: a. 86. The identification of deficits in working memory is particularly interesting with regard to schizophrenia because it links to other evidence regarding brain functions and this disorder. Processes that are associated with central executive processing are associated with brain activity located in the ________ area of the prefrontal cortex that seems to be dysfunctional in schizophrenia. a. preoptic b. dorsolateral c. verbal d. posterior Answer: b. 87. Research on the relationship between dysfunctional smooth-pursuit eye movement and schizophrenia has suggested that this dysfunction may be a. absent in other mental disorders. b. induced by an environmental toxin. c. present in all forms of schizophrenia. d. associated with a predisposition to schizophrenia. Answer: d. 88. The real test of any potential vulnerability marker for schizophrenia will be its ability to a. identify the neuropathology involved in schizophrenia. b. show that people with a family history of schizophrenia are at greater risk for the illness. c. predict the later appearance of schizophrenia. d. identify the right medications to be used to treat the illness. Answer: c. 89. While antipsychotic medication does relieve the symptoms of schizophrenia in many cases, approximately _____ percent of schizophrenic patients do not improve with the use of classical antipsychotic drugs. a. 10 b. 25 c. 50 d. 75 Answer: b. 90. After patients recover from acute psychotic episodes and are receiving antipsychotic medications, there is a high probability that they will have another episode if they discontinue their medication. According to your textbook, _____ percent of patients have a relapse in the first year after hospital discharge. a. 10-15 b. 25-30 c. 45-50 d. 65-70 Answer: d. 91. Which of the following symptoms is likely to show the most improvement with the use of antipsychotic medication? a. alogia b. avolition c. diminished emotional expression d. hallucinations Answer: d. 92. Most studies find that about half of the patients who receive antipsychotic medication are rated as being much improved after what length of time? a. twenty-four hours b. forty-eight hours c. four to six weeks d. two to four months Answer: c. 93. For patients with schizophrenia being treated with antipsychotic drugs, the real-world rates of relapse are significantly higher than best-case rates because a. the best-case rates are based on inaccurate assumptions about neurochemistry. b. many patients stop taking their medication to avoid unpleasant side effects. c. best-case rates are promoted by pharmaceutical companies trying to market their drugs. d. antipsychotic drugs only work for short periods of time. Answer: b. 94. Extrapyramidal symptoms, common side effects of traditional medications used to treat schizophrenia, are disturbances in a. attention. b. motor functions. c. affect regulation. d. weight regulation. Answer: b. 95. Mabel is taking an antipsychotic to treat her schizophrenia. Which of the following drugs would be expected to cause Mabel to gain the most weight? a. chlorpromazine (Thorazine) b. clozapine (Clozaril) c. risperidone (Risperdal) d. haloperidol (Haldol) Answer: b. 96. What is one common problem with prolonged use of traditional antipsychotic medications for treating psychosis? a. alogia b. anhedonia c. schizotaxia d. tardive dyskinesia Answer: d. 97. Why is the new class of antipsychotic medications called "atypical"? a. They do not produce extrapyramidal symptoms. b. They are used for unusual types of schizophrenia. c. They are effective for a small number of patients. d. They are usually used for non-schizophrenic disorders. Answer: a. 98. As a clinician treating schizophrenia, you know that which of the following statements about second-generation antipsychotic drugs is true? a. They are not significantly more effective than first-generation drugs for treating negative symptoms. b. Ultimately, they may decrease a patient’s risk for diabetes and hypertension. c. Most have more extrapyramidal side effects than first-generation drugs. d. They have no adverse side effects. Answer: a. 99. One action that all antipsychotic drugs share is that they a. cause extrapyramidable side effects. b. produce coronary side effects. c. block dopamine receptors. d. reduce tardictive properties. Answer: c. 100. Compared with traditional drugs, most second-generation antipsychotics a. produce a broader range of neurochemical actions in the brain. b. are less expensive. c. produce more dopamine. d. work on a narrower range of brain regions. Answer: a. 101. Patients who do not respond to traditional antipsychotic drugs may respond to new antipsychotic drugs like clozapine, which has a major effect on a. GABA levels. b. neuropeptides. c. dopamine systems. d. serotonin systems. Answer: d. 102. The major goal of most family treatment programs is to a. help family members improve their coping skills. b. instruct family members in the methods of administering drug treatments. c. encourage family members to keep the patient as calm and sedate as possible. d. provide family members that the same forms of therapy as the patient receives. Answer: a. 103. A comprehensive, integrated program aimed at the improvement of the cognitive abilities of schizophrenic patients, including those that are concerned with social cognition and performance on laboratory tasks, such as attention, working memory, and problem solving, is known as a. cognitive schizophrenic therapy. b. cognitive enhancement therapy. c. cognitive behavioral therapy. d. social skills training. Answer: b. 104. What is the key to the assertive community treatment programs for schizophrenia? a. The clinicians seek out the patients to provide services. b. The programs encourage members of the community to interact with patients. c. The programs use some of the same techniques used in assertive training for socially shy people. d. The clinicians insist that patients must live on their own in the community, without relying on drug treatments. Answer: a. 105. What have outcome studies found regarding the value of assertive community treatment programs for schizophrenia? a. They are effective but very costly. b. They can effectively reduce the number of days that patients spend in psychiatric hospitals. c. They can only work when they are staffed by psychiatrists and psychologists. d. They can dramatically reduce the need for dangerous antipsychotic medications. Answer: b. 106. Institutionalized schizophrenics are sometimes helped with the use of token economies. The basis of these programs is that the patients receive a. payment for unskilled labor. b. rewards for appropriate behavior. c. education about how to manage money. d. state aid for treatment. Answer: b. Short Answer 107. The phase of schizophrenia that precedes the active phase, but is characterized by deteriorating functioning, is known as the __________ phase. Answer: prodromal 108. The __________ phase follows the active phase of schizophrenia. Answer: residual 109. A schizophrenic client who is exhibiting lack of initiative, social withdrawal, and anhedonia would be showing __________ symptoms. Answer: negative 110. When seen in a schizophrenic client, a rigidly held, idiosyncratic belief or preposterous idea is known as a(n) __________ . Answer: delusion 111. When a schizophrenic demonstrates flattened emotions or restricted expression of verbal or nonverbal emotions, it is known as __________ emotional expression. Answer: diminished 112. Impoverished thinking in a schizophrenic client is known as __________. Answer: alogia 113. In a schizophrenic client, obviously incongruent and inconsistent emotional responses to situations are called __________. Answer: inappropriate affect 114. ________ behavior is characterized by motor immobility or purposeless movement. Answer: Catatonic 115. Subtypes of schizophrenia are __________ from DSM-5. Answer: absent 116. Current literature suggests that __________ are 30 to 40 percent more likely to develop schizophrenia than the opposite sex. Answer: men 117. In support of the theory that viral infection may play a role in the etiology of schizophrenia is the observation that children born during the __________ season are more likely to develop the disorder. Answer: winter 118. Neural circuits in the __________ prefrontal cortex may function improperly in schizophrenia. Answer: dorsolateral 119. The textbook refers to drugs that are used to treat schizophrenia as __________ medications. Answer: antipsychotic 120. Prolonged treatment with traditional antipsychotic drugs can lead to the development of _________ , a syndrome that consists of abnormal involuntary movements of the mouth and face, such as tongue protrusion, chewing, and lip puckering. Answer: tardive dyskinesia Essay 121. In addition to the duration of the disorder, what does the DSM-5 definition of schizophrenia take into account? Answer: In addition to the duration of the disorder, the DSM-5 definition of schizophrenia takes into account the person’s level of functioning and the exclusion of related conditions, particularly mood disorders. For the level of functioning, evidence is required of a person’s decline in social or occupational functioning in order to diagnose schizophrenia. If symptoms of mania or depression are present, they must be of brief duration relative to the active and residual symptoms of schizophrenia. 122. Are gender differences found in schizophrenia? Generally, what are the two hypotheses about gender differences in schizophrenia? Answer: Men are about 30 to 40 percent more likely to develop schizophrenia according to recent studies. Moreover, men show an earlier onset by about four or five years. The premorbid functioning of men tends to be poor and is marked by more schizotypal traits. In contrast, the premorbid functioning of women is good and is marked by fewer schizotypal traits. Men tend to exhibit more negative symptoms; women tend to have more hallucinations and paranoia. In men, the course of the disorder tends to be chronic, and men show a poorer response to treatment. The course of schizophrenia in women is less likely to be chronic, and women show a better response to treatment. Gender differences in the age of onset and symptomatic expression of schizophrenia can be interpreted in several ways. One approach assumes that schizophrenia is a single disorder and that its expression varies in men and women. A common, genetically determined vulnerability to schizophrenia might be expressed differently in men and women. Mediating factors that might account for this difference could be biological differences between men and women (e.g., hormones) or different environmental demands, such as timing and the form of stress associated with typical male and female sex roles. An alternative approach suggests that there are two qualitatively distinct subtypes of schizophrenia: one that is characterized by an early onset affects men more often than women, while the other, with a later onset, affects women more often than men. 123. Discuss the evidence that suggests the dopamine hypothesis as a factor in the cause of schizophrenia. Answer: The dopamine hypothesis derives from the discovery that all of the first generation of antipsychotic drugs reduced the activity of the neurotransmitter dopamine. It was then hypothesized that too much dopamine or too much dopamine activity was a causal factor in the etiology of this disorder. After the therapeutic effects were observed, studies showed that most antipsychotic drugs block or prevent dopamine from interacting with dopamine receptors. Eventually it was observed that a drug’s therapeutic effects were directly and strongly correlated with its ability to block dopamine reception. Imaging studies of schizophrenic patients’ brains have found that some patients have elevated levels of dopamine functioning in the striatum. Recent attention is focused on multiple neurotransmitters and receptors. 124. Explain the difference between the social causation hypothesis and the social selection hypothesis in the explanation of higher rates of schizophrenia among the lower classes in the United States. Answer: The social causation hypothesis holds that members of the lower classes experience more stressors; these experiences can trigger the manifestation of schizophrenia. The social selection hypothesis holds that schizophrenic individuals are less able to complete education and keep a good job, and so their status drifts down to the lower class. 125. Explain what is meant by expressed emotion (EE) and why researchers have been so interested in it. Discuss its relevance to our understanding of schizophrenia and other disorders. Answer: EE is an aspect of disturbed communication within families where one member suffers from schizophrenia. It is associated with family members who make statements that reflect negative or intrusive attitudes toward the patient. Family members may express hostility toward the patient or be repeatedly critical. Other family members appear to be overprotective or too closely identified with the patient. Patients who live in a family high in EE were more likely to relapse than patients from low EE families. Average relapse rates are 52 percent for patients in high EE families and 22 percent for patients in low EE families. However, the influence of EE is not unique to schizophrenia. Patients with mood disorders, eating disorders, panic disorder with agoraphobia, and obsessive-compulsive disorder are also more likely to relapse following discharge from a hospital if they are living with a high EE relative. 126. What criteria should be met by a potential marker for vulnerability to schizophrenia? Answer: A potential marker for vulnerability to schizophrenia should distinguish between persons who have schizophrenia and those who do not. The marker should be a stable characteristic over time. The proposed measure of vulnerability should identify more people among the biological relatives of schizophrenic patients than among people in the general population. The proposed measure of vulnerability should be able to predict the future development of schizophrenia among those who have not yet experienced psychotic episodes. 127. What are the atypical antipsychotic drugs and why are they used? Answer: The term “atypical” is used because these drugs do not produce extrapyramidal symptoms and are less likely to produce tardive dyskinesia. These drugs include Clozapine (Clozaril), risperidone (Risperdal), and olanzapine (Zyprexa). All of these drugs block serotonin receptors, in addition to other neurochemical actions. Test Bank for Abnormal Psychology Thomas F. Oltmanns, Robert E. Emery 9780205997947, 9780205970742, 9780134899053, 9780134531830, 9780205965090

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