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PSYC 340 > Chapter 8 - Depression > Flashcards

Chapter 8 - Depression Flashcards

1
Q

What are the different Depressive Disorders?

A

-Disruptive Mood Dysregulation Disorder (DMDD)
-Major Depressive Disorder (MDD)
-Persistent Depressive Disorder (Dysthymia)
-Premenstrual Dysphoric Disorder

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2
Q

What are the different Bipolar Disorders?

A

-Bipolar I Disorder
-Bipolar II Disorder
-Cyclothymic Disorder

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3
Q

How do we distinguish mood disorders from temporary emotional reactions?

A

-duration: mood pervasive across situations and time (weeks, months)
-impaired ability to function
-mood changes often occurs for no apparent reason or are extreme reactions not easily explained by what is happening in the person’s life
-cluster of additional signs and symptoms

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4
Q

What is the DSM-5 Criteria for MDD?

A

A: >= 5 of the following during a 2-week period and are present the majority of the time
-at least 1 of these: depressed mood or anhedonia (lack of pleasure)
-plus at least 4 of these: significant change in weight/appetite; insomnia or hypersomnia; psychomotor agitation or retardation; fatigue/loss of energy; feelings of worthlessness or inappropriate guilt; difficulty thinking/concentrating; recurrent thoughts of death, suicidal ideation with or w/out plan, or suicide attempt
B: Cause significant distress or impairment
C: Episode not attributable to substances or medical condition
D: Symptoms not better explained by another mental disorder
E: No history of manic episode or hypomanic episode
*Criteria A-C represents a major depressive episode

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5
Q

What are some MDD specifiers?

A

-severity: mild/moderate/severe
-in partial remission/in full remission
-single/recurrent episode
-with psychotic features: hallucinations or delusions
-with anxious distress: anxious symptoms
-with peripartum onset: onset during pregnancy or within 4 weeks of delivery
-with seasonal pattern: associated with changes in daylight as the seasons change

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6
Q

What is the recurrence of Depressive Episodes?

A

-each major depressive episode increases the risk of a subsequent episode:
1 episode - 50-60% will have another
2 episodes - 70% will have another
3 episodes - 90% will have another
-with each subsequent episode, the length of time to recurrence is shortened

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7
Q

What is Persistent Depressive Disorder (Dysthymia)?

A

-more chronic
-usually less severe symptoms, but not always
-depressed mood for at least 2 years

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8
Q

What are the DSM-5 criterias for Persistent Depressive Disorder (Dysthymia)?

A

A: Depressed mood for at least 2 years (most of the day, more days than not)
B: At least 2 of the following while depressed: poor appetite or overeating; insomnia or hypersomnia; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; feelings of helplessness
C: During the 2 year period, the individual has never been without symptoms for more than 2 months
D: Criteria for major depressive disorder may be continuously present for 2 years
E: Never been a manic or hypomanic episode
F and G: Not explained by another mental or medical condition
H: Cause significant distress or impairment

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9
Q

What is the prevalence of Depressive Disorders?

A

-2nd leading cause of disability worldwide
-MDD: lifetime prevalence of 15-20%; typical onset late 20s
-PDD: lifetime prevalence 3-6% in Canada; typical onset late childhood/adolescence
-72% of individuals with MDD has comorbidity: 59% anxiety disorder, 24% substance use disorder, 30% impulse control disorder

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10
Q

What is Neurotransmitter Dysfunction (biological dimension)?

A

-low levels of Norepinephrine, Dopamine, and Serotonin
-antidepressant medications –> increase availability of NTs

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11
Q

What is Norepinephrine’s role?

A

-regulation of attention, arousal and concentration, dreaming, and moods; as a hormone, influences physiological reactions related to stress

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12
Q

What is Dopamine’s role?

A

-influences motivation and reward-seeking behaviours; regulates movement, emotional responses, attention, and planning

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13
Q

What is Serotonin’s role?

A

-inhibitory effects regulate temperature, mood, appetite, and sleep; reduced serotonin can increase impulsive behaviour and aggression

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14
Q

Does heritability play a role in MDD?

A

-concordance rates for MDD: DZ twins - 10%; MZ twins - 40%
-~35% variability in risk of developing MDD due to heritability

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15
Q

What is neuroendocrine dysregulation?

A

-dysregulation and overactivity of HPA axis
-overproduction of stress-related hormones appear to play an important role in depression
–people with depression have higher blood levels of cortisol

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16
Q

What are the brain changes linked to depression?

A

-depressed individuals have decreased brain activity and other brain changes
-decreased neuroplasticity and neurogenesis in the hippocampus
-structural differences in hippocampus
-functional differences - reduced activation in prefrontal cortex and increased reactivity in amygdala

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17
Q

How do circadian rhythm disturbances impact depression?

A

-circadian rhythms: internal biological rhythms maintained by melatonin
-sleep disturbances strongly linked to depression
-depression linked to disruptions (for those with or without seasonal patterns)
-irregularities in rapid eye movement (REM)

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18
Q

What do Behavioural Theories think causes depression?

A

-depression occurs when people receive insufficient social reinforcement

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19
Q

According to behavioural theories, when does the risk of depression increase?

A

-limited opportunities to engage in reinforcing activities
-there are few reinforcements available in the environment
-person’s behaviour/social skills result in limited reinforcement

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20
Q

What do Cognitive Theories think causes depression?

A

-depression is a disturbance in thinking rather than a disturbance in mood

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21
Q

What does Beck’s theory of depression focus on (cog theory)?

A

-self - negative self-schema
-world
-future
negative thinking patterns

22
Q

What is the Response Styles Theory (Nolen-Hoeksema) (cog theory)?

A

-the way a person responds to a negative mood can have an impact on the severity and/or duration of the mood

23
Q

What is rumination (cog theory)?

A

-focused attention on negative emotional state, thinking repeatedly about the causes and consequences
-co-rumination: constantly talking of problems or negative experiences with others
-increases depression risk, especially in females

24
Q

What is Attributional Style and the 2 different types (cog theory)?

A

-characteristic way of explaining why a positive/negative event occurred
–negative attributional style = focus on causes that are internal, stable, and global
–positive attributional style = focus on causes that are external, unstable, and specific

25
Q

What is Learned Helplessness (cog theory)?

A

-a learned belief that one is helpless and unable to affect outcomes

26
Q

What is the Attribution and Learned Helplessness Theory?

A

-Aversive event/stressor –> Attributed to global, internal, and stable factors –> sense of helplessness –> depression

27
Q

What is the etiology of depression (social dimension)?

A

-maltreatment during early childhood is strongly associated with later depression (modify expression of genes associated with HPA axis)
-parental depression influences intergenerational transmission of depression
-stressful life event <-> depression
-low social support is associated with risk of depression (excessive reassurance-seeking; but not trust it)

28
Q

What are some racial and ethnic influences (sociocultural dimension)?

A

-African American and Latina women report depression in the form of somatic/bodily complaints (not sad)
-triggers for depression differ among cultural groups (Chinese teens - poor academic performance; fam conflict)
-Acculturation conflicts associated with depressive symptoms
-perceived discrimination based on race or ethnicity is strongly associated with depression

29
Q

What are some sex and gender influences of depression?

A

-LGBTQ+ individuals experience higher rates of depression and suicide
-fear of rejection and social isolation around decision to share sexual orientation or gender identity
-silence about one’s sexual orientation or gender identity can result in personal distress

30
Q

What are the sex differences in depression?

A

-female to male ratio ~ 2:1
-sex differences emerge in ado.
-women accept and seek help more
-hormonal differences
-women more likely experienced childhood trauma/other stressors
-gender role expectations/limited occupational opportunities that lead to feelings of helplessness or hopelessness
-cognitive styles that increase depression (such as ruminating or co-ruminating) are more common in women)

31
Q

How does poverty influence depression?

A

-difficulty to be hopeful about future when lack housing and food security
-limit opportunities including employment
-increased day to day stressors

32
Q

What are the evidence-based treatments for Depression?

A

-medications
-brain stimulation treatments
-behavioural activation
-cognitive-behavioural therapy
-mindfulness-based cognitive therapy
-interpersonal therapy

33
Q

What is the goal of antidepressant medications and 3 different types?

A

-increase availability of certain NTs
-block reabsorption of norepinephrine and serotonin (more side effects; 2nd line of treatment)
-block reabsorption of serotonin (1st line of treatment)
-affect other NTs (like dopamine)
1/3-1/2 discontinue the use of the meds due to side effects

34
Q

What are 3 types of antidepressants that increase norepinephrine and serotonin?

A

-Tricyclics
-Monoamine Oxidase Inhibitors (MAOIs)
-Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

35
Q

Which antidepressants increase serotonin?

A

-Selective Serotonin Reuptake Inhibitors (SSRIs)
–most commonly used

36
Q

Which antidepressants affect other NTs (like dopamine)?

A

-atypical antidepressants

37
Q

When are Brain Stimulation Treatments used?

A

-for severe depression or treatment-resistant depression
-promising, but based on research with small sample sizes

38
Q

What are the 3 types of Brain Stimulation Treatments?

A

-Electroconvulsive therapy (ECT)
-Vagus nerve stimulation
-Transcranial magnetic stimulation (TMS)

39
Q

How does ECT work?

A

-inducing seizure in the brain
-side effects: confusion, memory loss

40
Q

How does vagus nerve stimulation work?

A

-delivers frequent electronic impulses from vagus nerve to brain

41
Q

How does TMS work?

A

-non-invasive brain stimulation
-brief magnetic pulses to the brain

42
Q

What is Behavioural Activation?

A

-helps patient increase their participation in enjoyable activities and social interactions

43
Q

What are the steps of Behavioural Activation?

A

-identifying and rating pleasurable activities
-performing some of activities
-identifying day to day problems and troubleshoot
-improving social and assertiveness skills

44
Q

What is Interpersonal Psychotherapy (IPT)?

A

-therapy focuses on current relationship issues (oriented towards the present)

45
Q

What are the 3 goals of IPT?

A

-improving communication
-identifying role conflicts
-increasing social skills

46
Q

What are the 4 problem areas of interpersonal difficulties (IPT)?

A

-grief
-disputes
-major life changes
-loneliness

47
Q

What is Cognitive Behavioural Therapy (CBT)?

A

-focuses on altering negative thought patterns and distorted thinking

48
Q

What are the steps of CBT?

A

-identify negative, self-critical thinking
-examine the connection between negative thoughts and negative feelings
-examine accuracy of thoughts/beliefs
-learn to replace inaccurate beliefs with realistic interpretations

49
Q

What is the effectiveness of CBT and other treatments?

A

-CBT and antidepressant medications are comparable in short-term (16 weeks), although medication may act more quickly
~58% in both groups responded to treatment
-individuals treated with CBT less likely to relapse than those treated with antidepressants

50
Q

What is Mindfulness-Based Cognitive Therapy?

A

-calm awareness of one’s present experience, thoughts, and feelings
-promote acceptance instead of judgmental, evaluative, or ruminative
-mindfulness (focusing on the present) helps disrupt the cycle of negative thinking

PSYC 340 (13 decks)

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