Deck 10: Substance Use Disorders in Adolescents

Question 1

According to the text,which of the following is an impaired control symptom of substance use disorder?

A) recurrent failure to fulfill major role obligations
B) continued use depsite physical or psychological problems
C) tolerance
D) time spent obtaining the substance or recovering from its effects

Answer 1

time spent obtaining the substance or recovering from its effects

Question 2

Which of the following is true of a substance intoxication diagnosis?

A) It never occurs by itself, only in combination with a substance use disorder diagnosis.
B) It can be used to describe anyone who has ingested a substance.
C) It can be used to describe anyone who has ingested a substance to the point that he or she develops a change in behavior, experience, or functioning.
D) It can be used when intoxication results in distress or impairment.

Answer 2

It can be used when intoxication results in distress or impairment.

Question 3

Family therapy for adolescents was associated with all of the following EXCEPT for ______.

A) greater reduction in substance use than CBT
B) more rapid reductions in alcohol use
C) greater emphasis on decreasing family conflict than CBT
D) more lasting abstinence than CBT

Answer 3

greater reduction in substance use than CBT

Question 4

Which of the following is NOT a component of the CRAFFT assessment for substance use disorder in adolescents?

A) Have you ever CONVINCED yourself that you need alcohol or drugs to get through the day?
B) Do you ever use alcohol or drugs while you are ALONE?
C) Do you ever FORGET things you did while using alcohol or drugs?
D) Have you ever gotten into TROUBLE while you were using alcohol or drugs?

Question 5

In order to be diagnosed with a Substance Use Disorder,a person must ______.

A) be exhibiting tolerance and/or withdrawal
B) have at least two symptoms from each of the four symptom categories
C) use large amounts of the substance
D) experience clinically significant impairment or distress

Question 6

Which of the following is NOT a class of substances that can be abused,according to DSM-5 classification?

A) caffeine
B) tobacco
C) alcohol
D) cannabis

Question 7

Gil has been diagnosed with cannabis use disorder,however Gil has been in treatment,and hasn't used cannabis for 2 months,despite his cravings for cannabis.Which of the following is true of Gil?

A) Gil is not in remission because he still craves cannabis.
B) Gil is in early remission.
C) Gil is in sustained remission.
D) Gil is not in remission because he has had symptoms within the past 3 months.

Question 8

Substance-induced mental disorder ______.

A) only occurs during withdrawal from depressants and stimulants
B) can occur during substance use or during withdrawal
C) usually refers to the development of schizophrenia
D) is most common in those who use inhalants

Question 9

Most medications prescribed to reduce pain fall into which class of substances?

A) hallucinogens
B) opioids
C) stimulants
D) sedatives, hypnotics, and anxiolytics

Question 10

Relapse is ______.

A) relatively rare when youths have engaged in motivational enhancement therapy
B) relatively rare when youths have engaged in family therapy
C) relatively rare when youths have engaged in cognitive behavioral therapy
D) common, irrespective of the type of treatment

Question 11

Compared to adults with substance use disorder,adolescents with substance use disorder are ______.

A) more likely to crave the substance
B) more likely to binge on the substance
C) more likely to heavily use a single substance rather than to misuse a number of substances simultaneously
D) less likely to show comorbid behavior problems

Question 12

Which of the following is the most appropriate assessment for adolescent substance use disorder?

A) parent report
B) blood and urine tests
C) CAGE
D) ASSIST

Question 13

Which of the following is most strongly associated with high lifetime consumption of substances and risky patterns of substance use?

A) use of heroin
B) parental substance use
C) development of moderate to severe substance use disorder by age 18
D) use of alcohol by age 18

Question 14

Can someone be diagnosed with more than one substance use disorder?

A) Yes, but not simultaneously.
B) No, the diagnosis is made for the most severe substance use disorder.
C) Yes, people are diagnosed with a substance use disorder for each drug they abuse.
D) Yes, except if people abuse Alcohol and one or more other substances, they do not get an alcohol use disorder diagnosis.

Question 15

The Cannabis Treatment Study found ______.

A) the only effective treatment studied for cannabis use disorder in adolescents was 12 sessions of motivational enhancement therapy and CBT
B) unless treatment involved parent-family sessions, it was not reliably effective
C) 12 sessions of MET/CBT produced twice the effect of six sessions of MET/CBT
D) five sessions of MET/CBT was as effective as 12; thus, five sessions is the most efficient, effective treatment.

Question 16

The CAGE acronym ______.

A) teaches adolescents with substance use disorders ways to manage their emotions that don't involve substances
B) reminds clinicians of the common comorbidities of substance use disorders
C) is a way to remember the four main classes of substances that individuals can abuse
D) is a simple screening measure for alcohol use problems

Question 17

Daniel has just taken a substance at a party.Daniel is starting to feel disoriented and to see things that aren't really there,like hundreds of spiders crawling on the walls,and his friends' faces melting off their skulls.Which of the following do you suspect Daniel has just taken?

A) a hallucinogen
B) an inhalant
C) an opioid
D) a sedative, hypnotics, or anxiolytic

Question 18

Which of the following is NOT a symptom that is more common in adolescents versus adults with substance use disorder?

A) withdrawal
B) tolerance
C) time spent obtaining substances
D) substance use in hazardous situations

Question 19

Which of the following is NOT a cognitive factor related to likelihood of relapse among adolescents?

A) exposure to substance-using peers
B) encouragement to engage in substance use
C) desire to enhance mood
D) not regarding substance use as problematic

Question 20

Greta has had an alcohol substance use problem for several years.Recently,she has been going to a therapist for cognitive behavioral therapy.Greta has now been sober for 6 months.However,last weekend was her high school reunion.While there,she was with friends she used to drink with,and she had one shot of vodka.After that,she was full of guilt and thought to herself,"I'm so stupid.I'm just an addict and I'll never be cured." She had four more shots.This is an example of ______.

A) risky relapse
B) motivational deficit
C) situational cuing
D) abstinence violation effect

Question 21

The fact that nearly 90% of youths with substance use disorders show at least some problems with oppositional,defiant,or disruptive behavior demonstrates which of the following?

A) CD and substance use disorder share a common genetic or biological cause.
B) Disruptive behavior problems lead to substance use disorder.
C) Substance use disorder leads to disruptive behavior problems.
D) There is a strong relationship between conduct problems and substance use disorder, but this relationship does not tell us about the cause or direction of the link.

Question 22

What is the evidence against the assertion that marijuana is a "gateway drug"?

A) Almost all youths who use illicit substances have used marijuana.
B) Most who use illicit substances begin using marijuana after their illict substance use has already begun.
C) Most adolescents who use cigarettes, alcohol, and marijuana do not use other illicit substances.
D) There is no relationship between use of marijuana and use of illicit substances.

Question 23

Which of the following is the benefit of providing interpersonal training to an adolescent who drinks to fit in with peers?

A) It reduces the reinforcing effects of alcohol.
B) It prevents the classical conditioning underlying the use of alcohol.
C) It provides new social learning skills.
D) It changes the beliefs associated with using alochol.

Question 24

According to Monitoring the Future,illicit drug use among adolescents ______.

A) is more common than marijuana use
B) is less common than prescription medication misuse
C) is more common for inhalants than for other types of illicit drugs
D) has increased since 1995

Question 25

Which of the following has NOT been posited as a hypothesis for the high comorbidity between ADHD and substance use disorder?

A) ADHD and substance use disorder share a common genetic or biological cause.
B) ADHD and substance use disorder are both correlated with disruptive behavior problems.
C) Symptoms of ADHD increase the probability of substance use disorder.
D) Substance use disorder increases the probability of ADHD.

Question 26

Which neurotransmitter is NOT known to be affected by alcohol?

A) serotonin
B) norepinephrine
C) dopamine
D) GABA

Question 27

Results on the efficacy of CBT have indicated which of the following?

A) It is only effective for those with mild substance use problems.
B) It results in greater reductions in substance use than do other types of therapy.
C) The cognitive component is effective, but the behavioral component is not.
D) The behavioral component is effective, but the cognitive component is not.

Question 28

Based on its data collection methods,which of the following groups is not well-represented in the Monitoring the Future project?

A) females
B) those of non-English speaking backgrounds
C) those who have dropped out of high school
D) those with siblings

Question 29

Which of the following best describes the efficacy of multidimensional family therapy?

A) It is associated with reduction in substance use while traditional group therapy is not.
B) It is associated with reduction in substance use, but it takes much longer to get these results than to get comparable results with family therapy.
C) It is associated with greater reduction in substance use than traditional group therapy and produces more rapid results.
D) It has been shown to be more efficacious than family-based education, but less efficacious than individual or group supportive therapy.

Question 30

According to Monitoring the Future,alcohol ______.

A) has been used by nearly 75% of high school seniors
B) use disorder is reported in nearly 50% of high school seniors
C) use is more common than marijuana use among eighth graders, but less common than marijuana use among high school seniors
D) is second only to cigarettes among substances used by high school seniors

Question 31

Which of the following describes the relationship between anxiety and substance use?

A) Anxiety typically precedes substance use.
B) Anxiety typically develops after substance use.
C) Anxiety is very rare in those with substance use problems, so there is practically no relationship.
D) It is complex; sometimes anxiety precedes substance use, sometimes it develops afterward.

Question 32

Which is true about the relationship between ADHD and substance use disorder?

A) Most adolescents with ADHD eventually develop a substance use disorder.
B) Most adolescents with substance use disorder have ADHD.
C) Adolescents with ADHD and substance use disorder use a wider range of substances than adolescents with substance use disorder alone.
D) Adolescents with substance use disorder typically develop ADHD after beginning their substance use.

Question 33

Psychotic symptoms have been associated with the use of which substance in adolescence?

A) alcohol
B) cannabis
C) inhalants
D) anxiolytics

Question 34

The anxiety-reducing properties of low doses of alcohol can best be explained by which of the following?

A) stimulation of the norepinephrine system
B) inhibition of glutamate
C) increased activity in the amygdala
D) decrease in the release of endogenous opioids

Question 35

Which of the following best describes the differences between boys and girls,with respect to substance use?

A) Girls typically begin using substances at an earlier age than boys.
B) Girls are typically more likely to get in trouble at school because of alcohol and drugs.
C) Boys' substance use problems tend to be comorbid with disruptive behavior, whereas girls' substance use problems tend to be comorbid with emotional disturbance.
D) Boys with substance use problems are more likely to have abusive histories.

Question 36

One benefit of the ASSIST questionnaire for assessing child and adolescent substance use disorders is ______.

A) it involves biological measures of tolerance.
B) it collects reports from both the youth and the parent.
C) it has norms based on gender, ethnicity, and SES, which other measures do not.
D) it can be repeated without harming test-retest reliability, which other measures cannot.

Question 37

How does pharmacodynamic tolerance develop?

A) The most acute effect of alcohol occurs after the first few drinks in a day; because the liver can only process so much alcohol, these effects become less pronounced as more drinks are consumed.
B) Over sustained periods of using alcohol, the number or sensitivity of the neuroreceptors that respond to alcohol gradually decreases.
C) Sustained use of alcohol over months or years increases the sensitivity of GABA and dopamine receptors.
D) The amount of substance that can be used in a given period of time fluctuates based on circadian cycles and, in women, menstrual cycles.

Question 38

In adolescents,depression ______.

A) usually precedes the onset of a substance use disorder; the substance is used in an attempt to cope with the depression
B) is very uncommon in those with substance use disorder
C) when it develops, usually develops after the onset of substance use problems
D) is typically a substance-induced mental disorder

Question 39

Which of the following factors does NOT seem to predict an escalation in substance use among adolescents?

A) histories of impulsive and disruptive behavior
B) parent modeling of excessive substance use
C) friends' use of alcohol and other drugs
D) personal values related to abstinence and sobriety

Question 40

Which of the following best captures the changes in adolescent substance use over the last two decades,as recorded by Monitoring the Future?

A) Alcohol use has increased while cigarette use has dramatically decreased.
B) Alcohol use has increased while illicit drug use has decreased.
C) Alcohol use has decreased while other drug use has remained relatively stable.
D) Alcohol use has decreased while other drug use has increased dramatically, particularly after the legalization of marijuana.

Question 41

Which of the following is NOT one of the three interdependent ecological factors targeted in family therapy?

A) relationships with parents
B) home environment
C) school
D) peer relationships

Question 42

Those with behavioral undercontrol might be described as which of the following?

A) daredevils
B) overly creative
C) nosy
D) lazy

Question 43

Research has indicated that which of the following groups is least likely to develop substance use disorders via the negative affect pathway?

A) those with histories of having been abused
B) those from low-socioeconomic backgrounds
C) those from affluent backgrounds
D) those with anxiety disorder and/or depression

Question 44

Which of the following is NOT a cause of substance use disorder in the deviance-prone model?

A) low parental monitoring
B) early problems with neurobehavioral disinhibition
C) disruptive behavior and academic problems
D) peer rejection and affiliation with deviant peers

Question 45

The most common use of medication to address substance use disorders is ______.

A) as substitution therapy
B) for detoxicfication during withdrawal
C) to block the effects of the substance, making it less pleasurable to use
D) to treat comorbid disorders

Question 46

What is considered a success for motivational enhancement therapy?

A) complete abstinence from substance use
B) a change in attitude toward substances, even if it doesn't result in a change in behavior
C) a reduction in problematic substance use that decreases risk or harm
D) an increase in prosocial relationships

Question 47

Which of the following is a part of family sessions in multidimensional family therapy?

A) increasing the adolescent's social skills
B) helping the adolescent recognize and manage negative emotion
C) helping parents understand the importance of parental monitoring
D) improving communication and problem-solving skills between parent and child

Question 48

Clinicians who practice cognitive-behavioral therapy view problematic substance use as being acquired and maintained in all of the following ways EXCEPT for ______.

A) substance use acquired through operant conditioning, typically via positive or negative reinforcement
B) operant conditioning resulting in association between particular stimulus cues for substance use
C) social learning being a perpetuating cause for substance use disorders, particularly when it involves modeling of substance use by family or friends
D) distorted beliefs about events eliciting drinking or other drug use

Question 49

The results of studies of the effectiveness of secondary prevention programs indicate which of the following?

A) They are not effective.
B) They are very effective.
C) They are only effective when provided to those below the age of 12.
D) They are only effective when they target multiple risk factors and teach skills to avoid substances and develop positive relationships with peers.

Question 50

Which is true of the relationship between deviant peers and substance use?

A) Substance use is most common among controversial children.
B) Those who are using substances usually become neglected.
C) Girls who have late sexual maturation are more likely to experience substance use problems.
D) Early developing girls are more likely to develop substance use problems than typically developing girls.

Question 51

Which of the following is NOT among the three main goals of 28-day inpatient treatment programs for substance use disorders?

A) to separate the individual from antisocial peers who perpetuate substance use
B) to attend to immediate medical needs and detoxify the body
C) To help the adolescent understand the harmful effects of the substance use on health and functioning
D) to improve the quality of interpersonal relationships

Question 52

The genetic component of substance use disorder is ______.

A) almost completely deterministic
B) more pronounced for alcohol use disorder than for other substance use disorders
C) most pronounced for cannabis use disorder
D) predictive of the chronicity of substance use disorder

Question 53

With serious,dangerous drugs,such as methamphetamine or heroin,a single use is sufficient for a diagnosis of a substance use disorder.

Question 54

Which of the following is NOT one of the five principles of motivational interviewing?

A) approaching the client with acceptance and nonjudgment
B) persuading the client to change beliefs about sbustance use
C) rolling with resistance and avoiding argumentation
D) promoting the client's self-efficacy

Question 55

Both alcohol and sedatives affect GABA.

Question 56

Which of the following best describes the results of studies on the effectiveness of D.A.R.E.?

A) Children who participated in D.A.R.E. had lower rates of substance use by early adolescence.
B) Because D.A.R.E. was shown to be ineffective in lowering rates of substance use, most public schools no longer offer the program.
C) D.A.R.E. produced increases in knowledge about substance use problems, but no changes in rates of children's substance use.
D) D.A.R.E. seeemd to influence attitudes about substances, but not behaviors.

Question 57

Which of the following is associated with marijuana use?

A) It is associated with pharmacodynamic tolerance, but not with acute tolerance.
B) It may be associated with cognitive impairments persisting for weeks or months after discontinuing use of the substance.
C) It is not associated with withdrawal.
D) It is associated with changes in hormonal processes but not with changes in neurotransmitter patterns of activity.

Question 58

Brandy has been attending motivation enhancement therapy for a few weeks.When she first started,she didn't think her drinking was problematic and only attended because her mom made her.But,she now is starting to wonder whether she drinks too much.Which stage of change is Brandy currently in?

A) precontemplation
B) contemplation
C) action
D) maintenance

Question 59

The main difference between primary and secondary prevention programs for substance use disorders is which of the following?

A) Primary prevention programs are offered exclusively to those in primary school (elementary school).
B) Primary prevention programs are targeted toward all students, while secondary prevention programs are targeted to students more at risk.
C) Only those who have already gone through primary prevention programs would be eligible for secondary prevention programs.
D) Primary prevention programs are typically targeted toward alcohol and cigarettes while secondary prevention programs are typically targeted toward "harder" drugs.

Question 60

The utility of a nicotine patch is ______.

A) as substitution therapy that allows an individual to wean off of cigarettes
B) as detoxification during nicotine withdrawal
C) to block the effects of orally administered nictoine, since nicotine is already in the blood
D) to prevent orally administered nicotine from being metabolized

Question 61

One study of the efficacy of motivational enhancement therapy found that reductions in alcohol and marijuana use were greatest among adolescents who showed the most frequent use before treatment.What could some possible explanations for this finding be?

Question 62

Abstinence is the primary goal of motivational enhancement therapy.

Question 63

Why do schools in the United States continue to offer the D.A.R.E.program when it does not effectively minimize substance use in youths?

Question 64

The highest rate of problematic substance use occurs between 18 and 22 years of age.

Question 65

Relpase is uncommon in those who have undergone cognitive behavioral therapy.

Question 66

Discuss the ethical issues surrounding motivational enhancement therapy: Is it ethically permissible for therapists to support an adolescent's decision to engage in an illegal behavior?

Question 67

What are some ways in which the manifestation of substance use disorder differs between adolescents and adults,and why do these differences exist?

Question 68

There is a higher rate of suicide attempts among adolescents with substance use Ddisorder than among adolescents without substance use disorder.

Question 69

What is the role of expectations in the enhanced reinforcement pathway?

Question 70

Several studies have found a relationship between adolescent cannabis use and psychotic symptoms.What evidence is there that adolescents beginning to develop psychosis weren't self-medicating with cannabis-that is,that the psychosis didn't cause cannabis use?

Question 71

GABAA receptors play a large role in transmission of substance use problems from parents to children.

Question 72

What is the relationship between binge drinking and perceived risk associated with bingeing? Why do you think such a relationship exists?

Question 73

Some researchers believe that the DSM-5 criteria for substance use disorder are developmentally insensitive.What does this mean,and do you agree?

Question 74

Adolescents with substance use disorders are more likely to show comorbid mood and anxiety disorders than adults are.