mood disorders Flashcards
which is INCORRECT, regarding MDD;
a) it is associated with high striatal activation in response to reward
b) twin studies show a moderate genetic component
c) genome wide association studies have not found any candidate genes for MDD
d) a short allele of the 5-HT transporter gene predisposes you to MDD after stressful life event
A - LOW striatal activation relating to rewards
having a short 5-HT transporter gene can predispose you to having
greater negative tendencies, cognitions because of compromised serotonin function
The 3 NT’s associated with mood disorders are
Norepinepherine
5-HT
DA
Past research focused on ___________regarding NT’s whereas modern research looks at ____________
the sheer AMOUNT of NT; response of these NT and their behaviour in the synaptic cleft
Describe the process of tricyclic AD’s and how they differ from SSRI
NT’s get released into the synapse, and naturally get sponged back in via pump, so that not all of it reaches receptor sites. Tricyclics block the reuptake of NT, whereas SSRI’s speciifcially block reuptake of 5-HT = more in synapse/receptor sites.
People with depression have less DA ergic activity and respond less to drugs increasing DA (T/F)
True
bipolar clients often have reduced levels of DA accounting for their depressive symptoms (T/F)
FALSE - highly sensitive to DA because of a sensitised reward system, may trigger hypo/mania
Trytophan is a;
a) 5-HT precursor
b) Norepinepherine precursor
c) antidepressant
d) neurotransmitter
A
Which is INCORRECT regarding 5-HT;
a) Serotonin is thought to regulate emotional reactivity
b) Serotonin receptors are more sensitive in bipolar clients
c) serotonin levels regulate negative effect
none of the above
B - LESS sensitive in MDD + bipolar = less emotional reactivty, flatter affect overall
Amygdala action is ________in mood disorders whereas hipppocampus function is _________
Increased; decreased
In MDD amygdala action is elevated in response to negative images = greater risk assessment
loss of motivation in MDD is associated with_________
Reduced stratum activation
The anterior cingulate, hippocampus and dorsolateral PFC do ___________in MDD
Emotional regulation , which is compromised
the HPA axis involves ____________glands
Hypothalamus, pituitary, atrenocortical
The major hormone linked with HPA-Axis is__________ and regulates__________. In MDD this is _____active
Cortisol, stress; HYPERactive in MDD
Cushing syndrome is
When there is an excessive secretion of cortisol, gives depression like symptoms
the consequences of long term cortisol excess;
a) no consequences
b) damage to hippocampal volume
c) longevity predicts severity of next depressive episode
d) both B and C
D
expressed emotions relate to___________ and _______the chances of MDD expression/relapse
family members making critical comments towards person with MDD/ being over emotional; INCREASES
Which psychological factor is MOST associated with MDD? What does it share an aetiology with_________
Neuroticism - tendency for someone to feel persistent negative affect; also common trait to GAD + PTSD
Becks theory of depression centres around a negative triad, these are ___________
negative thoughts about self, world, future
how does Beck describe the cause of MDD
Person has a negative triad + NEGATIVE SCHEMAS based on poor childhood experiences, which operate on an unconscious level. When person encounters a life stressor, rely on COGNITIVE BIASES (result of learned schemas)
How does MDD affect information processing
Focus more on negative stimuli, remember more of it
Seligman’s theory of depressions emphasises__________ as the major cause of it
Hopelessness
hopelessness relates to MDD manifestation if person attributes outcomes to _______________
GLOBAL + STABLE features i.e.
I am stupud (global) vs I am tired
I lack all maths ability (stable) vs I am fed up with homework
The 2 dimensions of helpelesness theory are
stable / unstable
global / specific
How is hopelessnes measured?
Atrribution style questionnaire (ASQ) - Prediction of depressive symptoms if students attribute low grades to global and stable factors= hopelessness
Rumination theory suggests that
Rumination - tendency to dwell repetatively on SAD experiences. More common in WOMEN, those who do it = more negative mood
What is the evolutionary purpose of rumination? is there one?
YES - for risk management, problem solving. Our way of trying to control life’s negative stressors
2 psychological predictors of mania ;
a) reward sensitivity
b) sleep DEPRIVATION = more tired, more prone to experiencing mania
Depression in bipolar does not share the same aetiology as in MDD (T/F)
False
Psychological treatment for depression is typically recommended for ____________ duration
Weekly sessions 2-4 months
IPT for depression aims to____________ and does so by_______
examine existing IPT problems i.e. role transition, communication, identify feelings about the issue and work to resolve it
the idea that cognitive biases and negative schemas contribute to depression is part of ___________therapy
CBT
CBT entails ______________ steps
a) Educating person that negative thoughts influence mood + actions
b) client understanding connection between neg self-talk & behaviour
c) may be asked to complete homework i.e. monitoring mood, ID triggers
d) therapist challenges negative self beliefs
CBT is __________ effective whereas computerised CBT is ___________ effective
Moderate, lasts outside of therapy;
mixed results
Behavioural activation involves ____________, but first the individual must ___________
increasing social interaction; must challenge negative self talk or socialisation may make it worse
Couples therapy may help MDD by_____________ and is _________ effective compared to individual therapy
Improving communication; EQUALLY
Examples of third wave cognitive therapies are
Dialectical behavioural therapy
Mindfulness based CBT
acceptance + commitment therapy
decenter and diffuse therapy
decenter and diffuse perspective emphasises
thoughts are an event, rather than a true reflection of self. Instead of struggling with them, accept and detach from them. LOW EFFICACY
Bipolar tmt is often psychological (T/F)
False - but still recommended
The main benefit of psychoeducation is
ADHERENCE to medication, especially if currently asymptomatic
Interpersonal and Social Rhythm therapy (IPSRT) tries to
Stabilise ROUTINE in persons life + circadian rhythms
The 2 dominant biological treatments for bipolar are
Electroconvulsive therapy + meds
the process of ECT involves
inducing small seizure by placing electrodes on non dominant side of head with 70-130v. Done while person is asleep, given muscle relaxants, need 6-12 tmts over several days
When is ECT recommended?
not responsive to meds
psychosis present
The major classes of AD’s given for depressive symptoms are
MOA inhibitors
SSRI
SNRI
Tricyclic AD
The recommended course of AD is___________ during this time, the dosage should ________ adjusted
12 months; NOT be adjusted and stay the same as they were during acute symptoms to prevent relapse
Antidepressants are not more effective than placebos for mild-moderate MDD symptoms (T/F)
TRUE
What is the order of treatment regarding MDD meds?
a) try SSRI - citalopram
b) if doesn’t work / side efx, SWAP or ADD another med or recommend CBT
The MOST effective and LEAST effective AD’s are
SSRI’s - least side efc, MOAi least + have most side efx
TMS may be attempted if
2+ meds have FAILED. Tries to increase activity in the dorsolateral prefrontal cortex (emotion regulation). TMT lasts 30 mins for <10 days BUT coil often placed to wrong area
Which is INCORRECT;
a) combination therapy of psych + meds produces same effects as standalone
b) meds act faster than therapy
c) Psychotherapy advantage is teaching skills that may be used externally
d) none of above
A - combination works BEST
Which is INCORRECT;
a) lithium is a mood stabiliser
b) lithium targets depressive symptoms
c) lithium is often taken with other medications
d) body’s lithium levels should be monitored
B - helpful for mild depression but mainly used for MANIA.
Anticonvulsant Antipsychotic meds may be used when litihum is inneffective or side fx too high BUT a risk is
increased suicidal ideation
difference between TMS and DBS is
TMS in non-invasive whereas DBSinvovles INSERTION of electrode
the MOST common method of suicide is. In men this is _______, in women this is_____________
guns;
guns/hanging; overdose
Leading cause of death in Aboriginal populations;
a) alcohol use disorder
b) opioid use disorder
c) tobacco use disorder
d) suicide
D
Steps of preventing suicide
a) treat psych disorder w therapy meds
b) treat suicidal thoughts directly by ID triggers, problem solving skills to overcome triggers/hopelessness
c) policy approaches i.e. destigmatise, awareness, in at-risk pop’s
