Midterm 1

Question 1

Maria suffers from chronic back pain. Which intervention aligns with the biopsychosocial model?

Answer 1

Combining medication, therapy, and social support

Question 2

A patient with depression does not respond to a commonly prescribed antidepressant. Genetic testing reveals a polymorphism in a gene affecting serotonin metabolism. How might this information influence their treatment plan?

Answer 2

Prescribe a different antidepressant better suited to their genetic profile

Question 3

Joe develops depression after losing his job, whereas David adapts positively. Which factor likely contributes to David’s resilience?

Answer 3

Strong social support

Question 4

A child of Holocaust survivors exhibits hyper-reactivity to stress due to epigenetic changes. Which gene is likely affected?

Answer 4

NR3C1

Question 5

A pregnant parent experiences chronic stress during pregnancy, leading to elevated cortisol levels. Which of the following outcomes is most likely to occur in the child due to these stress-induced changes?

Answer 5

Reduced hippocampal volume and increased risk of anxiety and depression

Question 6

Which biological system mediates the stress response in a high-stress job?

Answer 6

Immune System
Endocrine System
Nervous System

Question 7

An intervention tailored to a patient’s genetic makeup to predict treatment efficacy exemplifies:

Answer 7

Personalized Medicine

Question 8

A patient with heart disease is prescribed enalapril to manage their condition without addressing psychological stress or social isolation. This approach aligns with:

Answer 8

Medical Model

Question 9

A patient working in a high-stress job begins experiencing digestive issues, frequent colds, and trouble concentrating. According to a holistic health perspective, which explanation best accounts for these symptoms?

Answer 9

Stress disrupts the gut microbiota, which impacts immune function and cognition.

Question 10

A study measures depression severity in Type 2 Diabetes patients using the Beck Depression Inventory a validated scale for depression symptom severity. Which type of data does this represent?

Answer 10

Quantitative

Question 11

Which factor is a protective psychological influence on depression in Type 2 Diabetes patients?

Answer 11

Not fearing complications or death

Question 12

How do biomarkers contribute to healthcare?

Answer 12

By predicting disease risk, diagnosing illness, and monitoring treatments

Question 13

What is the relationship between vulnerability and resilience?

Answer 13

They are interrelated constructs.

Question 14

A patient with depression is treated with antidepressants tailored to their genetic profile, weekly CBT sessions, and peer support groups. This approach aligns with which model of health treatment?

Answer 14

Biopsychosocial model

Question 15

Which of the following best defines comorbidities?

Answer 15

Coexistence of physical and mental health conditions

Question 16

What defines resilience in mental health?

Answer 16

Ability to recover from adversity and adapt

Question 17

What is the primary limitation of observational studies?

Answer 17

Lack of control over confounding variables

Question 18

Which factor is considered a psychological vulnerability?

Answer 18

Poor coping mechanisms

Question 19

Which of the following best describes what it means when genetics moderates the relationship between early-life stress and depression?

Answer 19

The strength of the relationship between early-life stress and depression differs depending on a person’s genetics.

Question 20

What is a primary characteristic of an ecological study?

Answer 20

They evaluate population-level phenomena.

Question 21

A 52-year-old individual has a history of smoking, physical inactivity, and a diet high in ultra-processed foods. Over several years, they develop both major depressive disorder and cardiovascular disease. According to the concept of comorbidity discussed in lecture, which explanation best accounts for the co-occurrence of these conditions?

Answer 21

Shared biological and behavioural risk factors contribute to the development of both conditions

Question 22

A patient with long-standing heart disease reports worsening depressive symptoms following reduced mobility and chronic fatigue. At the same time, elevated stress levels are contributing to physiological changes that further strain cardiovascular functioning. Which concept from lecture best explains this pattern?

Answer 22

Bidirectional interactions, where mental and physical conditions influence one another

Question 23

An adult with a history of early-life adversity shows heightened stress reactivity at the biological level. Despite this, they maintain good mental health outcomes over time. According to the framework presented in the slide, which factor would best explain this outcome?

Answer 23

Strong social support and access to resources can buffer biological risk

Question 24

Two people experience comparable levels of chronic life stress. One develops persistent anxiety symptoms, while the other does not. Which explanation best accounts for this difference?

Answer 24

Coping ability, emotion regulation, and social support modify risk trajectories

Question 25

A patient reports persistent pain and gastrointestinal discomfort that significantly interfere with daily functioning. Multiple medical tests have not identified a clear underlying cause. The patient spends considerable time worrying about the symptoms and frequently seeks reassurance. Which feature is most central to the diagnosis being considered?

Answer 25

The individual's distress, focus, and functional impairment related to symptoms

Question 26

A person with a long-standing anxiety disorder develops chronic gastrointestinal symptoms, including abdominal pain and altered bowel habits. Periods of heightened anxiety reliably worsen these physical symptoms, while ongoing physical discomfort increases psychological distress. How should this pattern best be classified?

Answer 26

A mental–physical comorbidity with reciprocal influence between conditions

Question 27

Which pairing best represents a mental–mental comorbidity, rather than a mental–physical or physical–physical one?

Answer 27

Alcohol use disorder and major depressive disorder

Question 28

An individual with type 2 diabetes has their blood glucose levels monitored regularly. These measurements are used both to confirm the diagnosis and to evaluate how well treatment is working over time. What does this example best illustrate?

Answer 28

Biomarkers can inform diagnosis and track disease progression

Question 29

A study finds that individuals who spend more time on social media report higher levels of loneliness. Which conclusion is most appropriate based on this finding alone?

Answer 29

The relationship may reflect correlation without direct causation

Question 30

Researchers observe that neighbourhoods with more green space tend to have lower average stress levels among residents. Which explanation best reflects appropriate scientific reasoning?

Answer 30

A third factor may influence both green space and stress levels

Question 31

A researcher wants to study whether environmental enrichment protects against stress-induced elevation in pro-inflammatory cytokines. They use a 2x2 factorial design, where one factor is stress (present vs. absent) and the other is enrichment (standard vs. enriched). How many experimental groups does this design produce?

Answer 31

4

Question 32

Which type of research study provides the highest level of evidence in clinical decision-making?

Answer 32

Randomized Control Trials (RCTs)

Question 33

Researchers are studying the relationship between childhood trauma and adult depressive symptoms. They find that: * Childhood trauma is associated with greater emotion-regulation difficulties * Greater emotion-regulation difficulties are associated with higher levels of depression * The strength of the relationship between emotion-regulation difficulties and depression differs depending on levels of social support Which Best discribes these findings? 1. Social support moderates the relationship between childhood trauma and depression, while depression mediates the relationship between trauma and emotion regulation. 2. Emotion-regulation difficulties mediate the relationship between childhood trauma and depression, and social support moderates how strongly emotion-regulation difficulties are associated with depression. 3. Social support mediates the relationship between childhood trauma and depression, while emotion-regulation difficulties moderate depressive symptoms. 4. Childhood trauma moderates the relationship between social support and depression, while emotion-regulation difficulties mediate social outcomes.

Answer 33

Emotion-regulation difficulties mediate the relationship between childhood trauma and depression, and social support moderates how strongly emotion-regulation difficulties are associated with depression.

Question 34

Researchers want to examine whether chronic academic stress increases the risk of developing major depressive disorder (MDD). They recruit a group of university students who do not meet criteria for depression at baseline, classify them based on their levels of academic stress, and follow them for 5 years to assess new onset of depression. Which study design is described?

Answer 34

Prospective cohort study

Question 35

Researchers want to determine whether long-term night-shift work increases the risk of developing major depressive disorder (MDD) later in adulthood. Using employment records from 20 years ago, they identify: One group of individuals with a documented history of long-term night-shift work A comparison group with no history of night-shift work They then use current medical records to compare rates of diagnosed depression between the two groups. Which study design is described?

Answer 35

Retrospective cohort study

Question 36

Researchers want to examine whether long-term exposure to workplace bullying is associated with an increased risk of major depressive disorder (MDD). They recruit: 250 individuals with diagnosed MDD (cases), and 250 individuals without MDD (controls), matched on age and sex. Participants are asked about their past experiences of workplace bullying using structured interviews. Which study design is described?

Answer 36

Case-control study

Question 37

Researchers want to test whether a new cognitive training program improves depressive symptoms and alters brain function in adults with major depressive disorder (MDD). They recruit participants with MDD and: Randomly assign them to either the cognitive training intervention or a control condition (e.g., sham training or standard care) Measure depressive symptoms using a validated scale (e.g., PHQ-9) Assess brain activity using fMRI Collect outcome data before and after the intervention Which study design is described?

Answer 37

Randomized control trial (RCT)

Question 38

A pharmaceutical company is developing a new centrally acting antidepressant intended for long-term, chronic use, including potential use in women of child-bearing age. Before initiating human clinical trials, which of the following preclinical toxicity studies would be most appropriate to characterize safety?

Answer 38

Chronic toxicity and carcinogenicity studies, reproductive and developmental toxicity studies, and developmental neurotoxicity studies

Question 39

A new antidepressant has now been approved and is widely prescribed. Several years after approval, researchers want to: Detect rare or delayed side effects that were not observed in earlier trials Evaluate how well the medication works in real-world clinical settings, including patients with comorbid conditions and polypharmacy Which phase of clinical research is most appropriate for addressing these questions

Question 40

Researchers are evaluating whether a new psychotherapy intervention reduces depressive symptoms. They find the following evidence: Several animal studies suggest a plausible neurobiological mechanism Multiple observational cohort studies show an association between the therapy and reduced depression scores One well-conducted randomized controlled trial (RCT) demonstrates a statistically significant reduction in depressive symptoms A systematic review and meta-analysis synthesizes results from multiple RCTs and reports a consistent treatment effect Based on the hierarchy of evidence, which source provides the strongest support for a causal conclusion in humans?

Answer 40

A systematic review and meta-analysis of randomized controlled trials

Question 41

Which of the following correctly describes the innate immune system?

Answer 41

It responds rapidly and non-specifically to pathogens.

Question 42

A researcher is studying immune responses in a patient exposed to a bacterial infection. The immune cells recognize a specific molecular pattern on the bacteria. What structure allows immune cells to recognize these patterns?

Answer 42

Pathogen-associated molecular patterns (PAMPs)

Question 43

A person experiences prolonged psychological stress due to workplace issues. Over time, they develop signs of depression. What role does the immune system likely play in this process?

Answer 43

Chronic stress leads to cortisol resistance, increasing pro-inflammatory cytokines, contributing to neuroinflammation.

Question 44

A scientist injects a virus into two groups of mice. One group mounts a rapid immune response, while the other takes longer but produces specific antibodies. What immune system components are responsible for these different responses?

Answer 44

The first group relies on the innate immune system, while the second uses the adaptive immune system.

Question 45

A patient diagnosed with major depression is found to have elevated levels of pro-inflammatory cytokines. What does this suggest about the role of the immune system in mental health?

Answer 45

Increased inflammation may contribute to depressive symptoms

Question 46

How do inflammatory cytokines impact tryptophan metabolism, influencing mental health?

Answer 46

Inflammatory cytokines (e.g., IL-6, TNF-α) shift tryptophan metabolism toward the kynurenine pathway, reducing serotonin production, which may contribute to depression.

Question 47

A 6-year-old exposed to chronic early-life stress shows elevated basal cortisol levels. Years later, neuroimaging reveals reduced hippocampal volume and impaired performance on memory tasks. According to the information presented in lecture, which of the following mechanisms best explains how chronic stress could contribute to reduced hippocampal synaptic plasticity in this individual?

Answer 47

The cortisol-GR complex enters the nucleus, increases DNMT expression, leading to hypermethylation of the BDNF promoter and reduced BDNF transcription.

Question 48

A researcher studies a nuclear hormone receptor (aka intracellular receptor) involved in stress regulation. After activation of this receptor in neurons, the following is observed: Gene A (which contains a hormone response element in its promoter) shows increased transcription. Gene B (which does not contain a response element) shows decreased transcription. The receptor is found physically interacting with a different transcription factor that normally activates Gene B. Which statement best explains these findings? 1. The receptor increases DNA methylation at Gene B, permanently silencing it. 2. The receptor directly binds the promoter of both genes to regulate transcription. 3. The receptor activates Gene A through transactivation and represses Gene B through transrepression. 4. The receptor remains in the cytoplasm and indirectly alters protein synthesis.

Answer 48

The receptor activates Gene A through transactivation and represses Gene B through transrepression.

Question 49

A longitudinal study finds that individuals exposed to severe early-life stress show increased methylation of stress-related genes in the hippocampus during adulthood. These individuals also display reduced synaptic plasticity and higher rates of depression. Which of the following best explains how early-life stress contributes to later mental illness?

Answer 49

Early-life stress induces epigenetic modifications that alter gene expression, leading to long-term changes in neural circuitry.

Question 50

During a CNS infection, B cells produce antibodies that bind to viral particles. The virus is successfully cleared after immune cells recognize and destroy the antibody-coated pathogens. Which part of the antibody is primarily responsible for recruiting immune cells to destroy the tagged pathogen?

Answer 50

The constant (Fc) region, which interacts with Fc receptors on immune cells