2-Ch 7/8: Mood Disorders/suicide Flashcards

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1
Q

Mood disorders

A

problems with moods/emotions NOT due to physical or other mental disorders

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2
Q

Unipolar

A

Typically just Depression

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3
Q

Bipolar

A

“Manic-depression”

2 poles: Mania & Depression

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4
Q

Prevalence of depression

A

more in females

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5
Q

prevalence of bipolar

A

equally male/female

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6
Q

risk of depression

A

increases with each additional episode of depression
1 episode = 50%
2 episodes = 70%
3 episodes = 90% risk

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7
Q

Depressive disorder core symptoms

A
  1. Depressed Mood

2. Diminished interest/pleasure in nearly all activities (Anhedonia)

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8
Q

Depressive disorders ( 9 symptoms)

A
  1. Depressed mood*
  2. Diminished interest/pleasure in nearly all activities*
  3. Significant weight loss/gain
  4. Insomnia/hypersomnia
  5. Psychomotor agitation or retardation
  6. Significant fatigue/loss of energy
  7. Feelings of worthlessness or guilt
  8. Diminished ability to think/concentrate
  9. Recurrent thoughts of death/suicidal ideation
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9
Q

Dysthymia

A

“milder”, less intense depressive disorder–>more chronic

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10
Q

Dysthymia DSM

A
  • Sx’s not absent for more than 2 months at a time
  • Chronic-duration = 2-20 years
  • similar sx’s to depression but less intense
  • increased risk for experiencing major depressive episode
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11
Q

Double Depression

A

both dysthymia & major depression

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12
Q

Major Depressive Disorder specifiers

A

Mild = just meet criteria
Moderate =Meet criteria a bit more
Severe = meet several criteria, with or without psychotic features

  • Other:
  • with Seasonal Patterning (SAD)
  • with Peripartum onset (postpartum)
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13
Q

Catecholamine hypothesis of depression

A

Availability of NT’s at synapse

-serotonin, dopamine, norepinephrine

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14
Q

Genetic hypothesis of depression

A

Much evidence for genetic contribution

-based on twin & pedigree studies

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15
Q

Freud theory of depression

A

“prolonged grief” related to a significant early loss

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16
Q

Bibring theory of depression

A

the loss itself is not what’s important, its the lost of what the person represented to you
(psychodynamic)

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17
Q

Bowlby theory of depression

A

attachment theory-unhealthy early attachment

psychodynamic

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18
Q

Behavioral theory of depression

A

lack of positive reinforcement in person’s environment

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19
Q

Behavioral Activation Therapy (BAT)

A

expose individual to positive reinforcement of environment

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20
Q

Beck’s cognitive errors

A

overgeneralizing
selective abstraction
catastrophizing
dichotomous thinking

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21
Q

overgeneralizing

A

assume circumstances in one situation will be the same in all similar situations

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22
Q

selective abstraction

A

attend only to failure or deprivation AND ignore any positives

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23
Q

Catastrophizing

A

always imagining the worse of any given scenario

“worst case scenario”

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24
Q

Dichotomous thinking

A

rigid thinking-all or nothing

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25
Q

Attributional model

A

assigning causes to situations

  • Internal: it’s all their fault
  • Stable: part of who they are
  • Global: not good at anything
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26
Q

Cognitive accuracy

A

“depressive realism hypothesis”

-are depressed people just more realistic?

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27
Q

Moore & Fresco meta-analysis

A

There was a small but significant effect supporting depressive realism

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28
Q

Humanistic/Existential theory of depression

A

Depression related most strongly to: a loss of self-esteem

-Carl Rogers: discrepancy b/w real & ideal self

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29
Q

Sociocultural theory of depression (US vs China)

A

culture plays role in symptom presentation & prevalence rates

US: higher rates among Native Americans & Southeast Asian Americans

China: report more somatic sx’s, fewer cognitive/affective sx’s

30
Q

Diathesis-stress model

A

Diathesis = predisposition/vulnerability

Predisposition to depression + significant stress = onset of depression

31
Q

Pharmacotherapy

A

Antidepressants

  • Medications: SSRI’s
  • ->increase availability of Serotonin, dopamine, norepinephrine
32
Q

Phototherapy

A

light therapy
-used for major depression with seasonal patterning

*results of studies have mixed reviews

33
Q

Electroconvulsive Therapy (ECT)

A

used for severe, major depression (last resort)

–>results in release of all NT’s

34
Q

Transcranial direct stimulation

A

magnetic stimulation

  • previously only used for severe depression
  • currently also used for resistant depression
35
Q

Psychodynamic treatment of depression

A
  • uncover unconscious conflicts–>”work through” conflicts

- work through grief over earlier loss

36
Q

Behavioral treatment of depression

A
  • increase positive reinforcement of one’s environment (BAT)

- Training in social skills that may be lacking

37
Q

Cognitive Therapy of depression

A
  • work on dysfunctional thinking (rational-emotive therapy)
  • cognitive restructuring
  • ACT
38
Q

ACT-Acceptance Commitment Therapy

A

Accept-emotions, thoughts, feelings, sensations

Know-that’s all they are, mindfullness (stay in the moment)

Commit to-taking action toward life values

39
Q

Humanistic treatment of depression

A
  • work towards more realistic real/ideal self

- focus on self-esteem

40
Q

Bipolar disorder: depression

A

may look exactly like major depression

41
Q

Bipolar disorder: mania

A
  • little sleep
  • elevated mood
  • rapid speech & racing thoughts
  • irritability (sometimes violent)
  • risky impulsivity
  • increase in psychomotor activity
  • may show psychotic symptoms (delusions/hallucinations)
42
Q

Bipolar I

A

Major depression & full on mania

43
Q

Bipolar II

A

Major depression & hypomania

44
Q

bipolar rapid cyclers

A

DSM-at least 4 episodes in 12 months

45
Q

Bipolar onset of symptoms

A
  • most evident in young adulthood
  • genetic links
  • much co-morbidity across all mood disorders
  • some links with early chaotic upbringing
  • stress can trigger mania
46
Q

Cyclothymia

A

“lesser” bipolar disorder

depressed mood & hypomania

Sx’s must have lasted at least 2 years

47
Q

Treatment of bipolar

A
  • antidepressants for depressive phase–>can trigger mania, must be watched closely
  • lithium: potentially toxic, must be monitored–decreases mood swings, but not to extent of “normal” person
48
Q

Problems with nonadherence to drugs for bipolar

A
  1. unpleasant side-effects

2. they miss the highs

49
Q

Study of suicide in children

A

Found in 5-11 year olds
-black children increasing at alarming rate, white boys decreasing

“good behavior game” reduces risk of future suicide by 50%

50
Q

Suicide definition

A

self-inflicted death that is an intentional, conscious, direct effort to end one’s life

51
Q

Parasuicide

A

An attempt to harm oneself and/or an unintentional suicide attempt

52
Q

Parasuicide differs from suicide

A
  • more impulsive
  • use less aggressive means
  • does not commit the act
53
Q

Schneidman

A

influential writer on this topic

4 types & subintentional death

54
Q

Death-seekers

A

have clear intentions of dying; take clear actions to be ‘successful’

55
Q

Death initiators

A

Believe they are already dying, just trying to hasten the process

56
Q

Death-ignorers

A

believe that dying will lead to a different/perhaps better existence

57
Q

Death-darers

A

an ambivalent attempt to die-but behave in risky ways

*often motivated more by getting attention, getting back at someone, making others feel guilty, etc.

58
Q

Sub-intentional death

A

“suicide like”

behaviors more covert, unconscious, indirect in leading to death

e.g., heart patients eating high fat diet, not taking meds, drug abuse, etc.

59
Q

Suicide rates in US

A

10th leading cause of death

8th in WA

60
Q

Highest rates of suicide

A

Asia, Eastern Europe, parts of central Europe

61
Q

Lowest rates of suicide

A

South America, Greece, Egypt, Spain

62
Q

Gender difference in suicide rates

A

Females make more attempts

-more males actually commit suicide

63
Q

Highest suicide rates in US states

A
  1. Montana
  2. Alaska
  3. Wyoming
  4. New York
  5. Washington
  6. Hawaii
64
Q

Marital status & suicide rates

A

high–>low:

divorced, widowed, single, married

65
Q

Ethnic group & suicide rates (native, white, african/hispanic/asian americans)

A

Native: recently had highest rates

White: now has highest rates

African/Hispanic/Asian: lowest rates

*but estimated rates among african americans may not be accurate

66
Q

Suicide in children

A

Rates are stable EXCEPT for African American children rising (ages 5-11)

67
Q

Typical preceding events in child suicide

A
  • running away
  • aggressive acting out
  • temper tantrums
  • self-criticism
  • social withdrawal/loneliness
  • sensitivity to criticism
  • notable change from usual behavior
  • unusual interest in death/suicide
68
Q

Adolescents & suicide rates in ethnic groups

A

2nd leading cause of death

Native: rates increasing sharply (greatest increase)

White: next highest group

Black: approaching rates of White

*1/2 suicides related to depression

69
Q

Elderly (>65 years) suicide rates

A

2nd highest rate among age groups
(highest is 45-65 years)

whites: highest
Native: relatively lower
African: lower rates

Fewer warnings (completion rate higher)

60% preceded by depression

70
Q

factors of elderly suicide

A
  • illness
  • loss of loved ones/pers
  • loss of control over life
  • loss of status in society (in our culture)
71
Q

Approaching the suicidal

A
  1. validate person’s feelings: avoid discounting
  2. Understand problem: active listen, help see circumstances/feelings transient, explore alternatives
  3. Assess potential for suicide: degree of stress, specificity of plan, have the means?
  4. Help them identify resources: talk about relatives/friends
  5. follow up plan: get them to commit to a plan, call external resources if it seems imminent