Task 6 Flashcards
What are the two Uni polar dissorder ?
- Major depressive
- dysthymic disorder
What are the DSM 5 criteria for major depressive dissorder ?
- 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
What are the DSM 5 Symptoms ?
- 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
What is meant by anhedonia ?
- Lost interest in everything in life
Define dysthymic disorder:
- 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
What is meant with seasonal affective disorder ?
- least two years in which major depressive episodes occur during one season of the year (usually the winter season) -> vanish after season is over
What is meant by peripartum onset disorder ?
- onset of major depressive episode during pregnancy or in the 4 weeks following delivery
What is meant by Premenstrual dysmorphic disorder ?
- women who frequently have significant increase in distress symptoms prior to menstruation
What in general is meant by unipolar disorder ?
- experiencing only periods of depression and not mania (craziness)
What is meant by double depression ?
- Dysthymic disorder and major depression
What is the prevalance of major depressive disorder ?
- increasing
- 16% in US
- 2 times more in woman
- 18- to 29-year olds are at the highest risk
- mainly caused by other disorder
What are the comorbidity disorders of major depressive disorder ?
-substance abuse and anxiety disorder
How do genetic theories explain major depression ?
- 1st degree relatives 2 to 3 times more likely
- Moderate heritability (30-40%)
- Stronger genetic base for early onset depression
- Serotonin transporter gene
How do neurotransmitter dysfunction explain major depression ?
- Monoamine neurotransmitters: norepinephrine, serotonin, dopamine in limbic system have been associated with depression -> low
How do brain abnorbilities explain major depression ?
- 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 !
How does the Hypothalamic-Pituitary-Adrenal explain depression ?
- 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 !
How do behavioural theories expalin major depression ?
- +/- 80% of depression cases report a negative life event prior to the onset
- Life stress leads to depression because it reduces the positive reinforcers
- Pattern esp. likely for people with poor social skills
What is meant by the learned helpessness theory ?
- 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
How can cognitive theories explain major depression ?
People have:
- Negative cognitive triad/self schema (Beck)
- Hopelessness depression
- Ruminative response style theory
What is meant by Reformulated learned helplessness theory ?
- 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
What is meant by negative cognitive self schema ?
- people have negative views of themselves
What is meant by Hoplessness depression ?
- people make pessimistic attributions for the most important events in their lives & think they have no way of coping with the consequences
What is meant by ruminative response style theory ?
- focus on how they feel and , identify many possible causes without doing anything about them & continue to ruminate about their depression
What are the 4 biases regarding major depression ?
- 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)
How do the interpersonal theories explain major depression ?
- Chronic conflict in their relationships
- Heightened need for approval & expression of support from others
- Rejection sensitivity
What are some cultural differences regarding depression ?
- 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
What are the DSM 5 criterias for bipolar disorder ?
- 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
What is the defintion of bipolar disorder ?
- characterized by changes from manic episodes to depressive episodes
What is meant by manic disorder ?
- above average regarding enthusiasm mood and general activity
What are the symptoms of the DSM 5 of bipolar dissorder ?
- more) self-esteem or grandiosity
- decreased sleep
- more talkative
- Flight of ideas
- Distractibility
- Increase in goal-directed activity
- active involvment in painful activites
What are the criterias for bipolar 1
All of the symptoms of mania are present and can be preceded or followed up by hypomania and depressive episode (but are not necessary)
What are the criterias for bipolar 2
- You do not have the mania symptoms but u have depressive and hypomania
- Mania is not present at all !
What is meant by hypomenia ?
- 4 followed up days
- not severe enough to interfere with daily functioning
- no hallucinations
- weakend form of mania
What is meant by Cyclothymic disorder ?
- less severe but more chronic form of bipolar disorder
- 2 years present
What is meant byRapid cycling bipolar I/II disorder ?
- four or more mood episodes that meet criteria for manic/hypomanic/major depressive episode within 1 year
What is meant by disruptive mood dysregulation disorder (temper dysregulation disorder with dysphoria)
- 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
What are the prevalence of bipolar disorder ?
- 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
How do gentic factor explain bipolar disorder ?
- First degree relatives 5-10x higher rates
- highly inherited
How do brain abnormalities explain bipolar disorder ?
- 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
What are the two phases regarding the straitum function in bipolar disorder ?
- Manic phase: : inflexibly & excessively seek reward
- Depressive phase:highly insensitive to reward
How does the psychsocial tehory explain bipolar disorder ?
- > greater sensitvity to reward = mania
- greater sensitvity to punishment = Depression
What is so special regarding the treatment of bipolar disorder ?
- all treatment methods are equal besides the combination of drugs and psychotherapy
- only 50/60% seek for treatment
What are some drugs which help unipolar dissorder (major depression)
- 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
What are some drugs which u should not take regarding unipolar disorder ?
- Bad drugs with dangerous side effect : Tricyclic antidepressants and MAO-inhibitors (breakdown of the monoamine neurotransmitters )
What are some drugs which help bipolar dissorder (mania disorder)
- Lithium
- Atypical antipsychotic medications
Explain the effects of Lithium:
- reducing suicide risk
- too much = toxic
- Improving functioning of the intracellular processes
Explain the effects of Atypical antipsychotic medications:
- reduce functional levels of dopamine (in amygdala)
- more for mania
What other major treatment options exist regarding bipolar disorder ?
- Electroconvulsive Therapy
- Brain Stimulation
- Light Therapy
Explain how electroconvulsive therapy works:
- passing electrical current through the patient’s head
- Decreases metabolic activity in several regions of the brain, incl. PFC & anterior cingulate
- Mostly right side
Explain how brain stimulation works on bipolar patients: (3 forms)
- 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)
For which particular disorer is light thearpy working out ?
- SAD
- Exposure to light in combination with cognitive therapy
- normalises production of hormones & neurotransmitters
- Melatonin down norepinephrine & serotonin up
How does behavioural therapy treat bipolar disorder ?
- 12 weeks
- Change interactions with environment to increase positive and decrease negative experiences & reinforcers
How does CBT treat unipolar disorder ?
- Change negative thinking patterns
- develop skills for concrete problems in daily life
- > tries to change attention and memory bias
- > only for unipolar
- > 6-12 weeks
How does interpersonal therapy treat bipolar disorder ? Name 4 steps
- 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
How does Interpersonal & Social Rhythm Therapy treat bipolar disorder ?
- Combines interpersonal and behavioural therapy
- teach advanced coping skill plus and better relationship skills
- uses: Self-monitor patterns
How does family focused therapy treat bipolar disorder ?
- Reduce interpersonal stress within family by educating about disorder and training communication & problem-solving skills
