Week 4 - Depressive and bipolar disorders

Question 1

Disorder 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.

a) Depressive Disorder
b) Bipolar Disorder
c) Generalized Anxiety Disorder
d) Post-Traumatic Stress Disorder

Answer 1

a) Depressive disorder

Question 2

Which of the following disorders involves one or more major depressive episodes?

a) Major Depressive Disorder
b) Persistent Depressive Disorder
c) Bipolar Disorder
d) Seasonal Affective Disorder

Answer 2

a) Major depressive disorder

Question 3

In ancient Greece, the term used to denote a mental condition characterized by fear and depression was:

a) Mania
b) Melancholia
c) Psychosis
d) Neurosis

Answer 3

b) 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 categorized as bipolar disorders and depressive disorders.

a) Emil Kraepelin
b) Sigmund Freud
c) Carl Jung
d) Kurt Schneider

Answer 4

a) Emil Kraepelin

Question 5

Kraepelin’s concept was controversial because it:

a) Classified all disorders of mood together
b) Focused solely on depressive episodes
c) Emphasized the biological over the psychological aspects
d) Ignored manic episodes completely

Answer 5

a) Classified all disorders of mood together

(Classified all disorders of mood together, rather than distinguishing between those who experience depressive episodes alone and those who experience both depressive and manic episodes (currently termed depressive disorders and bipolar disorders, respectively)

Question 6

Which psychiatrist made a distinction between depression and bipolar disorder, influencing the current classification system?

a) Emil Kraepelin
b) Karl Leonhard
c) Sigmund Freud
d) Aaron Beck

Answer 6

b) Karl Leonhard

Question 7

Which term is commonly used to refer to major depressive disorder as classified in the DSM-5’s chapter on ‘Depressive Disorders’?

a) Clinical depression
b) Chronic depression
c) Major depression
d) Persistent depression

Answer 7

c) Major depression

Question 8

In ICD-10, major depression is known as _____ ______ disorder:

a) Major depressive
b) Severe depressive
c) Recurrent depressive
d) Clinical depressive

Answer 8

c) Recurrent depressive

Question 9

Diagnostic criteria for Major Depressive Disorder include:

a) A period of at least 1 week with symptoms of anxiety and loss of interest.
b) A period of at least 2 weeks with feelings of depression, sadness, or loss of interest in nearly all activities.
c) A period of at least 3 weeks with significant weight changes and sleep issues.
d) A period of at least 4 weeks with symptoms of irritability and difficulty concentrating.

Answer 9

b) A period of at least 2 weeks with feelings of depression, sadness, or loss of interest in nearly all activities.

Question 10

Inability to experience pleasure from previously pleasurable activities is known as:

a) Anhedonia
b) Dysphoria
c) Hyperthymia
d) Euphoria

Answer 10

a) Anhedonia

Question 11

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 11

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 12

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

A) Diagnostic Criteria
B) Specifiers
C) Subtypes
D) Comorbidities

Answer 12

B) specifier

Question 13

Which of the following is a specifier for Major Depressive Disorder according to the DSM-5?

A) Severity (mild, moderate, or severe)
B) Number of Episodes (single or recurrent)
C) Degree of Recovery (in partial remission or in full remission)
D) Presence of Psychotic Features
E) All of the above

Answer 13

E) All of the above

Question 14

Depression in which the person experiences delusions and/or hallucinations is referred to as Major Depressive Disorder with:

A) Anxious Distress
B) Melancholic Features
C) Psychotic Features
D) Atypical Features

Answer 14

C) psychotic features

Question 15

Which of the following is a hallmark of Major Depressive Disorder with melancholic features?

A) Increased appetite and weight gain with a lack of early morning awakening

B) Severe anhedonia, worsening mood in the morning, early morning awakening, and significant weight loss

C) Frequent mood swings and psychomotor agitation without significant appetite changes

D) Stable mood with psychomotor retardation and no excessive guilt

Answer 15

B) Severe anhedonia, worsening mood in the morning, early morning awakening, and significant weight loss

Question 16

Which feature of Major Depressive Disorder involves movement disturbances like immobility or excessive, purposeless activity?

A) Melancholic features

B) Atypical features

C) Catatonic features

D) Psychotic features

Answer 16

C) Catatonic features

Question 17

Women with psychosocial stressors such as lack of support, feeding difficulties, and a history of depression are at higher risk of major depressive disorder with which onset?

A) Late-onset

B) Peripartum

C) Seasonal

D) Post-traumatic

Answer 17

B) peripartum

(during pregnancy or within four weeks after childbirth)

Question 18

Which of the following is considered more serious than the “baby blues” and includes severe symptoms during and after pregnancy?

A) Postpartum anxiety

B) Peripartum depression

C) Seasonal affective disorder

D) Generalized anxiety disorder

Answer 18

B) Peripartum depression

Question 19

Episodes of depressed mood, often referred to as ‘the baby blues,’ can occur in up to what percentage of women within 1–10 days after childbirth?

A) 30%

B) 50%

C) 60%

D) 70%

Answer 19

D) 70%

Question 20

Major depressive disorder with which pattern is characterized by episodes that occur at a specific time of the year, often in autumn or winter?

A) Melancholic

B) Peripartum

C) Seasonal

D) Atypical

Answer 20

C) seasonal

Question 21

Major depressive disorder with significant anxiety symptoms, such as irrational worry and a sense of impending threat, is known as major depressive disorder with:

A) Atypical features

B) Anxious distress

C) Catatonic features

D) Psychotic features

Answer 21

B) anxious distress

Question 22

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

a) 20
b) 30
c) 50
d) 70

Answer 22

c) 50

Question 23

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

True/False

Answer 23

True

Question 24

Under DSM-5, which change allows for the diagnosis of major depressive disorder in individuals with symptoms similar to bereavement?

A) Bereavement is no longer an exclusion criterion.

B) Bereavement symptoms are now treated with medication.

C) Bereavement is categorized as a psychotic disorder.

D) Bereavement is considered a mood disorder.

Answer 24

A) Bereavement is no longer an exclusion criterion

(In previous editions of the DSM, the presence of depressive symptoms in the context of bereavement was often excluded from a diagnosis of MDD. However, the DSM-5 recognizes that major depressive disorder can occur in the context of bereavement and allows for diagnosis if the symptoms are severe enough and cause significant impairment)

Question 25

According to DSM-5 guidelines and to minimise the chances of inappropriately diagnosing with mental illness, which of the following is a key distinction between non-pathological grief and major depressive disorder?

A) Grief involves a lack of interest in daily activities, while depression does not.

B) Grief is characterized by preoccupation with thoughts about the deceased, while depression involves self-critical thoughts.

C) Grief results in significant weight gain, while depression does not.

D) Grief includes hallucinations, while depression does not.

Answer 25

B) Grief is characterized by preoccupation with thoughts about the deceased, while depression involves self-critical thoughts.

Question 26

DSM-5 replaced dysthymic disorder with which term to describe a depressive disorder lasting more than two years with mood disturbance and at least two other symptoms?

A) Major depressive disorder

B) Persistent depressive disorder

C) Atypical depressive disorder

D) Seasonal affective disorder

Answer 26

B) Persistent depressive disorder

Question 27

Which new diagnostic category introduced in the DSM-5 is characterized by severe and persistent irritability in children, with temper outbursts that are out of proportion to the situation?

A) Major depressive disorder

B) Persistent depressive disorder

C) Disruptive mood dysregulation disorder

D) Oppositional defiant disorder

Answer 27

C) Disruptive mood dysregulation disorder

Question 28

What is a limitation of diagnosing disruptive mood dysregulation disorder due to its similarity with other DSM-5 diagnoses as viewed in Europe and Australasia ?

A) It lacks treatment options.

B) It is rarely diagnosed in children.

C) It overlaps with disorders emphasizing behavioral and emotional dysregulation.

D) It is exclusively diagnosed in adults.

Answer 28

C) It overlaps with disorders emphasizing behavioral and emotional dysregulation.

(Diagnosis of disruptive mood dysregulation disorder is highly prevalent in the US)

Question 29

Diagnosis of disruptive mood dysregulation disorder is challenging due to its similarity with which other disorders?

A) Schizophrenia and PTSD

B) Obsessive-compulsive disorder and social anxiety disorder

C) Oppositional defiant disorder, attention-deficit/hyperactivity disorder, impulse control disorders, and bipolar disorder

D) Generalized anxiety disorder and major depressive disorder

Answer 29

C) Oppositional defiant disorder, attention-deficit/hyperactivity disorder, impulse control disorders, and bipolar disorder

Question 30

According to the Australian subtyping model, which three broad classes of depressive disorders are suggested?

A) Psychotic, atypical, and bipolar

B) Melancholic, non-melancholic, and seasonal

C) Psychotic, melancholic, and non-melancholic

D) Anxious, psychotic, and neurotic

Answer 30

C) Psychotic, melancholic, and non-melancholic

(psychotic,
melancholic (both biologically based) and non-melancholic (driven by life-event stressors and psychological factors).

Question 31

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

A) Men; women

B) Women; men

C) Adolescents; adults

D) Rural areas; urban areas

Answer 31

B) Women; men

Question 32

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

Answer 32

1
1.5

Question 33

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

Answer 33

1

Question 34

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

True/False

Answer 34

False

(has not changed despite available treatments)

Question 35

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

Answer 35

Increasing

(girls have higher rates than boys)

Question 36

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

A) Women talking more readily about it and biological factors such as hormones

B) Increased rates of substance abuse and lack of social support

C) Economic disparity and lifestyle choices

D) Higher prevalence of chronic illness and social isolation

Answer 36

A) Women talking more readily about it and biological factors such as hormones

Question 37

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 37

5

Question 38

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 38

3

Question 39

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

A) 10

B) 15

C) 25

D) 30

Answer 39

D) 30

Question 40

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

A) 20%

B) 50%

C) 60%

D) 70%

Answer 40

A) 20%

Question 41

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.

Answer 41

50

Question 42

Major depressive disorder has a highly recurrent character. About _____ percent of people who recover from a first episode will have no further episodes, while many will experience additional episodes or not recover fully from the first episode.

A) 25%

B) 50%

C) 65%

D) 75%

Answer 42

B) 50%

Question 43

Which of the following are the four main problems associated with depression?

A) Increased risk of suicide

B) Difficulties with occupational and social activities

C) Anxiety disorders

D) Physical health problems

E) All of the above

Answer 43

E) All of the above

Question 44

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 44

male
female

Question 45

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

A) 20%

B) 40%

C) 60%

D) 75%

Answer 45

D) 75%

Question 46

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

Answer 46

declining

Question 47

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

A) Biological, psychological, social, and environmental

B) Genetic, cognitive, cultural, and economic

C) Behavioral, interpersonal, educational, and familial

D) Neurological, developmental, geographical, and historical

Answer 47

A) Biological, psychological, social, and environmental

Question 48

Genetics play a significant part in the development of depression. Current understanding highlights the interplay between genetic vulnerability and stressful life events. Which example illustrates this interplay?

A) Inherited anxious traits in children may lead to the development of chronic physical illnesses.

B) Genetic factors alone can determine the onset of depression without any environmental influence.

C) Inherited anxious traits in children may contribute to overprotective or authoritarian parenting styles, potentially undermining the child’s sense of mastery and increasing vulnerability to anxiety and depression.

D) Genetic predispositions are irrelevant in the presence of stressful life events.

Answer 48

C) Inherited anxious traits in children may contribute to overprotective or authoritarian parenting styles, potentially undermining the child’s sense of mastery and increasing vulnerability to anxiety and depression.

Question 49

The main neurotransmitters implicated in depression include:

A) Serotonin

B) Noradrenaline (norepinephrine)

C) Dopamine

D) All of the above

Answer 49

D) All of the above

Question 50

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

A) Amino acids

B) Monoamines

C) Peptides

D) Neurohormones

Answer 50

B) Monoamines

Question 51

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

A) Limbic

B) Somatic

C) Autonomic

D) Reward

Answer 51

A) Limbic

Question 52

Early theories suggested that depression was caused by a reduction in the availability of __________ neurotransmitters. More recent theories have implicated abnormalities in the number and sensitivity of receptors in __________.

A) amino acid; the brainstem

B) monoamine; synapses

C) peptide; the hypothalamus

D) cholinergic; the cerebellum

Answer 52

B) monoamine; synapses

Question 53

Euroendocrine (hormonal) theories suggest that hyperactivity in the __________ axis plays a role in the development of depression.

A) Hypothalamic-pituitary/adrenal (HPA)

B) Thyroid-stimulating

C) Sympathetic-parasympathetic

D) Renin-angiotensin

Answer 53

A) Hypothalamic-pituitary/adrenal (HPA)

(This axis is critical to the body’s response to stress and produces stress hormones involved in the fight or flight response)

Question 54

Neurophysiological theories focus on structural or functional abnormalities in certain brain structures, including the:

A) Pre-frontal cortex, hippocampus, anterior cingulate cortex, and amygdala

B) Cerebellum, basal ganglia, occipital lobe, and thalamus

C) Medulla, pons, temporal lobe, and substantia nigra

D) Hypothalamus, pituitary gland, parietal lobe, and corpus callosum

Answer 54

A) Pre-frontal cortex, hippocampus, anterior cingulate cortex, and amygdala

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

Question 55

Environmental factors (job loss, divorce, loss of loved one) are suggested to precede a depressive episode by how many months?

A) 1-3 months

B) 3-6 months

C) 6-9 months

D) 9-12 months

Answer 55

C) 6-9 months

Question 56

Early cognitive theories, such as the learned helplessness model of depression (Seligman), proposed that depression is a learned response to adverse events perceived as:

A) Controllable

B) Avoidable

C) Uncontrollable

D) Predictable

Answer 56

C) Uncontrollable

(based on observation from electric shock experiment on animals who gave up trying to escape)

Question 57

The depressive attributional style interprets negative life events due to:

A) Internal, global, and stable factors

B) External, specific, and temporary factors

C) Internal, specific, and unstable factors

D) External, global, and stable factors

Answer 57

A) Internal, global, and stable factors

Question 58

Which of the following is an example of an internal attribution in the depressive attributional style?

A) “I failed because the test was too hard.”

B) “I failed because I didn’t study enough.”

C) “I failed because the teacher doesn’t like me.”

D) “I failed because of bad luck.”

Answer 58

B) “I failed because I didn’t study enough.

(the individual’s own fault)

Question 59

Which of the following is an example of a global attribution in the depressive attributional style?

A) “I’m bad at this job, so I must be bad at all jobs.”

B) “I failed this task because I wasn’t focused.”

C) “I didn’t get the promotion because the competition was tough.”

D) “I made a mistake in this project due to a lack of experience.”

Answer 59

A) “I’m bad at this job, so I must be bad at all jobs.”

(applicable to all situations)

Question 60

Which of the following is an example of a stable attribution in the depressive attributional style?

A) “I didn’t succeed because I had an off day.”

B) “I always struggle with tasks like this.”

C) “I didn’t do well because I was distracted.”

D) “I failed because of temporary external factors.”

Answer 60

B) “I always struggle with tasks like this.”

(unchanging or invariable)

Question 61

Aaron Beck’s major cognitive theory of depression proposed that negative experiences in childhood may result in the development of dysfunctional core beliefs about the:

A) Self, others, and world

B) Self, family, and friends

C) Self, environment, and fate

D) Self, success, and relationships

Answer 61

A) Self, others, and world

(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 relationship then I’m lovable’).

Question 62

According to Beck, the negative view of the self, the world, and the future is maintained by cognitive distortions. Which of the following are errors in thinking likely to be engaged in by depressed people?

A) Arbitrary inference

B) Magnification and minimization

C) Personalization

D) Overgeneralization

E) All of the above

Answer 62

E) All of the above

Question 63

When a person draws a conclusion in the absence of supporting evidence or despite the presence of contradictory evidence.

A) Arbitrary inference

B) Selective inference

C) Overgeneralization

D) Catastrophic thinking

Answer 63

A) Arbitrary inference

Question 64

Which of the following is an example of arbitrary inference?

A) “I didn’t get the job because I wasn’t qualified enough.”

B) “I didn’t get invited to the party, so I must have done something to offend them.”

C) “I forgot to call back, so I’m a bad friend.”

D) “I didn’t understand the lecture, so I must be bad at this subject.”

Answer 64

B) “I didn’t get invited to the party, so I must have done something to offend them.”

Question 65

A statement in which a person magnifies perceived failure, such as ‘I couldn’t answer that question in class, everyone thinks I am such an idiot,’ is an example of ___________.

A) Arbitrary inference

B) Personalization

C) Magnification

D) Overgeneralization

Answer 65

C) Magnification

Question 66

Statement in which a person minimises or discounts his/her achievements such as ‘I managed to get a part-time job in the company but they were probably desperate to hire someone’ is an example of:

A) Self-deprecation
B) Minimisation
C) Rationalisation
D) Overgeneralisation

Answer 66

B) Minimisation

Question 67

What is the dominant behavioral theory proposal regarding the aetiology and maintenance of depression?

A) Cognitive distortions lead to depression.
B) Life events reduce positive reinforcement opportunities and in turn increase the risk of depression
C) Unresolved unconscious conflicts cause depression.
D) Neurochemical imbalances are the primary cause.

Answer 67

B) Life events reduce positive reinforcement opportunities and in turn increase the risk of depression

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

Question 68

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’).

A) Catastrophising
B) Personalisation
C) Overgeneralisation
D) All-or-Nothing Thinking

Answer 68

C) Overgeneralisation

Question 69

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’).

A) Catastrophising
B) Personalisation
C) Overgeneralisation
D) Discounting

Answer 69

B) Personalisation

Question 70

Which theory holds that depression is a form of pathological grief.

A) Cognitive
B) Behavioral
C) Psychoanalytic
D) Biological

Answer 70

C) Psychoanalytic

Question 71

Question 72

Conditions or variables associated with a reduced risk or chance of developing a disorder are known as:

A) Risk factors
B) Protective factors
C) Precipitating factors
D) Maintaining factors

Answer 72

B) Protective factors

Question 73

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, potentially contributing to the person’s relapse, is known as:

A) Expressed Emotion
B) Family Systems Theory
C) Enmeshment
D) Emotional Support

Answer 73

A) Expressed Emotion

(EE) = social factors

Question 74

Which of the following categories includes medications for the treatment of depression

A) Tricyclic Antidepressants (TCAs)
B) Selective Serotonin Reuptake Inhibitors (SSRIs)
C) Serotonin Noradrenalin Reuptake Inhibitors (SNRIs)
D) monoamine oxidase inhibitors (MAOIs)
E) All of the above

Answer 74

E) All of the above

Question 75

Medications frequently used for depression that work by increasing the availability of neurotransmitters or increasing the sensitivity of neuron receptors in the brain are known as:

A) Antipsychotics
B) Antidepressants
C) Anxiolytics
D) Stimulants

Answer 75

B) Antidepressants

Question 76

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

A) Antidepressant
B) Anxiolytic
C) Antipsychotic
D) Mood Stabilize

Answer 76

B) Antipsychotic

Question 77

In terms of efficacy, newer forms of antidepressants (such as SSRIs) were similar to tricyclic antidepressants for the treatment of depression; however, newer meds have a lower dropout rate due to:

A) Higher efficacy
B) Fewer side effects
C) Greater cost-effectiveness
D) Faster onset of action

Answer 77

B) Fewer side effects

Question 78

(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.

A) Repetitive Transcranial Magnetic Stimulation
B) Repetitive Transcranial Microstimulation
C) Radiological Transcranial Magnetic Stimulation
D) Reactive Transcranial Magnetic Stimulation

Answer 78

A) Repetitive Transcranial Magnetic Stimulation

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

Question 79

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, is known as:

A) Electroconvulsive Therapy (ECT)
B) Deep Brain Stimulation (DBS)
C) Vagus Nerve Stimulation (VNS)
D) Transcranial Magnetic Stimulation (TMS)

Answer 79

C) Vagus Nerve Stimulation (VNS)

Question 80

Treatment that involves exposure to bright light and is used particularly during the winter months for individuals with seasonal affective disorder is known as:

A) Light Therapy
B) Cognitive Behavioral Therapy
C) Electroconvulsive Therapy
D) Interpersonal Therapy

Answer 80

A) Light Therapy

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

Question 81

Treatment for mood disorders that involves the induction of a brain seizure by passing an electrical current through the patient’s brain while they are anaesthetised is known as:

A) Electroconvulsive Therapy (ECT)
B) Repetitive Transcranial Magnetic Stimulation (rTMS)
C) Vagus Nerve Stimulation (VNS)
D) Deep Brain Stimulation (DBS)

Answer 81

A) Electroconvulsive Therapy (ECT)

(for severe cases)

Question 82

ECT is usually delivered to the __________ side of the brain to minimize the likelihood of long-term memory and learning problems.

A) Right
B) Left
C) Both
D) Neither

Answer 82

A) Right

Question 83

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

A) Pleasant Activity
B) Behavioral Activation
C) Activity Monitoring
D) Cognitive Restructuring

Answer 83

A) Pleasant Activity

Question 84

A key cognitive technique is __________ restructuring, where 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 behaviors).

A) Behavioral; DEI
B) Cognitive; ABC
C) Emotional; DEF
D) Rational; XYZ

Answer 84

B) cognitive; ABC

Question 85

Question 86

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

A) Cognitive Behavioral Therapy
B) Interpersonal Therapy
C) Dialectical Behavior Therapy
D) Psychodynamic Therapy

Answer 86

B) Interpersonal Therapy

Question 87

Current treatment guidelines state that IPT is as effective as CBT in the treatment of:

A) Generalized Anxiety Disorder
B) Schizophrenia
C) Moderately Severe Depression
D) Post-Traumatic Stress Disorder

Answer 87

C) Moderately Severe Depression

Question 88

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

Answer 88

psychodynamic
therapies

Question 89

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

Answer 89

melancholia

Question 90

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

Answer 90

anxiety

Question 91

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

Answer 91

children

Question 92

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 92

5.1

Question 93

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 93

substance abuse
genetic vulnerability
trauma history

Question 94

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

Answer 94

30

Question 95

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

Karl Leonhand
Emil Kraeplin
Edward Thorndike
Hippocrates

Answer 95

Karl Leonhand

Question 96

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 96

‘baby blues’

Question 97

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 97

earlier age of onset

ongoing life stressors

Question 98

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 98

disruptive mood dysregulation disorder

Question 99

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

15
35
25
45

Answer 99

15

Question 100

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 100

3.1

Question 101

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 101

5

Question 102

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

18
25
15
21

Answer 102

25

Question 103

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 103

50

Question 104

Suicidal _________
refers to thoughts about suicide.

Answer 104

ideation

Question 105

For younger sufferers, depression can negatively impact academic __________.

Answer 105

achievement

Question 106

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

Multiple select question.

specific phobia
OCD
GAD
panic disorder

Answer 106

GAD
panic disorder

Question 107

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 107

diabetes
cancer
cardiovascular disease

Question 108

Neuroendocrine theorists emphasise the role of hyperactivity in the _____

pre-frontal cortex
limbic system
synapses
HPA axis

Answer 108

HPA axis

Question 109

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

90
75
80
85

Answer 109

75

Question 110

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 110

financial strain

lowered work productivity

Question 111

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 111

biological vulnerabilities

learnt psychological vulnerabilities

Question 112

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

Answer 112

immune

Question 113

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

3–4
1–2
2–3
4–5

Answer 113

2–3

Question 114

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 114

failure
loss

Question 115

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 115

personalisation

Question 116

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

Answer 116

contingencies

Question 117

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

pathological grief
negative behaviour
negative cognitions
melancholia

Answer 117

pathological grief

Question 118

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

Answer 118

women

Question 119

The main neurotransmitters implicated in depression are:

Multiple select question.

dopamine
GABA
serotonin
noradrenaline (norepinephrine)

Answer 119

dopamine

serotonin

noradrenaline (norepinephrine)

Question 120

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 120

overgeneralisation

Question 121

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 121

high family cohesion
high social connectedness

Question 122

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

interaction
support
competence
isolation

Answer 122

isolation

Question 123

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 123

have fewer side effects

Question 124

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

Answer 124

monoamines

Question 125

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 125

they perpetuate each other

Question 126

The purpose of pleasant activity scheduling is to:

improve sleep

decrease reliance on medication

decrease engagement in negative activities

improve mood

Answer 126

improve mood

Question 127

Within interpersonal psychotherapy, key target areas for treatment include:

Multiple select question.

dysfunctional cognitions
interpersonal disputes
grief from loss
life transitions

Answer 127

interpersonal disputes
grief from loss
life transitions

Question 128

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

negative behaviours
dysfunctional cognitions
interpersonal stressors
conflicts

Answer 128

conflicts

Question 129

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

catatonia
peripartum onset
seasonal pattern
psychotic features

Answer 129

seasonal pattern

Question 130

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 130

continue medication use

Question 131

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

Answer 131

beliefs

Question 132

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

Multiple select question.

the world
themselves
the past
others

Answer 132

the world
themselves
others

Question 133

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

the cognitive triad

negative cognitions

negative self-referent thoughts

maladaptive interpersonal skills

Answer 133

maladaptive interpersonal skills

Question 134

Most interventions to prevent depression teach skills in which areas?

Multiple select question.

interpersonal skills
sleep management
coping skills
meditation

Answer 134

interpersonal skills

coping skills

Question 135

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

mindfulness
ACT
CBT
IPT

Answer 135

CBT

Question 136

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

Answer 136

Thought

Question 137

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

Answer 137

inconsistent

Question 138

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 138

has some risk of developing depression

Question 139

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

Answer 139

maintain

Question 140

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

A) Major Depressive Disorder
B) Generalized Anxiety Disorder
C) Bipolar Disorder
D) Schizoaffective Disorder

Answer 140

C) Bipolar disorder

Question 141

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 19th century in France when Jean-Pierre _________ referred to the condition as the cycle of madness.

A) Pinel
B) Falret
C) Esquirol
D) Charcot

Answer 141

B) Falret

Question 142

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).

A) Sigmund Freud
B) Emil Kraepelin
C) Jean-Pierre Falret
D) Karl Jaspers

Answer 142

B) Emil Kraepelin

Question 143

Who argued that the term ‘manic depressive insanity’ was too inclusive and 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.

A) Emil Kraepelin
B) John Cade
C) Karl Leonhard
D) Sigmund Freud

Answer 143

Karl Leonhard

Question 144

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

A) Lithium
B) Sodium
C) Potassium
D) Calcium

Answer 144

A) Lithium

Question 145

The 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:

A) Major Depressive Disorder and Persistent Depressive Disorder
B) Schizophrenia and Schizoaffective Disorder
C) Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder
D) Generalized Anxiety Disorder and Panic Disorder

Answer 145

C) Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder

Question 146

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 behaviors is known as:

A) Major Depressive Episode
B) Hypomanic Episode
C) Manic Episode
D) Cyclothymic Episode

Answer 146

C) Manic episode

Question 147

Diagnosis of bipolar disorder requires a manic episode to last for at least a WEEK, and to have 3 of the following symptoms:

1) Grandiosity (inflated self-esteem)
2) Decreased need for sleep
3) Being talkative more than usual
4) Thoughts racing from one idea to another
5) Heightened activity
6) Risky behaviors

Question 148

For a diagnosis of a manic episode, the symptoms must be out of character for the individual, and the mood disturbance must be severe enough to impair functioning. This often requires hospitalization.

A) True
B) False

Answer 148

A) True

Question 149

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

A) Paranoia
B) Delusion of Reference
C) Grandiosity
D) Depersonalization

Answer 149

C) Grandiosity

Question 150

Which condition has symptoms similar to mania but is less severe and does not require hospitalization?

A) Hypomania
B) Cyclothymia
C) Major Depressive Episode
D) Mixed Episode

Answer 150

A) Hypomania

Question 151

The difference between hypomania and mania includes which of the following?

A) Less severe symptoms and no interfere with daily functioning
B) No hospitalization
C) Lacks hallucinations or delusions
D) Shorter duration
E) All of the above

Answer 151

E) All of the above

Question 152

What is the change in the DSM-5 to meet manic or hypomanic criteria?

A) Increased activity or energy is now required (along with mood changes) to meet the criteria for a manic or hypomanic episode.

B) The criteria for a depressive episode now include more symptoms.

C) Hallucinations and delusions are no longer considered for diagnosis.

D) The duration of episodes has been extended.

Answer 152

A) Increased activity or energy is now required (along with mood changes) to meet the criteria for a manic or hypomanic episode.

Question 153

Diagnostic requirement of increased energy (along with mood changes) is consistent with the idea that bipolar disorder is fundamentally a disorder of:

A) Cognition
B) Perception
C) Motivation
D) Emotion

Answer 153

C) Motivation

Question 154

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

A) Bipolar I Disorder
B) Bipolar II Disorder
C) Cyclothymic Disorder
D) Major Depressive Disorder

Answer 154

A) Bipolar I disorder

Question 155

What are the requirements for diagnosing hypomania according to the DSM-5 criteria?

A) A period of persistently elevated, expansive, or irritable mood lasting for at least 2 days.

B) A period of persistently elevated, expansive, or irritable mood lasting for at least 4 days, clearly different from the individual’s usual non-depressed mood.

C) A period of persistently elevated mood lasting for at least 1 week, with severe impairment.

D) A period of persistently depressed mood lasting for at least 2 weeks.

Answer 155

B) A period of persistently elevated, expansive, or irritable mood lasting for at least 4 days, clearly different from the individual’s usual non-depressed mood.

Question 156

What are the characteristics of bipolar disorders?

A) Occurrence of various combinations of manic episodes, hypomanic episodes, and major depressive episodes across time.

B) Presence of generalized anxiety, panic attacks, and major depressive episodes.

C) Occurrence of mood swings between severe depression and hypomanic episodes only.

D) Presence of hallucinations, delusions, and depressive episodes.

Answer 156

A) Occurrence of various combinations of manic episodes, hypomanic episodes, and major depressive episodes across time.

Question 157

Form of bipolar disorder characterized by hypomanic and major depressive episodes:

A) Bipolar I Disorder
B) Bipolar II Disorder
C) Cyclothymic Disorder
D) Major Depressive Disorder

Answer 157

B) Bipolar II disorder

Question 158

Manic episodes are seen in which type of bipolar disorder?

A) Bipolar I Disorder and Bipolar II Disorder
B) Bipolar II Disorder only
C) Bipolar I Disorder only
D) Neither Bipolar I nor Bipolar II Disorder

Answer 158

C) Bipolar I Disorder only

Question 159

Who were the first to distinguish between bipolar I and bipolar II disorders?

A) Kraepelin and Fieve
B) Dunner and Fieve
C) Akiskal and Beck
D) Clayton and Rothschild

Answer 159

B) Dunner and Fieve

Question 160

There is ongoing debate as to whether Bipolar I and II represent distinct forms of the condition or simply differences in severity.
True/False

Answer 160

True

Question 161

Around what percentage of people with bipolar disorder experience multiple episodes of mood disturbance during their lifetime, with episodes occurring over weeks or months rather than days?

A) 70%
B) 80%
C) 90%
D) 100%

Answer 161

C) 90%

Question 162

Which term describes a pattern in bipolar disorder where an individual experiences four or more episodes of mania or depression within a single year?

A) Mixed episode
B) Rapid cycling
C) Seasonal pattern
D) Persistent depressive disorder

Answer 162

B) Rapid cycling

Question 163

What does rapid cycling in bipolar disorder include?

A) Only those who recover fully between episodes
B) Only those who switch continually between manic and depressive states
C) Both those who recover between episodes and those who switch continually between states
D) Only those with a seasonal pattern of episodes

Answer 163

C) Both those who recover between episodes and those who switch continually between states

Question 164

Which of the following is a specifier for bipolar disorder?

A) With mixed features
B) With anxious distress
C) With seasonal pattern
D) Both A and B

Answer 164

D) Both A and B

Question 165

What distinguishes cyclothymic disorder from bipolar I or II disorders?

A) It involves more severe manic episodes
B) Symptoms are more chronic but less severe
C) It includes only depressive episodes
D) It is characterized by psychotic features

Answer 165

B) Symptoms are more chronic but less severe

Question 166

What is the relationship between cyclothymic disorder and bipolar I or II disorders in terms of family history?

A) Cyclothymic disorder is less common in the families of individuals with bipolar I or II disorders.
B) Increased rates of cyclothymic disorder are found in the family members of individuals with bipolar I or II disorders.
C) Cyclothymic disorder is unrelated to bipolar I or II disorders in terms of familial patterns.
D) Family history of cyclothymic disorder is a reliable predictor of developing bipolar I or II disorders.

Answer 166

B) Increased rates of cyclothymic disorder are found in the family members of individuals with bipolar I or II disorders.

Question 167

Underdiagnosis or misdiagnosis of bipolar disorder often includes which of the following for men and women?

A) For men: Schizophrenia; For women: Generalized anxiety disorder
B) For men: Schizophrenia; For women: Depression
C) For men: Borderline personality disorder; For women: Psychotic disorder
D) For men: Major depressive disorder; For women: Schizophrenia

Answer 167

B) For men: Schizophrenia; For women: Depression

Question 168

Overdiagnosis of bipolar II disorder is common in individuals with which of the following conditions, due to misinterpreting brief periods of elevated mood as hypomania?

A) Schizophrenia
B) Unipolar depression
C) Borderline personality disorder
D) Both B and C

Answer 168

D) Both B and C

Question 169

What is the median age of onset for bipolar disorder, and what percentage of individuals experience onset by age 17?

A) 30 years; 15%
B) 25 years; 25%
C) 20 years; 30%
D) 35 years; 10%

Answer 169

B) 25 years; 25%

Question 170

Bipolar disorder is relatively rare after which age?

A) 20
B) 25
C) 30
D) 35

Answer 170

C) 30

Question 171

In Australia, what are the prevalence rates of bipolar disorder for major symptoms in any 12-month period and over the lifetime?

A) 0.9% and 1.3%
B) 2% and 4%
C) 3% and 5%
D) 4% and 6%

Answer 171

A) 0.9% and 1.3%

Question 172

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

A) Men
B) Women
C) Both genders equally
D) Adolescents

Answer 172

B) Women

Question 173

For Bipolar I disorder, what percentage of time is typically spent in depression and in mania or hypomania?

A) Depression: 25%, Mania: 15%
B) Depression: 32%, Mania: 9%
C) Depression: 40%, Mania: 20%
D) Depression: 50%, Mania: 10%

Answer 173

B) Depression: 32%, Mania: 9%

Question 174

For Bipolar II disorder, what percentage of time is typically spent in depression and hypomania?

A) Depression: 40%, Hypomania: 10%
B) Depression: 50%, Hypomania: 1%
C) Depression: 60%, Hypomania: 5%
D) Depression: 30%, Hypomania: 15%

Answer 174

B) Depression: 50%, Hypomania: 1%

Question 175

What is the median duration for bipolar depressive episodes, manic episodes, and hypomanic episodes?

A) Depression: 10 weeks, Mania: 5 weeks, Hypomania: 2 weeks
B) Depression: 20 weeks, Mania: 10 weeks, Hypomania: 4 weeks
C) Depression: 15 weeks, Mania: 7 weeks, Hypomania: 3 weeks
D) Depression: 12 weeks, Mania: 8 weeks, Hypomania: 6 weeks

Answer 175

C) Depression: 15 weeks, Mania: 7 weeks, Hypomania: 3 weeks

Question 176

Lithium fully protects only what percentage of patients against further episodes, and what is a common issue with its use?

A) 20-30 percent; High efficacy
B) 25-50 percent; Compliance issues
C) 40-50 percent; Low cost
D) 50-60 percent; Lack of side effects

Answer 176

B) 25-50 percent; Compliance issues

Question 177

What is the less severe form of a manic episode that is an essential feature of bipolar II disorder?

A) Mania
B) Hypomania
C) Mixed episode
D) Depression

Answer 177

B) Hypomania

Question 178

What percentage of bipolar disorder patients relapse within one year, two years, and five years?

A) 30%, 50%, 70%
B) 40%, 60%, 73%
C) 50%, 65%, 80%
D) 45%, 55%, 75%

Answer 178

B) 40%, 60%, 73%

Question 179

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

Answer 179

True

Question 180

Question 181

Australian research found that about what percentage of people with bipolar disorder had a concurrent anxiety disorder?

A) 40 percent
B) 50 percent
C) 60 percent
D) 70 percent

Answer 181

B) 50 percent

Question 182

Which stimulant drug can produce symptoms such as euphoria, self-confidence, alertness, agitation, paranoia, perceptual illusions, and depression?

A) Cocaine
B) Heroin
C) Amphetamines
D) Benzodiazepines

Answer 182

C) Amphetamines

Question 183

Bipolar disorder is strongly associated with substance misuse, which is reported in what percentage of people with bipolar disorder?

A) 20 percent
B) 30 percent
C) 39 percent
D) 50 percent

Answer 183

C) 39 percent

Question 184

Following manic episodes, almost one-third of patients cannot work for how many months, and what percentage return to work at their former skill level?

A) 3 months; 25%
B) 6 months; 20%
C) 6 months; 30%
D) 12 months;15%

Answer 184

B) 6 months; 20%

Question 185

The suicide rate in people with bipolar disorder is approximately how many times that of the general population, and what percentage of these suicides occur during the depressive phase?

A) 10 times; 70%
B) 15 times; 80%
C) 20 times; 60%
D) 25 times; 90%

Answer 185

B) 15 times; 80%

Question 186

At least what percentage of patients with bipolar disorder will attempt suicide, and what percentage will complete suicide?

A) 15 percent; 5-10 percent
B) 20 percent; 5-10 percent
C) 25 percent; 10-20 percent
D) 30 percent; 15-25 percent

Answer 186

C) 25 percent; 10-20 percent

Question 187

The counselling strategy that encourages clients to consider both the positives and negatives of a particular behavior is called:

A) Cognitive Behavioral Therapy
B) Solution-Focused Therapy
C) Motivational Interviewing
D) Dialectical Behavior Therapy

Answer 187

C) Motivational Interviewing

Question 188

Bipolar disorder has a strong genetic component.

True/False

Answer 188

True

Question 189

In studies of bipolar disorder, what is the estimated heritability rate, and what is the increased risk of bipolar disorder in first-degree relatives of affected individuals?

A) Heritability rate: 70 percent; Increased risk: 10-fold
B) Heritability rate: 80 percent; Increased risk: 15-fold
C) Heritability rate: 85 percent; Increased risk: 13-fold
D) Heritability rate: 90 percent; Increased risk: 20-fold

Answer 189

C) Heritability rate: 85 percent; Increased risk: 13-fold

Question 190

Life stresses and poor coping strategies that disrupt which type of function can lead to early signs of mood disturbance and potentially result in a full-blown manic or depressive episode?

A) Cognitive
B) Emotional
C) Circadian
D) Social

Answer 190

C) Circadian

Question 191

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 191

circadian system

Question 192

The model originally developed in the context of schizophrenia that suggests abnormality is caused by the combination of a vulnerability or predisposition and life events is known as:

A) Cognitive Behavioral Model
B) Psychodynamic Model
C) Diathesis-Stress Model
D) Humanistic Model

Answer 192

C) Diathesis-Stress Model

Question 193

Question 194

The theory that manic episodes may be triggered by dysregulated goal pursuit, involving excessive involvement in the pursuit of goals, is called:

A) Cognitive Behavioral Theory
B) Goal Dysregulation Theory
C) Stress-Vulnerability Theory
D) Psychoanalytic Theory

Answer 194

B) Goal dysregulation model

Question 195

According to the goal dysregulation theory, which scenario illustrates how manic episodes can be triggered by excessive involvement in goal pursuit?

A) A person starts a new hobby and spends weekends working on it.
B) A person becomes overly focused on a business idea, sets unrealistic goals, works non-stop, and makes risky investments.
C) A person attends therapy and follows a structured daily routine.
D) A person maintains a balanced lifestyle with moderate exercise and social activities.

Answer 195

B) A person becomes overly focused on a business idea, sets unrealistic goals, works non-stop, and makes risky investments.

Question 196

The model that suggests increases in goal-setting and time spent pursuing goals can accelerate the development of hypomanic or manic symptoms is called:

A) Goal Attainment Model
B) Goal Dysregulation Model
C) Goal Management Model
D) Goal Achievement Model

Answer 196

B) Goal Dysregulation Model

Question 197

Individuals with a history of bipolar I disorder, even when not in an episode, tend to:

A) Place less emphasis on rewards and show minimal goal pursuit
B) Focus equally on rewards and goal pursuit as those without the disorder
C) Place a higher emphasis on rewards and be excessively engaged in pursuing goals
D) Avoid setting goals and reward-driven activities

Answer 197

C) Place a higher emphasis on rewards and be excessively engaged in pursuing goals

Question 198

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

Answer 198

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 199

According to Thomas and Bentall (2002), hypomania and mania are thought to represent:

A) A genetic predisposition to mood disorders
B) A deliberate, defensive attempt to avoid negative cognitions and emotions associated with depression and low self-esteem
C) An innate personality trait that causes emotional instability
D) A result of substance abuse and environmental stressors

Answer 199

B) A deliberate, defensive attempt to avoid negative cognitions and emotions associated with depression and low self-esteem

Question 200

According to Thomas and Bentall (2002), what coping styles were found to predict higher scores on a measure of hypomania?

A) Avoidance, meditation, and relaxation
B) Rumination, distraction, and risk-taking
C) Social support, problem-solving, and planning
D) Acceptance, cognitive restructuring, and mindfulness

Answer 200

B) Rumination, distraction, and risk-taking

Question 201

Which term refers to the innate aspects of personality, such as mood and emotional reactivity, that are believed to be genetically based?

A) Personality traits
B) Behavioral tendencies
C) Temperament
D) Cognitive styles

Answer 201

C) Temperament

Question 202

Temperamental traits such as perfectionism and sociotropy are:

A) Less prevalent in individuals with bipolar disorder than those with a depressive disorder
B) Equally prevalent in individuals with bipolar disorder and those with a depressive disorder
C) More prevalent in individuals with bipolar disorder than those with a depressive disorder
D) Not associated with either bipolar disorder or depressive disorder

Answer 202

C) More prevalent in individuals with bipolar disorder than those with a depressive disorder

Question 203

How can temperamental tendencies affect individuals with bipolar disorder?

A) They improve treatment adherence and reduce relapse risk
B) They have no impact on treatment or relapse risk
C) They can adversely affect acceptance of the illness, leading to poor treatment compliance and higher relapse risk
D) They make it easier to adapt to the illness and follow treatment

Answer 203

C) They can adversely affect acceptance of the illness, leading to poor treatment compliance and higher relapse risk

Question 204

Which of the following are commonly used bipolar self-report measures in Australia?

A) Depression Anxiety Stress Scale (DASS-21)/Dysfunctional Attitudes Scale (DAS-24)
B) BIS/BAS Scales (Behavioral Inhibition and Behavioral Activation Scale)
C) Response Style Questionnaire (RSQ)/Internal State Scale (ISS)
D) All of the above

Answer 204

D) All of the above

Question 205

The group of drugs, including lithium and anticonvulsants, used to treat bipolar disorder and aim to prevent mood shifts to the opposite pole are called:

A) Antidepressants
B) Antipsychotics
C) Mood Stabilizers
D) Anxiolytics

Answer 205

C) Mood stabilisers

Question 206

Which of the following is NOT commonly administered as a mood stabilizer for bipolar disorder?

A) Lithium
B) Carbamazepine
C) Valproate
D) Olanzapine
E) Quetiapine
F) Fluoxetine

Answer 206

F) Fluoxetine (antidepressant not mood stabliser)

(six mood stabilisers commonly administered: lithium,
carbamazepine,
valproate,
olanzapine,
quetiapine,
lamotrigine)

Question 207

The main role of which intervention includes providing education about early signs of relapse, medication adherence, and managing risk and protective factors?

A) Cognitive Behavioral Therapy
B) Psychoeducation
C) Dialectical Behavior Therapy
D) Interpersonal Therapy

Answer 207

B) Psychoeducation

Question 208

According to a study, the addition of 7–12 sessions of psychoeducation to medication resulted in a reduction of manic relapse rates by what percentage compared to medication alone?

A) 20 percent
B) 25 percent
C) 30 percent
D) 35 percent

Answer 208

C) 30 percent

Question 209

Encouraging clients to keep structured _____ diaries helps in identifying triggers to mood shifts and associated changes in thoughts and feelings.

A) Behavioral
B) Mood
C) Cognitive
D) Activity

Answer 209

B) Mood

Question 210

Cognitive restructuring for bipolar disorder involves which of the following?

A) Identifying and challenging hyper-positive cognitions
B) Addressing negative underlying beliefs
C) Cognitive adaptation to the experience of mental illness
D) All of the above

Answer 210

D) All of the above

Question 211

Interpersonal and Social Rhythm Therapy (IPSRT) is targeted towards reducing disruptions in which of the following to help manage bipolar episodes?

A) Medication adherence and therapy frequency
B) Daily routines and sleep/wake cycles
C) Social interactions and cognitive patterns
D) Nutritional habits and exercise routines

Answer 211

B) Daily routines and sleep/wake cycles

Question 212

The type of interventions that aim to reduce relapse by improving the family’s knowledge about bipolar disorder, communication, and problem-solving skills is called:

A) Cognitive Behavioral Therapy
B) Psychoeducation
C) Family-Focused Interventions
D) Dialectical Behavior Therapy

Answer 212

C) Family-Focused Interventions

(effectively used since 1970s for bipolar patients)

Question 213

Answer 213

B) Inherent mood instability and interaction with external stressors or internal biological factors

Question 214

How does the involvement of consumers benefit the development of psychological interventions for bipolar disorder?

A) It increases the number of research studies conducted
B) It helps better align interventions with the values and preferences of end-users and provides new directions for interventions
C) It focuses solely on medication-related aspects of treatment
D) It reduces the need for professional input in therapy development

Answer 214

B) It helps better align interventions with the values and preferences of end-users and provides new directions for interventions

Question 214

Which scenario best illustrates the instability model of relapse in bipolar disorder?

A) A person with stable mood who maintains a regular sleep schedule and has minimal stress.
B) A person with mood instability who develops a manic episode due to work stress and irregular sleep patterns.
C) A person who manages their bipolar disorder through consistent medication and avoids all external stressors.
D) A person who experiences a depressive episode after a predictable and minor life event.

Answer 214

B) A person with mood instability who develops a manic episode due to work stress and irregular sleep patterns.

Question 215

Which of the following terms historically has been used to denote bipolar disorder?

Multiple select question.

la belle indifference

manic depressive insanity

dementia praecox

la folie circulaire

Answer 215

manic depressive insanity
la folie circulaire

Question 216

Within the DSM-5, the term ‘bipolar disorder’ embraces a spectrum of disorders including

Multiple select question.

schizophrenia
dysthymic disorder
cylothymic disorder
bipolar I

Answer 216

cylothymic disorder
bipolar I

Question 217

Within manic episodes, individuals demonstrate an increase in:

insight
sleep
activity
irritability

Answer 217

activity

Question 218

Individuals who repeatedly experience sub-clinical levels of elevated and depressed mood would most likely be diagnosed with ______________.

Answer 218

cyclothymia

Question 219

The prevalence of bipolar I disorder:

is equal in males and females
is higher in females
is higher in males
is decreasing

Answer 219

is equal in males and
females

Question 220

Women suffering from bipolar disorder are most commonly misdiagnosed with _______________.

Answer 220

depression

Question 221

____________ carbonate dramatically improved treatment outcomes for people with bipolar disorder.

Answer 221

Lithium

Question 222

A primary difference between depressive and bipolar disorders is that individuals with bipolar disorders experience pathologically

irrational thinking
elevated mood
delusional thinking
depressed mood

Answer 222

elevated mood

Question 223

Hypomanic episodes are _________(less/more) severe and of
____________(shorter/longer) duration than manic episodes.

Answer 223

less
shorter

Question 224

The key features for
diagnosis of bipolar II disorder are the
presence of one or more:

Multiple select question.

manic episodes

concurrent manic and depressive symptoms

hypomanic episodes

major depressive episodes

Answer 224

hypomanic episodes

major depressive episodes

Question 225

Men suffering from bipolar disorder are most commonly misdiagnosed with ________.

Answer 225

schizophrenia

Question 226

Which of the following individuals is least likely to experience their first episode of hypomania?

Elliot, aged 17
Eric, aged 27
Ella, aged 22
Erin, aged 33

Answer 226

Erin, aged 33

(Hypomanic episodes often begin in the late teens to early twenties)

Question 227

The prevalence of bipolar II disorder:

is decreasing
is higher in females
is equal in males and females
is higher in males

Answer 227

is higher in females

Question 228

List in order from highest to lowest the median duration of mood disturbance experienced by people with bipolar I disorder:

(manic, hypomanic, depressive episode)

Answer 228

depressive episode
manic episode
hypomanic episode

Question 229

According to the findings of Perugi and colleagues (2001), social phobia symptoms generally:

preceded hypomanic or manic episodes

occurred concurrently with hypomanic or manic episodes

followed hypomanic or manic episodes

cannot be correlated with hypomanic or manic episodes

Answer 229

preceded hypomanic or manic episodes

Question 230

Hospitalisation is often required for people experiencing severe manic episodes due to the individual:

engaging in behaviours that place themselves at risk of harm

being a danger to others

behaving in a manner distressing to others

being distressed by their symptoms

Answer 230

engaging in behaviours that place themselves at risk of harm

Question 231

It is thought that individuals with bipolar disorder use substances such as marijuana, alcohol and amphetamines in an attempt to:

mimic mania
induce mania
escape reality
regulate mood

Answer 231

regulate mood

Question 232

Approximately
______ % of individuals experience onset of bipolar disorder by age 17.

Answer 232

25

Question 233

In an Australian survey conducted by Mitchell et al. (2013), individuals
with bipolar disorder were how many times more likely than the general population to experience relationship difficulties?

3
4
5
2

Answer 233

5

Question 234

Poor _____________
adherence has been associated with low levels of acceptance of a bipolar diagnosis.

Answer 234

medication

Question 235

According to the findings of Perugi and colleagues (2001), anxiety symptoms can occur when?

Multiple select question.

after (hypo)manic episodes

during (hypo)manic episodes

before (hypo)manic episodes

only in the absence of (hypo)manic episodes

Answer 235

before
during
after

Question 236

Substance misuse has been reported in ___% of people with bipolar disorder.

39
27
48
43

Answer 236

39

Question 237

Following a manic episode, approximately what percentage of individuals return to work at their former skill level?

40
30
20
50

Answer 237

20

Question 238

Which of the following individuals is most likely
to experience the poorest outcomes associated with their bipolar disorder diagnosis?

Jessica who demonstrated onset of the disorder at age 21

Jeffrey who demonstrated onset of the disorder at age 17

Jenna who demonstrated onset of the disorder at age 25

Jet who demonstrated onset of the disorder at age 31

Answer 238

Jeffrey who demonstrated onset of the disorder at age 17

(early onset of bipolar disorder is often linked to more frequent episodes, greater severity, and a higher risk of comorbid conditions, which can contribute to poorer overall outcomes)

Question 239

Vulnerability towards creativity and pathology share which of the following features?

affective blunting

bias towards novel stimuli

neural hyperconnectivity

cognitive disinhibition

Answer 239

bias towards novel stimuli

neural hyperconnectivity

cognitive disinhibition

Question 240

Suicide rates are highest among individuals with which condition?

euthymia
cyclothymic disorder
bipolar I disorder
bipolar II disorder

Answer 240

bipolar II disorder

Question 241

It is estimated that the heritability of bipolar disorder is ____%.

75
85
70
80

Answer 241

85

Question 242

In Australia, the anxiety disorders most commonly comorbid with bipolar disorder are:
Select all that apply:

panic disorder

obsessive compulsive disorder

generalised anxiety disorder

social phobia

Answer 242

panic disorder

generalised anxiety disorder

social phobia

Question 243

Researchers have demonstrated that in the context of (hypo)manic episodes, creative outputs:

increase in complexity
increase in diversity
increase in quantity
increase in quality

Answer 243

increase in quantity

(during hypomanic or manic episodes, individuals often experience heightened energy levels and a reduced need for sleep, which can lead to an increase in the amount of work or creative outputs they produce)

Question 244

The suicide rate is approximately how many times higher in bipolar compared to general populations?

5
20
15
10

Answer 244

15

Question 245

Researchers have demonstrated that compared to the general population, people with bipolar I disorder experience excessive goal-directed behaviour:

even when depressed
even when euthymic (state of tranquility)
only when (hypo)manic
only when euthymic

Answer 245

even when euthymic

(euthymia = state of tranquility, well being)

Question 246

Approximately what percentage of bipolar sufferers will relapse within five years?

55
65
45
75

Answer 246

75

Question 247

The pattern of social phobia preceding hypomanic and manic episodes suggests a causal role of what in triggering such episodes?

social fears
Lithium use
social cues
antidepressant use

Answer 247

social fears

Question 248

Ylia has recently experienced a manic episode, and behaved in uncharacteristic ways such as spending large amounts of money and promiscuous sexual acts. What emotions is she most likely to be experiencing now that this episode has ended?

Multiple select question.

anger
excitement
euphoria
guilt

Answer 248

anger
guilt

(While excitement and euphoria are characteristic of the manic episode itself, these emotions typically diminish after the episode ends and may be replaced by negative emotions such as guilt and anger)

Question 249

The lifetime risk of bipolar disorder in the family members of diagnosed individuals is approximately _______ percent.

Answer 249

10

Question 250

The majority of completed suicides occur within which phase of a bipolar disorder?

euthymic
depressive
manic
hypomanic

Answer 250

depressive

(Individuals with bipolar disorder are at a higher risk of suicide, and this risk is particularly elevated during depressive episodes. The intense feelings of hopelessness and despair experienced during these phases can significantly increase the likelihood of suicidal behavior)

Question 251

Acute drug treatments for bipolar disorder target the:

existing episode of mood disturbance

preventative components of bipolar disorder

chances of cure

chances of relapse

Answer 251

existing episode of mood disturbance

Question 252

Disruptions in the circadian symptom help to explain why early symptoms of (hypo)mania include:

Multiple select question.

restlessness
sleeplessness
agitation
fatigue

Answer 252

restlessness
sleeplessness

(Agitation and fatigue are not typically early symptoms of (hypo)mania related to circadian disruptions. Instead, agitation might be more associated with the increased energy and activity levels during manic episodes, while fatigue is usually more associated with depressive episodes or the aftermath of a manic episode)

Question 253

____________ refers to a high need for social acceptance.

Answer 253

sociotrophy

Question 254

Each of the psychological therapies recommended for the treatment and management of bipolar disorder share which framework?

nature–nurture
diathesis-stress
psychosocial
cognitive triad

Answer 254

diathesis-stress

Question 255

Maintenance drug treatments for bipolar disorder focus on:

targeting the mood disturbance

targeting the genes responsible for relapse

reducing manic symptoms

minimising the chances of relapse

Answer 255

minimising the chances of relapse

Question 256

Beliefs about a link between (hypo)mania and creativity can undermine client commitment to _________.

Answer 256

treatment

Question 257

Individuals with bipolar disorder who are exposed to high levels of stress are:

more likely to have a mood relapse

generally older and more experienced with the disorder

less likely to have a mood relapse

generally younger and less experienced with the disorder

Answer 257

more likely to have a mood relapse

Question 258

Compared to health controls, individuals with bipolar disorder have:

higher insight
lower motivation
higher intelligence
lower self-esteem

Answer 258

lower self-esteem

Question 259

Mood monitoring can assist in the identification of
_________ warning signs of a bipolar mood shift.

Answer 259

early

Question 260

Cognitive behaviour therapy relies on _________ to challenge unhelpful thoughts and assumptions, including hyper-positive cognitions, held by individuals with bipolar disorder.

medication
cognitive restructuring
defence mechanisms
transference

Answer 260

cognitive restructuring

Question 261

A combination of drug and psychological therapies has been shown to be cost ___________ for people with bipolar disorder, in terms of reducing the need for additional health services when symptomatic.

Answer 261

effective

Question 262

Family-based interventions for bipolar disorder aim to reduce relapse through improving family:

Multiple select question.

communication
problem solving
control
knowledge

Answer 262

communication
problem solving
knowledge

Question 263

Which of the following components is present in all psychological approaches to managing bipolar disorder?

psychoeducation
behavioural activation
reality testing
medication

Answer 263

psychoeducation

Question 264

Interpersonal and social
________ therapy focuses on the development and maintenance of healthy social routines to manage mood.

Answer 264

rhythm

Question 265

__________ approaches are considered the most effective in relapse prevention for bipolar disorder.

Answer 265

Biopsychosocial

Question 266

Which of the following mechanisms is NOT included in the instability model of relapse prevention?

disrupted routines
medication non-adherence
sleep hygiene
biological vulnerability

Answer 266

sleep hygiene

Question 267

A key advantage of CBT for bipolar disorder is the fostering of:

self-worth
independence
self-reliance
self-efficacy

Answer 267

self-efficacy

(CBT helps individuals with bipolar disorder develop skills and strategies to manage their symptoms and handle life stressors effectively. By enhancing self-efficacy, individuals gain confidence in their ability to manage their condition and make positive changes, which can lead to better outcomes in managing their disorder)

Question 268

Contemporary approaches to relapse prevention for bipolar disorder include which approaches?

Multiple select question.

medication

hospitalisation

transmagnetic stimulation

psychological approaches

Answer 268

medication

psychological approaches

Question 269

Risk factors associated with the development of a depressive disorder in young people include all of the following except:

a.
previous history of depression.

b.
cigarette smoking.

c.
history of abuse.

d.
family conflict.

e.
None of the options given is correct.

Answer 269

b.
cigarette smoking.

Question 270

What percentage of people with a major depressive disorder also experience significant anxiety symptoms?

a.
5 per cent

b.
10 per cent

c.
25 per cent

d.
50 per cent

e.
70 per cent

Answer 270

d.
50 per cent

Question 271

Seligman’s learned helplessness theory suggests that depressive disorders may develop when individuals interpret negative life events as being due to:

a.
external events that they cannot control.

b.
magnification and minimisation.

c.
negative events in childhood.

d.
high levels of expressed emotion.

e.
internal, global and stable factors.

Answer 271

e.
internal, global and stable factors
(According to this theory, when individuals attribute negative events to internal factors (believing the problem is due to their own personal failings), global factors (believing the problem affects all aspects of their life), and stable factors (believing the problem will persist over time), they may develop a sense of helplessness and hopelessness that contributes to depression)

Question 272

A new specifier—major depressive disorder with anxious distress-has been incorporated into the DSM-5 for all of the following reasons except:

a.
the strong comorbidity between depression and anxiety problems.

b.
the increased risk of suicide associated with mixed anxiety and depression.

c.
the longer length of the depressive episode when depression is mixed with anxiety.

d.
to enable clinicians to identify people at risk of a full-blown major depressive disorder or a significant anxiety disorder.

e.
All of the given options are correct.

Answer 272

d.
to enable clinicians to identify people at risk of a full-blown major depressive disorder or a significant anxiety disorder

(This specifier is primarily used to address the strong comorbidity between depression and anxiety, the increased risk of suicide, and the potential for a longer depressive episode when anxiety is present. It is not specifically intended to identify people at risk of developing a full-blown major depressive disorder or a significant anxiety disorder)

Question 273

The suicide rate in Australia has _______ since the late 1990s.

a.
declined

b.
increased

c.
stayed the same

d.
doubled

e.
None of the given options is correct.

Answer 273

a.
declined

Question 274

Which of the following does current research evidence not support as an effective treatment for depression?

a.
interpersonal psychotherapy

b.
medication

c.
cognitive behaviour therapy

d.
bright light therapy

e.
All of the given options are effective treatments for depression.

Answer 274

e.
All of the given options are effective treatments for depression.

Question 275

A MAJOR DEPRESSIVE DISORDER IS CHARACTERISED BY THE FOLLOWING SYMPTOMS EXCEPT:

a.
grandiosity.

b.
weight loss.

c.
sleep disturbance.

d.
psychomotor agitation or retardation.

e.
excessive guilt feelings.

Answer 275

a.
grandiosity.

Question 276

With regards to bipolar I disorder:

a.
it is more common in women.

b.
it is more common in men.

c.
it is equally common in men and women.

d.
it is found only in women.

e.
the gender ratio is unknown.

Answer 276

c.
it is equally common in men and women.

Question 277

Bipolar disorder is commonly comorbid with several other psychiatric illnesses, except:

a.
anxiety.

b.
obsessive-compulsive disorder.

c.
posttraumatic stress disorder.

d.
social phobia.

e.
schizophrenia.

Answer 277

e.
schizophrenia.

Question 278

Pharmacological treatments for bipolar disorder vary according to:

a.
how many manic episodes an individual has experienced.

b.
whether the patient is in an acute or maintenance phase of the condition.

c.
response to psychological intervention.

d.
experience of psychotic episodes.

e.
None of the options given is correct.

Answer 278

b.
whether the patient is in an acute or maintenance phase of the condition.

Question 279

Which of the following is not typically associated with a manic episode?

a.
inflated or expansive mood

b.
inflated self-esteem

c.
high trait anxiety

d.
risk taking

e.
grandiosity

Answer 279

c.
high trait anxiety

Question 280

Relapse prevention treatment for bipolar disorder includes all of the following except:

a.
psychoeducation.

b.
symptom monitoring.

c.
challenging unhelpful cognitions.

d.
taking medication only when feeling unwell.

e.
being aware of early-warning signs of relapse.

Answer 280

d.
taking medication only when feeling unwell.

Question 281

The goal dysregulation model suggests that mania is the result of:

a.
cognitive distortions.

b.
mood swings.

c.
stress.

d.
psychomotor retardation.

e.
excessive goal engagement.

Answer 281

e.
excessive goal engagement.

Question 282

Which of the options listed is a common measure of state/trait anxiety in Australia?

a.
Beck Depression Inventory

b.
Behavioural Inhibition Scale/Behavioural Activation Scale (BIS/BAS)

c.
Measure of Attachment Quality

d.
Brief Symptom Inventory

e.
Interpersonal Issues Inventory

Answer 282

b.
Behavioural Inhibition Scale/Behavioural Activation Scale (BIS/BAS)

Question 283

On average, an individual with bipolar I or II disorder is likely to experience:

a.
more time being manic or hypomanic than being depressed.

b.
more time being depressed than being manic or hypomanic.

c.
equal time being depressed and being manic or hypomanic.

d.
only time being manic, no time being depressed.

e.
None of the given options is correct–none of these patterns is more common than the others.

Answer 283

b.
more time being depressed than being manic or hypomanic.