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1. Cameron has a cup of coffee every morning, smokes 10 cigarettes a day, and has a beer with dinner. This is
an example of
a. substance use.
b. substance abuse.
c. polysubstance abuse.
d. substance intoxication.

2. Which of the following would NOT be an example of substance use?

a. Smoking a cigarette
b. Drinking a cup of coffee
c. Taking a sleeping pill
d. Getting drunk

3. The American Psychiatric Association defines substance abuse in terms of

a. how drunk or intoxicated a person gets after ingesting a psychoactive substance.
b. whether or not the substance interferes with the person's life.
c. the type and intensity of the substance abuser's biological reaction.
d. which drug is used and whether it is legal or illegal.

4. Substance intoxication includes all of the following EXCEPT

a. the specific drug that is used.
b. how much of a drug is used or ingested.
c. the drug user's individual biological reaction.
d. physiological dependence on the drug.

5. In terms of substance-related disorders, the word “addiction” is most closely associated with .
a. substance use
b. intoxication
c. drug dependence
d. polysubstance abuse

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6. How many symptoms must a patient display to meet the DSM-5 diagnosis of a Substance Use Disorder?
a. 1
b. 2
c. 4
d. 6 or more

7. How many symptoms must a patient display to meet the DSM-5 diagnosis of a moderate Substance Use Disorder?
a. 1
b. 2
c. 4
d. 6 or more

8. How many symptoms must a patient display to meet the DSM-5 diagnoses of a severe Substance Use Disorder?
a. 1
b. 2
c. 4
d. 6 or more

9. A person who is physiologically dependent on a drug will experience

a. tolerance to the effects of the drug.
b. withdrawal symptoms if the drug is withdrawn.
c. both tolerance and withdrawal.
d. neither tolerance nor withdrawal.

10. The repeated use of a drug, a desperate need to ingest more of the substance (stealing money to buy drugs, standing
outside in the cold to smoke), and the likelihood that use will resume after a period of abstinence are
behaviors.
a. drug-seeking
b. drug-avoidant
c. typical
d. psychological

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11. Carol has been addicted to narcotics for many years. Recently, she has been trying to quit and has not used any
drugs for the last week. We can expect that Carol will be experiencing _________________ .
a. fever and chills
b. nausea, vomiting, and diarrhea
c. aches and pains
d. all of these

12. A perspective of Substance Use Disorder that involves "drug-seeking behaviors" includes all of the following EXCEPT
a. repeated use of the drug.
b. a desperate need to ingest more of the drug.
c. resuming drug use after a period of abstinence.
d. physical symptoms when the drug is no longer used.

13. Tirkel steals money from his mother's handbag every time he needs to buy drugs. His Substance Use Disorder
is manifested by
a. withdrawal symptoms.
b. drug-seeking behavior.
c. continuing tolerance.
d. psychological addiction.

14. Angelina has had difficulty falling asleep for some time. She started taking a prescribed sleeping pill every night for her
insomnia. Now, she needs the pill to fall asleep. Without it, she will toss and turn all night, getting little sleep. Angelina
is
a. dependent and drug abusive.
b. dependent and not drug abusive.
c. dependent but not physiologically addicted.
d. dependent and tolerant.

15. Alcoholism and substance abuse, previously considered a___________________, is now conceptualized by many
as a disease.
a. sociopathic personality disturbance
b. schizophrenic-like behavioral pattern
c. type of dependent personality disorder
d. hysterical conversion syndrome

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16. Alcohol and the drugs Seconal, Halcion, and Valium are all classified as____________________ .
a. stimulants
b. opiates
c. depressants
d. narcotics

17. All of the following analgesic substances are classified as opiates EXCEPT .
a. cocaine
b. codeine
c. heroin
d. morphine

18. All of the following are hallucinogens EXCEPT .

a. cannabis
b. codeine
c. LSD
d. all of the answers are correct

19. Both morphine and codeine produce analgesia, which means that they
a. activate the central nervous system.
b. relieve pain and produce euphoria.
c. increase alertness.
d. cause delusions and dissociative experiences.

20. Which of the following is an example of alcohol's effects on brain functioning?

a. Faster reaction time
b. Improved judgment
c. Impaired motor coordination
d. Clear speech

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21. Which of the following neurotransmitters affects the emotion of anxiety during alcohol use?
a. GABA
b. Serotonin
c. Glutamate
d. Dopamine

22. Alcohol can initially appear to cause stimulation because it

a. makes vision and hearing more acute.
b. has an excitatory effect on the brain.
c. depresses inhibitory centers in the brain.
d. alters motor coordination.

23. Although most psychoactive substances interact with specific substances in brain cells, the effects of are
much more complex because several different neurotransmitter systems are affected.
a. opiates
b. tranquilizers
c. alcohol
d. marijuana

24. The condition called delirium tremens, also known as the "DTs," involves hallucinations and body tremors
during withdrawal from .
a. heroin
b. cocaine
c. alcohol
d. marijuana

25. Blackouts appear to be related to the interaction of alcohol with the system.
a. glutamate
b. serotonin
c. GABA
d. dopamine

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26. Because of its impact on GABA receptors, alcohol neuronal communication.

a. inhibits
b. facilitates
c. randomizes
d. eliminates

27. What explains the apparent stimulation, feeling of well-being, and outgoing behavior that occur as the initial effects
of alcohol ingestion?
a. Depression of the inhibitory centers in the brain
b. Activation of the inhibitory centers in the brain
c. Depression of the autonomic nervous system
d. Stimulation of the autonomic nervous system

28. Which of the following does NOT describe the specific effect of alcohol on a particular neurotransmitter system?
a. Serotonin - alcoholic cravings
b. Glutamate - alcoholic blackouts
c. Dopamine - slurred speech
d. GABA - anti-anxiety effect

29. All of the following are symptoms of withdrawal from alcohol EXCEPT______________.
a. nausea and/or vomiting
b. hypersomnia
c. transient hallucinations
d. agitation

30. In some individuals, chronic alcohol use causes physical damage to the body. Whether this occurs depends on all of
the following factors EXCEPT
a. blood alcohol levels during drinking periods.
b. type of alcohol consumed (e.g., beer, wine, liquor).
c. genetic vulnerability.
d. the frequency of alcohol use.

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31. Annabelle has been a heavy drinker for years. Her behavior reflects confusion, loss of muscle coordination
and unintelligible speech. Such behavior is probably the result of .
a. dementia
b. substance abuse psychotic disorder
c. fetal alcohol syndrome
d. Wernicke-Korsakoff syndrome

32. The correct pairing of the names, causes, and symptoms of two types of organic brain syndromes that may result
from chronic, long-term alcohol abuse are
a. dementia - loss of intellectual abilities caused by a deficiency of the vitamin called thiamine.
b. Broca’s disease - confusion, loss of muscle coordination, and unintelligible speech caused by a deficiency
of the vitamin called thiamine.
c. dementia - confusion, loss of muscle coordination, and unintelligible speech caused by the toxic effects of
alcohol on the brain.
d. Fetal alcohol syndrome - loss of intellectual abilities caused by the toxic effects of alcohol on the adult brain.

33. Fetal alcohol syndrome (FAS) is a combination of problems that can occur in a child whose mother drank alcohol
while pregnant. Symptoms of FAS include all of the following EXCEPT
a. cognitive deficits and behavior problems.
b. distorted facial features.
c. learning difficulties.
d. excessive fetal growth.

34. Differences in fetal alcohol syndrome (FAS) rates among women who drink may be due to differences.
a. cultural/racial
b. cognitive
c. metabolic
d. emotional

35. Research that asks individuals to indicate their frequency of alcohol use found that alcohol use is
highest among__________.
a. Hispanics
b. Asian Americans
c. Caucasian Americans
d. people with multiracial backgrounds

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36. Peak alcohol use is typical:

a. during late teen years
b. in graduate school
c. during the early 20s
d. over the age of 65

37. Which of the following is true about alcohol use disorders internationally?
a. Highest in Russia and other very cold countries
b. Highest in the Middle East
c. Highest in Latin America
d. Highest in the United States

38. Which of the following is an accurate statement about alcohol use?

a. Education is negatively correlated with recent alcohol use.
b. Half of all Americans over the age of 12 report being current drinkers of alcohol.
c. Female college students were more likely than male college students to report several episodes of binge
drinking in a two-week period.
d. Alcohol use in the elderly population is typically high.

39. In a large survey among college-age men and women, it was found that
a. about 75% of the respondents had gone on a binge of heavy drinking once in the preceding two weeks.
b. there was no relationship between frequency of drinking and grades.
c. students with a grade-point average of "A" had no more than one drink per week.
d. "D" and "F" students averaged 11 alcoholic drinks per week.

40. In 2012, researchers at the Substance Abuse and Mental Health Services Administration estimated that
more than Americans are probably dependent on alcohol.
a. 5million
b. 11 million
c. 16 million
d. 25 million

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41. A report from the Substance Abuse and Health Services Administration (2012) indicates that just under of
Americans reported binge drinking in the month preceding the report.
a. 2%
b. 24%
c. 51%
d. 65%

42. The prevailing view that alcohol abuse usually follows a predictable downward spiral was based on Jellinek's mid 20th
century survey of Alcoholics Anonymous (AA) members that asked them how alcohol had affected them physically
and psychologically. Data from this survey are now considered inaccurate because
a. respondents faked their answers to the questions on the survey.
b. too few AA members answered the survey questions.
c. since the survey was only sent to older members of AA, information on the progression of alcohol use was not
available.
d. Jellinek himself became an alcoholic and never finished the research.

43. According to Jellinek's model (no longer considered accurate but still of scientific interest), an individual with alcoholism
progresses through four stages. Which of the following INCORRECTLY describes the characteristic behaviors
associated with each of Jellinek's stages?
a. Prealcoholic stage - hangovers, DWI or DUI charges, blackouts
b. Prodromal stage - drinking heavily but few outward signs of problems
c. Chronic stage – primary daily activities involve drinking and getting drunk
d. Crucial stage – loss of control with occasional binges

44. A research study of 6,000 lifetime drinkers (DeWitt et al., 2000) found that drinking at an early age (ages 11 to 14)
a. was predictive of later alcohol use disorders.
b. had no relationship to alcohol use later in life.
c. caused more frequent blackouts than drinking at later ages.
d. resulted in more severe withdrawal symptoms than drinking at later ages.

45. Which of the following is an accurate statement about alcoholism?

a. A progressive pattern leading to alcoholism is inevitable for those who drink alcohol.
b. The factors that determine a drinker's susceptibility to alcoholism are not yet fully understood.
c. Alcohol use and aggressive behavior are negatively correlated.
d. Use of alcohol by preteens and young teenagers does not predict later abuse.

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46. Although alcohol use and aggression are positively correlated, the factors that actually determine aggressive
behavior involve all of the following EXCEPT
a. quantity and timing of alcohol consumed.
b. the person's previous history of violence.
c. the expectations about drinking.
d. the person's level of intelligence.

47. You have just heard about a situation in which someone who was drunk vandalized a building and assaulted a
security guard. From your knowledge of abnormal psychology, you are aware that although alcohol does not cause
aggressive behavior, it may
a. stimulate the inhibitory center of the brain, causing aggressive behavior.
b. activate the aggressive genes in the person's DNA.
c. impair the ability to consider the consequences of acting impulsively.
d. increase the anxiety associated with being punished for one's actions.

48. Alcohol is related to violence because it .

a. increases impulsivity
b. increases rational thinking
c. causes aggression
d. decreases aggressive behavior

49. Which of the following terms is the definition of anxioltytic?

a. Sleep-inducing
b. Anxiety-reducing
c. Anti-seizure
d. Anxiety-increasing

50. Which of the following terms is the definition of sedative?

a. Sleep-inducing
b. Anxiety-reducing
c. Anti-seizure
d. Calming

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51. Which of the following terms is the definition of hypnotic?

a. Sleep-inducing
b. Anxiety-reducing
c. Anti-seizure
d. Calming

52. Which of the following terms is the definition of anticonvulsant?

a. Sleep-inducing
b. Anxiety-reducing
c. Anti-seizure
d. Calming

53. Which of the following drugs is NOT classified as a barbiturate?

a. Amytal
b. Seconal
c. Rohypnol
d. Nembutal

54. Which of the following drugs is NOT classified as a benzodiazepine?

a. Ativan
b. Valium
c. Xanax
d. Seconal

55. Minerva was extremely anxious and worried about everything. She thought that something terrible would happen
and worried what people thought about her. Her doctor most likely prescribed to help her.
a. an opiate
b. an anticonvulsant
c. a sedative
d. an antidepressant

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56. Misuse of the benzodiazepine has resulted in it being referred to as the "forget-me pill," and
it has been used to facilitate date rape.
a. Amytal
b. Halcion
c. Rohypnol
d. Ritalin

57. Which of the following types of drugs typically is used in large amounts to commit suicide?
a. Benzodiazepines
b. Barbiturates
c. Stimulants
d. Hallucinogens

58. The most commonly consumed of all the psychoactive drugs are the stimulants, which include all of
the following EXCEPT_____________.
a. caffeine
b. cocaine
c. nicotine
d. mescaline

59. Which of the following is an accurate statement about amphetamines and/or amphetamine use disorders?
a. Amphetamines cause a period of depression and fatigue (called "crashing"), which is followed by feelings
of elation and euphoria.
b. Amphetamines cause an increase in appetite and a decrease in fatigue.
c. Amphetamines decrease the availability of dopamine and norepinephrine in the nervous system.
d. Amphetamine overdose can cause hallucinations, panic, agitation, and paranoid delusions.

60. Until 1903, Coca-Cola contained which of the following?

a. Cocaine
b. Heroin
c. Caffeine
d. Chocolate

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61. Ecstasy, or MDMA,

a. increases appetite.
b. rarely causes Emergency Room visits.
c. is now used more than LSD.
d. acts like speed, but has major withdrawal symptoms.

62. Which of the following effects is associated with cocaine use?

a. Decreased alertness
b. Increased appetite
c. Decreased pulse and blood pressure
d. Rapid and irregular heartbeat

63. "Crack babies," born to mothers who have used cocaine, often develop problems that are attributed not only to
the effects of cocaine but also to
a. mother’s use of alcohol.
b. mother’s use of nicotine.
c. disrupted home environments.
d. all of these.

64.
Stimulation of the neurons in the "pleasure pathway" (the site in the brain that seems to be involved in the
experience of pleasure) probably causes the "high associated with cocaine use.
a. dopamine
b. serotonin
c. adrenaline
d. endorphin

65. Your shy and introverted friend tells you that she has discovered a wonder drug that produces feelings of euphoria
and is not addictive. When you realize that she is talking about cocaine, you inform her that
a. scientists agree that it is a wonder drug just as she describes.
b. in the early 20t h century cocaine was an ingredient in Pepsi-Cola.
c. cocaine will make her more social and outgoing.
d. dependence on cocaine develops slowly over a period of years.

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66. Nikki has decided to stop smoking (again). She can expect to experience which of the following withdrawal symptoms?
a. Elevated mood
b. Decreased appetite
c. Weight loss
d. Irritability

67. The most common of the psychoactive substances, used by 90% of Americans, is .
a. nicotine
b. caffeine
c. marijuana
d. opium

68. Which of the following are examples of opioids?

a. Chemicals in the poppy
b. Hydrocodone
c. Enkephalins
d. All of the above

69. Legally available narcotic medications, including morphine and codeine, are used primarily as .
a. antagonists
b. analgesics
c. antibiotics
d. antidotes

70. Which of the following is an accurate statement about opiate (narcotic) addiction?
a. Discontinuing narcotic use brings on withdrawal symptoms in 1 to 2 hours.
b. Since opiates (narcotics) are usually injected, users are at increased risk for HIV and, by extension, AIDS.
c. The withdrawal process for narcotic addiction takes about 1 to 3 weeks.
d. Most addicts die before the age of 50 from a drug overdose.

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71. Angus had been "hooked" for a while before he decided to "go clean." Within 6 to 12 hours, he started to experience
excessive yawning, nausea and vomiting, chills, muscle aches, diarrhea, and insomnia. His behavior disrupted his work
and social relationships. These symptoms persisted for three days. After a week, he felt better. Angus is probably
withdrawing from .
a. alcohol
b. cocaine
c. heroin
d. LSD

72. Enkephalins and endorphins are natural opioids found in .

a. the brain
b. the humoral system
c. DNA
d. poppy seeds

73. Which of the following is an accurate statement concerning marijuana use and abuse?
a. Paranoia and hallucinations can occur.
b. Tolerance develops rapidly.
c. Substance Use Disorders can occur with even occasional use.
d. Marijuana is free of carcinogens.

74. Cannabis use often results in .

a. mood swings
b. blunted sensory experience
c. an accurate sense of time
d. enhanced nausea

75. Health-wise, marijuana

a. wards off nausea.
b. eases pain associated with multiple sclerosis.
c. contains as many carcinogens as tobacco smoke.
d. all of these.

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76. Even after Timon read "Psychedelics for Dummies," he was unable to produce LSD in the lab. He decided he
would have to find a hallucinogen naturally. Therefore, he should look for which naturally occurring hallucinogen?
a. Psilocybin
b. Mescaline
c. LSD
d. All of these

77. Which of the following hallucinogenic substances is processed synthetically?

a. Marijuana
b. LSD
c. Psilocybin
d. Mescaline

78. Which of the following statements is false about hallucinogens?

a. LSD is chemically similar to serotonin.
b. Mescaline is chemically similar to norepinephrine.
c. A number of hallucinogens are chemically similar to acetylcholine.
d. MDMD is chemically similar to glutamate.

79. All of the following are informative and accurate statements about inhalants EXCEPT
a. inhalant use is most commonly observed among college students.
b. symptoms of inhalant use include slurred speech, dizziness, and euphoria.
c. long-term inhalant use can damage bone marrow, the kidneys, the liver, and the brain.
d. use of inhalants can cause users to be antisocial and aggressive.

80. Use of the testosterone-derived anabolic-androgenic steroids differs from other illicit drug use because
a. the "high" produced from steroid use is more intense than that experienced with other drugs.
b. steroids are used to increase body mass and enhance performance.
c. more females than males use anabolic steroids.
d. steroids can be taken orally or by injection.

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81. Among the so-called recreational or illicit "designer drugs" is a dissociative anesthetic that produces a sense of
detachment along with a reduced awareness of pain. It is called .
a. Ecstasy (MDMA)
b. "K" or "Special K"
c. Eve
d. Nexus

82. A recent research study on alcoholism suggests that use of illegal drugs is influenced by environmental factors,
but abuse and dependence are more influenced by factors.
a. genetic
b. psychological
c. non-biological
d. cultural

83. The common factor among psychoactive drugs may be

a. their ability to activate the "pleasure pathways" of the brain.
b. the ease of obtaining them and the relatively inexpensive cost.
c. the similar way in which they are metabolized in the body.
d. their identical effect on neurotransmitters at the synapse.

84. The "pleasure pathways," or internal reward centers, in the human brain are primarily made up of________________.
a. dopamine-sensitive neurons
b. serotonin-sensitive neurons
c. both of these
d. neither of these

85. The drugs that directly stimulate the internal reward center or pleasure pathways in the brain include
a. amphetamines and cocaine
b. the opiates
c. all of these
d. none of these

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86. The field of research that studies how genes work to affect addiction is called .
a. behavior genetics
b. the genome project
c. functional genomics
d. genetic cross-transformation

87. Yesterday you asked your friend Ray for a couple of aspirin tablets. Ray has been taking a psychology
course and informs you that, in behavioral terms, aspirin is a headache begins to gets worse.)
a. positive
b. negative
c. neutral
d. variable

88. In behavioral terms, drugs like aspirin are considered negative reinforcers because they
a. quickly make a person feel good.
b. stop a person from feeling pain.
c. have toxic effects on the nervous system.
d. can cause frequent users to become dependent on them.

89. Which of the following drugs is known to have an anxiolytic (anxiety-relieving) effect?
a. Methamphetamine
b. Alcohol
c. Caffeine
d. LSD

90. In trying to understand why some people continue to use drugs until they become dependent on them and others
are able to stop before this happens, it is important to consider
a. how sensitive a person is to both the negative effects of alcohol when it is first ingested and to the
negative effects of alcohol after a few hours
b. how sensitive a person is to the positive effects of alcohol when it is first ingested and to the negative
effects after a few hours.
c. how sensitive a person is to the negative effects of alcohol when it is first ingested and to the positive effects
a few hours later.
d. how sensitive a person is to the positive effects of alcohol when it is first ingested and to the positive effects
a few hours later.

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91. In a study involving the sons of alcoholics who were at high risk themselves for developing alcoholism, it was found that
a. they were less sensitive to the positive effects of alcohol when it was first ingested.
b. they were more sensitive to the negative effects of alcohol after a few hours.
c. both of these.
d. neither of these.

92. In a laboratory research study involving "drug addiction" in animals, it was demonstrated that the positive reinforcing
effect of drugs was
a. biological only.
b. tied to social and cultural influences.
c. free from social and cultural influences.
d. biological, social, and cultural.

93. Many individuals use drugs as negative reinforcement to escape from the unpleasantness (pain, stress, anxiety) in
their lives. This phenomenon is called all of the following EXCEPT .
a. self-medication
b. tension reduction
c. controlled dosing
d. negative affect

94. The integration of both positive and negative reinforcement in explaining why the "crash" that follows the initial
euphoria of drug use is not a deterrent to further drug use is called
a. the opponent-process theory.
b. amotivational syndrome.
c. substance induced myopia.
d. an expectancy effect.

95. Which of the following is an accurate statement about the opponent-process explanation of drug addiction?
a. An increase in positive feelings will be followed by an increase in negative feelings
b. An increase in negative feelings will be followed by an increase in positive feelings
c. Both of these
d. Neither of these

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96. Research examining the expectations that kids in grades 7 through 11 have about drinking alcohol revealed that some
of the students begin drinking because they think it will have positive effects on their social behavior and cognitive and
motor skills, a phenomenon called
a. alcoholic myopia.
b. an expectancy effect.
c. opponent-process theory.
d. regressive alcoholism.

97. Expectancies about alcohol use

a. start before people even start drinking.
b. predict who will later have drinking problems.
c. change over time and alcohol use.
d. all of the above

98. Substance abuse can be seen from either a biological or a psychosocial perspective. For example, the condemnation
of drug abuse as an official sin by the Catholic Church is an example of .
a. the moral weakness model
b. the disease model of dependence
c. the AA model of drug dependency
d. a 12-step program

99. Drug-addicted parents may contribute to their child’s drug use by

a. failing to monitor the child’s behavior.
b. making drugs available to the child.
c. creating an environment where peers use drugs.
d. all of the above.

100. Cravings seem to be exacerbated by

a. the availability of drugs.
b. specific moods.
c. places and objects associated with drug taking.
d. all of the above.

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101. The disease model of dependence

a. assumes that dependence is caused by a psychological disorder.
b. assumes that dependence is caused by an underlying physiological disorder.
c. is a psychosocial perspective.
d. assumes that dependence is a failure of self-control.

102. Research on changes in Korean drug use patterns suggests that

a. cultural norms can override biological factors that inhibit alcohol use.
b. cultural norms cannot override biological factors that inhibit alcohol use.
c. personality factors contribute to substance use.
d. all of these.

103. The brain’s tendency to reorganize by forming new neural connections is called .
a. neuroplasticity
b. neuroelasticity
c. neuroconsolidation
d. neurogenesis

104. Which of the following are examples of agonist types of treatment for substance abuse?
a. The use of methadone to treat heroin addiction
b. A nicotine patch or nicotine gum to treat addiction to cigarette smoking
c. Both of these
d. Neither of these

105. The opiate-antagonist naltrexone is a treatment for substance abuse that works by
a. substituting a chemically similar drug for the addictive drug.
b. both counteracting the effects of opiates and producing withdrawal symptoms.
c. producing a cross-tolerance effect in a drug user.
d. producing only a temporary euphoric effect if opiates continue to be used.

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106. The drug called Antabuse helps people abstain from drinking alcohol by
a. causing alcoholic drinks to taste bitter.
b. disrupting breakdown of a byproduct of alcohol, leading to feelings of illness.
c. making people allergic to alcohol.
d. reducing the pleasurable feelings that are associated with alcohol.

107. An individual with alcoholism who is highly motivated to stop drinking and who understands the possibly
severe consequences of treatment may be prescribed the drug called Antabuse. This medication is an
example of an__treatment for alcoholism.
a. agonist (substitution)
b. antagonist
c. aversive
d. 12-step

108. Which of the following is NOT an accurate statement about Alcoholics Anonymous (AA)?
a. AA is clearly an effective treatment for some people with a Substance Use Disorder.
b. More than 9% of the adult population of the United States has attended an AA meeting.
c. AA advocates controlled drinking in which former alcoholics can become social drinkers.
d. It is difficult to conduct accurate research on AA because participation is anonymous.

109. For which of the following groups has Alcoholics Anonymous shown to have mixed results?
a. Women
b. Atheists
c. Asian Americans
d. Experience for all of these groups has been mixed.

110. A component that seems to be an integral part of substance abuse therapy is .

a. covert sensitization
b. contingency management
c. relapse prevention
d. pharmacotherapy

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[Link] community reinforcement approach, a new type of program that has been started to address the problem
of substance abuse, includes all of the following components EXCEPT
a. a non-substance-abusing relative participates with the alcoholic in relationship improvement sessions.
b. encouraging the substance abuser to accept that his or her friends may continue to be users but associating
with them is still OK.
c. assistance with employment, education, finances, or other social service areas is provided to help reduce stress.
d. suggesting options for new recreational activities to replace previous drug-related activities.

112. Contingency management involves

a. the use of reinforcement for specific behaviors.
b. the elimination of abuse cues.
c. altering expectations.
d. use of medications to create substance aversions.

113. According to your book, controlled drinking is believed to be

a. a viable alternative to abstinence.
b. much more effective than abstinence.
c. much less efficient than abstinence.
d. helpful for everyone.

114. Relapse prevention refers to a treatment mode that views relapse as

a. a failure of cognitive and behavioral coping skills.
b. a failure of willpower.
c. proof that a person will never be able to control his/her drinking.
d. an insurmountable obstacle to treatment for substance abuse.

115. Which of the following has NOT been shown to be effective in preventing drug use in adolescents?
a. Skills training to avoid or resist social pressure
b. Education on how the media glorifies drug use
c. Community strategies about each person’s role in reducing drug use
d. Fear based tactics on the dangers of drug use

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116. Substance abuse prevention efforts in the past have focused on

a. education-based approaches.
b. changing laws regarding drug use and possession.
c. working with parents to change substance use.
d. all of the above

117. Of the following types of drug prevention strategies, which one has the potential for the most successful
outcome (accordin
g to the information in your textbook)?

a. Education-based programs (e.g., DARE)

b. Skills training to resist social, media, and peer pressure to use drugs
c. Relapse prevention programs focusing on the learned aspects of dependence, i.e., the failure of cognitive and
behavioral coping skills
d. Cultural attitude change (e.g., widespread enactment of no-smoking legislation)

118. Although most impulse control disorders are considered rare, one that affects an increasing number of people is
______________.

a. kleptomania
b. pyromania
c. gambling disorder
d. intermittent explosive disorder

119. Pyromania
a. is fairly common among arsonists.
b. is a disorder where an individual is preoccupied with setting fires and the associated equipment involved
in putting out those fires.
c. is fairly common among people who were bedwetters as children.
d. is all of these.

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120. Which of the following statements is TRUE about kleptomania?

a. The stolen objects are not needed for personal use or their monetary value.
b. The disorder appears to be more common than many disorders.
c. The disorder has been fairly well-studied because of the somewhat high prevalence.
d. All of these are true.

121. Although AA (Alcoholics Anonymous) programs are considered effective, the drop-out rate for GA
(Gambler's Anonymous) programs is .

a. 10 to 30%
b. 30 to 50%
c. 50 to 70%
d. 70 to 90%

122. Nicotine synergism refers to combining nicotine with .

a. contextual cues
b. expectancies
c. practice
d. experience

123. In the impulse control disorders, the individual feels prior to carrying out the act.
a. relaxed and calm
b. tension and anticipation
c. spaced out
d. angry and aggressive

124. Compare and contrast the "levels of involvement" in the following substance-related disorders: use, intoxication, abuse,
and dependence. Define the meaning of the word "addiction."

ANSWER: Substance intoxication refers to the physiological reaction to an ingested substance. The degree of
intoxication is related to the drug used, how much is ingested, and the person’s individual biological
reaction. Substance abuse according to DSM-IV-TR is defined in terms of how significantly it
interferes with the user’s life. If it disrupts your education, job, relationships, health, or well-being, or
causes legal problems, it can be judged as abuse. Substance dependence is described as an addiction. It
can involve physiological reactions to the chemicals being ingested, and may include tolerance and
withdrawal, but does not have to. In general, the term addiction is used to describe people who are
under the control of a drug or drugs.

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125. According to your text, is it possible to use drugs without becoming addicted to them?

ANSWER: Yes, substance use (ingesting psychoactive substances in moderate amounts) is defined differently than
a Substance Use Disorder. Substance Use Disorder is defined in DSM-5 as having at least 2 symptoms
in the last year that interfere with your life or bother you a great deal. Many people use drugs casually,
such as drinking a cup of coffee in the morning to wake up or having a glass of wine with friends after
work to relax. However, genetics, social circumstances, and the environment can slowly increase use
to abuse and abuse to a disorder.

126. Compare and contrast benzodiazepines and the barbiturates. Discuss medical uses for these substances and the
potential for abuse and/or addiction.

enzodiazepines are drugs used to reduce anxiety, including Valium, Xanax, Rohypnol, and Ativan.
These drugs impact the GABA system, and their use can result in tolerance and dependence. In recent
years, Rohypnol has become known as the “forget-me drug,” and has been used to assist in date-rape.
Barbiturates include Amytal, Seconal, and Nembutal, and are prescribed to help people sleep. They
affect the GABA system and can be addictive. These drugs relax the muscles and produce mild well-
being, but can also impact speech, concentration, and walking. Overdoses can result in suffocation.

127. A commonly held-opinion is that alcohol increases social skills because it loosens inhibitions in
communication. Describe recent research that supports or negates this opinion.

lthough alcohol may seem to make us more sociable, in reality, alcohol makes it more difficult to communicate
with other people. The GABA system affects the emotion of anxiety and anti-anxiety properties
may result from its interaction with the GABA system. Alcohol reinforces movement of chloride
ions and as a result, neurons have difficulty firing. There are individual differences in this though.
Genetic research suggests that genes responsible for communication between neurons may also be
responsible for individual differences in response to alcohol.

128. Discuss some of the racial differences in binge drinking. What do you think accounts for these differences?

bout 63 Million Americans over the age of 18 report binge drinking in the last month. Binge drinking is defined as
four or more drinks (women) and five or more drinks (men) over a 2-hour time span. Whites and
Hispanic/Latinos report the highest levels of binge drinking while Asian Americans report the lowest
levels of binging. Reasons for this disparity are many including individual factors. Genetics,
acceptability within communities, and other environmental factors can account for much of the
difference between groups.

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129. Discuss the effectiveness of prevention education on adolescent drug use.

dolescents are at high risk for drug addiction due to their higher rates of experimentation with drugs. When done
right, education about drugs’ risks can lead to decreases in drugs of abuse (e.g., ecstasy and tobacco).
Many states and school districts have implemented education-based programs in schools to try to deter
students from using drugs. The widely used Drug Abuse Resistance Education (DARE) program
encourages a “no drug use” message through fear of consequences, rewards for commitments not to
use drugs, and strategies for refusing offers of drugs. Unfortunately, several extensive evaluations
suggest that this type of program may not have its intended effects (Pentz, 1999). Fortunately, more
comprehensive programs that involve skills training to avoid or resist social pressures (such as peers)
and environmental pressures (such as media portrayals of drug use) can be effective in preventing drug
abuse among some people.

130. Why are gambling problems so difficult to treat? What have researchers found to be effective in treating
Gambling Disorder.

ANSWER: Gambling Disorder impacts approximately 1.9% of adult Americans and can be quite devastating in
terms of job loss, bankruptcy, arrests, and incarceration. Gambling includes the same patterns of urges
that we see in other substance-related disorders and thus DSM-5 groups them together. Those with
gambling disorder exhibit a combination of characteristics—including denial of the problem, impulsivity,
and continuing optimism (“One big win will cover my losses!”)—that interfere with effective
treatment. There is also likely a genetic component to gambling disorders. Cognitive-behavioral
interventions can reduce symptoms of Gambling Disorders. However, effectiveness in the population is
weakened as impulsivity inherent in Gambling Disorders can lead to treatment dropout.

131. Discuss current research on the genetic/biological, cognitive, social, and cultural factors related to alcoholism.
Whic
h factors appear most strongly related to the development and progression of the disorder?

lcohol is thought to have an anxiolytic effect as a result of its effects on the septal/hippocampal system, which
includes a large number of GABA-sensitive neurons. Studies of the sons of alcoholics suggest that there
may be a genetic predisposition to being less sensitive to alcohol when it is first ingested and then less
sensitive to its effects over time, meaning that the euphoric effects take precedence. Alcoholics and
their sons also tend to show altered brain-wave activity, although it is not clear whether this pattern is
connected to the reasons people become alcohol dependent or a sign of some other similarity. Alcohol
may also enable people to cope with stress or anxiety, and so becomes a negative reinforcer; people
who experience stress or abuse are at risk for increased drinking. People’s expectancies about a drug
such as alcohol can affect their response to the substance and their tendency to use or abuse the drug.
Cultural guidelines influence people’s definitions of what is acceptable regarding substance use, how such
use is linked to daily activities and social events, and
may affect the social and legal consequences of such drinking.

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132. Discuss the various component treatments for substance abuse.

ANSWER:
Often, biological treatments are more successful when combined with psychotherapy. For example,
when using aversion therapy, the subject may utilize covert sensitization. The subject associates
substance use with something very unpleasant. The goal would be to counteract the positive
associations with the substance.
A component that seems a valuable part of therapy is contingency management, where the clinician
and client decide on the reinforcers that will reward reaching certain goals.
Another approach is the community reinforcement approach, in which several facets of the drug
problem are addressed to help identify and correct a person's behavior that might contribute to abuse.
For example, certain relationships are recognized as influencing drug use, so they are to be avoided,
etc.
Motivational interviewing suggests that reminding a client about what he or she cherishes most in
order to improve the client's belief that any changes made will have positive outcomes.
Cognitive-behavio
r therapy addresses multiple aspects of the disorder and the problem of relapse. Relapse prevention
treatment models help clients remove ambivalent feelings toward stopping their drug use and
confronting the negative consequences of its use.

133. Discuss what is meant by impulse control disorders, and describe why pathological gambling fits into this category
of disorders and how it can be treated.

ANSWER:
Impulse-control disorders are characterized by the temptation to engage in behaviors that are destructive
but irresistible in some way. Usually, the person experiences increased tension leading up to the act or
pleasurable anticipation about it. Pathological gambling refers to the need to gamble in spite of its
destructive effects on the person’s life. Pathological gamblers show decreased levels of activities in
brain regions involved in impulse regulation. It is believed that this pattern may be the result of
abnormalities in the dopamine reinforcement system and the serotonin impulse control system. The
treatment of gambling is difficult because the person often denies the problem and continues to believe
that he/she is just around the corner from a big win. Gamblers Anonymous programs incorporating a 12-
step approach have been used, although research suggests that 70 to 90% of people drop out of these
programs. Cognitive- behavioral approaches, which involve financial limit setting, alternative activity
planning, problem-solving relapse prevention, and imaginable desensitization, may also have some utility.

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