L10 Emotion Dysfunction

Question 1

What is an affective disorder?

Answer 1

A mental disorder characterised by sudden changes or extremes of affect. It involves significant distress and impaired functioning.
It can include episodes that are manic and/or depressive

Question 2

How do we classify affective disorders?

Answer 2

ICD-10
DSM-5
Use diagnostic symptoms and are usually determined by interviews - individuals have to meet defined criteria for defined period
Alternative method would be to use a continuum

Question 3

What are the symptoms of depression?

Answer 3

Unbearable sadness, loss of pleasure in activities for 2 weeks, sleep problems, lack of energy, can’t concentrate, feeling worthless/guilt, suicidal thoughts

Question 4

What are the 4 unipolar subtypes?

Answer 4

Atypical depression (reactive)
Melancholy (loss of pleasure)
Post-partum depression
Seasonal Affective Disorder

They require 5 symptoms

Question 5

What does non-major depression include?

Answer 5

Dysthymia (low daily mood for long periods) and brief recurrent episodes <2 weeks
Requires 2-4 symptoms

Question 6

What are the symptoms of bipolar disorder?

Answer 6

Elevated, expansive or irritable mood, inflated self-esteem, decreased sleep need, racing thoughts, distractible, and risk taking
Hypomanic is briefer, not psychotic and less impairment

Question 7

How do we classify bipolar I?

Answer 7

One or more manic episodes with or without a major depressive episode
Typical year = 32% weeks depressed, 9% weeks manic/hyper-manic

Question 8

How do we classify bipolar II?

Answer 8

Hypomanic and depressive episodes

Typical year = 50% weeks depressed, 1% weeks hypomanic

Question 9

What are the symptoms of anxiety?

Answer 9

Overwhelming fears, anxiety, avoidance of fears, loss of confidence

Question 10

What are the different types of anxiety?

Answer 10

GAD
Panic disorder
Phobias
Obsessions and compulsions
PTSD

Question 11

What are childhood externalising disorders?

Answer 11

Involve anger, hostility and aggression e.g. oppositional defiant disorder and conduct disorder

Question 12

What are childhood internalising disorders?

Answer 12

Involve depression, anxiety and withdrawal e.g. depression, anxiety disorder

Question 13

What are the prevalences of disorders in children?

Answer 13

Externalising disorders more common in younger children, and boys show these externalising behaviours more at all ages compared to girls
Anxiety disorder shows 9 fold increase from ages 3-8 and is more common in girls
Depression rate increases with age, equally likely in girls and boys until late adolescence and then its higher in girls

Question 14

What are the prevalences of disorders in adults?

Answer 14

Major Depression is seen in 21% of women and 13% of men in a lifetime and is more likely in Western countries - is this due to better diagnostic systems?
30% of women and 19% of men have an anxiety disorder in their lifetime
There is a prevalence of 1% in bipolar disorder and no gender differences

Question 15

What is the stress-diathesis hypothesis?

Answer 15

Davidson & Neale (2001)
Diathesis = predisposition or vulnerability to the disorder
Stress = negative environmental impact

Question 16

What are some examples of stressors in children?

Answer 16

Conflict between parents increases risk of externalising disorders
Parental psychiatric problem increases the risk of the same type of problem
Quality of parent-child relationship
Poverty

Question 17

What risk factors did Rutter identify for children?

Answer 17

6

Marital disharmony, parental depression, poverty, institutionalisation, large family, parental criminality

Question 18

What are some causes of affective disorders in adults? (stress)

Answer 18

Brown and Harris (1978) women in a community showed that a severe life event had preceded depression in >80% of cases
Events often involve: loss of valued role, humiliation, entrapment or danger
Life events usually precede anxiety too
Not everyone who experiences adversity develops a disorder
Social support may protect against life events

Question 19

How are genetics involved with affective disorders?

Answer 19

Twin studies show a moderate genetic risk for depression and anxiety
Genes may bias cognitive processes via serotonin
Genetic influence on personality may also influence the likelihood of a person encountering particular life events

Question 20

How are early experiences involved with affective disorders?

Answer 20

Only parental divorce, a frightening event and physical abuse predicted depression (Wainwright & Surtees, 2002)

Question 21

What is disordered in affective disorders?

Answer 21

May be an attentional problem e.g. noticing information consistent with fear
May be an appraisal/attribution bias e.g. making stable, internal and global attributions for negative events
May be due to one emotion system dominating - biased towards particular type of emotion
May be due to making inappropriate emotional responses
May be due to dysregulation of emotions
Or due to prolonged negative interpersonal interactions e.g. living with a depressed roommate

Question 22

What did Joorman (2010) suggest about cognitive inhibition and emotional regulation in depression?

Answer 22

That something negative happens, it puts us in a bad mood and activates negative cognitions
Deficit in the cognitive inhibition so can’t get rid of the negative material in our WM
Vicious cycle as now easier to access negative material

Question 23

What is the relationship between rumination and depression?

Answer 23

The repetitive dwelling thoughts that are involved in rumination may prolong depression
Women report high levels of rumination - explaining gender differences?

Question 24

What is the relationship between rumination, depression and creativity?

Answer 24

There is a 50% prevalence of depression in creative arts which is quite high compared to other fields
Rumination requires sensitivity to the self and reduced inhibition of cognitive material may lead to creative thought

Question 25

Outline bipolar disorder and affect regulation

Answer 25

Attempts at affect regulation are disturbed through multiple and conflicting meanings given to internal states
This prompts exaggerated control known as ascent behaviours (manic episode) and descent behaviours (depressive episode)

Question 26

What is an issue with AD research?

Answer 26

A lot of it is based on interviews with clients but the recall of symptoms may be inaccurate and disordered
Should track over time

Question 27

What is the relevance of emotion to other disorders?

Answer 27

Substance induced disorders e.g. drug addiction
Eating disorders e.g. using food to regulate emotions
Non-suicidal self injury
Physical health disorders e.g. CHD - acute stress can decrease immune response

Question 28

What are the implications for treatment in light of UK statistics?

Answer 28

Layard’s (2006) depression report:
1 in 6 people have depression or an anxiety disorder
Only 1 in 4 receive treatment
Cost would be £750
The report recommended the training fo 10,000 more therapists
Did lead to the IAPT scheme