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Chapter 15: Schizophrenia, Affective Disorders, and Anxiety Disorders 15.1 Multiple Choice 1) ________ proposed that removal of the frontal lobes could be used to alleviate human ________. A) Sigmund Freud; unconscious conflict B) Egas Moniz; anxiety C) Eugene Bleuler; schizophrenia D) Neil Carlson; anxiety E) Egas Moniz; schizophrenia Answer: B Rationale: Egas Moniz proposed that removal of the frontal lobes could be used to alleviate human schizophrenia. 2) The incidence of schizophrenia in the world population is approximately ________ percent. A) 0.1 B) 1 C) 2.5 D) 5 E) 8 Answer: B 3) Which of the following is NOT true of schizophrenia? A) Schizophrenia is a serious mental disorder. B) The term means "split mind." C) The incidence of schizophrenia is about 1 percent of the world population. D) The term means "split personality." E) Schizophrenia has been recognized as a disorder for thousands of years. Answer: D Rationale: Schizophrenia does not mean "split personality." 4) In coining the term schizophrenia, Bleuler emphasized A) the inability to make important decisions. B) delusional thinking. C) a separation of thoughts and feelings. D) extreme sadness in the presence of mania. E) multiple personalities. Answer: C Rationale: In coining the term schizophrenia, Bleuler emphasized a separation of thoughts and feelings. 5) An example of a negative symptom of schizophrenia is A) anxiety. B) flat mood. C) social withdrawal. D) intense euphoria.. E) difficulty in communicating via sign language. Answer: C Rationale: An example of a negative symptom of schizophrenia is social withdrawal. 6) The major types of symptoms noted in schizophrenia include A) positive symptoms, negative symptoms, and cognitive symptoms. B) hallucinations and social withdrawal. C) thought disorder and impaired language ability. D) delusions and hallucinations. E) delusions and profound sadness. Answer: A Rationale: The major types of symptoms noted in schizophrenia include positive symptoms, negative symptoms, and cognitive symptoms. 7) Delusions A) are beliefs that are contrary to fact. B) indicate the presence of depression. C) are perceptions that occur without the presence of stimuli. D) are linked to brain damage. E) are common negative symptoms of schizophrenia. Answer: A 8) Schizophrenic hallucinations are most likely to involve the ________ system. A) tactile B) visual C) kinesthetic D) audition E) olfactory Answer: D 9) A homeless person who believes that he is the President of the USA is most likely suffering from a delusion of A) perception. B) control. C) grandeur. D) low self-esteem. E) hypochondiasis. Answer: C 10) Negative symptoms of schizophrenia A) are associated with low levels of brain dopamine activity. B) usually require long hospital terms to treat. C) represent the absence or diminution of normal behaviors. D) indicate that the patient cannot accurately perceive reality. E) are specific to schizophrenia. Answer: C Rationale: Negative symptoms of schizophrenia represent the absence or diminution of normal behaviors. 11) An example of a negative symptom of schizophrenia is A) poor abstract thinking. B) the inability to experience pleasure. C) an auditory hallucination. D) low psychomotor speed. E) poor problem-solving. Answer: B 12) The negative symptoms of schizophrenia A) are best illustrated by hallucinations. B) represent additions to normal behaviors. C) are likely to be caused by excessive brain dopamine activity. D) represent the absence of normal behaviors. E) are best illustrated by delusions. Answer: D Rationale: The negative symptoms of schizophrenia represent the absence of normal behaviors. 13) An example of a cognitive symptom of schizophrenia is A) anxiety. B) difficulty in eye tracking. C) deficits in learning and memory. D) delusion. E) hallucinations. Answer: C 14) An example of a negative symptom of schizophrenia would be A) hearing voices that repeat senseless words and phrases. B) experiencing a feeling of euphoria at the start of an episode. C) believing that doctors are part of a plot to poison you. D) thinking that you are the most powerful being on earth. E) exhibiting flattened emotional expression. Answer: E Rationale: An example of a negative symptom of schizophrenia would be exhibiting flattened emotional expression. 15) The positive symptoms of schizophrenia may be caused by A) poor parenting. B) a single recessive gene. C) excessive activity in dopamine circuits in the brain. D) a degenerative disorder of the brain. E) an imbalance of norepinephrine and serotonin in the brain. Answer: C 16) All of the following statements about the genetic basis of schizophrenia are true EXCEPT that A) adoption studies indicate a biological basis for schizophrenia. B) the concordance rate for schizophrenia is higher for monozygotic than for dizygotic twins. C) a person with a "schizophrenia gene" will always develop schizophrenia. D) several genes may be involved in schizophrenia. E) genes impart a susceptibility to develop schizophrenia. Answer: C 17) The likelihood that a child born to two schizophrenic parents will become schizophrenic is less than 50 percent. This suggests that A) schizophrenia is not produced by a single gene. B) schizophrenic parents rarely marry. C) schizophrenia is a metabolic disorder. D) schizophrenia is produced by a single dominant gene. E) schizophrenia is associated with infertility. Answer: A Rationale: The likelihood that a child born to two schizophrenic parents will become schizophrenic is less than 50 percent. This suggests that schizophrenia is not produced by a single gene. 18) The correct order of appearance of schizophrenic symptoms is A) positive → negative → cognitive B) cognitive → positive → negative C) cognitive → negative → positive D) negative → cognitive → positive E) positive → cognitive → negative Answer: D 19) Chlorpromazine was initially developed to prevent surgical shock, but was later found to most effectively treat A) depression. B) schizophrenia. C) mania. D) anxiety. E) neuroses. Answer: B 20) The dopamine hypothesis of schizophrenia states that schizophrenia is caused by A) damage to ascending dopamine fibers. B) a breakdown product of the neurotransmitter serotonin. C) overactivity of dopaminergic synapses. D) low levels of one or more of the monoamines. E) an imbalance between acetylcholine and dopamine within the frontal cortex. Answer: C 21) The positive symptoms of schizophrenia are thought to result from overactivity of ________ neurons of the ________. A) cholinergic; basal forebrain B) NPY; hypothalamus C) dopaminergic; mesolimbic system D) noradrenergic; nucleus accumbens E) serotonergic; raphe nuclei Answer: C Rationale: The positive symptoms of schizophrenia are thought to result from overactivity of dopaminergic neurons of the mesolimbic system. 22) The mesolimbic pathway projects from the ________ to the ________. A) ventral tegmental area; frontal cortex B) globus pallidus; ventral tegmental area C) midbrain; cingulate cortex D) ventral tegmental area; nucleus accumbens and amygdala E) substantia nigra; caudate Answer: D 23) Imagine that you have been handed a list of drugs and that beside each drug name is a number that represents the potency of that drug for blocking dopamine receptors (where a low number means a greater potency at blocking). Which drug would be the most potent for the treatment of schizophrenia? A) potency value = 0.1 B) potency value = 0.3 C) potency value = 1.0 D) potency value = 5.0 E) potency value = 100.0 Answer: A Rationale: A drug that has great efficacy at blocking dopamine receptors ( potency value = 0.1) would be most potent for the treatment of schizophrenia. 24) The positive symptoms of schizophrenia are reversed by drugs that are A) similar in structure to the benzodiazepines. B) dopamine receptor agonists. C) antagonists at GABA receptors. D) agonists at serotonin receptors. E) dopamine receptor antagonists. Answer: E 25) Which of the drugs below would be expected to either produce or worsen the positive symptoms of schizophrenia? A) PROZAC B) caffeine C) cocaine D) aspirin E) lithium Answer: C Rationale: Cocaine would be expected to either produce or worsen the positive symptoms of schizophrenia. 26) John has been diagnosed with schizophrenia and has shown improvement in positive symptoms while taking chlorpromazine (CPZ). Which of the actions below, if taken by John, would be expected to greatly worsen his positive schizophrenia symptoms? A) John stops taking CPZ and takes part in a cocaine party. B) John takes double his normal CPZ dose per day. C) John takes reserpine in addition to CPZ. D) John mixes alcohol with CPZ. E) John ingests α-methyl-para-tyrosine in addition to CPZ. Answer: A Rationale: A schizophrenic who stops taking their medication (CPZ) and who then takes cocaine would be expected to relapse. 27) The dopamine hypothesis is supported by the finding that A) reserpine depletes monoamine vesicles and makes schizophrenia worse. B) cocaine and amphetamine induce negative schizophrenia symptoms. C) drugs that induce schizophrenic symptoms are dopamine antagonists. D) dopamine antagonists relieve the positive symptoms of schizophrenia. E) ketamine reverses positive schizophrenia sysmptoms. Answer: D Rationale: The dopamine hypothesis is supported by the finding that dopamine antagonists relieve the positive symptoms of schizophrenia. 28) Clozapine is referred to as an "atypical" antischizophrenic drug because it A) reverses both positive and negative symptoms of schizophrenia. B) has little blocking action within the striatum. C) is more potent at blocking D2 receptors than D4 receptors. D) effectively treats schizophrenia, but also produces motor side effects. E) does not induce mania. Answer: A Rationale: Clozapine is referred to as an "atypical" antischizophrenic drug because it reverses both positive and negative symptoms of schizophrenia. 29) The negative symptoms of schizophrenia may be related to A) having an older father. B) excessive birth weight. C) brain damage. D) a "schizophrenia gene." E) overactivity of dopaminergic neurons. Answer: C 30) Which of the following would represent a neurological symptom evident in schizophrenia? A) having poor control of eye movements and odd facial expressions B) exhibiting excessive emotional expression C) believing that doctors are part of a plot to poison you D) thinking that you are the most powerful being on earth E) experiencing a feeling of euphoria at the start of an episode Answer: A Rationale: An example of a neurological symptom would be having poor control of eye movements and odd facial expressions. 31) Which of the following supports the contention that schizophrenia is associated with brain damage? A) The size of the lateral ventricles decreases in schizophrenic patients. B) The size of the lateral ventricles increases in schizophrenic patients. C) The neurological symptoms noted in schizophrenia are unique to this disorder. D) Control subjects are more likely to show neurological symptoms. E) Older people, who have already lost substantial numbers of neurons, are more likely to develop schizophrenia than are younger people. Answer: B Rationale: The fact that the size of the lateral ventricles increases in schizophrenic patients supports the contention that schizophrenia is associated with brain damage. 32) Research conducted by Weinberger and others shows anatomical changes in the brains of schizophrenic patients, relative to controls. Which of the following was the major finding of these studies? A) decreased number of gyri and sulci in control patients B) increased number of cells within the corpus callosum in schizophrenic patients C) Schizophrenic patients show increased size of the lateral ventricles. D) Schizophrenic patients show an increase in cortical volume. E) Schizophrenic patients show fewer problems with eye tracking than do controls. Answer: C Rationale: Weinberger and others reported that schizophrenic patients show increased size of the lateral ventricles. 33) The seasonality effect refers to the observation that A) people born during the winter are more likely to develop schizophrenia. B) schizophrenic symptoms intensify during the summer. C) the rate of admissions to hospitals for schizophrenia is highest in the winter. D) people are more likely to contract flu during the summer months. E) the rate of admissions to hospitals for schizophrenia is lowest in the winter. Answer: A 34) Which of the following is true of the seasonality effect? A) Schizophrenia is more likely to occur in a person born in June, July, and August. B) The seasonality effect is lower in rural settings than in urban settings. C) The seasonality effect is mostly due to indoor smoking by the mother during the winter. D) The seasonality effect is enhanced when fall temperatures are higher than normal. E) The effect does not occur in regions that free access to antibiotics. Answer: B 35) Which of the following is known to increase the risk of schizophrenia? A) being born before a long flu season B) being born during the late summer C) being born in a southern latitude D) having a monochorionic twin who is schizophrenic E) having a father who smokes Answer: D Rationale: Having a monochorionic twin who is schizophrenic would increase the risk of schizophrenia. 36) Which of the following is most likely to be associated with the development of schizophrenia? A) being born into an affluent family B) having a young father C) being born five months after a major flu epidemic D) being born in a rural area E) being born in the summer Answer: C 37) Which of the following is an explanation offered by Carlson for the seasonality effect in schizophrenia? A) People are more likely to be outdoors during the early fall, leading to greater risk of a viral infection. B) A fetus born during the late summer is more likely to experience a viral infection during the second trimester. C) Immune function is generally enhanced during the winter months. D) A fetus born in the late winter is more likely to have been exposed to a viral infection during the second trimester. E) Birthing during the winter represents a stressor that impairs dopamine function. Answer: D 38) A key prediction of the viral hypothesis of schizophrenia is that A) children born a few months after the start of a flu outbreak are more likely to develop schizophrenia. B) mothers taking antibiotics should not have schizophrenic offspring. C) children born a few months before a flu outbreak are more likely to develop schizophrenia. D) exposure of the fetus to a virus during the third trimester is most likely to induce schizophrenia. E) rates of schizophrenia should not differ between northern and southern climates. Answer: A Rationale: A key prediction of the viral hypothesis of schizophrenia is that children born a few months after the start of a flu outbreak are more likely to develop schizophrenia. 39) Which of the following is a minor physical abnormality found in schizophrenia patients? A) thin-set eyes B) a short, round tongue C) symmetrical ears D) partial webbing of the two middle toes E) acne Answer: D 40) Children who later in life develop schizophrenia are more likely to show ________ in movies recorded earlier in their childhood. A) more sociability B) euphoria C) less sociability D) less overall activity E) symmetrical facial features Answer: C 41) Which of the following is an "environmental" factor that interacts with genetics for the development of schizophrenia? A) whether or not the twins were exposed to high levels of lead B) whether or not the mother consumed a high-fat diet during pregnancy C) whether identical twins shared the same or different placentas D) whether the pregnancy occurred on the East or West coasts E) whether or not fraternal twins experienced birth complications Answer: C 42) The majority of schizophrenia cases will develop the disorder between the ages of A) 12–14. B) 20–24. C) 30–34. D) 40–44. E) 55–59. Answer: B 43) MRI studies of schizophrenic brains indicates A) a sharp dip in brain volume during early adulthood in schizophrenic subjects. B) that schizophrenic patients showed more cortical volume than controls. C) a loss of brain volume starting in the occipital lobes. D) that excessive volume loss from the temporal lobes was related to the development of tactile hallucinations. E) a loss of brain volume starting in the temporal lobes. Answer: A 44) Weinberger argues that the negative symptoms of schizophrenia are related to A) increased neural activity within the ventral tegmental area. B) elevated dopamine activity within the nucleus accumbens. C) increased activity of the dorsolateral prefrontal cortex. D) decreased activity of the dorsolateral prefrontal cortex. E) gains in brain volume during young adulthood. Answer: D Rationale: Weinberger argues that the negative symptoms of schizophrenia are related to decreased activity of the dorsolateral prefrontal cortex. 45) ________ produces both positive and negative schizophrenia symptoms. A) Dopamine antagonists B) Haloperidol C) Phencyclidine D) Chlordiazepoxide E) Amphetamine Answer: C 46) Phencyclidine is of interest for the study of schizophrenia in that this drug A) is an agonist of the NMDA receptor. B) increases dopamine utilization in the prefrontal cortex. C) impairs feeding regulation in monkeys. D) reproduces the positive, negative, and cognitive symptoms of schizophrenia. E) produces minor physical anomalies. Answer: E 47) PCP acts as a(n) ________ at ________ receptors. A) agonist; NMDA B) antagonist; dopamine C) agonist; acetylcholine D) noncompetitive antagonist; NMDA E) antagonist; GABA Answer: D 48) Which of the following supports the notion that the prefrontal cortex is related to the negative symptoms of schizophrenia? A) Schizophrenic patients show a greater number of neurons within the gray matter of the frontal cortex. B) Schizophrenic patients show greater activity of the frontal cortex than do controls. C) Schizophrenic patients do poorly on neuropsychological tests that are sensitive to damage of the prefrontal cortex. D) MRI studies indicate abnormalities within the parietal cortex of schizophrenics. E) MRI studies indicate abnormalities within the temporal cortex of schizophrenics. Answer: C Rationale: The fact that schizophrenic patients do poorly on neuropsychological tests that are sensitive to damage of the prefrontal cortex supports the notion that the prefrontal cortex is related to the negative symptoms of schizophrenia. 49) A drug that decreases the activity of neurons within the dorsolateral prefrontal cortex would be expected to A) induce both positive and negative symptoms of schizophrenia. B) induce only the positive symptoms of schizophrenia. C) decrease the levels of dopamine within the nucleus accumbens. D) be an effective treatment for schizophrenia. E) be an effective treatment for thought and language disorders. Answer: A Rationale: A drug that decreases the activity of neurons within the dorsolateral prefrontal cortex would be expected to induce both positive and negative symptoms of schizophrenia. 50) A mutation of the _____ gene may induce abnormalities of neurons in the ____ which results in schizophrenia. A) DISC-3; hippocampus B) DISC-1; prefrontal cortex C) DISC-3; amygdala D) DISC-4; prefrontal cortex E) DISC-1; motor cortex Answer: B 51) ________ reverses the positive, negative, and cognitive symptoms by schizophrenia by acting as a ________ in the prefrontal cortex and nucleus accumbens. A) L-DOPA; competitive antagonist B) Aripiprazole; partial agonist C) Reserpine; monamine agonist D) Aripiprazole; reuptake inhibitor E) Amphetamine; reuptake inhibitor Answer: B Rationale: Aripiprazole reverses the positive, negative, and cognitive symptoms by schizophrenia by acting as a partial agonist in the prefrontal cortex and nucleus accumbens. 52) Atypical antipsychotic drugs increase activity in the _______, but decrease activity in the ______. A) ventral tegmental area; amygdala B) prefrontal cortex; nucleus accumbens C) amygdala; hippocampus D) nucleus accumbens; prefrontal cortex E) amygdala; ventral tegmental area Answer: B 53) Mania refers to feelings of A) extreme sadness. B) anxiety. C) extreme elation. D) pride. E) distance and loneliness. Answer: C 54) Another name for the major affective disorders is A) mood disorders. B) anxiety disorders. C) addictive disorders. D) schizoaffective disorders. E) manic-depressive disorders. Answer: A 55) Episodes of mania in bipolar disorder are characterized by A) strong feelings of guilt. B) extreme sadness. C) crying spells. D) suicidal thoughts. E) euphoria. Answer: E 56) Episodes of depression are characterized by A) strong feelings of euphoria. B) extreme sadness. C) hair pulling. D) high energy. E) hallucinations. Answer: B 57) Which of the following is NOT a symptom of depression? A) constipation and dry mouth B) sleep disturbances C) increased appetite for sex D) decreased appetite for food E) periods of intense crying Answer: C 58) Alternating episodes of elation and sadness are referred to as A) bipolar disorder. B) unipolar depression. C) severe mania. D) severe depression. E) schizoaffective disorder. Answer: A 59) Suffering from a major affective disorder carries with it a serious risk of A) developing delusions and compulsions. B) death by suicide. C) cardiac disease. D) loss of dopamine cells within the prefrontal cortex. E) poor grooming habits. Answer: B 60) An example of a positive benefit associated with a manic episode is A) intense effort at completing a project. B) intense euphoria. C) delusions of grandeur. D) increased energy to take on many projects at once. E) severe disorganization. Answer: A Rationale: An example of a positive benefit associated with a manic episode is intense effort at completing a project. 61) The concordance rate for affective disorder for monozygotic twins A) is identical to that of dizygotic twins. B) is the same whether or not the twins were raised in the same household. C) proves that affective disorder is mostly an effect of the environment. D) is higher than that for dizygotic twins. E) is less than that noted for close relatives suffering from affective disorder. Answer: D 62) An effective treatment for unipolar depression involves A) lithium salts. B) electroconvulsive shock therapy. C) drugs that block the reuptake of serotonin or norepinephrine. D) sleep deprivation. E) drugs that inhibit monoamine oxidase (MAOi). Answer: B Rationale: An effective treatment for unipolar depression involves electroconvulsive shock therapy. 63) A key function of monoamine oxidase is to A) convert norepinephrine into epinephrine. B) convert dopamine into norepinephrine. C) provide the precursor for the catecholamines. D) degrade catecholamines and serotonin into inactive forms. E) speed up the digestion of cheese within the gut. Answer: D 64) Drugs that inhibit the activity of monoamine oxidase (MAOi) A) can be an effective treatment for mania. B) decrease levels of serotonin within terminal buttons. C) decrease levels of norepinephrine in terminal buttons. D) can induce a fatal reaction in a person who eats cheese. E) can result in permanent motor dysfunction. Answer: D 65) Fluoxetine (Prozac) is an effective treatment for ________ that works by ________. A) schizophrenia; blocking dopamine receptors B) depression and obsessive-compulsive disorder; blocking serotonin reuptake C) anxiety disorders; inhibition of MAO D) delusions and hallucinations; blocking serotonin reuptake E) obsessive-compulsive disorder; releasing glycine Answer: B Rationale: Fluoxetine (Prozac) is an effective treatment for depression and obsessive-compulsive disorder that works by blocking serotonin reuptake. 66) The tricyclic antidepressant drugs are monoamine agonists in that these drugs A) block the reuptake of norepinephrine and serotonin into the terminals. B) stimulate the release of glycine within the limbic system. C) speed up the reuptake of norepinephrine and serotonin into the terminals. D) block NMDA receptors. E) block the reuptake of dopamine into the terminals. Answer: A Rationale: The tricyclic antidepressant drugs are monoamine agonists in that these drugs block the reuptake of norepinephrine and serotonin into the terminals. 67) Which of the following provides the best evidence that there is a difference between bipolar affective disorder and unipolar depression? A) Chlorpromazine is only effective in treating unipolar depression. B) There is a sex difference in the incidence of these disorders. C) Lithium is effective in treating only bipolar disorder. D) The age of onset differs between the two disorders. E) Serotonin reuptake inhibitors are effective for bipolar disorder but not unipolar depression. Answer: C Rationale: The observation that lithium is effective in treating only bipolar disorder provides the best evidence that there is a difference between bipolar affective disorder and unipolar depression. 68) The rationale for shocking the brains of mental patients to produce a seizure was that A) psychiatric patients show abnormal electrical activity of the cortex. B) painful shock made the patients more manageable. C) the occurrence of a brain seizure appeared to reduce symptoms in psychiatric patients. D) large doses of insulin had been shown to normalize brain activity. E) such treatments curbed inappropriate behavior. Answer: C Rationale: The rationale for shocking the brains of mental patients to produce a seizure was that the occurrence of a brain seizure appeared to reduce symptoms in psychiatric patients. 69) A major difference between electroconvulsive shock therapy (ECT) and treatment using antidepressant drugs is that A) antidepressant drugs act more rapidly to lift depression than does ECT. B) antidepressant drugs are more likely to impair memory. C) ECT has fewer dangerous side effects. D) ECT lifts depression faster than do antidepressant drugs. E) antidepressant drugs may work in depressed persons who do not respond to ECT. Answer: D Rationale: A major difference between electroconvulsive shock therapy (ECT) and treatment using antidepressant drugs is that ECT lifts depression faster than do antidepressant drugs. 70) Lithium salts are an effective treatment for ________ but not ________. A) delusions; hallucinations B) bipolar affective disorder; unipolar depression C) anxiety disorder; delusions D) unipolar depression; hallucinations E) depression; mania Answer: B 71) A serious problem for the use of lithium in treating mania is that A) lithium can only be used for short periods of time. B) the drug can produce a fatal overdose. C) lithium may not work in up to 50 percent of patients. D) lithium suppresses normal emotions. E) lithium is the least effective of the current drugs used to treat mania. Answer: B Rationale: An effective therapy for treatment-resistant depression involves the use of electrical stimulation of the subgenual ACC. 72) An effective therapy for treatment-resistant depression involves the use of A) anticonvulsant drugs. B) fluoxetine. C) electrical stimulation of the vagus. D) chlordiazepoxide. E) electrical stimulation of the subgenual ACC. Answer: E 73) The monoamine hypothesis states that depression is caused by A) overactivity of monoaminergic neurons. B) insufficient activity of monoaminergic neurons. C) excessive activity of dopamine synapses. D) loss of cells within the prefrontal cortex. E) excessive activity of serotonin synapses. Answer: B 74) The monoamine hypothesis of depression is NOT supported by the observation that A) monoamine antagonists produce depression. B) CSF levels of 5-HIAA are low in suicidal patients. C) monoamine agonists produce depression. D) families of subjects with low 5-HIAA levels were more likely to include people with depression. E) reserpine causes depression. Answer: C Rationale: The monoamine hypothesis of depression is NOT supported by the observation that monoamine agonists produce depression. 75) A group of depressed persons (with a family history of depression) on medication who are currently feeling well are recruited for an experiment. When these persons are fed a diet low in tryptophan on one day and a cocktail high in amino acids (other than tryptophan) on the following day, they A) become more aggressive. B) become manic. C) show changes in cognition, but not affect. D) relapse into depression. E) become voracious eaters. Answer: D 76) MRI studies indicate that bipolar depression is associated with abnormalities of the A) caudate nucleus. B) nucleus accumbens. C) cerebral ventricles. D) corpus callosum. E) prefrontal cortex. Answer: C 77) Which of the following has been implicated in depression? A) activation of the orbitofrontal cortex B) greater activity of the medial forebrain bundle system C) reduced volume of the brain ventricles D) enhanced activation of the subgenual prefrontal cortex E) enhanced activation of the amygdala Answer: E 78) Which of the following best describes the changes in sleep that occur during depression? A) Slow-wave sleep stages 3 and 4 are reduced and stage 1 sleep is increased. B) Depressed people awaken more in the first half of the night. C) All phases of slow-phase sleep are increased, while REM sleep is reduced. D) REM occurs in higher proportion later in the night. E) REM sleep is abolished. Answer: A 79) Evidence from animal and human studies shows that most antidepressant drugs A) suppress slow-wave sleep. B) increase REM sleep. C) increase slow-wave sleep. D) suppress REM sleep. E) produce an enhanced degree of fragmentation of REM sleep. Answer: D 80) The primary effect of many antidepressant medications may be to A) stimulate orexin receptors. B) suppress REM sleep. C) activate GABA receptors. D) reduce stages 3 and 4 of sleep. E) increase sexual motivation, which results in loss of sleep and improved mood. Answer: B 81) The effect of total sleep deprivation on depression A) suggests that sleep causes the destruction of an endogenous substance that promotes depression. B) develops slowly. C) is sufficiently large to justify this as an effective way to treat depression. D) is relatively long lasting. E) is lost after a night of sleep. Answer: E 82) The mood disorder characterized by depression, lethargy, sleep disturbances, craving for carbohydrates, and weight gain is called A) seasonal affective disorder. B) bulimia nervosa. C) the winter blahs. D) zeitgeber-induced depression. E) anorexia nervosa. Answer: A 83) ________ reduces the symptoms of seasonal affective disorder. A) Exposing people to ketamine daily B) Reducing light exposure C) Prolonged bed rest D) Administration of a monoamine agonist E) Prozac Answer: C 84) A key characteristic of the anxiety disorders is A) the absence of REM brain waves during the awake phase. B) an inability to control euphoria. C) the presence of unfounded feelings of fear and dread. D) a high level of dopamine receptors within the nucleus accumbens. E) an impulsive desire to mate that occurs at inappropriate times. Answer: C 85) Panic disorder A) occurs about twice as often in women as in men. B) rarely lasts more than a few seconds. C) rarely appears before the age of 35. D) is five times more likely to occur in older men than older women. E) is a disorder of young women, but not young men. Answer: A 86) Recurring attacks of acute and debilitating anxiety are a primary symptom of A) mania. B) psychoses. C) adult-onset depression. D) panic disorder. E) reactive depression. Answer: D 87) ________ refers to a fear of being away from home or other protected places. A) Anticipatory panic disorder B) Acrophobia C) Refractory anxiety D) Agoraphobia E) Claustrophobia Answer: D 88) Which type of drug should be avoided by a person suffering from panic disorder? A) benzodiazepine agonists B) tricyclic antidepressants C) MAO inhibitors D) ethyl alcohol E) benzodiazepine antagonists Answer: E Rationale: A person suffering from panic disorder should avoid taking a benzodiazepine antagonist drug. 89) Which of the following is among the most effective treatments for panic disorder? A) benzodiazepine drugs B) tricyclic antidepressant drugs C) MAO inhibitor drugs D) ketamine therapy E) behavioral therapy Answer: A Rationale: Benzodiazepine drugs are among the most effective treatments for panic disorder. 90) An obsession is a ________, while a compulsion is a ________. A) learned behavior; delusional thought B) delusion; feeling of emotion C) thought; behavior D) form of species-typical behavior; learned behavior E) recurring feeling of anxiety; form of intense euphoria Answer: C 91) All of the following are true of obsessive-compulsive disorder (OCD) EXCEPT A) OCD symptoms are similar across different cultures. B) OCD is associated with damage to the basal ganglia. C) PET scans have shown increased activity in the frontal lobes of OCD patients. D) OCD is much more common in men than in women. E) OCD is characterized by counting, checking, and cleaning rituals. Answer: D Rationale: OCD is not more common in men than in women. 92) Infections that result in autoimmune disorder and in symptoms of obsessive-compulsive disorder are likely to involve damage of the A) basal ganglia. B) hypothalamus. C) cingulate sulcus. D) somatosensory cortex. E) cerebellum. Answer: A 93) Which of the following is correct regarding neurosurgery for obsessive-compulsive disorder (OCD)? A) Ablation of the frontal cortex is most likely to produce improvement in OCD symptoms. B) Ablation of the cingulum bundle is most likely to produce negative cognitive changes in OCD patients. C) Neurosurgery works best when followed by drug treatment. D) Ablation of the cingulum bundle is most likely to produce improvement in OCD symptoms. E) Neurosurgery is the most common treatment for OCD. Answer: D Rationale: Ablation of the cingulum bundle is most likely to produce improvement in OCD symptoms. 94) In an anecdote in the text, how did a young man successfully treat his own compulsions? A) He took antibiotics which eliminated a brain infection. B) A bar fight resulted in damage to his cingulum bundle. C) He damaged his own frontal cortex by firing a bullet into his own brain. D) He ingested herbal supplements that destroyed his caudate nucleus. E) He moved to a country in which his compulsions were socially acceptable. Answer: C 95) ________ is(are) effective in treating obsessive-compulsive disorder. A) Clomipramine B) Serotonin agonists C) Fluoxetine D) Fluvoxamine E) All of the above are correct. Answer: E 96) The most effective treatment for obsessive-compulsive disorder is A) the use of serotonin agonist drugs. B) self-medication using alcohol and cocaine. C) neurosurgery. D) long-term psychotherapy. E) antibiotic drug therapy. Answer: A 97) Which of the following is true of trichotillomania? A) It can be treated by ketamine. B) It involves intense sadness. C) It is a symptom of depression.. D) It is a compulsive behavior. E) It is an example of a seasonal disorder. Answer: C 15.2 True-False 1) The term schizophrenia means a split of the mind into multiple personalities. Answer: False 2) Negative schizophrenia symptoms include lack of initiative and poverty of speech. Answer: True 3) Schizophrenia is linked to genes on chromosomes 21 and Y. Answer: False 4) Clozapine is an atypical antipsychotic drug in that it produces more motor side effects than do other antipsychotic drugs. Answer: False 5) Individuals born a few months after a major flu season are more likely to develop schizophrenia. Answer: True 6) The risk of developing schizophrenia increases if one has physical anomalies AND has a relative who is schizophrenic. Answer: True 7) The concordance rate for schizophrenia is higher in twins who shared the same placenta. Answer: True 8) Schizophrenia is associated with a sharp reduction of brain volume during young adulthood. Answer: True 9) PCP (phencyclidine) induces negative and positive symptoms of depression. Answer: False 10) A mutation of the DISC-1 gene may result in schizophrenia. Answer: True 11) Women are more likely to suffer from unipolar depression than are men. Answer: True 12) The rate of death by unnatural causes is 28.8 times higher in people with affective disorder than in normal people. Answer: True 13) Lithium is used to treat bipolar disorder. Answer: True 14) A person who suffers from agoraphobia has a fear of heights. Answer: False 15) Serotonin agonists decrease the symptoms of panic attacks. Answer: True 16) A compulsion is a behavior that a person cannot keep from performing. Answer: True 17) Damage to the cingulum bundle aggravates obsessive-compulsive disorder. Answer: False 18) Brain trauma can produce obsessive-compulsive disorder. Answer: True 15.3 Short-Answer Essay 1) Distinguish between positive and negative symptoms of schizophrenia and provide two examples of each type. Answer: Positive symptoms represent additions to normal behaviors. Hallucinations are perceptions that occur in the absence of a sensory stimulus. Delusions are incorrect beliefs that are resistant to change. Negative symptoms are represented by behaviors that are missing, such as poverty of speech or flattened emotional response. 2) Explain why it is thought that genes convey a susceptibility for schizophrenia. Answer: Schizophrenia is not the result of a single dominant gene nor is it the result of the action of a recessive gene. Adoption and twin studies show heritability of the disorder. A mutation of the DISC-1 gene may result in schizophrenia. 3) Compare and contrast the actions of amphetamine-like stimulant drugs and of antipsychotic drugs on brain dopamine. Answer: Amphetamine causes the dopamine transporter to run in reverse, resulting in the spillage of dopamine into the synapse. Administration of amphetamine can evoke symptoms of paranoid psychosis. Antipsychotic drugs, in contrast, relieve the positive symptoms of schizophrenia. 4) Explain why clozapine is considered to be an "atypical" antipsychotic medication. Answer: Antipsychotic medications block dopamine receptors. Typical antipsychotic drugs exert strong effects on dopamine receptors in the striatum and reverse positive schizophrenia symptoms. The atypical agent clozapine alters both positive and negative schizophrenia symptoms. 5) What does the seasonality effect suggest about the causation of schizophrenia? Answer: Children born in later winter and early spring are more likely to develop schizophrenia, particularly if the family resides in an urban rather than a rural setting. These data suggest that being indoors during the winter exposes the mother (and fetus) to viral illness. Brain toxicity may result when such illness occurs during the second trimester. 6) Describe results from MRI studies that indicate brain damage in schizophrenia. Answer: MRI studies indicate the loss of brain tissue in schizophrenia, as indexed by an increase in the size of the lateral ventricles and by the loss of volume of the cortical gray matter. The loss of brain tissue shows a sudden increase during young adulthood. 7) Explain why it is thought that unipolar depression and bipolar disorder are distinct syndromes. Answer: Unipolar depression occurs without mania and is more likely to be noted in women than men. Bipolar disorder represents alternating periods of depression and of mania (euphoria). A variety of treatments exist for unipolar depression (MAOI, tricyclics, serotonin reuptake inhibitors, ECT, sleep deprivation), while lithium is an effective treatment for bipolar disorder. 8) Describe the changes in sleep noted in depressed persons. Answer: Depression results in shallow sleep, reduced levels of stages 3 and 4 slow-wave sleep, frequent awakenings, and alterations of REM sleep. 9) Explain why it is believed that panic attacks are thought to have a biological basis. Answer: Twin studies indicate a high degree of concordance between identical and fraternal twins. Panic attacks are effectively treated using benzodiazepine drugs that facilitate GABA, whereas anxiety is induced by antagonism of GABA receptors. 10) Describe the symptoms noted in obsessive-compulsive disorder and explain why these might reduce the chance of marriage. Answer: Obsessions are unwanted thoughts, while compulsions are behaviors that the person feels compelled to enact. Compulsive behaviors related to counting, cleaning, checking, and avoidance lead to social isolation, which is somewhat incompatible with marriage. 11) Describe the surgical procedures used for the treatment of obsessive-compulsive disorder. Answer: OCD has been treated using limited damage to the cingulum bundles, which connect the prefrontal and cingulate cortexes with the temporal lobe limbic cortex. The cingulotomy procedure offers a change of improvement for patients, is not associated with personality changes, and is a procedure of last resort, after drug therapies have been tried and failed. 15.4 Essay 1) Compare and contrast positive and negative symptoms of schizophrenia and explain why these are thought to involve distinct mechanisms. Answer: Positive symptoms represent additions to normal behaviors. Hallucinations are perceptions that occur in the absence of a sensory stimulus. Delusions are incorrect beliefs that are resistant to change. Negative symptoms are represented by behaviors that are missing, such as poverty of speech or flattened emotional response. Overactivity of the dopamine system is thought to play a key role in the production of positive symptoms. Antipsychotic drugs block dopamine receptors, and stimulation of dopamine results in positive symptoms. Negative symptoms are also seen after brain trauma, and it appears that degeneration/loss of brain neurons occurs in schizophrenia. 2) Describe the types of evidence that support the proposition that alteration of prenatal development can contribute to the causation of schizophrenia. Answer: Epidemiological studies show that season of birth can increase the risk of developing schizophrenia, with greater risk apparent for children born during the later winter—this may reflect the occurrence of a viral illness during the second trimester of prenatal development. Identical twins who share the same placenta (monochorionic) are more likely to develop schizophrenia than are dichorionic identical twins. A mutation of the DISC-1 gene may result in abnormalities of the prefrontal cortex that in turn results in schizophrenia. 3) Explain why research involving PCP may offer important clues as to the causes of positive and negative symptoms of schizophrenia. Answer: PCP induces positive and negative symptoms. Reduced activity of the prefrontal cortex is associated with the negative symptoms of schizophrenia. Chronic abuse of PCP reduces the activity of the frontal lobes. The dorsolateral frontal cortex, in turn, projects to the VTA, which projects to the accumbens. Activation of the dorsolateral frontal cortex decreases the release of dopamine within the accumbens; presumably, hypofrontality results in increased release of dopamine in the accumbens (and the positive symptoms). 4) Describe the monoamine hypothesis of depression and discuss evidence that supports this hypothesis. Answer: Depression (without mania) reflects profound changes in mood, appetite, movement, and sleep. The monoamine hypothesis argues that depression reflects a reduced level of activity of the monoamine transmitters, specifically norepinephrine (NE) and serotonin (5-HT). A variety of treatments exist for unipolar depression (MAOI, tricyclics, serotonin reuptake inhibitors, ECT, and sleep deprivation). The tricyclic drugs block the reuptake of NE and 5-HT, while the serotonin reuptake inhibitors block only serotonin reuptake (resulting in more serotonin). The tryptophan deletion procedure lowers brain serotonin levels and can reinstate depression. 5) Explain the rationale used for sleep deprivation as a treatment for depression. Answer: Depression is accompanied by disorder of sleep in which sleep is shallow and fragmented. REM sleep comes on earlier in the night, and the first half of the night contains more REM periods. Sleep deprivation, either total deprivation or deprivation of REM sleep only, can alleviate depression. The suppression or delay of REM sleep appears to be involved in alteration of mood. Drugs that suppress REM sleep are antidepressant, and ECT both lifts mood and suppresses REM sleep. Test Bank for Foundations of Behavioral Neuroscience Neil R. Carlson 9780205968091, 9780134639796, 9780205947997

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