Early Onset Disorders Part 1 Flashcards
Intellectual-Mental Retardation
Symptoms
Population
-
Symptoms
- Significant sub-average on general intellectual functioning
- Concurrent deficits in adaptive behavior
- Onset <18 YO
- 3% of school-age children
- Boys > girls
Intellectual-Mental Retardation
Causes
Treatment
-
Causes
- Lack of stimulation
- Inadequate nutrition
- Exposure to toxins (lead)
- Chromosomal or metabolic abnormality (25%)
- Down Syndrome, Fragile X
- Phenylketonuria
- Pregnancy trauma
- Drugs, radiation, toxemia, alcohol
- Infection (German measles)
- Infections (encephalitis)
-
Treatment
- Parental support/guidance
- Special programs
Developmental: Pervasive Development Disorders
Symptoms
Types (2)
- Distortions in timing, rate, sequence of many basic psychological functions involved in the development of social skills & language
- Types
- Autism
- Asperger’s Disorder
Autism
Characteristics
Causes
-
Characteristics
- Impaired non-verbal behaviors (eye contact, gestures)
- Failure to develop age appropriate peer relations
- Lack of social reciprocity
- Delay or lack of spoken language
- Lack of make-believe play
- Restricted stereotyped patterns of behavior
- Causes: genetics, infections
Asperger’s Disorder
Characteristics
Treatment
-
Characteristics
- Impaired social interaction
- Restricted, stereotyped patterns of behavior
-
Treatment
- Parental support
- Special programs
Specific Developmental Disorders (Learning Disorders)
Symptoms
Population
Treatment
- Symptoms
- Delay in rate of learning a specific function so that children behave as though they are passing through an earlier normal developmental stage substantially below expected for chronologic age
- May be one or more in areas of arithmetic, expressive writing, reading, articulation, expressive language, receptive language, coordination
- 10% of children
- Boys > girls
- Treatment: remedial work
Unclassified Speech Disfluencies
Symptoms
Cause
Treatment
- Symptoms
- Stuttering (sound & syllable repetition)
- 3-4 YO
- Cause: developmental
- Treatment
- Ignore
- 1% persists & require speech therapy
Behavioral: Oppositional Defiant Disorder
Symptoms
Pattern of negativistic, hostile & defiant behavior
(at least 6 mo)
- Signs
- Often loses temper
- Often argues w/ adults
- Defied or refuses to comply
- Deliberately annoys
- Blames others
- Resentful, spiteful & vindictive
- Signs
**Behavioral: Oppositional Defiant Disorder **
Population
Cause
Treatment
- Children & adolescents
- Boys > girls
- Cause
- Environmental (parents over-assert control)
- Treatment
- Parent training program
- Psychotherapy
- Social skills training
- Cognitive behavior therapy
What are the symptoms of Attention Deficit Disorder?
- Fidgety or restless
- Unable to sit for a long time
- Always on the go
- Easily distracted
- Can’t concentrate well on work
- Impulsively acting before thinking
- Forgetting what was said or not listening
- Difficulty finishing work on time
- Often losing personal things
- Difficulty waiting in lines or jumping ahead of others
Attention Deficit Disorder
Population
Causes
- 5% of children
- Many times children w/ ADD have other learning problems
- Often starts in kindergarten or 1st grade & continues for years
- Causes
- Children are born w/ ADD & can’t control symptoms easily
- Often runs in families (hereditary)
- Not caused by allergies or too much sugar
How is Attention Deficit Disorder treated?
What happens if ADD is untreated?
-
Medications
- Ritalin (methylphenidate), Metadate, Concerta, Dexedrine (dextroamphetamine), Adderall, Cylert (pernoline), Pamelor (nortriptyline), Norpramin (desipramine), Catapres (clonidine), Strattera
-
Psychotherapies
- Behavioral therapy
- Parent management training
- Family therapy
-
Educational
- Special education classes
-
Untreated
- Can lead to difficulty w/ learning, classroom behavior, making friends, following rules at home
- Many children don’t outgrow ADD when they get older & benefit from long-term medication
What are the symptoms of Conduct Disorder?
- Frequent lying, stealing, truancy
- Running away from home
- Frequent fighting/bullying
- Property destruction
- Fire-setting
- Being mean to animals or people
- Breaking & entering into someone’s house or car
What is the population of Conduct Disorder?
- Older children & teenagers
- Boys > girls
- Most children w/ CD have other problems
- ADD
- Depression
- Alcohol abuse
- Family problems
What are the causes of Conduct Disorder?
What are teenagers at risk of?
- Causes
- Exact cause unknown
-
Many factors may contribute to behavioral problems
- Drugs
- Family problems
- Low self-esteem
- Physical abuse
- Impulsivity
-
Teenagers at risk…..
- Dropping out of school
- Being seriously injured in flights
- Getting hooked on street drugs
- Trouble w/ the police
What is the treatment for Conduct Disorder?
What happens if untreated?
Without treatment, many children/teenagers continue to have similar problems as adults (may become imprisoned)
-
Medication
- Meds for depression
- Lithium for aggressive & impulsive behavior
-
Psychotherapy
- Behavioral therapy
- Group therapy
- Family therapy
-
Special programs
- Probation programs
- Residential programs
What are the symptoms of Generalized Anxiety Disorder (GAD)?
- constant worrying
- unable to relax
- aches & pains (headaches, stomachaches)
- self-consciousness
- nightmares about the same things that cause worry
What are the symptoms of Separation Anxiety Disorder (SAD)?
- unable to leave parents b/c of worries that something bad may happen to them
- fear of going to sleep
- reluctant to go to school
- fear of being kidnapped
GAD & SAD
Population
Causes
- Children & teenagers
- SAD = younger children (7-10 YO)
- GAD = teenagers (12-15 YO)
- Causes
- Exact cause unknown
- Tendency to develop severe anxiety runs in some families (hereditary)
- Stress can play a role (death, parent’s illness, another medical problem, learning problems)
How are GAD & SAD treated?
-
Medications
- Tofranil (imipramine)
- Xanax (alpraxolam)
- BuSpar (Buspirone)
- Paxil (paroxetine)
- Zoloft (sertraline)
-
Psychotherapy
- Behavioral therapy
- Cognitive behavioral therapy
- Family therapy
What are the symptoms of Obsessive Compulsive Disorder (OCD)?
- Obsessions – thoughts or images (memories/pictures) that keep coming into one’s mind even though the person wants the thoughts to stop
- Compulsions – actions & behaviors that one feels need to be done over & over again; one can’t stop doing them
- _Worries & anxiety occur if one tries to stop the obsessions or compulsions _
Obsessive Compulsive Disorder
Population
Causes
- Children & teenagers (1%)
- Causes
- Exact cause unknown
- Some parts in the brain don’t seem to work well in OCT (basal ganglia) post strep infection
How is OCD treated?
-
Medication
- Anafranil (clomipramine)
- Prozac (fluoxetine)
- Zoloft (sertraline)
- Luvox (fluvoxamine)
-
Psychotherapy
- Behavioral therapy
- Cognitive behavioral therapy
What are the symptoms of Panic Disorder?
Periods of extreme anxiety or fear that begin suddenly (min to hrs)
- Shortness of breath
- Feeling dizzy or faint
- Racing heartbeat
- Feeling shaky
- Stomach upset
- Sweating
- Thinking one may lose control
- Big fear of getting another period of anxiety
What is the typical population of Panic Disorder?
- Rare in young children
- More frequent in teenagers
- Tendency to have PD runs in families (hereditary)
What causes Panic Disorder?
- In a very frightening situation, the symptoms of panic attack (extreme anxiety or fear) would be normal or expected
- In people w/ PD, the part of the brain that controls anxiety (locus coeruleus) reacts for no apparent reason, giving the person extreme anxiety even though he/she is not in a frightening situation
How is Panic Disorder treated?
-
Medication
- Tofranil (imipramine)
- Xanax (alprazolam)
- Paxil (paroretine)
-
Psychotherapy
- Cognitive behavioral therapy
What are the symptoms of Post-Traumatic Stress Disorder (PTSD)?
- Nightmares or flashbacks (re-experiencing the trauma in one’s mind, along w/ a sudden feeling of fear that the trauma is happening again)
- Avoid situations that bring the trauma back into memory
- Difficulty remembering the trauma
- Losing interest in things
- Hopelessness (the future doesn’t look good)
- Constant fear about not being safe
- **Severe anxiety & depression **
People w/ PTSD have had a very bad experience (physically or sexually abused, natural disasters, seriously injured), which leads to intense & continuing feelings of _____& ________.
PTSD may also be seen in ______ who have witnessed a serious accident or saw someone get badly injured
Anyone, of any age, who has lived through a traumatic event might show ______________.
threat, helplessness
children
PTSD symptoms
What are the causes of PTSD?
- Trauma that caused PTSD is so intensely frightening that the fears & memories are present for a long time
- It is almost as if some parts of the brain, such as the parts involved in remembering things, become over-charged & stay too active
- It is not clear why some people who experience trauma get PTSD & why others don’t
**Post-Traumatic Stress Disorder **
How long do symptoms last?
What happens if untreated?
Treatment?
-
Range of symptom length
- Weeks – months
- Years
-
Untreated PTSH can lead to…
- Depression
- Substance abuse
- Aggressive behavior
- Personality changes
-
Treatment
- Treatments used for depression or anxiety may be useful
What are the symptoms of Depressive Disorders?
- Depressed (feeling sad)
- Losing interest in things
- Sleep problems (difficulty staying or falling asleep, or sleeping too much)
- Changes in appetite or weight
- Difficulty concentrating
- Feeling slowed down
- Feeling worthless (like you’re a bad person)
- Feeling that life is not worth living
- **Hopelessness **
What is the population of Depressive Disorders?
- People of all ages can have depression
- Teenagers > children
- 5% of teenagers in teenage yrs
What are the causes of depressive disorders?
- Some types inherited
- Certain people under a lot of stress can develop depression
-
Stress can include…
- Losing someone important
- School problems
- Frequent arguments w/ family
- Having been abused
- Medical problems
- At other times, the part of the brain that keeps the mood happy (brain chemicals – serotonin & NE) doesn’t function well
When not treated, depression in children & teenagers might last for _________.
A person who has had one episode of depression might _______ _______ at a later time
Teenagers who have serious depressions may be at risk of developing ______ ____________in the future (substance abuse or suicide attempts)
months to years
develop another
other psychiatric problems
How are Depressive Disorders treated?
-
Tricyclic anti-depressant medications
- Norpramin (desipramine)
- Pamelor (nortriptyline)
-
SSRIs
- Prozac (fluoxetine)
- Celexa (citalopram)
- Zoloft (sertraline)
- Luvox (fluvoxamine)
- Paxil (paroxetine)
-
MAOIs
- Nardil (Phenelzine)
- Parnate (tranylcypromine)
-
Psychotherapy
- Cognitive therapy
- Interpersonal therapy
- Family therapy
What are the symptoms of Bipolar Disorder?
Depressive symptoms at some times & manic at other times
- Depressive symptoms (see previous card)
-
Manic symptoms
- Abnormally “high” mood (euphoria, feeling too good)
- Extreme irritability
- Impulsive behavior
- Abnormally high self-esteem
- Racing thoughts & talking more than usual
- Decreased need for sleep
- High energy level
- Inability to concentrate well
Bipolar Disorder
Population
Cause
- Relatively uncommon in young children
- More common in older teenagers
- Tendency to develop mania runs in some families
- Overall, much less frequent than depression
- BP believed to be due to a chemical imbalance
- The part of the brain that keeps the mood stable isn’t working well
- Most people w/ BP go through cycles of depression, mania & normal mood
- Many times, it’s a lifelong problem, but can respond well to medication
What are some things that Bipolar Disorder can progress to?
-
Depression
- Substance abuse
- Suicide attempts
- Anxiety
-
Mania
- Violence
- Making bad decisions
- Exhaustion
How is Bipolar Disorder treated?
-
Medications
- Eskalith CR (lithium)
- Tegretol (carbamazepine)
- Anti-psychotic medication
- Trilafon (perphenazine)
- Depakene or Depakote (valproate)
- Klonopin (clonazepam)
- Lamictal (Iamotrogine)
- Zyprexa (olanzapine)
-
Psychotherapy
- Supportive therapy
- Cognitive treatment for depression
- Family therapy
What are the symptoms of Psychosis?
-
Hallucinations
- Hearing or seeing things that are not there
- “mind is playing tricks on you”
-
Delusions
- Beliefs that are impossible or unrealistic
- Other people don’t believe
- Convinced that these beliefs are really true
- Difficulty organizing thoughts & actions
- Other people may have a hard time understanding what you are saying/doing
Schizophrenia always has ________ as a symptom.
psychosis
Psychosis
Population
Causes
- Children & adolescents can have psychosis
- Not a disorder, but a symptoms that can happen in many disorders
- Some disorders, like depression or bipolar, can happen w/ or w/o psychosis
- Intoxication w/ stress drugs can produce a temporary psychosis
-
Causes
- Some brain parts may be too active in psychosis
- Dopamine (NT) may be overproduced
How long does Psychosis last?
- Very brief (hrs or days) or very long (yrs)
- Can happen only once or come back many times
- Some people require hospitalization
How is Psychosis treated?
-
Medication
- Trilafon (perphenazine)
- Haldol (haloperidol)
- Mellaril (Thioridazine)
- Thorazine (chlorpromazine)
- Risperdol (resperidone)
-
Psychotherapy
- Supportive therapy
- Family therapy
What are the symptoms of Elimination Disorders?
- Elimination of urine or feces in inappropriate places (clothing) whether involuntary of intentional
- Encopresis – passage of feces (constipation + overflow incontinence or w/o constipation)
- Enuresis – passive of urine (nocturnal only or diurnal only)
Elimination Disorders
Population
Causes
- Both genders can have an elimination disorder
- Boys > girls
- Encopresis: age 4
- Enuresis: >5 YO
-
Causes
- Not due to laxatives or diuretics
- Neurological disease (seizure, spina bifida)
- Medical condition (infection, diabetes)
What may happen to children as a result of an elimination disorder?
Parental frustration w/ subsequent child abuse, humiliation, teasing
How are Elimination Disorders treated?
-
Physical exam
- Encopresis (laxatives, stool softener, restraining)
- Enuresis (retraining, pad & bell, behavior therapy)
-
Medication
- Impreamine
- DDAVP
Reactive Attachment Disorder
Symptoms
Population
-
Symptoms
- Inhibited, withdrawn
- Hypervigilant or excessive & inappropriate sociability w/ strangers
- Limited eye contact
- Children up to age 5
What are some causes of Reactive Attachment Disorder?
- Maltreatment
- Deprivation
- Repeated changes in primary caregivers
- Impaired parenting (retardation, depression, substance abuse)
**Reactive Attachment Disorder **
What may happen
Treatment
-
What may happen to children
- May spontaneously remit
- May have malnutrition, infection or death
- Long term behavior changes
- Short stature, low IQ
-
Treatment
- Medical care
- Nutrition
- Foster
- Work w/ parents
What are the symptoms of Anorexia?
- losing a lot of weight through diet/exercise
- thinking one is fat despite weight loss
- afraid of gaining weight
- may stop having monthly period
What are the symptoms of Bulimia?
- brief periods during which an enormous amount of food is eating (binging)
- feeling like one cannot control eating
- trying not to gain weight by exercising, dieting, pills, vomiting
- lot of worries about weight
Eating Disorders
Timeline
Causes
- Mostly girls, usually start having problems during **teenage years **
- Few weeks/months → long time & more serious
- Death can result from starvation in anorexia
- Many people w/ bulimia suffer from depression
-
Causes
- Different factors may play a role
- Brain parts (hypothalamus) involved in controlling appetite & hunger may not work well
- Other factors: stress, belief that it’s important to be thin
How are Eating Disorders treated?
-
Medication
- Anorexia + depression: anti-depressants
- Bulimia: Tofranil (imipramine), Prozac (fluoxetine)
-
Psychotherapy
- Cognitive behavioral therapy
- Family therapy
What are the symptoms of Tourett’s Disorder?
- Quick body movements (tics) that one can’t control
- Making sounds (like grunts) or saying words (sometimes swear words) w/o thinking & w/o being able to control it
Tourett’s Disorder
Population
Causes
- Most children are boys (but can happen in girls)
- Starts at 7-10 YO
- Many times children have other problems
- ADHD or OCD
- Causes
- Exact cause unknown
- Some parts of the brain (basal ganglia) that control movements are not functioning well
Tics may come & go, but are usually a ______ problem
People w/ tics may be ___________ b/c they are embarrassed about their symptoms & avoid social contacts.
lifelong
socially disabled
How is Tourett’s Disorder treated?
-
Medications
- Haldol (haloperidol)
- Orap (pimozide)
- Inversine (mecamylamine HCl)
-
Psychotherapy
- Support therapy
- Family therapy
What are the symptoms of Tic Disorder?
What can result from this?
- Single or multiple motor or vocal tics
- Sudden, rapid, recurrent, non-rhythmic, stereotyped motor movements or vocalizations
- What may happen: teasing, humiliation
Tic Disorder
Causes
Treatment
-
Causes
- Unknown
- Not due to Huntington’s chorea, Wilson’s disease, post-viral encephalitis or medication (stimulants)
-
Treatment
- Psychotherapy
- Behavior modification
- Medication
