Depression and Anxiety Disorders Flashcards
(36 cards)
1
Q
Endogenous versus reactive
A
From within versus to an event
2
Q
Early vs Late Onset
A
Worse prognosis from early
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
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
5
Q
Suicide by Age
A
More common 75+
Mostly older, white males committing suicide
6
Q
Suicide Methods
A
Firearms 49.8%
Suffocation 26.8%
Poisoning 15.4%
Other 7.9%
7
Q
Suicide Rates in US
A
Keeps going up
8
Q
Suicide Rate per State
A
- West Virginia - high level of obesity
- Alaska - dark all the time, isolated
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
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
11
Q
Prisoner suicide rate
A
In the US while incarcerated - 337 state prisoners committed suicide from 2001 to 2002
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
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
14
Q
Teenage Suicide
A
Increased by 200% since 1960
15
Q
Number one risk factor for suicide is…
A
Mental illness
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
Beck's Cognitive Model
- 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
Beck's Cognitive Distortions
- All or nothing
- Selective Abstraction
- Overgeneralization
- Emotional Reasoning
- Personalization
27
Can Beck's model explain causality?
- 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
Learned Helplessness Model
- 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
Reformulated Helplessness Theory (i.e., Attributional Theory)
- 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
Antidepressant Medication
- 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
Mood Stabilizers
- Depakote
- Tegritol
- Lithium Carbonate - natural mineral (Texas)
32
Electroconvulsive therapy (ECT)
- Affects level of serotonin and norepinephrine
- Severe Depression
- Short Term Memory Loss
- Kitty Dukakis - Shock: The Healing Power of Electroconvulsive Therapy
33
High Risk Groups
- 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
Protective Factors
- 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
Suicide in Westernized Countries
- Higher in men than women
| - Most common in Hungary, Finland, and Austria
36
Girlfriend encourages boyfriend
- Conrad and Michelle
- Encourages suicide via text messages and phone calls
- She was charged with murder
