9/30/08 B E H A V I O R D I S O R D E R S B E Mood Disorders H • Mood disorders - Psychological disorders A characterized by disturbances of mood. V I • Major forms of mood disorder: O • depressive disorders and R • bipolar disorders (mood swing disorders). D • Two major types of depressive disorders that vary in I severity: S • major depressive disorder and O • dysthymic disorder R D • Similarly, bipolar or mood swing disorders vary in E severity R S B E H A V I O R D I S O R D E R S 1 9/30/08 B E A Mood Thermometer H A V I O R D I S O R D Mood states can be conceptualized as varying E along a spectrum or continuum. R S B E Major Depressive Disorder H A Major depressive disorder - A severe mood V disorder characterized by major depressive I episodes. O R Mania - A state of unusual elation, energy, and D activity. I S Hypomania - A relatively mild state of mania. O R D E R S B E H A V I O R D I S O R D E R S 2 9/30/08 B E H A V I O R D I S O R D E R S B E The Case of Helen H A V I O R D I S O R D E R S Depression B E H A V I O R D I S O R D E R Major depressive episodes affect about twice as S many women as men. 3 9/30/08 B E Major Depressive Disorder H A Major depression impairs people’s ability to V meet the ordinary responsibility of everyday life. I O People with major depression may lose interest R in most of their usual activities and pursuits, have difficulty concentrating and making D I decisions, have pressing thoughts of death, and S attempt suicide. O R They even show impaired driving skills in driving D simulation tests (Bulmash et al., 2006). E R S B Risk Factors in E H Major Depression A Factors that place people at increased risk of V developing major depression include: I O R Age (initial onset is most common among young adults) D I Socioeconomic status (people lower down the S socioeconomic ladder are at greater risk than O those who are better off) R D Marital status (people who are separated or E R divorced have higher rates than married or S never-married people). B E Seasonal Affective Disorder H A Many people report that their moods do vary V with the weather. I O For some people, the changing of the seasons R from summer into fall and winter leads to a type of major depression called seasonal affective D I (mood) disorder (SAD). S O SAD is not a diagnostic category in its own right R in the DSM-IV but is a specifier or subcategory of D a mood disorder involving major depression. E R S 4 9/30/08 B E Postpartum Depression H Postpartum derives from the Latin roots post, A V meaning “after,” and papere, meaning “to bring I forth.” O R Postpartum depression (PPD) - Persistent and severe mood changes that occur after D childbirth. I S O R PPD is often accompanied by disturbances in D appetite and sleep, low self-esteem, and E difficulties in maintaining concentration or R attention. S B E Dysthymic Disorder H A Dysthymia derives from Greek roots dys-, V meaning “bad” or “hard” and thymos, meaning I “spirit.” O R Dysthymic disorder - A mild but chronic type of depressive disorder. D I S Dysthymia affects about 4% of the general O population at some point in their lifetimes (APA, R 2000; Conway et al., 2006). D E R S B E H A V I O R D I S O R D E Like major depression, dysthymic disorder R occurs in about twice as many women as men. S 5 9/30/08 B E Double Depression H Some people are affected by both dysthymic A V disorder and major depression at the same I time. O R The term double depression applies to those who have a major depressive episode D superimposed on a longer-standing dysthymic I S disorder. O R People suffering from double depression D generally have more severe depressive episodes E than do people with major depression alone R (Klein, Schwartz et al., 2000). S B E Bipolar Disorder H Bipolar disorder - A psychological disorder A characterized by mood swings between states of V extreme elation and depression. I O R People with bipolar disorder ride an emotional roller coaster, swinging from the heights of D elation to the depths of depression without I external cause. S O The first episode may be either manic or R depressive. Manic episodes, typically lasting from D E a few weeks to several months, are generally R shorter in duration and end more abruptly than S major depressive episodes. B E The Case of Craig H A V I O R D I S O R D E R Bipolar Disorder S 6 9/30/08 B E Manic Episode H • Manic episode - A period of unrealistically A heightened euphoria, extreme restlessness, and V excessive activity characterized by disorganized I O behavior and impaired judgment. R • During a manic episode, the person experiences a sudden elevation or expansion of mood and D feels unusually cheerful, euphoric, or optimistic. I • The person seems to have boundless energy and S is extremely sociable, although perhaps to the O R point of becoming overly demanding and D overbearing toward others. E • Other people recognize the sudden shift in R mood to be excessive in the light of the person’s S circumstances. B E Cyclothymic Disorder H Cyclothymia is derived from the Greek kyklos, which A means “circle,” and thymos, meaning “spirit.” V I Cyclothymic disorder - A mood disorder characterized O by a chronic pattern of less-severe mood swings than are R found in bipolar disorder. D The periods of elevated mood are called hypomanic I episodes (from the Greek prefix hypo-, meaning “under” S or “less than”). O R They are less severe than manic episodes and are not D accompanied by the severe social or occupational E problems associated with full-blown manic episodes. R S B E Stress and Depression H Stress plays an important role in determining A vulnerability in bipolar disorder and even more strongly V in major depression. I O Sources of stress may include: R The loss of a loved one D The breakup of a romantic relationship I Prolonged unemployment S Physical illness O Marital or relationship problems R Economic hardship D Pressure at work E Exposure to racism and discrimination R Living in an unsafe S Distressed neighborhood 7 9/30/08 B E Psychodynamic Theories H The classic psychodynamic theory of depression of Freud A (1917/1957) and his followers (e.g., Abraham, V 1916/1948) holds that depression represents anger I directed inward rather than against significant others. O R Freud believed that mourning, or normal bereavement, is a healthy process by which one eventually comes to D separate oneself psychologically from a person who is I lost through death, separation, divorce, or other reason. S O From the psychodynamic viewpoint, bipolar disorder R represents shifting dominance of the individual’s D personality between the ego and superego. E R S B E Research Evidence H Psychodynamic theorists focus on the role of loss in A depression. V I Research does show that loss of significant others O (through death or divorce, for example) is often R associated with the development of depression. D Evidence supports the view that a self-focusing style—an I inward or self-absorbed focus of attention—is associated S with depression, especially in women. O R D E R S B E Humanistic Theories H From the humanistic framework, people become A depressed when they cannot imbue their existence with V meaning and make authentic choices that lead to self- I fulfillment. O R Like psychodynamic theorists, humanistic theorists focus on the loss of self-esteem that can arise when D people lose friends or family members or suffer I occupational setbacks. S O We tend to connect our personal identity and sense of R self-worth with our social roles as parents, spouses, D students, or workers. E R S 8 9/30/08 B E Learning Theories H Whereas the psychodynamic perspectives focus on A inner, often unconscious, causes, learning theorists V emphasize situational factors, such as the loss of I positive reinforcement. O R We perform best when levels of reinforcement are commensurate with our efforts. D I Changes in the frequency or effectiveness of S reinforcement can shift the balance so that life becomes O unrewarding. R D E R S B E The Role of Reinforcement H Learning theorist Peter Lewinsohn (1974) proposed that A depression results from an imbalance between behavior V and reinforcement. I O A lack of reinforcement for one’s efforts can sap R motivation and induce feelings of depression. D Inactivity and social withdrawal reduce opportunities I for reinforcement; lack of reinforcement exacerbates S withdrawal. O R D E R S B E Interactional Theory H Difficulties in social interactions may help explain the A lack of positive reinforcement. V I Interactional theory, developed by psychologist O James Coyne (1976), proposes that the adjustment to R living with a depressed person can become so stressful that the partner or family member becomes D progressively less reinforcing.