2 - Assessment Flashcards
Define resilience.
Successful adaptation in children who experience adversity
Explain what differential susceptibility to the environment is.
- Orchid vs. dandelion
→ different people might have different sensitivities to their environment
→ dandelions: undergo a huge amount of stress and it doesn’t seem to have much of an impact on their psychological well-being
→ orchids: very sensitive to susceptible factors
→ if the environmental conditions are very good, you’re able to reach your full potential which may be more difficult for dandelion children (less susceptible to their environment)
True or false: Children may benefit from exposure to stress
True:
→ p.ex: going to the gym is a stressor (putting stress on muscles)
→ p.ex: studying for a test is a stressor (putting stress on the brain)
→ through stress, we develop, get stronger and learn that we’re capable of doing things
→ the ideal environment is thus not free of adversity
What are some risk (vulnerability) factors?
- just because it’s a risk factor doesn’t mean it’ll have a specific effect on any given person
- Poverty
- Problematic caregiving
- Mental illness in the family
- Difficult temperament/high neuroticism
- Traumatic events
- Genetics
- Birth complications
- Gender/sex, minority status
- people also reframe complicated events in ways that end up being beneficial to them
→ p.ex: “i can’t imagine my life without this event”
What are some protective (resilience) factors?
- High IQ and school achievement
- Easy temperament; low neuroticism
- Authoritative parenting style
- Financial resources
- Good schools, access to activities
- however it really depends on the concern of the person
→ p.ex: in OCD, having high average IQ is a risk factor
→ p.ex: the higher the IQ when on the autism spectrum, the higher your risk of depression
What are some approaches to conceptualizing child and adolescent psychopathology?
1) Individual child “symptoms”
2) Dimensional (symptom clusters)
3) Categorical (presence/absence of predetermined criteria)
4) Developmental psychopathology
Explain the individual child “symptoms” approach
In conceptualizing child and adolescent psychopathology, this approach explains that…
- Occur in almost all children at some point
→ p.ex: presence or absence of a tantrum doesn’t say much in a child or forgetfulness for example
→ if we only look at one behaviour or one experience, it doesn’t say much – we have to look at things that might be getting in the way of typical development
- Little correspondence to overall adjustment or later outcomes
- Many problems displayed by children referred for treatment are similar to those occurring in less extreme forms in younger children
→ failures of executive functioning in certain ages are typical, but what makes smt a meaningful construct is when someone who is old enough has these same failures
- Most individual problem behaviors do NOT, by themselves, discriminate between groups of clinic-referred and non-referred children
Explain the dimensional (symptoms clusters) approach
In conceptualizing child and adolescent psychopathology, this approach explains that…
- Typically seen with questionnaires
- Symptom clusters or syndromes
→ collection of symptoms that seem to be connected with each other
- Types:
→ Externalizing problems: “under-controlled” – directed at others; Oppositional and conduct problems
→ Internalizing problems or “over-controlled” – inner directed; Anxiety/fear, low mood/depression
- Similar structure in adult psychopathology
Explain the categorical (presence/absence of predetermined criteria) approach
In conceptualizing child and adolescent psychopathology, this approach explains that…
- Assumptions of the DSM categorical system
- Presence or absence of condition is based on diagnostic criteria
- Diagnostic criteria are observable behaviours
- Observable behaviours must be present for a specified period of time
- Many conditions have age requirements
- Several, but not all, diagnostic features must be present
- categories are useful and helpful to understand a diagnostic, however it can’t be the only thing we base ourselves on
→ it’s helpful because it is a meaningful group of behaviours, experiences and features to help guiding in what to do next
→ BUT it also lacks depth in a very important way; doesn’t touch on treatment p.ex, certain diagnostic criteria is very straight-forward and short
In the categorical approach, what happens when the symptoms are no longer present?
- p.ex: in the case of OCD, when you no longer meet the criteria, you don’t necessarily fall into the category anymore (like a cold, you have a cold when you have the symptoms, but otherwise you don’t)
- p.ex: in the case of learning development disorders, they tend to persist though
→ personality disorders tend to persist, mood disorders too
→ autism and ADHD for example though, people remain in this category
Explain selective mutism in the categorical approach
- some people can speak entirely normally to certain people, but won’t speak at all to others
- in selective mutism, you can always talk to your parents though
- sort of like a proto-social anxiety
Diagnostic criteria: - Consistent failure to speak in specific social situations in which there is an expectation for speaking (p.ex at school) despite speaking in other situations
- The disturbance interferes with educational or occupational achievement or with social communication
- The duration of the disturbance is at least 1 month (not limited to the first month of school)
- The failure to speak is not attributable to a lack of knowledge of, or comfort with the spoken language required in the social situation
- The disturbance is not better explained by a communication disorder (p.ex childhood-onset fluency disorder) and does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder
Explain the developmental psychopathology approach
In conceptualizing child and adolescent psychopathology, this approach explains that…
- Framework for understanding both normal development and its maladaptive deviations
→ looking more at the factors that are interacting in complex ways that can lead to different versions of development
- Consistent with transactional and ecological views
- Endogenous (e.g., genetic) and exogenous (e.g., family, social, culture) and interaction of the two in predicting and understanding developmental changes
- Addresses complex influences surrounding development
- Processes underlying healthy or pathological development – transactions between child
What are the pros and cons of diagnosing a child with psychological disorder?
- pros:
→ if diagnosed early enough, you can have more effective interventions to help them (for certain disorders)
→ a lot of people can experience relief when diagnosed
→ when they’ve never seen certain behaviours before, they can be terrifying to the person themself or to those around them, so to receive a diagnosis can reduce fear and helps with accurate interventions as well - cons:
→ might risk misdiagnosing them if diagnosed too early (there’s a lot going on at young ages)
→ lots of stigma with certain labels - might add to a person’s burden socially
→ have to be very conscious of identity formation especially in children
How important is diagnosis? Explain the 2 views of this
1) Diagnosis matters, and don’t let anyone tell you otherwise
→ Treatment recommendations, class placement, family’s ability to understand the situation, support groups, needed for difficult decisions
2) Never diagnose unless you are forced to do so
→ Pigeon-holed, stigma, only descriptive, not explanatory or gives false impression of explanation
How can we assess children and adolescents with the multi-method (i.e., what is multi-method)?
- Meet with child/adolescent
- Meet with parents
- Observe parents and children together
- Rating scales
- Classroom observations
→ can also meet with teachers, have them fill out scales for information - Standardized testing
How are clinical assessments with kids different from assessments with adults?
→ a lot less formal with kids; often over a game played together, sometimes drawing p.ex
→ depends on the age of the person though
What is the difference between a diagnostic interview and a questionnaire?
- Diagnostic interview: The professional fills out the form
- Questionnaire: The child, parent or teacher fills out the questionnaire
If the T-score of a child is at 70 for a social phobia in a questionnaire, what does this tell us?
- The child is 2 standard deviations from the norm
- They are at the 98th percentile, thus having a social phobia
What is the difference between the WISC and the WIAT?
- The WISC assesses cognitive results in a child
- The WIAT assesses academic results/achievement in a child
What would we see in a WISC and WIAT score for someone with a learning disability?
- For a learning disability, we will see regular functioning in other areas, but in one specific area it is lower
→ a high score isn’t smt to be worried about in terms of the reason why, but a low score could have multiple possible explanations
→ p.ex: nervous for the test, medical condition, bad day, etc.
→ so if we see low scores, we wanna be very cautious with our interpretations and get more evidence to interpret
Explain what a randomized controlled trial is.
- Study design used in healthcare – assess the effectiveness of treatments
- “Gold standard” for treatment research— minimizes bias and provides strong evidence for causality
→ allows us to be confident that the reason we’re seeing a positive change is because of the treatment – it’s not correlational data, we’re saying that there’s a cause
→ BUT, it doesn’t tell you why the treatment works; it’ll just tell you that it does or doesn’t - Random assignment of participants to groups
- One group gets the intervention; other groups get no intervention or a control intervention
- Groups are compared based on predetermined outcome measure (e.g., RCADS)
Explain what a meta-analysis is?
- A quantitative combination of studies
- A statistical technique for combining data (effect sizes) from several studies
- Validity of meta-analysis depends on quality of source studies
- Benefits:
→ Clarifies inconclusive areas of research
→ Helps identify sources of diversity across studies
→ Helps detect publication bias
→ BUT if you include biased studies (whether knowingly or not), it will affect the results
→ Can reveal how heterogeneity of populations may affect treatment outcome
→ helps us generalize data
True or false: Exposure-based therapies are effective for anxiety based disorders
True
What is the National Institute for Health and Care Excellence (NICE)?
→ provides clinical practice guidelines
→ group of knowledgeable experts and have them review the literature for you
