Transcript Abnormal Psychology - Western Carolina University

Abnormal Psychology
Dr. David M. McCord
Mood Disorders
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DSM-IV Classification Categories
Disorders Usually First Evident in Infancy, Childhood, or
Adolescence
Delirium, Dementia, and Amnestic and Other Cognitive
Disorders
Substance-Related Disorders
Schizophrenia and Other Psychotic Disorders
Mood Disorders
Anxiety Disorders
Somatoform Disorders
Dissociative Disorders
Sexual and Gender Identity Disorders
Sleep Disorders
Eating Disorders
Factitious Disorders
Adjustment Disorders
Impulse Control Disorders
Personality Disorders
Mood Disorders
• Major Depressive Disorder
(1 or more Major Depressive Episodes)
• Dysthymic Disorder
(2 years of depressed mood, no MDE)
• Bipolar I Disorder
(1 or more Manic or Mixed Episodes)
• Bipolar II Disorder
(1 or more MDE’s with Hypomanic Episode)
• Cyclothymic Disorder
(2 years of numerous periods of hypomanic symptoms)
Four types of Mood Episodes:
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Major Depressive Episode
Manic Episode
Mixed Episode
Hypomanic Episode
Major Depressive Episode
(at least 5 of these, including at least 1 of the 1st 2)
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Depressed mood most of the day, nearly every day, as indicated either by
subjective report (e.g., feels sad or empty) or observation made by
others.
Markedly diminished interest or pleasure in all, or almost all, activities
most of the day, nearly every day.
Significant weight loss when not dieting or weigh gain (more than 5%
body weight in 1 month) or decrease or increase in appetite nearly every
day.
Insomnia or hypersomnia nearly every day.
Psychomotor agitation or retardation nearly every day.
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt (which may
be delusional) nearly every day (not merely self-reproach about being
sick).
Diminished ability to think or concentrate, or indecisiveness, nearly every
day.
Recurrent thoughts of death, recurrent suicidal ideation without a specific
plan, or a suicide attempt or a specific plan.
Manic Episode
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A distinct period of abnormally and persistently elevated,
expansive, or irritable mood, lasting at least 1 week (or less if
hospitalization is necessary).
During the period of mood disturbance, 3 or more of the
following have persisted to a significant degree:
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Inflated self-esteem or grandiosity
Decreased need for sleep
More talkative than usual or pressure to keep talking
Flight of ideas, or subjective experience that thoughts are racing
Distractibility (attention too easily drawn to unimportant or
irrelevant external stimuli)
Increase in goal-directed activity (either socially, at work or
school, or sexually) or psychomotor agitation
Excessive involvement in pleasurable activities that have a high
potential for painful consequences (e.g., engaging in
unrestrained buying sprees, sexual indiscretions, or foolish
business investments)
Mixed Episode
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The criteria are met for both a Manic Episode and a Major
Depressive Episode (except for duration) nearly every day for at
least a 1-week period
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The mood disturbance is sufficiently severe to cause marked
impairment in occupational functioning or in usual social activities
or relationships with others, or to necessitate hospitalization to
prevent harm to self or others, or there are psychotic features
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The symptoms are not due to the direct physiological effects of a
substance (drug of abuse, medication, other treatment) or a
general medical condition
Hypomanic Episode
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A distinct period of persistently elevated, expansive, or
irritable mood, lasting throughout at least 4 days, that is
clearly different from the usual non-depressed mood.
During the period of mood disturbance, at least 3 of the
following have been present to a significant degree:
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Inflated self-esteem or grandiosity
Decreased need for sleep (e.g., feels rested after only 3 hours of
sleep)
More talkative than usual or pressure to keep talking
Flight of ideas or subjective experience that thoughts are racing
Distractibility
Increase in goal-directed activity or psychomotor agitation
Excessive involvement in pleasurable activities that have a high
potential for painful consequences
The episode is associated with an unequivocal change in
functioning that is uncharacteristic of the person when not
symptomatic
The disturbance in mood and the change in functioning are
observable by others
The episode is NOT severe enough to cause marked
impairment in social or occupational functioning, or to
necessitate hospitalization, and there are no psychotic
features
Mood Disorders
• Major Depressive Disorder
(1 or more Major Depressive Episodes)
• Dysthymic Disorder
(2 years of depressed mood, no MDE)
• Bipolar I Disorder
(1 or more Manic or Mixed Episodes)
• Bipolar II Disorder
(1 or more MDE’s with Hypomanic Episode)
• Cyclothymic Disorder
(2 years of numerous periods of hypomanic symptoms)
Major Depressive Disorder
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Presence of single Major Depressive Episode
There has never been a Manic Episode, a Mixed Episode, or a
Hypomanic Episode
MDE not better accounted for by schizophrenia or related psychotic
disorder
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Specifiers
Single Episode or Recurrent
Severity:
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Mild
Moderate
Severe without Psychotic Features
Severe with Psychotic Features
In Partial Remission
In Full Remission
Chronic
With Catatonic Features
With Melancholic Features
With Atypical Features
With Postpartum Onset
With or Without Interepisode Recovery
With Seasonal Pattern
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Examples:
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Major Depressive Disorder, Recurrent, Moderate,
With Atypical Features, With Seasonal Pattern, With
Full Interepisode Recovery
Dysthymic Disorder
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Depressed mood for most of day, for more days than not, as
indicated by either subjective account or observation by
others, for at least 2 years.
Presence while depressed of at least two:
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Poor appetite or overeating
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Insomnia or hypersomnia
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Low energy or fatigue
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Low self-esteem
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Poor concentration or difficulty making decisions
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Feelings of hopelessness
Symptoms have not disappeared for more than 2 months
No MDE, no Manic Episode, no Mixed Episode, no
Hypomanic Episode, no Cyclothymic Disorder
Specifiers:
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Early Onset versus Late Onset
With Atypical Features
Bipolar I Disorder
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(Single Manic Episode)
(Most Recent Episode Hypomanic)
(Most Recent Episode Manic)
(Most Recent Episode Mixed)
(Most Recent Episode Depressed)
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Currently or most recently in _________ Episode
There has been at least one ________ Episode
Specifiers:
Severity/Psychotic/Remission Specifiers
Chronic
With Catatonic Features
With Melancholic Features
With Postpartum Onset
With or Without Interepisode Recovery
With Seasonal Pattern
With Rapid Cycling
Bipolar II Disorder
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Presence of or history of one or more MDE’s
Presence of at least one Hypomanic Episode
Never has been a Manic Episode or a Mixed Episode
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Specifiers:
Hypomanic
Depressed
(and most other specifiers)
Cyclothymic Disorder
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For at least 2 years, numerous periods with hypomanic
symptoms and numerous periods with depressive symptoms
that do not meet criteria for MDE.
No MDE, Manic Episode, or Mixed Episode present during the
2 year period
Other Mood Disorders:
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Mood Disorder Due to a General Medical Condition
Substance-Induced Mood Disorder
Things to Study:
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Comer’s categorization of mood symptoms: emotional,
cognitive, motivational, behavioral
Definitions of specifiers
Neurotransmitters involved
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How tricyclics work
How 2nd-generation drugs work
Freudian perspectives on depression
Behavioral perspectives on depression
Cognitive perspectives on depression
Cognitive Therapy
Learned helplessness theory
Relative effectiveness of different therapies
Artifact, quality-of-life, and self-blame theories