the complexities of mood

Question 1

what are emotions

Answer 1

emotions are processes comprising appraisal, motivational, somatic, motor and feeling components (Moors et al, 2013) (i.e. reactive to situations/ events)

Question 2

what are moods

Answer 2

states

longer lasting, more pervasive

Question 3

what do prolonged negative emotional experiences lead to?

Answer 3

mood problems

Question 4

what is the appraisal element of emotion

Answer 4

evaluations of the environment and the person environment interaction

e.g. ‘this is going to be awkard’

environment, self

Question 5

what is the motivational element of emotion

Answer 5

specific action tendencies or other forms of action readiness
e.g. decision to avoid

Question 6

what is the somatic element of emotion

Answer 6

peripheral physiological responses

Increased heart rate and sweat palms

Question 7

what is the motor element of emotion

Answer 7

expressive and instrumental behaviour

run off down alley

Question 8

what is the feeling element of emotion

Answer 8

subjective experience (FEELINGS ARE A RESULT OF OUR EMOTIONS)

anxious relieved

Question 9

what is the process of experiencing emotion

Answer 9

appraisal

Question 10

what are the components of appraisal

Answer 10

experiencing an emotional state involves changes in a number of subsystems or components
this process is continous and recursive
changes in one component feedback to other components

Question 11

what is the somatic marker hypothesis

Answer 11

somatic markers are emotional reactions with a strong somatic component that supports decision making including rational decision making
somatic - physical bodily sensations
physiological changes to the body in response to the stimulus are relayed to the brain and experienced as an emotion
these over time and learning become somatic markers
associations with different situations

Question 12

how many pathways are there for the reactivation of the somatic marker ie subsequent behaviours

Answer 12

2
the body loop
the as if body loop

Question 13

what is the body loop

Answer 13

emotion is evoked by changes in th body projected to the brain - e.g. fight or flight response when coming across a snake
body sensation leads to behavioural reaction via brain

experience somatic reaction and that leads to your behaviour

Question 14

what is the as-if body loop

Answer 14

cognitive representations of the emotions - imaginging as if you were in the situation - activated in brain without being directly influenced by physical sensations - anticipation of event enough to trigger behavioural response

memory or connection with past experience that leads to anticipation and that leads to the reaction

Question 15

what did damasio say

Answer 15

emotion is integral to the process of reasoning for worse and for better

Question 16

do emotions help us to make decisions

Answer 16

yes

emotions allow us to mark things as good bad and indifference

Question 17

when would a mood state be diagnosed as a mood disorder

Answer 17

when it is negative over a long period of time

Question 18

what is a mood

Answer 18

Mood can be characterised as a pervasive state. By that, we mean that it is an emotion or set of emotions that have accumulated in a time frame so we can identify them.

Question 19

what is a mood disorder

Answer 19

a mood disorder is when emotions/feelings (the experience of emotion) become prolonged and/ or frequent/ pervasive.

Question 20

A mood ‘disorder’ is when emotions cause significant impairment in

Answer 20

social functioning
occupational functioning
self care

Question 21

what are emotional experiences linked to

Answer 21

Emotional experiences linked with depression include sadness, despair and deep sorrow (Mehu & Scherer, 2015).

Emotional experiences are linked to other components of experience including appraisals so this means that the way we think when we are depressed will be affected.

There are also individual differences in the way we appriase situations. Some people might be more inclined to evaluate situations in a consistently negative way (and so experience negative emotions).

If we have a negative style of appraisal, we are less likely to recognise when good things happen. In other words, we might see life through a tainted lens. It is difficult to say for sure what comes first - our tendency to see things negatively or our experience of depression. This cycle of thinking, feeling, behaviour

Question 22

what is depression

Answer 22

Depression is considered as a mental ‘illness’ though I might argue it should be considered as a psychological reaction.

Answer 23

Depression is a diagnosis. That means, it is a set of psychological and physical symptoms that tend to appear together and have been named/ labelled in order to inform the development of treatments or interventions.

Question 24

Negative emotional experiences, when long-lasting can become

Answer 24

negative mood states

Question 25

Long-standing mood states are known as

Answer 25

mood ‘disorders’

Question 26

what is a psychological formulation

Answer 26

Understanding contextual factors and their impact is done through information gathering and using that information to form a hypothesis about why something has happened. This is called a psychological formulation.

Question 27

what is the 5 p model

Answer 27

predisposing
precipitating
presenting
perpetuating
protective

Question 28

what is predisposing

Answer 28

what factors in the person’s life makes them vulnerable to psychological problems?

Question 29

what is precipitating

Answer 29

what event/ set of events has led to this problem occuring?

Question 30

what is presenting

Answer 30

what is the problem and how do you/ others know it is a problem?

Question 31

what is perpetuating

Answer 31

what keeps the problem going?

Question 32

what is protective

Answer 32

what has the person got in their lives that is positive and can be built on?

Question 33

what is the most important aspect of the 5 p’s formulation model

Answer 33

One of the most important aspects of this model are the ‘perpetuating factors’. With regards to depression, most of us experience low mood at some point in our lives, and sometimes this can be for weeks or months at a time. However, this is still quite normal in some contexts. Often depressive episodes are short lasting because the person’s mood is affected positively by something else. For example, depression that is triggered by loneliness after a relationship break-up can be affected positively by reactions of friends or even the start of a new relationship. The occurance of positive experiences can lift mood. However, sometimes there are other factors that maintain low mood. Depending on how you understand this, maintenance factors could be your family, your thoughts, your behaviour, your experience.

Question 34

what is biological vulnerability

Answer 34

Research suggests that biological factors such as genetic inheritance may create a vulnerability to depression (i.e. make it more likely to happen) though there is not a direct cause-effect link

It may be, for example, that there are genetic differences in the production and/ or uptake of certain neurotransmitters known to be involved in depression (e.g. serotonin)

Current thinking is that it is likely to be an interplay of several genes and processes that affect likelihood of developing depression

Question 35

what are the symptoms of depression

Answer 35

Typical symptoms include weight loss or gain, change in sleep pattern, feelings of lethargy and exhaustion, tearfulness, loss of sex drive, constipation – all very unpleasant and can also cause feelings of anxiety which is often a co-morbid condition to depression

Question 36

how can depression be maintained by unpleasant physucal symptoms

Answer 36

Unpleasant physical symptoms play a big part in the maintenance of depression e.g. exhaustion and lethargy can stop people from being physically active which then leads to weight gain, constipation and poor physical condition

Question 37

what do psychoogical approaches suggest

Answer 37

Psychological approaches suggest that people’s depressed feelings, thoughts, or behaviours are linked. Each psychological model might have a different emphasis on the important elements of depression that need to be addressed

Question 38

what are the 3 NICE recommended treatments for depression & their approach to change :

Answer 38

CBT – Cognitive Behaviour Therapy
IPT – Interpersonal Psychotherapy
BA - Behavioural Activation

Question 39

what is IPT

Answer 39

IPT – Interpersonal Psychotherapy

Question 40

what is BA

Answer 40

BA - Behavioural Activation

Question 41

what does CBT focus on

Answer 41

CBT focuses on unhelpful thinking and behaviour

Question 42

what does the client do in CBT

Answer 42

In CBT, the client is invited to identify thoughts about themselves, the world and others that are leading them to feel gloomy

The therapist helps the client RECOGNISE these thoughts by getting them to complete ‘thought diaries’

Then, the client completes behavioural experiments to look at the evidence for and against these thoughts – to CHALLENGE their thoughts

Question 43

whats the aim of CBT

Answer 43

Ultimately, CBT aims for the client to get a more realistic perspective on their situation which should lead to improved mood

Question 44

what does IPT assume

Answer 44

Mood and life situation (specifically one’s interpersonal situation)are linked

Depression is a medical illness which responds well to treatment

Assignment of the ‘sick role’ (your job is to get better, let yourself off the hook for other things)

Question 45

the Interpersonal problems targeted by IPT are

Answer 45

role dispute

role transition

complicated bereavement

interpersonal deficits (i.e. long standing problems forming and retaining relationships)

Question 46

what happens in IPT

Answer 46

Change in problem relationships/ relationship style will improve life and therefore mood
Define the problem (from one of the 4 possible interpersonal problems)

Complete an interpersonal inventory to gain an idea of the nature of the client’s relationships

Agree a focus

Therapist works with client to manage the business of changing the problem relationships, learning skills to form new more helpful relationships, thinking generally about the impact of relationships on the person’s mood.

Question 47

what is the role of the therapist

Answer 47

Therapist is ‘cheerleader’ and can be quite proactive with advice giving and questioning

Question 48

what is the behavioural activation framework

Answer 48

A model of depression based on learning theory

When people become depressed a lot of their behaviour functions to avoid unpleasant thoughts, feelings or situations but this also leads to missing out on positive reinforcers (especially social ones)

The therapy is designed to raise their awareness of this and the unintended consequences of their actions (i.e. that, rather than serve to improve the situation, client’s response can make the situation worse)

Question 49

how does behavioural activation work

Answer 49

Works by targeting the behaviours that maintain depression

Cognitions not targeted but some ways of thinking e.g. ruminating might be characterised as a behaviour which allows the person to avoid other things

Identify goals (short, medium and long term)that are meaningful to the client i.e. fit in with their values and abilities

Activity scheduling (avoided activities, not just pleasant ones), structuring, social skills training, problem-solving

Question 50

CBT v’s BA

Answer 50

CBT v’s BA
Richards et al (2016) In a randomised control trial, BA, a simpler psychological treatment than CBT, can be delivered by junior mental health workers with less intensive and costly training, with no lesser effect than CBT.

Question 51

CBT v’s IPT

Answer 51

CBT v’s IPT
Lemmens et al (2015) No differential effects between CT and IPT were found. Both treatments exceeded response in the WLC condition, and led to considerable improvement in depression severity that was sustained up to 1 year.

Question 52

IPT v’s BA

Answer 52

IPT v’s BA

Not a popular comparison

Question 53

what does CBT do

Answer 53

CBT has, at its heart, the assumption that our thinking is a heavy influence on our behaviour and that this is a symbiotic relationship.

CBT advocates that therapists work on challenging negative thinking, and a key way of doing this is through experimenting with behavioural change.

Question 54

what does IPT do

Answer 54

IPT sees a pivotal role for relationships (or lack of) and the interpersonal skills we have. The therapist works with the client to understand their relationship patterns better, and manage the access to positive relationships and promotion of effective interpersonal communication.

Question 55

what does BA do

Answer 55

BA also promotes behavioural change, but with an emphasis on the role depressed behaviour has in perpetuating the depression through the process of avoidance.

Question 56

theraputic intervention benefits

Answer 56

The aspect of the therapeutic intervention thought to successfully improve mood is know as the ‘mechanism of change.’ This includes aspects such as ‘therapeutic alliance’ and the adherence of the therapist to the therapy, but the application of theory to practice is also considered important.

Question 57

what is context

Answer 57

Context just means the ‘background’ to the person’s depression.

This could be individual contexts (e.g. living with domestic abuse) or the wider context of where, and under what circumstances we live. Individual contexts would certainly be important in a psychological formulation.

Question 58

what is the criticism levelled at models informing psychological interventions

Answer 58

However, there is sometimes criticism levelled at models informing psychological interventions that they don’t always take into account the reality of the world in which a person is living.

Question 59

intrapsychic phemomena

Answer 59

(e.g. thinking patterns)

Question 60

nterpersonal phenomena

Answer 60

(i.e. relationships)

Question 61

factors effecting appraisal

Answer 61

(key appraisals in depressive disorder (Beck, 1987). if a person is living in a violent or impoverished neighbourhood, this is likely to have an impact on anxiety (appraisal = something bad could happen) and dperession (appraisal = I am helpless to change this).

Anxiety and depression often co-exist. It is essential that psychologists take the wider context into account.

Another context (as well as the social and physical background impacting on levels of distress) is the way in which depression is understood. We discussed this a little earlier. It is generally understood that cultures vary in the way depression is described and understood which may make it seem that there are differences in prevelance.