Child and Adolescent Mental Health Flashcards
Define mental health?
Ability to function well from and emotional and social perspective within your culture/environment
Why is mental health important?
To be able to function well emotionally and socially are vital human function that allow us to withstand stress and to survive and reproduce as a society
Function of the physical brain?
Processes that control the social, emotional and behavioural aspects allowing survival as humans
Describe epigenetics
Genes are expressed differently when exposed to different environmental triggers
What is the Disability Adjusted Life Year (DALY)?
Measure of overall disease burden, expressed as the no. of YEARS lost due to ill health, disability or early death
Factors that shape mental health in children and young people?
Genetic risk (non-modifiable)
Environmental risk (modifiable)
Repetitive experience during childhood is important
Why are children and young people vulnerable to mental health issues?
Exist within systems they are dependent on and cannot change
Subject to significant stressors and transitions during their development
Why are children and young people often targeted for mental health change?
Early developmental windows of change
Reduction of impact at developmental transitions
Reduce morbidity and co-morbidity
Prevent formation of established pattern of behaviour and vicious cycles
Spiraling self-esteem and maladaptive coping
Define attachment?
Strong emotional tie that develops over time between an infant and its primary caregiver(s)
Describes the special, specific affective/emotional relationship normally observed between an infant and primary caregivers
Mechanism of developing attachment?
Infant and primary caregiver trigger each other’s instinctual social behaviours and form an attachment
Initial goal is to protect the infant and promote survival of the species; development of attachment ensures that someone will protect the infant during this defenceless period of life
Define a primary caregiver?
Anyone who satisfies infant’s attachment needs, i.e: predictable safety
Children develop different styles of attachment based on repetitive experiences and interactions with their caregivers
Importance of attachment?
Early relational experience in the context of stress leads to an “internal working model” for day-to-day life
It is often seen as an ingredient in the context of FORMULATION
Framework of how environmental influence in childhood can affect child (and caregiver’s) mental health
4 principles of attachment?
Part of the "Strange situation test": • Proximity maintenance • Safe haven • Secure base • Separation distress
Categories of infant attachment?
- Secure attachment - 70% of infants
- Anxious attachment (avoidant) - 15% of infants
- Anxious attachment (ambivalent) - 15% of infants
- Disorganised attachment response
Describe secure attachment
Confident child readily explores, using the carer as a secure base; cries infrequently and is easily put down after being held
Caregiver gives an appropriate response to upset child; encourages infant to explore and is tuned to their needs
Describe anxious attachment (avoidant)
Child avoids/ignores parent when they return, showing little overt indications of an emotional response; often, the stranger will not be treated much differently from the parent
Caregiver is disinterested, uncomfortable with showing affection but overly encourages separation/independence
Describe anxious attachment (ambivalent)
Child is unsure how to respond to the parent when they return, despite large emotional response;May seek comfort/be unsure with this attention
Caregiver is unpredictable, inconsistent, frightening
Describe disorganised attachment response
Older children in the context of severe trauma; they have no cohesive response and have bizarre behaviour, e.g: soiling, destruction of possessions and odd noises
It OVERLAPS with dissociation
Other ways of assessing attachment?
Observational strange situation (school, up to 18 months)
Semi-structures interviews
Story stems and picture responses
Attachment q sort
What is an attachment disorder?
Rare and individual has difficulty forming lasting relationships; often show nearly a complete lack of ability to be genuinely affectionate with others and they typically fail to develop a conscience
Define temperament?
Inherent, constitutionally based characteristics that constitute the core of personality and influence directions for development
Methods of measuring temperament?
Observations in socially-structures situations
Questionnaires
Physiological measures, e.g: HR, ECG, etc
9 dimensions of temperament?
- Activity level
- Approach/withdrawal
- Adaptability
- Mood
- Threshold
- Intensity
- Distractibility
- Rhythmicity
- Attention spans/persistence
3 broad catefories of temperament?
Acitivity - intensity and pace of behaviour
Emotionality - positivity/negativity of a person in general
Sociability - preferences for social interaction or solitude
Describe the stability of temperament over time
Temperament is inherent but development of it can be influenced by the environment, i.e: different trajectories and outcomes may occur for children with similar temperamental traits; also, children differing in temperament may come to similar developmental outcomes via different pathways
Differences in children in relation to resilience?
Some children manage well despite significant adverse experiences
When does a child who experiences chronic adversity fare better or recover more successfully?
- If they have a positive relationship with a competent adult (attachment)
- If they are good learners and problem-solvers (temperament)
- If they are engaging to other people (temperament)
- If they have areas of competence and perceived efficacy valued by self/society (systems)
Variations in neurobiology that can alter resilience?
Neuropeptide Y limits the stress response
5-DHEA protects brain from elevated cortisol
Ingredients of resilience?
Attachment
Temperament
Systemic model (family, support, etc)
