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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Presentation Transcript
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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