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CLP 4143 07 Exam 2 Study Guide This document is to be used as a basic guide for your exam It is by no means all inclusive and should not serve as your primary studying material Please use your learning objectives to help you prepare for the exam Depressive Disorders o 26 of exam questions o Important Topics to Review Differences between Major Depressive Disorder MDD and Persistent Depressive Disorder PDD i e what are the diagnostic criteria for each MDD PDD o Presence of a major depressive episode o Not better accounted for by another disorder o No history of a manic mixed or hypomanic episode o More chronic can be less severe o Depressed mood most of the day for more days than not for at least 2 years and o At least two of the following for at least 2 years Appetite problems Sleep problems Low energy Low self esteem Poor concentration Feelings of hopelessness Prevalence gender ethnic and age differences in MDD Prevalence o MDD o PDD Gender 1 in 6 1 in 20 Age o MDD 2X more common in women than men o Rates highest in 85 o Rates 2nd highest in the ages 15 29 o Rates lowest in people over 60 Less willing to report symptoms Difficult to make diagnosis Depressed people have greater morbidity Adaptive coping skills Symptoms of MDD and symptoms of PDD MDD o Depressed mood most of the day nearly everyday o Markedly diminished interest or pleasure in all or almost all activities most of the day nearly everyday o Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day o Insomnia or hypersomnia nearly every day o Psychomotor agitation or retardation nearly every day o Fatigue or loss of energy nearly every day o Feelings of worthlessness or excessive or inappropriate guilt nearly everyday o Recurrent thought of death recurrent suicidal ideation without a specific plan or a suicide attempt or a specific plan for committing suicide PDD o Poor appetite or overeating o Insomnia or hypersomnia o Low energy or fatigue o Low slef esteem o Poor concentration or difficulty making decisions o Feelings of hopelessness Neurotransmitter and brain differences associated with MDD Brain differences o Prefrontal cortex o Anterior Cingulate o Hippocampus o Amygdala Neuroendocrine factors o Hypothalamic pituitarity adrenal axis HPA Genetic contributions to MDD Caspi et al 2003 study o Gene by environment interaction o Serotonin transporter o Differences in alleles Long normal levels of serotonin levels Short abnormalities in serotonin levels o If you have two long alleles doesn t matter if you were abused as a child o If you have one short and one long more likely to develop a depressive episode if you had abuse as a child o If you have two short alleles increased likelihood to develop depressive episode a lot if you had abuse as a child Genetics deregulate serotonin levels which puts people at risk for depressive episodes Theories of Depression Learned helplessness theory o Unpredictable negative events serve as punishers cause behavioral o Reduced positive reinforcers behavioral withdrawal reduced withdrawal positive reinforcers Negative cognitive triad o Self o Future o World I am worthless Nothing will ever change Everything is against me Excessive reassurance seeking o Excessively asking for reassurance Rejection sensitivity Causal attributions o More prone to think people are rejecting you o Believe causes of negative events are stable internal and global o Stable I won t ever change Internal It must be my fault Global Empirically Supported Treatments for Depression nothing will work out for me Behavioral Activation o Increase positive reinforcers Interpersonal Therapy o Goal identify and address 1 of 4 interpersonal sources of depression Grief loss Evaluate relationship with person they lost Interpersonal Role Disputes Fighting with significant other Goal increase communication skills and compromise Role Transitions Interpersonal Skills Deficits Teach skills to have better relationships Social skills training Cognitive Behavior Therapy o Cognitive change negative thinking Cognitive restructuring to change their thoughts to reflect the evidence that they have o Behavioral increase positive reinforcers behavioral activation Identify values and activities that they can engage in that are important to them Functional analysis work with patient and find triggers for depressive symptoms Identify what makes you feel better and what makes you feel worse Improve social rhythms and sleep hygiene Balanced sleeping eating and outdoor activities that are social Sleep hygiene bed is for sex sleeping o Train body to know when in bed you should be sleeping o Both identify triggers and problem solve o Risk monitoring asses for suicidal symptoms Biological treatments psychotropic o Selective Serotonin Reuptake Inhibitiors SSRIs Most widely used medication Relief within a couple of weeks Less severe side effects better tolerated o Selective Serotonin and Norepinephrine Reuptake Inhibitors SSNRIs Similar advantages as SSRIs but has more stimulant effects o Monoamine Oxidase Inhibitors MAOIs Problems Fatal interactions with other meds Can cause liver damage weight gain o Tricyclic antidepressants Problems Numerous side effects o Electroconvulsive therapy ECT Brief seizures Treatment resistant MDD only o Transcranial Magnetic Stimulation TMS Noninvasive brain stimulation with electromagnet Treatment resistant depression Bipolar Disorders o 24 of exam questions o Important Topics to Review Differences between Bipolar I Bipolar II and Cyclothymia Bipolar I o Is characterized my mania Distinct period of elevated or irritable mood for at least 1 week Marked impairment Often results in hospitalization o Marked impairment or hospitalization required o At least 7 days can be less if hospitalized Bipolar II o Is characterized by hypomania and major depression Distinct period of elevated mood or irritability for at least 4 days Some impairment but not marked No psychotic symptoms No hospitalization Cyclothymia o No marked impairment hospitalization not required o At least 4 days o Depressive episode o No marked impairment hospitalization not required o At least 4 days o No full depressive episode Differences between mania and hypomania Mania o Euphoria o Fascinating more interconnected o Nothing is ever enough o Restless and compelled o Obsessive o One week o Leads to hospitalization o Leads to deep depression Hypomania o No marked impairment hospitalization not required o At


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FSU CLP 4143 - Depressive Disorders

Documents in this Course
Exam 1

Exam 1

8 pages

Exam 1

Exam 1

9 pages

Exam 3

Exam 3

8 pages

Notes

Notes

18 pages

Chapter 7

Chapter 7

10 pages

Test 1

Test 1

10 pages

Notes

Notes

12 pages

Test 1

Test 1

13 pages

Test 1

Test 1

10 pages

Exam 3

Exam 3

7 pages

CHAPTER 1

CHAPTER 1

27 pages

Anxiety

Anxiety

23 pages

Chapter 7

Chapter 7

10 pages

Test 1

Test 1

17 pages

Test 3

Test 3

13 pages

EXAM 3

EXAM 3

36 pages

Exam 2

Exam 2

31 pages

Exam 1

Exam 1

16 pages

Final SG

Final SG

19 pages

Exam 3

Exam 3

13 pages

Suicide

Suicide

20 pages

Suicide

Suicide

25 pages

Chapter 1

Chapter 1

107 pages

Exam 4

Exam 4

2 pages

Notes

Notes

23 pages

Notes

Notes

2 pages

Notes

Notes

5 pages

Notes

Notes

8 pages

Notes

Notes

2 pages

Notes

Notes

2 pages

Notes

Notes

7 pages

Notes

Notes

5 pages

Notes

Notes

5 pages

Exam 2

Exam 2

6 pages

Notes

Notes

8 pages

Notes

Notes

3 pages

Notes

Notes

4 pages

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