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Child & Adolescent Psychiatry Review > CAP1 > Flashcards

CAP1 Flashcards

1
Q

Which two antipsychotics have the least effect on QTc ?

A

Aripiprazole and olanzapine

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2
Q

Clonidine is an agonist at what receptor?

A

alpha 2a 2b 2c

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3
Q

Guanfacine is an agonist at what receptor

A

alpha 2, primarily 2a

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4
Q

What does marijuana impair?

A

short term memory, visual motor functioning

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5
Q

What are the side effects of PCP?

A

agitation, delusions, hypertension, flushing, diaphoresis

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6
Q

What are the consequences of inhalant use?

A

hearing loss, peripheral neuropathy, CNS brain damage, liver, kidney, bone marrow deterioration

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7
Q

What are the stages of stopping behavior in motivational interviewing?

A

Pre-contemplation, contemplation, preparation, action

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8
Q

Does anxiety precede substance use disorders or ‘post’cede them?

A

Likely to precede

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9
Q

What is successful at treating night fears?

A

Emotive imagery. Children are trained to imagine a super hero

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10
Q

What percent of children have at least one sleep walking episode?

A

15%

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11
Q

How do yo treat sleep terrors and sleep walking?

A

Time them and wake 10-15 minutes earlier

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12
Q

What percentage of children 6 to 12 years have nightmares?

A

20%

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13
Q

A closed head injury leads to what sleep disorder?

A

Circadian rhythm sleep disorder

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14
Q

By what age should imaginary companions end?

A

8 years of age

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15
Q

What symptoms might be found in Dissociative Identity Disorder that may overlap with Schizophrenia?

A

DID remains a controversial diagnosis. Command hallucinations, voices speaking to one another, delusional beliefs, illogical thought patterns, thought blocking. There is a normal range of affect and ability to relate warmly

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16
Q

What is the disease fatality rate for Neuroleptic Malignant Syndrome NMS in children?

A

9%

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17
Q

Geller’s study of Lithium for BiPD and SUD in adolescents showed what?

A

Better function on lithium and decreased substance use but no change on manic depression

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18
Q

What did a long-term naturalistic study of BiPD classic and lithium in 59 children over 10 years show?

A

Effective in 39/59, i.e. 2/3 (DeLong 1987)

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19
Q

Discontinuing lithium makes a difference or no difference in pediatric bipolar disorder?

A

Relapse more likely (Strober 1990)

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20
Q

What is the mechanism of action of lithium?

A

Unknown precisely. Affects a number of neurotransmitters and receptors, decreasing norepinephrine release and increasing serotonin synthesis.

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21
Q

What is the mechanism of action of valproate?

A

Although the mechanism of action of valproate is not fully understood, traditionally, its anticonvulsant effect has been attributed to the blockade of voltage-gated sodium channels and increased brain levels of gamma-aminobutyric acid (GABA).

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22
Q

What is the mechanism of action of topiramate?

A

Blocks voltage-dependent sodium and calcium channels. It also inhibits the excitatory glutamate pathway while enhancing the inhibitory effect of GABA.

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23
Q

What are the key cognitive side effects of topiramate?

A

Cognitive blunting and word retrieval difficulties

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24
Q

What is the prevalence of bipolar disorder in adults?

A

1-2%

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25
Q

What percent of highschoolers have tried drugs or alcohol by 12th grade?

A

85%

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26
Q

Which persons with alcoholism do worse by Cloninger and Babor’s classification?

A

Type 2, Type B

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27
Q

Is THC use genetic or environmental?

A

Experimental use has a more environmental component. Dependence is more likely to have genetic underpinnings

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28
Q

What is the mean elimination half-life of THC?

A

4 days

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29
Q

What percentage of suicide victims have/had relatives with suicidal tendencies

A

60% (compared with 12% for non-suicidal teens)

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30
Q

A family history of suicide increases risk of suicide by how much?

A

5 times for females and 3 times for males

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31
Q

in one study, what percent of children who commit suicide had history of attempt(s)

A

26-33%

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32
Q

Do LGBTQQIAP youth have an increased risk of suicide?

A

Yes. Although, sexual identity or orientation per se has likely little to do with the increased risk

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33
Q

What is the suicide rate for youths aged 10 to 18?

A

5/1000

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34
Q

CDC data has shown what percentage of high school students have had a suicidal idea, a plan, and an attempt in the last year?

A

17 %, 14%, and 2% respectively

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35
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school youth report rarely or never wearing a seatbelt?

A

6%

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36
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school students had ridden one or more times during the 30 days before the survey in a car or other vehicle driven by someone who had been drinking alcohol?

A

Nationwide, 16.5% of students had ridden one or moretimes during the 30 days before the survey in a car or other vehicle driven by someone who had been drinking alcohol

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37
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school students had carried a weapon at least one day in the previous 30 days?

A

Nationwide, 15.7% of students had carried a weapon (e.g., gun, knife, or club) on at least 1 day during the 30 days beforethe survey

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38
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school students had ever drunk alcohol?

A

60% ever. 16% before age 13 (more than a few sips). 30% of high school students had had a drink at least one day in the last 30 days.

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39
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school students had used THC?

A

36%

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40
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school students had texted or e-mailed while driving in the previous 30 days?

A

40%

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41
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school students had sexual intercourse?

A

Nationwide, 39.5% of students had ever had sexual intercourse and 9.7% had had sexual intercourse with four or more persons during their life.

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42
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school students in the previous 30 days had not used a condom (they or their partner) in their last sexual intercourse

A

46%

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43
Q

In a self-report measure of children with depression, what were the top three symptoms?

A
  1. Aches and pains 2. Sad affect 3. Helplessness/ hopelessness
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44
Q

What is higher, the number of suicides or homicides?

A

Homicideses

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45
Q

What is a crisis hotline and text line for suicidal thinking?

A

Calling: 1-800-273-TALK (8255) Texting: text home to 741741

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46
Q

What percentage of children and adolescents have a second depressive episode within two years after the first remits?

A

40% within two years, 75% within 5 years

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47
Q

What has been found of mothers of depressed children in their management of their children?

A

They use more reactive and fewer pre-emptive strategies; reactive strategies predict conduct problems

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48
Q

What are features of children with depression, besides symptoms?

A

Heightened empathy; misplaced sense of responsibility; unrealistic ideas about helping others

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49
Q

What percentage of high school students report having been bullied in the previous year?

A

19%

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50
Q

What is the ratio of suicide attemtps to suicide completions in youth?

A

50:01:00

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51
Q

What percent of suicide victims have had mental health treatment?

A

30 to 50%

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52
Q

What are the odds ratios of suicide in an adolescent with: 1) a prior attempt 2) major depressive disorder 3) substance use disorder

A

1) 22.5 for prior SA 2) 8.6 for MDD 3) 7.1 for Sub Use

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53
Q

In interpersonal psychotherapy by Klerman what are the four areas of interpersonal concern?

A
  1. interpersonal deficits 2. interpersonal role conflicts 3. abnormal grief 4. role transitions. A modification for adolescents is single parent families
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54
Q

The Youth Risk Behavior Surveillance System showed what percentage of high school students reported feeling felt so sad or hopeless almost every day for 2 or more weeks in a row that they stopped doing some usual activities?

A

31.50%

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55
Q

What are the elements of problem-solving?

A
  1. Problems are part of everyday life; inhibit impulse to avoid 2. Formulate problem into a workable problem and goals 3. Generate alternative solutions 4. Evaluate them and implement one 5. Verify the merit/outcome of the chosen solution  
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56
Q

What are two types of cognitive dysfunction?

A
  1. Deficiency 2. Distortion
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57
Q

What does “cognitive structures” refer to?

A

AKA cognitive schemata. Refers to memory principally–information that is internally represented in memory. Cognitive content is the information actually represented (self talk). Cognitive processing refers to how we go about perceiving and interpreting experience. Cognitive products (attributions) is a result of the interaction of the above

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58
Q

Does psychotherapy work?

A

In a meta-analysis of 100 studies Weisz 1987 found an effect size of 0.79 for all therapies combined

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59
Q

What percentage of adolescents will have a depressive episode by age 18?

A

20%

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60
Q

Where do most adolescent suicides occur?

A

After school hours and in a teen’s home; most are precipitated by an interpersonal conflict

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61
Q

What time do most adolescent suicides occur?

A

Late afternoon, early evening

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62
Q

What precipitates suicide attempts in adolescents?

A

Family fight, parent-child discord, lower grades, long absence from school

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63
Q

What is the presumed lifetime risk of a mood disorder if both parents have mood disorders in their sides of the family?

A

100%; 24% if one parent’s family; 17% if no extended family has a mood disorder

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64
Q

In one study, what percentage of children who were depressed and hospitalized were re-hospitalized within two years of first hospitalization?

A

80%

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65
Q

In Emslie’s study of depression in children and adolescents, what percentage who responded had a clinical global impression (CGI) score of 1 or 2 for fluoxetine and placebo, respectively?

A

56% for fluoxetine and 33% for placebo (CGI 1 = very much, 2 = much improved)

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66
Q

What are the key ‘rhythmic’ interventions in bipolar disorder?

A

Sleep and regular daily activities

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67
Q

What therapy has been shown to reduce suicidal behavior in adults?

A

Dialectical behavior therapy (DBT)

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68
Q

A history of sexual abuse increases the risk of a suicide attempt by how much?

A

8

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69
Q

Do suicide prevention telephone interventions seem to help reduce suicidality?

A

Yes with a small positive effect

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70
Q

What is the point prevalence of schizophrenia in 2 to 12 year olds?

A

2/100,000

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71
Q

What are some premorbid findings in schizophrenia?

A

Language development, speech and learning disorders, disruptive behaviors

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72
Q

What is the age of onset for schizophrenia

A

Rare before age 9. Less than 1% have it before age 13; less than 10% have it before age 15; the rest are diagnosed above 16 years of age

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73
Q

What percentage of children with schizophrenia have visual hallucinations?

A

Close to 100%

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74
Q

What did a group with childhood onset schizophrenia studied by Eggers 1978 and 1989 show about outcome?

A

20% showed remission, 30% had satisfactory social adaptation, 50% remained impaired

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75
Q

When was depression in children and adolescents first recognized in the US?

A

The first official recognition occurred at an NIMH conference in 1975. (In part, prior to this, psychodynamic ideas about superego and ego formation precluded the ideas of depression in children.)

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76
Q

Emil Kraepelin found what percentage of persons with mania had an onset before 10 years of age?

A

0.40%

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77
Q

What percentage of children have atypical depression?

A

16.50%

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78
Q

The age of onset of depression is associated with duration or recovery?

A

Duration

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79
Q

What findings are there for cortisol and growth hormone in children with depression?

A

Cortisol hypersecretion and blunting of nocturnal growth hormone

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80
Q

What is the tricyclic antidepressant response compared to placebo in child and adolescent depression?

A

The same, a 50% response for both

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81
Q

What percentage of adolescents present with depressed mood as the index episode in bipolar disorder?

A

60%

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82
Q

What percentage of child and adolescent patients with bipolar disorder have ADHD? 

A

57 to 98% (Geller, Wozniak)

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83
Q

What is the concordance rate for depression in monozygotic and dizygotic twins, respectively?

A

54% MZ, 24% DZ

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84
Q

What is the concordance rate for bipolar disorder in Monozygotic and dizygotic twins, respectively?

A

65% MZ, 14% DZ

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85
Q

What is the ‘cognitive triad’ in depression?

A

Pessimistic and deprecatory about: 1) oneself 2) one’s experience, and 3) the future

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86
Q

What lab tests might be obtained before lithium use?

A

Renal and thyroid function, calcium leve. Others include a CBC with differential since a slight leukocytosis can occur

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87
Q

What is the risk of schizophrenia if one parent has schizophrenia?

A

10 to 15%

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88
Q

Is there an association between temporal lobe epilepsy (TLE) and the development schizophrenia?

A

One study showed 10% of children with TLE developed SZP

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89
Q

What is found in the conversational language of patients with schizophrenia?

A

They use fewer linguistic cohesive devices

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90
Q

What structures of the brain are reduced in schizophrenia?

A

Frontal-temporal area (the ventricles are increased)

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91
Q

When depressed, what percentage of adolescents would meet criteria for a personality disorder?

A

60%, i.e. about 2/3. 30% of these are for BPD. After the remission of the depression the PD symptoms are no longer evident

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92
Q

After a depressive episode in children and adolescents, do social skills deficits and psychological morbidity persist?

A

Yes

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93
Q

What are some elements of ‘pragmatic language’?

A

Conventions for eye contact, gestures, verbal and non-verbal cues, sustaining conversation, maintaining a shared topic, taking turns in dialogue

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94
Q

Does a Jehovah’s Witness practitioner have the right to refuse a blood transfusion for their child?

A

No

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95
Q

What percent of divorces have custody issues and conflicts arise?

A

<10%. 1.5% need to rely on a judge. When conflict is present 75% of families have little conflict; 25% have severe conflict

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96
Q

What is the central principal of custody and placement decisions?

A

The least detrimental alternative

97
Q

What is the least detrimental alternative for children in extreme cases where parents are ‘addicted’ to fighting?

A

In such instances it is best to support and protect the child’s relationship with the custodial parent

98
Q

Which are more sensitive to findings, structured or semi-structured interviews?

A

Structured

99
Q

Do increased levels of income lead to decreased levels of psychiatric disorders?

A

Yes, up to a point.

100
Q

What percentage of children live in two parent families?

A

69%

101
Q

In one study, what percentage of daycare centers are considered of good quality?

A

1 in 9. Family based daycares fare even more poorly

102
Q

What percent of divorces involve children?

A

60%

103
Q

What is an IEP?

A

Individualized Education Plan

104
Q

How often is an IEP reviewed?

A

Every 3 years (Triennial)

105
Q

Children subject to discipline who have not been evaluated for special education but who are suspected of meeting criteria have the same protections, true or false?

A

TRUE

106
Q

How many children are in out of home non-relative placements in the U.S.?

A

500,000 (1998 data)

107
Q

What is the average number of foster care placements for a child who enters the foster care system in Connecticut?

A

3.5

108
Q

Who was among the first to use home visitation as part of a comprehensive intervention?

A

Sally Provence (also David Olds)

109
Q

What is MST

A

Multisystemic Therapy

110
Q

Who developled MST?

A

Henggeler and Boroduin

111
Q

What population does MST primarily serve?

A

Children and adolescents with delinquency

112
Q

When was AACAP formed?

A

1953

113
Q

What is a fiduciary relationship?

A

One in which one person receives the trust or confidence of another and is under a duty to act for the benefit of that person

114
Q

What is the difference between confidentiality and privilege?

A

Privilege is a patient’s right to bar disclosure of treatment information in judicial or quasi-judicial proceedings. Confidentiality refers to treatment information and third parties

115
Q

Who popularized the term adolescence?

A

Stanley Hall in his two volume work on adolescence (1904)

116
Q

When did the subspecialty of child psychiatry emerge from the ABPN?

A

1957

117
Q

When did child guidance clinics emerge?

A
  1. A psychiatrist worked with the patient; a psychologist did testing; a social worker worked with the family
118
Q

Arnold Gesell saw behavior and life determined by____?

A

Biopsychosocial events; like Hall, his mentor, and unlike Watson a behaviorist

119
Q

How many children are substantiated victims of abuse, neglect or both?

A

One million

120
Q

How many children die each year because of abuse or neglect?

A

2000

121
Q

How many children are sexually abused each year?

A

130,000

122
Q

How many adolescents run away from home and live on the street?

A

Two million

123
Q

What percentage of runaways are absent from home many weeks or months?

A

15%

124
Q

There are two main types of runaway, what are they?

A

Pushed from home and running from home

125
Q

What is the lower age of consent to treat for drugs or alcohol?

A

There is no lower age limit. A 9 year old has the same rights to confidentiality as 17 year old.

126
Q

What are clinical features associated with Rett’s disorder?

A

Sleep-wake cycle disturbance; increased Q-T; orthopedic problems; decreased T4 and TSH; decreased bone density; feeding problems; respiration apneustic

127
Q

According to Thomas and Chess, what percentage of children are: easy, slow to warm-up, and difficult, respectively?

A

40% easy, 15% slow to warm-up, 10% difficult. The rest do not fit into a category. The temperaments are not a/w adult adjustment, but difficult temperaments have a harder time with stress.

128
Q

What constellation of behaviors in the NYLS by Thomas and Chess led to behavior disorder at age 9 for many?

A

Irregularity, withdrawal, predominanty negative mood, slow adaptability, high intensity

129
Q

By the age of 3 years, what percentage of child utterances continue the previous topic of conversation?

A

50% (Two year old kids can handle conversational breakdowns)

130
Q

At what age do telegraphic sentences appear?

A

18 months

131
Q

At what age do children utter 3-4 word sentences?

A

2 years

132
Q

What number of words does an 18 month old know?

A

100

133
Q

What number of words does a 24 month old know?

A

300

134
Q

What number of words does a 3 year old know?

A

900

135
Q

What number of words does a 4 year old old know?

A

1500

136
Q

What number of words does a 5 year old know?

A

2500

137
Q

What percentage of children who stutter at age 4 years recover?

A

Up to 85%

138
Q

By what age is the typical developing child fully intelligible?

A

4 years old

139
Q

At what age does the babbling of a child with deafness differ from a child with hearing?

A

4 to 8 months old

140
Q

When does reduplicative babbling occur?

A

6 months to 1 year. AKA ‘canonical babbling’, consonant-vowel sounds

141
Q

What are the four major components of language?

A
  1. Comprehension 2. Acquisition of speech sounds 3. Expression of words and sentences 4. Pragmatic communication
142
Q

At what age do babies distinguish the mother’s breast pad from others’?

A

Newborn

143
Q

At what age do sounds evoke movement in the fetus?

A

Third trimester

144
Q

Attention as a construct consists of what elements?

A

Strategic scanning, exclusion of irrelevant stimuli, sustained attention, divided attention, inhibition of impulsive action, selection and monitoring of response

145
Q

When does metacognition, thinking about thinking, begin?

A

3 years of age

146
Q

Which emerges first, implicit or explicit memory?

A

Implicit

147
Q

How many neurons are in the human brain?

A

Tens of billions (there are 10,000 synaptic junctions per neuron)

148
Q

Early child abuse is associated with impairment in what brain anatomic areas?

A

Corpus callosum and decrease in brain size

149
Q

The Australia temperament study showed that adolescents with anxiety disorders were shy as children, true or false?

A

False. They were not more shy. 2,443 kids studied

150
Q

Variability in temperament is accounted for by parent practice, true or false

A

FALSE

151
Q

The difficult versus easy temperament at age 3 related to early adult disposition, true or false?

A

TRUE

152
Q

What are the Thomas and Chess temperament categories

A
  1. Activity level 2. Rhythmicity 3. Approach or withdrawal 4. Adaptability 5. Threshold of responsiveness 6. Intensity of reaction 7. Quality of mood 8. Distractibility 9. Attention span and persistence
153
Q

An inhibited style is associated with right or left activation on EEG?

A

Right activation

154
Q

What did Jerome Kagan find regarding the development of anxious symptoms?

A

A 4 month old temperamental profile of high reactivity (and not the level of fearful or inhibited behavior in lab). This was better predictor than 14 and 21 month old behavior

155
Q

Describe the attachments of the Strange Situation

A

Securely attached; insecure-avoidant/ambivalent (delayed acknowledgment); insecure-resistant (anger or high passivity); insecure-disorganized (e.g. approaches parent with head avoided)

156
Q

Who introduced systemic desensitization?

A

Joseph Wolpe (1915-1997)

157
Q

What experiment are Watson and Rayner especially known for from 1920?

A

Study of Albert, an 11 month old. White animal (rat) for which he had no fear + loud noise (the latter is an unconditioned stimulus) –> startle. Eventually the white animal became the conditioned stimulus (CS) and a startle resulted from it alone (stimulus generalization)

158
Q

Who are key historical figures in operant conditioning?

A

Pavlov, Thorndike, Skinner

159
Q

What is negative reinforcement?

A

The likelihood of a response increasing by the removal of a negative or unpleasant stimulus or situation

160
Q

What is observational learning?

A

Social learning, learning by observing others (Bandura 1969)

161
Q

How is information processing related to cognitive development?

A

Encoding occurs; hold info on screen for appraisal and transform it into knowledge by connecting it to prior knowledge

162
Q

What are the views of Vygotsky?

A

Intelligence begins in the social environment and directs itself inward. Cognitive development is rooted in 3 genetic domains, phylogenesis, cultural hx, and ontogenesis. Culture’s psychological tools–language–are shared with and internalized by the child. Internalization of language gives rise to metacognition (thinking about thinking).

163
Q

What is the zone of proximal development?

A

The potential of a child to do something with support as opposed to what they can actually do. Scaffolding

164
Q

Children require higher or lower doses of opioids mg/kg than adults for pain?

A

Higher 2/2 more rapid tolerance (and relatively higher doses of chemo)

165
Q

What are some sequelae of bone marrow transplant?

A

Learning disorder, growth retardation, and infertility

166
Q

Which is ‘worse’, emotional or physical abuse?

A

Emotional abuse is a stronger predictor for internalizing and externalizing behaviors, low self-esteem, SI, social impairment, psychiatric disorders, and hospitalization

167
Q

Psychopathology in a proband tends to show what psychiatric disturbances in a parent

A

Mother depression; Father etoh, ASPD, lability

168
Q

What are the types or patterns of emotional abuse?

A

Rejecting, isolating, terrorizing, ignoring, corrupting

169
Q

What is the most common type of inflicted burn?

A

Scald

170
Q

What has been shown about kids who disclose their HIV status to peers?

A

No decrease in function or self concept. Increase in immune response

171
Q

There are approximately 20 million cases of STDs in the U.S.A. What percentage are in those aged 15 to 24?

A

50%

172
Q

Cyclosporine levels are effected by drugs which interact with which P450 system?

A

3A4

173
Q

If a mother reacts with depressive symptoms to a birth defect, is the severity of the reaction related to the magnitude of the defect?

A

No

174
Q

What percentage of mothers have a medical background in Caregiver Fabricated Illness?

A

30 to 50%

175
Q

What might be a father’s presentation in Caregiver Fabricated Illness?

A

Father may be demanding, overbearing, legal minded

176
Q

What is the presentation of a child with Caregiver Fabricated Illness?

A

Passively tolerates medical procedures. Child, especially older, may collude

177
Q

What percentage of children die from Caregiver Fabricated Illness?

A

9%. Another 8% may have permanent disfigurement. It is unclear if removal or not from family improves outcome. Brief foster placement appears to improve situation.

178
Q

At what age can children manage their insulin dependent diabetes on their own?

A

Starting at 12 years. Some older, some younger.This does not mean parent should not be involved.

179
Q

What do studies show about psychiatric disorders and malignancies in children?

A

Contradictory. Generally, if problems persist they are usually related to school (missed days). Those that do worse are children with cranial irradiation and intrathecal methotrexate.

180
Q

What is the perspective taking of 3 to 6 year olds?

A

Attributes own perspective to others

181
Q

What is the perspective taking of 6 to 12 year olds?

A

Self reflective and reciprocal perspectives; can see from another’s perspective

182
Q

What is the perspective taking of 10 to 15 year olds?

A

Third person and mutual; observing ego

183
Q

What is the perspective taking of 12 year olds?

A

In depth and societal, symbolic; understand that observing ego cannot understand the complexity of internal reactions; something is always hidden

184
Q

What is empathy?

A

Empathy has both an affective and cognitive component; vicarious affective response to another and the cognitive awareness of another person’s internal states. A person with sociopathy will often have cognitive empathy.

185
Q

What is theory of mind?

A

The ability to attribute mental states, such as thoughts, beliefs, intentions, desires, and feelings, to others and oneself

186
Q

What tests assess first order theory of mind, second order, third and higher order?

A

Smarties and Sally Anne Test, Ice Cream Van Story, 12 Stranger Stories.

187
Q

What is an example of second order theory of mind?

A

Where does person Y think person X will look for the object. E.g. false-belief test (Sally and puppet)

188
Q

What is an example of higher order theory of mind?

A

Does X mean what he says; what is X thinking or feeling

189
Q

What is mentalizing?

A

The ability and the drive to predict relationships between external states of affairs and internal states of mind

190
Q

What are the prevalence rates of psychiatric disorders for children, pre-adolescents, and adolescents, respectively?

A

10%, 13%, and 16.5%

191
Q

What percentage of children identified with a psychiatric disorder have two or more, according to the Great Smoky Mountain Study?

A

33% 

192
Q

What percentage of infants have a temperamental trait that predisposes them to being highly reactive in novel situations

A

20%

193
Q

What percentage of sex abuse cases are by adolescents?

A

20%

194
Q

What percentage of prepubertal children with depression have hallucinations?

A

48%. 36% report complex AH

195
Q

What is the point prevalence of depression in adolescents?

A

2 to 5%

196
Q

What did the National Comorbidity Survey show for lifetime prevalence of depression in adolescencts?

A

15.3% (For adults it was 17% suggesting most adult depression starts in adolescence)

197
Q

What percent of those with severe TBI have seizures as a complication?

A

33% (6% in mild TBI)

198
Q

For a proband with a reading disorder, what percentage of relatives have a reading disorder

A

40%

199
Q

What percentage of children with OCD have tics?

A

Up to 55% have tics. 15% have Tourette’s

200
Q

What is the concordance rate for depression in monozygotic and dizygotic twins

A

76% MZ, 19% DZ

201
Q

What percentage of those with bulimia nervosa had prior anorexia nervosa?

A

25 to 33%

202
Q

What is the rate of new psychiatric disorders after severe injury?

A

60%; 25% mild

203
Q

What percentage of infants have temperamental trait that predisposes them to being highly reactive in novel situations

A

20%

204
Q

What percentage of sex abuses are by adolescents?

A

20%

205
Q

What percentage of depressed prepubertal children have hallucinations?

A

48%; 36% report complex AH

206
Q

What is the point prevalence of depression in adolescents?

A

2 to 5%

207
Q

What percentage of those with learning disorders have ADHD?

A

20%

208
Q

What percentage of those with learning disorders have a psychiatric diagnosis?

A

50% (refers to children and adol)

209
Q

What percentage of children with learning disorders have social skills deficits?

A

up to 75%

210
Q

What percentage of children with subtance use disorders have a learning disorder?

A

Up to 70%

211
Q

What percentage of those with disruptive or depressive disorders have a learning disorder?

A

10 to 25%

212
Q

What percentage of those with a learning disorder have substance use disorder?

A

24%

213
Q

What percentage of those with conduct disorder have speech and language difficulties?

A

33%

214
Q

When there is the death of a parent what factors are associated with risk of psychiatric morbidity?

A
  1. Being less than 5 yo or an adolescent 2. For females less than 11 yo, loss of M; for adolescent males, loss of father 3. Premorbid psychiatric difficulties 4. Lack of social and community supports 5. An unanticipated death or SI or HI 6. Surviving parent has problems 7. Conflictual relationship of parents or parent remarries quickly
215
Q

Who is a key figure in pediatric PTSD research which involved a bus kidnapping?

A

Lenore Terr (Chowchilla CA incident; children kidnapped from bus, held in bunker)

216
Q

What is a re-enactment behavior in PTSD?

A

Replication of some aspect of the traumatic experience

217
Q

What is Type 1 vs. Type 2 trauma?

A

Type 1 is a single acute incident; Type 2 is chronic or ongoing

218
Q

In which type of anorexia, restricting or binge-purging, do majority of patients develop symptoms of the other type?

A

Restricting type develop binge-purging rather than other way around

219
Q

What is Pickwickian syndrome?

A

Respiratory hypoventilation, daytime hypersomnolence a/w severe obesity. Mortality rate of 40%

220
Q

What are the reasons for clinical hypothyroidism in Anorexia Nervosa?

A

Decreased T3

221
Q

What percentage of one’s bone mass is formed during adolescence?

A

90%. Those with onset of anorexia in adolescence are at risk for decreased bone mass

222
Q

How might a patient with anorexia view limits on safety?

A

It is evidence of imposed control but also unconscious relief that someone is taking over a situation that is out of control

223
Q

What therapy other than CBT has been shown to be effective for bulimia nervosa?

A

Interpersonal therapy (IPT)

224
Q

What has been found about the caudate’s size in Tourette’s disorder, increased or decreased?

A

Decrease in size (Peterson 2005)

225
Q

What has been found about oxytocin levels in tic related OCD vs. non-tic OCD?

A

Oxytocin is increased in the CSF for those with non-tic OCD. It is the same for those with tic related OCD

226
Q

If a parasomnia persists or is present in adolescence, what should be considered?

A

A seizure disorder

227
Q

What is the likelihood of obesity if both parents have obesity?

A

80% (50% if one)

228
Q

What is the likelihood of obesity if 2 siblings have obesity?

A

80% (40% if one sibling)

229
Q

What is the correlation between obesity in infancy and later childhood, good or poor?

A

Poor correlation. Infant obesity is not a/w obesity in later childhood

230
Q

What is the definition of obesity in children based on body mass index percentiles

A

95% or greater. Overweight is 85 to 95%

231
Q

What is the key to PTSD treatment?

A

Expose the individual to traumatic cues under safe conditions, incorporating reparative and mastery elements in a structured manner

232
Q

Which researcher said parents are better at alleviating externalizing symptoms and children internalizing ones?

A

EJ Costello 1989, one of the authors of the Great Smoky Mountain Study, a larger epidemiological study run by Angold and Costello

233
Q

What is a social learning theory of PTSD formation?

A

It involves classical and operant conditioning. There is a classic unconditioned event with an unconditioned response. Operant conditioning after the trauma in that avoidant behaviors result in stimulus generalization

234
Q

What is the prevalence of PTSD in children and adolescents?

A

Ranges from 10 to 40% [40 seems high; doubt this figure includes impairment]

235
Q

A study of children with obesity found what three most common psychosocial events may be present in some cases?

A

Early separation from mother < 24 months; family dysfunction; exposure to traumatic or violent events

236
Q

What leads to diabetes insipidus in anorexia nervosa?

A

Abnormal vasopressin secretion

237
Q

What percentage of patients with anorexia nervosa have amenorrhea that precedes the weight loss?

A

20 to 30% and it persists despite weight gain

238
Q

How is insulin-like growth factor (IGF-1) implicated in anorexia nervosa?

A

It is a nutritionally dependent endogenous bone trophic factor

Child & Adolescent Psychiatry Review (6 decks)

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