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PSC 168 > Chapter 17 Disorders of Childhood and Adolescence > Flashcards

Chapter 17 Disorders of Childhood and Adolescence Flashcards

1
Q

Gender differences

A

prior to puberty=more boys
post puberty
>boys externalize (acting out, conduct disorder, sub. abuse, ADHD)
>girls internalize (depression, eating disorders)

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2
Q

Childhood Depression Symptoms

A 
sadness, grief
hopelessness, helplessness
low self-esteem
acting out, angry, irritable
somatic complaints
very anxious
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3
Q

Childhood Depression Etiology

A

dysfunctional family, losses, divorce, attachment problems
HX of poor affective regulation (attitude)
genetic predisposition
biochemical imbalance

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4
Q

Disorders seen in CHILDHOOD

A
  1. ADHD
  2. oppositional-defiant disorder
  3. learning disorders
  4. separation-anxiety disorder
  5. phobias
  6. tic disorders
  7. elimination disorders (enuresis, encopresis)
  8. sleep disorders
  9. OCD
  10. Autism Spectrum Disorder
  11. Adjustment disorders
  12. Depression and early BP disorder
  13. PTSD
  14. attachment disorder
  15. Childhood onset schizophrenia (RARE)
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5
Q

Disorders seen in ADOLESCENCE

A 
mostly boys
1. Conduct Disorder
2. Substance use disorders
mostly girls
3. depression 
4. eating disorders
5. social anxiety disorder
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6
Q

children under 10 years

A

depression/anxiety is equally distributed among boys and girls

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7
Q

Autism Spectrum Disorder

A
  1. Deficits in social-emotional reciprocity
  2. Deficits in non-verbal communicative behaviors used for social interaction
  3. Deficits in developing, maintaining, understanding relationships
  4. At least 2 of…
    >stereotyped or repetitive movements, use of objects/speech
    >Insistence on sameness, inflexible adherence to routines, ritualized patterns of verbal/nonverbal behavior
    >highly restricted, fixated interests that are abnormal in intensity/focus
    >Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
  5. symptoms present in early developmental period
  6. cause clinically significant impairment in social, occupational, or other important areas of life
  7. symptoms not better explained by diagnosis of intellectual disability
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8
Q

Autism core deficit

A
  1. inability to relate to others and take perspective
    (cognitively/emotionally)
  2. difficulty to perceive and understand the overall meaning of events
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9
Q

Asperger’s

A

higher functioning autism
speech ok but communication impaired
single interest that is pursued obsessively

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10
Q

savants

A

special memory abilities in areas of music, calculation, or drawing (photographic memory)

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11
Q

Epidemiology of Autism Spectrum

A

1 in 88 children
evident by age 3
life-long disorder
5:1 (males:females)

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12
Q

Neurobiological Factors in Autism

A 
Genetic
age of father
cerebellum abnormalities
amygdala and hippocampus abmormaliteis
fewer connections in corpus callous (speech)
abnormal frontal lobe functioning (fewer connections
      between L/R)
more EEG abnormalities
more pregnancy and birth complications
excessive brain growth in 1st yr of life
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13
Q

Treatment of Autism

A
  1. Behavior modification
  2. no medication for inability to relate
  3. medication for OCD/anxiety (SSRI’s)
  4. medication for mood (mood stabilizers/antidepressants)
  5. medications for agitation (antipsychotics in low dosage)
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14
Q

ADHD

A
  1. Inattention
  2. Hyperactivity-Impulsivity
    * **symptoms occur in 2 or more settings
    * **some symptoms must be present before age 12
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15
Q

Inattention (at least 6)

A 
fails to pay attention to details
difficulty sustaining attn
not listening when spoken to 
not following instructions
not completing tasks
disorganized
messy work
losing things for tasks
easily distracted
forgetful in daily activities
(also may be hyper focused if really like task)
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16
Q

Hyperactivity-Impulsivity (at least 6)

A 
HYPERACTIVITY
-fidgeting w/ hands or feet
-squirming in seat
-runs/climbs about excessively
-has difficulty playing quietly
-always on the go
-often talks excessively
IMPULSIVITY
-blurts out answers
-has difficulty  awaiting turn
-interrupts or intrudes on others
17
Q

Types of ADHD

A
  1. Hyperactive-Impulsive type
  2. Inattentive type (often misdiagnosed as “dreamer”)
  3. Combined type (most people)
18
Q

Prevalence/Gender of ADHD

A

7-9%
4:1 boys
boys==hyperactive
girls==inattentive

19
Q

onset and course of ADHD

A

prior to age 12
2/3 ADHD continues into adolescence
50% diagnosed continue as adults
untreated can take toll on life

20
Q

Etiology

A
  1. Biological (strongest)
    - neurobiological disorder
    - genetics
    - dopamine/norepinephrine
    - dysfunction in frontal lobes and basal ganglia
  2. Psycho-social/ cultural factors
    - chaos in home
    - crowded living conditions, sedentary activity
    - overstimulation (technology)
    - larger classes (less tolerance)
    - modern society doesn’t teach children how to quiet down
21
Q

Treatment of ADHD

A
  1. MEDICATIONS
    * *stimulants (standard)
    • improve 70% school aged kids
    • increase dopamine activity (shuts down overactive lobe
      • *antidepressants
    • prozac, wellbutrin, strattera**
  2. BEHAVIORAL APPROACHES
    * *immediate rewards
    * *consistent parenting with clear consequences
    * *structured environment
    * *establish routines
    * *modify school environment
    * *teach self-instructional procedures
22
Q

Comorbidity with ADHD

A 
substance use
oppositional defiant disorder
conduct disorder
depression
anxiety disorders
OCD spectrum
learning disabilities (more boys than girls)
23
Q

Disruptive Behavior Disorders

A
  1. Oppositional Defiant Disorder (ODD)

2. Conduct Disorder (CD)

24
Q

Oppositional Defiant Disorder (ODD)

A

pattern of negativistic, hostile, and defiant behavior that may include…..

  • temper
  • argues with adults
  • defies or refuses to comply with adult requests
  • deliberately annoys people
  • touch and easily annoyed by others
  • angry resentful, blaming
  • spiteful, vindictive
  • *****GETS ALONG WITH PEERS
25
Q

Conduct Disorder (CD)

A

repetitive pattern of behavior that violates social norms and the basic rights of others, including peers…

  • aggression, intimidation bullying
  • physical/sexual cruelty to humans or animals
  • destroying property, fire setting
  • lying cheating, stealing
  • truant from school (before age 13)
  • staying out at night (before age 13)

PSC 168 (5 decks)

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