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Clinical Psychology > Mood Disorders > Flashcards

Mood Disorders Flashcards

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1
Q

Depression

A
  • pervasive and persistent
  • impairs functioning
  • may occur in the absence of precipitating events
  • may be out of proportion to circumstances
  • ‘feel strange’ (difficult to describes)
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2
Q

DSM Major Depressive Disorder criteria

A

5 or more symptoms in same 2 week period:

  • depressed mood
  • diminished interest or pleasure in activities
  • weight loss/gain or increased/decreased appetite
  • insomnia or hypersomnia
  • psychomotor agitation or retardation
  • fatigue
  • feelings of worthlessness or guilt
  • difficulty to concentrate
  • recurrent thoughts of death or suicidal agitation
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3
Q

Dysthymia

A 
persistent depressive disorder:
-depressed mood for most of the day for most days for at least 2 years
2 or more symptoms:
-poor appetite or overeating
-insomnia/hypersomnia
-low energy or fatigue
-low self esteem
-poor concentration
-feelings of hopelessness
never been without symptoms for more than 2 months
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4
Q

Manic Episode

A
  • a period of abnormally and persistently elevated or irritable mood and increased goal-directed energy
  • lasting at least 1 week
  • impairment or hospitalisation
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5
Q

Manic Episode Symptoms

A

3 or more of the following symptoms:

  • inflated self-esteem or grandiosity
  • decreased need for sleep
  • more talkative than usual or pressure to keep talking
  • racing thoughts
  • distractibility
  • increased goal-directed activity or psychomotor agitation
  • excessive involvement in activities that have a high potential for painful consequences
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6
Q

Hypomanic Episode

A
  • 3 or more symptoms of a manic episode
  • BUT last for 4 days
  • not severe enough to cause a marked impairment in functioning or to hospitalise
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7
Q

Bipolar 1 Disorder

A
  • at least 1 manic episode
  • MAY be followed by 1 major depressive or hypomanic episodes
  • marked impairment in functioning or need to hospitalise if there are psychotic features
  • not due to another medical condition
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8
Q

Bipolar 2 Disorder

A
  • hypomanic episode AND a major depressive episode
  • never had manic episode
  • not severe enough to cause impairment in functioning or to hospitalise
  • not due to another substance or another medical condition
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9
Q

Cyclothymic Disorder

A
  • at least 2 years (1 for children/adolescents)
  • hypomanic symptoms that do not meet criteria for hypomanic episode
  • periods with depressive symptoms that do not meet criteria for major depressive episode.
  • not without symptoms for 2 months
  • never meet criteria for mania, hypomania or major depressive episode
  • symptoms cause significant distress or impairment
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10
Q

Neurochemical factors of Bipolar Disorder

A

-abnormalities in levels of dopamine and noreponephrine

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11
Q

serotonin (bipolar)

A
  • regulation of mood
  • appetite and sleep
  • learning and memory
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12
Q

dopamine (bipolar)

A
  • motivation

- reward and pleasure

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13
Q

norepinephrine (bipolar)

A
  • secreted in response to stress

- lower levels of arousal, alertness and concentration

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14
Q

Prefrontal cortex in bipolar

A
  • lower levels of activation
  • representations of goals
  • failure to anticipate incentives
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15
Q

Hippocampus in bipolar

A
  • deficits in hippocampus
  • dissociates affective response from context
  • sadness occurs independent of context
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16
Q

Amygdala in (bipolar)

A
  • increased activation
  • attention to stimuli
  • priorities threatening info
  • interprets it negatively
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17
Q

Anterior cingulate cortex

A
  • regulating emotions when failing to achieve a desired outcome
  • deficit in ‘will-to-change’
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18
Q

Hypothalamic Pituitary Adrenocortical (HPA) netwok

A
  • manages and reacts to stress
  • triggers secretion of cortisol in response to stress
  • cortisol lowers frequency of serotonin transmitters
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19
Q

Psychodynamic theories of (bipolar)

A

depression is anger turning inward in response to the loss of a significant person

  1. regress to oral stage:
    - integrate person’s identity with your own
    - depend on others for support
  2. introjection:
    - direct feelings toward the other person onto yourself (anger, guilt)
    - self-hatred, low self-esteem, depression
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20
Q

Behavioural Theories (bipolar)

A
  • lack of motivation
  • diminished repertoire of behaviours
  • less positive social behaviour
  • the future lacks positive, fulfilling experiences
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21
Q

Behaviour Theories (bipolar) 3 steps

A
  1. lack of appropriate reinforcement
  2. loss of an important source of reinforcement
  3. eliciting negative reactions from others
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22
Q

Beck’s Cognitive Theory

A
  • depression is caused by biases in thinking and info processing
  • negative schema
  • stressful experiences reactivate negative schema
  • leads to negative cognitive biases
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23
Q

Negative schema

A

personality characteristics resulting from adverse childhood experiences (loss)

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24
Q

cognitive distortion:

over generalisation

A

Unjustified generalisation on the basis of a single event

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25
Q

cognitive distortion: selective abstraction

A

Abstracting a detail out of context and missing the significance of the whole situation

26
Q

cognitive distortion: dichotomous thinking

A

Events are labelled as good or bad, wonderful or horrible

27
Q

cognitive distortion: magnification and minimisation

A

Perceiving events in a greater or lesser light than it truly deserves

28
Q

cognitive distortion: personalisation

A

Relate external events to yourself, even when there is no basis for it

29
Q

Beck’s negative schema of depression

A
  1. negative triad (neg views of self, the world and the future)
  2. cognitive bias (all events are interpreted neg)
  3. failures and losses (individual fails to take initiatives and opportunities are lost)
    = DEPRESSION
30
Q

Rumination Theory

A
  • driven by meta-cognitive beliefs
  • think deeply about the experience of depression or on its possible causes
  • increases the risk of depression
  • increases the likelihood of a relapse
31
Q

Treatment of Bipolar Disorder: Drug treatment

A
  • lithium carbonate
  • mood stabilisers - anticonvulsants
  • antipsychotics combined with SSRI
  • electroconvulsive therapy when symptoms are resistant to drug treatments
32
Q

Treatment of Bipolar Disorder: Cognitive Behaviour Therapy

A

focuses on:

  • medication compliance
  • mood monitoring
  • anticipating and coping with stressors
  • interpersonal functioning
  • problem-solving
33
Q

Treatment of Depression- drug therapy

A
  • tricyclics and SSRIs
  • MAO inhibitors
  • ssris have fewer side effects and dietary reactions and harder to OD
34
Q

Treatment of depression- Electroconvulsive therapy

A
  • 70-130 volts of current is passed through person’s head for half a second
  • provides short term relief (4 weeks)
35
Q

side effects of electroconvulsive therapy

A

memory loss, confusion, nausea, euphoria

36
Q

Psychoanalysis (depression)

A

aim: to achieve insight into repressed conflicts and help release inwardly directed anger
- little evidence to support effectiveness
- explores long term sources of depression
- problematic relationships with attachment figures
- recall early experiences of loss

37
Q

Social skills training (depression)

A

-modelling
-rehearsal
-role-playing
-homework
(people with depression have deficits in general social skills)

38
Q

Behavioural Activation Training (depression)

A
  • assessment of depressed behaviour
  • weekly self monitoring exercise
  • identify behaviour goals
  • weekly rewards if goals are met
39
Q

Effectiveness of Behavioural Activation Training

A
  • beneficial for severe depression

- effective in preventing relapse after 24 months

40
Q

Cognitive Therapy (depression)

A
  1. identify negative thoughts and beliefs
  2. challenge thoughts as dysfunctional
  3. replace negative beliefs with more rational ones
  4. monitor negative automatic thoughts
  5. link automatic thoughts to specific situations and outcomes
  6. think through possible rational alternatives
  7. monitor changes in thoughts and feelings
41
Q

Cognitive Therapy effectiveness

A
  • as effective as drug therapy in treating symptoms
  • few relapses in the long term
  • combo of cog therapy and drug therapy is superior
42
Q

Mindfulness-Based Cognitive Therapy rationale

A
  • Depression is caused by periods of negative mood that activates patterns of negative thinking
  • Downward spiral towards relapse
  • Risk of relapse is greater with each episode
  • Need to predict and eliminate a possible relapse after remission and successful treatment
  • Need to adopt a detached, decentred relationship to depression-related thoughts and feelings
  • Thoughts and feelings are treated as passing events
43
Q

Mindfulness-Based Cognitive Therapy aim

A

to improve emotional well-being by increasing a person’s awareness of how their automatic cognitive and behavioural reactions can cause distress

44
Q

Mindfulness-Based Cognitive Therapy skills

A
  • live in the moment
  • pay attention to your thoughts
  • acknowledge and accept thoughts in non judgemental way
  • assist a person to deal more effectively with life stressors
  • respond reflectively (thoughtfully) not reflexively (reacting)
45
Q

Deliberate Self Harm

A

-direct bodily harm with no intent to commit suicide

46
Q

nonsuicidal self-injury DSM 5

A
  • in the last year has on 5 or more days engaged in intentional self harm
  • no suicidal intent
  • obtain relief from a negative feeling
  • to resolve interpersonal difficulty
  • to induce a positive feeling
47
Q

self-harm risk factors

A
  • adolescents
  • interpersonal crises
  • psychological disorders
  • poor verbal communication skills
  • poor social problem-solving skills
  • history of childhood abuse and or trauma
48
Q

self harm triggers

A
  • being alone
  • neg thoughts and feelings
  • reliving traumatic memories
  • anger
  • self hatred
  • numbness
49
Q

function of self harm

A
  • brings relief
  • emotional regulation
  • increase physiological arousal if feeling numb
  • communicating distress
  • help-seeking
50
Q

self harm treatment

A
  • prevention is difficult (impulsive, secretive)
  • no drug treatment or psychological treatment available
  • problem solving therapy
  • CBT for depression if it is the underlying factor
51
Q

women vs men suicidal rates

A

women 3x more likely to attempt suicide

men 4x more likely to succees

52
Q

risk factors of suicide

A
  • Previous suicide attempt
  • Diagnosable psychological disorder
  • Hopelessness
  • Low self-esteem
  • Poor physical health and disability
  • Life stress
  • Relationship issues and interpersonal conflicts
  • Financial issues
  • Genetic factors
  • Social factors
53
Q

warning signs of suicide

A
  • Talking about suicide
  • Seeking out lethal means
  • Preoccupation with death
  • No hope for the future
  • Self-loathing and self-hatred
  • Getting affairs in order
  • Saying goodbye
  • Withdrawing from others
  • Self-destructive behaviour
  • Sudden sense of calm or increase in energy
54
Q

Bereavement

A
  • not merely grief

- thoughts about death and dying focused on the deceased person or ‘joining’ them

55
Q

Disruptive Mood Dysregulation Disorder

A
  • severe recurrent temper outbursts that are out of proportion to the situation
  • outbursts are inconsistent with developmental level
  • occurs 3 or more times a week
  • mood is generally irritable or angry most of the day nearly every day
  • symptoms for 12 months
  • 6-18 yrs old
56
Q

Premenstrual Dysphoric Disorder

A
  • severe depression symptoms btw 5-11 days before start of menstrual cycle
  • at least 5 symptoms
  • start to improve after bleed
  • causes distress and disruption to daily life
  • mood swings,irritability, anger, hopelessness, decreased interest in activities, decreased concentration, disrupted sleep patterns, lethargy, food cravings, physical symptoms e.g. breast sensitivity
  • 2 to 5% of women
  • Treatment – healthy lifestyle; antidepressants; CBT
57
Q

In Major Depression, which of the following is a significant neurotransmitter?

A

serotonin

58
Q

Lower levels of activation in the Prefrontal Cortex results in:

A

failure to anticipate incentives

59
Q

Decreased activation in the Anterior Cingulate Cortex (ACC) results in?

A

Failure to regulate emotions.

60
Q

In depression deficits in Hippocampal function may result in:

A

The individual dissociating affective responses from their relevant contexts.

61
Q

In Major Depression, hippocampal abnormalities are regularly linked with?

A

high levels of cortisol

Clinical Psychology (10 decks)

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