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PSYC2101 > Childhood Disorders and Treatment > Flashcards

Childhood Disorders and Treatment Flashcards

1
Q

Two examples of anxiety disorders in childhood?

A

Separation anxiety disorder, selective mutism

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2
Q

Two examples of neurodevelopmental disorders in childhood?

A

ADHD (prevalence of ~5%) and ASD (prevalence of ~1%)

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3
Q

Example of depressive disorders in childhood?

A

Disruptive mood dysregulation disorder

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4
Q

Categories of DSM-V Internalising Disorders?

A

Anxiety disorders and depressive disorders

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5
Q

DSM-V Externalising Disorders are a group of…

A

Disruptive, impulse control, and conduct disorders

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6
Q

DSM-V Externalising Disorders include

A 
– Oppositional defiant disorder
– Conduct disorder – IntermiRent explosive
disorder
–  Pyromania 
–  Kleptomania
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7
Q

Kim-Cohen et al, 2003 study?

A
  • Longitudinal study
  • CD and ODD seems to precede many problems in later life
  • “Most adult disorders should be reframed as extensions of juvenile disorders?
  • A ‘priority prevention target’ for reducing adult mental illness
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8
Q

Conduct Disorder DSM-V criteria?

A
  • involving (3 or more)
    • Deceitfulness/Theft
    • Aggression to people and animals
    • Destruction of property
    • Any other serious violation of rules (running away from home, truancy)
      … persistently for 12 months or more
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9
Q

Oppositional Defiant Disorder (ODD) DSM-V criteria? And development trajectory?

A

Pattern of: Angry/irritable mood, argumentative/defiant behaviour, or vindictiveness

- Often loses temper
- Touchy, easily annoyed
- Angry, resentful         … anxiety disorders
  • Argumentative
    - Defiant and noncompliant
    - Blames others for mistakes
    … conduct disorders
  • Spiteful/vindictive (want to get back at others)
    … severe conduct disorders
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10
Q

Likely outcome of angry/irritable mood in ODD?

A

Anxiety disorders

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11
Q

Likely outcome of argumentative/defiat behaviour

A

CD

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12
Q

Likely outcome of vindictive behaviour?

A

More severe, aggressive-type CD

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13
Q

About ___ percent of ODD kids go on to develop CD

A

40

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14
Q

Estimates of prevalence of disruptive behaviour disorders vary across…

A
  • Settings (community
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15
Q

Prevalence of ODD

A

3.3% worldwide

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16
Q

Prevalence of CD

A

3.2% worldwide

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17
Q

Prevalence of ADHD

A

5.3% worldwide

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18
Q

Developmental course of childhood conduct problems

A

There is an increase in behavioural repertoire
3-8: ODD symptoms
Arguing, defiance, noncompliance, tantrums
8-17: CD symptoms building upon ODD symptoms
Aggression, property destruction, truancy, theft, lying

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19
Q

Antisocial Personality Disorder (APD) DSM-V criteria?

A
  • Pervasive pattern of disregard for/violation of others rights occurring since age 15
    • Repeated criminal behaviour
    • Repeated lying/conning
    • Impulsivity or poor planning (comorbidity with ADHD)
    • Reckless disregard for others’ safety
    • Chronic irresponsibility
    • Lack of remorse
  • Evidence of CD before 15 years
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20
Q

Stability of CD?

A

Relatively stable and persistent;~50% maintained CD diagnosis 5 years later

21
Q

Factors affecting stability/persistence of conduct problems?

A
  • Early onset of serious antisocial and criminal activity with greater initial severity
  • Frequent and intense symptoms across settings
  • Comorbid ADHD
  • Family dysfunction and socioeconomic disadvatnge
22
Q

Factors affecting desistance from conduct problems?

A
  • Most youth desist in early to late 20s due to increased maturity leading to development of internal controls, formation of prosocial identities (e.g. relationships/marriage), employment
    • Social controls
23
Q

Dispositional risk factors for childhood conduct problems (ODD or CD)

A
  • Difficult temperament
  • Genetic factors
  • Thrill seeking
  • Impulsivity
  • Low verbal intelligence
  • Reward dominance
  • Autonomic irregularities (e.g. low resting HR)
  • Cognitive biases
  • Premature birth
  • Poor academic achievement
24
Q

Environmental risk factors for childhood conduct problems (ODD or CD)

A
  • Prenatal exposure to toxins/drugs
  • Low SE status
  • Parental psychopathology (e.g. mothers with postnatal depression)
  • Deviant peers
  • Violence exposures
25
Q

Subtypes of conduct problems?

A

Childhood-onset subtype (from 10)

Adolescent-onset subtype (10 or later)

26
Q

Dunedin longitudinal study 2008?

A

Developmental course is heterogenous

  • LCP (‘childhood-onset persistent) (~10%): childhood onset, only decreases very slightly throughout life
  • Childhood-limited (~24%): desist during adolescence
  • Adolescent-onset persistent (~20%)
27
Q

Why subtype groups?

A

Different behaviour, neurocognitive, and parenting risk factors

LCP group

  • Parenting risk factors
  • IQ deficits
  • Hyperactivity and peer rejection

AL onset group
- Most problem in peer delinquency around adolescent and pre-adolescent period

28
Q

LCP Adult outcomes at age 32?

A
  • Both women and men had worst crimnal, violent, mental and physical health, and economic outcomes
  • More violent crime - no desistance at early adulthood (33% of men convicted of a new voilent crime between ages 26 and 32)
  • More mental and physical health problems
  • Worse economic outcomes
29
Q

Adolescene-Onset outcomes at age 32?

A
  • Moderate levels of criminal activity and substance related problems
  • Women were adolescence limited whereas men continued to show problems
30
Q

Childhood limited type outcomes at age 32?

A

Very few problems

31
Q

The subtypes (yikes) of childhood-onset subtype?

A
  • Primarily impulsive type

- Callous-Unemotional type

32
Q

Primarily impulsive type of childhood-onset conduct problems characteristics?

A
  • Impulsive with high rates of ADHD
  • Have empathy/guilt for effect of behaviour on others
  • High levels of emotional reactivity, not much self-control
33
Q

What are CU traits?

A 
-—  Lack of remorse or guilt
—-  Lack of concern for
others’ feelings
—-  Lack of concern over poor
performance at school
—-  Shallow or deficient emotions
34
Q

What do CU traits in CD mean in terms of outcomes?

A
  • Greater number and variety of conduct problems
  • More delinquency (property destruction and also aggressive type)
  • More severe and frequent violence
    • More (instrumental) proactive and reactive aggression
    • More violent sexual offending
    • More severe victim injuries
    • Shorter time to violent re-offense
35
Q

Frick et al. study?

A

Childhood to adolescence

  • CP + CU much more contact with police, ~60% of police contacts in entire sample of kids; poorest outcome
  • CP only (primarily impulsive type)
36
Q

Role of dysfunction parenting in ODD/CD symptoms?

A
  • Wootton study
  • Low CU traits: harsher parenting = drastic increase ODD/CD symptoms
  • High CU traits: harsher parenting = small decrease in ODD/CD symptoms
    • “Good parenting” still resulted in high number of ODD/CD symptoms
    • Other factors for engaging in CP type behaviours?
37
Q

Viding et al study on twins?

A

Twin studies show greater genetic contribution to conduct problems in youth with CU traits

  • Childhood onset CD with CU traits, or without (Impulsive type)
  • CU type - H = .81 vs.
  • Impulsive type - H= .3
38
Q

Dispositional traits of kids with CU traits?

A
  • Fearless/behaviourally uninhibited temperament
  • More thrill seeking and reward dominant
  • Insensitive to punishment
  • Insensitive to others distress cues
39
Q

Gene/environmental contribution non-CU trait CD?

A

50/50 genetics and environmental contribution

40
Q

fMRI brain differences in kids with low vs high CU traits?

A

Conduct problems with low CU
Comparison subjects
Conduct problems with high CU
- Fearful, calm targets
- Looked at how active amygdala was during presentations
- High CU had less activation of the amygdala

41
Q

Other deficits in CU kids?

A
  • SCR in adolescents with CU traits - lower to distressing images and fearful faces
  • Other impairments: attention task; CU kids equally engaged by pictures of chair and someone in distress
42
Q

DSM-5 criteria for CD With Limited Prosocial Emotions?

A
  • Meets full criteria for Conduct Disorder and they show 2 or more of 4 criteria:

1) Lack of remorse or guilt
2) Callous-Lack of empathy
3) Unconcerned about performance
4) Shallow or deficient affect

43
Q

Patterson from the Oregon Social Learning Centre…

A
  • Studied interactions between parents and children with conduct problems
  • Developed Parent Management Training which is based on Social Learning Theory and Operant Conditioning principles
44
Q

What is Social Learning Theory?

A
  • Bandura Study: aggression towards dolls; Importance of modelling, especially from authority figures
    • Generalised: picked up hammer to beat doll even though it wasn’t shown
45
Q

Thorndike’s puzzle box?

A

Cat has food outside the box
Law of effect
- Behaviours with favorable consequences will occur more frequently and vice versa

46
Q

Gerald Patterson’s Coercion Theory?

A

Cycle of reinforcement taking place with child and parent
- Child: positive reinforcement (scream -> cookie)
- Parent: negative reinforcement (buy cookie -> silence)
Parent and child learning how to be more coercive

47
Q

Patterson’s parent training for ODD and CD involves…

A
  • Behavioural monitoring (giving parents ABC chart)
  • Changing reinforcement schedule
    • Positive reinforcement (descriptive praise: “I really like how…”)
    • Extinction (ignoring)
    • Punishment (timeout, low energy punishment)
    • Commands vs. requests
48
Q

What factors predict poorer treatment outcomes?

A

– CU traits
– Greater initial severity of CPs
– Comorbid ADHD
– Parental stress and psychopathology – Family conflict

PSYC2101 (12 decks)

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