PSY 250 CH 7 MOOD DISORDERS & SUICIDE

Explain prevalence rates of suicide among people with mood disorders.

* 40-60% of those who complete the act do so during a depressive episode or in the recovery phase * Paradoxically, the act often occurs @a point when a person appears to be emerging from the deepest phase of the depressive attack. * risk of suicide is 1% during the yr in which a depressive episode occurs, but the lifetime risk for someone who has recurrent depressive episodes in about 15% * to put it differently, depressed people are 50x more likely to commit suicide than non depressed people. * estimated that approx. 90% of people who either attempted or successfully committed suicide had some psychiatric disorder at the time. * among 10 leading causes of death in most Western Countries ( in US 8th or 9th leading cause w/est of 31,000 suicides/yr) * experts agree that the # of actual suicides is @least 2-3x higher than the #officially reported because many self-inflicted deaths are attributed in official records to other, more "respectable" causes. *Completed suicides, estimate are that approx. 1/ a million people attempt suicide each yr & that nearly 3% of Americans have made a suicide attempt at some time their lives.

Explain how various sociocultural factors affect unipolar and bipolar disorders. (p#260)

* CROSS-CULTURAL DIFFERENCES IN DEPRESSIVE SYMPTOMS - although depression occurs in all cultures that have been studied, the form that it takes differs widely, as does its prevalence. EX. in China & Japan rates of depression relatively low, many of the psychological symptoms of depression are often not present. Instead people tend to exhibit so called somatic & vegetative manifestations such as sleep disturbance, loss of appetite, wt loss, & loss of sexual interest. Possible reasons stem from Asian beliefs in the unity of the mind & body , a lack of expressiveness about emotions more generally, & the stigma attached to mental illness in these cultures. * CROSS-CULTURAL DIFFERENCE IN PREVALENCE - prevalence rates for depression (whether expressed primarily thru somatic or psychological symptoms) vary a great deal across countries, as revealed by many epidemiological studies. (p#261) * DEMOGRAPHIC DIFFERENCES IN THE US - No large racial differences, however in each study the prevalence was slightly lower among African-Americans than among European White Americans. Hispanics fell in between the other 2 however in more recent studies Hispanics & European White Americans were comparable. RATES OF UNIPOLAR depression are inversely related to socioeconomic status; that is, higher rates occur in lower socioeconomic groups. This may well be because low SES leads to adversity & life stress. However for BIPOLAR DISORDER THE FINDINGS ARE THE OPPOSITE: A # of studies show that bipolar disorder is more common in the higher socioeconomic studies show that individuals w/bipolar disorder tend to have more education & that they come, on average, from families w/higher socioeconomic status than those w/unipolar depression. - might be because some of the personality & behavioral correlates of bipolar illness,@least in hypomanic phases (such as outgoingness, increase energy, & increased productivity), may lead to increased achievement & accomplishment. - Jamison also documented a # of famous creative individuals how their periods of productivity covary w/the manic, or hypomanic, & depressive phases of their illnesses. Hypothesis=mania or hypomania actually facilitates the creative process, &/or that the intense negative emotional experiences of depression provide material for creative activity.

Describe various types of bipolar disorders.(p#253-254)

* CYCLOTHYMIC DISORDER -less serious version of major bipolar disorder, minus certain extreme symptoms& pscyhotic features, such as delusions, & minus the marked impairment caused by full-blown manic or major depressive episodes. (p#253) * BIPOLAR DISORDERS I - distinguised from major depressive disorder by at least 1 episode of mania or a mixed episode (symptoms of both full-blown manic & major depressive episodes for @least 1wk, whether the symptoms are intermixed or alternate rapidly every few days) * BIPOLAR DISORDERS II - person does not experience clear-cut hypomanic episodes, as well as major depressive episodes as in Bipolar I disorder - More common than Bipolar I. est 3% of US pop will suffer from 1 or the other disorder. Bipolar II evolves into Bipolar I disorder in only about 5-15% of cases, suggesting they are distinct forms of the disorder.

Explain the prevalence of mood disorders. (p#227)

* Occur at least 15-20x more frequently than schizophrenia * Almost the same rate as all the anxiety disorders taken together. *OF THE 2 TYPES OF SERIOUS MOOD DISORDERS - UNIPOLAR Major depression is much more common, & it's occurrence has apparently increase in recent decades. - Nat'l Comorbidity Survey-Replication study found lifetime prevalence rates of unipolar major depression @nearly 17% (12 mo. prevalence rates were nearly 7%) - Unipolar rate much higher for women than men (2:1) -BIPOLAR DISORDER is much less common; lifetime risk of developing this disorder ranges from 0.4-1.6%, 7 there is no discernible difference in the prevalence rates between the sexes.

Identify the mild to moderate depressive disorders.

*DYSTHYMIC DISORDER * MAJOR DEPRESSIVE DISORDER *

mixed episode

A condition in which a person is characterized by symptoms of both full blown manic & major depressive episodes for at least 1 week, whether the symptoms are intermixed or alternate rapidly every few days

manic episode

A condition in which a person shows markedly elevated, euphoric, or expansive mood, often interrupted by occasional outbursts of intense irritability or even violence that lasts for at least 1 week. In addition at least 3 out of 7 other designated symptoms must also occur.

hypomanic episode

A condition lasting at least 4 days in which a person experiences abnormally elevated, expansive or irritable mood. At least 3 out of 7 other designated symptoms similar to those in a manic episode must also be present but to a lesser degree than a mania.

bipolar II disorder

A form of bipolar disorder in which the person experiences both hypomanic episodes & major depressive episodes.

bipolar I disorder

A form of bipolar disorder in which the person experiences both manic (or mixed) episodes & major depressive episodes

major depressive episode

A mental condition in which a person must be markedly depressed for most of every day for most days for at least 2 weeks. in addition, a total of at least 5 out of 9 designated symptoms must also be present during the same time period.

recurrence

A new occurrence of a disorder after a remission of symptom

rapid cycling

A pattern of bipolar disorder involving at least 4 manic or depressive episodes per year

learned helplessness

A theory that animals & people exposed to uncontrollable aversive events learn that they have no control over these events & this causes them to behave in a passive & helpless manner when later exposed to potentially controllable event. Later extended to become a theory of depression.

major depressive episode with atypical features

A type of major depressive episode which includes a pattern of symptoms characterized by marked mood reactivity, as well as at least 2 out of 4 other designated symptoms

major depressive episode with melancholic features

A type of major depressive episode which includes marked symptoms of loss of interest or pleasure in almost all activities, plus at least 3 of 6 other designated symptoms.

Describe the various motives for why someone takes their own life.

ADOLESCENTS -Treatment of adolescent mood disorders w/antidepressant medication also seems to produce a very slightly increased risk for suicidal ideation & behavior in children & adolescents, & so now pharmaceutical co. must put warning to this effect on these meds. - Obvious reason-period of depression, anxiety, alcohol & drug use, & conduct disroder problems also show increasing prevalence & increased risk for suicide. - Exposure to suicide (especially to celebreties) thru the media, where they are often portrayed in dramatic terms, has probably also contributed to these aggregate increases since they are highly susceptible to suggestion & imitative behavior. - the fact the media rarely discuss the mental disorder suffered by the suicide victims may further increase the likelihood of imitation. - estimate between 1-13% of adolescent suicides occur as a result of contagion factors. COLLEGE STUDENTS - Academic demands - social interaction problems - career choices - perhaps interacting w/challenges to their basic values-evidently makie it impossible for some students to continue making the adjustments their life situations demand. MIDDLE AGES -Severe financial reversals, imprisonment, interpersonal crises of various sorts. - "success suicides" occasional depressive episodes that seem to be precipitated by positive life events. - hopelessness about the future -major depression include sever psychic anxiety, panic attacks, severe anhedonia (inability to experience pleasure), global insomnia, delusions & alcohol abuse.

Evaluate the ethical issues involved in the right to die. (P#276)

AGAINST -fears that the rt to suicide might be abused - ex. terminally ill & severely incapacitated might feel pressured to end their own lives rather than burden their families w/their care or w/the cost of their care in a medical facility or hospice. (have not seen in Oregon or Netherlands where legal) FOR -terminally ill could have dignified -those w/chronic or debilitating pain to shorten their agony Could person get help & change their mind but would it require them to be hospitalized against their will clinical judgement is no longer the only consideration in intervention decision

Describe who is likely to attempt suicide and who is likely to complete suicide.

ATTEMPTED SUICIDE * Until recently most suicide attempts were most common in people between 25-44 yrs old, but it is now people between 18-24 yrs old who have the highest rates. * In US, women are about 3x as likely to attempt suicide as men. * Rate of suicide attempst are also about 3-4x higher in people who are separated or divorced than for those w/any other marital status. * Most attempts occur in the context of interpersonal discord or other severe life stress. COMPLETED SUICIDES * 4X more men than women die by suicide each yr in US * Highest rates of completed suicides in in the elderly (aged 65 & over). w/high proportion are divorced or widowed, or suffer from a chronic physical illness that can lead to increase risk for dsuicide, usually because the person is depressed. * For women, the method most commonly used is drug ingestions; men tend to use methods more likely to be lethal, particularly gunshot, which may be a good part of the reason why completed suicides are higher among men. *Besides the elderly, person w/mood disorder & separated or divorced persons, there are a # of other high risk groups among adults - people w/mood disorder have highest risk about 15% - schizophrenia - 10% risk - those hospitalized for alcohol dependence- 3-4% risk, relative to the avg risk of 1.4% in the general pop. SUICIDE IN CHILDREN * rates still very low but have been increasing * suicide is rare for 5-14 yr (0.7 per 100,000) but nevertheless the 7th leading cause of death in the US for this age group & has increase by 70% since 1981 * Trend not limited to youngsters from deprived or troubled backgrounds. * Increased risk for suicide if they have lost a parent or have been abused. *Several forms of psychopathology - depression, antisocial behavior, & high impulsivity - are also known to be risk factors for suicide in children. ADOLESCENTS & YOUNG ADULTS *rate of successful suicides essentially triples between the mid 1950's & the mid 1980's for ages 15-24. * Declined slightly from 1981-2000 but remained unacceptably high * 3rd most common cause of death in the US for 15-24 y.o. (after accidents & homocides) occurring in about 13 per 100,000 * increase in raees no unique to US but has been observed in most of the many countries studied in this age group * Est rates of self reported attempts from H.S. students about 10% w/twice as many admitting they seriously considered it * In 1 study among male adolescents who had attempted suicide, nearly 9% completed suicide w/in 5 yrs; the comparable rates for girls were 1-4% * Suicide rate in college students are also high = 2nd leading cause of death in this group. 1 large survey found about 10% had seriously contemplated suicide in the past yr. & that most of these had some sort of plan.

Discuss biological and psychosocial causal factors in unipolar and bipolar mood disorders. (p#235)

BIOLOGICAL CAUSAL FACTORS * GENETIC INFLUENCES-prevalence of mood disorders is approx 3x higher among blood relative of persons w/clinically diagnosed unipolar depression than in pop at large. * NEUROCHEMICAL FACTORS - disruptions in the delicate balance of neurotransmitters substances that regulate & mediate the activity of the brain's nerve cells * ABNORMALITIES OF HORMONAL REGULATORY SYSTEM -possible hormonal causes or correlates of some forms of mood disorder; majority of attn on Hypothalamic-pituitary-Adrenal (HPA) axis 7 in particular on the hormone CORTISOL, which is excreted by the outermost portion of the adrenal glands 7 is regulated through a complex feedback loop. (p#237) * NEUROPHYSIOLOGICAL & NEUROANATOMICAL INFLUENCES-dame (for ex from a stroke) to the left, but not the right, anterior or prefrontal cortex often leads to depression. Led to idea that depression in people w/o brain damage may nonetheless be linked to lowered levels of brain activity in this same region. * SLEEP & OTHER BIOLOGICAL RHYTHMS - SLEEP-characterized by 5 stages that occur in a relatively invariant sequence throughout the night (1-3 non-REM, 5 REM) CIRCADIAN RHYTHMS - 24 hr cycles other than sleep, including body temp, propensity to REM sleep, 7 secretion of cortisol, thyroid-stimulating hormone, & growth hormone. Some kind of circadian rhythm dysfunction may play a causal role in many of the clinical features of depression. 2 current theories 1) that the size or magnitude of the circadian rhythms is blunted & 2) that the various circadian rhythms that are normally well synchronized w/each other become desynchronized or uncoupled. SUNLIGHT & SEASONS-most pts seem to be responsive to the total quantity of available light in the environment (p#240) PSYCHOSOCIAL CAUSAL FACTORS (P#240) * STRESSFUL LIFE EVENTS- many studies show that severe stressful life events(loss of loved 1, serious threats to important close relationships, or to 1's occupation, or severe economic or serious health problems) often serve as precipitating factor for unipolar depression - MILDLY STRESSFUL EVENTS & CHRONIC STRESS-recently raised that minor events may play more of a role in the onset of recurrent episodes than the initial episode, although new research studies will be needed to confirm this hypothesis; Chronic Stress associated w/increased risk for the onset 7 maintenance of major depression. - INDIVIDUAL DIFFERENCES IN RESPONSES TO STRESSORS VULNERABILITY & INVULNERABILITY FACTORS - genetic variable may make pt vulnerable but also women who experienced a sever event, 4 factors were associated w/not becoming depressed 1) having an intimate relationship w/a spouse or lover 2) having no more than 3 children still @home 4) having a serious religious commitment. Conversely not having the above 4 factors - not having a close relationship w/a spouse or lover, having 3 children under the age of 5 @home, not having a job, & having lost a parent by death before the age of 11 were strongly associated w/the onset of depression following a major negative life event. (p#242) * DIFFERENT TYPE OF VULNERABILITIES FOR UNIPOLAR DEPRESSION - PERSONALITY & COGNITIVE DIATHESES - NEUROTICISM (or negative affectivity isstable & heritable personality trait that involves a temperamental sensitivity to negative stimuli) is the primary personality variable that serves as a vulnerability factor for depression. Also high levels of introversion may serve as vulnerability for depression alone or when combined w/neuroticism. COGNITIVE DIATHESIS - focus on particular negative patterns of thinking tat make peopelewho are prone to depression more likely to become depressed. - EARLY ADVERSITY & PARENTAL LOSS AS A DIATHESES - early parental loss thru death or permanent separation seemed to create a vulnerability to depression in adulthood. 3x more higher in women who had lost their mothers before the age of 11. If child continues to receive good parental care after their loss & there are not too many disruptions to the child's environment (p#242) - SUMMARY OF DIFFERENT TYPE OF VULNERABILITIES - SEVERAL DIFFERENT TYPES OF DIATHESES FOR UNIPOLAR DEPRESSION HAVE BEEN STUDIED. SOME PROPOSE A GENETIC DIATHESIS THAT, OFTEN IN CONJUNCTION W/STRESSFUL LIFE EVENTS CAN PRODUCE DEPRESSION. OTHER MODELS SUGGEST THAT PERSONALITY VARIABLES (SUCH AS NEUROTICISM) OR COGNITIVE VARIABLE (SUCH AS PESSIMISM OR DYSFUNCTIONAL BELIEFS) PROVIDE A DIATHESIS THAT, PERHAPS IN INTERACTIONS W/NEGATIVE LIFE EVENTS, CAN PRODUCE DEPRESSION,. FINALLY, MODELS PROPOSING THE IMPORTANCE OF EARLY PARENTAL LOSS OR DYSFUNCTIONAL PARENTING OR OTHER FORMS OF EARLY ADVERSITY HAVE ALSO RECEIVED A GOOD DEAL OF ATTN. - * PSYCHODYNAMIC THEORIES - * BEHAVIORAL THEORIES * BECK'S COGNITIVE THEORY * THE HELPLESSNESS & HOPELESSNESS THEORIES * INTERPERSONAL EFFECT OF MOOD DISORDERS

bipolar disorder with a seasonal pattern

Bipolar disorder w/recurrences in particular seasons of the year

Describe criteria for diagnosing major depressive disorder and the subtypes. (p#231)

CRITERIA FOR MAJOR DEPRESSIVE DISORDER * Presence of single (initial) Major Depressive Episode * the Major Depressive Episode is not better accounted for by another disorder * there has never been a Manic episode or a Mixed Episode, or a Hypomanic Episode (A PT EITHER HAS LOST INTEREST OR PLEASURE IN ALMOST ALL ACTIVITIES OR DOESN'T REACT TO USUALLY PLEASURABLE STIMULI OR DESIRED EVENTS.) SUBTYPES * DEPRESSION THRUOUT THE LIFE CYCLE * SPECIFIERS FOR MAJOR DEPRESSION 1) early morning awakening 2) depression being worse in the morning 3) marked psychomotor retardation or agitation 4) significant loss of appetite & wt 5) inappropriate or excessive guilt, & 6) depressed mood that is qualitatively different form the sadness experience during a non-melancholic depression * DEPRESSION AS RECURRENT DISORDER * SEASONAL AFFECTIVE DISORDER (SAD)

pessimistic attributional style

Cognitive style involving a tendency to make internal, stable, & global attributions for negative life events.

mood-incongruent delusions

Delusional thinking that is inconsistent w/a person's predominant mood

mood-congruent delusions

Delusions or hallucinations that are consistent w/a person's mood

specifiers

Different patterns of symptoms that sometimes characterize major depressive episodes which may help predict the course & preferred treatments for the condition

chronic major depressive disorder

Disorder in which a major depressive episode does not remit over a 2 year period

mood disorders

Disturbances of mood that are intense & persistent enough to be clearly maladaptive.

depressogenic schemas

Dysfunctional beliefs that are rigid, extreme, & counterproductive & that are thought to leave 1 susceptible to depression when experiencing stress.

depression

Emotional state characterized by extraordinary sadness & dejection

mania

Emotional state characterized by intense & unrealistic feelings of excitement & euphoria

Define the characteristics of mood disorders. (p#226)

MANIA - characterized by intense & unrealistic feelings of excitement & euphoria DEPRESSION - usually involves feelings of extraordinary sadness & dejection. UNIPOLAR DISORDER - person experiences only depressive episodes MAJOR DEPRESSIVE EPISODE - Person must be markedly depressed (or show a marked loss of interest in pleasurable activities) for most of every day & for most days for at least 2 wks MANIC EPISODE - person shows markedly elevated, euphoric, or expansive mood often interrupted by occasional outbursts of intense irritability or even violence - particularly when other refuse to go along w/the manic person's wishes & schemes. These extreme moods must persist for at least a week for this diagnosis to be made.

severe major depressive episode with psychotic features

Major depression involving loss of contact w/reality, often in the form of delusions or hallucinations

Assess treatments and outcomes of mood disorders. (p#263)

Many pts who suffer from mood disorders (esp. unipolar disorder) never seek treatment, & w/o formal treatment, the great majority of manic & depressed pts will recover (often only temporarily) w/in less than 1 yr. * PHARMACOTHERAPY - Antidepressants-require 3-5wks to take effect. If no signs of improvement after 6wks physicians should try a new med, because about 50% of those who not not respond to the 1st drug prescribed do respond to the 2nd one. since depression tends to be a recurrent disorder, physicians have increasingly recommended that pts continue for very long periods of time on the drugs (ideally @same dose) in order to prevent recurrence. 25% show symptoms of recurrence while still on meds UNPLEASANT SIDE EFFECT: problems w/orgasm & lowered interest in sexual activity, although insomnia increased physical agitation, & gastrointestinal distress also occur in some pts. also wt gain. - mood-stabilizing (LITHIUM) - effective in preventing cycling between manic & depressive episodes (although not necessarily for pts w/rapid cycling) & bipolar pts are frequently maintained on lithium therapy over long periods of time, even when not manic or depressed, simply to prevent new episodes. UNPLEASANT SIDE EFFECT=lethargy, decreased motor coordination & gastrointestinal difficulties in some pts. Long term use associated w/kidney malfunction & sometimes permanent kidney damage. - antipsychotic drugs are all used in the treatment of uni & bipolar disorders. *ALTERNATIVE BIOLOGICAL TREATMENTS (P#265) -ELECTROCONVULSIVE THERAPY (ECT) - often used w/severely depressed pt (especially among the elderly) who may present an immediate & serious suicidal risk. since antidepressants often take 3-4 wks to produce significant improvement. - TRANSCRANIAL MAGNETIC STIMULATION (TMS) - only recenlty begun to receive a good deal of attn. TMS is a noninvasive technique allowing focal stimulation of the brain in pts who are awake. Brief but intense pulsating magnetic fields that induce electrical activity in certain parts of the cortex are delived. Procedure is painless, & thousands of stimulations are delivered in each treatment session. treatment usually occurs 5/days/wk for 2-6wks. As effective as ECT & antidepressants med in some studies. - BRIGHT LIGHT THERAPY - orig used in SAD, but it has now been shown to be effective in nonseasonal depressions as well. *PSYCHOTHERAPY - (P#265) - COGNITIVE (CBT) & BEHAVIORAL ACTIVATION THERAPY - INTERPERSONAL THERAPY (IPT) - (P#267) - FAMILY & MARITAL THERAPY CONCLUSIONS - EVEN W/O FORMAL THERAPY, THE GREAT MAJORITY OF MANIC & DEPRESSED PTS RECOVER FROM A GIVEN EPISODE IN LESS THAN A YR; W/MODERN METHODS OF TREATMENT, GENERAL OUTLOOK FOR A GIVEN EPISODE HAS BECOME INCREASINGLY FAVORABLE MORE MANY, BUT BY NO MEANS ALL, AFFLICTED INDIVIDUALS. ALTHOUGH RELAPSES & RECURRENCES OFTEN OCCUR, THESE CAN NOW OFTEN BE PREVENTED OR AT LEAST REDUCED IN FREQUENCY BY MAINTENANCE THERAPY - THRU CONTINUATION OF MEDS O&/OR FOLLOW UP THERAPY SESSIONS @REGULAR INTERVALS.

cyclothymia (Cyclothymic disorder)

Mild mood disorder characterized by cyclical periods of hypomanic & depressive symptoms

major depressive disorder

Moderate to sever mood disorder in which a person experiences only major depressive episodes, but no hypomanic, manic, or mixed episodes. Single episode if only 1, recurrent episode if more than 1

dysthymia (Dysthymic disorder)

Moderately severe mood disorder characterized by a persistently depressed mood most of the day for more days than not for at least 2 years. Add'l symptoms may include poor appetite, sleep disturbance, lack of energy, low self esteem, difficulty concentrating, & feelings of hopelessness.

unipolar depression

Mood disorder in which a person experiences only depressive episodes, as opposed to bipolar disorder, in which both manic & depressive episodes occur

seasonal affective disorder

Mood disorder involving at least 2 episodes of depression in the past 2 years occurring at the same time of year (most commonly fall or winter), with remission also occurring at the same time of year (most commonly spring)

dysfunctional beliefs

Negative beliefs that are rigid, extreme, & counterproductive.

negative cognitive triad

Negative thoughts about the self, the world, & the future.

Differentiate depressions that are not mood disorders from those that are. (P#228)

Normal depressions are nearly always the result of a recent stress. THERE ARE 2 FAIRLY COMMON CAUSES OF DEPRESSIONS THAT ARE GENERALLY NOTCONSIDERED MOOD DISORDERS EXCEPT WHEN THEY ARE UNUSUALLY SEVER & /OR PROLONGED * LOSS & THE GRIEVING PROCESS - psychological process 1 goes through following a death of a loved one - a process that appears to be more difficult for men than for women. Include 4 phases 1) Numbing & disbelief-may last few hrs to 1 wk, may be interrupted by outbursts of intense distress, panic, or anger 2) Yearning & searching for the dead person (more similar to anxiety than depression) may last for wks or months. Typical symptoms restlessness, insomnia, & preoccupation ( or anger) w/the dead person. 3) Disorganization & despair that set in after yearning & searching diminish. finally accept loss as permanent & tried to establish a new identity 4) Some level of reorganization when people gradually begin to rebuild their lives, sadness abates, & zest for life returns * POSTPARTUM "BLUES" - Depression occurring after childbirth. most commonly it is mild & transient (postpartum blues) but can become a major depressive episode.

relapse

Return of the symptoms of a disorder after a fairly short period of time

Explain the sociocultural and biological variables that affect suicide. (p#271)

SOCIOCULTURAL (p#272) -different ethnic/racial groups in US (white higher than African Americans except among young then rates are similar) - Native Americans show rate similar to white American males - Vary considerably from 1 society to another: Hungary annual incidence >40 per 100,000, has the world's highest rate - about 4x as high as US); - Religious taboos -Catholicism & Islamic strongly condemn suicide, & suicide rates are Catholic & Islamic countries are correspondingly low. Many still regard it as a crime as well as a sin. - Japan is one of few societies in which suicide has been socially approved under certain circumstances- such as conditions that bring disgrace to an individual or group. - during WW II, many Japanese were reported to have committed mass suicide when faced w/defeat & imminent capture by allied forces. or my military personnel under threat of defeat - Today in Middle East, Muslim extremists & terrorists all to often commit suicide in order to ensure that a bomb explodes in a designated target area BIOLOGICAL -runs in families - genetic factors - alterations in serotonin functioning, w/reduced serotonergic activity being associated a/increase suicide risk

suicide

Taking one's own life

negative automatic thoughts

Thoughts that are just below the surface of awareness & that involve unpleasant pessimistic predictions

Describe unipolar mood disorders. (P#228)

UNIPOLAR DISORDER - person experiences only depressive episodes

diathesis-stress model

View of abnormal behavior as the result of stress operating on an individual who has a biological, psychosocial, or sociocultural predisposition to developing a specific disorder

attributions

process of assigning causes to things that happen