Clinical vignette of persistent depressive disorder
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- Clinical vignette of persistent depressive disorder
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Clinical vignette of persistent depressive disorder
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[post_date] => 2024-12-27 08:46:22
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[post_content] => Practice Passage (Question 1-5)
*This passage is the property of Khan Academy and has been reformatted into an AAMC-style interface in their entirety by MedLife Mastery. MedLife Mastery does not endorse and is not an affiliate of Khan Academy.
John Smith is a 30 year old married male who feels down most of the time. He experiences frequent, intrusive thoughts that he is not good enough, despite personal and professional successes. He tries to overcompensate for his thoughts by taking on more than he can handle, which leads to failure and furthers his feelings of inadequacy. His wife suggests that he seek help after finding him crying. The following is an excerpt from his intake interview with his psychiatrist.
“I feel pretty worthless and have felt that way for a long time - for over ten years. It feels normal to be down. Sometimes I start to feel better, but it never lasts - I feel bad about my life most of the time. I don’t think that I’ll amount to anything and l might never be successful at work. I feel exhausted all of the time. I have trouble sleeping. I’ve been waking up in the middle of the night and can’t stop thinking about all of my failures. I’ve lost weight in the past few months. Food just doesn’t taste as good as it used to. I feel hopeless and often have trouble concentrating when I’m with my family and friends. Maybe I’m just pessimistic.”
John’s psychiatrist tells him that his experience isn’t normal and diagnoses him with persistent depressive disorder. He prescribes an antidepressant and begins to conduct therapy with John. John begins to feel better after therapy sessions and a month on the medication.
[post_title] => Clinical vignette of persistent depressive disorder
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[question] => John has a persistently negative mindset and experiences frequent, intrusive, and unpleasant thoughts about his self-worth. Instead of trying to change the thoughts or improve his situation, he endures the thoughts and believes that he cannot change or control his life. What term best describes this phenomenon?
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[description] => Reason for the Correct Answer:
John believes that he cannot change the unpleasant and intrusive thoughts that he experiences on a daily basis.
Neuroticism refers to a personality trait characterized by excessive anxiety, worry, envy, and depressed mood. While John may have elevated levels of neuroticism, the term does not best describe the scenario.
A person with an internal locus of control believes that their life experiences are the result of his or her own actions and can be controlled. In this example, John does not have an internal locus of control.
Victim mentality refers to a personality trait in which a person feels as though they are a victim of the actions of others, even when there is no evidence to support their victimization. John does not refer to himself as a victim, and seems to blame himself for shortcomings.
Learned helplessness refers to a mental state in which an individual learns to accept their present situation, even when the situation is aversive or painful. This term best describes the phenomenon that John experiences in the vignette.
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[each_answer] => A. Victim mentality
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[each_answer] => B. Neuroticism
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[each_answer] => C. Learned helplessness
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[each_answer] => D. Internal locus of control
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[quiz_unique_key] => 3873426850
[question] => An adult must have symptoms of persistent depressive disorder for what length of time in order to meet DSM 5 criteria and receive a diagnosis?
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[answer] => 2
[description] => Reason for the Correct Answer:
Persistent depressive disorder is a chronic type of depression.
Persistent depressive disorder must be experienced for a longer period of time than major depressive disorder. Most individuals diagnosed with major depressive disorder must experience symptoms for a minimum of two weeks.
For a child to receive a diagnosis of persistent depressive disorder, he or she must experience symptoms for one year.
Adults must experience symptoms for two years to receive a diagnosis. The long duration of symptoms “proves” that the individual experiences symptoms more often than not.
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[each_answer] => A. Six months
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[each_answer] => B. Two years
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[each_answer] => C. Two months
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[each_answer] => D. One year
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[2] => Array
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[quiz_unique_key] => 83407773
[question] => The antidepressant prescribed by John’s psychiatrist is classified as a Selective Serotonin Reuptake Inhibitor (SSRI). Which of the following accurately describes how an SSRI functions?
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[answer] => 2
[description] => Reason for the Correct Answer:
MAO Inhibitors inhibit chemicals that remove neurotransmitters in the body.
Tricyclic antidepressants increase the available amount of neurotransmitters in the brain.
Electroconvulsive therapy (ECT) induces brief seizures through the use of electric currents passed through the brain.
Selective Serotonin Reuptake Inhibitors (SSRIs) block the reabsorption of serotonin in the brain.
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[each_answer] => A. Inhibits chemicals that remove neurotransmitters in the body
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[each_answer] => B. Blocks the reabsorption of the neurotransmitter at the cellular level in the brain
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[each_answer] => C. Induces brief seizures through the use of electric currents passed through the brain
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[each_answer] => D. Increases the available amount of neurotransmitters in the brain
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[question] => One theory of persistent depressive disorder states that the disorder is the result of anger experienced in childhood that manifests as self-loathing and results in depressed mood and maladaptive thoughts. What type of theory would this be classified as?
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[description] => Reason for the Correct Answer:
The theory focuses on experiences in childhood and cites anger as a causal factor in development of depression.
Humanistic theories tend to focus on a holistic view of the individual’s environment, and view depression as the result of specific needs not being met (like safety or belonging).
Behavioral theories emphasize learned behavior, and focus on the impact of reinforcement and punishment.
Cognitive theories focus on maladaptive thought patterns and faulty belief systems.
Many psychodynamic theories focus on how experiences in childhood shape adulthood. This is most likely a psychodynamic theory of persistent depressive disorder.
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[each_answer] => A. Behavioral
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[each_answer] => B. Humanistic
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[each_answer] => C. Psychodynamic
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[each_answer] => D. Cognitive
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[quiz_unique_key] => 574431310
[question] => John’s psychiatrist decides to write a research article describing John’s depressive disorder and subsequent treatment in depth. What type of study design would John’s psychiatrist use to develop his research?
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[answer] => 1
[description] => Reason for the Correct Answer:
Naturalistic observation would require John’s psychiatrist to observe John at home or at work, as he interacts with others naturally.
An experimental study involves highly controlled manipulation of variables and typically involves more than one individual.
Correlational studies look at general relationships between variables.
Case studies are in-depth investigations of a single person’s (or small group’s) behavior, course of disease and treatment. John’s psychiatrist used a case study design.
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[each_answer] => A. Case study design
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[each_answer] => B. Experimental design
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