CH-7 Mood Disorders and Suicide – Abnormal Psychology in a Changing World : Exam Guide

7. Mood Disorders and Suicide Multiple-Choice Questions 1. The famous American author who described his severe depression in Darkness Visible was ______. A. Tom Wolfe B. Phillip Roth C. William Styron D. Bernard Malamud Answer: C 2. Enduring states of feeling that color our psychological lives are called ______. A. motivational states B. moods C. drives D. traits Answer: B 3. Disturbances in mood that are serious enough to impair daily functioning are called ______. A. adjustment disorders B. personality disorders C. anxiety disorders D. mood disorders Answer: D 4. The DSM-5 does not include a general category of mood disorders but instead distinguishes between ________ and _ ______. A. depressive disorders; bipolar and related disorders. B. depressive disorders; cyclothymic disorders C. cyclothymic disorders; bipolar and related disorders D. dysthymic disorders; cyclothymic disorders Answer: A 5. There are _______ major types of bipolar disorders listed in the DSM-5. A. 1 B. 2 C. 4 D. 6 Answer: B 6. Which of the following is listed under “Bipolar and Related Disorders” in the DSM-5? A. major depressive disorder B. unipolar disorder C. cyclothymic disorder D. persistent depressive disorder Answer: C 7. Bipolar disorders include _______. A. bipolar I disorder and bipolar II disorder B. bipolar I disorder , bipolar II disorder, and cyclothymia C. bipolar I disorder , bipolar II disorder, and dysthymia D. bipolar I disorder , bipolar II disorder, cyclothymia, and dysthymia Answer: A 8. Disorders such as depression and dysthymia are ______ in nature. A. unipolar B. bipolar C. unilinear D. multilinear Answer: A 9. Disorders such as cyclothymia are ______ in nature. A. unipolar B. bipolar C. unilinear D. multilinear Answer: B 10. Mood disorders in which the disturbance lies in only one direction are considered ______. A. unipolar B. unilinear C. monopolar D. monolinear Answer: A 11. Mood disorders, which involve mood swings from one extreme to another, are considered ______. A. dipolar B. bilinear C. bipolar D. multilinear Answer: C 12. Which of the following is listed under the category of “Depressive Disorders” in the DSM-5? A. bipolar I disorder B. bipolar II disorder C. cyclothymic disorder D. persistent depressive disorder Answer: D 13. Major depression cannot be diagnosed if a person shows a history of ______. A. anxiety disorder B. personality disorder C. dysthymia D. mania Answer: D 14. A severe disorder characterized by feeling sad, hopeless, or “down in the dumps,” or loss of interest or pleasure in all activities for at least two weeks is ______. A. bipolar disorder B. major depressive episode C. dysthymia D. cyclothymia Answer: B 15. To be diagnosed with a major depressive episode, one experiences either depressed mood or loss of interest or pleasure in all things for a period of at least ______. A. two days B. two weeks C. two months D. two years Answer: B 16. A severe mood disorder characterized by the occurrence of one or more major depressive episodes in the absence of a history of mania is ______. A. major depressive disorder B. bipolar disorder C. dysthymia D. cyclothymia Answer: A 17. A state of unusual elation, energy, and activity is known as ______. A. synergy B. dysthymia C. mania D. flat affect Answer: C 18. Which of the following is a common change in motivation noted with depression? A. irritability B. tearfulness C. lack of interest in social activities D. depressed mood Answer: C 19. Which of the following is an emotional symptom of depression? A. loss of enjoyment in pleasurable activities B. depressed mood C. reduced interest in sex D. lack of interest in social activities Answer: B 20. Changes in sleep habits is a ___________ symptom of depression? A. motivational B. motor behavior and functioning C. emotional D. cognitive Answer: B 21. Difficulty concentrating is a _______ symptom of depression? A. cognitive B. motivational C. emotional D. motor behavior and functioning Answer: A 22. Rani has been diagnosed with depression and has no interest in playing on her soccer team, which she has done each week for over two years. This loss of enjoyment in pleasurable activities is a _______ symptom of depression. A. cognitive B. motor behavior C. emotional D. motivational Answer: D 23. Joanne is in a very downcast mood. She has a poor appetite, has lost weight, and feels constantly fatigued. She has lost interest in most of her regular activities because they seem like "too much effort" and they no longer give her any pleasure. She seems indifferent to her family and friends and has recurrent thoughts of suicide. She is best described as suffering from ______. A. dysthymic disorder B. cyclothymic disorder C. major depressive disorder D. bipolar disorder Answer: C 24. In a case study described in the text, “The Beast is Back,” the female patient referred to her ______ as the Beast. A. husband B. depression C. headaches D. manic episodes Answer: B 25. Which U.S. president struggled with depression and wrote “I am now the most miserable man living”? A. Herbert Hoover B. Abraham Lincoln C. Bill Clinton D. George W. Bush Answer: B 26. The most common diagnosable mood disorder is ______. A. major depressive disorder B. bipolar disorder C. cyclothymia D. dysthymia Answer: A 27. Because of cultural judgments, about half of Americans with major depression ________. A. fail to receive help from a mental health professional B. attempt suicide C. become hostile and aggressive D. later develop psychoses Answer: A 28. A client has major depressive disorder. That client is ________. A. most likely to be a female B. most likely to be a male C. equally likely to be a female or a male D. most likely to be a child Answer: A 29. Nearly _______ of people with moderate to severe depression report impaired work, family, or social functioning. A. 20% B. 40% C. 60% D. 80% Answer: D 30. The annual financial impact of depression in the U.S. is estimated to be in the _______. A. millions B. hundreds of millions C. billions D. trillions Answer: C 31. Which statement is true about the diagnosis of major depressive disorder? A. It cannot include delusion or hallucinations or the diagnosis is invalid. B. It can include delusions but not hallucination. C. It can include hallucinations but not delusions. D. It can include both delusions and hallucinations. Answer: D 32. Major depressive episode tends to have a pattern of ______ occurrences and ______ symptoms. A. isolated, fleeting B. repeated, fleeting C. isolated, long-lasting D. repeated, long-lasting Answer: D 33. Which of the following is true of major depressive disorder? A. Fewer than half of those who suffer an initial major depressive episode will eventually have a recurrence. B. Major depression is never accompanied by psychotic features such as delusions. C. All individuals who experience major depression never have a full return to previous levels of functioning. D. Major depressive disorder can only be diagnosed if the individual began experiencing depressive episodes prior to age 18. Answer: A 34. Initial onset of major depressive disorder is most common among ______. A. children B. adolescents C. young adults D. middle-aged adults Answer: C 35. Which of the following people is MOST likely, statistically, to suffer from depressive disorder? A. an older wealthy, never-married person B. a young, wealthy, never-married person C. an older, poor, married person D. a young, poor person who is separated or divorced Answer: D 36. Which of the following people is LEAST likely to develop major depression? A. an older, poor, divorced person B. a young, wealthy, divorced person C. an older, wealthy, married person D. a young, poor person who is separated Answer: C 37. Factors that place people at increased risk of developing major depression include all of the Following except A. ethnic background B. socioeconomic status C. religion D. race Answer: C 38. The difference between males and females in relative risk for developing major depressive disorder begins in ______. A. childhood B. adolescence C. young adulthood D. middle age Answer: B 39. Leslie finds that every winter she becomes fatigued, excessively sleepy, has a craving for carbohydrates, and puts on weight. In the spring, her symptoms disappear. She is most likely suffering from ______. A. dysthymic disorder B. cyclothymic disorder C. bipolar disorder D. seasonal affective disorder Answer: D 40. Although the causes of SAD remain unknown, one possibility is that _________ may alter the body’s underlying biological rhythms. A. seasonal changes in vegetation B. seasonal changes in light C. seasonal changes in environmental temperature D. season changes due to celebration of holidays Answer: B 41. The gender gap between men and women in rates of depression exists ______. A. only in the United States B. only in nations other than the United States C. only in the United States and Japan D. in the United States and many other countries Answer: D 42. Compared to men, women are at higher risk for developing major depression due to which the following factors? A. Women experience less stress than men and are more prone to boredom. B. The high expectations for achievement advocated by feminist movement are unobtainable for most women and lead to depression. C. Women are less likely to distract themselves when they are depressed. D. Women often turn to alcohol as a form of self-medication. Answer: C 43. Compared to women, men are ______ likely to report depression and ______ likely to seek treatment for it. A. less, less B. less, more C. more, less D. more, more Answer: A 44. Research indicates that ______ who ruminate more following the loss of a loved one or when feeling down or sad are more likely to develop severe and prolonged depression. A. neither men nor women B. only women C. only men D. both men and women Answer: D 45. The American Psychological Association’s expert panel concluded that women experience more depression than men because _________. A. of hormonal differences B. men underreport depression due to their belief that it is a sign of weakness C. women encounter more stress in society than men D. they are more passive problem solvers Answer: C 46. Nolan-Hoeksema proposed that men are less prone to depression because they know how o ______. A. use alcohol to escape from their problems B. joke rather than take problems too seriously C. blame the other person rather than themselves D. distract themselves by doing something they enjoy Answer: D 47. Both women and men who ______ more after a loved one’s death are more prone to suffer long and severe depression. A. consume large amounts of alcohol B. ruminate C. express anger D. rely on religion Answer: B 48. The therapy of choice for patients with seasonal affective disorder is ______. A. phototherapy B. logotherapy C. chemotherapy D. physical therapy Answer: A 49. Postpartum "blues" typically last about ______. A. 2 or 3 days B. 2 weeks C. 2 months D. 4 months Answer: A 50. Anne had a baby about 10 months ago. Ever since, she has had a poor appetite, been unable to sleep (even when the baby wasn't waking her), poor self-esteem, and has been unable to concentrate for any length of time. She is most likely suffering from ______. A. postpartum blues B. postpartum psychoses C. cyclothymic disorder D. postpartum depression Answer: D 51. Corrine had a baby one month ago. Since the birth, her moods have varied wildly between earful to irritable. She has outbursts of sadness and crying and at other times feels out of control. She hears voices telling her that her baby should be returned to the heavens. Corrine is most likely suffering from ______. A. baby blues B. postpartum psychosis C. cyclothymic disorder D. postpartum depression Answer: B 52. An estimated ______ of mothers suffer from some form of postpartum depression. A. 1 to 5% B. 10 to 15% C. 20 to 25% D. 30 to 35% Answer: B 53. Which of the following women is LEAST likely to develop postpartum depression? A. a first-time mother with a supportive partner B. a single mother C. a second-time mother with a supportive partner D. a mother with a sick baby Answer: B 54. Which of the following women is most at risk for developing pat-partum depression? A. Abigail, a married, moderate income mother with a history of major depression B. Pamela, a single, adolescent with a supportive family and no history of depression C. Maria, a recent immigrant to the US who has a working husband and supportive family nearby D. Heather, a mother of three with a good income and healthcare benefits Answer: A 55. A depressive disorder which often develops during childhood or adolescence, involves less severe symptoms than major depression, but has a longer lasting, more chronic pattern of development, and often results in sufferers being seen as "whiny" or "complaining" would be classified as _____ in the DSM-5. A. dysthymic disorder B. cyclothymic disorder C. bipolar disorder D. persistent depressive disorder Answer: D 56. In the DSM-5, dysthymia is also referred to as ___________. A. persistent depressive disorder B. bipolar disorder C. low-grade depressive disorder D. hypo depressive disorder Answer: A 57. The word "dysthymia" stems from the Greek words meaning ______. A. melancholy B. sorrowful C. bad spirit D. circle spirit Answer: C 58. Compared to major depression, dysthymia has ______ severe symptoms and is ______ in duration. A. less, shorter B. less, longer C. more, shorter D. more, longer Answer: B 59. ______ percent of people with dysthymia eventually develop major depression. A. 45 B. 60 C. 75 D. 90 Answer: D 60. Dysthymic disorder affects about ______ percent of the general population at some point. A. 4 B. 14 C. 24 D. 34 Answer: A 61. Dysthymia is ______ common in men than in women. A. less B. more C. equally as D. twice as Answer: A 62. Others often perceive people with dysthymic disorder as ______. A. whining and complaining B. selfish and impulsive C. arrogant and demanding D. unpredictable and irresponsible Answer: A 63. A major depressive episode occurring concurrently with dysthymic disorder is called ______. A. cyclothymic disorder B. bipolar disorder C. anhedonia D. double depression Answer: D 64. __________ was introduced as a new diagnostic category in the DSM-5. A. Dysthymic disorder B. Cyclothymic disorder C. Premenstrual dysphoric disorder D. Bipolar II disorder Answer: C 65. Each month, one week prior to the onset of her menstrual cycle, Melissa experiences mood swings, sudden tearfulness, feelings of hopelessness, irritability and negative thoughts about herself. These symptoms cause significant impairment in her functioning and lessen in severity within a few days following the onset of menses. Melissa is likely to be diagnosed with _____________. A. dysthymic disorder B. premenstrual dysphoric disorder C. cyclothymic disorder D. bipolar II disorder Answer: B 66. __________ of women experience moderate to severe mood-related premenstrual symptoms. A. Less than 10% B. About 25% C. About 35% D. More than 50% Answer: D 67. Approximately __________ of women experience premenstrual physical or mood-related symptoms severe enough to interfere with their daily functioning, including causing absenteeism from work or producing significant emotional distress A. 10% B. 20% C. 30% D. 50% Answer: B 68. People who have severe mood swings from extreme elation to severe depression are suffering from ______. A. dysthymic disorder B. cyclothymic disorder C. bipolar disorder D. double depression Answer: C 69. Alex has severe mood swings from extreme elation and hyperactivity to major depression. One moment he feels like he's on top of the world, the next moment he feels suicidal. He is probably suffering from ______. A. dysthymic disorder B. cyclothymic disorder C. bipolar disorder D. double depression Answer: C 70. In bipolar disorder, manic episodes are usually ______ in duration and end ______ abruptly hand depressive episodes. A. shorter, less B. shorter, more C. longer, more D. longer, less Answer: B 71. In An Unquiet Mind, Kay Redfield Jamison described her struggles with ______ disorder. A. dysthymic B. major depressive C. cyclothymic D. bipolar Answer: D 72. The DSM distinguishes between ______ general types of bipolar disorder. A. two B. three C. four D. five Answer: A 73. The essential feature of bipolar I disorder is the occurrence of at least one full-blown ______ episode. A. major depressive B. dysthymic C. hypomanic D. manic Answer: D 74. In bipolar II disorder, a person experiences ______ episodes. A. has experienced neither manic nor hypomanic B. manic episodes, but has not experienced hypomanic C. hypomanic episodes, but has not experienced manic D. has experienced both manic and hypomanic Answer: C 75. Bipolar I disorder affects about ______ of the adult population. A. 1% B. 5% C. 8% D. 12% Answer: A 76. Bipolar II disorder effects ______ of the adult population. A. less than 1% B. about 5% C. about 11% D. about 15% Answer: A 77. The average age of onset for bipolar disorder for both men and women is about age ______. A. 13 B. 20 C. 27 D. 34 Answer: B 78. Women are ______ as likely as men to develop bipolar I disorder. A. half B. equally C. twice D. four times Answer: B 79. In men, the onset of bipolar I disorder typically begins with a _____ episode, whereas with women it usually begins with a __________ episode. A. major depressive; manic B. manic; major depressive C. hypomanic; manic D. hypomanic; major depressive Answer: A 80. The onset of bipolar I disorder usually begins with a ______. A. manic episode for both men and women B. manic episode for men and a major depressive episode for women C. manic episode for women and a major depressive episode for men D. major depressive episode for both men and women Answer: B 81. An individual with a bipolar I disorder who experiences two or more full cycles of mania and depression within a year without intervening normal periods is considered to have ______. A. rapid cycling B. sequential cycling C. mixed cycling D. differentiated cycling Answer: A 82. In the rapid cycling type of bipolar disorder, the individual experiences at least ______ or more full cycles of mania or depression within a year. A. two B. four C. six D. eight Answer: A 83. Rapid cycling is relatively ______ and occurs ______ often among men than women. A. uncommon, less B. common, less C. uncommon, more D. common, more Answer: A 84. Rapid cycling is associated with a ______ severe form of the disorder and ______ serious suicide attempts. A. less, more B. more, less C. less, less D. more, more Answer: D 85. Guillermo was having a normal day when suddenly he felt an overwhelming expansion of his mood. He now feels euphoric, cheerful, optimistic, has boundless energy, and feels sociable and confident. However, he is also hyperactive, impulsive, demanding, and overbearing. His behavior is typical of a ______. A. bipolar episode B. hypomanic episode C. manic episode D. dysthymic episode Answer: C 86. Don suddenly quit his job, enrolled in law school for day classes, took on a job waiting tables at night, and began organizing charity drives on weekends. He also began work on his "great American novel" and offered to coach a little league team in his "spare time." His behavior is typical of someone having a ______. A. hypomanic episode B. dysthymic episode C. cyclothymic episode D. manic episode Answer: D 87. Which of the following is characteristic of manic episodes? A. insatiable appetite B. overbearing behavior C. weeping D. selfishness Answer: B 88. A person who speaks very rapidly and urgently and has difficulty pausing has ______. A. circumstantial speech B. euphoric speech C. pressured speech D. tangential speech Answer: C 89. People in a manic episode generally experience which of the following? A. extreme self-confidence B. a lack of self-confidence C. lethargy D. slow, rambling speech Answer: A 90. The tendency of a person to jump from topic to topic during a manic episode is referred to as ______. A. multidirectional cognitions B. accelerated thought C. rapid flight of ideas D. quickness on the feet Answer: C 91. During a manic episode, bipolar people almost always show a decreased need for ______. A. sex B. new achievements C. creativity D. sleep Answer: D 92. The term "cyclothymia" is derived from the Greek terms meaning ______. A. melancholy B. phlegmatic C. bad spirited D. circle spirit Answer: D 93. Cyclothymic disorder may be _______ of the bipolar disorders but tends to be ________ in clinical practice. A. the most common; underdiagnosed B. the least common; overdiagnoses C. the most researched; the most difficult to diagnose D. about as common as the other forms; over diagnosed Answer: A 94. Cyclothymic disorder usually begins in one's ______. A. early childhood B. early adolescence C. late adolescence or early adulthood D. late adulthood Answer: C 95. Among people with cyclothymic disorder, few, if any, periods of normal mood last for more than a ______. A. day or two B. week or two C. month or two D. year or two Answer: C 96. A disorder characterized by a cyclical pattern of mild mood swings, not reaching the level of full-blown manic episodes or major depressive episodes is ______. A. dysthymic disorder B. cyclothymic disorder C. anhedonnia D. anencephaly Answer: B 97. To meet the DSM criteria for a diagnosis of cyclothymic disorder, disturbances of mood in adults must persist for at least ______. A. 1 year B. 2 years C. 3 years D. 4 years Answer: B 98. Cyclothymic disorder is characterized by the occurrence of ______ episodes. A. major depressive B. psychotic C. hypomanic D. manic Answer: C 99. Dave is having a normal day when suddenly he feels charged with energy and unusually alert. He knows that when he gets these feelings, he is capable of working long hours with little fatigue or need of sleep. He is still capable of using good judgment and has no hyperactivity. He is best described as suffering from a ______. A. dysthymic episode B. manic episode C. hypomanic episode D. paranoid episode Answer: C 100. A period of elevated mood that is less severe than a manic episode is called a(n) ______ episode. A. exhilaration B. hypomanic C. acceleration D. hypermanic Answer: B 101. According to your text, approximately ______ percent of those with cyclothymia go on to develop full-fledged bipolar disorder. A. one in two B. half C. two out of three D. one in three Answer: D 102. Unemployed people are at highest risk for developing which of the following mood disorders? A. cyclothymic disorder B. dysthymic disorder C. bipolar disorder D. major depressive disorder Answer: D 103. Which of the following is true of depression and stress? A. Experimental research has demonstrated causal links between stress and depression. B. The relationship between stress and depression is not impacted by social support. C. Some research indicates that depression is often preceded by significant life stress. D. Overly-concerned family and friends may make it more difficult to overcome a depressive episode. Answer: C 104. Identify the characteristic that has been found to insulate people from depression and suicide attempts during times of stress. A. wealth B. use of alcohol as a relaxant C. successful marriage D. regular aerobic exercise Answer: C 105. A recent study suggests that stress associated with interpersonal problems contributes to depression in young people, but only among those who ________. A. have trouble asserting themselves B. have a family history of depression C. were children of divorce D. tend to think negatively Answer: D 106. A normal grief reaction to the death of a loved one is ______. A. major depression B. bereavement C. mild depression D. reactive depression Answer: B 107. Lucy has been depressed since her mother died last month. She has difficulty sleeping and has lost her appetite. Lucy is suffering from ______. A. major depression B. bereavement C. mild depression D. reactive depression Answer: B 108. Freud believed that pathological mourning was most likely to occur in people who had powerful feelings of ______ toward the dead person. A. love B. ambivalence C. anger D. dependence Answer: B 109. Freud believed that mourning, or normal bereavement, is ______. A. a psychologically healthy process B. a symptom of inner conflict C. a sign of emotional immaturity D. a symptom of an underlying pathological process Answer: A 110. Psychodynamic theories see bipolar disorder as the result of shifting dominance between the ______. A. id and ego B. id and superego C. ego and superego D. conscious and unconscious Answer: C 111. Recent psychodynamic theories see depression as ______. A. loss of self-worth or self-esteem B. the result of an existence lacking in meaning C. overdependence on parental figures for love and support D. anger turned inward Answer: A 112. Carl's wife has just left him for another man. While everyone else can see that Carl's relationship with his wife is truly over, he continues to dwell on ways that he can somehow restore the relationship. He cannot bear the loss of self-esteem and security he has suffered since his wife left him. Carl's actions are best explained by the ______ model of depression. A. introjection B. self-focusing C. existential D. interactional Answer: B 113. According to the self-focusing model, ______ can help to overcome the loss of self-esteem and the insecurity that leads to depression after the loss of an important relationship. A. surrendering the relationship B. developing a greater sense of spirituality C. immersing oneself in a charitable experience D. traveling away from the scene of the loss for at least a week Answer: A 114. Research has shown that people suffering from depression engage in ______ following an experience of failure. A. higher level of introjection B. lower level of introjection C. higher level of self-focusing D. lower level of self-focusing Answer: C 115. A limitation of the self-focused attention model of depression is that ______. A. self-focused attention is more pervasive in society than in prior decades B. self-focused attention is more generally linked to psychopathology C. research has not been conducted to support the link D. certain popular child-rearing techniques have emphasized self-focus Answer: B 116. From the humanistic perspective, depression arises from ______. A. anger turned inward B. imbalanced social interactions C. inadequate social reinforcement D. lack of self-fulfilment, meaning, and authentic choices in life Answer: D 117. Both humanistic and modern psychodynamic theorists focus on ______ as a causal factor in depression. A. inadequate social relationships and support B. anger turned inward C. loss of self-esteem D. lack of self-fulfilment and meaning in life Answer: C 118. Learning perspectives tend to focus on ______ that contribute to depression. A. personal factors B. unconscious conflicts C. esteem factors D. situational factors Answer: D 119. According to Lewinsohn, the low rate of activity typical of depressed individuals may also be a source of _________. A. secondary reinforcement B. negative reinforcement C. extinction D. stimulus discrimination Answer: A 120. Peter Lewinsohn proposed that depression results from an imbalance between behavior and ______. A. ability B. reinforcement C. motivation D. thought Answer: B 121. Gina, who has suffered from a major depressive disorder, is seeking help from a therapist who follows Lewinsohn’s model linking depression and reinforcement. The therapist will probably advise Gina to increase her ______. A. serotonin levels B. pleasurable activities C. communications with friends and relatives D. self-focus Answer: B 122. The belief that depressed people make unrealistic demands on the people around them, leading to rejection by those people, is called _______. A. situational theory B. self-focus theory C. interactional theory D. humanistic theory Answer: C 123. Which of the following is true of the social interactions of depressed people? A. They tend to respond too quickly to others. B. They are very approving of other people. C. They tend to be quire eager to engage with others. D. They tend to be uninvolved and even impolite when interacting with others. Answer: B 124. Coyne’s interactional theory is based on the principle of ______. A. coordinated communication B. relational harmony C. reciprocal inhibition D. reciprocal interaction Answer: D 125. Research on interaction theory indicates that ______ may best explain why depressed people are often rejected by others. A. unrealistic demands by the depressed person B. a lack of social skills in the depressed person C. a lack of emotional energy in the depressed person D. insensitivity by those surrounding the depressed person Answer: B 126. Cognitive theorists argue that depression results partially from ______. A. anger turned inward B. imbalanced social interactions C. negative beliefs about oneself D. a life lacking in purpose and meaning Answer: C 127. The "cognitive triad of depression" is a concept pioneered by ______. A. Wolpe B. Lazarus C. Ellis D. Beck Answer: D 128. Which of the following beliefs is in the cognitive triad of depression? A. negative beliefs about life B. negative beliefs about one’s family C. negative beliefs about the world at large D. negative beliefs about the past Answer: C 129. Aaron Beck refers to an error in thinking as ______. A. cognitive dissonance B. cognitive distortion C. cognitive selection D. cognitive erosion Answer: B 130. According to Aaron Beck, ______ sets the stage for depression when one faces a personal loss or negative life event. A. cognitive selection B. cognitive erosion C. cognitive dissonance D. cognitive distortion Answer: D 131. Which of the following is one of the 10 cognitive distortions related to depression as described by Burns? A. all or nothing thinking B. analytical reasoning C. compartmentalization D. objectivism Answer: C 132. According to David Burns, a depressed individual who is dismissive of congratulations for a job well done and thinks “Oh, it’s no big deal. Anyone could have done it,” is engaging in the cognitive distortion of _______. A. overgeneralization B. emotional reasoning C. disqualifying the positive D. labeling and mislabeling Answer: C 133. An individual who routinely predicts that something bad is always about to happen even when there is no evidence to support this thinking is engaging in a type of cognitive distortion identified by David Burns as _______. A. mind reading B. fortune telling C. overgeneralizing D. weather forecasting Answer: B 134. Albert Ellis felt that creating unrealistic expectations, which he termed ______, can lead one to become depressed when one falls short. A. shoulding B. labeling C. musterbation D. incantation Answer: C 135. Judd is a perfectionist. His cognitive distortion is most likely to be ______. A. overgeneralization B. emotional reasoning C. should statements D. all or nothing reasoning Answer: D 136. After Jed was "dumped" by his girlfriend, he began thinking that women cannot be trusted. He promised never to let himself get involved with another woman again, because "she will leave me just like my last girlfriend did." His cognitive error is ______. A. labeling and mislabeling B. emotional reasoning C. overgeneralization D. mental filter Answer: C 137. Luke reviews his annual performance evaluation from his boss. Although there is only one negative comment on the entire evaluation, Luke ignores the positive comments and focuses only on the negative comment. His cognitive error is ______. A. overgeneralization B. labeling and mislabeling C. disqualifying the positive D. mental filter Answer: D 138. Selective abstraction is a process used in which of the following cognitive distortions? A. magnification and minimization B. mental filter C. jumping to conclusions D. labeling and mislabeling Answer: B 139. The process of pulling isolated negative details from an event and ignoring all the positive details from the same event, is known as ______. A. catastrophizing B. musterbation C. selective abstraction D. personalization Answer: C 140. After winning a big competition at work, Fred dismisses the compliments he receives by saying, "Oh, it's nothing. Anyone could have done it!" His cognitive error is ______. A. overgeneralization B. labeling and mislabeling C. disqualifying the positive D. mental filter Answer: C 141. Mac has a pain in his chest. Despite the fact that he just ate ten tacos and a can of refried beans, he convinces himself that he must be having a heart attack. His cognitive error is ______. A. jumping to conclusions B. mental filter C. emotional reasoning D. labeling and mislabeling Answer: A 142. The “fortune teller error” and “mind reading” are both typical of ______. A. jumping to conclusions B. mental filter C. emotional reasoning D. labeling and mislabeling Answer: A 143. Ramon is taking a final exam. When he reaches the first question to which he does not know he answer, he begins worrying that he will miss the other questions too, which will result in his failing the test, which will result in his failing the class, which will result in his flunking out of school, which will abruptly terminate his future career as a lawyer. His cognitive error is ______. A. magnification B. mental filter C. disqualifying the positive D. overgeneralization Answer: A 144. Catastrophizing is a process used in which of the following cognitive distortions? A. magnification and minimization B. labeling and mislabeling C. jumping to conclusions D. mental filter Answer: A 145. A cognitive distortion in which one interprets feelings and events based on emotions rather than a fair consideration of the evidence is known as ______. A. should statements B. emotional reasoning C. mental filter D. overgeneralization Answer: B 146. Tyrone wakes up one morning feeling guilty. He's not sure why he feels guilty but he tells himself "I must have done something wrong or I wouldn't feel so guilty!" He then begins to think of all the things he's done recently for which he ought to feel guilty. His cognitive error is ______. A. “should” statements B. emotional reasoning C. mental filter D. overgeneralization Answer: A 147. "Musterbation" is a process used in which of the following cognitive distortions? A. magnification and minimization B. jumping to conclusions C. overgeneralization D. “should” statements Answer: D 148. Lloyd gets a poor grade on a test, despite extensive studying for it. He immediately thinks "I am really stupid!" When other students tease him about his poor grade, he calls them "insensitive jerks." His cognitive error is ______. A. overgeneralization B. mental filter C. labeling and mislabelling D. jumping to conclusions Answer: C 149. Mel walks into his house one night and finds his wife sitting at the dinner table crying. He immediately thinks "What have I done to hurt her?" His cognitive error is ______. A. personalization B. mental filter C. overgeneralization D. magnification Answer: A 150. The idea that different types of disorders are characterized by different types of thoughts is called the ______. A. cognitive triad B. cognitive-generativity hypothesis C. multiple cognition theory D. cognitive-specificity hypothesis Answer: D 151. Which of the following is an automatic thought associated with depression? A. I'm worthless. B. I need to make more friends. C. I am not a healthy person. D. I need to exercise more. Answer: A 152. Which of the following is an automatic thought associated more with depression than anxiety? A. I'm losing my mind. B. I'm a social failure. C. Something will happen to my appearance D. I'm going to have an accident. Answer: B 153. Which of the following is an automatic thought associated with anxiety? A. I will never overcome my problems. B. I’m a social failure. C. I’m losing my mind. D. I’m worse off than they are. Answer: C 154. Which of the following is an automatic thought associated more with anxiety than with depression? A. I'm worthless. B. I'm worse off than they are. C. Nothing ever works out for me anymore D. I'm losing my mind. Answer: D 155. Research regarding depression and distorted negative cognitions ______. A. indicates that distorted thinking causes depression B. indicates that distorted thinking and depression develop at the same time C. indicates that depression leads to distorted negative thinking D. is not yet clear as to whether distorted thinking causes or is merely a feature of depression Answer: D 156. Sam is depressed. He's been depressed for so long that he no longer believes he can do anything to improve his life or his future. He believes nothing he does will make any difference. Sam has developed ______. A. cyclothymic disorder B. cognitive dissonance C. learned helplessness D. cognitive specificity Answer: C 157. The concept of learned helplessness was pioneered by ______. A. Beck B. Burns C. Seligman D. Lewinsohn Answer: C 158. Martin Seligman developed the ______ theory to explain the cause of depression. A. cognitive specificity B. cognitive distortion C. interactional D. learned helplessness Answer: D 159. Seligman believes that people learn to perceive themselves as helpless because of their ______. A. experiences B. cardinal traits C. ordinal traits D. failure to self-actualize Answer: A 160. The learned helplessness model straddles the ______ and the ______ approaches. A. psychodynamic, behavioral B. psychodynamic, humanistic C. humanistic, cognitive D. behavioral, cognitive Answer: D 161. In Seligman's model, dogs exposed to an inescapable electric shock, later ______ when exposed to an escapable shock. A. failed to learn escape responses B. took longer than normal to learn escape responses C. learned escape responses normally D. learned escape responses more quickly than normal Answer: A 162. Seligman proposed that some forms of depression in humans could be explained in terms of ______. A. cognitive dissonance B. loss of self-esteem C. cognitive specificity D. learned helplessness Answer: D 163. In Seligman's research, animals that developed learned helplessness showed behaviors that were similar to those of people with ______. A. depression B. anxiety C. autism D. schizophrenia Answer: A 164. Which of the following behaviors are shared by animals and humans with learned helplessness? A. paranoia B. attention seeking C. competitiveness D. difficulty acquiring new skills Answer: D 165. The original learned helplessness model ______ the low self-esteem typical of people who are depressed and _______ the variations in the persistence of depression. A. fails to explain, does not account for B. explains, does not account for C. fails to explain, accounts for D. explains, accounts for Answer: A 166. Seligman and his colleagues proposed that some forms of depression in humans could be explained in terms of ______. A. cognitive dissonance B. loss of self-esteem C. cognitive specificity D. attributional style Answer: D 167. A personal style of explaining one’s situation in life is known as ______ style. A. perceptual B. interactive C. attributional D. self-actuating Answer: C 168. Which of the following is one of the three dimensions of attributional style proposed by Seligman and his colleagues? A. open/closed B. positive/negative C. stable/unstable D. inquisitive/accepting Answer: B 169. Eric goes on a disastrous date. Afterwards he says "Some couples just don't hit it off!" His statement reflects a(n) ______ attribution. A. internal B. external C. global D. stable Answer: B 170. Reggie goes on a disastrous date. Afterwards he says "I really messed it up this time!" His statement reflects a(n) ______ attribution. A. internal B. external C. global D. stable Answer: A 171. Brock goes on a disastrous date. Afterwards he says "I really messed it up because of my lousy personality!" His statement reflects a(n) ______ attribution. A. stable B. specific C. external D. unstable Answer: A 172. Matt goes on a disastrous date. Afterwards he says "I really messed it up. It must be this head cold, which ruined things for me." His statements reflect a(n) ______ attribution. A. global B. unstable C. internal D. stable Answer: B 173. Art goes on a disastrous date. Afterwards he says "I really messed it up. I guess I'm just no good with women!" His statements reflect a(n) ______ attribution. A. global B. specific C. external D. unstable Answer: A 174. Ricky goes on a disastrous date. Afterwards he says "I really messed it up. My problem is that I don't know how to make small talk with women!" His statements reflect a(n) ______ attribution. A. global B. specific C. external D. unstable Answer: B 175. Leo goes on a disastrous date. Afterwards he says "What an awful time! I guess she was just in a bad mood!" His statements reflect ______ attributions. A. internal, stable, global B. external, unstable, specific C. internal, unstable, global D. external, stable, specific Answer: B 176. Leo goes on a disastrous date. Afterwards he says "I really messed it up because of my lousy personality!" His statements reflect ______ attributions. A. internal, stable, global B. internal, unstable, global C. internal, unstable, specific D. internal, stable, specific Answer: A 177. Carl goes on a disastrous date. Afterwards he says "I really messed up! My problem is I just haven't learned how to make small talk with women!" His statements reflect _______ attributions. A. internal, stable, global B. internal, unstable, global C. internal, unstable, specific D. internal, stable, specific Answer: D 178. Of the attributional styles listed below, which is MOST likely to be related to prolonged depression if the attributions are negative? A. external, stable, specific B. external, unstable, global C. internal, unstable, specific D. internal, stable, global Answer: D 179. Of the attributional styles listed below, which is LEAST likely to be related to prolonged depression if the attributions are negative? A. external, stable, global B. external, unstable, specific C. internal, unstable, specific D. internal, stable, global Answer: B 180. The reformulated helplessness theory holds that ______ attributions are linked to diminished self-esteem. A. global B. stable C. specific D. internal Answer: D 181. The reformulated helplessness theory holds that _______ attributions explain the persistence, or chronicity, of helplessness cognitions. A. global B. stable C. external D. internal Answer: B 182. The reformulated helplessness theory holds that ______ attributions are associated with the pervasiveness of feelings of general helplessness. A. global B. stable C. specific D. internal Answer: A 183. The concordance rate between monozygotic twins for major mood disorders is more than ______ he rate in dizygotic twins. A. equal to B. twice C. three times D. four times Answer: B 184. Which statement most accurately reflects the current understanding of causative factors in the development of major depression? A. Genetics play a greater role than environment. B. Environment plays a greater role than genetics. C. Environment plays at least as great a role as genetics. D. Personality style is more important than either genetics or environment. Answer: C 185. The chance of developing depression following major life stress is doubled in people who inherit a gene involved in the transmission of ______. A. viruses that strike during infancy B. proneness to migraine headaches C. radical nucleotides D. serotonin Answer: D 186. Antidepressant drugs have been designed to increase levels of serotonin and ______. A. amitriptyline B. norepinephrine C. dopamine D. cortisol Answer: B 187. Brain imaging studies show lower metabolic activity of the ______ in clinically depressed people. A. temporal lobe B. prefrontal cortex C. medulla D. hippocampus Answer: B 188. Recent research on biological factors of depression show evidence for which of the following? A. Depression involves too few receptors on receiving neurons for neurotransmitters. B. Depression involves abnormalities in the cerebellum. C. Depression involves excesses of certain neurotransmitters. D. Depression involves abnormalities in the parietal lobe. Answer: A 189. Which food substance has been linked to lower risks of mood disorders? A. red wine B. blueberries C. fish oil D. spinach Answer: C 190. Adding ______ fatty acids in supplement form can improve treatment through antidepressant medication. A. alpha-4 B. beta-3 C. iota-6 D. omega-3 Answer: D 191. There is a strong relationship between eating ______ and low rates of bipolar disorder. A. dark chocolate B. seafood C. strawberries D. walnuts Answer: B 192. Among the following countries, the lowest rate of bipolar disorder has been found in ______. A. Germany B. Iceland C. Italy D. Israel Answer: B 193. Genetics appears to play _______ role in bipolar disorder than it does in major depressive disorder A. a much weaker B. a weaker C. a stronger D. about the same Answer: C 194. Research has shown the concordance rates for bipolar disorder to be _______ for monozygotic twins and ______ for dyzotic twins. A. 16%; 23% B. 23%; 27% C. 33%; 23% D. 43%; 6% Answer: D 195. Researchers in Sweden (2008) showed a higher risk of bipolar disorder with _________. A. greater paternal age at birth, especially when the fathers was over 55 B. greater paternal age at birth, especially when the fathers was over 45 B. lower paternal age at birth, especially when the fathers was under 25 D. lower paternal age at birth, especially when the fathers was under 20 Answer: A 196. Among people with bipolar disorder, social support appears to ______ recovery from mood episodes and ______ the likelihood of future attacks. A. have no effect on, reduce B. have no effect on, increase C. speed, reduce D. speed, increase Answer: C 197. Recent research indicates that ______ can enhance the functioning of bipolar patients. A. doubling the normal amount of medication B. having a tightly structured schedule C. eliminating seafood and caffeine-rich foods D. social support from family members and friends Answer: D 198. Traditional psychoanalysis focuses on helping depressed patients ______. A. turn their anger outward and express it verbally B. develop a positive sense of self-worth through new goals and relationships C. expand their awareness of their authentic feelings D. modify behaviors that contribute to depression Answer: A 199. Modern psychoanalysts focus on helping depressed patients ______. A. turn their anger outward and express it verbally B. focus on present as well as past conflicted relationships C. expand their awareness of their authentic feelings D. modify behaviors that contribute to depression Answer: B 200. Interpersonal psychotherapy focuses on ______. A. resolving unconscious conflicts B. changing learning schedules C. current relationships D. helping a person to self-actualize Answer: C 201. Interpersonal psychotherapy is relatively ______ and focuses on a client’s ______ interpersonal relationships. A. brief, past B. brief, current C. long, past D. long, current Answer: B 202. Interpersonal psychodynamic therapy differs from traditional psychoanalysis in that it ______. A. focuses on current relationships B. emphasizes sexual themes in early childhood conflicts C. focuses on behavioral techniques to supplement traditional psychoanalysis D. emphasizes adolescent social experiences as a source of anxiety Answer: A 203. Interpersonal therapy has been shown to be an effective treatment for ______. A. bipolar 1 B. bipolar II C. cyclothymia D. major depression Answer: D 204. Behavioral psychologists focus on helping depressed patients ______. A. turn their anger outward and express it verbally B. develop a positive sense of self-worth through new goals and relationships C. expand their awareness of their authentic feelings D. develop more effective social and interpersonal skills Answer: D 205. Cognitive psychologists focus on helping depressed patients ______. A. change their dysfunctional thinking patterns B. develop a positive sense of self-worth through new goals and relationships C. expand their awareness of their authentic feelings D. modify behaviors that contribute to depression Answer: A 206. Cognitive therapy, ______ behavioral therapy, entails a(n) ______ therapy format. A. like, brief B. unlike, brief C. unlike, extended D. like, extended Answer: A 207. Cognitive behavior therapy appears to be ______ antidepressant medications in treating depression. A. less effective than B. significantly less effective than C. as effective as D. significantly more effective than Answer: C 208. Research has demonstrated that a combination of psychotherapy and antidepressant medication produced ______ outcomes for treatment of depression compared to either treatment alone. A. approximately equal B. slightly better C. slightly worse D. much better Answer: B 209. A biological approach to the treatment of mood disorders could involve which of the following? A. cingulotomy B. insulin therapy C. a prefrontal lobotomy D. electroconvulsive therapy Answer: D 210. Which of the following drugs (or drug groups) is used to treat depressive disorders? A. electrolytes B. selective serotonin reuptake inhibitors C. lithium D. benzodiazepines Answer: C 211. Tricyclic antidepressants work by interfering with the reuptake of ______. A. cortisol and thyroxin B. epinephrine and norepinephrine C. serotonin and cortisol D. norepinephrine and serotonin Answer: D 212. Prozac relieves depression primarily by raising levels of ______ in the brain. A. serotonin B. acetylcholine C. endorphins D. monoamine oxidase Answer: A 213. MAO inhibitors interfere with the action of ______. A. serotonin B. monoamine oxidase C. dexamethasone D. norepinephrine Answer: B 214. The potential side effects of ______ include psychomotor retardation, dry mouth, constipation, blurred vision, urinary retention, confusion, delirium, low blood pressure, and potentially suicidal overdoses because of high toxicity. A. SSRIs B. neuroleptics C. tricyclics D. lithium Answer: C 215. The potential side effects of ______ include psychomotor retardation, dry mouth, constipation, blurred vision, urinary retention, confusion, delirium, and cardiovascular complications. A. MAO inhibitors B. neuroleptics C. SSRIs D. lithium Answer: A 216. Significant side-effects of ______ include upset stomach, headaches, agitation, insomnia, lack of sexual drive, and impaired sexual responsiveness. A. SSRIs B. MAO inhibitors C. lithium D. tricyclics Answer: A 217. SSRIs are ______ toxic and have ______ side effects than MAO inhibitors and tricyclics. A. less, fewer B. less, more C. more, fewer D. more, more Answer: A 218. Overall, about ______ percent of depressed patients treated on an outpatient basis respond favourably to either psychotherapy or antidepressant medication alone. A. 10 to 30 B. 30 to 50 C. 50 to 70 D. 70 to 90 Answer: C 219. Adding ______ therapy to medication treatment may help reduce the risk of relapse in depressed patients after the medication is withdrawn. A. ECT B. St. John’s Wort C. interpersonal D. cognitive-behavioral Answer: D 220. Research indicates that in treating severe depression, ECT is ______. A. neither safe nor effective B. safe but not effective C. effective but unsafe due to its side-effects D. safe and effective Answer: D 221. Electroconvulsive therapy is used to treat ______ in people who fail to respond to medication. A. major depressive disorder B. cyclothymia C. dysthymia D. bipolar disorder Answer: A 222. In ECT, a current of between ______ volts is passed through a patient's brain. A. 10 to 70 B. 70 to 130 C. 130 to 200 D. 200 to 270 Answer: B 223. ECT is usually administered in a series of 6 to 12 treatments over a period of several ______. A. hours B. days C. weeks D. months Answer: C 224. Recent research on ECT suggested that it leads to improvement in ______ people with major depression who have failed to respond to antidepressants. A. virtually no B. only a small minority of C. a large minority of D. a majority of Answer: D 225. ECT has ______ rate of relapse following treatment. A. a low B. a high C. neither a high nor a low D. a highly variable Answer: B 226. A significant risk for people treated with ECT is ______. A. thyroid cancer B. brain cancer C. memory loss D. migraine headaches Answer: C 227. Which of the following is true of ECT? A. It can have dramatic effects on reducing suicidal thinking. B. It works because it reroutes neural messages. C. It induces a convulsion that is similar to a petit mal seizure. D. It can also be effectively used in the treatment of schizophrenia and bipolar disorder. Answer: A 228. The first people to use lithium as a form of chemotherapy were the ______. A. Aztecs B. ancient Greeks and Romans C. druids D. Medieval monks of France Answer: B 229. Bipolar disorder is most commonly treated with ______. A. tricyclics B. MAO inhibitors C. lithium D. reserpine Answer: C 230. Which of the following is true of lithium? A. It can lead to dramatic weight loss. B. It can lead to sleep problems. C. It can cause diabetes. D. It diminishes motor speed. Answer: D 231. Tegretol and Depakote are drugs originally used to treat ______. A. muscular dystrophy B. epilepsy C. Parkinson’s disease D. dysthymic disorder Answer: B 232. Tegretol and Depakote can be used to treat ______. A. major depressive disorder B. seasonal affective disorder C. dysthymia D. bipolar disorder Answer: D 233. ______ drugs have been used to treat people with bipolar disorder who do not respond to lithium or cannot tolerate it. A. Antipsychotic B. Anti-inflammatory C. Anticonvulsive D. Antihistamine Answer: C 234. Which of the following statements is true about gender-related coping styles differences? A. Men are more likely to ruminate and women are more likely to abuse alcohol. B. Men are more likely to abuse alcohol and women are more likely to ruminate. C. Men and women are equally likely to abuse alcohol or ruminate. D. Men are more likely to abuse alcohol and women are less likely to ruminate. Answer: B 235. Anton Mesmer believed that hysteria was caused by an underlying imbalance of ______ in the body. A. neurotransmitters B. hormones C. blood D. magnetic fluids Answer: D 236. A promising new treatment alternative to ECT for cases of major depression who do not respond to pharmacological treatment is ______. A. dialectical behavior therapy B. transcranial magnetic stimulation C. day treatment intensive group therapy D. transdermal seratonergic patch Answer: B 237. A possible negative side effect of TMS is the risk of ______. A. cancer B. seizures C. memory loss D. sexual apathy Answer: B 238. The part of the brain that appears to be directly affected by TMS is the ______. A. prefrontal cortex B. hindbrain C. limbic system D. reticular activating system Answer: A 239. About ______ percent of U.S. adults report having experienced suicidal thoughts. A. 3 B. 13 C. 33 D. 63 Answer: B 240. About ______ Americans attempt suicide each year. A. 100,000 B. 250,000 C. 400,000 D. 500,000 Answer: D 241. About ______ Americans commit suicide each year. A. 30,000 B. 60,000 C. 90,000 D. 120,000 Answer: A 242. The Federal government estimates that about ______ percent of people who commit suicide suffer from a mood disorder. A. 40 B. 60 C. 80 D. 100 Answer: B 243. The Federal government estimates that the majority of people who commit suicide suffer from a ______. A. psychotic B. somatoform C. mood disorder D. personality disorder Answer: C 244. Suicide is most likely among ______. A. teenagers B. young adults C. middle-aged adults D. elderly adults Answer: D 245. Who among the following is MOST likely to commit suicide? A. an African American teenage male B. a white middle-aged female C. an African American female in her mid-twenties D. an elderly white male Answer: D 246. Which of the following is suspected of causing the increase in the suicide rate among the Elderly? A. they are worse off economically than they were in earlier decades B. Many fear financial exploitation by their children. C. Today's increased tolerance of suicide as a means of "solving" problems may make it seem to be an acceptable alternative. D. The media and current culture are youth-focused and sends messages that to be old is not good. Answer: A 247. American ______ are more likely to attempt suicide. ______ are more likely to succeed in a suicide attempt. A. men, Men B. men, Women C. women, Men D. women, Women Answer: C 248. Men are most likely to use ______ in their suicide attempts. A. their cars B. poison C. hanging D. guns Answer: D 249. Compared to women, men use ______-acting and ______ lethal means in their suicide attempts. A. slower, less B. quicker, less C. slower, more D. quicker, more Answer: D 250. In the United States, for every female suicide ______. A. there is one male suicide B. there are two male suicides C. there are four male suicides D. there are eight male suicides Answer: C 251. Whites are about ______ as likely as Blacks to commit suicide. A. half B. equally C. twice D. four times Answer: C 252. Overall, ______ are at the greatest risk for suicide. A. European Americans B. Hispanic Americans C. Asian Americans D. Native Americans Answer: D 253. The majority of suicides are apparently connected with ______. A. conversion disorder B. severe mood disorders C. schizophrenia D. adjustment disorder Answer: B 254. The risk of suicide is much greater among people diagnosed with ______. A. major depression B. dissociative disorders C. schizophrenia D. adjustment disorders Answer: A 255. The risk of suicide is much greater among people diagnosed with ______. A. bipolar disorder B. dissociative disorders C. schizophrenia D. adjustment disorders Answer: A 256. Which of the following is true? A. People who fail on a first suicide attempt rarely try it again. B. All suicides are connected to psychological disorders. C. Suicidal thinking accompanies a loss of contact with reality. D. Suicide attempts often occur in response to highly stressful life events. Answer: D 257. Which of the following is true of people who attempt or commit suicide? A. Suicide attempts frequently follow a success in the person’s life. B. People who consider suicide in response to stressful events rarely have poorer problem-solving skills when compared to those who do not contemplate suicide in similarly stressful situations. C. People with terminal illness consider suicide "rational." D. Many people who take their lives are basically attention seekers. Answer: C 258. According to classic psychodynamic theorists, suicide represents a reaction to ______. A. negative outcome expectancies B. the perception that life has become meaningless, dull, empty, and hopeless C. anger, which has reached the point of murderous rage, turned inward D. the effects of stress, seeing no viable solution to unavoidable problems, and prolonged depression Answer: C 259. In his later writings, Sigmund Freud related suicide to ______. A. a collapse of the id leading to destructive dominance of a guilt-ridden superego B. the effects of stress and external social forces C. the perception that life has become meaningless, dull, empty, and hopeless D. an inborn death instinct Answer: D 260. Existential and humanistic theorists see suicide as a reaction to ______. A. negative outcome expectancies B. the perception that life has become meaningless, dull, empty, and hopeless C. anger, which has reached the point of murderous rage, turned inward D. the effects of stress and external social forces Answer: B 261. Sociocultural thinkers, such as Emile Durkheim, see suicide as largely a reaction to ______. A. alienation resulting from today's lifestyles B. negative outcome expectancies C. anger, which has reached the point of murderous rage, turned inward D. the effects of stress and previous suicide attempts Answer: A 262. A sense of feeling lost, rootless, and without identity is known as ______. A. lethargy B. apathy C. anomie D. anhedonia Answer: C 263. Learning theorists see suicide as largely a reaction to ______. A. negative outcome expectancies B. alienation and isolation resulting from today's lifestyle C. the perception that life has become empty, meaningless, and hopeless D. the effects of stress and reinforcing effects of previous suicide attempts Answer: D 264. Social-cognitive theorists see suicide as a reaction to ______. A. positive outcome expectancies B. negative outcome expectancies C. alienation and isolation resulting from today's lifestyle D. personal outcome expectancies Answer: D 265. Which of the following is true regarding suicide? A. A social contagion, or spreading of suicide in a community rarely occurs in the wake of a suicide that received widespread publicity. B. Teenagers may romanticize a suicidal act as one of heroic courage. C. Copycat suicides are just an effort to garner attention by social outcasts. D. Copycat suicides are more likely with young persons with Twitter accounts. Answer: B 266. There is evidence of reduced ______ activity in people who attempt or commit suicide. A. acetylcholine B. epinephrine C. serotonin D. thyroxin Answer: C 267. According to your text, ______ is perhaps the most important predictor of suicide. A. hopelessness B. loss of pleasure C. mood swings D. increased reactivity Answer: A 268. Shneidman found that about ______ percent of those who committed suicide had left clear clues beforehand, such as disposing of their possessions. A. 30 B. 50 C. 70 D. 90 Answer: D 269. If someone you know discloses that he or she is contemplating suicide, your goal should be o ______. A. try to intervene on your own B. get them to seek some professional help C. leave them alone to sort through their thoughts and feelings D. show them how crazy or misguided a suicide attempt would be Answer: B 270. Which of the following is a question Shneidman suggests could be used to draw a suicidal person out and engage them in talking? A. “Why would you want to do that?” B. “Think of how your mother would feel!” C. “What would you like to see happen?” D. “Do you have a will or DNR in place?” Answer: C 271. Which of the following is something you should do when talking to someone who is suicidal? A. Suggest that means other than suicide might help solve the person's problems. B. Be tough-minded and not too empathetic. C. Avoid asking how the person intends to commit suicide. D. Talk with them by yourself as long as you can. Answer: A True-False Questions 272. It is abnormal to feel depressed. Answer: False 273. Mood disorders can impair normal functioning. Answer: True 274. Major depression is simply a state of sadness or “the blues.” Answer: False 275. The economic toll of depression is about half that of heart disease or diabetes. Answer: False 276. Most people who experience a major depressive disorder never go on to have another one. Answer: False 277. The longer the period of recovery from major depression, the lower the risk of relapse. Answer: True 278. Men are about twice as likely as women to develop major depression. Answer: False 279. The bleak light of winter casts some people into a diagnosable state of depression. Answer: True 280. The treatment of choice for SAD is phototherapy. Answer: True 281. The treatment of choice for SAD is antidepressant medication. Answer: False 282. "Maternity blues" are believed to be an abnormal response to the hormonal changes attending childbirth. Answer: False 283. Dysthymic disorder usually begins in middle adulthood. Answer: False 284. Dysthymic disorder occurring together with depressive episode is known as a double depression. Answer: True 285. Premenstrual dysphoric disorder was introduced as a new diagnostic category in DSM-5. Answer: True 286. Premenstrual dysphoric disorder symptoms occur in the week before menses and do not show improvement following the conclusion of the menstrual cycle. Answer: False 287. Some people ride an emotional roller coaster, swinging from the heights of elation to the depths of depression without external cause. Answer: True 288. Manic episodes, occurring with or without intervening episodes of depression, are labelled bipolar disorder. Answer: True 289. In bipolar disorder, the initial episode for men is usually manic. Answer: True 290. Hypomanic episodes are usually more severe than manic episodes. Answer: False 291. Cyclothymic disorder frequently progresses to dysthymic disorder. Answer: True 292. Stressors may make it more difficult to overcome a depressive episode. Answer: True 293. Freud believed that mourning over the loss of a loved one was a pathological process. Answer: False 294. According to the self-focusing model, depression occurs when an individual pursues love objects or goals it would be more adaptive to surrender. Answer: True 295. There is no clear research evidence to support Freud's notion that self-directed anger is a cause of depression. Answer: True 296. Like psychodynamic theorists, humanistic theorists focus on the loss of self-esteem as a component of depression. Answer: True 297. There is no research evidence to support Lewinsohn's model of depression being linked to a lack of positive reinforcement. Answer: False 298. Depressed people tend to experience rejection in long-term relationships. Answer: True 299. Distorted, negative thinking tends to be experienced as occurring automatically. Answer: True 300. Depressed people tend to think more negatively than other people do. Answer: True 301. Some research has supported the hypothesis that depressed people think more negatively than others because their thinking is unrealistic or distorted. Answer: True 302. Seligman developed his learned helplessness model after observing the behavior of dogs initially denied an avenue of escape from electric shock but later given access to escape. Answer: True 303. Seligman's original learned helplessness model was one of the first to account for the low self- esteem that is typical of depression. Answer: False 304. Research has shown that some attributional styles can cause depression. Answer: True 305. Mood disorders tend to run in families. Answer: True 306. Both biological and psychological factors appear to be involved in the development of mood disorders. Answer: True 307. Both interpersonal therapy and traditional psychoanalysis focus on the client's current relationships. Answer: False 308. Behavioral approaches to treating depression assume that depressive behaviors are learned and can be unlearned. Answer: True 309. Research studies have failed to support the efficacy of cognitive therapy in treating major depression. Answer: False 310. Tricyclic antidepressants are highly toxic. Answer: True 311. Talk therapies are more effective than antidepressant drugs in treating cases of severe depression. Answer: False 312. Electroconvulsive therapy is no longer used to treat depression. Answer: False 313. ECT often leads to greater levels of depression than existed before it was administered. Answer: False 314. No one really knows how electroconvulsive therapy works. Answer: True 315. The ancient Greeks and Romans used a chemical to curb turbulent mood swings that is still used today. Answer: True 316. Despite more than 40 years of use, no one yet knows how lithium works. Answer: True 317. Lithium reduces the risk of recurrent depressive episodes. Answer: False 318. Placing a powerful electromagnet on the scalp can relieve depression. Answer: True 319. Many people have contemplated suicide at some moment of great stress. Answer: True 320. Teenagers are the highest risk group for committing suicide. Answer: False 321. Among ethnic and racial groups, suicides are most common among African Americans. Answer: False 322. People who threaten to commit suicide are only seeking attention. Answer: False 323. Hopelessness is an important predictor of suicide among psychiatric outpatients. Answer: True Essay Questions 324. Define mood disorder, and distinguish between normally and abnormally depressed moods. Answer: Mood Disorder Definition and Distinguishing Depressed Moods Mood Disorder Definition: Mood disorders, also known as affective disorders, are a category of mental health conditions characterized by significant disturbances in a person’s mood. These disorders primarily involve periods of intense emotional states, which can include depression, mania, or both. Common mood disorders include major depressive disorder, bipolar disorder, and dysthymia. Normal vs. Abnormally Depressed Moods: Normal Depressed Moods: • Contextual and Temporary: Occur in response to specific life events, such as loss, disappointment, or stress. • Proportional Reaction: The intensity of the mood matches the situation and is understandable given the circumstances. • Duration: Typically short-lived, lasting days to a few weeks. • Functionality: While there might be some disruption in daily activities, individuals can generally continue with their responsibilities and self-care. Abnormally Depressed Moods: • Persistent and Pervasive: Depression that is persistent over time, often lasting for weeks, months, or even years, without a clear external cause. • Disproportionate Intensity: The severity of the mood is extreme and often not proportional to any specific event or circumstance. • Duration and Impact: Symptoms persist for at least two weeks (for major depressive disorder) and cause significant impairment in social, occupational, or other important areas of functioning. • Symptoms: Includes a combination of emotional, cognitive, and physical symptoms such as pervasive sadness, loss of interest in activities, changes in appetite and sleep patterns, fatigue, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of death or suicide. 325. Describe the features of major depression. Answer: Features of Major Depression Major Depressive Disorder (MDD): Major depressive disorder is characterized by a persistent and intense feeling of sadness or despair and/or a loss of interest in nearly all activities. It significantly impairs an individual's ability to function in daily life. Key Features: • Depressed Mood: Persistent feelings of sadness, emptiness, or hopelessness. • Anhedonia: Loss of interest or pleasure in most or all normal activities, such as hobbies, sports, or social interactions. • Weight Changes: Significant weight loss or gain, or decrease or increase in appetite. • Sleep Disturbances: Insomnia or hypersomnia (excessive sleeping). • Psychomotor Changes: Observable agitation or retardation (slowness). • Fatigue: Persistent fatigue or loss of energy. • Feelings of Worthlessness or Guilt: Excessive or inappropriate feelings of worthlessness or guilt. • Cognitive Impairment: Diminished ability to think, concentrate, or make decisions. • Suicidal Ideation: Recurrent thoughts of death, suicidal ideation without a specific plan, or a suicide attempt. 326. Discuss the prevalence of and risk factors for major depression. Answer: Prevalence and Risk Factors for Major Depression Prevalence: • Global Prevalence: Major depression is a common mental disorder worldwide, with an estimated prevalence of about 5% in adults. • Lifetime Prevalence: In the United States, the lifetime prevalence of major depressive disorder is around 16.2%, with higher rates in women compared to men. Risk Factors: • Biological Factors: Genetic predisposition, neurotransmitter imbalances (e.g., serotonin, norepinephrine), and hormonal changes (e.g., thyroid issues, postpartum). • Psychological Factors: Personality traits such as neuroticism, history of trauma or abuse, and chronic stress. • Social Factors: Lack of social support, isolation, and stressful life events such as loss of a loved one, divorce, or financial difficulties. • Environmental Factors: Exposure to significant stressors, adverse childhood experiences, and chronic illness. • Co-morbid Conditions: Presence of other mental health disorders (e.g., anxiety disorders, substance use disorders) or chronic medical conditions (e.g., diabetes, heart disease). 327. Discuss the findings regarding gender differences and depression. Explain how gender biases may play a role in accentuating those differences. Answer: Gender Differences and Depression Findings on Gender Differences: • Prevalence: Women are approximately twice as likely as men to be diagnosed with major depression. • Age of Onset: Depression tends to occur earlier in women than in men. • Symptom Expression: Women may experience more somatic symptoms (e.g., fatigue, changes in appetite and sleep) and men may exhibit more irritability and risk-taking behaviors. Gender Biases and Their Role: • Socialization and Coping: Women are often socialized to be more expressive of their emotions and to seek help, which might lead to higher reporting rates. Men might underreport depressive symptoms due to societal expectations around masculinity and emotional stoicism. • Stressful Life Events: Women are more likely to experience certain types of stressors, such as sexual abuse and gender-based discrimination, which are significant risk factors for depression. • Hormonal Factors: Hormonal changes related to menstruation, pregnancy, postpartum, and menopause can contribute to mood fluctuations and increase the risk of depression in women. • Health Care Utilization: Women are more likely to visit healthcare providers and discuss mental health concerns, leading to higher diagnosis rates. Men's reluctance to seek help can result in underdiagnosis and undertreatment of depression in men. • Cultural Expectations: Gender roles and expectations can exacerbate stress and limit access to social support, affecting the prevalence and presentation of depression. In summary, these essay responses define mood disorders, distinguish normal and abnormal depressed moods, describe the features and prevalence of major depression, explore risk factors, and discuss gender differences and biases in depression. Each topic highlights the complexity of mood disorders and the various factors that influence their development and manifestation. 328. Discuss the features of and treatments for seasonal affective disorder. Answer: Features of and Treatments for Seasonal Affective Disorder (SAD) Features of SAD: • Definition: Seasonal Affective Disorder (SAD) is a type of depression that occurs at a specific time of year, usually during the fall and winter months when there is less natural sunlight. • Symptoms: Symptoms of SAD include persistent low mood, loss of interest in activities once enjoyed, low energy, changes in sleep patterns (often oversleeping), changes in appetite (craving carbohydrates), weight gain, difficulty concentrating, and feelings of hopelessness or worthlessness. Symptoms typically remit during the spring and summer months. • Prevalence: SAD affects about 1-2% of the population in temperate climates, with a higher prevalence in regions farther from the equator. Women and younger adults are more frequently affected. Treatments for SAD: • Light Therapy: The primary treatment for SAD is light therapy, which involves exposure to a light box that simulates natural sunlight. Patients typically sit in front of the light box for 20-60 minutes daily, usually in the morning. • Medication: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can be effective in treating SAD. Bupropion extended-release (Wellbutrin XL) is also approved for preventing SAD. • Psychotherapy: Cognitive-behavioral therapy (CBT) tailored for SAD can help individuals identify and change negative thought patterns and behaviors associated with seasonal depression. • Lifestyle Modifications: Increasing exposure to natural light, regular physical activity, maintaining a consistent sleep schedule, and managing stress can help alleviate symptoms. 329. Discuss postpartum depression and explain how it is different than "maternity blues." Answer: Postpartum Depression vs. Maternity Blues Postpartum Depression (PPD): • Definition: Postpartum depression is a severe and long-lasting form of depression that occurs in some women after childbirth. • Symptoms: Symptoms include severe mood swings, intense sadness, anxiety, irritability, feelings of hopelessness, difficulty bonding with the baby, withdrawal from family and friends, changes in appetite and sleep patterns, and thoughts of harming oneself or the baby. • Prevalence: PPD affects about 10-15% of new mothers. • Duration: Symptoms typically begin within the first few weeks after childbirth but can start earlier (during pregnancy) or later (up to a year postpartum). Maternity Blues ("Baby Blues"): • Definition: Maternity blues are a common and transient mood disturbance experienced by many women shortly after childbirth. • Symptoms: Symptoms include mood swings, tearfulness, anxiety, and irritability. The symptoms are mild and fluctuate throughout the day. • Prevalence: The baby blues affect up to 80% of new mothers. • Duration: Symptoms usually peak around the fourth or fifth day after delivery and resolve within two weeks without treatment. Differences: • Severity and Duration: PPD is more severe and persistent compared to the baby blues. PPD requires medical intervention, whereas the baby blues typically resolve on their own. • Impact on Functioning: PPD significantly impairs a mother’s ability to care for herself and her baby, while the baby blues have a minimal impact on daily functioning. 330. Compare and contrast major depression and dysthymic disorder, and explain the meaning of “double depression.” Answer: Major Depression vs. Dysthymic Disorder and “Double Depression” Major Depressive Disorder (MDD): • Definition: MDD is characterized by one or more major depressive episodes involving severe depressive symptoms that last at least two weeks and significantly impair daily functioning. • Symptoms: Symptoms include persistent sadness, loss of interest or pleasure, significant weight change, sleep disturbances, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and recurrent thoughts of death or suicide. Dysthymic Disorder (Persistent Depressive Disorder, PDD): • Definition: Dysthymic disorder is a chronic form of depression with less severe but longer-lasting symptoms compared to MDD, persisting for at least two years in adults (one year in children and adolescents). • Symptoms: Symptoms include depressed mood for most of the day, more days than not, along with two or more of the following: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness. Comparison: • Severity and Duration: MDD involves more severe symptoms that are present for a shorter period, whereas dysthymic disorder involves less severe symptoms that are more chronic. • Impact on Functioning: Both disorders impair functioning, but MDD typically causes more acute disruptions, while dysthymic disorder results in long-term, lower-level impairment. Double Depression: • Definition: Double depression occurs when an individual with dysthymic disorder experiences a superimposed major depressive episode. • Implications: Individuals with double depression tend to have a more severe course of illness, with greater functional impairment and a more challenging recovery process. 331. Describe the symptoms and prevalence of and types of premenstrual dysphoric disorder Answer: Premenstrual Dysphoric Disorder (PMDD): Symptoms, Prevalence, and Types Symptoms: • Emotional Symptoms: Marked mood swings, irritability or anger, depressed mood, feelings of hopelessness, anxiety, tension, and increased sensitivity to rejection. • Behavioral Symptoms: Decreased interest in usual activities, difficulty concentrating, lethargy or fatigue, changes in appetite, sleep disturbances, and feelings of being overwhelmed or out of control. • Physical Symptoms: Breast tenderness or swelling, joint or muscle pain, bloating, and weight gain. Prevalence: • PMDD affects approximately 3-8% of women of reproductive age. Symptoms typically begin in the luteal phase (the week or two before menstruation) and resolve within a few days after menstruation begins. Types of PMDD: • Primary PMDD: Characterized by cyclical and severe premenstrual symptoms that are present in the absence of other mood disorders. • Secondary PMDD: Occurs in women with an underlying mood disorder (e.g., major depression or anxiety disorder) that is exacerbated during the luteal phase of the menstrual cycle. Conclusion: These essay responses provide detailed insights into the features and treatments for Seasonal Affective Disorder (SAD); the differences between postpartum depression and maternity blues; comparisons between major depression, dysthymic disorder, and double depression; and the symptoms, prevalence, and types of premenstrual dysphoric disorder. Each topic emphasizes the importance of understanding and appropriately treating these mood disorders to improve the quality of life for those affected. 332. Describe the features and types of bipolar disorder. Answer: Features and Types of Bipolar Disorder Features of Bipolar Disorder: Bipolar disorder, also known as manic-depressive illness, is characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). These mood swings can affect sleep, energy levels, behavior, judgment, and the ability to think clearly. Types of Bipolar Disorder: Bipolar I Disorder: • Features: Characterized by at least one manic episode, which may be preceded or followed by hypomanic or major depressive episodes. Manic episodes can be severe and may require hospitalization. • Manic Episodes: Periods of extremely elevated mood, energy, and activity levels lasting at least one week. • Depressive Episodes: Periods of low mood, lack of energy, and other symptoms of depression lasting at least two weeks. Bipolar II Disorder: • Features: Characterized by at least one major depressive episode and at least one hypomanic episode. There are no full-blown manic episodes. • Hypomanic Episodes: Periods of elevated mood and increased activity or energy that are less severe than manic episodes and last at least four days. • Depressive Episodes: Similar to those in Bipolar I Disorder but often more frequent and severe. Cyclothymic Disorder (Cyclothymia): • Features: Chronic, fluctuating mood disturbance involving numerous periods of hypomanic symptoms and periods of depressive symptoms that are not severe enough to meet criteria for a major depressive episode or a full hypomanic episode. • Duration: Symptoms must persist for at least two years in adults (one year in children and adolescents) and be present for at least half the time without symptom-free periods longer than two months. Other Specified and Unspecified Bipolar and Related Disorders: • Features: These categories are used for cases where symptoms do not precisely fit the criteria for Bipolar I, Bipolar II, or Cyclothymic Disorder but still cause significant distress or impairment. 333. Describe the features of a manic episode. Answer: Features of a Manic Episode Manic Episode: A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least one week and present most of the day, nearly every day (or any duration if hospitalization is necessary). Key Features: • Mood: Elevated (euphoric), expansive, or irritable. • Activity and Energy: Increased goal-directed activity or physical restlessness. • Self-Esteem: Inflated self-esteem or grandiosity. • Sleep: Decreased need for sleep (e.g., feeling rested after only three hours of sleep). • Talkativeness: More talkative than usual or feeling pressure to keep talking. • Thought Processes: Flight of ideas or subjective experience that thoughts are racing. • Distractibility: Easily distracted by unimportant or irrelevant stimuli. • Risky Behaviors: Increased involvement in activities that have a high potential for painful consequences (e.g., unrestrained spending sprees, sexual indiscretions, foolish business investments). Impairment: The mood disturbance is severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. 334. Discuss the diagnostic differences between bipolar disorder and cyclothymic disorder. Answer: Diagnostic Differences Between Bipolar Disorder and Cyclothymic Disorder Bipolar Disorder: • Manic Episodes: Bipolar I disorder involves full manic episodes, while Bipolar II disorder involves hypomanic episodes. • Depressive Episodes: Bipolar I disorder may include major depressive episodes, while Bipolar II disorder requires at least one major depressive episode. • Severity: Episodes in Bipolar I and Bipolar II disorders are more severe than those in cyclothymic disorder. Cyclothymic Disorder (Cyclothymia): • Duration: Symptoms must be present for at least two years in adults (one year in children and adolescents) with no symptom-free periods longer than two months. • Severity: Involves chronic, fluctuating mood disturbances with numerous periods of hypomanic symptoms and periods of depressive symptoms that do not meet the criteria for a full hypomanic episode or major depressive episode. • Functioning: Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Key Differences: • Episode Type: Cyclothymic disorder does not involve full manic, hypomanic, or major depressive episodes as seen in bipolar disorder. • Chronology: Cyclothymic disorder is characterized by a longer duration of mood symptoms with less severe mood swings compared to bipolar disorder. • Diagnosis: Cyclothymic disorder is often considered a milder but more chronic form of bipolar disorder. 335. Discuss the relationship between stress and mood disorders. Answer: Relationship Between Stress and Mood Disorders Role of Stress in Mood Disorders: Triggering Episodes: • Acute Stressors: Stressful life events such as loss of a loved one, job loss, divorce, or trauma can trigger the onset of mood episodes in individuals predisposed to mood disorders. • Chronic Stress: Long-term stress, such as ongoing financial difficulties or a highly stressful work environment, can contribute to the development and maintenance of mood disorders. Biological Impact: • HPA Axis Dysfunction: Stress can dysregulate the hypothalamic-pituitary-adrenal (HPA) axis, leading to altered cortisol levels and contributing to mood disorders. • Neurotransmitter Imbalance: Chronic stress can affect neurotransmitter systems (e.g., serotonin, norepinephrine, and dopamine) implicated in mood regulation. Psychological Impact: • Cognitive Vulnerability: Stressful experiences can reinforce negative thinking patterns and cognitive distortions, which are risk factors for depression and anxiety. • Behavioral Consequences: Stress can lead to maladaptive coping behaviors, such as substance abuse or social withdrawal, which can exacerbate mood disorders. Protective Factors: • Resilience: High resilience, characterized by positive coping strategies and strong social support, can mitigate the impact of stress on mood disorders. • Therapeutic Interventions: Psychotherapy (e.g., cognitive-behavioral therapy) can help individuals develop healthier coping mechanisms, reduce stress, and manage mood symptoms. Conclusion: These essay responses provide detailed insights into the features and types of bipolar disorder, the characteristics of manic episodes, the diagnostic differences between bipolar disorder and cyclothymic disorder, and the relationship between stress and mood disorders. Each topic highlights the complexity of mood disorders and the various factors that influence their development, manifestation, and treatment. 336. Discuss classic and modern psychodynamic perspectives on the mood disorders. Answer: Classic and Modern Psychodynamic Perspectives on Mood Disorders Classic Psychodynamic Perspectives: • Freud's Theory: Freud suggested that depression is a result of internalized anger and loss. According to his theory, individuals experience unconscious conflicts stemming from early childhood relationships, especially with parents. When these conflicts are triggered by a loss (real or symbolic), the person turns the anger inward, resulting in depressive symptoms. • Melancholia: Freud also differentiated between normal grief and melancholia. He believed melancholia involved an unconscious process where the individual regresses to an earlier stage of development, resulting in self-reproach and self-blame. Modern Psychodynamic Perspectives: • Object Relations Theory: Modern psychodynamic theorists focus on the quality of early relationships and how these relationships shape an individual’s sense of self and emotional regulation. Dysfunctional early attachments can lead to difficulties in managing emotions and relationships, contributing to mood disorders. • Self-Psychology: Heinz Kohut's self-psychology emphasizes the role of self-esteem and self-cohesion in mental health. Failures in empathic attunement by caregivers can lead to a fragile self, predisposing individuals to depression. • Interpersonal Focus: Modern psychodynamic therapy often includes an emphasis on current interpersonal relationships and how past relational patterns are reenacted in present relationships, contributing to depressive symptoms. 337. Compare and contrast the psychodynamic and humanistic perspectives on mood disorders. Answer: Psychodynamic vs. Humanistic Perspectives on Mood Disorders Psychodynamic Perspective: • Focus: Emphasizes unconscious processes, early childhood experiences, and internal conflicts. • Key Concepts: Defense mechanisms, internalized anger, object relations, and attachment patterns. • Therapy Goals: Aims to uncover and resolve unconscious conflicts, understand the influence of past relationships, and develop healthier ways of relating to oneself and others. Humanistic Perspective: • Focus: Emphasizes individual potential, self-actualization, and the importance of self-awareness and personal growth. • Key Concepts: Self-concept, unconditional positive regard, authenticity, and the inherent drive toward personal growth. • Therapy Goals: Aims to create a supportive environment that fosters self-exploration, self-acceptance, and the realization of one’s potential. Therapists focus on the here-and-now and provide empathy, congruence, and unconditional positive regard. Comparison: • View of the Person: Psychodynamic theory views individuals as shaped by unconscious forces and past experiences, while humanistic theory views individuals as inherently good with an innate potential for growth. • Therapeutic Relationship: Psychodynamic therapy often involves analyzing transference and countertransference, while humanistic therapy emphasizes a non-judgmental, empathic, and genuine therapeutic relationship. Contrast: • Depth vs. Surface: Psychodynamic therapy tends to delve into the unconscious and historical influences, while humanistic therapy focuses on conscious experiences and current personal growth. • Pathology vs. Potential: Psychodynamic theory often focuses on pathology and conflict, whereas humanistic theory focuses on potential and growth. 338. Discuss behavioral perspectives on the mood disorders, focusing on the relationships between reinforcement and depression. Answer: Behavioral Perspectives on Mood Disorders Behavioral Perspectives: • Reinforcement and Depression: Behavioral theories suggest that depression results from a reduction in positive reinforcement or an increase in negative reinforcement. When individuals experience fewer rewarding activities and outcomes, they may become less motivated and more inactive, leading to depressive symptoms. • Learned Helplessness: Martin Seligman’s theory of learned helplessness proposes that depression occurs when individuals feel they have no control over the outcome of their situations. Repeated exposure to uncontrollable stressors leads to a sense of helplessness and passive behavior. • Behavioral Activation: A therapeutic approach based on behavioral principles; behavioral activation involves helping individuals engage in activities that are likely to provide positive reinforcement. This intervention aims to break the cycle of inactivity and depression by encouraging patients to participate in rewarding activities. 339. Discuss cognitive perspectives on depression, focusing on Beck's cognitive theory and the reformulated helplessness (attributional) theory. Answer: Cognitive Perspectives on Depression Beck's Cognitive Theory: • Cognitive Triad: Aaron Beck proposed that depression is characterized by negative views of the self, the world, and the future. These negative thought patterns form the cognitive triad. • Automatic Thoughts: Depressed individuals have automatic, involuntary negative thoughts that contribute to their depressive symptoms. • Cognitive Distortions: These are systematic errors in thinking that reinforce negative beliefs and contribute to depression (e.g., all-or-nothing thinking, overgeneralization). • Therapeutic Approach: Cognitive-behavioral therapy (CBT) aims to identify and challenge these negative thought patterns and cognitive distortions, replacing them with more realistic and positive thoughts. Reformulated Helplessness (Attributional) Theory: • Learned Helplessness: This theory, originally proposed by Seligman, was reformulated by Abramson, Seligman, and Teasdale to focus on attributions. It suggests that individuals who attribute negative events to internal, stable, and global causes are more likely to develop depression. • Attributions: The way individuals explain the causes of events affects their vulnerability to depression. Negative attributional styles (e.g., “It’s my fault, it will always be this way, and it affects everything”) can lead to feelings of helplessness and hopelessness. • Therapeutic Approach: Cognitive therapy aims to change these maladaptive attributional styles by encouraging more balanced and specific explanations for events. 340. Identify and briefly explain the ten cognitive distortions enumerated by Burns. Answer: Cognitive Distortions Enumerated by Burns David Burns identified ten cognitive distortions commonly seen in individuals with depression: 1. All-or-Nothing Thinking: Viewing situations in black-and-white terms, without recognizing any middle ground. For example, “If I’m not perfect, I’m a failure.” 2. Overgeneralization: Drawing broad, negative conclusions based on a single incident or piece of evidence. For example, “I failed this test; I’ll never succeed in anything.” 3. Mental Filter: Focusing exclusively on negative details while ignoring positive aspects of a situation. For example, “I made a mistake during my presentation, so it was a disaster.” 4. Disqualifying the Positive: Rejecting positive experiences by insisting they don’t count. For example, “That compliment was just someone being nice, it doesn’t mean anything.” 5. Jumping to Conclusions: Making negative interpretations without evidence. This includes mind reading (assuming others have negative thoughts about you) and fortune telling (predicting things will turn out badly). 6. Magnification (Catastrophizing) or Minimization: Exaggerating the importance of problems or shortcomings and minimizing the significance of positive qualities. For example, “My mistake is the end of the world” or “My accomplishments don’t matter.” 7. Emotional Reasoning: Assuming that negative emotions reflect reality. For example, “I feel like a failure, so I must be one.” 8. Should Statements: Using “should,” “ought,” or “must” statements to impose rigid expectations on oneself or others, leading to guilt and frustration. For example, “I should always be successful.” 9. Labeling and Mislabelling: Assigning global, negative labels to oneself or others based on specific behaviours. For example, “I’m a loser” instead of “I made a mistake.” 10. Personalization: Taking responsibility for events outside of one’s control, leading to feelings of guilt or blame. For example, “It’s my fault that my friend is upset.” Conclusion: These essay responses provide a comprehensive understanding of the classic and modern psychodynamic perspectives on mood disorders, compare and contrast the psychodynamic and humanistic perspectives, explore behavioral perspectives focusing on reinforcement and depression, discuss cognitive perspectives emphasizing Beck’s cognitive theory and the reformulated helplessness theory, and identify and explain the ten cognitive distortions enumerated by Burns. Each topic highlights different theoretical frameworks and their contributions to understanding and treating mood disorders. 341. Discuss genetic factors in the mood disorders. Answer: Genetic Factors in the Mood Disorders Genetic Factors: • Heritability: Mood disorders, including major depressive disorder (MDD) and bipolar disorder, have a significant genetic component. Heritability estimates suggest that genetic factors account for approximately 40-50% of the risk for MDD and about 70-80% for bipolar disorder. • Family Studies: Studies consistently show that mood disorders run in families. First-degree relatives of individuals with MDD are two to three times more likely to develop the disorder, while the risk is even higher for bipolar disorder. • Twin Studies: Twin studies reveal higher concordance rates for mood disorders in monozygotic (identical) twins compared to dizygotic (fraternal) twins. For MDD, the concordance rate is about 40-50% in monozygotic twins and 10-20% in dizygotic twins. For bipolar disorder, the rates are approximately 60-70% for monozygotic twins and 20% for dizygotic twins. • Genetic Linkage and Association Studies: Research has identified several genes that may contribute to the risk of mood disorders, though no single gene has been found to be solely responsible. Variants in genes related to the serotonin transporter (5-HTT), brain-derived neurotrophic factor (BDNF), and other neurotransmitter systems are of particular interest. 342. Discuss biochemical factors in the mood disorders. Address genetic research and the results of twin studies. Answer: Biochemical Factors in the Mood Disorders Neurotransmitter Imbalances: • Serotonin: Low levels of serotonin are associated with depression. Serotonin is thought to regulate mood, emotion, and anxiety. Many antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), work by increasing serotonin levels. • Norepinephrine: Abnormalities in norepinephrine levels are linked to both depression and mania. Norepinephrine plays a role in attention, arousal, and stress response. Tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) target this neurotransmitter. • Dopamine: Dysregulation of dopamine is implicated in mood disorders, especially in bipolar disorder. Dopamine affects reward processing, motivation, and pleasure. Neuroendocrine Factors: • Hypothalamic-Pituitary-Adrenal (HPA) Axis: Dysfunction of the HPA axis, which controls the body’s response to stress, is commonly observed in individuals with mood disorders. Elevated cortisol levels are often found in depressed patients, indicating a hyperactive stress response system. • Thyroid Dysfunction: Thyroid hormones also play a role in mood regulation. Hypothyroidism can mimic depressive symptoms, and hyperthyroidism can cause mood swings, including symptoms of mania. Genetic Research and Twin Studies: • Genetic Research: Advances in molecular genetics have identified potential genetic markers associated with mood disorders. For example, variations in the 5-HTT gene promoter region (5-HTTLPR) are linked to an increased risk of depression, especially in the context of stressful life events. • Twin Studies: Twin studies further support the genetic basis of mood disorders. As mentioned earlier, monozygotic twins show higher concordance rates for mood disorders than dizygotic twins, indicating a strong genetic influence. 343. Discuss psychodynamic treatment of the mood disorders, differentiating between traditional psychoanalytic approaches and the modern approaches. Answer: Psychodynamic Treatment of the Mood Disorders Traditional Psychoanalytic Approaches: • Focus: Traditional psychoanalysis, based on Freud’s theories, focuses on uncovering unconscious conflicts and childhood experiences that contribute to mood disorders. • Techniques: Techniques include free association, dream analysis, and interpretation of transference and resistance. The therapist helps the patient gain insight into their unconscious processes and how these affect their current emotions and behaviors. • Goals: The goal is to bring unconscious conflicts to conscious awareness, allowing the patient to understand and resolve them, leading to symptom relief and improved emotional functioning. Modern Psychodynamic Approaches: • Focus: Modern approaches, such as short-term psychodynamic therapy and interpersonal therapy (IPT), focus more on current relationships and interpersonal functioning. • Techniques: Techniques include exploring relational patterns, identifying and modifying maladaptive behaviors, and improving communication and relationship skills. Therapy is often more structured and time-limited compared to traditional psychoanalysis. • Goals: The goals are to improve interpersonal relationships, increase emotional regulation, and address unresolved conflicts that contribute to mood disorders. 344. Discuss behavioral treatment of the mood disorders. Answer: Behavioral Treatment of the Mood Disorders Behavioral Activation (BA): • Focus: Behavioral activation is a structured therapeutic approach that aims to increase engagement in positively reinforcing activities to combat depression. • Techniques: Techniques include activity scheduling, identifying and reducing avoidance behaviors, and increasing pleasurable and meaningful activities. The therapist works with the patient to identify activities that provide a sense of accomplishment and enjoyment. • Goals: The goal is to break the cycle of inactivity and withdrawal that often accompanies depression, thereby improving mood and overall functioning. Contingency Management: • Focus: Contingency management involves modifying the environmental contingencies that maintain depressive behaviors. • Techniques: Techniques include setting up a system of rewards and consequences to reinforce desired behaviors and reduce maladaptive ones. For example, rewarding oneself for completing daily tasks or engaging in social activities. • Goals: The goal is to increase positive reinforcement for healthy behaviors and decrease reinforcement for depressive behaviors. Social Skills Training: • Focus: Social skills training aims to improve interpersonal skills and increase social support, which can help alleviate depressive symptoms. • Techniques: Techniques include role-playing, modeling, and behavioral rehearsal to teach effective communication, assertiveness, and problem-solving skills. • Goals: The goal is to enhance the individual’s ability to form and maintain healthy relationships, thereby reducing social isolation and improving mood. Conclusion: These essay responses provide a comprehensive understanding of the genetic and biochemical factors in mood disorders, discuss psychodynamic and behavioral treatments, and highlight the distinctions between traditional and modern psychodynamic approaches. Each topic underscores the multifaceted nature of mood disorders and the importance of various theoretical and therapeutic perspectives in addressing them. 345. Discuss cognitive treatment of the mood disorders. Answer: Cognitive Behavioral Therapy (CBT): • Focus: CBT, developed by Aaron Beck, focuses on identifying and modifying distorted thought patterns and beliefs that contribute to mood disorders. • Techniques: • Cognitive Restructuring: Helping patients identify and challenge negative automatic thoughts and replace them with more realistic and balanced thoughts. • Behavioral Experiments: Testing the validity of negative beliefs through structured activities and experiments. • Activity Scheduling: Planning and engaging in activities that provide a sense of accomplishment and pleasure to counteract depressive inertia. • Goals: The goal is to change maladaptive thinking and behavior patterns to improve mood and functioning. CBT is structured, time-limited, and typically lasts 12-20 sessions. Mindfulness-Based Cognitive Therapy (MBCT): • Focus: MBCT combines traditional cognitive therapy with mindfulness practices to prevent relapse in individuals with recurrent depression. • Techniques: • Mindfulness Practices: Teaching patients to focus on the present moment and develop a non-judgmental awareness of their thoughts and feelings. • Cognitive Skills: Using cognitive strategies to address and alter negative thought patterns. • Goals: The goal is to help individuals disengage from the habitual automatic thoughts that can trigger depressive episodes. Rational Emotive Behavior Therapy (REBT): • Focus: Developed by Albert Ellis, REBT focuses on changing irrational beliefs that lead to emotional distress and maladaptive behavior. • Techniques: • Disputing Irrational Beliefs: Actively challenging and debating irrational thoughts. • Homework Assignments: Encouraging patients to practice new, rational thinking and behaviors in their daily lives. • Goals: The goal is to replace irrational beliefs with rational ones to reduce emotional distress and improve well-being. 346. Discuss the use of medications in the treatment of the mood disorders. Answer: Use of Medications in the Treatment of Mood Disorders Antidepressants: • Selective Serotonin Reuptake Inhibitors (SSRIs): Commonly prescribed antidepressants that increase serotonin levels in the brain. Examples include fluoxetine (Prozac) and sertraline (Zoloft). • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Medications that increase both serotonin and norepinephrine. Examples include venlafaxine (Effexor) and duloxetine (Cymbalta). • Tricyclic Antidepressants (TCAs): An older class of antidepressants that affect several neurotransmitters. Examples include amitriptyline and nortriptyline. • Monoamine Oxidase Inhibitors (MAOIs): Effective but less commonly used due to dietary restrictions and side effects. Examples include phenelzine (Nardil) and tranylcypromine (Parnate). Mood Stabilizers: • Lithium: A well-established mood stabilizer used primarily for bipolar disorder to reduce mania and prevent future episodes. • Anticonvulsants: Medications like valproate (Depakote) and lamotrigine (Lamictal) are used as mood stabilizers, particularly for bipolar disorder. Atypical Antipsychotics: • Usage: Often used in combination with other medications to treat bipolar disorder and treatment-resistant depression. Examples include quetiapine (Seroquel) and olanzapine (Zyprexa). 347. Discuss the use of ECT in the treatment of depression. In what types of situations is it most useful? What are the risks involved with modern ECT? Answer: Use of ECT in the Treatment of Depression Electroconvulsive Therapy (ECT): • Mechanism: ECT involves inducing controlled seizures by passing electrical currents through the brain. It is typically performed under general anaesthesia with muscle relaxants to minimize discomfort and risk. • Indications: ECT is most useful for severe depression that is resistant to other treatments, depression with psychotic features, and situations where a rapid response is necessary (e.g., suicidal ideation, severe malnutrition). • Effectiveness: ECT has a high efficacy rate, with significant improvement observed in many patients after a few sessions. Risks: • Short-term Memory Loss: A common side effect, which often improves within weeks to months. • Confusion: Some patients experience confusion immediately after treatment, which usually resolves within hours. • Physical Side Effects: Due to anaesthesia, there are risks such as cardiovascular complications, but these are rare with modern ECT protocols. 348. Discuss the use of lithium in the treatment of bipolar disorder. Answer: Use of Lithium in the Treatment of Bipolar Disorder Lithium: • Mechanism: Lithium is a mood stabilizer that helps to control the symptoms of mania and, to a lesser extent, depression in bipolar disorder. It is believed to work by affecting neurotransmitter systems and stabilizing neuronal activity. • Effectiveness: Lithium is effective in reducing the frequency and severity of manic episodes and in preventing recurrence of both manic and depressive episodes. • Dosage and Monitoring: Regular blood tests are required to monitor lithium levels and ensure they remain within a therapeutic range, as the therapeutic dose is close to the toxic dose. • Side Effects: Common side effects include weight gain, tremors, increased thirst and urination, and potential thyroid and kidney function issues. Long-term use requires regular monitoring of thyroid and kidney function. 349. Discuss the incidence of suicide in terms of who is most at risk and why. Answer: Incidence of Suicide: Who is Most at Risk and Why Incidence and Risk Factors: • Prevalence: Suicide is a leading cause of death worldwide, with high rates among adolescents, young adults, and the elderly. • Demographic Factors: • Age: Higher risk in teens and young adults (15-24 years) and adults over 65. • Gender: Men are more likely to die by suicide, while women are more likely to attempt suicide. • Ethnicity: Suicide rates can vary by ethnicity and cultural background. For example, higher rates are observed among Native American and Alaskan Native populations. Psychological and Psychiatric Risk Factors: • Mental Illness: Major depressive disorder, bipolar disorder, schizophrenia, and substance use disorders are strongly associated with increased suicide risk. • Previous Suicide Attempts: A history of prior suicide attempts significantly increases the risk of future attempts and completed suicide. • Hopelessness: Feelings of hopelessness and worthlessness are strong predictors of suicidal behavior. Social and Environmental Risk Factors: • Isolation: Lack of social support and feelings of isolation or loneliness increase suicide risk. • Life Stressors: Significant life events such as loss of a loved one, relationship breakups, financial problems, and legal issues can trigger suicidal thoughts and behaviors. • Access to Means: Availability of lethal means, such as firearms or certain medications, increases the risk of suicide. Prevention and Intervention: • Mental Health Treatment: Access to effective mental health care and treatment for underlying psychiatric disorders can reduce suicide risk. • Crisis Intervention: Hotlines, crisis centers, and emergency psychiatric services can provide immediate support to individuals in crisis. • Social Support: Strengthening social connections and providing community support can help reduce feelings of isolation and hopelessness. • Restricting Access to Means: Implementing measures to limit access to common means of suicide, such as firearms and toxic substances, can prevent suicide attempts. Conclusion: These essay responses provide a comprehensive understanding of cognitive, medication, and ECT treatments for mood disorders, the use of lithium in bipolar disorder, and the incidence and risk factors for suicide. Each topic underscores the complexity of mood disorders and the multifaceted approaches required for effective treatment and prevention. 350. Discuss strengths, weakness, and applications of the main theoretical perspectives on the causes of suicide. Answer: Psychodynamic Perspective: • Strengths: • Emphasizes the role of unconscious processes and early life experiences in shaping suicidal behavior. • Highlights the importance of internal conflicts, such as feelings of guilt, worthlessness, and anger turned inward. • Weaknesses: • Lacks empirical support and is often difficult to test scientifically. • Overemphasizes internal factors while underestimating social and environmental influences. • Applications: • Useful in therapeutic settings to explore deep-seated emotional issues and unresolved conflicts. • Can inform treatment approaches such as psychoanalytic or psychodynamic therapy. Sociocultural Perspective: • Strengths: • Recognizes the influence of societal and cultural factors on suicidal behavior. • Highlights the role of social integration and regulation in preventing or contributing to suicide. • Weaknesses: • May overlook individual psychological factors and the complexity of personal motivations. • Difficult to apply in clinical settings due to its broad focus. • Applications: • Useful in public health initiatives and community-based prevention programs. • Can inform policies aimed at improving social support and reducing stigma. Cognitive-Behavioral Perspective: • Strengths: • Supported by empirical research and evidence-based interventions. • Focuses on modifying maladaptive thoughts and behaviors that contribute to suicidal ideation. • Weaknesses: • May not fully address underlying emotional issues or deep-seated conflicts. • Can be too focused on symptom reduction rather than holistic understanding. • Applications: • Effective in clinical settings through cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT). • Can be applied in crisis intervention and relapse prevention strategies. Biological Perspective: • Strengths: • Provides insights into genetic and neurochemical factors associated with suicidal behavior. • Highlights the role of neurotransmitter imbalances and genetic predispositions. • Weaknesses: • May downplay the importance of psychological, social, and environmental factors. • Difficult to translate biological findings into practical interventions. • Applications: • Can inform pharmacological treatments and research on biological markers. • Useful in identifying high-risk individuals based on genetic and neurochemical profiles. 351. Discuss the contributions of Emile Durkheim and Edwin Shneidman to the understanding of suicide. Answer: Contributions of Emile Durkheim and Edwin Shneidman to the Understanding of Suicide Emile Durkheim: • Key Contributions: • Durkheim's seminal work, "Suicide" (1897), established a sociological framework for understanding suicide. • Identified four types of suicide based on the degree of social integration and regulation: egoistic, altruistic, anomic, and fatalistic. • Proposed that social factors, such as lack of integration (egoistic suicide) or sudden changes in society (anomic suicide), significantly influence suicidal behavior. • Impact: • Durkheim’s theories highlighted the importance of social context in understanding suicide, shifting the focus from purely individual factors to broader societal influences. • His work laid the foundation for subsequent sociological research and public health approaches to suicide prevention. Edwin Shneidman: • Key Contributions: • Considered the founder of modern suicidology, Shneidman introduced the concept of "psychache," referring to unbearable psychological pain as the primary driver of suicide. • Developed the "cubic model" of suicide, which considers psychological pain, stress, and perturbation as key components. • Emphasized the role of crisis intervention and the importance of understanding the individual's subjective experience and motivations. • Impact: • Shneidman’s work has influenced clinical practice, particularly in the development of assessment tools and therapeutic interventions focused on alleviating psychological pain. • His contributions have advanced the field of suicidology, promoting a multidisciplinary approach that incorporates psychological, social, and cultural factors. 352. Identify five myths of suicide and briefly explain why each is incorrect. Answer: Five Myths of Suicide and Why Each is Incorrect 1. Myth: People who talk about suicide won’t really do it. • Reality: Many people who are contemplating suicide give verbal or behavioral clues about their intentions. Talking about suicide can be a cry for help and should always be taken seriously. 2. Myth: Suicide happens without warning. • Reality: Most individuals who attempt or complete suicide exhibit warning signs, such as changes in behavior, mood, or communication patterns. These signs provide opportunities for intervention. 3. Myth: Once a person decides to commit suicide, nothing can stop them. • Reality: Suicidal crises are often temporary, and timely intervention can save lives. Providing support, addressing underlying issues, and ensuring safety can significantly reduce the risk. 4. Myth: People who commit suicide are always mentally ill. • Reality: While mental illness is a significant risk factor, not all individuals who commit suicide have a diagnosable mental disorder. Other factors, such as situational crises and overwhelming stress, can also lead to suicide. 5. Myth: Talking about suicide may give someone the idea. • Reality: Discussing suicide openly and empathetically can actually reduce risk by allowing individuals to express their feelings, feel understood, and access support. It does not plant the idea but can provide relief and prevent attempts. 353. Summarize the research on predicting suicide, making sure to identify the various clues often presented by people contemplating suicide. Answer: Summarize Research on Predicting Suicide and Identify Clues Research on Predicting Suicide: • Challenges: Predicting suicide is complex due to the interplay of multiple risk factors and the variability in individual circumstances. No single factor can predict suicide with certainty, but a combination of factors increases risk. • Risk Factors: Research identifies several key risk factors, including mental illness (depression, bipolar disorder, schizophrenia), substance abuse, history of previous suicide attempts, family history of suicide, chronic pain or illness, and significant life stressors. Clues Often Presented by People Contemplating Suicide: • Verbal Clues: Statements such as “I wish I were dead,” “I can’t see any way out,” or “Life isn’t worth living” are direct indicators of suicidal thoughts. • Behavioral Clues: • Preparatory Actions: Making final arrangements, giving away prized possessions, or saying goodbye to loved ones. • Isolation: Withdrawing from friends, family, and social activities. • Risky Behavior: Engaging in reckless or self-destructive behaviors, such as substance abuse or dangerous activities. • Emotional Clues: • Hopelessness: Expressing a sense of hopelessness, helplessness, or feeling trapped. • Sudden Calmness: A sudden sense of calm or relief after a period of severe depression can indicate that the person has decided to commit suicide. • Physical Clues: • Changes in Sleep or Appetite: Significant changes in sleep patterns or appetite can be indicators of severe distress. • Neglect of Personal Appearance: A noticeable decline in personal hygiene or appearance. 354. Discuss methods of suicide prevention. Answer: Methods of Suicide Prevention Crisis Intervention: • Hotlines and Helplines: Providing immediate support through suicide prevention hotlines, where trained counselors can offer crisis intervention and emotional support. • Crisis Centers: Establishing community-based crisis centers that offer emergency psychiatric services and temporary housing for individuals in crisis. Mental Health Treatment: • Access to Therapy: Ensuring access to effective mental health care, including cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and other evidence-based treatments. • Medication: Prescribing appropriate medications for underlying mental health conditions, such as antidepressants for depression or mood stabilizers for bipolar disorder. Public Awareness and Education: • Stigma Reduction: Promoting awareness and reducing stigma associated with mental health and seeking help for suicidal thoughts. • Education Programs: Implementing education programs in schools, workplaces, and communities to teach individuals about the warning signs of suicide and how to respond. Social Support and Community Involvement: • Strengthening Social Networks: Encouraging individuals to build and maintain supportive relationships with friends, family, and community members. • Community Programs: Developing community programs that provide social support, recreational activities, and opportunities for social engagement. Restricting Access to Means: • Safe Storage: Encouraging safe storage of firearms, medications, and other potential means of suicide. • Environmental Controls: Implementing measures to reduce access to common means of suicide, such as installing barriers on bridges and limiting the availability of lethal substances. Follow-up Care: • Post-Discharge Support: Ensuring that individuals who have been hospitalized or treated for suicidal behavior receive appropriate follow-up care and support. • Continued Monitoring: Regularly monitoring individuals at high risk for suicide, providing ongoing mental health care, and maintaining contact through follow-up calls or visits. Conclusion: These essay responses provide a comprehensive understanding of the strengths, weaknesses, and applications of the main theoretical perspectives on the causes of suicide, the contributions of Emile Durkheim and Edwin Shneidman, myths about suicide, research on predicting suicide, and methods of suicide prevention. Each topic highlights the multifaceted nature of suicide and the importance of a comprehensive approach to understanding and preventing it. Test Bank for Abnormal Psychology in a Changing World Jeffrey S. Nevid, Spencer A. Rathus, Beverly Greene 9780205965014, 9780135821688, 9780134458311, 9780205961719, 9780130052162