Lecture 8 - The Complexities of Mood Flashcards
What is an Emotion?
Processes / states that consist of appraisal, motivational, somatic, motor and feeling components (Moors et al. 2013)
What is a Mood?
A prolonged emotional state. Emotion of sadness may become a mood of depression.
What are the Appraisal Theory components?
- Appraisal (environment and self) e.g I am going to fail
- Motivation (action tendencies / readiness) e.g avoidance
- Somatic / arousal (physiological responses) e.g rapid heart-rate
- Motor (behaviour) e.g agitation
- Feeling (subjective experience) e.g dread
What is Damosio’s Somatic Marker Hypothesis?
Somatic markers are bodily sensations that help us make decisions
Bodily sensation -> emotion -> decision making.
Physiological changes in response to a stimulus relayed to the brain and experienced as an emotion
Become learnt over time - associations, any sign of the stimulus = body responds
What is the body loop pathway?
Emotion is evoked by changes in the body projected to the brain e.g FIGHT OR FLIGHT - body sensation leads to behavioural reaction via the brain
What is the ‘As-if’ body loop pathway?
Cognitive representation of emotions - imagining an unpleasant situation as if you were there
AROUSAL WITHOUT ACTUALLY SEEING THE STIMULUS
Anticipation to the event triggers behavioural response
A memory or connection can bring on emotional and somatic responses
- causes avoidance behaviours
What functions do emotions serve? - Domasio
Integral to the process of reasoning and decision making
What is a mood disorder?
- Pervasive state
- Emotion or set of emotions that have accumulated in a time frame
- Can be positive
- Recognise triggers for negative moods = find a solution to get back to a good mood
What is a negative style of appraisal?
- More inclined to evaluate situations in a negative way
- Less likely to recognise when good things happen
- Seen in depression
How can psychological models understand and treat depression?
- CONTEXT (info about individual’s contextual factors forms a psychological formulation)
What are the 5 P’s formulation model?
- Predisposing (factors that makes one vulnerable)
- Precipitating (what event has led to this problem occurring?)
- Presenting (what is the problem and how do you know its a problem?)
- Perpetuating (what keeps the problem going?)
- Protective (what has the person got that is positive?)
What is the Biopsychosocial model?
Bio = genetic vulnerability
Physical symptoms = weight gain or loss, change in sleep, exhaustion, loss of sex drive, anxious
Psycho = feelings, thoughts, behaviours
What psychological interventions does NICE recommend for depression?
- CBT
- Interpersonal Psychotherapy (IPT)
- Behavioural Activation (BA)
What is the CBT framework - formulation of depression
Thoughts -> behaviours -> feelings and emotions -> physical symptoms
LOOP!
How does CBT treat depression?
- Challenge the thoughts
- Propose measures of behaviour to increase pleasure and break the cycle
- Increase feelings and emotions, more realistic perspective
- Better physical outcomes
What are negative automatic thoughts (NATs) in depression?
Centres on themes of negativity, low self esteem and uselessness
What are NATs in anxiety?
Overestimation of risk
Underestimation of ability to cope
What is collaborative empiricism?
Based on the establishment of a collaborative therapeutic relationship where therapist and patient work together as a team to identify maladaptive cognitions and behaviours
What are some behavioural techniques within CBT?
- Enhance functioning and increase pleasure
- Planning of each day
- Reevaluate catastrophic thoughts in anxiety
What does IPT propose as the framework of depression?
- Mood and life situations are linked
- Focus on interpersonal relationships
- Role dispute, role transition, complicated bereavement, interpersonal deficits
- Integrates relational theory
- Highlights contextual factors
- Frames therapy around a central interpersonal problem - crisis, relationship problem that is disrupting social support and increasing stress
How does IPT work?
- Define the problem
- Complete interpersonal inventory to gain an idea of the nature of the relationship
- Agree a focus
- Therapist works with client to manage the problem, learn skills to form new helpful relationships, think about the impact of the relationship on their mood
- Therapist is a cheerleader - proactive
What does BA propose about depression?
- Learned theory
- When people become depressed their behaviour acts to avoid unpleasant thoughts / situations - leads to them missing out on positive behavioural reinforces (socialising)
- Therapy raises awareness of this
How does BA work?
- Target the behaviours that maintain depression
- Identify goals
- Activity scheduling (social skills and use of avoided activities as a guide)
- Rumination and self attack serve to avoid aversive situations
- Therapist encourages individuals to be aware of the context and engage
- Exercise, healthy eating, problem solving therapy, sleep management
What are the pros of BA?
Simpler treatment, can be delivered by junior MH workers, less intense and costly training, still effective
What does CBT assume?
Our thinking is a heavy influence on behaviour
What does BA emphasise?
The role depressed behaviour has in maintaining depression - process of avoidance
What does IPT emphasise?
The pivotal role of relationships or lack of and the interpersonal skills we have
What are appraisals?
Beliefs about the world, environment and others. If living in a violent neighbourhood, anxiety is impacted (believe something bad could happen)
What is the DSM criteria for diagnosing depression?
Five or more symptoms in the same two week period - change from normal functioning
At least one is either depressed mood or loss of pleasure
- Depressed mood
- Loss of pleasure
- Weight loss or gain / increase or decrease in appetite
- Insomnia
- Agitation
- Fatigue
- Worthlessness
- Diminished ability to concentrate / be decisive
- Thoughts of death / suicide ideation
Symptoms cannot meet criteria for Mixed Episode, have to cause significant distress and impairment, not due to effects of substance use, not bereavement
