General introduction to MOD.

Question 1

What is abnormal affect?

Answer 1

-This is abnormal mood.

Question 2

What are mood disorders?

Answer 2

-They are a group of mental disorders that significantly affect an individuals mood enough to interfere with their daily functioning.

Question 3

Outline two examples of mood disorders?

Answer 3

1. Bipolar; bipolar type 1 and 2.
2. Unipolar; depressive disorder.

Question 4

Describe the ICD- 11 criteria for Unipolar disorder?

Answer 4

-Unipolar is defined by the concurrent presence of at least 5 out of a list of 10 symptoms which must occur; most of the day, nearly ever day for at least 2 weeks.
-One of the symptoms must be; Depressed mood or Anhedonia.
-The mood disturbances must cause; significant functional impairment and must not be a manifestation of another health condition.

Question 5

List 5 characteristics or symptoms of depression?

Answer 5

1. Depressed mood; sadness.
2. Anhedonia; loss of interest.
3. Recurrent thoughts of death/ suicidal idea.
4. Disrupted sleep or excessive sleep.
5. Distrusted appetite or weight gain.

Question 6

Describe the ICD- 11 criteria for Bipolar disorder type1?

Answer 6

-It’s characterized by the occurrence of at least one manic or mixed episode.
-A person alternates between periods of either manic, mixed episodes and depression.

-A manic episode lasts at least one week and its characterized by an extreme mood usually feeling euphoric but also irritable; it involves high levels of activity and feelings of increased energy.

Question 7

What are some characteristics individuals would usually portray in Bipolar type 1?
[High mood phases]

Answer 7

1. Rapid speech.
2. Impulsivity.
3. Reckless behavior; gambling.

Question 8

What is a Mixed episode characterized by?

Answer 8

-It is characterized by a mixture or rapid alternating between manic and depressive state on most days during a 2 week period.

Question 9

What are depressive episodes?

Answer 9

-Depressive episodes involve depressed moods or lack of interest in daily activity [Anhedonia] and lasts for at least 2 weeks.

Question 10

Describe the ICD- 11 criteria for Bipolar type 2?

Answer 10

-A person must have had one or more Hypomanic episode and at least one depressive episode.
-The individual has no history of manic or mixed episode.

Question 11

What is hypomania?

Answer 11

-This is a less severe version of Mania [Mild Version].

Question 12

What is Mania characterized by?

Answer 12

1. Irritability.
2. Euphoria.
3. Risky behavior; gambling.

Question 13

Describe the BDI psychometric?
[Measures of Depression].

Answer 13

-It is a Self report tool that measures; attitudes and symptoms of depression.

-It has 21 items [Known symptoms of depression] eg; Anhedonia, Lethargy and Depressed mood.
-Each item consists of at least 4 statements and the person taking the test must choose one out of the 4 that best describes;
‘How they have been feeling in the past one or two weeks and the day of the test.’

-Each statement is rated from 0-3 on a 4 point rating scale that is anchored on each item.

Question 14

Give an example of a statement in BDI?

Answer 14

1. Based on sadness;
   I don’t feel sad [0].
   I feel sad much of the time [1].
   I am sad all the time [2].
   I am sad or unhappy I can’t stand it [3].

Question 15

How was scoring of BDI done?

Answer 15

-The maximum score was 63.
-The minimum score was 0.
-A score between 0-1- means normal up’s and down’s.
-A score between 11-16 normal mood disturbance.
-A score between 17-20 borderline depression.
-A score between 21-30 moderate depression.
-A score between 31-40 severe depression.
-A score of 40 and above extreme depression.

Question 16

Describe the Biochemical [Catecholamines] explanation for MOD?

Answer 16

-Catecholamines are implicated in the development of Mood disorders/ Affective disorders.
-The known catecholamines are; Serotonin, Dopamine and Norepinephrine.

Question 17

What is the role of Dopamine?

Answer 17

-The role of Dopamine is to transmit signals related to feelings of pleasure and motivation therefore it is sensible to say a drop in dopamine levels in the brain is implicated in lethargy and anhedonia which is characteristic of depression.

Question 18

What is the role of Serotonin?

Answer 18

-Serotonin is a neurotransmitter that regulates; sleep, anxiety, mood and appetite.
It is therefore sensible to say that a drop in serotonin levels in the brain could be responsible for; disrupted sleep, disrupted appetite and disrupted mood which is characteristic of Unipolar disorder.

Question 19

What is the function of Association analysis according to the Genetic explanation?

Answer 19

-Association analysis seeks to link phenotypes with genotypes.

Question 20

What is Polymorphism?

Answer 20

-This is the existence of variants of a gene.

Question 21

What is Sexual Dimorphism?

Answer 21

-This is the differences in form between males and females of the same species other than organs. The differences usually have a male or female pattern of inheritance eg; In some species of spiders, the female is larger than the male.

Question 22

What does Serotonin have?

Answer 22

-Serotonin has a female pattern of inheritance since it has a neurotransmitter that is Sexually Dimorphic.

Question 23

[Oruc et al study; 1997]
What was the study by Oruc based on?

Answer 23

-It is based on the idea that Genetic factors are responsible for Bipolar Disorders precisely if the neurotransmitter levels in the brain are too low, it could lead to the disorder to develop.

Question 24

What are the other 2 competing explanations other than the Genetic explanation?

Answer 24

1. Psychological explanation; In this explanation, Bipolar is associated with difficult life events such as; break down of a relationship, trauma and even the death of a loved one.
2. Cognitive explanation; in this explanation, Cognitive Distortion is implicated where victims are found to distort reality and perceive or evaluate their experiences negatively.

Question 25

What is the main theory of the study?

Answer 25

-The study is based on the theory of Genetics and it has variants of 5- HTT and 5- HTR2c that would be responsible for the increased risk of Bipolar within women.
-Genetic factors are said to account for up to 80% of the causes of Bipolar.

Question 26

What are researchers attempting do do by using Association analysis?

Answer 26

-By using Association analysis, researchers attempt to link Bipolar disorder with variants of 5- HTT and 5- HTR2c in the Serotonergic pathway.

Question 27

What does the Serotonergic pathway have?

Answer 27

-They have a known link to depressive disorders therefore to understand depression, it would be sensible to look at genes that; receive and transport these neurotransmitters.

Question 28

What is the aim of the study by Oruc et al?

Answer 28

-To examine the genetic basis of Bipolar disorder in a sample of 42 patients compared to a controlled group [40] who had no personal history of Psychiatric disorders.

Question 29

What was the type of experiment employed within the study? And what type of design did it use giving an explanation for it?

Answer 29

-It was a Laboratory based study that used a matches pairs design.
-It was a matched pairs design because the control group [40] were matched with the experiment group [42] for; age and sex.
[Generalizability and Sexual Dimorphism].

Question 30

Describe the sample that was used?

Answer 30

-The bipolar patients were 42 and they had Bipolar type 1.
-The control group was made up of 40 non- clinician patients.
-The bipolar patients were drawn from 2 psychiatric hospitals in Croatia.
-16 out of them had at least one first degree relative who had been diagnosed with a major affective disorder like type 1.
-They were all aged between 31 to 70 years.
-There were 25 females and 17 males of the clinical sample.

Question 31

Describe the procedure of the study?

Answer 31

-DNA testing was carried out by the participants to test for Polymorphism in 5- HTT and 5- HTR2c.
-These specific genes were chosen since they had alternations in them that can lead to disturbances in specific Biochemical pathways with no links to Depressive disorders.
-Diagnosis of the Bipolar disorder in the relatives of the group was confirmed through medical records and interviews with the family members.

Question 32

Outline 2 results obtained from the study?

Answer 32

1. There was no significant association in the sample meaning participants with bipolar were not more likely to have Polymorphism for 5- HTT and 5- HTR2c than the control group.
   -Also those with a family history of mood disorders were not more likely to have polymorphism in the 2 genes than the other participants.
2. When data was being analyzed according to gender, trends for association with Polymorphism for both the genes were observed in female patients.
   - The variant of these genes were more inherited in females.

Question 33

What was concluded from the study by Oruc et al?

Answer 33

-Polymorphism in 5- HTT and 5- HTR2c could be responsible for developing bipolar disorder in females.

Question 34

What is the cognitive theory of Mood disorders?

[Cognitive explanation; Beck]

Answer 34

-The cognitive theory of Mood disorders is the idea that Mood disorders stem from Cognitive Distortions.

Question 35

What are Cognitive Distortions?

Answer 35

-These are forms of irrational thinking that cloud our perceptions and emotions hence biasing our view of the self, world and the future.

Question 36

Irrational thinking is considered to be what?

Answer 36

-They are considered to be automatic processes that develop because of adverse early life experiences such as;
1. Deprivation.
2. Neglect.
3. Abuse.
4. Trauma.

Question 37

What are Schemas? And what do we use the Schemas for?

Where do Negative triads stem from?

Answer 37

-These are packets of knowledge that we acquire in our early life socialization.
-We use them to evaluate our future experiences and they become our reality.

-Negative triads stem from our early life experiences being adverse or difficult leading us to develop a negative view of the self, the world and the future.

Question 38

Describe the negative view of the self?

Answer 38

-The self is viewed as worthless.
-Bad events or unpleasant experiences are attributed internally.

Question 39

Describe the negative view of the world?

Answer 39

-The world is viewed as full of obstacles that are unsurmountable [cannot be overcome].
-They misinterpret external forces as being against them.

Question 40

Describe the negative view of the future?

Answer 40

-They anticipate failure or rejection when they undertake tasks in the future.

Question 41

Give 2 examples of Cognitive distortions and describe them?

Answer 41

1. Arbitrary Influence; this is the process of forming a conclusion in the absence of factual evidence. Eg; as John walked the streets, he thought to himself ‘Everyone can tell that I am a looser’ and this thought is distorted in many ways;
   - He has no way of knowing what other ppl thought.
   - It was highly unlikely that anyone was thinking of him.
2. Selective Abstraction; this is the process of focusing on a detail that is taken out of a context and ignoring other Salient features of the situation. Eg; Jane was delivering some teaching in her work place and later on, she got a round of applause at the end for her presentation as well as ppl saying how useful the presentation was however when she went to check the feedback forms, she noticed one critical comment that had a poor rating and thought to herself ‘I am a rubbish teacher’.
   This thought is distorted in that;
3. She chose to negatively focus on one negative piece of feedback and clearly ignoring other more positive pieces of feedback.

Question 42

Describe Learnt Helplessness? [5]

Answer 42

-This is when an individual has to endure suffering and unpleasantness because they feel trapped in an inescapable situation.
-The feeling of being trapped in an inescapable situation results from previous futile attempts at overcoming the suffering.
-When ppl attempt severely in vain to surmount their suffering, they are more likely to degenerate into a state of helplessness. They have exhausted all their resources.
-This feeling is synonymous with Avolition and the Hopelessness/ Helplessness symptom that is characteristic of depression.
-Learnt helplessness is the basis of Attributional style or Explanatory style.

Question 43

What is an Explanatory style?

Answer 43

-This is how we explain causes of good and bad events in our life.

Question 44

Describe the 2 types of Attributional profiles that are used to explain the causes of good and bad events in ppl?

Answer 44

1. Internal, Stable and Global profile.
   -This type of attributional style is a risk factor to depression and is mal adaptive [meaning rigid has no room for improvement].

Internal; this is when bad events are attributed internally eg; blaming oneself.
Stable; the suffering will not end.
Global; Many aspects of life are also affected eg; I am a failure.

2. External, Unstable and Specific.
   -This type of attributional style is adaptive [meaning flexible and versatile].
   -It’s a life enhancing profile.

External; bad events are attributed externally eg; blaming bad grades to teachers or bad weather.
Unstable; the suffering is short- lived and will go away soon.
Specific; only one area of functioning is affected eg; academic, social or occupational.

Question 45

What was the aim of Seligman et al?
[Learnt Helplessness].

Answer 45

-To investigate how well attributional style could predict depressive symptoms.

Question 46

Describe the sample that was used in the study? [6]

Answer 46

-There were 39 Unipolar patients used.
-There were 12 patients with Bipolar disorder used.
-All the patients were obtained from the same clinic [Out- patient].
-They were a mix of both genders.
-They had a mean age of 36 years.
-The clinical group was compared with a non clinical control group made up of 10 participants and they were matched for age and education.

Question 47

Describe the procedure that the participants underwent?

Answer 47

-At the start of the study, participants completed a short form of BDI to assess the severity of their symptoms.
-The BDI had 13 items.
-They also completed an Attributional study questionnaire comprising of 12 hypothetical good and bad events.
-They were tasked to makes casual attributions for each one of the events and rate them on a 7 point rating scale for; Internality, stability and globality.

Question 48

Outline 2 results that were obtained from the study?

Answer 48

1. Both Bipolar and Unipolar participants were found to have more pessimistic negative attributional styles than the non- clinical control group.
2. The more severe the depression score on the BDI the worse the pessimism on the ASQ at therapy intake, termination and at a one year follow up.

Question 49

What was concluded from this study?

Answer 49

-How we explain the causes of behavior is an important mechanism underlying depression.