mood disorders Flashcards by Alexandra Antonova

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

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having a short 5-HT transporter gene can predispose you to having

greater negative tendencies, cognitions because of compromised serotonin function

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The 3 NT’s associated with mood disorders are

Norepinepherine
5-HT
DA

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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

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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.

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People with depression have less DA ergic activity and respond less to drugs increasing DA (T/F)

True

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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

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Trytophan is a;

a) 5-HT precursor
b) Norepinepherine precursor
c) antidepressant
d) neurotransmitter

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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

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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

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loss of motivation in MDD is associated with_________

Reduced stratum activation

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The anterior cingulate, hippocampus and dorsolateral PFC do ___________in MDD

Emotional regulation , which is compromised

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the HPA axis involves ____________glands

Hypothalamus, pituitary, atrenocortical

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The major hormone linked with HPA-Axis is__________ and regulates__________. In MDD this is _____active

Cortisol, stress; HYPERactive in MDD

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Cushing syndrome is

When there is an excessive secretion of cortisol, gives depression like symptoms

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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

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expressed emotions relate to___________ and _______the chances of MDD expression/relapse

family members making critical comments towards person with MDD/ being over emotional; INCREASES

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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

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Becks theory of depression centres around a negative triad, these are ___________

negative thoughts about self, world, future

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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)

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How does MDD affect information processing

Focus more on negative stimuli, remember more of it

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Seligman’s theory of depressions emphasises__________ as the major cause of it

Hopelessness

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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

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