Pediatric Psychiatry Flashcards
A preschooler misses his long-term nanny who has recently moved away. To help this child, the parents should: (2x)
SHOW THE CHILD PICTURES OF THE NANNY
Newly married college graduate now needing more parental support with decisions
PHASE OF LIFE PROBLEM
Adopted kid, shy and clings to mother, difficulty at school
REACTIVE ATTACHMENT DISORDER
Secure attachment in an infant is associated with which of the following outcomes?
EMOTIONAL AND SOCIAL COMPETENCE
2 y/o M has been preoccupied with a small blanket for several months, carries it w/ him everywhere and becomes upset if anyone tries to take it away. He refused to stay w/ a baby-sitter until it was retrieved. The psychiatrist should:
EXPLAIN THIS IS NORMAL AND CHILD WILL EVENTUALLY GIVE IT UP ON HIS OWN.
10 month old child distressed when parents leave him with the babysitter. The parents say goodbye and leave quickly without display of affection. What is most likely to observed later in life?
INCREASED CLINGING AND AVOIDANT BEHAVIOR TOWARDS BEHAVIOR
Adult’s patterns of interacting with others predicted by what according to object relations and attachment theory
CAPACITY TO PERCEIVE AND THINK ABOUT THE INTENTIONS OF OTHERS
Infants are more likely to have insecure attachment with poor child care if primary caretakers are also:
UNRESPONSIVE TO THEIR INFANT’S NEEDS
Hormone shown to be critical to the development of maternal-infant bonding in animals:
OXYTOCIN
In contrast to attachment, “bonding” is associated with
THE NATURE OF A PARENT’S RELATIONSHIP TO AN INFANT
Key characteristic of preschoolers who are securely attached
TRUST AND RECIPROCITY
What has been found regarding infants’ attachment to their parents?
STRENGTH OF INFANT’S ATTACHMENT IS A FUNCTION ONLY OF THE AMT OF INTERACTION WITH THE PRIMARY PARENT
5 y/o child with behavioral problems in school, in and out of foster care for the first 2 years of life. Friendly and affectionate with others even with strangers. Parents don’t feel “close” to the child and doesn’t seem to have enduring friendships. Diagnosis:
REACTIVE ATTACHMENT DISORDER
4 yo raised in Multple foster homes, minimally smiles , does not seek comfort
REACTIVE ATTACHMENT DISORDER
Toddler soothed at night by inner memory of secure relationship with mother. Called what (in attachment theory):
OBJECT CONSTANCY
10-month old infant becomes distressed when parents leave child w/ babysitter without affection. Which subsequent behavior pattern is likely?
CLINGY AND AVOIDANT TOWARD PARENTS
18 month old shows a marked awareness of vulnerability to separation and seems to be constantly concerned about the mother’s actual location is exhibiting Mahler’s stage of?
OBJECT CONSTANCY
5 y/o adopted at age 4 now hugging strangers, age appropriate vocabulary, doesn’t respond well to limits, easily frustrated.
REACTIVE ATTACHMENT D/O
3 y/o with diminished appetite, slow speech development, poor social interactions; parents are detached from him. After 2 weeks in hospital is improving and friendly with staff members. Dx?
REACTIVE ATTACHMENT D/O
20-month child repeatedly returns to her mom when playing w/ other 2-y/o children. This is:
RAPPROCHEMENT
The term rapprochement in Mahler’s developmental theory refers to the:
RECONCILIATION FOLLOWING A BRIEF ATTACHMENT RUPTURE BETWEEN TODDLERS AND PARENTS
Final phase of Mahler’s separation — ability to maintain positive emotional attachment in face of frustration
OBJECT CONSTANCY
Following a brief separation from the parents, a securely attached toddler is most likely to do which of the following:
SEEK CONTACT EAGERLY
According to operant conditioning, behavior decreases in frequency if (5x)
INCOMPATIBLE WITH A POSITIVELY REINFORCED BEHAVIOR
Pt with cocaine addiction experiences cravings for cocaine whenever passing by a “crack house”. This reaction exemplifies: (3x)
CLASSICAL CONDITIONING
A form of learned fear in which a person or an experimental animal learns to respond strongly not only to a harmful stimulus, but also to a sub-threshold stimulus, refers to: (3x)
SENSITIZATION
Most important protective factor determining preschool child’s reaction to disaster (2x)
PARENTAL FUNCTIONING
Risk factor influencing psychological outcome of child following death of parent: (2x)
PRIOR CONFLICTUAL RELATIONSHIP BETWEEN CHILD AND DECEASED PARENT
Behavioral frequency altered by application of positive and negative consequences (2x)
OPERANT CONDITIONING
An operant conditioning reinforcement schedule that is used in casino slot machines and may play a role in the development of pathological gambling: (x2)
VARIABLE-RATIO
Pt works near a train and soon doesn’t notice the noise anymore. What’s this called?
HABITUATION
Effect of prompts for tobacco use on provider behaviors
BEHAVIORS INCREASE
In behavioral psychology, extinction is defined as :
WEAKENING OF CONDITIONED RESPONSE DUE TO WITHDRAWAL OF STIMULUS
A 10-yo child is afraid of dogs and has exposure therapy to the point where he can tolerate a small dog. A week later, he encounters a large dog. What is his response?
GIVEN THE NON-CLINICAL SETTING, THE REACTION IS IMPOSSIBLE TO PREDICT
Child is shown a rat and does not react. Then show child rat w a loud noise. After several pairing of rat and noise, the child then becomes fearful when just rat presented. In Pavlovian conditioning, what is the conditioned stimulus in this case?
THE RAT
In biofeedback, the autonomic nervous system can come under voluntary control through which of following mechanisms?
OPERANT CONDITIONING
Repeated presentation of a conditioned stimulus without being paired with its unconditioned stimulus will result in what?
PARTIAL REINFORCEMENT
Pt who was in frightening MVA, consults psychiatrist for fears of driving, made car travel impossible. Behavior intervention is planned: psychiatrist will ride in traffic with pt and remain with pt until physical signs of fear diminished. What learning tx?
CLASSICAL CONDITIONING
In Operant Conditioning, a partial or intermittent reinforcement schedule results in:
MAINTAINING A BEHAVIOR THAT IS RESISTANT TO EXTINCTION.
What type of reinforcement is most effective for maintaining behavior that is resistant to extinction?
PARTIAL
If a response inhibitory to anxiety occurs in the presence of anxiety-evoking stimuli, it weakens the connection between the stimuli and the anxiety. This is called:
RECIPROCAL INHIBITION
A 79yr old man seeks therapy following stress due to uncontrolled online shopping, patient begins to understand how each purchase improved mood and improved loneliness, this best explains what learning theory?
OPERANT CONDITIONING
As result of a MVA a pt feeling panic before have to drive and has begun to avoid it. Example of mechanism of fear development:
DIRECT CONDITIONING
Pt undergoing chemotherapy. Commonly becomes nauseated and vomits in waiting room prior to the treatment. Reaction is ex of?
CLASSICAL CONDITIONING
Pt ate meat loaf then had a severe GI virus; develops a strong aversion to meat loaf.
CLASSICAL CONDITIONING
IV heroin user upon seeing the needle during a blood draw develops intense craving is an example of:
CLASSICAL CONDITIONING
Systematic desensitization is derived from
CLASSICAL CONDITIONING THEORY
Which of the following terms was developed by Rene Spitz to describe a common outcome following sudden or prolonged separation of otherwise normally attached infants?
ANACLITIC DEPRESSION
18 m/o is vulnerable to separation and constantly concerned about mother’s actual location. This is representative of Mahler’s stage of:
RAPPROCHEMENT
2 y/o does not want to let go of wool blanket and resists going anywhere without it. Attachment type is:
TRANSITIONAL OBJECT
What is true regarding infant attachments when comparing the strength of bond with each parent?
INFANTS CAN FORM MULTIPLE ATTACHMENTS, BUT THE STRENGTH OF THOSE ATTACHMENTS MAY DIFFER
Explanation for child’s anxiety from operant conditioning model? Child anxious about getting on bus and irrationally fears it will crash.
“HOW DO YOUR PARENTS RESPOND WHEN YOU ARE AFRAID OF THE BUS?”
Which of the following is most important protective factor in building resilience in children? Social skills, cognitive ability, quality of parenting, easy temperament, socioeconomic status
QUALITY OF PARENTING
Person afraid of loud noises has a panic attack in grocery store after shelving unit hits floor, person takes lorazepam after hearing a loud noise, person then avoids grocery store. according to classical conditioning, what is the conditioned stimulus?
GROCERY STORE
7 y/o with temper tantrums, refuses to go to school. Stomachaches and headaches on school days. Nightmares about being kidnapped, fears parents will die. Dx? (4x)
SEPARATION ANXIETY D/O
An example of parallel play: (4x)
A 2 YO CHILD SITS NEAR ANOTHER TODDLER WITH A TRUCK AND PICK UP A CAR.
Children demonstrate a preference for the human voice and speech over other sounds at what age? (3x)
BIRTH
Core gender identity is typically established by what age? (3x)
3 YEARS
An infant who engages in an interactive game of peek-a-boo most closely demonstrates the concept of which cognitive ability? (3x)
OBJECT PERMANENCE
The “strange situation” in child development is used to assess the infant’s in attachment theory: (2x)
SECURITY OF ATTACHMENT
Which ages of children are interested in secrets, collecting, and participating in organized games? (2x)
ELEMENTARY SCHOOL
Parents report 3 y/o has not begun to talk. Since birth child has been distractible. Also report child seems to have problem empathizing with siblings. What question should the Psych MD ask first? (2x)
“HAS YOUR CHILD’S HEARING BEEN TESTED?”
2 y/o clings to mother when introduced to a new child, refusing to join in play during 1st visit. On 2nd visit, child plays behind mother, and on 3rd visit, she seems to continue her usual activities while warily eyeing the new child. What temperamental traits or constellations best describes this child’s behavior? (2x)
SLOW-TO-WARM-UP
A 5 year old child whose mother was in a minor car accident believes he is responsible for causing the accident because he yelled “I hate you” in protest when his mother left him with a baby sitter an hour earlier. This belief represents which of the following? (x2)
AGE APPROPRIATE EGOCENTIC THINKING
3 1⁄2 y/o girl has increasingly become interested in dressing up in her mother’s clothes and shoes, with increased remarks about being a girl. It would be most consistent with a social learning theory explanation of psychosexual development to say that her behavior is (2x):
BASED ON MATERNAL MODELING AND BEHAVIOR
Integration of clinical and experimental observations in early childhood development supports what statement about infant/parent interactions (2x)?
INFANTS ARE BORN WITH SOPHISTICATED PERCEPTUAL ABILITIES THAT FACILITATE ATTACHMENT
The father of a 3 1⁄2 year old boy who attends preschool reports that on several occasions the boy has come into the bathroom while the father is in the shower interested in observing his father’s genitals asking once “why is it so fat?” This behavior most likely is an indication of? (2x)
NORMAL PRESCHOOL AGE SEXUAL INTEREST
A 10 yo child remains sad and angry about his parent’s divorce but no longer believes that he caused the separation. This cognitive change is example of what mechanism? (2x)
DECENTRATION
The age at which children typically first use sentences of 2 or more words is: (X2)
24 MONTHS
School aged boy, plays BBall and w/ boys, not w/ girls. What Freud’s psychosexial stage?
LATENCY
2-3 y.o. Capacity to tolerate frustration influenced by
ABILITY TO INTERNALIZE SOCIAL NORMS
Difficulty with which physical task is most concerning in elementary school aged kid?
JUMPING AND HOPPING
Innate feelings
MOST STRONGLY INFLUENCE GENDER ID
Four yo meeting all milestones. What on PE will raise concern about development?
WALKING ON TOES
Developmental period with highest level of response to rewards in nucleus accumbens
ADOLESCENCE
Developmental stage w/ max. number of axons and synapses?
INFANCY
Piaget’s major contribution to development theory explain…
HOW INDIVIDUALS LEARN ABOUT AND UNDERSTAND THE WORLD
Identity diffusion describes
LACK OF CONTINUITY IN HOW THE SELF IS EXPERIENCED IN RELATIONSHIPS OVER TIME
Piaget’s model limitations include
DOES NOT INCLUDE EMOTIONAL FACTORS RELEVANT TO LEARNING
will there be clowns in the parade like the circus?, this is an example of
USE OF PREVIOUS EXPERIENCES TO THINK CATEGORICALLY
2 year old development language
TWO-WORD OR LONGER PHRASES
stage of development with peak of DA-R in striatum, increased reward response
ADOLESCENCE
stage of development of maximal pruning of cortical synapses
ADOLESCENCE
flavor preference determined by
COGNITIVE ASSOCIATION
Developmental concept of mother responding to baby seeking attention
ATTACHMENT
Child enjoys opposite gender stuff. If patient gets symptoms of gender dysphoria what’s the course
RESOLVES SPONTANEOUSLY BY ADULTHOOD
Developmental task of school-age stage
BEGIN TO ESTABLISH PEER RELATIONSHIPS AND PURSUE GROUP ACTIVITIES
Adolescent M aroused by other males, but attracted to F
THESE FEELINGS ARE COMMON AND HIS SEXUAL PREFERENCE WILL CONTINUE TO SOLIDIFY
What is the likely course for a child’s development after their parents divorce?
CHILDREN DO WELL IN ONE PARENT HOMES PROVIDED STABLE PARENTAL FUNCTIONING AND FINANCIAL SECURITY
Which is a basic emotion, learned directly or inferred by infants in 1st year of life?
FEAR
First marker of impending puberty in females?
ACCELERATION OF LINEAR GROWTH
When do cortisol level peak in healthy children?
MORNING
Two 4-yr olds playing, one makes loud noise, the other does not want to play any more. Why?
PLAY PRODUCED EXCESSIVE ANXIETY FOR CHILD
Which of the following parent behavior is most important to toddlers language development?
ENGAGING IN FREQUENT CONVERSATION AND THINKING ALOUD
Pretend play, based on ability to symbolize, typically appears at which of the following stages of development?
TODDLERHOOD
Cognitive strategy of typically developing school-age children in response to their environment?
GRADUALLY INTEGRATING THESE NEW EXPERIENCES INTO PRE-EXISTING MENTAL CONSTRUCTS
Which of the following is characteristic of preadolescent children’s physical growth?
THE GROWTH RATE FOR BOYS LAGS BEHIND THE GROWTH RATE FOR GIRLS
Stage of development associated w/ setting up clubs, making rules
LATENCY
Ability of preschool children to regulate emotions is most strongly enhanced by the development of:
LANGUAGE
At what developmental stage due kids first exhibit ability to recognize their thoughts and feelings are their own, and that others may think and feel differently?
PRE-SCHOOL AGE
Starting around age 3 years, children spontaneously use language in which of the following ways?
DESCRIBE PAST EVENTS
Compared to preschool-age children, a school-age child with normal language development will demonstrate what ability?
CONSTRUCTING SENTENCES WITH MULTIPLE CLAUSES
Preschool children with imaginary friends are:
FAIRLY NORMAL
The parents of a 3 y/o child are concerned because she has not begun speak intelligently. The child’s hearing is normal. Doctor’s response:
EXPRESS SOME CONCERNS BC MOST CHILDREN THIS AGE CAN EFFECTIVELY MAKE THEMSELVES UNDERSTOOD.
Ability of an infant to utilize symbolic representation at age 18 months allows for:
USING LANGUAGE PROFICIENTLY
Child holds toy telephone to face and speaks to Daddy. This behavior is called?
SYMBOLIC REPRESENTATION
Which of following parental tasks becomes important during toddlerhood?
LIMIT SETTING
2.5 y/o observes mother take an apple from the refrigerator, mother briefly turns back to the child and beings eating, when mother turns toward child he animatedly grabs for the apple and say, “my apple, not Mommy’s.” This behavior is best described as which developmental achievements?
AWARENESS OF BEING A SEPARATE SELF
Adolescent who was previously getting along with parents is now becoming more resistant to parental control and insistent about making his own decisions about daily life. Feeling irritated with parents and guilty after minor arguments. Feelings of guilt are likely explained by?
A WISH TO SEVER THE PARENT-CHILD RELATIONSHIP
A child with temper tantrums at home begins to have better control over her outbursts following which intervention by parents?
HAD NEGATIVE REINFORCEMENT OF THE TANTRUMS REMOVED
The parents of a toddler are concerned about a rent increase in the frequency, intensity and duration of the child’s temper tantrums. The parents report that the toddler gets on the floor, kicks and screams when they set limits. The child’s health and developmental history is unremarkable. FMHx significant for mood disorders and ADHD and ODD. Which of the following would be most appropriate as next step?
EXPLORE THE PARENTS’ CONCERNS ABOUT SEEMINGLY NORMAL BEHAVIOR
In 8-11 y/o kids, which moral skill is the 1st one to fully develop?
INTERNALIZATION OF PARENTAL VALUES
17 1⁄2 y/o pt mentions drinking “a few beers” at parties and smoking THC “sometimes with friends.” The adol is doing well in school. Has close friends and has no significant conflicts at home. Adol’s use of substance is best characterized as:
TYPICAL ADOLESCENT BEHAVIOR
When asked to describe why a same-age, same-sex peer is a “best friend,” an 11-year-old child is most likely to cite which of the following as most important?
FEELING CARED ABOUT BY THE OTHER CHILD
Ask a child, “What makes a train go?” He replies, “The smoke makes it go.” This is:
PRE-OPERATIONAL THINKING
Learning triangular relationships
OEDIPAL STAGE
Following divorce, which behaviors in non-residential father contributes most positively to child’s future mental health?
TRADITIONAL PARENTING SUCH AS HELPING WITH HOMEWORK OR CELEBRATING HOLIDAYS TOGETHER
4 1⁄2 y/o child insists there is a small monkey who shares the child’s room. He talks to monkey, asks others to converse with monkey and insists that monkey have a seat at dinner table. Parents ask if they should be concerned, best response:
BEHAVIOR TYPICAL FOR PRESCHOOLERS
