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Comer, Abnormal Psychology, 6e – Chapter 8 1 Chapter 8 Handouts Mood Disorders Slides & Handouts by Karen Clay Rhines, Ph.D. Seton Hall University.

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Presentation on theme: "Comer, Abnormal Psychology, 6e – Chapter 8 1 Chapter 8 Handouts Mood Disorders Slides & Handouts by Karen Clay Rhines, Ph.D. Seton Hall University."— Presentation transcript:

1 Comer, Abnormal Psychology, 6e – Chapter 8 1 Chapter 8 Handouts Mood Disorders Slides & Handouts by Karen Clay Rhines, Ph.D. Seton Hall University

2 2Comer, Abnormal Psychology, 6e – Chapter 8 Mood Disorders Two key emotions on a continuum: Two key emotions on a continuum: Depression Depression Low, sad state in which life seems dark and overwhelming Low, sad state in which life seems dark and overwhelming Mania Mania State of breathless euphoria and frenzied energy State of breathless euphoria and frenzied energy DepressionMania

3 3Comer, Abnormal Psychology, 6e – Chapter 8 Mood Disorders Most people with a mood disorder experience only depression Most people with a mood disorder experience only depression This pattern is called ____________________ This pattern is called ____________________ Person has no history of mania Person has no history of mania Mood returns to normal when depression lifts Mood returns to normal when depression lifts Some people experience periods of depression that alternate with periods of mania Some people experience periods of depression that alternate with periods of mania This pattern is called ______________________ This pattern is called ______________________ One might logically expect a third pattern – unipolar mania, in which people suffer from mania only – but this pattern is uncommon One might logically expect a third pattern – unipolar mania, in which people suffer from mania only – but this pattern is uncommon

4 4Comer, Abnormal Psychology, 6e – Chapter 8 Mood Disorders These disorders have always captured people’s interest These disorders have always captured people’s interest Millions of people have mood disorders Millions of people have mood disorders Economic costs of mood disorders amount to more than $80 billion each year Economic costs of mood disorders amount to more than $80 billion each year Human suffering is incalculable Human suffering is incalculable

5 5Comer, Abnormal Psychology, 6e – Chapter 8 Unipolar Depression The term “depression” is often used to describe general sadness or unhappiness The term “depression” is often used to describe general sadness or unhappiness This usage confuses a normal mood swing with a clinical syndrome This usage confuses a normal mood swing with a clinical syndrome Clinical depression can bring severe and long- lasting psychological pain that may intensify over time Clinical depression can bring severe and long- lasting psychological pain that may intensify over time

6 6Comer, Abnormal Psychology, 6e – Chapter 8 How Common Is Unipolar Depression? About 7% of the U.S. population experiences severe unipolar depression each year About 7% of the U.S. population experiences severe unipolar depression each year As many as 5% experience mild depression As many as 5% experience mild depression The prevalence is similar in Canada, England, France, and many other countries The prevalence is similar in Canada, England, France, and many other countries Approximately 17% of all adults experience unipolar depression at some time in their lives Approximately 17% of all adults experience unipolar depression at some time in their lives Rates have been steadily increasing since 1915 Rates have been steadily increasing since 1915

7 7Comer, Abnormal Psychology, 6e – Chapter 8 How Common Is Unipolar Depression? In almost all countries, women are _______ as likely as men to experience severe unipolar depression In almost all countries, women are _______ as likely as men to experience severe unipolar depression Lifetime prevalence: 26% of women vs. 12% of men Lifetime prevalence: 26% of women vs. 12% of men These rates hold true across socioeconomic classes and ethnic groups These rates hold true across socioeconomic classes and ethnic groups Approximately 50% recover within six weeks, some without treatment Approximately 50% recover within six weeks, some without treatment Most will experience ____________ at some point Most will experience ____________ at some point

8 8Comer, Abnormal Psychology, 6e – Chapter 8 What Are the Symptoms of Depression? Symptoms may differ dramatically from person to person Symptoms may differ dramatically from person to person Five main areas of functioning may be affected: Five main areas of functioning may be affected: Emotional symptoms Emotional symptoms Feeling “miserable,” “empty,” “humiliated” Feeling “miserable,” “empty,” “humiliated” Experiencing little pleasure Experiencing little pleasure Motivational symptoms Motivational symptoms Lacking drive, initiative, spontaneity Lacking drive, initiative, spontaneity Between 6% and 15% of those with severe depression commit suicide Between 6% and 15% of those with severe depression commit suicide

9 9Comer, Abnormal Psychology, 6e – Chapter 8 What Are the Symptoms of Unipolar Depression? Five main areas of functioning may be affected: Five main areas of functioning may be affected: Behavioral symptoms Behavioral symptoms Less active, less productive Less active, less productive Cognitive symptoms Cognitive symptoms Hold negative views of themselves Hold negative views of themselves Blame themselves for unfortunate events Blame themselves for unfortunate events Pessimism Pessimism Physical symptoms Physical symptoms Headaches, dizzy spells, general pain Headaches, dizzy spells, general pain

10 10Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Unipolar Depression Criteria 1: Major depressive episode Criteria 1: Major depressive episode Marked by five or more symptoms lasting two or more weeks Marked by five or more symptoms lasting two or more weeks In extreme cases, symptoms are psychotic, including In extreme cases, symptoms are psychotic, including ___________________________ ___________________________ __________________________ __________________________ Criteria 2: _______________________ Criteria 2: _______________________

11 11Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Unipolar Depression Two diagnoses to consider: Two diagnoses to consider: _______________________________ _______________________________ Criteria 1 and 2 are met Criteria 1 and 2 are met _______________________________ _______________________________ Symptoms are “mild but chronic” Symptoms are “mild but chronic” Depression is longer lasting but less disabling Depression is longer lasting but less disabling Consistent symptoms for at least 2 years Consistent symptoms for at least 2 years When dysthymic disorder leads to major depressive disorder, the sequence is called “___________________” When dysthymic disorder leads to major depressive disorder, the sequence is called “___________________”

12 12Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? Stress may be a trigger for depression Stress may be a trigger for depression People with depression experience a greater number of stressful life events during the month just prior to the onset of their symptoms People with depression experience a greater number of stressful life events during the month just prior to the onset of their symptoms Some clinicians distinguish _________________ depression from _________________ depression, which seems to be a response to internal factors Some clinicians distinguish _________________ depression from _________________ depression, which seems to be a response to internal factors The utility of this distinction is questionable and today’s clinicians usually concentrate on recognizing the situational and the internal aspects of any given case The utility of this distinction is questionable and today’s clinicians usually concentrate on recognizing the situational and the internal aspects of any given case

13 13Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Biological View Genetic factors Genetic factors Family pedigree, twin, adoption, and molecular gene studies suggest that some people inherit a _______________________ Family pedigree, twin, adoption, and molecular gene studies suggest that some people inherit a _______________________ Researchers have found that as many as 20% of relatives of those with depression are themselves depressed, compared with fewer than 10% of the general population Researchers have found that as many as 20% of relatives of those with depression are themselves depressed, compared with fewer than 10% of the general population Twin studies demonstrate a ___________________________: Twin studies demonstrate a ___________________________: Rates for identical (MZ) twins = 46% Rates for identical (MZ) twins = 46% Rates for fraternal (DZ) twins = 20% Rates for fraternal (DZ) twins = 20% Adoption and molecular gene studies also have implicated a genetic factor in cases of severe unipolar depression Adoption and molecular gene studies also have implicated a genetic factor in cases of severe unipolar depression

14 14Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Biological View Biochemical factors Biochemical factors NTs: ___________ and ______________ NTs: ___________ and ______________ In the 1950s, medications for high blood pressure were found to cause depression In the 1950s, medications for high blood pressure were found to cause depression Some lowered serotonin, others lowered norepinephrine Some lowered serotonin, others lowered norepinephrine This led to “discovery” of effective antidepressant medications which relieved depression by increasing either serotonin or norepinephrine This led to “discovery” of effective antidepressant medications which relieved depression by increasing either serotonin or norepinephrine Depression likely involves not just serotonin nor norepinephrine… a complex interaction is at work, and other NTs may be involved Depression likely involves not just serotonin nor norepinephrine… a complex interaction is at work, and other NTs may be involved

15 15Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Biological View Biochemical factors Biochemical factors Endocrine system / hormone release Endocrine system / hormone release People with depression have been found to have abnormal levels of _____________ People with depression have been found to have abnormal levels of _____________ Released by the adrenal glands during times of stress Released by the adrenal glands during times of stress People with depression have been found to have _______________________________ People with depression have been found to have _______________________________ “Dracula hormone” “Dracula hormone” Other researchers are investigating whether deficiencies of important proteins within neurons are tied to depression Other researchers are investigating whether deficiencies of important proteins within neurons are tied to depression

16 16Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Biological View Biochemical factors Biochemical factors Model has produced enthusiasm but has significant limitations: Model has produced enthusiasm but has significant limitations: _______________________________________ _______________________________________ Do these symptoms correlate with human emotions? Do these symptoms correlate with human emotions? _______________________________________ _______________________________________ Current studies using modern technology are attempting to address this issue Current studies using modern technology are attempting to address this issue

17 17Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Three main models: Three main models: Psychodynamic model Psychodynamic model Not strongly supported by research Not strongly supported by research Behavioral model Behavioral model Modestly supported by research Modestly supported by research Cognitive model Cognitive model Has considerable research support Has considerable research support

18 18Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Psychodynamic view Psychodynamic view Link between depression and ________ Link between depression and ________ When a loved one dies, the mourner regresses to the oral stage When a loved one dies, the mourner regresses to the oral stage For most people, grief is temporary For most people, grief is temporary If grief is severe and long-lasting, depression results If grief is severe and long-lasting, depression results Those with oral stage issues (unmet or excessively met needs) are at greater risk for developing depression Those with oral stage issues (unmet or excessively met needs) are at greater risk for developing depression Some people experience “___________” (not actual) loss Some people experience “___________” (not actual) loss Newer psychoanalysts focus on relationships with others (object relations theorists) Newer psychoanalysts focus on relationships with others (object relations theorists)

19 19Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Psychodynamic view Psychodynamic view Strengths: Strengths: Studies have offered general support for the psychodynamic idea that depression may be triggered by a major loss Studies have offered general support for the psychodynamic idea that depression may be triggered by a major loss Research supports the theory that early losses set the stage for later depression Research supports the theory that early losses set the stage for later depression Research also suggests that people whose childhood needs were improperly met are more likely to become depressed after suffering a loss Research also suggests that people whose childhood needs were improperly met are more likely to become depressed after suffering a loss

20 20Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Psychodynamic view Psychodynamic view Limitations: Limitations: Early losses don’t inevitably lead to depression Early losses don’t inevitably lead to depression May not be typically responsible for development of depression May not be typically responsible for development of depression Many research findings are inconsistent Many research findings are inconsistent Theory is largely untestable because of its reliance on unconscious processes Theory is largely untestable because of its reliance on unconscious processes

21 21Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Behavioral view Behavioral view Depression results from changes in ____________________________ people receive in their lives Depression results from changes in ____________________________ people receive in their lives As life changes, we experience a change (loss) of rewards As life changes, we experience a change (loss) of rewards Research supports the relationship between the number of rewards received and the presence or absence of depression Research supports the relationship between the number of rewards received and the presence or absence of depression _______________ are especially important _______________ are especially important

22 22Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Behavioral View Behavioral View Strengths: Strengths: Researchers have compiled significant data to support this theory Researchers have compiled significant data to support this theory Limitations: Limitations: Research has relied heavily on the self-reports of depressed subjects Research has relied heavily on the self-reports of depressed subjects Behavioral studies are largely correlational and do not establish that decreases in rewards are the cause of depression Behavioral studies are largely correlational and do not establish that decreases in rewards are the cause of depression

23 23Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Two main theories: Two main theories: Negative thinking Negative thinking Learned helplessness Learned helplessness

24 24Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Negative thinking Negative thinking Beck theorizes four interrelated cognitive components combine to produce unipolar depression: Beck theorizes four interrelated cognitive components combine to produce unipolar depression: 1._________________________________ Self-defeating attitudes are developed during childhood Self-defeating attitudes are developed during childhood Beck suggests that upsetting situations later in life can trigger further rounds of negative thinking Beck suggests that upsetting situations later in life can trigger further rounds of negative thinking

25 25Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views 2.This negative thinking often takes three forms, called the ____________________: Individuals repeatedly interpret (1) their experiences, (2) themselves, and (3) their futures in negative ways, leading to depression Individuals repeatedly interpret (1) their experiences, (2) themselves, and (3) their futures in negative ways, leading to depression

26 26Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Negative thinking Negative thinking 3.Depressed people also make ___________________, including: Arbitrary inferences Arbitrary inferences Minimization of the positive and magnification of the negative Minimization of the positive and magnification of the negative 4.Depressed people experience _________________ A steady train of unpleasant thoughts that suggest inadequacy and hopelessness A steady train of unpleasant thoughts that suggest inadequacy and hopelessness

27 27Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Strengths: Strengths: There is significant research support for Beck’s model: There is significant research support for Beck’s model: High correlation between the level of depression and the number of maladaptive attitudes High correlation between the level of depression and the number of maladaptive attitudes Both the cognitive triad and errors in logic are seen in people with depression Both the cognitive triad and errors in logic are seen in people with depression Automatic thinking has been linked to depression Automatic thinking has been linked to depression Limitations: Limitations: Research fails to show that such cognitive patterns are the cause and core of unipolar depression Research fails to show that such cognitive patterns are the cause and core of unipolar depression

28 28Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Learned helplessness Learned helplessness Theory asserts that people become depressed when they think that: Theory asserts that people become depressed when they think that: They no longer have control over the reinforcements in their lives They no longer have control over the reinforcements in their lives They themselves are responsible for this helpless state They themselves are responsible for this helpless state

29 29Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Learned helplessness Learned helplessness Theory is based on Seligman’s work with laboratory dogs Theory is based on Seligman’s work with laboratory dogs Dogs subjected to uncontrollable shock were later placed in a shuttle box Dogs subjected to uncontrollable shock were later placed in a shuttle box Even when presented with an opportunity to escape, dogs that had experienced uncontrollable shocks made no attempt to do so Even when presented with an opportunity to escape, dogs that had experienced uncontrollable shocks made no attempt to do so Seligman theorized that the dogs had “learned” to be “helpless” and drew parallels to human depression Seligman theorized that the dogs had “learned” to be “helpless” and drew parallels to human depression

30 30Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Learned helplessness Learned helplessness There has been _______________ research support for this model There has been _______________ research support for this model Human subjects who undergo helplessness training score higher on depression scales and demonstrate passivity in laboratory trials Human subjects who undergo helplessness training score higher on depression scales and demonstrate passivity in laboratory trials Animal subjects lose interest in sex and social activities Animal subjects lose interest in sex and social activities In rats, uncontrollable negative events result in lower serotonin and norepinephrine levels in the brain In rats, uncontrollable negative events result in lower serotonin and norepinephrine levels in the brain

31 31Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Learned helplessness Learned helplessness Recent versions of the theory focus on _____________ Recent versions of the theory focus on _____________ __________ attributions that are _______ and ______ lead to greater feelings of helplessness and possibly depression __________ attributions that are _______ and ______ lead to greater feelings of helplessness and possibly depression Example: “It’s all my fault [internal]. I ruin everything [global] and I always will [stable]” Example: “It’s all my fault [internal]. I ruin everything [global] and I always will [stable]” If they make other kinds of attributions, this reaction is unlikely If they make other kinds of attributions, this reaction is unlikely Example: “She had a role in this also [external], but I have been a jerk lately [specific], and I don’t usually act like that [unstable]” Example: “She had a role in this also [external], but I have been a jerk lately [specific], and I don’t usually act like that [unstable]”

32 32Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Learned helplessness Learned helplessness Some theorists have refined the helplessness model again in recent years; they suggest that attributions are likely to cause depression only when they further produce a sense of hopelessness in an individual Some theorists have refined the helplessness model again in recent years; they suggest that attributions are likely to cause depression only when they further produce a sense of hopelessness in an individual

33 33Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Psychological Views Cognitive views Cognitive views Learned helplessness Learned helplessness Strengths: Strengths: Hundreds of studies have supported the relationship between styles of attribution, helplessness, and depression Hundreds of studies have supported the relationship between styles of attribution, helplessness, and depression Limitations: Limitations: Laboratory helplessness does not parallel depression in every way Laboratory helplessness does not parallel depression in every way Much of the research relies on animal subjects Much of the research relies on animal subjects The attributional component of the theory raises particularly difficult questions in terms of animal models of depression The attributional component of the theory raises particularly difficult questions in terms of animal models of depression

34 34Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Sociocultural View Sociocultural theorists propose that unipolar depression is greatly influenced by the social structure in which people live Sociocultural theorists propose that unipolar depression is greatly influenced by the social structure in which people live This belief is supported by the finding that depression is often triggered by outside stressors This belief is supported by the finding that depression is often triggered by outside stressors Researchers have also found links between depression and culture, gender, race, and social support Researchers have also found links between depression and culture, gender, race, and social support

35 35Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Sociocultural View How are culture and depression related? How are culture and depression related? Depression is a worldwide phenomena, but the experience of symptoms differs from culture to culture Depression is a worldwide phenomena, but the experience of symptoms differs from culture to culture For example, non-Westerners report more __________ (rather than psychological) symptoms For example, non-Westerners report more __________ (rather than psychological) symptoms As cultures become more Western, symptoms shift As cultures become more Western, symptoms shift

36 36Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Sociocultural View How do gender and race relate to depression? How do gender and race relate to depression? Rates of depression are much higher among women than men Rates of depression are much higher among women than men One sociocultural theory holds that the ______________ _________________ in society leaves them particularly prone to depression (see Box 8-3) One sociocultural theory holds that the ______________ _________________ in society leaves them particularly prone to depression (see Box 8-3) Few differences have been seen overall among Caucasians, African Americans, and Hispanic Americans, _______________________________________________: Few differences have been seen overall among Caucasians, African Americans, and Hispanic Americans, _______________________________________________: In a study of one Native American village, lifetime risk was 37% among women, 19% among men, and 28% overall In a study of one Native American village, lifetime risk was 37% among women, 19% among men, and 28% overall These findings are thought to be the result of economic and social pressures These findings are thought to be the result of economic and social pressures

37 37Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Unipolar Depression? The Sociocultural View How does social support relate to depression? How does social support relate to depression? The availability of social support seems to influence the likelihood of depression The availability of social support seems to influence the likelihood of depression Rates of depression vary based on marital status Rates of depression vary based on marital status Interpersonal conflict may be a factor Interpersonal conflict may be a factor Isolation and lack of intimacy also are key factors Isolation and lack of intimacy also are key factors Research shows that depressed people who lack social support remain depressed longer than those who have a supportive spouse or warm friendships Research shows that depressed people who lack social support remain depressed longer than those who have a supportive spouse or warm friendships

38 38Comer, Abnormal Psychology, 6e – Chapter 8 Bipolar Disorders People with a bipolar disorder experience both the __________________ and the _______________________________ People with a bipolar disorder experience both the __________________ and the _______________________________ They describe their life as an emotional roller coaster They describe their life as an emotional roller coaster

39 39Comer, Abnormal Psychology, 6e – Chapter 8 What Are the Symptoms of Mania? Unlike those experiencing depression, people in a state of mania typically experience dramatic and inappropriate rises in mood Unlike those experiencing depression, people in a state of mania typically experience dramatic and inappropriate rises in mood Five main areas of functioning may be affected: Five main areas of functioning may be affected: 1.Emotional symptoms Active, powerful emotions in search of outlet Active, powerful emotions in search of outlet 2.Motivational symptoms Need for constant excitement, involvement, companionship Need for constant excitement, involvement, companionship

40 40Comer, Abnormal Psychology, 6e – Chapter 8 What Are the Symptoms of Mania? Five main areas of functioning may be affected: Five main areas of functioning may be affected: 3. Behavioral symptoms Very active – move quickly; talk loudly or rapidly Very active – move quickly; talk loudly or rapidly Key word: ____________! Key word: ____________! 4. Cognitive symptoms Show poor judgment or planning Show poor judgment or planning Especially prone to poor (or no) planning Especially prone to poor (or no) planning 5. Physical symptoms High energy level – often in the presence of little or no rest High energy level – often in the presence of little or no rest

41 41Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Bipolar Disorders Criteria 1: Manic episode Criteria 1: Manic episode Three or more symptoms of mania lasting one week or more Three or more symptoms of mania lasting one week or more In extreme cases, symptoms are psychotic In extreme cases, symptoms are psychotic Criteria 2: History of mania Criteria 2: History of mania If currently experiencing hypomania or depression If currently experiencing hypomania or depression

42 42Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Bipolar Disorders DSM-IV-TR distinguishes between two kinds of bipolar disorder: DSM-IV-TR distinguishes between two kinds of bipolar disorder: Bipolar I disorder Bipolar I disorder Full manic and major depressive episodes Full manic and major depressive episodes Most sufferers experience an alternation of episodes Most sufferers experience an alternation of episodes Some experience mixed episodes Some experience mixed episodes Bipolar II disorder Bipolar II disorder Hypomanic episodes and major depressive episodes Hypomanic episodes and major depressive episodes

43 43Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Bipolar Disorders Without treatment, the mood episodes tend to recur for people with either type of bipolar disorder Without treatment, the mood episodes tend to recur for people with either type of bipolar disorder If people experience four or more episodes within a one-year period, their disorder is further classified as rapid cycling If people experience four or more episodes within a one-year period, their disorder is further classified as rapid cycling If their episodes vary with the seasons, their disorder is further classified as seasonal If their episodes vary with the seasons, their disorder is further classified as seasonal

44 44Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Bipolar Disorders Regardless of particular pattern, individuals with bipolar disorder tend to experience depression more than mania over the years Regardless of particular pattern, individuals with bipolar disorder tend to experience depression more than mania over the years In most cases, depressive episodes occur three times as often as manic ones, and last longer In most cases, depressive episodes occur three times as often as manic ones, and last longer

45 45Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Bipolar Disorders Between 1% and 2.6% of adults in the world suffer from a bipolar disorder at any given time Between 1% and 2.6% of adults in the world suffer from a bipolar disorder at any given time The disorders are equally common in women and men The disorders are equally common in women and men Women may experience more depressive episodes and fewer manic episodes than men Women may experience more depressive episodes and fewer manic episodes than men Rapid cycling is more common in women Rapid cycling is more common in women

46 46Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Bipolar Disorders The prevalence of the disorders is the same across socioeconomic classes and ethnic groups The prevalence of the disorders is the same across socioeconomic classes and ethnic groups Onset usually occurs between 15 and 44 years of age Onset usually occurs between 15 and 44 years of age In most cases, the manic and depressive episodes eventually subside, only to recur at a later time In most cases, the manic and depressive episodes eventually subside, only to recur at a later time Generally, when episodes recur, the intervening periods of normality grow shorter and shorter Generally, when episodes recur, the intervening periods of normality grow shorter and shorter

47 47Comer, Abnormal Psychology, 6e – Chapter 8 Diagnosing Bipolar Disorders A final diagnostic option: A final diagnostic option: If a person experiences numerous episodes of hypomania and mild depressive symptoms, a diagnosis of cyclothymic disorder is appropriate If a person experiences numerous episodes of hypomania and mild depressive symptoms, a diagnosis of cyclothymic disorder is appropriate Mild symptoms for two or more years, interrupted by periods of normal mood Mild symptoms for two or more years, interrupted by periods of normal mood Affects 0.4% of the population Affects 0.4% of the population May blossom into bipolar I or II disorder May blossom into bipolar I or II disorder

48 48Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Bipolar Disorders? Throughout the first half of the 20th century, the search for the cause of bipolar disorders made little progress Throughout the first half of the 20th century, the search for the cause of bipolar disorders made little progress More recently, biological research has produced some promising clues More recently, biological research has produced some promising clues New insights have come from research into NT activity, ion activity, brain structure, and genetic factors New insights have come from research into NT activity, ion activity, brain structure, and genetic factors

49 49Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Bipolar Disorders? Neurotransmitters Neurotransmitters After finding a relationship between low norepinephrine and unipolar depression, early researchers expected to find a link between high norepinephrine levels and mania After finding a relationship between low norepinephrine and unipolar depression, early researchers expected to find a link between high norepinephrine levels and mania This theory is supported by some research studies; bipolar disorders may be related to overactivity of norepinephrine This theory is supported by some research studies; bipolar disorders may be related to overactivity of norepinephrine

50 50Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Bipolar Disorders? Neurotransmitters Neurotransmitters Because serotonin activity often parallels norepinephrine activity in unipolar depression, theorists expected that mania would also be related to high serotonin activity Because serotonin activity often parallels norepinephrine activity in unipolar depression, theorists expected that mania would also be related to high serotonin activity Although no relationship with HIGH serotonin has been found, bipolar disorder may be linked to LOW serotonin activity, which seems contradictory… Although no relationship with HIGH serotonin has been found, bipolar disorder may be linked to LOW serotonin activity, which seems contradictory…

51 51Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Bipolar Disorders? Neurotransmitters Neurotransmitters This apparent contradiction is addressed by the “____________________” about mood disorders: This apparent contradiction is addressed by the “____________________” about mood disorders: Low serotonin may “open the door” to a mood disorder and permit norepinephrine activity to define the particular form the disorder will take: Low serotonin may “open the door” to a mood disorder and permit norepinephrine activity to define the particular form the disorder will take: Low serotonin + Low norepinephrine = ________________ Low serotonin + Low norepinephrine = ________________ Low serotonin + High norepinephrine = ________________ Low serotonin + High norepinephrine = ________________

52 52Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Bipolar Disorders? Ion activity Ion activity Ions, which are needed to send incoming messages to nerve endings, may be improperly transported through the cells of individuals with bipolar disorder Ions, which are needed to send incoming messages to nerve endings, may be improperly transported through the cells of individuals with bipolar disorder This improper transport may cause neurons to fire too easily (mania) or to resist firing (depression) This improper transport may cause neurons to fire too easily (mania) or to resist firing (depression) There is some research support for this theory There is some research support for this theory

53 53Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Bipolar Disorders? Brain structure Brain structure Brain imaging and postmortem studies have identified a number of abnormal brain structures in people with bipolar disorder; in particular, the basal ganglia and cerebellum among others Brain imaging and postmortem studies have identified a number of abnormal brain structures in people with bipolar disorder; in particular, the basal ganglia and cerebellum among others It is not clear what role such structural abnormalities play It is not clear what role such structural abnormalities play

54 54Comer, Abnormal Psychology, 6e – Chapter 8 What Causes Bipolar Disorders? Genetic factors Genetic factors Many experts believe that people __________________ _______________________ to develop bipolar disorders Many experts believe that people __________________ _______________________ to develop bipolar disorders Family pedigree studies support this theory; when one twin or sibling has bipolar disorder, the likelihood for the other twin or sibling increases: Family pedigree studies support this theory; when one twin or sibling has bipolar disorder, the likelihood for the other twin or sibling increases: Identical (MZ) twins = 40% likelihood Identical (MZ) twins = 40% likelihood Fraternal (DZ) twins and siblings = 5% to 10% likelihood Fraternal (DZ) twins and siblings = 5% to 10% likelihood General population = 1% likelihood General population = 1% likelihood Recently, genetic linkage studies have examined the possibility of “faulty” genes Recently, genetic linkage studies have examined the possibility of “faulty” genes Other researchers are using techniques from molecular biology to further examine genetic patterns Other researchers are using techniques from molecular biology to further examine genetic patterns Such wide-ranging findings suggest that a number of genetic abnormalities probably combine to help bring about bipolar disorders Such wide-ranging findings suggest that a number of genetic abnormalities probably combine to help bring about bipolar disorders


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