Chapter 7 Mood Disorders and Suicide

Question 1

Mood disorders

Answer 1

1. Depressive disorders, affective disorders, depressive neuroses
2. Group of disorders involving severe and enduring disturbances in emotionality ranging from elation to severe depression.
3. Experiences of depression and mania, either singly or together

Question 2

Major depressive episode

Answer 2

1. The most commonly diagnosed and most severe depression
2. An extremely depressed mood state that lasts at least 2 weeks and includes cognitive symptoms and disturbed physical functions to the point that even the slightest activity or movement requires an overwhelming effort
3. Is typically accompanied by a general loss of interest in things and an inability to experience any pleasure from life
4. The most central indicators of a full major depressive episode are the physical changes (somatic or vegetative symptoms), along with the behavioral and emotional “shutdow”
5. Anhedonia: loss of energy and inability to engage in pleasurable activities or have any “fun”
6. Most common and severe experience of depression, including feelings of worthlessness, disturbances in bodily activities such as sleep, loss of interest, and the inability to experience pleasure, persisting at least two weeks.

Question 3

Mania

Answer 3

1. The second fundamental state in mood disorders is abnormally exaggerated elation, joy or euphoria
2. Individuals find extreme pleasure in every activity
3. Became extraordinarily active (hyperactive), require little sleep, and may develop grandiose plans, believing they can accomplish anything they desire.
4. Persistently increased goal-directed activity or energy
5. Speech is typically rapid and may become incoherent, because the individual is attempting to express so many exciting ideas at once- flight of ideas
6. Require duration of only 1 week, less if the episode is severe enough to require hospitalization
7. Irritability
8. Being anxious or depressed
9. The duration of an untreated manic episode is typically 3 to 4 months
10. Dysphoric (anxious or depressive)

Question 4

Hypomanic episode

Answer 4

1. A less severe version of manic episode that does not cause marked impairment in social or occupational functioning and need last only 4 days rather than a full week
2. Not in itself necessarily problematic, but its presence does contribute to the definition of several mood disorders

Question 5

Mixed features

Answer 5

1. An individual can experience manic symptoms but feel somewhat depressed or anxious at the same time; or be depressed with a few symptoms of mania

Question 6

Major depressive disorder

Answer 6

1. The absence of manic, or hypomanic episodes before or during the disorder

Question 7

Recurrent

Answer 7

1. If two or more major depressive episodes occurred and were separated by at least 2 months during which the individual was not depressed
2. Predicting the future course of the disorder, as well as in choosing appropriate treatments

Question 8

Persistent depressive disorder (dysthymia)

Answer 8

1. Shares many of the symptoms of major depressive disorder but differs in its course
2. May be fewer symptoms
3. Depression remains relatively unchanged over long periods, sometimes 20 or 30 years or more
4. Depressed mood that continues at least 2 years, during which the patient cannot be symptom free for more than 2 months at a time even though they may not experience all of the symptoms of a major depressive episode
5. Differs from a major depressive disorder in the number of symptoms required, but mostly in the chronicity
6. More severe
7. With higher rates of comorbidity with other mental disorders
8. Less responsive to treatment
9. Slower rate of improvement over time

Question 9

Double depression

Answer 9

1. Severe mood disorder typified by major depressive episodes superimposed over a background of dysthymic disorder.
   Severe mood disorder typified by major depressive episodes superimposed over a background of dysthymic disorder
2. 22% of people suffering from persistent depression with fewer symptoms (called dysthymia) eventually experienced a major depressive episode
3. These individuals who suffer from both major depressive episodes and persistent depression with fewer symptoms
4. Typically, a few depressive symptoms develop first, perhaps at an early age, and then one or more major depressive episodes occur later only to revert to the underlying pattern of depression once the major depressive episode has run its course.

Question 10

Clinicians use eight basic specifiers to describe depressive disorders

Answer 10

1. With psychotic features (mood-congruent or mood-incongruent)
2. With anxious distress (mild to severe)
3. With mixed features
4. With melancholic features
5. With atypical features
6. With catatonic features
7. With peripartum onset
8. With seasonal pattern
9. Some of these specifiers apply only to major depressive disorder. Others apply to both major depressive disorder and persistent depressive disorder.

Question 11

Psychotic features specifiers

Answer 11

1. Hallucinations
2. Delusions
3. Somatic physical delusions, believing
4. Auditory hallucinations
5. Mood congruent
6. Delusions of grandeur

Question 12

Hallucinations

Answer 12

seeing or hearing things that aren’t here

Question 13

Delusions

Answer 13

Strongly held but inaccurate beliefs

Question 14

Delusions of grandeur

Answer 14

Believing, for example, they are supernatural or supremely gifted

Question 15

Anxious distress specifier

Answer 15

1. The presence and severity of accompanying anxiety, whether in the form of comorbid anxiety disorders (anxiety symptoms meeting the full criteria for an anxiety disorder) or anxiety symptoms that do not meet all the criteria for disorders

Question 16

Mixed features specifier

Answer 16

Predominantly depressive episodes that have several (at least three) symptoms of mania

Question 17

Melancholic features specifier

Answer 17

1. If the full criteria for a major depressive episode have been met, whether in the context of persistent depressive disorder or not.
2. Some of the more severe somatic (physical) symptoms

Question 18

Catatonic features specifier

Answer 18

1. Can be applied to major depressive episodes whether they occur in the context of a persistent depressive order or not, and even to manic episodes, although it is rare- and rarer still in mania.
2. Catalepsy

Question 19

Catalepsy

Answer 19

1. Absence of movement (a stuporous state)
2. The muscles are waxy and semirigid, so a patient’s arms or legs remain in any position in which they are placed.
3. Involve excessive but random or purposeless movement
4. More commonly associated with schizophrenia, but some recent studies have suggested it may be more common in depression than in schizophrenia.

Question 20

Atypical features specifier

Answer 20

1. This specifier applies to both depressive episodes, whether in the context of persistent depressive disorder or not.
2. Oversleep and overeat during their depression and therefore gain weight, leading to a higher incidence of diabetes.
3. Although they also have considerable anxiety, they can react with interest or pleasure to somethings, unlike most depressed individuals.
4. Is associated with a greater percentage of women and an earlier age of onset.
5. Has more symptoms, more severe symptoms, more suicide attempts, and higher rate of comorbid disorders including alcohol abuse

Question 21

Peripartum onset specifier

Answer 21

1. Can apply to both major depressive and manic episodes
2. Women giving birth
3. After birth

Question 22

Seasonal pattern specifier

Answer 22

1. Recurrent major depressive disorder

2. Accompanies episedes that occur during certain seasons

Question 23

Seasonal affective disorder (SAD)

Answer 23

1. The most usual pattern is a depressive episode that begins in the late fall and ends with the beginning of spring
2. Must have occurred for at least two years with no evidence of non seasonal major depressive episodes occurring during that period of time

Question 24

Integrated grief

Answer 24

1. Finality of death and its consequences are acknowledged and the individual adjusts to the loss
2. Often recurs at significant anniversaires

Question 25

Complicated grief

Answer 25

1. Persistent intense symptoms of acute grief
2. The presence of thoughts, feelings, or behaviors reflecting excessive or distracting concerns about the circumstances or consequences of the death

Question 26

Premenstrual Dysphoric Disorder (PMDD)

Answer 26

1. Suffered from severe and sometimes incapacitating emotional reactions during the premenstrual period
2. Uncomfortable premenstrual symptoms (PMS)
3. Combination of physical symptoms, severe mood swings, and anxiety

Question 27

Disruptive Mood Dysregulation Disorder

Answer 27

1. Severe recurrent temper outburst manifested verbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation or provocation
2. Temper outbursts occur, on average, three or more times per week
3. Persistently irritable or angry most of the day

Question 28

Bipolar I Disorders

Answer 28

1. Alternation of major depressive episodes with full manic episodes.

Question 29

Bipolar II Disorders

Answer 29

1. Alternation of major depressive episodes with hypomanic (not full manic) episodes.

Question 30

Cyclothymic disorder

Answer 30

1. Chronic (at least two years) mood disorder characterized by alternating mood elevation and depression levels that are not as severe as manic or major depressive episodes.

Question 31

Learned helplessness theory of depression

Answer 31

1. Seligman’s theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether in reality they do or not).
2. Depression may follow marked hopelssness about coping with the difficult life events
3. The depressive attributional style is internal, in that the individual attibutes negative events to personal failings; stable, in that even after a particuar negative event passes, the attribution that “additional bad things will always be my fault” remains; and global, in that the attibutions extend across a variety of issues.

Question 32

Mood-stabilizing drug

Answer 32

1. Lithium
2. Effective in preventing and treating manic episodes
3. Gold standard for treatment of bipolar disorder
4. a medication used in the treatment of mood disorders, particularly bipolar disorder, that is effective in preventing and treating pathological shifts in mood

Question 33

Electroconvulsive therapy (ECT)

Answer 33

1. The most controversial treatment for psychological disorders after psychosurgery
2. Biological treatment for severe, chronic depression involving the application of electrical impulses through the brain to produce seizures. The reasons for its effectiveness are unknown.

Question 34

Cognitive therapy

Answer 34

Treatment approach that involves identifying and altering negative thinking styles related to psychological disorders such as depression and anxiety and replacing them with more positive beliefs and attitudes-and, ultimately, more adaptive behavior and coping styles.

Question 35

Interpersonal psychotherapy (IPT)

Answer 35

Newer brief treatment approach that emphasizes resolution of interpersonal problems and stressors such as role disputes in marital conflict, or forming relationships in marriage or a new job. It has demonstrated effectiveness for such problems as depression.

Question 36

Maintenance treatment

Answer 36

Combination of continued psychosocial treatment or medication designed to prevent relapse following therapy.

Question 37

Suicidal ideation

Answer 37

Serious thoughts about committing suicide

Question 38

Suicidal plans

Answer 38

the formulation of a specific method for killing oneself

Question 39

Suicidal attempts

Answer 39

Efforts made to kill oneself; the person survives

Question 40

Chological auopsy

Answer 40

Postmortem psychological profile of a suicide victim constructed from interviews with people who knew the person before death.

Question 41

depressive cognitive triad

Answer 41

Aaron T. Beck’s theory that depression may result from a tendency to think negatively about three areas: oneself, one’s immediate world, and one’s future.

Question 42

Dysthmic Disorder

Answer 42

Mood disorder involving persistently depressed mood, with low self esteem, withdrawal, pessimism or despair, present for at least two years, with no absence of symptoms for more than two months.

Question 43

impacted/pathological grief reaction

Answer 43

Extreme reaction to the death of a loved one that involves psychotic features, suicidal ideation, or severe loss of weight or energy, or that persists more than two months.

Question 44

mixed episode/dysphoric manic episode

Answer 44

Condition in which the individual experiences both elation and depression or anxiety at the same time.

Question 45

neurohormones

Answer 45

Hormones that affect the brain and are increasingly the focus of study in psychopathology.

Question 46

phototherapy

Answer 46

Treatment of seasonal affective disorder with large doses of exposure to bright light.

Question 47

psychological autopsy

Answer 47

Postmortem psychological profile of a suicide victim constructed from interviews with people who knew the person before death.

Question 48

list the types of suicide

Answer 48

altruistic, egoistic, anomic, and fatalistic

Question 49

altruistic

Answer 49

brought dishonor to themselves or family

Question 50

egoistic

Answer 50

loss of social support

Question 51

anomic

Answer 51

marked disruptions

Question 52

fatalistic

Answer 52

loss of control over one’s life

Question 53

what disorder is time-limited?

Answer 53

major depressive disorder

Question 54

most common and extreme mood disorder

Answer 54

major depressive episode

Question 55

cyclothymic disorder is a milder but more chronic form of __________

Answer 55

bipolar disorder

Question 56

Last week, as he does about every 3 months, Ryan went out with his friends, buying rounds of drinks, socializing until early morning, and feeling on top of the world. Today, Ryan will not even get out of bed to go to work, see his friends, or even turn on the lights.

Answer 56

Bipolar I disorder

Question 57

Feeling certain he would win the lottery, Charles went on an all-night shopping spree, maxing out all his credit cards without a worry. We know he’s done this several times, feeling abnormally extreme elation, joy, and euphoria.

Answer 57

Mania

Question 58

Ayana has had some mood disorder problems in the past, although some days she’s better than others. Many days it seems like she has fallen into a rut. Although she manages to get by, she has trouble making decisions because she doesn’t trust herself.

Answer 58

Persistent depressive disorder

Question 59

For the past few weeks, Jennifer has been sleeping a lot. She feels worthless, can’t get up the energy to leave the house, and has lost a lot of weight. Her problem is the most common and extreme mood disorder.

Answer 59

Major depressive episode

Question 60

Eusebio is always down and a bit blue, but occasionally he becomes so depressed that nothing pleases him.

Answer 60

Double depression

Question 61

T or False- Women are approximately twice as likely as men to be diagnosed with a mood disorder.

Answer 61

True

Question 62

T or False- Depression requires some life experience, indicating that babies and young children cannot experience the disorder.

Answer 62

False. It does not require life experience.

Question 63

T or False- It’s often difficult to diagnose depression in the elderly because its symptoms are similar to those of medical ailments or dementia.

Answer 63

True

Question 64

T or False- Somatic symptoms characterizing mood disorders are nearly equivalent across cultures.

Answer 64

True

Question 65

List five biological sources that can contribute to mood disorders

Answer 65

Genetics, neurotransmitter system abnormalities, endocrine system, circadian or sleep rhythms, neurohormones

Question 66

What psychological factors can have an impact on mood disorders?

Answer 66

Stressful life events, learned helplessness, depressive cognitive triad, a sense of uncontrollability

Question 67

Name several social and cultural dimensions that contribute to mood disorders

Answer 67

Marital dissatisfaction, gender, few social supports

Question 68

The controversial but somewhat successful treatment involving the production of seizures through electrical current to the brain.

Answer 68

Electroconvulsive therapy

Question 69

This teaches clients to carefully examine their thought process and recognize “depressive” styles in thinking.

Answer 69

Cognitive therapy

Question 70

These come in three main types (tricyclics, MAO inhibitors, and SSRIs) and are often prescribed but have numerous side effects.

Answer 70

Antidepressants

Question 71

This antidepressant must be carefully regulated to avoid illness but has the advantage of affecting manic episodes.

Answer 71

Lithium

Question 72

This therapy focuses on resolving problems in existing relationships and learning to form new interpersonal relationships.

Answer 72

Interpersonal psychotherapy

Question 73

This is an effort to prevent relapse or recurrence over the long run.

Answer 73

Maintenance treatment

Question 74

Ralph’s wife left him and took the children. He is a well-known television personality, but, because of a conflict with the new station owners, he was recently fired. If Ralph kills himself, his suicide would be considered___________.

Answer 74

Anomic

Question 75

Sam killed himself while a prisoner of war in Vietnam

Answer 75

Fatalistic

Question 76

Sheiba lives in a remote village in Africa. She was recently caught in an adulterous affair with a man in a nearby village. Her husband wants to kill her but won’t have to because of a tribal custom that requires her to kill herself. She leaps from the nearby “sinful woman’s cliff”

Answer 76

Altruistic

Question 77

Mabel lived in a nursing home for many years. At first, her family and friends visited her often; now they come only at Christmas. Her two closest friends in the nursing home died recently. She has no hobbies or other interests. Mabel’s suicide would be identified as what type?

Answer 77

Egoistic