Unit 30 Mood Disorders in Children Flashcards
Which 3 things is Mental Health marked by?
- Cognition
- Emotional stability
- Socially acceptable coping skills and socialization within and outside of family
When does an emotional problem exist?
If behavioral manifestations:
- Are not age appropriate
- Deviate from cultural norms
- Create deficits or impairments in adaptive functioning
What are risk factors for mood disorders in children?
- Genetics
- Biochemical
- Pre and post natal: drugs, alcohol, toxins,, malnutrition, birth hypoxia, abuse, etc.
- Temperament
What is temperament?
- Behavior used to cope with environment that is genetic
- Born with it
What are family risk factors for mood disorders in children?
- Low socioeconomic status
- Severe family discord
- Large families and overcrowding
- Foster care placement
- Maternal psych disorders
- Parental criminality
What is true regarding risk factors and stressors in relation to mood disorders?
The greater the number of stressors the greater the risk of developing mood disorder
What is resilience?
- The temperament to adapt to change
- The ability to form nurturing relationships with other adults if parent in unavailable
- Ability to distance themselves from emotional chaos of parent or family
- Good social intelligence
- Ability to problem solve
What is an important part of the first interview with a child?
The interactions between the child, the caregiver, and the siblings
What is Autism Spectrum Disorder and how is the diagnoses formed?
- A disorder that is characterized by an impairment in social interaction skills and interpersonal communication with a restricted arsenal of activities and interests
- The Dx is adapted to each individual by clinical and associated features like severity, verbal ability, intellectual disability, etc.
Briefly describe Autism.
- It is a developmental disability
- Children and adults exhibit atypical repetitive behaviors and deficits in social and communication skills
- Dx BEFORE 3 years old
- More prevalent in boys
- Characterized by withdraw into self
What is SEEN in autism?
- Speech abnormalities such as echolalia, unconventional word use, unusual tone pitch.
- Difficulty with social interactions and communications (difficulty sharing feelings or information)
- Difficulty understanding common nonverbal cues such as body language, eye contact, or facial expressions
- Delay in or lack of development of spoken language
- Unusual behaviors
- Very resistant to changes in routine
- Peculiar sustained play activites
What is echolalia?
Repetition of another person’s spoken words
What two medications are used in treating Autistic Disorder and what do they target?-
resperidone aripiprazole (Abilify) **they are atypical antipsychotics
These Rx's target: Aggression Deliberate self-injury Temper Tantrums Quickly changing moods
(Dosage based on weight and clinical response)
(Would use these Rx’s for serious symptoms)
What are common side effects of resperidone?
- Drowsiness
- Increased appetite
- Nasal congestion
- Fatigue
- Constipation
- Drooling***
- Dizziness
- Weight gain
What are common side effects of aripiprazole (Abilify)?
Sedation
Fatigue
Weight gain
Vomiting
Tremors
Somnolence (sleepiness, drowsiness)
Describe Asperger’s Disorder.
Shares the social deficits and behaviors of autism but DO NOT have a history of substantial cognitive or communication delays.
Describe ADHD (Attention Deficit Hyperactivity Disorder).
-Persistent pattern on hyperactivity-impulsivity
or inattention that is more severe when compared to individuals at a comparable level of development
- 3x more common in boys
- Difficult to Dx before age 4
- IMPULSIVE, distractible, excessive motor activity, failure to attend to detail, careless mistakes, not listening, avoiding or delaying tasks.
What is the etiology of ADHD?
Unknown, but these factors could contribute:
- Genetics
- Biochemical decrease in dopamine and norepinephrine
- Environmental lead exposure
- Diet
- Psychosocial
As many as how many children with comorbid conditions such as anxiety, depression, bipolar disorder, substance abuse disorder, conduct disorder, etc also have ADHD?
2/3 of children
What is true regarding other conditions and ADHD together?
The other conditions for example such as anxiety, substance abuse disorder, etc must be stabilized before treating ADHD.
Describe the types of medication used for ADHD, their side effects and warnings/other info.
[CNS stimulants - all the amphetamines]
Side effects: insomnia, weight loss, anorexia, tachycardia, decreased rate of growth and develop.
Warning! Monitor cardiovascular functioning carefully, psychiatric symptoms may worsen,
drug holiday necessary to determine effectiveness and need for continuation, break from Rx beneficial
atomoaxatine (Strattera)
[SNRI] selective norepinephrine reuptake inhibitor
Side effects: Headache, NandV, upper abdominal pain,
dry mouth, weight loss, insomnia, tachycardia and increased BP, sexual dysfunction
Warning! Monitor cardiovascular and liver functioning carefully, psychiatric symptoms may worsen
bupropion (Wellbutrin)
[non-selective reuptake inhibitor]
Side effects: tachycardia, dizziness, shakiness, anorexia, weight loss, insomnia, nausea, constipation
**Warning! individuals with history of seizures or eating disorders should not take this medication
What is important regarding medication for ADHD and behavior?
Behavior modification in conjunction with medication is essential,
don’t treat just with medication!!
Describe conduct disorder and the 2 diagnosis.
- Persistent pattern of behavior which the basic rights of other and major age-appropriate societal norms are violated
- Bullying, cruelty to animals, fighting, setting fires, theft, more common in boys, physical aggression, difficult peer relationships, etc.
Dx: Childhood onset prior to age 10 (likely to be antisocial personality disorder after age 18)
Dx: Adolescent onset (less aggressive, more normal relationships)
What are the predisposing factors to conduct disorder?
- ADHD (meaning you see ADHD when a child has conduct disorder)
- Parental rejection
- Inconsistent parenting with harsh discipline
- Early institutional living
- Absent father
- Antisocial or alcoholic parent
