Mood Instability Flashcards
Define mood instability Know the clinical presentations of mood instability Describe how to measure mood instability Understand the neurocognitive models of mood instability - particularly for emotion regulation, mental imagery, and future simulation Explore the future directions of psychiatric treatment of mood instability
Define mood instability
Rapid oscillations of intense affect, with difficulty in regulating these oscillations or their behavioural consequences
Name at least 3 disorders which feature mood instability
Bipolar disorder, borderline personality disorder, ADHD, PTSD
What percentage of patients with depression or anxiety disorders have mood instability? (Marwaha et al, 2013)
40-60%
When does the incidence of mood instability peak? (Marwaha et al, 2013)
16-24
State some consequences of mood instability
Poor clinical outcomes, suicidal thoughts, increased use of healthcare services, self-harm, addiction
State the 2 traditional ways of measuring mood instability
Self-report scales of trait constructs and clinician-rated assessments
Give a disadvantage of self-report scales for mood instability
They are retrospective, and hence can be affected by memory biases
Describe the True Colours system for rating mood instability
Patients are sent a weekly email or text-reminder to self-report their symptoms using mood rating scales. Patients are then sent mood graphs so that they can understand fluctuations in their mood, and how those correlate with other symptoms (e.g. lack of sleep)
Describe how the MoodZoom app could differentiate between borderline personality disorder and bipolar disorder (Tsanas et al, 2016)
Borderline personality disorder caused greater overall variability and more irritability than bipolar disorder
Give 2 advantages of app-based mood monitoring (Scwartz et al, 2016)
Collects more data so more sophisticated mathematical models can be applied, more convenient and user-friendly than conventional questionnaires
Give a disadvantage of app-based mood monitoring (Faurholt-Jepsen et al, 2016)
While it seems to be valid in depression, it may not be in mania
Describe the emotional processing biases in bipolar disorder
Patients have negative memory biases, and prospectively perceive greater instability in their depressive and manic symptoms
Describe the neural correlate of emotional processing biases in bipolar disorder
Patients have abnormalities in reciprocal connectivity between the amygdala and other areas of the brain - increased connectivity between the ventromedial prefrontal cortex and amygdala, but decreased connectivity between the anterior cingulate cortex and amygdala
Describe the difference in brain activity between bipolar disorder patients and healthy controls during emotion processing
Inferior frontal cortex activity is less in bipolar disorder patients than healthy controls, but anterior cingulate cortex activity increases
Name 2 brain networks which are dysfunctional in bipolar disorder
Central executive network (involved in functional control) and salience network (involved in emotion regulation)