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Child and Adolescent Psychopathology > Midterm > Flashcards

Midterm Flashcards

1
Q

Multifinality

A

one event can lead to many outcomes eg. not all victims of CSA develop PTSD

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2
Q

Equifinality

A

multiple causes can lead to the same outcome

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3
Q

Etiology

A

cause of a disease or condition

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4
Q

Nosology

A

branch of medicine dealing with classification

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5
Q

Epidemiology

A

branch of medicine dealing with incidence, distribution, and control of diseases

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6
Q

Prevalence of child/adolescent mental health problems

A

50% of mental illness sets in by age 14, 75% by age 24
Of 14-18 yr olds, - 32% have anxiety
15% have depression
49% meet criteria in DSM for at least one mental illness
27% have a severe disorder

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7
Q

ACE’s

A

Adverse Childhood Experiences
50% of children have at least one
ACE score of 4 risks dying early, suicide attempts, depression, STIS

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8
Q

Galen

A

humoral theory

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9
Q

John Locke

A

tabula rasa, raise children with care, parents have all the control over how the child turns out

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10
Q

Jean-Marc Itard

A

studied Victor the Wild Child=> critical periods for development

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11
Q

Phillippe Pinel

A

father of French psychiatry, free people from mental institutions, moral treatment

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12
Q

Ben Rush

A

American, reform for mentally ill, progressive

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13
Q

Dorothea Dix

A

teacher and social reformer, 32 humane mental institutions

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14
Q

Freud

A

psychoanalysis, talk about feelings, first to say mental illness is not inevitable

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15
Q

Health paradox of adolescence

A

Peak strength, smarts, health, etc. BUT get sick more and die more than people older and younger

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16
Q

Freud’s theory of development

A

oral, anal, phallic, latency, puberty

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17
Q

Mahler’s theory of development

A

(separation and individuation from parents) normal autism, symbiosis, differentiate, practicing subphase, rapprochement, object constancy

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18
Q

Erikson’s theory of development

A

stages of psychosocial development depending on important conflicts eg. infant as trust vs mistrust

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19
Q

Piaget’s theory of development

A

(cognitive errors) sensorimotor, preoperational, concrete operational, formal operational

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20
Q

risk factors for mental health

A

1 Poverty; about 30% genetic; 70% socioeconomic(good doctors and hospitals, economic stability, education, community, neighborhood)

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21
Q

resilience factors for mental health

A

emotional regulation and self efficacy increase the ability to cope with stress

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22
Q

Mild Intellectual Disability

A

Previously referred to as “educable”
Largest segment of those with ID (85%)
Typically develop social/communication skills during preschool years and have minimal impairment in sensorimotor areas, often indistinguishable until a later age (by late teens will acquire skills up to approx the 6th grade level)

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23
Q

Moderate intellectual disability

A

“Trainable”
10% of ID
Learn Communication skills during early childhood
Will generally benefit from social/vocational training and with moderate supervision can attend to personal care
Difficulties recognizing social conventions which interferes with peer relations in adolescence
Unlikely to progress beyond the 2nd grade academically
Often adapt well to life in the community in supervised settings (performing unskilled or semiskilled work)

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24
Q

Severe intellectual disability

A

3-4% of people with ID
Acquire little/no communicative speech in childhood; MAY learn to talk later on
Can master sight reading “survival” words
Able to perform simple tasks as adults in closely supervised settings
Most adapt well to life in the community, living in group homes or with families

25
Q

Profound intellectual disability

A

1-2% of people with ID
MOST HAVE IDENTIFIABLE NEUROLOGICAL CONDITION THAT ACCOUNTS FOR IT
Considerable impairments in sensorimotor functioning
Optimal development may occur in a highly structured environment

26
Q

Down’s syndrome

A

Most common chromosomal abnormality leading to an ID
Nondisjunction of chromosome 21
Relative strengths:
Visual (vs auditory)
Social functioning
Relative weaknesses:
Language expression and pronunciation
Generally viewed to suffer less severe psychopathology than other developmentally delayed groups
After about 40 yrs of age, affected individuals nearly always demonstrate postmortem neuronal defects indistinguishable from Alzheimer’s Disease
Females have better cognitive abilities and speech production compared to males
Males have more behavioral troubles

27
Q

Fragile X Syndrome

A

Fmr-1 gene
An example of a “dynamic mutation” where more mutations occur with successive generations
Only 50% of females with the full mutation demonstrate IQs in the borderline/mild ID range vs 100% of males
Increases the risk for ADHD and autism and social phobia
Increasing deficits in adaptive and cognitive functioning with age
Relative strengths: verbal long-term memory
Weaknesses: short term memory, integration, sequential processing math and attention

28
Q

Fetal Alcohol Syndrome

A

More than 1 in 1000
Irritable as infants and hyperactive as children ADHD
Teratogen amount: 2 drinks/day (smaller birth size), 4-6 drinks/day (subtle clinical features), 8-19 drinks/day (full syndrome)
General problems: prenatal onset of growth deficiency, microcephaly, short palpebral fissures
Syndrome can include: facial deformities (like cleft lip and protruding ears), CNS deformities, NECK deformity, Cardiac deformities, and other abnormalities

29
Q

Prader-Willi Syndrome

A

Deletion in chromosome 15
Infantile hypotonia(decreased muscle tone), hyperphagia (food seeking), morbid obesity, small hands and feet, mild to moderate ID
Relative stability in adaptive functioning
Relative Strengths:
Expressive vocabulary, LT memory, visual/spatial integration and visual memory and unusual interest in jigsaw puzzles
Relative Weaknesses
Tantrums, emotional lability, mood symptoms, anxiety, skin picking, OCD in more than 50%

30
Q

Angelman Syndrome

A

Severe ID, seizures, ataxia and jerky arm movement (puppet-like gait), absence of speech, and bouts of laughter
Deletion in chromosomes 15
In contrast to PWS, all identified cases of deletion traces to maternal chromosome 15 (illustrating genomic imprinting)

31
Q

Williams Syndrome

A

Id, supravalvular aortic stenosis “elfin-like” facies, infantile hypercalcemia, and growth deficiency
Deletion of elastin gene
Relative strengths:
Remarkable facility for recognizing facial features
Loquacious, psuedo-mature “cocktail party speech”
Relative weaknesses:
Adhd, anxiety

32
Q

Major findings from the MTA study

A

Multimodal treatment study
Largest randomized control trial ever of psychiatric disorder
Kids between 7 and 9yr 9mo
Treatment arms: RX, behavior therapy, combined, community control
Lasted 14mo
Medication is better for core symptoms
med=behavioral for social skills, peer socio ratings, academic, classroom observed beh
Combination the best

33
Q

Factors important in making a convincing diagnosis of ADHD

A

Tests
No single test
Diagnostic must be multifactorial
CPT: continuous performance test
Use stroop and mazes, statue test(not diagnostic, but ADHD kids tend to do worse)
Clinical interview
Talk to family, teachers, other interview(MORE important than other )
Must have some symptoms by age 12
Rating scales(Conners, SNAP)
Treatment trial: give medicine, if you respond well you have ADHD
Never diagnose in 1on1 interview(ADHD kids often do well 1on1)
Symptoms often show in group settings

34
Q

Age, gender, and race related differences in ADHD

A

Latino and black children are less likely to be diagnosed by parent report
Children without insurance receive less attention in all domains
Black children are less likely to receive stimulants

35
Q

Impairments in executive functioning with ADHD

A

Goal directed behaviors, including strategic planning,
Parents sometimes have to be prefrontal cortex for child
Do not lack empathy, just over it quickly
Neuropsych testing shows where deficits are
Inhibition of responses

36
Q

Brain areas implemented in ADHD

A

Group data only– brain scans are not for individual child, cannot be used to diagnose
Numerous imaging studies say: caudate nucleus and globus pallidus affected
Command center(prefrontal cortex) is smaller
posterior(coordination) affected
Prefrontal cortex takes 5 years longer to develop than NT(no filter, emotionally immature)
Not enough dopamine in receptors, adderall with increase dopamine

37
Q

History of DSM & major differences between versions

A

DSM I- did not have biological cause, considered “reactions”
DSM II- breif descriptions of symptoms but no diagnostic criteria
DSM III- provides diagnostic criteria, has separate section for childhood disorders, more reliable, removes homosexuality
DSM IV- refined diagnostic criteria, gave background info, added Asberger’s, ADD=>ADHD, multiaxial system
DSM V- move away from categorical diagnosis and towards dimensional diagnosis, recognize crossover, cross cultural understanding

38
Q

What causes death and disability in adolescence

A

accidents, suicide, homicide

39
Q

Maturation of brain neural tracks & networks

A

as an adolescent, develop more synapses, which are pruned when transitioning to adulthood, grey matter=potential, white matter=mylienated

40
Q

Neonatal/childhood differences between males and females

A

girls: more internalizing problems, resilience comes from a female caregiver, get a rush from talking, more interested in faces, brains mature faster
boys: externalizing problems, need a male role model, use fewer words than girls, more testosterone=> growth of amygdala(aggression), more interested in objects

41
Q

Adolescent risk taking behavior & why it occurs

A

striatum(love, anger jealousy) doesn’t mature as fast as the PreFrontal Cortex(CEO of brain that makes decisions)
dopamine, oxytocin

42
Q

History of present illness (what is addressed?)

A

all areas of life= current difficulties, recent stressors, neurovegitative status(sleep, energy), attention and concentration, appetite, medical history, family history, prior evaluations and treatment

43
Q

Major diagnostic categories to consider

A

PAM ATE A PEST: psychosis, anxiety, mood, ADHD, tics, externalizing disorders, PDD, eating disorder, self injurious behavior, trauma

44
Q

Components of the mental status exam

A

background info, behavioral info and observations, tests, summary, recommendations

45
Q

Biopsychosocial assessment (what is the purpose and what is included?)

A

biological psychological and social aspects, can explain why symptoms are happening

46
Q

Intelligence scales (most common)

A

Most common: Weschler scales- divided by age
Other common tests:
Stanford-Binet Intelligence Scale
Kaufman Assessment Battery for Children
Woodcock-Johnson Tests of Cognitive Ability

47
Q

IQ vs. Achievement Tests (describe the difference)

A

IQ: predict school achievement, relatively unchanging, descriptive, influenced by heredity and environment
Achievement: measure current knowledge, directly affected by what the child has already learned
if they are very different, there may be an achievement gap

48
Q

Identify the purpose of neuropsychological assessments & why you would do one

A

for learning and cognitive disability, normed and comprehensive, used if parents question the child’s academic achievement or if teachers have concerns

49
Q

Domains assessed with neuropsychological testing

A

explain intelligence-academic gap
explain variability between tests
recommend specific accommodations
can test motor skills, executive functioning, perception, language, memory

50
Q

IDEA, U.S. Public Law 101-476

A 
individuals with disabilities education act, access bill: every disabled child must have access to
Free Appropriate Public Education
Appropriate Evaluation
Individualized Education Plan
Least Restrictive Environment
Parent Participation
Procedural Safeguard
51
Q

DSM diagnostic categories for learning disability

A

tests of reading, writing and math ability substantially (2 SD) below age, schooling and intelligence
specific, not attributable to intelligence or other developmental disabilities

52
Q

dyslexia

A

Specific learning disorder with impairment in reading, distortion submissions and omissions of words, affect 4% of kids, 60-80% are boys, can be caused by problems in decoding or comprehension

53
Q

decoding

A

tool that enables students to become proficient readers, sight words, reading rate and accuracy

54
Q

Factors that influence reading development

A

general intelligence, vocab, reasoning, concept formation, development of phonemic awareness and alphabet, automation of words

55
Q

Broca’s versus Wernicke’s Areas

A

Broca- motor expression in speech, production issues

Wernicke- understanding audible speech, comprehension issues

56
Q

History of ADHD

A 
"fidgety phils"
DSM II- hyperactivity syndrome
DSM III- ADD + diagnostic criteria
DSM IIIR- ADD becomes ADHD
DSM IV- add subtypes
57
Q

Diagnostic and functional criteria of ADHD

A

18 symptoms, must have at least 6, some present before age 12, must be cross situational, persists for at least 6 months, social/academic/occupational impairment, inattentive, hyperactive/impulsive, or combined type

58
Q

Symptoms and prevalence of ADHD and subtypes

A

3-7% of kids in the US(most commonly diagnosed behavioral disorder in childhood)
Inattention:
Makes careless mistakes/poor attention to detail
Difficulty sustaining attention in tasks/play
Does not seem to listen when spoken to directly
Difficulty following instructions
Difficulty organizing tasks/activities
Avoids tasks requiring sustained mental effort
Loses items necessary for tasks/activities
Easily distracted by extraneous stimuli
Often forgetful in daily activities
Hyperactive/impulsive:
Fidgets
Leaves seat
Runs or climbs excessively (or restlessness)
Difficulty engaging in leisure activities quietly
“On the go” or “driven by a motor”
Talks excessively
Blurts out answers before question is completed
Difficulty waiting turn
Interrupts or intrudes on others

59
Q

Natural history of ADHD

A

Rule of “thirds”:
1/3  complete resolution
1/3  continued inattn, some impulsivity
1/3  early ODD/CD, poor academic achievement, substance abuse, antisocial adults
symptoms present differently as age changes

Child and Adolescent Psychopathology (2 decks)

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