Class Schedule

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Class Schedule

• Course schedule
• Article for 4/9
• Writing tips

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Assignment Option 1

• Monitor your emotions and moods over the next
  week
• Label each feeling state (e.g., fear)
• Write down what your cognitive, behavioral, and
  physiological experiences were
• Write a 1 paragraph reaction. What did you
  notice? What did you learn?
• E-Mail me by 9PM on Tues (Apr 8)

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Assignment Option 2

• What emotional reactions did you have to each
  video we watched?
• Specific cases Chuck OCD, Barbara MDD, Mary
  Bipolar Disorder
• Think in terms of all the dimensions of emotion
  (feeling states, cognitive appraisals,
  physiology, behavior or behavioral tendencies)

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Assignment Option 2

• Some questions to consider
• Do you feel the same emotions the patient feels?
  Why or why not?
• What do you respond differently to different
  cases?
• What (if anything) have you learned about
  yourself or human emotion from this task?
• E-Mail me by 9PM on Tues (Apr 8)

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Mood Disorders

• Major deviations in mood
• or
• Major Deppressive Disorder and Dysthymia

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Mania

• Manic Episode
• Elevated, irritable mood for at least 1 week
• At least 3 of
• 1) Excessive self-esteem
• 2) Less need for sleep
• 3) More talkative
• 4) Racing thoughts
• 5) High distractibility
• 6) Agitation and increase in goal-directed
  behavior
• 7) Impulsive, pleasure-seeking activity

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Bipolar Disorder

• Defining Feature
• Manic and MDE alternations
• Statistics
• 0.4 - 1.6 percent lifetime prevalence
• Average age of onset 18-20 years
• Chronic
• Equal gender balance

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Bipolar Disorder

• Marys experiences
• What changes do you notice between the 1st and
  2nd videos?
• Cognition
• Affect
• Behavior

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Cyclothymic Disorder

• More chronic, less severe version of bipolar
  disorder (at least 2 years)
• Analogy Cyclothymia Bipolar as Dysthymia
  Major Depression

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Cyclothymic Disorder

• Statistics
• Average age of onset is 12 or 14 years
• Chronic and lifelong
• Most are female

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Etiology Cognitive Factors

• Aaron T. Beck
• ABC Model

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Specific Cognitive Errors

• Dichotomous thinking
• Seeing the world in an all-or-none way
• Overgeneralization
• Generalizing one negative part to all parts of a
  situation
• Arbitrary inference
• Drawing a conclusion from insufficient evidence
• Selective abstraction
• Drawing a conclusion by focusing on only one
  element

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Becks Cognitive Triad
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Examples of Dysfunctional Beliefs

• I am nothing if a person I love doesnt love me
• If I am to be a worthwhile person, I must be
  truly outstanding in at least one major respect
• If others dislike you, you cannot be happy
• If I do not do well all the time, people will not
  love me

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Cognitive Factors

• Learned helplessness
• Develops based on attributions

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Cognitive Factors

• Attributional style
• Global (vs. specific)
• Stable (vs. unstable)
• Internal (vs. external or environmental)

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Attribution Examples

• Why I failed my GRE math exam?
• I lack intelligence
• Global, internal, stable
• I lack mathematic ability
• ???
• I was exhausted
• I am fed up with math
• Standardized math tests are unfair
• I was the 13th student to enter the room

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Self-Theory

• Low self-esteem implicated in cognitive theories
• Self-verification theory
• William Swann

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Personality
Table 8.4
Clark, Watson, Mineka (1994)
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Social Dimensions

• Relationship problems/breakups

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Social Dimensions

• Social support (Stice, Ragan, Randall, 2004)
• Stress-buffering model vs. interpersonal accounts
  vs. reciprocal relations
• Methodology?
• Findings?

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Neurotransmitters
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Genetic Influences
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Diathesis-Stress Perspective
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Diathesis-Stress
Caspi et al. (2003)
Serotonin Transporter Gene (5-HTT)
Same interaction with current of stressful life
events
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Diathesis-Stress

• Personality
• Neuroticism x life events
• Cognitive
• Dysfunctional attitudes x life events
• Attributional style x life events
• Self
• Self-esteem x life events

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Etiology Summary

• Many factors in isolation can predict depression
• Genes
• Cognitions
• Social support
• Interpersonal problems
• Diathesis-stress interactions important too

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Drug Treatment of Depression

• 1) Serotonin re-uptake inhibitors (SSRIs)
• Block re-uptake
• Prozac, Zoloft, Paxil
• Side effects are common
• Insomnia, low sex drive, GI problems
• Suicidality

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Drug Treatment of Depression

• 2) Tricyclic Medications (e.g., imipramine)
• Block reuptake of norepinephrine and serotonin
• 2 to 8 weeks to work
• Negative side effects
• blurry vision, dry mouth, constipation, weight
  gain, sexual problems, nervousness

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Drug Treatment of Depression

• 3) Monoamine Oxidase (MAO)
• Enzyme that blocks serotonin norepinephrine

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Drug Treatment of Depression

• Major disadvantages of MAO inhibitors
• Must avoid foods containing the substance
  tyramine (e.g., beer, red wine, cheese)
• Interact with common cold meds
• Possibly fatal hypertension

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Treatment Medication

• Meds are first-line treatment for depression in
  North America
• In UK, CBT is first-line treatment
• 50-70 show improvement
• Side effects ? discontinuation
• Relapse after discontinuation

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Medical Treatment Electroconvulsive Therapy (ECT)

• ECT
• brief electrical current to the brain
• temporary seizures
• 6 to 10 treatments once every 2 days
• Severe depression with imminent suicidal risk
• Potential memory loss (usually short-term)
• Uncertain why ECT works (mediator unknown)
• ECT Video (152)