CAMHS - 1 Flashcards
prevalence of mental health problems in children and adolescents
10% age 5-16 have clinically diagnosable mental health problem
70% with MH problems have not had appropriate interventions at a sufficiently early age
prevalence around 10%, lower in girls, some studies report incidence as high as 20%
issues diagnosing psych problems in a child
- lack of ability to communicate and articulate feelings and thoughts
- may report somatic symptoms - e.g. say they have a stomach ache which could be caused by anxiety but they don’t know this
- change with age - normal at one age is not at another - developmental trajectories (regression etc.)
- cultural norms
externalising disorder
disorders based on outward-directed behaviour problems such as aggressiveness, hyperactivity, non-compliance or impulsiveness
internalising disorder
disorders represented by more inward-looking and withdrawn behaviours, and may represent the experience of depression, anxiety and active attempts to socially withdraw
childhood anxiety - separation anxiety
specific to children
excessive anxiety from those attached to - at least 3 of:
disproportionate distress when anticipating or experiencing separation from home or attachment figures
ongoing and unnecessary concern about:
- losing attachment figure or harm to them
- unexpected event which causes separation from attachment figure
- aversion to going out or away from home
- being left alone or without attachment figure
- sleeping alone or away from home
repeated nightmares around separation
physical symptoms - headaches, nausea - when separated or anticipating separation
last at least 4 weeks in kids, 6 months in adults
not better explained by another mental disorder
childhood anxiety - OCD
similar to adults - children can get compulsions without obsessions (e.g. intrusive thoughts)
OCD cycle in adults
obsession –> anxiety –> compulsion –> relief –>
Obsessions = intrusive and recurring thoughts that the individual finds disturbing and uncontrollable.
- often associated with causing harm to oneself or a loved one
- can take the form of pathological doubting and indecision, and this may lead to sufferers developing repetitive behaviour patterns such as compulsive checking or washing
compulsions = represent repetitive or ritualised behaviour patterns that the individual feels driven to perform in order to prevent some negative outcome from happening
- e.g. ritualised and persistent checking of door/light switches
- ritualised compulsions act to reduce stress and anxiety caused by the sufferer’s obsessive fears
- in most cases compulsions are clearly excessive and are recognised as so by the sufferer
4 types of OCD
checking
contamination
symmetry and ordering
ruminations/intrusive thoughts
OCD diagnostic criteria
- obsessions
- compulsions
- belief that behaviour will prevent a catastrophic event
- obsessions and compulsions cause difficulty in performing other functions
- symptoms not explained by other disorders
childhood anxiety - GAD
+specififc focus of worries in childhood
generalised anxiety disorder
(similar to adult)
in children:
- chronic worrying about potential problems and threats
- pathological worrying
specific focuses of worries in childhood:
- 4-7 years = separation from parents and fear of imaginary creatures
- 8 years = have double the worries of 5 year olds
- 11-13 years = social threats
1% prevalence in UK - some US studies show 11%
specific phobias
normal:
- appear and disappear quickly
- e.g. heights, spiders
social phobia:
- begins as a fear of strangers
anxiety prevalence and causes in childhood (3)
moderate anxiety = 54%
causes:
- trauma
- modelling and exposure to info (e.g. showing a child an animal they haven’t seen before, tell them they are scary, they will be scared of it)
- parenting style
childhood and adolescent depression - how it presents
difficult to recognise in young children, can be seen as:
- ‘clingy’ behaviour school refusal, exaggerated fears
- somatic complaints: stomach aches and headaches
however, same as adult with minor amendments (DSM-5)
childhood and adolescent depression - heritability and risk factors
heritability - varies, some studies find low in childhood which increases into adolescence
younger children - abuse and neglect as risk factors
increased risk of depression in children of those with depression:
- genes associated with depression
- psychological factors: home environment, modelling of parental behaviours, parenting styles, transmit low mood and attributions, may not be able to respond well to their emotions
adolescent depression risk factor (7 domains)
cognitive
- depressive negative cognitions
- depressive attributional style
dispositional (and other psychopathologies)
- self-consciousness
- low self-esteem
- emotional reliance
- current depression
- internalising and externalising problem behaviours
- past suicide attempts
- past depression
- past anxiety
stress
- daily hassles
- major life events
social and coping skills
- low self-rated social competence
- poor coping skills
- interpersonal conflict with parents
social support
- low from family
- low from friends
physical
- physical illness
- poor self-rated health
- reduced activity levels
- lifetime number of physical symptoms
- current rate of tobacco use
academic
- school absenteeism
- dissatisfaction with grades
