clinical child psychology exam 3

Depression

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persistent negative mood as reflected in nervousness, guilt, anger, and sadness
"common cold" of psychopathology

$210.5 Billion per year
depression is costly due to worker absenteeism, presenteeism (reduced productivity at work), direct medical costs, and suicide expenditures

When do feelings of depression become a disorder?

interferes with daily routines, social relationships, school performance, and overall functioning

Why is depression often overlooked in young children?

in children, sadness or irritability are usually attributed to temporary factors

How are symptoms of depression different at different ages?

younger children like infants are more likely to struggle with sleep disturbances, lack of appetite
depressed preschoolers are tearful and somber and lack enthusiasm in play
depressed school age children have academic difficulties, physical complaints, and disruptive behavior
adolescence that are depressed exhibit low self esteem and increasing self blame and may struggle with suicidal thoughts or attempts

Major Depressive Disorder

For 2 WEEKS
• Depressed mood (subiective or observed)
• Loss of interest or pleasure
• Change in weight or appetite
• Insomnia or hypersomnia
• Psychomotor retardation or agitation (observed)
• Loss of energy or fatigue
• Worthlessness or guilt
• Impaired concentration or indecisiveness
• Thoughts of death or suicidal ideation or suicide attempt

persistent depressive disorder

for at LEAST A YEAR BUT NOT MORE THAN 2
• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self-esteem
• Impaired concentration or indecisiveness
• Hopelessness
Never without symptoms for more than 2 months

Disruptive Mood Dysregulation Disorder

1 YEAR +; no more than 3 MONTHS w/o symptoms
A. Severe recurrent temper outbursts manifested verbally (e.g., verbal
rages) and/or behaviorally (e.g., physical aggression towards people
or property) that are grossly out of proportion in intensity or duration
to the situation or provocation.
B. The temper outbursts are inconsistent with developmental level.
C. The temper outbursts occur, on average, 3-4 times per week.
D. The mood between outbursts is persistently irritable or angry most of
the day, nearly every day, and is observable by others (e.g., parents,
teachers, peers).

two core symptoms of depression

dysphoria and anhedonia

Why might rates of depression change with age?

Growing self awareness & cognitive capacity;
verbal ability to report symptoms;
increased performance and social pressures;
biological maturation at puberty interaction with developmental changes in adolescence

True or False- MDD is recurrent condition - 70% of children/people with depression will be depressed again within 5 yearsTrueWhat is one theory about why depression is recurrent?Kindling/Stress sensitizationwhat is Kindling/Stress sensitizationfirst depressive episodes are linked to a specific stressor; depression produces changes in biological processes and heighten future reactivity to stress; minor future stressors can result in depressionWhat are possible reasons that depression is much more common in girls than boys in adolescence and into adulthood?biological reasons, and also include gender socialization - more acceptable for girls to show sadness than boys. Girls experience discrimination, are at risk for victimizationWhy do people get hospitalized for depression?danger to themselves; threatening or attempting suicideWhat is the peak age for 1st suicide attempt?13-14Suicidethe act of intentionally taking one's own life; most children with depression think about it; 1/3 act on itCognitive deficits associated with depressive disorders• Executive functions (attention, speed, problem solving) • Cognitive biases (negative thinking, pessimistic, selective attention to negative things)(T/F) Adolescence with depression report having little to no family problems. They feel connected and involved in the family dynamicfalseWhat is co-rumination?extensively discussing and self-disclosing emotional problems with another personWhat are risk factors for depression?Genetic Developmental Psychosocial Stressors familyMost successful treatment for depressionINTEGRATED CBTwhat does integrated cbt focus onmodifying cognitive and behavioral characteristics and symptoms associated with depression(T/F) Tricyclic antidepressants not as effective for children as adults and may have serious side effectstrueWhy are there black box warnings on antidepressants?because the antidepressant may increase suicidal thoughts, behaviors, or ideationsTADS study - which treatment worked most quickly? Which was best in the long run?COMBINING MEDICATION AND CBTbasic symptoms for Bipolar DisordersMania and depressive episodesWhat is mania and what are the symptoms? How do symptoms present in children?Mania: a period of unusually and persistently elevated, expansive, or irritable mood. Symptoms include restlessness, agitation, sleeplessness, pressured speech, flight of ideas, racing thoughts, sexual disinhibition, surges of energy, expansive grandiose beliefs In a child- mania is endless energy, restlessness at bedtime, rapid cycling, Great conviction about correctness or importance of ideasWhat is hypomania?a mild form of mania, marked by elation and hyperactivity.What does "rapid cycling" refer to?Goes between mania and depression rapidly, within a one week period or less; also called a mixed episodeWhat is typical age of onset for bipolar disorder?About age 19; early onset & before age 10 is usually chronic and resistant to treatmentWhat are common triggers for mania?-Lack of sleep -Substance Use -Antidepressant medication -Emotional blow-up/break up -Pregnancy and childbirth -Grief(T//F) People with bipolar disorder are at low risk for substance abuse.False(T/F) Genetics strongest risk factor for bipolar disorderTrueIs there a cure for bipolar disorder?No, but in most cases treatment can stabilize mood and symptomsHow do you treat bipolar disorder?multimodal plan!What are issues with treating bipolar disorder?poor adherence to medication; medication is toxic and needs close monitoring; lithium cannot be given to children in chaotic home environments because hard to monitor; bad side effects of medicationsWhy did they create the Disruptive Mood Dysregulation Disorder diagnosis?group of kids being misdiagnosed as bipolar, but didn't grow up to have bipolar disorder - needed a diagnosis to better characterize themWhat are symptoms of DMDD?severe, recurrent temper outbursts and persistent irritable mood most of every dayFour types of child maltreatmentneglect, physical abuse, sexual abuse, emotional abuseWhat is the dilemma that abused or neglected children face?-The victim wants to stop the violence but also longs to belong to the family in which they are being abused -Affection and attention may coexist with violence and abuse -Intensity of violence tends to increase over time, but in some cases, physical violence may decrease or stopDescribe characteristics of physical abusephysically harming a child by hitting, beating, burning, shaking, kicking etc. Often the result of "over discipline" or severe physical punishmentDescribe characteristics of neglect.physical, educational, or emotional neglect of a child's needsDescribe characteristics of sexual abuse.Fondling a child's genitals, intercourse with the child, incest, rape, sodomy, exhibitionism, and commercial exploitation through prostitution or the production of pornographic materialsIs there a typical way children respond to sexual abuse?reactions and recovery vary depending on nature of assaultWhat is child exploitationForm of abuse where children are taken advantage of for the benefit of othersDescribe characteristics of psychological/emotional abuse.Repeated acts or omissions that may cause serious behavioral, cognitive, emotional, or mental disordersWhat is the most common type of Maltreatmentneglect - 74.8% of casesWhat is foster care?The temporary placement of children in the homes of adults who are not related to them.If foster care is meant to help children, why does being in foster care put children at risk?being removed from parent is a huge trauma in itself even if they were being maltreated, children in the system are vulnerableDescribe the concept of the invisible suitcase.the memories of maltreatment stay with a child for a long time and influence a child's future experiences and developmentWhy is it important to take into consideration child maltreatment when treating children for other disorders?to ensure proper treatmentTraumaactual or threatened death or injury, or threat to one's physical integrity - overwhelming event that occurs outside the range of usual human experienceFor PTSD, trauma can happen to the person...directly; can be witnessed by the person as it happens to someone else; can occur from learning about a traumatic event happening to a close family member or friend; and can occur through repeated exposure to the details of traumatic eventsKnow the 4 core features of PTSD and examples of symptomspersistent re-experiencing of the traumatic event; Persistent avoidance of stimuli associated with traumatic event; persistent symptoms of extreme arousal; negative alterations in cognitions and moodWhat are symptoms of the Dissociative Subtype of PTSD?depersonalization and derealizationKnow the difference between PTSD and Acute Stress DisorderPTSD experience symptoms for more than a month Acute Stress Disorder you experience symptoms for a monthWhy might PTSD be misdiagnosed as ADHD?derealization and hyper vigilance may be mid diagnosed as inattentionKnow the symptoms of Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement (DSE) Disorder and what specifically brings on symptoms.Reactive Attachment Disorder- •Consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers accompanied by persistent social/emotional disturbance; Not seeking or responding to comfort when distressed; Limited social responsiveness, positive affect •Pattern where child actively approaches and interacts with unfamiliar adults in some of the following ways: • Lack of reticence in approaching unfamiliar adults • Overly familiar verbal/physical behavior (not culturally sanctioned or age-appropriate) • Diminished checking back with adult caregiver when venturing away Willingness to go off with unfamiliar adult with minimal/no hesitation MALTREATMENT BRINGS THESE ONBe able to describe the two core deficits in Autism Spectrum Disorder (ASD)Deficits in social communication and restrictive, repetitive patterns of behaviors/ interestsGive 2 examples of deficits in social communicationlacking reciprocity, difficulty understanding social contextGive 2 examples of restricted interests and behaviorshighly restricted, fixated interest that are abnormal intensity and pervasive ; self - stimulatory behaviorsWhat are 3 developmental patterns found with ASD?1-Abnormalities become obvious in the first year of life or soon afterwards 2-Mild delays until close to age 2, and then either a gradual or sudden plateau 3-Regression (stopping meaningful use of words, orienting to name) during the second year of life (more rare)Know factors that contribute to the spectrum nature of ASDvarying degrees of intellectual ability, language, and behaviorList some examples of nonverbal communication.-eye contact and body language -lack of facial expressions/nonverbal communications -deficits in use of gesturesWhat is echolalia?Repeats other's words or phrasesWhat is pragmatic language?language in social contextsAt what age do symptoms of ASD usually become apparent?Age 2What genetic syndrome is a known risk factor for autism spectrum disorder?Fragile X syndromeDo vaccines cause autism?NOASD is much more common in boys, by how muchboys 3-4.5x more likely than girlsWhat traits are associated with better adult outcomes for kids with ASD?resilienceWhy are there so many documented treatments for ASD?Treatment must be tailored for each child and family, so that child can meet his/her full potentialWhat do Sensory Integration Therapies address?gradually introducing autistic children with sensory experiences and helping them deal with stressorsDo all kids with sensory integration problems have ASD?NoName one intervention approach that seems to be helpful in helping children with autism recover language and functional abilities?Applied Behavior Analysis (ABA)IQ scores have a mean of100 and a standard deviation of 15Normal Intelligence Range85-115 IQDo you inherit an IQ?No. Children inherit a genotype and that in addition to the environment results in phenotypical intelligence heritability of intelligence = about 50%IQ scores below 70 indicate...intellectual impairmentWhy did they change from using mental retardation to intellectual disability?stigmaIntellectual disability (IDOnset during developmental period (very early childhood) and characterized by deficits in both intellectual functions and adaptive functioning Severity levels (mild, moderate, severe, profound) determined by adaptive functioning, not IQ.Know the definition of adaptive functioning and be able to describe several activities of daily living.how effectively individuals cope with everyday life demands and how capable they are of living independently and abiding by community standards examples- laundry, cleaning, cooking, bathingChildren with ID have 3-7x more behavior problems, why?Due to limited communication skills, neurological deficitsWhat are some examples of Self-Injurious Behavior?head banging, eye gouging, scratchingKnow the difference between Organic and Cultural-familial ID• Organic: clear biological basis, associated with more severe ID • Cultural-familial ID: No clear organic basis, usually associated with mild ID -Environmental and situational factorsBe familiar with risk factors for IDpoverty, domestic violence, lack of access to prenatal care, child abuse or neglect, parental abandonment, parental drug/ alcohol useBe able to name 2 genetic disorders associated with IDPrader-Willi Syndrome , Angelman Syndromes Fragile X Syndrome Down SyndromeBe able to name 2 adverse biological conditions that are associated with IDmalnutrition, exposure to toxins, prenatal and perinatal stressorsHow do prenatal education and screening help prevent ID?help screen for genetic abnormalities, many of the debilitating forms of ID can be prevented if precautions are takenWhat is one of the most promising methods for enhancing the intellectual and social skills of young children with developmental disabilities?early interventionKnow the definition of a learning disability.learning problems that occur in absence of other conditions like ID or traumatic brain injury. Affects how individuals of at least normal intelligence take in, retain, or express information). "Learning Disability" has been replaced in the DSM-5 with Communication Disorders and Learning Disorders.What are the three types of Specific Learning Disorders (SLD)?reading (dyslexia) mathematics writingWhat is the core deficit for SLD with impairment in Reading?decoding- applying knowledge of letter- sound relationship in order to correctly pronounce written wordsSLD with Impairment in Written Expression is often associated with problems withHand - eye coordinationCommunication and Learning Disorders have a lot of overlap with each other. They are also associated with behavior problems likeconduct disorder, oppositional defiance disorder, and attentional deficit hyperactivity disorderWhy would kids with communication and learning disorders be at risk for behavior problems?it is frustrating to not be able to demonstrate the things you know because of deficits in bringing different information from different brain regions together to understand information