Chapter 7/8 Flashcards
Automatic Thoughts
In cognitive therapy, persistent, often negative, thoughts that occur automatically in response to situations and contribute to emotional distress.
Bipolar Disorder
A mood disorder characterized by alternating periods of depression and mania or hypomania
Bipolar I Disorder
A type of bipolar disorder involving at least one full manic episode, often alternating with depressive episodes
Bipolar II Disorder
A type of bipolar disorder characterized by at least one hypomanic episode and at least one major depressive episode, but without full manic episodes
Cognitive Triad
A concept in cognitive therapy that describes three negative thought patterns common in depression: negative views about oneself, the world, and the future
Cyclothymic Disorder
A milder form of bipolar disorder involving chronic mood swings between hypomania and mild depression for at least two years
Depression
A mood disorder characterized by persistent sadness, lack of energy, low-self worth, loss of interest in activities, and feelings of hopelessness
Major Depressive Disorder
A severe form of depression involving prolonged and intense feelings of sadness, worthlessness, and lack of interest in daily activities, lasting at least two weeks
- Weight change/appetite change
- Issues sleeping
- Agitation and fatigue
- Issues with concentration
- Suicidality
Mania
A state of extreme energy, euphoria, impulsivity, and sometimes irritability, often seen in bipolar disorder
Norepinephrine
A neurotransmitter involved in mood regulation, alertness, and stress responses; often implicated in depression and anxiety disorders
Serotonin
A neurotransmitter that plays a crucial role in mood regulation, sleep, appetite, and overall well-being; imbalances are linked to depression and anxiety
Symbolic Loss
In psychodynamic theory, the idea that a perceived or imagined loss (e.g., loss of a loved one’s approval) can lead to depression, even if no actual loss has occurred
Unipolar Depression
A mood disorder involving depression without any episodes of mania or hypomania
- 20% of all adults experience at some point in life (1 in 5)
- 26% of women vs 12% of men
- Approx 85% recover, some w/o treatment
- 1/2 experience another episode later
Behavioral Activation
A therapy for depression that focuses on increasing engagement in positive, rewarding activities to improve mood and social skills
Brain Stimulation
A category of treatments that use electrical or magnetic stimulation to improve brain function in mood disorders
Cognitive Therapy
A treatment that helps individuals identify and challenge negative thought patterns to improve mood and behavior
Deep Brain Stimulation
A surgical procedure that implants electrodes in the brain to treat severe depression and other neurological disorders.
Electroconvulsive Therapy (ECT)
A treatment for severe depression that involves applying electrical currents to the brain to induce a controlled seizure, which can relieve symptoms
Interpersonal Psychotherapy (IPT)
A therapy that focuses on improving interpersonal relationships and communication skills to help treat depression
Lithium
A mood-stabilizing medication commonly used to treat bipolar disorder by reducing manic and depressive episodes
MAO Inhibitor (Monoamine Oxidase Inhibitor)
An antidepressant that works by blocking the enzyme monoamine oxidase, which breaks down neurotransmitters like serotonin and norepinephrine
- Helps approx 1/2 of patients
Mood-Stabilizing Drugs
Medications, such as lithium and anticonvulsants, that help regulate mood swings in bipolar disorder
- Researchers don’t understand how they operate, may be due to change in synaptic activity, production of neuroproductive proteins, or size of hippocampus/amount of gray matter
Selective Serotonin Reuptake Inhibitors (SSRIs)
A class of antidepressants that increase serotonin levels by blocking its reuptake in the brain (e.g., Prozac, Zoloft)
- Acts on serotonin alone without affecting others
- As effective and fast and tricylics but lead to some side effects
Transcranial Magnetic Stimulation (TMS)
A noninvasive treatment that uses magnetic pulses to stimulate brain activity in depression
Tricyclic Antidepressants
An older class of antidepressants that block the reuptake of norepinephrine and serotonin, increasing their levels in the brain
- Drugs taken for at least 10 days before improvement
- 50-60% of patients symptoms improve
- Relapse may occur if therapy ended too quickly
Vagus Nerve Stimulation
A treatment for depression involving electrical stimulation of the vagus nerve to influence mood-related brain regions
Depressive Disorders
Group of disorders marked by unipolar depression
- Unipolar: depression w/o mania
- Bipolar disorder: alternating or intermixed depression and mania
Biological View of Unipolar Depression
Genetic
- Family pedigree studies
- Twin studies: 38% concordance in MZ twins, 20% in DZ twins
- Gene studies: abnormality of serotonin transporter gene (risk version of genes)
Biochemical Factors
- Low activity of serotonin and norepinephrine
- 1950s: blood pressure meds reveal what damage causes depression
- Antidepressants increase NT activity
- HPA pathways = overly reactive in depression (anxiety and depression can go together
Psychodynamic View of Unipolar Depression
- Freud/Abraham: reaction when some people experience loss (real or symbolic)
- Object relations theorists: depression results when relationships (esp. early ones) make individual feel unsafe or insecure
Strengths
- Depression can be triggered by major loss
- Early losses set stage for later depression
- If childhood needs are/were poorly met, more likely to become depressed after loss
Weaknesses
- Early losses and inadequate parenting can explain some cases but not all so may not cause depression
Psychological View of Unipolar Depression
Behavioral dimensions (behavioral)
- Reduction in rewards cause fewer positive behaviors, lower rewards rate, and eventually depression
- Depressed participants: fewer positive rewards than nondepressed
- When rewards increase, mood improves
- New experiences can reverse the cycle of depression
Negative Thinking (cognitive)
- Beck: unipolar depression produced by maladaptive attitudes, cognitive triad, errors in thinking, and automatic thoughts
- Maladaptive attitudes: ex. my general worth is tied to the tasks I perform
- Cognitive triad: negative view of experiences, self, and future
- Errors in thinking: negative conclusions based on little evidence
- Automatic thoughts: unpleasant thoughts surrounding inadequacy and hopelessness
- Legitimate view that oneself cannot succeed and is not worthy due to mistakes, powerlessness and hopelessness
Sociocultural View of Unipolar Depression (1)
Influenced by social context around individual
Family-social perspective
- Depressed people are hard to be around, may cause avoidance from others which decreases social contacts and rewards
- Reinforces belief that one is unworthy of love
- Depression tied to weak/unavailable social support, isolation, and lack of intimacy
- May be around others, but lack of genuine closeness
Sociocultural View of Unipolar Depression (2)
Across various cultures, women 2x as likely as men to receive diagnosis of unipolar depression
- Artifact theory: clinicians less likely to detect depression in men
- Hormone explanation: women seen to be less stable/more hormonal, hormonal changes predict mood change
- Life stress theory: women face more poverty/less fulfilling work, less adequate housing, and more discrimination
- Body dissatisfaction explanation: relation to EDs, more pressure on female bodies
- Lack-of-control theory: women feel they have less control over lives, men feel more control
- Rumination theory: women more likely to ruminate (reprocess)
Integrating the Models of Unipolar Depression
- Unipolar depression is caused by a combination of the various models
- Genetically inherited biological predisposition
- Significant early life trauma and/or inadequate parenting can influence
- Low self-concept: temperament marked by feelings of guilt, negative thinking styles, general feelings of helplessness, and/or interpersonal dependent - Factors unfold/intersect in developmental sequence
Biological View of Bipolar Disorders
Neurotransmitter Activity
- Mania may be related to high norepinephrine activity and low serotonin activity
Ion Activity
- Ions across membranes = necessary for action potentials
- Irregularities in transport may cause easy firing (mania) or stubborn firing (depression)
Genetic Factors
- Family pedigree: MZ 40% concordance, siblings 5-10%
- Linked to genes on variety of chromosomes, possibility that abnormalities combine
How Effective are Antidepressants?
Fail to help at least 40% if not closer to 50%
- When including placebos, improvement is closer to about 30-35%
Psychodynamic Therapy for Unipolar Depression
Seek to bring issues of loss into consciousness and work through them
- Free association, therapist interpretation, review of past events and feelings
- Depressed clients gain awareness of losses in life, become less dependent on others, and cope w/ loss more effectively
Strengths
- Sucessful case reports, most often w/ modestly or moderately depressed clients with a clear history of abuse
Limitations
- Long-term therapy only occasionally helpful
- Depression clients too passive and weary to participate fully
- Clients may become discouraged + end treatment
Adjunctive Psychotherapy for Bipolar Disorder
- Psychotherapy or mood stabilizing alone is rarely helpful
- Individuals may stop taking mood stabilizers due to side effects - Individual, group, or family therapy used with lithium/medication therapy
- Support systems can emphasize importance of taking meds, help improve skills, help with problems, and help prevent suicide
- Improves variety of behaviors, especially for cyclothymic disorder
Cognitive-Behavioral Therapy for Unipolar Depression
Behavioral Activation
- Therapist works to increase number of positive/enjoyable activities in a clients life
- Reintroduce pleasurable events/activities and reward nondepressive/depressive behaviors
- Help improve social skills
Beck’s Cognitive Therapy:
- Guides clients to recognize + change negative cognitive processes
- Increasing activities & elevating mood
- Challenging automatic thoughts by identifying negative ones and changing them
- 50-60% show significant improvement/elimination of their symptoms
New-Wave Cognitive-Behavioral Therapists
- Believe in noticing issues rather than disregarding
- Uses mindfulness training and other techniques to recognize negative thoughts as mere thoughts rather than guides
Sociocultural Approach: Family-Social Treatments
Interpersonal psychotherapy (IPT: Kerman & Weissman): explore, grieve, & let go
- Interpersonal problems may lead to depression
- Interpersonal loss: encourage clients to explore their relationship w/ lost person and express any feelings of anger they may discover
- Interpersonal role dispute: occur when two people have diff expectations of their relationship + how to interact
- Interpersonal role transition: develop the social supports + skills the new roles require (become a parent, a partner, divorced, etc.)
- Interpersonal deficits: teach social skills & assertiveness
- Useful for depression related to social conflicts/role changes/social loss
