Exam 3 Study Guide: Depressive Disorders, Bipolar Disorders, Suicide, and Schizophrenia

A comprehensive vocabulary review deck covering major concepts, diagnostic criteria, etiologies, and treatments for Depressive and Bipolar Disorders, Suicide and NSSI, and Schizophrenia.

Major Depressive Disorder (MDD)

A mood disorder diagnosed when an individual experiences a major depressive episode lasting at least $2\,\text{weeks}$ with $5$ or more symptoms (representing a change in functioning, with depressed mood or loss of interest/pleasure being central) and has no history of mania.

SIG E CAPS

A diagnostic mnemonic for the symptoms of a major depressive episode: Sad/depressed mood or suicidal ideation; reduced Interest/pleasure; Guilt or worthlessness; low Energy/fatigue; poor Concentration/indecisiveness; Appetite/weight change; Psychomotor agitation or retardation; Sleep disturbance.

Postpartum Specifier (MDD)

A specifier applied to Major Depressive Disorder when an episode begins within $4\,\text{weeks}$ of giving birth.

Melancholic Specifier (MDD)

A specifier for Major Depressive Disorder designated when the individual is almost totally unresponsive and unaffected by pleasurable activities.

Catatonic Specifier (MDD)

A specifier for Major Depressive Disorder marked by profound immobility or excessive, purposeless motor activity.

Persistent Depressive Disorder (PDD)

A chronic mood disorder (also known as dysthymic disorder) characterized by depressed mood on most days for at least $2\,\text{years}$, accompanied by at least $2$ additional depressive symptoms, with symptoms not absent for more than $2\,\text{months}$ at a time, and no history of mania or hypomania.

Double Depression

A condition characterized by co-occurring Major Depressive Disorder and Persistent Depressive Disorder, where an acute major depressive episode is layered on top of chronic, milder dysthymic symptoms.

Other Specified Depressive Disorder

A diagnostic category used when a patient presents with depressive symptoms that cause significant impairment but do not meet full criteria for a specific depressive disorder, and the clinician explicitly documents the specific reason why.

Unspecified Depressive Disorder

A diagnostic category used when depressive symptoms cause distress or impairment but fail to meet full criteria for another mood disorder, and the clinician chooses not to specify the reason or lacks sufficient information.

Diathesis–Stress Model

A clinical model proposing that psychological disorders develop when a pre-existing predisposition (biological, psychological, or social vulnerability) is activated by a stressful life event.

Cognitive Triad

Beck's cognitive theory of depression asserting that depressed individuals repeatedly and automatically interpret three areas negatively: the self, the world, and the future.

Learned Helplessness

A cognitive model proposing that depression develops when individuals believe they lack control over reinforcements in their lives and make internal, global, and stable attributions for negative events.

Behavioral Activation

A behavioral therapy technique (also called pleasant-events scheduling) that systematically reintroduces enjoyable, rewarding activities to reduce social withdrawal and alleviate depression.

Acceptance and Commitment Therapy (ACT)

A cognitive therapy approach that guides clients to recognize and accept negative thoughts as mere thoughts rather than feeling the need to eliminate, dispute, or judge them.

Interpersonal Therapy (IPT)

A sociocultural therapy for depression that targets four interpersonal problem areas: grief and loss, role disputes, role transitions, and interpersonal deficits.

Electroconvulsive Therapy (ECT)

A biological treatment used for severe depression involving targeted electrical currents to induce a brain seizure, typically administered in $6\text{--}12\,\text{sessions}$ over $2\text{--}4\,\text{weeks}$.

Manic Episode

A mood episode defined by at least $1\,\text{week}$ of abnormally and persistently elevated, expansive, or irritable mood accompanied by at least $3$ symptoms such as grandiosity, decreased need for sleep, pressured speech, or racing thoughts.

Hypomanic Episode

A mood disturbance lasting at least $4\,\text{days}$ with persistently elevated, expansive, or irritable mood and at least $3$ manic symptoms, clearly distinct from normal mood but less severe than full mania and without psychotic features.

Bipolar I Disorder

A mood disorder characterized by the occurrence of at least one full manic episode; major depressive episodes commonly alternate but are not required for diagnosis.

Bipolar II Disorder

A mood disorder characterized by the presence of at least one hypomanic episode and at least one major depressive episode, with no history of a full manic episode.

Cyclothymic Disorder

A chronic mood disorder characterized by numerous periods of hypomanic symptoms and mild depressive symptoms lasting for $2$ or more years, interrupted by brief periods of normal mood, with a prevalence of about $0.4\%$.

Lithium

A metallic element and first-line mood stabilizer that produces improvement in more than $60\%$ of people with mania, but requires strict dosage monitoring to prevent lithium intoxication.

Manic Switch

A clinical phenomenon in which antidepressant treatment (most notably tricyclic antidepressants) inadvertently triggers a manic or hypomanic episode in a vulnerable individual.

Non-Suicidal Self-Injury (NSSI)

Intentional, direct destruction of body tissue without suicidal intent, most frequently presenting as cutting/scratching ($70\text{--}97\%$), hitting/banging ($21\text{--}44\%$), or burning ($15\text{--}35\%$).

Emotion Regulation Model (NSSI)

The explanatory model of non-suicidal self-injury with the strongest empirical support, proposing that individuals engage in self-injury to obtain relief from intolerable or intense negative emotions.

Anti-Dissociation Model (NSSI)

A model of non-suicidal self-injury proposing that individuals self-injure to interrupt episodes of dissociation or numbness and restore a grounded sense of self.

Suicide

A self-inflicted death in which a person acts intentionally, directly, and consciously to terminate their own life.

Suicide Attempt

A nonfatal, self-directed, potentially injurious behavior carried out with any intent to die, regardless of whether injury actually occurs.

Suicidal Ideation

Cognitive processes that involve thinking about, considering, or planning suicide.

Retrospective Analysis

A research methodology (psychological autopsy) used in suicidology that reconstructs a deceased individual's psychological history, habits, and background from records and surviving contacts.

Death Seeker

One of Shneidman's suicidal classifications identifying a person who clearly and explicitly intends to die at the precise moment of the suicide attempt.

Death Initiator

A suicidal classification describing a person who attempts suicide intending to die but believes that death is already underway naturally and they are merely speeding up the process.

Death Ignorer

A suicidal classification describing an individual who attempts suicide not believing that death ends their existence, but rather expecting to enter a better afterlife or state.

Death Darer

A suicidal classification describing a person who feels ambivalent about dying and engages in risky, lethal behaviors without definitively guaranteeing death.

Suicide Contagion

The process by which exposure to suicide or suicidal behavior within family networks, peer groups, or media increases the likelihood of suicidal behavior in others.

Suicide Cluster

An occurrence of more suicides than statistically expected, defined in the lecture slides as comprising $3$ or more deaths.

Point Cluster

A suicide cluster in which suicides occur in close proximity in both time and geographic space, such as within a single school or local community.

Mass Cluster

A suicide cluster where deaths cluster closely in time irrespective of geographic proximity, typically following high-profile media coverage.

Echo Cluster

A series of suicides that occur over an extended period following an original suicide cluster, sometimes emerging months afterward.

Joiner's Interpersonal Psychological Theory

A suicide theory proposing that severe suicidal behavior occurs when perceived burdensomeness and thwarted belongingness combine with an acquired capability for suicide.

Perceived Burdensomeness

A component of Joiner's theory reflecting an individual's belief that they are a heavy burden or liability to family, friends, or society.

Thwarted Belongingness

A component of Joiner's theory representing the painful feeling of social alienation, isolation, and lack of meaningful connectedness.

Acquired Capability for Suicide

A component of Joiner's theory referring to an individual's lowered fear of death and elevated pain tolerance, developed through repeated physical or emotional trauma.

Positive Symptoms

Pathological excesses or bizarre additions to normal human behavior in schizophrenia, including delusions, hallucinations, disorganized speech, and inappropriate affect.

Delusion of Persecution

A false, unshakeable belief that one is being targeted, spied on, plotted against, threatened, or victimized by outside individuals or agencies.

Delusion of Reference

A false belief that ordinary external events, objects, or actions of others possess a special, direct, and personal meaning for the individual.

Delusion of Grandeur

A false belief that one possesses remarkable powers, immense wealth, unique importance, or a divine identity, such as being a great inventor or religious figure.

Delusion of Control

A false belief that one's thoughts, feelings, bodily impulses, or behaviors are being directly directed and manipulated by outside forces.

Loose Associations (Derailment)

A formal thought disorder characterized by rapid shifts from one subject to another with tenuous, illogical, or completely disconnected transitions.

Neologism

A disorganized speech symptom in schizophrenia involving the creation and use of completely made-up words that have meaning only to the speaker.

Clang Association

Disordered speech where words are linked together based purely on rhyme or sound similarities rather than logical semantic meaning.

Perseveration

A speech abnormality characterized by the continuous, inappropriate repetition of specific words, phrases, or thoughts.

Negative Symptoms

Pathological deficits or reductions in normal behaviors and emotional responsiveness in schizophrenia, such as alogia, blunted or flat affect, avolition, and social withdrawal.

Alogia

A negative symptom of schizophrenia characterized by poverty of speech, manifesting as a marked reduction in speech quantity or meaningful content.

Flat Affect

A negative symptom characterized by an almost complete absence of emotional expression, showing an immobile face, dull tone, and lack of eye contact.

Avolition

A negative symptom characterized by profound apathy, lack of initiative, and inability to start or persist in basic daily or goal-directed tasks.

Catatonic Stupor

A psychomotor symptom of schizophrenia in which a person remains entirely motionless, unresponsive, and silent for extended periods.

Catatonic Posturing

A psychomotor symptom wherein an individual assumes and holds awkward, bizarre physical positions for hours, often demonstrating waxy flexibility.

Stress of Poverty Theory

A sociocultural theory suggesting that the severe stressors, deprivation, and challenges of low socioeconomic status causally contribute to the development of schizophrenia.

Downward Drift Theory

A theory proposing that schizophrenia causes significant functional and cognitive deterioration, which forces affected individuals to drift down into lower socioeconomic brackets.

Prodromal Phase

The early stage of schizophrenia marked by insidious deterioration and mild symptoms such as social withdrawal, odd beliefs, vague speech, and reduced emotional expression.

Active Phase

The acute phase of schizophrenia during which prominent, fully developed positive symptoms (such as full hallucinations and delusions) are active.

Residual Phase

The phase following an active episode of schizophrenia in which acute positive symptoms diminish, but blunted affect and negative symptoms typically persist.

Type I Schizophrenia

A classification of schizophrenia dominated by positive symptoms (delusions, hallucinations), typically associated with better premorbid functioning and normal brain anatomy.

Type II Schizophrenia

A classification of schizophrenia dominated by negative symptoms (alogia, avolition, flat affect), often linked to structural brain abnormalities such as enlarged ventricles.

Schizoaffective Disorder

A psychotic disorder marked by symptoms of schizophrenia co-occurring with a major mood episode, requiring that delusions or hallucinations also occur for at least $2\,\text{weeks}$ when mood symptoms are absent.

Brief Psychotic Disorder

A psychotic disorder characterized by the presence of at least one psychotic symptom lasting more than $1\,\text{day}$ but less than $1\,\text{month}$, ending in a return to full baseline functioning.

Dopamine Hypothesis

The neurochemical theory positing that schizophrenia results from excessive dopamine neurotransmission, including overactive dopamine neuron firing or elevated receptor sensitivity.

Tardive Dyskinesia

An extrapyramidal, involuntary movement disorder resulting from prolonged use of conventional antipsychotics, characterized by involuntary chewing, sucking, lip-smacking, and jerky limb movements.

Agranulocytosis

A potentially fatal biological condition marked by a severe drop in white blood cell count, recognized as a significant risk of certain atypical antipsychotics.

Community Mental Health Act of 1963

Federal legislation aimed at establishing community-based treatment centers, which led to the nationwide deinstitutionalization of thousands of individuals with chronic mental disorders.

Revolving Door Pattern

A chronic cyclical pattern where psychiatric patients are repeatedly discharged into underfunded community care, deteriorate due to inadequate services, and are readmitted to inpatient facilities.