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Psychopathology > Bipolar and Depressive Disorders > Flashcards

Bipolar and Depressive Disorders Flashcards

1
Q

A manic episode is characterized by ________ mood and ________ for at least ________. It includes ________ characteristic symptoms (e.g., ________ , ________, ________) and marked impairment in functioning, a ________ to avoid harm to self or others, and/or the presence of ________.

A
  • an abnormally and persistently elevated, expansive, or irritable
  • increased activity or energy
  • one week
  • three or more
  • inflated self-esteem or grandiosity
  • decreased need for sleep
  • flight of ideas
  • need for hospitalization
  • psychotic features
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2
Q

A hypomanic episode is characterized by ________ mood; ________; and ________ symptoms of mania for at least ________. Symptoms are ________ to cause marked impairment in functioning or a need for hospitalization and do not include ________.

A
  • an abnormally and persistently elevated, expansive, or irritable
  • increased activity or energy
  • three or more
  • four consecutive days
  • not severe enough
  • psychotic features
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3
Q

A major depressive episode is characterized by ________ characteristic symptoms with at least one symptom being ________ or ________. Symptoms last for at least ________ and cause significant ________.

A
  • five or more
  • depressed mood
  • loss of interest or pleasure in most or all activities
  • two weeks
  • distress and/or impaired functioning
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4
Q

The diagnosis of bipolar I disorder requires:

A

At least one manic episode that may or may not have been preceded or followed by one or more major depressive or hypomanic episodes.

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5
Q

The diagnosis of bipolar II disorder requires:

A

At least one hypomanic episode and at least one major depressive episode.

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6
Q

The diagnosis of cyclothymic disorder requires:

A
  • numerous periods of hypomanic symptoms that do not meet the criteria for a hypomanic episode
  • numerous periods of depressive symptoms that do not meet the criteria for a major depressive episode.
  • the minimum duration of symptoms for cyclothymic disorder is two years for adults or one year for children and adolescents.
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7
Q

What are the concordance raes for bipolar disorder for the following groups:
* identical twin
* fraternal twin
* child of one parent with bipolar disorder
* child of two parents bipolar disorder

A
  • identical twin - 75% (.67 to 1.0)
  • fraternal twin - 20%
  • child of one parent with bipolar disorder - 25%
  • child of two parents bipolar disorder - 60%
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8
Q

Neurotransmitters that have been linked to bipolar disorder include ________, ________, ________, and ________ (Ayano, 2016), and structural and functional abnormalities have been found in several areas of the brain including ________, ________, ________, and ________ (Miklowitz & Johnson, 2014).

A
  • norepinephrine
  • serotonin
  • dopamine
  • glutamate
  • the prefrontal cortex
  • amygdala
  • hippocampus
  • basal ganglia
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9
Q

Circadian rhythm irregularities linked to bipolar disorder include abnormalities in ________, ________, ________, and ________ (Nusslock & Frank, 2012).

A
  • the sleep-wake cycle
  • the secretion of hormones
  • appetite
  • core body temperature
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10
Q

Evidence-based psychosocial interventions for bipolar disorder include:

A
  • family focused therapy
  • psychoeducation
  • interpersonal and social rhythm therapy
  • cognitive-behavior therapy
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11
Q

With regard to pharmacotherapy, ________ is usually most effective for “classic bipolar disorder” which is characterized by ________, ________, and an onset between ________ of age.

A
  • lithium
  • separation of manic/hypomanic and depressive episodes by long periods of recovery
  • a low likelihood of mixed mood states and rapid cycling
  • 15 and 19 years
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12
Q

Anticonvulsant and second generation antipsychotic drugs are most effective for “atypical bipolar disorder,” which is characterized by ________, ________, ________, and an onset between ________ of age (Aiken, 2018).

A
  • mixed mood states
  • rapid cycling
  • a lack of full recovery between episodes
  • 10 and 15 years
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13
Q

The DSM-5 provides the specifier “with atypical features” for bipolar disorders that involve ________ and at least two of the following: ________, ________, ________, ________.

A
  • mood reactivity
  • significant weight gain or increase in appetite
  • hypersomnia
  • leaden paralysis
  • interpersonal rejection sensitivity
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14
Q

The diagnosis of major depressive disorder:

A
  • requires five or more symptoms of a major depressive episode for at least two weeks
  • at least one symptom being depressed mood or loss of interest or pleasure in most or all activities.
  • specifier with peripartum onset: onset of symptoms is during pregnancy or within four weeks after delivery
  • specifier with seasonal pattern: temporal relationship between mood episodes and time of year, which is usually winter.
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15
Q

Up to ____ of women experience “baby blues” after the birth of their children and, according to DSM-5, about ________ have symptoms that are sufficiently severe to meet the criteria for a major depressive episode ________. [Note that other sources report higher rates of major depressive disorder with peripartum onset, usually within the ________ range (e.g., English et al., 2018).

A
  • 80%
  • 3 to 6%
  • during pregnancy or the weeks or months following delivery
  • 10 to 20%
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16
Q

The symptoms of seasonal affective disorder (SAD) include:

A
  • hypersomnia
  • overeating
  • weight gain
  • a craving for carbohydrates
17
Q

SAD has been linked to a lower-than-normal level of ________ and a higher-than-normal level of ________, which is a hormone that plays an essential role in the sleep-wake cycle. SAD is often responsive to ________ which involves exposure to bright light that suppresses the production of melatonin.

A
  • serotonin
  • melatonin
  • phototherapy
18
Q

The diagnosis of persistent depressive disorder:

A

requires a depressed mood with two or more characteristic symptoms (e.g., poor appetite or overeating, insomnia or hypersomnia, feelings of hopelessness) for at least two years in adults or one year in children and adolescents.

19
Q

The diagnosis of disruptive mood dysregulation disorder:

A

Requires the presence for at least 12 months of:

  • severe and recurrent temper outbursts that are verbal and/or behavioral, are grossly out of proportion to the situation or provocation, and occur three or more times each week; and
  • a persistently irritable or angry mood that is observable to others most of the day and nearly every day between outbursts.
20
Q

During childhood, the rates of depression are ________ for boys and girls; however, the rate for females ________ in early adolescence while the rate for males ________. Explanations for this gender difference incorporate the impact of ________ and psychological factors.

A
  • similar
  • increases
  • remains fairly stable
  • biological
21
Q

The higher rate of depression for females persists into adulthood, with female adolescents and adults having a rate that is ________ times higher than the rate for male adolescents and adults.

A

1.5 to 3

22
Q

According the NSDUH, from 2009 to 2017, the highest rates of depression (with three exceptions) were for respondents ages ________ followed by, in order, respondents ages ________, ________, and ________.

A
  • 12 to 17
  • 18 to 25
  • 26 to 49
  • 50+

The exceptions were in 2009, 2010, and 2017: In 2009, respondents ages 12 to 17 and 18 to 25 had a similar rate; in 2010, respondents ages 18 to 25 had a slightly higher rate than those ages 12 to 17; and, in 2017, respondents ages 12 to 17 and 18 to 25 again had similar rates.

23
Q

What are the concordance rates for depression among monozygotic and dizygotic twins?

A
  • 50% (.50) for monozygotic twins
  • 20% (.20) for dizygotic twins
24
Q

Studies looking at neurotransmitters have found that depression is related to low levels of ________, ________, and ________.

A
  • serotonin
  • dopamine
  • norepinephrine
25
Q

Depression has been associated with abnormalities in the ________ axis, which plays an important role in the body’s reaction to stress: Exposure to chronic stress (especially early in life) has been found to lead to ________ and ________, the primary stress hormone, which are associated with an ________ for depression (Nandam et al., 2020)

A
  • hypothalamic-pituitary-adrenal (HPA)
  • persistent hyperactivity of the HPA axis
  • hypersecretion of cortisol
  • increased risk
26
Q

Neuroimaging studies have linked depression to structural and functional abnormalities in:

A
  • the prefrontal cortex
  • cingulate cortex
  • hippocampus
  • caudate nucleus
  • putamen
  • amygdala
  • thalamus
  • several other areas of the brain
27
Q

With regard to the prefrontal cortex, the studies have found that depression is associated with abnormally high levels of activity in ________ and abnormally low levels of activity in ________ and that remission of depressive symptoms in response to psychotherapy or an antidepressant is associated with the ________ (Koenigs & Grafman, 2009).

A
  • the ventromedial prefrontal cortex (vmPFC)
  • the dorsolateral prefrontal cortex (dlPFC)
  • opposite pattern (i.e., to decreased activity in the vmPFC and increased activity in the dlPFC)
28
Q

Lewinsohn’s (1974) social reinforcement theory describes depression as the result of a low rate of ________ for social behaviors due to a lack of reinforcement in the environment and/or poor social skills. This results in ________, ________, ________, and other characteristics of depression that, in turn, further ________ of positive reinforcement in the future.

A
  • response-contingent reinforcement
  • social isolation
  • low self-esteem
  • pessimism
  • decrease the likelihood
29
Q

Seligman’s (1974) original version of the learned helplessness model links depression to ________ that results in ________, and a reformulated version stresses the role of a ________ that involves attributing negative life events to stable, internal, and global factors.

A
  • repeated exposure to uncontrollable negative life events
  • a sense of helplessness
  • negative cognitive style
30
Q

Beck’s (1974) cognitive theory attributes depression to a negative cognitive triad that consists of ________.

A

negative thoughts about oneself, the world, and the future

31
Q

The treatment of major depressive disorder ordinarily consists of ________ and/or ________.

A
  • a psychosocial intervention
  • pharmacotherapy
32
Q

In treating depression in adolescents, the APA recommends ________ or ________ as a psychosocial intervention and ________ as a first-line medication. However, it notes there is insufficient evidence to recommend either of these treatments (psychotherapy or fluoxetine) over the other.

A
  • cognitive-behavioral therapy (CBT)
  • interpersonal psychotherapy for adolescents (IPT-A)
  • fluoxetine
33
Q

In treating depression in adults, the APA guideline recommends that clinicians offer patients either psychotherapy or ________. The psychotherapies it recommends are ________, ________, ________, ________, ________, and ________. Although it does not recommend one therapy over the others, it recommends ________ as a combined treatment.

A
  • a second-generation antidepressant (an SSRI or SNRI)
  • CBT
  • mindfulness-based cognitive therapy (MBCT)
  • interpersonal therapy (IPT)
  • behavioral therapy
  • psychodynamic therapy
  • supportive therapy
  • CBT or IPT plus a second-generation antidepressant
34
Q

In treating depression in older adults, the guideline recommends that clinicians offer patients either ________ or the combination of ________.

A
  • group cognitive-behavioral therapy (group-CBT)
  • IPT and a second-generation antidepressant
35
Q

Suicide rates in the United States ________ from 2000 to 2018 but then ________ from 2018 to 2020. Rates have been consistently higher for ________ , with rates from 2000 to 2020 being 3 to 4 times higher for ________.

A

increased
decreased slightly
males than for females
males

36
Q

Overall, the suicide rates were highest in 2020 for individuals ages ________ and for ________ followed by, in order, Whites, Hispanics, Blacks, and Asians/Pacific Islanders. However, when gender and age are both considered, the highest rate for males in 2020 was for those ________, but the highest rate for females was for those ________ of age.

A
  • 75 and older
  • American Indians/Alaska Natives
  • 75 years of age and older
  • 45 to 64 years

Psychopathology (4 decks)

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