DBP Prep 2023 Flashcards
Adverse effects of SSRI?
- manic symptoms
- aggravation of depression and anxiety
- agitation
SSRI-induced activation syndrome symptoms?
- disinhibition
- impulsivity
- insomnia
- restlessness
- hyperactivity
- irritability
Definition of Manic episode in bipolar disorder?
periods of where an individual has abnormally elevated, expansive, or irritable mood and increased energy OR goal-directed activity for at least 1 week (or less if hospitalization needed)
at least 3 accompanying symptoms:
1. grandiosity
2. decreased need for sleep
3. more talkative
4. flight of ideas
5. distractibility
6. engaging in activities with negative consequences (e.g. excessive spending or risky sexual activity)
Can get rapid shifts in mood (depressive and psychotic symptoms) during manic episodes
Definition of Hypomanic episode in bipolar disorder?
at least 4 consecutive days of symptoms
similar to manic episodes but not severe enough to cause major impairment in functioning or need hospitalization
Major Depressive Disorder symptoms?
at least 2 week period of depressed mood, decreased interest or pleasure in activities
at least 5 symptoms including one of two above plus
1. weight loss or weight gain or change in appetite
2. insomnia
3. psychomotor agitation or retardation
4. fatigue
5. feelings of worthlessness or guilt
6. decreased concentration
7. suicidal thoughts
Red flags for bipolar disorder in adolescents?
rage outbursts, verbal or physical aggression, episodes requiring little sleep, spontaneous mood changes, running away, sneaking out at night, spending money impulsively, hypersexuality, grandiosity, agitation/mania with antidepressants
A preschooler doesn’t like rhyming games or rhyming words. What may the child be at risk for?
Dyslexia (language-based learning disorder)
-have problems with phonological processing at the word level (e.g. difficulty processing the sounds of spoken words)
-can’t recognize rhyming words (“bat” vs “cat”)
Definition of Dyslexia?
-have difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities
-usually due to deficit in phonological awareness of language out of norm form cognitive abilities and when given effective classroom instruction
-affects 5-10% of kids
-runs in families/heritable; happens in up to 50% of people who have 1st degree relatives with dyslexia
-lots of ppl with dyslexia usually had speech or language delay
intervention for dyslexia?
systematic, highly structured programs that focus on explicit instruction for both phonemic awareness and decoding
without intervention, kids who remain poor readers in first 3 years of elementary school will likely never acquire average level of word reading fluency.
Risk of untreated reading disability/disorder?
difficulty pursuing higher level education beyond high school
more likely to enter juvenile justice system
less earning potential for jobs
when do kids stop doing letter reversals?
usually wait it out for first 2-3 years after starting reading as it is common
usually by end of second grade (7-8 years)
What is sleep-onset association?
when child relies on a stimulus (e.g. person, object, activity) to fall asleep
Once that stimulus is removed from their environment, the kid wakes up, and relies on it to fall back asleep
How to treat sleep-onset association?
Extinction
Fading
How long should children sleep per age group?
infants 4-12 months: 12-16 hours including naps
1-2 years: 11-14 hours
3-5 years: 10-13 hours
6-12 years: 9-12 hours
13+ years: 8-10 hours
Symptoms of Obstructive Sleep Apnea?
it’s a sleep-related breathing disorder that leads to mechanical obstruction of the airway at night (due to tonsils, weight, etc)
symptoms:
1. feel tired during day
2. snoring
3. apneic events at night
4. open-mouth breathing
5. chronic headaches
6. dry mouth
Features of Night Terrors?
non-rapid eye movement (NREM) parasomnia; happens in slow-wave sleep
-happens in beginning of night
-children with cry and yell, heighted autonomic system activity like rapid breathing, rapid heart rate
-amnesia of event
-if you arouse them then it can be distressing and lead to delayed return to sleep
When there is delay in falling asleep at the desired time with inability to wake up at desired and accepted times
Circadian rhythm sleep disorders
Children have a stable delay in their sleep onset but they maintain adequate quantity and quality of sleep
Definition of Encopresis?
-passing of stool into inappropriate places
-needs to happen at least 1x/month for at least 3 months
-happens in children at least 4 years old (or equivalent developmental level)
Difference btwn primary and secondary encopresis?
primary: person has never established fecal continence with toilet training
secondary: encopresis develops after an established period of fecal continence
Steps of central nervous system development (“sculpting”):
- Neurogenesis/apoptosis
- synaptogenesis/pruning
- myelination
Neurogenesis (in CNS development)?
-occurs prenatally with almost all neurons present at birth
-then brain tissues is shaped with apoptosis (programmed cell death)
Synaptogenesis/pruning (in CNS development)?
-results in increased connectivity between neurons starting at 27 weeks postgestational age, intensifying in first 2 years of life
ex. auditory cortex synaptogenesis emerges at 3 months vs prefrontal cortex synaptogenesis occurs at 18 months
-synaptic pruning is the developmental process in which elements of the structural synapse (presynaptic terminals and postsynaptic membranes) are eliminated
-activity-depending pruning occurs at different periods in development depending on the brain region and the neuron subtype
-synaptic pruning peaks in early childhood (0-4 years) and during adolescence (12-18 years)
Myelination (in CNS brain development)?
-myelination leads to increased speed of neuronal communication
-prolonged process in brain development and goes into adulthood
What is neural patterning?
biological process by which cells in the developing brain acquire distinct identifies and spatial positions; happens during fetal development
What is neuroplasticity?
it is the brain’s inherent dynamic capacity that includes maturation and brain’s ability to change structurally in response to enrichment and injury
what is difference between provisional tic disorder vs chronic/persistent tic disorder?
duration since onset
provisional tic disorder is when tics present for < 1 year
all tic disorders start before age?
18 years
what is a tic?
sudden ,rapid, recurrent, non-rhythmic motor movement or vocalization
common simple motor tics: eye blinking, shoulder shrugging
simple vocal tics:
throat clearing, sniffing, grunting
complex vocal tics: repeating words/sounds/phrases
peak age of tic disorder?
peak age for severity: 10-12 years
initially present: 4-6 years
usually transient, fluctuate in severity and presentation over time; worsens with anxiety and stress
February 2023
