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PSY 459 Final Exam

Terms in this set (25)

Unipolar depression
only depressive episodes
bipolar disorder
manic and depressive epsides
DALYs (disability-adjusted life years)
the sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability
Features of Major Depressive Disorder
2 or more nearly every day for 2 weeks:
-depressed mood
-loss of interest in activities
-appetite and sleep problems
-loss of energy
-difficulty thinking/concentrating
-psychomotor slowing/agitation
-feeling of worthlessness/inappropriate guilt
-thoughts of death or suicide
-in children/adolescents, see more irritableness and anger outbursts
Epidemiology of MDD
-U.S. lifetime risk about 15%, half of these cases severe or very severe
-twice as common in women after childbirth
-each successive generation born after WWII higher rates of depression
-estimated that 10-15% of people diagnosed with severe MDD complete suicide
Suicide
-at the highest level in 30 years, with steep increases for middle-aged white individuals, especially women
-white males accounted for 7 of 10 suicides in 2015
Golden Gate Bridge studies
suicidal intent remains uncertain up to the very last second
-ambivalence is the norm (this is the interaction of risk and protective factors that changes literally moment by moment)
MDD Treatment
-antidepressant medications
-psychotherapy
-electrconvulsive therapy
-ketamine infusions
-brain stimulation treatments
Features of Bipolar Disorder
distinct period of manic episodes (usually also depressive episodes):
-euphoria
-inflated self-esteem
-sleeplessness
-distractibility
-agitated, irritable, "touchy"
-racing thoughts, fast speech
-reckless behavior
Epidemiology of Bipolar Disorder
-average age of onset: 18
-80% of all cases classified as "severe"
-no gender differences
-tends to be a chronic course
Bipolar Disorder Treatment
-"Mood Stabilizers" Lithium, Valproic Acid, Carbamazepine, Atypical Antipsychotics
-antidepressant medications (must be carefully monitored because can trigger a manic episode)
-psychotherapy and supportive therapy
Major Depressive Disorder (adoption/twin studies)
-6 different twin studies show average concordances of 43% MZ and 28% for DZ
-largest twin study to date yielded heritability estimates of .38, with no shared environment influence
-more severe depression shows higher heritability, about .58
Bipolar Disorder (adoption/twin studies)
-average concordances MZ approach 80%, 15% DZ
-small study of twins reared apart showed concordances of 72% for MZ, 24% DZ
-pooled twin study: 55% MZ, 7% DZ
Environmental Risk Factors for MDD and Bipolar Disorder
-being divorced or separated (twofold increase compared to those married and those never married)
-adverse life events (especially interpersonal loss)
-early life trauma, abuse, neglect (particularly sexual abuse)
-chronic stress
Serotonin Pathways
Noradrenergic pathways
Dopamine pathways
5 HTT (serotonin) transporter gene
-regulated the structure and function of serotonin transporter proteins, especially reuptake
-one (& esp. 2) copies of the "short" allele of 5 HTT gene significantly increases risk of MDD
-those with the short allele(s) also have about a 15% reduction of cell bodies in amygdala, and 25% reduction in anterior cingulate cortex
HTPH2 mutation
-10x more frequent in severally depressed people than in non-depressed controls
-produces defective version of an enzyme that synthesizes serotonin in the brain
-depressed patients with this mutation are resistant to SSRI's simply because don't produce enough serotonin in the brain
Anxiety Disorders
-most common form of mental illness
-most forms of anxiety are twice as common in women
-median age of onset is 11
-lifetime prevalence of 24%
-includes Generalized Anxiety Disorder, Panic Disorder, Phobias, OCD, PTSD
Anxiety Disorders Treatment
-benzodiazepines (used for short-term treatment due to addiction potential)
-SSRI's and SNRI's
-cognitive behavioral therapy
Anxiety Disorders Genetic Studies
-far less genetic research on these
-in general, family and twin studies show that anxiety is moderately genetically influenced
Genetic Overlap between MDD and GAD
-high rate of co-morbidity with mood disorders (50-60% of patients with MDD also have anxiety)
Multivariate genetic analyses of MDD and GAD
-a multivariate design involves 2 or more DVs
-main goal of behavior genetics research is to understand the causes of variation in traits
-genetic design allows estimating the relative contributions of the source of variation
-when multiple traits are considered, genetic designs also allow looking at the causes of co-variation or correlation between 2 or more traits
Results of Multivariate genetic analyses of MDD and GAD
1. heritability of liability (risk) was 42% for MDD and 69% for GAD
2. Genetic correlation of 1.0 suggests that the disorders are the same thing, genetically (same genes affect depression and anxiety)
3. non-shared environmental influences correlated .51, suggesting that non shared environmental factors differentiate the 2 disorders to some extent
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