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Abnormal Psychology 3018 > Depression I > Flashcards

Depression I Flashcards

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1
Q

What was the name of the chapter containing depressive disorders in DSM-4, and what two groups of disorders did it contain?

A

‘Mood Disorders’:

  • Depressive (Unipolar) Disorders.
  • Bipolar Disorders.
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2
Q

What were the specific depressive disorders (and any others in the same chapter) grouped in the DSM-4?

A

‘Mood Disorders’:

  • Major Depressive Disorder.
  • Dysthymic Disorder.
  • Bipolar I Disorder.
  • Bipolar II Disorder.
  • Cyclothymic Disorder.
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3
Q

What was the reasoning behind the depressive (and other) disorders being grouped together in DSM-4?

A

Unipolar and Bipolar disorders were grouped together because they involved extremes of normal mood.
Unipolar disorders involve one extreme of mood and Bipolar disorders involve two.

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4
Q

Why was the DSM-4 depressive chapter uncoupled for the DSM-5?

A

Unipolar and Bipolar disorders have different causes, different genetic loading, different prognosis and onset.
They are different sets of disorders.

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5
Q

What is the name of the chapter containing depressive disorders in the DSM-5, and what does it contain?

A

‘Depressive Disorders’:

  • Disruptive Mood Dysregulation,
  • Major Depressive Disorder.
  • Persistent Depressive Disorder (Dysthymia).
  • Premenstrual Dysphoric Disorder.
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6
Q

What are the new disorders in the DSM-5’s Depressive Disorders chapter?

A
  • Disruptive Mood Dysregulation Disorder.

- Premenstrual Dysphoric Disorder.

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7
Q

What did the DSM-4 disorder, ‘Dysthymia’ have its name changed to in the DSM-5?

A

Persistent Depressive Disorder.

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8
Q

What was Persistent Depressive Disorder previously known as?

A

Dysthymia.

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9
Q

What are the main characteristics of Disruptive Mood Dysregulation Disorder? When is it diagnosable?

A

Severe, recurrent anger outbursts and in between the person is persistently irritable.
Diagnosis can only be made in between the ages of 6 and 18.

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10
Q

The onset of Disruptive Mood Dysregulation Disorder should be observable by which age? Even if the diagnosis was made later.

A

By the age of 10.

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11
Q

How often must anger outbursts occur and for what length of time in Disruptive Mood Dysregulation Disorder for a diagnosis to be made?

A

3 anger outbursts per week for at least 12 months.

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12
Q

What is the situational specifier in Disruptive Mood Dysregulation Disorder?

A

Anger outbursts must occur in two or more different situations to determine that it is the child’s mood and not a particular situation that is the problem.

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13
Q

Why was Disruptive Mood Dysregulation Disorder created?

A

To divert children, who experience anger outbursts, from being misdiagnosed as having a Bipolar disorder.

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14
Q

What other disorder(s) is someone with Disruptive Mood Dysregulation Disorder at risk of developing? What disorder(s) are they not at risk of?

A

At risk of Depression & Anxiety.

Not at risk of Bipolar.

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15
Q

What are some treatments for Disruptive Mood Dysregulation Disorder?

A

Child-appropriate versions of emotional regulation treatments, such as Dialectical Behaviour Therapy (talking therapy for those with strong emotions).

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16
Q

What is Premenstrual Dysphoric Disorder?

A

When at least 5 symptoms (involving changes in mood and changes in behaviour) are present in the week leading up to the beginning of period. The symptoms should begin to subside after the period starts, and be gone when the period is gone.

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17
Q

What is the potential treatment for Premenstrual Dysphoric Disorder?

A

A short-term dosage of anti-depressants in the lead up to the period.

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18
Q

What is Persistent Depressive Disorder?

A

It is a longer-standing and lower intensity depression.

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19
Q

What is the A. & B. criteria for Persistent Depressive Disorder? And the 6 symptoms listed under B. criteria?

A

A. Depressed Mood most of the day, more days than not.
B. The presence of two (or more) symptoms:
1. Poor appetite/overeating.
2. Insomnia/hypersomnia.
3. Low energy or fatigue.
4. Low self-esteem.
5. Poor concentration/difficulty making decisions.
6. Feelings of hopelessness.

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20
Q

What length of time, as defined in DSM-5, should someone experience Persistent Depressive Disorder symptoms in order to be diagnosed?

A

For two years, with no more than 2 months of feeling ‘normal’.

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21
Q

What is the process that often leads people to a diagnosis of Persistent Depressive Disorder?

A

It is often after a person has a Major Depressive episode they go back to baseline and realise they have always been a little bit depressed.

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22
Q

What is Persistent Depressive Disorder often comorbid with?

A

Major Depressive Disorder.

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23
Q

It often takes a long time for people with Persistent Depressive Disorder to be diagnosed. Why is that?

A

They feel as though they have always been like this and don’t feel compelled to seek help.

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24
Q

Give a summary of the changes made from DSM-4 to DSM-5:

A
  • ‘Mood Disorders’ gone, replaced by ‘Depressive Disorders’ and ‘Bipolar & Related Disorders’.
  • ‘Disruptive Mood Dysregulation Disorder’ and ‘Premenstural Dysphoric Disorder’ added.
  • Removed ‘grief’ exclusion from the diagnosis of MDD.
  • ‘Dysthymia’ changed to ‘Persistent Depressive Disorder’.
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25
Q

What is the (brief) definition of Major Depressive Disorder?

A

A single or recurrent depressive episode.

26
Q

What 9 symptoms define a Major Depressive Episode?
How many symptoms are needed to be diagnosed with Major Depressive Disorder?
For how long must they be present?

A
  1. Depressed mood most of the day, nearly every day.
  2. Markedly diminished pleasure/interest in activities.
  3. Significant weight loss/gain.
  4. Insomnia/hypersomnia.
  5. Psychomotor agitation or retardation.
  6. Fatigue/loss of energy.
  7. Feelings of worthlessness/excessive guilt.
  8. Diminished ability to concentrate.
  9. Recurrent thoughts of death, suicide, suicide attempts.
    - 5 or more is needed (including 1. or 2.) in a two-week period.
27
Q

What is one specifier for Major Depressive Disorder?

A
  • There has never been a manic episode or hypomanic episode.
28
Q

What was a DSM-4 specifier for Major Depressive Disorder that is no longer in DSM-5?

A

Bereavement specifier: ‘symptoms should not be due to bereavement: if so, should not persist longer than two months.’

29
Q

Why was a specifier removed from the DSM-5 definition of Major Depressive Disorder?

A

Because bereavement looks different to depression. In grief, emotions/ideations (like guilt and suicide) are focused on the dead person.

30
Q

Bereavement is no longer a specifier for Major Depressive Disorder, but what is?
What must a clinician ask?

A

The responses to stressful life events, such as loss of job, relationship, financial ruin can look like depression.
Clinician must ask: ‘are depressive symptoms out of proportion/inappropriate to situation?’

31
Q

What kind of disorder is Major Depressive Disorder? What does it fluctuate between?

A

It is an episodic disorder. A person will fluctuate between ‘normal functioning’ and ‘depression’.

32
Q

Can a person with Major Depressive Disorder get better without treatment? Why/why not?

A

Yes, a person with MDD tends to get better eventually.

33
Q

What does every Major Depressive Episode increase the risk of (%)?

A

Every episode increases the risk of another episode by 16%.

34
Q

What is the average amount of Major Depressive Episodes a person with Major Depressive Disorder will experience in their lifetime?

A
  1. Although many experience more than that.
35
Q

What are the 8 symptom specifiers for Major Depressive Disorder?

A
  1. Anxious Distress; common, involves a lot of worrying/anxiety.
  2. Mixed Features; minor displays of mania/hypomania.
  3. Melancholic Features; very severe depression, no joy for anything.
  4. Atypical Features; mood reactivity to environmental events.
  5. Psychotic Features; hallucinations, etc.
  6. Catatonia; no speaking/responding to things for a prolonged period.
  7. Peripartum Onset; depression experienced due to pregnancy/birth.
  8. Seasonal Pattern (SAD); mood reacting to weather/seasons.
36
Q

The Anxious Distress specifier in MDD is very important, why? (3)

A

People tend to be unresponsive to treatment, the episode lasts longer, at a greater risk of suicide.

37
Q

Some experts believe that the Melancholic Feature (specifier) in MDD is what?

A

A disorder of its own.

38
Q

Peripartum Onset has had its name changed from what? Why?

A

From Postnatal Depression because 50% of cases begin during pregnancy, not after.

39
Q

What percentage of women experience Peripartum Onset?

A

3-6%.

40
Q

What are the two main causes of Peripartum Onset?

A

Hormonal fluctuations and changes in lifestyle.

41
Q

What disorder (related to MDD) is in the ICD but not the DSM?

A

Mixed Anxiety/Depressive Disorder. Because MDD often occurs with anxiety.

42
Q

What is the lifetime and 12-month prevalence of MDD?

A

Lifetime prevalence: 16.4%.

Point prevalence: 3-5%.

43
Q

What has been the trajectory of MDD prevalence over the years?

A

Since the 1950’s there has been an increase in onset (more and more), and decrease in age (younger and younger).

44
Q

WHY has the prevalence of MDD changed over the years? (3 ideas)

A

Because people are more stressed?
Decreased social/family support?
OR not a real effect, people are just reporting symptoms more.

45
Q

What is the gendered prevalence of MDD? When does the difference start and when does it subside?

A

2:1 imbalance. Women are twice as likely to have MDD than men.
Imbalance begins in adolescence but evens out after the age of 65.

46
Q

In Major Depressive Disorder, what are some causal/maintaining factors influenced by biology? (4)

A
  • Genetics; family studies show high rate in relatives of probands, identical twins > fraternal twins.
  • Neurochemistry; low levels of noradrenalin, dopamine, serotonin.
  • Brain structure; but do brain changes cause depression, or occur after?
  • Neuroendocrine System; too much cortisol (overstimulated HPA axis).
47
Q

There is evidence to suggest chemical imbalances in the brain may be causal factors of MDD. What is the counter argument?

A

We do not know what the mechanism (role) is of each neurotransmitter, so do not know how they may actually cause the experience of depression.

48
Q

The Hypothalamic-Pituitary-Adrenocorticol axis (HPA axis) is the hormonal system responsible for the release of cortisol and the response to stress. What does research on the HPA axis indicate in relation to depression?

A

That depression is strongly associated with stress.

49
Q

What is the general conclusion experts agree on when looking at the causal factors of MDD, in relation to biology?

A

The interaction between genetic vulnerability and negative life events may cause depression.

50
Q

What are some psychological theories pertaining to the causation/maintenance of Major Depressive Disorder? (6)

A
  • Learned Helplessness.
  • Attribution Theory.
  • Hopelessness Theory.
  • Schema Theory.
  • Response Style Theory.
  • Interpersonal Approaches.
51
Q

What is Learned Helplessness Theory?

A

An early lack of control over stressful life events can lead to an inability to respond to future stressors, due to perceived lack of control.

52
Q

What is Attribution Theory?

What are the three attributions that contribute to the maintenance of depression?

A

People who believe they lack control over stressful life events (learned helplessness) tend to make negative attributions to normal occurrences.
Internal (vs. external), stable (vs. unstable) & global (vs. specific) attributions lead to depression.

53
Q

What is Hopelessness Theory?

A

Expect to be helpless in stressful situations but also expect negative outcomes (extension of learned helplessness).

54
Q

What is Schema Theory?

A

A pre-existing negative schema that is activated by stress and results in cognitive biases (memory, attention, interpretation).

55
Q

Who tend to develop negative schema?

A

Vulnerable children who are constantly faced with stressful life events.

56
Q

In Schema Theory what are three cognitive biases a person may perform?

A
  • Arbitrary Inference; drawing conclusions without any evidence.
  • Overgeneralisation; apply one experience to all experiences, even those in the future.
  • Magnification; exaggerates the importance of insignificant events.
57
Q

In Schema Theory, what is the Depressive Cognitive Triad? What is the triad?

A 
Negative thoughts about:
the self;
the world;
the future.
They feed each other and cause negative cognitive biases to dominate consciousness.
58
Q

What is Response Style Theory?

A

The passive and repetitive focus on the causes, consequences and symptoms of one’s depression (rumination).

59
Q

What does Response Style Theory propose to be healthy alternative(s) to rumination?

A

Positive distraction and problem solving.

60
Q

What does Interpersonal Approach Theory say about the maintenance of MDD?

A

Depression negatively alters interpersonal relations, causing depressed people to become more isolated and even elicit rejections. This maintains the depressive cycle.

61
Q

Similar to Interpersonal Approaches Theory, what is the Stress-Generation Hypothesis?

A

That depressive cognitions generate negative life events.

The recurrence of depression may be explained by self-generated negative life events.

Abnormal Psychology 3018 (29 decks)

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