Lecture 3 - Depression Flashcards
What is similar/different between emotions, feelings, and mood?
Lots of overlap in literature for definitions
Some consensus in:
Emotions made of continuous/recursive components (Appraisal theory)
Feelings: subjective experiences, result of emotions
Moods states that can be longer lasting, more pervasive
Emotions normal + functional (contribute to decisions/behaviour) but prolonged negative emotional experiences lead to mood problems which may require treatment
What is appraisal theory? (Moors et al.)
Appraisal –> Feeling/Motivational –> Motor/Somatic/Arousal (encompasses emotion)
What are mood disorders?
‘Mood’ used to describe state of mind rather than emotion we experience in the moment, characterised as pervasive state, emotion/set of emotions in time frame
Can be positive/negative, low mood to elevation
When mood is negative, distinctly unusual, significantly impacting person’s QoL might be diagnosed as mood disorder
What is the range of the bipolar spectrum?
Major depression (severe/moderate/mild/sub-threshold) –> sub-syndromal depression –> sub-syndromal elevated mood –> hypomania –> mania
Facts/figures regarding depression?
One of most common worldwide, 300 mil people of all ages worldwide suffer from it, primary driver of disability in 26 countries
10% presenting to GP have depression, lifetime prevalence rate in UK is 5%
Most common psychiatric disorder in later life: 10-15% of pop aged 65+ suffer significant depressive symptoms, depression will become 2nd most cause of disability worldwide by 2020
What are the symptoms of major depression?
At least 2 weeks of depressed mood (most of day, nearly every day) or diminished interest in pleasure in all/almost all activities most of day/nearly every day
Plus at least 3 of: significant change in appetite/weight, insomnia/hypersomnia. psychomotor agitation/retardation, fatigue/loss of energy, feelings of worthlessness/inappropriate guilt, diminished ability to think/concentrate, recurrent thoughts of death/suicidal ideation/attempt/plan
Results in distress/functional impairment in person’s life (eg. Social/occupational)
What are diff depression diagnoses?
Major depressive episodes characterised by certain specifiers:
Anxious distress, postpartum, mixed features, melancholic features, atypical feature
Persistent depressive disorder: 2 years, every day
Major depressive disorder:
Seasonal pattern/psychotic features/panic attacks
Other Specified depressive disorder: Brief recurrent, short-duration depressive episode (4-13 days), depressive episode w/ insufficient symptoms
What 3 factors are related to onset/maintenance of depression?
Biogenetic: familial risk, genetic diffs in production/uptake of certain neurotransmitters (serotonin), gender, physical health conditions
Sociocultural: environmental factors, gender, ethnicity, socioeconomic status, discrimination, (Self) stigma
Psychological: early/recent trauma, maladaptive schemas/coping, rumination, meta-emotion (feel emotion based on other emotion), gender
How does National Institute for Health & Care Excellence (NICE) care for depression in adults?
Principles of care: build trusting relationship, explore treatment choices, be aware of stigma/discrimination
Recognition/assessment: validated questionnaires, assess for severity, previous history/duration/course of illness/impact on functioning/risk assessment
Choice of treatments: discuss ideas/preferences, recommended treatments, how/where they will be delivered
What are treatments for less severe depression?
Guided self-help, group CBT, group activities, counselling, antidepressants, etc.
What is diff between CBT and Behavioural Activation (BA)?
CBT assumes thinking is heavy influence on behaviour + symbiotic relationship (focuses on unhelpful thinking/behaviour)
eg. core beliefs, dysfunctional assumptions, automatic thoughts, collab to identify/challenge thoughts)
BA has emphasis on role depressed behaviour has in perpetuating depression through process of avoidance –> change avoidance
What are typical behavioural assignments in CBT?
Activity scheduling for depressed clients, exposure techniques
Interpersonal skills, emotional regulation, mindfulness
Problem solving, using techniques to improve sleep, regulate eating, decrease use of harmful substances
What is the BA model?
Based on learning theory
When people become depression, lot of behaviour functions to avoid unpleasant thoughts/feelings/situations but also leads to missing out on positive reinforcers
BA therapy designed to raise awareness of this + unintended consequences of actions
Target behaviours/ways of thinking maintaining depression, identify goals, activity scheduling
What is the importance of context?
Background to depression could be individual/wider context
Individual is important but some criticism says psychological interventions don’t always take into account reality of world person is living in
Can impact appraisals/feelings on mood
