PSYC 210 Lecture Notes - Lecture 7: Interpersonal Psychotherapy, Neuroplasticity, Grandiosity
28 Jun 2018
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Emotion - Acute psychological response to a specific stimulus event --- Short Duration (mins-hours)
Flow on the heels of other emotions - many emotions in sequence - from annoyed to
embarrassed to guilty
Mood - Emotional state; can be stimulus-independent --- Moderate Duration (hours-day)
Can be triggered by external and internal events
More pliable than traits
Trait/Temperament - Stimulus-independent, stable pattern of processing information and responding to
environment --- Long Duration (lifetime)
Fairly hardwired, can be changed with effort but day to day practices - they tend to be very
ingrained and in our ways of responding
Moods operate along two axes - Circumblack's model of mood
Two independent axes - Valence (pos to neg) and Intensity (high to low)
These moods together make up our normal range of mood states
Mood disorders occur when too much time is spent in one quadrant, problems in moving from one
quadrant to another, too far in intensity in valence or intensity -- over time this can cause impairment
and distress among people
Two types - depressive symptoms, manic symptoms
Depressive disorders
Unipolar - high levels of negativity (dysphoria) or low levels of positivity (anhedonia)
Bipolar - when you have both dysphoria and anhedonia but along with mania (high levels of positivity)
Unipolar is only diagnosed If you have had depressive episodes along with no manic episodes ever
Mood disorders - most common psychopathology
Unipolar - most common mood disorder - 16% prevalence, 7% of US population has depression in any
given year
Lower for dysthymia(persistent depression, mild) and bipolar depression
Large sex differences in prevalence - twice has common in women compared to men -- unipolar but with
bipolar, there's equal risk
MAJOR DEPRESSIVE DISORDER (UNIPOLAR) ---- episodic disorder because symptoms occur for a while
then clear
9 essential symptoms required for diagnosis of depression (unipolar): (5 or more should be present daily
or most of the day for at least 2 weeks)
Depressed mood (sad or empty)
Anhedonia (loss of interest or pleasure) (Must include one of these)
Insomnia or hypersomnia
Change in appetite or weight
Psychomotor retardation/agitation (sped up or slowed down)
oAgitation - Nervous energy, fidgety
oRetardation - move, talk slowly but it has to be severe enough to cause noticeable
impairment
Fatigue
Feelings of worthlessness or guilt
Diminished ability to think, concentrate, and make decisions
Recurrent thoughts of death, suicidal ideation, suicide attempts
----> Doesn't meet criteria for mixed episode (Ie. No mania)
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----> symptoms cause significant impairment/distress in social/occupational/other
-----> symptoms not due to the effects of a drug of general medication condition
-----> symptoms not due to bereavement (no longer true in DSM 5) -- could only validate depression
after the loss of a loved one if it was persistent for 2 months
Varies across individuals' description - physical, emotions
Course of Illness - single episode (most people) and recurrent (at least 2 separated by 2 months)
Typical: 4-5 lifetime episodes each 4-5 months
Depression is a CHRONIC disease
Specifiers:
Atypical Features:
Anxiety
Mood reactivity
Rejection sensitivity (trait like pattern)
Over eating and weight gain
More common in women, earlier onset, increased suicide risk
Melancholic Features: (first two required)
Severe anhedonia
Severe dysphoria
Psychomotor symptoms
Sleep symptoms
Loss of appetite
Persistent, inappropriate guilt
Psychotic Features:
Delusions (related to guilt)
Hallucinations
Longer episodes
Worst long-term prognosis
Seasonal Pattern: (seasonal affective disorder)
Appears at a particular time each year
Persistent Depressive Disorder (PDD):
Chronically depressed - more than half of the time for at least 2 years
Dysthymia - when people come out of depression, it does not just disappear away and it is
persistent through a long time but is milder for at least 2 years
Lose interest in activities and have at least two of the other symptoms of depression
oPoor eating or overeating
oSleeping too much or too little
oLow energy
oLow self esteem
oTrouble concentrating or making decisions
oFeelings of hopelessness
-----> symptoms do not clear for more than 2 months at a time
-----> bipolar disorder is not present
Other depressive disorders:
Disruptive mood dysregulation disorder: severe recurrent temper mood bursts
Premenstrual dysphoric disorder: mood symptoms in the week before menses
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Depression is not development - it need not express as early life problems
There can be adult causal problems - developing depression at 40
Diagnoses of depression is like fever - it lacks the specificity to be a homogenous identity, it can have
root causes that are all completely different medical conditions which require different treatment. It is
difficult to match someone with the treatment because depression is subjective for everyone.
It is heterogeneous - two people can have completely different symptoms
Comorbidity - anxiety and depression are comorbid, anxiety can be before or after depression
BIPOLAR DISORDER:
Anhedonia/dysphoria + mania
Mania - high levels of intensity along with positivity - can sweep the whole house, a rush of energy but
when they lose energy - they fall asleep anywhere, cant find the easiest things. Flight of ideas - difficult
to interrupt, change topics randomly
Treatment for this leads you to lose energy and numbs you down - you do not like yourself on this
medication and miss your old self because this is not the real me
Symptoms of Mania -
Euphoria
Hyperactivity/decreased need for sleep
Grandiosity - feel clear, strong, and able to do big things
Rapid, incoherent speech
Impulsivity like hyper sexuality, spending, drugs
Irritability and aggression
Diagnoses: (Charlie Sheen video)
Any 3 symptoms: decreased need for sleep, more talkative than usual, excessive involvement in
pleasurable activities, racing thoughts, grandiosity
Doesn't meet criteria for mixed episode
Impairment/dysfunction caused by mood disturbance
Symptoms not due to effects of a drug
Hypomania is lesser than mania - not as destructive but still hyper, more social, energized, sexually
alluring
Bipolar 1: Full manic episodes alternate with full depressive episodes
Include a single manic episode during the course of a person's life
Bipolar 2: Hypomanic episodes alternate with full depressive episodes
At least one depressive and one manic episode
Cyclothymic Disorder: Chronic; long-lasting hypomanic states alternating with mild depressive states
Symptoms present for at least 2 years
Etiology
Genetic Factors:
37% heritability for MDD for MZ and DZ twins
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