Bipolar Disorder

Question 1

What are disorders of affect

Answer 1

-a set of psychiatric disorders, also called mood disorders.
-The main types of affective disorders are depression and bipolar disorder.

Question 2

What is a mood disorder?

Answer 2

-Emotions are amplified beyond the normal ups and downs, in either extremely negative or positive directions which can persist for long periods of time.
-Individuals might experience strong feelings of
despair and emptiness; in other instances they may also feel anger or euphoria.
-Disorders involving abnormal affect significantly impair the individual’s ability to function normally.

Question 3

What is unipolar depression?

Answer 3

-Unipolar depression is another name for major depressive disorder.
-The term “unipolar” means that this form of depression does not cycle through other mental states, such as mania.

Question 4

What is bipolar disorder?

Answer 4

-Bipolar disorder, (also known as manic depression) is a serious mental illness that causes unusual and severe mood changes.
-The person may experience ‘highs’ (clinically known as mania) and ‘lows’ (known as depression), which may persist for a few days or many weeks.
-The person may experience distinct episodes of mania and depression, and these episodes may switch rapidly, even multiple times in one week.

Question 5

Maniac Symptoms

Answer 5

Changes in mood
• Long period of feeling euphoric or ‘high’
• Rage; irritability

Changes in behaviour
• Becoming easily distracted, having racing thoughts
• Sudden interest in new activities or projects
• Over-confidence in one’s abilities
• Speaking quickly
• Sleeping less or appearing not to need sleep
• Engaging in risky behaviours (e.g. gambling, sexual promiscuity)

Question 6

Depressive Symptoms

Answer 6

Changes in mood
• Long period of feeling sadness and despair
• Loss of interest in enjoyable activities

Changes in behaviour
• Struggling to concentrate or remember easily
• Withdrawing from activities or friends
• Fatigue or lethargy
• Finding it difficult to make decisions
• Change to appetite or sleeping patterns
• Considering or attempting suicide

Question 7

Psychometric tests

Answer 7

-They are used to measure an individual’s mental capabilities and behaviour.
-They are designed to show your overall suitability for a particular role based on your performance.
-They show your personality characteristics and aptitude/cognitive ability.

Question 8

A good way to measure depression

Answer 8

Beck Depression Inventory (BDI)

Question 9

BDI

Answer 9

A 21-item self-report measure that assesses attitudes and symptoms of depression such as feelings of guilt and hopelessness as well as physiological symptoms such as weight loss. The total score across the test is used to determine the severity of the disorder

Question 10

Each item in the BDI inventory consists of

Answer 10

at least four statements, of which the person taking the test must choose the one that best fits how they have been feeling during a recent period of time (either in the past week or two weeks, depending on the version of the test that is being used)

Question 11

An example of an item in the BDI inventory

Answer 11

I get as much satisfaction out of things as I used to (0)
I don’t enjoy things the way I used to (1)
I don’t get real satisfaction out of anything anymore (2)
I am dissatisfied and bored with everything (3)

Question 12

what’s the minimum score needed to diagnose mild depression

Answer 12

10

Question 13

The range of scores on BDI for moderate depression

Answer 13

19-29

Question 14

What scores on BDI indicates severe depression

Answer 14

30 or more

Question 15

Evaluate the BDI

Answer 15

-It has high validity and reliability as it is an accurate and consistent measure of depression.
-Quantitative measurement as it provides a numerical score, increasing objectivity.
-Allows clinicians to measure deterioration or improvement of depression with treatment.
-It cannot capture the detail and richness that a less structured approach could.
-Validity may be at risk as there could be response bias.
-Depressive patients may exaggerate their responses which will not be an accurate representation of how they are feeling

Question 16

Issues and Debate Beck Depression Inventory: Application to Everyday Life

Answer 16

-Can be used to diagnose and treat depression.
-Can help identify patients with a high risk of suicidal thoughts and death.
-Adapted for use with children below age 13 who suffer from depression.

Question 17

The 3 explanations for depression

Answer 17

• biological: genetic and neurochemical (Oruc et al., 1997)
• cognitive (Beck, 1979)
• learned helplessness/attributional style (Seligman, 1988)

Question 18

The genetic explanation for bipolar disorder

Answer 18

-Some mental disorders are thought to have a genetic basis, meaning they can be transmitted from one generation to the next., such as in first-degree relatives like parents and siblings who share 50% of their DNA.
-Current evidence for bipolar depression suggests that there is at least some genetic explanation for why some individuals are more at risk of developing such disorders.

Question 19

The neurochemical explanation for bipolar disorder

Answer 19

-Imbalance of chemicals affects the functioning of the brain and consequently the mood.
-Depressed individuals have low activity of serotonin and norepinephrine neurotransmitters.

Question 20

Who studied the genetic and neurochemical explanations for depression?

Answer 20

Oruc et al. (1997)

Question 21

Sample of Oruc et al. study

Answer 21

-42 participants (25F, 17M), diagnosed with bipolar disorder, aged between 31-70, were drawn from two psychiatric hospitals in Croatia.
-A healthy control group of 40 participants with no personal/family history of mental disorders were also included (they were also matched for sex and age).
-16 of the bipolar participants had a first-degree relative with major disorders.
-This information was collected from participants and their family members, with diagnosis confirmed through medical records.

Question 22

Procedure of Oruc et al. (1997) study

Answer 22

DNA testing was carried out to test for polymorphisms (gene variation) in serotonin receptor 2c (5-HTR2C) and serotonin transporter (SERT/5-HTT) genes

Question 23

polymorphisms

Answer 23

-a variation in a gene or genes
-rather than the term ‘mutation’ which suggests a unique change, polymorphism refers to the different expressions that may be present in a normal population, even if that expression occurs infrequently

Question 24

Results of Oruc et al. (1997) study

Answer 24

-There were no significant differences between the two groups
-However, serotonin (5-HT) is sexually dimorphic, and females had trends of polymorphism in the serotonin genes, which could be responsible for the increased risk of bipolar in females

Question 25

Sexually dimorphic

Answer 25

any differences in males and females of a species, excluding organs and genitalia

Question 26

Who studied the cognitive explanation for depression

Answer 26

Beck (1979)

Question 27

Outline the cognitive explanation for depression

Answer 27

-Cognitive theorists believe that the negative views of someone with depression form a reality for that person, even if they seem far-fetched to others.
-The reason for the individual’s low mood and physiological symptoms is an underlying process of incorrect information processing.

Question 28

cognitive distortion

Answer 28

-a form of irrational thinking
-an automatic process that develops as a result of earlier life experiences through schemas
-adverse events and schemas activate the underlying negative assumptions and create pessimistic thoughts and beliefs about the future
-results in the emotional, cognitive and behavioural symptoms typical of depression

Question 29

schemas

Answer 29

-units of knowledge about the world
-as we grow and learn, information from our senses is arranged meaningfully in our minds; it helps us to categorise new experiences and details
-our individual systems of schema underlie virtually all cognition, such as reasoning, memory and perception

Question 30

Cognitive Triad

Answer 30

The first component of this model relates to the individual’s view of themselves. Unpleasant experiences are attributed internally; the individual thinks that they are worthless and not capable of being happy
↓
Secondly, the individual perceives the world as presenting them with insurmountable obstacles to happiness and well-being. They misinterpret external forces as being against them
↓
The third component is a negative view of the future; when considering undertaking a specific task in future, the person anticipates failure or rejection

Question 31

Who studied the learned helplessness and attribution style explanation for depression

Answer 31

Seligman et al. (1988)

Question 32

Learned helplessness

Answer 32

-A behaviour that occurs as a result of a person having to endure an unpleasant situation which they perceive as inescapable

Question 33

Seligman et al.’s view

Answer 33

-Depression is a direct result of a real/perceived lack of control over the outcome of one’s situation
-The individual learns that they are unable to control the situation and cannot prevent suffering and so eventually cease to resist it

Question 34

Example of learned helplessness

Answer 34

In Seligman’s 1974 research on dogs, they received electric shocks preventing them from escaping (experiencing a lack of control). They accepted the situation and eventually stopped trying to escape. In future trials, they had an opportunity to escape, but due to past experience, they did not try.

Question 35

Attribution

Answer 35

A cognitive process wherein individuals explain the causes of events and behaviour. It may be faulty/biased as it is based on previous life experiences.

Question 36

What type of attributional style will a person who has had a traumatic experience have

Answer 36

Negative because of their learned helplessness

Question 37

A negative event can be attributed as:

Answer 37

• Internal (personal)/ external (environment)
• Stable (constant)/ unstable (occasional)
• Global (affecting many aspects)/ specific (affecting one aspect)

Question 38

Aim of Seligman et al. (1988) study

Answer 38

how well attributional style could predict depressive symptoms

Question 39

Sample of Seligman et al. study

Answer 39

-39 patients with unipolar depression and 12 with bipolar disorder during a depressive episode from the same clinic
-Included a mix of genders with a mean age of 36
-They were compared with a control group of 10 participants.

Question 40

The procedure of Seligman et al. study

Answer 40

-All participants completed BDI to assess the severity of symptoms
-Then, completed an Attributional Style Questionnaire (ASQ) consisting of 12 hypothetical good and bad situations
-They had to make causal attributions for each event and rate the cause on a 7-point scale for internality, stability and globality

Question 41

Results of Seligman et al. study

Answer 41

-Bipolar and unipolar patients had more pessimistic, negative attributional styles than the control group
-The more severe the score on BDI, the worse the pessimism on ASQ
-For those with unipolar depression undergoing cognitive therapy, an improvement in attributional style correlated with an improvement in BDI score
-Thus, the way we make attributions is an important underlying mechanism of depression

Question 42

Evaluate the study by Oruc et al. (1997)

Answer 42

-Limited sample size makes it difficult to generalise; genetic studies require a large sample to be valid and accurate. Similarly, establishing the importance of serotonin-linked genes in increasing the risk of depressive illness in females requires a large sample.
-Some participants in the study were still within range for detecting the onset of bipolar
disorder. This means the findings might have changed if the researchers had used an older population, so age is an extraneous variable.
-DNA samples were collected and analysed in a lab with automatic equipment, increasing validity and removing researcher bias.

Question 43

Evaluate the study by Seligman et al. (1988)

Answer 43

-Used standardised questionnaires to assess participants. The ASQ and BDI are considered to be valid and reliable measurement tools
-Positive correlation between BDI and ASQ does not indicate a causal relationship

Question 44

Issues and Debates of Explanations for Depression: Nature vs Nurture

Answer 44

-Biological explanation for depression reflects nature in the nature vs nurture debate. As particular genes and neurochemicals are implicated in developing these illnesses, biology is seen as the primary cause.
-Other complementary explanations which might explain why depression is ‘triggered’, e.g. adverse life events are more nurture based

Question 45

Issues and Debates of Explanations for Depression:

Question 46

Issues and Debates of Explanations for Depression:

Question 47

Issues and Debates of Explanations for Depression:

Question 48

Issues and Debates of Explanations for Depression: