Deck 16: Schizophrenia and the Affective Disorders

Question 1

The risk of a child developing schizophrenia is increased by

A) maternal age.
B) his or her sex.
C) paternal age.
D) their ethnic background.
E) educational level.

Answer 1

C

Question 2

A person who believes that others are plotting against them is most likely suffering from a delusion of

A) control.
B) persecution.
C) grandeur.
D) perception.
E) fallacy.

Answer 2

B

Question 3

The dopamine hypothesis of schizophrenia states that schizophrenia is caused by

A) low levels of one or more of the monoamines.
B) a breakdown product of the neurotransmitter serotonin.
C) overactivity of dopaminergic synapses.
D) damage to ascending dopamine fibers.
E) an imbalance between acetylcholine and dopamine within the frontal cortex.

Answer 3

C

Question 4

Delusions

A) are beliefs that are contrary to fact.
B) are linked to brain damage.
C) are perceptions that occur without the presence of stimuli.
D) indicate the presence of depression.
E) are common negative symptoms of schizophrenia.

Question 5

The phrase "split mind" as it refers to schizophrenia means

A) multiple personalities.
B) delusional thinking.
C) a separation of thoughts and feelings.
D) extreme sadness in the presence of mania.
E) an inability to make important decisions.

Question 6

Negative symptoms of schizophrenia

A) represent a lack of normal behaviors.
B) usually require long hospital terms to treat.
C) are associated with low levels of brain dopamine activity.
D) indicate that the patient cannot accurately perceive reality.
E) are specific to schizophrenia.

Question 7

In the opening vignette of the schizophrenia and affective disorders chapter, the psychiatric problem experienced by Larry was treated using

A) chlorpromazine.
B) electroconvulsive shock.
C) fluoxetine.
D) antianxiety medications.
E) psychotherapy.

Question 8

After a few years of treatment with chlorpromazine, Larry developed

A) overeating to obesity.
B) a serious motor problem involving his tongue.
C) a worsening of his schizophrenia.
D) a mild form of bipolar disorder.
E) an intense fear of being poisoned at lunch.

Question 9

The incidence of schizophrenia in the world population is approximately ________ percent.

A) 0.1
B) 1
C) 5
D) 12
E) 15

Question 10

The key event that resulted in the treatment of Larry's schizophrenia was

A) his uncontrollable use of amphetamine.
B) motor problems that grew worse over time.
C) his attack on his mother.
D) his refusal to take antianxiety medications.
E) his need for psychotherapy.

Question 11

The two major types of symptoms noted in schizophrenia include

A) thought disorder and impaired language ability.
B) hallucinations and social withdrawal.
C) delusions and hallucinations.
D) positive symptoms and negative symptoms.
E) delusions and profound sadness.

Question 12

The fact that the odds that a child born to two schizophrenic parents will become schizophrenic is less than 50 percent suggests that

A) schizophrenia is associated with infertility.
B) schizophrenic parents rarely marry.
C) schizophrenia is not produced by a single gene.
D) schizophrenia is produced by a single dominant gene.
E) schizophrenia is a metabolic disorder.

Question 13

Women seeking to reduce the risk of their offspring developing schizophrenia would do well to seek a mate who

A) is in his early twenties.
B) has abstained from drugs and alcohol.
C) is older than fifty.
D) smokes marijuana, but does not use alcohol.
E) has an identical twin who is schizophrenic.

Question 14

The negative symptoms of schizophrenia

A) are best illustrated by delusions.
B) represent additions to normal behaviors.
C) are likely to be caused by excessive brain dopamine activity.
D) represent the absence of normal behaviors.
E) are best illustrated by hallucinations.

Question 15

Chlorpromazine was initially developed to prevent surgical shock, but was later found to be an effective treatment for

A) phobias.
B) schizophrenia.
C) mania.
D) depression.
E) neuroses.

Question 16

A person who believes that he or she is President of the World is most likely suffering from a delusion of

A) control.
B) persecution.
C) grandeur.
D) perception.
E) sensation.

Question 17

The positive symptoms of schizophrenia may be caused by

A) an imbalance of norepinephrine in the brain.
B) a single recessive gene.
C) excessive activity in dopamine circuits in the brain.
D) poor parenting.
E) a degenerative disorder of the brain.

Question 18

Which of the following is true of schizophrenia?

A) Schizophrenia has been recognized as a disorder for hundreds of years.
B) Schizophrenia is a serious disorder only in adulthood.
C) The incidence of schizophrenia is about 10 percent of the world population.
D) The term means "split mind."
E) The term is synonymous with bipolar disorder.

Question 19

With regard to the genetic basis of schizophrenia

A) a person with a "schizophrenia gene" will always develop schizophrenia.
B) the concordance rate for schizophrenia is lower for monozygotic than dizygotic twins.
C) adoption studies indicate a biological basis for schizophrenia.
D) several genes may be involved in schizophrenia.
E) genes impart a susceptibility to develop schizophrenia.

Question 20

The ________ sensory system is most likely to be involved in a schizophrenic hallucination.

A) visual
B) tactile
C) kinesthetic
D) auditory
E) olfactory

Question 21

A drug company seeking to develop a new antischizophrenic drug would want to develop a drug that reverses both positive and negative symptoms but that avoids the blockage of ________ receptors within the ________ of the schizophrenic brain.

A) D1; nucleus accumbens
B) D2; medial prefrontal cortex
C) D3; hippocampus
D) D2; striatum
E) D4; amygdala

Question 22

Imagine that you have been handed a list of drugs and that beside each drug name is a number that represents the potency of that drug for blocking dopamine receptors (where a low number means a greater potency at blocking). Which drug would you choose for the treatment of schizophrenia?

A) Potency value = 0.1
B) Potency value = 0.3
C) Potency value = 1.0
D) Potency value = 5.0
E) Potency value = 100.0

Question 23

Studies by Weinberger and others of brain abnormality in schizophrenic patients report

A) decreased number of gyri and sulci in control patients.
B) increased number of cells within the corpus callosum in schizophrenic patients.
C) larger lateral ventricles in schizophrenic patients.
D) flattening of the cortex in schizophrenic patients.
E) schizophrenic patients show more problems with eye tracking than do controls.

Question 24

Studies suggest that schizophrenia may be associated with an increased sensitivity of ________ receptors within the ________.

A) D8; ventral tegmental area
B) D2; cortex
C) D1; medial preoptic area
D) D2; substantia nigra
E) D4; frontal cortex

Question 25

John has been diagnosed with schizophrenia and has shown improvement in positive symptoms while taking chlorpromazine (CPZ). You would expect his positive schizophrenia symptoms to return if John

A) stops taking CPZ and takes part in a cocaine party.
B) takes double his CPZ dose per day.
C) takes reserpine in addition to CPZ.
D) mixes alcohol with CPZ.
E) ingests alpha-methyl-para-tyrosine in addition to CPZ.

Question 26

Relative to same-age control subjects, schizophrenics show a more rapid loss of gray matter in the

A) spinal cord.
B) medulla.
C) amygdala.
D) hypothalamus.
E) cerebral cortex.

Question 27

An example of a neurological symptom evident in schizophrenia would be

A) having poor problem solving and problems in learning and memory.
B) experiencing a feeling of euphoria at the start of an episode.
C) exhibiting excessive emotional expression.
D) thinking that you are the most powerful being on earth.
E) believing that doctors are part of a plot to poison you.

Question 28

John has been diagnosed with schizophrenia and has shown improvement in positive symptoms while taking chlorpromazine (CPZ). Which of the actions below, if taken by John, would be expected to speed up his recovery from schizophrenia?

A) John stops taking CPZ and takes part in a cocaine party.
B) John takes half of the normal CPZ dose per day.
C) John takes reserpine in addition to CPZ.
D) John mixes alcohol with CPZ.
E) John ingests amphetamine in addition to CPZ.

Question 29

The negative symptoms of schizophrenia may be related to

A) a "schizophrenia gene."
B) excessive birth weight.
C) damage to cells of the brain.
D) overactivity of dopaminergic neurons.
E) having an older father.

Question 30

Which of the issues below are serious problems for the use of antipsychotic drugs for schizophrenia?

A) These drugs reverse the negative but not the positive symptoms.
B) These drugs may reverse the positive but not the negative symptoms.
C) These drugs block D4 receptors in the striatum, which results in motor side effects.
D) Long-term administration of these can induce depression as a side effect.
E) The drugs exaggerate both positive and negative symptoms.

Question 31

PET studies indicate that schizophrenic patients treated with amphetamine show ________ from the striatum and a corresponding ________.

A) reduced release of dopamine; increase in positive symptoms
B) reduced release of GABA; decrease in positive symptoms
C) greater release of dopamine; decrease in negative symptoms
D) greater release of dopamine; increase in positive symptoms
E) reduced release of serotonin; increase in negative symptoms

Question 32

Which of the following supports the contention that schizophrenia is associated with brain damage?

A) Control subjects are more likely to show neurological symptoms.
B) The size of the lateral ventricles increases in schizophrenic patients.
C) The neurological symptoms noted in schizophrenia are unique to this disorder.
D) The size of the lateral ventricles decreases in schizophrenic patients.
E) Older people, who have already lost substantial numbers of neurons, are more likely to develop schizophrenia than are younger people.

Question 33

The dopamine schizophrenia hypothesis is supported by the finding that

A) antipsychotic drugs are dopamine agonists.
B) cocaine and amphetamine do not have antischizophrenic effects.
C) drugs that induce schizophrenic symptoms are dopamine antagonists.
D) dopamine antagonists relieve the positive symptoms of schizophrenia.
E) reserpine depletes monoamine vesicles and makes schizophrenia worse.

Question 34

Clozapine is referred to as an "atypical" antischizophrenic drug because it

A) can reverse schizophrenic symptoms without producing the motor disorder tardive dyskinesia.
B) has little blocking action within the striatum.
C) is more potent at blocking D2 receptors than D4 receptors.
D) effectively treats schizophrenia, but also produces motor side effects.
E) was an accidental discovery.

Question 35

The positive symptoms of schizophrenia are reversed by drugs that are

A) agonists at serotonin receptors.
B) dopamine receptor agonists.
C) antagonists at GABA receptors.
D) similar in structure to benzodiazepines.
E) dopamine receptor antagonists.

Question 36

The mesolimbic pathway projects from the ________ to the ________.

A) substantia nigra; caudate
B) globus pallidus; ventral tegmental area
C) midbrain; cingulate cortex
D) ventral tegmental area; nucleus accumbens and amygdala
E) ventral tegmental area; frontal cortex

Question 37

Administration of high doses of drugs such as ________ would be expected to produce the positive symptoms of schizophrenia.

A) GABA
B) glycine
C) caffeine
D) amphetamine
E) chlorpromazine

Question 38

Which of the following is true of clozapine (CL)?

A) CL blocks D2 receptors in the amygdala.
B) CL is a typical antipsychotic medication.
C) CL is less likely than chlorpromazine to produce tardive dyskinesia.
D) CL may be effective in treating patients who were refractory to older drugs.
E) CL can worsen delusions.

Question 39

The seasonality effect refers to the observation that

A) people born during the late winter are more likely to develop schizophrenia.
B) schizophrenic symptoms intensify during the summer.
C) the rate of admissions to hospitals for schizophrenia is highest in the winter.
D) the rate of admissions to hospitals for schizophrenia is lowest in the winter.
E) people are more likely to contract flu during the summer months.

Question 40

The capacity of an antischizophrenic drug to produce tardive dyskinesia may result from

A) subsensitivity of dopamine receptors.
B) reduced release of dopamine.
C) enhanced release of dopamine.
D) supersensitivity of dopamine receptors.
E) degeneration of dopamine neurons in the substantia nigra.

Question 41

The incidence of schizophrenia may vary as a function of season because

A) birthing during the winter represents a stressor that impairs dopamine function.
B) a fetus born during the late summer is more likely to have experienced a viral infection during the second trimester.
C) immune function is generally enhanced during the winter months.
D) a fetus born in late winter may be exposed to a viral infection during the second trimester.
E) people are more likely to be outdoors during the early fall leading to greater risk of viral infection.

Question 42

Weinberger argues that the negative symptoms of schizophrenia are related to

A) loss of neurons from the cerebellum.
B) elevated dopamine activity within the nucleus accumbens.
C) increased neural activity within the ventral tegmental area.
D) decreased activity of the dorsolateral prefrontal cortex.
E) increased activity of the dorsolateral prefrontal cortex.

Question 43

The risk of a person developing schizophrenia is higher for a person

A) born into an affluent family.
B) whose father was quite young.
C) born in a northern latitude during the late winter months.
D) born in a rural area.
E) born during the summer months.

Question 44

The atypical antipsychotic clozapine produces a(n) ________ activity within the ________.

A) increase in GABA; ventral tegmental area
B) decrease in GABA; ventral tegmental area
C) increase in dopamine; nucleus accumbens
D) decrease in dopamine; hippocampus
E) increase in dopamine; prefrontal cortex

Question 45

An increased risk of developing schizophrenia is associated with

A) the mother experiencing obstetric complications.
B) being born during the late summer months.
C) a child born to a mother who experienced alcohol withdrawal.
D) having an elderly father.
E) being born in the fall months.

Question 46

The majority of schizophrenia cases will develop between the ages of

A) 12-14.
B) 20-24.
C) 30-34.
D) 40-44.
E) 55-59.

Question 47

The symptoms of schizophrenia are more likely in a person whose

A) mother experienced obstetric complications.
B) father was under the age of 20.
C) birth occurred during the summer months.
D) mother had adequate nutrition during the pregnancy.
E) mother was obese.

Question 48

Which of the following is true of the seasonality effect?

A) Schizophrenia is more likely to occur for a person born in September and October.
B) The seasonality effect rarely occurs in rural settings.
C) The seasonality effect is mostly due to indoor smoking by the mother during the winter.
D) The seasonality effect is enhanced when fall temperatures are higher than normal.
E) Families living in crowded cities do not show the seasonality effect.

Question 49

A key prediction of the viral hypothesis of schizophrenia is that

A) children born a few months after a flu outbreak are more likely to develop schizophrenia.
B) mothers taking antibiotics should be unlikely to have schizophrenic offspring.
C) children born a few months before a flu outbreak are more likely to develop schizophrenia.
D) exposure of the fetus to a virus during the third trimester is most likely to induce schizophrenia.
E) antiviral drugs have increased the incidence of schizophrenia.

Question 50

Analysis of the childhood behavior of schizophrenics have found that these children show ________ than do their normal siblings or normal peers.

A) more overall activity
B) fewer abnormal movements
C) more negative affect in their facial expressions
D) less overall activity
E) more symmetrical facial features

Question 51

Complications of prenatal development and delivery are more likely to result in

A) depression.
B) anxiety disorder.
C) obsessive-compulsive disorder.
D) early-onset schizophrenia.
E) agoraphobia.

Question 52

Positive and negative schizophrenia symptoms are shown by humans after ingestion of

A) alcohol.
B) haloperidol.
C) phencyclidine.
D) chlordiazepoxide.
E) a low dose of cocaine.

Question 53

PCP acts as a(n) ________ at ________ receptors.

A) agonist; NMDA
B) antagonist; dopamine
C) agonist; acetylcholine
D) indirect antagonist; NMDA
E) antagonist; GABA

Question 54

The likelihood of developing schizophrenia increases to 31 percent for a person with ________ and ________.

A) birth complications; stress during adulthood
B) a mother who consumed a high-fat diet dieting pregnancy; a family history of schizophrenia
C) an identical twin who is normal; physical anomalies
D) a family history of schizophrenia; physical anomalies
E) minor physical anomalies; who was born during the summer months

Question 55

In MRI studies of brain anatomy in identical twins discordant for schizophrenia, the schizophrenic twin usually

A) had smaller lateral and third ventricles.
B) had larger lateral and third ventricles.
C) had a larger anterior hippocampus.
D) showed a smaller corpus callosum.
E) had a thinner cerebral cortex.

Question 56

Which of the following is true of brain development and schizophrenia?

A) Rapid neuron loss occurs in early childhood in schizophrenia with little subsequent loss during adulthood.
B) Schizophrenics show rapid neuron loss that occurs in early adulthood, but not continuous neuron loss.
C) Schizophrenia shows the same degenerative pattern as is noted in Alzheimer's disease.
D) Schizophrenia shows the same degenerative pattern as is noted in Parkinson's disease.
E) Schizophrenia involves the creation of new, but abnormal, neurons.

Question 57

The viral hypothesis of schizophrenia is supported by the observation that

A) children born a few months before a flu outbreak are more likely to develop schizophrenia.
B) mothers taking antibiotics are unlikely to have schizophrenic offspring.
C) analysis of stored serum from mothers whose children later developed schizophrenia showed evidence of maternal infection.
D) exposure of the fetus to a virus during the third trimester is most likely to induce schizophrenia.
E) obstetrical complications can predispose for schizophrenia.

Question 58

Identical twins who are mirror images in terms of their ________ are more likely to be ________.

A) fingerprints; monochorionic
B) ventricular size; dichorionic
C) hair color; dichorionic
D) handedness; dichorionic
E) facial features; trichorionic

Question 59

Brain damage is thought to produce the ________ symptoms of schizophrenia.

A) positive
B) concordant
C) cognitive
D) negative
E) mood

Question 60

Which of the following supports the notion that impairment of the prefrontal cortex is related to the negative symptoms of schizophrenia?

A) MRI studies indicate abnormalities within the temporal cortex of schizophrenics.
B) Schizophrenic patients show greater activity of the frontal cortex than do controls.
C) Schizophrenic patients do poorly on neuropsychological tests that are sensitive to damage of the prefrontal cortex.
D) MRI studies indicate abnormalities within the parietal cortex of schizophrenics.
E) Schizophrenic patients show a greater number of neurons within the gray matter of the frontal cortex.

Question 61

Drugs that inhibit the activity of monoamine oxidase (MAO)

A) can result in excess levels of glycine in terminal buttons.
B) can result in excess levels of serotonin within terminal buttons.
C) are an effective treatment for depression.
D) can have minor side effects.
E) can induce schizophrenia.

Question 62

The best evidence that there is a difference between bipolar affective disorder and unipolar depression is that

A) the age of onset differs between the two disorders.
B) there is a sex difference in the incidence of these disorders.
C) lithium is effective in treating only bipolar disorder.
D) chlorpromazine is only effective in treating unipolar depression.
E) serotonin reuptake inhibitors are effective for bipolar disorder but not unipolar depression.

Question 63

Episodes of mania are characterized by

A) suicidal thoughts.
B) extreme sadness.
C) crying spells.
D) strong feelings of guilt.
E) intense euphoria.

Question 64

Hypoactivity of the frontal cortex contributes to the positive symptoms of schizophrenia by

A) inducing apoptosis within cortex.
B) inhibiting GABA released onto cells of the tegmentum.
C) increasing the release of dopamine within the nucleus accumbens.
D) decreasing the release of dopamine within the nucleus accumbens.
E) decreasing the release of Ach in the hippocampus.

Question 65

Ketamine is used as an anesthetic in children but not adults because

A) it does not produce serious blood pressure changes in children.
B) adults show episodes of depression when recovering from ketamine anesthesia.
C) ketamine is rapidly excreted in adults but not children.
D) adults but not children experience an episode of psychosis when recovering from ketamine anesthesia.
E) adults do not respond to the anesthetic properties of ketamine.

Question 66

A drug such as aripiprazole counters the positive, negative, and cognitive symptoms of schizophrenia because this drug

A) is a pseudo-agonist at dopamine receptors in the VTA.
B) is an antagonist at dopamine receptors in the prefrontal cortex and nucleus accumbens.
C) causes the release of dopamine in brain.
D) is a partial agonist at dopamine receptors in the prefrontal cortex and nucleus accumbens.
E) blocks the release of dopamine in brain.

Question 67

A person with severe depression is at greater risk for

A) serious cardiac disease.
B) death by suicide.
C) poor grooming habits.
D) loss of norepinephrine cells within the prefrontal cortex.
E) developing major delusions and unhealthy compulsions.

Question 68

Alternating episodes of elation and sadness are referred to as

A) bipolar disorder.
B) severe depression.
C) severe mania.
D) unipolar depression.
E) schizoaffective disorder.

Question 69

All but ________ are a symptom of depression.

A) slow movements
B) periods of intense crying
C) increased appetite for sex
D) decreased appetite for food
E) sleep disturbances

Question 70

A drug that binds with high affinity to a receptor, but has less efficacy than the endogenous transmitter, would be termed a(n)

A) pseudo-agonist
B) antagonist.
C) partial agonist.
D) autoreceptor agonist.
E) autoreceptor antagonist.

Question 71

A drug that decreases the activity of dopamine within the dorsolateral prefrontal cortex would be expected to

A) induce both positive and negative symptoms of schizophrenia.
B) induce only the positive symptoms of schizophrenia.
C) be an effective treatment for schizophrenia.
D) decrease the levels of dopamine within the nucleus accumbens.
E) be an effective treatment for thought and language disorder.

Question 72

The capacity of tricyclic antidepressant drugs to ________ is why these drugs function as monoamine agonists.

A) block the reuptake of norepinephrine and serotonin into the terminals
B) block the reuptake of dopamine into the terminals
C) speed up the reuptake of norepinephrine and serotonin into the terminals
D) block NMDA receptors
E) stimulate the release of glycine within the limbic system

Question 73

Lithium is an effective treatment for ________ but not ________.

A) depression; mania
B) bipolar disorder; unipolar depression
C) anxiety disorder; delusions
D) unipolar depression; hallucinations
E) delusions; hallucinations

Question 74

The major affective disorders are also known as

A) anxiety disorders.
B) mood disorders.
C) addictive disorders.
D) schizoaffective disorders.
E) manic-depressive disorders.

Question 75

Mania involves feelings of

A) pride.
B) anxiety.
C) extreme elation.
D) extreme sadness.
E) distance and loneliness.

Question 76

The ability of ketamine to induce symptoms of psychosis requires

A) the presence of glycine in the synapse.
B) an immature brain.
C) the presence of magnesium ions at the synapse.
D) repeated administration.
E) a mature brain.

Question 77

________ is (are) an effective treatment for bipolar depression.

A) Lithium
B) Drugs that inhibit MAO
C) Drugs that block the reuptake of serotonin or norepinephrine
D) Sleep deprivation
E) Electroconvulsive shock therapy

Question 78

An example of a positive benefit associated with a manic episode would be

A) intense effort at completing a project.
B) intense euphoria.
C) severe disorganization.
D) increased energy to take on many projects at once.
E) delusions of grandeur.

Question 79

Susceptibility to develop affective disorder is most strongly associated with

A) the gene for the dopamine transporter.
B) multiple genes on multiple chromosomes.
C) a gene located on chromosome 11.
D) specific chromosomes linked to sleep and circadian rhythms.
E) a gene located on the Y chromosome.

Question 80

An important function of monoamine oxidase is to

A) provide the precursor for the catecholamines.
B) convert dopamine into norepinephrine.
C) convert norepinephrine into epinephrine.
D) convert catecholamines and serotonin into inactive forms.
E) speed up the digestion of cheese within the gut.