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Mental Health > LD and MH > Flashcards

LD and MH Flashcards

1
Q

What is ASD characterised by? (3)

A
  1. Deficits in social interaction and communication
  2. Presence of stereotyped behaviour and restricted interests (DSM-V, 2013)
  3. Role of spectrum
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2
Q

What is Down syndrome? (2)

A
  1. Genetic disorder due to an extra chromosome 21

2. Typically associated with growth delays, intellectual disability and a characteristic phenotype

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3
Q

What did Howlin (2013) believe about MHD in ASD?

A

MHD can be a bigger barrier to functioning than the core symptoms in ASD

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4
Q

What lifetime rates did Hofvander et al (2009) find?

A

53% mood disorders

50% anxiety disorders

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5
Q

What rates of anxiety did White, Oswald, Ollendick & Schahill (2009) find?

A

11-84%

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6
Q

What did White et al (2009) find regarding anxiety in ASD?

A

Higher prevalence of anxiety in ASD compared to other developmental disorders

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7
Q

What did Howlin (2004) find about the rates of psychotic disorders?

A
  1. Despite Kanner (1949) believing a strong association between ASD and schizophrenia
  2. Rates of psychotic disorders are typical, if not lower than the general population
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8
Q

Why is there considerable variance in MHD rates in ASD?

A

Hutton et al (2008)

  1. Samples derived from psychiatric service referrals are going to suggest a high prevalence rate
  2. But samples selected from follow up studies suggest lower rates of 30%
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9
Q

Summarise the prevalence of MHD in ASD (5)

A
  1. Bigger barrier
  2. 53% mood, 50% anxiety
  3. 11-84% anxiety
  4. Considerable variation in rates
  5. Psychotic disorders = low/typical
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10
Q

What is a longitudinal trajectory?

A

Looks at development across the lifespan in cognitive, language and psychosocial domains

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11
Q

What are methodological problems associated with longitudinal studies? (3)

A
  1. Very few studies due to difficulties with following up
  2. Variation in findings
  3. Selection bias: only a small proportion of LF individuals can respond to psychiatric ratings and interviews (Howlin, 2014)
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12
Q

Summarise the cognitive trajectory in ASD (3)

A
  1. 75% remain stable, some deterioration (Howlin, Moss et al., 2014)
  2. Rigid behaviours persist but fluctuate in severity and type
  3. Performance IQ decline, verbal IQ increases
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13
Q

Summarise the language/communication trajectory in ASD (3)

A
  1. Small improvements
  2. Disparity between receptive and expressive language disappears
  3. Marked persisting problems in lang and comm (Seltzer et al., 2004)
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14
Q

Summarise the psychosocial trajectory in ASD (4)

A
  1. Increased prevalence of epilepsy and MHD -> independence
  2. Seltzer et al (2004) outcomes
  3. Dependent on families/care services
  4. Social isolation and independence
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15
Q

What psychosocial outcomes did Seltzer et al (2004) find in ASD? (5)

A

Very few:

  1. Marry
  2. Live independently
  3. Attend higher education
  4. Work competitive jobs
  5. Develop large social network
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16
Q

Summarise the cognitive trajectory in DS (3)

A
  1. Cognitive growth until adolescence, followed by decline in IQ
  2. Premature dementia and Alzheimer’s
  3. STM and LTM deficits
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17
Q

What is the average onset age for dementia in DS?

A

55 years (McCarron et al., 2014)

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18
Q

Why is there an early onset of dementia in DS? (2)

A

Grieco et al (2015)

  1. Accelerated volume loss in frontal, temporal and parietal lobes
  2. Reduced connectivity
19
Q

Summarise the language trajectory in DS (4)

A
  1. Decline in receptive language after 40 years (Rondal & Comblain, 1996), less decline in expressive
  2. Decline in communicative abilities due to IQ and memory deficits
  3. Higher rate of dysfluencies
  4. Age related changes in hearing
20
Q

Explain the higher rate of dysfluencies in DS

A

Higher rate of hesitations and word retrieval problems (Rondal & Comblain, 1996)

21
Q

Summarise the psychosocial trajectory in DS

A
  1. Decline in daily living skills beyond 50 years
  2. Decrease independence
  3. Superior independence and functioning compared to ASD (Carr, 2003)
  4. High rates of internalising but decline in externalising behaviours
  5. Psychiatric problems in some individuals (Maatta et al., 2006)
22
Q

What did Grieco et al (2015) find about externalising and internalising symptoms in DS?

A
  1. Higher rates of internalising symptoms in adulthood eg. withdrawal, depression, anxiety
  2. Lower rates of externalising behaviours
23
Q

Summarise the biological factors of MHD in ASD (3)

A
  1. Diagnosis eg. Aspergers
  2. High trait anxiety
  3. Genetic mechanism
24
Q

Who found that anxiety problems were more apparent in Asperger’s?

A

Weisbrot, Gadow, Devincent and Pomery (2005)

25
Q

Why may a higher rate of anxiety occur in Aspergers? (2)

A
  1. Increased awareness of differences and interpersonal difficulties (White et al., 2009)
  2. Wish their social disconnectedness could be different (Attwood, 2000)
26
Q

What did Hutton et al (2008) find about ASD diagnosis and psychiatric disorders?

A

Psychiatric disorders occured equally in low- and high-functioning groups

27
Q

Explain high trait anxiety as a biological factor (2)

A
  1. Tantum (2000) suggests that high trait anxiety is common in ASD
  2. Predisposed to anxiety disorders and poor stess management
28
Q

What may increase the predisposition to anxiety in ASD?

A
  1. A family history of anxiety disorders, provides support for a genetic component
29
Q

What did Kerbeshian & Burd (1986) suggest about a genetic component in ASD? (2)

A
  1. Genetic mechanism may underlie compulsive disorders (eg. Tourette’s, OCD) in Asperger’s
  2. Increased expression of lymphocyte antigen D8/17 in children with ASD who are ritualistic and those with compulsive disorders
30
Q

Summarise the psychological factors which may contribute to MHD in ASD (3)

A
  1. Low self esteem
  2. Reaction to diagnosis
  3. Difficulty seeking help
31
Q

Describe the psychological factor of low self esteem (2)

A
  1. Compare their achievements to others (Hardy et al., 2010)
  2. Difficulty copying with daily stressors and understanding anxiety provoking situations
32
Q

What contributes to distress and disability in ASD according to Tantam (2000)

A

The individual’s own reaction to their diagnosis and the reaction of those around them contributes to distress and disability

33
Q

According to Hurlbutt & Chalmers (2002) how does the reaction to diagnosis contribute to MHD? (3)

A
  1. Some see diagnosis as negative and unwanted identity
  2. Others focus on strengths of their condition
  3. Some are able to leverage their condition for more positive mental health outcomes
34
Q

Explain the bi-directional effects of anxiety in ASD

A
  1. Co-occuring anxiety could worse the social impairment in ASD
  2. Person wants to avoid social situations, promoting further isolation from peers (Myles et al., 2001)
35
Q

Explain the maintaining factor of seeking help (2)

A
  1. Appointments are anxiety provoking, worry they will be ‘blamed’ or have difficulty describing their symptoms
  2. Do not get the support that could help reduce MHD
36
Q

Summarise the social factors of MHD in ASD (4)

A
  1. Adverse life events
  2. Bullying/victimisation
  3. Lack of social support
  4. Societal stigma
37
Q

Explain the factor of adverse life events (2)

A
  1. Higher rates of social deprivation, life transitions, loss and social isolation (Tantum, 2000)
  2. Family tension and breakdown -> tense atmosphere, losses/separations, stress and emotional problems and years in care
38
Q

Explain the factor of bullying (3)

A
  1. Attending mainstream school may lead to teasing and bullying
  2. Can lead to long term frustration, poor self-esteem, distrusting of others and increased awareness of their difficulties (Tantam, 2000)
  3. Can ruminate for many years and lead to increased aggression and oversensitivity
39
Q

Explain the lack of social support as a factor in MHD (3)

A
  1. Access to fewer resources and coping skills (RCN, 2010)
  2. Gaps in services, particularly for HFA
  3. Help find and keep employment (Howlin & Chapman, 2006) - fewer than 50% able to find work: low self-esteem, isolation and poor coping skills
40
Q

Describe the factor of societal stigma on MHD (3)

A
  1. Negative impact on self-esteem and poor psychological wellbeing (Gray, 2002)
  2. Others may avoid people with ASD if they have a perception of awkward interactions
  3. Social isolation and lack of friendships - risk factor for MHD (Hardy et al., 2010)
41
Q

Summarise the interventions for MHD in ASD (5)

A
  1. Medication
  2. Identity management strategies
  3. New technology eg. Molehill mountain app
  4. Social support
  5. Anxiety strategies
42
Q

What is the Molehill mountain app? (2)

A
  1. Designed to help people with ASD understand their anxiety

2. Eg. causes, symptoms, track worries/triggers and tips on management

43
Q

How can social support reduce MHD? (2)

A
  1. Reduce perpetuating factors such as lack of employment and independence
  2. Support groups to share experiences
44
Q

How can identity management strategies reduce MHD?

A
  1. Develop a sense of positivity and increased self esteem, increasing psychological wellbeing

Mental Health (8 decks)

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