CCAP College 5 Flashcards
Internalizing Disorders in Adolescence
depressive disorder: DSM-V
- MDD
- disruptive mood dysregulation disorder
- premenstral dysphoric disorder
- substance-/medication-induced depressive disorder
disruptive mood dysregulation disorder
characterized by persistent feelings of sadness and worthlessness and a lack of desire to engage in formerly pleasurable activities
anxiety disorders: DSM-V
- GAD
- seperation anxiety disorder
- selective mutism
- specific phobia
- social anxiety disorder
- panic disorder
- panic attack specifier
- agoraphobia
when is sadness not normal?
- difficulty resolving sadness
- persistent
- interferes with daily life
MDD (DSM-V)
5 or more symptoms for at least 2 weeks
MDD = disorder of emotion regulation, with dysregulation in 2 systems:
1) heightened aversive sensitivity and activity
2) lowered appetitive sensitivity
1) heightened aversive sensitivity and activity
more sensitive to NEGATIVE EXPERIENCES AND STIMULI
2) lowered appetitive sensitivity
reduced sensitivity for POSITIVE EXPERIENCES AND STIMULI
- anhedonia
fear
acute threat responses evoked by direct exposure to threatening stimulus
anxiety
potential threat responses evoked by anticipation of exposure to threatening stimulus
- anxiety prevalence: huge peak in females pubety onwards; way smaller peak in males
GAD: DSM-V
excessive anxiety/worry more days than not for at least 6 months
Does the Average Emotional Experience Become More Positive or Negative? (Larson et al., 2002)
do happy people remain happy, or does reordering take place?
- affect and mood decreases with age
results:
- depressed boys and girls remain in angry states longer
- depressed girls remain in dysphoric states longer
- depressed adolescents didn’t maintain happy states for as long as their healthy peers
Neurobiological Mechanisms of Lowered Positive Affect (Forbes et al., 2006)
- reward anticipation phase: lower activity in ACC, caudate and OFC, which means: DECREASED EMOTIONAL REACTIVITY TO REWARD ANTICIPATION
- reward outcome phase: lower activity in ACC, caudate and OFC; more so during loss/small rewards and increased response in amygdala to loss/small rewards which means:
INCREASED EMOTIONAL REACTIVITY TO NEGATIVE OUTCOME
rumination
pattern of repetitive, self-focused thought in response to an emotional state
1: constantly replaying past interactions to understand what went wrong
2: feeling anxious about upcoming events and obsessing over them
effects of rumination
- rumination increases negative affect and decreases positive affect
- rumination interferes with social functioning; avoidance of social situations
- rumination interferes with effective problem solving
—> anger, sadness, poor sleep, shame
Rumination and Psychopathology: Are Anger and Depressive Rumination Differentially Associated with Internalizing and Externalizing Psychopathology? (Du Pont et al., 2018)
depressive and anger rumination
results:
- males with internalizing disorder show more anger rumination (irritability), but also depressive rumination
- females with internalizing disorder mostly experience depressive rumination
Emotional Awareness: Do 3 Year-old Children with Depressed Mothers Recognize Positive Emotions Less Accurately and Negative Emotions More Accurately than Control? (Székelyet et al., 2014)
methods:
- non verbal emotion-matching, and verbal emotion-labeling task
results:
- depressed mother children: reduced accuracy in labeling all emotions
- difficulty correctly connecting verbal labels to facial labels of emotion
- facial expression recognition important for social interactions
Depression and Social Interactions (Kearney et al., 2013)
access to social world
<-> emotional competence
-> mental health
- sad facial expressions, poor affect (no smiling, frowning, complaining), decreased social activity, decreased eye contact
Heritability of Depression (Lee et al., 2022)
BDNF risk factor: Brain-Derived Neurotrophic Factor = protein that plays a crucial role in growth, maintenance and development in brain neurons
- in adolescence, there is a drop in BDNF, which later stabilizes; not the drop, but the SUDDEN CHANGE in BDNF results in INCREASED SUSCEPTIBILITY for developing internalizing disorders and negative experiences
summary: biopsychosocial model of depression
social:
- environmental stress in childhood
- bullying
- abuse, trauma, traumatic brain injury (TBI), maternal stress during pregnancy
psycho:
- affective competence
- emotion regulation & awareness
- rumination
bio:
- dysfunctioning reward related regions/amygdala response
- BDNF
- immune system, genetics, gut bacteria
resilience: protective factors biopsychosocial model
social:
- friends’ modeling and communication
- socialization effect
- parents contingencies: maternal constructive response leads to + affect and less depressive symptoms
psycho:
- high intelligence
- effective parenting
- adult mentor
bio:
- genetic predisposition
- typical neurodevelopment
Maternal Response to Positive Affect (Fredrick et al., 2018)
parental responses to positive affect
- enhancing: acknowledge, encourage, reciprocate
- dampening: punishing, interfering (depressive symptoms)
active-constructive maternal response leads to increased positive affect regulation, which reduced depressive symptoms
