Lecture 6 Depression

Question 1

DSM-IV Mood Disorders

Answer 1

DMS-IV Depressive (Unipolar) Disorders 
- MDD
- Dysthymic Dis
DMS-IV Bipolar Disorders 
- Bipolar I, II
- Cyclothymic 
Extremes in normal mood

Question 2

DSM-5 Depressive Disorders

Answer 2

• Disruptive Mood Dysregulation Disorder
• Major Depressive Disorder
• Persistent Depressive Disorder (Dysthymia)
• Premenstrual Dysphoric Disorder

Question 3

Disruptive Mood Dysregulation Disorder

Answer 3

• Severe recurrent temper outbursts (verbal
  rages, physical aggression)– out
  of proportion in intensity or duration to situation
• Mood between temper outbursts= irritable / angry
• Observable by others
• Diagnosis should not be made for the first
  time before age 6 years or after age 18 years

Question 4

Persistent Depressive Disorder

Answer 4

• Depressed mood most of days (than not)
• Presence, while depressed, of 2 (or more) of following:
  
  1. Poor appetite or overeating
  2. Insomnia or hypersomnia
  3. Low energy or fatigue
  4. Low self-esteem
  5. Can’t concentrate, not good at making decisions
  6. Feeling hopeless
• No more than 2 months normal mood in 2 years
• No manic features
• Symptoms= milder than MD
• Can develop major depressive episodes

Question 5

Main changes to DSM-5

Answer 5

• DSM-IV Mood Disorders to DSM-5 “Depressive Disorders” vs “Bipolar and Related Disorders”
• Added “Disruptive Mood Dysregulation
  Disorder”
• Added “Premenstrual Dysphoric Disorder”
• Removed Grief exclusion from diagnosis of
  Major Depressive Disorder
• Changed DSM-IV Dysthymia to DSM-5 “Persistent Depressive Disorder”

Question 6

Prevalence of MDD

Answer 6

• 16.4% lifetime prevalence
• 3-5 % one-year prevalence in Australia
  ◦ Steady increase in prevalence since 1950s
  ◦ Steady decrease in age of onset

Question 7

Biological influences

Answer 7

Neurochemistry:
- Low levels of
- Noradrenalin, Dopamine, Serotonin
- Brain structures
- Amygdala, Hippocampus, Prefrontal Cortex, Anteriour Cingulate
- Differences between people with current or history of
depression vs no depression

Question 8

Other biological influences

Answer 8

Neuroendocrine System (hormonal)
◦ Overactivity in the Hypothalamic-pituitary adrenocortical axis (HPA Axis)
- Involved in regulating response to stress
- Excess cortisol (stress hormone)
- Interaction between genetic vulnerability
and negative life events

Question 9

Psychological influences

Answer 9

• Learned Helplessness Theory
  
  • Lack of control over life events
• Attribution Theory
  
  • Internal vs external attributions
  • Stable vs unstable attributions
  • Global vs specific attributions
• Hopelessness Theory
  
  • expect everything to be helpless
  • think outcome negatively

Question 10

Internal vs external attributions (ex)

Answer 10

Exam: didn’t do well

• internal= blame yourself
• external= blame the noise outside

Question 11

Global vs specific attributions (ex)

Answer 11

• global= if I can’t do this, then I probs can’t do all the other things
• specific= if I can’t do well on this exam, then I probs wont do well next exam

Question 12

Other Psychological influences

Answer 12

• Schema Theory

- Response style theory

Question 13

Schema Theory

Answer 13

• Pre-existing negative schema
  
  • Developed during childhood
  • Activated by stress
    
    • cognitive biases (memory, attention)
    • Overgeneralization, Magnification
    • Depressive Cognitive Triad :
      
      • negative thoughts about self, world, future become
        dominant in consciousness

Question 14

Response style theory

Answer 14

Rumination (deeply thinking about something) vs distraction, problem solving, etc