Lecture 22: Infant, Child And Adolescent Mental Health Flashcards
What is the difference between mental health and mental illness?
Mental health/ mental well-being:
Positive concept that is about more than the absence of mental illness.
It refers to resilience and good functioning but also incorporates flourishing, happiness and getting the most out of life
Mental illness is a diagnosed clinical condition- common disorders include depression, anxiety, psychosis, substance abuse, eating disorders
What is the model of development like?
It is dynamic and interactive
It involves physical development,
Social, emotion and environmental development,
And cognitive development, across the life course
Do infants, toddlers and preschoolers have mental health problems?
Some are genetic or occur through perinatal trauma/events
E.g. Preterm, low birth weight, chromosomal disorders, prenatal exposure to stress or alcohol/drugs
Some emerge due to living in toxic environments
E.g. Domestic violence, ongoing parental drug abuse, parental mental illness
Often it is a result of a combination of perinatal and environmental risk factors
What is the result of substance abuse, psychopathology and toxic environment?
Poor outcomes for childrn
How significant is the problem for infants?
Worldwide risk of death by maltreatment is ~3x greater for under ones than for 1-4 years.
1-4 years are at 2x the risk than 5-14 years
For every child that dies, and estimated 300-1500 are being abused or neglected
Alcohol/substance abuse contribute to at least 50% of all child abuse
NZ has a level of child maltreatment for 4-6 times higher than the average for leading countries
The risk is particularly high for maori and pacific families where there is a higher poverty and other social problems
How significant is the problem for children under 2?
2009: 16 babies and 502 children went into CYFS car
2008: 3,456 children under 2 were found to be physically, emotionally or sexually abused or neglected
An unknown but even larger number of infants and young children will be growing up in unsatisfactory environments
Average of 63children under 2 are admitted to hospital each year as a result of serious abuse
What are common GENETIC IMH problems?
Autistic spectrum disorder:
The diagnostic criteria is predominantly associated with poor social and emotional development, and delayed or lack of language development, or global delay.
Children have no theory of mind
They often exhibit repetitive stereotypical behaviours like spinning, lining up toys, they are inflexible to change
What are common BEHAVIOURAL IMH problems?
Disorganised attachment
Disinhibition- executive functions including problems with inhibiting prepotent responses, attention problems
Early regulatory problems including eating, sleeping, toiletkng problems
What are common IMH or ECH problems?
Attention deficit hyperactivity disorder:
Affects about 2-7% of school children, and 3:1 ratio of more males.
Critera: Must demonstrate problems with attention and impulsivity for at least 6months prior to 7 years of age.
ADHD is often associated with oppositional disorder and learning difficulties.
Problems with ADHD continue into adolescence and adulthood. 50-70% will have problems in adulthood
What is the impact of early adversity on later physical and mental health?
Ace study showed a linear relationship between the number of adult health outcomes and adverse childhood experiences
Adults who had experiences 4 or more ACE, were
- 2x more likely to have ischaemic heart disease
- 9x more likely to have any cancer
- 4x more likely to have had a stroke
- 9x more likely to have chronic bronchitis or emphysema
- 6x more likely to have diabetes
What did the christchurch health and development and dunedin multidiscinplinary health and development studies find?
Early conduct problems associated with early adverse environments were associated with
Crime, arrest and imprisonment Mental health problems Suicidal thoughts Teen pregnancy Impaired parenting Poor physical health and poor dental health
What are common childhood and Mental health problems?
Conduct problems in childhood and adolescence may affect up to 10% of the population.
Profoundly affecting later problem behaviour
Characteristics of conduct problems are
Aggressive behaviour, dishonesty, deliquent, defiant and disruptive behaviours
This causes distress to child, peers, and family and impacts criminal justice system and general society
What are common adolescent MH problems?
Depression during adolescence
This affects nearly 1/5 of young people by the age of 18
One of the most expensive illnesses next to heart disease, diabetes and stroke.
It is a leading risk factor for suicide and NZ has the highest youth suicide rate in the OECD
Depressive disorders mostly start between the ages of 15-18
It is associated with teen pregnancy, school failure, substance abuse.
3/4 of young people get jo treatment
What are the characteristics of depression?
Sleep problems, either too much or too little sleep
Eating problems: weightloss or sudden weight gain
Little interest in things that used to be of interest
Suicidal thoughts
What are the common risk factors for MH disorders? (Depression and conduct disorders)
Genetics- family history
Early environmental adversity including poverty and deprivation
Stress
Relationships-family and peers
