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by: Hayoung Lee

textbook Psy 3315

Hayoung Lee
Texas State
GPA 3.9

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ch 7
Abnormal Psychology
\ Etherton
Class Notes
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This 11 page Class Notes was uploaded by Hayoung Lee on Friday October 7, 2016. The Class Notes belongs to Psy 3315 at Texas State University taught by \ Etherton in Fall 2016. Since its upload, it has received 2 views. For similar materials see Abnormal Psychology in Psychology at Texas State University.

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Date Created: 10/07/16
Abnormal psych Textbook notes CH 7 7.1 Mood disorders: an overview  Mood disorder – disturbances of mood that are intense and persistent enough to be clearly maladaptive  Depression – emotional state characterized by extraordinary sadness and dejection  Mania – emotional state characterized by intense and unrealistic feelings of excitement and euphoria  Unipolar depressive disorders – person experiences only depressive episodes  Bipolar and related disorders – person experiences both depressive and manic episodes  Depressive episode – person is markedly depressed or loses interest in formerly pleasurable activities (or both) for at least 2 weeks, as well as other symptoms such as changes in sleep, appetite, or feelings or worthlessness  Manic episode – person shows a markedly elevated, euphoric, or expansive mood, often interrupted by occasional outbursts of intense irritability or even violence o Persist for about a week for diagnosis o 3 or more additional symptoms must occur in the same time period from behavioral symptoms to mental symptoms  Hypomanic episode – person experiences abnormally elevated, expansive, or irritable mood for at least 4 days o Must have 3 other symptoms similar to those involved in mania but to a lesser degree  Major depressive episodes – aka unipolar major depression, a mental condition in which a person must be depressed for most of every day for most days for at least 2 weeks o Also a total of at least 5/9 designated symptoms must also be present  Quiz o People diagnosed with mania would be most accurately described as experiencing periods of  Excitement and euphoria o What is the defining characteristic of a mixed episode case of a mood disorder?  Experiencing rapidly alternating moods, such as sadness and euphoria, all within one episode of the illness o The minimum required duration of symptoms for a depressive episode is ____ and the minimum required duration of symptoms for a manic episode is ____.  2 weeks, 1 week Abnormal psych Textbook notes o A person who suffers from a less-severe form of mania that lasts for a minimum of 4 days might be described as experiencing a(n) _____ episode. It is typically less disruptive of a person’s life than a full episode of mania  Hypomania o Which of the following is the most reasonable sociocultural explanation for the increased incidence of major depressive disorder in people from lower socioeconomic statuses?  Low SES leads to greater levels of adversity and life stress 7.2 Unipolar Depressive Disorders  Major depressive disorder – must be in a major depressive episode, and never have had a manic, hypomanic, or mixed episode o Single episode if only one; recurrent if more than one o Depressive episodes usually last 6-9 months if untreated  Relapse – the return of symptoms within a fairly short period of time, reflects the fact that the underlying episode of depression has not yet run its course  Recurrence – the onset of a new episode of depression, probability of recurrence increases with number of prior episodes and also when person has comorbid disorders  Specifiers – different patterns of symptoms that sometimes characterize major depressive episodes that may help predict the course and preferred treatments for the condition  Major depressive episode with melancholic features – marked symptoms of loss of interest/pleasure in almost all activities, plus at least 3/6 other designated symptoms  Severe major depressive episode with psychotic features – involves loss of contact with reality, often in the form of delusions or hallucinations  Mood congruent – delusions or hallucinations that are consistent with a person’s mood Specifier Characteristic Symptoms Melancholic Three of the following: early morning awakening, features depression worse in the morning, marked psychomotor agitation/retardation, loss of appetite/weight, excessive guilt, qualitatively different depressed mood Psychotic Delusions or hallucinations (usually mood congruent); features feelings of guilt and worthlessness common Atypical features Mood reactivity – brightens to positive events; 2/4 following symptoms: weight gain or increase in appetite, hypersomnia, leaden paralysis (arms and legs feel heavy as lead), being acutely sensitive to interpersonal rejection Catatonic A range of psychomotor symptoms from motoric Abnormal psych Textbook notes features immobility to extensive psychomotor activity, as well as mutism and rigidity Seasonal Pattern At least 2 or more episodes in the past 2 years that have occurred at the same time (usually fall or winter), and full remission at the same time (usually spring). No other non-seasonal episodes in the same 2-year period  Persistent depressive disorder – characterized by persistently depressed mood most of the day, for more days than not, for at least 2 years (1 year for children + adolescents) o 2/6 additional symptoms when depressed  Double depression – person with dysthymia has a superimposed major depressive episode  4 phases of normal response of loss o 1. Numbing and disbelief o 2. Yearning and searching for dead person o 3. Disorganization and despair that sets in when person accepts the loss as permanent o 4. Some reorganization as the person gradually begins to rebuild his/her life  Postpartum blues: changeable mood, crying easily, sadness, irritability Quiz  Which of the following details would exclude a person from receiving a diagnosis of major depressive disorder? o Having experienced a hypomanic episode in the past  What is the relationship between the experience of depressive symptoms and significant levels of anxiety? o There is a very high level of comorbidity between depressive and anxiety disorders  How might one most aptly distinguish between a relapse and a recurrence of depressive symptoms? o A relapse is a re-emergence of previous symptoms; a recurrence is the emergence of a new episode of depression  According to research presented in this module, somewhere between ____ and ___ percent of adolescents experience either major depressive disorder or subclinical levels of depression at one point o 25;40  Marcellus has been struggling with the symptoms of a major depressive episode for quite some time. Dr. Ting, his therapist, notes that Marcellus meets the criteria for a major depressive episode, and in addition seems to have lost interest or pleasure in almost all activities, and that he recently turned down a chance to go to a concert of his Abnormal psych Textbook notes favorite musician for no discernable reason. The diagnosis of major depressive disorder would probably best include the specifier of o With melancholic features 7.3 Casual Factors in Unipolar Mood Disorders  Family studies have shown the prevalence of mood disorders is about 2-3x higher among blood relatives of persons with clinically diagnosed unipolar depression than the population at large  Distinction between stressful life events that are independent of the person’s behavior and personality o Independent: losing a job because one’s company is shutting down or having one’s house hit by a hurricane o Dependent: events that may have been at least partly generated by the depressed person’s behavior or personality  Dysfunctional beliefs – negative beliefs that are rigid, extreme, and counterproductive  Depressogenic schemas – dysfunctional beliefs that are rigid, extreme, and counterproductive and that are thought to leave one susceptible to depression when experiencing stress  Negative automatic thoughts – thoughts that often occur just below the surface of awareness and involve unpleasant, pessimistic predictions  Negative cognitive triad – includes self (“I’m worthless), world (“no one loves me”), and future (“it’s hopeless because things will always be this way”)  Dichotomous or all-or-none reasoning – tendency to think in extremes  Selective abstraction – tendency to focus on one negative detail of a situation while ignoring other elements of the situation  Arbitrary inference – involves jumping to a conclusion based on minimal or no evidence  Learned helplessness – a theory that animals and people exposed to uncontrollable aversive events learn that they have no control over these events and this causes them to behave in a passive and helpless manner when later exposed to potentially controllable events. Later extended to become a theory of depression  Attributions – process of assigning causes to things that happen o 1. Internal/external o 2. Global/specific o 3. Stable/unstable  Pessimistic attributional style – cognitive style involving a tendency to make internal, stable, and global attributions for negative life events  Rumination – the process of going over and over in one’s mind or going over a thought repeatedly time and again Abnormal psych Textbook notes  According to twin studies, monozygotic twins who have a co-twin with major depressive disorder are about ____ as likely as dizygotic twins to develop depression o Twice  Levinia has been going through a very difficult time lately, with both an increase in life stressors and the emergence of depressive symptoms. If her physician were to take a sample of blood from her, it is likely that she would find elevated levels of which stress hormone? o Cortisol  Why is seasonal affective disorder much more common in the fall and winter months than in spring and summer? o Those seasons provide a reduction in the amount of available light  In a single word, what did Sigmund Freud was at the root of most people’s symptoms of depression? o Loss  Which researcher was the first to propose the idea of learned helplessness as being a significant contributing factor to the symptoms of a major depressive episode? o Martin Seligman 7.4 Bipolar and Related Disorders  Bipolar disorders – mood disorders in which a person experiences both manic and depressive episodes  Cyclothymic disorder – the repeated experience of hypomanic symptoms for a period of at least 2 years o Must be a 2 year span of numerous periods with hypomanic and depressed symptoms (1 for adolescents and children) o Symptoms must cause clinically significant distress or impairment in functioning o Greater risk of bipolar 1 or 2 disorder  Bipolar I disorder – the person experiences both manic (or mixed) episodes and major depressive episodes o Person has full blown mania  Mixed episode – characterized by symptoms of both full-blown manic and major depressive episodes for at least 1 week, either intermixed or alternating rapidly every few days  Bipolar II disorder – the person does not experience full blown manic (or mixed) episodes but has experienced clear-cut hypomanic episodes as well as major depressive episodes.  Bipolar disorder with a seasonal pattern – bipolar disorder with recurrences in particular seasons of the year Abnormal psych Textbook notes  ____ disorder is marked by repeated experiences of hypomanic symptoms for a period of at least _____. o Cyclothymic; 2 years  Why is a person who demonstrates symptoms of mania without any history of depression still given a diagnosis of bipolar disorder? o It is assumed that either they have an undiagnosed depressive symptoms or that such symptoms will occur in the future  Which of the following individuals exhibit symptoms that are consistent with a diagnosis of bipolar II? o Zenia alternates between hypomanic and depressive symptoms  In order for a person with bipolar disorder to be described as having a rapid cycling pattern, he or she would have to have at least _____ episodes of manic/depressive episodes in a given year o 4 7.5 Causal Factors in Bipolar Disorders  The average concordance rate for bipolar disorder is about ____ percent for monozygotic twins, compared to ____ percent for dizygotic twins. o 60;12  Several different neurotransmitters seem to be involved in the regulation of mood states in human beings. They include all but which of the following? o Acetylcholine  Henry suffers from bipolar disorder and experiences one or two manic episodes in a given year, more when he is not taking his medication. Between episodes, which of the following symptoms is he most likely to experience? o Substantial sleep difficulties 7.6 Sociocultural Factors Affecting Unipolar and Bipolar Disorders  Lao lives in China, where he has resided with his family for his entire life. Recently he has begun experiencing symptoms of depression. Which symptom would he most likely demonstrate, given the cultural influences of his surroundings? o Loss of sexual interest Abnormal psych Textbook notes  In the 2004 World Mental Health Study conducted by the World Health Organization, the prevalence and characteristics of psychological disorders was examined in 20 different countries. The 12-month prevalence rate of depression rate was round to be lowest in o Nigeria  Jarli is a young Australian Aboriginal who lives in a native community in the northern territory of Australia. If Jarli was clinically depressed, what types of behaviors is he likely to exhibit? o Venting of hostilities onto others might be observed 7.7 Treatments and Outcomes  Monoamine oxidase inhibitors (MAOIs) – first category of antidepressants that inhibit the action of monoamine oxidase, the enzyme responsible for the breakdown of norepinephrine and serotonin once released  Tricyclic antidepressants – increase neurotransmission of the monoamines, primarily norepinephrine and to a lesser extent serotonin, used to treat depression sometimes anxiety disorders, are thought to block the reuptake of norepinephrine and serotonin at the synapse  Selective serotonin reuptake inhibitors (SSRIs) - medication that inhibits serotonin and is used in the treatment of depression  Lithium – a common salt that consists of a soft, silver white metal; it has been found to reduce the symptoms of bipolar disorder although it has a number of negative side effects  Electroconvulsive therapy (ECT) – use of electricity to produce convulsions and unconsciousness; a treatment used primarily to alleviate depressive and manic episodes. Aka electroshock therapy  Transcranial magnetic stimulation (TMS) – noninvasive technique allowing focal stimulation of the brain in patients who are awake. Brief but intense pulsating magnetic fields that induce electrical activity in certain parts of the cortex are delivered  Deep brain stimulation – implanting an electrode in brain then stimulating that area with electric current  Brain light therapy – for non-seasonal depression  Cognitive-behavioral therapy (CBT) – originally developed by Beck, therapy based on altering dysfunctional thoughts and cognitive distortions  Mindfulness based cognitive therapy – for people with highly recurrent depression, change the way in which people relate to their thoughts, feelings, and bodily sensations Abnormal psych Textbook notes  Behavioral activation treatment – focuses intensively on getting patients to become more active and engaged with their environment and with their interpersonal relationships  Interpersonal therapy (IPT) – time limited psychotherapy approach that focuses on the interpersonal context and on building interpersonal skills  Which of the following people has the least likelihood of receiving some sort of treatment? o Ulie, who has been diagnosed with a mild to moderate case of major depressive disorder  Why might a physician be somewhat unwilling to give a person with major depressive disorder a prescription for monoamine oxidase inhibitors (MAOIs) as the first pharmaceutical approach to addressing their symptoms? o These drugs can have severe, even fatal side effects of foods containing a specific amino acid that are consumed while on the medication  Generally speaking, a person who has just started taking antidepressants should not expect to experience a significant reduction in depressive symptoms for about o 3-5 weeks  Which of the following is one of the benefits offered by transcranial magnetic stimulation for the treatment of mood disorders? o The treatment does not cause any deficit in cognitive performance or memory skills like those that occur with electroconvulsive therapy (ECT)  What type of therapy aimed at the treatment of depression involves meditation techniques that emphasize patient’s awareness of unwanted thoughts, feelings, and sensations? o Mindfulness-based cognitive therapy 7.8 Suicide: The Clinical Picture and The Casual Pattern  Suicide – intentionally taking one’s on life  Non-suicidal self injury (NSSI) – direct, deliberate destruction of body tissue (often taking the form of cutting or burning one’s own skin) in the absence of any intent to die  Concordance rate in identical: 3x higher than in fraternal  Perceived burdensomeness: feeling like a burden to others  Thwarted belongingness: feeling alone Abnormal psych Textbook notes  Acquired capability for suicide: believed to be acquired through pain or provocative experiences  The disorder that is most commonly linked to suicide is o Depression  Angelina is 12-years old, and several times a week she sits in a locked bathroom in her home and uses a razor blade to cut the insides of her thighs. The practice is painful to her, but she experiences that pain as a positive sensation rather than a negative one. Angelina’s behavior would be classified as o Non-suicidal self injury (NSSI)  While suicide is relatively rare among children, the prevalence of such behaviors increases starting at around age ___ and continues to increase to the early mid 20s. o 12  Which figure, described in your text as the “godfather of suicide research” has written extensively about what constitutes a suicidal mind? o Shneidman 7.9 Suicide Prevention and Intervention  Objectives to help coping o 1. Maintaining supportive and often highly directive contact with the person over a short period of time – usually one to six contacts o 2. Helping the person to realize that acute distress is impairing his or her ability to assess the situation accurately and to see that there are better ways of dealing with the problem o 3. Helping the person to see that the present distress and emotional turmoil will not be endless  The Food and Drug Administration (FDA) has required pharmaceutical companies to place warnings on the packaging for antidepressant medications that state that these drugs might o Increase the risk of suicidal behaviors  Since the 1960s, the availability of competent assistance at times of suicidal crisis has been expanded through the establishment of o Suicide hotlines  In classical Greece, a person who was extremely ill could o Petition the state and receive permission to end his life  Mood disorders have previously been referred to as _____ disorders, as they involve extremes of emotions – soaring elation or deep depression – that dominate the clinical picture o Affective Abnormal psych Textbook notes  Research consistently finds higher rates of depression-related problems in adolescent girls as compared to adolescent boys. Which of the following is one of the explanations for why this occurs? o Negative cognitions about attractiveness and body image are more salient for girls than for boys  How might one support the statement that the development of major depressive disorder has moderate genetic contributions? o The co-twin of a monozygotic twin with major depressive disorder is twice as likely to develop the condition as are dizygotic co-twins  Which of the following would be the correct combination of neurotransmitter activities during different stages of bipolar disorder? o Increased norepinephrine activity during manic episodes and decreased serotonin activity during depressed and manic stages  Rennette has been suffering from the symptoms of major depressive disorder for several months, and her psychiatrist has prescribed a new type of medication. She is told that she must avoid foods that contain the amino acid tyramine, including red wine, salami, beer, and aged cheese. What kind of medication has Rennette been prescribed? o A monoamine oxidase inhibitor (MAOI)  Approximately _____ percent of adolescents and young adults have engaged in at least 1 suicidal self injury behavior, often with the goal of decreasing high levels of distress and eliciting help from others o 15-20  Research of finding an increase in _____ among adolescents taking antidepressant medications vs placebos prompted the Food and Drug Administration to place a warning on the labels of such medications alerting the public to this risk o Suicidal thoughts and behaviors  In the United States, the first state to pass a Death with Dignity Act in 1994 was _____. This gave physicians legal permission to prescribe a lethal dose of medication for a terminally ill patient to ingest on their own o Oregon  Among children who are diagnosed with depression o Boys are equally likely or slightly more likely than girls to be diagnosed  EEG sleep studies of persons with depression reveal that depressed persons on the average _____ when compared to persons who are not depressed o Enter REM sleep 15-20 minutes earlier after going to bed, and spend a lower than normal amount of time in stage 3-4 sleep  It is estimated that about _____ of people with a first onset of depression have experienced a recent major stressful life event o 70% Abnormal psych Textbook notes  In addition to being effective in the treatment of severe depression, electroconvulsive therapy (ECT) has proven to be effective in treating about 80% of cases of ____. o Manic episodes


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