Deck 11: Mental Health Issues and Treatment

Question 1

Depressive symptoms can place the older adult at risk for developing which other diseases or conditions?

A) sarcopenia
B) emphysema
C) arthritis
D) hyperthermia

Answer 1

C

Question 2

In generalized anxiety disorders, individuals experience which of the following symptoms?

A) hand tremors
B) restlessness
C) irrational fears
D) sense of guilt

Answer 2

B

Question 3

Of the following, which category of disorders has the highest lifetime prevalence?

A) depressive
B) PTSD
C) anxiety
D) schizophrenia

Answer 3

C

Question 4

The 12-month prevalence of generalized anxiety is 5.7% and of these, _____ per cent are classified as severe.

A) 20
B) 30
C) 50
D) 75

Question 5

Which of the following coping strategies is not a risk factor for developing symptoms of late life depression?

A) Avoidance coping
B) Problem focused coping
C) Reframing
D) Venting

Question 6

According to the text, higher rates of mortality among older adults with anxiety symptoms exist for which racial/ethnic group?

A) Pacific Islanders
B) African Americans
C) Non-hispanic whites
D) Native Americans

Question 7

Which of the following selected diagnoses in the DSM-5 is least likely to occur with a medical problem in older adults?

A) Major depression
B) Anxiety disorder
C) Schizophrenia
D) Delirium

Question 8

A potential contributor to late life depression is lack of _____.

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin E

Question 9

Based on prevalence data, older adults with bipolar disorder were most likely to have developed it by the time they reached the age of about:

A) 25
B) 65
C) 50
D) 35

Question 10

An older woman becomes so enraged at what she believes is poor service that she storms out of a restaurant and vows never to eat there again even though she's gone there for years, and there was nothing different about the way she was treated. What would a psychologist need to know in order to consider whether her behavior fits the criteria for abnormality?

A) How long she had been a regular at the restaurant.
B) Whether she really was treated poorly or not.
C) Exactly how old she was at the time of the incident.
D) Whether she had recently become a widow.

Question 11

Unlike the Diagnostic and Statistical Manual (DSM-5), the International Classification of Diseases makes possible diagnosis of which conditions?

A) Personality disorders
B) Neurocognitive diseases
C) All medical illnesses
D) Disorders of later life

Question 12

According to the profile of Dr. O'Rourke in your text, geropsychology training in English Canada is hampered relative to other developing countries due to:

A) Negative attitudes of prospective clients
B) Ageist attitudes of professionals
C) Excessive costs to the health care system
D) The rapidly growing aging demographic

Question 13

A 45-year-old man Is concerned because his 70-year-old mother seems unusually restless, tense, irritable, and prone to worrying. It is possible that his mother has developed which psychological disorder?

A) post-traumatic stress
B) major depressive
C) generalized anxiety
D) agoraphobia

Question 14

Which of the following is not a DSM-5 criteria for diagnosis?

A) Medical condition
B) Stress
C) Overall level of functioning
D) Minimum number of symptoms

Question 15

Compared to younger adults, older adults with major depressive disorder are more likely to have symptoms involving:

A) suicidal thoughts.
B) feelings of guilt.
C) physical pain.
D) low self-esteem.

Question 16

Older adults with white matter hyperintensities are at increased risk for developing ____________disorder.

A) substance abuse
B) generalized anxiety
C) major depressive
D) bipolar

Question 17

According to the Canadian Community Health Survey (2012) and other studies of older adults' mental health concerns, the most frequent and unmet need was:

A) Health care
B) In-home assistance
C) Counseling
D) Assessment and diagnosis

Question 18

A clinician may fail to diagnose correctly an older adults' major depressive disorder because he or she assumes that:

A) older adults deliberately try to disguise their symptoms.
B) what seems to be depression is really a medical disease.
C) depression is a natural consequence of growing older.
D) older adults would prefer not to receive such a diagnosis.

Question 19

The lifetime prevalence of major depressive disorder is estimated to be ____%.

A) 6.7
B) 16.6
C) 30.4
D) 2.0

Question 20

Generalized anxiety disorder tends to affect a higher percentage of _____________ compared to the general population.

A) medical patients
B) high school dropouts
C) early retirees
D) military personnel

Question 21

The development of PTSD in older individuals is linked to risks of which physical health condition?

A) Emphysema
B) Heart disease
C) Arthritis
D) Sarcopenia

Question 22

It is estimated that ____ per cent of older adults who receive medical attention in hospitals and emergency rooms have symptoms of alcohol dependence.

A) 10
B) 14
C) 20
D) 32

Question 23

Which of the following is an appropriate modification that clinicians should use when assessing older adult clients?

A) Taking physical limitations of the client into account such as arthritis.
B) Skipping questions on a standardized measure to reduce total testing time.
C) Speaking in as soft a voice as possible so that clients don't feel stressed.
D) Turning the lights in the room down to reduce the client's stress levels.

Question 24

According to the Canadian Centre on Substance Abuse (2013) adults aged 65 and older had the highest rates of use for which of the following substances?

A) Marijuana
B) Sedatives and tranquillizers
C) Antidepressants
D) Anti-anxiety drugs

Question 25

APA's geropsychology guidelines suggest that if clinicians are not familiar with a particular disorder affecting older adults, they should:

A) inform the client that treatment is not advised.
B) seek consultation with or referral to an expert.
C) treat the client with whatever skills they have.
D) encourage the client to consult a self-help manual.

Question 26

According to Williams and colleagues (2012), the average rate of problem gambling among adults aged 60 and older across the Canadian provinces is _____percent.

A) 1.2
B) 2.4
C) 4.8
D) 9.7

Question 27

According to a study in Ontario, the gambling activity of preference among older adults is:

A) Scratch tickets .
B) casinos
C) Lotteries
D) raffle tickets

Question 28

The problems of older adult alcoholics has receved less attention until recently because:

A) These individuals were social isolates
B) Excessive life-long drinkers rarely lived past 50 years of age.
C) There were too few to be considered a social problem
D) These individuals were institutionalized

Question 29

Which type of substance is most commonly abused among older adults?

A) cocaine
B) prescription drugs
C) marijuana
D) opioids

Question 30

In the disorder known as _______________, individuals continually collect objects that they don't need, are unable to throw out those objects, and may clutter up their homes to the point of being almost unlivable.

A) agoraphobia bia
B) schizophrenia
C) psychopathy
D) hoarding

Question 31

Older adults are most likely to seek help for mental health problems from a:

A) Geropsychologist
B) Mental health worker
C) Pastoral counselor
D) Primary care physician

Question 32

Which characteristic is most likely to be seen by health care workers in an older adult who later commits suicide?

A) Extreme psychological distress.
B) History of previous suicide attempts.
C) An urgent desire for help.
D) Willingness to share thoughts and feelings.

Question 33

Which demographic category in Canada includes the highest age-adjusted suicide rate?

A) Males ages 20 - 24
B) Females ages 50 - 54
C) Females ages 80-84.
D) Males ages 85 and older.

Question 34

An 85-year-old woman was injured when a hurricane struck her neighborhood and she couldn't get out in time. For the past month, she has experienced severe nightmares and doesn't want to return home even though her house is completely repaired. This woman seems to meet the diagnostic criteria for _____________ disorder.

A) post-traumatic stress
B) major depressive
C) acute stress
D) social anxiety

Question 35

Which of the following would be considered a "positive" symptom among older adults who have survived schizophrenia?

A) hallucinations
B) improved mood
C) variable coping skills
D) hoarding

Question 36

Which of the following is a sociocultural contributor to suicide risk in older adults?

A) depression
B) memory loss
C) stress
D) chronic pain

Question 37

Risks for what appears to be a schizophrenic-like disorder that develops late in life include:

A) symptoms of depression.
B) reliance on others for help.
C) extreme poverty.
D) social isolation.

Question 38

One of the key symptoms of LOSS is the experience of:

A) depression after the death of a spouse.
B) unwillingness to seek treatment.
C) increased memories about an earlier traumatic experience.
D) being unwilling to part with unnecessary objects.

Question 39

Approximately what percent of individuals with schizophrenia attempt to commit suicide during their lifetimes?

A) 15
B) 50
C) 1
D) 40

Question 40

According to the Canadian Community Health Survey (2012), ____ percent of Canadians aged 15 and over met the criteria for substance abuse disorder in the previous year.

A) 4.4
B) 8.4
C) 14.6
D) 20.6

Question 41

Summarize the prevalence of substance abuse disorders in adulthood. What are three possible reasons that substance abuse rates are lower in older compared to younger adults?

Question 42

Analyze five major forms of individual psychotherapy that are used in the treatment of psychological disorders in terms of their appropriateness for older adults.

Question 43

An older adult client is being seen in a clinic to evaluate whether she has depression or a neurocognitive disorder. One indication that will help a clinician in making the diagnosis is that if she is depressed, she will show which behavioral tendencies?

A) Have progressive cognitive declines over time.
B) Show cognitive symptoms before depression symptoms.
C) Tend to be overconfident about memory abilities
D) Not respond to psychotherapeutic intervention.

Question 44

What are the criteria for diagnosis in the DSM-5?

Question 45

Of all the available options for treating anxiety disorders in older adults with medication, the category with the greatest effectiveness, though potentially addictive, is:

A) lithium.
B) neuroleptic.
C) clozapine.
D) benzodiazepine.

Question 46

Among individuals diagnosed with PTSD in a given year, approximately _____% have symptoms rated as severe.

A) 37
B) 12
C) 7
D) 17

Question 47

Describe the three possible courses of schizophrenia along with the percentage of adults who fall into each of these courses. What are two differences between schizophrenia that arises in early adulthood and late-onset schizophrenia?

Question 48

In the method of treatment known as ________________ therapy, clinicians help older adults understand and improve their social skills, methods of conflict resolution, and relationships.

A) telepsychology
B) psychodynamic
C) life review
D) cognitive-behavioral

Question 49

An advantage of the MMSE for the assessment of an older individual is the fact that it is:

A) able to diagnose specific disorders
B) insensitive to cultural factors
C) quick and easy to administer
D) useful as a standalone measure

Question 50

A selective serotonin reuptake inhibitor is a treatment for an older adult's depressive disorder that would fall in the category of the ______________ model.

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

Question 51

An important first step in psychotherapy with older adults is establishing a(n)___________ in which the client and clinician strive to collaborate in treatment.

A) life review process
B) therapeutic alliance
C) behavioral intervention
D) evidence-based agreement

Question 52

What are the three major categories of somatic treatments for older adults? Describe the forms of disorder which are most responsive to these treatments.

Question 53

Females in which age group show the highest rates of serious mental illness?

A) 65+
B) 18-25
C) 40-49
D) 30-34

Question 54

When is ETC indicated? What are the risks and benefits of the the of ETC with older adults?

Question 55

During a psychological assessment, the clinician may use a(n) _______________, which involves a flexible series of questions designed to gain initial information.

A) mental status examination
B) clinical interview
C) standardized screening tool
D) intelligence test

Question 56

Describe the major assessment techniques used for older adults. Contrast their advantages and disadvantages.

Question 57

Describe five possible reasons for the misdiagnosis of mood disorders in older adults.

Question 58

How would you explain the lower incidence of mental health problems with the exception of dementias, among the elderly?

Question 59

A mental status examination of an older adult typically includes a measure of ______________, or knowledge of the time, the place, and the person's own identity.

A) affect
B) perception
C) mood
D) orientation

Question 60

Who is most at risk for committing suicide in later adulthood? List three factors that are related to higher suicide rates in older adults.

Question 61

Why is an integrated treatment model recommended to address mental health issues of older adults?

Question 62

How does depression differ in older than younger adults?

Question 63

You are a clinician seeing an 86-year-old white male complaining of shortness of breath, stomach upset, problems with memory, and difficulty sleeping. This client has recently experienced the loss of his wife.
a. What assessment measures would you use?
b. What are the possible diagnoses you would consider?
c. What possible serious difficulties might you envision for this client in terms of risk? How would you assess this risk?
d. Describe the alternative treatments you would recommend for this client.