Term
| Schizophrenia characteristic |
|
Definition
| characterized by psychosis or loss of reality |
|
|
Term
|
Definition
| childhood-onset - younger than 13 |
|
|
Term
|
Definition
| early (adolescent) onset - younger than 18 |
|
|
Term
| schizophrenia - criterion A |
|
Definition
two or more of the following, each present for a significant portion of time during a 1-month period. at least one should include 1, 2, or 3:
1. delusions - false beliefs
2. hallucinations - false perceptions
3. disorganized speech - incoherent, bizarre, lacking logical organization or meaning
4. grossly abnormal psychomotor behavior, including catatonia - repetitive behaviors, purposeless hyperactivity, catatonic behaviors
5. negative symptoms - restricted affect, avolition (no goal-directed behavior), alogia (poverty of speech), asociality (no desire to form relationships), anhedonia (inability to experience pleasure) |
|
|
Term
| schizophrenia - criterion B |
|
Definition
| when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement |
|
|
Term
| schizophrenia - criterion C |
|
Definition
| symptoms must persist for six months, one month active, remainder can be only negative symptoms |
|
|
Term
| schizophrenia - criterion C: prodromal phase |
|
Definition
| decrease in functioning leading up to psychosis |
|
|
Term
| schizophrenia - criterion C: residual phase |
|
Definition
| symptoms remaining after active-phase has subsided |
|
|
Term
| schizophrenia - criterion D |
|
Definition
| schizoaffective disorder and depressive or bipolar disorder with psychotic features must be ruled out |
|
|
Term
| schizophrenia - criterion E |
|
Definition
| to due to physiological effects of a substance or a general medical condition |
|
|
Term
| schizophrenia - criterion F |
|
Definition
| with Autism spectrum disorder (or other communication childhood disorders), additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least 1 month |
|
|
Term
| schizophrenia - diagnosis issues |
|
Definition
| difficult to diagnos because symptoms may be indistinguishable from typical aspects of childhood (imaginary friends, sleep disturbances), early symptomatology is similar to autism spectrum disorder and communication disorders |
|
|
Term
|
Definition
| onset is non-episodic and gradual, neurodevelopmental impairments early in life, rapid deterioration, 2/3 children will be chronically ill, earlier age of onset - worse prognosis, 25% attempt suicide in adulthood |
|
|
Term
| schizophrenia - prevalence |
|
Definition
| 1 in 10,000, 4% EOS, 1% COS, twice as many boys diagnosed with COS but age of onset is equal |
|
|
Term
| schizophrenia - comorbidities |
|
Definition
| 99% COS have at least 1 comorbid disease, ADHD, ODD, depression, separation anxiety disorder |
|
|
Term
|
Definition
neurodevelopmental: abnormalities in synaptic pruning, reduced cerebral volume, smaller thalamus, rate of gray matter volume loss, overabundance of dopamine
genetic: highly heritable
environmental: prenatal viral infections, poor nutrition, lack of oxygen at birth
psychosocial: abuse (highly related), stressful life circumstances |
|
|
Term
| schizophrenia - risk factors |
|
Definition
| deceptive onset, onset prior to age 12, premorbid dysfunction, severe symptoms during acute phase, low cognitive functioning, older fathers, living in an urban area, low SES, ongoing abuse |
|
|
Term
| schizophrenia - protective factors |
|
Definition
| high IQ, mostly positive symptoms, social competence, supportive family relationships |
|
|
Term
| schizophrenia - treatment |
|
Definition
antipsychotics - dopamine
antagonists (blocking dopamine transmission)
-typical: help with positive systems, high risk of tardive dyskinesia (involuntary movements)
-atypical: help with positive and negative symptoms, side effects (excessive weight gain)
psychosocial treatments: CBT, social and basic life skills, training, family psychoeducation |
|
|
Term
|
Definition
| prolonged bouts of sadness (or irritability) |
|
|
Term
|
Definition
| feel little joy and lose interest in nearly all activities |
|
|
Term
|
Definition
| abnormally elevated or expansive mood and feelings of euphoria |
|
|
Term
|
Definition
| exaggerated sense of well-being |
|
|
Term
| depression: main features |
|
Definition
mood: sadness more exaggerated and persistent, irritability, guilt, shame
behavior: restlessness, agitation, reduced activity, slowed speech, excessive crying
changes in attitude: feelings of worthlessness and low self-esteem
thinking: preoccupied with inner thoughts and tensions, slowed thought, distorted reasoning, difficulty concentrating
physical changes: disruptions in eating and sleeping |
|
|
Term
| depression and development: infants |
|
Definition
| anaclitic depression: infants raised in a clean but emotionally cold institutional environment displayed reactions resembling a depressive disorder, reported after prolonged separation from parents |
|
|
Term
| depression and development: preschoolers |
|
Definition
| extremely somber and tearful, clingy, fear separation, stomachaches |
|
|
Term
| depression and development: school aged children |
|
Definition
| irritability, disruptive behavior, temper tantrums, weight loss, headaches, and sleep disturbances, suicide threats |
|
|
Term
| depression and development: preteens |
|
Definition
| self-blame, low self-esteem, social inhibition, hopelessness, sleeping difficulties |
|
|
Term
| depression and development: teens |
|
Definition
| inability to sleep or sleep excessively, eating disturbances, irritability, anhedonia, angry discussions with parents, negative body image and self-consciousness, excessive fatigue and energy loss, feelings of loneliness, guilt, worthlessness, suicidal thoughts and attempts |
|
|
Term
| Major Depressive Disorder (MDD) - key features |
|
Definition
| sadness, anhedonia, irritability |
|
|
Term
| Major Depressive Disorder (MDD) - criteria |
|
Definition
5 or more symptoms during the same 2-week period:
1. depressed/irritable mood most of the day, nearly every day
2. anhedonia: diminished interest
3. significant weight loss, change in appetite
4. insomnia or hypersomnia nearly every day
5. psychomotor retardation nearly every day
6. fatigue/loss of energy
7. feelings of worthlessness or excessive or inappropriate guilt
8. diminished ability to think or concentrate, or indecisiveness
9. recurrent thought of death, suicide ideation, suicidal attempt, or a specific plan |
|
|
Term
| Major Depressive Disorder (MDD) - Single Episode |
|
Definition
| presence of a single major depressive episode |
|
|
Term
| Major Depressive Disorder (MDD) - recurrent episode |
|
Definition
| presence of two or more major depressive episodes, must have an interval of at least two months |
|
|
Term
| Major Depressive Disorder (MDD) - course |
|
Definition
average episode: 6 months
recurrence: 25% within 1 year
40% within 2 years
70% within 5 years |
|
|
Term
| Major Depressive Disorder (MDD) - prevalence |
|
Definition
under 13: girls = boys
over 13: girls > boys
preschoolers: 1%
school aged: 2%
adolescence: 8%
lifetime prevalence: 20% |
|
|
Term
| Major Depressive Disorder (MDD) - comorbidities |
|
Definition
| anxiety disorder, conduct disorder, ADHD, substance abuse, boderline personality disorder |
|
|
Term
| Dysthymic Disorder - characteristics |
|
Definition
| display depressed mood for most of the day, on most days, for at least 1 year; unhappy or irritable most of the time, symptoms chronic, but less severe than those with MDD |
|
|
Term
| Dysthymic Disorder - criteria |
|
Definition
a. depressed mood for most of the day, for more days than not for at least two years
b. presence, while depressed, of two (or more) of the following:
poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, feelings of hoplessness |
|
|
Term
|
Definition
| MDD + Dysthymia: low baseline and major dips |
|
|
Term
| Dysthymic Disorder - prevalence |
|
Definition
children: 1%
adolescents: 5%
during course, 70% may have an episode of major depression |
|
|
Term
| Dysthymic Disorder - comorbidities |
|
Definition
| MDD, anxiety disorders (SAD, GAD), ADHD, conduct disorder |
|
|
Term
| Dysthymic Disorder - course |
|
Definition
| develops about 3 years earlier than MDD, 11-12 years of age, average duration 2-5 years |
|
|
Term
| depressive disorders: associated characteristics, intellectual functioning |
|
Definition
| score lower on standardized tests, lower grades, poor concentration, psychomotor retardation, fatigue, insomnia, somatic complaints |
|
|
Term
| depressive disorders: associated characteristics, cognitive disturbances |
|
Definition
| feelings of worthlessness, negative beliefs, attributions of failure, depressive ruminative style (focus narrowly on negative events for long periods) |
|
|
Term
| depressive disorders: associated characteristics, social problems |
|
Definition
|
|
Term
| depressive disorders: associated characteristics, family problems |
|
Definition
| poor relations and conflict with parents and siblings, reinforcing depression, perpetuating |
|
|
Term
| depressive disorders: theories, psychodynamic |
|
Definition
| caused by a loss of or separation from loved objects (fear and uneasiness), superego punishes the ego, anger turned inward (opposite of projection) |
|
|
Term
| depressive disorders: theories, attachment |
|
Definition
| insecure early attachments: anxious and avoidant types |
|
|
Term
| depressive disorders: theories, behavioral |
|
Definition
| positive reinforcements (they only get the negative) |
|
|
Term
| depressive disorders: theories, cognitive |
|
Definition
-separation as learned helplessness
-cognitive distortions: catastrophizing, overgeneralizing, personalizing, selective attention to negative events
-internal, stable and global attributions
-negative view of self, world and future |
|
|
Term
| depressive disorders: causes, genetic influences |
|
Definition
| genetic contribution is high with early onset, risk of depression is 50% greater if parent has had history, monozygotic twins concordance rate very high |
|
|
Term
| depressive disorders: causes, neurobiological influences |
|
Definition
| decreased frontal lobe volume, may have increased frontal lobe activity in some areas, increased limbic system activity, reduced hippocampus volume, disturbances in HPA axis, decrease in serotonin, dopamine and norepinephrine |
|
|
Term
| depressive disorders: causes, family influences |
|
Definition
more critical and punitive behavior
families tend to have: conflict and anger, less warmth, poorer communication, marital discord
depressed moms: more withdrawn or more intrusive, modeling of maladaptive thinking patterns, low levels of child misbehavior not tolerated and viewed as problematic |
|
|
Term
| depressive disorders: causes, stressful life events |
|
Definition
| moving, changing schools, serious accident, family illness |
|
|
Term
| depressive disorders: causes, emotional regulation |
|
Definition
may use avoidance or negative behavior to regulate distress instead of problem solving
overregulation: inability to express one's feelings
remember that depressive disorders are internalizing disorders |
|
|
Term
| depressive disorders: treatments, medications |
|
Definition
| antidepressants: SSRIs (fewer side effects and are more effective, but may increase risk of suicide), Tricyclics (no good for kids) |
|
|
Term
| depressive disorders: treatments, cognitive behavioral therapy CBT |
|
Definition
70% respond
A - always find something to do to feel better
C - catch the positive
T - think about it as a problem to be soved
I - inspect the situation
O - open yourself to the positive
N - never get stuck in the negative muck |
|
|
Term
| depressive disorders: treatments, interpersonal therapy |
|
Definition
| helps child deal with ongoing interpersonal concerns and issues |
|
|
Term
| depressive disorders: treatments, combined treatment |
|
Definition
CBT + medication
most effective, lowest relapse rate, may protect against increased suicide risk |
|
|
Term
| bipolar disorder: bipolar I disorder |
|
Definition
mania for at least one week
1+ manic episode(s)
(1+ major depressive episode)-not required |
|
|
Term
| bipolar disorder: bipolar II disorder |
|
Definition
hypomania for at least 4 days
1+ hypomanic episode
1+ major depressive episode |
|
|
Term
| cyclothymic disorder - criteria |
|
Definition
hypomanic symptoms, depressive symptoms (no MDE, no hypomanic episode)
a. 1 year in children, numerous periods with hypomanic symptoms and depressive symptoms that do not meet the criteria for Hypomanic Episode and Major Depressive Episode
b. symptoms present more days than not
c. first 2 years - no major depressive episode, manic episode, or hypomanic episode present |
|
|
Term
|
Definition
a. distinct period of abnormally and persistantly elevated,expansive, or irritable mood, activity, energy for at least 1 week
b. 3 or more: inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual or pressure to keep talking, racing thoughts/flight of ideas, distractibility, increase in goal-directed activity of psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for painful consequences |
|
|
Term
| hypomanic episode - criteria |
|
Definition
a. distinct period of abnormally and persistantly elevated,expansive, or irritable mood, activity, energy for 4 consecutive days
b. 3 or more: inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual or pressure to keep talking, racing thoughts/flight of ideas, distractibility, increase in goal-directed activity of psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for painful consequences
c. episode is not severe enough to cause marked impairment in social or occupational functioning |
|
|
Term
|
Definition
| MDE(s) + 3 non-overlapping symptoms of hypomania or mania |
|
|
Term
| bipolar I disorder with mixed features |
|
Definition
| mania + 3 non-overlapping features of depression |
|
|
Term
| bipolar II disorder with mixed features |
|
Definition
| hypomania + 3 non-overlapping features of depression |
|
|
Term
| bipolar disorder - differences between adults and children |
|
Definition
adults: distinct periods of mania and/or depression, good functioning in between, mania, defining characteristic
kids and adolescents: short episodes, frequent mood shifts, mixed moods, irritability most commonly associated with bipolar disorder in children |
|
|
Term
| bipolar disorder - manic symptoms |
|
Definition
frequency, intensity, number, duration (FIND)
elated mood and grandiose behaviors |
|
|
Term
| bipolar disorder - differential diagnosis |
|
Definition
ADHD: show a consistent pattern of overactivity or distractibility
bipolar disorder: show a change from usual behavior to overactivity or distractibility
--------------------------------------
conduct disorder or ODD: irritability and dysregulation but also vindictive, intentional, and without guilt
bipolar disorder: irritability and dysregulation with impulsivity and sense of omnipotence (nothing can hurt me!) |
|
|
Term
| bipolar disorder - prevalence |
|
Definition
lifetime prevalence: .4%-1.2%
girls = boys |
|
|
Term
| bipolar disorder - comorbidities |
|
Definition
| ADHD, learning disorders, ODD and conduct disorder, substance use disorder |
|
|
Term
| bipolar disorder - course |
|
Definition
| 20% of all patients have first episode in adolescence, peak age: 15-19, onset before 10 is rare, first episode tends to be depression, median duration: 10.8 months, mean duration: 80.2 months, chronic and resistant to treatment, in 5 years 50% relapsed or never achieved complete remission |
|
|
Term
| bipolar disorder - causes |
|
Definition
| strong genetic component (80% heritability), reduced amygdala volume |
|
|
Term
| bipolar disorder - treatment |
|
Definition
| no FDA approved medication for children, antidepressants may create mania |
|
|
Term
| disruptive mood dysregulation - criteria |
|
Definition
a. temper outbursts (verbally, behaviorally), inconsistent with developmental level
b. frequency: 3+ times/week
c. between temper tantrums mood is persistently irritable or angry, obvious to others
d. duration of 12+ months
e. at least two settings (one setting it must be severe)
f. not be diagnosed before 6 or after 18
g. onset before 10 years of age
h. distinct period lasts more than one day, differentiated from developmentally appropriate mood elevation
i. is not better accounted for by a different disorder |
|
|
Term
| disruptive mood dysregulation - associated characteristics |
|
Definition
prevalence: ~3% of 10-18 y.o.
childhood DMDD may be risk factor for unipolar depression and GAD in adulthood
2/3 cases are males
may be highly related to ODD |
|
|
Term
|
Definition
depression increases the risk of a first suicide attempt
7% completion
four times as many males commit suicide
tree times as many females attempt suicide
53% of those who attempt suicide abuse substances
more than half of all suicides involve firearms
men: firearms, hanging
women: firearms, self-poisoning (drug overdose) |
|
|
Term
| suicidal thoughts - example |
|
Definition
| e.g. "i wish i were dead" |
|
|
Term
|
Definition
|
|
Term
|
Definition
| suicidal gestures, nonlethal self-injury, e.g. cutting |
|
|
Term
|
Definition
| depressed mood, substance abuse, running away or incarceration, family loss or instability, expressions of suicidal thoughts, or talk of death or the afterlife during moments of sadness or boredom, withdrawal from friends and family, difficulties in dealing with sexual orientation, anhedonia, unplanned pregnancy, impulsive, aggressive behavior or rage |
|
|
Term
| suicide: developmental model of suicide ideation - what is the most common word? |
|
Definition
|
|
Term
| suicide - protective factors |
|
Definition
| effective clinical care for mental, physical, and substance abuse disorders (treatment), easy access to a variety of clinical interventions and support for help seeking, family and community support, support from ongoing medical and mental health care relationships, skills in problem solving, conflict resolution, and nonviolent handling of disputes, cultural and religious beliefs that discourage suicide and support self-preservation instincts |
|
|
Term
| suicide - factors leading to an attempt |
|
Definition
1. long-standing history of problems from early childhood
2. acceleration of problems in adolescence
3. progressive failure to cope and isolation from meaningful social relationships
4. dissolution of social relationships
5. justification of the suicidal act, giving the adolescent permission to make the attempt
first few weeks on antidepressants: motivation and energy level increases, mood still depressed |
|
|
Term
| suicide - causes and correlates |
|
Definition
| low serotonin levels: depression (most common diagnosis), aggression, impulsivity |
|
|
Term
| suicide - cognitive factors |
|
Definition
| hopelessness, poor problem solving skills |
|
|
Term
| suicide - disinhibition of suicidal behavior |
|
Definition
| suicide attempts: predictor of future suicide completion |
|
|
Term
|
Definition
parent psychopathology: sebstance abuse, depression
poor parent-child relationships: lo levels of parent warmth, support, emotional responsiveness, high levels of violence, disapproval, harsh discipline, abuse and general conflict
lack of support |
|
|
Term
| suicide - contagion effect |
|
Definition
| children exposed to suicide are at greater risk for suicide |
|
|
Term
|
Definition
1. educate parents and peers of risk signs
2. crisis intervention: remove means, no harm contract, medicate, hospitalize
3. cognitive therapy
4. family therapy
5. dialectical behavioral therapy: targets emotion regulation and stress tolerance, mindfulness |
|
|
Term
|
Definition
non-REM: stage 1, 2, 3
REM: stage 4; high frequency brain waves, paralysis or large muscles |
|
|
Term
| sleep disorder - insomnia |
|
Definition
dissatisfaction with sleep quality/quantity, difficulty initiating or maintaining sleep,non-restorative sleep, early-morning awakening w/inability to return to sleep
infants: repetitive night wakening, inability to fall asleep
children: prolonged resistance going to bed
at least 3 nights a week for at least 3 months, significant distress or impairment of daytime functioning |
|
|
Term
| sleep disorder - insomnia, prevalence and treatment |
|
Definition
25-50% of 1-3 y.o. - decreases with age
behavioral treatment: gradual extinction
family guidance
drugs not typically used in children |
|
|
Term
| sleep disorder - narcolepsy/hypocretin deficiency |
|
Definition
recurrent periods of irrepressible need to sleep, lapses into sleep, naps occurring in the same day
two or more of: cataplexy (loss of muscle tone), hypocretin deficiency, rapid entry into REM sleep |
|
|
Term
| sleep disorder - narcolepsy/hypocretin deficiency, prevalence and treatment |
|
Definition
<1%
tx: structure, support, psychostimulants, SSRIs |
|
|
Term
| sleep disorder - circadian rhythm sleep-wake disorder |
|
Definition
| sleep disruption leading to excessive sleepiness/insomnia, misalignment between sleepiness and environment or schedule |
|
|
Term
| sleep disorder - circadian rhythm sleep-wake disorder, subtypes |
|
Definition
delayed sleep phase type (night owl)
advanced sleep phase type (early bird)
irregular sleep phase type (serial napper)
non-24 hour sleep-wake type (sleep drifts day to day) |
|
|
Term
| sleep disorder - circadian rhythm sleep-wake disorder, prevalence and treatment |
|
Definition
prevalence unknown - underreported
treatment: behavioral treatment, light therapy, chronotherapy |
|
|
Term
| sleep disorder - nightmare disorder |
|
Definition
repeated awakenings with recall of dysphoric dreams, common between ages 3 and 8, occurs in REM sleep
treatment: encouraged to face fears during the day, reduce stress |
|
|
Term
| sleep disorder - disorder of arousal |
|
Definition
| mixed elements of wakefulness and nREM sleep, recurrent episodes of incomplete awakening from sleep, usually occurring during the first third of the major sleep episode, relatively unresponsive to efforts to comfort during the episode, little to no dream imagery, often amnesia for the episode |
|
|
Term
| sleep disorder - disorder of arousal, subtypes |
|
Definition
confusional arousals: incomplete awakening from sleep, relative lack of autonomic arousal
sleepwalking: rising from bed during sleep and walking, blank, staring faces
sleep terrors: abrupt terror arousals from sleep beginning with a panicky scream, intense far, autonomic arousal |
|
|
Term
| sleep disorder - disorder or arousal, prevalence/age, treatment |
|
Definition
prevalence/age
sleep walking: 1-8%, 4-8 y.o.
sleep terror: 3%, 18 months to 6 years
treatment: take safety precautions, reduce stress and fatigue, add late afternoon nap, scheduled awakening, usually grown out of |
|
|
Term
| sleep disorder - differential diagnosis |
|
Definition
nightmares: occur during REM, usually during 2nd half of the night, moderate physiological arousal, few or no movements, easy to arouse, episodes frequently remembered, quite common
disorder of arousal - sleep terrors: occur during NREM sleep, during the first third of the night, intense physiological arousal, child wakes with scream, cry, and verbalizations, difficult to arouse, little or no memory of episode, somewhat rare (1-6%) |
|
|
Term
| sleep disorder - what it can look like |
|
Definition
| ADHD, learning difficulties, aggression, cognitive deficits, substance use, depression, anxiety |
|
|
Term
| elimination disorders - enuresis |
|
Definition
involuntary discharge of urine, over 5 years of age
1. limitations imposed on social activities: sleeping away from home, preschool
2. effects on self-esteem: social ostracism imposed by peers
3. parental reactions: punishment, anger, rejection (can perpetuate the problem) |
|
|
Term
| elimination disorders - enuresis, subtypes |
|
Definition
1. nocturnal only (most common)
2. diurnal only
3. nocturnal + diurnal |
|
|
Term
| elimination disorders - enuresis, prevalence and course |
|
Definition
13-33% of 5 y.o. wet the bed, boys>girls, more common in lower SES groups
declines rapidly with age |
|
|
Term
| elimination disorders - enuresis, causes |
|
Definition
antidiuretic hormone (ADH) deficiency
genetics: both parents 77%, mz 68% |
|
|
Term
| elimination disorders - enurssis, treatment |
|
Definition
behavioral: urine-alarm, dry bed training (change sheets), overlearning
medication: desmopressin, tricyclics (rarely used due to side effects) |
|
|
Term
| elimination disorders - encopresis |
|
Definition
| repeated passage of feces into inappropriate places (clothing or floor), involuntary or intentionally, must be at least 4 years old |
|
|
Term
| elimination disorders - encopresis, subtypes |
|
Definition
1. with or without constipation
2. overflow incontinence (liquid poop flowing around impacted poop) |
|
|
Term
| elimination disorders - encopresis, prevalence and course |
|
Definition
prevalence: 1.5-3%, 5-6 times more common in boys
course: decrease rapidly with age, may feel ashamed and try to avoid situations, more likely to occur during the day |
|
|
Term
| elimination disorders - encopresis, causes and treatment |
|
Definition
causes: megacolon, defecation dynamics
treatment: fiber, enemas, laxatives or lubricants, behavioral methods |
|
|
Term
| eating disorders - rumination criteria |
|
Definition
a. repeated regurgitation for at least one month
b. no associated medical conditions
c. does not occur exclusively during bouts of other eating disorders
d. warrant additional clinical attention if symptoms occur in the context of another mental disorder |
|
|
Term
| eating disorders - rumination, possible causes and prevalence |
|
Definition
possible causes: physical illness or severe stress, neglect, to gain attention
prevalence: most often occurs in infants and very young children (3-12 months), more common in males, in children with intellectual developmental disorder, it is rare in older children and adolescents |
|
|
Term
| eating disorders - rumination, possible complications if untreated |
|
Definition
| malnutrition, lowered resistance to infections and diseases, failure to grow and thrive, weight loss, stomach diseases such as ulcers, dehydration, bad breath and toot decay, aspiration pneumonia and other respiratory problems (from vomit that is breathed into the lungs), choking, death |
|
|
Term
|
Definition
| persistent eating of non-nutritive, non-food substances over a period of at least 1 month, minimum age of 3 years, not a part of cultural or social or religious practice, sufficiently severe to warrant additional clinical attention when occurring in the context of another mental disorder |
|
|
Term
| eating disorders - pica, complications |
|
Definition
| malnutrition, intestinal obstruction, intestinal infections or parasites from soil, anemia, mercury poisoning, liver and kidney damage, constipation and abdominal problems |
|
|
Term
| eating disorders - pica, unclear causes |
|
Definition
| may appear in normally developing children, environmentally deprived with low stimulation and caregiver interaction, sometimes due to vitamin or mineral deficiency |
|
|
Term
| eating disorders - pica, treatment |
|
Definition
| caregiver reinforcing appropriate behavior, encourage positive attention and interaction with child, vitamin supplements |
|
|
Term
| eating disorders - avoidant/restrictive food intake disorder, criteria |
|
Definition
a. avoidance based on the sensory characteristics of food, significant weight loss, significant nutritional deficiency, dependence on nutritional supplements, psychosocial functioning interference
b. no evidence for lack of food or cultural practice to account for the disorder
c. no evidence of body image disturbance
d. not better accounted for by another medical/mental disorder |
|
|
Term
| eating disorders - avoidant/restrictive food intake disorder, prevalence and causes |
|
Definition
prevalence: boys = girls, 3%
causes: neglect or abuse, family disadvantage, poverty, unemployment, parental mental illness, mothers with eating disorders, anxiety, or depression, negative experience(s) with food |
|
|
Term
| eating disorders - avoidant/restrictive food intake disorder, treatment |
|
Definition
| medical/biological intervention (get the child eating and to normal weight), multidisciplinary treatments can improve parenting skills and may have greater long-term success |
|
|
Term
| eating disorders - continuum of eating pathology |
|
Definition
problem eating ->
rejected by peers ->
drive for thinness ->
negative body image ->
increased risk of eating disturbances |
|
|
Term
|
Definition
| the individual believes that losing more weight is the answer to overcoming troubles and to achieving success |
|
|
Term
| eating disorders - anorexia nervosa, criteria |
|
Definition
| restriction of food, significantly low body weight, intense fear of gaining weight/being fat, disturbance in body weight/shape experience |
|
|
Term
| eating disorders - anorexia nervosa, 2 types |
|
Definition
restricting type: significantly low body weight, intense fear of gaining weight, significant disturbance in perception and experiences in own size
binge-eating/purging type: (all of the above plus) may binge and purge on small amount of food, unlike bulimia nervosa, although binges may also be large |
|
|
Term
| eating disorders - anorexia nervosa, prevalence |
|
Definition
among adolescents: 0.3%
disproportionately female: 11:1
may be greater among homosexual males than heterosexual males |
|
|
Term
| eating disorders - anorexia nervosa, development |
|
Definition
onset between 14 and 18 years old
especially common during life transitions
often preceded by dieting |
|
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Term
| eating disorders - anorexia nervosa, subsequent course |
|
Definition
rate of mortality: 5%
death rate can be as high as 10%, highest death rate out of all disorders
less than 1/2 of survivors fully recover
1/3 show some improvement
in 1/5, the disorder is chronic and lifelong |
|
|
Term
| eating disorders - bulimia nervosa, criteria |
|
Definition
a. recurrent episodes of binge eating, larger portions, lack of control, within 2 hour period
b. recurrent inappropriate compensatory behavior
c. both occur at least once per week for 3 months
d. self-evaluation unduly influenced by body shape and weight
e. does not occur during episodes of AN |
|
|
Term
| eating disorders - bulimia nervosa, prevalence |
|
Definition
1-2% in 16-35 y.o.
disproportionately female: 30:1
underreported in men
homosexual men > heterosexual men |
|
|
Term
| eating disorders - bulimia nervosa, development |
|
Definition
| onset usually late adolescence and young adulthood, slightly later than, usually starts with dieting |
|
|
Term
| eating disorders - bulimia nervosa, subsequent course |
|
Definition
|
|
Term
| eating disorders - AN and BN causes, biological |
|
Definition
genetics: 4-5 times more likely if the individual has a relative with AN or BN, if twin has AN 58-88% concordance rate, inherited personality traits
neurobiological: serotonin imbalance (can remain imbalanced for a while after recovery) |
|
|
Term
| eating disorders - AN and BN causes, family and social |
|
Definition
family: family weight history, negative self-evaluations
social: belief that physical appearance is key to happiness, self-worth, femininity, success; cultural ideals |
|
|
Term
| eating disorders - AN and BN comorbidities |
|
Definition
| 90% with depression, anxiety disorder (particularly OCD) |
|
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Term
| eating disorders - AN treatment |
|
Definition
| help patient realize she/he needs help, weight restoration, family therapy (Maudsley approach), CBT |
|
|
Term
| eating disorders - BN treatment |
|
Definition
| CBT, interpersonal therapy (grief, role transitions, role disputes, interpersonal deficits), antidepressants |
|
|
Term
| eating disorders - binge eating disorder BED |
|
Definition
marked distress regarding binge eating
average once a week for 3 months
not associated with compensatory behavior |
|
|
Term
| eating disorders - binge eating disorder BED, prevalence |
|
Definition
BED is more common that AN or BN, and has a later age of onset
3.5% of women
2% of men |
|
|
Term
| eating disorders - binge eating disorder BED, course |
|
Definition
| 67-85% recovered within 5 years |
|
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Term
| eating disorders - binge eating disorder BED, comorbidities and associated problems |
|
Definition
often associated with obesity
comorbidities: MDD, GAD, panic attacks
associated problems: obesity, diabetes, hypertension, cardiac problems, asthma, insomnia, early menarche |
|
|
Term
| eating disorders - binge eating disorder BED, causes |
|
Definition
associated with less fullness, more distress and perceived lack of control, heritability -0.57%
associated with low ghrelin suppression (peptide the stimulates hunger and promotes food ingestion) |
|
|
Term
| eating disorders - binge eating disorder BED, treatment |
|
Definition
cognitive-behavioral interventions: break the pattern of unhealthy eating, monitor eating habits, avoid binge-triggers, alternative stress management techniques
prozac: SSRI, may help with depression and obsession with weight |
|
|
Term
|
Definition
1. identify, describe, and classify psychological disorder
2. determine the causes of the disorder
3. treat and prevent disorder |
|
|
Term
| what is the most important factor in childhood psychological disorders? |
|
Definition
|
|
Term
| behavioral indicators of disorders |
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Definition
1. time course: developmental delay or regression, the difficulty persists over time
2. quantitative indicators: extremely high or low frequency and intensity
3. qualitative indicators: inappropriate to the situation, behavior different from normal |
|
|
Term
| role of culture in psychological disorders |
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Definition
| deviance is always related to cultural standards, shaping abnormal and normal development, defining and labeling abnormality, conceptualizing and explaining problem behavior, treatment |
|
|
Term
| role of gender in psychological disorders |
|
Definition
| biological, archetypes, underrepresented or underreported, gene issues, media/social differences, boys more biologically vulnerable, referral bias |
|
|
Term
| gender prevalence - males |
|
Definition
| intellectual disabilities, language disabilities, learning disabilities, autism spectrum disorder, conduct disorders, rumination, encopresis, enuresis, Tourette's, substance abuse, ADHD, more externalizing problems |
|
|
Term
| gender prevalence - female |
|
Definition
| rett's disorder, anxiety disorders, depression, eating disorders, more internalizing problems |
|
|
Term
|
Definition
| different pathways may lead to similar expressions of psychopathology |
|
|
Term
|
Definition
| similar initial pathways may result in different forms of dysfunction |
|
|
Term
|
Definition
| etiology of any psychopathology is multidetermined |
|
|
Term
| general causes - biological influences |
|
Definition
| brain development, neurobiology, endocrine system, biological risk, neurotransmitters, genetics |
|
|
Term
| general causes - emotional influences |
|
Definition
emotion reactivity: threshold and intensity of emotional experience
emotion regulation: 2 types of dysregulation, under and over
temperament: easy, slow-to-warm-up, difficult, goodness of fit with parents |
|
|
Term
| general causes - behavioral and cognitive influences |
|
Definition
| classical conditioning, positive/negative reinforcement, positive/negative punishment, operant conditioning |
|
|
Term
| general causes - family and cultural influences |
|
Definition
| authoritative, authoritarian, indulgent/permissive, neglectful |
|
|
Term
|
Definition
-midbrain: motor supply to muscles
-pons: face sensation and movement
-medulla: breathing, heartbeat, digestion |
|
|
Term
| neurobiology: cerebellum, thalamus, hypothalamus |
|
Definition
-cerebellum: controls motor coordination
-thalamus: relay station for sensory input
-hypothalamus: regulates behavior and emotion |
|
|
Term
|
Definition
| regulates emotional experiences, expressions, basic drives, critical for learning and impulse control |
|
|
Term
|
Definition
regulate, organizes, filters info related to cognition, emotions, mood and motor function
highly connected to frontal lobes |
|
|
Term
|
Definition
frontal: thinking, reasoning, working memory, self-control, social cognition
parietal: integrate signals
temporal: memory, language |
|
|
Term
|
Definition
| hypothalamus, pituitary gland, adrenal gland = HPA axis |
|
|
Term
|
Definition
GABA: reduces arousal, linked to anxiety disorders
dopamine: "switch," turns on various circuits, linked to schizophrenia, mood disorders, ADHD, substance abuse
norepinephrine: controls emergency reactions and alarm responses, role in regulating emotions and behavior, modulates behavior
serotonin: information processing, motor coordination, inhibits exploration, regulates eating, sleeping, aggression, linked to eating and sleep disorders, OCD, schizophrenia, mood disorders |
|
|
Term
|
Definition
| secure attachment, avoidant attachment, anxious attachment, disorganized |
|
|
Term
| diagnosis - clinical description |
|
Definition
| intensity, frequency, severity, age of onset and duration, symptoms |
|
|
Term
|
Definition
| formulation of predictions concerning future behavior under specified conditions |
|
|
Term
| diagnosis - treatment planning and evaluation |
|
Definition
| plan treatment and evaluate effectiveness |
|
|
Term
|
Definition
| use problem-solving strategies to understand the disturbances, the family environment, school and peer relations |
|
|
Term
| clinical assessments goal |
|
Definition
| to achieve effective solutions, to promote and enhance well-being of the child |
|
|
Term
|
Definition
A: antecedents (teased at school)
B: behaviors of interest (school refusal)
C: consequences (no teasing) |
|
|
Term
|
Definition
| develop awareness of unconscious factors |
|
|
Term
|
Definition
| positive reinforcement, time out, modeling, systematic desensitization |
|
|
Term
|
Definition
| change faulty cognitions, like irrational beliefs and misinterpretations |
|
|
Term
| cognitive-behavioral treatment |
|
Definition
| combined elements of behavioral and cognitive treatments |
|
|
Term
| client-centered treatment |
|
Definition
| fix social or environmental circumstances |
|
|
Term
|
Definition
| work with entire family, to foster communication |
|
|
Term
|
Definition
|
|
Term
|
Definition
| combining two or more treatments |
|
|
Term
|
Definition
| mood state characterized by strong negative emotion and bodily symptoms of tension in which an individual apprehensively anticipates future danger or misfortune and often feels a lack of control |
|
|
Term
|
Definition
| immediate reaction to danger |
|
|
Term
|
Definition
| excessive and debilitating anxiety, worry, and/or fear |
|
|
Term
|
Definition
physical system: autonomic arousal, fight/flight response
cognitive system: expectation of danger, worry about future danger
behavioral system: avoidance |
|
|
Term
| separation anxiety disorder - criteria |
|
Definition
| developmentally inappropriate and excessive fear or anxiety concerning separation from home or from those to whom the individual is attached |
|
|
Term
| separation anxiety disorder - prevalence and comorbidities |
|
Definition
10% in all children
declines after childhood
higher prevalence in lower SES
greater risk is mom has high anxiety
comorbidities: GAD, depression |
|
|
Term
| separation anxiety disorder - course |
|
Definition
| often occurs after major stressor, mild to severe, symptoms can fluctuate, school refusal, most recover |
|
|
Term
| generalized anxiety disorder (GAD) |
|
Definition
| the child experiences chronic or exaggerated worry and tension, almost always anticipating disaster, even in the absence of an obvious reason to do so; worrying is often accompanied by avoidance, procrastination, and requests for reassurance |
|
|
Term
| generalized anxiety disorder (GAD) - criteria |
|
Definition
| excessive anxiety and worry about 2 or more domains of activities or events, occurs on more days than not, associated with restlessness or feeling keyed up or on edge, or muscle tension, avoidance of activities that have possible negative outcomes, marked procrastination due to worries, repeatedly seeking reassurance |
|
|
Term
| generalized anxiety disorder (GAD) - prevalence and course |
|
Definition
3-6%, more common in girls
age onset 10-14
symptoms persist over time |
|
|
Term
| ADHD - 3 prominent symptoms |
|
Definition
1. inattention: not focused on demands or details
2. hyperactivity: constantly in motion, on-the-go
3. impulsivity: acting without thinking |
|
|
Term
|
Definition
1. attentional capacity: the amount of info that can be remembered and attended to for a short time
2. selective attention: ability to focus on relevant stimuli and not be distracted by irrelevant stimuli
3. sustained attention: ability to maintain persistent focus on a task over a period of time, or when fatigued |
|
|
Term
|
Definition
| constantly in motion, more active at night, more likely to occur in situations where the child is required to sit still and regulate his/her behavior |
|
|
Term
|
Definition
| often perceived as careless, irresponsible, immature, lazy, rude |
|
|
Term
| oppositional defiant behavior (ODD) |
|
Definition
| age-inappropriate pattern of negativistic, hostile and defiant behaviors |
|
|
Term
|
Definition
| severe aggressive and antisocial acts that involve inflicting pain on others or interfering with others' rights, usually preceded by ODD |
|
|
Term
| antisocial personality disorder (ASPD) |
|
Definition
| antisocial behavior, ego-centrism, lack of empathy, multiple illegal behaviors, callous, manipulative, deceitful, remorseless, hostility, risk-taking, 40% of those with CD grow up to have ASPD |
|
|
Term
|
Definition
developmental brain disorder that causes an inability to relate to people and situations
involves social interaction impairments, communication impairments, restricted and repetitive behaviors
spectrum disorder |
|
|
Term
| autism spectrum disorder - characteristics |
|
Definition
social interactions: little interest in people, difficulties establishing social relationships
communication: delay or absence of language and communication precursors, echolalia, impairments in speech pragmatics, no pretend play
restricted/repetitive/stereotyped behaviors, difficulty understanding theory of mind |
|
|
Term
| autism spectrum disorder - prevalence |
|
Definition
|
|
Term
| autism spectrum disorder - criteria |
|
Definition
1. persistent deficits in social communication and social interactions across contexts
2. restricted, repetitive patterns of behavior, interests, or activities
3. symptoms must be present in early childhood
4. symptoms together limit and impair everyday functioning |
|
|
Term
| autism spectrum disorder - causes |
|
Definition
| neurobiological, environmental, genetic |
|
|
Term
| autism spectrum disorder - treatment |
|
Definition
| early intervention is key, individually specific treatment, occupational/physical therapy, behavior modification, sensory integration therapy, medication, diet |
|
|
Term
|
Definition
| sound omissions are worse than sound substitutions, delayed speech and sound production, more prevalent in males |
|
|
Term
|
Definition
| persistent difficulties in the acquisition and use of spoken and written language |
|
|
Term
| social (pragmatic) communication disorder |
|
Definition
| socially inappropriate in conversation but did not meet the full criteria for ASD, pragmatic difficulties dissociated from phonological and semantic-syntactic problems, pragmatic problems in both production and comprehension |
|
|
Term
| specific learning disorder - reading |
|
Definition
| difficulties in the areas of: word recognition, pronunciation, reading fluency, vocabulary, comprehension, memory for read material, more boys |
|
|
Term
| specific learning disorder - written expression |
|
Definition
| problems with transcription (putting ideas into written form and/or copying) and/or text generation (creation of meaning in the written form) |
|
|
Term
| specific learning disorder - dyscalculia |
|
Definition
| deficit in mathematics, delay in learning mathematics, problems with numbers or counting, boys = girls |
|
|
Term
| intellectual developmental disorder (IDD) - conceptual domain |
|
Definition
mild: difficulties and limitations in acquiring academic skills
moderate: ongoing daily assistance is needed to complete conceptual tasks of day to day life
severe: caretakers provide all support for this area throughout life, attainment of conceptual skills is extremely limited |
|
|
Term
| intellectual developmental disorder (IDD) - social domain |
|
Definition
mild: immature in social interactions
moderate: social and communicative support is needed in work settings for success
severe: relationships based on attachment than friendship, nonverbal communication |
|
|
Term
| intellectual developmental disorder (IDD) - practical domain |
|
Definition
mild: can function, may need support in some areas
moderate: can care for personal needs with training
severe: requires support and supervision for all activities of daily living |
|
|
Term
| intellectual developmental disorder (IDD) - prevalence |
|
Definition
1-3% of population
boys > girls
low SES = risk factor |
|
|
Term
| intellectual developmental disorder (IDD) - down syndrome |
|
Definition
| better receptive language than expressive language, hippocampal functioning differs |
|
|
Term
| intellectual developmental disorder (IDD) - fragile X syndrome |
|
Definition
| pinched chromosome, macroorchidism, autism-like behaviors, quantitative and visuospatial deficits |
|
|
Term
| intellectual developmental disorder (IDD) - williams syndrome |
|
Definition
| deletion of genetic material from chromosome 7, elfin appearance, cocktail party syndrome |
|
|
Term
| intellectual developmental disorder (IDD) - prader-willi syndrome |
|
Definition
| short stature, incomplete sexual development, low muscle tone, involuntary urge to eat constantly, hypotonia (no muscle tone, dead fish as a baby) |
|
|
Term
| intellectual developmental disorder (IDD) - angelman syndrome |
|
Definition
| profound desire for personal interaction, frequent laughter, happy disposition, still walk, fascination with water, nonverbal or can only say one or two words |
|
|
Term
| intellectual developmental disorder (IDD) - PKU |
|
Definition
| genetic disorder that can successfully be treated by environmental change (staying away from certain foods) |
|
|
Term
| intellectual developmental disorder (IDD) - lesch nyhan syndrome |
|
Definition
| self-mutilating, irritability, uncontrolled aggression or conpulsive actions beginning around age 2-3, hypotonia (no muscle tone), spastic movements |
|
|
Term
| intellectual developmental disorder (IDD) - fetal alcohol spectrum, fetal alcohol syndrome |
|
Definition
extensive prenatal exposure to alcohol
problems in: intellectual functioning, central nervous system, behavior, growth, physical abnormalities of the face
smooth philtrum, thin vermillion, short palprbral fissures |
|
|
Term
| unusual characteristics of intellectual developmental disorders |
|
Definition
angelmans - fascination with water
williams syndrome - gregarious, musical prowess
lesch nyhan - sandy diapers
prader-willi - voracious appetite
FAS - smooth philtrum
fragile X - macroorchidism |
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