Ch 17-Childhood/Adolescence Flashcards
Child vs Adult clinical
- children less verbal with thoughts/feelings
- information gathered in other verbal/non-verbal ways
- expectations of behaviors different
- Must work with parents
Risk factors for childhood disorders
- parent psychopathy
- family discord/divorce
- lower SES
- child temperament issues
- stressful experiences
- early physical/health problems
- prenatal/perinatal difficulties
Neurodevelopmental disorders
developmental deficits that can impair a range of areas (social and/or academic functioning)
Autism spectrum disorder
- Impairment in social interactions/communication skills (range from mutism to echolalia)
- difficulties with perception of sensory stimuli (hypo or hyperactivity)
- 75% show some degree of intellectual disability (higher end of spectrum)
Autism spectrum prevalence
1 in 88 children recent increase: -increased awareness? -broadening of diagnostic criteria? -increased parental age -other environmental toxins/factors -rates higher in males
Treatments of autism spectrum
- often use operant conditioning
- Lovaas method, applied behavioral analysis, discrete trials training, early start denver model
Early start denver model
Autism spectrum
-works on improving several skills at once
Attention Deficit-Hyperactivity Disorder (ADHD)
- INATTENTION: fails to follow through on tasks, frequent shifts from topic to topic
- HYPERACTIVITY: jumps around, cannot sit still, fidgets, talks excessively
- IMPULSIVITY: acts out of turn, often interrupts, engages in risky/dangerous behaviors
Prevalence ADHD
more male children
11% of children
- overdiagnosed?
- misdiagnosed?
- over medication?
Combined type ADHD
- must have at least 6 sx’s associated with attention deficit,
- 6 sx’s associated with hyperactivity/impulsivity
Predominately inattentive type ADHD
- must have at least 6 sx’s associated with attention deficit
- must have LESS than 6 sx’s associated with hyperactivity/impulsivity
Predominately Hyperactivity/Impulsivity type ADHD
- must have 6 sx’s associated with hyperactivity/impulsivity
- & LESS than 6 sx’s associated with attention deficit
Diagnostic criteria of ADHD
DSM 4: sx’s must be present before age 7
DSM 5: sx’s must be present before age 12 & impairment must be seen in at least 2 settings & observed by 2 different sources
additional features of ADHD
- often fail in school: lack of focus? problem in structure of school systems? Bias on part of school personnel?
- may put child at risk for future antisocial behavior
Proposed causes for ADHD
- metabolic dysfunction in brain areas associated with dopamine & norepinephrine (inadequate levels)
- decreased activity in areas associated with attention & movement
- lack of synchrony in DMN
- difficulties at birth (hypoxia)
- findings on diet mixed
- families with Antisocial PD, alcoholism, depression, bipolar, anxiety disorders
Gabrieli study on Default Mode Network (DMN
adults who had not recovered from ADHD showed lack of synchrony in the functioning of the DMN
Tic disorders
often comorbid with ADHD
Tics: involuntary, sudden, stereotyped motor movements
Transient tic disorder
greater than 4 weeks
but less than 1 year
Chronic tic disorder
greater than 1 year
Tourettes disorder prevalence
1/2 who have tourettes also have ADHD but NOT vice versa
-more common in males
Tourettes disorder
sx’s must begin before 18
- motor & vocal tics
- impulse control: smaller frontal brain volume–>less control of impusles
Coprolalia
sudden uttering of obsenities
Externalizing disorders
“acting out”
conduct disorder
more serious than just pranks
-predictive of antisocial PD
- rule breaking
- behavior violates rights of people/animals
conduct disorder prevalence
1-10% children
-more common in males
gender differences of conduct disorder
Males: aggressive, confrontational behaviors
Females: more substance abuse, truancy, prostitution, running away
Oppositional Defiant Disorder
not all ODD go onto CD, but almost all CD first had ODD
- argumentative, irritable, defiantly negative, resentful, temper issues
- no harm to others
Oppositional defiant disorder prevalence
onset: usually before 8 years
before puberty: more males
after puberty” equally male & female
risk factors for CD, ASPD, & ODD
- problems with hyperactivity & inattention
- parental rejection and/or abuse
- having delinquent friends
Disruptive Mood Dysregulation disorder (DMDD)
- irritability, temper issues, frequent tantrums
- significantly exaggerated in intensity & duration
- cannot be diagnosed b/f 6 years, and not after 18 years
- sx/s more related to mood disorder/depression than ODD
Internalizing disorders
“acting in”
more females
- separation anxiety disorder
- reactive attachment disorder
fears & phobias
- sx’s present for at least 6 months
- exposure treatments used
sx’s: crying, tantrums, screaming
Generalized Anxiety disorder
- anticipatory anxiety
- excessive worry
- poor self-esteem
- trouble with social relations
- somatic problems/complaints
OCD children
repetitive thoughts/rituals
- washing, checking, ordering
prognosis: not good, ~50% recover
treatment: exposure & response prevention
OCD differences in prevalence rates of adults & children
adults: equally male/female
child: higher rates in males
separation anxiety disorder
excessive anxiety when separated from familiar people
sx’s: headaches, diarrhea, vomiting
- must last at least 4 weeks in children
(adults: show for at least 6 months)
Separation anxiety prevalence by gender
preschool ages: equally male/female
pre-adolescence: more females
Childhood depression gender differences
Males: irritability, hostility, social withdrawal, “acting out”
females: body image problems, loss of appetite, dissatisfaction with life, somatic sx’s, “acting in”
