University of Houston Major Depression and Bipolar Disorder Paper Newsletter: An “Abnormal Newsletter”, 4 typed (single-spaced) pages and no less than 1200

University of Houston Major Depression and Bipolar Disorder Paper Newsletter: An “Abnormal Newsletter”, 4 typed (single-spaced) pages and no less than
1200 words in length. From the various abnormal psychology topics that are frequently explored in the popular press, you
will select a topic that is of particular interest to you. Examples of topics include mood disorders
such as major depression and bipolar disorder, anxiety disorders, attention deficit hyperactivity
disorder, use of medications in treating abnormal behavior, and “radical” therapies in use today.
Your newsletter topic should focus on a disorder different than the one you wrote your paper on.
Your newsletter should include: 1) information read in three (3) independent newspaper,
magazine or internet articles, and 2) information obtained from two (2) peer-reviewed journal articles that address your topic.
Your newsletter should include the following information:

Diagnostic criteria used in determining the presence or absence of the target problem

Clinical features of the target problem (i.e., prevalence rates, onset and course of the target
problem, gender and sociocultural differences in rates of diagnosis, and associated problems)

Commonly employed and psychometrically sound assessment instruments and procedures

Detailed descriptions of at least two treatments for the target problem

A statement regarding the relative effectiveness of various treatment options

Lay perspectives (non-professional conceptualizations) of the target problem

All six information resources should be used in creating your newsletter; however, one of your peer-
reviewed journal articles should serve as your primary resource for information pertaining to various clinical assessment procedures and instruments. You should suggest the procedures and instruments
that are most commonly employed in making determinations about the target problem. You should
also include information about the reliability and validity of the assessment procedures and
instruments you have reviewed. The other peer-reviewed article should be used as your primary
resource for information pertaining to the various treatments used for the target problem and their
relative effectiveness. The newsletter must be titled and typed in newsletter format. Mood Disorders
Depressive Disorders
Major Depressive Disorder (MDD) defined by the presence of depression and
the absence of manic, or hypomanic episodes, before or during the disorder
MDD Factoids
• 70% of MDD people are female
• Mean age of onset = 27 years old
• Mean duration = 9 months untreated
• 50% with single episode will have another
• 80% with 2+ episodes will have a 3rd
An Overview of Depression and Mania
Mood Disorders group of disorders involving severe and enduring disturbances
in emotionality ranging from elation to severe depression
Major Depressive Episode most common and severe experience of depression,
including feelings of worthlessness, disturbances in bodily activities such as
sleep, loss of interest, and inability to experience pleasure, persisting at least 2
weeks; if untreated, the duration is approximately 4 to 9 months.
Symptoms of Major Depressive Episode (5+ during the same 2-week period)
• Sleep (more or less)
• Interest* (anhedonia)
• Guilt
• Mood* (depressed, sad)
• Energy
• Concentration
• Appetite changes (eat more or less)
• Psychomotor activity (agitated or fatigued)
• Suicidal ideation
Mania period of abnormally excessive elation (great happiness) or euphoria,
associated with some mood disorders; if untreated, the duration is typically 3 to 4
months
Symptoms of Mania (3 or more)
• Extraordinarily active (hyperactive)
o Excessive involvement in pleasurable activities with high potential
for painful consequences
• Require little sleep
• Distractibility
• Believe they can accomplish anything they desire
o
“persistently increased goal-directed activity or energy”
•
•
Flight of ideas (racing thoughts)
Speech is typically rapid and may become incoherent due to excitement
Hypomanic Episode less severe and less disruptive version of a manic episode
that is one of the criteria for several mood disorders; lasts only 4 days rather than
a full week
The Structure of Mood Disorders
Individuals who experience either depression or mania are said to suffer from a
unipolar mood disorder
Unipolar Mood Disorder mood remains at “one” pole of the usual depressionmania continuum.
• Mania by itself (unipolar mania) is rare because people with unipolar mood
disorder eventually develop depression
Causes of Unipolar Depression
• Recent life events (exogenous)
• Endogenous/melancholic depressions is assumed to have an internal
cause
• Adoption studies
Prevalence of Mood Disorders
•
•
Last as much as one’s life
Women twice as likely to have mood disorders as men
o Major depressive disorder and persistent depressive disorder
(dysthymia)
o Bipolar disorders are approx. equally distributed across genders
Prevalence in Children, Adolescents, and Older Adults
Prevalence in all age groups is high, demonstrating impact not only on the
affected individuals and their families but also on society
Lifespan Development Influences on Mood Disorders
• 3-month-old babies can become depressed
• Preschool depression is predictor for later depression at the ages of 6-13
o Boys are more depressed than girls
• Adolescents who developed major depressive disorders between 14 and
16 years of age are at risk for occurrence of major depression, anxiety
disorders, substance abuse, and suicide attempts
o Girls are more depressed than boys
Age-based Influences on Older Adults
• Late onset depressions are associated with marked sleep difficulties,
illness anxiety disorder, and agitation
•
•
Entering menopause increases the rate of depression among women who
never experienced depression before (hormonal, life events occurring at
the time)
Depression can contribute to physical disease and death
o Optimism
Depression: Special Populations
• Children
• Elderly
Causes of Mood Disorders
Biological Dimensions
Sleep and Circadian Rhythms
• Depressed patients enter rapid eye movement (REM) shortly after falling
asleep
• Depressed patients experience REM activity more intense
Biological Influences
• Serotonin, norepinephrine and dopamine
• Permissive hypothesis (Goodwin and Jamison, 1990)
• Elevated levels of cortisol
• Dexamethasone suppression test (DST)
Psychological Dimensions
Learned Helplessness
Learned helplessness theory of depression the theory according to which
depression is the result of perceived or real absence of control over the outcome
of an undesirable situation
• Depressive attributional style
o Internal – in which the individual attributes negative events to
personal failings (e.g.) “it’s all my fault”
o Stable – after a negative event passes the attribution remains (e.g.)
“other bad stuff will happen”
o Global – attributions extend across a variety of issues (e.g.) “I’m a
big, fat failure”
Negative Cognitive Styles
Depressive Cognitive Triad thinking errors in depressed people in three areas
• Think negatively about
o Themselves
o Their immediate world
o Their future
• Depressed people develop a negative schema/negative cognitive bias
Social and Cultural Dimensions ** possible essay question **
Mood Disorders in Women
•
•
•
•
•
•
•
Women are more depressed than men; 2:1 ratio
o Gender imbalance is constant around the world, even though all
rates of disorder may vary from country to country
Gender differences in the development of emotional disorders are strongly
influenced by perceptions of uncontrollability
Gender roles assigned to men and women in our society
o Men are encouraged to be independent, mastery, and assertive
o Women are encouraged to be more passive, sensitive to others,
and rely on others
▪ Puts women at risk for emotional disorders by increasing
their feelings of uncontrollability and helplessness
o Parenting styles that encourages gender roles = depression
▪ (e.g.) smothering, over-protective style prevents child from
developing initiative
Women tend to place greater value on intimate relationships than men do
o Strong social networks = protective, if not it puts them at risk
o Disruptions and inability to coping with disruptions = damaging
Men have less intimate social networks than women
o 7% of men become depressed after divorce
Women ruminate more than men
o Women blame themselves for being depressed and about their
situation
o Men tend to ignore their feelings by engaging in activities to take
their minds off
Women are at a disadvantage
o Experience more discrimination, poverty, sexual harassment, and
abuse
o Earn less respect and accumulate less power
o Stay-at-home moms are more depressed than full or part-time
working moms
o Single, divorced, and widowed women are more depressed than
men in the same categories
Supermom Attitude Risk for Depression
• T1 supermom attitude — women can combine employment and family care
without tradeoffs
o Women feel guilt and failure when they struggle to achieve this
ideal
o Were at higher risk for T2 depression compared to working mom
who were more realistic
• “Employment is still ultimately good for women’s health, but for better
mental health, working moms should accept that they can’t do it all”
Treatment for Mood Disorders
Medications
Antidepressants
Four types to treat depressive disorders
• Selective-Serotonin Reuptake Inhibitors (SSRIs) – block the
presynaptic reuptake of serotonin which temporarily increases levels of
serotonin
o Prozac
o Sarafem
o Paxil
o Seroxat
o Zoloft
o Luvox
o Celexa
o Side effects: agitation, insomnia, stomach upset, lack of libido
•
Mixed Reuptake Inhibitors – have different mechanisms of
neurobiological action
o Wellbutrin (atypical)
o Effexor (generic name: venlafaxine) = serotonin and norepinephrine
reuptake inhibitor; reduce side effects of SSRIs
o Celexa
o Side effects: nausea, vomiting, sexual dysfunction
•
MAO Inhibitors – block the enzyme MAO that breaks down such
neurotransmitters as norepinephrine and serotonin
o Marplan
o Nardil
o Parnate
o Must avoid food containing tyramine (e.g.) cheese, red wine, beer
o Good for atypical depression
•
Tricyclics (used before SSRIs; less common now) – works on
norepinephrine
o Tofranil
o Anafranil
o Elavil
o Side effects: blurred vision, dry mouth, constipation, drowsiness,
weight gain, sexual dysfunction, lethal if overdose
Antidepressants According to Level of Activation/Sedation
Activating Wellbutrin (atypical)
Effexor (SNRI)
Prozac (SSRI)
Zoloft (SSRI)
Cymbalta (SNRI)
Lexapro (SSRI)
Paxil (SSRI)
Sedating
Trazodone (atypical)
•
•
MAO-I’s (e.g. Parnate) are highly activating for some, sedating for
others
Tricyclics vary by brand
Electroconvulsive Therapy (ECT)
Biological treatment for severe, chronic depression involving the application of
electrical impulses through the brain to produce seizures. The reasons for its
effectiveness is unknown.
• Works with 50%-70% of people not responding to medication
• Few sides effects
o Short-term memory loss
o Confusion
o Maybe long-term memory problems
• High relapse rates (60%)
New Research on How ECT Works
• fMRI of 9 severely depressed people scanned before and after ECT
• Found dampening connections in the left dorsolateral prefrontal cortex
(DLPFC)
• Left DLPFC is associated with negative thoughts, criticism, anxiety,
pessimism and rumination
• Right hemisphere DLPFC handles more uplifting, optimistic and cheery
ideas
Psychological Treatments for Depression
Cognitive-Behavioral Therapy
• Changing errors in thinking (Beck, Ellis)
• Reactivation/behavioral activation
• Dr. Lynn Rehm’s Self-Control Therapy
• CBT better protection against relapse than drugs
Interpersonal psychotherapy (IPT)
Brief treatment approach that emphasized resolution of interpersonal problems,
stressors, such as role disputes in marital conflict, forming relationships in
marriage or a new job and identifying and correcting social skill deficits
• Improves social functioning long-term
• Neil Jacobson’s couple therapy successfully treats depressed married
women
Combined Treatments for Depression
Combined treatment (therapy + drugs) seem to be the best with more severe
depression
Dr. Babcock
Newsletter Scoring Format:
Coverage of relevant treatment issues
•
•
Coverage of relevant assessment/diagnostic issues
•
•
•
/25
Diagnostic criteria used in determining the presence or absence of
the target problem.
Commonly employed and psychometrically sound assessment
instruments and procedures (i.e., procedures/instruments most
commonly employed in making determinations about the target
problem and the reliability and validity of procedures/instruments).
Supplemental Information
•
/25
Detailed descriptions of at least two treatments for the target
problem
A statement regarding the relative effectiveness of various
treatment options
/20
Clinical features of the target problem (i.e., prevalence rates,
onset and course of the target problem, gender and sociocultural
differences in rates of diagnosis, and associated problems).
Lay (non-professional) perspectives on the target problem.
Interview Data
Writing and presentation
References
• Reference list in APA format
Newsletter Total Score:
/10
/15
______/5
/100
Dr. Babcock
An “Abnormal Newsletter”, 4-5 typed (single-spaced) pages in length, will account for
the remaining 25% of the final course grade. From the various abnormal psychology
topics that are frequently explored in the popular press, you will select a topic that is of
particular interest to you. The topic must be different one than the one you wrote about
in your first paper for this class. Examples of topics include mood disorders such as major
depression and bipolar disorder, anxiety disorders, attention deficit hyperactivity disorder,
use of medications in treating abnormal behavior, and “radical” therapies in use today.
Your newsletter should include: 1) information read in three (3) independent newspaper,
magazine or internet articles; 2) information obtained through face-to-face, email, or
telephone interviews with one or more private or government agencies relevant to your
topic; and 3) information obtained from two (2) peer-reviewed journal articles that
address your topic.
Your newsletter should include the following information:
 Diagnostic criteria used in determining the presence or absence of the target
problem
 Clinical features of the target problem (i.e., prevalence rates, onset and course of the
target problem, gender and sociocultural differences in rates of diagnosis, and
associated problems)
 Commonly employed and psychometricly sound assessment instruments and
procedures
 Detailed descriptions of at least two treatments for the target problem
 A statement regarding the relative effectiveness of various treatment options
 Lay perspectives (non-professional opinions) on the target problem
 Citations in the text as needed
 Statements obtained from the interview with the speaker identified
 Reference list in APA format. Include a reference for your interview and for the
websites used
 Example of personal interview reference:
 Shmoe, J. (personal communication, October 13, 2000).Director of Houston Institute
for Substance Abuse. Houston, TX.
 Example of APA format for citing an on-line article:
Author, I., (date). Title of full work [On-line]. Available: Specify path.
All six information resources should be used in creating your newsletter; however, one of
your peer-reviewed journal article should serve as your primary resource for information
pertaining to various clinical assessment procedures and instruments. You should
suggest the procedures and instruments that are most commonly employed in making
determinations about the target problem. You should also include information about the
reliability and validity of the assessment procedures and instruments you have reviewed.
The other peer-reviewed article should be used as your primary resource for information
pertaining to the various treatments used for the target problem and their relative
effectiveness. Do not attach articles or appendices to your newsletter.

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