Drugs Society and Human Behavior

16th Edition Hart Test Bank

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 Chapter 08
Medication for Mental Disorders

Multiple Choice Questions

1. (p. 165-166) The perspective that symptoms of a mental disorder lead to a diagnosis that
illuminates both the underlying cause and a cure for the disorder is referred to in the text as
the
A. medical model.
B. double-blind design.
C. logical approach.
D. inclusion criteria.

Blooms Level: 01. Remember

2. (p. 166) The most recent (2013) version of the American Psychiatric Association's
classification system for mental disorders is called the
A. Physician's Desk Reference (PDR).
B. Merck Manual.
C. DSM-V.
D. Treatment Guide.

Blooms Level: 01. Remember

3. (p. 167) A major disturbance of intellectual and social functioning in which there is a loss of
contact with reality is called
A. anxiety disorder.
B. phobia.
C. depression.
D. psychosis.

Blooms Level: 01. Remember

4. (p. 168) Both depressed and manic symptoms appear in the general classification of
A. schizophrenia.
B. mood disorders.
C. obsessive-compulsive disorder.
D. psychosis.

Blooms Level: 01. Remember

5. (p. 168) Bipolar I Disorder refers to

A. panic attacks.
B. agoraphobia.
C. posttraumatic stress disorder.
D. manic episodes with possible alternating depression.

Blooms Level: 01. Remember

6. (p. 170) Although electroconvulsive therapy (ECT) was first used to treat schizophrenia, it is
now used primarily to treat
A. other forms of psychosis.
B. anxiety.
C. personality disorders.
D. severe depression.

Blooms Level: 01. Remember

7. (p. 171) Phenothiazines and neuroleptics were terms used to describe the early forms of
A. antipsychotics.
B. shock therapy.
C. antidepressants.
D. anticonvulsants.

Blooms Level: 01. Remember

8. (p. 171) The antipsychotic drugs that have been marketed in the past ten years, such as
Zyprexa (olanzepine), are referred to as
A. conventional antipsychotics.
B. nouveau antipsychotics.
C. atypical antipsychotics.
D. postmodern antipsychotics.

Blooms Level: 01. Remember

9. (p. 172) What is the mechanism of action for typical antipsychotics?

A. block serotonin reuptake.
B. stimulate acetylcholine receptors.
C. increase brain levels of norepinephrine.
D. block D2 dopamine receptors.

Blooms Level: 01. Remember

10. (p. 173) One side effect common with the older antipsychotics, but less common with the
newer ones, is
A. pseudoparkinsonism.
B. positive symptoms.
C. a lag period.
D. MAO inhibition.

Blooms Level: 01. Remember

11. (p. 174) Many of the new atypical antipsychotics are known to cause
A. liver disorders.
B. manic episodes.
C. significant weight gain and metabolic changes.
D. very few side effects.

Blooms Level: 01. Remember

12. (p. 173) A recent study of the long-term effectiveness of antipsychotic drugs found that
A. atypicals are much more effective than the conventional drugs.
B. these drugs are very effective for over 90 percent of schizophrenic patients.
C. there is tolerance to the beneficial effects and doses must be increased after six weeks.
D. three-fourths of the patients stopped taking their medication within 18 months.

Blooms Level: 01. Remember

13. (p. 174) People taking monoamine oxidase inhibitors for depression must avoid
A. exposure to strong sunlight.
B. foods high in tyramine, such as aged cheeses.
C. strenuous exercise.
D. grapefruit juice.

Blooms Level: 01. Remember

14. (p. 169, 172) A patient presents with these symptoms: irrational beliefs, incoherent speech, and
a severe lack of emotional response. He has had these symptoms for over 9 months and they
interfere with his social function. He would most likely be diagnosed with _______ and
treated with __________.
A. schizophrenia; aripiprazole
B. schizophrenia; paroxetine
C. bipolar disorder; lithium
D. bipolar disorder; amphetamine

Blooms Level: 01. Remember

Blooms Level: 02. Understand

15. (p. 175) Tricyclic antidepressants work by

A. blocking acetylcholine receptors.
B. blocking D2 dopamine receptors.
C. inhibiting reuptake of norepinephrine, dopamine, and serotonin.
D. inhibiting metabolism of GABA.

Blooms Level: 01. Remember

16. (p. 176) Prozac was one of the early
A. tricyclic antidepressants.
B. MAO inhibitors.
C. selective serotonin reuptake inhibitors (SSRIs).
D. anti-manic drugs.

Blooms Level: 01. Remember

17. (p. 176) The FDA now requires a printed warning on several selective reuptake inhibitors
because they increase the risk of
A. suicide in children and adolescents.
B. liver disorder in elderly patients.
C. psychotic episodes.
D. seizures.

Blooms Level: 01. Remember

18. (p. 178) What is the average lag period for antidepressants to begin to be effective?
A. 1 day
B. 2 weeks
C. 4 weeks
D. 6 weeks

Blooms Level: 01. Remember

19. (p. 178) Current theories of the antidepressant action of drugs focus less on the initial
biochemical effects of the drugs and more on the
A. patient's personality.
B. levels of brain serotonin.
C. electrical potential of the membrane.
D. delayed reaction of the neurons to repeated drug exposure.

Blooms Level: 01. Remember

20. (p. 170) The fastest, and probably the most effective, treatment for severe cases of depression
is
A. imipramine (Tofranil).
B. paroxetine (Paxil).
C. electroconvulsive therapy (ECT).
D. psychotherapy.

Blooms Level: 01. Remember

21. (p. 178) The acceptance of the mood stabilizer _____________ was slowed by a series of
overdose poisonings and by the fact that the drug is one of the basic elements and could not
be patented.
A. lithium
B. valproic acid
C. carbamazepine
D. lamotrigine

Blooms Level: 01. Remember

22. (p. 180) The introduction of chlorpromazine in the U.S. in 1955 marked the last year in
which
A. the rate of imprisonment declined.
B. the major pharmaceutical companies reported net losses.
C. the population of mental hospitals increased.
D. schizophrenia was a major cause of suicide.

Blooms Level: 01. Remember

23. (p. 181) Each year, more mentally ill persons are _______ than are admitted to state mental
hospitals.
A. killed
B. jailed
C. sued
D. treated for agranulocytosis

Blooms Level: 01. Remember

24. (p. 175) Tricyclics treat depressive symptoms by
A. decreasing monoamine neurotransmitters in the synapse by inhibiting metabolism.
B. increasing monoamine neurotransmitters in the synapse by inhibiting metabolism.
C. decreasing monoamine neurotransmitters in the synapse by blocking reuptake.
D. increasing monoamine neurotransmitters in the synapse by blocking reuptake.

Blooms Level: 01. Remember

Blooms Level: 02. Understand

25. (p. 169) In the early part of the 20th century, a cure was found for a syphilitic infection that
caused a psychosis called
A. schizophrenia
B. specific phobia
C. general paresis
D. phenothiazine

Blooms Level: 01. Remember

True / False Questions

26. (p. 166) Modern antidepressants cure depression by treating the known underlying biological
cause of the disorder.
FALSE

Blooms Level: 01. Remember

Blooms Level: 02. Understand

27. (p. 169) A chronic psychotic condition with no known physical cause is likely to be
diagnosed as schizophrenia.
TRUE

Blooms Level: 01. Remember

28. (p. 168-170) The mood disorders include specific phobia.
FALSE

Blooms Level: 01. Remember

29. (p. 171) The first antipsychotic drugs were the phenothiazines, introduced in the 1950s.
TRUE

Blooms Level: 01. Remember

30. (p. 174) The MAO inhibitors are considered to be atypical antipsychotics.
FALSE

Blooms Level: 01. Remember

31. (p. 176) All selective reuptake inhibitors work primarily by blocking serotonin reuptake.
FALSE

Blooms Level: 01. Remember

Blooms Level: 02. Understand

32. (p. 177) The latest evidence on the effectiveness of antidepressants is that they are only
slightly better than placebos.
TRUE

Blooms Level: 01. Remember

33. (p. 178) Lithium was the first effective mood stabilizer.
TRUE

Blooms Level: 01. Remember

34. (p. 181) One indirect consequence of effective drug treatment for serious mental disorders is
that more mentally ill people are now in jail or prison than in mental hospitals.
TRUE

Blooms Level: 01. Remember

35. (p. 170) One of the symptoms of a major depressive episode is decreased or increased
appetite.
TRUE

Blooms Level: 01. Remember

36. (p. 166) In the DSM-V, Obsessive-Compulsive Disorder is now listed as an anxiety
disorder.
FALSE

Blooms Level: 01. Remember

Essay Questions

37. (p. 168) Distinguish between Bipolar I Disorder and schizophrenia.

Schizophrenia is a chronic state of psychosis with no known physical cause. Symptoms may
include hallucinations, delusions, and other evidence of loss of contact with reality. Bipolar I
Disorder is a mood disorder characterized by a history of at least one manic episode with
possible alternating periods of depression.

Blooms Level: 01. Remember

38. (p. 174) Explain the danger associated with monoamine oxidase (MAO) inhibitors.

They alter the normal metabolism of a dietary amino acid, tyramine, such that if an individual
consumes foods with a high tyramine content while taking MAO inhibitors, a hypertensive
(high blood pressure) crisis can result. A severe headache, palpitations, flushing of the skin,
nausea, and vomiting are some symptoms of this reaction, which has in some cases ended in
death from a stroke. Patients taking MAO inhibitors must also avoid sympathomimetic drugs,
such as amphetamines, methylphenidate, and ephedrine.

Blooms Level: 01. Remember

39. (p. 177) Explain the arguments for and against prescriptive licensing for psychologists.

Argument for: There is a general shortage of psychiatrists especially in rural and low-income
urban areas. People are then usually prescribed psychoactive drugs by a general practitioner
and may be seeing a psychologist. There is often little communication between the two, so
patients could be receiving incorrect treatment. General medical training covers very little
about mental illness and clinical psychology training is extensive on mental illness but no
background in medicine. If psychologists could undergo more training in medicine and
prescription of medicine, they could be well equipped to give drug treatment to patients.
Argument against: Medical doctors fear that even with this training psychologists could still
miss important medical considerations and, therefore, put a patient's health at risk. Some
psychologists fear that this could turn the field of psychology into pill pushing and neglect the
other treatment approaches.

Blooms Level: 01. Remember

Blooms Level: 02. Understand
40. (p. 178-179) Discuss the three factors that slowed the acceptance of lithium in the U.S.

First, was an incident involving lithium chloride as a sodium chloride substitute for heart
patients. Above a certain level, lithium is toxic and, because there was no dose limit, many
users became ill and several died. Lithium then had a bad reputation as potentially lethal.
Second, mania was not seen as a major problem in the U.S. The behavior of mania is rarely
the kind in which people would seek treatment. Patients who would become quite manic and
lose touch with reality would have been called schizophrenic at that time, and antipsychotics
are usually effective in controlling mania. The third reason deals with economics and the
problem with drug introduction in the U.S. A company that wants to sell a drug must spend a
great deal of money to demonstrate safety and effectiveness to the FDA. Because lithium is
one of the basic chemical elements and its simple salts had been available for many years, it
would have been impossible to receive a patent making it easy for others to sell the drug after
approval. Therefore, the company could not have recouped expenses.

Blooms Level: 01. Remember

Blooms Level: 02. Understand