Chapter 8 Mood Disorders

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Chapter 8Mood Disorders
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Mood Disorders (also called affective disorders)

• Extreme, persistent, or poorly regulated
  emotional states
• Depression in children
• Not masked, but rather may be overlooked
• Prevalence in children is increasing and age of
  onset is decreasing
• Experience of depression changes with age
• Depression in children under age 7 tends to be
  diffuse and less easily identified

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Major Depressive Disorder

• Depressed mood/sadness most of the day, most days
  (in children and adolescents, may be irritable
  mood)
• Diminished interest or pleasure in activities
• Changes in appetite or weight
• Sleep disturbances
• Psychomotor retardation or agitation
• Fatigue or loss of energy
• Feelings of worthlessness or inappropriate guilt
• Difficulty thinking or concentrating
• Thoughts of death or suicidal ideation

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Developmental Course of MDD
Figure 8.1
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Dysthymic Disorder

• Lower prevalence and earlier onset
• Less severe but more chronic than MDD
• less anhedonia, social withdrawal, impaired
  concentration, death thoughts, and physical
  complaints
• more constant sadness, self-depreciation, low
  self-esteem, anxiety, irritability, anger, and
  temper tantrums
• Double Depression

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Associated Characteristics of Depressive Disorders

• Academic performance
• Cognitive/Perceptual disturbances
• Social difficulties
• Family dysfunction

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Theories of Depression

• Psychodynamic theory loss of a love object
• Attachment theory parental separation and
  disruption of an attachment bond
• Behavioral theories inaccurate learning and
  environmental consequences
• Cognitive theories focus on depressogenic
  cognitions

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Theories of Depression (cont.)

• Self-control theories difficulties in organizing
  behavior
• Interpersonal theories disruptions in
  relationships
• Neurobiological models genetic vulnerabilities
  and neurobiological abnormalities
• Socioenvironmental theories stressful life events

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Causes of Depression

• Genetic and family risk
• Diathesis-Stress model
• Neurobiological influences
• Brain structures
• Neurotransmitters
• Family influences
• Anger/conflict, stress, control, poor
  communication, over-involvement, less warmth and
  support, disorganization
• Emotion regulation
• Poor coping strategies
• Stressful life events

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Causes of Depression (cont.)
Figure 8.3 A developmental framework for
depression in young people.
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Bipolar Disorder (BD)

• Abnormally and persistently elevated, expansive,
  or irritable mood, alternating with one or more
  major depressive episodes
• Over-excitement, restlessness, agitation,
  sleeplessness, pressured speech, flight of ideas,
  sexual disinhibition, inflated self-esteem,
  reckless behavior

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Variations of BD

• Manic, mixed, or hypomanic episode
• Bipolar I Bipolar II
• Cyclothymia
• Rapid cycling

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Developmental Course of BP

• Peak age of onset between 15 and 19 years of age
• Affects males females equally
• Depression usually appears first
• Chronic and resistant to treatment, with poor
  long-term prognosis

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Treatment of Affective Disorders

• Psychosocial Interventions
• Cognitive therapy
• Behavior therapy
• Cognitive-behavioral therapy (CBT)
• Medications
• Family therapy
• Group therapy