L11: Mood Instability Flashcards
(22 cards)
Define mood instability
rapid oscillations of intense affect, with a difficulty in regulating these oscilattions or their behavioural consequences
What are the characteristics of a depressive episode? 11
- low mood
- loss of enjoyment (anhedonia)
- loss of interest & motivation for everyday activities
- sleep problems
- appetite problems
- loss of concentration
- poor energy
- psychomotor agitation/retardation
- feelings of emptiness or worthlessness
- self doubt/blame
- suicidal thoughts
What are the characteristics of (hypo)mania? 10
- constant elation or euphoria
- irritable mood, getting into arguments easily
- observable hyperactivity
- increased energies
- inappropriate optimism
- overestimating personal ability
- poor judgment, grandiose plans
- speeding up of thought and speech, flights of ideas
- need for little sleep
What is the time course of bipolar disorder? 5
- switching episodes of mania vs depression in varying severity
- can also have mixed states
- and in between “euthymic” states
- looks very different for every person
- around 50-60% relapsing within a year of recovery from a mood episode
What are other common symptoms in bipolar disorder? 3+6
comorbidity & differential diagnosis
- 30-70% report anxiety
- 93% anxiety disorder lifetime comorbidity
- 75% psychotic symptoms (at either episode)
important differential diagnosis
- MDD
- schizoaffective disorder & psychotic disorder
- anxiety disorder
- substance use disorder
- personality disorder
- ADHD (in children)
What do you know about the epidemiology of bipolar disorder? 5
- around 2-4% of pop
- bipolar I affects men & women equally
- bipolar II more women (hypomania)
- strong genetic component
- high risk of suicide (30-50% attempts, of which 15-20% complete)
What is the developmental trajectory of BD? 3+2+1
for most
- starts before age of 21
- starts w single depressive episode
- family history of BD
into young adulthood:
- becomes recurrent depression and prodomal hypomania symptoms present throughout young adulthood
- then mania or hypomania episode comes
this is also referred to as the bipolar spectrum (how it develops over time)
What is typically the treatment for bipolar disorder? 3
- in acute phase: medication but need to be careful here
- psychosocial interventions
- challenge of treating anxiety
Is there a link between bipolar disorder & creativity? 2
- correlational evidence between creativity & bipolar
- first degree relatives of BD more likely to have creative/high achieving professions
In what other disorders does mood instability present?1+2
part of diagnostic symptoms in BPD & partly ADHD and PTSD
recent studies
- over half ppl w depression & ADs
- generally ppl w mental disorder have higher chance of mood instabiltiy
-> TRANSDIAGNOSTIC PHENOMENON
In the general pop, is there a developmental specificity to mood instablity?
adolescents more mood instability
Why is mood instability so clinically relevant? 6+1
its associated w
- general poor clinical outcomes
-suicidal thinking
- healthcare service use
- self harm
- addiction
- trauma
-> GENERAL POOR PROGNOSIS
Are there any abnormalities in cognitive functioning that are associated w mood instability? 3
- biases in processing emotional info (negative memory biases) in BD
- attentional dysfunction in ADHD w hypomanic symptoms
- dysfunctional mental imagery
-> both a bit confusing research
How do we usually measure mood instability? 2
- self report scales of trait constructs
- weekly (or longer) retrospective ratings of symptoms (but memory biases)
How could we improve how we capture mood instability?
combination of maths & digital tools
like mood tracking applications
How does mental imagery relate to mood instability in bipolar? 1+4+2
dysfunctional mental imagery is “emotional amplifier” in between episodes, it amplifies the mood rapidly changing (so positive imagery -> more positive affect etc)
- higher levels of intrusive prospective imagery & more vivid imagery of future negative events
- these higher levels correlated w levels of anxiety & depression in bipolar sample
- intense suicidal flashforwards & positive flashforwards
- feels very real
-> this intenseness of the mental imagery can be seen in general mood instability across mental illnesses (TRANSDIAGNOSTIC)
associated w differential activation in frontal gyrus & insula
What are some ways to use imagery to reduce mood instability?
imagery rescripting & meta cognitive imagery manipulation can reduce mood instability
What is positive mood amplification? why can it be problematic? 3
- the process leading to elevated mood
- dysregulated positive mood = key feature of (hypo) mania and bipolar disorder which is linked to risk taking, reduced sleep, and socially inappropriate behaviour
- so need to target this early mood amplification to avoid future issues
What is mental imagery?
the experience of perception in the absence of eliciting sensory input
What are 2 questions that remain about the relationship between mental imagery & mood instability? How were the 2 questions investigated?
- does mental imagery also elicit mood amplification if stimulus is not as mood congruent? (stimulus specificity) like does calm mental imagery also elicit positive mood amplification?
-> compare changes in self reported affect across 2 eliciting stimulus categories (elated vs calm mental imagery generation) - How specific is the effect in terms of affective response? is negative mood also amplified in certain mental imagery conditions or does it only amplify positive moods? (response specificity)
-> investigate task dependent changes in self reported affect across distinct affect clusters (negative affect, positive calm affect, positive excitiement affect)
How is mental imagery’s relationship with mood instability generally measured? 4
- imagery generation training
- positive (elated) or neutral (calm) picture word cue imagery generation task (got either a positive or neutral word paired with a picture, then asked to generate mental image)
- rate vividness of mental imagery
- affect measurement (before, during, and after task)
What were the results from the mental imagery-mood instability research paper? 3
- the higher the mood instability, the more the affect changed as a result of mental imagery
- the more elated the word associated with the picture (stimulus), the faster the affect increased
- no effect of the positive/neutral mental imagery on negative affect
-> amount of mood amplification depended on type & content of mental imagery
