Psychological Disorders (Chapter 11 book & online)
What is the one year prevalence of cyclothymia? Is there gender differences?
0.4%; no
What are the three types of bipolar disorders?
1. Bipolar I disorder 2. Bipolar II disorder 3. Cyclothymic disorder
What are three types of bipolar disorders?
1. Bipolar I disorder 2. Bipolar II disorder 3. Cyclothymic disorder
What are three good therapies for mood disorder?
1. Cognitive behavioral therapy 2. learned helplessness paradigm 3. psychodynamic treatment
What are the two broad categories of mood disorders?
1. Depressive disorders 2. Bipolar disorders
What are six treatments for depressive disorders?
1. antidepressants 2. ECT 3. transcranial magnetic stimulation (TMS) 4. cognitive-behavior therapy 5. behavioral therapy 6. phototherapy
What are five broad kinds of symptoms in mood disorders?
1. emotional 2. motivational 3. behavioral 4. cognitive 5. somatic
What are three treatments for bipolar disorders?
1. lithium carbonate (for the manic phase of Bipolar I disorder) 2. cognitive-behavioral therapy 3. adjunctive interpersonal therapy
What are the four types of depressive disorders?
1. major depressive disorder 2. persistent depressive disorder (dysthymia) 3. disruptive mood dysregulation disorder 4. premenstrual dysphoric disorder
What are the three mood episodes?
1. major depressive episode 2. manic episode 3. hypomanic episode
What are five causes of mood disorders?
1. neurotransmitters: 5-HT and NE 2. Ions: Na and K 3. brain structure: basal ganglia and cerebellum 4. hormonal dysregulation: HPA axis, stress 5. genetic: polygenetic
What are six biological treatments for mood disorders?
1. norepinepherine and serotonin 2. tricyclics block reuptake of norepinepherine 3. MAO inhibitors prevent breakdown of NE 4. SSRI's prevent reuptake of serotonin 5. polypharmacy: fairly common now 6. ECT- works very quickly
What are six risk factors for suicide?
1. previous suicide attempt 2. contemplated method at hand 3. being a male 4. hopelessness 5. diagnosis of mood disorder or schizophrenia 6. previous psychiatric admissions
What are Beck's three inner statements?
1. the person may exaggerate the magnitude of obstacles, responding to any minor frustration with thoughts such as "I might as well give up" 2. the person may interpret relatively trivial events as important issues 3. the person may be continually self-disparaging, magnifying criticisms and insults
What is the prevalence of bipolar for 12 months? Bipolar I? Bipolar II?
1.3-1.6% I: 1.6% II: 1%
In the U.S., suicide ranks among the top ____ leading causes of death.
10
Disruptive mood dysregulation disorder: before age ____, recurrent severe ____ ____, ____ or more times per week, for at least ____ month(s). Must occur in at least ____ settings. More common among ____. What is the prevalence?
10, temper outbursts, 3, 12. 2. males. 2-5%
Up to ____% of people who have a hypomanic episode will also develop a manic episode
15
Females are ____-____ times more likely than men to have a unipolar (depressed) disorder.
2-3
What is the lifetime prevalence of mood disorders?
20.8%
Depressive disorders may be ____ times higher among first-degree relatives of people with the condition.
3
Females make nearly ____ times as many suicide attempts as males.
3
Males succeed at suicide at near ____ times the rate of females and represent almost ____% of suicide deaths.
4, 80.
What is the hereditability for depressive disorders?
42% for females and 29% for males
Antidepressants are effective for ____-____% of outpatients in treating depression.
50-70
For a major depressive episode, you must have ____ or more symptoms for ____ weeks.
5; 2
What is the best predictor of suicide?
A previous suicide attempt
View that depression is caused by a pessimistic attribution style that emphasizes internal, stable, and global factors to explain personal problems.
Attribution model of depression
Covert self-statements, often pessimistic and negative, that occur readily and may contribute to depression.
Automatic thoughts
Referring to the two extreme poles of mood: mania and depression.
Bipolar
Manic or mixed episodes.
Bipolar I
No full-blown manic episode, has been hypomanic with a MDE.
Bipolar II
____ disorder is associated with the highest risk of suicide among male veterans, while among female veterans the highest risk was among those with ____ ____ disorders.
Bipolar, substance use
Periods of hypomanic and depressive symptoms, not either a manic or major depressive episode, symptoms last at least 2 years.
Cyclothymia
What was persistent depressive disorder formerly known as?
Dysthymia.
Repetitively imitating the movements of others.
Echopraxia
Therapeutic induction of convulsive seizures by applying electrical current to the head; found to have some effectiveness with severe depression
Electroconvulsive therapy (ECT)
True or False? In bipolar I disorder, there is a major depressive episode plus a hypomanic episode.
False
True or False? Major depressive episodes tend to be briefer in duration than manic episodes.
False
True or False? The major depressive episode, the manic episode, and the hypomanic episode are diagnoses in the DSM-5.
False
True or false? Presently, the MAO-Inhibitors are generally the first-line medical treatments for depression.
False
True or false? There are clear neuroanatomical causes of major depressive disorder.
False
Similar but less severe than a manic episode. At least 4 days of elevated, expansive, or irritable mood with no psychotic symptoms
Hypomanic episode
Cyclothymia disorder was on Axis ____ and Bipolar was on Axis ____.
I, II
(a cause of depressive disorders) in psychoanalytic theory, part of the process of identification, whereby a person incorporates or internalizes the characteristics of others.
Introjection
The theory that depression is caused by a lack of connection between responses and their outcomes (i.e., a lack of control over events)
Learned helplessness
What is primarily used for bipolar disorder? What else?
Lithium; also, anticonvulsants (valproic acid/carbamazapine)
In MDE/MDD there is a genetic component: MZ: ____% and DZ: ____%
MZ: 54% DZ: 19%
What is the MZ and DZ concordance for bipolar disorder?
MZ: 79% DZ: 24%
What is the most commonly diagnosed disorder among adults?
Major depressive disorder
2-week period of nearly constant depressive symptoms such as sadness, loss of interest or pleasure, changes in weight, changes in sleep, loss of energy, agitated or slow movement, difficulty concentrating, guilt, and/or thoughts of death. Must represent a change from previous functioning. Some people may experience psychotic symptoms
Major depressive episode
What is the 12-month prevalence of MDE/MDD in males and females? What is the lifetime prevalence of MDE/MDD?
Males: 7.7-12.7% Females: 12.9-21.3% Lifetime: 10.3-17.1%
Abnormally and persistently elevated, expansive, or irritable mood lasting at least a week.
Manic episode
At least 1 week of expansive, elevated, or irritable mood. Grandiose or inflated self-esteem, little need for sleep, pressured speech, flight of ideas, and distractibility. May include angry outbursts and hostility. May be incoherent
Manic episode
____ ____ ____ is less severe than major depression, always chronic, depressed mood most of the the day for the majority of days for 2 years, symptoms absent for over 2 months.
Persistent depressive disorder.
Use of board-spectrum light to treat seasonal depression.
Phototherapy
What is usually the first-line medical treatment for depression? What is another medication used?
SSRIs, tricyclics and MAO-Is
How many suicides and how many homicides are committed in the U.S.?
Suicides: 27,000 Homicides: 17,000
Pulsed magnetic stimulation of the brain, as a treatment for severe depression.
Transcranial magnetic stimulation (TMS)
True or false? Females are more likely than males to attempt suicide.
True
True or false? Generally, younger people tend to have higher overall rates of depression than those in later life.
True
True or false? The diagnosis of bipolar I disorder requires the occurrence of a manic episode.
True
True or false? The first antidepressant drugs were originally created to treat tuberculosis.
True
What is the difference between unipolar and bipolar disorders?
Unipolar: depression only Bipolar: depression and mania
Suicide rates are much higher among who?
White and Native American/Native Alaskan males than other groups
All of the following are categories of suicidal acts defined by Baechler (1979) according to the meaning of the act to the person committing it, EXCEPT ______. a. an academic or career conflict b. an act of sacrifice c. aggression d. an escape from an intolerable situation
a.
All of the following are mood disorders new to the DSM-5, EXCEPT ______. a. bipolar II disorder b. premenstrual dysmorphic disorder (PMDD) c. disruptive mood dysregulation disorder d. persistent depressive disorder
a.
Antidepressants are ______ cognitive therapy in treating ______ depression, according to research. a. as effective as; most b. more effective than; all c. better than; severe d. less effective than; all
a.
Between 15% and 50% of those diagnosed with cyclothymic disorder subsequently develop ______. a. one of the bipolar disorders b. schizophrenia c. disruptive mood dysregulation disorder d. major depression
a.
Chocolate, cheese, some meats, and some wines contain the amino acid tyramine, which should be avoided by those who take which of these medications? a. MAO-Is b. tricyclics c. SSRIs d. lithium
a.
Estrogen-related changes, which are often the context for mood disorders in women, occur in all of the following EXCEPT ______. a. seasonal affective disorder b. menopause c. premenstrual dysphoric disorder d. post-partum onset depression
a.
It is thought that ______ plays an important role in the mood disorders, due to the link between stressful events and depression. a. the hypothalamic-pituitary-adrenal axis b. dopamine c. perinatal chromosomal interaction d. the prefrontal cortex
a.
Learned helplessness is the theory that depression is caused by a lack of connection between responses and their outcomes, which was proposed by ____. a. Seligman b. Beck c. Freud d. Skinner
a.
Lithium is recommended for which disorder? a. bipolar I disorder b. bipolar II disorder c. cyclothymic disorder d. major depressive disorder
a.
One of the most reliable sleep disturbances associated with depression is ____. a. shorter latency to REM b. longer latency to REM c. early evening awakening d. late evening awakening
a.
Persistent depressive disorder differs from major depression in that ______. a. it usually lasts longer b. it responds better to medication c. it usually has a precipitating event d. it is more severe
a.
The depressive episode includes all of the following EXCEPT ____. a. distractibility b. sleep disturbance c. fatigue d. indecisiveness
a.
The key feature of a manic episode is a distinct period (at least ____) of expansive, elevated, or irritable mood. a. 1 week b. 2 weeks c. 4 days d. 5 days
a.
The presence of a manic episode results in the DSM-5 diagnosis of ____. a. bipolar I disorder b. bipolar II disorder c. major depressive disorder d. cyclothymic disorder
a.
The view that depression is caused by a pessimistic causal style (emphasizing global, stable, and internal factors) is known as the ______ model of depression. a. attribution b. pessimistic sensitization c. learned helplessness d. monoamine
a.
Which of the following cannot involve psychotic symptoms, according to the DSM-5? a. a hypomanic episode b. a manic episode c. a major depressive episode d. a delusional episode
a.
______ disorder begins before age 10 and extends to age 18, and is characterized by severe, chronic irritability that is exhibited in temper outbursts. a. disruptive mood dysregulation b. bipolar II c. persistent depressive d. dysthymic
a.
mood disorders are also called what?
affective disorders
Mood disorders are the most prevalent class of disorders after the ____ disorders.
anxiety
A(n) ______ is characterized by accelerated motion and speech, talkativeness, flight of ideas, irritability, and excessive elation. a. affective episode b. manic episode c. melancholic episode d. atypical mood episode
b.
All of the following are presented in the text as ways in which a lack of contingent positive reinforcement for nondepressed behavior could come about, EXCEPT ______. a. a response style that others find aversive b. the belief that one has little control over events in life c. behavior aimed at avoiding aversive consequences d. a lack of social skills necessary for obtaining social reinforcement
b.
All of the following are true statements about suicide statistics, EXCEPT ______. a. that American Indians and Alaska Natives are at highest risk prior to age 25 b. that men make nearly three times as many suicide attempts as women c.that the U.S. military lost more men to suicide than combat in Afghanistan in 2012 d.that men successfully commit suicide four times more often than women
b.
All of the following can distinguish a major depressive episode, EXCEPT ______. a. degree of disturbance b. age of onset c. degree of impairment d. duration
b.
All of the following have been implicated as biological contributors to the development of the depressive disorders, EXCEPT ______. a. increased cortisol levels b. decreased dopamine levels c. sleep dysregulation d. genetics
b.
For chronic major depressive disorder, the 12-month prevalence rate is ______. a. 0.07 b. 0.015 c. 0.05 d. 0.03
b.
If echolalia, echopraxia, or disturbances in motor activity are dominant among the depressive symptoms, which specifier applies? a. "with melancholic features" b. "with catatonic features" c. "with postpartum onset" d. " with a seasonal pattern"
b.
Mood disorders have a lifetime prevalence of ____ in the population. a. 0.43 b. 0.21 c. 0.07 d. 0.32
b.
The depressive disorders include ______ disorder and ______ disorder. a. cyclothymic; major depressive b. major depressive; premenstrual dysphoric c. cyclothymic; dysthymic d. bipolar II; major depressive
b.
The evidence regarding cognitive therapy for depression indicates that ______. a. it is less effective than psychoanalytic, or talk-based, therapy b. it is the "gold standard" against which other psychotherapies have been compared c. past evaluations of its usefulness were exaggerated d. it is less effective at preventing relapse than are pharmaceutical treatments
b.
The prevalence of premenstrual dysphoric disorder is close to ____% of women. a. 1 b. 6 c. 10 d. 20
b.
Which kind of depression occurs in the wake of stressful life events? a. learned depression b. exogenous depression c. determined depression d. endogenous depression
b.
Which of the following are the building blocks that, combined, make up the definitions of the various mood disorders in the DSM-5? a. mood categories b. mood episodes c. mood components d. mood phases
b.
Among adolescents, those who completed suicide were more likely to have displayed a(n) ____ within 1 week of the suicide, suggesting that it may serve as an effective warning sign. a. eating disturbance b. motor disturbance c. sleep disturbance d. visual disturbance
c.
Infants who are separated from their mothers for long periods of time in their first year of life may ______. a. never fully recover b. not even notice c. develop signs of depression d. develop mania later in life
c.
More severely depressed patients can be effectively treated by ______-a relatively simple, enduring, and cost-effective option. a. interpersonal psychotherapy b. antidepressant medication c. behavioral activation d. cognitive therapy
c.
Temper outbursts in disruptive mood dysregulation disorder must persist for ____. a. 1 month b. 6 months c. 1 year d. 2 years
c.
What percentage of those with major depressive disorder commit suicide? a. less than 10% b. more than 20% c. up to 15% d. nearly 30%
c.
Which disorder shows an equal sex ratio? a. major depressive disorder b. disruptive mood dysregulation disorder c. bipolar I disorder d. bipolar II disorder
c.
Which of the following frequently precedes or follows a hypomanic episode? a. a delusional episode b. a cyclothymic episode c. a major depressive episode d. a seasonal affective episode
c.
Which of the following has been implicated in the onset of bipolar cycles? a. dopaminergic b. GABA c. norepinephrine d. serotonin
c.
Which of the following has only been inconsistently supported by evidence, showing little indication of a link between these neurotransmitters and depression? a. the GABA/ACh hypothesis b. the lithium hypothesis c. the monoamine hypothesis d. the dopaminergic hypothesis
c.
Which of the following is most true for the remission rates of major depressive disorder and the bipolar disorders? a. The remission rates for major depression are lower than for the bipolar disorders. b. It is harder to establish remission rates for major depression than for the bipolar disorders. c. The remission rates for major depression are higher than for the bipolar disorders. d. The remission rates for major depression and the bipolar disorders are about equal.
c.
Which of the following is most true of the differences between bipolar II and bipolar I patients? a. Bipolar I patients spend approximately 20% more time in the depressive state. b. Bipolar I patients spend approximately 40% more time in the depressive state. c. Bipolar II patients spend approximately 40% more time in the depressive state. d. Bipolar II patients spend approximately 20% more time in the depressive state.
c.
A major depressive episode can include the experience of ______. a. pressure to keep talking b. flight of ideas c. grandiosity d. psychotic symptoms
d.
How many possible combinations of symptoms and specifiers are there for all of the bipolar conditions? a. more than 5 million b. more than 5 trillion c. more than 500,000 d. more than 5 billion
d.
In what percentage of the population does bipolar I disorder occur, approximately? a. 0.02 b. 0.014 c. 0.002 d. 0.006
d.
Some patients who undergo electroconvulsive therapy experience ______, which can be a significant problem. a. tardive dyskinesia b. sexual dysfunction c. epilepsy d. memory loss
d.
Studies of concordance rates for unipolar and bipolar mood disorders in MZ and DZ twins suggest that ______. a. there are similar concordance rates in MZ and DZ twins with bipolar mood disorders b. there are similar concordance rates in MZ and DZ twins with unipolar mood disorders c. genetic factors play a larger role in unipolar mood disorders d. genetic factors play a larger role in bipolar mood disorders
d.
The attributional style of depressed individuals is characterized by a tendency to make ____ attributions for negative events. a. internal, stable, specific b. external, unstable, global c. internal, unstable, specific d. internal, stable, global
d.
The hypomanic episode cannot include which symptom? a. inflated self-esteem b. distractibility c. decreased need for sleep d. delusional grandiosity
d.
The idea of learned helplessness originated from studies of ____. a. college students who interacted with depressed outpatients b. infant monkeys separated from their mothers c. unwed mothers in an institutional nursery d. dogs receiving inescapable shocks
d.
Those with premenstrual dysphoric disorder ____. a. have higher levels of norepinephrine and dopamine b. are mostly Western European or American c. are less likely to attempt suicide d. experience pain more intensely due to lower pain thresholds
d.
What percentage of those diagnosed with major depressive disorder, who have had three episodes of major depression, will have a fourth episode, according to the APA? a. 0.42 b. 0.5 c. 0.75 d. 0.9
d.
When major depressive and manic episodes alternate nearly every day over a week-long period, a specifier of ______ is used. a. with dysthymia b. with mood dysregulation c. with brief psychotic episode d. with mixed features
d.
Which class of antidepressants shows lower discontinuation rates due to intolerance and is generally the first-line medical treatment for depression? a. tricyclics b. TPAs c. MAO-Is d. SSRIs
d.
Which of the following is most true of depression rates? a. Women tend to have lower rates of depression than men. b. Adolescents tend to have lower rates of depression than older adults. c. Young adults tend to have lower rates of depression than older adults. d. Those in later life tend to have lower rates of depression than younger people.
d.
Which of the following is part of the process of identification whereby an individual internalizes and incorporates the characteristics of others, according to psychoanalytic theory? a. attribution b. self-image c. self-talk d. introjection
d.
Which of these disorders is most common? a. bipolar I disorder b. bipolar II disorder c. cyclothymic disorder d. major depressive disorder
d.
Persistent depressive disorder (dysthymia) is persistent ____ mood, usually including ____ ____ episode for at least ____ year(s). ____ reliable than other mood disorders. What is the 12-month prevalence for persistent depressive disorder? 12-month prevalence for chronic major depressive disorder? More common among ____.
depressed, major depressive, 2. Less. 0.5%. 1.5%. females.
Cyclothymic disorder: recurrent ____ and ____, without ____ ____ or ____ episodes for at least ____ year(s). Slightly more common in ____.
depression, hypomania, major depressive, manic, 2. females
PDD: "____ ____"
double depression
What is the male/female ratio of bipolar?
equal
Two other causes of depressive disorders: ____-____ attachment and reduction of ____ ____.
infant-mother, positive reinforcement
Premenstrual dysphoric disorder is mood ____ and ____ during most menses for at least ____ year(s). Must be present ____ menses, improve ____ menses onset, and become minimal by a ____ after menses. Because some women have lower ____-____ levels which make them feel pain more intensely. What is the prevalence in menstruating women?
lability, irritability, 1. before, after, week. beta-endorphin. 5.8%
Major depressive disorder is the presence of a ____ ____ episode for at least ____ week(s). More common among ____. As many as ____ in ____ females experience MDD (risk of men is ____ of that). Average age of onset is mid-____s. Homosexual males/females have ____ rates. up to ____% of those with MDD die by suicide. What is the 12-month prevalence in the U.S.?
major depressive, 2. females. 1, 4 half. 20. higher. 15. about 7%, 3 times more prevalent in young adults than elderly
Bipolar II disorder: ____ ____ episode plus ____ episode for at least ____ week(s). More common among ____.
major depressive, hypomanic, 2. females
What is the 12-month prevalence of PDD for males? females? lifetime?
males: 2.1-4.8% females: 3-8% lifetime: 2.5-6.4%
Bipolar I disorder: presence of ____ episode for at least ____ week(s). Equal sex ratio. What is the prevalence? Average age of onset? Up to ____% successfully commit suicide.
manic, 1. about 0.6%. 18. 15
particularly deep level of depression characterized by absence of interest or pleasure in all things, changes in sleep, changes in weight, and/or excessive guilt
melancholia
Hypothesis that depression is caused by a deficiency of certain monoamine neurotransmitters in the brain.
monoamine hypothesis
In the treatment of bipolar disorder, ____ alone is useless. Medications are effective in about ____% of sufferers.
psychotherapy; 80
In depressive disorders, REM begins more ____ after falling asleep and REM sleep periods tend to last ____.
quickly, longer
Tricyclics and MAO-Is are less well ____ and have ____ ____ ____.
tolerated, bad side effects
Females are ____ as likely as men to be sufferers of major depressive disorder.
twice
