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Psych > Development + Children + Autism + ADHD > Flashcards

Development + Children + Autism + ADHD Flashcards

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1
Q

In how many settings do symptoms have to occur to diagnose ADHD?

A

symptoms must cause impairment in at least two domains (ex. school and home)

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2
Q

What is a specific phobia?

A

A strong fear to an object, animal, event, etc

often associated with another anxiety disorder

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3
Q

A physician with Type 1 diabetes became a pediatric endocrinologist to help children who develop Type 1 diabetes. What is the value of self-disclosure for this doctor in the care of patients?

a) there is no risk in the doctor’s relationship with their patients by self-disclosure
b) most patients would think that the doctor was seeking sympathy from the patient
c) most patients would think that doctor who self-discloses was shaming them for being upset when they were newly diagnosed with Type 1 diabetes
d) patients might be encouraged by having a doctor who is also a role model

A

d) patients might be encouraged by having a doctor who is also a role model

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4
Q

What is the formal operational stage?

A

occurs age 12-18

child capable of abstract thinking, scientific thinking, engaging in philosophical discussions

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5
Q

What are the three major strategies to reduce stigma?

A

education, protest, and interpersonal contact

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6
Q

What are the two stages of post-conventional moral development?

A

Stage 5: social contract - behavior driven by balance between social order and individual rights

Stage 6: universal ethics - morality based on rules that transcend mutual benefit

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7
Q

What are the red flags of adolescence?

A

depression

social anxiety

substance use/abuse

conduct disorder

psychotic disorders

bipolar disorders

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8
Q

What are Freud’s stages of psychosexual development?

A

oral stage (birth - 2 years)

anal stage (2 - 3 years)

phallic stage (3 - 6 years)

latency stage (6 - 12 years)

genital stage (puberty to adulthood)

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9
Q

What is conservation? When in the Piaget stages does it develop?

A

ability to realize that mass/volume does not change merely due to physical changes

occurs in the concrete operational stage

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10
Q

How can you distinguish between autism spectrum disorder and intellectual disability?

A

children with just intellectual disability will still demonstrate social relatedness, a desire to connect, and will not have restricted and repetitive patterns of behavior, interests, and activities

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11
Q

What type of drug is adderall?

A

a mixed salt amphetamine stimulant

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12
Q

What are the characteristics of selective mutism?

A

young children with the ability to speak that do not speak in social situations

occurs outside of the context of other disorders

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13
Q

How long do major depressive episodes last? Minor depressive episodes?

A

major: 7-9 months
minor: > 3 years

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14
Q

What are the main components of an ADHD assessment?

A

parent interview + rating scales

patient interview

school information

complete medical history and physical exam

can also include psychological testingand language + speech evaluation

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15
Q

What is the general clinical course of untreated/undiagnosed anxiety?

A

childhood onset

adolescence: symptoms and accumulated disability, can morph to depression

young adulthood: symptoms and failure in major life roles, can evolve to panic disorder or substance abuse

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16
Q

What are the key parental behaviors during the autonomy vs. shame and doubt period of psychosocial development? Consequences of lack of behaviors?

A

parents must encourage their child’s use of initiative and reassure them when mistakes are made

if not (meaning if parents are overpowering, controlling, or disapproving): child may feel ashamed and doubt their abilities

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17
Q

What are the side effects of atomoxetine?

A

nausea, vomiting, stomach ache, fatigue

black box anti-depressant warning for suicide

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18
Q

What is the mechanism of stimulant medications for treatment of ADHD?

A

increases the effect of dopamine and norepinephrine by blocking reuptake transporters and by facilitating release into the synapse

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19
Q

At which stage of development does intellectual disability most often begin?

A

prenatally

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20
Q

What is self-stigma?

A

incorporation of the beliefs of others into ones’ self attitude

can be overt (self-loathing, self-preservation) or covert

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21
Q

What type of drug is ritalin?

A

a methylphenidate stimulant

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22
Q

What are the treatments for teens with depression?

A

psychological treatments: CBT, interpersonal therapy

medications: SSRIs/atypical antidepressants, tricyclic antidepressants, MAO-inhibitors

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23
Q

The ane of onset of panic disorder occurs during which stage of development?

a) before puberty
b) after puberty
c) older adolescence and young adulthood
d) middle age

A

c) older adolescence and young adulthood

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24
Q

At what age are autism spectrum disorder symptoms typically first recognized?

A

12-24 months

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25
Q

Based on the child/adolescent anxiety multimodal study (CAMS), which statement regarding treatment of anxiety is true?

a) medication treatment is equivalent to placebo
b) CBT is equivalent to placebo
c) medication and CBT are equivalent
d) medication is better than CBT
e) CBT is better than medication

A

c) medication and CBT are equivalent

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26
Q

What is cultural competence vs. cultural humility?

A

competence - mastry of knowlesge

humility - knowledge + self-exploration and self-critique

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27
Q

What are the side effects of guanfacine and clonidine?

A

low blood pressure, dizziness, fainting, sedation

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28
Q

What is the autonomy vs. shame and doubt stage of psychosocial development?

A

occurs between 1 - 2 years of age

when toddlers learn to walk, talk, use toilets, and do things for themselves

self-control and self-confidence begins to develop

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29
Q

What are the two substages of the preoperational stage?

A

1) symbolic activity (age 2-4): thnking and reasoning symbolically
2) decentration (age 4-7): child begins to recognize other points of views

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30
Q

What are the key physcial development milestones of preschoolers?

A

slow physical growth

brain maturation (improved motor control, coordination)

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31
Q

How can you distinguish between autism spectrum disorder and stereotypic motor disorder?

A

these children will lack all other symptoms of ASD (ex. intact social skills)

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32
Q

What is accommodation? When in the Piaget stages does it develop?

A

modifying a schema to account for new information

develops in the sensorimotor stage

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33
Q

What are the DSM-5 diagnostic criteria for ADHD?

A

6 or more inattention symptoms and/or 6 or more hyperactivity/impulsivity symptoms

symptoms must appear before age 12 and last 6+ months

symptoms must occur in at least 2 settings

symptoms must cause distress/impairment

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34
Q

What are the key cognitive development milestones in middle childhood?

A

more accurate observations

reading, writing, memory, attention, logical thinking

goals and planning

problem solving

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35
Q

How can you distinguish between autism spectrum disorder and hearing impairment?

A

Hearing test

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36
Q

What are the key developmental tasks of the toddler years?

A

balance attachment with exploration

internalize parental values and standards

play (initially imitative, then symbolic)

grow vocabulary

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37
Q

What is the gender prevalence of ADHD?

A

2.4:1 male to female ratio

girls may take longer to diagnose due to increased prevalance of inattentive subtype

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38
Q

What is the sensorimotor stage of Piaget’s cognitive development?

A

stage from birth to age 2

learning through action, exploration of motor functions, producing effects on objects

object permanence, assimilation, and accomodation develop

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39
Q

How can you distinguish between autism spectrum disorder and obsessive compulsive disorder?

A

these children have intact social skills and do not have restricted interests

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40
Q

What is the role of genetics and environment in anxiety?

A

genetic vulnerability set off by environmental trigger

self-perpetuating and “contagious” from parent to child

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41
Q

What is the etiology of ADHD? Risk factors?

A

strongly genetic with environmental components (high heritability)

risk factors: maternal smoking, lead exposure, brain injury

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42
Q

What are the key components of parent training for ADHD?

A

education about ADHD

info on giving clear commands and giving praise for appropriate behavior

determining appropriate rewards and consequences

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43
Q

How is autism spectrum disorder diagnosed?

A

rating scales or structured interview

physical examination

vision + hearing test, EEG, lab tests, speech/language evaluation, neuropsychological testing, and occupational therapy may be used

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44
Q

The ordering of treatment benefit in the Treatment of Adolescents with Depression Study (TADS) is which of the following?

a) combination treatment > medication = CBT > placebo
b) combination treatment > medication > CBT > placebo
c) combination treatment = medication > CBT > placebo
d) combination treatment = medication > CBT = placebo

A

d) combination treatment = medication > CBT = placebo

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45
Q

What are the treatments for autism spectrum disorder?

A

appropriate educational placement

behavioral modification (applied behavior analysis)

social skills training

speech and language therapy

occupational therapy

treatment of comorbid conditions

secondary adjunctive pharmacological interventions

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46
Q

What is the difference between normal human sadness, demoralization, and sadness without cause?

A

normal human sadness: common, expectable reaction to events that are time limited

demoralization: chronic unhappiness due to adverse circumstances, can be severe but without anhedonia

sadness without cause: depression with anhedonia, physical manifestations, disproportionate and unexpected

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47
Q

How can you distinguish between autism spectrum disorder and social (pragmatic) communication disorder?

A

children will have deficits in social communication and interaction, but do not have restricted and repetitive patterns of behavior, interests, and activities

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48
Q

What is the typical age of diagnosis of ADHD?

A

4-7 years (or later if mild)

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49
Q

What is the utility of pharmacotherapy for autism spectrum disorder?

A

to treat comorbid symptoms

aggression: atypical antipsychotics, alpha-2 agonists

inattention/ADHD: stimulants, alpha-2 agonists

anxiety/depression: SSRIs

Tourette’s/Tics: alpha-2 agonists

Insomnia: melatonin

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50
Q

What were the results of the ADAPT trial for depression?

A

SSRIs and SSRI+CBT had similar efficacy (combination maybe slightly better)

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51
Q

What are disidentifiers (in the context of stigma)? What are the types of disidentifiers?

A

an unexpected experience or characteristic that disrupts one’s perception of the other

can be positive valance (improves perception) or negative valance (worsens perception)

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52
Q

How can you distinguish between autism spectrum disorder and language disorder?

A

children with language disorders will still demonstrate social relatedness, a desire to connect, and will not have restricted and repetitive patterns of behavior, interests, and activities

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53
Q

What are the key cognitive development milestones for preschoolers?

A

egocentrism: seeing their own perspective only

believing there is always a relationship between things that occur at the same time

transductive reasoning (generalizing past experiences)

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54
Q

What are the key parental behaviors during the initiative vs. guilt period of psychosocial development? Consequences of lack of behaviors?

A

parents must be encouraging and consistent in discipline

if not: children may develop guilt and believe it is wrong to be independent

55
Q

What are the two stages of pre-conventional moral development?

A

stage 1: obedience/punishment - rules followed to avoid punishment

stage 2: self interest - rules followed to maximize gain

56
Q

What are the key language development tasks of infancy?

A

vocalization and babbling

following simple directions

receptive language > expressive language

first words (~ 12 months)

57
Q

What is the typical age of diagnosis of ASDs?

A

0-3 years of age (or later if mild)

58
Q

The age of onset of anxiety and depression is associated with which stages of development?

a) anxiety before puberty and depression after puberty
b) anxiety and depression both before puberty
c) anxiety and depression after puberty
d) anxiety and depression both after puberty

A

a) anxiety before puberty and depression after puberty

59
Q

What is the typical age of diagnosis for panic disorders?

A

16-25 years of age

60
Q

How might a patient interact with a physician who could be stigmatized based on race?

a) ask for a different doctor
b) express confidence in the doctors skills
c) answer the doctor’s questions fully and honestly
d) follow the doctor’s treatment recommendations

A

a) ask for a different doctor

61
Q

How is depression different from demoralization?

a) depression has a sudden onset and demoralization is chronic
b) depression has sleep disturbance and demoralization has normal sleep patterns
c) depression has pervasive loss of interest in pleasurable activities and demoralization doesn’t
d) depression has feelings of sadness and demoralization doesn’t

A

c) depression has pervasive loss of interest in pleasurable activities and demoralization doesn’t

62
Q

What is the typical age of onset of pediatric anxiety disorders?

A

ages 6-12

63
Q

What are the key red flags of infancy?

A

parent can’t attach (physically or emotionally absent)

child can’t attach (ex. autism)

64
Q

What diseases are associated with autism spectrum disorder?

A

Fragile X

Tuberous sclerosis

genetic/chromosomal syndromes that lead to intellectual disability

65
Q

What are the causes of postnatal onset of intellectual disability?

A

results from head trauma with brain injury, meningitis/encephalitis, or errors of metabolism

characterized by period of normal development followed by an obvious injury (deterioration) or gradual loss without obvious injury (degeneration)

66
Q

What is the genetic component of autism spectrum disorder?

A

high concordance between monozygotic twins (60-90%)

increased prevalance between siblings (4.5%)

some genes identified as potentially playing a role

67
Q

What parental risk factors are associated with development of autism?

A

maternal age > 40

paternal age > 50

maternal grandfather age > 50 when he had the mother

extreme prematurity

68
Q

What are examples of hyperactivity and impulsivity criteria for ADHD diagnosis?

A

fidgeting/squirming

doesn’t stay seated

runs/climbs inappropriately

trouble playing quietly

seems to be “on the go”

excessive talking

blurting out answers

difficulty waiting turn

interrupting/intruding on others

69
Q

Who are “the wise” in the context of stigma?

A

“normal” people who are accepted by the stigmatized because they are wise to the issue

can be active or passive

70
Q

How can you distinguish between autism spectrum disorder and selective mutism?

A

child would have intact social skills at home and with familiar people

71
Q

What are the general outcomes of autism spectrum disorder?

A

depends on severity of presentation

worsened by comorbid epilepsy

many adults can have some independence

72
Q

What are discredited vs. discretible stigmas?

A

discredited - individuals who have a stigma that is predominantly visible (ex. race/ethnicity, gender, physical disability)

discreditable - individuals who have a stigma that is predominantly concealable (ex. mental illness, HIV infection, sexual minority status)

73
Q

What is the most common chromosomal cause of intellectual disability?

A

Down Syndrome

74
Q

What are the key social development milestones of infancy?

A

social smile

stranger anxiety

separation anxiety

awarness of others’ point of view (joint attention, social referencing)

75
Q

What are the characteristics of separation anxiety disorder?

A

excessive concern when separated from home/attachment figures

fearful of bad things happening to parent or self, fear of being alone

trouble falling asleep, sleeping with loved ones

physical pain

impairment or distress

duration > 6 months

76
Q

What are the possible causes of perinatal onset of intellectual disability?

A

interruption of oxygen supply to the brain around the time of delivery, complicated labor, poor gas exhange through the placenta, compromised fetal circulation

77
Q

What are the primary areas of impairment seen in autism that are required for diagnosis?

A

1) social communication and interaction
2) restricted and repetitive patterns of behavior, interests, and activities

78
Q

What are examples of inattentive criteria for ADHD diagnosis?

A

poor attention to detail

difficulty focusing

does not listen when spoken to directly

trouble finishing tasks

difficulty organizing

avoiding/disliking tasks that require sustained mental effort

loses things

easily distracted

forgetful

79
Q

What does it mean for intellectual disability to have a prenatal onset?

A

onset of disability that occurs before birth and is associated with recognizable defects in brain morphogenesis

often linked to multiple congenital anomalies

80
Q

What are the characteristics of obsessive compulsive disorder?

A

prominent obsessions or compulsions (dirt/germs/contamination, ordering and arranging, repetitive acts) that are impairing or time consuming

81
Q

How can you distinguish between autism spectrum disorder and schizophrenia?

A

they will have disorganized behavior and thinking

they will also have delusions, paranoia, or auditory/visual hallucinations

82
Q

What is the gender ratio of autism spectrum disorder?

A

more frequent among males (4 times more common)

83
Q

What are the key emotional development stages for preschoolers?

A

self-regulation, emotional regulation

84
Q

What is the Honest, Open, Proud program?

A

an anti-stigma program focused on the concept of self-disclosure and the decision-making process that surrounds it

85
Q

What are the structural brain differences associated with ADHD?

A

prefrontal cortex and striatum dysfunction

smaller total brain volum

global thinning of gray matter

neuroimaging not used for diagnosis

86
Q

What are the two stages of conventional moral development?

A

Stage 3: conformity and interpersonal accord - “good girls” rules followed to gain approval

Stage 4: authority and social order - fixed rules to protect the social order

87
Q

What is the difference between deterioration and degeneration? What do these processes indicate about the time when intellectual disability has its cause?

A

deterioration - almost always post-natal in orgin (head trauma, infection, etc.)

degeneration - pre-natal or post-natal (inherited disorders that can present gradually, Alzheimer’s disease, etc.)

88
Q

What are the three types of ADHD?

A

predominantly inattentive presentation

predominantly hyperactive/impulsive presentation

combined presentation (most common)

89
Q

What are the side effects of stimulants?

A

decreased appetite/weight loss, insomnia, headaches, nausea, irritability, tics, increased HR or BP

90
Q

What is the mechanism of Guanfacine?

A

alpha-2 agonist

used for ADHD in combination with stimulants

91
Q

What are the key cognitive development milestones of infancy?

A

object permanence

92
Q

What is the typical age of diagnosis for depression?

A

12-16 years of age

93
Q

What is the industry vs. inferiority phase of psychosocial development?

A

occurs between age 6 - 12

learning to make things, use tools, acquire skills

transition to world of school and peers

94
Q

Meta-analysis of antidepressant studies such as in Cipriani et al., 2017 do not take into account which one of the following methodological factors?

a) sample size
b) age of the study population
c) studies with active comparators (other antidepressants)
d) the role of funder or study sponsor in outcome

A

d) the role of funder or study sponsor in outcome

95
Q

What are possible consequences of untreated ADHD?

A

increased difficulties in interpersonal relationships, difficulties at school/work, increased risk of accidents/injuries, higher rates of substance abuse

96
Q

What are the general treatment options for anxiety?

A

anxiety symptoms: CBT and medications

accumulated disability: life skills training

maladaptive behaviors: behavioral treatments

97
Q

What are the key language development milestones of preschoolers?

A

expressive: more words and phrases
receptive: grows to following multi-step commands

98
Q

What is the difference between normal and pathological anxiety?

A

normal: predictable triggers, expectable + proportionate reactions, can be chronic if trigger is persistent
pathological: triggers are normative developmental experiences, excessive + disproportionate reactions, highly stereotyped behaviors across individuals

99
Q

What is the most common inherited cause of intellectual disability?

A

Fragile X

100
Q

What are characteristics of panic disorders?

A

anxiety attacks (increased HR, hyperventilation, SOB, chest pain, etc.)

worry about next panic attack

avoidance behavior related to attacks

agoraphobia

101
Q

Based on the Corrigan et al paper, what was the relative value of education and interpersonal contact in reducing stigma?

a) education was more effective in reducing stigma than interpersonal contact
b) education was equally effective in reducing stigma compared to interpersonal contact
c) education was less effective in reducing stigma compared to interpersonal contact
d) neither education nor interpersonal contact were effective in reducing stigma

A

c) education was less effective in reducing stigma compared to interpersonal contact

102
Q

What is the difference between a stereotype, prejudice, and discrimination?

A

sterotype = belief

prejudice = judgment based on belief

discrimination = action based on judgements and beliefs

103
Q

How can you distinguish between autism spectrum disorder and anxiety/social phobia?

A

intact social skills with familiar people or social skills that improve as they become more comfortable

will not have restricted and repetitive patterns of behavior, interests, or activities

104
Q

What are the red flags for toddler and pre-schooler development?

A

language delay

delayed self-regulation (persistent tantrums/outbursts)

cognitive flexibility/rigidity (trouble tolerating changes in routines)

105
Q

What is the typical age of diagnosis for bipolar disorder or psychosis?

A

> 16 years of age

106
Q

What is object permanence? When in the Piaget stages does it develop?

A

realization that objects continue to exist even when you can’t see them

develops in sensorimotor stage

107
Q

What is the concrete operational stage?

A

occurs ages 7-11

child no longer thinks one-dimensionally

child achieves conservation (realizing that mass/volume does not change if the container changes)

108
Q

What is assimilation? When in the Piaget stages does it develop?

A

taking a new object/experience and grouping it with other objects that have the same or similar function

develops in the sensorimotor stage

109
Q

What is the anxiety triad?

A

anxious thoughts, anxious feelings, anxious behaviors

110
Q

What are the key parental behaviors during the trust vs. mistrust period of psychosocial development? Consequences of lack of behaviors?

A

parents must provide for the needs of the infant and respond to them

if not: development of mistrust towards people, their environment, and themselves

111
Q

What is true about cultural competence and cultural humility?

a) cultural competence requires that the doctor has the knowledge and skills to interact appropriately with all patients from diverse backgrounds
b) cultural humility requires that the doctor have the knowledge and skills to interact appropriately with all patients from diverse backgorunds
c) cultural competence requires that the doctor be open to learning about their patients, and being respectful of their beliefs, customs, and values
d) cultural humility requires that the doctor be open to learning about their patients, and being respectful of their beliefs, customs, and values

A

d) cultural humility requires that the doctor be open to learning about their patients, and being respectful of their beliefs, customs, and values

112
Q

What other features/conditions are associated with autism spectrum disorder?

A

intellectual disability (including Fragile X, tuberous sclerosis, and other syndromes)

regression in social skills after relatively normal development

behavioral problems

sensory sensitivity

sleep problems

anxiety, mood disorders

seizures

113
Q

What are the characteristics of general anxiety disorder?

A

excessive worry/apprehensiveness

restlessness, being on edge

fatigue

concentration problems

sleep problems

tense and irritable

114
Q

What is the typical age of diagnosis of anxiety?

A

6-12 years of age

115
Q

What is the most common cause of mild intellectual disability?

A

multifactorial/unknown etiology

116
Q

What is the first line treatment for ADHD?

A

stimulant medications

ex. ritalin, adderall

117
Q

What psychiatric disorders are often comorbid with ADHD?

A

ODD/conduct disorders

anxiety

depression/mood disorders

learning disorders

118
Q

What is the initiative vs. guilt phase of psychosocial development?

A

occurs between 2 - 6 years

children have more motor skills and engage more in social interactions

balance between adventure and controlling fantasies

119
Q

What is social stigma?

A

A social belief that devalues of disapproves a person (or activity) based on characteristics that serve to distinguish them from other members of society

120
Q

What is intellectual disability?

A

subaverage intelligence associated with deficits in adaptive behavior

implies IQ 2 standard deviations below the mean and diagnosis before age 10

121
Q

What are the key motor development milestones of infancy?

A

gross motor skills (sit up, walk)

fine motor skills (swat, rake, pincer grasp)

122
Q

What medications are used to treat anxiety disorders?

A

all types: fluvoxamine, fluoxetine

social: paroxetine, fluoxetine, venlafaxine
generalized: sertraline, venlafaxine, duloxetine, buspirone

123
Q

What is the general treatment model for ADHD?

A

medication is more effective than behavioral therapy, particularly for core ADHD symptoms, aggression, oppositional-defiant behaviors, peer-related social functioning

behavioral treatment can help as an additive therapy (particularly for comorbid conditions)

124
Q

What is the identity vs. role confusion phase of psychosocial development?

A

occurs between ages 12 - 18

youth explore self and develop sense of self

125
Q

What are the characteristics of social anxiety disorder?

A

fear of social or performance situations

can be specific to certain situations or generalized to many social interactions

126
Q

What are examples of stimulant medications for ADHD?

A

Methylphenidate derivatives (ex. Ritalin)

Amphetamine derivatives (ex. Adderall)

can be short or long acting formulations

127
Q

What were the findings of the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) trial?

A

combination of SSRI/antidepressant + CBT works better than antidepressant alone

128
Q

What is the mechanism of clonidine?

A

alpha-2 agonist

can be used in combination with stimulants to treat ADHD

129
Q

What is attachment theory?

A

the theory that infants are born with an innate need for a single attachment figure and need continuous access to this figure for at least the first 2 years of life

130
Q

What is the trust vs. mistrust stage of psychosocial development?

A

occurs between 0 - 1 years of age

when infants develop trust for their caregivers

131
Q

What are the DSM-5 criteria for autism spectrum disorder?

A

persistent deficits in social communication and social interaction across multiple contexts

restricted, repetitive patterns of behavior, interests, activities

symptoms present in early developmental period

symptoms causing clinically significant impairment

disturbances not better explained by intellectual disability or global developmental delay

132
Q

What are the red flags of middle childhood development?

A

inattention/hyperactivity

separation anxiety

phobias

generalized anxiety

133
Q

What is the mechanism of atomoxetine?

A

a selective NE reuptake inhibitor and direct DA agonist in the prefrontal cortex

used to help with ADHD and anxiety, but not as effective as stimulants

134
Q

How might a patient sigmatized based on racial differences engage in medical care?

a) ask questions about their diagnosis and treatment plan
b) discuss personal needs and beliefs about being ill
c) engage friends and relatives in their care
d) be deferential and self-effacing when working with the medical team

A

d) be deferential and self-effacing when working with the medical team

Psych (6 decks)

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