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Chapter 17: Contemporary and Legal Issues in Abnormal Psychology Multiple-Choice Questions 1. The concepts of universal, selective, and indicated interventions were widely used by a. psychodynamic therapists to describe ways of reducing neurotic anxiety. b. city planners to describe ways of eliminating crime and other social problems. c. public health experts to describe ways of preventing disease. d. developmental psychologists to describe problems that occur in early, middle, and later childhood. Answer: c. public health experts to describe ways of preventing disease. 2. Efforts at reducing racism as a means of preventing mental illness would be a(n) ___________ intervention. a. universal b. selective c. indicated d. tertiary Answer: b. selective 3. "Efforts that are aimed at influencing the general population" best describes a. crisis interventions. b. universal interventions. c. selective interventions. d. indicated interventions. Answer: b. universal interventions. 4. Universal interventions are concerned with two key tasks: a. identifying people with a particular disorder and referring them for help. b. providing timely therapy and evaluating its usefulness. c. strengthening individuals' psychological coping skills and improving their biological health. d. altering conditions that cause disorders and establishing conditions that foster positive mental health. Answer: d. altering conditions that cause disorders and establishing conditions that foster positive mental health. 5. Which of the following might be a component of a biologically based universal strategy for preventing mental illness? a. Identifying people with a particular disorder and referring them for help b. Determining whether or not there is a family history of mental illness c. Encouraging regular physical activity d. Offering tuberculosis testing Answer: c. Encouraging regular physical activity 6. Which of the following is a requirement for psychosocial health? a. High socioeconomic status b. Having sound moral judgment c. Having a realistic view of one's self d. Being a member of a religious organization Answer: c. Having a realistic view of one's self 7. Having skills for effective problem solving, possessing an accurate set of assumptions about oneself, and being prepared for problems one is likely to encounter at various life stages are all requirements for a. cultural adjustment. b. psychosocial health. c. biological health. d. being a candidate for deinstitutionalization. Answer: b. psychosocial health. 8. Which of the following is a sociocultural effort toward universal prevention of mental disorders? a. Daycare. b. Penal systems. c. Private schools. d. Social security. Answer: d. Social security. 9. Which of the following is a sociocultural effort toward universal prevention? a. Public education b. Teaching adolescents to not use drugs c. Hospitalizing the mentally ill d. Deinstitutionalization of the mentally ill Answer: a. Public education 10. The fact that funding for community mental health centers was cut in the 1980s while money for the "war on drugs" was increased illustrates the a. current shift away from attacking personal risk factors and toward attacking social circumstances. b. tendency for selective and indicated interventions to use different funding sources. c. trend of government to provide fewer selective interventions and more universal ones. d. likelihood that political philosophy will influence efforts at social change. Answer: d. likelihood that political philosophy will influence efforts at social change. 11.The school – based intervention program called DARE has been shown to be: a. highly effective b. largely not effective c. effective only in some stated. d. effective only with upper middle class students Answer: b. largely not effective 12. Efforts to counterbalance the social factors that entice adolescent binge drinking are examples of a. selective interventions. b. crisis interventions. c. indicated interventions. d. social-learning programs. Answer: a. selective interventions. 13. Although the rate of adolescent substance use has decreased, a. tobacco use has been eliminated. b. binge drinking has not. c. alcohol and tobacco use remains a persistent problem. d. adult use has increased. Answer: c. alcohol and tobacco use remains a persistent problem. 14. Why has the attempt to reduce the drug supply from other countries not reduced the rate of adolescent substance abuse? a. Most smugglers are still able to find a way to bring drugs in. b. Local residents account for most of the illegal drug traffic. c. The drugs most abused by adolescents are alcohol and tobacco, which are easily available. d. Drug abusers are traveling to other countries to obtain their supply. Answer: c. The drugs most abused by adolescents are alcohol and tobacco, which are easily available. 15. Why is it important to prevent teen alcohol use? a. Teens are more susceptible to alcoholism than adults. b. Most teens who drink go on to do "harder drugs." c. Teens are more prone to violence while drinking than adults. d. Early alcohol use is associated with later alcohol abuse and dependence. Answer: d. Early alcohol use is associated with later alcohol abuse and dependence. 16. What is the goal of school-based drug and alcohol education programs? a. To teach children how to recognize the drugs that they might be exposed to b. To ensure that children are educated consumers c. To teach children about drugs so that they can make informed choices d. To scare children away from using drugs Answer: c. To teach children about drugs so that they can make informed choices 17. Family-oriented alcohol prevention programs have been developed because a. teen views of alcohol typically reflect those of their parents. b. most underage alcohol use occurs at home. c. parents need to help their children resist peer pressure. d. teen drinking frequently starts when problems in the home have become unmanageable. Answer: a. teen views of alcohol typically reflect those of their parents. 18. Mrs. Lloyd was shocked when she learned of Julia's drinking. While she knew that Julia drank on occasion, she never expected that her 16-year-old daughter was drinking on a daily basis. What is unique about this scenario? a. Mrs. Lloyd was aware that her daughter drank. b. Most parents overestimate their children's drug and alcohol use. c. While teenaged boys are likely to drink, teenaged girls rarely do. d. Nothing. Answer: d. Nothing. 19. Why are extracurricular strategies so important? a. They provide middle-class youth with a place to go. b. They provide counseling and medical attention after school. c. They provide a means of supervision and opportunity for high-risk teens. d. They provide an opportunity to meet with teachers and go over schoolwork. Answer: c. They provide a means of supervision and opportunity for high-risk teens. 20. A group of professional educators and counselors met to discuss prevention efforts in a neighborhood school district. Which of the following would be the most effective way to prevent adolescent alcohol and other drug use? a. classroom education b. mass media c. Internet approach d. multicomponent program Answer: d. multicomponent program 21. Combined prevention programs that educate about drugs and teach skills needed to refuse alcohol and drug use demands a. are more successful than one single approach. b. are rarely as successful as family-based programs. c. are most effective when targeted at college students. d. are not as successful as classroom education. Answer: a. are more successful than one single approach. 22. Dr. Jones says, "These projects have clearly shown a promising path toward reducing the extent of substance abuse in young people." What projects is Dr. Jones talking about? a. Ones that combine different intervention strategies b. Ones that involve the interdiction or reduction in supply of drugs c. Ones that contradict the movies and TV commercials that glamorize drugs d. Ones that use teachers to tell students why drugs are bad for their health Answer: a. Ones that combine different intervention strategies 23. Project Northland demonstrated that a. a psychotherapist's involvement is the key ingredient in most drug prevention efforts. b. the development of peer pressure resistance skills can decrease drug use by 44 percent. c. there is no way of counteracting the positive representation of drugs in the media. d. community-wide "no use" norms for teens can be taught. Answer: d. community-wide "no use" norms for teens can be taught. 24. While there is little research on the different substance abuse prevention programs, what there is on programs such as Project Northland suggests a. they are extremely successful. b. they are more effective when they utilize a multicomponent approach. c. they are effective for children and adolescents who have not already started using. d. they are effective for non-minority children and adolescents only. Answer: b. they are more effective when they utilize a multicomponent approach. 25. In order to prevent long-term consequences, ___________ interventions are provided immediately after a disaster such as a plane crash. a. universal b. indicated c. education d. selective Answer: b. indicated 26. Indicated prevention emphasizes a. education efforts to an entire population regardless of the individual's social situation. b. the early detection and prompt treatment of maladaptive behavior in a person's community setting. c. teaching social skills and problem solving as a way of improving self-esteem. d. genetic screening. Answer: b. the early detection and prompt treatment of maladaptive behavior in a person's community setting. 27. Which of the following is an element of "milieu therapy"? a. Systematic desensitization. b. Patients are encouraged to participate in making decisions. c. Teaching social skills and problem solving. d. Challenging irrational thoughts. Answer: b. Patients are encouraged to participate in making decisions. 28. Which of the following is a characteristic of a therapeutic community? a. Individual responsibility b. Minimal interaction amongst the patients c. Extensive use of medications d. Many restrictions Answer: a. Individual responsibility 29. In a study by Paul and Lentz designed to assess the effectiveness of different approaches to the treatment of chronically hospitalized patients, what treatment approach was found to yield the best results? a. Milieu therapy b. Social learning c. Traditional mental hospital treatments d. Psychotherapy alone Answer: b. Social learning 30. At Rush General, the inpatient mental ward employs a program that focuses on modifying the behavior of the patients by giving them gold stars for good behavior and ignoring undesirable behavior. What type of treatment program does this appear to be? a. Milieu therapy b. Social learning c. Traditional mental hospital treatments d. Psychotherapy alone Answer: b. Social learning 31. Which of the following is a criticism of the use of token economies? a. They are ineffective. b. They are inconsistent with how the real world works. c. The patient is not an active part of the treatment process. d. It is inhumane to expect a mental patient to behave in accordance with an established schedule of reinforcements. Answer: d. It is inhumane to expect a mental patient to behave in accordance with an established schedule of reinforcements. 32. A major difference between social-learning programs and milieu therapy is that social-learning programs a. are never provided in mental hospitals. b. require each patient to be involved in groups that "govern" the ward. c. expect patients to care for one another. d. target specific behaviors for reinforcement. Answer: d. target specific behaviors for reinforcement. 33. Community-based treatment programs are now referred to as a. crisis intervention. b. deinstitutionalization. c. aftercare programs. d. managed care initiatives. Answer: c. aftercare programs. 34. Community-based facilities that provide aftercare are typically run by a. the residents themselves. b. mental health professionals. c. trained paraprofessionals. d. community activists. Answer: a. the residents themselves. 35. For which person is aftercare likely to be helpful because the person will fit the services typically offered? a. Bart, who has a lengthy criminal record b. Helen, who has developed posttraumatic stress disorder after being attacked c. Ned, who has had several schizophrenic episodes d. Vera, who has few psychological problems but who frequently moves from place to place Answer: c. Ned, who has had several schizophrenic episodes 36. In order for community-based aftercare for psychiatric patients to be successful a. there must be a crisis intervention component. b. milieu methods must be used rather than social-learning methods. c. the facilities must be run by mental health professionals. d. the staff must provide a secure environment. Answer: d. the staff must provide a secure environment. 37. Which of the following is a barrier to effective deinstitutionalization? a. Society's desire to free previously confined persons b. The use of antipsychotic medications c. The lack of sufficient mental health services in the community d. Deinstitutionalized patients do not fair better than those who remain hospitalized Answer: c. The lack of sufficient mental health services in the community 38. Which of the following was an unforeseen consequence of deinstitutionalization? a. An increased demand on the welfare system b. Abuses of antipsychotic and anxiolytic medications c. The need for mental health services in the community d. A rise in homelessness Answer: d. A rise in homelessness 39. The most recent research on deinstitutionalization has found a. inpatient hospitalization has been increasing due to the failures to provide adequate care in the community. b. inpatient hospitalization has continued to decrease, despite an increase in problems as a result. c. inpatient hospitalization has continued to decrease and communities have stepped up their response to improve outpatient care. d. inpatient hospitalization has been increasing due to increasing numbers of mentally ill. Answer: a. inpatient hospitalization has been increasing due to the failures to provide adequate care in the community. 40. Dr. McDougal's specialty is forensic psychology. We can imagine that she a. provides preventive services to prevent criminal behavior. b. is concerned with the legal status of the mentally ill. c. does research on the impact of deinstitutionalization. d. works for a managed care organization. Answer: b. is concerned with the legal status of the mentally ill. 41. One difference between voluntary hospitalization and involuntary commitment is that people who are in the hospital voluntarily a. need to be assessed as dangerous to themselves or others. b. can, with sufficient notice, leave the hospital when they want to. c. are eligible for aftercare services following. d. must be treated in the least restrictive environment. Answer: b. can, with sufficient notice, leave the hospital when they want to. 42. Which of the following can be committed against their will to a psychiatric hospital? a. Carole, who has schizophrenia and will not take her medications because they make her feel ill. b. Tina, who has schizophrenia and is homeless. c. Kathie, who has schizophrenia and has been threatening to hurt people on the street. d. Any of these three, schizophrenia is a serious enough disorder for the person to be forced into the hospital. Answer: c. Kathie, who has schizophrenia and has been threatening to hurt people on the street. 43. Once a person is committed to a mental hospital a. he or she must establish their sanity before they can be released. b. he or she must participate in whatever treatment they are prescribed. c. the hospital must report to the court as to whether or not continued confinement is necessary. d. the court establishes the minimum treatment necessary as indicated by testimony from two examiners. Answer: c. the hospital must report to the court as to whether continued confinement is necessary. 44. Emergency hospitalization without a commitment hearing is permitted when a. a judge declares that imminent danger exists. b. the person to be hospitalized has a criminal history. c. the person to be hospitalized is found to be insane. d. a physician signs a formal statement saying that imminent danger exists. Answer: d. a physician signs a formal statement saying that imminent danger exists. 45. Suppose a family is quite alarmed about the threatening behavior of a relative. They want to petition the court for commitment but there is no time to get a court order. What option does the family have? a. None. They must wait until there is a court evaluation of the person's dangerousness. b. They can ask the police to declare the person "insane." c. After getting a physician to state that the person is dangerous, they can have the police pick up and detain the person for up to 72 hours. d. After getting a police officer to examine the person, they can require the person's attendance in a crisis intervention program. Answer: c. After getting a physician to state that the person is dangerous, they can have the police pick up and detain the person for up to 72 hours. 46. Once a person has been involuntarily committed to a mental institution, he or she a. may refuse treatment. b. may refuse medication but not therapy. c. may refuse therapy but not medication. d. may not refuse treatment. Answer: a. may refuse treatment. 47. Although the majority of currently disordered persons shows no tendency toward violence, an increased risk of violence is likely among those who a. currently experience psychotic symptoms. b. have been extremely emotionally rigid in the past. c. have just experienced a natural or man-made form of disaster. d. are religiously preoccupied. Answer: a. currently experience psychotic symptoms. 48. Homicidal behavior amongst former patients is greatest with a diagnosis of a. alcoholism. b. bipolar depression. c. major depression. d. schizophrenia. Answer: a. alcoholism. 49. Which phrase best captures how well mental health professionals do in predicting the occurrence of dangerous acts? a. Exceedingly well, especially if the person has a diagnosed mental condition b. Rather well, as long as the patient provides honest information c. Miserably poorly, especially with people who are actively schizophrenic or delusional d. Not as well as we would like Answer: d. Not as well as we would like 50. What kind of mistake do most mental health professionals make when assessing dangerousness? a. They overemphasize the importance of situational factors. b. They overpredict violence. c. They underestimate the likelihood of violence in psychotic patients. d. They make many "false negatives." Answer: b. They overpredict violence. 51. One of the main reasons it is so hard to predict future dangerousness is a. there are no psychological tests to help measure dangerousness. b. most potentially violent people refuse to talk to therapists. c. there is very little research into who becomes violent and who doesn't, and why. d. situational circumstances play as large a role as an individual's personality traits. Answer: d. situational circumstances play as large a role as an individual's personality traits. 52. What is one of the best predictors of future violence? a. Compliance with treatment b. Past history of violence c. Family support d. Employment history Answer: b. Past history of violence 53. Predicting dangerousness is most comparable to a. preparing a team for a sports competition. b. reviewing for a comprehensive examination. c. figuring your taxes at the end of the year. d. preparing a weather forecast. Answer: d. preparing a weather forecast. 54. Under what circumstances can a therapist violate a client's confidence? a. When someone is in danger b. When a crime has been committed several years ago c. Only when the client gives permission d. Never Answer: a. When someone is in danger 55. What doctrine came out of the original Tarasoff v. Regents of the University of California et al. case? a. Treatment in the least restrictive environment b. The duty to warn c. The right-versus-wrong principle in insanity cases d. The duty to protect Answer: b. The duty to warn 56. In most states that have a Tarasoff-type rule, when a client threatens someone, a therapist must a. make a reasonable effort to warn potential victims. b. continue trying to warn potential victims until he or she reaches them. c. not break confidentiality. d. warn as many people who know the client as possible. Answer: a. make a reasonable effort to warn potential victims. 57. The Tarasoff rule usually applies a. anytime a client threatens to do a violent act. b. only to violent acts against people. c. only if the target of violence is clearly identifiable. d. only if the client has given an informed consent. Answer: c. only if the target of violence is clearly identifiable. 58. Tarasoff-style laws a. are in every state. b. are in a minority of states. c. are in a majority of states but vary quite a bit. d. are no longer law in most states. Answer: c. are in a majority of states but vary quite a bit. 59. The underlying basis of the insanity defense is a. people who have a mental illness should not be punished. b. people who have a mental illness cannot ever form the intent needed to commit a crime, so shouldn't be punished. c. some people who have a mental illness are not able to fully comprehend their behavior, so are not able to form the needed intent for a crime, so should not be punished. d. even if they had the required intent for a crime, the mentally ill still shouldn't be punished. Answer: c. some people who have a mental illness are not able to fully comprehend their behavior, so are not able to form the needed intent for a crime, so should not be punished. 60. What was unusual about the Hinckley case? a. He used the insanity defense. b. The public believed that he did not need to pay for his crime. c. He was successful in pleading the insanity defense. d. His petitions for release have been consistently denied. Answer: c. He was successful in pleading the insanity defense. 61. An attorney says, "My client has a mental disorder that made it impossible, at the time of the crime, to have intended to do harm. Because of this, he is not legally responsible for his actions." The attorney is arguing for a. involuntary commitment. b. the Tarasoff principle. c. deinstitutionalization of his client. d. an insanity defense. Answer: d. an insanity defense. 62. Why should defense lawyers be cautious about using the insanity defense? a. It rarely works. b. Most defendants feign mental illness in order to escape punishment. c. Hospitalization is not an appropriate consequence for those who have committed violent crimes. d. No reason - it frequently is successful. Answer: a. It rarely works. 63. A typical defense strategy, to try to counteract public anger about the insanity defense, is to a. portray the defendant as someone who was him- or herself a victim. b. portray the defendant as suffering terribly from their mental illness. c. portray the defendant as tremendously likeable. d. portray the victim as negatively as possible. Answer: a. portray the defendant as someone who was him- or herself a victim. 64. The insanity defense is employed in ___________ percent of capital cases in the United States. a. less than 2 b. roughly 10-15 c. 20 d. 33 Answer: a. less than 2 65. According to the M'Naghten Rule, insanity is defined as a. failing to understand the consequences of one's actions. b. not knowing right from wrong. c. acting on an irresistible impulse. d. lacking the capacity to understand that an action violates the law. Answer: b. not knowing right from wrong. 66. Darryl has schizophrenia, disorganized type. He has visual hallucinations, and one day he saw a giant bug standing in front of him. He picked up a large knife and stabbed it. In reality, Darryl stabbed his mother who had come to tell him dinner was ready. His lawyer argues that Darryl cannot be found guilty because he had no idea what he was doing or that it was wrong. His lawyer is arguing the a. M'Naghten rule. b. Durham rule. c. irresistible impulse rule. d. American Law Institute standard. Answer: a. M'Naghten rule. 67. Knowing right from wrong is to ___________ as "unlawful act was the product of mental disease" is to ________. a. irresistible impulse; Durham Rule b. M'Naghten Rule; Durham Rule c. Durham Rule; M'Naghten Rule d. M'Naghten Rule; irresistible impulse Answer: b. M'Naghten Rule; Durham Rule 68. The Durham Rule a. made the criteria for establishing insanity more objective. b. focused on the cause of an unlawful act. c. established that one was sane unless they did not know right from wrong. d. is often referred to as the "substantial capacity test." Answer: b. focused on the cause of an unlawful act. 69. The broadest of the insanity rules is the a. M'Naughten Rule. b. irresistible impulse rule. c. Durham Rule. d. Federal Insanity Defense Reform Act. Answer: c. Durham Rule. 70. Which of the following changed with the Federal Insanity Defense Reform Act of 1984? a. It became much easier for defendants to quality for the insanity defense. b. It narrowed the definition of insanity to the "product test" (Durham Rule). c. It abolished the "knowing right from wrong" principle. d. It put the burden of proof on the defense. Answer: d. It put the burden of proof on the defense. 71. Which of the following has the best chance of successfully pleading not guilty by reason of insanity? a. Tim, who is depressed, has never been hospitalized and murdered his wife. b. Ernie, who has schizophrenia, was in the hospital once a long time ago and murdered three former co-workers. c. Lori, who has bipolar disorder, has never been hospitalized and tried to murder a stranger. d. Susie, who has schizophrenia, has been in and out of hospitals all her life, who tried to break the arm of a romantic rival. Answer: d. Susie, who has schizophrenia, has been in and out of hospitals all her life, who tried to break the arm of a romantic rival. 72. The verdict of Guilty but Mentally Ill a. means people with mental illness that are found guilty of a crime are put in jail but in a special section. b. means people with mental illness that are found guilty of a crime get shorter sentences. c. means people with mental illness that are found guilty of a crime go to jail but get mental health treatment while in jail. d. means people with mental illness that are found guilty of a crime go to the hospital until they are better, then return to jail to serve out their sentence. Answer: d. means people with mental illness that are found guilty of a crime go to the hospital until they are better, then return to jail to serve out their sentence. 73. Why did World War II lead to a greater recognition of the pervasiveness of mental illness? a. Over 70 percent of veterans suffered from either PTSD or substance abuse after the war. b. Many women developed psychiatric conditions when left to raise families and make a living on their own. c. Two out of seven potential military recruits were rejected for psychiatric reasons. d. The military was unable to provide adequate mental health services to men in the field. Answer: c. Two out of seven potential military recruits were rejected for psychiatric reasons. 74. Which of the following funds research on mental disorders and assists communities in establishing effective mental health services? a. The National Association for Mental Health (NAMH) b. The American Psychological Association (APA) c. Health maintenance organization (HMO) d. The National Institute on Mental Health (NIMH) Answer: d. the National Institute on Mental Health (NIMH) 75. Which of the following activities does NIMH perform? a. Provide communities with psychologists and psychiatrists who do individual and group therapy b. Do nationwide universal and selective preventive interventions c. Pay for the hospital care of the chronically mentally ill d. Support professional training and provide the public with information on mental health Answer: d. Support professional training and provide the public with information on mental health 76. Most of NIMH's programs are a. actually planned and run by state and local organizations. b. actually focused on the prevention of crime rather than mental disorder. c. designed, controlled, and implemented by the federal government. d. much larger and better funded than they were in the 1960s and 1970s. Answer: a. actually planned and run by state and local organizations. 77. What is an important function of organizations such as the American Psychological Association, the American Psychological Society, and the American Medical Association? a. They fund most of the treatment and prevention research done in the United States. b. They draw up the policies that determine which clients get treatment and of what duration. c. They set and maintain professional and ethical standards. d. They control forensic issues such as the insanity defense and the policies for committing patients against their will. Answer: c. They set and maintain professional and ethical standards. 78. What do the National Association for Mental Health, the National Association for Retarded Citizens, and the National Alliance for the Mentally Ill (NAMI) have in common? a. They all provide training for psychologists and psychiatrists. b. They are all government-funded organizations that do research on mental disorders and related problems. c. They all try to improve services and educate the government and public about various problems. d. They are all working to increase the awareness of work-related stress and its impact on mental health. Answer: c. They all try to improve services and educate the government and public about various problems. 79. Which of the following is TRUE regarding the use of mental health resources in private industry? a. Private industry typically does not acknowledge the importance of mental health-promoting factors in the work place and therefore dramatically underutilizes mental health resources. b. Primary prevention programs have been routinely used in private industry for many decades. c. Many companies have recently begun providing psychological services through employee assistance programs. d. Psychological services are provided on an extremely limited basis, even at the most elite private corporations. Answer: c. Many companies have recently begun providing psychological services through employee assistance programs. 80. In understanding and treating mental disorders, the World Health Organization at the present time has a. almost completely ignored the impact of physical disease on mental health. b. almost completely ignored ethnic and cultural differences. c. focused exclusively on physical diseases, not on mental health. d. been very much aware of the interrelationship between physical, psychosocial, and sociocultural factors. Answer: d. been very much aware of the interrelationship between physical, psychosocial, and sociocultural factors. 81. The history of abnormal psychology makes it clear that a. the field can be profoundly changed and improved through individual effort. b. international efforts in dealing with mental disorders are doomed to failure because there is no agreement on the definition of "disorder." c. more domestic and fewer international efforts are needed. d. we are no further today in understanding mental disorders than we were in the time of Pinel, Dix, and Beers. Answer: a. the field can be profoundly changed and improved through individual effort. 82. What impact have HMOs had on mental health care? a. The cost of mental health services has risen. b. Greater emphasis has been placed on finding treatment approaches that are time and cost efficient. c. The reliance on medical therapies has decreased. d. Mental health treatment is more readily available. Answer: b. Greater emphasis has been placed on finding treatment approaches that are time and cost efficient. 83. What treatment approach is most likely to be employed by an HMO to treat an anxiety disorder? a. Aversion therapy b. Flooding c. Pharmacotherapy d. Systematic desensitization Answer: c. Pharmacotherapy Fill-in-the-Blank Questions 1. Efforts that are aimed at influencing the general population are known as __________ interventions. Answer: universal 2. Efforts that are aimed at a specific at risk subgroup are known as __________ interventions. Answer: selective 3. Efforts that are directed toward high-risk individuals with detectable symptoms are called __________ interventions. Answer: indicated 4. The movement to close down mental hospitals and treat the mentally ill in the community is __________. Answer: deinstitutionalization 5. The ruling that came to be known as "duty to warn" was also called the __________ decision. Answer: Tarasoff 6. The American Law Institute (ALI) standard is also called the __________ test. Answer: substantial capacity Short Answer Questions 1. Name and briefly describe the three subcategories of preventive interventions. Answer: Universal: efforts aimed at influencing the general population. Selective: efforts aimed at specific subgroups that are considered to be at risk for developing mental health problems. Indicated: efforts directed at high-risk individuals identified as having minimal symptoms of a mental disorder but who do not meet criteria for clinical diagnosis. 2. Discuss the three requirements for psychosocial health. Answer: Developing the skills needed for problem solving and relating to others, accurate frame of reference on which to build an identity and preparation for types of problems one is likely to encounter. 3. What are the three strategies that the United States government has used to address the drug abuse problem? How effective have these strategies been? Answer: Reducing the supply of drugs, providing treatment for those with substance abuse or dependence, and encouraging prevention are all approaches taken to combatting the "drug problem". All have been found to be insufficient. 4. What principles guide the approach called milieu therapy? Answer: Staff in psychiatric hospitals communicate both negative and positive feedback to patients to encourage appropriate actions. Patients are encouraged to participate in decisions concerning them. There is self-government. Group cohesiveness is encouraged so that patients feel supported and so group pressure exerts control over patient behavior. 5. What are aftercare programs? Who is least likely to benefit from such programs? Answer: Aftercare programs are programs designed to facilitate adjustment back into the community following hospitalization. These are community-based live-in programs, typically, that help ease the former patient back into society. Those who have a criminal history or who tend to be transient tend to not do well in aftercare programs. Interestingly, those who have less severe symptoms may also not do well as facility staff do not recognize that they need assistance as much as those with more severe symptoms. 6. What have been some of the negative effects of deinstitutionalization? Answer: Despite the well-meaning intentions of the movement to release the mentally ill from inpatient facilities, this has lead to many negative consequences. Many went from institutions to the streets, with little or no care. The community-based services that were to be available to this population were not there at all, or were insufficient. Many of the mentally ill do not receive that care that they desperately need. 7. What are the conditions, in addition to mental illness, that must be met in most states for someone to be involuntarily committed? Answer: Dangerous to self or others, incapable of providing for basic needs, unable to make responsible treatment decisions about hospitalization, and in need of treatment in a hospital. 8. What factors increase the risk of violence in someone with mental illness? Answer: A history of violent behavior, psychotic symptoms, antisocial personality disorder, alcoholism, and situational factors. 9. What is the importance of the Tarasoff case? Answer: This ruling established the legal obligation for a mental health professional to violate confidentiality in order to warn someone that a client has threatened to harm them. In Tarasoff II, the duty to warn was changed to the duty to protect a prospective victim. The duty to protect may be discharged if the therapist makes "reasonable efforts" to inform potential victims and an appropriate law enforcement agency of the pending threat. However, numerous other lawsuits in other jurisdictions have been adjudicated in confusing and inconsistent ways. Essay Questions 1. What are the key tasks involved in universal interventions? Why is epidemiological research particularly important to these efforts? Answer: Universal interventions focus on altering conditions that can cause or contribute to mental disorders (risk factors) and establishing conditions that foster positive mental health (protective factors). Epidemiological research supplies data on the incidence and prevalence of various disorders and the populations that are most affected. Equipped with this information, those who design universal interventions know where to look and what to look for. 2. Discuss three principles that are commonly used to define insanity. How is insanity most commonly defined today? Answer: The M'Naghten Rule emphasizes not knowing right from wrong at the time of the crime, while the irresistible impulse rule that holds that the person is not responsible if he or she could not avoid doing the act in question. The Durham rule or "product test" says the accused is not criminally responsible if the unlawful act was the product of a mental disease or defect. Thus, we see a movement from not knowing right from wrong, an emphasis on thought processes, to establishing that some illness was the cause of the behavior. Over time, the insanity defense has become more difficult to use, as a consequence of a number of controversial cases. Today the burden of proof is on the defense; the defense must establish that the defendant is insane, as opposed to the prosecution establishing sanity. Most states today employ the M'Naghten or the American Law Institute (ALI) Standard. The ALI standard requires a combination of M'Naghten and irresistible impulse - the individual must not know right from wrong and be moved by an irresistible impulse. 3. Discuss three of the six specific mental health risk factors in work situations. Answer: 1. work load and pace - the degree of control the worker has over this is what is important - the less control, the higher the risk. 2. work schedule - rotating shifts have the highest risk. 3. role stressors - role ambiguity and role conflict have the highest risk. 4. career security factors - concerns about job future and job development raise risk. 5. interpersonal relationships - if relationships with co-workers and bosses are bad, risk is higher. 6. job content - if there is little room for creativity or little sense of making a contribution, risk is increased. Test Bank for Abnormal Psychology: DSM 5 James N. Butcher, Jill M. Hooley, Susan M. Mineka 9780205965090, 9780205944286

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