Chapter 8 Book Notes
Chapter 8 Book Notes psy 240
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This 11 page Class Notes was uploaded by Alicia Rinaldi on Tuesday September 8, 2015. The Class Notes belongs to psy 240 at University of Miami taught by Dr. Parlade in Fall 2014. Since its upload, it has received 38 views. For similar materials see abnormal psychology in Psychlogy at University of Miami.
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Date Created: 09/08/15
Chapter 8 Disorders of Mood l Preface A Depression a low sad state marked by signi cant levels of sadness lack of energy low selfworth guilt or related symptoms B Mania a state or episode of euphoria or frenzied activity in which people may have an exaggerated belief that the world is theirs for the taking C Depressive disorders the group of disorders marked by unipolar depression D Unipolar depression depression without a history of mania E Bipolar disorder a disorder marked by alternating or intermixed periods of mania and depression F There is no such thing as unipolar mania ll Unipolar Depression The Depressive Disorders A How Common is Unipolar Depression 1 8 in any given year 19 t some point in their lives 2 can be suffered at any age 3 women are at least twice as likely as men 4 85 recover 40 have at least one other episode B What are the Symptoms of Depression 1 Emotional Symptoms a Feel sad amp dejected b Lose sense of humor amp get little pleasure from anything c Anhedonia inability to experience any pleasure at all d Some experience anxiety anger or agitation 2 Motivational Symptoms a Lose desire to pursue activities b Lack of drive initiative spontaneity described as quotparalysis of willquot c 615 of people suffering from depression will commit suicide 3 Behavioral Symptoms a Less active amp productive b Spend time alone amp stay in bed 4 Cognitive Symptoms a Hold negative views of themselves i Inadequate undesirable inferior evil b Blame themselves c Pessimism feeling like nothing will improve and expecting the worst i Leads to procrastination d Complain about poor intellectual ability i Perform worse on tasks of memory attention and reasoning 5 Physical symptoms a Headaches indigestion constipation dizzy spells general pain b Disturbances in sleep and appetite i Could sleep more or less than normal C Diagnosing Unipolar Depression 1 Major depressive episode 2 or more weeks marked by at least 5 symptoms of depression a May include psychotic symptoms i Delusions bizarre ideas without foundann ii Hallucinations perceptions of things that aren t actually present Major depressive disorder a severe pattern of depression that is disabling and is not caused by such factors as drugs or a general medical condition a Recurrent preceded by previous episodes b Seasonal changes with the seasons c Catatonic marked by immobility or excessive activity d Postpartum occurs within 4 weeks of giving birth e Melancholic totally unaffected by pleasurable events f If someone has a manic period at a later time the diagnosis is changed to a bipolar disorder Persistent depressive disorder if a case of unipolar disorder is chronic prolonged Dysthymic disorder a mood disorder that is similar to but longerlasting and less disabling than a major depressive disorder Premenstrual dysphoric disorder a disorder marked by repeated experiences of signi cant depression and related symptoms during the week before menstruation Disruptive mood dysregulation disorder combination of persistent depressive symptoms and recurrent outbursts of severe tempers What Causes Unipolar Depression A Preface 1 Unipolar depression is usually triggered by stressful events 2 Reactive exogenous depression follows clear cut stressful events 3 Endogenous depression a response to internal factors B The Biological View 1 Genetic Factors a e Family pedigree studies select people with unipolar depression as probands the person who is the focus of the genetic study and examines their relatives to see if it also affects them 20 of those relatives are depressed compared to less than 10 of population twin studies i monozygotic 46 chance if one twin was depressed the other twin would be too ii dizygotic 20 chance adoption studies show that biological parents of depressed adopted kids were also likely to be depressed many gene abnormalities can be related to depression 2 biochemical factors a an norepinephrine a neurotransmitter whose abnormal activity is linked to depression and panic disorder serotonin a neurotransmitter whose abnormal activity is linked to depression OCD and eating disorders antidepressants were discovered by accident complicated relationship between norepinephrine amp serotonin and cause of depression neuromodulator a chemical whose primary function is to increase or decrease the activity of key neurotransmitters i some researchers think serotonin is a neuromodulator endocrine system can be a cause i high levels of cortisol released during stress ii melatonin has been linked to depression depression may be linked to activity within neurons h de ciencies of brainderived neurotrophic factor promotes growth and survival of neurons researchers still aren t positive and some rely on animal studies that may not be able to be generalized to humans 3 Brain Anatomy and Brain Circuits a Brain circuit responsible for depression i prefrontal cortex involved in mood attention and immune functioning sometimes lower or higher activity amp blood ow in depressed patients ii hippocampusneurogenesis production of neurons decreases during depression iii Amygdala involved in expression of negative emotions amp memories higher blood ow in depressed patients iv Brodmann Area 25 smaller in depressed people higher activity 4 Immune system d e a Fights off bacteria viruses other invaders b c Stress leads to dysregulated immune system Lower functioning of lymphocytes white blood cells Increased production of Creactive protein causes in ammation and illnesses Relationship between depression and immune system dysregulation is still unclear C Psychological Views 1 Received more research support than psychodynamic and cognitive 2 The Psychodynamic View a b C Freud noted lots of similarities between clinical depression and grief Unconscious stages happen during grief i Oral stage merging one s identity with the one they lost ii lntrojection directing their feelings towards a loved one including sadness and anger toward themselves iii Depression can result from grief 2 types of people likely to become depressed from grief i those whose parents failed to nurture them and their needs during the oral stage ii those whose parents grati ed those needs excessively d symbolicimagined loss according to Freudian Theory the loss of a valued object for example a loss of employment that is unconsciously interpreted as the loss of a loved one e object relations theorists emphasize relationships depression results when people s relationships leave them feeling unsafe and insecure f anaclitic depression a pattern of depressed behavior found among very young children that is caused by separation from one s mother g losses suffered early in life set the stage for later depression h problems with explanation i inadequate parenting doesn t always contribute ii less than 10 of all people that suffer a loss become depressed ill some studies don t relate childhood loss to depression iv symbolic loss is supposed to be unconscious so it is hard to do research 3 the behavioral view a behaviorists believe unipolar depression results from changes in the number of rewards and punishments people receive in their lives b as rewards decrease depression increases c social rewards are particularly important when it comes to depression d received research support but relies heavily on selfreport data which can sometimes be biased 4 cognitive views a Negative Thinking i According to Beck maladaptive attitudes a cognitive triad errors in thinking and automatic thoughts combine to produce unipolar depression vi vii Maladaptive attitudes begin as children and later in life situations can trigger more negative thinking Cognitive triad the three forms of negative thinking that Aaron Beck theorizes lead people to feel depressed The triad consists of a negative view of one s experiences oneself and the future Depressed people often minimize the signi cance of positive experiences or magnify that of negative ones Automatic thoughts numerous unpleasant thoughts that help to cause or maintain depression anxiety or other forms of psychological dysfunction Ruminative responses repeatedly dwelling mentally on one s mood without acting to change it Research supports these theories but does not show that such patterns of thought are the main cause for depression b Learned Helplessness vi vii Learned helplessness the perception based on past experiences that one has no control over one s reinforcements Feel responsible for their helpless state Seligman s dog experiment day 1 shocked them no matter what day 2 shocked 12 of the box they were in but dogs continued to believe they were helpless Attributionhelplessness theory when people view events as beyond their control they ask themselves why this is so If they attribute lack of control to internal cause global and stable they will feel helpless It s my fault internal l ruin everything I touch global and always will stable Attributing lack of control to external causes speci c and unstable will not make someone lose control viii Speci c the way I behaved last week ruined my relationship unstable I don t usually act like this external she never knew what she wanted ix Some imperfections lab helplessness doesn t always parallel depression animal symptoms may not re ect depression can animals make attributions D Sociocultural Views 1 FamilySocial Perspective a Depressed people often display weak social skills and communicate poorly b They expect repeated reassurances which may cause people to avoid them they then lower expectations of what they can get from a relationship c Happily married people are 3x happier than the divorcedwidows and 2x happier than those who have never been married d Depression can cause relationships to deteriorate but more often low support in relationships leads to depression e People whose lives are isolated amp without intimacy are more likely to become depressed at times of stress 2 The Multicultural Perspective a Gender and Depression i Women are twice as likely as men they re younger depression lasts longer respond less successfully to treatment ii Artifact theory women and men are equally prone to depression but clinicians often fail to detect depression in men because they display less emotional symptoms lacks research support iii Hormone explanation hormone changes trigger depression in many women not much research support and has been called sexist suggesting the woman s body is awed iv Life stress theory women in our society experience more stress than men v Body dissatisfaction explanation females in western society are taught to seek a IV vi vii low body weight and slender body shape often unreasonable or unattainable Lackof control theory women feel less control than men over their lives women are more likely to be victimized and develop learned helplessness Rumination theory the tendency to keep focusing on one s feelings when depressed and to consider repeatedly the causes and consequences of that depression women do this more than men b Cultural Background and Depression vi Bipolar Disorders Depressed people in many countries report sadness joylessness anxiety tension lack of energy loss of interestability to concentrate thoughts of suicide Depressed people in some nonwestern countries are more likely to be troubled by physical symptoms such as self blame low selfesteem and guilt There are few differences in depression between different cultural groups in the US Hispanic Americans and African Americans are 50 more likely than whites to have recurrent episodes of depression because more white people seek treatment Speci c ethnic populations living under oppressive circumstances have higher rates of depression Depression can be distributed unevenly within some minority groups A What Are the Symptoms of Mania 1 Affects emotional motivational behavioral cognitive and physical functioning but in an opposite way from depression 2 Active powerful emotions euphoric joy amp well being that is disproportionate to their life 3 Want constant excitement involvement and companionship 4 Move quickly talk loudly dress in ashy clothes give money away involvement in dangerous activities 5 Show poorjudgment and planning extremely high self esteem have trouble keeping in touch with reality 6 Feel remarkably energetic B Diagnosing Bipolar Disorder 1 Manic episode for at least one week person displays abnormally high or irritable mood increased energy and at least 3 other symptoms of mania a Sometimes delusions or hallucinations b Hypomanic episode is when symptoms are less severe 2 Bipolar l disorder a type of bipolar disorder marked by full manic and major depressive episodes a Weeks of mania period of wellness episode of depression 3 Bipolar ll disorder a type of bipolar disorder marked by mildly manic hypomanic episodes and major depressive episodes 4 Many people get recurring mood episodes without treatment a Rapid cycling 4 or more episodes in a one year pedod 5 Usually depression episodes occur 3 times as often as manic ones and depressive episodes last longer 6 126 of adults suffer 4 over the course of their lives I more common than ll equally common in men and women onset 1544 7 cyclothymic disorder a disorder marked by numerous periods of hypomanic symptoms and mild depressive symptoms C What Causes Bipolar Disorders 1 Neurotransmitters a Norepinephrine activity of people with mania is higher than normal decreases with the drug reserpine b No relationship found with high serotonin levels but depression is linked to low serotonin c May also be tied to GABA 2 Ion Activity a Positively charged sodium ions are allowed to ow into the neuron starts wave of electrical 10 activity and positively charged potassium ions ow outside the neuron b Irregularities in the transport of ions cause neurons to re too easily mania or too slowly depression 3 Brain Structure a Smaller basal ganglia amp cerebellum in depressed people b Structural abnormalities in dorsal raphe nucleus striatum amygdala hippocampus prefrontal cortex c Not clear what role these abnormalities have may be a cause or result 4 Genetic Factors a Family pedigree studies support that people can inherit a biological predisposition to develop bipolar disorder b Genetic linkage studies observe patterns of distributions of disorders among family members to determine if it is a genetically transmitted family trait c Chromosomes and genes have been linked to bipolar disorder Chapter 17 Disorders of Childhood and Adolescence p 522525 I Childhood Mood Problems A Major Depressive Disorder 1 2 3 Very young children lack the cognitive skills that produce clinical depression Childhood depression is still possible but it is much more common in adolescents After the age of 13 girls are twice as likely to become depressed as boys because of changes during puberty 4 Treatments for Adolescents with Depression Study 5 TADS a Antidepressants and cognitivebehavioral therapy alone weren t as effective as their combination b Antidepressants alone were more helpful than CB therapy alone c CB therapy alone was barely more helpful than placebo therapy Antidepressants may be dangerous for childrenadolescents a May increase suicidal thoughtsbehaviors 11 b Researchers argue that antid s prevent more suicides than they cause B Bipolar Disorder and Disruptive Mood Dysregulation Disorder 1 it was once thought that bipolar disorder was an adult disorder but the numbers for teens amp children are rapidly rising numbers probably rise due to a new diagnostic trend rather than an increase in prevalence of the disorder some researchers think teenschildren are misdiagnosed with bipolar disorder because it s used as a quotcatchallquot term a 23 of the childrenteens with bipolar disorder are boys b BUT equal number of adult men amp women diagnosed Disruptive mood dysregulation disorder a childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood a Became a disorder to correct for the over appication of bipolar diagnoses among childrenteens b This diagnosis is expected to increase while bipolar diagnosis is expected to decrease There s an increase in children who take adut drugs antipsychotic antibipolar mood stabilizing antidepressant stimulant most of which have not been testedapproved for children
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