Download Models in Psychopathology

Mood
Disorders
and
Suicide
Types of Mood Disorders- I
 Depressive disorders
 Dysthymic disorder – Depressed mood most of
the time
 Major depressive episode or Major Depressive
disorder – One or more major depressive
episodes
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Major Depressive Disorder
Symptoms may include:
•Sad, depressed mood
•Loss of interest & pleasure in usual activities
•Sleep difficulties
•Change in activity level (psychomotor retardation or
agitation)
•Poor appetite & weight loss (or reverse)
•Decreased energy, fatigue
•Negative self-worth, self-blame, guilt
•Difficulties concentrating, slowed thinking, indecisive
•Recurrent thoughts of death or suicide
To meet DSM criteria, either one or both of the first two must
be present; must be present for a minimum of two weeks, must
have a minimum of five symptoms.
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Psychosocial Models of Depression
Psychodynamic theory
Behavioral theory
- Reinforcement
- Learned Helplessness
Cognitive Theory
- Beck’s Cognitive Model of Depression
Interpersonal Theory
Life Events Models (Loss-related)
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Beck’s Cognitive Model of Depression
Core beliefs;
assumptions;
schemas
Negative emotions and thoughts
Distortions;
automatic
thoughts
• Emotions
• Behaviors
Life events
Avoidance, withdrawal
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Attributional style and depression
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Biological Models of Depression
 Genetic Risk 
 Neurotransmitter Models 
 Abnormality in serotonin, catecholamines,
GABA, and acetylcholine
 Structural/ activity models 
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Hereditary Risk for Major Depression
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Neurotransmission of Serotonin
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
PET Scans of Depression
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Integrative Models of Depression
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Emphasize the interaction among biological
characteristics, psychological vulnerabilities,
and stressful life events or ongoing stressful
life situations
Emphasize the need for optimal treatment,
using combinations of effective approaches
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Treatments for Depression
 Biological treatments
 Antidepressant drugs
 Electroconvulsive therapy (ECT) 
 Phototherapy (for SAD)
 Behavioral treatment
 Social skills training and Behavioral activation
 Cognitive-Behavioral Therapy (CBT)
 Change dysfunctional thought patterns and modify
maladaptive behaviors
 Interpersonal psychotherapy (IPT)
 Psychodynamic focus on relationships and social
support in times of stress
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Modern ECT
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Types of Mood Disorders- II
 Bipolar disorders
 Bipolar I disorder – Manic and depressive
episodes
 Bipolar II disorder – Major depressive episodes
but without manic episodes
 Cyclothymic Disorder – Hypomanic episodes
with depressive symptoms
 Other mood disorders
 Mood disorder due to general medical
condition
 Substance-induced mood disorder
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Mania
Mania is an elevated, expanded or irritable mood for at
least one week, plus at least 3 of:
•increase in activity level
•rapid speech
•flight of ideas
•decreased need for sleep
•increased self esteem/may be sense of grandiosity
•distractibility
•risk taking activities
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Models of Bipolar Disorder
 Genetic vulnerability
 Neurotransmission (action potential
irregularity)
 Environmental and family stress
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Treatments for Bipolar Disorder
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Lithium and anticonvulsant drugs
Family psychoeducation and therapy
Cognitive-behavioral therapy for relapse
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Mental Disorders and Suicide
 Mental disorders increase the probability of
suicide attempt.
 The highest rate among mood disorders is for
bipolar II disorder; lowest rate is for unipolar
depression.
 The highest rate of all mental disorders is for
schizophrenia
 Patients are much more likely to be suicidal
than homicidal
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Risk Factors for Suicide
 Age – Teenagers, young adults, and people
past middle age are highest risk.
 Gender – Women attempt more; Men have
higher completion rate.
 Race and ethnicity – American Indian and
Alaskan Native groups have highest rates;
white men the next highest.
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
American Age Adjusted Suicide Rates
(per 100,000 population)
Group
Men
Women
White
19.26
4.73
Black
11.63
1.97
Hispanic
11.19
1.74
American
Indian/Alaskan
Native
Asian Pacific
Islander
24.92
5.12
9.71
3.51
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Issues in Suicide
 Themes for those with suicidal preoccupations
 Negative expectations and hopeless
 Perfectionism
 Life events and suicide
 Stressful life events, especially involving loss,
may be precipitating factors
 Suicide contagion
 Well-known person’s suicide can increase rates
in the short term
 Parasuicide – Suicidal behavior that does not result
in death
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Suicide Prevention
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Increased awareness of suicidal thinking
Provision of crisis centers and services (e.g. 911)
Changing cultural expectations about dealing with the
problem
“Postvention” programs after suicide helps survivors
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Warning Signs of Suicide Risk
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Changes in eating and sleeping habits
Withdrawal from family, friends, and regular activities
Violent actions, rebellious behaviors, running away
Drug and alcohol use
Neglect of personal appearance
Marked personality change
Somatic complaints (headaches and stomach aches)
Loss of interest in pleasurable activities
Inability to tolerate praise or rewards
“Making up”; giving back borrowed items
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005