Chapter 7 Flashcards
1
Q
mood disorder facts
A
- Lifetime prevalence o 4-11% Canadian studies - Gender differences o Females 2x as likely to have mood disorders - Age and culture o Mood disorders are fundamentally similar in kids and adults • Typical onset = adolescent • Depression seen in all age groups • Characterized by irritability in kids o Prevalence similar across subcultures
2
Q
mdd - Serious disturbances of mood and affect
A
o V depressed mood state
o Anhedonia – loss of pleasure/interest, affecting many or most areas of life
• Nothing matters anymore, very detached
o Need 1 of above symptoms
o Thoughts of death or suicide
3
Q
- Cognitive disturbance and negative cognitions
A
o Diminished ability to think or concentrate o Indecisiveness o Feelings of worthlessness o Excessive or inappropriate guilt o Lots of worry
4
Q
- Serious somatic symptoms
A
o Appetite disturbances with wright loss or gain
o Sleep disturbances (insomnia or hypersomnia)
o Lack of energy and/or easily fatigued
o Psychomotor agitation/slowing
5
Q
- Course and form of MDD
A
o Reps a change from previous functioning, causing significant distress or impairment in functioning
o Symptoms are present all day, nearly every day for the same 2 week period
o 2 weeks – 9 months
• Present all day nearly every day
o Single episode highly unusual
o Recurrent episodes are more common
o Sometimes infants can exhibit symptoms → caregiver has symptoms and don’t give the care kid needs
6
Q
pdd
A
o Continues for 2+ years o A lot of people say they have been depressed for as long as they can remember o Symptom free for no more than 2mo o Similar symptoms to MDD o More chronic and severe than MDD o May persist unchanged over long periods o Higher rates of co-morbidity o Greater levels of psychopathology o Lots of feelings of hopeless that leads to o Higher rates of suicidality o Less responsive to treatment o Many develop MDD
7
Q
mania
A
- Manic episode
o Severe mood disturbance – usually really elevated
o Cognitive and behavioral symptoms, often psychosis
o Duration: at least 1 week; 2-6mo if untreated
o High risk that symptoms will be self destructive - Hypomanic episode
o Similar symptoms to mania
o Less severe
o Doesn’t cause marked impairment
o Symptoms of shorter duration – only a few days
o Extreme about of heightened activity and energy compressed into a short period
8
Q
manic episode
A
- Severe mood disturbance with increased energy and activity
o Abnormally and persistently elevated, expansive mood or irritable mood
o Persistently increased goal-directed activity or energy - Cooccuring symptoms
o Mood and cog:
• Inflated self esteem or grandiosity
• Flight of ideas or subjective experience that thoughts are racing
• Distractibility
• Often includes psychosis
o Behavior and psychomotor:
• Decreased need for sleep
• More talkative than usual or pressure to keep talking
• Excessive involvement in pleasurable activities (with high potential for painful consequences
9
Q
bipolar 1
A
- Overview and defining features:
- Alternations between full manic and major depressive episodes
o Meets full criteria for both - May show evidence of psychosis
- Suicide is a common consequence
- Facts and stats:
- Average age of onset is 18
- Chronic
10
Q
bipolar 2
A
o Alternations between hypomanic episodes and major depressive episodes o Meets criteria for each o May include psychotic features o High risk of suicide - Facts and stats: o Average age of onset is 22 o Can begin in childhood/adolescence o Tends to be chronic o 10-13% progress to bipolar I o one of most debilitating disorders
11
Q
cyclothymic disorder
A
- More chronic but less severe version of bipolar
- Hypomanic episodes alternate with depressive episodes (not full mdd) → some symptoms but not all
o Numerous alternations
o Pattern for almost at least 2y – 1 for kids and teens
o Symptom free for no more than 2mo - High risk for developing bipolar
- Subtypes
o Predominance of mild depressive symptoms
o Predominance of hypomanic symptoms
o Equal distribution of both mild depressive symptoms and hypomanic symptoms
12
Q
Premenstrual dysphoric disorder
A
- To enable women to get help and to correctly diagnose
- Severe mood liability (moment to moment shifts in mood) , irritability, anxiety/depressive symptoms occurring during the premenstrual phase of the menstrual cycle
o Andedonia
o Cant concentrate
o Fatigue
o Hyper/insomnia - Also
o Sense of being overwhelmed or out of control
o Breast tenderness or swelling, joint or muscle pain, sensation of bloating or weight gain
o Change in appetite, overeating, specific food cravings - Disturbance is
o Not an exacerbation of another depressive, anxiety or personality disorder
o Must be present during most cycles for a year
o Confirmed by prospective dauly ratings of symptoms
o Must cause distress or interfere with work, school, social, relationships - Remit around or following onset of menses
13
Q
Disruptive mood dysregulation
A
- Frequent, severe temper outburst or tantrums
o Not age appropriate, out of proportion - Chronic irritability, aggression, moodiness
- Extreme difficulty controlling emotions
- Severe relationship difficulties
- On your way to having a different disorder in adulthood
- Facts and stats:
o New dsm diagnosis
o Aimed at increasing diagnostic precision
o Many kids misdiagnosed resulting in improper treatment
o Must be evident by age 10
o Must occur in at least 2 settings
o Must be happening for a long period of time
14
Q
Familial and genetic influences
A
- Genetic research findings
o High concordance rate for identical twins
o Stronger genetic contributions for severe mood disorders
o Greater genetic vulnerability for females
o Polarity: mixed evidence on type of vulnerability inherited
o Serotonin transporter gene
• ‘s’ allele associated with vulnerability to depression and brain volume differences - Joint heritability of anxiety and depression
o Some evidence that same genetic factors may contribute to anxiety and depression
15
Q
Neurobiological influences
A
- Neurotransmitters research findings
o Permissive hypothesis
• Low serotonin levels permit other neurotransmitters to become dysregulated
• Low levels of 5HT implicated in depression but only in relation to other neurotransmitters
o Now NE levels: found in bipolar and severe unipolar depression
o NE, DA, 5HT are theorized to play a role in manic episodes - EEG andMRI/fMRI stidies of mood disorders
o ID of characteristic patterns of prefrontal cortex activation
• Associated with depression
• Increased activation in right anterior
• Decreased activation in left anterior
• Associated with bipolar
• Increased activation in left anterior which predicts onset
o ID of structural differences and neural circuits involved in the cognitive-emotional deficits associated with depression
• ‘s’ allele of 5HT transporter gene associated with smaller amygdala and cingulate cortex volume resulting in deficits
• amygdala works too well and cortex doesn’t buffer – amygdala adds too much meaning to emotional events
• fuels negative thinking
