Child Psychiatry Flashcards
What is the most important predictor of a child’s future personality development?
Relationship with primary care giver
What are the three main attachment styles?
Secure
Insecure avoidant
Insecure ambivalent/ resistant
(There is also disorganised which is inconsistent in behaviours)
Child shows distress when separated from mother, avoids stranger unless accompanied by mother, happy to see mother on return?
Secure attachment
Child shows no interest when separated from mother, plays happily with a stranger and ignores mother on return?
Insecure avoidant attachment
Child shows intense distress when separated from mother, fear of stranger and then approaches mother on return but rejects contact?
Insecure ambivalent/ resistant
Avoidant and resistant/ ambivalent attachment are termed?
Disordered attachment
What is reactive attachment disorder?
Markedly disturbed and developmentally inappropriate social relatedness in most contexts that begins before age 5 and is associated with grossly pathological care
Grossly pathological care that could cause reactive attachment disorder?
Persistent disregard for the child’s emotional needs, for comfort, stimulation and affection. Persistent disregard for the child’s physical needs, repeated changes of primary care givers.
Difference between two subtypes of RAD?
Inhibited: Children continually fail to initiate and respond to social interactions in a developmentally appropriate way. Child doesn’t seek comfort from a caregiver.
Disinhibited: Children have inability to display appropriate selective attachments. Child displays excessive familiarity with strangers.
Treatment of RAD?
Family Therapy
Individual Therapy
Play therapy- learn skills to interact with peers
Medication- if symptoms of co-morbid disorder
Special education interventions- programs to help learn skills needed for academic and social success
What is conduct disorder?
A repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate norms or rules are broken
Criteria for conduct disorder?
Presence of 3 or more of the following in the past 12 months with at least one present in the past 6 months:
- Aggression to people or animals
- Destruction of property
- Deceitfulness or theft
- Serious violation of rules
Usually other co-morbid conditions are present e.g. ADHD, learning difficulties, depression, substance misuse, deviant sexual behaviour
Treatment of conduct disorder?
No medication but it is rare that they wouldn’t have a co-morbid condition which you would treat with medication
Parent foster training if less than 11
Child focused programmes if between 9-14
Multimodal interventions if 11-17
Triad in ADHD?
Inattention, hyperactivity, impulsivity
Causes of ADHD?
Multifactorial but does show familial clustering
