Chapter 13: Depressive Disorders and Suicide

Test Bank

Multiple Choice

1. Eight-year-old Gordon is constantly throwing temper tantrums at home and seems just generally upset. He’s been this way as long as his parents can remember and when something sets him off, he terrorizes the house, pulling things off the wall and breaking whatever he can find. His family is on their third set of dishes this year. Which of the following would be necessary to know before diagnosing Gordon with DMDD?

a. Is Gordon living with his biological parents?

b. Does Gordon exhibit these problems at school or with peers?

c. Does Gordon have an ODD diagnosis?

d. Did this pattern of behavior begin prior to the age of 4?

Ans: B

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Application

Answer Location: What Is Disruptive Mood Dysregulation Disorder?

Difficulty Level: Hard a. universal prevention program b. selective prevention program c. indicated prevention program d. tertiary prevention program

2. Brookridge Middle School is targeting a suicide prevention program to students at risk due to their social and bullying status. This would be considered which of the following?

Ans: B

Learning Objective: LO 13.3 Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Application

Answer Location: Can We Prevent Suicide in Children and Adolescents?

Difficulty Level: Easy a. major depressive disorder b. disruptive mood dysregulation disorder c. persistent depressive disorder in adults d. persistent depressive disorder in children

3. Which of the following disorders has the shortest minimum duration for diagnosis?

Ans: A

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Located throughout chapter

Difficulty Level: Medium a. In DMDD, irritability is more persistent. b. In DMDD, irritability has earlier onset. c. In DMDD, irritability has later onset. d. DMDD involves reliably different environmental triggers.

4. How does the irritable mood seen in DMDD differ from the mood features seen in disruptive behavior disorders?

Ans: A

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Comprehension

Answer Location: What Is Disruptive Mood Dysregulation Disorder?

Difficulty Level: Medium a. ADHD b. ODD c. bipolar disorder d. MDD

5. The existence of persistent irritability and recurrent temper outbursts best distinguishes DMDD from which of the following?

Ans: A

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Analysis

Answer Location: Attention-Deficit/Hyperactivity Disorder

Difficulty Level: Hard a. restricting adolescents’ means of suicide at home b. parent sessions with the therapist c. a no harm contract d. developing coping strategies

6. Safe Alternatives for Teens and Youths involves all EXCEPT which of the following?

Ans: C

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior. Cognitive Domain: Knowledge

Answer Location: Family-Focused Treatments

Difficulty Level: Hard a. Children with ODD usually direct their defiance toward particular individuals, while children with DMDD usually direct their anger and aggression more generally, even destroying their own property. b. Temper outbursts are longer and more severe in DMDD. c. DMDD is more persistent than ODD. d. DMDD is more likely to lead to anxiety and depressive disorders in adolescence than ODD.

7. Which of the following is NOT a way in which DMDD can be differentiated from ODD?

Ans: C

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Comprehension

Answer Location: Oppositional Defiant Disorder

Difficulty Level: Medium a. They are particularly bad at judging positive emotions in faces and show hyperactivity in the amygdala when viewing angry or fearful faces. b. They are particularly good at judging angry and fearful faces and show hyperactivity in the amygdala when viewing these faces. c. They are particularly bad at judging sad, fearful, and angry faces and show hyperactivity in the amygdala when viewing these faces. d. They are particularly bad at judging sad, fearful, and angry faces and show underactivity in the amygdala when viewing these faces.

8. Youths with DMDD have been shown to have which deficits related to emotional processing?

Ans: D

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Knowledge

Answer Location: What Causes Disruptive Mood Dysregulation Disorder?

Difficulty Level: Hard a. more agitation and greater activation of the amygdala b. more negative arousal and lower activation of the amygdala c. more agitation and greater activation in the right medial frontal gyrus and left anterior cingulate cortex d. more negative arousal and lower activation in the right medial frontal gyrus and left anterior cingulate cortex

9. In a frustrating visual task that was rigged to provide inaccurate feedback, children with DMDD produced which pattern of response compared to healthy controls?

Ans: C

Learning Objective: 13.1 Describe the key features of Disruptive Mood Dysregulation Disorder (DMDD) and differentiate DMDD from other conditions affecting young children. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: What Causes Disruptive Mood Dysregulation Disorder?

Difficulty Level: Hard a. They may interpret their own frustration as anger and act accordingly. b. They may interpret others’ fear as anger and act aggressively toward them as a result. c. They may like that others are afraid of them and act out to perpetuate their power in these situations. d. They may find frustration and other similar states as particularly aversive and hard to handle and may act out more than the average child in response to similar stressors.

10. Research has indicated that those with DMDD may demonstrate temper outbursts for all of the following reasons EXCEPT ______.

Ans: C

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Comprehension

Answer Location: What Causes Disruptive Mood Dysregulation Disorder?

Difficulty Level: Medium a. Lithium is the first-line medicinal treatment. b. Antipsychotics are the first-line medicinal treatment, but these are only effective in those with comorbid ADHD. c. Stimulant medication is the first-line medicinal treatment, but only in those with no comorbidities. d. Antidepressants are recommended for some youths with DMDD.

11. What is the recommended role of medication in treating DMDD?

Ans: D

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Knowledge

Answer Location: What Evidence-Based Treatments Are Available for Disruptive Mood Dysregulation

Disorder?: Medication

Difficulty Level: Medium a. All treatment conditions showed equivalent effectiveness. b. Any treatment is more effective than no treatment. c. Combined treatment is no more effective than medication alone. d. CBT is no more effective than medication.

12. Because the Treatment of Adolescent Suicide Attempters (TASA) study had no control group, which of the following CANNOT be concluded?

Ans: B

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Analysis

Answer Location: How Can Clinicians Help Youths Who Attempt Suicide?: Hospitalization and Safety

Planning: Medication

Difficulty Level: Medium a. Parent training is most effective in managing the child with DMDD’s irritability and anger. b. Summer programs for children with DMDD are effective in the short term, but show few longer term benefits. c. Family treatment is most effective when child and parent are in the same room for the duration of treatment. d. One focus of treatment is often on helping children with DMDD better interpret their own emotions and those of others.

13. Which of the following is true of treatment for DMDD?

Ans: D

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Comprehension

Answer Location: Behavior Therapy

Difficulty Level: Medium a. Children with a history of sleep problems are more likely to develop DMDD. b. The irritability and brain activation differences of children with DMDD make it harder for them to sleep. c. The comorbidity between DMDD and ADHD moderates the relationship between DMDD and sleep disturbance. d. Children with DMDD often experience sleep problems, but the direction of this relationship is still unknown.

14. Which is true regarding the relationship between sleep and DMDD?

Ans: D

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Comprehension

Answer Location: Sleep Enhancement

Difficulty Level: Medium a. Yes. b. No, because it was triggered by a break-up. c. No, because it hasn’t persisted long enough. d. No, because it’s not clear that she has depressed mood or a loss of interest or pleasure in most activities.

15. Melanie has lost a significant amount of weight and hasn’t been able to sleep since she broke up with her boyfriend a month ago. She feels guilty for not having spent enough time with him while they were together and is having difficulty thinking about anything else She is still happy to go to dance class and her weekly pizza night with friends, but often finds that she’s moving more slowly throughout her day. Her parents have observed that she also seems to be moving more slowly than before. Can Melanie be diagnosed with major depressive disorder?

Ans: D

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Application

Answer Location: What Is Major Depressive Disorder?

Difficulty Level: Medium a. needn’t experience symptoms as long in order to be diagnosed b. needn’t experience as many symptoms in order to be diagnosed c. can display depressed mood as irritability d. can show weight gain or increased sleep instead of just reduction in eating or sleeping

16. Compared to adults with depression, children with depression ______.

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: What Is Major Depressive Disorder?

Difficulty Level: Easy a. means restriction b. identification of triggers c. identification of support sources d. consequences for not following the plan

17. Safety plans involve all EXCEPT which of the following?

Ans: D

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Hospitalization and Safety Planning

Difficulty Level: Medium a. hypersomnia, weight gain, psychomotor agitation b. insomnia, weight loss, psychomotor agitation c. hypersomnia, weight loss, psychomotor retardation d. insomnia, weight gain, psychomotor retardation

18. Which of the following patterns of symptoms of MDD is more common in children than adults?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: What Is Major Depressive Disorder?

Difficulty Level: Medium a. feelings of worthlessness or guilt b. depressed mood c. temper outbursts d. thought and concentration problems

19. Which of the following is NOT a symptom of major depressive disorder?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders. Cognitive Domain: Knowledge

Answer Location: What Is Major Depressive Disorder?

Difficulty Level: Easy a. number of episodes b. duration of the disturbance c. number of symptoms and amount of distress or impairment d. degree of suicidality

20. Severity in major depressive disorder is determined by which of the following?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: What Is Major Depressive Disorder?

Difficulty Level: Medium a. She will likely be sent home and her parents can protect her there. b. She must not have reported an active plan to commit suicide. c. She likely has thoughts of death but no current intent to die. d. She is likely to be hospitalized until her risk decreases.

21. Billie is assessed for suicide and determined to be at acute high risk. Which of the following is likely true of Billie?

Ans: D

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Application

Answer Location: How Do Clinicians Assess Suicide Risk?

Difficulty Level: Medium a. MDD b. PDD c. DMDD d. bipolar disorder

22. A children’s book called The Pout Pout Fish describes a fish who wants to be cheery but can’t because “It’s just the way I am.” This is most consistent with which disorder?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: What Is Persistent Depressive Disorder (Dysthymia)?

Difficulty Level: Easy a. Persistent depressive disorder tends to have gradual onset while the onset of major depressive disorder tends to be more sudden. b. Symptoms of MDD tend to be more severe. c. Though they both entail general sadness, there are no symptoms that overlap between major depressive disorder and persistent depressive disorder. d. Persistent depressive disorder is typically longer-lasting than major depressive disorder

23. Which of the following is NOT a true distinction between major depressive disorder and persistent depressive disorder?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: What Is Persistent Depressive Disorder (Dysthymia)?

Difficulty Level: Medium a. Overall, it has increased dramatically in the last 10 years. b. Boys are more likely than girls to have persistent depressive disorder while girls are more likely than boys to have major depressive disorder c. The prevalence of major depressive disorder increases dramatically from childhood to adolescence. d. 20% of youths experience major depressive disorder at any given time.

24. Which of the following is true regarding the prevalence of depression in children and adolescents?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Overall Prevalence

Difficulty Level: Medium

25. All of the following are true of girls with depression (as compared to boys with depression) a. Girls tend to show a greater number of symptoms. b. Girls tend to show more sudden onset of symptoms. c. Girls tend to show greater likelihood of self-harm. d. Girls tend to have longer initial depressive episodes.

EXCEPT which of the following?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Depression in Girls

Difficulty Level: Medium a. It limits the development of autonomy. b. It creates social tension with others. c. It provides few alternative coping strategies. d. It can lead to excessive guilt and helplessness.

26. Excessive compliance may lead to depression because of which of the following?

Ans: A

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Depression in Girls

Difficulty Level: Hard a. perceived burdensomeness b. thwarted belongingness c. capability for suicide d. hopelessness

27. Which of the following is NOT a factor that prompts suicide according to interpersonal theory?

Ans: D

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Interpersonal Theory

Difficulty Level: Medium a. Those with a genetic predisposition toward depression would be more likely to manifest depressive symptoms. b. Those who have experienced recurrent depression are more likely to experience major life stressors. c. Those who have experienced an early depressive episode are more likely to view later minor stressors as more severe. d. Those who have experienced multiple depressive episodes become desensitized to stressors and have greater resilience in the face of future stressors.

28. The kindling hypothesis would predict which of the following?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Depression Over Time

Difficulty Level: Hard a. very low levels of depression across childhood and adolescence b. high levels of depressive symptoms in childhood that gradually diminish through adolescence c. consistent, moderate levels of depressive symptoms throughout childhood and adolescence d. low levels of depressive symptoms in childhood with dramatically higher levels in adolescence

29. Which of the following was NOT a course of depressive symptoms identified by researchers?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Depression Over Time

Difficulty Level: Easy a. Monozygotic twins raised together had only slightly higher concordance for MDD than monozygotic twins raised apart. This indicates a strong genetic component to the disorder. b. Monozygotic twins raised together had a higher concordance for MDD than monozygotic twins raised apart. This indicates the importance of nonshared environmental factors as primary in the development of the disorder. c. Dizygotic twins have a higher concordance rate for MDD than monozygotic twins, whether raised together or raised apart. This indicates there is a strong genetic component to the disorder. d. Twins had to have been raised together to show any concordance for MDD above that of typical siblings. This indicates a relatively small genetic role in MDD.

30. Which of the following sets of individuals had the highest concordance for MDD and what does that tell us?

Ans: A

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Genes and Neurotransmitters

Difficulty Level: Medium a. Cyberbullying increases the rate of suicide in the victim, while bullying does not. b. Bullying increases the likelihood of suicide in the victim, while cyberbullying does not. c. Bullies are at increased risk for suicide while victims of bullies are not. d. Both bullies and their victims are at increased risk of suicide.

31. Which of the following is the relationship between bullying/cyberbullying and suicide?

Ans: D

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Bullying and Cyberbullying

Difficulty Level: Medium a. Children with difficult temperament may overreact to negative life events and have emotion regulation difficulties. b. Children with difficult temperament tend to selectively affiliate with each other, exacerbating their likelihood of experiencing and reacting severely toward life stressors. c. Children with difficult temperament may elicit negative reactions from caregivers and peers leading to low self-worth and depression. d. Children with difficult temperament may have greater problems coping with early childhood stressors.

32. Which of the following is NOT a way in which temperament is thought to relate to the development of depression?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Temperament

Difficulty Level: Medium a. Chronically high levels of cortisol are found in those with depression. b. Giving synthetic cortisol to those with depression doesn’t “shut off “ cortisol production. c. Depressed youths sometimes show an enlarged pituitary. d. Depressed youths have increased sensitivity to small amounts of cortisol.

33. Which of the following is NOT evidence presented in the text that the HPA axis is affected in depression?

Ans: D

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Hypothalamus-Pituitary-Adrenal Dysregulation

Difficulty Level: Medium a. Stressful life events, particularly during puberty, account for almost all of the variance in adolescent depressive symptoms. b. Stressful life events are most impactful in the development of depression when they occur in childhood. c. Stressful life events are most impactful in the onset of the initial depressive episode. d. The relationship between stressful life events and depression is that stressful life events predict depression but there is no influence in the other direction.

34. Research has indicated which of the following with respect to the role of stressful life events in the development of depression?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Stressful Life Events

Difficulty Level: Medium a. A cognitive distortion refers to selective attention to negative events while cognitive bias refers to selective attention to negative attributes of people. b. A cognitive distortion refers to a misperception of others’ intentions while cognitive bias refers to selective attention to one’s own motives. c. A cognitive distortion involves a perception or interpretation that is overblown and not consistent with reality while cognitive bias is a shift in looking at the world that involves selective attention to negative experiences. d. Cognitive bias involves perceptions of others while cognitive distortions refer to misperceptions of one’s self.

35. The main difference between a cognitive bias and a cognitive distortion as these terms apply to depression is which of the following?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Beck’s Cognitive Theory of Depression

Difficulty Level: Medium a. the inability to develop independent coping skills when parents are particularly intrusive b. expressions of uncertainty and help-seeking when faced with environmental stressors c. the propensity to not seek escape from stressors when past stressors were inescapable d. the informational transmission that social mores cannot be changed or overcome

36. Learned helplessness refers to which of the following?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Depressogenic Attributions

Difficulty Level: Easy a. There was a big shell on the beach that I didn’t see. b. I’m so clumsy. c. No one could ever be friends with a kid like me. d. No matter how hard I try I just can’t help but be clumsy.

37. Ryan falls into the water during a school trip to the beach. Which of the following attributions is LEAST depressogenic?

Ans: A

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Application

Answer Location: Depressogenic Attributions

Difficulty Level: Easy a. internal, stable, global b. internal, stable, specific c. external, stable, specific d. external, unstable, specific

38. A person with a depressogenic attributional style is likely to have which pattern of attributions for scoring a goal in a soccer game?

Ans: D

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Application

Answer Location: Depressogenic Attributions

Difficulty Level: Medium a. genetics b. negative life events c. depression itself d. social contagion

39. Research has linked depressogenic attributions to all EXCEPT which of the following?

Ans: A

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Depressogenic Attributions

Difficulty Level: Medium a. Parents who have committed suicide have children with higher risk of suicide. b. Parents with mood disorders, substance use disorders, and personality disorders can compromise the care of their children and increase family stress, increasing the risk of suicide in children. c. Parents who provide strong support to their children, but whose children don’t perceive this support, have children at higher risk of suicide. d. Parents who are verbally abusive toward their children have children with higher rates of suicide than children who experience any other kind of child maltreatment.

40. Parents can increase the suicide risk of their children in all of the following ways EXCEPT ______.

Ans: D

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Family Problems; Child Maltreatment

Difficulty Level: Medium a. Children who receive intrusive care expect similar interactions with later individuals they will encounter. b. Children who receive unresponsive care often seek responsiveness in others. c. Children often believe they are incapable of engaging in interactions in ways other than the way their parents interacted with them. d. Insecurely attached children often believe that the best possible romantic partner is the one who most resembles their parents’ interaction style.

41. How does parental attachment form a template for future relationships?

Ans: A

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Parent–Child Attachment

Difficulty Level: Medium a. feelings of low self-worth b. deriving self-esteem from accomplishments and approval c. less help-seeking in times of crisis d. low self-reliance

42. Insecure attachment is associated with all of the following EXCEPT ______.

Ans: D

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Parent–Child Attachment

Difficulty Level: Medium a. Adopted children would show no particular relationship between their depressive status and their adoptive parents’ depressive status. b. Twins raised apart would not be similar in their depressive status. c. Biological siblings would be more similar in their depressive status than parents and children would be. d. Parents who were discordant for depression would have the highest rate of depression in their children.

43. If the link between maternal depression and child depression were purely genetic, which of the following would you expect?

Ans: A

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Maternal Depression

Difficulty Level: Hard a. stress; dopamine b. stress; cortisol c. depression; GABA d. depression; testosterone

44. Mothers who have high levels of ______ during pregnancy often have offspring who have difficulty regulating ______.

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Maternal Depression

Difficulty Level: Medium a. the monoamine hypothesis b. the intergenerational interpersonal stress model c. the peer contagion model d. the social-information processing theory of depression

45. The finding that maternal depression is associated with less responsive and more hostile parenting behavior provides support for which hypothesis of the cause of depression?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Maternal Depression

Difficulty Level: Medium a. Mikayla, who has few friends and thinks to herself, “Who cares about them anyway? They’re all a bunch of phonies.” b. Teagan, who has few friends and thinks to herself, “Everyone else has someone and I have no one. There must be something really wrong with me.” c. Akeela, who has a lot of friends but who sometimes wonders, “Who am I really? What is really important to me?” d. Willa, who has an average number of friends, but asks herself, “I wonder what they’d like me to do? How can I make them happiest?”

46. Based on findings of the factors that predict depressive symptoms, which of the following individuals would be at highest risk?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Application

Answer Location: Friends

Difficulty Level: Hard a. Positive peer relationships can provide substantial resilience in the face of other psychosocial stressors. b. Problematic peer relationships can predict depression. c. Positive peer relationships can provide resilience against depression and problematic peer relationships can predict depression. d. There is no reliable relationship, positive or negative, between peer relationships and depression.

47. Which of the following best reflects the results on the relationship between peers and depression?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Friends

Difficulty Level: Hard a. Children with depression have a hostile attribution bias and believe that others’ perceived hostile actions derive from external and unstable factors. b. Children with depression have a victim attribution bias and believe that others’ perceived hostile actions derive from external and unstable factors. c. Children with depression have a hostile attribution bias and believe that others’ perceived hostile actions derive from internal and stable factors. d. Children with depression have a victim attribution bias and believe that others’ perceived hostile actions derive from external and stable factors.

48. The social information-processing theory of depression holds which of the following?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Social Information Processing

Difficulty Level: Medium a. They are the most effective treatment for childhood depression. b. They affect serotonin and dopamine systems. c. They are much more effective in children than in adults. d. They have severe side effects for more than 10% of children.

49. Which of the following is true about tricyclic antidepressants?

Ans: D

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Effectiveness

Difficulty Level: Medium a. are more effective than placebo in treating childhood depression b. increase the availability of serotonin, modulating it to normal levels c. are FDA approved for treating depression in children d. showed a large (>20%) increase in improvement of childhood depressive symptoms over placebo

50. Complete this statement: No SSRIs ______.

Ans: D

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Effectiveness

Difficulty Level: Medium a. Alcohol is often used immediately before suicide and may reduce inhibitions against self-injury. b. Amphetamine may increase the risk of suicide by increasing impulsive decision-making. c. Marijuana may increase the risk of suicide by making the adolescent more careless, for instance when driving. d. Substance use disorders increase the risk of suicide, particularly when an individual has several substance use disorders simultaneously.

51. In which of the following ways is substance use NOT related to suicide?

Ans: C

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Comprehension

Answer Location: Substance Use Problems

Difficulty Level: Medium a. conduct disorder b. persistent depressive disorder c. bipolar disorder d. obsessive compulsive disorder

52. Which of the following diagnoses is NOT associated with an increased risk of suicide?

Ans: D

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Mental Health Problems

Difficulty Level: Easy a. removing response-contingent reinforcement to give youths a sense of unconditional positive regard b. enhancing anhedonia c. challenging cognitive bias and distortion d. valuing the client’s independence and preventing overreliance on social networks in times of stress

53. One of the main components of CBT for depression is which of the following?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Cognitive–Behavioral Therapy for Children

Difficulty Level: Easy a. a component of the Coping with Depression Program b. a component of coping with negative emotions c. a term for directing all of a child’s energy and attention to solving a problem d. a way for a child with depression to reward himself or herself after solving a problem

54. “Psyching-up” is which of the following?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Cognitive–Behavioral Therapy for Children

Difficulty Level: Medium a. providing alternative explanations for situations that have contributed to the child’s negative mood b. teaching relaxation exercises c. asking the child to interview nondepressed peers to generate additional coping ideas d. introducing pleasurable activities into the week that the child actively plans

55. Which of the following is NOT a method to improve coping skills used in Stark’s treatment for childhood depression?

Ans: A

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Cognitive–Behavioral Therapy for Children

Difficulty Level: Medium

56. Ayumi, an 8-year-old working through a depression, tells her therapist that the other day when she came back from the classroom after having gone to the bathroom, none of the kids even looked at her when she walked in the door. She said it proved that no one liked her or cared about her. Her therapist asked her whether there was anything else that might have explained their behavior for instance, were they all working on a math worksheet when she came in? Her therapist is helping Ayumi engage in which of the following? a. What’s the Evidence? b. Alternative Interpretations c. What If? d. Psyching Up

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Application

Answer Location: Cognitive–Behavioral Therapy for Children

Difficulty Level: Easy a. It is no more effective than placebo. b. It is more effective than any other kind of psychotherapy. c. It is as effective as several other kinds of psychotherapy, particularly in the long term. d. It is less effective than several other kinds of psychotherapy in the short term, but more effective in the long term.

57. Which of the following best describes the effectiveness of CBT for treating childhood depression?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Cognitive–Behavioral Therapy in Children

Difficulty Level: Medium a. to be more familiar to adolescents b. to be more cost-effective, allowing for the treatment of many youths at the same time c. to be less stigmatizing d. to allow researchers to use existing schools to carry out treatments

58. Why is the Adolescent Coping With Depression (CWD-A) course held in a classroom environment?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Cognitive–Behavioral Therapy for Adolescents

Difficulty Level: Medium a. Only cognitive–behavioral therapy for children involves planning pleasurable activities. b. Only cognitive–behavioral therapy for adolescents involves relaxation techniques. c. Only cognitive–behavioral therapy for adolescents involves learning how to brainstorm possible solutions to interpersonal problems. d. Only cognitive–behavioral therapy for children specifically involves the What’s the Evidence? and What If? approaches to cognitive restructuring.

59. Which of the following is one of the primary differences between cognitive–behavioral therapy for children and for adolescents?

Ans: D

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: What Evidence-Based Psychotherapies Are Available for Youths With Depression?

Difficulty Level: Medium a. diagnosis of depression b. ethnicity c. the combination of age and gender, with females between 12 and 18 at highest risk d. previous suicidal thoughts and actions

60. Which of the following is the best predictor of a future suicide attempt?

Ans: D

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Previous Suicidal Thoughts or Actions

Difficulty Level: Easy a. grief and loss b. interpersonal role dispute c. role transition d. interpersonal deficit

61. Ronnie describes his parents as uncaring and unyielding. “They won’t let me stay out late, even for football games, so I had to quit the team,” Ronnie said. “It’s like they don’t remember what it was like to be young.” Robbie’s experiencing which of the following?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Application

Answer Location: Interpersonal Psychotherapy for Adolescents

Difficulty Level: Medium a. grief and loss b. interpersonal role dispute c. role transition d. interpersonal deficit

62. “I just couldn’t find my place in the family anymore after my sisters had their children,” Sherry said. ”Being the youngest, I suddenly felt like a third class citizen. That’s when I began to feel depressed.” Sherry’s interpersonal therapist might help her through which of the following?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Application

Answer Location: Interpersonal Psychotherapy for Adolescents

Difficulty Level: Medium a. has never had its effectiveness examined in adolescents b. is no more effective than traditional counseling in improving social functioning c. is no more effective than traditional counseling in reducing depressive symptoms d. is more effective than traditional counseling in both improving social functioning and reducing depressive symptoms

63. Complete the following statement: Interpersonal therapy ______.

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Interpersonal Psychotherapy for Adolescents

Difficulty Level: Medium a. fluoxetine (Prozac) only b. CBT only c. psychotherapy placebo d. placebo

64. The Treatment for Adolescents with Depression Study did NOT include which of the following groups?

Ans: C

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Should Medication and Psychotherapy Be Combined to Treat Depression?

Difficulty Level: Medium a. Statistically, the combination of CBT and medication is no more effective than CBT alone. b. Statistically, the combination of CBT and medication is more effective than medication alone. c. Medication was no more effective than placebo. d. Any group that had medication as part or all of their treatment outperformed placebo groups.

65. Which of the following best describes the effectiveness of CBT combined with medication to treat depression?

Ans: D

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Should Medication and Psychotherapy Be Combined to Treat Depression?

Difficulty Level: Hard a. African Americans tend to have higher self-esteem than other ethnic groups. b. African Americans tend to have higher degrees of religious belief and involvement. c. African Americans may prioritize the needs of the family and community above their own needs. d. African Americans may experience a high rate of stigma regarding mental health issues.

66. Which of the following is one of the reasons that African Americans may have lower rates of suicidality overall than other ethnic groups?

Ans: B

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Comprehension

Answer Location: Ethnicity

Difficulty Level: Medium a. additional improvement when CBT was added to their treatment, and the added benefits were still present at 24-week follow-up b. additional improvement when CBT was added to their treatment, though the added benefits were no longer present at 24-week follow-up c. no additional improvement when CBT was added to their treatment initially, though some gains were seen at the 24-week follow-up d. no additional improvement when CBT was added to their treatment

67. Children who don’t respond to antidepressant medication showed which of the following?

Ans: B

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Should Medication and Psychotherapy Be Combined to Treat Depression?

Difficulty Level: Hard a. Yes. b. No, because it only happened once. c. No, because it is not deliberate. d. No, because the step stool was the instrument that hurt her, not Marlene herself.

68. Marlene accidentally falls off a step stool when she’s changing a lightbulb and hits the step stool, getting a large red mark on her leg. Is this self-injurious behavior?

Ans: C

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Application

Answer Location: Suicide

Difficulty Level: Medium a. African Americans report the highest rates of suicidal thoughts. b. American Indian girls show the highest rates of suicide death. c. White girls show the highest rates of suicide attempts. d. Latinas are one of the groups most likely to attempt suicide.

69. Which of the following statements regarding suicidality by ethnicity is true?

Ans: D

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Ethnicity

Difficulty Level: Medium a. It remains the highest cause of death among adolescents in the United States. b. The prevalence of suicide, though high, has remained steady for the past 20 years. c. The prevalence of suicide among young girls has increased 200% in the past 15 years. d. In the past 15 years, suicide has become more common in children (ages 10–14) than in adolescents (ages 15–24)

70. Which of the following is true of the prevalence of suicide?

Ans: C

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: How Common Is Child and Adolescent Suicide?

Difficulty Level: Medium a. Many more youths plan suicide than actually attempt it. b. About 10 times as many youths have suicidal ideation than actually plan suicide. c. More youths attempt suicide than plan it because some youths attempt suicide without a plan. d. The number of adolescents with a lifetime history of suicidal ideation is almost exactly the same as the number with a lifetime history of depression.

71. The results of the National Comorbidity Survey have indicated which of the following?

Ans: C

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Comprehension

Answer Location: How Common Is Child and Adolescent Suicide?

Difficulty Level: Medium

True/False

1. Temper outbursts must be physical to meet criteria for DMDD. Ans: F

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Knowledge

Answer Location: What Is Disruptive Mood Dysregulation Disorder?

Difficulty Level: Medium

2 Parent training is typically sufficient to treat DMDD.

Ans: F

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Knowledge

Answer Location: Behavior Therapy

Difficulty Level: Easy

3. Girls have a higher prevalence of depression in adolescence than boys do, though boys and girls show equal rates of depression in childhood.

Ans: T

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Overall Prevalence

Difficulty Level: Medium

4. Having a single episode of major depressive disorder is less common than having recurrent episodes.

Ans: T

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Depression Over Time

Difficulty Level: Medium

5. Automatic cognitions about threat and personal vulnerability are most common in depressed youths.

Ans: F

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Beck’s Cognitive Theory of Depression

Difficulty Level: Hard

6. Relational aggression is associated with depression in both boys and girls.

Ans: T

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Knowledge

Answer Location: Friends

Difficulty Level: Medium

7. Cognitive–behavioral therapy is more effective than any other treatment for adolescents with depression.

Ans: F

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Comprehension

Answer Location: Should Medication and Psychotherapy Be Combined to Treat Depression?

Difficulty Level: Medium

8. Girls are more likely to die from suicide than boys.

Ans: F

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Gender

Difficulty Level: Easy

9. Parents who have committed suicide have children at greater risk of suicide but otherwise parents’ mental health status does not impact children’s risk of suicide.

Ans: F

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Family Problems

Difficulty Level: Easy

10. A therapist asks a boy, “Is there any part of you that wants to die?” This question is meant to assess thoughts of death.

Ans: F

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Application

Answer Location: How Do Clinicians Assess Suicide Risk?

Difficulty Level: Medium

11. Research has shown that the increased risk of suicide in gay, lesbian, bisexual, and transgender youth can be accounted for almost entirely by their increased risk of bullying.

Ans: F

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Sexual Minority Identification

Difficulty Level: Medium

12. Asking about suicide directly has been shown to increase suicide risk, so alternative methods are typically used in clinical practice.

Ans: F

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Comprehension

Answer Location: How Do Clinicians Assess Suicide Risk?

Difficulty Level: Medium

13. The time of greatest risk for a suicide attempt is the first year after hospitalization for a prior suicide attempt.

Ans: T

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior. Cognitive Domain: Knowledge

Answer Location: Hospitalization and Safety Planning

Difficulty Level: Medium

14. Peer support programs can be very effective in reducing suicidal thoughts, but not attempts, in adolescents.

Ans: F

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Knowledge

Answer Location: Can We Prevent Suicide in Children and Adolescents?

Difficulty Level: Medium

Essay

1. Why did rates of bipolar disorder in children increase so much from the 1990s through the 2000s? What was the response of the DSM-5?

Ans: The combination of hyperactivity, irritability, and severe temper outbursts greatly impaired some children’s lives across multiple settings. ADHD and ODD did not seem to capture the severity of their condition, and so bipolar disorder was the diagnosis used instead. This “pediatric bipolar disorder” included mixed moods and relatively persistent dysphoria with frequent rages. This new definition vastly increased the number of diagnoses of the condition. However, children with this condition were very unlikely to have bipolar disorder in later life. This is why DMDD was developed as a separable condition in DSM-5 and classified as a depressive disorder.

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Comprehension

Answer Location: Pediatric Bipolar Disorder

Difficulty Level: Easy

2. In what ways might the challenges those with DMDD have with face processing relate to the emergence of the disorder?

Ans: Studies have shown that individuals with DMDD have challenges with face processing, in particular, in separating negative emotions such as “sad”, “fearful” and “angry ” This could cause them, along with hostile attribution bias, to view those who are sad and fearful as being angry and could provoke a temper outburst. This means that those who are sad and would often provoke a comforting response in others might provoke an angry or irritated response in those with DMDD, lessening their social connections with others. Further, those who are exhibiting fearful reactions to the child with DMDD could provoke him or her further if their reaction were perceived instead as anger. Because of these deficits in emotional processing, kids with DMDD may selectively pay attention to negative social cues and then respond impulsively in an angry or aggressive manner.

Learning Objective: LO 13.1. Describe the key features of disruptive mood dysregulation disorder (DMDD), and differentiate DMDD from other conditions affecting young children. Identify and give examples of evidence-based treatments for DMDD.

Cognitive Domain: Analysis

Answer Location: What Causes Disruptive Mood Dysregulation Disorder?

Difficulty Level: Medium

3. A model of depression to explain its higher prevalence in girls centers around excessive empathy, excessive compliance, and problems with emotion regulation. If a boy exhibited all three of these factors, would he too be at higher risk for depression? Why or why not?

Ans: Yes. There’s nothing about these factors that is particular and exclusive to girls, it’s just that these factors tend to be seen more in girls than in boys. If a boy had all of these traits, he too would be at higher risk for depression.

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Depression in Girls

Difficulty Level: Medium

4. What is the evidence for the monoamine hypothesis?

Ans: Youths treated with medications that produce changes in serotonin functioning often show alleviation of depression. Further, the more their serotonin is adjusted, the greater their symptom reduction. Further still, molecular genetics has found several genes that predicted depression in adolescent females; these genes were responsible for serotonergic activity, though they may not produce depression unless the girl also experienced stressful life events.

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults. Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Genes and Neurotransmitters

Difficulty Level: Medium

5. What does it mean that the influence between stressful life events and depression is bidirectional? How could that be?

Ans: It was originally thought that stressful life events predisposed individuals toward depression. This direction makes sense because such stressors could tax underdeveloped social skills, remove or minimize social support, or reinforce feelings of guilt, worthlessness and hopelessness. However, a bidirectional approach also would predict that depression increases the likelihood of experiencing stressful life events. This could be true if youths with depression elicit stressful events from the environment, perhaps due to peer rejection and social isolation which perpetuates social and other challenges.

Learning Objective: LO 13.2. Describe the key features of major depressive disorder (MDD) and dysthymic disorder, and show how children might manifest these disorders differently than adults Analyze the major causes of depressive disorders in children and adolescents ranging from genetic–biological factors to social–cultural influences. Evaluate the efficacy and safety of medication, psychosocial therapy, and combined treatment for youths with depressive disorders.

Cognitive Domain: Analysis

Answer Location: Stressful Life Events

Difficulty Level: Medium

6. How does the hopelessness theory differ from the interpersonal-psychological theory with respect to the risk for suicide?

Ans: Hopelessness theory predicts that suicide risk increases due to youths’ internalization of the negative nature of certain events. In particular, this occurs when they attribute negative events to causes that are unlikely to change and that are global (i.e., not isolated to the specific occurrence). Further, because youths believe these negative consequences are important, they see themselves as worthless because of the event and collectively this leads to hopelessness which predicts suicide. The interpersonal-psychological theory focuses more on the relationship between the individual and others.

According to this theory, people might become suicidal when they view themselves as burdens, feel a sense of exclusion or non-belongingness, and feel capable of self-harm (probably through reduced inhibition through repeated self-injury, or progressive self-injury or attempts at suicide).

Learning Objective: LO 13.3. Differentiate suicidal and nonsuicidal self-injury (NSSI), and describe how the prevalence of self-injurious behaviors varies as a function of age, gender, and ethnicity. Identify some of the main causes of suicide in youths and evidence-based techniques to prevent and treat suicidal behavior.

Cognitive Domain: Comprehension

Answer Location: What Theories Help Explain Suicide in Children and Adolescents?

Difficulty Level: Medium