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Psychopathology Continued (Cognitive processes in Depression (Aron…
Psychopathology Continued
Major Depressive Episode
Criteria
Profound, persistent period of depression that exists for two or more weeks as indicated by the presence of 5 or more symptoms
depressed mood (most of the day, everyday)
psychomotor agitation or psychomotor retardation
Fatigue or loss of energy
insomnia or hypersomnia
significant weight loss or weight gain
feeling of worthlessness or excessive or inappropriate guilt
marked diminished interest and pleasure in almost all activities
diminished ability to think, concentrate, or make decisions
recurrent thoughts of death or recurrent suicidal ideation
Depressive Disorders
Persistent Depressive Disorder (Dysthymia and neurotic depression)
chronic (2 year duration or more) "low grade" depression (does not meet criteria for Major Depression) indicated by 2 or more of the following
low energy or fatigue
low self-esteem
insomnia or hypersomnia
poor concentration or difficulty making decisions
Poor appetite or overeating
feeling of hopelessness
Major Depression
One or more "major depressive episodes" without any history of mania or hypomania
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Can be one episode of Major Depression or Recurrent
Bipolar Disorders
Cyclothymia
2-year duration of numerous alternating periods of hypomanic symptoms (shy of mania) and depressive symptoms (shy of major depressive episodes)
Bipolar Disorder
present mental state can be principally a "manic-episode" or "hypomanic episode' or a "major depressive episode" -as long as there has been a past history of mania or hypomania
if currently depressed with history of mania the diagnosis becomes "Bipolar disorder, depressed"
Bipolar I disorder
involves the presence of mania at some point
Bipolar II Disorder
Recurrent Major depressive episodes with hypomanic episodes
Diathesis-Stress Model
general framework for explaining the causes of psychopathological conditions
Diathesis: predisposing factors
Stress: Precipitating factors or triggering factors
genetic and non-genetic factors are influential as predisposing factors
Stress is influential as a precipitating/triggering factor, but who experiences stress is influenced not only by objective MLE's and objective hassles, but also cognitive and personality predispositions
Three theories behind what causes what when it comes to brain chemistry, cognition, and mood
Psychoanalytic Theory
anger turned inward: the punishing role of the harsh superego
Goal: insight, makes the unconscious conscious, expand the ego's control
Resolve it by Free association, analysis of transference, and dream analysis
Behavioral Learning Theory
an insufficiency of contingencies of positive reinforcement
(S-R model)
Goal: change behavioral responses to increase reinforcement of non-depressed behavior
change environment, change behavior in environment, change contingencies
Cognitive and Social Learning Theories
Emotions and moods are caused by cognitive processes
depression and depressive mood episodes result from irrational thinking , irrational beliefs, irrational cognitions
Seligman's ABC Model(borrowed from Ellis )
Anticedent
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beliefs
consequences
Treatment ABCDE Model
D:dispute
E: Energization
freedom from irrational beliefs
Cognitive processes in Depression
Seligman
S-O-R: O is beliefs
Permanence, Pervasiveness, Personalization
Bandura's Self Efficacy model
Goal: alter expectations through exploring rationality of cognitions and altering behavior to change reinforcement probablilities
Aron Beck's "Cognitive Triad"
Negative view of self
negative view of world
negative view of future
Ellis: Musterbation
musts- do not think must
GO BACK TO DRUG UNIT AND REVIEW
Medications work in 60% of cases (review 3 types)
Psychotheraphy-long term effects are good
paring meds with therapy is the best