Chp 15 depression and anxiety

Question 1

Clinical depression dx requires

Answer 1

aka major depressive disorder

five or more symptoms occurring on most days of the week for more than TWO weeks

AND must be associated with some sort of impairment at home

Question 2

Depression coincides with other mental health issues such as…

Answer 2

Alcohol use disorder - 40%
Drug use disorder - 17%
Anxiety - 41%
Personality d/o - 14%

Binge eating disorder, moreso with obese individuals

Question 3

Screening questionnaire name and score indicator

Answer 3

PHQ-9
Score of 5 or greater = possible depression - referral

Question 4

Evidence based tx for depression (3)

Answer 4

1) medication
2) psychotherapies
3) brain stim therapies

Question 5

Psychotherapies are…

Answer 5

behavioral activation
cognitive behavioral therapy
interpersonal therapy
problem solving therapy
ACT
Self control therapy

Question 6

What do psychotherapies do?

Answer 6

focus on helping the client learn healthy coping skills

avoid negative thinking patterns

practice emotional regulation skills

Question 7

Brain stimulation therapies are…

Answer 7

ECT
Transcranial stimulation
Vague nerve stimulation

Question 8

Why is exercise not recommended consistently for depression?

Answer 8

Lack of awareness of its efficacy - mixed research results

skepticism re: the evidence

skepticism that pts will follow through

Question 9

Anxiety defn

Answer 9

characterized by nervousness, fear, and/or worry.

Can be acute or chronic

Question 10

Chronic anxiety – dx criteria

Answer 10

Sx must last 6 months or longer and be severe enough to interfere with ADLs, relationships and/or work

Question 11

Identifying anxiety and stress, what does it gauge?

High score is?

Alternate ID test

Answer 11

10 item Perceived Stress Scale

Gauges the level of stress a person has been experiencing

27 and higher indicate high stress – at risk for depression and/or anxiety disorder – REFER to HCP

Generalized Anxiety Disorder 7 Item (GAD-7)

Question 12

Treatment options (3)

Answer 12

Medication
Psychotherapies
Meditative therapies

Question 13

First line tx for anxiety disorders is?

Answer 13

Antidepressants

Question 14

Effective psychotherapies?

Highly fear based anxiety d/o benefit from what type of therapy?

Answer 14

CBT - cognitive based better for rumination or obsessive thoughts

EXPOSURE based – structured approach to helping someone confront the fear stimulus

Question 15

Best responders to meditative therapies are?

Answer 15

people with SUBCLINICAL anxiety and/or stress

Question 16

Higher or lower intensity exercise associated with negative mood?

Answer 16

Higher

Question 17

What should guide intensity of exercise with depression/anxiety

Answer 17

Continuous self monitoring of how pleasant/unpleasant the exercise is - adjust intensity PRN

Question 18

Behavioral strategies (6)

Answer 18

1) mood monitoring - KEY STRATEGY
2) goal setting
3) positive reinforcement
4) social support
5) dealing with negative thinking
6) distress tolerance

Question 19

Goal setting, why/benefit?

Confidence ruler, what rating to pursue a goal?

Answer 19

provides structure for forward motion and for progress to be MEASURED

80% or 8 on 1-10 scale

Question 20

Low motivation? 2 approaches

Answer 20

1) encourage client to think about how the healthy behavior ties into things he/she/they value

2) collaboratively structure behavior to enable client to accomplish something else that is important

Question 21

Positive reinforcement - headline take away

Answer 21

Reviewing multiple metrics of success during each session, validating, providing affirmations

Question 22

Distress tolerance defn

Results of low distress tolerance?

Best strategies to deal with this?

Answer 22

one’s perceived capacity to tolerate physical discomfort or emotional distress

avoiding or stopping the activity causing it

Acceptance based strategies

Question 23

3 acceptance based strategies and how they work

Answer 23

1) mindful awareness - tolerating the discomfort - view it as a subjective experience that eventually subsides

2) acceptance – acknowledging discomfort is present, but knowing it does not DEFINE the experience

3) commitment to values - knowing that escaping discomfort is NOT more important than the values driving the lifestyle changes