Abnormal Psychology Test 2 Chapter 5 Monday February 23 2015 Mood Disorders and Suicide Emotion The state of arousal de ne by subjective states of feeling as sadness anger digust Affect Pattern of observable behaviors associated with subjective feelings as facial expression pitch of voice body movements Mood A pervasive and sustained emotional response that can color perception Depression can refer to a mood or to a clinical syndrome a combination of emotional cognitive and behavioral symptoms Clinical depression Depressed mood accompanied by other symptoms loss of energy loss of pleasure fatigue changes in sleep and appetite Mania Flip side of depression Disturbance of mood accompanied by euphoria exaggerated feeling of physical emotional well being People who are manic feel like their thoughts are being sped up Mood disorders are de ned in terms of episodes discrete periods of time in which the person s behavior is dominated by either a depressed or manic mood Depressive disorder Experience of a depressive episode Bipolar mood disorders 1 Monday February 23 2015 Episodes of depression and mania Emotional Symptoms Depressed of dysphoric unpleasant mood Euphoria periods of inexplicable unbounded joy elated joy Irritability Anxiety Somatic symptoms Aches and pains Loss of sleep and appetite Loss of interest in pleasurable activities DSM5 recognizes two types of mood disorders Depressive Disorders Major depressive disorder Persistent depressive disorder Premenstrual dysphoric disorder Bipolar Disorders All three types of bipolar disorders involve manic episodes DSM5 criteria for manic episodes At least one manic episode Bipolar I Bipolar II Cyclothymia At least one hypomanic episode no full blown manic episode chronic but less severe form of bipolar disorder Further Descriptions and Subtype 2 Monday February 23 2015 Postpartum onset women who become manic or depressed following pregnancy Average age of onset is 32 Length of episodes vary widely Min duration is two weeks To meet this you need 2 episodes of major depression with no other periods of Episode speci ers Presence of psychotic features Hallucinations or delusions Given birth in past 4 weeks Depressive Disorders psychological disturbance Remission A period of recovery Relapse A return of active symptoms Bipolar disorders Onset usually occurs between ages of 18 and 22 years First onset can be depression or mania Average duration of a manic episode runs between two and three months Long term prognosis is mixed Risk for mood disorders across the lifespan Has the frequency of depression increased in recent years YES Mood disorders are most frequent among young and middle aged adults People born after WWII seem to be more likely to develop mood disorders than people from precious generations 3 Chapter 5 cont d Monday February 23 2015 Gender Differences Women are two or three times more vulnerable to depression than men Women are more likely than men to present for mental health services Men have more dif culty admitting to subjective feelings of distress Not typically observed for bipolar mood disorders Cognitive Therapy Helps patients replace self defeating thoughts with more rational self statements Clients are helped to develop objective ways of evaluating experiences Role of therapist is active directive CBT is effective in treatment of non psychotic depression Antidepressant Medications Selective Serotonin Reuptake Inhibitors SSRIs Tricyclics TCAs Monoamine Oxidase Inhibitors MOAIs Others Treatment focuses on combined use of medication and psychotherapy Medication Mood stabilizing drugs used with antidepressant medications Clinicians to be cautious of drug effects Lithium Effective treatment in alleviation of manic symptoms 40 of patients do not improve Non compliance with drug due to side effects Psychotherapy 4 Monday February 23 2015 Can be effective supplement to biological intervention Cognitive therapy Interpersonal therapy Combination of psychotherapy and medication is more bene cial than medication alone Electroconvulsive Therapy Effective for unipolar and bipolar disorders Given three times a week for 2 to 7 weeks Electrodes placed on skull Used when medication and therapy have not been effective Seasonal Mood Disorders Changes in seasons can bring about mood disorders Depression in winter recovery in spring most typical Jean Esquirol advised patients to move to regions with longer daylight Suicide The highest rate in the US is among white males over the age of 50 Within this group men who have been occupationally successful are more likely to commit suicide especially if that success is threatened There is a strong relationship b w depression and self destructive acts 15 to 20 of all patients with mood disorders will eventually kill themselves DSM5 does not address the issue of suicide Lists suicidal ideation only as a symptom of mood disorder Non suicidal Self Injury Deliberate self harm without desire for suicide Cutting burning scratching the skin Most typical in borderline personality disorder 5 Monday February 23 2015 The pain serves a useful purpose Punish the self a re ection of anger Bad way to regulate intense negative emotional states Frequency of Suicide In the US more than 35 000 people kill themselves every year Rates vary as a function of age gender SES Suicide attempts are more than completed suicides ratio is approximately 10 to 1 Females attempt suicide more often men succeed more often Completion rates are four times higher in males Suicides in the US military increased dramatically after combats in Iraq Afghanistan Causes of suicide Psychological Factors Psychological pain Social isolation feelings of being a burden previous attempts Gender Differences Women are two or three times more vulnerable to depression than men Women are more likely than men to present for mental health services Men have more dif culty admitting to subjective feelings of distress Not typically observed for bipolar mood disorders Cognitive Therapy Helps patients replace self defeating thoughts with more rational self statements Clients are helped to develop objective ways of evaluating experiences Role of therapist is active directive 6 Monday February 23 2015 CBT is effective in treatment of non psychotic depression Antidepressant Medications Selective Serotonin Reuptake Inhibitors SSRIs Tricyclics TCAs Monoamine Oxidase Inhibitors MOAIs Others Treatment focuses on combined use of medication and psychotherapy
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