Unit 3: clinical psychology III

2 types of affective disorders

• unipolar affective disorder

• bipolar affective disorder

Most widely recognized mood disorder

Major depression episode

Rate of suicide attempts attributed to individuals struggling with depression

50%

What is “psychomotor inhibition”

A noticeable slowing down of cognitive processes and physical movements

What is “psychomotor agitation”?

Exhibition of restlessness and inability to sit still

DSM-5 criterias for major depression episode

Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning. At least one of them must include “depressed mood” or “loss of interest or pleasure”

• Depressed mood

• loss of interest or pleasure

• weight loss when not dieting or weight gain, or loss of appetite

• Insomnia / hypersomnia

• Psychomotor agitation or retardation

• Fatigue

• Feeling of worthlessness / inappropriate guilt

• Diminished ability to think

• Recurrent thoughts of death

What type of depression is major depression episode?

Unipolar depression

Lifetime prevalence rate of unipolar depression

28.2% .

Higher prevalence for age range between 18 to 29, and twice as high for women then for men

several factors contributing to an unfavorable course of major depression, by Beesdo-Baum and Wittchen

• young age at first manifestation

• severe depressive episodes

• incomplete remission between episodes

• previous dysthymic disorder (double depression)

• a family predisposition

• comorbid anxiety disorders, substance use disorders, and medical determinants of illness

What is dysthymic disorder?

persistent depressive mood lasting for at least two years

etiological factors of depressive disorders

Biological Components:

• Genetics

• Neuroendocrinology (Dysregulation in the stress axis, often leading to elevated cortisol levels)

• Neuropsychology (Altered activity in key brain regions involved in emotion processing)

Social Components:

• Critical life events

• Lack of social support

• Loss of positive reinforcers

Psychological components

• Distorted/Negative cognitions

Who designed the Depression Model? What are the 3 components related to Depression according to this model

Aron T.Beck

3 components:

• Negative schemas

• Cognitive distortions

• Negative cognitive triad

Who did experiments with dogs in shuttle boxes, to study depression?

Seligman

What is hypomania? + criterias by DSM-5

Less severe case of bipolar disorder

• Excessive self-esteem or ideas of greatness.

• Reduced need for sleep (e.g., the person feels rested after only three hours of sleep).

• Increased talkativeness or urge to talk.

• Flight of ideas or subjective feeling of racing thoughts.

• Increased distractibility is reported or observed (e.g., attention is drawn too easily to unimportant or irrelevant external stimuli).

• Increase in goal-directed activity (social, professional, academic, or sexual) or psychomotor restlessness (e.g., haphazard, non-goal-directed activity) as well.

• Excessive involvement in activities that are likely to have unpleasant consequences (e.g., unbridled shopping, sexual adventures, or foolish business investments).

3 forms of bipolar disorder by DSM-5

1. Bipolar I disorder
   - at least 1 manic episode & 1 depressive episode
   

2. Bipolar II disorder

   - at least 1 hypomanic episode % 1 depressive episode
   

3. Cyclothymia

   - multiple affective (depressive/manic) symptoms over a long-term period (at least two years)

What is rapid cycling in bipolar disorders?

The occurrence of at least four depressive, manic, or hypomanic episodes per year

Estimated lifetime prevalence of bipolar disorders

from 1.1% to 2.2% to 4% (depending on the assessment method and sample)

No significant gender based differences

Risk of suicide is 15 times higher

2 factors that have shown predictive value for manic symptoms

• sleep deprivation

• reward sensitivity

Suicidal idealisation definition

a psychological state in which thoughts and behaviors, varying in severity, revolve around causing one’s own death

Non-suicidal self-injurious behavior definition

Associated with borderline personality disorder, self-harm

how many people die from suicide each year, worldwide? Gender comparaison + why

800 000

Men are 3x more likely to attempt suicide:

• Suicide attempts among young women are sometimes seen as a “cry for help.

• ”Men often use “hard” methods (such as falling, shooting, hanging), while women tend to use “soft” methods (like drugs or gas). Consequently, women have a higher likelihood of being rescued in time (Cal, 2012).

• Recent research findings indicate that traditional gender roles and the associated pressures on men (referred to as “toxic masculinity”) contribute to an increased suicide rate among young males (Freeman et al., 2017)

90% of individuals who make suicide attempts have a coexisting mental disorder.

Hierarchical classification of risk factors, what + who

Rihmer

Primary factors : mental disorders, previous suicide attemps

Secondary factors: early trauma , negative life events

tertiaty factors: Male gender, vulnerable periods

This aids in identifying targets and strategies for intervention

What is something often experienced at the onset of a manic episode?

disruption in circadian rhythm

3 primary eating disorders

• anorexia nervosa

• bulimia nervosa

• binge eating

3 key caracteristics common to people with eating disorders by Hilde Buch

• body schema disorders (ex: anorexic thinking they’re overweight)

• Disorders of proprioceptive (awareness and perception of one’s body position and movement in the air), interoceptive (perception of internal body processes such as disrupted sensation of hunger and satiety) , and emotional perception

• Feelings of inadequacy (low self-esteem)

Commonly employed criterias to determine if someone is anorexic

• Body mass index (BMI) of less than 18.5 kg/m² for adults, and for children BMI-for-age below the 5th percentile

• Rapid weight loss, more than 20 % of total body weight within 6 month (if other criterias of anorexia are met)

2 types of anorexia nervosa according to DSM-5

• restrictive type

• binge eating/purging type

Lifetime prevalence of anorexia nervosa + gender comparaison + mortality rate

1%

Women are 10x more likely to be affected by anorexia nervosa then men

Mortality rate is estimated 10x higher for people with anorexia

Lifetime prevalence of bulimia nervosa + gender comparaison + mortality rate

1 %

Women 10x more prone to develop bulimia than men

Mortality rate : 4%

Lifetime prevalence of binge eating + gender comparaison

1.9%

Women affected twice as often as men

2 most prevalent comorbid disorders that people with ED present

• affective disorders (Bipolar, depressive disorders)

• anxiety disorders (social phobia)

What is Thought-Shape Fusion? + it’s 3 components

Describes a cognitive distortion in which thoughts about one's body shape or weight become fused with moral or emotional significance, often leading to irrational beliefs and behaviors related to eating and body image

3 components:

• The belief that merely thinking about a forbidden food leads to the likelihood of gaining weight or altering one’s body shape

• Viewing thoughts about consuming forbidden foods as morally reprehensible, akin to actually eating those foods.

• The perception that thoughts about eating forbidden foods intensify feelings of being overweight or having gained weight.