mental health quiz 4
trauma and stressor related disorders
-classified by psychological symptooms and behaviors that emerge in response to an external event/stressor -often share overlapping symptoms on the diagnostic spectrum (anxiety, OCD, dissociative disorders) -some people experience anhedonic and dysphoric symptoms
cultural considerations for disruptive, impulse, control, and conduct disorders
-consider how aggression and behaviors are viewed in different cultures -some test measures may not be suitable for ethnic and racial minorities and some may have bias -the disproportionate rates of minority youth in juvenile justice may be the effect of inconsistent treatment within the juvenile justice system or from dynamics within their social environment -lower SES of ethnic or racial minority children has shown to negatively impact mental health outcomes ranging in difficulties including behaviorally -persistent racism and discrimination is a risk factor for the development of a mental illness
neurodevelopmental disorders
-d/o usually are recognized in the early developmental years -d/o range from transient, developmental difficulties -> chronic, long-term disorders -occur along a continium from mild -> very severe -often time present in childhood but may still affect the individual as an adult -early detection and intervention is key
intermittent explosive disorder
-recurrent episodes of failing to resist aggressive impulses that manifest as either verbal and/or physical aggression -the destructive behaviors are impulsive, not intentional -the degree of aggressive is excessive for what the situation requires -must rule out other medical or mental disorders that could include such outbursts -minimum age of 6yo
assessment of trauma and stressor related disorders: emergency considerations
-safety and stabilization is of upmost importance -increased risk of self-harm, SI, and suicidal attempts -suicidal risk increases in individuals who experienced -childhood physical and/or sexual abuse -combat trauma or military sexual assault -psychiatric comorbidity -substance abuse
autism spectrum disorder (ASD)
-chronic impairments in reciprocal social interactions, nonverbal communication, and social-emotional relationships -display of repetitive behaviors, fixations, and distress related to changes in environment -occurs along a spectrum
cultural considerations
-bring language and cultural interpreters when necessary -use language that families can understand -in some cultures, mental health issues are viewed as taboo -age-appropriate behaviors may vary by culture -some neurodevelopmental disorders may be over- or under- diagnosed in minority children -geneder roles may vary by culture
tic disorders
-can be dx at any age but symptoms are present before 18yo and have lasted for 1+ year -vocal tic disorder -irresitable movements and/or vocal sounds -can involve single or multiple tics -tourettes disorder -having both motor and vocal tics
disruptive, impulse, control, and conduct disorders
-characterized by externalizing behaviors and poor control regarding an individual's emotional or behavioral responses manifested in behaviors that violate the rights of others -problems in emotional and behavioral regulation -tend to be more common in males than females -onset typically is during childhood or adolescence
posttraumatic stress disorder (PTSD)
-associated with exposure to traumatic events involving death or threatened death, serious injury or sexual violation to the client or another person -symptoms have persisted for at least one month -exposure to trauma may have occure at any time before symptom onset -symptoms are not attributable to substance use or a medical condition -there is a subtype created to use with children under 6yo
acute stress disorder (ASD)
-associated with exposure to traumatic events involving death or threatened death, serious injusry or sexual violation to the client or another person -symptoms usually begin during or immediately after the trauma exposure -symptoms must at least be between 3 days and 1 month -very similar to PTSD with the main difference being the onset and duration of symptoms
disinhibited social engagement disorder
-associated with social neglect (the absence of adequate caregiving during childhood) -often found in maltreated, institutionalized children and refugee populations where children have been abandoned or lost their parents -primary feature is inappropriate and exceedingly friendly behavior with a person who is unfamiliar to the child -they demonstrate socially disinhibited behavior compared to social impulsiveness -musth have a developmental age of at least 9 months -occurs in individuals from age 2yo through pre-adulthood
reactive attachment disorder (RAD)
-associated with social neglect (the absence of adewuate caregiving during childhood) -often found in maltreated, instituionalized children and refugee populations where children havebeen abandoned or lost their parents -the core feature is underdeveloped attachment to caregivers, withdrawn behavior, emotional and social disruptions over long periods of time -diminished positive emotions -limited emotional or social responsiveness to others -unecplained delays of fear, sadness, or irritability not suitable for circumstances -must have the developmental age of at least 9 months with inhibited attachment behaviors evident before 5yo
specific learning disability (SLD)
-below average cognitive or academic functioning when compared to a person's intellectual capapcity -areas include reading, math, writing -reflected in academic underachivement regardless of age -for adults, dx depends on psychosocial interview and supporting documentation of academic difficulties
intellectual disability (ID)
-dx when the child is significantly below avergae intellectual and adaptive functioning -more than just the IQ, looks at adaptive skills -adaptive functioning is assessed along a continuum of mild, moderate, severe, profound -etiology can include down syndrome, traumatic brain injury, serious illness, prenatal conditions, etc. -global developmental delay -reserved for individuals under 5 years old who are not meeting developmental milestones within expected timeframes
social support
-early identification and intervention is best -children and adolescents rely on family, educational staff, environmentl supports for development -some youth may develop high resiliency and coping strategies -positive peer groups -fully assess the individual's environment
intervention for trauma and stressor disorders
-exposure therapies -cogntive behavioral therapy -treatment and support groups -individual therapy
intervention for disruptive, impulse, control, and conduct disorders
-intense in home services (IIH) -outpatient therapy -therapeutic day treatment (TDT) -community-based intervention (schools and community organizations)
conduct disorder (CD)
-involves behaviors and activities that violate developmentally appropriate social norms often of an illegal/criminal nature -must engage in 3+ of theses activities/behaviors within the previous 12 months with at least one occurence happening within the past 6 months -behaviors are chronic and repetitive four categories: 1. aggression to people or animals 2. destruction of property 3. deceitfulness or theft 4. serious violations of rules -individuals with childhood onset (began before 10yo) are more likely to have ADHD, poor peer relations, demonstrate aggression, and develop a more chronic pattern into adulthood
cultural considerations for trauma and stressor related disorders cont.
-low SES and educational attainment are risk factors -women are more than 2x as likely than men to develop PTSD in their lifetime -in general population women report being "exposed to trauma" less often than men but the trauma is more likely to be sexually related trauma -women report more numbing and avoidance symptoms while men report more irritability and impulsiveness -LGBT survivors of interpersonal violence are more likely to experience PTSD that heterosexuals -adolescence has a greater risk of experiencing trauma and potentially traumatic experiences
cultural considerations for disruptive, impulse, control, and conduct disorders cont.
-males are more often dx with child onset and pyromania -females dx with CD are at greater risk of teenage pregnancy, have higher mortality rates, and significant increase in criminal behaviors -females are not dx with CD as frequently as males but the rates. have increased over the past 20 years -female offenders are more likely to have comorbid mental disorders and are less likely to receive full treatment
assessment of neurodevelopmental disorders
-most assessment instruments are designed for children or adolescents -information is typically gathered from parents, caregivers, physicians, school personnel (teacher, counselor, etc.) and older childen can provide self-report -always refer to medical screening first to rule out medical causes -assessment instruments -Wechsler Intelligence Scale for Children fourth edition (WISC-IV) -Vineland Adaptive Behavior Scale, second edition (Vineland II) -trauma is often misdiagnosed as ADHD
oppositional defiant disorder (ODD)
-must display 4(+) symptoms/behavior for 6(+) months with an individual that is not a sibling -commonly displayed during childhood/adolescence -sometiems developed into CD but cannot be comorbid with CD symptoms/behaviors: -angry/irritable -often loses temper -often touchy or easily annoyed -often angry and resentful -argumentative/defiant -argues with authority or adults -defies or refuses to comply with rules -deliberately annoys others -blames others for his/her mistakes -vindictiveness -spiteful or vindictive
disruptive, impulse, control, and conduct disorder examples
-oppositional defiant disorder -intermittent explosive disorder -conduct disorder -antisocial personality disorder -pyromania -kleptomania -other specified disruptive impulse, control, and conduct disorders -unspecified disruptive, impulse, control, and conduct disorders
social support for disruptive, impulse, control, and conduct disorders
-positive relationships with adults are one of the strongest protective factors youth can have -family, coaches, teachers, school admin, community leaders, neighbors, etc. -incorporating intervention support services aime at lessening chronic disruptive behaviors in children has been shown to reduce frequent violent behaviors and criminality adulthood
pyromania
-premeditated fire setting -shows general facination with fire -not related to receiving material gain, expressing an ideological viewpoint, or concealing other criminal activity -not a response to anger or diminished judgment
communication disorders
-problems of language, speech, or social development -language disorder -difficulties with spoken word (speech and vocabulary) -speech sound disorder -difficulty in ability to produce and articulate sounds intelligibly -childhood-onset fluency disorder -stuttering, problems with fluency and timing of speech patterns -social communication disorder -impairments in communication skills that affect areas of functioning -difficulties with one-on-one and group interactions -nonverbal communication is misperceived and misunderstood
attention deficit hyperactivity disorder (ADHD)
-problems with attention and hyperactivity that causes significant impairment -frequently dx in school-aged children -two main categories: inattention and hyperactivity -symptoms appear before 12yo and are present for 6+ months -males are dx at higher rates than females -males display hyperactivity while females present with inattention
motor disorder
-problems with physical or perceptual corrdination and/or movement -developmental corrdination disorder -motor coordination deficits that significantly impair the ability to function in school or daily living activities -stereotypic movement disorder -recurring motor behaviors (rocking or head banging) which serves no apparent purpose -typically comorbid with ID or ASD
trauma stressor related disorder examples
-reactive attachment disorder (RAD) -disinhibited social engagement disorder -posttraumatic stress disorder (PTSD) -actue stress disorder -adjustment disorder -other specified trauma and stressor related disorder -unspecified trauma or stressor related disorder
social support for trauma/stressor related disorders
-social supports have strong correlation to fosteting resiliency -it is important to build, mobilize, and utilize as many support systems as possible for the client -social supports can act as a protective factor for trauma -assess the exent to which members of the support system are affected by the trauma -a person who is not affected may be more willing to provide support -be aware of secondary trauma and compassion fatigue -support systems can include family, friends, community, religious institutions, etc.
cultural considerations for trauma and stressor related disorders
-stereotypically was thought to only affect military member -lifetime prevalence of PTSD is highest among Blacks followed by Hispanics and Whites and lowest among Asians -stressors that affect people adversely and these symptoms they elicit differe among ethnic groups -cultural competency includes taking into account the nuances that are part of symptom expression while being respectful of the cultural meaning of symptoms/emotions to the individual -lower rates of treatment seeking for PTSD among US racial and ethnic minorities
kleptomania
-the continuous inability to resist the urge to steal -stolen objects are not needed for personal or monetary use -not an expression of anger or revenge -not related to a delusion
intervention
-therapeutic day treatment (TDT) -special education services (SpED) -individual counseling -intensive in home services (IIH) -applied behavioral analysis (ABA)
assessment of trauma and stressor related disorders
-there must be a stressful or traumatic event that must precede a change in an individual's affective states, cognitions, and behaviors resulting in impairment and significant distress -use a comprehensive assessment, screen for safety and SI assessment instruments: -clinician-adminstered PTSD scale (CAPS) -the PTSD checklist -impact of event scale revised (IES-R) -acute stress disorder interview (ASDI)
adjustment disorders
-when an individual's normal coping mechanisms prove to be ineffective in response to a stressful life event -may occur when emotional and/or behavioral difficulties arise in reaction to an indentifiable stressor -symptoms begin with 3 months from the exposure to the stressor and last no more than 6 months after the stressor ends -grief and bereavement should be ruled out -stressors can be a single event, recurrent event, chronic or continuous event, or correspod to developmental events -can be dx in children and adults
assessment of disruptive, impulse, control, and conduct disorders
assessment instruments: -child behavior checklist (CBCL) -self-administered or given by interview -screens a large range of emotional and behavioral problems in children -high cost for training and scoring -child and adolescent functional assessment scale (CAFAS) -mesaures emotional, behavioral, and psychological problems in children emergency considerations: -keep in mind the risk of the dangerous behaviors that characterize the disorders -comorbidity of additional dx leads to increased outcomes
assessment of neurodevelopmental disorders (cont.)
emergency considerations: -sometimes dx are severe enough that children are at risk for hurting themselves or others -depression is commonly comorbid with neurodevelopmental disorder -for nonverbal language or language impaired children, changes in eating or sleeping patterns may warrant screening for anxiety or depression -adolescents with ADHD are at a greater risk for accidental injury -individuals with ADHD are at increased risk of substance use -children with neurodevelopmental disorders are at higher risk of being bullied or teased
neurodevelopmental disorder examples:
intellectual disabilities, communication disorders, autism spectrum disorder, attention-deficit hyeractivity disorder, specific learning disorder, motor disorders, other specified/unspecified neurodevelopmental disorders
