Chapeter 7 Emotional and Mental Well being Assessment and Interventions Flashcards
- Which of the following statement are true?
A. 70% on Primary care provider visits are related to stress and lifestyle
B. When people are stress and overwhelmed, they are more likely to engage in healthy habits.
C. Chronic stress may lead to activation of the immune system and long-term organ and tissue repair.
D. In one Finnish study 3-4 hours of overtime a day increased heart disease risk.
E. In a study, work stressors increased the incidence of type 2 DM by 2-fold in men.
Answer: 1. A D E
B less likely
C suppression of immune system and long-term organ and tissue damage
E women
- The following unhealthy behaviours results from job characteristics except:
A. Stress
B. Smoking
C. Physical activity
D. Unhealthy diet
E. Heavy alcohol use
- C
- Unhealthy behaviours increase the risk of HT and Obesity which may lead to the following risk factor for CVD except
A. Sleep problems
B. Increased heart rate variability
C. Inflammation
D. Hypocoagulability and atherosclerosis
E. Decreased immune system functioning
F. Increased cortisol (HPA axis) and catecholamine production
- B and D Its decreased heart rate variability and hypercoagulability
- Perceived stress scale assessment: the following are true
A. It is a 10-item questionnaire devised by psychologist Dr Sheldon Cohen in 1983
B. The higher the total score, the more perceived stress one is under.
C. Score 0f 0-13 is low stress
D. Score of 27-40 is moderate stress
- D 14-26 is moderate stress and 27-40 is high stress
- In relation to screening for depression the following statement/s is/are false:
A. The grade B USPSTF 2016 recommendation is to screen the general population including pregnant and postpartum women excluding adolescents 12-18 years of age for depression in primary care setting that have adequate support systems in place.
B. PHQ-2 screening questions with score is >3= is a negative screen.
C. PHQ-2 sensitivity is 85% and specificity is 72%
D. A positive screen requires further assessment with the PHQ-9 or Hamilton depression scale (HAM-D) or Beck Depression inventory (BDI-II)
E. Diagnosis of major depressive disorder is made based on American Psychiatric Association Diagnostic and Statistical Manual (DSM-5) Criteria
F. Spanish speaking Latinos are less likely to endorse crying versus English speaking Latinos.
- A, B, C, F A; Adolescents are included B; its positive screen C; 72% sensitivity and 85% specificity F; Spanish speaking Latinos are more likely to endorse crying vs English speaking Latinos
- Screening for Generalized Anxiety Disorder (GAD) which is/are not true
A. It is important to rule out anxiety before concluding symptoms are due to stress.
B. USPSTF currently has specific recommendations on anxiety screening.
C. A score of >3= is a positive screen to be followed up by HAM-A, GAD-7, DSM-5 or Beck Anxiety Inventory (BAI) diagnostic Criteria.
D. PHQ-4 is a brief screening for depression and anxiety.
E. A score of 6-8 is severe anxiety and depression
- B and E B; no specific recommendation by the USPSTF E: score of 0-2= normal, 3-5= mild, 6-8= moderate, 9-12= severe
- In relation to emotional distress and poor health, modifiable risk factor include:
A. Stress, Nutrition, Environment
B. Genetics and perinatal infection
C. Sedentary lifestyle, Lack of light exposure, Addictions
D. Social cultural, economic, and political factors
- A and C but Band D are non-modifiable
- There is over 100 potential causes of clinical depression and anxiety disorders that can be categorised into 10 categories. Among these nutritional causes include all except:
A. Not enough folate
B. Too less arachidonic acid
C. Not enough tryptophan, tyrosine, and antioxidants
D. Deficient in Omega-3
- B it is too much Arachidonic acid
- The relationship between mental illness and chronic disease which statements are false:
A. Depression and diabetes have a unidirectional association.
B. Depression is associated with increased risk of cardiac disease, stroke, cancer, and diabetes.
C. Poorer emotional health was associated with positive perceptions of diabetes including perceptions about the seriousness of the illness and the severity of the consequences.
D. Insulin therapy, duration of diabetes and unsatisfactory glycaemic control (HbA1c >=6.5) are risk factors for suicidal ideation in individuals with diabetes.
- A and C A; Bidirectional C: Negative perceptions
- Coronary Artery disease and Emotional Health which option/s is/are false:
A. Depression increases cardiac risk by 15-20% in patients with coronary artery disease
B. Depression is a non- modifiable risk factor for CAD that generally precedes CAD by several months.
C. Major depressive disorder and GAD predicted increased risk from cardia death, MI, cardiac arrest, and non-elective revascularisation over a 2 year follow up.
D. Patients with depression suffer from increased heart rate variability.
E. Treatment of depression improves survival in CAD.
F. Optimal treatment includes medication, psychotherapy, CBT, and reversal of associated lifestyle risk factors.
- B, D and E. B: modifiable and several years D: decreased heart rate variability E: treatment improves symptoms and quality of life. There are no clear findings regarding survival.
- Non-pharmacological stress management plans include all except:
A. Light therapy especially red light
B. Abdominal breathing
C. Expressive and creative pursuits such as movement or dance, playing a musical instrument, singing, and creating art.
D. Massage
E. Tai Chi
F. Bibliotherapy (The use of books with the intent to bring medical and psychological healing) and self-help websites
G. Volunteering for meaningless causes
H. Spiritual and religious activities
I. Regular time indoors
J. Mindful exercises, meditation, relaxation, and time for contemplation
K. Physical exercise.
- A G I A; blue light G: meaningful causes I: outdoor in nature
- Healthy coping skills for emotional well-being are all except:
A. Learning cognitive behavioural skills
B. Developing problem solving skills
C. Improving one’s sense of humour
D. Learning time management Techniques
E. Improving frustration tolerance via CBT techniques
F. Improving artificial intelligence
- F its emotional intelligence
- The following statements are false except:
A. Exercise is more effective in depression treatment when compared with psychological or pharmacological therapies.
B. SSRIs/SNRIs are second line treatment for depression.
C. Refined grains, sugar and meat are associated with an increased risk of anxiety.
D. Meat, Fish, and eggs are rich in arachidonic acid which is associated with less depression.
E. Adults who eat fast food are 40% more likely to develop depression that those who avoid fast food.
F. Diets higher in trans fats were associated with increased risk of depression.
G. Among childbearing age women deficiencies of folate, B12, Ca, Iron, Zn, Selenium, and omega 3 fatty acids were more common among depressed Vs non depressed women.
H. Supporting patients’ autonomy and promoting patients’ self-efficacy are tips for supportive provider-patient relationship.
I. In ABC model for CBT A: action B: beliefs C: complications
- E, F, G, H A: exercise is not more effective B: First line C: risk of depression D: These foods are risk on arachidonic acid leading to inflammation to and increase risk of depression I: C is consequences not complications.
- The provider’s role in promoting activities for emotional well-being are following except:
A. Help the patients with self-management
B. Help patients to focus on events that can’t be changed
C. Help with treatment plans
D. Help to prepare relapse prevention plan
E. Celebrate success
- B cognitive restructuring is to not to focus on events that can’t be changed. Find another way to look at the situation.
- In relation to Positive psychology which options are false:
A. The ideal ratio of positive to negative emotions is 5:1
B. When ratio of emotions is below 3:1; Its likely people will be able to overcome the obstacles at the current time.
C. Experiencing contentment with the past, happiness in the present, hope for the future.
D. Only about one third of adults know what their strengths are.
E. Thinking about the sad days in one’s life frequently is one the practical techniques of positive psychology.
- A, B, E A: ideal ratio 3:1 B: unlikely people will be able to overcome obstacles E: It’s happiest days
