Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSYC 337 > Chapter 7 > Flashcards

Chapter 7 Flashcards

1
Q

Mood disorders definition

A
  • abnormal mood is the defining feature
  • disturbances of mood are intense and persistent enough to lead to serious problems in relationships/at work
  • two key moods are depression and mania (can be just depression or can be both, can feel ‘normal’ in between)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Depressive mood state

A
  • feelings of extraordinary sadness and dejection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Manic mood state

A
  • characterized by intense/unrealistic feelings of excitement and euphoria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mixed-episode cases

A
  • when a person has symptoms of mania and depression during the same time period
  • rapidly alternating moods within same episode of illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Unipolar depressive disorders

A
  • mood disorder in which a person experiences only depressive episodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bipolar disorders

A
  • mood disorders in which a person experiences both manic and depressive episodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The most common form of mood disturbance involves…

A

a depressive episode (markedly depressed or loss of interest in formerly pleasurable activities for 2 weeks+; plus other symptoms like changes in sleep or appetite)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Manic episode

A
  • markedly elevated, euphoric, or expansive mood (often interrupted by periods of intense irritability or violence)
  • persist for at least a week
  • plus 3 or more additional symptoms (behavioral, mental, or physical)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypomanic episode

A
  • abnormally elevated, euphoric, or expansive mood for at least 4 days
  • must have at least 3 other symptoms involved in mania
  • don’t have to have as many symptoms as for manic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

DSM-5 criteria for Manic Episode

A

A: distinct period of abnormally elevated, expansive, or irritable mood + increased goal-directed activity or energy lasting at least 1 week (most of the day on most days)
B: three or more additional symptoms from:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual
- Racing thoughts
- Distractibility
- Increase in goal-directed activity or psychomotor agitation
- Excessive involvement in activities that have high potential for painful consequences
C: disturbance sufficiently severe to cause impairment in social/occupational functioning
D: episode not attributable to effects of a substance or medical condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mood disorders occur ___x more frequently than schizophrenia

A

15 to 20 (almost same rate as all anxiety disorders together)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Major depressive disorder

A
  • MDD, major depression, unipolar depression
  • most common serious mood disorder
  • occurrence has increased in recent decades
  • US lifetime prevalence rate 17% (12mo rate 7%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mood disorders worldwide prevalence

A
  • second most prevalent (second to anxiety disorders)
  • 12mo prevalence of 1-10% across diff. countries
  • highest in United States, lowest in Nigeria (might be ab measurement and not actual prevalence)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Gender differences in MDD

A
  • higher in women (about 2:1); similar to anx. disorders
  • boys equally or more likely to be diagnosed as schoolchildren
  • women more likely to be diagnosed in starting in adolescence until 65
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bipolar disorder prevalence

A
  • lifetime risk of developing classic form is 1%
  • no discernable sex differences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ethnicity and prevalence of mood disorders in the US

A
  • less frequent among African Americans vs European white Americans and Hispanics
  • Native Americans have higher rates vs white americans
  • no significant differences for bipolar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

SES and unipolar/bipolar disorders

A
  • low SES = higher rates of unipolar disorders
  • bipolar not related, despite previous research indicating it was linked to high SES
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Artists and mood disorders

A
  • elevated rates, esp. for bipolar
  • productivity of some artists dramatically increases during manic episodes
  • mania or hypomania might facilitate creative process
  • intense negative emotions of depression may provide material for creative activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mild and brief depression may be…

A

“normal” and adaptive in the long run

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

DSM5 Criteria for Major Depressive Disorder

A

A: 5+ symptoms present in same 2-week period; at least 1 is depressed mood or loss of interest/pleasure
- depressed mood most of day on most days
- markedly diminished interest/pleasure in almost all activities
- significant weight loss or increase/decrease in appetite
- insomnia or hypersomnia
- psychomotor agitation or retardation (has to be observable by others!)
- fatigue or loss of energy
- feelings of worthlessness or excessive guilt
- diminished ability to think/concentrate
- recurrent thoughts of death, suicidal ideation, suicide attempt or plan
B: clinically significant distress or impairment
C: episode not attributable to substance or medical condition
D: not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other schizophrenia spectrum/psychotic disorders
E: there has never been a manic or hypomanic episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

There is a high comorbidity or depressive disorders with…

A

anxiety disorders!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Length of MDD

A
  • typically 6 to 9mo if untreated
  • in 10-20% of cases, systems do not remit for over 2 years (persistent depressive disorder)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Relapse vs. recurrence

A
  • relapse: return of symptoms within short period of time (usually bc underlying episode has not yet run its course)
  • recurrence: onset of a new episode of depression (40-50% of ppl who have one episode)
  • probability of recurrence increases w additional past episodes and w comorbid conditions
  • might have symptoms 1/2-2/3 of time in between episodes (this group more likely to have recurrence)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

PHQ-9

A
  • patient health questionnaire
  • self-report depression questionnaire
  • diagnostic interview (gold standard) takes 1h30
  • most studies use self-report bc it takes much less time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Depression in childhood

A
  • used to think kids can’t have depression
  • fairly uncommon, 1-3% of school-age children
  • recurrence rates are high like with adults
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Depression in adolescence

A
  • onset most often late adolescence to middle adulthood
  • 15-20% of teens experience MDD at some point
  • another 10-20% experience subclinical depression
  • sex differences first emerge (2x more women)
  • can have long-lasting effects throughout young adulthood
  • very likely to recur in adulthood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Depression in adults

A
  • prevalence lower in those over 65
  • difficult to diagnose later in life bc many symptoms overlap with other issues associated w ageing
  • many adverse consequences, 2x risk of death for those who’ve had a heart attack or stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Specifiers

A
  • diff. patterns of symptoms that sometimes characterize MD episodes that may help predict course and preferred treatments for the condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Major depressive episode with melancholic features

A
  • specifier of MDD
  • might involve: wake up very early, depression worse in morning, psychomotor agitation/retardation
  • applied when person meets criteria for major depressive episode AND has lost pleasure/interest in activities or does not react to usually pleasurable stimuli
  • more heritable than other forms of depression
  • often associated w history of childhood trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Severe major depressive episode with psychotic features

A
  • specifier of MDD
  • depressive and psychotic symptoms (loss of contact w reality, delusions, hallucinations)
  • usually delusions/hallucinations are mood congruent
  • likely to have longer episodes, more cognitive impairment, and poorer long-term prognosis
  • recurrent episodes likely to involve psychotic symptoms
  • treatment usually involves antipsychotics and antidepressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Major depressive episode with atypical features

A
  • specifier of MDD
  • pattern of symptoms characterized by mood reactivity (mood brightens in response to potential positive events)
  • more often women, earlier than average age of onset, more likely to show suicidal thoughts
  • linked to mild form of bipolar associated w hypomanic rather than manic episodes
  • might respond better to different class of antidepressants (monoamine oxidase inhibitors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Major depressive episode with catatonic features

A
  • specifier of MDD
  • marked psychomotor disturbances (ie mutism and rigidity)
  • catatonia known more as subtype of schizophrenia but more associated w certain forms of depression and mania
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Recurrent major depressive episode with a seasonal pattern

A
  • specifier of MDD
  • seasonal affective disorder
  • at least 2 episodes in past 2 years at same time of year (most commonly spring)
  • cannot have had another nonseasonal episode in same 2 years; most of lifetime episodes must be seasonal
  • winter affective disorder more common in ppl living at higher latitudes (northern climates) and in younger ppl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Persistent depressive disorder general info

A
  • formerly called dysthymic disorder or dysthymia
  • depressed mood most of day, more days than not, for at least 2 years (1 year for kids/teens)
  • periods of normal mood can occur from a few days to 2 months
  • show poorer outcomes and as much impairment as MDD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

DSM5 Criteria for Persistent Depressive Disorder

A

A: depressed mood for most of day on most days for at least 2 years
B: 2 or more of following symptoms during depressive periods
- poor appetite/overeating
- insomnia/hypersomnia
- low energy/fatigue
- low self-esteem
- poor concentration
- feelings of hopelessness
C: in 2 years, never been without A and B for more than 2 months
D: criteria for MDD may be continuously present for 2y
E: never been a manic/hypomanic episode or cyclothymic disorder
F: not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other schizophrenia spectrum/psychotic disorders
G: not attributable to substance/medical condition
H: clinically significant distress/impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Double depression

A
  • persistent depressive disorder and MDD
  • moderately chronically depressed, but undergo increased problems sometimes (when they meet criteria for MD episode)
  • study of 100 ppl w early-onset dysthymia for 10 years found 84% experienced at least one MD episode
  • most ppl recover, but recurrence is frequent
  • in DSM5 is classified as form of persistent DD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Lifetime prevalence of persistent DD

A

2.5-6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Duration of persistent DD

A
  • avg. 4-5 years
  • can last 20 years or more
  • chronic stress increases severity of symptoms over 7.5 year follow-up period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Onset of persistent DD

A
  • often during adolescence (over 50% before age 21)
  • in study of early-onset dysthymia found 74% recovered within 10y but 71% of recovered cases relapsed within about 3 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Depression is nearly always precipitated by….

A

stressful life events! (like death or birth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Gender differences in grief

A
  • more difficult for men vs women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Bowlby’s 4 phases of normal response to loss of a spouse or close family member

A
  1. numbing and disbelief
  2. yearning and searching for the dead person
  3. disorganization and despair (when they accept death as permanent)
  4. reorganization as person gradually rebuilds life
    - depressive symptoms tend to peak 2-6mo after loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Bereavement exclusion and the DSM

A
  • in DSM4, can’t be diagnosed w MDD within 2 months after loss of loved one (doesn’t apply to loss of job or divorce…)
  • DSM5 removed it instead of expanding definition, was very controversial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Loss and depression

A
  • about 50% of ppl exhibit genuine resilience
  • show minimal, short-lived symptoms of depression/bereavement
  • these people are not emotionally maladjusted!
45
Q

Premenstrual dysphoric disorder DSM5
(not on exam)

A
  • diagnosed if woman has set of symptoms in majority of cycles for past year
  • symptoms week before period, improve few days after
  • marked affective lability (ie mood swings)
  • marked irritability/anger/conflicts
  • marked depressed mood/hopelessness
  • marked anxiety/tension
  • PLUS 5/7 of: decreased interest, difficulties in concentration, fatigued, changes in appetite, hyper/insomnia, being overwhelmed, physical symptoms
  • form of depression where hormones play important role
46
Q

Postpartum depression

A
  • thought to sometimes occur in new mothers (occ. fathers!)
  • “postpartum blues” more common; mix of bad and good feelings (depression and hypomania); occurs in 50-70% of women within 10 days of birth and subside on their own
  • doesnt exist any more, its blues or MDD
47
Q

Risk factors of postpartum blues/depression

A
  • MDD in women postpartum occurs no more frequently than expected in normal women same age and SES
  • greater likelihood of MDD after postpartum blues
  • might be partly bc of hormonal readjustments and alterations in serotonergic/noradrenergic functioning
  • especially likely if mom has lack of social support, difficulty adjusting to new role, or family history of depression
48
Q

Hippocrates and depression

A
  • believed depression was caused by excess of black bile
49
Q

Genetic influences on unipolar depressive disorders

A
  • 2-3x prevalence of mood disorders among relatives of someone diagnosed w unipolar DD
  • MZ twin of someone w MDD 2x more likely than DZ twin to develop MDD
  • 31-42% of liability due to genetic diff.; 70-80% for severe/early-onset/recurrent
  • nonshared environment plays bigger role
50
Q

Serotonin-transporter gene

A
  • candidate for gene implicated in depression
  • alleles are s/s, s/l, or l/l
  • longitudinal study found genotype-environment interaction
  • s/s 2x as likely to develop MD episode after 4+ stressful live events in last 5 years vs l/l
  • s/s who experienced severe severe maltreatment as children w l/l 2x as likely to develop MDD
  • findings support diathesis-stress model
  • findings not replicable
51
Q

Neurochemical factors in depression

A
  • early attention in 60s and 70s on monoamines norepinephrine and serotonin
  • lead to monoamine theory of depression: depression sometimes due to depletion of one or both of these nts at important receptor sites in brain
  • by 80s, clear it cant be this straightforward
  • some studies showed HIGHER norepinephrine in MDD (esp. severe or melancholic)
  • minority of patients had lowered serotonergic functioning; tend to have higher suicidal ideation behavior
  • dopamine dysfunction plays role in some forms (incl. atypical and bipolar)
  • now integral theories have been proposed, neurotransmitters are only one part of puzzle
52
Q

Norepinephrine and serotonin

A
  • regulation of behavioral activity, stress, emotional expression, vegetative functions (appetite, sleep, arousal)
  • all disturbed in mood disorders!
53
Q

Stress response, HPA axis, and cortisol

A
  • perception of stress/threat leads to activity in hypothalamus, released CRH which triggers release of ACTH from pituitary
  • ACTH travels through blood to adrenal cortex of adrenal glands where cortisol is released
  • sustained elevations of cortisol are bad for us; can result from increased CRH or ACTH or failure of feedback mechanisms
  • elevated in 20-40% of outpatients w depression and 70-80% of hospitalized patients w severe depression
54
Q

Dexamethasone

A
  • potent suppressor of plasma cortisol
  • research found that 45% of patients w serious depression dexamethasone fails to suppress cortisol
  • nonsuppression might be nonspecific indicator of generalized mental distress (bc it is found in other groups like those w panic disorder)
55
Q

Patients w depression and elevated cortisol tend to show….

A

memory impairments and problems w abstract thinking/complex problem solving

56
Q

Prolonged elevations in cortisol result in cell death in the ___

A

Hippocampus (part of limbic system heavily involved in memory functioning)

57
Q

Stress in infancy and childhood can increase reactivity of…

A

the HPA axis

58
Q

Hypothalamic-pituitary-thyroid axis

A
  • ppl with low thyroid levels often become depressed
  • 20-30% of patients w depression and normal thyroid levels still show dysregulation of the axis
  • thyrotropin-releasing hormone can be used as treatment when traditional treatments dont work
59
Q

Depression and the immune system

A
  • depression accompanied by dysregulation of immune system
  • activation of inflammatory response (proinflammatory cytokines) can contribute directly to development of depressive symptoms
60
Q

Tricyclics

A
  • early antidepressants
  • fairly nonspecific, acted more on norepinephrine than serotonin
  • lots of side effects due to action on norepinephrine system
  • drugs now more serotonin specific
61
Q

Key brain regions involved in affect and mood disorders (NOT TESTED)

A
  • orbital prefrontal cortex (reward)
  • ventromedial prefrontal cortex
  • dorsolateral prefrontal cortex (cognitive control)
  • hippocampus (learning and memory)
  • amygdala
  • anterior cingulate cortex (selective attention)
    these areas have decreased function in depression
62
Q

Stressful life events as causal factors

A
  • sle’s involved in precipitating depression (loss, severe economic or health problems)
  • depressed ppl might perceive things as more stressful so we need to use strict interview to objectively determine how stressful events were
  • dependent life events (depressed person behaves in ways that makes situation more stressful)
  • minor events may play more of a role in onset of recurrent episodes vs initial episode
63
Q

SES and depression

A
  • low SES/adverse environments increases risk of depression
  • one of clearest findings in terms of risk factors
64
Q

Cognitive diatheses for depression (3)

A
  • neuroticism or negative affectivity
  • perfectionism
  • perceived injustice
65
Q

Psychodynamic theories and depression

A
  • Freud: depression occurs when anger is turned inwards (ie subconscious anger toward mother for having control over you is turned inward by superego when she dies)
  • Freud+Karl Abraham hypothesized that when a loved one dies, the mourner regresses to oral stage of development
66
Q

Behavioral theories and depression

A
  • depression occurs when response no longer produces positive reinforcement or when rate of negative reinforcement increases
  • ie leaving uni and starting job (dont get As for working hard!)
67
Q

Beck’s cognitive theory and depression

A
  • most dominant theory of depression
  • psychoanalyst, questioned if everything that went wrong was about the subconscious, focus on conscious
  • hypothesized that cognitive symptoms of depression often precede and cause affective mood symptoms
  • negative cognitions are central to theory
  • underlying dysfunctional beliefs (depressogenic schemas) are rigid, extreme, and counetrproductive
  • when dysfunctional beliefs are activated by current stressors or depressed mood, they create a pattern of negative automatic thoughts
  • negative cognitive triad includes negative thoughts ab self, world, and future
68
Q

Evaluating Beck’s theory

A
  • research on theory has generated effective treatment (cognitive therapy)
  • research supports most of descriptive aspects of theory
  • research on causal hypothesis has yielded mixed results
69
Q

Reformulated Helplessness Theory

A
  • Abramson and colleagues
  • proposed when ppl are exposed to uncontrollable negative events, they ask themselves why
  • attributions we make central to if we become depressed
  • ppl w pessimistic attributional style have vulnerability for depression when faced w uncontrollable negative events
70
Q

Hopelessness Theory of Depression

A
  • having pessimistic attributional style in conjunction w negative life event not sufficient cause for depression
  • hopelessness expectancy (no one has control so something bad will happen) thought to be sufficient cause for depression
71
Q

Ruminative Response Styles Theory of Depression

A
  • rumination: pattern of repetitive and relatively passive mental activity
  • higher risk for developing depression (bad event keeps happening in their head afterwards)
72
Q

Comorbidity of anxiety and mood disorders

A
  • high rate of comorbidity
  • occurs at all levels of analysis (patient self-report, clinical ratings, diagnosis, family and genetic factors)
73
Q

Interpersonal effects of mood disorders

A
  • lack of social support makes you more vulnerable
  • depressive behavior can elicit negative feelings and rejection in other ppl
  • high correlation between marital dissatisfaction and depression; marital distress increases relapse; parental depression puts kids at high risk
74
Q

Bipolar disorders general info

A
  • distinguished from unipolar disorders by presence of manic or hypomanic episodes
  • Bipolar 1, 2, or cyclothymic disorder
75
Q

Cyclothymic disorder

A
  • repeated experience of hypomanic episodes for a period of at least 2 years
  • less serious version of bipolar disorder (lacks extreme mood and behavior changes)
76
Q

Symptoms of a manic episode

A

3 or more of:
- inflated self-esteem/grandiosity
- decreased need for sleep
- increased talkativeness
- racing thoughts
- distracted easily
- increase in goal-directed activity/psychomotor agitation
- engaging in risky activities

77
Q

Bipolar I disorder

A
  • distinguished from MDD by presence of manic episode
  • can be pure or mixed (symptoms of both manic and depressive episodes for at least 1 week – intermixed or alternating rapidly)
  • periods of depression don’t need to meet DSM criteria of MDD for bipolar I diagnosis
  • on average ppl w bipolar will spend 32% of life in depressive episode, 9% in manic episode, and don’t meet diagnostic criteria rest of time
78
Q

Bipolar II disorder

A
  • clear-cut hypomanic (manic episodes of less severity) and major depressive episodes
  • recurrences can be seasonal (bipolar disorder w seasonal pattern)
  • periods of depressed mood meet criteria for MDD
79
Q

Genetic influences on bipolar disorders

A
  • genes account for 80-90% of variance in liability to develop bipolar I (probably most genetically determined disorder)
  • efforts to locate specific gene not super successful (probably polygenic)
80
Q

Neurochemical factors in bipolar disorders

A
  • mania: increased dopamine (lot of drugs that increase dopaminergic activity ie cocaine and speed create mania-like symptoms)
  • depressive and manic episodes: low serotonin activity
81
Q

Hormonal regulatory systems and bipolar disorders

A
  • cortisol (gets us ready to do stuff ie in fight or flight) elevated in bipolar depression (not manic episodes)
  • many bipolar patients have abnormalities in functioning of hypothalamic-pituitary-thyroid axis
  • thyroid hormone can precipitate manic episodes in patients w bipolar
  • low activity of thyroid can mimic symptoms of depression, increased activity can mimic symptoms of mania
82
Q

Neurophysiological and neuroanatomical influences (NOT TESTED)

A
  • blood flow in left PFC reduced in depression, increased in other parts of PFC during mania
  • basal ganglia and amygdala enlarged in bipolar but reduced in unipolar depression
83
Q

Sleep and biological rhythms in bipolar disorder

A
  • in manic episodes often engage in very little sleep; often hypersomnia in depressive episodes
84
Q

Psychological causal factors of bipolar

A
  • stressful life events can activate underlying vulnerability
  • low social support = more depressive recurrences
  • neuroticism associated w symptoms of depression and mania
85
Q

Cross-cultural differences in mood disorders

A
  • North America: more psychological symptoms of depression (guilt, suicidal ideation)
  • not prominently reported in non-Western cultures (physiological aspects more prominent)
86
Q

Pharmacotherapy and bipolar disorders

A
  • 1950s: monoamine oxidase inhibitors (MAOIs) are first category of antidepressants (many side effects; involved not eating dairy or alcohol bc you could die)
  • 1960s-90s: tricyclic antidepressants (TCAs); also anxiolytic effects; not super specific, affected norepinephrine system to created more side effects than treated symptoms (ex helps sleep so much its hard to get up in the morning)
  • side effects of TCAs led to prescribing of SSRIs
87
Q

Course of treatments with antidepressant drugs

A
  • block reuptake of serotonin as soon as you start taking
  • antidepressant effects only take hold 3-5 weeks later
  • suggested that antidepressants don’t change absolute level of neurotransmitters, but change how system is functioning
  • 50% of patients don’t respond to first drug prescribed
  • discontinuing drug when symptoms have remitted can cause relapse
  • biggest impact on highest levels of severity; not much difference between drug and placebo at lower levels
88
Q

Lithium and mood stabilizing drugs

A
  • lithium widely studied to treat manic episodes (therapeutic window just below toxicity levels for drug)
  • anticonvulsants often effective in those who don’t respond well to lithium
89
Q

Electroconvulsive therapy (ECT)

A
  • invented to try to cure schizophrenia
  • often used in patients who are severely depressed and are at immediate suicidal risk
  • common side effects: confusion, period of amnesia, slowed response time
  • might just feel better bc you forget what made you depressed
90
Q

Transcranial magnetic stimulation

A
  • treatment for depression
  • sends magnetic pulses into brain, depolarizes nerve cells where pulse goes
  • soma data suggests that it can be as or more effective than antidepressants (but not often used as first line of treatment)
  • 30-60minute sessions every day (so less desirable bc more costly)
91
Q

Deep brain stimulation

A
  • electrodes implanted into brain to stimulate area w electrical current
  • used for individuals who don’t respond to other treatments
92
Q

Bright light therapy

A
  • originally used in treatment of SAD
  • now shown to be effective in depression without seasonal pattern
93
Q

Cognitive behavioral therapy and depression

A
  • most use psychological intervention
  • try to change nature of thoughts contributing to depression
  • less likely to relapse after treatment vs taking meds
  • mindfulness-based cognitive therapy used in highly recurrent depression, works on learning to accept negative thoughts/feelings/sensations as just thoughts and not reality (could be useful for ppl w bipolar between episodes!)
94
Q

Behavioral activation treatment

A
  • textbook says it’s new but it’s not (acc. same time as CBT)
  • goals are to increase positive reinforcement and to reduce avoidance and withdrawal (set goals with clients and work on giving them experiences of achievement)
  • can be used by non mental health professionals!
95
Q

Interpersonal Therapy (IPT)

A
  • as effective as CBT but not as studied/available
  • short-term psychodynamic based therapy intervention
  • focus on current relationship issues, try to help person understand and change maladaptive interaction patterns
96
Q

Family and Marital Therapy

A
  • as effective as cognitive therapy in reducing unipolar depression in a depressed spouse
97
Q

Even without therapy, the great majority of ppl w mania and depression…

A

recover from a given episode in less than a year

98
Q

Suicide

A
  • intentional taking of one’s life
  • depression most commonly linked to suicidal behavior (but risk increases for any mental health disorder)
  • belief-based, distress-based
  • not same as nonsuicidal self-injury (NSSI) – motivation is not to end their life
  • bipolar might be at increased risk bc they are more likely to act on impulse
  • high rates in Russia, medium in north america
  • psychiatrists more at risk for suicide
99
Q

Suicide accounts for ____% of all deaths worldwide

A

1.4% (more deaths by suicide than wars/murder/IPV combined)

100
Q

Prevalence of suicidal thoughts and attempts (U.S.)

A
  • 15% experience suicidal thoughts in lifetime
  • 5% have made a nonlethal attempt (1/3)
  • risk of transitioning from suicidal thoughts to an attempt is highest in first year
101
Q

Differences in suicide attempts and deaths

A
  • underreporting of suicidal deaths in some cultures where it is taboo
  • women more likely to think ab suicide and make nonlethal attempts
  • men 4x more likely to die by suicide
  • increase in suicidal thoughts starts at 12 until mid 20s
  • suicide rate for white men in US shows dramatic increase at age 75
  • higher risk if depressed, even higher if 2 comorbid disorders
102
Q

Suicide methods in men (in order)

A
  • firearms
  • hanging
  • asphyxiation or suffocation
  • jumping
  • moving objects
  • sharp objects
  • vehicle exhaust gas
103
Q

Suicide methods in women (in order)

A
  • self-poisoning (more time for others to intervene probably plays role in lower rate of deaths; women don’t want to leave a mess for others when they die)
  • exsanguination (bleeding out from cut)
  • drowning
  • hanging
  • firearms
104
Q

Suicide and the trans community (U.S. 2015)

A
  • 40% of trans adults have attempted suicide
  • 50% of trans men reported suicide attempt in last year
  • 42% or NB teens reported self-harm in previous year
105
Q

Risk factors of suicide

A
  • any psychological disorders (esp. comorbidity)
  • strong implicit association between self and death (IAT)
  • background of child maltreatment and family instability
  • concordance rate much higher in MZ twins
106
Q

Joiner’s Interpersonal-Psychological Model of Suicide

A
  • perceived burdensomeness and thwarted belongingness (don’t feel like you truly belong) interact to produce suicidal thoughts
  • only if person also has acquired capability for suicide will they have the desire/ability to make a lethal attempt
107
Q

Suicide prevention

A
  • treating depression leads to reduction in suicidal thoughts
  • in antidepressants there is an increased risk of suicide in first few weeks (esp. in teens)
  • crisis intervention
  • focus on high-risk groups (those who have already attempted) for ‘suicidal inoculation’ (cognitive therapy)
108
Q

Crisis Intervention

A
  • most widely used type of intervention for suicide prev.
  • call lines
  • goal is maintaining supportive contact w person, help them realize that acute stress is impairing ability to assess situation accurately, help them realize that present distress will not be endless
  • not much difference in suicide rates in areas that have crisis lines

PSYC 337 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions