CAP6

Question 1

What did Widom (1989) say regarding parental aggression and child aggression?

Answer 1

No convincing evidence of a clear link that a child who is aggressive has parents who are aggressive; rather certain processes transmit aggression: 1) injurious actions are normal and justified. 2) egocentrism is normal and virtuous

Question 2

What did a 10-15 year follow-up study of inpatient patients with anorexia show regarding outcome?

Answer 2

75% do not have an eating disorder and recovery time is about 5 years (Strober et al. 1997); 15% had chronic anorexia

Question 3

What do bone density findings show in anorexia?

Answer 3

90% have bone density 1 standard deviation below normal; 38% have 2.5 standard deviations below

Question 4

What is the outcome of OCD per follow up data?

Answer 4

In children, Swedo found that 30% met criteria 2 years later and had lower scores of OCD; there was a 70% recovery rate. Many, however, had depression and anxiety despite the improved OCD

Question 5

What did an RCT multisite study by March et al. 1998 show regarding SSRI treatment?

Answer 5

In children, 42% of patients had a reduction of 25% of symptoms. Sertraline was used.

Question 6

What are the recommendations regarding tricyclic antidepressants and the cardiovascular system?

Answer 6

Obtain an EKG at baseline and at 3mg/kg/day and at the final dose not to exceed 5mg/kg/day. Parameters should remain be follows: PR interval less than .21; QRS changes no more than 30% over baseline; heart rate less than 130; systolic BP less than 130; diastolic BP less than 85 (Elliott and Popper 1990)

Question 7

What is the long -term urinary continence for treatment with imipramine, DDAVP, and the alarm system after weaning from therapy?

Answer 7

Imipramine 36% with treatment, 16% once discontinued; DDAVP 68% with treatment and 10% discontinued; alarm 63% with treatment and 56% when discontinued

Question 8

What are common laboratory findings in anorexia?

Answer 8

Decreased anemia, leukopenia, hypoproteinemia, estrogen, testosterone, T3, diurnal cortisol, metabolism, bone density, hyposecretion of GnRH, and leptin. Increased CRH, hypercarotenemia, GH fasting (decreased response), HCG

Question 9

What are the key mental representations in attachment?

Answer 9

1) Attachment figure is accessible and emotionally available in time of need. 2) Feeling self-worthy and lovable

Question 10

What is the effect of a punitive style on moral development?

Answer 10

Dienstbier study 1984 showed that if children are coerced, they attribute resistance to external forces and if they are not discovered it is okay. If they are not coerced, they attribute resistance to their own choice

Question 11

Auditory hallucinations are associated with what brain structures?

Answer 11

Dysfunction in the primary auditory cortex in the anterior and middle superior temporal gyrus

Question 12

How are magical thinking and morbid fantasies related to delusions?

Answer 12

They are precursors if they are fixed and pervasive, the child acts on them, or the child does not accept the imaginary quality

Question 13

What can immediate termination of parental rights proceed?

Answer 13

Murder, rape, sexual abuse

Question 14

When can the state petition for termination of parental rights?

Answer 14

After 18 months if family reunification has failed and the child has been in foster care 18 months

Question 15

What is the most frequent outcome of children who are abused?

Answer 15

Aggression and attribution of hostile intent to peers

Question 16

Who helped prosecute the first child abuse case?

Answer 16

The Amercian Society for the Prevention of Cruelty to Animals (ASPCA)

Question 17

When was the concept of a child’s best interest originally acknowledged?

Answer 17

Chapsky v. Wood 1881

Question 18

Juvenile, family, and surrogate courts deal with what issues respectively?

Answer 18

Juvenile–delinquency, abuse, neglect. Family: divorce and child custody. Surrogate: civil commitment, guardianship, adoption, administration of trusts and estates, contested wills

Question 19

What is characteristic of children who are genuine victims of sex abuse compared to those who are not?

Answer 19

Children are genuinely ashamed, embarrassed, and less willing to reveal details. Children who falsely accuse embellish events, incorporate unrealistic details, have little discomfort in revealing the alleged acts

Question 20

What is the level of certainty required for termination of parental rights?

Answer 20

Clear and convincing evidence

Question 21

What did the federal government enact to address lack of stable, healthy, consistent attachment of children in foster care

Answer 21

Adoption Assistance and Child Welfare Act of 1980. It mandated social welfare agencies to help families remedy issues leading to removal of their children, and if reunification failed to begin permanency plans within 18-20 months

Question 22

What does Wheeler v. US (1985) find?

Answer 22

A 5 year old is not automatically disqualified as a witness

Question 23

What does media violence do?

Answer 23

According to some, increases aggression; desensitized to violence in the real world; creates perception of world as unfriendly and dangerous; risk of psychological problems

Question 24

What did Kent vs. U.S. (1996) decide?

Answer 24

Due process for juveniles being transferred to adult court

Question 25

What did in re Gault 1967 decide?

Answer 25

Due process rights for children, which includes notice of charges, a right to counsel the right to confront witness and cross examine, the privilege against self-incrimination, and the right to appellate review

Question 26

What decision allowed for pretrial detention of youth?

Answer 26

Schall v. Martin 1984

Question 27

What case said juveniles do not have a constitutional right to a jury trial?

Answer 27

In re Winship 1970

Question 28

What case declared that the standard of proof in juvenile cases should be beyond a reasonable doubt?

Answer 28

McKeiver v. PA 1971

Question 29

What did NJ vs. TLO 1985 decide?

Answer 29

A principal can search a student’s purse (belongings) without warrant

Question 30

What is a rationale for interpreting unconscious conflict?

Answer 30

To bring such material (and its behavioral and emotional derivatives) under greater control

Question 31

What study looked at children with autism resulting in higher IQ?

Answer 31

Lovaas 1987. 30 points higher with 40 hours a week of behavioral modification for two years  

Question 32

What is a hypothesis about fathers who can be abusive?

Answer 32

The father is extremely jealous of a spouse’s attention toward the targeted child, stemming from his own maternal deprivation and sibling rivalry.

Question 33

What four factors are involved in the extent of the psychological effects in sex abuse?

Answer 33

Traumatic sexualization, powerlessness, stigmatization, betrayal

Question 34

What percentage of kids average 5 years in foster care?

Answer 34

60% (Massachusetts study)

Question 35

What are cognitive factors in conduct disorder?

Answer 35

Social problems are based on the perception that others are hostilely motivated; have fewer and less effective solutions; less likely to get into trouble for exhibiting aggressive behaviors; fewer social problem-solving strategies; negative conflict management; delayed play skills; immature mode of role taking

Question 36

When was the first case of juvenile delinquency recorded?

Answer 36

3000-4000 B.C. Sumerian clay tablets

Question 37

What is NVLD?

Answer 37

Nonverbal learning disorder. It is postulated to result from right hemisphere deficits. Associated with math disorder; handwriting difficulties; deficits in spatial reasoning; visuomotor integration problems; and social skills deficits

Question 38

What percentage of those with juvenile delinquency have a learning disorder?

Answer 38

30% National Council on Disability (2003)

Question 39

In juvenile justice what does the Weinberger inventory show?

Answer 39

Personality functions along two dimensions, distress and self-restraint resulting in 4 types. Non-reactives are those that have both low distress and low self restraint. 90% of this subtype is re-arrested at 4.5 years. 

Question 40

What are examples of cognitive problem-solving skills?

Answer 40

Alternative solution thinking. Means end thinking. Consequential thinking. Causal thinking. Sensitivity to interpersonal problems. 

Question 41

What did Lewis say about children who are abused?

Answer 41

The capacity of abused children to repress or deny their own painful feelings or those of others, their emotional lability and impulsivity, distortion of reality, feeling of threat where no threat exists, tendency to put angry feelings into action rather than words, results in an enduring adaptational style with unlovable characteristics and results in clinicians’ tendency to dismiss severely abused children as conduct disordered or sociopathic

Question 42

What is the FIND acronym for Bipolar Disoder?

Answer 42

Frequency: most days Intensity: symptoms are severe enough to cause extreme disturbance in 1 domain or moderate in 2 or more Number: Symptoms 3-4 per day Duration: 4 total hours per day (and sleep decreased by 2 hours or more)

Question 43

What are elements of PCIT (Parent Child Interaction Therapy)?

Answer 43

Praise, reflection, imitation, description, enthusiasm (PRIDE). Deliver commands. For ages 2 to 7 with ADHD; Adapted for age 4-12 for parents who are abusive

Question 44

What are the elements of trauma focused CBT?

Answer 44

Child: coping skills training, emotional expression skills, cognitive coping training, relaxation training, gradual exposure and processing, education about child sexual abuse, healthy sexuality, personal safety skills

Question 45

What are resilient positives in a child for adaptation?

Answer 45

Good self esteem; engaging; desire to be loved and cared for; hope for the future; appreciates appropriate social behavior; fine and gross motor skills; higher IQ; internal locus of control; problems are viewed as external; psychologically minded; good social relationships; empathy; enjoys leisure; has best friend; can work; responds to discipline; has impulse control; able to put feelings into words

Question 46

What is QT dispersion?

Answer 46

Potentially more useful than QTc finding. The difference between the longest and the shortest QT on the EKG leads. Pathological if > 100ms difference among the leads or if increased 100% from baseline); 40-60 ms differences are considered acceptable.

Question 47

What are the detection time for drugs: stimulants, opiates, cocaine, THC, benzodiazepines?

Answer 47

Stimulants 48h Cocaine 3 days Opiates 2 days THC 4 days to 1 mo Benzos 4 days

Question 48

What is an alternative to the CAGE questions for adolescents?

Answer 48

CRAFFT C - Car; in car with driver high R - Relax; use drugs to relax, feel better, fit in A - Alone; use drugs alone F - Forget; forget things F - Family; family or friends mention it T - Trouble; trouble with law etc. (Knight et al. 1999)

Question 49

What EKG parameters would lead to a dose reduction if on a medication that might prolong them?

Answer 49

Qtc > 460, QRS > 120, PR > 200

Question 50

When was the first psychiatric unit established for adolescents?

Answer 50

in the 1930s for males; referred by the courts

Question 51

When is the last time a parent successfully sued a physician for the treatment of a minor 15 years or older without parental consent?

Answer 51

40 years ago (however a parent is not responsible for the cost of medical care if they do not consent to treat the minor)

Question 52

What is the most frequent source of legal suits against psychiatrists?

Answer 52

Drug reactions

Question 53

What is binge drinking definition and what percentage of high school seniors have binged in the last month?

Answer 53

Nationwide, 13.5% of students had had four or more drinks of alcohol in a row (if they were female) or five or more drinks of alcohol in a row (if they were male) within a couple of hours on at least 1 day during the 30 days

Question 54

How many cases were referred to child protective services in the USA in 2016?

Answer 54

4.1 million referrals. Of these referrals, approximately 2.3 million reports concerning approximately 3.6 million children (duplicate count) were screened in as “appropriate” for CPS response. Approximately 17.2 percent of the children investigated were found to be victims of abuse or neglect. The remainder of the children investigated 82.8 percent were found to benon-victims (Childwelfare.gov 2018)

Question 55

What is most common form of abuse?

Answer 55

ƒIn regard to CPS findings: 74.8 percent of victims suffer neglect.ƒ 18.2 percent of victims suffer physical abuse.ƒ 8.5 percent of victims suffer sexual abuse.ƒ 5.6 percent of victims suffer psychologicalmaltreatment.ƒ 2.1 percent of victims suffered medical neglect.ƒ 6.9 percent of victims experienced “other”maltreatment, which may include threatened abuseor parental substance use. States define “other”differently. (Childwelfare.gov 2018)

Question 56

What percentage of patients with suicidal ideas go on to make an attempt?

Answer 56

33%. 66% do so within the first year

Question 57

What is the odds ratio of suicidal ideation, plan, attempt if three or more psychiatric disorders are present?

Answer 57

OR 6, 9, 9

Question 58

Which disorder, depression or anxiety, is associated with a likelihood of suicidal thinking and which is associated with an attempt?

Answer 58

Depression–SI; anxiety–SA

Question 59

What test examines automatic links in the mind?

Answer 59

Implicit Association Test

Question 60

What is a measure of self-injurious behavior?

Answer 60

Functional Assessment of Self Mutilation

Question 61

Do those who self injure have a higher or lower physiologic response to stress?

Answer 61

Higher

Question 62

Among individuals who commit suicide in inpatient settings, what percentage deny suicidal ideas on last contact?

Answer 62

78%

Question 63

What is an evidence based measure for suicidality?

Answer 63

Columbia-Suicide Severity Rating Scale (C-SSRS)

Question 64

What might be more effective than the MMSE for screening cognition in emergency populations?

Answer 64

Brief cognitive screen (BCS). The BCS has four components: the two-part Oral Trail Making Test (OTMT) and animal fluency and and the Clock Drawing Test (CDT). http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2010.00682.x/full

Question 65

What is a reliable screen for depression for teens

Answer 65

The PHQ-9 (Patient Health Questionnaire - 9 items) screens for major depression in adolescents

Question 66

Describe the clock drawing test

Answer 66

The CDT requires the patient to generate a graphomotor representation of a clock face with a specific designated time. In the current administration, the patient is instructed to draw a clock and put all the numbers where they belong and to subsequently set the clock for 10 minutes past 11. The CDT can be scored using a 5-point system; 1 point each is given for 1) an adequate contour (size, circularity); 2) presence of all 12 numbers; 3) correct positioning of all numbers within appropriate contour quadrants; and correct placement of both the 4) hour and the 5) minute hands.

Question 67

Describe the animal fluency test

Answer 67

Name as many animals as quickly as possible. They can be from the farm, ocean, jungle, even house pets. The total animal fluency score represents the number of animals generated within a 1-minute interval. Repetitions are not included in the total score, but superordinate categories and category exemplars are considered valid responses

Question 68

Describe the Oral Trail Making Test (OTMT)

Answer 68

The OTMT consists of two parts. Part A (OTMT–A) requires the patient to count rapidly from 1 to 25; the patient is timed to completion. Part B (OTMT–B) requires repeatedly shifting between two cognitive sets; the patient is instructed, “I’d like you to count again, but now I want you to switch back and forth between numbers and letters, for example, 1–A–2–B–3–C, and so on. Keep going until I ask you to stop.” Test performance proceeds through number 13 and is timed to completion. If the patient is unable to acquire set or proceed beyond 3–C, the test is terminated and a score of 300 seconds is assigned to the performance. For cases in which the patient progressed beyond the clinician-provided example (1–A, 2–B, 3–C) but is subsequently unable to complete the test in its entirety (ending 12–L–13), his or her performance is prorated to yield an estimated time to completion. The OTMT–B consists of 25 individual steps (e.g., 1–A = 2 steps); estimated time to completion is calculated by multiplying the interval time (in seconds) at discontinuation by 25 and dividing that result by the number of steps actually completed

Question 69

What are the scores for response and remission on the Children’s Yale-Brown Obsessive Compulsive Scale.

Answer 69

A CY-BOCS reduction of 25% appears to be optimal for determining treatment response, a reduction of 45% to 50% appears to be optimal for detecting symptom remission, and a CY-BOCS raw score of 14 best reflects remission after treatment.

Question 70

What are three trait areas in psychopathy?

Answer 70

Interpersonal (egocentric), affective (callous), behavioral (impulsive)

Question 71

What seems to distinguish high psychopathic traits in children compared to adults?

Answer 71

High trait anxiety is associated with high psychopathy, which contrasts with adult findings

Question 72

Fetal exposure to elevations in which maternal interleukin led to structural neuroanatomic alterations among cases in regions of the brain consistently implicated in schizophrenia research

Answer 72

Interleukin 8

Question 73

Do callous-unemotional states extend lengths of stay for inpatient youth, beyond a diagnosis of conduct disorder or oppositional defiant disorder?

Answer 73

Yes.  To meet the therapeutic needs of hospitalized youth with prominent C/U traits, it has been suggested to utilize non-coercive and non-confrontational treatment programs that encourage patients to take personal responsibility for improving their lives

Question 74

What is a diagnostic instrument for children less than 7

Answer 74

Diagnostic Infant Preschool Assessment (DIPA)

Question 75

Atomoxetine has been shown to block which receptor, besides norepinephrine?

Answer 75

NMDA (of the glutamate system)

Question 76

Enuresis in ADHD is associated with what additional diagnosis?

Answer 76

ODD

Question 77

What do teenage girls who have a propensity for violence fail to discern in others’ faces?

Answer 77

Anger or disgust

Question 78

Over a 6-month period does risperidone cause cognitive decline?

Answer 78

No

Question 79

Do antipsychotics increase risk of insulin resistance mechanistically?

Answer 79

Increased insulin resistance may not be related to weight gain alone

Question 80

What was concluded in a randomized controlled trial with a total of 225 patients diagnosed with bipolar I who were randomly assigned in to 21 days of double-blind treatment with divalproex ER or placebo?

Answer 80

No difference from placebo

Question 81

What has been found, in one study, about the treatment of obsessive-compulsive disorder by experienced and non-experienced therapists?

Answer 81

Results indicated that clinically inexperienced master’s students with no postgraduate training can be as capable as experienced and certified behavior therapists in treating OCD patients, as long as therapists adhere to a standardized treatment manual and adequate training and supervision is provided. In contrast to other studies, it did not find a supposed benefit of therapist-controlled ERP versus self-controlled ERP in patients with OCD. RCT trial of 100+ patients. van Oppen et al. 2010

Question 82

What is the odds ratio for developing schizophreniform disorders by age 26 if psychotic symptoms are self reported at age 11?

Answer 82

A research team previously reported that members of the Dunedin (New Zealand) Longitudinal Study birth cohort who self-reported psychotic symptoms at age 11 years had an elevated risk of developing schizophreniform disorders by age 26 (odds ratio, 16.4; 95% confidence interval, 3.9-67.8).

Question 83

Children’s psychotic symptoms are familial and heritable and associated with what risk factors?

Answer 83

Children’s psychotic symptoms are familial and heritable and are associated with social risk factors (e.g, urbanicity); cognitive impairments at age 5; home-rearing risk factors (eg, maternal expressed emotion); behavioral, emotional, and educational problems at age 5; and co-morbid conditions, including self-harm.

Question 84

What did subjects with Research Diagnostic Criteria bipolar I disorder prospectively followed up for as long as 25 years show?

Answer 84

Mood episodes last on average 13 weeks. More than 75% recover from their mood episode within 1 year. Severe onset of an episode or years spent ill impact recovery (Solomon et al. 2010)

Question 85

In bipolar I is recovery from mania, hypomania or major depression more quick?

Answer 85

Mania, hypomania

Question 86

What has been found about racial disparities in psychotherapy use from 1996 to 2006?

Answer 86

Caucasians and African Americans access therapy equally and slightly more than Latinos. (Chen and Rizzo from date from the Medical Expenditure Panel Survey 1996 to 2006)

Question 87

One study showed the sustained recovery rate for mild to moderate depression to be?

Answer 87

25%. A total of 39 (24%) achieved sustained recovery, associated with being female, married/cohabiting, having a low BSI score and receiving preferred treatment. Based on 220 participants. (Dowrick et al. 2010)

Question 88

Psychotic-like experiences are common in the population. What are some factors that effect the persistence or increase over time in the adolescent population?

Answer 88

Three developmental subgroups of PLEs: (1) persistent; (2) increasing; (3) low. Adolescents on the persistent trajectory reported frequent victimization and consistently elevated scores in depression and anxiety. Adolescents on the increasing trajectory were engaging in cigarette use prior to any increases in PLEs and were engaging in cocaine, cannabis and other drug use as PLEs increased at later time points (Mackie et al. 2010)

Question 89

Who ends up worse, children with private coverage or those enrolled in public plans?

Answer 89

Children with special health care needs do better with public plans overall (Davis 2010)

Question 90

What’s an advantage of the MINI Kid International compared to the K-SADS PL?

Answer 90

The MINI-KID generates reliable and valid psychiatric diagnoses for children and adolescents and does so in a third of the time as the K-SADS-PL.

Question 91

Do highly aggressive boys, whether prosocial or less social, prefer highly aggressive or low aggressive friends?

Answer 91

They have no preference but they end up with aggressive peers. They also seek out peers that can provide emotional support but get peers who do not provide it.

Question 92

What about marital conflict is distressing to children?

Answer 92

Marital conflict that is intense, poorly resolved, and child-related has adverse effects on children, whereas conflicts that do not concern children and are resolved constructively and non-aggressively even if they occur frequently do not

Question 93

How do parents in marital conflict respond to their opposite sex children?

Answer 93

Fathers lower in marital satisfaction are more negative toward their daughters, and less maritally satisfied mothers are more likely to reciprocate sons’ negative affect and to respond negatively when their daughters were assertive. The reciprocal nature of this relationship is illustrated by the finding that, compared with children from happy marriages, daughters from less-satisfied marriages are less compliant with their fathers than with their mothers.

Question 94

What did a 13 year follow-up study of young Norwegian adults diagnosed with dyslexia in childhood show?

Answer 94

The dyslexia continued but educational attainment was only slightly lower than peers. Undheim 2009

Question 95

What did a large study show about prevalence rates for ODD if the ‘and-rule’ or the ‘or-rule’ is used?

Answer 95

Prevalence is 2.6% if one informant is used and 0.2% if two (parent and teacher). However, when one informant alone endorses ODD the other still endorses significant problems even if not full ODD

Question 96

Those with borderline personality disorder show what finding about empathy compared to controls?

Answer 96

Higher affective empathy compared to cogntive empathy. Opposite in controls

Question 97

What is the course of hyperactivity and innatention after foster care placement?

Answer 97

Average level of inattention declined according to the biological parent, whereas hyperactivity/impulsivity symptoms declined according to both biological and foster parents. Higher inattention was associated with lower parental warmth (foster parent), higher parental hostility (biological, foster, and teacher), and discharge from care (biological parent). Higher hyperactivity was also associated with lower parental warmth (foster parent) and higher parental hostility (biological and foster parent), higher (average) number of foster-home moves, and discharge from care (biological report). Higher teacher-derived hyperactivity symptoms were associated with a history of child abuse (versus neglect); however, abused children showed a steeper decline of hyperactivity over time than those with neglect histories.

Question 98

What can be said about heart rate response and trauma?

Answer 98

HRR to standardized trauma reminders at 1 month after the trauma differentiate between trauma survivors with and without PTSD, and predict chronic PTSD. Results are consistent with a role of associative learning in PTSD and suggest that early stimulus generalization may be an indicator of risk for chronic PTSD.

Question 99

In patients with abuse fractures what percentage had at least one visit in which it was missed?

Answer 99

Of 258 patients with abusive fractures, 54 (20.9%) had at least 1 previous physician visit at which abuse was missed. The median time to correct diagnosis from the first visit was 8 days (minimum: 1; maximum: 160). Independent predictors of missed abuse were male gender, extremity versus axially located fracture, and presentation to a primary care setting versus pediatric emergency department or to a general versus pediatric emergency department.

Question 100

What are the longitudinal outcomes of children with externalizing behaviors?

Answer 100

The developmental trajectories of the four types of externalizing behavior mostly predicted intrusive, aggressive and rule-breaking behavior in adulthood. Non-destructive behaviors in childhood such as opposition and status violations predict adult problems to a larger extent than destructive behaviors such as aggression and property violations. In general, children who develop through high-level trajectories are likely to suffer from both internalizing and externalizing problem behavior in adulthood, regardless the direction of change (i.e. increasing/decreasing/persisting) of the high-level trajectory

Question 101

How do household routines effect obesity in US pre-school age children?

Answer 101

U.S. preschool-aged children exposed to the three household routines of regularly eating the evening meal as a family, obtaining adequate nighttime sleep, and having limited screen-viewing time had an approximately 40% lower prevalence of obesity than those exposed to none of these routines.

Question 102

For acutely agitated patients with psychosis what is the pharmacotherapy approach with the best evidence?

Answer 102

Lorazepam administered with haloperidol. Battaglia 1997

Question 103

What is the 10 year diagnostic consistency of bipolar disorder in a first admission sample?

Answer 103

Overall, 50.3% of 195 respondents were diagnosed with bipolar disorder at every available assessment, but 49.7% (n = 97) had a diagnostic shift to a non-bipolar disorder at least once over the course of the 10-year study. Childhood psychopathology and poorer illness course were among the few variables associated with increased odds of a change in diagnosis. Even with optimal assessment practices, misdiagnosis of bipolar disorder is common, with complex clinical presentations often making it difficult to consistently diagnose the disorder over the long term. Ruggero et al. 2010

Question 104

What do suicide attempts show in bipolar I and II?

Answer 104

30%+

Question 105

Is there a difference between parent delivered ABA or therapist delivered ABA?

Answer 105

Not if there is sufficient supervision and training for parents

Question 106

How are auditory and visual hallucinations impacted by subjected loudness and inner speech network?

Answer 106

Strong activation of the inner speech processing network may contribute to the subjective loudness of AVH. However, a relatively increased contribution from right hemisphere language areas may be responsible for the more complex experiential characteristics, such as the non-self source or how real AVH are.

Question 107

What is one view of the emergence of inflexibility from a linguistic transactoinal model?

Answer 107

Rather than inflexibility being an inherent deficit, inflexibility emerges from conversational transactional patterns. Muskett et al. 2010

Question 108

What did the GAZEL youth study find?

Answer 108

Hyperactive-impulsive symptoms independently predict grade retention, failure to graduate from secondary school, obtaining a lower-level diploma, and lower academic performance. Negative academic outcomes are also significantly associated with childhood symptoms of conduct disorder

Question 109

What may explain the association between depression and mortality?

Answer 109

Cognitive hostility. 20,625 employees of the French national gas and electricity companies gave consent to enter in the GAZEL cohort in 1989. Depressive mood predicted mortality, even after adjustment for age, sex, education level, body mass index, alcohol consumption, and smoking. However, this association was dramatically reduced after further adjustment for cognitive hostility. Cognitive hostility was the only personality measure remaining associated with mortality after adjustment for depressive mood

Question 110

In assessing sexual recidivism risk in an individual with intellectually disability who sex offends, what must be distinguished?

Answer 110

Differentiating sexual deviance, the primary factor predisposing most individuals to criminal sexual violence, from impulsive, immature, and inappropriate behavior stemming from cognitive deficits

Question 111

What might be the relative risk for schizophrenia in fathers over 50 and younger than 25?

Answer 111

1.6 and 1.08 respectively. The younger fathers increase risk for male offspring but not females.

Question 112

Patients with learning disabilities seem to have what kind of coping pattern?

Answer 112

Ignoring the problem and not coping

Question 113

What is the adolescent clinical outcome for young people with ADHD?

Answer 113

In a UK study, most adolescents (69.8%) continued to meet full criteria for ADHD after 5 years and exhibited high levels of antisocial behaviour, criminal activity and substance use problems. Maternal childhood conduct disorder predicted offspring ADHD continuity; maternal childhood conduct disorder, lower child IQ and social class predicted offspring conduct disorder symptoms.

Question 114

What is the effect size for cognitive behavior therapy after taking into account publication bias?

Answer 114

0.42

Question 115

What is the risk of a psychiatric disorder in an offspring if respectively both parents have schizophrenia or both have bipolar disorder?

Answer 115

27.3% of offspring will have schizophrenia (39.2% when schizophrenia-related disorders are included) 24.9% will have bipolar disorder (36% if unipolar depression disorder is included)Up to 2/3 of offspring will have any psychiatric disorderOne parent with szp: 7% in offspringOne parent with bipolar: 4.4%No parents with szp: 0.86% szp in offspringNo parents with bipolar: 0.48% bipolar in offspringGottesman et al. From a large Danish data set of 2.6 million patients with treatment records.

Question 116

Do stimulants increase anxiety in the treatment of ADHD?

Answer 116

Not according to a meta-analysis. M. Bloch 2015

Question 117

Use of stimulants in pediatric settings showed what?

Answer 117

Improvement in parent and teacher symptom ratings, but not change in functional impairment

Question 118

What is choice impulsivity?

Answer 118

The term delay aversion has been used both to describe a behavioral tendency of greater preference for smaller-immediate over larger-delayed rewards (choice impulsivity) and to refer to a secondary explanatory construct put forward by delay aversion theory

Question 119

What did a 24 year follow-up study show regarding adult continuity of childhood psychopathology?

Answer 119

Of the participants who were classified as deviant [study term] in childhood, 22.2% were also classified as deviant in adulthood. Both homotypic and heterotypic continuity was found. Childhood aggressive, delinquent, and anxious/depressed problems were associated with most adult psychopathology. Attention problems did not predict later problems independently

Question 120

What is potentially more efficacious than usual care for suicidal and depressed adolescents according to one RCT?

Answer 120

Attachment Based Family Therapy

Question 121

What is the effect of stimulants on growth in ADHD treatment?

Answer 121

Weight and height effects

Question 122

Patients with somatoform disorders may show what on theory of mind and emotional awareness?

Answer 122

Patients with somatoform disorders requiring inpatient treatment manifest deficits in both emotional awareness and ToM functioning. These deficits may underlie the phenomenon of somatization.

Question 123

What is a problem with clinical outcome measures and recovery?

Answer 123

Consumer definitions of recovery and outcomes do not necessarily match clinicians’

Question 124

What is one clinical tool to assess patients’ capacities to make treatment decisions

Answer 124

MacArthur Competence Assessment Tool-Treatment (MacCAT- T)

Question 125

What is misleading vividness?

Answer 125

Misleading vividness is a term that can be applied to anecdotal evidence describing an occurrence, even if it is an exceptional occurrence, with sufficient detail to permit hasty generalizations about the occurrence (e.g., to convince someone that the occurrence is a widespread problem

Question 126

What is heuristic?

Answer 126

Heuristics refers to experience-based techniques for problem solving, learning, and discovery. Heuristic methods are used to speed up the process of finding a good enough solution, where an exhaustive search is impractical.

Question 127

What might have an effect on compulsiveness?

Answer 127

Activation of NMDA receptors may have an anti-compulsive effect in OCD patients

Question 128

What does stress do to DNA in rats brains?

Answer 128

One week after a single stressful event, a reversible DNA damage was identified in the prefrontal cortex and in the amygdala, whereas DNA damage in the hippocampus still remained.

Question 129

In adolescent parricides what may play a large role, emotionally?

Answer 129

Shame and humiliation (rather than PTSD or maltreatment)

Question 130

What percentage of patients report a 10 minute interval between a suicidal thought and act in referrals to a psychiatric university hospital center?

Answer 130

50%

Question 131

What is the increased rate of pregnancy in adolescents who had been sexually abused?

Answer 131

CSA increases the odds of experiencing an adolescent pregnancy by two-fold. Up to 4.5 out of 10 pregnant adolescents may have a prior history of CSA.

Question 132

What is the predictor of first episode psychosis 3 years out?

Answer 132

Demographic and neuropsychological measures relating to premorbid functioning are the best predictors of long-term outcome in first episode psychosis, with baseline psychiatric symptoms not contributing  

Question 133

What can be said about perspective taking in children with ADHD?

Answer 133

Children with ADHD use lower levels of social perspective taking, defining of problems, identification of feelings, and evaluation of outcomes than children without ADHD (irrespective of other factors)

Question 134

What does sleep do for suicide?

Answer 134

Short sleep appears to be associated with increased likelihood of suicidal ideation and suicidal attempt in adults independent of the effects of comorbid mental disorders

Question 135

Who first introduced the term psychiatry?

Answer 135

Professor Johann Christian Reil of Halle, Germany, first introduced the term ‘psychiatry’ in 1808. He argued that mental illness should be treated by physicians. He stressed the important relationships between physical and mental factors in illness and the role of psychotherapy as one of the main treatment approaches in medicine. He was a strong advocate of humane treatment and reduction of stigma.

Question 136

What can be said about race and hospitalization from an emergency room?

Answer 136

African-American pediatric patients are more likely to be hospitalized (OR=1.50)

Question 137

What is the link between threats to kill and future violence?

Answer 137

Of 613 individuals convicted of threats to kill, within 10 years, 44% of threateners were convicted of further violent offending, including 19 (3%) homicides. Sixteen threateners (2.6%) killed themselves, and three were murdered. Warren et al.

Question 138

What does ADHD treatment show when comparing meds to psychosocial treatment?

Answer 138

Both methylphenidate and psychosocial interventions can be effective in reducing ADHD and associated symptoms, e.g. ODD. Overall, core ADHD symptoms in the classroom respond better to medications.

Question 139

What is involved in the genetic testing of those with intellectual disabilities who do not have a clear etiology?

Answer 139

The approach to the evaluation of the patient in whom an etiologic diagnosis is not suspected after the history and physical examinations can include a standard karyotype, Fragile X molecular genetic testing, aCGH (array comparative genomic hybridization ), and neuroimaging, based on the evidence to date.

Question 140

What percentage of patients with first episode psychosis discontinue treatment within 12 months.

Answer 140

The number of patients who discontinue treatment for any cause within 12 months is 63%. Comparisons with haloperidol show lower risks for any-cause discontinuation with olanzapine, quetiapine and ziprasidone. However, symptom reductions are virtually the same in all groups at around 60%. Kahn et al.

Question 141

What has been found about self-harm in 14 year old adolescents?

Answer 141

Correlations between deliberate self-harm and general psychopathology, a relative absence of positive feelings toward parents, and a ruminative style of emotional regulation. Rumination/negative thinking and a relative absence of positive feelings toward parents are predictors of self-harm independently of general psychopathology.

Question 142

What does one need to be concerned about in the gastrointestinal system on clozapine?

Answer 142

Gastric hypomotility. Assess for constipation, use laxatives

Question 143

What can be said about Omega 3s and ADHD?

Answer 143

Might help with executive function

Question 144

What is the effect on religiosity and psychiatric illness?

Answer 144

The rates of psychiatric illness among those who report never attending religious services are not statistically different from those who either have always been religiously active or those who report changing patterns of attendance

Question 145

For young adult males what is the rate of substance use and sex during incarceration?

Answer 145

A survey of men with a history of incarceration, ages 18-29, revealed that 50% and 17% of participants, respectively, had used substances or had sex while confined. Seal et al.

Question 146

Can intelligence be trained?

Answer 146

Fluid intelligence is intelligence independent of prior experience and knowledge and is considered immutable. (However, one study showed that training on a demanding working memory task might help improve intelligence. Jaeggi et al.)

Question 147

Does outpatient versus inpatient treatment for anorexia nervosa make a difference?

Answer 147

First-line in-patient psychiatric treatment does not appear to provide advantages over out-patient management. A multicenter randomized controlled trial of 167 young people comparing inpatient, specialist outpatient and general child and adolescent mental health service treatment. Results: each group made considerable progress at 1 year, with further improvement by 2 years. Full recovery rates were poor (33% at 2 years, 27% still with anorexia nervosa). Adherence to in-patient treatment was only 50%. Neither in-patient nor specialist out-patient therapy demonstrated advantages over general mental health treatment by intention to treat. In-patient treatment (randomized or after out-patient transfer) predicted poor outcomes. Gowers et al.

Question 148

How does appraisal of trauma effect outcome in kids?

Answer 148

The majority of the variance of chronic posttraumatic stress is accounted for by negative appraisals about future harm. Cognitive models of PTSD would explain this and suggest that younger children who exaggerate their vulnerability after trauma exposure are at higher risk for PTSD after trauma

Question 149

What has been found about physical abuse and sexualize behaviors?

Answer 149

Maltreatment other than sexual abuse, and the developmental periods in which it occurs, may be linked to the development of sexualized behaviors

Question 150

Non-suicidal self injury is related to sexual trauma or psychiatric illness?

Answer 150

In studies that statistically controlled for psychiatric risk factors, childhood sexual abuse explains little or no unique variance in self-injurious behavior

Question 151

What is an example of a college suicide prevention program and how much did it reduce suicide?

Answer 151

In the fall of 1984, the University of Illinois instituted a formal program to reduce the rate of suicide among its enrolled students. At the core of the program is a policy that requires any student who threatens or attempts suicide to attend four sessions of professional assessment. The consequences for failing to comply with the program include withdrawal from the university. In the 21 years that the program has been in effect, reports on 2,017 suicide incidents have been submitted to the Suicide Prevention Team. The rate of suicide at locations within Champaign County (where the university is located) have decreased from a rate of 6.91 per 100,000 enrolled students during the 8 years prior to the program’s start to a rate of 3.78 during the first 21 years of the program. This represents a reduction of 45.3 percent. This reduction occurred against a backdrop of stable rates of suicide both nationally and among 11 peer institutions within the Big Ten.

Question 152

What percentage of parents are unaware of self-harm behavior by their children?

Answer 152

50%

Question 153

What is the relative risk of suicidal thinking on anti-epileptic drugs?

Answer 153

About 2

Question 154

What has been found about mothers and their view of sexual abuse on their child?

Answer 154

Practitioners should ask mothers whether they believe the abusers’ behavior was sexual and abusive. If mothers do not perceive sexual abuse, then they will not believe abuse occurred or attribute responsibility to the abusers.  

Question 155

Stigma begins at what age?

Answer 155

Children as young as three show some endorsement of stereotypes, which increases and seems to peak around age five to six. Older children show lower rates of prejudice

Question 156

What is the prevalence of depression and anxiety in adolescent substance users?

Answer 156

50 to 75%

Question 157

What can be said about high functioning autism and math?

Answer 157

Many have average ability, some have weaknesses, some are gifted

Question 158

What is the connection between child temperament and maternal discipline?

Answer 158

Children with difficult temperaments are more susceptible to negative discipline (i.e., they show more externalizing problems) as well as more susceptible to positive discipline (i.e., they show fewer externalizing problems and less physical aggression), as compared with children with relatively easy temperaments

Question 159

What are the rates of tardive dyskinesia for youths on second generation antipsychotics?

Answer 159

Annualized TD rates of 0.38%.

Question 160

What is nonviolent resistance to child behavior?

Answer 160

(a) parents commit themselves to a strictly nonviolent and non-humiliating stance; (b) parents assume responsibility for their own side in the escalation process; (c) whereas in a more usual kind of fight one’s goal is to defeat the adversary, in NVR the goal of the parents is to resist the child’s destructive behaviors, while protecting themselves and the children (both the perpetrator and the potential victims); and (d) the parents fight the child’s violence while at the same time maintaining and furthering the positive elements in the relationship.

Question 161

What are the effect sizes for the medication and therapeutic treatment of obsessive-compulsive disorder in children?

Answer 161

0.48 for pharmacotherapy and 1.45 for cognitive behavioral therapy (adjusted for publication bias)

Question 162

When stopping a stimulant when a child is taking both risperidone and a stimulant what should one watch for?

Answer 162

Acute dystonic reaction when a concomitant stimulant medication is discontinued.

Question 163

What is the role of prior trauma in PTSD emergence?

Answer 163

Prior trauma increases the risk of PTSD after a subsequent trauma only among persons who developed PTSD in response to the prior trauma.

Question 164

What does the Treatment for Adolescent Depression trial show for maintenance and continuation?

Answer 164

Total rates of sustained response by week 36 were 88.4% combined treatment, 82.5% fluoxetine, and 75.0% cognitive behavioral therapy.

Question 165

What is the stability of borderline personality disorder?

Answer 165

Of children known to have BPD in the primary school age-group, 80% meet the criteria for a personality disorder in adulthood and 16% met the criteria for BPD. In adults with BPD, 30% still meet the criteria two years later. The most stable symptoms are feelings of emptiness, anger, affect-instability, and identity problems. Less stable symptoms are suicidality, self-harm, impulsiveness, unstable relationships, derealisation, and paranoid thinking. Deschamps and Vreugdenhil

Question 166

What are the neuropsychological deficits for those at risk of psychosis?

Answer 166

Individuals with an at risk mental state for psychosis already show impairment of neuropsychological functions prior to the onset of the first psychotic episode and can best be distinguished from healthy controls on the basis of working memory.

Question 167

What are peer relations like for children with ADHD in regard to likability?

Answer 167

Children with ADHD like identified others more than they are liked back by the same

Question 168

What has been shown as an effect of melatonin in individuals with chronic insomnia and intellectual disability?

Answer 168

Advance of mean sleep onset time by 30 min, decrease of mean sleep latency by 30 min, increase of mean total sleep time by 50 min, reduction of the mean number of times the person wakes during the night by 0.4, decreases the mean duration of the night waking periods by 17 min, and advances endogenous melatonin onset at night by an average of 2 hours

Question 169

What is the rate of missed psychotic depression in one academic center study?

Answer 169

Psychotic depression had not been diagnosed prior to research assessments for one-quarter of patients

Question 170

When is suicide most likely to happen, during a patient’s first episode or second episode of Major Depression?

Answer 170

First

Question 171

Is youth aggression influenced by parental ideas?

Answer 171

Parent attitude can predict a youth’s aggressive behavior, even after controlling for a youth’s attitude

Question 172

Is the drug placebo difference greater than previously believed?

Answer 172

Perhaps, according to one hypothesis. In unipolar depression trials, perhaps all the placebo responders might have been anti-depressant responders as well, and so drug placebo difference is greater than thought

Question 173

Is paternal incarceration an independent risk factor?

Answer 173

Not necessarily. Controlling for socio-economic status, maternal mental health and substance use, parenting style and family adjustment, associations became non-significant. Kinner et al.

Question 174

What is the relationship between psychiatric treatment and later offense?

Answer 174

One study in Sweden, looked at 1,400 former patients followed into adulthood. Every third child patient treated between 1975 and 1990 (every second man and every fifth woman) had entered the Register of Persons Convicted of Offences during the observation period, a significantly higher rate than the general population; Engqvist and Rydelius. In a U.S. based study, youth with 3 or more diagnoses (16.0% of the studied population) accounted for 54.1% of youth self-reporting arrest for violent crime; Coker et al. Another study showed that of 1,420 child patients ages 9, 11, 13 followed from intake, 33% had offended by age 21; Copeland et al.

Question 175

What is a mentalizing model for the development of borderline personality?

Answer 175

The model suggests that disruption of the attachment relationship early in development in combination with later traumatic experiences in an attachment context interacts with neurobiological development. The combination leads to hyper-responsiveness of the attachment system which makes mentalizing–the capacity to make sense of ourselves and others in terms of mental states–unstable during emotional arousal. The emergence of earlier modes of psychological function at these times accounts for the symptoms of BPD. The model has clinical implications and suggests that the aim of treatment is not only to encourage development of mentalizing but also to facilitate its maintenance when the attachment system is stimulated.

Question 176

What is a quick may to assess hyperammonia in valproic acid treated patients?

Answer 176

Urine smell

Question 177

What are the rates of tardive dyskinesia and antipsychotic use for different age cohorts?

Answer 177

Stratified by age, annual tardive dyskinesia incidence rates are 0.35% with second-generation antipsychotics in children, 2.98% with second-generation antipsychotics versus 7.7% with first-generation antipsychotics in adults, and 5.2% with second-generation antipsychotics versus 5.2% with first-generation antipsychotics in the elderly

Question 178

What is the association between child abuse and health care use and costs?

Answer 178

Child abuse is associated with long-term elevated health care use and costs, particularly for women who suffer both physical and sexual abuse.

Question 179

What is the effect f lead level on development?

Answer 179

No level of lead exposure appears to be ‘safe’ and even the current ‘low’ levels of exposure in children are associated with neurodevelopmental deficits.

Question 180

What is the relationship of ADHD and substance use disorders?

Answer 180

ADHD is a risk factor for the development of SUD in adulthood. Conversely, approximately one fifth of adults with SUD have ADHD. Individuals with SUD and ADHD have a more severe and complicated course of SUD. Pharmacotherapeutic treatment of ADHD in children seems to reduce the risk for later cigarette smoking and SUD in adulthood.

Question 181

What reported assymetry is there in the basal ganglia in those with ADHD?

Answer 181

An increased left > right asymmetry of the basal ganglia

Question 182

What is the optimal serum lithium level in the long-term treatment of bipolar disorder?

Answer 182

The minimum efficacious serum lithium level in the long-term treatment of bipolar disorder is 0.4 mmol/L with optimal response achieved at serum levels between 0.6-0.75 mmol/L. Lithium levels >0.75 mmol/L may not confer additional protection against overall morbidity but may further improve control of inter-episode manic symptoms. Abrupt reduction of serum levels of more than 0.2 mmol/L is associated with increased risk of relapse. In the long-term treatment of bipolar disorder clinicians should initially aim for serum lithium levels of 0.6-0.75 mmol/L, while higher levels may benefit patients with predominantly manic symptoms. Severus et al.

Question 183

What has been found about lamotrigine for the acute treatment of bipolar depression in disorder in adults?

Answer 183

The efficacy of lamotrigine as maintenance treatment for bipolar disorder (BD), particularly for delaying depressive episodes, is well established, however, lamotrigine monotherapy has not demonstrated efficacy in the acute treatment of bipolar depression in four out of five placebo-controlled clinical studies; Calabrese et al. A follow up analysis of patient level data showed that lamotrigine can be effective for the more severely depressed patient, one wth a Hamilton Ratings Scale for Depression score of 24 or more; Geddes, Calabrese and Goodwin

Question 184

How does fluoxetine fare compared to placebo in preventing relapse in children and adolescents with depression?

Answer 184

Continuation treatment with fluoxetine is superior to placebo in preventing relapse and in increasing time to relapse in children and adolescents with major depression. Emslie et al.

Question 185

What is the association of pain killer overdose and eventual suicide?

Answer 185

A prior admission for a weak analgesic poisoning increases incident risk ratio of suicide by 24. The effect is highest one week after an overdose with an effect of 740, decreasing over time remaining high three years out

Question 186

What are the three dimensions of oppositionality in youth?

Answer 186

Irritability, hurtful and headstrong

Question 187

What is the optimal blood level for valproate for bipolar I disorder in adults?

Answer 187

The target blood level of valproate for best response in acute mania is above 94 μg/ml. Wozniak 2006

Question 188

What areas of cognitive development does cannabis use affect in adolescents?

Answer 188

Recall memory, perceptual reasoning, inhibition and working memory. Conrod et al.

Question 189

Is violent video game play by adolescents associated with increases in physical aggression over time?

Answer 189

Yes, according to at a Dartmouth meta-analysis published in the Proceedings of the National Academy of Sciences (PNAS) in 2018. This remains a controversy.

Question 190

In male-female teen dating physical violence who is the more common victim?

Answer 190

Depends on the survey question and location. In a study of 35,900 youth in British Columbia in Canada in grade 7 to 12 who were in dating relationships, researchers found 5.8 per cent of boys and 4.2 per cent of girls said they had experienced dating violence in the past year–being pushed, hit or slapped. In the U.S. Youth Risk Behavior Survey, The prevalence ofhaving experienced physical dating violence was higher among female (9.1%) than male (6.5%) students

Question 191

What percentage of adolescents are considered completely adherent to their medication?

Answer 191

60%. 40% are non-adherent to varying degrees. Niemeyer et al.

Question 192

The Child/Adolescent Anxiety Multimodal Extended Long-Term Study (CAMELS) showed what about remission?

Answer 192

Rates of remission in each year by treatment group ranged from 40% to 60% in CBT, 40% to 52% with sertraline use, and 41% to 49% with combination treatment. When rates of remission were examined within person across all 4 years, results indicated that 21.7% were in stable remission, 30% were chronically ill, and 48% were relapsers

Question 193

What is rapid onset gender dysphoria?

Answer 193

A controversial term that describes the phenomenon of youth who are observed by their parents to rapidly develop gender dysphoria symptoms over days, weeks or months during or after puberty. Until recently, it was unusual for a teen to report initial feelings of gender dysphoria during or after puberty without childhood symptoms.

Question 194

Which two antidepressants does the data most support for children and adolescents with major depression?

Answer 194

The evidence continues to support fluoxetine and escitalopram as first-line treatment and demonstrated effect to prevent relapse. Ignaszewski and Waslick

Question 195

What noradrenergic agent has shown promise for reducing alcohol consumption in adults?

Answer 195

Prazosin. From a double blind randomized controlled trial. Simpson et al.

Question 196

What does maternal depression increase in a child?

Answer 196

Exposure to early and chronic maternal depression can increase a child’s susceptibility to psychopathology and social-emotional problems, including social withdrawal, poor emotion regulation, and reduced empathy to others.

Question 197

What can be said about the height effects of methylphenidate?

Answer 197

1.29 to 2.55 cm decrease in final adult height with treatment. Significant effects on weight and height may require average doses of methylphenidate exceeding 1.5 mg/kg per day which are given continuously. Height suppression might not become statistically significant until the dose of MPH is ‚â•2.5 mg/kg/day for ‚â•4 years. Swanson et al.

Question 198

What might be the positive predictive value for an EEG given at 9 months of age for the diagnosis of autism?

Answer 198

Close to 100% in a Boston Children’s Hospital Study with a specific EEG algorithm. Bosl et al.

Question 199

Which agent approved for schizophrenia and bipolar depression in adolescents seems to have a good metabolic profile?

Answer 199

In a 6 week, double-blind, placebo controlled trial, lurasidone was not associated with clinically meaningful effects on body weight, lipids, measures of glycemic control, or prolactin. Goldman et al.

Question 200

What are the main cognitive skills that make up executive function?

Answer 200

Three core cognitive skills comprise executive function and its partner, self-regulation: mental flexibility, inhibitory control and working memory.

Question 201

What is a potential advantage about having a ‘growth mindset’ about intelligence?

Answer 201

Children who believe intelligence can grow pay more attention to and bounce back from their mistakes more effectively than kids who think intelligence is fixed. The validity of the ‘growth mindset’ for improved function as described by Dweck has been questioned, but here is an example of a benefit.

Question 202

How does angry parenting interact with ADHD?

Answer 202

A logistic regression demonstrated that both mothers’ and fathers’ Angry Parenting at wave 1 significantly predicted an ADHD diagnosis in children at wave 3. Demmer et al.

Question 203

What cognitive process might affect academic performance rather than ADHD symptoms themselves?

Answer 203

Low working memory rather than ADHD Symptoms might predict poor academic achievement in school-aged children. Simone et al.

Question 204

Is emotional dysregulation improved in children treated with methylphenidate independent of the treatment effect on their ADHD symptoms proper?

Answer 204

Yes, according to Kutlu et al. Symptoms of ADHD and ED were significantly improved with 1-year of MPH treatment. The improvement in ED was independent of improvement in ADHD symptoms and parent training.

Question 205

The mortality rate for those with oppositional defiant disorder and conduct disorder is increased in comparison to the general population. Which two additional co-morbid diagnoses increase this rate further?

Answer 205

ADHD and substance use

Question 206

Do patients with anxiety disorder learn from the ‘carrot’ or the ‘stick’?

Answer 206

Patients fail to learn from both rewards and punishments as well as healthy individuals do. Etkin et al.

Question 207

Are emotions innate or cognitive?

Answer 207

Emotions are not innately programmed into our brains, but, in fact, are cognitive states resulting from the gathering of information, according to some researchers.

Question 208

How does our brain process fear?

Answer 208

The amygdala and the hippocampus directly exchange signals when an individual recognizes emotional stimuli. Neurons in the amygdala fire 120 milliseconds earlier than the hippocampus. A unidirectional flow of information from the amygdala to the hippocampus occurs when fear is present. The amygdala first extracts emotional relevance and then sends this information to the hippocampus to be processed as a memory. Zhang et al.

Question 209

What is one theory about the effect of marijuana on life outcomes?

Answer 209

THC and poorer life outcomes may be due to a drug-induced decrease in willingness to allocate cognitive effort, rather than or in addition to impairments in fundamental cognitive abilities per se. Silveira et al.

Question 210

What is an another explanation for the inability to delay gratification when immediate versus delayed rewards are offered?

Answer 210

The inability to mentally travel in time

Question 211

What was the effect on the QTc in a population of 211 treatment naive children and adolescents receiving quetiapine, risperidone, or olanzapine over 12 months?

Answer 211

There was no observed mean increase in QTc or in heart rate. Alda et al

Question 212

What does the American College of Medical Genetic recommend about genetic testing?

Answer 212

In 2010, the American College of Medical Genetics recommended chromosomal microarray (CMA) as first-tier testing in the population of individuals with developmental delay, intellectual impairment, autism spectrum and multiple congenital anomalies. Fragile X remains indicated as CMA does not detect Fragile X. CMA can also detect most gross chromosome abnormalities detected by standard karyotype. Karyotype is still appropriate for patients who strongly fit the features of a specific chromosomal abnormality diagnosis, such as Down syndrome.

Question 213

Which three genes and their variants may contribute to aggressive or antisocial behavior in a manner of gene and environment interaction?

Answer 213

MAOA, BDNF, and 5-HTTLPR. Among carriers of the low activity variants of all three genes, those exposed to family conflict or sexual abuse or both reported high levels of delinquency while those who reported a positive and warm relationship with their parents reported little or no delinquency. Nilsson et al.

Question 214

What’s an intervention to reduce repetitive, negative thinking?

Answer 214

Getting enough sleep

Question 215

What is one predictor in pre-school of behavior problems in first grade?

Answer 215

Callous and unemotional behavior. A toddler who doesn’t feel guilty after misbehaving or who is less affectionate or less responsive to affection from others may have later behavior problems in 1st grade, and more so than than those who have ADHD or ODD. Waller et al.

Question 216

What is the effect of psychological controlling behavior by parents on teens?

Answer 216

Teens whose parents exert more psychological control over them when they are 13 have more problems establishing friendships and romantic relationships that balanced closeness and independence, both in adolescence and into early adulthood. Oudekerk et al.

Question 217

At what age can children detect anger in social interactions and then use that emotional information to guide their own behavior?

Answer 217

15 months. For some toddlers, their impulsive tendencies are also linked with the tendency to ignore other people’s anger, suggesting an early indicator for children who may become less willing to abide by rules. Repacholi and Meltzoff

Question 218

What risky behavior does perfectionism potentially increase?

Answer 218

Suicidality. Perfectionists can experience hopelessness (when they do not meet their own standards), psychological pain, life stress, overgeneralization, and a form of emotional perfectionism that restricts the willingness to disclose suicidal urges and intentions. Flett and Hewitt

Question 219

What is one unifying theory about autism?

Answer 219

It is a disorder of prediction. If we were unable to habituate to stimuli, then the world would become overwhelming very quickly. You cannot escape the cacophony that’s falling on your ears or that you’re observing. From this point of view, the repetitive behaviors, the preference for highly structured and predictable environments may be coping strategies. Sinha et al.

Question 220

What is the best time of day to take guanfacine ER for ADHD, morning, afternoon, or evening?

Answer 220

The time of day makes no difference. Rugino et al.

Question 221

What are the diagnostic cutoff levels for hemoglobin A1C and diabetes?

Answer 221

A1C <5.7 normal, 5.7 - 6.5 high risk (aka pre-diabetes), > 6.5 diabetes

Question 222

What is the evidence for interpersonal therapy for trauma?

Answer 222

It is non-inferior to exposure therapy and the dropout rate is much lower for IPT for those patients with comorbid depression. (14 week, randomized trial Markowitz et al.)

Question 223

One theory about teenage behavior and risk taking is that the prefrontal cortex is not fully developed. What is another?

Answer 223

The teenage prefrontal cortex is not much different than in the adult, but it can be easily overruled by heightened motivation centers in the brain

Question 224

What did Stappenbeck et al. in the journal Nature show about DNA transmission from parent to offspring?

Answer 224

In mice, the DNA of bacteria that live in the body can pass a trait to offspring in a way similar to the parents’ own DNA

Question 225

What is the effect of moving from a high poverty neighborhood to a lower poverty neighborhood on adolescents?

Answer 225

Moving from a high-poverty neighborhood to a lower poverty neighborhood is not associated with better mental health and risk behavior outcomes in adolescents. The continued effects of having grown up in a high-poverty neighborhood, the small improvements in the new neighborhood, the comparatively short length of time they live in their new neighborhood, and/or the stress of moving appears to worsen most of the mental health outcomes compared to control group participants who consistently live in the lower poverty neighborhoods. Byck et al.

Question 226

What is the National Sleep Foundation’s recommendations for sleep duration in children and adolescents?

Answer 226

School age children (6-13 yo): 9-11 hoursTeenagers (14-17 yo): 8-10 hours

Question 227

What are trait qualities more important than intelligence for academic success?

Answer 227

Openness and conscientiousness. People who are open to experience are more likely to be imaginative, sensitive to their feelings, intellectually curious and seekers of variety. Conscientious people, meanwhile, are disciplined, dutiful and good at planning ahead.

Question 228

What age is the peak of aggression in humans?

Answer 228

17 to 41 months

Question 229

The activation cannabinoid receptors by endocannabinoids (the brains native cannabinoids) leads to what?

Answer 229

Reduced anxiety. Chronic marijuana use downregulates cannabinoid receptors, leading to anxiety at first but increased anxiety in the longer run.

Question 230

What is the SAFETY Program

Answer 230

A cognitive-behavioral family intervention designed to increase safety and reduce suicide attempt, a brief intervention designed for integration with emergency services for suicide-attempting youths

Question 231

What is a facial expression-emotion children with ADHD may have trouble appreciating?

Answer 231

Anger

Question 232

What study showed that, in mice, that memories can be passed down genetically?

Answer 232

A mouse study by Gaydos et al. in Science showed that fearful memories of a smell could be passed on from parent to child without the child ever having experienced the smell.

Question 233

What is a style of regulation emotion that can lead to depression?

Answer 233

Rumination

Question 234

What percentage of patients with anorexia nervosa have major depressive disorder?

Answer 234

50% - 70%, 50% with anxiety

Question 235

What are Nagy’s (1948) categories for kids’ concept of death?

Answer 235

3-5 year olds, long sleep; 5-9, people die, not them, not everyone; 9-10+ death inevitable and may happen to me (The grasping of death has been revised downward since)

Question 236

Define impulsivity

Answer 236

Failure to resist an impulse, drive, or temptation, resulting in rapid unplanned reactions to internal or external stimuli

Question 237

What is a learning theory of aggression?

Answer 237

Child learns to escape unpleasant tasks by becoming hostile and negative (however, why some adopt this stance is unclear given the negative relationship consequences)

Question 238

Which receptors does ketamine affect?

Answer 238

Ketamine has been thought to be an NMDA receptor antagonist, its putative mechanism of action in depression. However, the recruitment of the opioid system has also been more recently implicated. Williams et al.