CAMHS Flashcards
What are the different types of attachment style?
Secure
Insecure avoidant
Insecure ambivalent/resistant
Disorganised
What are the features of secure attachment?
Distressed when mother leaves
Avoidant of stranger when alone but friendly when mother present
Positive + happy when mother returns
What are the features of ambivalent attachment?
Signs of distress when mother leaves
Avoids/fear of stranger
When mother returns, child approaches but resists contact, may even push her away
Infant cries a lot and explores less
What are the features of avoidant attachment?
No signs of distress when mother leaves
Fine with stranger
Little interest when mother returns
Mother + stranger able to comfort infant equally
What are the features of avoidant attachment in adoelescents?
Feels unloved, self-reliant
Rejects others, seen as cold
Avoids intimacy + dependence
Views relationships as unimportant
What are the features of ambivalent attachment in adolescents?
Disruptive + attention seeking Insecure + coercive Antisocial behaviour, impulsivity, poor concentration Lots of complaining Dysregulated emotions
What is reactive attachment disorder (RAD)?
Marked disturbed + developmentally inappropriate social relatedness in most contexts that begins before 5 years
–> difficulty forming lasting, loving, intimate relationships
Associated with grossly pathological care
Which medical features may be seen in RAD?
Malnutrition Growth delay Evidence of physical abuse Vitamin deficiencies Infectious disease
What are the subtypes of RAD?
Inhibited - e.g. child doesn’t seek comfort from caregiver during times of distress
Disinhibited - e.g. child displays excessive familiarity with strangers, lack of selectivity in choice of attachment figure
Which symptoms should raise urgent wellbeing concerns in very young children?
Persistent + medically unexplained severe colic
Poor eye contact, difficulty tracking
No reciprocal smile response
Delayed gross motor development
Difficulty being comforted
Resists affection and cuddling from caregiver
Appear stiff, display tactile defensiveness
Poor suckling response when eating
Which treatments are effective in RAD?
Family therapy
Individual therapy
Play therapy
What is conduct disorder?
Repetitive + persistent pattern of behaviour in which the basic rights of others, norms or rules are violated (behavioural disorder)
- aka Oppositional Defiant Disorder in younger children
What are the features of conduct disorder?
3 or more of the following in the past 12 months:
- aggression to people or animals
- destruction of property
- deceitfulness or theft
- serious violation of rules
Which conditions are very often co-morbid with conduct disorder?
ADHD --> very common Attachment difficulties Reading/other learning difficulties Depression Substance misuse Deviant sexual behaviour
