Child and Adolescent Psychiatry

Question 1

Define whiter matter connectivity

Answer 1

• Important for functions requiring communication between areas of the brain → working memory, hippocampus and anterior cingulate
• Low connectivity → neural noise and cognitive instability
• Associated with ADHD

Question 2

Environmental factors during childhood

Answer 2

• Primary caregiver
• Parental skill and parental mental disorder
• Marital harmony, family function
• Nutrition, poverty, deprivation
• Abuse, neglect
• Discipline,
• Day-care and schooling
• Peer relationships
• Life events
• Physical disability

Question 3

Brain’s response to perceived stress

Answer 3

• Perceived behaviour and aggression
• Limbic response/ weighted amygdala activity
• Cortical response and preparation for aggressive response
• Behavioural/ aggressive response

Question 4

Define expressed emotion

Answer 4

• Carers negative response in clinic predicts rate of relapse of chronic illness
• Schizophrenia, depression, ADHD
• Also physical conditions epilepsy, CF, diabetes, asthma
• Aim is to reduce EE and reduce relapsing rate

Question 5

Define Conduct Disorders

Answer 5

• Repetitive and persistent patterns of antisocial, aggressive or defiant behaviours

Question 6

Define self harm

Answer 6

• Coping mechanism of self injury
• Cause physical harm to deal with emotional pain or break free of feel numb
• Self-poisoning, cutting, burning
• Indicates psychiatric or psychosocial problem

Question 7

Factors that increase risk of suicide

Answer 7

• Persistent suicidal ideas
• Previous suicidal behaviour
• High lethality of method used
• High intent and motivation
• Ongoing precipitating stresses
• Mental disorder
• Poor physical health
• Impulsivity, neuroticism, low self-esteem, hoplessness
• Parental psychopathology and suicidal behaviour
• Physical and sexual abuse
• Disconnection from support systems

Question 8

Management of suicide risk

Answer 8

• Safety of the young person is the priority
• Take it seriously
• Admit to medical ward for medical treatment and assessment
• Risk trained staff members with access to psychiatric help
• Confidentiality
• Referral to agencies

Question 9

Mental health problems associated with poor academic outcomes

Answer 9

• Anxiety
• Conduct disorder
• Autism
• Depression
• Obsessive compulsive disorder

Question 10

Features of adolescent anxiety disorder

Answer 10

• Anxious thoughts and feelings
• Autonomic symptoms
• Avoidant behaviours

Question 11

Treatment of adolescent anxiety

Answer 11

• Behavioural therapy
  
  • Learning and unlearning behaviours
  • Densensitisation
  • Overcoming fear
  • Managing feelings
• Medications

Question 12

Define autism spectrum disorder

Answer 12

• Syndrome of distinctive behavioural abnormalities
• Associated with low IQ
• Pervasive across life and across settings
• Highly heritable
• Spectrum from mild to severe

Question 13

Features of ASD

Answer 13

• Social
  
  • Reciprocal conversations
  • Expressing emotional concern
  • Non-verbal communication
• Repetitive behaviour
  
  • Mannerisms and stereotypes
  • Obsessions, preoccupations and interests
  • Rigid and inflexible behaviours
    *

Question 14

Clinical associations of ASD

Answer 14

• Learning disability
• Disturbed sleep and eating habits
• Hyperactivity
• Anxiety and depression
• OCD
• School avoidance
• Aggression
• Temper tantrums
• Self-injury, self-harm
• Suicidal behaviour

Question 15

Management of ASD

Answer 15

• Recognition, description and acknowledgement of disability
• Establishing needs and boundaries
• Reduce demands
• Psychopharmacology