CAADE Co-Occurring Disorders 2 — Questions and Answers
Question 1: Which screening tool is specifically designed to identify co-occurring mental health disorders in substance use treatment settings?
- AUDIT-C
- MINI International Neuropsychiatric Interview (Correct answer)
- CAGE questionnaire
- DAST-10
Correct answer: MINI International Neuropsychiatric Interview
The MINI International Neuropsychiatric Interview is a structured diagnostic tool validated for identifying psychiatric disorders in substance use populations.
Question 2: A client with PTSD and alcohol use disorder reports drinking to manage nightmares. This pattern is best described as:
- Recreational use
- Self-medication (Correct answer)
- Psychological dependence only
- Tolerance development
Correct answer: Self-medication
Using alcohol to manage PTSD symptoms like nightmares is a classic example of self-medication, where substances are used to cope with mental health symptoms.
Question 3: According to SAMHSA's integrated treatment model, services for COD should be provided:
- Sequentially with substance use treated first
- Sequentially with mental health treated first
- In parallel by separate providers
- Simultaneously by the same treatment system (Correct answer)
Correct answer: Simultaneously by the same treatment system
SAMHSA's integrated treatment model recommends that COD be addressed simultaneously within the same treatment system rather than sequentially or in parallel.
Question 4: Which neurotransmitter system is most implicated in the overlap between depression and stimulant use disorder?
- Serotonin and dopamine (Correct answer)
- GABA and glutamate
- Acetylcholine and norepinephrine
- Endorphin and histamine
Correct answer: Serotonin and dopamine
Both depression and stimulant use disorder involve dysregulation of serotonin and dopamine systems, contributing to mood disturbances and craving.
Question 5: A counselor notices a client's anxiety worsens during weeks when they reduce cannabis use. The MOST appropriate clinical interpretation is:
- The client has treatment-resistant anxiety
- Withdrawal or rebound anxiety from cannabis reduction (Correct answer)
- The treatment setting is causing anxiety
- Cannabis was effectively treating a panic disorder
Correct answer: Withdrawal or rebound anxiety from cannabis reduction
Anxiety that worsens during substance reduction is often withdrawal or rebound anxiety, which is a physiological response to reducing a substance that suppressed anxiety symptoms.
Question 6: In motivational interviewing with COD clients, ambivalence about psychiatric medication is BEST addressed by:
- Providing psychoeducation and exploring the client's own reasons for and against medication (Correct answer)
- Insisting the client take medication before continuing counseling
- Referring immediately to psychiatry without further discussion
- Documenting non-compliance and reducing session frequency
Correct answer: Providing psychoeducation and exploring the client's own reasons for and against medication
MI principles support exploring ambivalence collaboratively, offering accurate information while eliciting the client's own motivation regarding medication.
Question 7: Which of the following is a key principle of trauma-informed care in COD treatment?
- Confronting denial as the primary therapeutic strategy
- Prioritizing safety, trustworthiness, and empowerment (Correct answer)
- Requiring trauma disclosure before substance use treatment begins
- Avoiding discussion of trauma to prevent retraumatization
Correct answer: Prioritizing safety, trustworthiness, and empowerment
Trauma-informed care centers on creating safety, building trustworthiness, and empowering clients, recognizing the widespread impact of trauma on behavior and health.
CAADE Co-Occurring Disorders 2
Which screening tool is specifically designed to identify co-occurring mental health disorders in substance use treatment settings?