mood Flashcards
1
Q
what are the DSM criteria for depression?
A
- depressed mood for most of time for at least 2 weeks
- diminished interests in activities
- weight loss
- sleep disturbance > insomnia
- fatigue, feeling of worthlessness, guilt
- recurrent thoughts of death
2
Q
what are potential causes of depression?
A
- life events > e.g. divorce, financial strain
- significant distress
- social or occupational dysfunction
- distinction between suicidal ideation (thinking about it), plan & attempt
3
Q
what is persistent depressive disorder?
A
- previously known as dysthymia
- 2+ yrs of low mood w/o qualifying for major depression
- symptoms: poor appetite, sleep disturbances, low energy, poor self esteem & feeling of hopelessness
4
Q
what are biological theories of depression?
A
- genetic factors: > twin studies concordance = 31% -42% (MZ) & 20% (DZ)
- heritability of major depression= higher in women than men
- interaction between genetics + environment
- neurochemical factors: > monamine hypothesis > lack of serotonin & antidepressants aim to increase serotonin availability > MDMA & ketamine affecting neurotransmitters > investigated
- amygdala overactivity > reduced hippocampus vol & prefrontal cortex dysfunction > Chronic stress > affects the stress axis = leading to cortisol release & potential hippocampus volume reduction
5
Q
what are psychological theories of depression?
A
- learning models: > decreased environmental reward = insufficient positive reinforcement = reinforces depressive behaviours > avoidance as coping = further reinforcement
- cognitive theories: beck, distortions, learned helplessness (seligman)
6
Q
what is the rumination theory?
A
- Persistent focus on negative thoughts
- Rumination increases the risk of depression & prolongs depressive episodes
7
Q
what is Beck’s theory of depression?
A
- negative thought patterns organised around negative triad contribute to development & maintenance of depression
- negative triad: negative view of self > inadequate worthless // negative view of world > hostile + unrewarding // negative view of future> bleak
- negative schemas> formed through early experiences> pp w/ depression > filter info through distorted cognitive framework
- neg triad > cognitive bias (events interpreted negatively) > failures + losses (individual faults to take initiative = opportunities lost) = depression
8
Q
what are cognitive theories of depression?
A
- Emphasises tendency of ppl w/ depression to dwell on past negative events
- cognitive model: Beck > negative schemas > early learned assumptions influence worldview (depressive) + negative triad = neg views abt world, self & future // learned helplessness = feeling no control, blame
- cognitive distortions: > thinking influences behaviour = self-fulfilling > arbitrary inference (jumping to conclusions w/ little evidence), selective abstraction and personalisation (generalising one mistake) > ‘I never do anything right’
- learned helplessness: > feeling of no control, attributions, blame, and low self-esteem
- causal attribution: > abramson> internal self blame & helplessness= depression, i.e. it’s all my fault
9
Q
What are biological treatments for depression?
A
- drug therapy for depression>
- tricyclic drugs > affect multiple neurotransmitters = 60% improve
- MAO inhibitors > rarely used due to dietary restrictions & side-effects >influence neurotransmitters> stop the breaking down of serotonin = increase serotonin lvls = 50% improve
- SSRI’s > increase serotonin lvls in brain = 60% improve
- ECT > for severe depression = induced seizures
- beneficial but not of side effects
-delayed reaction
-some controversy around risk of suicide
10
Q
What are psychological treatments of depression?
A
- behavioural activation (BA) > increasing engagement & positive in rewarding activities= counteract, withdrawal & inactivity> daily monitoring, social skills
- CBT > helps identify & change & challenge & replace negative thought patterns & behaviours of depression> encourages development of healthier coping mechanisms e.g. activities lifting mood i.e. yoga = 40% improvement
11
Q
What is bipolar disorder?
A
- characterised by extreme mood, swings or episodes of mania and depression
- described as emotional amplifier
- three main types, bipolar I ( manic episodes), bipolar II (major depressive and hypomanic episodes), cyclothymia (Quick cycling between mood, extremes)
12
Q
What is the distinction between the three main types of bipolar disorder?
A
- bipolar I disorder > involves manic episodes, lasting at least seven days or severe enough to require immediate hospitalisation
-bipolar II disorder > pattern of depressive episodes, alternating w/ hypomanic episodes > less severe than full-blown manic episodes but same symptoms, lasting 4 consecutive days - cyclothymia disorder > numerous periods of hypomanic symptoms & depressive symptoms > not a severe as major depressive or manic episodes, but persist for at least 2yrs
13
Q
what is the DSM criteria for bipolar I?
A
- manic episodes may be proceeded or followed by hypomanic or depressive episodes
- mania > abnormally and persistently, elevated expansive, auditable mood, lasting at least one week and present most of the day nearly every day
- three of the following present: inflated self-esteem, decreased need for sleep, more talkative, distractibility, excessive involvement in activities with high potential for painful consequences, psychosis, depressive episode
14
Q
what are key facts of bipolar disorder?
A
- onset: early 20’s or before
- lifetime prevalence, bipolar I = 1% & bipolar II = 0.4%
- UK incidences = higher in black minority ethnic groups
- 40yr follow up in Zurich = 16% recovery > 50% recurrent episodes
- suicide = 25-56% > 10-12% acc die
15
Q
what are genetic risks of bipolar disorder?
A
- heritability =up to 85%
- 1st degree relatives 5-10%
- twin studies, concordance, 40-70% in MZ
- Neurobiological factors = serotonin and dopamine dysregulation> stress axis involvement, and circadian rhythm changes.
