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Abnormal 2 - mood disorders
mood disorders
41
Psychology
Undergraduate 3
03/22/2009

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Cards

Term

 

 

 

 

Depression:

Symptoms

Definition
  • Emotional: sadness, anhedonia: even when they try to do something enjoyable, they feel no emotional reaction
  • Physiological/behavioral:sleep, appetite, activity levels. anhedonia. early morning wakening. psychomotor retardation or agitation.
  • Cognitive: worthlessness, guilt, hopelessness, suicide. rarely, delusions and hallucinations.
Term

 

 

 

 

 Anhedonia

Definition
trying to do fun things but find no pleasure in them
Term

 

 

 

 

Major Depression:

Diagnosis and comorbidity

Definition
Major Depression: 
  • depressed mood or loss of interest in activities for more days than not for two weeks
  • plus 4 other depression symptoms
  • Over half of ppl. with this or dysthemia also have another psychological problem, namely substance abuse, eating disorer, anxiety disorder
Term

 

 

 

 

Dysthemic Deppressive Disorder:

Diagnosis

Definition
Dysthemic Disorder:
  • less severe than major depression but more chronic
  • depressed mood plus two other symptoms for two years, without exception of more than 2 months
Term

 

 

 

 

Double Depression:

Diagnosis and prevalence

Definition
Combo of major and dysthemic depression
 
chronically dysthemic with occasional spells of major depression
 
less likely to respond to treatments
 
 
Term

 

 

 

 

Subtypes of major depression

Definition
  1. Depression with melancholic features:physiological symptoms are especially prominent
  2. Depression with psychotic features: experience delusions and hallucinations during major depressive episode.
  3. Depression with catonic features: range from complete lack of movement to excited agitation (catatonia)
  4. Depression with atypical features: positive mood toward some events, weight gain, heavy feelings in arms and legs, sensitivity to interpersonal rejection
  5. Depression with postpartum onset: 30% of women experience blues, but only 1 in 10 experience post partum depression that is really serious.
  6. Depression with a seasonal pattern: usually winter (Seasonal Affective Disorder: SAD). History of 2 years of symptoms
Term

 

 

 

 

Depression:

Prevalence

Definition
  • At some point, 16% of Americans experience major depressive episode
  • 15-24 year olds at high risk, 45-54 year olds have low rates
  • 2x more common among women, adults, minorities
  • Study says depression wastes time in workplace (deficit of $44 billion a year in lost productivity)
Term

 

 

 

 

Depression and adolescence:

Prevalence

Definition
Major Depression:
-Children: 3%
-Adolescents: 8%
 
Dysthemic:
-Children: 2%
-Adolescents: 8%
 
 
Term

 

 

 

 

Childhood depression:

Stress generation Model

Definition
symptoms of depression such as low motivation and problems in concentration
 
can affect kids in every domain of life
 
which leads to more stressors, such as strain on parents
Term

 

 

 

 

Manic Episode:

Definition and Diagnosis

Definition
  • Elevated, expansive (everything is perfect) or irritable mood – (at least once a week)
  • At least three of the following (or 4, if irritable)
    • Inflated self-esteem or grandiosity
    • Decreased need for sleep (not tired)
    • Talkativeness, pressured speech - they can’t talk fast enough, words pushing each other out of their mouth.
    • Flight of ideas (jump from one topic to another) or racing thoughts (maybe has to do with pressured speech)
    • Distractibility
    • Hyperactivity or agitation
    • Excessive involvement in pleasurable behavior with a high potential for painful consequences
Term

 

 

 

 

Hypomanic Episode

Definition

  • "Manic Lite"
  • Mood elevation for 4 days, not a whole week
  • Not severe enough to cause impairment in functioning, but similar symptoms as manic
Term

 

 

 

 

Mixed episode

Definition
  • Criteria are met for both manic episode and depressive episode, nearly every day, one-week period (down, but irritated)
Term

 

 

 

 

Bipolar I

Definition
  •  
    • At least one manic or mixed episode
    • Often, but not always, at least one depressed episode
    • Most recent episode descriptor
Term

 

 

 

 

Bipolar II

Definition
  •  
    • At least one depressed episode
    • At least one hypomanic episode
    • No manic episodes
    • Often misdiagnosed as depression, but this can be bad because antidepressants can precipitate a full-blown manic episode
Term

 

 

 

 

Bipolar:

Prevalence

Definition
Video
 
-1% population
-Hits in early adulthood
Term

 

 

 

 

BPD:

Treatment

Definition
Lithium
 
Anticonvulsants (Tegretol, Depakote, Lamictal-new)
Term

 

 

 

 

Lithium

Definition
  •  
    • Ends 70% of manic episodes and 40% of depressive episodes
    • Stabilizes neurotransmitters (serotonin, dopamine)
    • May prevent further occurrence of mania
    • Can be toxic, damage liver (jaundice-when skin turns yellow)
    • Some people feel like lithium dulls everything (mania feels so good…some say Van Gogh’s great paintings were made during manic episodes)
Term

 

 

 

 

Anticonvulsants

Definition
  •  
    • Used in treatment of BPD sometimes
    • Affect several neurotransmitter systems
    • Not entirely clear why they have mood stabilizing properties (but don’t know why)
    • May not be as effective in prevention
    • Teratogenic-cause birth defects during first trimester
Term

 

 

 

 

Cyclothymic Disorder

Definition
  • Less severe than BPD I and BPD II
  • Person alternates between hypomania and moderate depression chronically over at least two years.
Term

 

 

 

 

Rapid Cycling Bipolar Disorder

Definition
If a personhad 4 or more cycles of mania and depression within a year
Term

 

 

 

Mood Disorders:

Genetic Theory

Definition

BPD

  • 62-80% concordance among MZ twins (REALLY high), 14% among DZ
  • Adoption studies suggest individual environment important, not shared environment.
  • Likely multifactorial rather than s single gene being responsible
Depression
  • Higher concordance for MZ twins, especially among women
  • Perhaps types of genes responsible for women and men are different
Term

 

 

 

 

Mood disorders:

Neurotransmitter Theory

Definition

  • Dysregulation of neurotransmitters and their receptors causes depression and mania.
  • Most research on monamine neurotransmitters (norepinephrine, serotonin, dopamine)
Term

 

 

 

 

Mood disorders:

Neurophysiological Abnormalities theory

Definition
Abnormalities in the structure and functioning of the prefrontal cortex, hippocampus, anterior cingulate cortex, amygdala
Term

 

 

 

 

Mood disorders:

Neuroendocrine Abnormalities theory

Definition
Depressed people show chronic hyperactivity in the hypothalamic-pituitary-adrena axis and slow return to baseline after a stressor, which affects the functioning of neurotransmitters
Term

 

 

 

 

Peter Lewinson's 

Behavioral Theory of Depression

Definition
Depressed people experience a reduction in positive reinforcers and an increase in aversive events, which leads to their depression
 
more common in people with bad social skills
Term

 

 

 

 

Learned helplessness theory of Depression

Definition
(behavioral)
 
Depressed people lack control, which leads to the belief that they are helpless, which leads to depressive symptoms
 
learned helplessness deficits: low motivation, passivity, indecisiveness
 
 
Term

 

 

 

 

Aaron Beck's Theory

of Depression

Definition
Depressed people have a negative cognitive triad of beliefs about the self, the world, and the future, which is maintained by distorted thinking
 
Negative Cognitive Triad: negative views of themselves, the world, the future
 
*very succesful theory*
Term

 

 

 

 

Reformulated Learned Helplessness Theory

of Depression

Definition
Depressed people tend to attribute events to internal, stable, and global factors, which contributes to depression
 
(causal attributions)
 
depressive realism: non-depressed people have a robust illusion that they can control all sorts of situations thaty truly are out of their control
 *perhaps it is actually hope and optimism that causes people to become depressed 
Term

 

 

 

Ruminative Response Styles Theory

of Depression

Definition
depressed people tend to ruminate about their symptoms and causes
Term

 

 

 

 

Psychodynamic theories of depression

Definition
introjected hostility theory - depressed people are unconsciously punishing themselves because they feel abandoned by another person but cannot punish that person
 
dependency and perfectionism are risk factors for depression
Term

 

 

 

Interpersonal theories of depression

Definition
Depressed people have poor relationships with others
 
contingencies of self-worth - children are taught that love and support are conditional
 
excessive reassurance seeking - constantly looking for assurance from others that they are accepted and loved
Term

 

 

 

 

9 Distortions in thinking in depression

Definition
  • All-or-nothing thinking (perfectionism)
  • overgeneralization (negatives generalized to all of life)
  • mental filter - filter out only negative info.
  • disqualifying the positive
  • jumping to conclusions
  • magnification/minimization
  • emotional reasoning - i feel it, so it must be true
  • "should" statements
  • labeling and mislabeling - extreme form of overgeneralization (attaching error to self or other-I am a loser, she is mean)
  • personalization - see self as cause of negative external event
Term

 

 

 

 

Cohort effect in Depression

Definition
Recent generations at higher risk
 
people with lower SES have higher rates of depression
 
less industrialized countries may have lower rates of depression...maybe depression and mania differ across all cultures
Term

 

 

 

 

Mood Disorders:

Electroconvulsive Therapy

Definition
(ECT) apply electrical current to the brain
 
may increase permeability of the blood-brain barrier, cause release of neurotransmitters, stimulate the hypothalamus, increase sensitivity to receptors
 

·         Shock of about 70 to 130 volts

o   Delivered unilaterally (Right side of the brain to reduce memory loss)

o   Thought to increase norepinephrine and serotonin

o   9-12 sessions

·         Side effect: memory dysfunction

o   Generally returns fully

o   Lessened if on side less related to language

Term

 

 

 

 

Mood disorders:

Repetitive transcranial magnetic stimulation

Definition
expose patients to repeated, high-intensity magnetic pulsed focused on particular brain structures;
 
may change functioning of neurotransmitters
Term

 

 

 

Mood disorders:

Vagus nerve stimulation

Definition
Stimulate by a small, electronic device much like a cardiac pace-maker, which is surgically implanted under a patient's skin in the left chest wall;
 
may increase activity in the hypothalamus and amygdala
Term

 

 

 

Mood disorders:

Light therapy

Definition
esp good for SAD
 
expose individual to bright light, may "reset" circadian rhythms
Term

 

 

 

 

Behavior therapies of depression

Definition
increase postive reinforcers and decrease aversive events by teaching the person new skills for managing interpersonal situations and the environment and engaging in pleasant activities 
 
3 steps:
  1. change environment
  2. teach skills for changing negative circumstances (esp social) 
  3. teach mood-management skills
Term

 

 

 

Cognitive-behavioral therapy for depression

Definition
challenges distorted thinking and helps the person learn more adaptive ways of thinking and new behavioral skills
 
very effective
 
(write down event, emotion, automatic thoughts)
Term

 

 

 

 

interpersonal therapy for depression

(4 types of problems)

Definition
helps the person change dysfunctional relationship patterns
 
4 types of problems
  1. grief/loss: accept feelings and invest in new relationships
  2. interpersonal role disputes: help client make decisions and learn better ways to communicate
  3. role transitions - help client develop more realistic perspectives toward roles that are lost and regard new roles in more positive manner
  4. interpersonal skills deficit: review past relationships and how they might affect current ones, directly teach skills such as assertiveness
Term

 

 

 

 

Psychodynamic therapy of depression

Definition
helps the person gain insight into unconscious hostility and fears of abandonment to facilitate change in self-concept and behaviors
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