Abnormal & Clinical Psychology - Mood Disorders Review (lecture 4)

This set of flashcards covers key concepts from the lecture on mood disorders, assessment techniques, and classification in abnormal and clinical psychology.

What is the focus of the mental status exam?

focuses on several critical areas to assess a person's current psychological functioning. These areas include:

• Appearance and Behavior: Observations of the individual's physical appearance, grooming, and level of activity, which can indicate their emotional state or engagement with the environment.

• Thoughts: Evaluation of thought processes, content, and patterns, including any signs of disorganization, delusions, or suicidal ideation.

• Mood and Affect: Assessment of the individual's emotional state (mood) and outward expression of feelings (affect), noting any discrepancies between the two.

• Intellectual Functioning: Consideration of the individual’s cognitive abilities, such as memory, attention, and reasoning skills, typically assessed through specific questions or tasks.

• Sensorium/Orientation: Determination of the person's awareness of surroundings, including orientation to time, place, and person, which can reveal levels of alertness and any potential cognitive impairment.

• Insight: Understanding of one’s condition and the ability to recognize the need for help or treatment, reflecting the individual’s awareness of their mental health.

• Judgment: Evaluation of decision-making skills and the ability to assess situations and make reasonable choices, important for determining safety and risk factors.

Personality inventories

self-report questionnaires that assess personal traits by asking respondents to identify descriptions that apply to themselves.

What is a key characteristic of major depressive episodes?

Periods of depressed mood or loss of interest lasting most of the day, nearly every day.

What does DSM 5 TR specify for diagnosing major depressive disorder?

Five or more symptoms present during a two-week period, with at least one symptom being depressed mood or loss of interest.

What is the MMPI 2 RF?

A personality and psychopathology assessment tool used for mental health, medical, forensic, and public safety settings, containing 338 true/false items.

What is the purpose of validity scales in the MMPI?

To identify inconsistent or random responding in the test answers.

• 51 scales

  • 9 validity

  • 3 higher order

  • 9 restructural clinical

  • 23 specific problem

  • 2 interest

  • 5 personality psychopathology

• inconsistency: 53 pairs of items, random responding

  • have similar content so the responses should be consistent

• underreporting: 14 items, denying common, minor flaws, dishonest?

What are the ABCs in behavioral assessment?

Antecedents, Behaviors, and Consequences that help identify problematic behaviors.

Behavioral observation and behavioral assessment

• can be formal or informal

• self-monitoring vs being observed by others

• problem of reactivity using direct observation

• focus on the present

• direct observation of behavior - environments relations

  • reactivity

• purpose is to identify problematic behaviors and situations

• ABCs

Neuroimaging Assessment

• pictures of the brain

• 2 objectives

  • understand brain structure and function

• techniques designed to provide information about brain functioning can offer valuable information to the diagnostic process

• some of these assess behavioral abilities to infer neurological integrity, while others involve imaging of the physical brain and its metabolic functioning

• procedures:

  • magnetic resonance imaging (MRI)

  • electroencephalography (EEG)

  • positron emission (PET)

  • allows researchers to examine noninvasively how structural and/or functional brain abnormalities contribute to relapse and other important clinical outcomes

Functional MRI

Detects changes in the local magnetic field that occur as a result of changes in the ratio of oxygenated to deoxygenated hemoglobin in arterial blood vessels in specific brain regions during a cognitive task.

The rationale for interpreting these changes as cellular activity is that cells in the brain, like those elsewhere in the body, use oxygen as fuel. (BOLD Blood-Oxygen-Level Dependent).

As cells increase in activity, they increase their demand for oxygen, and the arterial blood vessels respond by delivering more oxygenated hemoglobin to the region.

• Researchers can compare multiple images of a single individual:

  • At rest and then performing a task, or before and after exposure to a drug.

  • Or map which brain regions he or she activates to perform mental tasks or in response to experiences or chemical exposures.

• Or they can compare different individuals:

  • From different groups—for example, drug-addicted and nonaddicted.

  • This can reveal differences in brain regions the two groups use to perform identical tasks or respond to stimuli or exposures.

What is the difference between categorical and dimensional approaches to classification of disorders?

Categorical approach uses strict categories while dimensional approach recognizes varying degrees of symptoms.

Drawbacks:

• labeling

  • contributes to stigma.

  • Stigma contributes to discrimination in housing, employment, relationships, treatment, etc.

• imperfect diagnostic categories

  • The same label may be applied to similar behaviors that have varying causes.

Benefits:

• Provides information about the cause(s) of a condition.

• Provides common language.

• Realistic prognoses, founded in research.

• Indicates treatment options.

• Provides outlines for possible prevention programs

Mood Disorders

• Gross deviations in mood

• Composed of different types of mood “episodes”: periods of depressed or elevated mood lasting days or weeks, including:

  • Examples:

    • Major depressive episodes

    • Persistent depression

    • Manic and hypomanic episodes DSM-5 tr

    • Bipolar and Related Disorders

    • Depressive Disorders

Major Depressive Disorder (MDD)

This is characterized by a persistent feeling of sadness or a lack of interest in external activities. Symptoms must last for at least two weeks and can include significant weight change, insomnia or hypersomnia, fatigue, feelings of worthlessness, and recurrent thoughts of death or suicide.

• what does this look like?

  • anhedonia

  • obsessive sense of guilt and grief

  • psychomotor retardation

  • early morning wakening

  • loss of appetite (MDE severe)

  • lack of motivation

  • stress hormone

  • poor concentration

  • suicidal ideation/attempts

• severity:

  • mild: the intensity of the symptoms is distressing but manageable, and the symptoms result in minor impairment in social or occupational functioning.

  • moderate: The number of symptoms, intensity of symptoms, and/or functional impairment are between those specified for “mild” and “severe.”

  • severe: The number of symptoms is substantially in excess of that required to make the diagnosis, the intensity of the symptoms is seriously distressing and unmanageable, and the symptoms markedly interfere with social and occupational functioning.

Major Depressive Disorder Clinical Description

• One or more major depressive episodes, absence of manic episode, separated by periods of remission

• Single episode—highly unusual

• Recurrent episodes—more common

• From 35-85%of people with single episodes experience another episode.

• First year following- 20%

• Second year-40% • Median number of episodes 4-7

• Duration 4-5 months

• Waxes and wanes

MDD with psychotic features

subtype of MDD, Usually are delusions and/or hallucinations that are consistent with the depressive themes of feelings of worthlessness and/or guilt.

Persistent Depressive Disorder (Dysthymia)

A chronic form of depression where a person experiences a depressed mood for most of the day, for more days than not, for at least two years. The symptoms tend to be less severe than MDD, but they can still interfere with daily functioning.

Disruptive Mood Dysregulation Disorder (DMDD)

Primarily diagnosed in children and adolescents, DMDD is marked by severe temper outbursts that are out of proportion to the situation and a consistently irritable or angry mood. This diagnosis aims to address the increasing rates of childhood bipolar disorder diagnoses.

Substance/Medication-Induced Depressive Disorder

This type results from the direct effects of a substance, such as drugs or alcohol, or as a withdrawal symptom from medications. It is critical to distinguish this disorder from other depressive disorders to provide appropriate treatment that addresses the underlying substance use.

Premenstrual Dysphoric Disorder (PMDD)

A severe form of premenstrual syndrome (PMS) that can significantly impair social and occupational functioning. Symptoms occur during the luteal phase of the menstrual cycle and include mood swings, irritability, depression, and physical symptoms like bloating and breast tenderness.