Midterm 1, Developmental Psychopathology, Chapter 4- Assessment, Diagnosis, and Treatment, Chapter 6: Autism Spectrum Disorder and Childhood-onset Schizophrenia, Dev Psychopathology Final, Developmental Psychopathology, Developmental Psychopathology,...

precursors and comorbidity: schizoid personality disorder (3)

"A pattern of detachment from social relationships and a restricted range of emotional expression" 1. Extremely introverted, voluntarily choose to be socially isolated 2. No desire for social relationships 3. Emotionally apathetic

OPPOSITIONAL DEFIANT DISORDER (ODD)

"A recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months" .

precursors and comorbidity: schizotypal personality disorder (3)

"a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior" 1. Odd, awkward, superstitious 2. Uncomfortable with relationships 3. Associated with social anxiety and depression

externalizing behavior

"acting out" on the environment, such as aggressive or destructive behavior

Internalizing Problems

"overcontrolled" disorders (e.g. separation anxiety, selective mutism" -inner distress -shyness -moreso females

CONDUCT DISORDER (CD)

"repetitive and persistent pattern of behavior in which the basic rights of others or major age‐appropriate social norms or rules are violated" 4 categories of symptoms: - can occur in adulthood

Externalizing Problems

"undercontrolled" disorders (e.g. ADHD, conduct, ODD) -acting out -aggressive -moreso males -poor impulse control in children

RAD Characteristics

** only diagnosis that relies on etiology -- reaction to pathological emotional environment --Impacted by severe emotional neglect, trauma, abuse, and/or several changes in caregiver --Links to Borderline Personality Disorder, PTSD, and conduct disorder

Language and Communication Abilities

*In the past, 50% of children with severe autism never developed spoken language *Language in the autistic individual is disordered rather than delayed - Echolalia - Abnormal prosody (pitch, volume, intonation and emphasis) - Pronoun reversal - Trouble with the pragmatic or social use of - language - Use fewer different words even when they know them - Often do not ask wh- questions use of language may be very literal and concrete - Trouble with metaphor or other poetic use of language - May use words in a very limited way and have trouble generalizing to other uses

Timeline of brain growth and structuring

- 0-3 years primitive areas for sensory/motor skills improve - 3-7 perceptual and instinctual areas are strongly influenced by experiences - 5-7 prefrontal cortex and cerebrum are rewired - 9-11 major brain restructuring due to puberty

Facts about children's mental health

- 1 in 5 will be diagnosed with a mental illness - Mental health funding has recently been cut - Majority of those who need help with mental illness will not receive help - Increasing recognition at an early age helps more

Difficult temperament

- 10% of population - Are often irritable and fussy. They are upset easily and may be unpredictable when it comes to feeding schedules

Mathematics Learning Disabilities

- 2 groups: those who are behind in reading, spelling and math and those who are behind in math only - Both groups appear to have problems with working memory and executive functioning - The first group also has problems with language which seem to interfere with Math as well - The math LD only group shows deficiencies in visual-spatial and visual-perceptual domains and are more likely to have disorders of attention than those that also have problems in reading - Seem to have difficulty learning math because of procedural problems - Math LD can also be subtyped according to whether the child has problems with calculation or math reasoning - Calculation is considered a lower-order process while reasoning is a higher-order process - Children with these subtypes appear to show different cognitive profiles

Lateralization in the Brain

- 2 hemispheres: *Left - verbal & cognitive abilities Right - social perception & creativity Primary hemisphere we refer to in this course? The left hemisphere

Easy temperament

- 40% of population - Are calm and relaxed. They do follow predictable feeding schedules but are also flexible within their day. They are often seen as friendly and happy.

**Both Anna Freud and Melanie Klein used play as:

- A source of information about the child which could then be used in a standard analytic way - Did not see play as therapeutic in and of itself

Developmental Psychology

- Able to identify patterns of normal development - No models for explaining when development did not occur normally - These researchers tended to leave atypical individuals out of their research - Thought that clinical observation was not worthwhile because it was not scientifically rigorous

Cognitive hypothesis testing: there are three groups identified:

- About 85% of students achieve adequately when provided with *good empirically-based instruction* - Remaining 15% are then provided with specific interventions in their specific areas of deficit (RTI) - Remaining 5% who do not respond to intervention should receive a more in-depth evaluation and specific individualized programming

**Risk factors of family

- Abuse and neglect - Economic status (education, income) -.Nutrition - Lack of parental involvement - Financial stress - Mental health problems - Family size (over crowding) - Death in family - Single parent homes - Guardian having multiple partners

2 types of special education

- Academic - Adaptive skills

Collaboration of two different approaches

- Academic developmental psychology - Clinical child psychology and psychiatry

Internal processes

- Anxiety - Depression - Self-concept

Treatments for Autism

- Applied Behaviour Analysis or ABA approach - First devised by Lovaas in the 1970's - Emphasis is on structured systematic teaching of skills using behavioural principles and emphasizing positive incentives - Consistent and strong evidence for efficacy in improving but not "curing" the core symptoms of autism - Use of this type of treatment has resulted in gains in IQ and language, but the gains are less striking in those who are more impaired

Behavioral/Cognitive influences

- Applied behavior analysis - Classical conditioning - Social Learning - Social cognition

Frontal lobes

- Area of the brain located at the frontal of each cerebral hemisphere - Responsible for the functions underlying much of our thinking and reasoning abilities, including memory

Family therapy

- Assumption that symptomatology in one member of a family is an outward manifestation of family rather than individual dysfunction - One family member may be identified as having difficulty and is brought for treatment - they are known as "the identified patient" - Focus of treatment is on the family as a whole - Family is seen as a system which needs feedback in order to create positive change - Changing one part of the system will produce change in another part

**Social abilities in ASD

- Attachment - Social Imitation - Joint attention - Orienting to social stimuli - Face perception - Emotion perception and expression - Symbolic play - Language and Communication Abilities - Repetitive Behaviors and Interests

Cognitive Hypothesis Testing (processing approach)

- Based on research in the field of neuropsychology - Involves a series of steps in evaluation which includes RTI

**Melanie Klein: Play Therapy - Psychoanalytic

- Believed that play was similar to free association in adult analysis - Direct access to the unconscious

**Good quality imaginative play is associated with:

- Better creative thinking and problem-solving - Better coping strategies and ability to adjust to various situations - Improved emotion regulation - Ability to understand the emotions of others and take their perspective - Be used to build rapport - Diffusing negative emotions

Possible causes on a child's behavior

- Biological influences - Emotional influences - Behavioral and cognitive influences - Family, culture, ethnic influences

TREATMENT: Three models used in developing treatments for LD

- Biological model - Psycho neurological model - Direct teaching of skills

The main treatment for LD currently is some sort of special education

- Can be provided one-to-one or in a small group - Special programming can focus on teaching alternative strategies - Children can be encouraged to use other modalities such as listening and speaking to make up for weaknesses in reading and writing - Training in metacognition and learning strategies may also be useful

Medications

- Can be used to reduce the severity of some of the related symptoms - Psycho stimulants can be used for hyperactivity, - Mood stabilizers and anti-psychotics may reduce aggression - Anti-depressants may reduce withdrawal and compulsive repetitive behaviors - Intravenous administration of the hormone oxytocin is promising

Strauss and Werner

- Children approach learning tasks in different ways - Educational procedures tailored to patterns of processing strengths and weaknesses in the individual - Children with deficient learning processes may be helped to learn normally if those processes are strengthened or if teaching methods that do not stress weak areas can be developed

Features that distinguish children in adolescent disorders

- Children do not refer themselves for treatment - Problems usually involve not showing regular developmental progress - Many problems not entirely abnormal - Interventions promote development and reduce stress

Orienting to social stimuli

- Children with ASD do not pay as much attention to social stimuli as normal infants do - Typical children tend to pay more attention to human faces and social interaction than to inanimate objects from birth - Autistic children often pay more attention to objects than people or social interaction - Lack of preference for social stimuli may underlie a number of the other social deficits in autism (not motivated to do social things)

**Similar Sequence Approach (Developmental)

- Children with ID proceed through the same developmental sequences - Show similar development in the areas of conservation, role taking, symbolic play and language

Emotion perception and expression

- Children with autism may have more difficulty reading emotions in others and in expressing their own emotions - Emotional experiences may be simpler difficulty reading the body language of other people - May have to be taught what various postures and gestures mean in order to make sense of social interaction

Face perception

- Children with autism show impaired face recognition - Typical children are fairly good at identifying familiar versus unfamiliar faces - Children with autism seem to have more difficulty discriminating between these - Children with autism have an unusual way of processing faces

**Types of Cognitive Problems Associated with Intellectual Disability

- Cognitive development is delayed - Short attention span and over selectivity - Skills need to be taught specifically - Thinking is more concrete - difficulty with abstract ideas - Expressive and receptive language tend to be less well-developed - Socially naïve at times

The Difference Position

- Cognitive development of ID children differs in more than rate and upper limit - Qualitative as well as quantitative differences between ID and non-ID - Is mostly supported by research, especially for the mild familial group - Individuals with clear organic ID are less consistent - Often show specific areas of deficit and perform worse than their MA-matched peers - Some syndromes are associated with specific strengths and weaknesses

What must be evaluated to discern between normal and abnormal behavior?

- Context - Time frame (development) - Social norms and expectations Disorders are commonly viewed as deviances from normal

**Risk factors of Community

- Crime - Lack of community activities - Traumatic events - Natural diasters - School (metal detectors) - Bullying - Negative peer groups

2 types of diagnosis

- DSM-5 - ICD-10

Persistent deficits in social communication and social interaction

- Deficits in social-emotional reciprocity - Deficits in non-verbal communication - Deficits in relationships

What must we consider in competence

- Degree of Maladaptive behavior - The extent in which they achieve normal development milestones

By 12 months of age may:

- Demonstrate more frequent and intense responses to distress - Spend more time fixating on a single object rather than actively visually exploring their environment - Show less interest in looking at faces or other social interaction than their normally developing peers

From a developmental perspective

- Deviations from age-appropriate norms - Exaggerations of normal behavioral trends - Behaviors which interfere with normal development processes

Risk Factors in Childhood

- Disadvantaged families and neighborhoods - Abusive or negligent families - Inadequate child care - Born with a very low birth rate - Parents who have a mental illness or substance abuse problem

Joint Attention

- Earliest sign - The ability to co-ordinate attention between interactive partners with respect to shared awareness of an object or event - Normally developing infants use gaze and gesture to draw the attention of another person to a particular visual stimulus - Normal infants respond to the verbal and non-verbal cues of others - Children with ID matched for IQ were able to master joint attention when autistic children at the same IQ level could not

**Protective factors of child

- Easy Temperament - Sociability - High IQ - High self efficacy - Positive self esteem - Good emotion regulation - Talent or hobby valued by parents and peers

Why do we need this concept

- Either you have it or you don't - Psychological disorder has roots in children (Freud) - People back in the day didn't see that children needed help

Hanen program

- Emphasizes helping the child to communicate better - Sensory and sensory integration approaches address the sensory sensitivities seen in many autistic children - Biologic treatments include the use of medications and also the use of diet supplements or modifications to diet

Why is knowing culture important

- Establish relationship with child and family - Motivate family members to change - Obtain vital information - Arrive at accurate diagnosis - Develop meaningful treatment recommendations

Challenges of Longitudinal Studies

- Expensive - High attrition rate - Lack of compliance by subjects - Variables of interest may change - Take advantage of newer measurement procedures etc

Types of Validity

- Face Validity - Construct Validity - Convergent Validity - Discriminant Validity - Criterion Related Validity

**Research-Based Dimensional Diagnosis

- Factor-analytic studies - Internalizing - Externalizing

Floor Time (Greenspan and Wilder)

- Focuses on making an emotional connection with the autistic child - Once this connection is made, the therapist builds on it to develop communication and interaction skills - No well-designed research has evaluated this approach

Lobes of the brain

- Frontal - Parietal - Temporal - Corpus callosum

Pros and cons of a child being diagnosed

- Helps describe, organize and express complex features of behavioral patterns - Challenge of Stigma - Must separate child from the disorder

**Cultural-familial ID (when there is no organic cause)

- Heredity: often have parents who have a low IQ - Cultural or environmental deprivation - These factors combine to create a depressed level of functioning - Research has shown that early interventions can have an impact on these individuals

4 Implications of Research

- Identify those who are most vulnerable for developing psychopathology - Show us how to change risk factors - Find out how to reduce the effect of risk factors on the individual - Help us to provide opportunities for children that will counteract negative events and increase the field of life choices for an individual

Poverty Effects

- Impairments in learning ability - More conduct, school problems, emotional disorders and cognitive learning problems

Social Imitation

- In typical children, the ability to imitate has been observed to be present shortly after birth - The ability to imitate motor movements facilitates a developing child's understanding of the relationship between themselves and others - Children with ASD seem to be impaired in their ability to imitate - Interferes with their ability to develop reciprocity, joint attention and understanding of emotional states - Deficits in imitation skills are related to later expressive language difficulties

Levels of influence on child's mental health

- Individual - Family - Community - Culture

Interventions for associated emotional and behavioral problems

- Individual - Family - Medical

Ethical issues

- Informed consent - Assent - child agrees to take part (if >7) - Voluntary Participation - Confidentiality and anonymity - disclosed info must be kept confidential - Non-harmful procedures

**Ethical issues in research with children

- Informed consent (assent) - Voluntary participation - Confidentiality - Non-harmful procedures

**The level of support needed is identified along 4 dimensions

- Intellectual/adaptive - Psychological/emotional - Physical health/etiology - Environment

**Risk factors of child

- Intelligence (IQ) - Learning disabilities - Birth deficits - Temperament - Poor social skills - Genetic vulnerability

**Similar Structure Hypothesis (Developmental)

- Intelligence has the same organization in ID and non-ID - ID children should perform similarly to non-ID children when matched for Mental Age

Types of Reliability

- Internal consistency - Interrater reliability - Test-retest reliability

2 types of behavior problems

- Internalizing - Externalizing

More intense instruction is not sufficient

- Interventions need to be appropriate to each individual's learning disability subtype and include, at a minimum: Specific skill instruction Accommodations Compensatory strategies Self-advocacy skills

Assessment questions (a child or youth)

- Is there a problem? (not always a problem, normal or typical) - What is the problem? - Who has that problem? Who is the client? - What will be the goals for intervention? - What will be the most appropriate methods of intervention? - What is the likely outcome? - A baseline for evaluating change (can see if you can provide treatment to improve behavior)

**What qualities of pretend play make it a suitable medium for working with young children?

- It is a naturally-occurring activity - Associated with positive emotions (it's fun) - Don't need the same speech, can act things out) - It is a natural way to build rapport or strengthen the relationship with a child - The child can be in control, unlike in most other areas of life

In 1944, Hans Asperger described a similar

- Less severely impaired group - Had language, but showed social deficits and narrow, intense preoccupations

Reading Disorder

- Majority of children with difficulty learning to read English show the same weakness - poor phonological awareness - Children who do not master these skills and automatize them early in the reading process continue to struggle with fluency and develop problems with comprehension as well

Attachment

- Many ASD children do show preferential attachments - Seeking behaviors appear to be more disorganized and there is less display of emotion

What to keep in mind in the development of a disorder?

- Many contributors to a disordered outcome - Contributors vary among children - Children express features of disorder differently - Pathways leading to a particular disorder are numerous and interactive

**Why might children be more difficult to assess than adults?

- May not like talking to strangers - May not be able to express feelings (vocabulary) - They want to please you - May not like to talk a lot very few words

Skepticism on research

- Media oversimplifies it - Conflict between studies - Often no clear cut answers

**Danger of false postive

- Medication that give side effects - People become defined by labels - Wrong treatment plan

Severity of the disability should be specified as either

- Mild, - Moderate - Severe - Profound

**Disadvantage of Research-Based Dimensional Diagnosis

- More complex - Lack sensitivity in context (why are they sad, parent died)

**Advantages of Research-Based Dimensional Diagnosis

- More reliable - More formative

Types of Assessment

- Multimethod assessment - Clinical interviews - Behavioral assessment - Checklists and rating scales - Behavioral observation and recording - Psychological testing - Intelligence testing - Projective testing - Personality testing - Neuropsychological assessment

**Criticism of RTI

- No standardized, approach empirically-based approach being used for RTI (big picture approach) - No agreement on how to determine response or lack of response - The RTI approach has tended to focus primarily on word reading rather than more advanced skills (reading comprehension) - Many possible reasons that a child might not respond to instruction other than having a SLD

bulimia treatment

- Nutritional counseling, combination of SSRIs (Prozac) + CBT (coping with stress, distorted thoughts about self and food)

About 85% of persons with ID are in the Mild range

- Physically indistinguishable from others - Often no known organic cause - Usually diagnosed when they enter the school system - May develop literacy and math skills up to a middle school level - As adults, may work at low-skilled jobs, live independently, marry and have children - May experience adjustment problems when faced with complex stressors

Demensions of temperament

- Positive affect and approach - Fearful or inhibited - Negative affect or irritability (Early infant temperament may be linked to psychopathological or risk conditions)

**Protective factors of family

- Positive parent child relationship - Emotionally close family - Religion - Age appropriate parent involvement

Treatments for Intellectual Disability

- Prevention - Special education

What do interventions cover

- Prevention - Treatment - Maintanance

Problem perception

- Problem checklists - Sentence completion

Social and Environmental context

- Proximal events: close by (parental divorce) - Distal events: Further removed (school shooting a state away) - Shared environment - environmental factors that produce similar developmental outcomes among siblings - Non-shared environment - environmental factors that produce behavioral differences in siblings in the same family

General Treatment Approaches

- Psychodynamic - Behavioral - Cognitive - Cognitive behavioral - Client-centered - Family - Biological - Combined

**Strengths and weaknesses are identified in reference to

- Psychological/emotional domain - Physical health/etiology - Environment

LD in Written Expression

- Relatively little research in this area compared to reading LD - Children may show problems with spelling, handwriting, language, planning etc. - Dysgraphia which only affects handwriting is no longer diagnosable with DSM-5 - Children with LD in Reading frequently also have problems in Written Expression - poor phonological awareness typically affects spelling as well as reading

Repetitive Behaviors and Interests

- Repetitive motor movements (hand flapping) - Repetitive use of objects (line up toys) - Inflexible adherence to routines (performing things the same way) - Preoccupations with unusual objects (Ben with cups) - Circumscribed interests or preoccupations with specific topics - Unusual responses to sensory information (fascination of a light, etc)

Methods of measurement

- Reporting - Psychophysiological - Neuro imaging - Observational

Etiology, prognosis and exclusion

- SLD is lifelong but varies in expression according to the environment - Characterized by unexpected academic under-achievement or achievement which is maintained by unusually high levels of effort and support - Due to genetic and/or neurobiological factors or injury which affects brain function - Not primarily due to hearing/vision problems, SES, cultural or linguistic differences, lack of motivation or ineffective teaching - May be co-morbid with other conditions such as attentional, behavioral and emotional difficulties

Four patterns of attachment

- Secure - Insecure - anxious-avoidant - Insecure - anxious-resistant - Disorganized, disoriented

**Retrospective studies problems

- Self reporting bias (make yourself look good) - Memories may not be accurate - Children may tell you what they want you to hear - Negative bias (due to parents, telling you everything that is wrong) - Positive bias ( parents tell you everything that's right)

Multi-modal techniques

- Several types of intervention are provided at once - A result of the recognition that psychopathology has a complex origin and that changing one aspect of the problem may not deal with all the causal factors or the factors which tend to maintain the problem - This approach has also been encouraged by the fact that many uni-modal studies have shown disappointing results - Used most often with the more complex and difficult to treat disorders - Often used in situations where family dysfunctions such as abuse and divorce have led to pathology in the children

**Why do we need diagnosis?

- Shorthand description for large amounts of data - To communicate with other professionals (common language to talk about) - Basis for reliable research (what contribute it, what might be the outlook, know interventionist, etc)

By 2 years of age

- Show reduced ability to follow verbal instructions - Less verbal imitation - Less use of single words and phrases.

American Psychiatric Association guidelines for psychopathology

- Shows some degree of distress such as fear or sadness - Behavior indicates some degree of impairment or disability which interferes with one or more important areas of functioning - Such distress or disability increases the risk of further suffering or harm such as death, pain, disability or an important loss of freedom

Research Designs

- Single-Case Experimental Designs - Between-Group Experimental Designs - Cross-Sectional Studies - Longitudinal Studies

Differential Diagnosis for ADHD

- Situational hyperactivity - Behavioral Disorders (Opposition Defiant Disorder/ Conduct Disorder) - Emotional Disorders - Misuse of Substances - ASD - Intellectual Disability - Anxiety Disorders

Restricted, repetitive patterns of behavior or interest

- Stereotyped or repetitive movements - Insistence on sameness - Highly restricted, fixated interests - Over or under reactivity to sensory input

**Interventions using Structural family therapy model stress strategies such as

- Strengthening certain subsystems (e.g. parents), - - Re-ordering the hierarchy, - Strengthening or breaking down boundaries

Observation methods

- Structured Observation - Naturalistic observation

**Academic developmental psychology

- Study of normal development - Change and growth over the lifetime - Study of groups and averages - Tend to emphasize the role of cognition in development - Emphasize experimentation and quantification, - Similar to scientists such as physicists

**Clinical child psychology and psychiatry

- Study psychological problems and their treatment - Study mostly individuals and individual intervention - Often adopt the medical model of pathology, using such naturalistic tools as observations and interviews - Clinical psychologists tend to emphasize emotions rather than cognition

Public health risk

- Substance abuse (in pregnant women) - Diet/nutrition - SES - Alcohol - Smoking - Stress

**Structural family therapy

- Subsystems - Hierarchy - Boundaries

**Protective factors of community

- Support from adults in the community - Pioneer girls/ girl guides (group) - Involvement in activities - School ( structure and discipline)

**Levels of Treatment Evaluation

- Symptoms and diagnosis - Functioning - Consumer perspectives - Environmental - Systems

Symbolic Play

- The absence of symbolic play is one of the earliest symptoms of autism - In normal children it is considered an important precursor to language - Children with autism can develop symbolic play skills, but they are often mechanical and not spontaneous - Not yet clear whether this lack of symbolic play is related to the deficits in imitation or joint attention or whether it represents a more generalized deficit in symbolic thinking (not flexible in play).

Research by the early 20th century indicated

- The disorder was innate - More males than females were affected - The disorder was heterogeneous with respect to - The specific pattern and severity of deficits - The disorder appeared to be related to problems with the left hemisphere of the brain and central language processing - Normal classroom instruction was not adequate to meet the children's needs

**Severe and Profound - about 5%

- This group has the highest incidence of organically based causation - Often have severe birth defects and physical impairment - Higher incidence of behavior problems such as aggression, destructiveness, self-injury and feeding problems - Treatment is aimed at self-control and basic communication - Usually live in residential settings as adults or even as children - Remain highly dependent on others and require lifelong support services - May have a limited life span because of their associated medical conditions

What do we use diagnosis for?

- Treatment planning - Prognosis (what's going to happen in the future)

**DAWSON'S SOCIAL MOTIVATION HYPOTHESIS

- Typically developing children have a preference for social over non-social interactions and respond with positive emotion to social stimuli - If a child lacks this differential motivation, they will spend less time attending to social stimuli such as faces, the human voice (hand gestures) etc. and this in turn leads to deficits in their ability to process this information

Reporting Measurement method types

- Unstructured clinical interview - Structured diagnostic interview - Questionnaires Can be either self report or informant report

Strong evidence of a genetic factor in reading disorders

- Up to 60% of children whose parents have reading difficulties will also have such difficulties themselves - Twin studies have shown that the concordance rate for mono-zygotic twins is 80% while it is only 50% for dizygotic twins - There may also be an environmental component in that these parents may read less to their children because of their own problems - Attempts to identify a specific gene are not yet conclusive

Multi-method/ Multi-trait Assessment (questionnaire, info. from school, and medical records)

- Use a variety of methods (play therapy, observation, art therapy, protective test, talk to mom and dad) - Evaluate a number of different aspects of the individual

**Moderate ID - about 10%

- Usually diagnosed in early childhood - Many have a clear organic cause - Often have physical anomalies as well - More difficulty with language and communication - Can achieve some academic skills - usually no higher than a Grade 3 level - Need direct training in daily activities such as self-care, communication and social skills - Require lifetime support but may achieve some degree of independent living - May also be able to work, usually in a supervised workshop

**Children with Specific Learning Disorders are more likely than other children to experience social and emotional difficulties. What factors do you think might contribute to this?

- When they experience constant struggle and failure, students may develop negative self-esteem - Bullying (for being different) - Low confidence - Hard time understanding verbal and nonverbal communication - Difficulties managing their own behavior

EXTERNALIZING: SUBSTANCE USE

- alcohol must commonly abused - everything has been going down in the last five years

Emotional Regulation Strategies for Kids

- belly breathing - relaxation - counting to 10 first

Transactional approach

- child and environment both contribute to the expression of the disorder

Limbic system

- emotional experience

Clinical significance

- group mean does not indicate whether individuals improved due to treatment Kazdin (1999): "Does the intervention make a real (e.g., genuine, palpable, practical, noticeable) difference in everyday life to the clients or to others with whom the client interacts" (p. 332)?

anxiety disorder

- level of anxiety that interferes with normal functioning. • Most common mental disorder among teens. Some occur among very young children. Includes:

Interventions for trauma/abuse

- parent-focused programs aimesd at increasing parental sensitivity and quality of caregiving - psychoeducation on trauma and brain, attachment, and typical behaviors in abused/neglected children - directed and non-directed play therapy - Trauma-focused therapy

Types of Trauma and Abuse

- physical abuse - med/dent trauma - neglect - kidnapping - torture - sexual abuse - in utero trauma

Operant conditioning

- problems develop due to learned behavior Reinforcement increases behavior Positive reinforcement: adding a stimulus that increases future possibility of behavior Negative reinforcement: removing a stimulus that increases future possibility of that behavior Punishment decreases behavior Positive punishment: add an aversive stimulus that decreases the behavior (spanking) Negative punishment: removing an stimulus/ something you like that will decrease behavior

Psychological Tests

- tasks given under standard conditions -The purpose is to assess some aspect of the child's knowledge, skill, or personality - A child's scores are compared with a norm group

humanistic play therapy

- uses play with emphasis is on reflection and unconditional positive regard

The decision-making process: Clinical assessment:

- uses systematic problem-solving strategies to understand children with disturbances and their family and school environments

Authoritative

- warm, responsive (the parent to be) High Responsive High Control

Kazdin (2011) Parent Management Training (ADHD Treatment)

-->How to manage child's oppositional/ noncompliant behaviors -->Coping with emotional demands of raising child with ADHD

Family and Twin Studies

-15-20% of siblings of individuals with ASD have the disorder -Broader autism phenotype -Concordance rates -70-90% in identical twins -Near 0% for fraternal twins -Heritability of an underlying liability for ASD is 90%

ADHD Statistics

-5.2% of kids (more common in males) -females more likely to exhibit inattentive Sx

Are Cognitive Deficits Found in All ASD?

-A single cognitive abnormality cannot explain all the deficits present in in children with ASD -There is a view that children with ASD have an underlying impairment in social motivation

Medical Conditions and Physical Characteristics of ASD

-About 10% of children with ASD have a coexisting medical condition -Motor and sensory impairments, seizures, immunological and metabolic abnormalities -Sleep disturbances occur in 65% -Gastrointestinal symptoms occur in 50% -About 20% have a significantly larger-than-normal head size—more common in those who are higher functioning

Intellectual Deficits and Strengths of ASD

-About 70% of autistic children with autism have co-occurring intellectual impairment -A common pattern is low verbal scores and high nonverbal scores -About 25% have splinter skills or islets of ability -5% (autistic savants) display isolated and remarkable talents

DSM-5 criteria for age/setting/duration of ADHD

-Appears prior to age 12 (compared to age 7 in DSM-4) -Persists for more than 6 months -Developmentally inappropriate- more often and greater severity than other kids of same age/sex -Occurs across 2+ settings -Interferes with social or academic performance -Not better explained by another disorder

Neuropsychological Assessment

-Attempts to link brain functioning with objective measures of behavior known to depend on an intact central nervous system -Assess a full range of psychological functions

Early Intervention

-Begins before age 3 -intensive -high structure (predictable outcomes/routines, visual schedules, boundaries) -low student-teacher ratio -family inclusion (parent training) -Peer interactions -generalization -ongoing assessment

Brain Abnormalities

-Behavioral features of ASD may result from abnormalities in brain structures -Lack of normal connectivity and communication across brain networks -Multiple brain regions may be involved

ADHD outcomes

-Behavioral treatment is associated with less substance abuse -initial clinical representation and strength of the symptom response to any treatment are better predictors than the type of treatment received

Treatment of ADHD: Medication (6)

-Between 70-80% of children with ADHD have fewer symptoms when assuming stimulants -normalize frontostriatal structural abnormalities and functional connections (executive functions) -Increase availability of dopamine and norepinephrine -Leads to increased arousal, internal stimulation, concentration -Benefits are temporary and short-term, occur only while medication is taken -addiction and withdrawal

CD gender

-Boys have earlier age of onset -2-4 times higher in boys in childhood but narrows in adolescence -increases in adolescence and beyond

Treatment of COS

-COS is a chronic disorder with a poor long-term prognosis -Current treatments emphasize use of antipsychotic medications combined with psychotherapy and social and educational support programs -Medications help control psychotic symptoms -There can be serious side effects

DSM-V core deficits of ADHD

-Characteristics vary considerably across children -Different behavior patterns have different causes -They have attention, but it is all over the place, don;t have it focused in one area

Combined Type (ADHD-C)

-Children who have symptoms of both inattention and hyperactivity-impulsivity -Most often referred for treatment

Problems in Early Development

-Children with ASD experience more health problems during pregnancy, at birth, or immediately following birth -Prenatal and neonatal complications have been identified in a small percentage of children with ASD

Positive Findings

-Children's changes achieved through therapy are greater than changes for children not receiving therapy -Children receiving therapy are better off after therapy -Treatments are equally effective for internalizing and externalizing disorders -Treatment effects tend to be long-lasting

Genetic Influences

-Chromosomal and gene disorders -Fragile-X anomaly occurs in 2-3% of children with ASD -ASD individuals have a 5% elevated risk for chromosomal anomalies -About 25% of children with tuberous sclerosis have ASD

Depression presentation across developmental periods: school-aged children (2)

-Deficits in affective, cognitive, interpersonal functioning -Negative peer interactions

Cognitive and Motivational Deficits of ASD

-Deficits in processing social-emotional information -Difficulty in situations that require social understanding -Do not understand pretense or engage in pretend play -Deficit in mentalization or theory of mind (ToM) - difficulty understanding others' and their own mental states -Do not understand false-belief tests

Social Interaction Impairments

-Deficits in social and emotional reciprocity -Unusual nonverbal behaviors -Social imitation, sharing focus of attention, make-believe play -Limited social expressiveness -Atypical processing of faces and facial expressions -Joint attention

DSM 5 Positive Symptoms

-Delusions -Hallucinations most common for children are auditory - occur in 80% of cases with onset prior to age 11 -40 to 60% experience visual hallucinations, delusions, and thought disorder

Vulnerabilities

-Dependence on others -Lack of experience handling problems -Lack complex and realistic views of world and self

cultural influences of ADHD

-Diagnosed more in boys than girls in all cultures -Symptoms, expression, associated features, outcomes are similar -slightly more prevalent among lower SES groups -Found in all, but rates vary -Cultural differences may reflect cultural norms/tolerance for ADHD symptoms

Self-stimulatory behavior

-Different theories -A craving for stimulation to excite their nervous system -A way of blocking out and controlling unwanted stimulation from environment that is too stimulating -Maintained by sensory reinforcement it provides

Overview of Treatment Strategies

-Engaging children in treatment -Decreasing disruptive behaviors -Teaching appropriate social behavior -Increasing functional, spontaneous communication -Promoting cognitive skills -Teaching adaptive skills to increase responsibility and independence

Why is cultural information necessary when making a diagnosis?

-Establish relationship with child and family -Motivate family members to change -Obtain valid information -Arrive at accurate diagnosis -Develop meaningful treatment recommendations

A "classical/pure" categorical approach to diagnoses:

-Every diagnosis has a clear underlying cause -Each disorder is fundamentally different from other disorders

General Deficits of ASD

-Executive functions (higher-order planning and regulatory behaviors) -Weak drive for central coherence (strong human tendency to interpret stimuli in a relatively global way to account for broader context) -Do well on tasks requiring focus on parts of stimulus

Prevalence

-Extremely rare in children under age 12 -Dramatic increase in adolescence, with a modal onset around 22 years of age -Estimated prevalence is less than 1 per 10,000 children COS has an earlier age of onset in boys by two to four years -Gender differences disappear in adolescence

Negative Findings

-Fewer than 20% of treatments demonstrate evidence for reducing impairment in life functioning -Community-based clinic therapy is far less effective than structured research therapy -Conventional services for children may have limited effectiveness

course of autism

-Gradual improvements with age, especially with early intervention -Many problems likely to be lifelong, with worsening symptoms in adolescence -New challenges associated with each new stage of life -It is possible to live full typical life

Precursors and Comorbidities

-Gradual onset -Almost 95% have history of behavioral, social, and psychiatric disturbances before onset of psychosis -Developmental precursors -Other symptoms/disorders -70% meet criteria for another diagnosis - most commonly mood disorder or ODD/CD -COS and ASD may not be linked

What's wrong with mania or hypomania? (3)

-Hedonistic triad: spending spree, sexual activity, and substance abuse -Hallucinations or delusions -Frenzied activity, and disorganized cognition agitation and increased risk of violence toward both self and others

Treatment goals of societal importance

-Improve child's participation in school-related activities -Decrease involvement in juvenile justice system -Reduce need for special services -Reduce accidental injuries or substance abuse -Enhance physical and mental health

Predominately Inattentive Type (ADHD-PI)

-Inattentive, drowsy, daydreamy, spacey, confused -May have ID, processes info slowly and has trouble remembering things, low academic achievement -often anxious, apprehensive, socially withdrawn, mood problems Most often overlooked because the kid is labeled as "shy"

New Initiatives

-Increase recognition of children's mental health needs -Develop a wider range of service delivery models

Characteristics associated with ASD

-Intellectual deficits and strengths -Sensory and perceptual impairments -Cognitive and motivational deficits -Medical conditions and physical characteristics

Early Intervention

-Intensive 25 hours a week and 12 months a year -Low student-teacher ratio -High structure -Family inclusion -Peer interactions -Generalization

Causes of ASD

-It is now generally accepted that autism is a biologically based neurodevelopmental disorder with multiple causes 1. Problems in early development 2. Genetic influences 3. Brain abnormalities 4. A disorder of risk and adaptation

What is Specific to ASD?

-Lack of ToM is one of the most specific to ASD -Deficits in processing socio-emotional information and executive functioning deficits are less specific to ASD

Prevalence MDD

-Lifetime: 10-20% -rare among pre-K and school age (1-3%) but increases by 2-3 fold in adolescence

ADHD and dopamine

-Lower levels of this neurotransmitter, -neurons have higher concentrations of this transporter, which prevents the NT from going on to the next cell

Medications

-Many children with ASD receive psychotropic medications -Antidepressants, stimulants, and tranquilizers/ antipsychotics -Benefits are limited -Variable from child to child -Core deficits of these children are not altered -Risks, benefits, and costs must be carefully evaluated

Bipolar disorder: cyclothymia (4)

-Many mood swings, less severe symptoms than bipolar 1 or 2 -2 years, many periods of hypomanic and depressive symptoms -Symptoms do not meet the criteria for hypomanic or depressive episode -Symptoms never stopped for more than 2 months

treatment of pediatric bipolar disorder: medication- atypical antipsychotics, mood stabilizers (5)

-Mood stabilizers: lithium, lamictal, depakote -Atypical antipsychotics: abilify, seroquel, risperdal -Side effects make adherence difficult -Many people miss their manic symptoms -anti-depressant induced mania

Conduct problems

-Most costly mental health problem in North America -50% of all crime in US due to this population -occurs in 5% of children -annual public costs: $10,000 per child

Age of Onset of ASD

-Most often identified by parents in the months preceding child's second birthday -Diagnosis is made in preschool period or later -Earliest point in development for reliable detection period is from 12-18 months -Diagnoses made around 2-3 years are generally stable AAP recommends that all children be screened at 18-24 months

Causes of COS

-Neurodevelopmental model -Defective neural circuitry increases a child's vulnerability to stress -Biological factors -Strong genetic contribution -Molecular genetic studies have identified several potential susceptibility genes -CNS dysfunction and improvements with medication suggest it is a disorder of the brain Environmental factors -Familial disorder and nongenetic factors may play a role through interaction with a genetic susceptibility -High communication deviance -Stress, distress, and personal tragedy experienced by families of children with schizophrenia

ADHD Treatment

-No known cure, ongoing research -Main Treatments: Stimulant Meds, parent management training, and education intervention -Additional Treatments: Family counseling, support groups, individual counseling

Treatment of depressive mood disorders: medications

-Not as effective as therapy -Fluoxetine is the best option for children/adolescents (more effective than placebo) -Tricyclic antidepressants ineffective with children/adolescents -Venlafaxine associated with suicidal behavior

CD comorbidity

-ODD has much overlap -50% maintain their ODD without progressing -25% cease to display ODD -1/2 of children with CD have no prior ODD ADHD: 50% of ADHD have ODD 30-50% develops CD, 50% CD has ADHD depression/anxiety: 50% of CD has

CD Prevalence

-ODD: more prevalent than CD during childhood but by adolescence is equal, 12% lifetime prevalence, western countries similar prevalence -CD: 8% lifetime prevalence, not overrepresented in low SES but should be aware of context of behaviors

Key features of COS

-Occurs during childhood -Has a gradual, rather than sudden onset -Is likely to persist into adolescence and adulthood -Has profound negative impact on developing social and academic competence

ASD onset

-Often diagnosis is made in pre-K or later -Reliable diagnostic period: 12-18 mos, 2-3 yrs is generally stable diagnosis

Course and Outcome of ASD

-Often gradual improvements with age, -Likely to continue to experience many problems -Symptoms may worsen in adolescence -Complex obsessive-compulsive rituals may develop in late adolescence and adulthood

Sensory and Perceptual Impairments of ASD

-Oversensitivities or undersensitivities to certain stimuli -Overselective and impaired shifting of attention to sensory input -Impairments in mixing across sensory modalities -Sensory dominance -Stimulus overselectivity

First Person Account of Schizophrenia: Common Themes of Delusions (5)

-Persecutory Delusions (most common) -Grandiose Delusions -Religious Delusions -Delusions of Reference -Delusions of Control

Molecular Genetics

-Points to particular areas on many different chromosomes as possible locations for genes for ASD 1. Causally implicated but not a direct cause 2. ASD is likely to be a complex genetic disorder 3. Expression of ASD genes may be influenced by environmental factors occurring primarily during fetal brain development 4. Epigenetic dysregulation may be a factor

Assessment of Childhood/Adolescent Onset Schizophrenia: distinguishing features that are unique about assessing schizophrenia compared to other disorders

-Projective measures such at the Rorschach are often used to distinguish the presence of thought disturbance -self-report not valid to low self-awareness -individual, developmental, and family history -behavioral observations -clinical interviews with caregiver -neuropsychological assessment

Qualitative language impairments

-Pronoun reversals -Echolalia -Perseverative speech -Impairments in pragmatics

Treatment goals related to family functioning

-Reduce level of family dysfunction -Improve marital and sibling relationships -Reduce stress -Enhance family support

Treatment goals related to child functioning

-Reduce or eliminate symptoms -Reduce degree of impairment in functioning -Enhance social competence -Improve academic performance

Stereotyped body movements

-Repetitive sensory and motor behaviors -Insistence on sameness behaviors

Ethical/legal considerations... AACAP and APA ethical code provide minimum ethical standards

-Select treatment goals and procedures that are in the best interest of the client -Ensure participation is active and voluntary -Keep records to document treatment effectiveness -Protect confidentiality -Ensure therapist's qualifications and competencies -Determine when a minor is competent to make decisions -Be cautious about ineffective or potentially harmful treatment -Comply with federal, state, and local laws

Combined Treatments

-The use of two or more interventions, each of which can stand on its own as a treatment strategy -More communities are now implementing comprehensive mental health programs for children -Often delivered through schools

Treatment of ASD

-There are about 400 different treatments for ASD -There is no known cure -Treatment goals -Minimize core problems -Maximize independence and quality of life -Help the child and family cope more effectively with the disorder

ADHD: Anxiety disorders

-They constantly seek reassurance that they are safe and protected -Anxiety may worsen symptoms/severity of ADHD -May have greater long-term impairment

Personality Testing Central dimensions of personality - the "Big 5" factors

-Timid or bold -Agreeable or disagreeable -Dependable or undependable -Tense or relaxed -Reflective or unreflective

Communication impairments

-Uses protoimperative gestures (declaring needs through gestures or vocalizations) -Fail to use protodeclarative gestures (direct visual attention of other people to engage others/shared interests) -About 50% do not develop any useful language

Cognitive Treatments

-View abnormal behavior as the result of deficits and/or distortions in the child's thinking F-ocus is on changing faulty cognitions

Biological Treatments

-View child psychopathology as resulting from psychobiological impairment or dysfunction -Rely primarily on pharmacological and other biological approaches to treatment

Family treatments

-View individual disorders as manifestations of disturbances in family relations -Focus on the family issues underlying children's problematic behavior

Cognitive-Behavioral Treatments

-View psychological disturbances as the result of: -Faulty thought patterns -Faulty learning and environmental experiences -Focus on: -Identifying and changing maladaptive cognitions; teaching the child to use cognitive and behavioral coping strategies; and helping the child learn self-regulation

Other commonly administered tests

-Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) -Stanford-Binet-5 (SB5) -Kaufman Assessment Battery for Children (K-ABC-II)

History and evolution of autism: "refrigerator mothers"

-a mother who is uncharacteristically cold towards their child rather than warm and loving -caused autism

Hypomanic episodes

-abnormally, persistently elevated, expansive, or irritable mood/activity/energy lasting at least 4 consecutive days and present most of the day, nearly every day -not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic

7 developmental tasks of neurotypical infants/toddlers/preschool-aged children

-attachment (basic trust) to one or more specific caregivers -learning to sit, stand, walk, and jump -acquiring functional language -obedience to simple commands and instructions of adults -toilet training -appropriate play with toys and other people -achieving a sense of autonomy from parents

4 developmental tasks of neurotypical younger adolescents

-attending and behaving appropriately at school -learning to solve advanced problems with numbers (algebra) -learning required language, history, and other subjects -completing secondary schooling

Explain genetics in developmental psychopathology

-can lead to body structures and functions that can predispose behavior -not a 1:1 correspondence

Treatment of Childhood/Adolescent Onset Schizophrenia: problems with treatment and psychotherapy

-chronic disorder with poor long-term prognosis -Highly stigmatized -Many are not receptive to psychotherapy -Vocational interventions are often necessary

5 possible familial protective factors

-close relationship w/ at least one caregiver -sensitive, responsive parenting behavior -consistent use of parental discipline -adequate parental monitoring -good relationships with peers, extended kin

ADHD Characteristics

-cognitive deficits (executive function, ID, academic, SLD, distorted self-perception) -speech and language impairments -medical and physical concerns (accident prone, risk taker) -social problems

4 possible psychological risk factors

-cognitive delays or deficits -hyperactivity, inattention, learning problems -problems regulating emotions -problems in social interactions

What makes it a spectrum disorder? (3)

-differ in level of intellectual ability- from profound disability to gifted/talented intelligence -severity of language problems→ Asperger's vs. Autism- formerly believed that language was the distinction between the two categories -Behavior, symptoms, and prognosis of children with autism change with age and intervention

ADHD Cognitive Deficits

-distorted self-perceptions (higher self esteem than is warranted) (positive illusory bias) -inattentive=lower self-esteem, HI: exaggerated self-esteem

3 possible psychological protective factors

-enriched learning, environmental experiences -high-quality special educational services -help from therapist, school counselor, parents to remedy problems in emotional control or social functioning

Associated characteristics of ADHD: cognitive deficits

-executive function deficits in 50% of ADHD

ASD Etiology

-genetic -environ: advanced maternal age, low birth weight

2 possible genetic protective factors

-genetic screening -early identification

4 possible biological protective factors

-good access to prenatal and postnatal care -high quality nutrition -early recognition of medical and developmental delays or deficits -early intensive treatment for medical problems and developmental delays

5 possible biological risk factors

-inadequate prenatal health care -complications during pregnancy or delivery -inadequate postnatal health care, immunizations -malnutrition -exposure to environmental toxins

Depression

-includes excessive unhappiness (dysphoria) and loss of interest in activities (anhedonia) -was a mistaken belief that depression did not exist in children -frequently co-occurs with other more visible disorders

How is developmental psychopathology distinct from other fields according to Sroufe and Rutter?

-inherently developmental -vs. child (and Adolescent) clinical/abnormal/psychiatry ---emphasis on normal and abnormal development -vs. developmental psychology ---includes abnormal development

2 possible genetic risk factors

-inherited genetic disorders -genetic mutations

Predominately Hyperactive-Impulsive Type (ADHD-HI)

-involves hyperactivity and impulsivity problems -Primarily includes preschoolers and may have limited validity for older children -May be a distinct subtype if combined type

5 developmental tasks of neurotypical school-aged children

-learning reading, writing, maths -attending and behaving appropriately at school -following rules for behavior at home, at school, and in public places -getting alone with peers at school -making friends with peers

CD traits

-limited pro social emotions -lack of remorse or guilt -callous-lack of empathy -unconcerned about performance -shallow of deficient affect

5 possible social-cultural risk factors

-low socioeconomic status -dangerous, high-crime neighborhood -inadequate educational opportunities -rejected by peers or association with deviant peers -discrimination

Assessment of pediatric bipolar disorder: difficulty in accurate diagnoses (5)

-manic-specific measures -Parent-report is more reliable than self-report or teacher-report -Life-charting: track mood and symptoms over time through use of app or diary -Diagnosis more commonly made through rule-out procedures than rule-in -Response to treatment of possible alternative diagnoses will inform pBD diagnosis

5 possible familial risk factors

-parental death, separation, or abandonment -parental divorce, marital conflict -cold, distant, intrusive, or harsh parenting -child abuse or neglect -placement into foster care, group home

3 types of gene-environment interactions

-passive gene-environment correlation -evocative gene-environment correlation -active gene-environment correlation

4 possible social-cultural protective factors

-peer acceptance, close friends -involvement in prosocial activities -relationships with adult mentors -adequate educational opportunities

Mueller and Dweck (1998)

-purpose: how does praise influence motivation? -method: harder set of problems, negative feedback -Results: -hard task: compared to those given person praise, those given process praise had more desire to persist and more enjoyment -easy task: process praise group increased performance from first to last problems vs. decreased performance for person praise group -Conclusion: prase teaches children about the nature of intelligence (fixed vs. malleable)

Core deficits of autism: unusual behaviors/interests (4)

-rigidity in routines and insistence on sameness -"stims": craving for stimulation to excite nervous system, blocking out/controlling unwanted environmental stimulation -sensory over-responsivity: negative response to or avoidance of sensory stimuli, overactive brain responses -sensory dominance: focus on one sensory input

Depression in Preschoolers

-somber/tearful -lacking enthusiasm -clinging/whining excessively -fear of separation/abandonment -irritability

Authoritarian

-value obedience, demanding, unresponsive Low Responsive High Control

ASD Spectrum Factors

-vary in level of intellectual ability -vary in severity of language problems -behavior changes with age

MDD (major depressive disorder)

-when diagnosed in children, has the same criteria as adults but with the most common symptom being irritability (80% most common symptom in children) -5/9 symptoms present, at least one for dysphoria/anhedonia -2 week period

6 developmental tasks of neurotypical older adolescents

-working or preparing for future higher education -if working, behaving appropriately in the workplace -if in school, meeting academic standards for courses -forming and maintaining romantic relationships -obeying the laws of society -transitioning from parents to living independently

associated characteristics: physical/medical comorbidity and symptoms (5) (2)

-~10% have co-existing medical condition -Motor/sensory impairments, seizures, immunological and metabolic abnormalities -65% have sleep disturbance -50% have gastrointestinal symptoms -~20% have significantly larger than normal head size (More common in those who are higher functioning) Two most common comorbid disorders 1. Intellectual disability 2. Epilepsy

Prevalence Bipolar

0.5-2.5% in children (7-21), bipolar II or cyclothymic are more likely than bipolar I, Increases likelihood with puberty, since 1994 youth outpatients for BP increased by 40 FOLD but this is due to more exposure.

Significance of Children's Mental Health Problems in the US

1 in 5 children has a mental disorder resulting in at least mild functional impairment Fewer than 10% of children with mental health problems receive proper services 20/100

New Prevalence rate for Autism

1 in 68 (1.5%)

ASD Prevalence

1% of population Occurs in all social classes worldwide More in US: 1 in 88 (1 in 58 males)

ODD symptoms

1) Angry, irritable mood 2) Argumentative, defiant behavior 3) Vindictive

Hierarchy for risk factors:

1) Correlation - are these things related? does not equal causation (e.g. Childhood Sexual Abuse and depression) 2) Risk factors - correlations that precede an outcome (e.g. longitudinal studies) 3) Causal risk factors - identify causes through treatment or experimental studies

Purpose of Assessment (Clinical)

1) Diagnosis/diagnostic picture - Figure out what is happening to the child 2) Develop a treatment plan 3) Monitor treatment throughout - how will you assess progress? - effectiveness of treatments and interventions

treatments AD

1) behavior therapy (relaxation, anxiety hierarchy construction, exposure therapy. 2) CBT 3) Family Interventions 4)Medications

CD Prevalence

1-10%

prevalence of depression in 6-11 years

1-5%

process of neurons

1-> dendrites of a neuron receive message from other neurons 2-->electrival signal sent to the axon 3-->when signal reacjes the end of the acon, neurotransmitters are secreted 4--> neurotransmitters cross the synaptic gap and are absorbed by the dendrites of the receiving neuron 5--> the receiving neuron then generates new electrical impulses

ADHD: Developmental coordination and tic disorders (3)

1. 30-50% of children with ADHD display motor coordination difficulties (Clumsiness, poor performance in sports, poor handwriting) 2. 50% of children with ADHD have developmental coordination disorder (DCD) (marked motor incoordination; delays in achieving motor milestones) 3. Tic disorders occur in 20% of children with ADHD (Sudden, repetitive, nonrhythmic motor movements/sounds Eye blinking, facial grimacing, throat clearing, grunting)

ADHD: Mood disorders

1. ADHD in early childhood is risk factor for development of depression and suicidal ideation 2. Child demoralization

4 categories of conduct disorder

1. Aggression to people and animals 2. Destruction of property 3. Deceitfulness or theft 4. Serious violations of rules

CD symptoms

1. Aggressiveness to people and animals 2. Property destruction ( 3. Deceptiveness or theft 4. Serious rule violations

Treatment services for children must:

1. Attend to presenting problem 2. Consider the specific cultural practices of the family 3. Must be careful not to stereotype individuals of any cultural group

types of attention and what is impaired in children with ADHD (four types)

1. Attentional capacity: the amount of info we can remember and attend to for a short time= do NOT have attentional capacity deficits 2. Selective attention: the ability to concentrate on relevant stimuli and ignore task irrelevant stimuli in the environment (distractibility) 3. Sustained attention/vigilance: the ability to maintain a persistent focus over time on unchallenging, uninteresting tasks or activities 4. Alerting: initial reaction to a stimulus, the ability to prepare for what is about to happen

The Learning Disabilities Association of Canada adopted the following definition in 2002:

1. Average intelligence with Processing Impairments affecting academic and psychosocial functioning. 2. Etiology, prognosis and exclusion 3. More intense instruction is not sufficient

two types of conduct disorder

1. Childhood onset type (early starter) 2. Adolescent onset type (late onset)

Three factors contribute to the spectrum nature of autism:

1. Children with autism may differ in level of intellectual ability, from profound disability to above-average intelligence 2. Children with autism vary in the severity of their language problems 3. The behavior of children with autism changes with age

DSM-IV : A multiaxial system consisting of five axes...

1. Clinical disorders or conditions 2. Personality disorders and intellectual disability 3. General medical conditions 4. Psychosocial and environmental problems 5. Global assessment of functioning

DSM-5 provides detailed descriptions of functioning at each of these levels in three domains

1. Conceptual, 2. Social 3. Practical

Two Strategies for Integrating Left and Right Brain + what it means to integrate them (3-4 sentences)

1. Connect and Redirect: Surfing Emotional Waves --Step 1: acknowledge child's feelings and sit with them in the emotion (connect w/ right brain) --Step 2: Can now logically work through the problem (redirect w/ left brain) 2. Name it to Tame it: Telling Stories to Calm Big Emotions --Retell story of an event that triggers big emotions. Work towards naming the emotion and continue telling the story and filling in details until the event no longer triggers those feelings. (Identifying emotions from right brain and making logical sense of them using left brain) We want the brain to be horizontally integrated so left-brain logic and right-brain emotion work together (p.18). Children are primarily right-brained, especially the younger ages, so integrating the two hemispheres allows them to more positively manage their strong emotions by putting them into logical perspective.

Strategies

1. Connect and Redirect: acknowledge right brain emotion and redirect when ready to left brain explanation 2. Name it to tame it: Retelling of story to help child identify the emotion associated with an event in order to make sense of it with left brain logic (detailing events) 3. Engage Don't Enrage: Engaging the upstairs brain instead of playing into emotion (command/demand). Plays along with connect and redirect 4. Use it or lose it: Children need to exercise their upstairs brains regularly and parents should aid in this by letting them make decisions, asking questions that helps them gain self-understanding, bringing their attention to others emotions, and talking through how to regulate emotions on their own (deep breathing) 5. Move it or lose it: Exercise helps calm downstairs brains and re-integrate upstairs brain

DSM: Two important facts

1. DSM is categorical taxonomy 2. DSM is atheoretical

Cultural considerations of intervention/treatment

1. Development of evidence-based interventions has led to a growing awareness of children's and families' cultural contexts 2. Treatment is likely to be more effective when compatible with the cultural patterns of the child and family (The cultural compatibility hypothesis)

associated characteristics: general deficits (3)

1. Difficulties with executive functions 2. Tendency to focus on details rather than broader contexts 3. Gross and fine motor delays

Cons of Diagnostic Labels

1. Disagreement about effectiveness of labels to achieve their purposes 2. Negative effects and stigmatization 3. Can negatively influence children's views of themselves and their behavior

Two Strategies for Integrating Upstairs and Downstairs Brain + what it means to integrate them (3-4 sentences)

1. Engage, Don't Enrage: Appealing to the Upstairs Brain --Engaging the upstairs brain rather than the downstairs brain (avoiding command and demand) in order to help the child process their emotion and say what they actually mean. 2. Use It or Lose It: Exercising the Upstairs Brain --Letting child make decisions sometimes to exercise the upstairs brain (increases executive functioning) --give them some responsibility (i.e. give options and let them choose) --controlling emotions (strategies for regulation) --self-understanding ("why do you think..." questions) --empathy: draw attention to other peoples emotions to make child aware --morality: 3. Move It or Lose It: Moving the Body to Avoid Losing the Mind --exercising directly affects brain chemistry and can help with integrating the upstairs brain Vertical integration allows the more outer/upper brain regions (cortex) responsible for decision-making and deeper thought processes to work in conjunction with the more inner/lower parts of the brain (limbic system and brainstem) involved in instinctual reactions and survival. This works in a top-down and bottom-up fashion.

Childhood/Adolescent Onset Schizophrenia: positive symptoms (psychotic/ active)- disfunction (4)

1. Excess or disturbances in normal functioning (rare before age 7) 2. Delusions- false beliefs despite evidence 3. Hallucinations- Auditory hallucinations (kids) and visual 4. Disorganized speech- Thought disturbances, loose associations, illogical thinking, and impaired discourse skill

Criticisms of the DSM

1. Fails to capture the complex adaptations, transactions, and setting influences crucial to understanding and treating child psychopathology 2. Gives less attention to disorders of infancy/childhood 3. Fails to capture the interrelationships and overlap known to exist among many childhood disorders

Assessment of pediatric bipolar disorder: risk factors examined during assessment process (5)

1. Family history: 1st or 2nd degree relative with BPD 2. Psychosis: more commonly due to mood disorder in children than schizophrenia, occurs in the context of mood 3. Early onset depression: ⅓ of cases turns out to be PBD, before age 25, more commonly treatment resistant, recurrent, atypical 4. Episodic aggression: high-energy, reactive, not instrumental or planned 5. Sleep disturbance: decreased need for sleep without fatigue

4 lobes of the cortex

1. Frontal lobe 2. Parietal lobe 3. Occipital lobe 4. Temporal lobe

Pros of Diagnostic Labels

1. Help clinicians summarize and order observations 2. Facilitate communication among professionals 3. Aid parents by providing recognition and understanding of their child's problem

Three types of ADHD

1. Hyperactive/Impulsive (more in boys) --hyper behaviors include fidgeting, difficulty staying seated, excessive talking, etc. "as if driven by motor" --impulsive behaviors include inability to resist immediate gratification, difficulty waiting for turn, interrupting, may respond physically 2. Inattentive (more in girls) --inability to sustain attention, particularly for repetitive, structured, and less enjoyable tasks --may include: disorganization, forgetfulness, failure to finish assignments, frequent change in activities, easily distracted 3. Combination **must meet criteria from both (6 from each)

Three Subtypes of ADHD

1. Hyperactivity/Impulsivity 2. Inattentive 3. Combined

Associated characteristics of ADHD: speech/language impairments (4)

1. Impaired verbal working memory (+In) 2. Impaired discourse analysis: Difficulty understanding others' speech 3. (HI+)Pragmatic speech: Excessive and loud talking, Frequent shifts and interruptions in conversation, Difficulty listening to others, Inappropriate conversations 4. Speech Production Errors, fewer pronouns and conjunctions, tangential and unrelated comments, unclear links (related to inattention and low self-awareness)

Specific Learning Disorder Types

1. Impairment in reading: dyslexia 2. Impairment in writing: dysgraphia 3. Impairment in mathematics: dyscalculia

ADHD Symptoms

1. Impairment present in 2 or more areas 2. Sx must be inconsistent with developmental level 3. Significant impairment in social, academic or occupational settings

6 learning difficulties in academic

1. Inaccurate or slow word reading 2. Reading comprehension difficulty 3. Difficulties with spelling 4. Difficulties with written expression 5. Number sense and calculation difficulty 6. Difficulties with mathematical reasoning

**4 levels of support

1. Intermittent 2. Limited 3. Extensive 4. Pervasive

family/environmental influences for ADHD (3)

1. Low parental education, social class, poverty, bullying/peer victimization, negative parenting, maltreatment and family discord are associated with ADHD 2. How family manages ADHD may lead to greater severity of symptoms 3. Family conflict related to presence, persistence, and emergence of associated oppositionality and conduct problems

Associated characteristics: intellectual deficits and strengths

1. Lower-functioning kids may have low verbal scores and high nonverbal scores 2. Higher-functioning kids may have high verbal scores and lower nonverbal -Processing speed and working memory tend to be lower

early development for ADHD (7)

1. Maternal smoking→ +239% risk of ADHD 2. Maternal substance use 3. Maternal stress 4. Low birth weight (+IN) 5. Prematurity (IN+) 6. Organic pollutants, lead 7. Diet doesn't play a major causal role

Executive function: motor (4)

1. Monitor and regulate action 2. Following prohibitive instructions 3. Response inhibition 4. Motor coordination and sequencing

General Approaches to Treatment

1. More than 70% of clinicians use an eclectic approach Psychodynamic treatments: 1. View child psychopathology as determined by underlying unconscious and conscious conflicts 2. Focus is on helping the child develop an awareness of unconscious factors contributing to problems

DSM-V characteristics of ADHD

1. Neurodevelopmental disorder: refers to the brain and especially to its development --> Inattention --> Hyperactivity-impulsivity -Categorical separation of dimensions oversimplifies the disorder -Attention and impulse control are closely connected developmentally

Stress-trauma continuum (Sandra Gorman-Brown lecture)

1. Normal: Function of living as a human being in society -- largely positive -- causes brief increase in heart rate and stress hormones (Sympathetic NS) 2. Situational: stress level is more intense and acute but time limited --i.e. exams, interviews, car accident? 3. Toxic: stress is more chronic and can negatively impact brain development -- neglect, abuse Trauma: direct, personal experience of real or perceived threat of danger or serious risk to one's physical integrity OR witnessing an event that involves death, injury, etc.

**4 research in Developmental Psychopathology

1. Normative-developmental approach 2. Prevalence rates 3. Comorbidity 4. Need for intervention True experimental issues are rare due to ethical reasoning

common comorbid psychological disorders (5)

1. ODD 2. CD 3. Anxiety disorders 4. Mood disorders 5. developmental coordination and tic disorders

Executive function: cognitive (4)

1. Organize, prioritize, and activate 2. Focus, shift, and sustain attention 3. Regulate alertness effort and processing speed 4. Working memory and accessing recall

Family Systems: Rigid Triangles

1. Parent-child coalition: child becomes in alliance with one parent and excludes other parent -- can "parentalize" the child making them responsible for developmentally inappropriate tasks (i.e. emotional support for parent) 2. Triangulation: Child caught in middle of parents -- considered most stressful family dynamic for the child 3. Detouring: Parents devote all time and energy to children and ignore one another. -- parents may subtly encourage child's problems in order to keep avoiding their own marital issues

Behavioral Observation

1. Parents or other observers record baseline data to provide information about behaviors in real-life settings 2. Recordings may be done by parents or others (may not be 100% accurate) 3. Clinician may set up role-play simulation to observe children and their families

ASD categories of symptoms

1. Pervasive impairment in social communication and interaction 2. Restricted, repetitive patterns of behavior, interests, or activities

4 acts of child maltreatment

1. Physical Abuse 2. Sexual Abuse 3. Physical Neglect 4. Emotional Abuse

prevalence and etiology: Obstetric and pre-natal complications (5)

1. PreN infection- risk in child and adulthood 2. PreN exposure to influenza virus during the first semester of pregnancy > 7 times more at risk 3. PreN exposure to rubella virus, respiratory infection, malnutrition 4. Obstetric complications during childbirth 5. Episodes of hypoxia

Projective Testing

1. Present the child with ambiguous stimuli and asking the child to describe what he or she sees 2. The child projects his or her own personality, including unconscious fears, needs, and inner conflicts, on the ambiguous stimuli

Three types of diagnoses

1. Principle 2. Provisional 3. Other focus of clinical attention

Bowlby's Three Stages of Grief

1. Protest: child desperately tries everything possible to gain response from caregiver 2. Despair: sadness and grief similar to mourning 3. Detachment: unresponsive or passive to adults who attempt to engage (learned helplessness)

Clinical Interviews

1. Provide a large amount of information during a brief period 2. Include a developmental or family history 3. Most interviews are unstructured Semistructured interviews are more reliable

4 Types of Attachment

1. Secure: -- Children with this attachment style often receive consistent responsiveness by caregivers during times of distress. The parent/caregiver engages in positive bonding behaviors. Children often become distressed when separated from caregiver but soothe quickly once caregiver responds positively. 2. Insecure Avoidant: -- A child with this attachment may not outwardly express distress since they have learned that normal displays of need do not elicit a response from caregivers. They remain expressionless and undemanding as a way to keep their distance from others. 3. Insecure Resistant: -- This attachment style combines previous categories of ambivalent and anxious attachment. Children often express distress when caregiver leaves and is not easily soothed upon their return. Parents rarely meet needs consistently and usually meet them in an over-the-top manner confusing the child's expectations. 4. Disorganized -- This is an insecure attachment often developed when a child's attachment figure is both their source of safety and fear. The child does not develop clear attachment strategies

Executive function: emotional (2)

1. Self-regulation of arousal level -->State of excitement 2. Tolerating frustration

Piaget's stages

1. Sensory Motor 2. Preoperational 3. Postoperational 4. Concrete operational - Children's maturing brains build SCHEMAS which are used and adjusted through assimilation (adding to existing schema) and accommodation (altering schema w/ new info) -Social Cognitive Theory: internal schema and their influence on cognitive processes

Core deficits of autism: social interaction impairments (6)

1. Social or emotional reciprocity deficits 2. Unusual nonverbal behaviors Poor eye contact, socially inappropriate behaviors 3. Deficits in social imitation 4. Limited social expressiveness, and sensitivity to social cues 5. Impaired recognition of emotions, difficulty recognizing facial expressions 6. Deficits in joint attention

Debate about core deficits of ASD

1. Social-emotional development 2. Language development 3. Cognitive development

**5 developmental trajectories of adolescence

1. Stable adaptive 2. Stable maladaptive 3. Temporary maladaptive 4. Decline in adaptation 5. Reversal of maladaptation

ADHD subtypes (3): inattentive

1. Subclinical levels of hyperactivity-impulsivity 2. Sluggish cognitive tempo (SCT) Inattentive, daydreamy, drowsy, spacey, easily confused, "in a fog" 3. Originally ADHD-C Age-related reduction of symptoms of hyperactivity-impulsivity

Developmental psychopathology approach based on 7 core points or principles

1. Synthesis of studies on normal and pathological functioning 2. Continuities and discontinuities in development 3. Multiple levels of analysis 4. Multiple perspectives / multi-disciplinary perspective 5. Risk and protective factors 6. Reciprocal, transactional models 7. Social and cultural context

Symptom Categories for ODD

1. Temper 2. Argumentativeness 3. Vindictiveness

**Diagnosis using the AAIDD guidelines

1. The diagnostic criteria from DSM-5 are applied 2. Strengths and weaknesses 3. The level of support

The field of learning disabilities (Disorder) developed in response to

1. The need to understand those who displayed specific deficits in using spoken or written language while maintaining integrity in general intellectual functioning 2. The need to provide services to youngsters whose learning characteristics were not being adequately addressed by the educational system

ASD as a Disorder of Risk and Adaptation

1. The relationship between the child's early risk for ASD and later outcomes -Is mediated by alterations in how the child interacts with and adapts to his or her environment 2. Different children will follow different developmental pathways

Theories About Child Psychopathology

1. Theories attempt to explain the etiology of child psychopathology 2. No single model can explain the complexity so far 3. Many theories assume a simple linear association 4. Greater attention needs to be paid to the conditions under which particular models apply 5. Research often focuses on a specific static condition or the influence of a specific stressor

Accompanying Disorders and Symptoms of ASD

1. Two most common disorders: Intellectual disability and Epilepsy 2. Other disorders - ADHD, conduct problems, anxieties and fears, and mood problems 3. May engage in extreme and sometimes potentially life-threatening self-injurious behaviors (SIB)

ADHD: peer problems (5)

1. Unintentional problematic behaviors- they often see their behavior more favorably 2. Isolation and rejection 3. Lack of emotional regulation and sensitivity- aggressive 4. Sensation seeking is stronger than respecting the rules and getting along with others 5. Positive friendships may buffer negative outcomes

Use of 3 experimental approach

1. Usefulness of a particular treatment approach 2. Factors which improve responsiveness to treatment 3. Effects of behavior on the environment

Kazdin (2011): Specific parts of parental management training (14)

1. Using more immediate, frequent and powerful consequences, planning ahead, not personalizing the child's problem and practicing forgiveness 2. Reward and punishment system 3. Enjoyable time together, encourage child's success 4. how to reduce parent levels of arousal 5. Changing how the child responds in interpersonal situations 6. Learning-based procedures to develop behavior 7. Modeling 8. Setting events 9. Prompt and fading 10. Shaping 11. Positive reinforcement 12. Practice and repeated rehearsal 13. Extinction 14. Mild punishment

brain abnormalities- brain volume difference for ADHD (3)

1. Volumetric reductions in brain areas crucial for attention, working memory, decision making 2. Reduction amygdala: difficulty in emotional regulation, recognition of emotional stimuli 3. Reduction accumbens: reward process -->Children with ADHD have smaller total and right cerebral volumes, smaller cerebellum, delayed brain maturation

What are the limitations to diagnosing disorders?

1. We cannot always identify the underlying cause of children's disorders. 2. many children with disorders are best understood in an interpersonal context rather than within an individual.

Behavioral Assessment: Checklists and Rating Scales-

1. allow for a child's behavior to be compared with a known reference group 2. economical to administer and score 3. Lack of agreement between informants is relatively common, and is highly informative

CD Stages

1. antisocial symptoms 2. peer/family rejection 3. academic skills deficit 4. low self-esteem 5. gravitation toward other rejected peers 6. substance abuse 7. delinquency 8. limited opportunities 9. career antisocial offender

ADHD: impulsivity

1. blurts out answers/thoughts 2. can't wait in line, wait turn 3. interrupts, intrudes, butts in, often off track 4. fun trumps good judgement

ADHD: hyperactivity

1. fidgets with hands/feet 2. difficulty staying in seat 3. runs/climbs excessively 4. no quiet play 5. on the go, motor driven 6. often talks excessively

approach to using to organizing and using assessment information in terms of the "ABC's"

1. identify a wide range of antecedents and consequences 2. Develop hypotheses about which are most important and/or most easily changed

conduct problems: interventions

1. minor environment adjustment (more sleep) or minor tweaking (parent skill building) 2. behavioral parent training 3. multisystemic therapy 4. stimulant medication (found to be effective - consistent with Raine's theory

5 Core Principles of DP

1. normal development informs abnormal development; vice versa 2. Psychopathology focuses on deviations from normal dev pathways 3. Behavioral and Emotional DP share continuities and discontinuities 4. Interactions between biological and environmental factors determine healthy/pathological outcomes (diathesis stress, moderating variables etc) 5. DP Research relies heavily on understanding transactions (more complex than gene-environment interactions, incorporates culture, intricate social constructs, + genes and environment)

ADHD: inattention

1. poor attention to detail 2. can't sustain attention to tasks/play 3. doesn't listen 4. doesn't follow through on tasks 5. can't organize tasks 6. avoid tasks requiring sustained attention 7. loses things needed for tasks 8. distracted by extraneous stimuli 9. forgetful in daily activities

ABCs of assessment are to observe the...

1.Antecedents 2.Behaviors 3.Consequences of the behaviors

genetic influences for ADHD

1/3 in family, 60% risk of heritability (twin studies= 75% heritability for hyperactive and inattentive) -specific gene study: reward/sensation seeking and psychomotor activity (dopamine)(serotonin)

prevalence of depression lifetime

10-20%

perfect measurement

100% sensitive and 100% specific

Estimated cost of youth mental health treatment

12b

How prevalent are childhood disorders?

13-15% of youths experience a psychological disorder any given year

Major Depressive Disorder Age of onset

15-19 years (but some evidence that may start earlier, 13-15 years)

Number of Adolescents with Anxiety Disorder

17%

George Still

1902 described students with ADHD characteristics, the first formal description

Who identifed ASD

1943 by Leo Kanner - Group of children who presented with "extreme autistic aloneness"

Romanian orphan studies

1990's media attention directed to horrific conditions endured by children in Romanian orphanages. There was lack of nourishing foods, toys and social interaction. Many of these children were adopted and taken to more enriching environments

Rise in Autism

1990-2001: incidence by 5 years of age rose by 600% Possibly due to: increased awareness, broadened diagnostic category, differences in study methods, lower age of diagnosis, older age of parents

Bipolar disorders: I and II

1: At least one manic or mixed episode Usually accompanied by 1 or more depressive episodes, depression is not necessary for diagnosis 2: Major depressive episode lasting at least 2 weeks At least 1 or more hypomanic episodes

E‐CIGARETTES AND VAPING

2 most used sunstance after alcohol

lifetime prevalence of Generalized Anxiety Disorder GAD

2.2%

Lead and ADHD

20-30% higher Lead attaches itself to sites in the frontal cortex and striatum and disrupts brain development, brain activity, both

estimated cost of youth mental health problems

247b

associated characteristics: splinter skills vs. remarkable talents

25% have "splinter skills" (areas of high ability compared to individual's overall functioning) 5% have remarkable talents (extraordinary strengths compared to typical youth)

Anxiety Disorder Gender Differences

2:1 female to male ratio, except for panic disorders

Panic Disorder Ratio

2:1 male to female ratio

DSM criteria for CD

3 or more symptoms for >=12 months and 1 criterion in past 6 months Aggression (people/animals) Destruction of property Deceitfulness Severe violations of rules

Biological causes for autism

3-7% of family members also have the disorder. Twin rates of autism (36%-95%). Chromosomal abnormalities.

Diagnosis prevalence of GAD

37%

gender issues with conduct problems

3:1 - 4:1 boys to girls Narrows in adolescence Gender differences have decreased by more than 50% in past 50 years Crick & Grotpeter (1995) - over 80% of aggressive girls are not identified by a definition limited to physical aggression

Gender Difference CD

3x4 more common in boys earlier onset in boys CD: 2%-6% ODD: 12% Occur:

Old Prevalence rate Autism

4 in 10,000 (0.0004%)

What are the gender differences in autism

4-5 times more common in boys (girls more severely impaired)

Antisocial Personality Disorder Development

40% of children with CD develop APD as adults (Lahey et al., 2005)

ASD Treatment

400 different ones exist, no known cure. Goals are to minimize problems and maximize independence and quality of life for both individual and family members Components: -engaging children in treatment -decreasing disruptive behaviors -teaching appropriate social behaviors -increasing functional, spontaneous communication -promoting cognitive skills -teaching adaptive skills

Autism Gender Differences

4:1 male to female ratio

major depressive disorder

5 or more symptoms during a 2-week period with at least one symptom being either: (1) depressed mood, (2) loss of interest or pleasure Depressed mood most of the day nearly every day (feels sad, appears tearful, irritability) - in children this mood can be irritable Diminished interest or pleasure Change in body weight Insomnia/hypersomnia Psychomotor agitation/retardation (accelerated or slowed movement) Fatigue/ loss of energy Feelings of worthlessness/guilt Poor concentration, indecisiveness Suicidal ideation, thoughts of death

prevalence of depression

5% children and 10-20% adolescents, suicide among teens is a serious concern

prevalence of ADHD

5% of children, 2.5% of adults In 2016 Age 2-5: approximately 388,000 children Age 6-11: approximately 2.4 million children Age 12-17: approximately 3.3 million children

DSM Criteria: MDD

5/12 symptoms during same 2 weeks, change from previous level of functioning, 1 symptom must be depressed mood (1) or loss of interest in activities (2) 1. depressed mood/irritable 2. reduced interest/pleasure in activities 3. weight gain/loss 4. insomnia/hypersomnia 5. psychomotor agitation/retardation 6. fatigue/loss of energy 7. feelings of worthlessness/guilt 8. reduced ability to think/concentrate 9. recurrent thoughts of death/suicide with plan/attempt

CD outcome

50% active offenders decrease by early 20s, 85% decrease by late 20s. 40% of children with CD develop APD

Hyperactivity/Impulsivity Subtype

6 or more of following: -fidgety -often leaves seat when expected to remain seated -runs excessively -difficulty playing quietly -"on the go" always -often talks excessively -blurts out answers before question is finished -difficulty waiting turn -often interrupts or intrudes on others

Inattentive

6 or more of following: -makes careless mistakes, poor attention to detail -difficulty sustaining attention in work or play -often does not seem to listen when spoken to directly -does not follow instructions -loses things -easily distracted -forgetful in daily activties

prevalence of depression in adolescents

6-8%

onset bipolar

60% have first episode prior to 19, peak age: 15-19, before 10 is extremely rare. most report their first episode is depression. the earlier it start, the more chronic and resistant to treatment.

Lifetime Prevalence of Anxiety Disorders

8% - 27%

irritability and depression

80% of children and adolescents with depression in a clinic sample showed irritability

Panic attack

: sudden and overwhelming period of intense fear or discomfort accompanied by the flight/fight response; reaches a peak within minutes; includes physical symptoms such as heart palpitations, sweating, chest pain, dizziness; may also feel loss of control

The relationship between depression & social skills?

= negative correlation

Diagnostic criteria for Intellectual Disability (includes cognitive and adaptive)

A - Deficits in intellectual functions confirmed by both clinical assessment and individualized, standardized intelligence testing B - Deficits in adaptive functioning C - Onset during the developmental period

Multifinality

A basic principle of developmental psychopathology that holds that one cause can have many (multiple) final manifestations.

Neurobiological perspective

A biological perspective. Views brain and nervous system functions as underlying causes of psychological disorders. Brain continually changes as it adapts to its environment

Behavioral genetics

A branch of genetics that investigates possible connections between a genetic predisposition and observed behavior

Intervention

A broad concept that encompasses many different theories and methods with a range of problem-solving strategies directed at helping the child and family adapt more efficiently to circumstances

Preservation of samess

A characteristics of children with ASD who show an anxious and obsessive insistence on the maintenance of sameness that no one but the child may disrupt

What does hypothesis testing assess?

A child's emotional, behavioral, and cognitive functioning; the role of environmental factors; nature, causes, and likely outcomes of the problem

How does culture affect the identification of childhood disorders?

A childs ethnicity can affect their likelyhood of being diagnosed in 4 ways: 1. the cultural values of the childs family may be different from those of the clinician. 2.immigrant families may experience increased stress due to acculturation. 3. language differences can cause communication problems between the clinician and the family. 4. minority children are often underrepresented in mental health research.

Syndrome

A cluster of symptoms

Autism Spectrum Disorder

A complex neurodevelopmental disorder characterized by abnormalities in social behavior, language and communication skills, and unusual behaviors and interests

Autism Spectrum Disorder (ASD)

A complex neurodevelopmental disorder characterized by abnormalities in social behavior, language and communication skills, and unusual behaviors and interests

Developmental pathways

A concept to describe the sequence and timing of particular behaviors and to highlight the known and suspected relationships of behaviors over time

Social cognition

A construct to describe how people think about themselves in relation to others, and how they interpret ambiguous events and solve problems

Externalizing

A continuous dimension of behavior that includes mixture of impulsive, reactive, and aggressive acts that violate social norms

Disadvantages to diagnosing children

A diagnosis may not accurately reflect a childs environmental contect, may focus too much on individual, lead to stigma.

DMDD (disruptive mood dysregulation disorder)

A direct response to concerns about the increasing rates of bipolar diagnoses in young children and growing use of meds. (Alternative to BP). Temper outbursts (verbal rages, physical aggression), mood between tempers is persistently irritated or angry, ABSENCE OF MANIA. (12 or more months) Basically emotional disturbance cannot be diagnosed before 6 or after 18

Speech sound disorder

A disorder in which children have trouble controlling their rates of speech or lag behind playmates in learning to articulate certain sounds

Conduct Disorder (CD)

A disorder in which individual must display at least 3/15 criteria across four areas: 1) aggression to people or animals 2) destruction of property 3) deceitfulness or theft 4) serious violations of rules Needs to last at least one year

Neuropsychological assesment

A form of assessment that attempts to link brain functioning with objective measures of behavior known to depend on an intact CNS

neurodevelopmental disorders

A group of conditions with an onset in the developmental period that typically: - manifests in early development - characterized by developmental deficits that produce functional impairments -frequently co-occur with other disorders

Bipolar II

A hypomanic episode plus one or more depressive episode

Bipolar I

A manic episode plus one or more depressive episode

Discrete trail training

A method of teaching readiness skills or other desired behaviors that involves a step by step approach of presenting a stimulus and requiring a specific response

Incidental training

A method of teaching readiness skills or other desired behaviors that works to strengthen the behavior by capitalizing on naturally occurring opportunities

ADHD (Attention-Deficit Hyperactivity Disorder)

A neurodevelopmental disorder that is either predominately inattentive, predominately hyperactive-impulsive, or combined presentation

Dopamine

A neurotransmitter associated with movement, attention and learning and the brain's pleasure and reward system. "Switch" for other neurotransmitter systems to facilitate emotions or behavior; associated with pleasure-seeking behavior

Coercion Theory (Patterson)

A parent-child dynamic that reinforces argumentative or defiant behaviors by giving in to them and allowing the child to get what they want after these behaviors

Psychological disorder

A pattern of behavioral, cognitive, or physical symptoms that include one or more of the following prominent features - Some degree of distress in the subject - Behavior indicating some degree of disability - An increase risk of suffering, death, pain, disability, or an important loss of freedom

autistic savant

A person with ASD who has a remarkable talent far exceeding normally developing children

Fast track

A program for kinder children at high risk for CD, (grades 1-10). Components: -PMT -social cognitive skills training -academic tutoring -teacher-based class intervention

Cognitive Perspective

A psychological approach that emphasizes mental processes in perception, memory, language, problem solving, and other areas of behavior

evidence based treatment

A psychotherapy technique whose effectiveness has been supported by empirical research.

Equifinality

A result can come from many possible reasons

Stigma

A set of negative and often unfair beliefs that a society or group of people have about something

Decoding

A skills necessary for reading that involves breaking words down into parts

Operant speech training

A strategy used to help children use language more appropriately

Cortisol

A stress hormone produced by the adrenal gland

Retrospective Design

A study based on outcomes that have already occurred and compare them to past variables (childhood trauma v. non-stressful childhood ← Obesity v. Healthy weight)

DSM-5 Definition of Mental Disorder

A syndrome characterized by clinically significant disturbance in cognition, emotion regulation or behavior that reflects a dysfunction in psychological, biological or developmental processes Usually associated with significant distress or disability in social, occupational or other activities

Classification

A system for representing the major categories or dimensions of child psychopathology and the boundaries and relations among them

Moderators

A variable that will affect the outcome- (either increasing or decreasing the likelihood of a specific outcome), but not determining if it occurs. Ex: Girls are more likely to display depressive symptoms, but only if they undergo early puberty; Early puberty would be the example of this (Gender would be the IV).

MDD Criteria

A. 5+ symptoms for 2+ week --Depressed mood --Energy loss or fatigue --Anhedonia --Death thoughts and/or suicide --Sleep disturbances --Worthlessness and/or guilt --Appetite or weight change --Mentation decrease --Psychomotor agitation and retardation B. Causes distress or impairment C. No drugs or med D. Diff diagnosis E. No manic or hypomanic episode

Manic episode criteria

A. Abnormally and persistently elevated mood (very irritable or very happy for at least one week present for most of day). B. Manic symptoms (3 or more) C. Impairment, hospitalization, or psychotic features (mood disturbances are sufficiently severe that causes social or occupational dysfunction or necessitates hospitalization to prevent harm of self or others OR psychotic features present)

Behavioral Treatments

A. Assume that behaviors are learned B. Focus is on re-educating the child 1. Procedures include: -Positive reinforcement or time-out -Modeling -Systematic desensitization -Changes in the child's environment

DSM-5 Criteria for Specific Learning Disorder

A. Difficulties in learning and using academic skills for at least 6 months in spite of the provision of interventions B. Skills are below expectation for age and cause significant problems as confirmed by individually administered standardized tests C. Difficulties begin in the school-age years, but may not become fully apparent until the demands exceed the individual's capacity D. Not better accounted for by ID, sensory deficits, neurological disorder, lack of language proficiency or inadequate instruction

GAD Criteria

A. Excessive anxiety and worry occurring more days than not for at least 6 months B. individual finds it difficult to control the worry C. three of six symptoms (only one for child) --Tension in muscles --Concentration difficulties --Hyperarousal (irritability) --Energy loss (easily fatigued) --Restlessness --Sleep disturbances D. symptoms cause clinically significant distress or impairment E. Not due to substance or other med condition F. not better explained by another disorder *accompanied by at least one somatic symptom (headache etc)

DSM-V diagnostic criteria for ASD (2)

A. Impairments in social communication and in social interaction B. Restricted, repetitive, and stereotypes patterns of behavior, interests, and activities

DSM-5 criteria

A. Persistent deficits in social communication and social interaction B. Restricted, repetitive patterns of behavior or interest C. Symptoms present early in the developmental period D. Symptoms cause clinically significant impairment E. Not better explained by intellectual disability or global developmental delay

DSM-5 criteria for ASD

A. Persistent deficits in social communication and social interaction (most important) B. Restricted, repetitive patterns of behavior or interest (most important) C. Symptoms present early in the development period D. Symptoms cause clinically significant impairment E. Not better explained by intellectual disability or global developmental delay

RAD Criteria

A. consistent pattern of inhibited emotionally withdrawn behavior towards caregivers manifested by both of following: 1. child rarely/minimally SEEKS comfort when distressed 2. child rarely/minimally RESPONDS to comfort when distressed * know capitalized words for matching

Treatment of autism: ABA (5)

ABC models 1. Discriminative stimulus: stimulus that evoke a behavior. It signals that the reward is available 2. Prompt: an added antecedent stimulus that help the execution of a behavior 3. Mand: a "request" one of the first verbal skills that is taught "can I have an apple?" 4. Tact: a verbal response to a non-verbal stimulus "Look! An airplane!" 5. Intraverbal: basic verbal response ("fine" is the intraverbal of the question, "how are you?")

a highly prevalent brain based disorder associated with lifelong impairment. environmental factors can contribute to the expression and severity

ADHD

Competing Diagnoses Bipolar

ADHD (80% meet criteria), DMDD, ODD

Comorbidities of CD and ODD

ADHD 50% Depression and Anxiety 50% ODD more likely than CD

The prevalence of what disorders is higher among white non latino children?

ADHD and ASD is more prevelant for white youths. The prevalence of disruptive disorders is higher among african american children.

CD childhood comorbidities

ADHD, ADD, low IQ, neurophsychological deficits

2 most common neurodevelopmental disorders:

ADHD, AUTISM

Problems more commonly reported among males:

ADHD, Childhood Conduct disorder, intellectual disability, Autism Spectrum disorder, Enuresis, Language Deficit Disorder, specific learning disorder

Name and describe 2 strategies you think would be effecting in treating one of the disorders we discussed in class or from the book (1-2 sentences)

ADHD: 1. Connect and Redirect --fits of rage or frustration 2. Use it or lose it: finding way to help them self-regulate, develop empathy, and make sound decisions

What are some contextual theories and causes for eating disorders?

AN is found in all countries. BN appears to be more a disorder of Westernized culture.

Description and History

ASD refers to pervasive developmental disorders (PDDs) characterized by significant impairments in social and communication skills, and by stereotyped patterns of interests and behaviors 1. Kanner (1943) coined the term "early infantile autism" to describe young children with autistic symptoms 2. Asperger (1944) defined a milder form of autism ► Asperger's disorder 3. Autism is a biologically-based lifelong neurodevelopmental disability present in the first few years of life

Conduct Disorder

ASPD lite, repetitive and persistent pattern of violating basic rights of others and societal norms

Sustained attention

Ability to concentrate on and maintain persistent focus over time or when fatigued

Selective attention

Ability to concentrate on relevant stimuli and not be distracted by noise or other elements of external environment

**Why was important to combine 2 approaches

Able to identify patterns of normal development

Assumption 1:

Abnormal behavior is multiply determined (must look beyond current symptoms and look at developmental pathways and interacting events)

Assumption 3:

Abnormal developments involve continuities and discontinuities

HPA axis dysregulation

Abnormal pattern of cortisol release State of fear, stress, vigilance that can be problematic

SES

About 1 in 6 children in North America live in poverty Poverty is associated with greater rates of learning, academic and conduct problems, chronic illness, hyperactivity, and emotional disorders

Onset of pediatric bipolar disorder

About 60% of people with bipolar disorder have first episode prior to age 19 Onset before age 10 is extremely rare

5%

About ___ of individuals with ASD are autistic savants

Academic Problems with conduct disorder

Academic underachievement, grade retention, special ed placement, drop out, suspension and expulsion (Roeser & Eccles, 2000) Academic underachievement may be due to comorbid conditions (AD/HD & LD)

associated characteristics of ADHD: medical/physical concerns

Accident-proneness and risk-taking/sensation-seeking (HI+) -Risk-taking behaviors: early initiation of smoking, drugs, risky sex -Reduced life expectancy -Higher medical costs 1. Asthma 2. Dental health problems, poor fitness, obesity, eating problems and disorders 3. Sleep disturbances 4. Issues with dopamine regulation

Mediating Variables

Account for some or all of the apparent relationships between the apparent relationships between two variables (ineffective parenting, parent substance abuse)

Moral Insanity

Accounting for non-intellectual differences in children

ASEBA

Achenbach system for empirically based assessment, can be completed by parents, teachers, or older youths to assess a wide range of externalizing and internalizing symptoms.

Prevention

Activities directed at decreasing the chances that undesired future outcomes will occur

Epinephrine

Acts as a neurotransmitter and as a stress hormone, controlling the body's "fight or flight" response

Child Maltreatment

Acts by adults that either harm or have the potential to harm children's health, development, or survival

Psychodynamic theory (depression)

Actual or symbolic loss of a loved one

**Virginia Axline

Adaptation of client-centred therapy to be suitable for young children - Play itself is seen as therapeutic - The child is given the opportunity to express feelings and solve problems in the accepting environment of the relationship with the therapist - Based on the belief that the child has the potential to solve their own problems and come to terms with traumatic experiences - Therapy emphasizes respect and acceptance of the child as they are - The therapeutic environment is one which is seen by the child as a safe place to express negative or threatening emotions and to experiment with different ways of handling problems

Are children or adolescents more likely to experience a psychological disorder?

Adolescents

Course of pediatric bipolar disorder

Adolescents with mania typically have psychotic symptoms, unstable moods, severe deterioration in behavior Early onset and course is chronic and may be resistant to treatment

prevalence and etiology: environmental factors (neglect vs. mistreatment)

Adverse experiences and negative familial interactions can contribute Childhood neglect→ negative symptoms Childhood mistreatment→ positive symptoms

Specific Learning Disorder

Affected academic skills are substantially and quantifiably below expected based on chronological age and interfere with academic or occupational performance or activities of daily living; if older than 17, documented history can be used Difficulties learning and using academic skills

Serotonin

Affects mood, hunger, sleep, and arousal

Separation Anxiety Disorder

Age inappropriate, excessive anxiety about being apart from parents or away from home Often associated with school refusal

What defines childhood disorders?

Age inappropriateness and symptoms and impairment of functioning is a key consideration

persistent depressive disorder: onset, course, outcomes

Age of onset most commonly 11-12 years Mean episode 3-4 years Recovery 73.9% of cases. Median time to recover 4 years Relapse 71.4% of cases Adolescents with P-DD receive LESS social support than those with MDD

Dimensional (Research Domain Criteria/RoDC)

Aims to understand commonalities across different disorders that reflect underlying neural pathways e.g. positive valence pathway - disrupted in depression (anhedonia) High, low, or medium disruption within different dimensions - evaluated with scores for depression symptoms Disorders are present in everyone in varying degrees - everyone falls somewhere on the continuum

How is attachment studied?

Ainsworth's Strange Situation

Neural Plasticity

Aka malleability, the brain's ability to change throughout the course of development based on experiences. More sensitive and vulnerable in early development

Prevalence Rates

All cases, new or previous, that are observed during a specific time period

What is the Dodo Bird Verdict?

All therapies and treatments are equal

Symptoms of Schizophrenia

Alogia = poverty of speech Avolition = lack of desire or drive to pursue goals Delusions - false beliefs Hallucinations - auditory or visual Catatonia - don't move Flat affect - don't show any expressions Avolition - don't have the will to want to do things

Developmental Psychopathology

An approach for understanding the origins of mental disorders among children and adolescents

Health promotion

An approach to prevent of disease that involves education, public policy

Behavioral approach

An approach to psychology emphasizing the scientific study of observable behavioral responses and their environmental determinants.

Direct instruction

An approach to teaching children with learning disorders based on the premise that to improve a skill the instructional activities have to approximate those of the skill being taught

Exposure therapy

An approach to treatment that involves confronting an emotion-arousing stimulus directly and repeatedly, ultimately leading to a decrease in the emotional response

Personality disorder

An enduring pattern of inner experience and behavior that deviates noticeably from the expectations of the individual's culture, resulting in clinically significant distress or impairment in functioning

Randomized Controlled Trial

An experimental study in which researchers randomly assign individuals to either an experimental or a control group and expose the experimental group to the manipulated variable of interest.

Randomized Controlled Trial (RCT)

An experimental study in which researchers randomly assign individuals to either an experimental or a control group and expose the experimental group to the manipulated variable of interest.

Summer treatment programs

An intensive 8-week treatment for children (5-15) in a camplike setting that coordinates medication, PMT, social skills training, and educational interventions

Transaction

An interaction of an individual with one or more other persons, especially as influenced by their assumed relational roles of parent, child, or adult

Symptom

An observable behavior or state

Temperament

An organized style of behavior that appears early in development and shapes an individual's approach to his or her environment and visa versa

**Diagnosis

Analysis of the problem and/or a specific diagnostic label (description of the problem)

Externalizing

Anger, aggression, impulsivity, non-compliance with rules

Biological function of Anxiety

Anxiety is an evolutionary adaption to fear. Moderate amounts of anxiety can help to avoid danger and make people more productive.

Internalizing

Anxiety, sadness, withdrawal, shyness

Girls - report greater frequency and intensity

Anxiety: Boys versus Girls

Risk

Anything that increases the likelihood of negative outcomes (this includes isolated events with short-term outcomes)

False negative

Appears negative when it should not

Rates are 3 x higher in biological vs adoptive parents

Are biological ADHD rates higher in biological or adoptive parents?

**Organic impairments

Are psychological issues caused by issues in the brain

Functioning

Are they better in school, etc

Family system theorists

Argue that understanding or predicting the behavior of a particular family member cannot be done in isolation from other family members

ODD Argumentative/Defiant Behavior

Arguing with authority figures, adults Actively defies or refuses to comply with requests Point is to say no, power struggle Deliberately annoying Blaming others

New Directions

As many as 70% to 80% of children and families with significant mental health needs do not receive any specialized assessment or treatment services

History and evolution of autism: Aspergers

Asperger (1944)- "Asperger's disorder" described milder form of autism

Psychophysiological Methods

Assesses the relationship between physiological process and behavior. Limited by inconsistent findings, interference and extraneous influences

Idiographic case formulation

Assessments focus on obtaining detailed understanding of the child or family as a *unique entity*

Behavioral treatments

Assumed behavior is learned and tries to re-educate child

family approach

Assumed problem Stressful relationships Aims of therapy Relationship healing Key techniques Meet with family members; understand family system; ....explore rules, roles, and alliances; improve ....communication and boundaries

Biological model

Assumes that there is an underlying biological pathology which must be treated in order for the LD child to learn

Psycho neurological model

Assumes that treatment must focus on the underlying psychological deficits

High SES kids and risk

At a higher risk for substance abuse

Oppositional Defiant Disorder (ODD)

At least 4/8 criteria met across 3 dimensions: 1) negative affect (angry/irritable mood) 2) defiance (argumentative behavior) 3) hurtful behavior (vindictiveness) Lasting at least 6 months, only needs to be present in at least one setting

Examples of evidence to identify EBTs

At least two high-quality RCTs by multiple investigators (multiple sites) Three different investigators or research groups conducted five high-quality single subject design studies

Reactive Attachment Disorder

Attachment disorder in which a child with disturbed behavior neither seeks out a caregiver nor responds to offers of help from one; fearfulness and sadness are often evident

**Social learning

Attempts to expand on the behavioral approach by including the notions of vicarious and observational learning Ex: Child may learn to be aggressive due to parent being aggressive and they get their way

ADHD

Attention Deficit Hyperactive Disorder

Interpretation (social cognitive factors in CD)

Attribute hostile intentions to ambiguous events (hostile attribution bias)

Attributions and Interpretation of events

Attributions change how we respond to a stimulus Example: How do you feel about being called on in class?

possible causes/contributors to autism: brain abnormalities

Atypical connectivity and communication across brain networks (cortical-subcortical or interhemispheric): 1. Cerebral gray and white matter overgrowth 2. Decreased blood flow in frontal and temporal lobes 3. Default mode network: when you focused on the internal world 4. Elevated serotonin in 33% of cases 5. Disengagement of attention, joint attention, intentional communication, social imitation and linguistic information (fusiform gyrus) 6. Reward mechanism (amygdala): consolidates memories of social-emotional experiences

Parietal lobe

Auditory, visual and tactile signatures

Dawson (2008): role of brain-environment interaction and epigenetics

Autism not static but dynamic postnatal brain development and behavior --.Core autism--comorbid mental retardation-- comorbid language impairment

Course and outcome MDD

Average episode lasts 8 months, girls increase more after adolescence, most children eventually recover from initial episode but the disorder does not go away, Recurrence= 25% chance in one year, 40% in 2, 70% in 5, 1/3 develop bipolar, Overall outcome is not optimistic

differences between AN and BN

BMI - Weight "control" - anorexics feel that they are in control while bulimics feel out of control in an episode

Observational Learning

Bandura: bobo doll experiment How does this explain psychopathology? Conduct disorders Kids tend to follow/ copy parents, peers, and siblings

Group of structures that work together Important for response control and inhibition Lesions here result in symptoms that look like ADHD

Basal Ganglia

BASC-3

Behavior assessment for children, self report of personality assesses problem areas and areas of strength and adaptation in older kids and adolescents

Child Psych 1950s-1960s

Behavioral family was the systematic approach to behavioral disorders

Education Intervention

Behavioral treatment that involves classroom accommodations

Restricted and repetitive behaviors

Behaviors that are characterized by their high frequency , repetition in a fixed manner, and desire for sameness in the environment

Emotional disregulation

Being fearful and acting in a fearful manner for no particular reason (low emotional knowledge can lead to abnormal development)

Exposure to crime in area that you live like the city. Just having extra familial stressors like poverty leads to other opportunities that influence CD. Engaging in stealing behavior because they have no other access to those things. Being treated differently by peers and teachers. Parents in poverty probably don't work normal work hours and are not able to attend to their child as often.

Being in poverty one of the strongest predictors of CD and crime, Why?

Long-term outcomes of BN

Between 50%-75% show full recovery (Collings & King, 1994) Predictors of positive outcome: Younger age at onset Higher social class Removal from social pressures emphasizing thinness

Age ranges for diagnosing DMDD

Between 6 and 18

Developmental Framework

Biological Context: genetics, biochem, brain structure, neurological/neuropsychological factors (i.e. temperament) Individual Context: personality, thought process, emotional and internal expectations of relationships Family Context: parent-child relationships, abuse/neglect Social Context: peer relationships (popularity, rejection, friendship), extra-familial relationships (pastors, teachers, mentors) Cultural Context: social class, poverty, race/ethnicity

Developmental psychopathologists believe that development is shaped by multiple probabilistic factors.......

Biological, psychological, social, and the result of these factors influence over time.

ASD causes

Biologically based but a spectrum of possible causes, some specific genes known but many are not. Twin studies show it is partly genetically based

Bipolar disorders (early onset)

Bipolar 1, Bipolar 2, cyclothymic disorders

CD neurobiology

Both groups show smaller amygdalas, dysfunctional decision-making circuits, socioemotional info circuits, and emotion regulation

Order of Brain Development?

Bottom Up -- Brainstem --> Diencephalon/Cerebellum --> Limbic System --> Cortex

Sex differences in mental health

Boys and girls express problems in different ways. Boys usually show more externalizing problems, girls show more internalizing problems

Are boys or girls more likely to be diagnosed?

Boys are more likely to be diagnosed with a psycholgical disorder in early childhood, specifically with ADHD and ASD

How are risk factors quantified?

By using statistical research models

What is the standard treatment for BN

CBT Used for moderate to severe symptoms of BN

Assessment of autism: universal screening

CDC recommends universal screening at 18-24 months -most children diagnosed at age 4, reliably diagnosed at age 2, ASD at 18 months or earlier

Adolescent susceptibility in marketing

CDC ‐ nearly 4/5 MS and HS students exposed to e‐cigarette ads from at least one source in 2016 (12% more than in 2014) • Fun flavors and appearance make them appealing to youth • Little regulation on labeling, which is sometimes inaccurate (

Culture in mental health

Certain beliefs and practices can raise children in different environments to respond to different things, including how people treat children and how problems are expressed

Cognitive-Behavioral Approach

Change maladaptive Change antecedents, teach new skills/ behaviors, & modify consequences Increase behaviors Teach cognitive and behavioral coping strategies

Development

Change which occurs over the life span

Transitory Childhood Characteristics

Characterisitcs that change through growth/ over time shyness, anxiety, phobias

Conduct Disorder Definition

Characterized by persistent antisocial behavior that violates rights of others and age-appropriate norms

Unproven Treatments for autism

Chelation therapy Hyperbaric oxygen chambers - highly oxygenated chambers Secretin therapy

Examples of Dimensional Classification Systems

Child Behavior Checklist Conners' Rating Scales Child Depression Inventory

Assumption 2:

Child and environment are interdependent and interact dynamically (nature and nurture work together). Also known as transactional view

Attachment theory (depression)

Child confronted with unresponsive and emotionally unavailable caregiver. Goes through protest, despair, and detachment. Insecure= unworthy and unloved, views others as a threat or undependable.

Single Case Experimental Designs

Child is the base and involves systematic and repeated assessments over time. Examples are ABAB and Multiple baseline approaches. Limited by limited generalization and possible interaction between treatment and subject characteristics

Active rGE

Child seeks out environment that is consistent with their genetic predispositions

Evocative/reactive rGE

Child's genetic traits bring about a particular environmental response

age differences in cos

Childhood Onset Schizophrenia is not distinct from adult schizophrenia; it is a more severe form

Course and outcome PDD

Childhood onset has prolonged duration, generally 2-5 years, Poorer response to treatment, greater long-term morbidity, and greater familial loading, More severely impaired, most children eventually recover but are at high risk for developing other disorders

CD Types

Childhood-onset and adolescent-onset

Alternative to Transactional Model

Children react differently to their environments

John Locke beliefs on children

Children should be raised with care, not harsh treatment

psychodymaic play therapy

Children symbolically communicate their mental processes through play. Through interpretation, make child more aware of unconscious processes

Intergenerational transmission of stress

Children who experience high prenatal stress are more likely to be more susceptible to stress and anxiety

initial improvement in academics

Children with AD/HD who receive medication often show what?

instant gratification rewards// perform poorly if delayed gratification

Children with ADHD have a particular preference for what kind of rewards and will perform poorly if what?

possible causes/contributors to autism: early development (4)

Children with ASD have more health problems prenatally, at birth, and neonatally -Prenatal and neonatal complications have been identified -Parental age -IVF -Maternal use of drugs- illicit and prescribed

**Sigmund Freud: Play Therapy - Psychoanalytic

Children's play may have a therapeutic function

associated characteristics of ADHD: social-emotional problems

Children: Don't listen, are hostile, argumentative, unpredictable and explosive, Do not respect rules, don't learn from past mistakes Parents: negativity, child noncompliance, excessive parental control, sibling conflict Peers: emotionally immature, stubborn, socially awkward, socially insensitive, bothersome

flooded exposure

Classically conditioned method of exposure that moves faster than graded exposure; typically used for fears that are impossible to expose in a graded way. Ex. A patient who is afraid of puppies would sit in a room with a puppy- while eating their favorite food --> building a new and competing association with dogs

Efficacy

Clean Well done Organized Uncomplicated kids: only study one trait or no comorbidity

callous-unemotional traits (CU)

Cluster of traits used to designate a subgroup that has more severe and pervasive symptoms and poorer treatment outcomes. -less responsive to punishment and distress in others -more thrill-seeking behaviors (consequences don't matter to them)

Attention

Cognitive process that is indicative of absorption Changes as people grow up Sign of development

executive function

Cognitive processes in the brain that activate, integrate, and manage other functions Self-regulation functions: self-awareness, planning, self-monitoring, and self-evaluation

Characteristics of Romanian Orphans

Cognitive: IQ 40 points below mean Physical: Clumsy, poor balance Affective: very emotional, depression

Double depression" is common During the course of DD (persistent depressive disorder), as many as 70% of children have an MDD episode (Renouf & Kouvacs, 1995) Anxiety disorders AD/HD Conduct problems Substance use disorders Eating disorders

Common comorbid diagnoses for depression

Between group comparison designs

Compare experimental group and control group

Behavioral AssessmentChecklists and Rating Scales

Compares child's behavior to a normative sample Usually economical to administer and score Lack of agreement between informants is relatively common, and can be informative

Natural experiments

Comparisons between conditions that already exist

Sleeper (delayed) effect

Complicate study of risk and protective factors

Why is the biological perspective so compelling?

Concrete Quick fix Prevention tactic Just a different brain- not bad parenting Funding Verification Exoneration of others as a cause

Principle Diagnosis

Condition that is chiefly responsible for impairment and distress

What childhood disorders may be explained by the emotional perspective

Conduct disorders Anxiety Mood disorders

Disorganized Disoriented

Confusion about whether to approach or avoid mother; "freezing" or stilling for periods of time

issues interviewing younger children

Consider age of child when interviewing Very young children may have difficulty articulating feelings Middle childhood - may have trouble understanding source of feelings Adolescents-may be suspicious, concerned about where information is going

Idiographic case conceptualization

Consider the unique circumstances, personality, etc. of each case

Standardization

Consistency and objectivity of how tasks are administered and scored; Participants must receive identical testing and scoring measures.

Life-course persistent pathway (conduct problems)

Consistent conduct behaviors almost all their life and usually more severe behaviors

**Pervasive

Constant and high-intensity support over several settings

Positive Symptoms: Thought Disturbances (2)

Content of Thought -Religiosity -Delusions -Paranoia -Magical thinking (Slenderman) Form of Thought -Tangentiality -Loose associations -Perseveration -Neologisms

Treatment

Corrective actions that will permit successful adaptation by eliminating or reducing the impact of an undesired outcome that has already occurred

correlation

Correlation does not imply causation, but it does waggle its eyebrows suggestively and gesture furtively while mouthing 'look over there.' Patterns of relationships between variables Positive vs. negative correlation Sign (+, -) = Direction of relationship Number (range = 0 to 1) = Strength of relationship Increase in depression, decrease in social skills = negative correlation

_______________ is the majority of research in the field (DP); cannot infer causality

Correlational Research

Structural observation

Cost effective and in structured environment. Allows for focused attention in a set up and standardized space. Limitations are observer's presence can affect outcome and unsure if sample represents real life

Emotions on development

Critical for healthy adaption, provide motivation for action, good for internal monitoring and guiding

PBD vs. DMDD (persistent depressive disorder) (disruptive mood dysregulation disorder)

DMDD Absence of manic or hypomanic episode DMDD can coexist with MDD< ADHD, CD, and substance use disorder

dandelion vs. orchid children

Dandelion: withstand and grow in a variety of conditions Orchids: can bloom amazingly but are hard to take care of and finicky

Oppositional Defiant Disorder (ODD)

Defiant or vindictive behavior and resentment toward authority Similar to CD but less severe and more acting out toward authorities than peers

Cognitive deficits

Deficits in basic cognitive processes, including attention, memory and processing speed Poor problem solving Adhd and locker: kicking, hitting, yelling

What is research meant to do?

Define normal and abnormal behaviors in children of different ages, sexes and ethic backgrounds

Defining Abnormal Behavior

Definitions of abnormality define what a disorder is and who gets treatment - influences public perception of abnormality

External validity

Degree to which findings can be generalized to other people, places, times, etc. Threats are: - Characteristics of individual participants - Subjective reactivity to participation - Setting - Time measurements are made

Important Factors to Consider in Abnormal vs. Normal Dev.

Demographic info: child's AGE Frequency Intensity (behavior deficit or excess) Duration Different Settings?

Persistent Depressive Disorder (Dysthymia)

Depressed mood for most of the day, for more days than not for at least 2 years (in children, mood can be irritable, duration is 1 year) 2 or more of the following: Poor appetite; over-eating Insomnia or hypersomnia Low energy, fatigue Low self-esteem Poor concentration, indecisiveness Feelings of hopelessness

Mood disorders

Depressive and bipolar disorders

Categorical

Derives from medical model Very black or white Discrete categories People who have disorders are fundamentally different from people who do not

Temporal discounting

Desirability of a reward relative to how quickly that reward arrives

What is abnormal?

Determining "normal" and "abnormal" requires a standard; looks at deviation from the average Typical rate and sequence of growth Typical forms of physical skills, language, cognition, emotion, and social behavior -Not easily defined Pattern of behavioral, cognitive, emotional or physical symptoms that is associated with (one or more): Distress Disability Increase risk for further suffering or harm

ASD course and outcome

Develop along different pathways Often gradual improvements with age Minority of people live and work independently (but old age is very unknown)

SIT creator

Developed by Meichenbaum (1977)

Discontinuity

Developmental changes are abrupt and qualitative; not predictive of future behaviors (eating disorders and autism)

Continuity

Developmental changes are gradual and quantitative; predictive of future behavior patters (early onset and persistent conduct disorders)

DPP

Developmental psychopathology Dpp = the study of normal development that 'has gone awry" the origins and developmental course of disordered behavior Dpp also studies adaption and success DPP is the integration of various theories .

ADHD Limitations of DSM criteria

Developmentally insensitive--need for clinical judgement (reduction from 6->5 symptoms for diagnosis in adolescents and adults) -Categorical view of ADHD: no consideration of cases on the "edge" -overdiagnosis

Onset PDD

Develops 3 years earlier than MDD, 11/12 years, could be precursor of MDD

cerebal cortex

Develops last, controls high-order processes

Why it's important to understand abnormal development in order to diagnose abnormal development

Diagnosed disorders at different stages pertain to individual's ability to perform different developmental tasks (ex: autism is usually identified in infancy due to infant's lack of desire to connect and use language)

DMDD: age of onset, duration, diagnoses

Diagnosis should not be made for the first time before age 6 years or after age 18 years Age of onset before 10 years -cannot coexist with ODD, intermittent explosive disorder in presence of DMDD and ODD= DMDD

DSM-5

Diagnostic and Statistical Manual of Mental Disorders

DSM-5

Diagnostic and Statistical Manual of the American Psychiatric Association - 5th Edition

Abuse/maltreatment increased risk for CD in low-risk 5-year-olds by 2%; in igh-risk 5-year-olds increased risk by 24% (conduct disorder)

Diathesis Stress Model (multiplicity)

How does multiplicity explain the development of this disorder?

Diathesis-Stress Model

Diathesis-Stress Model of GxE

Diathesis: vulnerability Conditions of extreme stress activate genetic predispositions for psychological problems

Alleles

Different forms of a gene

Bronfenbrenner's Ecological Model

Different layers of influence on a child divided into four systems (micro, mess, exo, macro)

Cross sectional designs

Different subjects of different ages at the same time

CD progression

Different temperament Hyperactivity Overt conduct problems Withdrawal Poor peer relationships Academic problems Covert or concealed conduct problems Association with deviant peers Arrest

Problems with the IQ-Achievement Discrepancy Approach

Difficult to identify early (usually identified around 3rd grade); late identification makes remediation more difficult waiting to fail

Weak Central Coherence

Difficulty pulling together a lot of details to form a bigger picture. "cant see the forest for the trees". They get caught up in the details

Diagnosing Conduct Problems

Difficulty: balance between over-diagnosing common problems of children and ignoring serious problems that may evolve

Molecular genetics

Directly looks at DNA sequences and variations of a trait or traits. Are polygenic

Insecure Anxious-Ambivalent

Disinterest in exploration; fearful of strangers; mixes active contact-seeking with crying & fussiness; doesn't settle during reunite

Dyslexia

Disorder of reading not due to low intelligence

Reactive Attachment Disorder vs. Disorganized Attachment

Disorganized has no attachment strategies but still an attachment while RAD has NO attachment

CD categories

Disruptive, impulse-control (ODD), conduct disorders, and antisocial personality disorder

similarities between AN and BN

Distorted cognition - body dysmorphia Both include possible purging behaviors Both trying to prevent weight gain

Hallucinations

Disturbances in perception in which things are seen, heard or otherwise sensed even though they are not real or present

Delusions

Disturbances in thinking involving disordered thought content and strong beliefs that are misrepresentations of reality

Cognitive-Behavioral treatments

Disturbances result of faulty thought patterns and learning/environmental experiences

**Equifinality

Diverse paths or factors can be associated with the same outcome

Slow-to-warm-up

Do not like new situations. They are cautious and sometimes fussy, but they do warm up to new stimuli or situations with repeated exposure

Face Validity

Does it look like it measures what it is supposed to measure?

What does the behavioral approach do poorly?

Does not account for thinking only really measures observable behavior

Most common IDs related to genetics

Down's Syndrome Fragile X: minor to severe learning disabilities; high social intelligence but poor speech/writing Prader-Willi Syndrome: verbal skills deficit

Behavioral theory (depression)

Due to lower rate of response-contingent reinforcers for behavior, resulting in extinction of helpful behaviors as well as other features of the disorder, reducing likelihood of positive reinforcement opportunities in the future. (Vicious cycle)

Mis-use of research

E.g., advertising, pharmaceutical companies

Kindling effect

Each depression episode increases the risk of later depression, regardless of life stress -time between episodes gets shorter -why untreated outcomes not optimistic

Dawson (2008): critical period for intervention

Earlier age of detection→ higher chances of improvement

ADHD history 1. early 1900s 2. 40s-50s 3. late 50s 4. 70s 5. 80s

Early 1900s- poor "inhibitory volition" "defective moral control" 1940s-1950s- "minimal brain damage" and "minimal brain dysfunction" Late 1950s- "hyperkinesis" led to definition of "hyperactive child syndrome" 1970s- primary symptoms identifies as deficits in attention, impulse control, and hyperactivity 1980s- increased interest in ADHD, stimulant use generated controversy

Prevention (COnduct problems)

Early intervention and counteracting risk factors and strengthening protective factors at a young age to prevent escalation of problem behaviors

possible causes/contributors to autism: environmental factors

Early risk for ASD and later outcomes mediated by how child interacts with and adapts to their environment -GXE during postnatal life amplifies the effect of autism susceptibility

Low arousal positive emotion

East Asian culture values

Sources of cultural mismatch

Economics, language, community readiness, ethnicity, risk factors, staff competence, urban vs. rural

Efficacy vs. Effectiveness

Efficacy studies are most useful for establishing whether or not a treatment has an effect, while effectiveness studies are best for assessing clinical utility. Efficacy - Does it work? Effectiveness - What does it work for?

Clinical intervention

Effort to improve or maintain the health of a person

Maintenance

Efforts to increase adherence to treatment over time in order to prevent a relapse of a problem

Temporal Lobe

Emotional maturity

The Wechsler Intelligence Scale for Children (WISC-IV)

Emphasizes fluid reasoning abilities, higher order reasoning, and information processing speed

Nomothetic formulation

Emphasizes general inferences that apply to *large groups of individuals*

Nomothetic formulation

Emphasizes general principles that apply to all people

Developmental Psychopathology perspective

Emphasizes importance of developmental processes and tasks. Need to understand what it 'normal'

Multimethod assessment approach

Emphasizes the importance of obtaining information from different informants, in a variety of setting, using a variety of procedures that include interviews, observations, questionnaires, and tests

**Strategic family therapy

Emphasizes the patterns of behavior or interaction which serves to maintain the problem

**Narrative therapy

Emphasizes the problem as external to the family and also reduces the role of the therapist as a "fixer"

**Family systems

Emphasizes the role of family interactions and roles in the development of pathology Ex: Child who is caught up in battle between parents and has to get involved that is not age appropriate (parent is alcoholic and oldest child takes responsibility of younger siblings

**Solution-focused family therapy

Emphasizes the strengths in families rather than the weaknesses

Attachment

Enduring emotional bond between child and caregiver

Adolescent-limited pathway (COnduct problems)

Engagement in conduct behaviors only during adolescence and not before or after and usually less severe behaviors

Gender Differences of GAD

Equal among males and females, slightly higher among adolescent females

Adolescent-Limited Path:

Equal girls and boys Lesser severity and psychopathology Fewer violent offenses Less persistent

Who is at a greater disadvantage when being diagnosed?

Ethnic minority youth are at greater risk of misdiagnosis

Behavioral assessment

Evaluates the child's thoughts, feelings, and behaviors in specific settings

Intelligence Testing

Evaluating a child's intellectual and educational functioning

What are EST's?

Evidence based treatments An approach contrary to "rules of thumb", folklore, opinion & tradition Proven success using research methodology

Generalized Anxiety Disorder

Excessive anxiety and worry about numerous events and activities, occurring more days than not; difficult to control the worry Irritability, restlessness, fatigue, poor concentration, muscle tension, sleep problems May also have racing pulse, trembling, chills, sweating Seek approval & reassurance; self-critical, perfectionistic

_______________ is the minority of research in the field (DP); can infer causality

Experimental Research

Applied behavioral analysis (ABA)

Explains behavior as function of its antecedents and processes

Classical conditioning

Explains the acquisition of problem behavior in terms of paired associations between previously neutral stimuli and unconditioned stimuli

Secure

Explores the environment; seeks contact & proximity; distress when parent leaves room; returns to play & exploration

Insecure Avoidant

Explores, but little affect with caregiver; not anxious with strangers; as stress increases, avoidance increases; seems aloof, actively avoids caregiver

Behavioral Techniques: Exposure for treating anxiety

Exposure to feared stimulus, often combined with relaxation (75% success Chorpita & Southam-Gerow, 2006) Graduated exposure vs flooding Imaginal versus in vivo desensitization Child rates anxiety/fear

Internal validity

Extent to which the thing being studied, and not something else, account for findings. Threats to it are: - Maturation - Effects of testing - Selection biases

Childhood/Adolescent Onset Schizophrenia: duration

Extremely rare in children under 13 Prevalence in children is about 1 in 10,000 Tends to emerge earlier in males (late adolescence-early 20s) than females (early twenties-early thirties) Earlier onset in boys by 2-4 years

Predominantly Inattentive ADHD

Fails to give close attention to details; makes careless mistakes Difficulty holding attention on tasks Does not seem to listen when spoken to Doesn't follow through on instructions Difficulty organizing tasks Avoids tasks that require sustained mental effort Loses things Easily distracted Forgetful in daily activities

Adaptational failure

Failure to master or progress in accomplishing developmental milestone

What is one of the primary treatments for AN

Family Therapy, may be the most effective

Multidimensional treatment for foster care (MTFC)

Family based intervention for children in foster care system Goals to decrease disruptive behavior problems and to increase prosocial behavior

Environmental factors Conduct problems

Family level: -parental rejection and neglect -inconsistency -harsh discipline -abuse -early institution living Community level: -Peer rejection -association with delinquent peer group -neighborhood exposure to violence

**Systemic family therapy

Family members attribute meaning to behavior so that the meaning becomes more important than the behavior

FEAR (CBT Kendall)

Feeling frightened Expecting bad things Attitudes and actions that will help Results and rewards

Theories & Causes: Biological, eating disorders

Female relatives of patients with AN or BN are 4-5 x more likely to develop an eating disorder BN - Decreased serotonin activity; serotonin leads to feelings of "fullness" AN - Serotonin transporter gene disruption + environmental stressors (e.g., high parental control) triggers onset of Anorexia

Treatment depression

Fewer than 1/2 receive help, rates vary by racial background (white 40%, Asian 19%, 1/3 afam)

Fidelity vs Flexibility

Fidelity: how closely protocol is followed Flexibility: adaptations practitioner takes

features of hyperactivity (8)

Fidgeting Difficulty staying seated Moving, running, touching everything in sight Excessive talking Excessive energy Intense, inappropriate and not-goal directed activity "Like driven by a motor"

Hyperactive-Impulsive ADHD

Fidgets, taps, or squirm Leaves seat frequently Runs about or climbs excessively Unable to take part in leisure activities quietly "on the go"; "driven by a motor" Talks excessively Blurts out answers Difficulty waiting for turns Interrupts or intrudes on others

DMDD ages

First diagnosed between age 6 and 10. Can't be diagnosed before age 6 or after age 18CONDUCT DISORDER (CD)

Major depressive disorder: key features and symptoms (6)

Five or more of the following symptoms have been present during the same 2 week period 1. Loss of interest or pleasure: difficulty concentrating, remembering information, or making decisions 2. Feeling sad, anxious or empty: feeling irritable, worthless, helpless, guilty 3. weight loss/gain or increase/decrease in appetite 4. insomnia/hypersomnia 5. psychomotor agitation or retardation 6. fatigue or loss of energy

Clinical interviews

Flexible and over many sessions. Can be structured or unstructured

Client-centered treatments

Focus on creating a therapeutic setting which provides unconditional acceptance of the child

**Constitutional/neurobiological

Focus on the child's innate characteristics and how they may lead to the development of psychopathology Ex: Child born with down syndrome that affects behaviors

Family Systems Approach

Focus on the family issues underlying the problem Family participates in therapy as a unit Communication

Other Family Interventions

Focus on the parents as the unit of intervention and change 1. Parents' problems may be interfering with treatment of child or helping to maintain the child's problems 2. Marital therapy may be recommended if the parental conflict is contributing to the child's problems or the parents inability to manage those problems 3. Parent psycho-education may be used to inform the parents better about their child's problem and how to deal with it

Jean-Marc Itard beliefs on children

Focused on the care, treatment and training of mental defects

**Cognitive

Focuses on distorted or deficient cognitive structures and processes Ex: Child who are aggressive often have attribution that other children are being aggressive (Feels like they are being threaten, they need to defend self)

**Affective

Focuses on dysfunctional emotional regulation systems - Difficult regulating emotions Ex: Teens that respond to being ignored by a friend can't handle emotions may hurtself

**Psychodynamic

Focuses on inborn drives, conflicts, defenses, psycho-sexual stages and regression Ex: Child with eating problems maybe due to child having issues with oral stage

Longitudinal studies

Follow the same individuals over time

imaginal exposure

Form of exposure therapy that does not involve a real stimulus. Instead, the patient is asked to imagine the feared stimulus or situation; Typically used for situations that you cannot replicate- (plane crash)

behavioral interventions

From what theoretical approach are interventions for autism primarily drawn from? (e.g., cognitive, behavioral, family systems, etc. )

poor executive functions

Frontal lobe dysfunction in children with conduct disorder means

Connections which form pathways between frontal lobes and striatum Messages are passed along these connections via neurotransmitters ADHD → doesn't work as well, frontal lobes are smaller, looks different

Frontostriatal Circuitry

**Decline in adaptation

Function okay at the beginning at adolescence but decline as they got older - Schizophrenia, bipolar disorder

Gen environment corelations

GE revers to genetic differences in exposure to environment Maken duidleijk dat de ervaringen van een individu niet onafhankelijk zijn van genetische invloeden -->genetische invloeden spelen dus een belangrijke rol in de risico en protectieve factoren naarmate ze ouder worden

The Vile Weed

Gary Gilmore

Response search (social cognitive factors in CD)

Generate fewer and more aggressive response and have less knowledge about problem solving

Social Push Model of G x E

Genes become more important and influential as environmental conditions become more secure

Genetic contributions to maladaptive behavior

Genetic info from each parent but expression of gene is malleable and influenced by environment

ADHD Developmental Pathway

Genetic risk—->teratogens in utero—->brain/neurotransmitter dysfunction—->failure to adequately suppress inappropriate responses—->cognitive deficits in working memory, self-regulation—->behavioral symptoms of ADHD——>impairments in social and academic development—->disruptions in parenting—->ODD/CD

Prodeclarative gestures

Gestures or vocalizations that direct the visual attention of other people to objects of shared interest, such as pointing to a dog

Protoimperative gestures

Gestures or vocalizations used to express needs, such as pointing to an object that one desires but cannot reach

Cognitive theories and causes for eating disorders

Girls age 9-18: 58% perceived themselves to be overweight and only 15% were overweight. 10-year-olds: 81% reported restrained eating/dieting. Body build and self-esteem are correlated for girls (not boys) by the time they reach 4th grade.

In adolescents who is more likely to be diagnosed boys or girls?

Girls are more likely diagnosed in adolescence with anxiety and depression.

Criticisms of the DSM

Gives less attention to disorders of infancy and childhood (slightly better in the DSM5) Issue of co-morbidity (co-occurrence) Sometimes improperly used, such as when a specific diagnosis is needed in order for a child to qualify for special services Previous versions didn't align with the ICD-10

The Current Approach:Failing to Wait (RTI)

Good reading instruction (using an evidence-based curriculum) is provided to ALL students All students are regularly assessed Additional, more intensive interventions are provided to those who aren't making progress If ongoing assessment doesn't demonstrate progress, a Learning Disorder might then be diagnosed

Process of forming the crinkly folds of the cerebral cortex Creates greater surface area for the brain

Gyrification

Adrian Raine's Biosocial Model

HR, skin conductance and prefrontal glucose metabolism can predict criminal behavior 75% of individuals correctly classified social disadvantage cannot be accounted for though single murderer: driven by arousal --> not a lot of thought/planning so more likely to get caught

ODD Vindictiveness

Has been spiteful or vindictive at least twice within the past 6 months

Environmental

Has their been changes at school or home etc that can challenge them

**Temporary maladaptive

Have a rough period of time, but then regain level of adaptive - conduct disorder, depression

Mediators

Helps to explain the effect that the independent variable gave. Substance use linked to ADHD, partly because mutual association with deviant peers. Mediator= affects how strong the effect is.

Comorbidity for Eating Disorders

High Comorbidity (up to 90%): With Depression and Anxiety (60-80%) With OCD (35%) Others: substance use, personality disorders, bipolar disorder

Family Systems: Expressed Emotion (EE)

High EE families tend to show high levels of criticism and hostility and high levels of emotional overinvolvement High EE is related to: Schizophrenia Bipolar disorder There may also be cultural differences in EE that need further study

Strengths of Some Individuals with ASD

High IQ Attention to detail, pattern recognition Memory Visual skills

ASD intellectual strengths

High nonverbal scores Some splinter skills (25%) and savants (5%)

What are some contextual theories and causes for eating disorders

Higher rates in high SES, which may be related to higher rates of body dissatisfaction

comorbidity for anxiety

Highest co-morbidity is with other anxiety disorders (e.g., separation anxiety disorder and generalized anxiety disorder) High co-morbidity with depression

Validity

How accurate/close to measuring what the study actually intends to measure.

Physical abuse risk factor for aggressive behavior (authoritarian) and Poor parental monitoring: unsupervised time is + correlated with antisocial behavior (neglectful/indifferent)

How can Parent Discipline & Monitoring influence conduct disorder in children

not well in almost every way

How do children with conduct disorder do in school?

only friendships with deviant peers and engage in bullying

How do children with conduct disorder interact with peers

when the child had a medication that reduced the ADHD symptoms the mothers did not have as many conflicting behaviors. When the kids got a placebo pills, the mothers were constantly nagging. It appears then that the ADHD symptoms cause a response in the family environment, not the other way around.

How do families influence ADHD

their intelligence is average but they score low on IQ tests

How do individuals with conduct disorder score on IQ tests

alter activity in the frontostriatal brain region by increasing availability of dopamine

How do stimulants work?

75-80%

How high can the success rates be for medicating people with ADHD?

8 months

How long is the average episode for major depressive disorder

Approximately 1-2 students per classroom

How many students per classroom have ADHD

Systems

How many trips to hospital, or they haven't been in trouble with the law as much

Positive reinforcement: compliment, positive feedback, attention. Negative reinforcement: losing weight, removing aversive stimulus (being full and removing calories),

How might reinforcement contribute to eating disordered behavior?

Reliability

How replicable a study's results are (close to results each time)

Criterion related

How well a measure predicts behavior in specific settings • At the same time (concurrent validity) • In the future (predictive validity)

parents, friends, or the media may be displaying poor eating behaviors and you observe them and then repeat the behavior

How would Bandura suggest that disordered eating patterns develop?

Fidgeting, leaving the seat in the classroom, running or climbing excessively, difficulty playing or engaging in leisure activities, blurting out answers, difficulty waiting to take turns, and talking excessively are characteristics of:

Hyperactivity-Impulsivity

Hypo vs. Hypersensitive

Hypo: need more stimuli but don't seek it Hyper: more impacted by stimuli (can be intolerable) but seek it

regulates & organizes movement.

Hypothalamus helps to produce hormones, including stress hormones (anxiety) HPA Axis system

Difference between ID and Specific Learning Disorder

ID is a deficit in academic and adaptive learning while Specific Learning Disorder usually only affects one area of academics (reading, writing, math)

Screening

Identification of subjects at risk for a specific negative outcome

Mary Ainsworth

Identified 3 Patterns of Attachment (Secure, Insecure, Disorganized) -- Strange Situation Experiment:

2 strategies for determining the best plan for a given individual

Ideographic strategies- highlight a child's unique situation Nomothetic strategies- to benefit from all the information accumulated on a given problem or disorder Determine the general category to which the problem belongs

**The Base-rate problem

If we do not know the rate of a particular variable in the general population, we may over-estimate or under-estimate its value as a predictor

DSM- 5 Defining Features of ASD

Impairments in social interaction Impairments in communication Restricted repetitive and stereotyped patterns of behavior, interests, and activities

types of exposure therapy

In Vivo Imaginal Flooded Graded

Describe at least 2 differences between autism and COS.

In comparison to autism, schizophrenia has: Later age of onset Less intellectual impairment Less severe social and language deficits Presence of hallucinations and delusions Periods of remission and relapse

subtypes of impulsivity (behavioral and emotional)

Inability to control immediate reactions or voluntarily inhibit dominant or ongoing behavior Inability to delay a response or defer gratification Not thinking before acting Cognitive impulsivity: disorganization, hurried thinking, difficulty with executive functioning Behavioral impulsivity: difficulty inhibiting responses when situations require it Emotional impulsivity: impatience, low frustration tolerance, hot temper, quick to anger, irritability

Cognitive distortions

Inaccurate and irrational automatic thoughts or ideas that lead to false assumptions and misinterpretations. Distorted thinking Everyone is out to get me Everyone hates me Eating disorders

Failing to give close attention to details, difficulty sustaining attention, forgetful, easily distracted, difficulty organizing tasks, and loses things necessary for tasks are characteristics of:

Inattention

Core deficits of autism: communication impairments

Inconsistent use of early preverbal communications and gestures -children with ASD show deficits in protodeclarative gestures but NOT protoimperative gestures -About 50% of children with ASD don't develop meaningful language

Deviation from social norms Strengths:

Incorporates social values → focus on treating conditions that violate what we want to see in society and not on things we want to be there

Risk factors

Increase likelihood of negative outcomes for children

**Risk Factors

Increase of a child developing an emotional or behavioral disorder Ex: Parents have psychological problems and the child ends up being fine (not sure how they are fine do to their childhood)

Protective factors

Increase the likelihood of resilience despite hardship

False positve

Indicates that a given condition is present when it is not

Emotional reactivity

Individual differences in the threshold and intensity of emotional experiences

How is treatment implemented?

Individual treatment Group treatment: addiction or behavioral. Done less with kids Parent training: not necessarily working with child Family therapy: working with parents and child Residential treatment: working in a facility/ hospital

**Psychological

Individual's personality and how they feel and think about things

Treatment (COnduct problems)

Individual/family counseling (PMT, PSST, MST) Group treatments Residential treatment, inpatient hospitalization, incarceration

Longitudinal designs

Individuals studied over time at the same ages

outcomes of ADHD

Infancy: +HI, Difficult diagnosis of ADHD before the age of 3, Difficult temperament is not enough Preschool: HI becomes a problem Elementary School: IN symptoms more visible Adolescence: HI declines

Developmental progression of DSED (infant --> childhood)

Infant: unconsolable crying, lack of wariness Toddler: talk to strangers, inappropriately baby-ish Childhood: intrusive, lack impulse control

Developmental progression of RAD (infant --> childhood)

Infant: withdrawn, listless Toddler: no response to comfort, cannot regulate emotions Childhood: self-injury, runs away with approach

Moderating variables

Influence the direction or strength of the relationship of variables of interest (independent effect on relationship between two variables like culture)

Social cognition

Influenced by contextual variables such as families and how they think about themselves (I can't do math as well as my brother)

Behavioral Observations

Informal Observations Appearance, facial expression Interactions with adults and peers How the child approaches novel situations Emphasis on observing child's behavior directly, ideally in the natural environment Really helpful to perform observation in other setting Issue of reactivity: when observing, child and other people could react/act differently with you being there

Informed Consent

Informed permission from child's parents

effects of vaping on physical body

Inhalation of carcinogens ‐ lung irritation similar to that of smokers • Increase heart rate and blood pressure (circulatory problems), seizures

**Biological

Inherited genes and the biochemistry of the brain

Neuroplasticity

Initial synaptic growth Selective pruning

anorexia treatment

Inpatient hospitalization for very severe cases, nutritional counseling, CBT or Family‐therapy (Maudsley method) ‐ family is involved in re‐feeding process.

Psychiatry's Guide Is Out of Touch With Science, Experts Say

Insel: DSM lacks validity -started RDoC DSM based on symptoms but RDoC integrates dimensions and units of analysis

Who is most at risk for RAD?

Institutionalized Children

ASD comorbidity

Intellectual disability, epilepsy, SIB (ID + ___= higher likelihood of SIB), OCD (17%), ADHD, anxiety, mood disorders

Characteristics of depression

Intellectual/academic functioning, cognitive biases/distortions, negative self-esteem, social and peer problems, family problems, suicidal ideation

Corpus callosum

Intelligence, conscientiousness and self awareness

Multisystemic Therapy (MST)

Intensive combination of many therapies such as PMT and PSST for teens with severe conduct problems who are at risk for out of home placement

ICD-10

International Classification of Diseases - 10th Edition

Common Categorical Classification Systems

International Classification of Diseases and Health Related Problems (ICD-10) Published by the World Health Organization (WHO) Diagnostic and Statistical Manual of Mental Disorders (DSM) Published by the American Psychiatric Association

Pathogenic care = ?

Interpersonal context --related to treatment in an interpersonal relationship not just the trauma that occurs (treating baby/child AND someone)

Semistructured interviews

Interviews that include specific questions designed to elicit information in relatively consistent manner regardless of who is conducting the interview

Behavioral genetics

Investigates connection between genetic predisposition and observed behavior

**Boundaries

Invisible barriers which regulate the amount of closeness between individuals - on a continuum between rigid and diffuse

Discrete Trial Training (DTT)

Involves a step by step approach to presenting a stimulus and requiring a specific response that is rewarded if correct. Very structured

Emotional regulation

Involves enhancing, maintaining and inhibiting emotional arousal

Personality testing

Involves testing a child on the big 5: - Timid or bold - Agreeable or disagreeable - Dependable or undependable - Tense or relaxed - Reflective or unreflective

Depression presentation across developmental periods: preschoolers

Irritability + social withdrawal + anhedonia or excessive guilt = depression (maybe...) -caregiveers may fail to spontaneously report symptoms -GUILT and SHAME occur more often in pre-school children

Self injurious behavior

Is a serious and sometimes life threatening problem

Test

Is a task or set of tasks given under standard conditions with the purpose of assessing some aspect of the child's knowledge, skill, or personality

What is now left out of DSM-5 that should be there

Is need for assessment from academic test

**Attachment theory

Is on the effects of early relationships that children develop with their caretakers Ex: Child who doesn't get a secure attachment may have a hard time with connecting to other people

True negative

Is one that does not detect the condition when the condition is absent

Phonological awareness

Is the child's ability to manipulate phonemes - in other words, to recognize, recall, think about, manipulate and understand the basic word sounds

Neural plasticity

Is the process in which your brain's neural synapses and pathways are altered as an effect of environmental, behavioral, and neural changes

Phoneme

Is the smallest unit of meaningful speech sound spoken Ex: kuh-ah-tuh = cat

Hypothalamic pituitary adrenal axis (HPA)

It influences a person's response to stress and his or her ability to regulate emotions

How did the DSM-IV change when it became the DSM V?

It moved to a nonaxial system of diagnosis (formerly Axes I, II, and III), with separate notations for relevant psychosocial and contextual factors (was Axis IV) and disability (was Axis V)

Does the diagnosis of autism depend on IQ

It's Not about IQ: The Range of Autism Spectrum Disorders can go from Severe to Profound Intellectual Disability to Intellectually Gifted Almost half of children with ASD has average to above average IQ

Historical Perspective on Developmental Psychopathology 1800's

Itard; Wild Boy of Aveyron

History and evolution of autism: Kanner

Kanner (1943)- "early infantile autism" described young children with symptoms of autism

hangout with other kids who don't like school which in turn predicts substance abuse because they are not hanging out with the "straight edge" kids

Kid with IA don't like school and don't perform well in school therefore they start to

CONSIDERING NORMAL AND ABNORMAL PROCESSES TOGETHER

Knowledge of pathways and processes of normal development are essential for understanding pathology

The File Drawer effect

Lack of published negative research

callous-unemotional specifier

Lack of remorse or guilt Callous-lack of empathy Unconcerned about performance Shallow or deficient affect

Theory

Language of science that allows us to assemble and communicate existing knowledge effectively (make predictions on behavior based on samples and knowledge)

effects brain development which is a biological cause. Also, we are talking about social contextual factors that don't have to happen so we can approach it as contextual as well.

Lead, alcohol use, and other substance abuse: why can these factors be viewed as biological or contextual?

Cognitive theory (depression)

Learned helplessness results in prior exposure to uncontrollable negative events coupled with a tendency to attribute those events to internal, stable, and global factors

Nonverbal learning disability (NLD)

Learning disabilities characterized by deficits related to right hemisphere brain functioning, such as problems in social skills spatial orientation, and problem solving

ADHD Associated characteristics (6): inattentive

Learning disability Slow processing speed Difficulty remembering things Low academic achievement May be anxious, apprehensive Socially withdrawn Comorbid mood disorders

Outcomes of MTFC

Less aggressive behavior Fewer arrests Less running away Less home transitions

ADHD: High parental stress (6)

Less parenting competence Fewer contacts with extended family Caregiver strain Marital conflict Parental alcohol consumption Stigmatization

persistent depressive disorder: key features and symptoms

Less severe but more chronic than MDD Depressed mood for most of the day, for more days than not for at least 2 years OR 2 or more of the following symptoms Never been without symptoms for more than 2 months THOUGHTS: low self-esteem, hoplessness, difficulty concentrating, remembering information, or making decisions PHYSICAL: increase/decrease appetite, fatigue, loss in energy

Childhood/Adolescent Onset Schizophrenia: negative symptoms (loss in normal functioning) (8)

Linked to dysfunction in the frontal lobe: -Slowed thinking, speech, and movement -bland/flat affect -Inappropriate affect -Lack of motivation -Emotional ambivalence or apathy -Inability to initiate goal-directed activity -Catatonia -"Waxy flexibility"

Neuropsychogical assessment

Links brain function to objective measures and behavior and tests those (ex. connect the dots measures processing)

Historical Perspective on Developmental Psychopathology late 1600's

Locke: children require thought and care "blank slate"

Outcome of pediatric bipolar disorder

Long-term prognosis is poor and disorder tends to intensify through lifespan -->Coping skills can be learned and are helpful

Prospective Design

Longitudinal Design where subject pool has not experienced desired outcomes

Psychodynamic treatments

Look for unconscious and conscious conflicts within the child. Child develops awareness of of factors contributing to conflict

In what ways do peers lead to psychopathology

Looking down on you: leads to depression and anxiety Eating disorders You are who you hangout with Conduct disorders

Developmental norms

Looks at age inappropriate patterns and measures them. Measured by: 1. Frequency 2. Duration 3. Intensity Also take into account if child is uninterrupted in life or impaired

Neuro-imaging measurement method

Looks at structure/function of brain. Done in structional (brain anatomy) and functional brain imaging (processes like blood flow)

ODD Temper Category

Lose temper Quick to anger, easily annoyed Angry and resentful

Anhedonia

Loss of interest in activities

Theories and causes of Depressive disorders: cognitive theories- role of cognitive distortions

Low self-esteem -the depressive cognitive trifecta: hopelessness, helplessness, worthlessness -selective attention bias to negative factors -self-blame "it's always my fault", reflection of whole self-worth -rumination: getting stuck thinking everything that led and resulted from neg. experiences

ASD intellectual deficits

Low verbal scores & theory of mind

How well do students with ADHD perform on intelligence tests

Lower working memory scores Processing speed weaknesses

Forbrain

Made from: - Limbic System - Basal Ganglia - Cerebral cortex

ABA (applied behavior analysis)

Main treatment for Autism modern term for a form of behavior modification that uses shaping techniques to mold a desired behavior or response

Depressive disorders

Major depressive disorder, persistent depressive disorder, and disruptive mood dysregulation disorder

Neurotransmitters

Makes biological connections between different parts of the brain

Behavioral assessment

Makes hypothesis out of child's thoughts/behaviors in a specific setting to make a hypothesis on treatment. ABC is an example

Client centered treatments

Makes therapeutic setting where child feels no judgement and genuine acceptance to enhance personal growth

What do we know about age and gender variables?

Males are more likely to be diagnosed with a abnormality because of the definition and gender norms.

Gender Differences in Identification

Males at greater risk in general Prevalence Expression of disorders Bias in reporting and bias in samples Boys more aggressive (are we capturing girls with definition)

Educational Interventions

Manage classroom behavior Improve academic performance

Specific Phobia

Marked fear or anxiety about a specific object or situation The feared object is avoided even though it is not dangerous Child may not realize the fear is extreme and unreasonable Child may show crying, tantrums, freezing or clinging 2-4% of children

Social Anxiety Disorder (Social Phobia)

Marked, persistent fear of being scrutinized by other people (fear of humiliation or embarrassment) More likely to be highly emotional, socially fearful and inhibited, sad, and lonely Physical symptoms may occur 1-3% of children; slightly more girls than boys

Historical Perspective on Developmental Psychopathology mid-1600's

Massachusetts (mid-1600's)The Stubborn Child Law (also enacted in Connecticut, Rhode Island & New Hampshire) If your son was too stubborn you could take him to court and have him killed

Maternal cigarette smoking, Maternal alcohol use, Other substance abuse (cocaine, crack), Lead exposure (dust, soil, water pipes)

Maternal abuse during pregnancy linked with AD/HD

Difficult infant temperament ADHD Conduct disorder Poor emotional regulation Adolescent depression

Maternal anxiety can cause these

Onset MDD

May be gradual or sudden, age usually between 13-15

IQ score mean and standard deviation?

Mean=100 SD=15

EEG measuring

Measures electrical activity in brain. Part of psychophysiological method

Multiple baseline study

Measures multiple individuals both before and after the treatment

Models of Childhood Psych

Medical: - organic dysfunction: neurodysfunction, stress - diagnosis Behavioral: - learning principles: classical/operant conditioning and imitation/modeling - Social Learning Theory: how person and environ influence each other Cognitive: - Piaget's Stages and Schemas Psychoanalytic: - id, ego, superego (kinda) - Fixation and Regression (staying at same stage or going backwards) - ATTACHMENT Family Systems: - Homeostasis- family balance - Rigid Triangles

little effect on academic performance. There needs to be other intervention!

Medication treatment long-term shows what? And why?

Treatment of ADHD

Medication, Parent management training, Educational interventions

How do medications work for treating AN

Medications may NOT be useful for treating symptoms, improving self-image, or preventing relapse

Hindbrain

Medulla, pons, cerebellum. Regulation of autonomic activities

Excess dopamine hypothesis: Mesolimbic, Mesocortical, Amphetamine and cocaine, drugs...

Mesolimbic pathway: from Ventral tegmental area (VTA) to Accumbens (positive symptoms) Mesocortical pathway: from VTA to prefrontal cortex (negative symptoms) Amphetamine and cocaine: schizophrenic symptomatology Drugs that block dopamine reduce some positive symptoms of schizophrenia Not fully supported by all evidences

Behavioral Genetics

Methods - twin/adoption studies MZ twins DZ twins Average genetic relatedness (likelihood of family members displaying same or similar attributes)

sociometric measures

Methods that involve evaluations from peers

MMPI-A-RF

Minnesota multiphasic personality inventory adolescent restructured form. A broad self report measure of adolescents social-emotional functioning. It assesses; emotional disfunction, behavioral dysfunction, thought, 9 clincial scales. clinical scales are; demoralization, somatic complaints, low positive emotions, cynisism, antisocial behavior, ideas of persecution, negative meotions, abberant experiences, hypomanic activation.

Race and Ethnicity in mental health

Minority children are overrepresented in rates of substance abuse, delinquency, and teen suicide

Emotional regulation depression

Modeled in parents, children who receive prolonged periods of emotional distress or are exposed to maternal negative moods, avoidance or negative behavior to regulate distress

**Protective factors

Modify, ameliorate or alter people's responses to an environmental condition which predisposes them to a maladaptive outcome (have a shield to protect themselves)

Behavioral Observation and recording

More informal recording done in field. May be inaccurate as child knows they are being watched

Response decision (social cognitive factors in CD)

More likely to choose aggressive solutions

Child Maltreatment in mental health

More than 1/3 children 10-16 are physically/sexually assaulted by someone close to them

Long-term outcomes of AN

Mortality rate = 5%-10%; highest mortality rate of any psychiatric disorder; leading cause of death in females 15-24 (½ of deaths occur due to suicide, ½ due to medical complications)

other causes of psychosis

Most cases of psychosis are NOT schizophrenia Other causes of psychosis: amnia, major depression, drug-induced, infections, schizoaffective disorder Schizo: symptoms for at least 6 months (negative and positive must be present)

persistent depressive disorder: prevalence and comorbidity (4)

Most common comorbid disorder is MDD -about 70% will have episode of major depression -more severely impaired than those with one ~50% of children with P-DD also have 1+ non-mood disorders that precede dysthymia -Anxiety disorders -oppositional/conduct disorders -ADHD

Comorbidity MDD

Most common: anxiety disorder (early onset anxiety disorder is a strong predictor 85%), 90% have one or more disorders, 50% have 2 or more Other common: dysthymia, CD, ADHD, substance abuse

ADHD subtypes, characteristics and prevalence: combined

Most often referred for treatment Deficits in Inhibiting behavior Behavioral persistence Aggressive- defiant

Theories & Causes: Family Systems

Mother's critical comments related to weight (Fairburn, 1994) Perceived lack of maternal caring (Haudek, Rorty, & Henker, 1999) Receiving messages from parents related to body size/shape (father → daughter may be particularly important) (Schwartz , Phares, Tartleff-Dunn, & Thompson, 1999)

Serotonin

Motor activation & mood; regulates eating, sleep & aggressive behaviors

Two types of developmental pathways:

Multifinality: similar experiences lead to different outcomes Equifinality: different experiences can lead to the same disorder

MTA study

Multimodal treatment study of children with ADHD that showed that stimulant meds were superior to behavioral treatment after 14 months, but after 36 months, there was no significant differences, showing that BENEFITS DISAPPEAR OVER TIME

Interrater reliability

Multiple observers agree to what they see

Causes depression

Multiple reasons and pathways, genetic risk influences neurobiological processes and is reflected in early temperament (oversensitive to negative stimuli, high negative emotions), Family influences and stressful life events

Criteria for Intellectual Disability

Must meet all 3 of following A. Deficits in intellectual functioning: -- reasoning, problem solving, planning, abstract thinking -- academic learning -- experiential learning B. Deficits in adaptive functioning (result in failure to meet dev. and sociocultural standards for personal independence and responsibility) --w/o ongoing support, adaptive deficits limit functioning in one or more areas of daily life (communication, social participation, independent living) C. Onset of deficits during developmental period

Challenge of Stigma

Negative attitudes and beliefs that motivate fear, rejection, avoidance and discrimination

Prevalence and etiology: neurodevelopmental model

Neurodevelopment: growth and elimination of neural connections 1. Greater reduction of neural connections→ less connectivity and brain activity 2. too few neural connections eliminated→ excessive connectivity and brain activity 3. Enlarged ventricles: more difficult to treat, presence and persistence of positive and negative symptoms 4. Loss of gray matter may trigger the onset of COS: smaller brain size, poor prodromal functioning 5. High quality of gray matter: high prodromal ID

Neurotransmitters

Neurotransmitter molecules have specific shapes Receptor molecules have binding sites When the neurotransmitter binds to the receptor, ions enter - Reuptake process by which neurotransmitter molecules detach & are reabsorbed SSRI: selective serotonin reuptake inhibitor

neurobiological factors for ADHD

Neurotransmitters (NT)- dopamine, norepinephrine, serotonin may be involved Selective deficiency in availability of dopamine and norepinephrine

PDD (persistent depressive disorder) (dysthymia)

New in DSM, Combining Dysthymic disorder and MDD chronic, Symptoms of depressed or irritable chronic mood occurring on most days and persisting for at least one year, poor emotional regulation,

effects of vaping on behavioral

Nicotine can harm the parts of the brain that control attention, learning, mood, and impulse control. • Almost 4x more likely to smoke in the future than non‐user. Decreases perception that smoking cigarettes causes harm.

Discriminant/Divergent Validity

No correlation between different type tests

Mary Ellen McCormack case

No law that said you couldn't hit, hurt, or abuse your child No child protection

Integrative Approach

No single theoretical approach can explain various behaviors and disorders (each theory contributes one or more pieces to the puzzle)

CD causes

No single theory explains all forms, results from interplay of predisposing child, family, community, and cultural factors operating in a transactional fashion over time

Two approaches to Case Conceptualization

Nomothetic Idiographic

Intelligence with Conduct Disorder

Normal IQ but tend to score lower Lower IQ for those with early onset Executive function deficits similar to ADHD

Abnormal Development

Normal development gone awry

**Profond

Not able to talk

**Reversal of maladaptation

Not doing so well at first but they pick up their socks and they do better - Eating disorder, OCD, ADHD (with treatment)

major depressive disorder

Not just sadness. Other symptoms include feelings of worthlessness and hopelessness, a lack of pleasure, sleep and appetite disturbances, and possibly suicidal ideas or plans. 1% of children

Child Psych 1945 and 1965

Number of children in institutions decreased while the number in foster care and group homes increased

cyclothymic disorder

Numerous and persistent hypomanic and depressive symptoms for at least one year

Less Common Anxiety Disorders

OCD 2-3% Social Phobia 1-3% Panic Disorders 1%

ADHD Comorbidity

ODD (50%) Anxiety (25%) Depression/mood disorders (20-30%) Motor coordination difficulties and tic disorders

pathway of ODD from childhood to adolescence

ODD almost always precedes CD (around 96%), but not all ODD leads to CD

ODD vs CD

ODD also is characterized by a negative behavior pattern; however, the offenses *do not typically cause significant harm to others* or involve violations of major societal norms

Major disorders of childhood and adolescence

ODD, conduct disorder, ADD, ADHD, autism spectrum, fetal alcohol disorders, anorexia, schizophrenia, depression, anxiety

behavioral observations for children with ADHD

Observe in the natural environment Operationalize definitions On-task Calling out Disruptive

Social Learning

Observed learning as an effect

Criterion B for OCD

Obsessions or compulsions take more than 1 hour per day

Obsessive-Compulsive Disorder

Obsessions- Repeated, thoughts, urges or images that are intrusive and unwanted; the individual attempts to neutralize them with a thought or action Compulsions- Repetitive behaviors or mental acts that prevent or reduce distress and anxiety

**Retrospective studies

Obtain information about the child's development about past

Multi method assessment approach

Obtain information from a variety of settings and methods that have to be reliable and valid

pronoun reversals

Occur when child repeats personal pronouns exactly as heard, without changing them to suit the situation mixing up "you" and "me"

Prevalence of autism

Occurs across all social classes and cultures worldwide US: 1 in 40 children 4.3% boys and 1.5% girls Extreme male brain theory- Woman have a stronger drive to empathize, men to systemize Girls with gender-dysphoria more likely to show ASD

gender differences of ADHD

Occurs more frequently in boys→ 15.1% boys, 6.7% girls 1 in 5 high school boys 1 in 11 high school girls Girls with ADHD displaying defiance and aggression are referred at younger age Girls with ADHD have major problems in adolescence and young adulthood Girls with ADHD displaying HI more likely to report (Eating disorders, Self-injury, Suicide attempt)

**Intermittent

On an as-needed basis such as in a crisis or unusual situation

Multifinality

One experience can lead to many outcomes (divorce can lead to number of behaviors in a child)

Biology Interacts with Experience

One of the most important messages of genetic research has been that genetic influences are probabilistic and not deterministic, and that environmental factors are broadly speaking of roughly equal importance" (Rutter & Sroufe, 2000, p. 270)

Cross-sectional research

One period in time across different age groups or across groups with different types of problems

Conduct Disorder:Age of Onset (childhood)

Onset in childhood (1 symptom before age 10) More boys More aggressive More illegal activities

Major depressive disorder: onset, course, outcomes

Onset may be gradual or sudden, usually with history of milder episodes -13 to 18 critical period -In high school students the average is 4 months duration -duration affected by age of onset, severity, comorbidity, parental history -Recovery: 30-40% of patients recover by 6 months, 70-80% by 1 yr -Recurrence: 40% by 2 years and 70% by 5 years

Not evidence:

Opinion of respected authorities, case reports, descriptive studies

ADHD: Oppositional Defiant Disorder (ODD) Conduct Disorder (CD)

Oppositional Defiant Disorder (ODD) Conduct Disorder (CD) ODD: 1. Irritability (over-reactive) 2. Defiance (argumentative, defiant) CD: 1. Getting into serious trouble 2. Violating societal rules 3. Fighting, cheating, stealing 4. Risk-taking behaviors -->By age 7 children with ADHD meet criteria for ODD and CD (HI+) -->COMT gene common genetic contribution for ADHD, ODD, CD

Causes in research

Other variables directly or indirectly influence behavior

Dimensions of Externalizing Behavior

Overt-covert and destructive-nondestructive

ADHD Neurobiology

PFC and basal ganglia dysfunction/abnormalities

Stress response

PVN secretes corticotropin releasing hormone (CRH) into blood. CRH travels in blood to pituitary gland, stimulating release of ACTH. ACTH acts on adrenal glands to produce glucocorticoids like cortisol

Developmental Individual-difference Relationship-Based model

Parent get's down on the floor and interacts with child at their level Alternative to ABA; engage in reciprocal play

Examples of V. Code

Parent-Child relational problem Phase of Life Problem Child affected by Parental distress

Passive rGE

Parents create a home environment that is influenced by their own heritable traits

Be overinclusive of behaviors characterized as deviant "Natter" in response to low levels of behavior (non-stop nagging) Fail to follow through with noncompliance Fail to reward when compliance occurs

Parents of children with Conduct Disorders tend to:

ABC of assessments

Part of behavioral assessment. 1. Antecdents - what happened before 2. Behaviors - what researcher sees or hears 3. Consequences - what follows

Developmental tests

Part of psychological testing, used to screen infants and small children to see who is at risk

Types of gene-environment correlation (rGE)

Passive Active Evocative/reactive

Oppositional Defiant Disorder

Pattern of negativistic, hostile, defiant behavior; 4 of the following for 6 months Often loses temper Touchy, easily annoyed Angry, resentful Argues with authority figures Actively defies or refuses to comply with requests Deliberately annoys others Blames others for mistakes Spiteful or vindictive

Psychological Disorders

Patterns of behavioral, cognitive, emotional or physical symptoms associated with: 1. Distress 2. Disability 3. Increased risk for future suffering or harm

Cortisol diurnal pattern

Peaks 45 min after wake up Lowest point is 3-4 hours after sleep

Bias

People tend to seek out, remember and report examples that support their own opinion

Conduct Disorder

Persistent pattern of behavior in which rights of others are violated 3 or more in the past 12 months Aggression to People or Animals Bullies, threatens, intimidates, physical fights, cruel, confronts with weapon Destruction of property Fire setting, vandalism Deceit or Theft Breaking and entering, lies or cons others, shoplifting Rule Violations Stays out past curfew (starts before age 13), has run away at least twice, often truant (before age 13)

Protective Factors

Personal or situational variables that reduce the chances of a child developing a disorder

Antisocial Personality Disorder (APD)

Pervasive pattern of disregard and violation of rights of others, occurring since age 15. 3 of the following: Failure to conform to social norms-doesn't obey laws, may have frequent arrests Deceitfulness, lying, uses aliases, cons others Impulsive doesn't plan ahead Irritable and aggressive; fights Reckless about safety of self or others Irresponsible - e.g., doesn't pay bills or child support Lack of remorse

Biological/medical approaches:

Pharmacological and other biological approaches to treatment medication

Cerebral cortex

Planning, reasoning and creating. Left side is verbal and cognitive processes and right side is social perception and creativity

Theories & Causes:Contextual, SLD

Poor quality learning environments Poor early reading instruction Lack of exposure to phonemic awareness activities

The relationship between anxiety & depression?

Positive correlation

Brain differences for autism

Possible disturbance in brain development in the 1st trimester of pregnancy. Frontal lobe. Smaller cerebellum → attention shifting. Structural & functional abnormalities in the amygdala & hippocampus → emotion regulation. Not just one place or thing that causes autism.

Minority Status

Poverty Exclusion from societal benefits and poverty Once the effects of SES, age, sex, and referral status are controlled, very few differences in the rate of children's psychological disorders emerge in relation to race or ethnicity

Attention deficit disorder

Precursor to ADHD

categorical systems of diagnosis

Presence/absence of a disorder Either you are anxious or you are not anxious

Projective testing

Presenting child with ambiguous stimuli and asking what they see (writing story). Believes that child projects own personality

1 in 59 children - rates are increasing

Prevalence of Autism

prevalence of conduct disorder

Prevalence of CD - 2 to 6% of US children (1-4 million); rates between 1%-16% (Loeber et al., 2000) May account for up to 90% of criminal behavior 2 million dollars in lifetime costs

3 to 1

Prevalence with boys having ADHD is _ to _ over girls

Intellectual Disability: Age of onset, demographics

Prevalence: 1-3% of pop Gender: 3x more BOYS than girls Socioeconomic status/ethnicity: relevant to mild ID Onset: developmental period (birth-18)

Classical conditioning

Problems develop due to paired associations Watson-Little Albert Unconditioned stimulus (bell) -> unconditioned response (crying/fear) Conditioned stimulus (animal) -> conditioned response (crying/fear) pavlov - dogs salivating Unconditioned stimulus (food) -> unconditioned response (salivation) Conditioned stimulus (bell) -> conditioned response (salivation) The responses are always the same

Resilience

Process of displaying positive adaptation in the face of adversity

Attachment

Process of establishing emotional bond with others

Pros of Categorical Diagnoses

Professional consensus → eases communication; how we bill insurance People feel relief after hearing their symptoms Synthesis of information Understand level of severity, types of medicine that should be offered, etc.

Benjamin Rush beliefs on Children

Proponent of moral insanity

True positive

Proportion of positives that are correctly identified

Nature of genes in DP

Proteins produced by genes produce tendencies to respond in a certain way. How we respond to environment and are in turn influenced by said environment

**Hierarchy

Provides guidance and leadership

two parts to DP

Psychobiological vulnerabilities X environmental risk factors

Child Psych 1930-1950

Psychodynamic approaches were dominant

What are the four C's of child and family ethics?

Psychologists must practice within the boundaries of Competence, Custodial parents must consent to therapy, following confidentiality, not pursuing a relationship with someone closely related to Client.

Historical Perspective on Developmental Psychopathology Late 1800's to today

Psychology emerging

Multiplicity

Psychopathology is multiply determined 3 ways to think of multiplicity: Transactional approach: child and environment Diathesis-stress model: predisposition + stressor = disorder Mutiple perspectives (e.g., biological + behavioral + family systems) In many cases, psychopathology is caused by a combination of influences: Biological Emotional Behavioral Cognitive Family systems Contextual

Developmental task

Psychosocial tasks of childhood that reflect broad domains of competence and tell us how children typically progress within each of these domains as they grow

ADHD medications

Psychostimulants (ritalin, dexedrine)

comorbid psychiatric and medical problems (6)

Psychotic symptoms: hallucinations or delusions They match the mood "I'm extremely famous!" manic episode "I committed a crime" depressive episode -Anxiety -ADHD -Irritability, distractibility, inattention, hyperactivity, impulsivity -Substance use -Suicide (25-50% attempt suicide and 15% die by suicide)

Treatment of autism: medications

Psychotropic medications treat symptoms present in many disorders -no autism-specific medications -More commonly prescribed: Antidepressants, stimulants, tranquilizers, atypical antipsychotics -melatonin, Miralax

behavioral subtypes

Punishment and reinforcement

core features of Autism Spectrum Disorder

Qualitative impairments in - Joint attention -expressive nonverbal behavior -social "mind" and reciprocity

structured interview

Questions are fixed and interviewer has almost no flexibility; Can be administered by computer Pros: set questions less bias improved comprehensiveness more reliable and valid Cons: long time training can ruin rapport

Cons of RoDC

Quickly becomes complicated Harder to communicate into layman's terms or between professionals Lots of work to consolidate findings

Midbrain

RAS. Coordinates movement with sensory input

ASD continuum of severity

Range from a complete lack of speech to impaired use of speech for social interaction. DSM‐5 eliminated the diagnosis of Asperger's, and folded it into ASD.

dimensional systems of diagnosis

Rank on a continuous quantitative dimension Degree to which a symptom is present How anxious are you on a scale of 1 to 10? the reason autism can be on a spectrum

Co-Morbidities of ASD

Ranked 1) Intellectual Disability (70%) 2) Epilepsy (25%) 3) Anxiety and OCD; Phenotypic overlap with other symptoms

Rapid cycling

Rapid shifts of mood many times a day in children with bipolar disorder

Major depressive disorder: prevalence and comorbidity (6)

Rare before adolescence (1-2%) but increases 2-3x by puberty -3 in 4 children age 3-17 years with depression also have anxiety -1 in 2 have behavioral problems -anxiety and depression become more visible and separate, co-occurring disorders as aging occurs -ADHD -substance-use disorder

ADHD subtypes, characteristics and prevalence: hyperactive-impulsive

Rarest subtype Usually preschoolers, may have limited validity for older children

Prevalence PDD

Rates are lower than MDD, 1% in children, 50% have one or more disorder that preceded this (anxiety, CD or ADHD)

Types of Aggression

Reactive: impulsive reaction to perceived threat Instrumental: no provoking situation, aggression to achieve a goal

Males have a harder time _______________________. Females have a harder time ________________________

Reading Math

In Vivo Exposure

Real life graded exposure to specified fear stimuli Ex. Fear of germs --> touch dirty objects If you ask child to do it, you need to do it as well.

Effectiveness

Real world Use local clinicians Complicated kids with multiple diagnoses

Emotion regulation (3.1)

Recognizing and understanding of child's own internal experience enhancing, maintaining, or inhibiting emotional arousal, which is usually done for a specific purpose or goal

ADHD Medication

Recommendation (NICE) for this depends on developmental age of the child and symptom severity (ex: preschool child-no meds unless certain circumstances, school age: only if severe)

Intermittent Explosive Disorder

Recurrent behavioral outbursts representing a failure to control aggression, either one: Verbal aggression (temper tantrums, tirades, verbal arguments); 2 x weekly for 3 months 3 behavioral outbursts involving damage or destruction of property and/or physical assault in a 12-month period Not premeditated, at least 6 years of age

bulimia nervosa

Recurrent episodes of binge eating In 2 hour period eats more than the average person ~1500 calories per episode Feels out of control during the binge Recurrent, inappropriate compensatory behavior in order to prevent weight gain Occurs at least 1 time per week for 3 months Self evaluation unduly influenced by body shape and weight

Culture-bound syndrome

Recurrent patterns of maladaptive behaviors and/or troubling experiences associated with different cultures and localities

Culture-bound syndromes include:

Recurrent patterns of maladaptive behaviors and/or troubling experiences associated with different cultures or localities (abnormalities may vary between cultures)

DMDD (disruptive mood dysregulation disorder): key features and symptoms

Recurrent temper outbursts out of proportion in intensity or duration (for 12+ months) Mood persistent irritable (for 12+ months) -Temper outbursts occur, on average, three or more times per week -No period without symptom lasting 3 or more consecutive months -Symptoms present in 2 or 3 settings (severe at least in one)

Parent Management Training (PMT)

Reduce parent-child conflict Manage disruptive child behavior at home

Assessment of ADHD

Referral by teacher or parents; clinical itnerview 1. checklist 2. observations 3. psychological testing 4. neuropsychological measures

**Extensive

Regular involvement in some environments - not time-limited

Hormones

Regulate body growth, chemical messengers controlled by endocrine system

Limbic system

Regulates emotional experiences and expression. Impulse control (sex, hunger, etc)

Basal ganglia

Regulates, organizes and filters things involving cognition, mood, motor function

Endocrine system

Regulatory system related to anxiety and mood disorders. Glands include adrenal, thyroid and pituitary glands

what are some peer problems for children with conduct disorder

Rejection in elementary school is a risk factor for adolescent conduct problems (5 x greater) Friendships with deviant peers Bullying

behavioral inhibition system (BIS) (Gray)

Related to sensitivity to punishment and avoidance motivation (low in CD)

Behavioral Activation System (BAS) (Gray)

Related to sensitivity to reward and approach motivation (drive, fun seeking) (high in CD)

Talk therapy as an intervention

Relationship between someone who is designated a therapist and someone who is designated a client

**Social

Relationships with family and friends, the larger community

DSM-V Changes to Autism

Removed Autistic Disorder and Asperger's Syndrome and formed Autism Spectrum Disorder

self-stimulatory behaviors

Repetitive sensory and motor behaviors such as hand-flapping, rocking, toe-walking

DSM-V Changes to Intellectual Disability

Replacing term "mental retardation" with "intellectual developmental disorder" previously only looked at IQ score (<70) addition of adaptive behavior to criteria (capabilities in intelligence and adaptive skills)

sociometric classification

Represented by High Social Preference: Like by many, Disliked by few Low Social Impact: Liked by few, disliked by few High Social Impact: Disliked by many, liked by many

Quasi-experimental design

Research design with some, but not all, characteristics of an experimental design

Naturalistic Observation

Researcher goes into child's home, school, etc.

True Experiments

Researchers have maximum control over the independent variable, subjects are randomly assigned, and possible sources of bias are controlled

Reactive Aggression vs. Proactive Aggression

Response to perceived threat vs. aggressive to achieve goal

Brain stem

Responsible for automatic functions that keep us alive. Made from: - Hindbrain - Midbrain - Dienceplon

anorexia nervosa

Restriction of energy intake relative to requirements, leading to significantly low body weight Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain Disturbance in the way one view's body shape or size, undue influence of body weight or shape on self-evaluation

Pros of RoDc

Retains valuable information about disorders Measures severity Reduces stigma

Child care in early 20th century

Return to custodial care and punishment. From a fear of contamination eugenics and segregation were implemented. DSM I was first published in 1952

ADHD Prevalence

Risen sharply over past 20 years because attributing allergens and food additives to ADHD

Dawson (2008): environmental(3), genetic(3), phenotypic (1), neurophysiological (3) risk factors

Risk factors allowing for early identification of ASD vulnerability -Genetic (ex: EN-2, fragile X, SLC6A4) -Environmental (ex: toxins, viruses, maternal hypothyroxinemia -Phenotypic (ex: trajectory of head growth) NEUROPHYSIO -Endophenotypes -Event-related potential to faces -Event-related potentials to speech sounds

Risk factors for developmental abnormalities

Risk factors: poverty family issues parental inadequacies, parental psychopathology

Risk vs. Resilience

Risk: any condition or circumstance that increases the likelihood that psychopathology will develop Resilience: factors that prevent/protect a child from psychopathology, despite presence of risk factors --i.e. intelligence, personality, support, affectionate ties

**Social anxiety VS Autism

SA- fear of interaction , Gets emotionally distressed during many social interactions, Feeling uncomfortable in social situations, and Fear of being negatively judged or evaluated ASD- No motivation, no eye contact, Upset with changes in routine,Repeats words over and over, and Doesn't respond when name is called (appears deaf)

contextual subtypes

SES

Biological treatment for OCD, GAD, and SAD

SSRIs

Medication for Treatment of BN

SSRIs (Prozac, Zoloft, Paxil) may help with underlying negative affect, anxiety and mood problems. If used, should be in conjunction with CBT or other therapy

ADHD Summer Program Readings

STP: focuses on problem solving strategies, academics and behavioral training instead of medication - created by William Pelham Jr point system parent trainings academic rigor of school increased --> harder for kids with ADHD increased number of Dx of ADHD and Rx (b/c new drugs) beginning with behavior therapy --> faster improvement and less expensive over time stimulants more effective as supplemental at lower dose than prescribed for those who need other experts say medication can improve attention/academic performance in addition to behavior parents with kids on drugs less interested in following up with behavior classes

Retrospective Designs

Sample is found at a current time and asked about a time before that

Real-time Perspective Design

Sample is identified at the beginning and followed over a period of time while being recorded

precursors and comorbidity: schizoaffective disorder

Schizophrenia + depression/bipolar (major mood episodes)= schizoaffective disorder BP:manic episodes, depression may or may not be present DE:only major depressive episodes, depression may or may not also be present Psychosis must occur in the absence of mood episodes

Childhood-Onset Schizophrenia (COS)

Schizophrenia is a neurodevelopmental disorder of the brain - expressed in abnormal mental functions and disturbed behavior

School Reluctance and Refusal

School refusal behavior -Refusal to attend classes or difficulty remaining in school for an entire day Occurs most often in ages 5-11 Fear of school may be fear of leaving parents (separation anxiety), but can occur for many other reasons Serious long-term consequences result if it remains untreated

Developmental tests are used in...

Screening, diagnosing, and evaluating infants and young children and identify those at risk

Depression and Suicide

Second leading cause of death among youth in US, Ideation common across psychiatric disorders, but attempts are more common in depression. 60% report thinking about it, 30% attempt by 17, 13-14 peak periods for first attempt, Completed methods: firearms, suffocation, poisoning. Attempted methods: wrist cutting and drug overuse

Patterns of Attachment

Secure - 65% of infants Insecure - 30% of infants Avoidant - 20% Anxious Ambivalent- 10% Disorganized, disoriented - 5% of infants Assumption: Parent behavior impacts child attachment pattern

Categories of Attachment

Secure attachment - 60% Avoidant attachment - 15% Insecure-resistant attachment - 10% Disorganized/disoriented attachment - 15%

**Behavioral/reinforcement

Seeks to explain aberrant behavior by focusing on the learning history of the individual Ex: Child may develop deviant behavior because parents reinforce behaviors

Frontal lobe

Self-control, judgement, emotional regulation

Common features of Autism

Sensory processing (hyper or hyposensitivity) Savant (less than 10%)

Normal Anxieties

Separation Test Concern about competence Need for reassurance Harm to a parent *girls display more symptoms than boys (4-10% of children)

Most Common Anxiety Disorders

Separation Anxiety 4-10% Specific Phobia 7%, 8%, or (4-10%) (most aren't treated

Neurobiology Depression

Serotonin, norepinephrine, dopamine. HPA axis, decreased PFC, increased limbic system activity

During the second year of life

Show specific difficulties with social orienting and shared attention

Poor appetite, Weight loss, Growth reduction (rebound when off medication), Sleep problems, Tics in children prone to tic disorders, "Rebound" effect

Side effects of stimulants

Depression in preteens

Similar to preschool and school age, plus self blame and low self esteem, persistent sadness, and social inhibition

Depression in school age

Similar to preschool, plus increased irritability, disruptive behaviors, tantrums, and combativeness .

cultural mismatch

Situation in which a child's home culture and the school culture hold conflicting expectations for the child's behavior.

splinter skills

Skills in a person with ASD that are above average to have for the general population and are above general intellect

Negative Symptoms

Slowed thinking, speech, movement; emotional apathy; and lack of drive

ASD DSM Criteria

Social-communicative Repetitive behaviors

**Severe

Some ability to talk

Why is the dodo bird verdict a dangerous assumption?

Some therapies are potentially harmful and some are better than others

Clifford Beers beliefs on children

Spearheaded efforts for detection and intervention

Standardization

Specifies a set of standards and norms for a method of measurement to remain consistent

Checklists and rating scales

Standardized reports (good for generalization) but lack of agreement on on information common

What are some reasons parents don't want their child to be diagnosed?

Stigma Blame or guilt Better education Fuzzy boundaries

behavioral inhibition system (BIS)

Stops you when engaging in an ongoing response. Children with conduct disorder have an underactive BIS system.

Strengths of Statistical Deviance

Strengths: -very clear-cut and clean cutoffs -appealing in its objectivity measurable -good for advancing science

TREATMENT FOR CONDUCT DISORDER

Strengths‐based, intensive treatments such as Multisystemic Family Therapy (MST) that involve family, schools, peers, and community work better than "tough love" programs

What is the primary cause of schizophrenia?

Strong evidence of genetic causes of COS

prevalence and etiology: genetics (NT=4) (5)

Strong genetic contribution -Age of paternal parent= risk factor (genetic mutation) -family history of schizophrenia or personality disorder -Parents with children with COS: 10 times more likely to develop schizophrenia -Altered functionality of neurotransmitter: dopamine, serotonin, glutamine, and GABA

Theories & Causes: Biological, SLD

Strong genetic influence - 35%-45% of family members of a child with a LD also have a Learning Disorder Brain Differences Planum temporale- (roughly found in Wernicke's area) in children with LD the size of this area is equal in both hemispheres Inferior frontal gyrus - understanding phonemes Parieto-temporal gyrus - analyzing words Occipito-temporal gyrus - automatically detecting words

Provisional Diagnosis

Strong presumption that criteria will ultimately be met for a disorder, not enough to make firm diagnosis

Neurobiology: Brain Differences

Structural differences: the brain looks different compared to an average brain Functional differences: each area of the brain has a separate and important function

Types of Clinical Interviews

Structured, unstructured, semi-structured

Case study

Study a child over a period of time. Often inconsistent as it only studies a few and can be inconsistent and ungeneralizable

Samples of convenience

Subjects selected merely because of their availability (often used in child studies over random selection)

Clinical Description

Summarizes child's unique behaviors, thoughts and feelings that make up their disorder. Uses: - Intensity - Frequency - Severity - Age of onset - Duration of symptoms - Different symptoms and their configuration

**Limited

Support that is more consistent over time such as time-limited job training

ADHD Predominantly inattentive presentation

Symptom criteria for inattention but not hyperactivity-impulsivity Inattentive, drowsy, daydreamy, spacey, easily confused, "in a fog" Often creative, imaginative, artistic, perceptive

Adolescent-onset Type (CD)

Symptoms appear after 10 years old

Childhood-onset Type (CD)

Symptoms appear before 10 years old

Depression presentation across developmental periods: teens (5)

Symptoms more frequent in adolescence than in adulthood 1. More mood lability or irritability 2. Temper outbursts 3. Somatic complaints 4. Social withdrawal 5. Diminished frustration tolerance

Mental disorder

Syndrome characterized by a disturbance in cognition, emotional regulation, behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning

Best practice guidelines

Systematically developed statements to assists practitioners and patient with decisions regarding appropriate treatment for specific clinical conditions

Concern with behavioral assessment

Target behaviors and the factors that control or influence them

Psychological testing

Tasks given under standard conditions with the purpose of assessing some aspect of a child's knowledge

**Stable adaptive

Teens that were adaptive all the way through development

emotional subtypes

Temperament, emotional cues from other people

Test-retest reliability

Test will give similar answers if given to same person on multiple days

Developmental tests

Tests used to asses infants and young children that are generally carried out for the purpose of screening, diagnosis, and evaluation of early development

Dienceplon

Thalamus and hypothalamus. Regulates emotion and coordinates between forebrain and lower level of the forebrain

Idiographic case formulation

That emphasize the detail representation of the individual child or family as a unique entity

Randomized Controlled Trial

The "Gold Standard" Features: 2 or more conditions, usually 1 intervention, 1 control Random assignment of participants to the different conditions Eliminates selection bias Problems: Ethical considerations Practical considerations

casinos providing money for families who were in poverty making them no longer in poverty. Rates in anxiety and depression remained the same as they moved out of poverty but Conduct Disorder decreased

The Great Smoky Mountains Study (American Indians)

HPA axis system

The HPA Axis. The hypothalamic pituitary adrenal (HPA) axis is our central stress response system. The HPA axis is an eloquent and every-dynamic intertwining of the central nervous system and endocrine system

theory of mind and "mindblindness"

The ability to attribute mental states, beliefs, intentions, and desires to oneself and others. Understanding that one's own perspective are different from others' Sally-Anne Test: marble in basket, moved to box, child says box instead of basket

Resilience

The ability to avoid negative outcomes despite being at risk for psychopathology Associated with strong self-confidence, coping skills, ability to avoid risk situations, ability to fight off or recover from misfortune

Adaptive functioning

The ability to cope effectively with ordinary life demands, to live independently, and to abide by community standards

Resilience

The ability to fight off or recover from misfortune. Aided by protective factors

**Resilience

The ability to recover readily from illness or adversity (bounce back)

Competence

The ability to successfully adapt in the environment

Competence

The ability to successfully adapt to an environment

Pragmatics

The aspects of language that focuses on its appropriate use in social and communicative contexts

Naive essentialism

The assumption that biological predispositions don't matter

Organization of development

The assumption that early patterns of adaption evolve over time and transform into higher order functions in a structured manner Ex: infant eye contact and speech sounds evolve and transform into speech and language

Clinical Psychology

The branch of psychology concerned with the assessment and treatment of mental illness and disability.

Temperament

The characteristics and aspects of personality that we are born with

Depression presentation across developmental periods: tweens

The clinical presentation resembles that in adults -Less likely to explicitly complain of feeling depressed and to exhibit symptoms

**Theory of mind

The cognition and understanding of mental states that cannot be observed directly, such as beliefs and desires, both in one's self and in others

Reliability

The consistency or repeatability of results obtained using a specific method of measurement

Categorical classification

The diagnostic systems that are primarily based on informed professional consensus, which is an approach that has dominated and continues to dominate the field of child psychopathology

Transactional View

The dynamic interaction between child and environment (both child and environment contribute to maladaptive behavior)

Behavioral assesment

The evaluation of the child's thoughts, feelings, and behaviors in specific setting

Incidence Rates

The extent to which new cases of a disorder appear over a specified time period

Validity

The extent to which the method actually measures the dimension or construct of interest

Adaptation failures

The failure to master or progress a developmental milestone for that age range

Prognosis

The formulation of predictions about future behavior under specified conditions

Cultural compatibility hypothesis

The hypothesis that treatment is likely to be more effective when compatible with the compatible with the cultural patterns of the child and family

Comorbidity

The individual meets the criteria for two or more disorders - May be the result of ambiguity in definitions - One disorder may be the cause the other - May be a function of developmental level or temporal relationship - Disorders may share an underlying cause - Some may be true comorbidity

Charles has noticed that every time it rains, both his car and his lawn mower are hard to start up. On the basis of these observations, he develops a theory that humidity reduces the ability of gasoline to burn effectively. Charles theory can be said to have been developed on the basis of which of the following?

The inductive method

Inclusion movement

The integration of individuals with disabilities into regular classroom setting, regardless of the severity of the disability

Severity level is based on

The level of impairment and the degree of support and intervention required

homotypic continuity

The manifestations stay the same, but the underlying process changes. Similar behaviors, traits, or symptoms over time (rare). Polythetic classification

Developmental cascades

The process by which a child's previous experiences and interactions may spread across other systems and alter his or her course of development

Neuromgnaaing

The process of producing images of the structure or activity of the brain, or other part of the nervous system by techniques such as magnetic resonance imaging or computerized tomography.

Treatment planning and evaluation

The process of using assessment information to generate a treatment plan and evaluate its effectiveness

heterotypic continuity

The reflection of the consistency of fundamental differences in personality that changes with age; e.g., the emotionally fragile child will act differently than the emotionally fragile adult, but the underlying trait is the same. the way disorders are expressed changes with development

Dawson (2008): Social Motivation Hypothesis

The role of enrichment (social and physical stimulation) mitigate the effects of genetic and environmental risk factors -->Earlier age of detection→ higher chances of improvement

**Multifinality

The same experience or factor may lead to different outcomes in different individuals

Developmental Pathways

The sequence of timing between particular behaviors and possible relationships between behaviors over time. Multifinality and Equifinality are aspects of this

Comorbidity

The simultaneous occurrence of two or more disorders than would commonly be predicted from general population base rates of individual disorders

Homotypic Continuity

The stability of specific diagnoses and symptom patterns over time. Disorder may continue with similar disorders later on. EX childhood anxiety may progress into Adult anxiety disorders (generalized anxiety, OCD etc.)

Homotypic continuity

The stability of specific diagnoses and symptom patterns over time. For example anxious and internalizing symptoms present during preschool, childhood, and adolescence for the same individual. core features always look the same

Central coherence

The strong tendency of humans to interpret stimuli in a relatively global way that takes the broader context into account

Etiology

The study of causes of childhood disorders. Considers biological, environmental and psychological processes

Developmental Psychopathology

The study of the origins and course of individual patterns of behavioral maladaptation

**Vulnerability

The susceptibility to negative developmental factors under high risk conditions

Research process

Theory to identifying the sample to data collect and back to theory

Direct teaching of skills

There are no assumptions made about the underlying cause

Individuals with ID are more at risk for developing other mental health problems

There is a 3-7 times higher prevalence of emotional and behavior problems in children with ID, although these children show a similar developmental course to normal children with both externalizing and internalizing behavior problem decreasing with age

"There is no such thing as a baby...

There is a baby AND someone"

Semi-structured interview

There is a list of questions that have been worked out in advance but interviewers are also free to ask follow up questions when they feel it is appropriate. Pros: Set questions, less bias, improved comprehension, more reliable and valid Cons: long time, training, and can ruin a rapport

What does multiplicity mean in the context of psychopathology?

There is never just one source or one cause

where does psychopathology begin?

There is no cutoff point that determines where psychopathology "begins"

Intelligence

Thinking and behaviors that are adaptive for individuals as they meet life's demands and pursue life's goals

**"Response to Intervention" or RTI

This approach tends to assume that learning difficulties are external to the child and strongly influenced by the environment

**Subsystems

This could be parents, sibling subgroup, parent-child

Interdependent

To describe the social exchange components of personal relationships

Nonshared environment

To the environmental factors that produce behavioral differences among siblings living in the same household.

Molecular genetics

To the methods of Genetics that directly assess the Association between variations in DNA sequences and variations in particular traits.

Heritability

Trait is determined by the genetic variation by the people across a population

Risk Factor

Trait of individual/their environment related to probability of negative outcome

Treatment for PTSD

Trauma focused cognitive behavioral therapy

Cultural compatibility hypothesis

Treatment is likely to be more effective when compatible with the cultural patterns of the child and family

Diathesis Stress

Two factor measurement, based on genetic predisposition to stressful "triggering" event. The more genetically loaded you are, the less stressful an event needs to be to trigger a mental disorder.

Convergent Validity

Two tests of the same type should give a similar score

Treatment of Childhood/Adolescent Onset Schizophrenia: Mediations- typical vs. atypical antipsychotics, mechanisms of action, side effects

Typical: have MORE Short and long-term side effects Less positive symptoms but more negative symptoms Atypical: Less side effects Emergent research show similar long-term neurotoxicity ---> Medications block or normalize dopamine transmissions

Bowlby

Under Psychoanalytic Model of CP - Object Relations Theory: Refers to our attachment to other people in determining what kind of people we become Stages of Grief and Mourning: 1. Protest: desperate attempt to elicit response from caregiver 2. Despair: sadness and grief similar to mourning 3. Detachment: learned helplessness. Passive and unresponsive to adults that try to engage

theory of mind and who has a problem with this?

Understanding that you have different opinions, views, knowledge than everyone else. Children with autism do not develop that. Sally-Anne example.

nomothetic case conceptualization

Understanding the general pattern of symptoms somebody comes in with

MULTIPLE LEVELS OF ANALYSIS

Understanding the origins and maintenance of psychopathology requires a simultaneous analysis on multiple levels ranging from the neurobiological (e.g., neural systems) to the individual (e.g., temperament) and to all the contexts in which the individual is embedded (e.g., family, school, social).

**Developmental Course of ASD

Up to 6 months of age few noticeable differences from typical infants (not a lot of evidence) Between 6 and 12 months may show: - a failure to respond to their name - a decrease in visual attention - lower activity level

Encoding (social cognitive factors in CD)

Use fewer cues before making a decision and seek less info about an event before acting

Clinical Assessment

Use of systematic problem solving strategies to understand children with disturbances in their family and school environments (assessments and interventions go hand in hand)

Enactment (social cognitive factors in CD)

Use poor verbal communication and strike out physically

Dimensional Systems

Use statistical techniques to identify patterns of behavior that are interrelated Identify factors or clusters Compare scores with other children by gender and age Higher reliability and validity Where do you fall on the scale from 1-10 (worry, anxiety, doubt?)

**Anna Freud: Play Therapy - Psychoanalytic

Used play like dreams would be used in adult psychoanalysis

**Synthesized approach

Uses strategies and viewpoints form a variety of approaches to find what best fits the family and the problem

Reporting measurement method

Utilized to assess perceptions, thoughts, behaviors, feelings, and past experiences of the child, parents, and teachers

An ounce of prevention is worth a pound of cure

Vaccines and young fives

Correlates

Variables associated at a point in time with no clear proof that one proceeds the other

Risk Factors

Variables that precede a negative outcome and increase the chances that the outcome will occur

Protective Factors in research

Variables that precede an outcome of interest and decreases the chance of negative outcomes

Risk Factors in Research

Variables that precede an outcome of interest and increase the chance of a negative outcome

Protective Factor

Variables that reduce the chances of a child developing disorder (ex: social support, access to health care, psychologically healthy parents)

Protective Factor

Variables that reduce the chances of pathological development

Correlates

Variables that share a statistical relationship, in which one variable affects or is dependent on another (but does not necessarily have causality).

Molecular Genetics

Variations in DNA sequencing -- how these affect traits Polygenic model - psychological disorders likely result from multiple interactive genes rather than a single gene

Executive function: language (2)

Verbal fluency Self-directed speech -->Less of it

associated characteristics: cognitive and motivational deficits (6)

Verbal intelligence Orienting and selecting attention Memory (visual recognition and working memory) Pragmatic language Executive functions Cerebellum, limbic system

Cognitive treatments

Views behavior as distortions in child's thinking and seeks to correct faulty cognitions

Family treatments

Views disorders from family disturbances and seeks to fix family issues that are affecting children

Neurobiological treatments

Views issue from psychobiological impairments and uses medicine and other biological approaches to help

Behaviorism works...

We know how to alleviate or eliminate phobias through extinction-based therapies; we know the power of a token economy in regulating behavior on a mental ward; we can reduce problematic behaviors and increase the probability of desired behaviors by judiciously providing and withholding reinforcements. Even for problems that cognitively oriented psychologists study, behavioristic therapies are the treatments of choice. For an autistic child, Lovaas's behavioristic techniques provide the greatest (indeed, so far the only) hope. (Theory of mind debates about autism are fine, but not if you want therapies and treatment - go to behaviorism). Similarly, for stuttering and aphasia, as interesting as their analysis by psycholinguists may be, the treatments come largely from the behaviorists' labs. In the field of neurobiology of learning, the central paradigm is classical conditioning and the main theoretical model is the Rescorla-Wagner model. And behavioristic analyses exist in self-management programs, in industry (Organizational Behavior Management), in sports, in parenting guides, and of course in animal training programs for pets and for zoos. Anywhere that prediction and control of overt behavior is critical, one finds behavioristic analyses at work. In sum, this answer maintains that, although most psychologists don't know it, behaviorism still is alive and thriving...

Weaknesses of Statistical Deviance

Weaknesses: -things that we might think of as being in need of treatment aren't always rare and rare things aren't always in need of treatment. -approach misses some things that we might consider to be real problems and includes as problems things that we might not consider to be problems. -cut-off is arbitrary ex: little may separate a kid who is one point above from another who is one point below a cut-off

WISC-V

Welscher intelligence scale for children, a full IQ score and measures of verbal comprehension, fluid reasoning, visual-spatial reasoning, working memory and processing speed.

**Stable maladaptive

Were stable, but weren't doing well and still wasn't doing well at the end - OCD, Antisocial, anxiety, autism - Not getting worse but not getting better

High Arousal positive emotion

Western culture values

Pervasive Developmental Disorder (PDD)

What ASD was originally called in previous DSM, (included Autism, Aspergers, Retts, , child degenerative disorder, and PDD-NOS)

Gestures, Eye gaze, proximity

What are some Nonverbal behaviors for children with autism

Stereotyped and repetitive motor mannerisms Insistence on sameness Restricted and fixated interests Hyper or hyporeactivity to sensory input

What are some Restricted and Repetitive Patterns of Behavior & Interests

extreme violence, substance abuse, and early sexual activity.

What are some other behaviors that children with conduct disorders get involved in

they tend to be stable across generations

What are the genetic influences of conduct disorders

antisocial personality disorder (APD)

What conduct problems may eventually turn into once the person reaches 18 and has a history of CD before the age of 15

Delays in maturation of the brain thus delays in good executive functions.

What does Delays in cortical development mean? (ADHD)

reduced life expectancy (8 years)

What does impulsivity predict in people with ADHD?

Consumer perspectives

What does your client think about what is happening, Feel better?

it narrows

What happens during adolescents for gender differences for conduct disorder

Activates you in response to rewards. Children with conduct disorder and gambling have an overactive BAS system.

What is Behavioral activation system (BAS)

If a parent learns that they can no longer make their child do anything, they are negatively reinforced that they shouldnt try and yell at their kid anymore because it doesn't work and now the kid is also being negatively reinforced for their bad behavior. Example of prof and 14 year old boy.

What is Coercion theory: negative reinforcement trap

when parents are ineffective they will increase the punishment which lead to an abusive type of punishment (moving from mild to severe). Could be across years of time.

What is Punishment acceleration

back-and-forth conversation, poor sharing of emotions// children with autism

What is Social-emotional reciprocity, and who struggles with it?

Insecure attachment is correlated with later antisocial behavior

What is one family systems theory and cause for conduct disorder

Kanner 1940's; described 11 children with common characteristic: "maintenance of sameness"

What is the historical perspective for autism

**Prognosis

What is the likely outcome or long-term effect with/without treatment?

Deficits in developing, maintaining and understanding them

What kind of relationship problems do children with autism have

associated with anxiety, Mood Disorders, experience depression, Tic Disorders, Oppositional Defiant Disorder by age 7 (mostly boys), Conduct Disorder

What kinds of disorders are comorbid with ADHD?

high levels of inattention symptoms

What most predicted substance use and abuse?

Genes involved in dopamine regulation

What particular genes aren't working as effectively in people with ADHD?

**Treatment Planning

What treatment(s) will likely be most effective?

behavioral and cognitive

What two theory and cause does selgmans work focus on

behavioral inhibition

What type Motor activity is hard for people with ADHD

self-regulation of arousal: having trouble persisting in a boring activity. Or instead of thinking through someone elses actions as an accident rather than on purpose.

What type of Emotion is hard for children with ADHD

Self-talk - walking yourself through something

What type of language do children with ADHD lack?

stimulants

What type of medications are most effective for treatment attention, impulsivity, and activity level?

Working memory- take information from environment, interpret information, manipulate it, and give it back

What type of memory is hard for people with ADHD?

males with CD and callous unemotional (but recognized happiness as quickly)

What types of participants made more errors processing fearful and sad expressions

Treatment efficacy

Whether a treatment can produce changes under well controlled conditions (more often used)

Treatment effectiveness

Whether a treatment can show to work in clinical practice not just well controlled research settings

Internal consistency

Whether all parts of a method of measurement contribute in a meaningful way to the information obtained

Construct Validity

Whether scores on a measure behave as predicted by theory or past research

childhood onset because adolescent limited pathway tends to be more influenced by peers

Which has a higher genetic component childhood- onset or adolescent limited pathway Conduct disorders

executive function deficits, no motivation to do well on test

Why do individuals with conduct disorder score lower on IQ tests

May be associated with limbic system or hippocampus dysfunction

Why is it that children with conduct disorder may not show anxiety in the presence of anxiety-producing stimuli

Major depressive disorder: differences of presentation in children vs. adults (5)

Why the increase of MDD in adolescence? -Confluence of physical, hormonal, social, emotional, and psychological changes -Vulnerabilities potentiate the depressogenic impact of stressful life events -Exposure to peer stress -Early and middle childhood-onset depression is not necessarily predictive of depression in adulthood -The majority of lifetime cases of depression among adults derive from adolescent-onset disorder

Sensitive periods

Window of time during environmental influences on development are heightened, thus providing enhanced opportunities to learn

Sensitive periods

Windows of time where the environment can be most influential

CD heritability

With CU: strong heritability and little shared environmental traits without CU: modest heritability with substantial shared environmental traits

WJ-IV

Woodcock-Johnson IV, yields achievement scores on three broad dimensions; reading, math, and written expression/

Cons of Categorical Diagnoses

World isn't black and white - people don't always fit neatly into specified categories could have 7/8 of symptoms so cannot get diagnosis Can oversimplify something very complicated ex: sad depression vs angry depression People/Children often do not fit into categories Comorbidity Impaired but does not meet criteria Loss of information through oversimplification Current categories are not specific enough May not be the most valid groupings

persistent depressive disorder: differences of presentation in children vs. adults (4)

Worse long-term outcomes than major depression -Social skill learning -Psychosocial functioning -Professional and academic life -Higher risk of relapse or development of major depression

Biological, behavioral, cognitive, peers, poor parental monitoring, abusive parents, and many other influences can lead to conduct disorder making it equifinality. Many to one.

Would it be more accurate to say that conduct problems represent equifinality or multifinality of influences?

Psychotropic medication in youth

Youth are most often prescribed psychostimulants, anxiolytics, antidepressants, mood stablizers, anitconvulsants, or antipsychotic medications. Approximately 7.5% of youths are taking one psychotropic medication.

Equifinality

a basic principle of developmental psychopathology that holds that one symptom can have many causes

Methylation

a biochemical process that influences behavior by suppressing gene activity and expression

hypothalamic-pituitary-adrenal (HPA) axis

a body system involved in stress responses

What is developmental psychology?

a branch of psychology that studies physical, cognitive, and social change throughout the life span

The DSM5 uses what approach to diagnosis?

a categorical approach, a prototypical approach, and a dimensional approach.

Diathesis Stress Model

a diagnostic model that proposes that a disorder may develop when an underlying vulnerability is coupled with a precipitating event Predisposition + stressor = disorder Examples: Schizophrenia, Depression, Alcoholism

How does the DSM-5 define a mental disorder?

a disorder reflects a biological, developmental, or psycholgical dysfunction that causes distress or disability in the indivudal.

multifinity

a given risk factor (e.g., attention problems) can cause multiple different outcomes (e.g., academic failure, substance use, poor social relationships)

panic

a group of unexpected physical symptoms of the fight/flight response that occur in the absence of any obvious threat or danger

classical conditioning

a learning process that occurs when two stimuli are repeatedly paired; a response that is at first elicited by the second stimulus is eventually elicited by the first stimulus alone.

Ecological Model

a model that represents or describes the relationships between the components of an ecological system

Conduct Disorder (CD)

a pattern of repetitive behavior in which the rights of others or social norms are violated

Antisocial personality disorder

a personality disorder in which a person exhibits a lack of conscience for wrongdoing, even toward friends and family members; may be aggressive and ruthless or a clever con artist

cognitive-behavioral therapy (CBT)

a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior) Mindfulness-based cognitive therapy was associated with a 44% reduction in risk of relapse in those with severe MDD

Clinical Interview

a procedure in which questions are adjusted in accord with the answers the interviewee provides are the most common clinical assessment method Interview: Parent/guardian Teacher Child

Parent Management Training (PMT)

a program aimed at teaching parents to cope effectively with their child's difficult behavior and their own reactions to it

statistical significance

a statistical statement of how likely it is that an obtained result occurred by chance

cross-sectional study

a study in which people of different ages are compared with one another

DSM

a system for classifying different symptoms people experience and how they cluster together to become disorders

Classification

a system for representing the major categories or dimensions of child psychopathology

distractibility

a term used to describe deficits in selective attention The inability to maintain attention

Cognitive-Behavioral approach

a treatment approach that incorporates basic principles of learning to change the way people think

operant conditioning

a type of learning in which behavior is strengthened if followed by a reinforcer or diminished if followed by a punisher

mediating variable

a variable that helps explain the relationship between two other variables Anti-social behaviors are linked to substance abuse, partly due to the mutual association with deviant peers. In this case, the association with deviant peers is a _________ variable

mediator

a variable that indirectly causes an effect

moderator

a variable that influences the direction of the relationship between an independent variable and a dependent variable

Separation Anxiety: normal range

about 7 months through preschool years

community factors to promote resiliency

access to services, mentors, community cohesion, school, etc

functional anaylsis

activating events behaviors consequences

genotype

actual gene makeup (individuele genetische aanleg)

Developmental psychopathologists view behavior as....

adaptive or maladaptive, thoughts, feelings and actions promote childrens competence and help them meet important developmental tasks.

impact of Developmentaldevelopmental level late onset

additional developmental influence -->learning disorder -->conduct disorder --> attention defelect hyperactivity disorder -->schizophrenia -->anorexia nervosa

ADHD treatment: neurofeedback

addressed ADHD relevant brain waves detected via EEG (high theta waves - daydreaming and low beta - attention) lots of anecdotal support but no evidence of difference in RCT

Depression presentation across developmental periods: infants

age three is the lowest threshold at which depression appears

Dimensional Approach: YSR/CBCL (youth self report/child behavior checklist)

age, gender, date T-score and percentile standing internalizer vs externalizer specific problems and severity

Separation Anxiety Disorder (SAD)

age-inappropriate, excessive, and disabling anxiety about being apart from parents or away from home. at least 3/8 of symptoms lasting 4 weeks in children

Risk factors

agent or characteristic of an individual or environment that is increases likelihood a person will develop a problem/negative outcome (e.g. poverty, divorce, parent mental illness, community violence)

treatment goals AD

aim at modifying: 1) distorted info processing 2)physiological reactions to perceived threat 3) sense of lack of control 4) excessive escape and avoidance behaviors

ADHD medication MOA

altering activity in PFC and basal ganglia by increasing dopamine availability low dopamine also implicated in motor movement problems stimulants can act as dopamine agonists: -facilitate pre-synaptic release -inhibit MAO action (degrades dopamine) -block dopamine transporters - "selective dopamine reuptake inhibitors"

reinforcement...

always increases the liklihood of the future behavior, can be positive or negative.

Client-centered approach (humanistic)

an approach in which the client, family, and significant others are active participants throughout the therapeutic process

Family Systems Perspective

an approach to doing therapy with individuals or families by identifying how each family member forms part of a larger interacting system

Biological Approach

an approach to psychology focusing on the body, especially the brain and nervous system

Quasi-Experimental

an experimental design that lacks random assignment

Case Study

an observation technique in which one person is studied in depth in the hope of revealing universal principles

Diagnosis involves...

analyzing information and drawing conclusions about the nature or cause of the problem

comorbidity social anxiety disorder

another anxiety disorder, depression, and self-medication

other focus of clinical attention

another target of treatment that affects the diagnosis, course, prognosis, or treatment (aka, V code)

Functional analysis of behaviors follows

antecedents, behavior, consequence. It seeks to identify the antecedents that prompt a specific behavior or the consequences that maintain the behavior over time.

higher risks disorders women

anxieties and fears depression eating disorder --> vrouwen hebben een hogere kans op internalizerende problemen --> emoties

Problems more commonly reported among females:

anxiety disorders, adolescent depression, sexual abuse, eating disorders

Anxiolystic

anxiety inhibitor ex: klonopin

Three broad aspects of psychologcial functioning

appearance and actions, emotions and cognitions.

How comorbid are youth?

aproximatley 40% of youths with one disorder are comorbid, having at least one more disorder. Children are more likely to be comorbid than adults.

autonomic nervous system

arousal and emits sympathetic increase arousal parasympathetic decrease arousal opwinding en stoot sympathiek uit opwinding vergroten parasympathische vermindering van opwinding

A researcher uses a fixed format self-report scale to assess peoples feelings about an issue using a set of items that consist of pairs of adjectives. What type of scale is being used?

assent

Heritability models association analysis

associate gene with behavior --> hiermee kan worden bestudeerd of een bepaalde vorm van een gen samenhangt met een trait of stoornis in de populatie -->vaak wordt op basis van een eerder onderzoek gekeken naar een specifiek gen --> betere methode om meedere genen te ontdekken die een relatief klein effect hebben op een trait of stoornis

benodiazepine-GABA

associated with anxiety Reduces arousal, anxiety & emotional responses

Passive GxE

association between genotype and environment genotype x rearing conditions

gene-enviornment correlation model

assumes that peoples genotypes and their enviornments are not independent, people actively select environments that are conducive to their genes.

ADHD medication: non-stimulant alternatives

atomoxetine --gradual improvement in behavioral regulation boosts norepinephrine lower effect size, bigger individual differences but no potential for abuse/addiction

family systems subtypes

attachment patterns

higher risks disorders men

autism oppositional disorder drug abuse intellectual disability attention deficit hypractivity disorder conduct disorder language disorder reading disability --> mannen hebben een hogere kans op externalizerend probleemgedrag -->neurologische ontwikkelings stoornis

echolalia

automatic and immediate repetition of what others say

course of ADHD

average age diagnosis 7 8- mild ADHD 7- moderate ADHD 5- severe ADHD

Phenylketonuria (PK)

baby appears normal at birth but lacks liver enzyme needed to break down phenylalanine (amino acid)

observational learning

bandera found that children can learn behaviors through simple observation The child imitates the behaviors he/she has observed these learned behaviors can become generalized over the situations Findings from conditioning and observational learning experiments informs on the development of behavior

Temperament

basic emotional style that appears early in development and is largely genetic in origin

hypothalamus

basic urges

Why aren't there many RCTs for treatment of Anorexia?

because they are typically pretty sick therefore, they should not be placed in a control group and everyone should receive treatment

Explanation for why experimental research so difficult to do in developmental psychology

because you can't assign someone to most of the relevant categories i.e. be abused or have depression

behaviorism skinner

behavior is learned Caused by interactions with the environment -->social learning thepory

What are the major forms of psychotherapy?

behavior, cognitive, interpersonal, family systems, psychodynamic.

Parent Management Training (PMT)

behavioral program in which parents are taught to modify their responses to their children so that prosocial rather than antisocial behavior is consistently rewarded For ADHD: manages oppositional behaviors, helps cope with emotional demands of raising child, contains problems

Treatment of depressive mood disorders: : behavioral activation

behavioral therapy for depression in which the clinician helps the client identify activities associated with positive mood -Supportive guidance and watchful waiting as an initial intervention -Treating parental depression is important!

Learning theory

behaviors are acquired through classical conditioning, operant conditioning, or modeling.

ADHD: psychosocial treatment

best is behavioral parent and teacher training, classroom/summer camp programs and emphasizing rewards for attention, self control and obeying rules

bulimia nervosa

binge eating involving enormous amounts of food following compensatory action (purging by vomiting or laxatives, over‐ exercising). Typically maintain normal weight. • Prevalence: 1 - 1.5%; 10x more common in females • Onset in late adolescence (avg age is 18)

Binge-eating/purging type

bingeing followed by vomiting, misuse of laxatives, diuretics or enemas

micro paradigm

biological, behavioral, psychoanalytic, cognitive systems

diathesis-stress model

both a genetic risk and an environmental stressor are necessary for a disorder to arise

Central tenet of developmental psychopathology

both normal and abnormal development are shaped by interactions of biological, psychological, and socio-cultural factors over time

CD more common in...

boys

who are more likely to vape?

boys

frontal cortex

brain region that regulates personality and goal-directed behavior

Define protective factors

buffer against risk factors, promote adaptation, increase likelihood of positive outcome

Developmental course for AN

c. 50% full recovery c. 33% fair recovery c. 20% chronic course

Deviation from social norms Weaknesses:

can be biased by social values of the time requires that we trust that we have the right social values (ex: think about how homosexuality was considered to be a mental disorder many years ago)

sufficient cause

can be responsible alone

neurotransmitters

can inhibit neurons or make them more active

temporal maladaptation

can reflect transit experience,emta; risk taking --> temporary maladaptation --> experimental risk behavior example --> use of illigal drugs -->een slechte fase

moderating effects

can't change--age, skin color, etc

Functional impairment/disability Strength:

captures how much an issue negatively impacts your life important in terms of determining whether or not someone needs treatment. Maybe it's not a problem if it's not impacting the person's functioning.

Multisystemic therapy

caregivers key to achieving outcomes intensive process highly individualized, strength based improved family functioning is critical to achieving favorable youth outcomes assumptions: multiple systems have direct and indirect influences (family, school, peers, neighborhood) influences are reciprocal and bidirectional

Etiology

cause of disease

beta instructions

chain, vague, question, "let's" instructions instructions followed by rationale

Persistent Childhood Characteristics

characteristics that do not change over time like sociability, obsession, and aggression

anal phase

child becomes clean

oral phase

child does everything in his mouth

Conduct problems etiology/precursors: modeling

child imitates parent behavior

cumulative continuity

child in an environment that perpetuates maladaptive style

genital phase

child receives secondary sex characteristics

Active GxE

child's heritable trait leads to selection of compatible environment youth with genotype seeks similar peers

Conduct disorder subtypes

childhood onset: at least 1 symptom before age 10 (greater in boys, more aggression & crime, higher likelihood of APD by 18) adolescent-onset: no symptoms before age 10 (less aggression/crime - more likely to outgrow over time)

define active gene-environment correlation

children actively select environments that fit genotype -child selects moody friends who reinforce own moodiness child's genes -> child selects environment -> child's phenotypes

Transactional Model of Development

children and their environments are interactive and dynamic; children and their environments are also reciprocal

Children from what kind of families are at a greater risk for psycholgical disorders?

children from low-SES (socioeconomic status)

3 x

children with ADHD are how much more likely to experience serious accidental injuries as children

SIT most . effective for...

children with attention problems PARENT TRAINING

intelligence

childs ability to adapt to their environment to solve problems, and to learn and use information accurately and efficiently.

gen environment correlations active

childs gene makeup and child's selection of experiences --> neemt toe naarmate ze ouder worden

gen environment correlations reactive

childs gene makeup and reactions from others --> neemt toe naarmate ze ouder worden

define association studies

choose a gene and look for an association with the disorder

stable maladaption

chronic environmental adversities -->exposure to chronic negative conditions -->maladaptive behacior, such as anticocial behacior is involved -->example: aggressice, antisocial behavior maintained constant slecht

wet stop alarm

classical conditioning: neutral stimulus of full bladder becomes conditioned stimulus and elicits waking response operant conditioning: alarm sound is aversive stimulus that leads to avoidance response (not urinating) to end aversive stimulus -- neg reinforcement

kreapelin

classification verschillende symptomen vormen samen een syndroom en hebben waarschijnlijk een gemeenschappelijke oorzaak

contingency management

clear and consistent consequences for child's behavior

evidence-based practice

clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

Conduct problems etiology/precursors: differential rewarding

coercion theory: parent child interactions as training ground for antisocial behavior neg reinforcement neg reciprocity (e.g. arguing --> build upon neg things said) escalation

disorder

common set of signs and symptoms

What do twin studies analyze?

compare concordance between MZ & DZ twins difference between DZ twins' scores is from genetic and/or environmental effects difference between MZ twins' scores is from environmental effects

Neglectful/Indifferent

completely uninvolved Low Responsive Low Control

Disinhibited Social Engagement Disorder

condition in which a child shows no inhibitions whatsoever in approaching adults

Domains of Competence

conduct the self Particular areas of skills and achievements such as academic achievement, behavioral competence, and social competence.

Behavioral geneticists

conduct family, adoption and twin studies to determine the heritability of intelligence, personality and disorders.

Molecular genetics

conduct linkage and association studies to identify specific genes that may underline certain disorders.

bipolar disorder as related to schizophrenia: along the same spectrum of disorders

conduct/oppositional disorder, major depressive disorder, schizophrenia/unspecified psychosis are more likely diagnoses -Episodic nature of illness and dramatically different presentations make it difficult to diagnose

midbrain

connects hindbrain to higher structures Reticular activating system (walking and sleeping)

reliability

consistency across multiple measurements/across different sources dimensional estimates more reliable

risk factors

constitutional (genetic/health) family emotional and interpersonal intellectual and academic ecological nonnormative life events

The validity of a test refers to...

content, construct, criterion related validity

DP operates on a...

continuum

mediating effects

coping mechanisms, motivation

Psychopathology is failure to obtain....

core developmental competences progressive veering from normal developmental trajectories and an accumulation of behavior patterns considered maladaptive in most contexts

Heterotypic continuity: CD-ODD

core problem may be same but outward forms may change so symptoms of ODD lead to symptoms of CD mean age ODD is 6 and CD is 9 --> ODD gateway to CD? ODD: 0.25 progress to CD 0.5 stay ODD 0.25 lose dx

Child MDD recovery

correlation between having more episodes and faster recovery from episodes

Client-centered approaches:

create a therapeutic setting that provides a corrective experience for the child Unconditional positive regard

Historical Perspective on Developmental Psychopathology In 1866

cruelty to animals became a punishable offense in England 60 years later, child abuse became a punishable offense

5 levels of analysis in developmental psychopathology

cultural socio-familial psychology biology genetics

CD/ODD etiology

cumulative continuity interactional continuity

ADHD etiology: neurotransmitters

deficiency in available dopamine

clinical significance

degree to which research findings have useful and meaningful applications to real problems

Proactive aggression (conduct disorder)

deliberate, aversive behaviors; picking fights; bullying Cognitive deficit: positively evaluate aggressive situations (kicking the kid and taking the ball is the best option)

Beck's cognitive triad

depressed people make negative interpretations about life events -->Filters for understanding world are biased and negative

Naturalistic design

design in which experimenters investigate participants in their everyday environment

The discontinuities of Behavioral and Emotional Disorders

development changes are inconsistent and non-linear (ex: child develops normally until adolescence)

The continuities of Behavioral and Emotional Disorders

development changes are persistent and stable (ex: child is aggressive and continues to be so throughout adulthood)

Define developmental epigenesis

development unfolds over time. Genetic biological, psychological, social-familial, and cultural factors interacts with each other across time to shape outcomes. Because of the complex interplay of factors affecting development, children's outcomes are probabilistic, not predetermined

variables of indentification of problems of youth

developmental norms cultural norms gender norms situational norms role of adults changing views of abnormality

Four pillars of child assessment

diagnostic interviewing, behavioral assessment, norm reference testing, and informal data gathering.

Equifinality (branching tree)

different beginning points lead to the equal ending (ex: CSA or brain injury BOTH lead to depression) IMG: predictor 1, predictor 2, predictor 3 --> all lead to a specific behavior, distress, or success.

heterotypic continuity

different diagnosis in adulthood from childhood, but similar symptoms and same salient developmental issues Anxiety --> OCD

Equifinality:

different experiences can lead to the same disorder

cross sectional

different groups observed at one point participants are examined once often groups are compared with each other that differ in age or development level

Multifinality

different outcomes can have similar beginnings

difficult Temperament and attachment issue

difficult temperament can lead mothers to ignore and neglect children because nothing you do calms them down. Thus, leading children to become insecure and disorganized

externalizing problems in middle childhood and convictions for violent offenses in adolescence & adulthood

difficult temperament in childhood predicts what?-

Emotion Reactivity

dimension of emotional processes associated with individual differences (in threshold) and intensity of emotional experience

DISRUPTIVE MOOD DYSREGULATION DISORDER (DMDD)

disorder in which children with are irritable and angry (most of the day nearly everyday) and have frequent temper outbursts (3 or more times per week) and in many different situations.

Heterotypic Continuity

disorder predicts other types of disorders (e.g. anxiety predicts depression)

CD childhood onset

display at least one symptom before 10 y/o Typical onset is 9 y/o more likely to be boys agressive/persistent antisocial behavior Higher risk for maladjustment than teen-onset Account for majority of violent crime

psychotropic medications

drugs that mainly affect the brain and reduce many symptoms of mental dysfunctioning

Differences between ODD and CD

earlier onset than CD (6 y/o) lower magnitude of risk factors than CD can develop into CD always precedes CD

onset SAD

earliest reported age (7-8)

Developmental trajectories

early biological and psychosocial experiences affect brain development and later brain structure and functioning and psychological development

symptoms must be present in...

early childhood

Define evocative gene-environment correlation

early genotype & early phenotype evoke responses from others that may further strengthen the phenotype -initial child moodiness leads others to over/under-respond, leads to more moodiness child is predisposed to moodiness which makes them act moody, and then people start saying "ignore them that's just how they are" so the child's moodiness is reinforced

What are the 3 primary temperament classifications (Thomas & Chess, 1977)?

easy Slow to warm up difficult

temperament types

easy (can be a resilience factor) slow to warm (can be a risk factor) difficult (can be a risk factor)

Usual clinical care

eclectic and diverse not highly structured focused on therapeutic relationship not based mainly on empirical evidence

RNA (nederlands)

een molecuul die informatie vervoert naar andere delen van een cel waarbij het een rol speelt in de vertaling van de poducties van proteins

Behavior therapy is mostly _____ for children

efficacious

DSM Criteria: ADHD

either A) inattention and/or B) hyperactivity-impulsivity 6 mos duration -- misfit with developmental level other requirements for diagnosis: 1. symptoms must be present in 2 or more situations 2. several symptoms before age 12 3. must cause clinically significant distress or impairment in social, academic, or occupational functioning 42% increase in dx 2003-->2011

developmental regression or detrioration

emergence Bedwetting as 7 years old

developmental delay

emergence phonological disorder

limbic system

emotion and memory center

decline of adaption

environmental or biological shifts bring adversity example--> family divorce contributes to maladaptation -->goed naar slecht

Pros of Prospective Design

establishes temporal order

tertiary prevention

ex: after-the-fact, such as rehab

secondary prevention

ex: getting child involved, such as a sport, to increase self-esteem and sense of beloning & reduce depression

primary prevention

ex: vaccines

Separation Anxiety Disorder

excessive anxiety about separation from major attachment figure

Seperation Anxiety Disorder

excessive distress when away from caregiver

Dysphoria

excessive unhappiness

people with ADHD have brain structure differences in areas associated with _________

executive function abilities

anxiety disorders

experience excess and debilitating anxieties compared to the moderate, helpful anxieties in everyday life. many suffer from more than one type

mediators

explain relationship; x = y; probably because of z early puberty (x) causes depression in adolescent girls(y), probably because of bullying(z)

diathesis stress model

explains disorder as result of interaction between predispositional vulnerability and stress caused by life experience

Risk and Resilience

exploration extends earlier risk-taking personal factors & social support foster resilience (planning & decision making, positive self-esteem, sense of responsibility, secure relationship with parents)

ESTs

expressed sequence tags

phenotype

expression of genetic makeup(observeerbare kenmerken van een persoon)

3 approaches of behavioral genetics

family studies adoption studies twin studies

Family and Peer Context

family system theorists say it is difficult to predict behavior of child, due to focus on relationships

stable adaption

few environmental adversities: few behaviour problems: good self worth --> low exposure to negative conditions --> the adolescent had a few behavioural problems and a positive self image constant goed

causes bipolar

few studies, but it is the most heritable of mental disorders. 5x greater likelihood for child to get diagnosis if parent has.

Barriers to children receiving treatment are?

financial problems, cultural deviancy, behavior rigidity.

operant conditioning Skinner shaping

first provide praise for child cleaning the room after being nagged, later only provide praise when child cleans on his own without first being nagged

ADHD issues

fit youth to environment? maybe just problem because don't fit with current environment

Treatment Strategies: Initial Stages

focus on building rapport and teaching learning-readiness skills

Developmental psycopathology

focuses on children and adolescents studied in terms of age differences some developmental specific treatments no grand developmental theory DSM: junior versions of adult disorders youth treatments also junior version

Treatment of depressive mood disorders: interpersonal therapy

focuses on improving interpersonal communication and social context; works on understanding poor relational templates and establishing healthy relationships

Developmental Psychopathology

focuses on origins and course of psychological maladaptation in the context of normal development

ADHD etiology: diet

food dyes/preservatives not well accepted kids in general may improve on diet w/o preservatives

abrupt changes in behaviour

form appearance of social withdrawal

behaviour qualitatively different form normal

form lack of normal eye contact

several problems behaviour

form separation anxiety

missouri delinquency project

found MST completers less likely to get arrested after therapy and takes longer to get arrested MST dropouts do better than IT (individual therapy) completers and dropouts MST also cheaper than usual services

fMRI

functional magnetic resonance imaging, provide information about brain functioning while performing specific tasks.

Conduct problems etiology/precursors: genetic influences

genes influence 50% of pop variation in ASB shared environment 20% person specific environment 30%

define genotype

genes inherited from parents

Genotype

genetic makeup of an organism individual inherits

Downs Syndrome

genetic mutation that is best known of clinical conditions associated with moderate and severe intellectual disability

impact of originsdevelopmental level earlyonset

genetic/ prenatal etiology --> language disorder --> autism -->rett disorder --> asperger disorder

depression more common in...

girls and hispanic and white children

The Child Behavior Checklist (CBCL) does what?

gives clinicians a useful profile of the variety and degree of the child's problems

usefulness of categorical approach

good for organizing knowledge into clusters, assessing epidemiology (prevalence, incidence), studying recovery/recurrence, info to public, payment systems organization

precursors and comorbidity: prodromal phase

gradual onset Prodromal phase: behavioral, social, psychiatric disturbances before onset of psychosis (95%) 70% meet criteria for another diagnosis, most commonly a mood disorder or ODD/CD

latent phase

great urge of knowing

ADHD etiology: genes

greater concordance in MZ/identical twins parent w/ ADHD - risk to child is 60% DRD4 -- consistent with reduced dopaminergic activity

CD adolescent onset

greater gender equality less severe than childhood onset less likely to commit violent crimes/persist in behavior over time few child risk factors most antisocial behaviors stop by early adulthood (especially in lower SES)

individual approach

guided by what will result in the individual's best long-term interests, which ultimately are in everyone's self-interest

Enuresis

habitual involuntary discharge of urine

physical consequnces of eating disorders

heart problems, damage to teeth, GI problems, dehydration, dry skin, stopping menstruation, stress fractures, growth delay

Purpose of Assessment (Research)

help us understand epidemiology Age on onsets Risk factors for disorders, correlates, etc. What does this tell us about their developmental trajectory?

Evocative GxE

heritable behavior evokes corresponding environmental response genotype x classroom/teacher/peer response

community risk factors for child abuse

high crime, poverty, unemployment, etc

Conduct problems etiology/precursors: inter-parent discord

high in CD youth parents could distract from child management/be modeled in children

Conduct problems readings

high intensity defiant behavior, aggression towards people/animals, high intensity destruction of property, peer problems --> CD likely many CD kids low income and history of abuse/neglect, not intact households

Children with anxiety disorders tend to show "hypervigilance"

hostile attributional bias - other people are out to get me and whatever happens to me is done purposefully -like conduct disorder

Family Instability & Stress Extrafamilial stressors (moving to new location) Parental psychopathology Marital discord

how can family systems influence conduct disorder

Kids with CD tend to hangout with other deviant peers. These peers create these dangerous environments and opportunities

how can peers influence conduct disorder

Children with conduct disorder - view large amounts of violent material, prefer aggressive characters, and believe fictional content to be true Correlation between TV violence and aggressive behavior

how can the media influence conduct disorder (contextual)

As many as 90%

how many adolescents with depression have comorbid diagnoses

goodness of fit

how the childs behavioral tendencies fit with their parents temperament and their social environment

ADHD etiology: CNS dysfunction

hyperactivity/impulsivity attributed to reticular formation & pons/RAS attention deficits attributed to faulty functioning of PFC & basal ganglia (ADHD kids have smaller right PFC and reduced BG volume) underarousal hypothesis: general account -- psychophysiological measures show diminished arousal, lower PFC activation during attention tasks, lower blood flow to PFC and other frontal regions

Treatment of depressive mood disorders: cognitive behavioral therapy

identifying, challenging, and modifying cognitive distortions and increasing self-reinforcement -evidence based treatment for severe depression

What do adoption studies analyze?

if genetic, should be more similar to bio relatives than adoptive families

family risks AD

if the parents have, children 5x more likely, 1/3 of variance in child symptoms are genetic. low levels of serotonin and dopamine reported, parenting practices: overinvolved, intrusive, limiting independence, prolonged exposure to family dysfunction, insecure early attachment

protoimperative vs. protodeclarative gestures

imperative: pointing to indicate wants and desires declarative: pointing to draw attention to object or share interests

Neurofeedback reading

improvement on neurofeedback equal regardless of medication children on neurofeedback did not increase medication dose over year

Anhedonia

inability to experience pleasure from activities usually found enjoyable

what are the operant principles for conduct disorder

inadequate positive reinforcement for good behavior reinforced for negative behavior ineffective or no punishment

to be diagnosed with ADHD you must have at least 6 of the _____________ symptoms, and 6 of the ________ symptoms before age 7

inattention, hyperactivity

3 subtypes of ADHD

inattentive, hyperactive-impulsive, combined

Epidentic structures

include histones and other chemicals that can turn genes on or off.

Personal Distress Strength:

incorporates the feelings of the parties involved captures the phenomenology of the experience, which is an important part (ex: if the person is distressed, that should matter)

How psychostimulants work

increase dopamine levels in frontostriatal circuitry

Emotion reactivity

individual differences in the threshold and intensity of emotional experience, which provide clues to an individual's level of distress and sensitivity to the environment. infant-caregiver relationship important

protective factors

individual/personal factors family factors extra familial / factors outside the family

Resilience

individuals display positive adaptations despite negative life events or significant adversity - "thrive in the face of adversity" Result of many different factors

Secure attachment

individuals easily seek and respond to comfort from caregivers and other close relationships

dopamine

influences movement, learning, attention, and emotion

retrospective longitudinal

information is collected about their precious characteristics and life experience

Clinical Assessment

information is obtained from different informants, in a variety of settings, using various methods

partieel lobe

integrating senses

anorexia nervosa

intentional extreme restriction of food intake and fear of gaining weight. Despite being thin, they see them selves as overweight. • Prevalence: 0.4%, more common in females (primarily post‐puberty)

Transaction

interdependence of child and environment

Define risk factors

interefere with ability to adapt to environment, increase likelihood of negative outcome

endophenotype

intermediate phenotype between genetic makeup and full expression e.g. anhedonia allows for focus on more homogenous cluster or people, more precise analysis, features

amygdala

involved in memory and emotion, particularly fear and aggression.

Case Study

involves an intensive, usually anecdotal, observation and analysis of an individual child brings together a wide range of information about an individual child from various sources, including interviews, observations, and test results

Depression and Kids

irritability is much more common than depressed mood

Most recover, but are then at risk for other disorders

is Persistent Depressive Disorder likely to reoccur?

Psychotherapy

is a professional relationship between at least two people with the goal of alleviating distress or impairment and promoting growth and adaptation in one person. It requires; a trusting relationship, plausible techniques to improving function, unconditional positive regard, congruence and empathy.

What do family studies analyze?

is behavior/disorder more common among closer biological relatives vs. more distant relatives?

Substance use disorder (SUD) i

is marked by cravings, using more than intended; problems with peers, at home, or in school; risky use of the substance even when teens know it is causing problems in their lives; and the build‐up of tolerance to the substance.

Why have people referred to these historical views and ways that children have been treated in society as a pendulum?

it has moved back and forth. you can kill your child to locke to they are possessed to you can no longer beat them

advantage

it provides guidelines for the way a problem is approached, investigated and interpreted

Conduct problems etiology/precursors: active rGE

kid's genetic liability --> seek out bad environment e.g. pick aggressive peers

Orthorexia

kind of the same behaviors as anorexia except you only eat super healthy food like nuts and kale and end up malnourished. Not about losing weight but being as healthy as they can

parenting style neglectful

kinderen kunnen verwaarloosd worden ouders zijn niet betrokken bij het kind er worden geen grenzen gesteld kind heeft meer kans op antisociaal gedrag, aggressie, weinig zelfvertrouwen

Insecure attachment

lack of trust and difficulty forming close bonds with other people Expect to not be supported, could be harmed by others

gene-driven development

largely directed by biological factors

Manic episodes (7)

lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary) -Inflated self-esteem or grandiosity -Decreased need for sleep -More talkative than usual or pressure to keep talking -Flight of ideas or subjective experience that thoughts are racing -Distractibility as reported or observed -Increase in goal-directed activity or psychomotor agitation -Excessive involvement in activities that have a high potential for painful consequences

Conduct problems etiology/precursors: chronic underarousal

leads to stimulus seeking studies show criminals have lower HR and skin conductance than normal

behaviorism bandura

learned behavior also comes from observations of one's environment -->cognitive model

prevalence of depression in preschoolers

less than 1%

sluggish cognitive tempo

lethargy, susceptibility to daydreams, confusion, and social withdrawal

prevalence social anxiety disorder

lifetime: 6-12% children, twice as common in girls (hippocampal activity in females only increased)

Conduct disorder specifiers - callous/unemotional traits

limited prosocial emotions lack of remorse/guilt callous-lack of empathy unconcerned about performance shallow/deficient affect

heritability models Linkage analyses (nederlands)

locating defective genes --> hiermee kan worden uitgezocht wat de precieze locatie is van een defect gen --> hiermee kan worden nagegaan of een specifieke stoornis het gevolg is van defecte genen

define linkage studies

look for differences in genes for people with and without the disorder

ADHD etiology: pregnancy & birth problems

low birth weight, environmental toxins, birth complications, disease

Conduct problems etiology/precursors: MAOA

low level of enzyme linked to aggressive behavior

Yerk Dodson Law

low or high arousal leads to poor performance

MRI

magnetic resonance imaging, provide information about brain structure

cumulative continuity

maladaptive behavior perpetuates itself through accumulation of its own consequences

interactional continuity

maladaptive interactional style evokes reciprocal, maintaining responses from others

Social Anxiety Disorder (Social Phobia)

marked fear/anxiety about social situations in which the individual exposed to possible scrutiny and fears they will act like they are anxious or show anxiety symptoms. social situations are avoided or endured with intense anxiety. 6 months or more

Dev tasks elementary school

mastery of language increased gross and fine motor skills increased focus increased response inhibition

individual factors to promote resiliency

mastery, relationships, understanding, temperament, expression, conflict resolution, culture

Causes for deviations from pathways of normal development

may be caused by include life events, experiences, biology, etc.

validity

measures what it's supposed to measure dimensional estimates also more valid

MTA findings

med & combined groups better than behavior/community on many measures meds superior to other approaches combined treatments better for some outcomes 36 month assessment: no groups differ significantly critiques: design limitations - timing relative to treatment intensity (behavior intervention ended 14 mos earlier) combined group receiving 20% less meds at end but considered equal to medication group

onset social anxiety disorder

median age: 13, rare under 10, may follow stressful or humiliating experience or develop slowly

DSM Criteria: ODD

misconduct for at least 6 months with at least 4 symptoms from any of these clusters: angry/irritable mood: -lose temper -touchy or easily annoyed -angry/resentful argumentative/defiant: -argue with authority -refuse adult requests -deliberately annoy others -blames others for mistakes vindictiveness

opportunity school

misnomer "troubled" youth sent there often reinforces behavior

mixed methods (accelerated longitudinal research

mixes cross-sectional and longitudinal designs different groups compared for a long period

cultural adaptation

modifying interventions either in content or program delivery to address core values, beliefs, etc. of community receiving the intervention

causes of pediatric bipolar disorder: brain abnormalities (5)

mood fluctuations related to: -Emotional regulation in prefrontal and anterior cingulate cortex -Hippocampus -Amygdala -Thalamus -Basal ganglia

anxiety

mood state characterized by strong negative emotions and bodily symptoms of tension in anticipation of future danger (future-oriented)

Children with anxiety don't worry ___ , they worry more ____.

more; intensely

of average or above average intelligence

most kids with ADHD are

Hindbrain

most primitive part of the brain - information is processed outside of our awareness without any conscious effort

ADHD etiology: sugar intake

most studied show no effect of reducing sugar intake

cerebellum

movement and cognitive processes

equifinality

multiple causes, one outcome

Equifinality

multiple pathways can lead to the same development outcome (e.g., aggressive behavior can be the result of a variety of bio or environmental factors)Equifinality

necessary cause

must be present for disorder to occur

internalizing behavior

negative behaviors that are directed inward at oneself, creating anxiety or depression.

negative cognitive triad

negative thoughts about the self, the world, and the future

Beck's Negative Cognitive Triad

negative views and devaluing of the self, the world, and the future

peripheral nervous system

nerves outside the CNS --> these nerves send messages between cns and other areas

Autism Spectrum Disorder

neuro-developmental disorder that involves a wide range of problematic behaviors including deficits in language and perceptual and motor development

disabilities in the functioning of the brain that affect behavior, memory, or ability to learn

neurodevelopmental disorders

biological subtypes

neurotransmitters brain structures

treatment bipolar

no cure, but treatment can stabilize mood and allow for management and control of symptoms. multimodal plan=necessary

causes AD

no single theory is sufficient, born with a predisposition to be sensitive to stimuli, hyper vigilant, and behavioral inhibition. parents=overprotective or overinvolved, rigid parenting,

Relational aggression

nonphysical acts, such as insults or social rejection, aimed at harming the social connection between the victim and other people common with girls

contributing cause

not always necessary but sufficient for cause

abnormaal behavior

not just atypical but can be also harmful Developmentally inappropriate When the act of someone deviates from the normal standard of behavior according to this definition, a child with a far above avarage IQ is also abnormal Not only atypical but can also be harmful, developmentally inappropriate --> klinisch significant patroon bij een individu

incidence

number of new cases developing disorder within specified period of time

period prevalence

number of people with disorder at any time during specified period

point prevalence

number of people with disorder at specific point in time

define phenotype

observable expression of genes -determined by gene-environment interactions

extremely high or low frequency of behavior

occurence compulsions

behavioural difficulty persisting over time

occurence depression

extremely high or low intensity of behaviour

occurence specific phobia

behavioral inappropriate to the situation

occurence Specific disorder

social learning

occurs when a child acquires a behavior though imitation or modeling

Classical conditioning

occurs when a child learns to associate two stimuli together in time. Pavlovs dogs

Operant conditioning

occurs when child associates one behavior with a consequence in the environment

Equifinality

occurs when children with different histories show the same outcomes

Multi finality

occurs when children with the same history show different outcomes.

phallic phase

oedipuscomplex a boy want to have his mother for himslef Electracomplex A girl falls in love with her father

Personal Distress Weaknesses:

often times the person who has the problem isn't distressed about it (but others are) ex: kids who exhibit antisocial behavior or kids with ASD often they are unaware of the problem or think that others are the problem.

multifinality

one cause can have many manifestations

multifinality

one cause, multiple outcomes

Equifinality

one disorder can have many causes

prevalence SAD

one of 2 most common anxiety disorders, occurs 4-10% of children (mostly girls), more than 2/3 have another AD. or 1/2 depressive.

Equifinality

one symptom/disorder can have many causes

transactional/ systems model

ongoing reciprocal transactions of environment and person

Oppositional Defiance Disorder ODD

onset 8 y/o Similar symptoms to CD, especially irritability, aggression, defiance, and vindictiveness

Historical Perspective on Developmental Psychopathology Late 1800's

organic disease model compulsory education improved health practices mental illness vs. mental retardation

hostile attributional bias (conduct disorder)

other people are out to get me and whatever happens to me is done purposefully Cognitive deficit

parenting style permissive/ indulgent

ouder zijn niet gericht op responsiviteit ouders zijn weinig veeleisend/hanteren weinig regels de kinderen hoeven zich niet gepast of volwassen te gedragen kind heeft meer kans op antisociaal gedrag, aggressie, weinig zelfvertrouwen en schoolproblemen

parenting styles autoritarian

ouders zijn koud , onverantwoordelijk en veeleisend ouders zijn erg gericht op contole en duiden geen tegenspraak ouders hanteren strenge regels kind heeft meer kans op antisocial gedrag, aggressie, weinig zelfvertrouwen en schoolproblemen

parenting styles authoritative

ouders zijn veeleisend ouders geven veel steun ouders zijn warm, accepterend en responsief duidelijke normen en grenzen en verwachten dat het kind zich aan de regels houdt geassocieerd met positieve kind eigenschappen: onafhankelijkheid, prosociaal en zelfverzekerd

temperament AD

overactive behavioral inhibition system (BIS), heightened sensitivity to nonreward things, punishment, and novel stimuli. results in avoidance of such environments to prevent negative experiences

operant conditioning Skinner extinction

parent ignores bad behavior and behavior decreases

operant conditioning Skinner positive reinforcement

parent praising goof behavior increases this behavior

operant conditioning Skinner negative reinforcement

parent stops nagging if child spontaneously cleans roomm

Conduct problems etiology/precursors: passive rGE

parents give kid genetic liability and create violent environment that is symptomatic of parents' genetic liability

gen environment correlations Passive

parents transmit both genes and environment to their children --> neemt af naarmate ze ouder worden

prefrontal cortex

part of frontal lobe responsible for thinking, planning, and language (executive functioning)

Three types of gene environment correlations?

passive, evocative and active

Oppositional Defiant Disorder (ODD)

pattern of angry mood, irritable behavior, vindictiveness lasting at least 6 months 4 symptoms exhibited

Conduct problems etiology/precursors: differential attending

paying attention to behaviors affects how child responds e.g. giving attention for annoying behavior --> child reinforced to do behavior

PTSD

persistent, frightening thoughts that occur after a traumatic experience

course and outcome SAD

persists into adulthood for more than 1/3

parent-related risk factors for child abuse

personal history of abuse, single parents, teenage parents, domestic violence, etc

paradigm

perspective shared by investigators a kind of cognitive frame of reference that includes assumptions and concepts It serves to define - what should be studied - what questions should theories. -how they should be asked what rules should be followed in interpreting the answers obtained

Gene-environment interaction

phenotypic effects that result from environmental influences interacting with genetic predispositions

endophenotypes for ASB:

phenotypic traits thought to represent biological systems underlying a disorder -- assumed to be under more direct genetic influence than disorder itself 1. callous/unemotional 2. executive dysfunction (poor problem solving and planning ability --> impulsive choices) 3. dorsolateral PFC dysfunction (impulse braking failure)

macro paradigm

phonologically, morphology syntactically, semantically

Phenotype

physical characteristics of an organism

somatic complaints

physical complaints about emotional pain stomach or head aches

anxiety components

physical, cognitive, behavioral

Treatment

planning and evaluation apply assessment information to generate a treatment plan and to evaluate its effectiveness

Context

plays a crucial role in pathology through which behavior develops. These forces interact to produce healthy outcomes or pathology

CD/ODD prevalence

point prevalence|CD: 2-6% ODD: 4-12% childhood onset: male>female adolescent onset: male=female risk factors for girls: early menarche & mixed gender schools & poor parental monitoring (more affiliation with boys getting into trouble --> peer group effects)

Do Children with ADHD do poorly or well on a partial reinforcement schedule?

poorly. The more reinforcement the better for children with ADHD

operant conditioning Skinner generalization

positie reinforcer increases multiple behaviors

Define resilience

positive outcomes despite large risk factors (promoted by protective factors)

demonology

possessed or otherwise influenced by evil spirits and demons

heterotypic continuity

prediction of a disorder by another disorder

ADHD subtypes

predominantly inattentive presentation predominantly hyperactive-impulsive presentation combined presentation

child-related risk factors for child abuse

prematurity, low birth weight, handicaps, etc

fear

present-oriented, in the face of current danger, and marked by strong escape tendency

anticonvulsants

prevent or control seizures (clonazepam, phenytoin, gabapentin)

Functional impairment/disability Weaknesses:

problems that aren't currently impacting a kids' functioning could impact the functioning later if not addressed people aren't aware of the ways in which an issue is affecting their functioning ex: sometimes clients with social anxiety aren't aware of all of the ways in which having this problem is affecting them because the distress with which they endure social interactions makes those experiences less desirable to them in the first place) many times people are able to function through pathology, so that others don't know they are suffering because they can keep it together in certain ways/times ex: student who is getting perfect grades but dying inside

thalamus

process and relay information between cerebral hemispheres

- Reuptake

process by which neurotransmitter molecules detach & are reabsorbed

limbic system

processes emotional functioning information

Dimensional Approach

profile across dimensions, degree of severity, empirical, statistical analysis, behavioral model (doesn't assume illness), covariation/correlation, bottom up (families provide data), good for preventing human error

Limitations of categorical approach used in DSM

proper diagnosis takes 2-4hrs, not reimbursed by 3rd party payers diagnosis often not valid 1 dx common whereas multiple likely comorbidity

sigmund freud

psychoanalytic theory 1. oral phase 2. anal phase 3. phallic phase 4. latent phase 5. genital phase

Polygenic model of inheritance

psychological disorders likely result from multiple interactive genes rather than a single gene

Psychopathology as ....

quantitative/dimensional, not a qualitative/categorical

destructive-nondestructive dimension

ranges from destructive acts such as cruelty to animals or physical assault to nondestructive behaviors such as arguing or irritability

Overt-covert dimension

ranges from overt visible acts such as fighting to covert hidden acts such as lying or stealing

Brain development is characterized by....

rapid neural growth followed by periods of neural pruning.

what is the most diagnosed specific learning disability

reading

Define passive gene-environment correlation

receive genotype and environment from parents -more moody genes, parents create environment that is more moody child is predisposed to moodiness, but then being in a moody environment causes child to be a moody child

Panic disorder

recurrent unexpected panic attacks, concern about the possible implications and consequences of another attack

Psychostimulants

reduce impulsive behavior by increasing the level of neurotransmitters, most frequently perscribed to children and adolescents.

social conigition

refers to a childs ability to think about social situations and solve interpersonal problems

Brain plasticity

refers to the ability of the nervous system to reorganize based on experience

Research based conditions effectiveness

refers to the effects of treatment in real world conditions where it is typically diverged.

attachment

refers to the meotional bond between caregiver and child that serves to promote safety and security.

Caudate nucleus

regulates & organizes movement.

hindbrain medulla

regulates heart and lungs

HPA axis (hypothalamic-pituitary-adrenal axis)

regulates mood, immune system, energy, digestion, sexuality

Child-Caregiver Attachment

relationship helps the child to regulate behavior and emotions Assumption: parent behavior impacts child attachment pattern from the very beginning of life

family factors to promote resiliency

relationships, role models, health, networks, stability

hindbrain pons

relays information

Historical Perspective on Developmental Psychopathology 1700s

religious explanations for disorders; children as property You could use them however you wanted

DSM Criteria: Conduct disorder

repeatedly violating rights of others, or societal rules/norms - at least 3 symptoms in past 12 mos aggression towards people/animals: -bullying/intimidating -physical fights -weapon use -physical cruelty to people/animals -stealing while confronting victim -forcing sexual activity destroying property: -setting fires -deliberate destruction deceitfulness/theft: -breaking in -lie/con to obtain goods/avoid obligations -steals without confrontation serious violations of rules -status offenses 3/15 symptoms required for dx --> 455 combinations -- highly heterogeneous

echolalia

repeating what other people say (e.g. whats your name? - "whats your name"

people with ASD have ________, _________difficulties in ___________,

repetitive behavior, narrow interests, (difficulties in) social communications

Self stimulatory behaviors

repetitive body movements or movement of objects, such as hand flapping or spinning a pencil

experience expectant

require stimuli from the environment to emerge properly they emerge during sensitive periods of development.

RDoC

research domain criteria initiative external validity - concept maps onto real world dimensional approach focus on biology --> more related to etiology than to symptoms domains: neg valence, pos valence, cognitive social processes, arousal and regulatory systems units of analysis: genes, molecules, cells, circuits, physiology, behavior, self-reports, paradigms

longitudinal study

research in which the same people are restudied and retested over a long period

single-case experimental design

research tactic in which an independent variable is manipulated for a single individual, allowing cause-and-effect conclusions but with limited generalizability

disadvantage

researchers can limit themselves by adopting a perspective they can limit themselves in the kind of research questions or in the interpretation or research results

Reactive aggression (conduct disorder)

retaliation for perceived provocation or frustration; hot-blooded anger

Causes of pediatric bipolar disorder: genetic factors

runs in family one of the most heritable disorders Environmental: childhood maltreatment, stressful life events, cannabis

subjective dysphoria

sadness

Multifinality

same beginning points lead to multiple endings (ex: CSA leads to depression OR PTSD) predictor 1 --> leads to either outcome 1, outcome 2, or outcome 3.

prospective

same group evaluated repeatedly Data collection can be done either --> how does the disorder develop

Treatment of ADHD: educational interventions (8)

school accommodations and help in class 1. Clear assignments 2. Reinforcement of positive behaviors 3. Not long and repetitive assignments 4. Allow for time for movement and exercise 5. Minimize distractions 6. set realistic goals 7. preferential seating, frequent breaks, extended time on tests 8. Response-cost (time-out) procedures to reduce disruptive/off-task behaviors

four patterns of attachment

secure, insecure-avoidant, insecure-ambivilant, insecure-disorganized.

Two types of attention

selective and sustained

somatic nervous system

sensory organs and muscles

types of anxiety disorders

separation anxiety disorder, generalized anxiety disorder, specific phobia, social anxiety disorder, panic disorder

SMART

sequential multiple assignment randomized trial assess at 8 weeks and randomize if necessary behavior first parents more interested in attending training sessions than medication first parents

major neurotransmitter

serotonin dopamine norepinephrine glutamate GABA

occipital lobe

sight

Multifinality

similar experiences lead to different outcomes

psychomotor retardation

slowing of movement

graded exposure

slowly increasing exposure to fear stimuli over time Ex. talking to patient about the idea of dogs, visualizing holding a dog, showing pictures of dogs, and finally, petting a puppy.

ADHD etiology: psychosocial factors

small correlations w/ family adversity and disorganization but cause/effect unclear

synapses

small openings located between the cells

temporal lobe

smell and sound

heterotypic continuity

specific behavioral manifestations will change but there is continuity and stability at the level of an underlying trait (e.g., tantrums and non‐compliance as a toddler substance use and delinquency in adolescence criminality in adulthood)

define alleles

specific genetic variations

alpha instructions

specificity and directness focused on one behavior at a time make sure child is looking and listening ask child to repeat followed by pause for obedience

homotypic continuity

stability in highly similar overt behaviors over time (e.g., withdrawn, fearful behavior of a maltreated child who continues to be reared in an abusive environment)

homotypic continuity

stability of a diagnosis and symptom patterns over time.

ADHD medication effects

stimulant effects increases attentional focus, inhibitory control and regulation of extraneous motor behavior

ADHD medication risks

stimulant prescription increased 7x (1991-2007) psychophysical: appetite and sleep problems psychological: implicit message of medication (control, responsibility, attributions for good/bad outcomes: societal pressure on parents tolerance misuse addiction (dopamine stimulates nucleus accumbens)

Protective Triad

strength of the child, strength of the family, strength of the school/community

Incidental Training

strengthens behavior by capitalizing on naturally occurring opportunities Spontaneous, not structured. Involves observing and waiting for teaching or reward opportunities

somatogenesis

strong focus on a single cause --> belief that mental disorders can be attributed to bodily malfunction or imbalance -->hippocrates

Evidence based treatment

structured, focused on building specific skills (behavioral, cognitive, emotional), sessions guided by an agenda, aimed at specific goals with measured progress derived from clinical trials

Animal studies

studies that attempt to test theories of psychopathology using animals

define behavioral genetics

study of association between genes and behavior

Define developmental psychopathology

study of normal and abnormal development across the lifespan

developmental psychopathology

study of the development of psychological disorders

1st step of description and diagnosis

summarizes the child's unique behaviors, thoughts, and feelings that together make up the features of the child's psychological disorder

Assent

symbolic consent for children

Encopresis

symptom disorder of children who have not learned appropriate toileting for bowel movements after age 5

heterotypic continuity

symptom expression change with development --> expression of some disorders changes over time -->for example depression manifest itself differently in chldhoof than in adolescence More common among girls.

Cons of Prospective Design

takes a long ass time have to be careful ruling out the effects of other factors may be hard to find enough people does not establish that A changes B

education of parents

teach parents to use techniques based on conditioning to modify problematic behavior in children

temperament

temperament is a person's basic disposition or behavioral tendencies

selective attention

the ability to focus on only one stimulus from among all sensory input

Joint attention

the ability to focus on what another person is focused on

sustained attention

the ability to maintain attention to a selected stimulus for a prolonged period of time

efficacy

the ability to produce the desired or inteded result

Competence

the ability to successfully adapt to the environment reflected through ability to use internal and external to achieve a successful adaptation use of developmental tasks to track success

Neuroplasticity

the ability within the brain to constantly change both the structure and function of many cells in response to experience or trauma

pragmatics

the appropriate use of language in different contexts (social, body language) "can you look at me?" "yes." child doesn't look

Genetic essentialism

the assumption that because something is genetically influenced, it is not malleable or sensitive to external influences

determining a disorder depends on

the definition of a disorder criteria to identify a disorder the method used to determine a disorder the population being studied

Define transactional processes

the different factors interact with each other over time across all levels of the pyramid

Synaptogenesis

the formation of synapses between neurons in the nervous system

Prognosis

the formulation of predictions about future behavior under specified conditions

Gene-environment correlation

the idea that heredity influences the environments to which individuals are exposed

fetal programming hypothesis

the idea that things that happen to a person during critical periods of development can change the way that the tissues and structures of his or her body and brain function

"Diagnosis" when deviations from

the normal healthy course of development ‐ What disrupts normal process? Where is the threshold?

Who/what is primary patient in treatment for RAD?

the parents

Biological Perspective

the psychological perspective that emphasizes the influence of biology on behavior

longitudinal design

the same children are studied at different ages or periods of development can track changes in development

Developmental Pathways

the sequence and timing of particular behaviors and possible relationships between behaviors over time can visualize development as an active, dynamic process that can account for many different beginnings and outcomes multifinality and equifinality

Epigenetics

the study of environmental influences on gene expression that occur without a DNA change

causes of pediatric bipolar disorder: epigenetics

the study of environmental influences on gene expression that occur without a DNA change -runs in family -genetic vulnerability x environmental factors

maladaptive emotional responsiveness

the suppression of emotions. This may be a denial of one's feelings or a detachment from them. A transient suppression of feelings may at times be necessary to cope, as in an initial response to a death or tragedy.

Hostile attributional bias

the tendency to interpret ambiguous interactions with others as deliberately hostile

Contextual Perspective

the theory that considers the relationship between individuals and their physical, cognitive, personality, and social worlds Series of nested and interconnected structures Family Home surroundings School Peers Mass media Extended family Community services Ideology, laws, and customs of the child's culture

social learning theory

the theory that we learn social behavior by observing and imitating and by being rewarded or punished

temperament

the way young children and infants organize their behavior in response to environmental stimuli. Three categories: easy, dfficult, slow to warm up

Kids with adhd have executive functioning deficits

these function help you organize, plan, and make good decisions (self-awareness)

frontal lobe

thinking

Goals of a Case Study

to get as complete a picture as possible of the child's psychological functioning, current environment, and developmental history to describe the effects of treatment on the child

single gene inheritance dominant

transmission form one parent

single gene inheritance recessive

transmission from both parents

interpersonal therapy

treatment that strengthens social skills and targets interpersonal problems, conflicts, and life transitions

specificity

true negatives

sensitivity

true positives

Personality Disorder

type of psychological disorder that refers to a chronic and recurrent pattern of behavior people have and don't grow out of

Tourette's Disorder

type of tic disorder that is classified as a motor disorder that involves multiple motor and vocal patterns

treatment approach

typically depends on the perspective/training of the clinician: Psychodynamic Cognitive-behavioral Client-centered Family systems Biological More than 70% of clinicians employ an eclectic approach

What did the study with autistism and typical toddlers tracking eye movement show

typically developing toddlers are watching people's eyes while toddlers with autism are watching people's mouths which indicates why they are bad at detecting emotion and other social cues.

Conduct problems etiology/precursors: parenting skills gaps

unrealistic expectations, poor communication (beta instead of alpha instructions), nattering (litany of complaints/instructions --> becomes background noise) overly harsh discipline inconsistent rules/consequences low involvement & weak bonding (--> low motivation to obey) poor parental monitoring

ADHD point prevalence

up to 7% (1-4% if stricter criteria used for pervasiveness & significant impairment) Male:Female 4:1 in general pop but 9:1 in clinics

Direct instruction approaches (SLD)

use prompting, error correction, reinforcement and repeated learning opportunities to teach reading skills

categorical approach

used in DSM separate disorders, all or nothing, clinical approach, committee judgement, medical model, comorbidity, top-down, good for identifying rare conditions

Single Case Experimental Design

used to evaluate the impact of a clinical treatment (ex: reinforcement or stimulant medication) on a child's problem core features: systematic repeated assessment of behavior overtime the replication of treatment effects within the same subject over time the participant's serving as his or her own control by experiencing all treatment conditions most common method: A-B-A-B design

indirect cause

variable X influences other variables that turn lead to outcome

direct cause

variable X leads straight to outcome

moderating variable

variable that alters the nature of the relationship between two other variables Ex: Children with ADHD are more likely to struggle with addiction, but only if they come from low SES ADHD is the independent variable; SES is the ___________ variable

moderators

variable that determines the strength between two other variables x = y depending on z; girls --> depression; only if early puberty

interactional model

variables interrelate to produce an outcome

verder gaan

verder gaan lecture 2

principle of multifinality

very first pathway most important and sets the course for life, multiple pathways

Permissive

very responsive, uncontrolling, no limits. (fun mom) High Responsive Low Control

perspective

view, approach, cognitive set

Antisocial

violating social conventions, hostile or antagonistic behaviors

court system insanity plea

want high sensitivity (only catch true positives) even if price is low specificity (many false negatives)

TSA security check

want high specificity (no false negatives) even if price is low sensitivity (many false positives)

What is joint attention and who has issues with it

watching someone interact with something and then joining in the same interaction. (e.g. a plane flies overhead and the child looks at the mom, looks at the plane, then looks at the mom again to see how to react) joint attention is shared around an object and a person.

one on one time

way to decrease conduct problems by strengthening child/parent relationship need to make attention from parent valued so can be used as a reinforcer done by having parent dedicating time each evening to spend with child and reinforce by talking about it

Restricting type

weight loss is primarily accomplished through dieting, fasting, exercise, but not binge-purge behavior

SSRIs appear to be more effective than TCAs Prozac has been approved by the FDA for use with children (8 & older) and adolescents with MDD Concerns about side effects Increased risk of suicidal thinking or behavior on medication Combined with CBT or IPT is recommended

what are biological treatments for depression

excessive parental control - "Over-intrusive": helicopter parents. Shows parents have lower expectations of childs ability to cope teaching child that they don't have the skills to cope Insecure early attachments (particularly anxious/resistant attachment) Children view others as undependable, unavailable or hostile Insecure attachment may result from Over-intrusive parenting Insensitivity to child's signals

what are some Family System causes for anxiety disorders

Fears and anxieties learned though classical conditioning and maintained through operant conditioning: Two-factor theory Development of specific phobias: - environmental paths: 1. Direct exposure 2. Indirect exposure 3. Transmission of information

what are some behavioral causes for anxiety disorders

Emphasis is on learning principles, environmental consequences, and skill deficits in the onset and maintenance of depression

what are some behavioral causes for depression

Children of parents who have an internalizing disorder (especially an anxiety disorder) are at higher risk The disorder is not always same type

what are some biological causes for anxiety disorders

Children whose parents are depressed are 2-3 times more at risk If parent had early onset depression (as a child), their child was 14 x more likely to be depressed before the age of 13 Gene X environment interactions have been found Deletion of COMT gene + psychosocial deprivation = higher risk of depression HPA axis dysregulation: Adults with MDD show high levels of cortisol Abnormal salivary cortisol levels in children with depression High morning levels predict onset of MDD in adolescents

what are some biological causes for depression

faulty cognitions and inappropriate focus on anxiety-producing events Describe the development of panic attacks according to cognitive theory "im dying" - is not a calming thought. Intervention would be to control focus on whats happening "this has happened before... this calms me down"

what are some cognitive causes for anxiety disorders

Perception of lack of control over environment (Seligman & Peterson, 1986) Internal, stable, and global attributions for the cause of negative events Depressive ruminative style Negative automatic thoughts

what are some cognitive causes for depression

Being bullied increase the chances of having a social phobia. These children are becoming hypersensitive to these kinds of scrutinies. They remember each event more because it means more to them

what are some contextual causes for anxiety disorders

Lower SES is associated with higher rates of depression; likely mechanisms → limited parental education, environmental adversity, discrimination (Hammen & Rudolph, 2003) Disruptions in interpersonal relationships with families or peers can lead to depression negative life events

what are some contextual causes for depression

Depressed appearance, somatic complaints

what are some depression symptoms that decrease with age?

Anhedonia, psychomotor retardation Subjective dysphoria and hopelessness Children are less likely to report these symptoms, but adolescents often do (Ryan et al., 1987)

what are some depression symptoms that increase with age?

Responding to emotional cues of others Children born with a low threshold for novelty and stimuli (behaviorally inhibited hypothesis) Temperamental vulnerability to anxiety disorders mixed with parental response

what are some emotional causes for anxiety disorders

Only 8% of adolescents with depression were securely attached c. 50% of adolescents without depression were securely attached Links between family dysfunction and childhood depression Links between parental depression and child depression

what are some family system causes for depression

CBT Ask the participant cue questions to change cognitions/ thoughts. "whats going to happen if you see a clown" No escape Graduated exposure: easy and work your way up to the hard things jack in the box > scary picture > actual clown Calming statements Breathing techniques Parsley the lamb: bad idea because power cannot be in the object, it has to be in the child Ratings: using numbers to identify their fear with a number (0-100) your body wont maintain a 90 in the presence of a phobia, eventually, your body will have to calm down

what are some intervention strategies for anxiety

Biological but then you've been social reinforced. Also there are poor cognitions contributing as well.

what are some multiplicity causes for anxiety disorders

High genetic predisposition PLUS family conflict (Rice et al., 2006) Social support ameliorates the child's genetic risk for depression

what are some multiplicity causes for depression

Neurotransmitter system Over-activation of the GABA system - anticipatory stress Serotonin system - abnormalities may relate to behavioral inhibition Endocrine system HPA axis system - regulation of stress Functional brain differences Over-responsive limbic system/ amygdala

what are some structural and functional causes for anxiety disorders

Neurotransmitter systems: dopamine, serotonin, norepinephrine Amygdala/Limbic system Prefrontal cortex/frontal lobe

what are some structural and functional causes for depression

highly probable 70% have another episode within 5 years

what are the chances of having another episode if you have major depressive disorder

twice as common in boys

what are the gender differences for Obsessive-Compulsive Disorder

Equally common in boys and girls

what are the gender differences for Separation Anxiety Disorder

slightly more girls than boys

what are the gender differences for Social Anxiety Disorder (Social Phobia)

more girls than boys

what are the gender differences for panic disorder

girls are twice as likely as boys

what are the gender rates in adolescent depression

equal

what are the gender rates in childhood depression

Better results for reactive vs. proactive aggression (McLeer & Wills, 2000) Generally not viewed as the most effective intervention strategy

what are the results of treating children with conduct disorder with Pharmacological/Medication

Evidence-Based Treatment:Cognitive-Behavioral Therapy

what is a good treatment for depression

Earliest onset of the anxiety disorders, may be chronic or sudden

what is different about the age of onset for Separation Anxiety Disorder

comorbid conditions

what is one reason children with conduct disorder have academic underachievement

Invisible to others Doesn't harm others Isolated symptoms are often short-lived Functional aspect Lifetime prevalence estimates between 8-27%

what is some General Information About Anxiety

2-5 years

what is the Average episode length for Persistent Depressive Disorder

9-12 years

what is the age of onset for Obsessive-Compulsive Disorder

4% of children

what is the age of onset for Separation Anxiety Disorder

early to mid-adolescence

what is the age of onset for Social Anxiety Disorder (Social Phobia)

between ages 10 and 13

what is the age of onset for Specific Phobia

15-19 years

what is the age of onset for panic disorder

evidence based treatment

what is the best way to treat conduct disorder?

Anxiety (19-53%) Depression (12-25%) And substance abuse

what is the likelihood of comorbidity with conduct disorder

11-12 years

what is the most common age of onset for Persistent Depressive Disorder

late childhood or early adolescence (age 10-14)

what is the onset for Generalized Anxiety Disorder

1-3% of children

what is the prevalence for Social Anxiety Disorder (Social Phobia)

3-6% of children

what is the prevalence of Generalized Anxiety Disorder

2-3% of children

what is the prevalence of Obsessive-Compulsive Disorder

2-4% of children

what is the prevalence of Specific Phobia

5%-17%

what is the prevalence rate for a specific learning disability

SSRIs Best response for OCD Recommendation: If you're using medications to treat anxiety disorders, use them in combination with CBT

what kind of medication is used for anxiety

Abnormalities in frontostriatal area of the brain. Decreased blood flow to frontal & prefrontal regions of the brain. Abnormalities in the structure of the basal ganglia. These areas help control executive functions, response organization.

what types of abnormalities do people with ADHD often have?

Risk/Protective continuus

when a risk factor's counterpart is a protective factor; vice versa

Risk/Protective separately

when a risk factor's counterpart is not a protective factor; vice versa

equifinality

when different factors can lead to the same outcome children with different experience can develop the same problems

Issue of reactivity

when observing, child and other people could react/act differently with you being there

multufinality

when one factor can lead to multiple outcomes children with the same experience can develop different problems --> child abuse can lead to different psychological problems

resilience

when there is a positive psychological result, while there had been a negative or traumatic experience Defined as the abscence of psychopatholoy

ADHD etiology: maternal drug use in pregnancy

widely accepted but not well supported scientifically b/c adversity piles on

Teens more susceptible to addiction than adults b/c:

• Brains are still developing; more likely to habituate to using drugs and alcohol • Optimistic bias • Susceptibility to peer influence

Problem solving skills therapy (PSST)

• Child uses the following steps to engage in better social problem solving • What am I supposed to do? • I have to look at all my possibilities • I have to consider the consequences • I have to make a choice • "I did a good job" or "I made a mistake"

DEVELOPMENTAL PROCESSES ARE RECIPROCAL AND TRANSACTIONAL

• Developmental processes are almost always reciprocal and transactional in nature • Child level factors influence environmental factors and vice versa and such mutually reciprocating influences cause changes in both child and environmental factors

Prevention

• FDA efforts to reduce sales and marketing to youth • Public health working on anti‐marketing programs

PARENT TRAINING

• Form of behavioral therapy • Parents are the primary agents of change in children's behavior. Can include:

PLAY THERAPY

• Methods of therapy may have to be adjusted when working with very young children or non‐ verbal children • Play therapy is practiced in a way that consistent with the therapist's theoretical orientation

presentation of depression in childhood

• Presentation may differ in younger children ‐ irritability, sadness, more somatic symptoms (tummy ache, headache), sleep disturbance, low energy • Often comorbid with anxiety disorders (rate as high as 75%)

CBT: SELF‐INSTRUCTIONAL TRAINING (SIT)

• Retraining the voice in your head (cognitive) • Talking to yourself first aloud and then internally (silently) • Therapist models first

COGNITIVE‐BEHAVIORAL THERAPY WITH CHILDREN

• Similar to CBT for adults, but with different methods

SAND TRAY THERAPY

• Useful for younger and non‐ verbal children • Nonverbal, therapeutic intervention that makes use of a sandbox, toy figures, and sometimes water, to create scenes of miniature worlds that reflect a person's inner thoughts, struggles, and concerns.