Chapter5 Mood Disorders Flashcards
(114 cards)
1
Q
mood disorders effect what three parts of life
A
- how people feel what they believe and expect
- how they think and talk
- and how they interact with others.
2
Q
two types of mood disorders
A
major depressive disorder and bipolar disorder
3
Q
depressive disorders
A
mood is consistently low
4
Q
bipolar disorder
A
persons mood is sometimes decidedly upbeat perhaps to the point of mania and sometimes low
5
Q
three types of mood episodes
A
major depressive
6
Q
DSM-5 Criteria for Major Depressive Episode
A
A mood episode characterized by severe depression that lasts at least 2 weeks.
affect
depressed mood most of the day
diminished interest or pleasure
behavior
weight change
sleep problems
motor agitation or retardation
fatigue or loss of energy
cognition
feelings of worthlessness
diminished ability to think
recurrent thoughts of death
7
Q
Anhedonia
A
inability to experience pleasure
8
Q
two behavioral indicators of depression
A
psychomotor agitation or psychomotor retardation
9
Q
psychomotor agitation
A
An inability to sit still@ evidenced by pacing@ hand wringing@ or rubbing or pulling the skin@ clothes@ or other objects.
10
Q
Psychomotor retardation
A
A slowing of motor functions indicated by slowed bodily movements and speech and lower volume@ variety@ or amount of speech.
11
Q
Hypersomnia
A
excessive sleepiness
12
Q
During a depressive episode@ people may also report
A
ifficulty thinking@ remembering@ concentrating@ and making decisions
13
Q
is depression heterogeneous or homo
A
heterogeneous meaning that people with depression experience these symptoms in different combinations
no single set of symptoms is hared by all ppl
14
Q
prodrome for MDE
A
An early or premonitory sign or symptom of a disorder.
anxiety mild depressive symptoms that last weeks to months
15
Q
premorbid
A
referring to the period of time prior to a patient’s illness
16
Q
comorbid
A
two or more disorders in the same individual
17
Q
what percentage of MDE return to premorbid functioning
A
2/3
18
Q
one state that mimics depression symptoms
A
grief
19
Q
bereavement exclusion
A
sad bc loss of loved one
A stipulation in which people who have experienced the loss of a significant loved one would not be given the diagnosis of major depression within the first 2 months of the loss. This exclusion was removed from the DSM-5.
On the other hand, removing the bereavement exclusion may lead to overdiagnosis of—and rush to treat with medication or psychotherapy
20
Q
major depressive disorder
A
A mood disorder marked by five or more symptoms of an MDE lasting more than 2 weeks.
21
Q
heterogenous symptoms
A
different for each individual
22
Q
are Younger children who are depressed are considered to be at high risk for being depressed as adults.?
A
no
23
Q
recurrent depression
A
More than half of those who have had a single depressive episode go on to have at least one additional episode@
24
Q
absenteeism
A
the failure to show up for work
25
Presenteeism
attending scheduled work when one's capacity to perform is significantly diminished by illness or other factors
26
Phototherapy
Treatment for depression that uses full-spectrum lights; also called light-box therapy.
27
how many americans will experience MMD
how much does it cost the economy
20percent
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age cohort and depression
people born at roughly the same time who pass through the life course together
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peripartum onset
subtype of depression that applies to women who experience an episode of major depression either during pregnancy or in the four weeks following childbirth
30
before puberty do boys or girls experience depression more
after?
before the same
after girls
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ppl with MMD also tend to have
anxiety disorder 50 PERCENT
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likelihood of having another MDE table
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Persistent depressive disorder (dysthymia)
Not as severe as MDE MDD@ fewer symptoms@ younger age@ no vegetative or psychomotor symptoms but lasts longer and incorporated into self image
34
Disruptive mood dysregulation disorder
a depressive disorder in children characterized by persistent irritability and frequent episodes of out-of-control behavior.
It is supposed to be a more accurate description of kids who have outofcontrol rage episodes and were incorrectly labeled as having bipolar disorder and then were (inappropriately) treated for that disorder
35
Understanding Depressive Disorders
Brain Systems
unusually low activity in frontal lobe that has direct connections to the amygdala and limbic structures
alters connection to dopamine serotonin and norepinephrine systems MODULATORY SYSTEMS
36
Understanding Depressive Disorders
Neural Communication
Researchers have long known that the symptoms of depression can be alleviated by medications that alter the activity of serotonin or norepinephrine
alters connection to dopamine serotonin and norepinephrine systems MODULATORY SYSTEMS
37
is depression caused by too little or too much of any specific NT
the disorder arises in part from complex interactions among numerous neurotransmitters and depends on how much of each is released into the synapses@
how long each neurotransmitter lingers in the synapses,
and how the neurotransmitters interact with receptors in other areas
38
Understanding Depressive Disorders Neurological Factors
The stress diathesis model of depression
(Stress Related Hormones)
stress–diathesis model
excess of cortisol in blood, which makes their brains prone to overreacting when they experience stress.
alters serotonin and norepinephrine and decreases size of hippocampus(memory)
FOCUSES ON HPA AXIS
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3
avoidant@ anhedonic@ and: unenthusiastic
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The HPA axis
Stress activates the hypothalamus@ which releases corticotropin-releasing factor (CRF)@
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Understanding Depressive Disorders Neurological Factors
Genetics
One possibility is that genes influence how a person responds to stressful events (Costello et al.@ 2002; Kendler et al.@ 2005). If a person is sensitive to stressful events@ the sensitivity could lead to increased HPA axis activation (Hasler et al.@ 2004)@ which in turn could contribute to depression.
42
Attentional Biases
People who are depressed are more likely to pay attention to sad or angry stimuli.
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negative triad of depression.
Negative view of
world,
self
future
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Dysfunctional Thoughts
cognitive distortions
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rumination
compulsive fretting; overthinking about our problems and their causes
46
Rumination and Attributional Style
Three particular aspects of attributions are related to depression: whether the attributions are
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internal attributional style
people who consistently attribute negative events to their own qualities
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hopelessness depression
people who consistently make stable and global attributions for negative events—whether to internal or external causes—are more likely to feel hopeless in the face of negative events and come to experience hopelessness depression
49
learned helplessness
t can arise from situations in which undesirable outcomes do occur and the person is helpless to change the situation@ s
50
Stressful Life Events
In approximately 70% of cases@ an MDE occurs after a significant life stressor@
51
Social Exclusion
feeling the chronic sting of social exclusion—being pushed toward the margins of society—is also associated with depression.
52
race a reason for depression?
Latinos and African Americans experience more depression than other ethnic groups in the United States; a closer look at the data@ however@ suggests that socioeconomic status@ rather than ethnic or racial background per se@ is the variable associated with depression
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Social Interactions
Emotions are contagious
54
attachment style and depression
Secure attachment
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Culture
A person's culture and context can influence how the person experiences and expresses depressive symptoms
56
Gender Difference four explanations
In North America@ women are about twice as likely as men to be diagnosed with depression
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feedback loop
people's psychological characteristics affect how they interpret things
58
Three medications for depressive disorders
Selective serotonin reuptake inhibitors (SSRIs)
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what do depression medications work
medication targets SEROTONIN and NOREPINEPHRINE
60
Selective serotonin reuptake inhibitors (SSRIs)
Medications that slow the reuptake of serotonin from synapses.
61
Tricyclic antidepressants
Older antidepressants named after the three rings of atoms in their molecular structure.
62
Monoamine oxidase inhibitors (MAOIs
MAOIs inhibit this chemical breakdown@ to increase the amount of NT in the synapse.
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St. John's Wort
St. John's wort to prescription antidepressants and placebos indicate that the herbal medication can help patients with mild to moderate depression@ and sometimes—but less commonly—even those with severe depression (
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electroconvulsive therapy (ECT)
A procedure that sends electrical pulses into the brain to cause a controlled brain seizure@ in an effort to reduce or eliminate the symptoms of certain psychological disorders.
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ect used when 3
ECT may be used when a patient:
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Transcranial magnetic stimulation (TMS)
A procedure that sends sequences of short@ strong magnetic pulses into the brain via a coil placed on the scalp@ which is used to reduce or eliminate the symptoms of certain psychological disorders.
67
Behavior therapy for depression
such methods focus on the ABCs of an unwanted behavior pattern:
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behavioral activation (part of behavior therapy for depression)
Three techniques
69
rests on three ideas
The form of treatment that rests on the ideas that:
70
cognitive restructuring
a therapy that strives to help clients recognize maladaptive thought patterns and replace them with ways of viewing the world that are more in tune with reality
71
Cognitive-behavior therapy
as good or better than medication
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CBT versus medication
In some ways@ CBT may be better than medication.
73
Interpersonal therapy (IPT)
The form of treatment that is intended to improve the patient's skills in relationships so that they become more satisfying.
74
Systems Therapy
the family is a system that strives to maintain homeostasis@ a state of equilibrium@ so that change in one member affects other family members.
75
3 goals of any treatment for depressive disorders
to reduce symptoms of distress
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bipolar disorders
Mood disorders in which a person's mood is often persistently and abnormally upbeat or shifts inappropriately from upbeat to markedly down.
77
whats shorter manic or depressive episode
manic
78
manic episode
A period of at least 1 week characterized by abnormally increased energy or activity and abnormal and persistent euphoria or expansive mood or irritability
79
Expansive mood
A mood that involves unceasing@ indiscriminate enthusiasm for interpersonal or sexual interactions or for projects.
80
flight of ideas
thoughts that race faster than they can be said.
81
manic episode onset and ending
Typically@ a manic episode begins suddenly@ with symptoms escalating rapidly over a few days; symptoms can last from a few weeks to several months. Compared to an MDE@ a manic episode is briefer and ends more abruptly.
82
hypomanic episode
Pervasive elated@ irritable@ or euphoric mood but less distressing than mania and does not impair functioning • No psychosis - but uncritically self- confident - minimum of 2-4 days (rather than a week)
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3 types of bipolar disorder
Bipolar I
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Rapid cycling (of moods)
Having four or more episodes that meet the criteria for any type of mood episode within 1 year.
85
bipolar or depressive
bipolar people MDEs that are more severe and lead to more lost work days
86
bipolar II?
equal for both
87
do they have more manic or depressive episodes?
more manic episodes
88
do they have more manic or depressive episodes?
more depressive episodes
89
Cyclothymic disorder
A mood disorder characterized by chronic@ fluctuating mood disturbance with numerous periods of hypomanic symptoms alternating with depressive symptoms@
90
Brain Systems
amygdala is enlarged in people who have been diagnosed with a bipolar disorder
91
amygdala involved in
Amygdala involved in
92
DIFFUSE MODULATORY SYSTEMS IN BIPOLAR
Norepinephrine: levels reduced by lithium
93
Genetics
• A first degree relative with bipolar disorder increases your risk by 4 - 24
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Psychological Factors: Thoughts and Attributions
up to one third of people may have residual cognitive deficits@ ranging from difficulties with attention@ learning@ and memory to problems with executive functioning
95
Social Factors: Social and Environmental Stressors
Social factors can also have indirect effects@ such as occurs when a new job disrupts a person's sleep pattern@ which in turn triggers neurological factors that can lead to a mood episode.
96
Feedback Loops in Understanding Bipolar Disorders
t may directly or indirectly affect neurological functioning@ making the person more vulnerable to a manic or depressive episode. Moreover@ like people with depression@ people with a bipolar disorder tend to have an attributional style (psychological factor) that may make them more vulnerable to becoming depressed. In turn@ their attributional style may affect how these people interact with others
97
Treating Bipolar Disorders Medication
mood stabilizer
98
lithium
type of mood stabilizer
99
why do ppl stop taking mood stabilizers
not because of side effects but their mood evens out and they can miss their manic episodes
100
antidepressants in bipolar
Patients with a bipolar disorder may be given antidepressant medication for depression@ but such medications can induce mania and so should be taken along with a mood stabilizer
101
CBT for bipolar
• CBT to help: - Stick with medication schedule - Sleep strategies (regular sleep & wake times) - Recognize signs of mood swings
102
interpersonal and social rhythm therapy
identifying themes of social stressors@
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Feedback Loops in Treating Bipolar Disorder
Successful treatment can also affect interpersonal relationships@ leading patients to interact differently with others@ develop a more regular schedule@ and come to view themselves differently. Moreover@ such therapy leads patients to change the attributions they make about events and even change how reliably they take medication for the disorder.
104
prevalence of suicide
10th biggest killer
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suicidal ideation
serious thoughts about committing suicide
106
Warning signs for suicide
giving away possessions@
107
parasuicidal behavior
in fact@ suicide attempts. Such deliberate but nonlethal self-harming is sometimes referred to as parasuicidal behavior
108
The three most common types of disorders among those who commit suicide
major depressive disorder (50%)@
109
Neurological Factors for suicide
ppl who committed suicide tended to have fewer neurons in the part of the brain that produces serotonin t
110
Psychological Factors for suicide 5
such as poor coping skills (e.g.@ behaving impulsively)
111
cultural factors for suicide
One important social factor that influences suicidal behavior is religion
112
crisis intervention for suicide steps 3
the first aim of suicide prevention is to make sure that the person is safe.
113
Impulsivity is associated with low levels of the neurotransmitter
serotonin
114
adolesent depression
answer
