Deck 9: The Mood Disorders

Question 1

Major Depressive Disorder (MDD)
a) According to the DSM, what is the length of time symptoms must be present in order for a diagnosis to be made?
b) Fill in the blanks:
In order for an individual to be diagnosed with MDD, an individual must show evidence of
_________________, or _____________________, which may appear as _______________
in children.
c) Name four other symptoms of MDD that may appear in children or adolescents (specify if different in young children versus teens).

Answer 1

a) 2 weeks
b) loss of interest or pleasure; or pervasive depressed mood (anhedoni) which may appear as irritability in children
c) weight/loss or weight gain (5% in adults), failure to meet anticipated weight/height ratio in children; insomnia or hypersomnia (most likely in adolescents); inability to concentrate; psychomotor agitation or retardation; low self esteem; feelings of hopelessness

Question 2

For a diagnosis of dysthymia, children must experience ___ symptoms and for ________ length of time.

Answer 2

Two symptoms from the Major Depressive Episode symptoms list Over the course of one year

Question 3

In addition to DSM criteria, name five associated characteristics that are likely to be evident in children and adolescence with depression.

Answer 3

Somatic complaints, absenteeism, complaints of boredom, irritable outbursts, easily upset, talks about running away, overly sensitive, increased risk‐taking, social withdrawal, substance abuse, saying "nobody cares"

Question 4

According to studies conducted by Luby and colleagues (2002‐2006), preschoolers who experience anhedonic depression differ from those who experience hedonic depression in several ways.
a) Describe the major difference between these two forms of depression.
b) How does the etiology of each form of depression differ?
c) Which is the most severe form of depression?
d) What are some of the increased risks for this type of depression? Give four examples.

Question 5

a) Fill in the following chart:

b) What type of BD do children usually exhibit?

Question 6

What are the four suggestions for sub‐typing juvenile BD? Provide an example of each.

Question 7

Name three risk factors for BD in children and adolescents.

Question 8

Explain how brain chemistry and function are implicated in the etiology of BD in children and youth.

Question 9

There has been considerable discussion regarding differential diagnosis for BD with other disorders that share overlapping symptoms. Compare BD to one of the other disorders that has the most similarity of symptoms.
a)Whatisthedisorder?
b)Whatarethesharedsymptoms?
c)Whatdirectionhasbeengiventomakethebestdifferentialdiagnosisbetweenthetwodisorders?

Question 10

List five warning signs to alert individuals to child and adolescent suicide attempts.

Question 11

What is the ACT program and what do the letters stand for?

Question 12

In the 1970s, the prevailing concept of depression in children was that

A) children were too young to be depressed.
B) depression in children was a temporary "adjustment" to circumstances that would self? correct within 6 months.
C) children experienced anaclitic depression due to lack of contact comfort.
D) depression in children was demonstrated as a wasting away or "marasmus."

Question 13

Masked depression was a term used to describe

A) sadness worn on the face like a mask.
B) depression that caused children to feel painful physical symptoms.
C) depression in children expressed in acting out behaviors (lying, fighting).
D) sadness that had no explainable cause.

Question 14

Which of the following did Kovac and colleagues (1988) discover about the depressed children in their longitudinal study?

A) Children who had depression earlier on grew out of it in their teens.
B) They found that if children had conduct disorder (CD) as well as depression, the conduct disorder remained but the depression dissipated as they got older.
C) Long?term outcomes for children with depression and CD were no different than outcomes for children with depression without CD.
D) Almost one quarter of their sample had evidence of combined depression and CD by the time the study was completed.

Question 15

When discussing symptoms of depression, vegetative symptoms refer to

A) emotional symptoms.
B) cognitive symptoms.
C) physical or somatic symptoms.
D) environmental symptoms.

Question 16

Jason is eight years old. He comes home from school, upset and irritable. He says that he does not want to go back to school tomorrow because he feels like he is getting the flu. His teacher sends a note home saying that Jason has developed a very negative attitude lately, and that he is not doing his homework. You later discover that Jason is actually stressed out about the state? wide testing program that is going on next week. After you talk to Jason and calm him down, he is much better able to cope and comes home the following week, excited about his performance. Jason was most likely experiencing symptoms of

A) depressed mood.
B) dysthymic disorder.
C) depressed syndrome.
D) major depressive disorder.

Question 17

Wally is feeling sad. He is upset because his parents are moving and he will have to leave all his friends. He is irritable, and has been complaining about stomach?aches, ever since the move was announced, three weeks ago. You think it is just a phase, but after the move takes place he continues to sulk around the house, has locked himself in his room, and says he hates the new house. He complains there are no kids around and that he is dreading beginning the Grade Five program at his new school because he doesn't know anyone. Today, you surprise him with a trip to the veterinarian's where he is introduced to his new puppy. While at the vet's, he meets another boy his age, who has just moved in down the street. The depression lifts and Wally is his old self again. The type of depression that Wally was exhibiting is most likely due to

A) major depressive disorder.
B) adjustment disorder with depressed mood.
C) dysthymic disorder.
D) depressed syndrome.

Question 18

Anedonia is a term that refers to

A) pervasive depressed mood state.
B) irritability.
C) masked depression.
D) thoughts of self harm.

Question 19

In children, depression symptoms related to weight loss or gain include

A) weight loss in excess of 10%.
B) weight gain in excess of 10%.
C) weight loss or gain in excess of 10%.
D) failure to meet anticipated weight/height ratios.

Question 20

Studies of recurrent depressive episodes have found that, relative to adults

A) children do not experience as many recurrent depressive episodes.
B) children experience about the same number of recurrent depressive episodes as adults.
C) children may experience even more recurrent depressive episodes than adults.
D) the area of recurrent episodes has not been researched to date.

Question 21

Which of the following is not a "vegetative symptom of depression"?

A) weight loss
B) weight gain
C) insomnia
D) fatigue

Question 22

Major Depressive Disorder in children can be diagnosed if the symptom criteria have been met for

A) two years.
B) one year.
C) two weeks.
D) 6 months.

Question 23

The difference between hedonic depression and anhedonic depression is that

A) hedonic depression refers to euphoria in addition to depression.
B) anhedonic depression refers to melancholia and loss of pleasure.
C) hedonic depression is related more to genetic vulnerability.
D) anhedonic depression is related more to environmental factors.

Question 24

Luby and colleagues found that for preschoolers with anhedonic depression, all of the following were true, except

A) symptoms were more severe.
B) more neurovegetative symptoms.
C) lowered level s of cortisol.
D) increased non?compliance and avoidant behaviors.

Question 25

Which of the following is not among the three most common comorbid disorders for children with depression:

A) behavior disorders
B) ADHD
C) learning disorders
D) anxiety disorders

Question 26

Which of the following is true regarding childhood depression:

A) males exhibit more depressive symptoms at this age
B) symptoms include poor academics, low frustration and poor social skills
C) females exhibit more depressive symptoms than males at this age
D) parenting style is not related to depression at this age level

Question 27

The most common form of depression in adolescents is:

A) reactive to situation
B) contagion, following the crowd
C) melancholic
D) copy cat modeling famous suicides

Question 28

Which of the following is true regarding pediatric depression;

A) in childhood, bouts of depression are more related to genetics than environment
B) in adolescents, bouts of depression are more related to genetics than environment
C) in children and youth bouts of depression are related more to genetics than environment
D) all of the above are true.

Question 29

In adolescents, the most common comorbid associations with depression include all of the following, except

A) behavior disorders.
B) ADHD.
C) substance and eating disorders.
D) intellectual disabilities.

Question 30

Peers and school environment can be protective factors that can buffer the development of depression. Which of the following is false?

A) Team sports involvement can be a protective factor.
B) Females tend to be protected by a "circle of friends."
C) Even if peers are deviant, if they are supportive, they pose no risk.
D) Males tend to be protected by a "network" of peers who share common activities.

Question 31

Sarah has an identical twin. Her twin has been diagnosed with a depressive disorder. Given current prevalence rates, Sarah's genetic risk for developing a depressive disorder is

A) 15%.
B) 10%.
C) 20%.
D) 45%.

Question 32

Which of the following neurotransmitters has not been associated with depression?

A) serotonin
B) dopamine
C) norepinephrine
D) glutamate

Question 33

The term "learned helplessness" was originally used to describe

A) reactions of experimental animals that did not escape after repeated shocks.
B) people who do not sense a state of release.
C) children who learn that they can get help instead of producing output.
D) battered wives who did not seek help.

Question 34

Greg does not have an ability to calm himself down when he is under stressful circumstances. According to an ecological transactional model, Greg would have difficulty in this area due to

A) being simultaneously rewarded and punished for the same behavior.
B) lack of self?regulatory ability due to parenting practices that did not promote adaptive development in areas of self soothing.
C) over?indulgent parents that emphasized soothing behaviors.
D) over development of the self?regulatory system.

Question 35

All of the following are true regarding FDA approval of medications for child depression, except

A) approval of Paxil for major depressive disorder.
B) approval of fluoxetine for major depressive disorder.
C) black box warning on most antidepressants for adolescent and child use.
D) approval of Prozac for major depressive disorder.

Question 36

Of all the therapies that are used to treat unipolar depression in youth, the most common therapeutic approach is

A) cognitive behavioral.
B) psychodynamic.
C) humanistic.
D) family systems.

Question 37

The difference between a full manic and hypomanic episode is the

A) duration of the symptoms.
B) the number of the symptoms.
C) the intensity of the symptoms.
D) both a and c.

Question 38

Compared to adults, pediatric bipolar disorder (BD) often evidences which of the following?

A) severe irritability
B) grandiosity
C) insomnia
D) pressured speech

Question 39

Researchers/theorists have suggested four different rationale for subtyping juvenile BD. All of the following are among the categories suggested, except

A) age of onset.
B) nature of developmental episodes.
C) familial history.
D) clinical phenotypes.

Question 40

Early childhood onset of BD has been associated with all of the following, except

A) most common in females.
B) chronic, irritable subtype.
C) has onset with mania.
D) high comorbidity with ADHD and ODD.

Question 41

According to Wilens and colleagues, BD in preschool children

A) has not yet been supported empirically.
B) is no different than BD across different age spans.
C) has onset with depression.
D) can produce an elevated mood that resembles a giddy, goofy, drunk?like state.

Question 42

All of the following are true regarding "rapid cycling," except

A) rapid cycling in adults occurs if 4 episodes occur within a year.
B) 10?20% of the adult population who experience BD will have rapid cycling.
C) in children, rapid cycling can produce multiple, brief episodes on a daily basis.
D) unlike adults, children with BD do not experience rapid cycling.

Question 43

Leibenluft and colleagues (2003) have suggested all of the following clinical phenotypes for BD, except

A) narrow phenotype.
B) novelty?seeking phenotype.
C) hypomania NOS.
D) irritable hypomania.

Question 44

According to Wozniak and colleagues (2005) severe irritability should be recognized at three levels of severity. Which of the following is not one of the levels?

A) silly, goofy, perseverative, and goal?directed behaviors
B) easily annoyed, loss of temper
C) mad, cranky mood occurring most of the day
D) super angry, grouchy, cranky with violent outbursts

Question 45

Children with BD who also have anxiety disorders are at risk for all the following, except

A) higher risk for separation anxiety disorder (SAD) and obsessive compulsive disorder (OCD).
B) higher bias to threat.
C) increased risk for hospitalization.
D) increased risk for suicide.

Question 46

Papolos and colleagues (2007) found six personality factors associated with BD. Which of the following was not one of the six factors?

A) fear of harm
B) sleep?wake cycle disturbance
C) obsessive preoccupations
D) sensory sensitivity

Question 47

All of the following are true regarding prevalence rates for BD in children and youth, except

A) Prevalence rates have been difficult to determine due to overlapping criteria with other disorders.
B) Between 1996 and 2004 diagnosis of BD in children has increased over 53%.
C) Between 1996 and 2004 diagnosis of BD in adolescents has increased over 58%.
D) None are false, all of the above statements are true.

Question 48

Which of the following statements are true?

A) Mania is caused by low levels of serotonin and high levels of norepinephrine.
B) Depression is caused by low levels of serotonin and low levels of norepinephrine.
C) Mania is caused by high glutamine levels.
D) Both a and b are true.

Question 49

One of the dangers of misdiagnosis regarding BD is that

A) if you give a child with BD medications for depression, it will trigger a severe depressive episode.
B) if you give a child with BD medication for ADHD, it will make the child more aggressive.
C) if you give a child with BD medication for Anxiety, it will make the child more anxious.
D) none of the above are true.

Question 50

Which of the following statements is true regarding BD?

A) Having a parent with BD increases one's risk for BD by 20%.
B) Increased volume of the amygdale in children is responsible for lack of impulse control.
C) Glial cell abnormality has been linked to BD in children.
D) Children with BD also demonstrate executive function deficits.

Question 51

A diagnosis of BD has symptom overlap with two other disorders. The disorders with the most overlap of symptoms are

A) ADHD and panic disorder.
B) ADHD and oppositional defiant disorder.
C) conduct disorder and oppositional defiant disorder.
D) obsessive compulsive disorder (OCD) and ADHD.

Question 52

At the time of her death, at four years of age, Rebecca Riley was taking all of the following medications, except

A) Ritalin, a stimulant for ADHD.
B) Depakote, an anticonvulsant.
C) Seroquel , a mood stabilizer.
D) Clonidine, a blood pressure medication.

Question 53

In August 2007, the FDA approved the use of which of the following for BD in children and adolescents?

A) Buspar
B) Risperdal
C) Paxil
D) Dexedrine

Question 54

All of the following are true regarding the SOS prevention program, except

A) the program has documented a 40% reduction in suicide attempts.
B) the program trains peers to recognize suicide signals in peers.
C) the program has been adopted by 25 schools to date.
D) the program has been empirically supported by a randomized study.

Question 55

Which of the following is false regarding suicide rates?

A) Child suicide rates have increased by 8% since the 1950s.
B) 1 in 100 children under fourteen years of age will attempt suicide, annually.
C) Boys are five times more likely to commit suicide than girls.
D) Youth with depressive disorder are five times more likely to engage in suicide ideation.

Question 56

Which of the following is false regarding risks and protective factors for suicide?

A) Girls who feel socially isolated are at twice the risk for suicide.
B) Boys are at increased risk for suicide if their friends do not get along.
C) Boys who have a network of friends who engage in shared activities are at less risk for suicide.
D) Children who are high on novelty seeking are at increased risk for suicide.