PSYC 3023 1st Edition Exam 2 Study Guide Lectures 6 8 10 7 The exam is 50 multiple choice questions and covers chapters 6 7 8 and 10 Be sure to carefully read each chapter and that you understand the major points covered in the chapter summaries There will be exam questions based on your reading that we did not explicitly discuss in class The exam will emphasize lecture material Chapter 6 Mood Disorders and Suicide From lecture Understand the clinical description statistics etiological models and treatment for major depressive disorder Major Depressive Disorder MDD p 204 Emotional Symptoms Must have a total of 5 symptoms for at least 2 weeks but has to include below Depressed mood irritability in children adolescents Anhedonia Lost interest in pleasurable things Physiological Behavioral Symptoms Sleep disturbances Appetite disturbances Cognitive Symptoms Poor concentration Excessive guilt rumination Prevalence 17 experience one episode Duration is 4 9 months untreated Up to 85 will experience another episode MDD Recurrent episodes separated by 2 months when person is not depressed Mean age of onset 32 Median of lifetime episodes is 4 7 Average duration 4 5 months Women 2x likely starting at age 15 Scar model The episode leaves a scar and makes you more vulnerable for the next episode Dysthymia Depressed mood 2 symptoms 2 years Premenstrual Dysphoric Disorder PMDD p 208 5 symptoms e g affective lability Depressive Attributional Style 2 5 of women Disruptive Mood Dysregulation Disorder p 208 6 18 years No mania Tantrums 3 week across settings for at least 1 year Double depression MDD and dysthymia chronically depressed with peaks of major depression Poor course Subtypes of major depressive disorder With melancholic features near absence of pleasure With psychotic features mood congruence hallucinations etc can be dangerous With catatonic features rocking or super stillness waxy flexibility With atypical features leaden feeling in body hypersomnia hypersensitivity to rejection etc With post peri partum onset 3 6 in pregnant females With seasonal onset 2 year that are only present during one season typically winter Biological causes of mood disorders Genetics STABLE Neurotransmitter systems Permissive Hypothesis when serotonin is low the effect is disruption with other neurotransmitter Endocrine System Elevated cortisol impacts on neurogenesis Sleep Psychological causes of mood disorders Stressful life events p 219 stress generation Cognitive Vulnerability Learned helplessness INTERNAL Cognitive Triad Negative thoughts about self world future The negative triad GLOBAL Medication for mood disorders p 227 MDD Antidepressants e g SSRI 50 70 of adults respond to meds Bipolar Disorder Lithium Pros quick acting Cons doesn t last after medication runs out can be dangerous such as lithium Psychosocial treatments for mood disorders p 230 MDD Cognitive behavior therapy 10 20 sessions Beck s Cognitive Therapy Lewinsohn s Behavioral Activation Therapy Interpersonal Therapy 15 20 sessions Effectiveness Understand the core elements of each therapy type May be more effective together than either alone Medications produce faster relief Psychotherapies produce longer effects Bipolar disorder Fluctuating between two poles p 209 Manic episode At least 1 week Elevated expansive irritable mood abnormally increased energy at least 3 symptoms below Inflated self esteem grandiosity Decreased need for sleep Excessive talkativeness X Flight of ideas racing thoughts Highly Distractible Increase in goal directed activity psychomotor agitation Excessive involvement in pleasurable activities with risk for bad outcomes Hypomanic Episode Bipolar I Disorder Alternating major depressive and manic episodes AAO 15 18 yrs Bipolar II Disorder MDE hypomania AAO 19 22yrs Statistics 1 lifetime prevalence Equal male female Bipolar disorder treatment p 234 Suicide p 235 Death from Suicide National Health Epidemic 10 th leading cause of death White phenomenon Native American Rates high among adolescents middle age Death by suicide 4 5x more men than women Women more likely to attempt Risk Factors p 238 Family History Neurobiology Serotonin Preexisting Psychopathology History of Suicidal Behaviors Past behavior is the best predictor of future behavior Stressful Life Events Cluster suicides Joiner s Interpersonal Theory of Suicide Passive Suicidal Ideation I wish I were dead Thwarted Belongingness I am alone Perceived Burdensomeness I am a burden Active Suicidal Ideation Hopelessness This will never change Suicidal Intent Acquired Capability Decreased fear of death Increased pain tolerance Lethal or near lethal attempt Suicide Intervention p 240 Assess Presence of desire to die Access to means Past attempts Presence of a plan No suicide contract Hospitalization Complete or partial Understand facts and myths about suicide Understand the concept of a psychological autopsy and risk factors for suicide derived from this approach Understand Joiner s interpersonal theory of suicide Text Materials Carefully read all of chapter 6 with an emphasis on o Life span developmental influences on the mood disorders p 213 o Social cultural influences on the etiology of mood disorders p 223 Electroconvulsive Therapy and Transcranial Magnetic Stimulation as treatments for mood disorders p 230 Chapter 8 Eating and Sleep Disorders From lecture Eating Disorders Anorexia Nervosa p 286 Primary symptoms Significantly low weight Intense fear of weight gain in turn end up very skinny Disturbed body image Subtypes 3 month duration Restricting type Binge eating purging type Medical consequences Amenorrhea Dry skin Brittle nails hair Lanugo Body swelling Reduced bone density Chest pains Muscle cramps Metabolic Electrolyte imbalance Low body temperature Low blood pressure Slow heart rate Poor circulation Dizziness Bulimia Nervosa p 284 Not driven by losing weight so typically at a normal weight Primary symptoms Hallmark binge eating Eating is uncontrollable Compensatory behaviors prevent weight gain Purging type Non purging type Medical consequences Erosion of dental enamel electrolyte imbalance Kidney failure cardiac arrhythmia seizures intestinal problems permanent colon damage Statistics for both Majority women 90 95 Bulimia 1 5 more common than Anorexia Nervosa 1 6 7 of college student females BN Age of onset 18 21 yrs dieting prior Both chronic AN more treatment resistant Etiology of eating disorders Social Factors Media and Culture Cultural standards