Depressive Disorders (final exam)

Child psy

What was the Historical Perspective based on children having depression?

Mistakenly believes start depression did not exist in children and it was like a phase. 

What do we know about children who experience depression

children do experiences recurrent depression

depression in children is not masked, but rather may be overlooked

Co-occurs with other more visible disorders (CD)

What is the depression developmental perspective based on children under age 7?

Symptoms may be diffused and less easily

What is anaclitic depression?

infants raised in a clean but emotionally cold environment (lack of love) who show depression like reactions, sometimes = death. 

What is the developmental depression perspective based on preschoolers?

May appear extremely somber & tearful; may display excessive clinging and whiny behavior around mothers (Harrison)

What is the developmental depression perspective based on school-age children? 

Increasing irritability, disruptive behavior & tantrums 

What is the developmental depression perspective based on preteens? 

Plus self-blame, low self-esteem, persistent sadness and social inhibition 

What is depression as a (symptom)?

feeling sad or miserable

What is depression as a (syndrome) ?

a group of symptoms that occur together more often than by chance.

What is depression as a (disorder)?

MDD & Persistent Depressive Disorder

What is Major depressive disorder (MDD)?

lasts for at least two weeks with several specific symptoms and significant impairment in functioning

What is Persistent Depressive Disorder?

(dysthymia) depressed mood is generally less severe but

with longer-lasting symptoms (a year or more) and significant impairment in

functioning

How do we assess for depression?

• Clinical interviews

• Rating scales

• Structured clinical interview

• Addition Testing for Rule-Outs (not ADHD?)

What is the Prevalence of MDD?

• 2-7% of children aged 4-18 experience MDD

• Depression is rare among preschool & school-age children (1-2%)

• Prevalence increases two-to threefold by adolescence

• Sharp increase in adolescence may results form biological maturate at puberty 

What is Onset, Course & Outcomes of MDD?

• Onset may be gradual or sudden

• Age of onset usually between 13 and 15 years

• Average episode lasts eight months

  • Longer duration if a parent has a history of depression

• Most children eventually recover from initial episode, but the disorder does not go away

• Chance of recurrence is 25% within one year, 40% within two years, and 70% within five years

• About one-third develop bipolar disorder within five years after onset of depression

(bipolar switch)

What is the Prevalence of P-DD

Rates of P-DD are lower than those of MDD

Most common comorbid disorder is MDD

what is the Onset, Course & Outcomes of P-DD?

Childhood-onset dysthymia has a prolonged duration, generally 2-5 years

Most recover, but are at high risk for developing other disorders: MDD anxiety disorders & CD

What are the comorbidtiesof depression?

90% has depression or another disorder

the most common on is anxiety disorders (GAD), specific phobias & operation anxiety disorders 

Are there gender differences with depression?

NOPE!!! but adolescence (females) are 2-3 times to suffer from depression

Are there any ethnic and cultural differences when it comes to a child having depression?

Non-white (African, American, Hispanic, & Asian) adolescents reported more symptoms of depression that White adolescents. Keep in mind that it may be bc of structural factors: SES, racism , marginalization. 

What is the intellectual and academic functioning?

• difficulty concentrating, loss of interest & slowness of though & movement 

• interference with academic performance, but not necessarily related to intellectual deficits 

What are the social problems children with depression experience?

Social & peer problems along with family problems 

• peers: few close friendships & feeling soft loneliness & isolation

• Family : less supportive & more conflicted relationships with parents and siblings

What is the connection between depression & suicide?

Most youth with depression think about suicide. 1/3 who think about it do it!.

What are the interacting causes of depression

multiple pathways to depression are likely

• genetic risk influences neurobiological processes 

• early temperament 

• negative emotionality 

What are the genetic & family risk of depression?

Children of parents with depression have about 3 times the risk of having depression. What is inherited is likely a vulnerability to depression & anxiety. 

what are neurobiological risk factors for depression?

• Abnormalities in the structure & function of several brain regions & regulate emotional functions

• Abnormalities in amygdala, cingulate, prefrontal cortex, hippocampus 

What are family risk factors?

Families display more critical & punitive behaviors towards the depressed child than toward other children. 

When parents are depression it interferes with the parents’ ability to meet the needs of the child. 

What are some life event triggers?

interpersonal stress & actual or perceived personal losses, life changes, violent family environment, daily hassles & other non-severe stressful life events 

what are the behavioral theory?

depression is rated to a lack of response-contingent positive reinforcement.

What is the cognitive theory?

Empathize depressiogenic conditions

Hopelessness theory: info processing biases, or errors in their thinking in specific situations called negative automatic

A negative view of the world, self and future!!! (COGNITIVE TRIAD!)

What are some cognitive biases & distortion?

• selective attentional biases 

• feelings of worthlessness, negative beliefs

• depressive outlook

• negative thinking across situation, hopelessness & suicidal ideation

What are some preventions for Depression?

CBT & interpersonal psychotherapy more effective at lowering the risk & preventing recurrence.

school based initiatives may identity those at risk. 

online & computer based interactive progman’s for use in primary care 

What are the treatments that are most effective for children with depression?

Cognitive behavioral therapy (CBT) & Interpersonal psychotherapy for adolescent depression (IPT-A).

• Some psychopharmacological treatments may also be used but have been found less effective. 

What are some psychological interventions?

behavior therapy, cognitive therapy, CBT, and Interpersonal psychotherapy for adolescent-depression (IPT-A)

How do depressed youth respond to placebo medications?

there is 60% that they are getting medication that it is working