Psychopathology Unit 2

anhedonia

loss of interest of pleasure in usual activity

sad mood and anhedonia

the two symptoms that must be present to be diagnosed of major depressive disorders

persistence

when symptoms occur most of the day, nearly every day, for 2+ weeks

impairment

when symptoms are causing significant imapct or distress

peripartum onset

when a diagnosis occurs within 4 weeks of a childbirth

persistent depressive disorder

formerly called dysthymia - chronic condition - depressed mood more days than not for at least 2 years + 2 or more other symptoms - does not qualify if have a break in symptoms for 2 months or more

major depressive disorder

5+ depressive symptoms, including sadness and/or anhedonia + persistence and impairment - at least 2 weeks

early 30’s but decreasing

average onset age of depression

about 50

the percent of people that recover within 6 months

10

the percent of disability that depression accounts for worldwide

16-20

the percent of the population that experiences major depression

2x more likely

how likely women are to be diagnosed with depression compared to men

stressful life event

a social predictor of depressive disorders

42 - 67

the percent of people that report a stressful life event in year prior to depression

cognitive theories of depression

the way we think, perceive, and remember events influences how we feel and act

automatic negative thoughts

the thing associated with depression that fits into the cognitive theories of depression

attributions theory

the idea regarding the way we explain causes of events

internal, stable, global

the positive of the attribution style

external, unstable, specific

the negative of the attribution style

50%

the heritability of depression

low levels of seretonin

one of the leading theories for the cause of depression

seretonin, dopamine, norepinephrine, GABA

the neurotransmitters that are likely involved in depression

dorsolateral prefrontal cortex

the part of the brain that is responsible for planning and executive functioning and has decreased activity in those with depression

ventromedial prefrontal cortex

the part of the brain involved in regulating emotion that is increased in those with depression

anterior cingulate cortex

the part of the brain involved in motivation and emotional regulation and has decreased activity in those with depression

amygdala

the part of the brain responsible for emotional salience that has increased activity in response to threats or negative stimuli

CBT

the treatment for depression that targets psychological causes - identifies thoughts, feelings, and cognitive distortions - all or nothing thinking, disqualifying the positive, catastrophizing, shoulds - also helps with anxiety,

behavioral activation

the part of CBT that focuses on increased activity with reinforcing events

mindfulness based cognitive therapy

the treatment for depression that recognizes when someone starts to feel sad and adopts the perspective that those thoughts are mental events not facts - observe thoughts and feeling - useful in reducing relapse of depression

interpersonal psychotherapy

treatment for depression that focuses on improving relationships - the theory is that problematic relationships lead to lower mood

selective seretonin reputake inhibitors

medication that blocks reuptake of serotonin - side effects are fairly common but it is pretty effective - takes 4-6 weeks - not effective for up to 1/3 of people - helpful for depression, anxiety, OCD, PTSD

electroconvulsive therapy

treatment for depression that involves brief seizures to treat mental health issues

transcranial magnetic stimulation

treatment for depression that involves applying a magnetic pulse to the brain - 30-40% remission rate - dorsolateral prefrontal cortex

ketamine

treatment for depression that is an anesthetic used in surgeries and has hallucinogen effects - the theory is that it acts to suppress neurotransmitter activities and alters brain activation patterns and connectivity - seems to require much higher doses

manic episode

defined by a distinctly elevated or irritable mood - abnormally increased activity or energy and at least 3 other symptoms - lasts at least a week most of the day nearly every day or requires hospitalization

hypomanic episode

defined by a distinctly elevated or irritable mood - abnormally increased activity or energy and at least 3 other symptoms - last at least 4 days, clear changed in functioning but impairment isn’t as significant

bipolar 1

type of bipolar that has at least one manic episode - includes depressive episodes

bipolar 2

type of bipolar that includes hypomanic episodes but not full mani episodes - includes depressive episodes

18 - 22

average age of onset for bipolar

3x

the amount of days depressed vs. manic/hypomanic

15%, 25%, 50%

people with bipolar who die by suicide, reported suicide attempts, reported suicidal ideation in the past 12 months

70 - 90

the percent heritability of bipolar

prefrontal, limbic structures

the places in the brain that show reduced volume when someone has bipolar

amygdala and striatum

places in the brain that shows increased activation in someone with bipolar

mania

hypersensitivity to dopamine receptors

reward sensitivity

how excited a person is to obtain a reward - increase response to reward cues or pursuing rewards in those with Bipolar disorder and those at risk - predicts onset of disorder and more severe symptoms over time

goal striving

setting, pursuing, and committing to goals - predicts future mania symptoms and onset of bipolar

lithium

a common mineral - mood stabilizer, side effects may be severe, 1/3 show dramatic response and another 1/3 only show some response - protective effect against suicide

social rhythms therapy

talk therapy that focuses on developing daily rhythms, sleep and daily routines, identifying patterns and predictors of mood episodes

life charting

the identification of personal patterns and triggers

goal regulation

a talk therapy focused on not doing away with high goals - focus on breaking down goals into smaller steps - checking in with others on goal pacing

10x increase

the difference in rate of bipolar disorder among artists compared to the general population

fear

present focused response to immediate danger or threat - intensity builds quickly

anxiety

future focused anticipation and preparation - general diffuse emotional reaction

Yerkes-Dodson Law

the inverted u model that presents the theory that there is an optimal level of anxiety - axes are arousal vs. performance

atypical behavior

pervasive and persistent symptoms of anxiety and fear - involves excessive avoidance - causes significant distress and impairment

anxiety disorders

an disorder that is among the most common mental disorders

social anxiety disorder

fear or anxiety specific to social settings, in which a person feels noticed, observed, or scrutinized - fear that others will notice their anxiety and experience social rejection, social interaction consistently results in distress - social interaction is avoided or endured with intense anxiety and distress - disproportionate

worry

negative emotional thoughts - uncontrollable - concerned with possible future threats or dangers

generalized anxiety disorder

when worry becomes frequent, about a range of topics, or impairing - excessive worry at least 50% of the day about a number of events - trouble controlling those worries

panic attack

a sudden onset of intense apprehension, terror, and/or feelings of impending doom that peaks quickly (about 10 minutes)

depersonalization

feels like outside body

derealization

feel like world isn’t real

panic disorder

recurrent, unexpected panic attacks - persistent worry about having more attacks or the consequences of attacks - significant change in behavior related to attacks

agoraphobia

fear of anxiety or being in situations where is is difficult to escape or receive help - situations are avoided or endured with intense fear/anxiety

specific phobia

intense fear of an object or situation that is excessive or unreasonable - exposure to phobic stimulus means an immediate fear response - persists for 6 months or more - interferes with daily routines

common phobias

blood-injury-injection, situational, natural environment, animal

more common in women

the gender difference for all anxiety disorders - slightly different for each category

30-50%

heritability rate for anxiety disorders

limbic system

the key system in anxiety disorders

amygdala and insula

places in the brain with heightened activity in those with anxiety disorders

prefrontal cortex

the place in the brain that lowers its activity in response to a threatening stimuli

sympathetic nervous system

the nervous system involved in anxiety disorder

attention to threat

the tendency to notice negative environmental cues - selective attention to signs of threat

sustained negative beliefs about the future

psychological factor of anxiety that bad things are likely to happen

exposure therapy

treatment for anxiety focusing on role playing - effective for about 70-90 percent of clients who do it

benzodiazepines

sedative that works quickly, but its addictive and only short term solutions - helps with PTSD (prescribed but no research thats how resulrs), OCD, anxiety

beta blockers

short term medication solution to specific phobias

attention bias modification training

a type of therapy designed to retrain automatic attention patterns toward or away from specific emotional or threatening stimuli

mindfulness based cognitive therapy

treatment for anxiety that focuses on the present moment - stops the person’s mind from wandering to “what ifs” - relaxation strategies

interoceptive exposure

creating a physical sensation of a panic attack - wait for distress to reduce

obsessions

recurrent, persistent, and unwanted thoughts, impulses or images - experienced as intrusive, inappropriate and often nonsensical - not just excessive worries about real life problems

fear of harm to self or others, contamination, sexual, morality

common obsession themes

compulsions

repetitive behaviors or mental acts performed in response to an obsession or according to rules that must be applied rigidly - acts are aimed at reducing anxiety or distress or preventing obsessive thought, but they are excessive or aren’t realistically connected

19.5 years

average age of onset for OCD

.57, .22

concordance for MZ twins, concordance for DZ twins (OCD)

CBT

most effective therapy for OCD with a heavy emphasis on the behavioral element

exposure and response prevention

treatment for OCD that involves setting up situations that will trigger compulsions

0.4 - 0.5

heritability range for OCD

frontal striatal circuitry

place in the brain that is overactive when shown stimuli the provoke obsessions

post traumatic stress disorder

the only disorder to give a cause to the symptoms - the cause is exposure to trauma - has 4 categories of symptom domains

trauma

exposure to actual or threatened death, serious injury, or sexual violence - happens to person (direct experience) - witnessing in person or occur to others - learning event occurred to close family or friend

vicarious trauma

repeated exposures to aversive details

intrusive memories

unwanted memories or traumatic events, flashbacks, or nightmares - reoccurring - intense distress or physiological reactivity in response to reminders of trauma

avoidance symptoms

avoids reminders of the trauma - internal memories, thoughts or feelings - external people, places or activities

negative changes in mood and thoughts

difficulty remembering important aspects of the trauma - persistent negative beliefs - persistent blame of self or others about the trauma - feel disconnected from others - anhedonia

changes in physical and emotional reactions

hyper vigilance - exaggerated startle response - irritable - reckless or self destructive behavior - trouble concentrating - sleep disturbance

acute stress disorder

similar to PTSD but the symptoms only last 3 say to one month - could be pathologizing a short term response

7%

prevalence of PTSD

hippocampus

place in the brain that is smaller in size and has diminished activation in those with PTSD