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Abnormal Psych, Week 5 notes

by: Rachael Eddowes

Abnormal Psych, Week 5 notes Psys 170

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Rachael Eddowes
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About this Document

General notes on Chapter 6 in Beidel book and Lecture
Abnormal Psychology
Dr. Kelly Rohan
Class Notes
abnormal psych, Abnormal psychology, Bipolar disorder, depression




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This 5 page Class Notes was uploaded by Rachael Eddowes on Tuesday October 4, 2016. The Class Notes belongs to Psys 170 at University of Vermont taught by Dr. Kelly Rohan in Spring 2016. Since its upload, it has received 6 views. For similar materials see Abnormal Psychology in Psychological Science at University of Vermont.

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Date Created: 10/04/16
Depressive and Bipolar Disorders th Sept 30  Lecture A) Overview of Mood Disorders (cover each more closely in separate slides/sections) 1. Types of Episodes (three types) a. Major depressive episodes b. Manic and hypomanic episodes 2. DSM­5 Depressive Spectrum Disorders a. Major Depressive Disorder b. Persistent Depressive Disorder c. Double Depression 3. DSM­5 Bipolar Spectrum Disorders a. Bipolar I Disorder b. Bipolar II Disorder c. Cyclothymic Disorder B) Mood Disorders vs. Depressed Mood 1. Can be looked at/thought of on a continuum of mood (this class focuses on the disorders  at the tails of the bell curve) 2. Mood disorders differ from sadness; causes disabling disturbance, personal distress,  dysfunction a. Intensity­ tails of bell curve, the extremes b. Duration­ long periods of time, cannot stop for certain durations of time, re­ occurring c. Impact­ personal distress/dysfunction d. Symptoms­ the total number, how many at once or lifetime C) Major Depressive Episode (MDE) 1. To be diagnosed, must have 5 of more of the following symptoms daily for 2 weeks and  at least one star is a must: a. *Sad or depressed mood b. *Loss of interest in activities­ individually based, but a sense of not feeling the  usual enjoyment for regular activities c. Sleep difficulties­ hypersomnia (sleeping too much) or insomnia (having  difficulty falling asleep). Always total number of hours spent asleep per day d. Significant weight or appetite change­ increase or decrease of 5% body change e. Loss of energy or fatigue f. Psychomotor retardation/agitation­ movement or speech disturbances g. Sense of worthlessness or guilt (example: Wayne Brady the comedian revealed  his struggle with MDE and in an interview this trait was president) h. Difficulty concentrating or making decisions i. Recurrent thoughts of suicide or death D) Major Depressive Disorder (MDD) Epidemiology 1. Clinical depression 2. Single episode­ uncommon 3. Recurrent episodes­ most common, appear and feel like a tsunami 4. Almost all cases are recurrent and 85% who have one episode will most likely have  another. Basically, with each episode, there is increased risk for another episode. 5. Mean MDE duration is 4 months 6. World­wide lifetime prevalence is 16% a. In the US, according to the NCS­R: whites= 17.9%, non­Hispanic blacks=  10.8%, and Hispanics= 13.5% 7. More common in women 2:1 8. Mean age of onset MDD is 25 yrs.­old (the range is 18­30) a. “Fun” fact: replicated around the world, the age range is getting younger E) Persistent Depressive Disorder (PDD) (old term: Dysthymia) 1. Milder symptoms than MDD 2. Has to have been prevalent for 2 yrs. or longer (cannot have not had the symptoms for 2  months during this time) a. *Depressed mood­ essential symptom b. Poor appetite/overeating c. Insomnia/hypersomnia d. Low energy e. Low self­esteem f. Poor concentration/difficulty making decisions g. Hopelessness 3. There are parallels between MDD and PDD, but with PDD being less severe 4. Greater toll than MDD (which only lasts between 2­16 weeks) F) Persistent Depressive Disorder Epidemiology 1. Mean duration of 5 yrs. (can persist unchanged over long periods of time) 2. Late onset is early 20s 3. Early onset is before age 21 (if developed early, then there is a greater chance of  chronicity/more risk over the lifetime. These people tend to not respond as well to  treatment and have stronger family history (genetic component) with mental health  disorders) 4. World­wide prevalence is 3.6% G) Double Depression 1. Not in DMS­5, but can be paired 2. MDEs + PDD 3. PDD (Dysthymia) develops first (has chronic low­grade depression that then leads to  MDE break through) 4. ~80% of PDD cases will have an MDE 5. Associated with a. Severe psychopathology b. Problematic future course c. High recurrence when dysthymia is untreated (target point for  treatment/therapy) H) Bipolar I Disorder (used to be called manic disorder) 1. At least one manic episode, usually alternates with MDE 2. Alternate between manic and depressed mood, time length varies person and episode 3. Manic episode symptoms: a. *Elevated, expansive, or irritable AND increase goal­directed activity OR  energy 1. If diagnosed elevated or expansive, then only need 3 other symptoms  below. If irritable, then need 4 other symptoms below. 2. Goal­directed activity includes work projects, social relationships, and  hyper sexuality. b. Inflated self­esteem c. Reduced need for sleep d. Unusual talkativeness, rapid speech e. Flight of ideas, racing thoughts f. Distractibility g. Excessive high­risk, pleasurable activities h. Hyperactivity (work, social, sexual) 4. Goal­directed and hyperactivity are part of the DSM­5 diagnosis; however, it is  technically double­counting. Current clinical psychologists are questioning APA. I) Bipolar I vs. Bipolar II Bipolar I Disorder Bipolar II Disorder One or more manic  One or more hypomanic  episodes episodes. (hypo­ just below  manic, doesn’t last as long) Manic symptoms last  Hypomanic symptoms last  more than 1 week (or  more than 4 days less if hospitalized) Marked impairment An observable change Mania usually alternates Hypomania alternates with  with major depression major depression 1. Stress is a huge trigger as to the onset of a Bipolar disorder J) Bipolar Disorders Epidemiology 1. World­wide prevalence= 1% a. US NCS­R: .9% males and 1.3% females 1. Women have more MDEs with less hypomanic/manic episodes, whilst  men are the opposite. b. Whites more commonly diagnosed than African Americans, who have the  same criteria, but often get diagnosed with schizophrenia  2. Bipolar I a. Average age of onset is 18 yrs. b. Tends to be chronic c. Suicide common (15% rate) 3. Bipolar II a. Average age of onset is 22 yrs. b. 10­13% of cases progress to Bipolar I (Because of this, it suggests  categorically distinct disorders) c. Tends to be chronic Depresrdve and   polar Disorders Oct 3  Lecture A) Cyclothymic Disorder 1. Cyclothymic; longer lasting, less severe form of Bipolar disorder, mania, and MDE a. Highs not as high, lows not as low b. Depression does not hit threshold for MDE or PDD c. Able to blend into society easily 2. Lasts ≥ 2 yrs. (Can’t be without it for less than 2 months within this period) 3. Lifetime prevalence = 1% 4. Mean age of onset = 12­14 yrs. 5. Tends to be lifelong 6. Most cases are female 7. High risk for developing Bipolar I or II (normally 1 out of 3 people) B) Premenstrual Dysphoric Disorder (PMDD) 1. Fairly new addition to DSM; was in previous DSM for future studies, but now there are  treatments and drugs available 2. Confirmand by: women take home a rating scale chart they must fill out daily over the  course of two consecutive cycles (this helps make sure women themselves aren’t buying  into the stereotype) 3. Have 5 or more symptoms in the late luteal phase 4. One or more: affective lability, irritability/anger, depressed mood, anxiety/tension 5. Also one or more: anhedonia (loss of interest), decrease concentration, fatigue, appetite  change, sleep disruption, feeling overwhelmed, physical symptoms (tender breasts, sore  joints, feeling of being bloated) 6. Have to question: are we labeling normal body systems as disorders? Stereotyping the  “hysterical” woman? C) Mood Disorders Specifiers Anxious Distress Anxiety symptoms Mixed ≥ 3manic symptoms + MDE (co­occurring) Atypical Oversleep, overeat, weight gain (only MDE and PDD). Tend to  get better. Melancholic Severe depressive and somatic symptoms (early morning  wakening). More difficult to treat. Catatonic Absence of movement, serious (MDE and manic; strange  freezing and body position manipulation). Difficult to treat. Psychotic Hallucinations/delusions Peripartum (used  During pregnancy or after childbirth (13% of women develop  to be postpartum, this; usually those with a past mental health history) but now it is  during and after) D) Seasonal Pattern Specifiers 1. Regular relationship between MDE onset and a time of year 2. Remission (or change to mania or hypomania) at a particular time of year (has to go away at a specific time/duration). Has to be this pattern over the last 2 yrs. 3. Seasonal MDEs substantially outnumber non­seasonal MDEs over life (required) 4. Normally happens over winter season, but there is summer depression that is to heat and  humidity. E) Seasonal Affective Disorder (SAD) Symptoms Atypical Typical Depression *Decreased energy (always present) Depressed mood *Increased appetite/weight Loss of interest Carbohydrate craving     (related) Impairment *Increased sleep length (+ naps) Decreased interest in sex Afternoon/evening mood or energy  Decreased concentration slump F) SAD Prevalence  1. US prevalence increases with latitude (9.7% New Hampshire, 5% Washington, D.C.,  1.4% Florida) 2. Mean age of onset is mid 20s 3. 61% MDD, 34% Bipolar II, 5% Bipolar I 4. More common in women 2:1 5. Mean length of MDE = 5 months of the year every year.


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