Chapter 6- Depression and Mood

Question 1

Major Depressive Episode

Answer 1

Extremely depressed mood state that lasts for 2+ weeks with cognitive and physical symptoms
Characterized by loss of interest and pleasure

Question 2

Anhedonia

Answer 2

Loss of interest and pleasure

Question 3

Manic Episode

Answer 3

A distinct period of elevated mood with extreme pleasure, hyperactivity, little need for sleep, extremely goal-oriented, and flight of ideas with delusions of grandeur lasting over 1 week
See no problems with behavior

Question 4

Hypomania

Answer 4

Less severe episode than mania that lasts 4 days or more without delusions

Question 5

Major Depressive Disorder

Answer 5

Presence of major depressive episode lasting 4-5 months without mania

Question 6

Recurrent mood disorders

Answer 6

Presence of 2+ major episodes with at least 2 months between episodes

Question 7

Persistent Depressive Disorder

Answer 7

Like major depression with less symptoms and unchanged intensity for long periods; symptoms last for over 2 years

Question 8

Double depression

Answer 8

Experience of major depressive episodes with persistent depressive disorder between episodes

Question 9

Natural Grief

Answer 9

Experience of depressive symptoms- Anxiety, numbness, denial- following loss; Usually lasts 6 months - 1 year

Question 10

Integrated Grief

Answer 10

Later stages of grief
Acknowledgment of finality of death and consequences
Positive, bittersweet memories no longer dominate thoughts
Can recur, typically around significant dates

Question 11

Complicated grief

Answer 11

Abnormal or prolonged grief that becomes disorder
Persistent feelings of acute grief
Share risk factors with mood disorders

Question 12

Premenstrual Dysphoric Disorder (PMDD)

Answer 12

Severe mood changes during the premenstrual period for 2-5% of the population
NOT Premenstrual symptoms (PMS; 20-40%)
Physical symptoms, mood swings, and anxiety

Question 13

Disruptive Mood Dysregulation Disorder

Answer 13

Chronic childhood negative mood (anger/irritability) without mania
Frequent outbursts with negative mood between
Increased risk for depressive and anxious episodes later in life

Question 14

Bipolar Disorders

Answer 14

Alternation between depressive and manic episodes

Question 15

Bipolar I

Answer 15

Major depression alternates with manic episodes
Onset 15-18

Question 16

Bipolar II

Answer 16

Major depression alternates with hypomania, no full manic episodes
Progresses into Bipolar I in 10-25% of cases
Onset 19-22

Question 17

Cyclothymic Disorder

Answer 17

Mild and chronic bipolar disorder that doesn’t reach severity for either major depressive or hypomanic episodes
Must last 2 or more years (1 in children)
Onset 12-14

Question 18

Onset of Bipolar Disorders

Answer 18

Preceded by minor oscillations in mood
Chronic course with high risk of suicide
Highly treatable with lithium

Question 19

Mood Disorder Prevalence Rates

Answer 19

Any Mood: 16% lifetime; 6% annual
Dysthymia and Chronic Major Depression- 3.5% lifetime and annual
Bipolar- 1% lifetime and 0.8% annual

Question 20

Gender Ratio for Mood Disorders

Answer 20

Women > Men 2:1 for MDD and Dysthymia
Women = Men for bipolar disorders

Question 21

Age and Major Depression

Answer 21

Peaks in adolescence and older adults; Low in childhood and middle adulthood

Question 22

Biological Dimensions of Mood Disorders

Answer 22

37% heritability
Risk factors for MDD- Cognitive/Psychomotor, Mood, and Melancholy
Decreased non-REM sleep
Low serotonin in relation to norepinephrine and dopamine
Dopamine associated with mania
High levels of cortisol and HPA axis activity
Depression associated with Hippocampus

Question 23

Psychological Dimensions of Mood Disorders

Answer 23

Stressful life events
Learned helplessness
Negative Cognitive Styles

Question 24

Learned Helplessness

Answer 24

Stable, internal, global depressive attitude that develops into hopelessness about life; Major theory of depression

Question 25

Depressive Cognitive Triad

Answer 25

Negative cognitive errors about self, immediate world, and future

Question 26

Negative cognitive errors

Answer 26

Arbitrary interference- Emphasize negative aspects over positives Overgeneralizations- Taking one piece of information to logical extreme

Question 27

Sociocultural Dimensions of Mood Disorders

Answer 27

Interpersonal stress Gender roles and expectations Social support helps prevent depression

Question 28

Applied Diathesis-Stress Model

Answer 28

Biological and Psychological Vulnerabilities are triggered by stressful life events to trigger mood disorders

Question 29

Classes of Antidepressants

Answer 29

Selective Serotonin Reuptake Inhibitors (SSRI) Mixed Reuptake Inhibitors Tricyclic Reuptake Inhibitors Monoamine Oxidase Inhibitors (MAO)

Question 30

SSRIs

Answer 30

Increase serotonin levels Fluoxetine (Prozac) Side effects- Low sex drive, insomnia, upset stomach, physical agitation

Question 31

Mixed Reuptake Inhibitors

Answer 31

Block reuptake of norepinephrine and serotonin Reduced side effects Venlafaxine (Effexor)

Question 32

Tricyclic Reuptake Inhibitors

Answer 32

Imipramine (Tofranil) and Amitriptyline (Elavil) Causes norepinephrine to pool in synapse and cause down-regulation Severe Side effects- Blurred vision, dry mouth, constipation, UTI, drowsiness, weight gain Not used anymore

Question 33

MAO Inhibitors

Answer 33

Blocks MAO enzyme that breaks down norepinephrine and serotonin, causing neurotransmitters to pool in synapse Fewer side effects as tricyclics with same effectiveness Dangerous drug combinations- only used in severe cases

Question 34

Lithium Carbonate

Answer 34

Mood stabilizer used to treat BPD High side effects, toxicity, hypothyroidism, and weight gain

Question 35

Electroconvulsive Therapy (ECT)

Answer 35

Treatment for drug-resistant depression with controlled seizure

Question 36

Transcranial Magnetic Stimulation (TMS)

Answer 36

Deliver electromagnetic pulse to brain; similar effectiveness to drugs

Question 37

Psychological Mood Disorder Treatment Methods

Answer 37

Cognitive Behavior Therapy (CBT)- Beck Interpersonal Psychotherapy (IPT)

Question 38

Cognitive Behavioral Therapy

Answer 38

Recognize depressive errors of thinking and work through triggers Interpersonal and problem-solving skills Effective in preventing relapse

Question 39

Interpersonal Psychotherapy

Answer 39

Resolve relationship issues and learn to form new relationships Interpersonal issues covered- Role disputes, adjusting to loss, acquiring new relationships, and deficits in social skills

Question 40

Stages of Interpersonal Disputes

Answer 40

1) Negotiation- Both aware and working toward negotiation 2) Impasse- No attempts at resolution; Resentment high 3) Resolution

Question 41

Types of Prevention efforts

Answer 41

Universal- Everyone receives Selected- At risk individuals receive Indicated- Those showing symptoms receive

Question 42

Psychological Treatment for Bipolar Disoder

Answer 42

Major goal- Keep patients on medication during mania Treat psychosocial with IPT with family focus

Question 43

Suicide Terminology

Answer 43

Ideation- Seriously thinking about suicide (9.2%) Planning- Making plan rooted in reality (3.1%) Attempt- Person survives (2.7%)

Question 44

Types of Suicide

Answer 44

Altruistic- Dishonorable and socially approved of Egotistic- Loss of social support Anomic- Marked life disruptions Fatalistic- Loss of control over life

Question 45

Suicide risk factors

Answer 45

Family history Low serotonin Existing disorders Hopelessness Alcohol abuse Impulsivity

Question 46

Suicide Prevention and Treatment

Answer 46

Assess suicidal ideation and planning Forced hospitalization Educational programs Crisis intervention and hotlines CBT