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Chapter 7: Depressive and Bipolar Disorders

by: Justin Sequerra

Chapter 7: Depressive and Bipolar Disorders PSY 4343

Marketplace > University of Texas at Dallas > Psychlogy > PSY 4343 > Chapter 7 Depressive and Bipolar Disorders
Justin Sequerra
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These notes will cover what we have discussed about Depressive and Bipolar Disorders.
Abnormal Psychology
Dr. David Farmer
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This 8 page Class Notes was uploaded by Justin Sequerra on Sunday February 21, 2016. The Class Notes belongs to PSY 4343 at University of Texas at Dallas taught by Dr. David Farmer in Winter 2016. Since its upload, it has received 172 views. For similar materials see Abnormal Psychology in Psychlogy at University of Texas at Dallas.


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Date Created: 02/21/16
ABNORMAL PSYCHOLOGY CHAPTER 7: DEPRESSIVE AND BIPOLAR DISORDERS This general outline is meant as a supplement to the Abnormal Psychology (4343) course  taught at the University of Texas at Dallas and should not be taken as a standalone study  guide for the overall curriculum. However, I do hope that this broad summary of the textbook  (where most of this information comes from) helps you all in becoming successful  undergraduate students here at UTD. ­ Justin Sequerra, “Normal people scare me.” – American Horror Story 1 DEPRESSIVE AND BIPOLAR DISORDERS UNIPOLAR DEPRESSION: THE DEPRESSIVE DISORDERS How Common is Unipolar Depression?  Depressive Disorders:  Unipolar Depression—Bipolar Disorder—Unipolar Mania (This spectrum illustrates that on one side depression is  dominant while on the other pole, mania is dominant; Bipolar  Disorder has both bouts of mania and depression) What Are the Symptoms of Depression?  Emotional ­  “miserable”, “empty”, or “humiliated” ­ May lead to anhedonia (inability to experience any  pleasure), crying spells, or anxiety/anger/agitation  Motivational ­ “paralysis of will” (lack of drive, initiative or spontaneity) ­ Suicide (6%­15%) seems like an escape from an  “uninteresting life” for many people with depression  Behavioral ­ More time alone and in bed (overall less active or  productive)  Cognitive ­ Hold very negative views of themselves ­ Pessimism  Procrastination  Suicidal Vulnerability ­ Perform poorly on memory, attention, and reasoning skills (might be due to motivation and not cognitive)  Physical ­ Depressions are often misdiagnosed as medical problems  (headaches, indigestion, dizzy spells, etc.) ­ Disturbances of appetite and sleep patterns=common Diagnosing Unipolar Depression?  Major Depressive Episode ­ Period: 2 or more weeks; Symptoms: At least 5 ­ Extreme: Delusions (bizarre ideas w/o foundation) or  hallucinations (perception of things that are nonpresent)  Major Depressive Disorder (no history of mania) ­ May be seasonal, catatonic (immobile/excessive activity),  peripartum (during pregnancy; most commonly called  postpartum), and melancholic (anhedonia)  Persistent Depressive Disorder ­ Duration: At least 2 years ­ May be w/ major depressive episodes, or w/ dysthymic  syndrome (less severe; able to go through daily functions) Note: Psychology professors prefer to see the exact definitions of specific terminology  whenever they are grading essays. DEPRESSIVE AND BIPOLAR DISORDERS WHAT CAUSES UNIPOLAR DEPRESSION?  Often triggered by stressful events (more so than any other disorder)  May be reactive (exogenous) depression (result of stressful events) or endogenous  depression (response to internal factors) The Biological View:  Genetic Factors ­ 4 Kinds of research state that people inherit depression: Family Pedigree, Twin, Adoption, and Molecular Biology Gene studies ­ Family Pedigree: Compare probands (depressed person=focus of genetic study) to relatives ­ Adoptions Studies: Concluded that at least severe depression is more likely to be caused by  genetic factors than more mild cases ­ Molecular Biology Gene: Abnormality of serotonin transporter gene (5­HTT)  low serotonin  level  prone to depressive symptoms  Biochemical Factors ­ Linked depression to epinephrine and serotonin (now believe it is caused by these NT’s  interactions with other NTs rather than just the individual serotonin/epinephrine levels) ­ Endocrine: Caused by high levels of cortisol (stress reactions) or melatonin, (Dracula  hormone) which is only released in the dark (explains why people are more depressed at  night) ­ Also may be due to deficiencies of chemicals within some neurons, especially brain­derived  neurotrophic factor (BDNF) which impairs the health of neurons ­ Limits: Relies on analogue studies which creates depression­like symptoms in lab animals  Brain Anatomy and Brain Circuits ­ Brain Circuit responsible for depression involves: prefrontal cortex (high or low activity),  hippocampus, amygdala, Brodmann Area 25 (under cingulate cortex) (full of serotonin and 5­ HTTs) ­ Hippocampus: Involved in neurogenesis (formation of new neurons); decreases with  depression ­ Amygdala: negative emotions and memory (increased activity due to depression) ­ Brodmann Area 25: “depression switch”; tends to be small/more active with depression  The Immune System ­ Induced stress  immune system dysregulation  low function of lymphocytes and increased  production of C­reactive protein (CRP) (causes inflammation and other illnesses) The Psychological Views:  The Psychodynamic View (no strong support) ­ Freud/Abraham note similarities between depression and grief ­ Loved one dies  regress to oral stage (total dependency on others)  introjection  (direct all feelings toward the loved one; even merge into their identity) ­ For some, introjection is temporary, but for others it is long­lasting (due to the lack of  or excessive treatment by parents during the oral stage) ­ Become depressed w/o losing someone: Freud equated a stressor event with the loss of a loved one with the term Symbolic Loss ­ Influenced object relations theorists who emphasize how relationships may affect  ones depression ­ Anaclitic depression studies (separation from mother) and early childhood losses  have offered general support to the idea ­ Limits: parenting is not typically responsible for the disorder, inconsistent findings  between studies, and some are impossible to test (symbolic loss)  The Behavioral View (moderate support) ­ Peter Lewinsohn: positive rewards dwindle over time  fewer constructive behaviors   depression spiral (social rewards are particularly important) ­ Limits: Relies too heavily on self­reports (biased); also correlational (≠causation)   Cognitive Views (considerable support) ­ Two leading explanations: theories of negative thinking and learned helplessness Negative Thinking (most influential): ­ Aaron Beck believes that maladaptive attitudes, a cognitive triad (definition in  sidebar), errors in thinking, and automatic thoughts lead to unipolar depression ­ Maladaptive attitudes: made as a kid; “If I fail, others will be repelled by me” ­ Common error of logic: draw arbitrary inferences with little evidence (“She’s trying  not to look at me”); Minimizes successes and magnifies failures ­ Automatic Thoughts: like obsessions (they are intrusive thoughts) but they suggest  that the person is inadequate ­ Studies have found that ruminative responses (repeatedly dwell on their depressed  mood w/o trying to change it) are more likely to develop clinical depression Learned Helplessness: ­ Created by Martin Seligman after his experiment with dogs, where he continually  shocked these dogs no matter what they did. By putting them into a state of learned  helplessness (one’s belief that he/she cannot change his/her situation), Seligman  found out that they couldn’t pass any other tests since they gave up with minimal  effort. ­ New version of theory (Attribution­helplessness theory) where when people view  events as beyond their control, they ask why this is so. If they attribute it to internal,  global, and stable factors (rather than to external,  4 specific, or unstable factors), they are more likely  going to develop depression. Sociocultural Views:  The Family­Social Perspective ­ Lack of social rewards from behavioral explanations also  ties in with this perspective ­ Researchers have found that depressed people often have poor social skills and unavailable social supports  (especially when it comes to marriage). Those w/ isolated  lives and a lack of intimacy are also prone to depression.  The Multicultural Perspective Gender and Depression ­ Young women are twice as likely than men to  experience unipolar depression (reasons following) ­ Artifact Theory: men and women are equally prone to depression but clinicians detect it more easily in  women (more emotional vs. more socially guarded);  not consistent with many findings ­ Hormone Explanation: Women experience more  frequent changes in hormone levels (criticized for  being sexist) ­ Life Stress Theory: Women experience more stress  than men (due to sexual discrimination) ­ Body Dissatisfaction Explanation: Western cultural  goals have set unreasonably high standards for  women (doesn’t cause it but it may be a result of  depression) ­ Lack­of­Control Theory: Have less control over their  lives than men (learned helplessness), especially  after victimization. ­ Rumination Theory: Those who ruminate on their  depressed mood more and longer, are the ones who  tend to stay depressed (women ruminate more than  men). Cultural Background ­ Most non­Westernized societies are more troubled  by the physical symptoms of depression while more  Westernized ones take on more of the cognitive  afflictions (self­blame). ­ No overall differences in the rate or symptoms of  depression could be found between ethnic lines, but  chronicity (likelihood of recurrence) was higher in  5 African Americans and Hispanics (due to limited  treatment or socioeconomic conditions) Note: Psychology professors prefer to see the exact definitions of specific terminology whenever they are grading essays. DEPRESSIVE AND BIPOLAR DISORDERS BIPOLAR DISORDERS What Are the Symptoms of Mania?  Emotional ­ Powerful emotions range from euphoric joy to irritability  Motivational ­ They seek out constant excitement and involvement, not  realizing that their social style might feel excessive  Behavioral ­ Their manner is usually active in talk and flamboyant  style; have inflated sense of self (grandiosity)  Cognitive ­ Show poor judgment or planning (move too fast to  consider dangers); may lose their touch with reality  Physical ­ Little sleep and always energetic even w/o sleep Diagnosing Bipolar Disorders  Manic Episode (at least one week with 5 symptoms) ­ May be extreme (delusions/hallucinations) but they may  also be mild (called hypomanic episode)  Bipolar I  Disorder (see definition in sidebar) ­ May experience alternation of episodes (week of mania,  week of wellness, week of depression) or mixed where  they experience both mania and depression in the same  period (racing thoughts with feelings of sadness)  Bipolar II Disorder (see definition in sidebar) ­ Finish huge amounts of work during hypomanic periods ­ Overall, the depression periods occur more often and are  longer than manic episodes; bipolar I is more common  than bipolar II; all have more medical issues ­ More than 4 episodes in a year = rapid cycling  Cyclothymic Disorder (see definition in sidebar) ­ 2 or more years to be diagnosed, interrupted by normal  periods, and begins during adolescence What Causes Bipolar Disorders?  Neurotransmitters ­ Often linked to the over­activity of epinephrine (unlike  depression) as well as the low activity of serotonin (like  depression)  Ion Activity ­ Irregularities in the transportation of ions across the neural  membrane (which helps conduct the electrical impulses that  traces its way down a neurons axons) may cause neurons to fire too easily (mania) or not (depression)  Brain Structure ­ Basal ganglia and cerebellum tend to be smaller, lower volumes of gray matter, and more structural abnormalities  Genetic Factors ­ Family pedigree, genetic linkage, and molecular biology techniques have found that some X chromosome genes have been linked to bipolar disorders DEPRESSIVE AND BIPOLAR DISORDERS *PRACTICE QUESTIONS* 1. According to Freud’s psychodynamic theory, the first stage of response to loss is called introjection where the individuals regresses to the:  A) Anal Stage  B) Oral Stage   C) Phallic Stage   D) Latency Stage 2. Which of the following is one of the most influential theories of depression?  A) Beck’s Cognitive Theory B) Freud’s Psychodynamic Theory  C) Seligman’s Learned Helplessness Theory  D) Lewinsohn’s Positive Rewards Theory 3. The attribution­helplessness theory of depression proposes that those who are likely to become depressed attribute negative life events in which of the following ways? A) Internal, Stable, Specific  B) Internal, Unstable, Specific  C) External, Stable, Global  D) Internal, Stable, Global 4. In major depression, hippocampal abnormalities are regularly linked with which of the following?  A) High Levels of Cortisol   B) Low Levels of Cortisol   C) High Levels of Dopamine   D) Low Levels of Dopamine 5. Researchers believe that the brain circuit involved in unipolar depression includes:  A) Hypothalamus, Brodmann Area 25, Corpus Collosum, Anterior Cingulate Cortex 7 B) Prefrontal Cortex, Anterior Cingulate Cortex, Amygdala, Basal Ganglia   C) Prefrontal Cortex, Hippocampus, Amygdala, Brodmann Area 25   D) Hippocampus, Brodmann Area 25, Corpus Collosum, Hypothalamus


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