Chapter 7 - Mood disorders and su!c!de

Mood disorders are ____ deviations in mood

Gross

An individual with a depression or mania related disorder may experience ____ to ____ of depressed or elevated mood

Days…weeks

Episodes of depressed or elevated mood, experienced by someone with depression or mania may include: major _____ episodes, ____ depression, and ____ and ____ episodes

Depressive…persistent…manic…hypomanic

What is the essential feature of a major depressive episode?

Extremely depressed mood and/or loss of pleasure (anhedonia)

How often does someone with a major depressive disorder experience episodes of extremely depressed mood/loss of pleasure?

Most of the day, nearly every day, for at least two weeks

How many additional symptoms must a patient have in order to be diagnosed with a major depressive episode?

At least four

Some symptoms of major depressive episode include: i____, feelings of w____, f____, change in a____, r____ or feeling s____ down, sleep d____

Indecisiveness…worthlessness…fatigue…appetite…restlessness…slowed…disturbance

What is the essential feature of a manic episode?

Elevated, expansive mood for at least one week

During a manic episode one might experience a ____ need for sleep

Decreased

Someone experiencing a manic episode may have ____ self-esteem

Inflated

True or false: Excessive talkativeness is a symptom of a manic episode

True

True or false: Someone experiencing a manic episode will not have flight of ideas or a sense that thoughts are racing

False

Someone with a manic episode may experience easy d____

Distractibility

during a manic episode, one may experience an increase in ____-____ activity or psychomotor ____

Goal-directed…agitation

True or false: Someone experiencing a manic episode may exhibit excessive involvement in pleasurable but risky behaviors

True

Hypomanic episodes are ____, ____ severe version of manic episodes

Shorter…less

True or false: Mixed features include symptoms from both valances

True

With major depressive disorder, there is/are ____ or more major ____ episode(s) separated by periods of ____

One…depressive…remission

True or false: In cases of major depressive disorder, single episodes are more common than recurrent episodes

False

Specifiers of major depressive disorder include ____ onset and ____ pattern

Peripartum…seasonal

What is peripartum onset?

The occurrence of a mental health condition, such as depression or psychosis, in the period around childbirth

With persistent depressive disorder, depressive symptoms last for at least how long?

Two years

For individuals suffering from persistent depressive disorder, they experience depressed mood most of the day on more than what percentage of days?

50%

Someone with persistent depressive disorder will not experience more than (at most) ____ months symptom free

Two

What is double depression?

Episode of major depression concurrent with PDD

Epidemiology of depressive disorders: Risk follows a ____-____ pattern

U-shaped

Epidemiology of depressive disorders: Depressive disorders vary in ____

Length

Epidemiology of depressive disorders: If untreated, what is the typical amount of time a depressive episode may last for someone with a depressive disorder?

Several months

True or false: For someone with a depressive disorder, a depressive episode can last several years

True

What sub type of depressive disorder is described by the following: Significant depressive symptoms occurring prior to menses during the majority of cycles

Premenstrual dysphoric disorder

What sub type of depressive disorder is described in the following: Frequent severe temper outburst, coupled with angry or irritable mood

Disruptive mood dysregulation disorder

What is the age range someone must be to be diagnosed with disruptive mood dysregulation disorder?

6-18

Bipolar I disorder is characterized by ____ manic and major ____ episodes

Full…depressive

Bipolar II disorder is characterized by ____ and ____ depressive episodes

Hypomanic…major

What type of bipolar disorder is described in the following: Less severe depressive and less severe hypomanic periods

Cyclothymic disorder

In the context of bipolar disorder, a minimum of how many episodes does the patient experience in a year?

Four or more

In the context of bipolar disorder, ultra-rapid cycling involves ____ mood shifts

Monthly

In the context of bipolar disorder, ultradian or ultra-ultra-rapid cycling is when mood shifts occur within a ____-____ period

24-hour

What is the percentage of worldwide lifetime prevalence for major depression?

16%

What percentage of people have experienced major depression within the last year?

6%

Females are ____x more likely than males to have major depressive disorder

2

True or false: Bipolar disorders are equal for males and females

True

There is less imbalance of sex differences among the prevalence of mood disorders after what age?

65

What other mental health condition are children often misdiagnosed with instead of major depressive disorder?

ADHD

True or false: Severe mood disorders do not have a strong genetic contribution

False

In the context of major depressive disorders, concordance rates are ____ in identical twins

High

In the context of psychology, what is ‘concordance rate’ referring to?

A statistical measure of the portion of pairs of individuals who share a specific trait, given that one member already has it

Heritability rates are ____ for females compared to males

Higher

In the context of psychology, what is ‘heritability rate’ referring to?

The proportion of variation in a population trait that is due to genetic differences among individuals in that population

True or false: Heritability is the proportion of the trait itself that is genetic

False

Unipolar or bipolar disorder appear to be inherited ____

Separately

Mood disorders are related to low levels of ____

Serotonin

Permissive hypothesis: Serotonin “permits” other neurotransmitters to vary more ____, which ____ vulnerability to depression

Widely…Increased

Some of the neurotransmitters which serotonin “permits” to vary are n____ and d____

Norepinephrine…dopamine

Neurobiological influences of mood disorders are associated with ____ cortisol and ____ disturbance

Elevated…sleep

Stress is strongly related to mood disorders as mood disorder, patients who are experiencing stress tend to have ____ response to treatment and ____ time before remission

Poorer…longer

Some psychological dimensions relating to stress for mood disorders include: g____-e____ correlation and learned h____ theory

Gene-environment…helplessness

Which type of gene-environment correlation is described by the following: Parents provide both genes and environment

Passive

Which type of gene-environment correlation is described by the following: A person’s genetically influenced traits elicit a response from others

Evocative

Which type of gene-environment correlation is described by the following: An individual six out environments that match their genetic predispositions (aka “niche picking”)

Active

What is gene-environment correlation?

The process where a person‘s genetic makeup influences the environments they are exposed to and create

What are the three main types of gene-environment correlation?

Passive, evocative, and active

What is learned helplessness theory?

A psychological theory describing a state where an individual stops trying to escape or change a negative situation after repeatedly experiencing uncontrollable events

What is an attributional style of depression?

A pattern of thought where individuals attribute negative events to a certain type of cause

What are the three types of attributional style of depression?

Internal, stable, and global causes

Which depressive attributional style is described in the following: Blaming oneself for the negative event (“it’s my fault”)

Internal

Which depressive attributional style is described in the following: Believing the negative situation is long-lasting (“it’s always going to be like this”)

Stable

Which depressive attributional style is described in the following: Thinking the negative event affects all areas of life (“I’m a failure at everything”)

Global

What is the depressive cognitive triad?

A psychological model that describes three interconnected negative beliefs that individuals with depression often hold

Which category of the depressive cognitive triad is described in the following: Feeling worthless, inadequate, or unlovable; believing that one is incapable of achieving goals or making positive changes

Negative view of self

Which category of the depressive cognitive triad is described in the following: Perceive the world as hostile, unfair, or dangerous; expect negative events to occur and see others as uncaring or untrustworthy

Negative view of the world

Which category of the depressive cognitive triad is described in the following: Feeling hopeless and believing that things will never improve; expecting continued suffering and setbacks

Negative view of the future

Some of the negative coping styles exhibited by a person with a depressive or mood related disorder include: Depressed persons engage in ____ ____ ; a tendency to ____ life events ____

Cognitive errors…interpret…negatively

Social support and depression: Lack of support predicts ____ ____

Late onset

Social support and depression: Substantial social support predicts ____

Recovery

Marital ____ is strongly related to depression; and is particularly strong in ____

Males

Classes of antidepressants include: ____s, t____ antidepressants, m___ o____ inhibitors, mixed r____ inhibitors

SSRIs…tricyclic…monoamine oxidase…reuptake

What does SSRI stand for?

Selective serotonin reuptake inhibitors

What does SNRI stand for?

Serotonin-norepinephrine reuptake inhibitors

SNRIs work by ____ the levels of mood-improving chemicals ____ and ____ in the brain

Increasing…serotonin…noradrenaline

Mixed reuptake inhibitors ____ the ____ (reuptake) of multiple ____ such as ____ and ____ in the brain

Block…reabsorption…neurotransmitters…serotonin…norepinephrine

By inhibiting reuptake, mixed reuptake inhibitors ____ the availability of ____ in the brain, which is believed to improve m____, e____, and f____

Increased…neurotransmitters…mood…energy…focus

SSRIs work by ____ levels of the neurotransmitter ____ in the brain

Increasing…serotonin

SSRIs block the reuptake of serotonin from the ____

Synapse

Tricyclic antidepressants work by preventing the brain from ____ serotonin and norepinephrine, which ____ the levels of these neurotransmitters in the brain and can help ____ depression symptoms

Reabsorbing…increases…alleviate

Monoamine oxidase inhibitors work by inhibiting the ____ monoamine oxidase, which ____ ____ neurotransmitters such as s____, n____, and d____

Enzyme…breaks down…serotonin…norepinephrine…dopamine

True or false: The different classes of antidepressants are approximately equally effective

True

About ____% of patients benefit from taking antidepressant medication

50%

Of the patients who benefit from taking antidepressant medication, what percent achieve normal functioning?

25%

What medication is the treatment of choice for bipolar disorder?

Lithium carbonate

Lithium carbonate is considered a ____ stabilizer because it treats both ____

Mood…valences

True or false: Lithium carbonate is toxic in large amounts

True

Lithium carbonate is effective for what percentage of patients?

50%

if lithium carbonate is not effective for a patient with bipolar disorder, anti____ and ____ ____ blockers may be used for treatment instead

Convulsants…calcium channel

Other, non-medication treatments for bipolar disorder include: ____ therapy and ____ magnetic stimulation

Electroconvulsive…transcranial

What non-medication treatment is effective for severe medication-resistant depression?

Electroconvulsive therapy

Electroconvulsive therapy has been known to induce temporary ____

Seizures

Some side effects of electroconvulsive therapy are h____ and m____ l____

Headaches…memory loss

In transcranial magnetic stimulation, magnets generate precise ____ ____

Electromagnetic pulse

Transcranial magnetic stimulation has ____ side effects but is ____ effective than electroconvulsive therapy

Fewer…less