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59 Cards in this Set
- Front
- Back
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Mood Disorders |
• Mood disorders – Psychological disorders characterized by usually severe or prolonged disturbances of mood. |
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Two major forms of mood disorders |
• The major forms of mood disorder: 1) depressive disorders 2) bipolar disorders and related disorders (mood swing disorders). |
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Two types of mood disorders that vary in severity: |
1. major depressive disorder = more severe type; and persistent depressive disorder = milder type.
2. Bipolar disorder = more severe disorder; and the milder disorder is termed cyclothymic disorder (also called cyclothymia). |
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Major Depressive Disorder |
A severe mood disorder characterized by major depressive episodes in the absence of mania or hypomania.
• Mania – A state of unusual elation, energy, and activity. (bipolar 1) • Hypomania – A relatively mild state of mania.(bipolar 2) |
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3 different episodes: |
1. major depressive 2. manic 3. hypomanic -The episodes do not have a clinical code* |
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Common features of Depression |
Common features:
-changes in emotional state -changes in motivation -changes in function/motor behavior -cognitive changes |
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Lifetime prevalence rates for major depressive disorder |
Major depressive disorder affects about twice as many women as men
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Depression Severity |
-Depression inventory (ex: Becks Depression Inventory) to test |
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Major Depressive Disorder Features |
• Major depression impairs people’s ability to meet the ordinary responsibility of everyday life.
• People with major depression may lose interest in most of their usual activities and pursuits, have difficulty concentrating and making decisions, have pressing thoughts of death, and attempt suicide.
• They even show impaired driving skills in driving simulation tests |
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Risk Factors in Major Depression |
Factors that place people at increased risk of developing major depression include: – Age (initial onset is most common among young adults) – Socioeconomic status (people lower down the socioeconomic ladder are at greater risk than those who are better off) – Marital status (people who are separated or divorced have higher rates than married or never-married people). |
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Seasonal Affective Disorder |
• Many people report that their moods do vary with the weather.
• For some people, the changing of the seasons from summer into fall and winter leads to a type of major depression called seasonal affective (mood) disorder (SAD).
• SAD is not a diagnostic category in its own right in the DSM-5 but is a specifier or subcategory of a mood disorder involving major depression. |
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Postpartum Depression |
•Postpartum depression (PPD) – Persistent and severe mood changes that occur after childbirth.
PPD is often accompanied by disturbances in appetite and sleep, low self-esteem, and difficulties in maintaining concentration or attention.
(women can become suicidal/homocidal |
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Persistent Depressive Disorder |
• People with persistent depressive disorder may have either chronic major depressive disorder or a chronic but milder form of depression called dysthymia. - (a low grade form of depression) -(adults have low grade symptoms for 2 year or more) -(kids symptoms for 1 year)
• People with dysthymia feel “down in the dumps” most of the time, often for years, but are not as severely depressed as those with major depressive disorder. |
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Lifetime prevalence rates for dysthymia |
twice as many women than as men |
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Double Depression |
• Some people are affected by both dysthymic disorder and major depression disorder at the same time. • double depression applies to those who have a major depressive episode superimposed on a longer-standing dysthymic disorder. • People suffering from double depression generally have more severe depressive episodes than people with major depression alone |
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Premenstrual Dysphoric Disorder |
• (PMDD) – a disorder characterized by physical and mood-related symptoms occurring during the woman’s premenstrual period.
• Psychological symptoms manifest in the week before menses and improve within a few days following the onset of menses.
• Symptoms are associated with significant emotional distress or interference with the woman’s ability to function.
-New to DSM 5 |
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Bipolar Disorder |
A psychological disorder characterized by mood swings between states of extreme elation and depression. (bi=2, polar=opposites) -severe highs & lows 2 episodes: -mania -depression |
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Bipolar Disorder features |
ride an emotional roller coaster, swinging from the heights of elation to the depths of depression without external cause.
• The first episode may be either manic or depressive. Manic episodes, typically lasting from a few weeks to several months, are generally shorter in duration and end more abruptly than major depressive episodes. |
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Bipolar I Disorder |
applies to people who have had at least one full manic episode at some point in their lives.
– Typically involves extreme mood swings between manic episodes and major depression. – Possible for bipolar I disorder to apply to those who have only experienced mania without ever having a major depressive episode. |
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Bipolar II Disorder |
applies to people who have had hypomanic episodes AND at least one major depressive episode (without ever having a full-blown manic episode). (hypo = less severe)
-still able to function daily |
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Hypomanic Episode |
episodes that are less severe than manic episodes and are not accompanied by the social or occupational problems associated with full-blown mania. |
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During a hypomanic episode, a person might: |
– feel unusually charged with energy – show a heightened level of activity – have an inflated sense of self-esteem – be more irritable than usual – experience little fatigue or need for sleep. |
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Manic Episode |
A period of unrealistically heightened euphoria, extreme restlessness, and excessive activity characterized by disorganized behavior and impaired judgment. |
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In manic episode person experiences: |
• During a manic episode, the person experiences a sudden elevation or expansion of mood and feels unusually cheerful, euphoric, or optimistic. • The person seems to have boundless energy and is extremely sociable, although perhaps to the point of becoming overly demanding and overbearing toward others. • Other people recognize the sudden shift in mood to be excessive in the light of the person’s circumstances. |
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Cyclothymic Disorder |
A mood disorder characterized by a chronic pattern of less-severe mood swings than are found in bipolar disorder.
-(a low grade of bipolar/less severe) -adults 2 ys or more -child 1 yrs or more |
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Cyclothymic Disorder features |
The periods of elevated mood are called hypomanic episodes
They are less severe than manic episodes and are not accompanied by the severe social or occupational problems associated with full-blown manic episodes. |
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Stress and Depression • Sources of stress may include: |
• Stress plays an important role in determining vulnerability in bipolar disorder and even more strongly in major depression.
• Sources of stress may include: -The loss of a loved one -The breakup of a romantic relationship -Prolonged unemployment -Physical illness -Marital or relationship problems -Economic hardship -Pressure at work -Exposure to racism and discrimination -Living in an unsafe, distressed neighborhood |
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Psychodynamic Theories |
-depression represents anger directed inward rather than against significant others.
• Freud believed that mourning, or normal bereavement, is a healthy process by which one eventually comes to separate oneself psychologically from a person who is lost through death, separation, divorce, or other reason.
•this view: bipolar disorder represents shifting dominance of the individual’s personality between the ego and superego. |
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Research Evidence for Psychodynamic |
• Psychodynamic theorists focus on the role of loss in depression.
• Research does show that loss of significant others (through death or divorce, for example) is often associated with the development of depression.
• Evidence supports the view that a self-focusing style—an inward or self-absorbed focus of attention—is associated with depression, especially in women. |
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Humanistic Theories |
• From the humanistic framework, people become depressed when they cannot imbue their existence with meaning and make authentic choices that lead to self-fulfillment. (people feel like they are being inauthentic)
• Like psychodynamic theorists, humanistic theorists focus on the loss of self-esteem that can arise when people lose friends or family members or suffer occupational setbacks.
• We tend to connect our personal identity and sense of self worth with our social roles as parents, spouses, students, or workers. |
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Learning Theories |
Whereas the psychodynamic perspectives focus on inner, often unconscious, causes, learning theorists emphasize situational factors, such as the loss of positive reinforcement.
• We perform best when levels of reinforcement are commensurate with our efforts.
• Changes in the frequency or effectiveness of reinforcement can shift the balance so that life becomes unrewarding. |
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The Role of Reinforcement |
• Learning theorist Peter Lewinsohn (1974) proposed that depression results from an imbalance between behavior and reinforcement.
• A lack of reinforcement for one’s efforts can sap motivation and induce feelings of depression. • Inactivity and social withdrawal reduce opportunities for reinforcement; lack of reinforcement exacerbates withdrawal. |
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Interactional Theory |
• Difficulties in social interactions may help explain the lack of positive reinforcement.
• Interactional theory, developed by psychologist James Coyne (1976), proposes that the adjustment to living with a depressed person can become so stressful that the partner or family member becomes progressively less reinforcing.
• Interactional theory is based on the concept of reciprocal interaction. |
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Cognitive Theories |
Cognitive theorists relate the origin and maintenance of depression to the ways in which people see themselves and the world around them.
Cognitive triad of depression – The view that depression derives from adopting negative views of oneself, the environment or world at large, and the future. -negative views about all there -table 7.3 |
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cognitive theorists: Aaron Beck |
relates the development of depression to the adoption early in life of a negatively biased or distorted way of thinking—the cognitive triad of depression. |
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cognitive theorists: David Burns |
enumerated a number of the cognitive distortions associated with depression:
1. All-or-nothing thinking 2. Overgeneralization 3. Mental filter 4. Disqualifying the positive 5. Jumping to conclusions 6. Magnification and minimization 7. Emotional reasoning 8. “Should” statements 9. Labeling and mislabeling 10. Personalization |
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Automatic thoughts |
-table 7.4
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Cognitions and Depression |
• Evidence that depressed people show higher levels of distorted or dysfunctional thinking than non depressed controls supports Beck’s model.
• People with bipolar disorder tend to show higher levels of dysfunction in thinking than nonpatient controls
• We also find that dysfunctional attitudes (above a certain threshold) increase vulnerability to depression in the face of negative life events. |
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Learned Helplessness |
A behavior pattern characterized by passivity and perceptions of lack of control.
• The originator of the learned helplessness concept, Martin Seligman, suggests that people learn to perceive themselves as helpless because of their experiences.
• The learned helplessness model therefore straddles the behavioral and the cognitive: Situational factors foster attitudes that lead to depression. |
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Learned Helplessness (Attributional) Theory |
Reformulated helplessness theory: people who explain the causes of negative events (such as failure in work, school, or romantic relationships) according to the following three types of attributions are most vulnerable to depression:
1. Internal factors (vs external) 2. Global factors (vs specific) 3. Stable factors (vs unstable) |
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Genetic Factors |
• Genetic factors play a significant role in determining proneness to mood disorders
• Not only does major depression tend to run in families, but the closer the genetic relationship people share, the more likely they are to share a depressive disorder.
• An emerging model in the field focuses on interactions of genetic and environmental factors in the development of major depression and other mood disorders. |
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Biochemical Factors and Brain Abnormalities |
antidepressants: increase levels in the brain of the neurotransmitters norepinephrine and serotonin, often helped relieve depression.
Brain-imaging studies show lower metabolic activity in the prefrontal cortex of clinically depressed people as compared to healthy ppl.
brain abnormalities in people with mood disorders in parts of the brain involved in governing emotions. |
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Causal Factors in Bipolar Disorders |
concordance rate to be seven times greater among MZ twins than DZ twins (43% versus 6%)
If bipolar disorder were caused entirely by heredity, then an identical twin of someone having the disorder would always develop the disorder, but this isn’t the case.
Consistent with the diathesis–stress model |
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Treating Depression |
• Depressive disorders are typically treated with psychotherapy, such as in the form of psychodynamic therapy, behavior therapy, or cognitive therapy, or with biomedical approaches, such as antidepressant medication or electroconvulsive therapy (ECT). (shock through the head)(short term memory loss)
• Sometimes a combination of treatment approaches is used. |
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Psychodynamic: Interpersonal psychotherapy |
Interpersonal psychotherapy (IPT) is a brief psychodynamic oriented therapy that focuses on a person’s current interpersonal relationships. |
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Psychodynamic Approaches |
help people who become depressed understand their ambivalent feelings toward important people (objects) in their lives they have lost or whose loss was threatened.
• By working through feelings of anger toward these lost objects, people can turn anger outward— through verbal expression of feelings, for example—rather than leave it to fester and turn inward. |
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Behavioral Approaches |
focus on helping depressed patients develop more effective social or interpersonal skills and increasing their participation in pleasurable or rewarding activities.
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Cognitive Therapy |
• Cognitive therapists believe that distorted thinking (cognitive distortions) play a key role in the development of depression.
• Depressed people typically focus on how they are feeling rather than on the thoughts that may underlie their feeling states. • That is, they usually pay more attention to how bad they feel than to the thoughts that may trigger or maintain their depressed moods. |
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Becks Depression inventory (BDI-II) |
Add up the points. Total score levels of depression -normal to extreme depression -score of 17 or above may need treatment |
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four major classes of antidepressants *on test! |
(1) Tricyclic antidepressants (TCAs) -older class of drugs/ used for migraines (2) Monoamine oxidase (MAO) inhibitors (3) Selective serotonin-reuptake inhibitors (SSRIs) (4) Serotonin-norepinephrine reuptake inhibitors (SNRIs) |
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Electroconvulsive therapy (ECT), |
more commonly called shock therapy, continues to evoke controversy. • The idea of passing an electric current through someone’s brain may seem barbaric. • Yet ECT is a generally safe and effective treatment for severe depression |
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Lithium and Other Mood Stabilizers |
The ancient Greeks and Romans were among the first to use lithium as a form of chemotherapy. – They prescribed mineral water that contained lithium for people with turbulent mood swings.
• Today, lithium carbonate, a powdered form of the metallic element lithium, is widely used in treating bipolar disorder. • Other mood stabilizers include anticonvulsant drugs such as carbamazepine (Tegretol) and divalproex (Depakote). |
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Suicide |
-Table 7.6 !!! |
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Suicide in Older Adults |
• Older people are more susceptible to diseases such as cancer and Alzheimer’s, which can leave them with feelings of helplessness and hopelessness that, in turn, can give rise to depression and suicidal thinking.
• Many older adults also suffer a mounting accumulation of losses of friends and loved ones, leading to social isolation.
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Gender and Ethnic/Racial Differences |
•more women attempt suicide -more men “succeed.” • For every female suicide, there are four male suicides. • More males “succeed” in large part because they tend to choose quicker-acting and more lethal means, such as handguns. • Suicides are more common among (non-Hispanic) White Americans and Native Americans than African Americans, Asian Americans, or Hispanic Americans. |
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The root cause of depression |
Is pain
-physical -psychological |
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Why do people commit suicide? |
• Suicidal thinking does not necessarily imply loss of touch with reality, deep seated unconscious conflict, or a personality disorder. • The risks are greater among people with major depression and bipolar disorder. • Suicide is often linked to psychological disorders. • Past suicide attempts are an important predictor of future attempts |
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Theoretical Perspectives on Suicide |
• Suicide represents inward directed anger that turns murderous (e.g., Psychodynamic). • Influence of Emile Durkheim • Suicide is a wish to escape unbearable psychological pain • Suicide is motivated by personal expectancies (Social-Cognitive). • Suicide is attributed to reduced use or availability of serotonin • Mood disorders and parental suicide can also increase risk |
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Predicting Suicide |
Evidence points to the pivotal role of hopelessness about the future in predicting suicidal thinking and suicide attempts.
People who commit suicide tend to signal their intentions, often quite explicitly, such as by telling others about their suicidal thoughts.
most people who commit suicide make contact beforehand with a health-care provider. |
