PSI Perinatal Mental Health Certification Exam Questions
and Answers.
Theories of etiology - ANS biological sensitivities to hormone changes (sleep), genetic
vulnerability (prior diagnosis), psychological (identity), social/environmental (poor social
support/racism)
Baby Blues - ANS 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 - ANS severity, intensity, duration of
symptoms
Prevalence of postpartum anxiety - ANS 8-20%
Prevalence of prenatal anxiety - ANS 15%
Prevalence of postpartum depression - ANS 21%
Prevalence of postpartum panic disorder - ANS 11%
Prevalence of postpartum OCD - ANS 11%
Prevalence of postpartum PTSD - ANS 9%
Percentage of bipolar symptoms that relapse w/o meds - ANS 70%
Prevalence of postpartum psychosis - ANS 1-2 out of 1,000
Prevalence of PPD in fathers - ANS 10%
Prevalence psychosis in women with known bipolar disorder - ANS 20-30%
Traits of OCD - ANS 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 - ANS 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 - ANS intrusive thoughts (flashbacks), avoidance, negative cognitions
and mood, arousal (sleep disturbance, poor concentration, aggression, hyper vigilance)
Maternal mortality-all women - ANS 1,200 a year or 14.4 per 100,000
Maternal mortality-black women - ANS 43.5 per 100,000
Bipolar 1 Disorder - ANS a type of bipolar disorder marked by at least one lifetime full
manic and major depressive episodes
Hypomania - ANS A mild manic state in which the individual seems infectiously merry,
extremely talkative, charming, and tireless. Up to 4 days in length
Mania - ANS a mood disorder marked by a hyperactive, wildly optimistic state-function
is impaired. Can last 7 days
Prevalence of first diagnosis of bipolar disorder postpartum - ANS 50%
Risk factors for postpartum psychosis - ANS History of bipolar or psychotic disorder,
first pregnancy, family history, recent discontinuation of psychotropic medication
Postpartum psychosis symptoms - ANS onset-2 weeks postpartum, poor concentration,
disorientation, agitation, aloof, lack of self-care, elated/labile mood, rambling speech,
thought broadcasting/delusion of grandiosity, disorganized thoughts, flight of ideas,
hallucinations
Reducing risk of postpartum psychosis - ANS stay on bipolar medication, treat
immediately in women with history of psychosis and bipolar, good sleep is essential
Evidence based risk factors for PMADS - ANS 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 - ANS endocrine dysfunction (diabetes,
thyroid imbalance, and fertility challenges), social factors (IPV, low support, financial
stress, and racism), high stress parenting (military families, adolescent parents, parents
of multiples, single parents)
Exacerbating factors of postpartum depression - ANS 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
