abnormal psych presentatation
TRANSCRIPT
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CHAPTER 8
DISORDERS OF MOOD
DANNY EURESTI
FRANCISCO HERNANDEZ
HAVANNAH CASCOS
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TWO GROUPS:
Mania• Euphoria, Energetic, Exaggerated Beliefs
Depression• Low, Sad, Dark, Overwhelming Challenges
Depressive Disorder• Unipolar depression
Bipolar Disorders
- Unipolar Mania (uncommon)
TWO KEY EMOTIONS:
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UNIPOLAR DEPRESSION:
Loose use of the term “Depression”
• Normal periods melancholy
• Can be beneficial
Actual Clinical Syndrome
• Severe
• No redeeming characteristics
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HOW COMMON IS UNIPOLAR DEPRESSION? In the United States
• 8% Severe
• 5% Mild
• 19% of all Adults
• Higher among poor people
Age
• 40’s more likely than any other age group
• Median age 26 (in United States)
Women vs Men
• Women are at least twice as likely to experience an episode
• 26% Women
• 12% Men
After Treatment
• 85% recover
• 40% will experience at least one more episode
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SYMPTOMS – 5 MAIN AREAS
Varies among people
• Severe– sobbing, indecisive, despair, anger, worthlessness
• Mild – able to function, ineffective, no pleasure
Emotional
Motivational
Behavioral
Cognitive
Physical
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EMOTIONAL SYMPTOMS
Feeling sad and dejected
Miserableness, Humiliation, and Emptiness
Anhedonia
Experiencing anger, anxiety, and agitation
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MOTIVATIONAL SYMPTOMS
Loss of desire to perform activities
Lack drive, initiative, and spontaneity
“Paralysis of Will”
• Must force themselves to partake in activities
Suicide
• 6% - 15% commit suicide
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BEHAVIORAL SYMPTOMS
Less active and productive
Slower speech and movements
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COGNITIVE SYMPTOMS
Negative views of themselves
• Inadequacy, undesirableness, and inferiority
Pessimism
• Helplessness, hopelessness, procrastination
Complain about intellectual ability
• Confusion, distraction, forgetful
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PHYSICAL SYMPTOMS
Physical Ailments
• Headaches, indigestion, constipation, dizziness, pain
Misdiagnoses
• Caused by the physical ailments
Eating and Sleeping
• Most: eat less and sleep less
• Some: excessively eat and sleep
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DIAGNOSING UNIPOLAR DEPRESSION
Major depressive episode
• 2 or more weeks
• At least 5 symptoms of depression
Extreme Cases
• Hallucinations
• Delusion
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DIAGNOSING UNIPOLAR DEPRESSION CONT’D
Major depressive disorder
• Seasonal, recurrent, catatonic, postpartum, or melancholic
Dysthymic disorder
• Similar to MDD but less severe and more persistent
Premenstrual dysphoric
• Depressive or related symptoms one week before menstruation
Disruptive mood regulation disorder
• Persistent depressive symptoms
• Recurrent temper outbursts
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CELEBRITIES AND MOOD DISORDERS
Gwyneth Paltrow
• Postpartum depression after birth of second child
Abraham Lincoln
• “I am now the most miserable man living”
Tiki barber
• Depression after retiring from NFL. “I would literally... sit on the couch and do nothing for 10 hours.”
Carrie Fisher
• Diagnosed with by polar disorder
Others• Moses, Nebuchadnezzar, Saul, Queen Victoria, Ernest Hemingway, Sylvia Plath,
Jim Carrey, Rodney Dangerfield, Eminem, and Beyoncé Knowles
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WHAT CAUSES UNIPOLAR DEPRESSION ?
Stress
• Key trigger of depression
• Experience and report more stressful events
Reactive (exogenous) depression
Endogenous depression
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THE BIOLOGICAL VIEW
Diseases and drugs have been know to cause mood changes
Evidence from genetic, biochemical, anatomical, and immune studies
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BIOLOGICAL VIEW CONT’D
Genetic Factors
• Twin, Adoption, and Family pedigree studies
Biochemical Factors
• Norepinephrine, Serotonin, Cortisol, Melatonin (Dracula Hormone)
Brain Anatomy and Circuits
• Prefrontal cortex, hippocampus, amygdala, and Brodmann Area 25
Immune System
• Decrease in white blood cells, increase in C-reactive protein, and higher incidence of illness
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PSYCHOLOGICAL VIEWS
Psychodynamic
• not strongly supported by research
Behavioral
• modest support
Cognitive
• Considerable research, support, and following
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PSYCHODYNAMIC VIEW
Freud and Abraham
Connection to loss
• Regression to oral stage
• Introjection
Symbolic Loss (Imagined loss)
Support
• Anaclitic depression
Limitations
• Parenting only sometimes relates to depression
• Inconsistent findings
• Certain features are impossible to test
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BEHAVIORAL VIEW
Change number of rewards and punishments
Support from research
• Lewinsohn
• Social rewards
Limitations
• Relies on self-reports
• Do not establish decreases in rewards as cause
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COGNITIVE VIEWS
Negative Thinking
• Cognitive Triad – experiences, themselves, futures
• Automatic thoughts
Learned helplessness (Seligman)
• No control over reinforcements
• They themselves are responsible for their helpless state
• Internal attributions that are global and stable
Limitations
• Does not show cognitive patterns cause unipolar depression
• Laboratory helplessness does not parallel depression in every way
• Relies heavily on animals
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SOCIOCULTURAL VIEWS
Influenced by social context that surrounds people
Supported by findings that show depression is triggeresd by outside stressors
2 kinds of sociocultural views
• The family-social perspective
• The multicultural perspective
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THE FAMILY-SOCIAL PERSPECTIVE
Individual with depression display social deficits
• Other people –avoid the individual
• Further deterioration of social skills
Depression tied to unavailability of support such found in a happy marriage
• Divorced people show 3 times the depression of those married or widowed
• Double the rate of those never married
• Correlation between marital conflict and sadness: .37 for men and .42 for women
• Those isolated without intimacy become depressed in times of stress
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MULTICULTURAL PERSPECTIVE
Gender and Depression
• Artifact Theory – equally prone but clinicians fail to detect depression in men
• Hormone Explanation – changes in hormones trigger depression for women
• Life Stress Theory – women experience more stress than men
• Body Dissatisfaction Explanation – women are taught to seek low weight and slender bodies
• Lack of Control Theory – women feel less in control of their lives than men do
• Rumination theory – rumination makes people become depressed and stay depressed longer
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MULTICULTURAL PERSPECTIVE CONT’D
Cultural Background and Depression
• Constant symptoms of depression across all countries
• Depression in Non-Western countries –more physical
• Depression in Western countries – more cognitive
Ethnic groups
• Symptoms and overall rates are similar
• Chronicity – Hispanic and African Americans are 50 percent more likely to have recurrent episode of depression
• Specific population high rates of depression – For Native Americans: 37% of women, 19% of men, and 28% overall
• Depression is unevenly distributed within minority groups due to varied backgrounds and cultural values
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BIPOLAR DISORDERS
Lows of depression and highs of mania
“Emotional rollercoaster”
Suicidal
Impacts friends and family
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WHAT ARE THE SYMPTOMS OF MANIA?
Inappropriate rises in mood
5 main areas – emotional, motivational, behavioral, cognitive, and physical
• Emotional - active powerful emotions
• Motivational- urge for excitement, involvement, and companionship
• Behavior – talk loud and fast, move quickly, flamboyance
• Cognitive – poor judgment
• Physical – very energetic
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DIAGNOSING BIPOLAR DISORDERSManic episode – one week, high/irritable mood, increased activity or energy, at 3 other
symptoms
Hypomanic episode – less severe, causing little impairment
Bipolar I Disorder – alternating between manic and major depressive episodes
Bipolar II Disorders – alternating between hypomanic and major depressive episodes
• Rapid Cycling – four or more episodes in one-year period
• Seasonal – episodes vary with the seasons
• Experience depression more than mania
• 1% - 2.6% at any given time; 4% over a lifetime
• Equally common in women and men
• Occurs between 15 and 44 years of age
Cyclothymic disorder
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WHAT CAUSES BIPOLAR DISORDERS?
Research for a cause has made little progress
Biological research has brought more promising findings
• Neurotransmitter activity
• Ion activity
• Brain Structure
• Genetic Factors
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NEUROTRANSMITTER
Overactivity of norepinephrine could lead to mania
• Supported by research studies
High serotonin expected to be related to mania
• Contradictory- results show that bipolar disorder may be linked to low serotonin
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ION ACTIVITY
Role of ions – relay messages within a neuron
Theorists suggest irregularities in transport of ions may cause…
• Neurons to fire too easily – leading to mania
• Resist firing – leading to depression
Invesitgative findings of those dealing with bipolar disorder
• Abnormalities in funtioning of the proteins that transport ions
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BRAIN STRUCTURE
Brain imaging and postmortem studies found abnormal brain structures
• Smaller ganglia and cerebellum
• Lower volume of gray matter in the brain
• Structural abnormalities in dorsal raphe nucleus, striatum, amygdala, hippocampus and prefrontal cortex
Unclear what role these abnormalities play in bipolar disorder
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GENETIC FACTORS
Belief that people inherit a biological predisposition to develop bipolar disorder
• Family pedigree studies support this idea
• Identical twins - 40% likelihood
• Fraternal, siblings, and other close relatives – 5 -10% likelihood
Genetic linkage studies
Molecular biology
• Bipolar disorders linked to X chromosome
Wide range of findings
• Genetic abnormalities may combine to help bring about bipolar disorders