Deck 13: Depressive Disorders and Suicide

Question 1

Which of the following is NOT a way in which DMDD can be differentiated from ODD?

A) Children with ODD usually direct their defiance toward particular individuals, while children with DMDD usually direct their anger and aggression more generally, even destroying their own property.
B) Temper outbursts are longer and more severe in DMDD.
C) DMDD is more persistent than ODD.
D) DMDD is more likely to lead to anxiety and depressive disorders in adolescence than ODD.

Answer 1

DMDD is more persistent than ODD.

Question 2

Melanie has lost a significant amount of weight and hasn't been able to sleep since she broke up with her boyfriend a month ago.She feels guilty for not having spent enough time with him while they were together and is having difficulty thinking about anything else.She is still happy to go to dance class and her weekly pizza night with friends,but often finds that she's moving more slowly throughout her day.Her parents have observed that she also seems to be moving more slowly than before.Can Melanie be diagnosed with major depressive disorder?

A) Yes.
B) No, because it was triggered by a break-up.
C) No, because it hasn't persisted long enough.
D) No, because it's not clear that she has depressed mood or a loss of interest or pleasure in most activities.

Answer 2

No, because it's not clear that she has depressed mood or a loss of interest or pleasure in most activities.

Question 3

Compared to adults with depression,children with depression ______.

A) needn't experience symptoms as long in order to be diagnosed
B) needn't experience as many symptoms in order to be diagnosed
C) can display depressed mood as irritability
D) can show weight gain or increased sleep instead of just reduction in eating or sleeping

Answer 3

can display depressed mood as irritability

Question 4

In a frustrating visual task that was rigged to provide inaccurate feedback,children with DMDD produced which pattern of response compared to healthy controls?

A) more agitation and greater activation of the amygdala
B) more negative arousal and lower activation of the amygdala
C) more agitation and greater activation in the right medial frontal gyrus and left anterior cingulate cortex
D) more negative arousal and lower activation in the right medial frontal gyrus and left anterior cingulate cortex

Question 5

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

A) feelings of worthlessness or guilt
B) depressed mood
C) temper outbursts
D) thought and concentration problems

Question 6

Research has indicated that those with DMDD may demonstrate temper outbursts for all of the following reasons EXCEPT  ______.

A) They may interpret their own frustration as anger and act accordingly.
B) They may interpret others' fear as anger and act aggressively toward them as a result.
C) They may like that others are afraid of them and act out to perpetuate their power in these situations.
D) They may find frustration and other similar states as particularly aversive and hard to handle and may act out more than the average child in response to similar stressors.

Question 7

Which of the following is true of treatment for DMDD?

A) Parent training is most effective in managing the child with DMDD's irritability and anger.
B) Summer programs for children with DMDD are effective in the short term, but show few longer term benefits.
C) Family treatment is most effective when child and parent are in the same room for the duration of treatment.
D) One focus of treatment is often on helping children with DMDD better interpret their own emotions and those of others.

Question 8

Safe Alternatives for Teens and Youths involves all EXCEPT which of the following?

A) restricting adolescents' means of suicide at home
B) parent sessions with the therapist
C) a no harm contract
D) developing coping strategies

Question 9

How does the irritable mood seen in DMDD differ from the mood features seen in disruptive behavior disorders?

A) In DMDD, irritability is more persistent.
B) In DMDD, irritability has earlier onset.
C) In DMDD, irritability has later onset.
D) DMDD involves reliably different environmental triggers.

Question 10

Brookridge Middle School is targeting a suicide prevention program to students at risk due to their social and bullying status.This would be considered which of the following?

A) universal prevention program
B) selective prevention program
C) indicated prevention program
D) tertiary prevention program

Question 11

Youths with DMDD have been shown to have which deficits related to emotional processing?

A) They are particularly bad at judging positive emotions in faces and show hyperactivity in the amygdala when viewing angry or fearful faces.
B) They are particularly good at judging angry and fearful faces and show hyperactivity in the amygdala when viewing these faces.
C) They are particularly bad at judging sad, fearful, and angry faces and show hyperactivity in the amygdala when viewing these faces.
D) They are particularly bad at judging sad, fearful, and angry faces and show underactivity in the amygdala when viewing these faces.

Question 12

Which is true regarding the relationship between sleep and DMDD?

A) Children with a history of sleep problems are more likely to develop DMDD.
B) The irritability and brain activation differences of children with DMDD make it harder for them to sleep.
C) The comorbidity between DMDD and ADHD moderates the relationship between DMDD and sleep disturbance.
D) Children with DMDD often experience sleep problems, but the direction of this relationship is still unknown.

Question 13

Because the Treatment of Adolescent Suicide Attempters (TASA)study had no control group,which of the following CANNOT be concluded?

A) All treatment conditions showed equivalent effectiveness.
B) Any treatment is more effective than no treatment.
C) Combined treatment is no more effective than medication alone.
D) CBT is no more effective than medication.

Question 14

Severity in major depressive disorder is determined by which of the following?

A) number of episodes
B) duration of the disturbance
C) number of symptoms and amount of distress or impairment
D) degree of suicidality

Question 15

Safety plans involve all EXCEPT which of the following?

A) means restriction
B) identification of triggers
C) identification of support sources
D) consequences for not following the plan

Question 16

Which of the following disorders has the shortest minimum duration for diagnosis?

A) major depressive disorder
B) disruptive mood dysregulation disorder
C) persistent depressive disorder in adults
D) persistent depressive disorder in children

Question 17

Which of the following patterns of symptoms of MDD is more common in children than adults?

A) hypersomnia, weight gain, psychomotor agitation
B) insomnia, weight loss, psychomotor agitation
C) hypersomnia, weight loss, psychomotor retardation
D) insomnia, weight gain, psychomotor retardation

Question 18

Eight-year-old Gordon is constantly throwing temper tantrums at home and seems just generally upset.He's been this way as long as his parents can remember and when something sets him off,he terrorizes the house,pulling things off the wall and breaking whatever he can find.His family is on their third set of dishes this year.Which of the following would be necessary to know before diagnosing Gordon with DMDD?

A) Is Gordon living with his biological parents?
B) Does Gordon exhibit these problems at school or with peers?
C) Does Gordon have an ODD diagnosis?
D) Did this pattern of behavior begin prior to the age of 4?

Question 19

The existence of persistent irritability and recurrent temper outbursts best distinguishes DMDD from which of the following?

A) ADHD
B) ODD
C) bipolar disorder
D) MDD

Question 20

What is the recommended role of medication in treating DMDD?

A) Lithium is the first-line medicinal treatment.
B) Antipsychotics are the first-line medicinal treatment, but these are only effective in those with comorbid ADHD.
C) Stimulant medication is the first-line medicinal treatment, but only in those with no comorbidities.
D) Antidepressants are recommended for some youths with DMDD.

Question 21

Which of the following is NOT a way in which temperament is thought to relate to the development of depression?

A) Children with difficult temperament may overreact to negative life events and have emotion regulation difficulties.
B) Children with difficult temperament tend to selectively affiliate with each other, exacerbating their likelihood of experiencing and reacting severely toward life stressors.
C) Children with difficult temperament may elicit negative reactions from caregivers and peers leading to low self-worth and depression.
D) Children with difficult temperament may have greater problems coping with early childhood stressors.

Question 22

A person with a depressogenic attributional style is likely to have which pattern of attributions for scoring a goal in a soccer game?

A) internal, stable, global
B) internal, stable, specific
C) external, stable, specific
D) external, unstable, specific

Question 23

Ryan falls into the water during a school trip to the beach.Which of the following attributions is LEAST depressogenic?

A) There was a big shell on the beach that I didn't see.
B) I'm so clumsy.
C) No one could ever be friends with a kid like me.
D) No matter how hard I try I just can't help but be clumsy.

Question 24

Research has linked depressogenic attributions to all EXCEPT which of the following?

A) genetics
B) negative life events
C) depression itself
D) social contagion

Question 25

Which of the following sets of individuals had the highest concordance for MDD and what does that tell us?

A) Monozygotic twins raised together had only slightly higher concordance for MDD than monozygotic twins raised apart. This indicates a strong genetic component to the disorder.
B) Monozygotic twins raised together had a higher concordance for MDD than monozygotic twins raised apart. This indicates the importance of nonshared environmental factors as primary in the development of the disorder.
C) Dizygotic twins have a higher concordance rate for MDD than monozygotic twins, whether raised together or raised apart. This indicates there is a strong genetic component to the disorder.
D) Twins had to have been raised together to show any concordance for MDD above that of typical siblings. This indicates a relatively small genetic role in MDD.

Question 26

Which of the following was NOT a course of depressive symptoms identified by researchers?

A) very low levels of depression across childhood and adolescence
B) high levels of depressive symptoms in childhood that gradually diminish through adolescence
C) consistent, moderate levels of depressive symptoms throughout childhood and adolescence
D) low levels of depressive symptoms in childhood with dramatically higher levels in adolescence

Question 27

Which of the following is NOT evidence presented in the text that the HPA axis is affected in depression?

A) Chronically high levels of cortisol are found in those with depression.
B) Giving synthetic cortisol to those with depression doesn't "shut off " cortisol production.
C) Depressed youths sometimes show an enlarged pituitary.
D) Depressed youths have increased sensitivity to small amounts of cortisol.

Question 28

The kindling hypothesis would predict which of the following?

A) Those with a genetic predisposition toward depression would be more likely to manifest depressive symptoms.
B) Those who have experienced recurrent depression are more likely to experience major life stressors.
C) Those who have experienced an early depressive episode are more likely to view later minor stressors as more severe.
D) Those who have experienced multiple depressive episodes become desensitized to stressors and have greater resilience in the face of future stressors.

Question 29

Which of the following is true regarding the prevalence of depression in children and adolescents?

A) Overall, it has increased dramatically in the last 10 years.
B) Boys are more likely than girls to have persistent depressive disorder while girls are more likely than boys to have major depressive disorder.
C) The prevalence of major depressive disorder increases dramatically from childhood to adolescence.
D) 20% of youths experience major depressive disorder at any given time.

Question 30

Which of the following is NOT a factor that prompts suicide according to interpersonal theory?

A) perceived burdensomeness
B) thwarted belongingness
C) capability for suicide
D) hopelessness

Question 31

Excessive compliance may lead to depression because of which of the following?

A) It limits the development of autonomy.
B) It creates social tension with others.
C) It provides few alternative coping strategies.
D) It can lead to excessive guilt and helplessness.

Question 32

Billie is assessed for suicide and determined to be at acute high risk.Which of the following is likely true of Billie?

A) She will likely be sent home and her parents can protect her there.
B) She must not have reported an active plan to commit suicide.
C) She likely has thoughts of death but no current intent to die.
D) She is likely to be hospitalized until her risk decreases.

Question 33

Which of the following is the relationship between bullying/cyberbullying and suicide?

A) Cyberbullying increases the rate of suicide in the victim, while bullying does not.
B) Bullying increases the likelihood of suicide in the victim, while cyberbullying does not.
C) Bullies are at increased risk for suicide while victims of bullies are not.
D) Both bullies and their victims are at increased risk of suicide.

Question 34

Research has indicated which of the following with respect to the role of stressful life events in the development of depression?

A) Stressful life events, particularly during puberty, account for almost all of the variance in adolescent depressive symptoms.
B) Stressful life events are most impactful in the development of depression when they occur in childhood.
C) Stressful life events are most impactful in the onset of the initial depressive episode.
D) The relationship between stressful life events and depression is that stressful life events predict depression but there is no influence in the other direction.

Question 35

Which of the following is NOT a true distinction between major depressive disorder and persistent depressive disorder?

A) Persistent depressive disorder tends to have gradual onset while the onset of major depressive disorder tends to be more sudden.
B) Symptoms of MDD tend to be more severe.
C) Though they both entail general sadness, there are no symptoms that overlap between major depressive disorder and persistent depressive disorder.
D) Persistent depressive disorder is typically longer-lasting than major depressive disorder.

Question 36

Learned helplessness refers to which of the following?

A) the inability to develop independent coping skills when parents are particularly intrusive
B) expressions of uncertainty and help-seeking when faced with environmental stressors
C) the propensity to not seek escape from stressors when past stressors were inescapable
D) the informational transmission that social mores cannot be changed or overcome

Question 37

A children's book called The Pout Pout Fish describes a fish who wants to be cheery but can't because "It's just the way I am." This is most consistent with which disorder?

A) MDD
B) PDD
C) DMDD
D) bipolar disorder

Question 38

The main difference between a cognitive bias and a cognitive distortion as these terms apply to depression is which of the following?

A) A cognitive distortion refers to selective attention to negative events while cognitive bias refers to selective attention to negative attributes of people.
B) A cognitive distortion refers to a misperception of others' intentions while cognitive bias refers to selective attention to one's own motives.
C) A cognitive distortion involves a perception or interpretation that is overblown and not consistent with reality while cognitive bias is a shift in looking at the world that involves selective attention to negative experiences.
D) Cognitive bias involves perceptions of others while cognitive distortions refer to misperceptions of one's self.

Question 39

All of the following are true of girls with depression (as compared to boys with depression)EXCEPT which of the following?

A) Girls tend to show a greater number of symptoms.
B) Girls tend to show more sudden onset of symptoms.
C) Girls tend to show greater likelihood of self-harm.
D) Girls tend to have longer initial depressive episodes.

Question 40

Parents can increase the suicide risk of their children in all of the following ways EXCEPT ______.

A) Parents who have committed suicide have children with higher risk of suicide.
B) Parents with mood disorders, substance use disorders, and personality disorders can compromise the care of their children and increase family stress, increasing the risk of suicide in children.
C) Parents who provide strong support to their children, but whose children don't perceive this support, have children at higher risk of suicide.
D) Parents who are verbally abusive toward their children have children with higher rates of suicide than children who experience any other kind of child maltreatment.

Question 41

Which of the following is the best predictor of a future suicide attempt?

A) diagnosis of depression
B) ethnicity
C) the combination of age and gender, with females between 12 and 18 at highest risk
D) previous suicidal thoughts and actions

Question 42

Which of the following best reflects the results on the relationship between peers and depression?

A) Positive peer relationships can provide substantial resilience in the face of other psychosocial stressors.
B) Problematic peer relationships can predict depression.
C) Positive peer relationships can provide resilience against depression and problematic peer relationships can predict depression.
D) There is no reliable relationship, positive or negative, between peer relationships and depression.

Question 43

Why is the Adolescent Coping With Depression (CWD-A)course held in a classroom environment?

A) to be more familiar to adolescents
B) to be more cost-effective, allowing for the treatment of many youths at the same time
C) to be less stigmatizing
D) to allow researchers to use existing schools to carry out treatments

Question 44

Which of the following is NOT a method to improve coping skills used in Stark's treatment for childhood depression?

A) providing alternative explanations for situations that have contributed to the child's negative mood
B) teaching relaxation exercises
C) asking the child to interview nondepressed peers to generate additional coping ideas
D) introducing pleasurable activities into the week that the child actively plans

Question 45

Ayumi,an 8-year-old working through a depression,tells her therapist that the other day when she came back from the classroom after having gone to the bathroom,none of the kids even looked at her when she walked in the door.She said it proved that no one liked her or cared about her.Her therapist asked her whether there was anything else that might have explained their behavior-for instance,were they all working on a math worksheet when she came in? Her therapist is helping Ayumi engage in which of the following?

A) What's the Evidence?
B) Alternative Interpretations
C) What If?
D) Psyching Up

Question 46

"Psyching-up" is which of the following?

A) a component of the Coping with Depression Program
B) a component of coping with negative emotions
C) a term for directing all of a child's energy and attention to solving a problem
D) a way for a child with depression to reward himself or herself after solving a problem

Question 47

How does parental attachment form a template for future relationships?

A) Children who receive intrusive care expect similar interactions with later individuals they will encounter.
B) Children who receive unresponsive care often seek responsiveness in others.
C) Children often believe they are incapable of engaging in interactions in ways other than the way their parents interacted with them.
D) Insecurely attached children often believe that the best possible romantic partner is the one who most resembles their parents' interaction style.

Question 48

Based on findings of the factors that predict depressive symptoms,which of the following individuals would be at highest risk?

A) Mikayla, who has few friends and thinks to herself, "Who cares about them anyway? They're all a bunch of phonies."
B) Teagan, who has few friends and thinks to herself, "Everyone else has someone and I have no one. There must be something really wrong with me."
C) Akeela, who has a lot of friends but who sometimes wonders, "Who am I really? What is really important to me?"
D) Willa, who has an average number of friends, but asks herself, "I wonder what they'd like me to do? How can I make them happiest?"

Question 49

In which of the following ways is substance use NOT related to suicide?

A) Alcohol is often used immediately before suicide and may reduce inhibitions against self-injury.
B) Amphetamine may increase the risk of suicide by increasing impulsive decision-making.
C) Marijuana may increase the risk of suicide by making the adolescent more careless, for instance when driving.
D) Substance use disorders increase the risk of suicide, particularly when an individual has several substance use disorders simultaneously.

Question 50

One of the main components of CBT for depression is which of the following?

A) removing response-contingent reinforcement to give youths a sense of unconditional positive regard
B) enhancing anhedonia
C) challenging cognitive bias and distortion
D) valuing the client's independence and preventing overreliance on social networks in times of stress

Question 51

Insecure attachment is associated with all of the following EXCEPT ______.

A) feelings of low self-worth
B) deriving self-esteem from accomplishments and approval
C) less help-seeking in times of crisis
D) low self-reliance

Question 52

Which of the following diagnoses is NOT associated with an increased risk of suicide?

A) conduct disorder
B) persistent depressive disorder
C) bipolar disorder
D) obsessive compulsive disorder

Question 53

Which of the following is one of the primary differences between cognitive-behavioral therapy for children and for adolescents?

A) Only cognitive-behavioral therapy for children involves planning pleasurable activities.
B) Only cognitive-behavioral therapy for adolescents involves relaxation techniques.
C) Only cognitive-behavioral therapy for adolescents involves learning how to brainstorm possible solutions to interpersonal problems.
D) Only cognitive-behavioral therapy for children specifically involves the What's the Evidence? and What If? approaches to cognitive restructuring.

Question 54

Complete this statement: No SSRIs ______.

A) are more effective than placebo in treating childhood depression
B) increase the availability of serotonin, modulating it to normal levels
C) are FDA approved for treating depression in children
D) showed a large (>20%) increase in improvement of childhood depressive symptoms over placebo

Question 55

Which of the following is true about tricyclic antidepressants?

A) They are the most effective treatment for childhood depression.
B) They affect serotonin and dopamine systems.
C) They are much more effective in children than in adults.
D) They have severe side effects for more than 10% of children.

Question 56

Which of the following best describes the effectiveness of CBT for treating childhood depression?

A) It is no more effective than placebo.
B) It is more effective than any other kind of psychotherapy.
C) It is as effective as several other kinds of psychotherapy, particularly in the long term.
D) It is less effective than several other kinds of psychotherapy in the short term, but more effective in the long term.

Question 57

The finding that maternal depression is associated with less responsive and more hostile parenting behavior provides support for which hypothesis of the cause of depression?

A) the monoamine hypothesis
B) the intergenerational interpersonal stress model
C) the peer contagion model
D) the social-information processing theory of depression

Question 58

If the link between maternal depression and child depression were purely genetic,which of the following would you expect?

A) Adopted children would show no particular relationship between their depressive status and their adoptive parents' depressive status.
B) Twins raised apart would not be similar in their depressive status.
C) Biological siblings would be more similar in their depressive status than parents and children would be.
D) Parents who were discordant for depression would have the highest rate of depression in their children.

Question 59

Mothers who have high levels of ______ during pregnancy often have offspring who have difficulty regulating ______.

A) stress; dopamine
B) stress; cortisol
C) depression; GABA
D) depression; testosterone

Question 60

The social information-processing theory of depression holds which of the following?

A) Children with depression have a hostile attribution bias and believe that others' perceived hostile actions derive from external and unstable factors.
B) Children with depression have a victim attribution bias and believe that others' perceived hostile actions derive from external and unstable factors.
C) Children with depression have a hostile attribution bias and believe that others' perceived hostile actions derive from internal and stable factors.
D) Children with depression have a victim attribution bias and believe that others' perceived hostile actions derive from external and stable factors.

Question 61

The Treatment for Adolescents with Depression Study did NOT include which of the following groups?

A) fluoxetine (Prozac) only
B) CBT only
C) psychotherapy placebo
D) placebo

Question 62

Automatic cognitions about threat and personal vulnerability are most common in depressed youths.

Question 63

Cognitive-behavioral therapy is more effective than any other treatment for adolescents with depression.

Question 64

Temper outbursts must be physical to meet criteria for DMDD.

Question 65

Parent training is typically sufficient to treat DMDD.

Question 66

The results of the National Comorbidity Survey have indicated which of the following?

A) Many more youths plan suicide than actually attempt it.
B) About 10 times as many youths have suicidal ideation than actually plan suicide.
C) More youths attempt suicide than plan it because some youths attempt suicide without a plan.
D) The number of adolescents with a lifetime history of suicidal ideation is almost exactly the same as the number with a lifetime history of depression.

Question 67

Complete the following statement: Interpersonal therapy ______.

A) has never had its effectiveness examined in adolescents
B) is no more effective than traditional counseling in improving social functioning
C) is no more effective than traditional counseling in reducing depressive symptoms
D) is more effective than traditional counseling in both improving social functioning and reducing depressive symptoms

Question 68

Parents who have committed suicide have children at greater risk of suicide but otherwise parents' mental health status does not impact children's risk of suicide.

Question 69

"I just couldn't find my place in the family anymore after my sisters had their children," Sherry said."Being the youngest,I suddenly felt like a third class citizen.That's when I began to feel depressed." Sherry's interpersonal therapist might help her through which of the following?

A) grief and loss
B) interpersonal role dispute
C) role transition
D) interpersonal deficit

Question 70

Girls are more likely to die from suicide than boys.

Question 71

Ronnie describes his parents as uncaring and unyielding."They won't let me stay out late,even for football games,so I had to quit the team," Ronnie said."It's like they don't remember what it was like to be young." Robbie's experiencing which of the following?

A) grief and loss
B) interpersonal role dispute
C) role transition
D) interpersonal deficit

Question 72

Which of the following is true of the prevalence of suicide?

A) It remains the highest cause of death among adolescents in the United States.
B) The prevalence of suicide, though high, has remained steady for the past 20 years.
C) The prevalence of suicide among young girls has increased 200% in the past 15 years.
D) In the past 15 years, suicide has become more common in children (ages 10-14) than in adolescents (ages 15-24).

Question 73

Children who don't respond to antidepressant medication showed which of the following?

A) additional improvement when CBT was added to their treatment, and the added benefits were still present at 24-week follow-up
B) additional improvement when CBT was added to their treatment, though the added benefits were no longer present at 24-week follow-up
C) no additional improvement when CBT was added to their treatment initially, though some gains were seen at the 24-week follow-up
D) no additional improvement when CBT was added to their treatment

Question 74

Which of the following best describes the effectiveness of CBT combined with medication to treat depression?

A) Statistically, the combination of CBT and medication is no more effective than CBT alone.
B) Statistically, the combination of CBT and medication is more effective than medication alone.
C) Medication was no more effective than placebo.
D) Any group that had medication as part or all of their treatment outperformed placebo groups.

Question 75

Girls have a higher prevalence of depression in adolescence than boys do,though boys and girls show equal rates of depression in childhood.

Question 76

Relational aggression is associated with depression in both boys and girls.

Question 77

Marlene accidentally falls off a step stool when she's changing a lightbulb and hits the step stool,getting a large red mark on her leg.Is this self-injurious behavior?

A) Yes.
B) No, because it only happened once.
C) No, because it is not deliberate.
D) No, because the step stool was the instrument that hurt her, not Marlene herself.

Question 78

Having a single episode of major depressive disorder is less common than having recurrent episodes.

Question 79

Which of the following is one of the reasons that African Americans may have lower rates of suicidality overall than other ethnic groups?

A) African Americans tend to have higher self-esteem than other ethnic groups.
B) African Americans tend to have higher degrees of religious belief and involvement.
C) African Americans may prioritize the needs of the family and community above their own needs.
D) African Americans may experience a high rate of stigma regarding mental health issues.

Question 80

Which of the following statements regarding suicidality by ethnicity is true?

A) African Americans report the highest rates of suicidal thoughts.
B) American Indian girls show the highest rates of suicide death.
C) White girls show the highest rates of suicide attempts.
D) Latinas are one of the groups most likely to attempt suicide.