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Clinical Psychology > 3: Mood Disorders > Flashcards

3: Mood Disorders Flashcards

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1
Q

How are mood disorders classified?

A

depressive or maniac episodes

- each have key symptoms associated with both

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2
Q

What are the cirterias to be diagnosed with a mood disorder?

A
  1. depressive/ maniac episodes must be severe enough that it is causing significant impairment in their social + occupational function
  2. episodes should not be explained by other external factors like medication/ other disorders
  3. for depressive = must not be the result of bereavement
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3
Q

What are the subdivision within depressive disorders?

A
  1. major depressive disorder
  2. dsythymic disorder
  3. disruptive mood dsyregulation disorder
  4. premenstrual dysphoric disorder
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4
Q

Describe major depressive disroder

A
  • single or recurrant episodes of depression

- where symptoms last for more than 2 months

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5
Q

Describe dsythymic disorder

A
  • persistent depressive disorder
  • similar symptoms to major depression but less severe
  • but last much longer like 2 yrs
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6
Q

Describe disruptive mood dsyregulation disorder

A
  • severe recurring temper tantrums

- verbal/ behavioural nature

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7
Q

Describe premenstrual dysphoric disorder

A

mood swings associated with phases of menstrual cycle

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8
Q

Describe bipolar disorder

A
  • extreme fluctuation in mood
  • alt between depression + mania
  • og called manic depression
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9
Q

What are the 3 subtypes of bipolar disorder?

A

Bipolar I D
Bipolar II D
Cylcothymic disorder

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10
Q

What is hypomania?

A
  • symptoms similar to those in mania
  • but not sever enough to impair functioning
    so = less severe form of mania
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11
Q

What is the difference between bipolar I vs II?

A

I = depressive/ manic/ hypomaic episodes present

  • previous manic/ depressive episode may have been present
  • psychosis also may be present

II = major depression/ hypomanic episodes
- history of at least one episode of major depression/ hypomania

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12
Q

Describe Cylcothymic disorder, one of the subtypes of bipolar diorder

A
  • within 2 yrs = cycle of hypomanic episodes at w/ depressive symptoms
  • major depression not severe enough = major depression
  • no history of major depression/ mania
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13
Q

Who is Nathalie?

A
  • og quiet person + periods of depression
  • sudden change in energy + xp grandiose delusions
    = diagnosed with bipolar I
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14
Q

What is…

  1. Rapid cycling
  2. Ultra-rapid cycling
  3. Ultradian cycling
A

The different cycling nature of bipolar disorder:

  1. 4+ episodes of manic/ hypomanic + depressive symptoms within one year
  2. Extreme fluctuation over a period of days
  3. Extreme fluctuation within the same day
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15
Q

What are some symptoms of someone experiencing a manic episode?

A
  • extremely elevated mood
  • grandiose ideas
  • flight of ideas
  • Distractibility
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16
Q

Some patients can have both manic + depressive episodes together. Why is this particularly dangerous?

A
  • increased risk of suicide

- recurring thoughts of death + impulsivity (Swann et al, 2007)

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17
Q

What are the monoamine neurotransmitter?

A

Dopamine, serotonin + norepinephrine

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18
Q

Which genes have been suggested to have a role in the development of depression?

A
  1. Seretonin transporter gene
    - stress –> depletion of neurotransmitter
  2. DRD4 - dopamine D4 receptor
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19
Q

How is stress related to development of depression (Karg, Burmeister, Shedden + Sen, 2011)?

A

depressed patients = higher cortisol lvls than others

- increased prolonged reactivity to stressor may deplete neurotransmitter system, esp serotonin (Leonard, 2010)

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20
Q

What is the circadian rhythm?

A

describes the cyclical physiological changes than occur within an organism over a repeated time period
eg 24hr sleep-wake cycle

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21
Q

How has the circadian rhythm been suggested to have a role in the development of depression?

A

dsyfunctional central regulator which controls circadian rhythm found in depression (Germain + Kupfer, 2008)

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22
Q

Which neuroanatomical parts of the brain are suggested to have a role in the development of depression?

A
  1. Pre-frontal cortex
    - reduced activity
    (Davidson + Pizzagalli, Nitschke + Putnam, 2002)
  2. Hippocampus
    - reduced size in depressed patients
    (Malhi + Lagopoulos, 2008)
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23
Q

What is thought to be the role of the pre-frontal cortex, related to depression?

A

control fear response from the limbic system esp amygdala

- no control = fear response manifests eg anxiety - symptom of depression

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24
Q

What is thought to be the role of the hippocampus, related to depression?

A

learning + memory

- memory impairment eg memory recollection mediated by hippocampus (Campbell + MacQueen, 2004)

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25
Q

What are some difficulties with drawing conclusions about neuroanatomical irregularities and depression?

A
  1. cannot tell if affect of medication or disorder

2. irregularities as a result of symptom or stable biological markers

26
Q

What are the different biological factors?

A
  1. Genetics
  2. cortisol
  3. circadian
  4. neurotransmitters
27
Q

What are the different psychological factors?

A
  1. Behavioural
    - loss of positive social reinforcement
    - Lewinsohn
  2. Psychodynamic
    - Low self-esteem
    - Guilt
  3. Cognitive
    - Negative interpretations
    - learned helplessness
  4. Environmental
    - Stress
    - genetic vulnerability for stress
28
Q

How did Freud explain how depression developed (Psychodynamic)?

A

Emphasis on: LOW self-esteem

  1. Loss of a loved one/ figure = negative effect on self-esteem
  2. This reflected via guilt, self-criticism etc = trigger depression
29
Q

What did McWilliams (1994) emphasised was important in the development of depression (Psychodynamic)?

A

emphasis on: GUILT
- even children likely to develop depressive feelings from depressed parents because of the guilt they xp from imagined role

30
Q

What are the criticisms of the psychodynamic explanation of the development of depression?

A
  • not everyone who loses someone = depression

- Freud making conclusions from a small sample of viennese women (Dozois, 2000)

31
Q

What does the behaviourist approach emphasise in the development of depression?

A

LOSS of positive social reinforcement

  1. Learn you are happy with job/ in a relationship
  2. Loss of either = loss of the positive reinforcement
32
Q

What did Lewinsohn emphasised were important in the development of depression (behaviourist approach)?

A
  1. Social environment
    - can’t find another job = withdrawn from all positive job related reinforcement
  2. behaviour of individual
    - shy = unable to make new friends
33
Q

What are some criticism of the behaviourist explanation of depression?

A
  • lacking empirical evidence

- doesn’t consider the emotional + cognitive factors (Blaney 1977, Eastman, 1976)

34
Q

What does the cognitive explanation emphasise on being important for the development of depression?

A

THOUGHT process
Ellis (1993)
- the negative interpretation = problematic = depressive emotional reaction

Learned helplessness = HOPELESSNESS
- belief no control over their physical/ social environment (seligman, 1975) = hopelessness

35
Q

What are some faulty thinking present in depression?

A
  1. Catastrophic thinking
    - worst will always happen
  2. Overgeneralising
    - negative generalisation made from isolated incidents
36
Q

What environmental factor has been emphasised to have an intricate relationship with depression?

A

STRESS

- actue (loss of job) + chronic (relationship difficulties)

37
Q

What type of stress is more likely to lead to depression?

A

stress from loss, social rejection/ humiliation more likely = depression VS stress from dangerous situations

38
Q

How is genetics related to the environmental explanation for the development of depression?

A

genetic role in the vulnerability to stress:
- evidence of POLYMORPHISM of serotonin transporter mediating relationship between stress + depression (Karg et al, 2011)

39
Q

What environmental factors offer some protection against depression being triggered by stress?

A
  • familia support
  • financial support
  • participation in sport
40
Q

Is there a high genetic component for bipolar disorder?

A

HIGH concordance rate
MZ = 20/75%
Dz = 0-8%
* also evidence genes responsible for the regulation of circadian rhythms play a role in disorder (Soria et al, 2010)

41
Q

What are the different explanations for the aetiology of bipolar disorder?

A
  1. biological
    - high genetics component
    - brain abnormalities
42
Q

What brain abnormalities are observed in people with bipolar disorder?

A
  1. enlarged amygdala (Arnone et al, 2009)
    - generation of emotional response
  2. decreased cerebellum volume (Baldacara et al, 2011)
    - emotional regulation
  3. Fluctuation between dopaminergic + serotonergic systems when in depressed/ manic phase
    - increased serotonin lvl in limbic system when in depressed phase (Heinzel + Muller, 2012)
43
Q

How do the psychodynamic approach explain the mania part of bipolar disorder?

A
  1. Freud: symbolic liberation from the depression

2. Melanie Klein: defence mechanism triggered by guilt for the hostile feels they held for their loved ones

44
Q

What do the behavioural approach say about the mania part of bipolar disorder?

A

at risk of heightened sensitivity to reward

= get more pleasure from a positive event (Johnson + Jones, 2009)

45
Q

What do the cognitive + environmental explanations say about the mania part of bipolar?

A 
Cognitive = certain thinking style = increased risk eg acting before thinking, over confidence (Johnson + Jones, 2006)
Environment = home which emphasise achievement/ ambition related to manic symptoms (Chen + Johnson, 2012)
46
Q

Which country has the highest and lowest prevalence of bipolar disorder?

A

USA = 4.4% VS India = 0.1%

47
Q

What are biological treatment approaches for major depression?

A
  1. Antidepressants

2. Electroconvulsive therapy (ECT)

48
Q

What are the 3 main classes of antidepressants for major depression?

A
  1. Tricyclics
  2. Selective Serotonin re-uptake inhibitors (SSRI)
  3. Serotonin + noradrenaline re-uptake inhibitors (SNRI)
49
Q

How do the antidepressants tricyclics work for the treatment of major depression?

A
  • Amitriptyline
    prevent absorption of serotonin + norepinephrine
    SA: dry mouth, increased heartbeat + constipation
50
Q

How do the antidepressants SSRI work for the treatment of major depression?

A
  • Fluoxetine
    stop re-uptake of serotonin
    SA: nausea, anxiety, indigestion
51
Q

How do the antidepressants SNR work for the treatment of major depression?

A
  • Venlafaxine
    obstruct obstruction of norepinephrine + serotonin
    SA: nausea, anxiety, indigestion
  • not be used for ppl with existing heart problems
52
Q

How does Electroconvulsive Therapy (ECT) work for the treatment of major depression ?

A
  • producing a seizure by applying electric current to the brain
  • used when all other options are not working
    ST-SA: headaches, muscle ache
    LT-SA: memory problems
53
Q

What are the psychological treatment for major depression?

A
  1. CBT

2. Behavioural Activation Therapy

54
Q

How does Behavioural Activation Therapy for the treatment of major depression?

A
  • main goal to increase number of enjoyable activities an individual engages in
55
Q

What are the main biological treatments for bipolar disorder?

A
  1. Mood-stabilising drugs

2. Antipsychotic drugs

56
Q

How do mood-stabilising drugs work for the treatment of bipolar disorder?

A
  • Lithium, Sodium Valproate
  • unsure how it works
  • works on both parts of bipolar disorder
    SA: weight gain, thirstiness, blurred vision
57
Q

How do antipsychotic drugs work for the treatment of bipolar disorder?

A
  • usd for bipolar 1 = psychosis may be present
  • Olanzapine, Risperidone
  • alt lvls of neurotransmitters esp serotonin + dopamine
58
Q

What are psychological treatment for bipolar disorder?

A
  1. CBT
  2. Psychoeducation
  3. Family Focused Therapy (FFT)
59
Q

How does psychoeducation for the treatment of bipolar disorder work?

A
  • improve understanding of the disorder for the individual + family
  • symtoms, treatments, coping strategies etc
  • create a more caring + understanding environment to reduce environmental stressors + likelihood of relapse
60
Q

How does Family-Focused therapy (FFT) for the treatment of bipolar disorder work?

A

work on psychoeducation + positive communication

Clinical Psychology (17 decks)

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