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7171 Mood Disorders
Mood Disorders
25
Psychology
Graduate
12/05/2011

Additional Psychology Flashcards

 


 

Cards

Term
Mood disorders and irritability
Definition
it's a criterion/associated with most of the mood disorders, like a fever, doesn't discriminate b/t disorders
Term
Depressive Disorders - time periods for MDD and Dysthmia
Definition
MDD - 2 weeks

Dysthymia - a year for children (2 years for adults)
Term
What is major depressive disorder?
Definition
Presence of at least one major depressive episode

Not better accounted for by other things (bereavement, PTSD)

No mania, mixed, or hypomania

At least 2 week period of time of meeting criteria for MDE - you should reassess periodically to make sure you're not missing a manic episode
Term
Dysthymic Disorder
Definition
Kids 1 year, adults 2 yrs, more often than not down, depressed, not more than 2 months without symptoms

More long standing than MDD - discussed even as a personality disorder b/c so long-lasting
Term
What is double depression?
Definition
Dysthymia followed by MDD
Term
Prevalence of depressive disorders
Definition
Community samples
o 1-3% school aged
o 5-6% of adolescents

Clinical Settings
o 8-15% children
o 50% adolescents
Term
Gender difference in depressive disorders?
Definition
No consistent gender difference in children but by 15 years rate for females more than double
Term
Onset of MDD and Dysthymia

Mean length of each

Recurrence rate
Definition
Onsets: both around 11-14 yrs

Mean length of MDD = 7-8 months – as a child

Mean length of DD = 48 months – people often don’t pick up on it b/c they are quiet and not bothersome

Recurrence = 40% over 3-5 years in community samples
Term
Continuity of depressive disorders

Heritability
Definition
1. Adolescent to adult…good predictor/continuity – good chance you will continue to have problems

2. Preadolescent to adult…much poorer - not as good of a predictor for specifically MDD as an adult
o Intersection/interaction with sex differences?
o Higher rates of disorders/maladjustment overall, just not MDD

– Higher rates of MDD among 1stdegree relatives

– Heritability around 30-35% for many studies
Term
Parents and depressive disorders
Definition
- 1 of the strongest predictors of MDD is having a depressed parent

- Depression is associated with maladaptive parents
Term
2 patterns of mother-child interaction
Definition
Withdrawal, disengagement, flat

OR

Hostile, intrusive
Term
Masked depression
Definition
Someone with ODD or CD who has depression, gets overlooked
Term
Stress effects
Definition
1. Random external stressors
o More rare? Ish – odds of exposure are less
o Accidents, disasters etc

2. Family-dependent stressors
o Internal family problems
o Internal strife, marital discord, parenting practices

3. Stress Generation
oYou’re locked in a feedback loop
- Depressed individuals “generate” stressful circumstances which trigger more depression

Diathesis-stress model
Term
Cognitive/CBT model: depressed people have
Definition
o Systematic biases/thinking errors (automatic thoughts)

o Negative cognitive schemas (structures that guide thinking
Term
Clark and Watson CBT model
Definition
o Negative cognitive triad


o Tripartite Model

o Comorbidity of depression and anxiety
Term
Negative cognitive triad - clark and watson
Definition
Perceive self, world, and future negatively
Term
Tripartite Model - Clark and Watson
Definition
General distress, anhedonia, physiologic arousal
Term
Comorbidity of depression and anxiety
Definition

Differential diagnosis - de-emphasize general distress 

 

Depression will have general distress and anhedonia

 

Anxiety will have general distress and physiologic arousal

Term
Bipolar I criteria
Definition
Criteria varies but:
- At least one manic episode

- Possibly at least 1 major depressive episode (don’t have to have one)

- Not better accounted by any other disorders
Term
Bipolar II Criteria
Definition
- 1 or more MDE

- At least one hypomanic episode

- Has never had a manic episode or a mixed episode – rapid alternation b/t depression and mania, appearing together almost
Term
Manic Episode Criteria

Hypomanic Episode
Definition
- At least 1 week of “abnormally and persistently elevated, expansive, or irritable mood” (or any duration if hospitalized)
- 3 or more of
o Grandiosity
o Decreased sleep
o More talkative/pressured speech
o Flight of ideas
o Distractibility
o Increased goal setting
o Increased high-risk pleasurable activities

Hypomanic episode – generally same criteria just not sufficiently severe to caused “marked impairment in social or occupational functioning or to require hospitalization”

*** How does this translate in children?
Term
Phenotypes of Bipolar Disorder
Definition
1. Narrow (think strict DSM-IV)

2. Broad (BD-NOS?)
o “…children with the “broad” phenotype constitute the majority of referrals to clinicians…”

o present with severe irritability, affective storms, mood lability, severe temper outbursts, symptoms of depression, anxiety, hyperactivity, poor concentration, and impulsivity with or without clear episodicity.”

- Irritability is emphasized and is considered by some to be the appropriate “core” symptom, even without other symptoms (e.g., grandiosity, elation, episodicity) (Pavuluriet al., 2005, p. 847).
Term
How to diagnose Bipolar Disorder in children (or how to pervert the diagnostic process....)
Definition
- HOWEVER, BD can be “…differentiated from ADHD by the presence of grandiosity, elated mood, flight of ideas, hypersexuality, and decreased need for sleep” (p. 851)!

- “More often than not, children…with BD will present with other psychiatric disorders, particularly ADHD, ODD, CD, and anxiety disorders.”

- If we take out the episodes, what does that mean?

- What would an oppositional, anxious, inattentive, hyperactive child look like anyway?  irritable without clear episodes….right?

- Assessments for bipolar disorder should be a long-term assessment
Term
Implications of bipolar disorder diagnosis
Definition
- Yet another fad for parents to sort through?

- Contraindicated treatment? (e.g., lithium, anti-psychotics, psycho-stimulants)
o Antidepressants may worsen or precipitate a manic episode
o Need to be very careful with this
Term
Youngstrom et al (2005) identified 3 camps of people in regards to the existence of bipolar disorder in children
Definition
1)BD does not occur in children

2)RTI -- Child has BD if fails a trial of psychostimulant. We’ve been here before, confuses ax with tx

3)Agnostic - Disorder occurs, but is rare in children
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