Mental Health: A Report of the Surgeon General

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. The definitions of a mental disorder and mental wellness are derived from empirical evidence and are not influenced by values.

a) true
b) false

2. Despite public education, stigma about mental illness remains strong because of:

a) social status
b) fear of violence
c) negative symptoms of mental illness
d) homelessness

3. The preferred research method for assessing causation is:

a) correlational research
b) random sampling
c) experimental research
d) longitudinal studies

4. In the United States today, the highest rates of suicide are found in:

a) adolescent females
b) individuals with schizophrenia
c) young adult males
d) older males

5. The percentage of children ages 9-17 who receive mental health services in a given year is:

a) 5%
b) 21%
c) 12%
d) 32%

6. The study of the origins and causes of disease is:

a) virology
b) neurology
c) etiology
d) epidemiology

7. In the human brain, the area associated with integrating cognitive and emotional streams of information is the:

a) prefrontal cortex
b) parietal lobe
c) cerebral cortex
d) frontal lobe

8. The area of the human brain involved with memory is the:

a) parietal lobe
b) amygdale
c) hippocampus
d) basal ganglia

9. Most neurotransmitter receptors can be divided into two classes. These are:

a) simple and complex
b) excitatory and inhibitory
c) legand-gated and G protein-linked
d) glutamate and neuroteptide

10. A false belief held despite evidence to the contrary is:

a) hallucination
b) delusion
c) psychosis
d) impaired thought

11. Positive symptoms of schizophrenia include all of the following except:

a) agitation
b) hallucinations
c) loose associations
d) anhedonia

12. The percentage of those with a mental disorder who have a co-morbid addictive disorder is:

a) 12%
b) 15%
c) 35%
d) 40%

13. The study of mental illness differs from the study of other diseases because it includes social and psychosocial factors.

a) true
b) false

14. The most influential theories of cognitive development were formulated by:

a) B.F. Skinner
b) Erik Erikson
c) Jean Piaget
d) Konrad Lorenz

15. The ability of an individual to withstand chronic stress is referred to as:

a) resilience
b) protective factors
c) adaptivity
d) preventive factors

16. All psychodynamic theories have in common:

a) belief in the unconscious
b) emphasis on ego-function
c) role of past experiences
d) a and b
e) a and c

17. The difference in results from clinical trial settings and in clinical practice settings is known as:

a) somatic factors
b) efficacy-effectiveness gap
c) controlled-monitoring effect
d) artificial-reality gap

18. Today's mental health delivery system is designed to facilitate access to those with the most complex needs.

a) true
b) false

19. Over-utilization of inpatient treatment by African American individuals has been attributed to:

a) clinician bias
b) social status
c) stigma in the community
d) lack of resources

20. The ability of consumers to influence mental health policy and program design is known as:

a) the liberation movement
b) empowerment
c) reform movement
d) self-help

21. The term "recovery" refers to:

a) a service model
b) restoration of full functioning
c) absence of symptoms
d) meaning and purpose in one's life

22. Mental disorders in children can improve as development takes place.

a) true
b) false

23. The concept of "attachment" was introduced by:

a) Freud
b) Erikson
c) Bowlby
d) Piaget

24. Temperament is believed to be the result of early childhood experiences.

a) true
b) false

25. Central concepts for understanding children's mental health and illness include all of the following except:

a) self-righting tendencies
b) age and timing factors
c) ego factors
d) context

26. Benefits from preventative programs with children have been determined to be primarily:

a) social
b) cognitive
c) educational
d) developmental

27. The field of childhood mental health has historically downplayed diagnosis.

a) true
b) false

28. The most commonly diagnosed behavioral disorder of childhood is:

a) conduct disorder
b) ADHD
c) social disorders
d) learning and communication disorders

29. Cognitive behavioral therapy is the most effective modality in providing changes in behavior in children with ADHD.

a) true
b) false

30. The most common form of mood problems in children is:

a) major depressive disorder
b) dysthymia
c) bipolar disorder
d) reactive disorder

31. In research, behavior therapy has been demonstrated to be effective in reducing symptoms in autism.

a) true
b) false

32. In children's mental health, the clinical intervention with the weakest research support is:

a) outpatient treatment
b) inpatient treatment
c) day treatment
d) residential treatment

33. According to published reports, what percentage of young people with a diagnosable mental disorder actually receive mental health services?

a) 20%
b) 30%
c) 60%
d) 70%

34. The primary focus of family support groups is to provide:

a) Emotional support
b) structure
c) education
d) a and c
e) a and b

35. The multiple problems associated with serious emotional disturbance in children and adolescents are best addressed with:

a) a systems approach
b) a structured residential setting
c) group therapy
d) specialized service delivery

36. According to the findings of Drake and Osher, what percentage of individuals with serious mental illness also develop an alcohol or drug problem?

a) 30%
b) 40%
c) 50%
d) 60%

37. Low-income individuals are considered a high-risk population for mental illness.

a) true
b) false

38. The neurotransmitter associated with the acute-stress response is:

a) serotonin
b) acetylcholine
c) norepinephrine
d) dopamine

39. A major limitation of cognitive-behavioral therapies is:

a) client anxiety
b) avoidance behaviors
c) availability of therapists
d) cost

40. What percentage of those who have been hospitalized for depression commit suicide?

a) 10-15%
b) 15-20%
c) 20-25%
d) 30%

41. Hypomania is characterized by:

a) impairment in judgment
b) psychosis
c) increased energy and creativity
d) all of the above

42. ender differences in the prevalence of depression vary in different cultures.

a) true
b) false

43. The response rates for ECT and pharmacology are comparable.

a) true
b) false

44. The course of schizophrenia is believed to be influenced by which of the following factors?

a) personal orientation
b) family support
c) socioeconomic factors
d) all of the above

45. A potentially fatal blood disease found in about one percent of patients taking Clozapine is:

a) leukemia
b) agranulocytosis
c) aplastic anemia
d) hemochromatosis

46. Assertive Community Treatment Programs have demonstrated high effectiveness rates in all of the following areas except:

a) reduction of inpatient hospital days
b) housing
c) employment
d) community tenure

47. The priority concern for persons with serious mental illness is:

a) income
b) health benefits
c) supportive services
d) housing

48. With co-occuring mental health and substance abuse problems, evidence supports:

a) treating substance abuse first to determine the etiology of symptoms
b) treating mental health issues first to end self-medicating use
c) simultaneous, combined treatment
d) inpatient treatment

49. What percentage of older adults aged 55 and older experience mental disorders not considered part of normal aging?

a) 20%
b) 23%
c) 30%
d) 33%

50. Memory complaints in older people are considered to primarily be caused by:

a) changes in the hippocampus
b) decreased amount of stimulation
c) depression
d) normal aging process

51. Older adults most likely encounter a higher risk of side effects from medications because of:

a) lowered metabolism
b) decreased physical activity
c) taking multiple drugs
d) physical effects of aging on organs

52. Risk factors for late-onset depression include all of the following except:

a) loss of spouse
b) retirement
c) educational level less than high school
d) alcohol consumption

53. The prevalence of clinically significant depression in later life is estimated to be highest in individuals:

a) living below the poverty level
b) with chronic illness
c) without family support
d) who are widowed

54. Genetic factors play a significant role in the development of Alzheimer's disease.

a) true
b) false

55. The most common form of substance abuse in older adults is:

a) prescription drugs
b) over-the-counter medications
c) alcohol
d) illicit drugs

56. The majority of older adults with severe and persistent mental illness are treated in a nursing-home setting.

a) true
b) false

57. Because of complications from co-morbid physical and mental health issues, which of the following may be clinically counter-indicated in treating older adults?

a) carved-in mental health services
b) carved-out mental health services

58. In the United States, the majority of adults access mental health services through which sector of the de facto mental-health service system?

a) specialty mental health sector
b) general/medical primary-care sector
c) human services sector
d) voluntary support network

59. Studies have shown that the primary reason for not seeking mental-health care by those who perceived a problem was:

a) stigma
b) belief that the problem would go away
c) difficulties in obtaining services
d) cost

60. Most of the indirect costs of all mental illness are reflected by:

a) loss of productivity in usual activities
b) loss of productivity because of premature death
c) loss of productivity because of incarceration
d) loss of productivity because of family-care giving needs

61. Virtually all of public funding for mental-health and substance-abuse services remains separate.

a) true
b) false

62. In the past two decades, the shift in responsibility for mental-health services has leaned toward:

a) private insurance companies
b) individuals
c) federal government
d) state government

63. To reduce "moral hazard," insurance companies often:

a) charge higher premiums
b) restrict services
c) limit amount of visits
d) incorporate cost-sharing policies

64. The majority of Americans are now covered by what type of medical insurance?

a) managed care
b) fee for service
c) public-sector insurance
d) unmanaged fee for service

65. Current incentives for health care within and outside of managed care encourage an emphasis on quality of care.

a) true
b) false

66. The Mental Health Parity Act of 1996 prohibited:

a) co-payments for mental-health care
b) per episode limits on lengths of stay
c) annual and lifetime limits on coverage
d) high deductibles for mental-health care

67. The principle of confidentiality is designed to advance the value of:

a) reducing stigma
b) fostering trust
c) furthering individual autonomy
d) all of the above

68. The majority of states that have enacted "duty to warn" laws typically provide that a clinician can be held liable if he or she does not act.

a) true
b) false

69. The Surgeon General's Report cites shortages in mental health in all of the following areas except:

a) rural areas
b) cognitive therapists
c) severe and persistent mental illness
d) older adults

70. In states requiring parity, cost increases have been shown to be almost imperceptible as long as:

a) preventive measures are in place
b) care is managed
c) evidence-based models are utilized
d) there is public financing