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63 Cards in this Set
- Front
- Back
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Depression |
A mood state characterized by sadness despair feeling of worthlessness (futility) and withdrawal from others |
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Mania |
Mental state characterized by elevated mood and excessive excitement energy or irritability with impairment in social and occupational functioning |
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Affective symptoms of depression |
Feelings of hopelessness worthlessness low self-esteem limited enthusiasm four things that previously brought pleasure and joy and anxiety
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Cognitive symptoms of depression |
-Pessimistic beliefs about present and future -inability to concentrate -negative thinking -loss of interest and motivation -suicidal Thoughts - irrational or unjustified beliefs -Self-denigration and rumination |
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Self-denigration |
Belittling oneself or feelings of incompetence thoughts of suicide |
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Rumination |
Continually thinking about certain topics or reviewing events that have transpired(happened) |
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Behavioral symptoms of depression |
-Fatigue lethargy social withdrawal reduced work productivity diminished motivation poor hygiene slow speech agitated and Restless -Anhedonia is also prevalent |
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Anhedonia |
Loss of the capacity to derive pleasure from normally pleasant experiences |
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Physiological symptoms |
-Appetite and weight changes (increase it decrease eating) -Sleep disturbances (insomnia or hypersomnia) -Aches and pains -Aversion to sexual activity (reduced sex drive) |
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Hypomania |
Mild level of manic intensity Increased levels of activity and goal-directed behaviors combined with an elevated expansive or irritable mood |
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Characteristics of hypomania |
Does not involve: -a loss of contact with reality (psychosis) -Or impairment in Social and occupational functioning -or a need for hospitalization Involves: Increased productivity decreased need for sleep and generate many disconnected ideas Form goals that are unfinished |
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Affective symptoms of mania |
Volatility (change rapidly and unpredictably) from extreme elation to intense rage Inappropriate humor lack of restraint and expressing feelings or opinions and grandiosity |
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Grandiosity |
Overvaluation of one significance or importance and and being Superior |
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Cognitive symptoms of mania |
Disorientation intrusive thoughts lack of focus and attention poor judgement and lack of insight regarding inappropriateness of behaviors and verbiage Failure to evaluate consequences of decisions Communication and speech can be difficult to interpret |
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Behavioral symptoms |
-Act impulsively socially destructive behavior Speech is rapid and unclear Difficulty delaying gratification Wild excitement ranting raving constant movement & agitation Paranoia hallucinations delusions Can become a danger to self and others |
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Physiological symptoms of mania |
Decreased need for sleep and high levels of arousal Minimal fatigue and ongoing restlessness intense activity Increased libido and hypersexuality Weight loss due to energy |
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What are some specifiers to consider when diagnosing a mood disorder? |
1. Mixed features: Symptoms from the other ends of the mood continuum Exhibiting milder symptoms from the opposite pole 2. Suicide risk severity: Socio-cultural variables, comorbid anxiety, personality or substance use disorder, feelings of worthlessness, suicidal behavior Any past or current indicators of suicide 3. Postpartum onset: Depression after childbirth Affects 13% of women |
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Mood congruent |
Consistent or realted the individuals mood state |
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Psychotic symptoms that are mood congruent |
Delusions or hallucinations are consistent with depressive moods (themes of inadequacy death guilt or punishment) |
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Psychotic symptoms that are incongruent |
Delusions or hallucinations that are unrelated to depressive mood (beliefs of being controlled by aliens) Indicates a more severe illness and greater cognitive impairment
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Catatonia |
Unresponsive to external stimuli such as mutism, taking a specific posture and not moving, extreme agitation with purposeless excessive motor activity Occurs frequently with schizophrenia |
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Schizoaffective disorder |
Someone with a psychotic disorder who experiences prolonged episodes of mania or major depression |
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How is the diagnosis of a depressive disorder based? |
Based on severity and chronicity of depressive symptoms as well as pattern of symptom development |
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Major depressive episode |
Two week period involving major episodes of feelings of sadness/ emptiness and or loss of Interest in previously enjoyed activities |
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Major depressive disorder (MDD) |
-Occurrence of at least one major depressive episode for two weeks - weight or appetite changes, changes in sleep patterns, fatigue, low energy, and recurrent thoughts of death or suicide No history of mania or hypomania |
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Chronic depressive disorder (CDD) or dysthymia |
-Depressed mood has lasted for at least 2 years with no more than 2 months symptom-free - ongoing presence of at least two of the following: hopelessness, low self-esteem, poor appetite, low energy, - negative world view, pessimistic outlook on future |
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Mixed anxiety / depression (MAD) |
-Simultaneously experience significant anxiety symptoms (anxious distress) along with.. - multiple symptoms of major depression including depressed mood and or anhedonia - neither anxiety nor depression is clearly predominant ** associated with longer depressive episodes and higher risk of suicide |
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Seasonal affective disorder (SAD) |
-Major depression occurs with a seasonal pattern associated with decreasing light - at least two major depressive episodes occurring during fall / winter and remitting(stop) in Spring / summer - seasonal episodes of depression outnumber non-seasonal episodes - associated with vegetative symptoms |
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Anxious distress |
Symptoms of motor tension difficulty relaxing pervasive worries or feelings that something catastrophic will occur |
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Vegetative symptoms |
Declining energy, lethargy, increased need for Sleep, carbohydrate craving associated with weight gain, and social withdrawal |
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Premenstrual dysphoric disorder (PMDD) |
-Severe depression, mood swings, anxiety or irritability occurring before the onset of Menses for at least one year - at least five symptoms must occur - similar to PMS however interferes with social and interpersonal relationships or academic / occupational functioning |
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Epidemiology of depressive disorders |
- leading cause of worldwide disability - 15 million Americans experience disorder a year - 50 billion spent annually on Healthcare and lost work days - being female Native American middle-aged Widow to separated or divorced are having low income increases risk - African Americans 40% less likely than whites to experience it however they have more severe and chronic depression - 15% fail to show any significant remission of symptoms and many of these cases represent undiagnosed bipolar disorder |
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Role of heredity in the etiology of depression |
-tends to run in families, because higher among biological families compared to adoptive families - carriers of the shorter allele of serotonin transporter gene release more stress hormone when mistreated as children - have difficulty absorbing and releasing serotonin (needed for effective neurotransmission) |
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Role of circadian disturbances and depression |
- Rhythm allows adaptation to factors occurring in the external environment - light related changes affecting secretion of the hormone melatonin and serotonin regulation - insomnia worsens depressive symptoms - exhibit REM sleep |
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Role of Abnormal cortisol levels in depression |
- register higher blood levels of cortisol which deplete the chemicals (serotonin) necessary for effective neurotransmission - immune system dysfunction resulting in brain inflammation and the formation of neurotoxins - exposure to stress during early development affects cortisol levels and HPA system - stress the timing of stress (increases cortisol release) and genetic predisposition can interact to produce depression |
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Stress circuitry and depression |
-Stress increases levels of cortisol - cortisol restores homeostasis by signaling the brain to dampen HPA activity - high levels of cortisol can damage hippocampus resulting in dysregulation of stress circuitry - chronic stress depletes serotonin and affect the production of them science necessary for serotonin to metabolize |
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Role of neurotransmitters and depressive |
-Depletion of neurotransmitters elevates depression -Anti depressant medication increases availibility of neurotransmission and helps normalize HPA function and facilitate regeneration of neurons |
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Neuroanatomy and depression |
-HPA axis alterations as well as smaller hippocampal volume might be predicted by stress dysregulation - decreased activation of prefrontal lobes associated with MDD - decreased brain activity due to reduction in Gray matter |
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Behavioral explanations of depression |
-Insufficient social reinforcement due to losses such as unemployment divorce or death of a loved one - results from changes in a custom level of reinforcement (love affection companionship) - depression can be reduced by increasing activity that generates environmental reinforcement -Lewinsohn's law |
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Lewinsohn's law of depression |
Low rates of positive reinforcement due to: 1. The number of events and activities that are potentially reinforcing to the person (Age, gender, biological traits may determine availability of reinforcers) 2. The availability of reinforcements in the environment (Harsh/ isolating enviroment) 3. The instrumental behavior of the infant individual -(social interactions) *Stress plays a major role by destructing well-established behavioral patterns Lack of positive reinforcement increasing adversative experiences |
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Cognitive explanation of depression |
-The experience of negative thoughts and errors in thinking result in pessimism negative self perception feelings of hopelessness and depression - have exaggerated irrational and catastrophic thinking patterns - the development of schemas reducing disturbance in thinking(Beck's theory) - have memory bias of recalling more negative words and depressing events so presumably have developed negative schemas - cope with stressful circumstances via rumination or co-rumination - have difficulty using positive events to regulate negative mood |
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Schemas |
Cognitive framework that helps organize & interpret information ** can create depression by perpetuating a negative outlook and attention to negative messages / tendency to focus on negative information |
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Beck's Theory (4 negative skemas) |
1. Arbitrary inference -Drawing conclusions not supported by evidence 2. Selected abstraction - focus on minor incidents or trivial details taken out of context (a minor comment) 3. Overgeneralization - drawing conclusions about their ability performance or worth from a single experience or incident 4. Magnification and minimization - magnify or exaggerated limitations and difficulties and minimize accomplishments achievements and capabilities |
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Rumination |
Repeatedly thinking about concerns or events |
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Co-rumination |
Constantly talking over problems with peers |
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Seligman's Behavioral and cognitive learning theory |
Both cognition and feelings of helplessness are learned So depression results from learned helplessness Those who feel helpless make depressive causal attributions |
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Learned helplessness |
Belief that one is helpless and unable to affect outcomes in one's life |
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Seligman's Causal attributions (examples on page 229) |
Speculations about why events occur Which can be eaither: -Internal or external - stable or unstable - Global or specific ** individuals whose speculations are internal, stable, and global are likely to have feelings of depression |
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Beck's Theory versus Seligman's theory |
Results tended ro support Beck's Theory High levels of a negative cognition coupled with stress predicted subsequent depression while negative attributional style did not result in greater depression |
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Social dimension of the etiology of depression |
-Maltreatment, death of or abandonment by a parent, parental depression -Adopted infants exhibit high levels of reaction to frustration when mother demonstrates high levels of depression - interpersonal stress such as problems with dependency -Psychosocial stress such as life-threatening medical condition, frustration regarding major life goals, and death of loved one - timing of onset, type, and severity of stress are important indicators that determine the likelihood of depression - social support and resources can help individuals cope and adjust to stress which is important for remission
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Socio-cultural dimension on the etiology of depression |
Includes socioeconomic status culture race ethnicity and gender |
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Culture ethnicity and depression |
-May create distinctive and environments for gene expression and physiological reaction - In some cultures maybe experience largely in the form of somatic or bottle bodily complaints rather than as sadness or guilt - perceived discrimination increased depressive symptoms |
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Gender and depressive disorders |
-Far more common among women regardless of region in the world race and ethnicity -Differences May reflect differences and self-report or willingness to seek treatment - Heritability is higher among women than in men - ruminating and Co-ruminating more common in women - hormone secretion patterns, menopause, traditional gender roles, increased vulnerability to interpersonal stress |
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Treatment for depression |
Includes medication, circadian related treatments, brain stimulation Therapies, Psychotherapy and behavioral treatments ** adjunctive therapy ( adding on to therapy) is preferred over switching from one therapy to another |
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Medications used for depression |
-Antidepressants which increase the availability of neural communication - continuation of medication is necessary to prevent against return of symptoms -Discontinuation syndrome flu like symptoms intense fatigue insomnia or increase emotionality and irritability or suicidal thinking - unfortunately many individuals do not respond to antidepressant medication and less than 1/3 experience full remission of symptoms |
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Circadian related treatments for depression |
Treats SAD -The use of bright light spectrum or blue wavelengths -Light therapy influence circadian rhythm by stimulating photoreceptor system -Involves dawn like stimulation (timer activated light that gradually increases in brightness) or daily use of box visor or lighting system that delivers light of a particular intensity for a period of time -Advantages include absence of side effects and more rapid treatment response and maybe as beneficial as antidepressant treatment |
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Brain stimulation Therapies for depression |
Electroconvulsive therapy (ECT): -Involves application of moderate electrical voltage to the brain in order to produce seizures lasting for 15 seconds -FDA approved - considered a first line treatment for life-threatening depressive symptoms Vegas nerve stimulation: -Approved for use if prior treatment has failed -Combined with ECT Transcranial magnetic stimulation: - electromagnetic field stimulates the brain ( has received some support as well as skepticism) |
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Behavioral activation therapy( BAT) for depression |
Treatment involves increasing exposure to pleasurable events and activities improving social skills and facilitating social interaction STEPS: 1. Identifying and rating different activities in terms of pleasure and mastery 2. Performing selected activities hence increasing feelings of pleasure or mastery 3. Identify problems and using Behavior techniques to deal with them 4. Improving social and assertiveness skills |
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Interpersonal psychotherapy (ITP) for depression |
- focused on current problems and altering current/present relationship patterns - uses psychodynamic, cognitive behavioral, and other forms of therapy - relationship issues are the targets of therapy and strive to improve Communications with others, identifying role conflicts, and increasing social skills |
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Cognitive behavioral therapy for depression |
- focuses on altering extreme negative thought patterns - helps individuals: 1. Identify negative thoughts 2. No connection between negative thoughts and subsequent 3. Examine the negative thoughts and decide if it is true 4. Replace distorted negative thoughts with a realistic interpretations -also aim to eliminate ruminative positive thoughts and negative metacognition *** individuals treated with CBT are less likely to relapse |
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Ruminative positive thoughts |
Worry helps me overcome my problems |
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Negative metacognition |
Other people reject me if I worry too much |
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Mindfulness-based cognitive therapy (MBCT) for depression |
Involves calm awareness of one's present experience thoughts feelings and having an attitude of acceptance rather than being judgemental - disrupt cycle of negative thinking by focusing on the present |
