Mental Illness in Children and Adolescents Flashcards
What are protective factors within children that can protect them from mental illness?
-“normal” physical and psychosocial development
-an “easy” temperament
-secure attachment
-learning ability
-sense of competence
-positive beliefs
-lone-term support from at least 1 adult
What are some protective factors within a family that protect them from mental illness?
-low stress
-stable employment
-adequate resources for child care
-higher SES
What are some protective factors that can help protect a child against mental illness?
-positive and cohesive families, schools and neighbourhoods
Describe an easy temperament
positive mood, regular patterns, positive approaches, low emotional intensity
Describe a difficult temperament
irregular patterns, negative responses to new stimuli, slow adaptation, negative mood, and high emotional intensity
Describe a slow-to-warm temperament
negative, mildly emotional response to new situations, but adaptation evolves
What are some common childhood stressors?
loss: death and grieving
separation and divorce
stressful sibling relationships
physical illness
adolescent risk-taking behaviours
What are some examples of risk-taking behaviours in adolescents?
smoking, alcohol, unprotected sex, truancy, delinquent behaviours and running away
What are some interventions for adolescent risk-taking behaviours?
-intervene at peer level, educational programs
-alternative recreation activities
-peer counseling
What makes up a developmental assessment?
-intellectual functioning
-language
-gross and fine motor functioning
-cognition
What should you do to build rapport during an interview with a child and their parents?
-maintain appropriate eye contact, speak slowly, clearly and calmly with friendliness and acceptance
-use a warm, expressive tone
-show interest in what is being said
-make the interview a joint undertaking
What are the difficulties with interviewing preschool children?
They have difficulty putting feelings into words, thinking concrete
-use play; conduct assessment in play room
What are the aspect of interviewing school-age children?
Able to use constructs, provide longer explanations
-establish rapport through competitive games
What are the unique aspects of interviewing adolescents?
Can seem egocentric, increased self-consciousness, fear of being shamed
-let them know what information will be shared with parents
-direct, candid approach
What are neurodevelopmental disorders?
-significant delay in one or more lines of development
-developmental pathways and developmental delays are closely interwoven
-disorders usually first diagnosed in infancy, childhood or adolescence
What are the signs of neurodevelopmental disorders?
-may or may not have an intellectual disability
-uneven pattern of intellectual strengths and weaknesses
-developmental delay (developmental outside the norm)
What are some types of developmental delays?
-socialization
-communication
-peculiar mannerisms
-idiosyncratic interests
What are some learning disorders?
verbal: dyslexia (reading) and dysgraphia (written expression)
nonverbal: dyscalculia (math)
What are some examples of motor disorders?
Stereotypic movement disorder (body ricking, head nodding, hand shaking, waving)
Self-injurious behaviours
Tourette’s disorder
Define tics
sudden, rapid, repetitive, stereotyped motor movements or vocalizations
-have to have the tics for at least 1 year to be diagnosed
What are the characteristics of autism spectrum disorder?
-deficits in social communication and social interaction
-restricted repetitive behaviours, interests, and activities (RRBs)
What are the clinical symptoms of autism spectrum disorder?
-delayed and deviant language, or concrete thinking
-pronoun reversals and abnormal intonation
-stereotypical behaviour: repetitive rocking, insistence on sameness, self-injurious behaviour
When is the onset of autism spectrum disorder?
onset is early, usually before 30 months
What is the cause of autism?
exact cause is unknown but is likely a combination of genetics, perinatal insult and impaired parent-child interactions, increased platelet serotonin, excessive dopaminergic activity, and alteration in opioids
What are some pharmacological interventions for autism?
Antipsychotics
Methylphenidate (Ritalin)
Opioid antagonist
SSRIs
Lithium
Beta-blockers
Buspirone and trazodone
What are some non-pharmacological interventions for autism?
ABA: applied behaviour analysis
ABM: anat baniel method
What is Applied Behaviour Analysis (ABA)?
a process of systemically applying interventions, based on the principles of learning theory, to improve socially significant behaviours (the goal is to determine what happens to trigger a behaviour, and what happens after that behaviour to reinforce it)
What is Anat Baniel Method (ABM)?
NeuroMovement: accessing the power of the brain to change itself by creating new neural patterns
What is Asperger’s Disorder?
-severe and sustained impairment in social interaction and restricted, repetitive patterns
-profound social deficits
What are the profound social deficits seen in Asperger’s Disorder?
-inappropriate initiation of social interactions
-inability to respond to social cues
-concrete in interpretation of language
-stereotypical behaviour
What are the nursing interventions for Asperger’s Disorder?
-promoting interaction
-ensuring predictability and safety
-managing behaviour
-supporting the family
What are the disruptive behaviour disorders?
Attention Deficit/Hyperactivity Disorder
Oppositional Defiant Disorder
Conduct Disorder
What is the pharmacologic treatment for ADHD?
Stimulants: they increase ability to concentrate, improve focus and increase motivation
-they increase dopamine and norepinephrine
Non-stimulants: SNRI, adrenergic receptor agonists (Guanfacine and Catapres), Bupropion, Modafinil
-less effective but fewer side effects and minimal abuse potential
What are the stimulants used for treatment of ADHD?
Methylphenidates (Biphentin, Concerta, Ritalin): acts faster but doesn’t last as long (lasts 4 hours)
Amphetamines (Adderall): longer onset but lasts longer
What are the side effects of stimulants used for treatment of ADHD?
growth restriction, appetite suppression, irritability, agitation, restlessness, insomnia, abuse potential
What are the nursing management strategies/interventions for ADHD?
-Cognitive behavioural techniques
-set clear limits with clear consequences
-establish/maintain predictable environment with decreased stimuli
-establish eye contact before giving directions; as to repeat what was heard
-encourage child to do homework
-encourage 1 assignment at a time
-improving self-esteem
Describe Oppositional Defiant Disorder
-angry and irritable mood
-disobedient, argumentative
-defiant and vindictive behaviour
-they experience social difficulties (trouble making friends), conflicts with authorities
-academic problems
Describe Intermittent Explosive Disorder
-inability to control aggressive impulses
-usually begins in late childhood/adolescence, the extends into adulthood
-leads to problems with interpersonal relationships, occupational difficulties, and criminal difficulties
Describe Conduct Disorder
-behaviour is usually abnormally aggressive
-rights of others are violated and societal norms or rules are disregarded
-complications such as academic failure, school suspensions and dropouts, juvenile delinquency, drug and alcohol abuse, and juvenile court involvement
Two problems: pyromania and kleptomania
Which adolescent disorder is more likely to lead to criminality and a later diagnosis of antisocial personality disorder?
Conduct disorder
Describe Separation Anxiety Disorder
-related to school phobia
-4% of school-age children
-runs in families
-may emerge after a change
-may require medication– antidepressants
-treatment can be psychotherapy or behaviour therapy
Describe Obsessive-Compulsive Disorder in adolescents
-may have onset in childhood
-exposure and response prevention
Obsessions: unwanted persistent, intrusive thoughts, impulses or images related to anxiety
Compulsions: unwanted behavioural acts or patterns of behaviour
Which mood disorder is extremely rare in children?
Bipolar disorder
