2nd bm Flashcards
valve prolapse id the same as the prevalence of panic disorder inpatients without mitral valve prolapse
True
False
True
for Panic Disorder
All of the above
Mitral Valve Prolapse
Epilepsy
Asthma
All of the above
The lifetime prevalence of specific phobia is about
10 percent
1 percent
0.1 percent
15 percent
10 percent
Psychodynamic themes in Panic Disorder
All of the above
Physical or emotional separation from significant person both in childhood and in adult life
Difficulty tolerating anger
Perception of parents as controlling, frightening, critical, and demanding
All of the above
often in persons without close interpersonal relationships and in those who are divorced or separated.
True
False
True
An untreated depressive episode lasts
None of the above
1 to 3 months
3 to 5 months
6 to 13 months
6 to 13 months
The environmental stressor most often associated with the onset of an episode of depression is
Unemployment
losing a parent before age 11 years
the loss of a spouse
all of the above
the loss of a spouse
Patients with generalized anxiety disorder frequently develop major depressive disorder
True
False
True
According to the National Comorbidity Study the lifetime prevalence of anxiety disorder in men
None of the above
30.5 percent
17.7 percent
19.2 percent
19.2 percent
Behavioral theories of postulate that anxiety is
a conditioned response to a specific environmental stimulus
response to the perceived void in existence and meaning
none of the above
a signal of the presence of danger in the unconscious
a conditioned response to a specific environmental stimulus
True regarding anxiety
all of the above
to deal with a threat
warns of impending danger
an alerting signal
all of the above
Unipolar disorder is typically the most common form of mood disorder in families of bipolar probands
True
False
True
The correlation studies between the downregulation or decreased sensitivity of β- adrenergic receptors and clinical indicating a direct role for this biogenic amine in depression
Histamine
Dopamine
Norepinephrine
Serotonin
Norepinephrine
As many as 20 percent of patients actually have syncopal episodes during a panic attack
True
False
True
Patients with only major depressive episodes are said to have
bipolar ll disorder
major depressive disorder or unipolar depression
bipolar l disorder
all of the above
major depressive disorder or unipolar depression
Fear is a response that is
known
conflictual
internal
vague
known
True regarding clinical features of Panic Attack
impending death and doom
all of the above
the first panic attack is often completely spontaneous
physical signs often include tachycardia, palpitations, dyspnea, and sweating
all of the above
Hallmark of a manic episode
elevated, expansive, or irritable mood decreased need for sleep
more talkative than usual
flight of ideas
elevated, expansive, or irritable mood
For a diagnosis of Major Depressive Disorder to be made, how long should the depressive episode last
At least 2 weeks
3 to 4 days
at least 5 days
At least 1 week
At least 2 weeks
For a diagnosis of Bipolar l Disorder to be made, a manic episode must last
At least 2 weeks
at least 5 days
At least 1 week
3 to 4 days
At least 1 week
The lifetime prevalence of panic disorder is
None of the above
10 to 15 percent
5 to 10 percent
1 to 4 percent
1 to 4 percent
A role of this neurotransmitter in anxiety disorders is most strongly supported by the undisputed efficacy of benzodiazepines
GABA
None of the above
Galanin
Neuropeptide Y
GABA
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
Fear
Mood
Anxiety
Affect
Mood
**
True regarding co- morbidity with Generalized Anxiety Disorder
All of the above
most often coexists with another mental disorder, usually social phobia, specific phobia, panic disorder, or a depressive disorder
As many as 25 percent of patients
50 to 90 percent of patients have another mental disorder
All of the above
True statements regarding co-morbidity of Panic Disorder
two-thirds first experience panic disorder during or after the onset of major depression
one-third have major depressive disorder before onset
91 percent have at least one other psychiatric disorder
all of the above
two-thirds first experience panic disorder during or after the onset of major depression
As to general description, the most common symptom of depression
hand wringing
hair pulling
none of the above
generalized psychomotor retardation
generalized psychomotor retardation
Essential characteristic/s of generalized anxiety disorder
all of the above
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
Family data indicate that if one parent has a mood disorder, a child will have a risk of between ________ percent for mood disorder
50 and 75 %
80 to 90 %
30 and 50 %
10 and 25 %
10 and 25 %
Benzodiazepines have the most rapid onset of action against panic, often within the first week, and they can be used for long periods without the development of tolerance to the anti-panic effects. These include the following, EXCEPT
Diazepam
Escitalopram
Alprazolam
Clonazepam
Escitalopram
The biogenic amine neurotransmitter most commonly associated with depression’
Serotonin
Histamine
Norepinephrine
Dopamine
Serotonin
Increasing evidence also indicates that mood-stabilizing drugs act on
None of the above
G proteins or other second messengers
Dopamine
Serotonin
G proteins or other second messengers
Drugs approved by the US Food and Drug Administration (FDA) for the treatment of panic disorder
Alprazolam (Xanax)
Paroxetine (Paxil)
Both a and b only
A only
Both a and b only
Effective drug/s for the treatment of social anxiety disorder include
all of the above
SSRIs
Benzodiazepines
Venlafaxine (Effexor)
all of the above
The two major schools of thought about psychosocial factors leading to the development of generalized anxiety disorder are the cognitive-behavioral school and the psychoanalytic school. The cognitive-behavioral school hypothesizes that anxiety is a symptom of unresolved, unconscious conflicts
True
False
True
The twin data provide compelling evidence that genes explain only 50 to70 percent of the etiology of mood disorders. Considering unipolar and bipolar disorders together, these studies find a concordance rate for mood disorder in same-sex dizygotic (DZ) twins of
40 to 60 %
16 to 35 %
70 to 90 %
None of the above
16 to 35 %
Anxiety is a response to a threat that is
Known
Conflictual
External
definite
Conflictual
The prevalence of anxiety disorders decreases with higher socioeconomic status
True
False
True
Freud believed that anxiety is
a conditioned response to a specific environmental stimulus response to the perceived void in existence and meaning
a signal of the presence of danger in the unconscious
none of the above
a signal of the presence of danger in the unconscious
Fear of heights
Acrophobia
Cynophobia
Xenophobia
Mysophobia
Acrophobia
The psychoanalytic school hypothesizes that patients with generalized anxiety disorder respond to incorrectly and inaccurately perceived dangers
True
False
True
True statements regarding the course and prognosis of generalized anxiety disorder
only one-third of patients seek psychiatric treatment
most patients with the disorder report that they have been anxious for as long as they can remember
all of the above
many go to general practitioners, internists, cardiologists, pulmonary specialists, orgastroenterologists, seeking treatment for the somatic component of the disorder
all of the above
Other neurotransmitter disturbances in mood disorders involve Acetylcholine. Cholinergic agonists can produce lethargy, anergia, and psychomotor retardation in healthy subjects, can exacerbate symptoms in depression, and can reduce symptoms in mania
True
False
True
minimum number of symptoms needed in order to make a diagnosis of Major Depressive Disorder?
2
3
4
5
5
The most compelling data indicate that the life event most often associated with development of depression is
all of the above
losing a parent age 11 years
unemployment
the loss of a spouse
losing a parent age 11 years
most patients with Bipolar l Disorder experience both depressive and
manic episodes, although 10 to 20 percent experience only manic episodes
True
False
True
Which of the following statements regarding sex distribution in mood disorders is/are true:
All of the above
bipolar I disorder has an equal prevalence among men and women
twofold greater prevalence of major depressive disorder in women than in men
Manic episodes are more common in men, and depressive episodes are more common in women
All of the above
Recent epidemiological data suggest that the incidence of major depressive disorder may be increasing among people younger than 20years of age. This may be related to
none of the above
increased use of alcohol and drugs of abuse
effects of childbirth
hormonal differences
increased use of alcohol and drugs of abuse
Research has demonstrated that stressors that the patient experiences as reflecting negatively on his or her self- esteem are more likely to produce depression
True
False
True
Existential theories postulate that anxiety is
none of the above
response to the perceived void in existence and meaning
a signal of the presence of danger in the unconscious
a conditioned response to a specific environmental stimulus
response to the perceived void in existence and meaning
Situation in which Agoraphobia can occur
in an enclosed space
all of the above
in an open space
using public transportation
all of the above
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
Respiratory panic-inducing substances cause respiratory stimulation and a shift in the acid–base balance. These include
carbon dioxide (5 to 35 percent mixtures)
sodium lactate
Bicarbonate
all of the above
all of the above
Neurochemical panic- inducing substances
Bicarbonate
sodium lactate
carbon dioxide (5 to 35 percent mixtures)
none of the above
none of the above
According to the National Comorbidity Study the lifetime prevalence of anxiety disorder in women
17.7 percent
None of the above
30.5 percent
19.2 percent
30.5 percent
A peculiar triangle-shaped fold in the nasal corner of the upper eyelid often associated with depression
None of the above
Freud’s fold
Klein’s fold
Veraguth’s fold
Veraguth’s fold
Most frequent disorders associated with major mood disorders
panic disorder obsessive-compulsive disorder (OCD)
all of the above
alcohol abuse or dependence
all of the above
The only social factor identified as contributing to the development of panic disorder is
financial ruin
none of the above
a death in the family
a recent history of divorce or separation
a recent history of divorce or separation
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
Whether an event is perceived as stressful depends on the nature of the event and on the person’s resources, psychological defenses, and coping mechanisms
True
False
True
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
Charles Darwin
None of the above
Jacob Mendes DaCosta
Sigmund Freud
Jacob Mendes DaCosta
Fear of dogs
Mysophobia
Xenophobia
Cynophobia
Acrophobia
Cynophobia
Fear of strangers
Cynophobia
Acrophobia
Mysophobia
Xenophobia
Xenophobia
Modern affective neuroscience focuses on the importance of four brain regions in the regulation of normal emotions, EXCEPT:
prefrontal cortex (PFC)
hippocampus
anterior cingulate
cerebellum
cerebellum
Bipolar I disorder most often starts with depression
True
False
True
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
psychotic symptoms that are in harmony with the mood disorder (“I deserve to be punished because I am so bad”)
mood congruent
mood incongruent
mood congruent
The autonomic nervous systems of some patients with panic disorder have been reported to
to respond excessively to moderate stimuli
all of the above
adapt slowly to repeated stimuli exhibit increased sympathetic tone
all of the above
Fear of dirt and germs
Acrophobia
Cynophobia
Mysophobia
Xenophobia
Mysophobia
These areas have become the focus of much hypothesis- forming about the neuroanatomical substrates of anxiety disorders
Locus ceruleus
Raphe nuclei
Both a and b
Only a
Both a and b
Diagnosis of Panic Disorder
1 month or more of persistent concern or worry about additional panic attacks
A significant maladaptive change in behavior related to the attacks
Recurrent unexpected panic attacks
All of the above
All of the above
The following statements regarding socioeconomic and cultural factors in mood disorder is/are true
Bipolar I disorder is more common in persons who graduated from college Depression is more common in urban areas
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
No correlation has been found between socioeconomic status and major depressive disorder
Lifetime prevalence for social anxiety disorder
30 percent
none of the above
3 to 13 percent
0.3 to 1.3 percent
3 to 13 percent
This theory of depression connects depressive phenomena to the experience of uncontrollable events
Classical
None of the above
Cognitive
Learned helplessness
Learned helplessness
Fear of cats
Hydrophobia
Ailurophobia
Pyrophobia
Zoophobia
Ailurophobia
Has been demonstrated to be involved in a number of physiological and behavioral functions, including learning and memory, pain control, food intake, neuroendocrine control, cardiovascular regulation, and, most recently, anxiety
Galanin
None of the above
GABA
Neuropeptide Y
Galanin
Psychodynamic therapy proceeds with the assumption that anxiety can increase with effective treatment. The goal of the dynamic approach maybe to increase the patient’s anxiety tolerance (a capacity to experience anxiety without having to discharge it), rather than to eliminate anxiety
True
False
True
Panic attacks generally lasts 20 to 30 minutes and rarely more than an hour
True
False
True
Patients with agoraphobia rigidly avoid situations in which it would be difficult to obtain help
True
False
True
Mean age of onset for major depressive disorder is about
50 years
20 years
30 years
40 years
40 years
symptom feature of Major Depressive Disorder characterized by severe anhedonia, early morning awakening, weight loss, and profound feelings ofguilt (often over trivial events)
None of the above
With Melancholic Features
With Atypical Features With Psychotic Features
With Melancholic Features
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
percentage of patients with Major Depressive Disorder who commit suicide
20 to 30 %
10 to 15 %
15 to 20 %
None of the above
10 to 15 %
Most theories of mania view manic episodes as a defense against underlying depression
True
False
True
The lifetime prevalence rate for Bipolar l disorder
0.3-4.8 %
1.5-17 %
1 percent
0-2.4 %
0-2.4 %
In patients with Panic Disorder
2 to 15 to 30 percent have generalized anxiety disorder
15 to 30 percent have social anxiety disorder or social phobia
All of the above
All of the above
The National Comorbidity Study reported that
women are more likely to have an anxiety disorder than are men
there is a 12-month prevalence rate of 17.7 percent
all of the above
one of four persons met the diagnostic criteria for at least one anxiety disorder
all of the above
Mean age of onset for Bipolar l disorder
30 years
20 years
50 years
40 years
30 years
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
The lifetime prevalence rate for major depression
0-2.4 %
0.3-4.8 %
5-17 %
1 percent
5-17 %
Has counterregulatory effects on corticotropin releasing hormone (CRH)and Locus Ceruleus-Norepinephrine systems at brain sites that are important in the expression of anxiety, fear, and depression
None of the above
Galanin
Neuropeptide Y
GABA
Neuropeptide Y
The three major neurotransmitters associated with anxiety on the bases of animal studies and responses to drug treatment are
dopamine, glycine, glutamate
norepinephrine (NE), serotonin, and γ- aminobutyric acid (GABA)
none of the above
dopamine, glycine, neuropeptide Y
norepinephrine (NE), serotonin, and γ- aminobutyric acid (GABA)
Various studies have found that the first-degree relatives of patients with panic disorder have a four- to eightfold higher risk for panic disorder than first-degree relatives of other psychiatric patients
True
False
True
About 50 to 75 percent of all depressed patients have a cognitive impairment, sometimes referred to as
Depressive pseudodementia
Alzheimer’s Disease
None of the above
Subcortical dementia
Depressive pseudodementia
An untreated manic episode lasts about
3 months
None of the above
1 week
1 month
3 months
Peripheral manifestations of anxiety
Palpitations
Restlessness
All of the above
Diarrhea
All of the above
The twin data provide compelling evidence that genes explain only 50 to70 percent of the etiology of mood disorders.
Considering unipolar and bipolar disorders together, these studies find a concordance rate for mood disorder in the monozygotic (MZ) twins of
40 to 60 %
70 to 90 %
None of the above
16 to 35 %
70 to 90 %
The experience of anxiety has two components: the awareness of the physiological sensations (e.g., palpitations and sweating) and the awareness of being nervous or frightened
True
False
True
In 1854, Jules Falret described this condition in which patients experience alternating moods of depression and mania
folie impose
folie circulaire
none of the above
folie a deux
folie circulaire
According to cognitive theory, depression results from specific cognitive distortions present in persons susceptible to depression. These distortions, referred to as ________, are cognitive templates that perceive both internal and external data in ways that are altered by early experiences
Anxiety
Hallucinations
depressogenic schemata
learned helplessness
depressogenic schemata
