CLINICAL- Mood disorders Flashcards
What are mood disorders
- These refer to a group of disorders that are characterised by episodes of time where mood is either very low or very high
define a manic episode
- This is a period of at least a week where mood is extremely high
Define a depressive episode
- a period of at least 2 weeks which involves depressed mood or lack of interest in usual activities for most of the day, nearly every day.
define a mixed episode
- A period of 2 weeks where its a mixture of manic and depressive states
define a hypomanic episode
- a less extreme version of a manic episode which can involve several days of elevated mood disturbances
What are the symptoms of a unipolar mood disorder (depression)
*7 symptoms
- Feelings of sadness
- irritable
- difficulty in concentration
- feelings of guilt
- recurrent thoughts of death
- changes in eating patterns
- changes in sleeping patterns
When is a depressive disorder diagnosed and how long do they usually last
- A person is only diagnosed if they have no previous history of manic or hypomanic episodes
- Recurrent ones are diagnosed once two or more occur and are separated by several months or more
- They usually last 2 weeks
Describe a Type 1 Bipolar disorder
- They have at least one manic or mixed episode
- they can last 2 weeks
- it involves impulsivity, rapid speech, euphoric mood and reckless behaviour
- It also can involve depressive moods, lack of will to carry out activities and feelings of guilt
Describe the Type 2 bipolar disorder
- Defined by one or more hypomanic episodes and at least 1 depressive episode
- involves behaviours of increased mood, increased self-esteem, talkativeness, and impulsivity.
- There is no history of manic or mixed episodes
What refers to psychometric testing
- This is a method of measuring personality traits, emotional states or other experiences by using a set of questions and numerical scales.
Describe the Beck Depression Inventory
- is a 21 item self report measure
- it assess symptoms of a depressive disorder
- Each item contains 4 statements that relates to the symptoms of depression such as suicidal thinking
- The total scores will determine the severity:
>10 -18(mild depression)
> 19-29(moderate depression)
>30 and up (severe depression)
Evaluate the BDI
+Quantitative data is objective
+High in reliability as it is consistent
+High in validity as it is accurate
-closed questions limit their responses
-Social desirability, they can exaggerate or underemphasise their responses
-Cultural differences , focuses mainly towards western language
Describe the biochemical reasoning of the Biological explanation
- It states that there are low levels of dopamine and low levels of serotonin
- low levels of dopamine: Shows a lack of interest in previously enjoyed tasks, low moods and motivation
- Low levels of serotonin : low levels of mood an anxiety, changes in sleeping and eating patterns
Describe the genetic reasoning of the Biological explanation
- Current evidence has shown that first degree relatives such as parents/ siblings which share 50% of DNA are likely to transmit bipolar or unipolar. from one generation to the next.
What is the Main theory in Oruc et al.
- The study suggests that lower serotonin activity may be linked to bipolar disorder, suggesting further investigation into genetic factors influencing serotonin levels.
Which receptors are involved the susceptibility of BP
- 5HT2c
- 5HTT
What is the aim in Oruc et al.
Whether the genes that are used to code for certain serotonin receptors are involved in the susceptibility to bipolar
Describe the sample of Oruc etal.
- 42 in total (25 females , 17 males)
- all contained type 1 bipolar disorder
- were from 2 Croatian hospitals
- age range of 31-70 years
- 16 of these patients had first degree relatives with a mood disorder
- there was an included control group with 40 participants that had no previous mood disorder or any that runs in the family.
What was the experimental design and how did they carry it out in oruc et al.
- Matched pairs design
- by matching them based on sex and age
What was the procedure in Oruc
- They carried out DNA testing to test for polymorphisms (variation) in the genes responsible for a particular serotonin receptor
- These genes were selected because alterations in them have lead to disturbances in the biochemical pathways
What were the results of the study Oruc
- There was no significant relationship between people with bipolar and having polymorphisms compared to the control group
- they found dopamine to be sexually dimorphic hence, women with bipolar showed that polymorphisms were more common in them that in the control group
What was the conclusion in Oruc
The analysis suggested that polymorphisms of these geneses could be responsible for an increased risk in developing bipolar in females only.
Evaluate Oruc et al.
+ Use of objective accurate data with the use of DNA testing, making it more precise and comparable
+ The results from the study can be used for application to everyday as this helps individuals who have relatives that are bipolar to go get screened or have an early diagnosis
-the study is limited due to a smaller sample size and due to the fact that all participants were from Croatia.
Evaluate the biological explanation in terms of issues and debates
- Supports the nature side of the debate suggesting that genes play a role
- considered reductionist as it only gives the reasoning to genes and neurotransmitters but excludes other factors
- Considered deterministic as it bases the explanation on someones genes which they cannot control and have no choice but to deal with their condition
what did Beck define cognitive distortion as
- He believed that this is when a person tends to see things in a negative way and were developed as a result of negative experiences in their childhood which later grew into negative schemas
describe Beck’s cognitive triad
1- Negative views about oneself
2- Negative views about the world
3- Negative views about the future
define attribution
the cognitive process wherein individuals explain the causes of particular events and behavior
define learned helplessness
A behavior that occurs as a result of the person having to endure an unpleasant experience that they deem inescapable
a negative event can be attributed to
- internal(personal) VS external(environment)
- stable (constant) VS unstable(occasional)
- Global (affects many aspects) VS specific(affects one area)
what was the aim of seligman et al.
to investigate how well attributional styles could predict depression
describe the sample of Seligman
- 39 patients with unipolar
- 12 with bipolar
- 10 from the control group
- all patients were from the same clinic
- included a mix of genders
- average age of 36 years
describe the attributional style questionnaire in seligman and how did the participants respond
- a 12 item self-report of good and bad hypothetical situations
- they had to attribute the cause for each scenario and rate them on a 7-point scale for internally, stability and globally
State 3 results found in Seligman et al
- The unipolar and Bipolar group had the most pessimistic negative attributional styles than the control group
- The more severe the BDI score was, the worse the pessimism on ASQ
- there was an improvement in attributional styles for patients with unipolar who are under CBT
what did Seligman conclude
The way we make attributions can contribute to developing depression
evaluate the BDI and ASQ
+ A standardized and consistent measure that is accurate hence, high validity
+ quantitative data which is objective and enables comparison
-socially desirable answers
-closed-ended questions limit individuals’ response
-Cultural differences as the BDI is designed towards the Western culture.
Evaluate seligman et al.
+The use of quantitative measures such as questionnaires can allow for easy objective comparisons to be established
-Low number of participants hence lacks generalizability
Evaluate the cognitive explanation of mood disorders
- The holistic side of the debate is supported as it focuses on more than one aspect
- supports the nurture side of the debate as individuals learn the behavior leading to depression
- supports the nomothetic side of the debate as it produces quantitative data such as the BDI scores
- to some extent, it is deterministic as they do not have any control over the events that cause helplessness
- Individual side of the debate blames it on theindividuals dysfunctional thinking style however sitauational side says helplessness arises due to their environment
describe the biological treatment with Monoamine Oxidase inhibitors (MAOIs)
- Monoamine Oxidase is an enzyme that breaks down neurotransmitters such as serotonin
- MAOIs will inhibit these enzymes so that they can maintain high levels in the synapse
List 5 side effects from MAOIs
- Headaches
- Diahorrea
- Nausea
- Insomnia
- Suicidal thoughts
Describe the biological treatment with Selective serotonin reuptake inhibitors (SSRIs) and how they work
- This treatment only works on the neurotransmitter serotonin. It works by stopping its reabsorption into the pre-synaptic neuron, keeping it at high levels in the synapse
What are the disadvantages of using ECT to treat depression
- It is a short-term treatment so patients will resort back to other treatments
- relapse rates are just as high as those stopping antidepressants and will have a reoccurrence of symptoms
Describe the use of tricyclics as a biological treatment
- They are the first-generation treatment and act as the last resort when other treatments fail
- They increase the levels of serotonin and norepinephrine by stopping them from being reabsorbed
- side effects include drowsiness and blurred vision
Evaluate drug therapy as a treatment for depression
+Supports the nature side and targets neurotransmitters
+Readily available and less costly compared to other treatments
+Fournier et al. proved drugs are more effective in moderate to severe depression than those with mild
-side effects
-Deterministic as the patient cannot control the interaction of serotonin with the medication to bring about an improvement
-Reductionist as it only focuses on the improvement of symptoms
describe becks cognitive restructuring talking therapy
- First begins with the therapist explaining the theory of depression using the cognitive triad so the patient understands their thinking styles
- patients are then trained to recognize and observe their thoughts and once they do recognize them they can link their thoughts to their behavior
- They then discuss whether these thoughts are really an accurate reflection of reality.
- The therapy finishes when the patient is able to employ cognitive restructuring for themselves and can see a reduction in their depressive symptoms
Therapists often use ‘reattribution’ as a technique in therapy, what does it involve
- This is where the therapist and patient discuss whether the cause of problems/failures they have faced are internal or external
- By doing this, the patient can then refrain from thinking that they are responsible for bad situations happening to them.
what did the study by Wise et al. find
those who received therapy were 3 times more likely to show a reduction in depressive symptoms `
Define stoicism
This is a philosophy where one of the principles is that the individual is not directly affected by external things but by how they perceive those external things
describe the ABC model of Ellis
A- activating event
B- beliefs
C- consequences
Describe the Rational emotional Behaviour Therapy (REBT)
- Ellis believed that depression is a result of a persons attitude towards events in their lives and he labeled this as internal constructions.
- This therapy involves disputing with the patient whereby the therapist will forcefully question their irrational beliefs using a variety of methods
- Patients must first see their C (consequences) and that they are partly a result of the A (activating event)
- Then they must accept that holding onto negative and irrational B (beliefs) will result to a destructive tendency.
What did Lyon and woods find out about REBT
- They found that people who received REBT demonstrated significant improvements over baseline measures and the control groups
