ANCC Certification PMHNP Chapter 7(Mood Disorders) questions with complete solutions

Mood Disorders correct answer: Most common psych illnesses Primary characteristic is persistent disturbance in mood correct answer: Major Depressive Disorder Often occurs without precipitating event correct answer: MDD Object loss theory correct answer: Fairbairn, Winnicott & guntrip Aggression turned inward theory of MDD correct answer: Freud Cognitive Theory correct answer: Beck Learned Helplessness-Hopelessness Theory correct answer: Seligman Genetic predisposition correct answer: Strong genetic load for depression for child of depressed parent -having 3 fold increase in lifetime risk of MDD & 40% chance of depressive episode before age 18. Endocrine dysfunction Theory correct answer: Probably related to etiology of MDD Sleep disturbances, appetite disturbances, libido disturbances, lethargy, anhedonia are neurovegitative symptoms that are related to functions of the correct answer: Hypothalamus and pituitary gland secretions Endocrine dysfunction and pregnancy correct answer: A high incidence of postpartum mood disturbances is suggested with this Hypothalamic-pituitary-adrenal axis (HPA) correct answer: A theory of MDD, may be a result of an abnormal stress response related to dysregulation of this system HPA axis correct answer: Controls the physiological response to stress and is composed of interconnective feedback pathways between the hypothalamus, pituitary gland, and adrenal gland. Hypothalamus releases correct answer: corticotropin-releasing hormone (CRH) Adrenocorticotropin hormone (ACTH) correct answer: Released by pituitary in response to CRH by hypothalamus Cortisol correct answer: Released by adrenal glands in response to ACTH by pituitary gland Hyperactivity of the HPA axis correct answer: Demonstrated to be present in individuals with MDD. May also have elevated cortisol levels Elevated cortisol levels correct answer: Over time damages the CNS by altering neurotransmission and electrical signal conduction. Cortisol over time can cause changes in size and function of brain tissue Dexamethasone suppression test (DST) correct answer: Not commonly used in clinical practice for screening of depression as it is too non specific. Hypovolemic hippocampus and hypovolemic prefrontal cortex-limbic striatal regions correct answer: Abnormalities demonstrated by neuroimaging in individuals with chronic and severe depression Brain damage, including that from stroke and trauma correct answer: Depression is a acommon comorbidity in individuals who have experienced these events What is the Chronobiological theory of MDD correct answer: Desynchronization of the circadian rhythms produces the symptom constellation collectively called MDD Circadian rhythms control these biological processes that are frequent problems with depressed individuals correct answer: Sleep-rest cycle disturbances * Increased cortisol secretions * REM abnormalities Increased emotional reactivity Frequent waking More intensified dreaming Diurnal variations to circadian-related behaviors Decreased arousal and energy levels Decreased activity patterns * Incidence of MDD correct answer: 5% of U.S. population ages 18 and older each year. About 9.9 million Americans