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Chapter 7- Mood Disorders.docx

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PSYC 353
Richard Yi

Chapter 7 Mood terminology: pervasive, dysorphic, expansive etc Affect Observable behaviors that are how one’s inner feelings are expressed - Broad, restricted (constriction in expressive range), blunted (reduction in intensity, ex. Win 1 million dollars but exhibiting little affect), flat (not exhibiting any), inappropriate, labile (fluctuating in abrupt shifts) Episodes- specific mood disorder is comprised of - Type or combination of episodes tell us what diagnosis is o Major depressive disorder: at least one major depressive episode o Bipolar 2 disorder: recurrent major depressive episodes and hypomanic episodes Major Depressive Episode - Either depressed mood or anhedonia (inability to experience pleasure from normal things) - Plus at least 4 other symptoms o Appetite change/ weight loss o sleep disturbance o psychomotor symptoms (pacing or rubbing, anxious) o fatigue or loss of energy o feelings of worthlessness/guilt (exaggerated responsibility for failures) o difficulty concentrating/ making decisions o thoughts of death/ suicide - Symptoms must last at least 2 weeks Manic Episodes - Abnormally and persistently elevated, expansive or irritable mood - Accompanied by 3 of the following (4 if only irritable) o Inflated self- esteem or grandiosity o Decreased need for sleep o More talkative than usual or pressured speech o Flight of ideas o Distractibility o Increase in goal- directed activity o Psychomotor agitation o Engaging in pleasurable activity w/ likely painful consequences - At least one week of symptoms (unless hospitalized) Hypomanic Episode - Similar to manic episode but less severe - Different from non- depressed mood - No impairment or psychosis - Lasts at least 4 days Mixed Episode - Meet criteria for both a major depressive and manic episode for at least one week - Often rapidly shifting moods - Often includes agitation, insomnia, appetite problems, psychotic features, suicidal thinking - More prevalent in males - Usually evolves into depressive vs manic episode Types of Mood Disorders - Acute (intense but lasts for short period of time)- major depression and bipolar disorder (BP I and II) - Chronic(not intense experience, but lasts 2+ years)- Dysthymia and Cyclothemia - Unipolar- major depression and Dysthymia - Bipolar- Bipolar I and II, Cyclothemia Unipolar Depression Symptoms - Depressed mood - Anhedonia - Psychomotor retardation/ agitation - In severe cases: hallucinations and delusions Major Depressive Disorder (MDD) Criteria - One or more major depressive episode - No manic, mixed, or hypomanic episodes - Differentiated from bereavement if o Normal reaction to loss of loved one o w/in 2 months of loss o does not cause marked impairment Associated Features - obsessional thoughts/ rumination - irritability - physical health concerns - phobias - panic attacks Epidemiology - lifetime prevalence estimates women:10-25%, men: 5-12% Risk Factors - 1 degree biological relative o Genetics: Monozygotic Twins 42- 54%, Dizygotic Twins 19-20% chance both will have it - Single people and divorced vs married males - Low SES - Age Etiologies - Biological: Neurotransmitters: Monoamine hypothesis (reduces serotonin and norepinephrine which work in limbic system), Catecholamine hypothesis (norepinephrine- adrenaline) o Dysfunction in these lead to depressive disorder o Problem is that is temporary, same drugs treat other types of problems, many roles for neurotransmitters, can’t differentiate cause from relation - Psychoanalytic: anger turned inward (Freud), oral fixation (dependency), punishing super ego - Behavioral: too many punishing events relative to positives o Due to environmental changes o Lack of skills needed to elicit reinforcement o Unable to enjoy reinforcement due to interference - Cognitive- Behavioral: o Learned Helplessness (animal model) o Revised Learned helplessness (attributions)- people w/ MDD tend to attribute negative events to causes that are inter
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