Child Psych Unit 2 Lecture Notes Flashcards by Tyler Pollock

Anxiety Disorder Characteristics

Anxiety and avoidance behaviors
Most common- Specific phobia
Most treated- Panic disorder
Lifetime prevalence 4-8%

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Fear Definition

Normal response to objective threat or danger with clearly delineated stimulus

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Anxiety definition

Apprehension without apparent course or identifiable stimulus
Normal in moderation

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Freud’s Conception of Anxiety

Objective Anxiety- Natural response to perceived danger, fear
Neurotic Anxiety- Free floating anxiety, attachment to object causes phobia

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Behavioral Anxiety Symptoms

Motor uneasiness, hyper vigilance
Screaming and crying
Compulsive escape-avoidant behaviors
Shyness
School refusal

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Cognitive Anxiety symptoms

Increased inattentiveness and distractability
Decreased school performance
Impaired memory

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Physiological Anxiety symptoms

Increased heart rate and blood pressure
Sweating
Abdominal pain
Enuresis

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Phobia Definition

Excessive and unreasonable response leading to severe avoidance
Most common anxiety disorder in children

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Common fears across age groups

Infants- Height, noise
1-2 years- Strangers, toileting, injury
Preschool- Animals, dark, strangers, alone, imaginary creatures
Elementary- Animals, dark, lightening, thunder, safety
Middle- Realistic, academic, social, health, parent disapproval

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Separation Anxiety Disorder

Excessive anxiety concerning separation from the home or attachment figure beyond developmental level
Periods of exacerbation and remission across several years

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SAD Associated features

Fear of the dark
Depressed mood
Physical complaints
Demanding, needing attention presentation
Conscientious, eager to please presentation

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Potential SAD Causes

Hospitalization
Loss of parent by death or divorce
Parental depression

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PTSD History

1918- Frued’s first conception
1930-40s- Alarm period, study post-holocaust
1970- Studied in Vietnam Vets and school bus kidnapping
1980- Included in DSM-III

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PTSD Potential Causes

Natural Disasters
Human violence
Abuse
Kidnapping or crimes against child
Man-made disasters
Illness or injury

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PTSD Compounding Factors

Lack of closure
Children as accessories to crimes
Not allowed to grieve and process
Lack of parental emotional support
Ongoing abuse or trauma

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PTSD Presentation in Children

Traumatic, abnormal play
Nightmares
Regressive behaviors
Hopelessness, feeling of shortened life

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Rutter 1970 Isle of Wight Study

Longitudinal depression study in isolated UK island
Found 13% grade-school depression and 40% adolescent depression

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Major Depressive Disorder (MDD)

Presence of 5+ symptoms for 2+ weeks, causing significant distress or impairment
Major features of depressed mood and anhedonia

Depression Symptoms

Depressed mood
Loss of interest or pleasure- Anhedonia
Sleep changes
Fatigue
Psycho-motor changes
Feelings of worthlessness or guilt
Poor concentration
Suicidal ideation

Dysthymia

Depressed mood for most of the day on more days than not lasting for 2+ years (1+ in children)
Never without symptoms for more than 2 months
No impairment- Manageable

Mania symptoms

Inflated self-esteem or grandiosity
Decreased need for sleep
Pressure or rapid speech and ideas
Distractability
Increase in goal-directed activity
Psycho-motor agitation
Engagement in pleasurable activities with consequences

Bipolar I

History of 1+ manic episode- Delusions lasting 1+ weeks
Does not require depressive symptoms

Bipolar II

History of 1+ MDD episode and 1+ hypomanic episode
No delusions, lasting 4+ days

Cyclothymia

Numerous hypomanic and depressed moods for 2+ years
Never without symptoms for 2+ months
Do not meet criteria for MDD or bipolar disorders

Lifetime prevalence of mood disorders

MDD- 10-25% for women, 5-12% for men Dysthymia- 6% Bipolar and cyclothymia- 1% each

Developmental Depression Presentation

Infancy- Alaclitic Depression Toddler- Aggression and hyperactivity Preschoolers- Irritability, social withdrawal School- Withdrawal, avoid play and family, hopelessness, apathy 12- Pessimistic, sleep disturbances, decreased appetite 17- Nightmares, suicidal ideation

Abraham-Freud Depression Theory

Aggression turned inward Loss of self-esteem

Object-Loss Depression Theory Spitz-Bowlby

Disruption of attachment bond Insecure mother-infant attachment Atmosphere without love

Beck's Depression Theory

Negative cognitive triad- Self, past, future Worthlessness, hopelessness, and helplessness

Learned helplessness (Seligman) Depression Theory

Individual does not recognize relationship between actions and relief from adverse effects

Loss of Reinforcement Depression Theory Lazarus and Lewinsohn

Loss of positive Reinforcement

Biological Depression Theory

Genetic and neuropsychological factors

Electroconvulsive Therapy (ECT)

Used for treatment-resistant depression IV anesthetic and muscle relaxants provided to patient Electrodes placed on scalp and current passed to induce Grand-Mal seizure Repeated 2-3 times per week for 3-4 weeks

ECT Electrode placement

Traditional- One on each side of scalp Modern- Both on right half of head Thought is protecting dominant (left) hemisphere from potential damage

Postpartum Depression

Non-psychotic depressive episode after or prior delivery extending into the postpartum period MDD criteria for 1+ week Treated with interpersonal or cognitive-behavioral therapy

Prevalence of Postpartum Conditions

Postpartum Blues- Benign and short-lived- 30-75% Postpartum depression- MDD Criteria- 13% Postpartum psychosis- Severe, rapidly evolving- 0.1-0.2% (rare)

Mintz and Betz Theory of Eating Pathology

Continuum of normal, atypical, and disordered eating

Sociocultural Influences on Eating Disorders

Attitudes emphasizing thinness and ideal beauty Endorsing "Super Woman Pattern"

Feminist Theory of Eating Disorders

Acceptance of nurturing role providing food to others while restricting own needs Identity and self worth are tied to body image

Opposing Feminist theory of Eating Disorders

Anorexia is the rejection of the female role because it defeminizes the body Causes loss of secondary sex characteristics

Anorexia Nervosa

Nervous loss of appetite Refusal to maintain within 15% of normal body weight Restrictive or binging/purging form

Anorexia Associated Symptoms

Amenorrhea Laxative use or excessive exercise Preoccupation with food Loss of hair and dental problems Many physical symptoms

Bulimia Nervosa

Recurrent binge eating followed by compensatory purging behaviors Maintain normal or slightly overweight Surrounded by guilt or shame Occurs 2-30 time per week