PSYC 336 Exam Flashcards
global burden of depression
“common cold” of mental disorders
so common
more costly than some medical disorders
276 mill people- crossculturally; twice as many women
epidemiology of depression
lifetime prevalence 17%
accounts for 70% of suicides
increases suicide rate 4 fold
major depressive disorder criteria
5+ symptoms present for at least 2 weeks
1 has to be either depressed mood or loss of interest
- depressed mood
- loss of interest/pleasure (anhedonia)
- change in appetite and/or weight
- insomnia or hypersomnia
- psychomotor agitation or retardation
- fatigue or loss of energy
- concentration problems and/or indecisiveness
- worthlessness or guilt
- suicidal ideation, intent, or action
huge heterogeneity of symptoms, presents challenge for developing etiology model and treatment models
“depression” in the global south
DSM criteria based on the manifestation of depression in area of the world where only 10% of world’s population lives
manifests differently in other cultures
Kufungisisa in Zimbawe - “thinking too much”
‘tension’ in India- somatic symptoms (ex. headaches)
Depression course (and draw them)
episodic (70-80%)
- 50% one (swoop)
- 50% multiple episodes
persistent (20-30%)
- persistent MDD (persistent at least to years)
- “double depression” (always feeling some depression), currently in episode
- “dysthymia” (chronic minor depression)
- “double depression” not currently in episode
single lifetime episode depression (SLEDs)
the lifetime course of 50% of those with episodic depression
should it be treated differently? maybe not; shouldn’t give $ treatments unnecessarily, better treatment if identified
depression is a multietiological disorder
SLEDS
- life circumstances
PERSISTENT
- underlying vulnerability
ACES
questionnaire; higher score associated with worse outcomes
building a depression model (draw and explain)
look at ipad
relation of early life stress to the onset of depression and anxiety disorders
review on slides ** make sure correct in notes **
takeaway: emotional abuse looks differently when it’s moms vs dads and who the kid is
relation of child maltreatment to severity of depression
those with a child maltreatment history and major depression have:
- younger age at onset
- poorer premorbid functioning
- greater severity of symptoms
- more persistent or recurrent coure
- more treatment resistance
- higher comorbidities
** emotional and sexual abuse are strongest predictors
resilience to early life stress
4 year longitudinal study of high schoolers at risk for dropout
- violence exposure and family conflict were strong risk factors for increasing depression over time
- support from mother significantly buffered these effects and was associated with lowering of depression of time
eisman 2015
Dr Cleopatra Caldwell
not everyone who experiences early life stress develops depression
the cognitive model of depression
the manner in which an event or stimulus is appraised or evaluated determines the type, intensity, and persistence of the experienced emotion
it’s not the stimulus itself that causes the response; it’s the manner it’s appraised/thoughts about it that causes the response
S > R
Dr Aaron T Beck (beck)
famous, revolutionized field of psych
was a freudian psychologist where there was a focus of S>R behaviour
but Beck was looking at what happened between S >R in the mind
***Beck says that cognitions determine the type, intensity etc of our emotions
levels of depressotypic cognition
AUTOMATIC THOUGHTS
(“she doesn’t like me”)
- highest level of cognition
- conscious
- running commentary in mind
- not necessarily negative
- cog theory- get ppl to be aware and evaluate accuracy of thoughts
INTERMEDIARY BELIEFS / ASSUMPTIONS
(“if someone gets close to me, they’ll reject me”)
CORE BELIEFS / SCHEMA
(“i’m unloveable”)
cognitive schemas
hypothetical structures containing the stored representation of beliefs that are abstracted from sensory experiences
- guide the selection, encoding, organization, storage and retrieval of information
- we have schemas of things we’ve experienced in life which guide how we approach new situations
depressotypic schemas
depressotypic schemas
enduring, rigid, and complex negative beliefs about the self, personal world and future that are resistant to change despite the presentation of disconfirming information
enduring- persists despite other experiences
rigid- hard to argue against
complex- everything wrapped up into complex bundle
resistant to change
does negative cognition cause depression (study, explain findings and how they did it)
temple-wisconsin project (Alloy 2006)
1st year students given measures of negative cognitive schema content and negative cognitive style - rumination
students with no history of depression were divided into groups and followed for 4 years
- high cog risk
- low cog risk
high risk more likely to develop major depression as well as experiencing subthreshold symptoms
high risk also predicted recurrence
findings specific to depression, not anxiety disorder
vulnerability model: early life stress affects the development of the HPA axis
purpose of the HPA axis is to release cortisol and other neurochemicals to enable fight or flight during acute life threatening events
goal is to release cortisol but then shut off when the threat is gone
it’s not developed to deal with chronic “human made” stressors
early life stressors can tune the HPA axis to become more sensitive; affects development of the HPA axis
cortisol kills brain cells: glucocorticoid toxicity model
hypocampus: hold short term memories and transfer them to long term; emotional processes, including anxiety and avoidance behaviours
amygdala: links emotions to many other brain abilities, especially memories, learning and sensations
Dr McEwen
the cortisol that’s released kills brain cells particularly in the hippocampus and amygdala
consequences of cortisol toxicity
smaller amygdala and hippocampal volume
disrupted connectivity between amygdala and hippocampus and the cortex
- rumination: when there’s not as much connectivity there’s repetitive rumination bc frontal cortex isn’t dampening it
- impaired extinction of painful memories: painful memories consisting, harder to integrate
- emotional dysregulation: problems with control
