Developmental Psychopathology & Interviewing

Question 1

What proportion of children and adolescents exp sig mental illness?

Answer 1

20%

Question 2

What proportion od adult mental disorders cna be traced to onset in youth?

Answer 2

50%

Question 3

What are some of main complicating factors when diagnosing child psychopathology?

Answer 3

• sx presentation in youth is rarely neat (comborbidity is the norm)
• within group htereogeneity (e.g. two kids, even sibs, with ADHD can look completely different)
• can rarely trace the cause of disorder to a signle factor

Question 4

List some common determinants of child psychopathology

Answer 4

genes
temperament
attachment
problems with goodness of fit
social cog deficits
social learnin deficits
emo reg difficulties
impulse control 
response inhibition
martial discord
effects of poverty
exposure to trauma crime or illness
etc.

Question 5

How long is the typical tantrum (for a typically developing child)?

Answer 5

20 mins;

if there’s no immediate risk of physical harm, ignoe ignore ignore

parents reaction moderates the duration and intensity of the tantrum

Question 6

Short list of biological risk factors

Answer 6

age of the mother
poor parental (maternal) nurtrition
maternaluse of etoh
maternal use of tobacco
use of other drugs
prenatl and postnatal illness
pregnancy or birth complications
genetics
LBW (this is a biggie; most of hte above place fetus at risk for LBW)

Question 7

In general, why is maternal age important to know?

Answer 7

B/c with increased age comes increased risk for complicaton

Question 8

What does Down’s have to do with maternal age?

Answer 8

higher age, increased risk

Down’s = trisomy 21

Question 9

By age, what proportion of births affected by Downs’?

Answer 9

under 30 = 1 in 1500
40 - 44 = 1 in 130
45 and over = 1 in 64

HUGE jumps in risk

Question 10

In US, what is considered to be “advacned maternal age?”

Answer 10

35 and older

increased risk for a number of things, e.g. down’s, placenta previa, and LBW (this is the biggie), hypertension, gestational diabetes, and thir trimester bleeding (effects blood development of fetus)

Question 11

Maternal age, relation to indidence rtes of preg and birth complications

Answer 11

20 - 29 = approx 10%
35 - 39 = approx 20%

risk doubles after 35

Question 12

When assessing biological risk factors, what are some key questions to ask?

Answer 12

Was your preg remarkable in anyway?
Complications? Major Concerns?
How far along were you when you found out you were pregnant? surprise or planned?
APGAR scores?
Folic acid during preg? prior to preg?
Under the care of a doctor?
Health habits during pregnancy? Etoh? Tobacco or other drugs? Nutrition?

Question 13

Summarize recent research re: age of fathers?

Answer 13

recent research (Nature, 2012) links advacned paternal age with increased risk for Autism spectrum and other developmental disorders

Early findings; doesn’t prove older fathers more likely to pass on bad genes

basically, the study shows that gene mutations accrue overtime; bad genes put the kid at risk; when interacts with environmental factors

Question 14

why is maternal nutrition important to know about?

Answer 14

poor maternal nutrion related to wide range of developmental delays and physical complications

Question 15

How much folic acid should someone take?

Answer 15

approx 400 mg (the does available in most OTC vitamin supplements)

important for preventing NTD’s

MUST begin before pregnancy

Question 16

relation between folic acid and rates of spina bifida?

Answer 16

research show that takinf standar 400 mg does of folic acid reducares rates of SB by 50%

Question 17

How much etoh is safe during pregnancy? how much tobacco

Answer 17

there’s not safe amount according to AAP and CDC, and American Preg Associ same for tobacco

Question 18

Will a little bit of etoh cause FAS?

Answer 18

No, FAS is assocaite with heavy and binge drinking during preg

But, FAE is possbile

Question 19

Among heanvy drinker moms, what are the chances of FAS?

Answer 19

over 40%

Question 20

Boradly, what is FAS

Answer 20

syndrome charactersized by a distinct pattern of facial malformations and developmental delays, perceptual-motor deficits, attention deficits, exec fx deficits (planning, problem solving, response inhibition, etc) and activity level problems (temp factor)

the cog, motor, language, and activty deficits een more prououned that phy abnormalities

Question 21

Re: to FAS and etoh consupmtion what do you wanna ask in your interview?

Answer 21

Did you consume etoh during preg? did you smoke tobacco? how much, on avg, did you drink during preg?

Question 22

dx FAS

Answer 22

epicanthal folds
microcephaly
low nasal bridge
small chin
thin upper lip
indistinct philtrum
flatened midface
low set ears
minor ear abnormalisities
short palpebral fissures

Question 23

Tobacco use during preg can result in

Answer 23

premature birth
LBW
decreased placental blood flow
various developmental delays
some research suggests, higher risk of cancer and CD, increased risk for ADHD

Question 24

Effects of other drug use

Answer 24

wide ranging (e.g. attention, emo reg, physcial development; again anything that restricts sixe of fetus is bad)

usually, when maternal drug use is associated with disrupted early child-parent interactions

Question 25

What percetnage of nerborns are exposed to cocaine

Answer 25

1-2%

Question 26

Potential effects on fetus from cocaine use during preg?

Answer 26

``` Spontaneous Abortion Prematurity and Low Birth Weight Microcephaly Fetal Growth Retardation Placental Abruption - A dangerous birth complication in which the placenta separates from the uterus prematurely. Lower IQ Increased rates of leanring, emotional and behavioral disorders SIDS ```

Question 27

SIDS rates and cocaine exposed newborns

Answer 27

15%; 30 times that seen in the general population

Question 28

Marijuana?

Answer 28

Mixed findings; again, anything that resticts blood is bad b/c can result in LBW; neurological effects are liekly; THC crosses the plaental barrier and corsses the blood brain barrier inthe fetus

Question 29

common pre- or postnatal illnesses or injuries

Answer 29

congential rubella head injuries high fevers strep infections (PANDAS)

Question 30

congential rubella is associate with

Answer 30

deafness heart problems cleft palate MR

Question 31

Why are high fevers bad? what's high?

Answer 31

high varies by individuals, look at patterns over time for a single person fevers can --> seizure children under 1, very common to have on seiure that doesn't repliacte however, high fever --> siezure --> seizures beget more seizures --> epileptic disorder

Question 32

PANDAS?

Answer 32

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptoccoal Infentions OCD-like disorder in children

Question 33

How can you assess genetic risk for psych disorders?

Answer 33

Ask about family history, not in clinical terms, but with things like: Anyone worry a lot? Paticularly irrituable? probelms with the law? See things other dont? etc. etc.

Question 34

How do you assess temperament

Answer 34

``` Ask questions like: What were they like as a baby? When you picked them up, did they arch toward or away from you? COuld oly one person hold them? How did you soothe your child? Sleep patterns? ``` These questions map on later categoires of bipolar d/o

Question 35

what proportion of kids has some kinds of clinically signifcant difficulty?

Answer 35

1 in 5

Question 36

What proportion of kids has a dx'able disorder?

Answer 36

1 in 10

Question 37

What are the projections for childhood psych disorders by 2020?

Answer 37

will increase by 50% internationally will in among the 5 most common causes of morbidity, mortality, and disability worldwide

Question 38

generally speaking, what do we knoe about gender and rates of childhood psych disorder

Answer 38

gender differences are often found boys have difficulty eraler in life girls difficulties usually pop up later in life boys are more often externlizers girls are more often itnernalizers girls are underrap in externalizing studies, and in research in general generder usually accout for a small rpoprotion of the variance in studies differences disappear in nonreferred populations; differens most prounounced in referred samples

Question 39

when is it normal? enuresis

Answer 39

3 years and 8 years

Question 40

when is it normal? negativsim

Answer 40

2 years and 7 years

Question 41

when is it normal? separation anxiety

Answer 41

8-24 months and 5 years

Question 42

when is it normal? in ability to complete tasks

Answer 42

3 years and 10 years

Question 43

ADHD and perferred vs. nonperferred tasks

Answer 43

assess ability to complete nonperferred tasks; this is much more indicative od sx's than performance on perferred tasks

Question 44

exmples of dimiensional mesaures of childhod psychopathology?

Answer 44

BASC, CBCL, the Connors

Question 45

What does youngstrom (2007) have to say about informant discrepancy?

Answer 45

An early meta-analysis (Achenbach, McConaughy, & Howell, 1987) found: 2 parents tended to agree with each other about a child's behavior problems (r = .60) Parents and teachers agreed only minimally (r = .26) on average Youths only agreed (r = .20) minimally with parents or teachers Even with the most reliable and widely used behavior rating checklists, cross-informant agreement typically ranges in the range of r = .3-.4 (Achenbach, 1991). These r values are still LOW

Question 46

Common findings regarding informant discrepancy

Answer 46

People generally agree more on externalizing than internalizing disorders Although Seiffge-Krenke & Kollmar, 1998 reported the opposite in their German sample of adolescents People generally agree for younger rather than older (especially adolescent samples) Inconclusive for child gender and informant discrepancies Parents generally agree for chronically ill children rather than healthy controls Although parents seem to under report capabilities and over patholagize with chronically ill children Why?? Most studies have found that agreement is lower, or discrepancies are greater, among informants’ ratings of African American children compared with informants’ ratings of European American children. However, a meta-analysis that focused specifically on mother–father agreement did not find a relation between informant agreement and ethnicity Parents and teachers agree as often as they disagree

Question 47

What does youngstrom (2007) have to say about informant discrepancy?

Answer 47

An early meta-analysis (Achenbach, McConaughy, & Howell, 1987) found: 2 parents tended to agree with each other about a child's behavior problems (r = .60) Parents and teachers agreed only minimally (r = .26) on average Youths only agreed (r = .20) minimally with parents or teachers Even with the most reliable and widely used behavior rating checklists, cross-informant agreement typically ranges in the range of r = .3-.4 (Achenbach, 1991). These r values are still LOW

Question 48

Common findings regarding informant discrepancy

Answer 48

People generally agree more on externalizing than internalizing disorders Although Seiffge-Krenke & Kollmar, 1998 reported the opposite in their German sample of adolescents People generally agree for younger rather than older (especially adolescent samples) Inconclusive for child gender and informant discrepancies Parents generally agree for chronically ill children rather than healthy controls Although parents seem to under report capabilities and over patholagize with chronically ill children Why?? Most studies have found that agreement is lower, or discrepancies are greater, among informants’ ratings of African American children compared with informants’ ratings of European American children. However, a meta-analysis that focused specifically on mother–father agreement did not find a relation between informant agreement and ethnicity Parents and teachers agree as often as they disagree