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Psyc 260 > Chapter 8 Depression and Mania > Flashcards

Chapter 8 Depression and Mania Flashcards

1
Q

What are mood disorders characterized by?

A

Gross deviations in mood.

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2
Q

Define major depressive episode.

A

-The most severe depression

-Cognitive symptoms such as feelings of worthlessness, indecisiveness, disturbed physical functions, and notable loss of energy.

-Physical symptoms such as altered sleeping patterns, significant changes in appetite and weight, or a very notable loss of energy)

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3
Q

What is anhedonia?

A

General loss of interest and of the ability to experience any pleasure from life

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4
Q

What symptoms are associated with mania?

A

Extreme pleasure in activities, hyperactivity, rapid speech, flight of ideas.

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5
Q

What is the average duration of an untreated manic episode?

A

3-4 months

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6
Q

What is a hypomanic episode? (hypo-less)

A

Not as severe as a manic episode with no marked impairment in social or occupational functioning.

Ex. Could get some sleep but doesn’t feel like they need it

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7
Q

Differentiate between unipolar and bipolar mood disorders.

A

Unipolar mood disorder remains at one pole of depression–mania continuum; bipolar mood disorder travels between depression–mania poles.

Unipolar means they have just depression or just mania not both like bipolar disorders

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8
Q

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, what is this known as?

A

An episode with mixed features.

Condition in which the individual experiences both elation and depression or anxiety at the same time. Also known as dysphoric manic episode or mixed manic episode.

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9
Q

What is major depressive disorder defined by?

A

The presence of depression and the absence of mania; is recurrent.

If two or more major depressive episodes occurred and were separated by at least two months during which the individual was not depressed, the major depressive disorder is noted as being recurrent.

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10
Q

What is persistent depressive disorder?

A

Similar to major depressive disorder but differs in its course as the depression remains unchanged over long periods (years)

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11
Q

What is double depression?

A

Persistent depressive disorder with episodes of major depression.

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12
Q

Overall depressive disorders:

A

Panel (a) is nonchronic major depressive disorder (in this case, recurrent, as two depressive episodes are depicted).

Panel (b) is persistent depressive disorder.

Panel (c) is double depression (major depressive episode superimposed on antecedent persistent depressive disorder).

Panel (d) is chronic major depressive episode.

Panel (e) is major depressive episode in partial remission.

Panel (f) is recurrent major depression without full inter-episode recovery.

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13
Q

There are also additional criteria used for identifying depressive disorders, what are these known as?

A

Specifiers

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14
Q

What are the eight specifiers used in depressive disorders?

A
  • With psychotic features
  • With anxious distress
  • With mixed features
  • With melancholic features
  • With atypical features
  • With catatonic features
  • With peripartum onset
  • With seasonal pattern
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15
Q

The specifier for depressive disorders - “With psychotic features” , these can either be mood congruent or mood incongruent meaning what?

A

Mood congruent: Dark images, hallucinations, or delusions (directly related to the depression)

Mood Incongruent: Happy place, delusions of grandeur (less common)

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16
Q

What is seasonal affective disorder (SAD)?

A

Depression that accompanies episodes during certain seasons, typically winter.

This falls into the Seasonal pattern specifier

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17
Q

What is the prevalence of persistent mild depressive symptoms in children compared to adults?

A

0.07% prevalence in kids vs 3-6% in adults

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18
Q

Persistent depressive disorder may last how many years?

A

20-30

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19
Q

What is integrated grief?

A

The finality of death and its consequences are acknowledged and the individual adjusts to the loss.

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20
Q

When does integrated grief often appear?

A

Often recurs at significant anniversaries, such as the birthday of the loved one, holidays, and other meaningful occasions, including the anniversary of the death.

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21
Q

What is premenstrual dysphoric disorder (PMDD)?

A

Physical symptoms and severe mood swings occuring in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become or absent in the week post-menses.

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22
Q

What is Disruptive Mood Dysregulation Disorder?

A

Intense negative affect in children that seems to be driving irritability and marked inability to regulate mood.

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23
Q

What disorder in kids looks similar to ADHD but is different?

A

Disruptive Mood Dysregulation Disorder

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24
Q

What is the identifying feature of bipolar disorders?

A

The tendency of manic episodes to alternate with major depressive episodes

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25
What is the difference between bipolar 1 and 2?
Bipolar I: (Full mania) The individual experiences a full manic episode as well as depressive episodes Bipolar II: (Some mania) Major depressive episodes alternate with hypomanic episodes rather than full manic episodes
26
What is cyclothymic disorder?
-Milder version of bipolar -A chronic alternation of mood elevation and depression that does not reach the severity of manic or major depressive episodes (medium lows, medium highs)
27
What is the mixed-features specifier in bipolar disorder?
To describe the major depressive or manic episode that has some symptoms from the opposite polarity; for example, a depressive episode with some manic symptoms.
28
What specifier is unique to bipolar disorders?
Rapid-Cycling specifier
29
What is the Rapid-Cycling Specifier in bipolar?
Some people move quickly in and out of depressive or manic episodes. An individual with bipolar disorder who experiences at least four manic or depressive episodes within a year is considered to have a rapid-cycling pattern. ## Footnote This is very hard to treat, switching may become more frequent over time to ultrarapid cycling.
30
What is the average age of onset for Bipolar I disorder?
15–18 years. (earlier onset than II)
31
What is the average age of onset for Bipolar II disorder?
19-22 years
32
60% of cyclothymic patients are what sex?
Female
33
What is a common consequence of bipolar disorders?
Suicide
34
What is the prevalence of mood disorders in Canada as reported in 2019?
2.9 million Canadians reported a mood disorder. (9% of population)
35
Which demographic is twice as likely to experience mood disorders?
Women compared to men.
36
Are mood disorders different in children vs adults?
Mood disorders are fundamentally similar in children and in adults. ## Footnote Therefore, no “childhood” mood disorders in the DSM-5-TR are specific to a developmental stage, except for disruptive mood dysregulation disorder.
37
How does mood disorder manifestation differ in children compared to adults?
The look of depression changes with age. For example, children under three years of age might manifest depression by their facial expressions, as well as by their eating and sleeping.
38
Compare the prevalence of mood disorders between children, adolescents, and adults from most frequent to least
Adolescents > Adults > Children
39
Explain this chart:
This shows that the rates of depression are higher in females than males, and that there is a decline is prevalence with increase in age.
40
What % of nursing home residents experience major depressive disorder?
18-20%
41
What makes late onset depression hard to diagnose?
Because the presentation of mood disorders is often complicated by the presence of medical illnesses or symptoms of dementia. Ex. Seniors who become physically ill or begin to show signs of dementia might become depressed about it, but the signs of depression would be attributed to the illness or dementia and thus missed
42
Depression in older adults is strongly associated with race and ethnicity:
People from ethnic minority groups still had a 1.5- to 2-fold higher risk for experiencing anhedonia, sadness, and psychomotor symptoms as compared with non-Hispanic white participants.
43
True or false: Depression can also contribute to physical disease in seniors
True
44
Across cultures how does the prevalence of mood disorders vary?
-More common in individualistic cultures -Increased rates for indigenous people living outside natural territory
45
True or false: Creativity is associated with depression?
False, its associated with manic episodes
46
What do twin studies suggest about the heritability of depression?
Depression is about 37% heritable, with nonshared environmental factors contributing 63%.
47
True or false: The biological vulnerability for mood disorders may not be specific to that disorder but may reflect a more general predisposition to anxiety or mood disorders, or more likely to a basic temperament underlying all emotional disorders, such as neuroticism.
True, the specific form of the disorder would be determined by unique psychological, social, or additional biological factors
48
Low levels of what NT can lead to mood disorders?
Serotonin
49
How is dopamine linked to mood disorders?
Dopamine agonists can trigger hypomania in bipolar disorder, and chronic stress reduces dopamine, leading to depressive symptoms.
50
How are cortisol levels related to depression?
Elevated cortisol levels are common in depression and linked to life stress.
51
How might gut microbiota influence mood disorders?
Some gut bacteria are involved in neurohormone production and may affect depression.
52
How do sleep patterns differ in depressed individuals?
Faster onset of REM sleep, more intense REM activity, and reduced deep sleep.
53
Studies on the brain structure of those with mood disorders show what?
-Greater right-sided anterior activation of their brains (less left side) -Adolescent offspring of depressed mothers tend to show this pattern, compared with offspring of nondepressed mothers (Tomarken et al., 2004), also suggesting that this type of brain functioning could become an indicator of a biological vulnerability to depression
54
Depression is caused by stressful life events in what % of cases?
20-50% of cases *This depends on the interpretation of the stressful life events though
55
What is a common solution/treatment for mood disorders caused by stressful life events?
Reframing the clients interpretation of events
56
What is learned helplessness?
A theory suggesting people become depressed when they feel they have no control over life’s stresses. ## Footnote Being able to see an opportunity for future control can help overcome depression
57
The depressive attributional style of learned helplessness involves what three descriptors?
(1) internal, in that the individual attributes negative events to personal failings (“It is all my fault”) (2) stable, in that, even after a particular negative event passes, the attribution that “additional bad things will always be my fault” remains (3) global, in that the attributions extend across a wide variety of issues.
58
What did Beck say depression arises from?
From interpreting everyday events negatively
59
What is the cognitive triad according to Beck?
Negative thinking about oneself, immediate world, and future. (schemas)
60
Overall:
Seligman and Abramson, on the one hand, and Beck, on the other, developed their theories independently, but the basic premises overlap a great deal and considerable evidence suggests that depression is always associated with pessimistic explanatory style and negative cognitions. Evidence also exists that cognitive vulnerabilities predispose some people to view events in a very negative way, putting them at risk for depression
61
Marital dissatisfaction and divorce can lead to?
Depression
62
How does conflict in marriage affect women vs men?
Depression seems to cause men to withdraw or otherwise disrupt the relationship. For women, in contrast, it is problems in the relationship that most often cause depression.
63
Bipolar individuals are more or less likely to marry?
Less
64
What percentage of people with major depressive disorder and persistent depressive disorder are women?
70%
65
Why may this gender imbalance in mood disorders occur?
-Women are raised to be more passive which may lead to increased risk of feelings of uncontrollability and helplessness -Rumination -Poverty -Single mothers -Abuse histories -Unequal division of household labour
66
How does living alone affect depression risk?
People who live alone have an almost 80% higher risk of depression than those who live with others.
67
How does social support affect recovery from depression?
It speeds recovery from depressive episodes and helps reduce symptoms.
68
Lack of social support predicts what?
The onset of depressive symptoms and can delay recovery.
69
What is the common biological vulnerability for depression and anxiety?
An overactive neurobiological response to stress, influenced by genetic factors like the serotonin transporter gene.
70
How does gender affect biological vulnerability to depression?
Women appear to have a stronger biological vulnerability to depression than men.
71
What psychological vulnerability is linked to mood disorders?
A sense of inadequacy and inability to cope with stress.
72
What role do stressful life events play in depression?
They often trigger the onset of depression, particularly in genetically and psychologically vulnerable individuals.
73
How do stress hormones contribute to depression?
They affect neurotransmitter systems (serotonin, norepinephrine) and may cause long-term brain changes, such as neuron atrophy in the hippocampus.
74
Why do some people develop bipolar disorder while others develop unipolar depression or anxiety?
Specific psychosocial circumstances, early learning experiences, and genetic vulnerabilities interact to shape different emotional disorders
75
What types of antidepressant medications are commonly used?
* Tricyclics * MAOIs * SSRIs
76
The antidepressant lithium is used for what?
Mood-stabilizing for manic episodes
77
What is the effectiveness of lithium carbonate?
Effective in preventing and treating manic episodes for 50% of patients.
78
What is electroconvulsive therapy (ECT)?
A controversial but effective treatment for psychological disorders for those who do not respond to other treatments. Electric shock is administered directly through the brain for less than a second, producing a seizure and a series of brief convulsions that usually lasts for several minutes
79
What is TMS therapy?
Places a magnetic coil over the individual’s head to generate a precisely localized electromagnetic pulse used for depression treatment.
80
What is cognitive therapy aimed at?
Correcting cognitive errors in deep-seated negative thinking. Teaches clients to recognize their negative thoughts, correct them by substituting less depressing/more realistic thoughts. Clients must monitor and log their thought processes.
81
What is Transcranial magnetic stimulation (TMS) effective for?
Treating depression ## Footnote TMS is specifically noted for individuals who do not respond to other treatments.
82
What is the goal of interpersonal psychotherapy (IPT)?
Resolving problems in existing relationships ## Footnote IPT also involves learning to form new interpersonal relationships.
83
What are the stages of a dispute looked at in interpersonal psychotherapy?
* Negotiation stage: aware of dispute * Impasse stage: low-level resentment * Resolution stage: take action (e.g., divorce or separation)
84
How does combined treatment for depression compare to separate therapies?
Combined treatment is generally just as effective as separate drug or psychosocial therapies ## Footnote Particularly effective in severe depression.
85
What works better: Cognitive therapy / IPT or antidepressatns?
Studies comparing the results of cognitive therapy and IPT with those of tricyclic antidepressants have found equal effectiveness, and all treatments are more effective than placebo conditions.
86
Is combining psychosocial treatments with medication more effective than either treatment alone in treating depression or preventing relapse?
Combined treatment is just as effective as separate treatments ## Footnote Depends on the individual
87
What is the purpose of maintenance treatment in depression?
To prevent relapse
88
What works best for recurrent depression?
Mindfulness based therapy over regular treatment
89
What does mindfulness-based cognitive therapy teach?
Teaches depressed patients to disengage from negative thinking ## Footnote This therapy helps prevent depressive relapse.
90
What is interpersonal and social rhythm therapy (IPSRT) used for?
Psychosocial treatments for bipolar disorder ## Footnote It combines family-focused treatment with medication. It works to regulate circadian rhythms.
91
How effective is CBT for bipolar patients?
Effective for bipolar patients with rapid cycling
92
It is the controversial but somewhat successful treatment involving the production of seizures through electrical current to the brain.
electroconvulsive therapy
93
This teaches clients to carefully examine their thought process and recognize depressive styles in thinking.
cognitive therapy
94
These come in three main types (tricyclics, MAO inhibitors, and SSRIs) and are often prescribed but have numerous side effects.
antidepressants
95
This antidepressant must be carefully regulated to avoid illness but has the advantage of affecting manic episodes.
lithium
96
This therapy focuses on resolving problems in existing relationships and learning to form new interpersonal relationships.
interpersonal psychotherapy
97
This is an effort to prevent relapse or recurrence over the long run.
maintenance treatment
98
What is the global annual suicide statistic according to WHO?
About 703,000 people per year
99
What is the incidence rate of completed suicides per 100,000 people?
9.0 per 100,000 people
100
What are the types of suicidal behavior?
* Completed suicides * Suicidal attempts (survivors) * Suicidal ideation (serious thoughts about suicide)
101
What are some populations with higher incidence of suicide?
* Indigenous Peoples * Alcoholics * Seniors * Males
102
Suicide is more common for what demographic?
Older males
103
What are the four types of suicide identified by Émile Durkheim?
-Altruistic (e.g., hara-kiri in Japan) -Egoistic (due to lack of social support) -Anomic (from sudden disruptions like job loss) - Fatalistic (loss of control over destiny, e.g., cult suicides).
104
What does a psychological autopsy reveal?
The psychological profile of a person who died by suicide
105
What family history factors are associated with suicide risk?
* A suicidal family member * Depression * Genetics
106
What neurobiological factor is linked to suicide?
Low levels of serotonin
107
What role does impulsivity play in suicidal behavior?
Impulsivity, possibly inherited, may increase vulnerability to suicide, particularly in people with mood disorders.
108
What percentage of suicides are associated with existing psychological disorders?
Over 90%, with mood disorders being the most common.
109
What are some psychological disorders associated with suicide?
* Mood disorders * Hopelessness * Alcohol abuse * Impulsivity
110
What types of stressful life events can lead to suicide?
* Shame * Humiliation * Unexpected arrest * Rejection * Physical or sexual abuse * Natural disasters
111
Model for suicidal behaviour:
112
Is suicide contagious?
Positive relationship exists between suicidal behavior and exposure to media coverage.
113
What happens to suicide rates after widespread publicity about a suicide?
Suicide rates increase during the nine days following widespread media coverage of a suicide.
114
How does media coverage contribute to suicide contagion?
The media often romanticizes suicides, provides detailed methods, and omits information on failed suicide attempts and their consequences.
115
Is suicide contagious in the same way as an infectious disease?
No, but stress from a friend’s suicide can trigger suicidal behavior in vulnerable individuals with psychological disorders.
116
What factors increase suicide risk?
A detailed plan, final acts (e.g., giving away possessions), violent methods, and precautions against discovery.
117
What is a 'no-suicide contract'?
A promise not to attempt suicide without contacting a mental health professional first.
118
What is Canada’s Federal Framework for Suicide Prevention?
A national initiative to raise awareness, reduce stigma, and improve access to suicide prevention resources.
119
What is the Canada Suicide Prevention Service (CSPS)?
A 24/7 crisis service providing support in both official languages through phone, text, and chat.
120
Are general suicide prevention programs effective?
Research shows mixed results; targeted programs for at-risk individuals tend to be more effective.
121
What suicide prevention strategies are used for at-risk adolescents?
Immediate mental health services for friends and family of suicide victims and restricting access to lethal means.
122
How do suicide prevention programs for older adults typically operate?
They focus on reducing risk factors like depression rather than enhancing protective factors like social support.
123
How do Indigenous suicide prevention programs incorporate culture?
They emphasize community, language, land, and environment to promote mental wellness.
124
What role does cognitive therapy play in suicide prevention?
Studies show 10 sessions of cognitive therapy can reduce future suicide attempts by 50% over 18 months.

Psyc 260 (11 decks)

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