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1. Adulthood is a time for achieving productive vocations and for sustaining close relationships at home and in the community. While these aspirations are readily attainable for adults who are mentally healthy, they are generally out of reach for adults who have mental disorders, which is extremely frustrating for these adults and for their loved ones.
A. True
B. False
2. Stressful life events in adulthood may reflect current or past events, and although some kinds of stressful life events are encountered almost universally, certain demographic groups have greater exposure and/or vulnerability to their cumulative impact. According to the authors, these groups include all of the following EXCEPT:
A. Elderly adults
B. African Americans
C. Unmarried adults
D. Individuals of lower socioeconomic status
3. Mental health and mental illness can be seen as the product of various personality traits, behavior patterns, and other characteristics which have roots in the individual’s prior life experiences or biology. Which of the following is an accurate statement about healthy and maladaptive characteristics in adulthood?
A. Self-esteem is defined as one’s own abilities to cope with adversity, either independently or by obtaining appropriate assistance from others, and is an important part of emotional wellness
B. Neurasthenia is a construct that refers to a broad pattern of psychological, emotional, and psychophysiologic reactivity that may contribute to mental illness
C. The trait of avoidance appears to be partly inherited and is associated with shyness, anxiety, and depressive disorders in adult life, as well as the subsequent development of substance abuse disorders
D. There is some developmental continuity between high levels of impulsivity in childhood and several adult mental disorders, including depression and panic disorder
4. Domestic violence is considered one of the foremost causes of serious injury to women ages 15 to 44, and victims of domestic violence are at increased risk for mental health problems and disorders including depression, anxiety disorders, suicide, eating disorders, and substance abuse.
A. True
B. False
5. Anxiety disorders are the most common, or frequently occurring, mental disorders, and they encompass a group of conditions that share extreme or pathological anxiety as the principal disturbance of mood or emotional tone. Which of the following most accurately describes these disorders?
A. Panic disorder is diagnosed when a person has experienced at least four unexpected panic attacks and develops persistent concern or worry about having further attacks or changes his or her behavior to avoid or minimize such attacks
B. Agoraphobia is described as severe and pervasive anxiety about being in situations from which escape might be difficult, or avoidance of situations such as being alone outside of the home, traveling in a car, bus, or airplane, or being in a crowded area, and is usually developed before the onset of panic disorder
C. Generalized anxiety disorder is defined by a protracted period of anxiety and worry, accompanied by multiple associated symptoms such as muscle tension, easy fatigability, poor concentration, insomnia, and irritability, and it is about three times more common in women than in men
D. Obsessive-compulsive disorder is characterized by the occurrence of obsessions that are recurrent, intrusive thoughts, impulses, or images that are perceived as inappropriate, grotesque, or forbidden, or by compulsions such as repetitive behaviors or mentalacts that reduce anxiety
6. Post-traumatic stress disorder refers to the anxiety and behavioral disturbances that develop and persist after exposure to an extreme trauma, including dissociation, generalized anxiety and hyperarousal, avoidance of situations that elicit memories of the trauma, and persistent, intrusive recollections of the event via flashbacks, dreams, or recurrent thoughts or visual images. About ___ percent of those with post-traumatic stress experience symptoms that can continue for years and can dominate the sufferer’s life.
A. 30
B. 40
C. 50
D. 60
7. Anxiety differs from fear in that the fear-producing stimulus is either not present or not immediately threatening, but in anticipation of danger, the same arousal, vigilance, physiologic preparedness, and negative affects and cognitions occur.
A. True
B. False
8. Benzodiazepines are a large class of relatively safe and widely prescribed medications that have rapid and profound antianxiety and sedative-hypnotic effects. Which of the following is NOT one of the four benzodiazepines currently widely prescribed for treatment of anxiety disorders?
A. Diazepam
B. Citalopram
C. Alprazolam
D. Clonazepam
9. In a one year period, about seven percent of Americans suffer from mood disorders, a cluster of mental disorders best recognized by depression or mania. Each of the following as an accurate statement about mood disorders EXCEPT:
A. Bipolar disorder is the most predominant mood disorder, affecting three times more women than men
B. In the workplace, depression is a leading cause of absenteeism and diminished productivity, and depressed people are significantly more likely than others to visit a physician for some other reason
C. Suicide is the most dreaded complication of major depressive disorders, and about 10 to 15 percent of patients formerly hospitalized with depression commit suicide
D. Mood disorders often coexist with other mental and somatic disorders, and about one-half of those with a primary diagnosis of major depression also have an anxiety disorder
10. Dysthymia is a chronic form of depression, and its early onset and unrelenting “smoldering” course are among the features that distinguish it from major depressive disorder. It affects about three percent of the adult population in one year, and has a duration of at least eighteen months for adults and one year for children.
A. True
B. False
11. According to the DSM-IV, in order to meet the criteria for major depressive disorder, the person must have five or more symptoms that have been present during the same 2-week period and represent a change from previous functioning, and at least one of the symptoms is a depressed mood or loss of interest or pleasure. Each of the following is one of the diagnostic symptoms of major depression EXCEPT:
A. Fatigue or loss of energy nearly every day
B. Distractibility or attention too easily drawn to unimportant or irrelevant external stimuli
C. Insomnia or hypersomnia nearly every day
D. Recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
12. Bipolar disorder is distinct from major depressive disorder by virtue of a history of manic or hypomanic episodes. Other differences concern the nature of depression in bipolar disorder which includes:
A. Depressive episodes that are typically associated with a later age at onset
B. A decreased likelihood of reversed vegetative symptoms
C. Fewer depressive episodes or recurrences
D. A higher familial prevalence
13. Cyclothymia is marked by manic and depressive states, yet neither are of sufficient intensity nor duration to merit a diagnosis of bipolar disorder or major depressive disorder. In addition, the diagnosis of cyclothymia is appropriate if there is a history of hypomania, but no prior episodes of mania or major depression.
A. True
B. False
14. It is widely recognized that biological, genetic, and psychosocial factors correlate with or predispose one to depression. Which of the following is an accurate statement about biological factors in depression?
A. A biological abnormality reliably associated with depression is likely the causal factor
B. The current prevailing hypothesis is that depression is caused by an absolute or relative deficiency of monoamine transmitters in the brain
C. A new model of depression proposes that depression results from reductions in neurotrophic factors that are necessary for the survival and function of particular neurons
D. All of the above
15. Anxiety and depression frequently coexist, so much so that experts report that patients with combinations of anxiety and depression are the rule rather than the exception.
A. True
B. False
16. The death of a loved one is viewed as one of the most powerful life stressors and the grief that ensues is a universal experience, Grief, in fact, has such emotional impact that the diagnosis of depressive disorder should not be made unless there are definite complications such as incapacity, suicidal thoughts, or:
A. Psychosis
B. Overwhelming feelings of hopelessness
C. Excessive or inappropriate guilt
D. All of the above
17. Major depressive disorder and dysthymia are more prevalent among women than men, and this difference appears in different cultures throughout the world. Which of the following is NOT a true statement about women and depression?
A. A combination of life stress and inadequate social support seems to contribute to women’s greater susceptibility to depressive symptoms
B. Because women tend to use more ruminative ways of coping and, on average, have less economic power, they may be more likely to perceive their problems as less solvable
C. A woman’s greater vulnerability to depression may be amplified by endocrine and reproductive cycling, as well as by a greater susceptibility to hypothyroidism and the onset of menopause
D. Women are more likely than men to have experienced past sexual abuse, and sexual abuse is strongly associated with the subsequent development of major depressive disorder
18. Numerous investigators have documented that susceptibility to a depressive disorder is _________________ greater among the first-degree relatives of patients with mood disorder than among other people, and the risk among first-degree relatives of people with bipolar disorder is about ___________ times greater.
A. onefold to threefold; two to four
B. twofold to fourfold; six to eight
C. threefold to fivefold; four to six
D. fourfold to sixfold; three to five
19. The treatment of mood disorders is complex because it involves several stages: acute, continuation, and maintenance stages. The acute phase for medication typically requires 10 to 12 weeks during which patients are seen weekly or biweekly for monitoring of symptoms, side effects, dosage adjustments, and support.
A. True
B. False
20. Firstline treatment for most people with depression today consists of antidepressant medication, psychotherapy, or the combination. However, in situations where these options are not effective or too slow, electroconvulsive therapy may be considered.
A. True
B. False
21. Based on reviews of extensive research conducted over several decades, which of the following is an accurate statement about electroconvulsive therapy (ECT)?
A. Accumulated clinical experience had demonstrated that ECT is effective in the treatment of dysthymia and anxiety
B. A typical course of ECT entails 10 to 15 treatments, administered at a rate of two times per week, on either an inpatient or outpatient basis
C. It is now recognized that a single course of ECT should be regarded as a short-term treatment for an acute episode of illness
D. The most common adverse effects of this treatment are confusion and memory loss for events surrounding the period of ECT treatment, and the confusion and disorientation seen upon awakening after ECT typically clear within 24 hours
22. Successful acute phase antidepressant pharmacotherapy should almost always be followed by at least 6 months of continued treatment, and research indicates that continuation pharmacotherapy reduces the risk of relapse from 40-60 percent to:
A. 25-35 percent
B. 20-30 percent
C. 15-25 percent
D. 10-20 percent
23. Maintenance pharmacotherapy is intended to prevent future episodes of mood disorders, and a ________ is viewed as a new episode of illness, rather than a reactivation of the index episode.
A. Recurrence
B. Relapse
C. Reversion
D. Intermittence
24. While antidepressant medications are effective across the full range of severity of major depressive episodes, in major depressive disorder and bipolar disorder, the degree of effectiveness varies according to the intensity of the depressive episode. With mild depressive episodes, the overall response rate is believed to be about 60 percent, and with severe depressive episodes, the overall response rate to any one drug is about 15-30 percent.
A. True
B. False
25. There are four major classes of antidepressant medications, and according to the Depression Guideline Panel, the selection of a particular antidepressant for a particular patient depends upon each of the following EXCEPT:
A. The patient’s past treatment history
B. The likelihood of side effects
C. The expense of the medication
D. The patient’s age and sex
26. Tricyclic antidepressants (TCAs) are named for their chemical structure and are effective for treatment of severe depression. However, side effects and potential lethality in overdose are the major drawbacks of these medications, and an overdose of as little as a 7-day supply of a TCA can result in potentially fatal cardiac arrhythmias.
A. True
B. False
27. Many people prefer psychotherapy or counseling over medication for treatment of depression. Which of the following is NOT an accurate statement about psychotherapy and mood disorders?
A. Research conducted in the past two decades has helped to establish at least several newer forms of psychotherapy as being as effective as antidepressant pharmacotherapy in mild-to-to moderate depressions
B. These methods use a time-limited approach, a here and now focus, and emphasize patient education and active collaboration
C. Cognitive-behavioral therapy to treat depression centers around four common problem areas: role disputes, role transitions, unresolved grief, and social deficits
D. Interpersonal psychotherapy and cognitive-behavioral therapy both appear to have some relapse prevention effects
28. Maintenance pharmacotherapy is the best-studied means to reduce the risk of recurrent depression, and the magnitude of effectiveness in prevention of recurrent depressive episodes depends on the dose of the active agent used, the length of time being considered, the patient’s adherence to the treatment regimen, and:
A. The inherent risk of the population
B. The severity of the depression
C. Whether or not psychotherapy was included as part of the treatment
D. All of the above
29. While success rates of 80 to 90 percent were once expected with lithium for the acute phase treatment of mania, lithium response rates of only 40 to 50 percent are now commonplace. Additionally, the efficacy of lithium for prevention of mania also appears to be significantly lower now than in previous decades.
A. True
B. False
30. Primary care practice has been studied extensively, revealing low rates of both recognition and appropriate treatment of depression, with approximately one-fourth to one-third of patients with major depression going unrecognized in primary care settings.
A. True
B. False
31. Although people with schizophrenia tend to be perpetually incoherent or psychotic, schizophrenia is neither “split personality” nor “multiple personality”.
A. True
B. False
32. Each of the following is an accurate statement about the characteristics of schizophrenia EXCEPT:
A. Schizophrenia is characterized by profound disruption in cognition and emotion, affecting the most fundamental human attributes such as language, thought, perception, affect, and sense of self
B. The array of symptoms, while wide ranging, frequently includes psychotic manifestations, such as hearing internal voices or experiencing other sensations not connected to an obvious source
C. For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset
D. While the diagnosis sometimes encompasses a pattern of signs and symptoms, a single obvious symptom is often definitive for diagnosis
33. Symptoms of schizophrenia are typically considered to be either positive or negative. Delusions, hallucinations, catatonic behaviors and ________________ are all considered positive symptoms.
A. Affective flattening
B. Grossly disorganized behavior
C. Alogia
D. Avolition
34. Many people with schizophrenia experience cognitive dysfunction and functional impairment. Which of the following most accurately describes problems in these areas?
A. Cognitive problems include information processing, planning and regulating goal-directed behavior, cognitive flexibility, attention, memory, and visual processing, and are usually associated with positive symptoms
B. Cognitive problems vary from person to person, but usually stay consistent over time
C. Significant dysfunction in major life areas such as interpersonal relations, work or education, family life, communication, or self-care represent the most distressing aspects of the illness for many people and contribute to the increased risk of suicide among people diagnosed with schizophrenia
D. Functional problems are most commonly linked to positive and disorganized symptoms of schizophrenia and lead to unemployment, disrupted education, limited social relationships, isolation, legal involvement, family stress, and substance abuse
35. Although symptoms of schizophrenia like hallucinations, delusions, and bizarre behavior seem easily defined and clearly pathological, increased attention to cultural variation has made it very clear that what is considered delusional in one culture may be accepted as normal in another. For example, among members of some cultural groups, “visions” or “voices” of religious figures are part of normal religious experience and being “visited” by a recently deceased person is not unusual among family members.
A. True
B. False
36. Studies of schizophrenia’s prevalence in the general population vary depending on the way diagnostic criteria are applied and the population, setting, and method of study, but in general, 1-year prevalence in adults ages 18 to 54 is estimated to be ________.
A. 1.3 percent
B. 2.3 percent
C. 3.3 percent
D. 4.3 percent
37. Research indicates that the course of schizophrenia over time varies considerably from person to person and it is difficult to study because of the changing nature of diagnosis, treatment, and social norms. Each of the following is an accurate statement about its course and recovery EXCEPT:
A. Most individuals experience periods of symptom exacerbation and remission, while others maintain a steady level of symptoms and disability which can range from moderate to severe
B. Most people experience at least one relapse after their first actively psychotic episode, and often these are periods of more intense positive symptoms, yet the person continues to struggle with negative symptoms in between episodes
C. The course of schizophrenia is influenced by personal orientation and motivation, and by support in the form of skill-building assistance, rehabilitation and family factors
D. Gradual onset and delays in obtaining treatment seem to raise the risk of longer episodes of acute illness over time, and later years with the illness are often more difficult than earlier ones
38. There appears to be gender differences in the course and prognosis of schizophrenia, and women are more likely than men to experience more pronounced mood symptoms, better prognosis, and:
A. A more gradual development of symptoms
B. Later onset
C. More neuropsychological problems
D. Earlier initial diagnosis
39. The cause of schizophrenia has not yet been determined, although research points to the interaction of genetic endowment and major environmental upheaval during development of the brain. Which of the following is a true statement about the etiology of schizophrenia?
A. Immediate biological relatives of people with schizophrenia have about 5 times greater risk than that of the general population
B. Neurodevelopmental disruption may be the result of genetic and/or environmental stressors early in development, leading to subtle alterations in the brain, while environmental factors later in development will likely ameliorate expression of genetic or neurodevelopmental defects
C. Family studies suggest that people have varying levels of inherited genetic vulnerability, from very low to very high, and the development of the disease depends on this and the amount and types of stresses the person experiences over time
D. In about 30 percent of identical twins in which one is diagnosed with schizophrenia, the other never meets the diagnostic criteria, which clearly indicates that environmental as well as genetic factors likely play a role
40. Excessive levels of the neurotransmitter acetylcholine have long been implicated in schizophrenia, although it is unclear whether the excess is a primary cause of schizophrenia or a result of a more fundamental dysfunction.
A. True
B. False
41. There is consistent evidence that prenatal stressors are associated with increased risk of the child developing schizophrenia in adulthood, although prenatal and obstetric complications associated with schizophrenia could reflect already disrupted fetal development, rather than being causal themselves.
A. True
B. False
42. Conventional antipsychotics have been shown to be highly effective both in treating acute symptom episodes of schizophrenia and in long-term maintenance and prevention of relapse. Across many studies, positive symptoms improved in about ___ percent of patients, compared with only ___ percent improvement in placebo groups.
A. 75; 30
B. 70; 25
C. 65; 20
D. 60; 15
43. Conventional or older antipsychotic medications as well as and the more recently developed medications are used to treat schizophrenia. Each of the following is an accurate statement about the use of medications in treatment EXCEPT:
A. Medication studies have found that intermittent dosage levels are more effective for positive symptom reduction over the long run than very high, moderate, or very low doses
B. On conventional neuroleptics, patients experience symptom reduction over the first 5 to 10 weeks of treatment, with more gradual improvement sometimes continuing for more than double that time
C. Apart from their minimal effects on negative symptoms, the greatest problem with conventional neuroleptic medications is their pervasive, uncomfortable, and sometimes disabling and dangerous side effects
D. Efficacy data on the newer antipsychotics indicate that they are as efficacious as the older agents at reducing positive symptoms and carry fewer side effects
44. Growing awareness that ethnicity and culture influence patients’ response to medications has catapulted to prominence the field of ethnopharmacology, and in the past decade, studies have demonstrated that psychiatric medications interact with patient ethnicity in multiple ways, with response to the same medication and dose varying by patient ethnicity. Which of the following most accurately demonstrates this notion?
A. Due to racial and ethnic variation in pharmacokinetics, Asians and Hispanics with schizophrenia may require higher doses of antipsychotics than Caucasians to achieve the same blood levels
B. Racial and ethnic variation likely stem from genetic factors rather than psychosocial factors
C. Studies suggest that medication differences among African American people diagnosed with schizophrenia may reflect clinician biases in diagnosis and prescription practices more than differences in medication metabolism or health behaviors alone
D. All of the above are accurate statements about ethnic and cultural influences
45. Professionals believe that it is clear that individual and group therapies that focus on practical life problems associated with schizophrenia are superior to _______________________, which are considered to be potentially harmful.
A. Psychodynamically oriented therapies
B. Dialectical behavioral therapies
C. Interpersonal therapies
D. Person centered therapies
46. For those with schizophrenia, an important goal of recovery and the consumer movement is to enable patients themselves to participate more actively in their own treatment. While complete remission of all symptoms is unlikely for the majority, most can and do learn skills and techniques over time that they can use to manage distressing symptoms and the effects of the illness.
A. True
B. False
47. Controlled studies of vocational rehabilitation interventions with schizophrenics have shown that such programs seem to increase work-related activities while people are engaged in them and translate into more independent employment once services cease.
A. True
B. False
48. The purpose of case management for mentally ill adults is to coordinate service delivery and to:
A. Establish support from the social welfare system
B. Develop a series of basic treatment recommendations
C. Strive for greater reductions in major life problems for the clients
D. Ensure continuity and integration of services
49. Assertive community treatment is an intensive approach to the treatment of people with serious mental illnesses that relies on the provision of a comprehensive array of services in the community, and it includes which of the following?
A. An interdisciplinary team of usually 5 to 7 professionals, including a case manager, a psychiatrist, a nurse, a social worker, and a vocational specialist
B. Comprehensive treatment planning, ongoing responsibility, staff continuity, and small caseloads, most commonly with 1 staff member for every 5 clients
C. A treatment program that is most cost-effective when targeted to individuals with the greatest service need, particularly those with a history of multiple hospitalizations
D. All of the above
50. Psychosocial rehabilitation services for schizophrenics combine pharmacologic treatment, independent living and social skills training, psychological support to clients and their families, housing, vocational rehabilitation, and social support and network enhancement. Randomized clinical trials have shown that psychosocial rehabilitation recipients experience fewer and shorter hospitalizations than comparison groups in traditional outpatient treatment.
A. True
B. False
51. The role of psychiatric hospitalization has changed greatly over recent decades, stemming from the recognition of poor and occasionally abusive conditions, excessive patient dependency, and patients’ loss of connection to the community. Which of the following is NOT a true statement about psychiatric hospitalization and its alternatives?
A. The new priorities of psychiatric hospitalization focus on ameliorating the risk of danger to self or others, and the rapid return of patients to the community
B. Hispanic Americans and Asian Americans are overrepresented in psychiatric inpatient units in relation to their representation in the population, probably because of the mix of limited access to outpatient services and differences in cultural patterns of help-seeking behavior and overt discriminatory practices
C. Inpatient units are seen as short-term intensive settings to contain and resolve crises that cannot be resolved in the community, and emphasize safety measures, crisis intervention, acute medication and reevaluation of ongoing medications
D. Mobile crisis services and day hospital programs, where a multidisciplinary team comes directly to the aid of the client in the community to provide immediate evaluation and services, have developed in many urban areas to prevent hospitalization
52. Theories to explain comorbidity of severe mental illness and substance abuse range from genetic to psychosocial, although empirical support for any one theory is inconclusive. Research indicates that as many as ____ percent of people with serious mental illnesses develop alcohol or other drug abuse problems at some point in their lives.
A. 30
B. 40
C. 50
D. 60
53. Substance abuse worsens clinical course and outcomes for individuals with mental disorders, and it is associated with symptom exacerbation, treatment noncompliance, more frequent hospitalization, greater depression and likelihood of suicide, incarceration, and family friction. Each of the following is an accurate statement about mental illness and substance abuse EXCEPT:
A. Mentally ill patients may be jeopardized by the consequences of substance abuse, namely, increased risk of violence, HIV infection, and alcohol-related disorders
B. Research amassed over the past 10 years supports a shift to treatment that combines interventions directed simultaneously to both conditions by the same group of providers
C. Most successful models of combined treatment include case management, group interventions, and assertive outreach to bring people into treatment
D. Although there is little evidence for any particular approach to combining treatments for comorbidity, incorporating 12-step approaches into substance abuse treatment seem superior to traditional behavioral approaches
54. Organized self-help has a long history, with an estimated 2 to 3 percent of the general population involved in some self-help group at any one time, and over the past several decades, people with serious mental illnesses have formed mutual assistance organizations to aid each other and to combat stigma. In a survey of mental health self-help group leaders in New York State, respondents identified three positive outcomes that were directly related to their self-help group membership: greater self-esteem, more hopefulness about the future, and:
A. A greater sense of well-being
B. Fewer symptoms and fewer hospitalizations
C. A greater display of interpersonal skills
D. An increase in problem solving abilities
55. The mental health field has witnessed great changes in policy development, with consumers playing increasingly visible roles in advocacy. Consumers have become advocates in the communities where they live and work, in order to shape policy at the local level and to improve access to, or quality of, needed services and to counter employment and housing discrimination.
A. True
B. False
56. Housing ranks as a priority concern of individuals with serious mental illness. Research has reported that almost ____ percent of all very low-income disabled residents, including persons with serious mental illness have “worst case” needs for housing assistance, and it is estimated that up to ____ percent of individuals who experience homelessness have a mental illness.
A. 40; 24.2
B. 45; 27.9
C. 50; 33.3
D. 55; 38.6
57. People with severe mental illnesses tend to be poor, often become dependent on public assistance shortly after their initial hospitalization, and the unemployment rate among adults with serious and persistent mental disorders hovers at about 79 percent.
A. True
B. False
58. While newer vocational rehabilitation and employment initiatives strive to remedy persistently high levels of unemployment for the mentally ill, most consumers find themselves unable to work consistently or at all because of active symptoms, profound interruptions of education and employment caused by symptom onset and exacerbations, stigma and discrimination, and:
A. The lack of higher education programs for this population
B. Lack of flexibility at the work site
C. The high occurrence of substance abuse among them
D. All or the above
59. Integrating the range of services needed by individuals with severe and persistent mental disorders has been a vexing problem for decades, but research has concluded that system integration and traditional case management can be very effective, and are probably sufficient to produce optimal social and clinical outcomes.
A. True
B. False
60. Important clinical research has improved our understanding of mental disorders in the adult stage of the life cycle, and has also demonstrated that:
A. Anxiety, depression, and schizophrenia present special problems in this age group, and depression and schizophrenia in particular contribute to the high rates of suicide in this population
B. Chronic depression is the most persistently disabling condition, especially for young adults, in spite of recovery of function by some individuals in mid to late life
C. Substance abuse is a major co-occurring problem for adults with mental disorders, and evidence supports combined treatment, and thanks to this research, communities are now ensuring that combined treatment is readily available
D. Research has contributed to our ability to recognize, diagnose, and treat each of these conditions effectively in terms of symptom control and behavior management, and medication and other therapies can be independent, combined, or sequenced depending on the need
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