Chapter 15 - Behaviour and Emotional Disorders Flashcards by Philia Yip

What are the current issues of behavioural and emotional disorders of children/adolescents?

Age-specific variations in symptoms

Lack of concordance of reporting

Relies on self-report

How well did you know this?

Not at all

Perfectly

What are the two types of childhood mental disorders?

Externalizing and internalizing

How well did you know this?

Not at all

Perfectly

What are the externalizing disorders?

Attention deficit/hyperactivity

Oppositional defiant

Conduct

How well did you know this?

Not at all

Perfectly

What are the internalizing disorders?

Anxiety

Separation anxiety

Selective mutism

Reactive attachment

Depressive

How well did you know this?

Not at all

Perfectly

What is comorbidity?

Co-occurence of 2+ disorders

How well did you know this?

Not at all

Perfectly

In childhood and adolescent disorders, comorbidity is seen as a(n) _______ rather than a(n) ___________.

Rule; exception

How well did you know this?

Not at all

Perfectly

Current diagnosis is often ________.

Predictive

How well did you know this?

Not at all

Perfectly

What is homotypic continuity?

Prediction of same diagnosis in future

How well did you know this?

Not at all

Perfectly

What is heterotypic continuity?

Prediction of different diagnosis in future

How well did you know this?

Not at all

Perfectly

In North America, the most common disorders in youth and children are…

Anxiety, conduct, ADHD

How well did you know this?

Not at all

Perfectly

What is the average age onset of anxiety disorders?

How well did you know this?

Not at all

Perfectly

What is the average age onset of behaviour problems?

How well did you know this?

Not at all

Perfectly

What is the average age onset of mood disorders?

How well did you know this?

Not at all

Perfectly

What is the average age onset for substance use disorders?

How well did you know this?

Not at all

Perfectly

What disorders do girls tend to be diagnosed more for?

Mood, anxiety, eating

How well did you know this?

Not at all

Perfectly

What disorders do boys tend to get diagnosed more for?

Behaviour, substance

How well did you know this?

Not at all

Perfectly

What is attention deficit/hyperactivity disorder?

Persisting pattern of inattention/hyper-impulsivity that interferes with functioning or development

How well did you know this?

Not at all

Perfectly

Under which DSM-5 section is ADHD listed?

Neurodevelopmental disorders (brain-based)

How well did you know this?

Not at all

Perfectly

Symptoms of ADHD almost always emerge in __________, and 1/3 children _______ diagnosis into _________.

Childhood; retain; adulthood

How well did you know this?

Not at all

Perfectly

What are symptoms of inattention?

Careless mistakes

Difficulty focusing

Unorganized

Avoidant

Forgetful

How well did you know this?

Not at all

Perfectly

What are symptoms of hyperactivity/impulsivity?

Fidgeting

Inappropriately active

Excessive and loud talking

Difficulty waiting

How well did you know this?

Not at all

Perfectly

To diagnose ADHD, how many symptoms and for how long do they have to be present for?

6+ symptoms for 6+ months

How well did you know this?

Not at all

Perfectly

What are the diagnostic criteria for ADHD?

Symptoms present before age 12

Present in 2+ settings

Interference with functioning

How well did you know this?

Not at all

Perfectly

What are the 3 situations of ADHD presentation?

Combined

Predominantly inattentive

Predominantly hyperactive/impulsive

How well did you know this?

Not at all

Perfectly

What are the subtypes of ADHD?

ADHD-I ADHD-H ADHD-HI

What is ADHD-I characterized with?

Academic/social problems Organizational and motor control

What is ADHD-H and ADHD-HI characterized with?

Higher rates of comorbid conduct problems

Regarding the subtypes of ADHD, _________ is more common in girls, whereas _________ and __________ are more common in boys.

ADHD-I ADHD-H; ADHD-HI

What are the 5 other disorders that 50% children with ADHD are comorbid with?

ODD/conduct Learning Anxiety Depression Substance abuse

Individuals with ADHD have higher rates of...

Grade retention, suspension, and dropout

When is ADHD typically identified?

Elementary school

What are the brain and function factors of ADHD?

Reduced/delayed brain maturation Abnormal dopamine/noradrenergic NTs Abnormal prefrontal cortex and basal ganglia

What are the genetic factors of ADHD?

77% risk of heritability No gene specifically identified

What are the prenatal risk factors of ADHD?

Prenatal toxin exposure Poor diet Pregnancy/delivery complications

What are the psychosocial risk factors of ADHD?

Low SES Large/dysfunctional family Parental mental health difficulties Maltreatment Foster care

___________ for specific dopamine receptor gene expressed in ________ associated with greater risk for ADHD when children also exposed to _______.

Homozygosity; prefrontal cortex; inconsistent parenting

ADHD symptoms associated with maternal __________ during pregnancy only in those with __________.

Smoking; genetic predisposition

What is the assessment for ADHD?

Comprehensive Multi-informant Self-report for adolescents Psychoeducational testing

What are the pharmacological treatments for ADHD?

Ritalin (methylphenidate) and dexedrine (dextroamphetamine)

What do the pharmacological treatments of ADHD do?

Increase release of DA and NE, block reuptake Increase functioning and reduce undesirable behaviour

What are the side effects of pharmacological treatments of ADHD?

Decreased appetite Sleep disturbances

What are the psychoeducational interventions of ADHD?

Academic skill facilitation and remediation Parent training

What is academic skill facilitation and remediation?

Focus on academic organization Identify challenges

What is parent training?

Educate parents on how to manage child Contingency management Consistency

What is conduct disorder?

Problems with basic rights of others and violation of age-appropriate societal norms

What are 4 characteristics of conduct disorder?

Aggression Destruction of property Deceitfulness/theft Violation of rules

Conduct disorder is often comorbid with _________ and ________ difficulties.

ADHD; learning

What are the psychopathic tendencies associated with conduct disorder?

Callous/unemotional trait specifier

What are the subtypes of conduct disorder?

Childhood onset Adolescent onset Unspecified onset

What would classify childhood onset type of conduct disorder?

1+ symptoms present before age 10

According to assortative mating, what are the 4 factors of conduct disorder?

CD females date/marry CD males Discord in relationship Poor parenting of offspring Children higher genetic load for CD

What is oppositional defiant disorder?

Pattern of being defiant and negative behaviours towards others

Some argue that ODD is an earlier expression of...

What is the difference between CD and ODD?

CD: more pre-meditated ODD: more reactive/emotion regulation difficulties

What are the 3 symptom groups of ODD?

Angry/irritable mood Argumentative/defiant behaviours Vindictiveness

More _________ are diagnosed with ODD.

Boys

What is the failure model of ODD?

Engaging in externalizing behaviour increases probability of experiencing social failure, related to development of internalizing problems

What is the acting out model of ODD?

Youth mask mood problems by behaving aggressively

What is the reciprocal model of ODD?

Associations between externalizing and internalizing problems reciprocal

What is the order of the developmental trajectory (top to bottom)?

ASPD CD ODD ADHD

What is the genetic etiology for CD and ODD?

High genetic risk/influence Intergenerational patterns of criminal behaviour Shared heritability between depression and ODD

The shared heritability between depression and ODD is mediated by __________.

Irritability

What is the neurobiologic etiology for ODD?

Decreased glucose metabolism (frontal lobe) Damaged PFC and amygdala Abnormal SE, NE, and cortisol

What are the prenatal risk factors of ODD?

Maternal smoking/substance use Pregnancy/birth complications Maternal stress

What are the psychosocial risk factors of ODD?

Poor parenting Peer rejection/influence Abnormal parenthood Low social status

According to Capsi's study of gene-environment interactions affecting CD, childhood maltreatment AND low _________ activity led to CD in adulthood compared to childhood maltreatment with high _______ activity.

MAOA (x2)

The differential susceptibility theory and biological sensitivity to context theory state...

Vulnerability influences outcomes depending on context of environment

Children with ODD and CD more likely to interpret ambiguous situations as being __________, leading to them relying on _________ strategies.

Hostile; aggressive

What happens in problem-solving skills training for ODD and CD?

Modelling and practice Roleplaying Reinforcement contingencies

What does problem-solving skills training do for a child with ODD or CD?

Increase repertoire for available behaviours Flexibility of responses Reduce problematic behaviour

Pharmacological treatments are used for ADHD when ADHD is __________.

Comorbid

What pharmacological treatment is used for disruptive and aggressive behaviour?

Antipsychotics Lithium (only short-term)

Why are interactions between parent and child considered to maintain and promote conduct problems?

Coercive process, where situation becomes escalated then parent gives in

What are the factors of parent training for CD?

Break coercive process Increase positive parenting Increase compliance Ignore unwanted behaviour Consistency and problem solving

What is the school and community based treatment for conduct problems?

Reduce stigmatization so no child singled out for treatment Available to all children

When fear is age-specific, intensity is proportional to ___________, meaning it is _____________.

Perceived threat; developmentally appropriate

When fear is excessive, may impact ________________ and lead to ______________.

Normal functioning; anxiety disorders

What is separation anxiety disorder?

Excessive fear/anxiety concerning separation from those to whom individual attached

How many and for how long do symptoms have to be present to diagnose separation anxiety disorder?

3+ symptoms, 4+ weeks

What is the prevalence and onset of separation anxiety disorder?

5% equal in boys and girls Preschool years

What are associated features of separation anxiety disorder?

Social withdrawal Concentration difficulties Sadness, aggression, demanding Strange perceptual experiences School refusal

What is the etiology for separation anxiety disorder?

Temperament Abnormal amygdala Genetics Psychosocial risk factors

What are the psychosocial risk factors of separation anxiety disorder?

Modelling Life stress Parental overprotection

What is selective mutism?

Failure to speak in specific social situations

How long do disturbances need to be present for to diagnose selective mutism?

1+ months

What is the onset of selective mutism?

Before 5 years old

What are associated features of selective mutism?

Shyness/withdrawal Clinging Temper tantrums Delays in communication/language development

What are the consequences of selective mutism?

Social communication Underestimation of capabilities

What is the behavioural conceptualization of selective mutism?

Negative reinforcement, where child too anxious to speak and adult comes to rescue

What is the aim of treatment for anxiety?

Reduce physical symptoms and pattern of avoidance

What are the treatments for anxiety?

Psychoeducation of causes CBT Pharmacological (SSRIs)