Untitled Quiz

Premenstrual Dysphoric Disorder (PMDD)

• PMDD is characterized by recurrent episodes of significant depression and related symptoms during the week before menstruation.
• The symptoms of PMDD resemble those of a major depressive episode.

Major Depressive Episode

• Diagnosed when a person experiences increased depressed mood and/or decreased enjoyment or interest in activities for most of each day, for at least two weeks.
• During this period, they must also experience at least three of the following symptoms:
  • Significant weight change or appetite change
  • Daily insomnia or hypersomnia
  • Daily agitation or decreased motor activity
  • Daily fatigue or lethargy
  • Daily feelings of worthlessness or excessive guilt
  • Daily reduction in concentration or decisiveness
• Other symptoms include:
  • Repeated focus on death or suicide, a suicide plan, or a suicide attempt
  • Significant distress or impairment

Major Depressive Disorder

• Diagnosed when a person experiences a major depressive episode without any pattern of mania or hypomania.

Persistent Depressive Disorder

• Diagnosed when a person experiences symptoms of major or mild depression for at least two years, with these symptoms not being absent for more than two months at a time.
• Must have no history of mania or hypomania.
• Significant distress or impairment.

Dysthymic Disorder

• Characterized by mild but chronic symptoms of depression.
• Depression is longer-lasting but less disabling.
• Consistent symptoms for a minimum of two years.
• Double depression occurs when dysthymic disorder progresses to major depressive disorder.

Stress and Unipolar Depression

• Stressful events can trigger depressive episodes, with 80% of severe episodes occurring within a month or two of a significant negative event.

Psychodynamic Treatments for Unipolar Depression

• Based on Freudian principles, it involves:
  • Free association
  • Interpretation of client associations, dreams, and displays of resistance and transference

Psychodynamic View

• Strengths:
  • General research support
  • Depression can be triggered by major loss; early losses can set the stage for later depression.
  • Depression after loss may be linked to poorly met childhood needs.
• Limitations:
  • Depressed clients may be too passive and feel too weary to engage fully in subtle therapy discussions.
  • Clients may feel discouraged and end treatment prematurely.

Cognitive-Behavioral Model

• Asserts that depression results from problematic behaviors and dysfunctional thinking.
• Theoretical perspectives:
  • Behavioral dimension
  • Negative thinking
  • Complex interplay of cognitive and behavioral factors

Behavioral Dimension

• Proposed by Lewinsohn and others.
• A reduction in positive life rewards may lead to fewer positive behaviors, resulting in a lower rate of positive rewards, and eventually depression.
• Social rewards are crucial in the downward spiral of depression.
• A strong connection exists between positive life events and feelings of life satisfaction and happiness.

Negative Thinking

• Beck's theory emphasizes a combination of maladaptive attitudes, a cognitive triad, cognitive errors, and automatic thoughts as underlying causes of unipolar depression.
  • Cognitive triad: Negative views of experiences, oneself, and the future.
• Watkins and colleagues highlight the link between ruminative responses during depressed moods and prolonged feelings of dejection, increasing the likelihood of clinical depression later in life.

Learned Helplessness

• Seligman's theory suggests that depression occurs when individuals believe they have no control over life's reinforcements and internalize blame for their helplessness.

Attribution-Helplessness Theory

• A modified learned helplessness theory.
• Internal, global, and stable attribution of a current lack of control leads to feeling powerless to prevent future negative outcomes.
• It results in depression.

Challenges of Learned Helplessness and Attribution-Helplessness

• Much research relies on results from animal subjects.
• Attribution features raise complex questions.

Cognitive-Behavioral Therapy (CBT)

• Key components of behavioral activation include:
  • Reintroduction to enjoyable events and activities
  • Consistently rewarding non-depressive behaviors and withholding rewards for depressive ones
  • Assisting clients in improving social skills
• Challenges:
  • Limited effectiveness as a sole treatment, more useful when combined with cognitive techniques.

New-Wave Approach to CBT

• Suggests that individuals do not need to completely eliminate negative cognitions to overcome depression.
• Acceptance and Commitment Therapy (ACT).

Cognitive Therapy (Beck)

• Consists of four phases:
  • Phase 1: Increasing activities and elevating mood
  • Phase 2: Challenging automatic thoughts
  • Phase 3: Identifying negative thinking and biases
  • Phase 4: Changing primary attitudes
• Often followed by preventive cognitive therapy.
• Approximately 50-60% of patients experience significant improvement or elimination of their symptoms.

Sociocultural Model of Unipolar Depression

• Unipolar depression is influenced by social context and often triggered by external stressors.
• Perspectives:
  • Family-social perspective
  • Multicultural perspective

Family-Social Perspective

• A decline in social rewards contributes to depression.
• Social deficits may lead to avoidance by others, decreasing social contacts and rewards.
• Weak or unavailable social support, isolation, and lack of intimacy are repeatedly linked to troubled or unhappy marriages.

Lack-of-Control Theory

• Draws on learned helplessness research and argues that women may be more prone to depression because they perceive less control over their lives compared to men.

Rumination Theory

• Research reveals that women are more likely than men to ruminate when their mood deteriorates, potentially making them more vulnerable to the onset of clinical depression.

Cultural Background and Depression

• The specific presentation of depression varies across countries.
  • Non-western countries: Higher prevalence of physical symptoms and fewer cognitive symptoms compared to Western countries.
  • Ethnic or racial groups: Minimal differences in overall rates or symptoms, however, differences in recurrence rates exist. Uneven distribution within some minority groups.

Multicultural Treatments

• Culture-sensitive therapies address the distinctive challenges faced by members of cultural minority groups.
  • Cultural training and heightened awareness:
    • Development of a comfortable bicultural balance
    • Recognition of the impact of both their own and the dominant culture
  • Combined with traditional forms of psychotherapy

Integrating Models: Developmental Psychopathology

• Unipolar depression is caused by a combination of factors from various models.
• A genetically inherited biological predisposition, influenced by significant early life trauma, is a key factor.
• The magnitude and timing of negative factors contribute to its development.
• Resilience is linked to moderate, manageable adversities throughout childhood.
• These factors unfold and interact in a developmental sequence.

Bipolar Disorders

• Involve periods of depression (lows) and mania (highs).
• Shift between extreme moods.
• Have a significant impact on relatives and friends.

Symptoms of Mania

• Individuals experiencing mania typically exhibit dramatic and inappropriate mood elevations.
• Symptoms:
  • Emotional: Active, powerful emotions seeking expression.
  • Motivational: Intense need for constant excitement, engagement, and companionship.
  • Behavioral: Highly active, moving quickly, talking loudly or rapidly, flamboyance is common.
  • Cognitive: Impaired judgment, planning, difficulty maintaining coherence or contact with reality.
  • Physical: High energy levels, often despite minimal rest.

Diagnosing Bipolar Disorders: Manic Episode

• Diagnosed when a person exhibits an abnormally inflated, unrestrained, or irritable mood, accompanied by heightened energy or activity for the majority of every day, for at least one week or more.
  • At least three of the following symptoms must be present:
    • Grandiosity or exaggerated self-esteem
    • Reduced need for sleep
    • Rapidly shifting thoughts or a sense that thoughts are racing
    • Difficulties focusing attention
    • Increased activity or agitation
    • Excessive pursuit of risky and potentially problematic activities
• Significant distress or impairment is evident.

Diagnosing Bipolar Disorders: Bipolar I Disorder

• Defined by the occurrence of a manic episode.
• Hypomanic or major depressive episodes may precede or follow the manic episode.

Diagnosing Bipolar Disorders: Bipolar II Disorder

• Presence or history of at least one major depressive episode.
• Presence or history of at least one hypomanic episode.
• No history of a manic episode.

Diagnosing Bipolar Disorders: Cyclothymic Disorder

• A milder form of bipolar disorder that persists for at least two years.
• Periods of normal mood lasting only a few days or weeks interrupt the cycle.
• Typically begins in adolescence or early adulthood.
• No gender differences in rates of occurrence.
• May evolve into bipolar I or bipolar II disorder.

Bipolar Disorders: Prevalence

• Globally, between 1 to 2.8% of adults experience bipolar disorder at any given point in time, with 4.4% experiencing it at some point in their lives.
• Onset usually occurs between 15 and 44 years old.
• No notable gender differences, but higher rates are observed in lower-income groups.