Chapters 7 and 8 - Mood Disorders and Suicide Flashcards

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1
Q

Unipolar vs. Bipolar disorders

A
  • Unipolar: depression

* Bipolar: “manic depression” 2 poles: mania (euphoria) and depression (dysphoria)

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2
Q

Prevalence of mood disorders?

A
  • Depression: more females
  • Bipolar: equal male and female
  • Risk increases with each additional episode of depression
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3
Q

Core depression symptoms?

A

1) Depressed mood

2) Diminished interest or pleasure in nearly all activities (ankedonia)

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4
Q

Other depression symptoms?

A
  • Significant weight loss or gain
  • Insomnia or hypersomnia
  • Psychomotor agitation or retardation
  • Significant fatigue or loss of energy
  • Feelings of worthlessness or guilt
  • Diminished ability to think or concentrate
  • Recurrent thoughts of death or suicidal ideation
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5
Q

What is dysthymia?

A

Milder, less intense depressive disorder - more chronic

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6
Q

Diagnosis criteria for dysthymia?

A

Symptoms not absent for more than 2 months at a time, chronic duration of 2-20 years

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7
Q

What is double depression?

A

Individual possesses symptoms of both dysthymia and major depressive episode

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8
Q

What is major depressive disorder?

A

More intense experiences of symptoms

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9
Q

Specifiers of major depressive disorder?

A
  • Mild - just meet criteria
  • Moderate - meet criteria and a bit more
  • Severe - meet several criteria, also with or without psychotic features (delusions or hallucinations)
  • Other specifiers - with seasonal patterning, with peripartum onset
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10
Q

Biological theory of depression

A
  • Catecholamine hypothesis - deficiency of 5HT, NE, DA at synapse
  • Genetics: based on twin studies and pedigree studies
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11
Q

Psychodynamic theory of depression

A
  • Freud - prolonged grief related to earlier loss
  • Bibring - loss itself is not important, but loss of what the person represented to you
  • Bowlby - attachment theory; unhealthy early attachment
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12
Q

Behavioral theory of depression

A
  • Depression - lack of positive reinforcement in person’s environment
  • Treatment - behavioral activation therapy
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13
Q

Cognitive theory of depression

A
  • Beck’s cognitive errors
  • Attributional model
  • Depressive realism hypothesis
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14
Q

What were Beck’s cognitive errors?

A
  • Overgeneralizing: assume circumstances in one situation will be the same in all similar situations
  • Selective abstraction: attend only to failure or deprivation and ignore any positives
  • Catastrophizing: always imagining the worst of any given situations, always entertains the worst case scenario
  • Dichotomous thinking: rigid thinking, all or nothing thinking
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15
Q

What is the attributional model?

A

Assigning causes to situations - internal, stable, global attributions for negative situations

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16
Q

What is the depressive realism hypothesis?

A

Are depressed people just more realistic than non-depressed? Research finds that there was a small but significant effect supporting depressive realism

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17
Q

Humanistic/Existential theory of depression

A

Depression related mostly to loss of self-esteem

*Carl Rogers: discrepancy between real and ideal self

18
Q

Sociocultural theory of depression

A

Culture plays a role in symptom presentation and prevalence rates

  • US: higher rates seen among Native Americans and Southeast Asian Americans
  • China: report more somatic symptoms, fewer cognitive symptoms
19
Q

Diathesis stress model

A

Predisposition to depression and add on to major life stressors - this leads to onset of depression

20
Q

Biological treatment of depression

A
  • Pharmacotherapy: antidepressants (SSRIs)
  • Phototherapy: “light therapy” - used for major depression with seasonal patterning, results of outcome studies are mixed
  • ECT: mainly used for severe major depression, results in massive release of all NTs
  • Transcranial direct stimulation - magnetic stimulation, which is less invasive and targets specific areas, also used for resistant depression
21
Q

Psychodynamic treatment of depression

A

Uncover unconscious conflicts, then work through such conflicts - work through grief over earlier loss

22
Q

Behavioral treatment of depression

A

Increase positive reinforcement in one’s environment (BAT)

Training in social skills that may be lacking

23
Q

Cognitive treatment of depression

A
  • Work on dysfunctional thinking (rational-emotive therapy)
  • Cognitive restructuring
  • ACT - Acceptance Commitment Therapy
    • Accept: emotions, feelings, thoughts - depression related
    • Know: they are only emotions
    • Commit to: take action towards life values
24
Q

Humanistic treatment of depression

A
  • Work toward a more realistic Real and Ideal Self

* Focus on self-esteem and self-concept

25
Q

Characteristics of mania

A

Little sleep, elevated mood, rapid speech, irritability, risky impulsivity, increase in psychomotor activity, may show psychotic symptoms

26
Q

Types of bipolar disorder

A
  • Bipolar I: major depression and full-on mania

* Bipolar II: major depression and hypomania (lesser mania)

27
Q

DSM characteristic of diagnosis of bipolar

A

Rapid cycles - at least 4 episodes in 12 months

28
Q

Onset of symptoms of bipolar

A
  • Most evident: young adulthood
  • Genetic links
  • Co-morbidity across mood disorders
  • Some links with early chaotic upbringing
  • Stress can trigger mania
29
Q

What is cyclothymia?

A

“Lesser” bipolar disorder - depressed mood and hypomania

*DSM: symptoms must have lasted at least 2 years

30
Q

Bipolar treatments

A
  • Antidepressants for depressive phase may trigger mania
  • Lithium - but potentially toxic
  • Problems with non-adherence: side effects are not pleasant and they miss their highs
31
Q

What is suicide?

A

Self-inflicted death that is an intentional, conscious, direct effort to end one’s life

32
Q

What is parasuicide?

A

An attempt to harm oneself and/or an unintentional suicide attempt

33
Q

How is parasuicide different than suicide?

A
  • More impulsive
  • Use less aggressive means
  • Does not commit act
34
Q

What are Schneidman’s types of suicidal people?

A
  • Death Seekers: clear intentions of dying, takes clear actions to die
  • Death Initiators: already dying and are just speeding process
  • Death Ignorers: believe that dying would lead to better existence
  • Death Darers: ambivalent attempts to die, acts in risky ways. Motivated by attention-seeking
  • Sub-intentional death: suicide-like category, behaviors more covert or unconscious, indirect in leading to death
35
Q

Places with highest rates of suicide?

A

Asia, Eastern Europe, parts of Central Europe

36
Q

Places with lowest rates of suicide?

A

South America, Greece, Egypt, Spain

37
Q

What is cause of different places having different rates of suicide?

A

Mainly culture - perhaps suicide is more acceptable in some cultures than others

38
Q

Gender differences in suicide

A

More females attempt, more males commit

39
Q

Suicidal rates ranked by relationship status

A

1) Divorced
2) Widowed
3) Single
4) Married

40
Q

Suicide rates in ethnic groups

A
  • Native Americans: recently had higher rates
  • White Americans: have highest rates
  • African Americans and Hispanic Americans: lower rates (Asian Americans too)
41
Q

How to approach the suicidal

A
  • Validate the person’s feelings
  • Understand person’s problems
  • Assess potential for suicide
  • Help them identify strengths and resources, get them to talk about themselves and friends
  • Follow-up plan - get them to commit to a plan