Midterm Flashcards
K-3 paradigm for diagnostic purposes
knowledge of theories
knowledge of development
knowledge of contexts
knowledge of theories
developmental psychopathology
maladaptive behavior is viewed in relation to what is considered normative for a given developmental period
4 major theoretical approaches
attachment theory
cognitive theories (CB theories/dev. of schemas)
emotion theories → emotional regulation
neurobiological theories
2 overarching objectives of psychiatric genetics
- determine variability in bx traits into portions accounted by genetics, environmental, or both
- identify specific alleles that make a person more vulnerable to psychopathology
3 laws of behavioral genetics
- all human bx traits are heritable
- effects of being raised in the same family are smaller than genetic effects
- a substantial portion of variation in bx traits is not accounted for by genes or environment
gene-environment correlation
parent’s heritable traits affect children’s exposure to adverse environments
OR
children’s heritable traits affect their own exposure to adverse environments
vulnerability factors
chronic poverty
parental psychopathology
homelessness
decreased financial resources
parental conflict/breakup
perinatal stress
protective factors
positive self-esteem
high self-efficacy
close relationship with at least one person who is attuned to the child’s needs
a talent/hobby that is valued by adults
community members/peers
attractiveness
easy temperament
early coping strategies
high intelligence
6 core strengths (Perry, 2002)
attachment - capacity to form healthy emotional bonds with others
self-regulation - ability to notice and control primary urges such as hunger and sleep, as well as frustration, anger and fear
affiliation - capacity to join others and contribute to a group
attunement - recognizing the needs, interests, strengths and values of others
tolerance - the capacity to understand and accept how others are different from you
respect - appreciating the worth in yourself and in others
the brain develops in hierarchical order from:
brainstem
midbrain/diencephalon
limbic
cortex
two types of neuroplasticity
functional: rewiring from damaged area
structural: change physical structure as a result of learning
3 neurological responses to stress
- sympathetic adrenal medulla (SAM) activation (ANS)
- amygdala-locus coeruleus activation (CNS)
- hypothalamic activation (CNS)
sympathetic adrenal medulla activation (SAM)
occurs in the autonomic nervous system (ANS)
produces epinephrine and norepinephrine. these are critical for initiating the fight-or-flight response.
amygdala-locus coeruleus activation (LC)
response to stress, fear, and attention regulation. It plays a key role in threat detection, arousal, and autonomic nervous system activation.
hypothalamic activation
occurs in the CNS
sensory relay through the hypothalamus
regulate stress response
excites the HPA axis
Nervous systems in response to stress:
ANS: controls involuntary body functions like heart rate, digestion, breathing, and stress responses. the two branches are SNS and PNS.
SNS: “Fight or Flight” - Activates in response to stress or danger. Increases heart rate, blood pressure, and breathing rate.
PNS: “Rest and Digest” - Helps the body return to normal after stress.
3 main biological functions of the stress response system
to coordinate an individual’s response to stress
to encode and filter information from the environment
regulate a range of experiences and traits
glucocorticoids
Released during stress as part of the HPA axis (Hypothalamic-Pituitary-Adrenal axis).
Cortisol is the primary glucocorticoid, helping the body manage stress by increasing energy availability and suppressing non-essential functions.
dissociative continuum
hyperarousal – dissociation
child’s response to persistent threat
freezing
cognitive flooding that causes shutdown
can be interpreted as being oppositional, which increases anxiety and intensifies the response
dissociation
another response to fight-or-flight
ability varies individually
dissociation in young children
numbing, compliance, avoidance, and restricted affect
dissociation in older children
report going to a different place, assuming the persona of heroes, a sense of watching a movie, or floating
two distinct mechanisms of child maltreatment
direct injury
mediated through stress pathways
proprioception
components of muscles, joints, and tendons that provide awareness of body position
process information about body position and body parts
vestibular functioning
structures within the inner ear that detect movement and changes in position of the head
processes information about movement, gravity, and balance
interoception
sense of the internal state of the body that is both conscious and unconscious
includes sense of self, thought, emotion, and self-regulation
stimulus attributes
modality
intensity
duration
location
symptoms of dysfunction in the tactile system
avoiding/craving touch
food/clothing preferences
aversion/craving to washing, brushing teeth, clipping nails
hypo/hypersensitive to pain
self-imposed isolation
symptoms of dysfunction in the vestibular system
hypersensivity: fearful of ordinary movement, fearful of uneven surfaces, clumsy in appearance)
hyposensitivity: actively seeks out very intense sensory experiences
symptoms of dysfunction in the proprioceptive system
clumsiness/accident prone
lack of awareness of bodily needs
difficulties with body awareness
odd body posturing
difficulties with motor planning
hyper-reactive children
tend to have sympathetic nervous system bias
high arousal, inability to focus attention, negative affect, impulsive/defensive action
may engage in sensory-based activities that they find organizing in attempt to manage hyperactivities
sensory avoiders
sympathetic nervous system bias
withdraw from excitatory input
often go unnoticed
affect is frequently fearful or anxious
may use stereotyped behavior to protect against too much stimulation
hyporeactive children
parasympathetic system bias
usually go unnoticed
decreased state of arousal
flat and restricted affect
appear bored and uninvolved
sensory seekers
parasympathetic system bias
actively pursue excitatory sensory input
hard to achieve and maintain sensory homeostasis
heightened but labile arousal
variable affect
3 central characteristics of SPD (sensory processing disorder)
1) maladaptive behaviors, 2) sensory processing difficulty, and/or 3) motor difficulty:
over or under-reactivity to high- or low-pitched tones, bright lights or new and striking visual images, odors, temperature
tactile defensiveness and/or oral hypersensitivity
oral motor difficulties or poor coordination and/or tactile hypersensitivity
under-reactivity to touch or pain
gravitational insecurity
developmental coordination disorder (DCD)
acquisition and execution of motor skills is below expectations for developmental level
interferes with daily functioning
not better explained by intellectual disability or neurological condition
ASD
deficits in social communication and social interaction across multiple contexts
restricted, repetitive patterns of behaviors, interests, or activities
social communication disorder
persistent difficulties in the social use of verbal and nonverbal communication
social emotional competence
awareness of own and other’s emotional state
emotional use of words
ability to cope with emotional distress
ability to attend to the reactions of others
theory of mind
capacity to imagine or form opinions about the cognitive states of other people
crediting beliefs, aims, and wishes to other people in effort to foretell their actions
language and communication difficulties in ASD
50% remain mute
85% have echolalia
difficulties with personal pronouns
irrelevant details
unexpected shifts in conversation
double empathy problem (ASD)
ASD individuals interact better with other ASD individuals and tend to have relationships with them → higher likelihood of passing it on
John Bowlby: the goal of attachment is to..
keep close to a preferred person in order to maintain a sense of security
transactional model
child-parent transactions are key to attachment and development
functions of attachment
provides a sense of security in the world
facilitates regulation of affect and arousal
expression of feelings and communication
provides a base of operation for exploration
interactive play
infants imitate and initiate interactions to engage parents
relationship is used for communication
importance of vision
central to neurobiology of attachment
mother’s face is a critical stimulus
Mary Ainsworth
developed the Strange Situation procedure
discovered that infant response after mother returns to the room is the most sensitive indicator for attachment
factors that influence parental responsiveness
caregiver’s early experiences
risk factors (mental illness, substance abuse, etc.)
if caregiver has outside support from other adults
types of attachment
secure, avoidant, ambivalent, disorganized
secure attachment
70% of kids
happy to see mom, moved close to her
calmed quickly when soothed
explored room when mom was present, stopped when she left
expressed feelings openly after reunification
avoidant attachment
15% of kids
not distressed when mom left, ignored her when she came back and avoided contact
more hostility and unprovoked aggression, doesn’t ask for help, will sulk and withdraw
ambivalent attachment
15% of kids
intense reaction when separated, desperate for contact upon return but also resisting it
angry at mom’s inconsistency
preoccupied w attachment instead of exploring, unassertive, bx inhibition, poor social skills
disorganized attachment
<4% of kids
contradictory bx when reunited, may be afraid of caregiver
can’t self regulate
poor self-confidence, dissociation, more aggression, poor social skills
cross cultural attachment
rates of secure attachment is between 65-70% across cultures
rates of other types vary depending on cultural practices
reactive attachment disorder (RAD)
pattern of inhibited, avoidant social behaviors and reluctance to seek or respond to attention or nurturing
indiscriminate sociability
wandering off without distress
approaching strangers and going off with them without checking back with parent
not being shy or being overly friendly with new adults
disinhibited social engagement disorder (DSED)
pattern of overly familiar and culturally inappropriate behavior with relative strangers, due to social neglect or deprivation
treatment resistant
problems with behavioral inhibition are linked to ___________ disorders
externalizing
lack of attentional control has been linked to _____________ disorders
internalizing
differences in the maltreated brain
smaller right temporal, right frontal, and bilateral parietal lobes
larger volumes in right posterior cingulate and white matter in the cerebellum causing overdeveloped pathways
20% less working memory
8 point loss in VIQ and 10 point loss in PIQ
trauma treatment implications
must access brain at level of trauma
must focus on area of dysregulation
must be compatible with brain level
must be hierarchical
4 major types of maltreatment
neglect, physical abuse, sexual abuse, emotional abuse
PTSD Criterion
A: stressor
B:intrusion symptoms
recurrent memories, distressing dreams, dissociative reactions, psychological distress, physiological reactions
C: avoidance
D: negative alterations in cognitions and mood
E: alterations in arousal and reactivity
PTSD with no treatment in adults vs. children
adults: symptoms lessen over time
children: no change
time skew
child mis-sequences trauma related events when recalling the memory
omen formation
belief that there were warning signs that predicted the trauma
children often believe that if they are alert enough, they will recognize warning signs and avoid future traumas
Why is important to study child and adolescent psychopathology?
Disorders of childhood often show significant continuity with later childhood disorders, they may also be found in adult disorders, a lot of child disorders are comorbid with anxiety and mood
Contextual influences
Child as context - unique child characteristics, predictions and traits influence the course of development
Child of context - child comes from a background of interrelated family, peer, classroom, teacher, a school, community and cultural influences
Child in context - child is a dynamic and rapidly changing entity, and that descriptions taken at different points in time or in different situations may yield very different info and results
Epigenetics
the study of changes in how genes work without changing the DNA sequence itself. It’s like a light switch that can turn genes on or off. These changes can be influenced by things like environment, experiences, and lifestyle, and they can sometimes be passed down to future generations.
Bruce Perry’s hierarchy of brain function (brain development)
Top: NeoCortex: Abstract and concrete thought
Limbic: sexual behavior and emotional reactivity
Midbrain: appetite, sleep
Brainstem: blood pressure, heart rate and body temperature
Neuroplasticity
younger brain more malleable
involves several processes: neurons, glial
changes happen due to experience (can be positive or negative)
other parts can assume role of damaged parts
interaction between environment and genetics important
two types: functional (moving functions from damaged parts of brain to a different part) vs. structural (INSERT)
Brainstem
Started at the low point (blood pressure, heart rate, body temperature)
Diencephalon/Midbrain
motor regulation, arousal, appetite, sleep
Limbic System
attachment, sexual behavior, emotional reactivity
Neocortex
last to fully develop, abstract and concrete thinking, affiliation/reward
4 nervous systems
Central Nervous System (CNS): controls and processes information from the body.
Autonomic Nervous System (ANS): controls automatic functions like heartbeat and digestion, reacting to how the body interacts with the environment.
Parasympathetic Nervous System (PNS): helps the body relax and return to a calm state, especially when there’s no threat (rest and digest).
Sympathetic Nervous System (SNS): kicks in during stress or danger, preparing the body for “fight or flight” by increasing heart rate and alertness.
The stress response and HPA systems
The stress response has two parts:
SAM System: Kicks in quickly, releasing adrenaline for immediate action (fight or flight).
HPA System: Activates later, releasing cortisol to manage longer-term stress.
When does SAM (sympathetic adrenal medulla activation) branch out?
When stress happens, the SAM system kicks in quickly, releasing adrenaline to prepare your body for immediate action. The HPA (Hypothalamic-Pituitary-Adrenal Axis) activates later, releasing cortisol to help your body deal with longer-term stress. Both systems work together to handle stress.
Short term stress responses
Release of adrenaline or cortisol that will do all of these things internally to become more alert, or a stressor that is non-life threatening
Long term stress response
Really hard on the body, when there is repeated exposures to stress, no way to shut off that stress response ex: kids living in abusive home
ANS sympathetic nervous system response to stress
Increased arousal via the release of hormones (dopamine, acetylcholine and norepinephrine) this leads to higher levels of norepinephrine and epinephrine, which prepare your body for action, increasing heart rate, blood pressure, and energy levels.
What happens after a stressor starts?
When a stressor happens, your brain quickly sends signals to your body. This activates the “fight or flight” system, which releases hormones like adrenaline to make your heart beat faster, increase your alertness, and get your body ready to act. The body also releases cortisol to help manage the stress longer. After the stress is over, your body works to calm down and return to normal.
What happens to the acute stressors in short term ?
For short-term acute stressors, your body reacts quickly to help you handle the situation. The “fight or flight” response is triggered, releasing hormones like adrenaline and cortisol.
What happens to long term stressors?
Long-term stress keeps the body on high alert. The brain’s stress system sends signals to the hypothalamus, which helps control the stress response. The hypothalamus then tells another part of the brain (the pituitary) to send signals to the adrenal glands, which release stress hormones like cortisol.
Parasympathetic Nervous System (PNS)
It helps the body relax and recover by slowing down heart activity, improving focus, and allowing the brain’s prefrontal cortex to regulate these processes.
Vagal withdrawn
PNS reduces its calming influence on the body. This allows the sympathetic nervous system (SNS), which is responsible for the body’s “fight or flight” response, to act more strongly and cause increased heart rate, blood pressure, and alertness.
What helps the vagus nerve help the parasympathetic nervous system?
Pressure points
Central Nervous System (CNS)
Controls and coordinates the body’s functions, process and send instructions to the rest of the body
HPA system
a group of interactions mainly between the pituitary gland, amygdala, hippocampus, and hypothalamus. These areas work together to control the body’s response to stress, including releasing hormones that help manage how we react to challenges or threats.
Adaptive calibration model summary suggests that the stress response system (SRS) has 3 main biological functions
A. To coordinate an individuals response to stress
B. To encode and filter information from the environment
C. Regulate a range of experiences and traits
What is more experience dependent region of the brain?
Cerebellum, we need this to work effectively so we can use it as building blocks to get to higher order functioning
Neurodiversity (the natural diversity of humans)
The fact that all human beings vary in the way our brains work, process information differently and behave differently
Neurodivergent
A person whose brain functioning differs from what is considered “normal” (what most people do)
Neurotypical
A person whose brain functioning is considered “normal”
What does the sympathetic system do to your body?
Raises your heart rate and gets your body ready
What does the parasympathetic system do to your body?
Calms your body down
Dunns model of sensory processing (2007)
explains how people respond to sensory information based on two main factors: neurological threshold and behavioral response strategy
High Threshold (H): Individuals with a high threshold need a lot of sensory input to notice or respond. They may not easily detect sensory stimuli and might seem unresponsive.
Low Threshold (L): Individuals with a low threshold react quickly and strongly to sensory stimuli. They may be easily overwhelmed by sensory input.
Passive Response (P): The person does not try to change their sensory experience; they let stimuli happen as they come.
Active Response (A): The person actively seeks out or avoids sensory input to control their experience.
Low Registration (HP): High sensory threshold and low self-regulation—may not notice sensory input easily and may struggle to respond appropriately. (hypo-reactive)
Sensory Seeking (HA): High sensory threshold but high self-regulation—actively seeks out more sensory input because they need more stimulation.
Sensory Sensitivity (LP): Low sensory threshold and low self-regulation—easily notices sensory input and reacts strongly to it. (hyper-reactive)
Sensory Avoiding (HA): Low sensory threshold and high self-regulation—overly sensitive to sensory input and tries to avoid it.
What are the levels of autism?
1: requiring support
2: requiring substantial support
3: requiring very substantial support
DSED (Disinhibited Social Engagement Disorder) and RAD (Reactive Attachment Disorder) Differences:
children with DSED exhibit overly friendly and indiscriminate social behavior towards strangers, whereas children with RAD show social withdrawal and difficulty forming attachments with caregivers, often failing to seek comfort when distressed
