Deck 11: Mood Disorders and Suicide

Question 1

For several months, Jack tells his friends that he feels depressed. When questioned by his friends, he states that he feels "down" most of the time. Jack has:

A) clinical depression
B) mood disorders
C) depressed mood
D) depression

Answer 1

C

Question 2

Dysthymia, major depressive disorder, cyclothymic disorder, and the bipolar disorders are classified as

A) neuroses.
B) mood disorders.
C) anxiety disorders.
D) personality disorders.

Answer 2

B

Question 3

Approximately what percentage of people have met the criteria for a mood disorder in the past?

A) 2%
B) 10%
C) 16%
D) 32%

Answer 3

B

Question 4

An expert on depression has been asked to testify before a committee of the United States Senate that is investigating the treatment of depression. Which of the following points is this expert likely to include in the testimony?

A) Depression is often misdiagnosed as schizophrenia.
B) Health care providers often fail to recognize depression.
C) Gene therapy is the major hope in the fight against depression.
D) A lack of will power is a major reason for the epidemic of depression.

Question 5

DSM-IV-TR divides mood disorders into three general categories. These categories are depressive disorders, bipolar disorders, and:

A) clinically related mood disorders
B) medically related mood disorders
C) major depressive disorders with psychotic features
D) recurrent depressive disorders

Question 6

Which of the following is not a reason why people do not seek treatment for mood disorders?

A) lack of awareness of effective treatment
B) being socially stigmatized
C) high cost related to treatment
D) health care providers not recognizing the disorder

Question 7

An epidemiologist is preparing a report on the rates of depression among people of different races and ethnic groups in the United States. What is the best title of the presentation?

A) "Ethnicity, but not race, matters in depression rates"
B) "Depression: Rates not affected by race and ethnicity"
C) "Why the symptoms of depression vary with ethnicity and race"
D) "Social support in some racial and ethnic groups makes depression rates"

Question 8

Which disorder occurs at a much higher rate among women than men?

A) bipolar I disorder
B) bipolar II disorder
C) cyclothymic disorder
D) major depressive disorder

Question 9

Which of the following disorders tends to occur with approximately equal frequency in men and women?

A) bipolar disorder
B) unipolar disorder
C) dysthymic disorder
D) dissociative identity disorder

Question 10

People who have experienced one or more episodes of major depression, but no episodes of mania or hypomania, are classified as having

A) dysthymia.
B) cyclothymia.
C) bipolar II disorder.
D) unipolar depression.

Question 11

Which of the following is not a risk factor affecting depression?

A) lack of social support
B) heredity
C) education
D) gender

Question 12

Which of the following cases of depression is most representative of those for which genetic factors seem to play an especially great role?

A) Alan who sleeps more than average
B) Cara whose depression began early in life
C) Agnes whose diagnosis is of a less severe form of depression
D) Dave whose depressive symptoms do not respond to medication

Question 13

Which aspect of a depressive disorder is most closely associated with stressful life experiences (rather than genetic predisposition)?

A) severity
B) early onset
C) number of recurrences
D) response to medication

Question 14

Which of these individuals falls within the age range of women who are at highest risk for a first episode of depression?

A) Sally, who is 15 years old
B) Mary, who is 24 years old
C) Barbara, who is 45 years old
D) Theresa, who is 55 years old

Question 15

Which of these individuals falls within the age range of men who are at greatest risk for a first episode of depression?

A) Al, who is 21 years old
B) Edward, who is 29 years old
C) Randolph, who is 45 years old
D) Salvatore, who is 65 years old

Question 16

During a case conference, a psychiatrist described several hospitalized patients as exhibiting "negative symptoms" of depression. What does this description tell us about these patients?

A) They had refused all forms of therapy.
B) They were experiencing troubling delusions.
C) They had been difficult to treat during therapy sessions.
D) They were experiencing appetite, weight, and sleep problems.

Question 17

What is a birth cohort?

A) a genetic predisposition to a disorder
B) a group of people born around the same time
C) a risk factor related to problems during pregnancy
D) the number of children born to mentally ill parents

Question 18

Which birth cohort has the highest rate of depression?

A) larger cohorts
B) earlier cohorts
C) more recent cohorts
D) smaller birth cohorts

Question 19

Which of these persons is a member of a cohort that has a higher than average risk of developing depression?

A) Bob who was born in 1975
B) Steve who fought in World War II
C) Frank who earned a doctoral degree in 1940
D) Dan who is the oldest member of the plumber's union

Question 20

One explanation for the higher rates of depression among women is that women experience more stress associated with

A) poor nutrition.
B) alcohol abuse.
C) providing social support.
D) lack of physical strength.

Question 21

Which person has the greatest risk for developing depression?

A) a father with young children
B) a mother with young children
C) a working man with no children
D) a working woman with no children

Question 22

Which aspect of intimate relationships is most clearly associated with increased risk for depression?

A) criticism
B) interference from in-laws
C) spending a lot of time apart
D) lack of support for career choices

Question 23

Which of these individuals is most likely to experience depression?

A) Al, who is 35-years old and single
B) Carl, who is 54-years old and married
C) Bob, who is 69-years old and widowed
D) Darla, who is 29-years old and has two young children

Question 24

Which of the following is not a factor in why women experience more depression than men?

A) Women receive more social support and become involved in the lives of others.
B) Coping strategies are different.
C) Women are expected to offer more social support.
D) Women are more involved in problems and stressors experienced by others.

Question 25

Which of the following groups are at a higher risk for depression than others?

A) Poor young women who are African American and Hispanic
B) White women between the ages of 22 - 42
C) Women who are middle-class
D) None of the above.

Question 26

How do men and women differ in coping with depression?

A) Men are reactive and women are proactive.
B) Men have an action-oriented style, while women have a cognitive style.
C) Men repress depression, while women openly discuss depression.
D) Women's coping styles are better adapted to deal with depression than men's.

Question 27

Which of the following is not true regarding stressful life situations and depression?

A) Some people seem to be vulnerable genetically to recurrent episodes of depression.
B) Many stressful situations in life are associated with relationships in the social network of the person.
C) How people interact with those close to them can create stressful situations.
D) People's behavioral-interactive style can contribute to depression.

Question 28

What is the prevalence of dysthymia in the general population?

A) .5%
B) 1%
C) 6%
D) 8%

Question 29

Which mood disorder has sometimes been considered a personality disorder?

A) dysthymia
B) bipolar I disorder
C) major depression
D) bipolar II disorder

Question 30

Maria has experienced chronic sadness, poor appetite, and insomnia nearly every day over the last 2 years. What is her most likely diagnosis?

A) dysthymia
B) cyclothymia
C) bipolar I disorder
D) major depressive disorder

Question 31

Marsha was seen last year at the Mental Health Center where she was diagnosed as having a major depressive episode. During the last six months, she has had five additional episodes. What is her present diagnosis?

A) major depressive disorder with psychotic features
B) bipolar I disorder
C) dysthymia
D) recurrent major depressive disorder

Question 32

Which disorder is most likely to occur with dysthymic disorder?

A) cyclothymia
B) bipolar I disorder
C) bipolar II disorder
D) major depressive disorder

Question 33

A psychiatrist wrote the following note on a patient's chart, "Classic case of double depression." A secretary was transcribing the psychiatrist's notes and asked what the term meant. What will the secretary be told?

A) The patient actually has an underlying schizophrenic disorder.
B) The patient has both dysthymic disorder and major depression.
C) The presenting symptoms look like a mirror image of depression.
D) The patient's depression is more than twice as serious as other forms of depression.

Question 34

What is "double depression"?

A) bipolar mood disorder
B) two episodes of depression
C) helplessness and hopelessness
D) comorbid dysthymia and major depression

Question 35

How does dysthymia differ from major depression?

A) In major depression rates increases in certain age groups but in dysthymia, the rates of increase is stable from age 18 to 64. Dysthymia tends to be chronic while major depression is time-limited.
B) Major depression increases with age due to life stressors and situational factors. Dysthymia seems to decrease in intensity with age.
C) Men seem to be more vulnerable to dysthymia and women are more vulnerable to major depression.
D) Dysthymia tends to be acute and pervasive, while major depression is chronic and developmental.

Question 36

What characteristic must a person's symptoms exhibit in order to meet the criteria for major depressive disorder?

A) worse in the morning
B) present for two weeks or more
C) chronically present for over 2 years
D) alternates with mania in a cyclical pattern

Question 37

How does age affect the severity of dysthymia?

A) Dysthymia is stable throughout adulthood.
B) Dysthymic periods are more brief with age.
C) Dysthymic periods occur more frequently with age.
D) Dysthymia lessens over time, even without treatment.

Question 38

Loraine describes the following symptoms to her therapist: depression, loss of interest, weight gain, sleep problems, feelings of worthlessness and suicidal ideation. The symptoms have been present for at least 3 weeks. Loraine's diagnosis is:

A) dysthymia
B) major depressive episode
C) cyclothymia
D) major depressive disorder

Question 39

What is the most appropriate description for a person who loses a loved one to death and who shows depressive symptoms for two months?

A) bereavement
B) dysthymic disorder
C) major depressive episode
D) adjustment disorder with depressed mood

Question 40

Which psychotic symptom often occurs with severe depression?

A) delusions
B) hallucinations
C) incoherent affect
D) incongruent affect

Question 41

What is the most likely biological basis for depression?

A) lesions in the limbic system
B) loss of neurons in the frontal lobes
C) irregular electrical activity in the brain
D) abnormal levels of neurotransmitters in the brain

Question 42

When a neuron is stimulated, it releases chemicals from storage areas called

A) vesicles.
B) receptors.
C) synapses.
D) dendritic clefts.

Question 43

What is the synaptic cleft?

A) the space between two neurons
B) a pattern of brain waves seen on an EEG
C) a specialized receptor protein on a neuron
D) the amount of neurotransmitter a neuron produces

Question 44

The monoamine hypothesis of the development of depression focuses on insufficient activity of several neurotransmitters. Although this hypothesis has influenced treatment, it is not without shortcomings as an explanation for depression. What is one of the problems of this hypothesis?

A) In some cases, high levels of these neurotransmitters are the actual cause of depression.
B) Not all people who suffer depression have all the neurotransmitters thought to be involved in depression.
C) Other neurotransmitters such as GABA and acetylcholine appear to be involved in some cases of depression.
D) The neurotransmitter levels thought to be involved in depression are actually responding to changes in diet that often accompany depression.

Question 45

What is the purpose of the enzyme monoamine oxidase?

A) speeding up release of serotonin into synapses
B) deactivating serotonin by chemically altering it into another form
C) directing various neurotransmitters to their appropriate synapses
D) protecting synapses from interference from drugs that might have an unfavorable effect on the body

Question 46

What effect does monoamine oxidase have on serotonin levels?

A) increases serotonin production
B) keeps serotonin in the synapse longer
C) speeds serotonin's delivery to receptors
D) decreases amount of serotonin in the synapse

Question 47

How does monoamine oxidase decrease the availability of serotonin in the synapse?

A) It promotes reuptake.
B) It slows production of serotonin.
C) It changes serotonin into another form.
D) It speeds delivery of serotonin to the receptors.

Question 48

Suppose a new technique is developed that can accurately and quickly measure monoamine oxidase levels in the brain. Using this technique, a scientist finds a very low level of monamine oxidase in the brain of a research participant. What will the scientist conclude about this person's current level of serotonin?

A) The serotonin level is normal.
B) The serotonin level is likely to be very high.
C) The level of serotonin is at such low levels that it may cause death.
D) The level of serotonin is not related to monoamine oxidase, so no conclusion could be reached.

Question 49

What is the biological effect of MAO inhibitors?

A) increases availability of serotonin
B) decreases availability of serotonin
C) increases availability of acetylcholine
D) decreases availability of acetylcholine

Question 50

Agnes has been depressed for the last six months. She finally decides to seek help at the mental health center where a psychiatrist prescribes a tricyclic antidepressant. Before she leaves, the psychiatrist advises her to be aware of several possible side effects. Which side effects will the psychiatrist include on the list?

A) constipation, dry mouth, and headaches
B) delusions, hallucinations, and sleepiness
C) depersonalization, memory loss, and tremors
D) joint pain, loss of appetite, and upper body rash

Question 51

Why do serotonin reuptake inhibitors have fewer side effects than other antidepressants?

A) They block acetylcholine.
B) Their effect is more specific.
C) They are taken for a shorter period.
D) They affect more neurotransmitters.

Question 52

Based on criteria ranging from effectiveness to cost, which drug would be the likely first choice for treating a depressed patient?

A) a benzodiazepine
B) an MAO inhibitor
C) a tricyclic antidepressant
D) a selective serotonin reuptake inhibitor

Question 53

What is the biological effect of the tricyclic antidepressants?

A) They chemically alter serotonin.
B) They block reuptake of serotonin.
C) They speed production of serotonin.
D) They inhibit MAO from altering serotonin.

Question 54

Why do the tricyclic antidepressants have so many side effects?

A) They are addictive.
B) They cause drops in serotonin levels.
C) They cause toxic reactions with some foods.
D) They block reuptake of norepinephrine and dopamine.

Question 55

Dysphoric mood, inability to experience pleasure, helplessness, and feelings of sadness are associated with decreased metabolism in what part of the brain?

A) thalamus
B) cerebellum
C) corpus callosum
D) frontal-temporal cortex

Question 56

In what part of the world are seasonal affective disorders most prevalent?

A) near the poles
B) near the equator
C) industrialized countries
D) non-industrialized countries

Question 57

For someone living in the United States, when is seasonal affective disorder likely to start?

A) February
B) April
C) July
D) November

Question 58

What changes in sleep may be associated with lowered levels of serotonin in depressed people?

A) increased REM sleep
B) decreased REM sleep
C) REM period ending later in the sleep cycle
D) REM sleep beginning later in the sleep cycle

Question 59

What are the major factors that are related to the prevalence of seasonal affective disorder around the world?

A) Prevalence is tied directly to latitude.
B) The prevalence varies quite a bit depending on treatments available.
C) In addition to latitude, other factors such as climate, appear to play a role.
D) The rate of seasonal affective disorder is tied directly to the number of hours of daylight, regardless of geography.

Question 60

A survey of the effectiveness of antidepressant medications reveals that not all depressed people respond full to these medications. Approximately what percentage respond fully?

A) 10%
B) 20%
C) 35%
D) 70%

Question 61

A physician is deciding whether to prescribe one of the older tricyclic antidepressant drugs or one of the newer, more recently developed ones. Fortunately, a medical journal just published a review of the drugs. What is the likely conclusion?

A) There are no difference other than cost between the two groups of drugs.
B) The newer drugs are more effective, work faster, and have fewer side effects.
C) The older drugs have a higher degree of effectiveness but they have some troubling side effects.
D) The two types of drugs do not differ in effectiveness, although the newer ones have fewer side effects.

Question 62

Which treatment for depression requires careful restrictions in diet?

A) tricyclic antidepressants
B) electroconvulsive therapy
C) monoamine oxidase inhibitors
D) selective serotonin reuptake inhibitors

Question 63

A patient at the mental health clinic is given a list of foods he should not consume while taking a drug prescribed for depression. What type of drug has been prescribed for this patient?

A) MAO inhibitor
B) benzodiazepine
C) tricyclic antidepressant
D) selective serotonin reuptake inhibitor

Question 64

A severely depressed patient is brought to a hospital emergency room. He has tried to commit suicide, and he says he will try again. When the man's family members arrive, what treatment will physicians recommend?

A) MAO inhibitors
B) electroconvulsive therapy
C) selective serotonin reuptake inhibitors
D) a double dose of a tricyclic antidepressant

Question 65

Why is electroconvulsive therapy sometimes used instead of antidepressant medication in the treatment of severe depression?

A) It is less expensive.
B) It works more quickly.
C) It has fewer side effects.
D) It has a stronger theoretical rationale.

Question 66

Among severely depressed patients who have not responded to antidepressant medications, what percentage show marked improvement after electroconvulsive therapy?

A) 10%
B) 30%
C) 50%
D) 70%

Question 67

Over the years several changes have occurred in electroconvulsive therapy. Because you have seen movies such as One Flew Over the Cuckoo's Nest you are reluctant to give consent for such treatment for your uncle who the court has declared unable to make the decision for himself. You express your concerns to the chief psychiatrist. What will you be told that will allay your fears?

A) The patient is under general anesthesia and the treatment is done to only one side of the head.
B) Treatment now involves battery-powered shocks that are given only once, with no side effects.
C) The electrical pulse is about one-third what it was in the past, and with bifrontal placement, there is little effect on memory.
D) Prior to receiving the treatment, both antidepressants and anesthetics are given, so the treatment is safer and works more quickly.

Question 68

Which of the following individuals is most likely to be treated and respond to treatment with electroconvulsive therapy?

A) Ann who is suffering from dysthymia
B) Barbara who is suffering from cyclothymia
C) Carl whose diagnosis is major depression with delusions
D) David whose diagnosis is adjustment disorder with depressed mood

Question 69

Robert is severely depressed and suicidal. At a hastily called case conference, the staff recommends electroconvulsive therapy. What is the most likely series of treatment that Robert will receive?

A) daily treatments for three weeks
B) six to 12 sessions at about three sessions per week
C) one treatment per week for approximately one month
D) one massive ECT treatment followed by antidepressant medication

Question 70

In 1972, George McGovern chose Thomas Eagleton for his presidential running mate. Thomas Eagleton was removed from the ticket because he had the following treatment for depression?

A) drug therapy
B) electroconvulsive therapy
C) seizures resulting from medication
D) psychotherapy

Question 71

What did Sigmund Freud believe characterized the psychic structure of a depressed person?

A) a strong ego
B) an unregulated id
C) a strong, punishing superego
D) diffuse boundaries between id, ego, and superego

Question 72

The psychoanalyst, John Bowlby, viewed depression as:

A) a relationship between childhood loss and later development.
B) the Oedipus complex.
C) a strong and punitive superego.
D) the ego's feeling of helplessness.

Question 73

Interpersonal therapy is a variation of what form of therapy?

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

Question 74

What do existential theorists view as the central cause of depression?

A) cognitive distortions
B) significant loss of a loved object
C) changes in self assessment following a loss
D) repressed anger at others perceived to be intrusive

Question 75

Which theoretical perspective holds that the higher rate of depression among women (compared to men) might be due to women's frustrations with not being able to perform multiple roles as well as they would like?

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

Question 76

According to the behavioral perspective, what characterizes depressed persons' coping?

A) delaying action
B) impulsive actions
C) use of irrational attributions
D) unconscious anger at others

Question 77

What is a schemata?

A) a map of the brain
B) attention-seeking behavior
C) a way of interpreting behavior
D) a treatment plan for changing behaviors

Question 78

According to Aaron Beck, the cognitive triad consists of negative thoughts about

A) self, others, and society.
B) past, present, and future.
C) oneself, the situation, and the future.
D) one's intelligence, looks, and personality.

Question 79

What is the cognitive triad?

A) major depression, dysphoria, and double depression
B) unipolar mood disorder, bipolar I disorder, and bipolar II disorder
C) attention to negative features of the self, the situation, and future
D) behavioral, cognitive, and emotional changes that occur in depression

Question 80

According to Aaron Beck, which of the following is typical of the cognitions of persons with anxiety disorders?

A) focus on negative aspects of the past
B) worry about whether or not they can cope
C) pessimistic view of what the future will bring
D) belief that nothing can be done to change the future