Mood (Affective) Disorders

Question 1

depressive episode

Answer 1

at least two weeks
diminished interest in activities
difficulty concentrating
feelings of worthlessness
excessive guilt
hopelessness
recurrent thoughts of death/suicide
changes in appetite/sleep
psychomotor agitation/retardation
reduced energy/fatigue

Question 2

bipolar - type 1

Answer 2

very low and very high moods
occurrence of at least one manic/mixed episode

Question 3

manic episode

Answer 3

extreme mood (usually euphoric but also irritable)
lasts at least one week
high levels of activity/feelings of increased energy
rapid speech, impulsivity, reckless behaviour and extremely high self-esteem
rapid changes between mood states

Question 4

mixed episode

Answer 4

Aspects of both depressive and manic episodes may be apparent within the same day/week.

Question 5

hypomanic episode

Answer 5

no experience of full-blown manic episodes
some of the symptoms may be present in an attenuated form
several days of persistently elevated mood/increased irritability
increased energy and activity

Question 6

bipolar - type 2

Answer 6

The same intensity of depressive episodes as type 1 + hypomanic rather than manic episodes

diagnosed when:

the person’s daily functioning is less impaired
still coping relatively well in different areas of their life
there is no history of manic or mixed episodes

Question 7

name the mood disorder:
Depressive symptoms for much of the time
Never quite reaches the threshold for a diagnosis of a depressive episode

Answer 7

dysthymia

Question 8

name the disorder:
numerous hypomanic episodes + depressive symptoms within a 2 year period
little breaks between periods
experience symptoms more time than not
symptoms less intense but relentless

Answer 8

cyclothymia

Question 9

measure of depression
4 options

Answer 9

detailed clinical interviews - guidelines from ICD/DSM, qualitative data

Psychometric tests - to gauge the range, intensity, duration of a person’s symptoms
,qualitative data
, the nomothetic approach in clinical psychology

Beck Depression Inventory

Psychological Formulation

Question 9

BIO-CHEM EXPLANATION:

monoamine hypothesis

Answer 9

Noradrenaline and serotonin are called ‘monoamines’.

Imbalance of Serotonin → Noradrenaline levels to drop → depressive episode

Noradrenaline levels too high → manic episodes

Question 10

BIO-CHEM EXPLANATION:

serotonin imbalances

Answer 10

Receptors may become over-sensitive, particularly when serotonin levels are low.

Postsynaptic cell attempts to compensate for low levels of serotonin creating more receptors (upregulation) → Leads to even more problems

Following transmission: serotonin is absorbed back into the presynaptic cell via transporter molecules in the presynaptic membrane

Problems: serotonin is not cleared out of the synapse effectively

if taken back too readily it reduces the availability of serotonin molecules for binding on the postsynaptic cell

Question 11

BIO GENETIC EXPLANATION

Biopsychologists believe:

Answer 11

thoughts, feelings, and behaviours are determined by signals passed between clusters of neurons in our nervous systems.

Genes provide the instructions that dictate how these networks develop

meaning depressive or manic episodes may be determined via genetic inheritance and/or mutations occurring during cell division

Question 12

BIO CHEM EXPLANATION

Dopamine

Answer 12

Levels of dopamine reduced → motivation and pleasure affected

Antidepressants reduce symptoms of depressive disorder by increasing dopamine levels
supports the theory that low dopamine levels were the cause of the depressive symptoms

Question 13

Oruc et al
AIM

Answer 13

To determine whether specific polymorphisms of two genes associated with serotonin transmission (5-HT2c and the 5-HTT gene) were more common in people with bipolar disorder

Question 14

Oruc et Al Sample

Answer 14

all participants were Croatian and recruited via opportunity sampling.

25 females and 17 males

Aged 31-70
With bipolar disorder (type 1)

From psychiatric hospitals in Zagreb, Croatia
The average age of onset was 32

Medical records showed that 16 of participants had at least one first-degree relative (a parent or sibling) with a mood disorder

An age and sex-matched control group of 25 females and 15 males were also recruited via opportunity sampling of hospital staff, friends and family
None had first-degree relatives with a psychiatric diagnosis

Question 15

Oruc
conclusion

Answer 15

This study focused on two specific polymorphisms of genes associated with serotonergic function but neither appears to play a major role in increasing vulnerability to bipolar disorder
This said, the study suggests that females may be more vulnerable to genetic alterations to serotonergic transmission

Question 16

measure of depression: BDI

Answer 16

Beck’s depression inventory
over 13 year olds
when answering people should be thinking about the past two weeks
21 items
5 - 10 mins
determines the severity of a person’s symptoms
scores: 14-19 mild depression, 20-28 Moderate, 29-63 severe
designed to be used by qualified health professionals

Question 17

PSYCHOLOGICAL EXPLANATIONS
Beck’s Cognitive Theory of Depression

Answer 17

negative cognitive triad

Depressed people hold negative beliefs about:

the self (‘I am worthless’),
the world (‘Everything is doomed to failure’)
the future (‘The future is hopeless/Nothing will ever change’)

Evidence that does not match their beliefs is filtered out
Evidence that confirms their negative views is focused upon and stored.

Question 18

PSYCO EXPLANATION

Beck: Faulty Thinking Strategies

Answer 18

dichotomous thinking - black or white

arbitrary interferences - drawing conclusions with insufficient evidence lead to ‘fortune telling’ or ‘mind reading’

catastrophising - minor thing happens triggers a flood of negative thoughts, resulting in overwhelming anxiety about worst case scenarios
(cancer from a freckle)

personalisation - taking the blame for negative outcomes

Question 19

PSYCHOLOGICAL EXPLANATIONS:

Answer 19

Beck’s Cognitive Theory of Depression + faulty thinking strategies

attributional style

learned helplessness

Question 20

PSYCHOLOGICAL EXPLANATIONS:

attributional style

Answer 20

Depressed people make attributions that are:
Internal
Global
Stable

People who are unlikely to become depressed make attributions that are:
External
Specific
Unstable

Question 21

PSYCHO EXPLANATION

learned helplessness

Answer 21

If a person learns that their behaviour makes no difference to their aversive environment, they may stop trying to escape from aversive stimuli even when escape is possible.

Seligman et al: experimental dogs were classically conditioned to associate a neutral stimulus (a light) with an unavoidable shock
Later failed to escape from shocks even when it was possible to do so - LEARNED HELPLESSNES

Maier & Seligman (1976)
People subjected to inescapable noise, insoluble problems. Later gave up trying in similar situations, similar to Seligman’s dogs

Learned helplessness does have similarities to depressed behaviour in humans though findings are pretty inconsistent

Question 22

BIO TREATMENT

Answer 22

Tricyclics
MAOIs-monoamine oxidase inhibitors and Subtypes
Selective serotonin reuptake inhibitor SSRIs

Question 23

BIO TREATMENTS

Tricyclics

Answer 23

• blocking serotonin transporter molecules and noradrenaline transporter molecules in the presynaptic cell

Side effects: drowsiness, nausea, vomiting, blurred vision and weight gain.

Question 24

BIO TREATMENT
MAOIs

Answer 24

monoamine oxidase INHIBITOR!
One way of increasing serotonin and noradrenaline levels is to stop monoamine oxidase from breaking down these molecules

monoamine oxidase is an enzyme which breaks down these neurotransmitters (Serotonin, noradrenaline and dopamine) following reabsorption by the transporter molecules in the presynaptic cell membrane.

only used if other drugs have not worked - can lead to a build-up of substances called tyramine - can increase the risk of a stroke

Question 25

BIO TREATMENTS

SSRIs

Answer 25

Selective Serotonin Reuptake Inhibitor

prozac

The drug binds to serotonin transporter molecules (SERT) in the presynaptic cell membrane.
This means that serotonin that has been released into the synapse cannot be reabsorbed for recycling and remains in the synapse.
The reuptake process has therefore been inhibited

Question 26

PSYCHO TREATMENT:

Answer 26

Beck’s cognitive reconstructing

REBT Ellis’ rational emotive behaviour therapy
- three musts
- (musturbation), ABC model

Question 27

Beck’s Cognitive Reconstructing

PSYCHO TREATMENT

Answer 27

• ‘cognitive restructuring’ - the process of identifying and challenging negative thoughts
• talking therapy, one-to-one, questioning to identify illogical thinking…
• at the beginning between 5 and 20 weekly sessions

1. psychoeducation (learn ab links between thoughts, feelings and behaviour
2. homework (keeping a mood diary for later discussion - to increase awareness of things that trigger negative thinking)
3. Socrative questioning - ask questions to help the client to analyse and reflect on their thoughts, together they seek alternative explanations for negative attributions - reframe their thinking

Question 28

PSYCHO TREATMENT

Ellis’ Rational Emotive Behaviour Therapy (REBT)

Answer 28

Principles of stoicism: An individual is not affected by external things , but by their own perception of external things.

Three Musts - Musturbation
1. people must approve of everything i do
2. other people must treat me well
3. i must get what I want and not what i do not want

ABC model:
A - activating events
B - beliefs
C - consequences

+ D - disputing until the person realises that their beliefs are irrational