Attachment and Behavioural Disorders Flashcards

1
Q

what is reactive attachment disorder

A

disturbed and developmentally inappropriate social relatedness beginning before the age of 5 and associated with pathological care

individuals have difficulties forming lasting, loving and intimate relationships

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2
Q

some common causes of RAD

A

Persistent disregard for child’s emotional needs

persistent disregard for child’s physical needs

repeated changes of primary care giver

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3
Q

who is more likely to have RAD

A

children orphaned at young age

those who move through foster parents but don’t have one primary care giver

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4
Q

what are the two subtypes of RAD

A

Inhibited

Disinhibited

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5
Q

what are the symptoms/signs of inhibited RAD

A

children continually fail to initiate and respond to social interactions

child does not seek comfort from care giver

if child is left alone, then mother comes back to comfort them they can’t be comforted

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6
Q

What are some symptoms/signs of disinhibited RAD

A

Child has inability to display appropriate selective attachments

eg. has excessive familiarity with strangers

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7
Q

what is an ‘alien self’

A

when the mother does not respond to the emotional/physical needs of the child the child develops an altered sense of self, not feeling worth of being looked after

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8
Q

what are some alarming symptoms in young children that would raise safeguarding concerns

A
  • Persistent colic
  • poor eye contact, difficulty tracking
  • no reciprocal smile
  • delayed gross motor skills
  • difficulty being comforted
  • resists affection and cuddling
  • appears stiff, defensive
  • poor sucking response when eating
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9
Q

RAD symptoms in older kids

A
  • lack of self control/impulsive
  • speech and language delays
  • lack of conscience/no remorse
  • lack social boundaries
  • indiscriminately affectionate with strangers or hesitancy in social interactions
  • avoids/over seeks physical contact
  • hyperactive
  • aggressive
  • food issues:hordes, gorges, hides food, refused to eat
  • anxious, wary
  • prefers to play alone
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10
Q

where does anger tend to stem from in difficult children

A

shame-based
originated from past experiences of humiliating abuses of power where they were made to feel worthless, useless and unworthy of respect

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11
Q

what effect do childhood experiences have on the emotional centres of the brain

A

they dramatically change the number for neurons and the number of axons connecting them so affect how the emotional centres of the brain communicate with the cortex

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12
Q

Differentials which are often either mistaken for, or a co-morbidity of RAD

A

Conduct disorder
-these children are able to form some satisfying relationships

Depression
-often able to form appropriate relationships with those who reach out to them

ASD
-more able to adapt based on what they get out of different relationships

ADHD
-difficulties are persistent - more able to initiate and maintain relationships

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13
Q

what percentage of those with RAD also have a co-morbid disorder

A

50%

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14
Q

what are some effective treatments for RAD

A
  • Family therapy
  • Individual therapy
  • Play therapy
  • Medication (for symptoms of co-morbid disorder)
  • Special education interventions
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15
Q

how does family therapy help RAD

A

helps parents or other children understand symptoms of disorder and effective interventions

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16
Q

how does individual therapy help RAD

A

Helps child directly with monitoring of emotions and behaviour

17
Q

how does play therapy help RAD

A

helps child learn skills for interacting with peers and other social situations

18
Q

What is Conduct Disorder

A

a repetitive and persistent pattern of behaviour where the basic rights of others or major age appropriate norms/rules are violated

type of behaviour disorder

19
Q

What is Oppositional Defiant Disorder

A

lesser degree of conduct disorder seen in younger children

20
Q

what are the criteria for Conduct Disorder

A

presence of 3 or more in the last 2 months and at least 1 in the last 6 months:

  • aggression to people or animals
  • destruction of property
  • deceitfulness or theft
  • serious violation of rules
21
Q

what are some consequences of Conduct Disorder

A

serious impairment in social, academic or occupational function

  • school
  • family
  • criminality
  • health, social services, criminal justice system
  • mental health co-morbidity
22
Q

what is mild-moderate Conduct Disorder

A

restricted to family environment

23
Q

what are the 2 types of severe conduct disorder

A

Unsocialised

Socialised

24
Q

what is unsocialised conduct disorder characterised with

A

violent behaviour, more likely to be dealt with my criminal justice system

25
what is socialised conduct disorder characterised with
better ability to avoid getting involved with criminal justice system
26
what are common Conduct Disorder co-morbidities
``` RAD ADHD!! (common) Learning difficulties Depression Substance misuse Deviant sexual behaviour ```
27
what are the triad of ADHD difficulties
Inattention Hyperactivity Impulsivity
28
symptoms of co-occuring ADHD and Conduct Disorder
Developmentally inappropriate Impairing functioning Pervasive across settings Longstanding from age 5
29
what are the causes of ADHD
genetic + environment | runs in families
30
whats the difference between children with ADHD and children with both CD and ADHD
Children with both have higher rates of antisocial personality as adults
31
what are some causes of Conduct Disorders
Genetic Brain injury Environmental
32
what factors may make a family vulnerable to not meeting the needs of their children
- families with parents with mental illness and intellectual difficulties - drug and alcohol problems - domestic violence - single parent families
33
what are some predictors of antisocial behaviour within the family
- Lack of house rules - lack of clarity as to how children should behave - Lack of effective contingencies (inconsistent responses to behaviour) - lack of techniques to deal with family crisis - lack of supervision
34
Treatment for Conduct disorder (in those without co-morbid disease)
parent/foster training if child is under 11 Child focused programmes multimodal interventions for ages 11-17 medication - used for extreme aggression
35
what medications are used to treat CD
Risperidone (antipsychotic)