Child Psych Lecture

Question 1

ADHD triad?

Answer 1

Hyperactivity
Inattention
Negative behavioral impulsivity

Question 2

Difficulty listening, sustaining attention
Difficulty with organization
Avoidance of cognitively challenging activities
Forgetfulness
Distractibility

Answer 2

Inattention aspect of ADHD

*MC in girls

Question 3

Blurting out answers
Difficulty waiting for turn
Interrupting others

Answer 3

Impulsivity aspect of ADHD

Question 4

Fidgetiness
Running about inappropriately
Difficulty being quiet
Excessive talking

MC in preschool and elementary aged kids

Answer 4

hyperactivity aspect of ADHD

Question 5

True or false..

With ADHD, hyperactivity tends to decline as child gets older, but inattentive symptoms will persist into adulthood

Answer 5

True

Question 6

Teens will report “internal restlessness” which leads to thrill seeking behavior

Answer 6

ADHD

Question 7

Decrease caudate nucleeus, globus pallidus, posterior brain regions

Genes involved:
Human thyroid receptor beta gene on chromosome 3
Dopamine transporter gene (DAT) on chromosome 5
Dopamine receptor D4 gene on chromosome 11

Answer 7

ADHD

Question 8

think of what NT when it comes to ADHD?

Answer 8

Dopamine

Question 9

3 aspects must be present for this dx:

1. IQ under 70 on individually administered test
2. impairment in present adaptive functioning in at least 2 domains
3. Onset before age 18

Answer 9

Intellectual disability (formerly called mental retardation)

Question 10

For an intellectual disability dx, IQ must be under…

Answer 10

below 70

Question 11

What is the IQ range for mild intellectual disability?

(educable, need assistance under stress)

Answer 11

IQ of 50-70

*this is about 85% of cases!

Question 12

What is the IQ range for moderate intellectual disability?

(communication deficits)

Answer 12

IQ range 35-49

10% of cases

Question 13

What is the IQ range for severe intellectual disability?

(motor and communication deficits, may live in homes)

Answer 13

IQ 21-34

4% cases

Question 14

What is the IQ range for profound intellectual disability?

(noticeable at birth, needs help with basic skills)

Answer 14

IQ <20

1-2% cases

Question 15

Impairment in social interaction

Impairment in communication-language delays

Repetitive, stereotyped patterns of behavior, interests

Onset prior to age 3 yrs.

Genetic origin

Answer 15

Autistic disorder

Question 16

Impairment in Social Interaction

Restricted, stereotyped patterns of behavior

No language delays but the “Odd Professor,” pedantic speech.

More boys than girls

Higher functioning than Autistic Disorder

Answer 16

Asperger’s (aka autism spectrum disorder)

Question 17

Traumatic Event has occurred

Re-experiencing, (flashbacks)

Avoidance/Numbing

Increased states of arousal

Duration at least 1 month

Impairment of functioning

Answer 17

PTSD

Question 18

True or False…

untreated ADHD is a significant risk factor for substance abuse in adolescence and adulthood

Answer 18

True

Question 19

Comorbid Disorders:

Learning disabilities
Oppositional defiant disorder(50%)
Anxiety disorders(30%)
Depressive disorders(25%)
Bipolar disorder(15%)

Answer 19

ADHD

Question 20

Diagnosis of ADHD is largely made through….

Answer 20

history

Question 21

The Vanderbilt Scale and the The Connors’ Rating Scale are most common in screenig of…

Answer 21

ADHD

Question 22

Reuptake inhibition of NE & DA
Cause increased release of presynaptic NE/DA
Amphetamine promotes passive diffusion of NE and DA into synaptic cleft
Amphetamine promotes release of NE and DA from cytoplasmic pools
Amphetamine & Methylphenidate are mild inhibitors of MAO

Answer 22

MOA of stimulants (used to treat ADHD)

Question 23

Amphetamine promotes passive diffusion of _____ and ____ into synpatic cleft

Answer 23

NE and DA

(also causes release of NE and DA from cytoplasmic pools)

Question 24

_____% of pts with ADHD will respond to a single stimulant (DEX/MPH), ____% respond if both tried

Answer 24

70% with one
90% if both

Question 25

Decreased appetite Weight loss Insomnia G.I. Complaints Headaches Check for tics

Answer 25

SE of stimulants used in ADHD tx

Question 26

How should you dose stimulant drugs when treating ADHD

Answer 26

start low, can titrate up if needed

Question 27

diagnosed **before age 8** high comorbidity with abuse DOs, mood DOs, ADD/ADHD ## Footnote **at least 6 months of negativistic, hostile and defiant behavior**

Answer 27

Oppositional defient disorder

Question 28

At least 4 of the following needed for dx: - frequent loss of temper - arguments with adults - defying adult's rules - deliberately annoying others - easily annoyed - anger and resentment - spitefulness - blaming others | (**for at least 6 months**)

Answer 28

Oppositional defient disorder

Question 29

**40% risk of developing anti-social personality DO in adulthood** \*high co-morbidity with ADD, ADHD, learning disability, mood DO, substance abuse

Answer 29

Conduct disorder

Question 30

Violation of basic rights of others or of social norms with at least 3 acts of: - aggression towards people or animals - destruction of property - deceitfulness - serious violation of rules

Answer 30

Conduct disorder (oppositional defient DO can turn into this if not treated)

Question 31

For a major depressive **episode**, 5 or more depression symptoms must be present during the same ________ period

Answer 31

2 week

Question 32

True or False.. There is marked functional impairment in a major depressive episode

Answer 32

True

Question 33

Irritable or cranky mood most of the day Preoccupation/identification with poetry/songs about death. describes depressed mood in a(n)....

Answer 33

child! (vs an adult, who have a depressed mood throughout the day)

Question 34

True or False... a depressed kid will often go to the school nurses office for complaints like a stomach ache

Answer 34

true

Question 35

Biggest risk factor for major depression?

Answer 35

Genetics

Question 36

MC way of suicide in kids

Answer 36

Fire arms

Question 37

a) the presence of one or more diagnosable mental disorders – particularly a depressive disorder or aggressive disorder, occurring alone or co-morbid with alcohol or drug use disorder, and: b) a prior suicide attempt.

Answer 37

2 risk factors for suicide

Question 38

The duration of an antidepressant trial must continue for **minimum of 6 weeks** before maximum response can be determined. If response is positive, medication trial should be continued for a minimum of....

Answer 38

4-6 months

Question 39

T or F... you would have to treat 10 pediatric pts with SSRIs to help 1?

Answer 39

true