Week 5: Mood Disorders and Suicide
a
Diane's treatment for depression included training in meditation techniques that helped her become aware of her unwanted negative thoughts and to accept them as just thoughts. She was undergoing _________ a. mindfulness-based cognitive therapy. b. psychodynamic therapy. c. behavioral activation therapy. d. transcranial magnetic stimulation
b
Which of the following is true about the monoamine hypothesis of depression? a. Alternative theories have replaced this theory. b. It has not been replaced by a compelling alternative. c. This theory remains the standard of current and accurate information. d. This theory has been continuously updated to meet current research
Answer: Beck's theory is that thinking precedes and causes depression. First, people hold dysfunctional beliefs that predispose them to depression. These are rigid, extreme, and unhelpful beliefs about the world. They create automatic, negative thoughts that center around the cognitive triad—the self, the world, and the future. Negative beliefs and feelings about the triad are maintained by cognitive errors such as all-or-none reasoning and arbitrary inference. This theory has been well supported as an explanation for many aspects of depression, but evidence confirming it as a cause of depression is mixed.
Discuss Beck's cognitive theory of depression.
a
Which of the following is true of major depressive episode? a. It does not begin until adolescence. b. It is equally common in men and women. c. It occurs five times as often in elderly people as in middle-aged adults. d. It is the most prevalent mood episode.
Answer: Mood disorders, conduct disorder and substance abuse all increase the risk of both nonfatal and fatal suicide attempts. If the adolescent has two or more of these risk factors, the risk for completion of suicide is extremely high. Antidepressant medications slightly increase the risk as well.
Discuss the risk factors for adolescent suicide.
d
Which of the following is true of major depressive episode? a. It does not begin until adolescence. b. It is equally common in men and women. c. It occurs five times as often in elderly people as in middle-aged adults. d. It is the most prevalent mood episode.
Shneidman
Which figure, described in your text as the "godfather of suicide research," has written extensively about what constitutes a suicidal mind?
Having experienced a hypomanic episode in the past
Which of the following details would exclude a person from receiving a diagnosis of major depressive disorder?
Zenia alternates between hypomanic and depressive symptoms.
Which of the following individuals exhibit symptoms that are consistent with a diagnosis of bipolar II?
a
Which of the following is a behavioral explanation for depression? a. Lack of environmental reinforcers b. Insecure attachment c. Pessimistic tendencies d. Reliance on depressogenic schemas
a
Which of the following is a brain area that has been found to exhibit abnormalities in depressed patients? a. Amygdala b. Basal ganglia c. Posterior cingulate cortex d. Medulla oblongata
a
Depression _________ a. can occur even in very young children. b. is extremely rare in childhood. c. cannot occur in childhood. d. can occur in childhood in females but not in males.
d
Which of the following is a hormonal abnormality associated with both bipolar disorder and unipolar depression? a. Decreased thyroid hormone levels b. Increased thyroid hormone levels c. Decreased cortisol levels d. Increased cortisol levels
Appetite and weight loss.
Which of the following is a symptom of major depressive disorder? Checking and rechecking things. Appetite and weight loss. Running thoughts. Impulsive spending.
b
Which of the following is a symptom of major depressive disorder? a. Checking and rechecking things b. Appetite and weight loss c. Running thoughts d. Impulsive spending
d
Which of the following is a true statement about rapid cycling in bipolar disorders? a. It is seen in men more than women. b. It occurs in only those with bipolar II disorder. c. Lithium may trigger a cycling episode. d. It is seen in 5 to 10 percent of those with bipolar disorder
c
Depression during adolescence _________ a. is much rarer than during childhood. b. has little effect on adult functioning. c. can affect a person into young adulthood. d. is decreasing in prevalence.
It is seen in 5-10% of those with bipolar disorder.
Which of the following is a true statement about rapid cycling in bipolar disorders? It is seen in men more than women. It occurs in only those with Bipolar II disorder. Lithium may trigger a cycling episode. It is seen in 5-10% of those with bipolar disorder.
b
Which of the following is a true statement about the recurrence of depressive symptoms? a. If a recurrence is not experienced within one year after an initial depressive episode, recurrence is highly unlikely. b. Almost half of all individuals diagnosed with major depression will exhibit a recurrence. c. Those with depression with psychotic features are less likely to experience a recurrence. d. Clients are usually asymptomatic between depressive episodes.
c
Which of the following is an example of a cognitive diathesis for depression? a. Neuroticism b. Optimism c. Attributing negative events to internal causes d. Attributing negative events to external causes
a
Which of the following is most likely to be seen in children who are at risk for depression? a. Decreased left hemisphere activity b. Decreased right hemisphere activity c. Increased serotonin levels d. Increased GABA levels
The occurrence of at least one manic episode.
Which of the following is necessary for a diagnosis of bipolar I disorder? The occurrence of two or more episodes of major depression. Unremitting symptoms for a period of at least two years. Symptoms of psychosis. The occurrence of at least one manic episode.
d
Which of the following is necessary for a diagnosis of bipolar I disorder? a. The occurrence of two or more episodes of major depression b. Unremitting symptoms for a period of at least two years c. Symptoms of psychosis d. The occurrence of at least one manic episode
c
Which of the following is necessary for a diagnosis of cyclothymia? a. The occurrence of two or more episodes of major depression b. Unremitting symptoms for a period of at least two years c. Clinically significant distress or impairment d. The occurrence of at least one episode of anxiety
The treatment does not cause any deficit in cognitive performance or memory skills like those that occur with electroconvulsive therapy (ECT).
Which of the following is one of the benefits offered by transcranial magnetic stimulation for the treatment of mood disorders?
b
Depressogenic schemas ________ a. are inherited. b. predispose a person to develop depression. c. serve a protective function and are readily modified by positive life experiences. d. ensure that a low rate of reinforcement will be experienced
a
Which of the following is statistically most likely to attempt suicide? a. A 77-year-old single white man from Wyoming with chronic back pain. b. A 58-year-old African American woman from Maryland who has lost her job. c. An 8-year-old boy from New Jersey who has received a poor report card. d. An 23-year-old Inuit woman who has just had a baby.
Low SES leads to greater levels of adversity and life stress.
Which of the following is the most reasonable sociocultural explanation for the increased incidence of major depressive disorder in people from lower socioeconomic statuses?
Mania is characterised by elevated, expansive or irritable mood and increased energy/activity for at least 1 week as well as 3 other symptoms such as inflated self-esteem, decreased need for sleep, pressured speech, flight of ideas, distractibility, increased goal-directed activity or psychomotor agitation, or involvement in pleasurable, risky activities. Mania is associated with Bipolar Disorder 1. Hypomania is constituted of the same symptoms as mania but lasts for only 'at least 4 days' and has to be an unequivocal change in functioning which is uncharacteristic of the individual and must be observable by others. Hypomania along with a major depressive episode is associated with Bipolar Disorder 2. Excitement is a normal human mood state, which may involve some of the features of mania and hypomania but either lasts for less than 4 days or does not cause significant impairment to social and occupational functioning. Excitement and subsyndromal depression could be associated with cyclothymia.
Describe and distinguish between mania, hypomania and excitement.
Answer: Having a pessimistic attributional style along with negative life events is not enough to produce depression. A state of hopelessness is needed as well. Hopelessness expectancy is the perception that one has no control over a situation that is about to occur as well as an absolute belief that what is going to happen is going to be bad.
Describe the hopelessness theory of depression.
Answer: the presence of mania
Bipolar I disorder is distinguished from major depression by__________.
Answer: unipolar major depression
Major depressive episode is also known as __________.
These drugs can have severe, even fatal side effects if foods containing a specific amino acid are consumed while on the medication.
Why might a physician be somewhat unwilling to give a person with major depressive disorder a prescription for monoamine oxidase inhibitors (MAOIs) as the first pharmaceutical approach to addressing their symptoms?
Cyclothymic; 2 years
________ disorder is marked by repeated experiences of hypomanic symptoms for a period of at least ________.
depression
The disorder that is most commonly linked to suicide is __________.
Answer: Independent life events are stressful events that are not a result of a person's behavior or character. Dependent life events are a result of those things that are, at least partly, related to a person's behavior or character. Dependent events are especially important in the onset of major depression
What are independent and dependent life events? What is their importance?
Answer: The normal response to the loss of spouse or close family member begins with a numbing and disbelief. This is followed by a yearning for the person that may possibly last for months. Eventually, despair is seen and then, finally, some adaptation and reorganization such that life can continue without the departed loved one.
What are the four phases of the grieving process?
c
What are the two key moods involved in mood disorders? a. Anger and depression b. Sadness and anxiety c. Mania and depression d. Anger and mania
Answer: The two main forms of mood disorder are unipolar, in which a person only experiences depression, and bipolar, in which a person has mood swings that range from hypomania or mania to depression. A person with bipolar disorder, however, may not exhibit any depression. The mood disorders are differentiated in terms of severity—the number of areas of life that are impaired, and the degree and duration of impairment—and whether the disorder is acute, chronic, or intermittent. In addition, each type of mood disorder is further divided into multiple subtypes
What are the two main forms of mood disorder? How are these disorders further characterized?
Answer: Marked change in mood and behavior, especially withdrawal, decline in self-esteem, not taking care of personal hygiene, uncharacteristically impulsive behaviors, not attending classes. Many students communicate their impulses. Often the behavior is a reaction to the break-up of a romance.
What are the warning signs of student suicide in college or university?
Answer: Over half of depressed patients experience some form of insomnia. In addition to having problems getting to sleep or staying asleep, the sleep of the depressed is not normal. More time is spent in REM sleep and REM sleep is entered more quickly, leading to a reduction in the amount of time spent in other forms of deep sleep. The observed alterations in sleep suggest a general disturbance in biological rhythms.
What changes in sleep are seen in depression?
d
What do all mood disorders have in common? a. The presence of a negative mood state. b. They are at least 6 months in duration. c. The presence of irrational thoughts. d. They are characterized by emotional extremes.
They both involve periods of hypomania symptoms.
What do cyclothymic disorder and bipolar II disorder have in common?
d
What is meant by the phrase "double depression"? a. Symptoms are consistent with two different subtypes of major depression. b. The individual has been diagnosed with an anxiety disorder and a mood disorder. c. Symptoms of both typical and atypical depression are exhibited. d. An individual with persistent depressive disorder later develops major depressive disorder as well.
Experiencing rapidly alternating moods, such as sadness and euphoria, all within one episode of the illness
What is the defining characteristic of a mixed-episode case of a mood disorder?
Answer: A diagnosis of bipolar I is made when there has been a manic episode. This diagnosis is made with or without the occurrence of a bout of major depression. In bipolar II, there is at least one episode of major depression and a hypomanic episode. If the individual with bipolar II exhibits a manic episode, a diagnosis of bipolar I is warranted.
What is the difference between bipolar I and bipolar II disorder?
c
What is the most important characteristic used to distinguish persistent depressive disorder from major depression? a. The length of time the person has had the symptoms b. How severe the symptoms are c. Whether there are occasional brief periods of normal moods during the disorder d. The types of symptoms the person has
c
What is the primary objective of crisis intervention? a. To help people work on their problems over the long-term. b. To help people work on their problems with their family. c. To help people work on their immediate life crisis. d. To integrate people's spouses into long-term therapy.
There is a very high level of comorbidity between depressive and anxiety disorders.
What is the relationship between the experience of depressive symptoms and significant levels of anxiety?
Answer: The presence of psychotic symptoms indicates that a break with reality has occurred and involves the presence of hallucinations and/or delusions. The psychotic symptoms seen in depression are mood-congruent, they are symptoms that are consistent with being depressed. The depressed individual, for example, might believe that their friends and family want them dead.
What type of psychotic symptoms might be seen in someone suffering from major depression?
Mindfulness-based cognitive therapy
What type of therapy aimed at the treatment of depression involves meditation techniques that emphasize patients' awareness of unwanted thoughts, feelings, and sensations?
b
What was Dr. Jack Kevorkian known for? a. Lowering the risk of suicide in terminally ill people b. Making it possible for more than 130 gravely-ill people to commit suicide c. Developing suicide hotlines across the United States. d. Increasing the number of drugs available to treat people contemplating suicide
b
When a nondepressed student lives with a depressed roommate, which of the following often results? a. Frequent verbal fights, which may even become physical b. Increased rejection and hostility in the roommate who was not originally depressed c. A decrease in depression in the depressed roommate d. Increased caretaking by the nondepressed roommate, but only after the nondepressed roommate becomes depressed
a
A diagnosis of bipolar I disorder indicates that the person has met DSM-5 criteria for ________ a. an episode of mania. b. an episode of mania or major depression. c. an episode of hypomania and a major depression. d. an episode of mania and psychosis.
c
A diagnosis of bipolar II disorder indicates that the person has experienced ________ a. an episode of mania. b. an episode of mania or major depression. c. an episode of hypomania and an episode of major depression. d. an episode of mania and an episode of major depression.
an episode of hypomania and an episode of major depression.
A diagnosis of bipolar II disorder indicates that the person has experienced: an episode of mania. an episode of mania or major depression. an episode of hypomania and an episode of major depression. an episode of mania and an episode of major depression.
a
A hypomanic episode is best described as a _________ a. mild manic episode. b. short manic episode. c. manic episode characterized by inactivity. d. manic episode followed by symptoms of a mild depression
Answer: seasonal affective disorder
A kind of depression related to the total amount of light a person receives is often called __________.
Answer: five
A major depressive disorder is diagnosed when __________ or more symptoms are present during the same two-week period.
d
A person who shows psychotic depression that involves mood-congruent thinking _________ a. is diagnosed as having "double depression." b. usually responds rapidly to anti-depressant medications. c. rarely shows the symptoms of melancholia. d. has a poorer prognosis than others with major depression.
hypomania
A person who suffers from a less-severe form of mania that lasts for a minimum of 4 days might be described as experiencing a(n) ________ episode. It is typically less disruptive of a person's life than a full episode of mania.
c
A rapid return of symptoms immediately after drug treatment is terminated is a common example of ________; a return to depressive symptoms after a period of spontaneous remission of symptoms is called a ________. a. melancholia; recurrence b. recurrence; relapse c. relapse; recurrence d. mood-congruent depression; mood-incongruent depression
a
A recurrent depressive episode _________ a. is preceded by one or more previous episodes. b. suggests that chronic major depression has developed. c. typically lasts two to three weeks. d. is characteristic of all forms of bipolar disorder.
d
A relationship between depression and marital dissatisfaction ________ a. has yet to be established. b. only exists due to the submissive behavior of depressed wives. c. is only seen when depression leads to substance abuse. d. is well-established.
a
A review of several studies found that ________ increased the likelihood of developing a more severe depression. a. experiencing a stressful life event b. being in an intimate relationship c. working outside of the home d. having religious faith
a
A therapist with a(n) ________ orientation would emphasize the depressed person's need to improve his or her social skills. a. interpersonal b. psychodynamic c. cognitive d. sociocultural
d
Abramson revised the learned helplessness theory to suggest that ________ a. the worldview dimension of attributions is the most important to depression. b. hopelessness is needed to produce depression, helplessness is not important. c. the number of negative life events someone experiences is more important than his or her attributions for those events. d. the pessimistic attributional style people have about negative events produces depression.
c
According to Freud, depression ________ a. and grief are the same thing. b. must be treated with introjection. c. is a consequence of loss. d. reflects fixation in the anal stage.
b
According to Joiner's interpersonal-psychological model, the interaction of perceived burdensomeness (e.g., feeling like a burden to others) and thwarted belongingness (e.g., feeling alone) produce suicidal thoughts and desires, but only the presence of a third factor, ________, will move a person to make a suicide attempt. a. major depressive disorder b. acquired capability for suicide c. implicit associations d. bipolar disorder acquisition
c
According to Wang, Lane, et al., what percent of people with mood disorders receive no treatment or inadequate care? a. 40 b. 50 c. 60 d. 70
25; 40
According to research presented in this module, somewhere between ____ and ____ percent of adolescents experience either major depressive disorder or subclinical levels of depression at some point.
b
According to research, ________ is the primary personality variable that makes a person vulnerable to depression and anxiety disorders. a. psychosis b. neuroticism c. introversion d. extroversion
twice
According to twin studies, monozygotic twins who have a co-twin with major depressive disorder are about __________ as likely as dizygotic twins to develop depression.
a
Although bipolar I disorder is described as "bipolar," ________ a. a depressed episode is not necessary for a diagnosis. b. few patients show both manic and depressed symptoms. c. both depressed and manic symptoms typically occur simultaneously. d. a year or two commonly passes between manic and depressed episodes.
boys are equally likely or slightly more likely than girls to be diagnosed.
Among children who are diagnosed with depression, ________
c
Angela has had several periods of extremely "up" moods. They last for a couple of weeks and she has gotten into trouble several times. During those times she doesn't sleep, spends way too much money, gets involved in bad business decisions, talks quickly and thinks even more quickly, and believes she can do anything. The best diagnosis for Angela is ________ a. manic disorder. b. bipolar II disorder. c. bipolar I disorder. d. cyclothymic disorder.
bipolar I disorder.
Angela has had several periods of extremely 'up' moods. They last for a couple of weeks and she has gotten into trouble several times. During those times she doesn't sleep, spends way too much money, gets involved in bad business decisions, talks quickly and thinks even more quickly and believes she can do anything. The best diagnosis for Angela is manic disorder. bipolar II disorder. bipolar I disorder. cyclothymic disorder.
nonsuicidal self-injury (NSSI)
Angelina is 12 years old, and several times a week she sits in a locked bathroom in her home and uses a razor blade to cut the inside of her thighs. The practice is painful to her, but she experiences that pain as a positive sensation rather than a negative one. Angelina's behavior would be classified as __________.
8-12
Approximately _______ percent of adolescents and young adults have engaged in at least one nonsuicidal self-injury behavior, often with the goal of decreasing high levels of distress and eliciting help from others.
b
Beck's negative cognitive triad involves feeling negatively about ________ a. helplessness, hopelessness, and sorrow. b. one's self, one's experiences, and one's future. c. one's past, one's present, and one's future. d. one's family, one's self, and one's friends.
d
Behavioral activation treatment _________ a. focuses on implementing cognitive changes. b. combines pharmacotherapy and behavioral therapy. c. combines interpersonal therapy and behavioral methodology. d. emphasizes activity and involvement in interpersonal relationships.
b
Bipolar disorder is to major depression as ________ is to ________. a. persistent depressive disorder; cyclothymia b. cyclothymia; persistent depressive disorder c. mania; hypomania d. hypomania; mania
c
Brittany came to a therapist complaining that she just doesn't enjoy life lately. She says that for the past couple of months, she finds she just doesn't feel like doing the things that she used to love to do. She has also lost a lot of weight and sleeps much more than usual but still feels tired all the time. She says she just can't concentrate on anything. However, she denies feeling sad. Brittany's most likely diagnosis is _________ a. dysthymic disorder. b. bipolar II disorder. c. major depressive disorder. d. no disorder.
d
Carleen comes to therapy because she is feeling sad. Carleen says she has often had periods of extreme sadness in the past and they typically last between 6 and 8 months. During those times she overeats, has trouble sleeping, feels exhausted all the time, and thinks a lot about dying. At other times, however, Carleen says she feels wonderful. During those times, which last about a week, she gets a lot done, feels as if she could do anything, talks a lot and quickly, and doesn't sleep but doesn't feel tired. Carleen says her "up" times are great and have never caused her any trouble. Carleen's most likely diagnosis is ________ a. major depressive disorder. b. persistent depressive disorder. c. bipolar I. d. bipolar II.
b
Childhood depression ________ a. has been clearly linked to genetic factors. b. is more likely in children with a depressed parent. c. has not been associated with parental depression. d. can usually be causally related to marital discord.
d
Childhood suicide _________ a. is very rare. b. has been declining since the early 1950s. c. is the third most common cause of death in the United States for 15 to19 year-olds d. has been increasing since the early 1950s.
b
Christine just found out that she did poorly on a test. Which of the following reactions would suggest a cognitive diathesis for depression? a. I'll do better next time. b. I'll never understand this. c. Why didn't I study more? d. That test was way too hard.
Answer: the United States
Cross cultural studies have shown consistently that __________ is the country with the highest prevalence of mood disorders.
d
Cross-cultural studies of mood disorders are made difficult due to _________ a. the variability in the prevalence of bipolar disorders. b. the variability in the prevalence of unipolar disorders. c. the lack of clear-cut distinctions between bipolar and unipolar disorders. d. differences in diagnostic practices
a
Debbie receives her paper back from her instructor. It is marked with an A grade and has several positive comments. The instructor also suggested Debbie reword one small section. Debbie becomes extremely upset and tells her friends her instructor hated the paper and wants her to redo it. This is an example of ________ a. selective abstraction. b. dichotomous thinking. c. arbitrary inference. d. learned helplessness.
c
Deena has major depressive disorder. Most days she feels very sad, but when her sister came and told Deena she was going to be an aunt, Deena felt happy for a little while. She has been gaining weight and sleeping much of the day. Deena most likely has _________ a. melancholic features. b. double depression. c. atypical features. d. psychotic features.
atypical features.
Deena has major depressive disorder. Most days she feels very sad, but when her sister came and told Deena she was going to be an aunt, Deena felt happy for a little while. She has been gaining weight and sleeping much of the day. Deena most likely has: melancholic features. double depression. atypical features. psychotic features.
Answer: Cyclothymia is best described as a less severe, yet chronic, version of bipolar disorder. While the individual with bipolar I disorder exhibits a full manic state, the individual with cyclothymia exhibits hypomania. People with bipolar II have full major depressive episodes, people with cyclothymia have depressive symptoms but not full episodes. In cyclothymia the lows and the highs do not rise to the level that is needed for a diagnosis of major depressive episode or manic episode, respectively. The disorders differ in that there need not be any depressive symptoms in bipolar I disorder, although this is usually the case as pure mania is rare. Only bipolar I involves manic episodes.
Distinguish between cyclothymic disorder, bipolar I disorder and bipolar II disorder. How are these disorders alike and how are they different?
d
Drugs that alter the availability of norepinephrine and serotonin are not clinically effective in the treatment of depression for several weeks. Which of the following does this finding suggest? a. These neurotransmitters are not involved in depression. b. It is overactivity of these neurotransmitters that underlies depression, not underactivity. c. That the effectiveness of antidepressants is a placebo effect, as opposed to a result of a biochemical manipulation. d. Changes in neurotransmitter function, as opposed to neurotransmitter level, cause depression.
enter REM sleep 15 to 20 minutes earlier after going to bed, and spend a lower than normal amount of time in stage 3-4 sleep
EEG sleep studies of persons with depression reveal that depressed persons on the average ____________ when compared to persons who are not depressed.
a
Efforts to find the gene or genes that underlie bipolar disorder suggest that ________ a. multiple genes are involved. b. the underlying gene is on the Y chromosome. c. the underlying gene is on the X chromosome. d. there is a genetic basis for bipolar disorder, but not for cyclothymia
d
Freud suggested that depression ________ a. was actually a healthy adaptation to stress. b. was a result of overly high self-esteem. c. involved the anal stage of development. d. was anger turned inward.
Answer: women, men
Generally speaking ________ are more likely to attempt suicide and ____________ are more likely to complete suicide.
3 to 5 weeks
Generally speaking, a person who has just started taking antidepressants should not expect to experience a significant reduction in depressive symptoms for about _________.
Answer: greater
Genetics plays a(n) _________ role in causing bipolar I disorder compared to unipolar disorders.
d
George, a 22-year-old mechanic, always seems to have a cloud over his head. For the past three weeks, he has had problems sleeping and he has little appetite or enjoyment of food. While he may sometimes seem to be relatively content for short periods of time, this happens very rarely and it never lasts for more than a week. If George were to seek help for his negative mood state, which of the following diagnoses would he most likely receive? a. Adjustment disorder with depressed mood b. Chronic adjustment disorder with depressed mood c. Bipolar II d. Major depressive disorder
Substantial sleep difficulties
Henry suffers from bipolar disorder and experiences one or two manic episodes in a given year, more when he is not taking his medication. Between episodes, which of the following symptoms is he most likely to experience?
b
Herbert awakens early in the morning and feels more depressed in the morning than the evening. He has lost all interest in activities and derives no pleasure from things that used to please him. Herbert is diagnosed with MDD with _________ features. a. psychotic b. melancholic c. atypical d. catatonic
d
How does persistent depressive disorder compare to major depressive disorder? a. Symptoms are much more severe than in major depressive disorder. b. Symptoms change from day to day, with lots of days with normal functioning in between dysthymic episodes. c. There are many more symptoms required to meet persistent depressive disorder than to meet major depressive disorder. d. Symptoms are mild to moderate but last for much longer than in major depressive disorder
A relapse is a re-emergence of previous symptoms; a recurrence is the emergence of a new episode of depression.
How might one most aptly distinguish between a relapse and a recurrence of depressive symptoms?
The co-twin of a monozygotic twin with major depressive disorder is twice as likely to develop the condition as are dizygotic co-twins.
How might one support the statement that the development of major depressive disorder has moderate genetic contributions?
c
If Jamal is having a thought that could be an example of arbitrary inference. Which of the following would fit that description? a. Life is so unfair. b. If she won't go out with me, I'll die. c. She looked at me funny. She hates me. d. Why should I even try? She'll definitely reject me.
Loss
In a single word, what did Sigmund Freud feel was at the root of most people's symptoms of depression?
manic episodes
In addition to being effective in the treatment of severe depression, electroconvulsive therapy (ECT) has proven to be effective in treating about 80% of cases of _____________.
petition the state and receive permission to end his life
In classical Greece, a person who was extremely ill could ________.
4
In order for a person with bipolar disorder to be described as having a rapid cycling pattern, he or she would have to have at least _____ episodes of manic or depressive episodes in a given year.
a depressed mood or loss of pleasure most of the day for at least 2 weeks.
In order to meet the criteria for a major depressive episode, a person MUST have: a depressed mood or loss of pleasure most of the day for at least 2 weeks. significant weight loss. intense irritability. insomnia.
Nigeria
In the 2004 World Mental Health Study conducted by the World Health Organization, the prevalence and characteristics of psychological disorders was examined in 20 different countries. The 12-month prevalence rate of depression was found to be the lowest in _________.
Oregon
In the United States, the first state to pass a Death with Dignity Act was ________ in 1994. This gave physicians legal permission to prescribe a lethal dose of medication for a terminally ill patient to ingest on their own.
Answer: While the Western constellation of depressive symptoms is primarily psychological, in many cultures the symptoms tend to be more somatic. In those cultures in which there is great stigma associated with mental illness and/or a lack of emotional expressiveness, depression may manifest itself in symptoms such as weight loss, sleep disturbances, and sexual dysfunction. In addition, the feelings of guilt and worthlessness that characterize depression in individualistic cultures may not be seen in more communal cultures.
In what way do the symptoms of depression in Western and non-Western societies differ?
Persistent Depressive Disorder.
In which of the following disorders must symptoms be present for at least 2 years in order for a diagnosis to be made? Persistent Depressive Disorder. Bipolar I disorder. Major depressive disorder. Bipolar II disorder.
a
In which of the following disorders must symptoms be present for at least two years in order for a diagnosis to be made? a. Persistent depressive disorder b. Bipolar I disorder c. Major depressive disorder d. Bipolar II disorder
b
Independent life events are those that ________ a. only affect one area of a client's functioning. b. are out of the client's control. c. are linked causally to the behavior or personality of the client. d. affect the client and not those around him or her.
d
Individuals who do not show a decrease in cortisol levels in response to an injection of dexamethasone ________ a. have a severe form of depression. b. are likely to be suffering from both major depression and a personality disorder. c. will not respond well to pharmacological treatment. d. have an HPA axis that is not functioning normally.
80%
It is estimated that about ____ of people with a first onset of depression have experienced a recent major stressful life event.
a
Jacob and Matt both flunk their math test. Jacob says to his friends that there is no point in his continuing in the course because, although Jacob feels highly about himself, he suspects that the teacher just doesn't like him. Matt says he is going to drop the course because he is just stupid in math. According to the reformulated learned helplessness theory, ________ a. Matt is more likely to become depressed than Jacob. b. Matt is more likely to feel helpless than Jacob. c. Jacob is more likely to become depressed than Matt. d. Jacob is more likely to feel helpless than Matt.
Venting of hostilities onto others
Jarli is a young Australian Aboriginal man who lives in a native community in the northern territory of Australia. If Jarli were clinically depressed, what types of behaviors would he be likely to exhibit?
c
Jill's marriage has suffered ever since the birth of her second child. Since the birth, she has been depressed and has had little interest in intimacy with her husband. Jill feels unattractive with the additional weight she carries since the birth and has been rejecting her husband's advances. After Jill discussed her feelings with Dr. Tora, Dr. Tora decided to prescribe her an antidepressant. Considering the problems she has been having in her marriage, which of the following is Dr. Tora most likely to prescribe? a. Imipramine b. Prozac c. Bupropion d. Venlafaxine
a
Joanne tends to blow up at people and then feel guilty. She worries a lot. She complains that she just doesn't really find anything exciting and life is boring. Joanne ________ a. shows evidence of neuroticism and low positive affectivity, and has a high risk of developing depression. b. shows evidence of neuroticism and has a moderate risk of developing depression. c. shows evidence of introversion, and has a mild risk of developing depression. d. shows no evidence of any kind that would increase her risk for developing depression.
c
John's erratic behavior finally ruined his marriage. What kind of life event would this be described as? a. Acute b. Chronic c. Dependent d. Independent
b
Katy may develop depression if she continues to make attributions like which of the following? a. I am never going to make it through this course because it is too early in the morning and I'm having trouble getting up. b. I am never going to make it through this course because I'm stupid and I just can't learn the material. c. I am never going to make it through this course because the professor is unfair. d. I am never going to make it through this course because I just don't feel like studying lately.
b
Kerry suffers from depression. He is experiencing delusions that his brain is deteriorating and that he is aging quickly. These delusions _________ a. clearly suggest a diagnosis of schizophrenia. b. are typical of depressive delusions because they are mood congruent. c. suggest that he is suffering from a bipolar rather than a unipolar disorder. d. are most likely to persist after the depression remits.
b
Knowing what we know about neurotransmitter imbalances in bipolar disorder, a physician should give which of the following pieces of advice? a. "Eat lots of foods that are rich in norepinephrine." b. "Don't take drugs that increase dopamine levels because they can produce manic-like behavior." c. "Stay away from drugs that include lithium because bipolar is associated with excessive lithium activity." d. "If you can keep your serotonin levels normal, you do not have to worry about having a manic episode."
Loss of sexual interest
Lao has lived in China with his family for his entire life. Recently he has begun experiencing symptoms of depression. Which symptom would he most likely demonstrate, given the cultural influences of his surroundings?
Cortisol
Levinia has been going through very difficult times lately, with both an increase in life stressors and the emergence of depressive symptoms. If her physician were to take a sample of blood from her, it is likely that she would find elevated levels of which stress hormone?
b
Lithium _________ a. is more effective than antidepressants at treating bipolar depression. b. has both antimanic and antidepressant effects. c. is an anticonvulsant. d. is well-tolerated by most bipolar patients.
d
Lori has periods of dejection and apathy that are not as severe as are seen in major depression. She also has periods when she abruptly becomes elated and has little need for sleep. Her symptoms never reach the level of psychosis, but the mood swings have been recurrent for over four years. The best diagnosis for Lori is ________ a. schizoaffective disorder. b. bipolar I disorder. c. recurrent persistent depressive disorder. d. cyclothymia.
c
Many people who are depressed ________ a. show very little REM sleep, instead they spend large amounts of time in the deeper stages (3 and 4) of sleep. b. do not enter REM sleep until much later in the night than normal and have smaller amounts of REM sleep throughout the night than normal. c. enter REM sleep earlier than normal and have larger amounts of REM sleep early in the night. d. enter REM sleep at a normal time, but have very slow and mild rapid eye movements and have less overall time in REM sleep than normal
with melancholic features
Marcellus has been struggling with the symptoms of a major depressive episode for quite some time. Dr. Ting, his therapist, notes that Marcellus meets the criteria for a major depressive episode, and in addition seems to have lost interest or pleasure in almost all activities, and that he recently turned down a chance to go to a concert of his favorite musician for no discernable reason. The diagnosis of major depressive disorder would probably best include the specifier of "________."
a
Margaret has been suffering with persistent depressive disorder for several years and has sought treatment on several occasions. About one month ago, she developed more severe symptoms of depression, which have been maintained almost daily. The condition she is experiencing is best described as _________ a. double depression. b. chronic melancholia. c. adjustment disorder with bipolar features. d. recurring melancholic depression.
b
Melissa is severely depressed and wants to commit suicide. If she is typical of most individuals who commit suicide, _________ a. she is determined to kill herself and will choose a lethal means such as a gun to ensure that she is successful. b. she is ambivalent about committing suicide. c. she will change her mind at the last minute and reexamine her problems in a more objective fashion. d. she will show no outward signs of her distress.
affective
Mood disorders have previously been referred to as ________ disorders, as they involve extremes of emotions - soaring elation or deep depression - that dominate the clinical picture.
b
Nadia has been depressed for several months. She is considering cognitive therapy. What advice would you give her? a. "Cognitive therapy is much less effective than interpersonal therapy and takes much longer, too." b. "Many studies have shown the usefulness of cognitive therapy and it seems to prevent relapse." c. "Drug treatment is much more effective than cognitive therapy and has less likelihood of relapse." d. "The only way that cognitive therapy is of any value is if it is coupled with family therapy."
c
No matter what prisoners try to do, they cannot escape. Eventually, they become passive and depressed. This illustrates the central idea in the ________ theory of depression. a. attribution b. depressogenic schema c. learned helplessness d. behavioral
b
One criteria for diagnosing major depressive disorder is that _________ a. the episode can be associated with the side effects of certain medications. b. there has never been a manic or hypomanic episode. c. it lasts less than two weeks. d. schizophrenia is diagnosed as a comorbid condition
d
One factor that is especially likely to produce depression relapse is _________ a. family members ignoring the depressed behavior expressed by the depressed individual. b. excessive attention from family members. c. family members discussing the depressed individual's negative thoughts and feelings with him or her. d. behavior by a spouse that can be interpreted as criticism
Answer: lithium
Over the long-term, _______________seems to be the best drug to prescribe to patients who have suicidal ideations, but is less effective for acute cases.
d
Over the past two years, Kelly has experienced depressive episodes three different times. Two of the three episodes occurred in the winter and the third occurred last fall. It is now winter and Kelly's depressive symptoms once again are consistent with major depressive disorder. Which of the following diagnoses should she be given? a. Dysthymic disorder b. Chronic major depressive disorder c. Recurrent major depressive disorder d. Recurrent major depressive disorder with a seasonal pattern
excitement and euphoria
People diagnosed with mania would be most accurately described as experiencing periods of _________.
b
Postpartum blues" are _________ a. a serious disorder. b. common, usually brief, and not a disorder. c. a subtype of Major Depressive Disorder. d. serious, brief, and a type of unipolar depression.
b
Quentin is severely depressed and presents an immediate and serious suicide risk. In the past he has not responded to tricyclics. A wise course of action is to treat him with _________ a. Prozac because it can reduce symptoms in 12 to 24 hours. b. electroconvulsive therapy because it can rapidly reduce symptoms. c. lithium because suicide is almost always accompanied by manic episodes. d. anticonvulsants such as carbamazepine and valproate because they can prevent future depressions.
b
Recent research on relapse among bipolar patients suggests that _________ a. stressful life events have very little influence. b. personality styles interact with stress to increase the likelihood of relapse. c. relapse is most likely among those with unrealistically positive attributional styles. d. the more frequently a person has bipolar episodes, the less likely stressful events are able to induce a relapse.
A monoamine oxidase inhibitor (MAOI)
Rennette has been suffering from the symptoms of major depressive disorder for several months, and her psychiatrist has prescribed a new type of medication. She is told that she must avoid foods that contain the amino acid tyramine, including red wine, salami, beer, and aged cheese. What kind of medication has Rennette been prescribed?
b
Stressful life events _________ a. do not trigger manic episodes. b. appear to increase the time to recovery from a manic episode. c. do not generally precipitate an initial manic episode, but tend to play more of a role over time. d. play no role in the development or progression of bipolar II disorder.
Negative cognitions about attractiveness and body image are more salient for girls than for boys.
Research consistently finds higher rates of depression-related problems in adolescent girls than in adolescent boys. Which of the following is one of the explanations for why this occurs?
suicidal thoughts and behaviors
Research finding an increase in ________ among adolescents taking antidepressant medications versus placebos prompted the Food and Drug Administration to place a warning on the labels of such medications alerting the public to this risk.
c
Reynaldo has been diagnosed with bipolar disorder. The most effective drug for him is _________ a. one that will increase his dopamine levels. b. one that will counteract the effect of sodium in his nerve cells. c. lithium. d. dexamethasone.
a
Sam has been diagnosed with major depressive disorder. He tells you that he is certain the world will end next Tuesday because everyone in it is so wicked. He refuses to consider that he might be wrong. Sam has _________ a. mood congruent delusions. b. mood incongruent delusions. c. atypical features. d. melancholic features.
b
Sean describes himself as having hardly ever being happy. He occasionally feels okay, but it never lasts more than a day or so. He has trouble sleeping, doesn't eat much, and feels like nothing will ever change in his life. He says this has been going on for as long as he can remember. The best diagnosis for Sean is _________ a. cyclothymia. b. persistent depressive disorder. c. major depressive disorder. d. bipolar II.
d
Seasonal affective disorder is best described as a ________ depressive disorder. a. mood-congruent b. minor c. psychotic d. recurrent
d
Selective abstraction is ________ a. a tendency to think in extremes. b. a tendency to jump to conclusions based on little or no evidence. c. part of Beck's cognitive triad. d. a tendency to focus on one negative detail of a situation while ignoring other aspects
c
Selective serotonin reuptake inhibitors _________ a. were the first antidepressants to be developed. b. are more effective than the tricyclic antidepressants. c. may lead to sexual problems. d. act to stabilize the mood swings of those with bipolar disorder
Acetylcholine
Several different neurotransmitters seem to be involved in the regulation of mood states in human beings. They include all except which of the following?
suicide hotlines
Since the 1960s, the availability of competent assistance at times of suicidal crisis has been expanded through the establishment of __________.
increase the risk of suicidal behaviors
The Food and Drug Administration (FDA) has required pharmaceutical companies to place warnings on the packaging for antidepressant medications that state that these drugs might _________
a
The WHO World Mental Health Survey revealed _________ a. the prevalence of mood disorders in countries around the world varies from .8 percent to 9.6 percent. b. the prevalence of mood disorders is about the same from one country to the next. c. the prevalence of mood disorders in countries around the world varies from 0 percent to 50 percent. d. the United States has the lowest prevalence of mood disorders of countries around the world.
anterior cingulate cortex; decreased volume and abnormally low levels of activation
The _______________, an area of the brain involved in selective attention, shows ____________ in patients with depression.
60; 12
The average concordance rate for bipolar disorder is about ____ percent for monozygotic twins, compared to _____ percent for dizygotic twins.
a
The average duration of an untreated episode of depression is _________ a. six to nine months. b. one year. c. two years. d. unknown as individuals not seeking treatment haven't been studied.
Answer: hypomanic episode
The diagnosis of a(n) __________ occurs when symptoms are similar to a manic episode but are milder.
b
The director of a city health department wants to know who is most likely to complete suicide in her city. The group with the highest risk is _________ a. teenagers, especially depressed girls. b. elderly men with chronic physical illnesses. c. young women who were recently separated or divorced. d. college-educated people.
c
The effectiveness of lithium in the treatment of bipolar disorder _________ a. supports the hypothesized role of serotonin in this disorder. b. is inconsistent with the established effects of dopamine on mood states. c. supports the role of dopamine in mania. d. suggests that it is not neurotransmitter function that is disrupted in bipolar disorder, but neurotransmitter levels.
b
The fact that bright light may be an effective treatment for seasonal affective disorder suggests that ________ a. this is a not a real form of depression as any response to light is merely a placebo effect. b. this form of depression is produced by a malfunctioning biological clock that needs resetting. c. changes in circadian rhythms underlie most forms of depression. d. seasonal affective disorder is a unique entity that should not be categorized with other forms of unipolar depression.
d
The finding that people with one type of serotonin transporter gene and childhood maltreatment had higher rates of depression than either those without the gene or those with the gene without the maltreatment suggests that ________ a. childhood maltreatment causes depression. b. only one type of gene causes depression. c. the diathesis-stress model is unlikely. d. the diathesis-stress model is likely
Answer: the monoamine oxidase inhibitors
The first category of antidepressant medications is __________.
Answer: cortisol
The hormone __________ has been found to be elevated in 60 to 80 percent of patients who have been hospitalized with major depressive disorder.
d
The main difference between a manic episode and a hypomanic episode is _________ a. whether the person also experiences depression. b. the number of symptoms the person has. c. whether the person has irritable mood. d. the amount of social and occupational impairment.
a
The majority of individuals who attempt suicide are ________ and the majority of those who complete suicide are ________. a. women and people between age 18 and 24; men and people over age 65 b. men and people over age 65; women and people between age 18 and 24 c. adolescents; the elderly d. the elderly; adolescents
two weeks; one week
The minimum required duration of symptoms for a depressive episode is ________ and the minimum required duration of symptoms for a manic episode is ________.
a
The presence of which of the following is a major risk factor for panic disorder, depression, and other anxiety disorders? a. Neuroticism b. Positive affect c. Helplessness d. Rumination
c
The rate of suicide deaths peaks during which part of the lifespan before leveling off? a. Ages 11-19 b. Ages 26-32 c. Ages 45-55 d. Ages 65-80
d
Transcranial magnetic stimulation is a _________ a. biological test for altered brain waves in bipolar disorder. b. noninvasive biological test for changes in brain function in depression. c. noninvasive biological treatment for manic episodes. d. noninvasive biological treatment for depression
d
Two months after her husband's death, Connie was still not herself. She often forgot to feed the dog, was late for work on a regular basis, and had not yet taken his clothes out of the closet. Which of the following diagnoses could apply to Connie according to the DSM-5? a. Adjustment disorder with depressed mood b. Persistent depressive disorder c. Postpartum depression d. Major depressive disorder
Major depressive disorder.
Two months after her husband's death, Connie was still not herself. She often forgot to feed the dog, was late for work on a regular basis, and had not yet thrown out his clothes. Which of the following diagnoses could apply to Connie according to the DSM-5? Adjustment disorder with depressed mood. Persistent depressive disorder. Postpartum depression. Major depressive disorder.
Answer: unipolar
Two types of mood disorders are __________ and bipolar depressive disorders
Bipolar disorder is more strongly inherited than unipolar disorder
Which of the following is true? Neither unipolar nor bipolar disorder have a strong genetic contribution. Unipolar and bipolar disorders have an equally strong genetic contribution. Unipolar disorder is more strongly inherited than bipolar disorder. Bipolar disorder is more strongly inherited than unipolar disorder.
a
Which of the following is true? a. Most first-time episodes of depression are preceded by a very stressful life event. b. Both first-time and recurrent episodes of depression are usually preceded by a very stressful life event. c. Even mildly stressful events are associated with the onset of episodes of depression. d. Mildly stressful events are only associated with the onset of first-time depression, not with recurrent episodes.
d
Which of the following is true? a. Neither unipolar nor bipolar disorder have a strong genetic contribution. b. Unipolar and bipolar disorders have an equally strong genetic contribution. c. Unipolar disorder is more strongly inherited than bipolar disorder. d. Bipolar disorder is more strongly inherited than unipolar disorder.
c
Which of the following might explain why rates of depression are low in China and Japan? a. Mental illnesses are not stigmatized, thus those who are depressed receive much social support and do not seek treatment. b. The heavy emphasis on the individual decreases the likelihood of blaming the self for failure. c. Symptoms of depression tend to be discussed as somatic. d. Blunted emotions characterize Asian peoples, so both positive and negative emotional extremes are rare.
b
Which of the following neurochemical profiles has been associated with manic episodes? a. High serotonin, high norepinephrine, high dopamine b. Low serotonin, high norepinephrine, high dopamine c. Low serotonin, low norepinephrine, high dopamine d. Low serotonin, high norepinephrine, low dopamine
Ulie, who has been diagnosed with a mild to moderate case of major depressive disorder.
Which of the following people has the highest likelihood of receiving some sort of treatment?
b
Which of the following statements about rumination is true, according to the ruminative response styles theory? a. Rumination is a protective factor against depression. b. People who ruminate a great deal tend to have more lengthy periods of depressive symptoms. c. Gender differences in depression are explained by ruminative styles. d. Biological factors have been most clearly linked to the development of rumination in those who do not have a family history of mood disorders
a
Which of the following statements is supported by research on the role of genetic influences in unipolar disorder? a. The more severe the depressive disorder, the greater the genetic contribution. b. Twin studies do not consistently find evidence of an inherited susceptibility to depression. c. Genes play a more significant causal role in bipolar disorders than they do in unipolar disorders. d. Bipolar and unipolar disorders are equally heritable.
Loss of interest in having sex
Which of the following symptoms of depression would you be most likely to see in a person from Korea?
Increased norepinephrine activity during manic episodes and decreased serotonin activity during depressed and manic stages
Which of the following would be the correct combination of neurotransmitter activities during different stages of bipolar disorder?
b
Which of the following would eliminate a potential diagnosis of cyclothymia? a. Gil had been showing both hypomanic and depressed symptoms for over three years. b. Carol was absolutely convinced that her mother wanted to kill her, although there was no evidence for this. c. Bob's most recent hypomanic episode lasted 3 days. d. Between her more recent episodes, Carla functioned quite well for 3 weeks.
Martin Seligman
Which researcher was the first to propose the idea of learned helplessness as being a significant contributing factor to the symptoms of a major depressive episode?
c
Which statement about bipolar I disorder is accurate? a. The depressive phase is more likely to involve psychotic features than in major depressive disorder. b. The onset of bipolar symptoms are never associated with seasons of the year as they are in unipolar depression. c. Single episodes of the disorder are extremely rare. d. Manic and depressive phases are always separated by lengthy intervals of normal mood.
c
Which statement about the risk of suicide is true? a. Depressed people are no more likely to commit suicide than nondepressed people. b. The risk of suicide is greatest at the lowest point in a depression. c. The risk of transitioning from suicidal thoughts to suicide attempt is highest in the first year after onset of suicidal thinking. d. Suicide is most likely when a person in a manic episode is getting "high."
a
Which statement best describes the relationship between mood disorders and domestic distress? a. Critical comments trigger negative affect in the spouse. b. Women who are depressed avoid their partners. c. Whenever there is a problem, it is caused by a man who, in a manic episode, is unaware of the nature of his behavior or even who he is attacking. d. Men become violent as a way of protecting themselves when their wives, who suffer from depressive episodes, become impulsively aggressive.
c
Which statement is the most true about suicide hotlines in the United States? a. There has been a steady decrease in the number available since the 1960s. b. There are millions available. c. They have not been shown to have much impact on suicide rates. d. They boast a near 100 percent success rate.
B
While suicide is relatively rare among children, the prevalence of such behaviors increases starting at around age ________ and continues to increase into the early- to mid-20s. a. 10 b. 12 c. 14 d. 16
b
While there is much support for some elements of Beck's cognitive theory, ________ a. treatments based on his view of depression are not effective. b. findings supporting it as a causal hypothesis are limited. c. it does not account for the known biological aspects of depression. d. is does not account for sex differences in depression.
It is assumed that either they have had undiagnosed depressive symptoms or that such symptoms will occur in the future.
Why is a person who demonstrates symptoms of mania without any history of depression still given a diagnosis of bipolar disorder?
a
Why is it not wise to treat an individual who has a bipolar disorder with a tricyclic antidepressant? a. The unpleasant side effects cause many to stop taking them. b. Individuals with bipolar disorder may or may not exhibit symptoms of depression. c. The drugs used to treat unipolar disorders do not alter the activity of the neurotransmitters that are affected in bipolar disorder. d. The combination of antidepressants and lithium is likely to be lethal.
Those seasons provide a reduction in the amount of available light.
Why is seasonal affective disorder much more common in the fall and winter months than in spring and summer?