Guide
Guide | Reference

29  Predominant Mood and Drive Prototypes

29.1 Summary

  • Prototypes dominated by shifts in mood tone, energy, and drive that shape function and risk.

29.2 Included Prototypes (Guide exemplars)

  • Major Depressive Episode Prototype (exemplar).
  • Bipolar Spectrum Episode Prototypes (exemplar).
  • Full catalog appears in the Clean Reference.

29.3 How to Use This Cluster

  • Start with the Atlas entry for affect and mood experiences.
  • Rate the Mood and Drive Dysregulation domain.
  • Apply a prototype label only when it improves communication or documentation.

29.4 Boundary Markers

  • What it is: mood/drive patterns that dominate functioning or risk.
  • What it is not: short-lived, proportional reactions to clear events.

29.5 Common Overlap

  • Sleep and circadian disruption.
  • Anxiety and threat sensitivity.
  • Somatic distress or fatigue.

29.6 Major Depressive Episode Prototype (Exemplar)

29.6.1 Summary

  • A pattern of sustained low mood or loss of interest with reduced drive and functional impairment.

29.6.2 Prototype Features

  • Persistent low mood, emptiness, or anhedonia.
  • Reduced energy, motivation, or concentration.
  • Sleep or appetite disturbance.

29.6.3 Threshold Guidance

  • Use when low mood/anhedonia is prominent, sustained, and impairing.

29.6.4 Expected Domain Profile

  • Mood and Drive Dysregulation: moderate to high (low mood, low drive).
  • Arousal, Sleep, and Circadian Regulation: mild to moderate disruption.

29.6.5 Time-Course and Trajectory

  • Often episodic with variable recovery.
  • May be triggered by losses or stressors.

29.6.6 Differential and Red Flags

  • Bereavement or situational sadness without persistent impairment.
  • Substance or medication effects.
  • Medical contributors (endocrine, neurologic).
  • Psychosis or catatonia signals elevated risk.

29.6.7 Specifiers

Specifiers: course + contributors + risk, as relevant; see Reference for full.

29.7 Bipolar Spectrum Episode Prototypes (Exemplar)

29.7.1 Summary

  • A set of episodic patterns marked by elevated or irritable mood with increased energy, drive, or activity, often alternating with low mood periods.

29.7.2 Prototype Features

  • Elevated, expansive, or irritable mood with increased activity or drive.
  • Decreased need for sleep or heightened goal-directed behavior.
  • Risk-taking, impulsivity, or agitation in elevated states.

29.7.3 Threshold Guidance

  • Use when elevated or mixed states are distinct, recurrent, and impairing or risky.

29.7.4 Expected Domain Profile

  • Mood and Drive Dysregulation: high variability or mixed elevation/low.
  • Arousal, Sleep, and Circadian Regulation: notable disruption.

29.7.5 Time-Course and Trajectory

  • Episodic with variable duration and recovery.
  • May show cyclicity or seasonal patterns.

29.7.6 Differential and Red Flags

  • Substance or medication-induced elevation.
  • Sleep deprivation or circadian disruption alone.
  • Psychosis during elevated states.

29.7.7 Specifiers

Specifiers: course + contributors + risk, as relevant; see Reference for full.