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Ch. 8 - Mood Disorders.docx

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York University
PSYC 3230
James Alcock

Ch. 8 - Mood Disorders Monday, March 4, 2013 9:00 AM Unipolar disorders  Major Depressive Disorder  Dysthymia Major Depressive Disorder  Depressed mood or a loss of interest or pleasure in daily activities consistently for at least a two week period  Occupational, educational, or other important function must also be negatively impaired by the change in mood  Not due to alcohol, drugs, medical condition, or grief at loss of a loved one  Mean age of onset 25 years  Emotional symptoms o Extreme sadness, feelings of worthlessness o Anhedonia-- inability to find pleasure in previously pleasurable activities o Crying spells, or being "unable to cry" o Loss of feelings of affection for family/friends  Motivational symptoms o Lack of drive; markedly diminished loss of interest in almost all activities o Loss of libido o Thoughts of suicide  Behavioral symptoms o Lower activity level o Psychomotor retardation or agitation  Cognitive symptoms o Negative self-image o Negative self-talk o Guilt and self-blame o Confusion, poor memory, indecisiveness  Somatic symptoms o Disturbances in sleep-- early morning awakening, insomnia, sleeping all the time o Fatigue, exhaustion o Decrease or increase in appetite; weight change o Aches and pains, dizziness  Psychotic symptoms (severe depression) o Delusions o Hallucinations  An estimated 1 in 4 Canadians has a degree of depression serious enough to need treatment at some time in his or her life  Until age 65, twice as many women as men receive treatment for depression. Possible reasons: o The most vulnerable are single mothers with small children o Women are taught to handle stresses differently than men o Female hormones may possibly contribute to higher rates of depression o Women may be more likely to seek help  Men tend to suffer more prolonged depression than women later in life o Perhaps due to the fact that widowers tend to grieve more than widows because the wife may tend to keep many aspects of his life together (e.g., cooking, cleaning) Dysthymia  Chronic mild depression  Less disabling than Major Depressive Disorder, but more prolonged  May be associated with impaired social and/or vocational functional  Mean age of onset: early 20s  Symptoms can go unchanged for 20 years or more  Onset prior to age 20: greater chronicity Theories of unipolar depression  Psychodynamic o Depression often triggered by major loss o Due to a series of unconscious processes set in motion when people feel real or imagined (symbolic) loss o E.g., losing a job may be symbolic of losing a partner: "My husband won't want me if I can't keep a job"  Behavior theory o Depressive style of functioning is the result of a significant reduction in the total rate of reinforcements-- especially social reinforcements  Social reinforcements-- e.g., strangers smiling at you, saying "hello"  Cognitive theory (Beck) o Due to negative and distorted automatic thoughts o "Cognitive triad of depression":  Negative view of self  Negative view of environment  Negative view of future o Have patient record situations in the following categories:  Situation | Interpretation | Emotion | Physical response | Action | Outcome o Negative thoughts produce negative feelings and negative actions, leading to negative outcomes  Learned helplessness model (Seligman, Peterson, et al.) o Individuals learn that their actions do not bring about any positive results  Attributions may play a role in learned helplessness o When people perceive circumstances to be beyond their control, they may attribute this to stable, internal causes, leading to depression  An attribution to unstable, external causes may help avoid depression Bipolar disorders  Formerly called "manic-depressive psychosis" Mania  May involve frenzy, anger, laughing binges, racing and disjointed thoughts, agitation, over-talkativeness, impulsivity  May involve delusions (grandeur, erotomania [e.g., believing that famous people are in love with you]) or even hallucinations  May cycle from mania to depression, with or without intervening normal periods  Questions a psychologist may ask re: mania o Was there ever a time when you:  Stayed very excited (e.g., for days)?  Were to
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