Deck 25: The Client With Co-Occurring Disorders: Substance Use Disorders and Mental Illness

Question 1

For years it has wrongly been assumed that clients with co-occurring disorders

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 1

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

Question 2

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.

Answer 2

The alcohol-dependent patient with bipolar disorder is more likely to use alcohol during the manic phase of the disorder.

Question 3

What is described as being essential if a clinician is to accurately distinguish between substance-induced versus actual psychiatric problems?

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

Answer 3

Thorough clinical history

Question 4

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% 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 5

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

A)If their ADHD symptoms are well controlled, they are at a lower risk for CNS stimulant misuse.
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 6

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)Posttraumatic stress disorder
D)Antisocial personality disorder

Question 7

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 8

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 9

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 10

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 his or her 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 that he or she will be able to return to society and resume his or her role as a productive citizen.

Question 11

The majority of individuals who would have been referred to a state hospital in the mid-1900s would, at the start of the 21st century, have been

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 12

Persons with a bipolar disorder tend to abuse drugs (except alcohol) 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 13

It is believed that of people with co-occurring disorders received treatment for both conditions in the past year.

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

Question 14

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 15

Adolescent girls with an eating disorder 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 16

Which of the following is NOT true of clients with co-occurring disorders?

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)Illicit substance use is associated with a later onset of the symptoms of schizophrenia.
D)They use drugs to offset the side-effects of their prescription medications.

Question 17

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, and then developed a mental health disorder.
D)a clearly defined psychiatric condition with proven treatment modalities.

Question 18

Which of the following statements is NOT true about clients with co-occurring disorders?

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 19

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 20

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, though it has been a model that many accepted in the past.
B)is the assumption on which most treatment for patients with co-occurring disorders 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 21

Describe the theoretical models attempting to explain clients with co-occurring disorders.

Question 22

Emergency room physicians commonly attribute symptoms in patients with co-occurring disorders to their SUDs with the exclusion of psychiatric disorders.

Question 23

It has been estimated that the suicide risk in those with co-occurring disorders is 200-300 times higher than the general population.

Question 24

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

Question 25

The "common factors" model of explaining clients with co-occurring disorders suggest that substance use disorders and mental health conditions result from the same risk factors.

Question 26

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

Question 27

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

Question 28

Describe the complicated relationship between schizophrenia and SUDs regarding clients with co-occurring disorders.

Question 29

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

Question 30

Discuss how the presence of a traumatic brain injury can complicate the diagnosis and treatment of a client with a substance abuse disorder as well as another mental health condition.