Depression and Anxiety Disorders Flashcards

1
Q

Endogenous versus reactive

A

From within versus to an event

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2
Q

Early vs Late Onset

A

Worse prognosis from early

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3
Q

Mixed Anxiety-Depression

A
  • Comorbidity: co-occurrence of depressive and anxiety disorders
  • 2/3rd of depressed patients have a concurrent anxiety disorder
  • High occurrence with Bipolar Disorder and anxiety
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4
Q

Mood Disorders and Suicide

A
  • People with Major Depression are 11 times greater risk of making a suicide attempt
  • Manic episode - 30 times greater risk of suicide
  • Those who commit suicide - 55% were depressed before the attempt
  • More worried about suicide when first coming out of depression
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5
Q

Suicide by Age

A

More common 75+

Mostly older, white males committing suicide

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6
Q

Suicide Methods

A

Firearms 49.8%
Suffocation 26.8%
Poisoning 15.4%
Other 7.9%

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7
Q

Suicide Rates in US

A

Keeps going up

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8
Q

Suicide Rate per State

A
  • West Virginia - high level of obesity

- Alaska - dark all the time, isolated

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9
Q

Is living in a “happy” place a risk factor for suicide?

A
  • UK’s University of Warwick, Hamilton College in New York, and the Federal Reserve Bank of San Francisco (2011)
  • States with people who are generally more satisfied with their lives tended to have higher suicide rates than those with lower average levels of life satisfaction
  • E.g., Utah is ranked first in life-satisfaction, but has the 9th highest suicide rate. Compared to: New York was ranked 45th in life satisfaction, yet had the lowest suicide rate in the country
  • Validation of feelings vs. deviation from the norm
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10
Q

Suicide Prediction

A
  • Unbearable psychological pain
  • Self-denigration
  • Constriction of the mind
  • Isolation
  • Hopelessness
  • More worried about people in jail vs. in prison (jail is unknown)
  • Sex offenders exiled and raped in prison
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11
Q

Prisoner suicide rate

A

In the US while incarcerated - 337 state prisoners committed suicide from 2001 to 2002

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12
Q

Suicide by numbers

A
  • 44,193 suicides per year in US
  • 121 suicides per day
  • One every 17 minutes
  • With handguns, deaths from suicide are more frequent than deaths from homicide
  • 10th leading cause of death for all Americans
  • 3rd leading cause of death for young people aged 15-24
  • Males are 4 times more likely to die of suicide than are females
  • Females are more likely to attempt suicide than are males
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13
Q

Culture

A
  • China has one of the highest female suicide rates in the world and is the only country where it is higher than that of men
  • The highest rate of female suicide is found in South Korea at 22 per 100,000, with high rates in South East Asia and the Western Pacific generally
  • White males accounted for 7 of 10 suicides in 2015
  • Firearms account for almost 50% of all suicides
  • The rate of suicide is highest in middle age - white men in particular
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14
Q

Teenage Suicide

A

Increased by 200% since 1960

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15
Q

Number one risk factor for suicide is…

A

Mental illness

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16
Q

Mental illness and suicide scenarios

A
  • People with Major Depressive Disorder getting better…
  • Schizophrenics recognizing the devastation of their illness
  • Substance Use
    • Alcohol intoxication present in 20 to 50% of completed suicides
    • Alcohol has been identified as a contributory factor to death in more than 1/3rd of completed suicides
17
Q

Myths about Suicide

A
  • People who threaten will not carry it out - in one study more than half clearly stated their intent 3 months before
  • Just looking for sympathy - 40% had a previous attempt (more attempt = greater likelihood)
  • Questioning depressed people about suicide will put the thought in their head
18
Q

Biochemical Research Theory (Suicide)

A

Neurotransmitter imbalance

19
Q

Behaviorists Theory (Suicide)

A

Loss of reinforcement, elicit too much reinforcement inappropriately

20
Q

Cognitive Theory (Suicide)

A

Learned helplessness (believing you can’t control) and negative schemas (images of self, world, and future)

21
Q

Psychodynamic Theory (Suicide)

A

Early trauma, feelings of powerlessness

22
Q

Werther Effect

A
  • Goethe’s novel
  • The hero shoots himself after an ill-fated love
  • After its publication there were many reports of young men using the same method to commit suicide (copycat suicide)
  • David Phillips coined the term
  • Copycat suicide is mostly blamed on the media
23
Q

The most popular place to commit suicide

A
  • Golden Gate Bridge (in the US, used to be the world)

- Now Nanjing Yangtze River Bridge

24
Q

Beck’s Cognitive Theory

A
  • Cognitive symptoms of depression precede and cause mood symptoms
  • Early experience –> dysfunctional beliefs –> critical incident(s) –> beliefs activated –> negative automatic thoughts –> symptoms of depression (which then feedback on negative automatic thoughts)
25
Q

Beck’s Cognitive Model

A
  • Pessimistic predictions caused by negative automatic thoughts
    = Negative Cognitive Triad
  • Negative thoughts about self
    • “I’m ugly, worthless, failure”
  • Negative thoughts about experiences and world
    • “no one loves me, people treat me badly”
  • Negative thoughts about the future
    • “it’s hopeless because things will always be this way”
  • To maintain cognitive triad, distort interpretations of events
26
Q

Beck’s Cognitive Distortions

A
  • All or nothing
  • Selective Abstraction
  • Overgeneralization
  • Emotional Reasoning
  • Personalization
27
Q

Can Beck’s model explain causality?

A
  • Maybe
  • Results are mixed
  • Lewinsohn et al. followed 1500 adolescents for one year
  • Those with dysfunctional beliefs at baseline AND who have a high stress event were more likely to develop major depression than those with low stress or low dysfunctional beliefs and high stress
  • Otto et al. followed 700 women for 3 years
    • Dysfunctional beliefs at baseline predicted new onset and recurrence in 3 years
    • However, knowing past history depression was more predictive than dysfunctional beliefs
28
Q

Learned Helplessness Model

A
  • Seligman and helpless dogs
  • People, after experiencing stressful life events for which they see no control, develop helplessness
  • See self as continually trying and failing
    • Repeated loss of positive reinforcement and increase in negative reinforcement leads to giving up
29
Q

Reformulated Helplessness Theory (i.e., Attributional Theory)

A
  • HOW people answer why uncontrollable negative events occur determines whether they become depressed
  • Pessimistic attributional style
  • e.g., boyfriend treats you badly “it’s because I’m ugly and boring” versus “it’s because he’s in a bad mood today after getting in a car accident and he’s taking it out on me”
30
Q

Antidepressant Medication

A
  • Mono-amine Oxidizers (MAO) Inhibitors - are a class of powerful antidepressant drugs prescribed for the treatment of depression. They are particularly effective in treating atypical depression (Phenelzine - Nardil)
  • Tricyclic Antidepressants - Antidepressant Drug (Imipramine)
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
31
Q

Mood Stabilizers

A
  • Depakote
  • Tegritol
  • Lithium Carbonate - natural mineral (Texas)
32
Q

Electroconvulsive therapy (ECT)

A
  • Affects level of serotonin and norepinephrine
  • Severe Depression
  • Short Term Memory Loss
  • Kitty Dukakis - Shock: The Healing Power of Electroconvulsive Therapy
33
Q

High Risk Groups

A
  • Young males (age 15-49)
  • Elderly people, especially males
  • People with MI
  • People with alcohol/drug problems
  • People with a history of previous attempts
  • People in custody
34
Q

Protective Factors

A
  • Effective clinical care for mental, physical, and substance abuse disorders
  • Easy access to a variety of clinical interventions and support for help seeking
  • Family and community support (connectedness)
  • Support from ongoing medical and mental health care relationships
  • Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
  • Cultural and religious beliefs that discourage suicide and support instincts for self-preservation
35
Q

Suicide in Westernized Countries

A
  • Higher in men than women

- Most common in Hungary, Finland, and Austria

36
Q

Girlfriend encourages boyfriend

A
  • Conrad and Michelle
  • Encourages suicide via text messages and phone calls
  • She was charged with murder