Deck 8: Treatments for Depressive and Bipolar Disorders

Question 1

One of the difficulties with the use of mood stabilizers to treat bipolar disorder is that patients often stop taking the medication. Discuss three reasons why a person who is experiencing bipolar disorder might stop taking this highly effective medication and what a therapist might do to improve treatment compliance.

Answer 1

not answered

Question 2

ECT causes a(n) _____ that activates many brain areas and releases neurotransmitters.

Answer 2

brain seizure

Question 3

Describe the approach you would take if treating a client for unipolar depression using the four-phase cognitive-behavioral treatment approach. Give examples of specific interventions you would employ at each phase.

Answer 3

not answered

Question 4

Pretend you are treating a client for moderate unipolar depression using behavioral activation. Describe the three components of this approach, and give examples of each.

Question 5

Determining what a patient truly likes to do is part of a therapy for depression based on _____ principles.

Question 6

Describe adjunctive psychotherapy, why it is needed for those who have bipolar disorders, and its related effectiveness.

Question 7

Matthew is taking imipramine. He is MOST likely being treated for _____.

Question 8

Molly is not getting what she expected out of her new marriage. Her husband is demanding but often absent. This situation is leading to depression for her. This scenario describes what interpersonal psychotherapists call a(n) _____.

Question 9

The final phase of Beck's cognitive therapy approach involves changing _____.

Question 10

What is the underlying premise of multicultural treatments for unipolar depression? When would you recommend using such an approach?

Question 11

The therapeutic practice of ignoring depressive behavior while reinforcing nondepressive behaviors is called _____.

Question 12

The type of antidepressant drug that works by interfering with the enzyme that normally degrades serotonin and norepinephrine is a(n) _____.

Question 13

Pretend you are a biological clinician treating a patient with newly diagnosed unipolar depression. Which general approach-drug therapy or brain stimulation-would you recommend first? Based on effectiveness studies, which specific drug or brain stimulation technique would you start with?

Question 14

A client of yours is interested in electroconvulsive therapy (ECT) but is afraid of being hurt during the procedure. Which steps can be taken to reduce the client's fears and negative side effects?

Question 15

People being treated for depression with MAO inhibitors should avoid foods containing _____.

Question 16

Another name for dietary supplements that are taken as drugs is _____.

Question 17

The physician of one of your friends has prescribed a tricyclic to treat her depression, but your friend is hesitating to take the medication. How would you help her make this decision? That is, what are the advantages and disadvantages of using tricyclics? When are they MOST effective?

Question 18

Interpersonal therapists believe that any of four interpersonal problem areas can lead to depression and must be addressed in therapy. Briefly describe each of these areas, and provide an example of each.

Question 19

How does the psychodynamic approach to treating unipolar depression differ from the cognitive-behavioral approach?

Question 20

According to psychoanalytic theory, depression is in part caused by the patient's _____ on others.

Question 21

What do psychodynamic therapists believe is the cause of unipolar depression?

A) Repression of feelings of inadequacy
B) A biological imbalance in neurotransmitters
C) Unconscious grieving over real or imagined loss
D) Projection of internal anxiety onto a loved object

Question 22

If a therapist asked you to say whatever came to mind, then suggested interpretations designed to help you work through grief over real or imagined losses, your therapist would be using:

A) psychodynamic therapy.
B) cognitive therapy.
C) behavioral therapy.
D) sociocultural therapy.

Question 23

Whereas antidepressant drugs affect a neuron's initial reception of neurotransmitters, mood-stabilizing drugs appear to affect a neuron's _____.

Question 24

A therapist using free association and dream interpretation discovers that as a small child her client had been left alone by her mother on several occasions. The therapist concludes that the patient is experiencing unipolar depression. The therapist is MOST likely from which orientation?

A) Cognitive
B) Psychodynamic
C) Behavioral
D) Humanistic

Question 25

Which statement about psychodynamic therapy in treating unipolar depression is MOST accurate?

A) Carefully controlled, multiple-participant studies validate the success of this therapy.
B) Case studies have shown almost no support for the effectiveness of this therapy.
C) Long-term therapy is occasionally helpful for those individuals with moderate symptoms.
D) Short-term therapy is less effective than long-term therapy, especially in cases where past trauma cannot be established.

Question 26

If racial and ethnic disparities regarding access to treatment did not exist in the United States, then you would expect to observe which of the following?

A) A decrease in the prevalence of depression across all racial and ethnic groups
B) An equal prevalence of depression across all racial and ethnic groups
C) An increase in the percentage of Hispanic Americans and African Americans who receive treatment for depression
D) An increase in the percentage of all racial and ethnic groups who receive treatment for depression

Question 27

Psychodynamic approaches to the treatment of depression may be helpful for individuals who:

A) experience symptoms that are severe and debilitating.
B) expect therapy to produce a rapid decrease in the severity of their depressive symptoms.
C) do not have a childhood history of loss or trauma.
D) experience mild or modest symptoms of depression.

Question 28

Psychological approaches to treating depression share which assumption?

A) Depression is a physical problem that should be treated with medication.
B) Depression should be treated by changing how people interact with family members and loved ones.
C) Depression stems from what one has learned in the past, so it should be treated by "unlearning" maladaptive behaviors.
D) Depression should be treated by helping people recognize, interpret, evaluate, and change how they think about and respond to past losses.

Question 29

The BEST evidence for the effectiveness of the psychodynamic approach comes from:

A) work with people who have severe depression.
B) case study reports.
C) large-scale research projects conducted by the APA.
D) situations when the childhood loss is less obvious.

Question 30

Free association, interpretation of associations, and dream interpretation are all techniques used primarily by:

A) interpersonal therapists.
B) cognitive therapists.
C) family therapists.
D) psychodynamic therapists.

Question 31

Which explanation of depression has connected mood to the rewards in a person's life?

A) Psychodynamic perspective
B) Behaviorism
C) Interpersonal psychotherapy
D) Socioculturalism

Question 32

Based on survey data, most Americans DISAGREE with which of the following statements?

A) Untreated or under-treated depression can result in long-term disability.
B) A combination of medications and psychotherapy is often the most effective treatment for depression.
C) People diagnosed with depression would recover if they could just "snap out of it."
D) Depression is a serious medical condition that requires treatment.

Question 33

Antidepressant drugs that reduce depression by acting on neurotransmitter "reuptake" mechanisms are called _____.

Question 34

The therapy in which a stimulating current is sent through a patient's prefrontal cortex, thereby substantially reducing the patient's symptoms of depression, is called _____.

Question 35

_____ is a treatment approach in which a therapist reintroduces clients to pleasurable activities, consistently reinforces nondepressive actions, and helps clients improve their social skills.

A) Psychodynamic therapy
B) Behavioral therapy
C) Cognitive therapy
D) Sociocultural therapy

Question 36

One problem with psychodynamic approaches to treating depression is:

A) the research that supports this approach stems mostly from case studies.
B) it is often too brief to show therapeutic efficacy.
C) it cannot explain why some people improve even when they did not receive therapy.
D) techniques such as free association and dream interpretation are frequently used.

Question 37

About what percentage of clients with unipolar depression receive treatment from a mental health professional each year?

A) 50 percent
B) 33 percent
C) 75 percent
D) Almost all

Question 38

Which is an example of an aspect of psychodynamic therapy for depression?

A) A therapist questions a client about losses she may have suffered in her past.
B) Every time the client says anything a little positive to his therapist, the therapist smiles.
C) The therapist questions a client about the frequency and nature of her daily activities, including those that give her pleasure.
D) The therapist attacks the irrationality of a client's beliefs about himself.

Question 39

Bipolar disorders respond better to a combination of lithium treatment and psychotherapy than to either therapy alone. The psychotherapy component of this combination is called _____.

Question 40

The first effective drug for the treatment of bipolar disorders was _____.

Question 41

Increasing pleasant activities is MOST likely to be a part of a(n) _____ therapy program.

A) sociocultural
B) cognitive-behavioral
C) interpersonal
D) psychoanalytic

Question 42

Which treatment would a cognitive-behavioral therapist be MOST likely to use with a patient with unipolar depression?

A) Electroconvulsive treatments
B) Praise for engaging in positive activities
C) Insight into the underlying problem
D) Antidepressant medications

Question 43

The contingency management approach is an example of the application of _____ to the treatment of depression.

A) business principles
B) role playing
C) reinforcement
D) imitation (modeling)

Question 44

Which approach helps people with depression identify and change the maladaptive assumptions and negative thoughts that contribute to their psychological disorder?

A) Psychodynamic therapy
B) Existential therapy
C) Cognitive-behavioral therapy
D) Sociocultural therapy

Question 45

José is depressed. His therapist told him that reading a book each month would help. He should also visit friends, go bowling, do the laundry, mow the lawn, and eat meals with his partner. In short, José should increase his positive activity. His therapist has MOST likely adopted the _____ orientation.

A) cognitive-behavioral
B) psychodynamic
C) humanistic
D) interpersonal

Question 46

A cognitive-behavioral therapist treating a person with depression would be LEAST likely to:

A) hold the person's hand and say, "I feel so sorry for you," in response to a client who says, "I can't do anything right."
B) ask the client to record what happened immediately before and after each depressive episode.
C) teach the client how to maintain eye contact and smile when interacting with a person he or she has never met before.
D) praise the client by saying, "You are fun to talk to," after the client smiles in response to receiving a compliment.

Question 47

Which action is MOST consistent with a contingency management approach?

A) Providing sympathy when the person talks about depressed feelings
B) Praising the person for engaging in nondepressive activities
C) Limiting the contact family members have with the person
D) Analyzing the person's irrational thoughts

Question 48

Cognitive-behavioral therapy for the treatment of unipolar depression may include:

A) changing irrational thoughts.
B) altering interpersonal deficits.
C) uncovering conflicts over loss.
D) reinforcing nondepressed behavior.

Question 49

Which is the BEST example of the therapy technique known as behavioral activation?

A) Systematically ignoring the patient's depressive behavior
B) Asking patients to say whatever comes into their minds
C) Adding positive activities to the patient's life
D) Asking family members to help reinforce the patient's positive behavior

Question 50

A therapist is treating a client with severe depression using only behavioral activation techniques. How beneficial do you expect this treatment to be?

A) It will have limited effectiveness.
B) It will be as effective as any other nondrug treatment.
C) It will be as effective as all other treatments.
D) It will be more effective than most other treatments.

Question 51

Which is a correct match of person and approach?

A) Lewinsohn and psychodynamic therapy
B) Beck and cognitive therapy
C) Seligman and behavioral activation therapy
D) Weissman and learned helplessness

Question 52

A therapist turns on a buzzer when a client speaks slowly and laboriously. She turns it off when the client speaks more rapidly. In other cases the therapist instructs the client's spouse to ignore his mate when she complains or acts in a self-deprecating manner. This is an example of:

A) existential therapy.
B) cognitive-behavioral therapy.
C) humanistic therapy.
D) psychodynamic therapy.

Question 53

Systematically ignoring a client's depressive behaviors while praising or rewarding instances of nondepressed behavior defines the _____ approach to treating depression.

A) integrated therapeutic
B) contingency management
C) client-centered
D) family-oriented

Question 54

What is the "contingency" in the contingency management approach?

A) How mood changes after people engage in various behaviors
B) How one develops social skills by interacting with family members
C) How reinforcers are delivered or withheld depending on the nature of the behavior one produces
D) How activity levels increase after people take antidepressant medications according to the instructions that were given to them by their doctor

Question 55

Cognitive-behavioral therapists would be MOST likely to say that people with depression must improve their social skills because:

A) the performance of socially unacceptable behavior is irrational.
B) it is important to reinforce the client's depressive behavior.
C) people with depression may be experiencing interpersonal role transition.
D) positive reinforcement is given to people who exhibit positive social behavior.

Question 56

Which finding would support behavioral activation as an effective treatment for depression?

A) People feel less depressed after talking with a therapist about traumatic experiences from childhood.
B) People display fewer symptoms of depression when depressive behaviors are no longer reinforced.
C) People display fewer depressive symptoms after a therapist teaches clients to recognize the maladaptive attitudes they hold.
D) People feel less depressed after they interact with people who are more depressed than they are.

Question 57

Which is important in using contingency management effectively?

A) Increase the total number of activities, both positive and negative, so the person can learn to tell the difference.
B) Make sure that the person receives reinforcement for engaging in positive activities.
C) Make sure the person receives feedback from a group regarding which activities are positive and which are negative.
D) Develop ways for the person to express depressed feelings through journal writing.

Question 58

Aaron's persistent feelings of sadness and impending doom dominate his life. Every time he says anything even a little positive to his therapist, the therapist smiles. Otherwise, the therapist maintains a stone face. This therapist is probably using some variation of:

A) existential therapy.
B) behavioral activation therapy.
C) psychoanalytic therapy.
D) interpersonal psychotherapy.

Question 59

A therapist treating a patient for depression first finds out which activities the client once found pleasurable. These activities are then reintroduced into the patient's daily schedule. Which type of therapy is this therapist using?

A) Behavioral therapy
B) Humanistic therapy
C) Interpersonal therapy
D) Psychodynamic therapy

Question 60

Focusing on the addition of positive activities to the life of a patient with depression is a behavioral technique known as:

A) behavioral contingency management.
B) behavioral cognition.
C) behavioral activation.
D) behavioral confrontation.

Question 61

Clients who tend to see everything that occurs as either all right or all wrong, with nothing in between, need to focus on which phase of Beck's treatment for depression?

A) Increasing activities and elevating mood
B) Challenging automatic thoughts
C) Identifying negative thinking and biases
D) Changing primary attitudes

Question 62

In which way is Beck's cognitive therapy similar to the behavioral activation techniques used to treat depression?

A) It teaches clients to identify and change negative and biased ways of thinking.
B) It attempts to uncover how negative past experiences can be brought safely into conscious awareness.
C) It helps people understand how to socially interact in ways that will be reinforced.
D) It initially encourages clients to increase the number of constructive activities they engage in.

Question 63

Oliver is receiving therapy for unipolar depression. His therapist tells him that many-even most-of the negative thoughts that an individual experiences and records have no basis in fact. Which element of cognitive therapy does this represent?

A) Changing primary attitudes
B) Challenging automatic thoughts
C) Training the individual in dichotomous thinking
D) Negatively reinforcing verbal avoidance responses

Question 64

Beck's cognitive therapy is to _____, as acceptance and commitment therapy is to _____.

A) changing maladaptive attitudes; changing maladaptive behaviors
B) changing negative cognitions; accepting negative cognitions
C) four phases of treatment; three phases of treatment
D) use of psychotherapy; use of antidepressants

Question 65

The treatment approach that uses mindfulness training and other cognitive-behavioral techniques is called:

A) behavior activation therapy.
B) acceptance and commitment therapy.
C) interpersonal therapy.
D) Beck's cognitive therapy.

Question 66

Which statement is TRUE about the research on the effectiveness of cognitive-behavioral therapy in treating unipolar depression?

A) Cognitive-behavioral therapy is less effective than placebo treatments.
B) The research has not provided consistent results on this issue.
C) Cognitive-behavioral therapy is more effective in group therapy sessions than in individual therapy sessions.
D) Cognitive-behavioral therapy significantly improves depressive symptoms in 50 to 60 percent of clients.

Question 67

Which is the BEST example of interpersonal role transition?

A) Taking an important exam
B) Going away to college for the first time
C) Exploring the spiritual dimensions of one's life
D) Planting a garden

Question 68

Many of today's cognitive-behavioral therapists would agree that:

A) Beck's approach to therapy should continue to be followed without modification.
B) negative cognitions should be accepted, not necessarily eliminated.
C) acceptance and commitment therapy is outdated and no longer useful.
D) therapy needs to be individualized, not delivered in a group setting.

Question 69

The second phase of Beck's cognitive therapy is to get the client to:

A) increase activity and elevate mood.
B) identify negative thinking and biases.
C) challenge automatic thoughts.
D) change primary attitudes.

Question 70

Which would a cognitive-behavioral therapist be LEAST likely to say to a client?

A) "Please prepare a detailed schedule of your activities for the week."
B) "Write down your automatic thoughts as they occur to you."
C) "Try to evaluate what happens to you in 'black-and-white' terms."
D) "Let's do a little experiment to test that attitude."

Question 71

If you are a member of a minority, you are:

A) more likely to receive antidepressant medication.
B) likely to receive therapy with a culturally sensitive focus.
C) likely to benefit from culturally sensitive therapy.
D) unlikely to be affected by economic pressures and a minority identity.

Question 72

_____ developed a therapeutic approach to treating depression that guides clients to identify and change maladaptive attitudes and negative thoughts.

A) Beck
B) Freud
C) Rogers
D) Seligman

Question 73

A person experiencing unipolar depression writes in an activity schedule, "Go to store; doctor's appointment; visit museum; read novel; clean room." Which type of treatment is this person MOST likely receiving?

A) Psychodynamic therapy
B) Cognitive therapy
C) Interpersonal therapy
D) Adjunctive therapy

Question 74

If cognitive-behavioral therapy is an effective treatment for depression, then all of the following must be true EXCEPT:

A) Depressive symptoms should diminish after a person's maladaptive attitudes, negative thoughts, and biased ways of thinking have been remedied.
B) Most people who receive cognitive-behavioral therapy should show greater improvement than those who receive no treatment.
C) Cognitive-behavioral therapy should produce a greater percentage of improvement than other therapeutic approaches.
D) Cognitive-behavioral therapy should produce a decrease in depressive symptoms regardless of depression severity.

Question 75

Which is NOT a part of Beck's cognitive therapy for unipolar depression?

A) Getting people to become more active and confident
B) Recording and challenging maladaptive automatic thoughts
C) Discussion with family members about their maladaptive thoughts
D) Getting people to change their primary attitudes

Question 76

Clients who are encouraged to test their assumptions about what is causing their depression are working in which phase of Beck's treatment program?

A) Changing primary attitudes
B) Challenging automatic thoughts
C) Identifying negative thinking and biases
D) Increasing activities and elevating mood

Question 77

The "increasing activities and elevating mood" phase of Beck's treatment for depression:

A) requires the use of antidepressant medication to be effective.
B) is the phase most related to cognitions.
C) makes the therapy cognitive-behavioral rather than purely cognitive.
D) deals with the problem of dichotomous thinking.

Question 78

Which is NOT a goal of the cultural-sensitive therapy movement?

A) Therapy for minority clients delivered exclusively by minority therapists
B) An awareness of the impact of the dominant culture on the self-views of the minority client
C) Special cultural training for majority therapists
D) Efforts to help minority clients establish a bicultural balance in their lives

Question 79

"I don't know why you think you are a terrible surgeon. You haven't lost a patient during an operation in two years. No one else in the city has that kind of record." Which element of cognitive therapy is this therapist MOST likely using?

A) Getting the client to challenge automatic thoughts and change biased ways of thinking
B) Getting the client to uncover an unconscious belief that stemmed from a past traumatic experience
C) Getting the client to feel good about herself so that she can reach her fullest potential
D) Getting the client to change her behavior so that past surgical mistakes can be avoided in the future

Question 80

Why would a cognitive therapist have clients keep records of instances when they tell themselves, "I can't do anything right" and "Nobody will ever love me again"?

A) To teach clients how to avoid situations in which these thoughts occur
B) To help clients understand that these thoughts are probably baseless
C) To identify the early traumatic experiences that created these thoughts
D) To motivate clients to persist in the face of adversity