AP. Chapter 07: Mood Disorders and Suicide MOOD DISORDERS AND SUICIDE

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Prior to the DSM-III, conditions that are currently characterized as mood disorders were referred to by several different names, including all of the following EXCEPT
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depressive disorders, affective disorders, and depressive neuroses are currently characterized as mood disorders were referred as Except psychotic episodes
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The physical symptoms of a major depressive disorder include
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changes in appetite or weight.
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One of the symptoms of a mood disorder is called anhedonia, which means
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an inability to engage in pleasurable activities.
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Mood disorders can range from mild to severe; the most severe type of depression is called
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major depressive disorder
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The first episode of major depression is usually time-limited – often lasting up to ________ – if left untreated.
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9 months
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Which of the following is a symptom of a manic mood state?
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Grandiose planning
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When used in connection with mood disorders, “flight of ideas” means
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rapid speech expressing many exciting ideas at once.
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In comparing the length of untreated depressive episodes to untreated manic episodes, which of the following is an accurate statement?
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Depressive episodes generally last longer.
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Which of the following is NOT TRUE about a hypomanic manic episode? a. It is not necessarily problematic. b. It does contribute to the definition of several mood disorders. c. It causes marked impairment in social or occupational functioning. d. It need only last 4 days.
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It causes marked impairment in social or occupational functioning.
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A 35-year-old individual named Manny has recently formulated an elaborate plan to cure AIDS with vitamin therapy. To provide funding for this cause, he has withdrawn all the money from his bank account and purchased thousands of jars of vitamins and small boxes in which to put them. When he appeared at a hospital emergency room loudly demanding names of patients with AIDS, he himself was hospitalized for psychiatric observation. What is your diagnosis of Manny?
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Manic episode
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Unipolar mania
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is rare.
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During a dysphoric manic episode, the patient experiences mania and ___________.
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anxiety and depression
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Dysphoric mania refer to a type of mood disorder in which manic episodes are
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accompanied by depression or anxiety.
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Most individuals who experience a single episode of major depressive disorder will
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probably have several episodes throughout their lives.
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Debbie has been diagnosed with major depressive disorder, recurrent. She wants to know what to expect in the future regarding her condition. You tell her that according to recent research the median lifetime number of major depressive episodes is _____.
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2-3
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Persistent depressive disorder (formerly called dysthymia) differs from major depressive disorder because people diagnosed with dysthymia have symptoms of depression that are ________.
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longer-lasting
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Jack has experienced recurrent episodes of major depressive episodes. In the intervals between the episodes, he does not seem to return to “normal.” In fact, during those periods, he has been diagnosed as suffering from persistent depressive disorder. Jack’s condition is referred to as _______________.
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double depression
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A person who experiences a persistent depressed mood for at least 2 years but is not experiencing major depression may have
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persistent depressive disorder.
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Milton has been mildly depressed for many years. Just recently, however, his depression deepened, and he was severely depressed for about three months. His deep depression then lifted and he was once again mildly depressed. Milton
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will require a longer and more intense course of treatment to maintain a normal mood state.
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Katie has been diagnosed with major depressive disorder. Most recently, she has been lying immobile for long periods. If someone moves one of her arms to a different position, it just stays there. Katie has stopped speaking and does not appear to hear what is being said to her. What specifier would you apply to her diagnosis of major depressive disorder?
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With catatonic features
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Tamara gave birth to a healthy child four days ago. Now she is tearful and having mood swings. Fortunately, these symptoms disappeared relatively quickly. Tamara was probably suffering from _______________.
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baby blues
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A person who eats and sleeps too much is experiencing a depressive episode with __________ features.
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atypical
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The melancholic specifiers for depressive disorders include all of the following EXCEPT a. weight loss. b. loss of libido (sex drive). c. sleeping late and hypersomnia. d. anhedonia.
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sleeping late and hypersomnia
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Although catatonic symptoms occur in major depressive disorders, they are more frequently associated with ______________.
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schizophrenia
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The peripartum onset specifier is used to characterize a severe manic or depressive episode with psychotic features that occurs in a woman immediately before or after ____________.
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childbirth
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In rare tragic cases, a mother suffering from major depression with peripartum onset sometimes
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kills her child.
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The most usual pattern of a temporal specifier in major depressive disorder occurs in the late fall and ends with the beginning of spring. This type of depression is known as __________.
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seasonal affective disorder
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Which of the following statements applies to the condition known as seasonal affective disorder (SAD)?
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Women with SAD reported more autonomous negative thoughts throughout the year than women without SAD.
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Morning light is thought to help with seasonal affective disorder because it
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produces phase advances of the melatonin rhythm.
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An effective treatment for SAD is
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exposure to bright light shortly after awakening.
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According to recent research (Kessler et al., 2003), the percentage of people aged 18 to 29 that have already experienced major depression is _______.
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25%
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How many patients with severe cases of depression where the episode lasts 5 years or longer can be expected to recover?
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38%
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The probability that a person will recover from a major depressive episode within 1 year approaches 90% in _________________.
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almost all cases
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Symptoms of severe depression are generally NOT considered a psychological disorder when they are associated with ________________.
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a grief reaction
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A woman who is extremely depressed a year or so after the loss of her spouse might be diagnosed with ___________.
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complicated grief
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Although grieving is considered a normal process, it does sometimes become a psychological disorder. Which of the following cases would NOT be diagnosed as a pathological grief reaction?
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Mrs. C’s dog recently died. Three weeks later, her friends suggest that she get another dog “to help her get over the loss.” Mrs. C. refuses and says she just isn’t ready to get another dog and besides, it would be impossible to replace her beloved “Toto.”
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If a friend of yours stops sleeping and suddenly claims that he is going to go to law school and medical school simultaneously so he can change the world, you might suspect he is __________.
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manic
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Andy is currently completing a chemical formula that he knows will cure cancer. Shortly before, he had submitted a book to a publisher and was sure that it would become a bestseller. For several weeks prior to this, he was bedridden, morose, had no energy, and lacked any spontaneity. He never left his bed and had to be cared for by his family. Andy’s diagnosis is ________________.
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bipolar II disorder
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Bipolar II disorder consists of
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depression with hypomanic episodes.
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Jane is diagnosed with bipolar II disorder. You can expect that she will experience
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hypomanic episodes.
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When manic episodes alternate with depressive episodes, the disorder most correctly diagnosed would be
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bipolar disorder.
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Recent evidence indicates a higher level of ___________ in patients with bipolar disorder that was marked by a rapid cycling pattern compared to those with a non-rapid cycling pattern.
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suicide
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Suicide associated with bipolar disorder almost always occurs during
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depressive episode.
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The rapid-cycling specifier refers to an individual with bipolar disorder who experiences at least ___ manic or depressive episodes in a year.
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4
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In studies of bipolar patients who experience rapid cycling, it has been found that from 60% to 90% are _________.
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female
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At various times, Cynthia, a 20-year-old college student, has been considered by her family and/or friends to be moody, high-strung, explosive, or hyperactive. She never fails to take care of her responsibilities, but the fact that she seems to experience mood swings that are outside the norm has been noticed by those around her. Knowing the criteria for mood disorders, you would diagnose Cynthia with ___________.
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cyclothymic disorder
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When referring to the mood disorders called cyclothymia and persistent depressive disorder, it would be accurate to say that an individual with cyclothymia probably
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would be considered “moody.”
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The less severe but more chronic version of bipolar disorder is called __________ disorder.
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cyclothymic
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In about _____________patients, cyclothymic mood swings develop into full-blown bipolar disorder.
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33% to 50%
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Approximately ______ experience major depressive disorder over a lifetime and approximately _____ in the last year
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16%; 6%
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With regard to the prevalence of mood disorders, which of the following has been found consistently?
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Bipolar disorders occur equally across the sexes.
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Depression rates in adolescents appear to be
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about the same as adults.
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All of the following are accurate statements about the prevalence of mood disorders in children and adolescents EXCEPT a. Bipolar disorder in children is often misdiagnosed as attention deficit hyperactivity disorder (ADHD). b. Major depressive disorder in adolescents is largely a female disorder. c. Rates of attempted suicide decrease during adolescence. d. Adolescents with bipolar disorder may become aggressive, impulsive, sexually provocative and accident- prone.
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Rates of attempted suicide decrease during adolescence.
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A child raised by depressed parents is likely to
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struggle with depression as well.
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A common characteristic of depression in boys is ___________________.
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aggression
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Which of the following is TRUE of depression in the elderly?
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The prevalence of depression is almost equal among elderly men and women.
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Being depressed __________ the risk of death in elderly patients who have had a stroke or heart attack.
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doubles
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Cross-cultural research indicates that, due at least in part to appalling social and economic conditions, the prevalence of major depression is extremely high among ________.
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Native Americans
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According to your textbook, researchers have been studying the life histories of American poets to determine if there is a relationship between creativity and _______.
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bipolar disorder
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In research looking at the biological causes of mood disorders, studies have shown that if one of a set of twins has a mood disorder, the probability that the other twin will have a mood disorder is _________.
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66%
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all the statements are true
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-Overwhelming evidence suggests mood disorders are familial and reflect an underlying genetic vulnerability. -Studies are now beginning to identify a small group of genes that may contribute to genetic vulnerability to some types of depression. -The genetic contribution to depression falls in the range of approximately 40% for females and 20% for males.
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Recent research suggests that
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the same genetic factors contribute to both anxiety and depression.
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Current research into neurotransmitter systems has produced the “permissive” hypothesis, which states that
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when serotonin levels are low, other neurotransmitter systems become dysregulated and contribute to mood irregularities.
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A friend of yours tells you that thinks he is mildly depressed but he’s not sure. Knowing that you are studyin abnormal psychology, he asks if there is any kind of laboratory test that could determine whether or not someone is depressed. You respond correctly with one of the following statements:
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Currently there is no way of diagnosing depression with a laboratory test.
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In regard to most disorders, serotonin is thought to
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regulate other neurotransmitters, such as norepinephrine and dopamine.
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The best conclusion about the dexamethasone suppression test (DST) for the diagnosis of depression is that
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it is not useful as a diagnostic tool.
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Recent research suggests that
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-the suppression of neurogenesis in the hippocampus is due to the connection between high stress hormones and depression. -low hippocampal volume may precede and contribute to the onset of depression -electroconvulsive therapy seems to produce neurogenesis in the hippocampus
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One symptom of depression is an increase in sleeping. What other symptoms related to sleep occur in depression?
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A reduction of slow-wave (deep) sleep.
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Which of the following is NOT characteristic of the sleep of depressed patients? a. They enter REM sleep quickly. b. They experience intense REM episodes. c. They show delayed slow wave sleep. d. They show advanced slow wave sleep.
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They show advanced slow wave sleep.
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Depressive individuals tend to exhibit
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greater right anterior brain activity.
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n regard to the relationship between stress and depression, all of the following statements are true EXCEPT a. the context of the life event, as well as its meaning to the individual, is more important than the nature of the event itself. b. an individual’s current mood state might distort earlier memories of stressful life events that precipitated the depression. c. stressful life events are strongly related to the onset of mood disorders. d. recurrent episodes of depression, but not initial episodes, are strongly predicted by major life stress.
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recurrent episodes of depression, but not initial episodes, are strongly predicted by major life stress.
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When individuals who are biologically vulnerable to depression place themselves in high-risk stressful environments, it is called
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the gene-environment correlation model.
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Stressful events are strongly related to the onset of ____________.
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both
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Martin Seligman’s theory that people become anxious and depressed because they believe that they have no control over the stress in their lives is called
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the learned helplessness theory.
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In 1989, Abramson and his colleagues revised Seligman’s theory of learned helplessness, changing the focus from specific attributions to _________ as the crucial factor in depression.
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a sense of hopelessness
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A student who has been doing very well in her psychology class receives a minor critical comment on an essay that she wrote as part of an exam. The student thinks, “This is terrible. I’m probably going to fail the course.” This type of cognitive error in thinking is called _________.
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overgeneralization
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Regarding Beck’s views on depression, which of the following definitions of cognitive errors and negative schema is NOT correct? a. In a self-blame schema, depressed individuals feel personally responsible for every bad thing that happens. b. Arbitrary inference means that a depressed individual emphasizes the positive rather than the negative aspects of a situation. c. In a negative self-evaluation schema, depressed individuals believe that they can never do anything correctly. d. Overgeneralization occurs when a small error is magnified to mean something much more significant.
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Arbitrary inference means that a depressed individual emphasizes the positive rather than the negative aspects of a situation.
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Negative cognitive styles are associated with a vulnerability to subsequent depression
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in people in general.
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According to recent research on the development of depression, dysfunctional attitudes (a negative outlook) and hopelessness attributes (explaining things negatively) constitute a _____________ vulnerability to depression.
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cognitive
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In Aaron Beck’s depressive cognitive triad, individuals think negatively about all of the following EXCEPT ________.
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their past
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For individuals who had not been previously depressed, research studies indicate that a marital separation or divorce resulted in
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a higher rate of depression in men.
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Possible reasons for the higher rates of depression found in women include all of the following EXCEPT a. culturally induced dependence and passivity. b. sense of uncontrollability and helplessness. c. low value placed on intimate relationships. d. self-blame for being depressed.
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low value placed on intimate relationships.
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Possible reasons for the higher rates of depression found in women relate to the disadvantages experienced by women in the United States such as
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both of these
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With regard to social support,
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having social support helped speed recovery from depressive episodes.
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Which of the following factors contribute to the integrative theory of depression?
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Stressful life events, Stress hormones, and Neurotransmitter systems
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The following types of medications are all used to treat depression EXCEPT a. SSRIs. b. mixed reuptake inhibitors. c. MAO inhibitors. d. GABA inhibitors.
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SSRIs.
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Which of the following is perhaps the best-known and widely used SSRI medication?
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Prozac
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The antidepressant medications known as imipramine (Tofranil) and amitriptyline (Elavil) are included in the class of drugs called
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tricyclics.
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The class of drugs that blocks the enzyme that breaks down norepehinephrine and serotonin is
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MAO inhibitors.
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Which of the following statements is TRUE about tricyclics?
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They can be accompanied by very unpleasant side effects.
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Side effects of the tricyclic antidepressants include _______________.
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sexual dysfunction
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Clinical studies have shown that the response rate for patients receiving at least some relief from depressive symptoms is approximately ________.
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50%
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Studies has shown that tricyclics have caused
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sudden death in some children under 14 years old.
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With regard to treatment of mood disorders, which of the following statements is accurate?
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Delaying or preventing future episodes of major depression is an important treatment goal.
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A goal of treatment for patients who have experienced major depressive disorders is delaying or preventing the next episode. In which of the following situations would this goal be LEAST important?
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Patients who have had a single, brief episode of major depressive disorder and recovered without treatment
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All of the following are side effects of lithium therapy EXCEPT ____________. a. lowered thyroid functioning b. weight loss c. toxicity d. lack of energy
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weight loss
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All of the following statements about lithium therapy are true EXCEPT a. lithium can act as an antidepressant. b. lithium can act as a mood stabilizer. c. dosage must be carefully regulated to prevent toxicity. d. the side effects of lithium are less serious than those of other antidepressants.
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the side effects of lithium are less serious than those of other antidepressants.
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A relative of yours has been diagnosed with bipolar disorder. Your family is impressed when you mention that the preferred drug for this condition is ________.
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ithium
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All of the following statements about lithium therapy are true EXCEPT a. for those patients who respond to lithium, approximately 70% will relapse. b. for anyone with recurrent manic episodes, maintenance on lithium is recommended to prevent relapse. c. once a person is symptom-free for 6 months, he/she may stop taking lithium. d. people stop taking lithium to regain the euphoric feeling that mania produces.
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once a person is symptom-free for 6 months, he/she may stop taking lithium.
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One of the problems encountered by psychiatrists who prescribe medication for patients with bipolar disorder is that patients often
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stop taking the medication in order to bring on a manic state.
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The antidepressant medication lithium is also referred to as a mood stabilizer because it
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helps to prevent manic episodes.
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Although electroconvulsive therapy (ECT) has been a controversial issue for decades, it is an effective treatment for depression especially when
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patient response to antidepressant medication is poor.
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All of the following statements are true about ECT EXCEPT a. electric shock is administered directly to the brain for less than a second. b. patient response to antidepressant medication is poor. c. for severely depressed patients with psychotic features, approximately 25% of those not responding to medication will benefit. d. ECT treatments are administered every other day for a total of 6 to 10 treatments.
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for severely depressed patients with psychotic features, approximately 25% of those not responding to medication will benefit.
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All of the following statements are accurate about electroconvulsive therapy (ECT) except a. relief of symptoms can occur within a week or two with ECT. b. ECT treatment should be followed up with medication. c. short-term memory loss can be a side effect of treatment with ECT. d. psychotically depressed patients should be treated with ongoing medication, not ECT, even when response to those drugs is poor.
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psychotically depressed patients should be treated with ongoing medication, not ECT, even when response to those drugs is poor.
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Recent research suggests that an equally effective alternative to some antidepressant medications that appears to alter electrical activity in the brain may be
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transcranial magnetic stimulation (TMS).
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Interpersonal psychotherapy deals with all of the following interpersonal problems EXCEPT a. environmental interactions. b. acquiring new relationships. c. identification and correction of deficits in social skills. d. interpersonal role disputes.
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environmental interactions.
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Prevention of mood disorders in children and adolescents include all of the following except a. universal programs. b. selected interventions. c. indicated interventions. d. milieu interventions.
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milieu interventions.
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Which of the following statements about suicide is correct?
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For teenagers, suicide is the third leading cause of death after auto accidents and homicide.
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Research has found that low serotonin levels may be implicated in suicidal behavior because they affect all of the following EXCEPT _______. a. impulsivity b. instability c. agnosia d. overreactivity
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agnosia
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With regard to the relationship between mood disorders and suicide, which of the following statements reflects the current thinking on this issue?
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Suicide is often associated with psychological disorders, especially depression.
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Statistics on suicide indicate that approximately one-quarter to one-half of all suicides are associated with _____________.
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alcohol use
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Although glorifying and romanticizing suicide in the media contributes to copycat suicides, it is more likely that the person copying the suicide is
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vulnerable due to an existing psychological disorder.
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Impulsive suicidal behavior is often a symptom of _____________ personality disorder.
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borderline
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Which of the following statements is accurate regarding the relationship between anxiety and depression?
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Many depressed patients are or have been anxious and many anxious patients are or have been depressed.
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On the “Abnormal Psychology Live” CD for Chapter 7, Barbara says that her primary depressive symptom was ______________.
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physically lethargy
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During Evelyn’s final interview on the “Abnormal Psychology Live” CD for Chapter 7, she describes the experience of starting to feel better as
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beginning to see some light.
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During the final interview with Mary on the “Abnormal Psychology Live” CD for Chapter 7, she is clearly in a manic state with an affect that can be considered inappropriate due to her ________.
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laughing
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Compare and contrast the symptoms of major depressive episode, a manic episode, persistent depressive disorder, and hypomania.
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Major depression is characterized by a depressed mood state that lasts at least 2 weeks and includes cognitive symptoms such as feeling worthless, disturbed physical function such as altered sleep or appetite, and the loss of interest and pleasure in activities and social interactions. Mania is characterized by exaggerated elation euphoria, little sleep, rapid speech, and grandiose plans. Persistent depressive disorder shares the symptoms of major depressive disorder, but the symptoms are milder . The condition, however, is more chronic, with symptoms lasting for a minimum of two years. Hypomania is a less severe version of a manic episode that does not cause marked impairment in social or occupational functioning.
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Discuss the symptoms, causes and treatments for seasonal affective disorder.
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This disorder occurs during winter, in cold environments. People with SAD report excess sleep, increased appetite, and weight gain. It is thought to be related to seasonal changes in light that affect the production of melatonin by the pineal gland. SAD patients may produce too much melatonin, experience disrupted circadian cycles, and reports negative cognitions and a tendency toward rumination. Exposure to light, called phototherapy, is an effective treatment.
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Discuss the relationship between depression and anxiety.
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Research suggests that almost all depressed patients are anxious, but not all anxious patients are depressed. It appears that while anhedonia is key to depression, the key to anxiety is the experience of autonomic activation, which can also occur in depressed people. Research in this area suggests that we may eventually need to rethink our diagnostic criteria to combine anxiety and the mood disorders into one larger category.
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Discuss the role of neurotransmitters, brain-wave activity, and negative cognitions in the etiology and treatment of depression.
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Low levels of depression in relation to norepinephrine and dopamine are thought to be related to the etiology of depression. The permissive hypothesis argues that when serotonin levels are low, other neurotransmitters are permitted to range more widely and so become deregulated. EEG studies suggest that depressed individuals exhibit greater right-side anterior activation in their brains and lower levels of such activity on the left side than non-depressed individuals. Negative thoughts or attributions about themselves, the immediate world, and the future are characteristic of depressed individuals. Antidepressant medications can effectively treat depression but may take several weeks to work, and symptoms may reappear when the medication is continued. Cognitive-based treatments take longer to work but can be instrumental in limiting later depression. The combination of both is often the most effective treatment.
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dentify and explain the risk factors associated with suicide.
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Family history: If a family member has committed suicide, there is an increased risk that someone else in the family will also. Research has shown that the offspring of family members who have attempted suicide had six times the risk compared to the offspring of nonattempters. If a sibling was the suicide attempter, this increased the risk even more. Neurobiology: Research indicates that low levels of serotonin may be associated with suicide and violent suicide attempts. Low levels of serotonin are associated with impulsivity, instability, and a tendency to overreact in situations. Existing Psychological Disorders: More than 80% of the people that kill themselves have an existing psychological disorder, usually a mood disorder, substance use disorder, or impulse control disorder. Hopelessness, a specific component of depression, is a strong predictor of suicide. Alcohol use and abuse are associated with 25% to 50% of all suicides and are especially prominent in adolescent suicides Stressful Life Events: The most important risk factor for suicide appears to be a severe, stressful event. Often a stressful event can put the person over the edge.

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