T4: Lecture 3 Flashcards
What is the diagnostic criteria for Major Depressive Episode (MDE)?
- FIVE or more of the following in a TWO WEEK PERIOD
- Must include depressed mood OR loss of interest
1. depressed mood most of the day
2. diminished interest/pleasure in most activities
3. significant weight loss/gain (>5% change)
4. insomnia or hypersomnia
5. psychomotor agitation retardation (difficulty controlling energy levels)
6. Fatigue or loss of energy
7. Feelings of worthlessness/excessive guilt
8. Diminished ability to think/concentrate, indecisive
9. Recurrent thoughts of death/suicidal ideation/plan/attempt
-Cannot be due to substance/medical condition
What are the two depressive disorders in the DSM-5?
- Major Depressive Disorder (MDD)
2. Persistent Depressive Disorder (Dysthymia)
What is the prevalence of these disorders?
- Common
- MDD more likely in women than men
- In PDD the gender difference isn’t as big
- No difference between Maori and Pakeha
What are the two Biochemical factors in depression?
- Neurotransmitters (receptor sensitivity)
2. Hormones (dysregulation)
What is norepinephrine linked to?
To energy and reward seeking
What is serotonin linked to?
To mood, memory, concentration, sleep
What is dopamine linked to?
To rewarding stimuli, pleasure seeking
(hormones) what is hypothalamic-pituitary-adrenal (HPA) axis linked to?
Stress
What is the pathway of interpreting and reacting to stress in the brain?
Stressor->amygdala (perceives stress) ->HPA ->Cortisol
What are the three brain abnormalities associated with depression?
- Emotions projecting into the prefrontal cortex
- Emotional regulation system
- Left frontal hemisphere Asymmetry
Where does the limbic system project into?
The prefrontal cortex
-Seritonergic pathway
What are the four emotional regulation systems?
- Amygdala (emotional importance)
- Subgenual anterior cingulate (emotional regulation)
- Dorsolateral prefrontal cortex (emotional regulation)
- Hippocampus ( emotional regulation)
What happens in Left Frontal Hemisphere Asymmetry?
The right side of the frontal lobe is more activated than the left
-The left side is associated with positive thought and relaxation
What is life stress?
Stress is the relationship between a person and environment thats APPRAISED by the person as taking/exceeding resources, or endangering their well being
What is the Diathesis-Stress model?
That it’s not just stress, but also individuals are more biologically vulnerable
What do Cognitive Theories say can attribute to depression?
Negative thoughts and beliefs -> depression
What did Aaron Beck say about individuals with depression?
That individuals have a set way to interpret negative events that lead to depressive symptoms
What is hopelessness in terms of depression?
That people have a thinking style that MAINTAINS the depressive symptoms
What is rumination in terms of depression?
Individuals continuously thinking over events negatively which reinforces the negative thoughts
What does Aaron Beck’s negative triad consist of?
Having negative beliefs about
- Self
- World
- Future
In Aaron Beck’s negative thought triad, what are some of the thought distortions?
- Automatic negative thinking way:
1. Should-ing
2. Over-generalisation
3. Unfair comparisons
4. Discounting positives
5. Black/white thinking
Beck’s Cognitive Therapy includes four phases, what are they?
- Increase activities that elevate mood
- Challenge automatic thoughts
- Identify negative thinking and biases
- Change primary attitudes/schemas
What do anti-depressent drugs target?
Neurotransmitter pathways
What 3 drugs are commonly used as anti-depressents?
- MAD (monoamine oxidase) inhibitors: MAD breaks down neurotransmitters by inhibiting this means more neurotransmitters
- Tricyclics: affects serotonin/norepinephrine. Large side effects
- Selective Serotonin Re-uptake Inhibitors: also affects serotonin/norepinephrine. Lighter side effects
