Chapter 11: Abnormal Behavior Across the Lifespan Flashcards
What are neurodevelopmental disorders?
usually evident in childhood, often before grade school
especially in cultures with mandatory schooling
What are disruptive, impulse control, and conduct disorders?
problems with behavioral and emotional regulation
onset in adolescence or later
What are neurocognitive disorders?
disruptions in previously normal cognitive ability
diminution in ability, onset is later in life
Why are neurodevelopmental disorders important?
the psychological problems and experienced by children and young people are often especially poignant in that they affect children at a time in their lives when they have relatively little ability to cope
they don’t know what is normal, they don’t have the language to ask for help, and coping mechanisms can be externalized (act out)
some problems of childhood prevent children from reaching their potential; others mirror the problems faced by adults
finally, there are some problems unique to childhood or disorders that manifest themselves differently in children compared to adults
what is considered normal and abnormal for children must be considered in light of developmental issues in addition to factors such as ethnicity or gender, what is acceptable behavior at one age becomes unacceptable as the child grows older
What needs to be considered when discussing childhood mental disorders when compared to adult disorders?
previously, children were regarded as smaller adults, need to consider:
neurodevelopmental differences (tendency to engage in risk-seeking behavior in adolescence)
learning history (children don’t have the ability to be accurately empathetic, it isn’t developed yet)
emotional resilience (consequences of trauma, trauma-educated therapy)
solidification of personality (solidified in early adulthood)
How have children which neurodevelopmental disorders been treated historically?
caring for congenitally ill children is a relatively recent adopted social value
Ancient Greece: left to die, or thrown off a cliff if they appeared to have a disability
terminating pregnancies where testing of fetal cells has shown evidence of Down’s syndrome
lower surgical and medical priority for severely disabled individuals
What are the levels of intellectual disability?
based on level of adaptive functioning (whether or not a person can function in their environment), not IQ
mild, moderate, severe, or profound
social adjustment can have a significant bearing on life success
What are the prenatal factors that cause intellectual disability?
cytomegalovirus (CMV): might be asymptomatic, member of herpes family, attacks brain cells
inadequate diet during pregnancy
maternal (while pregnant)
drinking (FASD): teratogen, alters the course of fetal development, days 19, 20, 21 causes distinct facial features
valproate: treatment of epilepsy, same consequences as alcohol
smoking: reduce birth weight, which increases risk for disabilities
antidepressants, antihypertensive drugs
heavy metals (lead, mercury)
What are cultural-familial causes of intellectual disability?
cultural-familial intellectual impairment
don’t have the resources to provide things necessary for the child to develop
What are interventions that help children with intellectual disability?
mainstreaming: put children in regular classrooms to increase social skills
diagnostic overshadowing: two or more disorders, one is so prominent everything seems to be because of it they are less likely to be treated appropriately for depression, schizophrenia, etc.
What are some medical conditions that may cause intellectual disability?
down syndrome
fragile X syndrome
phenylketonuria (PKU): metabolic disorder, damage to CNS nerves
smith-lemli-opitz syndrome: inborn cholesterol synthesis disorder
tay-sachs disease: can’t break down fatty acids
What is savant syndrome?
is a condition where a person with a neurodevelopmental disorder can perform expectationally in a specific domain such a mathematics
occurs in 0.06% of those with intellectual disability and is closely linked to autism spectrum disorder, it occurs about six times more often in males than females
What is autism spectrum disorder?
a disorder that involves markedly impaired behavior or functioning in multiple areas of development
autism spectrum disorder becomes apparent in the first few years of life and is often associated with intellectual disability
What is Kanner syndrome?
parents were high functioning
kids hated engaging in social situations
extreme resistance to change
parents lacked emotion toward kids
Kanner argued they learned from their parents to be anti-social
What are the characteristics of autism spectrum disorder in the DSM-5?
deficits in social communication and social interaction: deficits in social-emotional reciprocity, nonverbal communicative behaviors used for social interaction, and in developing, maintaining, and understanding relationships
restricted, repetitive patterns of behavior, interests, or activities: stereotyped or repetitive motor movements, insistence on sameness, fixated interests, hyper- or hypo-reactivity to sensory input
symptoms must be present in the early developmental period
clinically significant impairment
disturbances are not better explained by something else
What are theoretical perspectives on autism?
O. Ivar Lovaas: hypothesized inability to process more than one sensory datum at a time, leads to conditioning deficits
Simon Baron-Cohen: theory of mind, inability to take another person’s perspective
neurodevelopmental deficits: evidence of structural abnormalities is inconsistent, premature growth, but then slows down and they fall behind
What are treatments for autism spectrum disorders?
Lovass (1987) 40 hours/wk x 2 years = normal IQ scores for just under half of 19 subjects (intensive behavioral interventions)
social simulation (e.g. FaceSay), social adjustment training, helps with social interaction, coaching that isn’t focusing on IQ, can help improve social interactions
What are the symptoms of inattention associated with ADHD in the DSM-5?
often does not give close attention to the details or makes careless mistakes in schoolwork, work, or other activities
often has trouble keeping attention on tasks or play activities
often does not seem to listen when spoken to directly
often does not follow through on instructions
often has trouble organizing activities
often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time
often loses things needed for tasks and activities
is often easily distracted
is often forgetful in daily activities
What are the symptoms of hyperactivity-impulsivity associated with ADHD in the DSM-5?
often fidgets with hands or feet or squirms in seat when sitting still is expected
often gets up from seat when remaining in seat is expected
often excessively runs about or climbs when and where it is not appropriate
often has trouble playing or doing leisure activities quietly
is often “on the go”
often talk excessively
impulsivity
often blurts out answers to questions before they are answered
often has trouble waiting one’s turn
often interrupts or intrudes on others
What are the different types of ADHD?
ADHD, combined type: if both criteria A and B are met for the past 6 months
ADHD, predominantly inattentive type: if criterion A is met but criterion B is not met for the past six months
ADHD, predominantly hyperactive-impulsive type: if criterion B is met but criterion A is not met for the past six months
could be mild, moderate, or severe
What are the theoretical perspectives on ADHD?
genetic and environmental
prenatal risk factors: drinking, smoking, antidepressants, antihypertensive drugs, poor nutrition, heavy metals (lead, mercury)
What are treatments for ADHD?
stimulants: ADHD people are under-stimulated in ARES area of the brain
behavior therapy: for motoric excesses, not just punishment, give them coping skills like fidget toys
EEG biofeedback: attach electrodes to the brain, differs in terms of frequency, increase beta frequency, decrease delta frequency, basically a video game, very expensive
What are learning disorders?
noted deficiency in a specific learning ability
What is dyslexia?
a type of learning disorder characterized by impaired reading ability and may involve difficulty with the alphabet or spelling
problems differentiating similar-looking letters (e, c, o OR p, d, q)
words may appear reversed pr blurred
problems identifying speech sounds and learning how they relate to letters and words (decoding)
affects areas of the brain that processes language
What are specific learning disorders?
impairment in mathematics
impairment in written expression: can’t go from thoughts to sounds or written words
impairment of reading
What are theoretical perspectives of specific learning disorders?
neurobiological
genetic factors
How is an individual education plan used in the treatment of specific learning disorders?
specific skill instruction: find work arounds for problems
accommodations: more time, exams in a quiet area
compensatory strategies
self-advocacy skills: being able to stand up for oneself and say they need help at school or work
What is the relationship between genetics and dyslexia?
people whose patients have dyslexia are at greater risk themselves
higher rates of dyslexia are found between identical (MZ) than fraternal (DZ) twins: 70% versus 40%
genes may play a role in causing defects in the brain circuity involved in reading
What are theoretical perspectives on oppositional defiant disorder?
ineffective parenting: inadvertent reinforcement of difficult demanding behavior, (parent: + punishment, child: - reinforcement)
coercive exchanges could be the cause
not only treat it from a behavioral standpoint, but also their parents and their coercive exchanges
What are some treatments for oppositional defiant disorder?
ecological theory: treat them in their normal environment, if you train a person in one environment the behavior might not be generalized to their normal environment
multisystemic therapy (MST): scheduled and unscheduled treatments, home, school, peer group, sport, supervision in all areas of life to teach positive skills, available 24/7
parent-management theory: need to understand b. mod treatments
What are characteristics of the angry/irritable mood associated with ODD?
often loses temper
is often touchy or easily annoyed
is often angry and resentful
What are the characteristics of the argumentative/defiant behavior associated with ODD?
often argues with authority figures or, for children and adolescents, with adults
often actively defies or refuses to comply with requests from authority figures with rules
often deliberately annoys others
often blames others for his or her mistakes or misbehavior
vindictiveness
What is intermittent explosive disorder?
not only diagnosed in childhood
impulsive or anger-based aggressive outbursts that begin rapidly and have very little build-up
outbursts often last fewer than 30 minutes and are provoked by minor actions of someone close, often a family member or friend
aggressive episodes are generally impulsive and/or based in anger rather than premeditated
they typically occur with significant distress or psychosocial functional impairment
the person is at least 6 years of age (or developmentally siimilar)
What is the DSM-5 criteria for intermittent explosive disorder?
verbal aggression like temper tantrums, tirades, arguments or fights; or physical aggression toward people, animals or property
the aggression must occur, on average, twice per week for three months
the physical aggression does not damage or destroy property, nor does it physical injure people
What is the DSM-5 criteria for conduct disorder?
aggression to people and animals
destruction of property
deceitfulness or theft
serious violations of rules
differentials include ODD and antisocial personality disorder
What are the most effective treatments for conduct disorder?
continued education
anger management
victim empathy training
relapse prevention
substance abuse desistence
family therapy
individual psychotherapy of little use
meds of limited value but some possible success with mood stabilizers and neuroleptics, but not for frankly antisocial kids
What are major neurocognitive disorders?
significant cognitive decline
interference with independence in daily activities
What are mild neurocognitive disorders?
moderate cognitive decline
still capable of functioning with independence
What are the type specifiers of neurocognitive disorders?
Alzheimer’s disease
frontotemporal lobar degeneration (e.g. Pick’s)
Lewy body disease
vascular disease
TBI (mini strokes, loss of blood flow)
substance/medication use
Prion disease
What is delirium?
may produce dementia-like impairment: disturbances in orientation, memory, concentration, perception, reduced/clouded consciousness
often attributable to medical illness (e.g. bladder infections)
onset tends to be rapid (i.e. hours to days)
AD and vascular dementias much more gradual
What is dementia?
a form of cognitive impairment involving generalized progressive deficits in a person’s memory and learning of new information, ability to communicate, judgement, and motor coordination
What is Alzheimer’s disease?
fatal neurodegenerative disorder that accounts for the majority of dementia cases
first line of treatment: cholinesterase inhibitors
conclusive diagnosed posthumously
neuropsych testing is very sensitive and specific
What are vascular dementias?
best address by controlling cardiovascular risk factors (BP, diabetes, smoking, cholesterol)
step-wise decrement in functioning
tends to show up with diagnostic imaging (structure, not function)
Autistic Thinking
the tendency to view oneself as the center of the universe
to believe that external events somehow refer to oneself
Autism Spectrum Disorder (ASD)
disorder characterized by pervasive deficits in the ability to relate and communicate with others, and by restricted rand of activities or interests
children with ASD lack the ability to relate to others and seem to live their own private lives
Theory of Mind
the ability to appreciate that other people have a mental state that is different from one’s own
Lateralization
the developmental process by which the left hemisphere specializes in verbal and analytic functions and the right hemisphere specializes in nonverbal, spatial functions
Down Syndrome
condition caused by a chromosomal abnormality involving an extra chromosome on the 21st pair (trisomy 21)
it is characterized by intellectual disability and various physical abnormalities
formerly called mongolism and Down’s syndrome in Canada
Phenylketonuria (PKU)
genetic disorder that prevents the metabolization of phenylpyruvic acid, leading to intellectual disability
Tay-Sachs Disease
disease of lipid metabolism that is genetically transmitted and usually results in death in early childhood
Cytomegalovirus
maternal disease of the herpes group that carries a risk of intellectual disability to the unborn child
Cultural/Familial Intellectual Disability
milder form of intellectual disability that is believed to results, or at least be influenced by, impoverishment in the child’s home environment
Mainstreaming
the practice of having all students with disabilities included in the regular classroom
Dyslexia
type of specific learning disorder characterized by impaired reading ability that may involve difficulty with the alphabet or spelling
Specific Learning Disability
deficiency in a specific learning ability noteworthy because of the individual’s general intelligence and exposure to learning oppurtunities
Individual Education Plan (IEP)
a contractual document that contains learning and behavioral outcomes for a student
a description of how the outcomes will be achieved, and a description of how the outcomes will be evaluated
Attention-Deficit/Hyperactivity Disorder (ADHD)
neurodevelopmental disorder characterized by excessive motor activity, impulsivity and/or an inability to focus one’s attention
Hyperactivity
abnormal behavior pattern found most often in young boys that is characterized by extreme restlessness and difficulty maintaining attention
Conduct Disorder
patterns of abnormal behavior in childhood characterized by disruptive, antisocial behavior
Oppositional Defiant Disorder
disorder in childhood or adolescence characterized by excessive oppositionality or tendencies to refuse requests from parents and others
Time-Out
behavioral technique in which an individual who emits an undesired behavior is removed from an environment in which reinforcers are available and placed in an un-reinforcing environment as a form of punishment
time out is frequently used in behavioral programs for modifying behavioral programs in children, in combination with positive reinforcement for desirable behavior
Separation Anxiety Disorder
a childhood disorder characterized by extreme fears of separation from parents or others whom the child is dependent
Delirium
a state of extreme mental confusion in which people have difficulty focusing their attention, speaking clearly and coherently, and orienting themselves to the environment
Dementia
profound deterioration of cognitive functioning
characterized by deficits in memory, thinking, judgement, and language use
Amyloid Plaques
the accumulation of protein fragments, normally broken down in healthy brain, that accumulate to form hard, insoluble plaques between nerve cells (neurons) in the brain
a hallmark of Alzheimer’s disease
Neurofibrillary Tangles
pathological protein aggregated (or brain lesions) found within brain cells (in the cerebral cortex and hippocampus) in patients with Alzheimer’s disease and thought be contribute to the degradation of neurons in the brain
