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Chapter 8

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Psychology 2320A/B
James M Olson

Chapter 8: Mood Disorders Overview Overview - Dysphoria – mild MDD that lasts a - Mood disorder – disturbance in mood long time - Mood – feeling or emotion - Anhedonia – losing interest in shit - Dysphoria o Prolonged sadness o Anhedonia – losing interest in activities - Some people not sad, they’re irritated o Easily annoyed and touchy o 80% of kids with depression - Bipolar disorder o Periods of mania/euphoria combined with depression o Manic-depressive illness Depression - Pervasive unhappy mood - Lots of kids suffer depression and many try to suicide o Get anxiety and conduct disorder - History o Because kids didn’t have superego, people didn’t think they could be depressed o Masked depression – hidden signs that might mean kids are sad - Depression in young people o Adolescence experience more than kids o 90% have impairment in daily activity - Depression and development o At different ages, expression and experience of depression changes o Anaclitic depression – when kids raised in cold environment, they have depression o Preschool kids – somber and tearful o School-age kids – tantrum, irritable, combative Depression o Preteens – self-blame, low self-esteem, social inhibition - Masked (hidden) - Anatomy of depression o Symptom – sad/misery - Anaclitic (cold environment  o Syndrome – group of symptoms that occur together depression)  Converge on creating one negative effect - Symptom vs. o Disorder (2 types) syndrome vs. disorder  Major depressive disorder (MDD) - MDD • At least 2 weeks long o More severe • Sad, no interest, low self-esteem  Dysthymic disorder (DD) - DD • Less severe but longer lasting than MDD Major Depressive Disorder (MDD) - Key features – sadness, no interest in activities, irritability, - DSM for adults and kids the same - Kids at greater risk for bipolar disorder because they have first episode depression and recover faster from depressive episodes - Prevalence o 2-8% ages 4-18 get this disorder  Rates underestimate problem  Kids that don’t have enough symptoms, don’t register but they still have social impairment  In kids caused by self-awareness, cognitive capacity, verbal ability and social pressure  In teens caused by biological maturation (puberty) Major Depressive Disorder - DSM-IV-TR (MDD) o Need to register 5 or more symptoms - In teens, by puberty o Social impairment o Symptoms not from drugs or other medical conditions - Conduct, anxiety, personality, - Comorbidity substance abuse, o 90% kids with conduct disorder have depression (conduct) dysthymia o Clinic-referred kids have anxiety disorder with MDD (anxiety)- Gradual or sudden o 60% have personality disorder - RECURRENT o Substance abuse o Dysthymia (chronic depression) - Bipolar switch after 5 yrs - Onset, course and outcome - Stress sensitization o Gradual or sudden from first episode o First episode age 13-15 - More in girls o Usually lasts 8 months o Recurrent – 25% (1 yr), 40% (2 yrs), 70% (5 yrs) o Limbic system o 1/3 with MDD get bipolar after 5 yrs (bipolar switch) o First episode sensitizes to future episodes (stress sensitization) o MDD makes negative outcomes (stealing, arrest, etc.) - Gender, ethnicity and culture o Females 50% more than males  Except from 6-11 yrs old o Boys more anger, girls more sad o Girls 2:1 or 3:1 more than males after puberty o Boys get more school stress depression o Birth weight in girls determines depression (NOT boys) o Girls have more activation in limbic system o Low social economic status increases stress and depression Dysthymic Disorder (Dysthymia) - Mild depression (less than MDD) - Occurs for at least a year - Two somatic physical/cognitive symptoms - Double depression – major episode imposed on previous Dysthymia - Chronic depressive disorder – Dysthymia and chronic depression combined - Poor treatment response Dysthymic Disorder (Dysthymia, - Prevalence and comorbidity DD) o Low (1% kids, 5% adolescence) - Two somatic o Usually with MDD physical/cognitive symptoms - Double depression – major o ½ also have nonaffective disorder episode and dysthymia - Onset, course and outcome o 3 years earlier than MDD - Chronic depressive disorder – mild, long depression - Poor treatment response o Precursor for MDD? o 2-5 yr length o Many recover eventually, but get some other disorder o Less friend support (unique) o Psychosocial functioning effects last o Early onset is BAD Associative Characteristics Associated Characteristics of Depressive Disorders - IQ and depression - Intellectual and academic functioning unrelated o No relation between depression and IQ o Impairs ability to do tasks, not that they can’t do themNegative beliefs and attribution o Shitty performance in school - Depressive ruminative o Depression is cause and outcome of learning difficulties style - Cognitive biases and distortions o Focus on negative o Negative beliefs and attribution of failure events  Not part of diagnosis but come with disorder - Self-views – made from o Depressive ruminative style feedback  Focus on negative events for long periods of t-meCo-rumination o Hopelessness o Focus on emotion o Pessimism and problems (girls) - Negative self-esteem
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