PSYCH 476 FINAL

Sleep arousal disorders

(ex. sleep walking, sleep terrors) -Most often occur 60-90 minutes after sleep onset -Occur during slow-wave sleep -Children are generally unresponsive during an arousal episode -Episodes are usually brief (10-30 minutes) -Children usually go back to sleep, & have no memory of the episode

more prevalent hallucinations

(in order) 1. auditory 2. visual 3. tactile 4.olfactory

How can classical conditioning and operant conditioning be used to explain the onset and maintenance of Specific Phobia?

- A child may associate a fear response with a certain object, for example, a child who was bitten by a dog. Whenever she sees a dog, this fear response is displayed (classical conditioning). Over time, the child will learn to avoid dogs, which negatively reinforces the phobia (operant conditioning)

Only trained professionals should evaluate someone's risk for suicide. However, it is often helpful for parents and paraprofessionals (e.g., teachers, coaches) to know suicide risk factors. What are three risk factors for suicide?

- Abuse or neglect - Mental health problems - Expresses a desire to die

How are bribery and reinforcement different?

- Bribery: delivery of reinforcer to stop an undesired behaviors - Reinforcement: delivery of reinforcer when child is engaging in desired behavior

Mrs. Stark asks her seven-year-old son, Bran, to turn off the TV and eat dinner. Bran ignores his mother and continues to watch TV. Mrs. Stark repeats her request in a louder voice. In response, Bran whines and tantrums until his mother withdraws her request and lets him watch his TV program. Use the concept of "coercive family process" to show how Mrs. Stark might be reinforcing her son's oppositional behavior.

- Child is reinforced by mother for defiance and tantrums by withdrawing her request and letting him continue to watch TV - Mother is reinforced by child for backing down from her requests because he stops his tantrum

What is the difference between children with Bipolar Disorder and children with Disruptive Mood Dysregulation Disorder?

- Children with DMDD and BD can show problems with irritability and aggressive outburst, but children with DMDD show these problems persistently and children with BD show a noticeable increase in these symptoms during mood episodes - DMDD= depressive disorder, more closely resembles depression and anxiety

Many professionals identify children with learning disabilities using the IQ-Achievement discrepancy method. Describe the IQ-Achievement discrepancy approach and explain two reasons why it is not the best method to identify learning disabilities in children.

- Compare children's IQ and achievement using standardized tests - Weaknesses: o Children who demonstrate learning problems but do not meet the cutoff were denied services (had to be classified with a learning disability) • These children fall far behind their peers, and children do not receive help for their learning problems until AFTER they show serious delays o Neuroimaging studies do not support the cutoff as an accurate predictor of learning problems • Ex. poor readers show under activation of left hemisphere brain regions responsible for reading. There are no differences in brain activity between children who do and do not show significant differences between IQ and achievement

What are the three main domains of adaptive functioning? Give an example of a problem in adaptive functioning in each domain that might be shown by school-age children with Intellectual Disability?

- Conceptual skills: solving math problems - Social skills: making and keeping friends - Practical skills: personal care (getting dressed, grooming)

Most people believe that genes drive behavior. However, brain development can also be experience-expectant and experience-dependent. Explain these two concepts.

- Experience- expectant: formation of brain region partially depends on information received from the environment (connections that are used are maintained and strengthened, while others die) - Experience- dependent: environmental experiences lead to the formation of new neural connections or to changes in the brain's organization and structure

In what ways do the symptoms of PTSD depend on children's age?

- For younger children, symptoms are expressed in terms of actions or observable behaviors, also must show only ONE persistent avoidant symptom or one negative alteration to meet criteria, regressive behaviors, or nightmares - Older children: intrusive thoughts and nightmares, omen formation - Teens: no flashbacks but similar to adults, recurrent intrusive thoughts and memories

What is "joint attention" and why is it important to children's social and cognitive development?

- Joint attention: sharing focus on a topic or object with another person - Without joint attention, the child would miss out on countless learning opportunities, so the flow of info would be significantly reduced, like learning language, general knowledge, and intelligence, modeling behaviors - Wouldn't follow social references, like eye gazing because they can't focus their attention - A lack of or a delay in joint attention skills can limit children's ability to learn through imitation, develop play and social skills, and attend in a learning situation

Explain Wakefield's (1992) concept of "harmful dysfunction."

- Just because a person deviates from society doesn't mean they have a mental disorder - A disorder exists when o A person shows a dysfunction, which is a failure in some internal mechanism to perform a function for which it is naturally selected o The dysfunction must cause harm (limits or threatens the person in some way) - Behavior is understood in the context of a person's environment

What is the difference between late language emergence and specific language impairment?

- Late language emergence: significant delays in receptive or expressive language - Specific language impairment: specific deficits in language

What is the difference between equifinality and Multifinality? Give an example of each.

- Multifinality: children with similar early experiences show different social, emotional, and behavioral outcomes. Ex: 2 children with learning disorder. 1 family ignores it and the other family takes child to therapy and sets up academic accommodations. Child ends up doing well in school and very successful and other fails - Equifinality: Children with different developmental histories show similar developmental outcomes. Ex: a kid with no history of a conduct disorder and another kid with history of conduct disorder both end up in juvenile court

What is the difference between negative reinforcement and punishment? Provide an example of each.

- Negative reinforcement: withdrawing a stimulus to increase likelihood of behavior, ex. Allowing child to leave table for finishing veggies - Punishment: always decreases likelihood of future behavior. Ex. spanking

Identify three ways in which ODD and CD differ from one another.

- ODD= defiant behavior towards adults -People with ODD typically do not show physical aggression to people or animals, deliberately destroy property, or engage in theft or deceitfulness - CD= more serious and persistent, usually manifests in late childhood or adolescence

Sydney is an eleven-year-old girl with Down syndrome who often slams the doors in her house. How might her parents use overcorrection and positive practice to decrease her door slamming?

- Overcorrection: the child will correct her behavior by putting her surrounding back to the same or better condition than that which existed prior - Positive practice: the child will repeatedly practice an acceptable behavior (closing the door gently) following the unacceptable behavior

Explain the concepts of overextension and underextension and give an example of how a typically developing two-year-old girl might show each concept.

- Overextension: inappropriately generalizing a word (calling all adult men "daddy") - Underextension: failing to generalize a word ("cat" only refers to family's cat and not other cats)

etiologies of substance use disorder

- Partially heritable (explains 60% of the variance of alcohol use & 33% of other drugs attributable to genetics) -Two-thirds of teens with substance use problems have parents with a history of Substance Use Disorders -Unusually sensitive to the pharmacological effects of substances -Positive reinforcement (bring out pleasure) -Negative reinforcement (alleviate distress or boredom)

Imagine that you are school psychologist. You suspect that a 2nd grade student in your school has a reading disability. How might you use the RTI method to determine whether he has a learning disability? How might you use the comprehensive assessment method to determine whether he has a learning disability?

- RTI: Identifies learning disabilities based on educational progress and outcomes o All kids are a Tier 1: regular instruction, do screening assessments over the course of the assessments, if they do okay, they hang out in regular classroom o If they see delays, they go to Tier 2: interventions for 3-6 months o After 10-20 weeks they see how these kids are doing, some kids just needed to catch up. o After Tier 2, a teacher decides if we continue with group intervention, if not, move up to Tier 3 (individual intervention). o Early screening and interventions - Comprehensive assessment: Identification of learning disabilities by integrating classroom observations of academic performance with norm-referenced testing o Test the child's achievements, IQ test, other cognitive tests to see how they're thinking and processing information o Do we see problems that match up? Read slowly- processing and memory is slow

What are shared and nonshared environmental factors? Give two examples of shared and two examples of nonshared factors that might influence a child's development.

- Shared factors: experiences common to siblings, i.e. parents, house - Nonshared factors: factors that differ between siblings. i.e. different friends at school, different relationships with parents

All children with Autism Spectrum Disorder (ASD) show problems with social communication. List and briefly describe three ways in which children with ASD can show deficits in social communication.

- Social-emotional reciprocity: the normal back and forth of conversation and social interactions through the sharing of interests, affect, or emotions - Nonverbal communication: the effective use of eye contact, gestures, and facial expressions - Interpersonal relationships: showing an interest in others and the capacity to keep and make friends

Your 5th-grade daughter has trouble with reading comprehension. Although she reads the information in her textbooks, she seems to forget the information or inaccurately recalls it during exams. Identify three ways to improve her reading comprehension.

- Story mapping- teacher emphasizes aspects of story grammar when they occur, then organizes each aspect as a visual representation in a picture to help the child recall - Graphic organizers- diagrams or charts that display information simply and make abstract concepts concrete - Mnemonics- memory aids to increase recall (i.e. HOMES to help remember the Great Lakes)

The prevalence of youth diagnosed with Autism Spectrum Disorder has increased dramatically over the past 30 years. Give two hypotheses for this increased prevalence.

- There may be an actual ASD "epidemic" due to unidentified environmental factors or changes in lifestyle - A greater number of children are just being diagnosed with the disorder. More parents teachers and doctors are aware of the signs and symptoms, more mental health professionals may be more willing to assign the ASD diagnosis now, and there has been a broadening conceptualization of ASD to include children who do not meet the full DSM criteria but show abnormalities in social communication or stereotyped behavior

psychosocial treatments for substance use disorders

- Youths who participate in therapy experience better outcomes than youths who do not participate in therapy -Youths with more extensive substance use, history of conduct problems, comorbid anxiety and depression are less responsive to treatment - most youths never participate in psychotherapy for substance use disorders -28-day Inpatient Programs Attend to detox needs Recognize harmful effects of substances Improve quality of youth's relationship with others -12-Step Programs & AA/NA conceptualize alcohol and drug use as a disease (medical condition that develops bc of genetics and maintained bc of biology and "brain chemistry") - must recognize their inability to overcome their substance problem, surrender themselves to a "higher power" - rely on spirituality an others for support - group meetings - most frequently used for treatment Effective for adults Little research for youths

example of being a liaison

- a psychologist might work on hospital's pediatric oncology team, helping medical staff find ways to facilitate diagnosis, treatment, and recovery of children with cancer - might provide support services to family to help address emotions with child's illness - may teach relaxation techniques to kid

example of being a consult

- an adolescent might be brought to ER because she swallowed a bottle of over-the-counter pain meds - physicians might ask psychologist to assess adolescent and recommend course of treatment - or, provide a service to help child participate in treatment more effectively

appetite manipulation

- children are provided with fluids and essential electrolytes to maintain hydration but are prohibited from snacking - children only offered food during therapeutic meals, which are scheduled 3-4 times a day, approximately 3-4 hours apart - food restriction helps children recognize signs of hunger and increases motivation to eat when food is presented - children learn that food provides its own naturally reinforcing consequences

sleep onset insomnia

- falling asleep is an extended process that requires special conditions - sleep onset associations are highly problematic or demanding - in absence of associated conditions, sleep onset is significantly delayed or sleep is otherwise disrupted - nighttime awakenings require caregiver intervention for child to return to sleep

limit setting insomnia

- individual has difficulty initiating or maintaining sleep - individual stalls or refuses to go to bed at an appropriate time or refuses to return to bed following a nighttime awakening - caregiver demonstrates insufficient or inappropriate limit setting to establish appropriate sleeping behavior in child

premorbid stage of schizophrenia

- lasts from gestation through first signs of illness - no overt symptoms - deficits in motor skills and social emotional functioning - slow developmental milestones

prodromal stage of schizophrenia

- noticeable changes - marked change in youths' academic, behavioral, and social-emotional functioning - families may notice deterioration in overall function - problems with attention and concentration - 2-6 years before the child's first psychotic episode

How does a pediatric psychologist help children with cystic fibrosis?

- often help children and their families adhere to physician's recommendations regarding frequency of exercises - if children refuse to participate, psychologists may teach parents to use positive reinforcement and other behavioral techniques - other teens may become depressed, so psychologists may challenge their maladaptive cognitions that rob their motivation to manage their condition

cleanliness training

- parents ask kid to remove bedding and pajamas and place them in laundry - then expected to put on fresh pajamas and bedding and reactivate alarm

contingency management

- practiced during each meal in control by the therapist - parents aren't allowed in session so there are no negative or positive reinforcements for the kid to eat - treatment must involve presentation of food without inadvertent use of reinforcement - escape extinction is critical: refuses child to escape or avoid eating through tantrums - child is in high chair, therapist might place a small amount of food on a spoon and place spoon on child's lips. spoon isn't removed until child eats the food

Prevalence of eating disorders

-1-2% of infants & children More common among children with medical illnesses, developmental disabilities, or physical disabilities -About 2/3 of infants with feeding disorders have Failure to Thrive

Children with Chronic Health Problems

-7% of youths have chronic medical conditions that require ongoing care -Having a chronic illness can place a child at risk for a psychological disorder -Health outcomes are dependent on how well the family & child manage the situation

Etiology of nocturnal enuresis

-85% of kids with nocturnal enuresis show mono symptomatic primary enuresis (MPE): wet only at night, have never been able to stay dry each night for longer than 6 months -High heritability -Reduced secretion of arginine vasopressin (AVP) -Difficulty responding to signals of a full bladder during sleep -Difficulty inhibiting urination during sleep -AVP: slows down urine function in middle of night - signals: may just not recognize when they have to go while they're asleep

prevalence of schizophrenia

-Adult-onset Schizophrenia: 1% of the population -Adolescent-onset Schizophrenia: 0.23% of all youths -Childhood-onset Schizophrenia: 0.0019% chance a child will develop Schizophrenia -Boys are twice as likely as girls to develop Schizophrenia in childhood or adolescence -By middle adulthood, no gender difference

Treatment outcomes for eating disorders

-Anorexia & Bulimia are very difficult to treat -Most continue to exhibit psychiatric problems even if disorder is treated successfully -People with Binge Eating Disorder are more likely to recover

Treatment of nocturnal enuresis

-Behavioral treatment Urine alarm Cleanliness training Retention control training Reinforcement strategies (praise and rewards) -Medication DDAVP; synthetic version of vasopressin, which reduces nighttime urine production -doesn't work long term and is very expensive success depends on resources and motivation of family

Some critics of DSM-5 argue that children and adolescents should not be assigned diagnoses. What are two possible benefits and two negative consequences of diagnostic classification for children and adolescents?

-Benefits: family understanding, professional communication (all professionals are on the same page) - Consequences: stigmatization, failure to consider environment

prevalence of substance use in youths

-Boys tend to use alcohol and other dugs at slightly earlier ages than girls, engage in dangerous behaviors bc of substance use, and get in trouble at school for it -Alcohol: by senior year of high school, 75% of teens have used alcohol at some point in their life, 65% have used alcohol in the past year, almost 50% in past year; 8th graders: 40% at some point in their lives, 15% i the past month - Marijuana: 45% of high school seniors have tried it, 18% have used it within the past month; only 15% of eighth graders have tried it -Illicit drugs: only 25% of high school senior ( mainly prescription drugs: Vicodin 10%, narcotics 9%, medicinal amphetamines 9%, barbiturates 7%, tranquilizers 7%, OxyContin 6%). Less than 6% have tried crack cocaine, hallucinogens, heroin, methamphetamines - In general, substance use has decreased over the past decade - native americans show highest rates overall, then white and hispanics; lowest rates are african and asian americans

Cognitive-Behavioral Therapy for substance use disorders

-CBT is efficacious for teens - people learn to use alcohol and drugs through operant conditioning (+ or - reinforcement) - classical conditioning, people associate substance use with certain situations or mood states (weed w a certain group of friends) - social learning (through family members, see it as acceptable) -Monitor drinking, thoughts, & beliefs -Cost-benefits analyses (benefits of not drinking vs drinking and costs of drinking vs not drinking) -Teach tools to avoid substances -Challenge cognitive distortions about substances

Encopresis Assessment

-Child will often: Complain of clothes feeling tight State that they "can't go" Complain of pain related to bowel movements Have poor appetite Is there ever a long period between bowel movements? Are the bowel movements often large? Does the fecal matter have an unusually foul odor? Is the bowel movement painful for the child? Does the child complain that they do not know when they will have a bowel movement? Does the child ever hide soiled underwear? bowel assessment: check of size and consistency, where child pooped, when, time

Cognitive Behavioral Therapy for Bulimia Nervosa

-Conceptualizes Bulimia as reflecting disturbances in mood, cognition, & eating behaviors -Goal is to break cycle of negative reinforcement -Expose to normal amounts of food - Break cycle of binging and purging - very effective in purge frequency, dietary restraint, shape and weight concerns, binge frequency (from highest percent to lowest) - cost and risks analysis of bingeing and purging

Consultant-Liaison: Consultation

-Consultation: Address an immediate & specific concern (i.e., firefighting) - when a healthcare professional is treating a child with a behavioral, cognitive, or social emotional problem that interferes with child's treatment - physician might ask psychologist for recommendations regarding how to address child's psychological problems and recommend a course of treatment after child is stable -Assess for psychological problems Was it an accident or suicide attempt? Was it an accident or something else? -Provide tools to help manage current situation (e.g., relaxation exercises)

Challenges Applying the Substance Use Criteria to Youths

-Criteria are developmentally insensitive - Specific examples like truancy & low grades are most common -Researchers are examining these signs now -Some criteria are over-identified in teens -Teens become tolerant more quickly than adults -Teens spend a lot of time trying to buy alcohol, because it is harder for them to get it - more likely than adults to report substance use in situations that might be hazardous bc of their increased probability of engaging in impulsive, high rate behaviors - teens show different patterns of alcohol and other drug use than adults - Youths binge drink, not daily drinkers -Youths use a greater variety of substances at once - more likely than adults to outgrow their symptoms

Cystic Fibrosis

-Cystic Fibrosis: Genetic condition that causes thick mucus in the airways, lungs, & intestines -Foreign particles can accumulate in the lung's mucus & cause infection -Mucus in the intestines prevents nutrient absorption

Secondary Prevention Programs

-Designed for teens at risk for developing substance use problems - most are ecologically based (target at risk youths in certain areas or neighborhoods) -Target multiple risk factors simultaneously -Teens are taught about substance use & abuse -Teens are taught how to avoid substance use -Parents are taught about teens' substance use & how to decrease their own teens' use -Programs address teen's community & school More rigorous programs do better

Associated disorders with substance use

-Dual diagnosis of substance use & mental health condition (e.g., depression) makes treatment much harder -ADHD: 50-75% of youths with Substance Use Disorder have ADHD -Depression: 25-50% of substance users are depressed (directional) -Anxiety: 10-40% of substance users have anxiety -Schizophrenia: Repeated marijuana use may increase the likelihood of someone who is genetically predisposed to Schizophrenia developing the disorder

Encopresis Treatment: Basic Strategies

-Empty large intestine (work with pediatrician) -High fiber diet -Increase fluid intake -Exercise -Provide family education -Eliminate punishment*

Extinction Treatment

-Extinction "Cry it out" After the child is put to bed, the parent ignores the child's behaviors until the morning Stressful! -Graduated Extinction Ignore disruptive bedtime behaviors for a specific period of time Increase duration between check-ins gradually

Etiology of Anorexia & Bulimia

-Genetics: Females with a first degree relative with an eating disorder are 4-11 times more likely to develop an eating disorder themselves -Disturbance in serotonin levels Anorexia - Too high Bulimia - Too low -Bulimia: low levels of cholecystokinin (CCK). healthy individuals, cck is produced after eating a large meal. in people with BN, they produce much less CCK when they eat, which may allow them to binge without feeling full -Child sexual abuse - sort of - makes girls feel helpless and shameful, disgusted by their bodies or feel "tainted", especially BN -Tripartite influence model: sociocultural factors can lead to development of eating problems in girls 1. sociocultural influence - peers can influence a girl's eating when they place importance on weight and body shape, tease other girls about weight - parents: when they make comments about their own weight shape, etc. or when they criticize girls' weight or urge her to lose weight - media: watching models on TV show the importance of physical attractiveness 2. relationship between sociocultural factors and girls' eating might be mediated by: a. girls' internalization of thin idea - may cause girls to internalize often unrealistic standards for body shape and weight b. social comparison - compare weight and appearance to friends 3. leads to... body dissatisfaction 4. which then contributes to eating disorders

Fading Sleep-Onset Associations

-Gradually remove the sleep onset cue over time; for example: -Fade milk in a bottle over time to water -Fade parental presence by moving parent further & further away - Fade television by dimming brightness & lowering sound

where do pediatric psychologists work?

-Hospitals -Rehabilitation centers -Outpatient clinics

Effects of toilet training problems

-Impact on families Possible embarrassment Pressure from other family members Social withdrawal Financial issues -Impact on children Embarrassment Guilt Loss of self-esteem Anxiety Social withdrawal

brain abnormalities in schizophrenia

-Increased volumes of the third & lateral ventricles - 40% larger than healthy adults -Reductions in the total volume & thickness of the prefrontal, temporal, & parietal cortices - show 10% less cortical volume than health controls - these areas important for sensory motor processes, language and higher order planning and reasoning -Reductions in hippocampus & thalamus size - size of brain regions is 4.5%-10% smaller in healthy adults -Rapid & excessive neural pruning - dramatic reductions in gray matter that respond to onset of psychosis , (loss of 3-4% of gray matter per year on average)

treatment for anorexia

-Inpatient Behavioral treatment Eat an additional 500 calories/day until reach ~3500 calories/day to regain weight Positive reinforcement for eating (gain privileges for eating) Effective treatment for gaining weight, but people will lose the weight again if not in an outpatient program -Potentially useful programs Family therapy: Work on family relationships & communications (secretly via eating problems) Group therapy: People with eating disorders learn tools to manage their emotions and about their disorders - little evidence for efficacy of inpatient group therapy, too malnourished to participate

associated problems with schizophrenia

-Major Depressive Disorder -OCD -Generalized Anxiety Disorder -ADHD

relapse prevention

-Most youths will relapse -One study found 66-83% of teens who participated in a treatment program either did not response to therapy or relapsed within one year - most often used with CBT and MI -Teach stimulus cues to avoid high risk situations - Work on catastrophic thinking (just because you had one drink, all your progress is NOT ruined)

Obstructive sleep apnea

-Often a cause of sleep arousal disorders -Occurs when a child's airway is constricted or blocked during sleep (e.g., snoring or gasping) - often caused by enlarged adenoids or tonsils, obesity, thick tongue, etc. -symptoms: daytime fatigue, snoring, disrupted sleep, unusually sleeping patterns -Strong relationship to attention problems & irritability

Give two examples of CD symptoms that are overt. Give two examples of CD symptoms that are covert.

-Overt symptoms: initiates physical fights, bullies others - Covert symptoms: Runs away from home, steals without confrontation

Personality characteristics of individuals with anorexia

-Perfectionism -Rigidity & overcontrol -Black & white thinking - eager to please - lacking an autonomous sense of self - driven and goal oriented - overachievers, popular, academically successful - obsessive or excessively organized - often guard and emotionally reserved (hide their negative feelings)

PICA

-Persistent eating of non-nutritive substances (burnt matches, coins, crayons, glue, dirt, paper) -Most commonly associated with severe or profound Intellectual Disability

Define: phonology, morphology, grammar, and semantics.

-Phonology: Sounds of the language and rules for combining sounds (ex. Sghetti= spaghetti) - Morphology: study of word structure (Mommy bes nice= mommy is nice) - Semantics: meaning of language (overextension, under extension) - Grammar: Rules that govern the use of morphemes and syntax (why he like me= why does he like me?)

Graduated extinction example

-Positive attention (e.g., physical touch, verbal praise) was provided as long as Jenny was lying quietly in her bed. -Ms. Smith then said "Excuse me, I need to ..." and briefly left the room. Ms. Smith made sure to be out of the room when Jenny actually fell asleep. -Ms. Smith would return to Jenny & provide attention for appropriate behaviors. Inappropriate behaviors (e.g., crying out, out of bed) were ignored. -Ms. Smith's absences from the room grew longer over successive nights.

Treatment for sleep arousal disorders

-Provide lots of love & support to child -Improve sleep hygiene -Treat underlying condition -Address stress -Scheduled awakenings 15-30 minutes prior to typical event

Toilet Training Readiness

-Psychological Readiness Verbal understanding Compliance Positive relationship with adults Desire to master potty process -Physical Readiness Appropriate motor skills Reflex sphincter control Nervous system readiness

List two ways Reactive Attachment Disorder and Disinhibited Social Engagement Disorder differ.

-RAD: Child lacks clear attachment relationship to caregiver (minimally seeks comfort or responds to comfort), associated with a lack of sensitive and responsive care (social neglect, foster homes, etc.) - DSED: child typically shows attachment to caregivers (unusual attachment, will go off with strangers), not associated with quality of care

Treatment of pica & rumination disorder

-Reinforcement -Differential Reinforcement of Incompatible Behavior (DRI) ^ a child is positively reinforced for engaging in behavior that is incompatible with pica or rumination- ex. a child might be allowed to chew gum -Differential Reinforcement of Zero Behavior (DRO) ^children are reinforced for not engaging in pica or rumination ex) mom might give a child a bite of a snack every minute he does not engage in the undesired behavior -Punishment ^ only as last resort with parent's consent -Overcorrection ^ method of punishment that requires the child to engage in a fairly long and mildly aversive series of actions, following pica or rumination. ex. immediately brushing his teeth, rinse with mouthwash, and wash his face -Facial screening ^ + punishment, a child who engages in pica must wear a mask or bib over his mouth for 10 minutes

Rumination disorder

-Repeated regurgitation of stomach contents into the mouth -Most often seen among children with developmental disabilities -Can lead to malnutrition, dental erosion, & electrolyte imbalance - diagnosed if happens over the course of at least one month **usually an infant or young child -- brings back up and re-chews partially digested food that has already been swallowed. In most cases, the re-chewed food is then swallowed again; but occasionally, the child will spit it out.

Substance-Induced Mental Disorder

-Someone develops a mental health disorder due to the use or withdrawal of a substance - Alcohol, sedatives, & hypnotics - Depressive disorders develop after prolonged use - Anxiety & insomnia upon withdrawal -Stimulants & cocaine - Psychotic disorders after use

genetic etiologies of schizophrenia

-Strong genetic component - individuals with a first degree family member w schizo are significantly more likely (5.9%) to develop the disorder than individuals without - twin studies: MZ= 55.8%, DZ= 13.5% -High rate of genetic abnormalities & mutations - one of the most important genes in adolescent-onset schizophrenia appears to be the catechol-O-methyltransferase (COMT) gene ^ produces an enzyme which regulates dopamine in several areas ^ produces excessive dopamine activity in brain regions responsible for positive symptoms and diminish dopamine activity in brain regions responsible for negative symptoms - several children have a specific abnormality known as 22q11 deletion syndrome ^ 10-30% of youths who show this syndrome develop schizophrenia or psychotic disorders

Substance Withdrawal

-Substance-specific problematic behavioral change that is due to the cessation of, or reduction in, heavy & prolonged substance use -Symptoms are always problematic & cause distress and impairment

Encopresis Treatment: Scheduled Sits

-Use toileting chart to schedule regular toilet sits -Sits should occur 5-10 minutes after a meal -Include a reinforcement component ** behavioral treatments used in combination with laxatives works the best

How Useful Are Psychologists in a Medical Setting?

-Very useful! -Therapies that focus on symptom reduction are even better than education -Treatment effects are long lasting (potentially 12+ months)

parent training and counseling

-parents must be taught how to implement the behavioral feeding intervention and how to avoid inadvertently reinforcing inappropriate mealtime behaviors -therapy may also benefit parents who show a lack of sensitivity or responsiveness to child's hunger, their own depression, stress, anxiety, etc.

treatments for sleep apnea

-removal of tonsils (80% effective) - CPAP device (small mask attached to a ventilator that delivers continuous airflow to child)

When children with phobias encounter feared stimuli, they react behaviorally, emotionally, cognitively, and physiologically. Give an example of how a 12-year-old boy with Social Anxiety Disorder might react in each of these four domains, while giving a speech to his class.

1. Behaviorally- actively avoiding a social situation, staying quiet or sitting in the back 2. Emotionally- extreme fear of being judged or embarrassing yourself, excessive self-conscousness 3. Cognitively- negative thoughts ( "I am going to humiliate myself", "people will think I'm stupid") 4. Physiologically- sweaty palms, shaky hands, feeling dizzy

Five C's of Consultation-Liaison

1. Crisis: help children and families who are initially admitted to hospital or newly diagnosed with an illness. attempt to normalize families fears and help them take steps to address children's medical problems 2. Coping: help children and families cope with anxiety, fear, discomfort associated with medical procedures in hospital. also work with families to help children adjust to lifestyles in response to illness 3. Compliance: help children follow medical recommendations, such as taking medications, monitoring health, participating in check ups, etc. 4. Communication: act as liaisons between medical staff and families; educate children and family about medical procedures and help them cope with stressors associated with medical care 5. Collaboration: psychologists function as part of an interdisciplinary team of professionals

How does encopresis come about?

1. avoidance or fear of toilet - child refuses to go because of painful bowel movements or psychosocial stress (ex. over demanding parents) 2. stool is retained & rectal wall is stretched -sensory feedback is reduced and child has less urge to go 3. constipation and impaction - water is reabsorbed into body and stool hardens 4. overflow -diarrhoea like feces builds up behind hard fecal mass and seeps out; impacted mass remains

three subtypes of ARFID

1. infantile anorexia - children who do not eat enough and show little interest in feeding 2. sensory food aversion -children who show foods because of heir sensory characteristics, such as taste or texture 3. post traumatic feeding disorder - children who refuse foods because of pervious aversive experience associated with eating

Impaired control DSM Substance Use

1. substance is taken in larger amounts or over a longer period than was intended 2. persistent desire or unsuccessful efforts to cut down or control substance abuse 3. a great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects 4. craving, or strong desire to use the substance

Pharmacological Criteria DSM Substance Use

10. Tolerance, defined by either a. need for markedly increased amounts of the drug to be intoxicated or desired effect b. markedly diminished effect with continued use of the same amount of substance 11. Withdrawal, defined by either a. characteristic withdrawal syndrome for the substance b. substance is taken to relieve or avoid withdrawal symptoms

Prevalence of insomnia disorder

25-50% of parents report at least occasional sleep problems for their children 30% of children develop a sleep disorder at some point during childhood 25% of infants & toddlers have difficulty falling asleep independently 10% of school-aged children stall or resist bedtime

Social impairment DSM Substance Use

5. recurrent substance use resulting in failure to fulfill major role obligations at work, school, or home 6.continued use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance 7. important social, occupational, or recreational activities given up or reduced because of substance use

Risky Use DSM Substance Use

8. recurrent substance use in situations where it is physically hazardous 9. use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

Substance Intoxication

A disturbance of perception, wakefulness, attention, thinking, judgment, psychomotor and/or interpersonal behavior caused by the ingestion of a substance

bulimia dsm 5 criteria

A. Recurrent episodes of binge eating -Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. - sense of lack of control over eating during the episode. B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. C. At least once a week for 3 months. D. Self-evaluation is unduly influenced by body shape and weight. E. disturbances do not occur exclusively during episodes of anorexia Mild: An average of 1-3 episodes of inappropriate compensatory behaviors per week. Moderate: An average of 4-7 episodes of inappropriate compensatory behaviors per week. Severe: An average of 8-13 episodes of inappropriate compensatory behaviors per week. Extreme: An average of 14 or more episodes of inappropriate compensatory behaviors per week.

Binge Eating disorder

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: -eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances -a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating) B. The binge-eating episodes are associated with three (or more) of the following: -eating much more rapidly than normal -eating until feeling uncomfortably full -eating large amounts of food when not feeling physically hungry -eating alone because of feeling embarrassed by how much one is eating -feeling disgusted with oneself, depressed, or very guilty afterwards C. Marked distress regarding binge eating is present. D. The binge eating occurs, on average, at least once a week for three months. E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder. severity levels: Mild An average of 1-3 binges per week. Moderate: An average of 4-7 binges per week. Severe: An average of 8-13 episodes binges per week. Extreme: An average of 14 or more binges per week

encopresis

A. Repeated passage of feces into inappropriate places (e.g., clothing or floor) whether involuntary or intentional. B. At least one such event a month for at least 3 months. C. child is at least 4 years (or equivalent developmental level). D. not attributable to a medication (ex. laxatives) or a medical condition except one causing constipation specify: -with constipation and overflow incontinence -without constipation and overflow incontinence

anorexia dsm 5 criteria

A. Restriction of energy intake relative to requirement, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight C. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight. Subtypes Restricting: only caloric restriction and exercise Binge Eating/Purging: Binge Eating and or purging also present Mild: BMI >= 17 kg/m3 Moderate: BMI: 16-16.99 Severe: BMI: 15-15.99 Extreme: <15

insomnia

A. predominant complaint of dissatisfaction with sleep quantity or quality, associated with one or more of the following symptoms: 1. difficulty initiating sleep 2. difficulty maintaining sleep, characterized by frequent awakening or problems returning to sleep after waking 3. early morning awakening with inability to return to sleep B. causes significant distress or impairment C. sleep disturbance occurs at least 3 nights per week D. present for at least 3 months E. occurs despite adequate opportunity for sleep F. insomnia is not better explained by and does not occur exclusively during course of another sleep-wake disorder G. not attributable to physiological effects of a substance H. coexisting mental disorders and medical conditions do not adequately explain predominate complaint of insomnia

enuresis

A. repeated voiding of urine into bed or clothes, whether involuntary or intentional B. occurs either twice weekly for 3 months causes distress/ impairment C. child is at least 5 years of age (of equivalent developmental level) D. not attributable to a medication or medical condition specify: nocturnal only diurnal only nocturnal and diurnal

DSM 5 Criteria for Schizophrenia

A: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated): at least one of these must be 1, 2, or 3 (1) delusions (2) hallucinations (3) disorganized speech (e.g., frequent derailment or incoherence) (4) grossly disorganized or catatonic behavior (5) negative symptoms, i.e., affective flattening, alogia, or avolition B. For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement) C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). D. Depression & Bipolar Disorder With Psychotic Features have been ruled out because either (1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods. E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. F. If there is a history of Autistic Spectrum Disorder or Communication disorder of childhood onset, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).

associated problems with enuresis

ADHD (have difficulty responding to full bladder) Family stress Anxiety or mood problems - Child has enuresis first usually, then gets teased by friends or family and may later develop an anxiety or mood disorder

Which of the following is NOT a major difference between alcohol use problems shown by adolescents versus adults?

Adolescents are more likely to show internalizing disorders than adults.

Which of the following statements is true regarding the epidemiology of adolescent Substance Use Disorders?

African American adolescents are less likely than White adolescents to develop Substance Use Disorders.

positive reinforcement for sleep disorders

All interventions should contain a positive reinforcement component Reinforce the desired sleep & bedtime behaviors!

Anorexia versus bulimia

Anorexia: Ego-syntonic: Eating behavior is fine Low body weight Some binge Bulimia Ego-dystonic: Eating behavior is not fine Normal weight or overweight Everyone binges

prevalence of eating disorders

Anorexia: 0.5 - 1% for females; <0.3% for males Bulimia: 1.5-4% for women; <0.5% for males Binge Eating Disorder: 2.6% for adults; 1-1.5% for children & adolescents Adolescent girls are 10-15x more likely than boys to develop AN or BN Boys usually are trying to increase weight Prevalence of all eating disorders is higher in Western societies & industrialized nations

prevalence of encopresis

Approx. 3% of school-aged children Boys are 4-6 times more likely to develop encopresis

Etiology of binge eating disorder

Approx. 50% of adults with BED have a family member with obesity or BED Sensitivity to certain properties of food Weight problems & family members who make negative comments about them Anxiety & depression may contribute

Michelle is a 4-year-old girl with a history of gastrointestinal problems that cause her stomach cramps and gastric reflux (i.e., stomach acid burning her esophagus) and throat. These problems cause her considerable pain and discomfort. Consequently, she often avoids eating many solid foods that have caused her pain in the past. For which DSM-5 disorder might she qualify?

Avoidant/Restrictive Food Intake Disorder

Sleep problems areas of assessment

Bedtime difficulties Excessively sleepy Awaken during the night Regular sleep-wake schedule Snoring

Binge eating versus bulimia

Both are normal weight or overweight Both binge eat, but people with bulimia engage in compensating behaviors People with binge eating disorder are not "obsessed with food" unlike BN Some people with binge eating disorder later transition to bulimia

According to the tripartite influence model for eating disorders, which of the following is NOT a risk factor for eating disorders in adolescent girls? A.A mother who frequently diets and is concerned about her weight. B.A girl who frequently looks at fashion magazines. C.A girl who is rejected by her peers. D.A girl who frequently compares her body shape and weight to that of others.

C.A girl who is rejected by her peers.

CRAFFT

C: have you ever ridden in a CAR by someone who was "high" R: do you ever use alcohol or drugs to RELAX A: do you ever use drugs while ALONE? F: do you ever FORGET things you did while using drugs F: do your family or FRIENDS ever tell you to cut down? T: have you gotten in TROUBLE while using?

A recent meta-analysis investigating the effectiveness for cognitive behavior therapy (CBT) for youths with Schizophrenia showed....

CBT is generally not more effective than supportive therapy

What is the difference between primary and secondary enuresis? A.Children with primary enuresis have never been able to stay dry through the night. B.Children with primary enuresis have an underlying medical disorder that accounts for their problem. C.Children with primary enuresis have no other existing mental disorders. D.Children with primary enuresis do not also have encopresis.

Children with primary enuresis have never been able to stay dry through the night.

dsm5 changes in anorexia

Criterion A and periods

DSM 5 Criteria for Substance Use Disorder

Criterion A: problematic pattern of substance abuse leading to clinically significant impairment or distress, as shown by two of the following within a 12 month period: 1. substance is taken in larger amounts or over a longer period than was intended 2. persistent desire or unsuccessful efforts to cut down or control substance abuse 3. a great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects 4. craving, or strong desire to use the substance 5. recurrent substance use resulting in failure to fulfill major role obligations at work, school, or home 6.continued use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance 7. important social, occupational, or recreational activities given up or reduced because of substance use 8. recurrent substance use in situations where it is physically hazardous 9. use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance 10. Tolerance, defined by either a. need for markedly increased amounts of the drug to be intoxicated or desired effect b. markedly diminished effect with continued use of the same amount of substance 11. Withdrawal, defined by either a. characteristic withdrawal syndrome for the substance b. substance is taken to relieve or avoid withdrawal symptoms

What is the main difference between Bulimia Nervosa and Binge Eating Disorder in adolescents? A.Adolescents with Bulimia Nervosa are always of average weight, whereas adolescents with Binge Eating Disorder are overweight or obese. B.Adolescents with Bulimia Nervosa always binge and purge, whereas adolescents with Binge Eating Disorder only binge. C.Adolescents with Bulimia Nervosa often have histories of Anorexia, whereas adolescents with Binge Eating Disorder do not. D.Adolescents with Bulimia Nervosa always engage in compensatory behavior to avoid weight gain, but adolescents with Binge Eating Disorder do not.

D. Adolescents with Bulimia Nervosa always engage in compensatory behavior to avoid weight gain, but adolescents with Binge Eating Disorder do not.

Which of the following statements describes a major change between DSM-IV and DSM-5 in the conceptualization of Substance Use Disorders?

DSM-5 no longer differentiates between Substance Abuse and Substance Dependence.

Which of the following provides the best example of dual diagnosis?

Daphne is diagnosed with both Alcohol Use Disorder and Depression

eating disorders comorbidity

Depression - NOT a primary cause, usually emerges after onset of eating disorder, but most children and adolescents may experience it before Suicide -% of completion are high among people with AN - malnourishment & suicide are two leading causes of death associated with AN Substance Use -nicotine, marijuana, alcohol, cocaine 20-25% -those who binge eat are 3x more likely to show comorbid substance use then individuals with eating disorders that don't binge Social Anxiety -usuallly predates emergence of BN and AN, and persists after treatments - extremely sensitive to criticism and constantly seek approval from peers OCD -perfectionism and OCD symptoms precede development of eating disorders

Medications for Substance Use Disorders

Detoxification - helps patients cope with withdrawal symptoms - ex. clonidine, reduces heart rate BP, and physiological arousal; for opioid use - benzos Aversion therapy (e.g., Antabuse) Substitution therapy (e.g., methadone) - designed to eliminate cravings - methadone: synthetic opioid that binds to receptors and produces mild analgesia and anxiety reduction Block the effects (e.g., naltrexone) - reduces pleasurable consequences - naltrexone: opioid receptor antagonist which significantly reduces euphoric effects of alcohol after consumed - ex. bupropion, atypical antidepressant that affects dopamine and NE, blocks pleasurable effects of nicotine Comorbid disorders (e.g., treat depression)

Adam is a 5-year-old boy with developmental delays and Intellectual Disability who also engage in Pica. Adam will chew leaves, cigarette butts, and other debris that he finds on the street if not monitored by his parents. Before leaving the house, his father gives Adam a stick of gum to chew. When chewing gum, Adam usually does not engage in Pica. His father's use of gum illustrates....

Differential reinforcement of incompatible behavior.

prevalence of enuresis

Enuresis: 4-5% of children between the ages of 8 & 11 More common in boys (6.2%) than girls (2.5%) Decreasing prevalence with age On a yearly basis, about 15% of children with enuresis recover with no treatment

What is life like for a pediatric psychologist?

Everyday is different -Chasing down patients -Chasing down other health care professionals -Managing challenging cases -Easy days -Problem solving Medication adherence Treatment adherence Communication problems with loved ones Finding resources in the community

Group therapy is often recommended to help children cope with a chronic medical illness. Based on the results of a recent meta-analysis, what can we conclude about the effectiveness of group therapy for children with medical disorders? A.Group therapy is less effective than individual therapy tailored to the child's individual needs. B.Group therapy can be harmful if children share incorrect information to each other. C.Group therapy that focuses on children's problem-solving skills is most effective. D.Group therapy that focuses on providing children with facts about the illness is most effective.

Group therapy that focuses on children's problem-solving skills is most effective.

Vanessa is an 8-year-old girl with Cystic Fibrosis. Her pediatric psychologist, Dr. Blackburn, might help Vanessa by.... A.Helping her adhere to exercises to clear foreign particles from her lungs. B.Helping her adopt a diet that decreases the frequency or severity of gastrointestinal problems. C.Teaching coping strategies to decrease chronic pain, especially in the muscles and joints. D.Monitor her blood sugar.

Helping her adhere to exercises to clear foreign particles from her lungs.

Specifiers for Substance Use

In early remission: after full criteria has been met, no more criteria has been met for at least 3 months but no more than 12 mos in sustained remission: no criteria has been met for more than 12 months or longer Mild: 2-3 Symptoms Moderate: 4-5 symptoms Severe: 6 or more symptoms

goals of treatment for ARFID

Increase motivation to eat Change antecedents to increase likelihood that the child will accept food Provide reinforcement for appropriate eating Mild to moderate: outpatient treatment Severe: hospitalization 3 main components: appetite manipulation, contingency management, parent training

Consultant-Liaison: Liason

Liaison: Work with interdisciplinary staff to diagnose & treat kids (i.e., fireproofing) - rather than focus on specific problems, liaisons work as a part of an interdisciplinary team with medical and behavioral specialists, job is to assess medical procedures and hospital environment to avoid problems -Assess child during the diagnosis assessment -Educate child & family on treatments -Provide support & tools for child & family -problem solve with family to ensure adherence post-hospital stay

ASSIST

Longer questionnaire Screens for a wide-range of substance use problems Can be administered to both youths & their parents Overall agreement between youths & their parents on youths alcohol use is 22%

associated problems with encopresis

May be more likely to experience social & emotional problems -30% also show enuresis

Enuresis: Assessment

Medical exam Family history and medical variables What has the family tried already? Motivational level of child and family Toilet training readiness Baseline data on frequency of bedwetting

components of sleep assessment

Medical issues Behavioral issues Family issues Sleep hygiene (sleep diary)

Which of the following provides the best example of expressed emotion in a family of an adolescent with Schizophenia?

Mom says, "Why can't you act responsible, like other kids your age?"

Treatment for youth with Bipolar Disorder often involves families. Name two ways families are involved with their child's treatment?

Monitor child's mood each day and help live a balanced life style

What is "Normal" Toilet training?

Most children have achieved diurnal bowel and bladder control by 3 years of age Accidents often occur through 5 years of age

Multimodal treatment for pediatric schizophrenia

Multimodal treatment for pediatric schizophrenia Pharmacological: antipsychotic medication are usually used first, clozapine is used only in treatment-resistant cases as last resort Psychotherapy: individual therapy used to teach use about schizo. motivational interviewing, cognitive-behavioral techniques Family therapy: family members taught about schizo. seek to improve family communication Rehabilitation: therapists can coordinate return to school and other things long-term impairment is common, therapists can help family place

Are medications effective in helping children with Autism Spectrum Disorder? For what symptoms (if any) are medications useful?

Only for ADHD symptoms or anxiety or depression or seizures

sleep hygiene

Put your children to bed when they are sleepy Reduce or avoid naps Create a quiet sleep environment Reduce light NO TELEVISION OR VIDEO GAMES in bed Structured bedtime routine Structured sleep schedule

medication for eating disorders

Recent studies suggest that medication should not be a front line treatment for eating disorders

treatment for daytime wetting

Recognize the feelings of a full bladder Kegel exercises Increase bladder capacity

urine alarm

Sensor hooked up to underwear and senses moisture, then beeps to wake the child up to go to the bathroom Classical conditioning: the bell and pad system.. When you're asleep, you start to pee. The bell and pad system starts to go off. You jump and wake up, your muscles contract. Over time the child learns when they feel the wetness, they need to contract their muscles. Instead of the alarm now. - 59-78% of children treated with urine alarm stop bed wetting in 8-14 weeks

What is a main difference between Sleep Arousal Disorders and Nightmare Disorder? A.Sleep arousal disorders are often associated with other psychological problems, whereas Nightmare Disorder is not. B.Sleep arousal disorders are often associated with underlying medical problems, whereas Nightmare Disorder is not. C.Sleep arousal disorders occur during deep sleep, whereas Nightmare Disorder occurs during REM sleep. D.Older children usually experience sleep arousal disorders, whereas younger children usually experience Nightmare Disorder.

Sleep arousal disorders occur during deep sleep, whereas Nightmare Disorder occurs during REM sleep.

primary prevention programs

Target all youths, regardless of their risk status for developing a psychological disorder 1. D.A.R.E -Not effective 2. Media Campaigns (1990s) -Substance use decreased but it was already decreasing -Increased communication between parents & kids about substance use - Increase in youths using marijuana (don't tell me what to do!)

Which of the following provides the clearest example of the use of overcorrection to treat a child with Rumination Disorder? A.The child is misted with water from a spray bottle when she ruminates. B.The child is placed in time out when she ruminates. C.The therapist practices facial screening when the child ruminates. D.The child must brush her teeth and wash her face after she ruminates.

The child must brush her teeth and wash her face after she ruminates.

Ashwin is a 10-year-old boy with ADHD Combined Presentation. Ashwin has great difficulty completing math and reading homework for more than 10 minutes at a time. If you were Ashwin's therapist, how might you use behavior therapy to help him complete his math homework?

Use contingency management to help him concentrate - alter children's environments to maximize the frequency of desired actions - rely heavily on systematic rewards and punishments to shape behavior - increase attention, reduce disruptive behavior in classroom, improve child's ex. if ashwin reads for more than 10 minutes, he gets a reward (toys, hugs, etc.)

residual/chronic stage of schizophrenia

Variable Some return show improvements in functioning & some persistent negative symptoms (may remain withdrawn, moody, or irritable) Lasts months to years

According to the enhanced reinforcement model of alcohol use

adolescents overestimate the positive effects and minimize the negative effects of alcohol.

How do you describe Kegel exercises to a 5-year old

ask him to squeeze a ball the size of your fist between his legs, right above his knees.

Many over-the-counter medications used for insomnia act on receptors for GABA, a major inhibitory neurotransmitter. These medications, which include zolpidem (Ambien) and eszopiclone (Lunesta) are known as

benzo. receptor agonists

According to DSM-5, adolescents can develop Substance Use Disorders for all of the following drugs EXCEPT...

caffeine

CAGE

can identify alcohol problems over the lifetime two positive responses are considered a positive test and indicate further assessment 1. have you ever felt you should CUT down? 2. have people ANNOYED you by drinking? 3. have you felt GUILTY about drinking 4. EYE OPENER: have you ever had a drink first thing in the morning?

cultural acceptance hallucinations

do other people in your family or church have the same experience as you?

assessing tactile hallucinations

do you ever feel like someone or something is touching you, but when you look there is nothing there?

assessing delusions

do you ever feel that you are very important have super powers? does the tv or radio ever talk to you or send you messages? has anyone been making things hard for you, causing you trouble? do other people have similar thoughts?

Assessing visual hallucinations

do you ever see things that other children don't see? did you see something that looked real, or was it just like a shadow moving? How clear was it? did you see it many times or on different days?

olfactory hallucinations

do you ever smell things that other people don't smell

Assessing Auditory Hallucinations

do you hear voices, sounds, or noises that other people don't hear? ** are they in your head or do you hear them on the outside through your eyes? Do they sound as clear as someone speaking to you? - Commands: ** Do the voices tell you to do things? Have they ever told you to hurt or kill yourself or someone else? - Commentary: Do you hear voices that talk about what you're doing, feeling, or thinking? - Conversing: how many voices do you hear? do they talk with each other? - Thoughts aloud: do you ever hear your own thoughts spoken aloud? - Religious: do you ever hear the voice of God(jesus), angels or demons) - non-voices: do you ever hear other sounds, music, or noises that others don't hear?

delusions

fixed beliefs that are not amenable to change in light of conflicting evidence

Which of the following is the most common symptom shown by children and adolescents with Schizophrenia?

hallucinations

illusions

have you ever looked around your room at night and seen things that you thought were somethings else? for example, did you ever look at a stuffed animal or shirt and think it was a monster? have you ever looked at a belt or rope and thought it was a snake?

motivational interviewing for substance use disorders

increase adolescent's desire to reduce his alcohol consumption Principles: Develop a discrepancy between goals and current behavior Roll with resistance, don't argue Express empathy, warmth, and concern through active listening Support client's efforts to change, no matter how small Success should be acknowledged to build the client's self efficacy HARM REDUCTION approach to treatment: primary goal of therapy is to help adolescents identify and avoid alcohol use that has great potential for harm (ex. fewer than four beers at a party) - any reduction in alcohol that decreases risk or harm to teen is viewed as successful

Hendricks is a pediatric psychologist who helps children recently diagnosed with cancer cope with their diagnosis and learn about their illness. She also addresses the questions and concerns of the family members of these children. Which of the following terms best describes Dr. Hendricks' professional role? A.Adherence B.Psychotherapy C.Liaison D.Consultation

liaison

The White House Office of National Drug Control Policy media campaign...

may have actually increased children's risk for using alcohol and other drugs.

The results of the Cannabis Youth Treatment Study showed that...

most adolescents either did not respond to treatment or relapsed after treatment completion.

One of the primary limitations of inpatient treatment for adolescents with Substance Use Disorders is...

most adolescents relapse after discharge.

According to the cognitive-behavioral model of eating disorders, Bulimia Nervosa is often maintained by...

negative reinforcement.

Failure to Thrive

nutritional deficiency and weight below the 5th percentile for age and gender on standardized growth charts

Inpatient behavioral treatment for Anorexia Nervosa is based on the notion that...

patients are afraid of food and their avoidance is maintained through negative reinforcement.

hallucinations

perception like experiences that occur without an external stimulus

The most rapid form of treatment for infants and toddlers with sleep refusal is ___. A.Overcorrection with positive practice. B.Planned ignoring. C.Scheduled wakings. D.Bedtime fading.

planned ignoring

treatment for schizophrenia

prodromal signs checklist: marked change in behavior, inappropriate emotions, speech is difficult, lack of speech/thoughts, persistent feelings of unreality

Avoidant/Restrictive food intake disorder

show a lack of interest in eating, avoid certain foods based on their sensory characteristics (ex. texture, color, smell) or concerned about possible negative consequences of eating (eg. nausea, choking, vomiting) - persistent problems with meeting nutritional or energy needs - significant weight loss, significant nutritional deficiency, dependence on internal or oral nutritional supplements, marked interference with psychosocial functioning

Amotivational syndrome refers to

the lack of goal-directed behavior shown by some chronic users of marijuana.

The first-line treatment for most instances of nocturnal enuresis is... A.Cleanliness training. B.Overlearning with positive practice. C.Urine alarm. D.Retention control

urine alarm

pediatric psychology

-Interdisciplinary field concerned with the application of psychology to the domain of children's health -Promote the physical & psychological health & development of youths

personality characteristics of individuals with bulimia

-Low self-evaluation -Emotional lability -Temper outbursts chronic problems with emotion regulation - some engage in self harm or misuse alcohol or other drugs

retention control training

purpose is to increase child's functional bladder capacity so he can wait longer before urinating - parents ask child to drink a large glass of water and refrain from going for at least 3 minutes - small rewards are given - works way up to 45 minutes

Different Types of Substance Use Labels

Alcohol Caffeine-Related (no use) Cannabis-Related Hallucinogen-Related Inhalant-Related Opioid-Related Sedative-, Hypnotic-, or Anxiolytic-Related Stimulant-Related Tobacco-Related Other (or Unknown) Substance-Related Disorder

acute stage of schizophrenia

Onset of positive symptoms Lasts 1-6 months

Feeding/Eating Disorders

Young children: Pica, rumination, avoidant restricted food intake Older: anorexia, bulimia, binge eating

Earlier you experience a positive symptom

the worst your outcome is

Most instances of encopresis are caused by.... A.Constipation B.Oppositional-defiant behavior C.Anxiety or depression D.Lack of consistent toilet training

constipation