Chapter 17: Disorders of Childhood and Adolescence Flashcards Preview

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Flashcards in Chapter 17: Disorders of Childhood and Adolescence Deck (43):
1

What is a common misconception in child clinical care?

That children are smaller versions of adults
*Children are less verbal with thoughts/feelings
*Info gathered in other nonverbal/verbal ways
*Expectations of behaviors are different
*If you work with children, you must work with parents

2

Childhood disorder risk factors

*Parent psychopathology
*Family discord/divorce
*Lower socioeconomic status
*Child temperament issues
*Stressful experiences (abuse)
*Early childhood physical or health problems - isolation due to illness can prevent child from going through normal developments
*Prenatal/perinatal difficulties

3

What are neurodevelopmental disorders? Examples?

*Conditions characterized by developmental deficits that can impair a range of areas
*Autism Spectrum Disorder
*Attention Deficit Hyperactivity Disorder
*Tic Disorder

4

What was autism spectrum disorder originally split into?

*Autistic disorder
*Asperger's
*Pervasive Developmental Disorder Not Otherwise Specified

5

Prevalence of autism

1 in 88 children

6

Reasons for rise in prevalence

*Increased awareness - "availability bias"
*Broadening of diagnostic criteria
*Increasing parental age - age 35 onwards is high risk
*Other environmental toxins/factors going on

7

Characteristics of autism

*Impairment in social interactions and communication skills - ranges from mutism to echolalia
*Difficulties with perception of sensory stimuli - hypo or hyperactivity

8

Gender differences in autism

Rates higher in males - on higher end of spectrum

9

Treatments of autism

Usually using some form of operant conditioning - Lovaas method and Early Start Denver Model

10

ADHD basic symptoms

*Inattention - fails to follow through on tasks, frequent shifts of attention from topic to topic
*Hyperactivity - jumps around, cannot sit still, fidgets, talks excessively
*Impulsivity - acts out of turn, often interrupts, engages in risky/dangerous behaviors

11

Prevalence of ADHD?

11% of children (4-17 yrs) in US, rates higher in boys

12

Issues of ADHD

*Overdiagnosed
*Misdiagnosed
*Overmedicated

13

Subtypes of ADHD

*Combined type: >6 sx's for attention deficit and 6 for hyperactivity/impulsivity
*Predominantly inattentive type: >6 for attention deficit and 6 hyperactivity/impulsivity
*Predominantly hyperactive/impulsive type: >6 for hyperactivity/impulsivity and less than 6 inattention

14

Diagnostic criteria of ADHD

*DSM-IV: symptoms present

15

Possible reasons why ADHD children tend to fail in school?

*Lack of focus
*Problems with structure of school system
*Bias of school personnel

16

Possible causes of ADHD

*Metabolic - dysfunction in brain areas assoc with DA and NE (inadequate)
*Decreased activity in areas associated with attention and movement
*Recent study - adults who had not recovered from ADHD showed lack of synchrony in DMN functioning
*Difficulties at birth, traumatic births
*Higher rates in families with antisocial PD, alcoholism, depression, bipolar, anxiety

17

What are tics?

Involuntary sudden stereotyped motor movements

18

What are tics usually comorbid with?

ADHD

19

Subtypes of tic disorder

*Transient tic disorder: >4 wks but 1yr
*Tourette's

20

Gender differences of Tourette's

More males than females

21

Diagnostic criteria of Tourette's

Symptoms occur before 18

22

What is coprolalia?

Sudden uttering of obscenities

23

Main issue of Tourette's

Impulse control

24

What are examples of externalizing disorder?

*Conduct disorder
*Oppositional Defiant Disorder
*Disruptive Mood Dysregulation Disorder

25

What is conduct disorder?

More serious than just pranks - behavior violates the rights of others, predictive of antisocial PD, more males

26

Gender differences in conduct disorder

*Males: more aggressive/confrontational behaviors
*Females: more substance abuse, truancy, prostitution, running away

27

Symptoms of Oppositional Defiant Disorder

OFTEN:
*Argumentative
*Irritable
*Defiantly negative
*Resentful
*Temper issues

28

Onset of ODD

Usually before 8 years

29

Gender differences by age of ODD

Before puberty: more male children
After puberty: rates equal

30

Progression of disorder from ODD

ODD -> Conduct -> antisocial

31

Risk factors of CD/AD/ODD

*Problems with hyperactivity and inattention
*Parental rejection or abuse
*Having delinquent friends

32

What is disruptive mood dysregulation disorder?

*Marked irritability, temper issues, frequent tantrums
*Significantly exaggerated in intensity and duration
*Cannot be diagnosed below 6 years and not after 18
*Symptoms more related to mood disorder/depression than ODD

33

What are the internalizing disorders?

*Separation anxiety disorder
*Reactive attachment disorder
*Fears and phobias
*Generalized Anxiety Disorder
*OCD

34

Diagnostic criteria for fears and phobias

Symptoms present for at least 6 months - crying, tantrums, screaming

35

Typical features of GAD in children

*Anticipatory anxiety
*Excessive worrying
*Poor self-esteem
*Trouble with social relations
*Somatic problems/complaints - can manifest as unexplainable stomachaches

36

Most common child compulsions

*Washing
*Checking
*Ordering

37

Prognosis of OCD in children

Very bad - only about ~50% recover

38

Treatment of OCD in children

Exposure and response prevention

39

OCD prevalence differences

Adults: equally female and male
Children: significantly higher males

40

What is separation anxiety disorder?

Excessive anxiety when separated from familiar people

41

Symptoms of separation anxiety disorder

Headaches, diarrhea, vomiting

42

Prevalence of separation anxiety disorder

*Preadolescence: more female
*Preschool age: equal between genders (male children may outgrow it as they age)

43

Gender differences in manifestation of childhood depression

*Males: irritability, hostility, social withdrawal, "acting out"
*Females: body image problems, loss of appetite, dissatisfaction with life, somatic symptoms, "acting in"