PMH-C Exam Questions With 100% Correct Answers 2024, Exams of Advanced Education

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PMH-C Exam Questions With 100%

Correct Answers 2024

Perinatal Period - Correct Answer-conception through the first year after giving birth. Antenatal - Correct Answer-Term meaning "During Pregnancy" Postpartum/Postnatal - Correct Answer-The first year after giving birth Disorders - Correct Answer-Get in the way of daily functioning. Every year, how many infants are born to mothers who are depressed? - Correct Answer-400,000, making perinatal depression the most under diagnosed obstetric complication in America. What is the prevalence of PMAD's for women? - Correct Answer-1 out of 5-7 women.

What is the prevalence of PMAD's for men? - Correct Answer- 1 out of 10 men. What is the cost of untreated PMAD's? - Correct Answer-$14. Billion annually How many pregnancies are unplanned? - Correct Answer- ~50% What are the PMAD etiologies (causes)? - Correct Answer- Biological Sensitivity to hormonal changes (sleep deprivation), Vulnerability (such as genetic disposition), psychological (relationship with own mother, ambivalence to parenthood, self-image/perfectionism), Social/environmental (hx of trauma, poor social support, institutional racism). In what ways does culture influence whether PMAD's are recognized? - Correct Answer-There are diverse ways that mothers conceptualize and explain their symptoms culturally. They may not feel they are safe to express their symptoms. May be expressed in somatic (eg. stomach pains or appetite changes) or affective ways (moods, feelings).

Why is there variability in prevalence rates of PMAD's? - Correct Answer-Cultural context, screening inventories, cutoffs used on objective measures, timing of screening and onset of symptoms, relationship between the subject and the researcher. What is the strongest predictor for paternal (fathers) depression. - Correct Answer-Maternal depression When do father's depressive symptoms spike? - Correct Answer-Between 3-6 months postpartum What is "masked" male depression? - Correct Answer-Rather than sadnes, men may increase substance use, be more irritable, aggressive or hostile. May "check out", self isolate. Possible factors for partner depression. - Correct Answer- Feeling burdened/trapped, financial burdens, feeling left out, missing sexual relationship, sleep deprivation, isolation and loneliness, poor social support network.

Is this pregnancy emotions or depression? Mood is labile (frequently changes), teary. - Correct Answer-Pregnancy Is this pregnancy emotions or depression? Mood is gloom, irritable, agitation, or rage - Correct Answer-Depression Is this pregnancy emotions or depression? Self esteem is low. Guilt. - Correct Answer-Depression (In pregnancy, self esteem is unchanged) Is this pregnancy emotions or depression? Difficulty initiating and/or sustaining sleep. - Correct Answer-Depression (Having to urinate frequently or having heartburn are symptoms of pregnancy). Is this pregnancy or depression? Fatigue, rest does not restore. - Correct Answer-Depression (May be tired during pregnancy but rest restores.) Is this pregnancy or depression? Anhedonia - Correct Answer- Depression. Anhedonia is the inability to feel pleasure.

Is this pregnancy or depression? Dysregulation of appetite - Correct Answer-Depression How many new mothers are universally affected by the Baby Blues? - Correct Answer-60-80% Hormone fluctuation at the time of birth and acute sleep deprivation can lead to what common situation or non- disorder? - Correct Answer-baby blues How long do the baby blues last? - Correct Answer-2 days to 2 weeks after birth When do baby blues typically peak? - Correct Answer-on day 3-5 after delivery. What are the symptoms of baby blues? - Correct Answer- tearfulness, lability, reactivity, and exhaustion. Unrelated to stress or prior psychiatric hx. When making a determination between baby blues and major depression, what should be considered? - Correct Answer- severity/intensity, timing/onset, duration/chronicity

Under the DSM-5, what code can we use for postpartum depression? - Correct Answer-Major Unipolar Depression (with peripartum onset) For the DSM-5 code of Major Unipolar Depression (with peripartum onset), 5 or more symptoms must be present with the same 2-week period: - Correct Answer-Depressed mood most of the day nearly every day. Loss of interest, joy or pleasure (anhedonia). Significant wt or appetite changes. Sleep disturbances. Psychomotor agitation/retardation. Fatigue/loss of energy. Poor concentration/focus/indecisiveness. Feelings of worthlessness. Excessive/inappropriate guilt. Recurrent thoughts of death/suicidal thoughts. Signs of Generalized Anxiety Disorder - Correct Answer- Excessive anxiety/worry. Difficulty controlling one's worry. Agitation/Irritability. Restlessness. Poor concentration. Easily fatigues/sleep disturbances. Increased somatic symptoms. What is the prevalence for prenatal anxiety? - Correct Answer- 15.8%

What is the prevalence estimates for postpartum anxiety symptoms? - Correct Answer-8%-20% Panic Disorder symptoms? - Correct Answer-Episodes of intense fear or discomfort reaching a peak within minutes. SOB, chest pain, dizziness, feeling of choking. Hot/Cold flashes. Restlessness, rapid heart beat, numbness/tingling sensations. Excessive worry/fear. Feeling as though "going crazy", losing control, or having a future attack. Often no identifiable trigger. What are the 3 greatest fears of a panic disorder? - Correct Answer-Fear of dying, fear of losing control, fear of going crazy. What term describes recurrent and persistent thoughts, or impulses that are intrusive and unwanted and cause marked anxiety or distress? Individuals tend to attempt to try to ignore or suppress the thoughts, urges, or images or to neutralize them with some other thought or action. - Correct Answer-Obsessions What term describes repetitive behaviors that the individual feels driven to perform in response to the obsession.

Behaviors or mental acts are aimed at preventing or reducing anxiety or distress. - Correct Answer-Compulsions Perinatal women are at a _____ greater risk for OCD onset than the general population. - Correct Answer-1.5-2X % had OCD onset in the perinatal period. - Correct Answer- 32% Severe OCD remains largely unchanged across - Correct Answer-pregnancy and the postpartum period. 65% have co-morbid depression along with what? - Correct Answer-Perinatal OCD ego-dystonic thoughts - Correct Answer-Thoughts or impulses and behaviors that are felt to be distressing, unacceptable, or inconsistent with one's self concept. Is this perinatal OCD or Perinatal Psychosis? Parent recognizes thoughts/images are unhealthy. - Correct Answer-Perinatal OCD

Is this perinatal OCD or Perinatal Psychosis? Parent has extreme anxiety related to thoughts/images. - Correct Answer-Perinatal OCD Is this perinatal OCD or Perinatal Psychosis? Parent is overly concerned about "becoming crazy" or "snapping". - Correct Answer-Perinatal OCD. Is this perinatal OCD or Perinatal Psychosis? Parent does not recognize actions/thoughts are unhealthy. - Correct Answer- Perinatal Psychosis Is this perinatal OCD or Perinatal Psychosis? Parent may seem to have less anxiety when indulging in thoughts/behaviors. - Correct Answer-perinatal psychosis Is this perinatal OCD or perinatal psychosis? Parent has no insight about distortion of thoughts. - Correct Answer- perinatal psychosis Is this perinatal OCD or perinatal psychosis? The parent does not want to harm the baby. The thoughts are obsessive in

nature and frighten the parent. - Correct Answer-Perinatal OCD Is this perinatal OCD or perinatal psychosis? The parent has taken steps to protect the baby. - Correct Answer-Perinatal OCD Is this perinatal OCD or perinatal psychosis? Parent has NO delusions or hallucinations related to harming the baby. - Correct Answer-Perinatal OCD Is this perinatal OCD or perinatal psychosis? Parent has delusions about the baby (eg. baby is a demon) - Correct Answer-Perinatal psychosis Ego-syntonic - Correct Answer-instincts or ideas that are acceptable to the self and are compatible with ones way of thinking. Thoughts of harming baby are ego-syntonic. Perinatal OCD or perinatal psychosis? - Correct Answer-Perinatal psychosis. The parent thinks the thoughts are reasonable and/or feels tempted to act on them.

What are the 4 subcategories of PTSD in the DSM-5? Symptoms to follow a traumatic event that lasts for more than one month after the event: - Correct Answer-Intrusion (flashbacks, nightmares, somatic complaints) Avoidance ( constricted emotions, social withdrawal) Negativity in Cognitions and Mood (guilt, depression, hopelessness, negative thoughts) Arousal (sleep disturbance, poor concentration, aggression, hypervigilance) Prevalence of prenatal PTSD? - Correct Answer-mean 3.3%; postpartum PTSD 4%; 18.5% in high risk groups (those with maternal depression, hx of psychiatric illness, and infant complications) What is birth trauma? - Correct Answer-An event occurring during the labor and birth process that can involve actual or threatened serious injury or death to the mother or her infant or the women being stripped of her dignity.

Symptoms of birth trauma? - Correct Answer-the person may experience intense fear, helplessness, loss of control, and horror. Prevalence of birth trauma? - Correct Answer-3% in community samples and 16% in high risk samples. How many women report their births as being traumatic? - Correct Answer-45%; 3% will experience PTSD 22.6% of women who screened positive for PPD actually had ____. - Correct Answer-bipolar disorder Bipolar 1 Disorder: DSM 5 is defined as at least one lifetime episode of mania defined by________ - Correct Answer- elevated mood symptoms, euphoria or agitation, decreased need for sleep, racing thoughts, increased productivity, noticed by others, pressured speech, increased energy. Functioning is impaired. Lasts at least 7 days in length or requires hospitalization. May include psychotic sx's (hallucinations, paranoia, or disorganized thinking)

Characteristics of hypomania episode. - Correct Answer-lasts up to 4 days in length. Often improves functioning. 60% of women with bipolar disorder present initially as _____.

• Correct Answer-depressed What could happen if some with bipolar disorder is prescribed an antidepressant alone (being only diagnosed with unipolar depression)? - Correct Answer-It could induce cycling into mania. 50% of women with bipolar disorder are first diagnosed when? - Correct Answer-the postpartum period. The DSM- now recognized that there can be peripartum onset of bipolar disorder. Women who stopped mood stabilizers during pregnancy had ____ the risk of re-occurrence. - Correct Answer-2x and 4x more rapidly than women on medication. Most reoccurrences were depressive or mixed (often in 1st trimester)

Bipolar II disorder is often referred to as the ______. - Correct Answer-PPD imposter as it present with depressive symptoms and can be resistant to SSRI medication. Psychosis occurs in 20-30% of women with known _____. - Correct Answer-bipolar disorder 45-52% of women with Bipolar disorder experienced a relapse or an exacerbation of symptoms during ______. 70% relapsed within the first 6 months ________. - Correct Answer- pregnancy; postpartum Andrea Pia Yates - Correct Answer-Drowned her 5 children. Later found not guilty by insanity. 2006 How common is perinatal psychosis? - Correct Answer-1-2 in 1,000 postpartum women Of those women who have perinatal psychosis how many commit suicide and how many commit infanticide? - Correct Answer-5% die by suicide; 4.5% infanticide

50% of first time mothers who experience psychosis had no previous _____. - Correct Answer-psychiatric hospitalization When does onset of perinatal psychosis usually begin? - Correct Answer-within the first 2 weeks after birth Risk factors of perinatal psychosis - Correct Answer-first baby, discontinuation of a mood stabilizer, obstetric complications, perinatal or neonatal loss, previous bipolar episodes, psychosis or postpartum psychosis, family history of bipolar disorder or postpartum psychosis, sleep deprivation. Postpartum psychosis symptoms - Correct Answer-Onset is within 2 weeks postpartum. Cognitive: poor concentration, impaired sensorium, disorientation Behavioral: agitated, hyperactive, emotionally distant, aloof, lack of self-care Mood: Elated, labile, dysphoric, or less often depressed Speech: rambling Thought content: thought broadcasting, ideas of reference, infant being harmed/killed, persecutory, jealousy, paranoia, or being controlled, delusion of grandiosity

Thought process: disorganized, flight of ideas Perceptions: hallucinations, commanding auditory organic (visual, olfactory, tactile). Women with Bipolar Disorder should remain on medication throughout the pregnancy to avoid postpartum relapse. What else can reduce the risk? - Correct Answer--initiate treatment immediately postpartum in women with a history of psychosis limited to the postpartum period. -Protecting good sleep is essential. -With an adequate treatment regimen, nearly all individuals experiencing postpartum psychosis achieve full remission and the majority achieve good functional recovery. What is Action on Postpartum Psychosis (APP) - Correct Answer-Action on Postpartum Psychosis is the national charity for women and families affected by Postpartum Psychosis. Support, research, psychiatric services, public awareness Massachusetts General Hospital Postpartum Psychosis Project

• Correct Answer-looking for women who experienced an episode of psychosis within six months of giving birth. The episode must have occurred within the past ten years. Study participation involves a telephone interview and providing a

DNA sample with a saliva collection tube sent by mail. The purpose of the study is to better describe the symptom pattern of postpartum psychosis and to examine the genetic contributions to risk for this disorder. Melanie Blocker Stokes MOTHERS Act - Correct Answer- Federal law providing funding, education, and treatment. Was written to provide support services and education to women suffering from postpartum depression and psychosis, and to support research into the causes, diagnoses and treatments for postpartum depression and psychosis. Paternal depression is associated with increased negative parenting. Depressed fathers were nearly ____x more likely to report spanking. - Correct Answer-4x. Less than 50% read to their 1 year old child. "You are entitled to thoughts, but not entitled to _________" - Correct Answer-Actions or behaviors According to a UK study, children of fathers who had depression during the postpartum period were at increased risk of_______. - Correct Answer-developing depression at 18 years of age.

How many men in the US are offered paternity leave? - Correct Answer-1 in 5 men In 2019, Dove launched the Pledge for Paternity Leave and Paternity Leave Fund which does what?? - Correct Answer- Overcome barriers and make paid family leave for fathers more common. What types of endocrine dysfunction puts someone at greater risk of PMAD's? - Correct Answer-Diabetes, hx of thyroid imbalance, fertility challenges, other endocrine disorders. What social factors put someone at a greater risk for PMAD's?

• Correct Answer-Inadequate partner/social support, interpersonal violence, relationship stress, financial stress, childcare stressors, recent loss or move, barriers to care care (institutional racism), climate stressors (seasonal depression or mania) List some exacerbating factors for PMAD's - Correct Answer- lack of sleep, physical pain/inflammation, unresolved grief/loss (intrauterine loss, neonatal death, selective reduction, elective abortion), estrangement (or a loss) or a

complicated relationship with one's own mother, complications in pregnancy/birth/breastfeeding, health challenges in baby or parents, temperament of baby, age- related stressors (adolescence/perimenopause), Perfectionism/high expectations (superwoman syndrome, returning to work) What is the rate of illicit drug use among pregnant women aged 15-44? - Correct Answer-5.4% (1 in 20) (The drug abuse rate of pregnant women aged 15-16 is much higher at 14.6%) 1 in 10 pregnant women report alcohol use. - Correct Answer- 3.3 million US women are at risk of exposing their fetus to alcohol. Risks of cannabis use during pregnancy. - Correct Answer- adversely affect neurodevelopment, especially during sensitive period of critical brain growth in the developing fetal brain and during adolescent maturation. Tobacco use increases the risk of stillbirth by.... - Correct Answer-1.8-2.8x. Passive exposure to tobacco 2.1x greater risk.

Marijuana use increases the risk of stillbirth by... - Correct Answer-2.3x greater risk. Stimulant or prescription pain reliever use increases the risk of still birth by... - Correct Answer-2.2x greater risk. Where are we seeing growth of neonatal abstinence syndrome (NAS)? - Correct Answer-rural communities What is SAMHSA and what does it do? - Correct Answer- Substance Abuse and Mental Health Services. Offers clinical guidance for treating pregnant and parenting women with opioid use disorder and their infants. Women with anxiety or depression were more likely to stop breastfeeding before ________ - Correct Answer-6 months postpartum. Women with prenatal anxiety and/or depression experienced a greater increase in depression and anxiety after ______cessation than women without depression or anxiety during pregnancy. - Correct Answer-breastfeeding

True or False? Mothers with depression and on medication fed with human milk for longer durations than moms with untreated depression. - Correct Answer-True What is D-MER - Correct Answer-dysphoric milk ejection reflex. A condition where women who are breastfeeding develop negative emotions that begin just before the milk ejection reflex and last less than a few minutes. It is different from postpartum depression and a dislike of breastfeeding. Which hormones will depression suppress? - Correct Answer- prolactin and oxytocin- the 2 hormones essential to lactation. What can cause suppression of oxytocin? - Correct Answer- cesarean section birth, stressful or traumatic labor or birth, epidurals and other birth interventions, or depression. Some galactogogues can cause what? - Correct Answer- depression Reglan (metoclopramide often used to induce lactation)can lead to an increased risk of what? - Correct Answer-depression by 7x.

Thyroid dysfunction and anemia can reduce milk supply and also cause what? - Correct Answer-depression Black women have higher rates of PMAD's and birth trauma which is synergistic with..... - Correct Answer-lower rates of breastfeeding. Apps for breastfeeding and medication: - Correct Answer- Mother to Baby- Organization of teratology information (OTIS) Infant Risk-Mommy Meds Free, InfantRisk Center Health Care Mobile Resources ($9.99) LactFacts: Institute for the Advancement of Breastfeeding and Lactation Education (IABLE) How prevalent is adolescent pregnancy? - Correct Answer-1 in 4 teens get pregnant by age 20. Is teen pregnancy higher or lower in the U.S. than in that of other Western industrialized nations? - Correct Answer- substantially higher

What medical risks exist for pregnant teens? - Correct Answer- high blood pressure, anemia, nutritional deficiencies, early labor (before 37 weeks), low birth weight, STI's, higher rate of infant mortality, obstructed labor. Risk factors for PMAD's in teen moms? - Correct Answer- untreated depression in their mother (or caregiver), social isolation and peer rejection, weight/shape disturbance, low maternal self-efficacy, family conflict, low self-esteem, physical and sexual abuse How common is teen fatherhood? - Correct Answer-10.4 births / 1,000 men aged 15-19 Deployment of a spouse during pregnancy is associated with - Correct Answer-3.24 fold increased risk for preterm delivery and 3.01 increased risk of PPD in comparison to those whose spouses were not deployed. What percentage of newborns are admitted to NICU? - Correct Answer-10-15% in the US

What percentage of NICU parents experience a diagnosable mental health disorder during the first postpartum year? - Correct Answer-20-30% Additional PTSD symptoms that NICU parents may experience:

• Correct Answer-avoidance of NICU visits, disturbances in developing attachment with baby, later impairments in the growth and development of the baby and child. Prevalence estimates for clinically significant depression symptoms in NICU mothers is... - Correct Answer-25.5%-63% 27% of NICU mothers reported significant levels of ... - Correct Answer-anxiety symptoms 33% of NICU mothers reported having... - Correct Answer- suicidal thoughts PTSD was diagnosed in _______ of NICU mothers and 8%-33% in NICU fathers. - Correct Answer-15-53% What percentage of NICU fathers screened positive for depressive symptoms? - Correct Answer-30%

Mothers who experience a miscarriage are at increased risk for what? - Correct Answer-anxiety (particularly PTSD and OCD) 15% of recognized pregnancies will end in ..... - Correct Answer-an intrauterine loss. 80% of losses occur within the first 3 months of pregnancy. 14% of losses occur in the 2nd trimester. 6% of losses occur in the 3rd trimester. Definition of neonatal death? - Correct Answer-A loss during the first 28 days of life. Mortality rate is 3.93 per 1,000 live births. What is the leading cause of neonatal death? - Correct Answer-congenital anomalies 5 leading causes of infant death in 2017 - Correct Answer-birth defects, preterm birth & low birth weight, maternal pregnancy complications, SIDS, injuries (suffocation) Gestational surrogates carrying for gay male couples found to have a higher risk for? - Correct Answer-PMAD's (22%)