Abnormal Psych Exam 2 (Chapters 4,5,7,9)

Moods

feeling states that color our psychological lives

people with mood disorders experience...

disturbances in mood that are unusually severe or prolonged and impair their ability to function in meeting their normal responsibilities.

T/F: DSM-5 does not include a general category of mood disorders.

True. Instead, depressive disorders and bipolar disorders are now classified in separate groupings in the manual.

Two major types of depressive disorders

1) Major depressive disorder

2) Persistent depressive disorder

two major types of bipolar disorders

1) bipolar disorder

2) cyclothymic disorder (also called cyclothymia)

bipolar disorder is comprised of two distinct disorders

bipolar I disorder and bipolar II disorder

Why are Depressive disorders also called "unipolar" disorders?

because the mood disturbance goes in only one emotional direction or pole: down.

Why are mood swing disorders called bipolar disorders?

because they involve states of both depression and elation, which often appear in an alternating pattern

Lifetime Prevalence Rates of Major Depressive Disorders

14.7% in men; 26.1% in women; 20.6% overall

Major features of MDD

Episodes of severe depression characterized by downcast mood, feelings of hopelessness and worthlessness, changes in sleep patterns or appetite, loss of motivation, loss of pleasure in usual activities.

Following a depressive episode, a person may return to his or her usual state of functioning, but recurrences are common. Seasonal affective disorder is a type of major depression.

Lifetime Prevalence Rates of Persistent depressive disorder (dysthymia)

About 3 or 4%

Major Features of Persistent depressive disorder (dysthymia)

A chronic pattern of depression. A person experiences chronic mild or major depression or feels "down in the dumps" most of the time.

Premenstrual dysphoric disorder (PMDD) major features

Marked changes in mood during a woman's premenstrual period. A new diagnostic category in DSM-5, PMDD remains controversial; critics claim it unfairly stigmatizes women who have significant premenstrual symptoms by labeling them with a mental or psychological disorder.

T/F: The prevalence rates of Premenstrual dysphoric disorder (PMDD) are unknown.

True

Bipolar disorder Approximate Lifetime Prevalence Rate

1 percent

Bipolar disorder major features

Periods of shifting moods, energy level, and level of activity between mania and depression, perhaps with intervening periods of normal mood; two general subtypes are bipolar I disorder (occurrence of one or more manic episodes) and bipolar II disorder (major depressive episode and hypomanic episode, but no full manic episode)

Manic episodes are characterized by

Manic episodes are characterized by pressured speech, greatly increased energy or activity, flight of ideas, poor judgment, high levels of restlessness and excitability, and inflated mood and sense of self.

Cyclothymic disorder Prevalence rates

0.4-1 percent

Cyclothymic disorder major features

Mood swings that are milder in severity than those in bipolar disorder. Cyclothymia usually begins in late adolescence or early adulthood and tends to persist for years.

T/F: less than one in five Americans experience a diagnosable mood disorder at some point in their lives

False. More than one in five Americans experience a diagnosable mood disorder at some point in their lives

The diagnosis of major depressive disorder (also called major depression) is based on...

the occurrence of at least one major depressive episode (MDE) in the absence of a history of mania or hypomania.

A major depressive episode includes...

a clinically significant change in functioning involving a range of depressive symptoms, including depressed mood (feeling sad, hopeless, or "down in the dumps") and/or loss of interest or pleasure in all or virtually all activities for a period of at least two weeks

T/F: fewer than 30 percent of people who screen positive for depression receive treatment

true

_______ is the most common diagnosable mood disorder, affecting more than one in five U.S. adults (20.6 percent) in their lifetimes

MDD

T/F: nearly 80 percent of people with moderate to severe depression report impaired work, family, or social functioning.

true

Major depression, particularly in more severe episodes, may be accompanied by ___________, such as delusions that one's body is rotting from illness and hallucinations

psychotic features and behaviors

Describe the length one may experience a major depressive episode

they may resolve in a matter of months or last for a year or more. Some people experience a single episode of major depression and then return to their earlier state of normal psychological functioning

t/f: patients never go on to have a recurrent episode at some point in their lives

False. a half of these patients go on to have a recurrent episode at some point in their lives. However, the good news is that the longer the period of recovery from an episode of major depression, the lower the risk of eventual relapse

The risk of repeat episodes is related to...

genetic influences and to exposure to significant life stress.

Risk factors in developing depression

age (young adults), socioeconomic status (more poor), marital status (separated or divorced), and gender (women have higher rates). People with a family history of major depression and those with a childhood history of sexual abuse are also at higher risk

t/f: men and women have the same likelihood to develop mdd

false. Women are nearly twice as likely as men to develop major depressive disorder at some point in their lives

seasonal affective (mood) disorder (SAD).

a depression caused by the changing of the seasons from summer to fall and winter

SAD is not a diagnostic category in its own right, but is a a specifier or subcategory of...

major depression

major depressive disorder that occurs seasonally would be diagnosed as...

major depressive disorder with seasonal pattern

phototherapy

the therapeutic use of bright artificial light. often helps relieve depression in cases of SAD

Other treatments can also help relieve depressionin SAD, including...

antidepressant drugs and cognitive behavioral therapy

"maternity blues," "postpartum blues," or "baby blues" are...

almost 80 percent of new mothers experiencing mood changes following childbirth

postpartum depression (PPD; sometimes called perinatal depression) is

more severe and persistent mood changes occur around the time of childbirth that represent a form of major depression

postpartum derives from the Latin roots

post, meaning after, and papere, meaning to bring forth.

Postpartum depression typically begins within ____ weeks after childbirth

4

risk factors of PPD

Being a single or first-time mother

Having financial problems or a troubled marriage

Stressful life experience

Having a very low birthweight baby

Suffering domestic violence

Lacking social support from partners and family members

Having unwanted, sick, or temperamentally difficult infants

t/f: Postpartum depression is limited to American culture

false. Researchers find high rates of PPD among South African women and Chinese women from Hong Kong

postpartum psychosis

a new mother loses touch with reality and experiences symptoms such as hallucinations, delusions, and irrational thinking

reasons women may experience depression more

disproportionate stress burden women in our society tend to carry, women tend to ruminate or brood more about their problems, Depression in women is more often connected with problems in close, car- ing relationships

The diagnosis of persistent depressive disorder applies to cases of chronic depression lasting for

at least two years

a chronic but milder form of depression is called

dysthymia

The word dysthymia derives from Greek roots

dys, meaning bad or hard, and thymos, meaning spirit.

Whereas major depressive disorder tends to be __________ and _______, dysthymia is relatively _______ and _____, typically lasting for years.

severe and time limited; mild and nagging

Dysthymia it is diagnosed only in people who have never had episodes of....

either mania or hypomania, which are characteristics of bipolar disorder

Some people are affected by both dysthymia and major depression at the same time, called

double depression. applies to those who have a major depressive episode superimposed on a longer-standing dysthymia.

t/f: Premenstrual dysphoric disorder (PMDD) was introduced as a diagnostic category in DSM-5

true

PMDD is a more severe form of

premenstrual syndrome, which is a cluster of physical and mood-related symptoms occurring during a woman's premenstrual period

The diagnosis of PMDD is intended to apply to women who

experience a range of significant psychological symptoms in the week before menses

why is the diagnosis of PMDD controversial?

Critics fear it will pathologize a woman's natural menstrual cycle and may stigmatize women who have serious premenstrual complaints by labeling them with a psychiatric diagnosis

bipolar disorder

a psychological disorder characterized by extreme swings of mood and changes in energy and activity levels

how long does a manic episode typically lasts

a few weeks or perhaps a month or two, but generally is much shorter and ends more abruptly than major depressive episodes

t/f: most people with bipolar disorder cycle between mania and depression from day to day

false. However, there are cases of bipolar disorder involving mixed states that are characterized by episodes of both mania and depression

During mixed states, a person's mood may....

rapidly shift between mania and depression

The diagnosis of bipolar I disorder applies to

people who have had at least one full manic episode at some point in their lives

Bipolar II disorder applies to

people who have had both episodes and a history of at least one major depressive episode, but have never had a full-blown manic episode.

hypomanic root

from the Greek prefix hypo, meaning under or less than

T/f" Hypomanic episodes are less severe than manic episodes and are not accompanied by the extreme social or occupational problems associated with full-blown mania

true

During a hypomanic episode, a person might may feel...

unusually charged with energy and show a heightened level of activity and an inflated sense of self-esteem, and may be more alert, restless, and irritable than usual

Bipolar disorder typically develops around age ____ in both men and women and tends to become a _____, recurring condition requiring long-term treatment

20; chronic

t/f; rates of bipolar I disorder appear about equal in men and women

TRUE

Should bipolar I and bipolar II disorders should be considered two distinct disorders, or simply different points along a continuum of severity of a single bipolar disorder?

remains unsettled, but recent evidence points to different biological pathways in the development of bipolar I and bipolar II disorders, sup- porting the view that these are indeed distinct disorders

MANIC EPISODE

A manic episode typically begins abruptly, gathering force within days. A hallmark feature of a manic episode, as well as a hypomanic episode, is in- creased activity or energy. A person may seem to be on overdrive and to have boundless energy. During a manic episode, a person experiences a sudden elevation or expansion of mood and feels unusually cheerful, euphoric, or optimistic. poor judgment and to be argumentative, pressured speech, flight of ideas

What is the basic difference between a full manic episode and a hypomanic episode?

the degree or severity.

Cyclothymia root

Greek kyklos, which means circle, and thymos, meaning spirit

Cyclothymic disorder

usually begins in late adolescence or early adulthood and persists for years. During a period of at least two years, the adult with cyclothymia has numerous periods of hypomanic symptoms that are not severe enough to meet the criteria for a hypo- manic episode and numerous periods of mild depressive symptoms that do not measure up to a major depressive episode. In effect, the person fluctuates between periods of mildly high "highs" and mildly low "lows."

Stressful life events increase the risk of mood disorders such as

bipolar disorder and major depression

Sources of life stress linked to depression include

the loss of a loved one, breakup of a romantic relationship, prolonged unemployment and economic hardship, serious physical illness, marital or relationship problems, separation or divorce, exposure to racism and discrimination, and living in unsafe, distressed neighborhoods

Research evidence links stress associated with interpersonal problems involving friends, family members, and romantic partners to greater risk of depression in young people, but only among those who tend to---

think negatively

Factors that may lessen the likelihood of depression in the face of stressful events

coping skills, genetic endowment, and availability of social support

t/f: people who possess variants of certain genes may be more susceptible to developing depression if they have a history of severely stressful life experiences such as maltreatment during childhood

true

t/f : A lack of secure attachments to parents during infancy or childhood may also contribute to greater vulnerability to depression in later life following disappointment, failure, or other stressful life events

true

classic psychodynamic theory of depression proposed by Freud

depression represents anger directed inward rather than against significant others; Anger may become directed against the self following either the actual or the threatened loss of these important others

While mourning, or normal bereavement, is a healthy process by which one eventually comes to separate oneself psychologically from a person who has been lost, Pathological mourning, however...

does not promote healthy separation.

t/f: Pathological mourning fosters lingering depression

true

within Freudian psychodynamic theory, what is an object

lost person

How do ppl preserve a psychological connection to the lost object?

people introject, or bring inward, a mental representation of the object. They thus incorporate the other person into the self. Now, anger is turned inward, against the part of the self that represents the inward representation of the lost person. This produces self-hatred, which in turn leads to depression.

Although they emphasize the importance of loss, more recent psychodynamic models shift the focus toward an individual's sense of....

self-worth or self-esteem

self- focusing model

considers how people allocate their attentional processes after a loss, such as the death of a loved one or a personal failure or significant disappointment.

In this view, depressed people have difficulty thinking about anything other than themselves and the loss they experienced.

Humanistic approach for depression

people become depressed when they cannot imbue their existence with meaning and make authentic choices that lead to self-fulfillment.

T/F: Like psychodynamic theorists, humanistic theorists focus on the loss of self-esteem that can occur when people lose friends or family members or suffer occupational set- backs.

true

Learning Theories focus on..

situational factors, such as the loss of positive reinforcement. Changes in the frequency or effectiveness of reinforcement can shift the balance so that life becomes unrewarding.

Interactional theory

developed by psychologist James Coyne (1976), proposes that the adjustment to living with a depressed person can become so stressful that the person's partner or family member becomes progressively less reinforcing.

reciprocal interaction

The theory holds that depression-prone people react to stress by seeking support from their partners. At first, this effort to garner support may succeed—but over time, persistent demands for emotional support begin to elicit more anger and annoyance than expressions of support. Depressed people may react to cues of rejection with deeper feelings of depression, triggering a vicious cycle of further rejection and more profound depression.

Cognitive Theories on depression

relate the origin and maintenance of depression to the ways in which people see themselves and the world around them

Aaron Beck

One of the most influential cognitive theorists. He links the development of depression to the adoption early in life of a negatively biased or distorted way of thinking—the cognitive triad of depression

the cognitive triad of depression

Negative view of oneself, the environment, and the future

cognitive distortions

Inaccurate and irrational automatic thoughts or ideas that lead to false assumptions and misinterpretations.

examples of cognitive distortions

all or nothing thinking- events are all good or all bad

overgeneralization- if a negative event occurs, it is likely to occur again in similar situations in the future

jumping to conclusions- Forming a negative interpretation of events, despite a lack of evidence

Mental filter- Focusing only on negative details of events

Disqualifying the positive- neutralizing or denying one's accomplishments.

Magnification and minimization- exaggeration of the importance of negative events, personal flaws, fears, or mistakes. Minimization is the mirror image, a type of cognitive distortion in which one minimizes or underestimates one's good points.

Emotional reasoning- reasoning based on emotions

"Should" statements- i should do this

Labeling and mislabeling- im stupid, im lazy

Personalization- take blame for everything

t/f: Distorted thinking tends to occur automatically, as if the thoughts just popped into one's head

true

cognitive-specificity hypothesis

different disorders are characterized by different types of automatic thoughts

People with diagnosable depression more often reported automatic thoughts concerning themes of

loss, self-deprecation, and pessimism

People with anxiety disorders more often reported automatic thoughts concerning

physical danger and other threats.

learned helplessness model

View that depression results from the perception of a lack of control over the reinforcements in one's life that may result from exposure to uncontrollable negative events

learned helplessness effect

Exposure to uncontrollable forces apparently taught the animals that they were helpless to change the situation. Animals that developed learned helplessness showed behaviors like those of depressed people, including lethargy, lack of motivation, and difficulty acquiring new skills

attributional style

An attributional style is a personal style of explanation. When disappointments or failures occur, we may explain them in various characteristic ways. We may blame ourselves (an internal attribution), or we may blame the circumstances we face (an external attribution). We may see bad experiences as typical events (a stable attribution) or as isolated events (an unstable attribution). We may see them as evidence of broader problems (a global attribution) or as evidence of precise and limited shortcomings (a specific attribution)