Exam 2 Flashcards
What is major depressive episode?
an extreme depression that lasts up to 2+ weeks; duration includes 4 to 9 months if left untreated
What are symptoms of major depressive episode?
Depressed mood*
Loss of interest/pleasure*
Significant weight loss*
Insomnia/hypersomnia*
Psychomotor agitation/retardation*
Fatigue/loss of energy*
Feelings of worthlessness or excessive or inappropriate guilt*
Diminished ability to think/concentrate, or indecisiveness*
Recurrent thoughts of death, recurrent suicidal ideation, suicide attempt*
How long does a major depressive episode last?
2+ weeks
Which two symptoms must be present in major depressive episode?
depressed mood, loss of interest/pleasure
What is a manic episode?
exaggerated elation, joy, euphoria that lasts 7 days; duration includes 3 to 4 months if left untreated
What are the symptoms of manic episodes?
Inflated self-esteem or grandiosity
Decreased need for sleep (e.g., feels rested after 3 hours of sleep)
More talkative than usual or pressure to keep talking
Flight of ideas or subjective experience that thoughts are racing
Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
Increase in goal-directed activity or psychomotor
Excessive involvement in activities that have a high potential for painful consequences
What is hypomanic episode?
shorter, less severe version of manic episodes, lasts at least 4 days, milder symptoms as compared to manic episodes, associated w/ less impairment than a manic episode
What is major depressive disorder?
single episode, lack of mania/hypomania; recurrent 2+ episodes within 2 months apart, typically 4 to 7 episodes within a lifetime
What are two defining features of major depressive disorder?
at least one major depressive episode, lack of manic/hypomanic episode
What are the symptoms for major depressive disorder?
Poor appetite or overeating
Insomnia/hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
What are symptom specifiers of depression?
psychotic features (hallucinations, delusions)
What is a seasonal pattern of depression?
seasonal affective disorder (SAD)
What is the prevalence of seasonal affective disorder?
2.7%
What are treatment plans for seasonal affective disorder?
melatonin phototherapy and CBT
Describe the onset of depression.
risk increases in adolescence and young adulthood, decreases in middle adulthood, increases again in old age
What is the prevalence of depression?
16%
What is bipolar I disorder?
presence of a manic episode required, presence of a depressive episode considered optional
What is bipolar II disorder?
presence of a hypomanic episode required, presence of a depressive episode required
What is cyclothymic disorder?
alternating manic and depressive episodes; considered less severe, however it persists longer, chronic symptoms last up to 2+ years
What are familial/genetic influences of depression?
higher heritability for females
What are familial/genetic influences of bipolar disorder?
relatively equivalent among males and females
What neurotransmitters influence depression?
serotonin; was initially believed to have influence on depression, however this is now a discontinued thought
What neurotransmitters influence mania?
dopamine
What is the stress hypothesis?
this includes overactive HPA axis, elevated cortisol, suppressed hippocampal neurogenesis
How is brain wave activity relevant to depression/bipolar disorder?
thought to be an indicator of vulnerability
How is depression shown via brain wave activity?
greater right side anterior activation, less alpha wave activity, reduced basal ganglia and amygdala size
How is bipolar disorder shown via brain wave activity?
greater left side activation, larger basal ganglia and amygdala size
What type of stress is related to the onset of depression?
negative stress
What type of stress is related to the onset of mania?
positive stress
What factors are associated with depressive attributional style?
internal, stable, global
What is associated with the cognitive theory of depression?
negative schemas, automatic thoughts
What is/are the correlations between marriage/relationships and mood disorders?
relationship disruption precedes depression; gender differences are in a causal direction
What is/are the correlations between social support and mood disorders?
lack of support predicts late onset depression; substantial support predicts recovery for depression but not for mania
What gender is more likely to experience depression?
women
What is the correlation between race/ethnicity and mood disorders?
minority stress is related to depression in a number of minority groups; stigma around mental health higher in communities of color
What are treatments for mood disorders?
medications, ECT and TMS, psychological treatment
What are tricyclics (tofranil, elavail)?
They block reuptake of NE and serotonin; high lethality
What are monoamine oxidase (MAO) inhibitors?
block MAO; fewer side effects, but risky interactions
What are selective serotonin reuptake inhibitors (SSRI)?
prozac; first treatment choice, block presynaptic reuptake, no risks, many negative side effects
What are mixed reuptake inhibitors?
block reuptake of norepinephrine
What is lithium?
mood-stabilizing drug; common salt; primary treatment for bipolar disorders; unsure of mechanism of action; narrow therapeutic window (too little - ineffective; too much - toxic)
What is ECT?
brief electrical current, temporary seizures, high efficacy for severe depression
What is TMS?
localized electromagnetic pulse, fewer side effects, efficacy is likely good but not better than ECT
What is cognitive therapy?
identify errors in thinking, correct cognitive errors, substitute more adaptive thoughts, correct negative cognitive schemas
What is behavioral therapy?
increased positive events, exercise
What is cognitive-behavioral therapy?
What is CBT?
comparable to medications; more effective than placebos or brief psychodynamic treatment
What is psychological treatment?
management of interpersonal problems; increase medication compliance, interpersonal and social rhythm therapy, family-focused treatment
suicide rates
suicide is the 10th leading cause of death in the US, 44k Americans die by suicide, suicide costs the US $69 billion annually
suicide facts
males complete more suicides than females (males use more lethal methods), females attempt suicide more than males
risk factors of suicide
suicide in the family, low serotonin levels, preexisting psychological disorder, substance abuse, stressful life event (humiliation, media coverage, past suicidal behavior, plan and access to lethal methods
suicide contagion
some research indicates that a person is more likely to commit suicide after hearing about someone else committing suicide; media accounts worsen problem by sensationalizing/romanticizing suicide, describing lethal methods of committing suicide
treatment for suicide
no-suicide contract and safety planning, hospitalization, CBT
suicidal assessment
suicidal desire (ideation), suicidal capability (past attempts and means), suicidal intent (plan)
What is fear?
a present-oriented mood state, immediate fight/flight response to danger/threat, abrupt activation of sympathetic nervous system, avoidance/escapist tendencies
What is anxiety?
future-oriented mood state, apprehension about future danger/misfortune, physical symptoms of tension, avoidance of situations that provoke fear
What is panic?
abrupt experience of intense fear, cued or uncued
symptoms of panic
heart palpitations, chest pain, dizziness, sweating, chills/heat sensations, fear of losing control, dying, or going crazy
characteristics of anxiety disorders
pervasive and persistent symptoms of anxiety and fear, involve excessive avoidance and escape, cause clinically significant distress and impairment
biological contributions to anxiety
increased physiological vulnerability - cortisol and HPA axis; brain circuits and neurotransmitters - GABA, noradrenergic/serotonergic systems; limbic system - behavioral inhibition system, brain stem, amygdala; fight/flight system - panic circuit, alarm/escape response
psychological contributions to anxiety
FREUD - anxiety is a psychic reaction to danger, reactivation of infantile fear situation; BEHAVIORISTS - classical and operant conditioning, modeling
social contributions to anxiety
biological vulnerability triggered by stressful life events: family, interpersonal, occupational, educational
comorbidity and risk of anxiety
comorbidity among anxiety and depression; suicide attempt rates
