Chap 9: Depression/ Bipolar

Question 1

– Depressive disorders excessive unhappiness

Answer 1

dysphoria

Question 2

loss of interest in activities

Answer 2

anhedonia

Question 3

Bipolar disorder mood swings from deep sadness to

high elation

Answer 3

euphoria

Question 4

expansive mood

Answer 4

mania

Question 5

• A pervasive unhappy mood disorder
– More severe than the occasional blues or mood
swings everyone experiences
-Children who are ________ cannot shake their sadness -
interferes with their daily routines, social relationships,
school performance, and overall functioning
– Often accompanied by anxiety or conduct disorders
– Often goes unrecognized and untreated

Answer 5

Depression

Question 6

Depression and Development

Answer 6

• Experience and expression of depression change with
age
• In children under age 7 (as young as 3-5)
– Tends to be diffuse and less easily identified
– Anaclitic depression (Spitz) - infants
• Infants raised in a clean but emotionally cold institutional
environment showed depression-like reactions, sometimes
resulting in death
• Similar symptoms can occur in infants raised in severely
disturbed families

Question 7

– May appear extremely somber and tearful, lacking
exuberance; may display excessive clinging and whiny
behavior around mothers

Answer 7

Preschoolers

Question 8

– The above, plus increasing irritability, disruptive

behavior, and tantrums

Answer 8

School-aged children

Question 9

– The above, plus self-blame, low self-esteem,

persistent sadness, and social inhibition

Answer 9

Preteens

Question 10

: feeling sad or miserable
– Occurs without existence of serious problem, and
is common at all ages

Answer 10

Depression (symptom):

Question 11

: a group of symptoms that
occur together more often than by chance
– Mixed symptoms of anxiety and depression that
tend to cluster on a single dimension of negative
affect

Answer 11

Depression (syndrome):

Question 12

• Has a minimum duration of two weeks
• Is associated with depressed mood, loss of interest, and
other symptoms; and significant impairment in functioning

Answer 12

Major depressive disorder (MDD):

Question 13

is generally less
severe but with longer lasting symptoms (a year or
more) and significant impairment in functioning

Answer 13

– Dysthymic disorder depressed mood

Question 14

Prevalence
• Between 2% and 8% of children ages 4-18 experience
MDD
• Depression is rare among preschool and school-age
children (1-2%)
– Increases two- to threefold by adolescence
• The sharp increase in adolescence may result from
biological maturation at puberty interacting with
developmental changes

Answer 14

….

Question 15

Most common comorbid disorders of Depression include:

–

Answer 15

Anxiety disorders (especially GAD), specific phobias,
and separation anxiety disorders
Other common comorbid disorders are:
– Dysthymia, conduct problems, ADHD, and
substance-use disorder
-60% of adolescents with MDD have comorbid
personality disorders, especially borderline
personality disorder

Question 16

Is characterized by symptoms of depressed mood
that occur on most days, and persist for at least one
year
– Child with P-DD also displays at least two somatic
or cognitive symptoms
• Symptoms are less severe, but more chronic than
MDD
Characterized by poor emotion regulation
– Constant feelings of sadness, of being unloved and
forlorn, self-deprecation, low self-esteem, anxiety,
irritability, anger, and temper tantrums
– Children with both MDD and P-DD are more
severely impaired than children with just one
disorder

Answer 16

Persistent Depressive Disorder [P-DD] (Dysthymia)

Question 17

Depression and Suicide

Answer 17

• Most youngsters with depression think about suicide,
and as many as one-third who think about it, attempt it
• Most common methods for those who complete suicide are
firearms, hanging, suffocation, poisoning, and overdose
– Worldwide, the strongest risk factors are having a
mood disorder and being a young female
– Ages 13 and 14 are peak periods for a first suicide
attempt by those with depressio

Question 18

• Depression is viewed as the conversion of aggressive
instinct into depressive affect
– Results from the actual or symbolic loss of a love
object
• Children and adolescents were believed to have
inadequate development of the superego or
conscience
– Therefore, they do not become depressed

Answer 18

Psychodynamic Theories

Question 19

• Emphasize the importance of learning,
environmental consequences, and skills and deficits
during the onset and maintenance of depression
• Depression is related to a lack of responsecontingent positive reinforcement

Answer 19

Behavioral Theories

Question 20

Focus on relationship between negative thinking and
mood
• Emphasize “depressogenic” cognitions
– Negative perceptual and attributional styles and
beliefs associated with depressive symptoms
• Hopelessness theory
– Depression-prone individuals have a negative
attributional style (blame themselves for negative
events in their lives)

Answer 20

Cognitive Theories

Question 21

– Negative perceptual and attributional styles and

beliefs associated with depressive symptoms

Answer 21

depressogenic

Question 22

– Depression-prone individuals have a negative
attributional style (blame themselves for negative
events in their lives)

Answer 22

Hopelessness theory

Question 23

depressed individuals make
negative interpretations about life events
– Biased and negative beliefs are used as
interpretive filters for understanding events
– Three areas of cognitive problems
• Information-processing biases
• Negative outlook regarding oneself, the world, and the
future (negative cognitive triad)
• Negative cognitive schemata

Answer 23

Beck’s cognitive model

Question 24

When children are depressed

Answer 24

– Families display more critical and punitive behavior
toward the depressed child than toward other
children

Question 25

When parents are depressed

Answer 25

– Depression interferes with the parent’s ability to meet
the needs of the child
– Child experiences higher rates of depression phobias,
panic disorder, and alcohol dependence as
adolescents and adults

Question 26

• Features a striking period of unusually and
persistently elevated, expansive, or irritable
mood, alternating with or accompanied by one
or more major depressive episodes
– Elation and euphoria can quickly change to
anger and hostility if behavior is impeded
• May be experienced simultaneously with
depression
• Young people with BP display:
– Significant impairment in functioning, including
previous hospitalization, MDD, medication
treatment, co-occurring disruptive behavior and
anxiety disorders
• History of psychotic symptoms, and suicidal
ideation/attempts are common

Answer 26

Bipolar Disorder

Question 27

Three subtypes of BP

Answer 27

– Bipolar I disorder
– Bipolar II disorder
– Cyclothymic disorder

Question 28

• Symptoms include restlessness, agitation,
sleeplessness, pressured speech, flight of ideas,
racing thoughts, sexual disinhibition, surges of
energy, expansive grandiose beliefs

Answer 28

Bipolar Disorder

Question 29

multimodal plan for BP

Answer 29

Monitoring symptoms closely
– Educating the patient and the family
– Matching treatments to individuals
– Administering medication, e.g., lithium
– Addressing symptoms and related psychosocial
impairments with psychotherapeutic interventions