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Chapter 5: Mood Disorders and Suicide Multiple Choice 1. You were asked to give a talk to illustrate the problems caused by depression for youth as compared to their parents' generation. Which of the following could be an accurate way to start your talk? a. The younger generation is experiencing rates of depression higher than previous generations. b. The younger generation is experiencing rates of depression lower than previous generations. c. The younger generation is experiencing depression at a later age than previous generations. d. The younger generation is experiencing rates of depression at the same rate as previous generations. Answer: a. 2. Which of the following describes the term affect? a. a state of arousal b. subjective feelings c. observable behaviors associated with subjective feelings d. physiological changes associated with subjective feelings Answer: c. 3. Which of the following is the term that psychologists use for a pervasive and sustained emotional response that can color the person's perception of the world? a. affect b. mania c. depression d. mood Answer: d. 4. Which of the following is a clinical feature of mania? a. elated mood b. criminality c. dissociation d. blunted affect Answer: a. 5. Mary has had two episodes of major depression with no other periods of psychological disturbance. What is the appropriate description of her symptoms? a. dysthymia b. double depression c. bipolar mood disorder d. depressive disorder Answer: d. 6. Robert has just experienced an episode of mania. Which diagnostic label best describes his condition? a. dysthymia b. bipolar mood disorder c. depressive disorder d. dysphoric mood disorder Answer: b. 7. Euphoria is characterized by a. elated mood. b. labile affect. c. depressed mood. d. inappropriate affect. Answer: a. 8. Which one of these characteristics of clinical depression helps to distinguish it from normal sadness? a. altered brain chemistry b. caused by an identifiable precipitant c. occurs only in people who suffered early losses d. accompanied by a cluster of signs and symptoms, including cognitive features Answer: d. 9. The case of Cathy presented in your text is an example of major depressive disorder. One of the aspects of her case that clearly tells us her mood was more than just normal sadness is that Cathy a. had become impaired in her ability to work. b. did not have any manic or hypomanic symptoms. c. had been separated from her husband for five years. d. felt unworthy of her latest promotion at work. Answer: a. 10. What is dysphoric mood? a. elated mood b. labile mood c. depressed mood d. inappropriate mood Answer: c. 11. As was the case of Debbie in the textbook, it is often the case that symptoms of mania are initially a. very frightening. b. quite pleasant. c. triggered by some specific life stress. d. indistinguishable from depression. Answer: b. 12. Which of the following is an important consideration in distinguishing clinical depression from normal sadness? a. In clinical depression the mood change always occurs in the absence of any precipitating event. b. A clinically depressed mood is often accompanied by an enhanced ability to function in usual social situations. c. Engaging in pleasant activities may temporarily lift a clinically depressed mood. d. A clinical mood change is usually accompanied by a cluster of additional signs and symptoms. Answer: d. 13. Betty believes she is less capable than her coworkers, even though she has won many awards for her performance. She often feels lonely and believes no one wants to be her friend. Her future seems empty and meaningless. These traits characterize a. cyclothymia. b. psychotic depression. c. the "depressive triad." d. somatic deficits in depression. Answer: c. 14. People who are clinically depressed frequently note that their thinking is slowed down, while manic patients commonly report that their thoughts are __________. a. unrealistic b. very focused c. speeded up d. focused on the future Answer: c. 15. Which of the following is an example of a somatic symptom of depression? a. suicidal thoughts b. sleeping problems c. feelings of low self-worth d. pessimistic thoughts about the future Answer: b. 16. Depressed patients often walk and talk as though they are in slow motion; this quality is described by the term a. hypomania. b. psychomotor retardation. c. dysphoria. d. morbid preoccupation. Answer: b. 17. Harold has just been diagnosed as suffering from major depressive disorder. In planning his treatment, the mental health professionals will discover that he has a comorbid condition. Which of the following is the most likely comorbid condition? a. alcoholism b. hypochondriasis c. paranoid schizophrenia d. histrionic personality disorder Answer: a. 18. One of your patients has been diagnosed with depressive disorder and alcohol addiction. Which of the following do you need to consider in this light? a. For some people alcoholism develops first; for others, it is the depression that comes first. b. Neither disorder tends to run in families. c. Alcohol is actually good for some schizophrenic patients as it dampens their hallucinations. d. Marijuana use is also correlated with alcoholism. Answer: a. 19. In the DSM-5 classification of mood disorders, an emphasis is placed on the distinction between a. depressive and bipolar disorders. b. disorders with and without psychotic features. c. conditions precipitated by an identifiable stressor and conditions without identifiable stressor. d. disorders with somatic symptoms and disorders without somatic symptoms. Answer: a. 20. Which of the following is the most typical course of depressive disorder? a. a single episode of mania b. repeated episodes of major depression c. a single episode of major depression d. cycling episodes of depression and mania Answer: b. 21. For the past two years, Nick has experienced poor appetite, insomnia, fatigue, and several other symptoms. These symptoms have kept him from feeling happy, and yet they do not indicate a major depressive episode. When assessing Nick, what disorder is the psychologist most likely to consider? a. bipolar I disorder b. dysthymia c. cyclothymia d. seasonal affective disorder Answer: b. 22. Generally your patient of the past two years has exhibited depression. She did, however, have one quite dramatic symptom that rules out a diagnosis of both major depressive disorder and dysthymia. This symptom is a. alcohol addiction. b. extreme sadness. c. mania. d. comorbidity. Answer: c. 23. Henry has a serious episode of depression that is diagnosed as major depressive disorder. A year later he experiences an episode of mania. What is his diagnosis after this event? a. cyclothymia b. bipolar I disorder c. dysthymic disorder d. cyclical major depressive disorder Answer: b. 24. For several years, Greg has experienced alternating episodes of very severe depression and episodes of hypomania. What is the most appropriate DSM diagnosis? a. bipolar I disorder without psychotic features b. bipolar II disorder c. cyclothymic disorder d. mixed bipolar disorder Answer: b. 25. What is one way that dysthymia differs from major depression? a. Dysthymia is more severe. b. Dysthymia usually lasts longer. c. Dysthymia responds better to medication. d. Dysthymia usually has a precipitating event. Answer: b. 26. For the past two weeks Barbara has experienced serious symptoms including weight loss, feelings of worthlessness, insomnia, and difficultly in concentrating. She is also experiencing depressed mood and loss of interest in doing much of anything. What is the DSM-5 term for what Barbara is experiencing? a. dysthymic disorder b. bipolar I disorder, mixed episode c. cyclothymic disorder d. major depressive episode Answer: d. 27. Hypomania is an episode involving a. high energy, but less severe than mania. b. high energy, but more severe than mania. c. low energy, but less severe than depression. d. low energy, but more severe than depression. Answer: a. 28. A chronic but less severe form of bipolar disorder is a. dysthymia. b. dysphoria. c. cyclothymia. d. depressive disorder. Answer: c. 29. Melancholia is a term for a. dysthymia. b. neurotic depression. c. a severe type of depression. d. normal sadness unrelated to clinical depression. Answer: c. 30. Which of the following sets of symptoms suggests the presence of melancholia? a. weight gain, dysphoria, and hallucinations b. anxiety, excessive guilt, and depression worse in the evening c. difficulty getting to sleep, psychomotor agitation, and significant weight gain d. absence of any feelings of pleasure, early morning awakening, and marked psychomotor retardation Answer: d. 31. Which of the following patients exhibits depression with psychotic features? a. Ann, who wakes up early in the morning and cannot get back to sleep b. Kathy, who finds that food is unappealing, so she has been eating less c. Pete, who believes his digestive tract is dust and hears voices telling him he is evil d. Ted, who comes from a family with several depressed close relatives who committed suicide Answer: c. 32. Jane has recently become very depressed, and her doctor is explaining to her that she has a mood disorder with postpartum onset. If her doctor is correct, what do we know about Jane? a. Her depression will end very soon. b. She has given birth within the past four weeks. c. Her depression is linked to an identifiable environmental stressor. d. She has recently suffered the loss of someone she loves. Answer: b. 33. Rapid cycling bipolar disorder is characterized by a. many mood shifts per day. b. a seasonal pattern of symptoms. c. at least four episodes of mania, hypomania, or major depression within a year. d. the development of a manic episode in less than a week. Answer: c. 34. What is the most typical seasonal pattern in mood disorders? a. mania in summer, recovery in winter b. mania in winter, recovery in spring c. depression in winter, recovery in spring d. depression in summer, recovery in winter Answer: c. 35. Which of these individuals is at the average age for the onset of depressive disorder? a. Al, who is 15 years old b. Sid, who is 21 years old c. Sally, who is 32 years old d. Veronica, who is 65 years old Answer: c. 36. Andy has just experienced his first episode of major depression; if Andy is average for someone with depressive disorder, how many additional episodes is he likely to experience in his lifetime? a. none; recurrence is uncommon b. one or two c. five or six d. none unless he also experiences a manic or hypomanic episode Answer: c. 37. The return of active symptoms in a person who has recovered from a previous episode of a disorder is known as a. remission. b. relapse. c. refraction. d. rapid cycling. Answer: b. 38. Other than the presence of manic episodes in bipolar mood disorder, what is the main distinguishing factor between depressive disorder and bipolar mood disorder? a. later onset and more episodes in bipolar mood disorder b. later onset and fewer episodes in bipolar mood disorder c. earlier onset and more episodes in bipolar mood disorder d. earlier onset and fewer episodes in bipolar mood disorder Answer: c. 39. Despite differences among epidemiological surveys in samples, methods, and definitions of mental disorders, what is one common finding concerning mood disorders? a. Bipolar disorder occurs in fewer people than major depressive disorder. b. Dysthymic disorder is the most common form of mood disorder. c. Mood disorders are the most common form of mental disorders. d. Bipolar and depressive disorders are equally common in the general population. Answer: a. 40. According to the National Comorbidity Survey Replication, the approximate percentage of individuals diagnosed with a major mood disorder in the past 12 months who received adequate treatment for that disorder was a. 10 percent. b. 20 percent. c. 40 percent. d. 60 percent. Answer: b. 41. A report in the newspaper describes the common epidemiological finding that the rate of depression is higher among women than among men. How have researchers evaluated the validity of this finding? a. Men and women differ in their willingness to talk about their depressive symptoms. b. Mental health professionals are more prone to diagnose depression in women than in men. c. This gender difference is an artifact that occurs only in samples of patients that seek treatment. d. This gender difference exists, but it cannot be explained by methodological or sampling differences. Answer: d. 42. Comparisons of rates of emotional disorder across cultural boundaries encounter many problems. One such problem is that a. each culture has different words and concepts for describing illness. b. emotional disorders don't exist in every culture. c. there is no agreement on which diagnostic criteria to use. d. it is not ethical to study people from cultures different from our own. Answer: a. 43. What do cross‑cultural studies of psychopathology suggest concerning depression? a. DSM categories are culture-free. b. Chinese psychiatrists often mistake depression for a form of schizophrenia. c. There are very different rates of mood disorder in Western and non-Western countries. d. Depression is a universal phenomenon that may be expressed differently depending on cultural factors. Answer: d. 44. You are asked to consult about a patient who may be depressed. What you notice is that the focus of his symptoms is mostly somatic: on headaches, sleep disorder, and lack of energy. You ask if this patient happens to be from __________ the country where these symptoms are more generally seen in depression. a. The United States b. England c. Australia d. China Answer: d. 45. You are given the topic of age and mood disorders for a term paper in abnormal psychology and instructed to write the paper in the format of a newspaper report for the general public. Which of the following titles would be the best choice? a. "Mania Runs Wild in Older Generations" b. "Age and Mood Disorders: A Positive Correlation" c. "High Rates of Depression in the Elderly: Correcting a Myth" d. "Age Trends in Prevalence of Mood Disorders Obscured by Gender Effects" Answer: c. 46. What do the results of the epidemiological studies tell us about changes over time in the frequency of depression? a. Rates of depression appear to be decreasing. b. Rates of bipolar disorder appear to be increasing. c. Rates of depression appear to be increasing and with earlier onset. d. Rates of depression appear to be increasing but with later onset. Answer: c. 47. The rate of depression in women is about what percentage of the rate for men? a. 10 percent b. 50 percent c. 100 percent d. 200 percent Answer: d. 48. A strong correlation exists between stressful life events and the onset of depression, but it is difficult to interpret this relationship because a. there haven't been enough studies. b. stress can cause depression, but depression can cause stress. c. depression is a very subjective state and thus very difficult to measure. d. people are usually aware of any connection between their depression and stress in their lives. Answer: b. 49. A researcher investigating the link between stressful life events and depression has decided to use a prospective research design. This means that the researcher will have to a. select subjects with the prospect of becoming depressed. b. select subjects with the prospect of experiencing stress. c. follow subjects over time to see if stress predicts the onset of depression. d. question subjects carefully to see if their depression has always followed some identifiable stress. Answer: c. 50. The research by Brown and Harris on the cause of depression in women has suggested that types of events that have a greater likelihood of contributing to the cause of depression are a. an accumulation of many small, daily hassles. b. severe events that are particularly threatening. c. family events such as the loss of a parent. d. particularly related to the cause of depression. Answer: b. 51. What did Brown and Harris find when they followed women over a one-year period to study the link between depression and stressful life events? a. None of those who experienced a severe life event became depressed. b. Most of those who experienced a severe life event became depressed. c. Although life events and depression were related, most people who experienced such events did not become depressed. d. Although life events and depression were related, the results suggested that depression actually caused the life events. Answer: c. 52. Research shows that depression is often preceded by stressful life events, although not all such events lead to depression. What characteristics of a stressful life did Brown and Harris identify as more likely to lead to depression? a. devaluation and loss b. preexisting and dangerous c. biological and unpredictable d. feeling trapped and devalued Answer: d. 53. With respect to the link between stress and the onset of manic and depressive episodes, it appears that a. the types of stress are very similar. b. the types of stress tend to be different. c. stress is linked to depressive episodes but not manic ones. d. stress is linked to manic episodes but not depressive ones. Answer: b. 54. Severe events are clearly related to the onset of depression, but they do not provide a complete account of who will become depressed. Studies that examine factors that might explain which people are most likely to become depressed are seeking evidence for what psychologists call a. fragmentation. b. vulnerability. c. retrospective exposure. d. prospective exposure. Answer: b. 55. According to cognitive theories of depression, various types of cognitive errors, or distortions in thinking, are partly responsible for the disorder. Which of the following is one of the cognitive distortions mentioned in your textbook? a. assigning specific, impersonal meaning to an experience of failure b. a tendency to overgeneralize conclusions about the self based on positive experiences c. a tendency to turn suspicion toward others toward the self d. a tendency to recall selectively events with negative consequences Answer: d. 56. A good example of the type of cognitive distortions that lead to depression, according to the textbook, would include a. over generalized conclusions about one's self based on negative experiences. b. drawing inferences about one's self with ample evidence to back them up. c. exaggerating one’s own sense of intellectual ability. d. exaggerating the importance of positive events over negative. Answer: a. 57. What is a schema? a. a role played in a relationship b. an example of a cognitive distortion c. a point of contention in a relationship d. an organized cognitive representation of prior experience Answer: d. 58. According to the hopelessness theory of depression, what are depressed persons likely to do? a. make external causal attributions b. make unstable causal attributions c. believe that their fate is not determined at birth d. believe that aversive events will occur regardless of what they do Answer: d. 59. Mary fails a calculus exam. Although other students who failed the same exam complain that the exam was too hard and that the professor has a reputation for tough grading, Mary is convinced that she failed because she is incapable of understanding the material. How might we characterize Mary's attribution style? a. global b. stable c. primary d. internal Answer: d. 60. Robert strikes out during a softball game, causing his team to lose the game. He begins to brood about his failure, and concludes that not only is he a failure in sports, but in all areas of his life. How might we describe Robert's attribution style? a. stable b. global c. external d. magnified Answer: b. 61. Meredith is depressed. According to the concept of depressogenic attributional style, what is a likely description of Meredith? a. She makes internal, stable, and global causal attributions. b. Her interpersonal style may alienate others. c. Her grief over early childhood losses was not resolved. d. She erroneously believes that her relationships are inadequate. Answer: a. 62. Some research evidence suggests that persons who show a ruminative style by writing in a diary or talking extensively with friends about their depressed moods show a. increased empathy. b. longer and more severe depressed moods. c. shorter and less severe depressed moods. d. good ability to distract themselves from their bad moods. Answer: b. 63. A hypothesis with regard to the response style model that attempts to explain the difference in rates of depression between men and women is a. men are more likely to respond to depression with rumination, which prolongs and intensifies the depression. b. women are more likely to respond to depression with rumination, which prolongs and intensifies the depression. c. women are more likely to respond to depression with rumination, which has the effect of reducing their level of depression. d. men are more likely to respond to depression with rumination, which has the effect of reducing their level of depression. Answer: b. 64. What two response styles are emphasized by Nolen-Hoeksema in her research designed to understand the duration and severity of depression? a. social and individual b. internal and external c. distracting and ruminative d. predictable and unpredictable Answer: c. 65. Genetic factors seem to a. play a stronger role in bipolar than depressive disorders. b. play a stronger role in depressive than bipolar mood disorders c. play an insignificant role in the cause of mood disorders. d. be almost impossible to pinpoint with current technology. Answer: a. 66. Studies suggest that the heritability factor for bipolar disorder is approximately a. 20 percent. b. 40 percent. c. 60 percent. d. 80 percent. Answer: d. 67. Studies of the concordance rates for depressive disorder and bipolar mood disorder in monozygotic (MZ) and dizygotic (DZ) twins suggest a. a larger role of genetic factors in bipolar mood disorder. b. a larger role of genetic factors in depressive disorder. c. similar concordance rates for bipolar mood disorder in MZ and DZ twins. d. similar concordance rates for depressive disorder in MZ and DZ twins. Answer: a. 68. The best evidence for the influence of nongenetic factors in the cause of mood disorder is in the a. concordance rates for MZ twins, which are less than 100 percent. b. concordance rates for DZ twins, which are less than 100 percent. c. concordance rates for MZ twins, which are less than for DZ twins. d. concordance rates for DZ twins, which are less than for MZ twins. Answer: a. 69. A report in a research journal describes the symptoms of a mental disorder along with information on its etiology, including a heritability of 50 percent. How should this finding be interpreted? a. Genetic factors and the environment contribute about equally to this disorder. b. Half of the people who suffer from the disorder have a genetically caused disorder. c. Half of the children of carriers of this disorder will actually develop the disorder. d. Geneticists have identified half of the genes thought to be responsible for this disorder. Answer: a. 70. What is the estimated heritability for depressive disorder? a. 5 percent b. 25 percent c. 50 percent d. 75 percent Answer: c. 71. Which of the following lists mood disorders from the one with the highest degree of heritability to the one with the smallest degree of heritability? a. dysthymia, cyclothymia, major depressive disorder b. bipolar disorder, major depressive disorder, dysthymia c. major depressive disorder, bipolar disorder, dysthymia d. dysthymia, bipolar disorder, major depressive disorder Answer: b. 72. A study by Kendler and his colleagues involving twins was designed to investigate the etiology of depression. What was one of the major conclusions? a. Genetics plays a small role in depression. b. The environment plays a major role in depression. c. Genetic factors seem to influence the effect the environment may have on depression. d. Twins are relatively immune from depression as a result of the close bond that they form with each other. Answer: c. 73. To conduct linkage studies, researchers attempt to find evidence for a. an association between life events and specific disorders. b. similar rates of disorder in MZ and DZ twins. c. different rates of disorder in adopted children and in their biological and adopted parents. d. an association between a disorder and another trait within the same family. Answer: d. 74. Failure to suppress production of the hormone cortisol in response to the dexamethasone suppression test has implicated a dysfunction of which system in the etiology of depression? a. genetics b. MAO inhibition c. neurotransmitter system d. hypothalamus—pituitary—adrenal axis Answer: d. 75. The endocrine system and the central nervous system may be linked in the etiology of depression through which substance? a. cortisol b. dopamine c. HPA d. dexamethasone Answer: a. 76. You are running a clinical trial on a method of stimulating regions of the brain in order to relieve symptoms of depression. Given the evidence that underacting in this region is associated with depression, you decide to start clinical trials in the a. reticular activating system. b. dorsolateral prefrontal cortex. c. posterior occipital cortex. d. amygdala. Answer: b. 77. Using brain imaging techniques to examine activity of the prefrontal cortex (PFC) in depressed patients, researchers have reported finding a. decreased activity. b. increased activity. c. decreased activity in some PFC regions and increased activity in others. d. decreased activity in patients with depressive disorder and increased activity in patients with bipolar depression. Answer: c. 78. Brain imaging studies have identified elevated levels of resting blood flow and glucose metabolism in which area of the brain? a. amygdala b. cerebellum c. parietal lobes d. temporal lobes Answer: a. 79. Which of the following is a neurotransmitter? a. catecholamine b. hypothalamus c. norepinephrine d. dorsolateral Answer: c. 80. The activity at the synapse of which of the following is most especially enhanced by medications like Prozac? a. serotonin b. dopamine c. activity of the amygdala d. activity of the cingulate gyrus Answer: a. 81. What is the primary advantage of analogue studies in research on mood disorders? a. They can use animals rather than humans. b. They can employ an experimental procedure. c. They are not subject to Ethics Review Boards. d. They are highly generalizable to situations outside the laboratory. Answer: b. 82. Some clinicians have argued that mental disorders cannot be studied using laboratory animals as subjects, because a. studies of depression should only be done in natural settings, and very few of those exist. b. cognitive symptoms cannot be measured in animals. c. animals do not express emotions similar to depression. d. the brains of animals are too different from homo sapiens. Answer: b. 83. A group of rats was exposed to the uncontrollable stress associated with being forced to swim for 15 minutes in cold water from which they cannot escape. What did researchers notice when they observed these animals? a. Most rats were immune to the effects of the stress. b. The rats' depression was reduced by the high level of physical activity. c. The stress caused a form of brain damage that first led to motor retardation and then death. d. The rats that exhibited symptoms similar to depression had altered neurotransmitter levels. Answer: d. 84. Which of the following characterizes a cognitive therapy approach to the treatment of depression? a. probing for unconscious roots of anger b. focusing on early childhood experiences c. increasing internal causal attributions d. reducing patients' self-defeating thoughts Answer: d. 85. Your boss just praised you effusively for a superior job on a marketing report; he also said he liked the presentation you gave at the regional meeting. As you walk out the door, he says you might want to try wearing another tie. You spend hours mulling over that last comment and find yourself becoming depressed. Your reaction to the comment was, "I am washed up as an employee; they want someone to replace me." Your conclusion is an example of a. attribution. b. an inexact label. c. cognitive dissonance. d. selective abstraction. Answer: d. 86. What is the focus of interpersonal therapy for depression? a. current relationship difficulties b. patterns learned in childhood relationships c. unconscious feelings for the attachment figure d. close, dependent relationship with the therapist Answer: a. 87. Among patients who respond positively to antidepressant medication, a. improvement usually occurs within four to six weeks. b. side effects usually force them to terminate early. c. improvement usually occurs almost immediately. d. side effects are almost never a problem. Answer: a. 88. How do SSRI drugs produce their antidepressant effect? a. inhibiting reuptake of norepinephrine b. inhibiting reuptake of serotonin c. blocking production of norepinephrine d. blocking production of serotonin Answer: b. 89. What are the most frequently prescribed antidepressant medications? a. lithium b. tricyclics c. anticonvulsants d. selective serotonin reuptake inhibitors Answer: d. 90. Compared to tricyclics and MAO inhibitors, what is a major reason for the popularity of newer antidepressant drugs such as Prozac? a. lower cost b. fewer side effects c. available over-the-counter d. more effective Answer: b. 91. Which of the following are the most troublesome side effects of the use of selective serotonin reuptake inhibitors? a. muscle pain and double visions b. insomnia and excessive sweating c. sexual dysfunction and weight gain d. heart palpitations and difficulty breathing Answer: c. 92. Sal's psychiatrist wrote a prescription for him and warned him not to eat a long list of foods, including cheese and chocolate. If Sal's diagnosis is depression, what type of drug is likely to have been prescribed? a. tricyclics b. MAO inhibitors c. anticonvulsants d. selective serotonin reuptake inhibitors Answer: b. 93. The U.S. Food and Drug Administration has ruled that care should be taken when prescribing some SSRIs to children because of the possible side effects of a. catatonic, lethargic behavior. b. sever sleep disturbance. c. extreme weight loss. d. violent or suicidal thoughts or behavior. Answer: d. 94. Which of the following summarizes the research evaluating psychological and pharmacological treatments for depression? a. Antidepressant medication is the most effective approach. b. Cognitive therapy is the most effective approach. c. Antidepressants and cognitive therapy are both effective forms of treatment. d. Antidepressants work better on more severe depression and cognitive therapy works better with milder depression. Answer: c. 95. The first choice for treating bipolar disorders is a. an SSRI like Prozac. b. electroconvulsive therapy. c. lithium. d. cognitive therapy plus a self-help group. Answer: c. 96. Bonnie has been diagnosed with a mental disorder and is currently receiving medication. If the prescription is for anticonvulsant drugs, what is the most likely mental disorder? a. dysthymic disorder b. cyclothymic disorder c. major depressive episode d. rapid cycling bipolar disorder Answer: d. 97. A bipolar patient in therapy is learning to lead a more orderly life and to resolve interpersonal problems more effectively. With this type of therapy, mood stabilizing medication will a. still be very important. b. no longer be needed. c. only confuse the patient. d. be less likely to cause side-effects. Answer: a. 98. The family of a patient about to undergo electroconvulsive therapy (ECT) is concerned about how the treatment will affect their loved one's memory. They meet with the psychiatrist and ask questions. What is the psychiatrist likely to tell them? a. “Memory problems are typically of short duration." b. "Although there will be some loss of memory, the patients rarely complain." c. "Although there are serious memory losses, the benefits of treatment outweigh these losses." d. "The memory problems are actually a benefit because they keep negative memories out of consciousness." Answer: a. 99. Based on outcome studies that have evaluated the effectiveness of light therapy for seasonal depressions, it appears that a. many patients with seasonal affective disorders do respond well to light therapy. b. light therapy is an expensive but useless gimmick. c. no one knows the correct dosage of light. d. there is no theory to explain how light therapy could possibly work. Answer: a. 100. Durkheim's classification of suicides focused on a person's social circumstances in terms of high and low levels of social a. apathy and altruism. b. egotism and fatalism. c. integration and regulation. d. anomie and bonhomie. Answer: c. 101. The highest suicide rate in the United States is among a. White males under 40 years old. b. White males over 50 years old. c. Black females over 50 years old. d. teenage females. Answer: b. 102. Which of the following individuals is most likely to die as a result of suicide? a. Jim, a 60-year-old b. Zack, an 8-year-old c. Alice, a 23-year-old d. Laura, a 4-year-old Answer: a. 103. What percentage of patients with mood disorders will eventually kill themselves? a. 5-10 percent b. 15-20 percent c. 40-45 percent d. more than 50 percent Answer: b. 104. Deliberate self harm is listed in DSM-5 as one of the symptoms of a. schizophrenia. b. borderline personality disorder. c. psychopathy. d. self-injurious neuroses. Answer: b. 105. From rates of attempted and successful suicides, we can conclude that females more often attempt suicide and males more often _________. a. succeed b. give away prized possessions c. leave notes d. use poisons Answer: a. 106. According to Schneidman, the most common stressor in suicide is a. hostility. b. anger. c. frustration of psychological needs. d. the desire to make others suffer. Answer: c. 107. Studies of the role of genetic factors in suicide indicate that a. there is a genetic factor independent of the risk for depression. b. the only genetic factor is the genetic risk for depression. c. genetic factors do not play a role in suicide. d. genetic factors play a role in suicides by males but not in suicides by females. Answer: a. 108. According to Schneidman, the most common emotion in suicide is a. fear. b. anger. c. hopelessness. d. depression. Answer: c. 109. The state legislature is considering enacting measures that will have an impact in reducing suicide rates. Which of the following individuals who are testifying before a legislative committee will be able to provide the most empirical support for his or her suggestion? a. Al, who wants to reduce access to guns b. Jim, who wants to make suicide a criminal offense c. Stacey, who wants public service announcements focused on famous suicides d. Randy, who wants to establish crisis lines to handle calls from individuals contemplating suicide Answer: a. 110. The city council is considering funding a suicide hotline, and they ask you to review the literature on the topic. What will your report tell the council? a. Special training for police officers is a better way to spend the money. b. A hot line phone service is the most economical way to reduce the rate of suicide. c. Suicide rates do not differ between communities with and without suicide prevention programs. d. Crisis hot lines must be connected with hospital emergency rooms in order to be effective. Answer: c. Short Answer 111. Depressed, or ____________ (unpleasant), mood is the most common and obvious symptom of depression. Answer: dysphoric 112. The syndrome of depression is also called __________ depression. Answer: clinical 113. __________ or elated mood is the opposite emotional state from depressed mood. Answer: a. Euphoria 114. Mood disorder symptoms that are related to basic bodily functions are known as __________ symptoms. Answer: somatic 115. If, during a period of mood disturbance, your patient experiences inflated self-esteem or grandiosity, you likely will diagnosis this as a(n) __________ episode. Answer: manic 116. A mood disorder that is regularly associated with changes in the seasons is called __________ disorder. Answer: seasonal affective 117. When an individual's symptoms are improved for a period of time, this improvement is referred to as __________. Answer: remission 118. Gender differences are typically not observed in __________ mood disorders. Answer: bipolar 119. Brown and colleagues have found evidence that depression in women is more likely to occur when severe life events are associated with (provide one of the three terms suggested in the textbook) __________ . Answer: humiliation, entrapment or defeat 120. The system in the body responsible for regulating a person's response to stress is known as the __________ system. Answer: endocrine 121. When rats are exposed to stress in the lab, they exhibit signs of depression and evidence that the concentration of chemicals in their brains have been changed. These chemicals are known collectively as _________. Answer: neurotransmitters 122. In a case conference about a procedure you are about to perform on your depressed patient, the main topic is the amount of amnesia or memory loss they will experience as a result of the therapy. What treatment are you likely considering? Answer: ECT 123. _____ suicide occurs when the rules of a society or social group dictate that an individual must sacrifice his life for the good of the group. Answer: Altruistic Essay 124. What are the two primary issues central to the debate regarding definitions of mood disorders? What are the five major considerations we can use in distinguishing clinical depression from normal sadness? Answer: (1) should these disorders be defined in a broad or narrow fashion? (2) the issue of heterogeneity. All depressed persons do not have the same set of symptoms, same pattern of onset, or the same course over time. Some patients have manic episodes, whereas others experience only depression. Some exhibit psychotic symptoms, such as delusions and hallucinations. The important considerations in distinguishing clinical depression from normal sadness are: (1) Intensity: The mood change pervades all aspects of the person and impairs social and occupational functions. (2) Absence of precipitants: The mood may arise in the absence of any discernible precipitant or may be grossly out of proportion to those precipitants. (3) Quality: The mood change is different from that experienced in normal sadness. (4) Associated features: The change in mood is accompanied by a cluster of signs and symptoms, including cognitive and somatic features. (5) History: The mood change may be preceded by a history of past episodes of elation and hyperactivity. 125. What has research revealed concerning the rate of depression among the elderly? Answer: Although people mistakenly identify depression with the elderly, data from the NCS-R suggest that mood disorders actually are more frequent among young and middle-aged adults. The rates of both major depression and bipolar mood disorder are lowest among people over age 60. Several explanations have been offered for this pattern. It is possible that this finding is due to how the research was conducted, not actual differences in the rate of depression across age groups. One interpretation is that the elderly have greater difficulty remembering episodes of depression. In addition, mood disorders are associated with increased mortality; thus, some severely depressed people might not have survived into old age. However, the pattern observed in the NCS-R has been observed in several studies, and most investigators believe the effect (lower rates of depression among the elderly) is genuine. 126. Summarize the findings of research investigating the relationship between stressful life events and depression, and then explain why it is difficult to interpret what the relationship means. Answer: People who become clinically depressed experience an increased number of stressful life events. Comparisons among different populations show that communities with the highest rates of severe events produced the highest prevalence of major depression. One troublesome problem involves the direction of the relationship. If depressed people experience more stressful events, what is the direction of effect? Does failure lead to depression, or does depression lead to failure? Another problem is that many people who experience stressful life events do not become depressed, and we don't always know who will become depressed. The research of Brown, Harris, and others points to "severe" events, ones that are particularly threatening, as factors in the cause of depression, especially in women. Events that lead to humiliation, entrapment or defeat seem to be particularly related to depression. 127. Discuss the concept of cognitive vulnerability as a model of the cause of depression. Answer: There are several cognitive models of the etiology of depression. One model is based on the work of Aaron Beck who suggests that people develop, through the course of their lives, habitual ways of looking at the world and themselves. These cognitive patterns determine how they interpret and react to life events. Some patterns, or habitual ways of thinking and perceiving, make an individual more vulnerable to depression. From this perspective, persistent negative or pessimistic thoughts would be such a vulnerability. Various types of distortions, errors or biases in thinking or perceiving, such as a tendency to assign a global, personal meaning to negative experiences, would be conducive to depression. There are several cognitive distortions that could be mentioned here including a tendency to overgeneralize negative conclusions from one negative experience, a tendency to draw arbitrary inferences about one’s self without evidence, and a tendency to exaggerate any negative experience. Mention should be made of Beck’s concept of schema, which is a cognitive term for the collection of assumptions, attributions, and ways of perceiving that guide ones cognitive habits or tendencies. 128. What are the two response styles described by Nolen-Hoeksema? How are these response styles related to depression? Answer: Nolen-Hoeksema has proposed that the manner in which a person responds to the onset of a depressed mood influences its duration and severity. Ruminative styles involve responding to feelings of depression by turning attention inward, contemplating causes and implications of sadness. Distracting style involves diverting oneself from unpleasant mood by working on hobbies, playing sports, etc. People with ruminative style experience longer and more severe episodes of depression than do people with distracting style. Women tend to use the ruminative style. 129. Describe the research results suggesting that there is a greater genetic influence on bipolar disorder than on depressive disorder. Answer: (1) There is a greater difference in the concordance rates for MZ and DZ twins in the case of bipolar disorder than in the case of depressive disorder. (2) The rate of bipolar disorder in family members of depressive patients is similar to the rate in the general population, but the rate of depressive disorder in family members of bipolar patients is higher than the rate in the general population. 130. Briefly describe the brain regions that have been associated with a biological model of the cause of depression. Answer: There are several brain regions currently associated with models of the cause of depression. Likely they interact in some complicated fashion, but we are still in the process of sorting out their individual contributions. Mention could be made of the following. Hypothalamic–pituitary–adrenal (HPA) axis: When the CNS perceives a threat, it signals the hypothalamus, which in turn signals the pituitary gland to secrete the hormone ACTH. The ACTH modulates the secretion of, for example, cortisol from the adrenal cortex ,which helps the individual prepare for fight or flight in a number of ways. Depressed patients show a failure of suppression of the HPA axis after being given DST, which suggests that they have, during depression, a hyperactive HPA axis. Stress causes the release of adrenal steroids, such as cortisol, which has been shown to cause structural and functional changes in the brain, including alterations in gene expression that are associated with depression. Functional imaging of the brain suggests abnormal activation in several regions of the brain, including decreased activity in the regions of the prefrontal cortex (PFC) responsible for planning and the anticipation of emotion; increased activity in the region of the PFC responsible for the experience of reward and punishment; the anterior cingulate cortex (ACC), which is activated when a person’s goals are frustrated; increased activity in the amygdale, which is the part of the limbic system responsible for emotional experiences. Individuals who respond well to any form of therapy show reduced activity in the amygdala. 131. Summarize what is currently known about the effectiveness of psychotherapy and medication in the treatment of depression, and cite some of the research evidence. Answer: There are several different kinds of antidepressant medications, but they are generally equal in terms of effectiveness, with positive responses being shown by 50 to 60 percent of depressed patients. Cognitive therapy and antidepressant medication appear to be equally effective for people who suffer from depressive disorder, including major depressive disorder and dysthymia. Medication and psychotherapy also appeared equally effective in randomized trials conducted in primary care settings, with 64 percent of patients recovering from an episode of depression after 11 weeks of treatment with either an SSRI or problem-solving therapy. 132. Discuss Joiner's (closely related to Schneidman's) model of the psychological factors that are involved in the cause of suicide. Mention the common elements of suicide. Answer: For Joiner, social factors can set the stage for thoughts or motivations of suicide, but psychological events lie at the core of suicidal behavior. Emotional stress and hopelessness are central features of many individuals who actually attempt suicide. Joiner, and others, consider the common elements of suicidal psychology to focus on an attempt to escape from unbearable psychological pain, often the pain associated with prolonged frustration of basic psychological needs. Most important are the needs for affiliation and competence. People who view themselves as having failed in these domains—those who are low in belongingness or high in burdensomeness—will experience intense negative emotional states, such as shame, guilt, anger, and grief. Suicide then becomes a somewhat logical route to escape this on-going pain caused by these psychological states. Of particular association with the act of suicide are the belief and experience of being socially isolated and being a burden to others. 133. What are some of the recommendations for dealing with individuals who have expressed a serious intent to harm themselves? Answer: (1) reduce the lethality: reduce psychological pain and reduce access to means of committing suicide; (2) negotiate agreements: ask the client to sign a contract agreeing to postpone self-destructive behavior for at least a short period of time, include an agreement that the client will contact the therapist directly before engaging in any lethal actions; (3) provide support: make concrete arrangements for social support, alert friends and family members to be available; (4) replace tunnel vision with a broader perspective: suicidal individuals are often unable to consider alternative solutions for their problems; help clients to use a more flexible and adaptive pattern of problem solving to replace death as the only solution. 134. Discuss the concept of genetic risk interacting with stress as demonstrated in the work of Caspi on the 5-HTT gene. Answer: Caspi’s work focused on the 5-HTT transporter gene, which has been studied because several drugs that are used to treat depression have a direct impact on this particular neurotransmitter. There are two alleles or different versions of this gene, one of which is shorter and is associated with reduced efficiency of neural transmission in serotonin pathways. Individuals who inherit this short allele or version of the gene are at particularly high risk for becoming clinically depressed if they experience stressful life events. In the absence of increased stress, the presence of this gene does not increase the person’s risk for depression. Both factors seem to be necessary. Test Bank for Abnormal Psychology Thomas F. Oltmanns, Robert E. Emery 9780205997947, 9780205970742, 9780134899053, 9780134531830, 9780205965090

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