Lecture 8 - Atypical Development 1 - Childhood Anxiety Flashcards
Define Atypical development
Child progresses through patterns of developmental milestones, when these are not met = atypical development
- delay in the appearance of a specific behaviour
- behaviour that is qualitatively different (e.g. not following gaze of CG)
What are the 6 categories we look for in atypical development?
- Motor
- Cognitive
- Language
- Social
- Emotional
- Behavioural
What are the 3 general types of development disorders
- Neurodevelopmental disorders (Autism, ASD etc)
- Depressive and anxiety disorders - depression, phobias, OCD
- Disruptive, impulse-control and conduct disorders: e.g oppositional defiant disorder, conduct disorder
Whats the distinction between internalising and externalising problems
Internalising - inward behaviour, internal psychological environment, harmful to oneself
- e.g. anxiety dsorders
- difficult to detect - often seen as less of an issue by teachers/ parents
Externalising - outward behaviour, acting on external environment, harmful and disruptive towards others
- E.g. conduct disorders - difficulty following rules, behaving in socially acceptable way
Give some examples of developmentally appropriate fears
- some levels of anxiety are normsl
- Infancy: stranger, loud noises
- Early Childhood: Seperation, monsters, darkness
- Middle Childhood: natural disasters, school
- Adolescence: social factors, peers
Outline when anxiety and fear becomes atypical
- Object/ content: not devlopmentally appropriate - do others their age show same thing?
- Intensity: Disproprotionate to the threat
- Frequency and Persistence: repeated not easily overcome
- Impairment: avoidant behaviour, interfers with daily lfie
Give examples of Anxiety disorders
- GAD
- Specific phobias
- Social anxiety
- Seperation Anxiety
- Panic disorder
- PTSD
- OCD
Outline Symptoms of GAD
- excessive worrying = worrying about something that is either not present, or at a disproprotionate level
- More days than not for 6 months
- Most of waking hours are spent worrying
- Difficulty to control the worry
- Feelings are ever present, but content of worry may switch throughout day
DSM Symptoms: • Restlesness/ on edge • Easily fatigued • Difficulty concentrating/ mind going blank • irritability •Muscle tension • Sleep distrubance
- the anxiety, worry or physical sumptoms cause distress or impairment in functioning
- not caused by substance or other medical condition
- Not better explained by another mental disorder
Outline the prevalence rates of Childhood anxiety
One of the most common in childhood
- prevalence 2-5%
- More common in girls
- High co-morbidity (depression, anxiety, OCD)
1 in 10 may experience an anxiety disorder before the age of 18 and many more have subclinical anxiety
What is childhood anxiety associated with later in life?
Associated with poorer educational outcomes and mental health/ wellbeing in adulthood
- Adjustment, family relationships, life satisfaction, coping, stress, anxiety, substance abuse
- Anxiety/ depression as an adult
- Impacts on:
• Peer/ family relations
• Social/ emotional competence
•Education
Outline vulnerability factors and environmental factors for getting anxiety
Murray et al (2009), 2 broad categories of factors:
1. Vulnerability factors • familial/ genetics • Temperement • Information processing • Behavioural dispositions and information processing styles
- Environmental influences
• Life events
• Learning
•Parenting factors (bidrectional)
Outline family aggregation and genetics as a vulnerability factor
Clustering of anxiety disorders within families
- some limited evidence for heritability
- Child with a parent whos got an anxiety disorder are more likely to develop an anxiety disorder
Interaction with env factors
Outline temperement: behavioural inhibition as a vulnerability factor
- temperament = basic nature, how you respond to situations
- behavioural inhibition = temperemental pattern that characterises how children behave in certain situations - avoidance, inhibitions of urges.
- may be withdrawn in new situations/ avoid interactions
- Fear, reticence and withdrawal in novel situations
- Stable, doesnt really change over time
- Association between behaviourally inhibited children and anxious parents
- Bi predicts anxiety
Outline information processing as a vulnerability factor
There may be bias’ in informational processing that is causing anxiety. Two types of bias:
1. Attentional bias: more likely to attend to something that is threatening them in their environment
- Interpretation bias = more likely to assess situations as unrealistically threatening
Field & Lester (2010) - its normal to be fearful of things, but this should change during development, so it isnt feared, but in anxious people this may not happen so carry on being fearful. Levels of anxiety may interact with other factors - to create exaggerated fear
Anxious people more sensitive to fear, better at fear recognition
- Can learn to control it
Outline life events and difficulties as an environmental influence on developing anxiety
- Association - anxiety responses are classically conditioning
•pairing a neutral stimulus with a traumatic event - Negative, uncontrollable events that can happen - traumatic
- Risk factors:
• Trauma, dodgy neighbourhoods, parental psychopathology (interactions are bad), parental drug use
Could be bi-directional - being anxious leads to more negative events
outline Goodyear et al (in murray) about truama and anxiety
- Anxious children had experienced significantly more traumatic events in the 12 months before getting diagnosed
Outline modelling and information transfer as an environmental influence on developing anxiety
Observing other person displaying anxiety
- we learn from their reactions to stimuli
- How mums express fearfulness has been linked to child anxiety
- Phobias
- They learn by getting information about threats
- How information is presented to the child impacts on how a child responds to that stimuli
- Vicarious acquisition (through observation)
- Informational Acquisition (Communication) how information is discussed - how it is transmitted and who is transmitting it
- Parents teach child about threats in environment - careful, that pan is hot
- Catastrophising comments, fewer positive emotions
Outline parental warmth and control as an environmental influence on developing anxiety
- lack of warmth - perceive environment and situation as hostile and threatening -leads to low self-worth and competence
- shaping their environment through your parenting style
X - self-report is worse than observations - Overcontrol - fewer opportunities for exploration, being overprotective - limited competencey, mastery of skills, knowledge of their environment - tend to avoid challenges
- lack of opportunity to develop their own autonomy/ independence
Outline bi-directional effects as an environmental influence on developing anxiety
Behaviourally inhibited children + anxious mother = parenting styles that contribute to child anxiety
- Mother more likely to be critical
- Does the child develop anxiety because parents are more anxious? or is it because parents react in a certain way because they have an anxious child? or combination of the two
- Anxious mums with BI children more likely to be critical of their child
- these two things co-occuring likely to cause anxiety
What did Weems (2008) argue?
Anxiety is a multi-component process
- with each component being functional at healthy levels
- But when dysregulated cause anxiety. They are experienced at out of proportion levels, and this causes anxiety:
- Affective (e.g. being upset)
- Behavioural (e.g. avoidance/ escaping)
- Physiological (e.g. racing heart, dizziness)
- Cognitive (e.g. rumination/ concentration difficulties)
What are the biological and behavioural predispositions to emotion dysregulation associated with anxiety disorders (3 things)
- Difficulty controlling and understanding emotion
- Different physiological responses (linked to B.i)
- Different Sensitivity to distress
these 3 things are not at normal levels, and when they interact, they can cause various anxiety disorders
Outline Matthews et al (2016) meta-analysis into emotional competence
- 185 studies that looked at aspects of emotional competences (recognition, expression, regulation, understanding etc)
Found:
•Less effective at expressing and understanding emotions
• Less aware and accepting of own emotions
•Less emotional self-efficacy
•Anxious children more likely to use coping strategies - avoidance, externalising (outward explosion of behaviour), maladaptive cognitive coping
Outline Hurrell et al (2015) - parental reactions to negative emotions
- Parental reactions to childrens emotion has a role in development of childs emotional regulation
- anxious children have deficits in emotion functioning - expression
- mothers offered less problem-solving and emotional help
- maternal support and help associated with better emotional regulation
Outline UNiversal Prevention programmes
Aim to improve mental health and wellbeing of all children in a setting (usually school)
- easy way of implementing programes to large number of children
- Prmary prevention: promoting wellbeing and reducing problems developing
- Secondary prevention: stop mild or moderate problems getting worse
- Tertiary problems: minimise negative consequences of established disorders (treatment)
As you go up a tier, the problem becomes worse, and the trainer becomes more specialised
