question

what % of people with unipolar depression receive treatment

answer

50%

question

T or F There is strong evidence that psychodynamic therapy helps depression

answer

False but is still used often to treat depression

question

what mode of therapy has worked well in research to treat depression

answer

cognitive and cognitive-behavioral

question

where do psychodynamic therapists believe depression comes from

answer

unconscious grief over real or imagined losses, compounded by excessive dependence on other people

question

what occurs in psychodynamic therapy with depression

answer

1.encourage client to associate freely during therapy 2.suggests interpretations of the client's associations, dreams, and displays of resistance and transference 3. help person review past events and feelings

question

what aer the goals of psychodynamic therapy for depressed client

answer

gain awareness of losses in their lives become less dependent on others cope with losses more effectively make corresponding changes in their functioning

question

2 features that may limit effectiveness of psychodynamic therapy with depression

answer

1. depressed clients may be too passive and feel too weary to join fully into subtle therapy discussions 2. may become discouraged and end treatment too early

question

psychodynamic therapy helps most often with depression that involves

answer

a history of childhood loss or trauma long standing sense of emptiness feelings of perfectionism extreme self-criticism

question

what has performed better short-term or long-term psychodynamic therapies

answer

short-term

question

behaviorists theories of depression tie moods to

answer

rewards in a person's life

question

behavioral models to treat depression are modeled after what theorist

answer

Lewinsohn

question

how is depression treated in a typical behavioral approach

answer

1. reintroduce clients to pleasurable events and activities 2. appropriately award nondepressive behaviors and hold rewards for depressive behaviors 3. help clients improve social skills

question

adding positive activities to a person's life

answer

behavioral activation

question

what do behaviorists believe about crying, ruminating, complaining, or self-depreciation

answer

keeps other people at a distance from the depressed person and reducing chancs for rewarding experiences and interactions

question

systematically ignoring a client's depressive behaviors while praising or otherwise rewarding constructive statements and behavior

answer

contingency management

question

when 2 or more behavioral techniques are applied, behavioral treatment appears to

answer

reduce depressive symptoms, especially if the depression is mild

question

lead people repeatedly to view themselves, their world, and their future in negative ways

answer

maladaptive attitudes

question

self world and future

answer

cognitive triad

question

biased views combine with __________________ to produce _____________________, unrelenting negative thoughts that flood the mind and produce symptoms of depression

answer

illogical thoughts automatic thoughts

question

unrelenting negative thoughts that flood the mind and produce symptoms of depression

answer

automatic thoughts

question

treatment approach developed by Beck to help clients overcome negative thinking

answer

cognitive therapy

question

how does the cognitive therapy approach to depression work

answer

help clients recognize and change their negative cognitive processes and thus improve their mood

question

why do many people consider the cognitive approach to be cognitive-behavioral

answer

because it includes a lot of behavioral techniques

question

Beck's approach is similar to whose and what is it called

answer

Albert Ellis's rational-emotive therapy

question

Cognitive therapy is tailored to

answer

specific cognitive errors

question

Beck's Cognitive Therapy has 4 phases, what are they? These phases usually require fewer than

answer

1. Increasing activities and elevating mood 2. challenging automatic thoughts 3. identifying negative thinking and biases 4. changing primary attitudes usually require fewer than 20

question

what happens when challenging automatic thoughts

answer

client is taught to recognize and record automatic thoughts as they occur and bring lists to each session therapist and client test the reality behind the thoughts

question

treatments for depressive and bipolar disorders

answer

cognitive/cognitive-behavioral therapy interpersonal psychotherapy antidepressant drugs ECT vagus nerve stimulation transcranial magnetic stimulation psychotropic drugs

question

advtgs to recording inf through new apps and texting

answer

data is electronically stored and sorted clients and therapists can easily track subtle fluctuations and patterns in mood can guide clients and therapists to detect red flags some programs offer advtg of being able to reach out to clients - sending them text msgs to remember to send in their mood data

question

this prgrm texts clients periodically and clients reply with numerical scores and accompanying descriptions of how they have been feeling

answer

Mood 24/7

question

this program was created by Jon Cousins to help with his own mood disorder and offers the option of sharing modo data with other people; he found the scrutiny and support to be helpful

answer

Moodscope

question

this mood tracking app is controversial bc it integrates a wide range of smartphone data; collects inf about location changes, internet surfing habits, phone calls, and email use; some worry it could land in the wrong hands and be an invasion of privacy

answer

Emotion Sense

question

therapists that practice ____________________________ guide depressed clients to recognize and accept their negative cognitions simply as streams of thinking that flow through minds

answer

acceptance and commitment therapy

question

designed to address the unique issues faced by members of a cultural minority group

answer

culture-sensitive therapy

question

help clients change with how they deal with the close relationships in their lifes

answer

family and social approaches

question

most effective family-social approaches are which 2

answer

interpersonal psychotherapy couple therapy

question

who developed interpersonal psychotherapy

answer

Gerald Klerman Myrna Weissman

question

interpersonal psychotherapy holds that any of 4 interpersonal problem areas may lead to depression and must be addressed. what are the 4 areas

answer

interpersonal loss interpersonal role dispute interpersonal role transition interpersonal deficits

question

when do role disputes occur

answer

when 2 people have different expectations of their relationship and of the role each should play

question

interpersonal role transitions may occur when

answer

divorce birth of a new child life changing events occur

question

IPT is considered especially useful for depressed clients struggling with???

answer

social conflicts undergoing changes in careers or social roles

question

as many as _________ depressed people may be in a dysfunctional relationship

answer

half

question

the approach in which a therapist works with 2 people who share a long term relationship

answer

couple therapy

question

teach specific communication and problem solving skills to couples and further guide them to be more accepting of each other

answer

integrative behavioral couples therapy

question

biological treatments include

answer

antidepressant drugs or popular herbal treatments electroconvulsive tehrapy

question

one of the most controversial forms of treatment for depression; some consider it safe with minimal risks; others consider it an extreme measure that can cause memory loss and neurological damage; is used frequently bc it is an effective and fast-acting intervention for unipolar depression

answer

electroconvulsive therapy (ECT)

question

what is the procedure of ECT

answer

2 electrodes are attached to pt's head 65 - 140 volts of electricity are passed through brain for half a second or less causing a brain seizure lasting 25 seconds to 2 minutes

question

how many ECT treatments are typically done

answer

6 - 12 tretaments over 2 to 4 weeks

question

bilateral ECT

answer

electrode applied to both sides of forehead and electric current apsses trhough both sides of brain

question

unilateral ECT

answer

electrodes on 1 side and current on 1 side of brain only

question

how was ECT discovered as ameans for treating depression

answer

1930s believed brain seizure could cure schizophrenia or other psychotic disorders bc they observed that people who suffered from epilepsy rarely were psychotic and thsu in the 30s searched for ways to induce seizures as treatment for pts with psychosis

question

Joseph van Meduna gave this drug to pts suffering from psychosis to produce a seizure but was dangerous and sometimes caused death

answer

metrazol

question

dr named Manfred Sakel gave large doses of____________ to cause seizure as treatment but dangerous and could cause death

answer

insulin

question

physician named Ugo Cerletti discovered that he could do what to produce seizures

answer

applying electric currents

question

nutraceuticals are

answer

dietary supplements that are nonpharmaceutical and nonfood substances that people supplement their diets with to help prevent or treat psychological or physical ailments

question

popular herbal supplements for depression that are frequently helpful

answer

St John's wort Rhodiola rose

question

nutreints found in food that are sometimes helpful in treating depression

answer

omega 3 fatty acids vit B vit D folate

question

natural hormones/amino acids (substances identical to hormones or amino acids normally produced by human body) to treat depression

answer

SAM-e L-Trytophan melatonin

question

reasons why depressed people take nutraceuticals

answer

not helped by conventional treatments developed major side effects to antidepressant drugs cannot afford conventional treatments dislike modern meds prefer more natural treatments

question

risk of taking nutraceuticals

answer

assumed to be safe unless FDA can prove them harmful can be potent and even interact dangerously with conventional meds pts are often misinformed by friends or internet and may take them incorrectly reluctant to discuss use of supplements with dr

question

change sin use of ECT today

answer

administer muscle relaxants to minimize convulsions and eliminate fractures or dislocations use anesthetics to put pts asleep during procedure to reduce their terror

question

problems with ECT

answer

especiall bilateral - pts have trouble remembering some events that took place immediately before and after treatments - this usually clears up some have gaps in more distant memory and this form of amnesia is usually permanent

question

effectiveness of ECT

answer

60 - 80%improve particularly effective when pts followup with meds or ECT sessions particularly effective with severe depression that includes delusions

question

why has ECT use declined despite its effectiveness

answer

memory loss fear of procedure effective antidepressants

question

3 kinds of drugs that reduce symptoms of depression

answer

MAO - monoamine oxidase inhibitors tricyclics second generation antidepressants

question

slows the body's production of monoamine oxidase and thus stops destruction of norepinephrine causing a rise in norepinephrine and a reduction of depressive symptoms

answer

MAO inhibitors

question

what does MAO usually do

answer

breakdown or degrade norepinephrine

question

potential danger with MAO inhibitors

answer

eating foods that contain tyramine such as cheeses, bananas, and certain wines can cause blood pressure to raise dangerously

question

these meds were discovered in 1950s; have a 3 ring molecular structure; reduce depression by acting on neurotransmitter "reuptake" mechanisms' allows neurotransmitters to remain in the synapse longer and thsu increase their stimulation of the receiving neurons

answer

tricyclics

question

if pts continue taking tricyclic for 5 months after being free of depressive symptoms chance sof relapse decrease significantly - this is called

answer

continuation therapy

question

if pts continue taking tricyclic for 3 or more years after initial improvement may reduce relapse risk even more and this is called

answer

maintenance therapy

question

this group of medications increase serotonin activity without affecting norepinephrine or other neurotransmitter

answer

SSRI selective serotonin reuptake inhibitors

question

some of the SSRIs are

answer

Prozac Zoloft Lexapro

question

this group increases norepinephrine activity and an example

answer

selective norepinephrine reuptake inhibitors Straterra

question

this increases both serotonin and norepinephrine activity and an example

answer

serotonin-norepinephrine reuptake inhibitors effexor

question

why do clinicians often prefer the second generation antidepressants

answer

harder to overdose on them do not pose dietary problems of the MAO inhibitors or produce some of the unpleasant side effects of tricyclics

question

longest nerve in the human body, runs from brain stem trhough the neck down the chest and on to the abdomen serving as a primary channel of communication between the brain and major organs such as heart, lungs, and intestines

answer

vagus nerve

question

process of stimulating this nerve to stimulate the brain without producing undesired effects or trauma associated with ECT

answer

vagus nerve stimulation

question

in this procedure a surgeon implants a small device under the skin of the chest and then guides a wire which extends from the pulse generator up to the neck and attaches to the vagus nerve; electrical signals travel from the pulse generator through the wire to the vagus nerve; stimulated vagus nerve then delivers electrical signals to the brain

answer

vagus nerve stimulation research brings significant relief

question

tries to stimulate the brain without effects of ECT; was developed in 1985; clinician places an electromagnetic coil on or above patient's head; coil sends a currentinto prefrontal cortex

answer

transcranial magnetic stimulation

question

why might TMS - transcranial magnetic stimulation ork

answer

at least some parts of the prefrontal cortex of depressed people are underactive

question

efficacy of TMS

answer

procedure reduces depression when administered daily for 2 - 4 weeks; may be just as helpful as ECT

question

a brain area located just below the cingulate cortex and some suspect the area may be a kind of depression switch

answer

Brodmann Area 25

question

Mayberg and colleagues delivered this therapy to clients who had previously been unresponsive to other forms of treatment including ECT; drilled 2 tiny holes into pt's skull and implanted electrodes in Area 25; connected electrodes to batteries or a pacemaker that was implanted in pt's chest (men) stomach (women); sent a steady stream of low voltage electricity to Area 25; desire was to reduce Area 25 activity to a normal level and recalibrate and regulate the depression brain current

answer

deep brain stimulation

question

efficacy of deep brain stimulation

answer

4 of 6 original pts became almost depression free within months pts report improvements in short term memory and quality of life

question

important trends in the treatment of unipolar depression

answer

1. Cognitive, cognitive-behavioral, interpersonal, and biological therapies are all highly effective treatments. 2. The above therapies are not relapse proof. 3. When serious discord in marital relationships, couples therapy tends to be as helpful as the above therapies. 4. Depressed people who receive strictly behavior therapy have shown less improvement than those who receive cognitive, cognitive-behavioral, interpersonal, or biological therapy. 5. Traditional, long-term psychodynamic tehrapies are less effective than those other therapies in treating all levels of unipolar depression. 6. A combination of psychotherapy and drug therapy is modestly more helpful to depressed people tha either treatment alone. Trends may not carry over to children and teens. 7. ECT appears to be somewhat more effective than antidepressant drugs for reducing depression and reacts more quickly. However, half treated relapse within a year unless followed up by continuing drug treatment or psychotherapy.

question

Congress passed this Act which gave FDA jurisdiction over labels on prescriptions and OTC meds and most related forms of drug advertising

answer

1938 Food, Drug, and Cosmetic Act

question

Congress passed this law in 1962 requiring all pharmaceutical drugs be proved safe and effective; transferred more authority over prescriptions to FDA; set up laws companies were required to follow in their advertisements including contraindications, side effects, and effectiveness

answer

1962 Kefauver-Harris Drug Amendments

question

antidepressants may sometimes trigger a

answer

manic episode

question

effectiveness of ECT with bipolar

answer

only occasional success

question

a silvery-white element found in various simple mineral salts throughout the natural world as a treatment for bipolar disorder

answer

lithium

question

who discovered the use of lithium through a test of uric acid on guinea pigs

answer

John Cade, 1949

question

how is the correct dosage of lithium for a pt determined what can too high a dose cause

answer

requires regular analyses of blood and urine samples and other lab tests; too low a dose ahs little effect; too high a dose can cause lithium intoxication which can cause nausea, vomiting, sluggishness, tremors, dizziness, slurred speech, seizures, kidney dysfunction, and death

question

effectiveness of mood stabilizers on bipolar

answer

more than 60% with mania improve on the meds 28 times higher risk of relapse if stop taking the med helps to overcome depressive episodes but to a lesser degree prevent future depressive episodes, suicidal ideation, and manics

question

substances in neuron that carry out the changes because they relay original message from receptor site to firing mechanism of neuron

answer

second messengers

question

neurotransmitter is considered the

answer

first messenger

question

chemicals that are produced once neurotransmitters are received

answer

phosphoinositides

question

how is it believed that lithium and other mood stabilizers work

answer

they affect the second messenger system and in so doing correct the abnormalities increase the production of neuroprotective proteins changing sodium and potassium ion activity in neurons

question

key proteins within certain neurons whose job is to prevent cell death

answer

neuroprotective proteins

question

goals of psychotherapy with bipolar disorder

answer

emphasize importance of continuing to take meds improve social skills and relationships educate pts and families about bipolar disorders help pts solve family, school, and occupational problems caused by the disorder help prevent pts from attempting suicide

question

effectiveness of psychotherapy with bipolar

answer

helps reduce hospitalization improves social functioning increases pt's ability to obtain and hold a job

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