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Exam 3: Ch. 7- Mood Disorders and ******* Ch. 13- Schizophrenia and other psychotic disorders
Terms in this set (64)
Mood disorders all involve what?
a disturbance in mood that is characterized by one or more major depressive, manic, hypomanic, and/or mixed episodes
intense and unrealistic feelings of euphoria and excitement
feelings of sadness and dejection
mania and depression
The essential feature is a depressed mood and/or a loss of interest or enjoyment and in customary activities that represent a change from previous functioning and persist for at least two weeks.
Major Depressive Episode
In children and adolescents, major depressive episodes?
the mood may be irritability rather than sad.
What is needed for a diagnosis for major depressive episode?
At least five of the following symptoms must be present with 1 being either depressed mood or loss of interest in activities (anhedonia):
a. depressed mood most of the day nearly every day
b. diminished interest or pleasure in almost all activities (anhedonia)
c. feelings of worthlessness or inapproprate guilt
d. psychomotor agitation or retardation
e. loss of/ or increase in appetite or significant weight loss or gain
f. fatigue or loss of energy
g. insomnia or hypersomnia
h. reduced ability to concentrate or indecisiveness
i. suicidal ideation/recurrent thoughts of death
j. impairment or distress
*The symptom must be either newly present or must clearly have worsened compared with the person's pre-episode status
*Can't diagnose if the patient also reports symptoms of mania, then is called a mixed episode
Period of one week or longer in which the prevailing mood is abnormally and persistently elevated, expansive, or irritable. Also it must interfere with life.
Manic episodes are usually described as what?
euphoric, unusually cheerful, or high
What is the criteria to diagnose a manic episode?
At least three of the following symptoms are present (if the mood is irritable rather than euphoric, at least four of the following symptoms must be present)
a. increased goal directed activity or psychomotor agitation
b. flight of ideas
c. more talkative than usual or pressure to keep talking
d. decreased need for sleep
g. involvement in pleasurable activities that have high potential for negative consequences
*must be significant impairment in occupational or social functioning, the need to be hospitalized to prevent harm to self or others, and/or the presence of psychotic features.
Charactterized by a distinct period of abnormality and persistently elevated, expansive, or irritable mood that lasts at least foud days and is accompanied by at least three of the symptoms associated with a manic episode (4 if mood is irritable)
Last for at least one week and involves rapidly alternating symptoms of manic and major depressive episoes
Diagnosed in the presence of one or more major depressive episodes without a history of manic, hypomanic, or mixed episodes (must last all day nearly every day for at least 2 weeks)
major depressive disorder
Describes a combination of major depressive disorder and dysthymia
Physical symptoms predominate in the patient denies being depressed
What are the features of Major Depressive Disorder?
Melancholic Features: must have anhedonia
a. 3 of the following: early morning awakening, depression worse in morning, psychomotor retardation/agitation, significant loss of appetite and weight, depression is diff from grief (what experience with loss)
a. loss of contact with reality
What are delusions?
False beliefs that are firmly held despite what almost everyone else believes are existence of evidence to the contrary
What are hallucinations?
false sensory perceptions (most common auditory)
*usually mood congruent or seem appropriate
*mood incongruent (worse prognosis)- things that dont go together at all
Involves a chronically depressed mood that is present most of the time for at least two years
What is criteria for Dsythymic Disorder?
During this time, there is never a period of more than two months in which the person is symptom free, and depressive symptoms must not be severe enough to meet criteria for a major depressive episode (during fist 2 yrs)
Involves the occurence of one or more manic or mixed episodes with or without a history of one or more major depressive episodes
Bipolar I Disorder
What is the prevalence of Bipolar I Disorder?
.4 to 1.6% in community samples
Means that four or more mood episodes have occured during the previous 12 months; this pattern is associated with poor prognosis.
Rapid Cycling Pattern
Diagnosed when person has at least one major depressive episode and one hypomanic episode; causes significant distress, etc.
Bipolar II Disorder
Characterized by the presence of fluctuating hypomanic symptoms and numerous periods of depressive symptoms
What are the causes of Unipolar depression?
A. Biological (heredity, moderate genetic contribution, and biochemical)
B. Psychosocial (behavioral, CBT, learned helplessness)
What are biochemical factors related to Unipolar Depression?
1. neurotransmitters- norepinephrine, dopamine, and serotonin
2. monoamine hypothesis- depletion of one or all neurotransmitters
3. neuroendocrine theories (hormones)
4. sleep disturbances
CBT- Beck's theory of Psychosocial Unipolar Depression?
Focuses on schemas, dysfunctional beliefts; negative thoughts are central.
An underlying representation of knowledge that guides current processing of information?
Cognitive Behavior Therapy by beck has what components?
2. creates a pattern of negative automatic thoughts just below awareness and involve unpleasant pessimistic predictions
3. people who are depressed have what Beck termed a negative cognitive triad-beliefs about self, would and future are negative
4. thinking is characterized by cognitive distortions which maintains the triad. (all of none reasoning- perfectionist type person, selective abstraction- focus on one negative detail)
What is learned helplessness (Seligman)?
suggests that an organism that learns it has no control over aversive events will show motivational, cognitive, and emotional deficits.
What are the types of meds for depression?
tricyclics, SSRI's, MAOI's ECT
What are the types of meds for bipolar?
lithium, and a mood stabilizer carbemazepine and other anticonvulsants
Suicide attempts are most common in ppl btw what ages?
Completed suicides are most common in what ages?
elderly (65 or older)
Who is more likely to attempt a suicide and who is more likely to complete suicide?
women / men
What are the preferred methods of suicide in women?
overdose, cutting wrist, carbon monoxide
What are the preferred methods of suicide in men?
guns, hanging, jumping
Most suicides occur in what stage?
What are the factors associated with high-risk suicide?
History of suicide, presence of a specific plan, access to and a plan to use a lethal weapon, a history of suicide in first degree relatives to, most ppl who attempt suicide are ambivalent about their actions.
The defining in prominent feature is the presence of one or more of the following psychotic symptoms: delusions, hallucinations, disorganized speech or thoughts, disorganized or catatonic behavior
significant loss of contact with reality
What is the criteria for diagnosing schizophrenia?
1. involves a continuous disturbance of six months of more that includes at least one month (less if treated) of two or more active phase symptoms: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, or negative symptoms
2. dysfunction in areas of functioning (when delusions are bizarre or hallucinations consist of a voice that keeps a running commentary on the persons behavior or thoughts, only one active phase symptom is required)
What are type I distinctions for schizophrenia?
someone who displays primarily positive symptoms
What are type II distinctions for schizophrenia?
someone who displays more negative symptoms
What are positive symptoms?
excess or distortion of normal functioning (marked emotional turmoil)
In schizophrenia, delusions are often what?
persecutory (the person thinks he/she is being followed, tricked, or spied on) or referential (the person believes that passages from books or newspapers or other msgs are specifically directed to him/her)
What are bizarre delusions?
common- clearly implausible and outside range of ordinary life experiences
What are delusions of being controlled ?
when feelings, impulses, thoughts, or actions are experienced as being under the control of some external force
what is thought broadcasting?
the delusion that one's thoughts are being broadcast out loud so that they can be perceived by others
what is Thought insertion?
the delusion that certain of one's thoughts are not one's own, but rather are inserted
what are examples of positive symptoms of schizophrenia?
3. disorganized speech
4. grossly disorganized or catatonic behavior
What is disorganized speech?
considered by some to be the key feature schizophrenia
What is cognitive slippage?
person fails to make sense despite using the rules of language
What is loose associations?
Is manifested as incoherence, answers or comments that are unresponsive to questions, and "slipping off the track" from one topic to another
What is tangential?
What is catatonic?
display decreased motor activity and reduced reactivity to environmental stimuli
What are negative symptoms of schizophrena?
involve a restriction in the range and intensity of emotion another functions; an absence or deficit
What are examples of negative symptoms of schizophrena?
Most often they include affective flattening
alogia - poverty of thought and speech
avolition - restricted initiation of goal directed behavior
What is paranoid type?
preoccupation with one or more delusions and/or frequent auditory hallucinations within the context of relatively intact cognition and affect
What is disorganized type?
disorganized speech (laughter not related to content of speech), disorganized behavior, and flat or inappropriate affect
What is the etiology of schizophrenia?
genetics and elevated dopamine
what is the twin study realted to schizophrenia?
adopted twins had a higher chance of developing schizophrenia when the birth mom had it and the kid was placed in a dysfunctional home.
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