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Section 5
Major Depressive Episode

Question 5 | Test | Table of Contents

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According to the DSM, the Diagnostic and Statistical Manual of Mental Disorders, when a relative or close friend dies, it is quite natural to grieve. When the symptoms of the grieving process are a reason for receiving clinical attention, DSM allows you to make a diagnosis of Bereavement. The problem is that the sadness of grief can closely resemble the sadness associated with a Major Depressive Episode.

♦ The DSM points out certain symptoms to help you decide whether, in addition to being bereaved, the patient is suffering from a Major Depressive Episode.

6 Symptoms of a Major Depressive Episode
--1. Guilt feelings (other than about actions that might have prevented the death),
--2. Death wishes (other than the survivors’ wishing to have died with the loved one),
--3. Slowed-down psychomotor activity,
--4. Severe preoccupation with worthlessness,
--5. Severely impaired functioning for an unusually long time,
--6. Hallucinations (other than of seeing or hearing the deceased).

In addition, people who are "only" bereaved typically regard their moods as normal. A diagnosis of depressive illness is usually withheld in these cases until after the symptoms have lasted longer than two months.

A colleague treated Henry, age 68, who was grieving the loss of his nephew in the September 11th attacks, in addition to empathetic support and helping him to identify and express feelings. Henry, who was the comptroller for a large company wanted more factual information. By providing Henry with factual information, he was able to better put events into perspective. One of the several techniques used to quell his fears was an explanation of the force multiplier tactics of terrorism.

♦ Force Multipliers and Tactics
The force multiplier tactic is one of the bases behind the September 11th attacks. A basis of the psychology of terrorism is if the tactics of terrorism are made complex by the social meanings attributed to the actions of terrorists, groups of terrorists further confuse the issue by trying to portray an image of omnipotence.

That is, terrorist groups try to make the public believe that they are something more than they are, that terrorism can strike anywhere and that terrorists are in control of everyday life. Adding symbolic meanings to tactics helps to accomplish this objective, but there is a more significant factor. The success of terrorism generally depends on the size of the terrorist group.

Jenkins believed that terrorists turn to what is known as "force multipliers" to give the illusion of increased strength. In military terms, force multipliers increase the striking potential of a unit without increasing its personnel. For example, an infantry battalion can multiply its striking power by supplying its personnel with hand-held rocket launchers. Jenkins maintained that small terrorist groups routinely seek force multipliers. The therapist further explained to Henry that this is exactly what happened with the hijacked planes that crashed into the Twin Towers.

Immediately following September 11th, some clients experienced anticipatory grief, which is the grieving that occurs prior to the actual loss. Many were anticipating further terrorist attacks. I found it helpful with these clients who were experiencing anticipatory grief to partialize and prioritize their feelings through the preceding explanation of techniques used to increase striking power.

3 Techniques Terrorists Use to Increase their Striking Power
-- First, the mass media are manipulated to expand the aura of the group.
-- Second, transnational support networks give small groups logistical support and mobility.
-- Third, technology allows terrorists to increase their striking power as in the case of September 11th.
Reviewed 2023

Peer-Reviewed Journal Article References:
Ahern, E., & Semkovska, M. (2017). Cognitive functioning in the first-episode of major depressive disorder: A systematic review and meta-analysis. Neuropsychology, 31(1), 52–72.

Harris-Hogan, S. (2018). Terrorism, 1888–2018: Some change, but mostly the same. Journal of Threat Assessment and Management, 5(4), 245–247.

Mac Giollabhui, N., Hamilton, J. L., Nielsen, J., Connolly, S. L., Stange, J. P., Varga, S., Burdette, E., Olino, T. M., Abramson, L. Y., & Alloy, L. B. (2018). Negative cognitive style interacts with negative life events to predict first onset of a major depressive episode in adolescence via hopelessness. Journal of Abnormal Psychology, 127(1), 1–11.

Salman, N. L., & Gill, P. (2020). A survey of risk and threat assessors: Processes, skills, and characteristics in terrorism risk assessment. Journal of Threat Assessment and Management, 7(1-2), 122–129.

Wu, H., Mata, J., Furman, D. J., Whitmer, A. J., Gotlib, I. H., & Thompson, R. J. (2017). Anticipatory and consummatory pleasure and displeasure in major depressive disorder: An experience sampling study. Journal of Abnormal Psychology, 126(2), 149–159.

QUESTION 5
The sadness of grief can closely resemble the sadness associated with what? To select and enter your answer go to Test.

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