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PaedsJaz > Child psychiatry > Flashcards

Child psychiatry Flashcards

1
Q

the 4Ps formulation model stands for

A

predisposing
precipitating
perpetuating
protective

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2
Q

DALY =

A

disability adjusted life year

measure of overal disease burden, expressed as years lost due to ill health, disability or early death

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3
Q

leading cause of mortality in 15-29yos

A

suicide

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4
Q

___% of mental health problems start before 18yo

A

75%

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5
Q

attachment =

A

strong emotional tie that develops over time between an infant and primary caregiver(s).
Special and specific affective/emotional relationship

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6
Q

4 principles behind the theory of what attachment allows kids to do

A 
proximity maintenance (stay close to those attached to)
safe haven (return in times of stress)
secure base (to explore from)
separation distress (anxiety if carer anxious)
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7
Q

strange situation test 8 episodes =

A 
mum baby and experimenter
m +b
m+b+ stranger
s+ b
m + b 
b alone
s+b
m + b
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8
Q

secure attachment signs =

A 
child readily explores
use carer as secure base
confident
easily put down
carer = tuned in to child's needs, engaging
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9
Q

anxious attachment: avoidant signs

A

ignores carer on their return
stranger treated same as carer
carer = disinterested

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10
Q

anxious attachment: ambivalent signs

A

unsure how to respond to carer
cant deal with attention
carer = unpredictable

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11
Q

temperament =

A

inherent, constitutionally based characteristics that constitute the core of personality and influence directions for development

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12
Q

9 NYLS dimensions for temperament

A 
activity level
approach/withdrawal 
adaptability
mood
threshold
intensity
distractability
rhythmicity
attention span/persistence
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13
Q

if experience chronic adversity a child is more likely to be resilient if:

A

+ve carer relationship (attachment)
good learner/problem solver (temperament)
engaging to others (temperament)
feel competent and self-esteem (system)

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14
Q

age of a toddler =

A

1-3yo

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15
Q

age of a pre-schooler =

A

4-5yo

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16
Q

middle childhood =

A

6-12yo

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17
Q

depression = __+___ deficient

A

serotonin and dopamine

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18
Q

schizophrenia = __+__ deficient

A

glutamate and dopamine

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19
Q

at birth brain is ___% of adult brain size

A

30%

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20
Q

what time of the year are children more likely to be born with mental health problems and why

A

winter

vitamin D deficient

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21
Q

processes that occur in the brain during adolescence

A

myelination
dendritic and axonal arborisation
grey matter decreases
white matter increases

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22
Q

Id (Freudian) =

A

uncoordinated instinctual trends

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23
Q

ego (freudian) =

A

organised, realism - mediates Id and superego

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24
Q

superego (freudian) =

A

critical and moralising role

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25
Q

Maslow’s hierarchy of need from bottom to top (5)

A 
physiological
safety
love/beonging
esteem
self-actualisation
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26
Q

Piaget 0-2yo stage =

A

sensorimotor - co-ordinate senses with motor response, develop object permanence, curiosity

27
Q

4 stages of Piaget’s theory of cognitive development

A

sensorimotor (0-2yo)
preoperational (2-7)
concrete operational (7-11)
formal operations (11+)

28
Q

Piaget 2-7yo stage

A

preoperational -
egocentric
develop understanding of conservation

29
Q

Piaget 7-11yo stage

A

concrete operational

- concepts attached to concrete situations

30
Q

Piaget 11+ stage:

A

formal operations
hypothetical, theoretical and counterfactual thinking
abstract logic

31
Q

Pavlolv’s theory is to do with…

A

social learning

conditioning - to associate one signal with another to illicit a response eg. dogs salivate at bell

32
Q

shaping =

part of ___ theory

A

encouraging one behaviour to move towards an end-goal behavious
Pavlov’s

33
Q

Vygotsky’s theory =

A

need to do shaping in zone of proximal development

otherwise jump is too much

34
Q

Erikson said there was a __+__+__ for each age stage

A

conflict
virtue
culmination for old age

35
Q

the recent domain specific development theory =

A

there are sensitive stages for the development of each domain eg. language, maths etc

36
Q

OCD = a problem with ___

A

abstract thought - start rituals to control unbidden thought

37
Q

obsession =

A

an intrusive thought you don’t want to be there

38
Q

OCD usually presents at age __ with

A

11-12yo

cleanliness and safety issues

39
Q

grey matter wanes in adolescence in a __to___ pattern

A

back to front

40
Q

there is a change in ___ system balance in adolescence

A

dopamine

41
Q

part of the brain that handles reasoning and other executive functions (eg. wroking memory for problem solving) and impulse control

A

pre-frontal cortex

42
Q

dopamine system changes in adolescence => ___ syndrome

means take risks and get less ___ from normal +ve experiences

A

reward deficiency

pleasure

43
Q

11 developmental tasks of adolescence

A

adjust to: new intellectual abilities
new physical sense of self
increased cognitive school demands
Develop expanded verbal skills
develop a personal sense of identity
establish adult vocational goals
establish emotional and psychological independence from parents
develop stable and productive peer relationships
learn to manage sexuality
adopt a personal value system
develop impulse control and behavioural maturity

44
Q

__% of mental health problems established by age 14yo

A

50%

45
Q

in a family each member has multiple __+__+__

A

roles
attachment relationships
temperamental styles

46
Q

the 4 pillars of the family system =

A

structure
connection (communication)
pattern (maintain homeostasis)
adaptability

47
Q

Level one of team around the child

A

named person identifies problem

48
Q

level 2 of team around the child

A

MDT approach

49
Q

level 3 of team around the child

A

wellbeing concerns escalated to be at risk to CYP

50
Q

3 aspects of social care model =

A

1 - GIRFEC/SHANARRI
2 - MyWorld Triangle - decide intervention needed
3 - resilience matrix + vulnerability matrix (turn vulnerabilities to resilience; adversity to a protective envnt)

51
Q

in 0-10 days of life your named person is

A

the midwife

52
Q

if under 5yo then your named person is usually your

A

health visitor

53
Q

if child comes into clinic and is overly friendly suspect

A

sexual abuse

54
Q

50% of ___ are associated with ADHD

they tend to be hereditary, more so in boys

A

conduct disorders

55
Q

advantages of a categorical/diagnostic approach

A

consistency in clinical approach
accurate aeiological research
informs Rx and prevention

56
Q

advantages of dimensional/formulation based approach

A 
more flexible
more systemic understanding
more solution focused
improve risk assessment and ptnt education
reduce "lens effect"
57
Q

6 parts of the McMaster’s Model for the family system

A 
problem solving
communication
roles
affective responsiveness
affective involvement
behavioural controls
58
Q

factors to be considered in the problem solving stage of the McMaster’s Model

A

who identifies the problem? do others agree?
do members discuss problem in an effective way?
are different solutions considered?
is the agreed action taken? is this ensured by the family?
is there progress as a result of the action?

59
Q

things to consider in the communication part of the McMaster’s Model

A

Present? - clear/masked, direct/indirect, congruent/incongruent
Received and understood? - validated/ignored/disqualified

60
Q

Things to consider in the Roles part of the McMaster’s Model:

A

who allocated them?
how accountable is the person for successful undertaking of role?
5 categories = systems management and maintenance; resource provision ; nurturence and support ; sexual gratification ; life skills development

61
Q

things to consider in the affective responsiveness part of the McMaster’s Model

A

members responsive to others’ emotional needs?

welfare and emergency responses

62
Q

things to consider in the affective involvement of the McMaster’s Model

A

degree and quality of concern and interest for one another
varies between all encompassing closeness (enmeshment), appropriate empathic involvement, narcissistic through to virtual absence

63
Q

categories of behavioural controls in the McMasters Model

A

rigid
flexible
Laissez faire
chaotic

PaedsJaz (9 decks)

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