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CU: Abnormal Psychology > Test 4: Mood Disorders and Suicide > Flashcards

Test 4: Mood Disorders and Suicide Flashcards

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1
Q

What is depression?

A
  • feeling of sadness/dejection
  • resulting in increasingly pessimistic outlook on life
  • including mental dullness
  • seen in poor concentration & breakdown in reasoning
  • accompanied by social withdrawal, decreased motivation, decreased drive for intimacy, sleep disturbances, increased anxiety, edginess, and critical thoughts
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2
Q

What are examples of people in the Scriptures of depression?

A
  • David lost hope
  • Jonah wanted to die
  • Peter wept bitterly
  • Elijah felt fear and despair
  • Judas hanged himself
    Self-focus
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3
Q

What are examples of feelings associated with being depressed in scripture?

A
  • Having a fallen countenance
  • Having a broken spirit
  • Being sad
  • Experiencing despair
  • Being brokenhearted
  • Being burdened by the weight of sin
  • Mourning
  • Losing heart
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4
Q

What are the factors that may lead to depression?

A
  • Biological (chemical imbalance, illness, loss of sleep)
  • Cognitive (unbiblical thought patterns, focus on self)
  • Emotional (stress, guilt, regret, loss, loneliness)
  • Spiritual (pride, self-pity, worry anger, bitterness)
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5
Q

What are bible verses about dealing with disappointment?

A
  • Everyone has to deal with disappointment. If we don’t deal with disappointment properly, disappointment can lead to depression
  • Philippians 3:13,14 - forgetting what is behind and pressing ahead
  • Isaiah 42:9, 43:2 - look ahead for the new
  • Romans 8:28,29 - what I perceive as “bad” God can use for my good
  • Lamentation 3:22, 23 - His mercies are new every morning
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6
Q

What are bible verses about hope?

A
  • Hope changes everything
  • Romans 5:5, 15:13 - Hope = Joy & peace
  • Psalm 42:5, 43:2 - Hope in the LORD
  • Proverbs 3:5-6 - Don’t lean on myself-acknowledge Him-He directs
  • Philippians 4:4-8 - Pray = peace
  • I Peter 5:6-7 - Cast my cares on Him
  • II Corinthians 4:8-9, 16-18 - He renews me
  • Isaiah 40:31- Strength like an eagle
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7
Q

What are the D’s of the downward spiral?

A
  • Disappointment: to fail to satisfy a hope or expectation
  • Discouragement: focusing on the frustration caused by disappointment
  • Depression: Dwelling on the negative
  • Despondency: Unreactive to people, missing God’s blessings, and totally consumed with me
  • Despair: Hopelessness, helplessness, selfishness, bitterness
  • Death: Suicidal
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8
Q

What are tools for dealing with depression?

A
  • Confess sin, turn away from old destructive patterns
  • Cultivate a growing relationship with Christ
  • Write Bible verses on 3x5 cards, sticky nots, screensavers
  • Positive self-talk, claim God’s promises
  • Journal as a prayer to the Lord
  • Memorize/meditate on Scripture
  • Turn away from self-focus by serving others
  • Set goals with plans to reach those goals
  • Focus ahead, don’t look back
  • J.O.Y
  • Utilize social support
  • Pray…pray…pray, placing my dependence on God
  • Identify and reframe negative, harmful thoughts
  • Whatsoever things are…think on these things
  • Fill idle time with activity not center on myself
  • Count my blessings… name them one by one
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9
Q

What are two things depressed Christians need to think about?

A
  • what I may perceive to be “bad circumstances” may be just the tool God uses to refine me and cause me to grow- and may result in something very good. Even through hard times, God is always up to something good
  • God’s faithfulness is not proven by the absence of struggle, but by His sustaining grace, strength, and sweet fellowship through the trial
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10
Q

What about God’s truth and depression?

A

When there is a debate between what I am feeling and what Scripture says, Scripture always wins

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11
Q

What are Bible verses about believing God will do what His Word says He will Do?

A
  • The JOY of the Lord is my strength (Neh 8:10)
  • God’s GRACE truly is sufficient! (II Cor. 12:9-10)
  • God’s MERCIES are new every morning! (Lam 3:22-23)
  • Those who place their HOPE in God will never be disappointed (Rom. 5:5)
  • God CARES about the things that concern me (I Pet. 5:7)
  • REJOICE in the Lord always; again I say rejoice! (Phil 4:4)
  • JOY comes in the morning (Ps 30:5)
  • You, oh Lord, are my HIDING PLACE (Ps 32:7)
  • My HOPE is in the Lord (Ps 42:5)
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12
Q

What is the heart of the matter of depression for the believer?

A

Depression, anxiety, or other emotional problems
- not always unrepentant heart / sin
- some issues biologically based
- any source is an occasion for spiritual work to be done

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13
Q

What are mood disorders? What composes them?

A
  • Definition: Gross deviations in mood
  • Composed: different types of mood “episodes” which are periods of depressed or elevated mood lasting days or weeks
    – major depressive: episodes period of depressive mood
    – maniac episodes: period of severely elevated mood
    – hypomanic episodes: period of less severely elevated mood
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14
Q

What is a major depressive episode?

A
  • Extremely depressed mood and/or loss of pleasure (anhedonia)
  • Duration: most of the day, nearly every day, for at least two weeks
  • At least four additional physical or cognitive symptoms (indecisiveness, feelings of worthlessness, fatigue, appetite change, restlessness or feeling slowed down, sleep disturbance)
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15
Q

What is a maniac episode?

A
  • Elevated, expansive mood for at least one week
  • (Symptoms ie inflated self-esteem, decreased need for sleep, excessive talkativeness, flight of ideas or sense that thoughts are racing, easy distractibility, increased in goal-directed activity or psychomotor agitation, excessive involvement in pleasurable but risky behavior)
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16
Q

What is a hypomanic episode?

A
  • Shorter, less severe version of maniac episode
  • Last at least four days
  • Symptoms: fewer & milder
  • Less interfering & impairment
  • May not be problematic in and of itself, but usually occurs in the context of a more problematic mood disorder
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17
Q

What are mixed features?

A

Term for a mood episode with some elements reflecting the opposite valence of mood
(Depressive episode with some maniac)

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18
Q

What is the difference between unipolar and bipolar disorders? Types?

A
  • Unipolar: only one extreme of mood is expressed (depression alone is much more common)
    – Major depressive disorder, persistent depressive disorder, premenstrual dysphoric disorder, disruptive mood dysregulation disorder
  • Bipolar: both depressed and elevated moods are experienced
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19
Q

What are the clinical features of major depressive disorder?

A
  • 1+ major depressive episodes separated by periods of remission
  • single episode highly unusual while recurrent episodes more common
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20
Q

What are the clinical features of persistent depressive disorder?

A
  • At lease two years of depressive symptoms
  • Most of the day more than 50% days
  • No more than 2 months symptom free
  • Symptoms can persist long periods (>20yrs)
  • May include periods of more severe major depressive symptoms (intermitent, majority, entirety)
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21
Q

What are the types of persistent depressive disorder?

A
  • Mild depressive symptoms w/o any major depressive episodes (with pure dysthymic syndrome)
  • Mild depressive symptoms with additional major depressive episodes occurring intermittently (previously “double depression)
  • Major depressive episodes lasting 2+ yrs (with persistent major depressive episode)
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22
Q

What are specifiers?

A

Additional diagnostic label used by clinicians to convey extra information about symptoms
- not mandatory only assigned if appropriate

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23
Q

What is the psychotic features specifier of depressive disorders?

A

includes psychotic features
- hallucinations: sensory experiences in absence of sensory input
- delusions: strongly held but inaccurate beliefs

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24
Q

What is the anxious features specifier of depressive disorders?

A
  • several significant symptoms of anxiety
  • predicts poorer outcome
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25
Q

What is the mixed features specifier of depressive disorders?

A
  • several episodes include several (at least 3) manic symptoms
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26
Q

What is the melancholic features specifier of depressive disorders?

A

additional severe symptoms ie early morning awakenings, lack of reactivity to positive stimuli

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27
Q

What is the catatonic features specifier of depressive disorders?

A
  • extremely rare muscular symptoms
  • remaining in a still stupor
  • semi-rigid limbs remaining in place when manipulated
  • repetitive/purposeless movement
    (catatonia more common in schizophrenia)
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28
Q

What is the atypical features specifier of depressive disorders?

A

Presence of several symptoms less common in depression including oversleeping and overeating

29
Q

What is the peripartum onset specifier of depressive disorders?

A

depression occurring surrounding time giving birth (pregnancy –> 6 mo. post-birth)

30
Q

What is the seasonal pattern specifier of depressive disorders?

A

Depression occurring primarily in certain seasons (usually winter)
- sometimes “seasonal affective disorder”
- may be related seasonal changes in melatonin
- may be treated with light therapy

31
Q

What is the onset and duration of depressive disorders?

A
  • Rare in childhood
  • Risk increased in adolescence and young adulthood
  • Mean age 30
  • Earlier onset persistent depression associated with worse outcome
  • Episode length varies (usually several months, may be years)
32
Q

How does the DSM recognize grief? What are the types of grief?

A
  • Major depression may be occur as part of the grieving process
  • Acute grief: occurs immediately after loss
  • Integrated grief: eventual coming to terms with meaning of the loss
  • Complicated grief: persistent acute grief and inability to come to terms with loss
33
Q

What are Elisabeth Kubler-Ross’ Five Stages of Grief?

A

DABDA
- Denial
- Anger
- Bargaining
- Depression
- Acceptance

34
Q

What are the clinical features premenstrual dysphoric disorder? The controversy?

A

Significant depressive symptoms occurring prior to menses during the majority of cycles, leading to distress or impairment
- Symptoms: numerous, persistent, interfering, distressing
- Controversial:
– Advantage: legitimizes the difficulties some face w/ severe symptoms
– Disadvantage: pathologizes an experience many consider to be normal

35
Q

What are the clinical features of disruptive mood dysregulation disorder?

A
  • severe temper outbursts occurring frequently, against a backdrop of angry or irritable mood
  • Diagnosed only in children 6-12
  • criteria for manic/hypomanic episode are not met
  • To combat overdiagnosis of bipolar
36
Q

What are the three bipolar disorders?

A
  • Bipolar I disorder: alternate between major depressive episodes and manic episodes
  • Bipolar II disorder: alternate between major depressive episodes and hypomanic episodes
  • Cyclothymic disorder: alternate between less severe depressive and hypomanic periods
37
Q

What are the clinical features of cyclothymic disorder?

A
  • chronic version of bipolar
  • alternate between mild depressive & mild hypomanic symptoms
  • Not meet criteria for full major depressive/manic/hypomanic episodes
  • Mood states may persist for long periods
  • Lasts 2+ years (1 yr children/adolescents)
38
Q

What are the diagnostic specifiers for bipolar disorders?

A
  • all specifiers for depressive disorders
  • rapid cycling specifier:
    – rapid in and out of mania and depression
    – 4+ manic or depressive episodes w/i a year
    – 20-50% cases
    – associated with greater severity
39
Q

What is the word wide and sex difference prevalence of mood disorders?

A
  • Worldwide lifetime prevalence 16%, 6% experienced in last year
  • Sex difference:
    – Females 2x likely major depression and in bipolar more likely rapid cycling and in depressive period
    – Bipolar: affect men and women equally
40
Q

What is the prevalence of mood disorders by age?

A
  • occurs less often in prepubertal children
  • rapid rise in adolescents
  • 65+ ~50% less than general population
  • Bipolar: same childhood/adolescence/adults
  • Depression similar across subcultures
41
Q

How does life span development influence mood disorders?

A
  • 3 mo olds can show depressive symptoms
  • young children: typically not show classic mania/bipolar symptoms
  • mood disorder may be misdiagnosed ADHD
  • children diagnosed with bipolar at increasing rates
  • elderly depression 14-42%:
    – co-occurrence with anxiety disorders
    – less gender imbalance 65+
42
Q

What is the prevalence of mood disorders across cultures?

A
  • similar prevalence among U.S. subcultures, symptom experience may vary (cultures express somatic concern)
  • higher prevalence among Native Americans (4x)
43
Q

What are the familial influences of mood disorders?

A
  • risk higher when relative has mood disorder
  • relative with bipolar means greater risk of unipolar depression
  • twin study: mood disorders greater risk if identical twin has depression than fraternal
  • severe mood disorder strong genetic contribution
  • heritability rate greater females
  • some genetic factors confer risk both anxiety and depression
44
Q

What are the neurotransmitter neurobiological influences for mood disorders?

A
  • serotonin and regulation of other neurotransmitters: regulate norepinephrine and dopamine
  • mood disorders related to low serotonin
  • permissible hypothesis: low serotonin “permits” other neurotransmitters to vary more widely, increasing vulnerability to depression
45
Q

What are the endocrine system neurobiological influences for mood disorders?

A
  • elevated cortisol
  • stress hormones decrease neurogenesis in the hippocampus so it is less able to make new neurons
46
Q

What are the sleep disturbance neurobiological influences on mood disorders?

A
  • Hallmark of most mood disorders
  • depressed patients have quicker and more intense REM sleep (not get to deep sleep)
  • sleep deprivation may temporarily improve depressive symptoms in bipolar patients
47
Q

What is the psychological dimension of stress on mood disorders?

A
  • strongly related to mood disorder
  • poorer response to treatment
  • longer remission time
  • gene-environment correlation: more vulnerable to depression may be more likely to enter situations that will lead to stress
  • strong relationship to bipolar
48
Q

What is the psychological dimension of learned helplessness on mood disorders?

A
  • lack of perceived control over life events leads to decreased attempts to improve own situation
  • Martin Seligman research
  • Negative cognitive styles are risk for depression
49
Q

What are the depressive attributional style of the psychological factors affecting mood disorder?

A
  • internal attributions: Negative outcomes are one’s own fault
  • stable attributions: Believing future negative outcomes will be consistently one’s fault
  • global attribution: believing negative events will disrupt many different context in my life
    all contribute to hopelessness
50
Q

What is the cognitive theory of the psychological dimensions of mood disorders?

A
  • negative coping styles:
    – depressed engage in cognitive errors
    – tendency interpret life events negatively
  • types of cognitive errors:
    – arbitrary inference: overemphasize the negative aspects of a mixed situation
    – overgeneralization: negatives apply to all situations
51
Q

What is Beck’s cognitive triad of depression?

A

Think negatively about
- oneself
- the world
- the future

52
Q

What are the social and cultural dimensions of mood disorders?

A

Marital relations:
- marital dissatisfaction strongly related to depression
- relation particularly strong in males
Social support:
- level of social support is related to depression
- lack of social support predicts late onset depression
- substantial social support predicts recovery from depression

53
Q

What are the gender differences of mood disorders? The potential reason?

A
  • women: 7/10 cases of major depressive disorder
  • women have greater rates of anxiety disorders
    Causes?
  • women socialized to greater perception of uncontrollability
  • parenting styles make girls less independent
  • women more sensitive to relationship disruptions (breakups/tension)
  • women ruminate more
54
Q

What are the medication treatment options for mood disorders?

A
  • Antidepressants: SSRIs, Tricyclic antidepressants, monoamine oxidase inhibitors, mixed reuptake inhibitors
  • ~ equally effective: ~ 50% benefit, 25% normal functioning
55
Q

What are the facts of SSRIs?

A
  • Specifically block serotonin reuptake
  • Most popular: fluoxetine (Prozac)
  • Pose some risk of suicide, particularly in teens
  • negative side effects common
56
Q

What are the facts of tricyclic antidepressants?

A
  • Tofranil, Elavil
  • Mechanism not well understood: block reuptake norepinephrine & other neurotransmitters
  • Negative side effects common (drowsiness, weight gain): discontinuation common
  • Lethal in excessive dosage
  • Sudden death in children under 14
57
Q

What are the facts of mixed reuptake inhibitors?

A
  • block reuptake of norepinephrine as well as serotonin
  • best known: venlafaxine (Effexor)
  • Fewer side effects than SSRIs
58
Q

What are the facts of monoamine oxidase (MAO) inhibitors?

A
  • Block monoamine oxidase that breaks down serotonin/norepinephrine
  • Effective as tricyclics with fewer side effects
  • Dangerous in combinations
    – beer, red wine, cheese, cold meds
59
Q

What are the facts of lithium?

A
  • Lithium carbonate - common salt
  • treatment of choice for bipolar disorder
  • mood stabilizer (treats both poles)
  • toxic on large amounts: careful dosage monitoring
  • effective for 50% patients
  • unclear why works
60
Q

What are the facts of electroconvulsive therapy?

A
  • for medication-resistant depression
  • brief electrical current to brain
  • temporary seizure
  • 6-10 outpatient treatments
  • side effects: short-term memory loss, some long-term memory loss,
  • unclear mechanism
61
Q

What are the facts of transcranial magnetic stimulation?

A
  • magnets to generate precise localized electromagnetic pulse
  • few side effects (headaches)
  • less effective than ECT for medication-resistant
  • may be combines with meds
62
Q

What are the psychosocial treatments for depression?

A
  • CBT: address cognitive errors and includes behavioral activation (scheduling valued activities)
  • Interpersonal psychotherapy: focuses improving problematic relationships
  • prevention: preemptive psychosocial care for people at risk
    longer lasting effectiveness than meds - better at preventing relapse
63
Q

What are the psychosocial treatments for bipolar disorders?

A
  • Medication (usually Lithium) first line of defense
  • Psychotherapy helpful in managing problems that accompany bipolar disorder
  • Family therapy can be helpful
64
Q

What are the general facts and statistics of suicide?

A
  • 11th leading cause of death in USA (may be 2-3x higher)
  • most common white & native Americans
  • 3rd leading cause of death in teens
  • 2nd leading cause of death in college students
  • 12% college students consider suicide in a given year
65
Q

What are the facts and statistics about gender and suicide?

A
  • Males complete more (b/c more lethal means)
  • Females attempt more
  • Exception: more common among women in China - culture acceptance
66
Q

What are the risk factors of suicide?

A
  • suicide in the family
  • low serotonin levels
  • preexisting psychological disorder
  • alcohol use and abuse
  • stressful life event, especially humiliation
  • past suicidal behavior
  • plan and access to lethal methods
67
Q

What is suicide contagion?

A
  • some research indicated those already contemplating suicide more likely to commit after hearing about someone else committing suicide
  • media accounts may worsen problem: sensationalizing/romanticizing suicide, describing methods
68
Q

What are options for suicide prevention?

A
  • Professionals: risk assessment (ideation, plans, intent, means), develop safety plan with client (contract)
  • Programs: for at risk (CBT)
  • Remove lethal methods
  • Think at risk: talk to them and ensure getting support

CU: Abnormal Psychology (7 decks)

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