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Child/Adolescent Comps

Terms in this set (16)

Emotional, physiological, behavioral sx following traumatic event: response characterized by fear, helplessness, or agitated behavior
-reexperiencing symptoms: flashbacks, nightmares, intrusive images, unwanted thoughts
-avoidance symptoms: avoidance of situations or cues, refusal to discuss event, refusal to spend time with associated people, emotional numbing, detachment, refusal to separate from parents, refusing to go to bed, regressive bxs
-physiological arousal symptoms: sleep probs, concentration probs, irritability, anger, rage, hypervigilance, startle response

individual dev factors:
-preexisting phobias - more likely to dev PTSD after trauma
- based on cognitive appraisals: internal appraisals more likely to dev PTSD
- based on coping styles: emotional numbing worse prognosis
-exposure to trauma affects brain: overactive amygdala: excessive stress response (cortisol, HPA axis); overactive HPA: hypervigilance, startle response, sensitivity to stress, flashbacks

environmental factors
- parental support: stable and safe social support = better prognosis; parent psychopathology, parent's reaction to event
- major life events: death, divorce, hospitalization
-type of trauma: type 1 (acute, sudden) = typically leads to PTSD; type 2 (chronic) = may be varied response, less likely to be distinct PTSD symptoms, but will be emotionally numb, avoidant, regressive, and distressed; presentation different based on type of trauma (inappropriate sexual bxs in response to sex abuse, etc.)
-variables of exposure: perceptions of life threat, death of loved ones, proximity (witness vs. victim), frequency, etc.
-comorbities - maintenance: phobias play into avoidance, high rate of depression and suicide, alcohol abuse and drugs in teens, link to ADHD
excessive anxiety about leaving caregivers and others to whom they are emotionally attached - which is inappropriate at the developmental level (normal from 7mo to 6yrs); persistent about losing/harm to attachment figures
-nightmares involving theme of separation, refusal to sleep without attachment figure nearby
-cognitions that parent will be harmed
-avoidance of/anxious anticipation of separation situations
-mild SAD: hesitance to leave home, procrastination during morning routine, incessant questions about schedule
-moderate SAD: refusal to attend sleepovers, clingy-follow parents from room to room
-severe SAD: refusal to attend school, refusal to sleep in own room, feign illness and concoct excuses, leaves school or summer camp
-affects various areas of functioning: physical/somatic complaints, social - impaired relationships due to avoidance, academic - school refusal, inattentive/preoccupied at school, emotional - associated with phobias, comorbid with GAD or depression, related to development of panic in adults

individual dev factors:
-genetics possibility - triple vulnerability
-prognosis depends on severity, age - type of anx/fear depends on age (5-8 more fear of harm to parents, nightmares, school refusal; 9-12 more likely to show excessive distress; teens: more likely to endorse somatic symptoms, concerns about threats (illness, etc)

environmental factors:
-quality of parent-child relationships, early attachment (insecure attachment associated with inconsistent responsiveness from parents - risk highest for kids with insecure attachment and high level of behavioral inhibition due to high sensitivity to environment and inconsistent care)
-overcontrolling, overprotective parents
-stable patterns develop that maintain the disorder: allowing kid to sleep in parents bed due to nightmare
-school refusal: negative reinforcement (avoidance of neg affect, escape from aversive social eval); positive reinforcement (attention seeking granted, reinforcers like watching TV, snacks)
- onset common after stressful event (i.e. moving/new school, prolonged illness, death of parent)
marked and persistent fear of clearly discernible/specific objects or situations: almost immediate anxiety response, contact with feared stimulus =intense anxiety/panic (in kids: crying, tantrums, freezing, clinging), stimuli are avoided
-excessive and out of proportion, persistent over time, maladaptive, cognitions that are resistant to disconfirmatory evidence
-generally reflect the child's level of cognitive development: young (concrete, like monsters or animals) vs. older (situations that could cause harm, like storms) vs. adolescents (social interactions, exams, etc.)
-presentation: cognitively: catastrophic prediction of dreadful event occurring if exposed to stimuli; behaviorally: avoidance, apprehension, hypervigilance; physiologically: panic, increased heart rate, sweating, hyperventilation, shaking, stomach aches
-onset: before age 7 and not linked to specific event: linked to stability of fear over time

individual dev factors:
-genes play small role; blood/injury type may have more genetic load due to physiological component - sensitivity to vasovagal response?
-prognosis: resolves without treatment, but may derail college if not; vulnerable to substance abuse

environmental factors
-maintained through classical conditioning or social learning: can occur via observational learning (watching others' fear response) and information transmission (by talking to others)
-two factor theory of anxiety
1. develops due to classical conditioning
2. maintained via operant conditioning: negative reinforcement - avoidance as an effective way to reduce anxiety
-avoidance is fine in the short-term, but can interfere with learning of alternate coping strategies and routine life functioning over time
repetitive pattern of behavior in which basic rights of others or major age-appropiate norms/rules are violated
-aggression towards people and animals (bully, threaten, initiates physical fights, use a weapon, physically cruel, stole while confronting victim, force sexual activity)
-destruction of property
-deceitfulness or theft (breaking into, lies to obtain goods/favors, stolen nontrivial items without confrontation)
-serious rule violations (staying out late, run away at least twice, truant)

individual dev factors
- early onside (before 10) means more serious, very stable, poor prognosis; late onset (adolescence) may just be a stage - don't show the same genetics, temperamental and psychosocial risk factors as those with early onset
-without ODD show better prognosis
- genetics - can lead to emotion regulation problems, children who cannot be soothed, irritable
-higher level of motor activity, lack of frustration tolerance, excessive emotional reactivity, low level of HPA axis (slow to react to pleasurable stuff and slow to adjust behavior in the face of punishment), callous/unemotional, no fear or remorse

environmental factors
-hostile parenting behavior: harsh or inconsistent disciplinary tactics (yelling, spanking, hitting); disturbed family relationships: parents fighting; lack of parental responsiveness; reciprocal coercion: force on force, leads child to ignore parental commands in the future; less positive interactions, limited early exposure to encouragement of good social skills
-coercive family process: parents modeling hostile and aggressive behaviors, reinforcing child's non-compliant acts and child reinforcing the lax discipline (parent commands > child ignores > parent withdrawals command > child stops tantrum = child is negatively reinforced; parent commands > child tantrums > parent withdrawals command > child stops tantrum = parent is negatively reinforced)
-social information processing - how children solve interpersonal dilemmas - 5 steps:
1. encode cues/interpret cues
2. clarify goals
3. develop a plan of action
4. evaluate options
5. enact solution
-kids with CD show biases in processing
-reactive aggression: problems with encoding and interpreting cues; hostile attribution bias, have problems understanding their own emotional reactions
-proactive aggression: problems with clarifying goals and evaluating possible solutions - main objective is to get something, maximize benefits and minimize potential consequences
psychotic disorder characterized by one or more key symptoms including
1. positive symptoms
- bizarre delusions
-mood incongruent hallucinations
-thought dx
-grossly disorganized catatonic bx
-disorganized speech
2. negative symptoms
-affective flattening
-alogia
-avolition
Disturbances in perception, attention, memory, language, thought, will, judgement, emotion
-sometimes difficult to distinguish between normal and abnormal childhood experiences: children's thinking can be illogical, imaginary friends ,etc. (look for both illogical thinking and loose associations)
-antecedents: frequent daydreaming and social withdrawal, rapid mood changes, odd behaviors based on trivial observations (precursors to delusions and hallucinations), may be cyclical- acute episodes and remissions

individual dev factors:
- rare and serious: poor prognosis: 1/10,000
-earlier the onset, the worse the prognosis
-stress diathesis model: genetics and life stress: vulnerabilities (genetics, CNS dysfunction, family dysfunction)
-dopamine hypothesis - DA neurons play a role in modulation of mental, motor, and autonomic functions and appear to be involved in the integration of cortisol and subcortical functions: increasing DA, increases symptoms
-abnormalities in parietal and prefrontal lobes (visuospatial and sensorimotor)

environmental factors:
-stress diathesis model: stressors (major life events: death of a parent, traumatic accident; chronic stressors (poverty, parental conflict, parental mental illness) - associated with onset or relapse
-mostly males
- more lower SES