Chapter 8: Mood Disorder
General Characteristics of Mood Disorders
• Mood disorders: involve disabling disturbances in emotion, from
the sadness of depression to the elation and irritability of mania.
Mood disorders are often associated with other psychological
problems, such as panic attacks, substance abuse, sexual
dysfunction, and personality disorders.
Depression: Signs and Symptoms
• As illustrated by the case of John Bentley Mays, depression is an
emotional state marked by great sadness and feelings of
worthlessness and guilt. Additional symptoms include withdrawal
from others and loss of sleep, appetite, sexual desire, and
interest, and pleasure in usual activities.
• Paying attention is exhausting for depressed people.
• 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.
• Psychologizers: people who emphasize the psychological aspects
of depression.
Mania: Signs and Symptoms
• Mania: is an emotional state or mood on intense but unfound
elation accompanied by irritability, hyperactivity, talkativeness,
flight of ideas, distractibility, and impractical, grandiose plans.
• The individual shifts rapidly from topic to topic.
Formal Diagnosis Listing of Mood Disorders
• Two major mood disorders listed in DSM-IV-TR: major depression,
also referred to as unipolar depression, and bipolar disorder.
Diagnosis of Depression
• Major depressive disorder (MDD) requires the presence of five of
the following symptoms for at least two weeks. Either depressed
mood or loss of interest and pleasure must be one of the five
symptoms:
- Sad, depressed mood - Loss on interest and pleasure in usual activities
- Difficulties in sleeping
- Shift in activity level, becoming either lethargic or agitated
- Poor appetite and weight loss, on increased appetite and
weight gain.
- Loss of energy
- Negative self-concept
- Complaints or evidence of difficulty in concentrating such as
slowed thinking and indecisiveness.
- Recurrent thought of death or suicide.
• 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.
• Brooding: A moody contemplation of depressive symptoms –
“what am I doing to deserve this?” – that is more common in
females than males.
• An interpersonal form of rumination called corumination, in
which friends, typically female friends, discuss and brood over
each other’s problems as part of their friendship, has been linked
with depression in adolescent girls but, on a positive note it is
also fosters stronger friendships.
• Feminist scholar Dana Jack suggests that females are more likely
than males to engage in silencing the self – a passive style of
keeping upsets and concerns to oneself in order to maintain
important relationships (akin to “suffering in silence”). A
definitive longitudinal test of the hypothesis remains to be
conduced. Another explanation is objectification theory, based on
the premise that the tendency to be viewed as an object,
scrutinized and appraised by others, including appraisals of
physical appearance, has a greater negative, influence on the
self-esteem of girls than boys.
• Kindling hypothesis: the notion that once a depression has
already been experienced, it takes relatively less stress to induce
a recurrence.
Diagnosis of Bipolar Disorder
• Bipolar I disorder: as involving episodes of mania or mixed
episodes that include symptoms of both mania and depression.
• A formal diagnosis of a manic episode requires the presence of
elevated or irritable mood plus three additional symptoms (four if
the mood is irritable)
• The symptoms must be sufficiently severe to impair social and
occupational functioning:
- Increase in activity level at work, socially, or sexually - Unusual talkativeness; rapid speech
- Flight of ideas or subjective impression that thought are
racing
- Less than the usual amount of sleep needed
- Inflated self-esteem
- Distractibility
- Excessive involvement in pleasurable activities that are likely
to have undesirable consequences, such as reckless spending.
Heterogeneity within the Categories
• Bipolar II disorder individuals have episodes of major depression
accompanied by hypomania (hypo comes from the Greek for
“under”) a change in behaviour and mood that is less extreme
than full-blown mania.
• The term melancholic refers to a specific pattern of depressive
symptoms. People with melancholic features find no pleasure in
any activity (anhedonia) and are unable to feel better even
temporarily when something good happens. Their depressed
mood is worse in the morning.
• Seasonal affective disorder (SAD): The “winter depressions” that
stem from reduced exposure to daylight.
• Reduced light does cause decreases in the activity of serotonin
neurons of the hypothalamus, and these neurons regulate some
behaviours, such as sleep.
• Postpartum depression: The depression experienced by some
mothers after giving birth.
Chronic Mood Disorders
• In cyclothymic disorders: the personal has frequent period of
depressed mood and hypomania, which may be mixed with, may
alternate with, or may be separated by periods of normal mood
lasting as long as two months.
• The person with dysthymic disorder, is chronically depressed –
more than half the time for at least two years – according to the
DSM –IV-TR. Besides feeling blue and losing pleasure in usual
activities and pastimes, the person experiences several other
signs of depression, such as insomnia or sleeping too much;
feelings of inadequacy ineffectiveness, and lack of energy;
pessimism; an inability to concentrate and to think clearly; and a
desire to avoid the company of others.
• Double depression: A comorbid condition that applies to
someone characterized by both dysthymia and major depression. Psychological Theories of Mood Disorders
Cognitive Theories of Depression
Beck’s Theory of Depression
• Aaron Beck is responsible for the most important contemporary
theory that regards thought processes as causative factors in
depression. His central thesis is the depressed individuals feel as
they do because their thinking is biased toward negative
interpretations.
• Negative schemata, together with cognitive biases or distortions,
maintain what Beck called the negative triad: negative views of
the self, the world, and the future.
• Arbitrary inference – a conclusion drawn in the absence of
sufficient evidence.
• Selective abstraction – conclusion drawn on the basis of only one
of many elements in a situation.
• Overgeneralization – an overall sweeping conclusion drawn on
the basis of a single, perhaps trivial, event.
• Magnification and minimization – exaggerations in evaluating
performance.
• First, depressed individuals, relative to non-depressed
individuals, endorse more negative words and fewer positive
words as self-descriptive. Secondly, they exhibit a cognitive bias:
they have greater recall of adjectives with depressive content,
especially if the adjectives were rated as self-descriptive.
• Depressed and non-depressed people do not differ in whether
their schemas involve positive or negative content; rather, they
differ in cognitive processing. Depressed people pay greater
attention to negative stimuli and can more readily access
negative than positive information.
• Differences in cognitive processing are assessed via the Stroop
task. Participants are provided with a series of words in different
colours and are asked to identify the colour of each word and
ignore the actual word itself. The Stroop task assesses the
latency or length of time it takes to respond.
• People who had a history of depression but were in a neutral
mood tended to divert their attention when presented with
negative stimuli, once again suggesting the presence of a
protective bias.
Evaluation: • We must address two key issues when evaluating Beck’s theory.
The first is whether depressed people actually think in the
negative ways enumerated by Beck.
• The second issue represents perhaps the greatest challenge for
cognitive theories of depression: whether it could be that the
negative beliefs of depressed people do not follow the
depression but in fact cause the depressed mood.
Helplessness/Hopelessness Theories:
• In this section we discuss the evolution of an influential cognitive
theory of depression – actually, three theories: the original
learned helplessness theory; its subsequent, more cognitive,
attributional version; and its transformation into the learned
hopelessness theory.
Learned Helplessness:
• The basic premise of the learned
helplessness theory is that an
individual’s passivity and sense of
being unable to act and control his
or her own life is acquired through
unpleasant experiences and
traumas that the individual tried
unsuccessfully to control.
• Aaron Beck taking a cognitive perspective, proposed that
depression is associated with two personality styles: sociotropy
and autonomy. Sociotropic individuals are dependent on others.
They are especially concerned with pleasing others, avoiding
disapproval, and avoiding separation. Autonomy is an
achievement-related constructs that focuses on self-critical goal
striving, a desire for solitude and freedom from control.
• Congruency hypothesis: The prediction that people are likely to
be depressed if they have a personality vulnerability that is
matched by congruent life events (e.g. perfectionists who
experience a failure to achieve). It is derived from research on
personality, stress, and depression.
Attribution and Learned Helplessness:
• Depressive paradox: A cognitive tendency for depressed
individuals to accept personal responsibility for negative
outcomes despite feeling a lack of personal control.
• The essence of the revised theory is the concept of attribution – the explanation a person has for his or her behaviour. When a
person has experienced failure, he or she will try to attribute the
failure to some cause.
• Abramson, Seligman, and Teasdale formulation to various ways
in which a university student might attribute a low score on the
mathematics portion of the Graduate Record Examination (GRE).
The formulation is based on answers to three questions:
1. Are the reasons for failure believed to be internal (personal) or
external (environmentally caused)?
2. Is the problem believed to be stable or unstable?
3. How global or specific is the inability to succeed perceived to be?
Hopelessness Theory
• Depressogenic inferential style the tendency to perceive
negative events as having disastrous consequences.
• Depressive predictive certainty: the concept that people become
prone to depression when they perceive that an anticipated state
of helplessness in certain to occur. It is derived from the
hopelessness theory of depression.
• The measurement of stress generation involves making the
distinction between independent events (i.e. not due to oneself)
and dependent events (i.e. stemming from personal choices or
actions depend on the self)
• Stress generation predicted depression in adolescent girls but
not in boys.
Biological Theories of Mood Disorders
Genetic Vulnerability
• Research on genetic factors in bipolar disorder and MDD has
used twin, family, and adoption methods. Bipolar disorder is one
of the most heritable of disorders.
th
• Bipolar disorder results from a dominant gene on the 11
chromosome.
• Brain-derived neurotropic factor (BDNF) gene appears to predict
risk of developing rapid cycling.
• People who possess one or two copies of the short variant of the
5-HTTLPR (serotonin transporter) gene, which is involved in
modulating serotonin levels, experienced higher levels of
depression and suicidality following a recent stressful event.
• Non-depressed children homozygous for the 5-HTTLPR short
allele demo
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