Professional Documents
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MULTIPLE CHOICE
2. Laws at the state and national level limit the availability of drugs deemed to ____.
a. alter mental states c. have a significant risk of abuse
b. lead to drug addiction d. cause serious adverse health effects
ANS: C PTS: 1 REF: Regulatory Agencies and Drug Classification
3. One of the first national regulations on drugs of abuse was the Harrison Narcotics Act passed, which
restricted the sale of narcotics for medical uses. When was this law passed?
a. 1915 c. 1951
b. 1932 d. 1970
ANS: A PTS: 1 REF: Regulatory Agencies and Drug Classification
4. Which act first described drugs of abuse as controlled substances, requiring the legal regulation of certain
drugs with abuse potential and leading to an abuse potential/medical use classification system?
a. Harrison Narcotics Act c. Misuse of Drugs Act
b. Controlled Substances Act d. Dangerous Drugs Act
ANS: B PTS: 1 REF: Regulatory Agencies and Drug Classification
6. Dr. Rodriguez is characterizing the effects of a schedule I drug, ChemY, on the central nervous system.
According to its schedule, we can determine that ChemY is deemed to have a ____.
a. relatively low abuse potential and a legitimate medical purpose
b. moderate abuse potential and a legitimate medical purpose
c. high abuse potential and a legitimate medical purpose
d. high abuse potential and lack of medical usefulness
ANS: D PTS: 1 REF: Regulatory Agencies and Drug Classification
7. Big Pharma is testing a new drug, Medforma. Which governmental agency will be in charge of
designating Medforma’s schedule classification?
a. Food and Drug Administration
b. Drug Enforcement Administration
c. Alcohol, Tobacco, Firearms, and Explosives Bureau
d. Agency for Healthcare Research and Quality
ANS: B PTS: 1 REF: Regulatory Agencies and Drug Classification
9. A 1994 New York Times article illustrated the appropriateness of drug scheduling by gathering the
opinions of two prominent drug abuse experts, Jack Henningfield and Neal Benowitz (Hilts, 1994). What
was a major finding of this article?
a. Substances that pose the greatest addiction risk are not scheduled substances
b. Many drugs of abuse also have high therapeutic potential
c. Pharmaceutical companies heavily influence drug scheduling
d. Judicial penalties for drug offenses do not correlate well with drug schedules
ANS: A PTS: 1 REF: Regulatory Agencies and Drug Classification
10. Professor Eagleton is giving a lecture on drug enforcement and regulation. What point is she most likely
to make about the drug scheduling process?
a. The scheduling process is often too slow to be effective.
b. The scheduling process often makes snap judgements about drugs.
c. The scheduling process fails to take into account scientific evidence.
d. The scheduling process constantly reevaluates and reclassifies drug schedules.
12. Early clinical definitions of addiction focused on the development of tolerance, physical dependence, and
____ (National Institute on Alcohol Abuse and Alcoholism, 1995).
a. physical deterioration c. craving
b. behaviors consistent with drug abuse d. sensitization
ANS: C PTS: 1
REF: Clinical Definitions and the Diagnosis of Drug Addiction
13. Early clinical definitions of addiction focused on the development of tolerance, physical dependence, and
craving (National Institute on Alcohol Abuse and Alcoholism, 1995). What is a criticism of this
definition?
a. It is too inclusive. c. It is operational.
b. It is too limited in scope. d. It is not evidence-based.
ANS: B PTS: 1
REF: Clinical Definitions and the Diagnosis of Drug Addiction
14. One source currently describes addiction as substance dependence: “maladaptive pattern of substance use,
leading to clinically significant impairment or distress as manifested by three (or more) [symptoms]
occurring at any time in the same 12-month period.” What is the source?
a. Drug Enforcement Administration Resource Manual
b. Controlled Substances Act
c. Diagnostic and Statistical Manual of Mental Disorders
d. National Institute on Drug Abuse Regulatory Guidebook
ANS: C PTS: 1
REF: Clinical Definitions and the Diagnosis of Drug Addiction
15. The DSM addiction definition differs from earlier definitions because it considers ____.
a. drug use that persists despite a strong desire to stop
b. tolerance and psychological dependence
c. that addiction is characterized by lack of knowledge of physical or psychological harm
d. the fact that not all addictive drugs are harmful
ANS: A PTS: 1
REF: Clinical Definitions and the Diagnosis of Drug Addiction
16. A maladaptive pattern of substance use that does not involve tolerance or dependence is referred to as
____.
a. drug addiction c. recreational drug habit
b. substance abuse d. instrumental drug habit
ANS: B PTS: 1
17. A return to a chronic drug use state that meets the clinical features of addiction is referred to as ____.
a. resurgence c. relapse
b. reoccurrence d. reappearance
ANS: C PTS: 1
REF: Clinical Definitions and the Diagnosis of Drug Addiction
18. Suzette, a recovering heroin addict, is currently in sustained full remission. What does this mean?
a. She has shown no symptoms for dependence or abuse over the last 12 months.
b. She has not used heroin or any other addictive drug during the last 12 months.
c. She has not shown any signs of maladaptive behavior or poor health for the last 12
months.
d. Although she has strong cravings for heroin, she has resisted using the drug.
ANS: A PTS: 1
REF: Clinical Definitions and the Diagnosis of Drug Addiction
19. Stephan who has struggled with alcoholism most of his adult life has not had a drink of alcohol in the last
12 months. However, he still has strong cravings to drink alcohol from time-to-time. What term
characterizes Stephan’s remission state?
a. sustained full remission c. sustained partial remission
b. relapsing remission d. partial dependent remission
ANS: C PTS: 1
REF: Clinical Definitions and the Diagnosis of Drug Addiction
21. Dr. Benoit is a proponent of the disease model of drug addiction. Which statement is he most likely to
agree with?
a. The process of eliminating substance abuse should focus on a psychological, not
biological approach.
b. The abused substance is a manifestation of the disease, not the cause of it.
c. Drugs disrupt neurobiological processes, leading to addictive behaviors.
d. Drug addiction is caused by maladaptive behavior.
ANS: C PTS: 1
REF: Theoretical Models and the Features of Drug Addiction
22. Associative learning principles are likely to characterize the ____ features of drug use.
a. behavioral c. subconscious
b. cognitive d. biological
ANS: A PTS: 1
REF: Theoretical Models and the Features of Drug Addiction
26. Graduate student Sam sets up an experiment in which a rat hears a tone every time a fruit loop is placed in
his cage. The rat, when hungry, eventually emits responses in order to activate the tone. The tone is
referred to as a ____ reinforcer.
a. conditioned c. neutral
b. associated d. discriminating
ANS: A PTS: 1
REF: Theoretical Models and the Features of Drug Addiction
Classical Conditioning
Graduate student Marni must train her rats to enter an open arm of an elevated maze, despite the fact that
the rats prefer to stay in the safe and dark enclosed arm. She places a food pellet on the open arm, at
which point the rats enter the open arm to retrieve the pellet. Every time she presents the pellet in the
open arm, she also makes a clicking noise. Now the rats enter the open arm just from hearing the clicking
noise.
32. Incentive salience is the attribution of salient motivational value to a(n) ____ stimuli.
a. conditioned c. neutral
b. unconditioned d. reinforced
ANS: C PTS: 1
REF: Theoretical Models and the Features of Drug Addiction
33. Behavior that occurs when an organism engages in learned behaviors in order to achieve a desired
objective is referred to as ____.
a. reflexive behavior c. incentive salience behavior
b. operational behavior d. goal-directed behavior
ANS: D PTS: 1
REF: Theoretical Models and the Features of Drug Addiction
34. Who proposed one of the first drug-addiction models exclaiming that drug-addicted individuals develop a
drive to achieve a drug’s positive reinforcing effects, motivating a person to engage in drug seeking
behavior?
a. Wikler c. Pavlov
b. Solomon d. Corbit
ANS: A PTS: 1
REF: Theoretical Models and the Features of Drug Addiction
35. Which theory proposes that the body automatically counteracts the effects of a drug?
a. drug-homeostasis model c. reactionary-maintenance model
b. rebound theory d. opponent-process theory
ANS: D PTS: 1
REF: Theoretical Models and the Features of Drug Addiction
37. At a seminar on drug addiction, Dr. Chang makes a statement, “Drug addiction occurs after a shift from
“liking” the effects of a drug to “wanting ” the effects.” Dr. Chang is most likely to support which model
of drug addiction?
a. associative learning model c. goal-directed behavior model
b. incentive-salience model d. opponent-process model
ANS: B PTS: 1
REF: Theoretical Models and the Features of Drug Addiction
39. Postdoctoral research fellow Julio performs a cocaine self-administration experiment on rats. During a
presentation of his findings, Julio reports, “I have determined that rats will, on average, lever press around
200 times to receive a self-administered dose of cocaine.” What has Julio measured?
a. break point c. addiction index
b. excitatory constant d. reward threshold
ANS: A PTS: 1 REF: Self-Administration
40. The key structures along the brain’s reward circuitry consist of the ____.
a. hippocampus and thalamus
b. hippocampus and nucleus accumbens
c. ventral tegmental area and thalamus
d. ventral tegmental area and nucleus accumbens
ANS: D PTS: 1 REF: Drugs of Abuse and Reward Circuitry
41. Neurons containing which neurotransmitter largely compose the reward circuits of the brain?
a. dopamine c. GABA
b. glutamate d. acetylcholine
ANS: A PTS: 1 REF: Drugs of Abuse and Reward Circuitry
42. The discovery of the brain reward circuit in 1954 is attributed to ____.
a. Arvid Carlsson c. Kathleen Montagu
b. James Olds d. Abraham Wikler
ANS: B PTS: 1 REF: Drugs of Abuse and Reward Circuitry
44. Which has the greatest effect in enhancing dopamine release from axon terminals in the nucleus
accumbens?
a. food c. sex
b. novel stimuli d. amphetamine
ANS: D PTS: 1 REF: Drugs of Abuse and Reward Circuitry
45. To stimulate a reward pathway in the brain, Dr. Brochier targets GABA receptors with heroin. What is the
relationship between GABA receptors and the reward pathway?
a. Stimulating GABA receptors causes an increase in dopamine neuron activity.
b. Stimulating GABA receptors increases dopamine receptor levels.
c. Inhibiting GABA receptors causes an increase in dopamine neuron activity.
d. Inhibiting GABA receptors increases dopamine receptor levels.
ANS: C PTS: 1 REF: Drugs of Abuse and Reward Circuitry
46. Beyond the effects of acute drug administration, chronic administration of an abused drug leads to
changes in brain systems primarily involved in ____.
a. motivation and reward c. coordination and reflexive responses
b. learning and memory d. processing of sensory information
ANS: B PTS: 1
REF: Drug Abuse and Changes to Learning and Memory Systems
47. Beyond the reward system, which brain structures adapt to the chronic use of abused drugs?
a. amygdala, thalamus, prefrontal cortex, and hippocampus
b. ventral tegmental area, amygdala, thalamus, and nucleus accumbens
c. nucleus accumbens, caudate putamen, thalamus, and hippocampus
d. caudate putamen, thalamus, prefrontal cortex, and ventral tegmental area
ANS: A PTS: 1
REF: Drug Abuse and Changes to Learning and Memory Systems
48. Chronic treatment with an abused drug may also recruit procedural memory systems involving the ____.
a. dorsal lateral prefrontal cortex c. amygdala
b. dorsal striatum d. hippocampus
ANS: B PTS: 1
REF: Drug Abuse and Changes to Learning and Memory Systems
50. Leading authorities in drug-addiction research describe addiction as a cycle involving three primary
stages: intoxication, withdrawal, and ____.
a. craving and instigation c. homeostasis and maintenance
b. preoccupation and anticipation d. desire and fulfillment
ANS: B PTS: 1 REF: Neurobiology and the Stages of Drug Addiction
51. Which answer correctly pairs a stage of drug addiction with the associated brain pathway and drug
addiction model?
a. Intoxication: drive model and thalamo-cortical-amygdala pathway
b. Withdrawal: opponent-process model and amygdala
c. Preoccupation: drive model and reward pathway
d. Anticipation: opponent-process thalamo-cortical-amygdala pathway
ANS: B PTS: 1 REF: Neurobiology and the Stages of Drug Addiction
52. Studies by Kalivas and colleagues showed that stimuli once strongly paired with drug use activate what
type of neurons to elicit desire for the drug?
a. dopamine c. GABA
b. glutamate d. acetylcholine
ANS: B PTS: 1 REF: Neurobiology and the Stages of Drug Addiction
53. According to a longitudinal study by Mtzell (1998), what percent of heroin addicts remained drug free 20-
years after the study commenced?
a. 10% c. 30%
b. 20% d. 40%
ANS: A PTS: 1
REF: Psychological and Pharmacological Therapies for Treating Drug Dependence
54. After years of alcohol abuse, Charlene is beginning an addiction treatment program at an in-house
facility. What will likely be the first step in her addiction treatment program?
a. reconciliation c. intense psychotherapy
b. admitting that she is addicted d. detoxification
ANS: D PTS: 1
REF: Psychological and Pharmacological Therapies for Treating Drug Dependence
56. Which type of therapies attempt to provide alternative reinforcers for behaviors in the drug-seeking and
using process?
a. social therapies c. behavioral therapies
b. psychodynamic therapies d. cognitive–behavioral therapies
ANS: C PTS: 1
REF: Psychological and Pharmacological Therapies for Treating Drug Dependence
57. Which type of therapies teach drug-addicted individuals to identify and reduce their urges to use a
substance?
a. social therapies c. behavioral therapies
b. psychodynamic therapies d. cognitive–behavioral therapies
ANS: D PTS: 1
REF: Psychological and Pharmacological Therapies for Treating Drug Dependence
58. Which type of therapies are characterized by individuals joining others in their common battle with
addiction?
a. social therapies c. behavioral therapies
b. psychodynamic therapies d. cognitive–behavioral therapies
ANS: A PTS: 1
REF: Psychological and Pharmacological Therapies for Treating Drug Dependence
ESSAY
1. Discuss how chronic drug abuse induces changes to learning and memory systems. Include in your
answer a description of the neurobiological basis of this process and how it reinforces drug use.
ANS:
Chronic administration of an abused drug leads to changes in brain systems involved in learning
and memory. The interconnected structures that facilitate learning and memory include the amygdala,
thalamus, prefrontal cortex, and the hippocampus. Each of these structures adapt to the chronic use of
abused drugs.
The amygdala is a structure traditionally associated with fear and anxiety, yet it also supports
learning and memory by associating stimuli with emotional events such as experiencing reinforcing
effects from a drug. During chronic drug use, the amygdala forms associations between stimuli commonly
present during drug use and the reinforcing effects of the drug. The amygdala communicates this
information to two other structures important for learning and memory.
First, the amygdala is interconnected with the thalamus, a structure that routes sensory
information to the cerebral cortex. Second, the amygdala interconnects with the prefrontal cortex, the
brain’s executive center where stimuli are processed and motor responses are initiated. These structures
together form the thalamo-cortical-amygdala pathway.
PTS: 1 REF: Drug Abuse and Changes to Learning and Memory Systems
2. Food addiction is an emerging focus for mental health professionals. The current DSM fails to
characterize food addiction as a disorder. Drawing from the studies discussed in the text, illustrate how
obesity might satisfy the DSM’s criteria for dependence and how overeating shares many of the
neurobiological features of drug addiction.
ANS:
A study by Pretlow (2011) provides an illustration for how obesity might satisfy DSM criteria for
dependence. This study included a survey of anonymous qualitative statements provided by nearly 30,000
individuals ranging from ages 8 to 21. All participants had BMI levels 30 or higher and were, on average,
at the 96th percentile for BMI. From reviewing statements posted on the study’s Web site, Pretlow wrote
that “the majority of posts exhibited at least three criteria for substance dependence, particularly: (a) large
amounts of substance consumed over a long period, (b) unsuccessful efforts to cut down, and (c)
continued use despite adverse consequences.” Further, participants described food use that shared many
characteristics of drug tolerance, which consisted of progressively increasing food consumption over
time, and drug withdrawal, as characterized by urges to overeat when attempting to diet. Among those
who reported urges, nearly half described them as “intense cravings.”
Overeating shares many of the neurobiological features of drug addiction (Volkow, Wang,
Fowler, Tomasi, & Baler, 2011). Like drugs of abuse, foods can produce reinforcing effects by acting on
brain reward circuitry. Sugary liquid food consumed by rats causes large elevations in nucleus accumbens
dopamine levels. Appetite hormones also regulate dopamine neurons in the reward pathway. The hunger-
stimulating hormone ghrelin greatly enhances food-elicited increases in mesolimbic dopamine neuron
activity, and research also shows that ghrelin enhances self-administration responding for heroin). The
hunger-reducing hormone leptin diminishes food-elicited increases in dopamine neuron activity. Thus,
hunger enhances food’s reinforcing effects, whereas satiety reduces foods’ reinforcing effects. Research is
ongoing to determine how addictive food use may interact with learning and memory systems in ways
similar to addictive drug use.
Päämies värisi.
Sitten kuului yli ukkosen äänen uusi melu — kumea kohina, joka
pani soutajat melomaan tiheämmin.
— Huu-u-u!
— Melokaa!
Hän oli iso ja karkea ja vahva. Hän oli elänyt kyllin kauan
Englannissa luopuakseen Rannikolla oppimistaan paheista — sillä
hän oli kasvanut liikemaailmassa, osasi tusinan verran
alkuasukaskieliä ja tunsi jokaisen kansan tavat Dahomeystä
Angolaan. Pitkä mies, pulleaposkinen, kasvoilla pronssin puna,
huulet täyteläiset ja iho mehevä, ja hänellä oli koko se itseluottamus,
jonka rajaton rikkaus antaa.
Hän oli tullut tytön tutuksi, ennen kuin laiva, joka vei häntä takaisin
Sierra Leoneen, oli tullut Teneriffaan.
*****
— Yksin?
Tyttö nyökkäsi.
— Tunnetteko paikan?
*****
Komissaari Sanders tuli rannalle kohtaamaan tyttöä, eikä hän
mitenkään ollut oivallisella tuulella.
Hän kuvasi lyhyesti seudun, jonne tytön piti mennä asumaan; hän
kertoi enemmänkin kuin oli aikonut, mutta nuo harmaat silmät olivat
hyvin kehoittavat ja huulet niin valmiit hymyilemään.
*****
Sanders nyökkäsi.
— Lyö!
He päästivät hänet.
— Herra, hän oli suuri ja vahva, ja hänellä oli lihavat kasvot kuin
sialla ja sormus.
-— Hän arvaa liiaksi, sanoi päämies, — sillä hän sanoo, että sinä
et ole arabialainen, vaan valkoihoinen.