CHILD AND YOUTH

Question 1

Externalizing problems

Answer 1

Undercontrolled behavior
ADHD,ODD,CD

Question 2

Internalizing problems

Answer 2

Overcontrolled behavior
Anxiety and mood disorders

Question 3

Homotypic continuity

Answer 3

same disorder predicts itself in the future)

Question 4

Heterotypic continuity

Answer 4

(a disorder predicts another disorder at a later point)

Question 5

Attention-Deficit/Hyperactivity Disorder

Answer 5

Two symptom clusters:
1)Hyperactivity/impulsivity
2)Inattention
Behavior that is inappropriate for age in terms of
* Frequency
* Intensity
* Duration
Impairment in at least two settings (ie:home,school)

Question 6

Hyperactivity

Answer 6

Fidgets,squirms,gets out of seat
Difficulty playing quietly
Talks excessively
Runs and climbs excessively
Often “on the go” as if “driven by a motor”

Question 7

Impulsivity

Answer 7

Blurts out answers before question is completed
Difficulty waiting for turn
Interrupts or intrudes on others

Question 8

Inattention

Answer 8

Careless mistakes, poor attention to detail
Difficulty sustaining attention
Avoids or dislikes tasks requiring sustained mental effort
Does not listen to directions
Does not follow through to finish work
Difficulty organizing tasks
Loses things
Often distracted by external stimuli
Forgetful

Question 9

ADHD:Associated Features

Answer 9

Bad temper,labile mood
Rejection by peers
Academic achievement impaired
Low self esteem
Negative family relations

Question 10

Etiology/Risk factors for ADHD

Answer 10

Biological
~Strong genetic component

Prenatal toxin Exposure
~Maternal smoking or drinking (interacts with genetics)
~Lead, mercury, phthalates

Psychosocial risk factors
~Adverse childhood events(maltreatment, foster care ~placement, maternal mental illness, paternal criminality)

Question 11

Brain structure and function
of adhd

Answer 11

Structure
Abnormalities in prefrontal cortex
Delayed maturation in cerebellum

Function
Reduced activity in PFC (executive functions)

Question 12

Long term prognosis
of adhd

Answer 12

Many learn to adapt to challenges of ADHD
Most employed and financially independent, but attain lower SES
Risk of impaired social functioning
Risk of dropping out of high school and developing antisocial behavior
Stimulant medications reduce core symptoms but do not improve academic or social/emotional functioning

Question 13

Multimodal Treatment for adhd

Answer 13

Stimulant medication plus:
Caregiver psychoeducation(supports the child’s needs at home)
Classroom accommodations(maximize opportunities to learn, socialize)
Behavioral parent training (consistent use of reinforcement principles)

Question 14

Oppositional defiant disorder

Answer 14

angry/irritable mood
Loses temper,touchy or easily annoyed, angry and resentful
argumentative/defiant
Active noncompliance with requests from adults
Deliberately annoys others
Blames others for their mistakes or behavior
Spiteful or vindictive

Question 15

Conduct Disorder

Answer 15

Behaviors that violate basic rights of others and major societal norms
Aggression toward people and animals
Bullying,threatening,intimidate others
Starts physical fights
Physical cruelty to people or animals
Stealing while confronting a victim
Forced sexual activity
Deliberate
Deceitfulness or theft
Has broken into someone’s home,building care
Lies frequently to get things or avoid obligations
Stolen thing of nontrivial value
Serious Rule Violations
Stays out at night (<13 yrs)
Runs away
Skipping school

Question 16

Associated features
of conduct disorder

Answer 16

Misperceive others intentions
~Poor social cognition
~Deficits in recognizing facial/vocal emotions

Callous-unemotional traits
~Lack of remorse/guilt
~Lack of empathy
~shallow/deficient affect

Question 17

Common comorbidity
of conduct disorder

Answer 17

ADHD
ODD is a common precursor
Greater risk for substance related disorders,anxiety and depression as adult
Few children receive treatment

Question 18

course of conduct disorder

Answer 18

Childhood onset(around 10 yrs)
Increased likelihood of substance related disorder in adulthood
Greater risk of criminality in adulthood
Adolescent onset
High antisocial behavior associated with peer group

Question 19

Conduct problems-risk factors

Answer 19

Genetics
Heritability estimates of 44-72% stronger for males
Callous-unemotional trait more heritable than delinquent behaviour

Prenatal factors
Maternal stress
Smoking or alcohol use during pregnancy

Psychosocial Factors
Low parental monitoring, inconsistent parenting
Harsh discipline ranging up to abuse
Peer group influences
poverty/violent neighborhood

Question 20

Interaction is present if lines are not parallel, or if its a bar graph the slopes between the different groups are not equal

Question 21

Conduct Problems neurobiology

Answer 21

Decreased activity in frontal lobe

Amygdala hyporeactivity to others’ distress
~Under Activity in amygdala to others in distress/pain

Low ANS(autonomic nervous system) activity
~Low cortisol

Poor fear conditioning
~Predicts criminal behavior

Question 22

Conduct disorder neurocognitive feature

Answer 22

Poor executive functioning
Comorbid reading disorder
Poor social cognition

Question 23

Child Conduct Disorder Causal pathways

Answer 23

1)Marital discord is correlated with child conduct disorder
~Marital discord can cause child conduct disorder if parents are fighting and hostile, they’re modeling for child how to treat others
~Less consistent parenting
~Parents are focused on their own problems, less consistent parenting and rules/enforcement of rules if violated
~Distraction from marital problems

2)Reverse causal direction
~Challenges of child with behavioral problems can cause marital discord

3)Parental antisocial traits can cause marital discord or child conduct disorder

Question 24

Coercive Family Process

Answer 24

parents gives directive or sets limit->child responds aggressively or with resistance->parents reacts aggressively/unproductively->both escalate until parents or child “wins”-> hostility maintains and generalize

Question 25

giving in/escalation

Answer 25

Giving in serves as reinforcement of bad child behavior and more escalated
Escalation of behavior gets neg. reinforced

Question 26

Biological predisposition(conduct disorder)

Answer 26

Callous unemotional traits
LOW MAOA
Comorbidity with ADHD
Temperament of irritability
Poor fear condition
Cant experience fear

Question 27

Peers(conduct disorder)

Answer 27

Modeling aggressive behavior from peers
Peer rejection
Bullying

Question 28

Parents(overlap with biological predisposition and peers)

Answer 28

Inconsistent parenting
Low parental involvement
Harsh discipline/abuse
Marital conflict

Question 29

Sociocultural context(conduct disorder)

Answer 29

Poverty,low SES
Violent environment, unsafe
Failure in school

Question 30

Mental processes(conduct disorder)

Answer 30

Hostile attribution bias
Viewing ambiguous social situations viewed in a hostile way, person responds aggressively

Executive functioning problems
Ie:social cognition, problem solving

Question 31

Separation anxiety disorder

Answer 31

~Extreme distress when separated from attachment figure

~Can result in panic

~Typical recovery within 1 year of onset

Question 32

Separation anxiety features:

Answer 32

Worries about harm to parents
~Animals/monsters getting their parents
Fears of abandonment
Refusal to attend school
Avoidance of being alone
~Being separated from parent
Nightmares involving separation themes
Physical complaints at separation times
~Nausea

Question 33

Separation anxiety:Developmental trajectory

Answer 33

young(5-8):nightmares, worry about parents, worry about bad things happening to self
Older (9-12): distress upon separation,withdrawal, apathy,sadness, poor concentration
adolescents(12-19):school refusal and physical symptoms when confronted with separation

Question 34

Selective mutism

Answer 34

Declines to speak in specific situations where there is an expectation of speaking despite speaking in other situation
Lasts at least a month and interferes with educational achievement or social communication
Not attributable to lack of knowledge or comfort with the spoken language required in the situation
Not attributable to a communication disorder or autism spectrum disorder
Fairly rare, usually associated with Social anxiety
Social impairment, teased by peers
Can sometimes be aggressive when forced to speak

Question 35

Anxiety Disorder-etiology
temperament

Answer 35

Behavioral inhibition
* Tendency to avoid novel and unfamiliar situations
* Genetic influences, biological phenomenon
* Associated with differences in excessive autonomic reactivity(overreaction to fear situations)
* More easily conditioned to anxiety
~Anxious attachment style
~Poor social confidence

Question 36

Biological functions
of anxiety disorder

Answer 36

Amygdala reactivity

Hyperarousal
~Have difficulty maintaining normal heart rate

Question 37

Prenatal factors

Answer 37

Prolonged stress

Question 38

Psychosocial factors(anxiety)

Answer 38

Vicarious learning(from peer or parents)
Avoidance as coping mechanism
Bullying victimization
Stressful childhood(poverty)

Question 39

Gene Environment Interaction

Answer 39

Diathesis-stress framework