psych 239 midterm 2 Flashcards
what is mood disorder
it is a type of disorder characterized by disturbance of mood. they can take a variety of forms
what are types of mood disorder
- Mood Episodes
- Depressive Disorders
- Bipolar Disorders
- Other Mood Disorders
there should be a consideration of continuum
what is mood thermometer
ranges from severe mania to hypomania (mild to moderate mania), normal/balanced mood, mild to moderate depression, severe depression
mood states can be conceptualized as varying along a spectrum or continuum. one end represents severe depression and the other end has severe mania, which is a cardinal feature of bipolar I disorder. mild or moderate depression is often called “the blues” but is classified as dysthymia when it becomes chronic. in the middle of the spectrum is normal or balanced mood. mild mania is called hypomania
what is major depressive disorder (MDD)
Severe mood disorder characterized by the occurrence of major
depressive episodes in the absence
of a history of manic episodes
what are the characteristics of major depressive disorder
- depressed mood
- lack of interest or pleasure in usual activities
- lack of energy or motivation
- changes in appetite or sleep patterns
what are common feature of depression
- changes in emotional states: changes in mood, increased irritability or loss of temper
- changes in motivation: feeling unmotivated, reduced level of social participation or interest in social activities, loss of enjoyment or interest in pleasurable activities, reduced interest in sex, failure to respond to praise or rewards
- changes in functioning and motor behavior: changes in sleep habits (sleeping too much or too little, awakening earlier than usual ad having trouble getting back to sleep in early morning hours- so called early morning awakening, changes in appetite, changes in weight, functioning less effectively than usual at work or school
- cognitive change: difficulty concentrating or thinking clearly, thinking negatively about oneself and one’s future, feeling guilty or remorseful about past misdeeds, lack of self-esteem or feelings of inadequacy, thinking of death or suicide
what are the DSM-5 criteria for major depressive disorder
A. At least five of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either 1) depressed mood or 2) loss of interest or pleasure.
- Depressed mood most of the day, nearly every day, as indicated either by subjective report (e.g., feels sad or
empty) or observation made by others (e.g., appears tearful) - Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated either by subjective account or observation made by others)
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or
decrease or increase in appetite nearly every day - Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self reproach or guilt about being sick)
- Diminished ability to think or concentrate, or
indecisiveness, nearly every day (either by subjective
account or as observed by others) - Recurrent thoughts of death (not just fear of dying),
recurrent suicidal ideation without a specific plan, or a
suicide attempt or specific plan for committing suicide
when are changes in mood considered abnormal
when they are persistent or severe changes in mood or cycles of extreme elation and depression may suggest the presence of a mood disorder
what are important stats about major depressive disorder in canada
Depressive disorders are MOST common in adolescence and early adulthood (15-24 years of age)
Through adolescence and adulthood (15-64 years of age) WOMEN have a higher prevalence of depressive disorders compared to men
Older adults (65 and older) have the lowest prevalence of depressive disorders, and no significant difference between men and women
what are mood depressive disorder specifiers
- With anxious distress
- With mixed features
- With melancholic features
- With atypical features
- With mood-congruent psychotic features
- With mood-incongruent psychotic features* With catatonia
- With peripartum onset
- With seasonal pattern (recurrent episode
only)
what are the risks factors for depression
*Age – more often starts in younger adulthood (20s and 30s)
*Socioeconomic status: people with lower socioeconomic status are at a greater risk
*Marital status
*Women are nearly twice as likely as men to develop major depression
–Less pronounced difference in later years
–Greater array of life stressors?
* Coping styles of dealing with major life event
what may people with major depression experiences based on the textbook
major depression, in more severe episodes may be accompanied by psychotic features such as delusions that one’s body is rotting from illness. People who severe depression may also experience hallucation, such as hearing the voices of others or of demons condemning them for perceived misdeed or telling them to kill themselves
what are features SEASONAL AFFECTIVE DISORDER
aka major depressive disorder with seasonal pattern
This is when an individual mood vary with the weather, as often the changing of the season from summer into fall and winter leads to a type of depression
* fatigue
* excessive sleep
* craving for carbohydrates
* weight gain.
what are common stats factors with major depressive disorder with seasonal pattern
- affects women more often than men
- is most common among young adults
- possibly occurs in children but not as commonly as in young adults
what are some explanations to explain the causes of major depressive disorder with seasonal pattern
- one possibility is that seasonal changes in light may alter the body’s biological rhythms that regulate such processes as body temperature and sleep-wakes cycles
- another possibility is that some parts of the central nervous system may have deficiencies in transmission of the mood-regulating neurotransmitter serotonin during the winter months
- another possibility is the deficiency in vitamin D.
what is a treatment for major depressive disorder with seasonal pattern
A trial of intense light therapy called phototherapy helps to relieve depression. it involves exposure to a range of 30 minutes to 3 hours of bright artificial light a day.
what is major depressive disorder with peripartum onset
*Persistent and severe mood changes that occur
following childbirth.
*In fact, about half begin in the late stages of pregnancy (hence the switch to peripartum)
Prevalence: 10 to 15%
textbook definition: new mothers experiences mood changes, periods of tearfulness and irritability following the birth of a child. these mood changes are commonly called the maternity blues, postpartums blues or baby blues. they usually last for a couple of days and are believed to be a normal response to hormonal changes that accompany childbirth. however if these severe mood changes persist for months or even a year or more then it will be referred as a major depressive disorder
what is PERSISTENT DEPRESSIVE DISORDER
- Previously called Dysthymic Disorder
- a milder form of depression, seems to follow a chronic course of development that often begins in childhood or adolescence
- about 3-6% of canadian adults have dysthymic disorder
- dysthymic is less severe than major depressive disorder, it can depressed mood and low self-esteem can affect a person’s occupational and social functioning
what are the DSM-5 criteria for persistent depressive disorder
A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. Note: In children and
adolescents, mood can be irritable and duration must be at least 1 year.
B. Presence, while depressed, of two (or more) of the following: 1.Poor appetite or overeating.
2. Insomnia or hypersomnia.
3. Low energy or fatigue.
4. Low self-esteem.
5. Poor concentration or difficulty making decisions. 6. Feelings of hopelessness.
C. During the 2-year period (1 year for children or
adolescents) of the disturbance, the individual has never
been without the symptoms in Criteria A and B for more than 2 months at a time.
what is Premenstrual Dysphoric Disorder
Premenstrual Dysphoric Disorder is characterized by mood changes that revolve around a woman’s menstrual cycle
A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of
menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week post menses.
B. One (or more) of the following symptoms must be present:1. Marked affective lability (e.g., mood swings: feeling
suddenly sad or tearful, or increased sensitivity to rejection). 2. Marked irritability or anger or increased interpersonal
conflicts. 3. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts. 4. Marked anxiety, tension, and/or feelings of being keyed up or on edge
C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.
1. Decreased interest in usual activities (e.g., work,
school, friends, hobbies).
2. Subjective difficulty in
concentration.
3. Lethargy, easy fatigability, or marked lack of energy.
4. Marked change in appetite; overeating; or specific food cravings.
5. Hypersomnia or insomnia.
6. A sense of being overwhelmed or out of control.
7.Physical symptoms such as breast tenderness or
swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.
what is bipolar disorder I
an essential feature of bipolar I disorder is the occurrence of one or more manic episodes.
when manic episodes and depressive episodes occur simultaneously.People with bipolar I have had at least one manic episode, which may be very severe and require hospital care.
features states of extreme elation
(manic episodes); major depressive episodes are a
common feature
what is bipolar disorder II
features states of abnormally elevated mood (hypomania) and major depressive episodes.
it is associated with a milder form of mania called hypomania. with this disorder, the person experiences one or more major depressive episodes and at least one hypomanic episodes but never full blown manic episodes
what is an manic episode
Periods of unrealistically heightened euphoria,
extreme restlessness, and excessive activity
characterized by disorganized behaviour and impaired judgment.
what is the DSM-5 criteria for manic episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep). 3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless non-goal-directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained
buying sprees, sexual indiscretions, or foolish business
investments)
what is pressured speech
Outpouring of speech in which words seem to surge urgently for expression, as in a manic state. occur in people in manic phase
what is rapid flight of ideas
A characteristic of manic behaviour involving rapid speech and changes of topics.
what is the DSM-5 criteria for bipolar I disorder
A. Criteria have been met for at least one manic
episode.
B. The occurrence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
so a manic episodes is usually equivalent to a bipolar I disorder
what is DSM-5 criteria for hypomanic episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
B. During the period of mood disturbance and
increased energy and activity, three (or more) of the following symptoms have persisted (four if the mood is only irritable), represent a noticeable change from usual behavior, and have been present to a significant degree:
1. Inflated self-esteem or grandiosity. 2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep). 3. More talkative than usual or pressure to keep talking. 4. Flight of ideas or subjective experience that thoughts are racing. 5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. 6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation. 7. Excessive involvement in
activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
E. NOT severe enough to require hospitalization or cause major disruption
what is DSM-5 criteria for bipolar II disorder
A. Criteria have been met for at least one hypomanic episode and at least one major depressive episode (Criteria A-C under “Major Depressive Episode” above).
B. There has never been a manic episode.
C. The occurrence of the hypomanic episode(s) and major depressive episode(s) is not better explained by
schizoaffective disorder, schizophrenia, schizophreniform
disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
D. The symptoms of depression or the unpredictability caused by frequent alternation between periods of depression and hypomania causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
what is CYCLOTHYMIC DISORDER
Mood disorder characterized by a chronic pattern of mild mood swings between depression and mania that are not of sufficient severity to be
classified as bipolar disorder.
usually begins in late adolescence or early adulthood and persist for years
when they are “up” people with cyclothymic disorder show elevated activity levels which they directed toward accomplishing various professional or personal projects. however, their project may be left unfinished when their mood is reversed. when they enter a mildly depressed mood states they find it difficult to summon the energy or interest to persevere. they feel lethargic and depressed, but not to the extent typical of a major depressive episode
what are key factors to remember about cyclothymic disorder
- Numerous periods of hypomanic symptoms for at least two years that fail to meet the criteria for hypomanic episodes.
- Numerous periods of depressive symptoms that fail to meet the criteria for a major depressive episode.
- The person has experienced the periods mentioned above for at least half the time, and the person has not been without
symptoms for longer than two months. - The symptoms experienced are not due to another mental
health condition. - The symptoms experienced are not caused by a medical
condition or substance. - The symptoms experienced impair the person’s ability to
socialize, work, or function in other areas of his or her life
what is the relationship between stress and mood disorder
research indicates that there is a robust and causal association between stressful life event and major depressive episodes.
Even childhood experiences can later emerge as risk factors
Symptoms of depression may lead to interpersonal conflict and job loss = more stress
people are more likely to become depressed when they hold themselves responsible for an undesirable event
genetic predisposition can make someone more vulnerable to stress
Strong social support and a healthy coping style can be protective factors.
what is the psychodynamic perspective to depression
Freud believes depression represents anger directed inward rather than against significant others. anger may become directed against the self following either the actual or threatened loss of these important others
freud believed mourning or normal bereavement is healthy process by which one eventually comes to psychologically separate oneself from a person who has gone through death, separation, divorce and more. however pathological mourning doesn’t promote healthy separation as it fosters lingering depression
pathological mourning is likely to occur in people who hold powerful ambivalent feeling which is a combination of positive feelings (love) and negatives ones (anger, hostility) toward the person who has departed
when people lose or fear loing an important figure whom they feel ambivalent, their feeling anger towards the other person turn to rage, yet rage trigger guilt which in turns pervse the person from ventin ager directly at the lost person called an object. to preserve a psychological connection to the lost object, people itroject or take inward a mental representation of the object. incorporating the other person into self producing self-hatred which turns into depression
chronically depressed patient appear to engage in excessive slef-focusing following loss or failure, but so do other clinical groups
what is the psychodynamic viewpoint of bipolar disorder
bipolar disorder represents shifting dominance of the individual’s personality by the ego and superego. in the depressive phase, the superego is dominant, producing exaggerated notions of wrongdoing and flooding individuals with feelings of guilt and worthlessness. after a time, the egp rebounds and asserts supremacy, producing feelings of elation and self-confidence that come to characterize the manic phase. the excessive display of ego eventually triggers a return of guilt, once again plunging the individual into depression
what is the self-focusing model
how people allocate their attentional processes after a loss (death of a loved one, personal failure). according to this model, depression-prone people experience a period of intense self-examination (self-focusing) following a major loss or disappointment
what is the learning perspective to depression
it is suggested that depression may result when a person’s behavior receives too little reinforcement from the environment. the lack of reinforcement can reduce motivation and induce feelings of depression
it is a vicious cycle may ensures: inactivity and social withdrawal deplete opportunities for reinforcement; lower level of reinforcement exacerbate withdrawal. the low rates of activity typical of depression may also be a source of secondary reinforcement
what is interactional theory in relation to the learning perspective
the interactions between depressed individuals and other people may help explain the former group’s shortfall in positive reinforcement. interactional theory propose that the adjustment to living with a depressed person can become so stressful that the partner or family members becomes progressively less reinforcing towards the depressed person
interactional theory is based on the concept of reciprocal interaction. people’s behavior influences and is influenced by the behavior of others. the theory holds that depression-prove people react to stress by demanding greater social support and reassurance. At first, depressed people have great social support however their demand and behavior begin to elicit anger or annoyance
what is attribution styles relating to learned helplessness
learned helpfulness is related to Martin Seligman
the Attribution style is a person styles of explanation. when disappointment or failure occur, we may explain them in various characteristic ways. which are
- internal attribution
- stable vs unstable attribution
- global vs specific attribution
what is internal attribution
in the reformulated helplessness theory, a type of attribution involving the belief that the cause of an event involved factors within oneself. contrast with external attribution. in other words, it is blaming oneself
it is linked to lower self-esteem
what is external attribution
in the reformulated helplessness theory, a type of attribution involving the belief that the cause of an event involves outside the self. contrast with internal attribution
in other words, it is blaming circumstance around us
what is stable attribution
in the reformulated helplessness theory, a type of attribution involving the belief that the cause of an event involved stable rather than changeable factors. contrast with unstable attribution
in other words, it is seeing bad experiences as a typical event
it helps to explain the persistence or the chronicity of helplessness cognition
what is unstable attribution
in the reformulated helplessness theory, a type of attribution involving the belief that the cause of an event involved changeable rather than stable factors. contrast with stable attribution
In other words, it is seeing bad experiences as an isolated event
what is global attribution
in the reformulated helplessness theory, a type of attribution involving the belief that the cause of an event involved generalized rather than specific factors. contrast with specific attribution
in other words, it is seeing bad experiences as evidence of broader problems
it is associated with the generality or pervasiveness of feelings of helplessness following negative events
what is specific attribution
in the reformulated helplessness theory, a type of attribution involving the belief that the cause of an event involved specific rather than generalized factors. contrast with global attribution
in other words, it is seeing bad experiences as evidence of precise and limited short-coming
example of attribution styles in a real life situation
example of a university student who goes on a disastrous date. afterwards, he shakes his head in wonder and tries to make sense of his experiences. an internal attribution for the calamity would involve self-blame as in “ i really messed it up”
an external attribution would place the blame elsewhere as in “some couples just don’t hit it off” or “she must have been in a bad mood”
A stable attribution would suggest a problem that cannot be changed as in “it’s my personality”
an unstable attribution would suggest a transient condition as in “it was probably the head cold”
A global attribution for failure magnifies the extent of the problems as in “i really have no idea what i’m doing when i’m with people
A specific attribution in contrast chops the problem down to size as in “my problem i show to make small talk to get a relationship going
what is cognitive perspective to depression
according to Aaron Beck’s Cognitive Theory, the development of depression to the adoption early in life of negatively biased or distorted way of thinking which is the cognitive triad of depression.
the cognitive triad includes negative beliefs about oneself, the environment or the world and the future
people with this type of thinking are at a greater risk of becoming depressed
the negative concept of the self and the world as mental templates called cognitive schemes are adopted in childhood on the basis of early learning experiences
