Exam 2: Chapter 5: 1. Depression is the leading cause of disability worldwide. 2.

Emotion-A state of arousal defined by subjective states of feeling accompanied by physiological changes. 3. Affect-the pattern of observable behaviors like facial expression that are associated with these subjective feelings. 4. Mood-Sustained emotional response. 5. Depression can either be a mood or clinical syndrome (depressed mood = disappointment and despair; clinical syndrome-combo of cognitive, behavioral, & emotional symptoms, so not just numb/disappointed/despair, but also fatigue, loss of energy & appetite, difficulty sleeping + difficulty concentration, feelings of worthlessness & suicide + constant pacing & extreme inactivity). 6. Euphoria = opposite MOOD of depression. Mania = opposite state of clinical syndrome of depression. Includes inflated self-esteem, decreased need for sleep, distractibility, pressure to keep talking. 7. Mood disorders defined in terms of episodes-discrete periods of time in which a persons behavior is dominated by either a depressed or manic mood. 8. Most people experience more than one episode; 2 types-unipolar (only depression) & bipolar (depression + mania). 9. Differences between depression & normal sadness: depression-mood never changes, always depressed, not affected by one or two events; comes with social inability to function, & cognitive/behavioral symptoms; nature/quality of mood is different than just being sad-feels like being in a dark hole or black cloud. 10. Mania often occurs after one episode of depression, people typically have terrible judgment, get into trouble; main feature: persistently elevated/irritable mood that lasts for at least one week. 11. 4 different types of symptoms of mood disorders: A. Emotional symptoms: Dysphoric mood-Most common & obvious symptom of depression; basically feeling depressed. Manic moods-feeling happy, & productive but also destructive & out of control at times. Anxiety & easy to anger are key component of mood disorders. B. Cognitive symptoms-Depressed patients have trouble concentrating, thinking slowed down, easily distracted. Guilt + worthlessness surrounding themselves, their environment, & their futures common. Manic patients feel everything sped up, easily distracted, inflated selfesteem. Can lead to suicide. C. Somatic Symptoms-Fatigue, aches & pains, changes in appetite & lack of sleep, having every task require monumental effort. D. Behavioral Symptoms-Depressed patients experience psychomotor retardation (slowed down body movement) while manic patients

experience sped up movement, gregariousness, & excessive pursuit of life goals (I want to do everything!) E. Other-Experience anxiety disorders as comorbidity of depression, as well as eating disorders. Alcoholism also closely linked. 12. First accepted classification system for depression-Kraeplin, who divided the disorder into 2 categores-dementia praecox (schizophrenia) + manicdepressive psychosis. Based distinction based on age of onset, course of disorder, & clinical symptoms. 13. Manic-depressive psychosis-Included all depressive symptoms, regardless of manic/depressive, & showed episodic recurrent course with good prognosis; observed most patients returned to their normal level of functioning between episodes. 14. 2 objections to system: Should mood disorders be defined as broad or narrow? (just focus on severely depressed people vs also including milder forms of depression/normal if it follows an event? Questions validity of definition). Diagnosis of mood disorders based on heterogeneity-some symptoms are there, some arent, various different aspectsAre these symptoms from one disorder? From another? Or just simply different severity? 15. DSM-IV-TR emphasizes subtypes of depression & difference between unipolar vs bipolar depression: A. Unipolar-Major depressive disorder (Must experience 1 major depressive episode in absence of manic episode; most cases have repeated episodes) + dysthymia (chronic mild condition; Must have had at least 2 symptoms + depressed mood for at least 2 years). Any episode of mania automatically rules out both; distinctions between both are difficult so thought of as manifestations of one disorder. B. Bipolar disorder-3 types of disorders, must be severe enough to interfere w/ functioning & last for 1 week + 3 or 4 other symptoms; someone whos experienced at least 1 manic episode = bipolar I. Bipolar II-at least 1 major depressive episode, 1 manic episode, but NOT full blown mania. Manic vs hypomanic (not as severe as mania)-severity & duration (4 days, severe but not enough to impair functioning). Cyclothymia-chronic but less severe mania; equivalent to dysthymia. Qualify by 2 years & no history of major depressive episodes or mania before. C. Can also be broken down further into episode specifiers (more specific descriptions of symptoms) Ex. Melancholia-severe subtype of depression, caused by specific factors that may respond to medicationlost feeling of pleasure or capacity to feel better. Psychotic features (hallucinations/delusions), postpartum depression. D. & Course specifiers (more extensive descriptions of the pattern that the disorder follows over time). Ex. Rapid cycling-Person experiences at least 4 episodes of mania, hypomania, depression in less than a year. Likely to show poor response to meds, more likely suicide. SAD-most also have unipolar disorder with this, somatic symptoms (weight gain, sleeping all day-Tim).

16. Unipolar disorders-Age of onset = 30s, average 32. Length varies, but at least 2 depressive episodes, lifetime of 5 or 6. Major depressive disorder is chronic & recurrent (comes & goes); Remission & relapse. Half of all unipolar patients recover within 6 months; the longer the person remains free of depression (period of remission increases), the better his or her chance of avoiding relapse. 17. Bipolar disorders-Age of onset = 18-22 yrs. Duration of 2-3 months. Tend to have more lifetime episodes than unipolar ppl; course of disorder depends. 18. People in studies mentioned in text not necessarily treated in clinical settings; good since it takes these people into account. 19. NCSR study: Unipolar depression = one of most common forms of psychopathology; 16% suffered at some pt in lives, compared to 3% dysthymia & 4% bipolar disorder; ratio of unipolar:bipolar = 5:1. Also, only 20% of people who qualified sought help. 20. Most targeted group for mood disorders = young/middle aged people, NOT old ppl (old ppl might have forgotten? Or they might have died out). Also, people born after WWII more likely to be depressed; higher rates of depression in younger generations. 21. Women 2-3x more vulnerable to depression than men in unipolar disorders (NOT bipolar); clinical depression is universal, BUT the ways people describe it/cope with it are different depending on culture. 22. Evolutionary explanation for depression-most result from changes in environmentso symptoms of depression (slowing down, withdrawal, etc) may help person disengage from situation not going well, & redirect our energy elsewhere. 23. Psychodynamic approach-interpersonal relationships are cause of depression, Freud-stressful life events precipitate depression & depressed usually are people who depend on other peopleimportance of interpersonal relationships. 24. Depression and stressful life events are correlated, but not clear how/which direction: does depressionstress, or stressdepression? Lots of studies indicate stressdepression. 25. Another category of this is severe loss of a personunipolar depression. Severe events lead to depression, BUT only if the events are associated with feelings of humiliation, entrapment, & defeat. More stress = more depression in community, so huge social factor involved. 26. What is stress generation? Why are women more prone than men? 27. Bipolar disorders usually preceded by schedule disrupting (trouble sleeping) events & goal attaining events (exhilaration + ongoing emotional regulationmania). 28. Bipolar patients in hostile family settings or with less social supportmore likely to relapse. 29. Cognitive approach-events are same, but interpreted differently in nondepressed vs depressed people (negative thoughts about self/environment + distortions/errors/biases-personal meaning attached to

failure, overgeneralize conclusions on self based on negative experiences, drawing inferences about self despite lack of evidence) 30. Maladaptive schemas-general patterns of thought that guide the ways people perceive/interpret events; latent until a specific events activates them. Cognitive view of depression-hopelessness (bleak future, nothing you can do about it). 31. Causal attributions-explanations assigned that someone assigns to an event. Depressogenic-internal, stable, global. 32. Also difficulty in inhibiting negative thoughts; ruminative (turning attention inward, introspective & speculating feelings of depression) vs distractive (shifting attention elsewhere). People who are ruminative have more severe & longer episodes of depression; since women are usually ruminative, reason why theyre more likely to be depressed. 33. 3 stages of depression-vulnerability (relationships + schemas influence), onset (usually by stressful life event from bad relationship), & maintenance (interpretations of poor self-worth & etc. lead to persistent symptoms). 34. Bipolar disorders much more inheritable than unipolar disorders. 35. Heritability for bipolar disorder = 80% vs 50% for major depressive disorder; polygenic. 36. People who have serotonin transporter gene + environmental risk factors = high risk of depression, BUT need both, not just one or the other. 37. Neuroendocrine system plays huge role in mood disorders; specifically HPA axis (ACTHcortisolhelps respond to threat). Experiment with DST-failure of suppression; depression associated w/ dysfunctional HPA axis/cortisol overproduction. 38. Activity in prefrontal cortex, decreased activity in ACC, high amygdala metabolism, serotonin pathway malfunction. 39. Animal model for depression-rats forced to swim in cold water, suggest neurochemical processes may be reactions to environmental events. 40. Unipolar disorder treatments: A. Cognitive therapy-focus on replacing self-defeating thoughts with more rational self-statements. Therapists are active, directive & empirically evaluate their treatment programs, & assume conscious access to cognitive processes. B. Interpersonal therapy-Nondirective, focuses on developing social skills & interpersonal relationships, esp. family. C. Antidepressant meds-SSRIs (most frequently used, inhibit reuptake of serotonin, easier to use b/c of fewer side effects + less dangerous), tricyclics/TCAs (not so much in use due to more side effects, although just as effective as SSRIs, blocks reuptake esp. norepinephrine), MAOs (not as effective as tricyclics + high blood pressure as side effect), & combo of psychotherapy + meds more effective. 41. Bipolar disorder treatments: A. Lithium-Most common, helpful in reducing severity of mania/depressive symptoms & reduces relapse. BUT lots of patients dont improve (rapid cycling + alcohol abuse, side effects).

B. Anticonvulsant medications-50% respond to these drugs when lithium doesnt work, helpful for same reasons. C. Psychotherapy-address why patients dont take meds, or reactions to stressful life events. Social rhythm therapy-concentrates on regulating processes since disruptions in routine precipitate episodes. D. ECT-Given 3x/week for 2-7 weeks, useful for unipolar & bipolar patients. E. SAD-light therapy. 42. Highest rate of suicide found in successful white males over 50, closely linked to depression. DMS-IV lists suicide ideation as symptom of mood disorder, but thats it. 43. 1st system classifying suicide-Durkheim proposed highest risk of suicide came from high or low levels of social integration & regulation: egoistic (detached from society, existence meaningless; common among divorced & mentally ill-apathetic), altruistic (society dictates it so), anomic (breakdown/disruption of social norm or order that governs peoples behavior; following economic/political crisis-anger, exasperation, disappointment), fatalistic (commit suicide to escape horrible conditions of life). 44. Egostic & anomic suicide said to be most common; but doesnt explain why one person does it and the rest doesnt, or that different types of suicide may overlap. 45. Self-harm not specified as disorder in DMS-IV, although listed as symptom of personality disorder. Pain serves as purpose-either used to punish, combat feelings of emptiness, or most commonly to relieve intensity of negative emotional states (followed by guilt). 46. Suicide rates have increased among adolescents throughout years; more attempts to completed (10:1); females attempt 3x more than males, though completion are 4x higher among males. Highest completed suicides are among white elderly men, increases to midlife with women, but then levels off. 47. Intepersonal-psychological theory maintains people commit suicide to escape from unbearable psychological pain-frustruation from not fulfilling needs such as affiliation, competence, belonginess. Also must have attempted suicide or other gradual attempts to take life in the end. 48. Biological factors-Low levels of serotonin + genes associated with neurotransmitters systems like serotonin increase likelihood of suicide. 49. Social factors-religious groups decrease suicide, while access to firearms & seeing someone else do it increase risk of suicide. 50. Crisis centers & hotlines not very effective b/c people theyre trying to reach too difficult. 51. Psychotherapy-use to reduce lethality, negotiate agreements, provide support & broaden perspective. Chapter 6: 1. What are the most common type of abnormal behavior? 2. What are anxiety disorders?

3. What is anxiety? What is anxiety apprehension? 4. What is worry? Difference between normal worriness vs real problem? 5. What is a panic attack? How does it differ between anxiety? Characteristics? 6. How do obsessions differ from worry? 7. What are compulsions? Are people aware of them? 8. What is the most common form of compulsive behavior? 9. What were lumpers/splitters? 10. What does the DSM-IV break down anxiety disorders as? (6). 11. Course of outcome? 12. Most common anxiety disorder? 13. Comorbidities of anxiety disorders? (2) 14. Which disorder is the only gender neutral anxiety disorder? 15. Age of onset of anxiety disorders? Exceptions? 16. What kind of event precipitates an anxiety disorder? Depression? 17. How does attachment theory influence anxiety disorders? 18. What is the preparedness model?