Lecture 10: Chapter 14 - Emotion in Clinical Psychology Flashcards
In early days of clin. psych., few categories for disorders existed. Would classify people as either having ______ or _______.
Psychosis or Neurosis
Describe Psychosis
- A severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality
- Considered in past as more neurological problem
Describe Neurosis
- A relatively mild mental illness that is not caused by organic disease, involving symptoms of stress but not a radical loss of touch with reality
- Excessive and irrational anxiety or obsession
- Considered in past as more psychological problem
Describe the DSM diagnosis for MDD
Major Depressive Episode: either a depressed mood of a loss of interest and pleasure, persisting almost every day for at least 2 weeks
- Can also include feelings of worthlessness, agitation/inactivity, too much/little sleep, increased/decreased appetite, impaired concentration
What are the two ways a therapist can diagnose MDD?
- Talking with client, evaluate symptoms to determine diagnosis
- Ask client to fill questionnaire to diagnose disorder, can compare scores pre/post treatment more objectively
- MMPI – Minnesota Multiphasic Personality Inventory
- Beck Depression Inventory
- Hamilton Depression Rating Scale
Because of depression’s ____ nature, hard to determine whether treatment alleviated symptoms or if it went away on its own. Thus, we need to either compare treatment against either control, or another treatment
Episodic nature
Brumfiel (2013) examined behaviour of Japanese families after the earthquake that destroyed the Fukushima nuclear power plant. Initially people were energized and determined to cope with disaster, but over time as they were unable to return to normal lives, many became severely depressed. Such is similar to the ____ and _____ phases in stress responses.
Similar to resistance and exhaustion phases in stress responses
- People become especially vulnerable to depression from stress during exhaustion
What are the four types of depression?
- Anxious depression
- Melancholic depression
- Psychotic depression
- Atypical depression
_____ includes thought disorder similar to that observed in schizophrenia (type of depression)
Psychotic depression
____ includes anxiety as well as depression symptoms (type of depression)
Anxious depression
_____ includes severe depression, marked by lack of pleasure in anything (type of depression)
Melancholic depression
_____ is marked increased appetite and increased sleep
Atypical depression
- In contrast to most cases of depression, where people usually lose appetite and have insomnia
- People experience brief periods of enjoyment in response to positive events
Often times placing people into these depression categories helps narrow down treatment. T or F?
False, there’s too much variability in individual symptom profiles
Early hypothesis was that depression was due to a lack of either _____ or _____?
Norepinephrine or serotonin
- Early antidepressants increased the availability of serotonin, sometimes dopamine too at synapses (i.e. tricyclic antidepressants)
Main problem with the early hypothesis was _________?
Time course of drugs
- Drugs can enhance the activity at synapses within minutes/hours, but behavioural benefits generally do not emerge until at least 2 weeks later
Revised hypothesis was that the bombardment of synapses with NTs ______________________?
Reduces the number of receptors at synapses to alleviate symptoms
Main problem with revised hypothesis is that __________?
- Antidepressant drugs are ineffective for many people, especially those with mild/moderate depression
- These drugs affect the synapses just as much for people who do not respond beneficially to them
Most researchers have given up one finding a distinction between norepinephrine and serotonin type depression to target treatment. Thus, most researchers now try to relate depression to _________?
Altered neural circuits in the brain
- E.g. many studies indicate that depression is associated with decreased production of new neurons + synapses in hippocampus, impairing learning
- Anti-depressants, psychotherapy, or other
treatments that alleviate depression also increase
plasticity of hippocampus
DSM-5 makes a distinction between major depression and dysthymia: a condition in which _________?
Someone feels sad almost constantly for years at a time
Dysthymia is similar to melancholic depression, but different in that:
- Emphasis on sad mood rather than lack of pleasure
- Instead of lasting months, will last years
With respect to the causes of depression, stressful events create greater reactions in people _____________?
Predisposed to depression
- Nolen-Hoeksema & Morrow (1991) had college students fill our personality questionnaire that after a major earthquake in California
- Although virtually all students felt sad/depressed
shortly after damage, those already mildly depressed
before earthquake became more severely depressed
and remained depressed longer
- Although virtually all students felt sad/depressed
_____ factors are one possible basis for predisposition to depression
Genetic
- When an adopted children develops depression, depression is generally more common among their biological parents than their adoptive parents
- Comparisons of identical (monozygotic) and fraternal (dizygotic) twins show a moderate genetic influence
Whatever the genes facilitating depression may be, they appear to have multiple effects beyond depression. Major depression runs in the same families as ______ (7)
Alcohol/drug dependence
Antisocial personality disorders
Bulimia
Panic disorders
Migraine headaches
Attention deficit disorders
Binge eating
One study found that within Chinese women in China suffering from multiple episodes of severe depression, two genes increased the likelihood of depression by 15%. What does this suggest?
Suggests that different genes may promote depression by different biological mechanisms in different groups of people