Chapter 11: Abnormal psychology across lifespan Flashcards
Why are psychological problems that affect children so poignant?
Because children haven’t developed coping strategies yet
some prevent children from reaching their potential
When dealing with children with psychological issues what must be considered
development issues of children
what is normal for that age
Autism spectrum disorder
characterized by pervasive deficits in the ability to relate to and communicate with others, and by a restricted range of activities and interests
- lifelong condition
- spans all socioeconomic levels
- fours time for common in boys
- can’t be diagnosed before age 3
- becomes evident between the ages of 18-30 months (age range when kids get vaccines)
Features of autism spectrum disorder
aloneness, language, and communication problems, ritualistic/sterotyped behaviours
echolalia, pronoun reversal, made up words
twirling, flapping hands, or rocking back and forth with arms around knees
mutilate themselves, bang their head, slap their face, bite their hands and shoulders, or pull out their hair
preservation of sameness: aversion to environmental changes
intellectual development lags below the norm
Psychodynamic perspectives
Early views focused on pathological family relationships
Kanner + Eisenberg: cold-detached parents to blame
Bettelheim: extreme sel-absorption deficit that limits them to processing only one stimulus at a time
Cognitive perspective
Lovaas, et al.: have a perceptual deficit that limits them to processing only one stimulus at a time
Biological perspective
have a period of overgrowth of brain size early in postnatal development followed by a significant slowed growth resulting in a brain volume smaller than average for children aged 5-16
Smaller corpus callous: impact lateralization (the development process by which the left hemisphere specializes in verbal and analytic functions, while the right hemisphere specializes in non-verbal and spatial functions)
underdeveloped mirror neurons leading to social deficits
Treatment of autism spectrum disorder
- focus on behavioural, education, and communication deficits
- highly intensive and structured
- importance of early intervention
- comorbid with OCD
- haldol
Haldol
may help reduce social withdrawal and repetitive motor behaviour, aggression, hyperactivity, and self-injurious behaviour
Intellectual disability
Involved a broad delay in the development of cognitive and social functioning
assessed by a combination of formal intelligence tests and observation of adaptive functioning
3 criteria for an intellectual disability
need all three
An IQ score of approximately 70 or below on an intelligence test
Evidence of impaired functioning in adaptive behaviour
Onset of the disorder before the age of 18 (after 18 it could be dementia, or brain damage related)
Prevalence rate of intellectual disabilities
7.18 in 1000
Most common level of intellectual disability?
mild
IQ score of 55-70
can reach grand 6 level
90%
Down syndrome
trisomy 21
occurs in 1 in 800 births with an increased likelihood as parents age
physical features of down syndrome
round face
broad flat nose
downward sloping folds of skin at the inside corners of the eyes = slanted eyes
protruding tongue
small hands and short fingers
curved 5th finger
disproportionately small arms and legs in relation to their bodies
nearly all these children have MR, and may suffer from physical problems such as malformation of the heart and respiratory difficulties
most die by middle aged
Children with down syndrome
learning and development difficulties
uncoordinated due to lack of muscle tone
memory deficits
difficult following instructions and expressing their thoughts or needs clearly
Fragile X syndrome
belived to be caused by mutated gene on the X chromosome
the defective gene is located in an area of the chromosome that appears fragile hence the name
causes Mental retardation in 1/1000-1500 males and (generally less severe) mental handicaps in about 1/2000-2500 females
Phenylketonuria (PKU)
genetic disorder that prevents the metabolization of phenylpruvic acid leading to mental retardation.
- 1/10,000 births
- placed on low PKU diet
- detected through urine and blood tests
Tay-Sachs disease
disease of lipid metabolism that is genetically transmitted and usually results in death in early childhood
- recessive gene on chromosome 15
- effects mostly jews of eastern Europe ancestry, and french Canadians
- children experience gradual loss of muscle control, deafness, blindness, retardation, and paralysis
- usually die before the age of 5
Causes of intellectual disability
prenatal causes
cultural-familiar causes
prenatal factors of intellectual disability
- crytomegalovirus: maternal disease of the herpes virus group that carries a risk of intellectual disability to the unborn child
- maternal smoking or drinking (FASD): linked to the development of ADHD
birth complications: O2 deprivation or head injuries, prematurity, brain infections, traumas, toxins
Cultural-familial causes of intellectual disability
cultural-familal retardation: milder form of intellectual disability that is believed to result, or at least be influenced by, impoverishment in the child’s home environment
intervention
inlcusion/integration
behavioural approaches
inclusion/integration
least restrictive environment
accommodations and modifications
behavioural approaches
- teach persons with more severe retardation such as basic hygienic behaviours (tooth brushing)
- shape the desired behaviour by using verbal instruction, physical guidance, and rewards
- social-skills training
- help with adjusting to like in the community
- anger management
learning disorder
deficiency in a specific learning ability noteworthy because of the individual’s general intelligence and exposure to learning opportunities
- have average to above average intelligence (if lower than 70 it is an intellectual disability)
Dyslexia
type of learning disorder characterized by impaired reading ability that may involve difficulty with the alphabet or spelling
- most common learning disorder, 80%
- children have poorly developed skills in recognizing letters and words and comprehending text
- apparent by age 7, sometimes recognized earlier
mathematics disorder
deficiencies in arithmetic skills, problem understanding basic mathematical terms or operations, decoding mathematical symbols, learning sequential facts
may become apparent as early as grade 1 (6 years) but is not generally recognized until grade 3 (age 8)
Dysgraphia
disorder of written expression
5-10%
errors in spelling, grammar, punctuation, difficulty in composing sentences and paragraphs
severe writing difficulties apparent by age 7, milder cases not recognized until age 10
Theoretical perspectives for learning disorders
neurobiological
- sensory processing dysfunction
genetic factors
- people whose parents have dyslexia are at a greater risk
- higher concordance rates for dyslexia in MZ twins (70%) vs. DZ (40%)
Intervention for learning disorders
individual education plan
increase child self-esteem
individual education plan
contractual document that contains learning and behavioural outcomes for a student, a description of how the outcomes will be achieved and a description of how the outcomes will be evaluated
ADHS
behavioural disorder of childhood characterized by excessive motor activity and inability to focus one’s attention
- need to meet 6 criteria to be diagnosed (either have it or you don’t)
- subtypes: inattentive; hyperactive (distractible type); or a mix of both
- prevalence: 5-10% in children 6-14
- boys 2x more common, 6-8 year olds had higher rates than 12-14 year olds.
- needs to be prevalent in the school, community and home (at least in two places)
Features of ADHD
tend to do more poorly in school than their peers
- fail to follow or remember instructions and complete assignments
more likely to have a learning disability, to repeat grades, and to be placed in special ed. classes
greater risk for mood and anxiety disorders
problems getting along with family members
unpopular
tend to get in fights
Theoretical perspectives of ADHD
biological
areas of brain involve in regulating the processes of attention, inhibition of motor (movement) behaviour, and excitative control
environemtnal
children who have ADHD were found to be 2.5x more likely than other children to have had prenatal exposure to environmental tobacco smoke
Treatment of ADHD
Ritalin
CBT
Ritalin
stimulant brand of drugs
calming effects, increasing attention spans, and reduces impulsivity, over activity, and disruptive, annoying, or aggressive behaviour
successful in helping about three out of four children with ADHD
may cause loss of appetite or insomnia, agitation, hallucinations, retard a child’s growth, and in rare cases can result in cardiac arrest, stroke, or sudden death
CBT for ADHD
combines behaviour modification, typically based on reinforcement and cognitive modifications
Conduct disorder
more severe pattern of abnormal behaviour in childhood characterized by disruptive, antisocial behaviour (antisocial-like, precurcsor to antisocial personality disorder)
3.3%
more common in boys
features appear before age 10
boys: stealing, fighting, vandalism, or disciplinary problems at school
girls: lying, truancy, running away, substance abuse, prostitution
Oppositional defiant disorder
disorder in childhood/adolescence characterized by excessive oppositional or tendencies to refuse requests from parents and others
- precursor to CD (before age of 8)
- more closely related to non delinquent behvaiours
- one of the most common diagnoses in children (6-12%)
- features: negativstic, defiant of authority, tendency to argue with parents and teachers, refuse to follow requests from adult, may deliberately annoy people, become easily angered or lose temper, become touchy or easily annoyed, blame others, feel resentful towards others, act spiteful towards others
- many grow out of it
Learning theory of ODD
arising from parental use of inappropriate reinforcement strategies
- negative reinforcement
- may be linked to unassertive and ineffective parenting styles
Families of CD
tend to be characterized by negative, coercive interactions
family members use negative behaviours such as threatening or yelling at the child or using physical means of coercion
pushing, grabbing, spanking, hitting…
treatment of disruptive behaviours
- programs or treatment settings with explicit rules and clear rewards for obeying them may offer greater promise
- rewards and punishments
- anger management
- calming self-talks
very hard to change CD! lots of CBT
do not give attention to the negative behaviour, but give huge praise for appropriate behaviour
Separation Anxiety disorder
childhood condition characterized by extreme fears of separation from parents or others on whom the child is dependent
- usually follows a stressful life event
features: tend to follow family members around, voice concerns about death and dying, insist on someone stay them while they are trying to fall asleep, nightmares, stomach aches, nausea and vomiting when separation is anticipated, pleading with parents not to leave, throwing tantrums when parents are about to depart - 4% of children and adolescence
Psychoanalytic perspective on anxiety disorders
anxiety symbolizes unconscious conflicts
Cognitive perspective on anxiety disorders
cognitive bias in processing info (interpreting ambiguous situations as threatening, expecting negative outcomes, thinking poorly of themselves and their ability to cope and engaging in negative self-talk)
Depression in childhood/adolescence
depressed children show a greater sense of hopelessness, display more cognitive errors and negative attributions, have lower perceived competence or self-efficacy and have lower self-esteem than do their non depressed peers
2 % of canadian children
no gender difference, but at age 15 girls become 2 x more likely to be depressed (why? because of social pressures)
3/4 children who are depressed between ages 8-13 have a recurrence later in life
Attributional style of children with depression
internal
stable
global
adolescent girls and depression
social challenges such as pressure to narrow their interests and pursue feminine activities and develop a more passive style
Treatment for depression in children
CBT
- social skills training
Antidepressants
- Prozac
Factors associated with suicide in children/adolescents
Gender: girls more likely to attempt, boys more likely to complete
Age: greatest risk is between 15-24 years
Ethnicity: highest among first nations youth
Depression and helplessness: when combined with low self-esteem
previous suicidal behaviour: 1/4 attempters tend to repeat the behaviour
family problems: present in 75% of cases
Stressful life events: breakup, unwanted pregnancy, arrest, moving, etc.
Substance abuse: addiction
Social contagion: widespread publicity
Dementia
form of cognitive impairment involving generalized progressive deficits in a person’s memory and learning of new information, ability to communicate, judgment, and motor coordination
- memory loss and disturbance of executive function are two major losses with dementia
- the average duration of life after the individual contacts a doctor for a memory problem is out 3.3 years
abnormalities characteristic of dementia
amyloid plaques
neurofibrillary tangles
reduction in neurotransmitters
inflammation of the brain
causes of dementia
huntington's and parkinson disease head injury oxygen deprivation stroke meningitis
Alzheimer’s disease
fatal neurogenerative disorder that accounts for the majority of dementia cases (56%)
lack of ACh
- people with a mother with Alzheimers appear to be at the greatest risk for getting the disease
- the diagnosis is not given until after all other potential causes of dementia have been ruled out (i.e. parkinson’s, head damage)
Alzheimer’s treatment
no cure
some meds slow down the decline in memory, language, and thinking abilities which inhibit the breakdown of ACh
