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1. 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
2. What is described as being essential if a clinician is to get an accurate dual diagnosis assessment?
a. Thorough clinical history
b. Performingthe“CAGE”assessment
c. Detoxification medication
d. Significant levels of shame in the patient
3. 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.
4. Whichofthefollowingservesasapowerful“relapsetrigger”fordualdiagnosisclientstryingtoquitabusing
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
5. 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
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. Post traumatic stress disorder
d. Anti-social personality disorder
7. 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
8. Which of the following statements is NOT true about the treatment of bipolar disorder and SUDs?
a. Manicsymptomscanbeeasilymistakenas“progress”byrehabilitationstaff,leadingtoincreasedrateof
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.
9. 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.
10. Theterm“dualdiagnosis”referstoindividualswhohave
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.
11. 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
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. Themoreserioustheindividual’smentalillness,themore
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“underthetable.”
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.
19. 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.
20. 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.
21. 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.
22. 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
23. 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.
24. 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
25. 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
26. 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.
27. 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
28. 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.
29. 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
30. 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.
31. 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.
32. Describetheevolutionoftheideadualdiagnosesmayalsoincludepersonswithsubstanceabusedisorders.
33. Describethetheoreticalmodelsattemptingtoexplaindualdiagnosisconditions.
34. Describe the reasons why clinicians once believed a relationship existed between a patient's disorder and his or her
drugofchoice.
35. DescribethecomplicatedrelationshipbetweenschizophreniaandSUDsregardingdualdiagnosis.
36. DescribethestagesoftreatmentwhenworkingwithaclientwithadualdiagnosisthatincludesaSUD.
37. ER physicians commonly attribute symptoms in dual diagnosis patients to their SUDs with the exclusion of
psychiatric disorders.
a. True
b. False
38. Clear relationships have been found between specific forms of mental illness and a correlating drug of choice.
a. True
b. False
