Chapter 11: Schizophrenia 1. Schizophrenia ...


c. coherent speech. d. speech. .... The symptoms were actually caused by side effects of electroconvulsive therapy. b. .... is no association between degree of brain abnormality and medication effect. ..... b. school-based prevention programs.

Chapter 11: Schizophrenia

1. Schizophrenia is_________ researched and _________ understood. a. widely; well b. widely; not well c. sparsely; very well d. sparsely; poorly Answer: B Type: Factual Page: 350 2. During an acute episode of schizophrenia, the most prominent symptom(s) is/are a. disorientation. b. positive symptoms. c. difficulty concentrating. d. inability to bathe and take care of personal business. Answer: B Type: Factual Page: 351 3. The following are examples of positive symptoms of schizophrenia: a. social support, physical health b. low activity level, lack of intense emotional responses c. hallucinations and delusions d. coping skills, which are different for different individuals and help them to manage their illness Answer: C Type: Applied Page: 351 4. Mark’s parents bring him to see a psychologist because they believe Mark is experiencing delusions. What piece of information would most indicate that Mark had schizophrenia and not some other diagnosis? a. His delusions only come when his parents are around. b. His delusions are highly implausible. c. His delusions have persisted for more than 5 years. d. His delusions involve other people. Answer: B Type: Factual Page: 351 5. Among schizophrenics who suffer from delusions, a large majority experience a. delusions of persecution. b. thought broadcast. c. delusions of impulses imposed by others. d. hallucinations with the delusions. Answer: A Type: Factual Page: 351 6. "When I am trying to relax and read a book, my father puts his thoughts into my head so that I cannot concentrate." This statement by a schizophrenic patient is an example of what type of symptom? a. affective b. motor c. positive d. negative Answer: C Type: Applied Page: 351 7. Most hallucinations experienced by schizophrenics are a. visual. b. tactile. c. auditory.

d. olfactory. Answer: D Type: Factual Page: 352 8. Carla has schizophrenia. Which of her symptoms is most likely to be present outside of an acute episode of schizophrenia? a. Hearing a voice telling him he is not good at his job. b. Thinking that his thoughts are being broadcast so others can read them. c. Not showering for days on end. d. None of the above are correct. Answer: C Type: Applied Page: 353 9. Which of the following are examples of negative symptoms of schizophrenia? a. flat affect, lack of initiative b. hallucinations and delusions c. difficulty concentrating, low intelligence, poor memory d. catatonic immobility, waxy flexibility Answer: A Type: Factual Page: 353 10. Carlos is a schizophrenic living with his parents. One of his symptoms is a difficulty initiating any activity, and once started, he is unable to finish. This is an example of a. akesthesia. b. anhedonia. c. avolition. d. alogia. Answer: C Type: Applied Page: 353 11. Anhedonia as a symptom of schizophrenia refers to lack of a. emotional expression. b. interest or pleasure. c. coherent speech. d. speech. Answer: B Type: Factual Page: 354 12. The symptom alogia refers to lack of a. intelligence. b. energy and interest. c. emotional response. d. meaningful talk. Answer: D Type: Factual Page: 353 13. James is struggling with schizophrenia. He also finds it difficult to experience pleasure from activities that he enjoyed before his symptoms began. This is an example of a. alogia. b. anhedonia. c. avolition. d. asociality. Answer: B Type: Applied Page: 354 14. Roger has a vacant stare. He answers questions in an apathetic, monotone voice, and shows no emotion, even when discussing events such as his mother's death. Roger's affect would be described as

a. depressed. b. inappropriate. c. blase. d. flat. Answer: D Type: Applied Page: 354 15. When an individual with schizophrenia shows flat affect, that individual a. does not experience emotions. b. does not express emotions. c. does not experience physiological arousal in emotionally intense situations. d. All of the above are correct. Answer: B Type: Factual Page: 354 16. "My thoughts get all jumbled up. I start thinking or talking about one thing but then by the time I get to the end of the sentence, I find myself talking about something else instead." This is an example of which of the following symptoms of schizophrenia? a. delusions b. loose associations c. alogia d. avolitions Answer: B Type: Applied Page: 355 17. What symptom of schizophrenia is illustrated by the following? "I was just walking and there are wolves. When it's colder than ice cream. But I'm not fat. I go to school in the mountains." a. hallucinations b. anhedonia c. loose associations d. inappropriate affect Answer: C Type: Applied Page: 355 18. James suffers from schizophrenia and flails his limbs wildly with excitement. This is most appropriately labeled as a. catatonia. b. mania. c. hallucinations. d. delusions. Answer: A Type: Applied Page: 356 19. Which subtype of schizophrenia is characterized by unusual physical activity from not moving for hours to wild excitement and flailing about? a. disorganized b. paranoid c. catatonic d. undifferentiated Answer: C Type: Factual Page: 356 20. Catatonia is characterized by a disturbance of a. motor functions. b. thought form. c. attention and perception. d. affect.

Answer: A Type: Factual Page: 356 21. Mr. Hart spends long hours sitting in a chair with his arms behind his back and his left leg tucked under. No matter what is going on around him, he remains in this position. This is an example of which symptom of schizophrenia? a. somatic passivity b. waxy flexibility c. catatonic immobility d. inappropriate affect Answer: C Type: Applied Page: 356 22. When Marcia heard that her favorite cat had been hit by a car and killed, she giggled quietly. This is an example of a. flat affect. b. inappropriate affect. c. anhedonia. d. incoherence. Answer: B Type: Applied Page: 356 23. Which is required as part of the DSM-IV definition of schizophrenia? a. acute onset of symptoms b. symptoms for at least six months c. family history of schizophrenia d. dopamine imbalance Answer: B Type: Factual Page: 356 24. Howard had a psychotic episode following the death of his wife. He had hallucinations in which he would hear her speaking to him, telling him to kill himself. Howard developed elaborate delusions about his ability to communicate with his wife's spirit. Howard recovered from this episode after one week. What DSM-IV diagnosis would fit Howard's case? a. schizophreniform disorder b. brief psychotic disorder c. reactive schizophrenia d. process schizophrenia Answer: B Type: Applied Page: 358 25. Which is a problem with the subtypes of schizophrenia in DSM? a. They are not clearly defined. b. They each have different responses to treatment. c. Each one describes a broad range of behaviors. d. The symptoms overlap. Answer: D Type: Factual Page: 356 26. Sam has a delusion that the Queen of England is in love with him. He does not have any other symptoms. His most likely diagnosis would be a. schizophreniform disorder. b. schizoaffective disorder. c. delusional disorder. d. bipolar disorder with delusions. Answer: C Type: Applied Page: 358 27. Harvey has bizarre ideas, believing, for example, that his arms are decomposing. He has frequent hallucinations in which he sees his arms losing flesh and believes this is punishment for having brushed up

against a strange woman in a store several years before. Harvey has completely neglected his personal hygiene, never bathing or putting on clean clothes. He seems unaware of what is going on around him, frequently laughing and giggling for no apparent reason. Which of the following diagnoses would best fit Harvey? a. undifferentiated schizophrenia b. paranoid schizophrenia c. disorganized schizophrenia d. catatonic schizophrenia Answer: C Type: Applied Page: 356 28. The higher rate of the catatonic subtype of schizophrenia diagnosed in the early part of the century has been attributed to which of the following? a. The symptoms were actually caused by side effects of electroconvulsive therapy. b. Patients with the catatonic subtype are now diagnosed with schizoid personality disorder. c. Patients with other disorders, such as "sleeping sickness," were being misdiagnosed with schizophrenia. d. Deinstitutionalization has resulted in catatonic schizophrenics living in the community, where they are less likely to be identified and diagnosed. Answer: C Type: Factual Page: 356 29. Bill believes that he is an important spy for an underground militia, on a mission to investigate the military activities in his town. He spends most of his time devising ways to tap into the phone lines of the government office near his home, and at precisely 5:10 every afternoon, he stands outside his home facing to the west, believing that in this way he is transmitting information to his bosses in the militia’s hometown. Which of the following diagnoses would best fit Bill? a. catatonic schizophrenia b. disorganized schizophrenia c. paranoid schizophrenia d. undifferentiated schizophrenia Answer: C Type: Applied Page: 358 30. If an individual with paranoid schizophrenia is described as having ideas of reference, this means that he or she a. becomes extremely jealous with little provocation. b. views trivial events or actions to be of great personal significance. c. has an exaggerated sense of his or her own importance. d. believes that everything he or she thinks can be heard by others. Answer: B Type: Factual Page: 358 31. Betty remarks frequently that she is extraordinarily wealthy, despite being housed in a psychiatric hospital and having an empty bank account. When asked to explain this apparent contradiction, she indicates that the hospital is keeping her money, but that it is part of a vast conspiracy because the administrators fear her great power when she is not hospitalized. She has experienced symptoms such as these since she graduated high school. These symptoms are sometimes collectively referred to as a. grandiose delusions. b. delusional jealousy. c. ideas of reference. d. thought insertion. Answer: A Type: Applied Page: 358 32. Dr. Knough is interviewing a newly-admitted patient in a hospital. He feels that the patient likely suffers from paranoid schizophrenia. Which of the following symptoms would argue against this diagnosis? a. The patient reports hearing voices telling her she’s being watched. b. The patient insists that her husband is cheating on her. c. When asked what day it is the patient states “It’s today which is the day after yesterday. Yesterday was a good song that I heard when I was a kid. I like kids and babies. I was once a baby.”

d. None of the above; all these symptoms are frequently found in people with paranoid schizophrenia. Answer: C Type: Applied Page: 358 33. Which of the following is a limitation of the DSM system of subtyping schizophrenia? a. It does not provide information that helps in treatment planning or predicting the course. b. It excluded too many people with schizophrenic-like symptoms. c. It does not specify the causes of schizophrenic behavior. d. Behaviors of schizophrenics change rapidly making reliable diagnoses difficult. Answer: A Type: Factual Page: 358 34. Which of the following is a limitation of the DSM subtypes of schizophrenia? a. They are very difficult to distinguish in practice, and diagnostic reliability is low. b. They are too broad and include people not clearly schizophrenic. c. The definitions have changed repeatedly in recent years. d. Newer approaches offer more clear-cut distinctions. Answer: A Type: Factual Page: 358 35. Family studies of the genetic basis for schizophrenia look at a. the rate of schizophrenia in relatives of schizophrenic patients. b. concordance for schizophrenia in cultures where incest is relatively common. c. the likelihood that a schizophrenic patient will have children. d. the effects of being raised by a schizophrenic parent. Answer: A Type: Factual Page: 360 36. The concordance rate of schizophrenia for fraternal twins is about a. 12%. b. 45%. c. 75%. d. 95%. Answer: A Type: Factual Page: 360 37. If genetic transmission was the only factor in the etiology of schizophrenia, the concordance of the disorder for monozygotic twins would be a. 0%. b. 50%. c. 80%. d. 100%. Answer: D Type: Applied Page: 360 38. Of schizophrenic symptoms, the ones with the higher genetic component are a. negative symptoms. b. delusions. c. positive symptoms. d. persecution delusions. Answer: A Type: Factual Page: 360 39. Which of the following is a limitation of both family studies and twin studies of schizophrenia? a. Both methods employ self-report measures only. b. Both methods use too broad a definition of schizophrenia. c. Neither method accounts for the role of shared-environment.

d. Neither method distinguishes between subtypes of schizophrenia. Answer: C Type: Factual Page: 360 40. Studies of children whose mothers had schizophrenia but were raised by adopted parents indicate a. that there is not a strong genetic factor in the development of schizophrenia. b. that there is a strong genetic factor in the development of schizophrenia. c. that children who were adopted into homes with low EE were more likely to develop schizophrenia. d. These studies have been inconclusive. Answer: B Type: Factual Page: 360 41. The genetic data for schizophrenia is still not completely conclusive as a. the role of the environment has not been completely accounted for. b. the distinction between genotype and phenotype has not been elucidated. c. stressors during birth have not been investigated. d. most adoptive parents know the child had a schizophrenic relative. Answer: B Type: Factual Page: 360 42. Results of linkage analysis studies of schizophrenia point to a. a genetic diathesis for positive symptoms. b. the need to refine the definition of schizophrenia. c. a single recessive gene. d. no firm conclusions. Answer: D Type: Factual Page: 362 43. Since the symptoms of schizophrenia are so heterogeneous, it is likely that a. schizophrenia is genetically homogeneous. b. positive and negative symptoms are due to the same underlying causes. c. schizophrenia is caused by a dysregulation of dopamine. d. schizophrenia is genetically heterogeneous. Answer: D Type: Applied: Page: 363 44. Which of the following statements most accurately describes the influence of genetics on the development of schizophrenia? a. Schizophrenia is almost entirely caused by stressors in the environment. b. Schizophrenia is almost entirely caused by genetic factors. c. Genetic transmission of schizophrenia is only found when the child is also raised by a disturbed parent. d. Schizophrenia is caused by a combination of a genetic predisposition and some environmental stressors. Answer: D Type: Factual Page: 363 45. The text concludes that research has shown that genetic factors in schizophrenia are a. not yet distinguished from environmental factors. b. primarily linked to positive symptoms. c. only weak contributors at best. d. clearly important. Answer: D Type: Factual Page: 363 46. Which of the following findings led to the conclusion that schizophrenia may be caused by dopamine activity? a. Parkinson's disease is known to be caused by excess levels of dopamine. b. People with Parkinson's disease are more likely to develop schizophrenia. c. Drugs that relieve schizophrenic symptoms have side-effects similar to Parkinson's disease. d. All of the above are correct findings.

Answer: C Type: Factual Page: 363 47. Indirect support for the dopamine theory of schizophrenia arose from a. cases of amphetamine psychosis. b. the finding of higher levels of homovanillic acid in the blood of schizophrenics. c. the development of catatonia when psychotic episodes end. d. blockage of dopamine reuptake by antipsychotic medications. Answer: A Type: Factual Page: 363 48. Which of the following findings presents a serious challenge to the theory of schizophrenia that proposes an excess amount of dopamine to be at the core of this disorder? a. Antipsychotic drugs relieve the symptoms of both drug psychoses and the psychosis of schizophrenia. b. Homovanillic acid, the major metabolite of dopamine, is not present in greater amounts in schizophrenics. c. Positive symptoms of schizophrenia are reduced by antipsychotic drugs more than negative symptoms. d. None of the above represents a challenge to the dopamine activity theory. Answer: B Type: Factual Page: 363 49. Which of the following suggests that dopamine receptors are mainly related to positive (not negative) symptoms of schizophrenia? a. Antipsychotic drugs reduce only positive symptoms. b. Administering dopamine produces little increase in positive symptoms. c. MRIs of schizophrenics with positive symptoms show more receptors. d. Parkinson’s Disease involves similar symptoms. Answer: A Type: Factual Page: 365 50. The dopamine theory of schizophrenia appears incomplete because anti-psychotic drugs a. affect many non-dopamine tracts in the brain. b. take effect before they have reduced dopamine. c. must reduce dopamine below normal to be effective. d. are ineffective with a significant minority of patients. Answer: C Type: Factual Page: 365 51. Which of the following has not been proposed as an alternative to the excess dopamine theory of schizophrenia? a. Hypersensitivity of dopamine receptors is the primary cause of schizophrenia. b. An excess of dopamine receptors in the brain is the primary cause of schizophrenia. c. Depending on the neural pathway on which it acts, dopamine has different effects. d. Different subtypes of dopamine interact differently with dopamine receptors, some of which may lead to symptoms of schizophrenia. Answer: D Type: Factual Page: 364-365 52. A puzzling finding from research on medication for schizophrenia is that a. a therapeutic effect is only produced when dopamine levels drop below normal. b. medications that influence other neurotransmitter systems have no effect. c. there is no association between degree of brain abnormality and medication effect. d. medications do not appear to affect schizophrenia attributed primarily to the environment. Answer: A Type: Factual Page: 365 53. Current research on dopamine's role in schizophrenia emphasizes a. chemical precursors to dopamine. b. the dopamine/serotonin balance.

c. different dopamine neural pathways. d. dopamine reuptake mechanisms. Answer: C Type: Factual Page: 363-364 54. In which parts of the brain of schizophrenics are abnormalities most commonly found? a. parietal lobes. b. prefrontal cortex. c. corpus collossum and amygdala. d. diffuse lesions throughout the brain. Answer: B Type: Factual Page: 366 55. A consistent brain abnormality found among schizophrenics is a. frontal lobe enlargement. b. parietal lobe enlargement. c. enlarged ventricles. d. interrupted tracts in the reticular formation. Answer: C Type: Factual Page: 366 56. In people with schizophrenia, the amount of gray matter in the temporal and frontal cortexes is a. more than normal. b. normal. c. full of holes and lesions. d. less than normal. Answer: D Type: Factual Page: 367 57. Which of the following has NOT been proposed as a theory regarding the development of schizophrenia? a. Excessive elimination of synaptic connections in the developing brain. b. Brain injury early in development that does not result in symptoms until later in development. c. Viral infection that affects the unborn child during gestation. d. Extreme reactions to trauma that result in significant brain changes. Answer: D Type: Factual Page: 367 58. If a pregnant woman contracts influenza while pregnant, the risk of schizophrenia to the unborn child is greatest if she gets sick a. during the first trimester. b. during the first month. c. during the second trimester. d. at any time during pregnancy. Answer: A Type: Factual Page: 367 59. Congenital factors in schizophrenia are suggested by data showing increased risk of schizophrenia in children whose mothers while pregnant. a. were highly stressed b. were exposed to the flu c. drank excessively d. had a protein-deficient diet Answer: B Type: Factual Page: 367 60. Research suggests the brain abnormalities found in schizophrenics may be due to a. long-term use of antipsychotic drugs.

b. pregnancy and birth complications. c. chronic confused cognitive patterns. d. childhood malnutrition. Answer: B Type: Factual Page: 367 61. The social-selection theory proposes that a. poverty causes schizophrenia. b. schizophrenia causes poverty. c. social discrimination causes both schizophrenia and poverty. d. poverty and schizophrenia are not related. Answer: B Type: Factual Page: 368 62. Studies of socioeconomic class (SES) and schizophrenia find that the rate of schizophrenia a. is about equal in all SESs. b. has increased in lower SESs in the last decade. c. is sharply higher in the lowest SES. d. goes up as SES goes down. Answer: C Type: Factual Page: 368 63. Mr. Bradley was diagnosed as schizophrenic seven years ago. Prior to the onset of his illness, he was attending medical school and planning to be a pediatrician. However, his symptoms such as delusions and hallucinations made it impossible for him to finish school, and after attempting a series of lower-level jobs, Mr. Bradley gave up on being able to keep a job or earn a living. He now lives in a run-down hotel on skid row. Mr. Bradley's story fits the ___________________ theory of social class and schizophrenia. a. schizophrenogenic b. high-risk c. sociogenic d. social-selection Answer: D Type: Applied Page: 368 64. Mr. Cook grew up in severely impoverished circumstances. His mother was unmarried and homeless, and Mr. Cook and his six siblings lived on the streets or in shelters for most of their childhood. They had little formal education or opportunity to make progress in the world. After 17 years of this life, Mr. Cook had his first psychotic episode while digging through a trash can looking for food for his mother; he heard voices telling him to take off his clothes and eat them. Shortly thereafter, Mr. Cook was picked up by police, taken to a psychiatric hospital, and diagnosed as schizophrenic. Mr. Cook's story fits the _______________ theory of social class and schizophrenia. a. schizophrenogenic b. high-risk c. sociogenic d. social-selection Answer: C Type: Applied Page: 368 65. A particular ethnic group experiences high levels of racial prejudice and discrimination. The social-selection theory would predict which of the pattern of schizophrenia in this group? a. Members of the group who have experienced prejudice would have lower rates of schizophrenia. b. Members of the group who have experienced prejudice would have higher rates of schizophrenia. c. Among the upper classes, the group which has experienced prejudice would have lower rates of schizophrenia. d. Among the upper classes, the group which has experienced prejudice would have higher rates of schizophrenia. Answer: C Type: Applied Page: 368 66. In the above situation, which pattern of schizophrenia would be predicted by the sociogenic theory?

a. Members of the group who have experienced prejudice would have lower rates of schizophrenia. b. Members of the group who have experienced prejudice would have higher rates of schizophrenia. c. Among the upper classes, the group which has experienced prejudice would have lower rates of schizophrenia. d. Among the upper classes, the group which has experienced prejudice would have higher rates of schizophrenia. Answer: B Type: Applied Page: 368 67. According to the family theory of schizophrenia, a schizophrenogenic mother would be described as a. emotionally cold and domineering. b. overly warm and subtly seductive. c. also schizophrenic. d. carrying a recessive gene for schizophrenia. Answer: A Type: Factual Page: 369 68. Which of the following best describes the current view on communication deviance? a. When severe, communication deviance within a family alone is sufficient to produce schizophrenia in a normal child. b. Communication deviance within a family plays little role in the development of schizophrenia. c. Deviant communication within a family has been found to predict pathology, but this relationship is not specific to schizophrenia. d. Communication deviance is a significant risk factor for schizophrenia and lowers the threshold of the stressor necessary to product a first psychotic break. Answer: C Type: Factual Page: 369 69. Data on expressed emotion (EE) indicates that schizophrenics are more likely to relapse (that is, return to the hospital) if their families a. are cool, calm, unemotional and aloof. b. are uninvolved. c. are critical and over involved with them. d. provide excessive emotional support and encouragement. Answer: C Type: Applied Page: 370 70. Research investigating the role of the family in schizophrenia best supports the a. schizophrenogenic mother theory. b. triangulation theory. c. expressed emotion theory. d. dopamine theory. Answer: C Type: Factual Page: 370 71. Michael suffers from schizophrenia and was recently released from the hospital. Which of his symptoms are most likely to elicit critical comments from his family when he returns home? a. Believing that NASA has planted a tracking device in his head. b. Sitting on the couch for most of the day and refusing to go for walks with his mother, an activity he greatly enjoyed before his hospitalization. c. Hearing a voice telling him to kill his family. d. Wearing a winter coat, galoshes, and a ski mask while inside the house. Answer: B Type: Applied Page: 370 72. Which of the following best summarizes the relationship between EE (expressed emotion) and unusual thoughts in a person with schizophrenia? a. Critical comments made by family members lead a person with schizophrenia to have more unusual thoughts. b. Unusual thoughts by the patient lead the family of a person with schizophrenia to be more critical.

c. Both a and b. d. Neither a nor b. Answer: C Type: Factual Page: 370 73. Before their first psychotic break, pre-schizophrenic children were found to: a. have lower IQ’s than their peers. b. be more disagreeable. c. have poor motor skills. d. All of the above are correct. Answer: D Type: Factual Page: 371 74. Research examining childhood predictors of schizophrenia would employ which of the following research methods? a. case study b. epidemiological c. correlational d. high-risk Answer: D Type: Factual Page: 371 75. What is the term for research studies that follow the development of children born to schizophrenic mothers? a. schizophrenogenic mother studies b. maternal matrix studies c. family studies d. high-risk studies Answer: D Type: Factual Page: 371 76. High-risk studies of schizophrenia a. are considered unethical under current codes. b. have proven helpful in early detection of schizophrenia. c. can be helpful in protecting others in the community. d. yield more specific information about early development. Answer: D Type: Factual Page: 371 77. High-risk studies are used to investigate

factors in schizophrenia.

a. genetic b. environmental c. maternal d. childhood Answer: D Type: Factual Page: 371

78. Patients whose schizophrenia is characterized primarily by negative symptoms a. had more expressive behavioral problems in youth. b. had more complications during pregnancy. c. were more likely to have academic difficulties. d. were treated for severe anemia as children. Answer: B Type: Factual Page: 371 79. Data from high-risk studies suggests that patients with positive symptom schizophrenia had childhoods characterized by

a. pregnancy and birth complications. b. schizophrenogenic mothers. c. family instability. d. antisocial behavior. Answer: C Type: Factual Page: 371 80. In predicting later behavioral problems among patients with schizophrenia, a. neurobehavioral functioning was highly predictive. b. behavioral problems in early childhood only were most predictive. c. intellectual functioning was not predictive. d. none of these choices are correct. Answer: A Type: Factual Page: 372 81. In the classic behavior therapy study with hospitalized patients with schizophrenia, it was found that a. routine hospital management decreased negative symptoms only. b. social learning theory decreased the need to prescribe medication. c. milieu therapy, although less effective, was not as upsetting to patients. d. no therapy improved functioning. Answer: B Type: Factual Page: 374: Focus on Discovery 11.2 82. A token economy is based on ____________ theory and was ______ to milieu-therapy in decreasing symptoms of schizophrenia. a. cognitive; superior b. interpersonal; similar c. behavioral; superior d. bargaining; similar Answer: C Type: Factual Page: 374: Focus on Discovery 11.2 83. Rehospitalization rates for people with schizophrenia one year after discharge range from: a. 4-7% b. 40-50% c. 65-75% d. 85-95% Answer: B Type: Factual Page: 375 84. Dr. Smith, a psychiatrist, specializes in treating schizophrenia. When a patient is non-compliant with treatment, what reason is Dr. Smith most likely to hear? a. “Your medications have never helped me and will never help me at all.” b. “I like going to therapy more than coming to get medications.” c. “I want to go back to the hospital, so I’m not going to take my medications so that you can re-admit me.” d. “I’m not sick – there’s nothing wrong with me.” Answer: D Type: Applied Page: 373 85. The traditional drugs for treating schizophrenia a. enable schizophrenics to adjust to hospital life. b. commonly produce depressive side-effects. c. generally only reduce positive symptoms of schizophrenia. d. are effective with less than half of schizophrenics. Answer: C Type: Factual Page: 373 86. What is the current view regarding drugs in treating schizophrenia?

a. Recent advances have eliminated almost all side effects for patients. b. Recent advances now let most schizophrenics live normal lives. c. Despite side effects, they are an indispensable part of treatment. d. Persistent side effects have made them a treatment of last resort. Answer: C Type: Factual Page: 377 87. For which of the following reasons do patients with schizophrenia typically stop taking medication when they are discharged from the hospital? a. The side effects are unpleasant. b. Their psychiatrist determines that their illness is improved sufficiently so that they do not need to take daily medications. c. Their after-care programs emphasize psychological treatments and discourage reliance on medication, which is seen as a "crutch." d. They prefer their hallucinations to the monotony of daily existence. Answer: A Type: Factual Page: 376 88. Gary was effectively treated for schizophrenia using Navane, an antipsychotic medication. Following such benefits, the next part of treatment will likely be a. switching him to a long-lasting antipsychotic. b. tapering his doses until he no longer needs the medication. c. entering family therapy. d. continuing taking Navane, but changing to a maintenance dose. Answer: D Type: Applied Page: 375 89. Extrapyramidal side effects primarily affect __________ functioning. a. visual b. auditory c. motor d. cognitive Answer: C Type: Factual Page: 375 90. Connie is a 47-year-old woman with schizophrenia. She has recently begun taking Haldol (a neuroleptic), but her family recently read about extrapyramidal side effects and has raised their concern with her psychiatrist. What would be the optimal course of action for the psychiatrist to take? a. Reassure the family, since these side effects are rare and easily reversed when the medication is withdrawn. b. Keep the dosage low and have medication holidays where Connie does not take the drug for periods of time when she is doing well. c. Try one of the newer drugs for treating schizophrenia that do not have these side effects. d. Discontinue the drug immediately; the psychiatrist is out of date in his or her training and should not have prescribed this medication. Answer: C Type: Applied Page: 376 91. Sam is being treated with medication for schizophrenia. He involuntarily smacks his lips and seems unable to control his motor movements. Sam most probably is suffering from a. extrapyramidal side effects. b. tardive dyskinesia. c. dystonia. d. neuroleptic malignant syndrome Answer: B Type: Applied Page: 375 92. Clozapine, a newer medication for schizophrenia, has which dangerous potential side effect that requires close monitoring during administration? a. a sudden decrease in liver functioning.

b. deterioration of spinal fluid integrity. c. loss of white blood cells. d. decreased insulin production. Answer: C Type: Factual Page: 376 93. Research has shown that people being treated with some of the newer antipsychotic medications are less likely to drop out of treatment. Which of the following is the most likely reason for this fact? a. The newer medications are far more effective than the older medications which encourage people to continue to take their medication. b. The newer medications increase insight. That is, people taking the medications realize that they are sick and need the drugs. c. Compared to the older antipsychotics, the newer drugs can be discontinued after achieving the desired therapeutic gain. d. Compared to the older antipsychotics, the newer drugs have less extreme and intrusive side effects. Answer: D Type: Factual Page: 376 94. Atyical antipsychotic drugs such as clozapine or olanzapine a. have no side effects. b. commonly cause tardive dyskinesia. c. are related to the development of diabetes. d. are often used in conjunction with traditional antipsychotics. Answer: D Type: Factual Page: 376 95. Which of the following statements is TRUE? a. African American patients are more likely to be prescribed atypical antipsychotics than traditional antipsychotics. b. African Americans appear to suffer fewer side effects from traditional antipsychotics than do whites. c. The U.S. has an excellent track record of providing equal mental health treatment across different ethnic groups. d. There is less research on schizophrenia across ethnic groups than other DSM- IV diagnoses. Answer: D Type: Factual Page: 377 96. What is MATRICS? a. The set of chromosomes in which researchers believe the schizophrenia genes are located. b. A collaborative project aimed at developing new medications for schizophrenia. c. A new type of antipsychotic medication. d. A set of neurological tests for examining the cognitive functioning of people with schizophrenia. Answer: B Type: Factual Page: 377 97. The first person to use psychotherapy in treating people with schizophrenia was a. Sigmund Freud. b. Emil Kraepelin. c. Harry Stack Sullivan. d. Aaron Beck. Answer: C Type: Factual Page: 378 98. Corrinne is receiving psychological therapy for schizophrenia. A major focus has been upon practicing more effective methods for dealing with others, as well as basic life skills such as ordering in restaurants, filling out applications for employment, and reading train schedules. She is likely receiving a. ego-analysis. b. psychoeducation. c. social skills training. d. token economy.

Answer: C Type: Factual Page: 378 99. What is a goal of recent family therapy efforts with the families of individuals with schizophrenia? a. To provide insight into family patterns that produced the schizophrenia. b. To relieve guilt and help family shield the schizophrenic from social disgrace. c. To encourage the family to support more independence for the person with schizophrenia. d. To teach constructive ways of expressing feelings and resolving conflicts. Answer: D Type: Factual Page: 379 100. Psychotherapy with the families of individuals with schizophrenia includes a focus on a. behavior change techniques. b. education about schizophrenia. c. not having more children. d. increasing family time together. Answer: B Type: Factual Page: 379 101. Family therapy with families of individuals with schizophrenia commonly emphasizes a. discouraging inappropriate behavior. b. education about schizophrenia. c. minimizing use of drugs. d. genetic counseling. Answer: B Type: Factual Page: 379 102. Families with a schizophrenic member are now encouraged to a. begin preventive efforts, since other family members are likely to develop schizophrenia themselves without early intervention. b. place their mentally ill family member in long-term, out-of-home care. c. join support groups and organizations for the mentally ill, to help reduce stigma and isolation. d. All of the above are encouraged. Answer: C Type: Factual Page: 380 103. Cognitive enhancement therapy seeks to a. enhance basic cognitive functions for people with schizophrenia. b. challenge belief structures. c. incorporate the family members of people with schizophrenia into CBT treatment. d. All of the above are correct. Answer: A Type: Factual Page: 381 104. In some studies, cognitive training therapies for people with schizophrenia a. appear to be as effective as psychoanalysis. b. appear to be effective for improving cognitive abilities in African Americans. c. appear to be helpful in reducing EE. d. appear to be effective for improving cognitive abilities, as well as improving symptoms, but their findings are limited to white males. Answer: D Type: Factual Page: 381 105. Corrinne is receiving a newer psychological therapy for her schizophrenia. Here, she is being taught that many emotional reactions that she receives from members of her family and friends may be inappropriate. As part of this, she is taught muscle relaxation, and then practices applying these skills when faced with inappropriate emotional responses. This is also known as

a. personal therapy. b. family therapy. c. ego-analysis. d. biofeedback. Answer: A Type: Applied Page: 381 106. Focusing on cognitions in people with schizophrenia a. was thought to be of great importance in the past. b. can lead to changes in their beliefs. c. has not been tested empirically to detect if there is any benefit in treatment. d. None of the above are correct. Answer: B Type: Factual Page: 381 107. After being discharged from the hospital, case management for people with schizophrenia a. is typically conducted by a team. b. does not reduce time spent in the hospital. c. improves social functioning. d. All of the above are correct. Answer: A Type: Factual Page: 382 108. Research has made specific recommendations regarding what doses of medications to use in treating schizophrenia. In actual practice a. most do not receive medication in the recommended range. b. although most receive the recommended dosages while hospitalized, compliance is not monitored after discharge. c. a small percentage receives doses that are approximately twice the recommended dose. d. None of the above choices are correct. Answer: A Type: Factual Page: 354 109. Which of the following is not mentioned in the text as an ongoing issue in the care of schizophrenic patients? a. ending employment b. preventing substance abuse c. building satisfying social relationships. d. dealing with daily stressors Answer: C Type: Factual Page: 384 110. Which of the following is an ongoing issue in the care of patients with schizophrenia? a. preventing substance abuse b. reconnecting patients with their friends c. obtaining affordable long-term residential treatment d. protecting communities from their persons Answer: A Type: Factual Page: 384 111. Halfway houses have been found to have what effect on the aftercare of patients with schizophrenia? a. There has been little appreciable effect for patients with schizophrenia. b. It is most helpful for patients who do not have significant negative symptoms. c. There is a positive effect overall. d. There is little benefit as staff is frequently preoccupied with fears of layoffs. Answer: C Type: Factual Page: 382 112. Halfway houses are typically staffed by

a. clinical psychologists. b. graduate students. c. undergraduate psychology majors. d. All of the above could be on staff at a halfway house. Answer: D Type: Factual Page: 382 113. One of the biggest challenges in the treatment of schizophrenia is a. ensuring that patients receive adequate dosages of their medications. b. finding psychologists who are willing to work with people with schizophrenia. c. helping people with schizophrenia express their emotions and desires. d. getting people with schizophrenia to move out of residential treatment programs. Answer: A Type: Factual page: 384 114. Remaining challenges in the treatment of schizophrenia include a. integrating medical and psychoanalytic practices. b. school-based prevention programs. c. improving the quality of care. d. making care affordable. Answer: C Type: Factual Page: 384

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