Mood disorder

Question 1

State three types of anti-depressants:

Answer 1

Tricyclics
Monoamine oxidase inhibitor (MAOI)
Selective serotonin reuptake inhibitors (SSRI)

Question 2

Explain how MAOIs works.

Answer 2

MAOI inhibits the action of monoamine oxidase. This prevents the breakdown and removal norepinephrine, serotonin and dopamine.

Question 3

State the side effects of MAOIs.

Answer 3

Headache, drowsiness, insomnia, nausea, diarrhoea and constipation.

Withdrawal symptoms.

Interact with other medications, such as pain medications and other anti-depressants, which may cause high blood pressure or headaches.

Question 4

Explain how tricyclics work.

Answer 4

Increase levels of serotonin and norepinephrine in the brain by stopping them from being reabsorbed.

Question 5

State the side effects tricyclics.

Answer 5

Drowsiness, nausea and vomiting, blurred vision and weight gain.

Question 6

Explain how SSRIs work.

Answer 6

Act on serotonin to stop it from being reabsorbed and broken down.

Question 7

State the side effects of SSRIs.

Answer 7

Nausea, drowsiness and headache.

Question 8

Describe the sample of Oruč et al. (1997).

Answer 8

42 unrelated patients with bipolar disorder type 1.

From two Croatian hospitals.

25 females and 17 males.

31 to 70 years.

Participants in both groups are matched in terms of age and sex.

40 control participants with no family or psychiatric history.

Question 9

What is the main characteristic of depressive disorder.

Answer 9

Loss of pleasure.

Question 10

State other symptoms of depressive disorder.

Answer 10

1. Difficulty concentrating
2. Excessive feelings of worthlessness
3. Guilt
4. Recurrent thoughts of death
5. Changes to eating or sleeping patterns

Question 11

Describe the diagnosis of depressive disorder.

Answer 11

Single episode depressive disorder is characterised by the presence of one depressive episode, without history of previous episodes. Recurrent depressive disorder is diagnosed when there are at least two depressive episodes separated by several months or more without a significant mood disturbance. A depressive episode is a period of at least two weeks, during which time there is almost depressed mood or decrease in interest of activities.

A diagnosis can only be made if the individual has never experienced a manic, mixed or hypomanic episode.

Question 12

State 5 types of cognitive distortions.

Answer 12

1. Arbitrary inference
2. Selective thinking
3. Overgeneralization
4. Personalization
5. Magnification and minimization

Question 13

Define depressive episode.

Answer 13

A period of at least two weeks, during which time there is almost daily depressed mood.

Question 14

State the condition(s) required for the diagnosis of type 1 bipolar disorder.

Answer 14

At least one manic OR mixed episode.

Question 15

State the condition(s) required for the diagnosis of type 2 bipolar disorder.

Answer 15

At least one hypomanic AND depressive episode.

Question 16

Define a mixed episode.

Answer 16

A mixture of manic and depressive states on most days during a two week period.

Question 17

State and describe the assessment tool for depressive disorder.

Answer 17

Beck Depression Inventory (BDI).

1. 21 items
2. Each item consists of four statements with their respective score.
3. The responder choose the statement that fits them best.
4. The total score is used to determine the severity.
5. 10 to 18 indicates mild depression. 19 to 29 indicates moderate depression. 30 and above indicates severe depression.

Question 18

State the biochemical explanation for depressive disorder.

Answer 18

Low dopamine and serotonin.

Dopamine is responsible for pleasure and motivation. Low dopamine causes lack of motivation and enjoyment from usual activities, which are core symptoms of depressive disorder. Further evidence is shown by anti-depressants which raise dopamine levels can reduce depressive symptoms.

Serotonin regulates sleep, appetite, mood and anxiety. Low serotonin can lead to anxiety, disruption in sleep and appetite, which are common symptoms of depressive disorder. Further evidence is shown by SSRIs can reduce depressive symptoms.

Question 19

Explain arbitrary inference.

Answer 19

It involves drawing a conclusion without any evidence.

Question 20

Explain selective thinking.

Answer 20

It involves focusing on only one aspect of a situation while ignoring all other relevant aspects.

Question 21

Explain overgeneralization.

Answer 21

It involves drawing conclusions based on a single incident and applying it to unrelated events.

Question 22

Explain personalization.

Answer 22

It involves taking responsibility or blame for events that are unrelated to the person.

Question 23

Explain magnification and minimization.

Answer 23

It involves blowing negative events out of proportion while ignoring positive events.

Question 24

Explain learned helplessness.

Answer 24

A person having to endure an unpleasant situation and they perceive it as inescapable.

This is because the individual think they have no control over the situation to prevent suffering, so they eventually stop trying to resist it.

In the case of depression, it is suggested that depression is a direct result of a real or perceived lack of control over the outcome of their situation in life.

Question 25

Explain “attributional” style.

Answer 25

Attribution is an individual’s cognitive process of explaining the cause of an event.

Negative atrributional style may arise due to learned helplessness. For example, a person who has had a difficult upbringing or experienced death of a loved one during childhood may perceive a lack of control over negative events in their lives.

When bad events happen, they might blame themselves (internality); they might think things will never get better (stability) and they might think more things will go wrong (globality).

Question 26

Describe the sample of Seligman et al. (1988).

Answer 26

39 patients with depressive disorder
12 patients with bipolar disorder
10 non-clinical participants in control group
Mean age of 36 years

Question 27

Describe Beck’s cognitive theory of depression.

Answer 27

Negative views held by someone with depression becomes a reality to that person, even if they seem far-fetched to others.

This irrational, negative way of seeing things is known as cognitive distortion.

Negative experiences during childhood lead to formation of negative schemas.

When something bad happens, the schema is activated and their processing becomes biased. Cognitive distortions happen.

Cognitive processes involved in depression can be understood using Beck’s cognitive triad.

First, the person thinks they are worthless and unhappy. Second, the person perceives the world as presenting them with insurmountable obstacles to their happiness. Third, the person anticipates failure in future undertakings, leading to them feeling worthless again. And the cycle goes on.

Question 28

Describe the procedure of Seligman et al. (1988).

Answer 28

1. Participants completed BDI to assess severity of symptoms.
2. Participants completed Attributional Style Questionnaire. It consisted of 12 hypothetical good and bad events. Participants needed to say what or who is responsible for the event. Then, they rate each cause on a seven-point scale of internality, stability and globality.

Question 29

Describe the results of Seligman et al. (1988).

Answer 29

The higher the score of BDI, the greater the negativity displayed in the Attributional Style Questionnaire.

Bipolar and unipolar participants have more negative attributional styles than the control group.

For those unipolar participants undergoing cognitive therapy, an improvement in attributional style correlated with an improvement in BDI scores. This suggests that attributional style is an important factor in our experience with depresive disorder.

Question 30

Describe Beck’s cognitive restructuring as a treatment for depression.

Answer 30

It is believed that depression is caused by faulty thinking.

A form of talking therapy to identify illogical thinking and enables patient to understand that their way of thinking about themselves and the world contributes to their depression. It helps them to recognise irrational or inaccurate beliefs and statements.

It requires active participation from patients as patients need to do their own “homework”.

First, they have to understand the link between their thoughts, affect and behaviour and how each influence each other. This helps them to notice negative distortions in thinking for themselves.

Then, patients are taught “reattributing” where they discuss whether the cause of their failures are internal or external. This helps them to reframe their thinking about an upsetting situation.

Question 31

Briefly explain the strengths and weaknesses of cognitive restructuring as a treatment for depression.

Answer 31

Strengths:
1. Quicker than CBT because it only involves cognitive approach.
2. No side effects such as those caused by medication.

Weaknesses:
1. Requires active participation.
2. Costly.

Question 32

Describe rational emotive behavioural therapy (REBT).

Answer 32

Based on ABC model, A is activating event, B is belief and C is consequences.

B is the most important element. Albert Ellis argues that we all experience adversity but it is how we think about those experiences that have the greatest impact on our emotional well-being and behavioural outcome.

Based on principles of stoicisim which argue that individual is not directly affected by external things. It is believed that a person becomes depressed because of internal constructions.

The goal is to help individuals create and maintain constructive, rational patterns of thinking about their lives.

This is done through “disputing”.

Question 33

Describe the study by Wiles et al. (2013).

Answer 33

469 individuals with depressive disorder were randomly allocated to continued usual care or care with CBT.

Showed that CBT can reduce symptoms in people who fail to respond to anti-depressants.

Those who received CBT were three times more likely to respond to treatment and experience reduction in symptoms.

Question 34

Describe the study by Lyons and Woods (1991).

Answer 34

Meta analysis of 70 REBT studies that compared REBT to baseline, control groups or other psychotherapies.

Found that individuals receiving REBT showed significant improvement over baseline and control groups.

Question 35

Explain one reason why the Beck depression inventory (BDI) is valid.

Answer 35

It includes 21 items so measures a wide variety of symptoms.

These symptoms include both cognitive and physical symptoms so patients with different types of
symptoms could receive a diagnosis of depression.

Question 36

Describe the aim of Oruč et al. (1997).

Answer 36

To investigate whether genes coding for serotonin receptors and transporters are linked to bipolar disorder.

Question 37

Describe the procedure of Oruč et al. (1997).

Answer 37

Genetic analysis of DNA polymorphisms in serotonin receptor and transporter.

Question 38

Describe the results of Oruč et al. (1997).

Answer 38

No significant associations in polymorphism were found in the sample.

16 bipolar disorder type 1 patients had at least one first-degree relative suffering from major affective disorders.

Polymorphism in these genes are more common in women with bipolar disorder type 1.