CAP1 Flashcards
1
Q
Which two antipsychotics have the least effect on QTc ?
A
Aripiprazole and olanzapine
2
Q
Clonidine is an agonist at what receptor?
A
alpha 2a 2b 2c
3
Q
Guanfacine is an agonist at what receptor
A
alpha 2, primarily 2a
4
Q
What does marijuana impair?
A
short term memory, visual motor functioning
5
Q
What are the side effects of PCP?
A
agitation, delusions, hypertension, flushing, diaphoresis
6
Q
What are the consequences of inhalant use?
A
hearing loss, peripheral neuropathy, CNS brain damage, liver, kidney, bone marrow deterioration
7
Q
What are the stages of stopping behavior in motivational interviewing?
A
Pre-contemplation, contemplation, preparation, action
8
Q
Does anxiety precede substance use disorders or ‘post’cede them?
A
Likely to precede
9
Q
What is successful at treating night fears?
A
Emotive imagery. Children are trained to imagine a super hero
10
Q
What percent of children have at least one sleep walking episode?
A
15%
11
Q
How do yo treat sleep terrors and sleep walking?
A
Time them and wake 10-15 minutes earlier
12
Q
What percentage of children 6 to 12 years have nightmares?
A
20%
13
Q
A closed head injury leads to what sleep disorder?
A
Circadian rhythm sleep disorder
14
Q
By what age should imaginary companions end?
A
8 years of age
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
16
Q
What is the disease fatality rate for Neuroleptic Malignant Syndrome NMS in children?
A
9%
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
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)
19
Q
Discontinuing lithium makes a difference or no difference in pediatric bipolar disorder?
A
Relapse more likely (Strober 1990)
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.
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).
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.
23
Q
What are the key cognitive side effects of topiramate?
A
Cognitive blunting and word retrieval difficulties
24
Q
What is the prevalence of bipolar disorder in adults?
A
1-2%
25
What percent of highschoolers have tried drugs or alcohol by 12th grade?
85%
26
Which persons with alcoholism do worse by Cloninger and Babor's classification?
Type 2, Type B
27
Is THC use genetic or environmental?
Experimental use has a more environmental component. Dependence is more likely to have genetic underpinnings
28
What is the mean elimination half-life of THC?
4 days
29
What percentage of suicide victims have/had relatives with suicidal tendencies
60% (compared with 12% for non-suicidal teens)
30
A family history of suicide increases risk of suicide by how much?
5 times for females and 3 times for males
31
in one study, what percent of children who commit suicide had history of attempt(s)
26-33%
32
Do LGBTQQIAP youth have an increased risk of suicide?
Yes. Although, sexual identity or orientation per se has likely little to do with the increased risk
33
What is the suicide rate for youths aged 10 to 18?
5/1000
34
CDC data has shown what percentage of high school students have had a suicidal idea, a plan, and an attempt in the last year?
17 %, 14%, and 2% respectively
35
The Youth Risk Behavior Surveillance System showed what percentage of high school youth report rarely or never wearing a seatbelt?
6%
36
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?
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
37
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?
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
38
The Youth Risk Behavior Surveillance System showed what percentage of high school students had ever drunk alcohol?
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.
39
The Youth Risk Behavior Surveillance System showed what percentage of high school students had used THC?
36%
40
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?
40%
41
The Youth Risk Behavior Surveillance System showed what percentage of high school students had sexual intercourse?
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.
42
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
46%
43
In a self-report measure of children with depression, what were the top three symptoms?
1. Aches and pains 2. Sad affect 3. Helplessness/ hopelessness
44
What is higher, the number of suicides or homicides?
Homicideses
45
What is a crisis hotline and text line for suicidal thinking?
Calling: 1-800-273-TALK (8255) Texting: text home to 741741
46
What percentage of children and adolescents have a second depressive episode within two years after the first remits?
40% within two years, 75% within 5 years
47
What has been found of mothers of depressed children in their management of their children?
They use more reactive and fewer pre-emptive strategies; reactive strategies predict conduct problems
48
What are features of children with depression, besides symptoms?
Heightened empathy; misplaced sense of responsibility; unrealistic ideas about helping others
49
What percentage of high school students report having been bullied in the previous year?
19%
50
What is the ratio of suicide attemtps to suicide completions in youth?
50:01:00
51
What percent of suicide victims have had mental health treatment?
30 to 50%
52
What are the odds ratios of suicide in an adolescent with: 1) a prior attempt 2) major depressive disorder 3) substance use disorder
1) 22.5 for prior SA 2) 8.6 for MDD 3) 7.1 for Sub Use
53
In interpersonal psychotherapy by Klerman what are the four areas of interpersonal concern?
1. interpersonal deficits 2. interpersonal role conflicts 3. abnormal grief 4. role transitions. A modification for adolescents is single parent families
54
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?
31.50%
55
What are the elements of problem-solving?
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  
56
What are two types of cognitive dysfunction?
1. Deficiency 2. Distortion
57
What does "cognitive structures" refer to?
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
58
Does psychotherapy work?
In a meta-analysis of 100 studies Weisz 1987 found an effect size of 0.79 for all therapies combined
59
What percentage of adolescents will have a depressive episode by age 18?
20%
60
Where do most adolescent suicides occur?
After school hours and in a teen's home; most are precipitated by an interpersonal conflict
61
What time do most adolescent suicides occur?
Late afternoon, early evening
62
What precipitates suicide attempts in adolescents?
Family fight, parent-child discord, lower grades, long absence from school
63
What is the presumed lifetime risk of a mood disorder if both parents have mood disorders in their sides of the family?
100%; 24% if one parent's family; 17% if no extended family has a mood disorder
64
In one study, what percentage of children who were depressed and hospitalized were re-hospitalized within two years of first hospitalization?
80%
65
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?
56% for fluoxetine and 33% for placebo (CGI 1 = very much, 2 = much improved)
66
What are the key 'rhythmic' interventions in bipolar disorder?
Sleep and regular daily activities
67
What therapy has been shown to reduce suicidal behavior in adults?
Dialectical behavior therapy (DBT)
68
A history of sexual abuse increases the risk of a suicide attempt by how much?
8
69
Do suicide prevention telephone interventions seem to help reduce suicidality?
Yes with a small positive effect
70
What is the point prevalence of schizophrenia in 2 to 12 year olds?
2/100,000
71
What are some premorbid findings in schizophrenia?
Language development, speech and learning disorders, disruptive behaviors
72
What is the age of onset for schizophrenia
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
73
What percentage of children with schizophrenia have visual hallucinations?
Close to 100%
74
What did a group with childhood onset schizophrenia studied by Eggers 1978 and 1989 show about outcome?
20% showed remission, 30% had satisfactory social adaptation, 50% remained impaired
75
When was depression in children and adolescents first recognized in the US?
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.)
76
Emil Kraepelin found what percentage of persons with mania had an onset before 10 years of age?
0.40%
77
What percentage of children have atypical depression?
16.50%
78
The age of onset of depression is associated with duration or recovery?
Duration
79
What findings are there for cortisol and growth hormone in children with depression?
Cortisol hypersecretion and blunting of nocturnal growth hormone
80
What is the tricyclic antidepressant response compared to placebo in child and adolescent depression?
The same, a 50% response for both
81
What percentage of adolescents present with depressed mood as the index episode in bipolar disorder?
60%
82
What percentage of child and adolescent patients with bipolar disorder have ADHD? 
57 to 98% (Geller, Wozniak)
83
What is the concordance rate for depression in monozygotic and dizygotic twins, respectively?
54% MZ, 24% DZ
84
What is the concordance rate for bipolar disorder in Monozygotic and dizygotic twins, respectively?
65% MZ, 14% DZ
85
What is the 'cognitive triad' in depression?
Pessimistic and deprecatory about: 1) oneself 2) one's experience, and 3) the future
86
What lab tests might be obtained before lithium use?
Renal and thyroid function, calcium leve. Others include a CBC with differential since a slight leukocytosis can occur
87
What is the risk of schizophrenia if one parent has schizophrenia?
10 to 15%
88
Is there an association between temporal lobe epilepsy (TLE) and the development schizophrenia?
One study showed 10% of children with TLE developed SZP
89
What is found in the conversational language of patients with schizophrenia?
They use fewer linguistic cohesive devices
90
What structures of the brain are reduced in schizophrenia?
Frontal-temporal area (the ventricles are increased)
91
When depressed, what percentage of adolescents would meet criteria for a personality disorder?
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
92
After a depressive episode in children and adolescents, do social skills deficits and psychological morbidity persist?
Yes
93
What are some elements of 'pragmatic language'?
Conventions for eye contact, gestures, verbal and non-verbal cues, sustaining conversation, maintaining a shared topic, taking turns in dialogue
94
Does a Jehovah's Witness practitioner have the right to refuse a blood transfusion for their child?
No
95
What percent of divorces have custody issues and conflicts arise?
<10%. 1.5% need to rely on a judge. When conflict is present 75% of families have little conflict; 25% have severe conflict
96
What is the central principal of custody and placement decisions?
The least detrimental alternative
97
What is the least detrimental alternative for children in extreme cases where parents are 'addicted' to fighting?
In such instances it is best to support and protect the child's relationship with the custodial parent
98
Which are more sensitive to findings, structured or semi-structured interviews?
Structured
99
Do increased levels of income lead to decreased levels of psychiatric disorders?
Yes, up to a point.
100
What percentage of children live in two parent families?
69%
101
In one study, what percentage of daycare centers are considered of good quality?
1 in 9. Family based daycares fare even more poorly
102
What percent of divorces involve children?
60%
103
What is an IEP?
Individualized Education Plan
104
How often is an IEP reviewed?
Every 3 years (Triennial)
105
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?
TRUE
106
How many children are in out of home non-relative placements in the U.S.?
500,000 (1998 data)
107
What is the average number of foster care placements for a child who enters the foster care system in Connecticut?
3.5
108
Who was among the first to use home visitation as part of a comprehensive intervention?
Sally Provence (also David Olds)
109
What is MST
Multisystemic Therapy
110
Who developled MST?
Henggeler and Boroduin
111
What population does MST primarily serve?
Children and adolescents with delinquency
112
When was AACAP formed?
1953
113
What is a fiduciary relationship?
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
What is the difference between confidentiality and privilege?
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
Who popularized the term adolescence?
Stanley Hall in his two volume work on adolescence (1904)
116
When did the subspecialty of child psychiatry emerge from the ABPN?
1957
117
When did child guidance clinics emerge?
1921. A psychiatrist worked with the patient; a psychologist did testing; a social worker worked with the family
118
Arnold Gesell saw behavior and life determined by____?
Biopsychosocial events; like Hall, his mentor, and unlike Watson a behaviorist
119
How many children are substantiated victims of abuse, neglect or both?
One million
120
How many children die each year because of abuse or neglect?
2000
121
How many children are sexually abused each year?
130,000
122
How many adolescents run away from home and live on the street?
Two million
123
What percentage of runaways are absent from home many weeks or months?
15%
124
There are two main types of runaway, what are they?
Pushed from home and running from home
125
What is the lower age of consent to treat for drugs or alcohol?
There is no lower age limit. A 9 year old has the same rights to confidentiality as 17 year old.
126
What are clinical features associated with Rett's disorder?
Sleep-wake cycle disturbance; increased Q-T; orthopedic problems; decreased T4 and TSH; decreased bone density; feeding problems; respiration apneustic
127
According to Thomas and Chess, what percentage of children are: easy, slow to warm-up, and difficult, respectively?
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
What constellation of behaviors in the NYLS by Thomas and Chess led to behavior disorder at age 9 for many?
Irregularity, withdrawal, predominanty negative mood, slow adaptability, high intensity
129
By the age of 3 years, what percentage of child utterances continue the previous topic of conversation?
50% (Two year old kids can handle conversational breakdowns)
130
At what age do telegraphic sentences appear?
18 months
131
At what age do children utter 3-4 word sentences?
2 years
132
What number of words does an 18 month old know?
100
133
What number of words does a 24 month old know?
300
134
What number of words does a 3 year old know?
900
135
What number of words does a 4 year old old know?
1500
136
What number of words does a 5 year old know?
2500
137
What percentage of children who stutter at age 4 years recover?
Up to 85%
138
By what age is the typical developing child fully intelligible?
4 years old
139
At what age does the babbling of a child with deafness differ from a child with hearing?
4 to 8 months old
140
When does reduplicative babbling occur?
6 months to 1 year. AKA 'canonical babbling', consonant-vowel sounds
141
What are the four major components of language?
1. Comprehension 2. Acquisition of speech sounds 3. Expression of words and sentences 4. Pragmatic communication
142
At what age do babies distinguish the mother's breast pad from others'?
Newborn
143
At what age do sounds evoke movement in the fetus?
Third trimester
144
Attention as a construct consists of what elements?
Strategic scanning, exclusion of irrelevant stimuli, sustained attention, divided attention, inhibition of impulsive action, selection and monitoring of response
145
When does metacognition, thinking about thinking, begin?
3 years of age
146
Which emerges first, implicit or explicit memory?
Implicit
147
How many neurons are in the human brain?
Tens of billions (there are 10,000 synaptic junctions per neuron)
148
Early child abuse is associated with impairment in what brain anatomic areas?
Corpus callosum and decrease in brain size
149
The Australia temperament study showed that adolescents with anxiety disorders were shy as children, true or false?
False. They were not more shy. 2,443 kids studied
150
Variability in temperament is accounted for by parent practice, true or false
FALSE
151
The difficult versus easy temperament at age 3 related to early adult disposition, true or false?
TRUE
152
What are the Thomas and Chess temperament categories
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
An inhibited style is associated with right or left activation on EEG?
Right activation
154
What did Jerome Kagan find regarding the development of anxious symptoms?
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
Describe the attachments of the Strange Situation
Securely attached; insecure-avoidant/ambivalent (delayed acknowledgment); insecure-resistant (anger or high passivity); insecure-disorganized (e.g. approaches parent with head avoided)
156
Who introduced systemic desensitization?
Joseph Wolpe (1915-1997)
157
What experiment are Watson and Rayner especially known for from 1920?
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
Who are key historical figures in operant conditioning?
Pavlov, Thorndike, Skinner
159
What is negative reinforcement?
The likelihood of a response increasing by the removal of a negative or unpleasant stimulus or situation
160
What is observational learning?
Social learning, learning by observing others (Bandura 1969)
161
How is information processing related to cognitive development?
Encoding occurs; hold info on screen for appraisal and transform it into knowledge by connecting it to prior knowledge
162
What are the views of Vygotsky?
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
What is the zone of proximal development?
The potential of a child to do something with support as opposed to what they can actually do. Scaffolding
164
Children require higher or lower doses of opioids mg/kg than adults for pain?
Higher 2/2 more rapid tolerance (and relatively higher doses of chemo)
165
What are some sequelae of bone marrow transplant?
Learning disorder, growth retardation, and infertility
166
Which is 'worse', emotional or physical abuse?
Emotional abuse is a stronger predictor for internalizing and externalizing behaviors, low self-esteem, SI, social impairment, psychiatric disorders, and hospitalization
167
Psychopathology in a proband tends to show what psychiatric disturbances in a parent
Mother depression; Father etoh, ASPD, lability
168
What are the types or patterns of emotional abuse?
Rejecting, isolating, terrorizing, ignoring, corrupting
169
What is the most common type of inflicted burn?
Scald
170
What has been shown about kids who disclose their HIV status to peers?
No decrease in function or self concept. Increase in immune response
171
There are approximately 20 million cases of STDs in the U.S.A. What percentage are in those aged 15 to 24?
50%
172
Cyclosporine levels are effected by drugs which interact with which P450 system?
3A4
173
If a mother reacts with depressive symptoms to a birth defect, is the severity of the reaction related to the magnitude of the defect?
No
174
What percentage of mothers have a medical background in Caregiver Fabricated Illness?
30 to 50%
175
What might be a father's presentation in Caregiver Fabricated Illness?
Father may be demanding, overbearing, legal minded
176
What is the presentation of a child with Caregiver Fabricated Illness?
Passively tolerates medical procedures. Child, especially older, may collude
177
What percentage of children die from Caregiver Fabricated Illness?
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
At what age can children manage their insulin dependent diabetes on their own?
Starting at 12 years. Some older, some younger.This does not mean parent should not be involved.
179
What do studies show about psychiatric disorders and malignancies in children?
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
What is the perspective taking of 3 to 6 year olds?
Attributes own perspective to others
181
What is the perspective taking of 6 to 12 year olds?
Self reflective and reciprocal perspectives; can see from another's perspective
182
What is the perspective taking of 10 to 15 year olds?
Third person and mutual; observing ego
183
What is the perspective taking of 12 year olds?
In depth and societal, symbolic; understand that observing ego cannot understand the complexity of internal reactions; something is always hidden
184
What is empathy?
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
What is theory of mind?
The ability to attribute mental states, such as thoughts, beliefs, intentions, desires, and feelings, to others and oneself
186
What tests assess first order theory of mind, second order, third and higher order?
Smarties and Sally Anne Test, Ice Cream Van Story, 12 Stranger Stories.
187
What is an example of second order theory of mind?
Where does person Y think person X will look for the object. E.g. false-belief test (Sally and puppet)
188
What is an example of higher order theory of mind?
Does X mean what he says; what is X thinking or feeling
189
What is mentalizing?
The ability and the drive to predict relationships between external states of affairs and internal states of mind
190
What are the prevalence rates of psychiatric disorders for children, pre-adolescents, and adolescents, respectively?
10%, 13%, and 16.5%
191
What percentage of children identified with a psychiatric disorder have two or more, according to the Great Smoky Mountain Study?
33% 
192
What percentage of infants have a temperamental trait that predisposes them to being highly reactive in novel situations
20%
193
What percentage of sex abuse cases are by adolescents?
20%
194
What percentage of prepubertal children with depression have hallucinations?
48%. 36% report complex AH
195
What is the point prevalence of depression in adolescents?
2 to 5%
196
What did the National Comorbidity Survey show for lifetime prevalence of depression in adolescencts?
15.3% (For adults it was 17% suggesting most adult depression starts in adolescence)
197
What percent of those with severe TBI have seizures as a complication?
33% (6% in mild TBI)
198
For a proband with a reading disorder, what percentage of relatives have a reading disorder
40%
199
What percentage of children with OCD have tics?
Up to 55% have tics. 15% have Tourette's
200
What is the concordance rate for depression in monozygotic and dizygotic twins
76% MZ, 19% DZ
201
What percentage of those with bulimia nervosa had prior anorexia nervosa?
25 to 33%
202
What is the rate of new psychiatric disorders after severe injury?
60%; 25% mild
203
What percentage of infants have temperamental trait that predisposes them to being highly reactive in novel situations
20%
204
What percentage of sex abuses are by adolescents?
20%
205
What percentage of depressed prepubertal children have hallucinations?
48%; 36% report complex AH
206
What is the point prevalence of depression in adolescents?
2 to 5%
207
What percentage of those with learning disorders have ADHD?
20%
208
What percentage of those with learning disorders have a psychiatric diagnosis?
50% (refers to children and adol)
209
What percentage of children with learning disorders have social skills deficits?
up to 75%
210
What percentage of children with subtance use disorders have a learning disorder?
Up to 70%
211
What percentage of those with disruptive or depressive disorders have a learning disorder?
10 to 25%
212
What percentage of those with a learning disorder have substance use disorder?
24%
213
What percentage of those with conduct disorder have speech and language difficulties?
33%
214
When there is the death of a parent what factors are associated with risk of psychiatric morbidity?
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
Who is a key figure in pediatric PTSD research which involved a bus kidnapping?
Lenore Terr (Chowchilla CA incident; children kidnapped from bus, held in bunker)
216
What is a re-enactment behavior in PTSD?
Replication of some aspect of the traumatic experience
217
What is Type 1 vs. Type 2 trauma?
Type 1 is a single acute incident; Type 2 is chronic or ongoing
218
In which type of anorexia, restricting or binge-purging, do majority of patients develop symptoms of the other type?
Restricting type develop binge-purging rather than other way around
219
What is Pickwickian syndrome?
Respiratory hypoventilation, daytime hypersomnolence a/w severe obesity. Mortality rate of 40%
220
What are the reasons for clinical hypothyroidism in Anorexia Nervosa?
Decreased T3
221
What percentage of one's bone mass is formed during adolescence?
90%. Those with onset of anorexia in adolescence are at risk for decreased bone mass
222
How might a patient with anorexia view limits on safety?
It is evidence of imposed control but also unconscious relief that someone is taking over a situation that is out of control
223
What therapy other than CBT has been shown to be effective for bulimia nervosa?
Interpersonal therapy (IPT)
224
What has been found about the caudate's size in Tourette's disorder, increased or decreased?
Decrease in size (Peterson 2005)
225
What has been found about oxytocin levels in tic related OCD vs. non-tic OCD?
Oxytocin is increased in the CSF for those with non-tic OCD. It is the same for those with tic related OCD
226
If a parasomnia persists or is present in adolescence, what should be considered?
A seizure disorder
227
What is the likelihood of obesity if both parents have obesity?
80% (50% if one)
228
What is the likelihood of obesity if 2 siblings have obesity?
80% (40% if one sibling)
229
What is the correlation between obesity in infancy and later childhood, good or poor?
Poor correlation. Infant obesity is not a/w obesity in later childhood
230
What is the definition of obesity in children based on body mass index percentiles
95% or greater. Overweight is 85 to 95%
231
What is the key to PTSD treatment?
Expose the individual to traumatic cues under safe conditions, incorporating reparative and mastery elements in a structured manner
232
Which researcher said parents are better at alleviating externalizing symptoms and children internalizing ones?
EJ Costello 1989, one of the authors of the Great Smoky Mountain Study, a larger epidemiological study run by Angold and Costello
233
What is a social learning theory of PTSD formation?
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
What is the prevalence of PTSD in children and adolescents?
Ranges from 10 to 40% [40 seems high; doubt this figure includes impairment]
235
A study of children with obesity found what three most common psychosocial events may be present in some cases?
Early separation from mother < 24 months; family dysfunction; exposure to traumatic or violent events
236
What leads to diabetes insipidus in anorexia nervosa?
Abnormal vasopressin secretion
237
What percentage of patients with anorexia nervosa have amenorrhea that precedes the weight loss?
20 to 30% and it persists despite weight gain
238
How is insulin-like growth factor (IGF-1) implicated in anorexia nervosa?
It is a nutritionally dependent endogenous bone trophic factor
