Chapter 11: Abnormal Behavior Across the Lifespan

Question 1

What are neurodevelopmental disorders?

Answer 1

usually evident in childhood, often before grade school

especially in cultures with mandatory schooling

Question 2

What are disruptive, impulse control, and conduct disorders?

Answer 2

problems with behavioral and emotional regulation

onset in adolescence or later

Question 3

What are neurocognitive disorders?

Answer 3

disruptions in previously normal cognitive ability

diminution in ability, onset is later in life

Question 4

Why are neurodevelopmental disorders important?

Answer 4

the psychological problems and experienced by children and young people are often especially poignant in that they affect children at a time in their lives when they have relatively little ability to cope

they don’t know what is normal, they don’t have the language to ask for help, and coping mechanisms can be externalized (act out)

some problems of childhood prevent children from reaching their potential; others mirror the problems faced by adults

finally, there are some problems unique to childhood or disorders that manifest themselves differently in children compared to adults

what is considered normal and abnormal for children must be considered in light of developmental issues in addition to factors such as ethnicity or gender, what is acceptable behavior at one age becomes unacceptable as the child grows older

Question 5

What needs to be considered when discussing childhood mental disorders when compared to adult disorders?

Answer 5

previously, children were regarded as smaller adults, need to consider:

neurodevelopmental differences (tendency to engage in risk-seeking behavior in adolescence)

learning history (children don’t have the ability to be accurately empathetic, it isn’t developed yet)

emotional resilience (consequences of trauma, trauma-educated therapy)

solidification of personality (solidified in early adulthood)

Question 6

How have children which neurodevelopmental disorders been treated historically?

Answer 6

caring for congenitally ill children is a relatively recent adopted social value
Ancient Greece: left to die, or thrown off a cliff if they appeared to have a disability

terminating pregnancies where testing of fetal cells has shown evidence of Down’s syndrome

lower surgical and medical priority for severely disabled individuals

Question 7

What are the levels of intellectual disability?

Answer 7

based on level of adaptive functioning (whether or not a person can function in their environment), not IQ

mild, moderate, severe, or profound

social adjustment can have a significant bearing on life success

Question 8

What are the prenatal factors that cause intellectual disability?

Answer 8

cytomegalovirus (CMV): might be asymptomatic, member of herpes family, attacks brain cells

inadequate diet during pregnancy

maternal (while pregnant)

drinking (FASD): teratogen, alters the course of fetal development, days 19, 20, 21 causes distinct facial features

valproate: treatment of epilepsy, same consequences as alcohol

smoking: reduce birth weight, which increases risk for disabilities

antidepressants, antihypertensive drugs

heavy metals (lead, mercury)

Question 9

What are cultural-familial causes of intellectual disability?

Answer 9

cultural-familial intellectual impairment

don’t have the resources to provide things necessary for the child to develop

Question 10

What are interventions that help children with intellectual disability?

Answer 10

mainstreaming: put children in regular classrooms to increase social skills

diagnostic overshadowing: two or more disorders, one is so prominent everything seems to be because of it they are less likely to be treated appropriately for depression, schizophrenia, etc.

Question 11

What are some medical conditions that may cause intellectual disability?

Answer 11

down syndrome

fragile X syndrome

phenylketonuria (PKU): metabolic disorder, damage to CNS nerves

smith-lemli-opitz syndrome: inborn cholesterol synthesis disorder

tay-sachs disease: can’t break down fatty acids

Question 12

What is savant syndrome?

Answer 12

is a condition where a person with a neurodevelopmental disorder can perform expectationally in a specific domain such a mathematics

occurs in 0.06% of those with intellectual disability and is closely linked to autism spectrum disorder, it occurs about six times more often in males than females

Question 13

What is autism spectrum disorder?

Answer 13

a disorder that involves markedly impaired behavior or functioning in multiple areas of development

autism spectrum disorder becomes apparent in the first few years of life and is often associated with intellectual disability

Question 14

What is Kanner syndrome?

Answer 14

parents were high functioning

kids hated engaging in social situations

extreme resistance to change

parents lacked emotion toward kids

Kanner argued they learned from their parents to be anti-social

Question 15

What are the characteristics of autism spectrum disorder in the DSM-5?

Answer 15

deficits in social communication and social interaction: deficits in social-emotional reciprocity, nonverbal communicative behaviors used for social interaction, and in developing, maintaining, and understanding relationships

restricted, repetitive patterns of behavior, interests, or activities: stereotyped or repetitive motor movements, insistence on sameness, fixated interests, hyper- or hypo-reactivity to sensory input

symptoms must be present in the early developmental period

clinically significant impairment

disturbances are not better explained by something else

Question 16

What are theoretical perspectives on autism?

Answer 16

O. Ivar Lovaas: hypothesized inability to process more than one sensory datum at a time, leads to conditioning deficits

Simon Baron-Cohen: theory of mind, inability to take another person’s perspective

neurodevelopmental deficits: evidence of structural abnormalities is inconsistent, premature growth, but then slows down and they fall behind

Question 17

What are treatments for autism spectrum disorders?

Answer 17

Lovass (1987) 40 hours/wk x 2 years = normal IQ scores for just under half of 19 subjects (intensive behavioral interventions)

social simulation (e.g. FaceSay), social adjustment training, helps with social interaction, coaching that isn’t focusing on IQ, can help improve social interactions

Question 18

What are the symptoms of inattention associated with ADHD in the DSM-5?

Answer 18

often does not give close attention to the details or makes careless mistakes in schoolwork, work, or other activities

often has trouble keeping attention on tasks or play activities

often does not seem to listen when spoken to directly

often does not follow through on instructions

often has trouble organizing activities

often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time

often loses things needed for tasks and activities

is often easily distracted

is often forgetful in daily activities

Question 19

What are the symptoms of hyperactivity-impulsivity associated with ADHD in the DSM-5?

Answer 19

often fidgets with hands or feet or squirms in seat when sitting still is expected

often gets up from seat when remaining in seat is expected

often excessively runs about or climbs when and where it is not appropriate

often has trouble playing or doing leisure activities quietly

is often “on the go”

often talk excessively

impulsivity

often blurts out answers to questions before they are answered

often has trouble waiting one’s turn

often interrupts or intrudes on others

Question 20

What are the different types of ADHD?

Answer 20

ADHD, combined type: if both criteria A and B are met for the past 6 months

ADHD, predominantly inattentive type: if criterion A is met but criterion B is not met for the past six months

ADHD, predominantly hyperactive-impulsive type: if criterion B is met but criterion A is not met for the past six months

could be mild, moderate, or severe

Question 21

What are the theoretical perspectives on ADHD?

Answer 21

genetic and environmental

prenatal risk factors: drinking, smoking, antidepressants, antihypertensive drugs, poor nutrition, heavy metals (lead, mercury)

Question 22

What are treatments for ADHD?

Answer 22

stimulants: ADHD people are under-stimulated in ARES area of the brain

behavior therapy: for motoric excesses, not just punishment, give them coping skills like fidget toys

EEG biofeedback: attach electrodes to the brain, differs in terms of frequency, increase beta frequency, decrease delta frequency, basically a video game, very expensive

Question 23

What are learning disorders?

Answer 23

noted deficiency in a specific learning ability

Question 24

What is dyslexia?

Answer 24

a type of learning disorder characterized by impaired reading ability and may involve difficulty with the alphabet or spelling

problems differentiating similar-looking letters (e, c, o OR p, d, q)

words may appear reversed pr blurred

problems identifying speech sounds and learning how they relate to letters and words (decoding)

affects areas of the brain that processes language

Question 25

What are specific learning disorders?

Answer 25

impairment in mathematics impairment in written expression: can't go from thoughts to sounds or written words impairment of reading

Question 26

What are theoretical perspectives of specific learning disorders?

Answer 26

neurobiological genetic factors

Question 27

How is an individual education plan used in the treatment of specific learning disorders?

Answer 27

specific skill instruction: find work arounds for problems accommodations: more time, exams in a quiet area compensatory strategies self-advocacy skills: being able to stand up for oneself and say they need help at school or work

Question 28

What is the relationship between genetics and dyslexia?

Answer 28

people whose patients have dyslexia are at greater risk themselves higher rates of dyslexia are found between identical (MZ) than fraternal (DZ) twins: 70% versus 40% genes may play a role in causing defects in the brain circuity involved in reading

Question 29

What are theoretical perspectives on oppositional defiant disorder?

Answer 29

ineffective parenting: inadvertent reinforcement of difficult demanding behavior, (parent: + punishment, child: - reinforcement) coercive exchanges could be the cause not only treat it from a behavioral standpoint, but also their parents and their coercive exchanges

Question 30

What are some treatments for oppositional defiant disorder?

Answer 30

ecological theory: treat them in their normal environment, if you train a person in one environment the behavior might not be generalized to their normal environment multisystemic therapy (MST): scheduled and unscheduled treatments, home, school, peer group, sport, supervision in all areas of life to teach positive skills, available 24/7 parent-management theory: need to understand b. mod treatments

Question 31

What are characteristics of the angry/irritable mood associated with ODD?

Answer 31

often loses temper is often touchy or easily annoyed is often angry and resentful

Question 32

What are the characteristics of the argumentative/defiant behavior associated with ODD?

Answer 32

often argues with authority figures or, for children and adolescents, with adults often actively defies or refuses to comply with requests from authority figures with rules often deliberately annoys others often blames others for his or her mistakes or misbehavior vindictiveness

Question 33

What is intermittent explosive disorder?

Answer 33

not only diagnosed in childhood impulsive or anger-based aggressive outbursts that begin rapidly and have very little build-up outbursts often last fewer than 30 minutes and are provoked by minor actions of someone close, often a family member or friend aggressive episodes are generally impulsive and/or based in anger rather than premeditated they typically occur with significant distress or psychosocial functional impairment the person is at least 6 years of age (or developmentally siimilar)

Question 34

What is the DSM-5 criteria for intermittent explosive disorder?

Answer 34

verbal aggression like temper tantrums, tirades, arguments or fights; or physical aggression toward people, animals or property the aggression must occur, on average, twice per week for three months the physical aggression does not damage or destroy property, nor does it physical injure people

Question 35

What is the DSM-5 criteria for conduct disorder?

Answer 35

aggression to people and animals destruction of property deceitfulness or theft serious violations of rules differentials include ODD and antisocial personality disorder

Question 36

What are the most effective treatments for conduct disorder?

Answer 36

continued education anger management victim empathy training relapse prevention substance abuse desistence family therapy individual psychotherapy of little use meds of limited value but some possible success with mood stabilizers and neuroleptics, but not for frankly antisocial kids

Question 37

What are major neurocognitive disorders?

Answer 37

significant cognitive decline interference with independence in daily activities

Question 38

What are mild neurocognitive disorders?

Answer 38

moderate cognitive decline still capable of functioning with independence

Question 39

What are the type specifiers of neurocognitive disorders?

Answer 39

Alzheimer's disease frontotemporal lobar degeneration (e.g. Pick's) Lewy body disease vascular disease TBI (mini strokes, loss of blood flow) substance/medication use Prion disease

Question 40

What is delirium?

Answer 40

may produce dementia-like impairment: disturbances in orientation, memory, concentration, perception, reduced/clouded consciousness often attributable to medical illness (e.g. bladder infections) onset tends to be rapid (i.e. hours to days) AD and vascular dementias much more gradual

Question 41

What is dementia?

Answer 41

a form of cognitive impairment involving generalized progressive deficits in a person's memory and learning of new information, ability to communicate, judgement, and motor coordination

Question 42

What is Alzheimer's disease?

Answer 42

fatal neurodegenerative disorder that accounts for the majority of dementia cases first line of treatment: cholinesterase inhibitors conclusive diagnosed posthumously neuropsych testing is very sensitive and specific

Question 43

What are vascular dementias?

Answer 43

best address by controlling cardiovascular risk factors (BP, diabetes, smoking, cholesterol) step-wise decrement in functioning tends to show up with diagnostic imaging (structure, not function)

Question 44

Autistic Thinking

Answer 44

the tendency to view oneself as the center of the universe to believe that external events somehow refer to oneself

Question 45

Autism Spectrum Disorder (ASD)

Answer 45

disorder characterized by pervasive deficits in the ability to relate and communicate with others, and by restricted rand of activities or interests children with ASD lack the ability to relate to others and seem to live their own private lives

Question 46

Theory of Mind

Answer 46

the ability to appreciate that other people have a mental state that is different from one's own

Question 47

Lateralization

Answer 47

the developmental process by which the left hemisphere specializes in verbal and analytic functions and the right hemisphere specializes in nonverbal, spatial functions

Question 48

Down Syndrome

Answer 48

condition caused by a chromosomal abnormality involving an extra chromosome on the 21st pair (trisomy 21) it is characterized by intellectual disability and various physical abnormalities formerly called mongolism and Down's syndrome in Canada

Question 49

Phenylketonuria (PKU)

Answer 49

genetic disorder that prevents the metabolization of phenylpyruvic acid, leading to intellectual disability

Question 50

Tay-Sachs Disease

Answer 50

disease of lipid metabolism that is genetically transmitted and usually results in death in early childhood

Question 51

Cytomegalovirus

Answer 51

maternal disease of the herpes group that carries a risk of intellectual disability to the unborn child

Question 52

Cultural/Familial Intellectual Disability

Answer 52

milder form of intellectual disability that is believed to results, or at least be influenced by, impoverishment in the child's home environment

Question 53

Mainstreaming

Answer 53

the practice of having all students with disabilities included in the regular classroom

Question 54

Dyslexia

Answer 54

type of specific learning disorder characterized by impaired reading ability that may involve difficulty with the alphabet or spelling

Question 55

Specific Learning Disability

Answer 55

deficiency in a specific learning ability noteworthy because of the individual's general intelligence and exposure to learning oppurtunities

Question 56

Individual Education Plan (IEP)

Answer 56

a contractual document that contains learning and behavioral outcomes for a student a description of how the outcomes will be achieved, and a description of how the outcomes will be evaluated

Question 57

Attention-Deficit/Hyperactivity Disorder (ADHD)

Answer 57

neurodevelopmental disorder characterized by excessive motor activity, impulsivity and/or an inability to focus one's attention

Question 58

Hyperactivity

Answer 58

abnormal behavior pattern found most often in young boys that is characterized by extreme restlessness and difficulty maintaining attention

Question 59

Conduct Disorder

Answer 59

patterns of abnormal behavior in childhood characterized by disruptive, antisocial behavior

Question 60

Oppositional Defiant Disorder

Answer 60

disorder in childhood or adolescence characterized by excessive oppositionality or tendencies to refuse requests from parents and others

Question 61

Time-Out

Answer 61

behavioral technique in which an individual who emits an undesired behavior is removed from an environment in which reinforcers are available and placed in an un-reinforcing environment as a form of punishment time out is frequently used in behavioral programs for modifying behavioral programs in children, in combination with positive reinforcement for desirable behavior

Question 62

Separation Anxiety Disorder

Answer 62

a childhood disorder characterized by extreme fears of separation from parents or others whom the child is dependent

Question 63

Delirium

Answer 63

a state of extreme mental confusion in which people have difficulty focusing their attention, speaking clearly and coherently, and orienting themselves to the environment

Question 64

Dementia

Answer 64

profound deterioration of cognitive functioning characterized by deficits in memory, thinking, judgement, and language use

Question 65

Amyloid Plaques

Answer 65

the accumulation of protein fragments, normally broken down in healthy brain, that accumulate to form hard, insoluble plaques between nerve cells (neurons) in the brain a hallmark of Alzheimer's disease

Question 66

Neurofibrillary Tangles

Answer 66

pathological protein aggregated (or brain lesions) found within brain cells (in the cerebral cortex and hippocampus) in patients with Alzheimer's disease and thought be contribute to the degradation of neurons in the brain