Chapter 7 - Depressive Disorder Flashcards

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1
Q

What is Depression?

A

A low, sad state marked by significant levels of sadness, lack of energy, low self-worth, guilt, or related symptoms, life’s challenges seem overwhelming

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2
Q

What is Mania (opposite of depression)?

A

A state or episode of euphoria or frenzied activity/energy in which people may have an exaggerated belief that the world is theirs for the taking

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3
Q

What is a Depressive Disorder?

A

The group of disorders marked by unipolar depression, they do not experience mania. They return to a relatively normal mood when their depression lifts

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4
Q

What is unipolar depression?

A

Depression without a history of mania

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5
Q

What is bipolar disorder?

A

A disorder marked by alternating or intermixed periods of mania and depression

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6
Q

What is unipolar mania?

A

Is not regarded as existing by the psychology community

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7
Q

How is a depressive disorder different from feeling “depressed”

A

A depressive disorder brings severe and long-lasting psychological pain that may intensify as time goes by

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8
Q

What are the five areas of functioning? (symptoms of depression)

A

Emotional, Motivational, Behavioural, Cognitive, and Physical

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9
Q

True or false, people with depression can manage to function?

A

True, although their depression typically robs them of much effectiveness or pleasure

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10
Q

What are the emotional symptoms of depression?

A

Feel sad, dejected, miserable, empty, humiliated, anxiety, anger, or agitation. Tend to lose their sense of humour, report getting little pleasure from anything, some cases displayed anhedonia

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11
Q

What is anhedonia?

A

An inability to experience any pleasure at all

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12
Q

What are the motivational symptoms of depression?

A

Lose desire to pursue their usual activities, lack of drive, initiative, and spontaneity, they may force themselves to go to work, talk with friends, eat meals, or have sex

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13
Q

What are the behaviour symptoms of depression?

A

Usually less active and less productive. Spend more time alone and may stay in bed for long periods. May also move and speak more slowly

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14
Q

What are the cognitive symptoms of depression?

A

Hold extremely negative views of themselves. Consider themselves inadequate, undesirable, inferior, perhaps even evil. Blame themselves for nearly every unfortunate event, even things that nothing to do with them. Rarely credit themselves for positive achievements

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15
Q

What is pessimism (cognitive symptom of depression)?

A

Usually convinced that nothing will ever improve, they feel helpless to change any aspect of their lives, expecting the worst, they are likely to procrastinate. Sense of hopelessness and helplessness makes them especially vulnerable to suicidal thinking

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16
Q

What effect does depression have on a person’s intellectual ability?

A

Intellectual ability is very poor, feel confused, unable to remember things, easily distracted, and unable to solve even the smallest problems

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17
Q

What evidence has laboratory studies shown about a person with depression’s performance?

A

Depressed people do perform somewhat, but not extremely, more poorly than non depressed people on tasks of memory, attention, and reasoning (can also be interpreted as motivational symptoms

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18
Q

What are the physical symptoms of depression?

A

Physical ailments as headaches, indigestion, constipation, dizzy spells, and general pain. As well as, disturbances in appetite and sleep are particularly common, typically eat less, sleep less and feel more fatigued or they eat and sleep excessively

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19
Q

Diagnosing a major depressive episode according to DSM-5

A

A major depressive episode is a period of two or more weeks marked by at least 5 symptoms of depression, including sad mood and/or loss of pleasure. Episode may include psychotic symptoms

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20
Q

What are the psychotic symptoms of depression (in extreme cases)?

A

Loss of touch with reality, such as delusions and/or hallucinations

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21
Q

What is a delusion?

A

Bizarre ideas without foundation

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22
Q

What is a hallucination?

A

Perceptions of things that are not actually present

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23
Q

What are the several types of disorders listed in the DSM-5

A

Major Depressive Disorder, Persistent Depressive Disorder, Premenstrual dysphoric disorder

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24
Q

What is Major Depressive Disorder?

A

A severe pattern of depression that is disabling and is not caused by such factors as drugs or a general medical condition

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25
Q

What condition must be met to be diagnosed with Major Depressive Disorder?

A

A major depressive episode without having any history of mania

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26
Q

How can Major Depressive Disorder additionally be described?

A

Seasonal, catatonic, peripartum, melancholic

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27
Q

What does seasonal mean?

A

Seasonal if it changes with the seasons (ex: recurs each winter). People who experience depression in the winter may secrete more melatonin during the winter

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28
Q

What does catatonic mean?

A

Catatonic if it is marked by either immobility or excessive activity

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29
Q

What does peripartum mean?

A

Peripartum if it occurs during pregnancy or within four weeks of giving birth

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30
Q

What does melancholic mean?

A

If the person is almost totally unaffected by pleasurable events

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31
Q

What is persistent depressive disorder?

A

A chronic form of unipolar depression marked by ongoing and repeated symptoms of either major or mild depression. Experiences the symptoms of major or mild depression for at least 2 years

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32
Q

What is persistent depressive disorder with major depressive episodes?

A

A pattern that describes the chronic form of unipolar depression has repeated major depressive episodes

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33
Q

What is persistent depressive disorder with dysthymic syndrome?

A

A pattern that has less severe and less disabling symptoms

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34
Q

What is premenstrual dysphoric disorder?

A

A disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation. The inclusion of this pattern in DSM-5 is controversial

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35
Q

What is disruptive mood dysregulation disorder

A

Combination of persistent depressive symptoms and recurrent outburst of severe temper. Emerges during mid-childhood or adolescence.

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36
Q

What commonly triggers episodes of unipolar depression?

A

Triggered by stressful events in an individual’s life

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37
Q

What is a reactive (exogenous) depression?

A

Follows clear-cut stressful events, important to note: even if a stressful event occurred before the onset of depression, that depression may not be reactive

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38
Q

What is an endogenous depression?

A

Seems to be a response to internal factors

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39
Q

What do today’s clinicians usually concentrate on?

A

Recognizing both the situational and the internal aspects of any given case of unipolar depression

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40
Q

What are the current explanations of Unipolar depression?

A

Biological, psychological and sociocultural factors

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41
Q

What is the biological explanation of Unipolar depression?

A

Suggest there are genetic factors, that some people inherit a predisposition to unipolar depression

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42
Q

What are the three kinds of research? (biological/genetic factors view)

A

Family pedigree, twin, and gene studies

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43
Q

What are family pedigree studies?

A

Select people with unipolar depressions as pro bands, examine their relatives, and see whether depression also afflicts other members of the family. If a predisposition to unipolar depression is inherited, a proband’s relatives should have a higher rate of depression than the population at large

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44
Q

What is a proband?

A

A person who is the focus of such study

45
Q

What are twin studies?

A

When an identical twin has unipolar depression, there is a 38% chance that the other twin has already had or will eventually have the same disorder. this percentage is 20% between fraternal twins

46
Q

How has the field of molecular biology contributed to the biological perspective?

A

Helped to directly identify genes and determine whether certain gene abnormalities are related to depression

47
Q

What is the 5-HTT gene?

A

A abnormality with this gene located on chromosome 17 that is responsible for the activity of the neurotransmitter serotonin is linked to people with depression

48
Q

What are biochemical factors involved with depression?

A

Low activity of two neurotransmitter chemicals: norepinephrine and serotonin are strongly linked to unipolar depression

49
Q

What is norepinephrine?

A

A neurotransmitter whose abnormal activity is linked to depression and panic disorder

50
Q

What is serotonin?

A

A neurotransmitter whose abnormal activity is linked to depression, obsessive-compulsive disorder, and eating disorders

51
Q

How are the body’s hormones linked to depression?

A

The hypothalamic-pituitary-adrenal pathway of people with depression is overly reactive causing excessive releases of cortisol and related hormones at the time of stress (especially in those whose depression includes feelings of anxiety)

52
Q

What is a brain circuit?

A

Networks of brain structures that work together, triggering each other into action and producing a particular kind of emotional or behavioural action

53
Q

What structures are involved with the depression brain circuit?

A

Prefrontal cortex, hippocampus, amygdala, and subgenual cingulate (Brodmann Area 25)

54
Q

What is melatonin?

A

“Dracula hormone” linked to depression, is released only in the dark

55
Q

What can be said about the depression-related circuit?

A

Cannot decisively say it’s “hyperactive” or “under-achitive”, only can recognize that the circuit operates abnormally in persons with depression.

56
Q

How is the prefrontal cortex involved with depression?

A

Activity and blood flow are unusually low in certain parts and unusually high in other parts of the prefrontal cortex

57
Q

How is the hippocampus involved with depression?

A

Is undersized and its production of new neurons is low

58
Q

How is the amygdala involved with depression?

A

Elevated activity and blow flow

59
Q

How is the subgenual cingulate involved with depression?

A

Particularly small and active

60
Q

Neurotransmitters and the depression-related circuit?

A

Low activity of both serotonin and norepinephrine in this circuit, unsure if they cause the dysfunction or a product of the dysfunction in the brain circuit

61
Q

What is the raphe nuclei?

A

A cluster of neurons at the base of the brain that releases serotonin

62
Q

How is the raphe nuclei involved in the depression circuit?

A

May transmit the serotonin at too slow a pace within the circuit, causing the circuit to functioning improperly

63
Q

What is the alternative research on the raphe nuclei and the depression circuit?

A

When the circuit is not functioning properly, it may send messages to the raphe nuclei to reduce its serotonin activity, which in turn leads to relatively low serotonin activity throughout the brain

64
Q

How is the immune system linked to depression?

A

Stress causes the immune system to become dysregulated, leading to slow functioning of lymphocytes (white blood cells) and to increased production of C-reactive protein (CRP), in turn produces depression

65
Q

What is C-reactive protein?

A

A protein that spreads throughout the body and causes inflammation and various illnesses.

66
Q

Evidence that the immune system is linked to depression

A

People with depression have lower lymphocyte activity, higher CRP production, and greater body inflammation, unclear however if immune system dysfunction produces depression or that depression causes immune system dysfunction

67
Q

The psychological perspective on depression?

A

Involves the psychodynamic and cognitive-behavioural model

68
Q

What is the psychodynamic model?

A

Suggest that major losses, especially ones suffered early in life, may lead to depression

69
Q

What were Sigmund Freuds observations of depression?

A

Noted similarities between clinical depression and grief in people who lose loved ones: constant weeping, loss of appetite, difficulty sleeping lose of pleasure in life and general withdrawal

70
Q

What did Sigmund freud theorize in relation to his observations?

A

A series of unconscious processes occur when a loved one dies. Unable to accept the loss, mourners regress to the oral stage of development

71
Q

Oral stage of development and depression?

A

Regressing to this stage, mourners merge their own identity with that of the person they have lost, and so symbolically regain the lost person

72
Q

What is Introjection?

A

A process where people direct all their feelings for the loved one, including sadness and anger towards themselves. People develop clinical depression when introjection persists

73
Q

What is symbolic/imagined loss?

A

Person equates other kinds of events with the loss of a loved one. The loss of a valued object that is unconsciously interpreted as the loss of a loved one

74
Q

What do object relations theorists suggest?

A

Propose that depression results when people’s relationships -especially their early relationships- leaving them feeling unsafe, insecure and dependent on others

75
Q

What other research has the psychodynamic model suggest?

A

People whose childhood needs were poorly met are particularly likely to become depressed after experiencing loss

76
Q

The Cognitive behavioural model

A

Theories contend that unipolar depression results from a combination of problematic behaviours and dysfunctional ways of thinking

77
Q

The Behavioural dimension within the model

A

Link depression to significant changes in the number of rewards and punishments people receive in their lives

78
Q

Evidence for the behavioural dimension?

A

Researchers have found a strong relationship between positive life events and feelings of happiness

79
Q

Social rewards and depression

A

Research shows that depressed persons receive fewer social rewards than non depressed persons and as their mood improves, their social rewards increase

80
Q

What does Aaron Beck theorize about depression?

A

Argues that negative thinking, rather than underlying conflicts or a reduction in positive rewards, is the cause of depression.

81
Q

What does Aaron beck say contribute to depression?

A

Maladaptive attitudes, a cognitive triad, errors in thinking, and automatic thoughts combine to produce unipolar depression

82
Q

What are the three forms of negative thinking?

A

Negative view of one’s experiences, oneself, and the future

83
Q

What are errors in thinking/logic?

A

Arbitrary inferences - negative conclusions based on little evidence

84
Q

What are automatic thoughts?

A

Numerous unpleasant thoughts that help to cause or maintain depression, happened as though by reflex

85
Q

What are ruminative responses during a depressed mood? Rumination

A

Repeatedly dwell mentally on their mood without acting to change it

86
Q

What is learned helplessness theory developed by Martin Seligman?

A

The perception, based on past experiences, that one has no control over the reinforcements(rewards and punishments) in one’s life and that they themselves are responsible for this helpless state

87
Q

What is the attribution-helplessness theory?

A

People view events as beyond their control, attribute their present lack of control to some internal cause that is both global and stable (everything and always will be), feel helpless to prevent future negative outcomes, expect similar losses of control

88
Q

How has the attribution-helplessness theory been refined?

A

Suggest that attributions are likely to cause depression only when they further produce a sense of hopelessness in a person

89
Q

The sociocultural perspective

A

Propose that unipolar depression is strongly influenced by the social context that surrounds people. Depression is often triggered by external stressors

90
Q

The family-social perspective (sociocultural perspective)

A

Depressed people often display weak social skills and communicate poorly. Seek repeated reassurances from others and have low social support, isolation, and lack of intimacy

91
Q

The multi-cultural perspective (sociocultural perspective)

A

Two kinds of relationships: links between gender and depression, and links between culture and ethnic backgrounds and depression

92
Q

Theories about the gender differences found in depression:

A

Proposes 6 theories: artifact theory and hormone explanation, the life stress theory, body dissatisfaction theory, lack of control theory, rumination theory

93
Q

What is the artifact theory?

A

Holds that women and men are equally prone to depression but that clinicians often fail to detect depression in men. Suggest that depressed women display more emotional symptoms (easily diagnosed)

94
Q

What is the hormone explanation?

A

Hormone changes trigger depression in many women, particularly during puberty, pregnancy, and menopause. Social and life events that accompany these developmental milestones are also profound and may account for experiences of depression

95
Q

What is the life stress theory?

A

Suggests that women in our society are subject to more stress than men. Women face more poverty, more menial jobs, less adequate housing, more responsibility for child care and housework and more discrimination

96
Q

What is the body dissatisfaction explanation?

A

Females in Western society are taught to seek low body weight and slender body shape, females become dissatisfied with their weight and body, unclear if eating and weight concerns actually cause depression. May actually be the result

97
Q

The Lack of control theory

A

Women may be more prone to depression because they feel less control than men in their lives. More victimization across various domains

98
Q

What is the rumination theory?

A

Women are more likely than men to ruminate when their mood darkens

99
Q

Theories about the link between cultural backgrounds and depression?

A

Non-Western Depression, 4 countries, U.S.

100
Q

Non-Western Depression

A

People with depression in non-western countries tend to have fewer cognitive symptoms and more physical symptoms

101
Q

Canada, Switzerland, Iran, and Japan

A

All distinct countries but share similar symptoms of depression, largely cognitive symptoms

102
Q

U.S. Context

A

There are not significant differences in the symptoms of depression between members of different ethnic or racial groups, nor is there significant differences in overall rates of depression. There is striking differences in the recurrence of depression between white Americans and minorities

103
Q

True or false: Depression is distributed evenly within some minority groups?

A

False

104
Q

True or False: Premenstrual Dysphoric Disorder is an official category in the DSM-5?

A

True

105
Q

The Developmental Psychopathology Perspective?

A

Contend that unipolar depression is caused by a combination of the factors that intersect in a developmental sequence

106
Q

What do researchers of the developmental psychopathology perspective propose?

A

A genetically inherited predisposition and will develop into depression when an individual is subjected to significant traumas in life (particularly interpersonal losses) and inadequate parenting (childhood factors)

107
Q

What is negative affectivity?

A

Experience of negative emotions and poor self-concept

108
Q

First conclusion made by the developmental psychopathology perspective

A

Individuals who travel through thus unfavorable developmental sequence are particularly likely to become depressed when they experience stress in adult life

109
Q

Second conclusion made by the developmental psychopathology perspective

A

Also have found that perhaps severe trauma has an affect an individuals HPA stress pathway and depression-related brain circuit, meaning does not need to have a genetic predisposition