T4: Lecture 7 Flashcards
Why is it difficult to define a childhood disorder?
- Children are more likely to act out than seek help
- Certain degree of deviance and irrotational behaviour is typical in normal development
- Some disorders cause little/no conscious distress
What is the diagnostic criteria for Intellectual Disability?
- Onset BEFORE AGE 18
- Deficits in intellectual functioning determined by intelligence testing (around 2 standard deviations below mean) and as appropriate for social/cultural context
- Deficits in adaptive functioning
- > communication, social, practical
What are different types of intellectual disabilities based on?
Based on deficits (mild/moderate/severe/profound)
What is the etiology for Intellectual Disability
Genetic Abnormality
- Down Syndrome
- Fragile X syndrome
Metabolic Abnormalities
- PKU
- Tay-Sachs disease
Prenatal/postnatal complications
- Drug exposure e.g. fetal alcohol syndrome
- Anoxia at birth i.e cord around neck
Autism: What are the deficits in social communication?
- Non-verbal behaviours used, some individuals are mute
- Development in peer relationships is poor
- Social and emotional reciprocity is uncommon
Autism: What are examples of restricted/repetitive behaviour patterns?
- Stereotypic, repetition of speech
- Excessive adherence to routine, rituals
- Very restricted interests with abnormal focus
- Hypo or hyper reactivity to sensory input
Autism: Epidemiology
- Symptoms recognised during SECOND YEAR OF LIFE
- 4x more common in boys than girls
- No set period of development
- Less than 1% of population
Autism: Etiology
Genetics
-Highly heritable
Brain abnormalities
- Cerebellum, lymbic system, amygdala, white matter
- Neurotransmitter abnormalities
Prenatal/birthing factors
- -Drug exposure e.g. fetal alcohol syndrome
- Anoxia at birth i.e cord around neck
Parenting/Social Stress
Autism: what is the treatment?
- Modelling of social behaviours and operant conditioning
- Communication training
- Parent training
- Community integration
What behaviour is Externalising Disorders associated with?
With maladaptive behaviours
What other Disorders are types of Externalising Disorders?
- ADHD
- Oppositional defiant disorder
- Conduct disorder
What is the diagnostic criteria for ADHD
- Inattention
- Hyperactivity
- Impulsivity
What are the three subtypes of ADHD?
- Predominantly INATTENTIVE type
- Predominantly HYPERACTIVE IMPULSIVE type
- COMBINED type
What are the behaviours associated with Inattention?
Difficulties are beyond individuals control and disproportionate to normal development
- Easily distracted
- Can’t sustain attention
- Makes many careless mistakes
- Difficulty listening
- Difficulty organising
- Loses things
- Forgetful
- Avoids attention requiring tasks
- Doesn’t follow through on instructions
What are the behaviours associated with Hyperactivity/impulsivity?
- Fidgits
- Leaves seat when sitting expected
- Runs/climbs excessively
- Difficulty playing quietly
- ‘On the go’
- Talks excessively
- Blurts out answers
- Difficulty waiting their turn
- Interrupts or intrudes on others
What is the etiology of ADHD?
Genetic influences
-50-75% heritability
Structural abnormalities
- Under-responsive prefrontal and striate regions
- > dorsolateral region (attention/exectuive functioning)
Neurotransmitter abnormalities
-Dopamine levels often LOW
What are the treatments for ADHD?
BIOLOGICAL
Stimulant medications e.g. Ritalin
- Has high abuse potential
- Stimulates active prefrontal cortex
Non-stimulant medications e.g. trattera
- Lower abuse potential
- Less effective
PSYCHOLOGICAL: behaviour therapy
What is Oppositional Defiant Disorder?
- Early onset (age 4-5)
- Anger and hostility directed to authority figures e.g teachers/parents
What are the behaviours seen by individuals with Oppositional Defiant Disorder?
- Argumentative
- Temper tantrums
- Authority problems
- Refusal to comply with rules
- Blame externalisation
- Anger and resentment
What is Conduct Disorder?
- Either childhood onset (before age 10)
- Or adolescent onset (10+)
- More severe than ODD but has the same symptoms
- Shows broader disregard for social standards, aggression and hostility not necessarily directed at authority figures
What are the behaviours seen by individuals with Conduct Disorder?
- Same as ODD but more severe
- Aggression to people and animals
- Destruction of property
- Deceitfulness or theft
- Serious violation of rules
What are the Limited Pro-social emotions associated with Conduct Disorder?
Shows TWO + persistent persistently over AT LEAST 2 MONTHS, no situationally specific
- Lack of remorse or guilt
- Callous lack of empathy
- Unconcerned about performance
- Shallow of deficient effect ( not experiencing emotions strongly)
What is the Etiology of Oppositional Defiant Disorder and Conduct Disorder?
Genetic Factors
Familial Risk Factors
- Child Abuse
- Family conflict
Sociocultural risk factors
- Poverty
- Past antisocial behaviours
- Dangerous neighbourhoods where anti-social behaviour is displayed
What is the BEST predictor for ODD and CD?
Peer groups and past antisocial behaviour in combination is the best predictor
