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Diagnosis & Psychopathology EPPP test questions

Terms in this set (133)

Correct Answer is: B
Marlatt and Gordon's relapse prevention (RP) model for the treatment of substance addiction is a cognitive-behavioral approach that focuses on identifying and reducing or eliminating factors that can precipitate relapse. Treatment begins with assessment of the environmental and emotional factors that increase the risk of relapse, such as time spent with friends who still use, the client's beliefs about the benefits of using, and any unrealistic expectations he has about treatment and abstinence. Based on this assessment, the counselor then works with the client to develop a set of applicable cognitive and behavioral interventions, including some that apply to the immediate situation (e.g., self-monitoring of behavior and cognition to reduce exposure to high risk situations) and some global lifestyle changes, such as encouraging the development of alternative, positive addictions, such as exercise or meditation. A central component of the RP model is to reduce what Marlatt and Gordon refer to as the abstinence violation effect (AVE). This occurs when a client "slips" or "lapses" by using the substance again, and attributes the slip to internal, stable and global causes (e.g., "I'm hopeless" or "I'll always be an addict"). The AVE causes reduced feelings of self-efficacy and esteem and thereby often increases cravings to use, leading to a full-blown relapse. The RP model seeks to reduce this effect by, for example, directing the client's attention to situational factors that could have triggered the slip and modifying unrealistic expectations about the course of addiction.
referral to an inpatient clinic immediately if a client uses the substance.
Contrary to this choice, immediate referral to an inpatient clinic following any use of the substance would reinforce the notion that a slip constitutes a full-blown relapse and that the client has failed in his efforts. Therefore, it would not likely be part of treatment based on the RP model.
Correct Answer is: A
A panic attack is a sudden, discrete period of intense apprehension, terror, or fear, often accompanied by an urge to escape or a sense of doom. It consists of four or more symptoms such as: shortness of breath, dizziness, heart palpitations or accelerated heart rate, sweating, trembling, depersonalization, sense of choking, nausea, chest pain, numbness, chill or hot flashes, a fear of dying or going crazy. The symptoms develop abruptly, usually peak within 10 minutes, and may mimic a heart attack or hyperthyroidism. Panic attacks may occur in several of the anxiety disorders. Types of panic attacks include: Unexpected (uncued) panic attacks, which are not associated with any trigger (i.e., they occur "out of the blue" ). The diagnoses panic disorder with agoraphobia and panic disorder without agoraphobia must include two or more unexpected panic attacks, and people with panic disorder also may experience the other types of panic attacks. Situationally bound (cued) panic attacks occur almost invariably on exposure to, or in anticipation of, a situational cue or trigger and are most characteristic of social and specific phobias. Situationally predisposed panic attacks are more likely to occur on exposure to a situational cue or trigger but are not invariably associated with the cue or trigger and do not necessarily occur immediately after the person has been exposed to the cue or trigger. For example, a person may have panic attacks associated with shopping mall environments; however, the person does not have an attack every time he or she goes to a shopping mall and/or does not necessarily have the attack immediately upon entering the mall (the attack may occur after he or she has been shopping for a while). These attacks are most common in panic disorder, but can also occur in social phobia or specific phobia.
Correct Answer is: D
Between infancy and 15 years of age, cancer is the leading cause of death by disease among U.S. children. Among the 11 major types of childhood cancers, leukemias (blood cell cancers), brain and other central nervous system (CNS) tumors account for over half of new cases. Treatment for childhood cancers can include chemotherapy, radiation, surgery and stem cell transplants. Radiation and chemotherapy affect cognitive ability in children due to damage to the tiny blood vessels that carry nutrition and oxygen to the brain, resulting in calcifications; interference with the growing and thickening of the myelin; and with the growth and development of connecting nerve structures over time. Factors that increase the risk of long-term cognitive effects include: diagnosis of cancer at a very young age, cancer treatment that results in reduced energy levels, cancer treatment that affects hearing or vision, cancer treatment that results in physical disabilities, cancer therapy that includes treatment to the central nervous system, numerous or prolonged school absences, a history of learning problems before being diagnosed with cancer.
Research also indicates young girls are more vulnerable to lingering cognitive problems than boys, and children with acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma are at a higher risk of developing later cognitive problems than those who have other forms of blood cancers. In fact, as many as 40% of all pediatric ALL patients treated with chemotherapy alone will develop serious learning disabilities within two to three years following treatment and for children who receive cranial radiation, with or without chemotherapy, the percentage is 80% to 90%. The most common cognitive problems found as a result of radiation and chemotherapy are with handwriting, spelling, reading or reading comprehension, understanding math concepts, attention deficits (tend to drift off and are easily distracted), short term memory and information retrieval, planning and organizational skills, social maturity and social skills.
Correct Answer is: B
Marlatt's model of substance dependence holds that addicts learn to associate substance use with relief of self-criticism and guilt through a variety of cues and reinforcers, such as advertisements depicting people feeling cheerful when drinking and social occasions in which a carefree attitude is reinforced. In other words, there are a variety of cues and mediators that serve to encourage and reinforce use. Contrary to the person's expectations, however, excessive substance use only exacerbates problems, such as interpersonal or work-related problems. This leads to more self-criticism and guilt, which the person again attempts to relieve by using. In other words, substance use is self-reinforcing -- it is the cause of and the expected solution to the same problems. And it is "over-learned" in that, due to the multiplicity of its antecedents, it becomes a strongly ingrained behavior.

a relapse of dependence is likely if the person makes non-dispositional attributions for use following a "slip" (use of a drug after a period of abstinence).
You might have gone for this option, since you probably knew that Marlatt is associated with a theory of relapse prevention that has to do with attributions regarding the reasons for "slips." However, according to Marlatt, a slip is likely to lead to a full-blown relapse when the person makes dispositional attributions for it, such as when the person blames him or herself. Relapse prevention involves teaching the person to make non-dispositional attributions, such as blaming the situation or the nature of the disease. So this question illustrates the importance of reading carefully and processing what you read, rather than relying on the recognition of "buzzwords."
Correct Answer is: C
Multisystemic Therapy (MST), targeting chronic, violent, or substance abusing juvenile offenders at high risk of out-of-home placement, is consistent with social-ecological models of behavior and findings from causal modeling studies of delinquency and drug use. The approach views individuals as being nested within a complex network of interconnected systems that encompass individual, family, and extrafamilial (peer, school, neighborhood) factors. MST is a goal-oriented, intensive family- and community-based treatment that addresses the multiple determinants and factors in each youth's social network that are contributing to his or her antisocial behavior. It is provided using a home-based model of services delivery with a typical treatment duration of approximately 4 months. Intervention strategies include strategic family therapy, structural family therapy, behavioral parent training, and cognitive behavior therapies. MST interventions typically aim to improve caregiver discipline practices, enhance family affective relations, decrease youth association with deviant peers, increase youth association with prosocial peers, improve youth school or vocational performance, engage youth in prosocial recreational outlets, and develop an indigenous support network of extended family, neighbors, and friends to help caregivers achieve and maintain such changes. MST has demonstrated long-term reductions in criminal activity, drug-related arrests, violent offenses, and incarceration.