Chapter 13 - Psychosocial Problems Flashcards
What is the most common psychological disturbance among adolescents?
depression
What is the difference between depressed mood and major depressive disorder?
depressed mood
- feeling down, sad, empty, frustrated, stressed, unmotivated
- but passes
depressive disorders
- much more serious, can be disabling
- involve serious disturbances in mood
- extreme sadness/irritability
What are the 3 main areas of disturbance in depression?
affect/emotion
cognition
behaviour/functioning
How is emotion/affect disturbed in depression?
feelings of sadness, lowered mood, worthlessness, guilt
anhedonia - without pleasure
- decreased interest in previously enjoyed activities
- nothing feels good anymore
How is cognition disturbed in depression?
negative thoughts involving self-criticism, self-blame, expectations of negative outcomes
decreased concentration, slowed thinking
thoughts of death or suicide
How is behaviour/functioning disturbed in depression?
fatigue aches and pains change in sleep, appetite, weight behavioural slowing agitation loss of sexual desire/performance reduced participation in activities
How is adolescent depression typically displayed?
irritable mood
misinterpreted as annoying and argumentative
undetected and undiagnosed
What are some notable depressive symptoms in adolescence?
withdrawal from family
co-occurring substance misuse
NSSI
What is smiling depression?
non-clinical term describing people who mask their symptoms of depression
work hard to disguise symptoms
adolescents frequently hide depression
Why do youth keep their depression a secret?
fear of burdening others
- don’t want to stress family/friends
embarrassment over appearing weak or imperfect
denial
fear of peer disapproval
guilt and shame
- “shouldn’t be depressed”
- feel they must be doing something wrong
unrealistic views of happiness
- influenced by social media
- believe they are the only ones struggling
What are some signs to look for in youth to determine depression?
neuro-vegetative symptoms
change in habits, fatigue, loss of interest
What are the 3 main DSM-5 depressive disorders?
major depressive disorder (MDD)
persistent depressive disorder (dysthymia)
- chronic
premenstrual dysphoric disorder (PMDD)
What is premenstrual dysphoric disorder?
intense emotional and physical symptoms in the weeks prior to menstruation
markedly depressed mood, intense mood swings, increased sensitivity to rejection, anxiety, panic attacks, anhedonia
similar to PMS but so severe it impairs functioning in social activities, work, and relationships
typically starts in adolescence
What is major depressive disorder?
recurrent, discrete episodes of at least 2 weeks with clear changes in affect, cognition, and physical functions
inter-episode remissions
What are the DSM-5 criteria for MDD?
a) many symptoms, at least one of which is depressed mood or loss of interest/pleasure
- weight loss/gain
- appetite change
- insomnia or hypersomnia
- feeling worthless or guilty nearly everyday
- recurrent thoughts of death
b) symptoms cause significant distress or impairment in multiple areas of functioning
c) episode not attributable to physiological effects of a substance or other medical condition
d) episode can’t be explained by another psychological disorder
e) never been a manic episode
What is dysthymia?
ongoing, low-level depression
at least 2 years
same symptoms as MDD but less intense and continuous
“a veil of sadness”, chronic depressed mood
symptoms hard to spot, mild enough to hide easily and function daily
What happens when dysthymia starts in adolescence or earlier?
youth come to believe that depression is part of their personality
don’t remember what it feels like not to be depressed
What is double depression?
MDD and PDD at the same time
often PDD experience worsening symptoms resulting in onset of MDD
- often triggered by trauma
What is the difference between sadness and depression?
sadness
- caused by specific trigger
- temporary, distractible
- can sleep, eat, remain motivated
- a normal emotion!
depression
- no trigger needed
- all consuming
- serious disruption of eating, sleeping, motivation
- pervasive sense of worthlessness and guilt
How prevalent are depressive disorders in adolescence?
17% of 12-19 year olds have experienced a major depressive episode
15-24 year olds have highest rates of mood and anxiety disorders
- and increasing, though treatment rates are not changing
What are the biological factors contributing to depression?
genetics
NT imbalance
brain structure and processing difference
cortisol release
What is the diathesis stress model?
some people have a diathesis (vulnerability/predisposition) to depression
some people experience a stressor (negative circumstance/event)
combination of diathesis and stress = depression
What are some potential stressors for youth depression?
normative events
- puberty, grade transition
non-normative events
- divorce, moving
living in neighbourhoods with low collective efficacy
poor peer relationships
romantic relationship issues
cognitive factors
response style
How can peer relationships cause depression?
bullying/exclusion
strained relationships compounded by alienating behaviours that lead to avoidance by peers
- cycle of rejection and depression
What are the cognitive factors that can lead to depression?
3 attribution styles
- internal (something about me)
- global (not just this situation, all situations always)
- stable (will go on forever)
learned helplessness
How can response style lead to depression?
rumination
- dwelling on negative thoughts/feelings/events
- amplifies negative mood and depressive symptoms
- more common in females
distraction
- more common in males
- sports, video games, drinking