mood disorder chapter questions Flashcards
What is major depression?
Major depression is a psychological problem characterized by relatively extended periods of clinical depression which cause significant distress to the individual and impairment in social and occupational functioning.
What is bipolar disorder?
Bipolar disorder is a psychological disorder characterized by periods of mania that alternate with periods of depression. For example, loud, spontaneously start conversations with strangers; indulge in appropriate or imprudent sexual interactions.
Are people with bipolar disorder especially creative?
People with bipolar disorder experience episodes of both mania (an exceptionally elevated, irritable, or energetic mood) and depression. During the early stages of a manic episode, people can be very happy, productive and creative. They have less need for sleep and don’t feel tired. There is some evidence that many well-known creative people suffer or have suffered from bipolar disorder. A seminal work by Jamison (1993) examined the lives of a sample of major 18th century British poets and found a rate of bipolar disorder 30 times greater in these poets than is present in general population. Jamison’s work also found that the hypomania periods can involve heightened creative thinking and expansiveness, high mental speed and cognitive flexibility, all elements underlying creativity. A series of more recent large scale studies also found a clear over-representation of people with bipolar disorder in the most creative occupational categories, which included artists, musicians, writers and scientists. Nevertheless, the correlation between creativity and bipolar disorder still needs to be examined carefully, since this didn’t imply any causal relationship, and it is possible that this link may be caused by an unknown third factor, such as temperament.
What is Beck’s negative triad? How has it been proposed to explain the development of depression?
Beck’s negative triad is a theory of depression in which depressed people hold negative views of themselves (e.g. ‘I am ugly’), of their future (e.g. ‘I will never achieve anything’) and of the world (e.g. ‘the world is a dangerous and unsupportive place’)
Beck claimed that depressed individuals have developed a broad ranging negative schema that tends them towards viewing the world and themselves in a negative way. In turn, these negative schemas influence the selection, encoding, categorization and evaluation of stimuli and events in the world in a way that leads to a vicious cycle of depressive affect and symptomatology.
Beck argued that the depressed individual’s negative schema maintained some interrelated aspects of negative thinking that he called the negative triad. This set of negative beliefs eventually generates self-fulfilling prophecies. That is, the depressed individual interprets events negatively, fails to take the initiative, and then inevitably experiences failure.
The negative triad of beliefs leads to a number of systematic biases in thinking, including arbitrary inference, selective abstraction, over-generalization, magnification and minimization, personalization and all-or-none thinking.
How does Beck’s theory compare with helplessness & hopelessness theories?
Beck’s theory argues that depression resulted from bias in ways of thinking and information processing.
Helplessness theory argues that depression resulted from unavoidable negative life events which give rise to a cognitive set that makes individuals learn to become ‘helpless’, lethargic and depressed.
Hopelessness theory argues that depression is resulted from the combination of negative attributional style, negative life events and low self-esteem.
What is the interpersonal Theory (IPT) of depression?
Interpersonal theories of depression claim that depressed individual alienate family and friends because of their perpetual negative thinking, and this alienation in turn exacerbates the symptoms of depression.
i.e., depression is maintained by: a cycle of reassurance-seeking, which is subsequently rejected by others because of the negative way in which the depressed individuals talk about their problems.
How strong is the evidence for a genetic component to mood disorders?
There is good evidence that depressive symptoms run in families, and this suggests the possible existence of an inherited or genetic component to major depression and bipolar disorder. For example, family studies have indicated that 10-25% of first-degree relatives of bipolar disorder sufferers have also reported significant symptoms of mood disorder, and it has been estimated that approximately 7% of the first-degree relatives of sufferers also have bipolar disorder – this is compared to a lifetime prevalence rate in the general population of between 0.4 and 1.6%. However, the increased risk of depressive symptoms for relatives of major depression sufferers is significantly less (5-10%) than for bipolar disorder, but still higher than would be expected in the general population.
Twin studies also suggest a significant inherited component in mood disorders. For example, concordance rates for mood disorders average 69% and 29% for MZ and DZ twins respectively, suggesting that sharing all genes as opposed to half of genes more than doubles the risk for developing a mood disorder. With respect to individual mood disorders, twin studies of major depression have indicated concordance rates of 46% and 20% respectively for MZ and DZ twins and 58% and 17% respectively in the case of bipolar disorder. These results clearly support the case for a genetic component to depression, and recent estimates suggest that around 30% of the variance in depressive symptomatology can be accounted for by inherited factors.
What do we know about the involvement of neurotransmitters in mood disorders?
Depressions and mood disorders have been shown to be reliably associated with abnormalities in the levels of certain brain neurotransmitter.
Two neurotransmitters are particularly significant: serotonin and norepinephrine. Depression is regularly associated with low levels of both these neurotransmitters, and mania found in bipolar disorder is found to be associated specifically with high levels of norepinephrine.
Because these neurotransmitters are necessary for the successful transmission of impulses between neurons, their abnormally low levels in depressed individuals may account for the cognitive, behavioural and motivational deficits found in major depression and the depressed phases of bipolar disorder
How do psychological therapies relate to the psychological explanations for mood disorders?
Psychoanalytic theory argues that depression is a response to loss and the loss of a loves such as a parent. Hence psychodynamic therapy uses a range of techniques (e.g. free association, dream analysis) to help individuals to explore the long-term sources of their depression.
Behavioural theories claim that depression results from a lack of appropriate reinforcement for positive and constructive behaviours, and this is especially the case following a ‘loss’ such as bereavement or redundancy.
Behavioural activation therapies attempt to increase the individual’s access to pleasant events and rewards and decrease his or her experience of aversive events. Technique used include daily monitoring of pleasant/ unpleasant events, schedule reinforcing activities so that patients reinforce less attractive activities, social skills and time management training, identification of behavioural goals within major life areas.
Beck’s cognitive theory of depression argues that depression is maintained by a negative schema that leads depressed individuals to hold negative view about themselves, their future and the world. Attributional accounts believe that negative attributional style of interpretation of life events contributes to depression. Learned helplessness theory argues that people become depressed because negative events give rise to a cognitive set that makes individuals learn to become ‘helpless’. Hopelessness theory suggests that depression is resulted from the combination of negative attributional style, negative life events and low self-esteem.
Cognitive therapy for depression attempts to help the depressed individual identify negative beliefs and thoughts, challenge these beliefs as irrational, and replace them with positive rational belief. Reattribution training is used and patients learn to interpret their difficulties in more hopeful and constructive ways, rather than in the negative personal, global, stable ways.
Interpersonal theories of depression claim that depressed individual alienate family and friends because of their perpetual negative thinking, and this alienation in turn exacerbates the symptoms of depression. Social skill training assumes depression is partly resulted from the inability to communicate and socialise appropriately, and aim to improve social skills using techniques such as role-play to alleviate depression symptoms.
Cognitive behavioural therapies (CBT) combine cognitive, behavioural and social skill elements together. Cognitive elements aim to identify and challenge dysfunctional thoughts. Behavioural part increase engagement in enjoyable activities. Skill training focused on problems solving techniques. CBT is a collaborative approach between client and therapist.
MBCT see 11
How do biological therapies relate to biological explanations of mood disorders?
Biological evidence suggested a clear link between depression and abnormalities in specific brain neurotransmitters such as serotonin and norepinephrine. Depression is regularly associated with low levels of both these neurotransmitters, and mania found in bipolar disorder is found to be associated specifically with high levels of norepinephrine. The development of drugs has significantly alleviated the symptoms of depression. The main ones were tricyclic drugs (such as imipramine) and monoamine oxidase (MAO) inhibitors (such as tranylcypromine). Tricyclic drugs have their beneficial effects by preventing the reuptake by the presynaptic neuron of serotonin and norepinephrine. More recently, the development of selective serotonin reuptake inhibitors (SSRIs) (such as Prozac) has allowed researchers to assess the specific role of serotonin in depression, and it is now believed serotonin levels play a central role in major depression. In contrast, norepinephrine levels were thought to be more important in bipolar disorder, where low levels of this neurotransmitter are associated with depression and high levels with mania. More recent neurochemical theories suggested that there might be interaction between serotonin and norepinephrine neurotransmitters. In addition, lithium carbonate is found to be effected for bipolar disorder and can provide relief for both mania and depressive episode. The mechanism behind is still unclear. Some researchers suggest lithium might help stabilizing activity of sodium and potassium ions in the membrane of neurons, other accounts argue that in changes synaptic activity, thus helping to facilitate neuron transmission.
What is MBCT?
Mindfulness-based cognitive therapy (MBCT) has been developed to prevent relapse in recovered depressed individuals by making them aware of negative thinking patterns that may be triggered by subsequent bouts of depression. The programme aims to get in touch with moment-to-moment changes in mind and body. It involves teaching patients to be more aware of their thoughts, feelings and bodily sensations, and to treat them in the non-negative thinking patterns.
Is it possible to identify people at risk of suicide? Should we try to prevent suicide?
Risk factors for suicide include existing psychiatric diagnosis, low self-esteem, poor physical health and physical disability and experiencing a significant negative life event. It is possible to identify people at risk of suicide. Prior suicide, individuals may be calm, rational, even show signs of improvement in their psychological condition. The main forms of intervening to prevent suicide include 24-hour helplines and telephone support lines (e.g., the Samaritans), and school-based educational programmes warning about the early signs of suicidal tendencies.
