Chapter 16 Flashcards
Temperament
Any emotional predisposition or personality traits
Child psychopathology
The emotional and behavioral manifestations of psychological disorders in children and adolescents. Characteristics that signify mental illness and adults such as difficulty with emotional regulation often occur normally developing children. Additionally symptoms of some disorders are quite different and children compared to adults.
Prevalence rates of childhood disorders
31.9% reported symptoms of any anxiety disorder 19.1% demonstrated a behavior disorder and 14% reported symptoms of a depressive or bipolar disorder. Out of 10,000 US adolescence 13 to 18 years old almost half of it already experienced significant mental health concerns. Depressive and bipolar disorder symptoms caused the greatest distress. Females get more depression and posttraumatic stress reactions whereas males demonstrated more inattention and hyperactivity. 40% had more than one disorder.two thirds of those with mental illness receive no treatment. Low treatment rates for depression is the worst.
Rates of youth taking medication
Medication is most frequent treatment among children and adolescents who do not receive treatment. 7.5% of youth from 6 to 17 years old take medication for emotional or behavioral difficulties including 9.7% to boys and 5.2% of girls. Low income youth who qualify for subsidized healthcare of the most likely to take psychotropic medication
Internalizing disorders
Conditions involving emotional symptoms directed inward. Anxiety and depressive disorder’s are the most common internalizing disorders they often lead to substance-abuse and suicide. They include anxiety trauma and stressor related disorders early in life, and mood disorders early in life
Separation anxiety disorder
Severe distress or worry about leaving home being alone or being separated from primary caregivers
Selective mutism
Consistent failure to speak in certain social situations
Anxiety disorders early in life
Separation anxiety disorder, selective mutism, attachment disorders, posttraumatic stress disorder, nonsuicidal self injury. Anxiety disorders are the most prevalent mental health disorder and childhood and adolescent. Of 32% who has experience and anxiety disorder specific phobias 19% and social phobia 9% are the most common.if untreated can lead to adult anxiety disorders. Inhibited and fearful children are at higher risk for anxiety disorders and overprotective or controlling parent practices, no parent to warmth, or perceive parental rejection can make the issue worse.childhood anxiety disorders are most effectively treated with CBT. These children show exaggerated autonomic responses and are apprehensive in new situations preferring to stay at home or another familiar environments.
Attachment disorders
Infants and children raised and stressful environments that little predictable parenting and nurturing show difficulties with emotional attachments and social relationships. Symptoms must be a parent before age 5 and went early circumstances prevent the child from forming stable attachments. Changes in primary caregiver, persistent neglect of physical or psychological safety including physical abuse and environments the void of stimulation or affection can disrupt attachment.
Reactive attachment disorder or RAD
Show little trust that adults will attend their needs. Do not readily seek or respond to comfort attention or neutering. A trauma related disorder characterized by inhibited avoidant social behaviors and reluctance to seek or respond to attention or nurturing. Use avoidance as a psychological defense, and experience difficulty responding to orinitiating social or emotional interactions. Rarely show positive emotions and demonstrate irritability sadness or fearfulness when interacting with adults. Symptoms often disappear of children begin to receive protectable caretaking and nurturance
Disinhibited social engagement disorder DSED
They socialize effortlessly but indiscriminately and readily become superficially attached to strangers and casual acquaintances. Interact with unfamiliar adults in an overly familiar Man are both verbally and physically while moving away from caregivers. They often have a harsh punishment history or inconsistent parenting in addition to emotional neglect and limited attachment opportunities. Symptoms are often persistent and continue into adulthood.
Post dramatic stress disorder in early life
Youth experience recurrent distressing memories of a shocking experience and desperately want to avoid any cues associated with the event. Many entail a)distressing dreams, b) intense psychological or physiological reactions to thoughts or cues associated with the event, c) episodes of play acting the event sometimes without apparent distress and D)dissociative reactions in which the child appears to re-experience the trauma or seems unaware of present surroundings. They also seem socially withdrawn show few positive emotions or seem disinterested in activities previously enjoyed. According to DSM behavioral evidence of PTSD includes Angry aggressive behavior or temper tantrum’s, difficulty sleeping or concentrating, and exaggerated startle response or vigilance for possible threats. 8% for girls and 3.2% for boys lifetime prevalence. CBT helps.
Nonsuicidal self injury
Intentional self inflicting harm intended to provide relief from negative feelings or to induce positive feeling; can also involve a preoccupation with engaging in self harm. Often there is a desire to resist the impulse to self-injure. This is a diagnostic category undergoing further study. For diagnosis individual must display he’s intentional behaviors at least five times over one year. Pain produces relief from uncomfortable feelings or a temporary sense of calm and well-being. A secondary motivation for some is that the self injurious behavior serves as a form of self punishment. Those who self injure tend to be highly self critical and have difficulty expressing in regulating emotions.risk of substance-abuse or attempted suicide. A negative cognitive style a negative self talk are associated with increased frequency of it and increased likelihood of suicide. Males more likely hit or burn themselves females more frequently cut themselves. 14 to 17% haveengaged at least once. Only few do it repeatedly. DBT is effective.
Childhood and abuse and a neglect
678,810 youth were victims of child neglect or physical or sexual abuse in 2012. 1640 died. Majority of deaths from abuse involve children three or younger and 80% of cases the perpetrator is one or both parents. Factors are poverty parental immaturity and lack of parenting skills. Many adults will be used for themselves abused as children many of the parents involved are young high school dropouts and under severe stress many of personality disorders and low tolerance for frustration or abuse alcohol and other substances. And child sexual abuseperpetrators are often friends or other family members in the parent is unaware that the abuse occurred
Mood disorders early in life
Depression most prevalent among females an older adolescence. Environmental factors are a frequent cause of depression in childhood where is genetic or other biological factors are more of an influence during adolescence. Increased by conditions such as childhood physical or sexual abuse, parental mental or physical illness, or loss of an attachment figure. Use with depressive disorder’s have a negative self-concept and are more likely to engage in self blame and criticism. Evidence-based treatment include individual or group CBT family focused therapy and programs focused on building resilience based on positive psychology principles strong association between depressive disorder is an adolescent suicide ideation and suicide attempts. SSRIs despite warnings may be helpfulin severely depressed
Disruptive mood dysregulation disorder
DM DD is characterized by chronic irritability and severe mood dysregulation including recurrent episodes of temper triggered by common stressors such as interpersonal conflict or being denied a request. And her reactions are extreme and both intensity and duration and may involve verbal rage or physical aggression. This is a depressive disorder even though behavioral symptoms are directed outward they reflect an irritable angry or sad mood state. For the diagnosis the mood between temper Appisodes must be irritable or angry most of the day nearly every day. Outbursts are present in at least two settings and occur at least three times a week for most months over a year. Cannot make the diagnosis until the child is at least six and symptoms must be evident before 10.symptoms are overlapping with bipolar disorder and this must be rolled out interventions are quite different for these two disorders. Ranges between. 8 to 8.2% many have comorbid disorders associated with emotional dysregulation such as depressive disorder’s or oppositional defiant disorder. Prevalences to the 5% more often in boys.
Pediatric bipolar disorder PBD
A serious disorder involving depressive and energize episode similar the mood swings seen in adults mood changes depressive episodes and the Departure from individuals typical functioning. May involve diminished need for sleep distractibility talkativeness or inflated self-esteem also may distribute recurring depressive episodes or periods of on characteristic irritability that alternate with the energized episodes can develop gradually are suddenly. Change from child’s normal mode or temperament. Youth often demonstrate rapid cycling of moods combined with difficulties in regulating behavior and social emotional functioning elevated neural logical responsiveness to environmental stimuli and various brain abnormalities. The new DM DD category is hope to help for greater diagnostic accuracy since some experts believe this prevalence rates are inflated. In adolescence a estimated to be 3% lifetime prevalence. Medications therapeutic techniques and psychosocial interventions are similar to those for adults use of lithium an antipsychotic medications does concern some mental health professionals family focused interventions help children learn to regulate their symptoms. Diagnosis usually occurs around age 10 through adolescence about five years later then DM DD. Prevalence is 1% affects boys and girls equally
Externalizing disorders
Sometimes called disruptive behavior disorders, include disruptive, impulse control and conduct disorders. Conditions associated with symptoms that are distressing to others. Can be distressing to parent and result in negative parent child interaction’s, high family stress and negative feelings about parenting. diagnosis of a disruptive impulse control or conduct disorder requires a persistent pattern of behavior that : is atypical for the child’s culture, gender, age, and developmental level; and is severe enough to cause distress of the child or others,or negatively affect social or academic functioning. They include oppositional defiant disorder intermittent explosive disorder and conduct disorder. Externalizing behavior disorders in thechild are associated with the development of depressive disorder’s in adulthood.
Oppositional defiant disorder
A childhood disorder characterized by negativistic argumentative and hostile behavior patterns that continues for at least six months directed at parents teachers and others in authority. At least four symptoms involving short tempered resentful blaming spiteful or hostile behavior’s must be present it’s mild if they occur and only one setting and severe if the behaviors occur in threeor more settings. Symptoms can resolve especially with intervention although some youth begin the demonstrate the more serious rule violations associated with conduct disorder. ODD has two components, one involving negative affect an emotional dysregulation such as angry irritable mood, and the other involving defiant and oppositional behavior. Negative affect predicts future depressive symptoms whereas oppositionalbehaviors are more productive of delinquency and conduct disorder. Half of those with ODD display inattention and hyperactivity
Intermittent explosive disorder or IED
Condition involving frequent lower intensity outbursts or low-frequency high intensity outbursts of extreme verbal or physical aggression. A diagnosis involves it’s under treated and underdiagnosed category. Diagnosis involves recurrent outbursts of extreme verbal or physical aggression that occur twice weekly for at least three months or three outbursts occurring within one year. That involve damaged injury people animals or property low-frequency high intensity outbursts. Outbursts occur suddenly in response to mine or provocation and do not involve premeditation they are exaggerated angry or impulsive reactions that caused distress or impairment interpersonal functioning. The moon is normal between outbursts unlike DM DDmust be at least six years old to be diagnosed. It’s associated with early exposure to family aggression and violence and enter personal trauma maybe diagnosed and individuals with ADHD, conduct disorder, or ODD if the outbursts of her and meet the criteria for IED. 63% of adolescents had experience angry outbursts however 7.8% met the criteria
Conduct disorder
A persistent pattern of behavior that violates the rights of others, including aggression, serious rule violations, and illegal behavior reflects dysfunction in the individual rather than a pattern of behavior within the person subculture, and include serious violations of rules and social norms and disregard for the rights of others. Diagnosis requires at least three behaviors involving: a) deliberate aggression such as bullying physical fights use of weapons cruelty to people or animals aggressive theft or sexual conduct; b) destruction of property including fire setting; c) theft or deceit such as stealing, forgery home or car invasion or conning others; or D)serious violation of rules such as staying out at night truancy running away. Disorderly condo at increases or becomes more serious with age. Boys with CD are often involved in confrontational aggression whereas girls are more likely to display truancy substance abuse or lying. 2 to 9% of youth meet diagnostic criteria for CD half also have inattention and hyperactivity.
Limited prosocial emotions
According to DSM-V some youth diagnosed with cd have this they display minimal guilt or remorse and are consistently I’m concerned about the feelings of others, their own wrongdoing, or poor performance at school or work. They are good at manipulating others and may appear superficially polite and friendly when they have something to gain. Cruelty aggression and a pervasive lack of remorse or common characteristics of the subgroup. They show limit Limited neural responsiveness and brain regions associated with empathy when presented with pictures of people in pain. In an MRI adolescents with CD and Calais traits demonstrated strong pleasure responses to video clips of people experiencing pain and distress. These traits are at high-risk for continuing criminal behavior and for receiving a diagnosis of antisocial personality disorder or later inLife
Etiology Of externalizing disorders
Biological factors appear to exert the greatest influence on the development of conduct disorder. Antisocial behavior has been linked to brain abnormalities associated with deficits in social information processing as well as reduced activity in the amygdala in situations associated with fear. These deficits appear to decrease the ability to learn from rewards and punishments. Risk ofconduct disorder is increased when carriers of the genotype low activity MAOA, an allele associated with fear regulating circuitry in the amygdala are subjected to childhood maltreatment. Reduced activity of the autonomic nervous system and an increased need for stimulation to achieve optimal arousal is also associated with conduct disorder in males; may account for risk-taking behaviors associated with the disorder. Elevated stress hormones cortisol have been associated with the symptoms of impulsive aggression where as low cortisol occurr in youth with callous and unemotional traitsand predatory aggression
Family and social context role in the development of externalizing disorders
Child’s environment moderates the relationship between individual vulnerability and the age at which antisocial behavior emerges. Parents and teachers able to exert more influence on the behavior of children with antisocial tendencies during childhood compared to adolescence. In adolescence peer influences dominate. Aggressive behaviors associated with harsh or inconsistent discipline, a punitive inconsistent or impatient man or in response to typical childhood misbehaviors leads to disruptive behavior power struggles confer their intensify behaviors.
Classical psychological behavioral model of disruptive behavior
Based on the following pattern of parental reaction to miss behavior: 1) the parent addresses miss behavior or makes in unpopular request 1)the child responds by arguing or counterattacking and 3)the parent withdraws from the conflict or gives into the Childs demands. Child does not learn to respect rules or authority. Alternate pattern sometimes occurs is a vicious cycle of harsh punitive parental responses to miss behavior resulting in defiance and disrespect on the part of the child and further coercive parental behaviors. Limited parental supervision, permissive parenting and avoidance of conflict, excessive attention for negative behavior, inconsistent disciplinary practicesand failure to teach prosocial skills or use positive management techniques can further exacerbate the stripped of behavior
Treatments of externalizing disorders
Interventions that address the family and social context of behaviors as well as deficits in psycho social skills can improve externalizing behaviors. Cognitive behavioral parent education teach parents to regulate their own emotions which increases positive interactions with children establishment of appropriate rolls and consistently improving child behavior and parental mental health. Psychosocial interventions focused on teaching youngsters assertiveness and anger management techniques and building skills and empathy communication and social relationships and problem-solving. Mobilize an adult mentors who demonstrate empathy warmth and acceptance is effective. Conduct disorder is particularly difficult to treat best before patterns of antisocial behavior or firmly established. Incarcerationproduce additional behavioral or psychological difficulties rather than rehabilitation especially if incarceration is an adult facilities
Elimination disorders
Enuresis and encopresismany exhibit significant distress and apprehension, sensitivity to real or imagined parental disapproval, and with drawl from peer relationships. On sympathetic or impatient responses from caregivers can increase anxiety and distress making the problem worse
Enuresis
Periodic forwarding of urine into one’s clothes or bad or onto the floor during the day or night. Usually involuntary although in rare situations may be intentional. Most likely to occur during sleep bedwetting. Child must be at least five and void inappropriately at least twice per week for three months. Temper cent of five-year-olds and 5% of 10-year-olds. 1% of adolescents. Psychological and biological factors are associated. Life situation such as death of parent birth of a new sibling family dysfunction or the presence of other emotional problems can increase risk. Severe nocturnal enuresis is usually due to heredity. Biological influence maybe genetics delays and physical maturation and I hypersensitive or smallletter. Provided you Acacian and support for parents and child set up rewards and use a bedtime your own alarm. Medication can also be used
Encopresis
Defecating onto ones close the floor or other inappropriate places child must be at least four years old and must have defecated inappropriately at least once a month for three months. .7 to 4. For prevalence in children. Intermittent episodes can last for years usually pattern is a child with constipation resulting in painful defecation and subsequent withholding of bowel emptying leads to National constipation fickle leakage an involuntary swelling. Inattention and hyperactivity or common. Treatment includes proper medical valuation increasing fluid intake and and parent and child education about toileting regimes
Neurodevelopmental disorder’s
Conditions involving impaired development of the brain and central nervous system that are evident early in the child’s life symptoms include difficulty with learning communication and behavior becoming increasingly evident as child grows and develops includes tip disorders attention deficit hyper activity disorder autism spectrum disorder’s and intellectual and learning disorders
Tick
And involuntary repetitive movement or vocalization. Motor tics involve various physical behaviors including blinking grimacing tapping jerking the head flaring the nostrils and contracting the shoulders. Vocal tics include coughing grunting throat clearing sniffling and son repetitive stereotyped outbursts of words.
Tick disorder
If the tech is present for less than a year diagnosis of provisional to disorders given chronic motor or VocalTec disorder refers to text lasting more than a year. Texas usually peak prior to puberty in the Kleiner disappear through adolescence. Neurological studies suggest symptom improvement maybe due to compensatory neuroplastic brain we organization that allows affect teens to suppress and eventually controlticks. Short term suppression of a tip is sometimes possible but results the subsequent increases in the tech. Many people report feeling tension before I took followed by a sense of relief after.2 to 5% four times as common in males. Have a genetic basis. Prenatal factors associated include alcohol and cannabis use in adequate maternal weight gain. You psychotherapies or habit reversal or antipsychotic medications for severe text
Tourette’s disorder TD
Characterized by multiple motor tics and one or more vocal tics. Motor tics involving self harm such as punching oneself or coprolalia occur and 10% of those with Tourette’s disorder. Tics are present for at least one year although not necessarily concurrently. motor tics include blinking grimacing shrugging jerking of the header shoulders. vocal tics such as repetitive throat clearing sniffling or grunting..77% had Tourette’s much more common in boys. has a genetic basis. Prenatal factors include maternal alcohol and cannabis use an in adequate maternal weight gain. TD is highly comorbid with obsessive-compulsive disorder therefore similar neurochemical abnormalities in brain structures are likely involved. Stress, negative social interactions, anxiety, excitement or exhaustion can increase the frequency of ticks. Psychotherapy can help as well as behavioral techniques such as habit reversal. Sometimes antipsychotic medications are used.
