Deck 24: The Dual-Diagnosis Client: Substance Use Disorders and Mental Illness

Question 1

Dual diagnosis clients are 300 percent more likely to contract the virus that causes

A) AIDS.
B) Hepatitis B.
C) Hepatitis C.
D) Hepatitis D.

Answer 1

AIDS.

Question 2

If a person suffers from some form of mental illness, he or she is also

A) 50 percent more likely to have a concurrent substance use disorder.
B) 100 percent more likely to have a concurrent substance use disorder.
C) as likely as the average person to have a substance use disorder.
D) 270 percent more likely to have a concurrent substance use disorder.

Answer 2

270 percent more likely to have a concurrent substance use disorder.

Question 3

For years it has wrongly been assumed that dual diagnosis clients

A) who are addicted share the same motivational traits as persons without a psychiatric problem who are addicted.
B) who abuse chemicals have the same motivational traits as persons who are addicted to chemicals.
C) who have a job are less motivated to quit than those without a job, since their stress level is higher.
D) do not abuse chemicals for the same reason(s) over the years.

Answer 3

who abuse chemicals have the same motivational traits as persons who are addicted to chemicals.

Question 4

Mental health professionals have understanding of the forces that initiate, or maintain, a substance use disorder in a person with mental illness.

A) a single, comprehensive theory that assists in the
B) a rather complete
C) virtually no
D) a frustratingly complex

Question 5

About the only sign of a mental illness a substance use disorder (or withdrawal from a drug of abuse) cannot simulate is

A) depression (possibly of suicidal proportions).
B) psychosis.
C) mania.
D) none of these. Substance abuse or withdrawal might present as virtually any form of mental illness.

Question 6

Which of the following statements is NOT true about the treatment of bipolar disorder and SUDs?

A) Manic symptoms can be easily mistaken as "progress" by rehabilitation staff, leading to increased rate of premature release from treatment.
B) It is hypothesized that bipolar patients might use CNS stimulants to simulate the manic phase of their disorder.
C) The alcohol dependent patient with bipolar disorder is more likely to use alcohol during the manic phase of the disorder.
D) Symptoms of bipolar disorder can be exacerbated by the abuse of many compounds.

Question 7

The theory that the SUD reflects another primary, psychiatric disorder that will resolve once the mental illness is effectively treated

A) has few adherents at this time.
B) is the assumption on which most treatment for dual diagnosis patients is based at this time.
C) tends to be true only for criminal offenders, but not for the majority of mentally ill substance abusers.
D) helps the client better understand his or her plight.

Question 8

What is described as being essential if a clinician is to get an accurate dual diagnosis assessment?

A) Thorough clinical history
B) Performing the "CAGE" assessment
C) Detoxification medication
D) Significant levels of shame in the patient

Question 9

Which of the following models of dual diagnosis conditions seems to be supported by the most evidence?

A) Self-medication model
B) Causal relationship model
C) Super-sensitivity model
D) Substance abuse as secondary model

Question 10

The term "dual diagnosis" refers to individuals who have

A) an addiction to two or more chemicals at the same time.
B) a person with both a mental health disorder and a substance use disorder at the same time.
C) a person who had a substance use disorder, recovered from that condition, then developed a mental health disorder.
D) a clearly defined psychiatric condition with proven treatment modalities.

Question 11

Which of the following serves as a powerful "relapse trigger" for dual diagnosis clients trying to quit abusing substances?

A) Untreated psychiatric symptoms
B) Going to jail
C) Being with friends
D) Walking by familiar drinking establishments or places where they formerly used substances

Question 12

Dual diagnosis clients

A) are less impulsive than normal persons.
B) are more impulsive than normal persons.
C) are about as impulsive as normal persons.
D) struggle with the side effects of prescribed medications so impulsiveness is not an issue.

Question 13

Which of the following statements is true about the relationship between borderline personality disorder (BPD) and SUDs?

A) People with BPD tend to use drugs or alcohol to intensify their emotions.
B) Substance abuse treatment for people with BPD is quite straightforward.
C) It is estimated that around 30-50 percent of people with a SUD will also have BPD.
D) Relaxation training seems to be the most effective form of treatment for individuals with BPD and SUD.

Question 14

It is estimated that up to of people with OCD have a concurrent SUD.

A) 7 percent
B) 15 percent
C) 27 percent
D) 36 percent

Question 15

It is believed that of people with MI/CD received treatment for both disorders in the past year.

A) 2 percent
B) 5 percent
C) 8 percent
D) 11 percent

Question 16

According to your text, which of the following mental illnesses seems to have the highest lifetime prevalence rate with SUDs?

A) Bipolar affective disorder
B) Schizophrenia
C) Post traumatic stress disorder
D) Anti-social personality disorder

Question 17

The majority of individuals who would have been referred to a state hospital in the 1950s are now

A) able to be referred to community treatment centers.
B) able to call upon large numbers of social support agencies in the community following treatment.
C) more likely to be homeless or incarcerated.
D) able to budget their funds without help from representative payees.

Question 18

Although the abuse of a chemical might not have caused the development of a mental illness

A) it might be intertwined with the mental illness.
B) it will not influence the course of that disorder, either.
C) it will easily be identified as a separate disorder from the mental illness.
D) the mental illness will always resolve once the substance use disorder is treated.

Question 19

Which of the following statements is NOT true about dual diagnosis clients?

A) They have higher rates of suicide.
B) They tend to have stronger support networks.
C) They have increased risk of being homeless.
D) They are less able to handle personal finances.

Question 20

The more serious the individual's mental illness, the more

A) likely he or she is to fear losing entitlement payments such as Social Security.
B) receptive he or she will be to an opportunity to supplement their income from entitlement payments by working "under the table."
C) difficult it will be to abstain from alcohol or illicit drugs.
D) likely it is he or she will be able to return to society and resume their role as a productive citizen.

Question 21

Adolescent girls with anorexia might use

A) alcohol to suppress their appetites.
B) CNS depressants to allow them to avoid becoming manic from the lack of adequate caloric intake.
C) alcohol to maintain a minimal degree of caloric intake to avoid loss of consciousness from lack of eating.
D) marijuana to stimulate their appetites.

Question 22

The most commonly encountered personality disorder found in persons with an SUD is

A) antisocial personality.
B) borderline personality.
C) histrionic personality.
D) schizoaffective personality.

Question 23

Your text suggests that of persons with a generalized anxiety disorder will also have a substance use disorder.

A) 30 percent
B) 15 percent
C) 40 percent
D) 50 percent

Question 24

Describe the complicated relationship between schizophrenia and SUDs regarding dual­diagnosis.

Question 25

Describe the theoretical models attempting to explain dual­diagnosis conditions.

Question 26

Persons with a bipolar disorder tend to abuse drugs during

A) the depressed phase of their disorder.
B) the period of stability before the next phase of their disorder.
C) the manic phase of their disorder.
D) all phases of their disorder equally.

Question 27

Available evidence suggests that, at best, only of persons with schizophrenia do not smoke cigarettes.

A) 10 percent
B) 90 percent
C) 40 percent
D) 25 percent

Question 28

Describe the reasons why clinicians once believed a relationship existed between a patient's disorder and his or her
drug of choice.

Question 29

Describe the stages of treatment when working with a client with a dual­diagnosis that includes a SUD.

Question 30

ER physicians commonly attribute symptoms in dual diagnosis patients to their SUDs with the exclusion of psychiatric disorders.

Question 31

Describe the evolution of the idea dual­diagnoses may also include persons with substance abuse disorders.

Question 32

Twenty-one percent of those persons who are depressed also meet the criteria for having had a in the past 12 months.

A) amphetamine use disorder
B) hallucinogen use disorder
C) benzodiazepine use disorder
D) alcohol use disorder

Question 33

Which of the following is NOT true of dual diagnosis clients?

A) They appear to experience a different cocaine withdrawal syndrome than other people.
B) Cocaine abusing patients with schizophrenia are at higher risk for the development of a movement disorder known as tardive dyskinesia.
C) They tend to seek out specific drugs, depending on their exact form of mental illness.
D) They use alcohol to self-medicate anxiety.

Question 34

Available evidence would suggest which of the following about persons with ADHD?

A) They are more prone to alcohol-related disinhibition than normal persons.
B) They are less prone to alcohol-related disinhibition than normal persons.
C) The issue of impulsiveness and ADHD are entirely separate conditions and cannot be assumed to be connected.
D) They tend to remain intoxicated for a longer period of time after consuming a given amount of alcohol when compared with a normal person.

Question 35

Persons with a bipolar disorder might find that marijuana their disorder.

A) might exacerbate
B) eliminates all signs of
C) causes/exacerbates hallucinations
D) has no effect on

Question 36

Which class of pharmaceuticals are now viewed as the most appropriate agents to treat anxiety disorders?

A) Adderall
B) Benzodiazepines
C) Selective serotonin reuptake inhibitors
D) Monoamine oxidase inhibitors

Question 37

Which of the following statements about persons who suffer from obsessive-compulsive disorder (OCD) is most true?

A) They apparently have no preference for a specific compound.
B) They tend to prefer CNS depressants such as the benzodiazepines.
C) They tend to prefer CNS stimulants such as methylphenidate or ephedrine.
D) They tend not to abuse chemicals at all because they fear the loss of control that substance abuse might bring, and persons with OCD are heavily invested in control.

Question 38

Clear relationships have been found between specific forms of mental illness and a correlating drug of choice.