Test 1 Flashcards
Attention-deficit/hyperactivity disorder (ADHD):
persistent age-inappropriate symptoms of inattention, hyperactivity, and impulsivity that are sufficient to cause impairment in major life activities
Inattention
Inability to sustain attention or stick to tasks or play activities, to remember and follow through on instructions or rules, and to resist distractions
Hyperactivity-Impulsitivity
Under-controlled motor behavior, poor sustained inhibition of behavior, the inability to delay a response or defer gratification
An inability to inhibit dominant responses in relation to ongoing situational demands
Prognosis:
formulation of predictions about future behavior under specified conditions
Psychoanalytic theory
Sigmund Freud: individuals have inborn drives and predispositions that strongly affect their development
− Experiences play a necessary role in psychopathology.
− Children and adults could be helped if provided with the proper environment, therapy, or both
Behaviorism
Evidence-based treatments for children, youths, and families
can be traced to the rise of behaviorism in the early 1900s.
* Pavlov’s research on classical conditioning
* Watson’s studies on the elimination of children’s fears and the
theory of emotions
− Famous study with Little Albert
Labels describe behaviors, not people
Stigmatization is a challenge.
− Separate the child from the disorder
− Problems may be the result of children’s attempts to adapt to
atypical or unusual circumstances.
* According to DSM-5-TR guidelines
− The primary purpose of using terms is to help describe and
organize complex features of behavior patterns.
multifinality
various outcomes may stem from similar beginnings
equifinality
similar outcomes stem from different early experiences
Risk factors
a variable that precedes a negative outcome of
interest
* Known risk factors that increase children’s vulnerability to
psychopathology
− Chronic poverty/socioeconomic marginalization
− Interactions with oppressive systems
− Serious caregiving deficits
− Parental mental illness
− Divorce, homelessness, and racism
Protective factor
a personal or situational variable that reduces the chances for a child to develop a disorder
Resilience
The ability to avoid negative outcomes despite being at risk for psychopathology.
resilience may vary over time and across situations.
* Resilience is seen in children across cultures.
* Positive cognitive schemas about self, coping skills, and abilities to avoid risky situations may be considered resilient.
Poverty and Socioeconomic
Disadvantage
Children from poor and disadvantaged families are more likely to be diagnosed with
− Conduct disorders, chronic illness, and school issues
− Emotional disorders and cognitive/learning challenges
Externalizing problems
Higher in boys than girls in preschool and early elementary years and rates converge by age 18
− Exhibited as acting-out behaviors
Internalizing problems
Similar rates in early childhood but higher rates among girls over time
− Include anxiety, depression, somatic symptoms, and withdrawn behavior
Possible causes of a child’s behavior
− Biological influences
− Emotional influences
− Behavioral and cognitive influences
− Family, cultural, and ethnic influences
Etiology
the study of the causes of childhood disorders
Adaptational failure
unsuccessful progress in developmental
milestones
Neurobiological perspectives
The brain is seen as the underlying cause of psychological disorders.
* The fetal brain develops from all-purpose cells into a complex organ.
* Neurons with axons develop.
* Synapses (axonal connections) form.
* Neural plasticity: the brain’s anatomical differentiation is use-dependent.
* Nature and nurture both contribute.
* Experience plays a critical role in brain development.
Endocrine system
linked to anxiety and mood disorders.
* Endocrine glands produce hormones.
− Adrenal glands produce epinephrine and cortisol.
− Thyroid gland produces thyroxine.
− Pituitary gland produces regulatory hormones, e.g., estrogen and testosterone.
− Hypothalamic–pituitary–adrenal (HPA) axis—linked in several disorders, especially anxiety and mood disorders
Neurotransmitters
Neurotransmitters make biochemical connections.
* Neurons more sensitive to a particular neurotransmitter cluster together and form brain circuits.
* Neurotransmitters involved in psychopathology include serotonin, benzodiazepine-GABA, norepinephrine, and dopamine.
* Psychoactive drugs are used in treatments.
Psychological Perspectives
Psychological perspectives have value in explaining the development of psychopathology.
− Transactions must be considered.
* Emotions play a role in establishing an infant’s ability to adapt to new surroundings.
* Behavioral and cognitive processes assist a young child in making sense of the world
Emotional Influences
Emotions and affective expression
− Are core elements of human psychological experience
− Are a central feature of infant activity and regulation
− Tell us what to pay attention to/what to ignore
− Affect quality of social interactions and relationships
− Are important for internal monitoring and guidance
Emotion reactivity
: individual differences in the threshold and
intensity of emotional experience
Emotion regulation
enhancing, maintaining, or inhibiting
emotional arousal
Temperament
an organized style of behavior that appears early in development
- Shapes an individual’s approach to their environment and vice versa
Self-regulation
a balance between emotional reactivity and self-
control (self-regulation)
Applied Behavioral Analysis
Explains behavior as a function of its antecedents and consequences
Classical Conditioning
Involves paired associations between previously neutral stimuli and unconditioned stimuli
Bronfenbrenner’s Ecological Model
The child’s environment is a series of nested and
interconnected structures with the child at the center.
child development is impacted by multiple
systems
Attachment
the process of establishing and maintaining an
emotional bond with parents or other significant individuals
* Four patterns of attachment
transactional view
Children and environments are interdependent
− Both children and the environment are active contributors to adaptive and maladaptive behavior.
Social learning
Social learning explanations consider overt behaviors and the role of possible cognitive mediators
Family systems theorists
Understanding or predicting the behavior of a particular family member cannot be done in isolation from other family members
* The study of individual factors alongside the child’s context is mutually compatible and beneficial to both theory and intervention
Classical conditioning
Involves paired associations between previously neutral stimuli and unconditioned stimuli
shared environment
environmental factors that produce similarities in
developmental outcomes among siblings in the same family
nonshared environment
environmental factors that produce
behavioral differences among siblings in the same family
Incidence rates
extent to which new cases of a disorder appear
over a specified time period
prevalence rates
all cases (new and existing) observed during a
specified time period
Correlates
variables associated at a particular point in time
− No clear proof that one precedes the other
Risk Factors(2)
variables that precede an outcome of interest
− Increase the chance of a negative outcome
Protective factors
variables that precede an outcome of
interest
− Decrease the chance of a negative outcome
Treatment efficacy
whether the treatment can produce changes under well-controlled environments
treatment effectiveness
whether the treatment can be shown to work in clinical practice
Standardization
process that specifies a set of standards or
norms for a method of measurement
Reliability
consistency or repeatability of results
Validity
extent to which it measures the dimension or construct that the researcher sets out to measure
Internal validity
The extent to which a particular variable, rather than extraneous influences, accounts for the findings
External validity
The degree to which findings can be generalized to other people, settings, times, measures, and characteristics
Comorbidity
the simultaneous occurrence of two or more
disorders
Longitudinal research
whereby the same individuals are studied at different ages/stages of development.
Cross sectional research
different individuals at different ages/stages of development are studied at the same point in time.
Informed consent
Before agreeing to participate, all participants must be fully informed of the nature of the research, including:
- Risks, benefits, expected outcomes, alternatives, and option to withdraw from the study at any time
− Minor’s consent must be obtained from parents or legal guardian
Assent
The child agrees to participate.
− Must be obtained if a child is around age 7 or older
Ethical and Pragmatic Concerns
− Deception, the use of mild forms of punishment, the use of participant payment or other incentives, or possible coercion
− Longitudinal research may involve unexpected crises, unforeseen consequences of research, and issues about continuing the research that affect a child’s well-being.
− Researchers are advised or, in the case of research funded by government agencies, required to seek advice from colleagues.
Clinical assessment
systematic problem-solving strategies to
understand children with disturbances and their family and school environments
Developmental considerations
in assessing children and families, one needs to be sensitive to
− The child’s developmental age should be considered, rather than just chronological age.
− The child’s gender also has implications for assessment and treatment.
− Cultural factors must be carefully considered during assessment and treatment.
Culture-bound syndromes
What is typical and atypical may vary between cultures.
More commonly reported among men
ADHD disorder,Childhood conduct disorder,
Intellectual disability, autism spectrum disorder,
Language disorder, Specific learning disorder,
Enuresis
More commonly reported among women
Anxiety disorders, Adolescent depression
Eating disorders, Sexual abuse
Equally reported among men and women
Adolescent conduct disorder,
Childhood depression. Feeding disorder,
Physical abuse and neglect
Prognosis
formulation of predictions about future behavior under specified conditions
untructured interviews
Provide a large amount of information during a brief period
* Include a developmental or family history
* Most interviews are unstructured.
− May result in low reliability and biased information
structured interviews
more reliable.
− Include specific questions
Behavioral assessment
Evaluates the child’s thoughts, feelings, and behaviors in specific settings
* Primary problems of concern
− Target behaviors and the factors that control or influence them
* ABCs of assessment are to observe the
− Antecedents
− Behaviors
− Consequences of the behaviors
Checklists and rating scales
Reports concerning child behavior and adjustment can be obtained using global checklists and problem-focused rating
scales.
− Used to ask parents, teachers, and sometimes the youths themselves to rate
The presence or absence of a wide variety of child behaviors
The frequency and intensity of these behaviors
− Child Behavior Checklist (CBCL) is a leading checklist for assessing behavioral concerns in children and adolescents ages 6 to 18.
Wechsler Intelligence Scale for Children (WISC-V):q
emphasizes fluid reasoning abilities, higher order reasoning, and information processing speed
* Comprehensive assessments often include achievement (academic) testing
Commonly Identified Dimensions
of Child Psychopathology
anxious, depressed, withdrawn, social problems, somatic symptoms(dizzy,headaches, pains), thought problems, aggressive behavior, attention problems, rule-breaking behavior
Neurodevelopmental disorders
− Intellectual Developmental Disorder
− Autism Spectrum Disorder
− Communication Disorders
− Specific Learning Disorder
− Attention-Deficit/Hyperactivity Disorder
− Motor Disorders
Psychodynamic treatments
View child psychopathology as determined by underlying unconscious and conscious conflicts
− Focus is on helping the child develop an awareness of unconscious factors contributing to problems
Behavioral treatment
Assume that behaviors are learned and focus on re-educating the child
Cognitive treatmenr
− View abnormal behavior as the result of deficits and/or distortions
in the child’s thinking
− Focus is on changing faulty cognitions.
Cognitive-behavioral treatment
− View psychological disturbances as the result of faulty thought patterns, faulting learning, and environmental experiences
− Focus is on identifying and changing maladaptive cognitions.
Client-centered treatmenr
Focus on creating a therapeutic setting that provides unconditional acceptance of the child
Family treatments
View individual disorders as manifestations of disturbances in family relations
Focus on the family issues underlying children’s problematic behavior
Neurobiological Treatments
- View child psychopathology as resulting from neurobiological impairment or dysfunction
- Rely primarily on pharmacological and other biological approaches to treatment
- Medication use has continued to increase
- The percentage of children receiving more than one class of medication has also increased
Attention-deficit/hyperactivity disorder (ADHD)
persistent age-inappropriate symptoms of inattention, hyperactivity, and impulsivity that are sufficient to cause impairment in major life
activities
− Inattentive: not focusing
− Hyperactive: constantly in motion
− Impulsive: acting without thinking
− No distinct physical symptoms
Inattention
Inability to sustain attention or stick to tasks or play activities, to remember and follow through on instructions or rules, and to resist distractions
Hyperactivity
Under-controlled motor behavior, poor sustained inhibition of behavior, the inability to delay a response or defer gratification
* An inability to inhibit dominant responses in relation to ongoing situational demands
* Hyperactive behaviors include
− Fidgeting and difficulty staying seated
− Moving, running, touching everything in sight, excessive talking, and pencil tapping
− Excessively energetic, intense, inappropriate, and not goal-directed
Impulsivity
− Inability to control immediate reactions or to think before acting
− Cognitive impulsivity includes disorganization, hurried thinking, and need for supervision
− Behavioral impulsivity includes difficulty inhibiting responses when situations require it
− Emotional impulsivity includes impatience, low frustration tolerance, hot temper, quickness to anger, and irritability
cognitive processes
working memory, mental computation,
planning, anticipation, and flexibility of thinking
Language processes
verbal fluency and the use of self-directed
speech
Motor processes
allocation of effort, following prohibitive
instructions, response inhibition, and motor coordination and sequencing
Emotional processes
self-regulation of arousal level and
tolerating frustration
Intellectual deficits
Most children with ADHD have at least typical intelligence—the difficulty lies in applying intelligence to everyday life situations
executive functions
Higher-order mental processes that enable a child to maintain a problem-solving orientation in order to attain a future goal.
Disorders associated with ADHD
About half or more of all children and adolescents with ADHD meet criteria for oppositional defiant disorder
* Are at high risk for getting into serious trouble at school or with the police
About 25% to 50% of children with ADHD experience excessive anxiety
− Co-occurring anxiety worsens symptoms or severity of ADHD
− Children with co-occurring ADHD and anxiety display social and academic difficulties
* 20% to 30% of children with ADHD experience depression
− ADHD at 4 to 6 years of age is a risk factor for future depression and suicidal behavior
Genetic influences on ADHD
Family, adoption, twin, and gene studies strongly indicate that the risk for ADHD is inherited
− The precise mechanisms are not yet known
* Specific gene studies
− Genes may contribute to the expression of ADHD
Focus on dopamine regulation and the serotonin system
− Role of environment: incorporated into any explanation of ADHD based on genetic influences
Course and Outcomes of ADHD
Infancy: signs of ADHD may be present at birth
* Preschool: symptoms become more visible and significant at ages 3 to 4
− Children with symptoms for at least 1 year are likely to continue to have difficulties later in middle childhood and adolescence
* Elementary school: symptoms are especially evident when the child starts school
− Oppositional defiant behaviors, defiance and hostility increase
− Increased problems with life: chores, academics, relationships Adolescence
− Many children with ADHD do not outgrow problems and some can get much worse
− At least 50% of clinic-referred elementary school children continue to experience ADHD into adolescence
* Adult challenges
− Some individuals either outgrow or learn to cope with their disorder by adulthood
− ADHD is established as an adult disorder
Primary ADHD treatment
Many children with ADHD, particularly those in greatest clinical need, do not receive specialty services for ADHD
* The primary treatment approach combines:
− Stimulant medication
− Parent management training
− Educational intervention
* Procedure for early detection and early intervention for ADHD is emerging
Parent management training
Managing disruptive child behavior at home, reducing parent-child conflict, and promoting prosocial and self-regulating behaviors
Provides parents with a variety of skills
− Managing the child’s oppositional and noncompliant behaviors
− Coping with emotional demands of raising a child with ADHD
− Containing the problem so it does not worsen
− Keeping the problem from adversely affecting other family members
* Parents are next taught behavior management principles and techniques
* Parents also learn to reduce their own levels of frustration through relaxation
Educational intervention
Managing disruptive classroom behavior, improving academic performance, teaching prosocial and self-regulating behaviors
teacher and child must set realistic goals
and objectives
− School-based interventions for ADHD have received considerable support
summer treatment programs(intensive)
Enhancing present adjustment at home and future success at school by combining many of the primary and additional treatment in an intensive summer treatment program
Support groups
Connecting adults with other parents of children
with ADHD, sharing information and experiences
about common concerns, and providing emotional support
Medication for ADHD
Among the most effective stimulants are dextroamphetamine and methylphenidate
− May help normalize frontostriatal structural abnormalities and functional connections
* In 80% of children stimulants produce
− Increases in sustained attention, impulse control, and persistence of work effort
− Decreases in task-irrelevant activity and noisy and disruptive behaviors
* Stimulant medications used appropriately and with proper supervision are usually quite safe
Neuropsychological tests
attempt to link brain functioning with objective measures of behavior known to depend on an intact central nervous system
* Neuropsychological assessments consist of comprehensive batteries that assess a full range of psychological functions
