Test 2

Question 1

projective personality tests

Answer 1

personality assessment - given ambiguous stimuli & asked to interpret what the stimulus means
- the projective hypothesis: as the stimulus materials are unstructured, the client’s responses will be determined by unconscious processes and will reveal
their true attitudes, motivations, &
behaviours

Question 2

the rorschach inkblot test

Answer 2

designed hundreds of inkblots
* Tested them on 400+ subjects
* Claimed that the blots could be
used to diagnose mental illness
* He eventually settled on 15 blots
that gave the best results
* Eliminated 5 more and published
the 10 in a book called
“Psychodiagnostik” in 1921

Question 3

thematic apperception test

Answer 3

a projective test for the assessment of children and adults b/c it utilizes images to gather info regarding a person’s feelings, conflicts, & desires

Question 4

Measuring intelligence: the Binet Scales

Answer 4

Alfred Binet originally constructed mental tests to help school board predict which children were in need of special schooling.
*An intelligence test, often referred as an IQ
(intelligence quotient) test, is a standardized means of assessing a person’s current mental abilitie

Question 5

The 1905 Simon-Binet Test

Answer 5

30 tasks or tests of increasing difficulty
(no measuring unit–just roughly categorized people)
- Idiots (most severe intellectual
impairment)
- Imbeciles (moderate impairment)
- Morons (mildest impairment)
Norms were based on a sample
of only 50 children

Question 6

The Wechsler Adult Intelligence Scale (WAIS)

Answer 6

First developed in 1937 b/c of criticisms w/ newer versions of the Binet scales.
- Administered w/ an experienced clinician
- Performance based
- Assesses full IQ and various subscales
- The FSIQ is composed by four scores & a general intelligence index
The four indexes are: Verbal Comprehension Scale, Perceptual Reasoning Scale, Working Memory Scale, and Processing Speed Scale. Every index is composed by two or three subtest that are required to obtain the total IQ score.

Question 7

Verbal Comprehension Scale - Core & Supplemental Subsets

Answer 7

Core:
- Similarities (what likeness 2 diff words have)
- Vocabulary (words to define)
- Information (subtest about general knowledge)
Supplemental:
- Comprehension (questions about social situations)

Question 8

Perceptual Reasoning Scale - Core & Supplemental Subsets

Answer 8

Core:
- Block design (timed test to copy presented model w/ the use of blocks)
- Matrix reasoning (series of pics, asked to fill in missing detail)
- Visual puzzles
Supplemental:
- Picture completion (points/names missing part of pic)
- Figure weights

Question 9

Working Memory Scale - Core & Supplemental Subsets

Answer 9

Core:
- Digit span (series of #s, asked to repeat either in sequence or reverse order)
- Arithmetic (timed oral questioning of arithmetic questions)
Supplemental:
- Letter-number sequencing (given series of letters & digits, report back the stimuli w/ the letters in alphabetical & digits in ascending numerical order)

Question 10

Processing Speed Scale - Core & Supplemental Subsets

Answer 10

Core:
- Symbol search (row of symbols & “target” symbol, asked if target symbol is present in each row)
- Coding (timed subtest, asked to write a digit-symbol code)
Supplemental:
- Cancellation (random pictures, mark target symbols given under time pressure)

Question 11

Self-report scales

Answer 11

Most common assessment tool
(Come in several formats)
⚬ Self-assessment on a 5-point Likert
scale (Strongly Disagree to Strongly
Agree)
⚬ Trait selection (Yes/No)
⚬ Symptom frequency
*Can be self-administered or administered
in a clinical setting
*Validity and reliability can vary
*Are in-line with current evidence and DSM
criteria

Question 12

Behavioural Cognitive Assessment & Case Formulation

Answer 12

Cognitive-behavioural case formulation:
hypothesis that ties together, in a brief narrative or diagram, the mechanisms that cause & maintain all of the patient’s problems, the origins of the mechanisms; & the precipitants that are currently activating the mechanisms to cause the problems.

Question 13

Biological Assessments and Brain Imaging

Answer 13

• CT or CAT Scan (Computerized axial tomography): uses X-ray tech to produce detailed images of very thin slices of the inside of the body
• MRI (Magnetic Resonance Imaging): uses strong magnetic fields & radio waves to produce detailed images of the inside of the body; produces higher quality images than a CT & doesn’t rely on radiation
• fMRI (Functional Magnetic Resonance Imaging): Allows for MRI images to be taken so quickly that metabolic changes can be measured, providing a picture of the brain at work rather than of its structure alone
• PET (Positron Emission Tomography): the PET scan uses a radioactive drug (tracer) to show both normal & abnormal metabolic activity

Question 14

DSM Classification System

Answer 14

Diagnostic & Statistical Manual (DSM) of the American Psychiatric Association:
- Covers all categories of mental health disorders
- No identification of symptoms
- DSM-III (first to provide clear direction on classification of symptoms)
- Nearly 300 mental disorders listed in the DSM-5-TR in 22 major categories

Question 15

Goals for DSM-5

Answer 15

• Address gaps in diagnoses
• Update criteria based on new research knowledge
• Reduce number of Not Otherwise Specified (NOS) classifications b/c too generic
• Add dimensions to categorical system
  Categorical (yes/no); Dimensional (add nuance - can scale symptoms)
• Streamline and simplify diagnoses (includes combining some disorders into one category); (new conceptualization for existing disorders) - E.g., OCD is no longer an anxiety disorder

Question 16

Controversies & the DSM-5

Answer 16

• Pathologizing normal human experience
  (E.g., Disruptive Mood Dysregulation Disorder is criticized as “temper tantrum disorder”); Bereavement can no longer exclude Major Depression – may over-diagnose normal grieving
• Lack of representation of certain disorders (E.g., internet addiction)
• Some disorders have been eliminated leading to issues in funding and access to resources (E.g., Asperger’s Syndrome – ppl w/ aspergers’ syndrome doesn’t have a diagnosed condition anymore and they’ll no longer provide resources for them because it “doesn’t exist”
• Ties to pharmaceutical companies

Question 17

Culture & Diagnosis

Answer 17

• Early editions of DSM were criticized for lack of consideration of culture and ethnicity.
• DSM-IV-TR introduced culture-bound syndromes: (E.g., Culture-bound syndromes eliminated in DSM-5 replaced with “cultural syndromes,” “cultural idioms,” and “cultural explanations”)
• DSM-5 elaborated four specific themes to be considered in making cultural formulation: 1) Cultural identity, 2)
  Cultural consideration of distress, 3) Cultural features of vulnerability & resilience, 4) Cultural features of the relationship between clinician & patient

Question 18

theory vs hypothesis

Answer 18

Theory: a well-developed set of ideas that aims to explain an observable phenomena
- primary goal of science is to advance theories to account for data, often by proposing cause–effect relationships
Hypothesis: a testable prediction or proposed explanation for an observable phenomenon

Question 19

Qualitative Research

Answer 19

quantitative looks at the specific, measurable changes in behaviour. But qualitative looks at what is the impact of a disorder on your daily life, what does it feel like & what is the depth of the experience.
*case studies - study of 1 individual
(case studies are useful for disproving aspects of a theory)

Question 20

nomothetic research

Answer 20

• measuring a group of people on a number of variables
• examines the relationship among the variables
• correlational methods are an example of nomothetic research
• variable centered
• research that uses data from a lg # of ppl to identify general trends & make predictions about human behavior; focused on using statistics, the scientific method, & group averages to understand human behavior

Question 21

idiographic research

Answer 21

• detailed understanding of the individual
• case studies & qualitative methods are examples of idiographic research
• person centred
• focuses on a complete, in-depth understanding of a single case (e.g. why do I not have any pets?)

Question 22

epidemiological studies

Answer 22

examines rates of occurrence of abnormal behavior in the population as a whole & in various subgroups: race, ethnicity, gender, age, or social class.
- provides a general picture of a disorder

Question 23

prevalence, incidence, & risk factors

Answer 23

Prevalence: Proportion of a pop. that has the disorder at a given point or period of time – how many ppl?
Incidence: The number of new cases of the disorder that occur in some period, usually a year – incident rate (e.g., 5% of ppl might be diagnosed w/ autism within a given year)
Risk factors: Conditions or variables that, if present, increases the likelihood of developing or worsening the disorder

Question 24

Basic Features of Experimental Study Methods

Answer 24

1. Researcher typically begins with an experimental hypothesis
2. Investigator chooses an independent variable (IV) that can be manipulated (different conditions – often experimental vs. control)
3. Participants are assigned to the conditions by random assignment
4. Researcher arranges for the measurement of a dependent variable (DV)
5. Analyze the data to determine if there has been an experimental effect

Question 25

Statistical significance in Experimental Research (within-group variance, between-group variance)

Answer 25

statistical significance is tested by dividing the between group variance by a
measure of the within-group variance.
When the avg. difference between the two groups is large relative to the
within-group variance, the result is more likely to be statistically significant.
- (you have control & manipulated group, need to look individually within those groups to measure their variance. Then, compare between the two groups to determine whether the manipulated ppl score higher than the ppl within the other group).

Question 26

assessing difference

Answer 26

use tests that allow us to compare the means of groups to see if the differences are statistically significant (meaningful). *Tests of statistical significance.
*p-value tells us how sure we can be that one thing is related to another or how sure we can be that two groups are different (the results are from group differences, not just random chance)
- P-value or Probability Statistic
E.g., happiness and parenting status - can we be sure they’re related?
- Effect size
E.g., parents vs not parents - can we be sure that these two groups are actually different?

Question 27

Effect Size and cohen’s d

Answer 27

use Cohen’s d to assess effect size when comparing the means (averages) of two experimental groups (e.g., treatment group vs. control group) or comparing two independent groups (e.g., men vs. women, before vs. after intervention).
- Basically, is there a big enough difference between the two peaks (a big enough impact) to matter

Question 28

single-blind & double-blind procedures

Answer 28

a. when the patient or client is unaware of what group they have been placed in (placebo or treatment)
b. when neither the researchers nor the clients are aware of who has been placed in the treatment or placebo control groups

Question 29

internal validity vs external validity

Answer 29

a. examines whether the study design, conduct, & analysis answer the research questions without bias (E.g., researchers randomize their participants, thus accounting for their biases)
b. can the results be generalized beyond immediate study? (E.g., Groups receiving treatment for depression were all white ppl w/ high paying jobs – can’t really take the results & attribute them to students in uni)

Question 30

confounders & analogue experiments

Answer 30

a. something that affects the result of a scientific experiment in a way that makes it less clear that one thing causes another
(E.g., passage of time could change scores on a stress scale; changes may not be due to the treatment)
b. the use of a related phenomenon (an analogue) in the lab behaviour is rendered temporarily abnormal through experimental manipulations (E.g., ppl have difficulty w/ memory during/following a panic attack; how do we actually study that - induce one & ask to do a memory task at diff times then compare to control group)

Question 31

meta analysis + limitations

Answer 31

review of many studies in order to determine the effects of treatment
- Examine published studies, combine the results into a common format & then determine the extent of improvement (effect size).
limitations: complicated process that requires decisions at each of numerous phases, results are difficult to interpret, need to take into account moderator variables

Question 32

illness vs no-illness

Answer 32

Illness: (you’re having serious impacts in your daily life due to chronic anxiety) you meet the criteria for a diagnosis even if you don’t want it
No illness: (You feel anxious sometimes – doesn’t mean you have anxiety disorder) no diagnosis because you don’t need one

Question 33

diagnosing a mental illness (intensity, duration, frequency)

Answer 33

Intensity: you could have only a discomfort w/ something or you could have a major intense reaction to it.
Duration & frequency: you could have these upset feelings after an upsetting life circumstance & they could be really intense for a bit but is it lasting awhile and is it very frequent?
*Your mental health condition needs to meet all the criteria; otherwise it could simply be attributed to something else that is distressing.

Question 34

anxiety disorders

Answer 34

Anxiety disorders are diff from ‘everyday anxiety’ in that the anxiety is disproportionate to the situation that elicited the anxious response (concerned about smtg that might happen in the future. The disorder comes in when there’s smtg that’s ambiguous or not even in the environment. But it also has to be chronic, cause significant distress for yourself or others, & disproportionate to the situation).

Question 35

components of anxiety

Answer 35

Physiological: heightened level of arousal and physiological activation (e.g., ↑ heart rate, shortness of breath, dry mouth
Cognitive: subjective perception of anxious arousal & associated cognitive processes
(e.g., worry & ruminations )
Behavioural: clinicians often add this component (e.g., ‘safety’ behaviours avoidance)

Question 36

prevalence of anxiety disorders

Answer 36

• the most common psychological disorders
• 16% of women; 9% of men suffered from anxiety disorders in the preceding year
• the highest one-year prevalence rates (i.e., almost 1 in 5) were found in women 15 to 24 years of age.
• more common in women than in men across all age groups

Question 37

separation anxiety

Answer 37

experience of excessive fear or anxiety concerning separation from those to whom they’re attached.
- children 6-12 month + toddlers prevalence in US is ~4%
- school-aged girls have higher prevalence rates than school-aged boys
- adolescents - 12 month prevalence rate in US is 1.6%
- adults - 12 month prevalence is the US ranges from 0.9% - 1.9%

Question 38

specific phobias

Answer 38

unwarranted fears caused by the presence or anticipation of a specific object/situation
- the fear & avoidance is out of proportion to the actual danger & is recognized by the sufferer as groundless
- the person suffers intense distress & social or occupational impairment b/c of the anxiety.
* Affects more women than men 2:1
- tend to be long-lasting (mean duration of 20 years)
- only 8% of ppl w/ a specific phobia
received treatment

Question 39

subtypes of phobias

Answer 39

• Blood-Injection-Injury
  ⚬ getting shot, donating blood, going
  to the doctor or dentist*, getting a
  needle
• Situations
  ⚬ enclosed spaces, elevators, planes
• Animals
  ⚬ insects, dogs, snakes
• Natural Environments
  ⚬ storms, water, heights
• Other
  ⚬ choking, vomiting, clowns
• most common specific phobia subtypes in
  order were:
  1. animal phobias (insects, snakes, & birds)
  2. heights
  3. being in closed spaces
  4. flying
  5. being in or on water
  6. going to the dentist
  7. seeing blood or getting an injection
  8. storms, thunder, or lightning

Question 40

social anxiety disorder

Answer 40

fearful or anxious about or avoidant of social interactions & situations that involve the possibility of being negatively evaluated by others.
* meeting unfamiliar people, situations where they may be observed eating or drinking, performing in front of others.
* Concerns that blushing, shaking, sweating will be observed by others
*Three types:
* Speaking or performing in public (e.g., piano recital)
* Social interactions (e.g., asking a store clerk for help)
* Being observed in public (e.g., sitting on a bus in rush hour)

Question 41

prevalence of social anxiety disorder

Answer 41

• onset takes place during adolescence,
  though can occur in children.
• prevalence of SAD was higher among ppl
  who had never married or were divorced, had not completed secondary education, had lower income or were unemployed, reported lacking adequate social support, reported low quality of life, or had a chronic physical condition

Question 42

Specific phobias & SAD: behavioural theories

Answer 42

theories about how someone develops phobias or social anxiety considers that the disorders are ‘learned’
* Avoidance conditioning
* Modeling
* Prepared learning
* Social Skills Deficits

Question 43

avoidance conditioning, modelling, & prepared learning

Answer 43

Avoidance conditioning: reactions are
learned avoidance responses that develop:
* via classical conditioning - neutral stimulus; (CS) is paired w/ frightening event
* via operant conditioning - fear is maintained; when person learns to reduce conditioned fear by escaping from or avoiding the CS
Modelling: person can learn fear through
imitating the reaction of others (vicarious
learning).
Prepared Learning: some fears may reflect
classical conditioning, but only to stimuli to
which an organism is physiologically prepared to be sensitive -> ppl fear spiders, snakes, & heights but not lambs

Question 44

Social Skills Deficits in Social Anxiety Disorder

Answer 44

• inappropriate behaviour or a lack of social skills is the cause of social anxiety.
• the individual has not learned how to act so that they feel comfortable w/ others or the person repeatedly commits faux pas, is awkward & socially inept, & is often criticized by social companions.
• socially anxious ppl often rated as being
  low in social skills.
• timing & placement of socially anxious
  responses in a social interaction, such as saying thank you at the right time & place, are impaired.

Question 45

Specific Phobias and SAD: cognitive theories

Answer 45

Ppl’s thought processes can serve as a
diathesis & thoughts can maintain a phobia
or anxiety. Ppl who experience phobias or social anxiety are more likely to:
* attend to negative stimuli;
* interpret ambiguous info as
threatening; &
* believe that negative events are more
likely than positive ones to re-occur.
Cognitive-behavioural models link SAD to
certain cognitive characteristics:
* Attentional bias to focus on negative social info
* Perfectionistic standards for accepted social performances
* High degree of public self-consciousness
Ppl w/ SAD have a tendency to interpret
ambiguous social situations as negative & a
reflection of their personal shortcomings, they also have a memory bias linked to this
interpretation bias

Question 46

Cognitive Theories of SAD

Answer 46

• Post-event processing (PEP) of negative social experiences
• A form of rumination about previous experiences &
  responses to these situations, especially experiences
  involving other ppl that didn’t turn out well.
• David Moscovitch (a prof and researcher here at UW) concluded that the fundamental core thematic fear in social phobia is “the self is deficient.”
• The key situational triggers are situations & circumstances that will publicly reveal the self as inadequate.

Question 47

Specific Phobias and SAD: biological theories

Answer 47

Predisposing Biological Factors:
- greater activity in two areas associated w/ negative
emotional responses: the amygdala & the insula
Autonomic Nervous System - stability-lability:
- labile, or jumpy, individuals have autonomic systems that are readily aroused by a wide range of stimuli; involved in fear & in phobic behaviour
- autonomic lability is to some degree genetically
determined
- heredity may have a significant role in the
development of phobias

Question 48

Specific Phobias and SAD: genetic factors

Answer 48

Jerome Kagan has focused on the trait of
behavioural inhibition or shyness.
- some infants as young as 4 months become agitated & cry when they’re shown toys or other stimuli. This behaviour pattern, which may be inherited, may set the stage for the later
development of phobias.

Question 49

Specific Phobias and SAD: psychoanalytic theory

Answer 49

Phobias are a defense against the anxiety produced
by repressed id impulses.
Anxiety is displaced from the feared id impulse &
moved to an object or situation that has some
symbolic connection to it.
These objects or situations then become the phobic
stimuli.
By avoiding them the person is able to avoid dealing
w/ repressed conflicts.

Question 50

Panic disorder

Answer 50

In a panic attack, a person suffers a sudden & often inexplicable attack of alarming symptoms:
* Rapid or laboured breathing, heart palpitations, nausea & chest pain;
* Feelings of choking & smothering;
* Dizziness, sweating, & trembling;
* Intense apprehension, terror, & feelings of impending doom.
Person may also experience:
* Depersonalization (a feeling of being outside one’s body).
* Derealization (a feeling of the world’s not being real, as well as fears of losing control, of going crazy, or even of dying).
Panic attacks may:
* Occur frequently
* Be situationally predisposed
* Be uncued
* Occur in seemingly benign states,
⚬ Relaxation or sleep, and in unexpected situations

Question 51

prevalence of Panic Disorder among Canadians

Answer 51

• women are more affected than men - 2:1
• prevalence is low before 14, rates increase in adolescence, peak during adulthood, & decline in older adults.
• panic attacks were related to poor overall functioning, suicidal ideation, psychological distress, activity restriction, chronic physical conditions, & self-rated physical & mental health

Question 52

Panic Disorder with or without Agoraphobia

Answer 52

Panic disorder is diagnosed as with or without agoraphobia
- Def of Agoraphobia: a cluster of fears centering on public places & being unable to escape or find help should one become incapacitated.
- Diagnosis requires anxiety in at least 2 of 5 situations: public transportation, open spaces, enclosed spaces, lines/crowds, being out of the house alone
- Many ppl w/ agoraphobia are unable to leave the house or do so only w/ great distress
- Ppl who have panic disorder typically avoid the situations in which a panic attack could be dangerous or embarrassing.

Question 53

Generalized Anxiety Disorder (GAD)

Answer 53

• Ppl w/ GAD are persistently anxious & overly concerned about minor items.
• Chronic, uncontrollable worries about everything (Seems like everything causes anxiety, very hard to pinpoint a specific cause).
• Most frequent worries concern their health & the hassles of daily life.
• Other features of GAD: difficulty concentrating, tiring easily, restlessness, irritability, high level of muscle tension
• Ppl w/ GAD don’t typically seek psychological treatment. (Getting help is a stimulus that makes them feel anxious, they don’t see the relief in that).
• typically begins in mid-teens; stressful life events play role in onset.
• 12-month prevalence - 0.9% among adolescents & 2.9% among adults in the general community of the United States.

Question 54

systematic densistization

Answer 54

create an anxiety hierarchy rating of fears. Relax & then start w/ the smallest fear & work up to conquering the greatest fears.
- clinical and experimental evidence indicates that this technique is effective in eliminating, or at least reducing, phobias.

Question 55

In Vivo & Virtual Reality

Answer 55

• In vivo exposure outperformed other modes of exposure (e.g., imaginal exposure & virtual reality) at post-treatment (but not at follow-up).
• In vivo exposure is associated w/ a high dropout rate & low treatment acceptance.
• VR exposure found to be just as effective
• VR exposure therapy has a powerful real-life impact & yields stable outcomes comparable to other treatment interventions.
• VR exposure treatment has comparatively better efficacy for the fear of flying.
• there is a move by some researchers from VR exposure to augmented reality (AR) exposure.

Question 56

Blood & Injection Phobias

Answer 56

• relaxation tends to make matters worse for ppl w/ blood-and-injection phobias.
• after the initial fright, accompanied by dramatic increases in heart rate & blood pressure, they’ll often experience a sudden drop in blood pressure & heart rate & faint.
• clients are now encouraged to tense rather than relax their muscles when confronting the situation

Question 57

Social skills training for SAD

Answer 57

Learning social skills can help ppl w/ Social Anxiety Disorder who may not know what to do or say in social situations.
- Some CBT therapists encourage clients to role-play interpersonal encounters in the consulting room or in therapy groups & several studies attest to the long-term effectiveness of this approach

Question 58

Behavioural therapy for GAD

Answer 58

(difficult to find specific causes of the anxiety suffered by clients w/ GAD)
- tend to prescribe more generalized treatment (intensive relaxation training), in hope that if clients learn to relax when beginning to feel tense, their anxiety will be kept from spiraling out of control.
- clients are taught to relax away low-level tensions, to respond to incipient anxiety w/ relaxation rather than alarm -> quite effective in alleviating GAD

Question 59

Cognitive treatment of phobias

Answer 59

Cognitive treatments for specific phobias have been viewed w/ skepticism b/c of a central defining characteristic of phobias:
- the phobic fear is recognized by the individual as excessive or unreasonable.
- if the person already acknowledges that the fear is of something harmless, what use can it be to alter the person’s thoughts about it?
- there is no evidence that the elimination of irrational beliefs alone, w/out exposure to the fearsome situations, reduces phobic avoidance

Question 60

Exposure-based treatments for Panic Disorders

Answer 60

A well-validated exposure-based therapy developed by Barlow is called panic-control therapy.
- Panic-control therapy has three principal components:
(1) relaxation training
(2) a combination of Ellis-and-Beck-type CBT interventions, including cognitive restructuring
(3) exposure to the internal cues that trigger panic (which is termed – interoceptive exposure)

Question 61

psychoanalytic approaches to anxiety treatment

Answer 61

Psychoanalytic therapies attempt to uncover the repressed conflicts believed to underlie the extreme fear & avoidance characteristic of these disorders.
Because the phobia itself was regarded as symptomatic of underlying conflicts, it is usually not dealt w/ directly.
Direct attempts to reduce phobic avoidance were contraindicated because the phobia is assumed to protect the person from repressed conflicts that are too painful to confront.
Many analytically oriented clinicians recognize the importance of exposure to what is feared, although they often regard any subsequent improvement as merely symptomatic & not as a resolution of the underlying conflict that was assumed to have produced the phobia

Question 62

symptoms of depression

Answer 62

Mood disturbances:
* emotional state marked by great sadness
* feelings of worthlessness and guilt
Cognitive or ‘thinking’ disturbance:
* Self-criticism, self-blame
* indecisiveness, slowed thinking, thoughts of
death or suicide
Physiological (somatic) and behavioural
disturbance:
* loss of sleep, appetite, and sexual desire
* loss of interest and pleasure in usual
activities
Symptoms vary between cultures
Children: somatic symptoms are most common
early signs

Question 63

symptoms of mania

Answer 63

An emotional state or mood of intense but unfounded elation accompanied by irritability, hyperactivity, talkativeness, flight of ideas, distractibility, and impractical, grandiose plans
May be characterized by
* euphoric mood,
* excessively talkative,
* difficult to interrupt,
* shifting from topic to topic,
* need for activity,
* grandiose thinking,
* little need for sleep,
* poor planning

Question 64

PREMENSTRUAL
DYSPHORIC DISORDER

Answer 64

Mood lability, irritability, dysphoria, &
anxiety symptoms that occur repeatedly
during the premenstrual phase & remit
around the onset of menses or shortly
thereafter.
Symptoms include:
* mood lability, irritability, anger, depressed mood, hopelessness, anxiety, tension, feelings of overwhelm, insomnia or hypersomnia, changes in appetite etc.
The prevalence of premenstrual dysphoric disorder symptoms in adolescent girls may be higher than that observed in adult women

Question 65

postpartum or peripartum onset depression

Answer 65

Major depression during pregnancy or in the
first 4 weeks following childbirth
- about 50% of episodes begin before
delivery
- can include feelings of anxiety, guilt,
agitation, weepiness, difficulty bonding w/ or caring for baby, & even panic attacks
- can appear w/ or w/out psychotic features
- in Canada, almost one-quarter of mothers who recently gave birth reported feelings consistent w/ either post-partum depression or an anxiety disorder

Question 66

seasonal affective disorder

Answer 66

• no longer a discrete diagnosis - it’s a
  specifier of major depressive disorder.
• full remittance is necessary during other seasons, & the pattern must continue for at least 2 years
• is not restricted to winter. SAD can coincide w/ diff seasons
• highest rates of SAD can be found among people who live in the Canadian Arctic (up to 18% of
  population)

Question 67

Bipolar disorder

Answer 67

Bipolar 1 - involves recurring mood episodes
(manic, depressive, and hypomanic), but the occurrence of at least one manic episode is necessary for diagnosis.
- peak age at onset is between 20-30 years, but occurs throughout the life cycle.
- mean age at onset is 22 years & slightly
younger for women (21.5 years) than for men
(23.0 years)
Bipolar 2 - characterized by recurring mood episodes consisting of one or more major depressive episodes & at least one hypomanic episode
- average age at onset is mid-20s

Question 68

persistent mood disorders

Answer 68

*symptoms for at least 2 years & are not severe enough to warrant a diagnosis of Major Depressive Disorder (MDD) or manic episode.
Cyclothymic disorder:
- numerous & alternating periods of hypomania & depression
- symptoms at least half the time w/ no more than two consecutive, symptom-free months
Persistent Depressive disorder
- mild to moderate depressed moods most of the day nearly every day for at least two years
- at least two of the other symptoms of MDD
Double Depression
- people w/ persistent depressive disorder may also experience episodes of MDD

Question 69

psychoanalytic theory of depression

Answer 69

Freud theorized that the potential for depression begins in early childhood during the oral period.
- children’s needs are insufficiently or oversufficiently met causing fixation in this stage.
- depression comes about through rejection & dependency
*Very little empirical support for this theory.

Question 70

beck’s theory of depression

Answer 70

Thinking is biased toward negative interpretations
Negative triad
- negative views of the self, the world, & the future
Principal Cognitive Biases
- Arbitrary inference
- Selective abstraction
- Overgeneralization
- Magnification & minimization

Question 71

Beck Depression Inventory (BDI II)

Answer 71

Scale used in the assessment of major depressive disorder
- self-report scale of 23 items rated on a 3-point scale.
- classifies individuals as having low, moderate, or significant depression based on scale total.

Question 72

Learned helplessness, attribution & learned helplessness, learned hopelessness

Answer 72

Learned Helplessness:
- individual’s passivity & sense of being unable to act & control own life is acquired through unpleasant experiences and traumas that were unsuccessfully controlled.
Attribution & Learned Helplessness:
- revised theory is the concept of attribution
- global attributions
- attributions to stable factors
- attributions to internal characteristics
Learned Hopelessness:
- advantage of theory is that it can deal the comorbidity of depression & anxiety disorders

Question 73

interpersonal theory of depression

Answer 73

Sparse social networks that provide little support
- decreases an individual’s ability to handle negative life events
- increases their vulnerability to depression
Depressed people also elicit negative reactions from others & are low in social skills.
They also constantly seek the reassurance of others.

Question 74

biological theories

Answer 74

Heritability estimate = 35%
- relatives of unipolar probands are at an increased risk for unipolar depression
- serotonin transporter gene-linked promoter region (5-HTTLPR) is being considered
- drug actions suggest that depression & mania are related to serotonin, norepinephrine, & dopamine.
- anti-depressants & mood stabilizer (anti-manic) medications may work by changing the responsiveness of receptors (which may be too insensitive in people w/ depression & too sensitive in people w/ mania) for these neurotransmitters.
Neuroendocrine System
- HPA axis may play a role in depression.
- limbic area of brain (closely linked to emotion) affects the hypothalamus which in turn controls endrocine glands (release of hormones)
- increased levels of cortisol in depressed patients
Disorders of thyroid function are often seen in bipolar patients.
- thyroid hormones can induce mania.
Right hemisphere dysfunction
- sense of indifference or flatness

Question 75

therapies for mood disorders

Answer 75

Psychological Therapies
- Psychodynamic Therapies
- Cognitive & Behaviour Therapies
- Mindfulness-Based Cognitive Therapy
- Psychological Treatment for Bipolar Disorder
Biological Therapies
- Electroconvulsive therapy (ECT)
- Drug therapy

Question 76

Suicide

Answer 76

• suicide is more about struggling to live, than wanting to die
• suicide was the 9th leading cause of death in Canada in 2005
• suicide is the 2nd cause of death (after accidents) in youth ages 15 to 24
  Women have higher rates of suicide attempts but lower rates of suicide as compared to men,
• gender paradox of suicidal behaviour

Question 77

terminology

Answer 77

A person died by suicide
- commit is harmful, judgmental, & stigmatizing language
Suicidal ideation
- thoughts and intentions of killing oneself
Suicide attempts
- self-injury behaviours intended to cause death but that do not lead to death - we do not say “successful” or “failed”
Suicide gestures
- self-injury in which there is no intent to die
Suicide
- behaviours intended to cause death & death occurs

Question 78

risk factors & suicide

Answer 78

Predisposing factors (make a person vulnerable to suicidal behaviour):
- psychological disorder, abuse, early loss
Precipitating factors (create a crisis):
- end of a relationship, job loss, rejection, pressure to succeed
Contributing factors (increase exposure to predisposing or precipitating factors)
- physical illness, sexual identity issues, isolation).
Protective factors (decrease risk of suicidal behaviour)
- personal resilience, adaptive coping skills, positive future expectations, and perceived social support.

Question 79

How do I know if someone is at risk? (IS PATH WARM)

Answer 79

I - Ideation
S - Substance abuse
P - Purposelessness
A - Anxiety
T - Trapped
H - Hopelessness
W - Withdrawal
A - Anger
R - Recklessness
M - Mood changes

Question 80

how can I help someone?

Answer 80

• Take all threats or attempts seriously.
• Be aware & learn warning signs of suicide.
• Be direct & ask if the person is thinking of suicide. If yes, ask if they have a plan.
• Be non-judgmental & empathic.
• Do not minimize the feelings expressed by the person.
• Do not try to debate with the person or talk them out of their thoughts of suicide.
• Reach out for appropriate support.
• In an acute crisis take them to an emergency room or walk in clinic or call a mobile crisis service.
• Do not leave them alone until help is provided.
• If safe to do so, remove any obvious means (e.g. firearms, drugs or sharp objects) from the area
• Or remove the person from the situation.
  *Do not promise to keep thoughts of suicide a secret