Depression

Question 1

What are the features of a depressive episode? (affective, motivation, cognitive, physiological)

Answer 1

Affective: low, flat mood
Motivation: low, disinterested in past hobbies
Cognitive: lack of concentration, guilt
Physiological: underaroused, hypersomnia (excessive sleep).

Question 2

What is the comorbidity % between depression and anxiety?

Answer 2

80% of ppl who are depressed will also have anxiety. Only 40% of people who are anxious will have depression.

Question 3

Describe dysthymia

Answer 3

Ongoing low mood occuring for a minimum of 2 years. Symptoms: loss interest in normal activities, low appetite, hopelessness, low self-esteem, low energy, sleep changes, poor concentration.

Question 4

What are four specifers of major depressive disorder, describe each one.

Answer 4

1) Melancholic features: can be exogenous (due to external stressors e.g. environment, social) or endogenous (due to internal stressor e.g. biological or cognitive)
• Anhedonia = inability to feel pleasure in normally pleasurable activities.
• Diurnal variation = Morning depression (worse in morning than afternoon).
• Early morning wakening

2) Post-natal depression / postpartum depression: depressoin that particularly occurs within 4 weeks after childbirth
3) Psychotic features: hullucinations or depressive dillusions e.g. they think they’re the devil. Sometimes convince them of suicide.
4) Seasonal variation: depression in winter months and manic in summer months (seasonal affective disorder- SAD).

Question 5

What is the onset of unipolar depression and bipolar?

Answer 5

Depression: onset is 14 years old, average is 30 yrs old
Bipolar: earlier onset than 14

Question 6

DESCRIPTIVE WISE What are differences and similarities in symptoms for depression and anxiety (as separate disorders)?

Answer 6

Common: worry, irratability, insomnia, crying, fatigue
Differences:
Anxiety = apprehension, trembling, tension, nightmares
Depression = Low mood, helplessness, low interest, low libido, suicidal thoughts

Question 7

What is the sex distribution of bipolar AND depression?

Answer 7

Bipolar: equal in both.
Depression: twice as common in woman than men. Same worldwide.

Question 8

What are the differences between anxiety and depression with regard to:

1) age of onset
2) course
3) trigger by life events
4) cognitive features

Answer 8

Anxiety: v early, chronic, not really triggered, future directed

Depression: Mid teens or older, episodic, common triggered, past directed

Question 9

Who is most likely to have bipolar / manic episodes?

Answer 9

One correlate is creativity, so artists and poets.

Question 10

What are the key features of manic episodes? (affective, motivation, cognitive, physiological)

Answer 10

Affective features: extremely high mood, positive and happy
Motivation: heightened energy, Engagement in unrealistic, risky activities, multiple activities
Cognitively: may lost touch with reality in extreme manic phase and have psychotic thoughts e.g. have super powers, god has chosen them. Inflated sense of importance, power, Difficulty concentrating, flight of ideas.
Physiologically: pressured speech (talks fast), tangents, always active

Question 11

Females are …. as …. likely than men to have both anxiety and depression. Ratio is … : …

Answer 11

twice as more likely

2: 1

Question 12

What are the three major depressive disorders?

Answer 12

1) Major depressive disorder / unipolar depression
2) Dysthymia
3) Bipolar

Question 13

How common is major depressive disorder AND bipolar in population over a 12 month period?
And dysthmia!

Answer 13

depression: 4%
bipolar: 1-2%
Dysthymia – 1.3%

Question 14

Likelihood of repeated episode of
depression
anxiety
(in %) e.g. its .. .% likely to have a repeat episode after first

Answer 14

• Depressive episode 80% > 1 episode - Manic episode 90% > 1 episode

Question 15

Major Depression more likely in three key demographics:

Answer 15

Major Depression more likely in
• Unemployed
• Single
• Low education

Question 16

4 Predisposing Factors to mood disorders?

Answer 16

• Parent pathology: if you have a parent with a disorder
• Early life adversity: may set up vulnerabilities
• Parent loss: more at risk down the track
• Parenting rearing practices

Question 17

How would parent psychopathology lead to a mood disorder in the child?

Answer 17

• child Modelling of parent’s depressive coping/ beliefs
• It may lead to Increased stressful events in child’s life.
• Poor parental care/ support for child

Question 18

Parent loss theories contributing to depression state that
early theories suggest its a … loss.
later more recent suggestions suggest it actually only has to be a … loss

Answer 18

• Suggestion to losing a parent early in life predisposes to later depression
• Early theories suggested real loss
• Later suggestions – conceptual loss
(ie. dismissive parent/neglectful parenting)

Question 19

Parents of people who are depressed tend to have more ….. and …. parenting methods.

Answer 19

critical, harsh

Question 20

One study (in evidence section) suggested that the number of house moves …

Answer 20

Number of moves (general life adversity/disruption), more moves predicted more likely to have depression.

Question 21

Stress needed to trigger depression, but need more OR less stress if you’ve already had early life adversity??

Answer 21

Stress needed to trigger depression, but need less stress if you’ve already had early life adversity.

Question 22

In the study that looked at reactions to early maternal separations in monkeys, Self mouthing and self clasping were…

Answer 22

were behaviours of stress.

Question 23

WILD CARD!

Answer 23

How rejected by their own parents (G1 is grandparents rejecting the parents). Then looked at parents rejecting child (G2). Found: depression from G1 predicted depression in adult. Depression in parent reflected more rejection to their child. Then in turn the kids were depressed (G3) third generation. More rejecting the parent is the more rejecting their child is.

Question 24

The more critical a parent is of the child, more likely the child will develop…?.. schemas.

bonus points for a second type of style

Answer 24

negative self schemas

and (bonus pts) negative attributional styles

Question 25

3 examples of chronic adversities are:

Answer 25

• Poverty
• Marital distress
• Chronic illness

(increase likelihood of depression) Chronic adversity different to one off life event.

Question 26

…% of depressed cases preceded by stressful event

Answer 26

80% of depressed cases preceded by stressful event

usually 3 month window before

Question 27

Does stress produce depression or does depression produce more stress?

Answer 27

Support for both directions. Most studies are correlational. Therefore evidence that depression leads to more stress.

more info and e.g.
–>because of their own actions e.g. someone vulnerable to depression and has a negative personality style, may have lots of arguments with ppl around them, more likely to have a relationship breakup, triggers depression.

Question 28

Describe what they mean by

independent vs dependent life events?

Answer 28

independent: death of loved one
dependent: caused by person e.g. relationship break up. Tend to have both independent and dependent.

Question 29

What is the response when people say that not everyone gets depressed when they have a life event

Answer 29

• Many people have life events, most don’t get depressed
• Theories predict interaction – diathesis-stress
• Diathesis can be physical (eg genes) or psychological (eg cognitive style)

Question 30

What are the problems with the diathesis stress model?

Answer 30

• Hard to get evidence on – need longitudinal studies and large samples
• Difficult to measure diathesis well
• Difficult to “wait for” stressful event
• Due to difficulties – results have been mixed

Question 31

What role does social support play in depression/mood disorders generally?

Answer 31

Good Social support is a factor, less likely to be depressed. Quality is important not quantity. E.g. ive got good people around me I can confide in in my problems. Social support seems to buffer the effects of stress and life events.

Question 32

Those who were depressed were more likely report
loss events than danger,
or danger than loss events?

Answer 32

Those who were depressed were more likely report loss events than danger.

Loss=break up, losing a job, death. Danger=illness in self or loved one, being in a car accident potentially.

Question 33

WILD CARD. FUN!

Answer 33

Dependent events are two times more likely, far more linked to cause stress and create negative events in your life when depressed .

Question 34

When looking at genetic markers, what is more at risk to develop depression
short arms of enzyme with less serotonin
or long arms of enzyme with more serotonin
????

Answer 34

Evidence for diathesis-stress models (some people are more likely).

Looks at genetic vulnerability. Divided them on a specific genetic marker. Basically one of the genes linked closely with depression (the amount of enzyme that transports serotonin), short arms of enzyme (less serotonin). Those with 2 long (l,l) likelihood of developing depression is small. Short arms, higher risk

Question 35

TAKE A BREATHER

Answer 35

THREE DEEP BREATHS PLEASE! KKILLLINGGG IT! :)

Question 36

Social support more imp for men or omen?

Answer 36

social support is so much more important for women than for men in protecting against depression.

Question 37

What is the social/Behavioural Theory of Depression – by Lewinsohn (1974)??

(Lewinsohn’s Theory of Depression)

Answer 37

The fact that depression is maintained by low response contingent positive reinforcement
• Depressed people experience few rewards in their lives
• Especially social / interpersonal rewards
• Largely due to poor social skills and social
avoidance

(reduction of +ves get from life and become miserable. E.g. you don’t smile at people and very few ppl smile back (don’t have the skills to elicit positives).

Question 38

What is Seligman’s Learned Helplessness Theory?

Give an example.

Answer 38

• Extensive experience with uncontrollable negative events leads to helplessness
• Later stress elicits helplessness (low perception of control)
• Leads to low mood and especially deficits in motivation and energy

E.g. if bought up in a neighbourhood where everything is poor and no one does anything you learn helplessness, learn not to try

Question 39

When one makes attributions for a negative event e.g. failing an exam, there are three types:

REFORMULATED LEARNED HELPLESSNESS THEORY to account for individual differences.

Answer 39

(global→everything in my life is bad vs specific (my relationship is bad). Interval (says something about me personally vs external (this could happen to anyone). Unstable (this event always happens in my life) vs stable (this is only a one off).

A combination of all three will make you depressed→its global, its internal and its stable e.g. if I fail a maths exam (I fail all exams and everything anyway).

Question 40

Cognitive Theory of Depression - Beck

Explain the negative cognitive triad

Answer 40

Negative view of world, self and future
• Some people characterised by negative schemas
• When triggered by stress leads to biases in information processing
• Symptoms of depression maintained by negative automatic thoughts and negative triad

People who have negative ways of viewing the world aren’t necessarily overtly depressed, might be vulnerable to depression because of their pessimism. Negative schema of the world + particular stressor = negative triad.

Question 41

Whats the response style theory, and what does it say about people who tend to ruminate?

(try remember what this means)

Answer 41

• People vary in tendency to ruminate
• Rumination – passive focus (not constructive problem solving) on symptoms, causes and consequences of distress
• Greater rumination increases risk that normal sadness will extend into mood disorder

Usually if something bad happens might motivate people to change etc, but for those with remunerative style, that’s when you lose motivation, lose ability to solve problems, helpless, vicious cycle, leads to depression.

Question 42

DEPRESSION

How likely is brandon to develop depression if I have it?

Answer 42

1st degree relative of depressed 2-4x more likely to

be depressed

Question 43

DEPRESSION

Does genetics play a role in depression? What evidence do we have that it does from twin studies (mono and di).

Whats the overall estimate of heritability of depression?

Answer 43

Higher concordance in MZ than DZ twins
• 15-60% MZ vs 10-40% DZ
• Thus estimate 30-40%heritability

Question 44

BIPOLAR

If George has bp, how likely is it that Laudie has it?

Answer 44

1st degree relative of bipolar 2-4x more likely to have depression.

Question 45

BIPOLAR

Does genetics play a role in bp? What evidence do we have that it does from twin studies (mono and di).
Whats the overall estimate of heritability of bp?

Answer 45

Higher concordance in MZ than DZ twins
• 20-75% MZ vs 0-8% DZ
• Thus estimate 80%heritability

Question 46

Depression caused by low levels of biogenic amines,

what two are they?

Answer 46

Depression caused by low levels of biogenic amines
• Serotonin (5HT)
• Noradrenalin

Question 47

What are the causes of lowered biogenic amines in depressed lads?

Answer 47

Causes of lowered biogenic amines
• Excessive reuptake to presynaptic cell
• Excessive activity of enzymes that break down amines (e.g., monoamine oxidase MAO) lmfao lemfao. lol

Question 48

Biochemical theories today are more complex than having low levels of serotonin and noradrenalin. What have they suggested recently?

Answer 48

• Possible interplay between neurotransmitters, receptors and specific brain sites
• Eg low 5HT may disregulate other neurotransmitters

• Now: Increased focus on role of Dopamine – lower levels seen in depression

Question 49

How does the neuroendocrine system contribute to depression?

hormones involved in fight/flight, role of these in depression, HPA in depression is overactive or underactive?

Answer 49

• Several hormones involved in regulating body in response to stress (e.g., adrenaline, noradrenaline, cortisol)
• Argued that these may be involved in onset, severity and relapse of depression

• Suggestion that HPA (hypothalamic-pituitary- adrenal) system is overactive
• Links onset of depression to stressful life events
• HPA axis also integrally linked with amygdala,
hippocampus, and pre-frontal cortex

Question 50

Circadian Rhythms? What are they?

Answer 50

Often referred to as the “body clock”, the circadian rhythm is a cycle that tells our bodies when to sleep, rise, eat–regulating many physiological processes.

Question 51

Disturbances in Circadian Rhythms?

Answer 51

Argued that disturbances in circadian rhythm is core feature of depression

Question 52

Some evidence that depriving depressed people of sleep ……

Answer 52

• Evidence that sleep disturbance precedes depressive episodes up to 12 months earlier
• Some evidence that depriving depressed people of sleep, stops depressive episode

Question 53

Evidence for and against Biogenic Amine hypothesis

Answer 53

For:
(depressed have naturally lower levels of metabolites)
drugs that decrease levels cause depression
drugs that increase levels of metabolites reduce depression.

Against:
delayed therapeutic effects (4-8 weeks after taking drugs, yet actual amines increase next day? weird).
Some drugs don’t seem to work on biogenic amines but still improve depression.

Suggests complex relationship, and maybe more factors involved e.g. receptors

Question 54

What is Tryptophan?

What happens if you reduce it?

Answer 54

Tryptophan is amino acid that is precursor to serotonin.

You get lower levels of serotonin and increase likelihood of depression.

Question 55

Do cortisol (arousal) levels in depressed change throughout the day?

Answer 55

No. they stay low all day.
Normally, cortisol levels would start of low in the morning as one gets up, and gradually becomes more alert and aroused throughout the day (within 30-60 mins even) lol

Question 56

Difference btn insomnia and hypersomnia ?

cos depressed people are both but more commonly insomniacs

Answer 56

insomnia: habitual sleeplessness; inability to sleep.
hypersomnia: a sleep disorder characterized by excessive daytime sleepiness, excessive sleep periods each day (usually taken to mean more than 10 hours

Question 57

Have suicide rates declined or increased in AU?

How much by per 100 000?

Answer 57

Suicide rates in Australia
• Decreased slightly 1995-2005
• 13 per 100,000 to 10 per 100,000

Question 58

Gender differences in suicide are confusing to wrap your head around. But males are … times more likely to successfully suicide, and females are … as more likely than men to attempt it.

Answer 58

4 times more males than females successful suicides. Twice as many women than men attempt suicide.

Question 59

What is parasuicide?

Answer 59

attempted suicide without the actual intention of killing oneself.

Question 60

Do previous attempts at suicide predict actual suicide, even if it was just parasucide?

Answer 60

yes. Usuallly those who commit sucuide would have had past attempts. not helpful saying parasuicide (apparent attempted suicide without the actual intention of killing oneself) isn’t significant.

Question 61

Age of suicide thats most common?
(age range)
(media attention focus?)

Answer 61

• Suicide most common in 20-30s. Rate decreases in middle age (much press attention). But equally likely is 60s – 70s spike or increase in suicide there BUT less press or media attention for this group.

Question 62

Risk Factors for Suicide in Australian Youth?

Answer 62

• Males more likely. Rural areas and who are aboriginal. Also lonely or role disengagement predicts suicide. Psychosis and substance abuse future predictor. Also people with personal history of attempted suicide or with family history are more likely to kill themselves.

Question 63

Common myths of suicide? (5 of them)

Answer 63

Discussing suicide will cause it
People who threaten suicide don’t do it
After a suicide attempt, the danger is over Suicide is an impulsive act
Truly suicidal people have made a clear decision to die
If a person attempts suicide, they are just “seeking attention” and are not really serious

More info here:
• MYTHS: 1) discussing suicide will cause it. Wrong. Exactly the opposite is case. Talking through when and how their reasons etc. 2) this idea that threaten suicide are not going to do it. WRONG. Parasuicides need to be taken seriously. 3) Once someone is saved from attempted suicide, its all going to be fine, theyre hospitalised and will be okay. WRONG. Actually most vulnerable period and high risk period is few months after unsuccessful attempt. Need to be vigilant in watching. 4) also if someone is talking about and theyre not sure really about it is they wont go ahead and do it vs someone who has decided about it will definitely go do it. WRONG. Most people who commit are really unsure about it. No one ever is 100% sure it’s the course of action. Many people will raise it and question it. You need to take it very seriously.

Question 64

People over 75+ are much more likely to die from suicide than other reasons.
True or false?

Answer 64

FALSE! People over 75+ are much LESS likely to die from suicide than other reasons.

Question 65

More terminal methods of suicide in
men or women?

What kind of methods do each gender use?

Answer 65

men obviously haha

Women: overdoses much more common
Men: firearms, poison, hanging.

Question 66

Being married is a protective factor against suicide.

True or false?

Answer 66

True! Being married is a protective factor against suicide. May be support reasons, or for practical reasons (less easy to kill yourself in house with other people there).

Question 67

Youre done? Wild card

Answer 67

:)