PSY 443 Exam 3

emotional

Anxiety is expressed by each of the following response systems except __________. emotional physical cognitive behavioral

Bodily symptoms

"You actually will feel it viscerally," Reynaldo tells the classroom during one of his talks about managing stress. Aside from such elements as a strong negative emotion and fear, what does he mean? Bodily symptoms Depression Hair pulling Nausea

psychodynamic theories of depression

Depression is viewed as the conversion of aggressive instinct into depressive affect. Results from the actual or symbolic loss of a love object. Children and adolescents are believed to have inadequate development of the superego or conscience. Therefore, they do not become depressed. High levels of maladaptive guilt and shame are related to the onset of depression

One in ten

Despite the greater attention paid by the justice system to the maltreatment of children, how many children are punished each year in a way that may cause injury or death? One in 25 One in ten One in one Three in 20

major depressive disorder (MDD)

= criteria children/adolescents. Depression missed other behaviors attention. Some features > children/adolescents. Diagnosis major episode + exclusion. similar symptoms/comparable rates comorbidity/recurrence. Clinic-referred youths 1st-episode, recover faster, > risk bipolar switch. 2-8% of children aged 4-18. Depression preschool/school-age 1-3%. Increases 2-3x adolescence. Adolescent increased 59% 2007-2017. trend through pandemic. Up to 90% 1+ comorbid; 50% 2+. Anxiety disorders, specific phobias, P-DD, conduct problems, ADHD, SUDs. Onset gradual/sudden. history milder episodes not meet criteria. onset 13-15 years. avg 8 months. children recover 1st episode. recurrence 25% in 1 year, 40% 2, 70% 5. ~1/3 BP switch 5 years. girls:boys 2:1, 3:1 after puberty. emotional reactivity preschool: Boys anger, Girls sadness. More in F sex nonbinary/male/transman/transmasc. varies worldwide. Non-White reported >. reflect: SES, Marginalization, Structural racism. Low SES: stress, depression

social anxiety disorder

A marked, persistent fear of social or performance requirements that expose the child to scrutiny and possible embarrassment. Anxiety over mundane activities. Most common fear is doing something in front of others. More likely than other children to be highly emotional, socially fearful; and inhibited, sad, and lonely. THIS encompasses a variety of social fears. Fear of performance situations − Fear of interaction situations Lifetime prevalence of 6% to 12% of children. Twice as common in girls. Two-thirds also have another anxiety disorder. 20% also suffer from major depression and may self-medicate with alcohol and other drugs. Most common age of onset is early to mid-adolescence, and is rare under age 10. Relative to males, adolescent females may have an increasing biological sensitivity to being evaluated by peers generally develops after puberty, at a time when most teens experience heightened self-consciousness and worries about what others think of them

Early insecure attachments

According to Bowlby's theory of attachment, which of the following is the primary cause of separation anxiety? Harsh treatment by the mother Fear of strangers Early insecure attachments Maternal neglect

Any type of maltreatment

According to more than one study, males who experienced which of the following are at high risk for promiscuity, sexual aggression, and victimization of others? Sexual abuse PTSD Any type of traumatic event Any type of maltreatment

One in four youths

According to one 2002 study, what percentage of youth experienced some form of major trauma before their sixteenth birthday? Nearly every child in the study 50 percent of all young people One in four youths One in four girls

34 percent

According to the APA's poll of teenage respondents, "Stress in America," what percentage believe their stress will increase in one year, which suggests that their lives are just as stressful as adults'? 90 percent 34 percent over half 25 percent

Neglect

According to the U.S. Department of Health and Human Services (USDHHS), the most common form of child maltreatment is which of the following? Sexual abuse Child labor Physical abuse Neglect

cognitive system

Activation leads to feelings of apprehension, nervousness, difficulty concentrating, and panic

specific phobia

Age-inappropriate persistent, irrational, or exaggerated fear that leads to avoidance of the feared object or event and causes impairment in normal routine. Lasts at least six months. Extreme and disabling fear of objects or situations that in reality pose little or no danger or threat. Child goes to great lengths to avoid the object/situation. Fear or anxiety may be expressed by crying, tantrums, freezing, or clinging About 20% of children are affected at some point in their lives, although few are referred for treatment. More common in girls. Common co-occurring disorders another anxiety disorder and depressive disorders. Onset at 7 to 9 years. Clinical phobias are more likely than normal fears to persist over time

behavioral system

Aggression is coupled with a desire to escape the threatening situation

Sexual abuse

Although most often reported in the news, especially between teachers and students, which of the following is NOT one of the more common forms of neglect? Psychological maltreatment Physical abuse Sexual abuse Corporal punishment

Delays in cognitive and socioemotional development

Although reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) are restricted to the early years of a child's life, what can they result in later in childhood? Impulsivity Poor parent-child attachment Delays in cognitive and socioemotional development ADHD

Obsessive-Compulsive Disorder

An unusual disorder of ritual and doubt − Characterized by recurrent, time-consuming, and disturbing obsessions and compulsions. THIS is extremely resistant to reason. THESE children often involve family members in rituals. Normal activities of children with THIS are reduced, and health, social and family relations, and school functioning can be severely disrupted Lifetime prevalence in children and adolescents is 1% to 2.5%. Clinic-based studies find it twice as common in boys. Common comorbidities are anxiety disorders, ADHD, ODD, and vocal and motor tics. As the child gets older, depressive disorders, substance-use disorders, learning disorders, and eating disorders are more common Average age of onset 9 to 12 years with peaks in early childhood and early adolescence. Children with an early age at onset are More likely to be boys, More likely to have a family history of THIS. Young children typically have obsessions that are more vague than those of older children. Chronic disorder: as many as two-thirds continue to have THIS 2 to 14 years after initial diagnosis

Fear of performance situations

Anjali can talk with ease and has a sense of humor and confidence among her friends. She is, however, impossible to hear when she is asked to read aloud in class. Which of the following is she experiencing? The continuum of severity Fear of performance situations The performance-only specifier Mutism

classical psychoanalytic theory

Anxieties and phobias seen as defenses against unconscious conflicts rooted in the child's early upbringing

Yes, for many children know to conceal their behaviors to avoid ridicule and/or being forced to confront and stop them.

Are children with obsessive-compulsive disorder self-aware of their obsessions and compulsion, and why do we think that's the case? Yes, because compulsions are intended to alleviate stress and one must be self-aware to self-treat. No, for children allow themselves to be overwhelmed as they "ramp up" their compulsive behavior, which is subject to the law of diminishing returns. No, especially when they are resistant to reason. Yes, for many children know to conceal their behaviors to avoid ridicule and/or being forced to confront and stop them.

Polyvictimization

Ashley has experienced sexual assault, rape, and domestic abuse on three separate occasions. Her experience can be clinically stated as which of the following? Hypervictimization Sexual abuse with specifiers Gross sexual imposition Polyvictimization

depression prevention

CBT and interpersonal psychotherapy are most effective at lowering the risk for depression and for preventing recurrences. Large-scale prevention: focus on the early detection of high school students at risk for depression and suicide to ensure that these students receive help. Family cognitive-behavioral interventions. Online and computer-based interactive programs for use in primary care, school, and other settings are examples of promising new prevention approaches

behavior lens principle

Child psychopathology reflects a mix of actual child behavior and the lens through which it is viewed by others in a child's culture

family interventions

Child-focused treatments may have spillover effects into the family. Greater parental involvement − Modeling and reinforcing coping techniques − Inclusion of parental anxiety-management strategies − Inclusion of parent skills training. Family treatment for OCD − Provides education about the disorder − Helps families cope with their feelings

unhealthy relationships

Children and adolescents who grew up in violent homes report more violence toward their dating partners and toward themselves. There is a connection between histories of maltreatment and Subsequent arrests as a juvenile or an adult, even among girls. Engaging in sexual and physical violence as a young adult, especially for males. Growing up with power-based, authoritarian methods can be toxic to relationships and social patterns

neurobiological changes

Children and adults with a history of child abuse. Long-term alterations in the hypothalamic-pituitary-adrenal (HPA) axis and norepinephrine systems. Affected brain areas include the hippocampus, prefrontal cortex, and amygdala. The neuroendocrine system becomes highly sensitive to stress. Leads to neurobiological changes that may account for later psychiatric problems

stress

Children and youths need a basic expectable environment to adapt successfully. THESE events affect each child in different and unique ways: Hyperresponsive reactions, Hyporesponsive reactions. Allostatic load. Child maltreatment, exposure to domestic violence, and chronic child poverty are among the worst forms of childhood THIS and trauma Forms of childhood THIS that may lead to poor adaptation include bullying, parental separation, peer conflict, and many others

PTSD

Children exposed to chronic or severe situations involving death or injury are more vulnerable to __________. trauma somatic signs of distress PTSD developmental problems and setbacks

False

Children express and experience depression similarly across ages. True False

emotion regulation in depression

Children who experience prolonged periods of emotional distress and sadness may Have problems regulating negative emotional states, Be prone to depression, May use avoidance or negative behavior to regulate distress, rather than problem-focused and adaptive coping strategies

Primary or secondary victimhood

Ciara is receiving CBT as part of her treatment for trauma. What kind of exposure will her therapist rely on in treating her? Self-exposure Primary or secondary victimhood Imagined exposure through role playing Disaster focused

mood disorders

DSM-5-TR has two general categories: depressive disorders and bipolar disorder

social and emotional deficits

Display low social performance and high social anxiety. See themselves as shy and socially withdrawn, and report low self-esteem, loneliness, and difficulty starting and maintaining friendships. Have deficits in understanding emotion and in differentiating between thoughts and feelings. Young children with symptoms of social anxiety may display lower levels of theory of mind

Bipolar disorder

Disruptive mood dysregulation disorder (DMDD) is a new classification intended to correct the misdiagnosis of what in young children? ADHD Bipolar disorder MDD Manic depression

cognitive disturbances

Disturbances in how information is perceived and processed. Intelligence and academic achievement − Deficits in specific areas of cognitive functioning, such as attention, executive functions, working memory, and speech or language. Cognitive errors and biases − Perceptions of threats activate danger-confirming thoughts − Children with conduct problems select aggressive solutions in response to a perceived threat − See themselves as having less control over anxiety-related events than other children Children with anxiety disorders display deficits in specific areas of cognitive functioning, such as attention, memory, and speech andlanguage

Writing poems against maltreatment and sexual abuse and publishing them in a scrapbook

Dr. Grom, a psychologist treating a group of adolescents who have suffered trauma through maltreatment or sexual abuse, wants to incorporate narrative therapy. Which of the following strategies should he avoid or modify? Writing a play about what happened to each member of the group Having each child get in a circle and tell their story, "What happened to me" Having the participants create a collaborative graphic novel of what each victim-author experienced Writing poems against maltreatment and sexual abuse and publishing them in a scrapbook

developmental framework of depression

Due to the many interacting influences, multiple pathways to depression are likely. Genetic risk influences neurobiological process and is reflected in early temperament characterized by: Oversensitivity to negative stimuli, High negative emotionality, Disposition to feeling negative affect. These early dispositions are shaped by negative experiences in the family

exposure-based therapy

Early exposure intervention has reduced acute stress symptoms. Many of these interventions are brief, ranging from 1 to 10 sessions. Are often delivered in groups to reach as many children as possible. Psychological First Aid (PFA). In-depth psychological interventions are for children who are severely affected by a traumatic event. The child begins by describing a particular traumatic incident and their feelings and thoughts about it

Yes, because Elijah senses danger in the dark.

Elijah, 7, refuses to enter closets unless he has a flashlight and someone with him. If a ball or Hot Wheel rolls under his bed, he will ask his mother to get it for him. He believes there are "monsters and ghosts" hiding in closets, under beds, and in dark places in general. Does he exhibit a specific fear? No, Elijah actually meets the criteria for claustrophobia. Yes, because Elijah senses danger in the dark. No, because Elijah has an irrational fear of imaginary beings. Yes; however, in Elijah's imagination, he has substituted monsters and ghosts for animals.

Emmett has experienced a panic attack that comes with anxiety about giving his speech.

Emmett experiences heart palpitations on the night before he is to give a speech in his communication seminar. He insists on being taken to the emergency room. Has he experienced anxiety, fear, panic, or a combination? Emmett has experienced fear; that is, the fear of failure and the need to escape it. Emmett has experienced both fear and panic, for he shows the symptoms of panic as well as fear. Emmett has experienced a panic attack that comes with anxiety about giving his speech. Emmett has experienced panic only, for there is no present danger.

Schools can allow children to express their grief, loss, or fear.

In what way do schools facilitate cognitive-behavioral interventions after a traumatic incident has occurred to children or people they know? Schools can identify students who are at special risk for PTSD. Schools can allow children to express their grief, loss, or fear. Schools can bring in specially trained counselors or adopt appropriate "first aid" programs. Schools can provide "safe spaces."

generalized anxiety disorder (GAD)

Excessive, uncontrollable anxiety and worry − Worrying can be episodic or almost continuous − Worry excessively about minor everyday occurrences. Accompanied by at least one somatic symptom, such as: Headaches, stomach aches, muscle tension, and trembling National survey: lifetime prevalence rate is 2.2%. Equally common in boys and girls. Accompanied by high rates of other anxiety disorders and depression. Average age of onset is early adolescence. Older children have more symptoms. Symptoms persist over time

selective mutism

Failure to talk in specific social situations, even though they may speak loudly and frequently at home or other settings. Estimated to occur in 0.7% of children. Average age of onset is 3 to 4 years. THIS may be a developmentally specific variant of social anxiety disorder in young children. May be an extreme type of social phobia, but there are differences between the two disorders

Teaching parents how to enjoy being around their children

Family interventions that recognize the concept of "prevention before occurrence" should begin with which of the following? Teaching parents basic child-rearing skills Teaching children how to recognize what abuse is and how it is not normal Teaching parents how to enjoy being around their children Inform parents that physical abuse and neglect are not only wrong but against the law

False

Fear and panic are essentially the same. True False

Bowlby's theory of attachment

Fearfulness is biologically rooted in the emotional attachment needed for survival

behavioral and learning theories

Fears and anxieties learned through classical conditioning and maintained through operant conditioning (two-factor theory)

behavior therapy

Focuses on increasing pleasurable activities and events, and providing the youngster with the skills necessary to obtain more reinforcement Main technique is exposure to feared stimulus − While providing children with ways of coping other than escape and avoidance. Systematic desensitization. Flooding. Response prevention prevents child from engaging in escaping or avoidance stimuli. Modeling and reinforced practice

attachment theory of depression

Focuses on parental separation and disruption of an attachment bond as predisposing factors for depression. Parent's consistent failure to meet the child's needs is associated with The development of an insecure attachment, A view of the self as unworthy and unloved, A view of others as threatening or undependable. These factors may place the child at risk for later depression

a depressive disorder

Following onset, many children diagnosed with SAD (about half) may develop __________. panic attacks ADHD a depressive disorder physical symptoms such as nausea

Persistent or excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death.

For over a month, Lucas, 12, has kept blocking the door when his parents have bowling night. This surprises them because he was proud that he never needed a babysitter. But now he worries that his parents might be changed into zombies or vampires. Which of the following symptoms for separation anxiety disorder (SAD) does he exhibit? Persistent and excessive worry about experiencing an untoward event (e.g., getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings. Persistent or excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation.

Megan's symptoms did not occur in the same 2-week period.

For several days, sometimes only a month apart, Megan, 15, felt depressed, bloated, irritable, took no pleasure in cheerleading, could not sleep, and felt tired for days. Her doctor assured her that she likely did not have major depressive disorder. Why? Megan's symptoms did not occur in the same 2-week period. Megan displayed none of the cognitive problems associated with MDD. Megan's episodes of depression were far enough apart to suggest another form of depression that comes with obesity. Her doctor most likely saw her symptoms as premenstrual syndrome.

Major depression (MDD)

Generalized anxiety disorder co-occurs with many other disorders. Which disorder has particularly high rates, in keeping with the feelings of vulnerability it facilitates? SOC Specific phobias Major depression (MDD) Panic disorder

Cortisol

HPA-axis abnormalities and dysregulation respond to stressors in the environment by the release of which of the following? Hormones Cortisol BDNF Adrenaline

Oppositional behavior

Hassan responds by telling his teacher, "I don't wanna talk to you right now!" Then he just looks sad and cannot speak to her. Dr. Alvaro explains it is not unusual to see this in children who may, in the end, have selective mutism. Which of the following is she referring to? OCD Irritability Disrespect Oppositional behavior

It can affect between 6 and 12 percent of people during their lifetime.

How common is social anxiety disorder? It can affect between 6 and 12 percent of people during their lifetime. Social anxiety disorder is uncommon, affecting only 6 percent of all children. It can affect between 6 and 12 percent of girls and boys before they reach 18. Twelve percent of all young people will experience social anxiety disorder at some point during their childhood.

Genetic differences

In addition to the different social roles that are expected of female adolescents and their experiences, what else might explain female vulnerability to anxiety? Cultural differences specific to females Hormonal differences, especially during puberty Genetic differences Self-reported femininity

A genetic predisposition for BP is likely; however, other factors play a part too.

In studies of identical twins, where one is diagnosed with BP, there is a 65 percent chance the other twin will be diagnosed with BP too. What does such a finding suggest? A genetic predisposition for BP exists and may simply present itself at different times. The evidence suggests that possibly more than one genetic vulnerability exists. Environmental factors account for the other 35 percent. A genetic predisposition for BP is likely; however, other factors play a part too.

Compensating

In the example of Jack in "A Closer Look," which of the following descriptions might best describe their parenting style, in addition to being "overprotective"? It is what the education program for the parents focused on most in the narrative. Facilitating Inhibitory Damaging Compensating

trauma- and stressor-related disorders

THIS is new category in DSM-5 (Acute Stress Disorder, Adjustment Disorder, Post-traumatic Stress Disorder (PTSD), Reactive Attachment Disorder, Disinhibited Social Engagement Disorder)

Stress

Joelle, a family therapist, asks a question: "There is only one right answer this time. Childhood must be a safe place, sure, but it must have some of this, too, or a child cannot learn to adapt." Which of the following might be the answer? Freedom from threats Anger Stress Psychological competence

A manic episode, where she might burst into laughter rather than tears

Joey is a 10-year-old girl diagnosed with major depressive disorder. What DSM-5 TR criteria might change her diagnosis to something else? Weight loss rather than weight gain Suicidal ideation A manic episode, where she might burst into laughter rather than tears A violent act, such as getting into a fight with another child

Episodes of irritability

Jordan is a 9-year-old experiencing depression. He isn't passive; instead, he expresses himself in another way. What other type of symptom is common in children? Episodes of irritability A loss of interest in favorite physical activities Extreme forms of sadness Feelings of euphoria

The twins still only have a less than 50 percent chance of experiencing depression.

LeBron and LeTonio are identical twins. Their father Terence has been diagnosed with MDD. This means that, based on studies of twins and other studies of the heritability of depression, which of the following is likely the case? Both twins have a moderate chance of developing depression, with at least one twin having a 65 percent chance. The twins still only have a less than 50 percent chance of experiencing depression. The twins are 14 times more likely than non-twins. The twins may not ever develop depression because depression can skip a generation.

emerging views of self and others

Maltreated children's emerging views of self and their surroundings are not fostered by healthy parental guidance and control. Emotional and behavioral problems are likely to appear. Negative representational models of self and others develop based on a sense of inner "badness," self-blame, shame, or rage. The sense of personal power or self-efficacy can be undermined by significant trauma, stress, or maltreatment

poor emotion regulation

Maltreated infants/toddlers have difficulty establishing reciprocal, consistent interaction with caregivers. Exhibit insecure-disorganized attachment. Have difficulty understanding, labeling, and regulating internal emotional states. Learn to inhibit emotional expression and regulation, remaining more fearful and on alert

School-based screening

Many parents are neither certain they can tell if their child is suicidal nor aware of their mental problems. This highlights the importance of which monitoring intervention? Teaching depressed parents and children problem-solving and coping skills Parent-student counseling School-based screening Proactive school psychologists

post-traumatic stress disorder

Marcie and Will, both 15, had been in a dating relationship since middle school. Will died in a car accident and Marcie, a year later, still can see his face in the coffin. Dean, her therapist, tells her such memories can be a criterion for __________. adjustment disorder acute stress disorder separation anxiety a flashback stressor post-traumatic stress disorder

A depressive ruminative style

Mark, 10, doesn't often smile, so his art teacher tries to give him a reason to do so. She tells him his work looks just "like a cloudy day at the beach." He looks over at another student's cotton ball painting, with the sun's rays in yellow poster paint. "Hers is prettier," he replies "It's sunnier." What is the proper term for his style of responding? Self-disparaging style Self-critical style Negative thinking A depressive ruminative style

It is normal for a parent not to assume the worst and see depression as temporary.

Martha thought her daughter Alice was just not getting enough sleep, even as her moodiness changed to fits of crying and even screaming. Eventually, Alice was diagnosed with a severe form of depression attributed to the suicide of a boy at school whom she didn't even know. Martha thought it was just a "phase." What might Dr. Bradley, the family therapist, say to calm her fears about "being a bad parent"? It is normal for a parent not to assume the worst and see depression as temporary. Many parents see depression as "just growing pains." Martha needs to read her daughter's moods better and see things in "crisis mode," especially given that suicide is a factor. Dean could say that Martha had done the right thing: seeing the family therapist before Alice's depression expressed more dire behaviors.

Morry has regained his normal rate of development.

Morry has experienced sexual abuse from a trusted member of his community. He has successfully completed treatment with a clinician, Dr. Morillo. How would Dr. Morillo ascertain that Morry's treatment was successful? Morry no longer needs to speak with a therapist regularly. Morry has confronted his abuser. Morry has regained his normal rate of development. Morry has returned to school and peer-related activities.

A person can experience agoraphobia with symptoms that do not rise to panic.

Most research published about young people considers agoraphobia alongside panic disorder. Why is it considered to be a separate anxiety disorder? The "panic" experienced in agoraphobia can more easily be anticipated and avoided; for that reason, it is rarely unexpected. A person can experience agoraphobia with symptoms that do not rise to panic. Agoraphobia is a fear of large and open space, a specifier that does not always apply to panic situations, which can occur anywhere. Agoraphobia more closely resembles the criteria for generalized anxiety and is not really a panic disorder in the classic sense.

suicide

Most youngsters with depression think about THIS, and as many as one-third who think about it, attempt it. Drug overdose and wrist cutting are among the most common methods for adolescents who attempt THIS. Most common methods for those who complete THIS are firearms, suffocation, and poisoning. Worldwide, the strongest risk factors are having a mood disorder and being a young female. Ages 13 and 14 are the peak periods for a first THIS attempt by those with depression

negative cognitive triad

Negative view about oneself, the world, and the future

adult offenders

Neglectful parents actively avoid interacting with their children, even when the child appropriately seeks attention. Physically abusive parents tend to deliver a lot of threats or angry commands. Information-processing disturbances can cause maltreating parents to misperceive or mislabel typical child behavior. Over 50% of pedophiles report an awareness of their pedophilic interests before they turn 17 years old. Use techniques to gain access to and compliance from the child

rituals and repetitive behavior

Normal routines help children gain control and mastery of their environment. Many common childhood routines involve − THIS − Doing things just right. Neuropsychological mechanisms underlying compulsive, THIS behavior in normal development and those in OCD may be similar

Social anxiety disorder

Oakley has been diagnosed with specific mutism. Which of the following will Oakley likely experience, based on that diagnosis? Separation anxiety disorder Obsessive-compulsive disorder Social anxiety disorder Generalized anxiety disorder

Disruptive mood dysregulation disorder (DMDD)

Of all the various mood disorders, which of the following is marked by frequent verbal temper outbursts? Major depressive disorder (MDD) Dysthymia Bipolar disorder (BP) Disruptive mood dysregulation disorder (DMDD)

Disassociation

Paula describes to Dr. Harada how she felt when her prom date tried to kiss her. "It was like I was a ghost or something." Knowing that she has previously experienced rape, where does Dr. Harada tell her that feeling comes from? A desire to escape Sexual adjustment Disassociation Guilt

True

Persistent Depressive Disorder (P-DD) is a new category in the DSM-5-TR; it combines the previous categories of dysthymic disorder and MDD-Chronic. True False

child maltreatment

Physical abuse, neglect, sexual abuse, psychological abuse. many forms: Acts experienced by many (corporal punishment, sibling violence, peer assault) Acts experienced by significant sub-group (beatings/abandonment). In North America, 1/4 girls and 1/20 boys sexual abuse condoned abuse of family members. Absolute authority over family by husband. Roman Law of Chastisement (753 BC). English common law moderate and reasonable chastisement. children as personal property past 30 yrs, condemned in Western world. 1989 Convention on the Rights of Children -> efforts to value rights/needs of children, recognize exploitation/abuse. 42 countries official policy on child abuse and neglect broad. Any act/failure of caretaker, which results in Death, serious harm, Sexual abuse, or exploitation. act/failure which = imminent risk of serious harm. Each year, ~1 million children in the US 75% neglect, 17% physical abuse, 8.3% sexual abuse, 6.8% other, 6% psychological maltreatment, 2.2% medical neglect Younger = more abuse/neglect, inversely related to age, sexes almost equal. Exception: sexual abuse > age 12, 80% female majority White (44%), Black (22%), Hispanic (21%). Highest rates Black, American Indian/Alaska Native, and multiple races. racial differences consistent over many years. historical/racial trauma adult offenders. Child (behavior/developmental limitations. misbehaving -> predictable parental rx -> control). Family (conflict/marital violence causal, caught in crossfire). Social/Cultural (sex roles, High visibility sexual assault, poverty, social isolation, Cultural norms) Obstacles to intervention/prevention. change how parents teach, discipline, and attend to children. Enhance positive experiences early in relationship. Instruct how to avoid/report sexual abuse. parenting skills/expectations

psychosocial interventions

Primary and Secondary Control Enhancement Training (PASCET) (Primary control skills (ACT skills) and Secondary control skills), The ACTION Program, Adolescent Coping with Depression Program (CWD-A), Interpersonal Psychotherapy for Adolescent Depression (IPT-A)

psychosocial treatments

Providing information to the child and family about the disorder, symptoms and course, possible impact. Family functioning, and heritability of the disorder. Positive family relationships can protect against the impact of genetic vulnerability. Ways of coping with symptoms and preventing relapse. Problem-solving. Behavioral parenting strategies and communication. Emotion regulation, and cognitive-behavioral skills

school refusal behavior

Refusal to attend classes or difficulty remaining in school for an entire day. Occurs most often in ages 5 to 11. Fear of school may be fear of leaving parents (social anxiety), but can occur for many other reasons. Serious long-term consequences result if it remains untreated

family context

Relational disorders are an important factor for physical abuse and neglect. These forms of maltreatment occur most often during periods of stress. Sexual abuse is primarily a premeditated act — the adult offender plays a purposeful and intentional role. Maltreatment is seldom caused by severe forms of adult psychopathology. Sexual abuse is committed more often by males and about 50% of these abusers are the child's father or father figure

Catastrophic thinking

Russell, who has generalized anxiety disorder, refuses to go camping with friends because of rabid bats. He will not go to the multiplex because he is afraid someone will shoot at the audience. In "coping" with what can be real threats, what does he rely on? Maladaptive behaviors Avoidant solutions Catastrophic thinking Common sense, given that both threats are real

anxiety disorders

Separation THIS, Specific phobia, Social THIS, Selective mutism, Panic disorder, Agoraphobia, Generalized THIS cognitive disturbances, physical symptoms, social/emotional deficits accompanying disorders varies w/ type. Depression > in children w/ multiple THESE. Negative/Positive affectivity. Physiological hyperarousal may be unique. Predictors/environmental influences different from depression By age 6, 2x girls as boys, suggests genetic influences, related neurobiological differences. Self-reported masculinity < fearfulness − No relation found b/t self-reported femininity & fearfulness > THIS in underrepresented ethnic groups in the U.S. − Black children > symptoms than White − White children > school refusal and > severity than Black − structural racism/racial trauma. Native Hawaiian adolescents rates of OCD 2x others THIS pervasive across cultures. Ethnicity/culture may affect expression/developmental course/and interpretation. Chinese adolescents >social anxiety than American. Behavior lens principle. No 1 theory is sufficient Parents of children with THESE > current/past THESE. Children of parents with THESE ~5x. Twin studies = ~30-40% of variance genetic. No strong/direct link b/t genetic markers and specific types No 1 structure/neurotransmitter controls THIS response system (several interrelated systems in brain). Overactive behavioral inhibition system. Brain irregularities implicated in THIS and/or behaviorally inhibited. γ-aminobutyric acidergic (GABA-ergic) system Parents overinvolved/intrusive/limiting. family dysfunction associated. Low SES. Insecure early attachments exposing to anxiety-producing situations/objects/occasions. modifying − Distorted information processing, Physiological rxs, lack of control, escape/avoidance behavior therapy, CBT, family interventions, medications, p

sexual adjustment

Sexual abuse can also lead to traumatic sexualization. A child's sexual knowledge and behavior are shaped in developmentally inappropriate ways. Their own sexual behavior is a means to an end. Emotions, such as fear, disgust, shame, and confusion translate into distorted views about the body and sexuality. Can lead to promiscuity, prostitution, sexual aggression, and victimization of others. More likely to fall victim to further trauma and violence

among other children, typically their own age

Social anxiety disorder (SOC), according to the diagnostic criteria, must occur when the child is __________. among adults among different age groups, but not adults among other children, typically their own age alone with themselves as well as with peers

physical symptoms

Somatic complaints: more common in children with GAD, PD, and SAD than in those with a specific phobia. 90% with anxiety disorders have sleep-related problems, for example, nocturnal panic. High rates of anxiety in adolescence are related to reduced accidents and accidental deaths in early adulthood. Anxiety takes its toll over time by increasing the long-term risk of serious health problems

anxiety prevention

THIS study − Researchers identified children with a mean age of less than 4 years who were at risk for later THESE disorders. Brief intervention (six 90-minute group sessions) was carried out − Intervention group (compared with a control group) showed fewer THESE disorders and lower symptoms severity. THESE programs for children at high risk for THESE disorders are also very good value for money

neglect

THIS takes three forms: Physical, Educational, Emotional. THESE children show behavior patterns vacillating between undisciplined activity and extreme passivity

cognitive therapy

Teaches depressed youngsters to identify, challenge, and modify negative thought processes

Social anxiety disorder

Steve is afraid of eating in public, expecting to be judged negatively and to feel humiliated. As a result, he always makes up excuses when asked out to eat. Which disorder would he most likely be diagnosed with? Social anxiety disorder Posttraumatic stress disorder Panic disorder Generalized anxiety disorder

mood and affect disturbances

Symptoms of depression, emotional distress, and suicidal ideation are common among children with histories of physical, emotional, and sexual abuse. Teens with histories of maltreatment have a much greater risk of substance abuse. Childhood sexual abuse also can lead to eating disorders, such as anorexia nervosa and bulimia nervosa. Children or adults may induce an altered state of consciousness known as dissociation

post-traumatic stress disorder (PTSD)

THIS for children (over age 6) as well as adults involves four core features that persist longer than 1 month: Symptoms of intrusion and avoidance of distressing thoughts, Distortions in thoughts or feelings and extreme arousal and reactivity, Some symptoms are expressed differently in children than in adults, Nightmares instead of flashbacks In adolescents 12 to 17 years of age in the United States, the 6-month prevalence of THIS was 3.7% for boys and 6.3% for girls. Prevalence of THESE symptoms is appreciably greater in children who are exposed to life-threatening events or prolonged interpersonal trauma. The course of THIS may begin during childhood with trauma-specific fears. Intervention is needed if THESE symptoms remain beyond half a year THIS can become a chronic psychiatric disorder for some children and youths. May persist for decades and in some cases for a lifetime. Children and youths with chronic THIS may display a developmental course marked by remissions and relapses. Children exposed to a traumatic event may not exhibit symptoms until months or years later Girls and boys tend to differ in the ways they process and express their turmoil and symptoms of THIS. Girls tend to show more internalizing signs of distress. Boys tend to show heightened levels of physical and verbal aggression. Physically abused and neglected children show less skill at recognizing or responding to distress in others. Severe and wide-ranging problems in school and interpersonal adjustment

healthy parenting

THIS includes: Knowledge of child development and expectations, Adequate coping skills and ways to enhance development through stimulation and attention, Normal parent-child attachment and communication, Parental knowledge of home management, Opportunities and willingness to share the duties of childcare, Provision of necessary social and health services

Reactive Attachment Disorder (RAD)

THIS is characterized by a pattern of disturbed and developmentally inappropriate attachment behaviors. Children with THIS Show no consistent effort to seek comfort or nurturance from their caregiver. Fail to respond to their caregiver's efforts to comfort them. Seldom express positive emotion when interacting with their caregivers. Emotion regulation is compromised The prevalence is currently unknown. Symptoms of THIS often disappear among children raised in an institution once they are adopted into a family THIS stems from very inadequate basic care early in development. It is unknown what factors might cause one neglected child to become reticent and unresponsive to adults, while another becomes disinhibited and indiscriminate in seeking adult attention. Interventions that focus on improving caregiving quality (e.g., stability, positive affection, and safety) are warranted

separation anxiety disorder (SAD)

THIS is important for a young child's survival − It is normal from about age 7 months through preschool years − Lack of THIS at this age may suggest insecure attachment. THIS is distinguished by − Age-inappropriate, excessive, and disabling anxiety about being apart from parents or away from home − Over time children with THIS may become increasingly withdrawn, apathetic, and depressed THIS is one of the two most common childhood anxiety disorders. Occurs in 4% to 10% of children − It is more prevalent in girls than in boys. More than two-thirds of children with THIS have another anxiety disorder and about half develop a depressive disorder THIS has the earliest reported age of onset of anxiety disorders (7-8 years of age) and the youngest age at referral. Progresses from mild to severe. Associated with major stress. Persists into adulthood for more than one-third of affected children. As adults, more likely to experience − Relationship difficulties − Other anxiety disorders and mental health problems − Functional impairment in social and personal life Children with THIS display age-inappropriate, excessive, and disabling distress related to separation from and fear of being alone without their parents

about 8 months

The average episode of MDD in clinically referred children lasts __________. about 8 weeks typically two weeks, in accordance with the DSM-5 criteria up to a year if the child has a parent with a history of depression about 8 months

physical system

The brain sends messages to the sympathetic nervous system, fight/flight response

Disruptive Mood Dysregulation Disorder (DMDD)

The central feature of THIS is chronic, severe persistent irritability. Two main clinical features: Frequent verbal or physical temper outbursts. Chronic, persistently irritable or angry mood. Occurs predominantly in males and in school age children. Has high comorbidity with anxiety, mood, and disruptive behavior disorders

disinhibited social engagement disorder (DSED)

The child with THIS Shows a pattern of overly familiar and culturally inappropriate behavior with relative strangers. Fail to check with caregivers and may venture away. Exhibit intrusive and overly familiar behavior with strangers. Have experienced extremes of insufficient care. Such behavior can be dangerous, especially since the child may be willing to walk away with a stranger The prevalence is currently unknown. THIS is more persistent than RAD. Not unusual for patterns of behavior to continue through middle childhood in adolescence. THIS stems from very inadequate basic care early in development. It is unknown what factors might cause one neglected child to become reticent and unresponsive to adults, while another becomes disinhibited and indiscriminate in seeking adult attention. Interventions that focus on improving caregiving quality (e.g., stability, positive affection, and safety) are warranted

As a public health matter

The future trend in preventing child abuse and neglect will increasingly treat these problems in which of the following ways? With the increasing participation of pediatric primary care providers As a public health matter With the involvement of the court system As a cognitive development issue

the child's growing self-awareness

The gradual increase in depression from preschool through grade school can be attributed to __________. decreased performance and social pressures the onset of puberty the child's growing self-awareness the child's diet, primarily from the increased consumption of fatty foods and refined sugar

One's own childhood

The model for how to raise children is as much a factor for a healthy family environment as it is for an unhealthy one. Which of the following is both an immediate and traditional source of this model, especially for new parents? The community One's own childhood Grandparents Parent-child attachment

severe irritability

The most salient feature of DMDD is __________. severe irritability disruptive behavior infantile colic depression coupled with temper tantrums

6 months

To meet the DSM-5-TR criteria for a specific phobia, a child must show fear or anxiety for a minimum of __________. 1 year 6 weeks 1 month 6 months

70

Together, both individual and family interventions may result in dramatic and lasting effects. For example, in one study, what percentage of children with an anxiety disorder saw such improvement? 50 70 90 25

trauma and stress

Trauma and stressful experiences in childhood or adolescence may involve: Actual or threatened death, Injury, A threat to one's physical integrity. Children exposed to chronic or severe stressors, for example, major accidents, natural disasters, kidnapping, brutal physical assaults, war and violence, or sexual abuse, have an elevated risk of PTSD

attachment

Trauma-focused cognitive-behavioral therapy (TF-CBT) incorporates elements of cognitive-behavioral, including humanistic, empowerment, family therapy, and __________ models. separation psychological first aid exposure theory attachment

Extreme or uncommon stressors

Traumatic events cause many forms of abnormal childhood development and can be defined as exposure to which of the following? Extreme or uncommon stressors A specific phobia Violence Anxiety and depression

an unfamiliar adult

Travis, 4, requires special monitoring when his preschool class goes to the Sunshine Farm, a petting zoo for rescued farm animals. When his class lines up to be counted or to walk as a group, he has been known to leave the line and wander off by himself. Dean, during his monthly seminar for preschool caregivers, says such behavior requires __________ for it to be disinhibited social engagement disorder (DSED). something that Travis found that made him comfortable (such as revisiting an animal) an unfamiliar adult an attractive nuisance a person Travis mistakes as a caregiver

genetic and family risk of depression

Twin and other genetic studies suggest moderate genetic influence, with heritability estimates ranging from 30% to 45%. Children of parents with depression have about three times risk of having depression. What is inherited is likely a vulnerability to depression and anxiety. With certain environmental stressors needed for these disorders to be expressed When children are depressed, Families display more critical and punitive behavior toward the depressed child than toward other children. When parents are depressed, Depression interferes with the parent's ability to meet the needs of the child. Child experiences higher rates of depression, phobias, panic disorder, and alcohol dependence as adolescents and adults

sexual abuse

Types of THIS: Fondling a child's genitals Intercourse with the child, incest, rape, and sodomy; Exhibitionism, and commercial exploitation through prostitution or the production of pornographic materials. May significantly affect behavior, development, and physical health of THESE children. Many exploited children began as victims of abuse and rape in their homes and are forced into commercial sexual activity at a young age Treatment programs for children who have experienced THIS provide several crucial elements to restore the child's sense of trust, safety, and guiltlessness. Education and support to help understand why this happened to them and how they can learn to feel safe once again. TF-CBT has been adapted for child THIS victims and others with complex trauma symptoms. Overall, gradual exposure, modeling, education, coping, and prevention-skills training have shown positive effects in the treatment of PTSD

Its impact on a child's development

Unlike MDD, what makes P-DD a concern for educators as well as mental health care professionals? Its impact on a child's development Its co-occurring ADHD That 60 percent of a child's life is spent chronically depressed The intellectual disability that can last throughout grade school

temperament

Variations in behavioral reactions to novelty result in part from inherited differences in the neurochemistry of brain structures. 15% to 20% of children are born with a low threshold for becoming overexcited and to withdrawing in response to novel stimulation − Behavioral inhibition (BI). Places an individual at greater risk for anxiety disorders. Development of disorders depends on gender, exposure to early maternal stress, and parental response

$124 billion

What are the estimated total lifetime costs related to children and adolescents who have experienced maltreatment in the United States? $129 million $100 million $60 billion $124 billion

P-DD is a chronic condition that does not respond well to treatment.

What distinguishes MDD from persistent depressive disorder (P-DD)? P-DD is a chronic condition that does not respond well to treatment. P-DD is the "PDQ" of depressive disorders and, because of its short durations, often confused with the "downs" experienced by children with bipolar disorder. The symptoms for P-DD are both chronic and far more severe. More children are diagnosed with P-DD, which is one reason why it is a new category in the DSM-5.

A specific phobia

What is a lasting and groundless fear of a specific object, activity, or situation called? A panic disorder Separation anxiety disorder Generalized anxiety disorder A specific phobia

The term doesn't place emphasis on how a child fixates on different objects of fear.

What is issue with the term "free-floating anxiety"? "Free-floating anxiety" suggests a fixed set or network of fear-producing objects or scenarios. Anxiety is only experienced in a free-floating state, without a specific object. "Free-floating anxiety" is flawed because anxiety must "land;" that is, focus on one thing. The term doesn't place emphasis on how a child fixates on different objects of fear.

2 to 8 percent

What is the annual prevalence of MDD for children between the ages of 4 and 18? 2 to 8 percent 6 to 10 percent roughly 25 percent 5 to 12 percent

From 7 to adulthood

What is the approximate age range for separation anxiety disorder to occur? From 7 to 8 During early childhood From 7 to 18 From 7 to adulthood

There is no attributable difference.

What is the attributable difference between just "feeling sad" and depression? Feelings of sadness are more likely to disappear without intervention. Depression has a longer duration than sadness. Sadness is a normal reaction, whereas depression is abnormal. There is no attributable difference.

Irritability

What is the most common co-occurring symptom of depression? Irritability Sadness Suicidal ideation Rapid eye movement

Excessive washing

What is the most common compulsion found in children and adults with OCD? Hair pulling Hoarding Excessive washing Counting and arranging things

Anxiety

What is the name for a mood state characterized by strong negative emotion and bodily symptoms of tension in which a child apprehensively anticipates future danger or misfortune? Depression Obsessive-compulsive disorder Anxiety Specific phobia

Children with P-DD have symptoms that are less severe than MDD.

What is the primary difference between children diagnosed with Persistent Depressive Disorder (P-DD) and other depressive disorders, such as MDD? Children with P-DD will not laugh, whereas children with MDD will laugh from time to time. Children with P-DD have co-occurring eating and sleep disorders that do not exist among children with MDD. Children with P-DD have symptoms that are less severe than MDD. Children with P-DD have symptoms that are more severe than MDD.

25

What percentage of parents see their children as overly fearful or anxious, despite the fact that fear and anxiety are normal for children? 11 34 25 75

The ability to handle distress, which can have a negative impact on the emotions

What physical and mental benefit derived from the secure attachment to a parent is compromised for children who face the loss (or abuse) of a parent? A source of positive reinforcement and feedback for mind and body A protective barrier from environmental stress, which comes from responsive and emotionally involved parents The ability to handle distress, which can have a negative impact on the emotions Fewer misperceptions of interpersonal relationships (i.e., trust, confidence in others)

reaction to perceived danger

When discussing anxiety, the "fight or flight response" is the __________. reaction to perceived danger human cognitive response to danger neurotic paradox in which a perceived fear becomes self-perpetuating abnormal reaction to imaginary danger

Between the ages of 15 and 19

When do most young people diagnosed with bipolar disorder experience their first episode? After a period of anxiety or depression During the early onset period, between the age of 5 and 10. By age 10 Between the ages of 15 and 19

Reactive attachment disorder (RAD)

Which disorder involves a pattern of disturbed and developmentally inappropriate attachment behaviors? Reactive attachment disorder (RAD) Specific phobia Posttraumatic stress disorder (PTSD) Disinhibited social engagement disorder (DSED)

Sleep disorders

Which of the following does a list of the most common somatic symptoms of anxiety disorders include? Nail biting Gastrointestinal problems Sleep disorders Hair pulling

A delay in seeking healthcare for a child who is ill

Which of the following experiences would qualify as physical neglect? Refusing to allow a child to see their friends A delay in seeking healthcare for a child who is ill Letting a teenager walk home from school alone Supervising a child from down the hall, out of sight

Celexa

Which of the following is a serotonin reuptake inhibitor (SSRI) used for treating children with depression? Ativan Lithium Celexa Ritalin

Minor depressive disorder (mDD)

Which of the following is not one of the recognized forms of depressive disorder? Persistent depressive disorder (P-DD) Disruptive mood dysregulation disorder (DMDD) Minor depressive disorder (mDD) Major depressive disorder (MDD)

Lithium

Which of the following medications has the FDA approved for use in treating children with BP? Lipitor Atypical antipsychotics Valium Lithium

Lila stares in the mirror and thinks, "What is wrong with me? Why does everyone hate me?"

Which of the following statements is likely to be an example of ruminative thinking? Lila stares in the mirror and thinks, "What is wrong with me? Why does everyone hate me?" To hang out with the other girls and look older, like them, Joyce tries to stuff her bra. Undine takes her tray and sits down at the lunch table with the girls she thinks are spreading rumors about her. Stephanie thinks to herself, "I don't care what she thinks anyway."

They may lead to maladaptive interactions learned in childhood.

Why are stressful social interactions with parents, siblings, and other children seen as a negative influence on a child's development? They can lead to violence and possible injury and death. They may lead to maladaptive interactions learned in childhood. They produce the various signs of stress that need to be monitored for intervention. They can lead to neurobiological changes that can affect social development.

Until the 1800s, the welfare of the child was strictly under the jurisdiction of the head of household.

Why has the maltreatment of children been seen as "problematic" in the modern period; that is, from the 1800s onward? Children have long been seen as "small adults." Indeed, childhood is a Victorian construct. Common law, dating to medieval times, has long allowed for corporal punishment. Children were once considered commodities, not unlike indentured servants. Until the 1800s, the welfare of the child was strictly under the jurisdiction of the head of household.

Childhood trauma is very likely linked to serious mental health consequences.

Why is childhood trauma seen as the "hidden epidemic"? Childhood trauma is very likely linked to serious mental health consequences. The justice system's focus on the maltreatment and sexual abuse of children has resulted in a virtual epidemic of caseloads in U.S. courts. Childhood trauma is the leading stressor for anxiety and depression disorders. Childhood trauma has led to an outbreak of PTSD.

The number of children diagnosed with MDD does not account for how widespread symptoms of depression are

Why is it possible that the estimates of depression for young people are still too low? The criteria for MDD are too loose. The number of children diagnosed with MDD does not account for how widespread symptoms of depression are. Many children just don't know that they are depressed. There is a stigma attached to self-reporting depression.

Because it is a form of separation anxiety

Why is school reluctance and refusal not a separate anxiety disorder? Because it is a fear of authority Because it is a fear of open spaces (i.e. agoraphobia) Because it is a fear of failure Because it is a form of separation anxiety

cognitive symptoms

a decline or impairment in: memory and working memory, language function, executive functions, slower processing speed, differences in ability to infer the intentions of other people (ToM), discern emotions from facial expressions or tone of voice, may attend to and interpret neutral stimuli or misinterpret other stimuli

panic

a group of physical symptoms of fight/flight response − Unexpectedly occurs in the absence of obvious danger or threat

behavioral inhibition (BI)

a low threshold for novel and unexpected stimuli

middle range continuum of care

poor/dysfunctional actions represent irresponsible and harmful childcare

positive end continuum of care

appropriate and healthy forms of child-rearing actions that promote child development

anxiety

characterized by strong negative emotion and bodily symptoms of tension in anticipation of future danger or misfortune. THESE disorders involve experiencing excessive and debilitating anxieties — occur in many forms. Many children with THESE disorders experience more than one type. Moderate amounts of THIS helps us think and act more effectively. Excessive, uncontrollable THIS can be debilitating. Fight/flight response future-oriented mood state − May occur in absence of realistic danger Moderate THIS is adaptive − Emotions and rituals that increase feelings of control are common in children and teens. THESE are common during childhood and adolescence − Girls display more THIS than boys, but symptoms are similar − Some specific THESE decrease with age − Nervous and THESE symptoms may remain stable over time. Children of all ages worry − Serves a function in normal development − Moderate worry can help children prepare for the future − Children with THESE disorders do not necessarily worry more − They worry more intensely than other children

Psychopharmacological treatments

concerns raised about their effectiveness, overuse, and possible side effects About 1 million youths in the United States receive antidepressant medication each year. SSRIs have clearly become the first line of antidepressant medication treatment. Concerns have been voiced about their use with children and adolescents. Possible serious side effects such as suicidal thoughts. Lack of information about the long-term effects. Up to 60% of depressed youngsters respond to placebo THESE can reduce symptoms, especially for OCD − The most common and effective THESE are selective serotonin reuptake inhibitors (SSRIs), especially for OCD. THESE are most effective when combined with CBT. CBT is the first line of treatment

historical trauma

cumulative emotional and psychological wounding, over the lifespan and across generations, emanating from massive group trauma experiences. Jewish communities and Holocaust survivors, Japanese American and Native American marginalization and enclosure

depression in school-aged children

many of the symptoms of preschoolers. Plus, increasing irritability, disruptive behavior, and tantrums

Coping Cat

decrease negative thinking, increase active problem solving, and a functional coping outlook

positive symptoms

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

persistent depressive disorder [P-DD] (dysthymia)

depressed mood that occur on most days, and persist for at least one year. at least two somatic or cognitive symptoms. Symptoms are less severe, but more chronic than those of MDD. Poor emotion regulation. Children with both MDD and THIS (double depression). More severely impaired than children with just one disorder ~1% of children and 5% of adolescents display THIS. Most prevalent co-occurring diagnosis with THIS is MDD. About half of the children with THIS. Have one or more co-occurring non-affective disorders that preceded THIS, including Anxiety disorders, Conduct disorder, ADHD THIS develops most commonly around 11 to 12 years of age. Childhood-onset THIS has a prolonged duration. Average episode length of two to five years. Almost all children eventually recover from THIS. Have a high risk of developing other disorders. Long lasting episodes of THIS can have extremely harmful effects on development. Early-onset THIS is almost always followed by MDD and sometimes by BP

acute stress disorder

development during or within 1 month after exposure to an extreme traumatic stressor

Gender Intensification Hypothesis

difference is due to the increased societal pressure for girls and boys to conform to normative gender roles during adolescence

interpersonal models of depression

disruptions in interpersonal relationships

depressive disorders

dysphoria, anhedonia. MDD, P-DD/dysthymia, DMDD. concentrating, lost interest, slow thought. harmful intellectual/academic functioning. Low test scores, poor teacher ratings, lower grade. unrelated intellectual deficits. problems attention/coordination/speed. depression cause/outcome learning difficulties? Selective attentional biases. worthlessness, negative beliefs, attributions failure, self-critical/automatic thoughts. Depressive ruminative, pessimistic, negative self-esteem. Negative thinking/faulty conclusions generalized, hopelessness, SI. Low self-esteem = depression. fluctuations self-esteem = depression after life stresses. Self-esteem girls = body image. self-views negative/narrowly focused one domain = instability self-esteem b/c lack alternative compensatory areas functioning. Social/peer problem. Few friends, loneliness, isolation. Social withdrawal/ineffective coping. Co-rumination. less supportive/conflicted w/ parents/siblings. socially isolated families, prefer alone

anhedonia

loss of interest in activities

trajectory model

ecological influences (e.g., families, schools, peers, communities) x biological influences (e.g., genetic heritability, genetic markers) in early adolescence -> stratification by group identities and statuses (e.g., intersectional race, ethnicity, and gender; sexuality; immigration; socioeconomic status) in later adolescence -> aspects of mental health (e.g., depressive symptoms, suicidal ideation) in transition to adulthood <-> aspects of physical health (e.g., metabolic syndrome, inflammation) in young adulthood

bipolar disorder (BP)

elevated/expansive/irritable, goal-directed activity/energy. Elation/euphoria -> anger/hostility if impeded. difficult identify. infrequent, variable. Symptoms overlap. hospitalization, MDD, medication, disruptive, anxiety, psychosis, SI. Restlessness, agitation, sleeplessness, Pressured speech, flight ideas, racing thoughts, Sexual disinhibition, energy, grandiosity. THIS I/II, Cyclothymic. THIS 0.5-2.5% 7-21 yrs. milder THIS II/cyclothymic > THIS I. Rapid cycling. Rate > puberty. Anxiety, ADHD, ODD/CD, SUDs, SI, Cardiovascular/metabolic, epilepsy, migraine. ~60% 1st episode <19. <10 rare. w/ mania: Psychosis, unstable, deterioration. early onset/course prognosis poor. genetic vulnerability/environment. maternal health/nutrition/substance use, early stress/trauma, Parental mood disorders. mood fluctuations: prefrontal/anterior cingulate cortex, hippocampus, amygdala, thalamus, basal ganglia. no cure. multimodal: Monitoring, Educating, Matching, medication (lithium), psychotherapeutic

behavioral theory of depression

emphasize the importance of learning and environmental consequences. Depression is related to a lack of response-contingent positive reinforcement

socioenvironmental models of depression

emphasize the relationship between stressful life events and depression. Diathesis-stress model Depression is associated with both severe and non-severe stressful life events. Triggers for depression may involve Interpersonal stress and actual or perceived personal losses, Life changes, Violent family environment, Extreme lack of family resources, Daily hassles and other non-severe stressful life events

dysphoria

excessive unhappiness

mania

expansive mood Youngsters with THIS may present with atypical symptoms, Volatile and erratic changes in mood, Psychomotor agitation, Mental excitation, Irritability, belligerence, and mixed THIS-depressive features occur more frequently than euphoria. Classic symptoms for children with THIS include pressured speech, racing thoughts, and flight of ideas

traumatic events

exposure to actual or threatened harm or fear of death or injury and are considered uncommon or extreme stressors How THIS is experienced depends on a number of factors. The child's developmental level and pre-disaster characteristics. Cognitive appraisal of the threat and coping style. Characteristics of the disaster or THIS. The child's efforts to integrate THIS into their existing cognitive view of the world. THIS can result in an individual's long-term response that continues well beyond the original stressor

social/occupational dysfunction

failure to achieve expected level of interpersonal/academic/occupational functioning

depression symptom

feeling sad or miserable

neurobiological models of depression

focus on genetic vulnerabilities and neurobiological processes. Effects of stress, child maltreatment, or maternal depression Irregularities in the structure and function of several brain regions that regulate emotional functions. Irregularities in amygdala, cingulate, prefrontal cortex, hippocampus. Cortical thinning in the right hemisphere. HPA axis dysregulation, sleep Irregularities, variants in BDNF, and neurotransmitters have also been implicated. Serotonin, Dopamine, Norepinephrine Brain scans of preschoolers with depression revealed elevated activity in the amygdala during face processing when compared with scans of young children exhibiting no signs of depression.

cognitive theory of depression

focus on relationship between negative thinking and mood. Emphasize depressogenic cognitions. Hopelessness theory: Information-processing biases, or errors in their thinking in specific situations, called negative automatic thoughts. negative cognitive triad

Interpersonal Psychotherapy for Adolescent Depression (IPT-A)

focuses on improving interpersonal communication and has also been effective

scale for the assessment of negative symptoms (SANS)

follow up assessment of negative symptoms of psychosis devised primarily to focus on schizophrenia

scale for the assessment of positive symptoms (SAPS)

follow up assessment of positive symptoms of psychosis devised primarily to focus on schizophrenia

brief psychiatric rating scale for children (BPRS-C)

follow up assessment. 21-item, clinician-based rating scale designed for use in evaluating psychiatric problems for children and adolescents

depression syndrome

group of symptoms that occur together

euphoria

high elation

fight/flight response

immediate reaction to perceived danger or threat aimed at escaping potential harm

anaclitic depression

infants: Infants raised in clean but emotionally cold institutional environment show depression-like reactions, sometimes resulting in death. Similar symptoms can occur in infants raised in severely disturbed families

social communication questionnaire (SCQ)

initial evaluation previously known as the autism screening questionnaire (ASQ). Brief instrument helps evaluate communication skills and social functioning in children who may have autism or ASD. completed by a parent or other primary caregiver in less than 10 minutes.

kiddie-SADS-present and lifetime version (K-SADS-PL)

initial evaluation. semi-structured diagnostic interview designed to assess current and past episodes of psychopathology in children and adolescents according to DSM-IV criteria. supplements (psychotic disorders, affective disorders, anxiety disorders, behavioral disorders, substance abuse and other disorders) used for diagnostic exploration and clarification; administered in the order in which symptoms appeared

racial trauma

involves ongoing individual and collective injuries due to exposure and re-exposure to race-based stress. Study of this distinct form of trauma is still in its infancy. A very real and present public health threat that significantly impacts young people in marginalized groups

agoraphobia

marked fear or anxiety in certain places or situations THIS is less common (about 2.5% of teens 13-17 years) THIS is characterized by marked fear or anxiety in certainsituations. The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available if they were to experience panic-like or other incapacitating symptoms

depression in preschoolers

may appear extremely somber and tearful. Lacking exuberance; may display excessive clinging and whiny

bipolar disorder

mood swings from deep sadness to euphoria and mania

Cognitive-behavioral therapy (CBT)

most success in treating children and adolescents with depression Most common form of psychosocial intervention combining behavioral and cognitive therapies Cognitive restructuring, Behavioral activation, Problem solving, coping ahead, Interpersonal skills, Relaxation/distress management, Mindfulness The most effective procedure for treating most anxiety disorders. Almost always used with exposure-based treatments. Coping Cat. Skills training and exposure combat problematic thinking. Computer-based THIS has also been shown to be effective

physical abuse

multiple acts of aggression. In most cases, the injuries from THIS may not be intentional. Occur as a result of over-discipline or severe physical punishment Interventions for THIS usually involve Ways to change how parents teach, discipline, and attend to their children. Training parents in basic child-rearing skills. Cognitive-behavioral methods that target specific anger patterns or distorted beliefs. Teaching parents how to improve their skills in organizing important family needs. Project Safe Care

thinking distortions in depression

negative beliefs, attributions of failure,and self-critical automatic negative thoughts

co-rumination

negative form of self-disclosure and discussion between peers focused narrowly on problems or emotions to the exclusion of other activities or dialogue

multidimensionally impaired

not formal diagnosis. individuals with multiple language/learning disorders, mood lability, and transient psychotic symptoms

negative end continuum of care

parents who violate their children's basic needs and dependency status in a physically, sexually, or emotionally intrusive or abusive manner, or by neglect

obsessions

persistent and intrusive thoughts, urges, or images

negative affectivity

persistent negative mood is related to both anxiety and depression

positive affectivity

persistent positive mood is negatively correlated with depression, but is independent of anxiety

depression

pervasive unhappy mood, More severe than occasional blues or mood swings. Children cannot shake sadness. Interferes with daily routines, social relationships, school performance, and overall functioning. Often accompanied by anxiety or conduct disorders. Often goes unrecognized. In past, Mistakenly believed THIS did not exist in children. Symptoms of THIS — typical and passing expressions of certain stages of development. We now know: Children experience recurrent THIS. THIS in children is not masked, may be overlooked. frequently co-occurs with other more visible disorders. Almost all young people experience some symptoms of THIS. Many experience significant THIS at some time. Is displayed as lasting mood with disturbances in: Thinking, Physical functioning, Social behavior. Suicide among teens. 90% show impairment in daily functions. Experience and expression of THIS change with age. In children under the age of 7, Tends to be diffuse and less easily identified. ~50% receive help.

fear

present-oriented emotional reaction − Occurs in the face of a current danger and marked by a strong escape tendency Moderate THIS is adaptive − Emotions and rituals that increase feelings of control are common in children and teens. Normal THESE − THESE that are normal at one age can be debilitating a few years later − THIS defined as normal depends on its effect on the child and how long it lasts− The number and types of THESE change over time

allostatic load

progressive wear and tear on biological systems due to chronic stress

flooding

prolonged repeated exposure

Project Safe Care

provides multicomponent interventions, such as marital counseling, financial planning, and lessons on cleanliness

childhood onset schizophrenia (COS)

rarer/more severe form of adult-onset. childhood gradual, not sudden onset. into adolescence/adulthood. negative impact on social/academic competence. Severe disturbance in sensory functioning and/or behavior. social/occupational dysfunction. at least six months. schizoaffective/mood disorder/substance/medical condition exclusion. relationship to autism spectrum or communication disorder. positive and negative symptoms rare < age 12. dramatic increase in adolescence, modal onset ~22 y/o. incidence <0.04% based on NIMH cohort. Estimated prevalence <1/10,000 children. earlier age of onset in boys by 2-4 years. Gender differences disappear in adolescence. neurodevelopmental model. biological factors: strong genetic contribution, molecular genetic studies have identified several potential susceptibility genes. environmental factors: familial disorder, high communication deviance, stress, and personal tragedy GPR153, DAOA, DTNBP1, (GAD1, PRODH, NRG1, CHRNA7 with ASD), (NRXN1, PCDH19 with ASD/intellectual disability), (COMT, BDNF with ASD/ADHD), (TPH1 with ADHD) substantial misdiagnosis (psychotic depression, bipolar disorder, ASDs, pervasive developmental disorders, OCD/GAD/PTSD, multidimensionally impaired). assess speech/language/educational deficits, obtain extensive collateral information, observe patients/families over several visits. chronic disorder with poor long-term prognosis. Serious mental illness (SMI). Current treatments = antipsychotic medications with psychotherapy and social/educational support programs. medications control psychotic symptoms. serious side effects. Rating scale to evaluate likelihood of psychosis and THIS. Higher psychosis and lower depression signals greater likelihood of THIS initial assessment: SCQ and K-SADS-PL with supplements. follow up assessment: SAPS, SANS, and BPRS-C

panic disorder

recurrent unexpected panic attacks − At least 1 month of persistent concern or worry about having another attack and its consequences − Significant change in behavior related to the attacks in order to avoid having them THIS is less common (about 2.5% of teens 13-17 years). Comorbidity adolescents with THIS: Most commonly have another anxiety disorder or depression. At risk for suicidal behavior; alcohol or drug abuse 95% of THESE adolescents are post-pubertal. Lowest remission rate for any of the anxiety disorders. In the absence of treatment, these disorders are likely to have a persistent and chronic course.

psychological abuse

repeated acts or omissions that may cause serious behavioral, cognitive, emotional, or mental disorders. Racial/systemic trauma often falls under the umbrella of THIS. Micro- and macro-aggressions that dehumanize or demonize children

compulsions

repetitive, purposeful, and intentional behaviors or mental acts performed to relieve anxiety

panic attack

short period of intense fear or discomfort that is accompanied by symptoms characteristic of the fight/flight response (escape) THESE are common (16% of teens). THESE are more common in adolescent females than adolescent males. Age of onset for first THIS 15 to 19 years

depression in preadolescents and adolescents

similar symptoms of younger children. Plus, self-blame, low self-esteem, persistent sadness, and social inhibition

negative symptoms

slowed thinking, speech, movement. emotional apathy. lack of drive/motivation.

neurodevelopmental model

specific neural circuitry increases a child's vulnerability to stress

abuse

universal/targeted prevention before occurrence -> THIS (physical/sexual/emotional/neglect/exposure to intimate partner violence) -> prevention of recurrence -> prevention of impairment -> long-term outcomes

self-control theories of depression

youths with depression as having deficits in self-monitoring, self-evaluation, and self-reinforcement