Halter chapter 14

Question 1

Disruptive mood dysregulation disorder

Answer 1

individuals need to exhibit the irritability, anger, and temper tantrums in at least two of these settings: home, school, and with peers.

Question 2

bipolar diagnosis as an adolescent

Answer 2

most of the young people who received a diagnosis of bipolar did not go on to exhibit classic bipolar symptoms as adults. In fact, most children and adolescents once diagnosed with bipolar disorder actually converted to major depressive disorder or an anxiety disorder in adulthood.

Question 3

Persistent depressive disorder

Answer 3

diagnosed when feelings of depression occur most of the day, for the majority of days. These low-level depressive feelings last at least 2 years in adults and 1 year in children and adolescents.

Question 4

Premenstrual dysphoric disorder

Answer 4

It refers to a cluster of symptoms that occur in the last week before the onset of a woman’s period. Premenstrual dysphoric disorder causes problems severe enough to interfere with the ability of a woman to work or interact with others.

swings, irritability, depression, anxiety, feeling overwhelmed, and difficulty concentrating.

include lack of energy, overeating, hypersomnia or insomnia, breast tenderness, aching, bloating, and weight gain.

Question 5

Substance/medication-induced depressive disorder

Answer 5

a depressive disorder, such as major depressive disorder, that is a result of prolonged use of or withdrawal from drugs and alcohol.

Question 6

Depressive disorder due to another medical condition

Answer 6

may be caused by disorders that affect the body’s systems or from long-term illnesses that cause ongoing pain.

Question 7

Major depressive disorder

Answer 7

characterized by a persistently depressed mood lasting for a minimum of 2 weeks.The length of a depressive episode may be 5 to 6 months

Question 8

bereavement exclusion

Answer 8

until recently clinicians were advised against diagnosing a person with depression in the first 2 months following a significant loss.

Question 9

Depression and Grieving

Answer 9

People who experience a significant loss can exhibit feelings and behaviors similar to depression. They may cry, feel hopeless about the future, have disruptions in eating and sleeping, and lose pleasure in everyday activities.

Question 10

leading cause of disability in the United States

Answer 10

Major depressive disorder

Question 11

stats

Answer 11

Nearly 3 million (about 11%) individuals between 13 and 18 years of age experienced depression in 2014

Question 12

Comorbidity

Answer 12

frequently accompanies other psychiatric problems such as schizophrenia, substance abuse, eating disorders, schizoaffective disorder, and borderline personality disorder. The combination of anxiety and depression is perhaps one of the most common psychiatric presentations.

Question 13

risk factors

Answer 13

The high variability in symptom manifestation, response to treatment, and course of the illness supports the supposition that depression may result from a complex interaction of causes.

Question 14

Genetic

Answer 14

genetic factors play a role in the development of depressive disorders.

Question 15

Primary Risk Factors for Depression

Answer 15

• Female gender
• Adverse childhood experiences
• Stressful life events
• First-degree family members with major depressive disorder
• Neuroticism (a negative personality trait characterized by anxiety, fear, moodiness, worry, envy, frustration, jealousy, and loneliness)
• Other disorders such as substance use, anxiety, and personality disorders
• Chronic or disabling medical conditions

Question 16

Two of the main neurotransmitters involved in mood

Answer 16

serotonin and norepinephrine

Question 17

biochemical

Answer 17

Research suggests that depression results from the dysregulation of a number of neurotransmitter systems beyond serotonin and norepinephrine.

Question 18

hormonal

Answer 18

hyperactivity of the hypothalamic-pituitary-adrenal cortical axis. People with major depression have increased urine cortisol levels and elevated corticotrophin-releasing hormone.

Question 19

inflammation

Answer 19

Inflammation is the body’s natural defense to physical injury. There is growing evidence that inflammation may be the result of psychological injury as well.

Question 20

Diathesis-Stress Model

Answer 20

takes into account the interplay between genetic and biological predisposition toward depression and life events. The physiological vulnerabilities such as genetic predispositions, biochemical makeup, and personality structure are referred to as a diathesis.

Question 21

Cognitive Theory

Answer 21

Cognitive theorists believe that people may acquire a psychological predisposition to depression due to early life experiences. These experiences contribute to negative, illogical, and irrational thought processes that may remain dormant until they are activated during times of stress

Question 22

Assessment in Children and Adolescents

Answer 22

The core symptoms of depression in children and adolescents are the same as for adults, which are sadness and loss of pleasure. What differs is how these symptoms are displayed.

adolescents may engage in substance abuse or sexual promiscuity and be preoccupied with death or suicide.

Question 23

general assessment

Answer 23

Assessment tool

Question 24

suicidal ideation.

Answer 24

passive fantasies are thoughts of wanting to die

Question 25

suicide

Answer 25

Patients diagnosed with major depressive disorder should always be evaluated for suicidal ideation. Risk for suicide is increased when depression is accompanied by hopelessness, substance use problems, a recent loss or separation, a history of past suicide attempts, and acute suicidal ideation.

Question 26

key assessment findings

Answer 26

anxiety
slow thinking
bad memory and concentration
dwell on and exaggerate their perceived faults and failures and are unable to focus on their strengths and successes.
Feelings of worthlessness, hopelessness, guilt, anger, and helplessness are common.

Question 27

anhedonia

Answer 27

Inability to feel pleasure

Question 28

seen together

Answer 28

Depression and chronic pain

Question 29

Affect

Answer 29

is the outward representation of a person’s internal state of being and is an objective finding based on the nurse’s assessment.

Question 30

physical signs

Answer 30

A person who has depression sees the world through gray-colored glasses. Posture is poor, and the patient may look older than the stated age. Facial expressions convey sadness and dejection, and the patient may have frequent bouts of weeping.

Question 31

thought process

Answer 31

the person’s ability to solve problems and think clearly is negatively affected. Judgment, or the ability to make reasonable decisions, is poor.

Question 32

Mood

Answer 32

Mood is the patient’s subjective experience of sustained emotions or feelings.

Question 33

Feelings

Answer 33

Feelings frequently reported by those with depression include worthlessness, guilt, helplessness, hopelessness, and anger.

Question 34

Cognitive Changes

Answer 34

Helplessness is demonstrated by a person’s inability to solve problems in response to common concerns

This feeling of utter hopelessness can lead people to view suicide as a way out of constant mental pain.

Anger and irritability are natural outcomes of profound feelings of helplessness.

Question 35

anergia

Answer 35

which refers to an abnormal lack of energy.

Question 36

psychomotor retardation

Answer 36

which movements are extremely slow, facial expressions are decreased, and gaze is fixed.

Question 37

psychomotor agitation

Answer 37

manifested in pacing, nail biting, finger tapping, or engaging in some other tension-relieving activity. Subjectively, patients commonly feel fidgety and unable to relax.

Question 38

Vegetative signs of depression

Answer 38

refer to alterations in those activities necessary to support physical life and growth

Question 39

Change in sleep pattern

Answer 39

cardinal sign of depression. Often, people experience insomnia, wake frequently, and have a total reduction in sleep, especially deep-stage sleep

Question 40

Appetite changes

Answer 40

vary in individuals experiencing depression. Appetite loss is common, and sometimes patients can lose up to 5% of their body weight in less than a month

Question 41

Changes in bowel habits

Answer 41

Constipation is seen most frequently in patients with psychomotor retardation. Diarrhea occurs less frequently, often in conjunction with psychomotor agitation or anxiety.