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1229 Test 6 Emotional Disorders Flashcards

1
Q

Cormorbidities of Emotional Disorders

A

-Attention deficit hyperactivity disorder (ADHD)
-Juvinile-onset bipolar disorder
-Oppisitional Defiant disorder
-Conduct Disorders
Conduct or oppositional disorders

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2
Q

Epidemiology

A
  • One if five children and adolescents in the United States has a major mental illness
  • Two-thirds of all young people with mental health problems are not getting treatment
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3
Q

Attention Deficity Hyperactivity Disorder (ADHD)

A
  • Inappropriate degree of attention, impulsiveness, and hyperactivity
  • Attention problems and hyperactivity contribute to low frustration tolerance, temper outburst, labile moods, poor school performance, peer rejection, and low self-esteem
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4
Q

Juvenile-Onset Bipolar Disorder

A
  • Mood disorders that include one or more manic episodes adn usually one or more depresive episodes.
  • Bipolar I-at least one episode of mania alternating with major depression
  • Bipolar II- hypomanic episodes alternatic with major depression
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5
Q

Oppositional Defiant Disorder

A

-A recurrent pattern of negativistic, disobedient, hostile, defiant behavior toward authority figures without going so far as to seriously violate the basic rights of others.

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6
Q

Conduct Disorders

A

-Characterized by a persistent pattern of behavior in which the rights of others are violated and age-appropriate societal norms or rules are disregarded
-It is one of the most frequently diagnosed disorders of childhood and adolescence.
There are 4 types of condunct disorders:
-Agression toward people and animals
-Property destruction
-Theft
-Serious violations of rules

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7
Q

Conduct or Oppositional Disorders

A

-A recurrent pattern of negativistic, disobedient, hostile, defiant behavior toward authority figures without going so far as to seriously violate the basic rights of others.

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8
Q

Risk Factors:

A
  • Witnessed Violence
  • Child who has a parent with depression(could have: anxiety disorder, conduct disorder, alcohol dependence)
  • History of abuse/neglect are at risk for developing emotional, intellectual, social handicaps.
  • History of abuse/stressful live events such as physical/sexual abuse/trauma can lead to: Increased incidence of accidental injuries, anxious children, depression, suicidal behaviors, insecure attachments, PTSD, conduct disorders, delinquency, impaired social/cognitive function. Can also lead to risk for dissociative identity disorder (DID)
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9
Q

Etiology

Biological Factors

A

Genetic:

  • Autism, bipolar disorder, schizophrenia, attention deficit problems, mental retardation
  • Direct genetic links- Tay-Sachs, Phenylketonuria, Fragile X.
  • Brain Development and biochemical changes during childhood/adolescence:
    1. Alterations in neurotransmitters can have a cause in depression, mania, and ADHD
    2. Elevated testosterone levels have been studied and may hae a role in mediating responses to environmental stress
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10
Q

Etiology

A

Temperament:

  • The style of behavior the child habitually uses to cope with the demands/expectations from the environment
  • Thought to be genetically determined and may be modified by the parent-child relationsp
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11
Q

Etiology

A

-Resilience-formed by the relationship between the child’s constitutional endowment and environmental factors.
-Characteristics include:
Temperment that adapts to environmental change, ability to form nuturing relationships with other adults when the parent is not available, ability to distance self from emotional chaos of parenting/family, good social intelligence, ability to use problem solving skills.

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12
Q

Etiology

Environmental Factors

A

-abusive, rejecting, or overly controlling, the child of these parents may suffer detrimental effects at the developmental point at which the trauma occurs.

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13
Q

Etiology

Cultural considerations

A
  • Culture shock and culture conflicts
  • Assimilation issues put immigrant children at risk for mental and learning disorders
  • Differences in cultural expectations, stresses, and support or lack of by the dominant culture have a profound effect on development and the risk of mental, emotional, and academic problems
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14
Q

Types of Assessment Data

Developmental Assessment

A
  • Psychomotor Skills
  • Language Skills
  • Cognitive Skills
  • Interpersonal and social skills
  • Academic achievement
  • Behavior
  • Problem-solving and coping skills
  • Energy level and motivation
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15
Q

Types of Assessment Data

Neurological Assessment

A
  • Cerebral Functions
  • Cerebellar Functions
  • Sensory Functions
  • Reflexes
  • Functions can be observed during developmental assessment and while playing games involving a specific ability
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16
Q

Types of Assessment Data

Medical History

A
  • Review of body systems
  • Traumas, hospitalizations, operations, and child’s response
  • Illness or injuries affecting central nervous system
  • Medications (past and current)
  • Allergies
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17
Q

Types of Assessment Data

Family History

A
  • Illnesses in related family members:
  • Seizures, mental disorders, mental retardation, hyperactivity, drug and alcohol abuse, diabetes, cancer.
  • Background of family members:
  • Occupation, education, social activities, religion
  • Family relationship:
  • Separation, divorce, deaths, contact with extended family, support system.
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18
Q

Types of Assessment Data

Mental Status Assessment

A
  • General Appearance
  • Activity level
  • Coordination and motor function
  • Affect
  • Speech
  • Manner of relating
  • Intellectual functions
  • Thought processes and content
  • Characteristics of play
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19
Q

General Interventions

Family Therapy

A
  • Critical to improving the function of a young person with a psychiatric illness
  • Family counseling is a key component of treatment
  • Specific goals are defined and outlined for each member
  • Learn how other families solve problems nd build on strengths
  • Develop insight and improve judgement about their own family
  • Learn and practice new information
  • Develop lasting and satisfying relationships with other families.
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20
Q

General Interventions

Group Therapy

A
  • Takes the form of play for younger children
  • Combines play and talking for grade school children
  • Talking for older cildren and adolescents
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21
Q

General Interventions

Continued

A

Milieu Management:
-Goals: to provide physical and phychological security, promote growth and mastery of developmental task, and ameliorate phychiatric disorders

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22
Q

General Interventions

Therapeutic Factors

A

-Boundaries/limits
-Reduction in stressors
-Opportunities to express feelings without fear of rejection/retaliation
-Emotional support/comfort
-Help with reality testing
-Support for weak ego functions
-Interventions in impulsive/agressive behaviors
-Opportunities for learning/testing new adaptive behaviors
-Consistent constructive feedback
-Reinforcement of positive behaviors
Development of sel-esteem
-Corrective emotional experiences
-Healthy role model identification
-Opportunityes to be spontaneous/creative
-Positive identity formation

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23
Q

General Interventions

Behavioral Therapy

A
  • Desired behavior is rewarded
  • Undesirable behavior is ignored or has limits
  • A level system has increasing levels of privileges that can be earned
24
Q

General Interventions

Seclusion and Restraint

A
  • Used judiciously

- Child/adolescent will always perceive seclusion as punishment

25
General Interventions | Quiet Room
- Unlocked room used for removing a child from a situation to regain self-control - Feelings room- carpeted and supplied with soft objects that can be punched or thrown - Freedom room- contains a large ball for throwing or kicking
26
General Interventions | Time-out
-Designated room or sitting on the periphery of an activity until self-control is gained and the incident is review with a staff member
27
General Interventions | Cognitive-Behavorial Therapy
-Goal-to change cognitive and behavioral processes, reducing the frequency of maladaptive responses and replacing them with new competencies.
28
General Interventions | Play Therapy
- The child's way of learning to master impulses and adapt to the environment - One on one session with a therapist - Principles: 1. Accept the child and follow their lead 2. Warm, friendly relationship 3. Recognize the childs feelings 4. Accept their ability to solve personal problems. 5. Set limits only to provide reality and security.
29
General Interventions | Mutual Storytelling
Technique for helping young children express themselves verbally
30
General Interventions | Bibliotherapy
- Uses children's literature to help the child express feelings in a supportive environment, gain insight, learn new ways to cope with difficult situations - Books are chosen to reflect the situations/feelings the child is experiencing
31
General Interventions: | Therapeutic Games
Facilitates the development of a therapeutic alliance and provides an opportunity for conversation. May require the child to say something or tell a story about various objects. Older children requires talking, feeling, and doing activities.
32
General Interventions: | Therapeutic Drawing
Capturing thoughts, feelings, and tensions a child may not be able to express verbally. General indicators of a child's emotions rather than indicators of psychopathology. The child may be questioned about he pictures and discus emotions.
33
General Interventions: | Psychopharmacology
Typically works best when combined with another treatment such as cognitive-behavioral therapy.
34
Autistic Disorder
Impairment in communication and imaginative activity Impairment in social interactions Markedly restricted stereotypical patterns of behavior, interest, and activities.
35
Presenting Symptoms of Autistic Disorder
Impairment in communication and imaginative activity. Impairment in social interactions. Markedly restricted stereotyped patterns of behavior, interest, and activities.
36
Asperger's Disorder
Hopefully observed by the age of 3. Recognized later than autistic disorder. No significant delays in cognitive and language development or self-help skills. Severe/sustained impairment in social interactions, development or restricted, repetitive patterns of behavior in interest and activities.
37
Rett's Disorder
Seen only in females. Onset before age 4. Characteristics include: Persistent loss of manual skills, development of stereotyped hand movements, problems with coordination and gait, severe psychomotor retardation, severe problems with expressive and receptive language, loss of interest in social interactions.
38
Attention Deficit Hyperactivity Disorder (ADHD)
Defining Characteristics: Inattention Hyperactivity Impulsivity
39
ADHD
Observe for level of physical activity, attention span, talkativeness, ability to follow directions, and impulse control Assess difficulty in making friends and performing in school. Assess for problems with enuresis and encopresis.
40
Oppositional Defiant Disorder
Identify issues that result in power struggles, when they begin, and how they are handled. Assess severity of defiant behavior and its impact on child's life at home, school, and with peers.
41
Conduct Disorder
Assess seriousness of disruptive behavior, when it started, and attempts to manage it. Assess levels of anxiety, aggression, anger, and hostility toward others and ability to control destructive impulses. Assess moral development for ability to understand impact of hurtful behaviors on others, for empathy and feeling remorse.
42
ADHD Assessment
Relationship between child and parents/caregiver. Developmental competencies Level of physical activity, attention span, talkativeness.
43
Nursing Diagnosis for ADHD
R/F self-directed or other-directed violence Defensive coping Impaired social interaction
44
ADHD Expected Outcomes
Remains safe Learns effective coping methods Develops friendships with peers.
45
ADHD Implementation
``` Pharmaceutical agents Behavior modification Family counseling Special education programs Cognitive-behavioral therapy Play therapy ```
46
Anxiety Disorders
Anxiety is part of normal development. Anxiety is a problem when: An individual fails to move beyond the fears associated with a particular problem It interferes with normal functioning over an extended period of time. Anxiety disorders affect as many as 10% of young people.
47
Two Anxiety Disorders of Children and Adolescents
Separation anxiety disorder | Posttraumatic Stress Disorder
48
Separation Anxiety Disorder
Chld becomes excessively anxious when separated or anticipating separation from home or parental figure. Excessive worry about being lost/kidnapped, parental figures will be harmed. Fear of being home alone or in situations without significant adults present. Refusal to sleep unless near a parental figure, refusal to attend school without a parental figure. Physical symptoms as a response to anxiety.
49
Posttraumatic Stress Disorder (PTSD)
Children of any age can develop PTSD Younger children appear to react more with behaviors indicative of internalized anxiety. Older children are adolescents find the anxiety is more externalized.
50
Separation Anxiety Disorder and PTSD Assessment
Anxiety and conflict between child and parents Recent stressors Parents' understanding of developmental norms Parenting skills Child's developmental level Symptoms of anxiety and coping style
51
Separation Anxiety Disorder and PTSD Implementation
Protect child from panic levels of anxiety Provide emotional support to help childs progress developmentally Increase child's self-esteem and feelings of competence. Help child accept and work through traumatic event. Teach coping skills Cognitive therapy -focused on underlying fears and concerns.
52
Most frequently diagnosed mood disorders:
Major depressive disorder Dysthymic disorder Bipolar Disorder
53
Symptoms of Mood Disorders
Sx are similar to adult symptoms Depression Psychomotor retardation and hypersomnia more evident in adolescents Associated factors: Physical and sexual abuse, neglect, death, divorce, learning disabilities, conflicts with or rejection by family/peers. Complications: School failure, drug/alcohol abuse, promiscuity, running away, suicide, similar responses.
54
Tourette's Disorder
Motor and verbal tics Causes marked distress Causes significant impairment in social functioning and occupational functioning Average age onset of motor tics is 7 years of age but can appear as early as 2. Associated symptoms are obsessions, compulsions, hyperactivity, distractibility, impulsivity, low self-esteem
55
Adjustment Disorder
Psychological response to an identifiable stressor but do not meet other DSM-IV-TR axis I criteria for other disorder. Symptoms develop within 3 months of stressors Decreased performance at school and temporary changes in social relationships occurring within 3 months of the stress but lasting no longer than 6 months after the stress has ceased. Subtypes classified according to presenting symptoms.
56
Pica
Persistent eating of nonnutritive substances
57
Rumination Disorder
The repeated regurgitation and re-chewing of food

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