28 Mental Health Issues of Children + Adolescence Flashcards
When does behavior of kids become problematic?
interferes w
- school
- home
- interactions w peers
Disorders that can appear in childhood/adolescence
- depressive disorder
- anxiety disorder
- trauma+stressor related disorder
- substance use disorder
- feeding/eating disorders
- disruptive, impulse control, + conduct disorder
- neurodevelopmental disorder
- bipolar + related disorder
- schizo-spectrum + other psychotic disorder
- nonsuicidal self-injury + suicidal behavior disorder
- impulse control disorder
types of neurodevelopmental disorders
- ADHD
- autism spectrum
- intellectual developmental disorder
- specific learning disorder
suicide is the leading cause of death for youth between the ages…
10-24 y.o.
why is diagnosis of children difficult?
- lack of language skills, cognitive/emo development to describe what is happening
- wide variation of “normal” behaviors
- difficult to determine if a child’s behavior indicates an emo problem which can delay diagnosis + intervention
characteristics of good mental health
- ability to interprey reality
- pos self concept
- able to cope w stress + anxiety in age approp way
- mastery of developmental task
- able to express oneself spontaneously + creatively
- able to dvlp + maintain satisfying relationships
etiology/general risk factors
- genetic/chromosomal
- biochemical
- social+environmental
- cultural + ethnic
- resiliency
- witness/experience traumatic event
depressive disorder
risk factors
- fam hx
- phys/sex abuse/neglect
- homeless
- dispute w peers, fam
- bullying (as aggressor or victim)
- engage in high risk behave
- learning disabilities
- chronic illness
depressive disorder
expected findings
- temper tantrums
- loss of appetite
- nonspecific complaints r/t health
- engage in solitary play/work
- chng in wt/sleep
- poor school performance
- suicidal
- high risk
anxiety/trauma/stressor disorder
expected findings
- anxiety/level of stress interferes w normal growth + dvlpt
- unable to function normally at home, school, in other areas of life
separation anxiety
excessive anxiety when separated fr home/parents that is developmentally inappropriate
-can develop after a specific stressor (death of loved one, pet, move, or assault)
separation anxiety can develop into…
- school phobia
- phobia of being left alone
- depression
- panic disorder
PTSD
- precipitated by experiencing, witnessing, or learning of a traumatic event
- exhibit psychosocial indication of anxiety, depression, phobia, or conversion rxn
anxiety resulting fr PTSD
- displayed externally
- irritability, aggressin w family friends
- poor academic performance
- somatic report
- belief that life will be short
- difficulty sleeping
small children w PTSD
-decr in play or engage in play that involves aspect of traumatic event
disruptive, impulse control, + conduct disorder
expected findings
- behavioral problems usually occur in school, home, social settings
- comorbid disorders can be present (ADHD, dprssn, anxiety, substance use disorder)
disruptive, impulse control, + conduct disorder manifestations worsen in…
- situations that require sustained attention (classroom)
- unstructured group situation (playground)
oppositional defiant disorder is characterized by a recurrent pattern of the following antisocial behaviors
- negativity
- disobedience
- hostility
- defiant behaviors (esp toward authority)
- stubbornness
- argumentativeness
- limit testing
- unwillingness to compromise
- refusal to accept responsibility for misbehavior
oppositional defiant disorder
- misbehavior usually demonstrated at home + directed towards person best known
- do not see themselves as defiant
- —view their behavior as a response to UNresonable demands
oppositional defiant disorder can exhibit
- low self esteem
- mood lability
- low frustration threshold
oppositional defiant disorder can develop into…
conduct disorder
disruptive mood dysregulation disorder
recurrent temper outbursts that are severe + do not correlate w situation
- temper outburst are manifested verbally/physically, can incl aggression
- temper outburst are not approp for client’s dvlptl level
in disruptive mood dysregulation disorder, the temper outbursts is…
angry + irritable
in disruptive mood dysregulation disorder, temper outbursts are present ___ per week observable by others in at least ___ settings
3 or more times; 2
disruptive mood dysregulation disorder
onset
6-18 y.o.
make sure disruptive mood dysregulation disorder manifestations are not due to…
another mental disorder like bipolar
intermittent explosive behavior is a type of ______ disorder
impulse control disorder
intermittent explosive behavior
recurrent episodic violent + aggressive behavior w the possibility of hurting people, property, or animals
-incl verbal + physical aggression
intermittent explosive behavior
age + sex
- diagnosed as early as 6
- typically diagnosed bw 13-21 y.o.
- more males
intermittent explosive behavior is characterized by ______ followed by ______
aggressive overreaction to norm events;
feelings of shame + regret
intermittent explosive behavior
effects on ADL
- prevents ability to have healthy relations
- hard to keep employment
- can lead to dvlpt of chronic disease [HTN, DM]
conduct disorder
persistent pattern that violates the rights of others or rules + norms of society
conduct disorder categories
- aggresion to ppl/anmls
- destructn of property
- deceitfulness
- theft
- serious violations of rules
intermittent explosive behavior
onset + sex
childhood onset: dvlps before age 10
adolescent onset: after age 10
males more prevalent
intermittent explosive behavior
contributing factors
- parental rejection/neglect
- difficult infant temperament
- inconsistent child rearing practice + harsh discipline
- phys/sex abuse
- lack of supervision
- early institutionalztn
- frequent change of caregivrs
- large fam size
- assoc w delinquent peer groups
- parent w a hx of psych illness
- chaotic home life
- lack of male role model
intermittent explosive behavior
manifestations
- lack of remorse/care for feelings of others
- bullies, threatens + intimidates others
- believes aggression is justified
- low self esteem, irritability, temper outburst, reckless behavior
- can demonstrate suicidal ideation
- concurrent learning disorders or impairments in cognitive functioning
- demonstrates phys cruelty to others/animals
- has used a weapon that could cause serious injuries
- destroys property of others
- has ran away fr home
- often lies, shoplifts, + is truant fr school
attention deficit hyperactivity disorder
inability of a person to control behaviors requiring sustained attention
-inattentive impulsive behavior can put child at risk
ADHD characteristics
- inattention
- hyperactivity
- impulsivity
inattention
difficulty in paying attention, listening, focusing
hyperactivity
fidgeting,
- inability to stay still,
- running + climbing inappropriately
- difficulty w playing quietly
- talking excessively
impulsivity
- difficulty waiting for turns
- constantly interrupting others
- acting wo consideration of consequence
how to diagnose ADHD
- behaviors must be present prior to age 12
- must be present in more than 1 setting
- received neg attention fr adults + peers
types of ADHD
ADHD predominant inattentive
ADHD predominant hyperactive-impulsive
combined type: both inattentive, hyperactive-impulsive
Autism Spectrum Disorder
complex neurodevelopmental disorder thought to be of genetic origin
- wide spectrum of behaviors affecting ability to communicate + interact w others
- cognitive + language devlpt are delayed
Autism Spectrum Disorder
characteristic of behavior
- inability to maintain eye contact
- repetitive actions
- strict observance of routines
- *wide variability in functions**
- fr poor (unable to perform self care, unable to communicate or relate to others) to high (able to function near norm levels)
Autism Spectrum Disorder
age + sex
early childhood;
males>females
Autism Spectrum Disorder
physical difficulties
- sleep disorders
- digestive disorders
- sensory integration dysfunction
- feeding disorder
- epilepsy
- allergies
intellectual developmental disorder
onset deficits + impairment during developmental period of infancy or childhood
- has intellectual deficits like reasoning, abstract thinking, academic learning, learning fr prior experience
- unable to maintain personal independence + social responsibility
- deficit range fr mild to severe
specific learning disorder
demonstrates persistent difficulty in acquiring reading, writing, or math skills
-performance in 1 or more academic areas is significantly lower than expected range for their age, lvl of intelligence, or educational level
those who have specific learning disorder could benefit from…
an individualized education program [IEP]
obtain a complete nursing hx to include in the following
- mom’s pregnancy + birth hx
- sleep, eat, elimination pattrn
- attachnt behavior
- recent wt loss/gain
- achvmnt/dvlpntl milestones
- peer/fam reltnshp
- school performance
- hx of emo, phys, sex abuse
- parental perception/tolerance of kid’s behavr
- fam hx incl membr of househld
- substance use
- safety at home/school
- risk for self injury
- availability of weapons at home
primary prevention (education, peer group disscussn, mentoring) to prevent risky behavior/promote healthy coping
- adopt realistic view of their bodies
- promote self esteem
- gun/weapon control strategies
- use of seatbelts
- use of protective gear
- sex educatn + contraceptives
- abstinence
intervene for clients who have engaged in…
HIGH RISK BEHAVIORS
anxiety disorder - interventions
- provide emo support that is accepting of regression + other defense mechanism
- offer protection during panic levels by providing for their needs
- implement methods to incr client self esteem + feelings of achievement
trauma + stressor related disorders - interventions
- provide assistance w working thru traumatic even or loss TO REACH ACCEPTANCE
- encourage group therapy
interventions for disruptive, impulse control, conduct disorders, + ADHD
- calm, firm, respectfl apporach
- modeling
- get attention before giving directions
- short + clear explanatn
- clear limits on unacceptable behaviors + BE CONSISTENT
- plan phys activities thru which kid can use energy + obtain success
- develop reward systm usin methods like wall chart/tokens
- focus on strengths not just problems
- support parent’s hopefulness
- specific pos feedback when expectatns are met
- ID issues that result in power struggles
- develop coping mechanism
autistic - interventions
- structured environment
- consistent, individualzd care
- encourage parents to participate in tx + care
- short, concise, developmentally approp communicaiton
- ID desired behavrs + reward them
- role model social skills
- role play situations that involve conflict + conflict resolutn strategies
- encourage verbal communctn
- limit self stimulating + ritualistic behaviros by providing alternative play activities
- determine emo + situatnl triggers
- give plenty of notice before changing routines
- carefully monitor behavior ot ensure safety
referrals for autistic
- -physical
- -occupational
- -speech
- great for early intervention
ADHD meds
PSYCH STIM: methylphenidate + amphetamine salts
NONSTIM SNRI: atomoxetine
AUTISM meds
SSRI
ANTIPSYCHOTIC: risperidone, olanzapine, quetapine, aripiprazole
Intermittent Explosive Disorder meds
SSRI: fluoxetine
MOOD STABLZR: lithium
ANTIPSYCHOTIC: clozapine + haloperidol
B-BLOCKERS
Oppositional Defiant Disorder meds
none
Conduct Disorder meds
usually prescribed to target specific behavioral problems: 2+3rd gen ANTIPSYCHOTICS TCA ANTIANXIETY MOOD STABLZR
Anxiety meds
**no FDA approved antianxiety for kids
SSRI may be prescribed
PTSD meds
meds prescribed are to target specific problems assoc w disorder (like dprssn or ADHD)
Disruptive Mood Dysregulation Disorder meds
antidepressant therapy
