Deck 7: Mood Disorders and Suicide

Question 1

Sean describes himself as having hardly ever been 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) dysthymia.
C) major depressive disorder.
D) bipolar II.

Answer 1

dysthymia.

Question 2

In order to meet the criteria for a major depressive episode, a person MUST have

A) a depressed mood most of the day for at least 2 weeks.
B) significant weight loss.
C) significant distress or impairment.
D) insomnia.

Answer 2

significant distress or impairment.

Question 3

What is the most important characteristic used to distinguish dysthymia 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.

Answer 3

Whether there are occasional brief periods of normal moods during the disorder.

Question 4

Which of the following is NOT a symptom of major depressive disorder?

A) Bouts of anxiety
B) Considerable appetite and weight gain
C) Excessive fidgeting and an inability to sit still
D) Sleeping excessive amounts

Question 5

Which of the following is true of unipolar major depression?

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 disorder.

Question 6

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.

Question 7

"Normal" depression becomes a mood disorder when

A) there is no identifiable cause for it.
B) the degree of impairment is judged severe enough to warrant a diagnosis.
C) it lasts for more than a month.
D) it ceases to be justified and adaptive.

Question 8

In which of the following disorders must symptoms be present for at least 2 years in order for a diagnosis to be made?

A) Dysthymia
B) Bipolar I disorder
C) Major depressive disorder
D) Bipolar II disorder

Question 9

A person who shows psychotic depression that involves mood-incongruent or 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.

Question 10

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) She has no disorder.

Question 11

How does dysthymia 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 dysthymia than to meet major depressive disorder.
D) Symptoms are mild to moderate but last for much longer than in major depressive disorder.

Question 12

George, a 22-year-old mechanic, always seems to have a cloud over his head. For the past three years, he has had problems sleeping and he seems to always overeat. 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) Dysthymia
D) Major depressive disorder

Question 13

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.

Question 14

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. If he is suffering from major depression, Herbert's symptoms suggest the subtype called

A) mood-congruent.
B) melancholic.
C) dysthymic.
D) postpartum.

Question 15

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 would apply to Connie?

A) Adjustment disorder with depressed mood
B) Dysthymia
C) Postpartum depression
D) Connie does not have a disorder.

Question 16

Depression

A) can occur even in infants and 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.

Question 17

"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.

Question 18

Kerry suffers from depression. He is experiencing delusions that his brain is deteriorating and that he is aging quickly. These delusions

A) are uncommon in depression and 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.

Question 19

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 dysthymia later develops major depressive disorder as well.

Question 20

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.

Question 21

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 spring. 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

Question 22

Margaret has been suffering with dysthymia 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.

Question 23

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) either or a gene or certain environmental factors need to be present to cause depression.
D) both a gene and certain environmental factors need to be present to cause depression.

Question 24

Which of the following is NOT a brain area that has been found to exhibit abnormalities in depressed patients?

A) Amygdala
B) Basal ganglia
C) Anterior cingulate gyrus
D) Hippocampus

Question 25

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.

Question 26

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

Question 27

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.

Question 28

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.

Question 29

The average duration of an untreated episode of depression is

A) 6-9 months.
B) 1 year.
C) 2 years.
D) unknown as individuals not seeking treatment haven't been studied.

Question 30

A recurrent depressive episode

A) is preceded by one or more previous episodes.
B) suggests that chronic major depression has developed.
C) typically lasts 2-3 weeks.
D) is characteristic of all forms of bipolar disorder.

Question 31

Which of the following is a true statement about the recurrence of depressive symptoms?

A) If a recurrence is not experienced within 1 year after an initial depressive episode, recurrence is highly unlikely.
B) Most 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.

Question 32

Which of the following is a research finding that is inconsistent with the monoamine hypothesis of depression?

A) Drugs that increase serotonergic activity are effective in treating depression.
B) Increases in noradrenergic activity have been seen in the brains of depressed patients.
C) Heightened sensitivity to drugs that increase GABA activity is commonly seen in individuals with bipolar disorder.
D) Tricyclic antidepressants work by blocking monamine reuptake.

Question 33

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

Question 34

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.

Question 35

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.

Question 36

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.

Question 37

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

Question 38

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.

Question 39

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.

Question 40

Seasonal affective disorder is best described as a depressive disorder.

A) mood-congruent
B) minor
C) psychotic
D) recurrent

Question 41

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.

Question 42

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.

Question 43

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.

Question 44

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

Question 45

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.

Question 46

Parental loss only results in a vulnerability to depression when

A) the loss is due to death.
B) poor parental care is a consequence of the loss.
C) the loss is not explained adequately to the child.
D) both parents are lost at an early age.

Question 47

Which of the following is an example of arbitrary inference?

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.

Question 48

Selective abstraction

A) is a tendency to think in extremes.
B) is a tendency to jump to conclusions based on little or no evidence.
C) is part of Beck's cognitive triad.
D) is a tendency to focus on one negative detail of a situation while ignoring other aspects.

Question 49

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.

Question 50

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 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.

Question 51

A therapist with a orientation would emphasize the depressed person's need to improve their social skills.

A) behavioral
B) psychodynamic
C) cognitive
D) sociocultural

Question 52

Which of the following statements about rumination is true, according to the ruminative reponse 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.

Question 53

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

Question 54

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.

Question 55

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

Question 56

Which of the following reactions to poor test performance suggests 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.

Question 57

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

Question 58

Which of the following is the type of attribution that is most likely to cause depression?

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.

Question 59

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.

Question 60

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 depression 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

Question 61

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.

Question 62

A diagnosis of bipolar I disorder indicates that the person has met DSM IV-TR 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 a major depression.

Question 63

Carleen comes to therapy because she is feeling sad. She says her 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, 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) dysthymia.
C) bipolar I.
D) bipolar II.

Question 64

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.

Question 65

According to Hammen's stress-generation model of depression,

A) marital distress can lead to depression and depression can lead to marital distress.
B) the source of most marital distress in the depression of one or both partners.
C) the stress and depression caused by marital discord explains the higher suicide rate seen in those who are married.
D) stress causes depression.

Question 66

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 5-10 percent of those with bipolar disorder.

Question 67

Why is it not wise to treat an individual who has a bipolar disorder with an antidepressant?

A) The drug may trigger a manic episode.
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.

Question 68

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

Question 69

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 dysthymia.
D) cyclothymia.

Question 70

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.

Question 71

The prognosis for bipolar disorder is

A) excellent, most people recover fully.
B) guarded, most people continue to have some symptoms.
C) unpredictable, all possible outcomes are seen frequently.
D) uncertain, although most people have only one episode.

Question 72

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.

Question 73

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

Question 74

Bipolar disorder is to major depression as is to .

A) dysthymia; cyclothymia
B) cyclothymia; dysthymia
C) mania; hypomania
D) hypomania; mania

Question 75

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.

Question 76

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.

Question 77

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.

Question 78

Which of the following is true?

A) Neither unipolar nor bipolar disorder have a strong genetic contribution.
B) Both unipolar and bipolar disorders have a strong genetic contribution.
C) Unipolar disorder is more strongly inherited than bipolar disorder.
D) Bipolar disorder is more strongly inherited than unipolar disorder.

Question 79

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.

Question 80

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.