Child Psychiatry Flashcards
What is proximity maintenance?
the desire to be near the people we are attached to
What is safe haven?
returning to the attachment figure for comfort and safety in the face of a fear or threat
what is a secure base?
the attachment figure acts as a base of security from which the child can explore the surrounding environment
What is seperation distress?
anxiety that occurs in the absence of the attachment figure
What is monotropy?
attachment conceptualized as being a vital and close bond with just one attachment figure
What are the 3 progressive stages of distress?
Protest
Despair
Detachment
What is seen in the protest stage?
the child cries and screams and will try to prevent the carer from leaving
What is seen in the despair stage?
The child’s protesting begins to stop and they appear to be calmer although still upset. The child refuses others’ attempts for comfort and often seems withdrawn and uninterested in anything
What is seen in the detachment stage?
the child will begin to engage with other people, thye will reject the caregiver on their return and display anger
What does the strange situation test determine?
the security of attachment in 1-2 yo’s
What happens during stages 1 and 2 of the strange situation test?
mum and infant go into room to get used to it before the obs begins
What is stage 3?
mum is in room and stranger enters
What is stage 4?
mum leaves and the stranger interacts wit hthe infant
What is stage 5?
mum returns
What is stage 6?
mum leaves and the infant is left alone
What happens in stage 7?
the stranger returns to the room
What happens in stage 8?
mum reenters the room and stranger leaves
What is recorded in stage 5?
reunion behaviour
What is recorded in stage 6?
seperation protest
What is recorded in stage 7?
stranger anxiety behavious
What is recorded in stage 8?
reunion behavious
What are the 4 interaction behaviours that attachment styles (strange situation classifications) are based upon?
- proximity and contacting seeking
- contact maintaing
- avoidance of proximity and contact
- resistance to contact and comforting
What are the 3 attachment styles?
type A- insecure avoidant
type B- secure
type C- insecure ambivalent/resistant
(later identified- disorganised)
What are the attachment styles of a child the result of?
the early interactions with the mother
What are the features of a child with secure attachment?
readily explores, using carer as a secure base. Cries infrequentyl. Easily put down after being held, Confident
What are the features of a caregiver with a secure child?
appropriate response to upset, appropriate encouragement to explore, tuned in to childs needs
What are the features of a child with avoidant attachment?
avoids or ignroe the parent when they resturns- whoing little overt indications of an emotional response. Often, the stranger will not be treated much differently from the parent.
What are the features of a caregiver with an avoidant child?
disinterested, uncomfortable with showing affection, but overly encourages seperation/independence
What are the features of an ambivalent child?
unsure how to respond to the parent when they return depsite large emotional response. May seek comfort, be unsure about how to manage the attention. Display clingy and dependent behaviour
What are hte features of a caregiver with an ambivalent child?
unpredicatable, inconsisten, frightening
What is the diorganised attahcment response?
no cohesive response, bizarre behaviour- soiling, destruction of possessions, odd noises
Who is the disorganised attachment seen in?
older children i nthe context of severe trauma
what are other ways of assessing attachment?
semistructured interviews; story stems picture responses; attachment q sort
What are the 2 types of reactive attachment disorder?
inhibited and disinhibtied
What is the difference between inhibited and disinhibited types of reactive attachment disorder?
inhibited- presistent failure to repsond or initiate social interactions in a developmentally appropriate way whereas disinhibited types who display indiscriminate socialibility
What is temperament?
can be seeen as inherent, constitutionally based characteristics that constitute the core of personality and influence directions for development
How can temperamnet be measured?
observations; questionnaires; physiological measures- HR; EEG; salivary cortisol
What are hte 9 dimensions of temperament?
1- activity level 2- approach/withdrawal 3- adaptability 4- mood 5- threshold 6- intensity 7- distractibility 8- rhythmicity 9- attention spans/persistence
What is the acitvity dimension of temperament?
intensity and pace of a persons behaviour
What is the emotionality dimension of temperament?
how positive or how negative a person is in general; jovial and happy or despondent and sad
What is the socaibilty dimension of temperament?
preferences for interaction or for solitude
How can temperament be influenced by environment if it is inherent?
the development of temperament can be influenced- children differing in temperaments may come to similar outcomes whereas children with similar traits may have different outcomes
What allows children to reover more successfully from chronic adveristy?
attachment; temperament- good learning and problem-solving; engaging with other eople; have areas of competence and perceived efficacy valued by self or society
What do Piaget’s stages of development describe?
the qualitative change in how children think as they get older
What is Piaget’s stage from 0-2 years?
the sensorimotor stage
What is the important element of the sensorimotor stage?
developing object permanance
What is Piaget’s stage between 2-7 years?
Preoperational Stage
What are children developing in the preoperational age?
learning through pretend play, struggle with logic, constancy and taking other peoples points of view
What is Piaget’s stage from 7-11 years?
The concrete operational stage
What are children developing in the concrete operational stage?
thinking about how others feel, that everyone has different feelings.
What is Piaget’’s stage from 11-adulthood?
the formal operational stage
What are people developing in the formal operational stage?
logic, deductive reasoning and abstract ideas.
What is Maslows heirarchy of need?
a pyramid of needs which people progress up, you must have the lower needs before higher ones. physiological–safety–love and belonging–esteem–self-actualisation
What is temperament?
a set of basic persaonlity characteristics one is born with
What is attachment
environmental influence on one’s developing mental health which is related to the earliest experience of being cared for by a mother
What is secure attachment?
infants will be reasonably upset when their caregiver leaves but will be happy to see them return and will be quickly soothed
What is insecure/avoidant attachment?
show little interest in their caregivers although thye cry when they leave the room, they don’t seem pleased when their caregiver returns and turn their back on them and try to get away
What is insecure/ambivilant attachment?
initally dont want to leave their caregiver to explore the room. they cry when caregiver leaves, seem angry when they return
What type of caregiver gives rise to insecure/avoidant attachment?
absent, distnat or disinterested carers
What type of carer gives rise to insecure/ambivilant attachment?
unpredicatble where may be reassuring but frightening at others
How do children with disorganised attachment act?
child sppears stressed, exhibiting ttension movements activated by the departure and return of their caregiver
What are the 6 elements of the McMaster model?
problem solving; communication; roles; affective responsiveness; affective involvement; behaviour controls
What are 4P’s in formulation?
Predisposing; precipitating; perpetuating and protective
What is the predisposing part of the 4Ps?
the risk factors
What are the precipitating part of the 4Ps?
what made it change from being a risk of a problem to an actual problem
What is the perpetuating part of the 4P’s?
what is keeping the problem going, why isn’t it getting better
What is the protective part of hte 4P’s?
what is preventing the problem from being even worse
