Child Psychiatry Flashcards
Describe conduct disorders
Characterised by repetitive and persistent patterns of antisocial, aggressive or defiant behaviours which violate age-appropriate societal norms
How is conduct disorder managed?
Possible components;
- parent training programme (12 or younger)
- mod school environment e.g. behavioural support
- functional fam therapy
- musti-systemic therapy
- child interventions; social skills, problem solving, anger, confidence
- treat comorbidity
- adress child protection concerns
Describe hyperkinetic disorders or ADHD
Characterised by core features; developmentally abnormal inattention, hyperactivity and impulsivity
Highly comorbid; motor coord problems, tics, substance misuse, anxiety, depression
Majority symptomatic into adulthood, esp inattention
What is management for ADHD?
Psychoeducation
Meds; stimulants, atomocetine, guanfacine
Behavioural intervention; realistic expectations, contingency management
Parent training School interventions Treat comorbidity Voluntary organisations Benefits
Describe methylphenidate
ADHD first line
Closely related to amphetamine, taken orally, similar principle to aspirin; non-addictive, purely symptomatic treatment, lasts 4hrs and wears off
Acts on NAd and DA systems
What factors increase risk of suicide?
Persistent suicidal ideas, previous suicidal behaviour
High lethality of method used, high suicidal intent and motivation
Ongoing precipitating stresses
Mental disorder, poor physical health
impulsivity, neuroticism, low self esteem, hopelessness
Parental psychopathology and suicidal behaviour
Physical and sexual abuse, disconnection from support systems
What are features of anxiety disorders?
3 As
- anxious thoughts and feelings
- autonomic symptoms
- avoidant behaviour
What is treatment for anxiety disorders?
behavioural
- learning alternative patterns
- desensitisation
- overcoming fear
- managing feelings
Medication
- serotonin reuptake inhibitors e.g. fluoxetine
What is psychoeducation?
Explaining the problem in terms that make sense to everyone
what is externalising?
taking blame, guilt and anger out of the equation
What are some distinctive features of autism?
Reciprocal conversation
Expressing emotional concern
Non-verbal communiaction
Repetitive behaviours
- mannerisms and stereotypes
- obsessions, preoccupations and interests
- rigid and inflexible patterns of behaviour
What are causes of autism?
Strongly genetic;
- comorbid with congenital or genetic disorders i.e. down’s syndrome, rubella, fragile X
Broader phenotype in siblings and paretns
How is autism managed?
Establishing needs
Appreciate the can’t and won’t
Decrease demands to reduce stress and improve coping
Psychopharmacology
What are key features of oppositional defiant children?
- refusal to obey adults request
- often argues with adults
- often loses temper
- deliberately annoys people
- touchy or easily annoyed by others
- spiteful or vindictive
What are parent training programmes?
Groups, individual ro self-taught
1-2hrs for 8-12 weeks
Structured
informed by social learning theory e.g. modelling behaviour
focus on positive reinforcement of desired behaviour and developing positive parent-child relationships
