Mood Disorders Flashcards
(118 cards)
1
Q
Who identified manic depressive insanity?
A
Emil Kraepelin.
2
Q
Who made the distinction between unipolar depression and bipolar depression?
A
Karl Leonhard.
3
Q
Define major depressive disorder.
A
Depressive disorder involving one or more major depressive episodes.
4
Q
Define anhedonia.
A
The inability to experience pleasure for previously pleasurable activities.
5
Q
What must low mood be accompanied by to be diagnosed as major depression? (7)
A
Significant weight loss when not dieting or weight gain, or a decrease or increase in appetite; insomnia or hypersomnia; loss of energy or fatigue; psychomotor agitation or psychomotor retardation; diminished concentration or ability to think; feelings of worthlessness or excessive or inappropriate guilt; and recurrent thoughts of death, recurrent suicidal ideation without a plan or a suicide attempt or a specific plan for committing suicide.
6
Q
What is a specifier?
A
An extension to the diagnosis that further clarifies the course, severity, or special features of the disorder.
7
Q
Define major depressive episode.
A
A state characterised by at least five depressive symptoms, one of which must be either sad mood or a loss in pleasure/interest in usual activities.
8
Q
What is major depressive disorder with melancholic features characterised by? (6)
A
A profound, nearly complete inability to experience pleasure; worse mood in the mornings; early morning awakening; psychomotor retardation or agitation; anorexia or weight loss; and excessive guilt.
9
Q
What is major depressive disorder with catatonic features characterised by?
A
Movement disturbance symptoms, like immobility or excessive, purposeless activity.
10
Q
What is major depressive disorder with peripartum onset refer to?
A
Episodes that occur during pregnancy or within four weeks after childbirth.
11
Q
Give some psychosocial stressors than can cause peripartum onset depression.
A
Perceived lack of support from their partner, family and friends; feeding and physical difficulties with the infant; stressful life events; previous history of depression and complications during pregnancy.
12
Q
When is major depressive disorder with seasonal pattern onset diagnosed?
A
When there is a regular relationship between the onset of the sufferer’s depressive episodes and a particular time of the year.
13
Q
What is major depressive disorder of mixed features?
A
Some symptoms of elevated mood are present alongside depression.
14
Q
What accompanies depression in major depressive disorder with anxious distress?
A
Significant anxiety, such as irrational worry, inability to relax or a sense of impending threat.
15
Q
About __% of people with major depressive disorder report significant anxiety symptoms.
A
50.
16
Q
What is dysthymia?
A
A depressive disorder that is less severe than major depression but more chronic.
17
Q
Give another name for dysthymia.
A
Persistent depressive disorder.
18
Q
What is disruptive mood dysregulation disorder?
A
A depressive disorder characterised by severe and persistent irritability as evident in temper outbursts that are extremely out of proportion to the situation.
19
Q
Who is disruptive mood dysregulation disorder usually observed in?
A
Children.
20
Q
Give the three broad classes of depressive disorders.
A
Psychotic, melancholic and non-melancholic.
21
Q
What is melancholic depression characterised by?
A
The presence of significant psychomotor disturbance.
22
Q
What is psychotic depression characterised by?
A
Both psychomotor disturbance and psychotic features.
23
Q
What are non-melancholic disorders thought to be driven by?
A
Life event stressors and psychological factors.
24
Q
Onset of a first episode of depression can occur from as young as:
A
3
25
What is early adult depression often preceded by?
An anxiety disorder in childhood or adolescence.
26
What is conduct disorder?
A disorder marked by chronic disregard for the rights of others including specific behaviour such as stealing, lying and engaging in acts of violence.
27
What is oppositional defiant disorder?
A disorder of chronic misbehaviour in children marked by belligerence, irritability and defiance.
28
Give four problems associated with unipolar depression.
Increased risk of suicide and suicide attempts, difficulties performing occupational and social activities, anxiety disorders and physical health problems.
29
Give some major risk factors for suicide.
Male gender, hospitalisation for depression, comorbidity with a substance use disorder, stressful life events, and a previous history of suicide attempts.
30
How can inherited traits in children lead to anxiety and depression?
Inherited traits like anxiety can contribute to overprotectiveness and authoritarian parenting, which can undermine a child's sense of mastery over their environment, creating vulnerability to anxiety and depression.
31
Which gene is associated with lower efficiency in serotonin reuptake?
A shorter allele of the 5-HTTLPT gene sequence.
32
What is the effect of having the shorter allele of the 5-HTTLPT gene sequence?
Higher levels of neuroticism and depression after stressful life events or childhood maltreatment.
33
What are the main neurotransmitters implicated in depression?
Serotonin, norepinephrine and dopamine.
34
What are serotonin, norepinephrine and dopamine involved in?
The regulation of sleep cycles, motivation and appetite.
35
What are monoamines?
Neurotransmitters including catecholamines (epinephrine, norepinephrine, dopamine) and serotonin that have been implicated in mood disorders.
36
What is the limbic system?
Part of the brain that relays information from the primitive brain stem about changes in bodily function to the cortex where the information is interpreted.
37
How do receptors relate to new theories of depression?
Abnormalities in the number and sensitivity of receptors available to take up monoamine neurotransmitters in synapses, which affects the balance of the available neurotransmitters.
38
What is the HPA axis?
The hypothalamic-pitutary-adrenal (HPA) axis, which is comprised of three components of the neuroendocrine system that work together in a feedback system interconnected with the brain's limbic system and cerebral cortex.
39
Explain the role of the HPA axis in neuroendocrine (hormonal) theories of depression.
People who are depressed tend to demonstrate chronic overactivity in the HPA axis, which results in the production of excess stress hormones, which then affects the way monoamine neurotransmitters work in the brain.
40
Explain neurophysiological theories of depression.
Structural or functional abnormalities in certain structures in the brain (like the prefrontal cortex, hippocampus, anterior cingulate cortex, and amygdala).
41
Explain the learned helplessness model of depression.
Depression is a learnt response to adverse events that are perceived as uncontrollable.
42
What observation is the learned helplessness model based on?
When laboratory animals are subjected to unavoidable adverse outcomes that were independent of their behaviour, they gave up.
43
What is a depressive attributional style?
An attributional style that interprets negative events as being due to internal, global, and stable factors.
44
What is the basis of Beck's cognitive model of depression?
Negative experiences in childhood may result in the development of dysfunctional core beliefs about the self, others and the world.
45
According to Beck, how do individuals deal with their negative core beliefs?
By adopting compensatory strategies or rules that protect them from developing depression.
46
How are negative core beliefs triggered?
Relevant negative life events.
47
Beck believes the thought patterns of depressed people are characterised by: (3)
Self-criticism, a negative view of others and life events, and a pessimistic expectations regarding the future.
48
What is Beck's negative cognitive triad?
The negative view of the self, the world and the future.
49
How is the negative cognitive triad maintained?
By a number of cognitive distortions in which depressed people are likely to engage.
50
Name four of Beck's cognitive distortions.
Arbitrary inference, magnification and minimisation, personalisation, and overgeneralisation.
51
Explain arbitrary inference.
Takes place when a person draws a conclusion in the absence of supporting evidence or despite the presence of contradictory evidence.
52
Explain magnification or minimisation.
When a person magnifies or exaggerates their perceived failures and minimises their achievements.
53
Explain personalisation.
Relating events to oneself in the absence of any clear evidence.
54
Explain overgeneralisation.
When a person draws a conclusion based on a single event.
55
Summarise the phases of Beck's cognitive model.
Negative early experiences, dysfunctional beliefs, critical incident, dysfunctional beliefs activate, negative cognitive triad, and finally, symptoms of depression.
56
According to behavioural models of depression, why is it maintained?
There are benefits for depressed behaviours, like avoidance of unpleasant or stressful tasks, deferring responsibilities and receiving sympathy.
57
How do coping skills relate to behavioural theories of depression?
A lack of effective coping skills to deal with life stressors can contribute to the onset of a depressive episode.
58
Explain how life events and stressors reducing the opportunity to experience positive reinforcers can cause depression.
The lack of reinforcement can result in gradual withdrawal from previously enjoyable activities or behaviours and increase the risk of depression.
59
Describe Seligman's behavioural theory of depression.
Uncontrollable negative life events, especially frequent or chronic ones, can lead to feelings of helplessness and the behavioural manifestations of depression.
60
Who coined the expression 'learned helplessness' and what does it refer to?
Seligman, and a collection of behaviours characterised by low motivation, passivity and indecisiveness.
61
What do psychoanalytic theories believe depression is?
A form of pathological grief.
62
What causes vulnerability to depression according to the psychoanalytic model?
Disruptions in childhood bonding experiences with caregivers are thought to sensitise people to losses in adulthood.
63
What effect do disruptions in childhood have on relationships?
Individuals become ambivalent in relationships and excessively dependent on others for support, encouragement, guidance, admiration and confirmation of their self-worth.
64
What effect do ambivalent feelings in relationships have on loss?
The combination results in anger directed towards the self.
65
According to the psychoanalytic model of depression, what does self directed anger manifest as?
Guilt and self-blame.
66
What is expressed emotion?
A family interaction style in which family members are overly protective and self-sacrificing towards the person with a psychological disorder while also expressing high levels of criticism and hostility, which may contribute to a relapse.
67
What are protective factors?
Conditions or variables associated with a reduced risk or chance of developing a disorder.
68
Name some protective factors that reduce an individual's chance of developing depression.
Good interpersonal skills and positive relationships with others, high levels of family cohesion, a sense of being connected with one's community, a sense of achievement in a valued area of pursuit, optimism and low anxiety, openness to new experiences, and effective coping skills.
69
Name some common antidepressants.
Tricyclics, SSRIs, SNRIs, and monoamine oxidase inhibitors.
70
What is repetitive transcranial magnetic stimulation?
A biological treatment that exposes patients to repeated, high-intensity magnetic pulses that are focused on particular brain structures in order to stimulate them.
71
What is repetitive transcranial magnetic stimulation thought to do?
Change the way that neurotransmitters work.
72
What is the vagus nerve?
Part of the autonomic nervous system that carries information from the head, neck, thorax and abdomen to several areas of the brain.
73
What is vagus nerve stimulation?
A biological treatment where the vagus nerve is stimulated by a small electronic device similar to a cardiac pacemaker, which is surgically implanted under a patient's skin.
74
How does vagus nerve stimulation combat depression?
It increases activity in the hypothalamus and amygdala.
75
Explain bright light therapy.
Regular exposure to light of a particular frequency and intensity, that affects melatonin, serotonin and norepinephrine levels.
76
Which non pharmaceutical method is used to treat seasonal affective disorder?
Bright light therapy.
77
What is seasonal affective disorder?
A depressive disorder characterised by a two-year period in which the individual experiences major depression during winter months and then recovers during summer.
78
What is electroconvulsive therapy (ECT)?
A treatment for mood disorders that involves the induction of a brain seizure by passing an electrical current through the patient's brain while they are anaesthetised.
79
What is ECT used to treat?
Severe depressive disorders.
80
Give two issues with ECT, and how they are corrected.
Permanent memory loss and difficulties in learning new information, but application to only the right side of the brain minimises this.
81
Explain cognitive behavioural therapy (CBT).
A type of psychological treatment that combines both cognitive and behavioural concepts and techniques.
82
What therapy is pleasant activity scheduling associated with, and what is it?
Cognitive behavioural therapy, and it involves the client and therapist working together to gradually increase the number of rewarding activities the client engages in each day as a way of improving their mood.
83
Explain cognitive restructuring.
The ABC model, where activating events trigger dysfunctional beliefs which result in negative consequences, such as negative mood and behaviours.
84
What is interpersonal psychotherapy?
A short-term psychological treatment for the treatment of depression, which focuses on addressing the client's interpersonal problems as a way of improving their psychological symptoms.
85
Who developed interpersonal psychotherapy?
Klerman and Weissman.
86
Which interpersonal problem areas are targeted in IPT? (3)
Grief over an interpersonal loss, interpersonal disputes, and life transitions.
87
Explain psychodynamic therapies.
Therapies focused on uncovering and resolving unconscious conflicts that drive psychological symptoms.
88
Who named bipolar disorder?
Leonhard.
89
What is bipolar disorder?
A mood disorder marked by manic/hypomanic episodes and depressive episodes.
90
What is lithium carbonate?
A drug classified as a mood stabiliser that is used in the treatment of bipolar disorder.
91
Who discovered lithum carbonate?
John Cade.
92
What is a manic episode?
A state of persistently elevated or irritable mood and abnormally increased goal-directed activity.
93
What symptoms are manic episodes often accompanied by? (5)
Inflated self-esteem, decreased need for sleep, racing thoughts, pressured speech and impulsive, self-destructive behaviours.
94
Explain grandiosity.
An inflated belief about one's worth, power, knowledge, ability or identity, and can result in a grandiose delusion.
95
In order to be diagnosed with a manic disorder, the individual must experience three of the following symptoms: (8)
Inflated self-esteem, grandiosity, sleep disturbance, pressure of speech, flight of ideas, distractibility, heightened activity, and risk taking.
96
What is the difference between hypomania and mania?
In hypomania, the symptoms are not severe enough to interfere with daily functioning, neccessitate hospitalisation, or involve hallucinations or delusions.
97
Define bipolar I disorder.
A form of bipolar disorder characterised by manic episodes, while major depressive episodes often occur but are not necessary for diagnosis.
98
Define bipolar II disorder.
A form of bipolar disorder characterised by hypomanic and major depressive episodes.
99
Who were the first to distinguish between bipolar I and bipolar II? (2)
Dunner and Fieve.
100
What is rapid cycling bipolar disorder?
A diagnosis given when an individual has four or more bipolar episodes within a single year.
101
What is cyclothymic disorder?
A milder but more chronic form of bipolar disorder.
102
Who developed the Shared Vulnerability Model?
Carson.
103
The shared vulnerability model proposes that a vulnerability to psychopathology shares features that also predispose individuals to creativity, such as: (3)
Cognitive disinhibition, an attentional bias toward novel stimuli, and neural hyperconnectivity.
104
Explain the Diathesis-Stress Model.
The view that abnormality is caused by the combination of a vulnerability or predisposition and life events.
105
Explain the Goal-Dysregulation model.
Manic episodes are triggered by dysregulated goal pursuit which entails the person being excessively involved in the pursuit of goals.
106
Give two psychological factors that predispose individuals to developing bipolar disorder.
Cognitive disturbance and temperament.
107
What are mood stabilisers?
A group of drugs including lithum and anticonvulsants that are used to treat psychological disorders characterised by unstable mood.
108
Name the six mood stabilisers.
Lithum, carbamazepine, valproate, olanzapine, quetiapine, and lamotrigine.
109
What is psychoeducation?
A treatment technique where the client is provided with information about the nature, causes, effects and treatment of their psychological issue.
110
Give the main strategies of psychoeducation (4).
Providing education regarding the importance of identifying early signs of relapse so that preventative action can be taken, medication adherence, minimising risk factors, and maximising protective factors.
111
What is mood monitoring?
An important intervention in the early stages of therapy, which encourages clients to keep structured mood diaries to identify mood shifts and warning signs.
112
What are the aims of CBT? (4)
To alleviate acute symptoms; prevent relapse and recurrence through identifying and challenging unhelpful thoughts and assumptions; improving adherence to medication; and implementing adaptive coping and problem-solving strategies.
113
Give some advantages of CBT. (3)
Brevity, coherent theoretical framework, and the development of self-efficacy.
114
Who developed Interpersonal and Social Rhythm Therapy (IPSRT)? (3)
Frank, Swartz and Kupfer.
115
What does Interpersonal and Social Rhythm Therapy target?
Reducing disruptions in daily routines and sleep/wake cycles that trigger bipolar episodes.
116
How do family interventions seek to reduce relapse? (3)
Improving the family's knowledge of bipolar disorder, communication and problem-solving skills.
117
Who developed the instability model of bipolar disorder relapse?
Sorenson.
118
What are the four mechanisms of the instability model of bipolar disorder relapse?
Biological vulnerability, medication non-adherence, disrupted routines, and dysfunctional interpretations of life events.
