CAHMS

Question 1

mental health biological factors

Answer 1

genetic
personality
neurodevelopment
temperament
biochemical

Question 2

mental health psychological factors

Answer 2

attachment
emotional (express, understanding, contain)
learning
cognitive

Question 3

types of attachment

Answer 3

secure
insecure avoidant - not value relationship, independent
insecure anxious - values relationship but sees as unpredictable so develops strategies to secure attention, confidence dependent on praise from others
insecure ambivalent - values relationship but unsure about how secure
disorganised - does not value relationship and not confident in themselves

Question 4

mental health social factors

Answer 4

abuse
trauma
sickness
loss
family history
financial
parenting

Question 5

factors affecting resilience

Answer 5

temperament
IQ
social skills
empathy
humour
parenting
relationship between child and carer
school achievements
extra-curricular activities

Question 6

chronic adversity factors

Answer 6

socio-economic
parental mental illness
parental loss
family conflict
parenting
abuse
exposure to community violence

Question 7

child factors to communicate with clinicians

Answer 7

feeling safe
willingness to engage
family/carer not present
cognitive ability
communication
emotional development

Question 8

hx off child

Answer 8

presenting complaint
development hx
family hx
social hx
school
observation of the child and carers

Question 9

emotional disorders of childhood and adolescence

Answer 9

generalised anxiety disorders
separation anxiety disorders
phobic disorders
obsessive-compulsive disorders
post-traumatic stress disorders
depression

Question 10

anxiety disorders prevalence

Answer 10

common
increases with increasing age

Question 11

anxiety disorders presetnation

Answer 11

similar to adults

Question 12

anxiety disorders risk factos

Answer 12

anxious parents
levels of reassurance
development

Question 13

anxiety disorders persisg

Answer 13

many into adulthood, especially OCD

Question 14

GAD presentation

Answer 14

anxiety
fears of death, loss of child/parents
somatic - nausea, abdo pain, sick, headache, sweating, palpitations, tension
panic attacks (sudden onset, fear, faintness)

Question 15

separation anxiety

Answer 15

anxiety manifests upon separation or threat of from attachment figures
somatic manifestations
nightmares
school refusal

Question 16

ocd children

Answer 16

obsessional thoughts and compulsive actions

Question 17

PTSD children

Answer 17

persistent re-experiencing trauma
avoidance of associated stimuli
increased arousal

Question 18

tx of anxiety disorders

Answer 18

behaviour therapy - systematic desensitisation, flooding, response prevention
psychotherapies
anxiolytics (most common - fluoxetine)

Question 19

presentation mood disorder

Answer 19

the low mood may not be pervasive
can be masked by anger in boys

Question 20

depressive disorders presetnation

Answer 20

low mood which may not be pervasive/anhedonia/low levels of enjoyment
biological sx not consistent/sleep may not be affected
concentration/motivation usually worse

Question 21

tx depressive disorders

Answer 21

CBT
SSRI
manage underlying problems

Question 22

bheavioural problems

Answer 22

oppositional disordero

Question 23

oppositional disorder

Answer 23

uncooperative, unwilling to comply
wilful, defiant

Question 24

conduct disorder types and presentation

Answer 24

socialised conduct disorder - less serious, phasic
unsocialised - more serious, can lead to criminality and diagnosis of antisocial personality disorder
presenting- lying, stealing, violence to people

Question 25

conduct disorder risk factors

Answer 25

lack of clear boundaries rejection family conflict child abuse child temperament comorbid learning or developmental difficulties

Question 26

conduct disorder tx

Answer 26

consistent care and parenting behavioural therapy school based interventions community interventions

Question 27

adhd prevalence

Answer 27

3-5% of children..underdiagnosed sx persist into adulthood 2/3 of cases common to have neurodevelopmental difficulties as well (dyslexia)

Question 28

ADHD diagnosis

Answer 28

clinical features observation in different settings QB test

Question 29

ADHD key features

Answer 29

poor attention and concentration physical overactivity impulsivity needs to occur in more than one environment diagnosis after 6 yrs but sx present before

Question 30

tx ADHD

Answer 30

mild/moderate - parenting and school interventions severe - methylphenidate, lisdexamphetamine, atomoxetine, guanfacine

Question 31

autism spectrum disorder prevalence

Answer 31

1% of children

Question 32

ASD diagnosis

Answer 32

clinicsa; features structured appraisals

Question 33

ASD co-morbid conditions

Answer 33

anxiety ADHD sleep problems OCD learning difficulties

Question 34

ASD features

Answer 34

socio/communication difficulties sensory processing difficulties thinking - lack of flexibility, social imagination, theory of mind, generalisation needs to occur in more than 1 environment sx present before 3 years of age

Question 35

ASD tx

Answer 35

no definitive psycho-education stress reduction environmental changes any co-morbidities

Question 36

psychotic ilness features

Answer 36

hallucinations delusions thought disorder need to consider substance missue rare pre puberty