Deck 11: Substance Use Disorders

Question 1

In one type of tolerance, cues that are regularly associated with the administration of a drug begin to function as conditioned stimuli and elicit a conditioned response that is opposite in direction to the natural effect of the drug in the process of

A) tolerance conditioning.
B) drug conditioning.
C) metabolic conditioning.
D) behavioral conditioning.

Answer 1

behavioral conditioning.

Question 2

Polysubstance abuse refers to abuse of

A) synthetic drugs.
B) more serious drugs.
C) prescription drugs.
D) several types of drugs.

Answer 2

several types of drugs.

Question 3

Which of the following offers a useful basis for distinguishing between people who are dependent on alcohol and those who are not?

A) legal involvement due to drinking
B) the amount of money spent on alcohol
C) the number of problems due to drinking
D) the amount of alcohol consumed each week

Answer 3

the number of problems due to drinking

Question 4

Which of the following is an example of psychological dependence on alcohol?

A) not wanting to drink alone
B) drinking to relieve negative moods
C) ability to drink more and more over time
D) cognitive impairments due to alcohol abuse

Question 5

For a class assignment you are asked to find information on cocaine. A reference book on drugs lists them by major category. Under which category will you find cocaine?

A) opiates
B) stimulants
C) depressants
D) hallucinogens

Question 6

Your friend misses work and has serious family difficulties because he uses drugs. However, he is not addicted to drugs. What DSM-IV diagnosis should be made in this case?

A) substance abuse
B) substance craving
C) substance dependence
D) substance ingestion habit

Question 7

What type of drug is alcohol?

A) opiate
B) analgesic
C) central nervous system stimulant
D) central nervous system depressant

Question 8

Which term describes central nervous system depressants that are used to relieve anxiety?

A) opiates
B) hypnotics
C) analgesics
D) anxiolytics

Question 9

What term is used to describe chemicals that can alter a person's mood, perception, or brain functioning?

A) legal drugs
B) illegal drugs
C) psychoactive substances
D) exogenous brain substances

Question 10

When in reaction to psychoactive drug use neurons adapt by reducing the number of receptors or by reducing their sensitivity to the drug, this is known as

A) down regulation.
B) up regulation.
C) neuron regulation.
D) metabolic regulation.

Question 11

What happens to a drinker's biological system to cause withdrawal from alcohol?

A) It is deprived of essential vitamins.
B) It has become psychologically dependent.
C) It rebounds after functioning in a chronically depressed state.
D) It rebounds after functioning in a chronically stimulated state.

Question 12

You are designing a research study to test the effectiveness of a new type of treatment program for alcohol dependence, and you want to be able to assess changes in your subjects' craving for alcohol. Which of the following would be a good index of their craving?

A) the amount of alcohol they drink
B) the discomfort they experience when they don't drink
C) their need to increase the amount that they drink
D) the amount of time they spend planning to drink

Question 13

While watching a television show you hear one of the characters, a physician, talk about narcotic analgesics. What is another name for these drugs?

A) opiates
B) hypnotics
C) cannabinoids
D) benzodiazepines

Question 14

You are reading an older text on alcohol and other drugs. The text has numerous references to the word addiction, which you find later has been replaced by ____________________. The two terms have essentially the same meaning.

A) abuse.
B) anhedonia.
C) substance dependence.
D) self‑destructive tendencies.

Question 15

DSM-IV defines substance abuse in terms of

A) addiction.
B) tolerance and withdrawal.
C) craving and lack of control.
D) interference with obligations at work and home.

Question 16

Metabolic tolerance involves changes in _____________ while pharmacodynamic tolerance involves changes in _____________.

A) neurons; enzymes
B) enzymes; neurons
C) brain; neuron
D) neuron; brain

Question 17

According the World Health Organization ______ use was responsible for 5 percent of the total burden of disease and disability worldwide in 2004.

A) heroin
B) alcohol
C) cocaine
D) marijuana

Question 18

Tolerance for a psychoactive substance refers to

A) withdrawal.
B) psychological dependence.
C) the ability to consume several drugs at the same time with limited adverse effects.
D) requiring more of a substance to achieve the same effect that lower doses used to achieve.

Question 19

In its presentation of diagnostic criteria the DSM-IV-TR uses which term for the more severe pattern of drug use that leads to increased doses, tolerance, and withdrawal?

A) addiction
B) dependence
C) abuse
D) craving

Question 20

Ernest Hemingway, the case presented at the start of chapter 11, suffered from

A) anxiety disorder.
B) cocaine dependence.
C) alcohol dependence.
D) borderline personality disorder.

Question 21

What is a blackout?

A) losing consciousness and passing out
B) a time-limited period of dementia
C) experience of nausea and vomiting
D) an inability to remember what has happened

Question 22

In your role as a police officer you sometimes come across individuals who are seem to be hallucinating and have delusions of persecution. In addition to the possibility that these individuals may have a mental disorder or be under the influence of various hallucinogenic drugs you must also consider the possibility of

A) marijauana withdrawal.
B) amphetamine use.
C) acute depression.
D) None of these would produce those symptoms.

Question 23

Which of the following are signs of alcohol intoxication according to DSM-IV-TR?

A) anhedonia, hallucinations, and delusions
B) nystagmus, rapid heart beat, and convulsions
C) slurred speech, lack of coordination, and nystagmus
D) feelings of pleasure, nausea, and constriction of the pupils of the eye

Question 24

What is the legal limit of alcohol concentration for driving in most states, as measured in number of milligrams (mg) of alcohol per 100 milliliters of blood (percent)?

A) 10 mg percent
B) 100 mg percent
C) 200 mg percent
D) 400 mg percent

Question 25

The police found C. Gram Seven along the highway. They immediately transported him to the emergency room where it was determined that his alcohol concentration was 600 mg percent. The police report probably described Mr. Seven as

A) dead.
B) stuporous.
C) unconscious.
D) uncoordinated.

Question 26

Alex is listening to a lecture on the history of opiate drugs and he learns something that he finds very surprising. What has he heard the lecturer say?

A) "Heroin is a synthetic opiate made from morphine."
B) "Heroin has actually been legally available by prescription in the U.S. for years."
C) "Heroin is a synthetic drug that was originally developed as an antidepressant."
D) "Heroin is not really an opiate because it is synthetic and does not actually come from poppies."

Question 27

Delirium tremens is a collection of symptoms that result when a person is withdrawing from

A) opiates.
B) alcohol.
C) stimulants.
D) hallucinogens.

Question 28

People who stop taking relatively high doses of benzodiazepines can experience an abrupt return of the anxiety they were using the drugs to suppress. This is called

A) return of the repressed.
B) high anxiety.
C) rebound anxiety syndrome.
D) discontinuance syndrome.

Question 29

Based on reports from people who use drugs, which psychoactive substance is least associated with tolerance and withdrawal effects?

A) opiates
B) sedatives and hypnotics
C) marijuana and hashish
D) cocaine

Question 30

What is the physiological basis of the short-term effects of nicotine?

A) blocks release of GABA and acetylcholine
B) increases release of GABA and acetylcholine
C) blocks release of norepinephrine and dopamine
D) increases release of norepinephrine and dopamine

Question 31

Which category of drugs is made up of those used to treat anxiety disorders and sleeping problems?

A) opiates
B) stimulants
C) benzodiazepines
D) selective serotonin reuptake blockers

Question 32

Why are cocaine and amphetamines called stimulant drugs?

A) They activate the sympathetic nervous system.
B) They activate the parasympathetic nervous system.
C) They reduce the level of GABA available in the brain.
D) They increase the level of GABA available in the brain.

Question 33

The textbook suggests that withdrawal from nicotine is on a par with

A) heroin.
B) LSD.
C) marijuana.
D) sugar.

Question 34

The active substances in opium are

A) LSD and PCP.
B) cocaine and heroin.
C) codeine and morphine.
D) marijuana and cocaine.

Question 35

Which of the following statements about the relationship between the misuse of alcohol and death is true?

A) Alcohol is responsible for relatively few deaths directly.
B) Alcohol related deaths due to injury are more common among young men.
C) Alcohol related deaths due to disease are more common among young men.
D) The number of alcohol-related deaths in the U.S. has been steadily declining for the past 20 years.

Question 36

A research participant in a study of drug effects has experienced a brief, intense, dreamlike euphoria with a sense of increased visual and auditory sensitivity. The brief sense of pleasure is very powerful. Which drug has this subject likely received?

A) PCP
B) LSD
C) heroin
D) cocaine

Question 37

Charles is administered a blood alcohol level test and the results show 350 mg percent. Which of the following characterizes his state?

A) slightly intoxicated
B) very intoxicated, at risk of slipping into coma
C) unaffected by the small amount he drank earlier
D) his driving is impaired, but he could walk home

Question 38

The police find a man in a seedy part of town; he looks in "bad shape" so they call for an ambulance. On the way to the hospital the paramedic calls the hospital base with the following: approximately 50-year-old white male, heavy sweating, hand tremors, seems delirious, and appears to be experiencing hallucinations. When the patient arrives at the hospital, the emergency room physician suspects that the patient is experiencing

A) cocaine withdrawal.
B) barbiturate overdose.
C) a schizophrenic episode.
D) alcohol withdrawal delirium.

Question 39

The family of drugs that includes barbiturates to benzodiazepines are also know informally as all of the following EXCEPT

A) tranquilizers.
B) sedatives.
C) hypnotics.
D) neuroleptics.

Question 40

Prolonged use of amphetamines has been linked to an increase in violent behavior, but it is not easy to interpret this link because

A) there are many different definitions of violence.
B) people are usually not willing to admit that they have taken amphetamines.
C) the violence could be due to the drug user's lifestyle, not the drug itself.
D) very few people actually engage in prolonged use of amphetamines.

Question 41

Which of the following must a person exhibit in order to be diagnosed with substance dependence in the DSM-IV-TR?

A) delirium tremens
B) tolerance and withdrawal
C) a pattern of compulsive use
D) concealed substance use and blackouts

Question 42

Which problems commonly occur along with alcoholism?

A) schizophrenia and bipolar disorder
B) adjustment disorder and somatization disorder
C) mood disorder and antisocial personality disorder
D) dependent personality disorder and specific phobia

Question 43

Why are amphetamines the most serious drug problem in Japan?

A) Amphetamines are readily available as over-the-counter diet aids.
B) There is a limited amount of land for cultivation of plant-based drugs and amphetamines are synthetic drugs.
C) Government agencies have managed to intercept most shipments of drugs that have a detectable odor.
D) These drugs have a long history of use there by people who use them to get a boost in energy and to increase the number of hours they can work.

Question 44

The workgroup that is preparing the definition of substance use disorders that will be used in the DSM-V may collapse substance dependence and substance abuse into a single disorder with a continuous range of severity. In the case of alcohol, this disorder may be called "________________."

A) delirium tremens
B) alcohol use disorder
C) Korsakoff's disorder
D) alcoholism

Question 45

What is the most common active ingredient in marijuana?

A) LSD
B) PCP
C) THC
D) LOB

Question 46

With regard to the diagnosis of substance dependence in the DSM-IV-TR, if tolerance and/or withdrawal are noticed, an additional specification is also made. This specification is

A) substance dependence.
B) substance abuse.
C) physiological dependence.
D) physiological abuse.

Question 47

While out in the wild, a group of vacationers pick some mushrooms. Later in the day, they use them in cooking the evening meal. Several members of the group begin to experience strange sensations and even hallucinations. The drug in the mushrooms was most likely

A) PCP.
B) marijuana.
C) psilocybin.
D) exogenous opiates.

Question 48

Cannabis intoxication is often accompanied by temporal disintegration. This means that

A) the drug breaks down quickly in the body.
B) people have trouble retaining and organizing information.
C) intoxication can quickly lead to a nervous breakdown.
D) intoxication leads to social withdrawal and isolation.

Question 49

Although the course of alcoholism is different in every individual, nearly all cases of alcoholism involve

A) onset before age 20.
B) antisocial behavior.
C) a predictable sequence of phases.
D) alternating periods of heavy use and abstinence.

Question 50

What hallucinogen at higher doses can induce psychotic behavior, including delusional thinking, catatonic behavior, manic excitement, and sudden mood changes?

A) LSD
B) PCP
C) cocaine
D) alcohol

Question 51

What evidence led developers of DSM to the distinction between substance abuse and substance dependence?

A) Substance abuse is more severe than dependence.
B) Substance abusers do not suffer serious impairment.
C) People who are dependent on substances do not all abuse substances.
D) People whose adjustment is impaired by substance abuse do not all progress to a level of dependence.

Question 52

People who stop taking hallucinogens after continued use

A) usually experience flashbacks.
B) show significant withdrawal effects.
C) often return to drug use.
D) show no withdrawal effects.

Question 53

Which of the following is least likely to be experienced while under the influence of MDMA, also known as ecstasy?

A) increased sensory awareness
B) enhanced mood
C) difficulty regulating body temperature
D) vivid hallucinations

Question 54

As a behavioral advisor to the World Health Organization it is your job to assess drug use and abuse in indigenous populations. You have been assigned to study the use of coca leaves, the plant from which cocaine is derived, among Indians of South America. In reading about past findings you discover

A) that these native groups have very few drug use problems.
B) that these native groups have very serious drug use problems.
C) that these native groups are so hostile to the WHO that no studies have been done.
D) that these native groups have almost been wiped out due to local drug wars.

Question 55

Follow-up studies of adults who used cannabis over a period of several years

A) found evidence of cognitive decline associated with the drug.
B) did not find evidence of cognitive decline associated with the drug.
C) found evidence of brain damage in several areas of the central nervous system.
D) found evidence of cognitive enhancement in creative skills.

Question 56

Mindy was just arrested for driving while intoxicated (DWI). Why would we not necessarily diagnose Mindy as an alcohol abuser?

A) She is female, and abuse is only seen in males.
B) DSM excludes DWI as a criterion for alcohol abuse.
C) DSM requires a recurrent pattern.
D) Intoxication is not pathological.

Question 57

What pattern of drinking-related behavior was reported by George Vaillant in his longitudinal study of males?

A) Most of the men stopped drinking prior to age 30.
B) Those who remained abstinent for six years were unlikely to relapse.
C) The majority of the men drank so heavily, they were dead before the age of 40.
D) The rate of abstinence was low and changed little over the course of the follow-up.

Question 58

You are a psychologist for a drug treatment program aimed at adolescents. In evaluating new clients you would be most concerned about the long-term continuous use of which substance?

A) PCP
B) psilocybin mushrooms
C) LSD
D) MDMA

Question 59

Among all men and women who have ever used alcohol roughly what percent will develop serious alcohol related problems?

A) 10
B) 20
C) 30
D) 50

Question 60

You have been asked to design a targeted drug prevention program. Your task is to decide on which sex, if any, should receive more attention. You decide that it depends on which drug or drugs are under consideration and that

A) for alcohol abuse the focus should be on women, who have a higher rate of alcohol abuse.
B) for alcohol dependence the focus should be on women, who have a higher rate than men.
C) for drug abuse, in general, the focus should be on men who have the highest rate.
D) for drug dependence in general the rates are equal, so each sex will have to be targeted.

Question 61

Bob and Vickie each weigh 150 pounds. They go out drinking and each has three beers. According to the textbook why does Vickie become intoxicated sooner?

A) Men's bodies have lower water content.
B) Women's bodies have lower water content.
C) Men's digestive functioning is less efficient.
D) Women's digestive functioning is less efficient.

Question 62

Scientists who study the biological basis of addiction have devoted considerable attention to understanding the rewarding properties of drugs. Much of this attention has focused on

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

Question 63

Which of the following conclusions about the genetics of alcohol abuse and dependence can be legitimately drawn from adoption studies?

A) Genetics do not play a very significant role.
B) There appears to be a strong association with antisocial personality traits.
C) Being reared by an alcoholic parent can fully account for the known risk.
D) There is too much inconsistency in the studies to allow us to draw any conclusions.

Question 64

The lifetime prevalence of alcoholism among families of alcoholics is higher than in the general population, by a factor of about

A) 2.
B) 3-5.
C) 10-15.
D) 20.

Question 65

What evidence has been cited by scientists who propose that alcoholism is related to endogenous opioid production?

A) Alcohol is an opioid derivative.
B) Rats given morphine refuse alcohol.
C) The symptoms of withdrawal from alcohol and heroin are similar.
D) Opioid-antagonists can reduce the subjective "high" of drinking.

Question 66

According to the National Epidemiologic Survey on Alcohol and Related Conditions the lifetime prevalence of alcohol abuse for men is approximately what percentage of the general population?

A) 5
B) 15
C) 25
D) 50

Question 67

You have access to an fMRI facility and plan to study brain regions associated with drug addiction. You advise your team that it would be wise to focus on

A) the reward pathways of the brain.
B) the ventral tegmental area of the brain.
C) the amygdala.
D) All of the above are important areas for this study.

Question 68

Which of the following characteristics are strong predictors of adolescents' initial experimentation with drugs?

A) extroversion and agreeableness
B) introversion and impulsiveness
C) rebelliousness and extroversion
D) introversion and conscientiousness

Question 69

Which of the following are you most likely to find among the elderly in the United States?

A) higher rates of alcohol abuse than among younger people
B) higher rates of drug abuse than among younger people
C) prescription drug abuse and dependence
D) illegal drug abuse and dependence

Question 70

Genetic factors in the cause of alcohol abuse could be somewhat indirect. It has been suggested, for example, that genes that influence __________________ may cause a person to be more likely to risk alcohol dependence.

A) intelligence
B) depression
C) ADHD
D) sensation seeking

Question 71

What is the estimated heritability of serious alcohol-related problems?

A) 13 percent
B) 33 percent
C) 66 percent
D) 86 percent

Question 72

Being reared by an alcoholic parent, in the absence of other etiological factors,

A) still significantly increases the chance of developing the disorder.
B) does not appear to be a critical consideration in the development of the disorder.
C) increases the risk of alcohol dependence, but decreases the risk of abuse.
D) reduces the risk of alcohol related problems but increases the risk of drug related problems.

Question 73

Alcohol-related disorders are

A) on the decline in the United States.
B) relatively rare forms of mental disorders.
C) among the most common forms of mental disorders.
D) not widely enough studied to draw firm conclusions.

Question 74

Which age group has the highest prevalence rates for alcohol dependence?

A) adolescents
B) the elderly
C) young adults
D) the middle aged

Question 75

Several genes that affect the reception of which neurotransmitter have been seen to correlate with the risk of alcohol dependence?

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

Question 76

Which statement is most accurate?

A) Younger people do not drink as much alcohol as older people.
B) Older people do not drink as much alcohol as younger people.
C) Younger men drink less alcohol than older men.
D) There is not a significant difference in the drinking habits between young and old.

Question 77

Why are investigators interested in the fast flush phenomenon?

A) It is often seen in people of Asian ancestry and might explain why they drink less.
B) It is often seen in people of Asian ancestry and might explain why they drink more.
C) It is often seen in young people and might explain why they drink more.
D) It is often seen in females and might explain why they drink less.

Question 78

How does the rate of alcohol problems compare in men and women?

A) Although the difference in the rates is narrowing, the rate is still much higher among men.
B) The rate is much higher among males and the difference between males and females is growing larger.
C) Community surveys indicate that the rates are virtually identical.
D) Although in the past males have had much higher rates, females now have higher rates.

Question 79

According the National Comorbidity Study the lifetime prevalence of nicotine dependence is approximately

A) 2 percent.
B) 10 percent.
C) 25 percent.
D) 40 percent.

Question 80

What have researchers concluded from research on the concordance rates of monozygotic (MZ) and dizygotic (DZ) twins?

A) The role for genetics is much larger for males than it is for females.
B) Genetic factors play a small role in etiology of alcoholism among women.
C) Similar concordance rates for MZ and DZ twins suggest no significant role for genetics.
D) Concordance rates suggest a role for genetics, and higher concordance among males reflects the higher prevalence of alcoholism among males.