Second exam preparation Flashcards
What is mood?
An enduring state of emotionality
What is depression characterized by?
Impairments of emotional states, motivation, fucntioning, and cognition
What do the characteristics of depression mean?
Like the impairments of emotional state, motivation etc.
- Emotional state: sad, tearful, irratible, jumpy, and hopeless
- Motivation: unmotivated, reduced social activity, anhedonia
- Functioning: slower movement/speech,
changes in sleep & appetite, less efficient - Cognition: difficulty concentrating, feelings
of inadequacy & guilt, thoughts of worthlessness
What are the characteristics of MANIA?
The states are the same of depression but impair differently.
- Emotional State: extreme energy, inflated self-esteem, grandoisty, irritability
- Motivation: Need constant excitment & activities, extrememe motivation
- Fucntioning: Little/no sleep, rapid speech & movemennt, risky behaviour
- Cognition: Lack of planning/judgement, racing thoughts, distractibility.
What are the three different structures of mood and what do they mean?
- Unipolar: mood remains at one area of the mood chart –> depression or mania
- Bipolar: mood changes between areas of the mood chart –> depression to mania
- Mixed: mix of symptoms across areas of mood chart.
Example of the mixed: depression with some features of mania or vise versa.
What is the diagnosis of major depressive disorder?
How many symptoms you need and how long you need to have them for.
- You need 5+ symptoms during a 2 week period REP change from before
- Symptoms must include 1 depressed mood or loss of interest AND/OR anhedonia
1 depressed mood or loss of interest + 4 of the other symptoms making 5.
What is the general coruse that Major depressive episodes take?
Like the trjaectory, does it reoccur, episodic etc.
- Tends to be episodic and reccurent.
- Dips down tot he dysthymia and back to base level
Whats the prevelance of major depressive disorder?
% in the population, onset, more common in men or women etc.
- 5.4 % if the population
- 2X more common in women
- Average onset in mid-late 20s
- Probably increasing in adolesents
What is the persistent depressive mood disorder (PDD) diagnosis?
How many symptoms etc.
- Depressed mood for atleast 2 years
- Atleast 2 of the symptoms
- Cant have been without A&B symptoms for 2+ months in the 2-year period
- Can also meet criteria for MDD
- Has never had a manor or hypomanic episode
How do MDD and PDD compare
- PDD is milder, but more chronic than MDD
- Median duration of PDD is 5 years
- PDD can last 20 - 30 years
- PDD is less repsonsive to treatment
- PDD higher risk of suicide
- PFF the chronciity is related to hopelessness
What is a depressive episode?
- Common in bipolar l, but not required. FIX THIS CARD
What criteria of Premenstrual Dysphoric Disoder (PMDD) do you need to meet for diagnosis
Dont forget onset
- Must have 5 symptoms
- Symptoms are presnet in week before menses
- Must have 1+ of difficulty concentrating, fatigue/low energy; apetite changes; sleep changes; feeling overwhelmed or out-of-control; physical symptoms.
- Onset –> absent or minimal
What are the diagnostic criteria for Disruptive mood dysregulation (DMDD)
Time of diagnosis, # of outbursts, occuring for atleast __ months etc.
- Only diagnosed between 6 – 18 years of age (with onset before 10 years)
- Severe recurrent temper outbursts (verbal or physical) that are out of proportion to event/situation
- Outbursts are not developmentally appropriate
- Avg 3+ outbursts per week
- Outbursts occur in at least 2 settings/week
- Occuring for 12+ months with no 3+ month __
What is a manic episode?
Dont forget symptoms
- Distinct period of abnormal and peristent elevated, expansive or irritable mood + increased activity, energy.
- Lasts atleast 1 week, most of the day, nearly every day
- 3+ of the following are present: inflated self esteem or grandoisty, decreased need for sleep, more tlakitive, pressured speech, flight ideas, racing thoughts, distractibility, icnreased in goal-directed activity, and excessive involvement in risky activities.
Basically, on crack
What is a hypomanic episode? What are its symptoms? What are the 2 key differences from a manic episode?
- Distinct period of abnormally & persistently elevated, expansive, or irritable mood + Increased activity, energy
- Lasts at least 4 days, most of the day nearly every day
- 3+ of following symptoms: inflated self esteem or grandoisty, decreased need for sleep, more tlakitive, pressured speech, flight ideas, racing thoughts, distractibility, icnreased in goal-directed activity, and excessive involvement in risky activities.
- Key differences from manic episode (1) Lasts 4 days and (2) episode is not severe enough to cause impairment in social or occupational fucntioning.
How is it different from manic episode?
What is the diagnostic criteria for Biopolar disorder l?
- Criteria met for 1 manic episode
- Occurance of manic and depressive episode is not better explanied by schizoaffective disoder, schizophrenia, shcizophreniform disorder, delusional disorder, psychotic disoder
Understand difference between Bipolar ll disoder
What is the diagnostic criteria for Bipolar ll disorder?
- Met criteria for 1 hypomanic episode & and 1 major depressive episode
- Never met criteria for manic episode
- Major depressive episode OR frequenct changes between depression & hypomania cause distress or impairment.
What are the specifiers for Bipolar l disorder?
- With anxious distress
- Mxied features
- Rapid cycling
- Melancholic features
- Mood congruent psychotic features
- Mood incongruent psychotic features
- Catatonia
- Peripartum onset
- Seasonal pattern
What are the speicifiers of Bipolar ll
- With anxious distress
- Mxied features
- Rapid cycling
- Mood congruent psychotic features
- Mood incongruent psychotic features
- Catatonia
- Peripartum onset
- Seasonal pattern
Meloncholic features in not present here, but is for bipolar l
What are the bipolar disoder specifiers?
This is more general to both disorders
- Mixed features: MD or manic episode having some symptoms from the opposite polairty
- Rapid cycling: Moving quickly in and out of depressive and manic episodes; at least four manic or depressive mood episodes within a year
What is criteria for cyclothymic disorder?
- 2 years, serveral periods of, hypomania symptoms that don’t criteria for full hypomanic disoder; depressive symptoms that don’t meet criteria for full major depressive episode
- Depressive or hypomania symtoms present at least 1/2 of the time during 2-year period
- No 2+ month period WITHOUT symptoms
- Have met criteria for manic, hypomanic, or depressive episodes.
What is the chronic flucutation in mood for cyclothymic disoder?
- Rarely, if ever, euthymic
- Can look like mood swings, but more intense and persistent.
Your mood is constanly going from a dysthymia and hypomania mood state
More Bipolar Disorder Specifiers
IDK why she has two slides bruh for this
- Anxious distress
- 2+ symptoms fo majority of days: keyed up or tense, unusually restless, diffulty concentrating becuase of worry, fear somthing awful may happen, feeling they may lose control of themselves.
Whats overall lifespan of mood disorders?
Preveleance of mood disorders tend to deline with age
How are mood disorders presented in children? What about in terms of specific diagnosises?
- Irratibility, agression
- More focus on physical/behavioural aspects due to difficulty expressing thoughts and moods/feelings
- Dysthymia > MDD in children
- MDD > dysthymia in adlensence/adults
How are mood disorders with adults?
- More diffcicult to diagnose
- No diff in rates betwene men and women
- More prevelent in folks in nursing homes (18-20%)
- Contributes to physical disease and/or culture
What are some genetic factors of mood disorders?
Rates of mood disorders, % of hertibility etc.
- Rates of mood disoders approx 2-3X higher in people with family history
- ~37% heritible
- Evidence for joint hertibility for anxiety and depression. <– suggests underlying joint vulnerability, or predisposition, for symptoms of anxiety & depression.
What is the perimissive hypothesis?
Argues that low levels of serotonin allow other neurotransmitter systems to become dysregulated.
What are the main functions of serotonin, norepinephrine, and dopamine?
- Serotonin regulates moods, and behaviours.
- Dopamine regulates reward processing & anticipation; anhedonia
- Norepeinpehrine regulates energy and stress reactions; sleep/energy.
Serotonin would
What neurotransmitters would be associated with each disoder we covered?
What are the psychological factors for mood disorders?
- Stressful life events; jobs, finances, single parenting, traumtic experinces
- Factors affecting stressful events: Interpretation, ability to cope, avavible resources.
What are the 6 cognitive distortions and depression?
- Seeing events as either all good or all bad; black and white
- Focusing only on negative details of experience
- Forming negative view of events, despite lack of evidence
- believing that negative events will occur again (more broad)
- Denying accomplishments
- Eaggerating the importance if your flaws or mistakes.
Examples of each
1. I got a B+, thats basically an F
2. Only seeing the room for improvements comments when you did really well
3. Mind reading
4. “I didn’t get this job, all my other apllications will be rejected.”
5. “Anyone could’ve done that”
6. Forgetting something minor = world is ending
Social factors
Mood disorders
1Romantic relationships; dissatisfaction
2. Gender; 70% with MDD and PDD are women
3. Social support; rate of depression is 80% for people who live alone; lack of social suppo. rt
What are the medications used for mood disorders
- Mood disoders - antidepressants include –> tricyclics, MAOI’s, and SSRI’s
- Bipolar disorder - mood stabilizer –> lithium
Hint: ECT and TMS
What are biological therpay based treatments?
Which one is better?
Mood disorders
- Electroconclusive Therapy; controverisal, effective for serve mood disoders that havnt responded to other treatment
- Transcranial Magnetic Stimulation; newer than ECT, more precise and effective in treating depression.
Transcranial would be better for the day to day cases.
What behavioural activation?
What does CBT focus on in treating depression? Give examples.
- Different targets like depressionogenic thoughts, core beliefs, behavioural goals.
- Doesn’t use exposure –> more about behavioural activation & maybe some behavioural expeirments depending on diffuclties.
What does Interpersonal Therapy (IPT) focus on in depression?
- Focuses on resolving problems in existing relationship
- Learning how to form new interperosnal realtionships.
- Stages –> 1 Negotiation, 2 impasse stage,and 3 resolution stage.
What does Cognitive Behavioural Therapy (CBT) focus on in Biopolar disorder?
- Psychoeducation
- Learn to identify/target unhellpful thoughts.
- Learning skills
- Intervention/prevention related to future episodes
- Example –>
- Example –> depressive thoughts during MDD episode, overly positive thoughts during mania
- Example –> coping, stress-reduction, social conlfict management, problem solving etc.
- Sleep management, medication adherence, learning early warning signs and intervention options.
What does Interpersonal and social rtythm therapy (IPSRT) focus on?
- Focuses on regulating circadian ryhthms
- Techniques include: Regulate eating/sleeping cycles, set and maintain daily schedules, more effective coping skills for stressful events & events interpersonal
What does Family focused Treatment (FFT) focus on for Bipolar disorder?
- Includes all immediate family members
- techniques include: Psychoeducation, family members taught to idenitfy early warning signs & how to respond
- Family taught effective coping responses
- Teach effective communication & problem solving skills
- Resolve family conflicts.
What is considered double depression?
When someone mets the criteria for major episode and perisistent despressive disorder.
Whats the difference beween mood congruent and in-congruent symptoms for depressive disorders? Provide exmaples.
- Mood congruent means the symptoms are directly related to depression. Examples –> halluncitions, somatic delusions, and auditory hallucinations
- In-congruent mood would be symptoms that don’t relate to the low mood state like delusions of grandeur, where an individual can feel like they can do anything.
Delusions of grandeur would be congruent with a manic episode.
What is the seasonal affective disorder (SAD)?
- Depressed episodes that manifest during specific times of the year for at least 2+ years.
- Research has found that depression varies from winter to summer in that during the winter people usually sleep more and gain weight.
- Adults (25+) showed variation only for sleeping and eating while youth (12-24) showed variation in feeling lack of interest, pleasure, concentration and feeling like a failure.
What is integrated grief?
Acute grief that usually follows the passing of close realtions but comes to terms with it
What is psycholoigcal autopsy?
psychological autopsy is the process of determining whether a deceased person has died as the result of a suicide
What are the other two rapid cycling conditions?
- Ultra rapid cycling, length of days to weeks
- Ultra-ultra rapid cycling, cycle length is less than 24 hours.
Rapid cycling is switching from depressive mood to mania. So this means that the shorter the cycle, the more they’re swtching between moods.
what is the average onset for bipolar l and ll disorder?
- Bipolar l –> 15 - 18
- Biopolar ll –> 19 - 22
What’s the difference of onset for MDD and bipolar disoder?
- Bipolar disorders have an acute onset (more sudden)
What age group is MDD and PDD more prevelent in?
- PDD is more prevelent than MDD in children, but switches as they get older.
- MDD is prevelent in adolensents than PDD
MDD is most common in females
Whats the connection between mania and children under the age of 9?
- More irratability and mood swings
- Symptoms always chronic rather than episodic in adults
What did research by Berenbuam find in people with affective flattening symptom?
Chapter 14
- Found that people with this symptom don’t lack emotions, they just have trouble expressing it.
What did Fahim and researchers find with people with affective flatting symptom of shchizophrenia.
Chapter 14
- Correct emotion was less instense than control group.
What is a shared psychotic disorder? (folie a deux)
Chapter 14
- Condiiton in which an individual will develop delusions becuase of a close realtionship with an individual.
What did the family studies on schizophrenia find?
Chapter 14
- The more severe a parents schizophrenic disorder was, the more likley their children were to develop it.
- People inherit a generla disposition that is similar or diffferent to your parents
- Risk of shchizophrenia depends on how many genes they share with the shizophrenic individual.
- 48% if it affected a monozygotic twin and 17% with a fraternal twin.
What did the twin studies find
Chapter 14
- 4 twins had same predisposition but onset, severeity, presentation and level of impairment differed.
WHat did the adoption study find in the context of shizophrenia?
What model would best represnt the reduced risk?
Chapter 14
- Children adopted had 22% of developing schizophrenia if they bio-mother had it
- Recued risk for healthy homes –> gene-environmental model
what did the offspring of twins study find
Chapter 14
- People can be carriers of various disorders without it being a dominant gene.
What did the linkage and assocation study find?
Chapter 14 Linkage and associtation studies heading
- Chromosome 8, 6, and 22 make someone more suspectable to devleoping schizophrenia
Chromosome 22 (catecholamine omethyl transferase) is cool becuase it helps dopamine metabolism, which can help explain etiology of schizophrenia.
What are the main three findings of dopamine affects on schizophrenia.
Chapter 14
- Less stimulation of the dopamine recptors of the prefrontal –> negative symptoms.
- Exessive stimulation of the striatal (part of the basal ganglia –> motor movement).
- Less stimulation of prefrontal receptors from glutamate
What did the brain strcuture find in relation to schizophrenia
Chapter 14
- Enlarged ventricles
- Hypofrontality –> Less activitation of the frontal lobe
Heinza Lehmann
Chapter 14
First to introduce neurleptics –> treatment for schizophrenia
What are extra pyrimidal symptoms
Chapter 14 Psychosis
Occur from not taking antipsychotic medication that result in parkisons like symptoms
What have recent studies said about serotonin and dopamine in relation to psychosis symptoms?
Related to positive symptoms.
Emil Kraeplin
came up with the description of schizophrenia