Abnormal PsychologyStudy GuideExam 3Chapter 7: Mood DisordersMood Disorders:- Criteria sets for mood disorders requires the presence of mood episodes:o Major Depressive Episodeo Manic Episodeo Hypomanic Episode- Unipolar Disorders include:o Major Depressiono Persistent Depression- Bipolar Disorderso Bipolar Io Bipolar IIo CyclothymiaUnipolarMajor Depressive Episode:- Emotional Symptoms of Depression (must have at least one of these)o Depressed moodo Loss of interest or pleasure (Anhedonia)- Cognitive Symptoms of Depressiono Concentration problemso Thoughts of death/suicideo Thoughts of worthlessness- Biological Symptoms of Depression:o Increase/Decrease in appetite or weighto Disturbances in sleep patternso Psychomotor changeso Loss of energy (fatigue)- Five or more symptoms are needed for a diagnosis of Major Depressive Disorder- Presence of a major depressive episode (lasting at least two weeks)- It is not better accounted for by another disorder- The individual has no history of a manic, mixed or Hypomanic episodePersistent Depressive Disorder:- Less “severe” but more chronic than the Major Depressive Episode- Two years in length- Emotional Symptoms:o Depressed moodo Loss or interest or pleasure (Anhedonia)- Cognitive Symptoms:o Concentration problemso Thoughts of worthlessness- Biological Symptoms:o Increase/decrease in appetite or weighto Disturbances in sleepo Psychomotor changeso Fatigue- Two or more symptoms are needed for a diagnosis Persistent Depressive DisorderFacts about Depression- An average of 16% prevalence rate- Depression is long-lasting and recurrent- It’s the leading cause of disease burdeno Around $37 billion per year is lost in overall productivity because of depression- Depression is 2 times more common in women than in menAge Differences in Depression- The highest level of individuals with depression are those 15-29o This can be caused by hormones, changes in life (college, etc.)- Depression rates drop significantly after this period but pick up for ages 85+o This could be caused by individuals having to watch their friends die offBiological Theories of Depression- Genetic Factorso Serotonin Transporter Geneo Long Allele versus Short Alleleo Basically, individuals are 2-3 times more likely to experience depression if someone in their family has suffered from it- Neurotransmitterso Serotonino Norepinephrineo Dopamine- Serotonin and norepinephrine are very important to mood regulation- Dopamine is related to the reward system (linked to Anhedonia) - Thus, problems with the production and regulation of serotonin and norepinephrine can cause depressiono Decrease in their production/synthesiso Abnormalities in their transportationo Increased degradation by synaptic enzymeso Impaired release or reuptakeo Abnormalities with receptor- Brain Abnormalitieso Prefrontal Cortex (responsible for thinking and concentration)o Anterior Cingulate (related to stress)o Hippocampus (related to memory)o Amygdala (related to emotions and fear)- Neuroendicrine Factorso Hypothalamic-Pituitary-Adrenal Axis (HPA) Elevated levels of cortisol is linked with depressed individuals It interacts with amygdala, hippocampus, and cerebral cortex which inhibits neurotransmitter receptors Cortisol is a stress hormone- High cortisol depression- Increased cortisol for long periods of time can actually change the structure of the brain- High cortisol levels are related to PTSDPsychological Theories of Depression- Behavioral Theorieso Stress in life reduces positive reinforcers (makes life less satisfying)o Learned helplessness which leads to no motivation (which can snowball into depression)- Cognitive Theorieso Negative Cognitive Triad Self, World, Future Individuals who are depressed exhibit errors in thinking whichcan negatively affect mood Depression leads to negative thoughts about the self, the world, and the futureo Reformulated Learned Helplessness Theory Causal Attribution Errors- My friends went to lunch without me because they don’tlike me anymore (not because they accidently ran into one another)o Cognitive Model of Depression (Causal Attributions) Global- Nothing will work out for me Stable- I wont ever be able to change Internal- It must be my faultInterpersonal Theories of Depression- Rejection Sensitivityo Easily perceive rejection from others- Excessive Reassurance Seekingo Individuals are constantly looking for reassurance from others that they are accepted and lovedBiological Treatments for Depression- Drug Treatmentso Monoamine Oxidase Inhibitors (MAOIs) Problems:- Fatal interactions with other meds- Can cause liver damage and weight gain- Can be fatal in overdose Prevents degradation and allows for more serotonin to be in the synapseo Tricyclic Antidepressants Problems:- Numerous side effects- Fatal in overdoseo Selective Serotonin Reuptake Inhibitors (SSRIs) Most widely used medication- Relief occurs within a couple weeks- Less severe side effects- Not fatal in cases of overdose Prevents presynaptic neuron from reuptaking serotonin Takes weeks to get used to the medicationo Selective Serotonin and Norepinephrine Reuptake Inhibitors (SSNRIs) Similar advantages as SSRIs, but has more stimulant effects Tends to amp the body up (more impulsive)- Electroconvulsive Therapy (ECT)o Treatment is administered to patients who do not respond to medicationo 6-12 sessionso It relieves depression in around 50-60%, but 85% relapseo Has been linked to memory loss- Vagus Nerve Stimulationo Provides more serotonin in the brain- Repetitive Transcranial Magnetic Stimulationo Very few side effectso Patients remain awakeo Treatment use magnetsPsychological Treatments for Depression- Cognitive-Behavioral Therapyo Goals: Change negative thinking and increase positive reinforcerso Achieved through therapy sessions that teach skills- Interpersonal Therapyo Identify and address 1 of 4 interpersonal sources of depression Greif/Loss (death of someone) Interpersonal Role Disputes (problems in relationship) Role Transitions (Use to be a husband, now divorced) Interpersonal Skills Deficits (difficult time with relationships)BipolarManic Episode- One week or more of an elevated or irritable mood- Additionally, you also need 3+ of the following:o Inflated self-esteem or grandiosityo Decreased need to sleepo More talkativeo Flight of ideaso Distractibility o Increase in goal directed activity or psychomotor agitationo Excessive
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