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Child & Adolescent Psychopath > Weeks 1-4 For Exam > Flashcards

Weeks 1-4 For Exam Flashcards

1
Q

Psychopathology

A

Behaviors that cause functional impairment and distress

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2
Q

Why is important to study child and adolescent psychopathology?

A

Disorders of childhood often show significant continuity with later childhood disorders, they may also be found in adult disorders, a lot of child disorders are comorbid with anxiety and mood

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3
Q

Unidentified mental health problems in children

A

Many problems in children go unidentified. It is usually a lack a resources, no one’s fault. Most families with try to find other help before psychological help

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4
Q

If these mental health problems go unidentified what happens to these children?

A

They will go unidentified until they end up in the criminal justice system at young adults, this is when they will receive treatment

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5
Q

What recent social changes are placing children at increasing risk for development of disorders at younger ages?

A

Poverty, family breakup, homelessness, single parenting, covid-19, exposure to trauma, multigenerational adversity in inner cities, substance use, HIV

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6
Q

Limitations when working with children

A

Research extrapolated from adult research because it is hard to get IRB to do research on children, case formulation because you are working with the family not only the child

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7
Q

DSM challenges when working with children

A

Doesn’t address children under 5, high rate of comorbidity of child disorders, for certain disorders children may not need to have as many symptoms to meet criteria, children and adults are different, children show more somatic symptoms

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8
Q

K-3 paradigm for diagnostic purposes

A

-knowledge of development (you will do a thorough history, before they were conceived)
-knowledge of contexts (we need to know when did these symptoms become present
-knowledge of theories

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9
Q

Contextual influences

A

Child as context, child of context and child in context

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10
Q

Child as context

A

The idea that unique child characteristics, predictions and traits influence the course of development

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11
Q

Child of context

A

The notion that the child comes from a background of interrelated family, peer, classroom, teacher, a school, community and cultural influences (everything around the child)

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12
Q

Child in context

A

The understanding that the child is a dynamic and rapidly changing entity, and that descriptions taken at different points in time or in different situations may yield very different info and results (understanding what’s going on)

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13
Q

What are some components of case formulation?

A

Descriptive information, diagnosis, inferential information, treatment planning

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14
Q

What are some precipitating or current stressors and or events

A

Problematic aspects/traits of the self, problematic aspects of relatedness to others, dysfunctional thoughts and or core beliefs, affect regulation or dysregulation

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15
Q

What is best to have when inferring biological mechanisms?

A

Need to have a thorough developmental history

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16
Q

Common etiological considerations and Risk factors

A

Genetic influences, temperament, difficult child behavior, social/ cognitive deficits, issues with emotional regulation, social learning, poverty, limited family resources

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17
Q

Gender differences, etiology between gender tends to differ

A

-females may be excluded from research, it is focused on boys

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18
Q

Issues in child psychopathology (Risk & resilience factors)

A

Adverse conditions, early struggles to adapt, failure to meet developmental tasks do not inevitably lead to pathology.

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19
Q

Issues in child psychopathology (vulnerability factors)

A

Acute and stress situations include chronic adversity, poverty, serious caregiving deficits, parental psychopathology, death of a parent, community disasters, homelessness, reduced social support, family break up

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20
Q

Protective factors for children

A

Easy temperament, early coping strategies, high intelligence, attractiveness, close with one person who is attuned to the child’s needs, effective communication

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21
Q

DSM limitations for children

A

Denial of services for children if they fail to meet a certain criterion

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22
Q

What are the 4 theoretical models?

A

Attachment theory, cognitive theories, emotion theories & constitutional/neurobiological theories

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23
Q

Do parents genes play into a child’s life?

A

Yes even if they don’t show signs, they may be a carrier

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24
Q

Three laws of behavioral genetics

A

-All human behavioral traits are heritable
-effects of being raised in the same family are smaller than effects of genes (genes can change the way a child acts over environment)
-a substantial portion of variation in complex human behavioral traits is not accounted by effects of genes or families (outside influence)

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25
Epigenesis
Changes in gene expression that are environmentally mediated (regulated, activated, turned on, silenced, etc.) these occur through structural changes to DNA molecules
26
How to be protected with protective factors if there is a predisposition?
With nurture, loving environment, secure attachment, these might postpone it or help with predisposition Ex: a child who is abused or living in a war zone may have these alleles and symptoms show earlier on than other children
27
What has neuroscience shown regarding early brain development?
Experience dependent and requires attuned child-parent interactions
28
Six core strengths
Attachment, self-regulation, affiliation, attunement, tolerance and respect
29
Attachment
The capacity to form healthy emotional bonds with others
30
Self-regulation
The ability to notice and control primary urges such as hunger and sleep, as well as frustration, anger and fear (sit down with them calm them down, speak slowly and quietly)
31
Affiliation
The capacity to join others and contribute to a group (joining a team, having some sort of team)
32
Attunement
Recognizing the needs, interests, strengths and values of othets
33
Tolerance
The capacity to understand and accept how others are different from you
34
Respect
Appreciating the worth in yourself and in others (giving a child praise also allowing them to praise themselves)
35
How does the brain develop?
In a hierarchical order from the brain stem to the diencephalon to the limbic and cerebral cortex
36
What disorders can impair behavior?
Developmental disorders of the brain
37
What interacts with experience to guide brain development?
Genes
38
Bruce Perry’s hierarchy of brain function (brain development)
Top: NeoCortex: Abstract and concrete thought Limbic: sexual behavior and emotional reactivity Midbrain: appetite, sleep Brainstem: blood pressure, heart rate and body temperature
39
What happens to reflexes in children?
Reflexes tend to disappear the older a child gets because motor behavior overrides, if a child holds onto a reflex for a long time, the nervous system may be overactive
40
Neuroplasticity
Varies by age-younger brain more malleable -involves several processes—neurons,glial, etc. -changes happen due to experience (can be positive or negative) -other parts can assume role of damaged parts -interaction between environment and genetics important -two types: functional vs. structural
41
Functional neuroplasticity
The brains ability to move functions from damaged parts of brain to a different part
42
Structural (neuroplasticity)
Able to move structure of face
43
Dopamine (feel good)
Regulating dopamine either too much or too little is being used in these neurons (pleasureful could be positive or negative)
44
What happens if there is too much dopamine?
Can be a problem, we might see aggression, poor impulse control, ADHD, these are all secondary to activating this dopamine hits over and over
45
Norepinephrine (stress hormone release)
Brain perceives a stressful event has occurred, perceives a threat is going to happen! Within this treatment you have to create a panic attack by separating the cognition and emotional response
46
Serotonin (stabilizes our mood)
Feelings of well being and happiness, known as the feel good aspect.
47
Brainstem
Started at the low point (attention, blood pressure, heart rate, body temperature and sleep)
48
Diencephalon/Midbrain
Motor regulation, arousal levels, appetite
49
Limbic system
Emotional brain, feelings of attachment and connection
50
Neocortex
Last to fully develop, responsible for abstract and concrete thinking, executive functioning
51
4 nervous systems
Central nervous system Autonomic nervous system (how our body reacts to the environment) Parasympathetic nervous system (relaxed non-threatened state) Sympathetic nervous system (our response to stress)
52
The stress response and HPA systems
The pituitary adrenal axis starts in the hypothalamus and this will release the CRF (corticotrophin releasing factor) to the anterior pituitary this releases ACTH (adrenocorticotrophic hormone) and goes to adrenal cortex which creates cortisol
53
What does cortisol do?
We need it to survive, it increases blood glucose, blood pressure and amino acids
54
When does SAM (sympathetic adrenal medulla activation) branch out?
Into short-term stress response, HPA axis in activated in both whenever stress is present
55
Short term stress responses
Release of adrenaline or cortisol that will do all of these things internally to become more alert, or a stressor that is non-life threatening
56
Long term stress response
Really hard on the body, when there is repeated exposures to stress, no way to shut off that stress response ex: kids living in abusive home
57
What is only present in long term stress response
Mineralocorticoids and glucorticoids
58
ANS sympathetic nervous system response to stress
Increased arousal via the release of hormones (dopamine, acetylcholine and norepinephrine) this leads to higher levels of norepinephrine and epinephrine
59
What happens after a stressor starts?
Goes to hypothalamus, next adrenal medulla, next release of catecholamines: epinephrine to help breath and norepinephrine (increases blood pressure) -leads to fight or flight response
60
What happens to the acute stressors in short term ?
Goes through the stress system to create cortisol and goes back to hypothalamus to shut off the negatives
61
What happens to long term stressors?
It will return to the hypothalamus for the negative shut off, it will return to the anterior pituitary
62
Parasympathetic Nervous System
Promotes vegetative functions (rest and restorative behavior) inhibits cardiac activity and output, and enables sustained attention as a consequence of regulatory mechanisms that occur in prefrontal cortex
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Vagal withdrawn
Quick response of the PNS to the withdraw its inhibitory functions which allows the excited SNS to work unopposed
64
What helps the vagus nerve help the parasympathetic nervous system?
Pressure points
65
CNS
Controls and coordinates the body’s functions, process and send instructions to the rest of the body
66
HPA system
Complex set of interactions that primarily between the pituitary gland, the amygdala, hippocampus and the hypothalamus
67
Adaptive calibration model summary The stress response system (SRS) has 3 main biological functions
A. To coordinate an individuals response to stress B. To encode and filter information from the environment C. Regulate a range of experiences and traits
68
Cortisol
Cortisol is released to manage alarm reactions to stress, activating an adaptive phase of a general adaptation syndrome in which alarm reactions including the immune response are suppressed, allowing the body to attempt to return to homeostasis! High cortisol helps fix a traumatic memory in your mind.
69
Glucocorticoids
Responsible also for modulating stress
70
What is more experience dependent region of the brain?
Cerebellum, we need this to work effectively so we can use it as building blocks to get to higher order functioning
71
What is the cerebellum involved in?
Attention, forms of learning, memory tasks, conditional anxiety, complex reasoning and problem solving and motor tasks
72
Impact on chronic neglect and cerebellum
-Smaller cerebellar lobe volume found -impairment in visual spatial memory and the planning component of executive functioning
73
Amygdala
Regulates emotional such as fear and aggression. Tying emotional meaning to our memories, reward processing and decision making
74
Hippocampus
Affected by stress and is tied to cognitive functioning such as learning, memory and behavior regulation
75
Orbitofrontal cortex
Central to social and emotional regulation, children who have been abused have a decreased volume of this
76
Mirror neurons
Active when you are watching someone do the activity like if you are doing the activity yourself
77
Sensitization
A sensitized neural response results from a specific pattern of repetitive neural activation or experience, it occurs when this pattern of activation results in an altered more sensitive system
78
Dissociative continuum
In the presence of a persistent threat, the child will move along the hyper arousal continuum or the dissociative continuum (they will mentally move away from the space) it is the body’s way of protecting
79
Freezing and oppositional defiant behaviors
-a first reaction to continuing threat is to freeze in order to help you figure out and organize your response to the threat (activated when child is anxious) -adults react to this as if the child is being oppositional (intensifying the freeze response)
80
Dissociation
-in young children you see numbing, compliance & avoidance affect -in older children they report going to different place -depersonalization and derealization
81
What areas are affected by the impact of child maltreatment on neurodevelopment
Poor emotional regulation (inability to cope with stress), high cortisol and catecholamines, decreased performance on neuropsychological tasks/IQ tests
82
Neurodiversity (the natural diversity of humans)
The fact that all human beings vary in the way our brains work, process information differently and behave differently
83
Neurodivergent
A person whose brain functioning differs from what is considered “normal” (what most people do)
84
Neurotypical
A person whose brain functioning is considered “normal”
85
Main diagnoses for neurodiversity
Dyslexia, Dyspraxia/DCD, Dyscalculia, ADHD, Autism, Tourette’s/Tics (motor or vocal manifestation), intellectual disability, sensory processing disorder, developmental coordination disorder
86
The main diagnoses for neurodiversity do what?
Overlap and are comorbid, we need to see what is causing the most distress or functional impairment
87
Where are the neurodiversity diagnoses usually overlooked?
In gifted children, those who are of lower intelligence receive more services but the gifted children who are doing well do not have any support they tend to act out
88
Somatosensory cortex
Taking sensory information, sending nerve signals from the thalamus to the CNS, the somatosensory cortex and motor cortex are needed to understand what a person is feeling
89
Broca’s area
Receptive language skills, ex: I can understand what you are saying but cannot say it.
90
What does the sympathetic system do to your body?
Raises your heart rate and gets your body ready
91
What does the parasympathetic system do to your body?
Calms your body down
92
What is a limitation when looking at sensory processing disorders?
It is under researched and under-utilized
93
Dunns model of sensory processing (2007)
-if we have a high threshold we can take a lot of sensory information we are hypoactive in a passive way, we can add more -low threshold I will be hyperactive (cup is already full) avoid sensory information
94
Dunns model continued with passive and active state
When we are in an active state-we are counteracting the sensory information (trying to rebalance) When we are in a passive state-brain acts in accordance with threshold (meaning we are in an okay state)
95
Sensory integration
The organization of sensation from the body and the environment for use! 5 interrelated components within this definition
96
Sensory processing
This refers to the way the nervous systems responded to sensory stimuli from the environment
97
Sensory modulation
Refers to how one regulates in response to sensory stimulation
98
Sensory discrimination
Essentially references the ability to accurately distinguish and differentiate different sensory stimuli
99
Sensory based motor skills
The motor responses/behaviors/actions that occur in response to sensory stimuli
100
Sensory processing disorder (SPD)
SPD is a condition where an individuals sensory processing is atypical, causing difficulties in daily life. It can manifest as hypersensitivity, hyposensitivity or sensory seeking behaviors
101
5 interrelated components of sensory integration
1. Sensory registration initial awareness of the sensory input 2. Orientation -selective attention to the new input 3. Interpretation integration of input across sensory modalities and or attribution of meaning (discrimination and perception) 4. Organization of a response- determination of a cognitive, affective and or motor response 5. Execution of the response- performance of the cognitive, affective and or motor response. If there is a motor act, new sensory input is then generated
102
Sensory system
Tactile-nerves underneath the surface of the skin register sensation, taste, smell, sight, sound, proprioception, vestibular functioning and introceptionn
103
Vestibular structures
Within the inner ear that detect movement and changes in position of the head. Processes information about movement, gravity and balance
104
Proprioceptive
components of muscles, joints and tendons that provide awareness of body position. Processes information about body position and body parts.
105
Interoception the 8th sense
The sense of the internal state of the body that is both conscious and unconscious, central to everything including sense of self, thought, emotion, and most critically self regulation
106
Vestibular System
We have different tubes that respond to different types of movement Ex: from the time of infancy the doctor wants to see that the baby can hold their head up when lifted back, if they have a head lag it shows an issue with this system
107
Why is it helpful to examine attributes of the stimulus?
This will lead to the interventions utilized.
108
What are some symptoms of dysfunction in the tactile system?
Avoiding touch, craving touch, food/clothing preferences, aversion/craving to washing, brushing teeth, combing hair, clipping nails, using fingertips rather than the whole hand/using only the whole hand
109
Symptoms of dysfunction in the vestibular system
Hypersensitivity & hyposensitivity
110
Hypersensitivity
Fearful of ordinary movement activities (swings, slides, ramps, stairs, etc.) , fearful of uneven or unstable surfaces, clumsy in appearance, generally fearful of
111
Hyposensitivity
Actively seeks out very intense sensory experiences (jumping, spinning, crashing)
112
Symptoms of dysfunction in the proprioceptive system
Clumsiness/accident prone, tendency to fall, lack of awareness of bodily needs (hunger, thirst), difficulties with body awareness, odd body posturing, difficulty manipulating small objects and with motor planning
113
Sensory threshold
The point at which the sensory input activates the CNS
114
How do children who are hyperreactive react?
Children tend to have a sympathetic nervous system, often described as insecure and engage in activities that help with hyperactivities such as pressure touch, heavy work or physical exercise
115
Sensory avoiders
Try to manage sympathetic nervous system bias by withdrawing from excitatory input. These protective reactions help them modulate their arousal, but attention is often hyper-vigilant as they attempt to avoid sensory overload, usually affect is fearful
116
Hyporeactive
Children tend to have a parasympathetic nervous system bias. Their state of arousal is usually decreased. There is a prolonged latency in maintaining focused attention. Affect is usually flat and restrictive
117
Sensory seekers
Children try to manage the parasympathetic nervous system bias by actively pursuing excitatory sensory input. Least common regulatory response. Usually results in over stimulation
118
Developmental coordination disorder
The acquisition and execution of coordinated motor skills is substantially below the individuals age
119
Nervous System Response to Acute Stress ■ Three neurological responses to stress occur
ANS sympathetic-adrenal medulla activation (SAM) – CNS amygdala-locus coeruleus activation – CNS hypothalamic activation, which can directly lead to excitation of the hypothalamic- pituitary-adrenal (HPA) AXIS

Child & Adolescent Psychopath (7 decks)

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