Psychopharmacology 1st Edition By R. H. Ettinger – Test Bank

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Sample Questions Posted Below

 

CHAPTER 3   MOOD DISORDERS

3.1 Multiple Choice

1. The lifetime prevalence of major depression is estimated to be about ________ percent of the population.

a. 30

b. 17

c. 50

d. 10

Answer: B

Diff: 1 Page Ref: 69

2. All of the following are symptoms of major depression EXCEPT

a. loss of appetite.

b. dulled sense of pain.

c. insomnia.

d. motor agitation.

Answer: B

Diff: 1 Page Ref: 70

3. Reactive depression

a. typically results in anhedonia and feelings of worthlessness.

b. leads to such loneliness that the person considers suicide as the only option.

c. is one of the more serious affective disorders.

d. often occurs following a significant life event such as the loss of a significant other or severe stress.

Answer: D

Diff: 2 Page Ref: 71

4. Depression

a. is often accompanied by agoraphobia.

b. affects men and women equally.

c. will not improve without therapy.

d. has an average age of onset of 20 years.

Answer: A

Diff: 2 Page Ref: 71

5. Monoamines are

a. drugs used to treat depression.

b. metabolites of major neurotransmitters.

c. neurotransmitters that contain a single anime group in their molecular structure.

d. drugs that can cause depression-like symptoms.

Answer: C

Diff: 2 Page Ref: 71

6. The earliest versions of the monoamine hypothesis could not

a. distinguish which monoamine transmitters were involved in depression.

b. determine the lag time between drug-induced changes in neurotransmitter availability.

c. determine why depressed patients often have lower blood levels of BDNF.

d. All of the above are correct

Answer: A

Diff: 2 Page Ref: 72

7. The observation that antidepressant treatment produces rapid changes in neurotransmitter availability but the symptoms of depression do not disappear as quickly is known as

a. reactive depression.

b. nonreactive depression.

c. a lag time.

d. downregulation.

Answer: C

Diff: 3 Page Ref: 72

8. Neural structures that often show signs of degeneration in untreated depression include the ________ and ________.

a. frontal cortex; hippocampus

b. frontal cortex; thalamus

c. hypothalamus; frontal cortex

d. None of the above are correct

Answer: A

Diff: 2 Page Ref: 72

9. The monoamine hypothesis assumes that depression is a consequence of

a. low levels of all neurotransmitters.

b. neural degeneration caused by monoamine neurons failing to produce amounts of growth factors.

c. downregulated receptor numbers.

d. the overexpression of amine receptors.

Answer: B

Diff: 2 Page Ref: 72

10. Brain-derived neurotropic factor (BDNF) is

a. a toxin produced by the brain that contributes to cell loss.

b. a nerve growth hormone produced by neurons.

c. essential for normal cell survival and receptor growth.

d. Both b and c are correct

Answer: D

Diff: 2 Page Ref: 72

11. The synthesis of BDNF depends on sufficient 

a. influx of Ca⁺⁺ following neural activation.

b. dietary amines.

c. levels of precursors for serotonin.

d. exposure to light.

Answer: A

Diff: 3 Page Ref: 72

12. Downregulation of monoamine neurons

a. disrupts neuronal signaling and plasticity.

b. occurs as a result of neuronal inhibition by autoreceptors.

c. may lead to cellular degeneration.

d. All of the above are correct

Answer: D

Diff: 2 Page Ref: 72

13. Long-term antidepressant treatment leads to

a. tolerance and a return of symptoms.

b. downregulation of amine receptors.

c. a decreased number of autoreceptors for norepinephrine and serotonin.

d. an increased number of autoreceptors for norepinephrine and serotonin.

Answer: C

Diff: 3 Page Ref: 73

14. The stress hormone cortisol 

a. causes a depletion of amine neurotransmitters.

b. leads to downregulation of amine receptors.

c. increases CREB activity in the cell nucleus.

d. contributes to BDNF downregulation.

Answer: D

Diff: 2 Page Ref: 73

15. Animal studies of the effects of antidepressants have shown that they can

a. decrease forced swim time.

b. decrease lethargy and sleep time.

c. suppress BDNF synthesis.

d. Both a and c are correct

Answer: D

Diff: 2 Page Ref: 74

16. Which of the following is NOT primarily used for treating major depression?

a. Selective serotonin reuptake inhibitors (SSRIs)

b. Lithium therapy 

c. Monoamine oxidase inhibitors (MAOIs)

d. Tricyclic antidepressants

Answer: B

Diff: 2 Page Ref: 75–79

17. Tricyclic antidepressants

a. bind to the reuptake transporter proteins for both serotonin and norepinephrine.

b. cause long-term adaptive changes at the synapse that are related to their therapeutic effects.

c. increase levels of BDNF.

d. All of the above are correct

Answer: D

Diff: 2 Page Ref: 76

18. Which of the following statements is TRUE concerning the side effects of tricyclic antidepressants?

a. Side effects are found in over 80 percent of people taking tricyclic antidepressants.

b. If tricyclic antidepressants are taken with foods containing tyramine, increased norepinephrine storage and release may occur.

c. Tricyclic antidepressants block histamine and acetylcholine receptors.

d. The toxic effects of the tricyclic drugs are typically seen at doses exceeding 5 times their normal dose.

Answer: C

Diff: 3 Page Ref: 76

19. Monoamine oxidase-_A (MAO-_A) deaminates all of the following monoamines EXCEPT

a. dopamine.

b. norepinephrine.

c. serotonin.

d. phenylanine.

Answer: D

Diff: 3 Page Ref: 78

20. In 2003, the Food and Drug Administration (FDA) approved a newer selective MAOI called ________ for treating Parkinson’s disease.

a. doxepin

b. sertraline

c. phenelzine

d. selegiline

Answer: D

Diff: 1 Page Ref: 79

21. Which of the following side effects is a frequent reason for individuals terminating SSRI use?

a. Anxiety

b. Severe headaches

c. Sexual dysfunction

d. Muscle rigidity

Answer: C

Diff: 1 Page Ref: 80

22. A toxic reaction caused by excessive serotonin activity due to overmedication with SSRI antidepressants is called

a. synaptic syndrome.

b. serotonin syndrome.

c. serotonin overdose.

d. serotonin reactivity.

Answer: B

Diff: 2 Page Ref: 80

23. The drop in prescriptions of SSRIs to adolescents after the FDA warned about suicide risk resulted in

a. a decrease in adolescent suicides.

b. an increase in adolescent suicides.

c. no change in suicide rates for adolescents.

d. an increase in the effectiveness of placebos for adolescents.

Answer: B

Diff: 2 Page Ref: 82

24. SNRI antidepressants

a. work on different mechanisms underlying depression.

b. are much more effective than SSRIs for most patients.

c. inhibit the reuptake of both serotonin and norepinephrine.

d. facilitate the reuptake of both serotonin and norepinephrine.

Answer: C

Diff: 1 Page Ref: 83

25. The atypical antidepressant bupropion

a. is also used to diminish cravings associated with smoking cessation.

b. acts as a selective dopamine reuptake inhibitor.

c. may be addictive because of its dopamine activity.

d. Both a and b are correct

Answer: D

Diff: 2 Page Ref: 84

26. An active placebo differs from a traditional placebo in that it

a. has some true therapeutic effects.

b. is only given to experimental patients with their consent.

c. causes similar side effects, such as dry mouth and drowsiness, as antidepressants do.

d. actually improves most symptoms of depression.

Answer: C

Diff: 1 Page Ref: 85

27. St. John’s Wort

a. is as effective as an antidepressant for most patients.

b. has the same mechanism of action as traditional antidepressants.

c. inhibits the vesicular storage of monoamine neurotransmitters.

d. All of the above are correct

Answer: C

Diff: 2 Page Ref: 88

28. Bipolar disorder differs from major depression in that patients must also experience

a. numerous episodes of mania intermixed with depression.

b. at least one episode of mania.

c. psychotic features in addition to depression.

d. depressive and manic symptoms simultaneously. 

Answer: B

Diff: 1 Page Ref: 90

29. Rapid-cycling bipolar disorder is characterized by ________ during a year.

a. 10–12 episodes of depression

b. 10–12 episodes of mania

c. 4 or more episodes of depression or mania

d. at least one episode of mania mixed with depression

Answer: C

Diff: 1 Page Ref: 90

30. Genetic studies have concluded that

a. several identified genes contribute to bipolar disorder.

b. increased BDNF synthesis may predispose individuals to bipolar disorder.

c. polymorphisms resulting in increased expression of the serotonin transporter gene strongly correlates with the incidence of major depression.

d. None of the above are correct

Answer: D

Diff: 2 Page Ref: 93

31. Patients who have had untreated bipolar disorder for a long time are more likely to

a. respond to medication.

b. have evidence of neural degeneration and enlarged ventricles.

c. express rapid-cycling symptoms.

d. All of the above are correct

Answer: B

Diff: 2 Page Ref: 93–94

32. Antidepressants and mood-stabilizing drugs 

a. promote neurogenesis. 

b. cause significant weight gain.

c. be cardiotoxic.

d. diminish in effectiveness over time.

Answer: A

Diff: 2 Page Ref: 94

33. ________ is credited with the discovery of lithium treatment for bipolar disorder.

a. Sigmund Freud

b. Solomon Snyder

c. John Cade

d. John Beck

Answer: C

Diff: 1 Page Ref: 94

34. Lithium acts by

a. resolving a lithium deficiency in bipolar patients.

b. deactivating a neurotoxin in the brains of bipolar patients.

c. activating genes that code for the expression of serotonin transporters.

d. increasing BDNF activity in the hippocampus and frontal cortex.

Answer: D

Diff: 2 Page Ref: 96

35. The manic phases of bipolar disorder appear to be caused by 

a. a lithium deficiency.

b. excessive dopamine activity. 

c. diminished serotonin activity. 

d. None of the above are correct

Answer: B

Diff: 2 Page Ref: 96

3.2 Discussion/Essay

1. How are the symptoms of major depressive disorder both similar to and different from reactive depression?

2. What is BDNF? What is its role in normal neural functioning, and how is it altered in major depression?

3. How do antidepressants alter BDNF activity? Describe the evidence for this as well as the improvement in the symptoms of depression that occurs.

4. Why is it incorrect to state that SSRIs increase the “levels” of serotonin and that this is their mechanism of action?

5. How is bipolar disorder different from major depressive disorder?

6. How might the misdiagnosis and treatment of bipolar disorder as major depression increase the severity of the disorder?

7. Describe how mood stabilizers correct the underlying neurobiology of bipolar disorder.