Mood and Bipolar Disorders - Practice Flashcards

Learning Objectives

• Learners can describe different types of mood affective disorders including unipolar and bipolar depression and how it can be diagnosed and measured.
• Explain and evaluate the biological and psychological explanations of schizophrenia.
• Explain and evaluate the biological and psychological treatments of depression and bipolar disorders.

Diagnostic Criteria

• Content appears to be listed as a heading only in the transcript; no specific diagnostic criteria details are provided in the material.

Mood Disorders: Overview

• Mood (affective) disorders are characterized by episodes of particular types of mood over time.
• Schizophrenia is described as a severe form of psychosis where individuals alternate between:
  • Clear thinking and communication with an accurate view of reality, and proper functioning of daily life.
  • Active phase of illness: psychosis – loss of touch with reality.
• During the illness, disturbances can occur across many aspects of a person’s thoughts, feelings, experiences, and behaviour.

Mood Symptoms: Categories of Depression (Depressive Episode)

• Affective symptoms:
  • Depressed mood
  • Marked diminished interest or pleasure in activities
• Cognitive-behavioural symptoms:
  • Reduced ability to concentrate
  • Low self-worth or inappropriate guilt
  • Hopelessness
  • Recurrent thoughts of death
• Neurovegetative symptoms:
  • Disrupted sleep
  • Change in appetite
  • Psychomotor agitation or retardation
  • Reduced energy/fatigue

Mood Symptoms: Mania/Hypomania (Euphoria and Related Symptoms)

• Euphoria: a state of elation, pleasure, happiness
• Other symptoms:
  • Increased talkativeness
  • Flight of ideas/racing thoughts
  • Increased self-esteem or grandiosity
  • Decreased need for sleep
  • Distractibility
  • Impulsive or reckless behaviour
  • Increase in sexual drive, sociability, or goal-directed activity

Mixed Episode

• Several prominent manic and several prominent depressive symptoms occur simultaneously or alternate very rapidly.
• Could be dominated by manic or depressive symptoms

Depressive Disorders (Unipolar)

• Diagnosed with the presence of a single depressive episode.
• Depressive episodes can be single or recurrent.
• No history of manic, mixed, or hypomanic episodes

Bipolar Disorders: I and II

• Type I:
  • History of at least one manic or mixed episode
  • Manic episodes last one week or more and can lead to severe disruption in daily life; may include risky behaviours, impaired judgment, and legal issues.
  • Depressive episodes in Bipolar I are severe, lasting at least two weeks; involve profound sadness and loss of interest.
  • Diagnosis is based on the presence of at least one manic episode, regardless of depressive history.
• Type II:
  • History of at least one hypomanic episode and at least one depressive episode
  • Hypomanic episodes last at least four days and have milder symptoms; less likely to cause significant disruptions.
  • Depressive episodes are similar to Bipolar I but may be less severe.
  • Diagnosis requires at least one hypomanic episode and one major depressive episode.

Psychometric Testing and Interpretation

• Psychometric testing: a method of measuring personality traits, emotional states, or other experiences using sets of questions and numerical scales.
• Scoring interpretation:
  • 0-9: no depression
  • 10-18: mild depression
  • 19-29: moderate depression
  • 30+: severe depression

Explanations

• (Content outline indicates general explanations section; specific details provided in subsequent slides.)

Biological Explanations: Neurochemistry

• Dopamine: carries signals in parts of the brain responsible for feelings of motivation and pleasure.
• Serotonin: regulates sleep, appetite, mood, anxiety, etc.

Biological Explanations: Genetic Explanations

• Depression might be related to genetic inheritance or mutations occurring during cell division.
• Kendler et al. (2006) reported concordance rates:
  • 44% concordance between female monozygotic (MZ) twins with depression; 16% for female dizygotic (DZ) twins; 31% for male MZ twins; 11% for male DZ twins.
• Genes related to postsynaptic serotonin receptors (e.g., 5-HT2c) and presynaptic transporter molecules (5-HTT) might be linked to depression.
• See key study for more details.

Cognitive Explanations: Distortions and Schemas

• Cognitive distortion: negative thinking bias.
• Schemas: units of knowledge about the world that organize in the mind; underlie cognition (memory, reasoning, perception) and influence interpretation of situations.

Learning and Attribution in Depression

• Learned helplessness: a state that occurs when an individual endures an unpleasant situation they perceive as inescapable, leading to cessation of attempts.
• Attributional style: the cognitive process by which individuals explain causes of behaviours and events.

Seligman et al. (1988) Attributional Style Study (Bipolar Depression Context)

• Design: compared 12 bipolar patients (during depressive episode) with a non-clinical control group.
• Methods:
  • Participants completed a short version of the Beck Depression Inventory (BDI).
  • Completed an Attributional Style Questionnaire (ASQ) with 12 hypothetical good and bad events.
  • For each event, participants attributed causes on a seven-point scale for internality, stability, and globality.
• Findings:
  • Bipolar patients exhibited more pessimistic, negative attributional styles than the non-patient control group.
  • The more severe the depression score, the worse the pessimism on the Attributional Style Questionnaire.
  • Among those undergoing cognitive therapy, there was a positive correlation between attributional style and improvement in BDI scores.

References

• Kitching, H., Wood, M., Croft, K., Holmes, L., Bentley, and Swash, L. (2022). Cambridge International AS & A Level Psychology. Hodder Education.
• Russell, J., Lintern, F., Gauntlett, L., and Davies, J. (2022). Cambridge International AS and A Level Psychology Coursebook (2nd Ed.). Cambridge University Press.

Practical and Ethical Considerations

• Practical implications include recognizing manic episodes can lead to risky behaviours and legal issues, affecting daily functioning and safety.
• Diagnostic distinctions between unipolar and bipolar disorders guide treatment decisions and prognosis.
• Psychological explanations (cognitive distortions, attributional styles) underpin psychotherapeutic approaches such as cognitive therapy.
• Biological findings (dopamine/serotonin systems, genetic influences) influence pharmacological treatment strategies and personalized medicine considerations.

Connections to Broader Concepts

• Links to foundational cognitive theories: schemas and cognitive distortions underpin interpretation of events in mood disorders.
• The learned helplessness model connects mood disorders to attributional processes and perceived control.
• Neurochemical and genetic perspectives align with biopsychosocial explanations for mental illness.
• The relationship between symptom profiles (depressive vs manic vs mixed) informs diagnostic classification and treatment planning.

Summary of Key Takeaways

• Mood disorders involve distinct depressive and manic/hypomanic episodes with characteristic symptom clusters across affective, cognitive-behavioural, and neurovegetative domains.
• Bipolar disorders are differentiated by manic/hypomanic episodes and their durations, with Type I emphasizing full manic episodes and Type II emphasizing hypomania plus depressive episodes.
• Diagnostic and measurement tools include psychometric testing with established scoring ranges to gauge depression severity.
• Biological explanations focus on dopamine and serotonin systems and genetic influences, including specific genes linked to serotonin receptors and transporters.
• Cognitive explanations emphasize negative thinking patterns, schemas, learned helplessness, and attributional style, with empirical evidence linking attributional style to depressive severity and response to cognitive therapy.
• Ethical and practical implications include managing safety during manic episodes, addressing functional impairment, and applying psychological therapies in conjunction with pharmacology where appropriate.