Download PSI Perinatal Mental Health Certification Questions and answersPSI Perinatal Mental Health and more Exams Health, psychology in PDF only on Docsity!
Questions and answers
Theories of etiology CORRECT ANSWERS✅ biological sensitivities to hormone changes (sleep), genetic vulnerability (prior diagnosis), psychological (identity), social/environmental (poor social support/racism). Baby Blues CORRECT ANSWERS✅ Affects 60-80% new mothers. Due to hormone changes and sleep deprivation. lasts 2 days to 2 weeks. Tearful, labile affect, reactivity, exhaustion BUT predominately happy, self-esteem remains unchanged. Resolves without intervention. Recommend self-care strategies. How to determine is it blues or depression CORRECT ANSWERS✅ severity, intensity, duration of symptoms Prevalence of postpartum anxiety CORRECT ANSWERS✅ 8-20% Prevalence of prenatal anxiety CORRECT ANSWERS✅ 15% Prevalence of postpartum depression CORRECT ANSWERS✅ 21% Prevalence of postpartum panic disorder CORRECT ANSWERS✅ 11% Prevalence of postpartum OCD CORRECT ANSWERS✅ 11% Prevalence of postpartum PTSD CORRECT ANSWERS✅ 9% Percentage of bipolar symptoms that relapse w/o meds CORRECT ANSWERS✅ 70%
Questions and answers
Prevalence of postpartum psychosis CORRECT ANSWERS✅ 1-2 out of 1, Prevalence of PPD in fathers CORRECT ANSWERS✅ 10% Prevalence psychosis in women with known bipolar disorder CORRECT ANSWERS✅ 20-30% Traits of OCD CORRECT ANSWERS✅ recognizes that thoughts are unhealthy, extreme anxiety related to thoughts/images, concerned about "snapping". parent does not want to harm the baby, thoughts are frightening. Traits of psychosis CORRECT ANSWERS✅ does not recognize actions/thoughts are unhealthy, may seem to have less anxiety when indulging in thoughts/behaviors, no insight about distortion of thoughts, parent has delusional beliefs about the baby, thoughts of harming the baby are ego-syntonic Traits of PTSD CORRECT ANSWERS✅ intrusive thoughts (flashbacks), avoidance, negative cognitions and mood, arousal (sleep disturbance, poor concentration, aggression, hyper vigilance) maternal mortality-all women CORRECT ANSWERS✅ 1,200 a year or 14.4 per 100, maternal mortality-black women CORRECT ANSWERS✅ 43.5 per 100,
Questions and answers
Evidence based risk factors for PMADS CORRECT ANSWERS✅ previous PMADS (family history, personal history, symptoms during pregnancy), history of mood/anxiety disorders (personal or family history of depression, anxiety, OCD, eating disorders, bipolar disorders), significant mood reactions of hormonal changes (puberty, PMS, hormonal birth control) More evidence based risk factors for PMADS CORRECT ANSWERS✅ endocrine dysfunction (diabetes, thyroid imbalance, fertility challenges), social factors (IPV, low support, financial stress, racism), high stress parenting (military families, adolescent parents, parents of multiples, single parents) Exacerbating factors of postpartum depression CORRECT ANSWERS✅ pain, lack of sleep, abrupt discontinuing of breast feeding, childcare stress, relationship stress, losses, history of childhood sexual abuse, complicated pregnancy, health changes in baby or parents, temperament of baby, climate stressors: seasonal depression or mania, perfectionism/high expectations, unresolved grief or attachment with mother, returning to work Substance Use in Pregnancy CORRECT ANSWERS✅ 5.4% all women use illicit drugs during pregnancy, 14.6% of adolescent moms Alcohol use in pregnancy CORRECT ANSWERS✅ 8.5% of women drank within last month, most during first trimester (17.9%) Postpartum substance abuse CORRECT ANSWERS✅ 40-49% report alcohol use, 4.5-8.5% report marijuana use
Questions and answers
Risks for single parents CORRECT ANSWERS✅ twice as likely to report depressive and anxious symptoms over partnered parents. NICU rates CORRECT ANSWERS✅ 10-15% of babies spend time in the NICU NICU parents often traumatized high rate of anxiety and depression Maternal psychological impact of neonate CORRECT ANSWERS✅ parents: difficulty bonding, poor attunement, smile less, less eye contact, avoid physical contact, less verbalization the depressive dyad CORRECT ANSWERS✅ when mom is depressed, babies are more often: delayed in speech and cog development, short attention span, sleep problems, feeding issues, increased frequency of GI upset, prone to colic, excessive crying, irritability. NICU family prevalence of PMADS CORRECT ANSWERS✅ 20-30% of diagnosable mental health disorder. more experience PTSD NICU moms rate of depression CORRECT ANSWERS✅ up to 63% NICU moms rate of anxiety CORRECT ANSWERS✅ up to 27% NICU moms rate of PTSD CORRECT ANSWERS✅ 53%
Questions and answers
PADS CORRECT ANSWERS✅ post adoption depression syndrome. can affect all adoptive mothers, but higher in adoption of older children and those coming from institutions. American Academy of Pediatrics on breastfeeding CORRECT ANSWERS✅ infants should be exclusively breast fed for first 6 months of life. Then add food. Breastfeeding should continue for at least the first year of life Breastfeeding and depression relationship CORRECT ANSWERS✅ bi-directional relationship. Breastfeeding may support maternal mental health, exclusively breastfeeding may be less likely to be depressed, depression leads to lower breastfeeding rates and earlier cessation. Hormones of lactation CORRECT ANSWERS✅ prolactin and oxytocin Galactagogue CORRECT ANSWERS✅ Increases breast milk production Reglan CORRECT ANSWERS✅ Metoclopramide, increased risk of depression medical conditions that decrease milk supply CORRECT ANSWERS✅ thyroid dysfunction, anemia breast feeding and depression CORRECT ANSWERS✅ prenatal PMADS more likely to stop breastfeeding before 6 months, weaning is associated with increased anxiety and depression, prenatal PMADS moms suffered greater anxiety and depression following cessation than non affected moms.
Questions and answers
birth trauma and lactation themes supporting breastfeeding CORRECT ANSWERS✅ proving oneself as a mother, atonement to infant after traumatic birth, healing mentally birth trauma and lactation themes impeding breastfeeding CORRECT ANSWERS✅ flashbacks, detachment from infant, physical pain, feeling violated, insufficient milk supply mothers who were medicated for depression breast fed longer than moms with untreated depression CORRECT ANSWERS✅ Breastfeeding and race CORRECT ANSWERS✅ gap between white and POC who breastfeed shrunk to 16% in 2008. Black infants had lowest rates of breastfeeding initiation and duration. POC higher rates of PMADS and birth trauma and lower rates of breastfeeding CORRECT ANSWERS✅ medical risks for teenage mothers CORRECT ANSWERS✅ high blood pressure anemia, nutritional deficiencies, early labor, preterm labor, low birth weight, STDs, higher rate of infant mortality, obstructed labor predictive factors for PMADS in adolescent mothers CORRECT ANSWERS✅ untreated depression in their mothers, social isolation/peer rejection, weight/shape disturbance, low maternal self-efficacy, family conflict, low self- esteem
Questions and answers
14-19 moderate depression 19-30 severe depression it is a screening tool. does not diagnose question #10 regarding self harm requires immediate follow through Patient Health Questionnaire (PHQ-9) CORRECT ANSWERS✅ A brief 9-item self- report questionnaire used as a screening tool to assess severity of depression; widely used by health care providers, in validity is well established, particularly for identifying severe depression. validated for perinatal use, but not exclusively for that purpose Postpartum depression screening scale (PDSS) CORRECT ANSWERS✅ first 7 questions are short form. if >14, long form should be administered. seven sub scales: sleeping and eating disturbances, anxiety and insecurity, emotional lability, cognitive impairment, loss of self, guilt and shame, contemplating self harm. targets both symptoms and risk factors underdiagnosed bipolar disorder CORRECT ANSWERS✅ 22% of women who screen positive n EPDS at >10 had bipolar. 50% of women with treatment resistant postpartum depression actually suffered from Bipolar disorder 1 Mood Disorder Questionnaire (MDQ) CORRECT ANSWERS✅ Screens for Bipolar Disorder MDQ plus EPDS improved the distrinctionof unipolar depression from bipolar depression at the level of screening in 50% of women.
Questions and answers
ACE CORRECT ANSWERS✅ Adverse Childhood Experiences abuse, neglect, house hold dysfunction Culture CORRECT ANSWERS✅ the enduring behaviors, ideas, attitudes, and traditions shared by a large group of people and transmitted from one generation to the next cultural humility CORRECT ANSWERS✅ an interpersonal stance that is other- oriented rather than self-focused, characterized by respect and lack of superiority toward an individual's cultural background and life experience trauma informed care CORRECT ANSWERS✅ involves viewing through an ecological and cultural lens and recognizing that context plays a significant role in how individuals perceive and process traumatic events, whether acute or chronic.k involves anticipating and avoiding institutional processes and individual practices that are likely to retraumatize individuals who already have histories of trauma, and it upholds the importance of consumer participation in the development, delivery and evaluation of services Trauma-informed approach CORRECT ANSWERS✅ realizes the prevalence of trauma and taking a universal precautions position recognizes how trauma affects all individuals involved with the program, organization, or system, including its own workforce responds by putting this knowledge into practice resists re-traumatization
Questions and answers
suicide risk factors in pregnancy CORRECT ANSWERS✅ when pregnancy is unwanted, especially when a termination was wanted, but could not get one; partner abandoned woman during pregnancy; issues of IPV; woman had prior pregnancy loss or death of children; medication stopped abruptly. less than 12 years education; major depressive disorder common therapeutic goals CORRECT ANSWERS✅ changing identity checking expectations with reality reducing perfectionism and comparison communication and conflict resolution anger management grief and loss resolution supports and referrals for connection CBT (cognitive behavioral therapy) CORRECT ANSWERS✅ teaches clients to identify, evaluation and change dysfunctional patterns of thinking, resulting in mood and behavioral changes a collaborative approach, relaxation training, education about CBT common CBT components CORRECT ANSWERS✅ assertiveness training, resiliency, cognitive restructuring, desensitization and exposure therapy cognitive restructuring CORRECT ANSWERS✅ a therapeutic approach that teaches clients to question the automatic beliefs, assumptions, and predictions that often lead to negative emotions and to replace negative thinking with more realistic and positive beliefs
Questions and answers
anxiety CORRECT ANSWERS✅ we overestimate the danger and underestimate our coping tools and ability to cope goals of CBT for anxiety CORRECT ANSWERS✅ reduce physical hyper vigilance, take away the danger, recognize anxiety as an alarm. increase perceived control and resilience, develop coping plans and skills, exposure to feared symptoms and situations trauma psychotherapy-CBT CORRECT ANSWERS✅ collaborative, educate, reconceptulaize the problem as a more hopeful formation, retelling or restoring process, shattered assumptions and rescripting CBT for OCD CORRECT ANSWERS✅ relabel, reattribute, refocus, revalue relabel CORRECT ANSWERS✅ notice and name the thoughts, it's just a thought reattribute/reframe CORRECT ANSWERS✅ increase awareness of cognitive distortions, examine the evidence refocus CORRECT ANSWERS✅ shift attention away from the worry/fear, refocus behavior on a pleasurable activity in the moment revalue CORRECT ANSWERS✅ thoughts do not equal actions, just a thought, show self compassion and positive self talk
Questions and answers
final phase-termination, discuss end of treatment, affirm all that has been learned, reinforce independent competence in recognizing and overcoming depression. attachment and infant mental health CORRECT ANSWERS✅ how baby is emotionally and physically attached to their caregiver, caregiver helps to regulate the baby's response to threat/anxiety, if caregiver is depressed or disregulated, they may not be able to meet the baby's emotional needs in a consistent way- poor infant development types of attachment CORRECT ANSWERS✅ secure-baby uses parent as secure base, can be soothed, can be independent insecure-avoidant, ambivalent, disorganized prevalence of attachment types CORRECT ANSWERS✅ secure-60-75% avoidant-15-25% ambivalent-10-15% disorganized-less than 14% disorganize in up to 62% in depressed mothers and 82% of maltreated infants Infant Mental Health CORRECT ANSWERS✅ "The developing capacity of the child from birth through 3 years of age to experience, regulate and express emotions; form close and secure interpersonal relationships; and explore the environment and learn—all in the context of family, community and cultural expectations for young children."
Questions and answers
promoting positive attachment CORRECT ANSWERS✅ support and intervention, assessing disruption in bonding and attachment evidence based approaches to facilitate secure attachments. Impact of poor bonding and attachment CORRECT ANSWERS✅ dysregulated sensitivity and responses, mother self criticism, avoidance of connection, anxious mothering, isolation from social support couples therapy CORRECT ANSWERS✅ partner support has measurable effect off PMADS marital disharmony is most commonly cited non-biological "cause" of PMADS, promote effective communication, understanding and support between partners. St. John's Wort CORRECT ANSWERS✅ may reduce effectiveness of birth control. should not be taken what anti-depressants. contraindicated for bipolar bright light therapy CORRECT ANSWERS✅ consider use if symptoms occur during fall/winter 7,000-10,000 lux acupunture CORRECT ANSWERS✅ benefits pain, nausea, sleep contraindicated for inducing labor mixed benefits regarding mood
Questions and answers
not as activating for some moms Paroxitine (SSRI) CORRECT ANSWERS✅ Paxil starting dose 10 mg range 20-40mg short half life noticeable withdrawal effects if missed dose Fluoxitine (SSRI) CORRECT ANSWERS✅ Prozac starting dose 10 mg range 20-80mg longest half life minimal withdrawal effect if missed dose SNRI CORRECT ANSWERS✅ serotonin norepinephrine reuptake inhibitor Duloxetine (SNRI) CORRECT ANSWERS✅ Cymbalta little safety data on use in pregnancy and lactation Venlafaxine (SNRI) CORRECT ANSWERS✅ Effexor start dose 25 mg range 75-300mg short half life most safety data for pregnancy/lactation in SNRI class Desvenlafaxine (SNRI) CORRECT ANSWERS✅ Pristiq
Questions and answers
bupropion CORRECT ANSWERS✅ Wellbutrin augmentation for partial response to SSRI Mirtazapine (Remeron) CORRECT ANSWERS✅ Atypical antidepressant: Can also be used as sleep aid and for hyperemesis gravidarum Vortiozetine CORRECT ANSWERS✅ trintellix- new medication, don't start in pregnancy/postpartum, but don't stop is already stable tricyclic antidepressants-definition CORRECT ANSWERS✅ 3rd line. only consider after failing multiple SSRI and SNRIs Anxiolytics CORRECT ANSWERS✅ Drugs that alleviate the symptoms of anxiety. Buspirone (Buspar) non-benzo anxiolytics CORRECT ANSWERS✅ Antianxiety hydroxyzine (non-benzo anxiolytics) CORRECT ANSWERS✅ Vistaril Quetlapine (Seroquel) non-benzo anxiolytics CORRECT ANSWERS✅ atypical antipsychotic Anxiolytics: Benzodiazepines CORRECT ANSWERS✅ Treat: anxiety, mangement and chronic alcohol withdrawal syndromes.
