Midterm 1 (Final)

Question 1

What is Unique about Understanding and
Treating Psychopathology in Youth?

Answer 1

• Some disorders are only diagnosed with childhood onset
  Ex: Autism, ADHD
• Indicators of a significant emotional or behavioral problem may be different
  Ex: children may not have the same cognitive capacity of adults to express their depressive feelings
• Presentation over time might change
  Ex: A child that’s depressed may just present a lot of irritability
• Developmental differences may lead to differences in efficacy in treatment
  Ex: Cognitive therapy & Medication
• Who advocates for youth? -> Decision-makers in course of care and treatment for a child is not usually the child

Question 2

Why is cognitive therapy not always effective for children?

Answer 2

Children may not respond well with therapies that are purely based on cognitive functions that focus on sharing cognitive experiences (sharing thoughts and feelings) since they may struggle to understand and vocalize their thoughts and feelings

Question 3

What are the indicators of abnormal behaviour?

Answer 3

1. Norm Violation
2. Statistical Rarity
3. Personal Discomfort
4. Maladaptive Behaviour
5. Deviation from an Ideal

Question 4

Describe the “norm violation” indicator of abnormal behaviour

Answer 4

• Norm violation indicates abnormality when one deviates from the “norm”
• Norms are culturally bound -> dependent on what our reference group is and to whom we are comparing people
• Dependent on reference groups and sub-groups within that reference group (ex: reference group = women in Canada and sub-group = women in Canada who attended university)

Question 5

Describe the “statistical rarity” indicator of abnormal behaviour

Answer 5

• Represent base rates or how frequent/likely we are to see a certain behaviour or diagnosis
• Statistical rarity looks at the tails of a distribution (2% or 0.1%)
  Ex: someone with an IQ of 145 is abnormal because you’re unlikely to have it (0.1% in distribution)
  Ex: Sheldon’s high IQ (from the Big Bang Theory) is a statistical rarity
  Ex: Eating insects in Canada or North America is a statistical rarity

Question 6

Are DSM disorders a statistical rarity?

Answer 6

• DSM disorders in general are not that rare
• Lifetime prevalence of meeting criteria for any disorder by age 75 is = ~ 12 - 47.4% (almost 1 in 2 people)
• However, abnormal levels of impairment (significant impairment) or higher levels of anxiety would be deemed more statistically rare

Question 7

TRUE or FALSE: Prevalence rates are always consistent

Answer 7

FALSE
* Prevalence rates may not be consistent across different samples and sources in part due to:

• Different sampling procedures
• Different sample sizes and variability
• Different populations (who is your reference group?)
• Changes in population over time (ex: mental health base rates change over time)

Question 8

Describe the “deviation from an ideal” indicator of abnormal behaviour

Answer 8

• Ideal self VS actual self
• Parents often have very high expectations for their children (they have an ideal of how their child should be -> if their child doesn’t meet expectations, this would be a deviation from an ideal with which the parents would consider their child as abnormal) -> example of deviation from an ideal as imposed on someone

Question 9

How is abnormal behaviour defined?

Answer 9

Defined as a pattern of symptoms associated with:
- distress
- disability
- increased risk for further suffering or harm

• Distress and disability can be lumped together as impairment

Question 10

With regards to abnormal behaviour, what can “disability” and “risk” be defined by?

Answer 10

Adaptational failure (of failure to meet benchmarks) with typical behaviour as a benchmark

Question 11

Describe the “personal discomfort” indicator of abnormal behaviour

Answer 11

• People have different thresholds of personal discomfort
• Someone may feel constantly burdened and bothered by their disorder, others may see the benefits in it
• Abnormality is determined by going above that threshold and leading to lots of personal discomfort

Question 12

Concerning developmental benchmarks, what are the normal achievements for a child between the ages of 0-2?

Answer 12

• Eating
• Sleeping
• Attachment

Question 13

Concerning developmental benchmarks, what are the normal achievements for a child between the ages of 2-5?

Answer 13

• Language
• Toileting
• Self-care skills
• Self-control
• Peer relationships

Question 14

Concerning developmental benchmarks, what are the normal achievements for a child between the ages of 6-11?

Answer 14

• Academic skills and rules
• Rule-governed games
• Simple responsibilities

Question 15

Concerning developmental benchmarks, what are the normal achievements for a child between the ages of 12-20?

Answer 15

• Romantic relations
• Personal identity
• Separation from family (may be more culturally-embedded)
• Increased responsibilities

Question 16

Concerning developmental benchmarks, what are common behaviour problems for a child between the ages of 0-2?

Answer 16

• Stubbornness
• Temper
• Toileting difficulties

Question 17

Concerning developmental benchmarks, what are common behaviour problems for a child between the ages of 2-5?

Answer 17

• Arguing
• Demanding attention
• Disobedience
• Fears
• Overactivity
• Resisting bedtime

Question 18

Concerning developmental benchmarks, what are common behaviour problems for a child between the ages of 6-11?

Answer 18

• Arguing
• Inability to concentrate
• Self-consciousness
• Showing off

Question 19

Concerning developmental benchmarks, what are common behaviour problems for a child between the ages of 12-20?

Answer 19

• Arguing
• Bragging

Question 20

Concerning developmental benchmarks, what are clinical disorders common for a child between the ages of 0-2?

Answer 20

• Intellectual disability
• Feeding disorders
• Autism spectrum disorder

Question 21

Concerning developmental benchmarks, what are clinical disorders common for a child between the ages of 2-5?

Answer 21

• Speech and Language disorders
• Problems stemming from child abuse and neglect
• Some anxiety disorders (ex: phobias)

Question 22

Concerning developmental benchmarks, what are clinical disorders common for a child between the ages of 6-11?

Answer 22

• ADHD
• Learning disorders
• School refusal behaviour
• Conduct problems

Question 23

Concerning developmental benchmarks, what are clinical disorders common for a child between the ages of 12-20?

Answer 23

• Anorexia
• Bulimia
• Delinquency
• Suicide attempts
• Drug and alcohol abuse (substance abuse)
• Schizophrenia
• Depression

Question 24

What is the Denver Dev Screening Test (DDST) and what does it evaluate?

Answer 24

A screening test that can be used to assess if developmental benchmarks are being met at the appropriate age according to a percentile range indicating abnormal development through statistical rarity

Question 25

How could failure to meet developmental benchmarks be an indicator of the onset of pathology?

Answer 25

• If a child fails to meet the normal achievements for their age range, that could be a predictor of the development of the clinical disorders related to that age range
• Ex: Failing to meet eating and sleeping achievements can be early indicators of intellectual disability or autism spectrum disorder

Question 26

What’s the developmental psychopathology framework?

Answer 26

• Broad approach to disorders of youth -> thinking about a lots of factors (ex: developmental processes and tasks) that may lead to disorders in youth
• Stresses importance of developmental processes and
  tasks
• To understand maladaptive behavior, one must view it in relation to what is considered normative within whatever our particular reference group is

Question 27

How can we describe the prevalence for child psychopathology?

Answer 27

• The prevalence is broad
• Numerous studies from different places and using different samples come to different prevalence rates
• However, often the fact that someone meets criteria for a disorder is considered more of a norm than abnormal

Question 28

What are lifespan implications of child psychopathology?

Answer 28

• Impact on someone’s life course outcome is most severe when problems go untreated for extended periods of time
• About 20% of children with the most chronic and serious disorders face life-long difficulties and on average have worse life course outcomes
• Lifelong consequences associated with child psychopathology are costly (for individuals and to healthcare systems)

Question 29

What are common problems with mental health services?

Answer 29

• Inadequate services (shortage of healthcare and mental healthcare workers in Quebec, often our systems aren’t set up to help individuals effectively)
• 1st point of contact often medical doctor (may not have the mental health knowledge to help out individuals)
• Racial/ethnic disparities in mental health service access
• Lower levels of utilization due to unique barriers (barriers related to geography and finances)
• Are your practitioners sensitive to cultural differences or nuances?
• Is the treatment that you’re getting tailored or adapted to your ethnic or cultural background?

Question 30

What are gender differences in psychopathology?

Answer 30

• Social and Biological differences
• Certain criteria aren’t well suited for particular genders (ex: women with ADHD often go undiagnosed)
• Differences in timing
  (Males show higher rates of disorders in childhood (ex: ADHD, early conduct problems) VS Females show higher rates of disorders in adolescence (ex: depression, eating disorder))
• Differences in form
  (disorders may look different in the different genders -> men tend to show higher levels of externalizing behaviours VS women tend to show higher levels of internalizing behaviours)

Question 31

What are SES differences in psychopathology?

Answer 31

• Poverty and socioeconomic (SES) disadvantage
• Yearly snapshots may underestimate the # of youth who live in poverty
• The ways we assess poverty may underestimate the percentage of children that experience poverty
• Poverty linked with higher rates of MANY disorders

Question 32

What are racial/ethnic differences in psychopathology?

Answer 32

• Disparities NOT all attributable to SES differences
• More noticeable in treatment settings
• Differential treatment: certain racial groups (ex: black children) may be more likely to be diagnosed with conduct disorders
• Black youth more likely to be diagnosed with disruptive behavior disorders & psychosis & less likely to be diagnosed with mood and substance use disorders (ex: school 2 prison pipeline)
• Shows bias in diagnostic practices (how do mental health practitioners and clinicians interpret behaviours? -> over-diagnosis of certain groups of people -> implicit bias in diagnostic practices)
• Racism = large driver of health disparities
• These groups show lots of resilience and positive outcomes

Question 33

What’s a large stressor that could lead to the onset of disorders in LGBTQ people?

Answer 33

• Victimization
• They’re more likely to be victimized by their peers and family members
• The vast majority of them experience verbal abuse (81%)
• Almost half (38%) threatened with physical attacks
• Higher rates of mental health problems stemming from this discrimination and maltreatment
• However, lots of resilience in these populations

Question 34

What are cultural differences in psychopathology?

Answer 34

• Meaning of behaviors varies
• Ex: Social anxiety (fear of evaluation by others) VS Taijin kyofusho (incapacitating fear of offending or harming others through one’s social awkwardness) -> Taijin has to do with cultural norms in Japan around group harmony, not sticking out from the group
• Expression of symptoms varies
• Racial/ethnic minority group members often reports physical symptoms when there is underlying mental health problem (ex: “I have a tummy ache)

Question 35

What are models of etiology & maintenance of disorder used in child psychopathology?

Answer 35

◼Diathesis-stress model
◼Developmental pathways (multifinality and equifinality)

Question 36

Describe the General Diathesis-Stress Model

Answer 36

• Diathesis:
  underlying vulnerability or tendency toward disorder (could be * biological, contextual, or experience-based)
• Vulnerability can be changed throughout your lifespan (ex: due to the loss of a loved one)
• Diathesis is subject to change but its more stable because it has a biological component
• Stress:
  situation or challenge that calls on resources (typically thought of as external, negative events)
• The underlying vulnerability interacts with stressors and could lead to the onset of some type of disorder
• Different people have different levels of vulnerability (determines where you start in the race)
• The stressors keep pushing us toward the onset of a disorder
• People that have more vulnerability have a higher likelihood of developing a disorder
• Applied to many disorders

Question 37

What’s the difference between Diathesis Stress Model and Differential Susceptibility

Answer 37

• Differential susceptibility: some children are more susceptible to the effects of their environments, both good and bad
• There may be vulnerability factors but there are also protective factors (these may reduce vulnerability and risk)
• Diathesis-stress: some children are more susceptible to the negative effects of a problematic environment

Question 38

What are the strengths of the Diathesis-Stress Model?

Answer 38

• Organizes thinking about nature AND nurture behavior & that emotions are complicated
• Almost no disorders is caused by “just” genes or “just” stress
• Brain structure and function changes (neural plasticity) in response to environment
• Genes change in response to environment (behavioral epigenetics)
• This model isn’t prescriptive (not if x then y) -> interaction makes disorder more probable
  (diathesis ≠ disorder & stress ≠ disorder)
• Can have multiple interacting diatheses & stressors

Question 39

What are developmental pathways?

Answer 39

• The sequence and timing of particular behaviors as well as the relationships between behaviors over time
• What kind of path do you get on and is that leading to an adaptive or maladaptive outcome?

Question 40

What are the 2 common types of developmental pathways?

Answer 40

• Multifinality
• Equifinality
• They refer to the end points

Question 41

What’s multifinality?

Answer 41

• Multi -> multiple outcomes
• A same stressor may lead to a wide variety of outcomes
• Ex: Early childhood maltreatment is a common stressor that can lead to a variety of disorders (conduct disorder, mood disorder, eating disorder, normal adjustment (aka resilience))

Question 42

What’s equifinality?

Answer 42

• Different stressors might lead to a similar outcome
• Ex: experiences of SA, car accident and gun violence can all lead to PTSD

Question 43

What’s the scientific approach and why is crucial when assessing child psychopathology?

Answer 43

• An organized way of investigating claims, without relying on common sense and casual observations, that requires that a claim be based on theories backed up by data from well-designed studies that test alternative explanations and that observations be checked and repeated before conclusions are drawn
• Parents and professionals who work with children tend to interpret and relate information according to their own belief systems and experiences

Question 44

Explain the reasons why people are skeptical about research in abnormal child psychology

Answer 44

1. Experts on childhood problems frequently disagree
2. Research in mainstream media is often oversimplified, and the way that findings are presented can make them more or less believable
3. Research findings in abnormal child psych often conflict with one another
4. Research has led to different recommendations regarding how children with problems should be helped
5. Even when scientific evidence is clear and produces a consensus, many parents and professionals may dismiss the findings because they have encountered an exception (usually from personal experience)

Question 45

What’s a real-life example of scientific methods and evidence being ignored or dismissed concerning abnormal child psychology?

Answer 45

• Facilitated communication (FC)
• Procedure used to teach children with autism and other impairments how to communicate
• Controlled studies have consistently found that the child’s communication is being controlled by the facilitator
• Example of pseudoscience

Question 46

Describe the research process

Answer 46

1. Develop a hypothesis (research question) based on observation, theory, and previous findings, and decide on general research approach
2. Identify sample to be studied, select measurement methods, and develop research design and procedures
3. Gather and analyze data and interpret results in relation to theory and previous findings
   - Findings and interpretations from the study can then be used to generate future research questions and stimulate further research

Question 47

What’s epidemiological research?

Answer 47

The study of the incidence, prevalence, and cooccurrence of childhood disorders and competencies in clinic-referred and community samples

Question 48

What are incidence rates?

Answer 48

• The rate at which new cases of a disorder appear over a specified period of time
• Ex: the number of youths who develop a depressive disorder during the school year
• Estimates of incidence and prevalence can be obtained over a short period, such as 6 months, or a much longer period

Question 49

What are prevalence rates?

Answer 49

• The number of cases of a disorder, whether new or previously existing, that are observed during a specified period of time
• Ex: the number of teens with conduct disorder in the general population during 2012 and 2013

Question 50

What’s the difference between lifetime prevalence estimates of mental disorders obtained prospectively and those obtained retrospectively?

Answer 50

Those obtained prospectively (studying the same sample of children over time and assessing them at periodic intervals) are double those found in retrospective studies (asking people to remember what occurred at an earlier time), which are subject to recall failure

Question 51

Why is a case definition in abnormal child psychology complex?

Answer 51

• Children don’t refer themselves for treatment -> equating illness with seeking treatment can be misleading
• The factors that lead to referral sometimes have more to do with the child’s parents, teachers, or doctor than with the child’s behavior
• Children who are not referred to clinics for treatment should also have their problems studied

Question 52

What are some explanations for why prevalence rates vary so widely in abnormal child psychology?

Answer 52

• Prospective vs retrospective studies
• Clinical cases vs community cases
• Whether cases are defined in terms of patterns of symptoms, impairment in functioning, or both
• Demographic and situational factors (ex: SES, parents’ marital status, age, gender, cultural background)
• Cultural variations in what constitutes abnormal behavior, how to identify such behavior, and what to do about it

Question 53

What are the 3 variables of interest in abnormal child psychology?

Answer 53

• Correlates
• Risk or protective factors
• Causes of other variables

Question 54

What are correlates (or correlated variables)?

Answer 54

Variables that are associated at a particular point in time with no clear proof that one precedes the other

Question 55

What’s a risk factor?

Answer 55

• Variable that precedes an outcome of interest and increases the chances of a negative outcome
• Doesn’t necessarily mean that it’ll occur -> its occurrence depends on other factors
• Sometimes the effects of exposure to a risk factor during infancy or early childhood may not be visible until adolescence or adulthood (delayed or sleeper effects)

Question 56

What’s a protective factor?

Answer 56

A positive variable that precedes an outcome of interest and decreases the chances that a negative outcome will occur

Question 57

What’s the key difference between moderating and mediating variables?

Answer 57

Moderators have an independent effect on the existing relationship between 2 variables, whereas mediators account for some or all of the apparent relationship between 2 variables

Question 58

What are moderator variables?

Answer 58

• A factor that influences the direction or strength of a relationship between variables
• The association between 2 variables depends on/differs as a function of moderating variables, such as the child’s age, sex, SES, or cultural background
• Ex: sex of the child moderates relationship between abuse and internalizing problems

Question 59

What are mediator variables?

Answer 59

• The process, mechanism, or means through which a variable produces a specific outcome
• Mediators describe what happens at the psychological or neurobiological level to explain how one variable results from another
• Ex: type of discipline used by mothers on days they’re feeling distressed mediates the relationship between maternal distress and child behavior problems

Question 60

What are randomized controlled trials (RCTs)?

Answer 60

• Design used to evaluate treatment outcomes in which children with a particular problem are randomly assigned to various treatment and control conditions
• Numerous studies evaluate treatment outcomes using RCTs
• Findings from controlled research studies indicate that children who receive treatment are generally better off than children who don’t

Question 61

What’s treatment efficacy?

Answer 61

• Degree to which a treatment can produce changes under well-controlled conditions that depart from those typically used in clinical practice
• In efficacy research, careful control is exercised over the selection of cases, therapists, and delivery and monitoring of treatment

Question 62

What’s treatment effectiveness?

Answer 62

• Degree to which a treatment can be shown to work in actual clinical practice, as opposed to under controlled laboratory conditions
• In research on effectiveness, treatment is evaluated in clinical settings, clients are usually referred rather than selected, and therapists provide services without many of the rigorous controls used in research

Question 63

Fill in the blank: The benefits of treatment for children with problems have generally been found to be lower in ______ than in _______

Answer 63

• The benefits of treatment for children with problems have generally been found to be lower in clinical practice settings (effectiveness trials) than in controlled research settings (efficacy trials)
• A high priority for intervention research is on developing and testing interventions in settings where clinical services for youths are typically provided and finding ways to strengthen the bridge between research, public policy, and clinical practice

Question 64

What’s standardization?

Answer 64

• Process by which a set of standards or norms is specified for a measurement procedure so that it can be used consistently across different assessments
• These standards and norms relate to the procedures that must be followed during administration, scoring, and evaluation of findings
• Without standardization, it’s nearly impossible to replicate the info obtained using a method of measurement
• Results are likely to be unique to the situation in which they are obtained and will not apply to other situations (ex: the test scores of an 8-year-old boy from a low-SES background should be compared with the scores of other children like him, not with the scores of a 16-year-old girl from an upper-SES background)

Question 65

What’s reliability?

Answer 65

• The extent to which the result of an experiment is consistent or repeatable
• 3 types: internal consistency, interrater reliability, test-retest reliability

Question 66

What’s internal consistency?

Answer 66

• Type of reliability
• Whether all parts of a method of measurement contribute in a meaningful way to the information obtained

Question 67

What’s interrater reliability?

Answer 67

• Type of reliability
• Info must not depend on a single observer or clinician -> various people must agree on what they see (consensus)

Question 68

What’s test-retest reliability?

Answer 68

• Tests or interviews repeated within a short time interval should yield similar results on both occasions
• The results need to be stable over time

Question 69

What’s validity?

Answer 69

• The extent to which a measure actually assesses the dimension or construct that the researcher sets out to measure
• It’s not all or none but rather a matter of degree
• Can be assessed in many ways: face validity, construct validity, convergent validity, discriminant validity, criterion-related validity

Question 70

What’s face validity?

Answer 70

• The extent to which the measure appears to assess the construct of interest
• Ex: a questionnaire that asks whether you get nervous before taking an exam would be a face-valid measure of test anxiety, whereas one that asks if you think you’re a parrot would not

Question 71

What’s construct validity?

Answer 71

• Whether scores on a measure behave as predicted by theory or past research
• Ex: an intelligence test has construct validity if children who obtain high scores on the test also have better grades in school, understanding of concepts, and verbal reasoning than do children who obtain low scores on the test
• 2 components of construct validity: convergent validity and discriminant validity

Question 72

What’s convergent validity?

Answer 72

• Type of construct validity
• Reflects the correlation between measures that are expected to be related
• Indication of the extent to which the 2 measures assess similar or related constructs
• Ex: a teen’s report of her depression in a screening interview and her scores on a depression questionnaire

Question 73

What’s discriminant validity?

Answer 73

• Degree of correlation between measures that are not expected to be related to one another
• Ex: scores on a measure designed to assess depression and another designed to assess intelligence should not correlate

Question 74

What’s criterion-related validity?

Answer 74

• Refers to how well a measure predicts behavior in settings where we would expect it to do so—at the same time (concurrent validity) or in the future (predictive validity)
• Criterion-related validity tells us whether scores on a measure can be used for their intended purpose
• Ex: a child’s high scores on a measure of social anxiety should predict that the child would display anxiety or avoidance in current social situations and will perhaps have difficulties making friends in the future

Question 75

What are the measurement methods used for abnormal child psychology?

Answer 75

• Interviews
• Questionnaires
• Checklists
• Rating scales
• Psychophysiological recordings
• Brain imaging
• Performance measures
• Direct observations of behavior
• A variety of intellectual, academic, and neuropsychological tests are also used
• Because the info we obtain from children and families often varies depending on the method used, researchers frequently rely on several methods to define and assess the constructs of interest

Question 76

What are reporting methods for abnormal child psychology?

Answer 76

• Assess the perceptions, thoughts, behaviors, feelings, and past experiences of the child, parents, and teachers
• Include relatively unstructured clinical interviews, highly structured diagnostic interviews, and questionnaires

Question 77

What’s an important question regarding reporting methods?

Answer 77

• Who is reporting on behavior?
• Self-report measure: a child or parent will provide info about their own behavior, feelings, and thoughts
• Informant-report measure: a person who’s well acquainted with the child (usually parent or teacher) will provide info about a child’s behaviors, feelings, or thoughts based on their observations of the child

Question 78

What are some of the limitations associated with psychophysiological measures?

Answer 78

• Findings for these measures can be inconsistent between studies -> researchers may have to infer how the child may have processed a particular event or stimulus
• Child’s physiological response can be influenced easily by other factors (ex: child’s reaction to the recording equipment or hunger, fatigue, or boredom)

Question 79

What’s the EEG and how is it relevant to abnormal child psychology?

Answer 79

• Electroencephalogram (EEG)
• Electrophysiological measure of brain functioning whereby electrodes are taped to surface of subject’s scalp to record the electrical activity of the brain
• EEG recordings are sensitive to changes in state and emotionality -> useful for studying social and emotional processes

Question 80

What’s a naturalistic observation?

Answer 80

• Unstructured observation of a child in their natural environment
• The researcher goes into the child’s home, classroom, or day-care center to observe and record the behaviors of interest of the child and often of parents, teachers, siblings, and peers with whom the child interacts
• The researcher may make a recording of behavior in the natural environment, which can be analyzed at a later time

Question 81

What’s a structured observation?

Answer 81

• Observation of a subject, usually occurring in a clinic or laboratory, in which the subject is given specific tasks or instructions to carry out, and researchers look for specific information
• Researchers set up a situation or provide instructions to elicit behaviors of particular interest (ex: the Strange Situation procedure for infant-caregiver attachment styles)

Question 82

What are the advantages of structured observations?

Answer 82

• Cost-effective
• Focus observations on the phenomena of interest
• Especially useful for studying child behaviors that occur infrequently in everyday life
• Researcher has greater control over the situation
• They permit the use of other assessment procedures

Question 83

What’s the disadvantage of structure observations?

Answer 83

• Observations in the laboratory or clinic may not provide a representative sample of the behaviors of interest
• Ex: knowing that they are being observed through a one-way mirror may make children and parents not behave in the laboratory as they do in real-life settings
• “Behavior in the presence of an observer”

Question 84

What’s internal validity?

Answer 84

• Extent to which an intended manipulation of a variable, rather than extraneous influences, accounts for observed results, changes, or group differences
• Extraneous influences that could explain the results are called threats to internal validity (including maturation, the effects of testing, and subject-selection biases)

Question 85

What’s external validity?

Answer 85

• Degree to which findings can be generalized, or extended to people, settings, times, measures, and characteristics other than the ones in the original study
• Threats to external validity include characteristics of participants that apply to some people but not others, the reactivity of subjects to participating, the setting in which the research is carried out, or the time when measurements are made
• Ex: many research studies in abnormal child psych underrepresent cultural minorities and children from low-SES backgrounds
• Ex: children or parents may not behave naturally in an unfamiliar laboratory setting (low external validity)

Question 86

What’s comorbidity?

Answer 86

• The overlapping of 2 or more disorders at a rate that is greater than would be expected by chance alone
• Research samples from clinical populations will have a disproportionately high rate of comorbidity because referral for treatment is most likely based on the combined symptoms of all disorders
• Failure to consider comorbidity may result in an interpretation of findings about one disorder when these findings are more validly attributed to a second disorder or to a combination of disorders

Question 87

Much of the research conducted on child psychopathology relies on what kind of experimental approaches?

Answer 87

• Nonexperimental, correlational approaches
• Natural experiments, aka quasi-experimental designs or known-group comparisons
• Comparisons are made between conditions or treatments that already exist
• The experiments may involve children with different disorders, parents with different problems, or different family environments

Question 88

What’s a cohort?

Answer 88

A group of individuals who are followed over time and who experience the same cultural or historical events during the same time period

Question 89

What are cohort effects?

Answer 89

Influences related to being a member of a specific cohort

Question 90

What are aging effects?

Answer 90

General changes that occur as participants age -> ex: increases in physical prowess, impulse control, or social opportunity

Question 91

What’s cross-sectional research?

Answer 91

Method of research whereby different individuals at different ages/stages of development are studied at the same point in time

Question 92

What’s longitudinal research?

Answer 92

Method of research whereby the same individuals are studied at different ages/stages of development

Question 93

What’s etiology?

Answer 93

• the study of the causes of childhood disorders
• Multiple, interactive causes help in understanding the complexity of disorders

Question 94

Describe the developmental psychopathology perspective

Answer 94

• Abnormal development is multiply determined (beyond current symptoms and need to consider developmental pathways and interacting events)
• Developmental history is crucial to understanding where an individual and their current disorder is coming from
• Children and environments are interdependent (both active contributors to adaptive and maladaptive behavior)
• Abnormal development involves continuities and discontinuities

Question 95

What’s the transactional view in child psychopathology?

Answer 95

• Children and environments are interdependent -> both active contributors to adaptive and maladaptive behavior
• Social and structural environments have a big impact on children
• Children also exert an influence on their environment (children may influence how people act around them)
  ○ Ex: a kid with anger issues may have parents that act different around them
• Gene-environment correlations

Question 96

What’s continuous development?

Answer 96

• Gradual and quantitative developmental changes
• Difference in degree
• Ex: how many words does this child know
• They’re predictive of future behaviours and patterns
• Development as an additive process that is ongoing
• Patterns of behavior that remain over time
• Ex: early-onset and persistent conduct disorders evolving into serious antisocial acts

Question 97

What’s discontinuous development?

Answer 97

• Abrupt and qualitative developmental changes
• Developmental stages
• Differences in kind
• Ex: what kind of competencies there are
• Ex: different stages of development -> no clear bridges showing transition between stages
• Big and abrupt differences between these stages
• Discontinuity implies that future behavior is poorly predicted by earlier patterns

Question 98

What’s qualitative research?

Answer 98

• Research for which the purpose is to describe, interpret, and understand the phenomenon of interest in the context in which it is experienced
• Qualitative researchers try to understand the phenomenon from the participant’s perspective
• Qualitative data are typically collected through observations or open-ended interviews and are recorded narratively
• The data are then examined to build general categories and themes

Question 99

What’s assent?

Answer 99

Evidence of agreement from a child to participate in a study without having a full understanding of the research that would be needed to give informed consent

Question 100

What’s an idiographic case formulation?

Answer 100

Approach to case formulation or assessment that emphasizes the detailed representation of the individual child or family as a unique entity

Question 101

What’s a nomothetic formulation?

Answer 101

Approach to case formulation or assessment that emphasizes general principles that apply to all people

Question 102

What are some gender differences in the onset of certain disorders?

Answer 102

• Boys are about 3-4x more likely than girls to display early-onset disorders (ex: autism spectrum disorder (ASD) and ADHD)
• Girls are more likely than boys to display disorders that have their peak onset in adolescence (ex: depression and eating disorders)

Question 103

What are some psychological problems that are more commonly reported among boys?

Answer 103

• ADHD
• Autism Spectrum Disorder
• Childhood conduct disorder
• Intellectual disability
• Language disorder
• Specific learning disorder
• Enuresis

Question 104

What are some psychological problems that are more commonly reported among girls?

Answer 104

• Anxiety disorders
• Adolescent Depression
• Eating disorders
• Sexual abuse

Question 105

What are some psychological problems that are equally reported among girls and boys?

Answer 105

• Adolescent conduct disorder
• Childhood depression
• Feeding disorder
• Physical abuse and neglect

Question 106

Describe the referral biases related to gender

Answer 106

• Boys tend to receive an excess of referrals, whereas girls tend to be overlooked because of their less visible forms of suffering
• Ex: ADHD being underdiagnosed for girls because of differences in how it expresses itself in girls

Question 107

What group of children have a greater risk of being misdiagnosed or underdiagnosed?

Answer 107

• Children who are ethnic minorities
• Ex: a study found that psychiatrically hospitalized African American adolescents were more often diagnosed with organic/psychotic disorders and less often diagnosed with mood/anxiety disorders than Caucasian teens

Question 108

What are cultural syndromes?

Answer 108

• Pattern of co-occurring, relatively invariant symptoms associated with a particular cultural group, community, or context
• These rarely fit neatly into one Western diagnostic category

Question 109

TRUE or FALSE: individual symptoms define childhood disorders

Answer 109

FALSE
- Age inappropriateness, severity, and pattern of symptoms define childhood disorders

Question 110

What are the 3 common purposes of assessment?

Answer 110

• Description and diagnosis
• Prognosis
• Treatment planning

Question 111

Name some of the more common comorbid disorders

Answer 111

• Conduct disorder and ADHD
• ASD and intellectual disability
• Childhood depression and anxiety

Question 112

What’s prognosis?

Answer 112

Prediction of the course or outcome of a disorder

Question 113

What’s developmental history/family history?

Answer 113

• Info obtained from parents regarding significant developmental milestones and historical events that might have an impact on child’s current difficulties
• Can be done by using a background questionnaire or interview

Question 114

List the areas that are covered within a background questionnaire or interview for a child’s developmental history

Answer 114

• Birth and related events (ex: pregnancy and birth complications)
• Developmental milestones
• Medical history
• Family characteristics and family history
• Interpersonal skills
• Educational history
• Adolescent’s work history and relationships
• Description of the presenting problem
• Parents’ expectations for assessment and treatment

Question 115

What are the “ABCs of assessment”?

Answer 115

A = Antecedents -> events that immediately precede a behavior
B = Behavior(s) of interest
C = Consequences -> events that follow a behavior

Question 116

What’s the organization of development?

Answer 116

• Early patterns of adaptation evolve with structure over time
• Ex: infant eye contact and speech sounds, evolve into higher-order functions -> speech and language
• Sensitive periods
• Development -> process of increasing differentiation and integration
• Current abilities or limitations = influenced by prior accomplishments
• Development can be cumulative -> based on foundation of abilities we have accumulated overtime
• Implies an active, dynamic process of continual change and transformation

Question 117

What are sensitive periods?

Answer 117

• Periods during which environmental influences on development (good and bad) are heightened -> providing enhanced opportunities to learn
• Ex: the boy found living with the wolves -> he missed sensitive periods in his development which hindered his ability to learn language

Question 118

What’s the integrative approach to studying child psychopathology?

Answer 118

• No single theoretical orientation explains various behaviors or disorders
• Abnormal child behavior is best studied from a multi-theoretical perspective
• Knowledge increases through research
• Best thing to do is integrate these multiple perspectives when assessing a person

Question 119

What’s the neurobiological perspective on child psychopathology?

Answer 119

• Brain = underlying cause of psychological disorders
• Fetal brain develops from all-purpose cells into a complex organ
• We can trace back a psychological problem to a dysfunction in the structure or function of the brain
• Neural plasticity -> the brain’s anatomical differentiation is use-dependent
• Use-dependent -> when we do certain activities, we use certain axons in our brain and these are reinforced and become stronger and if we don’t use these axons they prune (use it or lose it)
• Nature and nurture both contribute
• Experience plays a critical role in brain development
• Maturation of the brain

Question 120

Describe the process of maturation of the brain

Answer 120

• Areas governing basic sensory and motor skills mature during the first 3 years of life
• Perceptual and instinctive centers are strongly affected by early childhood experiences
• Prefrontal cortex and cerebellum are not rewired until 5 to 7 yrs old
• Major restructuring occurs from ages 9 to 11 due to pubertal development and again in adolescence
• Examples of sensitive periods -> important that these areas of the brain develop in early developmental stages for proper functioning later on

Question 121

What’s the Gene-environment interaction (GxE)?

Answer 121

• Normal and abnormal child development are the result of complex interchanges between nature and nurture and are affected not only by genetic and environmental influences but also by the timing of when they meet
• The interaction of our genes and our environment overtime
• Similar to Diathesis Model

Question 122

What are the different types of Gene-environment interactions (GxE)?

Answer 122

• Passive: simple association between your genes and the environment
• Evocative: you, as a function of who you are, elicit reactions from your environment (people are more likely to give positive attention to a smiling baby) -> how you’re invoking reactions from the environment
• Active: you actively control your environment and seek out certain environments due to your genes
• These gene correlations fluctuate in importance throughout your development
• In early years, passive g-e correlation is important because infants and toddlers are in an environment that’s mostly controlled by adults -> they don’t have the structure to influence their environment
• Later on, as children gain agency, the active g-e correlation becomes more important

Question 123

What are some genetic contributions to abnormal child behaviour?

Answer 123

• Expression of genetic influences = malleable & responsive to social environment
• Gene-environment interactions (GxE)
• Behavioral genetics
• Molecular genetics
• Genetic influences are probabilistic, not deterministic
• Most forms of abnormal behavior are polygenic

Question 124

What are behavioural genetics?

Answer 124

• Connections between genetic predisposition & observed behavior
• Ex: how are xyz gene variations associated with your likelihood of starting to smoke

Question 125

What are molecular genetics?

Answer 125

• Used to identify specific genes for childhood disorders
• Directly assess the association between variations in DNA sequences and variations in particular traits

Question 126

What’s projective testing?

Answer 126

• Form of assessment that presents the child with ambiguous stimuli (ex: inkblots or pictures of people) and the child is asked to describe what they see
• The hypothesis is that the child will “project” their personality (unconscious fears, needs, and inner conflicts) onto the ambiguous stimuli of other people and things
• Without being aware, the child discloses their unconscious thoughts and feelings to the clinician

Question 127

What are some neurobiological contributions to abnormal child behaviour?

Answer 127

• Neurotransmitters
• Neurotransmitters make biochemical connections
• Neurons more sensitive to a particular neurotransmitter cluster together and form brain circuits
• Neurotransmitters involved in psychopathology -> serotonin, benzodiazepine-GABA, norepinephrine, and dopamine
  ▪ Psychoactive drugs are used in treatments

Question 128

What are the major neurotransmitters involved in psychopathology?

Answer 128

• Benzodiazepine-GABA
• Dopamine
• Norepinephrine
• Serotonin

Question 129

What are the functions of Benzodiazepine-GABA?

Answer 129

• Reduces arousal and moderates emotional responses, such as anger, hostility, and aggression
• Linked to feelings of anxiety and discomfort

Question 130

What’s the role of Benzodiazepine-GABA in psychopathology?

Answer 130

Anxiety Disorder

Question 131

What are the functions of Dopamine?

Answer 131

• Can act as a switch that turns on various brain circuits, allowing other neurotransmitters to inhibit or facilitate emotions or behaviour
• Involved in exploration, extroversion, and pleasure

Question 132

What’s the role of Dopamine in psychopathology?

Answer 132

• Schizophrenia
• Mood disorders
• ADHD

Question 133

What are the functions of Norepinephrine?

Answer 133

Facilitates or controls emergency reactions and alarm responses

Question 134

What’s the role of Norepinephrine in psychopathology?

Answer 134

Not directly involved in specific disorders (acts generally to regulate or modulate behavioral tendencies)

Question 135

What are the functions of Serotonin?

Answer 135

• Emotional and behavioral regulation
• Information and motor coordination
• Inhibits children’s tendency to explore their surroundings
• Moderates and regulates several critical behaviours (ex: eating, sleeping, and expressing anger)
• SSRIs - Selective Serotonin Reuptake Inhibitors

Question 136

What’s the role of Serotonin in psychopathology?

Answer 136

• Regulatory problems -> ex: eating and sleep disorders
• OCD
• Schizophrenia and mood disorders

Question 137

What are externalizing behaviors?

Answer 137

Aggressive/rule-breaking behaviors

Question 138

What are internalizing behaviors?

Answer 138

Anxious/withdrawn/depressed behaviors

Question 139

What are the diagnostic criteria for ADHD?

Answer 139

A. Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
B. Several inattentive or hyperactive-impulsive symptoms were present before age 12 years
C. Several inattentive or hyperactive–impulse symptoms are present in 2 or more settings (ex: at home, school, or work, with friends or relatives)
D. Must be clear evidence that the symptoms interfere with, or reduce the quality of, social academic, or occupational functioning
E. The symptoms don’t occur exclusively during the course of schizophrenia or other psychotic disorders and are not better explained by another mental disorder (ex: mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal)

Question 140

What are the symptoms that characterize inattention in ADHD?

Answer 140

a) Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities
b) Often has difficulty sustaining attention in tasks or play activities
c) Often does not seem to listen when spoken to directly
d) Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
e) Often has difficulty organizing tasks and activities
f) Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
g) Often loses things necessary for tasks or activities
h) Is often easily distracted by extraneous stimuli
i) Is often forgetful in daily activities

Question 141

What are the symptoms that characterize hyperactivity and impulsivity in ADHD?

Answer 141

a) Often fidgets with or taps hands or feet or squirms in seat
b) Often leaves seat in situations when remaining seated is expected
c) Often runs about or climbs in situations where it is inappropriate
* In adolescents or adults, may be limited to feeling restless
d) Often unable to play or engage in leisure activities quietly
e) Often “on the go,” acting as if “driven by a motor” (ex: is unable to be or is uncomfortable being still for extended time)
f) Often talks excessively
g) Often blurts out answers before a question has been completed
h) Often has difficulty waiting their turn
i) Often interrupts or intrudes on others

Question 142

How many and how long do symptoms of inattention and hyperactivity-impulsivity have to be present for a child or an adult to meet the criteria for a diagnosis of ADHD?

Answer 142

• 6 (or more) of the symptoms (for each category) have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities
• For older adolescents and adults (age 17 and older), at least 5 symptoms are required

Question 143

People with ADHD are likely to have higher or lower levels of dopamine?

Answer 143

Lower levels of dopamine

Question 144

What are the psychological perspectives on abnormal child psychopathology?

Answer 144

• These perspectives have value in explaining the development of psychopathology
• Transactions must be considered
• Emotions play a role in establishing an infant’s ability to adapt to new surroundings
• Behavioral and cognitive processes assist a young child in making sense of the world

Question 145

What are the emotional influences on abnormal child psychopathology?

Answer 145

• Emotions and affective expression are core elements of human psychological experience and are a central feature of infant activity and regulation
• Emotions tell us what to pay attention to and what to ignore (if things make use feel bad, we’re less likely to engage with them)
• Emotions help us with our social relationships
• Emotions are crucial to our monitorial processes
• Younger children may not have a good vocab or insight into their emotional experiences (emotional wheel could help them identify emotions)
• Having a wider range of emotions to choose from to describe your own will help you understand yourself better
• Temperament

Question 146

What’s emotion reactivity?

Answer 146

• Individual differences in the threshold and intensity of emotional experience
• Someone who is rapidly and strongly fluctuating in emotional experience may indicate abnormal behaviour

Question 147

What’s emotion regulation?

Answer 147

• Enhancing, maintaining, or inhibiting emotional arousal
• AKA coping
• Ex: Emotion regulation at a funeral
• Someone who demonstrates no differences in emotions could indicate abnormal behaviour

Question 148

What are emotion reactivity and emotion regulation important signals of?

Answer 148

Normal and abnormal development

Question 149

What’s temperament?

Answer 149

• Organized style of behaviour that occurs very early in development
• Sort of like a precursor to later personality
• Temperament shapes individual’s approach to their environment and vice versa
• Early infant temperament may be linked to psychopathology or risk conditions -> high self-regulation is needed for healthy, normal adjustment

Question 150

According to (Rothbart), what are the 3 primary dimensions of temperament?

Answer 150

1. Positive affect and approach/Surgency
2. Fearful or inhibited/Effortful Control: ability to shift attention when necessary and inhibit emotions, high on effortful control = tendency to be very anxious and fearful
3. Negative affect or irritability/Negative affectivity: high on negative affectivity = tendency to be sad, frustrated, low mood, irritable
   - You could be high on all 3 dimensions

Question 151

What’s high self-regulation?

Answer 151

Balance between emotional reactivity and self-control

Question 152

What are some behavioural and cognitive influences on abnormal child psychopathology?

Answer 152

• Applied Behavior Analysis (ABA) -> think about learning and development through operant conditioning and think of behaviour as a function of its antecedents and consequences
• Classical conditioning -> pairings between things
• Cognitive theorists -> how thought patterns develop over time
• Social-cognitive theorists -> how children think about themselves and others, changing mental representations of themselves, others and the world, this learning has no obvious reinforcement, latent learning (parents can teach the children behaviours without the children actually engaging in the behaviour themselves -> ex: bobo doll experiment)

Question 153

What are the 4 primary operant learning principles?

Answer 153

• Positive reinforcement
• Negative reinforcement
• Punishment
• Extinction

Question 154

What does the bobo doll experiment exemplify?

Answer 154

• Example of children learning aggressive/externalizing behavior (social learning)
• Example of latent learning

Question 155

What’s infant-caregiver attachment?

Answer 155

• Process that occurs early in life of establishing and maintaining an emotional bond with parents or other significant individuals
• An internal working model of relationships comes from a child’s initial crucial relationship
• People can form attachments to multiple figures
• This attachment helps establish this internal-working model for subsequent relationships that are based on how this initial crucial attachment is (the nature of initial attachment)

Question 156

What’s the Strange Situation Task?

Answer 156

• Most widely used procedure to assess a child’s attachment to their parent
• Psychologists are most interest in the “reunion” when the parent comes back after the separation
• In the video example we watched in class, the baby showed signs of secure attachment

Question 157

What’s the approximate percentage of infants displaying the different types of attachment?

Answer 157

• Secure: ~60% (most)
• Resistant: up to 10%
• Avoidant: up to 15%
• Disorganized-Disoriented: up to 15%

Question 158

What are the different types of attachment?

Answer 158

• Secure (kid feels comfortable exploring when parents around, get sad when they leave but are comforted when they come back - slight majority of children show secure attachment)
• Resistant (not warm towards parent when they return)
• Avoidant (indifferent to departure of caregiver, not visibly comforted)
• Disorganized-Disoriented

Question 159

What psychopathological outcomes is each attachment type predictive of?

Answer 159

• Secure: protective function against disordered outcomes
• Resistant: Phobias, anxiety, psychosomatic symptoms, depression
• Avoidant: Conduct disorders, aggressive behavior, depressive symptoms
• Disorganized-disoriented: No consensus -> generally a wide range of personality disorders

Question 160

Describe Bronfenbrenner’s bioecological model

Answer 160

• This model considers different systems of influence
• Microsystem: where the child is located with their biological and psychological characteristics. In this system are parents, siblings and other people in their immediate environment -> these people have a lot of direct contact with the developing child)
• Mesosystem: interaction between agents of microsystem (2 people that have a high influence on the child interact with each other)
• Exosystem: when a parent interacts with another person/institution that doesn’t affect the child (ex: parent at work, work has nothing to do with the child but how a parent is treated at work may affect their mood and consequently how the child is treated)
• Macrosystem: cultural elements of society, socio-political aspects, religion
• Chronosystem: passage of time, all of the events that occur in a child’s life that has an influence on the systems overtime
• Changes to the chronosystem can affect the other levels of the bioecological model
  Parental divorce and COVID are events rooted in time that could affect these levels of the child’s system

Question 161

What are the strengths and weaknesses of Bronfenbrenner’s bioecological model?

Answer 161

Strengths
* Conceptualizes development as product of biological and environmental forces interacting within a complex system

Weaknesses
* Systems perspectives may never provide a coherent picture of development (“It depends”)
* Human development may be more predictable than bioecological model implies

Question 162

Describe Vélez-Agosto et al. (2017) reconceptualization of Bronfenbrenner model

Answer 162

• Reconceptualization of Bronfenbrenner with culture moved from macrosystem to a factor that permeates all levels of the ecological system
• Culture is important at all of these different levels

Question 163

Describe oppositional defiant disorder (ODD)

Answer 163

• Age-inappropriate anger/irritability, argumentative/defiant behavior, or vindictiveness
• Characterized by angry/irritable mood, argumentative/defiant behavior, and vindictiveness
• 4 of the behaviors (symptoms) have to be present -> child has to be engaging in behavior more than is normative for their developmental level
• Often ODD behaviours developmentally precede CD
• Symptoms have to be out of proportion
• For children under 5 we look for if these behaviours occur for most days of the week
• For children over 5, we look for if these behaviours occur at least once a week over 6 months
• If fighting/aggression only occurs with a sibling, we can’t diagnose ODD

Severity:
- Mild – occurs in only one setting
- Moderate – occurs in 2 settings
- Severe – occurs in 3 or more settings
- Settings (ex: at school, at soccer, at home)

Question 164

How do we assess ODD?

Answer 164

• Interviews and Checklists
• Observation -> Disruptive Behavior Diagnostic Observation Schedule (DB-DOS)

Question 165

How is the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) used to assess ODD?

Answer 165

• DB-DOS is for preschool age kids
• Try to elicit disruptive behaviour
• Preschoolers interacting in 3 contexts (with an interactive examiner, with a busy examiner, with their parent)
• “Presses” for disruptive behavior (compliance, frustration, rule-breaking)
• This can be useful because we want to see the full range of emotions that they show
• This observation can add additional info that parents maybe failed to observe or didn’t report on
• This can also be used for conduct disorder

Question 166

What’s conduct disorder?

Answer 166

• Repetitive and persistent pattern of violating basic rights of others and/or age-appropriate societal norms or rules
• Characterized by aggression to people and animals, destruction of property, deceitfulness or theft, serious violations of rules
• 15 specific behaviours
• 3 or more of the behaviors present within the past 12 months, with at least one present in the last 6 months
• There are many possible combinations of symptoms which can lead to widely different presentations of behaviours

Question 167

What are callous and unemotional (CU) traits?

Answer 167

• Lack of remorse or guilt
• Callous, lack of empathy
• Unconcerned about performance
• Shallow or deficient affect
• 2% - 6% of youth with CD have significant CU traits
• When youth have CU traits, CD is earlier onset, aggression is more severe and more instrumental (use aggression to get something out of it -> ex: using aggression to get snack you want)
• CU associated with insensitivity to punishment (unconcerned about performance) -> harder to treat

Question 168

What’s the with ‘limited prosocial emotions’ specifier for CD?

Answer 168

2 of the callous and unemotional (CU) traits have to be persistently present over the last 12 months, and in multiple relationships and settings

Question 169

What’s the difference between childhood onset and adolescence onset of CD?

Answer 169

Prognosis is poorer for early-onset, but adolescent limited may be associated with significant negative outcomes

Question 170

What’s the developmental course for Late-onset pathway / ‘adolescent-limited’ for CD?

Answer 170

• Onset in adolescence, frequently with social change
• Peer influences
• 2:1 or 1:1 male to female ratio
• Less extreme antisocial behavior
• Less likely to commit violent offenses
• Less likely to persist

Question 171

What’s the developmental course for Early-onset/life-course consistent for CD?

Answer 171

• At least one symptom before age 10
• 10:1 male to female ratio
• 50% persist in antisocial behavior into adulthood
• Aggression in childhood
• Less serious nonaggressive antisocial

Question 172

What are the 3 effective treatments for CD?

Answer 172

• Problem Solving-Skills Training
• Parent Management Training (PMT)
• Multisystemic Therapy

Question 173

What are the 3 critical steps of the Anger coping program?

Answer 173

• Children are taught:
  1) To inhibit early angry and aggressive reactions
  2) To cognitively re-label stimuli perceived as threatening
  3) To solve problems by generating alternative coping responses and choosing adaptive, nonaggressive alternatives

Question 174

What are the different types of protective factors?

Answer 174

• Protective
• Protective-stabilizing -> leads to no changes in wellbeing when exposed to risk factors (even high levels)
• Protective-enhancing -> works even better when risk gets higher (high exposure to stress)
• Protective-reactive -> works but its positive effects become less strong as risk increases

Question 175

Interaction/Moderation

Answer 175

The association between one IV and the DV varies as a function of the other variable

Question 176

3 types of validity

Answer 176

• Convergent validity: are scores on the measure related to other measures or indicators of the same construct
• Discriminant validity: are scores on the measure different from scores of other constructs
• Face validity: does this appear to measure what it is supposed to measure

Question 177

What are behavioural treatments for ADHD?

Answer 177

• Parent management training
• Behavioral classroom management
• Behavioral peer interventions

Question 178

Multimodal Treatment of ADHD (MTA)

Answer 178

Treatments
1. Medication management
2. Psychosocial treatment
3. Combination treatment (medication management + psychosocial)
4. Community treatment as usual

Results:
Combination treatment (medication management + psychosocial) significantly lower symptoms than Psychosocial treatment and TAU

• Moderators of the efficacy of combined treatment and medication only were identified

Question 179

What’s the coercive cycle?

Answer 179

1. Adult makes request
2. Child reacts with hostility
3. Adult reacts with hostility or withdraws
4. Child doesn’t do what was asked
   (positive punishment for parent -> less likely to make request again)

Question 180

The presence of ADHD is associated with what kinds of marked impairment?

Answer 180

• Problems with peers
• School failure
• Mortality

Question 181

What are the core characteristics of ADHD?

Answer 181

• Inattention
• Hyperactivity/Impulsivity

Question 182

Describe inattention in ADHD

Answer 182

• Inability to sustain attention, particularly for repetitive, structured, and less-enjoyable tasks
• If interested in something, may not see as much difference in attention
• Not always global attention deficits

Question 183

Describe hyperactivity/impulsivity in ADHD

Answer 183

• Hyperactivity: inability to voluntarily inhibit dominant or ongoing behavior
• Impulsivity: inability to control immediate reactions or to think before acting

Question 184

What are the 3 subtypes of ADHD?

Answer 184

1. Primarily Inattentive (ADHD-PI)
   * At least 6 inattentive symptoms but fewer than 6 hyperactive symptoms
2. Primarily Hyperactive (ADHD-HI)
   * At least 6 hyperactive symptoms but fewer than 6 inattentive symptoms
3. Combined (ADHD-C)
   * At least 6 inattentive and 6 hyperactive symptoms
   * Age 17 and older –> only need 5 symptoms for each

Question 185

Describe the Primarily Inattentive (ADHD-PI) subtype of ADHD

Answer 185

• Inattentive, drowsy, daydreamy, spacey, in a fog, and easily confused
• May be harder to diagnose because you don’t always see inattention super clearly

Question 186

Describe the Primarily Hyperactive (ADHD-HI) subtype of ADHD

Answer 186

• Primarily hyperactive
• Primarily diagnosed among preschool-aged children

Question 187

Describe the Combined (ADHD-C) subtype of ADHD

Answer 187

• Both inattention and hyperactivity/impulsivity
• Most often referred for treatment
• May be experiencing more impairment on average

Question 188

Describe the categorical VS dimensional issue with ADHD

Answer 188

• DSM treats ADHD as categorical
• Research evidence suggests it’s dimensional
• We all have an underlying level of inattentiveness, hyperactivity and impulsivity -> on a spectrum depending on context and other factors
• DSM criteria shape our understanding of ADHD
• DSM criteria are also shaped by, and in some instances lag behind, new research findings -> 10-year gap between each version of DSM
• Perspective that using these different dimensions (hyperactivity, impulsivity, inattention) may be an oversimplification

Question 189

How do we assess ADHD?

Answer 189

• Symptom rating scales and diagnostic interviews
• Strong focus on observable signs of inattention and hyperactivity/impulsivity
• Parent report
• Teacher report is critical for diagnosis of ADHD -> provide normative framework for placing children’s behavior
• Teachers have a good sense of the breadth of individual differences because work with so many children (better sense of what’s typical and atypical)
• Often do not ask youth (especially younger kids) -> report is not reliable from young children and children with ADHD tend to underreport their own symptoms

Question 190

What kind of interview is used for the assessment of ADHD in youth?

Answer 190

Kiddie SADS –> semi-structured interview

Question 191

What kind of rating scale is used for the assessment of ADHD in youth?

Answer 191

• The SNAP-IV ADHD rating scale (parent/teacher report version)
• Each question maps closely onto each specific symptom
• Children that score higher on each of these are at higher risk of meeting criteria for ADHD diagnosis

Question 192

What happens when we combine reports from parents and teachers of child with ADHD?

Answer 192

• Categorizing of children depends upon how reports from multiple informants is combined
• When you look at parent or teacher alone, you see more diagnoses of PI and PHI
• When parent and teacher are combined using the “or” rule for symptoms (symptom present if identified by either informant) many of those cases become combined (we see a lot more combined type presentations)
• Because different symptoms may be more apparent in certain contexts (ex: more inattentive at school and more hyperactive at home)
• Importance of relying on various informants

Question 193

What’s the “or” rule for symptoms?

Answer 193

• If a parent “OR” a teacher says a symptom is present it will count as present
• Symptom is present if identified by either informant

Question 194

Describe the heterogeneity in ADHD presentation

Answer 194

• Many different presentations of ADHD -> lots of heterogeneity in how people present with ADHD
• Ex: 10 ppl diagnosed with ADHD may display 10 very different symptom presentations -> could be evidence that ADHD is multiple disorders
• Implies there are likely different causes
• DSM-5 shapes our thinking, but lags behind research findings -> as more research comes out, the way we think about the disorder might change

Question 195

What’s Cognitive Disengagement Syndrome?

Answer 195

• Russell Barkley
• There are a subset of individuals who only are inattentive and never in their life are HI (0 symptoms of HI)
• 1/2 of inattentive only people have new attention disorder called sluggish cognitive tempo (now cognitive disengagement syndrome)
• Not treatable the way ADHD is
• Coherent among themselves (CDS symptoms more highly correlated with each other than with symptoms of other disorders, ex: ADHD)
• Form a distinct dimension or set of dimensions of symptoms from those comprising other disorders (ex: ADHD, anxiety and depression)
• Internally consistent (high internal reliability)
• Show reasonable test-retest reliability over short time periods
• Have significant stability and invariance over long periods, from 2-9 years
• Show decent interrater reliability -> comparable low-to-moderate relationships between parent and teacher ratings, as seen in other child psychopathologies
• Evident cross-culturally
• Cognitive disengagement syndrome is not a DSM diagnosis -> cannot diagnose it
• If you’re presenting with symptoms of CDS, according to the DSM you should get diagnosed with ADHD

Question 196

Describe Karalunas et al. (2019) research on an irritable subtype of ADHD, inspired by RDOC

Answer 196

• Looking at how neurobiology and temperament are associated with ADHD
• Looking at diff aspects of RDOC and looking for subgroups of people with ADHD based on their symptom presentation and their temperament
• Found 3 groups of individuals:
• Mild group (near the mean across everything -> typical temperament and behaviour characteristics)
• Group high in surgency (high in positive affect)
• Irritable sub-group -> implying there may be a sub-group of people with ADHD that are especially high in irritability
• Looking beyond DSM criteria and seeing what other domains of behaviour and characteristics may be associated with ADHD
• Did a network analysis of people based on all of the same criteria
• Showed that people with irritable sub-types were very associated with each other or similar to each other and very different from people in other clusters
• Conclusion: If we add this aspect of irritability, we may be able to further differentiate between diverse symptom presentations among people with ADHD
• There is no official irritability subtype for ADHD in DSM-5-TR -> cannot diagnose it

Question 197

What are some behavioural treatments for ADHD?

Answer 197

• Parent management training
• Behavioral classroom management
• Behavioral peer interventions

Question 198

What are some cultural and contextual differences in ADHD?

Answer 198

• Children in many cultures and countries meet diagnostic criteria for ADHD
• Slightly more prevalent among children living in poverty (lower SES communities) -> could be due to less access to adequate nutrition, increased exposure to different stressors
• Racial differences not clear (+ complicated by fact that minority groups overrepresented among low SES communities)
• Hyperactivity might be considered more problematic or impairing in certain cultures relative to others -> ex: in cultures that prioritize harmony and fitting in

Question 199

How do ADHD diagnostic rates vary by gender?

Answer 199

• 3 boys:1 girl ratio in community
• 6 boys:1 girl ratio in clinics
• Because boys tend to have symptom presentations that make them more likely to get referred
• Boys more likely in the HI or C type are doing things more outwardly apparent and impairment is more clear -> much more likely to be referred to the clinic
• In community samples, boys are more likely than are girls to be diagnosed with all subtypes of ADHD, but the gap is wider for ADHD-C and ADHD-HI than it is for ADHD-PI
• We don’t see the same differences in presentation between boys and girls in clinically referred samples
• Easier to see differences in gender in school settings (little difference in clinical settings)

Question 200

What’s the developmental course of ADHD?

Answer 200

• Heavily genetically weighed -> strong genetic biological basis
• Infancy -> “should” be present at birth, but no reliable and valid measures to assess symptoms below age 3
• Preschool -> start having better tools to assess/diagnose children with ADHD, if symptoms last for about a year, child is likely to continue to have challenges
• Early problems tend to lead to continued problems throughout childhood and adolescence
• Elementary school -> inattention becomes more noticeable because of our expectations (still less apparent than hyperactivity/impulsivity)
• Outward hyperactivity might continue to decline slightly -> still higher than most without ADHD

Question 201

What’s the prognosis of ADHD?

Answer 201

• Previously thought that symptoms of ADHD resolved in adolescence -> that people grow out of it
• 5+ prospective studies have shown that pre-adolescents who meet criteria for a diagnosis of ADHD have higher rates of ADHD symptoms in early adulthood (ages 21-27) compared to youth who don’t have ADHD, after accounting for related factors
• Increasing work has shown that this is not necessarily true and that people with ADHD continue to have functional impairments past the period of adolescence and into adulthood
• People with ADHD as kids don’t fully resemble non-adhd kids when they’re both adults
• About 1/3 of children diagnosed with ADHD will continue to meet criteria for ADHD in adulthood
• The other 2/3 may experience sub-threshold/sub-clinical levels of ADHD symptoms

Question 202

What are the core features of Disruptive Behavior Disorders?

Answer 202

• Age-inappropriate actions and attitudes that violate family expectations, societal norms, and personal or property rights of others
• Can range from minor/annoying behaviours (talking back to parents) to more severe acts (ex: assault)
• 2 diagnoses: Oppositional Defiant Disorder (ODD) & Conduct Disorder (CD)

Question 203

What’s the difference between overt, covert, destructive, and non-destructive behaviours?

Answer 203

• Overt: apparent and easy to see (ex: stubbornness or assault)
• Covert: not as apparent (ex: running away)
• Youth that engage in more overt and destructive behaviours are at higher risk of developing behavioural problems later on

Question 204

Describe sibling conflict

Answer 204

• Fighting between siblings is common
• During preschool years, siblings fight once every 10
  mins
• Mounting evidence that sibling aggression is harmful
• Sibling conflict, hostility, and negativity uniquely predict greater emotional and behavioral problems over time
• Conflict with siblings may lead to maladaptive behavior problems in other relationships

Question 205

Describe how the CD With Limited Prosocial Emotions specifier is assessed

Answer 205

• Clinical Assessment of Prosocial Emotions (CAPE1.1 - 2020)
• Interview measure -> semi-structured interview
• Need multiple information sources

Question 206

Can you have CD and ODD?

Answer 206

• In DSM-IV, CD subsumed ODD
• In DSM-5, they can be diagnosed at the same time
• If you’re presenting with symptoms of both, you can be diagnosed with both
• Nearly 1/2 of all children with CD have not been diagnosed with ODD
• ~50% of children with ODD do not progress to more severe CD
• Some do –> may start with ODD diagnosis then add CD diagnosis with age
• Often ODD behaviours developmentally precede CD

Question 207

Describe the prevalence of CD and ODD

Answer 207

Lifetime prevalence:
- ODD – 12%
- CD – 8%
- Ontario Child Health Study Sequel
- 6 month prevalence of ODD is 7.5%
- 6 month prevalence of CD is 1.3%
- ODD more common than CD

Question 208

Describe the cultural and contextual characteristics of prevalence for CD and ODD

Answer 208

• Cultural and contextual differences
• Strongly associated with poverty
• Strongly associated with exposure to violence
• “Concerns have been raised that the Conduct Disorder diagnosis may at times be misapplied to individuals in settings where patterns of undesirable behavior are sometimes viewed as protective (ex: threatening, impoverished, high crime)…a Conduct Disorder diagnosis should only be applied when the behavior in question is…not simply a reaction to the immediate social context” DSM-IV-TR
• If only responding to specific harmful environment, but symptoms aren’t present outside of that environment -> no diagnosis (could just be survival response)

Question 209

What’s social causation?

Answer 209

Stress of poverty leads to an increase in childhood psychopathology

Question 210

What’s social selection?

Answer 210

Families with genetic predisposition drift down towards poverty

Question 211

Describe Costello et al. (2003) Great Smoky Mountains study on poverty and disruptive behavior

Answer 211

• Longitudinal study of epidemiology of childhood psychiatric disorder
• Significant positive association between poverty and disruptive behavior -> often we find that people of lower SES are higher along these factors that lead to psychopathology
• Sample included a significant number of Indigenous youth, many of whom lived on a reservation
• During the study, a casino opened on the reservation
• All indigenous participants’ families got a stipend
• Led to 4 groups: persistently poor (poor before and after casino opened), ex-poor (poor before casino but after casino opened they weren’t poor anymore, had the means to acquire resources needed), never poor, newly poor (excluded because of small number)
• Naturally-occurring experiment allowed for test of 2 competing theories:
• Social causation theory -> increase in income should reduce children’s symptoms - Social selection theory -> increase in income should have no effect on children’s symptoms

Question 212

Describe the findings for Costello et al. (2003) Great Smoky Mountains study on poverty and disruptive behavior

Answer 212

• Found that youth whose families were no longer poor due to the stipend from the casino (ex-poor) reported decrease in disruptive behaviors
• Results support social causation theory

Question 213

Why is poverty associated with Disruptive Behavior Problems?

Answer 213

• Examined possible mediators of the association between increase in income and decrease in behavioral symptoms
• Found that increased parental supervision fully mediated relationship
• Increased income -> improved parental supervision -> fewer disruptive behaviour problems
• Increases in income gave them more resources to free up their time and energy which led to them being able to spend more time with children and give more supervision

Question 214

Describe gender differences in Disruptive Behavior Disorders

Answer 214

• Conduct problems are 2-4x more common in male children
• Smaller differences in early teens
• Early-onset persistent CD:
  10 male: 1 female ratio
• Adolescent-limited CD:
  2 male: 1 female or no gender difference