Internalising Disorders Flashcards
Internalising disorders include
anxiety and depressive disorders
List the three reasons why it is difficult to differentiate anxiety disorders in children
- valid assessment is often not possible in children
- lots of overlap in symptoms of the disorders generally
- disorders not quite differentiated in children
Which disorders can be easily differentiated in children?
OCD and PTSD
List all anxiety disorders according to the DSM in order of appearance
separation anxiety disorder selective mutism specific phobia social anxiety disorder panic >20 years agoraphobia GAD
Criterion A: Separation Anxiety Disorder (part a): Developmentally inappropriate and ________ ____ or _______ concerning ________ from those whom the individual is _______
excessive fear
anxiety
separation
attached
Criterion A: Separation Anxiety Disorder … at least 3 of the following …(part b)
- fear of being alone
- recurrent, excessive distress when anticipating separation
- persistent refusal to go out, go to school, etc
- persistent worry about losing attachment figure, or possible harm to them
- persistent worry about experiencing an untoward event that causes separation (e.g: kidnapping, getting lost)
- refusal to sleep without attachment figure
- nightmares involving theme of separation
- physical symptoms - headaches, stomachaches, nausea, when separated or anticipating separation
Criterion B: Separation Anxiety Disorder
The fear, anxiety or avoidance is persistent, lasting 4 weeks in children
Separation AD is strongly associated with school ______, and the child ultimately cares about the ____, and what will happen if something happens to the ________.
refusal, self, caregiver
Separation anxiety is normal around the ages of
6 months - 5 years. If it continues into school age it starts interfering with milestones. Also, it’s normal for us to go to school, etc. Some cultures do not.
Aetiology of Separation Anxiety Disorder involves three factors, which are
- Trauma - divorce, or sickness in caregiver. Insecure environment
- Genetic Component - pre-disposition, temperament inherited (shy, anxious temperament, not open to exploring, dislikes novelty)
- Parenting - parents could be already anxious, model anxious behavior (verbal information about worries “be careful), and generally display overprotective parenting. Or the parents could just be overprotective. Or the child’s temperament may entice anxiety.
Selective mutism is characteristic of
Child is incapable of talking. Not considered a choice. It’s a failure to speak when there is an expectation to (eg school).
Marianna’s “Worrying in Youth” study showed
That children 7-9 yrs and 10-12 years, worry more about physical outcomes. They know physical outcomes carry a much higher cost than social outcomes. However, they know social outcomes are more likely to occur. Hence, their worries are based on cost judgements rather than likelihood.
Young adults also know that physical outcomes are a higher cost than social outcomes and that social outcomes are more likely than physical ones. Their worry is based on both cost and likelihood outcomes.
It is believed children start worrying around the age of…
6-7 years
In order for a child to worry they need to be able to imagine _____ of ______ outcomes. And switch from ______ to ______ worry. This theory is the ________ ________ ________ (Borkovec).
chains of catastrophic outcomes
imagery to verbal
Cognitive Avoidance Theory
There is ____ evidence for SSRIs in the treatment of childhood anxiety, except for ____
no, OCD
There is good evidence for the use of __________ treatment in childhood anxiety disorders, especially ________ therapy
psychological, family
Children don’t want to be exposed to what they fear, so we often use ______.
bribes
In treatment of anxiety disorders, ______ _______ is used increasingly in younger children.
behavioural therapy
It is also important that we teach parents to not _______ anxious behaviour, or act in an ___________ manner
model, overprotective
The strong increase in prevalence of MDD in adolescence is said to be attributed to the consolidation of ________ _________ (aka ________) and an increase in _______ ________ ________. This is known as the ______ ________ _______.
thinking styles, schemas (personality is more settled)
negative life events (new stressors - independence, romantic relationships, etc)
cognitive diathesis model
Why is there such a large gender difference which emerges in adolescence and stays till ~50 yrs?
- Small differences a result of…
- Larger differences a result of…
Smaller differences attributed to
- reporting differences
- self-medication in males more common
- hormonal differences.
Larger differences due to
- higher stress exposure in females
- higher negative cognitive styles
- different coping functions.
What are some stressors experienced by females in adolescence?
- rape and sexual assault,
- body image concerns - physical attractiveness strongly valued by women, and their self-worth related to that. Also, men can get bigger, but women can’t get thinner. They cannot achieve the societal ideal
- interpersonal negative events (more weighting placed on peer group, women take on each others problems, and can be nasty to each other - social aggression)
What coping factors are more common in women? How does this affect depression?
Rumination very common (as opposed to distraction which is used in men). Rumination interferes with problem-solving.
In children with MDD, _____ _____ ______ usually precede _______ _______ _________.
negative life events
negative cognitive schemas
