Deck 15: Treatments for Schizophrenia Spectrum Disorders

Question 1

How many people typically reside in a halfway house?

A) between 12 and 24
B) between 4 and 6
C) 1 person at a time
D) anywhere between 25 and 50

Answer 1

between 12 and 24

Question 2

In one study of patients who had been receiving antipsychotic medication for at least five years, _____ percent of them relapsed within a year when they were switched to a placebo.

A) 75
B) 68
C) 40
D) 27

Answer 2

75

Question 3

The first medication approved for sale in the United States as an antipsychotic was:

A) Melarin.
B) Haldol.
C) Thorazine.
D) Zyprexa.

Answer 3

Thorazine.

Question 4

Posthospitalization follow-up care and treatment in the community is known as:

A) acute care.
B) aftercare.
C) day care.
D) halfway care.

Question 5

People who take _____ undergo periodic drug testing to monitor for agranulocytosis.

A) Haldol
B) Clozaril
C) Prolixin
D) Mellaril

Question 6

The move toward institutionalization of the mentally ill in hospitals rather than asylums began in:

A) Belgium.
B) the United States.
C) France.
D) Germany.

Question 7

Today, psychosurgery is used only in severe cases of:

A) schizophrenia.
B) bipolar disorder.
C) delusional disorder.
D) obsessive-compulsive disorder and depression.

Question 8

In most cases, antipsychotic drugs produce the maximum level of improvement within the first _____ of treatment.

A) month
B) week
C) 6 months
D) 9 months

Question 9

Generally speaking, persons with schizophrenia who feel _____ toward their relatives do better in treatment.

A) dependent
B) apathetic
C) detached
D) positively

Question 10

A growing number of community therapists have become _____ for people with schizophrenia and other severe mental disorders.

A) social workers
B) court advocates
C) case managers
D) psychologists

Question 11

Which positive symptom of schizophrenia is most quickly reduced by taking antipsychotic medications?

A) flat affect
B) poverty of speech
C) loss of volition
D) hallucinations

Question 12

Which receives the least amount of federal and state funds?

A) social security disability income
B) state hospitals
C) community treatment programs for people with severe mental disorders
D) services for people with mental disorders who live in nursing homes and general hospitals

Question 13

Which is not mentioned as being a useful form of psychotherapy for people suffering from schizophrenia?

A) insight therapy
B) cognitive-behavioral therapy
C) family therapy
D) social therapy

Question 14

Which criticism has NOT been made about token economy programs in the treatment of the mentally ill?

A) The programs raise legal and ethical concerns.
B) The quality of the improvement is questioned.
C) There is no evidence of improvement as a result of these programs.
D) Some of the studies used to laud the effectiveness of these programs were uncontrolled.

Question 15

What percentage of people with schizophrenia are homeless?

A) 5
B) 10
C) 20
D) 16

Question 16

What do family support groups and family psychoeducational programs have in common?

A) Family members of patients with schizophrenia are subjected to the same treatments as the patient so that they can understand what it is like to have the illness.
B) Family members meet with others in the same situation to share thoughts and emotions, provide mutual support, and learn about schizophrenia.
C) Family members are instructed to keep quiet while the patient with schizophrenia gives a presentation on his or her plan for recovery.
D) Family members work collaboratively with therapists on ways to convince the patient with schizophrenia to voluntarily agree to long-term hospitalization.

Question 17

Research has shown that people with schizophrenia and other severe mental disorders receiving this type of therapy often improve and that they leave the hospital at higher rates than patients in programs that offer primarily custodial care.

A) milieu therapy
B) cognitive-behavioral therapy
C) family therapy
D) psychotherapy

Question 18

The Parkinsonian and related symptoms that may be a side effect of taking antipsychotic medications seemed to be related to the reduction of _____ activity in the brain.

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

Question 19

In (a) _____ patients are rewarded when they behave acceptably and are not rewarded when they behave unacceptably.

A) community mental health clinic
B) state hospital
C) milieu therapy
D) token economy

Question 20

_____ is a severe, potentially fatal reaction to antipsychotic drugs consisting of muscle rigidity, fever, altered consciousness, and improper functioning of the autonomic nervous system.

A) Neuroleptic malignant syndrome
B) Tardive dyskinesia
C) Neurogenesis imperfecta
D) Huntington's chorea

Question 21

The first mental asylum was founded in:

A) Egypt.
B) London.
C) England.
D) Paris.

Question 22

Many people who are recovering from schizophrenia and other severe mental disorders receive occupational training in a(n) _____ workshop, which is a supervised workplace for individuals who are not ready to work independently in competitive or complicated jobs.

A) assisted
B) sheltered
C) halfway
D) probationary

Question 23

The Parkinsonian and movement-related side effects of certain antipsychotic medications seem to be caused by reductions of specific transmitters in the basal ganglia and _____ regions of the brain.

A) pia mater meninx
B) corpus callosum
C) substantia nigra
D) putamen

Question 24

Research has repeatedly shown that:

A) antipsychotic drugs reduce symptoms in the majority of patients with schizophrenia.
B) drugs are not as effective as milieu therapy.
C) electroconvulsive therapy is more effective than drugs in treating schizophrenia.
D) milieu therapy and token economies are more effective than drugs in treating schizophrenia.

Question 25

Day hospitals first appeared in _____ when a shortage of hospital beds led to the premature release of many patients.

A) Moscow
B) Paris
C) London
D) Boston

Question 26

Of the following living circumstances, _____ describes approximately one-third of those who suffer from schizophrenia and other severe mental disorders.

A) unsupervised living
B) living with a family member
C) jail or prison
D) living in a hospital

Question 27

The discovery of _____ revolutionized treatment for schizophrenia.

A) milieu therapy
B) antipsychotic drugs
C) token economies
D) leucotomy

Question 28

The premise of _____ is that institutions need to promote productive activity, self-respect, and individual responsibility.

A) social treatment
B) token economy program
C) milieu therapy
D) rational-emotional-behavior therapy

Question 29

Most people with schizophrenia who live in poorly supervised or unsupervised settings survive on:

A) family support.
B) community support.
C) support from religious institutions.
D) government disability payments.

Question 30

Conventional antipsychotic drugs are referred to as _____ drugs because of their undesirable movement-related side effects.

A) dangerous
B) controlled
C) neuroleptic
D) neuropsychotic

Question 31

Use of at least one atypical antipsychotic, Clozapine, has been associated with the development of:

A) tardive dyskinesia.
B) akathisia.
C) brain tumors.
D) agranulocytosis.

Question 32

The _____ requires that people with mental disorders receive treatment in their communities rather than being transported to institutions far from home.

A) Civil Rights Act
B) Mental Health Insurance Parity Act
C) Community Mental Health Act
D) Deinstitutionalization Act of 1963

Question 33

Who received the Nobel Prize for research that led to the development of the lobotomy procedure?

A) Walter Freeman
B) Egas Moniz
C) Phillipe Pinel
D) Elliot Valenstein

Question 34

Which is NOT an extrapyramidal effect of using antipsychotic medications to treat schizophrenia?

A) Parkinsonian-type symptoms
B) Huntington's-type symptoms
C) neuroleptic malignant syndrome
D) tardive dyskinesia

Question 35

The milieu therapy approach to treating schizophrenia is based on _____ principles.

A) sociocultural
B) psychodynamic
C) behavioral
D) humanistic

Question 36

As a result of institutionalization, many patients developed:

A) severe depression.
B) schizophrenia.
C) social breakdown syndrome.
D) diathesis-stress.

Question 37

Token economy programs relied on the systematic application of _____ techniques.

A) operant conditioning
B) classical conditioning
C) social modeling
D) cognitive restructuring

Question 38

Of the few psychotherapists who treated patients with schizophrenia before the discovery of antipsychotic drugs, most believed that the first task of therapy was to:

A) win the trust of patients and build a close relationship with them.
B) get the patient to openly admit that their hallucinations were not real.
C) challenge the delusions that so many patients held, so that they could treat the "real" person and not just the symptom.
D) make the family members understand that schizophrenia had no real cure and that only a modicum of improvement could or should be expected.

Question 39

Antipsychotic drugs reduce psychotic symptoms, at least in part, because they block excessive activity of neurotransmitters at the brain's _____ receptors.

A) dopamine D-2
B) GABA
C) dopamine D-4
D) serotonin

Question 40

The use of antipsychotic medication dates back to the 1940s, when _____ drugs were used to calm patients about to undergo surgery.

A) beta blocking
B) antihistamine
C) anticholinergenic
D) opioid

Question 41

What was the dominant way of treating people with schizophrenia during the first half of the twentieth century?

A) institutionalization
B) outpatient services
C) individual psychotherapy
D) treatment with neuroleptic drugs

Question 42

American Walter Freeman "improved" the procedure developed by Egas Moniz by developing the:

A) prefrontal lobotomy.
B) prefrontal leucotomy.
C) transorbital lobotomy.
D) complete prefrontal lobectomy.

Question 43

The usual way of dealing with troublesome or violent people with schizophrenia in institutions in the first half of the twentieth century was to:

A) use drugs.
B) beat them.
C) ignore them.
D) use physical restraint.

Question 44

The main contribution of Philippe Pinel to the care of those with severe mental illnesses was to:

A) develop state hospitals for people who couldn't afford private care.
B) use antipsychotic drugs in highly controlled settings.
C) treat patients with sympathy and kindness.
D) promote deinstitutionalization.

Question 45

If one were treated by therapists who believed that patients needed to live in a social climate that promoted productive activity, self-respect, and individual responsibility, one would be likely to be living in the:

A) 1920s.
B) 1930s.
C) 1940s.
D) 1950s.

Question 46

Who was the first physician responsible for developing the prefrontal lobotomy for use on human patients?

A) Egas Moniz
B) Eliot Valenstein
C) Walter Freeman
D) Carlyle Jacobsen

Question 47

Long-term mental patients frequently developed anger, aggressiveness, and loss of interest in personal appearance. This condition has been called:

A) psychosis.
B) schizophrenia.
C) social breakdown syndrome.
D) neuroleptic malignant syndrome.

Question 48

Milieu therapy is based primarily on the principles of _____ psychology.

A) cognitive
B) behavioral
C) humanistic
D) psychodynamic

Question 49

Some hospitalized mental patients not only failed to improve but also suffered negative effects of their care. This syndrome is called:

A) schizophrenogenesis.
B) hyperinstitutionalization.
C) social breakdown syndrome.
D) downward drift.

Question 50

Which therapy is based on the premise that when you change the social environment, you can change the patient?

A) milieu therapy
B) insight therapy
C) family therapy
D) the token economy

Question 51

Which statement is true of state mental hospitals in the United States in the mid-twentieth century?

A) They were built as places to warehouse, isolate, and punish mental patients.
B) They were built in large cities so patients could stay in contact with the "real" world.
C) They were overcrowded and understaffed.
D) Although successful treatments were available, they were too expensive to be used.

Question 52

Which statement accurately reflects current thinking about psychosis and schizophrenia?

A) Psychotic behavior is best labeled as schizophrenia.
B) Schizophrenia and psychosis are two distinctly different syndromes.
C) People with different diagnoses can exhibit psychosis; it's not limited to schizophrenia.
D) People with bipolar disorder or major depression don't exhibit psychosis; only people with schizophrenia do.

Question 53

A patient who is called a resident who lives in a therapeutic community and actively works with staff members to create a life that is as much like that outside the hospital as possible, is probably receiving _____ therapy.

A) token economy
B) custodial
C) milieu
D) lobotomy

Question 54

Why were lobotomies so enthusiastically accepted by the medical community in the 1940s and 1950s?

A) They were based on sound experimental studies with animals.
B) The inventors of this procedure were gifted and dedicated physicians.
C) There were relatively few of them and side effects were mild.
D) They could be used to control criminals as well as mental patients.

Question 55

During a _____ a needle is inserted into the brain through the eye socket and is then rotated to destroy brain tissue.

A) prefrontal lobotomy
B) transorbital lobotomy
C) singular nigra lobotomy
D) facial-cranial lobotomy

Question 56

Theorists propose that institutionalized patients deteriorate because they are deprived of opportunities to develop self-respect and independence. The therapy that counters this effect by creating an environment that encourages self-respect and responsibility is known as:

A) token therapy.
B) social therapy.
C) milieu therapy.
D) environmental enhancement.

Question 57

The technique for treating mental patients that was pioneered by Egas Moniz was:

A) ECS therapy.
B) the lobotomy.
C) the use of drugs.
D) the cingulotomy

Question 58

Maxwell Jones (1953) created an approach to psychotherapy of the institutionalized in London called:

A) oral therapy.
B) group therapy.
C) a token economy.
D) milieu therapy

Question 59

Most patients who lived on the hospital wards in state mental hospitals in the mid-1900s:

A) were people with schizophrenia.
B) were given individual "talk" therapy with no success.
C) interacted well with each other but not with staff members.
D) were in fact violent criminals.

Question 60

Patients who developed extreme withdrawal, anger, physical aggressiveness, and loss of personal hygiene as a result of poor institutional care were showing a pattern known as:

A) institutional deterioration.
B) social breakdown syndrome.
C) chronic back ward syndrome.
D) schizophrenic failure to thrive.

Question 61

The discovery of antihistamine drugs in the 1940s indirectly led to the development of:

A) lithium.
B) antianxiety drugs.
C) antipsychotic drugs.
D) antidepressant drugs.

Question 62

Antipsychotic drugs were discovered accidentally when researchers were trying to develop:

A) antihistamines.
B) analgesics.
C) sedatives.
D) antibiotics.

Question 63

Which BEST describes the effectiveness of token economy strategies?

A) They are ineffective in the long run.
B) They reverse the progress of schizophrenia.
C) They are successful at changing the patient's behavior.
D) They are successful in altering the patient's distorted thinking.

Question 64

The symptom of schizophrenia most likely to be relieved by antipsychotic drugs is:

A) delusions.
B) flat affect.
C) lack of speech.
D) lack of purpose.

Question 65

One of the unwanted and later side effects of antipsychotic medications is:

A) paralysis.
B) hyperactivity.
C) tardive dyskinesia.
D) Parkinson's disease.

Question 66

Which drug has antipsychotic properties?

A) Prozac
B) Valium
C) imipramine
D) haloperidol

Question 67

What statement is accurate advice that you could give someone thinking about taking traditional antipsychotic medication for schizophrenia?

A) "Try psychotherapy first; it often works just as well."
B) "If you have negative symptoms of schizophrenia, you can expect better results from medication."
C) "Although these drugs will probably work, there are significant side effects."
D) "Although these drugs work well, you probably won't see the maximum results until after six months."

Question 68

If a person with schizophrenia were taking antipsychotic medications, he or she could expect the drugs to:

A) be most effective against negative symptoms of schizophrenia.
B) be most effective against positive symptoms of schizophrenia.
C) be given in higher doses to women than to men.
D) need to be taken even after symptoms have been alleviated.

Question 69

Tokens:

A) are given by patients to other patients whom they admire.
B) can be exchanged for a variety of rewards.
C) are given as punishment when a patient behaves unacceptably.
D) have a great street value.

Question 70

Which statement is NOT a criticism of the token economy approach?

A) Many studies of effectiveness do not include a control group, confounding the treatment with attention.
B) Although token economy programs can change patients' delusional statements, they may not be changing delusional thoughts.
C) Token economy programs do not change the behavior of the most severely ill patients.
D) It is difficult for patients to make the transition from a token economy program to the community.

Question 71

The term neuroleptic is applied to drugs that:

A) cure psychosis.
B) cure schizophrenia.
C) have potency against depression.
D) can mimic symptoms of neurological disorders.

Question 72

If one could use only a single treatment for schizophrenia and wanted the MOST effective treatment, one should choose:

A) antipsychotic drugs.
B) psychodynamic therapy.
C) milieu therapy.
D) electroconvulsive therapy.

Question 73

A token economy approach to treatment is based on principles from which view of abnormal behavior?

A) cognitive
B) biological
C) behavioral
D) humanistic

Question 74

The first antipsychotic drug to be approved for use in the United States was:

A) Haldol.
B) Prozac.
C) Thorazine.
D) Mellaril.

Question 75

In behavioral terms, what is a token?

A) a stimulus
B) motivation
C) a reinforcer
D) punishment

Question 76

If a patient's chart said the patient had extrapyramidal side effects, you would expect to see the patient showing primarily _____ dysfunction.

A) motor
B) cognitive
C) emotional
D) language

Question 77

What is the concern regarding the changes produced by token economies?

A) Many studies of token economies are methodologically flawed.
B) Some patients can function in normal life but deteriorate in the hospital.
C) The skills learned in the hospital may not generalize to the outside world.
D) The person may have learned new behaviors without changing distorted thinking.

Question 78

Which is the more effective treatment for schizophrenia?

A) psychotherapy
B) milieu therapy
C) electroconvulsive therapy
D) antipsychotic medications

Question 79

A third-grade teacher gives students stickers throughout the school day when they engage in appropriate behaviors. At the end of the day, students can trade in their stickers for treats from the class "treasure chest." This program is MOST similar to which form of therapy used for institutionalized people with schizophrenia?

A) milieu therapy
B) insight therapy
C) token economy
D) partial hospitalization

Question 80

A hospitalized patient no longer talks about delusions and hallucinations, thanks to participating in a token economy program. However, critics of the token economy program would say that the token economy program has:

A) worsened the negative symptoms of the disorder.
B) treated the schizophrenia without medication.
C) not eliminated the delusions and hallucinations, but improved the patient's ability to imitate normal behavior.
D) changed a Type I disorder into a Type II disorder.