Abnormal Psy; Chapter 15 - Disorders of Childhood and Adolescence

Pediatric bipolar disorder (does/does not) equally affect both boys and girls

does

School phobia

fear of attending school

Most commonly reported and diagnosed mental disorder for a child

generalized anxiety disorder

Children with DSED often have a history of ____ punishment or inconsistent parenting in addition to emotional neglect and limited attachment opportunities.

harsh

Children and adolescents with internalizing disorders display what kind of behaviors?

heightened reactions to trauma, stressors, or negative events, as well as difficulty regulating their emotions

Behavior management programs teach parents what?

how to establish appropriate rules, consistently implement consequences, increase positive interactions, and encourage positive behaviors

Symptoms of RAD usually disappear in what contexts?

if the children are provided with an opportunity for predictable caretaking and nurturance

Treatment for Externalizing Disorders

interventions that address the family and social context of behaviors as well as the deficits in psychological skills are ideal

Coprolalia

involuntary utterance of obscenities or inappropriate remarks or motor movements involving self harm

Nonsuicidal self injury (NSSI)

is a relatively new phenomenon that involves the induction of bleeding, bruising, or pain by means of intentional, self inflicted injury

Infants or children with reactive attachment disorder (RAD) appear to have...

little trust that their needs will be attended to and do not readily seek or respond to comfort, attention, or nurturing. They appear to use avoidance or ambivalence as a psychological defense, have great difficulty with age-appropriate response to initiation of social or emotional interactions, and often behave in a very inhibited, watchful, or avoidant manner, even with family and caregivers -- they don't interact with others; they often won't make eye contact (over look past a person)

The defiant behavior that is characterized in oppostional defiant behavior is usually directed to whom?

parents, teachers, and others in authority

Symptoms of DSED are considered to be more ____, largely due to the fact that issues of mistrust and difficulties with intimate relationships may, in some cases, continue into adulthood

persistent

Chronic motor or vocal tic

refers to a tic that has lasted more than a year;

Children living with depression are more likely to engage in...

self blame and self criticism

Separation anxiety disorder

severe distress about leaving home, being alone, or being separated from a parent

Infants or children with disinhibited social engagement disorder (DSED) appear how...

socialize effortlessly but indiscriminately and readily become superficially 'attached' to strangers or casual acquaintances. They easily approach and interact with unfamiliar adults in an overly familiar manner (both verbally and physically) and demonstrate such eagerness for interpersonal contact that they venture away from caregivers -- overall, they will take any form of attention they can get

Psych, social, and sociocultural dimensions of ADHD

sociocultural and social adversity such as family stress, severe martial dischord, low SES class, family conflicts, maternal psychopathology, paternal criminality, maternal mental disorder, and foster care placement) seem to contribute to this disorder - also parents who encourage outdoor play may also prevent children from getting overtired or overaroused and may decrease the liklihood of the symptoms

Neurodevelopmental disorders

are conditions involving impaired development of the brain and central nervous system that are evident early in a child's life

Externalizing disorders (sometimes called disruptive behavior disorders) are...

associated with symptoms that are socially disrupting and distressing to others; they include disruptive mood dysregulation, oppositional defiant disorder, and conduct disorder

To receive a diagnosis of ADHD a child must display symptoms in at least how many settings?

at least 2 or more (psych office, home, school, etc)

an ADHD diagnosis requires the symptoms begin before the age of...and persist for how many months?

12...6

It is estimated that about ___% of adolescents and young adults have engaged in self injury at least once; and only a minority engaged in repeated self injury

14-17

T or F; Family physicians often make ADHD diagnoses and prescribe medication when symptoms of inattention, hyperactivity, and impulsivity are not severe enough to meet DSM diagnostic criteria

T

Approx. ____% of of youth meet the criteria for CD

2-9

T or F; NSSI behavior usually subsides spontaneously

T

T or F; PBD often occurs in families with a history of the illness and is likely to evolve into adult bipolar disorder or another chronic psychiatric disorder

T

Childhood disorders are nit rare; about 1 in __ children has a serious emotional or behavioral problem

5

DMDD often begins in early childhood but is not diagnosed until the child is about __ years of age

6

T or F; Reduced activity of the autonomic nervous system (assoc with increased need for stimulation to achieve optimal arousal) is associated with CD in males; this may account for the increased risk taking associated with the disorder

T

Lifetime prevalence for PTSD in girls is ___% and in boys ___%

8; 2.3

T or F; There is some concern about the safety of lithium and antipsychotic medications for children and adolescents

T

_____ the most frequently diagnosed disorder in school age children

ADHD

DMDD is predictive of later ____ and _____ disorders

Depression and anxiety

_____ and ______ disorders are prevalent in early life and are of particular concern because they often lead to substance use and abuse and suicide in later life

Depression and anxiety

Why do people report to engaging in NSSI behavior?

They expect that it will improve their mood, and many say that they report a respite from uncomfortable feelings or a temporary sense of calm and well being following self harm behaviors

internalizing disorders

conditions involving emotional symptoms directed inward

Biological dimension of ADHD

-highly heritable disorder (up to 80% of cases are explainable by genetic factors) -reduced activity in the prefrontal cortex when tasks require inhibition of responses (low arousal of inhibitatory mechanisms can affect impulsivity, organizational planning, working memory, and attentional processes) -differences in brain structure and circuitry in the frontal cortex, cerebellum, and parietal lobes (individuals with this have smaller frontal lobes, so less mass to give towards attention and motor planning) -inadequate dopamine and associated neurotransmitters that affect signal flow to and from the frontal lobes

Youth diagnosed with PBD typically display...

a.) recurring depression b) rapid mood changes and c.) distinct periods of abnormally elevated mood involve diminished need for sleep, increased activity, distractabiltiy, talkativeness, and inflated self esteem

Childhood anxiety can significantly affect what domains?

academic, social, and interpersonal functioning and can lead to adult anxiety disorders

Disinhibited social engagement disorder (DSED)

an attachment disorder characterized by indiscriminate, superficial attachments and desperation for interpersonal contact

Reactive attachment disorder (RAD)

an attachment disorder characterized by inhibited, avoidant social behaviors and reluctance to seek or respond to attention or nurturing

tic

an involuntary, repetitive movement or vocalization

Behavioral evidence for children with PTSD

angry, aggressive behavior, or temper tantrums, difficulty sleeping, or concentrating, and exaggerated startle response or vigilance for possible threats

Why can/what makes ADHD difficult to diagnose?

Because in early childhood, limited attentional skills and high levels of energy are common

Etiology of Externalizing Disorders

Bio- reduced activity in the amygdala and abnormalities associate with deficits in social information processing; together they decrease the ability to learn from punishment Psy- both family and social context play a large role in the development of this disorder

T or F; CD is particularly easy to treat

F; it is difficult to treat although treatment is most effective when it is implemented before patterns of disruptive behavior are firmly established

Drug treatment of choice when it comes to ADHD

Ritalin (had to take two a day) or Aderal (had to take one a day; middle of the pill waits to dissolve)

Concerns about ____ increasing suicidality lead to U.S. Food and Drug Admin warnings regarding the sue of certain antidepressants for treatment of depression in youth

SSRIs

T or F; some individuals report feeling tension build before a tic and it is followed by a sense of relief after the tic occurs

T

Oppositional Defiant Disorder

a childhood disorder characterized by negativistic, argumentive, and hostile behavior patterns -- children with this disorder often lose their temper, argue, and defy adult requests, but *do not demonstrate pervasive antisocial behavior and serious violations of the societal norm*

Pediatric bipolar disorder (PBD)

a childhood disorder involving depressive and energized episodes similar to the mood swings seen in adult bipolar disorder

Tourette's disorder (TD)

a condition characterized by multiple motor tics and *one or more* vocal tics that are present for at least one year, although not necessarily concurrently -- first seen between the ages of 7 and 10

Conduct disorders

a persistent pattern of behavior that violates the rights of others, including aggression, serious rule violations, and illegal behavior (theft, deceit, and vandalism) -- persistent patterns of antisocial behaviors that reflects dysfunction within the individual

vocal tic

a tic involving audible sounds such as coughing, grunting, throat clearing, sniffling, or making a sudden, vocal outburst

motor tic

a tic involving physical behaviors such as eye blinking, facial grimacing, or head jerking

Provisional tic disorder

a tic that has been present for less than a year

ADHD is associated with both ____ and _____ problems

behavioral and academic

Those who engage in NSSI do so how?

by way of cutting, burning, stabbing, or hitting or excessively rubbing themselves to the point of pain and injury

A ____ and ____ refers to those with CD who display minimal guilt or remorse and are consistently unconcerned about the feelings of others, their own wrongdoing, or poor performance at school or work

callous and unemotional subtype

Disruptive mood dysregulation disorder (DMDD)

characterized by chronic irritability and severe mood dysregulation, including recurrent episodes of temper triggered by common childhood stressors (interpersonal conflict, being denied a request). Anger reactions are significantly overexaggerated in both intensity and duration

Attention deficit/hyperactivity disorder (ADHD)

childhood onset disorder characterized by persistent attentional problems and/or impulsive, hyperactive behaviors that are atypical for the child's age and developmental level and that significantly interfere with social, academic, or occupational activities

Childhood onset CD is assoc. with...

chronic, serious offenses, criminal behavior, and substance abuse in adulthood

Factors that can increase vulnerability to depression

conditions such as childhood physical or sexual abuse, parental mental or physical illness, or less of an attachment figure

Selective mutism

consistent failure to speak in certain situations

NSSI is associated with an increased risk of attempted suicide, especially for those suffering from...

depressive symptoms, lower self esteem, and limited parental support

Youth diagnosed with PTSD may experience..

recurrent, distressing memories or a shocking experience -- the trauma that can perpetuate this can include threats of or direct experience with death, serious injury, or sexual violation , or even witnessing or hearing about to victimization of others can also result in this disorder

Most tics in children are ____ and disappear without treatment

transient