Mood disorders i chapter 7 march 7 2014 psyc 2340 abnormal psychology brett deacon ph d
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Mood Disorders I (Chapter 7) March 7, 2014 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D. Announcements. Exams will be returned on Monday This unit: Mood disorders (4 classes) Spring break (3/17 – 3/21) Eating disorders (2-3 classes) Substance use disorders (4-5 classes)

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Mood Disorders I (Chapter 7) March 7, 2014 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D.

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Mood disorders i chapter 7 march 7 2014 psyc 2340 abnormal psychology brett deacon ph d

Mood Disorders I(Chapter 7)March 7, 2014PSYC 2340: Abnormal PsychologyBrett Deacon, Ph.D.


Announcements

Announcements

  • Exams will be returned on Monday

  • This unit:

    • Mood disorders (4 classes)

    • Spring break (3/17 – 3/21)

    • Eating disorders (2-3 classes)

    • Substance use disorders (4-5 classes)

    • Exam #3 on 4/11


Mood disorders

Mood Disorders

  • Disorders/problems covered in this section

    • Major Depression

    • Bipolar Disorder

    • Suicide


Mood disorders1

Mood Disorders

  • Specific attention to:

    • DSM-IV diagnostic system

    • Causes (biological, psychological, social), including those from scientific studies and promoted in the media

    • Treatment (biological, psychological)


Special topics

Special Topics

  • Special topics of interest in the mood disorders section:

    • Causes of depression: myths vs. reality

    • Effects of different causal explanations on depressed individuals

    • Mental health screenings

    • Why have rates of disabling depression skyrockted in the US in recent decades?

    • Antidepressants: myths vs. reality

      • FDA approval process

      • Effectiveness vs. placebo

      • Suicide risk

      • Adverse effects

      • Long-term effects


Mood disorders2

Mood Disorders

  • Organization of the DSM-IV mood disorders section

  • 1. Types of mood “episodes” – building blocks for defining mood disorders

    • Major depressive episode

    • Manic episode


Mood disorders3

Mood Disorders

  • 2. Diagnostic criteria for specific mood disorders

    • Depressive disorders – major depressive disorder, dysthymic disorder

    • Bipolar disorder – bipolar disorder I, bipolar disorder II, cyclothymic disorder

    • Mood disorders defined by etiology – due to medical condition or effects of a substance


Major depressive episode

Major Depressive Episode

  • 5 or more symptoms must be met during a 2-week period

  • Person must have at least 1 of these symptoms: (1) depressed mood most of the day, nearly every day, and (2) diminished interest or pleasure in all or almost all activities most of the day, nearly every day

  • Other symptoms include:

    • Significant weight loss/gain or change in appetite

    • Insomnia or hypersomnia

    • Psychomotor agitation or retardation

    • Fatigue or loss of energy

    • Feelings of worthlessness or inappropriate guilt

    • Difficulty thinking or concentrating

    • Recurrent thoughts of death or suicidal ideation


Major depressive episode1

Major Depressive Episode

  • Cardinal features

    • Persistent sadness

    • Anhedonia (loss of interest/pleasure)

    • “Vegetative” symptoms (changes in sleep, appetite, psychomotor activity)

    • Cognitive symptoms

    • Psychotic features – 5%-20% of cases

      • Hallucinations

      • Delusions


Major depressive episode2

Major Depressive Episode

  • What does a Major Depressive Episode look like?

  • Video clips of Barbara


Major depressive disorder

Major Depressive Disorder

  • DSM-IV diagnostic criteria:

    • Presence of major depressive episode

    • Episode not part of a psychotic disorder

    • No history of manic episodes


Major depressive disorder1

Major Depressive Disorder

  • Single episode vs. recurrent depression

  • 85% have recurrent episodes

  • Typical # episodes = 4

  • Typical episode duration = 4-5 months

  • Treatment implications?


Major depressive disorder2

Major Depressive Disorder

  • Lifetime prevalence = 16.1%

  • Twice as common in women

  • Gender differences disappear by age 65

  • Few differences across subcultures

  • Mean age of onset = 25


Most common disorders in the national comorbidity survey replication study

Most Common Disorders in the National Comorbidity Survey Replication Study

% With

Disorder

Kessler et al. (2005)


Manic episode

Manic Episode

  • One-week period of elevated, expansive, or irritable mood

  • During period, 3 or more of these symptoms:

  • Inflated self-esteem or grandiosity

  • Decreased need for sleep

  • More talkative than usual or pressured speech

  • Flight of ideas/racing thoughts

  • Distractibility

  • Increase in goal-directed behavior or psychomotor agitation

  • Excessive involvement in pleasurable activities with potentially negative consequences


Mood episodes

Mood Episodes

  • For both major depressive and manic episodes:

    • Symptoms cause significant distress or impairment

    • Symptoms are not substance-induced or due to medical condition


Manic episode1

Manic Episode

  • What does a Manic Episode look like?

  • Video clips of Mary


Bipolar disorder

Bipolar Disorder

  • DSM-IV diagnostic criteria:

    • Presence of manic episode

    • Person may or may not have a history of major depressive episodes

    • Episode not part of a psychotic disorder


Bipolar disorder1

Bipolar Disorder

  • Lifetime prevalence = 1.3%

  • No gender differences

  • Age of onset – 18-22

  • Tends to be chronic


Causes of mood disorders

Causes of Mood Disorders

  • Psychological influences

    • Stressful life events – context and meanings

      • Death of loved one

      • Breakup of relationship

    • More negative life events = greater risk of depression


Causes of mood disorders1

Causes of Mood Disorders

  • Marriage and interpersonal relationships

    • Marital dissatisfaction strongly related to depression - particularly in men

  • Gender imbalance

    • Found in depression but not bipolar disorder

    • Likely due to socialization

  • Social support


Causes of mood disorders2

Causes of Mood Disorders

  • What is the typical behavior pattern for depressed people?

  • How might this maintain or even worsen depression?


Causes of mood disorders3

Causes of Mood Disorders

  • Learned helplessness

    • Lack of perceived control over life stress

    • Some stressors are simply not controllable

      • Poverty

      • Family


Depressive attributional style

Depressive Attributional Style

  • Event: significant other breaks up with you.

  • Internal vs. external attribution

    • It’s my fault vs. we weren’t a good match

  • Stable vs. situational attribution

    • I’ll screw up all future relationships vs. I’ll find the right person someday

  • Global vs. specific attribution

    • I’ll fail at all that I do in life vs. this unfortunate circumstance doesn’t mean I be successful in other areas of my life


Causes of mood disorders4

Causes of Mood Disorders

  • Depressed persons engage in cognitive errors - tendency to interpret life events negatively

  • Examples:

    • Overgeneralization

    • All-or-nothing thinking

  • Cognitive triad: erroneous thinking about…

    • Oneself

    • Immediate world

    • Future


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