Exam 2 Flashcards
1
Q
What is known about continuity and change of ADHD symptoms overtime? (Franke)
A
- Typically starts during childhood > follows trait like course
- Diagnostics and intervention dependent upon dynamic age presentations of ADHD
- Very young children > externalizing problems (hyperactive-impulsive)
- Middle childhood > inattentive Sxs
- Late adolescence and adulthood > inattention persists, hyperactivity declines, emotions easily aroused
2
Q
What is Franke opinion on adult onset ADHD?
A
- Diagnosable ADHD syndrome MAY arise in adulthood > but many likely to have undiagnosed ADHD or sub threshold ADHD in youth
- TBI correlated w/ADHD
3
Q
What is known about predictors of ADHD co-morbidity overtime?
A
- Pattern of comorbidity changes substantially
- ODD and CD most prevalent comorbid conditions
- SUDs more of a problem during adolescence and adulthood
- Adults > mood/anxiety, ASP, sleep disorders, somatic comorbidity
- Children w/ADHD > ASD, Tics, learning disabilit comorbidity
4
Q
How does ADHD treatment response differ overtime?
A
- Tx should be multimodal > psychoeducation, medication, disorder specify psycotherapy, skills training, CBT, family/couple therapy
- Older adults > practical and psychosocial support (daily life skills building, organizational skills, medication, support groups
- Franke suggest access to support and Tx is significant
- Adults > medication as primary + psychosocial support (mindfulness promising)
- Moderate severe cases for children and adolescents > non-pharmacological + medication
- Mild cases for children and adolescents > non-pharmacological
5
Q
Does treatment alter trajectories of ADHD overtime?
A
- ADHD associated w/negative academic outcomes, poor occupational outcomes, increased risk poor social relationships, risk transport accidents
- Reviews of treated vs untreated ADHD outcomes inconsistent
- Untreated > poorer long term outcomes
6
Q
ADHD Prevalence
A
- 6% in children
- 1-3% in adults
7
Q
What are barriers to access to ADHD care? Discuss with Brofenbrenner’s ecological systems theory? (Wright)
A
- Access to care not universal > under diagnosed, misdiagnosed?
- Child gender, age, ethnicity, social networks, low SES, urban residence > access to care
- AA and Latino children less likely recognized as having ADHD
- Parental decisions influenced by views of teachers to recognize ADHD
- Culture and language barriers more likely for non poor children
8
Q
Why is early detection of anxiety important? (Mohatt)
A
- Children > Most common mental illnesss, earlier age of onset, associated w/significant impairment, persist into adulthood > early Tx critical to prevent future disability and avoiding adulthood persistence
- Early tx mitigates coping and adaptation skill deficits
- Early tx ‘turns down the volume’ of Sxs
- Early tx teaches parents how they may be reinforcing maladaptive BX
- Early tx may teach children/ adolescents how to challenge anxious thoughts
9
Q
what are the proposed mechanisms by which media affects mood and anxiety? (Hoge)
A
- Amount of tv viewing > sleep problems
- Content of media exposure > trauma like Sxs
- Social comparison, dissatisfaction w/oneself > Attractive people leading exciting lives
- Digital distraction from distressful emotions
- Lack of social interaction > increase risk for substance abuse suicide > social anxiety dx
- Substituted digital communication > depression
- Constant connection to social networking > anxiety and depression
- Cyberbullying > suicidal thoughts and self-injurious Bx
10
Q
What do we know about social media use and anxiety mood overtime?
A
- Associations between social networking and depression
- Adults > depression decreases when internet use used for communicating w/friends and family but > More facebook = more satisfaction decreases over time
- Internet overuse > avoidance of negative emotions
11
Q
What are some interventions to reduce the impact of media use on youth well-being?
A
- Pediatrician screening of media exposure (amount and content) > Pts w/anxiety, insomnia
- Pediatricians guide parents > appropriate media content (ratings, reviews, plot descriptions)
- Children prone to social anxiety > parents provide ample face to face communication opportunities, limit online communication
- Parents implement rules about media use
- Clinicians help youth access social resources > face to face and mediated
12
Q
(Silverman) what gap in treatment may PCIT-ED (Parent child interactive therapy) fill?
A
- Prevention of chronic, highly tx resistant, relapsing childhood dx
- Suicide prevention efforts
- Moves beyond targeting childhood depressive Sxs > teaching parents to be external emotion regulators and emotion coach
- Only small effect sizes > CBT
- Long term safety of medication tx > unknown and practice is on the rise
- Capitalizes on neuroplasticity > altering of development and trajectory of illness
13
Q
What is PCIT-ED?
A
- Parent child interactive therapy > low risk
- Short term
- Targeting parent child interaction patterns
- Emotion development skills > emotional competence, emotion regulation
14
Q
Considering a family systems perspective and the etiology of dysregulation why do we think PCIT-ED is effective? What are the putative mechanisms?
A
- Emotion development skills not as outcome but as mediators
- PCIT-ED is likely effective as it correlates to attachment theory > secure attachments to parents results in intersubjective experience leading to learned emotion regulation in self, co-creation of meaning within ones life
- Parents model to their children > boundaries, rules, hierarchies, and status quo dependent upon family system patterns > children taught by parents (previous generational patterns)
15
Q
What is the association between severity of maltreatment and neurobiological outcomes? Timing of maltreatment? Gender effects? Persistence of neurobiological changes?
A
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