Chapter 7 abnormal psych

two years

A diagnosis of persistent depressive disorder is made if the symptoms persist for at least ___ _____

cyclothymic

A person who has had a mixed episode, a major depressive episode, or a manic episode cannot be diagnosed as having _______ disorder.

excellent low

College students who commit suicide, as a group, tend to be _______ students. While there may be a slight drop in their grades before the event, ___academic achievement is typically not a precipitating stressor associated with the suicide.

anxiety

Considerable evidence from genetic and family studies suggests a close relationship between _______________ and unipolar depressive disorders. Research suggests that the liability for both of these stem from the same genetic factors, including personality traits such as neuroticism.

2-year

Cyclothymic disorder occurs when the individual experiences significant mood swings over a ___ ____ period without meeting the diagnostic criteria for major depressive disorder or bipolar disorder

norepinephrine

High levels of ____________are linked with mania in people with bipolar disorder.

milder

Hypomanic episodes are similar in symptoms to manic episodes but the symptoms are _____ in severity and they cause less impairment.

bipolar I disorder

In ___________________________, the individual experiences both manic and depressive episodes.

Katherine has bipolar II disorder. People with this disorder do not experience full-blown mania (as people with bipolar I disorder do), but they do experience the hypomanic episodes that are seen with cyclothymic disorder as well as major depressive episodes. Bipolar disorder occurs at equal rates in males and females

Katherine is 30 years old. She experiences notable (but not extremely severe) mood changes. Although she does not have full-blown manic episodes, Katherine does experience major depressive episodes. What mood disorder does Katherine have? How likely are males and females to experience this type of disorder?

hypomanic

People with bipolar II disorder experience ______episodes rather than manic or mixed episodes. (p. 240)

rapid cycling

Some individuals with bipolar disorder experience at least four mood episodes (either manic or depressive) every year, a pattern known as ____________________________.

elderly (age 65 and older).

The highest rate of completed suicide is found in the ______

depressive episode

Women without a close confidant are more likely to experience a _____ _______. People who are lonely or isolated are more likely to experience depression, and depressed people tend to have smaller and less supportive social networks.

cyclothymic disorder

_____________ is defined by the DSM-5 as a less severe version of bipolar disorder. It is characterized by mild depressive symptoms and numerous periods of increased physical and mental energy.

monoamine oxidase inhibitors (MAOIs)

________________ inhibit the action of an enzyme responsible for the breakdown of norepinephrine and serotonin. They can be effective for treating depression, but can have potentially dangerous side effects if foods rich in tyramine are consumed

low

norepinephrine is ___ during depressive episodes, and serotonin is consistently low in both manic and depressive episodes in bipolar disorder.

Drastic changes in a student's mood and behavior can be a significant warning sign of possible suicide. Students who are contemplating suicide may become depressed and socially withdrawn. Their self-esteem may decline and they may begin to show deterioration in personal hygiene. They may also begin to engage in impulsive or reckless behavior, such as self-mutilating behavior. They may begin to show a profound loss of interest in their studies and may communicate their distress to at least one other person

Describe some warning signs of student suicide.

_____is a type of mood stabilizer used to treat people with bipolar disorder because it has both antimanic and antidepressant effects. Some side effects include lethargy, cognitive slowing, weight gain, decreased motor coordination, and gastrointestinal difficulties (p. 248).

Lithium

likely

Major depression that occurs in adolescence is very ____to recur in adulthood

more four

Men are more likely to use guns and women are more likely to attempt to overdose on drugs. Overall, men are ____ likely to use more lethal methods in suicide attempts. This may be why____times more men then women die by suicide.

bipolar II disorder.

People who have a history of professional instability, creative achievements, and flamboyant behavior are especially likely to be diagnosed later with___ ___ _____

major depressive disorder

People who ruminate have more lengthy periods of depressive symptoms. They are also more likely to develop full-blown episodes of ____ ______ ____

double depression

People with ___________________________ are moderately depressed on a chronic basis but undergo increased problems from time to time, during which they meet the criteria for a major depressive episode.

increase

Personality traits such as impulsivity, aggression, and pessimism all seem to _____________ an individual's risk for suicide.

"bereavement exclusion."

Previous editions of the DSM suggested that major depressive disorder should not be diagnosed if the individual displaying symptoms had lost a loved one in the past two months. This was known as the ______ ______. In the DSM-5, this exclusion was dropped; major depressive disorder may now be diagnosed even if the individual has recently suffered a major loss, as long as criteria are met

Rob likely has cyclothymic disorder. With this disorder, people experience cyclical mood swings that are less severe than the mood swings seen in bipolar disorder. Cyclothymic disorder does not have the extreme symptoms and psychotic features (such as delusions) caused by manic or major depressive episodes. For a diagnosis of cyclothymia, there must be at least a 2-year span of numerous periods with hypomanic and depressive symptoms, and the symptoms must cause significant distress or impairment in functioning, although not as severe as in bipolar disorder. Individuals with cyclothymic disorder are at a greater risk for developing bipolar I or II disorder

Rob is 22 years old. For the past 2 years, he has experienced irregular moods. For 3 or 4 days at a time, Rob lacks energy, confidence, and motivation. Abruptly, his mood shifts and he experiences overconfidence, heightened social awareness, promiscuity, and sharpened thinking for another 3 or 4 days. Because of these rapidly shifting mood states, his grades in school suffer at times but then become excellent. His job as a customer service representative sometimes suffers while his mood is shifting downward. What mood disorder might Rob have?

Samantha is probably suffering from major depressive disorder (p. 214). Since this is her first major depressive episode, it is considered her initial episode. The diagnosis also requires that Samantha has never had manic, mixed, or hypomanic episodes. Major depressive episodes are the most common form of mood episodes; to receive diagnosis a person must be markedly depressed and/or show a marked loss of interest in pleasurable activities for most of the day, for most days, for at least 2 weeks. In addition, a person must display at least five symptoms ranging from cognitive (feelings of worthlessness), to behavioral (such as fatigue), to physical (such as changes in sleep patterns)

Samantha, a 40-year-old school teacher married to a prominent businessman, was unexpectedly deserted by her husband for his younger assistant. Six months after the separation, friends and family started to notice worrisome changes in Samantha's behavior. Previously an energetic, confident, fun-loving individual, Samantha has been complaining of feeling fatigued and worthless every day for over two months. Additionally, although she previously loved her job, of late she claims the job is no longer enjoyable and she has lost interest in her work. Samantha told her mother that she is having trouble sleeping, which she blames for her lack of energy. Additionally, Samantha has gained a significant amount of weight in a short period of time.

Relapse

___________________________refers to the return of symptoms within a fairly short period of time, a situation that probably reflects that the disorder has not fully run its course.

Recurrence

_______refers to new episodes of depression within an individual. If the symptoms return fairly quickly, it is likely that the episode of depression has not yet run its course

Anhedonia dopaminergic

_____is the inability to experience pleasure, an important symptom of depression. The inability for many people with depression to experience pleasure may be linked to reduced _____activity in the brain

Lithium

_____is used in the treatment of bipolar disorders because of its mood stabilizing effects. It is effective at reducing both manic and depressive episodes. However, some studies have questioned whether it is any more effective than normal antidepressants in treatment of bipolar depression.

cognitive behavioral therapy

a brief therapy that treats depression by focusing on problems and issues at present. It features highly structured, systematic attempts to teach depressed patients to evaluate their dysfunctional beliefs and negative automatic thoughts.

70%

a study by Monroe and Harkness found that___% of initial depressive episodes were preceded by a major stressful life event, compared to only 40% of recurrent depressive episodes

mania facilitates the creative process. It has also been hypothesized that the intense negative emotional experiences involved in depression provide material for creativity

what are the hypothesis for why unipolar and bipolar mood disorders tend to occur with alarming frequency in poets, writers, composers, and artists

Persistent depressive disorder is generally considered to be of mild to moderate intensity, but its primary hallmark is its chronicity (p. 217). In spite of intermittently normal moods, the chronic course of persistent depressive disorder results in patients showing poorer outcomes and as much impairment as people with major depression.

what is the hallmark feature of PDD

cyclothymic disorder

A less serious version of bipolar disorder that is characterized by less severe cyclical mood changes is called _______.

behavioral activation treatment

A new and promising treatment for unipolar depression called ____________________________ focuses intensively on getting patients to become more engaged with their environment and with their interpersonal relationships.

Bipolar II disorder

According to the DSM-5, ________________ is characterized by the presence (or history) of hypomanic episodes but neither manic nor mixed episodes.

circadian rhythm

Although the exact nature of the dysfunction is not yet known, some kind of ___________________________ dysfunction may play a causal role in many clinical features of depression. For example, one theory is that synchronized daily bodily patterns become desynchronized, causing depressive symptoms.

These increase transmission of the monoamine neurotransmitters norepinephrine and serotonin. Side effects experienced with these drugs include dry mouth, constipation, sexual dysfunction, and weight gain. Large doses of these drugs are highly toxic.

Another type of antidepressant medicationis tricyclic antidepressants (p. 247). what do they do

selective serotonin reuptake inhibitors (SSRIs

Antidepressant medications of this type are typically prescribed because they tend to have few side effects and are tolerated well by patients. Negative side effects can include diminished interest in sexual activity, insomnia, physical agitation, or gastrointestinal distress.

dysthymic disorder

In order to be diagnosed with ___________________________, one must experience a persistently depressed mood most of the day, for most days, for at least 2 years.

more likely

Individuals are ___ ____to be depressed if their attributions are internal, global, and stable

Electroconvulsive therapy (ECT)

___ ______ ______ is used to treat high-risk depressed patients because it improves their condition more quickly than traditional antidepressants.

Unipolar major depressive disorder

____ _____ _____ _____ is much more common than bipolar disorder. The lifetime prevalence rate of major depressive disorder is almost 17%, whereas the lifetime prevalence rate of bipolar disorder is around 1%

Suicide

_____ is the tenth leading cause of death in the United States.

The three themes of Beck's negative cognitive triad are: (1) negative thoughts about the self (ex. "I'm ugly"; "I'm worthless"; "I'm a failure"); (2) negative thoughts about one's experiences and the surrounding world (ex. "No one loves me"; "People treat me badly"); and (3) negative thoughts about one's future (ex. "It's hopeless because things will always be this way") (p. 231).

. Included in Beck's cognitive model of depression is the creation of a pattern of negative automatic thoughts—thoughts that often occur just below the surface of awareness and involve unpleasant, pessimistic predictions. These pessimistic predictions tend to center around three themes of what Beck calls the negative cognitive triad. . What are the three themes included in the negative cognitive triad?

mixed episode

A ____________________________ is characterized by symptoms of both full-blown manic and major depressive episodes that last for at least 1 week, whether the symptoms are intermixed or alternate rapidly every few days

manic episode

A ___________________________is a mood episode in which an individual shows markedly elevated, euphoric, or expansive mood, occasionally interrupted by outbursts of intense irritability or even violence.

negative cognitive triad

Beck's ___________________________is composed of negative thoughts about the self, negative thoughts about one's experiences, and negative thoughts about one's future

bipolar I disorder

Bipolar I disorder differs from bipolar II disorder in that a person suffering from ____ __ _____ has experienced at least one manic or mixed episode.

If a person has symptoms similar to (but milder than) those of a manic episode, this is known as a hypomanic episode, in which a person experiences abnormally elevated, expansive, or irritable mood for at least four days. Although the symptoms are the same for manic and hypomanic episodes, the symptoms of hypomania occur to a lesser degree, there is much less impairment in social and occupational functioning, and the individual does not require hospitalization. (p. 213).

If Terry only displayed milder versions of the symptoms described above and did not require hospitalization, would his diagnosis change, and if so, what would it be?

mood disorders.

Individuals with high levels of accomplishments in the arts tend to have a higher risk of __ ______

Antidepressant, mood-stabilizing, and antipsychotic drugs are all used in treating unipolar and bipolar disorders. The first type of antidepressant medications are monoamine oxidase inhibitors (MAOIs) They inhibit the action of monoamine oxidase, an enzyme responsible for the breakdown of norepinephrine and serotonin. MAOIs have serious, potentially fatal side effects if certain foods high in the amino acid tyramine are consumed (such as red wine, beer, cheese, and salami).

Several different medications have developed over the years for treating people with bipolar and unipolar depressive disorders. List two of these medications. What kind of side effects does each type have?

equivalent to

Several forms of specialized psychotherapy have proven to be effective in the treatment of unipolar depression. Improvement is often ____________ that observed with medication.

depression

Sex differences in levels of neuroticism may play a role in the sex differences observed in rates of ______

Vinny is probably suffering from persistent depressive disorder (p. 217). To be diagnosed with this disorder, a person must have a persistently depressed mood most of the day, for more days than not, for at least 2 years (1 year for children and adolescents). In addition, individuals with persistent depressive disorder must have had at least two of six additional symptoms when depressed (such as low energy, poor appetite, low self-esteem, sleeping problems, difficulty making decision, or feelings of hopelessness). Periods of normal mood may occur briefly, but they usually last for only a few days to a few weeks

Since graduating college 4 years ago, Vinny has found that his outlook on life has been getting consistently worse. About a year after graduation, Vinny entered the work world and since that time he has been complaining of being "depressed" about just about everything. Although some days he feels that his mood is "normal", most days Vinny has low energy, low self-esteem, and feelings of hopelessness. All of this is worrisome to both Vinny and his family, but since he sometimes feels like things are improving they have avoided seeking treatment for Vinny.

higher

Suicide rates are ___________ in males than in females.

Susan likely has bipolar I disorder. This disorder is characterized by full-blown manic and major depressive episodes, which may alternate rapidly. People with this disorder may be diagnosed without the presence of a major depressive disorder because it is assumed that one will eventually occur

Susan is 25 years old. She experiences dramatic mood changes. For weeks at a time, she has remarkable energy, hyperactivity, and euphoria. At times she can act aggressively. She will spend large sums of money on unnecessary purchases, such as new cars. During her euphoric states, she believes that she will become the next president of the United States. Susan then experiences a deep depression in which she stays in bed all day and can hardly move. These depressed states last for at least two weeks. What mood disorder does Susan have?

Terry is experiencing a manic episode. A manic episode is a mood episode in which the person shows markedly elevated, euphoric, or expansive mood, which may be interrupted by occasional outbursts of intense irritability or even violence—particularly when others refuse to go along with the manic person's wishes and schemes. These extreme moods must persist for at least a week for this diagnosis to be made. During the period of mood disturbance, three or more symptoms—such as grandiosity, decreased need for sleep, distractibility, flight of idea—must persist, be present to a significant degree, and represent a notable departure from usual behavior (p. 214).

Terry's colleagues at his law firm noticed he had been acting strangely at work on Monday, but they were initially not concerned. Terry usually worked at a fairly laid back pace and was easy to get along with, but by Wednesday almost everyone had noticed that Terry was acting much differently than normal. Terry was extremely irritable, he told his coworkers that he had only been sleeping about three hours a night, and although he seemed to get distracted very easily, he had been working non-stop to complete casework that would not be relevant for months. After a full week at work where his behavior was of great concern, Terry was hospitalized following a violent outburst in a casino after he lost a large portion of his retirement fund.

MAOIs

The antidepressant medications known as ___________________________, can have potentially dangerous, even sometimes fatal, side effects if certain foods rich in the amino acid tyramine are consumed.

18 and 22

The average age of onset for bipolar disorder is between__and __ and it affects both males and females at equal rates.

one week four days

The symptoms of a manic episode must last ___ ____. A hypomanic episode must last at least___ ____ and is identified by milder symptoms than a manic episode

manic episode

The tendency to sleep very little is the most common symptom to occur prior to the onset of a ____________________________.

relapse

The term_____ describes a situation where symptoms return within a fairly short period of time.

Fewer side effects exist with SSRIs, although problems with orgasm, lowered interest in sexual activity, insomnia, physical agitation, and gastrointestinal distress may occur (p. 248).

The third type of antidepressants is selective serotonin reuptake inhibitors (SSRIs). what do they do

first depressive episode

There is a stronger relationship between stressful life events and a ____ ______ _____than between stressful events and recurrent depressive episodes.

serotonin

There is strong evidence that suicide sometimes runs in families and that genetic factors may play a role in the risk for suicide. Suicidal patients often have reduced levels of ___________, which may increase their risk of suicide.

interpersonal therapy

This is a treatment approach that focuses on current relationship issues to help the person understand and change maladaptive interaction patterns. It can be useful for unipolar depression, but has also been adapted for treatment of bipolar disorder.

bipolar I disorder

When an individual experiences symptoms of a manic (or mixed) episode and, he or she will meet the criteria for ______________.

Yolanda would be diagnosed with a major depressive episode with atypical features (p. 220). In addition to mood reactivity, she has three of the four symptoms (only two are required for diagnosis) characteristic of this specifier (acute sensitivity to interpersonal rejection is the only symptom she is not showing). A disproportionate number of individuals who have atypical features are females who have an earlier-than-average age of onset and are more likely to experience suicidal thoughts.

Yolanda meets all of the criteria for a major depressive episode and has a distinct pattern of symptoms that are characterized by mood reactivity (i.e. the person's mood brightens in response to potential positive events). In addition, she has experienced significant weight gain, hypersomnia (sleeping too much), and leaden paralysis (heavy feelings in arms or legs). Which specifier would be given to Yolanda's diagnosis of depression?

bipolar disorder

____ disorder is also typically recurrent, and very few people experience only one attack. In most cases an episode of mania immediately precedes or follows a period of depression

Interpersonal

_____ therapy focuses on the individuals' interactions, trying to get them to change maladaptive relationships for the better.

Depression is known as the stress-generation model of depression, in which people are thought to be at least partially responsible for causing some of the factors that create their depression

______ can create a negative affectivity that fuels marital problems, which in turn worsens the symptoms of depression, creating a cycle of worsening marital discord. ^^ what is this called

Neuroticism

_______ has been linked with the occurrence of more stressful life events, increased risk for depression, and a worse prognosis for complete recovery.

Electroconvulsive therapy

___________________________ involves treatments that induce controlled seizures in patients with severe depression.

Learned helplessness

___________________________ occurs when animals or humans find that they have no control over aversive events; they may learn that they are powerless, which makes them unmotivated to try to control stressors in the future.

Negative automatic thoughts

___________________________ often occur just below the surface of awareness and involve unpleasant pessimistic predictions.

The monoamine theory

___________________________ states that depression is at least sometimes due to an absolute or relative depletion of serotonin and/or norepinephrine at important receptor sites in the brain.

Lithium

____________________________ is a mood stabilizer that has been widely studied as a treatment for manic episodes.

Bright light therapy

____________________________ was originally used in the treatment of seasonal affective disorder, but has since been shown to be effective in nonseasonal depressions as well.

Major depressive episodes with atypical features

___________________________include a pattern of symptoms characterized by mood reactivity; that is, the person's mood positively enhances in reaction to positive events.

Chelsea failed a biology test and finds herself thinking, "I'm so stupid, of course I failed the test" (negative thoughts about the self). She becomes upset whenever she thinks about school, believing all the professors in her department to be out to get her (negative thoughts about the world). Though she has other opportunities in the class over the course of the semester to raise her grade, she is sure that her performance will not improve, she will always be terrible at biology, and she will fail the class (negative thoughts about her future) (pp. 230-231).

give an example of a pessimistic prediction characteristic of each of the three themes.