Task 6 Flashcards

1
Q

What are the two Uni polar dissorder ?

A
  • Major depressive

- dysthymic disorder

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2
Q

What are the DSM 5 criteria for major depressive dissorder ?

A
  • Five or more symptoms
  • 2 weeks
  • either depressed mood or loss of interest or pleasure MUST BE PRESENT
  • there has never been a manic or hypomanic episode
  • no substance
  • not better explained by other disorder
  • impairment of social functioning and distress
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3
Q

What are the DSM 5 Symptoms ?

A
  • Depressed mood most of the day, nearly every day
  • Diminished interest/pleasure
  • Significant weight loss/gai
  • Insomania or hypersomnia
  • Psychomotor agitation (aufrgung)
  • loss of energy
  • Feelings of worthlessness
  • Diminished ability to think or concentrate
  • Recurrent thoughts of death
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4
Q

What is meant by anhedonia ?

A
  • Lost interest in everything in life
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5
Q

Define dysthymic disorder:

A
  • Symptoms for at least 2 years (for children it’s 1 year)
  • 2 or more present
  • poor appetite, insomnia/hypersomnia, low energy/fatigue, low self-esteem, poor concentration, hopelessness
  • More chronic but less sever
  • depressive mood
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6
Q

What is meant with seasonal affective disorder ?

A
  • least two years in which major depressive episodes occur during one season of the year (usually the winter season) -> vanish after season is over
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7
Q

What is meant by peripartum onset disorder ?

A
  • onset of major depressive episode during pregnancy or in the 4 weeks following delivery
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8
Q

What is meant by Premenstrual dysmorphic disorder ?

A
  • women who frequently have significant increase in distress symptoms prior to menstruation
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9
Q

What in general is meant by unipolar disorder ?

A
  • experiencing only periods of depression and not mania (craziness)
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10
Q

What is meant by double depression ?

A
  • Dysthymic disorder and major depression
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11
Q

What is the prevalance of major depressive disorder ?

A
  • increasing
  • 16% in US
  • 2 times more in woman
  • 18- to 29-year olds are at the highest risk
  • mainly caused by other disorder
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12
Q

What are the comorbidity disorders of major depressive disorder ?

A

-substance abuse and anxiety disorder

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13
Q

How do genetic theories explain major depression ?

A
  • 1st degree relatives 2 to 3 times more likely
  • Moderate heritability (30-40%)
  • Stronger genetic base for early onset depression
  • Serotonin transporter gene
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14
Q

How do neurotransmitter dysfunction explain major depression ?

A
  • Monoamine neurotransmitters: norepinephrine, serotonin, dopamine in limbic system have been associated with depression -> low
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15
Q

How do brain abnorbilities explain major depression ?

A
  • PFC: reduced activity & grey matter (esp. left side which is particularly involved in goal-orientation)
  • Anterior cingulate: overactivity
  • Hippocampus: smaller volume & lower activity
  • Amygdala: large & increased activity
  • Many receptors for cortisol which is chronically adjusted !
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16
Q

How does the Hypothalamic-Pituitary-Adrenal explain depression ?

A
  • HPA
    Step 1: hypothalamus releases CRH (corticotropin-releasing hormone) onto receptors of anterior pituitary
    Step 2 AP: releases corticotropin into bloodstream which stimulates adrenal cortex
    Step 3 AC releases cortisol into bloodstream which helps body fight the stressor or flee from it
    Steo 4: hypothalamus has cortisol receptors that detect the increased levels & decreases CRH
    -> but the hippocampus does not work properly by depressed people
    and u also have and increased pituitary gland which leads to increase in cortisol !!
    -> More a trait then state !
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17
Q

How do behavioural theories expalin major depression ?

A
  1. +/- 80% of depression cases report a negative life event prior to the onset
  2. Life stress leads to depression because it reduces the positive reinforcers
  3. Pattern esp. likely for people with poor social skills
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18
Q

What is meant by the learned helpessness theory ?

A
  • an uncontrollable neagtive event is most likely to lead to depression
  • This leads people to think that the sitch isn’t controllable (which is wrong)
  • > explains abused partnership
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19
Q

How can cognitive theories explain major depression ?

A

People have:

  • Negative cognitive triad/self schema (Beck)
  • Hopelessness depression
  • Ruminative response style theory
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20
Q

What is meant by Reformulated learned helplessness theory ?

A
  • people habitually explain negative events by causes that are internal, stable & global
  • tends to blame themselves for these negative events and expect to experience negative events in the future
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21
Q

What is meant by negative cognitive self schema ?

A
  • people have negative views of themselves
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22
Q

What is meant by Hoplessness depression ?

A
  • people make pessimistic attributions for the most important events in their lives & think they have no way of coping with the consequences
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23
Q

What is meant by ruminative response style theory ?

A
  • focus on how they feel and , identify many possible causes without doing anything about them & continue to ruminate about their depression
24
Q

What are the 4 biases regarding major depression ?

A
  • biased attention (can not disengange of them)
  • negative interpretation bias
  • memory bias (enhanced memory for negative relative to positive information)
  • cognitive control bias (can’t inhbit negative material from entering WM & cant remove previous negative material)
25
Q

How do the interpersonal theories explain major depression ?

A
  • Chronic conflict in their relationships
  • Heightened need for approval & expression of support from others
  • Rejection sensitivity
26
Q

What are some cultural differences regarding depression ?

A
  • More recent generations at higher risk
  • desintegration of family and high expectations of self
  • Men compensate with alc and woman with rummination
  • Cultures with more poverty(por), unemployment & discrimination have higher rates
27
Q

What are the DSM 5 criterias for bipolar disorder ?

A
  • delusion
  • 1 week
  • abnormally & or irritable mood AND abnormally & persistently increased goal-directed activity/energy
  • 3 or more syptoms present
  • impair social functioning / or hospitalization
  • not to substance abuse
28
Q

What is the defintion of bipolar disorder ?

A
  • characterized by changes from manic episodes to depressive episodes
29
Q

What is meant by manic disorder ?

A
  • above average regarding enthusiasm mood and general activity
30
Q

What are the symptoms of the DSM 5 of bipolar dissorder ?

A
  • more) self-esteem or grandiosity
  • decreased sleep
  • more talkative
  • Flight of ideas
  • Distractibility
  • Increase in goal-directed activity
  • active involvment in painful activites
31
Q

What are the criterias for bipolar 1

A

All of the symptoms of mania are present and can be preceded or followed up by hypomania and depressive episode (but are not necessary)

32
Q

What are the criterias for bipolar 2

A
  • You do not have the mania symptoms but u have depressive and hypomania
  • Mania is not present at all !
33
Q

What is meant by hypomenia ?

A
  • 4 followed up days
  • not severe enough to interfere with daily functioning
  • no hallucinations
  • weakend form of mania
34
Q

What is meant by Cyclothymic disorder ?

A
  • less severe but more chronic form of bipolar disorder

- 2 years present

35
Q

What is meant byRapid cycling bipolar I/II disorder ?

A
  • four or more mood episodes that meet criteria for manic/hypomanic/major depressive episode within 1 year
36
Q

What is meant by disruptive mood dysregulation disorder (temper dysregulation disorder with dysphoria)

A
  • explains bipolar disorder for young kids
  • Childreen have more temper outburst
  • Must have at least 3 temper outbursts per week for at least 1 year in at least 2 settings
  • irritable or angry mood
37
Q

What are the prevalence of bipolar disorder ?

A
  • 1% World wide (bipolar 1 a bit better)
  • Onset usually in late adolescence/ early adulthood
  • Likelihood equal across cultures & genders
  • Only about 1 in 4 people will fully recover from symptoms
38
Q

How do gentic factor explain bipolar disorder ?

A
  • First degree relatives 5-10x higher rates

- highly inherited

39
Q

How do brain abnormalities explain bipolar disorder ?

A
  • Amygdala & PFC same as depression but not hippocampus
  • Basal ganglia: hypersensitivity to rewarding cues in environment
  • Striatum -> Dysregulation of dopamine system
  • PFC-basal ganglia-amygdala circuit
  • White matter abnormalities: bad communication between PFC & other areas
40
Q

What are the two phases regarding the straitum function in bipolar disorder ?

A
  • Manic phase: : inflexibly & excessively seek reward

- Depressive phase:highly insensitive to reward

41
Q

How does the psychsocial tehory explain bipolar disorder ?

A
  • > greater sensitvity to reward = mania

- greater sensitvity to punishment = Depression

42
Q

What is so special regarding the treatment of bipolar disorder ?

A
  • all treatment methods are equal besides the combination of drugs and psychotherapy
  • only 50/60% seek for treatment
43
Q

What are some drugs which help unipolar dissorder (major depression)

A
  • SSRIs and SSNRIs (best because leat amount of side effects)
  • Antidepressant drugs for at least 6 months
  • Bupropion (norepinephrine-dopamine reuptake inhibitor) goes along with SSRI to overcome sexual dysfunction
44
Q

What are some drugs which u should not take regarding unipolar disorder ?

A
  • Bad drugs with dangerous side effect : Tricyclic antidepressants and MAO-inhibitors (breakdown of the monoamine neurotransmitters )
45
Q

What are some drugs which help bipolar dissorder (mania disorder)

A
  • Lithium

- Atypical antipsychotic medications

46
Q

Explain the effects of Lithium:

A
  • reducing suicide risk
  • too much = toxic
  • Improving functioning of the intracellular processes
47
Q

Explain the effects of Atypical antipsychotic medications:

A
  • reduce functional levels of dopamine (in amygdala)

- more for mania

48
Q

What other major treatment options exist regarding bipolar disorder ?

A
  • Electroconvulsive Therapy
  • Brain Stimulation
  • Light Therapy
49
Q

Explain how electroconvulsive therapy works:

A
  • passing electrical current through the patient’s head
  • Decreases metabolic activity in several regions of the brain, incl. PFC & anterior cingulate
  • Mostly right side
50
Q

Explain how brain stimulation works on bipolar patients: (3 forms)

A
  • Repeated rTMS session: on left PFC cause low metabolic activity
  • Vagus nerve stimulation (VNS): increases activity in hypothalamus & amygdala
  • deep brain stimulation ( electrodes are implanted)
51
Q

For which particular disorer is light thearpy working out ?

A
  • SAD
  • Exposure to light in combination with cognitive therapy
  • normalises production of hormones & neurotransmitters
  • Melatonin down norepinephrine & serotonin up
52
Q

How does behavioural therapy treat bipolar disorder ?

A
  • 12 weeks

- Change interactions with environment to increase positive and decrease negative experiences & reinforcers

53
Q

How does CBT treat unipolar disorder ?

A
  1. Change negative thinking patterns
  2. develop skills for concrete problems in daily life
    - > tries to change attention and memory bias
    - > only for unipolar
    - > 6-12 weeks
54
Q

How does interpersonal therapy treat bipolar disorder ? Name 4 steps

A
  • Goal tries to change relationship with family members
  • Grieving (trauern): learn to face loss and move on
  • Interpersonal role disputes communicate better and only take choices which u can achieve
  • Role transitions = learn to forgett old roles and start accept new roles
  • interpersonal skills deficits: teach them social skills
55
Q

How does Interpersonal & Social Rhythm Therapy treat bipolar disorder ?

A
  • Combines interpersonal and behavioural therapy
  • teach advanced coping skill plus and better relationship skills
  • uses: Self-monitor patterns
56
Q

How does family focused therapy treat bipolar disorder ?

A
  • Reduce interpersonal stress within family by educating about disorder and training communication & problem-solving skills