Flashcards in Chapters 7 and 8 - Mood Disorders and Suicide Deck (41):
Unipolar vs. Bipolar disorders
*Bipolar: "manic depression" 2 poles: mania (euphoria) and depression (dysphoria)
Prevalence of mood disorders?
*Depression: more females
*Bipolar: equal male and female
*Risk increases with each additional episode of depression
Core depression symptoms?
1) Depressed mood
2) Diminished interest or pleasure in nearly all activities (ankedonia)
Other depression symptoms?
*Significant weight loss or gain
*Insomnia or hypersomnia
*Psychomotor agitation or retardation
*Significant fatigue or loss of energy
*Feelings of worthlessness or guilt
*Diminished ability to think or concentrate
*Recurrent thoughts of death or suicidal ideation
What is dysthymia?
Milder, less intense depressive disorder - more chronic
Diagnosis criteria for dysthymia?
Symptoms not absent for more than 2 months at a time, chronic duration of 2-20 years
What is double depression?
Individual possesses symptoms of both dysthymia and major depressive episode
What is major depressive disorder?
More intense experiences of symptoms
Specifiers of major depressive disorder?
*Mild - just meet criteria
*Moderate - meet criteria and a bit more
*Severe - meet several criteria, also with or without psychotic features (delusions or hallucinations)
*Other specifiers - with seasonal patterning, with peripartum onset
Biological theory of depression
*Catecholamine hypothesis - deficiency of 5HT, NE, DA at synapse
*Genetics: based on twin studies and pedigree studies
Psychodynamic theory of depression
*Freud - prolonged grief related to earlier loss
*Bibring - loss itself is not important, but loss of what the person represented to you
*Bowlby - attachment theory; unhealthy early attachment
Behavioral theory of depression
*Depression - lack of positive reinforcement in person's environment
*Treatment - behavioral activation therapy
Cognitive theory of depression
*Beck's cognitive errors
*Depressive realism hypothesis
What were Beck's cognitive errors?
*Overgeneralizing: assume circumstances in one situation will be the same in all similar situations
*Selective abstraction: attend only to failure or deprivation and ignore any positives
*Catastrophizing: always imagining the worst of any given situations, always entertains the worst case scenario
*Dichotomous thinking: rigid thinking, all or nothing thinking
What is the attributional model?
Assigning causes to situations - internal, stable, global attributions for negative situations
What is the depressive realism hypothesis?
Are depressed people just more realistic than non-depressed? Research finds that there was a small but significant effect supporting depressive realism
Humanistic/Existential theory of depression
Depression related mostly to loss of self-esteem
*Carl Rogers: discrepancy between real and ideal self
Sociocultural theory of depression
Culture plays a role in symptom presentation and prevalence rates
*US: higher rates seen among Native Americans and Southeast Asian Americans
*China: report more somatic symptoms, fewer cognitive symptoms
Diathesis stress model
Predisposition to depression and add on to major life stressors - this leads to onset of depression
Biological treatment of depression
*Pharmacotherapy: antidepressants (SSRIs)
*Phototherapy: "light therapy" - used for major depression with seasonal patterning, results of outcome studies are mixed
*ECT: mainly used for severe major depression, results in massive release of all NTs
*Transcranial direct stimulation - magnetic stimulation, which is less invasive and targets specific areas, also used for resistant depression
Psychodynamic treatment of depression
Uncover unconscious conflicts, then work through such conflicts - work through grief over earlier loss
Behavioral treatment of depression
Increase positive reinforcement in one's environment (BAT)
Training in social skills that may be lacking
Cognitive treatment of depression
*Work on dysfunctional thinking (rational-emotive therapy)
*ACT - Acceptance Commitment Therapy
- Accept: emotions, feelings, thoughts - depression related
- Know: they are only emotions
- Commit to: take action towards life values
Humanistic treatment of depression
*Work toward a more realistic Real and Ideal Self
*Focus on self-esteem and self-concept
Characteristics of mania
Little sleep, elevated mood, rapid speech, irritability, risky impulsivity, increase in psychomotor activity, may show psychotic symptoms
Types of bipolar disorder
*Bipolar I: major depression and full-on mania
*Bipolar II: major depression and hypomania (lesser mania)
DSM characteristic of diagnosis of bipolar
Rapid cycles - at least 4 episodes in 12 months
Onset of symptoms of bipolar
*Most evident: young adulthood
*Co-morbidity across mood disorders
*Some links with early chaotic upbringing
*Stress can trigger mania
What is cyclothymia?
"Lesser" bipolar disorder - depressed mood and hypomania
*DSM: symptoms must have lasted at least 2 years
*Antidepressants for depressive phase may trigger mania
*Lithium - but potentially toxic
*Problems with non-adherence: side effects are not pleasant and they miss their highs
What is suicide?
Self-inflicted death that is an intentional, conscious, direct effort to end one's life
What is parasuicide?
An attempt to harm oneself and/or an unintentional suicide attempt
How is parasuicide different than suicide?
*Use less aggressive means
*Does not commit act
What are Schneidman's types of suicidal people?
*Death Seekers: clear intentions of dying, takes clear actions to die
*Death Initiators: already dying and are just speeding process
*Death Ignorers: believe that dying would lead to better existence
*Death Darers: ambivalent attempts to die, acts in risky ways. Motivated by attention-seeking
*Sub-intentional death: suicide-like category, behaviors more covert or unconscious, indirect in leading to death
Places with highest rates of suicide?
Asia, Eastern Europe, parts of Central Europe
Places with lowest rates of suicide?
South America, Greece, Egypt, Spain
What is cause of different places having different rates of suicide?
Mainly culture - perhaps suicide is more acceptable in some cultures than others
Gender differences in suicide
More females attempt, more males commit
Suicidal rates ranked by relationship status
Suicide rates in ethnic groups
*Native Americans: recently had higher rates
*White Americans: have highest rates
*African Americans and Hispanic Americans: lower rates (Asian Americans too)