Chapter 7

Quentin has, in the past, been severely depressed. Recently, however, he has felt mildly ecstatic. He is more energetic than normal, doesn't sleep much, and has some pressured speech. This lasts for about 4 days before leveling off into more normal behavior. What is probably the best diagnosis for Quentin?

)Correct: -bipolar II disorder Incorrect: -cyclothymic disorder -major depressive disorder -bipolar I disorder (The key here is that he is mildly ecstatic, which suggests hypomania. This is indicative of bipolar II disorder.

Antidepressant medications take time to take effect, from to weeks.

2,6

At least half of all cases of bipolar disorder begin before a person reaches the age of __________.

25

Contemporary behaviorists base their approach to the cause of depression on the idea that depressed people have a low rate of

Coreect: -response-contingent positive reinforcement. Incorrect: -learned helplessness. -early childhood losses. -positive cognitive valuations. (Contemporary behaviorists do not base their approach to the cause of depression on positive cognitive valuations.)

Who of the following, based on age alone, would be most likely to commit suicide?

Correct: -51-year old John Incorrect: -75-year old Mary -17-year old Mi Ling -29-year old Thaddeus

______ therapy focuses on the client's dysfunctional thoughts and how to change them through cognitive restructuring.

Correct: -Cognitive behavioral Incorrect: -Humanistic -Interpersonal-sociocultural -Behavioral (Behavioral therapy focuses on behaviors.)

TCAs might be the most appropriate treatment choice

Correct: -when a person has disturbed sleep or appetite as part of the depression. Incorrect: -when a person has chronic depression that has not responded to other medication. -when a person has manic episodes as well as depression. -when a person has hypomanic episodes as well as depression.

Bipolar disorder has a lifetime prevalence rate of Blank______ in the U.S. population.

Correct: -1 percent Incorrect: -5 percent -12 percent -7 percent

The lifetime prevalence of major depressive disorder among U.S. adults is approximately

Correct: -17 percent Incorrect: -9 percent. -25 percent. -41 percent.

The lifetime prevalence of major depressive disorder among U.S. adults is approximately.

Correct: -17 percent Incorrect: -9 percent. -41 percent. -25 percent.

Approximately Blank______ of the adult population will develop persistent depressive disorder (dysthymia) in the course of their lives.

Correct: -2.5 percent Incorrect: -6.5 percent -1 percent -10 percent

Between Blank______ of individuals with major depressive disorder do not achieve symptom relief, even with the best of treatment.

Correct: -60 to 70 percent Incorrect: -5 to 10 percent -25 to 30 percent -85 to 90 percent

How many sessions does contemporary psychodynamic therapy usually involve?

Correct: -8-10 Incorrect: -5-7 -20-30 -12-15

Worldwide, there are about Blank______ suicides a year.

Correct: -800,000 Incorrect: -2 million -250,000 -500,000

Which of the following is true about the effectiveness of CBT and IPT for at least one year post-treatment?

Correct: -Both CBT and IPT are equally effective. Incorrect: -IPT is more effective than CBT. -CBT is more effective than IPT. -Neither CBT nor IPT are effective.

Which of the following is true of interpersonal therapy interventions?

Correct: -Clients are offered feedback on their social skills. -Therapists encourage self-exploration. -Clients are educated on the nature of their depression. Incorrect: -The focus of therapy is on past childhood and developmental issues.

Which of the following is true regarding cognitive-behavioral therapy and behavioral therapy?

Correct: -Cognitive-behavioral therapy and behavioral therapy both meet the criteria for evidence-based treatments. Incorrect: -Only cognitive-behavioral therapy meets the criteria for evidence-based treatments. -Only behavioral therapy meets the criteria for evidence-based treatments. -Neither cognitive-behavioral therapy nor behavioral therapy meet the criteria for evidence-based treatments.

______ disorder symptoms are more chronic and less severe than those of bipolar disorder but do include both hypomanic and depressive symptoms.

Correct: -Cyclothymic Incorrect: -Persistent depressive -Social anxiety -Panic

Which of the following statements regarding lithium are true?

Correct: -It is effective in treating manic episodes. -It is effective in preventing recurrence of manic episodes. Incorrect: -It is effective in preventing recurrence of depressive episodes. -It is effective in treating major depressive disorder.

______, the traditional treatment for bipolar disorder, is effective in treating acute mania symptoms and preventing the recurrence of manic episodes.

Correct: -Lithium Incorrect: -SSRIs -Ibuprofen -Tricyclic antidepressants

Which of the following people would be the least likely to develop a depressive disorder?

Correct: -Myra, who comes from a large, religious family and who is also very spiritual Incorrect: -Jada, who has a Ph.D. in nuclear physics -Jean-Pierre, whose mother suffered from major depressive disorder -Luke, who has many friends who have been able to overcome depression with therapy and medication

Because of the variable nature of bipolar disorder, treatments in addition to lithium may be necessary. Which of the following statements reflect this?

Correct: -People with depressive episodes may need antidepressant medication. -People with psychotic symptoms may need antipsychotic medication. -People with rapid cycling may need an anticonvulsant medication. Incorrect: -People with major manic episodes may need stimulant-based medication.

______ is the use of genetic testing to determine who will and will not improve with a particular medication.

Correct: -Pharmacogenetics Incorrect: -Pharmacology -Medicogenetics -Geneticapharmacology

______ helps people with bipolar disorder understand the nature of the disorder and the reasons that medication is critical to control symptoms.

Correct: -Psychoeducation Incorrect: -Pharmacological intervention -Biofeedback -Hypnotherapeutic intervention

Monique has been experiencing depression for several months. Her doctor puts her on antidepressessants. How long should she continue to take them?

Correct: -She should continue to take them for 4 to 5 months after the depression lifts. Incorrect: -She should discontinue taking them once the depression lifts. -She should continue to take them for the rest of her life to prevent depression from reoccurring. -She should continue to take them for at least a year after the depression lifts.

The cognitive triad consists of which of the following?

Correct: -a negative view of the self -a negative view of the future -a negative view of the world Incorrect: -a negative view of the past

People with bipolar disorder, rapid cycling

Correct: -are at higher risk for suicide. Incorrect: -have a shorter duration of the disorder. -are at higher risk for sleep apnea. -are at lower risk for diabetes.

Brain scans and testing suggest that people with bipolar disorder have difficulties in which of the following?

Correct: -attention -executive functioning -memory Incorrect: -motor abilities

Terrence has been diagnosed with bipolar disorder, and his symptoms are best controlled with medications. Although he will need to remain on medications, which theoretical perspective would emphasize the importance of Terrence maintaining employment, creating interpersonal relationships, and monitoring his overall physical health?

Correct: -biopsychosocial Incorrect: -cognitive behavioral -interpersonal -psychodynamic (A biopsychosocial perspective will encompass monitoring his thoughts, feelings, and behaviors)

Matilda has been on top of the world for the past week. She feels invincible and that she can do no wrong. She is working on solving the world's major problems and is sure she can come up with an answer. She has had very little sleep over the last few days. Matilda is likely suffering from

Correct: -bipolar disorder Incorrect: -dysthymic disorder. -rapid-cycling. -cyclothymic disorder. (Cylcothymia has much milder manic symptoms, called hypomanic, than these.)

Ian has experienced three manic and two major depressive episodes over the past year. Most likely Ian would be diagnosed with

Correct: -bipolar disorder, rapid cycling. Incorrect: -cyclothymic disorder. -major depressive disorder. -bipolar II.

Which of the following is true regarding the administration of interpersonal therapy?

Correct: -clients can administer it to themselves with instructions -nonmedical staff can administer it Incorrect: -only physicians can administer -only psychologists can administer it

Jala has been diagnosed with Bipolar I disorder, but has also been experiencing hallucinations and delusions. Besides Lithium, which might also be prescribed to Jala?

Correct: -clozapine Incorrect: -prozac -xanax -tegretol

Of the following, which therapy based on the resilience model appears to be effective in reducing suicides among those at high risk?

Correct: -cognitive-behavior therapy Incorrect: -Gestalt therapy -behavior therapy -psychodynamic therapy

Behavior therapy for depression includes each of the following except

Correct: -delving into the unconscious traumas which may have contributed to the depression. Incorrect: -beginning with an assessment of activities and social interactions. -teaching clients social skills -helping clients institute changes in their environments.

In general, behavior therapy for depression helps clients

Correct: -develop more positively reinforcing experiences. Incorrect: -adhere to their medication regime. -understand the origins of their depression. -reduce their negative thought patterns.

Seven-year old Felicia has temper outbursts at least three or four times a week, accompanied by severe irritability that her parents and teachers have been unable to control. What would be her likely diagnosis?

Correct: -disruptive mood dysregulation disorder Incorrect: -major depressive disorder -persistent depressive disorder -social anxiety disorder

Which of the following is a disorder in children that is characterized by severe and recurrent temper outbursts and irritability?

Correct: -disruptive mood dysregulation disorder Incorrect: -persistent depressive disorder -social anxiety disorder -major depressive disorder

According to interpersonal and social rhythm therapy, relapses in bipolar disorder can result from which of the following?

Correct: -disturbances in circadian rhythms -problems in interpersonal relationships -stressful life events Incorrect: -development of maladaptive assumptions

Which of the following are somatic alternatives to medication for treatment-resistant depression?

Correct: -electroconvulsive therapy -deep brain stimulation -light therapy Incorrect: -virtual reality

In behavioral activation, which of the following occur?

Correct: -engaging in behaviors that are consistent with core values -record-keeping of the frequency of engaging in rewarding activities -setting of small, weekly goals that gradually increase the frequency of rewarding activities Incorrect: -identifying underlying childhood traumas which may be the cause of the depression

Which of the following symptoms can be used to diagnose a manic episode?

Correct: -excessive participation in potentially dangerous activities -racing thoughts -inflated self-esteem Incorrect: -drowsiness or excessive sleep

According to the sociocultural perspective, individuals develop depressive disorders in response to

Correct: -external life circumstances Incorrect: -changes in circadian rhythms. -a genetic predisposition for sensitivity to anxiety. -lack of education regarding the impact of daily hassles.

People with cyclothymic disorder are never without symptoms

Correct: -for more than 2 months at a time. Incorrect: -for more than 6 months at a time. -at all. -for more than 1 year at a time.

Which lobe of the brain appears to be most involved in bipolar disorder?

Correct: -frontal Incorrect: -temporal -occipital -parietal

As compared to the general population, people with bipolar disorder more often have which of the following specific health issues?

Correct: -higher levels of cholesterol -higher rates of diabetes -higher rates of heart disease Incorrect: -higher rates of cancer

Which educational intervention is a part of behavior therapy?

Correct: -homework assignments Incorrect: -biofeedback -meditation -free association

Clinicians who use Blank______ for bipolar disorder focus on educating clients about medication adherence, giving them a forum to explore their feelings about the disorder, and helping them develop insight about the ways the disorders have altered their lives.

Correct: -interpersonal and social rhythm therapy Incorrect: -psychodynamic therapy -cognitive behavioral therapy -interpersonal therapy (IPSRT is used to treat bipolar disorders by focusing on educating clients about medication adherence, giving them a forum to explore their feelings about the disorder, and helping them develop insight about the ways the disorders has altered their lives.)

Which brief therapy lasts between 12 and 16 weeks and involves managing the interpersonal stress associated with symptoms?

Correct: -interpersonal therapy Incorrect: -medication therapy -cognitive behavioral therapy (CBT does not include collaboration to formulate a treatment plan as does interpersonal therapy.) -psychoanalytic therapy (Psychoanalytic therapy is typically a long-term therapy.)

Some people who experience manic episodes stop taking lithium because

Correct: -it interferes with the euphoria at the beginning of a manic episode. Incorrect: -it is not effective in reducing the frequency of manic episodes. -they no longer need the medication. -it causes the depressive episode to be much more severe.

Each of the following are behavior therapy interventions except

Correct: -journaling. Incorrect: -modeling. -role playing. -coaching.

One of the earliest behavioral formulations of theories of depression regards the symptoms of depression as resulting from

Correct: -lack of positive reinforcement. Incorrect: -environmental stressors. -formation of maladaptive assumptions. -loss of attachment. (Loss of attachment is not a behavioral formulation; it is instead an attachment theory formulation.)

Marissa has been severely down in the dumps for the last several weeks. She is not eating nor socializing, and most mornings she has trouble getting up. This occurred once before about 4 months ago and lasted for 2 months. Marissa is probably experiencing

Correct: -major depressive disorder. Incorrect: -panic disorder. -social anxiety disorder. -bipolar disorder.

Symptoms of PMDD include all of the below, except:

Correct: -mania Incorrect: -anxiety -irritability -depressed mood

Bipolar disorder involves an intense and very disruptive experience of a Blank______ episode, which may also occur in alteration with major depressive episodes.

Correct: -manic Incorrect: -dysthymic (Dysthymia is a disorder in and of itself and means low-level, chronic depression.) -dysphoric -hallucinatory

Which of the following are side effects of taking lithium?

Correct: -mild central nervous system disturbances -serious cardiac effects Incorrect: -severe muscular cramping -sexual dysfunction

Tremenitia cannot remember a time when she was not mildly depressed since the age of 16. Now, at 23, she works at her job, goes out with friends, and functions from day to day, but stills suffer from some sleep problems, low energy, low self-esteem, and ongoing feelings of hopelessness. She is probably suffering from which of the following?

Correct: -persistent depressive disorder Incorrect: -cyclothymic disorder -disruptive mood dysregulation disorder -major depressive disorder

The DSM-5 defines a manic episode as "increased activity or energy, lasting at least 1 week and

Correct: -present most of the day, nearly every day." Incorrect: -having at least one grandiose symptom." -present every other day for the duration of the episode." -continuing for at least another week."

Individuals develop feelings of grandiosity and elation or become hyperenergetic as an unconscious defense against sinking into gloom and despair. This is the explanation for bipolar disorder from which perspective?

Correct: -psychoanalytic Incorrect: -sociocultural -cognitive -behavioral (The key phrase in the question is "unconscious defense," which is not part of the behavioral theory.)

SNRIs selectively block the Blank______ of norepinephrine and serotonin.

Correct: -reuptake Incorrect: -effect -production -development

Increasing evidence points to the role of which neurotransmitters in the development of major depressive disorder?

Correct: -serotonin -norepinephrine Incorrect: -GABA -dopamine

According to the Blank______ perspective, individuals develop depressive disorders in response to external life events.

Correct: -sociocultural Incorrect: -biological -physiological -psychological

Which of the following contribute to an individual having a lower chance of developing major depressive disorder?

Correct: -strong religious beliefs -social support -spirituality Incorrect: -personal fable

According to psychoanalytic theory, people with depressive disorders

Correct: -suffered a loss early in life that affected them at a deep, intrapsychic level. Incorrect: -unconsciously felt that their mothers never loved them. -suffered from the phenomenon known as learned helplessness. (Psychoanalytic theory does not include the concept of learned helplessness.) -suffered from maladaptive assumptions learned in childhood. (Maladaptive assumptions suggest cognitive theory, not psychoanalytic theory.)

Which of the following are common side effects of the SNRIs?

Correct: -suicidal thoughts or attempts -memory loss -confusion -gastrointestinal problems Incorrect: -increased motor activity

Which of the following are considered suicidal behaviors?

Correct: -suicide attempt -plan development -suicidal ideation Incorrect: -plea for attention

Each of the following is a phase of treatment in interpersonal therapy except

Correct: -the administration of medication. Incorrect: -treatment being carried out, using various methods based on the primary problem. -client and therapist collaborating on a treatment plan. -assessing the magnitude of the depression.

The rate of suicide is underreported due to

Correct: -the difficulty of establishing cause of death as intentional rather than unintentional. Incorrect: -the fear of encouraging copycat suicides. -the desire to protect the good names of the families. -the fact that families can not collect insurance if the death is reported as a suicide.

MAOIs might be the most appropriate treatment choice

Correct: -when a person has chronic depression that has not responded to other medication. Incorrect: -when a person has disturbed sleep or appetite as part of the depression. -when a person has manic episodes as well as depression. -when a person has hypomanic episodes as well as depression.

Contemporary psychodynamic approaches to treatment focus on repairing the core of the individual's disturbed attachment.

False

The lifetime prevalence rate of persistent depressive disorder was higher in the United States than in Finland.

False

There are no significant differences in suicide rates between high-income and low-middle-income countries.

False

To get a diagnosis of bipolar II disorder, an individual must have had at least one major depressive episode and no hypomanic episodes.

False

True or false: Surprisingly, people with bipolar disorders have a higher life expectancy than the general population.

False (According to a comprehensive population study conducted in Denmark, bipolar disorder is associated with lower life expectancy.)

True or false: Because of activation within the brain's internally based attentional circuits, people with major depressive disorder focus their attention outward.

False (Alterations in neurotransmitters can cause activation within the brain's internally based attentional circuits, so that rather than focus their attention outward, individuals with major depressive disorder become overly preoccupied with their thoughts and feelings.)

True or false: People whose mood disorders are primarily biological in origin should only be treated with medication.

False (Even individuals whose mood disorder symptoms reflect a heavy influence of biology should have access to a range of therapeutic services.)

__________ is a self-inflicted destructive act with explicit or inferred intent to die.

Suicide

According to the minority stress model, racism and homophobia can lead to high levels of chronic stress.

True

Clinicians diagnose people who have manic episodes with bipolar disorder, a term that has replaced "manic depression."

True

SSRIs work by blocking the uptake of serotonin.

True

Clinicians diagnose people who have manic episodes with bipolar disorder, a term that has replaced "manic depression."

True (Clinicians diagnose people who have manic episodes with bipolar disorder, a term that has replaced "manic depression.")

True or false: The best antidepressant medication for a client is determined by the clinician, often following a process of trial and error.

True (Ultimately, the medications the individual receives may be selected by trial and error as the clinician attempts to identify which work best and produce the fewest side effects.)

In the method known as __________ __________ for depression, the clinician helps clients identify activities associated with positive mood.

behavioral activation

The __________ perspective helps to understand that people commit suicide because of physiological contributions, distorted cognitive processes, and stressful environments

biopsychosocial

The __________ hypothesis of suicidality describes resilience as a mediator to suicide, even among high-risk individuals.

buffering

Exposure to __________ strains can lead to persistent feelings of hopelessness.

chronic

The body's biological clock, called __________ rhythms, may contribute to a mood disorder when disrupted.

circadian

Clinicians who use __________ behavioral therapy work with their clients to try to challenge the nature of their thought processes.

cognitive

The __________ __________ is a negative view of the self, the world, and the future.

cognitive triad

The minority stress model posits that chronic levels of high stress due to societal oppression can lead to higher levels of __________.

depression

__________ an essential element of a depressive disorder, is an unusually elevated sad mood.

dysphoria

To receive a diagnosis of bipolar disorder, rapid cycling, an individual must have experienced __________ or more episodes within the previous year.

four

People with a(n) __________ attachment style have a greater risk for developing depressive disorders in adulthood.

insecure

Bipolar disorder is diagnosed if an individual experiences a __________ episode.

manic

Psychoanalytic explanations of bipolar disorder propose that __________ episodes are defensive responses through which individuals stave off feelings of inadequacy, loss, and helplessness.

manic

Clinicians treating people with bipolar disorder customarily turn first to pharmacological interventions but are also likely to incorporate __________ interventions designed to develop better coping skills.

psychological

If a person has bipolar disorder and has had four or more episodes within the last year, they would would most likely be given the diagnosis of bipolar disorder, __________ __________.

rapid cycling

According to the buffering hypothesis, an important factor that may prevent a high-risk person from committing suicide is __________.

resilience

Interventions based on the __________ model assess and strengthen the client's feelings of personal control and perceived abilities to handle stress.

resilience

IPT is an especially valuable for clients who are unable to __________.

take medication