Chapter 11 - Abnormal Behaviour Across Lifespan (Midterm 2)

Question 1

What is a neurodevelopmental disorder?

Answer 1

Disorders that begin in the developmental period. Become evident during the early years of life and are associated with personal, social or academic impairments.

Question 2

Autism Spectrum Disorder (ASD)

Answer 2

• One of the severest disorders of childhood. It is chronic, lifelong
• =characterized by persuasive deficits in the ability to relate to and communicate with others, and by a restricted range of activities and interests. Children lack the ability to relate to others and seem to live on their own private worlds

Question 3

Autistic thinking

Answer 3

The tendency to view oneself as the center of the universe, to believe that external events somehow refer to oneself

Question 4

Most poignant feature of ASD?

Answer 4

The utter aloneness that the child faces or tends to bring onto themselves. IN more extreme cases, children may be mute

Question 5

DSM-5 ASD

Answer 5

ASD – DSM 5
A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text):
1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
• 1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
• 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).
• 3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).
• 4. Hyper- or hypo-reactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life).
D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

Question 6

Neurocognitive Disorder are disruptions

Answer 6

To previously normal cognitive ability

Question 7

-Disruptive, Impulsive Control, and Conduct Disorders Are

Answer 7

Problems with behavioral and emotional regulation

Question 8

What is diagnostic overshadowing?

Answer 8

-two conditions at the same time, those who are lower-functioning, may have missed diagnoses of other mental illnesses because they are attributed to their lower functioning

Question 9

Causes of intellectual disability

Answer 9

• Prenatal Factors
  
  • Cytomegalovirus (CMV)
  • Inadequate diet during pregnancy
  • Maternal (while pregnant)
    
    • drinking (FASD)
    • Valproate
    • smoking
    • antidepressants, antihypertensive drugs
    • heavy metals (lead. Mercury)
• Cultural-Familial causes
  
  • cultural-familial intellectual impairment
• Intervention
  
  • Mainstreaming

Question 10

-some medical conditioning that may cause intellectual disability

Answer 10

• some medical conditioning that may cause intellectual disability
  
  • Down syndrome
  • Fragile x syndrome
  • Phenylketonuria (PKU)
  • Smith-Lemli-Opitz Syndrome
  • Tay-Sachs disease

Question 11

Savant Syndrome is

Answer 11

• Savant syndrome is a condition where a person with a neurodevelopmental disorder can perform exceptionally in a specific domain such as mathematics
  
  • Savant syndrome occurs in 0.06% if those with intellectual disability and is closely linked to autism spectrum disorder. It occurs about six times more often in males than females

Question 12

-O. Ivar Lovaas

Answer 12

-Hypothesizes inability to process more than one sensory datum at a time which leads to conditioning deficits (slow to learn classical conditioning)

Question 13

From a learning theory perspective (ASD)

Answer 13

Chidlren become attached to their primary caregiver because they are associated with food and hugging (reinforcers), children with ASD however, attend either to the food or to the cuddling and do not connect with the parent

Question 14

Cognitive Theorists (ASD)

Answer 14

Focus on the cognitive deficits that these children exhibit. They have issues integrating information form various sources, either hyper or hypo sensitive which may impede their development of the theory of mind. They struggle to make use of the incoming information due to these deficits

Question 15

ASD neurodevelopmental deficits

Answer 15

Are mostly inconsistent in findings, we do not know what strictly causes ASD but it is believed to by a combo of genetic and environmental factors

Question 16

Lateralization

Answer 16

The developmental process by which the left hemisphere specialized in verbal and analytic functions and the right hemisphere specialized in nonverbal, spatial functions

Question 17

ASD mirror neurons

Answer 17

Are not fully developed in most cases

Question 18

Best treatment for ASD focuses on

Answer 18

Focuses on behavioral, educational, and communication deficits and are highly intensive and structured, offering a great deal of individual instruction and must begin early

Question 19

Lovaas ASD study and treatment

Answer 19

• Lovaas (1987) 40 hours/week x 2 years = normal IQ scores for just under half of 19 subjects
• children who improved received normal IQ scores and were able to succeed Grade 1
• very intensive

Question 20

What is FaceSay?

Answer 20

Helps children with ASD recognize faces and and expressions, emotions

Question 21

Intellectual Disability (Intellectual Developmental Disorder)

Answer 21

-based on adaptive functioning, not just IQ alone but there is overlap
Involved a broad delay in the development of cognitive and social functioning, variable between children and can improve over time

Question 22

3 characteristics the DSM uses to diagnose intellectual disability

Answer 22

1. Deficits in intellectual functions as indicated by clinicians and standardized testing
2. Evidence of impaired functioning in adaptive behavior
3. Onset of the disorder in the developmental period

Question 23

Down syndrome

Answer 23

Condition caused by a chromosomal abnormality involving an extra chromosome on the 21st pair. Characterized by intellectual disability and various physical abnormalities.

Question 24

Fragile X Syndrome

Answer 24

• most common type of inherited genetic intellectual disability, 2nd most common overall after Down syndrome
• believed d to be caused by the mutation of a gene on the X sex chromosome
• range form mild to extreme symptoms so profound that people can hardly speak or function with this condition at times

Question 25

Phenylketonuria

Answer 25

Genetic disorder that prevents the metabolization of phenylpyruvic acid, leading to intellectual disability (PKU)

Question 26

Tay-Sachs Disease

Answer 26

Disease of lipid metabolism that is genetically transmitted and usually leads to death in early childhood (Chromosome 15)

Question 27

-Cytomegalovirus (CMV)

Answer 27

Maternal disease of the herpes virus group that carries a risk in intellectual disability to the unborn child

Question 28

Mainstreaming

Answer 28

The practice of having all students with disabilities included in the regular classroom. Also called integration and inclusion

Question 29

ADHD DSM - 5

Answer 29

DSM-5 ADHD
A. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level:
– Often does not give close attention to 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 and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand 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 (such as schoolwork or homework).
– Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
– Is often easily distracted.
– Is often forgetful in daily activities.
B. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:
– 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 (adolescents or adults may feel very restless).
– Often has trouble playing or doing leisure activities quietly.
– Is often “on the go” or often acts as if “driven by a motor”.
– Often talks excessively. – Impulsivity
– Often blurts out answers before questions have been finished.
– Often has trouble waiting one’s turn.
–Often interrupts or intrudes on others (e.g., butts into conversations or games).

• ADHD, Combined Type: if both criteria A and B are met for the past 6 months
• ADHD. Predominately Inattentive Type: if criterion A is met but criterion B is not met for the past 6 months
• ADHD, Predominately Hyperactive-Impulsive Type: is criterion B is met but Criterion A is not met for the past 6 months
• Also specify level of severity based on a number of signs present:
  
  • Mild
  • Moderate
  • Severe

Question 30

Specific Learning Disorder

Answer 30

Deficit in specific learning ability noteworthy because of the individuals intelligence and exposure to learning opportunities

Question 31

Dyslexia

Answer 31

Types of specific learning disability characterized by impaired reading ability that may involve difficulty with the alphabet or spelling
-problems differentiating similar looking letters (e, c, o, or p, d, q)

• words may appear reversed or blurred
• problems identifying speech sounds and learning how they relate to letter and words (decoding)
• affects areas of the brain that process language

Question 32

Specific Learning Disorders (types)

Answer 32

• impairment in mathematics
• impairment of written expressions (dysgraphia)
• impairment in reading (dyslexia)

Question 33

Specifc learning disorders theoretical perspectives

Answer 33

• contend that these disorders primarily originate from neurobiological disorders
• issues with auditory and visual perceptions
• issues in flow of information
• those whose parents had dyslexia are at a greater risk themselves

Question 34

Specific learning disorders interventions

Answer 34

• Individual Education Plan
  
  • Specific skill instruction
  • Accommodations
  • Compensatory Strategies
  • Self-advocacy skills

Question 35

-Theoretical Perspectives ADHD

Answer 35

• genetic and environmental are both believed to be involved but the causes are not known
• Prenatal risks: drinking, smoking, antidepressants, anti-hypertensive drugs, poor nutrition, heavy metals (lead, mercury)

Question 36

Genetics and Dyslexia

Answer 36

• people whose parents have dyslexia are at a greater risk themselves
• Higher rates of dyslexia are found between identical twins (MZ) than fraternal twins (DZ): 70% vs 40%
• genes may play a role in causing defects in the brain circuitry involved in reading

Question 37

Treatment of ADHD

Answer 37

• stimulants - paradoxical effect on those with ADHD. Believed to work by heightening dopamine and norepinephrine levels in the prefrontal cortex which regulates attention and control of impulsive behaviour
• behaviour therapy (for motoric excesses
• EEG biofeedback
• issues in the area of the brain that regulate and process attention, inhibition of motor movement and executive control

Question 38

Conduct disorder (CD)

Answer 38

Pattern of abnormal behaviour in childhood characterized by disruptive, antisocial behaviour (CD)
-there are 2 types: childhood-onset (before age 10) and adolescent-onset (after 10)

Question 39

Oppositional defiant disorder (ODD)

Answer 39

Disorder in childhood or adolescence characterized by excessive oppositionality or tendencies to refuse requests from parents or others

Question 40

DSM-5 ODD

Answer 40

A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories and exhibited during interaction with at least one individual who is not a sibling.
Angry/Irritable Mood
• Often loses temper.
• Is often touchy or easily annoyed.
• Is often angry and resentful.
Argumentative/Defiant Behavior
• Often argues with authority figures or, for children and adolescents, with adults.
• Often actively defies or refuses to comply with requests from authority figures or with rules.
• Often deliberately annoys others.
• Often blames others for his or her mistakes or misbehavior.
Vindictiveness
• Has been spiteful or vindictive at least twice within the past 6 months

Question 41

DSM-5 Conduct Disorder

Answer 41

• A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months: • Aggression to people and animals
(1) often bullies, threatens, or intimidates others
(2) (2) often initiates physical fights
(3) (3) has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)
(4) (4) has been physically cruel to people
(5) (5) has been physically cruel to animals
(6) (6) has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)
(7) (7) has forced someone into sexual activity
• Destruction of property
(8) has deliberately engaged in fire setting with the intention of causing serious damage –
(9) has deliberately destroyed others’ property (other than by fire setting)
• Deceitfulness or theft – (10) has broken into someone else’s house, building, or car –
(11) often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others) –
(12) has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)
• Serious violations of rules –
(13) often stays out at night despite parental prohibitions, beginning before age 13 years –
(14) has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period) –
(15) is often truant from school, beginning before age 13 years

– Differentials include ODD and Antisocial Personality Disorder
• Most effective treatments are delivered in a structured setting and include:
– 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 & neuleptics, but not for frankly antisocial kids.

Question 42

Treatment of ODD and CD

Answer 42

• some stimulants and antipsychotic drugs work to relieve the antisocial behaviour related
• no known cause is known
• behaviour therapy (for motoric excesses
• EEG biofeedback

• Most effective treatments are delivered in a structured setting and include:

– Continued education

– Anger management

– Victim empathy training

– Relapse prevention

– Substance abuse desistence

– Family therapy

Question 43

-Theoretical Perspectives On ODD and CD

Answer 43

• ineffective parenting: Inadvertent reinforcement of difficult, demanding behaviour
• Learning - reinforced behaviours
• genetic and environmental factory’s may play a role as well
• some researchers look into how those with these disorders process information, especially social

Question 44

Intermittent Explosive Disorder

Answer 44

it is intermittent, not characteristic
• 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 similar).
• Verbal aggression like temper tantrums, tirades, arguments, or fights; or physical aggression toward people, animals, or property.
• This aggression must occur, on average, twice per week for three months.
• The physical aggression does not damage or destroy property, nor does it physically injure people or animals. or
• Within 12 months, three behavioral outbursts resulting in:
• Damage or destruction of property, and/or
• Physical assault that physically injures people or animals.

Question 45

Separation Anxiety Disorder in children `

Answer 45

Childhood disorder characterized by extreme fears of separation from parents or others on whom the child is dependent

Question 46

Theoretical perspective on Anxiety disorders in children

Answer 46

-some degree run parallel to the same disorder in adults

Question 47

Psychoanalytic theorists on children anxiety disorder

Answer 47

Symbolize unconscious conflicts

Question 48

Cognitive theorists on child anxiety

Answer 48

Focus on the role of cognitive biases underlying anxiety reactions, shows that highly anxious children show cognitive biases in processing information, such as interpreting ambiguous situations as threatening, expecting negative outcomes, thinking poorly of themselves and of their ability to cope, negative self-talk

Question 49

Learning Theorists on child anxiety

Answer 49

Suggest that the occurrence of generalized anxiety may touch broad themes such as fears of rejection or failure, that carry across situations

Question 50

Depression in Children and adolescence

Answer 50

Similar to adults. Low self -esteem, confidence, sense of hopelessness, negative attributions on themselves etc.

• rarely occurs by itself and is usually accompanied by CD or ODD, and anxiety
• eating disorders are also common
• childhood depression can increase the chances of another psychological disorder by at least 20 fold

Question 51

Correlates of childhood depression

Answer 51

• older children who adopt more hopeless or helpless (pessimistic) explanatory style (attributing negative events to internal, stable and global causes, and positive events to external, unstable and specific causes
• genetic factors also appear to play a role

Question 52

Treatment of depressed kids

Answer 52

Cognitive - Behavioral therapy (CBT) has been has been proven an effective treatment. Usually involves a coping skills model where they receive social skills training. Family therapy can be a useful tool as well so family can support another
-antidepressants have mixed results

Question 53

Suicide in children and adolescents

Answer 53

Suicide is the 2nd leading cause of death in Youth aged 10 -19 years

• 15 years and older, rates are higher in males than females
• under 15 is higher in females

Question 54

Factors that can increases the chances of suicide in children

Answer 54

• gender (girls are more likely to attempt, boys are more likely to do it)
• age
• ethinicity
• depression and hopelessness
• previous suicidal behavior
• family problems
• stressful life events
• substance abuse
• social contagion

Question 55

Neurocognitive Disorders

Answer 55

Are diagnosed on deficits in cognitive functioning that represent marked changed form prior level of functioning
-they are caused by physical or module a diseases, drug use or withdrawal effects

Question 56

Cognitive disorder must be differentiated based on

Answer 56

severity:
• Major
-Significant cognitive decline
– Interference with independence in daily activities
• Mild
– Moderate cognitive decline
– Still capable of functioning with independence
• Several type specifiers
– Alzheimer’s disease
- Frontotemporal lobar degeneration (eg., Pick’s)

– Lewy body disease

– Vascular disease

– TBI

-Substance/medication use

Question 57

Vascular dementia cognitive ability declines

Answer 57

In a step down pattern

Question 58

Dementia declines

Answer 58

In a consistent downturn

Question 59

Regular aging cognitive decline

Answer 59

Gradual downturn

Question 60

Delirium

Answer 60

• state of extreme mental confusion, people have difficulty paying attention and focusing, speaking, orienting themselves to their environment
• May produce dementia-like impairment
  
  • disturbances in orientation, memory, concentration, perception. Reduced/clouded consciousness
  • sometimes: hallucinations, delusions
• Often attributable to medical illness (e.g., bladder infections)
  
  • will generally clears within days of underlying physical illness resolving
  • therefore, always check white cell count and assess for other symptoms and signs of infection
  • anywhere from 10 to 50% of seniors admitted to hospital for surgery will have, or develop, delirium
• Onset tends to be rapid (i.e., hours to days)
• AD and vascular dementias much more gradual
• may fluctuate between restless and stupor

Question 61

Delirium Treatment

Answer 61

-typically look for and treat the underlying medical issues causing the delirium

Question 62

Dementia

Answer 62

Profound deterioration of cognitive functioning characterized by deficits in memory, thinking, judgement and language use
-at least 50 known disorders that can cause Dementia

Question 63

Alzheimers disease (AD)

Answer 63

– fatal neurodegenerative disorder that accounts for the majority of dementia cases

• brain disease that leases to progressive and irreversible Dementia
• chances increase drastically with age

Question 64

-Neuropathy (AD)

Answer 64

Amyloid plaques are made largely of protein called beta amyloid or A-Beta and split from another molecule known as APP. The key to Alzheimer’s is that high amounts of A-beta accumulate in the brain, overwhelming the enzymes whose job it is to clear it away

• the neurofibrillary tangles are made form a protein called tau, which occur on normal nerve cells, and during Alzheimer’s disease, tau becomes chemically altered and piles up as thread-like tangles, imparting the proteins key role such as nerve sprouting which is important feature of the nervous systems self repair
• ACH depletion contributes significantly to memory deficiencies in the brain

Question 65

Treatment of AD

Answer 65

Drugs are the main treatment and one widely used drug is donepezil (Aricept) which boosts acetylcholine

• anti-inflammatory drugs are being researched such as Advil (ibuprofen)
• engaging in stimulating activities
• lifestyle choices help with prevention such as exercise, healthy diet,

Question 66

• Theoretical Perspectives - Autism

- Leo Kanner

Answer 66

• Kanner Syndrome

- “Refrigerator mothers”

Question 67

-Bruno Bettleheim

Answer 67

• “The Empty Fortress”

- Kids develop “internal solitude” against indifferent parents

Question 68

theory of mind

Answer 68

• being able to construct a working model about what others are thinking based on information available to them and environment
• ability to appreciated that other people have a mental state that is different form your own

Question 69

-ADHD, Combined Type:

Answer 69

if both criteria A and B are met for the past 6 months

Question 70

-ADHD. Predominately Inattentive Type:

Answer 70

if criterion A is met but criterion B is not met for the past 6 months

Question 71

-ADHD, Predominately Hyperactive-Impulsive Type:

Answer 71

is criterion B is met but Criterion A is not met for the past 6 months

Question 72

-Also specify level of severity based on a number of signs present: ADHD

Answer 72

• Mild
• Moderate
• Severe

Question 73

Learning Disorder

Answer 73

noted deficiency in a specific disorder

Question 74

Vascular dementia

Answer 74

best address by controlling cardiovascular risk factors (BP, diabetes, smoking, cholesterol)

• Stepwise decrement in functioning
• Mixed - co-occurrence of both forms