Understanding Trauma and Mood Disorders in Psychology

Trauma-Related Disorders

Relationship between PTSD, emotion dysregulation, identity disturbance, and relationship issues.

Trauma Treatment Approaches

Different treatment approaches for trauma (CBT/exposure, EMDR, CISD, psychodynamic).

Concept Creep

The concept of 'trauma' in popular culture and the issue of 'concept creep.'

Traumatic Repression Evidence

The scientific evidence (or lack thereof) supporting traumatic repression of memories.

Obsessive-Compulsive Disorder (OCD)

Definition of obsessions and common themes (aggression, sexuality, etc.).

Compulsions in OCD

Definition and purpose of compulsions/rituals (anxiety reduction).

OCD vs OCPD

Distinction between OCD and Obsessive-Compulsive Personality Disorder (OCPD), including the 'anal' personality aspect of OCPD.

Neurobiological Factors in OCD

Role of the anterior cingulate cortex (error detection), serotonin, and the CSTC circuit ('brain lock').

Serotonin Circuits in OCD

How serotonin circuits help inhibit the 'brain lock' pattern.

DSM-5 Criteria for OCD

DSM-5 diagnostic criteria for OCD (either obsessions or compulsions qualify).

Risk Factors for OCD

Risk factors for OCD: heritability (PANDAS).

OCD Treatments

Effective treatments for OCD: Exposure & Ritual Prevention (ERP) vs. antidepressants vs. placebo.

OCD Spectrum Disorders

OCD Spectrum Disorders: hoarding disorder, trichotillomania, excoriation disorder, body dysmorphic disorder.

Bipolar Disorder Symptoms

Major symptoms of mania, hypomania, and mixed episodes.

Bipolar Disorder Diagnostic Criteria

Diagnostic criteria for Bipolar I, Bipolar II, and 'Type III bipolar.'

Drug Triggers of Mania

Drug triggers of mania: antidepressants, stimulants, THC, binge drinking, steroids.

Iatrogenic Effects of Antidepressants

Iatrogenic effects of antidepressants in bipolar disorder.

Lifetime Prevalence of Bipolar Disorder

Lifetime prevalence of bipolar disorder (4%).

Suicide Risk in Bipolar Disorder

Suicide risk in bipolar disorder compared to Major Depressive Disorder (roughly 3x MDD).

Impact of Bipolar Disorder

Impact of bipolar disorder on disability, employment, and life expectancy.

Bipolar Disorder and Creativity

Association between bipolar disorder and creativity/divergent thinking.

Heritability of Bipolar Disorder

Heritability of bipolar disorder (~.80).

Neurobiological Factors in Bipolar Disorder

Neurobiological factors in bipolar disorder: excessive amygdala reactivity (intensity of emotion), dopamine circuitry (activation/arousal, goal-directed/reward-based behavior), frontal cortex/glutamate (mania = left>right activity; depression = left

Triggers for Mood Episodes in Bipolar Disorder

Common triggers for mood episodes in bipolar disorder: sleep deprivation, major life events, light.

Kindling Hypothesis

'Kindling hypothesis' in bipolar disorder.

Rapid Cycling in Bipolar Disorder

Concepts of rapid cycling and ultra-rapid cycling.

Pharmacological Treatments for Bipolar Disorder

Pharmacological treatments for bipolar disorder: Lithium, other anticonvulsants (Lamictal, Topamax, etc.), Novel Antipsychotics.

Lifestyle Interventions for Bipolar Disorder

Lifestyle interventions for bipolar disorder: Omega-3s (for depression), exercise, light/dark therapy (lightbox/amber light).

Major Depressive Disorder Criteria

DSM-5 diagnostic criteria for Major Depressive Disorder (including the requirement for either depressed mood or anhedonia).

Common Symptoms of Depression

Common symptoms of depression (changes in sleep, appetite/weight, energy, concentration, feelings of worthlessness/guilt, thoughts of death/suicide, psychomotor agitation/retardation).

Cultural Variations in Depression

Importance of considering cultural variations in the presentation of depressed mood.

Insomnia vs Hypersomnia in Depression

Distinction between insomnia (onset, middle, terminal) and hypersomnia in depression.

Bed Rotting

Concept of 'bed rotting' and its potential impact on mood.

Chemical Imbalance Theory of Depression

The limited role of the 'chemical imbalance' theory in explaining depression.

Neurobiological Factors in Depression

Neurobiological factors in depression: decreased left prefrontal cortex activity, role of neuroplasticity (and the potential negative impact of SSRIs in some contexts), stress response system (amygdala, hypothalamus).

Efficacy of Antidepressants

The modest efficacy of antidepressants compared to placebo in the majority of studies.

Classes of Antidepressants

Different classes of antidepressants: SSRIs (selective serotonin reuptake inhibitors - recognize generic and brand names), SNRIs (serotonin-norepinephrine reuptake inhibitors - recognize generic and brand names), NDRIs (norepinephrine-dopamine reuptake inhibitors like bupropion/Wellbutrin).

Omega-3 Fatty Acids and Mood

Potential benefits and side effects of Omega-3 fatty acids in relation to mood.

Omega-3 fatty acids

Potential benefits and side effects of Omega-3 fatty acids in relation to mood.

Anniversary effect

The 'anniversary effect' in relation to trauma and mood.

Automatic negative thoughts

The role of automatic negative thoughts (system one thinking) in depression (as per Beck).

Schemas

The concept of schemas and their influence on interpretation of events.

Polygenic nature of mental disorders

The polygenic nature of mental disorders; the absence of single 'genes' for depression or other complex traits.

Emerging treatments for depression

Emerging treatments for depression, such as ketamine and brexanolone.

Ego-dystonic vs. ego-syntonic

The concept of ego-dystonic versus ego-syntonic in the context of intrusive thoughts in OCD.

Exposure and Ritual Prevention (ERP)

Exposure and Ritual Prevention (ERP) as a key treatment for OCD.

Trauma in popular understanding vs. clinical definition

Popular understanding of trauma often includes any highly upsetting event, while clinically, PTSD typically requires exposure to actual or threatened death, serious injury, or sexual violence.

Obsessions in OCD

Obsessions are recurrent and intrusive thoughts, urges, or images that cause anxiety or distress.

Compulsions in OCD

Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession.

Bipolar I vs. Bipolar II

The key difference is the severity of the manic episodes; Bipolar I disorder is characterized by at least one full manic episode, while Bipolar II disorder involves hypomanic episodes.

Iatrogenic effect of antidepressants

Prescribing antidepressant medication to someone with undiagnosed bipolar disorder can trigger a manic or hypomanic episode.

Core symptoms of Major Depressive Disorder

The two 'core' symptoms are depressed mood and loss of interest or pleasure (anhedonia).

Chemical imbalance theory

The 'chemical imbalance' theory suggests that depression is simply caused by a lack of certain neurotransmitters like serotonin in the brain.

Concept creep

The concept of 'concept creep' as it relates to the term 'trauma' in popular culture.

Triggers for manic episodes

Describe one common trigger that might precipitate a manic episode in someone with bipolar disorder.

Ego-dystonic meaning in OCD

What does the term 'ego-dystonic' mean in the context of obsessions in OCD, and why is this often characteristic of the disorder?

Obsessions and compulsions relationship

Explain the roles of obsessions and compulsions in Obsessive-Compulsive Disorder and how they are related.

Neurobiology of Depression

Involves numerous neurophysiological abnormalities, brain circuits, and genetic and environmental factors.

Exposure and Ritual Prevention (ERP)

A behavioral therapy technique used to treat OCD by exposing the individual to triggering situations while preventing compulsive rituals.

Manic Episode Trigger

Sleep deprivation, which can destabilize mood regulation and is associated with the onset or relapse of manic symptoms in bipolar disorder.

Ego-dystonic

Refers to thoughts, urges, or behaviors that are inconsistent with the individual's self-image, values, and beliefs.

Obsessions in OCD

Often ego-dystonic because intrusive thoughts are typically abhorrent and unwanted, causing significant distress.

Concept Creep

The gradual broadening of the meaning of a term over time, often diluting its original specificity.

Trauma

Concept creep can lead to the label being applied to a wider range of upsetting experiences that may not meet the criteria for genuine psychological trauma.

Emotion Dysregulation

Difficulty managing and modulating emotional responses, leading to inappropriate or ineffective reactions to situations.

Identity Disturbance

A lack of a clear or stable sense of self, often characterized by shifts in values, goals, and relationships.

Traumatic Repression

A hypothesized psychological defense mechanism in which traumatic memories are unconsciously blocked from conscious awareness.

Obsession

A recurrent and persistent thought, urge, or image that is experienced as intrusive and unwanted, causing marked anxiety or distress.

Compulsion (Ritual)

A repetitive behavior (e.g., hand washing, ordering, checking) or mental act (e.g., praying, counting, repeating words silently) that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.

Anterior Cingulate Cortex (ACC)

A region of the brain involved in various cognitive functions, including error detection, conflict monitoring, and emotional processing.

CSTC Circuit

Cortico-Striato-Thalamo-Cortical circuit; a neural pathway involved in regulating information flow to the cortex, implicated in the repetitive thoughts and behaviors seen in OCD.

PANDAS

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections; a condition in which strep infections are hypothesized to trigger or exacerbate OCD and/or tic disorders in children.

Exposure & Ritual Prevention (ERP)

A behavioral therapy technique commonly used to treat OCD, involving exposure to anxiety-provoking obsessions while preventing the associated compulsive behaviors.

Hoarding Disorder

A persistent difficulty discarding or parting with possessions, regardless of their actual value, resulting in an accumulation of possessions that congest and clutter active living areas.

Trichotillomania

A disorder characterized by the recurrent pulling out of one's hair, resulting in noticeable hair loss.

Excoriation Disorder

A disorder characterized by the recurrent skin picking, resulting in skin lesions.

Mania

A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least one week and including other specified symptoms.

Hypomania

A less severe form of mania, characterized by a persistently elevated, expansive, or irritable mood and increased energy or activity, lasting at least four consecutive days and associated with unequivocal change in functioning that is observable by others, but not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization.

Mixed Episode

A period characterized by the criteria for both a manic episode and a major depressive episode being met nearly every day for at least one week.

Iatrogenic Effect

An adverse effect or complication resulting from medical treatment or intervention.

Amygdala Reactivity

The degree to which the amygdala, a brain region involved in processing emotions, particularly fear and threat, responds to stimuli.

Dopamine Circuitry

Neural pathways in the brain that utilize the neurotransmitter dopamine, involved in reward, motivation, and motor control.

Glutamate

An excitatory neurotransmitter in the brain, playing a role in various cognitive functions.

Kindling Hypothesis

A theory suggesting that repeated subthreshold stressors or mood episodes can progressively sensitize the brain, making future episodes more likely and severe.

Rapid Cycling

In bipolar disorder, the presence of four or more mood episodes (mania, hypomania, or major depression) within a 12-month period.

Ultra-Rapid Cycling

A pattern in bipolar disorder characterized by mood switches occurring within days or even hours.

Neuroplasticity

The ability of the brain to reorganize itself by forming new neural connections throughout life.

Anhedonia

Loss of interest or pleasure in activities that were once enjoyable.

Insomnia

Difficulty falling asleep (onset), staying asleep (middle), or waking up too early and being unable to fall back asleep (terminal).

Hypersomnia

Excessive sleepiness despite getting adequate sleep.

Psychomotor Retardation

A visible slowing of physical movements, speech, and thought processes.

Psychomotor Agitation

Excessive motor activity such as restlessness, pacing, fidgeting, and wringing of hands.

Diornal Mood Variation

Fluctuations in mood that occur throughout a 24-hour cycle.

Anniversary Effect

The reemergence or worsening of symptoms (e.g., depression, anxiety) around the anniversary of a significant or traumatic event.

Automatic Negative Thoughts

Spontaneous, negative thoughts that often occur without conscious awareness and can contribute to negative emotional states (system one thinking).

Schema

A deeply ingrained and pervasive pattern of thought, feeling, and behavior that organizes and interprets experience.

Polygenic

Involving many different genes, each contributing a small effect to a particular trait or disorder.

Ego-dystonic

Thoughts, feelings, or behaviors that are inconsistent with one's self-image and values, often causing distress.

Ego-syntonic

Thoughts, feelings, or behaviors that are consistent with one's self-image and are often seen as acceptable or even desirable by the individual.

Antidepressants

Medications primarily used to treat depression.