Abnormal Psych Ch. 6

Front 1

The fundamental experiences of what contribute, either singly or together, to all the mood disorders?

Back 1

Depression and Mania

Front 2

What is the most commonly diagnosed and most severe depression?

Back 2

Major Depressive Episode

Front 3

Major Depressive Episode

Back 3

An extremely depressed mood state that lasts at least 2 weeks and includes cognitive symptoms and disturbed physical functions to the point that even the slightest activity or movement requires an overwhelming effort. Accompanied by a general loss of interest in things and an inability to experience any pleasure from life.

Cognitive Symptoms- feelings of worthlessness, indecisiveness, etc.

Disturbed Physical Functions- altered sleeping patterns, changes in appetite and weight, loss of energy

Front 4

What are the most central indicators of a full major depressive episode?

Back 4

Physical Changes (somatic or vegetative symptoms)

Front 5

Anhedonia

Back 5

loss of energy and inability to engage in pleasurable activities

Front 6

Mania

Back 6

Individuals in mania find extreme pleasure in every activity. They become hyperactive, require little sleep, and may develop grandiose plans with the belief that they can accomplish anything they desire.

Front 7

Flight of Ideas

Back 7

When in mania, speech is typically rapid and may become incoherent because the individual is attempting to express so many exciting ideas at once

Front 8

Hypomanic Episode

Back 8

A less severe version of a manic episode that does not cause marked impairment in social or occupational functioning and need only last 4 days rather than a full week.

Front 9

Hypo-

Back 9

Below

Front 10

Unipolar Mood Disorder

Back 10

When mood remains at one "pole" of the usual depression-mania continuum

Front 11

Why is Unipolar Mania rare?

Back 11

Because most people with a unipolar mood disorder go on to develop depression eventually

Front 12

Bipolar Mood Disorder

Back 12

When one alternates between depression and mania

Front 13

Dysphoric Manic Episode or Mixed Manic Episode

Back 13

When one experiences manic symptoms, but feels depressed or anxious at the same time. The patient usually experiences the symptoms of mania as being out of control or dangerous and becomes anxious or depressed about this uncontrollability.

Front 14

Major Depressive Disorder, Single Episode

Back 14

When there is an absence of manic or hypomanic episodes before or during the disorder. Relatively Rare.

Front 15

Major Depressive Disorder, Recurrent

Back 15

When two or more major depressive episodes occurred and were separated by at least 2 months during which the individual was not depressed.

Front 16

Dysthymic Disorder

Back 16

Mood disorder involving persistently depressed mood, with low self-esteem, withdrawal, pessimism, or despair, present for at least 2 years, with no absence of symptoms for more than 2 months. Symptoms are less severe and less in quantity from a major depressive episode, but last longer.

Front 17

Double Depression

Back 17

Sever mood disorder typified by major depressive episodes superimposed over a background of dysthymic disorder.

Front 18

Typical Duration of the First Episode of Depression

Back 18

4-9 months if untreated

Front 19

Onset of Dysthymic Disorder before 21 Years of Age is associated with what characteristics?

Back 19

1. Lasts Longer
2. Poor response to treatment
3. Stronger likelihood of the disorder running in the family of the affected individual
4. More likely to have concurrent personality disorder

Front 20

Median Duration of Dysthymic Disorder

Back 20

5 years in adults / 4 years in children

Front 21

When is a depressive episode after the death of a loved one considered a disorder?

Back 21

When severe symptoms appear, such as psychotic features or suicidal ideation, or the less alarming symptoms last longer than 6 months.

Front 22

Pathological or Impacted Grief Reaction

Back 22

Extreme reaction to the death of a loved on that involves psychotic features, suicidal ideation, or severe loss of weight or energy that persists more than 2 months. History of past depressive episodes can help predict this.

Front 23

What is one therapeutic approach to help grieving individuals?

Back 23

Reexperiencing the trauma under close supervision. The person is encouraged to talk about the loved one, the death, and the meaning of the loss while experiencing all associated emotions, until that person can come to terms with reality. This would include incorporating positive emotions connected with the loss and arriving at the position that it is possible to cope with the pain and life will go on.

Front 24

What is the key identifying feature of bipolar disorders?

Back 24

The tendency of manic episodes to alternate with major depressive episodes is an unending roller-coaster ride from the peaks of elation to the depths of despair.

Front 25

Hallucinations

Back 25

Psychotic symptom or perceptual disturbance in which something is seen, heard, or otherwise sensed although it is not actually present

Front 26

Delusions

Back 26

Psychotic Symtom involving disorder of thought content and presence of strong beliefs that are misrepresentations of reality.

Front 27

Catalepsy

Back 27

Motor movement disturbance seen in people with some psychoses and mood disorders in which body postures can be "sculpted" to remain fixed for long periods.

Front 28

Seasonal Affect Disorder (SAD)

Back 28

Mood disorder involving a cycling of episodes corresponding the the seasons of the year, typically with depression occurring during the winter.

Front 29

Bipolar II Disorder

Back 29

Alternation of major depressive episodes with hypomanic episodes (not full manic episodes)

Front 30

Bipolar I Disorder

Back 30

Alternation of major depressive episodes with full manic episodes

Front 31

Cyclothymic Disorder

Back 31

Chronic (at least 2 years) mood disorder characterized by alternating mood elevation and depression levels that are not as severe as manic or major depressive episodes

Front 32

When do patients often deny they have a problem?

Back 32

During manic or hypomanic phases (they are so wrapped up in their enthusiasm and expansiveness that their behavior seems reasonable to them, and often stop taking their medication during periods of distress or discouragement in an attempt to bring on a manic stage)

Front 33

Individuals with cyclothymic disorder tend to be in one mood state or the other for how long, with few periods of neutral mood?

Back 33

Years

Front 34

Euthymic

Back 34

Neutral Mood

Front 35

How long must the pattern last for a child or adolescent to meet the criteria for cyclothymic disorder?

Back 35

1 year, as opposed to 2 in adults

Front 36

What is the average age of onset for bipolar I disorder?

Back 36

15-18

Front 37

What is the average age of onset for bipolar II disorder

Back 37

19-22

Front 38

What are the differences between the onset of Bipolar Disorders and Major Depressive Disorders?

Back 38

Bipolar Disorder has a younger average age of onset and begins more acutely (suddenly).

Front 39

Rates of completed suicide are how much higher in patients with bipolar disorder than recurrent major depression?

Back 39

4 times

Front 40

How long does Cyclothymia last?

Back 40

Usually chronic and lifelong

Front 41

Average age of onset for Cyclothymia?

Back 41

12-14

Front 42

Subtypes of Cyclothymia?

Back 42

Based on predominance of mild depressive symptoms, hypomanic symptoms, or equal distribution of both.

Front 43

What percent of the population worldwide experience major depressive disorder over a lifetime? In the past year?

Back 43

16% over a lifetime
6% in the past year

Front 44

Likelihood of mood disorders in women and men?

Back 44

Women are twice as likely to have mood disorders as men. (Equal until adolescence and after age 65)

Front 45

Likelihood of bipolar disorder in women and men?

Back 45

Equal
Women are more likely to experience rapid cycling, anxiousness, and depressive phase.

Front 46

Likelihood of major depressive disorder and dysthymia in blacks and whites?

Back 46

The prevalence of major depressive disorder and dysthymia is significantly lower among blacks than among whites

Front 47

Depressive disorders in kids and adults?

Back 47

Depressive disorders occur less often in prepubertal children than in adults but rise dramatically in adolescence

Front 48

Depressive disorders in population v individuals older than 65?

Back 48

The overall prevalence of major depressive disorder for individuals older than 65 is about half that of the general population.

Front 49

Childhood depression and mania is often associated with and misdiagnosed as what?

Back 49

ADHD

Front 50

Proband

Back 50

first-degree relatives

Front 51

Are mood disorders heritable?

Back 51

This seems to be the case because identical twins are 2-3 times more likely to present a mood disorder than a fraternal twin if the first twin has a mood disorder

Front 52

Environmental events influence on depression in men and women?

Back 52

Environmental events play a larger role in causing depression in men than in women

Front 53

Median lifetime number of major depressive episodes
...

Back 53

4-7

Front 54

Median length of a major depressive episode?

Back 54

4-5 months

Front 55

Average Age of onset for Major Depressive Disorder (MDD)

Back 55

30

Front 56

Average Age of onset for Dysthymic Disorder

Back 56

Early 20's

Front 57

Dysthymic Disorder Prevalence

Back 57

3.5% lifetime and past year

Front 58

Who is more likely to commit suicide...those with DD or MDD?

Back 58

Dysthymic Disorder

Front 59

Strongest Risk Factors for MDD in the Elderly

Back 59

1) loss of a loved one
2) loss of independence due to illness
3) Caregiving burden for ill spouse

Front 60

Genetic Contributions to depression in men v women...

Back 60

There is more of a genetic contribution in women to depression

Front 61

Biological Causes of Depressive Disorders

Back 61

Low Levels of Serotonin (emotion regulator) in relation to norephinephrine and dopamine

Front 62

Permissive Hypothesis

Back 62

When serotonin is low, it allows other NT's to range more widely and be dis-regulated, causing unstable mood.

Front 63

The Endocrine System on Depression

Back 63

Overproduction of cortisol prohibits neurogenesis. This suppression in the hippocampus may be one cause of depression

Front 64

Psychological Causes of Depression

Back 64

Stressful life events, learned helplessness, negative cognitive styles

Front 65

Learned Helplessness

Back 65

starts as anxiety, then depression comes after a marked feeling of hopelessness in ability to cope with the situation and results in behaving helplessly

Front 66

Negative Cognitive Styles

Back 66

Cognitive Errors:
Arbitrary inference
Overgeneralization
Depressive Cognitive Triangle
Negative Schema

Front 67

Attentional Biases in Depression

Back 67

Depressed people tend to remember more negative events and less positive events

Front 68

Social Risk Factors for Depressive Disorders

Back 68

Marital Dissatisfaction (particularly for men), smothering/overprotective parenting, women place a greater emphasis on interpersonal relationships so disruptions are more problematic

Front 69

Cultural Risk Factors for Depressive Disorders

Back 69

Women face more adversity and feel uncontrollability due to dependence and passivity of cultural expectations

Front 70

The importance of social support to depression

Back 70

Depression can lead to isolation, so more meaningful and greater number of social relationships and contacts is related to living longer and less depression

Front 71

Medicinal Treatment of Depressive Disorders

Back 71

Antidepressants:
SSRI
SNRI
Tricyclics- bad side effects
MAO's: for depression with atypical features such as adverse interactions with foods and medicines

Front 72

Goal of Medicine in Depression

Back 72

to prevent next episode, so treatment usually lasts for 6-12 months after episode

Front 73

ECT

Back 73

used with those not responding to meds

Front 74

Psychological Treatment for Depressive Disorders

Back 74

CBT: addresses cognitive styles
IPT: addresses resolution of interpersonal problems and stressors

Front 75

Preventative Approaches for Depression

Back 75

Universal programming, selected interventions, indicated interventions

Front 76

Medication vs. Therapy

Back 76

Combined treatment may be best, but there are better long term effects and relapse prevention with cognitive therapy

Front 77

Gender Differences in Suicide

Back 77

Males are 4 times more likely to commit suicide, but women attempt more.
Suicide rates for young men in the U.S. are highest in the world.
In China more women commit suicide than men, especially in rural areas

Front 78

Risk Factors of Suicide

Back 78

Mood, substance use or impulse control disorders (account for 80% of suicides)
Low levels of serotonin
Family History of Suicide
Family Violence
Firearms in home
Stressful events experienced as shameful or humiliating
Stress and disruption of natural disasters
Exposure to suicidal behavior of others

Front 79

Bully Victims and Suicide

Back 79

Bully Victims are between 2-9 times more likely to consider suicide than non victims
Half of suicides among young people are related to bullying

Front 80

Mood Disorder Specifiers

Back 80

Seasonal Pattern
Postpartum
Anxious Distress
Mixed Features
Melancholic Features
Atypical Features
Mood-Congruent Psychotic Features
Mood-incongruent Psychotic Features
Catatonia

Front 81

Psychosis

Back 81

Hallucinations and delusions

Front 82

Rapid Cycling Specifier

Back 82

4 or more episodes of manic or depressive symptoms in a 12 month period

Front 83

Advancements of BD

Back 83

1/3 with Cyclothymic Disorder will develop BD
10-25% of people with BDII will Develop BD 1

Front 84

BD Prevalence

Back 84

BD 1% lifetime; .08% in the past year

Front 85

Bipolar Disorder has a strong concurrence with what?

Back 85

Substance abuse disorder

Front 86

Neurotransmitters in BD

Back 86

low serotonin, dis-regulation of dopamine

Front 87

Psychological Causes/ Risk factors for BD

Back 87

stress, opportunities to strive for a goal, loss of sleep

Front 88

Medicinal Treatment of Bipolar Disorder

Back 88

Lithium (most common, but severe side-effects)
SSRI's: can trigger manic episodes
Anticonvulsants: good for rapid cycling (less effective at preventing suicide)

Front 89

SSRI

Back 89

Selective Serotonin Reuptake Inhibitor: increase serotonin by decreasing reuptake

Front 90

Psychological Treatment of BD

Back 90

Aims to manage interpersonal and practical problems and compliance with drug treatment
CBT- especially useful when rapid cycling is present
Psychosocial Treatments

Front 91

Changes to Depressive Disorders in DSMV

Back 91

Disruptive Mood Dysregulation Disorder: children up to 18 years of age who exhibit persistent irritability and extreme episodes of behavior dyscontrol (attempt to reduce overdiagnosis of Bipolar Disorder in Children)

Premenstrual Dysphoric Disorder: depressive disorder that begins sometime following ovulation and remits within a few days of menses and has a marked impact of Functioning

Persistent Depressive Disorder (Dysthymia)

Bipolar Disorder moved to separate chapter from depressive disorders

Front 92

Why was BD moved to separate chapter from DD?

Back 92

genetic contribution seems to be higher than in DD, age of onset is earlier, more insidious onset, different pharmacological treatments

Front 93

Cortisol

Back 93

Released in Response to Stress

Front 94

Arbitrary inference

Back 94

Emphasize Negatives

Front 95

Depressive Cognitive Triangle:

Back 95

Negative cognitions about themselves, their immediate world, and their future

Front 96

Negative Schema

Back 96

Self Blame, Self Evaluation

Front 97

Internal, Stable, & Global Learned helplessness

Back 97

internal- attributes negative events to personal failings
stable- even after event passes thinks additional bad things will always be their fault
global- attributions extend across a range of issues

Front 98

SNRI

Back 98

Serotonin-norepinephrine reuptake inhibitor- increase seratonin and norepinephrine

Front 99

Catatonia

Back 99

neurogenic motor immobility and behavioral abnormality