Affective disorders (connect quiz)

seasonal pattern specifier

Specifier that applies to bipolar disorders and to recurrent major depressive disorder that accompanies episodes occurring only during certain seasons

the overactivity in the _____ may bias people toward aversive or emotionally arousing information

amygdala

people suffering from depression with ________ features show strange behaviors ranging from a complete lack of movement to excited agitation

catatonic

whereas people with bipolar I experience mania, people with bipolar II disorder experience

hypomania

which of the following is true about the prevalence of bipolar disorder

women and men are equally likely to develop bipolar disorder

_____ to experience mild depressive symptoms and severe depressive disorders.

women are about twice as likely as men

which of the following is true of bipolar disorder A. most people who develop bipolar disorder do so early to late adulthood B. biological factors may be more responsible for bipolar disorder than for depressive disorder C. people with bipolar disorder are less likely to abuse substances than those with other disorders D. the prevalence of bipolar disorder is higher than that of depression

B. biological factors may be more responsible for bipolar disorder than for depressive disorder

Which of the following statements is true A. the DSM-5 no longer identifies different forms of depression B. the DSM-5 presents eight subtypes of depression C. the DSM-5 has replaced depression with dysthymic disorder D. The DSM-5 has removed sense of hopelessness from the symptoms of depression

B. the DSM-5 presents eight subtypes of depression

Which of the following is true of bipolar disorder A. only about 10% of people with bipolar disorder have multiple cycles during their lifetimes B. the length of individual episodes of bipolar disorder varies greatly from one person to the next C. most people with bipolar disorder swing from mania to depression and back again within one day D. A relatively common pattern in bipolar disorder is for episodes to get longer but less frequent over time

B. the length of individual episodes of bipolar varies greatly from one person to the next

Which of the following is true of ECT? A. ECT decreases metabolic activity in several regions of the brain B. These days, ECT is administered to only the left side of the brain C. People who undergo unilateral ECT experience memory problems D. The relapse rate among people who have undergone ECT is moderate to low

C. people who undergo unilateral ECT experience memory problems

Which of the following statements about mood disorders is NOT true A. writers, artist and composers have a higher prevalence of mania and depression than others B. creative people are more likely than less creative people to experience suicidality C. political figures, especially those who lose political races, are two or three times more likely than artists to experience mania and depression D. celebrities Jim Carey, Kirsten Dunst and Mariah Carey have publicized their mood disorders

C. political figures, especially those who lose political races, are two or three times more likely than artists to experience mania and depression

which of the following statements is true of mood disorders? A. a major depressive episode is necessary for a diagnosis of bipolar I disorder B. Hypomania is a diagnostic criterion for bipolar II disorder but not for cyclothymic disorder C. the level social and occupational functioning of bipolar I and II disorders are identical D. a diagnosis of cyclothymic disorder requires that the person alternates between cycles of hypomania and depression

D. a diagnosis of cyclothymic disorder requires the person alternates between cycles of hypomania and depression

which of the follow is true of the difference between persistent depressive disorder and major depressive disorder: A. major depressive disorder is less severe and more chronic than persistent depressive disorder B. major depressive disorder is less severe and less chronic than persistent depressive disorder C. major depressive disorder is more severe and more chronic than persistent depressive disorder D. major depressive disorder is more severe and less chronic than persistent depressive disorder

D. major depressive disorder is more severe and less chronic than persistent depressive disorder

Which of the following is not one of the possible bipolar diagnoses A. bipolar I disorder B. Bipolar II disorder C. cyclothymic disorder D. short cycling bipolar disorder

D. short cycling bipolar disorder

mood-incongruent psychotic features

Delusions or hallucinations whose content is not consistent with the typical themes of a depressed or manic mood. In the case of depression, the delusions or hallucinations would not involve themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. In the case of mania, the delusions or hallucinations would not involve themes of inflated worth, power, knowledge, or identity, or a special relationship to a deity or a famous person.

Subtypes of major depressive disorder

Depression with anxious distress Depression with mixed features Depression with melancholic features Depression with mood-congruent psychotic features Depression with catatonic features Depression with atypical features Depression with seasonal pattern Depression with peripartum onset

MDD biological etiology

Genetics: runs in families; 2-4x higher Neuroticism shown to be a predictor Monoamine hypothesis (including the catecholamine hypothesis) and sleep disturbance -depleted levels of serotonin, norepinephrine, and dopamine

differences between bipolar I and II

In Bipolar I, depression is not required for the diagnosis (mania must be present) In bipolar II, the person must experience hypomania and major depressive episodes in order to get a diagnosis

Difference between mania and hypomania

In mania, symptoms must be present for at least 1 week or any duration in hospitalization is required. causes severe impairment and psychotic features may be present In hypomania, there are the same symptoms as mania but they are milder, hospitalization cannot occur, episode not severe enough to cause marked impairment. however, there are some issues in social and occupational functioning, no psychotic features

"with rapid cycling" specifier

Individuals with bipolar I disorder who have multiple (four or more) mood episodes (major depressive, manic, or hypomanic) within 1 year

symptoms of mania

Inflated self esteem flight of ideas talkative/pressured speech irritable participating in impulse and risky behaviors that may have negative consequences increased goal-oriented activity

Which of the following statements is true of light therapy?

It may help reduce seasonal affective disorder by resetting circadian rhythms

Mild manic episode

Minimum symptom criteria are met for a manic episode.

DMDD criteria

Severe, recurrent temper outbursts Temper outbursts that are out of proportion to the stressor, and are inconsistent with developmental age and situation that is observable by others On average 3+ times a week The mood between tempter outbursts is irritable and angry nearly every day Symptoms have been present for 12+ months in two or more settings with no more than 2 consecutive months without symptoms Cannot diagnosis before 6 or after 18 Onset before age 10 Not due to mania/hypomania Not due to MDD Not dur to a substance or other medical or mental disorder

partial remission

Symptoms of the immediately previous manic, hypomanic, or major depressive episode are present but full criteria are not met, or there is a period lasting less than 2 months without any significant symptoms of a manic, hypomanic, or major depressive episode following the end of such an episode.

According to the DSM-5, which of the following is an appropriate diagnostic criterion for disruptive mood dysregulation disorder

Temper outbursts must occur at least three times per week for at least 12 months

Mood-congruent psychotic features (depressive episode)

The content of all delusions and hallucinations is consistent with the typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment.

mood-incongruent psychotic features (depressive disorder)

The content of the delusions or hallucinations does not involve typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment, or the content is a mixture of mood-incongruent and mood-congruent themes.

Risk factors of DMDD

-May also have met criteria for ODD before DMDD is diagnosed -May also meet criteria for ADHD -May also meet criteria for MDD -Similar to those with bipolar disorder and ADHD, may have information processing deficits (attention & decision making may be affect; especially related to processing emotional stimuli) -more common in males than females (unlike bipolar d/o)

Major Depressive Disorder (MDD)

1+ MDE No manic or hypomanic episodes; can be: a single episode chronic with/without psychotic features (must be specified) Differentiated from grief, the normal reaction to the loss of a loved is "uncomplicated grief" Psychotic depression: mood-congruent delusions usually related to guilt, inadequacy, deserved, punishment, or death "God is punishing me for my sins B. high mortality rate: females more likely to attempt, men more likely to complete C. Course, onset, duration can occur at any time typical onset after puberty chronicity increases the likelihood of underlying personality disorder, anxiety, and substance use disorders recovery typically occurs within 3 months for most longer duration predictive of future episodes D. epidemiology: 12-month prevalence 7% Varies by age: 12-29 y/o 3x more likely to experience MD than those over 60 Found across cultures; sleep and loss of interest occurs across cultures

in the U.S. which of the following age groups is more likely to have had a major depressive episode (MDE) in the past year

18-29 year olds

Beck theory of depression

3 components: 1 - Cognitive triad: negative view about self, negative view of the world, negative views of the future 2 - Schemas: helps us sense of the world, developed over time with experience triggered by negative life events 3 - Cognitive distortions/biases These three lead to depression

key features of OCD

A. Presence of obsessions, compulsions, or both 1. recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most people cause marked anxiety or distress 2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action Compulsions are defined as: 1. repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly 2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or clearly excessive B. The obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning C. Not attributable to the the physiological effects of a substance D. Not better explained by another mental disorder Age of onset for males:6-15 Age of onset of females: 20-29 Can be distressing, time-consuming, and harmful; sufferer may experience depression, panic attacks, phobias, substance abuse

Severe manic episode

Almost continual supervision is required in order to prevent physical harm to self or others.

As many as _____ percent of people who experience a first episode of depression will experience subsequent episodes

75%

Which of following statements about depression is true? A. depression is chronic and people diagnosed with its symptoms are unlikely to recover, even with treatment B. people with major depression lose an average of 60 days of work per year C. people with depression often do not seek treatment, as they expect to overcome their symptoms on their own D. the majority of people with depression seek treatment as soon as symptoms first appear

C. people with depression often do not seek treatment, as they expect to overcome their symptoms on their own

anxious distress specifier

Depression is accompanied by several significant symptoms of anxiety Predicts poorer outcome

learned helplessness theory of depression

Martin Seligman's theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether or not they actually have control).

MDD psychoanalytic approach (freud)

anger directed inward especially issues during the oral phase, people with MDD had very punishing superegos

Aaron Beck's concept of the negative cognitive triad led to one of the most widely used and successful therapies for depression, which is _____ therapy

cognitive-behavioral

DMDD prevalence

estimated to be 2-5% in children and adolescents higher in males and school aged children than in females or adolescents

Disadvantages of lithium

high toxicity potential, problematic side effects, can cause diabetes, hypothyroidism, and kidney dysfunction & contribute to birth defects

cyclothymic disorder is a form of bipolar disorder which is less severe but

more chronic

The diagnosis of depression in older adults is complicated because:

their symptoms often occur in the context of medical illnesses

which of the following is the main problem associated with lithium to treat mood disorders

The difference between an effective dose of lithium and a toxic dose is small

With atypical features specifier

This specifier can be applied when these features predominate during the majority of days of the current or most recent major depressive episode. A. Mood reactivity (i.e., mood brightens in response to actual or potential positive events). B. Two (or more) of the following features: 1. Significant weight gain or increase in appetite. 2. Hypersomnia. 3. Leaden paralysis (i.e., heavy, leaden feelings in arms or legs). 4. A long-standing pattern of interpersonal rejection sensitivity (not limited to episodes of mood disturbance) that results in significant social or occupational impairment. C. Criteria are not met for "with melancholic features" or "with catatonia" during the same episode.

Disruptive Mood Dysregulation Disorder

a childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood core feature is irritability Captures Affective D/0 in children and adolescents and addresses over-diagnosis of bipolar disorder in children not episodic like bipolar disorder Children with DMDD often go on to develop unipolar depression or anxiety disorders not bipolar disorder

The agitation and risky behavior accompanying mania in youth are difficult to distinguish from the symptoms of _____.

adhd

the combination of major depression and anxiety is so common that the authors of the DSM-5 introduced the subtype of

anxious distress

Luke is seeking treatment for his depression. His therapist tells him that his treatment will be short-term, will entail identifying the circumstances that precipitate his depressive symptoms, and will involve learning new skills necessary to interact effectively with his environment. Luke is most likely undergoing

behavioral therapy

Luke is seeking treatment for his depression. His therapist begins by helping him discover the negative automatic thoughts that he habitually exhibits and how these thoughts are connected to his depression. Luke is encouraged to challenge these thoughts and his therapist helps him to develop skills such as assertiveness to help him cope better in his daily life. The therapy Luke is most likely receiving is _____.

cognitive-behavioral therapy

one major difference between hypomania and mania is that the symptoms of hypomania

do not involve hallucinations

Several studies suggest that dysregulation of the _____ system contributes to bipolar disorder

dopamine

______ cycles of mania and depression within a year lead to a diagnosis of rapid cycling bipolar I disorder

four or more

Learned helplessness theory suggests that

frequent stressful events can make people believe their situation is uncontrollable.

Chronic excessive exposure to cortisol

has an inhibiting effect on receptors for the monoamine neurotransmitters.

DMDD comorbidity

highly comorbid with other disorders, particularly ODD symptoms If they meed criteria for BPD, only assign BPD not DMDD If they meet criteria for ODD or intermittent explosive disorder and DMDD, only assign DMDD Do not assign if irritability only occurs in the anxiety provoking context (for example routine changes in children with autism or OCD) or in the context of MDD

the reformulated learned helplessness theory focuses on people who habitually explain negative events by causes that are

internal, stable, and global

If a person experiences a loss of interest in usual activities and at least 4 other depressive symptoms chronically for at least two weeks, and these symptoms are severe enough to interfere with the persons ability to function in everyday life, the person meets criteria for

major depressive disorder

People with bipolar II disorder experience episodes that meet the criteria for major depression, but have:

milder episodes of mania known as hypomania

The neurotransmitters that have been implicated most often in depression are

monoamines

peripartum onset specifier

occurring 4 weeks following giving birth

Advantages of Lithium

people who maintain adequate doses of lithium have significantly fewer relapses

Martha gave birth to twins two weeks ago, she finds herself weeping while she is changing the twins or feeding them. she is irritable and has had little sleep since their birth. Martha feels guilt and shame because she says a good mother would be able to take care of her children. the subtype of major depression Martha is most likely suffering from is depression with ____

peripartum onset

If a person experiences depressed mood plus two other symptoms of depression for at least 2 years, and during the two years he or she has not been without depressive symptoms for more than two months, the person is most likely to be diagnosed with

persistent depressive disorder

in the DSM-5, dysthymic disorder is termed

persistent depressive disorder

negative cognitive triad

perspective seen in depressed people in which they have negative views of themselves, of the world, and of the future. These negative views reinforce the triad.

Hopelessness depression develops when people make _____ attributions for the most important events in their lives and perceive that they have no way to cope with the consequences of these events

pessimistic

_____ have a higher-than-normal prevalence of mania

poets

Lamotrigine is used in the treatment of mood disorders especially to

prevent episode recurrence

Bart has been diagnosed with major depression. Recently he has been experiencing hallucinations. He sees mystical beings cloaked in white swooping down from the sky trying to "whisk" him away. Bart is most likely experiencing major depression with ____ features

psychotic

With mood-congruent psychotic features

psychotic features that match the mood state (e.g., delusions & hallucinations are consistent with manic themes during a manic episode)

DMDD course

symptoms must be present before 10 about 50% will continue to show chronic irritability one year later symptom presentation may change as child matures more likely to develop MDD and/or anxiety than bipolar becomes less common as children move into adulthood

which of the following statements is true of gender differences in vulnerability to depression

the differences in the responses of men and women to stress may be due to social norms

defining feature of cyclothymic disorder

the hypomanic and depressive symptoms are insufficient in number, severity, or duration to meet full criteria for hypomania or major depressive disorder

which of the following statements is true about a person with bipolar disorder

the person experiences manic episodes for at least one week

What are the goals of CBT in treating depression?

to change negative and hopeless patterns of thinking while helping the person develop more effective life skills

which of the following is the most common explanation given by researchers for the low rate of depression among older adults? A. older people generally develop dementia, so they don't know they are depressed B. As people age, they develop adaptive coping skills and a psychologically healthier outlook on life C. Older adults tend to be in denial regarding the status of their psychological well-being D. The elderly usually decline request for participation in research studies on mental health

B. as people age they develop adaptive coping skills and a psychologically healthier outlook on life

Catatonia Specifier

This specifier can apply to an episode of mania or depression if catatonic features are present during most of the episode

full remission

During the past 2 months, no significant signs or symptoms of the disturbance were present.

MDD behavioral approach (ferster/lewinsohn)

Low positive reinforcement, a lot of punishment Depression due to low rate of pleasant events and poor social skills

Belinda has been warned not to mix her antidepressant medication with certain over-the-counter drugs. She has also been told to watch her consumption of aged cheese, red wine, and beer. Belinda's is most likely taking _____.

MAOIs

With mixed features specifier

Manic or hypomanic includes at least three: dysphoria or depressed mood, loss of interest or pleasure, psychomotor retardation, fatigue or loss of energy, feelings of worthlessness or guilt, or recurrent bouts of death or suicidality Depressive includes at least three: elevated or expansive mood, inflated self-esteem or grandiosity, pressured speech, flight of ideas or racing thoughts, increased energy or goal directed activity, involvement in activities that have a high likelihood of adverse consequences, or decreased need for sleep.

"with melancholic features" specifier

One of the following is present during the most severe period of the current episode: 1. Loss of pleasure in all, or almost all, activities. 2. Lack of reactivity to usually pleasurable stimuli (does not feel much better, even temporarily, when something good happens). Three (or more) of the following: 1. A distinct quality of depressed mood characterized by profound despondency, despair, and/or moroseness or by so-called empty mood. 2. Depression that is regularly worse in the morning. 3. Early-morning awakening (i.e., at least 2 hours before usual awakening). 4. Marked psychomotor agitation or retardation. 5. Significant anorexia or weight loss. 6. Excessive or inappropriate guilt.

Moderate manic episode

Very significant increase in activity or impairment in judgment.

the reformulated learned helplessness theory focuses on

causal attributions or an explanation of why an event happened

The agitation some people experience while taking an SSRI may contribute to an increase in suicidal thoughts and behavior. This risk may be greatest for:

children and adolescents

People with depression tend to show

chronic hyperactivity in the HPA axis.

depressive episode

depressed mood and/or loss of interest for at least 2 weeks accompanied by at least 4 additional symptoms: appetite changes sleep changes psychomotor agitation/retardation fatigue worthlessness/guilt concentration difficulties thoughts of death/suicide causes clinically significant distress or impairment

Which of the following is true according to the cognitive theories of depression

depressed people show a bias toward negative thinking