PMH-C EXAM QUESTIONS AND
ANSWERS
Neonatal Loss - Answer-About 20% of pregnancies end in loss
Anxiety more common than depression
At risk for:
PTSD
OCD
Anxiety
NICU Families - Answer-Stress associated with perception of severity of infant's
illness
Levels of depression related to mother's perception of nursing support
NICU Dads - Answer-Elevated and persistent levels of stress
Parents of Multiples - Answer-43% greater risk of developing PPD
Teen Parents - Answer-About half of adolescent mothers feel depressed postpartum
These feelings last longer in teens (after 4 years PP)
Predictive Factors for PPD in Adolescent Mothers - Answer-Untreated depression in
their mom
Social isolation
Weight/shape disturbance
Low maternal self efficacy
Family conflict
Low self-esteem
History of abuse is related to severity of depression
More likely to become pregnant again if stressed or depressed
Effects of PMDS on Teens - Answer-Decreased quality of life
Interference with developmental tasks of adolescence
Stresses relationship with parents
Decreased maternal role functioning
Disrupts school and work plans
What Helps Perinatal Teens? - Answer-Self-advocacy
Boundary setting skills
Support from mother
Recognition of role transition
Decreasing stigma of mental health care
,REACH Project Study for Teens - Answer-Relaxation
Encouragement
Appreciation
Communication
Helpfulness
Interpersonal psychotherapy
Encourages tees to ask for support, communicate needs
PPD was 56% lower for REACH program compared to control group
Military Pregnancy - Answer-Veterans with a pregnancy were twice as likely to have
a diagnosis of depression, anxiety, PTSD, bipolar, or schizophrenia as those without
a pregnancy
Length of spousal deployment relates to mental health diagnosis times the odds to
be diagnosed with suicidality in postpartum period compared to service women
without PPD
Dependent spouses with PPD had 14.5 times the odds of suicidality compared to
those without PPD
Veteran woman with PPD had 42.2
Types of Prevention - Answer-Reduce vulnerability to postpartum depression
(primary prevention)
Reduce severity and duration of symptoms when postpartum depression occurs
(Secondary Prevention)
Improve functioning, relationships, and prognosis for women and their offspring
(Tertiary prevention)
Elements of Prevention - Answer-Encouraged to get and maintain adequate rest,
sleep, exercise and proper nutrition,
Create postpartum plan and contract
Receive accurate information about PMADs and treatment including meds.
CBT - Answer-Cognitive behavioral therapy
Just as effective as medication
Can be done online
Flexible interventions
Founder = Aaron Beck
Teaches clients to identify, evaluate and change dysfunctional patterns of thinking,
resulting in changes of mood and behavior
, Effective treatment for depression, panic, anxiety, and OCD
IPT in Pregnancy for Prevention of PPD - Answer-Interpersonal Therapy
Reduction in likelihood of developing depression postpartum in high risk women
Sessions held following routine childbirth education classes
Focus on topics including managing role transition, identifying and establishing
support systems, and improving communication
Sleep Hygiene - Answer-No electronics 20-60 mins before bed
Use bed only for sex and sleep, go to bed when sleepy
Avoid alcohol, caffeine, and nicotine in the hours before bedtime
Warm bath/shower, pre-bed ritual
If medication is used, take 45-60 mins prior to bed
Eat a small protein snack before bed
Create a dark, comfortable, and peaceful sleep environment
Are there kids or pets in the bed that disturb sleep?
Why Screen? - Answer-Postpartum depression is not often recognized
PMADs remains underdiagnosed
Can greatly reduce the duration and severity of symptoms
Crucial for early detection and treatment
Opportunities for discussion
Reduces the stigma for mothers
Early detection can greatly reduce the duration and severity of symptoms
Screening tools are NOT diagnostic
Does not take the place of clinical judgement
Women with positive screens should be referred to a mental health professional
Who Should Screen? - Answer-All healthcare professionals that have contact with
pregnant or postpartum women
OB/GYN
Pediatricians
Nurses, Midwives, social workers
Home visitors
WIC programs
Hospitals
Childbirth educators
Lactation consultants
PDPI - Answer-Prenatal screening tool
Postpartum Depression Predictors Inventory
ANSWERS
Neonatal Loss - Answer-About 20% of pregnancies end in loss
Anxiety more common than depression
At risk for:
PTSD
OCD
Anxiety
NICU Families - Answer-Stress associated with perception of severity of infant's
illness
Levels of depression related to mother's perception of nursing support
NICU Dads - Answer-Elevated and persistent levels of stress
Parents of Multiples - Answer-43% greater risk of developing PPD
Teen Parents - Answer-About half of adolescent mothers feel depressed postpartum
These feelings last longer in teens (after 4 years PP)
Predictive Factors for PPD in Adolescent Mothers - Answer-Untreated depression in
their mom
Social isolation
Weight/shape disturbance
Low maternal self efficacy
Family conflict
Low self-esteem
History of abuse is related to severity of depression
More likely to become pregnant again if stressed or depressed
Effects of PMDS on Teens - Answer-Decreased quality of life
Interference with developmental tasks of adolescence
Stresses relationship with parents
Decreased maternal role functioning
Disrupts school and work plans
What Helps Perinatal Teens? - Answer-Self-advocacy
Boundary setting skills
Support from mother
Recognition of role transition
Decreasing stigma of mental health care
,REACH Project Study for Teens - Answer-Relaxation
Encouragement
Appreciation
Communication
Helpfulness
Interpersonal psychotherapy
Encourages tees to ask for support, communicate needs
PPD was 56% lower for REACH program compared to control group
Military Pregnancy - Answer-Veterans with a pregnancy were twice as likely to have
a diagnosis of depression, anxiety, PTSD, bipolar, or schizophrenia as those without
a pregnancy
Length of spousal deployment relates to mental health diagnosis times the odds to
be diagnosed with suicidality in postpartum period compared to service women
without PPD
Dependent spouses with PPD had 14.5 times the odds of suicidality compared to
those without PPD
Veteran woman with PPD had 42.2
Types of Prevention - Answer-Reduce vulnerability to postpartum depression
(primary prevention)
Reduce severity and duration of symptoms when postpartum depression occurs
(Secondary Prevention)
Improve functioning, relationships, and prognosis for women and their offspring
(Tertiary prevention)
Elements of Prevention - Answer-Encouraged to get and maintain adequate rest,
sleep, exercise and proper nutrition,
Create postpartum plan and contract
Receive accurate information about PMADs and treatment including meds.
CBT - Answer-Cognitive behavioral therapy
Just as effective as medication
Can be done online
Flexible interventions
Founder = Aaron Beck
Teaches clients to identify, evaluate and change dysfunctional patterns of thinking,
resulting in changes of mood and behavior
, Effective treatment for depression, panic, anxiety, and OCD
IPT in Pregnancy for Prevention of PPD - Answer-Interpersonal Therapy
Reduction in likelihood of developing depression postpartum in high risk women
Sessions held following routine childbirth education classes
Focus on topics including managing role transition, identifying and establishing
support systems, and improving communication
Sleep Hygiene - Answer-No electronics 20-60 mins before bed
Use bed only for sex and sleep, go to bed when sleepy
Avoid alcohol, caffeine, and nicotine in the hours before bedtime
Warm bath/shower, pre-bed ritual
If medication is used, take 45-60 mins prior to bed
Eat a small protein snack before bed
Create a dark, comfortable, and peaceful sleep environment
Are there kids or pets in the bed that disturb sleep?
Why Screen? - Answer-Postpartum depression is not often recognized
PMADs remains underdiagnosed
Can greatly reduce the duration and severity of symptoms
Crucial for early detection and treatment
Opportunities for discussion
Reduces the stigma for mothers
Early detection can greatly reduce the duration and severity of symptoms
Screening tools are NOT diagnostic
Does not take the place of clinical judgement
Women with positive screens should be referred to a mental health professional
Who Should Screen? - Answer-All healthcare professionals that have contact with
pregnant or postpartum women
OB/GYN
Pediatricians
Nurses, Midwives, social workers
Home visitors
WIC programs
Hospitals
Childbirth educators
Lactation consultants
PDPI - Answer-Prenatal screening tool
Postpartum Depression Predictors Inventory
