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Abnormal Psychology > Chapter 8 - Mood Disorders and Suicide > Flashcards

Chapter 8 - Mood Disorders and Suicide Flashcards

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1
Q

imagined loss

A

the individual unconsciously interprets other types of events as severe loss events ex. argument with friend

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2
Q

why is clinical depression different

A

longer duration and more severe

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3
Q

Types of mood disorders

A

unipolar and bipolar

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4
Q

what is unipolar?

A

depression

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5
Q

what is bipolar?

A

depressive and manic symptoms

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6
Q

how long must the symptoms for major depressive disorder be present

A

for at least two weeks

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7
Q

how much more time do individuals that meet the criteria for symptoms of major depressive disorder require to sleep?

A

more than an hour to fall asleep every night

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8
Q

depressive disorders

A

involve a change in mood in the direction of depression

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9
Q

bipolar and related disorders

A

involve periods of depression cycling with periods of mania

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10
Q

symptoms of major depressive disorder

A

1) persistent low mood and/or lack of enjoyment in activities
2) changes in weight
3) changes in mood
4) agitation/retardation
5) tired/low energy
6) feeling worthless/ excessive guilt
7) trouble concentrating/indecisive
8) trouble concentrating/indecisive
9) suicidal thoughts

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11
Q

how many symptoms must be present for MDD?

A

5

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12
Q

symptoms of MDD classification

A

must show persistent sad mood and/or lack of pleasure or enjoyment in activities for at least two weeks and must be accompanied by 4 other symptoms

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13
Q

how much of the population does MDD affect

A

5%

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14
Q

gender differences in MDD

A

twice as common in women

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15
Q

average time episodes last

A

6-9 months, can last for years though

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16
Q

average age onset for MDD

A

early twenties to mid-twenties (early adulthood/teenage years)

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17
Q

gender differences data study showed

A

equal rates of depression for both sexes throughout childhood then begin to diverge at about age 10

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18
Q

do most individuals with MDD suffer from one or more additional mental disorders?

A

yes - most common is anxiety disorders

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19
Q

persistent depressive disorder/ dysthymia

A

chronic low mood, lasting for at least two years along with three associated symptoms (full criteria of MDD has been met)

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20
Q

what are some symptoms for PDD

A

1) changes in eating
2) changes in sleep
3) tired/low energy
4) low self-esteem
5) trouble concentrating/indecisive
6) feeling hopeless

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21
Q

prevalence of PDD

A

3%

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22
Q

differences between PDD and MDD

A

PDD has the following: higher levels of impairment, younger age of onset, higher rates of comorbidity, a stronger family history of psychiatric disorder, lower levels of social support, higher levels of stress, and higher levels of dysfunctional personality traits, and treatment response

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23
Q

Mania

A

distinct period of elevated, expansive, or irritable mood that lasts at least one week and is accompanied by at least 2 symptoms

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24
Q

symptoms of mania

A

1) grandiosity
2) decreased need for sleep
3) talkative
4) racing thoughts
5) distractable
6) increased goal-directed behaviour or psychomotor agitation
7) involvement in activities with high change of negative consequences
8) increased energy

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25
Q

Hypomania

A

less severe form of mania that involves a similar number of symptoms, but those symptoms need to be present for only four days

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26
Q

can you have depressive and manic/hypomanic symptoms at the same time?

A

yes - called a “mixed state”

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27
Q

Bipolar I disorder

A
  • history of one or more manic episodes

- may or may not have had a depressive episode

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28
Q

Bipolar II disorder

A
  • history of one or more hypomanic episodes

- history of one or more depressive episodes

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29
Q

prevalence of bipolar I

A

0.8%

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30
Q

prevalence of bipolar II

A

0.5%

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31
Q

gender differences for bipolar disorder

A

equally in men and women

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32
Q

age onset in bipolar disorder

A

20 years is mean onset, some adult patines can experience it before age 17

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33
Q

cyclothymia

A

chronic, less sever form of bipolar disorder

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34
Q

how long must symptoms show for cyclothymia

A

at least 2 years in duration of altering between hypomania and subthreshold depression (depression that does not meet full criteria for major depression)

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35
Q

prevalence for cyclothymia

A

0.4%-1%

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36
Q

seasonal affective disorder (SAD)

A

can occur in both unipolar depression and bipolar disorder that are tied to changing seasons

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37
Q

prevalence of SAD

A

general population - 3%

MDD patients - 11%

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38
Q

melatonin theory SAD

A

melatonin - secreted at night by pineal gland, as sunlight increases, melatonin decreases - causes body temperature to rise, triggering body processes to their awake state. during winter months, more darkness so melatonin remains high and nothing switches body from sleep state to wake state

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39
Q

peri - or postpartum depression

A

last month of gestation (peri-partum) up to a couple months post-birth

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40
Q

theory about peri- and postpartum depression

A

hormones decrease, especially progesterone

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41
Q

psychodynamic theories

A

relationships between parents and children are important in shaping a child’s temperament and that neglectful/abusive parenting confers a strong risk for later depression. individuals that have experienced this interpret life events as having a greater impact

42
Q

cognitive theories

A

one’s emotional response to a situation is determined by the manner in which that situation is appraised or evaluated

43
Q

what are the 4 cognitive theories

A

1) all-or-nothing thinking
2) overgeneralization
3) magnification (catastrophizing)
4) jumping to conclusions

44
Q

all-or-nothing thinking

A

it’s one side or the other ex. C on math exam = I’m a failure I’ll never get into med school

45
Q

overgeneralization

A

single negative event is a never-ending patter ex. late for doctors appointment = I’m always screwing up

46
Q

magnification (catastrophizing)

A

exaggerate the importance of your errors or problems ex. forget someone’s name while introducing them = thinking this is horrible

47
Q

jumping to conclusions

A

interpret things negatively when there are no definite facts to support your conclusion ex. boyfriend doesn’t return call = thinking they don’t care about you anymore

48
Q

schemas

A

hypothetical structures in the mind that contain core beliefs about the self, world, and the future

49
Q

cognitive triad

A

self, world, future

50
Q

negative feedback seeking

A

tendency to actively seek out criticism and other negative interpersonal feedback from others

51
Q

excessive reassurance seeking

A

tendency to repeatedly seek assurance about one’s worth and lovability from others, regardless of whether such assurances have already been provided

52
Q

stress generation hypothesis

A

depressed individuals have been found to generate stressful life events in the interpersonal domain, including fights, arguments, and interpersonal rejection - depressed individuals contribute to the occurrence of these events due to their maladaptive interpersonal behaviours

53
Q

adoption study

A

32% for bipolar disorder in the biological parents of affectively ill adoptees as compared to 12% in the adoptive parents

54
Q

twin studies

A

genetic cause for mood disorders - twins both diagnosed with disorder are said to be concordant - consistent with genetic contribution to mood disorders, high concordance rates for unipolar major depression in identical twins. Concordance rates for bipolar disorder are 65% in identical twins and 14% in non-identical

55
Q

low levels of neurotransmitters is equal to what

A

mood disorders

56
Q

what are norepinephrine and serotonin related to

A

semantic and cognitive development (also linked to depression)

57
Q

what do high levels of dopamine cause

A

psychosis

58
Q

hypothalamic-pituitary-adrenal (HPA) axis

A

depressed people with chronic stress have elected levels of cortisol

59
Q

Sleep neurophysiology

A

depressive people spend more time in REM sleep than average, and bipolar disorder - sleep deprivation is a risk factor

60
Q

what are both bipolar and unipolar depression associated with in neuroimaging

A

decreased blood flow and glucose metabolism in the frontal cortex - particularly left side

61
Q

what happens in neuroimaging when patients shift from depression into mania

A

decreased blood flow and glucose metabolism in the frontal cortex - particularly right side

62
Q

when does increased glucose metabolism occur

A

depression (occurs in several subcortical regions)

63
Q

CBT techniques

A

activity scheduling, thought records, behavioural experiments

64
Q

activity scheduling

A

clients make a list of activities they used to engage in - found pleasurable and will eventually schedule these

65
Q

thought record

A

challenge negative thinking patterns - break down problem - situation, how you feel about it, what your mood was, evidence supporting your thought, evidence against though, alternatives, new mood after thinking about situation

66
Q

behavioural experiments

A

challenge negative and pessimistic beliefs - pick problem and then work out different solutions and try them out

67
Q

CBT vs. medication

A

CBT has better long-term outcomes vs. medication

68
Q

Behavioural components

A

as effective as full CBT, as effective as medication in short-term, more effective that medication in long-term

69
Q

mindfulness-based cognitive theory

A

more effective at preventing depression relapses vs. visiting family doctor/medication

70
Q

interpersonal theory (IPT)

A

presumes depression that occurs in an interpersonal context and that addressing current problems that depressed clients face in the interpersonal realm is key to relieving symptoms (12-16 sessions)

71
Q

what are the four areas IPT works on

A

1) interpersonal disputes
2) role transitions
3) grief
4) interpersonal deficits

72
Q

interpersonal disputes

A

conflicts in marital, family, or other social relationships - identifying sources of misunderstanding and using communication and problem-solving training to empower the client to change the situation

73
Q

role transitions

A

situations in which client has difficulty adapting to a life change - intervened by helping the client to reappraise the old and new roles, identify problems in adapting to the new role and use cognitive restructuring to alter his or her dysfunctional appraisals of the new role

74
Q

grief

A

IPT therapist uses empathic listening to help the client work through the mourning process, and encourages the client to form new relationships

75
Q

interpersonal deficits

A

main problem for a client who reports either a low number or poor quality of interpersonal relationships - identify personality issues in the client that may be interfering with formation of close relationships

76
Q

Tricyclic antidepressants

A

block reuptake of norepinephrine and sometimes serotonin - effective but poor side effects and lethal in overdose

77
Q

monoamine oxidase inhibitors

A

break down enzymes that break down neurotransmitters - dangerous side effect profile, require dietary restrictions, can raise blood pressure

78
Q

selective serotonin reuptake inhibitors

A

block serotonin reuptake - mild side effect, sage - first line treatment for unipolar depression

79
Q

other antidepressants

A

serotonin-norepinephrine reputake inhibitors

- some increase dopamine, others affect GABA levels

80
Q

antidepressants vs. placebo

A

antidepressant was no more effective than placebo in unipolar depression

81
Q

lithium

A

effective treatment for mania, requires physician monitoring, high risk of relapse, interferes with regulation of sodium and water levels

82
Q

anticonvulsants

A

increase GABA levels or decrease glutamate levels, often used alone or with lithium (glutamate has excitatory effect on brain)

83
Q

antipsychotics

A

may be used as short-term treatment or can have a mood-stabilizing effect

84
Q

antidepressants

A

treat depressive episodes, can trigger manic episodes, often used along with a mood stabilizer

85
Q

combining psychotherapy and medication for depression

A

no benefit seen

86
Q

what are the four exceptions to combing psychotherapy and medication for depression

A

1) severe depression: IPT + meds better than either on their own
2) persistent depression: CBT + meds better than either on their own
3) non-response to medication: add CBT
4) adolescents: CBT + meds better than either on their own

87
Q

combining psychotherapy and medication for bipolar disorder

A

most effective treatment is medication but in some cases high risk of relapse, substantial impairment

88
Q

three effective adjunctive treatments

A

family focused therapy, IPSRT, cognitive therapy

89
Q

family focused therapy

A

education for both patient and family members about disorder and effect on the patient’s functioning as well as communication and problem-solving training

90
Q

IPSRT

A

based on theory that disruptions in daily routines and conflicts in interpersonal relationships can cause relapses of bipolar episodes - patients are taught to regulate their routines and cope more effectively with stressful events

91
Q

cognitive therapy

A

how to regularize their sleep and daily routines, how to regularly monitor their mood to help identify early triggers, for manic episode relapses, importance of medication compliance

92
Q

SAD psychotherapy

A

phototherapy:
40% remission in severe depression
60% in mild depression
can trigger manic episodes in bipolar patients

93
Q

ECT

A
  • creates seizure in brain that lasts approximately 25 seconds, used for treatment-resisitant depression or depression with life-threathening consequences and need for immediate results
94
Q

TMS

A

currents from magnetic pulse stimulate nerve cells in the region of the cortex under the coil - helps because patients with depression have low levels of brain activity so this increases blood flow and nerve stimulation as well as glucose metabolism

95
Q

Vagus nerve stimulation

A

information on this nerve travels from major organs to it, device is planted and stipulations are delivered every 30 seconds for 5 minutes

96
Q

deep brain stimulation

A

surgically implanting wires into brain

97
Q

self-harm rates

A

general population: 1-4%
teenagers: 14-39%
college students: 15%

98
Q

gender differences in suicide

A

men are 3x more likely to complete suicide while women are 3x more likely to attempt

99
Q

biological factors for suicide

A

identical twins are 5-10x more likely to commit suicide, and in adoption studies it is shown that the rate of suicide in biological relatives of adoptees was more than 6x higher than for the group of adoptees who had committed suicide

100
Q

what neurotransmitter is involved with suicide

A

low levels of serotonin

101
Q

psychache

A

feeling of unendurable psychological pain and frustration

102
Q

treatment for suicide

A

CBT = identify and modify thoughts, images and core beliefs

Abnormal Psychology (14 decks)

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