Ch.5 (Mood Disorders) | Abnormal Psychology - Kring

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mood disorders

involve profound disturbances in emotion—from the deep sadness and disengagement of depression to the extreme elation and irritability of mania

William Styron

who said "a despairing, unchanging paralysis of the spirit beyond anything I had ever known or imagined could exist" to describe depression?

Psychomotor Retardation

slow thoughts and movements

Psychomotor Agitation

cannot sit still, they pace, fidget, and wring their hands

unipolar depressive disorders

involve only depressive symptoms

Major depressive disorder

Unipolar depressive disorder with five or more depressive symptoms, including sad mood or loss of pleasure, for 2 weeks

Persistent depressive disorder (PDD)

Unipolar depressive disorder with low mood and at least two other symptoms of depression at least half of the time for 2 years, and bipolar disorders are not present

dysthymia

PDD is similar to a DSM-IV-TR diagnosis of __

Premenstrual dysphoric disorder

Unipolar depressive disorder with mood symptoms in the week before menses

Disruptive mood dysregulation disorder

Unipolar depressive disorder with severe recurrent temper outbursts and persistent negative mood for atleast 1 year beginning before age 10

Winter Depression or Seasonal Affective Disorder

rates of this are higher as you are farther from the equator, where winter days are shorter

DOUBLE DEPRESSION

Alternating periods of major depression & dysthymia (MDD + PDD). Some affected by both at the same time.

MIXED ANXIETY/DEPRESSIVE DISORDER

Symptoms of both anxiety and depression are present

bipolar disorders

Severity and duration of mania defining feature

Bipolar I disorder

bipolar disorder with at least one lifetime manic episode. an episode of depression is not required for a diagnosis. Formerly known as manic-depressive disorder.

Bipolar II disorder

bipolar disorder with at least one lifetime hypomanic episode and one major depressive episode

Cyclothymia

bipolar disorder with recurrent mood changes from high to low for at least 2 years, without hypomanic or depressive episodes. milder, chronic form of bipolar disorder.

Episodic

Symptoms tend to dissipate over time

Recurrent

Once depression occurs, future episodes likely

20s

age of onset for depression

women

is depression more common in men or women?

Mania

State of intense elation, irritability, or activation

Flight of Ideas

may shift rapidly from topic to topic

Hypomania

Symptoms of mania but less intense; Does not involve significant impairment

manic episode

Distinctly elevated or irritable mood and abnormally increased activity and energy. Symptoms last for at least 1 week require hospitalization, or include psychosis. Symptoms cause significant distress or functional impairment

hypomanic episode

Distinctly elevated or irritable mood and abnormally increased activity and energy. Symptoms last at least 4 days. Clear changes in functioning that are observable to others, but impairment is not marked. No psychotic symptoms are present.

Chronicity of Symptoms

central feature of this diagnosis, which is a stronger predictor of poor outcome than the number of symptoms

Heritability

proportion of the variance in depression (within the population) that is explained by genes.

Gene x Environment Interaction

How a gene might increase risk in presence of environmental risk factor.

Serotonin transporter gene (5-HTT) polymorphism

Short allele combination of the 5-HTT gene and childhood maltreatment or adulthood stressful life events increasesrisk of MDD

Poor Serotonergic Function

associated with the presence of at least one short allele in this gene

CRH1

gene involved in guiding the reactivity of the cortisol system, which appears related to depression only among those with a history of child abuse.

reward system

believed to guide pleasure, motivation, and energy in the context of opportunities to obtain rewards

amygdala

engaged when people percieve salient and emotionally important stimuli

amygdala over-reactivity

elevated activity of the amygdala when processing emotion-relevant stimuli among people with MDD or those who have been exposed to recent stressful life events

Cortisol Dysregulation

causes bipolar depression and predicts a more severe course of illness for MDD.

Cortisol

stress hormone that increases activity of immune. system to help the body prepare for threats.

Cushing Syndrome

over-secretion of cortisol, frequently experience depressive symptoms.

Cortisol Awakening Response (CAR)

pattern wherein cortisol levels increase sharply as people wake and then in the 30-40 minutes after waking.

Expressed Emotion (EE)

a family member's critical or hostile comments toward or emotional over-involvement with the person with depression.

Dopamine

plays a major role in the reward system

Neuroticism

Tendency to experience frequent and intense negative affect. Predicts onset of anxiety, which is highly comorbid with depression

Nucleus Accumbens

a specific region in striatum

Cognitive Theories

Negative thoughts and beliefs cause depression. Beck's Theory, Hopelessness Theory, Rumination Theory

Negative triad

Negative view of self, world, future

Negative schema

Underlying tendency to see the world negatively

Information-Processing Biases / Cognitive biases

tendency to process information in negative ways

Dysfunctional Attitude Scales (DAS)

Self-report scale which includes items concerning whether people would consider themselves worthwhile or lovable.

Hopelessness Theory

Most important trigger of depression is hopelessness. Desirable outcomes will not occur. Person has no ability to change situation

Hopelessness

belief that desirable outcomes will not occur and that there is nothing a person can do to change this.

Attribution

explanations a person forms about why a stressor has occurred.

Attributional Style

Negative life events are due to stable and global causes.

Rumination Theory

tendency to repetitively dwell on sad experiences and thoughts, or to chew on material again and again. Most detrimental form is to brood regretfully overcauses of events

Susan Nolen-Hoeksema

Rumination theory is by __

Rumination-Induction Condition

participants are exposed to stress and then asked to dwell on their current feelings and on themselves.

Distraction (Control) Condition

participants are asked to think about topics unrelated to their self or feelings.

Reward Sensitivity

With BP, tend to describe themselves as highly responsive to rewards on self-report scales.

Sleep Deprivation

Protecting sleep can reduce symptoms of bipolar disorder.

Decentered Perspective

viewing thoughts merely as mental events rather than as core aspects of the self or as accurate reflections of reality.

Collaborative Care

three sessions of a control treatment which is a psychoeducation about bipolar disorder.

Interpersonal psychotherapy (IPT)

therapy that focus on major interpersonal problems (e.g., roletransitions). Identify feelings, make decisions, and resolve problems related to interpersonal issues

Cognitive therapy (CT)

therapy focused on altering maladaptive thought patterns, and monitoring and identifying automatic thoughts

Mindfulness-based cognitive therapy (MBCT)

therapy that makes use of strategies, including meditation, to detach from depression-related thoughts and prevent relapse

Behavioral activation (BA) therapy

therapy that makes use of increase participation in positively reinforcing activities to disrupt spiral of depression, withdrawal, and avoidance. also one component of cognitive therapy.

Behavioral couples therapy

therapy that enhances communication and relationship satisfaction

Psychoeducational approaches

Provide information about symptoms, course, triggers, and treatments

Cognitive Therapy (CT)

therapy that is similar to depression treatment with additional content to address early signs of mania

Family-focused treatment (FFT)

therapy used to educate family about disorder, enhance family communication, improve problem solving

Electroconvulsive therapy (ECT)

Reserved for treatment non-responders; Induce brain seizure and momentary unconsciousness; Side effects: Short-term confusion and memory loss

Transcranial Magnetic Stimulation for Depression(rTMS)

Electromagnetic coil placed against scalp. Pulses of magnetic energy increase activity in the brain. For those that fail to respond to first antidepressant

Mood-Stabilizing Medications

medications that reduce manic symptoms.

Lithium

naturally occurring chemical element that was the first mood stabilizer identified.

Lithium Toxicity

potentially serious side effect, so patients must have regular blood tests.

Anticonvulsants

antiseizure medications

Antipsychotics

medication that offers immediate calming effect.

Bilateral ECT

electrodes were placed on each side of the forehead.

Unilateral ECT

current passes only through the nondominant (typically the right) cerebral hemisphere.

STAR-D (Sequenced Treatment Alternatives to Relieve Depression)

Attempted to evaluate effectiveness ofantidepressants in real-world settings (comorbidpsychiatric conditions). Remission rates were low and relapse rates were high.

MAO Inhibitors (MAOIs)

least used antidepressants because of their potentially life-threatening side effects if combined with certain foods or beverages.

Selective Serotonin Reuptake Inhibitor (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitor (SNRI)

most commonly prescribed antidepressants because they tend to produce fewer side effects, but one of them have been associated with suicidality.

Suicide ideation

thoughts of killing oneself

Suicide attempt

behavior intended to kill oneself

Suicide

death from deliberate self-injury

Non-suicidal self-injury

behaviors intended to injure oneself without intent to cause death

Beck's Cognitive Approaches

lessens a patient's depression and suicidal risk

Marsha Linehan's Dialectical Behavior Therapy

therapy designed for treating borderline personality disorder.

Risperidone

an antipsychotic medication, reduces the risk of suicide attempts.