Week 4 - Depressive and bipolar disorders

Question 1

________ ___________is primarily characterised by persistent sad, empty or irritable mood accompanied by a range of other features, such as feelings of worthlessness, a sense of failure and low energy.

Answer 1

Depressive disorder

Question 2

Depressive disorder involving one or more
major depressive
episodes.

Answer 2

major depressive disorder

Question 3

In ancient Greece, the term ___________ was used to denote a mental condition characterised by fear and depression.

Answer 3

‘melancholia’

Question 4

German psychiatrist ______ ___________(1896) identified ‘manic depressive insanity’ as one of the major categories of mental illness. Manic depressive insanity encompassed the conditions that are currently categorised as bipolar disorders and depressive disorders.

Answer 4

Emil Kraepelin

Question 5

_____________ concept was controversial as it classified all disorders of mood together rather than distinguishing between those individuals who experience depressive episodes alone and those who experience both depressive and manic episodes (currently termed depressive
disorders and bipolar disorders, respectively).

Answer 5

Kraepelin’s

Question 5

The current classification system is founded on work of the German psychiatrist Karl __________ (1957) who made a distinction between depression and bipolar disorder.

Answer 5

Leonhard

Question 6

DSM-5 includes a chapter entitled ‘Depressive Disorders’. Among these conditions is major depressive disorder, commonly referred to as _______ depression

Answer 6

major

Question 7

In ICD-10, major depression is known as ________ __________ disorder.

Answer 7

recurrent depressive

Question 8

__________ ___________ is characterised by a continuous period of at least _______ weeks during which the person feels depressed, sad, empty or hopeless, or has lost interest in nearly all of his/her activities (anhedonia)

Answer 8

Major depression

two

Question 8

Inability to experience
pleasure from previously
pleasurable activities.

Answer 8

Anhedonia

Question 9

This period of low mood must represent a change in the person’s functioning and be accompanied by at least ________ of the following symptoms:
∙ significant weight loss when not dieting, or weight gain, or a decrease or increase in appetite nearly every day
∙ insomnia or hypersomnia nearly every day
∙ loss of energy or fatigue nearly every day
∙ motor restlessness (‘psychomotor agitation’) or slowed movements (‘psychomotor retardation’) nearly every day and observable to others
∙ diminished concentration or ability to think, or indecisiveness nearly every day
∙ feelings of worthlessness or excessive or inappropriate guilt nearly every day
∙ recurrent thoughts of death, recurrent suicidal ideation without a plan or a suicide attempt or a
specific plan for committing suicide.

Answer 9

four

(these symptoms also need to cause significant
distress and impairment in the person’s life—impacting on his/her social, occupational and other important roles)

Question 10

An extension to
the diagnosis used by DSM-5 that further clarifies the course,
severity or special features of the disorder.

Answer 10

specifier

Question 11

In the case of __________ ___________ disorder, there are several specifiers:
- severity (mild, moderate or severe),
- the number of episodes (single or recurrent),
- the degree of recovery between depressive
episodes (in partial remission or in full remission) and
- whether there are accompanying psychotic
features.

Answer 11

major depressive

Question 12

Depression in which the person experiences delusions and/or hallucinations is referred to as major depressive disorder with _________ ___________.

Answer 12

psychotic features

Question 13

Major depressive disorder with _____________ feature is characterised by a profound, nearly complete inability to experience pleasure.
Mood is usually worse in the mornings and the
sufferer may experience early morning awakening, marked psychomotor
retardation or agitation,
significant anorexia (i.e., loss of appetite) or weight loss and. excessive guilt

Answer 13

melancholic

Question 14

Major depressive disorder with _________ features, is characterised by movement disturbance
symptoms, such as immobility at one extreme or excessive, purposeless activity at the other extreme

Answer 14

catatonic

Question 15

Women experiencing psychosocial stressors such as a perceived lack of support from their partner, family and friends, feeding and physical difficulties
with the infant, stressful life events, a previous history of depression and complications during pregnancy, are at higher risk of major depressive disorder with ___________onset (during
pregnancy or within four weeks after childbirth).

Answer 15

peripartum

(more serious than postpartum depression known as ‘the baby blues)

Question 16

Episodes of depressed mood (often referred to as ‘the baby blues’) can occur in up to ______ per cent of women within 1–10 days after childbirth.

Answer 16

70

Question 17

Major depressive disorder with ___________ pattern, which is diagnosed when there is a regular relationship between the onset of the sufferer’s major depressive episodes and a particular time of the year (most often with onset in the autumn or winter months).

Answer 17

seasonal

Question 18

Major depressive disorder, accompanied by significant anxiety such as irrational worry, inability to relax or a sense of impending threat is known as major depressive disorder with _______ ________.

Answer 18

anxious distress

Question 19

Comorbidity between depression and anxiety, is found in about
______ per cent of people with major depressive disorder.

Answer 19

50

Question 20

The presence of
anxiety in depression
increases the risk of suicide and predicts a longer length of the depressive episode. True/False

Answer 20

True

Question 21

Patient who experience symptoms better fitting of bereavement are no longer excluded form DSM-5 meaning they can now be diagnosed with major depressive disorder. True/False

Answer 21

True

(The DSM-5 has attempted to minimise the chances of
inappropriately diagnosing bereaved individuals with a mental disorder by listing some distinctions between non-pathological grief and major depression (e.g., a preoccupation with thoughts about the
deceased in the former versus self-critical thoughts in the latter).

Question 22

DSM-5 replaced dysthymic disorder (less severe but more chronic depression) with __________ depressive disorder to more clearly describes a depressive disorder where the mood disturbance and at least two other symptoms last for more than two years.

Answer 22

persistent

Question 23

A new diagnostic category introduced in the DSM-5 is disruptive ________ ____________
disorder which is common in children and is characterised by severe and persistent
irritability as evident in temper outbursts that are extremely out of
proportion to the
situation

Answer 23

mood
dysregulation

Question 24

Diagnosis of disruptive mood dysregulation disorder is highly prevalent in the US
but has been generally viewed sceptically in Europe and Australasia, given similarity with other diagnoses in the DSM-5 where behavioural and emotional
dysregulation are core features (e.g., oppositional defiant disorder, attention-deficit/hyperactivity
disorder, impulse control disorders and bipolar disorder), reliably distinguishing disruptive mood
dysregulation disorder from these conditions could prove challenging. True/False

Answer 24

True

Question 25

Australian subtyping model suggests three broad classes of depressive disorders: psychotic, melancholic (both biologically based) and non-melancholic (driven by life-event stressors and psychological factors). True/False

Answer 25

True

Question 26

Depressive disorders are among the most prevalent psychological problems in Australia with higher rates in ________ 5.1% compared to _________ 3.1%.

Answer 26

women
men

Question 27

Rates of dysthymia are about _____ %for men and ______% for women.

Answer 27

1
1.5

Question 28

It has been estimated that ______ in 10 Australians
are affected by
someone close to them suffering from a mood disorder

Answer 28

1

Question 29

Psychological distress in the Australian population has significantly reduced between 1995 and 2011. due to effective treatments. True/False

Answer 29

False
(has not changed despite available treatments)

Question 30

Depressive disorders in children and adolescents have been steadily increasing/decreasing over the past 5–10 years in most developed countries.

Answer 30

Increasing

(girls have higher rates than boys)

Question 30

Women are found to be twice as likely to experience depression, this is believed to be due to:

Answer 30

-women talking more readily about it
- biological factors such as hormones

Question 31

Australian data released in 2015 indicated that _____ per cent of Australian adolescents (aged 12–17
years) had depressive disorders, including major depressive disorder and dysthymia, over a 12-month
period.

Answer 31

5

Question 32

Depressive disorders can affect people at any age. Onset of a first episode of depression can occur from as young as ______ years of age

Answer 32

3

Question 33

Median age of onset for mood disorders is about ______ years of age.

Answer 33

30

Question 34

In Australia, studies have found that approximately _____ per cent of those who experience depression meet criteria by the age of 25.

Answer 34

20

Question 35

Follow-up studies have demonstrated that up to ______ per cent of those with a depressive disorder will recover within the first six months following treatment. Unfortunately, major depressive disorder
has a highly recurrent character. About 50 per cent of people who recover from a first episode of depression will have no further episodes, but many will have a further episode or not recover fully
from the first episode.

Answer 35

50

Question 36

The four main problems associated with depression include:

Answer 36

1. an increased risk of suicide and suicide
   attempts,
2. difficulties performing occupational and social activities,
3. anxiety disorders and 4. physical health
   problems.

Question 37

The rate of suicide in the community from
depressive disorders is estimated to be approximately 3.5 per cent, with a higher preponderance
of _______ suicides (6.9%) over ________ suicides (1.1%)

Answer 37

male
female

Question 38

Depression is associated with an increased rate of suicide attempts and successful suicide, with
as many as ____ per cent of people who take their own life suffering from depression

Answer 38

75

Question 39

Suicide rates in Australia appear to have been increasing/declining since the late 1990s?

Answer 39

declining

Question 40

The aetiology of depression is believed to include a combination of which factors:

Answer 40

• biological,
• psychological,
• social and
• environmental

Question 41

Genetics play a significant part in the development of depression. True/False

Answer 41

True (yet not well understood and current understandings highlight the interplay between genetic vulnerability and
stressful life events)
(e.g. inherited anxious traits in children may contribute to the development of overprotective or authoritarian parenting styles which may in turn undermine the child’s sense of mastery over
his/her environment, rendering the child vulnerable to developing further anxiety problems and depression.

Question 42

The main _____________ implicated in depression are serotonin,
noradrenaline (norepinephrine)
and dopamine, which are also involved in the regulation of sleep cycles, motivation and appetite.

Answer 42

neurotransmitters (monoamines)

Question 43

Catecholamines
(adrenaline,
noradrenaline
and dopamine)
and serotonin belong to a family of neurotransmitters called __________.

Answer 43

monoamines

Question 44

Monoamines are concentrated in the _________ system, a part of the brain associated with integrating goal-directed activities

Answer 44

limbic

Question 45

Early theories suggested
that depression was caused by a reduction in the availability of _____________ neurotransmitters in the
synapses between neurons.

Answer 45

monoamine

Question 46

More recent theories of depression have implicated abnormalities
in the number and sensitivity of receptors available to take up monoamine neurotransmitters in
__________ which then affects the balance of the various available neurotransmitters

Answer 46

synapes

Question 47

Euroendocrine (hormonal) theories suggest a role for hyperactivity in the hypothalamic-pituitary/adrenal (HPA) axis in the development of depression as HPA axis is critical to the body’s response to
stress and produces stress hormones involved in the fight or flight response. People who are depressed
tend to demonstrate chronic overactivity in the HPA axis, resulting in the production of
excess stress hormones (such as cortisol), which in turn affects the way in which monoamine neurotransmitters work
in the brain.

Question 48

Neurophysiological theories focus on structural or functional abnormalities in certain structures in the brain such as the pre-frontal cortex, hippocampus, anterior cingulate cortex and the amygdala

Answer 48

Research yet to determine whether
these abnormalities are a cause or a consequence of depression.

Question 49

Environmental factors, which usually precede depressive episode by 6-9 months, include:

Answer 49

• stressful life events such as financial problems, divorce, break up, loss of a loved one, job loss, abusive relationships…..

Question 50

Early __________ theories such as the learned helplessness model of depression (Seligman) proposed that depression is a learnt response to adverse events that are perceived (based on the observation that when laboratory animals
were subjected to unavoidable adverse outcomes (i.e., electric shocks) that were independent of their
behaviour (i.e., uncontrollable), they gave up trying to do something about their situation

Answer 50

cognitive

Question 51

The depressive attributional style is one that interprets negative life events as being
due to internal (the individual’s own fault), global (applicable to all situations) and stable (unchanging or invariable) factors. For example, according to this theory, a person who interprets the ending of a romantic relationship as being due to an aspect of him/herself that
pervades all of his/her relationships
and that cannot be changed will be more likely to experience a sense of hopelessness regarding the possibility of establishing a meaningful relationship in the future and hence will be at risk of developing depression.

Question 52

(n another major cognitive theory of depression, Aaron Beck proposed that negative
experiences in childhood may result in the development of dysfunctional core beliefs about the _______, ________ and the ________(such as a highly critical parenting style resulting in the child’s belief that s/he is unlovable). Individuals generally deal with these negative core beliefs by adopting compensatory
strategies or rules that protect them from developing depression (e.g., ‘as long as I’m in a relationship
then I’m lovable’).

Answer 52

self,
others
world

= AKA negative cognitive triad

Question 53

Beck proposes that these negative core beliefs can be triggered by relevant negative life events (e.g., the ending of a relationship activating the belief ‘I am unlovable’) and thus result in a depressive episode. He argues that the thought patterns of depressed people are
characterised by self-criticism, a negative view of others and life events and pessimistic
expectations
regarding the future.

Question 54

_________ inference takes place when a person draws a conclusion in the absence of
supporting evidence or despite the presence of contradictory evidence (e.g., ‘I did not get invited to Jenny’s
party. That must mean that I have offended her in some way’).

Answer 54

Arbitrary

Question 54

According to Beck, this negative view of the self, the world and the future (known as the negative cognitive triad) is maintained by a number of cognitive distortions in which depressed
people are likely to engage. Among these errors in thinking are the following:

Answer 54

1. Arbitrary inference
2. Magnification and minimisation
3. Personalisation
4. Overgeneralisation

Question 55

__________ and ___________occur when a person magnifies or exaggerates his/her perceived failures (e.g., ‘I couldn’t answer that question in class. Everyone thinks I am such an idiot’) and
minimises or discounts his/her achievements (e.g., ‘I managed to get a part-time job in the company but they were probably desperate to hire someone’).

Answer 55

Magnification minimisation

Question 56

A dominant _____________ theory regarding the aetiology and maintenance of
depression proposes that some life events or stresses can reduce the opportunity to experience positive
reinforcers, which in turn increases the risk of depression.

Answer 56

behavioural

(e.g. life events, poor coping skills)

Question 57

_________________ occurs when a person draws a conclusion based on a single event (e.g., ‘My
boyfriend broke up with me last week. I’m hopeless with
relationships’)

Answer 57

Overgeneralisation

Question 57

____________ entails relating events to oneself in the absence of any clear evidence (e.g., ‘Terry was frowning when he saw me in the shop. I must have done something to make him angry’).

Answer 57

Personalisation

Question 58

___________ theories hold that depression is a form of pathological grief

Answer 58

Psychoanalytic

Question 58

Question 58

Conditions or variables
associated with a
reduced risk or chance of developing a disorder

Answer 58

protective factors

Question 59

Family interaction style in which family members are overly
protective and self-sacrificing towards the
person with a psychological
disorder while
also expressing high levels of criticism and
hostility; this may contribute to the
person’s relapse.

Answer 59

expressed emotion (EE) = social factors

Question 59

____________ include:
- tricyclic antidepressants (TCAs),
- selective serotonin reuptake inhibitors
(SSRIs),
- serotonin
noradrenaline reuptake inhibitors (SNRIs),
- monoamine oxidase inhibitors (MAOIs)
and several other newer medications that do not easily fit into the previous four categories.

Answer 59

Antidepressants

Question 59

____________ are the most frequently used medications for
depression.

Answer 59

Antidepressants

(work by increasing the availability of neurotransmitters or
increasing the sensitivity of neuron receptors in the brain)

Question 60

__________
medications are used to
treat psychotic
symptoms such as delusions and
hallucinations.

Answer 60

Antipsychotic

Question 61

In terms of efficacy, newer forms of antidepressants (such as the SSRIs) were similar
to tricyclic antidepressants for the treatment of depression, however newer meds have a lover dropout rate due to less side effects. True/False

Answer 61

True

Question 61

_______ ________ ________ ________ (rTMS) is a
biological treatment that
exposes patients to repeated, high-intensity
magnetic pulses that are focused on particular
brain structures in order to stimulate them.

Answer 61

repetitive transcranial magnetic stimulation

(approved in US, further research is required to refine and develop rTMS as a general treatment for depressive disorders)

Question 62

Biological treatment in
which the vagus nerve (the part of the
autonomic nervous system that carries
information from the head, neck, thorax
and abdomen to several areas of the brain) is
stimulated by a small electronic device similar
to a cardiac pacemaker, which is surgically
implanted under a patient’s skin in the left chest wall.

Answer 62

vagus nerve
stimulation

Question 62

Treatment that involves
exposure to bright light; used particularly during
the winter months for individuals with seasonal affective
disorder

Answer 62

bright light therapy

(one study showed it to be more effective than pharmacotherapy)

Question 63

Treatment for mood disorders that involves
the induction of a brain seizure by passing an
electrical current
through the patient’s brain while s/he is
anaesthetised.

Answer 63

electro-convulsive therapy (ECT)

(for severe cases)

Question 64

ECT is usually delivered to the _________ (right/left) side of the brain to minimise which minimises the
likelihood of long-term memory and learning
problems.

Answer 64

right

Question 64

________ ________
scheduling is a
behavioural technique
entailing planning
a gradual increase in the
level of pleasant activities the client
engages in as a way of improving his/her mood.

Answer 64

Pleasant activity

Question 65

A key cognitive technique is __________ restructuring. Here, the client is introduced to the ________ model
in which activating
events trigger dysfunctional beliefs that in turn result in negative consequences
(i.e., negative mood and behaviours)

Answer 65

cognitive
ABC

Question 66

Question 67

(IPT)
Short-term psychological treatment
originally developed by
Gerald Klerman,
Myrna Weissman
and their colleagues for
the treatment of depression; addresses
the client’s interpersonal
problems as a way of
improving his/her psychological symptoms.

Answer 67

interpersonal
psychotherapy

(Current treatment guidelines state that IPT is as effective as CBT
in the treatment of moderately severe depression)

Question 68

Therapies focused on
uncovering and resolving unconscious
conflicts that drive
psychological symptoms.

Answer 68

psychodynamic
therapies

Question 69

Historically, the term
____________ was used to describe both mental illness characterised by fear and depression, as well as a depressed.

Answer 69

melancholia

Question 70

The risk of suicide increases if depression is comorbid with _______.

Answer 70

anxiety

Question 71

Disruptive mood dysregulation disorder is most likely to be diagnosed in ___________
who behave in
developmentally inappropriate ways.

Answer 71

children

Question 71

Among Australian adults, the prevalence of major depressive disorder is estimated to be ___% for women over a 12-month period.

1.1
3.1
5.1
7.1

Answer 71

5.1

Question 72

Which of the following have been associated with a heightened risk of developing depression in young people?

Multiple select question.

substance abuse
genetic vulnerability
high social
connectedness
trauma history

Answer 72

substance abuse
genetic vulnerability
trauma history

Question 73

Epidemiological data suggest that the median age of onset for mood disorders is about ______ years of age.

Answer 73

30

Question 74

The distinction between depression and bipolar disorder was first made by:

Karl Leonhand
Emil Kraeplin
Edward Thorndike
Hippocrates

Answer 74

Karl Leonhand

Question 75

Zoe gave birth to her second child three weeks ago. During the first two weeks following the birth, she experienced some symptoms of depressed mood. Zoe was most likely suffering from:

major depressive disorder with peripartum onset

‘baby blues’

dysthymia

major depressive disorder with melancholic features

Answer 75

‘baby blues’

Question 76

Which of the following
have been associated with an increased risk of relapse for major depressive disorder?

Multiple select question.

earlier age of onset

ongoing life stressors

full resolution of symptoms following the first episode

fewer previous depressive episodes

Answer 76

earlier age of onset

ongoing life stressors

Question 77

A mood disturbance characterised by severe temper outbursts and persistent irritability is referred to as _____.

disruptive mood dysregulation disorder

bipolar disorder

intermittent explosive disorder

PTSD

Answer 77

disruptive mood dysregulation disorder

Question 78

Approximately ______% of depressed individuals hospitalised for their disorder successfully complete suicide.

15
35
25
45

Answer 78

15

Question 79

Among Australian adults, the prevalence of major depressive disorder is estimated to be ___% for men over a 12-month period.

3.1
1.1
5.1
7.1

Answer 79

3.1

Question 80

Australian data from 2015 indicates that up to ______% of adolescents will experience a depressive disorder within any 12-month period.

12
5
7
15

Answer 80

5

Question 81

Australian researchers have found that approximately 20% of individuals who experience depression meet criteria by the age of ______ years.

18
25
15
21

Answer 81

25

Question 82

Researchers have demonstrated that up to ______% of those with a depressive disorder will recover within the first six months of treatment.

60
70
50
40

Answer 82

50

Question 83

Suicidal _________
refers to thoughts about suicide.

Answer 83

ideation

Question 84

For younger sufferers, depression can negatively impact academic __________.

Answer 84

achievement

Question 85

Which of the following anxiety disorders commonly precede the development of depressive disorders?

Multiple select question.

specific phobia
OCD
GAD
panic disorder

Answer 85

GAD
panic disorder

Question 86

Researchers have found an association between the experience of depression and the following physical health conditions:

Multiple select question.

cerebral palsy
diabetes
cancer
cardiovascular disease

Answer 86

diabetes
cancer
cardiovascular disease

Question 87

Neuroendocrine theorists emphasise the role of hyperactivity in the _____

pre-frontal cortex
limbic system
synapses
HPA axis

Answer 87

HPA axis

Question 88

It has been estimated that as many as ________% of people who complete suicide suffered from depression.

90
75
80
85

Answer 88

75

Question 89

Higher rates of sick leave from work associated with depression can result in:

Multiple select question.

financial strain

lowered work productivity

increased motivation for change

increased social support provision

Answer 89

financial strain

lowered work productivity

Question 90

It is suggested that environmental factors are more likely to trigger depression when they interact with:

Multiple select question.

high social support

biological vulnerabilities

pre-existing resilient capabilities

learnt psychological vulnerabilities

Answer 90

biological vulnerabilities

learnt psychological vulnerabilities

Question 91

Depression has been correlated with poorer
__________ functioning, which may increase the risk of physical illness.

Answer 91

immune

Question 92

Individuals with a family history of depression are _______ times more likely to develop the disorder.

3–4
1–2
2–3
4–5

Answer 92

2–3

Question 93

Life events that include a sense of ______ and _______ are frequently associated with the onset of a depressive episode.

Multiple select question.

failure
satisfaction
loss
empowerment

Answer 93

failure
loss

Question 93

Rachel was in a busy shopping centre when she saw her friend Lynn across the other side of the food court. She called out to her, but Lynn did not answer. Objectively, this was because she may not have heard her. However, Rachel interpreted this as Lynn being angry at her. This is an example of what type of cognitive error?.

arbitrary inference
overgeneralisation
magnification
personalisation

Answer 93

personalisation

Question 94

Behavioural theories of depression focus on the
___________ associated with depressed and non-depressed behaviours.

Answer 94

contingencies

Question 95

Psychoanalytic theories of depression conceptualise the experience as a form of:

pathological grief
negative behaviour
negative cognitions
melancholia

Answer 95

pathological grief

Question 96

The absence of an intimate relationship can be a risk factor for depression, particularly for _________,

Answer 96

women

Question 97

The main neurotransmitters implicated in depression are:

Multiple select question.

dopamine
GABA
serotonin
noradrenaline (norepinephrine)

Answer 97

dopamine

serotonin

noradrenaline (norepinephrine)

Question 98

Laura was recently told she was unsuccessful in gaining the job she applied for. When telling her mum, Laura said ‘I’ll never get a job. I’m never going to be good enough.’ This type of thinking is an example of what cognitive distortion?

arbitrary inference
overgeneralisation
magnification
personalisation

Answer 98

overgeneralisation

Question 99

Which of the following factors may protect against the development of depression?

Multiple select question.

high family cohesion
high expressed emotion
high anxiety
high social connectedness

Answer 99

high family cohesion
high social connectedness

Question 100

As the symptoms of depression can negatively impact social interactions, this can lead to greater social ______.

interaction
support
competence
isolation

Answer 100

isolation

Question 101

Compared to tricyclic antidepressants, SSRIs:

have more side effects

are markedly less effective in managing symptoms

are markedly more effective in managing symptoms

have fewer side effects

Answer 101

have fewer side effects

Question 101

Serotonin, noradrenaline and dopamine belong to a family of neurotransmitters called __________.

Answer 101

monoamines

Question 102

Beck argues that there is a relationship between negative cognitions and depressive symptoms, such that:

they perpetuate each other

negative cognitions cannot occur in the absence of depressive symptoms

both will respond to the effects of medication

depressive symptoms will always precede negative cognitions

Answer 102

they perpetuate each other

Question 103

The purpose of pleasant activity scheduling is to:

improve sleep

decrease reliance on medication

decrease engagement in negative activities

improve mood

Answer 103

improve mood

Question 104

Within interpersonal psychotherapy, key target areas for treatment include:

Multiple select question.

dysfunctional cognitions
interpersonal disputes
grief from loss
life transitions

Answer 104

interpersonal disputes
grief from loss
life transitions

Question 105

Psychodynamic therapists assist a client to gain insight into the ______ that underpin their depressive symptoms.

negative behaviours
dysfunctional cognitions
interpersonal stressors
conflicts

Answer 105

conflicts

Question 106

Bright light therapy may be particularly effective for the treatment of depression with:

catatonia
peripartum onset
seasonal pattern
psychotic features

Answer 106

seasonal pattern

Question 107

The most common method of relapse prevention for depression in Australia is to:

continue medication use
begin use of medication
change the medication being used
cease use of medication

Answer 107

continue medication use

Question 108

In the ABC model, activating events trigger dysfunctional __________
which result in negative consequences.

Answer 108

beliefs

Question 109

According to Beck’s theory of depression, individuals have dysfunctional negative beliefs about:

Multiple select question.

the world
themselves
the past
others

Answer 109

the world
themselves
others

Question 110

IPT targets ________ that maintain or exacerbate factors contributing to depression.

the cognitive triad

negative cognitions

negative self-referent thoughts

maladaptive interpersonal skills

Answer 110

maladaptive interpersonal skills

Question 110

Most interventions to prevent depression teach skills in which areas?

Multiple select question.

interpersonal skills
sleep management
coping skills
meditation

Answer 110

interpersonal skills

coping skills

Question 111

Many empirically validated methods of relapse prevention for depression are based on ______ principles.

mindfulness
ACT
CBT
IPT

Answer 111

CBT

Question 112

_________ monitoring forms can assist a client to identify dysfunctional thinking patterns.

Answer 112

Thought

Question 113

Prevention programs for depression that are directed towards all members of a population have shown
_________ effect.

Answer 113

inconsistent

Question 114

Prevention programs for depression have been found to be most effective when the targeted group:

has some risk of developing depression

has internet access

have no history of depression

is highly educated

Answer 114

has some risk of developing depression

Question 115

Interpersonal psychotherapy focuses on interpersonal problems that may trigger or __________
a depressive episode.

Answer 115

maintain

Question 116

Mood disorder
marked by manic/
hypomanic
episodes and
depressive
episodes
(previously
called manic-depression)

Answer 116

bipolar disorder

Question 117

Throughout most of history, mania and depression were
viewed as separate illnesses. However, a turning point for the contemporary view of bipolar disorder
took place in the _____th century in France when Jean-Pierre _________ referred to the condition as cycle of madness.

Answer 117

Farlet

Question 118

During the late 19th century _____ ___________ formally made the landmark distinction between ‘manic
depressive insanity’ and other forms of severe mental illness, particularly
‘dementia praecox’ (an early term for schizophrenia).

Answer 118

Emil Kraepelin

Question 119

______ ________argued that the term ‘manic depressive insanity’ was too inclusive. He coined the term bipolar disorder to refer to a condition where individuals experience
both depressive and manic episodes, and distinguished this condition from one involving depressive
episodes alone.

Answer 119

Karl Leonhard

Question 120

Discovered by Australian psychiatrist, John Cade, __________ carbonate is a drug classified as a mood stabiliser that is used in the treatment of bipolar disorder.

Answer 120

lithium

Question 121

DSM-5 includes a
chapter entitled ‘Bipolar
and Related Disorders’ to reflect the fact that the term ‘bipolar
disorder’ actually embraces a spectrum of disorders, primarily consisting of bipolar I disorder, bipolar II disorder and cyclothymic disorder. True/False

Answer 121

True

Question 122

State of persistently
elevated or irritable mood and abnormally
increased goal-directed activity accompanied
by symptoms such as inflated self-esteem,
decreased need for sleep, racing thoughts,
pressured speech and impulsive, self
destructive behaviours

Answer 122

manic episode

Question 123

Diagnosis of bipolar disorder requires a manic episode to last for at least a _______, and to have ____ of the following symptoms:
- grandiosity (inflated self esteem)
- decreased need for sleep
- being talkative more than usual
- thoughts racing from one idea to another
- heightened activity
- risky behaviours

Answer 123

week
3

(these symptoms are considered symptoms of mania only if they are
out of character for the individual. To meet the diagnosis of a manic episode, the mood disturbance
must be severe enough to impair the individual’s functioning, and hospitalisation is often required)

Question 124

Inflated belief about one’s worth, power,
knowledge, ability or identity; when extreme,
may constitute a grandiose delusion.

Answer 124

grandiosity

Question 125

_________ has the same symptom profile as
mania but the symptoms are not severe enough to markedly interfere with daily functioning, do not
necessitate hospitalisation, and do not involve hallucinations or delusions. Also, the disturbance is of
shorter duration.

Answer 125

Hypomania

Question 125

A noteworthy change in the DSM-5 was the fact that increased activity or energy was now
required (along with mood changes) to meet the criteria for a manic or hypomanic episode. True/False

Answer 125

True

(This change to
the DSM diagnosis is consistent with the longstanding idea that bipolar disorder is fundamentally a
disorder of motivation)

Question 126

Form of bipolar disorder
characterised by manic episodes; major depressive episodes often occur but are not
necessary for the diagnosis.

Answer 126

bipolar I disorder

Question 126

DSM-5 criteria for _________ specifying a period of persistently elevated, expansive or irritable mood that is clearly different from the individual’s usual non-depressed mood,
lasting for at least ________ days.

Answer 126

hypomania
four

Question 127

Bipolar disorders are characterised in terms of the occurrence
of various combinations of _______, __________ and major depressive episodes across time.

Answer 127

manic
hypomanic

Question 128

Form of bipolar disorder
characterised by
hypomanic and major depressive episodes

Answer 128

bipolar II disorder

Question 128

Manic episodes are seen in both bipolar I and bipolar II disorders. True/False

Answer 128

False, manic episodes are only seen in bipolar I and not bipolar II

Question 129

________ and Fieve (1974) were the first to
distinguish between bipolar I and II disorders, although there is ongoing debate as to whether these represent distinct forms of the condition or simply differences in severity.

Answer 129

Dunner

Question 130

Multiple episodes of mood disturbance during their lifetime is experienced by around _____ percent of people with bipolar, with episodes occurring over weeks or months rather than days.

Answer 130

90

Question 130

Diagnosis given when
an individual has four or
more bipolar episodes (mania or depression)
within a single year, rapid ________ bipolar disorder.

Answer 130

cycling
(includes those who recover between episodes and those who
switch continually from one polarity to the other)

Question 130

Bipolar specifiers
include:
- with mixed features
- with anxious distress (presence of anxiety)

Question 131

Milder but more chronic form of bipolar disorder

Answer 131

cyclothymic disorder
(symptoms lack the severity to meet the criteria for bipolar I or II disorders)

Question 132

Increased rates of cyclothymic disorder are found in the family members of individuals with bipolar I or II disorders. True/False

Answer 132

True
(however the exact
nature of the link is not fully understood)

Question 133

Underdiagnosis (misdiagnosis) of bipolar most commonly includes __________
for men or ___________ depression for women.

Answer 133

schizophrenia
schizophrenia

Question 134

Overdiagnosis (especially for bipolar II) is common in those with unipolar
depression or borderline personality disorder due to diagnosing hypomania even for brief periods of elevated mood (i.e., of only a few hours in duration), rather than the DSM-5 criterion of hypomania lasting for at least four days. True/False

Answer 134

True

Question 135

The median age of onset for bipolar disorder is _____ years, with approximately 25 per cent of individuals experiencing onset of the disorder by age 17.

Answer 135

25
(relatively rare after the age of 30)

Question 135

In Australian, the prevalence of bipolar is
_______ percent for individuals with major symptoms in any 12-month period and
______ per cent over the lifetime.

Answer 135

0,9
1.3

Question 136

Women and men are equally likely to develop bipolar I disorder, while bipolar II is more common in _______.

Answer 136

women

Question 137

Bipolar I:
-time in depression ___ percent,
- time in mania or hypomania ___ percent.

Bipolar II:
- time in depression ____ percent,
- time spent in hypomania __ percent.

Answer 137

32
9
50
1

Question 138

Median duration is:
____ weeks for bipolar depressive episodes,
_____ weeks for manic episodes
____ weeks for hypomanic episodes

Answer 138

15
7
3

Question 139

Lithium fully protects only ____-_____per cent of patients against further episodes and there are often problems with gaining compliance from patients in taking their medication.

Answer 139

25-50

Question 140

Less severe
form of a manic
episode that
is an essential
feature of bipolar
II disorder

Answer 140

hypomanic
episode

Question 141

About ____ per cent of bipolar disorder patients relapse within one year,
_____ per cent in two years and _____ per cent over five years.

Answer 141

40
60
73

Question 142

Comorbidity between
anxiety disorders and bipolar disorder is believed to be greater than between anxiety disorders and depression. True/False

Answer 142

True

Question 143

Question 144

Australian research found about ______ per cent of people with bipolar disorder had a concurrent anxiety disorder.

Answer 144

50

Question 145

Stimulant drugs that can produce symptoms of
euphoria, self-confidence, alertness,
agitation, paranoia,
perceptual illusions and
depression.

Answer 145

amphetamines

Question 146

Bipolar disorder has frequently been found to be the psychological disorder most strongly associated with
substance misuse which is reported in _____ percent of people with bipolar.

Answer 146

39

Question 147

Following manic episodes,
almost one-third of patients cannot work for _____ months and only one-fifth return to work at their former skill level

Answer 147

6

Question 148

The suicide rate in people with bipolar disorder is about ____ times that of the general population, with 80 per cent of these suicides occurring during the depressive phase of the disorder

Answer 148

15

Question 149

At least ______ per cent of patients will attempt suicide and 10–20 per cent will complete suicide.

Answer 149

25

Question 150

A counselling strategy, originally used in the
addictions area, that encourages clients to think about both the
positives and the negatives of a particular
behaviour, ___________ interviewing.

Answer 150

motivational

Question 151

Bipolar disorder has a strong genetic component. True/False

Answer 151

True

Question 152

Large study of twins, estimated a heritability
rate of about _____ per cent, and a Danish population study sample of several million participants,
which reported a ______-fold increased risk of bipolar disorder in the first-degree relatives of affected individuals.

Answer 152

85
13

Question 153

Life stresses and events that disrupt _______ function, can result in the early signs of mood disturbance (such as restlessness, sleeplessness and feeling wired), and coupled with poor coping strategies (such as substance abuse) to deal with these symptoms, can in turn result in a full-blown manic or depressive episode.

Answer 153

circadian

Question 154

A part of the nervous system adapted to
coordinate the
organism’s interaction
with the light/dark cycle, and ensure optimal
timing of internal
physiological processes.

Answer 154

circadian system

Question 155

Originally developed in the context of schizophrenia, the view that abnormality is caused by the
combination of
a vulnerability or
predisposition (the diathesis) and life events
(the stressor)

Answer 155

diathesis-stress model

Question 156

Question 157

Theory that manic
episodes may be triggered by
dysregulated goal
pursuit, which entails the person being excessively involved in the pursuit of goals.

Answer 157

goal dysregulation model

Question 158

Goal __________ _______ found that increases in goal-setting and time spent pursuing goals accelerate the development of
hypomanic or manic symptoms such as inflated self-esteem, decreased need for sleep, flight of ideas and increased talkativeness

Answer 158

dysregulation model

Question 159

Even when not in an episode, individuals with a history of bipolar I disorder have been found to place a higher
emphasis on rewards and to be excessively engaged in the pursuit of achieving goals
compared to those without the disorder. True/False

Answer 159

True

Question 160

Individuals with bipolar
disorder have greater positive/negative beliefs regarding their worth, leading to higher/lower self-esteem.

Answer 160

negative
lower
(when negative events activate low self-esteem, the person may respond defensively with
grandiose ideas, which inhibit negative thoughts about the self)

Question 161

Thomas and Bentall (2002) proposed that hypomania and mania represent a deliberate, defensive attempt to
avoid the negative cognitions and emotions associated with depression and low self-esteem.
Consistent with their prediction, they found that a combination of rumination (i.e., thinking the same
thought over and over again), distraction and risk-taking coping styles predicted higher scores on a measure of
hypomania. True/False

Answer 161

True

Question 162

Personality traits
believed to be genetically based.

Answer 162

temperament

Question 163

Temperamental
traits such as perfectionism and sociotropy (high need for social acceptance) have been found to be more prevalent in individuals with bipolar disorder than those
with a depressive disorder. Also, temperamental tendencies can adversely affect a person’s ability to accept and adapt to the illness,
which can lead to poor compliance with treatment and a high risk of relapse

Question 163

Bipolar self-report measures commonly used in Australia:
- Depression Anxiety Stress Scale (DASS-21)
- Dysfunctional Attitudes Scale 24 (DAS-24)
- BIS/BAS Scales (behaviour inhibition and behaviour activation scale)
- Response Style Questionnaire (RSQ)
- Internal State Scale (ISS)

Question 164

Group of drugs including lithium and
anticonvulsants that are
used to treat
psychological disorders
characterised by unstable mood (such as bipolar disorder).

Answer 164

Mood stabilisers
(aim is to effectively treat or prevent bipolar
episodes (manic, depressive or mixed episodes) without triggering a mood shift to the opposite pole

Question 165

Today, there are six mood stabilisers commonly administered: lithium, carbamazepine,
valproate, olanzapine, quetiapine and lamotrigine.

Question 166

The main role of _____________ include providing education regarding the
importance
of identifying early signs of relapse so that preventative action can be taken, medication adherence, minimising risk factors (e.g., substance abuse) and maximising protective factors (e.g., maintaining
a regular sleep/wake cycle).

Answer 166

psychoeducation

Question 167

One study found that the addition of 7–12 sessions of psychoeducation
to medication resulted in a ______ per cent reduction in the rate of manic relapse compared to medication
alone

Answer 167

30

Question 168

Mood monitoring is an important intervention in the early stages of therapy. Encouraging clients to keep structured _________ diaries helps in identifying the triggers to mood shifts and the associated changes in thoughts and feelings

Answer 168

mood

Question 169

A key technique of CBT for bipolar disorder is __________ restructuring, which involves identifying and
challenging hyper-positive cognitions (e.g., ‘No one else can see it, but I will be highly successful if
I race ahead with this business plan’) as well as negative underlying beliefs (e.g., ‘I need to be highly successful to prove that I am worthwhile’).

Answer 169

cognitive