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

1
Q

Define mood instability

A

Rapid oscillations of intense affect, with difficulty in regulating these oscillations or their behavioural consequences

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2
Q

Name at least 3 disorders which feature mood instability

A

Bipolar disorder, borderline personality disorder, ADHD, PTSD

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3
Q

What percentage of patients with depression or anxiety disorders have mood instability? (Marwaha et al, 2013)

A

40-60%

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4
Q

When does the incidence of mood instability peak? (Marwaha et al, 2013)

A

16-24

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5
Q

State some consequences of mood instability

A

Poor clinical outcomes, suicidal thoughts, increased use of healthcare services, self-harm, addiction

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6
Q

State the 2 traditional ways of measuring mood instability

A

Self-report scales of trait constructs and clinician-rated assessments

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7
Q

Give a disadvantage of self-report scales for mood instability

A

They are retrospective, and hence can be affected by memory biases

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8
Q

Describe the True Colours system for rating mood instability

A

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)

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9
Q

Describe how the MoodZoom app could differentiate between borderline personality disorder and bipolar disorder (Tsanas et al, 2016)

A

Borderline personality disorder caused greater overall variability and more irritability than bipolar disorder

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10
Q

Give 2 advantages of app-based mood monitoring (Scwartz et al, 2016)

A

Collects more data so more sophisticated mathematical models can be applied, more convenient and user-friendly than conventional questionnaires

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11
Q

Give a disadvantage of app-based mood monitoring (Faurholt-Jepsen et al, 2016)

A

While it seems to be valid in depression, it may not be in mania

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12
Q

Describe the emotional processing biases in bipolar disorder

A

Patients have negative memory biases, and prospectively perceive greater instability in their depressive and manic symptoms

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13
Q

Describe the neural correlate of emotional processing biases in bipolar disorder

A

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

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14
Q

Describe the difference in brain activity between bipolar disorder patients and healthy controls during emotion processing

A

Inferior frontal cortex activity is less in bipolar disorder patients than healthy controls, but anterior cingulate cortex activity increases

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15
Q

Name 2 brain networks which are dysfunctional in bipolar disorder

A

Central executive network (involved in functional control) and salience network (involved in emotion regulation)

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16
Q

Describe the relationship between affective lability and brain activity in those at-risk of developing bipolar disorder (Bertocci et al, 2017)

A

Worsening affective lability is associated with increased amygdala and ventrolateral prefrontal cortex activity

17
Q

Define mental imagery

A

Perceptual information accessed from memory, allowing ‘seeing with the mind’s eye’ or ‘hearing with the mind’s ear’ etc.

18
Q

Describe the relationship between mental imagery and depression

A

Depression is associated with negative intrusive images of past events and a lack of positive mental imagery

19
Q

Describe the relationship between suicide and mental imagery

A

Suicide can be associated with flash-forward images of the act of suicide or the aftermath (e.g. seeing others at one’s funeral)

20
Q

Describe the relationship between social anxiety and mental imagery

A

It features embarrassing mental images, such as seeing oneself from the outside bright red and sweaty

21
Q

Describe the relationship between bipolar disorder and mental imagery (Bonsall et al, 2012)

A

Bipolar disorder is associated with higher levels of intrusive negative prospective imagery, and higher levels of intrusive future imagery correlating with higher levels of anxiety and depression in unstable bipolar disorder