chapter 7 Flashcards
1
Q
facts and stats
A
- lifetime prevalece
- females 2x as likely
- teen onset
- seen in all age groups
- irritability in kids
- prevalence similar across subcultures
2
Q
mdd disturbances of mood and affect
A
- depressed state
- anhedonia
- need one of the above
- thoughts of death or suicide
3
Q
mdd cognitive disturbance and negative cognitions
A
- diminished ability to think or concentrate
- indecisiveness
- worthlessness
- excessive guilt
- worry
4
Q
mdd somatic symptoms
A
- weight loss or gain
- sleep disturbances
- lack of energy/fatigue
- psychomotor slowing
5
Q
course and form of mdd
A
- change from previous functioning
- distress or impairment
- symptoms present all day every day for at least 2 weeks
- recurrent episodes common
- can be exhibited in infants
6
Q
persistent depressive disorder
A
- 2+years
- depressed for as long as they can remember
- symptom free for no more than 2mo
- similar to mdd
- more chronic
- higher comorbidity
- hopelessness
- high suicide
- less responsive to treatment
- may develop mdd
7
Q
manic episode
A
- really elevated mood
- often psychosis
- at least 1 week, 2-6mo if untreated
- symptoms can be self destructive
8
Q
hypomanic episode
A
- similar symptoms to mania
- less severe
- doesnt cause marked impairment
- shorter duration
- heightened activity and energy compressed into a short period
9
Q
manic episode
A
- mood disturbance with increased energy and activity
- persistently increased goal directed activity
- inflated self esteem
- racing thoughts
- distractibility
- psychosis
- decreased need for sleep
- more talkative
- excessive involvement in pleasurable activities
- delusions
10
Q
bipolar 1
A
- alternations between manic and md episodes
- may be psychosis
- suicide common
- average onset 18
- chronic
11
Q
bipolar 2
A
- alternations between hypomanic and md episodes
- may include psychosis
- suicide common
- average onset is 22
- can begin earlier
- chronic
- 10-13% get bipolar 1
12
Q
cyclothymic disorder
A
- more chronic but less severe version of bipolar
- hypomanic alternation with depressive episode but not full mdd
- numerous alternations -
- patterns for almost 2y
- symptoms free for no more than 2mo
- high risk of developing bipolar
- subtypes: predominance of mild depressive symtpoms
- predominance of hypomanic symptoms
- equal distribution of mds and hms
13
Q
premenstrual dysmorphic disorder
A
- so women can get help
- mood shifts, irritability, anxiety, depressive symptoms during premenstrual phase
- anhedonia, inability to concentrate, fatigue, hyper/insomnia
- being overwhelmed, breast tenderness or body aches, change in appetite
- not becuase of another disorder, present during most cycles, must cuase distress
14
Q
- disruptive mood dysregulation
A
- frequent, severe temper outburst or tantrums
- chronic irritability, aggression, moodiness
- cant control emotions
- relationship difficulties
- evident before 10
- in at least 2 settings
- happens for a long time
15
Q
familial and genetic cuases
A
- high coordinance for twins
- strong genetic contribustions for severe mood disorders
- greater genetic vulnerability for females
- serotonin transporter gene (s allele thing)
- genetic factors that contribute to both anxiety and depression
16
Q
neurobiological causes `
A
- neurotransmitters implicated
- permissive hypothesis: low serotonin allows other NTs to become dysregulated, low 5ht implicated in depression but only in relation to other NTs
- low NE in bipolar and severe devression
- NE, DA, 5HT in manic episodes
17
Q
EEG, MRI/fMRI studies of mood disorders
A
- depression: increased activation in right anterior, decreased in left
- bipolar: increased activation in left anterior
- s allele of 5ht transporter associated with smaller amygdala and cingulate cortex volume resulting in deficits (amygdala working too well and cortex doesnt bffer)
18
Q
psychological dimensions
A
- stress and trauma strongly related to onset and relapse
- both depression and bipolar
- learned helplessness: related to lack of percieved control, depressive attributional style - leads to hopelessness related
19
Q
becks cognitive theory of depression
A
- CBT based on theory
- depression = tendency to interpret life negatively, apply cognitive distortions to life situations
- cognitive disortions: all or nothing thinking, over generalization, magnification, jumping to conclusions
- depressive triad: think negatively about oneself, world, future can lead to hepelessness and depression
20
Q
social and cultural dimensions
A
- marital dissatisfaction related to depression
- gender imbalances in all mood except for bipolar
- females tend to internalize thoughts, male externalize
- gender imbalance partially due to socialization
- extent of social support related to depression (lack predicts late onset depression, good support helps recovery)
21
Q
biological treatment
A
- meds that act on NT systems (5HT, NA, NE)
- electroconvulsive therapy
- transcranial magnetic stimulation
22
Q
psychological treatment
A
- CBT
- Interpersonal therapy
23
Q
depressive disorders treatment: SSRIs
A
- fluoxetine most popular
- blocks presynaptic reuptake of serotonin
- negative side effects
- 50-70% effective
24
Q
depressive disorders treatment: SNRIs
A
- venlafaxine
- blocks presynaptic reuptake of serotonin and norepinephrine
- adresses cooccuring anxiety
- less siede effects
- dopamine energizes some
25
Q
depressive disorders treatments: antidepressant meds
A
- trycyclics: blocks presynaptic uptake of NE and other NTs, side effects common
- monoamine oxidase inhibitors: blocks MAO (enzyme that breaks down 5H and NE), fewer side effects, potentially fatal interactions so must avoid things like alocohol
- efficacy issues and negative side effects in kids, elderly
- some fail to improve
26
Q
Bipolar treatment: lithium
A
- too little: ineffective, too much: toxic, effective in 50%, high rates of relapse
- people like the feeling of mania but it reduces the feeling so they stop taking drug
- works on many NTs, endocrine system
- deactivates system that is theorized to affect biological thoughts/circadian rythms
- glutamate antagonist
27
Q
ETC and TMs
A
- etc: brief electrical current, temp seizures, usually get 6-10, used for severe depression if not responding to other treatments, relapse common
- tms: magnetic stimulation of brain, stimulates neurons
28
Q
psycholoigcal intervention
A
- CBT: identify thinking errors, more adaptive thoughts, correct cognitive errors, includes behavioral component
- behavioural activation: increased contact with reinforcing events
- interpersonal psychotherapy: adressess issues in relationships, life stressors
29
Q
suicide rates in canada
A
- highest in alberta, quebec, northwest territories
- lowest in newfoundland
- highest in indigenous
- rates increasing
30
Q
suicide gender differences
A
- more women attempt
- men more successful
31
Q
suicide risk factors
A
- family history
- low serotonin levels
- pre-existing disorders
- alcohol use/abuse
- past suicidal attempts
- shameful/humiliating stressor
- public talk about suicide
- illness, loss of spouse
32
Q
suicide assessment and treatment
A
- assess: previous attempts, recent stressful events, ideation vs intent, plan, methods, means, access
- no suicide contract (controversial)
- problem solving therapy
- CBT
- stress reduction
- hospitalization
33
Q
suicide warning signs
A
- verbal threats
- previous suicide attempt
- risk taking, reckless behaviour,
- final arrangements, giving things away
- separation from loved ones
- themes in writing or art about death, depression, suicide
- chronic depression
- unusual purchases
- unusual sadness, loneliness
