chapter 19: childhood and adolescent mental health issues

Question 1

risks for mental health problems

Answer 1

• many children are dealing with anxieties that were unknown in previous generations, which contribute to a variety of disorders
• 13-20% of children experience a mental health disorder within the previous year
• family dynamics, as well as genetics, play important roles
• common diagnoses include: depression, bipolar, suicidal behavior, ADHD, autism spectrum disorders, conduct disorder…amongst others

Question 2

depression in children and adolescents

Answer 2

• may be caused by family influence: if parents are depressed, the children are three times more likely to be depressed than their age mates
• environment and biochemical imbalances in the brain
• similar symptoms as adults
• may also see change in school routines: may become inattentive, experience a drop in grades, or become anxious about being at school
• teens also experience rebellion, intense ambivalence, anger, rage, pessimism, low self esteem, which may be more extreme in depression

Question 3

medical treatment of depression

Answer 3

• antidepressants used carefully as some reports of increased suicide risk in this population
• individual and family therapy
• education to strengthen coping skills

Question 4

attention-deficit/hyperactivity disorder (adhd)

Answer 4

• most common childhood mental health disorders
• impact often continues into adulthood
• characterized by a variety of age inappropriate behaviors
• can be inattentive and/or hyperactivity/impulsivity types
• other behaviors exhibited: inability to focus on tasks, underachievement (academic, social, etc.)
• hyperactivity, noncompliance (with rules, regulations, norms, etc)
• impulsive actions
• poor A concept both leading into the disorder after exhibiting the inappropriate behavior
• the diagnosis is generally made before age 12 and must be exhibited in multiple locations( for ex the child may display the impulsiveness at home and in church, at school, or in a shopping mall)
• about 50% of youths w/ ADHD have symptoms into adulthood such as impulsivity and inattention

Question 5

medical treatment for adhd

Answer 5

• pharmacologic treatment includes use of psychostimulants, which have a calming effect on ADHD sufferers
• examples include methylphenidate and dextroamphetamine/amphetamine
• individual and family therapy as well as family education need to be part of treatment

Question 6

conduct disorder

Answer 6

• long term (chronic) behavior problems associated with physical aggression, defiance, rule breaking, and disturbed peer relationships
• persistent pattern of violating rights of others, breaking rules
• underlying cause of the anger is hidden
• seems to affect males two to three times more frequently than females
• begins in childhood or adolescence

Question 7

conduct disorder treatment

Answer 7

• rule out other possible causes
• individual and family therapy
• parent management training

Question 8

autism

Answer 8

• now called ASD with gradient of mild to severe
• considered the most difficult to treat and least likely to be reversed
• incidence of autism on the rise
• affects males 3-4 times more frequently than females
• not curable
• children w/ autism are considered disabled for life
• should not be confused or misdiagnosed as schizophrenia, although some behaviors may be similar
• may demonstrate failure to achieve developmental milestones
• most common symptom is impaired social interaction
• etiology is still unknown

Question 9

common symptoms of autism

Answer 9

• no response to their name by 12 months
• avoid eye contact and want to be alone
• have trouble understanding other people’s feelings or talking about their own feelings
• delayed speech and language skills
• unusual reactions to the way things sound, smell, taste, look, or feel
• appear to be in their own world

Question 10

medical treatment of autism

Answer 10

• early diagnosis to begin intervention services early to help children from birth to 3 years old learn important skills and enhance development by taking advantage of the brain’s ability to adapt
• family education and counseling
• speech, occupational, and physical therapies
• supportive environment in home and school
• the FDA has approved the use of risperidone and aripiprazole when aggressiveness or self injury present in ages 6-17

Question 11

medical treatment for children and adolescents w/ mental health issues

Answer 11

• children and adolescents who have a real or perceived threat to their mental health will react to that threat in different ways
• medical providers must do a comprehensive examination and evaluation of the individual
• medications or therapy will be ordered on an individual, as needed basis
• listen to the child/adolescent and take his/her concerns seriously

Question 12

alternative treatment for children and adolescents w/ mental health disorders

Answer 12

• children benefit from alternative therapies, as do adults
• herbal preparations and nutritional supplements: ensure adequate nutrition to support normal growth and development
• aromatherapy
• play therapy
• massage
• neurolinguistic programming
• biofeedback (when age appropriate)

Question 13

nursing care for children and adolescents w/ mental health issues

Answer 13

• provide safety: in the examination area, the hospital room, and the school
• communicate effectively
• maintain agency policies regarding apparel, items allowed onsite, etc
• monitor and teach child and family regarding medications
• model and educate and support parents on behavioral management
• other interventions that may be specific to the situation

Question 14

effective communication w/ children and adolescents w/ mental health issues

Answer 14

• honest, age appropriate communication is essential
• listen to and then do something
• if the child or adolescent believes someone took what they said seriously and attempted to address that concern, chances for continued meaningful communication are greatly improved