2nd bm Flashcards
The many clinical drug trials that have been conducted support the hypothesis that dysregulation of this neurotransmitter is involved in the symptom formation of obsessions and compulsions in the disorder
Serotonin
Dopamine
Norepinephrine
None of the above
Serotonin
Some interest exists in a positive link between infection and OCD. The infection is caused by
Staphylococcus aureus
Group Aβ-hemolytic streptococcus
SARS-Cov 2
Streptococcus pneumoniae
Group Aβ-hemolytic streptococcus
OCD is considered a regression from the oedipal phase to the anal psychosexual phase of development
classic psychoanalytic theory
learning theory
cognitive theory
none of the above
classic psychoanalytic theory
Obsessions are conditioned stimuli. A relatively neutral stimulus becomes associated with fear or anxiety through a process of respondent conditioning by being paired with events that are noxious or anxiety producing
classic psychoanalytic theory
learning theory
cognitive theory
none of the above
learning theory
Good prognosis in OCD is indicated by
yielding to (rather than resisting) compulsions Poor
childhood onset Poor
bizarre compulsions Poor
none of the above
none of the above
A poor prognosis in OCD is indicated by
good social and occupational adjustment good
presence of a precipitating event good
episodic nature of the symptoms good
none of the above
none of the above
For extreme cases of OCD that are treatment resistant and chronically debilitating, the following are considerations
electroconvulsive therapy (ECT)
Psychosurgery
Deep Brain Stimulation
all of the above
all of the above
Characterized by a preoccupation with an imagined defect in appearance that causes clinically significant distress or impairment in important areas of functioning
Hair-Pulling Disorder
Body Dysmorphic Disorder
OCD
None of the above
Body Dysmorphic Disorder
It is also known as trichotillomania, a term coined by a French dermatologist
Hair-Pulling Disorder
Body Dysmorphic Disorder
OCD
None of the above
Hair-Pulling Disorder
Differential diagnosis in Body Dysmorphic Disorder
anorexia nervosa
gender identity disorder
major depressive disorder
all of the above
major depressive disorder
In OCD, the most common pattern is an obsession regarding
Contamination
Pathological doubt
Intrusive thoughts
Symmetry
Contamination
In OCD, the 2nd most common pattern is an obsession regarding
Contamination
Pathological doubt
Intrusive thoughts
Symmetry
Pathological doubt
In OCD, the 3rd most common pattern is an obsession regarding
Contamination
Pathological doubt
Intrusive thoughts
Symmetry
Intrusive thoughts
In OCD, the 4th most common pattern is an obsession regarding
Contamination
Pathological doubt
Intrusive thoughts
Symmetry
Symmetry
On mental status examinations, patients with OCD may show symptoms of depressive disorders. Such symptoms are present in about 50 percent of all patients.
True
False
True
The National Comorbidity Study reported that
one of four persons met the diagnostic criteria for at least one anxiety disorder
there is a 12-month prevalence rate of 17.7 percent
women are more likely to have an anxiety disorder than are men
all of the above
all of the above
According to the National Comorbidity Study the lifetime prevalence of anxiety disorder in women
30.5 percent
19.2 percent
17.7 percent
None of the above
30.5 percent
According to the National Comorbidity Study the lifetime prevalence of anxiety disorder in men
30.5 percent
19.2 percent
17.7 percent
None of the above
19.2 percent
The prevalence of anxiety disorders increases with higher socioeconomic status
True
False
False
The three major neurotransmitters associated with anxiety on the bases of animal studies and responses to drug treatment are
norepinephrine (NE), serotonin, and γ-aminobutyric acid (GABA)
dopamine, glycine, glutamate
dopamine, glycine, neuropeptide Y
serotonin, dopamine, glycine
norepinephrine (NE), serotonin, and γ-aminobutyric acid (GABA)
A role of this neurotransmitter in anxiety disorders is most strongly supported by the undisputed efficacy of benzodiazepines
Neuropeptide Y
Galanin
GABA
Dopamine
GABA
The idea of panic disorder may have its roots in the concept of irritable heart syndrome, which this physician noted in soldiers in the American Civil War
Jacob Mendes DaCosta
Sigmund Freud
Charles Darwin
None of the above
Jacob Mendes DaCosta
The lifetime prevalence of panic disorder is
1 to 4 percent
5 to 10 percent
10 to 15 percent
None of the above
1 to 4 percent
The only social factor identified as contributing to the development of panic disorder is
a recent history of divorce or separation
a death in the family
financial ruin
none of the above
a recent history of divorce or separation
Respiratory panic-inducing substances cause respiratory stimulation and a shift in the acid–base balance.
carbon dioxide (5 to 35 percent mixtures)
sodium lactate
bicarbonate
all of the above
all of the above
Diagnosis of Panic Disorder requires
Recurrent unexpected panic attacks
1 month or more of persistent concern or worry about additional panic attacks
A significant maladaptive change in behavior related to the attacks
All of the above
All of the above
Panic attacks generally lasts 20 to 30 minutes and rarely more than an hour
True
False
True
Organic differential diagnosis for Panic Disorder
Mitral Valve Prolapse
Asthma
Epilepsy
All of the above
All of the above
Selective Serotonin Reuptake Inhibitors are effective for panic disorder. These include
Paroxetine
Clonazepam
Alprazolam
All of the above
Paroxetine
When it becomes effective, pharmacological treatment for panic disorder should generally continue for
8 to 12 months
1 to 3 months
2 to 4 weeks
None of the above
8 to 12 months
Most cases of agoraphobia are thought to be caused by panic disorder. When the panic disorder is treated, the agoraphobia often improves with time
True
False
True
The lifetime prevalence of specific phobia is about
10 percent
1 percent
0.1 percent
None of the above
10 percent
Fear of heights
Cynophobia
Mysophobia
Acrophobia
Xenophobia
Acrophobia
Fear of dogs
Cynophobia
Mysophobia
Acrophobia
Xenophobia
Cynophobia
Fear of dirt and germs
Cynophobia
Mysophobia
Acrophobia
Xenophobia
Mysophobia
Lifetime prevalence for social anxiety disorder
3 to 13 percent
0.3 to 1.3 percent
30 percent
None of the above
3 to 13 percent
Persons with social anxiety disorder are fearful of
embarrassing themselves in social situations
a specific location
a specific object
having a panic attack
embarrassing themselves in social situations
Which of the following is an essential characteristic/s of generalized anxiety disorder
sustained and excessive anxiety and worry
accompanied by either motor tension or restlessness
the anxiety interferes with other aspects of a person’s life
all of the above
all of the above
atients with generalized anxiety disorder frequently develop major depressive disorder
True
False
True
True statements regarding the course and prognosis of generalized anxiety disorder
a. most patients with the disorder report that they have been anxious just recently
b. 90 percent of patients seek psychiatric treatment
c. many go to general practitioners, internists, cardiologists, pulmonary specialists, or gastroenterologists, seeking treatment for the somatic component of the disorder
d. all of the above
c. many go to general practitioners, internists, cardiologists, pulmonary specialists, or gastroenterologists, seeking treatment for the somatic component of the disorder
A pervasive and sustained emotion or feeling tone that influences a person’s behavior and colors his or her perception of being in the world
Mood
Affect
Anxiety
Obsession
Mood
Patients with only major depressive episodes are said to have
major depressive disorder
bipolar l disorder
bipolar ll disorder
all of the above
major depressive disorder
In 1854, Jules Falret described a condition in which patients experience alternating moods of depression and mania
folie impose
folie circulaire
folie a deux
none of the above
folie circulaire
According to Kraepelin, the absence of a dementing and deteriorating course in manic-depressive psychosis differentiated it from dementia precox (as schizophrenia was then called)
True
False
True
For a diagnosis of Major Depressive Disorder to be made, how long should the depressive episode last
At least 1 week
At least 2 weeks
At least 1 month
None of the above
At least 2 weeks
For a diagnosis of Bipolar l Disorder to be made, a manic episode must last
At least 1 week
At least 2 weeks
At least 1 month
None of the above
At least 1 week
How many symptoms are needed in order to make a diagnosis of Major Depressive Disorder?
3
4
5
None of the above
5
The lifetime prevalence rate for major depression
0-2.4 %
0.3-4.8 %
5-17 %
None of the above
5-17 %
The lifetime prevalence rate for Bipolar l disorder
0-2.4 %
0.3-4.8 %
5-17 %
None of the above
0-2.4 %
Which of the following statements regarding sex distribution in mood disorders is true?
twofold greater prevalence of bipolar disorder in women than in men
major depressive disorder has an equal prevalence among men and women
Manic episodes are more common in men, and depressive episodes are more common in women
d. All of the above
Manic episodes are more common in men, and depressive episodes are more common in women
Mean age of onset for Bipolar l disorder
20 years
30 years
40 years
50 years
30 years
Mean age of onset for major depressive disorder is about
20 years
30 years
40 years
50 years
40 years
Recent epidemiological data suggest that the incidence of major depressive disorder may be increasing among people younger than 20 years of age. This may be related to
increased use of alcohol and drugs of abuse
hormonal differences
effects of childbirth
none of the above
increased use of alcohol and drugs of abuse
Major depressive disorder occurs most often in persons without close interpersonal relationships and in those who are divorced or separated
True
False
True
Bipolar I disorder is more common in divorced and single persons than among married persons, but this difference may reflect the early onset and the resulting marital discord characteristic of the disorder
True
False
True
The following statements regarding socioeconomic and cultural factors in mood disorder is/are true
No correlation has been found between socioeconomic status and major depressive disorder
A higher than average incidence of bipolar I disorder is found among the lower socioeconomic groups
Bipolar I disorder is more common in persons who graduated from college
Depression is more common in urban areas
Depression is more common in urban areas
Most frequent disorders associated with major mood disorders
alcohol abuse or dependence
panic disorder
obsessive-compulsive disorder (OCD)
all of the above
all of the above
The correlation studies between the downregulation or decreased sensitivity of β-adrenergic receptors and clinical antidepressant responses is probably the single most compelling piece of data indicating a direct role for this biogenic amine in depression
Dopamine
Norepinephrine
Serotonin
Histamine
Norepinephrine
The biogenic amine neurotransmitter most commonly associated with depression
Dopamine
Norepinephrine
Serotonin
Histamine
Serotonin
Other neurotransmitter disturbances in mood disorders involve Acetylcholine. Cholinergic agonists can produce lethargy, anergia, and psychomotor retardation in healthy subjects, exacerbate symptoms in depression, and reduce symptoms in mania
True
False
True
Increasing evidence also indicates that mood-stabilizing drugs act on
G proteins or other second messengers
Dopamine
Serotonin
None of the above
G proteins or other second messengers
Elevated HPA activity is a hallmark of mammalian stress responses and one of the clearest links between depression and the biology of chronic stress
True
False
True
Depression is associated with a premature loss of deep (slow-wave) sleep and an increase in nocturnal arousal. The combination of increased REM drive and decreased slow-wave sleep results in a significant reduction in the first period of non-REM (NREM) sleep, a phenomenon referred to as
Insomnia
reduced REM latency
hypersomnia
none of the above
reduced REM latency
Modern affective neuroscience focuses on the importance of four brain regions in the regulation of normal emotions, EXCEPT
prefrontal cortex (PFC)
anterior cingulate
hippocampus
cerebellum
cerebellum
Family data indicate that if one parent has a mood disorder, a child will have a risk of between ________ percent for mood disorder
10 and 25 %
30 and 50 %
50 and 75 %
None of the above
10 and 25 %
A family history of bipolar disorder conveys a greater risk for mood disorders in general and, specifically, a much greater risk for bipolar disorder
True
False
True
Unipolar disorder (major depressive disorder) is typically the most common form of mood disorder in families of bipolar probands
True
False
True
Concordance rate for mood disorders (unipolar and bipolar disorders combined) in monozygotic (MZ) twins
16 to 35 %
40 to 60 %
70 to 90 %
None of the above
70 to 90 %
Concordance rate for mood disorders (unipolar and bipolar disorders combined) in same-sex dizygotic (DZ) twins
16 to 35 %
40 to 60 %
70 to 90 %
None of the above
16 to 35 %
DNA markers are segments of DNA of known chromosomal location, which are highly variable among individuals. Chromosomes 18q and 22q are the two regions with strongest evidence for linkage to bipolar disorder
True
False
True
The most compelling data indicate that the life event most often associated with development of depression is
losing a parent before age 11 years
the loss of a spouse
unemployment
all of the above
losing a parent before age 11 years
The environmental stressor most often associated with the onset of an episode of depression is
losing a parent before age 11 years
the loss of a spouse
unemployment
all of the above
the loss of a spouse
Persons out of work are three times more likely to report symptoms of an episode of major depression than those who are employed
True
False
True
The psychodynamic understanding of depression defined by Sigmund Freud and expanded by Karl Abraham is known as the classic view of depression. That theory involves four key points. Among these are
disturbances in the infant– mother relationship during the anal phase
depression can be linked to real or imagined object loss
projection of the departed objects is a defense mechanism invoked to deal with the distress connected with the object’s loss
all of the above
depression can be linked to real or imagined object loss
understood depression as involving the expression of aggression toward loved ones, much as Freud did
Melanie Klein
Edward Bibring
Edith Jacobson
Heinz Kohut
Melanie Klein
regarded depression as a phenomenon that sets in when a person becomes aware of the discrepancy between extraordinarily high ideals and the inability to meet those goals
Melanie Klein
Edward Bibring
Edith Jacobson
Silvano Arieti
Edward Bibring
saw the state of depression as similar to a powerless, helpless child victimized by a tormenting parent
Melanie Klein
Edward Bibring
Edith Jacobson
None of the above
Edith Jacobson
observed that many depressed people have lived their lives for someone else rather than for themselves; referred to the person for whom depressed patients live as the dominant other, which may be a principle, an ideal, or an institution, as well as an individual
Melanie Klein
Edward Bibring
Edith Jacobson
Silvano Arieti
Silvano Arieti
His conceptualization of depression, derived from his self-psychological theory, rests on the assumption that the developing self has specific needs that must be met by parents to give the child a positive sense of self-esteem and self-cohesion. When others do not meet these needs, there is a massive loss of self-esteem that presents as depression
Silvano Arieti
Heinz Kohut
John Bowlby
Edward Bibring
Heinz Kohut
He believed that damaged early attachments and traumatic separation in childhood predispose to depression. Adult losses are said to revive the traumatic childhood loss and so precipitate adult depressive episodes
Silvano Arieti
Heinz Kohut
John Bowlby
Edward Bibring
John Bowlby
Most theories of mania view manic episodes as a defense against underlying depression
True
False
True
According to cognitive theory, depression results from specific cognitive distortions present in persons susceptible to depression. These distortions are cognitive templates that perceive both internal and external data in ways that are altered by early experiences
depressogenic schemata
hallucinations
delusions
illusions
depressogenic schemata
This theory of depression connects depressive phenomena to the experience of uncontrollable events
Classical
Learned helplessness
Cognitive
None of the above
Learned helplessness
Symptom feature of Major Depressive Disorder characterized by severe anhedonia, early morning awakening, weight loss, and profound feelings of guilt (often over trivial events)
With Atypical Features
With Melancholic Features
With Psychotic Features
None of the above
With Melancholic Features
Percentage of patients with Major Depressive Disorder who commit suicide
10 to 15
15 to 20
20 to 30
None of the above
10 to 15
The DSM-5 criteria specify that patients with rapid cycling bipolar l disorder must have at least how many episodes within a 12-month period?
2
1
3
4
4
Hallmark of a manic episode
elevated, expansive, or irritable mood
decreased need for sleep
flight of ideas
increase in goal-directed activity
elevated, expansive, or irritable mood
Which of the following distinguishes Bipolar ll from Bipolar l Disorder
hypomanic episodes
major depressive episodes
obsessive-compulsive symptoms
none of the above
hypomanic episodes
As to general description, the most common symptom of depression
generalized psychomotor retardation
hand wringing
hair pulling
none of the above
generalized psychomotor retardation
A peculiar triangle-shaped fold in the nasal corner of the upper eyelid often associated with depression
Veraguth’s fold
Freud’s fold
Klein’s fold
None of the above
Veraguth’s fold
About 50 to 75 percent of all depressed patients have a cognitive impairment, sometimes referred to as
Subcortical dementia
Depressive pseudodementia
Alzheimer’s Disease
Huntington’s Disease
Depressive pseudodementia
An untreated depressive episode lasts
1 to 3 months
3 to 5 months
6 to 13 months
None of the above
6 to 13 months
An untreated manic episode lasts about
1 week
1 month
3 months
None of the above
3 months
Bipolar I disorder most often starts with depression
True
False
True
Most patients experience both depressive and manic episodes, although 10 to 20 percent experience only manic episodes
True
False
True
percentage of patients with an initial diagnosis of major depressive disorder who develop a manic episode ( usually 6 to 10 years after the first depressive episode)
5 to 10 percent
15 to 20 percent
25 to 30 percent
none of the above
5 to 10 percent
Characteristics of Anxiety
an alerting signal
warns of impending danger
enables a person to take measures to deal with a threat
all of the above
all of the above
Fear is a response to a threat that is
known
internal
vague
conflictual
known
Anxiety is a response to a threat that is
known
external
definite
conflictual
conflictual
Peripheral manifestation of anxiety
feeling of impending doom
fear of “going crazy”
palpitations
fear of dying
palpitations
