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106 Cards in this Set

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  • Back
What do most psychiatric problems of childhood and adolescence represent?
A crisis resulting from a strain on the child's coping ability as they grapple with a developmental task.
What is the major difference in childhood psychology compared to adult?
Children are developing; the same pathology at one age will not be pathologic at another age.
What do you have to distinguish between in assessing child psychology?
Whether an event is a STRAIN or a STRESS
What is an example of something that would commonly be a stressor?
Mother's death during childhood/infancy.
What determines the outcome of that stress and whether it becomes a traumatic experience?
Resiliency - don't always assume it's traumatic!
At what age can you not see OCD?
Before 4-5 yr old; the CNS simply isn't developed enough.
Do children seek help?
no; they're referred in by mothers in law.
What causes anxiety in children?
Forces that oppose their drive to do something.
What is the child's normal solution in response to opposition to their drive?
Developmental conflict - model what the parent's response is and take in the behavior others display.
What is Reactive/Developmental interference to the response?
The absence of modeling - for example due to a mother's death the caring is absent.
What is an example of a neurotic response?
The dog is afraid of the dog that barks because it reminds the child of his dad that barks.
What is neurotic response an example of?
Displacement and projection.
What is an example of a Psychotic solution?
A girl hallucinating and seeing a man telling her to kill herself because she was mad at her brother when he died and she thinks it's her fault.
What is an example of a psychophysiologic solution?
Asthma - ANS gets stirred up and can cause flare ups in psychological disorders.
What is a Characterologic solution?
Skillful manipulation of other people to pass off certain situations as being the other person's problem.
What are 4 questions to ask in determining the pathology of a child psychologic problem?
1. What is it
2. How long has it been going on
3. How many areas of life affected
4. Prior problems
How do children communicate?
-Acting up (spills over)
-Testing limits
-Experimenting
-Acting out (displacement)
What is the SOURCE of signs and symptoms of stress?
the ANS
What are 4 generic signs/symptoms of stress?
-Eating
-Sleeping
-Activity level
-Regression
What is regression?
Going back to infantile behaviors
What is the typical source of stress to infants? What do they fear?
Stranger anxiety
-Fear of being dropped, sudden stimulation
What is the Toddler's main fear?
What are their main symptoms of stress?
Fear: animals
Sx: temper tantrum, soil/wet, stutter
What is the Preschooler's fear? Main symptoms of stress?
Fear: Monsters, mutilation
Sx: intrusiveness, masturbation
What is the School aged child's fear? Main sx of stress?
Fear: Burglars and obsessions
Sx: truancy, lying, stealing, learning problems
What are the Adolescent's fears? Main sx of stress?
Fears: War and Death
Sx: identity crisis, sexually acting out, substance abuse, delinquency
What is the main intellectual disorder?
Mental retardation
What sex is it more common in? What is the prevalence in schoolage children?
More in males
3% of children
What is 25% of mental retardation due to?
Chromosomal abnormality
What is a very avoidable cause?
Alcohol
What are 2 pervasive developmental disorders?
-autism
-asperger's
What are symptoms of autism?
-Impaired eye contact/gestures
-Repetitive behaviors
How does asperger's disorder compare to autism?
Less pervasive, but still stereotyped/patterned behaviors. Very bright.
How are Mental retardation and Pervasive developmental disorders treated?
-Parental support
-Special education
What sex are learning disorders more common in? What is the txm?
Boys
Remedial work
What is a speech disfluency? What age is it most often seen?
Stuttering - 3-4 yr olds
What is the treatment for stuttering?
Ignore it
What behavioral disorder do we see in childhood and adolescence? in what sex?
Oppositional defiant disorder Boys more than girls.
What is the cause of it?
Environmental - over controlling parents.
What is the treatment for oppositional defiant disorder?
Parent training, psychotherapy, social skills training, and CBT.
What is the prevalence of ADD?
5% of children
What are symptoms of ADD?
Fidgety, restless, unable to sit still, etc.
Is ADD more prevalent in males?
no it's equal in males/females
When does ADD start?
Children are born with it and symptoms appear in early childhood.
What is the treatment for ADD?
Stimulants
What are some drugs for ADD?
-Ritalin
-Metadate
-Concerta
-Dexedrine
-Adderall, Norpramin, Strattera.
Do adults outgrow ADD?
No; they often need meds into adult life.
What do symptoms like frequent lying, stealing, truancy, firesetting, etc represent?
Conduct disorder.
What disorder is represented by constant worrying, unability to relax, aches/pains, self consciousness, and recurring nightmares?
General anxiety disorder
What is it when the person is unable to leave parents bc of worrying what might happen to them?
Separation anxiety disorder.
What age of children tend to have SAD? GAD?
Younger children get SAD
Older children get GAD
What are 2 factors associated with SAD/GAD?
-Heredity
-Stress
What is an important treatment for GAD/SAD?
Cognitive behavioral therapy
What is the purpose of CBT for GAD/SAD?
Production of a relaxed state to give a sense of being in control.
What is the prevalence of OCD in children and teenagers?
1%
What is a possible cause of OCD in children?
Strep infection disrupting the basal ganglia.
What is the treatment for OCD?
SSRI inhibitors
What are 4 SSRIs?
-Anafranil (clomipramine)
-Prozac (fluoxetine)
-Zoloft (sertraline)
-Luvox (fluvoxamine)
What is PANDAs?
A result of strep that can cause overnite OCD or ADD due to an allergic reaction to the strep toxin.
Can strep induced OCD be treated?
Yes with immediate treatment with antibiotics.
At what age does Panic disorder become more likely?
Teenagers
What is a factor related to the development of panic disorder in teens?
Hereditary
What part of the brain controls anxiety?
Locus ceruleus
What is a panic attack?
A reaction of extreme anxiety to a non-frightening situation due to overactivity of the locus ceruleus.
What are some meds for panic attacks?
-Tofranil
-Xanax
-Paxil
What disorder are symptoms like nightmares/flashbacks, situation avoidance, loss of memory of trauma, and constant fear, anxiety and depression characteristic of?
PTSD
Who can have PTSD?
People who have had a very bad experience which leads to intense and continual feelings of threat and helplessness.
What treatments are effective for PTSD?
The same that work for Depressive disorders and GAD.
What can untreated PTSD lead to?
-Depression
-Substance abuse
-Aggressive behavior
-Personality changes
What are the screening symptoms of depression?
SIGECAPS
Sleep, interest, guilt, energy, concentration, appetite, psychomotor retardation
suicidality
What are the key hallmark features of depression?
-Hopelessness
-Feeling worthless
-Life is not worth living
Who can have depression? What age is it more likely in?
Everyone - more likely in teenagers.
What is the prevalence of depression in teens?
Up to 5%
What are some factors that cause depression?
-Inheritance
-Stress
-Serotonin/norepinephrine dysfunction
What 2 treatments go HAND IN HAND for depression?
-Medication
-COGNITIVE BEHAVIORAL THERAPY
What are the 3 main categories of antidepressent meds?
-Tricyclics
-SSRIs
-MAOIs
What age is the common onset of bipolar in children?
4 YEARS OLD
What are symptoms of bipolar in children?
High moods and irritability
What is a major risk factor for getting bipolar as a child?
Family history
What is the suicide rate in patients with bipolar?
13%
What are the symptoms of Psychosis? What IS psychosis?
-Hallucinations
-Delusions
-Disorganized thoughts
It is a SYMPTOM not a diagnosis.
What are hallucinations?
Hearing or seeing things that are not there
What are delusions?
Beliefs that are impossible or unrealistic.
What are the 2 elimination disorders?
-Enuresis
-Encopresis
What is enuresis?
passage of urine
What is encopresis?
Passage of feces
What makes these disorders?
Doing it into inappropriate places.
Who can have elimination disorders?
-Both genders
-Moreso in boys
What is the age of diagnosis for
-Encopresis
-Enuresis
Encopresis: age 4
Enuresis: age 5
What are 2 types of treatment?
-Meds (desipramine, DDAVP)
-Behavioral therapy
-Retraining
What is Reactive Attachment Disorder?
Inadequete connection with parents early in life due to problem with child, or inaccessible parents.
Who can have reactive attachment disorder?
Children up to age 5
What are symptoms of reactive attachment disorder?
-Inhibited
-Withdrawn
-Hypervigilant
-Excessive/inappropriate sociability with strangers
-Limited eye contact
What are causes of Reactive Attachment disorder?
-Maltreatment
-Deprivation
-Repeated changes in primary caregivers
-Impaired parenting
What are the 2 eating disorders?
-Anorexia
-Bulimia
What are the symptoms of Tourettes?
-Tics
-Making sounds
-Saying words
without thinking or be able to control it
What are Tics?
Quick body movements - usually facial
When does Tourette's usually start? In what sex?
7-10 yrs old
males
What other syndromes does Tourettes often accompany?
-ADHD
-OCD
What is the problem with treating tourettes when in conjunction with ADHD?
Treating ADHD with a stimulant can exacerbate the tics.
What is another tic disease?
Tic disorder
How is Tic disorder different from Tourettes?
Tic disorder is transient.
What is the main thing that causes psychopathology in INFANTS and EARLY CHILDREN with medical illness? (age 0-6)
Separation from their parents.
What are the main things seen in school age children with medical illness?
-Regression
-Opposition
-Irrational explanation of illness
What are the things that are painful to adolescents with medical illness?
Loss of autonomy
Loss of privacy
Why do children and adolescents with medical illness partake in NONCOMPLIANCE?
-For attention
-In denial of the disorder
-Frustration
-For control
What are 4 psychopathologies we see in noncompliance?
-Depression
-Suicidal intent
-ADHD
-Eating disorders