PSY 280 Chapter 5 Exam 2

Question Answer
o Mood disorders two broad types • involves only depressive symptomsinvolves manic symptoms (bipolar disorders)
o DSM-5 Criteria for Major Depressive Disorder ¦ Sad mood OR loss of interest or pleasure (anhedonia)• Symptoms are present nearly every day, most of the day for at least 2 weeks• Symptoms are distinct and more severe than a normative response to significant loss
o Major depressive disorder (MDD) Episodic • Symptoms tend to dissipate over time
o Major depressive disorder (MDD)¦ Recurrent • Once depression occurs, future episodes likely • Average number of episodes is 4
o Major depressive disorder (MDD)¦ Subclinical depressions • Sadness plus 3 other symptoms for 10 days • Significant impairments in functioning even though full diagnostic criteria are not met
o DSM-5 criteria for persistent depressive disorder ¦ Depressed mood for at least 2 years; 1 year for children/ adolescentsPlus 2 other symptoms¦ Symptoms do not clear for more than 2 months at a time¦ Bipolar disorders are not present
o DSM-5 criteria for premenstrual dysphoric disorder ¦ In most menstrual cycles during the past year, at least 5 of the following symptoms were present in the final week before menses and improved within a few days of menses onset:• Affective ability• Irritability
o Epidemiology and consequences ¦ Depression is common • twice as common in women as in men• three times as common among people in poverty¦ prevalence varies across cultures ¦ depression is costly• cost is mostly due to comorbid conditions
¦ Traditional gender roles • Concerns about social roles• Body images concerns • Block women from pursing rewarding activates that are not considered “feminine”• Emotion-focused coping
¦ Abuse and stress • Girls more likely to experience childhood sexual abuse• Women more likely to experience chronic stressors like poverty and care taking responsibilities• Interpersonal stressors more likely
¦ Symptom variation across cultures • Smaller distance from equator (longer day length) and higher fish consumption associated with lower rates of MDD
o Bipolar Disorders¦ Three forms • Bipolar I, Bipolar II, and Cyclothymiao Mania defining feature of eacho Differentiated by severity and duration of mania• Usually involve episodes of depression alternating with mania• Depressive episode required for Bipolar II, not Bipolar I
¦ Mania • State of intense elation or irritability• Hypomania (hypo=under)o Symptoms of mania but less intenseo Does not involve significant impairment, mania does
o DSM-5 Criteria for Manic and Hypomanic Episodes ¦ Elevated or irritable mood for most of the day nearly every day¦ Abnormally increased activity and energy¦ At least 3 of the following are noticeably changes from baseline (4 if mood is irritable):
¦ For a manic episode • Last 1 week or require hospitalization or include psychosis• Symptoms cause significant distress or functional impairment
¦ For a hyper manic episode • Symptoms last at least 4 days• Clear changes in functioning that are observable to others, but impairment is not marked• No psychotic symptoms are present
¦ Bipolar I • At least one episode of mania
¦ Bipolar II • >1 major depressive episode and > episode of hypomania
¦ Cyclothymic disorder (cyclothymia) • Milder, chronic form of bipolar disordero Lasts at least 2 years in adults, 1 years in children / adolescents• Numerous periods with hypomanic and depressive symptomso Does not meet criteria for mania or major depressive episode
¦ New models focus on sensitivity of postsynaptic receptors • Dopamine receptors may be overlay sensitive in BD but lack sensitivity in MDDo People vulnerable to depression may have less sensitive serotonin receptors
o Social Factors ¦ Life events¦ interpersonal difficulties¦ behavior of depressed people often leads to rejection by others
¦ why do some people become depressed after a stressful life event and other do not? • Social support• Neuroticism• Cognitive theories
¦ Rumination ¦ Susan nolen-hoeksema• Repetitive and passive focus on distress from past event • Brooding• No problem solving action is taken
o Social and psychological factors in bipolar disorder ¦ Triggers of depressive episodes in bipolar similar to triggers of major depressive episodes• Negative life events, neuroticism¦ Predictors of mania• Reward sensitivity• Sleep disruption
Treatment of mood disorders interpersonal psychotherapy (IPT) ¦ focus on current relationships
Treatment of mood disorders cognitive therapy ¦ monitor and identify automatic thoughts• replace negative thoughts with more neutral or positive thoughts
¦ mindfulness- based cognitive therapy (MBCT) • strategies, including mediation, to prevent relapse
¦ behavioral activation (BA) therapy • increase participation in positively reinforcing activates to disrupt spiral of depression, withdrawal, and avoidance
¦ psychological treatment of bipolar disorder • adjunct to medication• partial programs
¦ psychological treatment of bipolar disorder CBT o Medication adherenceo Behavioral activation sensitivity
¦ psychological treatment of bipolar disorder Psyched o Life event triggerso Martial discord
¦ psychological treatment of bipolar disorder Family-focused treatment (FFT) o Educate family about disorder, enhance family communication, improve problem solving
o Biological treatment of mood disorders¦ Electroconvulsive therapy (ECT) • Reserved for treatment non-responders• Induce brain seizure and momentary unconsciousness• Side effectso Memory losso ECT more effective than medication¦ Unclear how ECT works
o Biological treatment of mood disorders¦ Transcranial magnetic stimulation for depression (rTMs) • Electromagnetic coll placed against scalp• For those that fail to respond to first antidepressant
o Research comparing treatments for major depressive disorder ¦ Combining psychotherapy and antidepressant medications increased odds of recovery by 10-20%• Medications quicker, therapy longer-lasting effects
o Research comparing treatments for major depressive disorder (2) ¦ Later studies • CT as effective as mediation for severe depression• CT more effective than medication at preventing relapse¦ CT more cost-effective long-term than medication
o Medications for bipolar disorder ¦ Lithium• Up to 80% receive at least some relief with mood stabilizer• Potentially serious side effect¦ Newer mood stabilizers• Anticonvulsantso Depakote• Antipsychoticso Zyprexa• Both also have serious side effects
Suicide ideation thoughts of killing oneself
Suicide attempt behavior intended to kill oneself
Suicide ¦ death from deliberate self-injury
Non-suicidal self-injury ¦ behaviors intended to injure oneself without intent to kill oneself
o Epidemiology of suicide and suicide attempts ¦ Men more likely to complete; women more likely to attempt¦ Guns are by far the most common means of suicide in the US (60%); men more lethal; women more likely to use pills¦ Suicide rate increases in old age
¦ Psychological disorders • Half of suicide attempts are depressed at the time of the act
¦ Neurobiological models • Heritability of 48% for suicide attempts• Low levels of serotonin• Overly reactive HPA system
¦ Social factors • Economic recession• Media reports of suicide• Social isolation and a lack of social belonging
¦ Psychological models • Problem-solving deficit• Hopelessness• Life satisfaction• Impulsivity
o Preventing suicide ¦ Talk about suicide openly and matter-of-factly¦ Most people ambivalent about suicide¦ Treat the associated mental disorder¦ Treat suicidality directly• Safety planning¦ Suicide prevention centers

Leave a Reply

Your email address will not be published. Required fields are marked *