Chapters 7 and 8 - Mood Disorders and Suicide Flashcards Preview

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Flashcards in Chapters 7 and 8 - Mood Disorders and Suicide Deck (41):

Unipolar vs. Bipolar disorders

*Unipolar: depression
*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
*Attributional model
*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)
*Cognitive restructuring
*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
*Genetic links
*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


Bipolar treatments

*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?

*More impulsive
*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

1) Divorced
2) Widowed
3) Single
4) Married


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)


How to approach the suicidal

*Validate the person's feelings
*Understand person's problems
*Assess potential for suicide
*Help them identify strengths and resources, get them to talk about themselves and friends
*Follow-up plan - get them to commit to a plan