Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Children and Adolescent Psychiatry > Flashcards

Children and Adolescent Psychiatry Flashcards

1
Q

When do mental health problems start?

A

Childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pre-conception factors influencing mental health

A

Genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which mental health problems are highly genetic?

A

ADHD

autism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which mental health problems are substantially genetic?

A

Depression

Anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Post conception factors influencing mental health

A

Maternal health
- antibodies
- obesity
- DM
Substance misuse (alcohol, marijuana)
Toxins (lead, mercury)
Drugs (esp psychotropics, antiepileptics)
Epigenetics (folate controlled methylation)
Endocrine environment - especially androgens
Immune environment
Premature birth / perinatal complications
Twinning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What substance is linked to depression later on in childhood?

A

marijuana

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In an androgen environment, what is more likely to develop?

A

Autism

ADHD in boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is premature birth / perinatal complications related to?

A

impaired development of attention and cognition - those being associated with ADHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Presentation of foetal alcohol syndrome

A 
Growth retardation (body, head, brain (inc. cerebellum), eyes 
Sensorimotor effects
cognitive development effects
executive function effects
language effects 
characteristic appearance
- short palpebral fissure length in eyes 
- thin upper lip
- smooth / absent philtrum 
Grey matter gyrification 
- increased cortical complexity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Outcomes of foetal alcohol syndrome

A 
Highly variable clinical picture 
Learning difficulties 
Conduct disorders (ODD)
Combined ADHD or ADD or hyp-imp subtypes 
Anxiety disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does ODD stand for?

A

Oppositional defiant disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Presentation of ODD

A 
Frequent loss of temper
Arguing
becoming easily angered or annoyed
showing vindictive, spiteful or other negativistic behaviours
Behaviour is learned - enacted to obtain a desired result 
Oppositional defiance 
Refused to obey adults request 
Deliberately annoys people
Touch of easily annoyed by others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Presentation of ADHD

A 
Distractibility 
sustaining attention to tasks that provide high level of stimulation or frequent rewards
problems with organisation
Impulsive aggression 
Poor cognition 
often remorseful  
resistant to pure behaviour management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Presentation of Hyp-imp subtypes disorders

A

Difficulties with remaining still - more evident in situations that require behavioural self control
Impulsivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is white matter connectivity important for?

A

Functions that require interplay between brain areas e.g. working memory between hippocampus and anterior cingulate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is low connectivity of white matter associated with?

A

More ‘neural noise’ in the system
cognitive instability
Poor integration of function

===»> ADHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Environmental factors during childhood influencing mental health

A 
Carer-child relationship (attachment)
Parenting skills 
Parental mental disorder 
Marital harmony / family function 
Abuse / neglect 
Discipline (too much is associated with mental health problems)
Day care and schooling
Peer relationships 
life events
physical disability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does early life stress influence in the brain?

A

The function of the limbic circuit including amygdala and determines the subsequent patterns of stress response (resilient or flight)

mood and patterns of response to threat including withdrawl and/or aggressive response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does experience of adversity do?

A

Trains the brain to adapt to a hostile environment

  • limbic response and heightened amyglada activity
  • cortical response and preparation of aggressive response
  • behavioural response and aggression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What happens in reward based learning?

A

Dopamine neurones fire when you associate an action with a subsequent reward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Association between early adversity and reward based learning

A

early adversity decreases DA response - so have to behave a bit more to get the reward = the hypoactive reward response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does the hypoactive reward response underpin?

A

underpins a variety of conditions e.g. addiction (obesity, drugs, alcohol, gambling, porn) and increases delay aversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Features of executive function and cortical control

A

Taking control over automatic and learned behaviours
inhibit prepotent responses
intentional decision making and forward planning
requires self awareness and capacity to self monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Delay aversion and ADHD

A

Inability to wait and maintain attention in the absence of an immediate reward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does the social brain reflect?

A

Increased understanding, reflection and control with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does carers negative emotion in the clinical predict?

A

Rates of relapse of chronic illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Mental health issues associated with school

A

Fear of leaving home
Fear of going to school
Unwilling to go to school
Unwilling to leave home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Mental health problems associated with being out of school

A 
Anxiety
Conduct disorder
Autism 
Depression 
OCD
29
Q

Mental health problems affecting school attendance and learning

A

Learning difficulties due to poor attention
co-morbid specific or general learning problems
difficulty controlling emotion (escalation of anger, frequent conflict)
Anxiety
lack of motivation / energy
difficulties joining in
sensory problems - too noisy / lots of people
preoccupation - fear of germs/contamination etc
Associations between mental health and learning difficulties e.g. dyslexia

30
Q

Motivational factors affecting school attendance

A 
affecting willingness to go to school
- learning difficulties 
- lack of friendships and relationships 
- bullying 
- lack or parental attention / concern 
Encouraging one to stay at home
- maternal depression / maternal psychiatric disorder making them concerned something will happen to the child once they leave the house 
- separation anxiety 
- social factors e.g. helping parents make money
31
Q

What is separation anxiety?

A

Fear of leaving parents and home

32
Q

What is social phobia?

A

Fear of joining the group

33
Q

Features of anxiety disorders - THE 3 AS

A

Anxious thoughts and feelings (e.g. impending doom)
Autonomic symptoms
Avoidant behaviour

34
Q

Brain affects in anxiety disorders

A

Amygdala activity suppressed and reduced connectivity between right ventrolateral cortex and amygdala

35
Q

Treatment of anxiety disorders

A 
Behavioural 
- learning alternative patterns of behaviour
- desensitisation 
- overcoming fear
- manging feelings
CBT
Medication 
- Serotonin reuptake inhibitors (SSRIs) e.g. fluoxetine 
Narrative approaches
- e.g. tell child "monster inside head"
36
Q

Management of child refusing to go to school because of anxiety

A

Contain anxiety

RETURN TO SCHOOL ASAP

37
Q

Principles of management of anxiety

A

Psychoeducation
- explaining the problem in terms that make sense to everyone
Goal setting
- choosing reasonable objectives that can be achieved
Motivation
- getting buy in so the goals can be achieved
Externalisation
- taking blame, guilt and anger out of the equation

38
Q

Principles of CBT

A

Thoughts
Feelings
Behaviour

39
Q

CBT in children

A

Mostly B and T

Dont expect children to have cognitive awareness

40
Q

Long term effects of CBT in respect to children and school

A

Successing the challenge (i.e. going to a day of school) will allow some self confidence and resilience and so will allow them to go and tackle the next thing

41
Q

When does ASD present?

A

Under 3 years

42
Q

What does ASD stand for?

A

Autistic Spectrum Disorder

43
Q

Who gets ASD?

A

M > F 3:1

44
Q

The autistic spectrum

A

Autistic - normal IQ
- only effects on the synaptic function
AS SEVERITY OF NEUROTRANSMITTER DYSFUNCTION INCREASES
Autism with LD
- effects on synaptic function, neural migration and brain development

45
Q

Presentation of ASD (varies with age and IQ)

A

Social - defects in

  • reciprocal conversation
  • expressing emotional concern
  • non verbal communication (eye contact, facial expression, gestures, declarative pointing)

Repetitive behaviour

  • mannerisms
  • obsessions, preoccupations and interests
  • rigid and inflexible patterns of behaviour (routines, rituals, play)
Learning disability - mild to severe
Disturbed sleep and eating habits
Hyperactivity
High levels of anxiety and depression 
OCD
School avoidance 
Aggression 
Temper tantrums 
Self injury / self harm 
Suicidal behaviour (6x)
46
Q

Features of play in ASD

A

Repetitive
Lined up
Same thing

47
Q

Presentation of ASD in young / lower IQ

A

Joint attention / attention to others
Emotional responses
Movements / actions e.g. flapping

48
Q

Presentation of ASD in older / higher IQ

A

Conversation
Empathy
Interests

49
Q

What congenital or genetic disorders is ASD associated with?

A

Rubella
Downs syndrome
Fragile X

50
Q

Increased rates of what in ASD?

A

Depression
OCD
Anxiety disorders
language impairment

51
Q

Management of ASD

A

Recognition, description and acknowledgement of disability
establishing needs
decreased demands -> reduce stress -> improve coping
Psychopharmacology

52
Q

What is ODD associated with?

A

Impaired parenting

Adversity

53
Q

What does a mental state examination represent?

A

A psychiatric stethoscope at the exact time, not the history
A snapshot of the current moment

54
Q

What are conduct disorders characterised by?

A

Repetitive and persistent patterns of antisocial, aggressive or defiant behaviours, which violate age appropriate societal norms

55
Q

Conduct disorders are associated with increased risk of…..

A

Early death often by sudden or violent means
Social exclusion
poor school achievement
long term unemployment
criminal activity
adult mental health problems
poor interpersonal relationships including with own children

56
Q

Treatment of conduct disorders

A 
Parental training programme (12 or younger)
Modification of school environment e.g. behavioural support 
Functional family therapy 
Multi systemic therapy 
Child interventions
- social skills
- problem solving
- anger management 
- confidence building 
treat comorbidity 
address child protection concerns
57
Q

What are the hyperkinetic disorders?

A

ADHD

HKD

58
Q

Pathology of ADHD

A

Your limbic system is asleep

59
Q

Core features of ADHD

A

Developmentally abnormal inattention
Hyperactivity
impulsivity
Present across time and situations

60
Q

Symptom pattern in ADHD

A

Majority are symptomatic into adulthood, especially inattention

61
Q

Associations of ADHD

A 
Specific LD
ASD
CD
tics
motor coordination problems
substance misuse
anxiety 
reduced academic and employment success
increased criminal activity
increased adult mental health problems
62
Q

Management of ADHD

A 
Psychoeducation 
Medication 
- stimulants, atomoxetine, guanfacine
- methylphenidate 
Behavioural interventions
- e.g. realistic expectation 
Parent training 
Treat comorbidity
school interventions
63
Q

Features of medicine management for ADHD

A 
Non addictive
purely symptomatic 
closely related to amphetamines 
taken orally 
acts on And and DA systems
64
Q

Side effects of ADHD medications

A

Appetite
weight
sleep
BP slightly

65
Q

Why is self harm carried out?

A

As a coping mechanism - harms them selves to deal with emotional pain or to break feelings of numbness by arousing sensation. it soothes the person that is doing it

66
Q

Modes of self harming

A

Self poisoning
cutting
burning

67
Q

Factors increasing risk of suicide

A 
Persistent suicidal ideas
Previous suicidal behaviour
Highly Lethality of method used 
High suicidal intent and motivation 
Ongoing precipitating stresses 
Mental disorder 
Poor physical health 
Impulsivity, neuroticism, low self esteem
hopelessness 
Parental psychopathology or suicidal behaviour 
Physical and sexual abuse
Disconnection from support system
68
Q

Treatment of attempted suicide

A

Usually admit to age appropriate medical ward after serious attempt for medical treatment and psychosocial assessment
Mental health and risk assessment
Further referral to agencies as appropriate e.g. child protection

Psychiatry (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions