Exam 2 Study Guide in textbook General scope The exam will consist of multiple choice questions Lecture materials class discussions and assigned textbook reading will be included in the exam Below is a guide for lectures and the list of assigned readings pages same as syllabus Even if not assigned there are pages in each chapter that may be helpful as a reference for class material NOTE Gender Dysphoria Sexual Abuse was listed on your syllabus for this Unit but it will NOT be on this exam because we did not cover it Depression Suicide Non injurious Behaviors continued Ch 5 128 135 138 139 Risk factors for mood disorders Social factors 42 67 report a stressful life event in year prior to depression onset e g romantic breakup loss of job death of loved one Replicated in 12 studies across 6 countries Brown Harris 1989b But most people still do not develop depression So who does Individuals are more at risk if they have feelings of humiliation entrapment defeat Psychological factors Cognitive vulnerability Cognitive triad Beck Negative view Self world future Cognitive errors Catastrophizing Generalizing Negative Filter Interpersonal factors Stressful social relationships Response styles Ruminative reflect on pass Homework interpret realize behavior alter negative views of self world future Poor communication styles poor relationships Hopelessness Theory related to helplessness theory with dogs being shocked Hopelessness expectation that desirable outcomes will not occur or that aversive outcomes will occur and that one cannot change this Negative inferences about events Stable global causes Negative consequences Negative self characteristics Biological factors Heritability moderate for depression strong for bipolar Genetics try to identify specific genes involved 5 HT serotonin transporter thousands of genes play a role 1 Exam 2 Study Guide in textbook 5 HT coding serotonin transporter necessary more transporters more serotonin long allele less serotonin short allele not exposed to much stress doesn t matter your genetic makeup more stress more different respond depending on genes drugs we use SSRIs it was a backwards discovery saw helpful what are they helpful for lower levels involved in depression Serotonin 5 HT Malfunction in 5 HT pathways seem to be involved in etiology of depression Norepinephrine NE Dopamine DA Brain imaging studies bigger picture brain structure regions depression different in structure and activity levels Neuroendocrine system HPA Axis and the role of cortisol how respond to stress and fluctuating hormones hippocampus reduced in depressed correlational studies Individuals with depression respond more strongly to stress HPA axis cortisol stress hormone before exam fight and flight depressed produce more cortisol treat someone and HPA axis changes decrease stress responses leads to predict if get better Integrative model nowadays How can we treat mood disorders Biological Treatment Depression 1 Selective Serotonin Reuptake Inhibitors SSRI Most commonly used anti depressant Most successful and accessible Primary care doc good access bad not trained in psych Prozac Zoloft increase serotonin still don t know why works 2 Monoamine Oxidase Inhibitors MOAIs Also used in tx of anxiety disorders 3 Tricyclics Equal in success rate to SSRIs Who should take antidepressants Medication vs psychotherapy trial and error Biological Treatment Bipolar some medications can trigger manic episodes Lithium 1 Effective in alleviating manic symptoms Large proportion of people have at least temporary side effects but the side effects usually subside Strengthen cell connections regulate mood can affect thyroid and kidneys upkeep 2 Anticonvulsant Medications e g Lamictal Tegretol and Depakene More than 50 of patients responds to these drugs Used to treat rapid cycling Meds for epilepsy too treat hyperactivity in brain 2 Exam 2 Study Guide in textbook Psychotherapies for Depression 1 Interpersonal Psychotherapy IPT o Focus on current relationships 2 Cognitive Behavioral Therapy CBT o Cognitive shifts o Behavioral activation 3 Mindfulness based cognitive therapy MBCT o Strategies including meditation to prevent relapse o Not religious o Combine with cognitive based sometimes o Physiologically relax let go 4 Brief Behavioral Therapy for Insomnia BBTI o Tentative treatment still up in air helps depression too Light Therapy Shown to be best treatment for seasonal affective disorder when used appropriately o I e regularly at the prescribed time etc Face the light at a distance of 1 to 3 feet away Other Treatments Hospitalization to maintain safety involuntary voluntary Crisis Centers Hotlines Antidepressants understand SSRIs lithium anticonvulsants You will not be expected to know the others covered in the book Antidepressants are NOT dangerous to mix with other medication not always addictive will change my personality something that I ll have to take for life if I start taking them quick fixes that don t get at the root of the real problem Suicide predictors Threat of suicide best indicator Previous attempts Family history Possession of firearms 50 of all suicides Hopelessness negative expectations Perfectionism extremely high standards for self Age Socioeconomic class Sex differences twice as many women try it twice as many men successful 4x higher completion rate for males in US 3 Exam 2 Study Guide in textbook men who have been occupationally successful are more likely to commit suicide especially if success threatened military increase dramatically after combats suicide ideation thoughts of killing oneself suicide attempt behavior intended to kill oneself suicide death from deliberate self injury Suicide what causes it Psychological pain social isolation hopelessness feelings of being a burden Biological poor impulse control reduced levels of 5 HT violent aggressive behaviors family history Social availability of guns media poor social integration regulation What is non suicidal self injury Why do people hurt themselves Behaviors intended to injure oneself without intent to kill oneself Cutting burning scratching the skin Why maladaptive coping skills attention seeking Stigma Anxiety Disorders Obsessive Compulsive Disorder OCD Ch 6 144 150 163 165 Anxiety Anxiety is universal experience most common 25 30 lifetime prevalence women more common comorbidity extremely common depression substance abuse 3xmorelikely more than one anxiety disorder How do we determine a disorder from normal