ch 13 encopresis enuresis

White children suffer the highest rates of _________ as compared to other ethnic groups, but reasons for this disparity are not known.

cancer

In general, the following stress factors that parents face are quite similar across all types of pediatric chronic illness:

financial and physical burdens, changes in parenting roles, sibling resentment, child adjustment problems, social isolation, frequent hospitalizations, and grief

usually encopresis results from...

from constipation that produces fecal impaction. thereby producing overflow incontinence in most cases

because it is common for young children to wet the bed when is it seen as a clinical problem

if it occurs more than once a month

relationship between sensation seeking and substanc euse was strongest for predicting

marijuana use, followed by alcohol use

various forms of physical and functional consequences and limitations that result from an illness

morbidity

Irresistible attacks of refreshing sleep occurring daily, accompanied by brief episodes of loss of muscle tone (cataplexy)

narcolepsy

Asthma is the most common chronic illness in childhood, followed by

neurological and developmental disabilities and behavioral disorders.

Repeated awakenings with detailed recall of extended and extremely frightening dreams, usually involving threats to survival, security, or self-esteem; generally occurs during the second half of the sleep period

nightmare disorder

repeated awakenings with frightening dreams you usually remember

nightmares

what is optimal treatment for encopresis

Optimal treatment of encopresis involves both medical and behavioral interventions to help the child learn to empty the colon to allow it to return to normal size and function -behavioral: teaching toilet-training procedure -combination of laxatives also helps

across all medical conditions, the illness parameters that play the most significant role in children's adjustment are

severity prognosis and functional status

_________ disorders can cause psychological problems, result from other disorders, or be a symptom of trauma or stress in the child's life.

sleep disorders

__________disorders are important to abnormal child psychology because they mimic or worsen many symptoms of the major disorders

sleep disorders

is actually a group of heterogeneous diseases in which there is a malignancy of the bone marrow, which produces blood cells. the bone marrow produces malignant cells called "lymphoblasts" that progressively replace normal bone marrow with fewer red blood cells and more white blood cells, causing anemia, infection, and easy bruising or excessive bleeding

acute lymphoblastic leukemia

the most common. form of childhood cancer is _______ which accounts for close to HALF of all forms of childhood cancer

acute lymphoblastic leukemia

what is one of the most widely supported risk factors for onset of substance use problems and subsequent disorders

age at first use

Children who continue to need to urinate at night may have a deficiency during sleep of an important hormone known as ___________. which helps concentrate urine during sleep hours, meaning that the urine contains less water and has therefore decreased volume.

antidiuretic hormone (ADH)

Recurrent episodes of abrupt awakening from sleep, usually occurring during the first third of the major sleep episode and beginning with a panicky scream; accompanied by autonomic discharge, racing heart, sweating, vocalized distress, glassy-eyed staring; difficult to arouse, inconsolable, disoriented; no memory of episodes in morning

sleep terrors

abrupt wakening accompanied by autonomic arousal but no recall

sleep terrors

getting out of bed and walking around but with no recall the next day

sleep walking

Repeated episodes of arising from bed during sleep and walking about, usually during the first third of the major sleep episode; poorly coordinated, difficult to arouse, disoriented; no memory of episode in morning

sleepwalking

___________ during adolescence involve self-administration of any of these substances that alters mood, perception, or brain functioning, resulting in substance abuse or substance dependence

substance use disorders

what is common. in parents of children with chronic illnesses

symptoms of PTSD

Among the more promising treatments for adolescent substance abuse are those that involve

the larger systems affecting the adolescent's behavior, such as peers, family, and school climate.

trends in grade 8, 9, 10: what drug was the most used and what was the least

the most used was alcohol followed by marijuana followed by other illicit drugs

refers to requiring more of the substance to experience an effect once obtained at a lower dose

tolerance

what is the prevalence of encopresis a. 50% b. 1% c. 4%

b 1%

A significant proportion of youths (_____%) meet criteria for a diagnosis of substance abuse or substance dependence a. 5% b. 12% c. 50%

b 12%

In general, researchers find that alcohol use before age ______ is a strong predictor of subsequent alcohol abuse or dependence, especially when early drink-ing is followed by rapid escalation in the quantity of alcohol consumption

before age 14

this model explains how children's adaptation to chronic illness is influenced not only by the nature of the illness itself, but also by personal and family resources

transactional stress and coping model

what treatment has been more effective overall than pharmacological treatments

urine alarm also those who use urine alarm usually remain dry at followup compared to others

enuresis is usually accompanied by psychological distress: depends on 3 features

(1) limitations imposed on social activities, such as sleeping away from home; (2) effects on self-esteem, including the degree of social ostracism imposed by peers; and (3) parental reactions, such as anger, punishment, and rejection

as many as ______ in ______ children with encopresis show significant psychological problems but these problems more likely result from rather than initially cause, the encopresis

1 in 5

It is estimated that in North America, ______ to ____% of the child population suffers from some form of chronic health-related disorder or condition (including obesity, diabetes, asthma, and others), and the rate has been rising dramatically in recent years a. 40-50 b. 10-20 c. 5-10

10-20% b

_______family history for alcoholism and ______influences play a large role in determining substance use.

A positive family history for alcoholism and peer influences

substance use disorder is highly comorbid with

ADHD

(A) Repeated passage of feces in inappropriate places (e.g., in clothing, on floor), whether involuntary or intentional. (B) At least one such event occurs each month for at least 3 months. (C) Chronological age is at least 4 years (or equivalent developmental level). (D) The behavior is not attributable to the physiological effects of a substance (e.g., laxatives) or another medical condition, except through a mechanism involving constipation

DSM criteria for encopresis

(A) Repeated voiding of urine into bed or clothes, whether involuntary or intentional (B) The behavior is clinically significant as manifested by either a frequency of at least twice a week for at least 3 consecutive months or the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning. (C) Chronological age is at least 5 years (or equivalent developmental level) (D) The behavior is not attributable to the physiological effects of a substance (e.g., a diuretic, an antipsychotic medication) or another medical condition (e.g., diabetes, spina bifida, a seizure disorder)

DSM criteria for enuresis

The impact of living with _______ and _________, currently the sixth leading cause of death among 15- to 24-year-olds in the United States, likely will be a major health issue in the years to come

HIV and AIDS

Many children and their families adapt favorably to the challenges associated with chronic illness. ________ and _________ are key components aiding their adaptation.

Perceived social support and maternal adaptation

are a group of related problems involving distressing somatic symptoms, such as pain and dizziness, that interfere with daily activities. These somatic or health concerns are accompanied by excessive thoughts, feelings, and behaviors, such as anxiety or worry about the seriousness of the symptoms

Somatic symptom and related disorders (previously called "somatoform disorders")

how prevalent is nocturnal enuresis for children of 10 or younger? a. 4-13% b. 5-7% c. 2-8%

a 4-13%

what is the central diagnostic feature for SUDS

a problematic pattern of substance use leading to significant impairment or distress

Although approximately 80% of pediatric cancer patients survive, about ______ of the survivors will have a serious physical or mental illness as adults

about half of survivors will have serious physical or mental illness

the most common chronic illness in childhood

asthma

Sleep disruption leading to excessive sleepiness or insomnia that is caused by sleep-related breathing difficulties

breathing-related sleep disorder

in general, children in poor families are _____x as likely to be in fair or poor health as children in families that are not poor a. 2x b. 3x c. 5x

c 5x

an illness that persists longer than 3 months in a. given year or that requires a period of continuous hospitalization of more than 1 month

chronic illness

Persistent or recurrent sleep disruption leading to excessive sleepiness or insomnia due to a mismatch between the sleep-wake schedule required by a person's environment and his or her internal sleep cycle (circadian rhythm); late sleep onset (after midnight), difficulty awakening in morning, sleeping in on weekends, resistance to change

circadian rhythm sleep disorder

(A) A problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

diagnostic criteria for substance use disorder

is defined as the passage of urine during waking hours, most often during the early afternoon on school days. is more common in females than males and is uncommon after age 9.

diurnal enuresis

are disorders of initiating or maintaining sleep, and include hypersomnia, narcolepsy, breathing-related sleep disorders, and circadian rhythm disorder.

dyssomnias

disorders initiating or maintaining sleep characterized by difficulty getting enough sleep, not sleeping when you want to, not feeling refreshed after sleeping, and so forth

dyssomnias

refers to the passage of feces in inappropriate places, such as in clothing or on the floor. Like enuresis, this act is usually involuntary, but may occasionally be done intentionally. The diagnostic criteria stipulate that this event must occur at least once per month for at least 3 months, and that the child must be 4 years old or older

encopresis

The criteria stipulate that the problem must be frequent (at least twice a week for 3 consecutive months) or accompanied by significant distress or impairment in social, academic, or other important areas of functioning.

enuresis

These disorders are one of the few areas of abnormal child psychology in which early referral and treatment can virtually eliminate long-term consequences.

enuresis and encopresis

Two elimination problems that occur during child-hood and adolescence are

enuresis and encopresis

what is an effective psychological treatment for most childhood sleep disorders

establishment and regulation of bedtime routines

Recent shifts to greater ________ and ___________ have resulted in innovative ways to help children cope with the challenges of chronic illness.

family empowerment and parental involvement

have the highest rate of lifetime usage for powder cocaine, crack cocaine, heroin with and without needle, meth, and crystal meth

hispanic seniors

Excessive sleepiness that is displayed as either prolonged sleep episodes or daytime sleep episodes

hypersomnolence disorder

Children respond to the stress of chronic conditions in many different ways, and adjustment problems are more likely among children with

increased disability

Primary enuresis, the most common type, is decidedly not due to stress or child obstinacy. On the contrary, this trait appears to be ?

inherited. If both parents were enuretic, 77% of their children are too; if only one parent was enuretic, then 44% of their offspring are also. If neither parent had this problem, only about 15% of their children develop enuresis.

Difficulty initiating or maintaining sleep, or sleep that is not restorative; in infants, repetitive night waking and inability to fall asleep

insomnia

a lifelong metabolic disorder in which the body is unable to metabolize carbohydrates because the pancreas releases inadequate amounts of insulin. This

insulin-dependent diabetes mellitus

Typically, rates of substance use peak around _________ and then begin to decline during young adulthood, in conjunction with adult roles of work, marriage, and parenthood

late adolescence

Substance-abusing adolescents experience withdrawal symptoms, but their physiological dependence and symptoms are .....

less common than the withdrawal symptoms experienced by adults. Adolescents

what has consistently emerged as a predictor of adolescent substance use

low parental monitoring

Adjustment problems may appear in the form of behavioral and emotional distress symptoms, such as

low self esteem lack of social competence poor school performance and sometimes psychiatric disorders

is there a gender difference in SUDS

no longer differ significantly

which is more prevalent nocturnal enuresis or diurnal

nocturnal is much more prevalent at 4-13% compared to diurnal at 3%

is the most common subtype of enuresis, in which wetting occurs only during sleep at night, typically during the first third of the night.

nocturnal only

DSM-5 distinguishes between three subtypes of enuresis

nocturnal only diurnal only nocturnal/diurnal

Diabetes affects boys and girls equally, and its incidence is increasing: a child born in North America in 2000 stands a _____ in _____ chance of being diagnosed with diabetes in his or her lifetime a. 1/100 b. 1/50 c. 1/3

one in three

physiological events intrude on ongoing sleep, arousing the sleeper. They include nightmares, sleep terrors, and sleepwalking

parasomnias

sleep disorders in which behavioral or physiological events intrude on ongoing sleep

parasomnias

this occurs when the body adapts to the substance's constant presence

physical dependence

children with this have reached age 4 without establishing fecal continence

primary encopresis

Approximately 85% of children with enuresis have ____________because they have never attained at least 6 months of continuous nighttime control.

primary enuresis

what is the standard behavioral intervention for enuresis

principles, is using an alarm that sounds at the first detection of urine. Bed-wetting alarms have been around since Mowrer and Mowrer (1938) first invented the "bell and pad". (a battery-operated device that produced a loud sound as soon as a drop of urine closed the electrical circuit) the modern urine alarm when used with other behavioral activities is the minimal standard in treatment of enuresis

what are the two main psychological approaches to helping children cope with stressful medical procedures and chronic and recurrent pain

providing. info and training them in coping. skills

Children with chronic illness are at increased risk for __________problems, which generally reflect their attempts to cope with stress

psychological

refers to the subjective feeling of needing the substance to adequately function

psychological dependence

Somatic symptom and related disorders include a new category known as __________________ This category may be relevant to children and youths with existing medical symptoms or conditions because psychological factors, such as distress or poor coping, may influence their physical condition or its treatment. For example,

psychological factors affecting other medical conditions.

children with this had established a period of continence before the current episode of encopresis began

secondary encopresis

_______________- is less common and refers to children who have previously established urinary continence but then relapse, usually between the ages of 5 and 8 years

secondary enuresis

Two subtypes of encopresis are described in DSM-5:

with or without constipation overflow continence