Lecture 5 Flashcards
(26 cards)
1
Q
Why is there an increase in mental health issues?
A
- Too fast = cannot be genetics
- Could be changes in family structure/functioning, increased use of day-care by parents of varying quality, changes in inequality, pressures and lengthening of adolescent period
- Over time, these increases may come full circle to perpetuate the rate in the next gen
2
Q
What is the recent change in mental health?
A
- Parent and teacher strength and difficulties ratings were used to compare rates of emotional, conduct and hyperactivity problems in 7yo children across Britain = self-ratings
- Not inevitable rise
- Levels of emotional and behavioural problems among children levelled off/reduced upto 2008
3
Q
What was a study looking at ‘is the child the father of man’?
A
- Looking at relationship of childhood antisocial behaviour predicting adulthood behaviour
- Looked at 4 male cohorts
- Child ASB was a prerequisite for adult ASB
- Most AS children did not become AS adults = interventions work
- Adult ASB better predicted by childhood behaviour than by family background or social class
- Social class made little contribution to prediction of serious adult ASB
4
Q
What was a study looking at conduct disorder and hyperactivity?
A
- Hyperactivity and conduct disorder in childhood were found to predict antisocial personality disorder and criminality in early and middle adulthood.
- Symptoms of each disorder exerted an additive effect in the prediction of adult outcomes.
- Of participants who did not have hyperactivity or conduct disorder, 2.5% had current antisocial personality disorder.
- Of participants who had both hyperactivity and conduct disorder, 35% had current antisocial personality disorder.
- A delinquent peer group and juvenile offending in the adolescent years were also predictors of criminal behaviour in adulthood. These behaviours are themselves predicted by childhood conduct disorder.
5
Q
What are the clinical implications of this study?
A
- Childhood disorders have lasting effects on ASB and health that extend to middle-adulthood
- Some evidence of mediation like hanging out with deviant peer group and juv offending
- High levels of ASB, crime and violence suggest that intervention programs that target childhood disorders should be a high priority for policy makers
6
Q
What is family risk?
A
- Immediate environment
- Poverty
- DV
- Inter-personal conflict within family
- Child abuse and neglect
7
Q
What is a risky family?
A
- Conflict/aggression
- Relationships are cold, unsupportive and neglectful
- Family characteristics create vulnerabilities and interact with genetic vulnerabilities in children = produce risk for mental health disorder, chronic disease and early mortality
8
Q
What is the impact of mental health on children? What happens if they have poor mental health?
A
- Less likely to meet developmental milestones when exposed to long-term stress = bedwetting, poor verbal skills, psychosocial functioning, disruptions in stress-responsive biological regulatory systems, poor health behaviours
- Infancy: poor sleep, regression in toilet behaviour, decreased verbal ability and irritability
- School-age: hostile attribution bias, attachment problems, hyper vigilance
- Adolescence: anxiety, depression, suicide, PTSD, risk-taking and escape behaviours
9
Q
What are adverse childhood experiences (ACE)? Examples
A
- Child maltreatment: verbal/physical/sexual abuse
- Parental separation, DV, mental illness, alcohol abuse, drug use, incarceration
10
Q
What is the relationship with ACE and later health? What could happen?
A
- Physical/mental health problems
- Substance abuse
- Risky sexual behaviour
- Aggression
- Cognitive difficulties
11
Q
What was a study looking at 10 ACEs and 7 potential ACEs in a low income sample of US women?
A
- Family finance, food insecurity, homelessness, parental absence, death, bullying and violent crime
- Correlated with smoking and stress except for parent/sibling death
- Depends on socio-economic state to see which ACEs will affect you more (listed above)
12
Q
What are problems of measurement with ACE screening tools?
A
- They vary which makes comparisons between studies difficult
- Some include bullying, war and parental death
- Argue for peer victimisation and community violence
- ACES are often yes/no and ignore severity, duration and frequency
- Most studies use unweighted ACE scores, only a few use weighted scores based on severity
- Simple additive models have been questioned - study looking at reviewing life events
13
Q
What is the Cumulative Risk theory?
A
- Accumulation of risk factors, independent of the presence or absence of risk factors impacts developmental outcomes
- Cumulative adversity has been linked with changes to the developing brain, compensatory health and behavioural habits, and difficulties in developing healthy relationships
14
Q
What is dose-response?
A
- Past a certain threshold, outcomes worsen dramatically
- Found that those individuals who reported 4+ ACEs were more likely to report a variety of behavioural, health and social problems
15
Q
What are the challenges of conducting these studies?
A
- Depends on the outcome in question and duration/timing of exposure
- Indicators of adversity tend to co-occur and may interact in complex ways to affect child development
- Low income and diverse populations are understudied and not well characterised
- Restricted to a 10 item checklist
- No consensus on what experiences count
- Retrospective recall is problematic
16
Q
What was a study looking at the advantages and disadvantages with ACES?
A
- Value of simplicity to raise awareness and understanding among the public and policy makers
- Challenge remains to develop models that explain effects which enable translation into effective prevention and intervention efforts
17
Q
What are the determinants of development?
A
- Genes
- Environment
- Past development
- Psychopathology is not something people are born with but outcome of developmental process
18
Q
What are the principles of contextualism?
A
- Development regulates and is regulated by multiple factors, events and processes at several levels that unfold over time
- Individual development can follow a number of trajectories
- Multiple causes can have the same outcome: equifinality
- Single cause can have many outcomes: multifinality
19
Q
What was the umbrella review?
A
- 97 meta-analysis, 2000 primary studies and over 11 million people
- There is a large magnitude of associations = 9/100 people without maltreatment would be expected to have some issues, but this is doubled with maltreatment
- Regardless of internalising/externalising, maltreatment creates a large association, does not really matter what maltreatment
- Childhood maltreatment appears to have comparable associations with all examined mental health difficulties
- Different forms of maltreatment each appear to have comparable association with mental health difficulties
- Maltreatment was associated with all examined mental health difficulties which suggests that a transdiagnostic approach might be a beneficial way of organising services
- Some forms of maltreatment are intrinsically more harmful to mental health than others
20
Q
What are early adversities in relation to neurodevelopmental conditions?
A
Interplay between adversity and neurodevelopmental conditions
21
Q
What is the Bioecological Model?
A
- Views child as developing within complex system of relationships
- Env is conceptualised as a series of nested structures
- Complex set of relationships between developing person and person developmental setting
- Whole is greater than sum of its component parts
22
Q
How is the child the centre?
A
- Genes, sex, gender, age, temperament, intelligence, motivation, physical appearance
- Found that maltreated children were nearly 10x as likely to have symptoms of neurodevelopmental conditions compared to non-maltreated BUT MALTREATMENT NOT CAUSAL
- Parents of children with NDCs are also more likely to experience stress, child maltreatment where NDCs are present may escalate family stress and worsen a child’s symptoms
23
Q
What are the stages of development?
A
1) Intra-individual subsystem: interplay between specific dimensions within a domain e.g. cognition: memory, language, attention, learning.
2) Intra-individual system:– interplay between biology, cognition, affect.
3) Interpersonal system:– family interaction, peer relationships.
4) Ecological or socio-cultural system:– community, cultural and political context
- The study of child development is a complex area due to individual factors, family and community
- Across childhood, we see increasing complexity among the parts and systems that shape our psychological development both at the intrapersonal and interpersonal level
24
Q
What was learning through social interaction?
A
- Vygotsky’s theory: learning occurs in social context = through guided support
- Zone of Proximal Development defines what a child can achieve with help
25
What are the approaches to measuring adversity in childhood?
- Cumulative: additive model = applied to childhood = easy for people to understand and use but assumes equal weight of ACES and misses mechanisms of ACEs
- Single adversity: examines the impact of individual adversities in isolation
- Theoretically driven models: Groups adversities based on theoretical frameworks about how they affect development
- Empirical: Uses data patterns to group adversities based on reported experiences
26
What is the public policy for ACES?
1) ACE awareness campaigns = awareness and looking at roles of supportive relationships
2) Trauma-Informing Training = To foster understanding and compassion, support secondary and tertiary prevention
3) Routine enquiry: encourage disclosure where reporting is unlikely = use information to tailor interventions or treatment
4) Screening for ACEs: Identify risk early and offer interventions preventing poor outcomes
5) Using clinical treatment
