PSYO 2220 Final

mood

state of emotionality that is longer and more consistent than emotions

hypomania

low-level mania, less intense but still positive

euthymia

natural mood state

dysthymia

low levels of depression, less intense but still negative

mania

the highest level of mood

unipolar mood disorder structure

mood remains at one side of the mood chart (either depression or mania)

bipolar mood disorder structure

mood changes between areas of the mood chart

mixed mood disorder structure

mixed symptoms from all areas of the mood chart

recurrent major depression

at least two MDD episodes separated by at least two months between each episode

persistant depressive disorder

depressed mood for more days than not for the past two years

pure dysthymic syndrome

full criteria for major depressive epidodes have not been met in at least the past two years

persistent major depressive episode

full criteria for major depressive episodes have been met for at least a 2 year period

Premenstrul dysphoric disorder (PMDD)

symptoms are present the week before your period, improve within your period, and go away after your period is over

disruptive mood dysregulation disorder

severe recurrent outbursts that are not developmentally appropriate and out of proportion to an event. Only diagnosed between 6-18 years and symptoms must have been present since 10 years old

manic episode

distinct period of abnormal and persistent elevated, expansive, or irritable mood and increased activity/energy lasting for at least 1 week, most of the day almost every day

hypomanic episode

distinct period of abnormal and persistent elevated, expansive, or irritable mood and increased activity/energy lasting for at least 4 days. No marked impairment, hospitalization, or psychotic features are present

bipolar 1

criteria has been met for at least one manic episode

bipolar 2

criteria has been met for at least 1 hypomanic, and 1 major depressive episode

mixed features

major depressive or manic episode having some symptoms of the opposite polarity (ex: depressive episode with some manic symptoms)

rapid cycling

moving quickly in and out of depressive and manic episodes with at least 4 episodes in a year

mood disorders in youth

expression and presentation is different in this population than in adults

• increased irritability and aggression

• increased focus on behavioural aspects of presentation

mood disorders in older adults

can be more difficult to diagnose than other populations and no difference in rates between men and women. Contributes to physical and mental decline

genetic factors of mood disorders

• rates of development are about 2-3x higher if you have family with this diagnosis

• 37% heritability

permissive hypothesis

argues that lower serotonin levels allow other neurotransmitter systems to become dysregulated

serotonin

regulates moods and behaviours

dopamine

regulates reward processing and anticipation of rewards

anhedonia

inability to experience pleasure/enjoyment in activities that were once pleasurable. accompanied by a loss of interest or motivation.

norepinephrine

regulates energy, sleep, and stress reactions

endocrine system

excessive cortisol release → depression

assessment for mood disorders

1. file review

2. intake interview

3. clinical interview

4. objective measures (PHQ-9, DASS-21, BDI, HAM-D)

anti depressant medication

• SSRIs

• tricyclics

• monoamine oxidase inhibitors (MAOIs)

mood stabilizer medications

lithium loften for BPD

electrocompulsive therapy (ECT)

electric shock to brain → mini seizure → increased serotonin → blocked stress hormones → neurogenesis promotion in hippocampus

• controversial usage but safer now than was in the past

• used for severe mood disorders that have been unresponsive to other treatments

trancranial magnetic stimulation (TMS)

electric coil placed over head to generate a localized electromagnetic pulse rather than a shock

• newer and more precise

• effective for depression treatment

behavioural activation therapy for depression

encourages people to do more of what matters to them, build motivation → feeling better

CBT or ACT for depression

targets depressive thoughts/behaviours, core beliefs, behavioural goals, exposures are replaced with behavioural activation

interpersonal therapy for depression

works on resolving problems in relationships and developing new relationships

CBT for BPD

psychoeducation, identifying and targeting unhelpful thoughts, coping and stress reduction skills, intervention and prevention of future episodes

interpersonal and social rhythm therapy (IPSRT) for BPD

focus to regulate circadian rhythm

• regulating sleeping and eating schedules

• maintaining a daily schedule

• building stress coping skills

family focused therapy for BPD

psychoeducaiton, identification and response to warning signs, family coping responses, communication and problem solving

psychosis

a mental state characterized by severe impairment or distortion in the experience of reality

delusions

beliefs that are fixed/rigid even though they are not accurate. often misinterpret reality

persecution

belief they will be harmed or harassed by someone

referential

beliefs that gestures, environmental cues, comments, etc. are directed at them specifically

somatic

preoccupation with health, organ functioning, body changes, and the meaning of these

grandiosity

belief they have exceptional abilities, wealth, are invincible, etc.

loss of control of mind/body

believes that thoughts are being removed/inserted into their mind. belief that body actions are being controlled by an outside force

bizzare delusions

completely impossible (ex: their organ has been taken by aliens)

non-bizzare delusions

plausible but very unlikely to be true (ex: they are being stalked by the government/police)

positive symptoms

add something to ones functioning (includes delusions, hallucinations, disorganized thoughts/speech, disorganized behaviours)

hallucinations

sensory experiences without external stimulus

disorganized symptoms

severe disruptions in speech, behaviour, emotions

disorganized thoughts/speech

loose associations between ideas

tangentiality

responses are unrelated to topic

derailment

jumping from topic to topic

cognitive slippage (word salad)

speech is incoherent and words are put together into sentences that do not make sense

innapropriate affect

mismatched affect for the situation (ex: crying and distraught when happy)

disorganized behaviours

unusual and erratic behaviours, difficulty with goal-directed behaviours

catatonia

reduction in motor functioning → random and erratic movements

waxy flexibility

tendency to keep limits in a position placed by someone else

negative symptoms

absence/insufficiency of normal behaviours

abolition

unable to initiate/participate in activities (can be seen by apathy)

anhedonia

lack of pleasure

alogia

relative absence of speech

asociality

severe deficits in social functioning

affective flattening

lack of expected emotional responses

schizophrenia development

1. premorbid

2. prodromal

3. onset/deterioration

4. chronic/residual

brief psychotic disorder

at least one key feature of psychotic disorders but no negative symptoms are present. episode duration is at least one day but less than one month with a full return to premorbid level of functioning

schizophreniform disorder

duration of at least 1 month and less than 6 months

delusional disorder

1 or more delusions with a duration of at least 1 month, never met criteria for schizophrenia, no significant impairment in functioning

schizoaffective disorder

major mood episode with positive symptoms that present for at least 2 weeks when not in a mood episode

dopamine hypothesis

the early view that overactive dopamine systems are found in schizophrenia

prefrontal cortex

has D1 dopamine receptors. people w schizophrenia have decreased stimulation of D1 receptors → negative symptoms

basal ganglia

has D2 receptors. people w schizophrenia have increased stimulation of D2 receptors

hypofrontality

decreased activity in the frontal lobe

sociogenic hypothesis

shows that people w schizophrenia are often in lower social classes

social selection hypothesis

believes that people w schizophrenia may experience a downward spiral that causes them to drift into lower social classes

conventional neuroleptics

lead to an overall decrease in dopamine, effective to treat positive symptoms but has side effects

psuedoparkinsonism

stooped posture, shuffled gait, rigidity, tremors, etc

akathisia

restlessness, trouble standing still, pacing, rocking feet

acute dystonia

facial grimacing, involuntary upwards eye movement, muscle spasms, laryngeal spasms

tardive dyskinesia

protrusion and rolling of tongue, facial dyskinesia, involuntary body movements

atypical neuroleptics

targets dopamine but less motor control, more effective for negative symptoms, may help to increase cognitive functioning

CBT for schizophrenia

targets delusions and depression increases flexibility in thinking

personality

patterns of thinking, feeling, and acting that characterize a given individual

personality traits

reflect behaviours and remain mostly consistent across settings and situations

dimensional model of personality disorders

personality traits are viewed as a continuum and have a degree of expression

personality pathology

an extreme variation of a certain personality trait

categorical model of personality disorders

personality disorders are defined and discrete with specific symptoms

personality disorder

meeting a specific criteria for diagnosis

five factor model of personality disorders

1. neuroticism

2. extraversion

3. openness to experience

4. conscientiousness

5. agreeableness

neuroticism

how prone someone is to experiencing unpleasant emotions

extraversion

how much someone prefers being social to being alone

openness to experience

how curious and receptive to new things someone is

conscientiousness

how much someone displays things like organization, punctuation, achievement, motivation

agreeableness

how much someone gets along with others and wants to cooperate

cluster A personality disorders

odd/eccentric (paranoid, schizoid, schizotypical)

cluster B personality disorders

dramatic, erratic, emotional (antisocial, histrionic, borderline, narcissistic)

cluster C personality disorders

anxious/fearful (avoidant, dependent, obsessive, compulsive)

assessment of personality disorders

1. file review

2. clinical review

3. self-reported measures/questionaires

4. informant reports (if applicable)