Bipolar Disorder Flashcards
On Exam 3 (Apr. 22) (30 cards)
What are the Criteria A symptoms for diagnosis?
Elated, expansive, or irritable mood
Increased goal-directed activity
What are the Criteria B symptoms for diagnosis?
Inflated self-esteem, decreased need for sleep, racing thoughts/flight of ideas, rapid speech, impulsivity, increased energy, distractibility
What differentiates a hypomanic episode from a manic episode?
Manic: 1 week + evidence of functional impairment or need for hospitalization
Hypomanic: shorter duration + no apparent functional impairment or damage
What is a mixed episode?
Meeting the full criteria or having subthreshold symptoms for both a manic episode and a depressive episode (defined by the criteria for MDD) at the same time
With respect to impairments in functioning, what factors are associated with less impairment in functioning?
The presence of a supportive relationship is the biggest predictor of high-functioning
Functioning may also be less impaired when residual symptoms post-episode are fewer
What evidence suggests that bipolar disorder is associated with creativity?
Are manic episodes themselves the cause of such creativity?
Many creative historical figures had it
Those w/ the disorder score higher on measures of creativity at a young age
Even relatives of those w/ the disorder (who are unaffected themselves) exhibit higher creativity
Mania may be related to other traits, such as optimism, impulsivity, and ambition, that are also correlated with creativity (an indirect relationship)
What is expressed emotion and how does it relate to bipolar disorder?
EE: criticism, hostility, negative affect, or emotional overinvolvement
Parents of kids with the disorder had higher levels of EE
What adverse early life experiences are related to more severe bipolar disorder later in life?
Physical or sexual childhood abuse or other traumatic events early in life
What evidence suggests that childhood adversity may potentiate the effects of stressful events on manic onset or recurrence?
Childhood adversity is associated with a higher risk of the onset of mania and recurrent manic episodes in adulthood
Stressful events are also correlated with onset or recurrence
What is the social rhythm stability hypothesis?
Life events that disrupt social rhythms are more highly reported prior to the recurrence of a manic episode than a depressive one
What are the characteristics of a manic episode?
Elated, expansive, or irritable mood
Increased goal-directed activity
Grandiosity
Decreased need for sleep
Racing thoughts or rapid speech
Impulsivity
Distractability
How do Bipolar I and II differ?
I: primarily manic symptoms (manic or mixed episodes), with some depressive components
II: primarily depressive symptoms, with some hypomania (but rarely a full manic episode)
What are the other two subtypes of Bipolar disorder (besides I and II)?
Cyclothymia: two or more years of switching, but neither meets full criteria for hypomania or depression
NOS: manic symptoms don’t meet criteria for any other type (meant for practicality)
What is the age of onset for BD?
Late childhood or early adolescence
Getting younger and younger (may be due to overdiagnosis in kids)
Why might BD have such high comorbidity rates with other disorders?
Trait impulsivity and distractibility (even when not having an episode)
What have we noticed about suicidality in BD?
15x greater risk than general pop.
4x greater risk than those w/ MDD
Usually occurs between mania and depression due to repercussions of actions done during mania or trait impulsivity
BUT those with a depressive course are more likely
What do we notice about impairments in BD?
Occurs even between episodes
Consequences of mania can be felt for years after the episode
Only about 1/3 are able to maintain full-time employment
What evidence is there to support the influence of biology and genes on BD?
High concordance rates or heritability (aggregates in families)
Medications like lithium can help control cycling
Major role of dopamine and serotonin
What role does dopamine play in BD?
Needed for reward, incentive, motivation, and goal-direction
High during mania and diminished during depression
Dopamine agonists can trigger mania
What role does serotonin play in BD? How does it relate to dopamine?
Modulates anger, body temp, mood, sleep, appetite, and sex
Overall has a regulatory mechanism
Dysfunction allows for greater variability or unmitigated expression of dopamine
What is the Diathesis Stress Model (specifically how does it relate to BD)?
Stressful life events put pressure on an already strained system
Chronic stress is more predictive and may precede relapse (tied to both mania and depression equally)
What is our circadian rhythm? How does stress affect it?
Our natural 24-hour biochemical and physiological cycle that allows us to anticipate and prepare for predictable daily changes
Minor changes may disrupt social rhythms, like mealtimes and bedtimes, which is closely related to serotonin functioning and triggers mania
What are zeitstorers? Zeitgebers?
Storers: something that’s added to your life that disrupts stability
Gebers: something that maintained stability is taken away
How do social support processes relate to stress and BD?
Social support buffers against life stress (it’s about having the right people around)
Interpersonal distress ties with risk of relapse
