PSYCH 2AP3 Chapter Notes - Chapter 6 & 7: Major Depressive Episode, Major Depressive Disorder, Mania

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25 Aug 2016
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Abnormal Psych Textbook notes
Chapter 6 (p.195-206)
Dissociative disorders
-Derealization: sense of the reality of the external world is lost
-Depersonalization: serious set of conditions where reality, experience and even our own
identity seem to disintegrate
-Depersonalization derealisation disorder: individual has repeated experiences of feeling
detached from his or her own thoughts or body
-Generalized amnesia: unable to remember anything, may be lifelong or may extend from
a period in the most recent past
-Localized or selective amnesia: failure to recall specific events, usually traumatic that
occur during a specific period
-Dissociative amnesia seldom appears before adolescence and usually occurs in adulthood
oEstimates of prevalence are from 1.8-7.3%
oDissociative amnesia is the most prevalent of all dissociative disorders
-Average number of alter personalities is around 15, onset is almost always in childhood
-Individuals who experience dissociative amnesia or a fugue state usually get better on
their own and remember what they have forgotten
Chapter 7 – Mood Disorders and Suicide
An overview of Depression and Mania
-Most common diagnosed and most severe depression is called a major depressive episode
oExtremely depressed mood state that lasts at least two weeks and includes
cognitive symptoms (such as feeling of worthlessness and indecisiveness) and
disturbed physical functions (such as altered sleeping patterns, significant changes
in appetite and weight or a very notable loss of energy) to the point that even the
slightest activity or movement requires an overwhelming effort
oEpisode is typically accompanied by a marked general loss of interest and of the
ability to experience any pleasure from life (anhedonia)
oPhysical symptoms (sometimes called somatic or vegetative symptoms) are
central to this disorder
oAverage duration of such an episode if untreated is approximately 9 months
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-Second fundamental state in mood disorders is abnormally exaggerated elation, joy or
euphoria  mania (extreme pleasure in every activity)
oDSM-5 criteria requires a duration of only one week, less if severe enough
oHospitalization can occur
oIrritability is often part of a manic episode, usually near the end
oBeing anxious or depressed is also commonly part of mania
oAverage duration of an untreated manic episode is 2-6 months
-Hypomanic episode: less severe version of a manic episode
oDoes not cause marked impairment in social or occupational functioning and need
last only four days rather than a full week
oHypomanic episode is not in itself necessarily problematic, but it does contribute
to the definition of several mood disorders
The Structure of Mood Disorders
-Individuals who experience either depression or mania are said to have a unipolar mood
disorder (mood remains at one “pole” of the usual depression-mania continuum
-Mania by itself is rare, so almost everyone with a unipolar mood disorder eventually
develops depression (mania episodes alone may be more frequent in adolescents)
-Bipolar mood disorder: alternate between depression and mania
-Mixed features: individual can experience manic symptoms but feel somewhat depressed
or anxious at the same time or be depressed with a few symptoms of mania
oResearch suggests that manic episodes are characterized by dysphoric (anxious or
depressive) features more commonly than was thought, and dysphoria can be
severe
Depressive Disorders
-The most easily recognized mood disorder is major depressive disorder
odefined by absence of manic or hypomanic episodes before or during the episode
-recurrent: if two or more major depressive episodes occurred and were separated by at
least two months during which the individual was not depressed
orecurrence is very important in predicting the future course of the disorder as well
as in choosing appropriate treatments
oindividuals with recurrent major depression usually have a family history of
depression unlike people who experience single episodes
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