Psy 363 Final
At what age does an understanding of death as final and inevitable emerge?
9-10 years old
A young child exhibits a persistent failure to eat adequately that results in the child's failure to gain weight. This child would likely revived a diagnosis of
Feeding disorder of infancy or early childhood
Is there a proportion of youth with diagnosable disorders that do not receive mental health services?
Fewer than one third of children receive the help they need ⅔-¾ of youth with diagnosable disorders do not receive mental health services Low-income and ethnic minority families
What role does family functioning have in asthma?
Home environment (ex. Dust, animal dander), activities of family members (ex. Smoking outdoor activities), and stress (ex. Family fights, divorce) may act as triggers for asthmatic attacks Negative emotional climate was associated with disease severity. Family members likely have to assist in the management of the disease, especially for young children Parents experience increased anxiety, lose work days because of child's illness and suffer high medical costs Siblings may experience loss of attention and restrictions in choice of family activities Annett & colleagues (2010) findings support the idea that family functioning affects the child's functioning and the the child's functioning and the control of the child's asthmatic condition affect both the child's and parent's quality of lif
What are some facts about asthma?
Hyperresponsiveness of airways Inflammation and narrowing of airways Difficulty breathing Prevalence: 10% of young people. More prevalent in urban( more toxins in the air), minority, and poor children Etiology: Concept of triggers and irritants Family factors don't cause asthma but can trigger attacks in at risk youth
What does research say about asthma in terms of the psychological and genetic causes?
Purcell & colleagues (1969) observed that asthmatic children were free of symptoms when seperated from parents. It was found that over time, the magnitude of changes reported from different studies similar to this study were not clinically significant Improvement in asthmatic symptoms could have been due to increased compliance with prescribed medical regimens when the substitute parents moved in and the children's parents were away.
What are some facts about HIV/AIDS in children and adolescents?
Medical advances have led to: Drop in number of babies born with HIV from HIV positive women Shift from terminal care to management of conditions Improved antiretroviral therapy slowed down progression of CNS disease Children have developmental and neurological problems If still present in school age → significant deficits in learning, language, attention, emotion, and social Problems are a direct outcome of disease + the medical treatment and stress Many are taken in by foster families (mothers had used drugs or had psychopathology)
Why is adolescence a problematic period for adherence to medical regimens?
This is when they are going through puberty and they worry about looking different from other children because they have to do certain things to manage their problem Ex. diet restriction, snack times, insulin injections for people with diabetes
What percent of married women with preschool children work outside of the home?
in 1950, 12% of married women with a preschool child worked outside the home. In 2003, that number was up to 60-77%
Professionals working in the area of childhood injury have suggested abandoning the term "accident" in favor of "unintentional injury" because
o "unintentional injury" acknowledges that the event, though not deliberate, might have been avoided
· Current treatments for encopresis
o Are likely to include positive reinforcement for appropriate toileting behavior and being clean
· The medication most frequently employed in the treatment of enuresis is
o Desmopressin acetate
· Sleep disorders are usually classified into two major categories
o Difficulties in initiation and maintenance and difficulties in arousal and transition
· Which of the following statements regarding the urine-alarm system is accurate?
o The system is effective in a majority of cases.
· Worldwide statistical data on the mortality of children under 5 years of age indicate that
o about 40% of deaths occur within the first month of life.
· Which of the following is the correct historical sequence for setting of mental health services for children?
o child guidance center, hospital based, mental health clinic/private practice
Pediatric psychology
o examines the impact of social and psychological factors on medical conditions
More recent research on the role of family functioning in asthma suggests that
o family functioning influences the frequency and severity of asthmatic symptoms
· The first task in the treatment of juvenile diabetes is to
o gain control of the diabetic condition
the term adherence describes
o how well a youngster or family follows recommended medical treatments
With regard to mental health services in the U.S., there is some evidence that minority group families are especially
o less likely to seek professional care and less likely to remain in care.
Which of the following best describes the history of mental health services for youth in the U.S.?
o poor coordination among relevant agencies and professionals
Findings regarding the association between chronic illness and children's social/emotional adjustment suggest that
o the young person's attitude toward the illness may impact the illness
Nightmares
occur during REM sleep
Do children from low-income homes benefit cognitively from day care center attendance?
yes, in care they become better in receptive lagnuage skills
An understanding of death as final and inevitable, and of personal mortality, emerges at about
9 or 10
What is "Eating Disorder Not Otherwise Specified?"
(EDNOS) - May be applied to eating disorder that would not meet the criteria for either anorexia or bulimia nervosa One such disorder is Binge-Eating Disorder (BED) - characterized by recurrent binge eating but does not engage in the inappropriate weight-control behaviors that are part of bulimia
What are some facts of sleepwalking?
- 15% of children between 5 and 12 experience a sleepwalking episode - Typically resolves by adolescence - May be related to immature nervous system - Can be stress-related - Higher concordance rates in MZ twins
What are some facts regarding childhood obesity?
- BMI at or above 85th or 95th percentile - Increasing in prevalence - 17% of US children overweight - More likely among Mexican-American male children and adolescents and non-Hispanic black adolescents - Related to other health concerns - Higher number of school absences - Related to behavioral problems - Related to peer rejection - Related to low self-esteem
What percen of infants and younger children experience some form of sleep problem?
- One quarter of infants and younger children experience some form of sleep problem that is disturbing to the family.
What is rumination?
- child voluntarily regurgitates food - Child finds experience pleasurable - Most common in infants and children with developmental disabilities - Associated with relationship problems or stimulation/habit
What are the differences between diurnal, nocturnal, secondary, and aggressive enuresis?
- diurnal is daytime - nocturnal is night - secondary is regression - primary is never had control
What do meta analyses on adoption suggest about adoptees?
- meta-analyses of research indicate 3 commonly found risk factors: More likely to be associated with poor outcome are late age of adoption, male gender, and pre-adoption factors such as neglect/abuse, prenatal drug exposure, behavioral problems, and foster or institutional care.
What are the characteristics of enuresis?
- problems with bladder control - Twice weekly for three consecutive months or associated with significant distress - After age 5 diagnosed prior to the age of 5 - Nocturnal - nighttime bed wetting - Diurnal - daytime wetting - Primary - child never gains bladder control - Secondary - child regresses or loses control - 85% are primary type - More common in males - Prevalence decreases with age
How prevalent is sleepwalking in children, and by what is it influenced?
15% of children between the ages of 5 and 12 have isolated experiences of walking their sleep Sleepwalking disorder (persistent) - estimated 1 to 6% of the population May continue for a number of years but likely to diminish in frequency with age Frequency influenced by insufficient sleep, changes in sleep routines, specific settings, and by stress the physical illness Strong genetic component; greater concordance with monozygotic twins and dizygotic twins, family patterns (80-90% of patients have first degree relative with a history of sleepwalking) Suggested, Immaturity of the central nervous system in sleepwalking disorder
At what age is the lack of urinary control diagnosed?
5 or prior to age 5
What is the rate of employment among U.S. married women with school aged children?
60% preschool children, 77% 6-17 age children
What is suggested by research on the effects of maternal employment on children?
Appears not to harm children Small positive effects on child achievement and behavior and is moderated by factors such as child gender, family structure, and socioeconomic variables
What is adherence?
Adherence is not just a matter of accurate information and knowledge; it requires that the prescribed tasks be accurately and consistently carried out. Describes how well a young person or family follows recommended medical treatments such as taking medications, following diets, or implementing lifestyle changes.
An adolescent female whose ideal weight is 120 lbs. weighs 95 lbs. She repeatedly engages in self-induced vomiting and exhibits an intense fear of gaining weight. She claims she feels fat and is highly concerned with her body's shape. In addition, her menstruation has been disrupted and she has a number of other physical problems. According to DSM-IV she would most likely receive the diagnosis of
Anorexia Nervosa
Timko's research into disease and funtional disability
Better parental social functioning, mother's involvement in social activities and father's number of close relationship seemed to facilitate the youth's adjustment Father's risk and resilience factors contributed to the youth's functioning and adjustment beyond what was already accounted for by maternal factors and other influences
What is the historical sequence for in what settings mental health services are provided for children?
Community approach → child guidance clinics → services become more hospital-based → guidance/mental health clinics experience a lack of funding and support → hospital and residential care increase → today's services vary in settings that include: mental health clinics, psychiatric or full service hospitals, residential centers, private professional practices, children welfare and juvenile agencies, and schools.
What is it called when a child has a persistent failure to eat adequately which results in the child's failure to gain weight?
Avoidant/Restrictive Food Intake Disorder
Why do professionals prefer "unintentional injurt" over "accident"?
Because serious injuries are often mistakenly assumed to occur infrequently and to be chance events, thus unavoidable These assumptions do not encourage active prevention effort to something that might have been avoided
What are the specifics of the urine alarm system?
Bell and pad treatment, a device near the genitals that detects moisture and has an audible sound to let someone know they need to go to the restroom. An absorbent sheet between 2 foil pads When urine is absorbed by the sheet, and electric circuit is completed which activates an alarm that sounds until it is manually turned off. Parents instructed to awaken the children when the alarm sounds; child taught to turn off the alarm and to go to the bathroom. Family keeps record of the dry and wet nights, and after 14 consecutive days of dryness, the device is removed.
What is it called when a child eats more during an hour period than most people would be expected to eat, and he/she reports an inability to control his/her eating during this period?
Binge eating
What disorder is characterized by recurrent episodes of binge eating and repeatedly fasting and engaging in excessive exercise to prevent weight gain
Bulimia nervosa
Which two factors are known to put adoptive children at risk for academic and behavioral problems?
Children not adopted immediately and preadoptive situations
Which management techniques are used to treat encopresis?
Combine medical and behavioral treatment Likely to include positive reinforcement for appropriate toileting behavior and being clean
What are the tasks in the treatment of juvenile diabetes?
Daily insulin injections, monitoring of urine and testing of blood glucose levels Timing of meals, diet, exercise, physical health, and emotional state
Do after school programs benefit low income youth?
Evidence supports the benefit of sustained participation in high-quality after-school programming both to academic and social behaviors Features of effective programs are good staff-child relationships, availability of diverse activities, intentional focusing on learning goals, and strong partnerships with schools, families, and community.
What are some facts about the foster care system and youth?
Foster care settings include non relative and relative family homes, group homes, emergency shelters, residential facilities, and homes preparing for adoption. Although foster care can have positive influences, it can be inadequate and the rate of disruption is high, with children being moved so much Youth in foster care are at risk for psychological problems; treatment foster care programs have been created. Special training and help given to foster parents The Incredible Years parent training program was employed, based on evidence of its effectiveness in teaching parenting skills and in reducing externalizing problems. Within a specified time, each child must either be returned to the biological family, or adopted, or be permanently placed with a foster family which can include relatives or legal guardians. The frequency of adoption from foster care has increased; however, finding families for older children is hard
What are some statistics regarding adoption?
In 2007, 1.8 million children lived with adoptive parents In 2007, 40% of the children adopted from foster care were between the ages of 2-5 In 2007, more than 40% of the children adopted privately within the US were younger than 1 years old In 2007, over 30%-40% of the children adopted internationally were younger than 1.
What does research by Palmer and colleagues suggest about adherence to diabetic regimens?
Individuals with low levels of self-reliance/autonomy and low pubertal status, transfer of diabetes responsibility from mother to child was associated with poorer control. When mom was involved with adhering to treatments for her child, there was better control of diabetes Young people with diabetes wish to avoid looking different to their peers so they don't adhere to unusual behaviors Behaviors required to control their diabetes Injections Glucose testing Eating at certain times
· Regarding the measurement of pain in young patients
It is difficult to differentiate the pain the youngster is suffering from the anxiety the youngster is experiencing while undergoing an aversive medical procedure.
Are children prepared for hospitalization? If so, how?
It is now common to have prehospital preparation for both the child and the parents Combine modeling with explicit training of coping techniques and programs targeting preparation for surgery including a film that shows realistic but adaptive reactions to procedures and other educational and anxiety reduction procedures Ethan Has an Operation film
How can the history of mental health services for youth in the US be described?
It is widely agreed that children and adolescents are underserved Early mental health services for youth emphasized a community approach Child guidance clinics provided interdisciplinary and low-cost services to children and adolescents and their families. Services became more hospital based and guidance and mental health clinics experienced lack of funding and support. Hospital and residential care increased during 1970s and 8-s, partly because of increased 3rd party payment. There was a dramatic increase in the population of poor minority children who needed but could not obtain mental health services. poor coordination among relevant agencies and professionals
When does adjustment to a chronic illness by a youngster and family occur and for how long?
Its likely to be an ongoing process, beginning at diagnosis and continuing through treatment, treatment completion, perhaps relapse, and the long-term course that is inherent in a chronic illness
Are mental minority group families more or less likely to seek professional help and remain in care?
Less likely to seek professional help and less likely to remain in car
What are some facts about diabetes?
Most common chronic disease in young people Affecting approx. 1,8 youths per 1000 Type 1- insulin dependent diabetes Lifelong disorder that results when pancreas produces insufficient insulin Daily insulin injection required Typically occurs in childhood, called childhood or juvenile diabetes Type 2- adult-onset disorder Increase in cases in youth- 10%-20% Disproportionately high among African American, American Indian, and Latino/Hispanic populations Manage by weight reduction, exercise, and careful diet
· A 5 year old boy is referred to a clinic for the treatment of enuresis. He wets his bed at night, but remains dry during the daytime. He does not exhibit any other behavior problems. His mother reports that her son slept through the night without wetting for about a year, or until his baby sister was born. The boy would probably be described as exhibiting
Nocturnal and secondary enuresis
What is it called when a child habitually eats substances such as paint, dirt, and bugs?
PICA - More common in 2- and 3-year olds - More common in children with developmental disabilities - May be related to nutritional deficits, parent inattention, lack of stimulation - Cultural influences - Education, behavioral interventions
What intervention has been proven to help bedtime refusal, difficulty falling asleep, and nightime awakenings?
Parents are taught to put the child to bed at a designated consistent time, develop a consistent routine (involves calm activities the child enjoys), once routines is complete and the child in bed the parents are told to ignore the child until the set time the next morning. If parents are uncomfortable with ignoring crying they can work on increasing the amount of time between check-in's on the child.
what are the different types of anorexia?
Restricting type and binge eating / purging type - on basis of whether or not the person binges
What is the primary goal of the Adoption and Safe Family Act?
Returning foster children to their biological families
What are some facts about the case study of cindy in your textbook?
She's 14-years old attending a demanding public school She reported she has been having daily headaches for 18 months She followed medication and other recommendations from her neurologists but only experienced minimal improvement. She received biofeedback-assisted relaxation training; within 3 sessions she reported decreased pain and anxiety while practicing these techniques. After 6 sessions, she had a dramatic decrease in her headaches and could resume normal activities and her grades got better.
How are nightmares, sleep terrors, insomnia, and anxiety attacks defined?When do they occur?
Sleep problems Occurs during R.E.M. Sleep?
What disorder is characterized by self induced vomiting and exhibitions of an intense fear of gaining weight?
anorexia nervosa
How is pain in young patients measured/assessed?
The behavioral component of children's behavior can interfere with effective medical treatment. Observational methods are often used to assess children's distress behaviors
How large are the effects of a chronic illness on a fmaily and the individual?
The effects of a chronic illness are likely to be pervasive, particularly if the illness is life threatening. The entire family may experience considerable anxiety and have appreciable stress placed on its daily routines.
Which of the following is true regarding the research by Geoffrey et al (2007)?
The highest receptive language scores were from kids who were from a low SES background and in full time non maternal care
Which components were included in the intervention by Jay and her colleagues (1987, 1991, 1995) on reducing children's distress during painful medical procedures?
The intervention package developed by Jay and her colleagues consists of 5 major components: filmed modeling, breathing exercises, emotive imagery/distraction, positive incentive, and behavioral rehearsal. Filmed modeling: child shown an 11-minute film of a same-age model undergoing procedure. After the film, patients taught breathing exercises. Then taught imagery/distraction techniques like emotive imagery. The positive incentive component includes a trophy presented as a symbol of mastery and courage The behavioral rehearsal phase is when the young children play doctor with a doll and older children are fuided in conducting a demonstration
What are some facts regarding chemotherapy and related treatments for childhood cancer?
Treatments are often lengthy, highly invasive, stressful, and accompanied by considerable pain. Assist families with coping with a long and stressful treatment regimen Advancements in treatments such as chemotherapy and radiation have contributed to increased life expectancy However, young people who have completed these treatments are at increased risk for physical health difficulties such as growth and reproductive difficulties, cardiological, pulmonary, renal/urological, orthopedia, sensory-motor, and neurological impairments, and secondary malignancies. These effects may not be apparent right after treatment, but may occur later among survivors, and their impact my evolve over time.
Watamura and colleagues (2011) used the term "double jeopardy" to refer to children with what circumstance?
Watamura and colleagues examined children who experienced a "double jeopardy" of low-quality care both at home and in other settings.
What are latchkey children?
Wear a key around their neck, neither of parents are home when school ended. Comes home by themselves
What characterizes pediatric psychology?
When the focus is on children and adolescents
A sleeping child suddenly sits upright in bed and screams. The child still appears to be sleeping, but shows obvious physiological signs of distress and appears disoriented. Eventually, the child returns to sleep without fully awakening and has no memory of this event the next day. The child has experienced
a sleep terror
Is the term Psychosomatic Disorders an historical predecessor of the DSM-IV category Psychological Factors Affecting Medical Condition?
Yes, Psychosomatic Disorders is the original title · Leading to other DSM changes: Psychophysiological Disorders, Psychological Factors Affecting Physical Condition, Psychological Factors Affecting Medical Condition · In DSM-5 a new chapter, Somatic Symptoms and Related Disorders includes the category Psychological Factors Affecting Other Medical Conditions
Are there medications for the treatment of enuresis?
Yes, desmopressin acetate (DDAVP)
Are adoptive children resilient?
Yes, particularly those who moved from disadvantaged or abusive pre-adoptive circumstances
· Research on the effects of maternal employment on children indicates that
children are generally positively affected
How are sleep disorders classified?
difficulties in initiating and maintaining sleep or of excessive sleepiness and disorders of arousal, partial arousal, or sleep-stage transitions(parasomnias)
· Research consistently indicates that early child care has little to no impact on the child.
false
Preparation of children for hospitalization
should include having the child observe a model who is apprehensive, but copes with the stresses of hospitalization
With regard to behavioral problems, adopted children are at _____ risk than non adopted children.
somewhat greater
What is the association between chronic illness and children's social/emotional adjustment?
the young person is likely to experience substantial stress and anxiety
In 2010, center based care was the primary setting for 24% of children age 0-4 years.
true
· Approximately 60 percent of married women with a preschool child work outside of the home.
true
which of the following is true regarding diabetes?
type I diabetes is the result of the pancreas producing insufficient amounts of insulin
Is there variability in adjustment in chronically ill youth?
• "research findings suggest that there is a considerable variation in adjustment among chronically ill youths" • some do not experience serious adjustment problems, but subsets of more vulnerable patients do exist • adjustment = complex function of a # of variable • variables: 1. characteristics of the young person and family members 1. youths existing competencies and the coping skills possessed 2. disease factors, such as severity, degree of impairment, and the functional independence of the young person 3. youths environment
