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
What are treatments for ODD and CD?
- Family focussed-looking at what causes the aggression
- Child focussed
- Prevention focussed
