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PSY240 > Chapter 8: Mood Disorders & Suicide > Flashcards

Chapter 8: Mood Disorders & Suicide Flashcards

1
Q

What did Hippocrates believe about depression?

A
  • first to extend ideas on the relationship between bodily fluids and emotional temperament
  • “exaltation” (mania) was caused by an excess of warmth and dampness in the brain
  • “melancholia” (depression) was caused by an excess of black bile
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2
Q

What did Freud believe about depression?

A
  • result from a fixation at the oral stage of development

- patients feel a perceived loss and thus are in mourning for it

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3
Q

How are mood disorders defined?

A
  • altered mood state severe enough to interfere with person’s social and occupational functioning and whose range of symptoms is not limited to the person’s feelings but also affects other bodily and behavioural systems
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4
Q

What are the two major categories of depressive disorders?

A
  • Major Depressive Disorder (MDD)

- Persistent Depressive Disorder (formerly dysthymic disorder)

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5
Q

What are the symptoms of Major Depressive Disorder?

A
  • persistent feelings of sadness
  • anhedonia
  • difficulty making decisions or concentrating
  • difficulty sleeping
  • fatigue
  • feelings of worthlessness or guilt
  • suicidal thoughts
  • agitation or slowing down
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6
Q

What is the prevalence and course of Major Depressive Disorder?

A
  • 5% lifetime prevalence in Canadians
  • typical age is mid-twenties
  • most frequent comorbid condition with depression is anxiety (50%)
    ○ more severe and chronic depression
    ○ slower and less complete response to treatment
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7
Q

What are the symptoms of Persistent Depressive Disorder?

A
  • less severe version of symptoms of MDD
  • distinguishing feature is persistence of chronic low mood for two years with only brief times when mood returns to normal
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8
Q

What is mania?

A
  • distinct period of elevated, expansive, or irritable mood lasting at least one week
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9
Q

What are the symptoms of mania?

A
  • increased energy
  • decreased need for sleep
  • racing thoughts
  • pressured speech
  • problems with attention and concentration
  • psychotic states
  • excessive self-esteem or grandiosity
  • increased risky and/or sexual behaviour
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10
Q

What is hypomania?

A
  • less severe form of manua
  • similar symptoms

BUT

  • no psychotic features
  • present only four days
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11
Q

What is bipolar I disorder?

A
  • history of one or more major mani episodes with or without one or more episodes of major depression
  • depressive episode not required but often occurs
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12
Q

What is bipolar II disorder?

A
  • at least one hypomanic episde and one or more major depressive episodes
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13
Q

What is cyclothymia?

A
  • chronic but less severe form of bipolar disorder
  • history of at least two years of alternating hypomanic episodes and episodes of depression that do not meet full criteria for major depression
  • at-risk for developing full-blown disorder
  • Stephen Fry has it
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14
Q

What is rapid cycling bipolar disorder?

A
  • presence of four or more manic and/or major depressive episodes in a 12-month period
    ○ separated by at least two months of full or partial remission
    OR by a switch to opposite mood state
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15
Q

What is the course of rapid cycling bipolar disorder?

A
  • higher rates of disability and lower rates of response to treatment
  • can be induced, or made worse, by antidepressants
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16
Q

What is seasonal affective disorder (SAD)?

A
  • recurrent depressive episodes tied to the changing seasons
  • typically present with atypical symptoms , including oversleeping, overeating, cravings for carbs, and weight gain
  • phototherapy is most effective way to treat
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17
Q

What is postpartum depression?

A
  • chronic and severe moodswings with onset before or after birth of child
  • severe cases include psychotic features and infanticide
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18
Q

What are the psychodynamic theories of mood disorders?

A
  • consider role of parenting and attachment
  • Blatt & Zuroff proposed there are two personality patterns that are prone to depression:
    ○ dependent: form their identity around relationships and thus are excessively needy, fear abandonment, and don’t feel a sense of control
    ○ self-critical: prone to fears of failure, self-blame, and inferiority
  • research support, people who were neglected or abused in childhood are at greater risk of developing depressin
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19
Q

What are cognitive theories of mood disorders?

A
  • Beck’s model is most enduring, suggesting patients see the world with a negative viewpoint because negative schemas bias their thoughts
  • diathesis-stress model since negative schemas leeve person prone to depression
  • supported by research, depressed individual do show more negative thinking and engage in more negative biases
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20
Q

What is Beck’s negative cognitive triad?

A
  • negative thoughts about the future, the world, and oneself
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21
Q

What are common cognitive distortions in depressed people?

A

○ all-or-nothing thinking (“I either get an A or I’m a total failure.”)
○ overgeneralization (“always” or “never”)
○ magnification/catastrophizing
○ jumping to conclusions

22
Q

What is negative feedback seeking?

A
  • tendency to actively seek out criticism and other negative interpersonal feedback
  • need to obtain this information to be consistent with own self-schemas
  • overrides pain of receiving negative feedback
23
Q

What is excessive reassurance seeking?

A
  • tendency to repeatedly seek assurance about one’s worth and lovability from others
  • depressed person doubts sincerity of reassurance and often demands more
24
Q

What is the stress generation hypothesis?

A
  • depressed individuals generate stressful life events in the interpersonal domain due to maladaptive interpersonal behaviours e.g., fights, arguments, interpersonal rejection
25
Q

What factors in a person’s personal history predict depression?

A
  • family history
  • early life stress
  • significant losses
26
Q

What are examples of a depressed person’s negative cognitive bias?

A
  • difficulties with overall concentration but ease with negative self-focused thoughts
  • overgeneral memory, especially for positive events
  • greatest difficulty in unstructured situations
27
Q

What is rumination?

A
  • analysis, recrimination, and self-deprecation over one’s negative thoughts
  • elevated in depression and predictor in future symptoms
  • experiential avoidance leading to abstraction rather than concrete experience
28
Q

How can the transactional model apply to depression?

A

PRIMARY APPRAISAL
- negative event triggers sadness as habitual response

SECONDARY APPRAISAL
- create habitual conceptual associations with sadness (sadness connected to perceived worthlessness, stupidity, hopelessness)

29
Q

What are the genetic factors of the development of mood disorders?

A
  • 2 to 5 times likely to develop depression if first-degree relatives have it; 7 to 15 times more likely with bipolar disorder
  • serotonin transport gene regulating action of serotonin in brain may also contribute
30
Q

Which neurotransmitters are most implicated in mood disorders?

A
  • serotonin
  • catecholamines (especially norepinephrine)
  • dopamine
31
Q

Why is the HPA axis implicated in depression?

A
  • principal stress response
  • chronic stress elevates levels of cortisol (found in depressed patiants) and can kill brain cells and cause permanent change in hippocampus
32
Q

What does neuroimaging reveal about mood disorders?

A
  • decreased blood flow and reduced glucose metabolism in frontal lobes
  • fMRI indicate cingulated cortex may lose ability to control emotional processing function of amygdala
    → may explain rumination and constant negative thinking
33
Q

Describe cognitive behaviour therapy.

A
  • structured form of treatment with focus on what can be done in the present to address depression-producing ways of thinking and behaving
  • tends to challenge negative thinking in an effort to reduce the symptoms of depression
  • techniques include activity scheduling, thought records, and behavioural experiments
34
Q

Describe activity scheduling as used in CBT.

A
  • encourage patients to start scheduling activities back into their lives
  • engaging in pleasurable activities again may start to bring some pleasure back to their lives
35
Q

Describe thought records as used in CBT.

A
  • help clients identify and test negative thinking patterns by focusing on a situation that recently evoked strong negative emotion
  • encouraged to write down all thoughts they had during that situation
  • encouraged to come up with alternate thoughts that represent a balance of evidence
36
Q

Describe behavioural experiments as used in CBT.

A
  • empirically test negative beliefs and assumptions about the world
37
Q

What is the interpersonal therapy approach to treating mood disorders?

A
  • focus on disruptions occurring in person’s interpersonal world as result of depression
  • brief and structured treatment focused solely on interpersonal issues
38
Q

What are the four areas of intervention in interpersonal therapy?

A
  • interpersonal disputes (conflicts in relationships)
  • role transitions (situations in which client has difficulty adapting to life change)
  • grief (empathic listening to help through mourning process)
  • interpersonal deficits (problem with low number or poor quality of interpersonal)
39
Q

What is mindfulness-based cognitive therapy?

A
  • combines CBT with mindfulness exercises to improve awareness and tolerance of dysphoric habits
40
Q

Which medications are used to treat depression?

A
  • tricylics
  • monoamine oxidase inhibitors
  • selective serotonin reuptake inhibitors
41
Q

Which medications are used to treat bipolar disorder?

A
  • lithium carbonate
  • anticonvulsant drugs
  • antipsychotic medications
42
Q

What is vagus nerve stimulation?

A
  • pulse generator surgically implanted in patient’s chest delivering electrical signals to vagus nerve up to the brain
43
Q

What is suicidal ideation?

A
  • set of thoughts or plans about ending one’s life
44
Q

What is the strongest risk factor for completed suicide?

A
  • being male
  • women attempt 3 times more often, but men complete 3 times more often
  • due to chosen suicide methods
    ○ men have more violent and definite methods
    ○ women have less messy and more passive methods
45
Q

What risk factors are associated with suicide?

A
  • being Native American
  • school failure
  • family violence
  • poverty
  • substance abuse
46
Q

What is the number one cause of suicide?

A
  • untreated mental disorder
47
Q

What was Emile Durkheim’s theories of suicide?

A
  • caused by a sense of “anomie”, feeling that one is rootless and without a place to belong
  • less integration in society meant greater sense of anomie

Three Reasons of Suicide:

  • anomic suicide, when a person experiences sudden change in their relation to society
  • egoistic suicide, when people have been cut-off from suicide
  • altruistic suicide, when people place group ahead of survival
48
Q

What are the biological factors of suicide?

A
  • tendency of suicide to run in suicides

- low levels of serotonin implicated

49
Q

What is psychache?

A
  • proposed by Schneidman
  • feeling of unendurable psychological pain and frustration, most direct and necessary cause of suicide
  • studies show psychache is more strongly related to suicide than hopelessness
50
Q

What are primary and secondary prevention strategies for suicide prevention?

A

PRIMARY
- restricting access to most lethal means of suicide

SECONDARY
- suicide prevention centres and telephone hotlines

51
Q

What are some examples of biological treatments for depression (other than medications)?

A
  • electroconvulsive therapy
  • transmagnetic stimulation
  • vagus nerve stimulation
  • deep brain stimulation
52
Q

What are some examples of adjunctive psychological treatments of bipolar disorder?

A
  • family-focused therapy
  • interpersonal and social rhythm therapy
  • cognitive therapy

PSY240 (16 decks)

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