Flashcards in 10 Childhood 1 – Depression Deck (19):
What percentage of childhood mental illness are treated?
Only 10% of sufferers get treatment.
Why is the establishment of norms more difficult with children?
What is normal changes with age. Normal at 6 is not normal at 16.
What is the distinction between internalising and externalising disorders?
Internalising. E.g. anxiety, mood disorders. Reflect an internal dysfunction.
Externalising E.g. Oppositional defiant disorder (ODD), Conduct disorder (CD), ADHD. The behaviour is dysfunctional.
What's the epidemiology of depression in pre-school, school-age and adolescence?
Pre-school – less than 1%
School-age – 2-3%
Adolescence (14-18) – 15-30%
Risk of depression rises greatly in adolescence
When do the gender differences in depression emerge?
During early-to-middle adolescence, girls become more depressed, leading to 2:1 male:female in adulthood.
At what age do the cognitive diathesis-stress models of depression (Beck - schemas; Seligman – helplessness, attributions) appear valid?
Once people hit 12-14, these are valid models of depression.
Why is mid-adolescence a critical time for major depression? (common-sense answer)
Thinking styles become consolidated. Time of stress – new schools, jobs, independent friendships, falling in love etc.
Five reasons why major depression might be more common in females?
1. Self-image is more associated with body image in females. Men have more control over body type (gym).
2. Females are more comfortable reporting symptoms than males are.
3. Males tend to self-medicate more with drugs and alcohol. This masks depression.
4. Females attribute more importance to social relationships, and are thus more vulnerable to depression when these relationships are, inevitably, disrupted.
5. Females more likely to have negative cognitive styles. Females tend to respond to stress with rumination – rehearsing negative aspects of problem. Males more likely to distract and problem-solve.
What evidence is there that increased depression among females is linked to hormones?
Not much. What appears to cause depression is when bodily changes are out of sync with age. E.g. your friends have boobs, you don't.
What two factors might account for depression in pre-adolescents?
1. Emotional abuse/neglect – which lead to negative schemas.
2. Depressed parents.
What are two reasons why having depressed parents might lead to depression?
1. Modelling behaviour on parents. Observationally learned helplessness, instead of problem-solving.
2. Depressed parents are also less responsive – or are non-contingently responsive. Child generalises to wider world. Depressed parents are more upset when child cries, but comfort less.
What percentage of people in Australia are on anti-depressants?
What anti-depressants are approved in Australia for the treatment of MDD?
None. This means there is no evidence they are effective or safe. But doctors can st ill prescribe them.
What is the evidence for SSRIs in treating people with depression under 24?
In RCTs, SSRIs appear no better than placebos in treating people under 24 with depression. Side effects are much worse – increased suicidal ideation and self-harm.
What is the first-line treatment for those with depression under 24?
What are the data on suicidality and SSRIs?
Effect size small – 1% of suicidal ideation in control vs 2% in treatment. But RCTs tend to leave out the suicidal – this effect may be higher in the community. Strongest association b/w Paxil and Effexor and dangerous outcomes.
What is the difference between universal, selective and indicated prevention?
Universal – all kids. Has advantage of not having to pick kids out from school.
Indicated prevention programs - aimed at high risk groups, kids with depressed parents, low SES.
Selective prevention programs – aimed at those with elevated scores.
How is CBT for kids different from CBT for adults?
It's not, really. It's simply adjusted to different life circumstances. Just as effective as for adults.