Concise overview of the aetiology & treatment approaches of mental disorders
Summary first exam Psychopathology & Psychodiagnostics
1.6 Clinical Psychology Problem 6 Summary
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Summary Exam Psychopathology & Psychodiagnostics part 2
Including:
Davey (2014):
Anxiety and Stressor-Related Problems (Chapter 6)
Depression and Mood Disorders (Chapter 7)
Substance Use Disorders (Chapter 9)
Eating Disorders (Chapter 10)
Neurocognitive Disorders (Chapter 15)
Groth-Marnat & Wright (2016)
Wechsler Intelligence Scales (Chapter 5)
The Rorschach (Chapter 11)
Screening for Neuropsychological Impairment (Chapter 12)
Treatment planning and Clinical Decision Making (Chapter 13)
Additional study material:
The reader:
- Pinel & Barnes (2014). Drug addiction and the Brain's reward circuits
(Chapter 15)
- Pinel & Barnes (2014). Biopsychology of emotion, stress, and health
(Chapter 17)
- Pinel & Barnes (2014). Biopsychology of psychiatric disorders
(Chapter 18)
The PowerPoint Slides that gave additional information
,Depression and mood disorders (Davey chapter 7)
Major depression (or unipolar depression) and bipolar depression are the two main types of
clinical depression.
DSM-5 criteria for a major depressive episode:
o At least five of the following are present, including either depressed mood or loss of interest:
- Depressed mood most of the time
- Less interest or enjoyment of most activities
- Significant weight change not associated with dieting
- Insomnia or excessive sleep
- Excessive increase or reduction in physical movement
- Substantial fatigue or lack of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Lack of concentration or ability to think or make decisions
- Recurrent thoughts of death and suicide or suicide attempt
o The symptoms are not better accounted for by schizoaffective disorder or other mental
disorder due to the effects of a substance or other medical condition
DSM-5 criteria for major depressive disorder:
o Presence of a single major depressive episode (not attributable to normal and expected
reactions to bereavement, etc.) without previous manic or hypomanic episode where
symptoms are not better accounted for by other disorders
o The symptoms must cause significant distress or impairment in social, occupational or other
forms of functioning
DSM-5 criteria for dysthymic disorder:
o Depressed mood most of the time for at least 2 years
o Presence of at least two of the following:
- Poor appetite or overeating
- Lack of or excessive sleeping
- Low levels of energy or fatigue
- Low self-esteem
- Poor concentration or decision-making abilities
- Feelings of hopelessness
o The symptoms are not due to the effects of a substance or other medical condition
Depression is the third most common reason for consulting a doctor or GP in the UK.
The lifetime comorbidity rate of major depression with another anxiety disorder is 58
percent and with more than one other DSM disorder is 74 percent suggesting that individuals
with depression experience a range of negative emotions.
Premenstrual dysphoric disorder, seasonal affective disorder (SAD), and chronic fatigue
syndrome (CFS) are three prominent disorders with depression as a significant element.
Premenstrual dysphoric disorder: A condition in which woman experience severe depression
symptoms between 5 and 11 days prior to the start of the menstrual cycle. Symptoms then improve
significantly within a few days after the onset of menses.
Seasonal affective disorder (SAD): A condition of regularly occurring depressions in winter with a
remission the following spring or summer.
,Chronic fatigue syndrome: A disorder characterized by depression and mood fluctuations together
with physical symptoms such as extreme fatigue, muscle pain, chest pain, headaches and noise and
light sensitivity.
Estimates of lifetime prevalence rates for major depressive disorder range from 5.2 to 17.1
percent.
Major depression is almost twice as common in woman as in men.
The incidence of major depression has increased since 1915 with a median onset age of
around 27 years.
There is good evidence for a genetic component to major depression.
Abnormalities in the levels of the brain neurotransmitters serotonin, dopamine and
norepinephrine are associated with depressed mood.
Depressed mood has been shown to be associated with abnormal activity in a number of
brain areas, including the prefrontal cortex, the anterior cingulate cortex, the hippocampus,
and the amygdala.
High levels of cortisol may lead to depression by causing enlargement of the adrenal glands
and in turn lowering the frequency of serotonin transmitters in the brain.
Psychoanalytic theory argues that depression is a response to loss, and the loss of a loved
one such as a parent.
Behavioural theories claim that depression results from a lack of appropriate reinforcement
for positive and constructive behaviours, and this is especially the case following a ‘loss’ such
as bereavement or losing a job.
Interpersonal theories of depression claim that depressed individuals alienate family and
friends because of their perpetual negative thinking, and this alienation in turn exacerbates
the symptoms of depression.
Beck’s cognitive theory of depression argues that depression is maintained by a ‘negative
schema’ that leads depressed individuals to hold negative views about themselves, their
future, and the world (the ‘negative triad’).
Learned helplessness theory argues that people become depressed following unavoidable
negative life events because these events give rise to a cognitive set that makes individuals
learn to become ‘helpless’, lethargic and depressed.
Attributional accounts of depression suggest that people who are likely to become depressed
attribute negative life events to internal, stable, and global factors.
Hopelessness is a cluster of depression symptoms that are characterized by an expectation
that positive outcomes will not occur, negative outcomes will occur, and the individual has
no responses available that will change this state of affairs.
Depressive rumination can increase the risk of depression or increase the risk of relapse.
Rumination: The tendency to repetitively dwell on the experience of depression or its possible
causes.
Bipolar disorder is characterized by periods of mania that alternate with periods of
depression.
DSM-5 criteria for a manic episode:
o Unusual and continual elevated, unreserved or irritable mood and unusual and continual
increase in energy levels lasting at least a week
o Presence of at least three of the following:
- Inflated self-esteem or grandiosity
, - Less need for sleep
- Increased talkativeness
- Racing thoughts
- Easily distractible
- Increase in goal-directed activity or unintentional and purposeless motions
- Unnecessary participation in activities with a high potential for painful consequences
DSM-5 criteria for bipolar disorder I:
o Presence or history of at least one manic episode(s)
o The manic episode may have been preceded by and may be followed by hypomanic or major
depressive episodes
o Symptoms are not better accounted for by schizoaffective disorder or other disorders
DSM-5 criteria for bipolar disorder II:
o Presence or history of at least one major depressive episode(s)
o Presence or history of at least one hypomanic episode(s)
o No history of manic episode(s)
o Symptoms are not better accounted for by schizoaffective disorder or other disorders
Hypomania are defined as mild maniac episodes
DSM-5 criteria for hypomania
o Unusual and continual elevated, unreserved or irritable mood and unusual and continual
increase in energy levels lasting at least a week.
o Presence of at least three of the following:
- Inflated self-esteem or grandiosity
- Less need for sleep
- Increased talkativeness
- Racing thoughts
- Easily distractible
- Increase in goal-directed activity or unintentional and purposeless motions
- Unnecessary participation in activities with a high potential for painful consequences
o A noted change in functionality which is not usually seen in the induvial and changes in
functionality and mood are noticeable by others
o The episode is not due to the use of medication, drug abuse or other treatment
Cyclothymic disorder is a mild form of bipolar disorder which ranges from mild depression to
mania.
DSM-5 criteria for cyclothymic disorder:
o For at least 2 years there have been many periods with hypomanic symptoms that do not
meet the criteria for a hypomanic episode and many periods with depressive symptoms that
do not meet the criteria for a major depressive episode. These symptoms have not been
absent for more than 2 months at a time
o No major depressive episode, manic episode or hypomanic episode has been present during
the first 2 years of the disorder
o The episode is not due to the use of medication, drug abuse or other treatment
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