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childhood: clinical > week 2 > Flashcards

week 2 Flashcards

1
Q

shared features of chronic worry

A

behavioural (escape, avoidance), cognitive (negative self-appraisals), and physiological (involuntary arousal – increased heart rate, rapid breathing, tremors, muscle tension)

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2
Q

DSM-III

A

separation anxiety, avoidance anxiety, overanxious disorder

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3
Q

how long should separation anxiety disorder last

A

4 weeks

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4
Q

sad onset age

A

before 6 it’s early, but always before 18

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5
Q

Diagnostic criteria – excessive worry about separation from the caregiver in at least three of the following ways (7)

A

o Fears about caregiver succumbing to an accident or harm
o Excessive worry about an anticipated separation at some future time
o School refusal
o Fear of being alone with the caregiver
o Reluctance to sleep alone or away from home
o Nightmares about separation
o Repeated physical complaints if separation occurs

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6
Q

prevalence of SAD in general and in the clinical population

A

4 vs 10%

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7
Q

separation anxiety is comorbid with

A

GAD, depression, somatic complaints

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8
Q

More than X% of children with SAD or GAD had mothers with history of anxiety disorders

A

80%

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9
Q

SAD treatment

A

CBT
Coping Cat problem - behaviorally oriented component

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10
Q

SAD and school refusal

A

75% of children with SAD demonstrate school refusal, 1/3 of children who refuse school have SAD

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11
Q

selective mutism - how long till diagnosed

A

1 month

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12
Q

mutism prevalence

A

0.3-1%

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13
Q

mutism onset

A

5 years - could be later if the child is homeschooled

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14
Q

controversy as to how to best conceptualize mutism

A

some see it as an early precursor to social anxiety disorder and other considering it a specialized form of language disorder impairment – 30-38% of children with selective mutism also experience speech or language disorders

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15
Q

when do fears tend to decrease

A

7 years

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16
Q

most common phobias

A

animals, natural environment, blood-injection-injury, situational causes

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16
Q

specific phobia

A

persistent, significant fears of an object or place that doesn’t have a reasonable basis
o Frequent avoidance of the feared object
o Exposure to it – significant physiological responses (dizziness, shortness of breath, increased heart rate, fainting)

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17
Q

Symptoms of phobias

A

excessive reactions to encountering a feared object or situation and can include provoked responses involving the following
o Immediate fear, anxiety
o Avoidance (active avoidance)
o Excessive responses, out of proportion to the danger assessed
o Persistence

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18
Q

how % of anxiety is specific phobia

A

15%

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19
Q

three broader types of phobias have been associated with onset most likely in middle adolescence

A

social anxiety disorder, panic disorder, agoraphobia

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20
Q

when do most phobias develop

A

childhood and adolescence
mean age is 10 and the onset is usually 7-11

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21
Q

behavioral explanations for phobias

A

classical conditioning, observation, modelling, operant conditioning

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22
Q

phobia treatment

A

systematic desentization

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23
Q

what is social anxiety disorder

A
  • Pervasive fear of embarrassment or humiliation  avoidance of social or performance situations
    o Situations where an individual feels they’re being evaluated or scrutinized – social interactions, being engaged in activities in public or performing
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24
Q

criteria for social anxiety

A

at least 6 months and interferes with functioning

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25
Q

two factors for social anxiety

A

o Personal fable – no one has ever experienced what they’re experiencing
o Imaginary audience – everyone is looking at them

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26
Q

lifetime prevalence for social anxiety

A

3-13%

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27
Q

prevalence for social anxiety for children

A

1-2%

28
Q

onset for social anxiety

A

median age is 13,

29
Q

social anxiety treatment

A

social skill training

30
Q

what are panic attacks

A

intense, overwhelming, inescapable fear that permeates thoughts, feelings, sensations
o Attacks are sudden and acute, last about 10 minutes

31
Q

symptoms of panic attacks (4/13)

A

o Heart palpitations
o Sweating
o Trembling/shaking
o Nausea and abdominal discomfort
o Chills or heat
o Feeling dizzy
o Numbness or tingling
o Feeling of loss of control
o Depersonalization
o Sensations of chocking
o Chest pain
o Shortness of breath
o Fear of dying

32
Q

lifetime prevalence for panic attacks

A

from 3.3% to 11.6%

33
Q

who has higher prevalence for panic attacks

A

older youth

34
Q

onset for panic attacks

A

15-19

35
Q

when is panic disorder diagnosed

A

if someone who experiences repeated panic attacks becomes preoccupied with the fear of having them

36
Q

the DSM-5 notes that in the month following a panic attack an individual is considered to have developed a panic disorder if

A

o There’s persistent fear of having another panic attack
o Attack results in significant behavioural change resulting from attempts to avoid having another panic attack

37
Q

most common symptoms of the panic disorder in youth

A

nausea, heart palpitations, shortness of breath, shaking, extremes in temperature

38
Q

lifetime prevalence for panic disorder

A

to 3.5% with onset between late adolescence and early thirties

39
Q

medium age for panic attack

A

20-24

40
Q

how many adolescents have at least one panic attack

A

16%

41
Q

which neurotransmitter is involved in panic attacks

A

norepinephrine

42
Q

which area triggers emotional reactions

A

locus coeruleus

43
Q

cognitive theories of panic attacks

A

panic attacks can result from a misinterpretation of bodily sensations

44
Q

agoraphobia - fears

A

o Use of public transportations
o Open spaces
o Enclosed spaces
o Standing in line
o Being out of home, alone

45
Q

agoraphobia prevalence

A

1.7%

46
Q

agoraphobia mean onset

A

17

47
Q

GAD in children vs adults

A

o Adults require 3 additional symptoms of excessive worry, children only need 1
o The mood must be a pervasive mood over 6 months
o The disorder must be responsible for significant adaptive functioning deficits in academic, social or familial relationship areas

48
Q

how many % of people will be diagnosed with GAD

A

2-5%

49
Q

GAD onset

A

8-10

50
Q

which neurotransmitter GAD

A

GABA (gamma-aminobutyric acid)

51
Q

cognitive bias for GAD

A
  • Anxious individuals anticipate and interpret ambiguous events in a negative way
    o And engage in self-blame more readily + focus on negative aspects of events
52
Q

coping cat acronym

A

Feel frightened
Expect the worst
Attitude/actions that can help
Results and rewards

53
Q

assessing children for anxiety disorder

A

Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version (AIDS for DSM-IV:C/P) + Achebach scales for internalizing disorders for parents

54
Q

Three instruments for evidence-based practice

A

The Revised Children’s Manifest Anxiety Scale (RCMAS), the State-Trait Anxiety Inventory for Children (STAIC) and the Fear Survey Schedule for children – Revised (FSSC-R)

55
Q

which category is OCD in

A

includes OCD, body dysmorphic disorder, hoarding disorder, body-focused repetitive behaviours such as hair pulling (trichotillomania) and skin picking (excoriation)

56
Q

prevalence rates for OCD

A

1%

57
Q

OCD men vs women

A

slightly more women but men have earlier onset

58
Q

Prevalence rates for body dysmorphia

A

2%

59
Q

Symptoms of anxiety

A

o Emotional – anxious feeling
o Cognitive – negative thoughts, tunnel vision
o Physiological – trembling, palpitations, sweaty hands, tension, headache, abdominal pain, butterflies
o Behavioural – avoidance and safety behaviour

60
Q

fear vs anxiety vs phobia

A

o Fear – emotional response to real or perceived immediate threat
o Anxiety – anticipation of future threat – often used interchangeably with fear
o Phobia – fearful or anxious about or avoidant of circumscribed object or situation (specific), no specific cognitive ideation (immediate response)

61
Q

why aren’t safety behaviors good in the long-term

A

o Because the child doesn’t experienced that the feared outcomes don’t occur without the safety behaviour or learn to cope with it
o The child attributes the absence of negative experience to the safety behaviour and not to own effort or abilities
o Safety behaviours can increase the feared outcome

62
Q

protective factors in child

A

o Deliberate control
 Attention control
 Behavioural control – physiological
 Emotion regulation
o Perceived control (also self-esteem)
 Sense of security that new situations can be controlled or tolerated

63
Q

family protective factors

A

o Authoritative parenting style
o Family support
o Safety (physical, psychological)
o Predictability

64
Q

school protective factors

A

o Positive climate
o Mentors
o Safety
o Predictability

65
Q

Three routes to anxiety

A

o Classical conditioning/experiential learning
o Model learning
o Informative learning

66
Q

Cognitive biases

A

o Fast response to threat stimulus
 Stimulus attracts attention but once detected one shifts attention quickly
 Implicit association that the stimulus is negative  negative outcomes
 Stimulus trigger negative memories
o People have little control
 Therapy rarely addresses them

67
Q
A

childhood: clinical (2 decks)

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