Clinical Neuroscience - Chapter 16

The incidence of schizophrenia in the world population is approximately __________ percent.

A) 0.1

B) 1

C) 2.5

D) 5

B

Which statement is true of schizophrenia?

A) Schizophrenia is not a serious mental disorder.

B) The term means "split mind."

C) The incidence of schizophrenia is about 15 percent of the world population.

D) The term means "split personality."

D

Children who later in life develop schizophrenia are more likely to show __________ in movies recorded earlier in their childhood.

A) more sociability

B) euphoria

C) less sociability

D) less overall activity

C

Which of the following would be a possible indicator of Jaeline's future diagnosis of schizophrenia?

A) thin-set eyes

B) a short, round tongue

C) symmetrical ears

D) partial webbing of the two middle toes

D

A __________ is to a belief that is contrary to fact as a __________ is to perceptions of stimuli that are not actually there.

A) delusion; hallucination

B) hallucination; episode

C) episode; delusion

D) hallucination; delusion

A

Jemutai's belief that alien forces are attempting to manipulate her movements is likely a delusion of __________.

A) persecution

B) paranoid

C) grandeur

D) control

D

A homeless person who believes that he is the president of the United States is most likely suffering from a delusion of __________.

A) perception

B) control

C) grandeur

D) paranoia

C

Schizophrenic hallucinations most likely involve the __________ system.

A) tactile

B) visual

C) audition

D) olfactory

C

The major types of symptoms noted in schizophrenia include __________.

A) positive symptoms, negative symptoms, and cognitive symptoms

B) hallucinations and social withdrawal

C) thought disorder and impaired language ability

D) delusions and hallucinations

A

__________ symptoms of schizophrenia are to additional abnormal behaviors as __________ symptoms are to subtraction of normal behaviors.

A) Positive; neutral

B) Neutral; negative

C) Positive; negative

D) Negative; neutral

C

Negative symptoms of schizophrenia __________.

A) are associated with low levels of brain dopamine activity

B) usually require long hospital terms to treat

C) represent the absence or diminution of normal behaviors

D) indicate that the patient cannot accurately perceive reality

C

An example of a positive symptom of schizophrenia is __________.

A) anxiety

B) flat mood

C) social withdrawal

D) intense euphoria

D

An example of a negative symptom of schizophrenia is __________.

A) poor abstract thinking

B) the inability to experience pleasure

C) an auditory hallucination

D) low psychomotor speed

B

Siddig would be classified as having negative symptoms of schizophrenia if he __________.

A) heard voices that repeat senseless words and phrases

B) experienced a feeling of euphoria at the start of an episode

C) believed that doctors are part of a plot to poison him

D) exhibited flattened emotional expression

D

An individual with schizophrenia demonstrates reduced or nonexistent speech and difficulty paying attention. These symptoms would be classified as ____________ symptoms.

A) positive and cognitive

B) negative and cognitive

C) positive and negative

D) strictly negative

B

An example of a cognitive symptom of schizophrenia would be __________.

A) anxiety

B) difficulty in eye tracking

C) deficits in learning and memory

D) delusion

C

The correct order of appearance of schizophrenic symptoms is __________.

A) positive -> negative -> cognitive

B) cognitive -> positive -> negative

C) cognitive -> negative -> positive

D) negative -> cognitive -> positive

D

Which statement about the genetic basis of schizophrenia is true?

A) Adoption studies indicate no biological basis for schizophrenia.

B) The concordance rate for schizophrenia is higher for dizygotic than for monozygotic twins.

C) A person with a "schizophrenia gene" will always develop schizophrenia.

D) Genes impart a susceptibility to develop schizophrenia

D

The likelihood that a child born to two schizophrenic parents will become schizophrenic is less than 50 percent. This suggests that __________.

A) schizophrenia is not produced by a single gene

B) schizophrenia is a metabolic disorder

C) schizophrenia is produced by a single dominant gene

D) schizophrenia is associated with infertility

A

Which of the following is an "environmental" factor that interacts with genetics for the development of schizophrenia?

A) whether or not the twins were exposed to high levels of lead

B) whether or not the mother consumed a high-fat diet during pregnancy

C) whether identical twins shared the same or different placentas

D) whether the pregnancy occurred on the East Coast or West Coast of the United States

C

Which of the following is known to increase the risk of schizophrenia?

A) being born before a long flu season

B) being born during the late summer

C) being born in a southern latitude

D) having a monochorionic twin who is schizophrenic

D

The term "seasonality effect" describes the observation that __________.

A) people born during late winter and early spring are more likely to develop schizophrenia

B) schizophrenic symptoms intensify during the summer

C) the rate of admissions to hospitals for schizophrenia is highest in the winter

D) the rate of admissions to hospitals for schizophrenia is lowest in the winter

A

Which statement is true of the seasonality effect?

A) Schizophrenia is more likely to occur in a person born in June, July, and August.

B) The seasonality effect is lower in rural settings than in urban settings.

C) The seasonality effect is mostly due to a mother's indoor smoking during the winter.

D) The seasonality effect is enhanced when fall temperatures are higher than normal.

B

Which of the following is most likely to be associated with the development of schizophrenia?

A) being born into an affluent family

B) having a young father

C) being born five months after a major flu epidemic

D) being born in a rural area

C

A key prediction of the viral hypothesis of schizophrenia is that __________.

A) children born a few months after the start of a flu outbreak are more likely to develop schizophrenia

B) mothers taking antibiotics should not have schizophrenic offspring

C) children born a few months before a flu outbreak are more likely to develop schizophrenia

D) exposure of the fetus to a virus during the third trimester is most likely to induce schizophrenia

A

What would increase Kacey's likelihood of developing schizophrenia?

A) being kept inside all of the time

B) living in a rural area

C) living in the Southern Hemisphere

D) being born in August

A

The positive symptoms of schizophrenia are thought to result from overactivity of __________ neurons of the __________.

A) cholinergic; basal forebrain

B) dopaminergic; mesolimbic system

C) noradrenergic; nucleus accumbens

D) serotonergic; raphe nuclei

B

Chlorpromazine is to a __________ as cocaine is to a ____________.

A) serotonin antagonist; serotonin agonist

B) serotonin antagonist; dopamine antagonist

C) dopamine antagonist; dopamine agonist

D) dopamine agonist; dopamine antagonist

C

If Leisl wanted to reduce her positive symptoms of schizophrenia, which treatment would be best?

A) dopamine receptor agonists

B) antagonists at GABA receptors

C) agonists at serotonin receptors

D) dopamine receptor antagonists

D

Which of the following drugs would be expected to either produce or worsen the positive symptoms of schizophrenia?

A) caffeine

B) cocaine

C) aspirin

D) lithium

B

The mesolimbic pathway projects from the __________ to the __________.

A) ventral tegmental area; frontal cortex

B) globus pallidus; ventral tegmental area

C) midbrain; cingulate cortex

D) ventral tegmental area; nucleus accumbens and amygdala

D

John has been diagnosed with schizophrenia and has shown improvement in positive symptoms while taking chlorpromazine. Which of the actions below, if taken by John, would be expected to greatly worsen his positive schizophrenia symptoms?

A) John stops taking chlorpromazine and participates in a cocaine party.

B) John takes double his normal chlorpromazine dose per day.

C) John takes reserpine in addition to chlorpromazine.

D) John mixes alcohol with chlorpromazine.

A

The hypothesis regarding the role of dopamine in schizophrenia states that schizophrenia is caused by __________.

A) damage to ascending dopamine fibers

B) a breakdown product of the neurotransmitter serotonin

C) overactivity of dopaminergic synapses

D) low levels of one or more of the monoamines

C

The hypothesis that dopamine is involved in schizophrenia is supported by the finding that __________.

A) reserpine depletes monoamine vesicles and makes schizophrenia worse

B) cocaine and amphetamine induce negative schizophrenia symptoms

C) drugs that induce schizophrenic symptoms are dopamine antagonists

D) dopamine antagonists relieve the positive symptoms of schizophrenia

D

Parkinson's disease is to __________ as tardive dyskinesia is to __________.

A) constipation and dry mouth; slowness of movement

B) slowness of movement; constipation and dry mouth

C) slowness of movement; excessive movement

D) excessive movement; slowness of movement

C

Dr. Singh is looking at a particular list of drugs; beside each drug name is a number that represents the efficiency of that drug for blocking dopamine receptors (where a low number means a greater efficiency at blocking). Which drug on Sam's list would be the most efficient for the treatment of schizophrenia?

A) efficiency value = 0.1

B) efficiency value = 0.3

C) efficiency value = 5.0

D) efficiency value = 100.0

A

Clozapine is referred to as an "atypical" antischizophrenic drug because it __________.

A) reverses positive, negative, and cognitive symptoms of schizophrenia

B) is more potent at blocking D2 receptors than D4 receptors

C) effectively treats schizophrenia, but also produces motor side effects

D) does not induce mania

A

Which of the following would have the greatest impact on the likelihood of someone developing negative symptoms of schizophrenia?

A) having an older father

B) excessive birth weight

C) brain damage

D) a "schizophrenia gene"

C

Excessive dopamine activity is to __________ as brain damage is to __________.

A) neutral symptoms; positive symptoms

B) positive symptoms; negative symptoms

C) negative symptoms; neutral symptoms

D) negative symptoms; positive symptoms

B

Which statement supports the notion that the prefrontal cortex is related to the negative symptoms of schizophrenia?

A) Patients show a greater number of neurons within the gray matter of the frontal cortex.

B) Patients show greater activity of the frontal cortex than do controls.

C) Patients do poorly on neuropsychological tests that are sensitive to damage of the prefrontal cortex.

D) MRI studies indicate abnormalities within the parietal cortex.

C

Weinberger argues that the negative symptoms of schizophrenia are related to __________.

A) increased neural activity within the ventral tegmental area

B) elevated dopamine activity within the nucleus accumbens

C) increased activity of the dorsolateral prefrontal cortex

D) decreased activity of the dorsolateral prefrontal cortex

D

Which statement supports the contention that schizophrenia is associated with brain damage?

A) The size of the lateral ventricles decreases in schizophrenic patients.

B) The dlPFC shows lower activation.

C) The neurological symptoms noted in schizophrenia are unique to this disorder.

D) Control subjects are more likely to show neurological symptoms.

B

A drug that decreases the activity of neurons within the dorsolateral prefrontal cortex would be expected to __________.

A) induce both positive and negative symptoms of schizophrenia

B) induce only the positive symptoms of schizophrenia

C) decrease the levels of dopamine within the nucleus accumbens

D) be an effective treatment for schizophrenia

A

Typical antipsychotics are to __________ as atypical antipsychotics are to __________.

A) antagonists; agonists

B) partial antagonists; agonists

C) antagonists; partial agonists

D) partial agonists; antagonists

C

Atypical antipsychotic drugs increase activity in the _________ but decrease activity in the __________.

A) ventral tegmental area; amygdala

B) prefrontal cortex; nucleus accumbens

C) amygdala; hippocampus

D) amygdala; ventral tegmental area

B

Which statement is true?

A) Aripiprazole is a dopamine antagonist in the mesolimbic system.

B) Aripiprazole is a dopamine antagonist in the prefrontal cortex.

C) Aripiprazole is a dopamine agonist in the mesolimbic system.

D) Aripiprazole is a dopamine agonist in the limbic system.

A

__________ reverses the positive, negative, and cognitive symptoms of schizophrenia by acting as a __________ in the prefrontal cortex and nucleus accumbens.

A) L-DOPA; competitive antagonist

B) Aripiprazole; partial agonist

C) Reserpine; monoamine agonist

D) Aripiprazole; reuptake inhibitor

B

__________ produces both cognitive and negative schizophrenia symptoms.

A) Dopamine antagonists

B) Haloperidol

C) Phencyclidine

D) Amphetamine

C

Phencyclidine is of interest for the study of schizophrenia in that this drug __________.

A) is an antagonist of the NMDA receptor

B) increases dopamine utilization in the prefrontal cortex

C) reproduces the positive, negative, and cognitive symptoms of schizophrenia

D) impairs feeding regulation in monkeys

A

A mutation of the __________ gene may induce abnormalities of neurons in the __________, which results in schizophrenia.

A) DISC3; hippocampus

B) DISC1; prefrontal cortex

C) DISC3; amygdala

D) DISC4; prefrontal cortex

B

Mania is to __________ as depression is to __________.

A) extreme sadness; extreme elation

B) anxiety; extreme sadness

C) extreme elation; extreme sadness

D) pride; distance and loneliness

C

If Beatriz is experiencing __________, she is likely having an episode of mania.

A) strong feelings of guilt

B) extreme sadness

C) crying spells

D) euphoria

D

Depression is diagnosed __________.

A) four times as often in women than men

B) twice as often in men than women

C) four times as often in men than women

D) twice as often in women than men

D

Diagnosis of __________ is to equal distribution between the sexes as diagnosis of __________ is to higher prevalence in women.

A) schizophrenia; depression

B) depression; schizophrenia

C) bipolar depression; depression

D) depression; bipolar depression

C

Alterations between elation and sadness are to __________ as sadness is to __________.

A) schizophrenia; major depressive disorder

B) major depressive disorder; schizophrenia

C) bipolar depression; major depressive disorder

D) major depressive disorder; bipolar depression

C

If Ronan is experiencing __________, he is likely having an episode of major depressive disorder.

A) strong feelings of euphoria

B) extreme sadness

C) hair pulling

D) high energy

B

Suffering from a major affective disorder carries with it a serious risk of __________.

A) developing delusions and compulsions

B) death by suicide

C) cardiac disease

D) loss of dopamine cells within the prefrontal cortex

B

Which of the following is a symptom of major depressive disorder?

A) better sleep

B) decreased appetite for sex

C) increased appetite for food

D) periods of intense euphoria

B

An example of a positive benefit associated with a manic episode is __________.

A) intense effort at completing a project

B) intense euphoria

C) delusions of grandeur

D) increased energy to take on many projects at once

A

Which is a similarity between mania and depression?

A) Both involve irritability.

B) Both involve a tendency to conduct movements quickly.

C) Both involve having little energy.

D) Both involve sleep issues.

D

The concordance rate of affective disorder for monozygotic twins __________.

A) is identical to that of dizygotic twins

B) is the same whether or not the twins were raised in the same household

C) is five times higher than that for dizygotic twins

D) is less than that noted for close relatives suffering from affective disorder

C

The __________ gene has been implicated in major depressive disorder and the __________ gene has been implicated in bipolar depression.

A) RORA; RORB

B) RORB; RORA

C) depression gene; RORA

D) RORB; depression gene

A

What do monoamine oxidase inhibitors and tricyclic medications have in common?

A) They both increase levels of dopamine.

B) They both increase levels of dopamine and serotonin.

C) They both increase levels of norepinephrine and serotonin.

D) They only increase levels of serotonin.

C

The tricyclic antidepressant drugs are monoamine agonists in that these drugs __________.

A) block the reuptake of norepinephrine and serotonin into the terminals

B) stimulate the release of glycine within the limbic system

C) speed up the reuptake of norepinephrine and serotonin into the terminals

D) block NMDA receptors

A

A key function of monoamine oxidase is to __________.

A) convert norepinephrine into epinephrine

B) convert dopamine into norepinephrine

C) provide the precursor for the catecholamines

D) degrade neurotransmitters

D

__________ is to an SSRI as __________ is to an MAO inhibitor.

A) Citalopram; duloxetine

B) Duloxetine; iproniazid

C) Iproniazid; citalopram

D) Citalopram; iproniazid

D

Fluoxetine (Prozac) is an effective treatment for __________ that works by __________.

A) schizophrenia; blocking dopamine receptors

B) depression and obsessive-compulsive disorder; blocking serotonin reuptake

C) anxiety disorders; inhibition of MAO

D) delusions and hallucinations; blocking serotonin reuptake

B

A serious problem with the use of lithium in treating mania is that __________.

A) lithium can only be used for short periods of time

B) the drug can produce a fatal overdose

C) lithium may not work in up to 50 percent of patients

D) lithium suppresses normal emotions

B

An effective treatment for depression is __________.

A) lithium salts

B) electroconvulsive therapy

C) drugs that increase levels of epinephrine

D) improved sleep

B

The rationale for shocking the brains of mental patients to produce a seizure was that __________.

A) psychiatric patients show abnormal electrical activity of the cortex

B) painful shock made the patients more manageable

C) the occurrence of a brain seizure appeared to reduce symptoms in psychiatric patients

D) large doses of insulin had been shown to normalize brain activity

C

A major difference between electroconvulsive shock therapy (ECT) and treatment using antidepressant drugs is that __________.

A) antidepressant drugs act more rapidly to lift depression than does ECT

B) antidepressant drugs are more likely to impair memory

C) ECT has fewer dangerous side effects

D) ECT lifts depression faster than do antidepressant drugs

D

An effective therapy for treatment-resistant depression involves the use of __________.

A) anticonvulsant drugs

B) fluoxetine

C) electrical stimulation of the vagus nerve

D) electrical stimulation of the subgenual ACC

D

In depression, hyperactivity is to the __________ as hypoactivity is to the __________.

A) orbitofrontal cortex; dorsolateral prefrontal cortex

B) dorsolateral prefrontal cortex; subgenual ACC

C) subgenual ACC; dorsolateral prefrontal cortex

D) orbitofrontal cortex; subgenual ACC

C

Research findings suggest that decreasing activity in the __________ decreases activity in the __________.

A) orbitofrontal cortex; amygdala

B) subgenual ACC; amygdala

C) amygdala; subgenual ACC

D) orbitofrontal cortex; subgenual ACC

B

Researchers who are planning for an experiment recruit a group of depressed persons (with a family history of depression) on medication who are currently feeling well. In the experiment, when these persons are fed a diet low in tryptophan on one day and a cocktail high in amino acids (other than tryptophan) on the following day, they __________.

A) become more aggressive

B) become manic

C) show changes in cognition, but not affect

D) relapse into depression

D

Who would have the best response to antidepressant treatment?

A) someone with one long and one short allele for the 5-HTT transporter gene

B) someone with no alleles for the 5-HTT transporter gene

C) someone with two long alleles for the 5-HTT transporter gene

D) someone with two short alleles for the 5-HTT transporter gene

C

Which statement describes the relationship between treatment of depression and neurogenesis?

A) If neurogenesis is suppressed, antidepressants work better.

B) The time delay for antidepressants to work is shorter than the time it takes neurons to mature.

C) There is no relationship between treatment effectiveness and neurogenesis.

D) The time delay for antidepressants to work is approximately the same as the time it takes neurons to mature.

D

The effect of total sleep deprivation on depression __________.

A) develops slowly

B) is sufficiently large to justify this as an effective way to treat depression

C) is relatively long lasting

D) is lost after a night of sleep

D

The mood disorder characterized by depression, lethargy, sleep disturbances, craving for carbohydrates, and weight gain is called __________.

A) seasonal affective disorder

B) bulimia nervosa

C) the winter blahs

D) zeitgeber-induced depression

A

If someone receives a diagnosis of seasonal affective disorder, which would be an effective treatment?

A) exposing that person to ketamine daily

B) reducing light exposure

C) phototherapy

D) administration of a monoamine agonist

C

Which statement is true regarding seasonal affective disorder?

A) There is no genetic component.

B) Resetting a person's circadian rhythm can help.

C) It is related to the depression gene.

D) It only affects people in warm climates.

B

A key characteristic of the anxiety disorders is __________.

A) the absence of REM brain waves during the awake phase

B) an inability to control euphoria

C) the presence of unfounded feelings of fear and dread

D) a high level of dopamine receptors within the nucleus accumbens

C

Panic disorder __________.

A) occurs about twice as often in women as in men

B) rarely lasts more than a few seconds

C) rarely appears before the age of 35

D) is five times more likely to occur in older men than older women

A

If Antonio has recurring attacks of acute and debilitating anxiety, he likely has a diagnosis of __________.

A) mania

B) adult-onset depression

C) panic disorder

D) reactive depression

C

If Devin constantly feels fearful and fears being away from home or other protected places, she likely has __________.

A) anticipatory panic disorder

B) acrophobia

C) refractory anxiety

D) agoraphobia

D

Which substance regulates neuronal survival and differentiation?

A) RORA

B) BDNF

C) RORB

D) GRM8

B

Which type of drug should be avoided by a person suffering from panic disorder?

A) benzodiazepine agonists

B) tricyclic antidepressants

C) MAO inhibitors

D) benzodiazepine antagonists

D

Which of the following is among the most effective treatments for panic disorder?

A) benzodiazepine drugs

B) tricyclic antidepressant drugs

C) MAO inhibitor drugs

D) ketamine therapy

A

Obsession is to __________ as compulsion is to __________.

A) learned behavior; delusional thought

B) delusion; feeling of emotion

C) thought; behavior

D) a form of species-typical behavior; learned behavior

C

Which statement is true regarding behaviors related to obsessive-compulsive disorder?

A) Individuals with OCD are not aware that their behaviors are unusual.

B) Some believe that behaviors in OCD stem from normal species-typical behaviors that have become disordered.

C) Behaviors are limited to checking and counting behaviors.

D) Individuals with OCD are often not bothered by lack of symmetry

B

Which statement is true of obsessive-compulsive disorder (OCD)?

A) OCD symptoms are different across different cultures.

B) OCD is associated with damage to the basal ganglia.

C) PET scans have shown increased activity in the parietal lobes of OCD patients.

D) OCD is much more common in men than in women.

B

Infections that result in autoimmune disorder and in symptoms of obsessive-compulsive disorder are likely to involve damage of the __________.

A) basal ganglia

B) hypothalamus

C) cingulate sulcus

D) somatosensory cortex

A

In obsessive compulsive disorder, overactivity is to the __________ as underactivity is to the __________.

A) parietal lobes and caudate nucleus; basal ganglia

B) frontal lobes and caudate nucleus; basal ganglia

C) basal ganglia; frontal lobes and caudate nucleus

D) basal ganglia; parietal lobes and caudate nucleus

B

The most effective treatment for obsessive-compulsive disorder is __________.

A) the use of serotonin agonist drugs

B) self-medication using alcohol and cocaine

C) long-term psychotherapy

D) antibiotic drug therapy

A

Which statement is true of trichotillomania?

A) It can be treated with ketamine.

B) It involves intense sadness.

C) It is a symptom of depression.

D) It is a compulsive behavior.

D

Trichotillomania is to __________ as onychophagia is to __________.

A) eating inappropriate items; nail biting

B) hair pulling; nail biting

C) nail biting; hair pulling

D) nail biting; eating inappropriate items

B

Which statement is correct regarding the incidence of schizophrenia?

a) Roughly 10 percent of the world's population is affected.

b) Schizophrenia is primarily diagnosed during childhood.

c) Positive symptoms tend to emerge before negative symptoms.

d) The symptom categories of schizophrenia are universal.

D

How is paternal age related to the incidence of schizophrenia?

a) Paternal age is unrelated to the likelihood of schizophrenia; younger maternal age, however, is a strong predictor.

b) Children of younger fathers are more likely to develop schizophrenia.

c) Children of younger fathers who were themselves children of older fathers are more likely to develop schizophrenia.

d) Children of older fathers are more likely to develop schizophrenia.

D

Research suggests that a deficiency of __________ may contribute to the development of schizophrenia.

a) Vitamin B complex

b) Vitamin C

c) Vitamin D

d) Vitamin E

C

The positive symptoms of schizophrenia are caused by:

a) underactivity of the mesolimbic system.

b) damage to the mesocortical system.

c) overactivity of the mesolimbic system.

d) overactivity of the mesocortical system.

C