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psychiatry > child and adolescent psychiatry > Flashcards

child and adolescent psychiatry Flashcards

1
Q

what is developmental psychopathology

A

the science underpinning the psychiatry

what are the processes that go wrong during development that result in problems with thinking and behaviour

genes/environment/biological processes

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2
Q

psychopathology components (mixing pot)

A

genes
biological processes
normal/abnormal brain development
life expriences: ACE, toxic stress, intrauterine exposures

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3
Q

normally developing brain: as cortex matures

A

changes in childs ability to override emotional outbursts and to coordinate movements

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4
Q

developmental psychology

A

changes across the physical development, cognitive development and social emotional development

motor skills 
executive functioning 
moral understanding 
language acquisition 
social change
personality 
emotional development
self concept + identify formation
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5
Q

intra-uterine and perinatal factors

A 
maternal health - obesity, diabetes
substance misuse - alcohol
toxins - lead, mercury
drugs - antiepileptics
epigenetics
endocrine environment
immune environment
premature birth/perinatal complications 
twinning 
impressive levels resilience
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6
Q

low white matter connectivity

A

assoc with neural ‘noise’ in system, intra-individual variability and ‘cognitive instability’

in developing brains assoc with ADHD - poor conc, distractibility

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7
Q

environmental factors during childhood

A 
carer-child relationship
parenting skill 
parental mental disorder
marital harmony/family function 
nutrition, poverty, deprivation
abuse, neglect
discipline 
day-care, schooling 
peer relationships
life events
physical disability
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8
Q

normal stress in childhood

A

includes everyday frustrations, disappointments, minor illness
can be good life lessons for kids and do not cause harm

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9
Q

toxic stress in childhood

A

long-term and undermines child’s sense of safety + support

prolonged stress leads to production of stress hormones like cortisol

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10
Q

prolonged exposure to stress hormones e.g. cortisol

A

reduces immunity to disease, leads to problems with digestion, blood pressure + muscle tensions

child undergoing chronic stress when brains are wiring themselves can develop low threshold to stress within brain circuitry = nervous and hyper-vigilant

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11
Q

proximity-seeking behaviour

A

infant seeking contact with parent when frightened, injured or ill

foundation of attachment

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12
Q

attachment theory

A

strong emotional and physical bond to one primary caregiver in our 1st years of life is critical to our development

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13
Q

securely attached

A

greater trust, can connect to others, more successful in life

feel safe to explore world, always have a safe base to return to

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14
Q

insecurely attatched

A

mistrust others, lack social skills, problems forming relationships

afraid to leave/explore scary world as not sure can return to base

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15
Q

3 types of insecure attachment

A

anxious/ambivalent
anxious/avoidant
anxious/disorganised

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16
Q

what does early life stress influence

A

the function of the limbic circuit incl amygdala

determines subsequent patterns of stress response

influences mood and patterns of response to threat inlc withdrawal and/or aggressive response

17
Q

traumatised brain - amygdala

A

thalamus constantly feeds inaccurate info to overactive amydala which keeps firing and so get sympathetic hyperarousal

anger, irritability, startled, fear, withdrawal, retreat

18
Q

reward based learning - operant conditioning

A

dopamine neurons fire when you assoc an action with a subsequent awar

19
Q

adversity and reward deficiency model of addiction

A

early adversity decreases DA response –> decreased reward sensitivity –> inc behaviour required to elicit reward –> intolerance –> inc behaviour –> dec reward sensitivity

20
Q

mental health problems assoc with being out of school

A 
anxiety
conduct disorder
autism 
depression 
OCD
21
Q

effects of mental health problems on school attendance and learning

A 
learning difficulties due to poor attention
co-morbid learning problems 
difficulty controlling emotions 
anxiety 
lack energy, motivation 
difficulties joining in 
sensort probs - noisy 
preoccupation e.g. fear germs 
assoc between mental health and learning difficulties e.g. dyslexia
22
Q

anxiety disorders

A

separation anxiety - leaving parents and home

social phobia - fear joining groups

23
Q

features of anxiety disorders (3A’s)

A

anxious thoughts and feelings (impending doom)
autonomic symptoms
avoidant behaviour

24
Q

what factors may affect willingness to go to school

A

learning difficulties
lack of friends/relationships
bullying
lack parental concern/attention (no interest in kids education)

25
Q

managing childhood anxiety: behavioural

A

learning alternative patterns of behaviour
desensitisation
overcoming fear
managing feelings

26
Q

managing childhood anxiety: medication

A

SSRI e.g. fluoxetine

27
Q

CBT with children and families

A

dont expect kids to have cognitive awareness
parents are collaborators in team

step-wise approach: ladder to success

28
Q

autism spectrum disorder

A

neurodevelopmental disorder

syndrome of persistent, pervasive and distinctive behavioural abnormalities

29
Q

distinctive features of autism spectrum disorder: social - reciprocity + communication

A

reciprocal conversion
expressing emotional concern

non-verbal communication

  • declarative pointing
  • modulated eye contact
  • facial expression
30
Q

distinctive features of autism spectrum disorder: repetitive behaviour

A 
mannerisms and stereotypes
obsessions, pre-occupations + interests
rigid and inflexible patterns of behaviour
-routines
-rituals
-play
31
Q

common clinical problems in autism spectrum disorder

A 
learning disability 
disturbed sleep + eating habits
hyperactivity 
anxiety, depression 
ocd
aggression 
temper tantrums 
SH 
suicidal behaviour
32
Q

principles of managing autism spectrum disorder

A

recognition, description + acknowledging disability
establishing needs
decrease demands - reduce stress - improve coping
psychopharmacology

33
Q

key features of oppositional defiant disorder

A 
refuse to obey adult request 
often argues with adults
often loose temper
delib annoys people 
touchy/easily annoyed
spiteful/vindictive
34
Q

factors relating to hard to manage children

A 
temperament 
ADHD
neurodevelopment 
parental depression 
poverty

effects of psychosocoial adversity and experience of hostility

psychiatry (20 decks)

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