chapter 8 Flashcards
mood disorder
what are the characteristics of mood disorders?
serious the typical emotional state
significant disturbances on emotion other or elation/irratation
dysfunction on social and occupational realms
what do mood disorders affect in life?
physical, perceptual, social, biological and thought processes
what are mood disorders not due to?
not due substance use
what are the emotional symptoms of major depressive disorder
depressed mood
what are the motivational symptoms of major depressive disorder?
loss of desire to do usual activities lack of drive
what are the behavioural symptoms of major depressive disorder?
less active and productive
move and speak slowly
physically agitated
what are the cognitive functioning of major depressive disorder?
negative self evaluation, indecisiveness, thoughts of death or suicide
what are the physical functionings of major depressive disorder?
headaches, indigestion, pain , eating disturbances, sleep disterbances
what is the criteria to get diagnosed with major depressive disorder?
must have one of the 2 core symptoms and 4 other common symptoms
what are the 2 core criteria for major depressive disorder?
- sad or blue mood most of the day or every day
- loss of pleasure for two weeks to longer (anhedonia)
what is the prevalence of major depressive disorder?
life time rates: 5.2% –> 17.1% (thought to be higher)
2x more common in women than men
why is major depressive disorder more common in women than men?
men tend to distract themselves
women tend to ruminate
what is the objectification theory for the gender difference in major depressive disorder?
women being viewed and evaluated as an object, reduces self esteem
what is mixed depression?
may have low grade symptoms of mania that doesn’t meet criteria for hypomania or mania
are married men happier than signal men?
yes
are married women happier than single women?
no
what is persistent depressive disorder?
depressive mood for most of the days than not, for more than 2 years or longer
doesn’t need the 2 core symptoms of depression
what is double depression?
person with persistent depressive disorder can have one or more episodes of major depressive disorder
what is postpartum depression?
happens after giving birth
lots of anxiety
common after dramatic birth
what is bipolar disorder?
very biologically based
what is the prevalence of bipolar disorder?
4.4% of the population
average onset is in 20s
occurs equally as often in men and women
what are the women differences in bipolar disorder?
episodes of depression are more common
what are the men differences in bipolar disorder?
episodes of mania are more common
what is bipolar 1 disorder?
depression that meets MDD and at least one episode of mania or mixed episodes include both mania and depression
what are the core symptoms required for a diagnosis of a manic episode?
distinct presence of a persistently elevated or irritable mood
increase goal-directive activity or at least one week +3 additional symptoms
how do you get a diagnosis of a manic episode?
core symptoms last at least one week and 3 more symptoms or 4 of if the mood is irritable
what are some symptoms of manic episode?
less than usual amount of sleep needed
inflated self esteem
distractibility
excessive involvement in pleasurable activities
what is bipolar 2 disorder?
at least one episode of depression that meets criteria of MDD and one or more episodes of hypomania (last at least 4 days)
what are core symptoms of hypomania?
presence of persistently elevated or irritable mood and persistently increased activity
symptoms not due to the effects of a substances
what is hypomania?
feel extra energetic. decrease need of sleep
unusually optimistic, increase talkativeness , risky and impulsive behaviour
what can hypomania affect?
damage to ruin relationships with friends, family and in the workplace
what is bipolar disorder with rapid cycling?
person has four or more episodes mood disturbances in a year
what is bipolar disorder 1 or 2 with mixed features?
combination of depression and mania or hypomania at same time
what is bipolar disorder with predominant polarity?
alternating periods of depression and hypomania
person spends significantly more times in one state over the other
what are the symptoms of Cyclothymic disorder?
periods of hypomania with mild depression over a period of 2+ years (adults) or 1 year (children)
what is the lifetime prevalence of Cyclothymic disorder?
0.04-1%
what is seasonal affective disorder (SAD)?
involves depression in the winter, some experience in the summer
can be bipolar or unipolar
where does SAD more prominent in, K.W or Vancouver?
vancouver
where are the higher rates of SAD?
higher rates in cloudy areas
what is the psychoanalytic theory of depression?
depression seems to be like grief
what is the psychoanalytic theory for people with introspective (self critical) depression?
feelings of inferiority, inadequacy, self criticism and guilt
what is the psychoanalytic theory for anaclitic depression?
feelings of being unloved and unwanted
what is the psychological theory for bipolar disorder?
largely neglected by scholars and clinicians
what are interpersonal models of depression?
sparse social networks that provide little support
what are the consequences of sparse social networks with interpersonal depression?
decrease in individual’s ability to handle negative life events
increase vulnerability to depression
what is the self-certification theory of interpersonal models of depression?
seek confirmation from others that consistent with their negative self-view
gravitate towards individuals who will evaluate them negatively
what is the stress generation hypothesis of interpersonal models of depression?
depressed individuals tend to experience negative interpersonal situations
what leads to schemata?
criticized excessively
think they are incompetent
expecting to fail
what are schemata?
perceptual sets and influences how we perceive and understand the world
what’s one thing that can create negative schemata?
very critical parents
what are dysfunctional attitudes?
negative conditions that distort how the person interpret situations that make them more valuable to depression after particular events
what are dysfunctional events related to?
need for approval
what does dysfunctional beliefs reflect?
need for achievement and perfection
what is beck’s negative cognitive triad for depression?
- self worthlessness
- future is hopeless
- cannot cope/ helpless to change events in one’s life
what is the helplessness/ hopelessness theories of depression?
learned helplessness involves passivity and having a sense of being unable to act and control own circumstances
what is hopelessness acquired through?
unpleasant experiences and traumas that they were unable to control at the time
what are the attribution of learned helplessness?
attribution to stable factors
attribution to internal characteristics
global attributions
what are attribution to stable factors?
could be something you can’t change or something you can
what are attribution to internal characteristics?
something you can’t really change
what is the hopelessness theory?
expectations that desirable outcomes will not occur
what does hopelessness theory think helplessness is caused from?
negative life events interact with diatheses and lead to a state of hopelessness
what vulnerabilities that the hopelessness theory include?
low self esteem and belief that negative life events will have severe negative consequences
what are things around depression and relationships?
having a spouse who is critical puts the target of criticism at risk of depression as much as 10 years
others become annoyed by partners who frequently seek reassurance
what are stress generation behaviour?
frequent reassurance seeking create a stressful environment
what is stress generation associated with?
depression in adolescent in girls
what does interpersonal stress generation predict with depression?
predicted depression in girls with history of childhood maltreatment but not girls without a history of childhood maltreatment
what are the social skills deficits and depression?
low social competence predict the onset of depression in children
poor interpersonal problem solving predicts increase in depression in adolescents
what are the advances in knowledge of biological processes in mood disorders?
genetic sequencing
imagine have contributed to growth in knowledge
structural differences found in schizophrenia
what are the biological theories for MDD?
heritability =35%
relatives of unipolar probands increase risk for unipolar depression
serotonin transporter gene linked promoter region
what are biological and environment risk factors for MDD?
many genes involved with onset of MDD
childhood trauma
negative styles of information processing
what are the biological theories for bipolar disorder?
concordance rate is high as 85%
strong heritable component
gene on the 11th chromosome
brain derived neurotrophic gene
what is neuroimaging study?
decrease hippocampal volumes and neurocognitive impairment
inconsistencies in biological findings in bipolar disorders?
gene 11th chromosome but not been consistently replicated
BDNF thought to predict rapid cycling bipolar disorder but not ethically replicated
what are biological theories (early theories)for bipolar disorder?
decreased levels of norepinephrine and dopamine lead to depression
increase levels lead to mania
what are the biological theories (serotonin theory) for bipolar disorder?
serotonin produces both depression and mania
clues for theories based on drug effectiveness?
tricyclic drugs prevent some of the reuptake of norepinephrine
monoamine oxidase inhibitors keep the enzyme from deactivating neurotransmitters
selective serotonin reuptake inhibitor
what chemical in food increases serotonin?
tryptophan
what neurotransmitters related to depression and mania?
serotonin, norepinephrine and dopamine
what makes the biological mechanisms not straight forward?
may not just be related to levels of neurotransmitters
how might anti-depressents and mood stabilizer medication work?
changing the responsiveness of receptors for serotonin, norepinephrine and dopamine
what is the neuroendocrine system?
HPA axis may play a role in depression
how might the HPA axis play a role in depression?
limbic area of brain affects hypothalamus which controls endocrine glands
increase levels of cortisol in depressed patents
what does it mean to have 4 Asus points
likely to die 20 years younger than most people
what organ disorder seems to have coronation to bipolar disorder?
thyroid
what can thyroid hormones induce?
can induce mania
what brain brain dysfunction has correlation to bipolar disorder?
right hemisphere dysfunction
what does right hemisphere dysfunction tend to do?
sense of indifference or flatness
what are the main biological hypotheses about major depression?
genetic diathesis, low serotonin or high serotonin receptor dysfunction, high levels of cortisol
what are the main biological hypotheses about bipolar disorder?
genetic diathesis, low serotonin or low norepinephrine in depressed phase, high norepinephrine in manic phase
when are ECT used for depression?
if patient is suicidal and already tried medication
when does the patient start to feel better when ECT is used for depression?
after 4 sessions
max 10-12 sessions
what are the biological treatments for depression that’s not medication?
ECT for depression
transcranial magnetic stimulation (rTMS)
what is ketamine use to treat?
used to treat sever depression
what does ketamine do?
rapid growth of dendritic spines in prefrontal cortex
really addictive
what are some psychological therapies for mood disorders?
psychodynamic therapies
cognitive and behaviour therapies
mindfulness-based cognitive therapies
