clinical child psychology exam 2

What are the three primary symptoms of ADHD?
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Family problems- interactions characterized by negativity; child noncompliance, excessive parental control, sibling conflict.
Peer problems - apparent at young age quickly evident when child enters new social situation three times as many peer problems Seen as bothersome stubborn socially awkward and socially and sensitive often suffers pure rejection have a few friends and receive low social support from peers
Be familiar with some specific examples of the risk factors for ADHD (e.g. genetic prenatal, family)genetic, prenatal, birth complications, severe stress during pregnancy, neurobiological factors, brain abnormalities, diet allergy and lead, family influencesIs ADHD heritable?yes, heritability rate is about .75Know what the most common treatments are for ADHDmedication, parent management trainingReview the results of the MTA study - what was best treatment at 14 months?medication modification and behavior modification treatmentConduct Problems/Antisocial Behaviorage-inappropriate actions/attitudes that violate family/societal norms and personal/property rights of others. Costly to society.What percent of children have conduct problems?5%What behaviors make up "externalizing dimension?"rule breaking behavior, aggressive behaviorBe familiar with the 4 dimensions/categories of conduct problemsovert destructive, overt nondestructive, covert destructive, covert nondestructiveKnow the symptoms of Oppositional Defiant Disorder (ODD).angry irritable mood, argumentative defiant behavior, vindictivenessKnow the symptoms of Conduct Disorder (CD)Repetitive and persistent pattern of severe aggressive and antisocial acts that involve inflicting pain on others or interfering with rights of others through physical and verbal aggression, stealing, vandalismWhat is the difference between ODD and CDODD symptoms emerge 2-3 years before CD symptoms,When does ODD usually occur?usually appears by age 8Does ODD lead to CD?is a risk factor, but no, most kids with ODD do not go on to have CDPathways to CD:1. Early-onset follows Life Course persistent (LCP) - early aggression (3-5 years), persists into adulthood, greater genetic component, neuropsychological deficits thought to increase vulnerability to antisocial elements in social environment 2. Adolescent-onset typically follows Adolescent-Limited Pathway (ALP) - begins puberty, ends young adulthood, unless snares; Not as severe or violentKnow the differences between Childhood-onset CD (LCP) and Adolescent-onset CD (ALP)Children with childhood-onset are more likely to: •Be boys •Show more aggressive symptoms •Account for a disproportionate amount of illegal activity •Persist in antisocial behavior over time Children with adolescent-onset are •More similar in terms of rates between girls and boys •Do not display severity that characterizes childhood onset •Less likely to commit violent offenses or persist in antisocial behavior over timeKnow what is meant by a "snare" and be able to give an exampleOutcomes of antisocial behavior that close the door to getting a good job, pursuing higher education, etcBe familiar with how conduct problems differ between boys and girls (gender differences) and possible reasons•During childhood, rates of conduct problems are about 2-4 times higher in boys •Boys have earlier age of onset and greater persistence Possible explanations: genetic, neurobiological, environmental risk factors, and definitions of conduct problems that emphasize physical violence •Girls use indirect, relational forms of aggression, tends to be more covertKnow how Conduct Disorder overlaps with Antisocial Personality DisorderAs many as 40% of children with CD develop APD as young adultsWhat are callous-unemotional traits?•Traits include •lacking in guilt •not showing empathy •not showing emotions •Narcissism •Impulsivity •Behavioral Inhibition they most reliably distinguish CD from other disorders (i.e. no other disorder has these traits; also called 'psychopathic traits.'What other disorders are comorbid with CD and ODD?ADHD, depression, anxietyODD and CD, especially childhood-onset CD, is associated with....cognitive (IQ/executive functions) and verbal/language deficits, academic deficitsWhy might language deficits contribute to conduct problems?Early language deficits →reading and communication difficulties→increased conduct problemsWhat are peer relationships like for CD?Young children with CD display poor social skills and verbal/physical aggression toward peers. •Form friendships with other antisocial peers, which predicts conduct problems •Antisocial peers reward "deviant talk" •Some become bullieshostile attribution biasattribute negative intent toward othersWhat are health problems associated with conduct problemsdrug use, injury, death, sexually transmitted infectionsFamily problems are STRONGEST factors associated with conduct problems - what kinds of family problems?•High levels of conflict in family (including siblings) •Lack of family cohesion •Deficient parenting practicesBe familiar with SPECIFIC examples of risk factors for conduct problemsConduct problems are seen as resulting from the interplay among predisposing child, family, community, and cultural factors, operating in a transactional fashion over timeWhat is Coercion Theory or Coercive Family Process?parent-child interactions that reinforce antisocial behaviorHow might the media and neighborhood contribute to conduct problems?antisocial behavior in youth is more common in neighborhoods with criminal subcultures •Drug dealing, peer group violence, gang membership, frequent transitions, low social support, low participation in community organizations, poor school environments media- correlation between media violence and conduct Short term precipitating factor (e.g. priming, imitation) Long-term predisposing factor (e.g. aggression is acceptableWhat treatments are NOT effective for severe conduct problems?•Office-based individual counseling and family therapy •Wilderness programs and bootcamps •Group Therapy (bringing together youth can make the problem worse) •Residential Treatment, Inpatient Hospitalization •IncarcerationWhy don't bootcamps work?they focus on punishment for negative behavior rather than identifying causeWhat are two evidence-based therapies found to help with conduct problems?PCIT - younger children; MST - older childrenWhy does anxiety often go unnoticed in children?Fears and anxiety as part of normal development Invisible nature of many symptoms Results in less damage to other people or propertyHow do we define anxiety?A mood state characterized by strong negative emotion and bodily symptoms of tension in anticipation of future danger or misfortuneHow is anxiety adaptive? Know about fight/flight response. Know Yerkes-Dodson Law and figurecan be adaptive emotion that readies us physically and psychologically for coping events; readies for escaping potential harm; Yerkes Dodson law - some anxiety is adaptive whereas too much anxiety hinders performanceWhen does anxiety become a problem/disorder?experiencing excessive and debilitating anxieties; occur in many formsKnow the three anxiety response systems and some examples1-Physical System •Fight/flight response •Chemical effects •Cardiovascular effects 2- Cognitive System •Thoughts of being scared or hurt •Difficulty Concentrating •Blanking out/Forgetfulness 3- Behavioral system •Avoidance •Crying/Screaming •Nail Biting(T/F) There are normal/developmentally appropriate childhood fears/worries/anxieties/rituals. Most children outgrow these over time.TrueKnow the differences between anxiety, fear, and panic.Anxiety - future oriented mood state, make her an absence of realistic danger; characterized by feelings of apprehension and lack of control over upcoming events Fear - present oriented emotional reaction to current danger characterized by strong escape tendencies and surge and sympathetic nervous system Panic- group of physical symptoms of fight or flight response or unexpectedly occur in the absence of obvious danger/threatWhat behavior reinforces anxiety and often makes it worseavoidancesymptoms of panic attackSweating, trembling, shaking Shortness of breath, chest pain or discomfort Nausea or abdominal distress Dizziness, chills, or hot flashes Numbness or tingling sensations Derealization or depersonalization Fear of losing control or "going crazy" Fear of dying(T/F) a panic attack can occur with any anxiety disordertrue(T/F) there is NO overlap between anxiety disorders. people generally only suffer from onefalse(T/F) It qualifies for panic disorder if someone has a panic attack occasionallyfalseOCDOwn category separate from other anxiety disorders - these disorders are characterized by repetitive thoughts, distress, and compulsive behaviors. (also Trichotillomania, hoarding, excoriation, body dysmorphic disorder)What are the symptoms of OCD? How can rituals lead to disruptions on functioning?•Repetitive thoughts •Distressing emotions •Compulsive behaviors disrupts functioning by- being time-consuming, Resistant to reasonKnow the types of cognitive problems associated with anxietyAttentional biases Cognitive errors/biasesautomatic thoughts and cognitive distortionsall or nothing thinking, catastrophizing, jumping to conclusions- mind reading, fortune teller error, personalizationWhat kinds of physical symptoms are associated with anxiety disorders?Somatic complaints (e.g. stomachaches, headaches); 90% have sleep-related problems, including nocturnal panic (abrupt waking in a state of extreme anxiety similar to daytime panic attack), insomnia, nightmaresWhat kind of social deficits do children with anxiety experience?Anxious children display low social performance and high social anxiety; See themselves as shy and socially withdrawn, and report low self-esteem, loneliness, and difficulty initiating and maintaining friendships(T/F) Strong overlap, comorbidity of anxiety and depressiontrueKnow how anxiety differs for boys and girls. What are 2 reasons there is higher incidence of anxiety for girlsHigher incidence in girls likely due to genetic vulnerabilities and gender role orientationsBe familiar with the role of temperament in anxiety disorders. Think about Baby 19Behavioral Inhibition (BI): A type of temperament describing children born with a low threshold for novel and unexpected stimuli are at greater risk for anxiety disorders; high reactive infants = higher anxiety incidenceHow do families influence anxiety disorders? Should families play a role in treatment?Genes are linked to broad anxiety-related traits (e.g., behavioral inhibition); small contributions from multiple genes, but no direct link with specific genes. About 1/3 of the variance in childhood anxiety symptoms is genetic. Addressing children's anxiety disorders in a family context may result in more dramatic and lasting effects than only focusing on the childWhat do treatments for anxiety seek to modify?-distorted information processing -physiological reactions to perceived threat -sense of a lack of control -excessive escape and avoidance behaviorsbehavior therapysystematic desensitizationhow systematic desensitization works -uses graded exposure, response prevention, and models/teaches child to use relaxation and coping strategies at each step.CBT used along with exposure-based treatmentsteach children how their thoughts contribute to anxiety and how to modify their thinking to decrease symptoms. Teaches kids skills. Most effective