CAHMS Flashcards
mental health biological factors
genetic
personality
neurodevelopment
temperament
biochemical
mental health psychological factors
attachment
emotional (express, understanding, contain)
learning
cognitive
types of attachment
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
mental health social factors
abuse
trauma
sickness
loss
family history
financial
parenting
factors affecting resilience
temperament
IQ
social skills
empathy
humour
parenting
relationship between child and carer
school achievements
extra-curricular activities
chronic adversity factors
socio-economic
parental mental illness
parental loss
family conflict
parenting
abuse
exposure to community violence
child factors to communicate with clinicians
feeling safe
willingness to engage
family/carer not present
cognitive ability
communication
emotional development
hx off child
presenting complaint
development hx
family hx
social hx
school
observation of the child and carers
emotional disorders of childhood and adolescence
generalised anxiety disorders
separation anxiety disorders
phobic disorders
obsessive-compulsive disorders
post-traumatic stress disorders
depression
anxiety disorders prevalence
common
increases with increasing age
anxiety disorders presetnation
similar to adults
anxiety disorders risk factos
anxious parents
levels of reassurance
development
anxiety disorders persisg
many into adulthood, especially OCD
GAD presentation
anxiety
fears of death, loss of child/parents
somatic - nausea, abdo pain, sick, headache, sweating, palpitations, tension
panic attacks (sudden onset, fear, faintness)
separation anxiety
anxiety manifests upon separation or threat of from attachment figures
somatic manifestations
nightmares
school refusal
ocd children
obsessional thoughts and compulsive actions
PTSD children
persistent re-experiencing trauma
avoidance of associated stimuli
increased arousal
tx of anxiety disorders
behaviour therapy - systematic desensitisation, flooding, response prevention
psychotherapies
anxiolytics (most common - fluoxetine)
presentation mood disorder
the low mood may not be pervasive
can be masked by anger in boys
depressive disorders presetnation
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
tx depressive disorders
CBT
SSRI
manage underlying problems
bheavioural problems
oppositional disordero
oppositional disorder
uncooperative, unwilling to comply
wilful, defiant
conduct disorder types and presentation
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
conduct disorder risk factors
lack of clear boundaries
rejection
family conflict
child abuse
child temperament
comorbid learning or developmental difficulties
conduct disorder tx
consistent care and parenting
behavioural therapy
school based interventions
community interventions
adhd prevalence
3-5% of children..underdiagnosed
sx persist into adulthood 2/3 of cases
common to have neurodevelopmental difficulties as well (dyslexia)
ADHD diagnosis
clinical features
observation in different settings
QB test
ADHD key features
poor attention and concentration
physical overactivity
impulsivity
needs to occur in more than one environment
diagnosis after 6 yrs but sx present before
tx ADHD
mild/moderate - parenting and school interventions
severe - methylphenidate, lisdexamphetamine, atomoxetine, guanfacine
autism spectrum disorder prevalence
1% of children
ASD diagnosis
clinicsa; features
structured appraisals
ASD co-morbid conditions
anxiety
ADHD
sleep problems
OCD
learning difficulties
ASD features
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
ASD tx
no definitive
psycho-education
stress reduction
environmental changes
any co-morbidities
psychotic ilness features
hallucinations
delusions
thought disorder
need to consider substance missue
rare pre puberty
