Child and adolescent psychiatry Flashcards
What factors can contribute to developmental psychopathology?
Genetics Intra-uterine and perinatal factors Environmental Adversity and reward deficiency model Delay aversion and delayed gratification
What intra-uterine and perinatal factors can contribute to psychopathology?
Maternal health Substance misuse Toxins Drugs Premature birth Perinatal complications
What environmental factors can contribute to psychopathology?
Carer child relationship Parental skill Discipline Marital harmony Abuse, neglect Poverty, deprivation Peer relationships Life events
What is the reward deficiency model?
Early adversity leads to reduced dopamine function, leading to decreased reward sensitivity
This causes increased behaviour required to elicit reward and for satiety
This can lead to tendency for addiction
What is the delay aversion and delayed gratification theory?
Inability to wait and maintain attention in absence of immediate reward- theory to explain ADHD
What are the features of anxiety in a child?
Anxious thoughts and feelings
Autonomic symptoms
Avoidant behaviour
What is the management of anxiety in children?
CBT- often with families, goal setting, externalising and psychoeducation
SSRI
What is autism and Asperger’s?
Syndrome of distinctive behavioural abnormalities
What is the spectrum of autism?
Starts with only affecting synaptic function
Up to affecting synaptic function, neural migration and brain development
What are the distinctive features of autism?
Communication -lack of reciprocal conversation -difficulty expressing emotional concern -declarative pointing -too little or much eye contact Decreased social understanding Repetitive behaviour -rigid and inflexible patterns -obsessions, preoccupations and interest
What are the clinical issues with autism?
Learning disability Anxiety and depression OCD Hyperactivity Disturbed sleep and eating habits School avoidance Aggression Temper tantrums Self injury Suicidal behaviour
What is the management of autism?
Recognition and coping mechanisms
Psychopharmacology
What is oppositional defiant disorder?
Relates to temperament
Behaviour is learned and enacted to obtain desired result
Often a result of impaired parenting
What are conduct disorders?
Caharacterised by repetitive and persistent patterns of antisocial, aggressive or defiant behaviours which violate age appropriate societal norms
What are conduct disorders associated with an increased risk of?
Early death, often by sudden or violent means Social exclusion Poor achievement Criminal activity Adult mental health problems Poor interpersonal relationships
