Chapter 8 Abnormal Psychology Treatments for Depressive and Bipolar disorders

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

50 percent

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

psychodynamic

Which of the following 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.

C. A therapist questions a client about losses she may have suffered in her past.

Which of the following statements about psychodynamic therapy in treating unipolar depression is MOST accurate?
A) Carefully controlled, multiple-participant studies validate the success of this therapy.
B) Not even case studies support the effectiveness of this therapy.
C) Long-term therapy is only occasionally helpful to those with unipolar depression.
D) Short-term therapy is less effective than long-term therapy.

C. Long-term therapy is only occasionally helpful to those with unipolar depression

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:

psychodynamic therapy.

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

unconscious grieving over real or imagined loss

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

case study reports.

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

psycho dynamic therapists.

Among the reasons cited for so many college students experiencing emotional problems are all of the following EXCEPT:

a lack of sensitivity to the issue by admissions counselors.

If your therapist tried to reintroduce you to pleasurable activities, reinforced nondepressive actions, and improved your social skills, your therapist would be using:

Behavioral Therapy

Increasing pleasant activities is MOST likely to be a part of a _______ therapy program

behavioral

Which of the following is important in using contingency management effectively?

Make sure that the person receives reinforcement for engaging in positive activities

Behavioral therapy for the treatment of uni polar depression may include:

reinforcing non depressed behavior

A behavioral therapist is MOST likely to use which of the following in treating a patient with uni polar depression?

praise for engaging in positive activities

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

adding positive activities to the patient’s life

Behaviorists would be MOST likely to say that depressed people must improve their social skills because:

positive reinforcement is given to people who exhibit positive social behavior.

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:

behavioral therapy

Arron’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 has a stone face. This therapist is probably using some variation of:

behavioral therapy.

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

reinforcement

Which one of the following is MOST consistent with a contingency management approach?

praising the person for engaging in non depressive activities

Focusing on the addition of positive activities to a depressed patient’s life is a behavioral technique known as:

praising the person for engaging in non-depressive activities

Current research regarding the effectiveness of behavioral therapy for depression is MOST consistent with which of the following statements?

Using a combination of behavioral techniques works better than using just one.

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 wife. In short, he should increase his positive activity. His therapist MOST likely reflects the ______ orientation.

behavorial

What kind of uni-polar depression is behavioral treatment MOST effective in treating?

mild depression

A therapist treating a patient for depression first finds out what 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?

behavioral therapy

Which of the following is a correct match of person and approach?

Beck and cognitive therapy

If your therapist concentrated on helping you recognize and change negative thoughts and thus improve your mood, your therapist would be using:

cognitive therapy

A person experiencing unipolar depression writes the following in an activity schedule, "Go to store; doctor’s appointment; visit museum; read novel; clean room." What treatment approach is this person MOST likely receiving?

cognitive therapy

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

makes the therapy cognitive-behavioral rather than purely cognitive

A depressed individual receiving therapy is told that many, even most of the negative thoughts that an individual experiences and records, have no basis in fact. MOST likely, the therapist is:

challenging automatic thoughts

Which of the following is NOT a part of Beck’s cognitive therapy for uni-polar depression?

discussion with family members about their maladaptive thoughts

Which of the following would a cognitive therapist be LEAST likely to say to you?

Try to evaluate what happens to you in "black and white terms"

"I do not know why you think you are a terrible surgeon. You have not lost a patient during an operation in two years. No one else in the city has that kind of record." Which of the following orientations is MOST likely to describe the therapist who made this statement?

cognitive

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?

Identifying negative thoughts and biases

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

changing primary attitudes

Which one of the following statements is MOST consistent with the use of acceptance and commitment therapy (ACT) for depression?

Accepting negative thoughts and working with them is preferable to rejecting them entirely

Which of the following is true about the research on the effectiveness of cognitive therapy in treating unipolar depression?

It nearly eliminates depressive symptoms in 50 to 60 percent of the cases.

Which of the following is TRUE about research on the effectiveness of cognitive therapy for treating uni-polar depression?

Research studies show its effectiveness

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

Negative cognitions should be accepted, not necessarily eliminated

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

therapy for minority clients delivered exclusively by minority therapists

If you are a minority, you are:

likely to benefit from culturally sensitive therapy.

Which of the following is the BEST example of interpersonal role transition?

going away to college for the first time

Why is interpersonal psychotherapy considered to be a sociocultural approach?

Depression is thought to result from disrupted social interactions and role expectations.

If your therapist encouraged you to explore your roles in life and how they might be changing, or how your expectations might be different from someone else’s, your therapist would be using:

interpersonal therapy

A woman who is in conflict with her husband over whether she should have a career or stay at home full-time to care for their children is experiencing:

interpersonal role dispute

A person who displays extreme shyness and insensitivity to others is showing signs of:

interpersonal deficits

Which interpersonal problem area identified by interpersonal psychotherapists is MOST like the cause of depression suggested by psychoanalysis?

interpersonal loss

Interpersonal psychotherapists believe that therapy must address:

role transitions in relationships

Tomas has withdrawn from most social contacts because he never seems to be able to say the right thing. He just doesn’t seem to fit in. His comments are always misinterpreted. He feels alone and is depressed. This is an example of what interpersonal psychotherapists refer to as an:

interpersonal deficit

Tony just does not feel close to anyone. He feels alone because although he can get to know someone (a woman) quite well on a friendship level, he doesn’t know how to get beyond that to a more intimate level. This is depressing him. This is an example of what interpersonal psychotherapists refer to as an:

interpersonal deficit

Which of the following is TRUE about the research on the effectiveness of interpersonal psychotherapy in treating unipolar depression?

It nearly eliminates symptoms in 50 to 60 percent of cases

According to research studies, the success rate for interpersonal therapy is about the same as that for:

cognitive therapy

About what percentage of people receiving treatment for depression are in dysfunctional relationships?

50 percent

If the focus of your therapist is primarily on how communication and problem-solving difficulties with your partner are contributing to your depression, your therapist is using:

couple therapy

If you are receiving therapy designed to teach you and your spouse specific communication and problem-solving skills, your therapist is practicing:

behavioral marital therapy

When is couple therapy preferable to individual therapy?

when the relationship conflicts and role transitions are paramount

Which of the following is not an example of a biological treatment for depression?

contingency management

If you live in the United States, you can be assured that:

you will be exposed to advertisements from the multi-billion-dollar dietary supplement industry

Typical consumers of nutraceuticals:

have easy access to a variety of products

Which of the following is the MOST effective dietary supplement/disorder pairing?

ginkgo Bilbao for treating dementia

The nutraceutical SAM-e:

is used for treating depression

If a friend is considering nutraceuticals for the treatment of depression, your BEST advice would be:

"St. John’s wort should only be used for mild or moderate cases of depression."

St. John’s wort:

is inexpensive compared to pharmaceuticals

What is the average length of time for the treatment of major depressive disorder with ECT?

2-4 weeks

If you were treated with ECT, you would experience a(n):

brain seizure

In the bilateral ECT, the electrical current passes through:

both sides of the brain

Which patient group was the first treated with ECT?

psychotic patients

Ugo Cerletti, the first psychiatrist to use ECT effectively, later abandoned the procedure, MOST likely because of:

the likelihood that convulsions caused by it would result in broken bones and dislocated joints

ECT (electroconvulsive therapy) has changed over the years. Patients given this treatment now may receive:

muscle relaxants

Today, electroconvulsive therapy:

also involves the use of muscle relaxants

One of the side effects of ECT is:

memory loss

Which of the following is the MOST important reason for the decline in the use of electroconvulsive therapy since the 1950s?

antidepressant drugs were developed

People who take MAO inhibitors and want to decrease the risk of negative side effects would make the greatest changes in which aspect of life?

what they eat

An individual receiving a treatment for depression is happier because of higher levels of norepinephrine in his or her brain. What treatment is this person MOST likely receiving?

an MAO inhibitor

Corrina took an antidepressant and then ate a meal. Shortly thereafter her blood pressure skyrocketed and she felt faint. Which of the following is MOST likely to be true?

She ate something containing tyramine.

If you had high blood pressure, you would want to be especially careful when using:

MAO inhibitors

MAO inhibitors work by:

blocking MAO from breaking down norepinephrine

MAO inhibitors are biochemical agents that alleviate depressive symptoms in approximately half of the clinically depressed patients who take them. What is the mechanism of action of these drugs?

They interfere with the destruction of norepinephrine.

Which of the following is MOST likely to elevate the mood in a depressed person?

an increase in the levels of norepinephrine

How do monoamine oxidase (MAO) inhibitors work?

They increase supplies of norepinephrine in neurons.

Researchers were searching for drugs to treat schizophrenia when they came across imipramine, which alleviated the symptoms of depression, although it was not effective against schizophrenia. It became the first of a class of drugs, all sharing a similar molecular structure, called:

tricylics

The mechanism of action of imipramine is to:

block reuptake of norpinephrine and serotonin

In order to effectively reduce the chances of relapse of depressive symptoms, patients should:

continue to take tricylics after they are symptom-free.

Apparently tricyclics work by:

blocking the re-uptake of norepinephrine and serotonin

"Second-generation" antidepressant medications include:

Anafranil and Eldepryl

A person who is recovering from depression continues to take tricyclic medication for several months after most symptoms are gone. This is called:

maintenance therapy, and is often necessary to keep symptoms from reappearing

Which of the following best represents how tricyclics work?

tricylic ingested, smaller amounts of norepinephrine and serotonin released, normal amounts of norepinephrine and serotonin released, reuptake triggers more neural firing

Second-generation anti-depressants appear to act by:

selectively blocking the re-uptake of serotonin

Second-generation antidepressants:

target specific neurotransmission reuptake

Compared to earlier antidepressant drugs, "second-generation" antidepressant drugs:

do not work either faster or more effectively

A clinician says at a workshop, "I prefer the most recently developed antidepressant medications, because they’re harder to overdose on, and they don’t require dietary restrictions." This statement is:

accurate

A person taking antidepressant medication is starting to gain weight, and reports decreasing interest in sexual activity. These changes are MOST common among people taking what kind of antidepressant medication?

second-generation anti-depressants

Therapists who treat African American clients for depression need to be aware that their clients are:

less likely to receive newer second-generation drugs.

White Americans receiving Medicaid are:

more likely than African Americans to be prescribed antidepressant medication, but may be less likely to respond to the medication

How likely are Medicaid recipients to be prescribed antidepressant medication?

White Americans more often than Hispanic Americans; Hispanic Americans more often than African Americans

Among the biological treatments for depression, the one that uses an implanted pulse generator is:

vagus nerve stimulation

Vagus nerve stimulation is MOST similar to:

ECT

Studies show that individuals with severe depression who have not benefited from more conventional treatments are about how likely to improve from using vagus nerve stimulation?

40 percent

In which of the treatments for depression is a stimulating current sent through a patient’s prefrontal cortex?

TMS

______ is a treatment in which tiny holes are drilled into the skull through which electrodes are implanted into the brain.

Deep brain stimulation

What do ECT, vagus nerve stimulation, and transcranial magnetic stimulation have in common?

They suggest that brain stimulation is effective in treating severe forms of depression.

There has been a significant increase in the number of physicians prescribing antidepressants in the past few decades:

despite the success of cognitive therapy

Conclusions from extensive studies of the effectiveness of various forms of treatment for depression show that:

Cognitive, cognitive-behavioral, interpersonal, and biological treatments are the best, and about equally effective

Outcome studies on treatments for depression, comparing drug treatments with cognitive and cognitive-behavioral therapies, show that:

Cognitive therapies are better at preventing relapses unless the drug therapy is continued even after the patient has improved

The key to long-term treatment of depression is:

some sort of maintenance therapy

Research now suggests that once someone has been successfully treated for depression he or she:

needs some type of continuation or maintenance therapy

Recent research indicates that behavioral therapy is the treatment of choice only:

over placebo treatment

Which of the following would a psychodynamic therapist be MOST likely to say about studies regarding the effectiveness of psychodynamic therapy for depression?

The therapy does not lend itself to empirical research.

Your BEST advice to a friend who is experiencing severe depression would be:

"Try combining cognitive therapy with drug therapy."

What would be your BEST recommendation (i.e., MOST scientifically valid) about behavioral therapy for someone experiencing depression?

It is better than nothing, but that’s about it.

What would be your BEST recommendation (i.e., MOST scientifically valid) about behavioral therapy for an adolescent experiencing depression?

Use a combination of drug therapy and cognitive therapy.

Which of the following is NOT true about the use of ECT and drug therapies for treating depression?

ECT is likely to prescribed first, and if it doesn’t work, then drugs are prescribed.

Which of the following treatments produces the fastest results in the biological treatment for unipolar depression?

electroconvulsive therapy

Electroconvulsive therapy would be MOST recommended when:

the patient has not responded to antidepressant drugs

What is currently true about pharmaceutical companies regarding their ads for medications in the United States?

They must recommend that patients consult with their doctors about taking the drugs in their ads.

Rosita swings between periods of bottomless depressions and high-flying enthusiasm. She never hits the middle. Her physician is MOST likely to recommend treatment with:

lithium

The effects of lithium were discovered during the investigation of:

the effect of toxic levels of uric acid

If a person taking lithium began experiencing nausea, vomiting, sluggishness, tremors, and seizures, one would suspect:

the person was experiencing lithium intoxication

At least ______ of manic patients treated with lithium improve.

60 percent

Lithium has been found to:

enhance the effectiveness of antidepressant drugs in unipolar depression

A person with bipolar disorder is taking a commonly used drug to stabilize mood in the manic episodes. What else might also happen as a result of taking this drug?

the person might experience at least partial relief from depressive episodes

All of the following about lithium as a treatment for bipolar disorder are true, EXCEPT that:

it interferes with the effectiveness of anti-depressant medications

Lithium appears to affect:

neuron’s second messengers

Second messengers are:

active inside the neuron

You would expect to see the biggest impact of lithium on which part of the neuron?

the firing of the receiving neuron

The combination of lithium and psychotherapy is better than lithium treatment alone. This therapeutic addition is called:

adjunctive psychotherapy

Which one of the following is the BEST example of adjunctive therapy?

A patient is receiving both drug therapy and interpersonal therapy with his or her family.

The best treatment recommendation you could give someone experiencing bipolar disorder is:

drug therapy, perhaps accompanied by psychotherapy

Which one of the following is a likely reason for using adjunctive therapy to treat bipolar disorder?

People stop taking lithium because they feel more productive and creative without taking it.

Which of the following is an example of effective adjunctive therapy for bipolar disorder?

individual or group therapy