module 12 Child and Adolescent Onset Flashcards
Attachment – Bowlby
Observed children in orphanages after WWII
Attachment: a secure bond, initially usually mother-infant,
beginning with nursing
Attachment – Harlowe
Experiments w/rhesus monkeys
separated from their mothers after
birth
Monkeys preferred cloth
covered surrogate (substitute)
mothers over wire ones they
received nourishment from
Attachment - Ainsworth
Strange Situation Task
Secure: upset when M leaves; becomes positive upon
return
Avoidant: not distressed by M leaving; disinterested in her
return
Anxious/ambivalent: upset when M leaves;
angry/ambivalent upon return
Later, others added 4th pattern: disorganized/controlling
(with or without M)
Attachment patterns –>
related to later
psychopathology
Secure-protective
associated w/successful
responses to stress
Avoidant
associated w/aggressiveness in
middle childhood
Anxious/ambivalent
associated w/passive
withdrawal, anxiety, depression
Disorganized/controlling
associated
w/personality and dissociative disorders
Mirror neurons
Neurons, especially in the motor cortex, that fire as if you had performed the same actions as you
observe
Involved in imitation learning, language, understanding others’ actions, empathy
Impairments possibly related to Autism Spectrum Disorder
Theory of Mind
The ability to understand one’s own or another’s mental state
Normally develops ages 3-5, leads to pretend play, capacity to lie
Deficits possibly related to autism
Adolescence
- Movement from a family to a peer orientation
- Increased risk taking/impulsivity, especially in presence of peers (more rewarding?)
Separation Anxiety Disorder
Extreme difficulty being away from primary attachment figures, typically parents
Reluctant/refuse to be separated from them, incl school refusal
Onset in preschool years; prevalence approx.
4%
Selective Mutism
Consistently fail to speak in certain, but not all situations
Often mute at school.
Major Depressive Disorder - Children
causal factors
Negative events (esp. losses)
Major changes
Rejection
Ongoing abuse
Anhedonia
loss of interest in pleasurable activities
Major Depressive Disorder - Adolescents
More common than among children
prior to age 13 – girls 1:1 boys
By age 16 - girls 2:1 boy
1994-2013
upswing in child/adolescent bipolar diagnoses; many believed this was inaccurate
Irritability, rage, aggression, and depressive Sx were typical but no mania or mood swings
DSM-5 created new category: Disruptive Mood Dysregulation Disorder
Oppositional Defiant Disorder (ODD)
Anger/defiance without aggression towards others, animals, property
Angry/irritable mood—temper, annoyed, resentful
Vindictive—a desire for revenge
Argumentative, defiant, refusals, annoying/blaming others
Conduct Disorder (CD) + prevelance
persistent/repetitive disregard for, actively violate, the rights of others, animals, society. Bullying,
threatening, cruelty, physical harm, stealing
Onset typically ages 7-15; prevalence 5-10%, mostly boys
Reduced amygdala volume; abnormal activation viewing human faces
CD and ODD
Criteria based on observed behavior not internal processes
CD diagnosis by age 15 required for ASPD diagnosis (18 and up)
Externalizing disorders
Elimination Disorders- Enuresis
Repeated involuntary (in some cases
intentional) bed-wetting or wetting one’s
clothes after the age where control would be
expected.
Must be at least 5yo.
Most cases correct with age and without Tx.
Various proposed causal factors. CBT most
effective
Elimination Disorders- Encopresis (soiling)
Repeated defecation into clothing, seldom
during sleep
Usually, involuntary
Onset age 4+ years
Shame, avoidance
Medical evaluation/Tx and CBT
Neurodevelopmental Disorders
Disabilities in brain functioning emerging at birth or in early childhood
Attention Deficit / Hyperactivity Disorder
(ADHD)
1) Inattention: difficulties w/focus, details, on task
2) Hyperactivity and impulsivity: difficulties waiting their turn, to respond; being still, seated
At least 6 months duration; several symptoms present before age 12
