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Child and Adolescent Psychopathology > Final Study Guide > Flashcards

Final Study Guide Flashcards

1
Q

Major findings from the MTA study

A

For core symptoms intention, ADHD;

treatment of choice - medicine

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2
Q

History of ADHD

A

ADHD has been around for over 100 years have labeled as disorder but can be called lots of diff things ADD (DSM3), ADHD combined (DSM3R), then ADHD (diff types in DSM4)

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3
Q

Other names of ADHD

A
  1. Fidgety Phils
  2. Minimal Brain Dysfunction
  3. Hyperkinetic/Hyperactivity Syndrome
  4. Recognition of Attentional Impairment and Impulsivity
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4
Q

DSM Diagnostic Criteria (Inattention)

A
  1. Can’t Follow instructions
  2. Careless mistakes
  3. difficulty sustaining attention
  4. forgetful in daily activities
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5
Q

DSM Diagnostic Criteria (Hyperactive/Impulsive)

A
  1. fidgets
  2. leaves seat
  3. runs or climbs excessively
  4. difficulty waiting turn
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6
Q

DSM Functional Criteria

A
  1. 6 of 9 symptoms in either or both categories
  2. Inattentive; Hyperactive/Impulsive; Combined type
  3. Persisting for at least 6 months
  4. Impairment in 2 settings
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7
Q

Natural history

A
  1. Preschoolers - Hyperactive
  2. Elementary to middle school - combined type
  3. Adolescent/adult - inattention
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8
Q

Factors important in making a convincing diagnosis

A
  1. Collateral Contact (Needs 2 settings besides parent reporting
  2. Neuropsych exam - doesn’t make diagnosis but supports diagnosis where issue is
  3. Rating scales for objective measures
  4. family history
  5. medication trial
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9
Q

Symptoms and prevalence of ADHD and subtypes

A
  1. Affects 5-7% of American children

2. have ADHD hyperactive impulsive type, inattentive, then combined type

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10
Q

Age, gender, and race related differences in ADHD

A
  • Most ADHD starts being diagnosed around school age around 7 or 8 when required to sit longer times in school
  • boys more than girl; if girl is diagnosed as combined type more impaired than boys
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11
Q

Race and ADHD

A

most prone kid to be medicated is 8 year old white boy

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12
Q

Impairments in executive functioning

A

difficulty organizing, time management, planning

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13
Q

Etiological Theory of mirror neurons

A
  • kids learn through imitation

- damage to area in monkey results in monkeys not being able to do behaviors

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14
Q

Etiological Theory of Amygdala

A
  • fear and aggression
  • may have loss of neuron density
  • avoids faces/eyes
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15
Q

Fusiform

A
  • used to recognize faces

- not active in autism (fMRI data shows this)

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16
Q

Basal Ganglia

A
  • kids with repetitive behaviors stereotype autistic behaviors
  • don’t like change
  • overactive in autism
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17
Q

Facial Inversion Effect and Fusiform Facial Area

A
  • people with no difficulty – fusiform lights up when see peoples faces/things interested in
  • Normal development causes babies to recognize faces more easily if right side up as opposed to upside down (not the case in autism)
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18
Q

Etiological theories of vaccines

A

No proof of vaccines causing autism

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19
Q

Etiological theories of diet

A
  • If you tell a kid to change his diet, the kid does better
  • if you don’t tell, no effect
  • kids with autism have increased constipation and gut problems
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20
Q

Common comorbidities

A
  • ADHD, anxiety, depression (minimally/mildly affected)

- medical – sclerosis, enzyme deficiencies

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21
Q

The greatest hallmark of ASD…

A

is inconsistencies in development

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22
Q

2 Domains of Diagnosis of Autism

A
  1. Social emotional reciprocity and communication

2. Repetitive stereotype behaviors, activities, and interest

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23
Q

The changing epidemiology of autism spectrum disorders and possible explanations

A
  • seeing more of it than post
  • sensitive about it, trained about it, popularized in movies/media
  • diagnostic criteria change –e easier for diagnosis
  • recognizing broader spectrum
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24
Q

Methods to clinically evaluate autism

A
  • interviews, observations, collateral history with parents/teachers/caregiver/coaches
  • kids observation - ADOS
  • parents interview - ADIR
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25
Q

Alternative diagnostic concepts for Asperger’s

A
  • nonverbal learning disorder, semantic pragmatic disorder, schizoid personality disorder, developmental disability of right brain
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26
Q

Nonverbal Learning Disorder

A
  • difficulties like Asperger’s r high functioning autism, sophisticated concrete language, don’t get sarcasm/idioms/dark humor, average/above average reading, can reading/interpret
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27
Q

Predictors of good outcome (prognostic indicators) for ASDs

A
  1. IQ – ability to have good intellectual engagement be good learner
  2. communication skills
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28
Q

Theory of Mind

A

being able to understand another person’s point of view

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29
Q

The role of neuropsychological testing for kids with ASD

A
  • understand what their learning is like

- Observe group work, attention issues, trouble sleeping to see what memory, nutrition are like

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30
Q

Define ODD & CD

A
  1. ODD: pervasive pattern of spiteful, vindictive, opposition behavior, argue, don’t follow rules
  2. Conduct disorder: infringement on rights of others, worse disorder
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31
Q

CD developmental progression model

A
  1. starts out and may have parents who give inconsistent/harsh punishments failing in school, rejected by peers
  2. identify with deviant peer group and may engage in criminal behavior - may put u on trajectory for CD
    (MODEL not always right)
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32
Q

Protective and risk factors

A
  1. protective is opposite of risk
  2. consistent parenting, 1 good relationship with at least 1 parent, positive peer role models, do well academically
  3. if you have inconsistent/abusive/harsh parenting, dangerous neighborhood with accepted behavior
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33
Q

The difference between obsessions and compulsions

A
  1. obsessions – unwanted intrusive thoughts

2. Compulsions is a ritualistic action or behavior to reduce thoughts

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34
Q

Vulnerabilities to developing anxiety

A

Behavioral inhibition, attachment, family history modeling

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35
Q

Differentiating “expected” anxiety from “disorders”

A
  1. Intensity
  2. Impairment
  3. Ability to recover

(are you anticipating anxiety, degree of reaction when in situation, ability to recover when out of situation)

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36
Q

Theories of how fears develop

A
  1. bit by a dog so now I’m scared

2. parent runs across when sees dog so I do, so I feel fear

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37
Q

Behavioral Inhibition

A
  • extremely shy kids – trait we think is relative enduring and can be risk factor of later anxiety disorder development
  • can’t speak/do actions in certain settings
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38
Q

amygdala and anxiety

A
  1. emotional brain gets activated in fear situations

2. teens prone to anxiety – more active in situations

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39
Q

hippocampus and anxiety

A
  1. (memory forms during times of trauma) not forming in typical way
  2. Cognitive distortions about traumatic memories happen here
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40
Q

Changes in child/adolescent anxiety diagnoses between DSM-IV & DSM-5

A
  1. everything used to fall under anxiety

2. now moved to anxiety disorder, obsessive disorder, compulsive, and trauma disorders

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41
Q

Risk and protective factors

A

same as externalizing

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42
Q

Differentiate between a panic attack and panic disorder

A
  1. panic attack - unexpected feeling of being overwhelmed

2. becomes a disorder if it starts triggering thoughts that you will have another attack

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43
Q

When anxiety disorder develop

A
  1. separation anxiety - one of first in development

2. panic

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44
Q

GAD

A

uncontrollable worry about # of things

45
Q

Social anxiety

A
  • anxiety in social situations
46
Q

SAD

A
  • separation and worrying about caregiver
47
Q

Selective Mutism

A
  • not being able to speak in certain situations
48
Q

Panic disorder

A
  • worrying about next panic attack
49
Q

Trichotillomania

A
  • pulling out of hair as a compulsion
50
Q

Difference between PTSD and Acute Stress Disorder

A

-Acute Stress disorder becomes PTSD after a month of symptoms

51
Q

The perspective of psychoanalysis in the history of child and adolescent depression

A

Have to go thru oedipal complex

52
Q

Gender ratio of depression

A
  1. 1:1 boy to girl before puberty then girls win out to 2:1 or 1/2:1
  2. Men 10-15%, total population is 25%
53
Q

Ages of depression

A

about 1% of kids preschool kids have depression, middle school 4-8%, end of adolescent 15%

54
Q

DSM-5 diagnostic criteria

A

Need 5 symptoms

55
Q

Neurovegetative signs of depression

A
  1. sleep – decrease
  2. appetite
  3. energy level
  4. attention/concentration
56
Q

Neurovegetative and medicine

A
  1. Neurovegetative signs get better before mood

2. Explains why suicide occurs in early stages of treatment

57
Q

Why does depression increase with age?

A

Understand abstract world, greater sense of world, more responsibility, more experience, getting old – death,

58
Q

3 theories of depression

A
  1. serotonin, not enough neurochemical makes you depressed
  2. attachment, don’t have bonded attachment have insecure attach, never settled in or happy
  3. genetics or observed family history
  4. behavioral theory – people don’t know how to seek reinforcement
  5. cognitive theory – think negative thoughts
59
Q

Genetics in depression

A
  1. if parent gets better, you get better

2. identical twins – high rate of depression

60
Q

What factor in parents history of depression is most potent

A

if parent has depression as kid

61
Q

The serotonin gene

A

short allele receptor at more risk of suicide/depression

62
Q

Developmental variants (children vs adolescents)

A
  1. Children - more somatic – irritability, stomach ache, don’t want to go to school
  2. Adolescence – angry, irritable, suicidal, anadomia, don’t want ot be with people
  3. look up adults
63
Q

Clinical course of child/adolescent depression

A
  1. treat/no treat: 6-9 months it goes away
  2. 50% of people have another episode some point in life adults, 70% in kids
  3. 2nd episode, 70% for 3rd, 90% for 4th episode(adults)
  4. more you have it the more you will have
64
Q

Predictors of increased duration and relapse of depression

A
  1. if parents have it now
  2. not taking treatment (medicine, doctor),
  3. psychosis, early onset
  4. more repeated episodes incomplete treatment in past
  5. Early on-set
  6. Never fully recovering
65
Q

Predictors of relapse of depression

A
  1. not taking treatment
  2. history of mental illness in family
  3. family member currently ill
66
Q

Factors that increase the risk of Bipolar Disorder among children/adolescents with depression

A
  1. Depression pre-puberty onset – high risk

2. 1/3 of kids who have depression before puberty will develop bipolar disorder

67
Q

What are risk factors that say child with depression is at risk to be bipolar after 1st episode?

A
  1. Look for psychosis
  2. family history of psychosis/BP
  3. pharmacologically induced hypomania (SSRI)
  4. psychomotor retardation (melancholic depression)
  5. earlier onset
68
Q

The importance of Emil Kraepelin’s findings regarding onset and mixed states

A
  1. early study of BPD, psychosis,

2. mixed states more common in kids – mania & depression at same time looks more like irritability

69
Q

DSM-5 diagnostic criteria

A

elated, euphoric mood for 4 days or 7 days, or any time if hospitalized, decreased need for sleep, increases talkatively, increased risk taking behaviors, grandiosity, flight of ideas, manic bipolar disorder – no disorder for mania only

70
Q

Mood cycles

A
  1. Up to hypomania, down to depression: bipolar 2
  2. cruise along - dysthymia
  3. look at slides
71
Q

Pediatric Bipolar Disorder diagnostic dilemmas

A

Is irritability an adequate diagnosis? Or no – previously would say yes but no today

72
Q

Most salient characteristics thought to separate BP Disorder in children from other psychiatric conditions

A
  1. Study of Barbara Keller
  2. Grandiosity (don’t see in ADHD), decreased need for sleep, hyper sexuality (could indicate sexual abuse, trauma, low IQ, cognitive impair, autistic, psychotic – raises question that its not normal behavior) – separates bipolar from ADHD
73
Q

Increase in comorbidities in earlier onset Bipolar Disorder

A
  1. more confusing the younger they are
74
Q

ADHD versus Bipolar symptoms

A
  1. talkatively isn’t good feature to distinguish, 2. hyperactivity is but not need for sleep
  2. must exhibit grandiosity/mania
75
Q

Atypical presentation of child Bipolar Disorder

A
  1. irritability altering complex cycling (?)
76
Q

Addiction

A

continues impulsive use of substance with physiological effects continued use despite knowing problems with usage.

77
Q

Dependence

A

continue to need drug emotionally physiologically, cognitively

78
Q

tolerance

A

can take more of it or need more to get same effect

79
Q

withdrawal

A

emotional/physiological response to stopping

80
Q

Most frequently abused drugs

A
  1. marijuana
  2. prescription
  3. alcohol
81
Q

Influence of early drug/alcohol use

A

if use early, more likely to become addict, misuse

82
Q

The “gateway” concept

A

a. people try milder drugs or what’s avail before other drugs; ciggs before marijuana; alcohol ciggs before other drugs

83
Q

Risk and protective factors for substance abuse

A
  1. Risk - low SES, disorganized neighborhood, kids/parents who use
  2. Protective – good verbal IQ, religion/spirituality, parents who don’t use, neighborhood not characterized by poverty/violence
84
Q

The role of education in drug abuse/addiction

A

More educated, less you use – may experiment but not addicted

85
Q

Dopamine theory of addiction

A
  1. low dopamine receptor complement associated with people who use
  2. monkey study – affect of being lower in social hierarchy – lower dopamine content, more likely to use cocaine
  3. lower receptors, use more drugs
86
Q

Negative health effects of alcohol

A

dehydration, liver damage, cancer, accidents

87
Q

Warning signs of drug and alcohol abuse

A

red eyes, changing friends, not going to classes

88
Q

CRAFFT screening tool

A

**know how to spell out

89
Q

Historical differences between AN and BN

A
  1. BN– modern disorder

2. AN – around for 100s of years

90
Q

DSM-5 diagnostic criteria of Eating Disorders

A
  1. common in our age group amongst women
  2. not achieving typical body weight – not certain body weight % but not being what’s considered standard body weight, fear of weight/fat, thinking still heavy when thing
91
Q

DSM-5 of AN

A

overeating in short period of time and then guilt, get rid through purging, fasting, exercising, laxative, diuretics

92
Q

Sub-types of AN and BN

A
  1. binge purge type/restricting

2. bulimia just bulimia

93
Q

Anorexia vs. Bulimia

A

look at slide

94
Q

Mortality rates with AN; increased risks associated with BN

A
  • higher than any otherpsychiatric disorder

- substance abuse, sexual activity, cutting

95
Q

Etiology of Eating Disorders (psychosocial and biological)

A
  1. psychosocial –not growing up/puberty, family conflict, oral impregnation, impact of media
  2. biological – hypothalamus, leptin
96
Q

Familial transmission/genetics of Eating Disorders

A

6-8% higher in 1st degree relatives – more likely to have

97
Q

Comorbidities of Eating Disorders

A
  1. depression in bulimia

2. OCD

98
Q

Methods of purging

A

look at slides

99
Q

Health consequences of AN and BN

A

look at maps

100
Q

Risk factors and prognostic indicators for AN and BN

A
  1. bulimia –athlete, horse jockey, wrestler, model, alcohol use in family, family who has
  2. AN – personality, family history, perfectionistic personality style
101
Q
  1. Incidence/prevalence and chronicity
A
  1. disorders don’t occur often but when they occur stick along time
  2. BN – less chronic, less negative outcome, carry # of years but not forever; grow out of it sometimes
  3. AN – keep for long time, high 30 year mortality rate. Die of AN or complications or suicidal
102
Q

Course and outcome of Eating Disorders

A

look at slides

103
Q

Definitions of obesity

A
  1. BMI over 30

2. 30% of population – growing as problem for us

104
Q

The Myth of ADHD (article)

A
  1. ADHD is stupid and doesn’t exist
  2. Kids put in repetitive situations cannot learn this way
  3. Result of society rather than a disorder
105
Q

ADHD in Children: One Consequence of the Rise of Technologies and Demise of Play?

A
  1. rise in technology

2. kids are not going out and playing – it is important.

106
Q

Prevalence and Incidence of Depression

A 
7% in the U.S. over 12 months
1- year incidence:
Preschool 1%
School 2%
Adolescent 4-8% (15% by end of adol)
107
Q

Sex Ratio of Depression

A

1:1 in childhood and 2:1 (female to male) by adolescence (1.5 – 3x higher rates in females)

108
Q

Lifetime prevalence of MDD

A

15 – 20% (similar to adults); 15.3% per NCS

Child and Adolescent Psychopathology (6 decks)

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