ANCC Certification PMHNP Chapter 7

ANCC Certification PMHNP Chapter 7 1. Mood Disorders: Most common psych illnesses 2. Primary characteristic is persistent disturbance in mood: Major Depressive Disorder 3. Often occurs without precipitating event: MDD 4. Object loss theory: Fairbairn, Winnicott & guntrip 5. Aggression turned inward theory of MDD: Freud 6. Cognitive Theory: Beck 7. Learned Helplessness-Hopelessness Theory: Seligman 8. Genetic predisposition: Strong genetic load for depression for child of de- pressed parent -having 3 fold increase in lifetime risk of MDD & 40% chance of depressive episode before age 18. 9. Endocrine dysfunction Theory: Probably related to etiology of MDD 10. Sleep disturbances, appetite disturbances, libido disturbances, lethargy, anhedonia are neurovegitative symptoms that are related to functions of the: Hypothalamus and pituitary gland secretions 11. Endocrine dysfunction and pregnancy: A high incidence of postpartum mood disturbances is suggested with this 12. Hypothalamic-pituitary-adrenal axis (HPA): A theory of MDD, may be a result of an abnormal stress response related to dysregulation of this system 13. HPA axis: Controls the physiological response to stress and is composed of interconnective feedback pathways between the hypothalamus, pituitary gland, and adrenal gland. 14. Hypothalamus releases: corticotropin-releasing hormone (CRH) 15. Adrenocorticotropin hormone (ACTH): Released by pituitary in response to CRH by hypothalamus 16. Cortisol: Released by adrenal glands in response to ACTH by pituitary gland 17. Hyperactivity of the HPA axis: Demonstrated to be present in individuals with MDD. May also have elevated cortisol levels 18. Elevated cortisol levels: Over time damages the CNS by altering neurotrans- mission and electrical signal conduction. Cortisol over time can cause changes in size and function of brain tissue 19. Dexamethasone suppression test (DST): Not commonly used in clinical practice for screening of depression as it is too non specific. 20. Hypovolemic hippocampus and hypovolemic prefrontal cortex-limbic striatal regions: Abnormalities demonstrated by neuroimaging in individuals with chronic and severe depression 21. Brain damage, including that from stroke and trauma: Depression is a acommon comorbidity in individuals who have experienced these events 22. What is the Chronobiological theory of MDD: Desynchronization of the circadian rhythms produces the symptom constellation collectively called MDD 23. Circadia