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Perinatal Mental Health Certification: Questions With Complete Solutions (Pass!)
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Perinatal Mental Health Certification: Questions With Complete Solutions (Pass!)
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Perinatal Mental Health Certification: Questions WithComplete Solutions (Pass!)
Theories of PMAD Etiology: Biology Right Ans - Sensitives to Hormone
changes (increases of estrogen, progesterone, onset of oxytocin and prolactin
at birth)
Evidence Based Risk Factors - Biological Right Ans - -Endocrine
Dysfunction (diabetes, hx of thyroid imbalance, fertility challenges, PMDD,
PCOS)
-Significant mood reactions to hormonal changes (puberty, PMS, hormonal
birth control; abrupt discontinuation of breast feeding; physical pain or
inflammation)
-Lack of sleep
Theories of PMAD Etiology: Psychosocial Right Ans - -Vulnerability (sleep,
genetic predisposition)
-Psychological (relationship with own mother-estranged, death; ambivalence
to parenthood, self-image/perfectionism)
-Social/environmental (hx of trauma, poor social support,
institutional/structural racism)
Evidence Based Risk Factors - Psychosocial Right Ans - Psychiatric Hx
-Family or personal hx of previous PMADs
-Family or personal hx of depression, anxiety, OCD, eating disorder, bipolar
disorder, etc
-Hx of childhood sexual abuse
Psychosocial: Exacerbating Risk Factors for PMADs Right Ans - -Inadequate
partner/social support
-Interpersonal violence
-Other relationship stress
-Financial stressors/poverty
-Childcare stressors
-Recent loss or move
-Barriers to care; institutional racism
-Climate stressors: seasonal depression or mania
-Complications in pregnancy, birth, or breastfeeding
,-Health challenges in baby or parents
-Temperament of baby
-Returning to work
-Unresolved grief and/or loss
Normal Pregnancy symptoms Right Ans - -Mood is labile, teary
-Self esteem is normal
-Sleep: bladder or heartburn may awaken. Can fall asleep
-No suicidal ideology
-Energy: may tire, rest restores
-Pleasure: joy and anticipation (appropriate worry)
-Appetite: increases
Abnormal Pregnancy Symptoms (Depression) Right Ans - -Mood: gloom,
irritable, agitation, rage
-Low self-esteem, guilt
-Sleep: difficulty initiating and/or sustaining sleep
-Suicidal thoughts, plans, or intentions
-Energy: rest does not restore; fatigue
-Anhedonia: no joy from things previously enjoyed
-Dysregulated appetite
Baby Blues Right Ans - -Symptoms: tearfulness, lability, reactivity, and
exhaustion
-Predominantly happy; self-esteem remains unchanged
-Lasts between 2 to 14 days after birth; usually peaks 3-5 days after delivery
-Due to the hormone fluctuation at the time of the birth and acute sleep
deprivation
-Resolves on it's own
Prevalence of Baby Blues Right Ans - Affects 60-80% of new moms
universally
Determination of Baby Blues or Depression Right Ans - -Severity/Intensity
-Timing/Onset
-Duration/Chronicity
Not Baby Blues if persists after than 2 weeks postpartum
,Prevalence of Prenatal Anxiety Right Ans - 15.8%
Prevalence of Postpartum Anxiety Right Ans - 8-20%
Prevalence of Anxiety for New Dads Right Ans - -4.1 - 16% during prenatal
period
-2.4 - 18% during the postnatal period
DSM-5 GAD Right Ans - 3 or more symptoms:
-Excessive anxiety and worry (usually about the baby, could also be about
one's health)
-Difficulty controlling one's worry (ruminating, persistent thoughts)
-Agitation, irritability, can escalate to rage (then spiral to guilt/shame); "what
kind of mom would do that?"
-there is usually a trigger to the thought spiral or symptom onset
-restlessness, inability to sit still, feeling on edge
-poor concentration
-sleep disturbance
-increased somatic symptoms
DSM-5 Panic Disorder Right Ans - Must have 4 or more symptoms:
-episodes of intense fear or discomfort reaching a peak within 10 minutes
-shortness of breath, chest pain, sensations of choking or smothering,
dizziness
-hot or cold flashes, trembling, rapid heart rate, numbness, or tingling
sensations
-restlessness, agitation, or irritability
-Excessive worry or fear
-Persistent fear of "going crazy", losing control, or having a future panic attack
-often no identifiable trigger to the thought spiral or symptom onset
3 greatest fears during a panic attack Right Ans - 1. Dying
2. Going crazy
3. Losing control
Prevalence of Postpartum Panic Disorder Right Ans - 11%
, DSM-5 OCD: Obsessions Right Ans - -Recurrent and persistent thoughts,
urges, or impulses that are intrusive and unwanted and cause marked anxiety
or distress
-Individual attempts to ignore or suppress thoughts, urges, or images or to
neutralize them with some other thought or action
DSM-5 OCD: Compulsions Right Ans - -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
Cycle of OCD Right Ans -
Prevalence of Perinatal OCD Right Ans - -Perinatal women 1.5-2x greater
risk for OCD onset than general pop
-32% OCD onset during perinatal period
-65% comorbid depression
Ego-dystonic Right Ans - thoughts, impulses, and behaviors that are felt to
be distressing, unacceptable, or inconsistent with one's self concept
Characteristics of OCD Perinatally Right Ans - -Intrusive, repetitive
thoughts, usually of harm coming to the baby (ego-dystonic thoughts)
-Caught in a spiral of "what if" thinking
-Tremendous guilt and shame
-Horrified by these thoughts
-Hypervigilance
-Mothers engage in behaviors to avoid harm or minimize triggers
Common Presentations of Perinatal OCD Right Ans - -41% Fears of
Deliberate Harm
-29% Contamination
-18% Accidental Harm
-6% Ordering/Arranging
-3% Religious
-3% Checking
Exposure & Response Prevention (ERP) Right Ans - - "Gold Standard" for
treatment of OCD
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