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PSYC 412 > Day 14-16 - Depression > Flashcards

Day 14-16 - Depression Flashcards

1
Q

What is dysphoria?

A

prolonged sadness

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2
Q

Distinguish between Symptom, Syndrome, and Disorder in terms of depression

A
  • symptom: feeling/emotion of sadness (very common)
  • syndrome: cluster of common symptoms, extreme on dimension of negative mood/affect
  • disorder: syndrome that has been occurring for certain amount of time and w certain level of impairment
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3
Q

What is are the requirements for MDD in the DSM?

A
  • presence of major depressive episode
  • 5 symptoms during same 2w period
  • at least one of: depressed mood/irritability most of day OR anhedonia most of day
  • plus 3-4 other symptoms (sleep issues, weight issues, decreased concentration, etc)
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4
Q

What are the 8 specifiers for depressive disorders?

A
  • Anxious distress
  • Mixed features
  • Melancholic features
  • Atypical features
  • With psychotic features
  • With catatonia
  • Peripartum onset
  • Seasonal pattern
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5
Q

Which 2 specifiers of depression are the only ones relevant to persistent depressive disorder?

A
  • anxious distress
  • atypical features
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6
Q

What is required for a diagnosis of pervasive depressive disorder?

A
  • depressed mood for 2y in adults (1y for kids/teens)
  • 2+ symptoms
  • never been without symptoms for more than 2mo during period of 1/2y
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7
Q

What is required for a diagnosis of DMDD?

A
  • severe recurrent temper outbursts
  • outbursts inconsistent w developmental level
  • outbursts avg 3+ times per week
  • irritable or angry mood between outbursts
  • symptoms for 12mo+
  • not diagnosed before 6 or after 18
  • age at onset of outbursts/mood is before 10y
  • has never met criteria for manic/hypomanic episode
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8
Q

DMDD is not diagnosed concurrently with ___ or ___

A

ODD (DMDD is more severe) or bipolar disorder

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9
Q

(T/F) DMDD is well-differentiated from ODD/CD

A

FALSE (no diff btw youth w/wo DMDD diagnosis in symptom severity or functional impairment)

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10
Q

In Copeland’s study, DMDD occurred w another disorder ___% of the time

A

62-92% of time

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11
Q

The ____ of the DMDD diagnosis is not firmly established

A

validity

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12
Q

What is the lifetime prevalence of MDD for:
- preschool kids
- elementary kids
- teens

A
  • preschool kids: 1%
  • elementary kids: 2%
  • teens: 11% (increases across teens)
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13
Q

What is the gender ratio for MDD?

A
  • similar levels in childhood but gap widens in late teens
  • far more women diagnosed
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14
Q

What are the 5 possible explanations for the gender gap in MDD? What does research say about each one?

A
  • girls more likely to seek help (FALSE)
  • biological factors (puberty linked to dep in girls only)
  • stress/interpersonal stress
  • cognition (cognitive bias; appears comparable across genders)
  • coping (girls more likely to ruminate)
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15
Q

Early onset depression is usually linked with (higher/lower) risk for more severe depression later on

A

HIGHER

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16
Q

What are some particular considerations for MDD in preschoolers?

A
  • 2w MDE duration criterion not as relevant
  • MDD in preschool ass w MDD 2y later even if 2w MDE criterion not met
  • 2.7x more likely to be depressed at school age
  • higher rates of anxiety and ADHD
17
Q

Children w parent who was depressed as child are __x more likely to become depressed before age 13. What are 2 reasons for this?

A
  • 14x
  • heritability (35-75%)
  • stress reactivity (early exp to stress can sensitize to later stress)
18
Q

T/F only post-partum depression can have lasting impact on the baby

A

FALSE (prenatal dep has effect on child’s cortisol at 6-7y)

19
Q

What are 2 ways postpartum depression can impact the baby?

A
  • through breastmilk (not much research)
  • behavioral (less responsive parenting)
20
Q

What stage of information processing most often goes wrong for those w mood disorders?

A
  • interpretation (automatic negative interpretation!)
21
Q

What did the study looking at interpretation of ambiguous words in girls at risk for depression find?

A
  • 10-14yrs (mom w history of dep OR control)
  • NONE had current diagnosis
  • presented w 2 words at same time (eg cry and dry)
  • assessed interpretation
  • at risk girls showed pref for negative words if depression-related!!
  • controls showed pref for positive words in neutral-pos pairing
22
Q

How are response search and response decision impacted in depression?

A
  • identify fewer assertive strategies
  • report self less able to carry out assertive strategies
  • think avoidant strategies are more likely to result in positive outcomes
23
Q

Define stress exposure vs stress generation models of depression

A
  • stress exposure: depression results from exposure to stressful events
  • stress generation: depression may lead individuals to generate stressful life events
24
Q

Describe the 2000 study by Rudolph investigating the stress generation model of depression

A
  • assessed life stress in 88 kids
  • subjective and objective (researcher ratings)
  • depression ass w dependent (caused by child) and interpersonal stress
  • depression not ass w independent stressors
  • kids w both depression and externalizing disorder experienced highest lvl of both interpersonal and non-interpersonal dependent stress
  • generally supports stress generation models
25
Q

How do depressed children impact their friends’ affect?

A
  • friends’ affect becomes more negative over interaction
  • co-rumination increases FQ but also increases internalizing sx
  • reassurance seeking gets irritating to friends
26
Q

Depression may begin or deepen as part of a ____

A

downward emotional spiral

27
Q

The goal of CBT is to bring the ___ in line with the ___

A

reaction in line w the event

28
Q

CBT is a great example of therapy as ____ and ____

A

observation and experiment

29
Q

CBT involves helping youth learn how to ___ their thoughts/feelings/behavior, ____ alternative explanation, and ____

A

observe, consider, solve problems

30
Q

A 2019 meta-analysis of CBT effectiveness for kids and teens by Oud et al found that:
- subclinical @ baseline had __% lower risk dep at follow-up
- clinical dep @ baseline had __% lower risk
- _____ and ____ predicted positive outcomes

A
  • subclinical: 63% lower risk
  • clinical: 45% lower risk
  • combo behavioral activation + thought challenging AND involving parents in intervention
31
Q

What 3 types of depression interventions for teens in LMIC worked best?

A
  • CBT
  • integrated (CBT and others)
  • economic interventions
  • (interpersonal therapy helped but not reliable finding)
32
Q

What are 4 types of antidepressants used for youth? What evidence do we have of efficacy?

A
  • Tricyclic antidepressants (no evidence of efficacy in youth)
  • MAOIs (mixed evidence for teens, potentially lethal side effects)
  • SSRIs (good evidence for Prozac in teens, not fatal in OD)
  • SNRIs (like SSRI but also block norepi and slower acting)
33
Q

What is a black box warning?

A
  • warning by FDA on SSRIs
  • suggestion of increased risk of suicide in kids/teens
34
Q

What do recent studies suggest about suicidality and antidepressants?

A
  • might not actually be a link
  • generally, as antidepressant use goes up in an area, suicidality goes down
  • FDA warnings decreased med use but increased attempts (no change in actual suicides)
  • basically, evidence is MIXED
35
Q

How is depression treated in preschoolers?

A
  • evidence for adapted parent management training
  • not much research otherwise
  • therapy recommended as first approach
  • if needed can try Prozac w lots of monitoring
36
Q

What did the Treatment for Adolescents with Depression (TADS) study find? What about the follow-up?

A
  • groups w active meds did better in terms of dep sx
  • CBT did not outperform placebo pill!!!! (maybe bc sample was very severe)
  • CBT is potential protective factor against suicidal events
  • SSRI + CBT best for moderate-severe MDD
  • after 36w CBT group caught up in terms of gains
  • suicidal ideation more common in meds only tx
  • gains maintained 1y later for all groups!
37
Q
A

PSYC 412 (9 decks)

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