chapter 15 Flashcards
what is the precent of Canadians kids have clinical disorders that cause significant distress and impairment?
14%
what is the most prevalent disorder in kids?
anxiety disorder
what is the precent of adults with mental health problems had symptom onset prior to age 20?
70%
what is the percent if young people receive the mental health treatment the need?
20%
what are the disorders of under controlled behaviour also known as?
externalizing problems
what are the disorders that the DSM 5 characterize as disruptive, impulse control and conduct disorders?
oppositional defiant disorder
conduct disorder
what is disruptive mood disregulation disorder?
as temper tantrum disorder
persistent irritability
what is the criteria for disruptive mood dysregulation disorder?
episodes of temper outbursts three or more times per week
what was disruptive mood dysregulation disorder used to be called in the DSM 4?
childhood bipolar disorder
what was the problem with childhood bipolar disorder?
when the kids grew up, they didn’t have bipolar disorder
what are the disorders of under controlled behaviour?
ADHD, opposite defiant disorder and conduct disorder
what is ADHD characterized as?
difficulty of concentrating on tasks
difficulty sustaining attention over time
trouble following through on instructions
forgetful in daily activities
what does ADHD have difficulty processing?
auditory instructionsw
what does the DSM 5 not do a good job with according to ADHD?
doesn’t do a good job covering it
what are the types of ADHD?
ADHD predominantly attention defect
ADHD predominantly hyperactive
ADHD combined
what is ADHD predominately attention defect?
problems with executing functions
what is the prevalence of ADHD world wide?
5.29%
what is the prevalence of ADHD in adults?
4.4%
is ADHD more common that girls or boys?
in boys but might be overestimated
what are boys like with ADHD?
more agressive
what are girls like with ADHD?
tend to be more talkativeness
what is hyperactivity?
constantly in motion, jiggling legs, fidgeting, talking out of turn
what are the 6 models of executive function impaired in ADHD?
- activation
- focus
- effort
- emotion
- memory
- action
what do kids with ADHD have troubles with?
peer-relations because their behaviour can be annoying to others
what is the precent of learning disabilities in kids with ADHD?
15-30%
does ADHD have comorbidity with other disorders?
yes
what is the genetic predisposition of ADHD?
considered to be the most heritable phenotypes
what is the estimated heritability of ADHD?
75%
what are the differences in brain structure in ADHD?
reductions in volumes in cerebrum and cerebellum
smaller basal ganglia volumes
dysfunction in dopaminergic and noradrenergic systems
what is the diathesis stress theory of ADHD?
hyperactivity develops when predisposition disorder coupled with authoritatian upbringing
attention seeking and hyperactivity
what drugs are used to treat ADHD?
stimulents
what do stimulant drugs do?
reduce attention attention deficit
what are the side effects of stimulants?
sleep problems and loss of appetite
what is psychological treatment of ADHD?
parent training and changes in classroom management based on operant conditioning
reinforcement for behaving appropriately
what is oppositional defiant disorder’s three main themes?
- pattern of disobedient, hostile and defined behaviour towards authority figures
- anger irritable mood
- vindictiveness
what is conductive disorder?
more sever than ODD
marked by callousness, viciousness, lack of remorse
repetitive pattern of behaviour
what do kids with oppositional defiant disorder not demonstrate?
doesn’t demonstrate serious violations of societal norms
what is the repetitive behaviour of conduct disorder?
agression to people and animals
destruction of property
deceitfulness or theft
serious violations of rules, rights of others
what is conduct disorder a criteria for?
anti social personality disorder
what is conduct disorder comorbidity with?
ODD and ADHD
what is the genetic factors of conduct disorder?
aggressive behaviour clearly heritable
delinquent behaviour seems not to be heritable
what does pregnant smoking increase risk for?
increase risk for conduct disorder
what are the biological factors of conduct disorder?
neuropsychological defects
neurological correlates (brain imaging studies)
what is neuropsychological defects?
poor verbal skills, difficulty with executive functioning, problems with memory
what do brain imaging studies suggest?
possible amygdala dysfunction
what are psychological factors in conduct disorder (learning theories)?
modelling and operant conditioning
what are psychological factors in conduct disorder (cognitive biases)?
social information processing theory
mistaken views of neutral peer behaviour
what is the ethology of conduct disorder in a chaotic social environment?
noise levels, crowding, unpredictability in home and neighbourhood
what is the course of treatment of conduct disorder?
improvements seen when addressed at young age
sever cases persist snd develop into APD in adulthood
family intervention
multi-systemic treatment
congnitive approaches
what is family intervention for conduct disorder?
parental management training
what are cognitive approaches for conduct disorder?
anger management
moral reasoning skills training
what are the preventions of conduct disorder?
beginning treatment before age 3
identifying families and mothers at risk
prenatal and postnatal in mother
what are the prenatal and postnatal risks in mother for conduct disorder?
maternal antisocial behaviour
young age pregnancy
smoking during pregnancy
maternal depression soon after birth
partner cruelty
harsh parenting
what is neurodevelopment disorders in DSM 5?
includes ADHD
specific learning disorders
communication disorders
motor disorders
intellectual disability disorder
autism spectrum disorder (ASD)
what are specific learning disorders?
inadequate development in specific area of academic, language, speech other motor skills
not due to intellectual disability autism
have average or above average intellect
what is the prevalence of specific learning disorders?
5% or higher
what is reading disorder (specific learning disorder)?
difficulty with word recognition and reading comprehension
known as dyslexia
what is mathematics disorder - dyscalculia (specific learning disorder)
difficulties rapidly and accurately recalling arithmetic facts, counting objects correctly and quickly, aligning numbers in columns
what is disorder of written expression - dysgraphia (specific learning disorders)?
difficulties in composing written work
spelling errors, errors in grammar or very poor handwriting
what are the biological factors of learning disorders?
heritable component
chromosome 13 is implicated in dyslexia
brain structure differences
what are the brain structure differences in learning disorders?
left temporal parietal cortex decrease activation
brain area responsible for “phonological awareness”
what are treatments for learning disorders?
occurs within special education programs in public schools
individualized programs
duration of treatment should match severity
parental involvement
what are the communication disorders?
language disorder
speech sound disorder
childhood onset fluency disorder (stuttering)
social (pragmatic) communication disorder
what is language disorder?
child sees car but had trouble communicating the word for it
what is speech sound disorder?
says wabbit not rabbit
what is childhood fluency disorder (stuttering)?
“go” - instead go go go go go
more common in boys than girls
most recover
what is social (pragmatic) communication disorder?
newly added to DSM 5
controversial
why is social communication disorder controversial?
does it really need a separate category?
is it limited to autism?
what are the motor disorders?
developmental coordination disorder
tics (vocal and motor)
Tourette’s disorder
what is developmental coordination disorder?
marked impairment in motor coordination, double tying shoelaces and buttoning shirts
diagnosis only made if significant impairment
what are tics?
involuntary repetitive movements or vocalizations
what are examples of motor tics?
eye blinking
facial grimacing
foot tapping
nostril flaring
what are examples of vocal tics?
coughing, grunting, throat clearing, sudden stereotypes outbursts of words
what is Tourette’s disorder?
multiple ,motor tics and one or more vocal tics
what are intellectual disability disorder?
previously termed mental retardation
significant limitations in intellectual functioning and adaptive behaviour
what is the diagnostic criteria for intellectual disability disorder?
IQ = 70 or lower
adaptive functioning (defects in conceptual skills, social skills and practical skills)
age on onset (before age 180)
what is the prevalence of intellectual disability disorder?
3%
what are the 4 levels of intellectual disability disorder (DSM5)
mild (most common)
moderate
sever
profound
how do you determine level of intellectual disability disorder in the DSM 5
use both IQ scores and adaptive functioning to determine severity levels
what were the previous DSM 4 classifications for intellectual disability disorder?
mild: 50-55 to 70 IQ; 85% of people
moderate: 35-40 to 50-55; 10%
server: 20-24 to 35-40 IQ; 3-4%
profound: below 20 to 25 IQ; 1-2%
what is the percent of no identified ethology for intellectual disability disorder?
30-40% of cases
what us the heredity disorder etiology for intellectual disability disorder?
5%
genetic or chromosome anomalies
phenylketonuria (PKU)
fragile X syndrome
what are the early alterations of embryonic development for intellectual disability disorder?
about 30%
down syndrome, trisomy 21; maternal alcohol consumption
what is the etiology for intellectual disability disorder with late pregnancy and perinatal problems?
10%
feral malnutrition, placenta insufficiency, prematurity, low birth weight, infecions
what is the etiology for intellectual disability disorder for environmental influences?
15-20%
deprivation, lack of nutrition, reduced stimulation
effects of low SES conditions
what is the prevention and treatment for intellectual disability?
environmental interventions and enrichment programs
what are environmental interventions and enrichment programs?
behavioural interventions based on operant conditioning
- applied behaviour analysis
cognitive interventions
- self instructional training
what is autism spectrum disorder?
has several subcategories
DSM 5 eliminated subcategories since found inconsistent
what are subcategories of autism spectrum disorder?
Asperger’s
Rett’s
childhood disintegrative
pervasive developmental
what is the increasing prevalence of autism spectrum disorder?
4/10000 (1970s and 1980s) to current 62/10000 (2012)
what is the sex ration for autism spectrum disorder?
more boys than girls
4:1
what is the onset of autism spectrum disorder?
infancy and early developmental period
what is the comorbidity with autism spectrum disorder?
depression, anxiety, ADHD
what are the characteristics of autism spectrum disorder?
defects in social communication and social interactions
troubles adjusting behaviours in changing contexts
repetitive and ridged behaviour
unusual motor movements
what is Rett’s disorder?
very rare, only found in girls
developed 1-2 years of life
head growth decelerates
loses ability to use hands purposefully
walks uncoordinated
poor speech
what is childhood Disintegrative Disorder?
very rare
normal development in 1st 2 Yeats of life
significant loss of social, play, language and motor skills
is autism spectrum disorder and intellectual disability connected?
yes
80% of ASD score below 70 on standardized IQ test
what is extreme autistic aloneness?
rarely engage others in play
fail to offer spontaneous greetings
what are communication defects in ASD?
echolalia echo speech (“do you want cookie? do you want cookie”)
pronoun reversal (refer to themselves as he she you)
what is obsessive compulsive and ritualistic acts in ASD?
upset easily over changes
prone to stereotypic behaviour
what is the psychological bases of ASD?
psychoanalytic and behavioural perspectives
was previously thought patents play crucial role in ASD
“refrigerator mothers”
not credible and it is cruel
what is the genetic factors of ASD?
risk of autism in siblings of people with disorder is 75x greater
fragile X syndrome
genetically broader spectrum of deficits in communication and social areas
reflects exceeding completion genetic variation with 100 genes being involved
what are neurological factors of ASD?
epileptic seizures
abnormal brainwave patterns
what are neurological factors and environmental risks with ASD?
chemicals, infections during pregnancy
possible brain regions impacted including:
cerebellum
amygdala and corpus callosum
medical frontal and medical temporal cortex
what is critical for ASD treatment?
early intervention to provide better chance of success in school and in living independently
what are the treatments used for ASD?
early intensive behavioural intervention
when is early intensive behavioural intervention more effective?
when delivered early and intensely
kids have higher initial cognitive levels and fewer early social interaction deficits show best response to treatment
what is disorders of over controlled behaviour?
also known as internalizing problems
no longer childhood disorder classification, now childhood onset
what are characteristics of disorders of over controlled behaviour?
separation anxiety
social phobia
selective mutism
specific phobia
generalized anxiety disorder
obsessive compulsive disorder
PTS
panic disorder
depression
what are childhood fears and anxiety disorders?
most kids experience fears and worries as part of normal development
fears and phobias reported more often for girls than for boys
what is the % of kids and adolescents have an anxiety disorder?
10-15%
what is the parent style do parents with anxious kids have?
helicopter parenting style
what is separation anxiety?
unrealistic concern about separation from major attachment figures
what are characteristics of separation anxiety?
worry about harm to major attachment figures
fears of abandonment
refusal to attend school
avoidance of being alone
nightmares involving separation
physical complaints in anticipation of being separated from attachment figures
what are characteristics of social phobias?
extremely quiet, shy, avoid strangers
may include selective mutism
what are some theories of social phobias?
individual differences in behavioural inhibition
higher risk when patient has social phobia
what is the treatment of fears and phobias in kids?
similar to adults
exposure to feared object while performing some action to inhibit their anxiety
CBT shows great promise in treating childhood anxiety
