ne
sh
ne
la
tz
sh
Sp
ANCC CERTIFICATION PMHNP TEST ne Commented [mak1]:
la
2024 REAL EXAM
sh
Sp
ne
Mood Disorders - Most common psych illnesses
la
tz
Primary characteristic is persistent disturbance in mood - Major Depressive Disorder
sh
Sp
Often occurs without precipitating event - MDD
ne
Object loss theory - Fairbairn, Winnicott & gun trip
la
Aggression turned inward theory of MDD - Freud
sh
Sp
Cognitive Theory - Beck
ne
Learned Helplessness-Hopelessness Theory - Seligman
la
Genetic predisposition - Strong genetic load for depression for child of depressed parent
tz
-having 3 fold increase in lifetime risk of MDD & 40% chance of depressive episode
sh
Sp
before age 18.
ne
Endocrine dysfunction Theory - Probably related to etiology of MDD
la
Sleep disturbances, appetite disturbances, libido disturbances, lethargy, anhedonia are
neurovegitative symptoms that are related to functions of the - Hypothalamus and
sh
pituitary gland secretions
Sp
ne
Endocrine dysfunction and pregnancy - A high incidence of postpartum mood
disturbances is suggested with this
la
tz
Hypothalamic-pituitary-adrenal axis (HPA) - A theory of MDD, may be a result of an
abnormal stress response related to dysregulation of this system sh
Sp
ne
HPA axis - Controls the physiological response to stress and is composed of
interconnective feedback pathways between the hypothalamus, pituitary gland, and
la
adrenal gland.
Hypothalamus releases - corticotropin-releasing hormone (CRH)
sh
Sp
Adrenocorticotropin hormone (ACTH) - Released by pituitary in response to CRH by
ne
hypothalamus
a
Cortisol - Released by adrenal glands in response to ACTH by pituitary gland
tz
l
sh
Hyperactivity of the HPA axis - Demonstrated to be present in individuals with MDD.
Sp
May also have elevated cortisol levels
ne
la
sh
Sp
la
Sp
, ne
sh
ne
la
tz
sh
Sp
ne
Elevated cortisol levels - Over time damages the CNS by altering neurotransmission
la
and electrical signal conduction. Cortisol over time can cause changes in size and
function of brain tissue
sh
Sp
Dexamethasone suppression test (DST) - Not commonly used in clinical practice for
screening of depression as it is too non specific.
ne
Hypovolemic hippocampus and hypovolemic prefrontal cortex-limbic striatal regions -
la
Abnormalities demonstrated by neuroimaging in individuals with chronic and severe
tz
depression
sh
Sp
Brain damage, including that from stroke and trauma - Depression is a acommon
ne
comorbidity in individuals who have experienced these events
la
What is the Chronobiological theory of MDD - Desynchronization of the circadian
rhythms produces the symptom constellation collectively called MDD
sh
Sp
Circadian rhythms control these biological processes that are frequent problems with
ne
depressed individuals - Sleep-rest cycle disturbances * Increased cortisol secretions *
REM abnormalities Increased emotional reactivity
la
Frequent waking
More intensified dreaming
tz
Diurnal variations to circadian-related behaviors
sh
Sp
Decreased arousal and energy levels
Decreased activity patterns *
ne
Incidence of MDD - 5% of U.S. population ages 18 and older each year. About 9.9
la
million Americans
sh
Most common psychiatric illness seen in primary care practices; only 50% of people
receive treatment - MDD
Sp
ne
25% women, 12% men - Risk during reproductive years
la
tz
Risk of MDD is for both genders below puberty and after menopause - equal
sh
Sp
MDD is (greater) or (lesser) source of morbidity for women than other illnesses. -
ne
Greater
la
Fifteen percent (15%) - Of people with MDD will commit suicide
People with MDD - Four times greater risk of premature death - Than normal control
sh
Sp
population
ne
a
tz
l
sh
Sp
ne
la
sh
Sp
la
Sp
sh
ne
la
tz
sh
Sp
ANCC CERTIFICATION PMHNP TEST ne Commented [mak1]:
la
2024 REAL EXAM
sh
Sp
ne
Mood Disorders - Most common psych illnesses
la
tz
Primary characteristic is persistent disturbance in mood - Major Depressive Disorder
sh
Sp
Often occurs without precipitating event - MDD
ne
Object loss theory - Fairbairn, Winnicott & gun trip
la
Aggression turned inward theory of MDD - Freud
sh
Sp
Cognitive Theory - Beck
ne
Learned Helplessness-Hopelessness Theory - Seligman
la
Genetic predisposition - Strong genetic load for depression for child of depressed parent
tz
-having 3 fold increase in lifetime risk of MDD & 40% chance of depressive episode
sh
Sp
before age 18.
ne
Endocrine dysfunction Theory - Probably related to etiology of MDD
la
Sleep disturbances, appetite disturbances, libido disturbances, lethargy, anhedonia are
neurovegitative symptoms that are related to functions of the - Hypothalamus and
sh
pituitary gland secretions
Sp
ne
Endocrine dysfunction and pregnancy - A high incidence of postpartum mood
disturbances is suggested with this
la
tz
Hypothalamic-pituitary-adrenal axis (HPA) - A theory of MDD, may be a result of an
abnormal stress response related to dysregulation of this system sh
Sp
ne
HPA axis - Controls the physiological response to stress and is composed of
interconnective feedback pathways between the hypothalamus, pituitary gland, and
la
adrenal gland.
Hypothalamus releases - corticotropin-releasing hormone (CRH)
sh
Sp
Adrenocorticotropin hormone (ACTH) - Released by pituitary in response to CRH by
ne
hypothalamus
a
Cortisol - Released by adrenal glands in response to ACTH by pituitary gland
tz
l
sh
Hyperactivity of the HPA axis - Demonstrated to be present in individuals with MDD.
Sp
May also have elevated cortisol levels
ne
la
sh
Sp
la
Sp
, ne
sh
ne
la
tz
sh
Sp
ne
Elevated cortisol levels - Over time damages the CNS by altering neurotransmission
la
and electrical signal conduction. Cortisol over time can cause changes in size and
function of brain tissue
sh
Sp
Dexamethasone suppression test (DST) - Not commonly used in clinical practice for
screening of depression as it is too non specific.
ne
Hypovolemic hippocampus and hypovolemic prefrontal cortex-limbic striatal regions -
la
Abnormalities demonstrated by neuroimaging in individuals with chronic and severe
tz
depression
sh
Sp
Brain damage, including that from stroke and trauma - Depression is a acommon
ne
comorbidity in individuals who have experienced these events
la
What is the Chronobiological theory of MDD - Desynchronization of the circadian
rhythms produces the symptom constellation collectively called MDD
sh
Sp
Circadian rhythms control these biological processes that are frequent problems with
ne
depressed individuals - Sleep-rest cycle disturbances * Increased cortisol secretions *
REM abnormalities Increased emotional reactivity
la
Frequent waking
More intensified dreaming
tz
Diurnal variations to circadian-related behaviors
sh
Sp
Decreased arousal and energy levels
Decreased activity patterns *
ne
Incidence of MDD - 5% of U.S. population ages 18 and older each year. About 9.9
la
million Americans
sh
Most common psychiatric illness seen in primary care practices; only 50% of people
receive treatment - MDD
Sp
ne
25% women, 12% men - Risk during reproductive years
la
tz
Risk of MDD is for both genders below puberty and after menopause - equal
sh
Sp
MDD is (greater) or (lesser) source of morbidity for women than other illnesses. -
ne
Greater
la
Fifteen percent (15%) - Of people with MDD will commit suicide
People with MDD - Four times greater risk of premature death - Than normal control
sh
Sp
population
ne
a
tz
l
sh
Sp
ne
la
sh
Sp
la
Sp
