• DSM-IV- three symptoms- onset before 18, bad intellectual ftn, bad adaptive ftn. Mild, moderate, severe, profound based on IQ scores.
• AAIDD- rated on intermittent, limited, extensive and pervasive. 

What are the IQ ranges for mild, moderate, severe and profound?

Average IQ of general pop. is 90-110...

Mild- 50-70

Moderate- 35-50

Severe- 20-35

Profound- below 20

• Organic- is a physiological defect such as downs syndrome (has an extra chromosome).
• Inorganic- environmental factors such as bad learning environment or bad home life.

Typically organic causes are considered worse and have poorer prognoses.

1. Down's Syndrome- caused by an extra chromosome. physical appearance, trouble with language. usually mild to severe intelligence. children are usually very outgoing and happy!
2. William's Syndrome- deficit in chromosome 7. deficits in cognitive ftn and visuospatial. strengths in language and music. crave attention and can be overly social
3. Fragile X Syndrome- mutation in FMR1 gene. speech and communication abilities. many symptoms like autism; behavioral issues.

A classroom with a normal teacher and special ed teacher, and normal and special needs kids combined.

• Benefits- promotes socialization and upholds a high standard. More stimulation and faster paced.
• Deficits- some students need very individualized courses. Can be very distracting to everyone.

• Generate fewer problem solving strategies
• Distress and negative self evaluations
• Sadness due to perceived incompetence
• Trouble in social situations/comprehending social situations

• Specialized education plans are the most powerful, but have to focus on matching treatment to etiology.
• Earlier interventions are better.
• Behavioral therapies help them learn adaptive skills and appropriate behaviors.

• Achievement on standardized tests in consistenly lower than average at age.
• Must intefere with academic and daily ftn
• Not due to normal factors (lack of opportunity, poor teaching, cultural factors).

• IEP- individualized educational plans
• Metacognitive skills- thinking about your thinking; slow down and process better
• Motivation

1. Social- innappropriate relationships; lack of spontaneous interests with other people; no social/emotional reciprocity. failure to respond to name.
2. Communication- delay or lack of spoken language; cannot sustain conversation; no make believe play; poor social requesting.
3. Restricted, repetitive behaviors- obsession with particular topic (disney channel movie!); inflexible adherence to routines; motor mannerisms.

• Behavioral observation- autism diagnostic observation schedule (ADOS)
• Parent Interviews- autism diagnostic interview (ADI)
• Parent Reports- Vineland Adaptive Behavior Scale
• Various cognitive and language tests

• Applied Behavioral Analysis (ABA)- small teaching units; builds socially useful repertoires.
• Early Denver Start Model- rooted in ABA; interpersonal exchange; verbal and nonverbal behavior; parent training.
• TEACCH- structuring of environment with visual cues (charts and stuff).

1. Predominantly inattentive type
2. Predominantly hyperactive-impulsive type
3. Combined type

DSM-IV- by age 7

DSM-V- by age 12

• Adult AND adolescent criteria
• Change in onset age
• There is exclusionary criteria
• Can be comorbid with autism disorder
• Now only need 5 of 7 symptoms.

• Forcing them to come to attention, focus and maintain it.
• Adapting the curriculum and being patient.
• Remove distractions
• Allow them to move often; provide lots of stimulation.

• Symptoms- he was often reserved, quiet, bored and bad at completing work in class; low test scores due to inability to concentrate; did not have many friends; could not sit still; very hyperactive at home and liked to do things; diagnosed innatentive type
• Treatments- replaced his cough medicine with Ritalin; the token system- if he sat in his seat for a long time he earned points that he could redeem later to participate in fun activities.

Ineffective- pediatricians often do this, just prescribing medicine because if they have ADHD it'll work and if they don't it won't affect them. This is bad!

Effective- going to a psychiatrist who can give diagnostic interview, test on rating skills and observe behavior and come up with the best treatment plan (not always meds).

• Anxiety and depression share common causal factor of negative affectivity
• Depression is high negative affect + low positive
• Anxiety is high negative affect + high physcial arousal

• Fears are anxieties in the presence of a specific stimulus
• Worries are anxieties of possible furture events

• Obsessions- persistent unwanted intrusions of thoughts or images
• Compulsions- persisten unwanted intense impulses to perform a specific behavior

1. Generalized Anxiety Disorder (GAD)- excessive fears/worries about a variety of stimuli/situations
2. Specific Phobia- SPIDERS
3. Separation Anxiety Disorder- removal from caregiver; age innapropriate
4. Social Phobia- fear of social situations
5. Panic Disorder- recurrent, unpredictable panic attacks
6. Obsessive Compulsive Disorder (OCD)- obsessions and compulsions that impair everyday life
7. Posttraumatic Stress Disorder (PTSD)- severe and ongoing; following traumatic event
8. Acute Stress Disorder- same as PTSD but under 3 months; turns into PTSD after 3 months; KNOW THE DIFFERENCE
9. Conversion Disorder- symptoms are loss of sensory or motor function
10. Somatoform Disorder- symptoms are presence of pain/physical symptoms

The best way is a combination of heavy cognitive-behavioral therapy and pharmacology.

CBT includes somatic management (e.g. deep breathing), cognitive restructuing, problem solving, exposure (never) and relapse prevention.

• People who attempt/plan suicide but don't follow through don't actually want to kill themselves and are okay.
• Talking about suicide will plant the seed in a person's head and make them want to do it.

• Drug use is the biggest one because it makes your more impulsive
• Depression
• If the have the plans, intent and means.
• Bullying- for the bully and victim
• The period right after they start taking anti-depressants

Symptoms- missing school, parents recently divorced, missed family, thought about suicide, used butter knife, did not make friends, overweight, "I wish I was dead."

Treatment- low dosage of fluoxetine; group therapy; inpatient therapy; outpatient- increase self esteem; weight loss; behavioral therapy; conversational therapy; getting rid of personalization; spend more time with mom; challenge negative thoughts

In adults, alternating periods of mania and depression. It lasts longer than in children. Can each be months at a time.

In children, is extremely rapid cycling between depressed and elevated moods, irratibility and hyperarousal.

Dysthemia is a long standing disturbance of mood. Can be depressed moods for many months straight, but does not impair everyday life and goes away.

Depression impairs every day life and will persist and get worse unless treated.

• Removal of dysthemia
• Took out grieving period restriction of depression
• Better guidance for assessing suicide risk
• Moving more towards spectrum and less categories
• Addition of disrupted mood dysregulation disorder- basically is bipolar disorder for children only because they don't wanna call it bipolar disorder

Children have a more depressed appearance; display more somatic/anxiety symptoms; externalizing behaviors.

Adults exhibit hopelessness; substance abuse; psychotic symptoms; suicidiality

Before adolescence, rates of depression in boys and girls are about equal. During it, depression is much more common in girls than in boys. Girls are much more likely to attemp suicide and idealize about it, however boys are much more likely to actually complete it.

LGBTQ youth are 2-3 times more likely to commit suicide.

• Abuse- use causes failure to succeed in work, school or home; using it in a hazardous way; results in legal problems; continued use despite it causing problems.
• Dependence- tolerance; withdrawal symptoms; taken in large amounts over long period of time

• Physical- susceptibility to withdrawal symptoms & occurs only in combination with tolerance
• Psychological- craving or compulsion to use substances despite significant harm; not always have withdrawal symptoms

• Now is substance use disorder- a combination of abuse and dependence; need two or more of the criteria
• Severity is based on a number scale: 2-3 is mild; 4-5 is moderate; 6+ is severe

Gateways- some drugs (such as alcohol) are gateways that lead to harder drugs.

Common Factors- factors such as environmental, family and personal characteristics can result in substance use.

• Don't just lock them up and then release them- that contains no actual treatment methods.
• Need continuing outpatient, inpatient and day treatment programs
• Need relapse prevention
• School and juvenile justice based programs are effective

• Water has calories in it.
• If they are not always exercising, they will get fat.
• Feeding the horse will make your fat because the calories will go through the skin.
• They're too fat for their age.

Anorexia- a fear of fatness; extreme behaviors leading to weight loss

Bulimia- binge eating; behaviors the prevent weight gain

• Anorexia- no longer a requirement amenorrhea.
• Bulimia- dropped behavior frequency from twice weekly to once weekly
• Added Binge-Eating Disorder

1. Restricting Type: not engaging in binge-eating or purging behavior
2. Binge-Eating/Purging Type: regularly engaging in binge-eating and/or purging

• Purging Type: regular self-induced vomiting or misuse of laxatives
• Nonpurging Type: other compensentory behavior that is not vomiting or laxatives

• Family: highly organized/controlled families usually lead to anorexia; chaotic/conflicted families usually lead to bulimia.
• Peers: can change person's view of their body image (e.g. calling them fat); can support/reject behaviors
• Media: social norms of what is SEXY BITCH. Personally I'm a fan of thin girl with huge tits but maybe that's just me.

Sports where physical appearance/weight play an important role or individual not team sports (running).

• Gymnastics; figure skating; diving- appearance
• Wrestling (has weight categories)
• Track- belief that lower weight will improve performance

Two important factors of all treatment... 1) changing attitude towards food and diet and 2) improving coping skills (of dealing with eating).

For the most severe- hospitalization and inpatient

For others- intensive outpatient therapy; cognitive-behavioral psychotherapy

• Lasts at least 6 months, 1 of which contains active phase symptoms (hallucinations; delusions; catatonic/disorganized behavior; disorganized speech)
• Decline in functioning
• Not exclusively during a mood disorder
• Not due to direct effect of a substance

• Positive: relfect an excess or distortion of normal symptoms (hallucinations; delusions; disorganized behavior).
• Negative: reflect absence of or diminished normal characteristics (lack of interest, motivation, emotion; no plan to carry out activities; bad hygiene; not social).

• Hallucinations: auditory (birds are telling me to do things); commands (voice inside head telling you to do things); visual (seeing things); religious (I'm a prophet); persecutory (the table was mean to me).
• Delusions (more like false beliefs): persecutory (my mom is trying to kill me); somatic (a spirit lives inside me); bizarre (convinced you're a dog); grandiose (I have superpowers).

If there is a bad psychotic episode, hopitalization.

Otherwise, pharmacology is very popular for psychotic disorders.

Family Training: education; coping strategies for dealing with it; communication; problem solving; crisis prevention.