Child psych: further clinical topics Flashcards
Which mental health problems are associated with being out of school?
- Anxiety
- Conduct disorder
- Autism
- Depression
- Obsessional compulsive disorder
What are some of the effects of mental health problems on school attendance and learning?
- Learning difficulties due to poor attention
- Co-morbid specific (or general) learning problems
- Difficulty controlling emotion e.g. frustration, escalation of anger, frequent conflict.
- Anxiety (see below)
- Lack of energy, motivation
- Difficulties joining in – wanting to be alone or unable to make friends (feeling different).
- Sensory problems – too noisy
- Preoccupation e.g. fear of germs and contamination
- Associations between mental health and learning difficulties e.g. dyslexia
What is separation anxiety?
Fear of leaving parents and home. Problems on the doorstep
What are the key features of anxiety disorders (3A’s):
- Anxious thoughts and feelings (e.g. impending doom)
- Autonomic symptoms
- Avoidant behaviour
What are motivational factors affecting school attendance?
- Affecting willingness to go to school
- Learning difficulties
- Lack of friends and relationships
- Bullying
- Lack of parental attention or concern (e.g. lack of interest in child’s education)
- Encouraging one to stay at home
- Maternal depression (enc. Separation anxiety)
How is the amygdala affected in anxiety disorder?
- Amygdala activity is supressed by right ventrolateral amygdala when labelling emotions.
- Reduced connectivity between right ventrolateral cortex and amygdala in generalised anxiety disorders in adolescents.
What are the treatment options for anxiety in children?
- Behavioural
- Learning alternative patterns of behaviour
- Desensitization
- Overcoming fear
- Managing feelings
- Medication
- Serotonin reuptake inhibitors e.g. fluoxetine
If a child has been absent of school due to anxiety what is the management ?
- Contain the anxiety
- Return to school ASAP
What are the long term effects of successful behavioural treatment?
- Challenge
- Success
- Self confidence
- Resilience
How does CBT work with children and families?
- Don’t expect children to have cognitive awareness
- Mostly B & T
- Parents as collaborators in the team
- Step-wise approach: the ladder to success
- Externalisation: disorder is not a matter of blame.
- Overcoming barriers to change: problem solving
What is:
- Psychoeducation
- Goal setting
- Motivating
- Externalising
- Psychoeducation – explaining the problem in terms that make sense to everyone.
- Goal-setting – choosing reasonable objectives that can be achieved.
- Motivating: getting buy-in so the goals can be achieved.
- Externalising: taking blame, guilt and anger out of the equation.
What is autism spectrum disoder?
- Defined as a syndrome of distinctive behavioural abnormalities.
- Often associated with Low IQ but not defined by low IQ.
- Pervasive: present across the life span (onset <3yrs) and across settings (a feature of brain development and function)
- Highly heritable.
- Now thought to affect 1%
- Male:female ratio 3:1
What are some of the altered proteins implicated in autism?
Many synaptic proteins are implicated mainly glutaminergic but also GABA.
Please explain the autism spectrum:
Autism normal IQ: effects are only on synaptic function
Autism with learning difficulties: Effects on synaptic function, neural migration and brain development
Distinctive features of autism:
Social: reciprocity and communication - please elaborate
- Reciprocal conversation
- Expressing emotional concern
- Non-verbal communication
- Declarative pointing
- Modulated eye-contact
- Other gesture
- Facial expression
What are the differences between ODD and ADHD?
