PSYC 3023 1st EditionExam # 2 Study Guide Lectures: 6, 8,10, 7The 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 materialChapter 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 thingsPhysiological/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)DepressiveAttributionalStyle2- 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 onset3-6% 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 GLOBAL•Cognitive Triad- Negative thoughts about self, world, futureThe negative triad ^• Medication for mood disorders [p. 227]MDD Antidepressants (e.g., SSRI) 50-70% of adults respond to meds Bipolar Disorder Lithium Pros quick actingCons 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 talkativenes s XFlight of ideas / racing thoughts Highly DistractibleIncrease 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? 10th leading cause of death White phenomenon Native American Rates high among adolescents, middle age Death by suicide 4-5x more men than womenWomen 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 circulationDizziness 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%)