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