Ch.10 Depressive and Bipolar Disorders
Compared to episodes of depression, untreated bipolar episodes __________. a. are shorter in duration b. produce less depression if they are not manic episodes c. recur one after the other, usually lasting only a few days d. are longer in duration and more frequent
a
Disruptive mood dysregulation disorder (DMDD) is a new classification intended to correct the misdiagnoses of __________ in young children. a. bipolar disorder b. MDD c. Manic depression d. ADHD
a
During a parent-teacher meeting about taking preventive measures for children who are at risk for depression, Dean discusses how important it is in his profession to know if any parent or guardian has a history of a depressive disorder. Why should he bring this subject up? a. Children who have a parent (or guardian) who suffers from depression are far more likely to develop depression themselves. b. There is a higher incidence of heritable depression and an at-risk child. c. Such parents are more likely to be in denial and not be willing to seek help for their child. d. The most important and obvious preventive measure for at-risk children begins with treatment of a parent or guardian with depression.
a
For several days, sometimes only a month apart, Megan, 15, felt depressed, bloated, irritable, took no pleasure in cheerleading, could not sleep, and felt tired for days. Her doctor assured her that she likely did not have major depressive disorder. Why? a. Megan's symptoms did not occur in the same 2-week period. b. Her doctor most likely saw her symptoms premenstrual syndrome. c. Megan displayed none of the cognitive problems associated with MDD. d. Megan's episodes of depression were far enough apart to suggest another form of depression that comes with obesity.
a
Given the recurrence of depression in young people, the high comorbidity, associated deficits, and other variables, which of the following statements best states the challenges of "getting well" with depression? a. There is no one treatment for depression with a definite beginning and end. b. Most forms of treatment require medication. c. As they get older, adolescents are more often noncompliant with their medications and begin to use "street drugs." d. There is always a small risk of suicide for adolescents during or post treatment.
a
Most young people diagnosed with BP experience their first episode ___________. a. between the ages of 15 and 19 b. during the early onset period, between the age of 5 and 10. c. by age 10 d. after a period of anxiety or depression
a
Of all the various mood disorders, __________ is marked by frequent verbal temper outbursts. a. Disruptive mood dysregulation disorder (DMDD) b. Dysthymia c. Bipolar disorder (BP) d. Major depressive disorder (MDD)
a
Some children are hardly passive when they experience depression. They can also express themselves with __________. a. episodes of irritability b. feelings of euphoria c. extreme forms of sadness d. a loss of interest in favorite physical activities
a
That part of the brain that responds to reward anticipation is called the __________. a. ventral striatum b. central striatum c. cortex d. posterior medula
a
The average episode of MDD in clinically referred children is __________. a. about 8 months b. typically two weeks in accordance with the DSM-5 criteria c. up to a year if the child has a parent with a history of depression d. about 8 weeks
a
The most common co-occurring symptom of depression in clinic-referred children is __________. a. irritability b. crankiness c. anger d. anomie
a
Unlike, MDD, what makes P-DD of concern for educators as well as mental health care professionals is __________. a. its deleterious impact on a child's development b. the intellectual disability that can last throughout grade school c. its co-occurring ADHD d. that 30 percent of a child's life is spent chronically depressed
a
What is MDD's "double standard"? a. Twice as many females than males suffer from depression. b. African Americans are more than twice as likely not to be diagnosed with MDD and benefit from treatment. c. MDD affects adult women for twice as long.
a
What physical and mental benefit is derived from the secure attachment to a parent--a benefit that is compromised for children who face the loss (or abuse) of a parent? a. The ability to handle distress that can have a negative impact on the emotions b. Responsive and emotionally involved parents who form a protective barrier from environmental stress c. A source of positive reinforcement and feedback for mind and body d. Fewer misperceptions of interpersonal relationships (i.e., trust, confidence in others)
a
Dean, Monique's therapist, attributes her low-test scores for a college entrance exam to the P-DD that impacted her grade and middle school years. What research does he rely on for this observation? a. Research that associates the long-lasting effects of P-DD on cognitive development b. Research that shows a deficit in psycho-intellectual functioning c. Research that shows depressed students are less likely to be motivated to achieve d. Research that suggests students with P-DD have a co-occurring intellectual disability
a Since depression is associated with many other academic and cognitive problems, the long-lasting episodes of P-DD can have extremely harmful effects on intellectual development.
Donald, 16, is a self-described loner, according to the school psychologist, dresses in a way that sets him apart and says the other boys his age "suck." Which of the following current theories might best fit his behavior and depression? a. Interpersonal models b. Behavioral theories c. Psychodynamic theories d. Self-control theories
a and b Interpersonal models view depressive symptoms in adolescence associated with increases in the negative quality and decreases in the positive quality of relationships over time. In this case, Donald's peers. The loss of his father, an environmental change, may also contribute to his depression.
The gradual increase in depression from preschool through grade school can be attributed to __________. a. increased performance and social pressures b. the child's diet, primarily from the increased consumption of fatty foods and refined sugar c. the child's growing self-awareness d. the onset of puberty
a and c
Two mood states associated with the manic phase of bipolar disorder include __________ . a. elation and euphoria b. fear and depression c. energy and displays of unnatural strength or endurance d. elevate and irritable moods
a and d
Ahmed's father has been diagnosed with MDD. This, in part, may explain Ahmed's first symptoms of depression. How many more times likely is his diagnoses likely to be similar to his father's? a. 25 b. 14 c. 75 d. 50
b
An adolescent diagnosed with disruptive mood dysregulation disorder (DMDD) cannot also be diagnosed with simultaneous __________. a. ADHD b. ODD c. CD d. MDD
b
Carla no longer enjoys going to gymnastics class as her body changed with puberty. She no longer enjoys eating, even though she overeats to compensate for what is missing in her life. The term that best describes this state is __________. a. anomie b. anhedonia c. aporia d. affective disorder
b
Consider behavioral and psychodynamic theories of depression. Which example below is a significant change in a child's life or environment that can be a key factor for both theories? a. Parental separation b. The death of a loved one c. A lack of positive reinforcement d. The death of a love object
b
Despite the differences in the nature of the symptoms and duration, P-DD __________. a. can develop into or mimic more serious conditions, such as anorexia nervosa b. can occur before a diagnosis of MDD later in life c. is always a precursor to other depressive disorders d. is really a form of ADHD
b
The text doesn't explain personality disorders, like Allysha's borderline personality disorder, in detail because they are rarely diagnosed until late adolescence or early adulthood. Which of the following are traits or behaviors that Allysha exhibited during her childhood that can make diagnosing a personality disorder difficult, as they're often considered relatively normal during adolescence? a.Cutting and suicidal ideation b.Impulsivity and mood swings c.Listlessness and withdrawal d.Anger and antisocial feelings
b
What is the primary difference between children diagnosed with persistent depressive disorder (P-DD) and other depressive disorders, such as MDD? a. Children with P-DD will not laugh whereas children with MDD will laugh from time to time. b. Children with P-DD have symptoms that are less severe than MDD. c. Children with P-DD have co-occurring eating and sleep disorders that do not exist among children with MDD. d. Children with P-DD have symptoms that are more severe than MDD
b
When can depression be detected in a child? a. Infants can be diagnosed as depressed if they are passive and unresponsive over long periods. b. Children as young as 3 can be identified with age-adjusted diagnostic criteria. c. True, clinical depression can only be diagnosed in adolescents with adult diagnostic criteria. This is because childhood depression leads to adult depression. d. Children usually must be 7 or older for age-appropriate diagnostic criteria to be accurate.
b
Which of the following is not a serotonin reuptake inhibitors (SSRIs) for treating children with depression? a. Celexa b. Lithium c. Prozac d. Zoloft
b
Which of the following is not one of the recognized forms of depressive disorder? a. Major depressive disorder (MDD) b. Minor depressive disorder (mDD) c. Disruptive mood dysregulation disorder (DMDD), d. Persistent depressive disorder (P-DD)
b
Which of the following is not part of the attachment theory sequence for a child with depression? a. Despair b. Disaffection c. Protest d. Detachment
b
Which of the following medications has the FDA approved for use in treating children with BP? a. Lipitor b. Lithium c. Atypical antipsychotics d. Valium
b
Why is depression in young people a quality of life issue? a. Depression causes low self-esteem and self-treatments, such as drugs, alcohol, overeating, and the like. b. Depression makes it harder for them to think clearly and function in every aspect of their day-to-day existence. c. Depression can lead to thoughts of suicide and suicide itself. d. Depression leads to other mental health problems and drug abuse.
b
Why might children with ADHD be perceived by therapists has having some form of childhood depression in the past? a. They are hyperactive, which is a symptom of depression. b. Their symptoms are similar to some of those associated with masked depression. c. Children with ADHD were (and still are) often unhappy over the setbacks they suffer in school. d. Children with ADHD, which is associated with a loss of interest in children with depression.
b
Given the changes in how DMDD has been defined, it has only recently been classified __________ in the DSM-5. a. as a temper dysregulation disorder b. as one of the depressive disorders c. as a severe mood dysregulation disorder d. as not a mild form of Tourette's syndrome
b DMDD was renamed and moved from the Disruptive, Impulse-Control, and Conduct Disorders section of DSM-5 to the Depressive Disorders section.
Mark, 10, doesn't often smile. So, his art teacher tries to give him a reason. She tells him his work looks just "like a cloudy day at the beach." He looks over at another student's cotton ball painting, with the sun's rays in yellow poster paint. "Hers is prettier," he replies, "sunnier." What is the proper term for his style of responding? a. Self-disparaging style b. A depressive ruminative style c. Negative thinking d. Self-critical style
b To focus narrowly and passively on negative events for long periods is referred to as a depressive ruminative style.
Martha thought her daughter Alice was just not getting enough sleep as her moodiness changed to fits of crying and even screaming. Eventually, Alice was diagnosed with a severe form of depression attributed to the suicide of a boy at school whom she didn't even know. Martha thought it was just a "phase." What might Dean, the family therapist, say to calm her fears about "being a bad parent"? a. Martha needs to better "read" her daughter's moods and see things in "crisis mode," especially given that suicide is a factor. b. Many parents don't see depression as not real "just growing pains." c. Dean could say that Martha had done the right thing: seeing the family therapist before Alice's depression expressed more dire behaviors. d. It is normal for a parent not to assume the worse and see depression as temporary.
b and d
Given the various risks and factors involved in developing any form of depression that can be diagnosed, it is an accepted fact that they __________ on a person's emotions. a. have a negative effect b. interact c. dysregulate d. regulate
b and d The genetic, neurobiological, family, cognitive, emotional, interpersonal, and environmental factors are interacting influences that cause multiple pathways to depression.
Allysha suffers from borderline personality disorder (BPD), one of ten personality disorders recognized by the DSM-5. As such, it's not grouped with mood disorders, though it's the most common comorbid personality disorder in which adolescent mood disorder? a.Persistent depressive disorder (P-DD) b.Disruptive mood dysregulation disorder (DMDD) c.Major depressive disorder (MDD) d.Bipolar disorder (BP)
c
Compared to other theories of depression, __________ theories see clinical depression in children as rare to nonexistent. a. cognitive b. attachment c. psychodynamic d. behavioral
c
Given the many associations that depressive symptoms have with a child's academic and intellectual functioning, this association __________. a. primarily experienced in nonverbal skills b. primarily experienced in verbal skills c. is still weak in the broad sense d. is strong in the broad sense
c
In studies of identical twins, where one is diagnosed with BP, there is 65 percent chance the other twin will be diagnosed with BP too. What does such a finding suggest? a. The evidence suggests that possibly more than one genetic vulnerability exists. b. A genetic predisposition for BP exists and may simply present itself at different times. c. A genetic predisposition for BP is likely, however, other factors play a part, too. d. Environmental factors account for the other 35 percent.
c
LeBron and LeTonio are identical twins. Their father Terence has been diagnosed with MDD. This means that, based on studies of twins and other studies of the heritability of depression, the twins __________. a. have a moderate chance of both developing depression, with at least one twin having a 65 percent chance b. are 14 times more likely than non-twins c. still only have a less than 50 percent chance of suffering from depression d. may not ever develop depression because depression can skip a generation
c
Maggie cannot stand to see herself in the swimming pool with others looking at her, who may see her as "so fat" despite the fact that she is over 5 feet tall and has a normal body weight for her body type. What role does her self-image play in depression? a. It internalizes her body shaming. b. It reveals her own incompetence about her negative body image. c. Maggie's perception of herself may heighten her risk for depression. d. It is the most observable manifestation of Maggie's preexisting depression.
c
Maggie continues telling Dean about herself. "I don't have friends. In fact, my friends are chickens around me. They flock together and run away." Dean explains to her about the pathways that her low social status has taken. "Well, clearly you don't sound to me as socially helpless, but there is a second path being taken here." What is that path in Maggie's case? a. Maggie is on that path where she will be socially helpless once her friends ultimately neglect her. b. Maggie is on the path of social isolation and a higher risk of DMDD. c. Maggie may be on an aggressive path, where she faces rejection by her peers. d. Maggie will eventually fall in with other "outsiders," who will then reinforce each other's negative self-esteem.
c
Maggie sees herself as overweight and exhibits many expressions of low self-esteem. What theory of depression emphasizes her mood and vulnerability for further, more dire symptoms? a. The depressogenic theory b. The self-control theory c. Cognitive theories d. Behavioral theories
c
ODD and CD can occurs in as many as __________ percent of children and adolescents with BP? a. 25 b. 50 c. 80 d. 90
c
Oscar, 14, plays his drums for an hour and then stop, throwing his sticks into an imaginary audience. Then he spends the next hour sitting in the Lazy Boy and watching the Cartoon Channel. Then he beats on his drums for another hour and sits in front of the television again—"like a catatonic" his mother tells Dean, the family therapist. Dean describes Oscar's symptoms as being more characteristic of __________. a. bipolar-ADHD syndrome b. hypomanic-depressive disorder c. a cyclothymic disorder d. bipolar I disorder
c
Primary and Secondary Control Enhancement Training (PASCET) and like interventions are derived from __________. a. the psychosocial tradition b. the behavioral therapy tradition c. behavior therapy and cognitive therapy d. the cognitive therapy tradition
c
The alternative term for a mood disorder is "affective disorder." What is operant in the word "affective"? a. An extreme affectation in behavior b. A disabling emotion, such as grief c. The way an emotional state regulates behavior d. The way depression and apathy changes a person
c
The most common co-occurring symptom of depression is ___________. a. rapid eye movement b. suicidal ideation c. irritability d. sadness
c
The most salient feature of DMDD is __________. a. depression coupled with temper tantrums b. disruptive behavior c. severe irritability d. infantile colic
c
What DSM-5 criteria might change the diagnosis of major depressive disorder (MDD) in the subject Joey? a. Suicidal ideation b. Weight loss rather than weight gain c. A manic episode, where he might burst into laughter rather than tears d. A violent act, such as getting into a fight with another child
c
What is the most common diagnosis in children when tested for bipolar? a. BP I b. ADHD c. The milder forms of BP d. Manic depression
c
A useful paradigm in illustrating the increasing use of antidepressants. The use of __________, for example, showed a dramatic uptick in prescriptions during the mid-1990s. a. OxyContin b. Ritalin c. Valium d. Prozac and other SSRIs
d
Allysha describes her experience with borderline personality disorder (BPD). Although it is not classified as a mood disorder, many of Allysha's descriptions of her traits and behaviors reflect similarities to elements of depression. For example, which of her following statements would be recognized as an example of the negative cognitive triad? a.I have worked so hard to stay positive every second of every day. b.I like the new Allysha that I've become. c.I was in an alternative school and I assaulted my teacher. d.What is wrong with you if you want to be with me?
d
Carla, a mother suffering from depression, will surprise her daughter with "something to show I'm not sad all the time." Carla tells the family therapist, Dean, that she just put up an artificial Christmas tree for June 25 to celebrate "Half Christmas." How might Dean interpret this as a matter of parenting and depression? a. Carla may have bipolar disorder since she needs more than one Christmas to show her love. b. Carla is hoping that making her daughter happy will provide for her own emotional needs. c. Dean sees Carla treating herself her depression, not addressing the child's real needs. d. Carla's unpredictable displays are intended to compensate for not meeting the day-to-day emotional needs of Melanie.
d
HPA-axis abnormalities and dysregulation respond to stressors in the environment by the release of __________. a. BDNF b. adrenaline c. hormones d. cortisol
d
Kelli, who identifies as female, has twice tried to kill herself in the past. Although her vegan mother worries about the side effects of so many chemicals in Kelli's body, Dean, their family therapist, recommends that her daughter continue with antidepressants as well as hormone therapy. What evidence might be compelling for his advice? a. Transgender adolescents have a higher incidence of suicide and antidepressants is virtually a mandatory prophylaxis against suicidal ideation. b. Due to the mood swings in hormone therapy, antidepressants will have a beneficial role that far outweighs drug complications. c. Although there can be risks of drug interactions, antidepressants and hormone therapy can be done simultaneously. d. Statistics show that the use of antidepressants is correlated with a lower incidence of suicide among young people
d
Maggie, 14, explains to Dean that seeing him is pointless. "You can't help me like people, like myself!" Why would Dean see this as a cue that cannot be ignored by him, her parents, teachers, and friends? a. Maggie is confused. She either hates all people or hates herself. b. Maggie is clearly suicidal. c. Maggie's depression may result in disruptive behaviors, such as lashing out at the well-meaning. d. Such cues are serious because they express the child's hopelessness.
d
That many parents are not certain they can tell their child is suicidal and that many parents are not aware of their children's mental problems highlight the importance of this monitoring intervention. a. Parent-student counseling b. Proactive school psychologists c. Teaching depressed parents and children problem-solving and coping skills d. School-based screening
d
The prevalence of P-DD among adolescents is approximately __________. a. 1 percent b. 10 percent c. half of that for adolescents with other depressive disorders d. 5 percent
d
The tragic phenomenon of "copycat suicides" among adolescents can, in part, be attributed to __________. a. a form of peer pressure, that is, a desire to famous like the suicide victim b. the lack of skills adolescents have for emotion regulation c. the misperception of blame, which is often symptom of some depressive disorders d. the many young people who develop a depressive disorder within 6 months of the loss of a friend or peer.
d
Vicente, 13, admits to his therapist Dean that, as a Hispanic, he always feels "cheated compared to the other kids and that's why I feel bad all the time." Since Vicente comes from a middle-class home, albeit both parents have to work more than one job, what Vicente says supports current research about a child's depression vis-à-vis his or her ethnicity and socioeconomic background? a. Vicente proves that children from economically stressed backgrounds have a form of depression that is imprinted on the brain early in childhood. b. For Vicente, his socioeconomic stress (SES) results in a misperception of his real circumstances and, with that, a precondition for his depression. c. Vicente evinces a neurological cause for his depression that is specific to Hispanic children. d. For Vicente, that part of the brain that senses reward doesn't connect in a way that makes him feel good about himself.
d
What distinguishes MDD from persistent depressive disorder (P-DD)? a. The symptoms for P-DD are both chronic and far more severe. b. P-DD is the "PDQ" of depressive disorders and, because of its short durations, often confused with the "downs" experienced by children with bipolar disorder. c. More children are diagnosed with P-DD, which is one reason why it is a new category in the DSM-5. d. P-DD is a chronic condition that does not respond well to treatment
d
What interaction could be called the "vicious circle" the child with DMDD and his or her parents? a. The downward spiral in the way the child is unresponsive to a parent's love and care. b. The vicarious feelings of social isolation that the parent's experience through the child. c. The "vicious circle" is the cyclic nature of DMDD, with very few "eyes in the storm" of a child's irritability. d. How the child's irritability is met by parents who respond in kind
d
What is the annual prevalence of MMD for children between the ages of 4 and 18?. a. half b. Between 5 percent and 12 percent c. About 6 percent d. 2 percent to 8 percent
d
What is the attributable difference between just "feeling sad" and depression? a. Depression has a longer duration than sadness. b. Sadness is a normal reaction, whereas depression is abnormal. c. Feelings of sadness are more likely to disappear without intervention. d. There is no attributable difference
d
Why is it possible that the estimates of depression for young people are still too low? a. Many children just don't know that they are depressed. b. The criteria for MDD are too stringent. c. There is a stigma attached to self-reporting depression. d. The number of children diagnosed with MDD do not account for how widespread depression is.
d
Which of the following statements is least likely to be an example of ruminative coping? a. "If she doesn't want to talk to me, I won't to talk to her." b. Lila goes off by herself and writes in her journal, "What is wrong with me? Why does everyone hate me?" c. To hang out with the other girls and look older, like them, Joyce tried to stuff her bra. But the results looked stupid in the mirror. d. Undine takes her tray and sits down at the lunch table with the girls she thinks are spreading rumors about her.
d Ruminative coping styles focus on the symptoms of distress and its causes rather than on solutions.