Final Exam Babyyyyy Flashcards
What are four features of anxiety disorders?
-common
-persistent
-often goes unnoticed/undiagnosed
-if untreated, it may predict future disorders
What are some cognitive, physical, and behavioural symptoms of anxiety?
Cognitive: worry abt future events, difficulty concentrating, lack of control- anxious apprehension
Physical: increase in adrenaline, heart rate, respiration - anxious arousal
Behavioural: desire to escape - avoidance behaviours
Is there some anxiety that is normal?
yes - developmentally appropriate fears (monsters, ghosts etc)
also situations where it is appropriate to feel fear
When should you be concerned/ what criteria should we consider to determine if anxiety is clinically significant?
-if its prolonged
-is it disabling/leading to avoidance
-is it overly intense/exaggerated and unreasonable
-is it overly distressing
What are 6 associated characteristics of anxiety?
-interferes with academics
-difficulty initiating and maintaining friendships
-social withdrawal, loneliness
-low self esteem
-substance use
-chronic negative feedback loop
What is a problem some youth may struggle with when they have anxiety?
Refusal to attend classes or difficulty remaining in school for an entire day
-equally common in boys and girls
-most often occurs 5-11
-2-5% of youth
-most common during transition periods (kindergarten, middle/high school, after summer break etc.)
What are 7 types of anxiety?
-Specific phobia
-Separation anxiety
-Generalized Anxiety
-Social Anxiety
-Selective Mutism
- Agoraphobia
- panic disorder
What defines Separation Anxiety Disorder?
-extreme distress when separated from home or from attachment figures
-worry about harm to caregivers or unexpected/unfortunate event causing separation
-avoidance behaviours
-physical complaints
Which gender experiences higher risk of separation anxiety?
Girls, however it is in boys as well.
What is the comorbidity of Separation Anxiety?
-another anxiety disorder
-depressive disorder
What is the age of onset for Separation Anxiety?
Can start as early as 7-8 years old - this is earliest onset and referral age of anxiety disorders
-symptoms may fluctuate throughout course
-more than 1/3 of children’s separation anxiety persists into adulthood
What is one of the most common anxiety disorders?
Separation Anxiety Disorder
What are 6 symptoms that define generalized anxiety disorder?
-Apprehensive expectation; wide range of issues; major and minor
-Episodic or continuous; uncontrollable
-physical symptoms ( ex. sore jaw from clenching)
-Chronic worry as cognitive avoudance
-intolerance for uncertainty
-associated characteristics (ex. seek lots of reassurance, perfectionist)
What gender is more likely to have generalized anxiety?
In general it is equally common in boys and girls, but theres a slightly higher prevalence in older adolescent females.
What is the comorbidity of generalized anxiety disorder?
-for younger children: separation anxiety, and conduct problems
-for older children: specific phobias, social anxiety, panic disorder, and MDD, as well as impaired social adjustment, low self-esteem, and increased risk for suicide.
What is the age of onset for Generalized anxiety disorder?
early adolescence
What defines social anxiety disorder?
-fear or anxiety of social or performance situations (+ fear of negative evaluation or causing offence)
-exposure = fear of anxiety
-avoidance behaviour or endured
-fear is out of proportion to actual danger
Which gender is most likely to experience social anxiety?
girls - 2:1
What is the age of onset for social anxiety?
11-12
-Extremely low chance of having it under the age of 10 - usually develops after puberty
Does social anxiety prevalence increase with age?
yes - social demands increase, development of self awareness
What is Specific phobia?
-fear or anxiety of specific object or situation
-exposure = fear or anxiety
-avoidance behaviour
-fear is out of proportion to actual danger
What is selective mutism?
Consistent failure to speak in social situations where it’s expected that you speak, despite speaking in other situations
-interferes with emotional, academic, and social development
-very rare, quite young onset
What are 7 anxiety treatments?
-education about anxiety
-progressive muscle relaxation exercises
-deep breathing techniques
-challenges to anxiety-provoking thoughts
-exposure to anxiety-provoking situations
-coping models
-involvement of families
What defines obsessive compulsive disorder?
-Repeated, intrusive, irrational, and anxiety causing thoughts
-ritualized behaviours (sometimes to relieve the anxiety)
-resistant to reason - kids dont understand logical reasoning as much
-severe disruptions in functioning
What gender is most likely to experience OCD?
-in childhood: males
-in adolescence: equal between males and females
What is the age of onset for OCD?
It is bimodal: onset spikes around 10-11, and also early adulthood (23)
What may be the adulthood result of children diagnosed with OCD?
If treated properly, OCD may be in remission by adulthood
-exposure therapy/other coping mechanisms
-symptoms may still come out in stressful situations
What is the comorbidity of OCD?
Anxiety, Major Depression, Tic Disorders, ADHD, Disruptive Behaviour Disorders
Is there an age where compulsions are normal?
To a certain extent yes: repeating behaviours and activities , adhering to rules, adn enacting rituals are important parts of normal development
What are some biological predispositions to anxiety?
Temperament
-Behavioural inhibition (quiet, withdrawing, and timid behaviour, reluctance to speak)
-Hyper-vigilant (state of neurological arousal in response to novel situations, including interacting with unfamiliar adults
Neurobiological - overactive stress response
Explain the temperament prediction video we watched in class
-can predict temperament based on reaction at 4 months old –> can predict outgoingness/shyness
-motor-tension, thrashing of the legs in response to stimulus predicts shyness
-lach of tenstion in response to stimulus = outgoing
*also depends on how parents react to the kids reaction –> gene environment interaction
Explain how parenting and parental modeling can positively or negatively reinforce anxiety
-parent sends subtle messages every day in repeated ways where they model reacting to specific situations
Negative: avoidance maintains anxiety, child never learns fears were unwarranted + never learns to cope
Positive: rewards : ex. stay home from school, have a good day, more likely to stay home again
What are 4 types of parental practices?
Intrusive parental control
Low psychological autonomy granting
-subtle but consistent ways parents can discourage kids from having their own options/autonomy
^Both of these are less emotionally availavle parents
Low parental expectations (ex. for childs coping)
Overprotection
^Both are over loving parents
*remember its always bidirectional between child and parent!
Attachment theory: what can cause insecure attachments?
-caregiver inaccessable or unpredictable
-less exploration
-not confident parent will provide security in time of stress
-experiences more fear
What are 2 attentional biases?
Anxious vigilance: selective attention
Threat appraisal biases: percieve threat more readily, play down safety info
What are some cognitive errors and biases of anxiety?
-overestimate likelihood of negative consequences
-underestimate ability to cope
-favour more avoidant response option
What are some characteristics of a negative information proccessing style in regards to OCD?
-inflated responsibility
-overestimation of the importance of thoughts
-the need to control thoughts
-overestimation of threat
-intolerance of uncertainty
-perfectionism
What are the three depressive disorders mentioned in the DSM-5?
- Major depressive disorder
- Persistent depressive disorder (dysthymia)
-Disruptive mood dysregulation disorder (new to DSM)
How has understanding depression in youth evolved?
psychoanalytic theory = kids aren’t capable of experiencing depression because they dont have enough superego to experience anger about the world. lol freud
storm and stress = basically just being like all adolescence is turbulence and angst, so everyone is depressed
“why isn’t Johnny crying” - maybe depression is expressed differently in kids.
masked depression = everything is depression (withdrawn / acting out = depression)
How should you respond to a youth who is saying things like “I’m a loser, no one likes me”
“I can understand why you might feel like ______”
dont say “but”, say “because” to provide validation to kid.
then meet need with reassurance / support, ect
What depressive disorder has almost identical criteria for children and adults?
Major Depressive disorder
What is the diagnostic criteria for a major depressive episode?
- 5+ symptoms.
- 2 + weeks
- change in functioning
what are the symptoms of a major depressive episode?
** depressed mood (or irritable)
** Loss of interprets or pleasure
———- 1 of these 2 MUST be present—–
- weight / appetite
- sleep
-psychomotor
-loss of energy
-worthlessness
-concentration
-thoughts of death
If untreated, how long on average does a depressive episode last?
8 months
what is the recurrence pattern of depressive episodes?
if left untreated, depressive episodes will reoccur..
the more you have, the more likely you are to keep getting them
same for adults and kids
that’s why early intervention is important… teach kids coping skills = prevent future depression
is a depressive episode brought on by a stressor?
the first few, we can usually point to a stressor.
later on, its less obvious and more internally normalized.
smaller causes of depressive episodes
fun fact:
negative mens mental health reports have doubled from 2013 to 2018.
das it
another fun fact:
big gender difference in diagnosing depression among youth.
mostly women diagnosed
why? (hehe answer bellow)
for kids, the symptom of depressed mood can present as irritable, but we lose this with adults..
but there are alot of grouchy cantankerous men who probably have undiagnosed depression because of our understanding of what it looks like.
what age does the rate of depression start to increase?
starts around 12 years old… then there’s a steep climb to mid adolescence (15-16 years old).
another big jump in cases diagnosed around 15-16, then stabilizes again. (big gender difference for women)
not so fun fact:
84% of trans and non binary kids indicated having chronic mental health condition…
- prairie Provences are the worst,
- Quebec is the best
:(
another not fun fact:
2/3 of the sample of non binary kids reported self harm / suicidal ideation.
21% attempted.
way higher than population average
what are some more sad stats on non binary and trans youth?
substantially higher rates of major depression episode, considered suicide, attempted suicide, feeling under stress, fee discouraged or hopeless
why is there an increase in depression during adolescence compared to younger ages?
- gender norms / social expectations become more apparent (kids are blissfully unaware)
- identity exploration
- peer evaluation becomes more saturated
- social worth / power
why are there higher rates among cis-gender girls compared to cis-gender boys in adolescence and adulthood?
- biological differences (puberty / hormones / birth control)
- stigma about boys talking about mental health
- girls express problems by manipulating, ruminating, gaslighting - lead to depression
- boys solve problems with physical aggression