Substance Abuse
1)

What do family, twin, and adoption studies suggest about the heritability of substance use disorders?
 
Heritability estimates range from 40% to 60% for alcohol and many drugs There is no evidence of genetic influence on addiction Heritability is less than 5% for most substances Adoption completely eliminates genetic vulnerability
 
2)

Which gene has been most studied for its role in addiction due to its link with dopamine receptor density?
 
DRD2 (dopamine D2 receptor gene) ACTH (adrenocorticotropic hormone gene) APOE (apolipoprotein E gene) HBB (hemoglobin beta gene)
 
3)

What role does the extended amygdala play in addiction and relapse?
 
It enhances memory recall for substance-related cues It improves impulse control under stress It reduces withdrawal symptoms and cravings It becomes overactive during withdrawal, creating stress and emotional dysregulation that drive relapse
 
4)

According to cognitive-behavioral theories, what often drives the cycle of substance use?
 
Distorted thoughts and learned behavioral patterns that link substances with relief Purely genetic predisposition and neurochemical imbalance A lack of access to substances in the environment Random chance and coincidence
 
5)

In the CBT model of addiction, which step follows a distorted thought such as ‘One drink won’t hurt’?
 
Trigger Thought Consequence Recovery
 
6)

What was Lena’s core belief in the vignette that fueled her reinforcement cycle of drinking wine?
 
“Drinking will make me popular.” “Wine helps me work faster.” “I can’t relax without a glass of wine.” “Alcohol improves my creativity.”
 
7)

From a psychodynamic perspective, addiction is best understood as:
 
An attempt to soothe unresolved inner conflicts and unmet emotional needs A conscious decision to maximize pleasure at all costs A behavior entirely caused by faulty brain chemistry A simple habit with no deeper meaning
 
8)

According to Khantzian’s Self-Medication Hypothesis, what motivates people to choose specific substances?
 
They use substances as tools to manage unbearable emotional states such as anger, anxiety, or depression They randomly experiment with drugs without any underlying reason They choose substances strictly based on cultural availability They are motivated solely by social pressure from peers
 
9)

In the casevignette, why did Anthony rely on alcohol for many years?
 
He enjoyed the taste and variety of alcoholic drinks He wanted to fit in with friends at social gatherings =c) It was the only tool he knew to calm the deep anxie It was the only tool he knew to calm the deep anxiety wired into him from childhood experiences He believed alcohol improved his work productivity
 
10)

From an object relations perspective, what do substances often function as for people with early attachment wounds?
 
A chemical enhancer of productivity A tool for peer acceptance and social status A way to improve memory and concentration A surrogate attachment figure providing the illusion of safety and consistency
 
11)

In the case vignette, why did Samantha describe alcohol as feeling like ‘a friend waiting for me at the end of the day’?
 
It gave her more energy for work tasks It symbolized the dependable comfort and stability she never fully received from her caregivers It helped her feel more socially confident at parties It increased her ability to concentrate on legal cases
 
12)

Which concept from learning theory best explains why Mark experienced intense cravings when passing the pub after work on Friday nights?
 
Operant conditioning Observational learning Classical conditioning Social reinforcement
 
13)

According to Bandura’s Social Learning Theory, how do many people first learn about substance use?
 
By reading medical pamphlets in school Through random experimentation without influence By observing family members, peers, or cultural role models using substances By studying clinical research about addiction
 
14)

How can clinicians apply Social Learning Theory in recovery work?
 
By encouraging clients to observe and imitate positive role models in therapy, peer groups, or communities By removing clients from all forms of social contact By focusing only on genetic explanations of addiction By ignoring cultural influences on behavior
 
15)

In Jordan’s case vignette, what was the main reason he started drinking?
 
He enjoyed the bitter taste of beer He wanted to improve his school performance He wanted to feel a sense of belonging with his peer group He was pressured by his parents to drink at home
 
16)

From a family systems perspective, addiction is best understood as:
 
Part of the larger emotional ecosystem of the family, affecting and being affected by all members A problem that belongs solely to the individual who uses substances A random event unrelated to family dynamics A behavior determined only by cultural norms outside the home
 
17)

In addicted families, what role is typically characterized by perfectionism, overachievement, and fear of failure?
 
Mascot Hero Scapegoat Lost Child
 
18)

What is meant by the term “intergenerational transmission” in the context of addiction?
 
The biological passing of addiction through DNA alone A cultural phenomenon that only affects grandparents The way substance misuse, trauma, and coping strategies are passed down through family patterns across generations A process where recovery cannot influence future family members
 
19)

Why do many adolescents or young adults begin using substances in peer settings?
 
Because they are biologically more addicted than older adults Because they enjoy the bitter taste of alcohol or drugs Because they want to belong, fit in, and share in what others seem to enjoy Because health classes encourage experimentation
 
20)

In Sophie’s case vignette, what belief pushed her into drinking at the party?
 
That alcohol would improve her grades That drinking would help her athletic performance That her parents expected her to drink That ‘everyone is doing it,’ even though only a few were actually drinking
 
21)

Which of the following is an example of an intervention targeting perceived norms around substance use?
 
Mentorship programs Refusal skills training Social norms media campaigns Genetic counseling
 
22)

According to sociocultural theories, what makes cultural messages so influential in shaping substance use?
 
They are consciously ignored by most individuals They only affect adolescents, not adults They teach people what is considered “normal,” acceptable, or taboo regarding substance use They are limited only to television advertisements
 
23)

In cultures where heavy episodic drinking is tolerated or celebrated, how might individuals who drink heavily perceive their behavior?
 
As shameful and abnormal As sociable, affirming, or even a source of cultural pride As medically irresponsible As unrelated to their identity or community
 
24)

What effect do higher alcohol taxes typically have on consumption, especially among young people?
 
They decrease overall consumption They increase consumption by making alcohol seem more valuable They have no measurable impact on drinking behavior They only affect older adults with steady income
 
25)

What is the primary difference in focus between the DSM-5-TR and ICD-11?
 
The DSM-5-TR is used internationally, while ICD-11 is used only in the U.S. The DSM-5-TR provides a detailed, clinically focused picture for U.S. practice, while ICD-11 emphasizes accessibility across cultures and global health systems The DSM-5-TR applies only to adolescents, while ICD-11 applies only to adults ICD-11 eliminates substance-related diagnoses altogether
 
26)

How did the DSM-5-TR change the way substance problems are categorized compared to earlier editions?
 
It eliminated all diagnostic labels related to substance use It divided people more strictly into abuse versus dependence It replaced ‘abuse’ and ‘dependence’ with a single diagnosis: Substance Use Disorder, measured on a continuum of severity It reduced all categories to one general “addictive disorder” without criteria
 
27)

According to DSM-5-TR, how many symptoms must be present within a 12-month period to diagnose a mild substance use disorder?
 
2–3 symptoms 4–5 symptoms 6 or more symptoms Only 1 symptom is required
 
28)

How did the DSM-I (1952) and DSM-II (1968) describe substance-related problems?
 
As clearly defined medical conditions with operational criteria As primarily neurological disorders with precise thresholds As vague “addictions,” “habit disturbances,” or “drug dependence,” reflecting stigma and limited science As spectrum-based disorders with severity levels
 
29)

What was the key innovation of the DSM-III (1980) in diagnosing substance use?
 
It eliminated all diagnostic categories for substance use It merged abuse and dependence into one unified diagnosis It introduced operationalized criteria distinguishing substance abuse from substance dependence It classified addiction solely as a personality disorder
 
30)

Which major change did DSM-5 (2013) introduce regarding substance use disorders?
 
It eliminated craving as a diagnostic feature It kept abuse and dependence as separate diagnoses It removed severity levels from diagnoses It unified abuse and dependence into one diagnosis—Substance Use Disorder—measured on a continuum of severity
 
31)

Why are structured interviews like the SCID-5 valuable in assessing substance use disorders?
 
They prevent clients from exaggerating symptoms They guarantee a faster diagnosis every time They ensure consistency across clients and help clinicians avoid overlooking important details They replace the need for clinical judgment entirely
 
32)

In Carlos’s vignette, what was the significance of using both the AUDIT and DAST-10 screeners?
 
They showed he had no problems with alcohol or drugs They were used mainly to confirm what Carlos initially reported They allowed the counselor to avoid asking direct questions about use They revealed patterns Carlos minimized at first, showing the value of screening for all substances
 
33)

What is one advantage of dual coding a client’s diagnosis in both DSM-5-TR and ICD-11 formats?
 
It ensures clarity and continuity of care if records are shared across countries or health systems It avoids the need for documenting functional impacts of substance use It eliminates the possibility of insurance denials altogether It guarantees that treatment will always be fully covered by insurance
 
34)

What does the term “comorbidity” (or dual diagnosis) mean in the context of substance use disorders?
 
A person who has relapsed multiple times after treatment A person who meets criteria for both a substance use disorder and another psychiatric condition A person who has switched from one substance to another A person who experiences withdrawal without tolerance
 
35)

Approximately how many U.S. adults experienced both a mental illness and a substance use disorder in 2022?
 
5.5 million 10.2 million 21.5 million 40 million
 
36)

Why is integrated care (treating both conditions together) recommended for clients with comorbidity?
 
It guarantees sobriety within three months It avoids the need for any psychiatric medication Because treating only one condition (SUD or mental illness) often fails, while integrated care leads to far better outcomes Because it eliminates the need for relapse prevention strategies
 
37)

How can clinicians distinguish between primary depression and substance-induced depression in clients with both conditions?
 
By testing only family history of depression By assuming all depressive symptoms are caused by substance use By checking for tolerance and withdrawal symptoms only By examining the timeline—whether depressive symptoms began before substance use and persist after 4–6 weeks of sobriety
 
38)

What treatment risk must medical personnel be cautious about when prescribing benzodiazepines to clients with anxiety disorders and SUDs?
 
They may permanently cure anxiety within a few weeks They have no effect on panic symptoms They carry a high risk of dependence and can worsen the cycle of anxiety and withdrawal They are ineffective for any short-term anxiety relief
 
39)

Why do PTSD and substance use so often co-occur?
 
Because substances provide temporary relief from trauma symptoms but ultimately worsen them through disrupted sleep, tolerance, and withdrawal Because trauma memories are permanently erased when substances are used Because PTSD prevents the body from metabolizing alcohol and drugs Because PTSD clients universally prefer substances to therapy
 
40)

Why is diagnosing bipolar disorder with co-occurring substance use often difficult for clinicians?
 
Because bipolar disorder is unrelated to substance effects Because clients rarely use substances during manic or depressive episodes Because substance effects (e.g., cocaine intoxication, alcohol withdrawal) can mimic mood episodes Because bipolar disorder has no overlapping symptoms with SUDs