become activated by stressful experiences, causing the
person to blow events out of proportion and feel per-
sonally responsible for failure and disappointment.
According to this viewpoint, negative and self-critical
thoughts are directly related to the onset of depression
following a stressful life event.
Additionally, a number of interpersonal problems
are linked with the risk for depressive disorders.
Individuals who are socially isolated and those who
lack the social skills for maintaining rewarding rela-
tionships are at high risk for depression. Once
depressed, pessimism and negative thinking may fur-
ther isolate the individual from other people who are
trying to avoid the negativity, setting up a self-perpet-
uating cycle. The importance of interpersonal factors
in the causation of depressive disorders is further
highlighted by the strong association between marital
distress and depression. Separation and divorce are
common antecedents of depression, as is ongoing
marital conflict. The direction of cause, however, is
not always obvious—relationship problems could
cause depression or the reverse could occur. Alterna-
tively, a separate factor, such as negative affectivity,
could be responsible for both depression and relation-
ship problems.Treatment
The two major approaches to treatment of the mood
disorders include medication and therapy. For bipolar
disorders, medication is the first line of treatment. It
usually consists of a mood stabilizer, which reduces
the frequency and intensity of manic episodes, often
in combination with an antidepressant. Approximately
75% of individuals with a bipolar disorder who com-
ply with medication will experience some improve-
ment. The amount of improvement, however, is
variable, ranging from mild to dramatic. Supportive
therapy and family therapy may be helpful supple-
ments for patients with severe bipolar disorder. The
unpleasant side effects of mood stabilizers, such as
drowsiness, upset stomach, and impaired coordina-
tion, along with the stigma of taking medication for a
mental disorder, cause problems with medication
compliance in many cases of bipolar disorder.
The depressive disorders are often treated with a
combination of antidepressant medication and psy-
chotherapy. Approximately two-thirds of patients will
benefit from antidepressant medications such as
Prozac (fluoxetine is the generic name), although it
may take several weeks before any improvement isnoticed. The newer antidepressant medications
produce relatively few side effects; however, it is not
uncommon to experience a decline in sex drive and
feelings of restlessness.
Cognitive therapy for depression is one of the best
documented treatments. Several large-scale studies
show that its effectiveness rivals medication in the
long term. Additionally, unlike medication, cognitive
therapy can reduce a person’s risk for future depres-
sive episodes. As a brief and structured form of treat-
ment, cognitive therapy is designed to help the patient
identify and modify distorted thinking. Marital and
family therapy may be useful for severe mood disor-
ders that are related to conflict at home.Richard D. McAnulty and Jocelyn M. BrinemanSee alsoMental Health Law; Psychotic DisordersFurther Readings
Butcher, J. N., Mineka, S., & Hooley, J. M. (2007). Abnormal
psychology(13th ed.). Boston: Allyn & Bacon.
Comer, R. J. (2007). Abnormal psychology(6th ed.).
New York: Worth.
Klein, D. F. (2005). Understanding depression: A complete
guide to its diagnosis and treatment.New York: Oxford
University Press.
Reamer, F. G. (2003). Criminal lessons: Case studies and
commentary on crime and justice. New York: Columbia
University Press.
Schneidman, E. S. (2001). Comprehending suicide:
Landmarks in 20th century suicidology.Washington, DC:
American Psychological Association.
Schneidman, E. S. (2004). Autopsy of a suicidal mind.
New York: Oxford University Press.MORAL DISENGAGEMENT
AND EXECUTION
People ordinarily refrain from behaving in ways that
violate their core moral standards because such con-
duct will bring self-censure. In some institutional role
functions, however, such as military combat and state
executions, the taking of human life presents a grave
moral predicament. Intentional infliction of death and
destruction can, therefore, exact a heavy emotional
toll and leave a troubled and haunted life for those
who have to do it. The challenge is to explain howMoral Disengagement and Execution——— 515M-Cutler (Encyc)-45463.qxd 11/18/2007 12:43 PM Page 515