Psyc 241 midterm 2 Chapter 7

predicting suicide

• People who commit suicide tend to signal their intentions, often quite explicitly, such as by telling others about their suicidal thoughts. • In fact, most people who commit suicide make contact beforehand with a health-care provider.

theoretical perspective on suicide

• Suicide represents inward directed anger that turns murderous (e.g., Psychodynamic). • EmileDurkheim (1897/1958), anomie. • Suicide is a wish to escape unbearable psychological pain (Shneidman, 1985). • Suicide is motivated by personal expectancies (Social- Cognitive). • Suicide is attributed to reduced use or availability of serotonin (Crowell et al., 2008). • Mood disorders and parental suicide can also increase risk (Brent et al., 2002).

lithium and other mood stabilizers

• The ancient Greeks and Romans were among the first to use lithium as a form of chemotherapy. - They prescribed mineral water that contained lithium for people with turbulent mood swings. • Today, lithium carbonate, a powdered form of the metallic element lithium, is widely used in treating bipolar disorder. • Other mood stabilizers include anticonvulsant drugs such as carbamazepine (Tegretol) and divalproex (Depakote).

antidepressant drugs: today we have 4 major classes of antidepressants that increase that availability of key neurotransmitters in the brain

(1) Tricyclic antidepressants (TCAs) (2) Monoamine oxidase (MAO) inhibitors (3) Selective serotonin-reuptake inhibitors (SSRIs) (4) Serotonin-norepinephrine reuptake inhibitors (SNRIs)

hypomania

a relatively mild state of mania

stress and depression

Stress plays an important role in determining vulnerability in bipolar disorder and even more strongly in major depression.

major depressive disorder

a severe mood disorder characterized by major depressive episodes in the absence of main or hypomania

factors that place people at risk of developing major depression include:

- Age (initial onset is most common among young adults) - Socioeconomic status (people lower down the socioeconomic ladder are at greater risk than those who are better off) (money and happiness?) - Marital status (people who are separated or divorced have higher rates than married or never-married people).

psychodynamic theories on depression

- depression represents anger directed inward rather than against significant others - Freud believed that mourning, or normal bereavement, is a healthy process by which one eventually comes to separate oneself psychologically from a person who is lost through death, separation, divorce, or other reason. -Psychodynamic theorists focus on the role of loss in depression.

predicting suicide (warning signs)

- likely have attempted in the past -have a plan ex, is it viable -experienced major loss - sense of hopelessness, helplessness -chronic illness - give away prized possessions -change in eating or sleeping -personality change - more drugs and alcohol -withdrawal isolation

seasonal affective disorder

- many people report that their moods do vary with the weather -for some people the changing of the seasons from summer into fall and winter leads to a type of major depression -SAD is not a diagnostic category in its own right in the DSM-5 but is a specifier or subcategory of a mood disorder involving major depression.

sources of stress may include

-The loss of a loved one -The breakup of a romantic relationship -Prolonged unemployment -Physical illness -Marital or relationship problems -Economic hardship -Pressure at work -Exposure to racism and discrimination -Living in an unsafe, distressed neighborhood

during a hypomanic episode a person might:

-feel unusually charged with energy - show a heightened level of activity - have an inflated sense of self-esteem - be more irritable than usual - experience little fatigue or need for sleep.

why do people commit suicide?

-suicidal thinking does not necessarily imply loss of touch with reality, deep seating unconscious conflict or personality disorder • The risks are greater among people with major depression and bipolar disorder. •Suicide is often linked to psychological disorders. • Past suicide attempts are an important predictor of future attempts

Psychiatrist david burns enumerated a number of cognitive distortions associated with depression:

1) all or nothing thinking 2) over generalization 3) mental filter (confirmation bias) 4) disqualifying the positive 5) jumping to conclusions 6) magnification and minimization 7) emotional reasoning 8) "should" statements 9) labeling and mislabeling 10) personalization

the major forms of mood disorders:

1) depressive disorders 2) bipolar disorders and related disorders (mood swing disorders)

The reformulated helplessness theory holds that people who explain the causes of negative events (such as failure in work, school, or romantic relationships) according to the following three types of attributions are most vulnerable to depression:

1) internal factors: or beliefs that failures reflect their personal inadequacies, rather than external factors, or beliefs that failures are caused by environmental factors. 2) global factors: or beliefs that failures reflect sweeping flaws in personality rather than specific factors, or beliefs that failures reflect limited areas of functioning. 3) stable factors: or beliefs that failures reflect fixed personality factors rather than unstable factors, or beliefs that the factors leading to failures are changeable.

cognitive triad of depression

1) negative view of oneself (perceiving oneself as worthless, deficient, inadequate, unlovable) 2) negative view of the environment (imposing excessive demands and presenting obstacles that are impossible to overcome) 3) negative view of the future (( future as hopeless and that one is powerless to change things for the better)

men are ___x more likely yo commit suicide than are women

4x

suicide is not the ____th leading cause of death in americans

8th

clyclothymic disorder

A mood disorder characterized by a chronic pattern of less-severe mood swings than are found in bipolar disorder.

manic episode

A period of unrealistically heightened euphoria, extreme restlessness, and excessive activity characterized by disorganized behavior and impaired judgment. • During a manic episode, the person experiences a sudden elevation or expansion of mood and feels unusually cheerful, euphoric, or optimistic. • The person seems to have boundless energy and is extremely sociable, although perhaps to the point of becoming overly demanding, pressured speech, and overbearing toward others. • Other people recognize the sudden shift in mood to be excessive in the light of the person's circumstances.

bipolar disorder

A psychological disorder characterized by mood swings between states of extreme elation and depression. • People with bipolar disorder ride an emotional roller coaster, swinging from the heights of elation to the depths of depression without external cause. • The first episode may be either manic or depressive. Manic episodes, typically lasting from a few weeks to several months, are generally shorter in duration and end more abruptly than major depressive episodes.

one of the most influential cognitive theorists, psychiatrist _____ related the development of depression tot he adoption early in life of a negatively biased or distorted way of thinking - cognitive triad of depression

Aaron beck

cognitive theories on depression

Cognitive theorists relate the origin and maintenance of depression to the ways in which people see themselves and the world around them.

bipolar 2 disorder

applies to people who have had hypomanic episodes AND at least one major depressive episode (without ever having awful blown manic episode)

dysthymia

People with dysthymia feel "down in the dumps" most of the time, often for years, but are not as severely depressed as those with major depressive disorder.

people with major depression may lose interest in most of their usually _____ and ____, have difficulty...

People with major depression may lose interest in most of their usual activities and pursuits, have difficulty concentrating and making decisions, have pressing thoughts of death, and attempt suicide -They even show impaired driving skills in driving simulation tests

persistent depressive disorder

People with persistent depressive disorder may have either chronic major depressive disorder or a chronic but milder form of depression called dysthymia.

post partum depression

PostpartumderivesfromtheLatinrootspost, meaning "after," and papere, meaning "to bring forth." - persistent and severe modd changes that occur after childbirth - PPD is often accompanied by disturbances in appetite and sleep, low self-esteem, and difficulties in maintaining concentration or attention. - affects 10-15% of new US moms in 1st year

mood disorders

Psychological disorders characterized by unusually severe or prolonged disturbances of mood.

learned helplessness (attributional) theory

a behaviour pattern characterized by passivity and perceptions of lack of control • The originator of the learned helplessness concept,Martin Seligman (1973, 1975), suggests that people learn to perceive themselves as helpless because of their experiences. • The learned helplessness model therefore straddles the behavioral and the cognitive: Situational factors foster attitudes that lead to depression.

premenstrual dysphoric disorder (PMDD)

a disorder characterized by physical and mood-related symptoms occurring during the woman's premenstrual period. • Psychological symptoms manifest in the week before menses and improve within a few days following the onset of menses. • Symptoms are associated with significant emotional distress or interference with the woman's ability to function. critique: may stigmatize women to have psychiatric diagnosis

mania

a state of unusual elation, energy and activity

bipolar 1 disorder

applies to people who have had at least one full manic episode at some point in their lives. - Typically involves extreme mood swings between manic episodes and major depression. - Possible for bipolar I disorder to apply to those who have only experienced mania without ever having a major depressive episode.

dysthymia in greek roots

dys-, meaning "bad" or "hard," and thymos, meaning "spirit."

hypomanic episode

episodes that are less severe than manic episodes and are not accompanied by the social or occupational problems associated with full-blown mania.

evidence points to the pivotal role of ______ about he future in predicting suicidal thinking and suicide attempts

hopelessness

learning theories on depression

learning theorists emphasize situational factors, such as the loss of positive reinforcement. • We perform best when levels of reinforcement are commensurate with our efforts. • Changes in the frequency or effectiveness of reinforcement can shift the balance so that life becomes unrewarding.

there are 2 major types of depressive disorders that vary in severity:

major depressive disorder (the more severe type) persistent depressive disorder (the milder type)

bipolar disorders vary in terms of severity the more severe disorder is called ______ whereas the milder disorder is termed _______

major: bipilar disorder milder: cyclothymic disorder (also called cyclothymia)

major depression imparts peoples ability to ....

meet the ordinary responsibilities of everyday life

major depressive disorder is the most common type of diagnosable mood disorder recent nationally survey showed life time prevalence for men females and over all:

men: 12% females: 21% overall: 16%

electroconvulsive therapy

more commonly called shock therapy, continues to evoke controversy. • The idea of passing an electric current through someone's brain may seem barbaric. • Yet ECT is a generally safe and effective treatment for severe depression, and it can help relieve major depression in many cases in which alternative treatments have failed.

reciprocal interaction

our behaviour changes how other people respond to us, and how they respond to us influences how we in turn respond to them

psychodynamic theories on bipolar disorder

represents shifting dominance of the individual's personality between the ego and superego.

what accounts for PPD

women with history of mood disorders or who experience the blues during pregnancy face an increased risk of FFD - being single or first time mother - having financial problems or a troubled marriage - suffering domestic violence -lacking social support from partners and family members - having unwanted. sick pr temperamentally difficulty infants

behavioural approaches to treating depression

• Behavior therapists generally focus on helping depressed patients develop more effective social or interpersonal skills and increasing their participation in pleasurable or rewarding activities. • Evidence shows that behavioral techniques can produce substantial benefits in treating depression in both adults and adolescents. • In fact, this model of therapy, generally called behavioral activation, produced higher rates of remission in treating severely depressed patients in one recent study than did alternative forms of treatment.

cognitive therapy for depression

• Cognitive therapists believe that distorted thinking (cognitive distortions) play a key role in the development of depression. • Depressed people typically focus on how they are feeling rather than on the thoughts that may underlie their feeling states. • That is, they usually pay more attention to how bad they feel than to the thoughts that may trigger or maintain their depressed moods. (learn to change distortions.)

treating depression

• Depressive disorders are typically treated with psychotherapy, such as in the form of psychodynamic therapy, behavior therapy, or cognitive therapy, or with biomedical approaches, such as antidepressant medication or electroconvulsive therapy (ECT). • Sometimes a combination of treatment approaches is used. • Interpersonal psychotherapy (IPT) is a brief psychodynamic oriented therapy that focuses on a person's current interpersonal relationships.

suicide in older adults

• Despite life-extending advances in medical care, some older adults find the quality of their lives less than satisfactory. • Older people are more susceptible to diseases such as cancer and Alzheimer's, which can leave them with feelings of helplessness and hopelessness that, in turn, can give rise to depression and suicidal thinking. • Many older adults also suffer a mounting accumulation of losses of friends and loved ones, leading to social isolation.

biochemical factors and brain abnormalities

• Early research more than 50 years ago showed that drugs we now call antidepressants, which increase levels in the brain of the neurotransmitters norepinephrine and serotonin, often helped relieve depression. • Brain-imaging studies show lower metabolic activity in the prefrontal cortex of clinically depressed people as compared to healthy controls. • Other research reveals brain abnormalities in people with mood disorders (major depression and bipolar disorder) in parts of the brain involved in governing emotions

humanistic theories on depression

• From the humanistic framework, people become depressed when they cannot imbue their existence with meaning and make authentic choices that lead to self-fulfillment. • Like psychodynamic theorists, humanistic theorists focus on the loss of self-esteem that can arise when people lose friends or family members or suffer occupational setbacks. • We tend to connect our personal identity and sense of self- worth with our social roles as parents, spouses, students, or workers.

genetics and mood disorders

• Genetic factors play a significant role in determining proneness to mood disorders, including major depression and bipolar disorder. • Not only does major depression tend to run in families, but the closer the genetic relationship people share, the more likely they are to share a depressive disorder. • An emerging model in the field focuses on interactions of genetic and environmental factors in the development of major depression and other mood disorders.

causal factors in bipolar disorders

• In a large population-based study in Finland, investigators found the concordance rate to be seven times greater among MZ twins than DZ twins (43% versus 6%, respectively). • If bipolar disorder were caused entirely by heredity,then an identical twin of someone having the disorder would always develop the disorder, but this isn't the case. • Consistent with the diathesis-stress model, stressful life factors and other biological influences may interact with a genetic predisposition to increase vulnerability to the disorder.

psychological approaches for bipolar

• Large-scale investigations of the effects of psychological treatments for bipolar disorder are underway. • Early studies suggest that psychosocial treatments, such as cognitive-behavioral therapy, interpersonal therapy, and family therapy, may be helpful adjunctive therapies when used along with drug therapy in the treatment of bipolar disorder. • We also have evidence that psychological treatment can improve the level of functioning and adherence to a medication regimen in bipolar patients.

the role of reinforcement

• Learning theorist Peter Lewinsohn (1974) proposed that depression results from an imbalance between behavior and reinforcement. • A lack of reinforcement for one's efforts can sap motivation and induce feelings of depression. • Inactivity and social withdrawal reduce opportunities for reinforcement; lack of reinforcement exacerbates withdrawal.

gender and ethinic/racial differences in suicide rates

• More women attempt suicide, but more men "succeed." • For every female suicide, there are four male suicides. • More males "succeed" in large part because they tend to choose quicker-acting and more lethal means, such as handguns. • Suicides are more common among (non-Hispanic) White Americans and Native Americans than African Americans, Asian Americans, or Hispanic Americans.

psychodynamic approaches to treating depression

• Traditional psychoanalysis aims to help people who become depressed understand their ambivalent feelings toward important people (objects) in their lives they have lost or whose loss was threatened. • By working through feelings of anger toward these lost objects, people can turn anger outward— through verbal expression of feelings, for example—rather than leave it to fester and turn inward. • Traditional psychoanalysis can take years to uncover and deal with unconscious conflicts. • Modern psychoanalytic approaches also focus on unconscious conflicts, but they are more direct, relatively brief, and focus on present as well as past conflicted relationships.

interacting theory

•Difficulties in social interactions may help explain the lack of positive reinforcement. • Interactional theory, developed by psychologist James Coyne (1976), proposes that the adjustment to living with a depressed person can become so stressful that the partner or family member becomes progressively less reinforcing. • Interactional theory is based on the concept of reciprocal interaction.

research evidence on cognitions and depression

•Evidence that depressed people show higher levelsof distorted or dysfunctional thinking than nondepressed controls supports Beck's model. • People with bipolar disorder tend to show higher levels of dysfunction in thinking than nonpatient controls • We also find that dysfunctional attitudes (above a certain threshold) increase vulnerability to depression in the face of negative life events.

double depression

•Some people are affected by both dysthymic disorder and major depression at the same time. • The term double depression applies to those who have a major depressive episode superimposed on a longer-standing dysthymic disorder. • People suffering from double depression generally have more severe depressive episodes than do people with major depression alone