Affective Disorders Flashcards
What is the ICD10 classification of mood or affective disorders?
Where the fundamental disturbance is a change in affect or mood to depression or to elation.
Mood change usually accompanied by change in level of overall activity. Most of these disorders are recurrent and onset can be related to stressful events.
2 criteria for depression diagnosis?
- Mood
- Anhedonia
At least 2 weeks + functional impairment.
2 criteria for bipolar disorder?
Constant elation/euphoria
Hyperactivity.
These can rapidly change to low mood, anhedonia etc.
What is the difference between bipolar 1,2, and cyclothymia?
Bipolar 1: Large peaks and troughs of hypermania and depression.
2: Smaller peaks (hypomania), large troughs of depression.
3. Small increases and decreases in mood- could be classed as temperamental disorder.
THERE IS ALOT MORE VARIABILITY THAN STANDARD UP AND DOWN GRAPHS.
How are we now starting to think about bipolar?
Not just as mania and depression, but also lots of small mood changes (instability) and anxiety in between. Graphs of each patient is very different.
What is Beck’s CB model of depression?
Cognitive distortions induce Thoughts (negative) -> Mood (low) -> Behaviour (reduced) and back to thoughts.
How has it been updated today?
There is another layer to the cognitive distortions- automatic thinking, and neurofucntional abnormalities lead to cognitive disortion.
What is emotional information processing?
A series of processes involving attentional, perceptual, appraisal and response preparation operations occuring in an individual during salient internal and external events, impacting on the experience and responses to the events .
Describe cognitive biases.
Emotional stimulus vs neural stimulus-> if emotional distractor interferes with neural distractor, you have an emotional bias.
(longer reaction time for sad faces->they have distracted)
Memory
Perception of facial expressions
Describe Attention biases
Depression is characterised by biases in shifting attention- difficulties in disengaging from negative material.
Depressives will look at the sad face for longer.
This is underpinned by a sustained amygdala response to negative stimuli.
ACC & lateral inferior frontal cortex also associated with attentional biases.
Describe memory biases.
Individuals with depression remember more negative stimuli rather than positive.
Describe Facial expression recognition.
Present faces for half a second.
In depression: Increased recognition of negative faces, and/or less recognition of happy faces.
There is robust evidence of emotion recognition deficits in MDD. There is enhanced amygdala response to negative faces.
Depressives exhibit neurocognitive biases in the automatic processing of emotional information. What are these biases?
Cognitive
Attention
Memory
Facial recognition
What factors are involved in emotion regulation?
Access to memories Facial recognition Prospection Attention Interpretation Cognitive control
What occurs to emotion regulation in depression?
Depressives use emotional regulation strategies differently. There is increased emotion suppression, rumination, catastrophising- these are unhelpful strategies.
There is less reappraisal, self disclosure, positive autobiographical memories.
Depressed individual habitually use maladaptive emotional regulation strategies, but they are still able to use normal strategies- this is a basis for therapy.
