Major Depressive Disorder

Question 1

What are the symptoms of major depressive disorder?

Answer 1

• affective: sadness, helplessness, loneliness
• motivational: difficulties with task initiation, impaired performance, difficulty making decisions
• cognitive: low self esteem, self blame, inability to hope
• psychological: loss of appetite, fatigue, personal health problems

Question 2

What are the prevalence rates of depression?

Answer 2

• 5-12% of men, 10-25% of women
• 25% do not seek help
• most treated by GPs, only about 10% referred to psychiatric services
• 1.5-5 times greater among 1st degree relatives than general population

Question 3

Understand that the serotonin system regulates norepinephrine and dopamine activity and low levels of serotonin lead to mood deregulation

Answer 3

Learn the top card

Question 4

How does MAO inhibitors work at the synapse?

Answer 4

Inhibits the breakdown of monoamine neurotransmitters in the synaptic cleft

Question 5

How does tricyclics work at the synapse?

Answer 5

Blocks the reuptake of monoamines into the presynaptic cell

Question 6

How does selective serotonin reuptake inhibitors (SSRIs) work at the synapse?

Answer 6

Blocks serotonin reuptake

Question 7

Understand the link between cortisol level and depression

Answer 7

High levels of cortisol (stress) hormone is related to depression

Question 8

Understand that depression is also associated with elevated CRH

Answer 8

Elevated CRH is associated with depressive symptoms, antidepressants and ECT can lower it

Question 9

Understand the implications of the finding that early life stress in animal models can lead to permanent changes in the level of CRH (and therefore cortisol)

Answer 9

There can be a permanent increase in CRH level among rats who were maternally deprived as new borns. This can set life long depression

Question 10

Understand the logic of the serotonin depletion experiments that allow us to get a handle on how serotonin levels affect depression

Answer 10

• have been used to see whether change in neurotransmitter level is a cause or effect of depression
• lowering serotonin levels does not induce depression in all people
• serotonin levels can be reduced artificially by introducing an agent that depletes tryptophan
• lower serotonin levels can be a causal agent in depression

Question 11

What is the red route into the anxiety-alcohol-depression vicious cycle?

Answer 11

• anxiety is the entry point
• to reduce anxiety is tot numb oneself with alcohol
• large amounts of alcohol has a depressive effect on the nervous system
• impacts motivation and productivity
• the body develops a tolerance to alcohol so more alcohol is necessary for the same numbing effect

Question 12

What is the green route into the anxiety-alcohol-depression vicious cycle?

Answer 12

• alcohol is the entry point
• late amounts of alcohol starts to depress the nervous system
• once depressed the person starts to become anxious as well
• this increases the need and attachment to heavy drink to dampen anxiety

Question 13

What is the blue route into the anxiety-alcohol-depression vicious cycle?

Answer 13

• depression is the entry point
• depression can bring under performance which elevates anxiety levels
• alcohol is then chosen as a self medication which succeeds in deepening depression

Question 14

What are the effects of chronic stress on the HPA axis?

Answer 14

• acute or chronic stress can damage the hippocampus

- early life elevation of CRH level due to stress can permanently alter the timing of the stress response

Question 15

What is Beck’s triad?

Answer 15

• trying to change how individuals think
• cognitive triad shows a pattern of thinking where they assume personal defectiveness, negatively interpret events and they have no hope for the future
• patterns of reasoning: my work is not valued, nobody likes me

Question 16

What is arbitrary inference?

Answer 16

Drawing a negative conclusion without a tight argument

Question 17

What is selective abstraction?

Answer 17

Picking up something negative and then broadening it into a more general principle

Question 18

What is over-generalisation?

Answer 18

Again, going from negative instances to broad negative views

Question 19

What is negative magnification?

Answer 19

Highlighting or over-estimating the importance of the negative aspects of experience

Question 20

What is personalisation?

Answer 20

Unwarranted levels of holding the self-responsible for negative things

Question 21

Understand the mechanism by which certain learning events can lead to global learned helplessness

Answer 21

Don’t know

Question 22

Understand the logic of seligman’s shock experiment.

Answer 22

• 3 conditions: inescapable shock, escapade shock and no shock
• the dogs in the escapade shock and no shock condition run out of the cage when given the shock
• the inescapable shock dogs stayed in the cage and took the shock even though the door was open

Question 23

What are the different types of explanatory styles from reports about patients’ styles of thinking?

Answer 23

• internal and external attributions
• stable explanations
• global causes
• internal-stable-global explanation
• external-unstable-specific explanatory style

Question 24

What is internal and external attributions?

Answer 24

• internal: blames the self

- external: finds causes outside the self

Question 25

What is stable explanations?

Answer 25

Imply that the reason for the outcome are persistent as opposed to unstable

Question 26

What are global and specific causes?

Answer 26

Broad reasons for negative outcomes whereas specific causes refer to only the current event

Question 27

What is internal-stable-global?

Answer 27

Places the highest more resilient level of blame on the self

Question 28

What is the external-unstable-specific explanatory styles?

Answer 28

Has the least impact on how the self is viewed