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Chapter 10

Chapter 10

22 Pages
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Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis

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Chapter 10 ± Mood Disorders
General Characteristics of Mood Disorders
mood disorders ± disorders in which there are disabling disturbances in emotion
- mood disorders are often associated with other psychological problems, such as panic attacks,
substance abuse, sexual dysfunction, and personality disorders
- the presence of other disorders can increase severity and result in poorer prognosis
Depression: Signs and Symptoms
depression ± a disorder marked by great sadness and apprehension, feelings of worthlessness and guilt,
withdrawal from others, loss of sleep, appetite, sexual desire, loss of interest and pleasure in usual
DFWLYLWLHVDQGHLWKHUOHWKDUJ\RUDJLWDWLRQFDOOHG³PDMRUGHSUHVVLRQ´LQ'60-,9DQG³XQLSRODUGHSUHVVLRQ´
by others; it can be an associated symptom of other disorders
- paying attention is exhausting for depressed people; conversation is a chore; they may speak slowly,
after long pauses, using few words and a low, monotonous voice; many prefer to sit alone and remain
silent; others are agitated and cannot sit still; they pace, wring their hands, continually sign and moan, or
complain; depressed people may neglect personal hygiene and appearance and make numerous
complaints of somatic symptoms with no apparent physical basis
- symptoms and signs of depression vary somewhat across the lifespan
- depression in children often results in somatic complaints, such as headaches or stomach aches
- in older adults, depression is often characterized by distractibility and complaints of memory loss
- depression is substantially less prevalent in China than in North America due in part to cultural mores
(customs/traditions) that make it less appropriate for Chinese people to display emotional symptoms
- DOWKRXJKLWVFRPPRQO\EHOLHYHGWKDWSHRSOH from non-western cultures (eg: Chinese) emphasize
somatic symptoms of depression, while people from Western cultures emphasize emotional symptoms,
studies suggest that people from various cultures, including Canadians, tend to emphasize somatic
symptoms rDWKHUWKDQWKHHPRWLRQDOV\PSWRPVHVSHFLDOO\ZKHQWKHUHEHLQJHYDOXDWHGLQDPHGLFDO
setting
- overall 15% of depressed primary care patients in Canada are referred to as psychologizers (people
who emphasize the psychological aspects of depression)
- people in most cultures tend to emphasize physical symptoms
- most depression, although recurrent, tends to dissipate with time
- about 1/3 of depressed people suffer from chronic depression
Mania: Signs and Symptoms
mania ± an emotional state of intense but unfounded elation (great happiness) evidenced in
talkativeness, flight of ideas, distractibility, grandiose plans, and spurts of purposeless activity
- mania's an emotional state or mood of intense but unfounded elation accompanied by
irritability, hyperactivity, talkativeness, flight of ideas, distractibility, and impractical, grandiose
plans
- some people who experience episodic periods of depression may at times suddenly become manic
- although there are clinical reports of individuals who experience mania but not depression, this condition
is quite rare
- the person in the throes (intense emotion) of a manic episode, which may last from several days to
several months, is readily recognized by his/her loud and incessant stream of remarks, sometimes full of
www.notesolution.com
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attention
Formal Diagnostic Listings of Mood Disorders
- 2 major mood disorders listed in the DSM-IV-TR: major depression, also referred to as unipolar
depression, and bipolar disorder
Diagnosis of Depression
major depressive disorder (MDD) ± an extreme form of depression that satisfies the number of
symptoms required for the category of depression to apply
- MDD requires the presence of 5 of the following symptoms for at least 2 weeks; either depressed mood
or loss of interest and pleasure must be 1 of the 5 symptoms:
Æ sad, depressed mood, most of the day, nearly everyday
Æ loss of interest and pleasure in usual activities
Æ difficulties in sleeping (insomnia); not falling asleep initially, not returning to sleep after
awakening in the middle of the night, and early morning awakenings; or, in some patients, a
desire to sleep a great deal of the time
Æ shift in activity level, becoming either lethargic (psychomotor retardation) or agitated
Æ poor appetite and weight loss, or increased appetite and weight gain
Æ loss of energy, great fatigue
Æ negative self-concept, self-reproach and self-blame, feelings of worthlessness, and guilt
Æ complaints or evidence of difficulty in concentrating, such as slowed thinking and
indecisiveness
Æ recurrent thoughts of death or suicide
- a study showed that even with fewer than 5 symptoms and a duration of less than 2 weeks, co-twins
were also likely to be diagnosed with depression and patients were likely to have recurrences
- other research suggests that depression exists on a continuum of severity
- the issue of whether depression is best seen as being on a continuum or as a discrete diagnostic
category is far from resolved
- MDD is one of the most prevalent of the disorders described in this book
- lifetime prevalence rates have ranged from 5.2% - 17.1% in some studies
- in many countries, the prevalence of MDD increased steadily during the latter part of the 20th century
- regardless of prevalence, MDD is about 2 times more common in women than in men
- WKHJHQGHUGLIIHUHQFHGRHVQWDSSHDULQSUHDGROHVFHQWFKLOGUHQEXWLWHPHUJHVFRQVLVWHQWO\E\PLG-
adolescence
- gender gaps emerge at age 14 and seem to be maintained across the lifespan
- this gender difference is clearly established by late adolescence, and is found in all adult age groups, in
numerous countries, and in a majority of ethnic groups
- current and lifetime prevalence rates are higher among younger than older persons
- although MDD was associated with 27.2 lost workdays per ill worker per year, bipolar disorder was
associated with 65.5 lost workdays; they attributed the difference to more severe and persistent
depressive episodes in workers with bipolar disorder
- depression tends to be a recurrent disorder; about 80% of those with depression experience another
episode, and the average number of episode, which typically last for 3-5 months, is about 4
- patients with MDD who had certain coexisting personality disorders (schizotpal, borderline, or avoidant)
had a significantly longer time to remission of symptoms than did MDD patients without any personality
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disorder
- it has been found that the 1st episodes of depression have a stronger link with major life events stress
than do subsequent bouts of depression; this has been explained by kindling hypothesis, which is a
concept derived from research on animals
kindling hypothesis ± the hypothesis that once a depression has been experienced, the person is
sensitized and it takes less stress to elicit a subsequent bout of depression
- ZKDWLVQWFOHDUDWSUHVHQWDFFRUGLQJWR0RQURHDQG+DUNQHVVLVZKHWKHUWKHDSSDUHQWUHGXFHGUROHRI
life events stress in subsequent depression is because depression has become autonomous and no
longer requires stress (the autonomy hypothesis) or whether the person has become sensitized to stress
(the sensitivity hypothesis) and even small amounts of stress are sufficient to induce depression
Focus on Discovery 10.1 ± Depression in Females vs. Males: Why is There a Gender Difference?
- major depression generally occurs about twice as often in women than in men
- Nolen and Girgus concluded that girls are more likely than boys to have certain risk factors for
GHSUHVVLRQHYHQEHIRUHDGROHVFHQFHEXWLWVRQO\ZKHQWKHVHULVNIDFWRUVLQWHUDFWZLWKWKHFKDOOHQJHVRI
adolescence that the gender differences in depression emerge
- females are more likely than males to engage in ruminative coping
ruminative coping ± a tendency to focus cognitively (perhaps to the point of obsession) on the causes of
depression and associated feelings rather than engaging in forms of distraction
- females focus their attention on their depressive symptoms; males are more likely to rely on distraction,
on doing something that diverts their attention
- a study confirmed that the ruminative coping style predicts the onset of episodes of depression and is
associated with more severe depressive symptoms
brooding ± a moody contemplation of depressive symptoms ± what am I doing to deserve this ± that is
more common in females than males
- brooding is like moody pondering; some people concluded that the relationship between gender and
depression could be due to the brooding component
- another possible explanation for the gender difference is that females and males differ in the stressors
they experience
- girls may face more social challenges than boys, including pressure to narrow their interests and pursue
feminine-typed activities
- thus, girls may face attitudes that devalue accomplishments and abilities in relation to boys, or face
restrictions on roles and activities deemed inappropriate for their gender
- another explanation is that females are more likely than males to be exposed to various forms of
victimization, including childhood sexual abuse
- greater levels of sexual violation were associated with lower levels of self-esteem and an external locus
of control
- victimization is apparently more common among women than men
Diagnosis of Bipolar Disorder
bipolar I disorder ± a disorder in which people experience episodes of both mania and depression or of
mania alone
- most individuals with bipolar I disorder also experience episode of depression
- a formal diagnosis of a manic episode requires the presence of elevated or irritable mood plus 3
additional symptoms (4 if the mood is irritable)
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Description
Chapter 10 Mood Disorders General Characteristics of Mood Disorders mood disorders disorders in which there are disabling disturbances in emotion - mood disorders are often associated with other psychological problems, such as panic attacks, substance abuse, sexual dysfunction, and personality disorders - the presence of other disorders can increase severity and result in poorer prognosis Depression: Signs and Symptoms depression a disorder marked by great sadness and apprehension, feelings of worthlessness and guilt, withdrawal from others, loss of sleep, appetite, sexual desire, loss of interest and pleasure in usual ,.9L;L9L08,30L9K07O09K,7J47,JL9,9L43.,OO02,M47057088L43L3$-,,3:3L54O,7057088L43 by others; it can be an associated symptom of other disorders - paying attention is exhausting for depressed people; conversation is a chore; they may speak slowly, after long pauses, using few words and a low, monotonous voice; many prefer to sit alone and remain silent; others are agitated and cannot sit still; they pace, wring their hands, continually sign and moan, or complain; depressed people may neglect personal hygiene and appearance and make numerous complaints of somatic symptoms with no apparent physical basis - symptoms and signs of depression vary somewhat across the lifespan - depression in children often results in somatic complaints, such as headaches or stomach aches - in older adults, depression is often characterized by distractibility and complaints of memory loss - depression is substantially less prevalent in China than in North America due in part to cultural mores (customstraditions) that make it less appropriate for Chinese people to display emotional symptoms - ,O9K4:JKL98.42243O-0OL0;09K,95045O0 from non-western cultures (eg: Chinese) emphasize somatic symptoms of depression, while people from Western cultures emphasize emotional symptoms, studies suggest that people from various cultures, including Canadians, tend to emphasize somatic symptoms r,9K079K,39K00249L43,O82594280850.L,OOZK039K070-0L3J0;,O:,90L3,20L.,O setting - overall 15% of depressed primary care patients in Canada are referred to as psychologizers (people who emphasize the psychological aspects of depression) - people in most cultures tend to emphasize physical symptoms - most depression, although recurrent, tends to dissipate with time - about 13 of depressed people suffer from chronic depression Mania: Signs and Symptoms mania an emotional state of intense but unfounded elation (great happiness) evidenced in talkativeness, flight of ideas, distractibility, grandiose plans, and spurts of purposeless activity - manias an emotional state or mood of intense but unfounded elation accompanied by irritability, hyperactivity, talkativeness, flight of ideas, distractibility, and impractical, grandiose plans - some people who experience episodic periods of depression may at times suddenly become manic - although there are clinical reports of individuals who experience mania but not depression, this condition is quite rare - the person in the throes (intense emotion) of a manic episode, which may last from several days to several months, is readily recognized by hisher loud and incessant stream of remarks, sometimes full of www.notesolution.com5:38M4N087K2L3J,3L3907M0.9L438,-4:94-M0.98,3K,5503L3J89K,9K,;0,997,.909K0850,N078 attention Formal Diagnostic Listings of Mood Disorders - 2 major mood disorders listed in the DSM-IV-TR: major depression, also referred to as unipolar depression, and bipolar disorder Diagnosis of Depression major depressive disorder (MDD) an extreme form of depression that satisfies the number of symptoms required for the category of depression to apply - MDD requires the presence of 5 of the following symptoms for at least 2 weeks; either depressed mood or loss of interest and pleasure must be 1 of the 5 symptoms: sad, depressed mood, most of the day, nearly everyday loss of interest and pleasure in usual activities difficulties in sleeping (insomnia); not falling asleep initially, not returning to sleep after awakening in the middle of the night, and early morning awakenings; or, in some patients, a desire to sleep a great deal of the time shift in activity level, becoming either lethargic (psychomotor retardation) or agitated poor appetite and weight loss, or increased appetite and weight gain loss of energy, great fatigue negative self-concept, self-reproach and self-blame, feelings of worthlessness, and guilt complaints or evidence of difficulty in concentrating, such as slowed thinking and indecisiveness recurrent thoughts of death or suicide - a study showed that even with fewer than 5 symptoms and a duration of less than 2 weeks, co-twins were also likely to be diagnosed with depression and patients were likely to have recurrences - other research suggests that depression exists on a continuum of severity - the issue of whether depression is best seen as being on a continuum or as a discrete diagnostic category is far from resolved - MDD is one of the most prevalent of the disorders described in this book - lifetime prevalence rates have ranged from 5.2% - 17.1% in some studies th - in many countries, the prevalence of MDD increased steadily during the latter part of the 20 century - regardless of prevalence, MDD is about 2 times more common in women than in men - 9K0J0307L110703.040839,550,7L3570,4O08.039.KLO703-:9L90207J08.438L89039O-2L- adolescence - gender gaps emerge at age 14 and seem to be maintained across the lifespan - this gender difference is clearly established by late adolescence, and is found in all adult age groups, in numerous countries, and in a majority of ethnic groups - current and lifetime prevalence rates are higher among younger than older persons - although MDD was associated with 27.2 lost workdays per ill worker per year, bipolar disorder was associated with 65.5 lost workdays; they attributed the difference to more severe and persistent depressive episodes in workers with bipolar disorder - depression tends to be a recurrent disorder; about 80% of those with depression experience another episode, and the average number of episode, which typically last for 3-5 months, is about 4 - patients with MDD who had certain coexisting personality disorders (schizotpal, borderline, or avoidant) had a significantly longer time to remission of symptoms than did MDD patients without any personality www.notesolution.com
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