Chapter 7 (Exam 2) Flashcards

Question

behavioral treatment depression

Answer 1

GOLD STANDARD: Beck's CBT (4 phases): 1. increasing activities and elevating moods 2. challenging automatic thoughts 3. identifying neg thinking and biases 4. changing primary attitudes evaluation: 50-60% success rate; limited help as a solo treatment; more helpful in combination with cog techniques (behavioral therapy alone can help mild depression) new therapies: acceptance and commitment therapy (ACT)- recognition and acceptance of neg cognitions evaluation: effective with unipolar depression and with follow-up preventive cog therapy

Answer 2

BPD the symptoms overlap; many people with BPD have persistent depressive disorder

Answer 3

unipolar depression is influenced by the social context that surrounds people (this belief is triggered by the finding that depression is often triggered by outside stressors) there are 2 kinds of sociocultural views: 1. family-social perspective 2. multicultural perspective

Answer 4

the connection between declining social rewards and depression (as discussed by behaviorists) is a two-way street - depressed people often display social deficits that make others uncomfortable, which may cause them to avoid the depressed indiv - this leads to decreased social contact and a further deterioration of social skills

Answer 5

interpersonal therapy (IPT)- this model holds that 4 interpersonal problems may lead to depression and must be addressed: 1. interpersonal loss (e.g. death/break up) 2. interpersonal role dispute (within relationship) 3. interpersonal role transition (life changes) 4. interpersonal deficits (e.g. social awkwardness( IPT is AS effective as CBT (50-60% improve)

Answer 6

a strong link exists between GENDER and DEPRESSION - women are twice as likely to be diagnosed with unipolar depression - women appear to be younger (when diagnosed), have more frequent, and longer-lasting bouts, and respond less successfully to treatment

Answer 7

theories that explain the gender differences in rates of depression: - ARTIFACT THEORY- women and men are equally prone to depression, but clinicians fail to detect it in men - HORMONE EXPLANATION- hormone changes trigger depression in women - LIFE STRESS THEORY- women experience more stress than men - BODY DISSATISFACTION THEORY- females are under more pressure to be thin - RUMINATION THEORY- women ruminate about their depressed mood more than men - LACK OF CONTROL THEORY- women feel less in control of their lives than men

Answer 8

cog behavioral (CBT), interpersonal (IPT), and biological therapies - all highly effective treatments for mild to severe depression - relapse is less likely if drug and psychotherapy are done together - a combination of therapies is more helpful than either treatment alone; drug therapy shows a faster response but CBPT and IPT show equal improvement rates to drug therapy after 12 weeks

Answer 9

people with bipolar disorder experience both the lows of depression and the highs of mania - many describe their lives as an emotional roller coaster - extreme shifts between moods - have a dramatic impact on relatives and friends

Answer 10

people in a state of mania typically experience dramatic and inappropriate rises in mood (often ego syntonic) five main areas of functioning may be affected: 1. EMOTIONAL symptoms- active, powerful emotions in search of an outlet 2. MOTIVATIONAL symptoms- need for constant excitement, involvement, companionship 3. BEHAVIORAL symptoms- very active; move quickly, talk loudly or rapidly; they feel there isn't enough time to do everything they want to do; flamboyance is not uncommon 4. COGNITIVE symptoms- show poor judgment or planning, refusing to listen to others who may try to slow them down or prevent them from making poor judgments; may have trouble remaining coherent or in touch with reality 5. PHYSICAL symptoms- high energy level, often in the presence of little or no rest

Answer 11

feels good

Answer 12

for 1 week or more, person displays a continually elevated, expansive, or irritable mood as well as continually heightened energy or activity (for most of every day) person also experiences AT LEAST 3 symptoms (4 if the mood is only irritable): - grandiosity or overblown self-esteem - decreased NEED for sleep - more talkative than usual or the pressure to keep talking - rapidly shifting ideas or the sense that one's thoughts are racing - distractibility/attention pulled in many directions - heightened goal directed activity (socially, at work or school, sexually) or agitated movements - excessive pursuit of risky and potentially problematic activities **significant distress or impairment

Answer 13

adult prevalence rate: 1.5% avg age of onset: 22 y/o

Answer 14

adult prevalence rate: 0.8% avg age of onset: mid-20s

Answer 15

- indiv. tend to experience more depression over mania over the years (more frequent and longer lasting episodes of depression) - lifetime suicide risk: 20-30x increased risk of suicide - equally common in men and women (women more experience more depressive episodes and fewer manic episodes more than men; rapid cycling is more common in women) - more common among people with low incomes

Answer 16

15-50% of people with this are diagnosed with bipolar I or bipolar II onset- diagnosed at younger age (first symptoms can appear in childhood) than bipolar (early adulthood)

Answer 17

- low norepinephrine and low serotonin (can explain depression) - early researchers expected to find a link between high norepinephrine levels and mania (supported by some research studies) - bipolar disorders may be related to overactivity of norepinephrine and low serotonin activity - more studies show dopamine and glutamate may also be involved

Answer 18

- ions (which are needed to send incoming messages to nerve endings) may be improperly transported through the cells of individuals with bipolar disorder - some theorists believe that irregularities in the transport of these ions may cause neurons to fire too easily (mania) or to stubbornly resist firing (depression) *there is some research for this theory

Answer 19

abnormal brain structure: BASAL GANGLIA, HIPPOCAMPUS, CEREBELLUM other structural abnormalities: RAPHE NUCLEI, STRIATUM, AMYGDALA, PREFRONTAL CORTEX

Answer 20

people may inherit a biological predisposition to developing bipolar disorders family pedigree studies support this: - identical twins: 40-70% likelihood - fraternal twins: 5-10% likelihood - general population: 1-2.8% likelihood - 90% heritability rate in some twin studies - molecular biology- genes on 13 chromosomes have been linked to bipolar disorders

Answer 21

MEDICATION IS THE GOLD STANDARD -lithium - mood stabilizers

Answer 22

- extraordinarily effective - determining the correct dosage is delicate (too low= no effect; too much= lithium intoxication/poisoning)

Answer 23

mood stabilizers- antiseizure drugs for mania: Lamictal, Depakote, and Tegretol for bipolar depression: atypical antipsychotics (Latuda)- blocks dopamine and serotonin - MORE THAN 60% OF PATIENTS WITH MANIA IMPROVE ON THESE MEDICATIONS - most indiv experience fewer new episodes while on the drug - findings suggest the mood stabilizers are also prophylactic drugs (ones that actually help prevent symptoms from developing) - mood stabilizers also help those with bipolar overcome their depressive episodes to a lesser degree; SOME PT WILL ALSO BE PLACED ON ANTIDEPRESSANT MEDS OR ATYPICAL PSYCHOTIC FOR DEPRESSIVE EPISODES

Answer 24

researchers do NOT fully understand how mood stabilizing drugs operate? - they suspect the drugs change synaptic activity in neurons, but in a different way from that of antidepressant drugs (although antidepressant drugs affect a neuron's initial reception on NTs, mood stabilizers seem to affect a neuron's second messengers - these drugs also increase the production of neuroprotective proteins (BDNF), which may decrease bipolar symptoms - they may improve communication between key structures in the brain (lithium increases the size of the hippocampus and gray matter in patients)

Answer 25

psychotherapy alone is RARELY HELPFUL for persons with bipolar disorder (but it CAN be sufficient) - mood stabilizing drugs alone are also not always sufficient (30% or MORE of patients don't respond, may not receive the correct dose, and/or may relapse while taking them) AS A RESULT... clinicians often use psychotherapy as an adjunct to drug therapy - psychotherapy increases medical compliance and reduces hospitalization - psychotherapy is often a central part of treatment for cyclothymic disorder (often more so than medication)

Answer 26

hypomania- milder, less disruptive form of mania mania- more severe and potentially disruptive state characterized by elevated mood, increased energy, and impaired functioning

Answer 27

4 or more mood episodes (depression or mania) in a given year

Answer 28

kids were being misdiagnosed a LOT; non episodic irritability and moodiness in children, usually manifests as anxiety and depression in adulthood