Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSRA Content > Level 2 - Emotional and Behaviour Problems > Flashcards

Level 2 - Emotional and Behaviour Problems Flashcards

1
Q

What is anxiety?

A
  • Anxiety is normal human experience to threat or danger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does anxiety become a problem?

A
  • Mental health issue if response is exaggerated, lasts more than 3 weeks and interferes with daily life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of anxiety?

A

o Separation anxiety disorder (SAD)

o Generalised anxiety disorder (GAD)

o Social anxiety disorder

o OCD

o Panic disorder (+/- agoraphobia)

o Phobias o PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Epidemiology of anxiety?

A
  • 2-5% of children
  • SAD and GAD more common
  • Women 2:1 Men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Aetiology of anxiety?

A

o Genetic

o Trauma and adverse life-events

o Stress (work, home, noise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk Factors in anxiety?

A

o Bullying

o Exams

o House moves

o Physical illness

o Abuse

o Bereavement

o Friendship problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Psychological symptoms in anxiety?

A

 Agitation

 Poor concentration

 Insomnia

 Repetitive thoughts/activities

 Thoughts going around and round

 Impending doom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Biological symptoms in anxiety?

A

 Dizziness

 Faint

 Tachypnoea

 Butterflies

 Nausea

 Sweating

 Muscle tension

 Heart racing

 Palpitations

 Tremor

 Lump in throat

o Panic Attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Social symptoms in anxiety?

A

 Reassurance seeking

 Avoidance

 Dependent on person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

DDx of anxiety?

A
  • Child Abuse Depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Assessment of anxiety?

A

MH history

  • Assessment of behaviours

o Antecedents, Behaviours, Consequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Psychoeducation in anxiety?

A

o Understanding

o Reassurance

o Information leaflet

o Regular exercise

o Meditation

o Relaxation techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of anxiety?

A

o CBT (First-line) includes:

 Clarity of diagnosis + education to child and parent  Helping child face their fears

 Identification of unhelpful thinking and practicing more functional thinking

 Skills acquisition (progressive muscle relaxation, guided imagery)

 Parents as motivators and behavioural coaches

 Relapse identification - Medication

o SSRIs (after CBT fails)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is attachment? When does it develop?

A
  • Describes relationship between caregiver & child
  • A process of proximity seeking to an identified attachment figure in situations of perceived distress or alarm for purpose of survival
  • Attachment not seen in humans before 6 months – develop stranger anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Importance of attachment?

A

o Secure attachment linked to better behavioural and academic outcomes in childhood

o Forms basis for working models of future relationships

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ICD-10 classification of Reactive attachment disorder?

A

 Abnormal social relationships associated with emotional disturbance due to circumstances

 Examples are fearfulness and hypervigilance, poor social interaction with peers, aggression towards self and others, misery, and growth failure in some children

 Withdrawn behaviour, with a lack of attachment behaviour towards caregivers

 Affected children tend not to seek comfort when distressed and not respond when comfort is offered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ICD-10 definition of disinhibited attachment disorder?

A

 Attention-seeking and indiscriminately friendly behaviour

 Attachment is described as diffuse rather than selectively focused and there are poorly modulated peer interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Risk factors of attachment disorderS?

A

o Neglect

o Abuse

o Institutionalism

o Disruption of care

o Separation from primary caregiver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Features of attachment behaviour?

A

o Proximity seeking to attachment figure

o Secure base

o Separation leads to protest by infant

o Permanent separation e.g. bereavement, affects capacity to feel secure & explore.

o Maximal at 18-36 months.

o Modulated by temperament of child.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

DDx of attachment?

A

Autism spectrum disorder, PTSD, ADHD, anxiety disorders, selective mutism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Classification of attachment - insecure avoidant?

A

 Attachment behaviour is downplayed by these children and they do not give signals regarding need for comfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Classification of attachment - insecure ambivalent?

A

 Up-regulation of attachment behaviour, with excessive amounts of distress and/or anger at separation from their caregiver and difficulty in calming the child after reunion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Classification of attachment - secure?

A

 Children can be comforted by their primary caregiver and use that person as a safe base from which to explore their environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Classification of attachment - disorganised?

A

 Behaviour patterns are disorganised. The caregiver may be the source of the stress as well as the supposedly safe base

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Advice to give carers and management of attachment?

A
  • Attachment styles can change if care-giver environment changes for the child

o Improve child-carer relationship

o Parenting programmes

o CBT

26
Q

Impact of attachment on adult attachment?

A

o Adult romantic relationships.

o Narrative capacity about our own childhood.

o Attachment style with our own children

27
Q

What is ADHD? Pathology behind it?

A
  • Triad of inattention, hyperkinesis and impulsivity
  • Pathology – frontal lobe under-activity using dopamine
28
Q

Prevalence, sex preference in ADHD?

A
  • Prevalence 3-5%
  • Boys 3:1 Girls
  • Presents early
29
Q

Aetiologies of ADHD?

A

o Genetic

o Influence of parenting

o Temperamental differences

30
Q

Symptoms of inattention in ADHD?

A

o Poor attention to tasks

o Appears not to listen

o Poorly organised

o Easily distracted

o Does not finish tasks

o Forgetful

31
Q

Symptoms of hyperkinesis in ADHD?

A

o Fidgets and squirms

o Leaves seat in class or meals

o Runs and climbs rather than walks

o Noisy – cannot play or work quietly

o Not moderated by social demands

32
Q

Symptoms of impulsivity in ADHD?

A

o Blurts out answers

o Fails to wait turn

o Interrupts

o Talks excessively

o Short tempers, form poor relationships

33
Q

DDX of ADHD?

A
  • Developmentally appropriate
  • Boisterous personality
  • Conduct Disorder
  • Attachment disorder
  • Anxious inattentiveness
  • ASD, Bipolar
  • Drugs (steroids)
34
Q

Diagnosis of ADHD?

A

o Problems in all areas:

 Excessive compared with norms of age

 Present from early age

 In more than 1 social setting

35
Q

Assessment in child with ADHD?

A

o Family background

o Social situation

o Development

o Associated behaviours

o Medical history

36
Q

Psychological treatment in ADHD?

A

o Information to parent and child

o Family support

o Behavioural management

o Structured tasks

o Simple instructions

o Time-outs

o School intervention programmes

 Encourage quiet self-occupation

37
Q

Drug treatment in ADHD? Effects, SE?

A

o Methylphenidate (Ritalin)

 Effects last a few hours (slow release preparations available)

 Does not cure disorder

 Improves some symptoms

 May need to continue for years

 SE: anorexia, slowed growth, tics, poor sleep, abdominal pain

o Atomoxetine

 Works over 24 hours, but takes 4 weeks to onset

38
Q

What is deliberate self-harm?

A
  • Varies from little actual harm, where there is a wish to communicate distress or escape from situation, to suicide
  • DSH - self-poisoning or injury, irrespective of the apparent purpose of the act
39
Q

What is suicide?

A
  • Suicide - intentionally taking of one’s life
40
Q

Epidemiology of self-harm?

A
  • 10% of children self-harm
  • Females 4:1 Males
41
Q

Most common DSH admissions?

A

o Overdoses (90%)

o Laceration (8%)

42
Q

Risk factors of DSH?

A

o FHx of DSH, learned ‘copycat’ behaviour

o Abnormalities in endorphin response and serotonin implicated

o Poor early care, abuse, neglect, bullying

o Identity problems (cultural, sexual, body image)

o Conduct disorder, drug misuse

43
Q

Common methods of suicide?

A

o Overdose

o Inhalation of car exhaust fumes

o Hanging

o Suffocation

o Shooting

44
Q

Common methods of DSH>?

A

o Overdose, cutting

45
Q

Common reasons to DSH?

A

o Communicate message

o Emotional immaturity

o Inability to cope with stress

o Maladaptive coping strategy – short-term feel effective and can become addictive

46
Q

Assessment in a DSH episode?

A
  • Assess capacity and MHA if needed
  • Assessment o Injuries to self

o Potential effects of ingestion of substance

o Childs capacity to consent or refuse treatment

o Presence or absence of mental illness

o Risk of further DSH episodes

47
Q

Management of DSH?

A
  • Psychiatric assessment urgently (CAMHS)
  • Social services
  • Counselling and support for person and family
48
Q

What is anorexia?

A
  • Weight loss, leading to at least 15% below expected
  • Self-induced avoidance of fattening foods
  • Self-perception of being too fat, with fear of fatness
  • Amenorrhoea
49
Q

Epidemiology of anorexia and bullaemia?

A
  • Girls 7:1 Boys
  • Mortality 5-20%
  • Bulimia more common (40%), Anorexia (10%), ED-NOS (50%)
50
Q

Aetiology of eating disorders? Anorexia and bullaemia?

A

o No single cause

o Biological

 Genetics (twin studies), malnourishment

o Psychological

 Perfectionism, reaction to stress, tendency to anxiety and depression, worry

o Environmental

 Puberty, stressful life event, bereavement, abuse, stresses

51
Q

Diagnostic criteria for anorexia nervosa?

A

• Dietary restriction (may be accompanied by vomiting, exercise, laxative abuse, or other weight control methods)

 significant and unhealthy self-induced weight loss. BMI of <17.5)

  • Intense fear of gaining weight even when severely underweight
  • Body image distortion with dread of fatness
  • Amenorrhoea
52
Q

Complications in anorexia? CNS, hair, heart, blood, muscles, kidneys, electrolytes, GI, hormones, skin?

A

o CNS - Can’t think right, depression, dizziness, fear of gaining weight, sad, moody, irritable

o Hair – thin and brittle

o Heart – Hypotension, bradycardia, palpitations, heart failure

o Blood – Anaemia

o Muscles and Joints – Weakness, swollen joints, fractures, osteoporosis

o Kidneys – Stones, failure

o Electrolytes – Low potassium, magnesium, sodium

o GI – Constipation, bloating

o Hormones – Amenorrhoea, bone loss, growing problems

o Skin – bruise easily, dry skin, fine hair all over body, cold easily, brittle nails

53
Q

Diagnostic criteria for bullaemia?

A

 Recurrent episodes of overeating (binges). ≥ 2 per week for 3 months

 Strong desire or compulsion to eat (craving)

 Attempts to counteract the “fattening” effects of food by one or more of:

  • Self-induced vomiting
  • Self-induced purging
  • Alternating periods of starvation
  • Use of drugs such as appetite suppressants, diuretics or thyroid preparations

 Self-perception of being too fat, with fear of fatness

• NB can be normal or overweight – atypical bulimia nervosa

54
Q

Complications in bullaemia? CNS, cheeks, mouth, throat, muscles, stomach, skin, hormones, GI, electrolytes, heart , blood?

A

o CNS – depression, fear of gaining weight, anxiety, dizziness

o Cheeks – Swelling, soreness

o Mouth – Cavities, tooth erosion, sensitivity

o Throat – Sore, irritated, torn

o Muscles – Fatigue

o Stomach – Ulcers, pain

o Skin – Abrasion of knuckles, dry skin

o Hormones – Irregular periods

o GI – Constipation, bloating, diarrhoea, cramps

o Electrolytes – Dehydration, low K, Mg, Na

o Heart – Arrhythmias, heart failure, low BP, HR

o Blood - Anaemia

55
Q

When to suspect an eating disorder?

A

o Weight loss, disordered thoughts about food/image, others concerned, socially withdrawn, physical symptoms

56
Q

What is the SCOFF questionnaire? when to use it?

A
  • SCOFF Questionnaire (General practise)

o Do you make yourself Sick because you’re uncomfortably full?

o Do you worry you’ve lost Control over how much you eat?

o Have you recently lost more than One stone in a 3-month period?

o Do you believe yourself to be Fat when others say you are too thin?

o Would you say that Food dominates your life?

o Score of 2 or more suggests likely AN or BN

57
Q

Investigations in eating disorders?

A

o Height/Weight/BMI (mBMI; <95% is underweight, >120% is overweight)

o BP lying/standing, HR, temp

o Bloods

58
Q

General advice in eating disorders?

A

o Challenge not collusion

o Food is medicine

o Restore weight before psychological

59
Q

What nutritional management is important in eating disorders?

A

o Weight gain – 0.5kg/week in community (Anorexia Nervosa)

o May need NG tubes

o Multivitamin supplementation

60
Q

what psychological management important in eating disorderS?

A

o CBT, Motivational enhancement therapy (MET)

o Family therapy

o Cognitive remediation therapy – groups that run to help affected people

61
Q

What is the prognosis of eating disorders in children?

A

o 50% recover

o 30% improve

o 20% chronic illness

MSRA Content (87 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions