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EOR: Behavioral Health > Disruptive, Impulse Control, and Conduct Disorders; Neurodevelopmental Disorders > Flashcards

Disruptive, Impulse Control, and Conduct Disorders; Neurodevelopmental Disorders Flashcards

1
Q

what are the neurodevelopmental disorders (2)

A

ADHD
autism spectrum disorder

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2
Q

3 hallmarks of ADHD

A

problems paying attention
excessive activity
diffiulty controlling behavior

that are not appropriate for person’s age

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3
Q

dsm 5 for ADHD

A

-hyperactivity, impulsivity, or inatentiveness manifesting prior to 12 yo
- >6 symptoms of inattention, hyperactivity-impulsivity that developmentally inappropriate and last > 6 months
-symptoms occur in more than 1 setting (ex school AND home)

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4
Q

for dx, symptoms of ADHD must occur prior to age

A

12

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5
Q

tx for ADHD

A

stimulants:
methylphenidate
mixed amphetamine salts

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6
Q

features commonly associated w. ADHD

A

-low self esteem
-dpn
-demoralization
-lack of ability to take responsibility for actions

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7
Q

common social characteristics of ADHD kids (7)

A

-immature
-bossy
-intrusive
-loud
-uncooperative
-out of synchrony w. expectations
-irritating to peers and adults

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8
Q

t/f: ADHD kids are more likely to sustain injuries

A

t!

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9
Q

mc person to make dx of ADHD

A

schoolteacher

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10
Q

ddx for ADHD

A

-adjustment d.o
-anxiety d.o
-bipolar d.o
-mental retardation
-specific developmental d.o
-drugs
-systemic d.o (hyperthyroidism)
-odd or conduct d.o

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11
Q

bipolar d.o in kids often manifests as a chronic mixed affective state marked by (3)

A

irritability
overactivity
difficulty concentrating

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12
Q

what 2 drugs are associated w. ADHD symptoms in kids

A

phenobarbital (sz)
theophylline (asthma)

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13
Q

t/f: rates of ADHD are higher in preschool kids than school-age kids

A

t!

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14
Q

when is ADHD mc in boys?
when is it mc in girls?

A

boys: childhood
girls: young adulthood

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15
Q

2 mainstay stimulants of ADHD

A

methylphenidate
dextroamphetamine

96% of kids respons positively

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16
Q

available doses of methylphenidate

A

short acting - ritalin
intermediate-acting - ritalin SR
long acting - concerta

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17
Q

available doses of dextroamphetamine

A

short acting
long acting

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18
Q

distractor ADHD drug that was removed from the market due to liver toxicity

A

pemoline

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19
Q

ADHD is specified by severity based on

A

social/occupational functional impairment

mild vs mod vs severe

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20
Q

3 types of ADHD

A

prdominantly inattentive
predominantly hyperactive/impulsive
combined

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21
Q

inattentive sx

A

-lacks attention to details/makes careless mistakes
-difficulty sustaining attention in tasks
-does not listen to what is being said
-does not follow through on instructions/does not finish tasks
-difficulty organizing tasks/activities
-avoids undesireable tasks
-often loses things necessary for tasks
-easily distracted by external stimuli
-forgetful in ADLs

-pt must have 6 x 6 mo

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22
Q

hyperactive/impulsive sx of ADHD

A

-fidgeting or tapping
-leaving seat often
-running/climbing inappropriately
-difficulty w. leisure/relaxation
-can’t sit still
-excessive talking
-blurting out answers
-can’t wait in line
-interrupting/intruding on others

-6 sx x at least 6 mo

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23
Q

t/f: ADHD is one of the most heritable psychiatric disorders

A

t!

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24
Q

t/f: diet, esp sugar, is a cause of ADHD

A

f!!

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25
Q

comorbidities associated w. ADHD

A

*antisocial personality d.o
*substance use disorder
other developmental d.o
conduct d.o/odd
bipolar
tourette syndrome
pervasive developmental d.o
mental retardation

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26
Q

t/f: stimulants are more effective than CBT for ADHD

A

t!

but stimulants + CBT is most effective first line tx

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27
Q

autism spectrum disorder (ASD) encompasses (4)

A

-autistic disorder
-childhood disintegrative disorder
-pervasive developmental disorder - not otherwise specified
-asperger disorder

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28
Q

what do you think when you see a child w. normal cognitive development but poor relationships who does not spontaneously seek activities w. others

A

asperger d.o

29
Q

disruption of social interaction and languate at age 3 or earlier

A

autistic disorder

30
Q

patients diagnosed w. autism spectrum disorder present with developmental delay in (3)

A

socialization
language
cognition

31
Q

dsm 5 for ASD

A
  1. social communication and social interaction deficit in many contexts such as:
    -lack of social-emotional reciprocity
    -lack of nonverbal communicative behaviors
    -impairment in developing, maintaining, and understanding relationships
  2. restricted or repetitive patterns of behavior, interests or activities such as
    -motor movements that are stereotyped or repetitive
    -inflexibility to change
    -restricted and fixated interests
    -hyper or hyporeactivity or unusual interest in sensory stimulus
  3. sx must be present in early developmental period w.o other etiology (ex hearing dysfxn)
  4. sx can not be explained by other condition
32
Q

tx for ASD

A

refer
audiology eval
behavioral therapy
second gen antipsychotics
+/- 1st gen antipsychotics
SSRIs
+/- EEG

33
Q

what are second gen antipsychotics used to treat in ASD (2)

A

aggression/hyperactivity
mood lability

34
Q

what are SSRIs used to treat in ASD

A

stereotyped/repetitive behavior

35
Q

what is echolalia

A

involuntary repetition of a word or sentence just spoken by another person

36
Q

echolalia might mask

A

deficiency in language skills in autistic pt

37
Q

common findings in autistic patients (8)

A

lower IQ
language
symbolic thinking
sterotypic behaviors
self-stimulation
self-injury
seizures
mental retardation

38
Q

what are sterotypic behaviors

A

-repetitive non productivemovements of hands and fingiers
-rocking
-meaningless vocalizations

39
Q

t/f: most autistic patients are in the mentally retarded range

A

t!

40
Q

autism is mc in _ (girls or boys),
and mc presents before age _

A

boys
1 yo

41
Q

CT-H finding of autism

A

enlarged ventricles

42
Q

EEG findings of autism

A

normal

43
Q

most autistic children are brought to provider because of poor

A

speech development

44
Q

what are the disruptive, impulse control, and conduct disorders (2)

A

conduct disorder
oppositional defiant disorder

45
Q

what do you think when you see a child who was referred to your office for unusual animal cruelty and bullying at school

A

conduct disorder

46
Q

definition for conduct disorder

A

repetitive and persistent pattern of behavior in which the basic rights of other or major age-appropriate social norms or rules are violated

47
Q

dsm 5 for conduct disorder

A

-at least 15 symptoms from 4 of the following categories in the past 12 months (one must be present w.in the last 6 months):
1. aggression to people and animals
2. destruction of property
3. deceitfulness or theft
4. serious violations of rules

48
Q

conduct disorder is often seen as the precursor to

A

antisocial personality disorder

49
Q

most effective tx for conduct disorder is one that seeks to

A

integrate individual, school, and family settings

50
Q

treatment for conduct disorder should also address

A

familial conflicts
ex marital discord or maternal dpn

51
Q

what do you think when you see a child who back talks and resists following instructions from parents or authorities - but is not aggressive towards people or animals, does not destroy property, and does not show a pattern of theft or deceit

A

oppositional defiant disorder (odd)

52
Q

3 hallmark characteristics of odd

A

angry/irritable mood
argumentative/defiant behavior
vindictiveness

53
Q

dsm 5 for odd

A

at least 4 sx for 6 months from any of the following categories exhibited during interaction w. at least on person who is NOT a sibling:
-frequent temper tantrums
-arguments w adults/authority
-does not conform to rules/regulations
-intentional exasperation of others
-easily annoyed by others
-revenge-seeking/vindictiveness
-angry attitude
-harsh and unkind

54
Q

tx for odd

A

CBT
family therapy
peer groups
mood stabilizers
antipsychotics
stimulants

55
Q

common comorbidity w. odd

A

ADHD

56
Q

2 antipsychotics that have been shown to be effective for odd

A

haldol
thiordazine

57
Q

what are the behaviors included in conduct d.o (11)

A
  1. stealing
  2. running away from home
  3. staying out after dark w.o permission
  4. lying as to “con” ppl
  5. setting fires
  6. repeatedly being truant before 13 yo
  7. vandalizing
  8. animal cruelty
  9. bullying
  10. physical aggression
  11. forcing sexual activity
58
Q

for dx of conduct d.o, _ behaviors must be present

A

3

59
Q

main characteristic of behaviors included in conduct d.o

A

they violate the rights of others

60
Q

adolescents who have conduct d.o are predisposed to the development of what other 2 disorders

A

antisocial personality
ADHD
AUD

61
Q

what factors are thought to contribute to the development of conduct d.o (9)

A
  1. temperament
  2. parents who provide attention to problem behaavior and ignore good behavior
  3. association w. a delinquent peer/group
  4. a parent “role model” of impulsivity and rule-breaking behavior
  5. genetic predisposition
  6. marital disharmony
  7. placement outside the home as an infant/toddler
  8. poverty
  9. low intelligence quotient or brain damage
62
Q

CBT is the mainstay of tx for conduct d.o, but what are some drugs that are used

A

alpha agonists
mood stabilizers
bb
antipsychotics

63
Q

pharm for conduct d.o targets what 2 symptoms

A

aggression
agitation

64
Q

a child has normal cognitive development, poor relationships, and does not spontaneously seek activities w. others

A

asperger

65
Q

disruption of social interaction and languate at age 3 or earlier

A

autism

66
Q

a child is referred to your office for unusual animal cruelty and bullying at school

A

conduct d.o

67
Q

a child is found to back talk and resist following instruction from parents or authorities

A

oppositional defiant d.o

68
Q

an 8 yo who is disruptive in class, always fidgeting, has difficulty concentrating, and does not complete assignments

A

ADHD

EOR: Behavioral Health (13 decks)

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