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EPPP Prep > Psychopathology: Neurodevelopmental D/O > Flashcards

Psychopathology: Neurodevelopmental D/O Flashcards

1
Q

Symptoms of Intellectual Developmental Disorder

A
  • deficits in intellectual functioning (measured by clinical assessment and individualized standardized intelligence testing score 2 SD below population mean)
  • deficits in adaptive functioning (conceptual, social, and practical) for personal independence and social responsibility–by which severity is based
  • onset of deficits during developmental period
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2
Q

What percentage of etiology of Intellectual Developmental Disorder is known?

A

25-50%

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3
Q

What percentage of etiology of Intellectual Developmental Disorder is due to Prenatal factors?

A

80-85%
Most common include: 1) Down Syndrome, 2) Fragile X, and 3) Fetal Alcohol Syndrome

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4
Q

What percetage of etiology of Intellectual Developmental Disorder is due to Perinatal factors?

A

5-10%
Asphyxia

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5
Q

What percentage of etiology of Intellectual Developmental Disorder is due to Postnatal factors?

A

5-10%

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6
Q

Symptoms of Autism Spectrum Disorder

A
  • deficits in social communication and social interaction across multiple contexts (imparied social-emotional reciprocity, impaired non-verbal communication that is used for social interaction, and impaired ability to develop, maintain, and understand relationships)
  • restrictive and repetitive behaviors, interests, and activities (stereotyped/repetitive motor movements, speech, or use of objects; insistence on sameness/inflexible adherence to routines; restricted or fixated interests that are abnormal in intensity or focus; hyper/hypo-reactivity to sensory output)
  • onset of symptoms must be during early developmental period
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7
Q

Factors for best prognosis for ASD

A

*IQ over 70
*Functional langauge skills by 5 yo
*Absense of comorbid mental health problems

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8
Q

What are associated features of ASD

A

intellectual and language impairments
self-injurious behaviors
motor abnormalities
disruptive/challenging behaviors
impaired face and emotion recognition–>deficits in social relationships

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9
Q

Research and findings of Dawson et al (2002)

A

*Compared reactions of 3-4 yo with and without ASD towards new and familiar faces and objects
*WITHOUT ASD reacted differently to new and familiar faces AND objects
*WITH ASD Reacted DIFFERENTLY to new and fmiliar OBJECTS; SIMILARLY to new and familar FACES

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10
Q

Research and findings of Fridenson-Hayo et al (2016) for ASD

A

Children with ASD had deficits in recognizing BASIC AND COMPLEX emotions in 3 expression modalities (Face, Voice, and Body)

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11
Q

Prevalence rates of ASD in US and Other countries and gender differences

A

1-2% of population
1 girls: 3-4 boys

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12
Q

Concordance rates for ASD (Proof of genetic factors of etiology of ASD)

A

Monozygotic twins (idential twins) 69-95%
Dizygotic twins (fraternal twins) 0-24%

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13
Q

Non-genetic factors that increase risk for ASD

A

*male gender
*birth before 26 weeks of gestation
*advanced parental age
*exposure to certain environmental toxins during prental development
*Research has NOT established link between ASD and vaccinations

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14
Q

Brain abnormalities associated with ASD

A
  • accelerated brain growth at 6M & plateaus in preschool years
  • larger-than-normal head circumference
  • increased brain volume and weight
  • abnormalities in cerebellum, corpus callosum, and amygdala
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15
Q

Neurotransmitter abnormalities associated with ASD

A
  • lower than norm levels of 5HT in brain + high levels of 5HT in blood
    *dopamine, GABA, gulatamate, and acetylcholine
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16
Q

Theory exp 5HT levels in brain/blood (Whitaker-Azmitia, 2005)

A

Blood serotonin enters fetal brain during early stages of development before blood-brain barrier is fully mature. This causes reduced development of or damage to serotonergic neurons in the brain.

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17
Q

Treatment goals of children with ASD

A

Minimize core sx of disorder
Maximize independence by promoting acquiition of functional skills
Reduce/eliminate behaviors that may interefere with functional skills

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18
Q

Recomended nonpharmeceutical intervention for those with ASD

A

Early Intensive Behavioral Intervention (EIBI) based on ABA = 40+ hrs per week of behavioral interventions
For nonspeaking children: shaping and discrimination

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19
Q

Symptoms with EIBI treatment greatest and less impact for ASD

A

Greatest positive impact: intelligence and langauge acquisition
Smaller and less consistent impact: adaptive skills, social functioning and secerity of core ASD sx

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20
Q

Impact of pharmaceutical interventions for ASD

A

NOT for CORE ASD sx
Assoc ADHD sx: Methylphenidate and other psychostimulants
Assoc Dep & Anx sx: SSRIs
Assoc irritability/aggression/self-injurious behavior/disruptive behaviors: Atypical antipsychotics (2nd Generation) Risperidone and Aripiprazole

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21
Q

ADHD Dx requirements

A

6+ of core symptoms for 16 & younger
5+ of core symptoms for 17 & older
symptoms persisted at least 6M
onset before 12 yo
present in 2 settings
Interferes with social, academic, or occupational functioning

22
Q

ADHD Core Sx

A

INATTENTION: don’t listen when spokent o, fails to pay close attention to detials, don’t follow-through on instructions, easily distracted, and forgetful
HYPERACTIVITY: cannot engage in leisure activities quietly, runs/climbs, talks excessively, trouble waiting turns, and interrupts/intrudes on others

23
Q

ADHD prevalence factors (age and gender)

A

most common between 3-17 yo
childhood male>females; adulthood male=female

24
Q

ADHD in adulthood + Maltezos, Whitwell & Asherson, 2020)

A

Adults maintain 1+ core symptoms
Study results:
*hyperactivity bx replaced by difficulty relaxting/sitting still, impatience, and sense of restlessness
*impulsivity decreases slightly and changes (reckless driving, abtrupt quitting jobs, ending relationships, and overspending)
*inattention continues in adulthood (inability to meet deadlines, making careless mistakes, procrastination
*sx most appartent in boring or tedius tasks

25
Q

D/O comobrid with ADHD

A

1) ODD
2) CD
3) Anxiety D/Os
4) Depressive D/Os

26
Q

Brain abnormalities associated with ADHD

A

*Prefrontal Cortex, Striatum (caudate nucleus/putamen), and Thalamus = impaired inhibition, working memory, sustained attention, and other executive functioning
*Prefrontal Cortex and Cerebellum = cannot perceive/organize sequences of events or anticipate when future events will occur
*Prefrontal Cortex and Amygdala = Emotion dystregulation
*Resuced total brain volume w/ smaller-than-normal voume of Prefrontal cortex, striatum, corpus callosum, and cerebellum + reduced activities in these areas

27
Q

Neurotransmitters associated with ADHD

A
  • low levels of dopamine and norepinephrine
28
Q

Genetic factors and concordance rates of ADHD

A

*Hertability estimate across twin studies being 76%
*Monozygotic 71%
* Dizygotic 41%

29
Q

Nongenetic factors of ADHD

A

low birth weight
premature birth
maternal smoking
alcohol use during pregnancy

30
Q

Treatment recommendations for ADHD by AGE

A

Preschool = Parent & Teacher Administered Behavioral Interventions (PTBM) ex: PCIT
(+Medication if behavioral tx doesn’t work)
Elementary & Middle school = Medication + PTBM
High school= Medication + available behavioral/instructional interventions + therapy (behavioral, motivational, mindfulness-based, and classroom training)
Adults=Medication (+CBT)

31
Q

Substance use and ADHD (Humphreys, Eng, Lee, 2013)

A

*linked to increased risk for substance use in teen and adults (NOT due to psychostimulant use in childhood)
*children with ADHD who did and did not receive psychostimulants had SAME rates of future subtance use
* Treatment of ADHD during childhood does not increase nor decreases risk of later substance use disorder

32
Q

Tourette’s D/O

A
  • 1+ VOCAL tic AND
  • 2+/multiple MOTOR tics
    (may ocur together or different times)
  • Sx persist for <1 Y
  • Onset before 18yo
33
Q

Persistent (Chronic) Motor or Vocal Tic D/O

A
  • 1+ Motor OR Vocal tics
    *Sx persist for <1 Y
    *Onset before 18yo
34
Q

Provisional Tic D/O

A
  • 1+ Motor AND/OR Vical Tic
  • Sx present >1Y
35
Q

Onset and severity of Tic Disorders

A

onset between 4-6 Y
severity peaks 10-12Y

36
Q

Comorbid dx with Tic D/O

A

1) ADHD

37
Q

Neurotransmitter and Brain Abnormalities associated with Tic D/O

A

*Dopamine OVERactivity
*Smaller-than-norm Caudate nucleus

38
Q

Therapeutic Tx for Tic Disorders

A

Comprehensive Behavioral Intervention for Tics (CBIT)= psychoeducation, social support, and habit refersal, competing response, and relaxation training

39
Q

Rx for Tic D/O

A

*Antipsychotics (Haloperidol)
* +Tx for comobid conditions: (SSRI for OCD, methylphenidate or clonidine for ADHD)

40
Q

Communication D/O or Childhood-Onset Fluency D/O (Stuttering)

A

Def: disturbance of normal fluency and time patterning of speech that does not fit person’s age/languge skills
*Persists over time
* 1+ of 7 sx: sound and syllable repetitions, sound prolongations, broken words, audible or silent blocking, circumlocutions, words prounounced with excessive physical tension, monosyllabic whole-word repetitions.
*Onset 2-7Y

41
Q

Progression of Stuttering/Childhood-Onset Fluency D/O

A

65-80% of children recover (severity of Sx at 8YO predicting presistance or recovery of stuttering).

42
Q

Treatment of stuttering/Childhood-Onset Fluency D/O

A

Habit reversa training (use of regulated breathing as competing response)

43
Q

Specific Learning D/O

A
  • <6M despite interventions to address difficultuies
    *1+ of 6 sx: inaccurate/slow and effortful word reading, difficulty with comprehension of what is read, difficulties with spelling, difficulties with written expression, difficulties mastering number sense/number facts/calculation, difficulties with mathematical reasoning
    *Difficulties cause substantially below performance expected for age
    *Interfere with academic/occupational performance or ADLs
    *School-age onset
44
Q

prevalence rates of Specific Learning D/O

A

5-15% have Specific Learning D/O
80% reading disorder (Dyslexia and dysphonic/auditory/phonological dyslexia most common–difficulty connecting sounds to letters)

45
Q

Assoc features and Comorbidities of Specific Learning D/O

A

Assoc feat: above-average IQ
Comorbid: ADHD

46
Q

Neuroimaging studies have linked ADHD to a:
A. larger-than-normal entorhinal cortex.
B. smaller-than-normal entorhinal cortex.
C. larger-than-normal prefrontal cortex.
D. smaller-than-normal prefrontal cortex.

A

D. smaller-than-normal prefrontal cortex.

Additional areas of the brain include: Striatum (claudate nucleus/putamen), Thalamus, Cerebellum, Amygdala, and corpus callosum

Assoc with Low Dopamine and Norepinephrine

47
Q

When assigning a DSM-5-TR diagnosis of intellectual disability to a child, the level of severity of the disorder is determined by considering the child’s:
A. adaptive functioning.
B. socioemotional functioning.
C. full-scale IQ score.
D. adaptive functioning and full-scale IQ score.

A

A. Adaptive functioning

Includes conceptual, social, and practical

48
Q

The most common comorbid disorder for specific learning disorder is:
A. major depressive disorder.
B. ADHD.
C. social anxiety disorder.
D. oppositional defiant disorder.

A

B. ADHD

49
Q

The DSM-5 diagnosis of ADHD requires an onset of symptoms before ____ years of age.
A. 7
B. 9
C. 12
D. 15

A

C. 12

50
Q

Which of the following is most associated with a better prognosis for autism spectrum disorder?
A. an IQ over 55
B. a sudden onset of symptoms
C. functional language skills by age five
D. brief duration of active-phase symptoms

A

C. Functional lanugage skills by age 5

51
Q

The most effective intervention for children with childhood-onset fluency disorder is likely to be which of the following?
A. overcorrection
B. habit reversal training
C. stimulus control
D. stress inoculation training

A

B. habit reversal training

Most notably regulated breathing

52
Q

For a DSM-5-TR diagnosis of Tourette’s disorder, the client must have which of the following?
A. at least one motor tic and one vocal tic.
B. at least one motor tic and multiple vocal tics.
C. multiple motor tics and at least one vocal tic.
D. multiple motor tics and multiple vocal tics.

A

C. multiple motor tics and at least one vocal tic

EPPP Prep (3 decks)

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