Tantrums and BreathHolding Spells, Lying, Stealing, and Truancy, Aggression, Self-Injurious Behavior

Question 1

What are temper tantrums typically a response to in young children?

Answer 1

Temper tantrums are developmentally normative expressions of frustration with limitations or anger about unmet desires.

Question 2

What triggers increase the likelihood of tantrums in young children?

Answer 2

Tiredness, hunger, and transitions can increase the likelihood of tantrums.

Question 3

What preventive strategies can parents use to reduce tantrums?

Answer 3

Plan ahead by addressing triggers, set clear expectations, and acknowledge positive behaviors.

Question 4

What approach should parents take when a child tantrums due to anger or sadness?

Answer 4

Parents should avoid yelling or threats, use choices to avert defiance, and ignore mild tantrums to prevent reinforcing negative behaviors.

Question 5

How should parents handle unsafe tantrum behaviors?

Answer 5

Remove the child from the unsafe situation and place them in time-out.

Question 6

What are breath-holding spells during tantrums?

Answer 6

Reflexive events where a crying child becomes apneic, pale or cyanotic, may lose consciousness, and occasionally has a brief seizure.

Question 7

What are the subtypes of breath-holding spells?

Answer 7

Cyanotic, pallid, or mixed episodes.

Question 8

What medical conditions should be ruled out in pallid breath-holding spells?

Answer 8

Seizures, Chiari crisis, familial dysautonomia, cardiac arrhythmias, cataplexy, hereditary hyperekplexia, and CNS lesions.

Question 9

How can parents manage tantrums effectively?

Answer 9

Intervene before high distress, set clear expectations, distract the child, and use time-out calmly.

Question 10

At what age is time-out most effective?

Answer 10

Time-out is effective for children up to approximately 10 years old.

Question 11

What should parents model to help children manage anger?

Answer 11

Parents should model calm anger control and provide choices to reduce power struggles.

Question 12

When is a mental health evaluation indicated for tantrums?

Answer 12

If tantrum behavior includes head banging, high aggression, or persists into preteen years.

Question 13

What is the developmental purpose of lying in young children?

Answer 13

It is often an attempt to understand language, communication, rules, or to engage in fantasy.

Question 14

Why do older children lie?

Answer 14

To maintain self-esteem, avoid negative consequences, or rebel against authority.

Question 15

What is a parental strategy to address lying?

Answer 15

Create an atmosphere where it is easier to tell the truth and confront lies calmly with the expected behavior.

Question 16

What is kleptomania and how is it treated?

Answer 16

An impulse-control disorder characterized by intense impulses to steal, treated with CBT and medications like SSRIs or naltrexone.

Question 17

What are common reasons children steal?

Answer 17

Impulsive behavior, expressing anger, peer approval, or survival mechanisms in poverty.

Question 18

What is the appropriate parental response to stealing?

Answer 18

Require restitution, explain expectations, and give consequences like loss of privileges or extra chores.

Question 19

When is a mental health evaluation warranted for stealing?

Answer 19

If stealing is part of a pattern of broader conduct problems.

Question 20

What are common causes of truancy in younger children?

Answer 20

Unsafe home environments, lack of supervision, or caretaker difficulties.

Question 21

What factors contribute to truancy in preteens and adolescents?

Answer 21

Learning difficulties, social anxiety, depression, bullying, peer pressure, and substance use.

Question 22

What are best practices for addressing school avoidance due to anxiety?

Answer 22

Address underlying psychological symptoms and create a consistent return-to-school plan.

Question 23

Why do older children run away, and what risks do they face?

Answer 23

Running away often signals serious family problems and puts children at risk for substance abuse, exploitation, and other dangers.

Question 24

What is the clinical significance of aggressive behavior in children?

Answer 24

Aggressive behavior is associated with significant morbidity and mortality; early intervention is crucial as children may not ‘grow out’ of aggressive tendencies.

Question 25

What are some environmental factors that promote aggression in children?

Answer 25

Poverty, chaotic family situations, chronic unemployment, family discord, exposure to violence, criminality, and psychiatric disorders.

Question 26

Which gender is more likely to display aggressive behavior from preschool to adolescence?

Answer 26

Males are more likely to display consistent aggressive behavior from preschool to adolescence.

Question 27

What type of parenting can increase aggression in children with a difficult temperament?

Answer 27

Punitive discipline strategies within the family environment can increase aggression.

Question 28

What are the three primary motives for intentional aggression?

Answer 28

Instrumental (to achieve an end), hostile (to inflict pain), and impulsive.

Question 29

What types of psychologic conditions are often associated with aggressive behavior?

Answer 29

ADHD, oppositional defiant disorder, intermittent explosive disorder, conduct disorder, and disruptive mood dysregulation disorder.

Question 30

What is bullying, and how is it distinct from normal teasing?

Answer 30

Bullying is unwanted aggressive behavior with a real or perceived power imbalance, involving repeated patterns over time, and can be physical, relational, or cyber in nature.

Question 31

What are some negative outcomes associated with bullying victims?

Answer 31

School avoidance, dropout, social isolation, somatic symptoms, depression, anxiety, and risk of suicide.

Question 32

What is nonsuicidal self-injury (NSSI)?

Answer 32

NSSI involves intentional self-inflicted harm without suicidal intent but can result in significant harm or death.

Question 33

What is the relationship between NSSI and psychiatric disorders?

Answer 33

Most youth engaging in NSSI meet diagnostic criteria for a psychiatric disorder.

Question 34

At what age is NSSI first documented, and how do its rates change across the lifespan?

Answer 34

NSSI is documented as early as 7 years old, increases in adolescence (~18%), and decreases in adulthood (~5.5%).

Question 35

Which demographic has particularly high rates of NSSI?

Answer 35

Transgender and gender nonconforming teens, with up to 55% reporting past-year NSSI.

Question 36

What is the most common form of NSSI?

Answer 36

Cutting is the most commonly reported and repeated form of NSSI.

Question 37

What are common triggers for NSSI in youth?

Answer 37

Intense negative emotions, feeling numb, a need for distraction, self-punishment, or a sense of control.

Question 38

What are protective factors against NSSI?

Answer 38

Lack of exposure to NSSI, aversion to pain or NSSI-related stimuli, positive self-image, adaptive emotion regulation strategies, and supportive social norms.

Question 39

What are effective treatments for NSSI?

Answer 39

Behavioral therapies like dialectical behavior therapy, cognitive-behavioral therapy, and mentalization-based therapy for adolescents.

Question 40

How should parents respond to discovering their child engages in NSSI?

Answer 40

Parents should maintain open communication, provide emotion coaching, monitor social media, seek mental health services, and receive psychoeducation about NSSI.

Question 41

What are some misconceptions parents may have about NSSI?

Answer 41

Parents may view it as purely attention-seeking or fail to understand its role as a coping strategy for emotional distress.

Question 42

What are the DSM-5 proposed criteria for NSSI?

Answer 42

Self-inflicted injury without suicidal intent on 5+ days in the past year, with associated distress, functional impairment, or interpersonal difficulties.

Question 43

Which parenting practices are associated with increased NSSI in youth?

Answer 43

Neglectful or highly punitive parenting practices.

Question 44

How does exposure to peers or media influence NSSI in youth?

Answer 44

Youth may imitate NSSI after exposure to peers or media, seeing it as a way to cope with emotions or gain social affiliation.