Child Psych Unit 2 Lecture Notes Flashcards
Anxiety Disorder Characteristics
Anxiety and avoidance behaviors
Most common- Specific phobia
Most treated- Panic disorder
Lifetime prevalence 4-8%
Fear Definition
Normal response to objective threat or danger with clearly delineated stimulus
Anxiety definition
Apprehension without apparent course or identifiable stimulus
Normal in moderation
Freud’s Conception of Anxiety
Objective Anxiety- Natural response to perceived danger, fear
Neurotic Anxiety- Free floating anxiety, attachment to object causes phobia
Behavioral Anxiety Symptoms
Motor uneasiness, hyper vigilance
Screaming and crying
Compulsive escape-avoidant behaviors
Shyness
School refusal
Cognitive Anxiety symptoms
Increased inattentiveness and distractability
Decreased school performance
Impaired memory
Physiological Anxiety symptoms
Increased heart rate and blood pressure
Sweating
Abdominal pain
Enuresis
Phobia Definition
Excessive and unreasonable response leading to severe avoidance
Most common anxiety disorder in children
Common fears across age groups
Infants- Height, noise
1-2 years- Strangers, toileting, injury
Preschool- Animals, dark, strangers, alone, imaginary creatures
Elementary- Animals, dark, lightening, thunder, safety
Middle- Realistic, academic, social, health, parent disapproval
Separation Anxiety Disorder
Excessive anxiety concerning separation from the home or attachment figure beyond developmental level
Periods of exacerbation and remission across several years
SAD Associated features
Fear of the dark
Depressed mood
Physical complaints
Demanding, needing attention presentation
Conscientious, eager to please presentation
Potential SAD Causes
Hospitalization
Loss of parent by death or divorce
Parental depression
PTSD History
1918- Frued’s first conception
1930-40s- Alarm period, study post-holocaust
1970- Studied in Vietnam Vets and school bus kidnapping
1980- Included in DSM-III
PTSD Potential Causes
Natural Disasters
Human violence
Abuse
Kidnapping or crimes against child
Man-made disasters
Illness or injury
PTSD Compounding Factors
Lack of closure
Children as accessories to crimes
Not allowed to grieve and process
Lack of parental emotional support
Ongoing abuse or trauma
PTSD Presentation in Children
Traumatic, abnormal play
Nightmares
Regressive behaviors
Hopelessness, feeling of shortened life
Rutter 1970 Isle of Wight Study
Longitudinal depression study in isolated UK island
Found 13% grade-school depression and 40% adolescent depression
Major Depressive Disorder (MDD)
Presence of 5+ symptoms for 2+ weeks, causing significant distress or impairment
Major features of depressed mood and anhedonia
Depression Symptoms
Depressed mood
Loss of interest or pleasure- Anhedonia
Sleep changes
Fatigue
Psycho-motor changes
Feelings of worthlessness or guilt
Poor concentration
Suicidal ideation
Dysthymia
Depressed mood for most of the day on more days than not lasting for 2+ years (1+ in children)
Never without symptoms for more than 2 months
No impairment- Manageable
Mania symptoms
Inflated self-esteem or grandiosity
Decreased need for sleep
Pressure or rapid speech and ideas
Distractability
Increase in goal-directed activity
Psycho-motor agitation
Engagement in pleasurable activities with consequences
Bipolar I
History of 1+ manic episode- Delusions lasting 1+ weeks
Does not require depressive symptoms
Bipolar II
History of 1+ MDD episode and 1+ hypomanic episode
No delusions, lasting 4+ days
Cyclothymia
Numerous hypomanic and depressed moods for 2+ years
Never without symptoms for 2+ months
Do not meet criteria for MDD or bipolar disorders
Lifetime prevalence of mood disorders
MDD- 10-25% for women, 5-12% for men
Dysthymia- 6%
Bipolar and cyclothymia- 1% each
Developmental Depression Presentation
Infancy- Alaclitic Depression
Toddler- Aggression and hyperactivity
Preschoolers- Irritability, social withdrawal
School- Withdrawal, avoid play and family, hopelessness, apathy
12- Pessimistic, sleep disturbances, decreased appetite
17- Nightmares, suicidal ideation
Abraham-Freud Depression Theory
Aggression turned inward
Loss of self-esteem
Object-Loss Depression Theory
Spitz-Bowlby
Disruption of attachment bond
Insecure mother-infant attachment
Atmosphere without love
Beck’s Depression Theory
Negative cognitive triad- Self, past, future
Worthlessness, hopelessness, and helplessness
Learned helplessness (Seligman) Depression Theory
Individual does not recognize relationship between actions and relief from adverse effects
Loss of Reinforcement Depression Theory
Lazarus and Lewinsohn
Loss of positive Reinforcement
Biological Depression Theory
Genetic and neuropsychological factors
Electroconvulsive Therapy (ECT)
Used for treatment-resistant depression
IV anesthetic and muscle relaxants provided to patient
Electrodes placed on scalp and current passed to induce Grand-Mal seizure
Repeated 2-3 times per week for 3-4 weeks
ECT Electrode placement
Traditional- One on each side of scalp
Modern- Both on right half of head
Thought is protecting dominant (left) hemisphere from potential damage
Postpartum Depression
Non-psychotic depressive episode after or prior delivery extending into the postpartum period
MDD criteria for 1+ week
Treated with interpersonal or cognitive-behavioral therapy
Prevalence of Postpartum Conditions
Postpartum Blues- Benign and short-lived- 30-75%
Postpartum depression- MDD Criteria- 13%
Postpartum psychosis- Severe, rapidly evolving- 0.1-0.2% (rare)
Mintz and Betz Theory of Eating Pathology
Continuum of normal, atypical, and disordered eating
Sociocultural Influences on Eating Disorders
Attitudes emphasizing thinness and ideal beauty
Endorsing “Super Woman Pattern”
Feminist Theory of Eating Disorders
Acceptance of nurturing role providing food to others while restricting own needs
Identity and self worth are tied to body image
Opposing Feminist theory of Eating Disorders
Anorexia is the rejection of the female role because it defeminizes the body
Causes loss of secondary sex characteristics
Anorexia Nervosa
Nervous loss of appetite
Refusal to maintain within 15% of normal body weight
Restrictive or binging/purging form
Anorexia Associated Symptoms
Amenorrhea
Laxative use or excessive exercise
Preoccupation with food
Loss of hair and dental problems
Many physical symptoms
Bulimia Nervosa
Recurrent binge eating followed by compensatory purging behaviors
Maintain normal or slightly overweight
Surrounded by guilt or shame
Occurs 2-30 time per week
