Chap 1: Introduction Flashcards
The earlier you experience the onset of a mental health disorder, the more likely you are to ….
be diagnosed with several disorders by the time you are in midlife
-> e.g. If first onset in adolescence, less than 10% had ‘only’ one mental disorder, most of them had 4-5 diagnosis. If first onset at ~45, most = 1 diagnosis.
What is Unique about Understanding and Treating Psychopathology in Youth? (5)
(1) Some disorders are ONLY diagnosed with childhood onset (e.g. Autism, ADHD)
(2) INDICATORS of a significant emotional or behavioral problem may be DIFFERENT (things might be more concerning at one age + kids’ brain/system of language is not fully developed - tummy aches vs ‘i don’t feel good’)
(3) Presentation OVER TIME might CHANGE (diff cog stages)
(4) Developmental differences may lead to differences in efficacy in treatment (involve family more in treatment)
(5) Who advocates for youth? (caregivers decide, impact on treatment as well)
Criteria for abnormal behavior (5)
(1) Norm Violation: Violation of a social, cultural norm
(2) Statistical Rarity
(3) Personal Discomfort
(4) Maladaptive Behavior
(5) Deviation from an Ideal
Norm Violation in criteria for abnormal behavior depends on: …
what your reference group is.
Are mental disorders rare? Give stats (DSM-IV criteria):
Lifetime prevalence of ANY disorder by age …: …
Lifetime prevalence of ANY disorder by age 75: ~12 - 47.4%
=> NOT statistically uncommon but significant impairment
Abnormal behavior is defined as a pattern of symptoms associated with: (3)
(1) Distress
(2) Disability
(3) Increased risk for further suffering/harm
“Disability” and “risk” can be defined by …
adaptational failure
-> Failure to reach dev milestones, or not right rate, lack of progress
Age 0-2:
- Normal achievement: …
- Common behavior: …
- Clinical disorders: …
- Normal achievement: eating, sleeping, attachment
- Common behavior: temper, toilet difficulties
- Clinical disorder: intellectual disability, feeding disorders, ASD
Age 2-5:
- Normal achievement: …
- Common behavior: …
- Clinical disorders: …
- Normal achievement: language, toileting, self-control, peer relationships
- Common behavior: arguing, demanding attention, fears, resisting bedtime
- Clinical disorder: speech disorders, pb stemming from abuse/neglect, phobias, anxiety
Age 6-11:
- Normal achievement: …
- Common behavior: …
- Clinical disorders: …
- Normal achievement: academic skills, rule-governed games, simple responsibilities
- Common behavior: arguing, inability to concentrate, showing off
- Clinical disorder: ADHD, learning disorders, school refusal, conduct pb
Age 12-20:
- Normal achievement: …
- Common behavior: …
- Clinical disorders: …
- Normal achievement: relationships (love), identity, separation from family, increased responsibilities
- Common behavior: arguing, bragging
- Clinical disorder: anorexia, delinquency, suicide, drug, schizophrenia, depression
DDST – Denver Dev Screening Test: Description
Commonly used in pediatric hospitals
On top: age ranges
Diff bars = diff type of behavior that a child might present
Bar = percentile range (25th percentile, 50th percentile, 75 percentile)
Dark Bar = bit late
=> The bar represents the range during which most children (from 25th to 90th percentile) achieve that skill.
If you are at the 25th percentile on the DDST for a given milestone, it means that 25% of children your age have already achieved this skill, while 75% have not yet reached it.
Developmental psychopathology framework (3)
(1) Broad approach to disorders of youth
(2) Stresses importance of developmental processes and tasks
(3) To understand maladaptive behavior, one must view it in relation to what is considered normative
Broad prevalence:
Ontario Child Health Study
- Children (ages 4- to 11-years): …%
- Adolescents (ages 12- to 17-years): …%
- Children (ages 4- to 11-years): 18%
- Adolescents (ages 12- to 17-years): 22%
Broad prevalence:
Great Smokey Mountains Study (US)
Cumulative prevalence of ANY DSM diagnosis BY AGE 21 was …%
61.1%
Broad prevalence:
Dunedin Birth Cohort Study
- …% with any disorder by age 15
- …% with any disorder by age 18
- 35% with any disorder by age 15
- 59% with any disorder by age 18
Impact is most severe when problems go … for …
untreated; extended periods of time
About …% of children with the most chronic and serious disorders face life-long difficulties.
20
-> Lifelong consequences associated with child psychopathology are costly
The Scope of the Problem: Getting treated for a mental disorder (3)
(1) Inadequate services to deal with size/demand of young people who need mental health services
(2) 1st point of contact often medical doctor (who might not be trained to deal with these problems)
(3) Racial/ethnic disparities in mental health service access
Around …% of pple having a DSM diagnosis receive actual treatment
35-45%
-> Inadequate services to deal with size/demand of young people who need mental health services
Racial/ethnic disparities in mental health service access: Why?
Financial concerns, treatment might not be adapted to culture
-> Lower levels of utilization due to unique barriers
Who Develops Psychopathology? (5)
(1) Gender (social and biological)
(2) Poverty and SES disadvantage
(3) Racial/Ethnic disparities in mental health
(4) Culture
(5) LGBTQ+ Youth
Diff between males and females in the TIMING and TYPE of disorders:
- Males: …
- Females: …
- Males show higher rates of disorders in CHILDHOOD: Early onset conduct/oppositional problems, ADHD, externalizing
- Females show higher rates of disorder in ADOLESCENCE: Depression, anxiety, eating disorders, internalizing
Socioeconomic (SES) disadvantage and Psychopathology (2): Scope of the problem
(1) Poverty linked with higher rates of MANY disorders
(2) Poverty isn’t always a chronic state
