Chapter Nine Mood Disorders and Suicide (Middle Childhood to Adolescence) - Vocabulary Flashcards

Vocabulary flashcards covering major concepts, definitions, and distinctions related to mood disorders and suicide across middle childhood and adolescence as presented in Chapter Nine.

Depressive spectrum disorders

A range of mood disorders from major depression to dysthymia and bipolar disorder; depression can emerge in childhood and adolescence and coverage focuses on transition to adolescence due to increased prevalence.

Major Depression

A depressive disorder defined by five or more symptoms during a 2-week period, with at least one symptom being depressed mood or irritability in children/adolescents; onset can be sudden and recurrence is common.

Dysthymic Disorder (Dysthymia)

Chronic depressed mood persisting at least 1 year in children/adolescents, with at least two accompanying symptoms; earlier onset and protracted course compared with major depression.

Adjustment Disorder with Depressed Mood

Least severe depressive spectrum disorder characterized by short-term emotional/behavioral problems in response to a identifiable stressor within 3 months, causing distress or impairment but not meeting another specific mental disorder.

Comorbidity (in depressive disorders)

High co-occurrence of depression with other disorders (e.g., anxiety, conduct disorders, eating disorders, substance use), complicating prognosis and treatment.

Etiology (genetic component)

Depression shows a genetic component; familial risk is about 20–45% heritable, with stronger genetic loading for early-onset depression.

5-HTTLPR (serotonin transporter gene)

Genetic variant (short allele) interacting with environmental stress to increase risk of depression; a key gene–environment interaction in adolescent depression.

HPA axis/Cortisol

Neuroendocrine system involved in stress response; dysregulated morning cortisol and heightened stress reactivity are linked to adolescent depression.

Left hemispheric hypoactivation

Reduced activation of the left hemisphere (associated with positive affect) observed in depression; may relate to processing of mood and affect.

Cognitive Triad

Beck’s model: negative views about the self, the world, and the future (worthlessness, hopelessness, helplessness) contributing to depression.

Self-efficacy

Bandura’s concept of belief in one's own ability to influence events; low self-efficacy contributes to depression via self-devaluation, social inefficacy, and perceived lack of control over thoughts.

Attributional Style (internal/stable/global)

Depressive attributional pattern where negative events are attributed to internal, stable, and global causes, fostering hopelessness and helplessness.

Rumination

Recurrent, passive focus on negative thoughts and feelings; linked to the development and maintenance of depression; co-rumination involves peers and is common among girls.

Co-rumination

Excessive discussion of problems with peers that can amplify internalizing problems, particularly in adolescent girls.

Emotion Regulation

Difficulty in identifying, regulating, and modulating emotions; linked to depressive symptomatology and maladaptive responses like withdrawal or excessive reassurance seeking.

Attachment and depression (internal working models)

Depression linked to insecure attachment experiences (dependent/anaclitic vs. self-critical/introjective); early caregiver relationships shape internal models of self and others.

Depressed Parenting

Parental depression (especially mothers) associated with withdrawal or intrusiveness, low warmth, and high conflict, influencing child emotion regulation and development.

Parental Loss / Maternal Deprivation

Loss of a caregiver (death or separation) can contribute to later depression; outcomes depend on context (institutionalization vs. foster care) and mediating factors.

Intergenerational Transmission of Depression

Depression risk transmitted through genetic and environmental pathways; multifactorial and influenced by parenting style, family dynamics, and life stress.

Stage-Salient Issues (Developmental)

Core developmental tasks at various ages (attachment in infancy, self-regulation in school-age, autonomy/peer relations in adolescence) that can be disrupted by depression.

Gender Differences in Adolescent Depression

During adolescence, rates rise especially for girls; by mid-adolescence girls have about a 2:1 rate compared with boys, due to biological, cognitive, and social stressors.

Point vs. Lifetime Prevalence

Point prevalence measures current or recent cases (e.g., 1–6% by age group); lifetime prevalence estimates total who will experience depression at some point; adolescence shows higher rates than preschool or early childhood.

Recovery and Relapse in Childhood Depression

Most youths recover from an initial depressive episode, but relapse rates are high (roughly 40% over 3–5 years); early onset and dysthymia predict poorer prognosis.

Bipolar Disorder (BD)

Mood disorder with alternating depressive and manic/hypomanic episodes; includes BD I, BD II, and cyclothymia; onset can be in childhood or adolescence with developmental differences from adults.

Manic Episode (BD)

Distinct period of abnormally elevated/expansive/irritable mood lasting at least 1 week with 3+ additional symptoms (e.g., decreased need for sleep, pressured speech, flight of ideas) causing impairment.

Bipolar I, II, Cyclothymia

BD I: mania with/without depression; BD II: hypomania with major depression; Cyclothymia: fluctuating mood symptoms not meeting full criteria for mania or major depression.

Rapid Cycling

Two or more mood episodes within a year (or shorter), with abrupt shifts between mood states; particularly common in youth with BD.

BD in Youth: Prevalence and Diagnostics

BD in children is controversial; high comorbidity with ADHD and other disorders; symptoms may differ from adults and diagnostic criteria may require modification.

Course and Outcome of Bipolar Youth (COBY)

Longitudinal study of 413 youths (ages 7–17) showing high recurrence and enduring distress; many convert to bipolar I/II and comorbidity with other disorders over time.

Lithium (BD treatment)

Mood stabilizer commonly used to treat BD; effective but with notable side effects in youth; often used with other medications.

Valproic Acid (Depakote)

Anticonvulsant mood stabilizer used in pediatric BD with evidence for efficacy; potential side effects to monitor.

Atypical Antipsychotics (BD treatment)

Risperidone, olanzapine, ziprasidone approved for adolescent BD symptoms; risk of extrapyramidal symptoms, weight gain, metabolic effects.

Family-Focused Therapy (FFT)

Miklowitz's family-based intervention for adolescents with BD; psychoeducation and training in communication/problem-solving; reduces relapse when combined with medication.

ABFT (Attachment-Based Family Therapy)

Family-focused intervention for adolescents focusing on repairing relational ruptures with parents to reduce hopelessness and improve mood.

TADS (Treatment for Adolescents with Depression Study)

Large trial comparing CBT, fluoxetine, and combination; combination therapy most effective; raised discussions about suicidality and safety.

Suicide - Key Categories

Suicidal thoughts (ideation), intent (plans), gestures (parasuicidal acts), suicide attempts, and completed suicide.

Youth Suicide Prevalence (CDC 2010)

Significant percentages of high school students report serious suicidal thoughts, specific plans, or past-year attempts; gender differences in rates and methods exist.

Protective Factors Against Youth Suicide

Family cohesiveness, religiosity, and Reasons for Living (adaptive beliefs and coping strategies) reduce suicidality risk.

Suicide Contagion / Media Guidelines

Media reports can influence youth suicidality; guidelines discourage sensationalism and glamorization and recommend responsible reporting.

Bullying and Suicide Risk

Bullying victimization increases suicide risk; cross-national studies show bullying as a robust predictor, with ring-fenced concerns about cyberbullying.

Cross-Cultural Differences in Suicide Risk

Ethnicity, SES, discrimination, and cultural factors influence suicide risk; Native American youth show high rates, while other groups vary by context.

Ethnicity and Socioeconomic Status (SES)

Ethnicity and SES interact to affect depression and suicide risk; poverty and discrimination are significant stressors influencing outcomes.

Integration: ABC Model (Affect–Biology–Cognition)

An integrative developmental framework for adolescent depression: biology and affect interact with cognitive vulnerabilities, with gender-specific life stress shaping outcomes.

Rumination and Co-Rumination in Relation to Gender

Ruminative thinking linked to depression, especially in girls; co-rumination among friends amplifies internalizing problems in adolescence.

Preventive Programs (PSSM/RAP)

Universal or targeted efforts (e.g., Penn Resiliency Program, RAP) aimed at reducing depressive cognitions and improving problem-solving and social skills.

Guardrails for Clinicians (Black Box Warning)

FDA warning (2004) about antidepressants and suicidality in youths; prompted monitoring and emphasis on combined psychotherapy with pharmacotherapy.