Disorders of Childhood Flashcards
(170 cards)
1
Q
What do parents of children with a mental disorder report higher levels of? (4)
A
Stress, mental health problems, marital conflict and problems with work functioning.
2
Q
What do siblings of children with a mental disorder report higher levels of? (4)
A
Stress, confusion and anxiety and a sense that they are left out.
3
Q
What are risk factors?
A
Characteristics or hazards that increase the possibility of occurrence, severity, duration or frequency of later psychological disorders.
4
Q
Explain the differential susceptibility hypothesis.
A
Genes previously seen to increase the risk for developing mental health problems have been found to operate more like plasticity genes that vulnerability genes, therefore making individuals more susceptible to positive as well as negative environmental effects.
5
Q
In contemporary diagnostic approaches, the most common forms of psychological disorders in children can be categorised as either:
A
Externalising or internalising.
6
Q
What does the developmental approach emphasise?
A
The need to examine child behaviour and adjustment across development and to examine both normal and abnormal development to gain a clear understanding of the precursors and course of psychological difficulties.
7
Q
Give the eight categories of childhood neurodevelopmental disorders in the DSM-5.
A
Intellectual disability (intellectual developmental disorder), communication disorders, attention-deficits/hyperactivity disorder, specific learning disorder, autism spectrum disorder, tic disorders, motor, disorders, and other neurodevelopmental disorders.
8
Q
Give the two categories of childhood anxiety disorders in the DSM-5.
A
Separation anxiety disorder and selective mutism.
9
Q
Give the two categories of childhood depressive disorders in the DSM-5.
A
Disruptive mood and dysregulation disorder.
10
Q
Give the two categories of childhood trauma and stressor related disorders in the DSM-5.
A
Reactive attachment disorder, and disinhibited social engagement disorder.
11
Q
Give the three categories of childhood feeding and eating disorders in the DSM-5.
A
Pica, rumination disorder, and avoidant/restrictive food intake disorder.
12
Q
Give the four categories of childhood elimination disorders in the DSM-5.
A
Enuresis, encopresis, other specified elimination disorder and unspecified elimination disorder.
13
Q
Give the two categories of childhood disruptive, impulse control and conduct disorders in the DSM-5.
A
Oppositional defiant disorder and conduct disorder.
14
Q
What are neurodevelopmental disorders characterised by?
A
Emergence in the early developmental period.
15
Q
Neurodevelopmental disorders cause deficits in: (4)
A
Personal, social, academic and occupational functioning.
16
Q
Define attention-deficit hyperactivity disorder (ADHD).
A
A disorder marked by deficits in attention, controlling impulses and regulating activity levels.
17
Q
What symptoms is ADHD defined by? (3)
A
Inattention, hyperactivity and impulsivity.
18
Q
Inattention includes symptoms such as: (5)
A
Not paying attention to task details or making careless mistakes, having difficulty sustaining attention over time, being easily distracted, and being forgetful.
19
Q
Hyperactivity symptoms include: (3)
A
Fidgeting, moving about excessively and not being able to stay seated.
20
Q
Impulsivity symptoms include: (3)
A
Difficulty waiting turns, blurting out answers or interrupting.
21
Q
ADHD can be diagnosed in three ways:
A
Combined presentation, predominately inattentive presentation or predominately hyperactivity/impulsive presentation.
22
Q
What do girls with ADHD show less that boys, and what to they show more?
A
Less hyperactivity, inattention, impulsivity and externalising problems, and more intellectual impairments and internalising problems.
23
Q
Which disorder does ADHD have a high level of comorbidity with?
A
Oppositional defiant disorder.
24
Q
Define executive functions. (4)
A
Functions of the brain that involve the ability to sustain attention, use abstract reasoning, plan, initiate and monitor goal-directed behaviours, and shift from maladaptive patterns of behaviour to more adaptive ones.
25
What did Brown believe about executive functions and their relation to ADHD?
Problems lie within switching executive functions on and off rather than problems with the function itself.
26
Give evidence for Brown's hypothesis about ADHD.
Individuals with ADHD can attend to a task as long as it is interesting.
27
What, similar to adults with externalising disorders, is seen in children with ADHD?
Autonomic under-arousal.
28
What do children with ADHD have a lower response to and what does this mean?
Reinforcement, meaning that they need stronger motivators to change behaviour.
29
Interventions targeting what are more effective than interventions targeting biological factors in the treatment of ADHD?
Interventions targeting both biological and parenting factors.
30
What is the Feingold diet?
A food elimination program to treat symptoms of hyperactivity.
31
The consumption of what has been implicated in the development of ADHD? (3)
Artificial sweeteners, colours and preservatives.
32
What does the Feingold diet eliminate? (5)
Artificial colours and flavours, aspartame, preservatives and salicylates.
33
What are the most common medications used to treat ADHD?
Stimulants like ritalin and dexedrine.
34
How do stimulant medications treat ADHD symptoms?
The increase the availability of dopamine and reduce the overactivity, impulsivity and inattentional characteristics of ADHD.
35
What is the current opinion for the use of stimulant medications for ADHD in children?
Don't use it unless it is in combination with psychosocial treatment and only in the short-term.
36
Define specific learning disorder.
A disorder of learning characterised by lower than expected performance in a particular area of learning relative to the child's chronological age and intellectual ability.
37
When is a specific learning disorder diagnosed?
When a child's academic achievement is lower that what is expected given their age and not accounted for by intellectual disability.
38
How is academic achievement assessed?
Through standardised testing.
39
What is the most common subtype of learning disorder?
Reading.
40
Learning disorders include subtypes of:
Reading, mathematics and written expression.
41
Define reading disorder.
A learning disorder involving deficits in reading ability.
42
What is reading disorder characterised by?
Difficulties in reading accuracy, fluency and comprehension that are unexpected in relation to the child's chronological age.
43
In order to be diagnosed with reading disorder reading problems must not: (5)
Be the result of general developmental disability, intellectual disability, sensory impairment or access to appropriate education or sociocultural opportunities.
44
What can persistent reading disorder result in?
Poor school grades, early school leaving and limited employment opportunities.
45
There is a __% chance of a boy being reading disabled if his father was reading disabled.
50.
46
Deficits in what can result in reading disorder? (3)
Phonological awareness, working memory and the speed of processing written language.
47
What is phonological awareness?
Understanding the sound structure of oral language.
48
What may phonological limitations lead to inefficiencies in?
Working memory.
49
Define working memory.
A processing resource of limited capacity involved in preservation of information while simultaneously processing the same or other information.
50
How do difficulties in phonological decoding lead to reading disorder?
They take up too much space in working memory, and lead to insufficient processing of other components of reading.
51
What can occur when working memory is deficient (in reference to reading disorder)?
The process of holding all the parts of the word and then putting it together becomes much more difficult.
52
Impairments in what have been found in children with reading disorder?
Verbal working memory.
53
What does written language processing speed refer to?
Time taken to read aloud words presented in the form of lists.
54
What does slow word reading create?
A bottleneck in the information processing system, where the readers attention is largely devoted to identification instead of understanding.
55
What are the most effective interventions for reading and writing?
Combine phonological and strategy-based approaches.
56
What is autism spectrum disorder characterised by?
Impairments in social communication and interaction, and repetitive behaviours, interests an activities.
57
What kind of impairments in social interaction are typical of autism spectrum disorder? (3)
Social-emotional reciprocity, abnormalities in eye contact or an absence of interest in peers.
58
Autism spectrum disorder is characterised by repetitive and restricted patterns of behaviour, such as: (3)
Preoccupation with a specific activity, an insistence on sameness in routines, or motor mannerisms.
59
Children with autism spectrum disorder are defined by two essential core deficits:
Social communication problems in the form of deficits in social-emotional reciprocity and difficulty comprehending non-verbal communication, and deficits in theory of mind ,
60
What is theory of mind?
An understanding that others have a perspective that differs from their own.
61
What are the predictors of good outcomes for people with autism spectrum disorder? (3)
Acquisition of language skills before age 6, IQ above 50 and having an area of greater strength.
62
What is the concordance rate for autism in monozygotic twins?
60%.
63
What psychosocial factors are implicated in the development of autism?
Extreme social deprivation.
64
What is the aim of interventions for autism?
To help the child develop better social and emotional relationships, learn communication skills and decrease stereotypic behaviours like head banging.
65
What kind of programs are helpful in improving the functioning of children with autism?
Behavioural modification.
66
What do behavioural modification programs begin with?
An analysis of the child's environment to assess the environmental conditions and contingencies that can be used to help the child acquire skills.
67
After an analysis of the environment in behavioural modification programs, what takes place?
Reinforcement procedures for increasing desirable behaviour and reducing undesirable behaviour are implemented.
68
Define intellectual disability.
Group of disorders characterised by deficits in intellectual and adaptive functioning.
69
According to the DSM-5, what does intellectual disability comprise? (3)
Deficits in intellectual functioning; deficits in adaptive functioning; and the onset of these deficiencies in childhood.
70
Name some deficits in intellectual functioning. (7)
Reasoning, problem solving, planning, abstract thinking, judgement, academic learning and learning from experience.
71
What do deficits in adaptive functioning result in a failure of?
A failure to meet developmental and sociocultural standards for personal independence and social responsibility.
72
How are deficits in intellectual functioning assessed?
Via intelligence tests, where scores between 65-75 are considered intellectually disabled.
73
Name the most common test for adaptive functioning skills.
The Vineland Adaptive Behaviour Scale.
74
Intellectual impairment co-occurs with a wide range of disorders:
Epilepsy, cerebral palsy, sensory deficits and pervasive developmental disorders.
75
Following assessment and diagnosis of the intellectual disability, what is it important to do?
Treat any underlying medical condition.
76
What should the focus of early intervention for intellectual disability be on? (4)
Physical, occupational, and speech therapy, as well as family support.
77
Define externalising disorders.
Broad categorisation of childhood disorders that includes disorders characterised by problems of under-control, where behaviours are directed at others.
78
What is oppositional defiant disorder characterised by? (3)
A persistent pattern of angry or irritable mood, argumentative and defiant behaviour, and vindictiveness.
79
What do children with oppositional defiant disorder have difficulty with?
Regulating emotion.
80
How does negative affect manifest in children with oppositional defiant disorder?
Blaming others and being easily annoyed by others.
81
The longer oppositional defiant disorder persists, the more likely that the child will develop other conditions, like: (4)
ADHD, anxiety, mood disorders and substance use.
82
What is androgen?
A substance that produces male characteristics.
83
Give some biological factors implicated in the development of oppositional defiant disorder. (4)
Alterations of androgen, differences in frontal brain activation causing negative affective style, autonomic under-arousal and traumatic brain injury.
84
Give two sociocultural risk factors for oppositional defiant disorder.
Difficult temperament and problems with understanding facial cues.
85
Parents of non-compliant, aggressive children are characterised as being: (3)
Highly punitive, critical, and more likely to attribute misbehaviour to intentional and stable characteristics.
86
What does Patterson's Coercive Processes Model propose?
Parents and children engage in progressively more coercive interactions with each other through learning processes involved for both parent and child.
87
Patterson's Coercive Processes Model incorporates a range of variables that can have a negative impact on parental discipline: (9)
Poor parental problem solving skills, parental arousal, family stress, illness, poverty, unemployment, marital conflict and divorce, psychiatric disturbance and substance use.
88
What is conduct disorder characterised by?
A persistent pattern of violation of rules and the rights of others.
89
What is conduct disorder believed to develop from?
Earlier oppositional defiant disorder.
90
What is conduct disorder a precursor to?
Antisocial personality disorder and adult criminality.
91
Give conduct disorder's two subtypes.
Early onset (before age 10) and late onset (after age 11).
92
For ____ the risk of conduct disorder remains low until adolescence.
Girls.
93
Children with persistent conduct disorder can be differentiated from other children at a young age, why?
They exhibit temperamental characteristics like negativity, behaviour problems, social competence, parenting practices and family relationships.
94
What two disorders can be a precursor to conduct disorder?
ADHD and oppositional defiant disorder.
95
Give some biological factors involved in the development of conduct disorder. (3)
A common genetic element between ADHD, oppositional defiant and conduct disorder, low cortisol levels, high androgen.
96
Give some psychological factors involved in the development of conduct disorder. (4)
Negativity, volatility and low persistence, and callous-unemotional personality traits.
97
What are callous-unemotional personality traits characterised by?
Manipulative behaviour and a lack of guilt, remorse and empathy.
98
Give some social factors involved in the development of conduct disorder. (3)
Poor social skills, associating with antisocial peers, and peer rejection.
99
Give some family factors involved in the development of conduct disorder. (3)
Family structure, family relationships, and parenting practices.
100
Give the characteristics of parents of antisocial children.
They monitor and supervise their children less, demonstrate less warmth and use harsher discipline.
101
Name four interventions designed to target the risk factors for conduct problems.
Interventions designed to improve parenting skills and family relationships, interventions designed to improve children's social relationships and problem-solving skills, school-based interventions to improve behaviour, and pharmacological approaches.
102
What is the parental intervention approach for conduct problems in children derived from? (2)
Social learning theory and CBT approaches.
103
What do parental interventions for conduct disorder generally involve?
Teaching parents to use a variety of positive parenting strategies, like praise and attention for desired behaviour, providing rewards for desired behaviours, clear and calm instructions, and using fair and age-appropriate rules.
104
What kind of punishments for unwanted behaviour are parents taught to replace punitive practices in the parental interventions for conduct disorder? (4)
Response cost, planned ignoring, quiet time, and time out.
105
Name two well known parenting programs.
The Incredible Years and Triple P-Positive Parenting Program.
106
What criteria need to be met for a large-scale implementation of a parenting program to work? (5)
Using an effective parenting program, using cost-effective programs ensuring that the program is culturally relevant, establishing achievable rates of participation by community members, and having a plan for evaluating the effectiveness of the intervention.
107
Who is responsible for attachment theory?
Bowlby.
108
Explain attachment theory.
Emphasises parental attunement to the child's emotional cues during early caregiving years as a means to promoting optimal social-emotional and cognitive development.
109
Children whose caregivers perceived and sensitively responded to their emotional cues have been more likely to:
Express their emotional distress directly to the caregiver and develop greater capacities for coping in response to distress.
110
What do attachment based approaches to parenting focus on?
Improving the quality of the parent's relationship with the child.
111
What are attachment bases approaches to parenting derived from?
Psychodynamic approaches.
112
Who do family therapies for parenting target?
The entire family unit.
113
What is functional family therapy?
A family-therapy intervention for delinquent youth at risk for institutionalisation.
114
What is functional family therapy designed to do? (3)
Improve the attributions family members make about each other's behaviours, family communication and supportiveness, and decrease negativity and dysfunctional patterns of behaviour.
115
Why are cognitive-behavioural interventions used to train children in social and problem-solving skills? (3)
Because children with conduct problems have difficulties solving social problems and tend to respond to conflict situations using combative, aggressive strategies, and they believe others are hostile.
116
In child-focused approaches for conduct problems, how does the child learn problem solving and social skills? (4)
The therapist models the desired behaviour, the child rehearses the behaviour, the therapist provides feedback to the child regarding their skill, and the child is positively reinforced for performing the desired behaviour.
117
What can the school-based management of conduct problems involve? (3)
Application of behaviour-change principles, like the teacher's attention and rewards for performing desired behaviour, and consequences for misbehaviour.
118
When is the Treatment Foster Care program used?
For longstanding externalising problems with complicating family factors.
119
What interventions are combined by the Treatment Foster Care program?
Interventions of the adolescent, the family, foster parents and teachers.
120
Define multisystemic therapy.
A therapy for delinquent youth that aims to treat them by changing aspects of the social environment.
121
Give two examples of internalising disorders.
Anxiety and depression.
122
Internalising disorders are often described as:
Over controlled, where feelings are states are inner-directed.
123
How are children with internalising disorders likely to behave? (3)
They withdraw from others, keep quiet, and avoid bringing attention to themselves.
124
For a child to meet the DSM-5 criteria for major depressive disorder, what behaviour must they exhibit?
Irritable rather than depressed mood and fail to gain weight.
125
How may anxious children respond to requests to attend an anxiety-provoking situation?
With non-compliance and oppositional behaviour.
126
When does normal separation anxiety peak in children?
13-18 months.
127
How is separation anxiety disorder different from separation anxiety?
It occurs in older children.
128
How is separation anxiety disorder expressed? (4)
Through distress in anticipation or separation from an attachment figure, the need to know the whereabouts of the attachment figure, extreme homesickness and preoccupation with harm coming to the attachment figure.
129
At what age is separation anxiety disorder likely to occur?
Age 7-9, in middle childhood.
130
What genetic vulnerability can children inherit which predisposes them to developing separation anxiety disorder?
Behavioural inhibition.
131
How is behavioural inhibition characterised?
By a tendency to display anxiety and to withdraw in unfamiliar situations.
132
Give an factor implicated in the development of separation anxiety disorder that has both a genetic and environmental component.
Parental anxiety.
133
How can parental anxiety affect their children's anxiety?
If parents model anxiety in fearful situations, the child will imitate them, the child may have fewer opportunities to confront and master fearful situations, and parents can inadvertently reinforce anxiety by providing too much attention, reassurance and sympathy.
134
Why are children who are securely attached to their caregivers protected from separation anxiety?
They feel confident to explore their environment and to experience new things, secure in the knowledge that their caregiver is their to protect them.
135
What can protect children from developing separation anxiety disorder ?
Brief, planned separations, because they give a child the chance to master separations.
136
What is the main intervention for separation anxiety disorder?
CBT.
137
CBT for separation anxiety disorder includes a number of elements like: (4)
Psychoeduation, exposure, coping-skills training and reinforcement.
138
Name a program developed to treat childhood anxiety?
The Friends Program.
139
Define selective mutism.
A disorder characterised by a persistent failure to speak in certain settings even though the individual has the ability to speak.
140
Give the diagnostic criteria for selective mutism. (4)
A persistent failure to speak in selected settings for a period of at least one month after the beginning of the school year, even though the child understands spoken language and can speak.
141
What disorders are most likely to be comorbid with selective mutism?
Anxiety disorders, like social phobia or separation anxiety disorder.
142
What kind of problems are common in children with selective mutism?
Speech and language.
143
What deficits are related to selective mutism?
Deficits in academic performance and social communication.
144
What does Dow believe selective mutism is?
A manifestation of a shy, inhibited temperament and social phobia.
145
How is selective mutism similar to social phobia?
Avoidance or fear of public speaking.
146
What are behavioural interventions for selective mutism directed at? (3)
Eliminating all reinforcement for mutism and bolstering self-confidence and decreasing anxiety.
147
An effective treatment of selective mutism consists of a number of steps to address three basic problems:
The child's high level of anxiety in social situations, the limited experience the child has in speaking to people who aren't family, and reducing reinforcement for non-verbal communication.
148
Define enuresis.
An elimination disorder in children who are at least five years of age who wet the bed or their clothes at least twice a week for three months.
149
Define encopresis.
An elimination disorder in children who are at least four years old and who defecate inappropriately at least once a month for three months.
150
What time of day does enuresis generally occur?
At night.
151
What is day time enuresis called?
Diurnal enuresis.
152
Enuresis is divided in to two categories:
Primary enuresis, where the child has never been dry, and secondary enuresis, where the child has a period of dryness for at least six months.
153
What does nocturnal enuresis have high comorbidity with?
ADHD.
154
What do children with enuresis experience?
Embarrassment, social isolation, behavioural problems, and low self-esteem.
155
Give the main difference between aetiology of primary and secondary enuresis.
Psychological factors rarely contribute to primary enuresis, but specific psychological events are more common in secondary enuresis.
156
What may the inherited factor in enuresis be related to?
General developmental immaturity, as well as hormonal and physical factors.
157
Name some specific factors implicated in the development of enuresis.
Reduced functional bladder capacity, hyperactivity of the parasympathetic nervous system, abnormal sleep patterns and arousability, and limited regulation of vasopressin.
158
What is the most effective treatment approach for enuresis?
Conditioning.
159
Explain the bell and pad method for preventing enuresis.
A urine sensitive pad is placed on the bed and is connected to an alarm, so when the child wets the bed they are woken up by the alarm and the child is expected to turn it off.
160
What other interventions is the bell and pad techniques combined with? (3)
Changing the sheets at night, bladder control exercises and rewards for dry nights.
161
How is the bell and pad technique thought to work?
By teaching the child to avoid the aversive situation of being woken up at night by the alarm.
162
Give the diagnostic criteria for encopresis. (3)
Repetitive soiling in inappropriate places at least once a month for three months, in a child at least 4 years old, which is or explained by medical or physical problems.
163
Describe retentive encopresis.
The most common form of encopresis, where the child holds their stool for as long as possible.
164
Describe non-retentive encopresis.
Soiling is intermittent and there is no evidence of constipation.
165
What can preclude encopresis in children?
A history of hard, painful stools at early ages and poor success with toileting.
166
Children with encopresis tend to have more: (5)
Anxiety/depressive symptoms, more attention difficulties, greater social problems, more disruptive behaviour and poorer social performance.
167
According to Cox, what causes encopresis?
The child initially experiences an episode of constipation which leads to fecal impaction and a large, hard stool, which is difficult and painful to pass. As a result, the child may experience rectal distention cues as unpleasant and avoid going to the toilet, which results in chronic constipation with overflow incontinence.
168
What combination of treatments is effective for encopresis?
Medical management and behavioural treatment.
169
What does medical intervention for encopresis involve?
Cleanout of the bowel with laxatives, dietary recommendations and a toilet-sitting schedule.
170
What does behavioural intervention for encopresis involve?
Psychoeducation for parents and children, combined with an appropriate reinforcement schedule for encouraging children to use the toilet.
