What are the symptoms of MDD
Persistent sad mood (has to be one of the symptoms)
Lack of pleasure aka. Anhedonia (has to be one of the symptoms)
Weight gain or loss
Sleep gain or loss (insomnia vs. Hypersomnia)
Fatigue
Suicidal thoughts
Agitation or 'retardation' - restless or slow
Recurrent thoughts of guilt /worthlessness
Diminished ability concentrate
What are the 8 depressive disorders in the DSM-5?
Disruptive mood regulation disorder
Major depressive disorder
Persistent depressive disorder (dysthymia)
Premenstrual dysphoric disorder
Substance / medication induced depressive disorder
Depressive disorder due to another medical condition
Other specified depressive disorder
Unspecified depressive disorder
What are the symptoms of dysthymia (persistent depressive disorder)?
Poor appetite / overeating
Insomnia/ hypersomnia
Fatigue
Low self-esteem
Poor concentration indecisiveness
Sense of hopelessness
What is the course of MDD??
Can begin at any age, but onset increases significantly with puberty
Peak onset is 20's
People can go 2 or more months with no symptoms or years without experiencing an episode
Most people experience spontaneous recovery (recover without intervention) -for 4 of 5 people, this will happen within 12 months
What are factors associated with lower rates of recovery for MDD?
Symptom severity
Personality disorders
Psychotic features
What are factors associated with an increased risk of an episode of MDD?
Severity of previous episode
Being younger at onset
More prior episodes
What is the course of persistent depressive disorder (dysthymia)?
Early and chronic onset
Some people rarely experience remission
Symptoms will return at a lower level
What is the prevalence of depressive disorders?
prevalence in adults is 6-7% (Aus and US)
12 month prevalence rate for dysthymia is 0.5%
What are the implications in the aetiology of depressive disorders?
Disruption in neurotransmitter functioning
Genetic risk
Childhood trauma,abuse or neglect
Incidence of negative life events
What is the cognitive behavioural model of depression?
Made up of 2 components:
Behavioural component - suggest that depression is maintained by a lack of positive reinforcement - feeds into a sense of learned helplessness in relation to external environment
Cognitive component - suggests that depression is about cognitive thoughts relating to the self, the world and the future -pessimism
What is used to treat depressive disorders?
Ants depressant medications
SSRI's ( selective serotonin reuptake inhibitors) -most prescribed class of anti-depressants
ECT ( electroconvulsive therapy)
Biological treatment used as a last resort
Psychological interventions - CBT (cognitive behavioural therapy) and IPT ( interpersonal therapy)
What are the key strategies in CBT for depression?
Behavioural activation aka pleasant events scheduling - targets symptom of anhedonia (loss of pleasure/ interest)
Engage in previously enjoyed activities - positive reinforcement
Cognitive restructuring
Help clients identify negative thoughts relating to sadness and hopelessness -evaluate evidence for and against these thoughts
What are the 10 anxiety disorders in the DSM-5?
Separation anxiety disorder
Selective mutism
Specific phobia
Social anxiety disorder (social phobia)
Panic disorder
Agoraphobia
Generalised anxiety disorder
Substance/ medication induced anxiety disorder
Anxiety disorder due to another medical condition
Other specified anxiety disorder
What are the 3 systems of anxiety?
Cognitive - what people think during anxiety -provoking situations
Behavioural- action taken when feeling anxious
Psychological - bodily responses to anxiety
What are the symptoms of specific phobia?
Extreme fear: fear that is disproportionate to the actual threat -specifically related to the identified object or situation
Avoidance behaviour
duration and impact:
Persist for 6 months or longer
Causes significant stress / interference in daily functioning
Symptoms cannot be better explained by another condition
Diagnostic criteria for generalised anxiety disorder (GAD)
6 months
Worry is difficult to control
At least 3 of 6 physiological symptoms present (muscle tension, restlessness, fatigue, difficulty concentrating, irritability and sleep disturbances
Distress and impairment
Exclusion criteria
Individuals with GAD also often exhibit hyper-vigilance
What are the symptoms of panic disorder?
Palpitations, pounding heart, accelerated heart rate
Sweating
Trembling or shaking
Shortness of breath
Feelings of choking
Chest pain/discomfort
Nausea or abdominal pain
Dizziness, lightheadedness
Chills or heat sensations
Derealisation
Depersonalisation
Numbness or tingling
fear of loosing control / going crazy
Fear of dying
Comorbidity
Simultaneous presence of more than one diagnose in an individual
Implications in the aetiology of anxiety disorders
Stressful life events
Genetic influence
Temperament
Exposure to traumatic events
Parenting behaviours
Interaction between biological and environmental factors
Stanley Rackmann's Pathways to Fear Development
Direct experience: personal negative experiences - conditioning
Instructional learning: warnings from others, particularly caregivers
Vicarious learning: observing significant others behaving fearfully
Interventions for anxiety disorders
psychoeducation about anxiety -use of a cognitive behavioural model
cognitive restructuring - ABC model
Behavioural strategies - exposure hierarchy