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PSY 230 > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

What is suicidal self-injury?

A

Any action that is self inflicted and results in injury or the potential for injury, with an intent to die

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2
Q

What is suicidal ideation?

A

It involves a variety of cognitions, from “fleeting thoughts that life is not worth living” to “very concrete, well-thought out plans for killing oneself”

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3
Q

What is suicidality?

A

It is the construct that includes suicidal ideation, parasuicide and suicide

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4
Q

What is the continuum for suicidal thoughts and actions?

A

Ideations, plan in place, attempt, death

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5
Q

What are the warning signs (behavior) of suicide?

A
  • Increased use of alcohol or drugs
  • Acting recklessly
  • Isolating and withdrawing from activities
  • Change in sleep, appetite, energy level
  • Visiting or calling people to say goodbye
  • Giving away prized possessions
  • Aggression or agitation
  • Discomfort due to psychosis
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6
Q

What are the warning signs (verbal) of suicide?

A

Things they could say:
- wanting to kill themselves
- having no reason to live
- being a burden to others
- feeling trapped
- unbearable pain
- feeling hopelessness

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7
Q

What are the warning signs (mood) of suicide?

A
  • depression
  • despair
  • loss of interest
  • rage
  • irritability
  • humiliation
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8
Q

What are the statistics of suicide?

A
  • Suicide is the 11th leading cause of death in the US
  • Men died by suicide 3.9 times more than women
  • White males accounted for almost 70% of the deaths of suicide in 2021
  • Suicide is the 2nd leading cause of death among children and adolescents
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9
Q

What are the statistics of suicide on adolescents?

A
  • Adolescent girls are twice as likely as boys to have suicidal thoughts or make suicidal plans
  • Adolescent girls are thrice as likely than boys to attempt suicide
  • Boys are twice as likely than girls to die from suicide due to more lethal strategies
  • Suicides among boys increased from 7.6 to 9.7
  • Suicides among girls increased from 2.3 to 4.2
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10
Q

How does age play apart in suicide?

A
  • Suicide death is higher in adolescents than children
  • The suicide rate among prepubescent children is very low
  • Suicidal ideation is rare in children but becomes slightly more common during early adolescence and then increases between the ages of 15 and 18
  • Death by suicide increases with age
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11
Q

What does the interpersonal-psychological theory of suicide include?

A
  • Perceived burdensomeness
  • Thwarted belongingness
  • Capability for suicide
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12
Q

What are the two categories of risk in the interpersonal-psychological theory of suicide?

A
  • Dysregulated impulse control
  • Intense psychological pain
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13
Q

What are the clinical features of a major depressive disorder?

A
  • One or more major depressive episodes, absence of manic episodes, separated by periods of remission
  • A single episode is highly unusual
  • Recurrent episodes are more common
  • Waxes and wanes
    -Duration 4-5 months
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14
Q

What are the psychotic features with MDD?

A
  • Delusions
  • Hallucinations
  • Disorganized speech (frequent derailment or incoherence)
  • Grossly disorganized behavior
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15
Q

What are the DSM-5 specifiers of MDD with mood-congruent psychotic features?

A

The content of all delusions and hallucinations is consistent with the typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment

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16
Q

What are the DSM-5 specifiers of MDD with mood-incongruent psychotic features?

A

The content of all delusions or hallucinations does not involve typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment, or the content is a mixture of mood-incongruent and mood-congruent themes

17
Q

What does catatonia include as a feature of depression?

A
  • Stupor (no psychomotor activity, not actively relating to the environment)
  • Catalepsy (passive induction of a posture held against gravity)
  • Waxy flexibility (slight, even resistance to positioning by the examiner)
  • Mutism (no, or very little, verbal response)
  • Negativism (opposition or no response to instructions or external stimuli)
  • Posturing (spontaneous and active maintenance of a posture against gravity)
  • Stereotypy (repetitive, abnormally frequent, non-goal-directed movements)
  • Agitation, grimacing, echolalia (mimicking another’s speech)
  • Echopraxia (mimicking another’s movements)
18
Q

What is the relationship between catatonia and incontinence?

A

Incontinence (urinary or fecal) is not part of the criteria listed in the DSM-5 for catatonia

Some clinicians believe it should be included as a sign of catatonia since clinical improvement is associated with improvement in incontinence and incontinence improves as catatonia improves with treatment

19
Q

What is persistent depressive disorder?

A

Being depressed most of the day, more days than not for a minimum of 2 years for adults
You cannot be symptom-free for more than two months

20
Q

What are the symptoms of PDD?

A

Must include two of the following symptoms
- Increased or decreased appetite
- Increased or decreased sleep
- Fatigue
- Low self-worth
- Concentration and decision-making difficulties
- Feelings of hopelessness

21
Q

What are the differences between major depressive disorder and persistent depressive disorder?

A

PDD has a minimum of symptoms required
Is more chronic
Has higher rates of comorbidity
Is less responsive to treatment and shows a slower rate of improvement over time

22
Q

What relationships are there between major depressive disorder and persistent depressive disorder?

A
  • About 20% of patients with an MDE report chronicity of this episode for at least two years, and therefore meet the criteria for PDD
  • Approximately 22% of people with PDD with few symptoms eventually experienced an MDE
  • Individuals who suffer from both MDE and PDD with fewer symptoms are said to have double depression
23
Q

What is the difference between the early and later onset of PDD?

A

Early onset has increased comorbidity, ACE’s, and family history of depression
Late onset is associated with stress

24
Q

What are some of the complications with diagnosis and treatment of PDD?

A

Mild and moderate depression may feel normal to the person experiencing it, and if they do seek treatment
- it is easy to miss PDD and diagnose a major depressive episode or another disorder
- it is difficult to get a comprehensive history to determining that the patient had PDD

25
Q

What is the relationship of MDD with peripartum onset?

A
  • Approximately 15% of women experience this including minor depressive episodes
  • Rates in adolescent mothers are higher (26-53%)
  • 60% of women have their first depressive episode in the postpartum period
  • Can present either with or without psychotic features
  • Infanticide is associated with postpartum psychotic episodes
    -Psychotic symptoms can also occur in severe postpartum mood episodes with specific delusions or hallucinations involving the infant
26
Q

What are the common symptoms of major depressive disorder with peripartum onset?

A
  • Extreme difficulty in day-to-day functioning
  • Feelings of guilt, anxiety and fear
  • Loss of pleasure in life
  • Insomnia
  • Bouts of crying
  • Thoughts of hurting oneself or the infant
27
Q

What does MDD with peripartum onset feature?

A
  • Hallucinations
  • Delusions
  • Confusion
  • Labile mood
  • Thoughts of harming oneself or the infant
    Approximately 1 of every 1000 births
    Women who have bipolar disorder or schizoaffective disorder are at increased risk
28
Q

What is included with late-life depression LLD?

A
  • Depression in the elderly between 14% and 42%
  • Co-morbid with anxiety disorders
  • Less gender imbalance after 65 years of age
  • Cultural differences exist
  • They can say they are “heartbroken”

Native American population has four times the rate of depressive disorders as the general population

29
Q

What is electroconvulsive therapy?

A
  • It is now a safe and effective treatment for severe depression
  • It is administered every other day for 6-10 treatments
  • Electric shock is administered directly through the brain for <1 second
  • Produces seizures for several minutes
  • Patients are anesthetized to reduce discomfort
  • Muscle-relaxing medication to prevent bone breakage from seizures
30
Q

What are the side effects of electroconvulsive therapy?

A
  • Nausea
  • Headache
  • Limited short-term memory loss
  • Confusion
  • Usually disappear after a week or two
  • Some patients have long-term memory problems

PSY 230 (11 decks)

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