1. Some health care providers have attitudes or beliefs about postpartum depression that may undermine breastfeeding, and they may even believe that breastfeeding is the cause of depression, although evidence does not support that position.
2. Each of the following is an accurate statement about the adaptiveness of breastfeeding EXCEPT:
A. Breastfeeding lowers stress that babies experience when their mothers are depressed
B. Stress is a potent risk factor for depression and breastfeeding lessens the stress response and promotes calm in mothers
C. Breastfeeding lowers the stress hormones norepinephrine and adrenaline in mothers
D. In one study of 28 mothers who were both breast- and bottle-feeding, researchers found that breastfeeding decreased negative mood whereas bottle feeding decreased positive mood in the same women
3. Many of the health problems associated with depression are due to the stress hormone cortisone, and increased levels of cortisone can also lead to atrophy of the hypothalamus and amygdala, brain structures involved in learning and memory.
4. In an American sample of 5,000 mother-infant pairs, researchers found that children of depressed mothers had more behavior problems and _____________ at age five.
A. Lower vocabulary scores
B. Poor social skills
C. Language difficulties
D. Less flexibility
5. Which of the following accurately describes incidence and symptoms of postpartum depression?
A. Perinatal depression is relatively common, affecting approximately 8% to 20% of new mothers worldwide
B. Some populations, such as low income ethnic minority mothers, may have rates as high as 30% to 40%
C. Postpartum psychosis is relatively rare, occurring in approximately 0.15% of postpartum women
D. Depression may also manifest as somatic complaints, severe fatigue, or increased use of health care services for the mother or her baby
6. To meet full criteria for PTSD, women must have experienced a traumatic event and have symptoms in at least two out of the three clusters of re-experiencing, avoidance, and hyperarousal.
7. Postpartum OCD can manifest itself as repetitive thoughts of infant harm or intrusive images of accidental harm to the baby, and women are usually appalled and frightened by these thoughts.
8. Experts believe that inflammation increases the risk of depression because:
A. When inflammation levels are high, people experience classic symptoms of depression, such as fatigue, lethargy, and social withdrawal
B. Inflammation decreases the neurotransmitter serotonin by lowering levels of its precursor, tryptophan
C. Inflammation increases levels of cortisone, a stress hormone that is often elevated in depressed people
D. All of the above
9. Postpartum women can experience many types of pain, resulting from birth or breastfeeding difficulties or from prior psychological trauma, and pain may trigger depression.
10. Infant illness, prematurity and disability can cause depression in mothers, and the onset of depression usually occurs immediately upon learning that the baby is at high-risk.
11. Each of the following accurately describes social factors that contribute to depression EXCEPT:
A. Current research includes a broad range of difficulties in mothers' families of origin that can increase the risk of depression or other problems
B. How people explain events in their lives, known as ascription style, can lead to an increased risk of depression
C. Loss can increase the risk of depression and might include loss of a parent during childhood, childbearing loss, and loss of a partner through death or divorce
D. Mothers who have endured additional recent stressful events, even positive ones, are at increased risk of depression
12. The Postpartum Depression Screening Scale (PDSS), the most commonly used postpartum depression screening tool in the world, was designed to give primary care providers and other health care workers a simple tool for screening in the postpartum period.
13. When considering antidepressant medications, it may be beneficial to help mothers make accurate risk-benefit comparisons by helping them balance the risks of being on medication and breastfeeding, the risk of not breastfeeding, and the risks to themselves and their babies of ongoing, untreated depression.
14. The psychotherapy of choice for postpartum depression will likely become ________________, which is based on attachment theory, is time-limited, and focuses on the client's relationships.
A. Cognitive-behavioral therapy
B. Family systems therapy
C. Interpersonal therapy
D. Psychodynamic therapy
15. Tricyclics antidepressant medications such as Elavil are used most frequently in pregnant women and breastfeeding mothers.
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