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1. The Diagnostic and Statistical Manual of Mental Disorders, 4th Ed, classifies mood or affective disorders as:
A. depressive
B. bipolar
C. both of these
D. neither of these
2. This article cites two epidemiological studies that provide striking documentation that mood disorders increase the risk of substance abuse disorders (SUD’S):
A. true
B. false
3. The ECA study showed a stunning 56% lifetime SUD among individuals with:
A. depression
B. bipolar disorder
C. OCD or anxiety disorders
D. none of these
4. One reason given for differences in reported comorbidity prevalence rates is that a person who is evaluated while in drug withdrawal may be misdiagnosed with a mood disorder:
A. true
B. false
5. Which theory below has not been proposed to explain the high co-occurrence of substance abuse and mood disorders:
A. individuals will select drugs to alleviate psychiatric symptoms and chronic substance abuse can unmask mood disorders
B. some individuals are vulnerable to a ‘kindling’ effect in which an underlying neurobiological tendency to sensitization may promote both substance dependence and mood disorder
C. research shows genetic risk factors for both substance abuse and mood disorders
D. all of the above are proposed theories
6. Which assessment tool below is not mentioned for help in diagnosing clients whose affective status is in question:
A. Symptom Check List (SCL - 90)
B. Savage Comorbidity Tool (SCT)
C. Addiction Severity Index (ASI)
D. Beck Depression Inventory (BDI)
7. Which of the following statements from the author’s discussion of Clinical Course and Treatment is not accurate:
A. a tragic association between substance abuse, mood disorders and suicide has long been recognized
B. maximum use of behavioral approaches is the first principle of treatment for patients with SUD and a concurrent mood disorder
C. active participation in AA or NA can greatly enhance recovery
D. studies in treating co-occurring depression and SUD’s with medications led to conclusions (Nunes and Levin) that SRI’s should be the first line meds for depression, not TCA’s
E. studies in treating co-occurring bipolar disorder and SUD’s with meds led to conclusions that benzodiazepines such as valium and xanax give the highest success rates
8. In studies where medication decreased depression, there was no favorable effect on co-occurring substance abuse observed:
A. true
B. false
9. Which of the following is not an accurately paraphrased statement from the "Response: The Path to Double Recovery" section at the end of this article:
A. Haning: The more comprehensive SCID screening test does not lead to a greater number of diagnoses compared with some of the faster, cheaper screeners.
B. Penn: Our patients abuse an average of three and a half drugs each; we see the same pattern (in recovery): a long struggle followed by self-reinforcing recovery 12-14 months out.
C. Haning: Some treatment programs mix all their patients together; others provide separate groups for patients with mood disorders. I think mixing is best.
D. All are accurately paraphrased statements from the "Response" section
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