chapter 8-11

Question 1

Unipolar depression

chapter 8

Answer 1

characterized by drops in mood or bouts of depression that last at least 2 weeks followed by a return to a normal mood. This can occur once or many times. no mania present

Question 2

Symptoms of Unipolar depression

chapter 8

Answer 2

(at least 5)

1. sleep
2. loss of interest
3. guilt
4. energy loss
5. difficulty concentrating
6. appetite (up or down, usually down)
7. psychomotor retardation (brain works slowly)
8. sucidality
9. depressed mood

Question 3

Episodes of Unipolar depression

chapter 8

Answer 3

Can occur in a lot of different ways like the following:

1. recurrent
2. seasonal
3. catatonic
4. postpartum
5. melancholic
6. typical
7. atypical
8. psychoic
9. double depression if coupled with dysthymia

Question 4

Variations of Unipolar depression

chapter 8

Answer 4

1. persistent depressive disorder-dysthymia (recurrent mild depression that lasts at least 2 years; if it leads to major depression then it is called double depression)
2. premenstrual dysphoric disorder (your period on steroids)

Question 5

Causes of unipolar depression

chapter 8

Answer 5

Nothing solid has been identified, however, there is a relevant genetic component and biochemical factor. Psychodynamic theorists point to regression to the oral stage in the face of a loss, you lose the distinction between yourself and the pieces of others you carry. Behaviorally conditioning may be to blame (as usual) loss of positives and introduction of negatives, eventual learned helplessness

Question 6

Bipolar Disorder

chapter 8

Answer 6

characterized by dramatic changes in mood, both up and down, mania and depression respectively, these episodes must last at least a week. The occurrence of even one manic episode warrants a diagnosis.

Question 7

Symptoms of bipolar disorder

chapter 8

Answer 7

Depressive symptoms are all the same. 
Manic symptoms are as follows; 1. irritability
2. elevated mood
3. inflated self-esteem (grandiosity) 
4. reduced need for sleep 
5. racing thoughts or speech
6. distractibility 
7. excessive involvement in pleasurable activities (sex, drugs, and rock n’ roll)

Question 8

Variations of bipolar disorder

chapter 8

Answer 8

1. Bipolar I - more serious, full manic and depressive cycles. typical bipolar
2. Bipolar II - also called hypomania, more mild, tend to be productive in mild bouts of mania, depression still pretty bad
3. Cyclothymia - even more mild hypomanic and dysthymic cycles

Question 9

Causes of bipolar disorder

chapter 8

Answer 9

same story as depression. Some genetic and biological markers. Alterations in brain structures.

Question 10

Psychodynamic treatment for Unipolar depression

chapter 9

Answer 10

goal is to resolve the regression to the oral stage. This one is difficult to complete, especially in severe cases, typically because of poor frustration tolerance. Not well supported by research.

Question 11

Behavioral treatment for Unipolar depression

chapter 9

Answer 11

goal is to reintroduce pleasurable activities and to use conditioning to extinguish depression. Hopes to improve social skills, force a regimen of fun stuff to do, most effectively done when the family or friends is involved in a sort of Contingency Management. Effective, but mostly in mild or moderate cases.

Question 12

Cognitive treatment for unipolar depression

chapter 9

Answer 12

Four phases.

1) increase activities to elevate mood
2) challenge negative automatic thoughts
3) Identify negative thinking and biases
4) Change primary attitudes.

This works about half the time. Increased effectiveness if you add behavioral therapy to the mix. Treats all levels of depression.

Question 13

Sociocultural treatment for Unipolar depression

chapter 9

Answer 13

Interpersonal Psychotherapy; addresses four different issues.

1) Interpersonal Loss
2) Interpersonal role dispute
3) Interpersonal role transition 4) Interpersonal deficits.

Successful about half the time. Also includes couples therapy.

Question 14

Biological treatment for unipolar depression

ECT

chapter 9

Answer 14

ECT (Electro-Convulsive Therapy): consists of 6-12 treatments over a 2 week period. subject is paralyzed and 65-140 volts cause a seizure lasting a minute or two that resets brain chemistry. Exceedingly effective and safe. Only reported side effect is some minor memory loss, typically just prior to treatment.

Question 15

Biological treatment for unipolar depression cont.

MAOI

chapter 9

Answer 15

MAOI (Monoamine oxidase inhibitors): increases use of and re-uptake of positive neurotransmitters by inhibiting enzymes that eat them. Unfortunate side effect breaks down Tyramine and causes a variety of problems, especially high blood pressure. Special diet must be enforced when taking these. Not really used anymore.

Question 16

biological treatment for unipolar depression

Tricyclics

chapter 9

Answer 16

Tricyclics: originally used as an anti-psychotic. It’s not an anti-psychotic. It does work as an antidepressant though! Prevents re-uptake of Serotonin, Norepinephrine, and Dopamine making them stay active longer. Side effects include salivation, lacrimation, urination, defecation, and sweating. Take a while to work. These aren’t fun so people stop taking these, coincidently relapse is common. Also, really bad overdose consequences.

Question 17

Biological treatment for unipolar depression

antidepressants

chapter 9

Answer 17

Second Generation Antidepressants (the good ones): includes drugs like Prozac. Works just as well as tricyclics but without nasty side effects and bad overdoses. Selectively inhibits re-uptake of Serotonin and Norepinephrine. Only real downside is some onset of anxiety when started on these drugs.

Question 18

Bipolar disorder Treatments

general description

chapter 9

Answer 18

almost always includes medication, therapy with these individuals is more difficult

Question 19

Bipolar disorder treatments

Psycho, anti, adjuctive

chapter 9

Answer 19

Psychodynamic: has little success and isn’t used much

Antidepressants: actually makes things worse.

Adjunctive Therapy: goal is to reduce risk of suicide, train the family to deal with the individual, help patient with their problem solving and social skills, and keep them in therapy

Question 20

Bipolar disorder treatments

mood stabilizers

chapter 9

Answer 20

Mood Stabilizers: Lithium Is the only important one. Lithium has a plethora of negative side effects like nausea, sluggishness, tremors, dizziness, slurred speech, seizures, and in overdose, death. Has up sides though. Decreases severity and frequency of manic episodes, doesn’t do much to help during a depressive episode, but can reduce their frequency as well. Randomly reduces risk of suicide. We don’t know how or why it works.

Question 21

Suicide

Chapter 10

Answer 21

defined as an individual intentionally ending their own life while leaving evidence, solid or implied.

Question 22

Variations of suicide

chapter 10

Answer 22

Parasuicide: an unsuccessful suicide attempt

Suicide Attempt: basically a parasuicide with some form of evidence they meant to leave behind.

Aborted Suicide Attempt: decided not to commit to dying partially through their suicide attempt (taking a lot of pills and calling an ambulance)

Suicidal Ideation: simply thoughts of being the one to kill oneself. Varies in degree and severity.

Suicidal Intent: desire for a self-destructive act to end in death, also varies in severity.

Deliberate Self-harm: act of hurting oneself without the intent of death.

Question 23

Ways to study suicide

chapter 10

Answer 23

Retrospective Analysis: look at what was left behind by somebody who committed suicide. (less than a third will leave a note)

Study Survivors: most suicide attempts are failures. Study those who attempted.

Question 24

Risk factors (for suicide)

chapter 10

Answer 24

Having a pre-existing mental disorder, 90% of people who commit suicide have a mental disorder. Schizophrenia, Depression, Anxiety, Anorexia, Bipolar

Drug and substance abuse, alcoholism, sedative abuse, opiate abuse, and even marijuana use.

Social factors, unemployment, poor social support, low SES, poor family relation, domestic violence, stress, childhood trauma, etc.

Question 25

Demographics and prevalence of suicide

chapter 10

Answer 25

More males die from suicide, more females attempt it though. 19 of every 100k men and 4 of every 100k women successfully commit suicide.

Widowed, divorced, or single more at risk, especially men.

Adolescents and Elderly at higher risk, especially the elderly.

Caucasians twice as likely to attempt compared to minority groups

Question 26

Protective factors of suicide

chapter 10

Answer 26

1.Having kids in the home
a sense of responsibility to your 2. family
3. pregnancy 
4. religiosity
5. life satisfaction
6. positive coping skills
7. good therapy relationship

Question 27

Four types of people who commit suicide:

Chapter 10

Answer 27

Death Seekers: clearly desire to end their own life, can be a transitory state.

Death Initiators: somebody who is or believes they will die soon, perhaps from a bad illness. They take matters into their own hands for a sense of control.

Death Ignorers: do not believe that death is the end but just a thing that must be done to get to a desired place. Going to heaven to see a loved one.

Death Darers: puts their life in immediate danger on purpose without caring much, may immediately regret decision directly after beginning risky activity. Russian Roulette.

Question 28

Three classes of suicide

chapter 10

Answer 28

Egoistic suicide: behavior not bound by society

Altruistic suicide: life given for another or a cause (jumping on a grenade)

Anomic: life taken when social structures fail to provide support, characterized by a decreased sense of belonging.

Question 29

Causes of suicide

chapter 10

Answer 29

Psychodynamic: similarly to depression, anal fixation and poorly placed anger stemming from it. Also points to loss of a parent as a child as a big risk factor.

Sociocultural: see the three classes listed above. These classes point to what this perspective views as the cause

Biological: low Serotonin levels

Question 30

Treatment for suicide

chapter 10

Answer 30

Treat underlying causes that can be identified.

Suicide Prevention: crisis intervention, assessment, planning, and actions

Question 31

Anorexia nervosa

chapter 11

Answer 31

characterized by extreme thinness and extreme loss of weight. There is a profound fear of gaining weight or becoming fat. They have a disturbance in body image that causes them to see negative characteristics and fat where there are none. Typically, there is a lot of denial about their condition and their current state of health

Question 32

Two types of Anorexia

chapter 11

Answer 32

1) Restricting: they simply don’t eat as much and the things they are willing to eat are usually very few and specific.
2) Binging and Purging: not necessarily bulimia. Eating in excess and then emptying themselves in any way possible with the constant intent to not gain weight or even lose some.

Question 33

Demographics for Anorexia

chapter 11

Answer 33

Almost all female at around 95%. Age of onset at highest between ages 14-18. Lifetime prevalence between .5-3.5%

Question 34

Course of anorexia

chapter 11

Answer 34

starts with dieting, often escalates after a stressful event. When they have little control over their life they find control in what they eat. 6% will die from a medical problem or suicide.

Question 35

Random information about anorexia

chapter 11

Answer 35

These guys are often perfectionists, have an odd obsession with food even though they don’t eat it. Have a variety of medical problems like Amenorrhea, low body temperature, low metabolic rate, low blood pressure (this one often kills them), body swelling, heart failure (due to the low blood pressure), rough skin, and thin hair.

Question 36

treatment for anorexia

chapter 11

Answer 36

Restoration of weight and proper eating habits, may involve feeding tubes or intravenous feeding

Behaviorism: reinforcement of proper eating habits coupled with medical monitoring and therapy

Changes in cognitive processes and familial support

Of those treated 85-90% will improve.

Question 37

Bulimia Nervosa

chapter 11

Answer 37

characterized by recurrent episodes of binge eating, about 2-40 of these episodes a week. They will be done in secret, purging usually follows, around 10k calories may be consumed at a time. Sort of like OCD the episode is preceded by tension that the binge eating somehow relieves. Because of the fear of being discovered, they are harder to spot.

Question 38

Types of bulimia

chapter 11

Answer 38

Purging: Use laxatives, vomiting, and sometimes diuretics

Non-Purging: Uses exercise or fasting.

Question 39

Levels of severity of bulimia

chapter 11

Answer 39

4-7 a week is moderate, twice a day is severe, anything more than that is extreme.

Question 40

Demographics and prevalence of bulimia

chapter 11

Answer 40

still mostly women at around 95%. Age of onset is a little later from 15-21. 5% lifetime prevalence in the west.

Question 41

Facts and Comparison with Anorexia:

chapter 11

Answer 41

Weight is usually in the normal range, though that will change if it progresses to anorexia.

Both are typically anxious, feel need to be perfect, have a distorted body image, fear of being fat, and have disturbed attitudes toward eating.

Bulimics care more about other people’s opinions and about social relationships. They also have some mood issues which often gets a diagnosis at some point

Question 42

Treatment for bulimia

chapter 11

Answer 42

Individual Insight therapy

Behavioral: conditioning coupled with keeping a journal of all food eaten. Exposure and Response Prevention

Antidepressant medications, helpful in about 40% of patients

Group therapy

80% improvement rate. Treatments seen as highly effective.

Question 43

Binge eating disorder

chapter 11

Answer 43

characterized by recurrent episodes of binge eating, its defined the same way bulimia is. Episodes occur at least once a week for at least three months. It’s associated with fear of being overweight, perfectionism, negative body image. Guys this is basically Bulimia without purging or exercise/ fasting. Only real big difference other than that is there isn’t a gender difference.